Proximal humeral bone loss in stemless shoulder arthroplasty: potential factors influencing bone loss and a new classification system.

Introduction: Proximal humeral bone loss in total shoulder arthroplasty (TSA) is more frequent than in hemiarthroplasty. Factors such as age, gender, inclination angle, and radiolucent lines may also contribute. Additionally, current bone loss grading systems are often not sensitive enough to detect slight bone changes, especially at the medial calcar where bone loss is commonly observed.

Revision arthroplasty with rotating hinge systems for total knee arthroplasty instability.

Objective: Restoring stability after total knee arthroplasty (TKA) and improving joint function using a cemented rotating hinge system.

Indications: Ligament instability and/or osseous defects (including Anderson Orthopaedic Research Institute [AORI] classification type II defects) after primary TKA or TKA revision surgery.

Contraindications: Distal femoral or proximal tibial bowing requiring implant systems that provide femoral or tibial offset stems.

Similar Outcomes of Two-Stage Revisions for Infection and One-Stage Revisions for Aseptic Revisions of Knee Endoprostheses.

Two-stage revision knee arthroplasty using an antibiotic-loaded spacer is the most widely performed procedure for infected knee arthroplasties. The clinical outcome of this type of surgery compared with aseptic joint revision with exchange of tibial and femoral components is still controversial. Therefore, we analyzed clinical outcomes of septic two-stage revisions compared with aseptic one-stage revision total knee arthroplasties (TKAs).

Revision knee arthroplasty with rotating hinge systems in patients with gross ligament instability.

Purpose: The clinical and radiographic outcomes after revision total knee arthroplasty (TKA) for instability with two rotating hinge knee prostheses were compared.

Methods: Fifty-one patients revised for TKA instability were prospectively randomized to either the Link Endo-Model (N = 26) or the EnduRo (N = 25). Clinical and radiographic outcome scores were compared pre-operatively and at 12 months' follow-up.

Treatment of hallux valgus deformity.

Hallux valgus deformity is a very common pathological condition which commonly produces painful disability. It is characterised as a combined deformity with a malpositioning of the first metatarsophalangeal joint caused by a lateral deviation of the great toe and a medial deviation of the first metatarsal bone.Taking the patient's history and a thorough physical examination are important steps.

[Total knee arthroplasty. Patient-specific instruments and implants].

This article describes the concept and surgical technique of patient-specific total knee arthroplasty. Patient-specific implants and instruments are designed and fabricated based on computed tomography (CT) data of the leg. The disposable patient-specific drill guides and cutting-jigs are manufactured taking into consideration the anatomical and biomechanical axes of the knee joint and mediating the efficient pre-navigation of the osseous saw-cuts, without the need for additional navigation or balancing aids.

The Wuerzburg procedure: the tensor fasciae latae perforator is a reliable anatomical landmark to clearly identify the Hueter interval when using the minimally-invasive direct anterior approach to the hip joint.

Background: The key for successful delivery in minimally-invasive hip replacement lies in the exact knowledge about the surgical anatomy. The minimally-invasive direct anterior approach to the hip joint makes it necessary to clearly identify the tensor fasciae latae muscle in order to enter the Hueter interval without damaging the lateral femoral cutaneous nerve. However, due to the inherently restricted overview in minimally-invasive surgery, this can be difficult even for experienced surgeons.

No significant difference in clinical outcome and knee stability between patellar tendon and semitendinosus tendon in anterior cruciate ligament reconstruction.

Introduction: ACL reconstruction with either patellar tendon or semitendinosus tendon autografts are standard procedures. Between these two grafts might be differences in stability, morbidity, or long-term changes. This study investigates outcomes of ACL reconstruction with patellar tendon versus semitendinosus tendon autografts.

Outcome of a modular head-neck adapter system in revision hip arthroplasty.

Purpose: Revision hip arthroplasty using a modular head-neck adapter gives the possibility of keeping a well-fixed femoral component while revising the acetabular prosthesis or femoral head and adapt leg length and femoral offset to the individual anatomy intraoperatively. The success of this kind of surgery is still unclear due to the lack of medium- to long-term follow-up. Therefore, we analyzed the clinical and radiological outcome of the modular Merete BioBall© adapter system in revision hip surgery.

Similar outcomes between two-stage revisions for infection and aseptic hip revisions.

Purpose: Two-stage revision hip arthroplasty using an antibiotic-loaded spacer is the most widely performed procedure for infected hip arthroplasties. The clinical outcome of this type of surgery compared with aseptic joint revision with exchange of femoral and acetabular components is still controversial due to the relative lack of medium- to long-term follow-up. Therefore, we analysed clinical and radiological outcomes of septic two-stage revisions compared with aseptic hip revision surgeries.

Outcome of a modular tapered uncemented titanium femoral stem in revision hip arthroplasty.

Purpose: Revision hip arthroplasty using a modular tapered design gives the possibility for customising the prostheses to the individual anatomy intra-operatively. The success of this kind of surgery is still controversial due to the relative lack of medium- to long-term follow-up. Therefore we analysed the clinical and radiological outcome of the modular MRP-TITAN stem with diaphyseal fixation in revision hip surgery.

Outcome of isolated polyethylene tibial insert exchange after primary cemented total knee arthroplasty.

Purpose: Total knee arthroplasty using a modular design gives the possibility for an isolated exchange of the tibial polyethylene insert in patients with failed total knee arthroplasty. The success of this kind of surgery is still controversial. We analysed the clinical outcome after isolated tibial polyethylene insert exchange.

Transforming Growth Factor-β1 and Laminin-111 Cooperate in the Regulation of Expression of Interleukin-6 and Interleukin-8 in Synovial Fibroblasts.

In a recent study we showed that binding of synovial fibroblasts (SF) to laminin-111 (LM-111) in the presence of TGF-β1 induced a significant production of IL-16. Here we go on to investigate the regulation of IL-6 and IL-8 in SF by LM-111 and TGF-β1. Changes in steady state mRNA levels encoding the interleukins were investigated by quantitative RT-PCR.

Metal-on-metal hip resurfacing in patients with pigmented villonodular synovitis: a report of two cases.

Pigmented villonodular synovitis (PVNS) of the hip joint is a rare and benign tumor of the synovia. This local, aggressive, proliferative disorder of the joint synovial membrane can lead to secondary osteoarthritis and represents a small percentage of all patients undergoing total hip replacement (THR). Because of the usually young age of the patients undergoing THR for PVNS, a resurfacing arthroplasty of the hip appears as a beneficial treatment option due to its bone-conserving nature, good joint stability, and ability to easily convert to a THR if needed.

Toll-like receptor engagement enhances the immunosuppressive properties of human bone marrow-derived mesenchymal stem cells by inducing indoleamine-2,3-dioxygenase-1 via interferon-beta and protein kinase R.

Mesenchymal stem cells (MSC) display unique suppressive properties on T-cell immunity, thus representing an attractive vehicle for the treatment of conditions associated with harmful T-cell responses such as organ-specific autoimmunity and graft-versus-host disease. Toll-like receptors (TLR) are primarily expressed on antigen-presenting cells and recognize conserved pathogen-derived components. Ligation of TLR activates multiple innate and adaptive immune response pathways to eliminate and protect against invading pathogens.

Induction of endostatin expression in meniscal fibrochondrocytes by co-culture with endothelial cells.

Introduction: The ultimate goal after meniscus damage is the preservation of the original meniscal tissue, which is often impossible due to the limited healing capacity of meniscal lesions, especially in the avascular zone. Factors produced by endothelial cells of meniscal vessels may contribute to better wound healing in vascularized zones. We therefore investigated the expression of different angiogenic factors, growth hormones and cytokines in human fibrochondrocytes and in fibrochondrocytes upon co-culture with endothelial cells, to examine mechanisms of repair of meniscal injury in more detail and to investigate the potential use of endothelial cells in co-cultures for autologous meniscal repair utilizing tissue engineering technology.

Improved survivorship of hybrid metal-on-metal hip resurfacing with second-generation techniques for Crowe-I and II developmental dysplasia of the hip.

Background: The purpose of this study was to determine the influence of improved femoral fixation techniques on the survivorship of metal-on-metal total hip resurfacing prostheses in patients with developmental dysplasia of the hip and to report the long-term results of our patients managed earlier with first-generation fixation techniques.

Methods: One hundred and three hips (ninety patients) were resurfaced for osteoarthritis secondary to developmental dysplasia. The mean age of the patients was forty-seven years, and 77% were women.

Attachment to laminin-111 facilitates transforming growth factor beta-induced expression of matrix metalloproteinase-3 in synovial fibroblasts.

Background: In the synovial membrane of patients with rheumatoid arthritis (RA), a strong expression of laminins and matrix degrading proteases was reported.

Aim: To investigate the regulation of matrix metalloproteinases (MMPs) in synovial fibroblasts (SFs) of patients with osteoarthritis (OA) and RA by attachment to laminin-1 (LM-111) and in the presence or absence of costimulatory signals provided by transforming growth factor beta (TGFbeta).

Methods: SFs were seeded in laminin-coated flasks and activated by addition of TGFbeta.