Orthopadie (Heidelberg, Germany)最新文献

{"title":"[Basic principles of the diagnostics and treatment of malignant bone tumors in old age].","authors":"M Weber, M Dietrich, A Hillmann","doi":"10.1007/s00132-025-04667-y","DOIUrl":"10.1007/s00132-025-04667-y","url":null,"abstract":"<p><p>Abnormal X‑ray images and magnetic resonance imaging (MRI) findings in older patients are common and require prompt evaluation to distinguish malignant diseases from harmless incidental findings. A thorough medical history, including pre-existing diseases and previous imaging, is essential. Conventional X‑ray images provide initial indications of lesion dignity using the Lodwick classification. The diagnostics are supplemented by contrast-enhanced MRI and, if necessary, additional CT scans. The most common malignant bone tumors in old age are metastases, followed by lymphomas, plasmacytomas and, less frequently, primary bone tumors. The fracture risk of the extremities can be assessed using the Mirels score and using the spinal instability neoplastic score (SINS) regarding the spine. In cases of unclear findings, a biopsy is necessary for further evaluation and should be performed at a specialized tumor center. The treatment depends on the tumor entity and staging and includes surgical procedures, radiotherapy and chemotherapy. The most important indicator of a pathological fracture is an inadequate trauma mechanism.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"825-833"},"PeriodicalIF":0.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546491","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":"Evolution of journal rankings in orthopedics and sports medicine (2000-2024) : A SCImago-based bibliometric analysis.","authors":"Raju Vaishya, Sudhir Shekhawat, Abhishek Vaish, Filippo Migliorini","doi":"10.1007/s00132-025-04683-y","DOIUrl":"10.1007/s00132-025-04683-y","url":null,"abstract":"<p><strong>Background: </strong>Academic journals are fundamental to scientific communication, facilitating the dissemination of research findings that spur innovation across clinical and scientific fields. Journal rankings provide valuable insights into the influence and credibility of scholarly outlets.</p><p><strong>Objective: </strong>This study analyzes the evolution of journal rankings in orthopedics and sports medicine (OSM) from 2000 to 2024, using SCImago Journal Rank (SJR) data to uncover trends in journal prestige and regional representation.</p><p><strong>Material and methods: </strong>A comprehensive bibliometric analysis was performed using SCImago data, comparing journal rankings over 25 years. Key metrics included SJR values and citation counts across orthopedic and sports medicine journals. Statistical significance was assessed using an Independent samples Kruskal-Wallis test.</p><p><strong>Results: </strong>The analysis revealed a significant average increase of 36.6% in the SJR of leading OSM journals over the study period. Notably, only 12% of the top ranking journals originated from non-western regions, indicating a geographic bias. Sports medicine-focused journals showed a higher average SJR of 1.75, compared to 1.40 for orthopedic journals (p < 0.05). A global median of 28.7% of female authors was found, reflecting ongoing gender disparities in authorship within OSM.</p><p><strong>Conclusion: </strong>The findings highlight marked shifts in journal prestige in the OSM field over 25 years, alongside persistent regional biases that may disadvantage high-quality research from non-western regions. The study underlines the importance of awareness regarding these dynamics for stakeholders in making decisions related to publication strategies and funding. Future research should further explore the impact of emerging subfields and the role of open-access publishing in shaping journal rankings in OSM.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"795-803"},"PeriodicalIF":0.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12457506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762579","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":"[Surgical treatment strategies for interprosthetic femoral fractures].","authors":"Christian Ries, Holger Bäthis, Stephan Kirschner, Patrick Gerhardt, Eva Goedecke, Tim Rolvien, Frank Timo Beil","doi":"10.1007/s00132-025-04686-9","DOIUrl":"10.1007/s00132-025-04686-9","url":null,"abstract":"<p><p>Due to demographic changes, a further increase in the number of arthroplasty procedures can be anticipated. As has been observed in recent years, a further increase in periprosthetic fractures is to be expected. An interprosthetic femoral fracture is a serious complication in cases of ipsilateral hip and knee endoprostheses. Although the incidence of interprosthetic fractures is low, fracture management can be highly demanding. In addition to the remaining implant stability, bone quality and comorbidities must also be taken into account in the decision-making process of fracture treatment. The surgeon's expertise in various osteosynthesis procedures and revision arthroplasty techniques appears to be indispensable. Taking into account various patient-specific factors, the following article provides an overview of the surgical treatment options for interprosthetic fractures.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"815-824"},"PeriodicalIF":0.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12457466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735930","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":"[\"Bending\" instead of explanting - Surgical treatment of thigh pain in diaphyseal anchored hip arthroplasty].","authors":"Birte Schoon, Stephan Brand, Max Ettinger","doi":"10.1007/s00132-025-04679-8","DOIUrl":"10.1007/s00132-025-04679-8","url":null,"abstract":"","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"804-805"},"PeriodicalIF":0.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593107","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":"[When nothing helps anymore outside: interdisciplinary multimodal pain therapy].","authors":"Hans-Raimund Casser","doi":"10.1007/s00132-025-04722-8","DOIUrl":"https://doi.org/10.1007/s00132-025-04722-8","url":null,"abstract":"<p><p>Nearly 10% of the German population suffers from debilitating chronic pain with psychosocial factors and significant consequences for their quality of life. These individuals require early interdisciplinary assessment and treatment when there are corresponding indications. Neurophysiologically detectable sensitization processes explain the clinical experiences and studies that timely referral of patients with unclear, persistent symptoms to an early interdisciplinary multimodal assessment (IMA) and, if necessary, to interdisciplinary multimodal therapy (IMST) can prevent the development or progression of pain chronification. The chronification of pain is not a problem of time but of the increase in the somatic and psychosocial factors involved. Therefore, recognizing and clarifying these chronification factors in a timely manner is more crucial than adhering to temporal definitions for chronic pain, which often leads to late interdisciplinary assessment and treatment.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115173","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":"[Robotic-assisted total knee arthroplasty in a case featuring a large tibial defect zone after resection of a giant cell tumor].","authors":"Hendrik Pott, Max Ettinger, Peter Savov","doi":"10.1007/s00132-025-04723-7","DOIUrl":"https://doi.org/10.1007/s00132-025-04723-7","url":null,"abstract":"","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082640","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":"[Good recovery of leisure activities and sport after primary implantation of cementless knee arthroplasty after 5 years : A retrospective study].","authors":"Manish Theiner, Julian Mehl, Norbert Freund","doi":"10.1007/s00132-025-04717-5","DOIUrl":"https://doi.org/10.1007/s00132-025-04717-5","url":null,"abstract":"<p><strong>Introduction: </strong>The ability to resume sporting activities after total knee arthroplasty (TKA) is a key concern for many patients. While cementless implantation techniques are gaining relevance, long-term data on their impact on physical activity are limited. This study aimed to evaluate individual leisure activities and functional outcomes following cementless TKA over a five-year period.</p><p><strong>Materials and methods: </strong>A retrospective analysis of prospectively collected data was conducted on 42 patients (age 35-80 years) who underwent primary cementless TKA (Attune, DePuy) between April 2017 and April 2018. For each patient, the three most relevant sports were identified using the Knee Society Score (KSS) and compared pre- and postoperatively (1 and 5 years). Additionally, activity-related subscales of the KSS and KOOS (Knee injury and Osteoarthritis Outcome Score) were evaluated. Statistical analyses included Wilcoxon, Friedman, and Spearman correlation tests.</p><p><strong>Results: </strong>Patient-reported outcome measures (PROMs) showed significant improvements in sports-related performance (p 0.05) at 1 and 5 years postoperatively. Pain during favorite sports decreased from \"severe\" to \"mild.\" KSS activity subgroups improved from \"severe-moderate\" to \"moderate-mild,\" and KOOS subgroups from \"extreme-severe\" to \"moderate.\" KSS and KOOS scores showed strong correlation. No aseptic loosening or periprosthetic infections were observed.ConclusionCementless TKA allows for a sustained return to sporting activity with significant symptom reduction over a five-year period, without increased risk of implant loosening. These findings support realistic patient counseling regarding postoperative expectations.</p><p><strong>Discussion: </strong>This study demonstrates that patients benefit long term from a significant improvement in athletic ability after cementless TKA. Recent studies suggest that cementless techniques are not only equivalent to cemented approaches but may even be superior in certain aspects. The low loosening rate further supports the use of cementless TKA in physically active patients.</p><p><strong>Conclusion: </strong>Cementless TKA allows for a sustained return to athletic activities with a significant reduction in discomfort. No loosening occurred over the 5‑year period. The results of this study can aid in patient counseling to set realistic expectations regarding postoperative athletic performance.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076872","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":"[Proximal femoral resection with endoprosthetic reconstruction for malignant bone tumors : Surgical technique via the anterior hip approach].","authors":"Dietmar Dammerer, Melanie Ardelt, Gianpaolo Leone, Martin Thaler, David Putzer, Hannes Stofferin, Johannes Neugebauer","doi":"10.1007/s00132-025-04720-w","DOIUrl":"https://doi.org/10.1007/s00132-025-04720-w","url":null,"abstract":"<p><strong>Objective of the surgery: </strong>Proximal femur resection with EPR aims to achieve oncological tumor removal while preserving surrounding soft tissue and neurovascular structures, ensuring functional restoration of hip joint stability.</p><p><strong>Indications: </strong>Malignant bone tumors of the proximal femur, pathological fractures due to tumor involvement, recurrent tumors after previous resection, extensive destruction of the proximal femur due to metastases.</p><p><strong>Contraindications: </strong>Extensive soft tissue infiltration with inadequate reconstruction potential, generalized metastases without curative treatment options, severe infections in the surgical area, critical general condition prohibiting major surgery.</p><p><strong>Surgical technique: </strong>A longitudinal skin incision is made, incorporating the biopsy scar. After sequential soft tissue preparation and preservation of neurovascular structures, femoral osteotomy is performed according to preoperative planning. The hip capsule is preserved and reconstructed. The tumor resection is followed by endoprosthetic reconstruction with a modular tumor prosthesis and subsequent soft tissue reconstruction to ensure optimal stability.</p><p><strong>Follow-up: </strong>Postoperative management includes early functional mobilization with partial weight-bearing. Adjuvant therapy is planned individually based on tumor staging. Regular radiological follow-up is essential for long-term success.</p><p><strong>Evidence: </strong>EPR following tumor resection is an established procedure with good functional outcomes and oncological safety. Long-term studies demonstrate satisfactory functional results and acceptable complication rates.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070699","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":"Erratum zu: Aus der Sektion Begutachtung der Deutschen Gesellschaft für Orthopädie und Unfallchirurgie in Zusammenarbeit mit der Deutschen Gesellschaft für Neurowissenschaftliche Begutachtung (DGNB).","authors":"Marcus Schiltenwolf, Klaus Dresing, Johannes Eckert, Torsten Eyfferth, Peter Wolfgang Gaidzik, Martin Grotz, Sven Lundin, Klaus-Dieter Thomann, Bernhard Widder, Johannes Zeichen","doi":"10.1007/s00132-025-04724-6","DOIUrl":"https://doi.org/10.1007/s00132-025-04724-6","url":null,"abstract":"","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071128","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":"Improved accuracy of functional alignment restoration with robotic-assisted total knee arthroplasty : A quasi-randomized controlled trial.","authors":"Filippo Migliorini, Luise Schäfer, Jens Schneider, Andrea Maria Nobili, Daniel Kämmer, Andreas Bell","doi":"10.1007/s00132-025-04711-x","DOIUrl":"https://doi.org/10.1007/s00132-025-04711-x","url":null,"abstract":"<p><strong>Background and objectives: </strong>This quasi-randomized controlled trial compared robotic-assisted and conventional total knee arthroplasty (TKA) in restoring patient-specific coronal alignment according to a functional alignment philosophy. Outcomes included preservation of the anatomical hip-knee-ankle angle (aHKA), mechanical axis deviation (MAD), and component positioning. Subgroup analyses assessed consistency in valgus and varus morphotypes.</p><p><strong>Material and methods: </strong>A single-blind parallel group quasi-RCT was conducted at the Department of Orthopedic Surgery, Eifelklinik St. Brigida, Germany (2021-2025). Patients underwent TKA following identical perioperative pathways. All procedures used a medial parapatellar approach and Smith & Nephew Legion Genesis II implants.</p><p><strong>Results: </strong>A total of 692 patients were enrolled (346 robotic, 346 freehand). Baseline characteristics were comparable. Postoperative HKA was similar between groups, but the robotic group achieved a significantly smaller aHKA delta (2.58° vs 4.49°, p = 0.002). Robotic-assisted TKA preserved joint line alignment more consistently in valgus (2.63° vs 5.72°, p = 0.03) and varus knees (2.56° vs 4.22°, p = 0.004). The MAD control was improved, while differences n the mechanical lateral distal femoral angle (mLDFA) and mechanical medial proximal tibial angle (mMPTA) were not significant.</p><p><strong>Conclusion: </strong>Robotic-assisted TKA enhanced accuracy in reproducing native joint line orientation, offering more consistent preservation of joint line obliquity in both valgus and varus morphotypes, thus supporting its role in personalized alignment strategies.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066713","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}