Musculoskeletal Rehabilitation: New Perspectives in Postoperative Care Following Total Knee Arthroplasty Using an External Motion Sensor and a Smartphone Application for Remote Monitoring.

Background: The number of total knee replacements performed annually is steadily increasing. Parallel options for postoperative care are decreasing, which reduces patient satisfaction. External devices to support physical rehabilitation and health monitoring will improve patient satisfaction and postoperative care.

10-year follow-up of the Columbus knee prostheses system in a prospective multicenter study.

Introduction: As endpoint of a prospective multicenter 10-year documentation using the Columbus system, this evaluation carried out results of clinical scores (Knee Society Score and Oxford Knee Score), an evaluation of radiological imaging, survival rates and a collection of complication statistics.

Materials And Methods: There was a multicenter prospective recruitment of consecutive patients with the indication for total knee replacement (TKR). Preoperatively and 10 years after implantation, clinical scores, range of motion and radiological imaging was performed.

Total hip arthroplasty following acetabular fracture: a clinical and radiographic outcome analysis of 67 patients.

Background: Total hip arthroplasty (THA) is a challenging option for the treatment of posttraumatic arthritis due to acetabular fractures.

Methods: The study aimed to determine the short- and mid-term clinical and radiographic results of THA following acetabular fracture. The fracture pattern, the extent of injury and the initial fracture treatment were considered to evaluate the influence of these factors on the clinical-radiographic outcome.

Periprosthetic tibial fractures in total knee arthroplasty - an outcome analysis of a challenging and underreported surgical issue.

Background: Periprosthetic fractures after total knee arthroplasty (TKA) are an increasing problem and challenging to treat. The tibial side is commonly less affected than the femoral side wherefore few studies and case reports are available. The aim of this study was to analyze the outcome of periprosthetic tibial fractures and compare our data with current literature.

[5-year follow-up of 210 Columbus knee prostheses : A prospective multicentre study].

Introduction: As part of 10-year documentation using the Columbus system, the interim evaluation was carried out 5 years after implantation with a collection of clinical scores, evaluation of radiological imaging and collection of statistics concerning complications.

Methods: There was a multicentre prospective recruitment of consecutive patients with the indication of implantation of a surface replacement prosthesis (Columbus CR, Deep Dish fixed inlay). Preoperatively, clinical scores were recorded (KSS and Oxford score).

Interview based malnutrition assessment can predict adverse events within 6 months after primary and revision arthroplasty - a prospective observational study of 351 patients.

Background: Being at risk for malnutrition can be observed among hospitalized patients of all medical specialties. There are only few studies in arthroplasty dealing with defining and assessing malnutrition as such a potentially risk. This study aims to identify the risk for malnutrition following primary (pAP) and revision arthroplasty (rAP) (1) using non-invasive interview based assessment tools and to analyze effects on clinical outcome (2) and quality of life (3).

Adverse Events in the Treatment of Periprosthetic Fractures Around the Knee - a Clinical and Radiological Outcome Analysis.

Background: The incidence of periprosthetic fractures associated with total knee arthroplasty (PpFxK) has been reported to be 0.3 - 5.5%.

Symphyseal fixation in open book injuries cannot fully compensate anterior SI joint injury-A biomechanical study in a two-leg alternating load model.

Introduction: In open book injuries type Tile B1.1 or B1.2 also classified as APC II (anteroposterior compression), it remains controversial, if a fixation of the anterior ring provides sufficient stability or a fixation of the posterior ring should be included.

[Implantation of a Modular Distal Femoral Replacement with Compressive Osseointegration as a Salvage Procedure in a Complex Femoral Posttraumatic Setting].

Background: Large bone defects and losses play a crucial role in both tumour surgery and in complex primary and revision total knee replacement. The established options of cemented or uncemented long intramedullary stems are limited by large bone defects and are at risk from relatively high exposure to aseptic loosening. There is no general valid agreement on implant fixation of the distal femur.

Distinct Gene Expression Patterns Defining Human Osteoblasts' Response to BMP2 Treatment: Is the Therapeutic Success All a Matter of Timing?

Background: Bone morphogenetic proteins (BMPs) play a key role in bone formation. Local application of BMP2 (Dibotermin alfa) supports bone formation when applied to complex fractures. However, up to 33% of patients do not respond to this therapy.

[Retrospective Analysis of Diabetics with Regard to Treatment Duration and Costs].

The increasing incidence of diabetes mellitus is also reflected in the patient population of a trauma and orthopaedic centre. Diabetics also exhibit more comorbidities than non-diabetics. In addition to surgical problems in these patients, hospitalisation is often accompanied by complications, which can prolong treatment and increase costs.

[Periprosthetic Acetabulum Fractures].

In contrast to periprosthetic fractures of the femur, periprosthetic fractures of the acetabulum are rare complications - both primary fractures and fractures in revision surgery. This topic is largely under-reported in the literature; there are a few case reports and no long term results. Due to an increase in life expectancy, the level of patients' activity and the number of primary joint replacements, one has to expect a rise in periprosthetic complications in general and periprosthetic acetabular fractures in particular.

BMP9 a possible alternative drug for the recently withdrawn BMP7? New perspectives for (re-)implementation by personalized medicine.

Promotion of rhBMP2 and rhBMP7 for the routine use to support fracture healing has been hampered by high costs, safety concerns and reasonable failure rates, imposing restrictions in its clinical use. Since there is little debate regarding its treatment potential, there is rising need for a better understanding of the mode of action of these BMPs to overcome its drawbacks and promote more efficacious treatment strategies for bone regeneration. Recently, BMP9, owing to its improved osteogenic potential, is gaining attention as a promising therapeutic alternative.

Navigated TKA After Osteotomy Versus Primary Navigated TKA: A Matched-Pair Analysis.

This article presents clinical and radiological outcome analysis of navigated total knee arthroplasty (TKA) following osteotomy compared with primary navigated TKA implantation. The study group (29 legs) received navigated TKA (Columbus with deep-dish, cruciate-retaining inlay, Aesculap AG, Tuttlingen, Germany) following distal femoral (6 legs) or high tibial (23 legs) osteotomy, and the control group (29 legs) received a primary navigated TKA. All patients were examined clinically and radiologically in a retrospective matched-pair analysis.

Loss of spatial organization and destruction of the pericellular matrix in early osteoarthritis in vivo and in a novel in vitro methodology.

Objectives: Current repair procedures for articular cartilage (AC) cannot restore the tissue's original form and function because neither changes in its architectural blueprint throughout life nor the respective biological understanding is fully available. We asked whether two unique elements of human cartilage architecture, the chondrocyte-surrounding pericellular matrix (PCM) and the superficial chondrocyte spatial organization (SCSO) beneath the articular surface (AS) are congenital, stable or dynamic throughout life. We hypothesized that inducing chondrocyte proliferation in vitro impairs organization and PCM and induces an advanced osteoarthritis (OA)-like structural phenotype of human cartilage.

Virtual mapping of 260 three-dimensional hemipelvises to analyse gender-specific differences in minimally invasive retrograde lag screw placement in the posterior acetabular column using the anterior pelvic and midsagittal plane as reference.

Background: Due to complex pelvic geometry, percutaneous screw placement in the posterior acetabular column can pose a major challenge even for experienced surgeons.

Methods: The present study examined the preformed bone stock of the posterior acetabular column in 260 hemipelvises. Retrograde posterior column screws were virtually implanted using iPlan CMF (BrainLAB AG, Feldkirchen, Germany); maximal implant length, maximal implant diameter and angles between the screw trajectories and the reference planes anterior pelvic plane as well as the midsagittal plane were assessed for gender-specific differences.

Primary human osteoblasts with reduced alkaline phosphatase and matrix mineralization baseline capacity are responsive to extremely low frequency pulsed electromagnetic field exposure - Clinical implication possible.

For many years electromagnetic fields (EMFs) have been used clinically with various settings as an exogenous stimulation method to promote fracture healing. However, underlying mechanisms of action and EMF parameters responsible for certain effects remain unclear. Our aim was to investigate the influence of defined EMFs on human osteoblasts' and osteoclasts' viability and function.

Computer-assisted navigation is beneficial both in primary and revision surgery with modular rotating-hinge knee arthroplasty.

Purpose: The objective of the present study was to explore the effect of navigation on the reconstruction of the mechanical leg axis, implant positioning and the restoration of the joint line in hinged knee arthroplasty in vivo. We present the first 1- to 3-year clinical and radiological results following computer-navigated implantation of the EnduRo modular rotating-hinge knee arthroplasty system (Aesculap AG, Tuttlingen, Germany) as a primary or revision implant.

Methods: Thirty-one patients were analysed retrospectively.

Retrograde lag screw placement in anterior acetabular column with regard to the anterior pelvic plane and midsagittal plane -- virtual mapping of 260 three-dimensional hemipelvises for quantitative anatomic analysis.

Percutaneous screw placement can be used for minimally invasive treatment of none or minimally displaced fractures of the anterior column. The complex pelvic geometry can pose a major challenge even for experienced surgeons. The present study examined the preformed bone stock of the anterior column in 260 hemipelvises (130 male and 130 female).

Influence of flexible fixation for open book injury after pelvic trauma--a biomechanical study.

Background: Implant loosening is frequently detected after fixation of open book injuries. Though many authors do not see this as a complication, it is often the reason for hardware removal or reinstrumentation in the case of remaining instability. We hypothesized that the flexibility of the implant has an influence on loosening and thus on failure of the construct.

Long-term results using the straight tapered femoral cementless hip stem in total hip arthroplasty: a minimum of twenty-year follow-up.

We report the first long-term results of a prospective cohort study after total hip arthroplasty using the cementless Bicontact hip stem. Between 1987 and 1990, 250 total hip arthroplasties in 236 patients were performed using the cementless Bicontact hip stem. The average follow-up was 22.

Intraoperative neurophysiological monitoring of somatosensory evoked potentials during hip arthroscopy surgery.

Arthroscopic hip surgery is used to treat many of the causes of hip pain, hip instability, and hip disorders. Hip pain and instability are often caused by injuries to the acetabular labrum. Repairing labral tears, suturing, and debridement involve stabilizing the hip and placing the operative side leg in traction (Phillipon 2006, Phillipon and Schenker 2006) to allow for instrument clearance and to avoid iatrogenic injury to the chondral surfaces.

Modular sleeves with ceramic heads in isolated acetabular cup revision in younger patients-laboratory and experimental analysis of suitability and clinical outcomes.

Purpose: One possibility in hip arthroplasty revisions is to combine a modular ceramic head with an adapter or sleeve in isolated acetabular cup replacement. This study consisted of an experimental part to analyse the reliability of taper damage predictions, and a clinical part to analyse the outcomes of modular ceramic head implantation in a case series of isolated cup replacements.

Methods: Analysis of scratch size on 11 explanted hip stems were examined macroscopically and by stereomicroscopy to classify damage to the conical taper.