Five years' trajectories of functionality and pain in patients after hip or knee replacement and association with long-term patient survival.

To describe the 5 years' trajectories in functionality and pain of patients with hip or knee osteoarthritis and arthroplasty and analyze the association of these with long-term patients survival. Patients with OA receiving total hip or knee arthroplasty were recruited and completed two sets of standardized questionnaires for functionality and pain 6, 12, and 60 months postoperatively. Multivariate mixed models were conducted to assess trajectories over time and the resulting improvement per month during the last time period was included in a landmark-model to estimate adjusted hazard ratios for mortality.

Regulation of cell-type-specific transcriptomes by microRNA networks during human brain development.

MicroRNAs (miRNAs) regulate many cellular events during brain development by interacting with hundreds of mRNA transcripts. However, miRNAs operate nonuniformly upon the transcriptional profile with an as yet unknown logic. Shortcomings in defining miRNA-mRNA networks include limited knowledge of in vivo miRNA targets and their abundance in single cells.

Association of incident obstructive sleep apnoea with outcomes in a large cohort of US veterans.

Rationale: There is a paucity of large cohort studies examining the association of obstructive sleep apnoea (OSA) with clinical outcomes including all-cause mortality, coronary heart disease (CHD), strokes and chronic kidney disease (CKD).

Objectives: We hypothesised that a diagnosis of incident OSA is associated with higher risks of these adverse clinical outcomes.

Methods, Measurements: In a nationally representative cohort of over 3 million (n=3 079 514) US veterans (93% male) with baseline estimated glomerular filtration rate (eGFR)≥60 mL/min/1.

The influence of joint line restoration on the results of revision total knee arthroplasty: comparison between distance and ratio-methods.

Introduction: Restoring the joint line (JL) in primary as well as revision total knee arthroplasty (TKA) influences clinical results as well as long-term survival rates. Whereas studies agree about the negative effect of JL alteration, the reference system of choice is unclear. The purpose of the present study was to evaluate the effect of JL allocation comparing a ratio to a distance method on clinical outcome following revision TKA.

Osteoblastoma of the sacrum: report of 18 cases and analysis of the literature.

Study Design: Retrospective case series.

Objective: (1) To analyze clinical and radiographical characteristics, treatment, and outcome in patients with sacral osteoblastoma, (2) to evaluate progression-free survival and local recurrence rate, and (3) to identify prognostic factors.

Summary Of Background Data: Osteoblastoma is a rare tumor that has been reported to affect the sacrum from 7% to 17%.

Estimates of kidney function in obese African Americans with chronic kidney disease.

Background/aims: Methods for assessing glomerular filtration rate (GFR) are controversial in obese individuals. This study compared clinical estimates of GFR in African Americans (AA) with chronic kidney disease (CKD) overall and by body mass index (BMI).

Methods: The estimated GFR was determined in AA with CKD using (1) the 4-variable Modification of Diet in Renal Disease equation (MDRD4), (2) the Cockcroft-Gault equation with ideal, adjusted and total body weight (TBW, with and without normalization for body surface area), and (3) urine collection methods.

Cervical spinal MRI in a patient with a vagus nerve stimulator (VNS).

Cranial MRI has been shown to be a safe procedure in patients with a vagus nerve stimulator (VNS), but body MRI may cause overheating of the stimulator lead. Here we report a case of a patient with an implanted vagus nerve stimulator who required a cervical spinal MRI due to a rapidly progressive paraparesis. The spinal MRI was performed in a 1.

[Embolisation of aneurysmal bone cysts as a minimally invasive treatment option - presentation of two cases].

Aim: The aim of this study was to evaluate embolisation as a therapy option for aneurysmal bone cysts of the trunk.

Method: Case reports about two males with intermittent pseudo-radicular lumboischialgia and coxalgia are discussed.

Results: The diagnostic work-up and biopsies verified an aneurysmal bone cyst in both males.

Evaluation and modification of the Tomita score in 217 patients with vertebral metastases.

Background: The Tomita prognosis score consists of the following 3 parameters: growth behavior, evidence of visceral metastases, and/or evidence of bony metastases.

Methods: 217 consecutive patients, surgically treated for vertebral metastases of different entities, were studied retrospectively. The score according to Tomita was determined.

CT-guided interventions in orthopedics.

Purpose: In this study we present our experience with CT-guided interventions for musculoskeletal diseases. Technical details, advantages and disadvantages and the accuracy of the method are described.

Materials And Methods: Between 2002 and 2005 we performed 77 CT-guided interventions on 72 patients (42 men, mean age 43.

[The prognostic influence of primary tumour and region of the affected spinal segment in 217 surgical patients with spinal metastases of different entities].

Aim: A retrospective study to evaluate the prognostic influence of the primary tumour and the anatomic level of spinal metastases was carried out.

Material And Methods: Between January 1984 and May 2005, 217 patients were surgically treated because of spinal metastases. The prognostic influence for the survival was analysed for the entity of the primary tumour and the localisation of the spinal metastases.

Evaluation of the Tokuhashi prognosis score and its modifications in 217 patients with vertebral metastases.

Aim: The Tokuhashi prognosis score consists of six parameters. The sum of points rated for each parameter can be correlated with the prognosis. This study evaluates the score variations that have been done by different authors and Tokuhashi et al.

Prognosis scores of Tokuhashi and Tomita for patients with spinal metastases of renal cancer.

Background: Retrospective evaluation of the prognosis scores of Tokuhashi and Tomita for life expectancy in 37 consecutive patients with spinal metastases secondary to renal cancer who underwent surgery. The score of Tokuhashi, composed of six parameters, each rated from zero to two, has been proposed in 1990 for the prognostic assessment of patients with spinal metastases. In 2001, Tomita et al.

Dynamic stabilization of the lumbar spine.

This study analyzed the outcome of patients treated with total disk replacement and posterior dynamic stabilization. For pathologies of different origin, dynamic stabilization of the lumbar spine is a novel alternative to fusion surgery. Although a physiological reconstruction of the sagittal profile was not always achieved, improvement was seen in all subscales of the clinical outcome measures in both treatment groups.

Classical and atypical location of adamantinomas--presentation of two cases.

Background: Adamantinomas are rare low-grade primary bone tumors of unknown histological origin. They typically develop in the diaphyses and metaphyses of long bones, prevalently the tibia.

Case Reports: The cases of 2 female patients, one with localized swelling of the lateral metatarsals and one with pain of the tibia are being reported.

Gait analysis and WOMAC are complementary in assessing functional outcome in total hip replacement.

Objective: To investigate the correlation between objective and subjective evaluation of patients with total hip replacement.

Design: Prospective preliminary trial comparing the Western Ontario and McMaster University questionnaire (WOMAC) and gait analysis preoperatively and three months postoperatively.

Setting: A German academic orthopaedic centre specializing in total hip replacement surgery.

[Surgical treatment and evaluation of prognostic factors in spinal metastases of renal cell carcinoma].

Aim: The aim of this study was the evaluation of surgical results and prognostic factors in spinal metastases of renal cancer.

Methods: 37 surgical patients with spinal metastases of renal cell carcinoma were retrospectively analysed. In 2 patients the cervical, in 16 patients the thoracic, in 4 patients the thoraco-lumbar and in 16 patients the lumbar spine was involved.

The Tokuhashi score: significant predictive value for the life expectancy of patients with breast cancer with spinal metastases.

Study Design: Retrospective study of 55 consecutive patients with spinal metastases secondary to breast cancer who underwent surgery.

Objective: To evaluate the predictive value of the Tokuhashi score for life expectancy in patients with breast cancer with spinal metastases.

Summary Of Background Data: The score, composed of 6 parameters each rated from 0 to 2, has been proposed by Tokuhashi and colleagues for the prognostic assessment of patients with spinal metastases.

Distractible vertebral body replacement for the thoracic and lumbar spine.

We retrospectively evaluated the results after corporectomy and vertebral body replacement in 40 patients with thoracic or lumbar spine collapse due to tumour osteolysis, unstable fractures, spondylodiscitis and Paget's disease. They underwent posterior transpedicular instrumentation followed 7 to 21 days later by vertebral body replacement with a distractible device, the "Obelisc" cage, filled up with autogenous/allogeneic bone graft. The mean residual kyphosis after surgery was only 13.

Posterior stabilisation of a malignant cervico-thoracic vertebral bone defect.

Oesophageal cancer is frequently complicated by malignant fistulae. Necrosis of the tumour following radiotherapy or chemotherapy may lead to the development of fistulae between the oesophagus and adjacent tissues and organs. We report the expansion of an extra-luminal oesophageal cancer after resection, invading the cervico-thoracic spine, fortunately without neurological deficit, and leading to instability and formation of a malignant fistula linking the tracheo-bronchial tree to the subarachnoidal space.

[Prognosis, surgical therapy and progression in cervical and upper-thoracic tumor osteolysis].

Introduction: This study analyzes the early and mid-term results of our modular rod-screw implant system for the posterior instrumentation of the occipito-cervical, cervical and cervico-thoracic spine (neon occipito-cervical system, Ulrich, Germany) in patients with tumor osteolysis. The prognosis of the patients was evaluated using the Tokuhashi score.

Methods: The cervical and upper thoracic spines of 14 patients (7 males, 7 females, mean age 61 years, range 40-77 years) with osteolysis due to plasmocytoma (n = 2), bronchial (n = 3), mamma (n = 4), thyroid (n = 2), esophageal (n = 1) and pancreatic (n = 1) carcinomas as well as melanoma (n = 1) were instrumentated between June 2001 and April 2004.

[Surgical treatment and prognosis factors in spinal metastases of breast cancer].

Aim: The aim of this study was the evaluation of surgical therapy results and prognosis factors in patients with spinal metastases of breast cancer.

Methods: 55 patients with spinal metastases of breast cancer who were treated surgically were retrospectively evaluated. In 11 patients the cervical, in 27 patients the thoracic and in 17 patients the lumbar spine was affected.

Sports activities 5 years after total knee or hip arthroplasty: the Ulm Osteoarthritis Study.

Objective: To analyse sports activities of patients with hip or knee osteoarthritis (OA) over lifetime, preoperatively, and 5 years after arthroplasty.

Methods: In a longitudinal four centre study, 809 consecutive patients with advanced OA of the hip (420) or the knee (389) joint under the age of 76 years who required total joint replacement were recruited. A completed questionnaire about sports activities at 5 year follow up was received from 636 (79%) of the 809 patients.