A modified Radiographic Union Score for Tibia (RUST) scoring system for patella fractures treated with osteosynthesis shows excellent intra und interobserver reliability.

Introduction: Patellar fractures are rare at 1% incidence of all fractures. However, they can cause significant functional impairments due to the patella's role in knee joint extension. Current scoring systems lack objectivity in assessing patellar healing.

Detection of Synchronous Foci of Infection using Positron Emission Tomography in Septic Patients Who Have a Periprosthetic Joint Infection.

Introduction: Periprosthetic joint infection (PJI) with sepsis is a life-threatening condition and identification of synchronous foci of infection is challenging. Positron emission tomography using F-fluorodeoxyglucose combined with computed tomography (F-FDG-PET/CT) is useful to detect PJI in elective, non-septic patients. We hypothesized that in patients who have PJI and concomitant sepsis requiring intensive care, F-FDG-PET/CT could accurately identify synchronous foci of infection.

Traumatic Complete Loss of Knee Extensor Mechanism and Its Reconstruction With a Fresh-frozen Patellar Allograft With Patellar and Quadriceps Tendon.

We report on an 18-year-old female who sustained complete loss of her knee extensor mechanism (patella, quadriceps and patellar tendon) due to a motorbike injury with severe soft tissue loss of the ventral aspect of the knee and subsequent infection. After infection control and successful latissimus dorsi free flap surgery, reconstruction of the knee extensor mechanism was performed using a fresh frozen extensor mechanism allograft with patella, quadriceps- and patellar tendon and integrated tibia tuberosity fragment. After a follow-up of 18 months, there was infection free integration of the allograft with a range of motion 0-0-90° (extension/flexion) and pain free gait.

Recent advancements and future directions in fracture related infections: A scoping review.

Fracture-related infections (FRIs) are complex challenges in orthopedic and trauma surgery, driving ongoing advancements in diagnostics, therapeutics, and management strategies. This scoping review examines recent progress and future directions in FRI management. Diagnostic enhancements encompass standardized definitions, improved biomarkers, advanced microbiological techniques, and innovative imaging modalities.

Multidisciplinary approach and host optimization for fracture-related infection management.

In orthopaedic trauma, fracture-related infections (FRI) are still dreadful challenges that can cause non-union, amputation and even death. Standardization of general treatment strategies for FRI is still lacking. Due to the complexity of FRI, a multidisciplinary approach addressing host status, state of the fracture and causative microorganism has been applied in the management of FRI.

Antimicrobial resistance: Biofilms, small colony variants, and intracellular bacteria.

Soft tissue and bone infections continue to be a serious complication in orthopedic and trauma surgery. Both can lead to a high burden for the patients and the healthcare system. Musculoskeletal infections can be induced by intraoperative contamination, bacterial contamination of open wounds or hematogenous bacterial spread.

The DAIR-procedure in fracture-related infection-When and how.

This narrative review discusses treatment strategies and key considerations guiding decisions in the surgical management of fracture-related infections (FRI). Treatment options primarily revolve around two approaches: debridement antibiotics and implant retention (DAIR), or implant exchange, either in a one or multiple-stage strategy. Several considerations, including time since infection onset, implant type, stability, causative pathogens, host physiology, and soft tissue conditions, inform the choice of surgical intervention for FRI.

[Unicondylar knee arthroplasties demonstrate a significantly increased risk of aseptic revisions compared with unconstrained and constrained TKA : Analysis of aseptic revisions after unicondylar and primary total knee arthroplasty of the German Arthroplasty Register].

Objective: Owing to the ageing population the implantation rate of total knee arthroplasty (TKA) continues to rise. Aseptic revisions in primary TKA are one of the main causes of revision. The aim of the following study was to determine the incidence of and reasons for aseptic revision in constrained and unconstrained TKA and in unicondylar knee arthroplasty (UKA).

[Low UKA implantation volume, comorbidities, male sex, and implantation of constrained TKA are risk factors for septic revision after knee arthroplasty implantation : A register-based study from the German Arthroplasty Register].

Aim: Periprosthetic joint infection (PJI) is one of the main causes of revision surgeries after total knee arthroplasty (TKA) and unicondylar knee replacement. Patient- and hospital-related risk factors must be evaluated to prevent PJI. This study identifies influencing factors and differences in infection rates between various types of implant.

Increased rate of injuries to the anterior cruciate ligament in amateur soccer players after the COVID-19 pandemic lockdown.

The COVID-19 pandemic led to the discontinuation of soccer activities at all levels of play. Injuries to the anterior cruciate ligament (ACL) are still one of the most severe injuries in soccer. The aim of this investigation was to analyze the changes in the incidence and mechanism of ACL injuries in professional and amateur soccer before and after the lockdown period.

What are the age-related factors linked to aseptic revisions in constrained and unconstrained TKA as well as UKA? A register-based study from the German arthroplasty registry (EPRD).

Purpose: The implantation rate of total knee arthroplasties (TKA) is continuously growing. Aseptic problems are a major cause of revision. The aim of the following study was to determinate the incidence of aseptic revisions in primary knee arthroplasty as well as aseptic revision rates and influencing factors according to the patients' age and type of procedure.

Osteomyelitis in Late-Stage Pressure Sore Patients: A Retrospective Analysis.

Background: Late-stage pressure sore (PS) patients are particularly susceptible to osteomyelitis (OM), as bony prominences commonly constitute the focal point of the ulcer. There are lack of data regarding the associated factors and the clinical relevance of this diagnosis in the context of PS treatment.

Methods: This retrospective analysis investigated the clinical characteristics, blood markers indicative of infection in PS patients, and development of histologically evident OM.

Development of a Infection Model to Evaluate the Efficacy of Antibiotic-Loaded Polymethyl Methacrylate (PMMA) Bone Cement.

Prosthetic joint infections (PJIs) can have disastrous consequences for patient health, including removal of the device, and placement of cemented implants is often required during surgery to eradicate PJIs. In translational research, in vivo models are widely used to assess the biocompatibility and antimicrobial efficacy of antimicrobial coatings and compounds. Here, we aim to utilize implant infection models to assess the antimicrobial activity of antibiotic-loaded bone cement (ALBC) implants.

Multidisciplinary Teams in Musculoskeletal Infection - From a Pathologist's Perspective.

Multidisciplinary team (MDT) meetings have emerged as a promising approach for the treatment of cancer patients. These meetings involve a team of healthcare professionals from different disciplines working together to develop a holistic, patient-centered treatment. Although MDT meetings are well established in oncology, they play a minor role in other diseases.

Repetitive combined doses of bacteriophages and gentamicin protect against Staphylococcus aureus implant-related infections in Galleria mellonella.

Aims: Bacteriophages infect, replicate inside bacteria, and are released from the host through lysis. Here, we evaluate the effects of repetitive doses of the phage 191219 and gentamicin against haematogenous and early-stage biofilm implant-related infections in .

Methods: For the haematogenous infection, larvae were implanted with a Kirschner wire (K-wire), infected with , and subsequently phages and/or gentamicin were administered.

Managing more than bones: the psychological impact of a recurrent fracture-related infection.

Aims: Fracture-related infections (FRIs) are a devastating complication of fracture management. However, the impact of FRIs on mental health remains understudied. The aim of this study was a longitudinal evaluation of patients' psychological state, and expectations for recovery comparing patients with recurrent FRI to those with primary FRI.

Case report: Local bacteriophage therapy for fracture-related infection with polymicrobial multi-resistant bacteria: hydrogel application and postoperative phage analysis through metagenomic sequencing.

Fracture-related infections can be challenging, particularly with concomitant severe bone defects and multi-resistant microorganisms. We present a case of a 42-year-old patient with a fracture-related infection following a war injury from a gunshot, resulting in a 12-cm subtrochanteric segmental bone defect and the detection of four different multi-resistant Gram-negative bacteria. Due to antibiotic drug resistance, treatment with bacteriophages was considered.

Risk of surgical site infection after hip hemiarthroplasty of femoral neck fractures: a systematic review and meta-analysis.

Introduction: Surgical site infection (SSI) is a major complication following hemiarthroplasty surgery for displaced neck of femur fractures. Our aim is to systematically analyse relevant peer-reviewed studies for recent clinical information on the quantitative risk of surgical site infection (SSI) after hemiarthroplasty (HA) of hip fracture patients and on the factors which influence the SSI rates.

Methods: A comprehensive search of electronic databases (PubMed, Cochrane) was performed for clinical articles published between 2005 and 2023 and systematically reviewed with a defined list of inclusion and exclusion criteria.

In-hospital mortality of patients with periprosthetic joint infection.

Aims: Periprosthetic joint infection (PJI) demonstrates the most feared complication after total joint replacement (TJR). The current work analyzes the demographic, comorbidity, and complication profiles of all patients who had in-hospital treatment due to PJI. Furthermore, it aims to evaluate the in-hospital mortality of patients with PJI and analyze possible risk factors in terms of secondary diagnosis, diagnostic procedures, and complications.

Unicondylar knee arthroplasty demonstrating a significant increased risk for aseptic revisions compared to unconstrained and constrained total knee arthroplasty: An analysis of aseptic revisions after unicondylar and primary total knee arthroplasty of the German Arthroplasty Registry.

Purpose: Due to ageing population, the implantation rate of total knee arthroplasties (TKAs) is continuously growing. Aseptic revisions in primary knee arthroplasty are a major cause of revision. The aim of the following study was to determinate the incidence and reasons of aseptic revisions in constrained and unconstrained TKA, as well as in unicondylar knee arthroplasties (UKAs).

Low implantation volume, comorbidities, male sex and implantation of constrained TKA identified as risk factors for septic revision in knee arthroplasty: A register-based study from the German Arthroplasty Registry.

Purpose: Periprosthetic joint infection (PJI) is a major cause of revision surgery after total knee arthroplasty (TKA) and unicondylar knee arthroplasty (UKA). Patient- and hospital-related risk factors need to be assessed to prevent PJI. This study identifies influential factors and differences in infection rates between different implant types.

Waning waves of mood: The declining trend of hospitalized patients with affective disorders in Germany.

Introduction: Affective disorders profoundly affect individuals' emotional well-being and quality of life. This study investigates the epidemiology of affective disorders in Germany from 2011 to 2021, focusing on incidence rates, age- and sex-standardized rates, and developmental trends.

Methods: Using nationwide data of ICD-10 diagnosis codes from 2011 to 2021, this cross-sectional study analyzed inpatient cases of affective disorders in individuals aged 20 years or older.