A prospective cluster trial to increase antibiotic prescription quality in seven non-ICU wards.

Aim: To evaluate general shortcomings and faculty-specific pitfalls as well as to improve antibiotic prescription quality (ABQ) in non-ICU wards, we performed a prospective cluster trial.

Methods: An infectious-disease (ID) consulting service performed a prospective investigation consisting of three 12-week phases with point prevalence evaluation conducted once per week (=36 evaluations in total) at seven non-ICU wards, followed by assessment of sustainability (weeks 37-48). Baseline evaluation (phase 1) defined multifaceted interventions by identifying the main shortcomings.

[Treatment of Achilles insertional calcific tendinosis using a longitudinal midline incision approach/central tendon splitting approach].

Objective: Treatment of Achilles insertional calcific tendinosis through a longitudinal midline incision approach with optional resection of the retrocalcaneal bursa and calcaneal tuberosity (Haglund's deformity).

Indications: Calcific Achilles tendinosis, dorsal heel spur, insertional tendinosis.

Contraindications: General medical contraindications to surgical interventions.

[Our path to electronic patient files].

Digitization in hospitals is developing rapidly. The aim of many tools is to save time and better interlink interprofessional teams. Digitization also harbors dangers which, in the best-case scenario, can be identified and resolved in good time.

[Plantar fascia release and decompression of the first branch of the lateral plantar nerve (Baxter's nerve)].

Objective: Treatment of chronic plantar fasciitis and release of the first calcaneal branch of the lateral plantar nerve (Baxter's nerve).

Indications: Chronic plantar fasciitis, compression of the first calcaneal branch of the lateral plantar nerve (Baxter's nerve).

Contraindications: General medical contraindications to surgical interventions, infection.

Isolated Arthroscopic Lateral Retinacular Release for Lateral Patellar Compression Syndrome.

Introduction: Evidence concerning the role of isolated lateral retinacular release (LRR) for lateral patellar compression syndrome (LPCS) dates back at least three decades. Appropriate indications, execution and outcomes still remain unclear and controversial. The present investigation analyzed the midterm result of isolated and arthroscopic LRR for LPCS in a cohort of patients who underwent such procedure at our institution.

Comparison of medial distal tibial angle in EOS imaging and weightbearing X-ray.

Background: The medial distal tibial angle (MDTA) is used for measurement of ankle alignment. Standard to measure MDTA is weightbearing mortise view. EOS imaging becomes more popular for limb alignment analysis using low-dose radiation.

[Adult acquired flatfoot deformity-operative management for the early stages of flexible deformities].

Flexible adult acquired flatfoot deformity includes a wide spectrum of fore- and hindfoot pathologies and remains a complex clinical challenge. Clinical history, inspection and accurate physical examination are paramount for diagnosis. Early stages of flexible adult acquired flatfoot deformity present with increased hindfoot valgus and medial arch collapse.

[Custom made total knee arthroplasty : Review of current literature].

Custom-designed total knee replacement has become a standard procedure in some orthopaedic centres worldwide. Due to the lack of literature, the discussion about the hypothetical advantages has remained controversial. It was the aim of this study to focus on the current literature on custom-made total knee arthroplasty.

Patient satisfaction - A comparison between patient-specific implants and conventional total knee arthroplasty.

Background: Despite recent innovations in total knee arthroplasty, 20% of the patients are not completely satisfied with the clinical results. Regarding patient-specific implants (PSI), the study aims to compare individual and off-the-shelf implant (OSI) total knee arthroplasty (TKA) concerning the postoperative outcome like function and global patient satisfaction.

Methods: In 2013/14 228 patients received a TKA due to primary osteoarthritis with an indication for a bicondylar, cruciate retaining prosthesis.

Comparison of the Manchester-Oxford Foot Questionnaire (MOXFQ) and the Self-Reported Foot and Ankle Outcome Score (SEFAS) in patients with foot or ankle surgery.

Background: Patient-reported outcome measures are a critical tool in evaluating the efficacy of orthopedic procedures. The intention of this study was to compare the psychometric properties of the Manchester-Oxford Foot Questionnaire (MOXFQ) and the Self-Reported Foot and Ankle Outcome Score (SEFAS) in patients with foot or ankle surgery.

Methods: 177 patients completed both scores and FAOS, Foot and Ankle Outcome Score (FAOS), Short Form 36 (SF-36) and numeric scales for pain and disability (NRS) before and after surgery.

Alignment in total knee arthroplasty - A comparison of patient-specific implants with the conventional technique.

Background: Incorrect positioning and malalignment of total knee arthroplasty (TKA) components can result in implant loosening. Restoration of neutral alignment of the leg is an important factor affecting the long-term results of TKA. The aim of our retrospective study was to compare mechanical axis in patients with conventional and patient-specific TKAs.

[Subtalare Screw Arthroereisis for the Treatment of Symptomatic, Flexible Pes Planovalgus].

Background: The purpose of this study was to determine the functional outcomes and radiographic results of the talus-stop screw method as minimally invasive subtalar arthroereisis in pediatric and juvenile flexible flatfoot.

Material And Methods: We retrospectively evaluated 73 feet from 41 children using the talus stop-screw method, for the period between 2002 and 2011. The age at time of surgery ranged between nine and 14 years.

Reliability, validity and responsiveness of the German self-reported foot and ankle score (SEFAS) in patients with foot or ankle surgery.

Background: Patient-reported outcome measures are a critical tool in evaluating the efficacy of orthopedic procedures and are increasingly used in clinical trials to assess outcomes of health care. The intention of this study was to develop and culturally adapt a German version of the Self-reported Foot and Ankle Score (SEFAS) and to evaluate reliability, validity and responsiveness.

Methods: According to Cross Cultural Adaptation of Self-Reported Measure guidelines forward and backward translation has been performed.

No difference between standard and high flexion cruciate retaining total knee arthroplasty: a prospective randomised controlled study.

Purpose: The purpose of this prospective, randomised, double-blind study was to test the hypotheses that patients with high-flexion total knee arthroplasty (TKA) have (1) a wider/greater range of motion (ROM) post-operatively and (2) higher levels of knee society score (KSS) and WOMAC score post-operatively compared to standard TKA.

Methods: In this study, 28 high flexion with 31 standard TKAs were compared. We measured ROM, pre-operatively, on day 3, 7, 28, and after 6 and 36 months post-operatively as well as KSS and WOMAC score pre-operatively, on day 28 and after 6 and 36 months post-operatively.

Assessing patient-oriented results after revision total knee arthroplasty.

Background: Revision total knee arthroplasties (TKA) have been performed with increasing frequency over the last 25 years.

Methods: In this study, we retrospectively analyzed 78 patients who underwent 78 revision TKAs during the years 2003–2007 with an average follow-up of 81 months (range 60–108 months). All patients were treated with a standard rotating hinge prosthesis (TC3, DePuy, Warsaw, IN, USA) due to significant instability.

The value of colour Doppler sonography of the knee joint: a useful tool to discriminate inflammatory from non-inflammatory disease?

Objective: To determine the diagnostic value of colour Doppler ultrasound (CDUS) in patients with inflammatory arthritis (IA) vs non-inflammatory disease (e.g. OA) of the knee joint.

A minimally invasive approach for total hip arthroplasty does not diminish early post-operative outcome in obese patients: a prospective, randomised trial.

Purpose: The benefits of minimally invasive surgical techniques in total hip arthroplasty (THA) are well known, but concerns about applying those techniques in obese patients are controversial. We prospectively compared patients with increased body mass index (BMI ≥ 30) undergoing THA with normal weight patients.

Methods: A total of 134 patients admitted for unilateral THA were randomised to have surgery through either a transgluteal or a minimally invasive approach (MicroHip).

Comparing navigation-based in vivo knee kinematics pre- and postoperatively between a cruciate-retaining and a cruciate-substituting implant.

Purpose: Individual physiological knee kinematics are highly variable in normal knees and are altered following cruciate-substituting (PS) and cruciate-retaining (CR) total knee arthroplasty (TKA). We wanted to know whether knee kinematics are different choosing two different knee designs, CR and PS TKA, during surgery using computer navigation.

Methods: For this purpose, 60 consecutive TKA were randomised, receiving either CR (37 patients) or PS TKA (23 patients).

Infusion, core decompression, or infusion following core decompression in the treatment of bone edema syndrome and early avascular osteonecrosis of the femoral head.

An increase in interstitial fluid is an expression of bone marrow edema (BME) and osteonecrosis (ON). The exact pathogenetic processes still remain unknown. Treatment options are mainly symptomatic with core decompression as surgical golden standard with immediate pain relief.

Computer-assisted navigation in total knee arthroplasty: a review of literature.

Computer-assisted navigation surgery (CAS) has been performed in total knee arthroplasty (TKA) for approximately 10 years. This technique offers experienced and inexperienced surgeons improved control and reproducible results. Currently, 30% of primary total knee replacements are performed using the CAS technique in Germany.

Simultaneous anabolic and catabolic responses of human chondrocytes seeded in collagen hydrogels to long-term continuous dynamic compression.

Cartilage repair strategies increasingly focus on the in vitro development of cartilaginous tissues that mimic the biological and mechanical properties of native articular cartilage. However, current approaches still face problems in the reproducible and standardized generation of cartilaginous tissues that are both biomechanically adequate for joint integration and biochemically rich in extracellular matrix constituents. In this regard, the present study investigated whether long-term continuous compressive loading would enhance the mechanical and biological properties of such tissues.

CRP and leukocyte-count after lumbar spine surgery: fusion vs. nucleotomy.

Background: Despite the fact that C-reactive protein (CRP) levels and white blood cell (WBC) count are routine blood chemistry parameters for the early assessment of wound infection after surgical procedures, little is known about the natural history of their serum values after major and minimally invasive spinal procedures.

Methods: Pre- and postoperative CRP serum levels and WBC count in 347 patients were retrospectively assessed after complication-free, single-level open posterior lumbar interlaminar fusion (PLIF) (n = 150) for disc degeneration and spinal stenosis and endoscopically assisted lumbar discectomy (n = 197) for herniated lumbar disc. Confounding variables such as overweight, ASA classification, arterial hypertension, diabetes mellitus, and perioperative antibiotics were recorded to evaluate their influence on the kinetics of CRP values and WBC count postoperatively.

Evaluation of implant position and knee alignment after patient-specific unicompartmental knee arthroplasty.

Implant positioning and knee alignment are two primary goals of successful unicompartmental knee arthroplasty. This prospective study outlines the radiographic results following 32 patient-specific unicompartmental medial resurfacing knee arthroplasties. By means of standardized pre- and postoperative radiographs of the knee in strictly AP and lateral view, AP weight bearing long leg images as well as preoperative CT-based planning drawings an analysis of implant positioning and leg axis correction was performed.