Orthopadie (Heidelberg, Germany)最新文献

{"title":"Total hip replacement in adolescents.","authors":"Salome Hagelstein, Dominic Simon, Gautier Beckers, Boris Michael Holzapfel, Lennart Marvin Schröder","doi":"10.1007/s00132-026-04813-0","DOIUrl":"10.1007/s00132-026-04813-0","url":null,"abstract":"<p><p>Total hip arthroplasty in adolescents is rare but increasingly performed due to advances in implant technology. The indications differ from adults and are primarily osteonecrosis, secondary osteoarthritis or residual deformities from pediatric hip diseases, such as developmental dysplasia of the hip or slipped capital femoral epiphysis. Anatomical challenges, smaller implant sizes and prior surgery demand careful preoperative planning with advanced imaging. Modern uncemented implants and enhanced wear-resistant articulations, such as ceramic-on-ceramic (CoC) or ceramic-on-highly cross-linked polyethylene (HXLPE) have shown promising durability. While complication rates are comparable to adults, the nature of complications differs, with higher revision rates due to activity levels and anatomical complexity. Standard outcome measurements often show ceiling effects and may not reflect adolescent-specific demands. Long-term data and age-adapted assessment tools are needed to optimize outcomes in this special patient group.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"387-393"},"PeriodicalIF":0.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Das Hüftgelenk im Kindes- und Jugendalter – Teil 2.","authors":"Chakravarthy Ugandhar Dussa, Christian Ziegler","doi":"10.1007/s00132-026-04827-8","DOIUrl":"https://doi.org/10.1007/s00132-026-04827-8","url":null,"abstract":"","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":"55 5","pages":"341-343"},"PeriodicalIF":0.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[3D-planning and guided hip and pelvic surgery].","authors":"Selina Streich, Domenic Grisch, Thomas Dreher","doi":"10.1007/s00132-026-04823-y","DOIUrl":"10.1007/s00132-026-04823-y","url":null,"abstract":"<p><strong>Background: </strong>Different conditions among all age groups, from toddlers to adults, require surgical procedures at the hip and pelvis. Well-established techniques are complex in planning and execution and currently rely mostly on two-dimensional pre- and intraoperative imaging, resulting in potential imprecision and outcome variability. Inadequate correction carries a considerable risk for recurring symptoms requiring revision surgery.</p><p><strong>Case examples: </strong>In this case series, we present three patient examples using three-dimensional imaging and their application to explore the chances these modalities offer for pre-operative planning and intraoperative referencing and navigation in routine and complex interventions. All three cases showed precise corrections and satisfactory postoperative follow-ups.</p><p><strong>Conclusions: </strong>To minimize inaccuracies and enable broader use in clinical practice, we therefore recommend further research to develop standardized protocols for the use of these supportive modalities with the aim of reducing the risk of recurrence or early coxarthrosis and thus improving long-term health-related quality of life in the spirit of patient-specific medicine. Due to the lack of specific data to date, the increase in precision and its long-term impact still need to be demonstrated for widespread use in routine clinical practice.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"379-386"},"PeriodicalIF":0.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Special flatfoot pathologies of the hindfoot and midfoot].","authors":"N Harrasser, A Toepfer","doi":"10.1007/s00132-026-04811-2","DOIUrl":"10.1007/s00132-026-04811-2","url":null,"abstract":"<p><p>Flatfoot pathologies in adolescents and adults are among the most common deformities of the hindfoot and midfoot. The etiology is multifactorial and often difficult to precisely classify in individual cases, which is why orthotic insoles and foot exercises often remain the only conservative therapeutic measure; however, there are typical clinical presentations that, while not frequently encountered in everyday practice, can lead to misinterpretation and the missed opportunity for important therapeutic interventions. Therefore, this article discusses the Müller-Weiss syndrome, tarsal coalition and instability of the first tarsometatarsal joint. All these conditions share the clinically prominent flatfoot (pes planus) but conservative and surgical treatment approaches differ considerably.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"407-417"},"PeriodicalIF":0.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The literary patient file-How Galen of Pergamum documented his diseases : On the discussion about the introduction of the electronic patient record].","authors":"Werner Golder","doi":"10.1007/s00132-025-04698-5","DOIUrl":"10.1007/s00132-025-04698-5","url":null,"abstract":"<p><p>Galen of Pergamon described his own illnesses in several of his works. The course was always favourable, although sometimes after invasive or time-consuming treatment. The author derived a number of measures for recurrence prophylaxis from the evolution of the illnesses. The reports are to be regarded as credible due to their attention to detail and self-critical commentary. With the documentation of his diseases, Galen created the first literary patient file.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"394-397"},"PeriodicalIF":0.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Slipped capital femoral epiphysis: pathomechanism, clinical presentation, diagnosis, natural history and treatment. A review of the literature.","authors":"Chakravarthy U Dussa","doi":"10.1007/s00132-026-04815-y","DOIUrl":"10.1007/s00132-026-04815-y","url":null,"abstract":"<p><p>Slipped capital femoral epiphysis (SCFE) occurs in preadolescent and adolescent children. The exact pathomechanism of the slip is not known. Several risk factors have been identified including hormonal derangement. Of the classification systems, stability and severity classification systems are most relevant to everyday practice. There is a strong agreement regarding the management of a mild slip. Controversies exist in the treatment of moderate and severe slips and also regarding the prophylactic pinning of the opposite side. Discrepancies exist amongst countries and surgeons as to the number of screws to be used for pinning. Increasing evidence of femoroacetabular impingement as a cause of osteoarthritis of the hip may change the treatment of moderate and severe slips in the future. The modified Dunn procedure may become a standard procedure in the future to treat moderate and severe slips; however, experience and accurate knowledge of surgical anatomy is required for good outcomes following this procedure.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"351-360"},"PeriodicalIF":0.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstractband KKOU 2026.","authors":"","doi":"10.1007/s00132-026-04825-w","DOIUrl":"10.1007/s00132-026-04825-w","url":null,"abstract":"","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"1-39"},"PeriodicalIF":0.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[A smart way back to work-The impact of digital rehabilitation on return-to-work outcomes after hand injuries].","authors":"Simon Bauknecht, Daniel Vergote, Martin Mentzel, Diego Chiquiza, Michael Lebelt, Richard-Tobias Moeller","doi":"10.1007/s00132-026-04814-z","DOIUrl":"10.1007/s00132-026-04814-z","url":null,"abstract":"<p><strong>Background: </strong>Restoring the ability to work after hand injuries is a central goal of rehabilitation. Digital therapy applications are increasingly finding their way into everyday clinical practice. However, data on the influence of such technologies on parameters relevant to everyday life, such as the duration of incapacity to work, is still lacking. In particular, it is unclear whether app-supported hand therapy can accelerate the return to work.</p><p><strong>Objective: </strong>The aim of the study was to investigate the effect of a hand therapy app in addition to standard care on the duration of incapacity to work compared to standard care alone.</p><p><strong>Material and methods: </strong>In a prospective, controlled study, 105 patients with surgically treated hand injuries were included. The control group received standardized follow-up treatment with hand therapy; the intervention group additionally completed an app-based training program over 90 days with an individualized, AI-supported exercise plan, gamification elements and visual progress monitoring. The primary endpoint was the number of sick days until return to work.</p><p><strong>Results: </strong>Patients in the intervention group had significantly fewer sick days than patients in the control group. With regard to the indication, patients with metacarpal fractures returned to work significantly earlier in the intervention group than in the control group. In addition, there was a significant effect of the hand therapy app on the duration of incapacity to work in patients with impairment of the non-dominant hand and in patients who do not carry out manual occupations.</p><p><strong>Conclusion: </strong>The results indicate that app-supported hand rehabilitation can shorten the duration of incapacity for work. For metacarpal fractures in particular, the digital therapy approach offers a promising addition to standard care. Further studies with larger case numbers are required to verify the effects for other indications.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"398-406"},"PeriodicalIF":0.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13144252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[EndoCert and EPRD-two pillars of quality assurance in arthroplasty].","authors":"Klaus-Peter Günther, Wolfram Mittelmeier, Holger Haas, Bernd Kladny","doi":"10.1007/s00132-026-04835-8","DOIUrl":"https://doi.org/10.1007/s00132-026-04835-8","url":null,"abstract":"<p><strong>Background: </strong>More than 10 years ago, the German Society for Orthopaedics and Orthopaedic Surgery (DGOOC) implemented the German Arthroplasty Registry (EPRD), as well as the EndoCert certification initiative to maintain highest possible quality standards for patients undergoing joint replacement procedures.</p><p><strong>Cooperation: </strong>In addition to the individual responsibilities assigned to each organization, their collaboration also generates further synergies. For hospitals participating in both programs, a key advantage lies in the combination of the high EndoCert standards (mainly created for perioperative and early postoperative treatment) with the long-term outcome monitoring provided by the EPRD (continuous feedback on implant survival).</p><p><strong>Conclusion: </strong>The integration of various quality assurance items ensures the highest possible level of safety for patients. Moreover, the structures underlying EPRD and EndoCert could also be used to support the further development of German hospital reform activities in the field of arthroplasty care.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Self-driving, fully motorized C-arm in spinal surgery: a comparative study].","authors":"Benno Bullert, Luca Rübel, Jochen Franke, Paul A Grützner, Sven Y Vetter, Felix Zimmermann","doi":"10.1007/s00132-026-04834-9","DOIUrl":"https://doi.org/10.1007/s00132-026-04834-9","url":null,"abstract":"<p><strong>Background: </strong>Intraoperative imaging using mobile C‑arms is well established in spine surgery. Traditionally, the C‑arm operation is performed by \"non-sterile\" OR staff. The full motorization of mobile C‑arms enables direct control from the sterile field and automated movement paths, potentially improving efficiency and imaging quality.</p><p><strong>Objectives: </strong>This prospective single-center study compared the use of a motorized mobile C‑arm (mC-arm) with a non-motorized standard C‑arm (sC-arm) in terms of intraoperative time, motion, and radiation parameters during spinal procedures.</p><p><strong>Materials and methods: </strong>A total of 41 minimally invasive spine surgeries with either ventral or dorsal spondylodesis were included. C‑arm movements were recorded using the system's log files (mC-arm) or IMU sensors (sC-arm). Additionally, radiation exposure and time-related parameters were collected.</p><p><strong>Results and discussion: </strong>In dorsal spondylodesis, there was a trend towards a reduction in the number of 2D images (-17.8%; p = 0.284) with improved collimation (+38.6%; p = 0.077) and a reduction in the dose area product (DAP) (-27.0% p = 0.483) when using the mC-arm, but without significance. In ventral spondylodesis, the use of the mC-arm showed a significant reduction in DAP (-53.0%; p = 0.040), a significant increase in the collimation rate (86.1% vs. 34.7%; p < 0.001), and a tendency towards shorter operating times (-22.0%; p = 0.197).</p><p><strong>Conclusion: </strong>The motorization of a mobile C‑arm combined with control from the sterile field can optimize intraoperative imaging and reduce radiation exposure. These findings suggest a substantial potential for workflow improvement that should be further evaluated in future studies.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}