[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.

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.

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.

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.

Influence of metal ions on human lymphocytes and the generation of titanium-specific T-lymphocytes.

Background: There is mounting evidence to suggest the involvement of the immune system by means of activation by metal ions released via biocorrosion, in the pathophysiologic mechanisms of aseptic loosening of orthopedic implants. However, the detailed mechanisms of how metal ions become antigenic and are presented to T-lymphocytes, in addition to how the local inflammatory response is driven, remain to be investigated.

Methods: Human T-lymphocytes were cultured in the presence of a variety of metal ions before investigating functional and phenotypic changes using flow cytometric analysis.

Health-related quality of life following spinal cordectomy for syringomyelia.

Background: Spinal cordectomy has been described as an effective treatment option in paraplegic patients for the treatment of syringomyelia to manage spasticity, pain and ascending neurological dysfunction. The objective of this study was to investigate the long-term health-related quality of life (HRQoL) after cordectomy in patients with intractable symptoms caused by syringomyelia.

Methods: Seventeen patients underwent spinal cordectomy for syringomyelia between February 2000 and July 2009.

Biocorrosion and uptake of titanium by human osteoclasts.

All metals in contact with a biological system undergo corrosion through an electrochemical redox reaction. This study investigated whether human osteoclasts (OC) are able to grow on titanium and aluminum, and directly corrode the metals leading to the release of corresponding metal ions, which are believed to cause inflammatory reactions and activate osteoclastic differentiation. Scanning electron microscopy analysis demonstrated long-term viable OC cultures on the surface of titanium and aluminum foils.

Functional and proteomic analysis of serum and cerebrospinal fluid derived from patients with traumatic brain injury: a pilot study.

Background: An enhanced fracture healing response has been reported in patients with traumatic brain injury (TBI). This has been attributed to circulating humoral factors that are thought to be proteins produced and released by the injured brain. However, these factors remain unknown.

Laboratory confirmed polymethyl-methacrylate (Palacos)-hypersensitivity after cranioplasty.

Polymethyl-methacrylate (PMMA) as part of bone cement is a widely used material in the context of orthopaedic implants and also in cranioplasty. Although PMMA is characterised by excellent biocompatibility with low intrinsic toxicity and inflammatory activation, a minor portion of patients develop allergic reactions. We present the case of a 39-year-old woman with an increasing headache and a corresponding erythema over the parieto-occipital cranioplasty, which was performed 42 days prior using a PMMA compound.

Recurrent laryngeal nerve monitoring during esophagectomy and mediastinal lymph node dissection.

Background: Patients who undergo surgery to the esophagus and lungs are in jeopardy of recurrent laryngeal nerve (RLN) damage during the procedure. This study was designed to investigate the feasibility of intraoperative monitoring of the RLN for single-lung ventilation esophagus and lung surgery.

Methods: Twelve consecutive patients booked for esophagus or lung surgery were included in this prospective, observational study.

Web-based audiovisual patient information system--a study of preoperative patient information in a neurosurgical department.

Background: In the current climate of increasing awareness, patients are demanding more knowledge about forthcoming operations. The patient information accounts for a considerable part of the physician's daily clinical routine. Unfortunately, only a small percentage of the information is understood by the patient after solely verbal elucidation.