Evidence for cemented TKA and THA based on a comparison of international register data.

Background: Hip and knee implants can either be fixed without cement, press-fit, or with bone cement. Real-world data from arthroplasty registers, as well as studies provide a broad database for the discussion of cemented versus uncemented arthroplasty procedures.

Objective: What does current evidence from international arthroplasty registries and meta-analyses recommend regarding cemented or cementless fixation of hip and knee implants?

Methods: A recommendation is generated by means of direct data comparison from the arthroplasty registries of eight countries (USA, Germany, Australia, UK, Sweden, Norway, New Zealand, Netherlands), the comparison of 22 review studies and meta-analyses based on registry data, as well as an evaluation of recommendations of healthcare systems from different nations.

[Register data on cemented arthroplasty : A proof for cementless fixation?].

Background: Hip and knee implants can be either fixated without cement, press-fit, or with bone cement. Real-world data from arthroplasty registers, as well as studies, provide a broad database for the discussion of cemented versus uncemented arthroplasty procedures.

Objectives: What is the recommendation for cemented or cementless anchorage of hip and knee implants based on the current evidence from international arthroplasty registries and meta-analyses?

Methods: A recommendation is generated by means of a direct comparison of data from the arthroplasty registries of eight different countries (USA, Germany, Australia, UK, Sweden, Norway, New Zealand, and The Netherlands), the comparison of 22 review studies and meta-analyses based on registry data, as well as the evaluation of the recommendation of healthcare systems of different nations.

Low-Load Unilateral and Bilateral Resistance Training to Restore Lower Limb Function in the Early Rehabilitation After Total Knee Arthroplasty: A Randomized Active-Controlled Clinical Trial.

Unlabelled: Continuous passive motion (CPM) is frequently used during rehabilitation following total knee arthroplasty (TKA). Low-load resistance training (LLRT) using continuous active motion (CAM) devices is a promising alternative. We investigated the effectiveness of CPM compared to LLRT using the affected leg (CAMuni) and both legs (CAMbi) in the early post-operative rehabilitation.

The variation of arthroplasty procedures in the OECD Countries: analysis of possible influencing factors by linear regression.

Total hip and knee replacements (THR, TKR) are among the most common surgeries but incidence rates vary between OECD countries. Previous studies suggested economic factors to be most influential but did not take into account health care system related factors. Hence we analysed the possible influence of healthcare system related factors on the operation rate.

The mental representation of the human gait in hip osteoarthrosis and total hip arthroplasty patients: A clinical cross-sectional study.

Objective:: To explore differences in gait-specific long-term memory structures and actual gait performance between patients with hip osteoarthrosis, patients seen six months after total hip arthroplasty and healthy controls to gain insights into the role of the gait-specific mental representation for rehabilitation.

Design:: Cross-sectional study.

Subjects:: Twenty hip osteoarthrosis patients, 20 patients seen six months after total hip arthroplasty and 20 healthy controls.

Projections of primary hip arthroplasty in Germany until 2040.

Background and purpose - The number of hip replacements in Germany has increased considerably during the last 2 decades but lately levelled off with no significant increase in operation rates. We analyzed the future trend of hip arthroplasty and projected the number of primary hip replacements that will be performed in Germany until 2040. Patients and methods - We used prevalence data of hip arthroplasty patients from 2010 to 2016 from the nationwide inpatient statistics and population forecasts from the German Federal Bureau of Statistics up to the year 2040.

Mental Fatigue Increases Gait Variability During Dual-task Walking in Old Adults.

Background: Mental fatigue is a psychobiological state induced by sustained periods of demanding cognitive activity and is characterized by feelings of tiredness which are common in everyday life. Recently, it has been hypothesized that mental fatigue might have an impact on gait performance in old adults. Therefore, the effect of mental fatigue on gait performance under single- and dual-task conditions was investigated in young and old participants.

The mental representation of the human gait in patients with severe knee osteoarthrosis: a clinical study to aid understanding of impairment and disability.

Objective: Objectives were (1) to explore differences in gait-specific long-term memory structures and gait performance between knee osteoarthrosis patients and healthy subjects and (2) to identify the extent to which the gait-specific mental representation is associated with gait performance.

Design: Cross-sectional study.

Subjects: In total, 18 knee osteoarthrosis patients and 18 control subjects.

Neuromuscular function of the quadriceps muscle during isometric maximal, submaximal and submaximal fatiguing voluntary contractions in knee osteoarthrosis patients.

Introduction: Knee osteoarthrosis (KOA) is commonly associated with a dysfunction of the quadriceps muscle which contributes to alterations in motor performance. The underlying neuromuscular mechanisms of muscle dysfunction are not fully understood. The main objective of this study was to analyze how KOA affects neuromuscular function of the quadriceps muscle during different contraction intensities.

The Bindex(®) ultrasound device: reliability of cortical bone thickness measures and their relationship to regional bone mineral density.

The Bindex(®) quantitative ultrasound (QUS) device is currently available and this study analyzed (I) its relative and absolute intra- and inter-session reliability and (II) the relationship between the data provided by Bindex(®)-QUS and the bone mineral density (BMD) measured by dual-energy x-ray absorptiometry at corresponding skeletal sites in young and healthy subjects (age: 25.0  ±  3.6 years).

Bone mineral density after implantation of a femoral neck hip prosthesis--a prospective 5 year follow-up.

Background: Bone resorption in the proximal femur due to stress shielding has been observed in a number of conventional cementless implants used in total hip arthroplasty. Short femoral-neck implants are claiming less interference with the biomechanics of the proximal femur. The goal of this study was to prospectively investigate the in vivo changes of bone-mineral density as a parameter of bone remodeling around a short, femoral neck prosthesis over the first 5 years following implantation.

The mental representation of the human gait in young and older adults.

The link between mental representation (MREP) structures and motor performance has been evidenced for a great variety of movement skills, but not for the human gait. Therefore the present study sought to investigate the cognitive memory structures underlying the human gait in young and older adults. In a first experiment, gait parameters at comfortable gait speed (OptoGait) were compared with gait-specific MREPs (structural dimensional analysis of MREP; SDA-M) in 36 young adults.

Caffeine-induced increase in voluntary activation and strength of the quadriceps muscle during isometric, concentric and eccentric contractions.

This study investigated effects of caffeine ingestion (8 mg/kg) on maximum voluntary torque (MVT) and voluntary activation of the quadriceps during isometric, concentric and eccentric contractions. Fourteen subjects ingested caffeine and placebo in a randomized, controlled, counterbalanced, double-blind crossover design. Neuromuscular tests were performed before and 1 h after oral caffeine and placebo intake.

Modulation and predictors of periprosthetic bone mineral density following total knee arthroplasty.

Total knee arthroplasty (TKA) leads to a loss of periprosthetic bone mineral density (BMD). Great importance is attached to the prevention of periprosthetic bone loss with a view to ensuring a long service life of the prosthesis. In order to provide appropriate recommendations for preventive movement therapy measures to combat peri-implant bone loss, it is necessary to know the predictors of periprosthetic BMD.

Postoperative development of bone mineral density and muscle strength in the lower limb after cemented and uncemented total hip replacement.

Background: Numerous studies have shown reduction of periprosthetic bone mineral density (BMD) after hip replacement. The effect on the whole limb, however, is still unexplored. This study's objective was to analyse the postoperative development of BMD and muscle strength of the limb after total hip replacement (THR) and to determine links between these parameters.

Alteration in neuromuscular function of the plantar flexors following caffeine ingestion.

The aim of this study was to compare the neuromuscular function of the plantar flexors following caffeine or placebo administration. Thirteen subjects (25 ± 3 years) ingested caffeine or placebo in a randomized, controlled, counterbalanced, double-blind crossover design. Neuromuscular tests were performed before and 1 h after caffeine or placebo intake.

Bacteriology swabs in primary total knee arthroplasty.

Objective: An early detection of possible periprosthetic infection may lead to an earlier and potentially less invasive treatment of infected total knee arthroplasty TKA). The purpose of the present study was to evaluate retrospectively our current, affordable clinical practice of intra-operative swab taking during primary TKA.

Methods: A total of 206 primary TKA were analysed retrospectively for intra-operative bacteriology swabs and subsequent periprosthetic infection.

bone mineral densities and mechanical properties of retrieved femoral bone samples in relation to bone mineral densities measured in the respective patients.

The bone mineral density (BMD) of retrieved cancellous bone samples is compared to the BMD measured in vivo in the respective osteoarthritic patients. Furthermore, mechanical properties, in terms of structural modulus (E(s)) and ultimate compression strength (σ(max)) of the bone samples, are correlated to BMD data. Human femoral heads were retrieved from 13 osteoarthritic patients undergoing total hip replacement.

Relationship between mechanical properties and bone mineral density of human femoral bone retrieved from patients with osteoarthritis.

The objective of this study was to analyse retrieved human femoral bone samples using three different test methods, to elucidate the relationship between bone mineral density and mechanical properties. Human femoral heads were retrieved from 22 donors undergoing primary total hip replacement due to hip osteoarthritis and stored for a maximum of 24 hours postoperatively at + 6 °C to 8 °C.Analysis revealed an average structural modulus of 232±130 N/mm(2) and ultimate compression strength of 6.

Atypical femoral fractures are a separate entity, characterized by highly specific radiographic features. A comparison of 59 cases and 218 controls.

Background: Estimations of the risk of bisphosphonate associated atypical femoral fractures vary between different population-based studies, from considerable to neglectable. A possible explanation for these discrepancies could be different definitions of atypical fractures. We aimed to identify specific radiographic fracture characteristics associated with bisphosphonate use.

Marginal contribution of UKS- versus TKA in varus arthritis of the knee.

Background: In recent years, decisions regarding the treatment of individual patients have increasingly been affected by economic considerations. The G-DRG system reimburses sledge endoprosthetic implantations at a much lower rate than surface replacements and at significantly different cost weights (CW). Therefore, when only G-DRG payments are considered, TKA produces higher gains.

Economic impact of infected total knee arthroplasty.

Background: An enormous economic impact can be observed for infected total knee arthroplasties (TKA). The aim of the present study was to evaluate whether a cost covering treatment of infected TKA is feasible in the German DRG System.

Patients And Methods: Average total treatment costs were evaluated for infected TKA and compared with a matched pair of primary TKA.

Impact of preoperative function on early postoperative outcome after total hip arthroplasty.

Purpose: To investigate the impact of preoperative functional status on early postoperative outcomes after total hip arthroplasty (THA).

Methods: 39 men and 36 women aged 50 to 76 years who underwent cementless THA for osteoarthritis were followed up for at least 2 years. Patients were evaluated pre- and post-operatively (at 6, 12, and 24 months) using the Harris Hip Score (HHS), 36-item Short Form Health Survey (SF-36), and Western Ontario and McMaster University Osteoarthritis Index (WOMAC).

Stimulation of implant fixation by parathyroid hormone (1-34)-A histomorphometric comparison of PMMA cement and stainless steel.

Whereas continuous exposure to PTH results in bone resorption, PTH administration at intermittent doses results in bone formation by increasing osteoblast number and activity. PTH leads to faster fracture repair and better fixation of orthopaedic implants in animal models. The present study evaluates if PTH is able to increase the contact surface between bone and implant and whether the effect of PTH is dependent on implant material characteristics.