Zeitschrift fur Orthopadie und Unfallchirurgie最新文献

{"title":"[Double-Level De-Rotational Osteotomy of the Knee].","authors":"Felix Ferner, Christoph Lutter, Mario Perl, Jörg Harrer","doi":"10.1055/a-2232-3506","DOIUrl":"10.1055/a-2232-3506","url":null,"abstract":"<p><p>Derotational osteotomies of the proximal tibia and distal femur are a common surgical treatment option in patients with a congenital or posttraumatic torsional deformity. Clinically, these patients present with isolated anterior knee pain alone or in in combination with patellofemoral instability. Since the combination of femoral and tibial deformity is common (quotation Cooke), a combined surgical treatment is needed for these cases. This includes high tibial derotational and a distal femoral osteotomy, stabilised by a plate respectively. The current video shows the technique of this combined osteotomy assisted by external fixateur and the tibial approach with tibialis anterior fasciectomy and neurolysis of the peroneal nerve.</p>","PeriodicalId":94274,"journal":{"name":"Zeitschrift fur Orthopadie und Unfallchirurgie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139503321","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":"Comparison of Pre- and Postoperative Motor-proprioceptive Abilities in Patients with Gonarthrosis.","authors":"Viktoria Schröter, Clemens Könczöl, Jens O Anders","doi":"10.1055/a-2151-4849","DOIUrl":"10.1055/a-2151-4849","url":null,"abstract":"<p><p>Both surgeons and patients want to achieve a high level of satisfaction and the best possible functional results within a short time after knee TEP surgery. By using a tool that digitally records various measurement parameters of balance and motor function preoperatively and postoperatively on a mobile basis and with little time expenditure, progressive results can be compared. Individual factors can thus be determined and these can influence the progress in regeneration and training progress perioperatively.In a prospective study, 100 patients before and 66 patients after installation of a cement-retained knee TEP were evaluated for the following parameters: balance, maximum strength, and power. All measurements were performed with the KMP measurement platform from MotoSana. The second measurements were performed in each case after a standardised follow-up treatment.It was shown that there are significant relationships between personal factors such as age, height, body weight and with baseline values and performance measures: maximum strength and power. Furthermore, it was shown that postoperative improvement could be achieved for the most part around balance support. All patients who previously had to hold on with one hand or both hands no longer needed support after surgery to maintain the single-leg stance for the specified time of 15 s. For a more detailed analysis of the balance parameters, the samples were adjusted and only the patients who did not hold on for support pre- and postoperatively were counted. In patients with low and medium initial stance, the sway area increased at the second measurement session, and in patients with large sway areas, it decreased, and the stance became more stable. In the area of maximum strength and power, patients with high baseline values still had higher values after AHB compared with the other patients, but lower values compared with their own baseline values.Patients who already had very good motor skills before surgery were able to achieve a greater increase in motor skills compared to the weaker group. However, all patients failed to reach their preoperative baseline values after completion of the AHB. Deficits in balance were still detectable in all groups. By using the presented force plate, measurement-based coordinated rehabilitation procedures are possible during and after completion of the AHB. Rehabilitation with individualised improvement of balance and motor function could be expected to prevent dissatisfaction after knee arthroplasty, e.g. due to muscular imbalance in femoropatellar pain syndromes.</p>","PeriodicalId":94274,"journal":{"name":"Zeitschrift fur Orthopadie und Unfallchirurgie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41167167","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":"[Blood Products and Stem Cells in Osteoarthritis Therapy].","authors":"Alexander Otahal, Markus Neubauer, Stefan Nehrer","doi":"10.1055/a-2192-8330","DOIUrl":"https://doi.org/10.1055/a-2192-8330","url":null,"abstract":"<p><p>The principle of regenerative medicine in the treatment of osteoarthritis pursues a functional restoration of cartilage tissue instead of just repairing cartilage defects. The use of blood products is intended to inhibit chronic inflammatory processes and promote tissue regeneration. Intraarticular injection of autologous platelet-rich plasma (PRP) is a prominent procedure. Clinical evidence supports PRP injection over hyaluronic acid or glucocorticoid injection. Comparability of studies is difficult due to missing standardisation of production procedures, dosing and donor variability. In particular, whether presence of residual leukocytes is required or should be avoided is an open debate. In contrast, stem cell therapies in osteoarthritis therapy are often based on mesenchymal stem cells (MSC) from adipose tissue or bone marrow aspirate. Different sources of MSC might render the cells more suitable for application in a given context. Nevertheless, it became evident that their secretome rather than the cells themselves are responsible for observed regenerative processes. Research on the mechanisms of action have focused on growth factors. However, an overlooked component of blood products called extracellular vesicles (EV) came to the center of attention, which are also released by MSC as intercellular signal carriers. EV cargo molecules such as miRNAs open up new dimensions in the investigation and explanation of clinically observed anti-inflammatory and regenerative effects.</p>","PeriodicalId":94274,"journal":{"name":"Zeitschrift fur Orthopadie und Unfallchirurgie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335662","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 S2e Guideline on Shoulder Stiffness.","authors":"Friedrich Dehlinger, Ulf Bökeler, Hanna Brandt, Lars Brunnader, Lars Eden, Andrea Pfingsten, Robert Prill","doi":"10.1055/a-2123-4952","DOIUrl":"10.1055/a-2123-4952","url":null,"abstract":"<p><p>The clinical picture of \"frozen shoulder\" is still poorly understood. In order to present the current state of knowledge on aetiology, diagnosis, and treatment, and to provide recommendations for the professional groups involved, a working group was formed by the DGOU and the DVSE to create a German language, evidence-based guideline, which was published in 2022 by the AWMF. The following summarises the development and the most important results.</p>","PeriodicalId":94274,"journal":{"name":"Zeitschrift fur Orthopadie und Unfallchirurgie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41173772","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":"Delayed Reconstruction of the Perforator Pedicle Propeller Flap after the Induced Membrane Technique for Gustilo IIIB Open Distal Tibial Fracture.","authors":"Shuming Ye, Neng Jin, Jian Sun, Liqian Zhang, Jisen Zhang, Juehua Jing","doi":"10.1055/a-2151-5175","DOIUrl":"10.1055/a-2151-5175","url":null,"abstract":"<p><p>This study aimed to evaluate the safety and efficacy of delayed reconstruction of the perforator pedicle propeller flap after the induced membrane technique in the treatment of Gustilo IIIB open distal tibial fracture, and to evaluate the clinical outcome and complications of two different perforator pedicle propeller flaps.Thirty-four patients with Gustilo IIIB open distal tibial fractures treated by the induced membrane technique and delayed reconstruction of two different perforator pedicle propeller flaps from May 2017 to March 2022 were retrospectively analyzed. Patients were divided into two groups according to the different kinds of perforator pedicle propeller flaps covered. The operation required two stages. The Radiographic Union Score for Tibial fractures (RUST) was used to evaluate the healing of the tibial bone defect. The American Orthopaedic Foot and Ankle Society (AOFAS) score was used to evaluate ankle function. The complications associated with the technique were recorded.The number of serial debridements, excluding those performed during emergency and final operations, was a mean of 2.28 ± 0.83 in the PAPF group. The PAPF group had a mean bone defect length of 6.76 ± 0.69 cm, the median healing time of 13.11 ± 0.96 months, RUST score 12.68 ± 1.63, and AOFAS score of 84.12 ± 6.38. On the other hand the PTAPF group's mean bone defect length was 6.73 ± 0.95 cm, the median healing time 12.63 ± 1.46 months, RUST score 13.73 ± 1.53 and AOFAS score 82.79 ± 5.49. There were no observed significant differences the two groups in the number of serial debridements, bone defect length, bone union time, RUST score, or AOFAS score (p > 0.05). Flap size ranged from 9 × 6 cm² to 14 × 7 cm² in the PAPF group and from 9 × 6 cm² to 13 × 7 cm² in the PTAPF group. There were no severe complications such as flap-related complications or amputation. The differences in complications in the two groups were not statistically significant.In cases of severe open tibial fracture, the reconstructive method is important. When delayed reconstruction is inevitable, surgeons should first perform radical debridement, followed by vacuum sealing drainage as a bridging therapy; both PAPF and PTAPF can be considered for definitive soft tissue coverage.</p>","PeriodicalId":94274,"journal":{"name":"Zeitschrift fur Orthopadie und Unfallchirurgie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11424166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41176096","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":"Führungsqualitäten braucht nur der Chefarzt?","authors":"Yasmin Youssef, Christoph G Wölfl, Maria E Dey Hazra","doi":"10.1055/a-2359-4966","DOIUrl":"https://doi.org/10.1055/a-2359-4966","url":null,"abstract":"","PeriodicalId":94274,"journal":{"name":"Zeitschrift fur Orthopadie und Unfallchirurgie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335664","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":"Retraction Note: Validity and Reliability of Sensor-based Measures of Lower Limb Range of Motion in Soccer Players: a Cross-sectional Study.","authors":"Sebastian Huber, Martin Alfuth","doi":"10.1055/a-2409-4411","DOIUrl":"https://doi.org/10.1055/a-2409-4411","url":null,"abstract":"","PeriodicalId":94274,"journal":{"name":"Zeitschrift fur Orthopadie und Unfallchirurgie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305419","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":"Implantation of Reverse Shoulder Endoprothesis Using Navigation.","authors":"Olaf Rolf, Andreas Blana, Philipp Hagedorn","doi":"10.1055/a-2346-9916","DOIUrl":"https://doi.org/10.1055/a-2346-9916","url":null,"abstract":"<p><p>The implantation of a reverse shoulder arthroplasty (RSA) is a proven method for pain relief and improvement in shoulder function. Results vary, depending on the patient's age, the severity of the disease, and the experience of the surgeon. Indications for RSA are diverse, ranging from rotator cuff arthropathy to fractures. Recent studies show improved survival rates and reduced complications after primary implantation. Preoperative planning using 3D-CT or MRI is considered to be the gold standard. Patient-specific instruments (PSI) have been introduced, but are associated with costs and waiting times. Navigation with augmented reality (AR) provides a more efficient alternative. The intraoperative transfer of the plan to the patient is carried out via AR glasses, allowing real-time information without having to divert the surgeon's attention from the surgical site. This optimises the workflow and potentially yields more precise implantation results. In summary, the combination of 3D planning, navigation, and AR offers a promising method for precise and efficient RSA-implantations. Nevertheless, long-term results and functional scores are not yet available.</p>","PeriodicalId":94274,"journal":{"name":"Zeitschrift fur Orthopadie und Unfallchirurgie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305418","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":"Clinical Outcome after Endoscopic Facet Denervation in Patients with Chronic Low Back Pain.","authors":"Maximilian Lenz, Philipp Egenolf, Johanna Menzhausen, Vincent Heck, Akanksha Perera, Peer Eysel, Max Scheyerer, Stavros Oikonomidis","doi":"10.1055/a-2348-1186","DOIUrl":"https://doi.org/10.1055/a-2348-1186","url":null,"abstract":"<p><p>Several studies have reported that low back pain has a high prevalence among the population, with up to 85%. Percutaneous radiofrequency facet denervation (PRFD) is the gold standard of today's rhizotomy for chronic low back pain (CLBP). However, previously published studies present controversial results for the efficacy of PRFD. Therefore, this study aimed to analyse the use of endoscopic facet joint denervation (EFJD) to treat chronic low back pain and to identify potential risk factors that could limit indications for surgery.We retrospectively included 31 eligible patients into the study with at least 24 months of CLBP. All patients underwent EFJD and had to complete ODI, COMI, EQ-5D and VRS scores postoperatively, with a minimum follow up of 12 months. Basic patient data was recorded to analyse correlations.We found a significant improvement in all clinical scores measured, such as ODI, COMI, EQ-5D and VRS scores. While the best result was found at the 3 months follow-up, a slight deterioration was found at 12 months follow-up. However, significant benefit was observed when compared to preoperative scores. 28/31 patients (93.3%) reported reduced pain at 12 months follow-up and were satisfied with the procedure. Older age and psychiatric precondition were identified as potential risk factors associated with poorer outcome. Postoperative complications such as haematoma, a sensibility disorder and temporary low extremity muscular weakness were rarely observed.EFJD showed significant improvement of the clinical outcome scores and VRS when compared to preoperative results of patients, with a minimum of 12 months of CLBP prior to surgery. Older patients and patients with a psychiatric precondition seem to benefit less from the procedure.</p>","PeriodicalId":94274,"journal":{"name":"Zeitschrift fur Orthopadie und Unfallchirurgie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074919","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":"One Year of Experience in the Orthopaedic and Trauma Surgical Care of War Refugees and Soldiers from Ukraine in a Maximum Care Trauma Centre.","authors":"Christian Prangenberg, Lisa Fiona Roder, Kristian Welle, Jonas Roos, Alberto Alfieri Zellner, Soufian Ben Amar, Christof Burger, Martin Gathen","doi":"10.1055/a-2331-1020","DOIUrl":"https://doi.org/10.1055/a-2331-1020","url":null,"abstract":"<p><p>According to the United Nations, around 8,400 people have been injured and over 5,800 killed on the Ukrainian side in the Ukraine war, which has been going on for over 14 months. Extensive humanitarian aid operations were carried out to support Ukraine, so that war-wounded people from Ukraine were also cared for in Germany. In a retrospective cohort study, 10 patients were examined who were treated in the department between February 24th 2022 and February 24th 2023, using the cloverleaf system from Ukraine.The average duration of inpatient treatment was 53.10 days. The average ISS was 23.7. The patients were operated on an average of 3.3 times in our institution. All patients received consultative psychological care. All patients were initially put into protective isolation until the results of a corona test and microbiological swabs were available. After preliminary protective isolation, further isolation had to be carried out in 5 cases due to germs requiring isolation. Eight patients were released to state accommodation. Three patients were transferred back to Ukraine at their own request.The treatment of war-injured patients from Ukraine represents a particular challenge. It absolutely requires an interdisciplinary treatment concept that, in addition to special trauma surgery and orthopaedic expertise, also requires plastic-reconstructive, microbiological and, last but not least, psychological care. Due to the high rate of infections requiring isolation, long, costly therapy with multiple revision operations is often necessary.</p>","PeriodicalId":94274,"journal":{"name":"Zeitschrift fur Orthopadie und Unfallchirurgie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989874","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}