[Treatment of symptomatic end-stage osteoarthritis of the ankle with anterolateral approach and an anatomical plate].

Objective: The aim of this paper is to describe the anterolateral approach using an anatomical plate for ankle arthrodesis and to present the first mid-term results with this technique in a high-risk population.

Indications: The indication for arthrodesis of the ankle joint with this described technique is moderate to severe osteoarthritis of the ankle.

Contraindications: In addition to the general contraindications typical of any operation, there is a specific contraindication in cases of active infection of the soft tissues and accompanying osteomyelitis at the ankle.

A five-year cohort study on German dental students: Self-assessment in regard to previous experience and attitude toward patients with different types of disability.

Aims: In Germany, a curriculum in special care dentistry (SCD) is not mandatory. As a result, very little is known about dental students' attitudes toward interacting with people with disability (PwD). The study´s aim was to assess this among dental students at Witten/Herdecke University (UW/H).

Caries Experience of Adults with Intellectual Disability in the Western Part of Germany.

Background: In Germany, there is limited evidence on the oral health of adults with intellectual disabilities (AwID).

Methods: In 2017/18, dental examinations of AwID and a questionnaire survey of their legal guardians were carried out. The mean D3MFT values were calculated to describe the caries experience.

Reducing Blood Loss in Revision Total Hip and Knee Arthroplasty: Tranexamic Acid Is Effective in Aseptic Revisions and in Second-Stage Reimplantations for Periprosthetic Infection.

Introduction: The aim of the study was to determine the usefulness of tranexamic acid (TXA) in revision total hip arthroplasty (rTHA) and revision total knee arthroplasty (rTKA). We analyzed the perioperative blood loss with and without TXA in aseptic rTHA and rTKA as well as in second-stage reimplantation for hip and knee periprosthetic infection.

Materials And Methods: In this prospective cohort study, 147 patients receiving TXA (96 rTHA, 51 rTKA) were compared to a retrospective cohort of 155 patients without TXA (103 rTHA, 52 rTKA).

Core Decompression and Autologous Bone Marrow Concentrate for Treatment of Femoral Head Osteonecrosis: A Randomized Prospective Study.

The aim of this study was to investigate the safety of injection of bone marrow aspirate concentrate during core decompression and to study its clinical (visual analogue scale; Harris-Hip-score) and radiological outcomes (magnetic resonance imaging). In this prospective and randomized clinical trial we evaluated 24 consecutive patients with non-traumatic femoral head necrosis (FHN) during a period of two years after intervention. In vitro analysis of mesenchymal stem cells was performed by evaluating the fibroblast colony forming units (CFU-Fs).

Modern Radiological Postoperative Diagnostics of the Hip Joint in Children and Adults.

Unlabelled: The assessment of bone healing and loosening of endoprosthesis material was long the primary indication for postoperative projection radiography and CT imaging of the hip joint following trauma and endoprosthesis implantation. With the increasing number of joint-preserving surgery, e. g.

Haematogenous infection of a total knee arthroplasty with Klebsiella pneumoniae.

This case report describes a prosthetic joint infection due to the haematogenous spread of Klebsiella pneumoniae from a genitourinary focus. Prior to the infection, the patient was diagnosed with early stage prostatic carcinoma, which had been successfully treated with surgery. However, in the time period following surgical treatment, the patient suffered recurring urinary tract infections.

The collagen component of biological bone graft substitutes promotes ectopic bone formation by human mesenchymal stem cells.

Synthetic bone substitutes are attractive materials for repairing a variety of bone defects. They are readily available in unlimited quantities, have a defined composition without batch variability and bear no risk of disease transmission. When combined with mesenchymal stem cells (MSCs), bone healing can be further enhanced due to the osteogenic potential of these cells.

Cranial vault remodeling in microcephalic osteodysplastic primordial dwarfism type II and craniosynostosis.

This is a survey of the long-term result after various surgical treatments in a child with microcephalic osteodysplastic primordial dwarfism type II (MOPD II) and craniosynostosis. We report a 17-year-old patient with MOPD II but some unusual clinical signs including bilateral knee dislocation, a misplaced upper lobe bronchus, and hypoplasia of the anterior corpus callosum. Because of premature fusion of several cranial sutures, the child developed signs of increased intracranial pressure with somnolence and papilledema.

Targeting the lateral but not the third ventricle induces bone loss in ewe: an experimental approach to generate an improved large animal model of osteoporosis.

Background: Osteoporosis is a chronic disease characterized by bone loss and increased skeletal fragility. Large animal models are required for preclinical testing of new therapeutic approaches. We have recently demonstrated that continuous intracerebroventricular (ICV) application of leptin into the lateral ventricle (LV) induces bone loss in ewe.

Pinealectomy affects bone mineral density and structure--an experimental study in sheep.

Background: Osteoporosis and associated fractures are a major public health burden and there is great need for a large animal model. Melatonin, the hormone of the pineal gland, has been shown to influence bone metabolism. This study aims to evaluate whether absence of melatonin due to pinealectomy affects the bone mass, structure and remodeling in an ovine animal model.

Prediction of in vivo bone forming potency of bone marrow-derived human mesenchymal stem cells.

Human mesenchymal stem cells (MSC) have attracted much attention for tissue regeneration including repair of non-healing bone defects. Heterogeneity of MSC cultures and considerable donor variability however, still preclude standardised production of MSC and point on functional deficits for some human MSC populations. We aimed to identify functional correlates of donor-dependency of bone formation in order to develop a potency assay predicting the therapeutic capacity of human MSC before clinical transplantation.

[Symptomatic bilateral soft tissue tumor of the breast wall].

A 54-year-old woman presented with progressive swelling of the right scapula as well as motion-dependent pain. The medical history revealed a polyglandular autoimmune syndrome and lumbar disc degeneration. The magnetic resonance imaging (MRI) scan showed a bilateral well-defined muscle isointense space-occupying lesion situated between the scapula, rib cage and thoracic muscles with homogeneous contrast enhancement.

Interobserver reliability of radiographic measurements of contralateral feet of pediatric patients with unilateral clubfoot.

Background: Radiographs have traditionally been used to describe and quantify foot deformities in infants and children. We hypothesized that the interobserver reliability of measurements obtained from radiographs of pediatric feet would be low, especially with regard to the infant foot, and that normal ranges and standard deviations would decrease in association with increasing patient age.

Methods: We retrospectively reviewed 494 radiographs of 121 patients treated for unilateral clubfoot at our institution and studied the contralateral normal foot.

Mechanical stability in a human radius fracture treated with a novel tissue-engineered bone substitute: a non-invasive, longitudinal assessment using high-resolution pQCT in combination with finite element analysis.

The clinical gold standard in orthopaedics for treating fractures with large bone defects is still the use of autologous, cancellous bone autografts. While this material provides a strong healing response, the use of autografts is often associated with additional morbidity. Therefore, there is a demand for off-the-shelf biomaterials that perform similar to autografts.

Influence of defective bone marrow osteogenesis on fracture repair in an experimental model of senile osteoporosis.

Bone marrow osteogenesis in senile osteoporotic bone is impaired and, as such, may have significant implications on the successful outcome of fracture repair. Here we utilize a well-established murine model of senile osteoporosis, the P6 strain of senescence-accelerated mice (SAMP6), to investigate fracture healing in aged osteoporotic bone. A femoral osteotomy was created in SAMP6 and in non-osteoporotic age-matched control R1 senescence-resistant mice (SAMR1).

Autologous capping during resection arthroplasty of the hip in patients with cerebral palsy.

In patients with severe quadriplegic cerebral palsy and painful hip dislocation proximal femoral resection arthroplasty can reduce pain, but the risk of heterotopic ossification is significant. We present a surgical technique of autologous capping of the femoral stump in order to reduce this risk, using the resected femoral head as the graft. A retrospective study of 31 patients (43 hips) who had undergone proximal femoral resection arthroplasty with (29 hips) and without autologous capping (14 hips) was undertaken.

Calcification or dedifferentiation: requirement to lock mesenchymal stem cells in a desired differentiation stage.

A current challenge in mesenchymal stem cell (MSC)-based cartilage repair is to solve donor and tissue-dependent variability of MSC cultures and to prevent chondrogenic cells from terminal differentiation like in the growth plate. The aim of this study was to select the best source for MSC which could promise stable cartilage formation in the absence of hypertrophy and ectopic in vivo mineralization. We hypothesized that MSC from synovium are superior to bone marrow- and adipose tissue-derived MSC since they are derived from a joint tissue.

Instant stem cell therapy: characterization and concentration of human mesenchymal stem cells in vitro.

In regenerative medicine, there is an approach to avoid expansion of the mesenchymal stem cell (MSC) before implantation. The aim of this study was to compare methods for instant MSC therapy by use of a portable, automatic and closed system centrifuge that allows for the concentration of MSCs. The main outcome measures were the amount of MSCs per millilitre of bone marrow (BM), clusters of differentiation (CD), proliferation and differentiation capacities of the MSC.

A sheep model for fracture treatment in osteoporosis: benefits of the model versus animal welfare.

Animal models are necessary to evaluate new options for the treatment of fractures in osteoporotic bone. They permit both the biological response of a living system and the influence of the pathological processes to be taken into account. A sheep model for osteoporosis was established by combining oestrogen deficiency, calcium and vitamin D-deficient diet with steroid medication.

Myoelectric hand prostheses in very young children.

Myoelectric prostheses have generally been provided for adolescent or adult patients. The availability of smaller-sized electric hands has enabled the introduction of myoelectric prostheses to preschool children, mainly in the Scandinavian countries. This study evaluates the acceptance of myoelectric prostheses in 41 children with unilateral upper limb deficiency between the ages of two and five years.

Ectopic expression of delta FBJ murine osteosarcoma viral oncogene homolog B mediates transdifferentiation of adipose-like spheroids into osteo-like microtissues.

Differentiation and transdifferentiation strategies have a large role in the manipulation of cells in replacing dysfunctional cells and tissues. We developed adipose-like microtissues using gravity-enforced self-assembly of monodispersed human primary preadipocytes to determine their transdifferentiation capacity to form bone-like tissues. Using lentivirus-derived particles to induce ectopic bone morphogenetic protein (BMP)-2 and delta FBJ murine osteosarcoma viral oncogene homolog B (DeltaFosB) gene expression, we demonstrated a time-dependent induction of osteoblast-specific genes and properties such as calcium deposits, bone-like extracellular matrix (ECM), and matrix mineralization.

Delayed administration of adenoviral BMP-2 vector improves the formation of bone in osseous defects.

The direct, local, administration of adenovirus carrying human BMP-2 cDNA (Ad.BMP-2) heals critical-sized femoral bone defects in rabbit and rat models. However, the outcome is suboptimal and the technology needs to provide a more reliable and uniform outcome.