Clinical Outcome After Replacement of Distal Femur/Proximal Tibia in a Heterogeneous Patient Cohort: Function Following Tumour, Trauma, and Loosening.

Background: Distal femur and proximal tibia replacements as limb-salvage procedures with good outcome parameters for patients with tumours have been broadly described. However, the overall midterm outcome in a mixed, heterogeneous patient collective is still unclear.

Patients And Methods: We retrospectively analysed 59 consecutive patients (33 for primary and 26 for revision surgery) between 1998 and 2017.

Evidence for anaphase pulling forces during C. elegans meiosis.

Anaphase chromosome movement is thought to be mediated by pulling forces generated by end-on attachment of microtubules to the outer face of kinetochores. However, it has been suggested that during C. elegans female meiosis, anaphase is mediated by a kinetochore-independent pushing mechanism with microtubules only attached to the inner face of segregating chromosomes.

Reduction of Patella-baja and Pseudo-patella-baja Does Not Improve Range of Motion in Patients After Mega-TKA.

Background/aim: Patella baja (PB) and pseudo-patella baja (PPB) have been shown to negatively influence outcomes after total knee arthroplasty. We hypothesized that there is a high incidence of PB and PPB after megaprosthetic total knee arthroplasty (M-TKA), and that this is associated with reduced range of motion.

Patients And Methods: We retrospectively analysed all patients in our Orthopaedic Trauma Department after distal femur or proximal tibia replacement.

Spherical spindle shape promotes perpendicular cortical orientation by preventing isometric cortical pulling on both spindle poles during female meiosis.

Meiotic spindles are positioned perpendicular to the oocyte cortex to facilitate segregation of chromosomes into a large egg and a tiny polar body. In , spindles are initially ellipsoid and parallel to the cortex before shortening to a near-spherical shape with flattened poles and then rotating to the perpendicular orientation by dynein-driven cortical pulling. The mechanistic connection between spindle shape and rotation has remained elusive.

High complication and revision rates after total femoral replacement: a retrospective single center analysis of indication, function, and complication.

Introduction: Total femoral replacement (TFR) is a limb salvage procedure performed for large bony defects. However, it is often associated with major complications and reduced function. Data on limb preservation rates and functional outcomes after TFR are limited.

Intraoperative computer-assisted prediction of intraarticular contact pressures in the knee during high tibial osteotomy.

Objectives: To develop an accurate intraoperative method to estimate changes in intraarticular contact pressures during high tibial osteotomy (HTO).

Methods: Changes in knee alignment and pressure were monitored in real time in seven cadaver specimens that received HTO. Intraarticular contact pressure (N/mm ) in each knee compartment was estimated based on extraarticularly acquired data (leg alignment, correction, and ankle tilt) and based on the application of an axial force of half bodyweight (400-450 N).

An interdisciplinary consensus on the management of bone metastases from renal cell carcinoma.

Bone is a major site of haematogenous tumour cell spread in renal cell carcinoma (RCC), and most patients with RCC will develop painful and functionally disabling bone metastases at advanced disease stages. The prognosis of these patients is generally poor and the treatment is, therefore, aimed at palliation. However, RCC-associated bone metastases can be curable in select patients.

[Injury prevention in amateur football with FIFA 11+ : What is implemented on the football pitch?].

Background: The warm-up and injury prevention program FIFA 11+ was developed to reduce injuries in recreational and amateur level football. Despite systematic education it is uncertain what amount of knowledge is passed down to the lower recreational level football players and what exercises are implemented in the daily routine. This study presents the summarized experiences of German coaches about the implementation of exercises on the football pitch.

Mechanisms that prevent catastrophic interactions between paternal chromosomes and the oocyte meiotic spindle.

Meiosis produces haploid gametes by accurately reducing chromosome ploidy through one round of DNA replication and two subsequent rounds of chromosome segregation and cell division. The cell divisions of female meiosis are highly asymmetric and give rise to a large egg and two very small polar bodies that do not contribute to development. These asymmetric divisions are driven by meiotic spindles that are small relative to the size of the egg and have one pole juxtaposed against the cell cortex to promote polar body extrusion.

Fatty degeneration of the deltoid muscle associated with displaced proximal humerus fractures.

Introduction: The use of reverse shoulder arthroplasty (RSA) has increased dramatically over the last two decades, with many surgeons now indicating RSA for the acute management of displaced proximal humerus fractures (PHF) in the elderly. RSA relies on adequate deltoid muscle function to obtain a good outcome, yet no literature to date exists which discusses preoperative assessment of deltoid structure prior to RSA. The purpose of this study was to assess for preoperative fatty deltoid-degeneration in patients with displaced PHF.

Long-term outcome in 324 polytrauma patients: what factors are associated with posttraumatic stress disorder and depressive disorder symptoms?

Background: Physical impairment is well-known to last for many years after a severe injury, and there is a high impact on the quality of the survivor's life. The purpose of this study was to examine if this is also true for psychological impairment with symptoms of posttraumatic stress disorder or depression after polytrauma.

Design: Retrospective cohort outcome study.

F-actin prevents interaction between sperm DNA and the oocyte meiotic spindle in .

Fertilization occurs during female meiosis in most animals, which raises the question of what prevents the sperm DNA from interacting with the meiotic spindle. In this study, we find that sperm DNA stays in a fixed position at the opposite end of the embryo from the meiotic spindle while yolk granules are transported throughout the embryo by kinesin-1. In the absence of F-actin, the sperm DNA, centrioles, and organelles were transported as a unit with the yolk granules, resulting in sperm DNA within 2 µm of the meiotic spindle.

Robotic distal locking of intramedullary nailing: Technical description and cadaveric testing.

Interlocked intramedullary nailing is the treatment of choice for femoral shaft fractures. However, distal locking is a technically challenging part of the procedure that can result in distal femoral malrotation and high radiation exposure. We have tested a robotic procedure for robotic distal locking based on the computation of a drilling trajectory on two calibrated fluoroscopic images.

Serum uric acid is not independently associated with plasma renin activity and plasma aldosterone in hypertensive adults.

Background And Aims: In experimental investigations conducted in rats, raising serum uric acid (SUA) levels resulted in the stimulation of intrarenal renin expression. Studies in humans exploring the association of SUA with plasma renin activity (PRA) yielded conflicting results. Moreover, little is known about the relationship of SUA with plasma aldosterone concentration (PAC).

[First results with a resorbable MgYREZr compression screw in unstable scaphoid fractures show extensive bone cysts].

Osteosynthesis with headless compression screws is an established treatment option for unstable scaphoid fractures. Common implants are made of titanium alloy or steel and usually remain in place. Due to implant density and ferromagnetic properties, artefacts are common in postoperative imaging procedures, e.

Feasibility of treating emulsified oily and salty wastewaters through coagulation and bio-regenerated GAC filtration.

In the present study, chemical oxygen demand (COD) removal by coagulation and packed-columns of both fresh and bioregenerated granular activated carbon (GAC) is reported as a feasible treatment for saline and oily wastewaters (slops) generated from marine oil tankers cleaning. The use of Ferric chloride (FeCl), Aluminium sulphate (Al(SO)) and Polyaluminum chloride (Al(OH)Cl) was evaluated in the pre-treatment by coagulation of a real slop, after a de-oiling phase in a tank skimmer Comparison of coagulation process indicated that Polyaluminum chloride and Aluminium sulphate operate equally well (20-30% of COD removal) when applied at their optimal dose (40 and 90 mg/l respectively) but the latter should be preferred in order to significantly control the sludge production. The results from the column filtration tests indicated the feasibility of using the selected GAC (Filtrasorb 400 -Calgon Carbon Corporation) to achieve the respect of the discharge limits in the slops treatment with a carbon usage rate in the range 0.

A novel chromosome segregation mechanism during female meiosis.

In a wide range of eukaryotes, chromosome segregation occurs through anaphase A, in which chromosomes move toward stationary spindle poles, anaphase B, in which chromosomes move at the same velocity as outwardly moving spindle poles, or both. In contrast, Caenorhabditis elegans female meiotic spindles initially shorten in the pole-to-pole axis such that spindle poles contact the outer kinetochore before the start of anaphase chromosome separation. Once the spindle pole-to-kinetochore contact has been made, the homologues of a 4-μm-long bivalent begin to separate.

Thermoablation of Bone Tumors.

Unlabelled: The aim of this article is to review the significance of percutaneous thermal ablation in the treatment of bone tumors. We describe available ablation techniques as well as advantages and disadvantages in specific settings. In detail, radiofrequency ablation (RFA), microwave ablation (MWA), laser ablation, high intensity focused ultrasound (HIFU) and cryoablation are presented.

Soft Tissue Coverage of the Lower Limb following Oncological Surgery.

The treatment of lower limb tumors has been shifted by advancements in adjuvant treatment protocols and microsurgical reconstruction from limb amputation to limb salvage. Standard approaches include oncological surgery by a multidisciplinary team in terms of limb sparing followed by soft tissue reconstruction and adjuvant therapy when indicated. For the development of a comprehensive surgical plan, the identity of the tumor should first be determined by histology after biopsy.

Biomechanical comparison of two surgical techniques for press-fit reconstruction of the posterolateral complex of the knee.

Background: To date, various surgical techniques to treat posterolateral knee instability have been described. Recent studies recommended an anatomical and isometric reconstruction of the posterolateral corner addressing the key structures, such as lateral collateral ligament (LCL), popliteus tendon (POP) and popliteofibular ligament (PFL). Two clinical established autologous respective local reconstruction methods of the posterolateral complex were tested for knot-bone cylinder press-fit fixation to assess efficacy of each reconstruction technique in comparison to the intact knee.

Dynactin-dependent cortical dynein and spherical spindle shape correlate temporally with meiotic spindle rotation in Caenorhabditis elegans.

Oocyte meiotic spindles orient with one pole juxtaposed to the cortex to facilitate extrusion of chromosomes into polar bodies. In Caenorhabditis elegans, these acentriolar spindles initially orient parallel to the cortex and then rotate to the perpendicular orientation. To understand the mechanism of spindle rotation, we characterized events that correlated temporally with rotation, including shortening of the spindle in the pole-to pole axis, which resulted in a nearly spherical spindle at rotation.

Nail-medullary canal ratio affects mechanical axis deviation during femoral lengthening with an intramedullary distractor.

Introduction: Callus distraction of the femur using an intramedullary distractor has several advantages over the use of external fixators. However, difficulty in controlling the mechanical axis during lengthening may cause deformities and knee osteoarthritis. Purpose of the study is to answer the following questions: (1) is lengthening with an intramedullary device associated with a medial or lateral shift of the mechanical axis? (2) Which factors are associated with varisation/valgisation of the mechanical axis during lengthening?

Materials And Methods: We analysed pre-treatment and post-treatment radiographs from 20 patients who underwent unilateral femoral-lengthening procedures using intramedullary distractors.

[New therapy approaches for giant cell tumors].

Background: Giant cell bone tumors (GCT) are benign but partially locally aggressive osteolytic tumors which typically occur around the knee joint in the epiphysis and metaphysis of long bones after maturation of the skeleton is completed. Due to the locally aggressive growth behavior with destruction of the bone structure, the rare possibility of pulmonary metastases in recurrent cases and a very rare possibility of malignancy, GCTs were previously also described as semimalignant bone tumors.

Therapy: The established therapy of these tumors at the typical locations consists of intralesional curettage, extension of resection margins using a high speed trephine and defect reconstruction with bone cement.

[Biopsy and approach routes for bone tumors. Where and how much is sufficient?].

Although biopsies are a key step in the diagnosis of bone tumors, they are often still referred to as a minor intervention which can be carried out by any surgeon as an outpatient procedure or quickly carried out between other more important tasks. A biopsy should, however, be regarded as the final part of the diagnostic procedure preceded by careful evaluation of the clinical course and analysis of the required imaging studies. Although the biopsy procedure seems technically simple to perform, an incorrectly performed biopsy can become an obstacle to correct tissue analysis (sampling error) and adequate tumor resection and may reduce the patient's chances of survival.