Effects of electrical stimulation with alternating fields on the osseointegration of titanium implants in the rabbit tibia - a pilot study.

Electrical stimulation has been used as a promising approach in bone repair for several decades. However, the therapeutic use is hampered by inconsistent results due to a lack of standardized application protocols. Recently, electrical stimulation has been considered for the improvement of the osseointegration of dental and endoprosthetic implants.

Invasive electrical stimulation in the treatment of avascular osteonecrosis of the femoral head - mid-term results.

The study aimed to evaluate the outcomes of osteonecrosis of the femoral head (ONFH) in adults after surgical treatment including invasive electromagnetic osteostimulation (E-Stim). Further, the influence of disease stage and several comorbidities on the joint preservation rate should be examined. Sixty patients (66 hip joints) with ONFH were included in this retrospective cross-sectional analysis (mean follow-up: 58 months, 19-110 months).

Net Promoter Score: a prospective, single-centre observational study assessing if a single question determined treatment success after primary or revision hip arthroplasty.

Background: Our study aimed to identify the relationship between treatment outcome assessed by patient-reported outcomes (PROMs) and satisfaction measured by calculation of the Net Promoter Score (NPS), which identifies promoters, following total hip arthroplasty (THA). The aim was to evaluate this association separately in primary and revision THA and to determine thresholds based on PROMs that identify detractors of the surgical procedure or the centre.

Methods: A total of 1,243 patients who underwent primary or revision THA at our hospital were asked to complete questionnaires of the Oxford Hip Score (OHS), Euroquol-5D (EQ-5D) and information on pain intensity preoperatively, three and 12 months after surgery.

Identification of Potentially High-risk Patients on the Basis of PROMs in a Certified Centre for Joint Replacement (EndoProthetikZentrum) Using the Example of Primary Knee Arthroplasty.

Background: The subjective evaluation of the patient's state of health with the help of Patient-reported Outcome Measurements (PROMs) provides valuable information for assessing the treatment outcome and for treatment planning. However, the use of PROMs in the field of arthroplasty is not mandatory, so that there is a lack of standardised recording and interpretation. The present study aims to identify patients, who have not achieved the intended treatment goals with regard to pain, function and quality of life after total knee arthroplasty, more easily in the future on the basis of postoperative PROMs.

[Individual megaspacers in two-stage revision of infected total hip arthroplasty-clinical and functional results after 2 years : Individual metal-endoskeleton cement spacer (iMECS)].

Background: Large femoral defects in late periprosthetic infection (PPI) after total hip arthroplasty (THA) often require the use of large, individual metal endoskeleton-reinforced cement spacers (iMECS).

Objectives: The aim was to record the clinical, radiological and functional results (Harris Hip Score HHS) up to the 2 years after treatment of a PPI using an iMECS. Major patient-specific parameters were to be evaluated with regard to the treatment outcome.

Periprosthetic Fungal Infections in Severe Endoprosthetic Infections of the Hip and Knee Joint-A Retrospective Analysis of a Certified Arthroplasty Centre of Excellence.

The treatment of periprosthetic joint infections (PJI), and especially of re-infections, poses a highly complex problem in orthopaedic surgery. While fungal infections are rare, they present a special challenge. The therapy is often protracted and based on limited evidence.

Identification of Potential High-Risk Patients on the Basis of PROMs in a Certified Centre for Joint Replacement (EndoProthetikZentrum) Using the Example of Hip Arthroplasty.

Background: In addition to clinical parameters, the subjective assessment by the patient to evaluate the operative outcome of an arthroplasty is becoming increasingly important. Questionnaires are used to identify patients who have not achieved the treatment goal at an early stage so that further interventions can be indicated.

Material And Methods: A questionnaire consisting of different PROMs was completed pre- and 3 months postoperatively by patients who had been treated with a hip arthroplasty.

[Total knee arthroplasty in the young patient-an update].

The absolute number of total knee arthroplasties (TKA) continues to rise every year. About 10% of the patients are less than 55 years of age, although it is known that functional results and patient satisfaction are lower combined with an increased likelihood of revision compared to older patients. Higher physical activity and patient expectations are a major challenge in this age group.

[Management of suspected early infection after osteosynthesis].

The infection rate after fracture osteosynthesis depends on many factors. The postoperative infection rate after osteosynthesis (inpatient treatment) was between 1.15% and 2.

Micromotion and subsidence of a cementless conical fluted stem depending on femoral defect size - A human cadaveric study.

Background: Cementless modular endoprostheses with tapered fluted stems cover a wide spectrum of femoral defects in reconstructive surgery of the hip. Nevertheless, for these hip stems the recommendations concerning the minimum diaphyseal anchorage distance differ widely. The present experimental study investigated the primary stability of a conical fluted revision stem depending on different types of femoral bone defects.

[Is the unlimited use of surgical instruments safe? : Discussion using the example of endoprosthetics].

As medical devices surgical instruments are important components when performing surgery. They can significantly influence the course and outcome of the surgery. Instruments are mechanically stressed in daily use and resterilized multiple times.

[Medical device training in arthroplasty : National practice and quality standards].

The qualified training of users of medicinal products is enshrined in law by the Medical Devices Act. In this article, a survey and analysis of the training measures for arthroplasty of the large joints offered by distributors of medical devices is carried out. To that end, the internet presence of suppliers of medical devices was evaluated with regard to the training measures on offer, and selected suppliers were sent questionnaires.

Primary stability of a cementless modular revision hip stem in relation with the femoral defect size: A biomechanical study.

Purpose: Cementless modular fluted hip stems are commonly used in revision arthroplasty. Nevertheless, there is a wide spectrum of recommendations concerning the minimum bone stock required to enable osseous ingrowth and implant-bone micromotions <100 µm. This experimental study investigated the primary stability of a tapered cementless fluted revision stem depending on different types of bone defects.

Antibiotics release from cement spacers used for two-stage treatment of implant-associated infections after total joint arthroplasty.

Two-stage revision arthroplasty is the treatment of choice for periprosthetic infection, a serious complication after knee or hip arthroplasty. Our prospective clinical trial aimed to investigate the concentrations of gentamicin and vancomycin in wound exudate and tissue in two-stage revision arthroplasty. Wound exudate and periprosthetic membrane samples were collected from 18 patients (10 hip and eight knee patients), who were due for two-stage treatment after a periprosthetic joint infection.

[What do orthopedic and trauma surgeons expect from radiologists when interpreting imaging of the elbow?].

Clinical Issue: The elbow is a complex joint with a multitude of acute and chronic pathologies. In addition to the clinical examination, radiological diagnostics play a decisive role in the further therapeutic management.

Diagnostic Work-up/performance: While acute traumatic injuries often present with obvious structural changes and the need for rapid treatment decisions, chronic processes can present with less evident alterations.

Association of joint replacement surgery with incident dementia diagnosis in German claims data.

Unlabelled: ABSTRACTBackground:Cognitive decline is an important complication of joint replacement surgeries in senior people.

Methods: We determined incidence rates of dementia diagnosis following endoprosthetic joint replacement surgery (upper and lower extremities). The observation period covered up to 28 quarters using German claims data comprising 154,604 cases 65 years and older.

Predictors of colonization with Staphylococcus species among patients scheduled for cardiac and orthopedic interventions at tertiary care hospitals in north-eastern Germany-a prevalence screening study.

As methicillin-resistant Staphylococcus aureus (MRSA) colonization and infection in humans are a global challenge. In Mecklenburg and Western Pomerania (Germany) 1,517 patients who underwent surgical interventions were systematically screened for MRSA and MSSA colonization on the day of hospital admission and discharge. Demographic data, risk factors and colonization status of the (i) nose, (ii) throat, (iii) groin, and (iv) thorax or site of surgical intervention were determined.

Experimental analysis of insertion torques and forces of threaded and press-fit acetabular cups by means of ex vivo and in vivo measurements.

Purpose: In THA a sufficient primary implant stability is the precondition for successful secondary stability. Industrial foams of different densities have been used for primary stability investigations. The aim of this study was to analyse and compare the insertion behaviour of threaded and press-fit cups in vivo and ex vivo using bone substitutes with various densities.

[Injuries in Karate Sports: A Survey Performed During the World Championship 2014].

In literature, the competitive sport of modern karate is almost always characterised as a combat sport involving injuries caused by impact effects and physical contact with opponents. There is a lack of data regarding the outcome after karate injuries, specifically with a view to the contact-free Kata karate. Performing a random test using a questionnaire, we collected data concerning regular medical treatment, prior surgeries of the locomotor system, and medical care.

Patient-specific factors influencing the traction forces in hip arthroscopy.

Introduction: The application of traction in hip arthroscopy is associated with peri-operative complications. Within a therapeutic case series, patient-related factors correlating with high-traction forces during hip arthroscopy and occurring complications should be identified.

Materials And Methods: In 30 male and 38 female patients (mean age: 44.

Prospective comparative clinical study of ceramic and metallic femoral components for total knee arthroplasty over a five-year follow-up period.

Background: The aim of this prospective comparative study was to evaluate the clinical and radiological outcomes of a TKA system, comparing a ceramic (BIOLOX® delta) and metallic (Co28Cr6Mo) femoral component over a five-year follow-up period.

Methods: Forty-three TKA patients (17 metallic and 26 ceramic femoral components) were enrolled in the study. Clinical and radiological evaluations were performed preoperatively and at three, 12, 24 and 60months postoperatively, using the HSS-, WOMAC- and SF36-Scores, in addition to standardized X-rays.

Press-fit versus threaded acetabular cups in total hip arthroplasty: Functional and radiological results after five years.

Prospectively the outcome after total hip replacement with a new threaded acetabular cup design was compared to an established press-fit cup. After 1, 2 and 5 years, the 36-item Short Form Health Survey, Western Ontario and McMaster University Osteoarthritis Index and Harris Hip Score revealed no significant differences between the two groups (each group: n=42 patients), except for a higher Harris Hip Score in the threaded cup group after five years (p=0.02).

Coexistent lumbar spine disorders have a crucial impact on the clinical outcome after total hip replacement.

Background: Degenerative hip and spine disease are known to frequently coexist. Lumbar spine disorders (LSDs), as opposed to other patient-related factors, are disregarded in the assessment of the clinical outcome after total hip replacement (THR). This prospective study investigates the influence of LSDs on the pre- and postoperative health-related quality of life and functional outcome of patients undergoing THR.