Orthopadie (Heidelberg, Germany)最新文献

{"title":"[Orthopaedics of the future : AI meets motion analysis: opportunities and risks].","authors":"Falko Heitzer, Dominik Raab, Wojciech Kowalczyk, Marcus Jäger","doi":"10.1007/s00132-025-04708-6","DOIUrl":"https://doi.org/10.1007/s00132-025-04708-6","url":null,"abstract":"<p><strong>Background: </strong>With the progress of digitalization and the rapid development of portable measurement systems, the integration of new technologies into clinical practice is inevitable. Considering the demographic change, the current healthcare system needs exactly this integration to appropriately address the growing challenges. Regarding orthopaedic patient care, the objective analysis of the musculoskeletal system represents an increasingly important aspect. Innovative key technologies are necessary to handle the amount of instrumental data and create new opportunities. While an enormous increase in efficiency, effectiveness and quality of care can be realized, potential risks from the application of artificial intelligence (AI) need to be considered.</p><p><strong>Methods: </strong>Based on a literature review using the PRISMA-method, specific opportunities for clinical integration are identified and potential risks are discussed.</p><p><strong>Results: </strong>A total of 188 publications were included, of which 54 were analyzed in detail.</p><p><strong>Conclusion: </strong>While the application of AI methods for the use of objective measurement systems opens a variety of opportunities in orthopaedic patient care, it is also associated with relevant risks. In order to address specific problems and achieve the primary goal of optimized healthcare, the appropriate use and the proper integration of AI methods are essential. It must be acknowledged that artificial intelligence can only play a supporting role, with transparency being the main criterion for trustworthy use in the healthcare sector.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981618","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":"[Ibuprofen for everything? : Differential pharmacotherapy for musculoskeletal pain based on case studies].","authors":"Ricarda Johanna Seemann, Antonios Douros","doi":"10.1007/s00132-025-04701-z","DOIUrl":"https://doi.org/10.1007/s00132-025-04701-z","url":null,"abstract":"<p><p>Non-steroidal anti-inflammatory drugs (NSAIDs) represent a heterogeneous group of medication with a wide range of effects and indications. Knowledge of the basic pharmacologic properties such as the plasma half-life allows NSAIDs to be used in a more targeted manner against specific pain and causes of pain. From an orthopaedic pain management perspective, the positive impact of NSAIDs is most likely due to both the direct inhibition of the inflammatory process and its subsequent reactions and, thus, the calming of the nocigenerator, as well as the interruption of central and peripheral sensitization processes, which leads to changes in the pain threshold.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981462","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: Verarbeitungseigenschaften und Viskositäten von PMMA-Knochenzementen.","authors":"Christian Paul, Erwin Steinhauser, Klaus-Dieter Kühn","doi":"10.1007/s00132-025-04684-x","DOIUrl":"https://doi.org/10.1007/s00132-025-04684-x","url":null,"abstract":"","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144839238","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":"[Pain modulating systems and manual medicine].","authors":"Michaela Habring, Karl Meßlinger","doi":"10.1007/s00132-025-04693-w","DOIUrl":"https://doi.org/10.1007/s00132-025-04693-w","url":null,"abstract":"<p><p>Pain can be modulated on several different levels of the nociceptive system. Starting with the primary nociceptive afferents, which can be sensitized and desensitized, a major part of the nociceptive control takes place on the spinal level, where the information is modulated through interneurons with excitatory and inhibitory neurotransmitters, before it is forwarded via projection neurons to the thalamus and different brain stem nuclei. Endogenous opioids play hereby an important role. The activity of the spinal neurons is, in turn, influenced by descending excitatory and inhibitory pathways from brainstem nuclei like the periaqueductal grey matter, the locus coeruleus and the rostral ventromedial medulla. Finally, these nuclei receive descending cortical information from prefrontal and limbic areas as well as the hypothalamus, which is accordingly associated with cognitive, emotional and autonomic functions of pain control. Virtually all therapeutic interventions for pain reduction, including therapeutic procedures in manual medicine, are based on the endogenous functions of these pain modulating systems.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144823363","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":"First experiences of immersive virtual reality as an additional learning tool in curricular teaching for orthopedic and trauma surgery.","authors":"Tobias Schöbel, Leonard Schuschke, Yasmin Youssef, Christoph-E Heyde, Daisy Rotzoll, Georg Osterhoff, Jan Theopold","doi":"10.1007/s00132-025-04697-6","DOIUrl":"https://doi.org/10.1007/s00132-025-04697-6","url":null,"abstract":"<p><strong>Introduction: </strong>Immersive virtual reality (iVR) simulators have been introduced for skills training in various medical disciplines. While iVR simulators have been shown to improve technical skills, they are currently not well established in curricular teaching for medical students. The aim of this study was to demonstrate the implementation of an iVR operating theater in addition to conventional bedside teaching in orthopedic and trauma surgery and to evaluate user feedback regarding expectations, acceptance and limitations.</p><p><strong>Methods: </strong>Medical students must complete a week of bedside teaching in orthopedic and trauma surgery in the fourth year. Of these students one third (n = 56) were given the opportunity to attend an iVR operation theater using Oculus Quest 2 headsets and controllers and the PrecisionOS software. Participants were able to train several surgical procedures. User feedback was obtained before and after the obligatory course by two questionnaires and compared statistically using the Mann-Whitney-U-test or Fishers' exact t‑test.</p><p><strong>Results: </strong>All students had high expectations regarding the implementation of iVR training in the course. The participants spent a mean time of 3.3 h per week using the iVR tool in addition to the regular course content. All students stated that iVR training was a useful addition to bedside teaching in orthopedic and trauma surgery. Most participants (87.0%) thought that VR applications will play a role in their future career. Motion sickness occurred in half of the participants. The main symptoms that were described were dizziness (37.0%), nausea (33.3%) and headaches (25.9%). Students who received an iVR tool rated the bedside course better than students who did not receive the iVR tool.</p><p><strong>Conclusion: </strong>The iVR training can be easily implemented into the curriculum of medical students. The high expectations of the participants were fulfilled and the students wished iVR to be a regular part of the obligatory courses in orthopedic and trauma surgery.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144823365","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":"[What does pain have to do with neuronal networks and the afferent matrix?]","authors":"Hans-Georg Schaible","doi":"10.1007/s00132-025-04703-x","DOIUrl":"https://doi.org/10.1007/s00132-025-04703-x","url":null,"abstract":"<p><p>Harmful (noxious) stimuli and many diseases cause pain. The pain described can reflect the nociception, i.e., the coding of the noxious stimulus or the pathological process. In many cases, however, this is not the case, especially if the pain lasts for along time. For this reason, it is important to understand pain in a broader sense as an expression of brain activity that also expresses other experiences in addition to nociception. This article describes the brain network which, according to our current understanding, generates the subjective sensation of pain. In addition to the areas of the brain that encode noxious stimuli, neuronal circuits of the limbic system, which evaluate the stimuli affectively and emotionally and are involved in response selection, are becoming important. Taking into account the complex neuronal mechanisms of pain development can contribute to better diagnostics and therapy.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144823364","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":"[Effectiveness of digital therapy in patellofemoral pain treatment].","authors":"Maleen Hinz, Daniel Wagner, Theresa Kölle, Tobias A Mayer-Roth, Christian Maiwald","doi":"10.1007/s00132-025-04704-w","DOIUrl":"https://doi.org/10.1007/s00132-025-04704-w","url":null,"abstract":"<p><strong>Background: </strong>Patellar pathologies are a common manifestation of musculoskeletal disorders. Digital health applications (DiGA), such as Mawendo, offer an alternative therapeutic approach to physiotherapy.</p><p><strong>Aim of the study: </strong>This study aimed to evaluate the effectiveness of the DiGA-Mawendo compared to conventional physiotherapy in patients with patellofemoral pain, based on the KOOS subscales.</p><p><strong>Methods: </strong>A total of 253 participants were randomly assigned to either a DiGA or physiotherapy group over a period of 12 weeks. The primary endpoints were the KOOS subscales, which were analyzed descriptively and using ANCOVA models.</p><p><strong>Results: </strong>DiGA-Mawendo showed significantly better outcomes in all subscales, exceeding the minimum clinically important difference (MCID) in each case.</p><p><strong>Discussion: </strong>DiGA demonstrated a clinically relevant, multidimensional therapeutic effect across all subscales. Its flexible use and high effectiveness support its complementary role in healthcare delivery.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144801134","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":"[Tibial plateau fractures : Tips and tricks].","authors":"Kai Fehske","doi":"10.1007/s00132-025-04681-0","DOIUrl":"https://doi.org/10.1007/s00132-025-04681-0","url":null,"abstract":"<p><p>Fractures of the tibial head continue to pose a challenge in surgical treatment. The goal is to achieve anatomical repositioning of the joint surface in order to prevent the development of posttraumatic gonarthrosis whenever possible. Sequential imaging techniques, such as computed tomography and magnetic resonance imaging, have become established for identifying the fracture morphology along with associated ligamentous and neurovascular accompanying injuries as well as for determining the treatment regimen, and for planning the surgical intervention. The updated S2k guidelines provide assistance for a structured and standardized approach that can be tailored to the individual patient. Based on the preoperative classification of the fracture the optimal procedure can be chosen. In addition to the timing of treatment, the choice of access also has a decisive impact on the postoperative outcome. Modern implants enable fracture-adapted osteosynthesis, likely resulting in less secondary loss of reduction in the hands of an experienced surgeon. Therefore, the training and further education of future surgeons is of great importance to ensure optimal care for our patients.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144786143","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":"[Through the foramen to the nerve root : The new S3 Guideline Epidural Injections].","authors":"Stephan Klessinger, Martin Legat, Patrick Weidle","doi":"10.1007/s00132-025-04700-0","DOIUrl":"https://doi.org/10.1007/s00132-025-04700-0","url":null,"abstract":"<p><strong>Background: </strong>In a transforaminal injection, medication is administered to a nerve root through the neuroforamen. Since the position of the nerve root is intradural, the target is the epidural space. Anti-inflammatory medication is usually used.</p><p><strong>Radicular complaints: </strong>In the case of radicular complaints caused by a herniated disc, there is a high level of evidence for the effectiveness of epidural injections. The needle position (supra- or infraneural) must be checked using imaging. The gold standard is fluoroscopy, but CT can also be used. The use of a non-particulate steroid is preferable due to the lower risk potential. The injection of a steroid into the epidural space is always an off-label therapy. After an intervention, it is necessary to examine the patient neurologically. It is only after 4 days that it is possible to assess whether long-term success has been achieved. A transforaminal injection can be repeated if a positive effect was achieved beforehand.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144786142","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 training Manual Medicine in the German Armed Forces : Touching medicine in military medicine].","authors":"Lutz-Michael Reichert, Helmut Stahlhofer","doi":"10.1007/s00132-025-04685-w","DOIUrl":"10.1007/s00132-025-04685-w","url":null,"abstract":"<p><p>Since 1998, over 600 medical officers have been trained in manual medicine at the Medical Academy of the Bundeswehr in Munich. In addition to the training content specified by the course manual of the German Medical Association and the education regulations of the Bavarian Medical Association, specific military medical topics are taught, focusing on the practical needs of troop, naval, and aviation medicine. The training is based on the School of Manual Medicine developed by Dr. Karl Sell from Isny-Neutrauchburg in Southern Germany, a pioneer of chiropractic therapy in the 1950s, and later expanded into a comprehensive teaching framework by Dr. Hans-Peter Bischoff.</p>","PeriodicalId":74375,"journal":{"name":"Orthopadie (Heidelberg, Germany)","volume":" ","pages":"636-641"},"PeriodicalIF":0.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735931","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}