Socioeconomic differences in the utilization of diagnostic imaging and non-pharmaceutical conservative therapies for spinal diseases.

Background: A different utilization of health care services due to socioeconomic status on the same health plan contradicts the principle of equal treatment. We investigated the presence and magnitude of socioeconomic differences in utilization of diagnostic imaging and non-pharmaceutical conservative therapies for patients with spinal diseases.

Methods: The cohort study based on routine healthcare data from Germany with 11.

Indication for spinal surgery: associated factors and regional differences in Germany.

Background: Rising surgery rates have raised questions about the indications for spinal surgery. The study investigated patient-level and regional factors associated with spinal surgery for patients with spinal diseases.

Methods: We undertook a cohort study based on routine healthcare data from Germany of 18.

[10-year development of spine surgery in Germany - An analysis of health insurance funds data from 2005 to 2014].

Background: Analysis of the regional development of spine surgery in Germany between 2005 and 2014.

Material And Methods: A secondary data analysis of inpatient data from the Scientific Institute of the AOK (WIdO) was carried out for the period 2005 to 2014. The number of spinal procedures was determined on the basis of 14 defined intervention groups (procedures according to OPS codes).

[Impact of Case Numbers on the 5-Year Survival Rate of Unicondylar Knee Replacements in Germany].

Background: Reported survival rates of unicondylar knee arthroplasty (UKA) vary considerably. The influences of patient characteristics and the type of implant have already been examined. This analysis investigated the influence of hospital volume on 5-year-survival rate, using administrative claims data of Germany's largest health insurance provider.

Are TKAs Performed in High-volume Hospitals Less Likely to Undergo Revision Than TKAs Performed in Low-volume Hospitals?

Background: High-volume hospitals have achieved better outcomes for THAs and unicompartmental knee arthroplasties (UKAs). However, few studies have analyzed implant survival after primary TKA in high-volume centers.

Questions/purposes: Is the risk of revision surgery higher when receiving a TKA in a low-volume hospital than in a high-volume hospital?

Methods: Using nationwide billing data of the largest German healthcare insurer for inpatient hospital treatment, we identified 45,165 TKAs in 44,465 patients insured by Allgemeine Ortskrankenkasse who had undergone knee replacement surgery between January 2012 and December 2012.

Five-Year Survival of 20,946 Unicondylar Knee Replacements and Patient Risk Factors for Failure: An Analysis of German Insurance Data.

Background: Improvements in implant design and surgical technique of unicondylar knee arthroplasty have led to reduced revision rates, but patient selection seems to be crucial for success of such arthroplasties. The purpose of the present study was to analyze the 5-year implant survival rate of unicondylar knee replacements in Germany and to identify patient factors associated with an increased risk of revision, including >30 comorbid conditions.

Methods: Using nationwide billing data of the largest German health-care insurance for inpatient hospital treatment, we identified patients who underwent unicondylar knee arthroplasty between 2006 and 2012.

General ultrasound screening reduces the rate of first operative procedures for developmental dysplasia of the hip: a case-control study.

Objectives: To assess the effectiveness of general ultrasound screening to prevent first operative procedures of the hip.

Study Design: We conducted a case-control study in a population in which general ultrasound screening supplementing clinical screening is recommended and offered free of charge for all children. Participation in ultrasound screening before week 7 as recommended in Germany was the exposure of interest.

Hip centralizing forces of the iliotibial tract within various femoral neck angles.

A contentious issue in the literature is the function and the biomechanical properties of the iliotibial tract. On account of this fact the aim was to take a measurement about the hip centralizing forces of the iliotibial tract by using a custom-made hip prosthesis with adjustable femoral neck angles and lengths in an anatomic model. By increasing the collodiaphyseal (CCD) angle (coxa valga) a higher load of the hip joint results.

Peer teaching: a randomised controlled trial using student-teachers to teach musculoskeletal ultrasound.

Objectives: This study (a post-intervention assessment) was designed to assess the effectiveness of peer-assisted learning (PAL) using student-teachers (STs) with limited training to teach complicated technical skills for interpreting ultrasound images of the shoulder.

Methods: Students in Years 3 and 4 of medical school were randomly assigned to two groups. In the PAL group (PG), teaching was delivered by a group of nine STs from Years 3 and 4, who undertook a 30-minute general training and 1 week of self-teaching.

Intravertebral pressure during vertebroplasty and balloon kyphoplasty: an in vitro study.

Study Design: Intravertebral pressure (IP) measurements were conducted on human cadaveric lumbar spines in a biomechanical study.

Objective: To assess the pressure that is generated in the center of the vertebral body during the cement fill in vertebroplasty (VP) and balloon kyphoplasty (BKP).

Summary Of Background Data: High IP during polymethylmethacrylate (PMMA) injection have frequently been raised as a reason for the higher cement leakage rate during VP in contrast to BKP.

[Surface pretreatment for prolonged survival of cemented tibial prosthesis components: full- vs. surface-cementation technique].

Aseptic loosening of tibial components due to degradation of the interface between bone cement and metallic tibial shaft component is still a persistent problem, particularly for surface-cemented tibial components. The surface cementation technique has important clinical meaning in case of revision and for avoidance of stress shielding. This study was done to prove crack formation in the bone cement near the metallic surface when this is not coated.

Surface pretreatment for prolonged survival of cemented tibial prosthesis components: full- vs. surface-cementation technique.

Background: One of few persisting problems of cemented total knee arthroplasty (TKA) is aseptic loosening of tibial component due to degradation of the interface between bone cement and metallic tibial shaft component, particularly for surface cemented tibial components. Surface cementation technique has important clinical meaning in case of revision and for avoidance of stress shielding. Degradation of the interface between bone cement and bone may be a secondary effect due to excessive crack formation in bone cement starting at the opposite metallic surface.

Bioactivation of inert alumina ceramics by hydroxylation.

Alumina ceramics (Al(2)O(3)) are frequently used for medical implants and prostheses because of the excellent biocompatibility, and the high mechanical reliability of the material. Inauspiciously alumina is not suitable for implant components with bone contact, because the material is bioinert and thereby no bony ongrowth, and subsequently loosening of the implant occurs. Here, we present a new method to bioactivate the surface of the material.

Osteonecrosis 15 years after femoral neck fracture and long-term low-dose inhaled corticosteroid therapy.

Posttraumatic avascular necrosis of the femoral head typically occurs immediately or within a few years after a femoral neck injury, and non-traumatic avascular necrosis is often related to systemic glucocorticoid therapy. We report an unusual case in which avascular necrosis of the femoral head occurred 15 years after a transcervical femoral fracture in a woman with a 20-year history of daily inhaled glucocorticoid therapy for chronic bronchitis. She had not taken glucocorticoids by any other route and had no other risk factors for osteonecrosis.

Effect of ultrasound screening on the rate of first operative procedures for developmental hip dysplasia in Germany.

Background: Ultrasound screening for developmental hip dysplasia and early conservative treatment might prevent later hip operations. A national hip ultrasound-screening programme, undertaken during the first 6 weeks of life, was introduced across Germany in 1996 and was continued for 5 years. We assessed the rate of first operation on the hip during this programme.

Concept and development of an orthotropic FE model of the proximal femur.

Purpose: In contrast to many isotropic finite-element (FE) models of the femur in literature, it was the object of our study to develop an orthotropic FE "model femur" to realistically simulate three-dimensional bone remodelling.

Methods: The three-dimensional geometry of the proximal femur was reconstructed by CT scans of a pair of cadaveric femurs at equal distances of 2mm. These three-dimensional CT models were implemented into an FE simulation tool.