First Experiences with Fusion of PET-CT and MRI Datasets for Navigation-Assisted Percutaneous Biopsies for Primary and Metastatic Bone Tumors.

The aim of this study was to compare the technique of navigation-assisted biopsy based on fused PET and MRI datasets to CT-guided biopsies in terms of the duration of the procedure, radiation dose, complication rate, and accuracy of the biopsy, particularly in anatomically complex regions. Between 2019 and 2022, retrospectively collected data included all navigated biopsies and CT-guided biopsies of suspected primary bone tumors or solitary metastases. Navigation was based on preoperative CT, PET-CT/-MRI, and MRI datasets, and tumor biopsies were performed using intraoperative 3D imaging combined with a navigation system.

Minimally invasive balloon-reduction of acute Hill-Sachs-lesions and impression fractures after shoulder dislocation - an experimental approach.

Background: The shoulder is the joint most often affected by dislocations. It is known that bony defects of the glenoid and/or humerus can lead to recurrent dislocations even after arthroscopic shoulder stabilization. To prevent recurrent instability, it appears reasonable to reduce fresh and larger Hill-Sachs lesions (off-track lesions).

Evaluation of a Digital Decision Aid for Knee Replacement Surgery.

Background: We studied whether an individualized digital decision aid can improve decision-making quality for or against knee arthroplasty.

Methods: An app-based decision aid (EKIT tool) was developed and studied in a stepped-wedge, cluster-randomized trial. Consecutive patients with knee osteoarthritis who were candidates for knee replacement were included in 10 centers in Germany.

Wide-range resistivity characterization of semiconductors with terahertz time-domain spectroscopy.

Resistivity is one of the most important characteristics in the semiconductor industry. The most common way to measure resistivity is the four-point probe method, which requires physical contact with the material under test. Terahertz time domain spectroscopy, a fast and non-destructive measurement method, is already well established in the characterization of dielectrics.

Early functional improvements using continuous passive motion therapy after angular-stable plate osteosynthesis of proximal humerus fractures - results of a prospective, randomized trial.

Background: The use of continuous passive motion therapy (CPM) has led to promising results in the early phase of rehabilitation after surgical treatment of rotator cuff tears and arthrolysis of the elbow. However, its use has not been proven in other pathologies of the upper extremity. Therefore, the aim of the underlying study was to evaluate the use of CPM therapy after plate osteosynthesis of proximal humeral fractures.

Patients risk for mortality at 90 days after proximal femur fracture - a retrospective study in a tertiary care hospital.

Background: Despite improving the management of proximal femur fractures (PFF) with legal requirements of timing the surgery within 24 h, mortality rates in these patients remain still high. The objective of our study was to analyze potential cofactors which might influence the mortality rate within 90 days after surgery in PFF to avoid adverse events, loss of quality of life and high rates of mortality.

Methods: In this retrospective, single-center study all patients with PFF aged 65 years and older were included.

No difference in patient reported outcome and inflammatory response after coated and uncoated total knee arthroplasty - a randomized controlled study.

Background: Allergies against implant materials are still not fully understood. Despite controversies about its relevance, some patients need treatment with hypoallergenic implants. This study compared coated and standard total knee arthroplasty (TKA) regarding inflammatory response and patient-reported outcome measures (PROMs).

Influence of bone density on stability in TBW.

Osteoporosis is a common disease that leads to a reduction in bone density and increases the risk of fractures. Stable surgical treatment is particularly important for these fractures. The aim of this study was to examine the influence of bone density in the area of ​​the proximal ulna on the failure of the fixation technique of K-wires in tension band wiring (TBW).

Better Flexion but Unaffected Satisfaction After Treatment With Posterior Stabilized Versus Cruciate Retaining Total Knee Arthroplasty - 2-year Results of a Prospective, Randomized Trial.

Background: Both the cruciate-retaining (CR) and posterior-stabilized (PS) implant systems are commonplace in modern total knee arthroplasty (TKA) practice. However, there is controversy regarding functional outcomes and survivorship. The aim of the underlying study was to evaluate differences between CR and PS TKA regarding knee function, patient-reported outcome measures (PROMs) as well as complication rates.

Fulfilment of patients' mandatory expectations are crucial for satisfaction: a study amongst 352 patients after total knee arthroplasty (TKA).

Purpose: Patient satisfaction with the results of their total knee arthroplasty (TKA) is one of the primary goals of this elective procedure. Furthermore, the association between the fulfilment of patients' expectations and their satisfaction is well known. The aim of this study was to identify the key expectations of patients awaiting a TKA, evaluate their fulfilment, and compare the outcomes between very and not fully satisfied patients.

Acquired Factor XIII Deficiency in Patients with Multiple Trauma.

Introduction: Fibrin stabilizing factor (FXIII) plays a crucial role in blood clotting, tissue repair, and immune defense. FXIII deficiency after trauma can lead to prolonged wound healing due to persistent infections or coagulation disorders. The aim of this study was to describe the prevalence of acquired FXIII deficiency after trauma and to provide a description of the time-course changes of important coagulation parameters in relation to FXIII activity.

Ankle fractures involving the anterolateral distal tibia: medium-term clinical results of 50 cases.

Purpose: The anterolateral distal tibial rim (anterior malleolus, AM) is frequently fractured in malleolar fractures. The aim of this study was to evaluate the medium-term outcomes of malleolar fractures involving the AM.

Methods: Among 100 patients with AM fractures that were treated over a 10-year period, 50 patients were available for follow-up.

Does the use of patient-specific instrumentation improve resource use in the operating room and outcome after total knee arthroplasty?-A multicenter study.

Patient-specific instrumentation (PSI) in total knee arthroplasty (TKA) has been introduced to reduce instruments and surgical time and to improve implant alignment. The aim of this study was to compare TKA with patient-specific and conventional instrumentation with regard to the use of resources in the operating room (OR), alignment and patient-reported outcome. A total of 139 TKA with PSI or conventional instrumentation were included in three centers.

Total knee arthroplasty in post-traumatic osteoarthritis is more challenging, but results in similar patient satisfaction - An analysis of 1646 cases.

Background: Patients with post-traumatic osteoarthritis (PTOA) present a variety of technical challenges to surgeons. Surgical parameters, complication rates and patient-reported outcomes (PROs) have been reported as detrimental in total knee arthroplasty (TKA) for PTOA. The purpose of this study was to compare these variables and satisfaction with the results of TKA in patients with post-traumatic osteoarthritis with a matched-pair cohort of primary osteoarthritis (POA).

A Novel Multilayer-Coating for Total Knee Arthroplasty Implants is Safe - 10-Year Results From a Randomized-Controlled Trial.

Background: This randomized-controlled trial was initiated to compare a new multilayer hypoallergenic coating system with the standard implant in total knee arthroplasty (TKA) in terms of serum metal ion levels, patient-reported outcomes (PROs), and implant survival.

Methods: A total of 120 patients were randomized to receive a coated or standard TKA of the same knee system. Serum metal ion levels (ie, cobalt, chromium, molybdenum, and nickel) as well as knee function (Oxford Knee Score, OKS), quality of life (SF-36), and physical activity (UCLA activity scale) were assessed before surgery and until the 10 year follow-up.

Complications following surgical treatment of posterior malleolar fractures: an analysis of 300 cases.

Aims: The treatment of ankle fractures and fracture-dislocations involving the posterior malleolus (PM) has undergone considerable changes over the past decade. The aim of our study was to identify risk factors related to the occurrence of complications in surgically treated ankle fractures with PM involvement.

Patients And Methods: We retrospectively analyzed 300 patients at a mean age of 57 years with 300 ankle fractures involving the PM treated surgically at our institution over a 12-year period.

Monteggia fractures: analysis of patient-reported outcome measurements in correlation with ulnar fracture localization.

Background: Monteggia fractures and Monteggia-like lesions result after severe trauma and have high complication rates. Preliminary biomechanical studies suggested a correlation between ulnar fracture localization and clinical result.

Objectives: Key objective was to evaluate whether the site of the ulnar fracture can be correlated to clinical outcome after open reduction and internal stabilization.

Increased inflammatory response is associated with less favorable functional results 5 years after total knee arthroplasty.

Purpose: Allergy against implant materials is discussed controversially and still not fully understood. Despite these controversies, a relevant number of patients receive hypoallergenic knee implants. The aim of this study was to compare a new coating system with the standard implant in total knee arthroplasty (TKA).

[The use of knee prostheses with a hypoallergenic coating is safe in the medium term : A randomized controlled study].

Background: In Germany, patients with contact allergy to implant components usually receive coated joint arthroplasties. Whether the treatment using these hypoallergenic implants achieves comparable results to standard treatment with implants consisting of cobalt-chromium alloy (CoCr) implants is controversially discussed internationally and has rarely been investigated in the mid-term.

Objectives: Are there differences in blood metal ion concentrations, knee function, and patient-reported outcomes (PROM) between coated and standard implants?

Material And Methods: 118 patients were randomized to receive either a coated or a standard implant.

An individualized decision aid for physicians and patients for total knee replacement in osteoarthritis (Value-based TKR study): study protocol for a multi-center, stepped wedge, cluster randomized controlled trial.

Background: Total knee replacement (TKR) is one of the most commonly performed routine procedures in the world. Prognostic studies indicate that the number of TKR will further increase constituting growing burden on healthcare systems. There is also substantial regional heterogeneity in TKR rates within and between countries.

Similar outcomes in computer-assisted and conventional total knee arthroplasty: ten-year results of a prospective randomized study.

Background: Computer-assisted navigation (CAS) was developed to improve the surgical accuracy and precision. Many studies demonstrated better alignment in the coronal plane in CAS TKA compared to conventional technique. The influence on the functional outcome is still unclear.

[Are the results of total knee arthroplasty after high tibial osteotomy worse?].

Background: In some cases, total knee arthroplasty (TKA) following high tibial osteotomy (HTO) is necessary. HTO can adversely affect anatomy and alignment resulting in more complicated and challenging TKA surgery. The aim of this study was to investigate whether patients having undergone HTO benefit from TKA to the same extent as patients with primary osteoarthritis of the knee.

Ultracongruent insert design is a safe alternative to posterior cruciate-substituting total knee arthroplasty: 5-year results of a randomized controlled trial.

Purpose: If substitution of the posterior cruciate ligament in total knee arthroplasty is necessary, there are two options available: posterior stabilized (PS) design with a post-cam mechanism or anterior-lipped ultracongruent (UC) inserts. UC inserts have the advantage that no femoral box is necessary and a standard femoral component can be used. The aim of this study was to compare the range of motion (ROM) and patient-reported outcome (PRO) after UC and PS fixed-bearing TKA.

Better short-term function after unicompartmental compared to total knee arthroplasty.

Background: Unicompartmental knee arthroplasty (UKA) is an established treatment option for patients with unicompartmental osteoarthritis (OA). However, strict patient selection is crucial for its success. The proposed advantages include nearly natural knee kinematics, faster rehabilitation and better functional outcomes.