Enhanced joint pain in diabetic patients with knee osteoarthritis is associated with increased synovitis, synovial immune cell infiltration, and erythrocyte extravasation.

Objective: Diabetes mellitus (DM) is an important risk factor for the development of osteoarthritis (OA), increasing OA progression and OA pain. To gain insight into the underlying mechanisms of how DM exacerbates OA processes and OA pain, this study analyzed histological differences of synovial tissues from non-DM and DM patients with OA and correlated these differences with knee pain severity.

Materials And Methods: Synovial tissue was obtained from 12 non-DM and 10 DM patients with advanced knee OA who underwent total knee arthroplasty.

Standardized analysis of syndesmosis stability in ankle trauma with an innovative syndesmosis-test-tool: a biomechanical study.

When treating ankle fractures, the question of syndesmosis complex involvement often arises. So far, there is no standardized method to reliably detect syndesmosis injuries in the surgical treatment of ankle fractures. For this reason, an intraoperative syndesmosis-test-tool (STT) was developed and compared to the recommended and established hook-test (HT).

Minimally invasive bilateral fixed angle locking fixation of the dorsal pelvic ring: clinical proof of concept and preliminary treatment results.

Purpose: Dorsal pelvic ring fractures may result from high energy trauma in younger patients or from osteoporosis as fragility fractures in elderly patients. To date, no strong consensus exists on the best surgical technique to treat posterior pelvic ring injuries. The aim of this study was to evaluate the surgical performance of a new implant for angle-stable fixation of the posterior pelvic ring and patient outcome.

Direct and indirect comparisons in network meta-analysis of SuperPATH, direct anterior and posterior approaches in total hip arthroplasty.

SuperPATH is a novel approach to the hip joint that needs to be compared to other known surgical approaches. To conduct a network meta-analysis (NMA) of randomized controlled trials (RCTs) comparing short-term outcomes of SuperPATH, direct anterior (DAA), and posterior/ posterolateral approaches (PA) in total hip joint arthroplasty (THA). We performed a systematic review on PubMed, CNKI, Embase, The Cochrane Library, Clinical trials, and Google Scholar up to November 30th, 2021.

Direct anterior approach vs. SuperPATH vs. conventional approaches in total hip replacement: A network meta-analysis of randomized controlled trials.

Background: Two minimally invasive approaches showed some advantages in outcomes compared to conventional approaches (CAs) - the direct anterior approach (DAA) and the supercapsular percutaneously assisted approach in THA (SuperPATH). To the best of our knowledge, these three approaches have never been ranked in a network meta-analysis (NMA) before. Therefore, we conducted a systematic review and NMA of randomized controlled trials comparing short-term outcomes of DAA, SuperPATH and CAs in total hip joint arthroplasty (THA), using CAs as common comparator.

Comparison of short-term outcomes between direct anterior approach (DAA) and SuperPATH in total hip replacement: a systematic review and network meta-analysis of randomized controlled trials.

Background: Two minimally invasive approaches showed some advantages in outcomes compared to conventional approaches (CAs)-the direct anterior approach (DAA) and the supercapsular percutaneously assisted approach in THA (SuperPATH). To the best of our knowledge, DAA and SuperPATH have never been compared, neither in clinical studies, nor in a meta-analysis. To conduct a systematic review and network meta-analysis of randomized controlled trials comparing short-term outcomes of DAA and SuperPATH in total hip joint arthroplasty (THA).

[Comparison between navigated and conventional percutaneous screw fixation of non-displaced scaphoid fractures].

Background: Incorrect screw placement and penetration in screw fixation of scaphoid fractures are found in 5 to 30 %. Therefore, optimizing of screw placement is desirable, especially because an exact central position of the screw in the proximal fragment leads to a significant higher stability as a more peripheral position.

Patients Und Methods: 36 patients with an acute non-displaced scaphoid fracture were included in this randomized prospective study.

Modified therapy concepts for fragility fractures of the pelvis after additional MRI.

Background: Fractures of the pelvic ring in elderly patients have increased in frequency over time. These injuries are associated with a high morbidity and have a socio-economic impact. The diagnostic procedures and their influence of therapy decisions are still controversial.

Effect of different multiplanar reformation algorithms on image quality of intraoperative three-dimensional fluoroscopy.

Different multiplanar reformation (MPR-512 and -256) algorithms of intraoperative acquired 3-D-fluoroscopy data exist without recommendations for use in the literature. To compare algorithms, 3-D-fluoroscopic data sets of 46 radius fractures were blinded and processed using MPR-256 and -512 (Ziehm, Vision-Vario 3D). Each reformatted data set was analysed to evaluate image quality, fracture reduction quality and screw misplacements.

Recommendations for iliosacral screw placement in dysmorphic sacrum based on modified in-out-in corridors.

(1) Can iliosacral osseous corridor diameters in sacral dysmorphism be enlarged by in-out-in screw placement at the posterior iliosacral recessus? (2) Are lumbosacral transitional vertebra (LSTV) the anatomical cause for sacral dysmorphism? (3) Are there sex-specific differences in sacral dysmorphism? 594 multislice CT scans were screened for sacral dysmorphism and 55 data-sets selected. Each pelvis was segmented manually and cylindrical iliosacral corridors (on the level of S1 and S2 vertebra) were semi-automatically determined. Corridor trajectories, -diameters and -lengths were measured.

Predictors for secondary hip osteoarthritis after acetabular fractures-a pelvic registry study.

Purpose: Secondary hip osteoarthritis after acetabular fractures requiring total arthroplasty (THA) poses a huge burden on the affected patients as well as health systems. The present study aimed to assess risk factors associated with THA after acetabular fractures based on the data from the German Pelvic Trauma Registry.

Methods: Retrospective analysis of 678 acetabular fracture cases without concomitant pelvic ring fracture treated and followed-up between January 2004 and May 2015 at six large trauma centres.

Pain sensation in human osteoarthritic knee joints is strongly enhanced by diabetes mellitus.

The major burden of knee joint osteoarthritis (OA) is pain. Since in elder patients diabetes mellitus is an important comorbidity of OA, we explored whether the presence of diabetes mellitus has a significant influence on pain intensity at the end stage of knee OA, and we aimed to identify factors possibly related to changes of pain intensity in diabetic patients. In 23 diabetic and 47 nondiabetic patients with OA undergoing total knee arthroplasty, we assessed the pain intensity before the operation using the "Knee Injury and Osteoarthritis Outcome Score".

The Anterior Intrapelvic Approach for Acetabular Fractures Using Approach-Specific Instruments and an Anatomical-Preshaped 3-Dimensional Suprapectineal Plate.

Objectives: Anatomical acetabular plates the anterior intrapelvic approach (AIP) were recently introduced to fix acetabular fractures through the intrapelvic approach. Therefore, we asked the following: (1) Does the preshaped 3-dimensional suprapectineal plate interfere with or even impair the fracture reduction quality? (2) How often does the AIP approach need to be extended by the first (lateral) window of the ilioinguinal approach?

Design: Observational case series.

Setting: Two Level 1 trauma centers.

Transsacral Osseous Corridor Anatomy Is More Amenable To Screw Insertion In Males: A Biomorphometric Analysis of 280 Pelves.

Background: Percutaneous iliosacral screw placement is the standard procedure for fixation of posterior pelvic ring lesions, although a transsacral screw path is being used more frequently in recent years owing to increased fracture-fixation strength and better ability to fix central and bilateral sacral fractures. However, biomorphometric data for the osseous corridors are limited. Because placement of these screws in a safe and effective manner is crucial to using transsacral screws, we sought to address precise sacral anatomy in more detail to look for anatomic variation in the general population.

Tangential View and Intraoperative Three-Dimensional Fluoroscopy for the Detection of Screw-Misplacements in Volar Plating of Distal Radius Fractures.

Background: Volar locking plate fixation has become the gold standard in the treatment of unstable distal radius fractures. Juxta-articular screws should be placed as close as possible to the subchondral zone, in an optimized length to buttress the articular surface and address the contralateral cortical bone. On the other hand, intra-articular screw misplacements will promote osteoarthritis, while the penetration of the contralateral bone surface may result in tendon irritations and ruptures.

Biomorphometric analysis of ilio-sacro-iliacal corridors for an intra-osseous implant to fix posterior pelvic ring fractures.

It is hypothesized that ilio-sacro-iliacal corridors for a new envisioned pelvic ring implant (trans-sacral nail with two iliacal bolts = ISI-nail: ilio-sacro-iliacal nail) exists on the level of S1- or S2-vertebra in each patient. The corridors of 84 healthy human pelves (42x ♂; 42x ♀, 18-85 years) were measured in high resolution CT scans using the Merlin Diagnostic Workcenter Software. Trans-sacral corridors (≥ 9 mm diameter) on the level of S1 and S2 were found in 62% and 54% of pelves with a mean length [mm ± SD] of 164 ± 12.

Sex-specific differences of the infraacetabular corridor: a biomorphometric CT-based analysis on a database of 523 pelves.

Background: An infraacetabular screw path facilitates the closure of a periacetabular fixation frame to increase the plate fixation strength in acetabular fractures up to 50%. Knowledge of the variance in corridor sizes and axes has substantial surgical relevance for safe screw placement.

Questions/purposes: (1) What proportion of healthy pelvis specimens have an infraacetabular corridor that is 5 mm or larger in diameter? (2) Does a universal corridor axis and specific screw entry point exist? (3) Are there sex-specific differences in the infraacetabular corridor size or axis and are these correlated with anthropometric parameters like age, body weight and height, or the acetabular diameter?

Methods: A template pelvis with a mean shape from 523 segmented pelvis specimens was generated using a CT-based advanced image analyzing system.

Is there a correlation between biophotonical, biochemical, histological, and visual changes in the cartilage of osteoarthritic knee-joints?

The aim of this study was to detect characteristic structural changes in the cartilage composition of osteoarthritis (OA), hereby improving the arthroscopic identification of cartilage pathology by the use of a non-destructive technique - NIRS (Near-Infrared Spectroscopy). 682 cartilage samples out of 25 knees with OA were classified visually, using the ICRS system, biophotonically, histologically (n = 66), using the Score of Mankin and the Score of Otte, and biochemically (n = 616), determining the content of glycosaminoglycan (GAG) and hydroxyproline (HP). Significant correlations were found between biophotonical, histological, biochemical and visual characteristics of cartilage lesions.

Percutaneous navigated screw fixation of glenoid fractures.

Background: Open or percutaneous arthroscopic-based procedures are reported to fix unstable or displaced intra-articular glenoid fractures. Approach related morbidity has to be considered for open procedures, and arthroscopic-based procedures are demanding. Therefore an alternative percutaneous navigated approach is described.

BMP-2 shows characteristic extracellular patterns in osteoarthritic cartilage: a preliminary report.

To determine bone morphogenetic protein (BMP)-2 protein and Aggrecan in osteoarthritic and healthy cartilage with special regard to localization and degree of cartilage damage 95 samples representing osteoarthritic cartilage and 17 samples out of normal cartilage were graded histological by Mankin Score and were studied by immunohistochemistry for the expression of BMP-2 and Aggrecan. BMP-2 protein was detected intracellular in normal and in osteoarthritic cartilage. Extracellular BMP-2 was detected exclusively in osteoarthritic cartilage and exhibits characteristic extracellular patterns: samples with BMP-2 in the extracellular matrix show BMP-2 negative coronae around BMP-2 positive cells.

Removal of a femoral nail with osseous overgrowth at the end-cap: A navigated and cannulated minimally invasive technique.

Intramedullary nail removal can be demanding, especially in cases of implant breakage or bony overgrowth at the end-cap, if the exact insertion depth of the nail is neglected in the index surgery. In the presented case, two challenging nail removals were necessary. The first was performed in a re-nailing procedure due to a pseudarthrosis with implant breakage, and the second was performed during hardware removal after fracture healing in a situation where there was deep intramedullary placement of the exchange nail.