Cost-effectiveness of a patient-reported outcome-based remote monitoring and alert intervention for early detection of critical recovery after joint replacement: A randomised controlled trial.

Background: While the effectiveness of patient-reported outcome measures (PROMs) as an intervention to impact patient pathways has been established for cancer care, it is unknown for other indications. We assessed the cost-effectiveness of a PROM-based monitoring and alert intervention for early detection of critical recovery paths following hip and knee replacement.

Methods And Findings: The cost-effectiveness analysis (CEA) is based on a multicentre randomised controlled trial encompassing 3,697 patients with hip replacement and 3,110 patients with knee replacement enrolled from 2019 to 2020 in 9 German hospitals.

[Postoperative rehabilitation after knee arthroplasty].

Background: Postoperative rehabilitation after knee arthroplasty plays a decisive role in restoring the function and mobility of the affected joint. However, there is still disagreement regarding the setting, structure and content of rehabilitation after knee arthroplasty, and the evidence on the individual measures is largely unclear. The aim of this article is to provide an evidence-based overview of the current status of rehabilitation after knee arthroplasty and to critically discuss the points that are still unclear.

Reconstruction of mechanical leg axis using non-modular cemented hinged prosthesis in complex primary total knee arthroplasty.

Purpose: Modular cementless knee arthroplasty systems are capable of precise reconstruction of the mechanical axis. However, they are considered more susceptible to complications. In contrast, non-modular cemented systems are said to be more forgiving and show good long-term results.

The role of different acetabular morphologies on patient-reported outcomes following periacetabular osteotomy in borderline hip dysplasia.

Introduction: The treatment option for borderline hip dysplasia (BHD) includes hip arthroscopy and periacetabular osteotomy (PAO). To the present day the controversial discussion remains, which intervention to prefer. Literature reports supporting an educated choice are scare, based on small patient cohorts and do not address the variability of acetabular morphology.

Elastic Compression Dressing after Total Hip Replacement Slightly Reduces Leg Swelling: A Randomized Controlled Trial.

: Even minor adverse reactions after total hip replacement (THR), including lymphedema, postoperative leg swelling, and blood loss, compromise patient comfort in times of minimally invasive fast-track surgery. Compression dressings are commonly used in surgical practice to reduce swelling or blood loss. However, the use of spica hip compression dressings after primary THR is controversial, and prospective studies are lacking.

Aseptic midterm survival rates between different cemented tibial stem designs in hinged total knee arthroplasty: a 6-year evaluation from the German Arthroplasty Registry.

Introduction: The rate of revision TKA and thus the use of hinged implants (HI) steadily rises. Aseptic loosening lies on the top of the failure patterns. However, no evidence exists until now based on national scale high-caseloads that analyzes the impact of cemented HI stem-design on aseptic survival rates.

Spacer rotation technique allows precise evaluation of gap balance in total knee arthroplasty.

The symmetry of the flexion and extension gap influences the functional and long-term outcome after total knee arthroplasty (TKA). Most surgeons check it by applying varus and valgus stress using spacers. This technique has limited accuracy and could be easily extended by rotational movement of the spacer.

Incidence of Secondary Osteoarthritis after Primary Shoulder and Knee Empyema and Its Risk Factors.

Empyema of the joint is an orthopedic emergency that is associated with a prolonged healing process despite adequate surgical and medical therapy. The risk of developing postinfectious osteoarthritis (OA) after successfully treated joint empyema is unknown. Both incidence and risk factors are important for prognostication and would therefore be clinically relevant for the selection of an adequate infectious therapy as well as for the individual follow-up of patients.

Significant difference in femoral torsion between coronal plane alignment of the knee type 1 and 4.

Purpose: The purpose of this study was to find out whether the torsions of the femur and tibia are dependent on the coronal plane alignment of the knee (CPAK) type.

Methods: Five hundred patients (1000 legs) were included, who received a whole leg standing three-dimensional (3D) radiograph using EOS imaging (EOS Imaging, Paris, France). SterEOS software was used for digital reconstruction.

Optimized reamer geometry for controlled reaming of the proximal femur.

Preparation of the femoral proximal medullary cavity by reaming is essential for intramedullary nail osteosynthesis and hip revision arthroplasty. The use of reamers sometimes exerts high torsional forces on the bone. Design and direction of rotation of the reamer are potential influencing factors.

Effect of Low-Frequency Renal Nerve Stimulation on Renal Glucose Release during Normoglycemia and a Hypoglycemic Clamp in Pigs.

Previously, we demonstrated that renal denervation in pigs reduces renal glucose release during a hypoglycemic episode. In this study we set out to examine changes in side-dependent renal net glucose release (SGN) through unilateral low-frequency stimulation (LFS) of the renal plexus with a pulse generator (2-5 Hz) during normoglycemia (60 min) and insulin-induced hypoglycemia ≤3.5 mmol/L (75 min) in seven pigs.

Plain radiographic indices are reliable indicators for quantitative bone mineral density in male and female patients before total hip arthroplasty.

Osteoporosis is underdiagnosed in patients undergoing total hip arthroplasty (THA). Bone mineral density measurement by dual-energy X-ray absorptiometry (DXA) is the gold standard, but indices on plain hip radiographs also seemed to be reliable screening tools in female or Asian ethnicities in previous studies. Given the lack of knowledge about male patients and Caucasian ethnicities, this study was conducted to evaluate plane hip radiographic indices as a screening tool for osteopenia and osteoporosis in Caucasian female and also male patients before undergoing THA.

Renal Glucose Release after Unilateral Renal Denervation during a Hypoglycemic Clamp in Pigs with an Altered Hypothalamic Pituitary Adrenal Axis after Late-Gestational Dexamethasone Injection.

Previously, we demonstrated in pigs that renal denervation halves glucose release during hypoglycaemia and that a prenatal dexamethasone injection caused increased ACTH and cortisol concentrations as markers of a heightened hypothalamic pituitary adrenal axis (HPAA) during hypoglycaemia. In this study, we investigated the influence of an altered HPAA on renal glucose release during hypoglycaemia. Pigs whose mothers had received two late-gestational dexamethasone injections were subjected to a 75 min hyperinsulinaemic-hypoglycaemic clamp (<3 mmol/L) after unilateral surgical denervation.

Validity of leg length measurement in the supine and standing position compared with pelvic survey X-ray after total hip arthroplasty.

Introduction: The correct adjustment of leg length is a major goal in the implantation of total hip replacements (THRs). Differences in leg length can lead to functional impairment and patient dissatisfaction. By determining leg length at an early stage, before the patient is discharged from hospital, compensatory measures such as the production of special insoles or orthopaedic footwear can be initiated promptly if there is a difference in leg length.

Psychological Factors as Risk Contributors for Poor Hip Function after Periacetabular Osteotomy.

Psychologic comorbidities have been identified as risk factors for poor outcomes in orthopedic procedures, but their influence on the outcome of hip-preserving periacetabular osteotomy (PAO) remains uncertain. This retrospective cohort study aimed to assess the impact of patients' psychological health on the outcome of PAO in patients with hip dysplasia (HD) and acetabular retroversion (AR). The study included 110 patients undergoing PAO for HD or AR between 2019 and 2021.

A Retrospective Analysis of the Association Between Male Facial Hair and the Incidence of Peri-Prosthetic Infections.

The wearing of male facial hair has been undergoing something of a renaissance for a number of years, with medical colleagues in the surgical disciplines being no exception. Meanwhile, there are a few reports in the literature that beards might have an increased bacterial colonization. This study aims to determine if wearing a beard leads to an increased rate of infection in total hip or knee arthroplasty.

"Koehlers teardrop is not a reliable landmark for assessing the centre of rotation after Total hip arthroplasty" - a retrospective radiological study.

Purpose: Various anatomical landmarks have become established in radiography for the assessment of cup positioning after total hip arthroplasty (THA). The most important one is Koehler's teardrop figure (KTF). However, there is a lack of data on the validity of this landmark, which is widely used clinically for assessing the centre of rotation of the hip.

[Complication management after periacetabular osteotomy].

Background: Hip dysplasia is the most common cause of secondary hip osteoarthritis. The Ganz periacetabular osteotomy (PAO) is a well-established procedure that allows a reliable and reproducible correction of the complex pathology. The promising medium and long-term good treatment results are offset by the potential risk of complications from an invasive pelvic procedure.

The Use of Iloprost in the Treatment of Bone Marrow Edema Syndrome of the Proximal Femur: A Review and Meta-Analysis.

Objective: The aim of this meta-analysis was to investigate the impact of intravenous iloprost therapy on pain, function, edema changes, and follow-up surgery in bone marrow edema syndrome of the proximal femur. Methods: A systematic literature search up to May 2022 was performed to find relevant papers that made a statement about the outcome of intravenous iloprost therapy alone. Factors such as the Visual Analog Scale (VAS), Harris Hip Score (HHS), edema reduction, and follow-up interventions were considered.

Topical vancomycin powder does not affect patella cartilage degeneration in primary total knee arthroplasty and conversion rate for secondary patella resurfacing.

Introduction: Vancomycin powder (VP) is an antibiotic first introduced in pediatric spinal surgery to prevent surgical site infections (SSI). Recently its topical application was expanded to total hip and knee arthroplasty (THA, TKA) and anterior cruciate ligament reconstruction (ACLR). Toxicity to cartilage is the subject of current research.

C-Reactive Protein Pretreatment-Level Evaluation for Ewing's Sarcoma Prognosis Assessment-A 15-Year Retrospective Single-Centre Study.

Background: A pathological/inflamed cellular microenvironment state is an additional risk factor for any cancer type. The importance of a chronic inflammation state in most diffuse types of tumour has already been analysed, except for in Ewing’s sarcoma. It is a highly malignant blue round cell tumour, with 90% of cases occurring in patients aged between 5 and 25 years.

Does stem profile have an impact on the failure patterns in revision total knee arthroplasty?

Introduction: Revision total knee arthroplasty (RTKA) has been increasing continuously. The results of RTKA still remain unsatisfactory. Failure patterns and risk factors in RTKA were thoroughly analyzed, with periprosthetic joint infections (PJI) and aseptic loosening remaining at the forefront of re-revision (ReRTKA) causes.

[Knee flexion after hospitalisation is no predictor for functional outcome one year after total knee arthroplasty].

Objective: In total knee arthroplasty (TKA), range of motion has become established as an important factor. The criterion of quality is set to flexion of 90° after hospitalisation. Currently, it is supposed to be a predictor for 1‑year postoperative outcome.

Comparison of two different antiseptics regarding intracutaneous microbial load after preoperative skin cleansing in total knee and hip arthroplasties.

Periprosthetic infections (PPIs) are a serious concern in total knee and hip arthroplasty, and they have an increasing incidence. To prevent PPI, preoperative skin disinfection, as a key element of antisepsis, represents an important part of infection prevention. However, no specific antiseptic agent is endorsed by the relevant guidelines.

Forgivingness of an Anteromedially Positioned Small Locked Plate for High Tibial Osteotomy in Case of Overcorrection and Lateral Hinge Fracture.

High tibial osteotomy (HTO) represents a sensible treatment option for patients with moderate unicondylar osteoarthritis of the knee and extraarticular malalignment. The possibility of a continuously variable correction setting and a surgical approach low in complications has meant that the medial opening osteotomy has prevailed over the past decades. The objective of the present study was to determine whether anteromedially positioned small plates are nevertheless forgiving under biomechanically unfavourable conditions (overcorrection and lateral hinge fracture).