Personalized, interdisciplinary patient pathway for cross-sector care of multimorbid patients (eliPfad trial): study protocol for a randomized controlled trial.

Background: Multimorbid and frail elderly patients often carry a high burden of treatment. Hospitalization due to the onset of an acute illness can disrupt the fragile balance, resulting in further readmissions after hospital discharge. Current models of care in Germany do not meet the needs of this patient group.

Midterm Development of Ultrasound-unstable Hip Joints After Overhead Traction and Treatment With Tübingen Splint and Fettweis Plaster: A Radiologic Follow-up Analysis Over 5.5 Years.

Purpose: The aim of this study was to determine the success rate for treatment of ultrasound unstable hips (type D, III and IV) with Fettweis plaster in terms of a midterm follow-up from the very beginning in the neonatal period until the age of 4 to 8 years.

Methods: In total, 69 unstable hips, which were successfully treated with Fettweis plaster and after with a flexion-abduction splint, were included into the study. Hip delvelopment was followed by determining the acetabular index (ACI) on routine pelvic radiographs at the age of 12 to ≤24, 24 to ≤48 and 48 to ≤96 months and the center edge angle on the latter, and classifying both angles according to Tönnis.

Radiological long-term follow-up up to 12 years of initially ultrasound unstable hip types D, III and IV after treatment with the Tübingen splint worn as a plaster.

Introduction: The treatment of ultrasound unstable hips with the Tübingen splint is currently under discussion. However, there is a lack of long-term follow-up data. This study presents to the best of our knowledge first radiological mid-term to long-term data of the successful initial treatment with the Tübingen splint of ultrasound unstable hips.

Influence of a Calcium Phosphate Coating (BONIT) on the Proliferation and Differentiation Potential of Human Mesenchymal Stroma Cells in the Early Phase of Bone Healing.

When implanting osteosynthetic materials or orthopedic implants, the surface condition plays a decisive role for mid- to long-term osseointegration. BONIT, an electrochemically produced calcium phosphate (CaP) coating, has been used in the surface refinement of implants since 1995. More than 3.

Dexamethasone Does not Compensate for Local Anesthetic Cytotoxic Effects on Tenocytes: Morphine or Morphine Plus Dexamethasone May Be a Safe Alternative.

Purpose: The purposes of this in vitro study were to investigate whether the addition of dexamethasone can compensate for any cytotoxic effects of the amide-type local anesthetics (LA) bupivacaine and ropivacaine and whether morphine and morphine-6-glucuronide (M6G) may be a safe alternative for peritendinous application.

Methods: Biopsies of human biceps tendons ( = 6) were dissected and cultivated. Cells were characterized by the expression for tenocyte markers, collagen I, biglycan, tenascin C, scleraxis, and RUNX via reverse transcriptase-polymerase chain reaction and immunohistochemistry.

Rifampicin has - Compared to clindamycin - A dose and time dependent effect on hMSCs during osteogenic differentiation .

Background: The effects of rifampicin and clindamycin on human mesenchymal stromal cell (hMSC) were examined.

Methods: hMSC were cultured with rifampicin and clindamycin (0.5 μg/ml, 5 μg/ml, 50 μg/ml) and examinations of proliferation (Bromodeoxyuridine), calcification (Alizarin red) and mineralization (alkaline phosphatase) were performed after 7th, 14th and 21st days.

Effective dose of radiation per screw in surgery of adolescent idiopathic scoliosis: matched pair analysis of 293 pedicle screws inserted using three different techniques.

Purpose: Reports on heterogenous groups of patients have indicated that pedicle screw insertion guided by navigation (PIN) leads to, for the patient, higher doses of radiation compared with pedicle screw insertion guided by fluoroscopy (PIF). This would be a major concern, especially in paediatric deformity correction.

Methods: After a power analysis (aiming at > 0.

Treatment of unstable hips with the Tübingen splint in early postnatal period: radiological mid-term results of 75 hips with mean follow-up of 5.5 years.

Purpose: For treatment of unstable hips, the Tübingen splint is a treatment option. After the initial treatment, regular radiological follow-up examinations are recommended but there is a lack of long-term outcome studies. Therefore, the further development of unstable hips treated with the Tübingen splint were evaluated.

MRI based analysis of grade of spinal canal stenosis and grade of compression of nerve root by lumbar disc herniation as tools to predict probability to need surgical treatment.

Background: Patients with a lumbar disc herniation (LDH) without high-grade neurological deficit (PWN) are usually treated non-operatively. If non-operative treatment is not successful, a postponed surgical treatment is performed. Postponed surgery is reported to show later improvement of pain and health-related quality of life and later return to work than early surgery.

The learning curve of patient-specific unikondylar arthroplasty may be advantageous to off-the-shelf implants: A preliminary study.

Introduction: Introducing a new arthroplasty system into clinical routine is challenging and could have an effect on early results. Since UKA are known to have failure mechanisms related to technical factors, reliable results and easy adoption are ideal. The question remains whether there are differences in objective procedure parameters in the early learning curve of different UKA systems.

Lumbar lordosis as tool to assess the level of pain in patients with low back pain after lumbar disc herniation.

Background: It is presently unknown if lumbar lordosis (LL) might be applied to monitor low back pain (LBP) in patients with lumbar disc herniation (LDH). There is presently only conflicting data that does not show a correlation of LL with LBP: Previous studies do either include chronic LBP or do not consider that each patient has an individual value of LL that cannot be compared to other patients.

Methods: Power analysis: At least 32 patients had to be enrolled in the study.

Position of the acromioclavicular joint and relation to the critical shoulder angle in shoulders with rotator cuff tears.

Objective: To evaluate the position of the acromioclavicular joint (ACJ) and relation to the critical shoulder angle (CSA) in shoulders with rotator cuff tears (RCT).

Methods: In a matched pair study including 75 shoulders with arthroscopically validated RCT and 75 controls (mean age 59.4 ± 7.

Signal Intensity of Lumbar Disc Herniations: Correlation With Age of Herniation for Extrusion, Protrusion, and Sequestration.

Background: There is presently insufficient data on small groups of patients, without focus on time since herniation occurred and without establishing a valid method of measurement for signal intensity (SI) of a lumbar disc herniation (LDH) in a standard magnetic resonance imaging (MRI). SI could be reported in relation to SI of nucleus pulposus of herniated intervertebral disc, nucleus pulposus of a healthy "control" intervertebral disc, cerebral spinal fluid, or anterior anulus fibrosus. It is not known which signal intensity ratio (SIR) shows the highest correlation with time since onset of pain and how SIR of different Combined Task Forces (CTF)-types of herniation develop over time.

Adjacent segment degeneration and topping off. Never stop at the apex!

We investigated if applying the Transition system (Globus Medical Inc., Audubon, PA, USA) as topping off can prevent Adjacent Segment Degeneration (ASD) and if rate of ASD is increased if instrumentation stopped at the apex of the Lumbar Lordosis (LL). We enrolled 99 consecutive patients in a retrospective study who have been operated by instrumented fusion of the lumbar spine.

Radiological outcome after treatment of juvenile flatfeet with subtalar arthroereisis: a matched pair analysis of 38 cases comparing neurogenic and non-neurogenic patients.

Purpose: Therapy of juvenile neurogenic flatfoot (JNF) with subtalar arthroereisis (SA) is currently under critical clinical investigation. In this retrospective matched pair analysis, the radiological outcome after arthroereisis in paediatric patients with infantile cerebral palsy and JNF was compared with children with juvenile flatfeet (JF) without neurological diseases.

Methods: From October 2007 to April 2018 80 patients with 149 flatfeet underwent surgery with SA.

Influence of leg length inequalities on pelvis and spine in patients with total hip arthroplasty.

Background: Leg length inequalities (LLIs) are a common finding in patients with a total hip arthroplasty (THA). Therefore, we compared the effects of simulated LLIs in patients with total hip arthroplasty (THA) with a matched control group.

Research Question: Do LLIs lead to different effects on the musculoskeletal apparatus of patients with a THA then in a control group?

Methods: In 99 patients with a THA the effects of simulated LLIs were compared to a matched control group of 101 subjects without a hip arthroplasty.

Symptomatic medial synovial plica of the knee joint: an underestimated pathology in young patients.

Introduction: To prospectively evaluate the outcome of arthroscopic resection of a symptomatic medial plica in patients under 30 years with evaluating the influence of sports, knee trauma and plica type.

Methods: 35 consecutive patients (38 knees), mean age 16.2 ± 4.

Outcome after subtalar screw arthroereisis in children with flexible flatfoot depends on time of treatment: Midterm results of 95 cases.

Objectives: The subtalar screw arthroereisis (SSA) is a treatment option for painful pediatric flexible flatfeet (PFF). Hence, the optimal time point for a SSA is discussed controversially. Therefore the present study evaluates the influence of the patient's age at surgery on the radiological outcome to provide further evidence in this matter.

[Slipped capital femoral epiphysis: clinical presentation, diagnostic procedure and classification].

Background: Slipped capital femoral epiphysis (SCFE) is a frequent chronic and often bilateral atraumatic slippage of the epiphysis relative to the femoral neck in adolescence. The success of the treatment depends on the extent of the slippage and possible complications.

Objectives: Review on current trends in clinical examination and diagnostic imaging protocols.

The association between a low critical shoulder angle and SLAP lesions.

Purpose: To evaluate the critical shoulder angle (CSA), acromion index (AI) and further acromion parameters in patients with isolated SLAP lesions compared with patients without SLAP lesions.

Methods: Between 2012 and 2016, the CSA, AI, lateral acromion angle (LAA) and acromion slope (AS) were radiologically examined in consecutive patients > 18 years having had a shoulder arthroscopy with isolated SLAP lesion types II-IV. These were compared to controls without SLAP lesions and without (control group I) or with (control group II) complete supraspinatus tendon (SSP) tears.

[Perthes disease-news in diagnostics and treatment].

Diagnostics: Perthes disease remains a challenge for paediatric orthopedic surgeons. X‑ray imaging is still the method of choice for diagnostics and follow-up examination. A more detailed differentiation of Waldenström's classification, especially in early and late fragmentation stages, might be relevant to optimize timing of containment surgery.

[Fixation techniques for slipped capital femoral epiphysis : Principles, surgical techniques, and complications].

The purpose of this review is to present the pros and cons as well as the surgical techniques of conventional implants used for fixation of slipped capital femoral epiphysis (SCFE). Worth mentioning are K‑wires, Hansson pins, transfixing screws, and gliding screws. We searched PubMed for "ECF" and "SCFE" in combination with "in situ fixation," "pin," "wire," "screw," and "nail.

T2* Mapping of the Adult Intervertebral Lumbar Disc: Normative Data and Analysis of Diurnal Effects.

In this prospective study, we sought to establish normative data for T2* analysis of lumbar intervertebral discs (IVDs). Further, potential diurnal effects regarding T2* relaxometry of the lower spine were examined. Lumbar IVDs of young, healthy, adult men (n = 20) and women (n = 20; mean age = 24.