[Septic arthritis].

Septic arthritis A painful, red, and swollen joint may have different causes. Septic arthritis is one of the most serious conditions and should be diagnosed and treated right away. In the native joint, an infection can damage the cartilage within the first 24 hours with impacts on joint function including lingering joint problems leading to possible future joint destruction.

The impact of specific fracture characteristics of low-energy fractures of the pelvis on mortality.

Background: Pelvic fractures in older patients are associated with relevant morbidity and mortality. Both might be determined by fracture morphology and/or patient characteristics. The aim of this project is to investigate the prognostic value of specific fracture characteristics with respect to overall survival and to compare it with an established classification system.

Focusing on individual morphological fracture characteristics of pelvic ring fractures in elderly patients can support clinical decision making.

Introduction: Pelvic ring fractures in the elderly are often caused by minor trauma. Treatment of these patients is currently based on fracture classification, clinical course, and ability to mobilize. Our aim was to identify morphological fracture characteristics with potential prognostic relevance and evaluate their association with clinical decision making and outcome, as well as their interobserver reliability.

Flouroscopic Control of Tibial Torsion After Intramedullary Nailing: A Technical Trick.

After intramedullary nailing of tibia shaft fractures, torsional malalignment greater than 10 degrees occur in up to 41% of operated legs. The reason is the difficult clinical assessment of rotation intraoperatively, the large variation in absolute torsion of the tibia, and the absence of established reliable methods to fluoroscopically evaluate tibial rotation and compare with the contralateral side. We present here a fast and low-tech intraoperative method on how to achieve identical tibial torsion of the operated and noninjured side.

Abductor Muscle Strength Deficit in Patients After Total Hip Arthroplasty: A Systematic Review and Meta-Analysis.

Background: The aims of this study were to assess and quantify hip abductor muscle strength deficits after total hip arthroplasty (THA) and to determine associations with external factors.

Methods: Studies reporting on hip abductor muscle strength before and/or after THA performed for osteoarthritis or atraumatic osteonecrosis of the hip were considered for inclusion. Data sources were Embase, Medline, and the Cochrane Central Register of Controlled Trials.

Scope and Limits of Teriparatide Use in Delayed and Nonunions: A Case Series.

Nonunion is known to occur in up to 10% of all bone fractures. Until recently, the treatment options considered in cases of delayed union and nonunion focused on revision surgery and improvement of local healing. Lately, teriparatide has been introduced as an osteoanabolic factor that induces fracture healing in cases with delayed or nonunions.

[Periprosthetic Joint Infections - An Overview].

Periprosthetic Joint Infections - An Overview Diagnostics and treatment of periprosthetic joint infections (PJI) is an interdisciplinary challenge. The key for success in the treatment of PJI is a rapid and adequate diagnostic and treatment in close cooperation between the general practitioner (GP), a specialised orthopaedic surgeon and an infectious disease specialist (ID). Acute PJI mostly occur peri- and early postoperative but can occur also lifelong due to haematogenous / lymphogenic seeding of the germs on the prosthesis.

Understanding the spread of de novo and transmitted macrolide-resistance in .

Background: The rapid spread of azithromycin resistance in sexually transmitted infections is a growing concern. It is not yet clear to what degree macrolide resistance in results from the emergence of de novo mutations or the transmission of resistant strains.

Methods: We developed a compartmental transmission model to investigate the contribution of de novo macrolide resistance mutations to the spread of antimicrobial-resistant .

Treatment of Periprosthetic Femoral Fractures Vancouver Type B2: Revision Arthroplasty Versus Open Reduction and Internal Fixation With Locking Compression Plate.

Introduction: The Vancouver algorithm recommends revision arthroplasty (RA) for Vancouver type B2 (VTB2) fractures. However, open reduction and internal fixation (ORIF) using locking compression plates (LCP) may be a valid and less invasive alternative treatment.

Materials And Methods: Between January 2007 and March 2017, we retrospectively recruited all patients treated with either ORIF with LCP or RA for VTB2 fractures in our clinic.

Influence of Vanadium 4+ and 5+ Ions on the Differentiation and Activation of Human Osteoclasts.

Background: In the pathophysiology of implant failure, metal ions and inflammation-driven osteoclasts (OC) play a crucial role. The aim of this study was to investigate whether vanadium (V) ions induce differentiation of monocytic OC precursors into osteoresorptive multinucleated cells. In addition, the influence of V ions on the activation and function of generated OC was observed.

Contemporary damage control surgery outcomes: 80 patients with severe abdominal injuries in the right upper quadrant analyzed.

Background: Damage control laparotomy (DCL) is a well-established surgical strategy in the management of the severely injured abdominal trauma patients. The selection of patients by intra-abdominal organs involvement for DCL remains controversial. The aim of this study was to assess the injury to the abdominal organs that causing severe metabolic failure, needing DCL.

The Role of Adherence and Retreatment in De Novo Emergence of MDR-TB.

Treatment failure after therapy of pulmonary tuberculosis (TB) infections is an important challenge, especially when it coincides with de novo emergence of multi-drug-resistant TB (MDR-TB). We seek to explore possible causes why MDR-TB has been found to occur much more often in patients with a history of previous treatment. We develop a mathematical model of the replication of Mycobacterium tuberculosis within a patient reflecting the compartments of macrophages, granulomas, and open cavities as well as parameterizing the effects of drugs on the pathogen dynamics in these compartments.

Direct transplantation of native pericytes from adipose tissue: A new perspective to stimulate healing in critical size bone defects.

Background Aims: Fractures with a critical size bone defect (e.g., open fracture with segmental bone loss) are associated with high rates of delayed union and non-union.

Postoperative segmental hypermobility after cervical arthroplasty: A possible pathomechanism for outcome failure.

We present a 41-year-old man who underwent a cervical discarthroplasty (CDA) C5-6 procedure with an increase of the segmental range of motion from 2.8° to 6.9° and an increase in disc height from 5.

Characterization of indeterminate spleen lesions in primary CT after blunt abdominal trauma: potential role of MR imaging.

The purpose of this study was to determine the value of magnetic resonance imaging (MRI) for characterization of indeterminate spleen lesions in primary computed tomography (CT) of patients with blunt abdominal trauma. Twenty-five consecutive patients (8 female, 17 male, mean age 51.6 ± 22.

Allergy or tolerance: reduced inflammatory cytokine response and concomitant IL-10 production of lymphocytes and monocytes in symptom-free titanium dental implant patients.

Hypersensitivity reactions to titanium (Ti) are very rare. Thus, we assessed the proinflammatory response and also potential tolerance favoring in vitro reactivity of human blood lymphocytes and monocytes (PBMC) to Ti in healthy individuals (14 without, 6 with complication-free dental Ti implants). The proliferation index (SI) in lymphocyte transformation test (LTT) and production of cytokines linked to innate immune response (IL-1 β , IL-6, and TNF α ) or immune regulation (IL-10) were assessed in response to TiO2 particles or Ti discs.

Pharmacological blocking of the osteoclastic biocorrosion of surgical stainless steel in vitro.

In vitro studies suggest that human osteoclasts (OC) are able to corrode surgical stainless steel 316L (SS). The aim of this study was to investigate whether osteoclastic biocorrosion can be blocked pharmacologically. Human OCs were generated in vitro from peripheral blood monocytic cells (PBMCs) in the presence of OC differentiation cytokines.

[Cervicobrachialgia - an update under special consideration of the surgical management].

The classic cervicobrachialgia results acutely from cervical nerve root compression by disc herniation or subacutely by radicular compression after progressive spondylotic changes of the cervical spine. The clinical presentation includes local and radiating pain syndromes that can be accompanied by sensorimotor deficits. Besides the medical history and a targeted clinical examination, supplementary radiographic means should be undertaken to confirm diagnosis.

Assessing the impact of adherence to anti-retroviral therapy on treatment failure and resistance evolution in HIV.

The adherence of patients to therapy is a crucial factor for successful HIV anti-retroviral therapy. Imperfect adherence may lead to treatment failure, which can cause the emergence of resistance within viral populations. We have developed a stochastic model that incorporates compartments of latently infected cells and virus genotypes with different susceptibilities to three simultaneously used drugs.

Central head perforation, or "cut through," caused by the helical blade of the proximal femoral nail antirotation.

Objective: This study was designed to investigate the specific type and incidence of implant failure in patients with a proximal femur fracture treated with a proximal femoral nail antirotation. This device has a helical-shaped blade as a neck-head holding device, instead of the lag screw used in other intramedullary nails. The advantage of the blade is believed to originate from bone impaction and a larger bone-implant interface in comparison with the lag screw design, with consequential greater mechanical resistance to torsion in the cancellous bone.

[Decompressive craniectomy in acute stroke - The different perspective].

Extensive space occupying strokes occur in about 1-10% of all ischaemic supratentorial infarctions. Both the high mortality and morbidity primarily result from secondary brain damage due to an accompanying brain edema. Therefore, the primary therapeutic target in patients with space occupying strokes is the control of the brain edema and the consecutively elevated intracranial pressure.

[The lumbar disc herniation - management, clinical aspects and current recommendations].

Lumbar disc herniation has a high prevalence and strong social-medical impact. Patients suffer from lower back pain that radiates from the spine. Loss of sensation or paresis adds to the clinical picture.