Orthopadie (Heidelberg, Germany)最新文献_第3页

Effects of postoperative hand therapy in patients with Dupuytren's disease : A prospective hyperspectral imaging study. Dupuytren病患者术后手部治疗的效果：一项前瞻性高光谱成像研究。

Orthopadie (Heidelberg, Germany) Pub Date : 2025-05-01 Epub 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":"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":"386-394"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12037647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671989","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}

引用次数: 0

[Nonoperative treatment for the management of osteonecrosis and bone marrow oedema of the foot and ankle]. 【足踝骨坏死及骨髓水肿的非手术治疗】。

Orthopadie (Heidelberg, Germany) Pub Date : 2025-05-01 Epub Date: 2025-02-11 DOI: 10.1007/s00132-025-04622-x

Konstantin Horas, Annette Eidmann, Ioannis Stratos, Dominik Rak, Maximilian Rudert

引用次数: 0

Subchondral insufficiency fracture of the knee. 膝关节软骨下不全性骨折。

Orthopadie (Heidelberg, Germany) Pub Date : 2025-05-01 Epub Date: 2025-01-14 DOI: 10.1007/s00132-024-04595-3

Parker Scott, Brandon Cabarcas, Louis Kang, Mario Hevesi, Aaron J Krych

引用次数: 0

[Pharmacological therapy for subchondral pathologies of the knee joint]. 膝关节软骨下病变的药物治疗。

Orthopadie (Heidelberg, Germany) Pub Date : 2025-05-01 Epub Date: 2025-03-19 DOI: 10.1007/s00132-025-04625-8

Patrick Orth, Matthias Brockmeyer, Niklas Stachel, Henning Madry

{"title":"[Pharmacological therapy for subchondral pathologies of the knee joint].","authors":"Patrick Orth, Matthias Brockmeyer, Niklas Stachel, Henning Madry","doi":"10.1007/s00132-025-04625-8","DOIUrl":"10.1007/s00132-025-04625-8","url":null,"abstract":"Background: Pathologies of the subchondral bone include both structural alterations such as osteonecrosis and bone marrow edema. Both entities are amenable to pharmacological therapy.Objective: Presentation of current recommendations for drug therapy of osteonecrosis and bone marrow edema of the knee joint based on the clinical data.Methods: The currently available literature is evaluated and discussed.Results: Antiresorptives such as bisphosphonates and denosumab and the osteoanabolic agent teriparatide therapeutically address the locally diminished bone density potentially resulting in insufficiency fractures. In contrast, vitamin K antagonists, heparin and new/direct oral anticoagulants, as well as iloprost exert their effects at the vascular and hemostatic level. All drug treatment concepts are \"off-label\" use. They are particularly promising in the early stages of primary, idiopathic osteonecrosis and bone marrow edema.Conclusion: In osteonecrosis and bone marrow edema of the knee joint, complementary drug therapy may be beneficial. However, the available data is not yet sufficiently robust for general treatment recommendations.","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"354-360"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665628","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

Bone marrow lesions related to bone marrow edema syndromes and osteonecrosis. 与骨髓水肿综合征及骨坏死相关的骨髓病变。

Orthopadie (Heidelberg, Germany) Pub Date : 2025-05-01 Epub Date: 2025-04-22 DOI: 10.1007/s00132-025-04640-9

Gad Shabshin, Nogah Shabshin

{"title":"Bone marrow lesions related to bone marrow edema syndromes and osteonecrosis.","authors":"Gad Shabshin, Nogah Shabshin","doi":"10.1007/s00132-025-04640-9","DOIUrl":"https://doi.org/10.1007/s00132-025-04640-9","url":null,"abstract":"Bone marrow lesions (BML) are abnormalities in the bone marrow identified on magnetic resonance imaging (MRI) and can generally be classified as traumatic or atraumatic. This review focuses on atraumatic bone marrow edema syndromes (BMES) and their imaging evaluation. The MRI remains the modality of choice for assessing BMES, particularly using fluid-sensitive sequences although other sequences such as Dixon and T1-weighted imaging can be of further assistance. Emerging evidence supports dual-energy CT (DECT) as a reliable alternative, with high sensitivity and specificity for detecting bone marrow edema. The term BMES is a collective term for conditions, such as transient osteoporosis (TO) and regional migratory osteoporosis (RMO), predominantly affect weight-bearing bones in middle-aged individuals and pregnant or postpartum females. Subchondral insufficiency fractures of the knee (SIFK) are a key subset of BMES. These fractures most commonly involve the medial femoral condyle (MFC) and are associated with risk factors, such as meniscal root tears and extrusion of the meniscal body. The MRI findings typically include bone marrow edema-like signals and subchondral fracture lines, with additional features, such as secondary osteonecrosis in advanced cases. Prognostic indicators are crucial for stratifying patients and guiding management. Low-grade or reversible lesions often resolve with conservative treatment, whereas high-grade or irreversible lesions may require surgical intervention.Avascular necrosis, another atraumatic BML entity, differs from BMES by its association with systemic factors, such as steroid use or alcohol abuse. Accurate imaging, particularly in the early stages, is vital to distinguish between reversible and irreversible lesions, facilitating timely and appropriate management.","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":"54 5","pages":"324-331"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12037679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058820","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}

引用次数: 0

[The value of physical therapy modalities for osteonecrosis and bone marrow edema : Current study situation and practical applicability in everyday clinical practice]. 【骨坏死、骨髓水肿物理治疗方式的价值：研究现状及在日常临床实践中的实用性】。

Orthopadie (Heidelberg, Germany) Pub Date : 2025-05-01 Epub Date: 2025-03-03 DOI: 10.1007/s00132-025-04624-9

Lutz Linneweber

引用次数: 0

[Etiology of osteonecrosis and bone marrow edema]. 【骨坏死和骨髓水肿的病因学】。

Orthopadie (Heidelberg, Germany) Pub Date : 2025-05-01 Epub Date: 2025-02-24 DOI: 10.1007/s00132-025-04629-4

Dietrich Pape, Ben Bertemes, Cristina Dinis, Julien Dessard, Tom Gryson, Yorick Fonteyn, Charlotte Deprouw, Romain Seil, Alexander Hoffmann

{"title":"[Etiology of osteonecrosis and bone marrow edema].","authors":"Dietrich Pape, Ben Bertemes, Cristina Dinis, Julien Dessard, Tom Gryson, Yorick Fonteyn, Charlotte Deprouw, Romain Seil, Alexander Hoffmann","doi":"10.1007/s00132-025-04629-4","DOIUrl":"10.1007/s00132-025-04629-4","url":null,"abstract":"Background: The frequent use of magnetic resonance imaging (MRI) introduced \"bone marrow edema\" (BME) as a descriptive radiological term for hyperintense signal changes in fluid-sensitive sequences. With the optimization of MRI soft tissue contrast, BME has evolved into a valid prognostic indicator associated with pain genesis, trauma, mechanical overload, and progressive cartilage and joint destruction.Diagnostics: Both osteonecrosis and BME manifest in early MRI as intraosseous fluid accumulation, characterized by hyperintense signals in T2-weighted and STIR sequences. Conventional radiography and computed tomography (CT) are limited in BME detection due to the absence of relevant density alterations or structural osseous lesions early on.Classification: Although BME is not pathognomonic for osteonecrosis, it represents the initial phase of every primary osteonecrosis. BME can be transient (transitory osteoporosis) and regress without residuals or serve as a prodromal stage of manifest osteonecrosis.Pathophysiology: Primarily, it represents a non-specific reaction of bone marrow to various noxious stimuli such as trauma, mechanical overload, inflammatory processes, vascular insufficiency, or metabolic dysregulations. This review explores the pathophysiological mechanisms underlying BME, its clinical significance for osteonecrotic joint diseases, and its role in pain genesis.","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"332-341"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484867","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]. [儿童骨折的超声检查-以实践为导向的频繁实体病例]。

Orthopadie (Heidelberg, Germany) Pub Date : 2025-05-01 Epub 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

[Bone marrow edema and osteonecrosis in sport : Relevance, prognosis and therapy]. [运动中的骨髓水肿和骨坏死：相关性、预后和治疗]。

Orthopadie (Heidelberg, Germany) Pub Date : 2025-05-01 Epub Date: 2025-02-28 DOI: 10.1007/s00132-025-04626-7

Matthias Brockmeyer, Henning Madry, Patrick Orth

{"title":"[Bone marrow edema and osteonecrosis in sport : Relevance, prognosis and therapy].","authors":"Matthias Brockmeyer, Henning Madry, Patrick Orth","doi":"10.1007/s00132-025-04626-7","DOIUrl":"10.1007/s00132-025-04626-7","url":null,"abstract":"Background: Sports activities lead to loading stress for the osteochondral unit of the joints, especially for the lower extremity. Athletes frequently suffer from articular cartilage defects, meniscus and ligament injuries, which are often associated with subchondral bone marrow edema and osteonecrosis.Objectives: Presentation of relevance, prognosis and therapeutic options for bone marrow edema and osteonecrosis in sport.Material and methods: This review describes the clinical relevance, prognostic aspects and potential treatment options for bone marrow edema and osteonecrosis in athletes.Results: Subchondral bone marrow edema and osteonecrosis frequently occur in athletes. Most commonly, they are caused by mechanical joint overload due to sporting activities, but they are also found posttraumatically and postoperatively. Their clinical relevance to athletes remains unclear. A stepwise treatment concept includes non-surgical as well as surgical treatment options for symptomatic bone marrow edema and osteonecrosis in sport with different clinical prognoses depending on severity and location of the lesion.Conclusions: Bone marrow edema and osteonecrosis may have a relevant impact on the joint function in athletes. They play a decisive role in the rehabilitation following joint injuries and surgeries and are associated with the clinical outcomes following joint injuries and have critical influence on the return to sporting activities.Level of evidence: IV, narrative review.","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"342-348"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143532187","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

[Subchondral pathologies: current conservative treatment concepts]. 【软骨下病变：当前保守治疗理念】。

Orthopadie (Heidelberg, Germany) Pub Date : 2025-05-01 Epub Date: 2025-04-28 DOI: 10.1007/s00132-025-04638-3

Patrick Orth, Henning Madry

引用次数: 0