Orthopadie (Heidelberg, Germany)最新文献_第2页

[Nerve compression syndromes of the median and radial nerves at the elbow].

Orthopadie (Heidelberg, Germany) Pub Date : 2025-04-01 Epub Date: 2025-03-07 DOI: 10.1007/s00132-025-04627-6

Adrian Cavalcanti Kußmaul, Wieland Hermann, Julie Boever, Ali Ayache, Frank Unglaub

引用次数: 0

[The importance of a verbal information session before surgical procedures]. [手术前口头告知的重要性]。

Orthopadie (Heidelberg, Germany) Pub Date : 2025-04-01 Epub Date: 2025-03-05 DOI: 10.1007/s00132-025-04637-4

Martin Schwarze, P W Gaidzik, A Sander, A-K Kanti, M Schiltenwolf

引用次数: 0

[Perioperative antibiotic prophylaxis in obesity].

Orthopadie (Heidelberg, Germany) Pub Date : 2025-04-01 Epub Date: 2025-02-19 DOI: 10.1007/s00132-025-04611-0

Christoph Schnurr

{"title":"[Perioperative antibiotic prophylaxis in obesity].","authors":"Christoph Schnurr","doi":"10.1007/s00132-025-04611-0","DOIUrl":"10.1007/s00132-025-04611-0","url":null,"abstract":"Background: In terms of perioperative infections, arthroplasty for obese patients represents a high-risk procedure. Correct antibiotic prophylaxis is a central pillar of infection prophylaxis. Studies showed increased infection rates if an antibiotic other than cefazolin was administered for prophylaxis. In patients with anamnestic penicillin allergy, an existing allergy is extremely rare, and the presence of cross-allergies to cephalosporins is similarly rare. Consequently, every effort should be made to administer a first- or second generation cephalosporin such as cefazolin.Dosage: Whether the dosage of antibiotic prophylaxis should be adjusted to the body weight remains unclear due to the limited data available: case series showed increased infection rates when cefazolin was underdosed and recommended increasing the dose to 3 g if the body weight exceeds 120 kg. However, no studies with a higher level of evidence exist. Published studies on the effective antibiotic levels in the tissue remain contradictory with regard to possible weight-dependent dose adjustments. Similarly, there is insufficient data on whether local intraoperative antibiotic prophylaxis may be useful in obese patients. By contrast, there is no evidence for a positive benefit of double prophylaxis with two different antibiotics or prolonged postoperative antibiotic prophylaxis in obesity.Conclusion: In summary, the data on antibiotic prophylaxis is generally insufficient, especially when focussing on possible dose adjustments in obesity. The well-timed administration of a cephalosporin such as cefazolin represents the golden standard in orthopedics and trauma surgery. A possible dose adjustment to 3 g for a body weight over 120 kg appears reasonable considering the low costs and the broad therapeutic window and is therefore recommended in the current AWMF S3 guideline.","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"253-260"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143461043","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}

引用次数: 0

[Influence of obesity on midterm outcome after primary hip and knee arthroplasty in Germany : Analysis from the EPRD].

Orthopadie (Heidelberg, Germany) Pub Date : 2025-04-01 Epub Date: 2025-01-28 DOI: 10.1007/s00132-025-04614-x

Jörg Lützner, Oliver Melsheimer, Alexander Grimberg, Carsten Perka, Klaus-Peter Günther, Cornelia Lützner, Arnd Steinbrück

{"title":"[Influence of obesity on midterm outcome after primary hip and knee arthroplasty in Germany : Analysis from the EPRD].","authors":"Jörg Lützner, Oliver Melsheimer, Alexander Grimberg, Carsten Perka, Klaus-Peter Günther, Cornelia Lützner, Arnd Steinbrück","doi":"10.1007/s00132-025-04614-x","DOIUrl":"10.1007/s00132-025-04614-x","url":null,"abstract":"Objectives: To determine the influence of obesity on revision rates and mortality after primary elective hip and knee arthroplasty in Germany.Materials and methods: In the German Arthroplasty Registry (EPRD) there were 403,073 elective total hip arthroplasties (THA), 320,913 bicondylar total knee arthroplasties (TKA) and 48,480 unicondylar knee arthroplasties (UKA) with valid BMI available for analysis. Cumulative revision rates and 1‑year mortality was calculated for BMI groups.Results: There were increased revision rates with increasing BMI, most distinctive for septic revisions in THA during the first year after surgery (non-obese 0.7%, obesity grade 1 1.3%, grade 2 2.1%, grade 3 4.2%). In TKA and UKA this increase was generally less pronounced. Age- and gender-standardized mortality was lower than expected in most groups, but also increasing with increasing BMI.Conclusion: The risk for revisions in obese patients is more distinctive in hip arthroplasty than in knee arthroplasty and is especially high in morbidly obese patients (BMI ≥ 40 kg/m2). Nonetheless, this risk may be acceptable for affected patients. Therefore, the possible benefits and risks of an arthroplasty should be weighed against each other and individually discussed with the patient.","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"244-252"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061715","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}

引用次数: 0

[Treatment of rotator cuff lesions using autologous conditioned plasma-a systematic review].

Orthopadie (Heidelberg, Germany) Pub Date : 2025-04-01 Epub Date: 2025-03-08 DOI: 10.1007/s00132-025-04632-9

Fabian Michalczik, Klemens Trieb

{"title":"[Treatment of rotator cuff lesions using autologous conditioned plasma-a systematic review].","authors":"Fabian Michalczik, Klemens Trieb","doi":"10.1007/s00132-025-04632-9","DOIUrl":"10.1007/s00132-025-04632-9","url":null,"abstract":"Background: Tendinopathies and rotator cuff tears account for significant medical costs in Germany and are driven by degenerative collagen changes. Despite multiple treatment options, no standard exists. This study examines PRP's growing use for pain relief and tissue healing in chronic tendinopathies.Objective: Effect of subacromial PRP-injections on VAS pain in patients with chronic tendinopathies and partial ruptures of the rotator cuff.Methods: A systematic review was conducted using PubMed, Livivo, Google Scholar, and Cochrane Library. Only randomized controlled trials published up to September 2024 were included; they were evaluated per PRISMA guidelines (2020) and the Cochrane Risk of Bias Tool.Result: Seven RCTs (n = 612 patients) examined PRP injections for rotator cuff pathologies, comparing them to controls receiving saline (n = 1), physiotherapy (n = 2), hyaluronic acid/combo injections (n = 1), cortisone (n = 2), or prolotherapy/corticosteroid/lidocaine (n = 1). The PRP group showed a significant VAS pain reduction in the 3‑month follow-up compared to the baseline measurement. The intergroup comparison revealed heterogeneous patterns of significance.Conclusion: This study provides moderate evidence that PRP may be preferred over other interventions, but may be effective as an additional treatment option. However, further high-quality single intervention placebo-control studies with a larger number of participants are needed to validate this result.","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"294-301"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143582413","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}

引用次数: 0

[Sonography of fractures in childhood-Practice-oriented case examples of frequent entities].

Orthopadie (Heidelberg, Germany) Pub Date : 2025-03-31 DOI: 10.1007/s00132-025-04642-7

Eduardo Sampaio, Jörg Scherer, Jakob Hoffmanns, Jakob Mayr, H-G Palm

引用次数: 0

Student assistantships in orthopedic surgery : A strategy to counteract the declining interest in surgical careers.

Orthopadie (Heidelberg, Germany) Pub Date : 2025-03-26 DOI: 10.1007/s00132-025-04645-4

Yasmin Youssef, Suzanne Zeidler, Christoph-Eckhard Heyde, Tobias Schöbel

{"title":"Student assistantships in orthopedic surgery : A strategy to counteract the declining interest in surgical careers.","authors":"Yasmin Youssef, Suzanne Zeidler, Christoph-Eckhard Heyde, Tobias Schöbel","doi":"10.1007/s00132-025-04645-4","DOIUrl":"https://doi.org/10.1007/s00132-025-04645-4","url":null,"abstract":"Introduction: The field of orthopedics and trauma surgery in Germany is facing an increasing shortage of young specialists. Several solutions have already been proposed to attract new residents. This study evaluates the influence of a student job in an orthopedic surgery department on the career choice and skill acquisition of medical students.Methods: A single center, cross-sectional survey was conducted among 51 medical students employed as paid student assistants in the Department of Orthopedics, Trauma and Plastic Surgery at the University of Leipzig since 2017. A total of 42 participants (response rate: 82.4%) completed an online questionnaire assessing sociodemographic data, career choices and skills acquired during their employment. Statistical analysis was performed using SPSS.Results: Half of the participants with completed medical studies chose surgical residencies, with 83.3% of these in orthopedic surgery. The experience as a student assistant was ranked as the second most influential factor for career decisions after the final practical year. Participants reported significant skill acquisition, particularly in practical ward activities (mean Likert scale: 4.40 ± 0.79), operating room skills 3.55 ± 1.14 and understanding clinical processes 3.45 ± 0.86; however, limited impact was observed on scientific motivation (2.29 ± 1.13) and conducting orthopedic-specific examinations (1.98 ± 0.79).Conclusion: Student assistantships in orthopedic surgery provide substantial practical training and positively influence career decisions, potentially countering the declining interest in surgical fields. These roles represent an effective strategy for junior staff recruitment, offering structured exposure to the surgical profession. Future research should explore broader multicenter implementations to confirm these findings.","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733517","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}

引用次数: 0

[Internet resources on plantar fasciitis : German-language analysis of the information content of digital sourcess].

Orthopadie (Heidelberg, Germany) Pub Date : 2025-03-25 DOI: 10.1007/s00132-025-04641-8

Marianne Rosenthal, Mark Lenz, Sophie Maria Tengler, Sebastian Sachse, Matthias Walcher, Klaus E Roth, Lena Mohr, Kajetan Klos

{"title":"[Internet resources on plantar fasciitis : German-language analysis of the information content of digital sourcess].","authors":"Marianne Rosenthal, Mark Lenz, Sophie Maria Tengler, Sebastian Sachse, Matthias Walcher, Klaus E Roth, Lena Mohr, Kajetan Klos","doi":"10.1007/s00132-025-04641-8","DOIUrl":"https://doi.org/10.1007/s00132-025-04641-8","url":null,"abstract":"Background: Plantar fasciitis belongs to the most common reasons for a consultation in medical institutions. Websites are assisting health education in this field; however, the quality is sometimes questionable.Objectives: The quality of websites thematising plantar fasciitis was evaluated in a descriptive survey regarding content, structure, readability and visual aspects. Information of literature added by score results was used to create a website describing foot diseases.Materials and methods: Keywords chosen by Google Ads were searched for in Google, Bing and Yahoo. Search results were analysed according to linguistic scores (EQIP36, 25-Item, Flesch-Kincaid). A third of these score worths were summarized as a total score. An online survey examined three websites with the highest scores. An optimized website was created.Results: 137 websites and 37 videos were scored. Arithmetic averages amounted to 72 (EQIP36), 15 (25-Item), 43 (Flesch-Kincaid), 59 (total score). Major websites with the best results in 25-Item were prepared by physicians. Websites of encyclopedias reached the best reading level, whereas those of health insurance funds received the highest values in EQIP36 and the total score. Websites with the lowest total score, EQIP36, 25-Item did not mention any sources. Websites including videos created by the medical sector reached a higher total score and reading levels. The outcome of the survey was slightly worse than the results of the score.Conclusions: A lack of high qualified websites regarding foot pain was identified. This information can help producers of websites for digital patient education to improve the inadequate aspects.","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712447","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}

引用次数: 0

Effects of postoperative hand therapy in patients with Dupuytren's disease : A prospective hyperspectral imaging study.

Orthopadie (Heidelberg, Germany) Pub Date : 2025-03-20 DOI: 10.1007/s00132-025-04631-w

F M Lorenz, E Henning, C Sicher, I Langner

{"title":"Effects of postoperative hand therapy in patients with Dupuytren's disease : A prospective hyperspectral imaging study.","authors":"F M Lorenz, E Henning, C Sicher, I Langner","doi":"10.1007/s00132-025-04631-w","DOIUrl":"https://doi.org/10.1007/s00132-025-04631-w","url":null,"abstract":"Background: Hyperspectral imaging enables noninvasive evaluation of the microcirculation, which affects wound healing. In patients with Dupuytren's disease the microcirculation should be improved in order to achieve good clinical results and reduce the risk of recurrence. The aim of the study was to evaluate the microcirculatory effectiveness of postoperative hand therapy in patients with Dupuytren's disease after partial fasciectomy.Methods: In an inpatient hospital setting 35 patients with Dupuytren's disease were investigated before and after partial fasciectomy. Standardized hand therapy was performed after surgery. Its effects on superficial and deep oxygenation, tissue hemoglobin index and tissue water index were assessed using hyperspectral imaging at 3 regions of interest (ROI) within the first 2 postoperative days. For image evaluation, three ROIs were placed manually within the palm, the fingertip of the affected digit (fourth or fifth digit) and a fingertip of a control digit (unaffected, second digit of the same hand) using the vendor's software (TivitaTM Tissue Suite, Diaspective Vision, Germany).Results: Superficial oxygenation increased 1 day after surgery and after hand therapy. The tissue water index decreased on the second postoperative day.Conclusion: Hyperspectral Imaging demonstrates that postoperative hand therapy effectively improves perfusion and oxygenation in the hands of patients with Dupuytren's disease and additionally reduces edema.","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671989","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}

引用次数: 0

[Guideline for the treatment of patellofemoral cartilage defects/arthrosis].

Orthopadie (Heidelberg, Germany) Pub Date : 2025-03-20 DOI: 10.1007/s00132-025-04644-5

Christoph Becher, Michael T Hirschmann

引用次数: 0