[Digital tools in primary total knee arthroplasty-Prevalence in the German-speaking region].

Background: Digital tools are being increasingly used worldwide in primary knee arthroplasty. This study aimed to analyze the utilization density of digital tools, the preferred alignment strategies, and the obstacles and benefits of implementing these technologies in German-speaking countries.

Materials And Methods: An online survey with 57 questions about digital tools in primary knee arthroplasty and their usage was conducted among members of the Arthroplasty Working Group (AE).

Survival of Patient-Specific Unicondylar Knee Replacement.

Unicompartmental knee arthroplasty (UKA) in isolated medial or lateral osteoarthritis leads to good clinical results. However, revision rates are higher in comparison to total knee arthroplasty (TKA). One reason is suboptimal fitting of conventional off-the-shelf prostheses, and major overhang of the tibial component over the bone has been reported in up to 20% of cases.

[Treatment options for femoroacetabular impingement syndrome and osteoarthritis].

Femoroacetabular impingement syndrome (FAIS) is a prearthritic deformity. Many patients with FAIS show signs of osteoarthritis at the time of initial presentation. Ideally, surgical correction of FAIS should stop the progression of osteoarthritis.

Stimulation of human bone marrow mesenchymal stem cells by electromagnetic transduction therapy - EMTT.

Many different pulsed electromagnetic field (PEMF) devises have been clinically used to stimulate healing processes, but many procedures are still without supporting basic research data. The aim of this study was to investigate a new modified pulsed electromagnetic field therapy: electromagnetic transduction therapy (EMTT). EMTT is technically based on high-intensive PEMFs with a magnetic field strength between 80 and 150 mT.

[Surgical treatment of femoroacetabular impingement syndrome : Arthroscopy-mini-open-surgical hip dislocation].

Background: Femoroacetabular impingement syndrome (FAIS) is one of the most common prearthritic hip deformities. Since FAIS is a mechanical pathology, surgical correction of the underlying deformity is the sole causal treatment. If surgery is indicated, a surgical technique that results in complete deformity correction with least morbidity should be selected.

[Stress fractures of the lower limbs].

Stress reactions and fractures represent an important differential diagnostic entity, especially in patients active in sports. The lower extremities have predilection sites for stress fractures, which require special treatment in the context of the underlying risk factors. Clinically, patients usually complain of stress-dependent pain in the affected region and sport activities are mostly limited or even impossible.

Kinematic alignment in total knee arthroplasty.

Objective: The objective of kinematic alignment in total knee arthroplasty is to implant the prosthesis according to the individual joint line, leg axis and ligament tension.

Indications: Knee osteoarthritis with failure of nonsurgical treatment according to current guidelines.

Contraindications: Severe deformity or instability requiring a constrained knee prosthesis.

[Avulsion injuries of the gluteus medius and gluteus minimus muscles].

Avulsion injuries of the gluteus medius and gluteus minimus muscles represent a diagnostic and therapeutic challenge. Such injuries are rarely to be expected in high-energy trauma. Degenerative damage or iatrogenic injuries in the context of hip surgery are more frequently identified as the cause.

Arthroplasty of the Knee: Current Techniques for Implant Alignment.

When a total knee arthroplasty (TKA) is implanted using the traditional mechanical alignment technique, this typically results in a straight leg, independently of pre-operative or even pre-arthrotic varus or valgus alignment. With mechanical alignment, we distinguish between 2 different alignment techniques: ligament balancing and bony referencing according to bony skeletal landmarks. In ligament balanced technique beside the straight mechanical axis, the prosthesis is implanted at 90° to the latter.

Antimicrobial peptides in human synovial membrane as (low-grade) periprosthetic joint infection biomarkers.

Background: Safe diagnosis of periprosthetic joint infection (PJI) is of utmost importance for successful exchange arthroplasty. However, current diagnostic tools show insufficient accuracy in the clinically common and challenging chronic low-grade infections. To close this diagnostic gap, reliable (bio)markers display the most promising candidates.

[Gluteal insufficiency].

Gluteal insufficiency or hip abductor mechanism deficiency mainly following (revision) total hip replacement is associated with highly painful complaints and severe suffering of patients. It represents a great diagnostic and therapeutic challenge. Differentiated conservative treatment pathways, open surgical and endoscopic anatomic repair techniques with intact gluteal musculature and muscle transfer are available as salvage procedures for chronic not anatomically reconstructable mass ruptures.

[Diagnostic algorithm "FAI and sports hernia" : Results of the consensus meeting for groin pain in athletes].

As a result of the complexity and diversity of diseases in the region of the groin, differentiation of the various soft-tissue and bone pathologies remains a challenge for differential diagnosis in routine clinical practice. In the case of athletes with pain localized in the area of the groin, femoroacetabular impingement (FAI) and athlete's groin must be considered as important causes of the groin pain, whereby the common occurrence of double pathologies further complicates diagnosis. Despite the importance of groin pain and its differential diagnoses in everyday clinical practice, there has been a lack of recognized recommendations for diagnostic procedure to date.

Autologous Chondrocyte Transplantation in Femoroacetabular Impingement Syndrome: Growth and Redifferentiation Potential of Chondrocytes Harvested from the Femur in Cam-Type Deformities.

Objective: Cam-type femoroacetabular impingement (FAI) syndrome is one of the most frequent reasons for cartilage damage in the hip. Autologous chondrocyte transplantation has proven high success rates in the treatment of focal chondral defects; however, harvesting of chondrocytes in the hip has been reported but not specifically from the region of femoral cam lesions. Therefore, the goal of this study was to analyze the growth and redifferentiation potential of cartilage samples harvested from the cam deformities in patients with FAI.

[Surgical refixation of gluteal tendon tears by mini-open double-row technique].

Objective: Stable refixation of gluteal tendons at the anatomic footprint by large-area contact by the means of knotless double-row anchor fixation (HipBridge technique).

Indications: Symptomatic tear of gluteus medius and/or gluteus minimus tendon with persisting pain after nonsurgical treatment, or primarily reconstructable mass rupture with gluteal insufficiency, revision surgeries.

Contraindications: Primary nonreconstructable mass ruptures, atrophic or fatty degeneration of gluteal muscles grade Goutallier 4, local infections.

Electromagnetic transduction therapy and shockwave therapy in 86 patients with rotator cuff tendinopathy: A prospective randomized controlled trial.

Rotator cuff (RC) tendinopathy is the most common cause of shoulder pain. The effectiveness of electromagnetic transduction therapy (EMTT), a high energetic pulsed electromagnetic field therapy in this field has not been tested yet in combination with extracorporeal shock wave therapy (ESWT). A total of 86 patients with RC tendinopathy were randomized to undergo three sessions of ESWT in combination with 8 sessions of EMTT or sham-EMTT.

[The minimally invasive AMIS technique for total hip replacement : Video article].

Objective Of The Surgery: Minimally-invasive implantation of a total hip arthroplasty without damage to or incision of muscles.

Indications: Osteoarthritis, femoral neck fracture, general indications for total hip arthroplasty.

Contraindications: Contraindications for hip arthroplasty.

The natural alpha angle of the femoral head-neck junction: a cross-sectional CT study in 1312 femurs.

Aims: Asphericity of the femoral head-neck junction is common in cam-type femoroacetabular impingement (FAI) and usually quantified using the alpha angle on radiographs or MRI. The aim of this study was to determine the natural alpha angle in a large cohort of patients by continuous circumferential analysis with CT.

Methods: CT scans of 1312 femurs of 656 patients were analyzed in this cross-sectional study.

[Surgical therapy of ischiofemoral impingement by lateralizing intertrochanteric osteotomy].

Objective: Lateralizing, derotating intertrochanteric varus osteotomy to increase the ischiofemoral space to counter painful impingement of the lesser trochanter and the os ischium with resulting entrapment of quadratus femoris muscle.

Indications: Symptomatic ischiofemoral impingement (IFI) caused by Coxa valga et antetorta, Coxa valga or Coxa antetorta, or a short femoral neck.

Contraindications: Anatomic configuration suggestive of IFI in asymptomatic patients.

A biocompatible sol-gel derived titania coating for medical implants with antibacterial modification by copper integration.

Implant-associated infections are dangerous complications and may cause dramatic illness with hematogeneous spread of bacteria and secondary infections. Since treatment of these infections remains most challenging and commonly requires implant removal, prevention is of utmost importance. In the present work a titania-sol was equipped with a copper salt resulting after calcination in a titania coating (TiO) with antibacterial properties combined with good cytocompatibility.

How to address ischiofemoral impingement? Treatment algorithm and review of the literature.

Ischiofemoral impingement (IFI) is a rare cause of hip pain defined by a narrowing of the space between the lateral aspect of the os ischium and the lesser trochanter of the femur. Several underlying anatomic, functional and iatrogenic pathologies have been identified for symptomatic IFI in native hip joints and after total hip arthroplasty. Clinical symptoms vary but most commonly consist of pain of the lower buttock and groin including the inner thigh, and a snapping or clunking phenomenon is often reported.

[Biologic Reconstruction of Full Sized Cartilage Defects of the Hip: A Guideline from the DGOU Group "Clinical Tissue Regeneration" and the Hip Committee of the AGA].

Symptomatic pre-arthritic deformities such as femoroacetabular impingement (FAI) or hip dysplasia often lead to localised cartilage defects and subsequently to osteoarthritis. The present review of the working group "Clinical Tissue Regeneration" of the German Society of Orthopaedics and Trauma (DGOU) and the hip committee of the AGA (German speaking Society for Arthroscopy and Joint Surgery) provides an overview of current knowledge of the diagnosis and surgical treatment of cartilage defects, in order to infer appropriate therapy recommendations for the hip. Review of FAI and resultant cartilage damage in the hip as reported in published study findings in the literature and discussion of the advantages and disadvantages of different surgical procedures to preserve the joint.

Electromagnetic transduction therapy in non-specific low back pain: A prospective randomised controlled trial.

Objectives: A prospective randomised controlled trial to investigate the efficacy of electromagnetic transduction therapy (EMTT) for treatment of patients with non-specific low back pain.

Design: Two groups with non-specific low back pain were either treated with conventional therapy alone over 6 weeks or in combination with 8 sessions of EMTT.

Results: In both intervention groups the low back pain related pain and the degree of disability decreased significantly at follow-up visits.

Randomized Placebo-Controlled Placebo Trial to Determine the Placebo Effect Size.

Background: It is the gold standard to use a placebo treatment as the control group in prospective randomized controlled trials (RCTs). Although placebo-controlled trials can reveal an effect of an active treatment, the pure effect of a placebo treatment alone has never been presented or evaluated. No evidence-based, placebo-therapeutic options are currently available, and no placebo-controlled trials have been performed to elucidate the pure placebo effect.