Stepwise implementation of an enhanced recovery pathway for elective total hip arthroplasty in a Swiss hospital: a cohort study.

Background: Enhanced recovery programs after total hip arthroplasty have been shown to reduce hospital length of stay without compromising results, but yet there is a lack of data for the Swiss population. Therefore, this retrospective cohort study evaluated whether similar positive effects on clinical outcomes are present in the context of the Swiss healthcare system.

Methods: Patients who underwent elective primary total hip arthroplasty were analysed.

Functional assessment of total hip arthroplasty using inertial measurement units: Improvement in gait kinematics and association with patient-reported outcome measures.

Inertial measurement units (IMUs) are commonly used for gait assessment, yet their potential for quantifying improvements in gait function and patterns after total hip arthroplasty (THA) has not been fully explored. The primary aim of this study was to compare spatiotemporal parameters and sagittal plane kinematic patterns of patients with hip osteoarthritis (OA) before and after THA, and to asymptomatic controls. The secondary aim was to assess the association between dynamic hip range of motion (ROM) during walking and the Hip Osteoarthritis Outcome Scores (HOOS).

Assessing Site Specificity of Osteoarthritic Gait Kinematics with Wearable Sensors and Their Association with Patient Reported Outcome Measures (PROMs): Knee versus Hip Osteoarthritis.

There is a great need for quantitative outcomes reflecting the functional status in patients with knee or hip osteoarthritis (OA) to advance the development and investigation of interventions for OA. The purpose of this study was to determine if gait kinematics specific to the disease-i.e.

Side to side kinematic gait differences within patients and spatiotemporal and kinematic gait differences between patients with severe knee osteoarthritis and controls measured with inertial sensors.

Background: Kinematic changes associated with knee osteoarthritis (OA) have been traditionally measured with camera-based gait analysis. Lately, inertial sensors have become popular for gait analysis with the advantage of being less time consuming and not requiring a dedicated laboratory.

Research Question: Do spatiotemporal and discrete kinematic gait parameters measured with the inertial sensor system RehaGait® differ between the affected and unaffected side in patients with unilateral knee OA and between patients with severe knee OA and asymptomatic control subjects? Do these differences have a similar magnitude as those reported in the literature?

Methods: Twenty-two patients with unilateral knee OA scheduled for total knee replacement and 46 age matched control subjects were included in this study.

Kinematic changes in severe hip osteoarthritis measured at matched gait speeds.

Kinematic differences between patients with osteoarthritis (OA) and control participants have been reported to be influenced by gait speed. The purpose of this study was to experimentally detect the effect of walking speed on differences in spatiotemporal parameters and kinematic trajectories between patients with hip OA and age-matched asymptomatic participants using wearable sensors and statistical parametric mapping (SPM). Twenty-four patients with severe unilateral hip OA and 48 control participants were included in this study.

Measuring gait kinematics in patients with severe hip osteoarthritis using wearable sensors.

Background: The popularity of inertial sensors in gait analysis is steadily rising. To date, an application of a wearable inertial sensor system for assessing gait in hip osteoarthritis (OA) has not been reported.

Research Question: Can the known kinematic differences between patients with hip OA and asymptomatic control subjects be measured using the inertial sensor system RehaGait®?

Methods: The patients group consisted of 22 patients with unilateral hip OA scheduled for total hip replacement.

Kinematic changes in patients with severe knee osteoarthritis are a result of reduced walking speed rather than disease severity.

Background: Kinematic changes in patients with knee osteoarthritis (OA) have been extensively studied. Concerns have been raised whether the measured spatiotemporal and kinematic alterations are associated with disease progression or merely a result of reduced walking speed.

Research Question: The purpose of this study was to investigate the effect of walking speed on kinematic parameters in patients with knee OA using statistical parametric mapping (SPM).

Accuracy of image-guided pedicle screw placement using intraoperative computed tomography-based navigation with automated referencing. Part II: thoracolumbar spine.

Background: Image-guided spinal instrumentation may reduce complications in spinal instrumentation.

Objective: To assess accuracy, time efficiency, and staff radiation exposure during thoracolumbar screw instrumentation guided by intraoperative computed tomography (iCT)-based neuronavigation (iCT-N).

Methods: In 55 patients treated for idiopathic and degenerative deformities, 826 screws were inserted in the thoracic (T2-T12; n = 243) and lumbosacral (L1-S1; n = 545) spine, as well as ilium (n = 38) guided by iCT-N.

Accuracy of image-guided pedicle screw placement using intraoperative computed tomography-based navigation with automated referencing, part I: cervicothoracic spine.

Background: Image-guided spinal instrumentation reduces the incidence of implant misplacement.

Objective: To assess the accuracy of intraoperative computed tomography (iCT)-based neuronavigation (iCT-N).

Methods: In 35 patients (age range, 18-87 years), a total of 248 pedicle screws were placed in the cervical (C1-C7) and upper and midthoracic (T1-T8) spine.

Less invasive surgical correction of adult degenerative scoliosis. Part II: Complications and clinical outcome.

Background: Surgical correction of adult degenerative scoliosis is a technically demanding procedure with a considerable complication rate. Extensive blood loss has been identified as a significant factor linked to unfavorable outcome.

Objective: To report on the complication profile and clinical outcomes obtained with less invasive image-guided surgical correction of degenerative (de novo) scoliosis in a high-risk population.

Less invasive surgical correction of adult degenerative scoliosis, part I: technique and radiographic results.

Background: Adult scoliosis is a condition with increasing prevalence and medical and socioeconomic importance. Surgery is fraught with a significant complication rate in an elderly multimorbid patient population.

Objective: To assess technical feasibility and radiographic results of image-guided less invasive correction of adult degenerative scoliosis.

[Molecular pathways in aseptic loosening of orthopaedic endoprosthesis].

Operative joint replacement to treat disabling joint conditions secondary to degenerative and inflammatory arthritides has become one of the most efficacious and cost-effective procedures to relieve pain and restore joint function. However, prosthetic implants are not built to last forever and osteolysis and aseptic loosening has been associated with prosthetic arthroplasties since their introduction. The functional life of a synthetic joint is influenced by many factors including the material of the implant, operation procedures and the surgeon involved, as well as patient-related factors.

Mechanisms of disease: Molecular insights into aseptic loosening of orthopedic implants.

Despite the success of treating rheumatic disorders with biologic therapies, joint replacement surgery still remains the final treatment option in many cases. Approximately 1.5 million joint arthroplastic operations are performed annually worldwide.

Increased polyethylene wear after cementless ABG I total hip arthroplasty.

Introduction: The cementless, hydroxyapatite-coated Anatomique Benoist Giraud-I (ABG-I) hip endoprosthesis represented a modern implant in the 1990s. The aim of the current retrospective study was to evaluate the clinical and radiological results of this prosthesis. In addition, an analysis of the complications and retrieved implants was conducted.

Complications after total knee arthroplasty: a comprehensive report.

In most reports of complications following TKA, the method of assessment and report of complications is not defined specifically. It is thus unclear whether certain complications did not occur or were simply not assessed at all. A detailed list of possible complications following TKA was developed, and the occurence of complications in 567 primary TKAs was followed up meticulously according to this list for one year postoperatively.

Robotic total knee arthroplasty: the accuracy of CT-based component placement.

Background: Accurate alignment of the components in total knee arthroplasty is important. By use of postoperative CT controls, we studied the ability of a robotic effector to accurately place and align total knee arthroplasty (TKA) components according to a purely CT-based preoperative plan.

Patients And Methods: Robotic TKA was performed in 13 patients (6 men) with primary gonarthrosis.

The internal calcar septum and its contact with the virtual stem in THR: a computer tomographic evaluation.

The internal calcar septum is a ridge of cortical bone protruding from the inner cortical wall of the proximal femur into the medullary canal. It extends from the lesser trochanter into the femoral neck and narrows the femoral cavity in its dorsal third. This region is essential for THR stability, but the degree of contact between the septum and standard THR implants has never been studied.

Cementless total hip replacement with subtrochanteric femoral shortening for severe developmental dysplasia of the hip.

Introduction: Total joint replacement in patients suffering from developmental dysplasia of the hip poses specific technical difficulties due to insufficient bone stock at the site of the original and secondary acetabulum and a narrow, cranially displaced proximal femur.

Materials And Methods: Twelve hips with severe congenital dislocation (4 Crowe type II, 5 type III, 3 type IV) were treated with cementless, porous structured total hip replacement. The cup was implanted at the anatomic height, a femoral segment was resected below the minor trochanter to reduce the femoral component in all cases.

Biological fixation of hydroxyapatite-coated versus grit-blasted titanium hip stems: a canine study.

Background: The purpose of the study was to evaluate the influence of a proximal hydroxyapatite (HA) coating in comparison with a grit-blasted titanium surface of an anatomic hip stem in an animal model over a maximum duration of 2 years.

Methods: Thirty adult dogs underwent implantation of either a proximally HA-coated or a grit-blasted anatomic titanium stem. The animals were clinically evaluated for their walking ability, and serial radiographs were taken.

New aspects in the histological examination of polyethylene wear particles in failed total joint replacements.

The most important long-term complication in total joint replacements is aseptic osteolysis. Wear particles such as polyethylene (PE) debris are considered to be one of the causes that play a central role. Several studies indicated that PE can be visualised in paraffin-embedded tissue sections not only by polarised light, but also after oil red staining.

[Interdisciplinary diagnosis and therapy of ischemic-osteomyelitic diabetic foot syndrome].

Advanced stages of the diabetic foot syndrome complicated by ischemia and osteomyelitis frequently result in minor amputation, followed by impaired wound healing and higher-level amputation in the context of regular health structures. Even in specialized foot care centers, peripheral arterial occlusive disease and osteomyelitis still represent the greatest challenge in the strife for limb salvage. Whereas the treatment of nonischemic foot lesions has increasingly become a matter of conservative medicine within recent years, for advanced diabetic foot wounds a multidisciplinary treatment policy is essential.