Synovial fluid D-lactate - a pathogen-specific biomarker for septic arthritis: a prospective multicenter study.

Objectives: The performance of synovial fluid biomarker D-lactate to diagnose septic arthritis (SA) and differentiate it from crystal-induced arthritis (CA), other non-infectious rheumatic joint diseases (RD) and osteoarthrosis (OA) was evaluated.

Methods: Consecutive adult patients undergoing synovial fluid aspiration due to joint pain were prospectively included in different German and Swiss centers. Synovial fluid was collected for culture, leukocyte count and differentiation, detection of crystals, and D-lactate concentration.

Accurate surgical posterior tibial slope alteration can be achieved in total knee arthroplasty regardless of surgeon skill level or local soft tissue thickness-A retrospective radiograph-based study.

Purpose: To retrospectively report on the impact of local soft tissue thickness and surgeon skill level on the accuracy of surgical posterior tibial slope (PTS) alteration achieved in patients undergoing total knee arthroplasty (TKA) utilising lateral knee radiographs.

Methods: Pre- and postoperative radiographs of 82 patients undergoing primary TKA using conventional mechanical alignment technique were measured by two observers and subjected to quality criteria for accurate measurement of the PTS. All patients underwent a standardised surgical approach for PTS alteration: cruciate-retaining (CR) cases with preoperative PTS ≤ 10° were set for reconstruction of the preoperative PTS.

Influence of the type of stem and its fixation on revision and immediate postoperative mortality in elective total hip arthroplasty.

Aims: Despite higher rates of revision after total hip arthroplasty (THA) being reported for uncemented stems in patients aged > 75 years, they are frequently used in this age group. Increased mortality after cemented fixation is often used as a justification, but recent data do not confirm this association. The aim of this study was to investigate the influence of the design of the stem and the type of fixation on the rate of revision and immediate postoperative mortality, focusing on the age and sex of the patients.

Increased ankle pain after total knee arthroplasty is associated with a preoperative lateralized gait and talar tilt, but not with ankle laxity or the range of motion of the subtalar joint.

Aims: Total knee arthroplasty (TKA) may provoke ankle symptoms. The aim of this study was to validate the impact of the preoperative mechanical tibiofemoral angle (mTFA), the talar tilt (TT) on ankle symptoms after TKA, and assess changes in the range of motion (ROM) of the subtalar joint, foot posture, and ankle laxity.

Methods: Patients who underwent TKA from September 2020 to September 2021 were prospectively included.

[Acute postoperative infections after dual head arthroplasty in geriatric patients].

Acute periprosthetic joint infections (PJI) after dual head arthroplasty represent a major challenge with a 1-year mortality rate up to 50% in the mostly multimorbid geriatric patient collective. Due to the limited possibilities of preoperative patient optimization, infection rates of up to 9% have been reported, which is significantly higher than in elective arthroplasty. A therapeutic gold standard has not yet been established due to the heterogeneous study situation and the lack of prospective randomized studies.

Bilateral simultaneous knee arthroplasty shows comparable early outcome and complication rate as staged bilateral knee arthroplasty for patients scored ASA 1-3 if performed by a high-volume surgeon: a retrospective cohort study of 127 cases.

Background And Purpose: The study compares early outcomes after simultaneous and staged knee arthroplasty in patients with bilateral knee osteoarthritis (OA) to evaluate whether simultaneous bilateral TKA shows comparable early outcomes and complication rates to staged bilateral TKA.

Methods: A retrospective cohort study including all patients scheduled for primary TKA for bilateral knee OA (n = 127) was conducted. Patients received either simultaneous (n = 53, 41.

Bilateral simultaneous hip arthroplasty shows comparable early outcome and complication rate as staged bilateral hip arthroplasty for patients scored ASA 1-3 if performed by a high-volume surgeon.

Purpose: The aim of this study was to compare early outcomes after simultaneous and staged hip arthroplasty (THA) in patients with bilateral symptomatic pathology.

Methods: We conducted a retrospective cohort study including all patients scheduled for primary THA for bilateral hip osteoarthritis (OA, n = 290). Patients either received simultaneous (n = 152, 52.

Functional gait analysis reveals insufficient hindfoot compensation for varus and valgus osteoarthritis of the knee.

Purpose: The hindfoot is believed to compensate varus and valgus deformities of the knee by eversion and inversion movements. But these mechanisms were merely found in static radiologic measurements. The aim of this study was, therefore, to assess dynamic foot posture during gait using pressure-sensitive wireless insoles in patients with osteoarthritis of the knee and frontal knee deformities.

Clinical evaluation of dithiothreitol in comparison with sonication for biofilm dislodgement in the microbiological diagnosis of periprosthetic joint infection.

Sonication of explanted devices is well investigated method and was shown to improve the microbiological diagnosis of impant-associated infections by physical removal of bacterial biofilms. Recently, novel approach with chemical agents have been investigated for biofilm dislodgement such as dithiothreitol (DTT). We compared the biofilm dislodgement efficacy of chemical method (dithiothreitol, DTT) compared to the sonication procedure in the diagnosis of prosthetic joint infections (PJI).

Major Shortening of the Patellar Tendon During Septic Two-Stage Knee Arthroplasty Revision Using Static Spacers.

Background: Two-stage septic revision knee arthroplasty (TKA) often results in inferior functional outcome after reimplantation, which might be due to impairments of the extensor mechanism. The aim of the current study was to elucidate possible alterations in extensor mechanisms during septic two-stage revision of TKA treated with a static spacer.

Methods: This retrospective study included 87 patients (42 women, 45 men, age 64.

Failure Analysis in Multiple TKA Revisions-Periprosthetic Infections Remain Surgeons' Nemesis.

Background: The aim of this study was to categorize reasons for failure and to analyze the survivorship of multiple total knee arthroplasty (TKA) revisions.

Methods: The study retrospectively evaluated all multiple TKA revisions performed between 2005 and 2015 at the authors' institutions. Sixty-three patients (35 female, 28 male, age 64 ± 10 years, follow-up 55 ± 36 months) underwent a total of 157 re-revision TKA surgeries (range 2-5).

[Septic revision arthroplasty: how to confirm diagnosis, plan surgery and manage follow-up treatment].

Background: Septic revision arthroplasty represents an interdisciplinary challenge in terms of diagnosis as well as surgical and follow-up treatment.

Diagnosis: The implementation of a standardized diagnostic algorithm including anamnesis, clinic, imaging, blood sampling and joint aspiration is essential. Depending on the duration of the symptoms acute (< 3 weeks) and chronic (> 3 weeks) infections are distinguished.

Significant increase in quantity and quality of knee arthroplasty related research in KSSTA over the past 15 years.

Purpose: This study aimed to evaluate both publication and authorship characteristics in Knee Surgery, Sports Traumatology, Arthroscopy journal (KSSTA) regarding knee arthroplasty over the past 15 years.

Methods: PubMed was searched for articles published in KSSTA between January 1, 2006, and December 31st, 2020, utilising the search term 'knee arthroplasty'. 1288 articles met the inclusion criteria.

Public Interest in Knee Pain and Knee Replacement during the SARS-CoV-2 Pandemic in Western Europe.

Due to the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) pandemic, a large number of elective knee replacement procedures had to be postponed in both early and late 2020 in most western countries including Germany and the UK. It is unknown how public interest and demand for total knee arthroplasties was affected. Public interest in knee pain, knee osteoarthritis and knee arthroplasty in Germany and the UK was investigated using Google Trend Analysis.

Soluble Pecam-1 as a Biomarker in Periprosthetic Joint Infection.

A reliable workup with regard to a single diagnostic marker indicating periprosthetic joint infection (PJI) with sufficient sensitivity and specificity is still missing. The immunologically reactive molecule Pecam-1 is shed from the T-cell surface upon activation via proinflammatory signaling, e.g.

Does sonography allow an objective and reproducible distinction between stable, hypermobile, and unstable elbow joints?

Background: The diagnosis of residual or chronic elbow instability is often challenging. Sonography allows a dynamic examination of the elbow joint without any radiation exposure. The purpose of this prospective single-center study was to investigate the application of sonography for the evaluation of ligamentous instabilities of the elbow joint.

Laminar air flow reduces particle load in TKA-even outside the LAF panel: a prospective, randomized cohort study.

Purpose: Released particles are a major risk of airborne contamination during surgery. The present prospective study investigated the quantitative and qualitative particle load in the operating room (OR) depending on location, time of surgery and use of laminar air flow (LAF) system.

Methods: The particle load/m was measured during the implantation of 12 total knee arthroplasties (6 × LAF, 6 × Non-LAF) by using the Met One HHPC 6 + device (Beckmann Coulter GmbH, Germany).

Reaction time and brake pedal force after total knee replacement: timeframe for return to car driving.

Purpose: This prospective cohort study aimed to examine objective and subjective parameters in patients who underwent total knee replacement (TKR) to assess from when on driving a car can be deemed safe again.

Methods: Thirty patients (16 women, 14 men, age 66 ± 11 years) who received TKR of the right knee and 45 healthy controls (26 women, 19 men, age 32 ± 9 years) were asked to perform an emergency braking manoeuvre using a driving simulator. Brake pedal force (BPF), neuronal reaction time (NRT), brake reaction time (BRT), and subjective parameters (pain, subjective driving ability) were measured preoperatively as well as 5 days, 3-4, and 6 weeks after TKR.

Effect of total hip arthroplasty on brake reaction time and braking force.

Introduction: The correct moment for return to driving after total hip arthroplasty (THA) remains unclear. Until today no uniform recommendation exists on the ability to perform an emergency brake.The aim of this prospective study was to investigate the braking ability of patients before and after THA implantation based on brake reaction time in milliseconds (BRT) and braking force in N (BF).

Local infiltration anaesthesia versus sciatic nerve and adductor canal block for fast-track knee arthroplasty: A randomised controlled clinical trial.

Background: Local infiltration anaesthesia (LIA) was introduced as an innovative analgesic procedure for enhanced recovery after primary total knee arthroplasty (TKA). However, LIA has never been compared with analgesia based on an adductor canal catheter and a single-shot sciatic nerve block.

Objective: To evaluate two analgesic regimens for TKA comparing mobility, postoperative pain and patient satisfaction.

Mid-Term Survival of Total Knee Arthroplasty in Patients with Posttraumatic Osteoarthritis.

PURPOSE OF THE STUDY There is limited evidence on survival and complication rates in patients after total knee arthroplasty for posttraumatic osteoarthritis. The failure mechanisms leading to revision remain an issue of constant debate. The purpose of this study was to analyze the mid-term survival of primary total knee arthroplasties as well as to evaluate complications and failure mechanisms in patients with posttraumatic knee osteoarthritis.