Publications by authors named "Melanie Schindler"
Purpose: This study investigated the epidemiology, risk factors, and outcomes of sepsis, a life-threatening complication, in the context of periprosthetic joint infections (PJI) of the hip and knee.
Methods: Sepsis was determined using the Sepsis-1 criteria. The cohort with PJI and sepsis was compared to patients who had PJI without sepsis.
Article Synopsis
- MRI is the primary diagnostic tool for spondylodiscitis, but the study highlights an increasing importance of [F]FDG PET/CT, especially in older patients.
- A Germany-wide study analyzed 29,362 hospital admissions from 2019 to 2021, finding that only 2.7% used [F]FDG PET/CT, yet those patients had lower in-hospital mortality rates compared to those who underwent other diagnostic methods.
- The results indicate that while [F]FDG PET/CT is rarely utilized, its use significantly correlates with reduced mortality in geriatric patients with spondylodiscitis, suggesting a need for more research on its effectiveness.
Article Synopsis
- Pyogenic vertebral osteomyelitis (VO) is a serious infection of the spine that can lead to a lot of health problems and even death.
- A study looked at 155 patients with VO and found that around 34% of them died during an average follow-up of about 7 years, with specific issues like heart and kidney diseases increasing the risk of death.
- The research suggests that checking for these health problems early and treating infections promptly could help doctors take better care of patients with VO and improve their chances of recovery.
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.
View Article and Find Full Text PDFBackground: Persistent knee synovitis leads to joint discomfort, incapacitating inflammation, and functional limitations. The conventional approach has involved surgical procedures to eliminate the actively inflamed synovial membrane. This study aims to investigate the recurrence-free survival and functional outcome after synovectomy and subsequent radiosynoviorthesis (RSO) in patients with knee synovitis.
View Article and Find Full Text PDFBackground: Vertebral osteomyelitis (VO) often necessitates surgical intervention due to bone loss-induced spinal instability. Anterior column reconstruction, utilizing expandable vertebral body replacement (VBR) implants, is a recognized approach to restore stability and prevent neurological compromise. Despite various techniques, clinical evidence regarding the safety and efficacy of these implants in VO remains limited.
View Article and Find Full Text PDFThe 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.
View Article and Find Full Text PDFInfluence of bone mineral density on femoral stem subsidence after cementless THA.
Arch Orthop Trauma Surg
January 2024
Article Synopsis
- Femoral stem subsidence can lead to complications after total hip arthroplasty (THA), and this study investigates whether low bone mineral density (BMD) increases the risk of this issue following cementless THA.
- The analysis of 79 patients showed that stem subsidence occurred regardless of BMD levels, with surprisingly higher subsidence in those with normal BMD, and a correlation between higher BMI and increased subsidence was noted.
- Ultimately, the study concludes that cementless stems can achieve stable fixation even in patients with low BMD, and enhanced recovery rehabilitation is safe for these patients without compromising outcomes.
Novel diagnostic markers for periprosthetic joint infection: a systematic review.
Front Cell Infect Microbiol
August 2023
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.
Background: Pyogenic vertebral osteomyelitis represents a clinical challenge associated with significant morbidity and mortality. The aim of this study was to analyze potential risk factors for the in-hospital mortality of vertebral osteomyelitis (VO) patients.
Methods: Based on the International Classification of Diseases, 10th Revision (ICD-10) codes for VO ("M46.
Background: Total hip arthroplasty (THA) is still ranked among the operations with the highest postoperative pain scores. Uncontrolled postsurgical pain leads to prolongated hospital stays, causes more frequent adverse reactions and can induce chronical pain syndromes. In 2014, we implemented a standardized, multidisciplinary pain management concept with continuous benchmarking at our tertiary referral center by using the "Quality Improvement in Postoperative Pain Management" (QUIPS) program with excellent results over a period of two years.
View Article and Find Full Text PDFArticle Synopsis
- This study compares total hip arthroplasties (THA) for primary osteoarthritis (OA) and femoral neck fractures (FNF), revealing significant differences in mortality and revision rates.
- Findings show that mortality is notably higher in patients with FNF at 1 and 5 years post-surgery compared to those with OA, along with increased rates of both septic and aseptic revisions.
- Factors such as higher Elixhauser comorbidity scores and body mass index (BMI) contribute to the risk of septic and aseptic failures, highlighting the importance of patient health status in surgical outcomes.
Background: Spondylodiscitis can lead to significant morbidity and mortality. Understanding its up-to-date epidemiological characteristics and trends is important to improve patient care.
Methods: This study analyzed trends in the incidence rate of spondylodiscitis cases in Germany between 2010 and 2020, as well as the pathogens, in-hospital mortality rate, and length of hospital stay.
Introduction: Enhanced recovery after surgery (ERAS) leads to less morbidity, faster recovery, and, therefore, shorter hospital stays. The expected increment of primary total hip arthroplasty (THA) in the U.S.
View Article and Find Full Text PDFBackground: Hip disarticulation and hemipelvectomy are defined as major ablative amputations of the lower limb. Due to the small number of patients, little is known about the outcome and follow-up.
Aims: We aimed to assess (1) reasons for performed major ablative surgeries such as hip disarticulation and hemipelvectomy in a German center for trauma and orthopedic surgery.
Background: Joint replacement surgeries have been known to be some of the most painful surgical procedures. Therefore, the options for postoperative pain management are of great importance for patients undergoing total knee arthroplasty (TKA). Despite successful surgery, up to 30% of the patients are not satisfied after the operation.
View Article and Find Full Text PDFHallux saltans is similar to digitus saltans and produces a spontaneous "snapping" of the big toe. This results in a constriction of the flexor hallucis longus tendon within the osteofibrous retromalleolar canal. The diagnosis was first described in 1940, and only a few case reports exist.
View Article and Find Full Text PDFBackground: The concept of enhanced recovery after total hip arthroplasty is gaining worldwide interest, as it shortens the length of hospital stay without an increase of complications. The aim of the study was to investigate the functional outcome and health-related quality of life 12 months after cementless total hip arthroplasty with the use of an enhanced recovery concept in comparison to a conventional rehabilitation.
Material And Methods: 320 patients were retrospectively analyzed who underwent primary cementless total hip arthroplasty (THA).
Article Synopsis
- The study investigates the impact of patient-related factors, such as age, gender, and preoperative anxiety/depression, on 1-year outcomes following total joint arthroplasty (TJA).
- A significant portion of the patients (53.3%) had anxiety/depression before surgery, and those without such conditions had better postoperative scores.
- Results indicate that older age, higher ASA scores, and anxiety/depression are associated with worse outcomes, suggesting the need for preoperative interventions to address these issues for better recovery post-surgery.
Article Synopsis
- Alluvial floodplain forests in Europe are facing significant reduction due to human activities such as deforestation and agricultural expansion, leading to a lack of effective management frameworks for these complex ecosystems.
- The study focused on how flooding duration and oxygen supply affect the growth and foliar injury of ten woody species saplings, identifying six as flooding tolerant and four as intolerant.
- Results indicated that flooding tolerant species improved growth with longer flooding durations, and incorporating a recovery period is crucial for evaluating their resilience to flooding stress.