Prediction of loss of correction after hemiepiphysiodesis for the alignment of lower limb angular deformities.

Guided growth by temporary hemiepiphysiodesis (HEPD) is established for the alignment of lower limb angular deformities. This retrospective cohort study was designed to assess the effect of HEPD in idiopathic coronal plane deformities around the knee and on the frontal knee joint line orientation, and to test the frontal knee joint line as predictive means for recurrence.Fourty-four patients (78 deformities: valgus n = 64, varus n = 14) were enrolled in the retrospective observational study.

Pathological fracture of the femoral neck following septic coxitis and chronic osteomyelitis: a potential complication of Lemierre's syndrome.

We portray the case of a 16-year-old girl who was initially admitted to the paediatric emergency department with non-specific symptoms of a severe cold and was first treated symptomatically on an ambulatory basis. Within 6 days she developed the full clinical picture of Lemierre's syndrome with the extraordinary manifestation of involvement of her right hip. Despite an interdisciplinary coordinated treatment as well as surgical therapy, a full-blown sepsis evolved within a short time period and resulted in almost 2 months of intensive care.

Quality-Adjusted Life Years Gained by Hip and Knee Replacement Surgery and Its Aftercare.

Objectives: To determine the lifetime quality-adjusted life years (QALYs) gained by total joint arthroplasty (TJA), and assess the QALYs attributed to specific postoperative rehabilitation interventions.

Design: Secondary analysis of 2 multicenter, randomized controlled trials (RCTs) with 3-, 6-, 12-, and 24-month follow-up.

Setting: Two university hospitals, 2 municipal hospitals, and 1 rural hospital.

Successful treatment of extensively drug-resistant Pseudomonas aeruginosa osteomyelitis using a colistin- and tobramycin-impregnated PMMA spacer.

Discovered in 1949, the antibiotic colistin was initially used for therapeutic purposes. Parenteral use of colistin was gradually abandoned because of its side-effect profile, especially its nephrotoxicity and neurotoxicity. Despite the risk of these potentially serious adverse effects, increasing resistance of Gram-negative bacteria has led to a renaissance of intravenous use of colistin in the last few years.

Multicenter randomized controlled trial comparing early versus late aquatic therapy after total hip or knee arthroplasty.

Objective: To evaluate if the timing of aquatic therapy influences clinical outcomes after total knee arthroplasty (TKA) or total hip arthroplasty (THA).

Design: Multicenter randomized controlled trial with 3-, 6-, 12-, and 24-month follow-up.

Setting: Two university hospitals, 1 municipal hospital, and 1 rural hospital.

Thirty-year follow-up after Wagner resurfacing hip arthroplasty: Case report.

Wagner hip arthroplasty has been used as a resurfacing and thereby bone-preserving method for the treatment of disabling osteoarthritis particularly in younger individuals. The underlying rationale was to replace exclusively diseased tissue, to restore anatomy and function and to optimize range of motion and stress transfer to the proximal femur. Wagner's approach was designed to reduce the risk of infection and to make later revisions easier.

Ergometer cycling after hip or knee replacement surgery: a randomized controlled trial.

Background: The optimal treatment strategy following primary total hip or knee replacement remains unknown. The purpose of this study was to evaluate the effect of ergometer cycling after hip or knee replacement surgery on health-related quality of life and patient satisfaction.

Methods: Three hundred and sixty-two patients were randomly assigned to either perform or not perform ergometer cycling beginning two weeks after total hip or knee replacement.

Cell-Laden and Cell-Free Matrix-Induced Chondrogenesis versus Microfracture for the Treatment of Articular Cartilage Defects: A Histological and Biomechanical Study in Sheep.

Objective: The aim of this study was to evaluate the regenerative potential of cell-laden and cell-free collagen matrices in comparison to microfracture treatment applied to full-thickness chondral defects in an ovine model.

Methods: Animals (n = 30) were randomized into 5 treatment groups, and 7-mm full-cartilage-thickness defects were set at the trochlea and medial condyle of both knee joints and treated as follows: 2 scaffolds in comparison (collagen I/III, Chondro-Gide(®); collagen II, Chondrocell(®)) for covering microfractured defects (autologous matrix-induced chondrogenesis), both scaffolds colonized in vitro with autologous chondrocytes (matrix-associated chondrocyte transplantation), or scaffold-free microfracture technique. One year after surgery, cartilage lesions were biomechanically (indentation test), histologically (O'Driscoll score), and immunohistochemically (collagen type I and II staining) evaluated.

A simple measuring device for laboratory indentation tests on cartilage.

Mechanical testing of articular cartilage and repair tissue enables judgment of their capacity in withstanding mechanical loading. In the past, different methods have been developed requiring a complex technical setup and extensive data analysis. Therefore, the aim of the present project was to build up a simple measuring apparatus for laboratory indentation tests.

Radial extracorporeal shock wave therapy is safe and effective in the treatment of chronic recalcitrant plantar fasciitis: results of a confirmatory randomized placebo-controlled multicenter study.

Background: Radial extracorporeal shock wave therapy is an effective treatment for chronic plantar fasciitis that can be administered to outpatients without anesthesia but has not yet been evaluated in controlled trials.

Hypothesis: There is no difference in effectiveness between radial extracorporeal shock wave therapy and placebo in the treatment of chronic plantar fasciitis.

Study Design: Randomized, controlled trial; Level of evidence, 1.

[The influence of bone quality and the fixation procedure on the primary stability of cementless implanted tibial plateaus].

Background: An overview of prospective studies on cementless and cemented primary knee joint endoprosthetics carried out between 1988 and 2004 reveals that the aseptic tibial loosening rate of cemented prostheses implanted with fixed meniscal bearings amounts to 2-6% within a period of 4-14 years, while cementless implanted prostheses show loosening rates of up to 28% within a period of 4-10 years. If these results arise from a lack of proper initial osseointegration as a result of insufficient primary stability, and how this is influenced by the tibial bone quality and the tibial fixation procedure has not yet been investigated.

Materials And Methods: Tibial plateaus were press-fit implanted, both screwed and unscrewed, into each of six pairs of tibial heads from corpses.

Magnetic resonance imaging and correlative gross anatomy of the ligamentum semicirculare humeri (rotator cable).

The purpose of this study has been to demonstrate macroscopic and MRI anatomy of the so-called rotator cable, otherwise known as the ligamentum semicirculare humeri (LSCH) of the superior shoulder joint capsule. Twelve shoulder joints from eight cadavers were dissected; seven of which, from four of the cadavers, were studied using MR arthrography (1.5-Tesla device Somatom Symphony, Siemens, Erlangen, Germany) prior to dissection.

The intraindividual agreement of the bone density of the human proximal tibia.

The interindividual variability in the biomechanical properties of cadaver bones has remained an unsolved problem in biomechanical investigation procedures. For this reason, it is postulated to use matched bone pairs from the same individual for comparative biomechanical tests. The rationale behind this procedure is based on the assumption that biomechanically similar behaviour is to be expected in an intraindividual rather than an interindividual comparison.

[Designing a surgical device for harvesting autologous fascia lata grafts as a minimal invasive procedure].

Aims: Fascia lata is used in different shapes and sizes as a graft material in surgical procedures. The conventional method of harvesting a fascia lata graft is through a long skin incision on the lateral aspect of the thigh. Minimal invasive procedures have been established to reduce the disadvantages of an extensive surgical approach for obtaining the autotransplant.

Matrix-associated autologous chondrocyte transplantation/implantation (MACT/MACI)--5-year follow-up.

Matrix-associated autologous chondrocyte transplantation/implantation (MACT/MACI) is a new operation procedure using a cell seeded collagen matrix for the treatment of localized full-thickness cartilage defects. A prospective clinical investigation was carried out in order to clarify whether this proves suitable and confirms objective and subjective clinical improvement over a period of up to 5 years after operation. Thirty-eight patients with localised cartilage defects were treated with MACT.

Zebra sign: cerebellar bleeding pattern characteristic of cerebrospinal fluid loss. Case report.

Supratentorial subdural hematoma is a well-known complication following spinal interventions. Less often, spinal or supratentorial interventions cause remote cerebellar hemorrhage (RCH). The exact pathomechanism accounting for RCH remains unclear, but an interventional or postinterventional loss of cerebrospinal fluid (CSF) seems to be involved in almost all cases.

Patellar tendon reconstruction using a free latissimus dorsi flap following resection of a prepatellar myxofibrosarcoma: case report.

The authors' experience indicates that good functional results are achievable in cases with wide resection of the knee extensor mechanism. They report a low-grade myxoid fibrosarcoma patient in whom a one-stage functional reconstruction was carried out by transfer of a free latissimus dorsi flap without secondary surgical procedures.

Periosteum stimulates subchondral bone densification in autologous chondrocyte transplantation in a sheep model.

In this sheep study, we have tested the hypothesis that an osteogenic response is triggered in the subchondral bone by periosteum implanted in full thickness cartilage defects and can be prevented by replacing the periosteum by a cell-free collagen type I/III membrane. Two 7-mm diameter osteochondral defects were made in the trochlea groove and in the medial femoral condyle of one of the knees in each of 15 adult sheep. The animals were divided into three groups (n=5): a control group with untreated cartilage defects, a group treated with autologous chondrocyte transplantation (ACT) and periosteum, and a group treated with ACT in combination with a collagen I/III membrane cover.

Apoptotic chondrocyte death in cell-matrix biocomposites used in autologous chondrocyte transplantation.

Tissue engineering may be a promising approach for the treatment of focal articular cartilage defects. Programmed cell death (apoptosis) plays an important role in multiple degenerative processes of cartilage (e.g.

Macroscopical anatomy of the so-called "rotator interval". A cadaver study on 19 shoulder joints.

The triangular capsular space between the insertion tendons of the Mm. supraspinatus and subscapularis--the "rotator interval", can be divided into lateral, medio-superior and medio-inferior parts. The lateral part of the capsule is strengthened by the "Lig.