Reverse rhino sign as a radiological sign of low-grade infected reverse shoulder arthroplasty.

Introduction: Low-grade infections following shoulder surgery are difficult to diagnose. Recently, curved-shaped bony spurs, further mentioned "reverse rhino signs" because of its shape, growing inferior on the glenoid were noticed on X-rays of patients with a reverse shoulder arthroplasty (RSA) and a Cutibacterium acnes (C. acnes) infection.

Better diagnostic value of tissue cultures obtained during mini-open and arthroscopic procedures compared with sterile punctures to identify periprosthetic shoulder infections: a retrospective cohort study.

Background: This study aimed to determine the sensitivity and specificity of sterile shoulder needle aspiration and cultures obtained during arthroscopic and mini-open procedures for detecting periprosthetic shoulder infections using tissue cultures from revision surgery as the gold standard.

Methods: All shoulder arthroplasty patients who underwent a synovial fluid puncture between August 2012 and February 2018 were selected. In addition, arthroplasty patients with cultures obtained during arthroscopic or mini-open procedures between May 2014 and May 2021 were selected.

Evaluation and Validation of the Dutch European Foot and Ankle Society (EFAS) Score.

The European Foot and Ankle Society (EFAS) score is a recently developed foot and ankle patient-reported outcome measure. It has been developed and partly validated in seven languages. This study's aim was to investigate the measurement properties of the Dutch version of the EFAS score.

Results of the Diaphragmatic Plication Database: 10 Years' Experience.

Background: Unilateral diaphragmatic paralysis or paresis (UDP) in adults is an often overlooked disease which relevantly impairs the patient's lung function and quality of life. Particularly in idiopathic UDP, there is no evidence for conservative therapy and only little evidence for surgical therapy.

Methods: The method involves retrospective single-center analysis of patients with UDP persistent for at least 1 year who were operated by diaphragmatic resection, plication, and augmentation with a polypropylene mesh.

Sarcoidosis involvement of the diaphragm leading to right diaphragmatic elevation: a case report.

A 69-year-old male Caucasian presenting with dyspnea on exertion related to unilateral diaphragmatic dysfunction as caused by sarcoidosis is described. First, right diaphragmatic elevation was unexplained, while the patient presented with a restrictive pattern in lung function testing using bodyplethysmography and with reduced global and diaphragmatic respiratory muscle strength as evidenced by respiratory pressures. Subsequently, surgical diaphragm plication was performed, unfortunately, without any clinical improvement.

Guidelines on analgosedation, monitoring, and recovery time for flexible bronchoscopy: a systematic review.

Background: Patients undergoing bronchoscopy in spontaneous breathing are prone to hypoxaemia and hypercapnia. Sedation, airway obstruction, and lung diseases impair respiration and gas exchange. The restitution of normal respiration takes place in the recovery room.

Pre- and peroperative diagnosis of infections in shoulder surgery: A systematic review.

Background: is the most commonly detected pathogen during shoulder surgery. Lack of typical infection signs make infections difficult to diagnose. This systematic review aims to determine which pre- and peroperative diagnostic tools are most reliable to identify infections after shoulder surgery.

Development of the Diaphragmatic Paralysis Questionnaire: a simple tool for patient relevant outcome.

Objectives: Measurement tools of health-related quality of life (HRQL) that are specific for the underlying disorder are inevitably needed to assess HRQL changes following specific treatment strategies. The aim of the current study was to develop a questionnaire assessing HRQL in patients with unilateral diaphragmatic paresis.

Methods: Firstly, topics of health impairments covering physical, psychological, social and functional aspects were predefined by a physician expert panel to ensure face validity.

Complications after sternoclavicular surgery.

Background: Sternoclavicular joint (SCJ) pathologies such as instability are rare; therefore, SCJ surgery is performed infrequently. Complications of these surgeries can be devastating. This study evaluated complications, and particularly infections, after SCJ surgery.

Restoration of pre-operative joint line orientation and alignment does not affect KSS and KOOS 1 year after total knee arthroplasty.

Purpose: The objectives of this study were to examine the relation between clinical outcomes 1 year postoperatively, in a cohort of mechanically aligned total knee arthroplasties (TKA), and (1) the degrees of alignment change of the tibial, femoral and the hip-knee-ankle (HKA) angle; (2) the change of phenotype; (3) the postoperative knee joint line orientation to the floor.

Methods: Pre-operative and postoperative long-leg X-rays of 90 patients were used to determine the coronal alignment. The absolute difference between the pre-operative and postoperative measurements was determined and the outcomes were categorized in whether or not a change in phenotype had occurred.

Maximal flexion and patient outcomes after TKA, using a bicruciate-stabilizing design.

Introduction: Physiological motion after total knee arthroplasty (TKA) should result in a large range of motion, which would lead to good clinical outcomes. An adjusted design of a bicruciate-stabilizing TKA was developed to reproduce physiological motion. The aim of this study was to (1) investigate the maximal knee flexion of this knee system, 1 year post-operatively; (2) determine the clinical and functional improvement and compare the outcomes between patients with and without high maximal flexion; and (3) evaluate the adverse events.

Cutibacterium acnes infections in revision surgery for persistent shoulder complaints: a retrospective cohort study.

Introduction: Low-grade Cutibacterium acnes (C. acnes) infections after shoulder surgery usually result in unexplained complaints. The absence of clinical signs of infection makes the incidence unclear and underreported.

The presence of Cutibacterium acnes on the skin of the shoulder after the use of benzoyl peroxide: a placebo-controlled, double-blinded, randomized trial.

Hypothesis And Background: We hypothesized that benzoyl peroxide (BPO) would reduce the presence of Cutibacterium acnes on the skin of the shoulder by 50% compared with placebo. Infections after shoulder surgery are most commonly caused by C acnes. Current prophylactic methods do not effectively reduce the bacterial load of this bacterium.

Sensitivity of chest ultrasound for postoperative pneumothorax in comparison to chest X-ray after lung resecting surgery.

Objectives: Thoracic ultrasound is superior to chest X-ray for the detection of a pneumothorax in trauma and intensive care medicine. Data regarding its use in non-cardiac thoracic surgery are scarce and contradictory. Previous studies are heterogeneous regarding sonographic methodology and patient selection.

[Video-assisted Thoracoscopic Surgery in Local Anaesthesia and Analgosedation - a Survey of the Members of the German Society of Thoracic Surgeons].

Introduction: There is increasing international interest in the use of video-assisted thoracoscopic procedures (VATS) with spontaneous respiration in the treatment of elderly and multimorbid patients. Data on the application and acceptance in Germany are not yet available.

Method: Germany-wide, online-based survey among the departments of thoracic surgery registered at the German Society of Thoracic Surgeons (DGT) on the application of VATS in local anaesthesia (LA).

Long-term outcomes after Instrumented Bone Preserving total elbow arthroplasty: a radiostereometric study with a minimum follow-up of 10 years.

Background: Aseptic loosening is a main concern in elbow arthroplasty. Evaluation of implant migration using radiostereometric analysis (RSA) might increase understanding of implant loosening. Previously, 2-year RSA results of 16 Instrumented Bone Preserving (IBP) elbow prostheses showed migration of the humeral component in the first weeks but most components stabilized within 6 months postoperatively.

Influence of a Tourniquet on Opioid Consumption After Local Infiltration Analgesia for Total Knee Arthroplasty.

Objective: Local infiltration analgesia (LIA) with ropivacaine is increasingly used to provide postoperative analgesia after total knee arthroplasty (TKA). TKA may be performed with or without the use of a tourniquet. The absence of local blood flow when infiltrating local anaesthesia below an inflated tourniquet may affect the rate of systemic absorption, and this may have an effect on the duration and intensity of analgesia as compared with LIA without the use of a tourniquet.

Rationale and design of PASSAT - patients' satisfaction with local or general anaesthesia in video-assisted thoracoscopic surgery: study protocol for a randomised controlled trial with a non-randomised side arm.

Background: Although general anaesthesia (GA) with one-lung ventilation is the current standard of care, minor thoracoscopic surgery, i.e. treatment of pleural effusions, biopsies and small peripheral pulmonary wedge resections, can also be performed using local anaesthesia (LA), analgosedation and spontaneous breathing.

Measurement techniques to determine tibial rotation after total knee arthroplasty are less accurate than we think.

Background: The present study assessed the inter- and intra-observer reliability of tibial and femoral rotation measures after total knee arthroplasty (TKA), and evaluated the correlation between these measurement techniques and their clinical relevance.

Methods: Femoral rotation and tibial rotation were determined on 42 2D CT-scans made three-months after TKA. Reliability of the radiological measurements (including Berger's method, the anatomical tibial axis and the tibial tuberosity trochlear-groove) was assessed with 15 randomly selected patients measured twice by three observers.

Long-term results after triple arthrodesis: Influence of alignment on ankle osteoarthritis and clinical outcome.

Background: Pain, deformity and instability are the main reasons for fusion of the tarsal joints, a triple arthrodesis. The short and midterm results show that mobility, function and satisfaction increase postoperatively. However, osteoarthritis (OA) of the adjacent ankle joint is described as a long-term complication.

Stability and alignment do not improve by using patient-specific instrumentation in total knee arthroplasty: a randomized controlled trial.

Purpose: The primary aim of the study was to examine stability and alignment after total knee arthroplasty (TKA) using patient-specific instrumentation (PSI) and conventional instrumentation (CI). The hypothesis was that stability and alignment would be better using PSI than CI, 12 months postoperatively. The secondary aim included the evaluation of clinical outcomes after TKA.

Comparable Stability of Cemented vs Press-Fit Placed Stems in Revision Total Knee Arthroplasty With Mild to Moderate Bone Loss: 6.5-Year Results From a Randomized Controlled Trial With Radiostereometric Analysis.

Background: Short-term stability after revision total knee arthroplasty (TKA) with either fully cemented or hybrid-placed implants is comparable. Interestingly, implant micromotion >1 mm/degree occurred with both techniques which might increase the risk of loosening in the midterm or long-term. Therefore, the present study investigated midterm stability and clinical results of fully cemented vs hybrid-placed revision TKA, with mild to moderate bone loss, using radiostereometric analysis (RSA).

Long-term Functional and Radiographic Outcome of a Mobile Bearing Ankle Prosthesis.

Background: Total ankle arthroplasty is an accepted alternative to arthrodesis of the ankle. However, complication and failure rates remain high. Long-term results of the Scandinavian Total Ankle Replacement (STAR) are limited, with variable complication and failure rates observed.

Short term results of the Mobility Total Ankle System: Clinical and radiographic outcome.

Background: Ankle arthroplasty is increasingly used to reduce pain and improve or maintain joint mobility in end-stage ankle arthritis. The aim of this study was to assess the clinical and radiographic short term results of the Mobility prosthesis.

Methods: Complications, secondary operations, failures and the survival rate were retrospectively examined in 67 primary Mobility total ankle arthroplasties.

[Left ventricular projectile migration after an accidental close-range gunshot wound].

We report the case of a 24-year-old female after sustaining a shotgun wound in the left upper extremity and chest. Initial emergency diagnostics revealed numerous shotgun pellets scattered throughout the left-side soft tissue, chest and upper lung lobe with one pellet having migrated into the left ventricle of the heart.Due to the devastating injury pattern, gunshot wounds are interdisciplinarily challenging and should include extended initial diagnostics, such as contrast agent CT.