Three-dimensional acetabular reorientation during periacetabular osteotomy: an intraoperative navigation method using an external fixator for periacetabular osteotomy.

Introduction: Bernese periacetabular osteotomy (PAO) is an effective procedure for treating acetabular dysplasia. However, limited visual control of the acetabular position during surgery may result in under- or overcorrection or changes in acetabular version resulting in residual dysplasia or femoroacetabular impingement. Thus, we wanted to develop a simple and straightforward navigation method that provides information about acetabular correction in all three planes during surgery.

Postural stability after operative reconstruction of the AFTL in chronic ankle instability comparing three different surgical techniques.

Background: Chronic lateral ankle instability is a relatively frequent consequence after acute ankle sprain. In case of unsuccessful conservative treatment, surgical therapy is recommended to prevent osteoarthritis of the ankle joint. To date, different surgical methods have evolved.

Polyethylene liner dissociation in total hip arthroplasty: a retrospective case-control study on a single implant design.

Background: Modular acetabular components for total hip arthroplasty (THA) provide intraoperative flexibility; however, polyethylene liner dissociation may occur. This study aimed to examine the incidence and causes of liner dissociation associated with a specific acetabular component design at a single centre.

Materials And Methods: A retrospective analysis of 7027 patients who underwent primary THA was performed to identify isolated liner dislocations.

Favourable mid-term isokinetic strength after primary THA combined with a modified enhanced recovery after surgery concept (ERAS) in a single blinded randomized controlled trial.

Purpose: Muscular deficits as part of severe osteoarthritis of the hip may persist for up to two years following total hip arthroplasty (THA). No study has evaluated the mid-term benefit of a modified enhanced-recovery-after-surgery (ERAS) concept on muscular strength of the hip in detail thus far. We (1) investigated if a modified ERAS-concept for primary THA improves the mid-term rehabilitation of muscular strength and (2) compared the clinical outcome using validated clinical scores.

Periprosthetic Joint Infections of the Knee-Comparison of Different Treatment Algorithms.

Periprosthetic joint infection (PJI) following total knee arthroplasty is a serious complication lacking evidence-based diagnostic and treatment protocols, particularly in ruling out persisting infection before reimplantation. This retrospective analysis assessed the mid-term outcomes of 66 patients undergoing septic two-stage knee revision surgeries from 2007 to 2013, diagnosed as per the Musculoskeletal Infection Society criteria. After implant removal and antibiotic treatment, reimplantation decisions were based on either joint aspiration, blood counts, and clinical examination (group A) or an open biopsy (group B).

Impressive Short-Term Improvement in Functional Outcome and Quality of Life after Primary Total Hip Arthroplasty (THA) in the Orthogeriatric Patient in a Prospective Monocentric Trial.

: Osteoarthritis (OA) represents the most frequent chronic joint disease worldwide. Facing an aging population, resulting from the demographic change, the number of primary total hip arthroplasties (THA) will further increase. Although the geriatric patient strongly differs from the younger one, the current literature on elective orthopedic surgery in the geriatric patient is scarce.

[Risk and complication profiles of orthogeriatric patients in elective hip and knee joint replacement].

Background: The care of geriatric patients undergoing elective orthopedic surgery is becoming increasingly more important due to demographic trends. Compared to geriatric traumatology, however, there are still no established orthogeriatric care models in Germany and therefore hardly any scientific data. The aim of this study was to describe the risk and complication profiles in older patients with elective hip and knee replacements.

[Navigation and robotics-current status and future implications].

Introduction: Both navigation systems and robotics enable greater precision in the implantation of an artificial knee joint. However, they do not improve clinical outcomes. We hypothesized that although implantation of a total knee arthroplasty results in reconstruction of the alignment in the coronal plane, the variable rotational tibial and variable translational femoral and tibial component positioning lead to a change in the remaining alignment parameters of the lower extremity.

The impact of primary total hip and knee replacement on frailty: an observational prospective analysis.

Background: Osteoarthritis is a prevalent condition in frail older adults that requires hip or knee replacement in many patients. The aim of the study was to determine the impact of hip and knee arthroplasty on frailty.

Methods: In this prospective short-term study, we used data from 101 participants of the ongoing Special Orthopaedic Geriatrics (SOG) trial, funded by the German Federal Joint Committee (GBA).

[SOG-Special Orthopedic Geriatrics : First interim results of a randomized controlled study on integrated orthogeriatric care in elective hip and knee arthroplasty].

Background: To date, there are no adequate care concepts for geriatric patients undergoing elective orthopaedic surgery in Germany. The Special Orthopaedic Geriatrics (SOG) study evaluates for the first time in Germany the impact of comprehensive orthogeriatric co-management on the outcome of elderly patients with elective hip and knee replacements compared to standard orthopaedic care.

Methods: The interim analysis of the ongoing study included 174 patients; 87 patients were randomized to the intervention group and 87 to the control group.

[Fast-Track-Arthroplasty].

Introduction: Essential components of fast-track or enhanced recovery programs in arthroplasty are the optimization of interdisciplinary organizational processes, as well as pre-, intra- and postoperative procedures in everyday clinical practice. The early postoperative mobilization of patients after joint replacement surgery is of central importance, with the aim of avoiding pain and complications. This article provides a detailed overview of fast-track procedures that have already been established in many units.

Arthrosis diagnosis and treatment recommendations in clinical practice: an exploratory investigation with the generative AI model GPT-4.

Background: The spread of artificial intelligence (AI) has led to transformative advancements in diverse sectors, including healthcare. Specifically, generative writing systems have shown potential in various applications, but their effectiveness in clinical settings has been barely investigated. In this context, we evaluated the proficiency of ChatGPT-4 in diagnosing gonarthrosis and coxarthrosis and recommending appropriate treatments compared with orthopaedic specialists.

Comparison of postoperative isokinetic quadriceps and gluteal muscular strength after primary THA: is there an early benefit through enhanced recovery programs?

Purpose: Although total hip arthroplasty (THA) is expected to result in a postoperative loss of muscular strength, no study investigated the benefit of an enhanced-recovery-after-surgery (ERAS) concept on the hip muscles in detail. We evaluated if (1) an ERAS-concept for primary THA results in reduced loss of muscular strength five days and four weeks postoperative. We (2) compared the two groups regarding Patient-Related-Outcome-Measures (PROMs), WOMAC-index (Western-Ontario-and-McMaster-Universities-Osteoarthritis-Index), HHS (Harris-Hip-Score) and EQ-5d-3L-score.

The impact of elective total hip and knee arthroplasty on physical performance in orthogeriatric patients: a prospective intervention study.

Background: Osteoarthritis is a prevalent condition in older adults that leads to reduced physical function in many patients and ultimately requires hip or knee replacement. The aim of the study was to determine the impact of hip and knee arthroplasty on the physical performance of orthogeriatric patients with osteoarthritis.

Methods: In this prospective study, we used data from 135 participants of the ongoing Special Orthopaedic Geriatrics (SOG) trial, funded by the German Federal Joint Committee (GBA).

[Outcome of joint replacement in patients with underlying rheumatoid disease].

Background: Artificial joint replacement is a meaningful treatment option for patients with advanced rheumatic degenerative joint diseases. The aim of this study was to investigate the influence of the underlying rheumatic diseases on postoperative complications and patient-reported outcome (PRO) after elective total joint replacement (TJR).

Material And Methods: In a retrospective analysis of 9149 patients with elective total knee or total hip arthroplasty (TKR and THR), complication rates and PRO of patients with and without rheumatic diseases (RD) were compared.

The Role and Efficiency of an AI-Powered Software in the Evaluation of Lower Limb Radiographs before and after Total Knee Arthroplasty.

The rapid evolution of artificial intelligence (AI) in medical imaging analysis has significantly impacted musculoskeletal radiology, offering enhanced accuracy and speed in radiograph evaluations. The potential of AI in clinical settings, however, remains underexplored. This research investigates the efficiency of a commercial AI tool in analyzing radiographs of patients who have undergone total knee arthroplasty.

Better early outcome with enhanced recovery total hip arthroplasty (ERAS-THA) versus conventional setup in randomized clinical trial (RCT).

Introduction: Numbers of total hip arthroplasty (THA) are steadily rising and patients expect faster mobility without pain postoperatively. The aim of enhanced recovery after Surgery (ERAS) programs in a multidisciplinary setup was to keep pace with the needs of quality and quantity of surgical THA-interventions and patients' expectations.

Methods: 194 patients undergoing THA procedures were investigated after single-blinded randomization to ERAS (98) or conventional setup group (96).

Novel diagnostic markers for periprosthetic joint infection: a systematic review.

Background: Identifying novel biomarkers that are both specific and sensitive to periprosthetic joint infection (PJI) has the potential to improve diagnostic accuracy and ultimately enhance patient outcomes. Therefore, the aim of this systematic review is to identify and evaluate the effectiveness of novel biomarkers for the diagnosis of PJI.

Methods: We searched the MEDLINE, EMBASE, PubMed, and Cochrane Library databases from January 1, 2018, to September 30, 2022, using the search terms "periprosthetic joint infection," "prosthetic joint infection," or "periprosthetic infection" as the diagnosis of interest and the target index, combined with the term "marker.

Isokinetic knee muscle strength comparison after enhanced recovery after surgery (ERAS) versus conventional setup in total knee arthroplasty (TKA): a single blinded prospective randomized study.

Purpose: Total knee arthroplasty (TKA) combined with the concept of enhanced recovery is of continued worldwide interest, as it is reported to improve early functional outcome and treatment quality without increasing complications. The aim of the study was to investigate isokinetic knee muscle strength after cemented TKA in combination with an enhanced recovery after surgery (ERAS) compared to a conventional setup.

Methods: In the single blinded prospective randomized study, 52 patients underwent navigated primary cemented TKA within an ERAS (n = 30) or a conventional setup (n = 22).

[Navigated or conventional acetabular surgery : Comparison of positional accuracy exemplified by the infra-acetabular screw].

Background: The principle of joint-preserving treatment of acetabular fractures is the anatomic reduction of joint-bearing elements and internal osteosynthesis. For stabilization of the anterior and posterior columns against each other, the infra-acetabular screw (IAS) is regularly used in the clinical routine.

Objective: The aim of this study was to compare the position of the IAS in the infra-acetabular corridor after navigated placement and after freehand placement.

Total Knee Arthroplasty Violates the Law of Burmester-A Biomechanical Investigation.

Background: Kinematic patterns of knees after total knee arthroplasty (TKA) are different from those of healthy knees. We hypothesised that these changes cause a relevant shift in the medial and lateral epicondyles and, consequently, the insertion sites of the collateral ligaments. Any alterations, however, violate the law of Burmester, which states a close relation between the course of the collateral and cruciate ligaments, and the articular surfaces.

Special orthopaedic geriatrics (SOG) - a new multiprofessional care model for elderly patients in elective orthopaedic surgery: a study protocol for a prospective randomized controlled trial of a multimodal intervention in frail patients with hip and knee replacement.

Background: Due to demographic change, the number of older people in Germany and worldwide will continue to rise in the coming decades. As a result, the number of elderly and frail patients undergoing total hip and knee arthroplasty is projected to increase significantly in the coming years. In order to reduce risk of complications and improve postoperative outcome, it can be beneficial to optimally prepare geriatric patients before orthopaedic surgery and to provide perioperative care by a multiprofessional orthogeriatric team.