Use of a silver-coated plate to treat a postoperative infection after high tibial osteotomy - a case report.

Unilateral osteoarthritis of the knee can be treated by osteotomy. In case of postoperative infection after high tibial osteotomy, treatment can be challenging and often requires implant removal with the risk of loss of reduction. In the presented case, a 47-year old patient suffered postoperative infection after high tibial osteotomy using an angular stable plate with the need for multiple revision surgeries and anti-infective therapy.

Rate of Complications after Hip Fractures Caused by Prolonged Time-to-Surgery Depends on the Patient's Individual Type of Fracture and Its Treatment.

Introduction: Hip fractures are common injuries in the elderly and are usually treated with timely surgery. While severe postoperative complications are reported for up to 10% of patients, many studies identified predictive factors for the occurrence of complications postoperatively. A controversially discussed factor is "time-to-surgery".

Stress shielding effect after total hip arthroplasty varies between combinations of stem design and stiffness-a comparing biomechanical finite element analysis.

Purpose: Total hip arthroplasty (THA) has become a highly frequent orthopaedic procedure. Multiple approaches have been made to design the femoral component for THA with a mechanical behaviour as close as possible to a natural femur. The aim of this study was to compare different combinations of design and biomechanical properties of THA prostheses and their impact on stress shielding of the periprosthetic bone.

Biomechanical comparison of different implants for PIP arthrodesis.

Background: Surgical correction of hammertoe deformities with arthrodesis of the proximal interphalangeal joint (PIP) is one of the most frequent forefoot procedures. Recently, new intramedullary fixation devices for PIP arthrodesis have been introduced. The aim of this study was to compare a newly developed absorbable intramedullary implant made of magnesium (mm.

The Level of Surface Coverage of Surgical Site Disinfection Depends on the Visibility of the Antiseptic Agent-A Virtual Reality Randomized Controlled Trial.

Background: Surgical site infections (SSIs) have a significant impact on outcome associated with surgical treatment. Therefore, skin antisepsis has evolved as a standard preoperative procedure in the operating room to reduce the perioperative risk of an SSI. In their "Global Guidelines for the prevention of surgical site infections", the World Health Organization (WHO) recommend the use of an agent with remanent additives and considers colored agents as helpful.

Perspective of potential patients on the hospital volume-outcome relationship and the minimum volume threshold for total knee arthroplasty: a qualitative focus group and interview study.

Background: Total knee arthroplasty (TKA) is performed to treat end-stage knee osteoarthritis. In Germany, a minimum volume threshold of 50 TKAs/hospital/year was implemented to ensure outcome quality. This study, embedded within a systematic review, aimed to investigate the perspectives of potential TKA patients on the hospital volume-outcome relationship for TKA (higher volumes associated with better outcomes).

Completion Rates of Advance Directives in a Trauma Emergency Room: Association with Age.

An advance directive (AD) is a written legal document in which a person can express wishes and preferences for medical treatment for the moment when that person is no longer able to make medical decisions because of a serious illness or injury. While ADs have emerged in public, it is unclear, how many adults in Germany have completed an AD, and frequencies differ among different patient cohorts and medical settings. The aim of this study was to evaluate how many patients visiting a trauma emergency room (ER) in an academic teaching hospital had completed an AD.

[Atraumatic instability of the anterior cruciate ligament caused by an intraligamentous cyst].

A 28-year-old man reported that he has a feeling of "giving away" in his knee while playing soccer. He has had no previous injury. At a physical examination, the results of Lachman's test and the pivot shift test were pathological.

Gender differences in blood transfusion strategy for patients with hip fractures - a retrospective analysis.

In the last decades, transfusion therapy with allogenic blood has progressively shifted to a more restrictive approach. The current study analyzed the transfusion practice and transfusion-associated factors in a regional trauma center over the course of five years. Retrospective analysis of all patients undergoing surgery for hip fractures in a level 1 trauma center of an academic teaching hospital from 2010 to 2014 (n=650).

Hospital volume-outcome relationship in total knee arthroplasty: protocol for a systematic review and non-linear dose-response meta-analysis.

Background: Knee osteoarthritis is a common, chronic condition and main contributor to global disability. Total knee arthroplasty (TKA) is the most successful treatment for end-stage knee osteoarthritis. It is assumed that in the field of surgery, there is a relationship between hospital volume and health outcomes and that higher hospital volume results in better health outcomes.

Efficiency of platelet-rich plasma therapy in knee osteoarthritis does not depend on level of cartilage damage.

Objectives: Osteoarthritis of the knee is common and often leads to significant physical disability. While classic conservative therapeutic approaches aim for symptoms like pain and inflammation, procedures like the intraarticular application of hyaluronic acids (HA) or platelet-rich plasma (PRP) are thought to stimulate the endogenous HA production, stop catabolism of cartilage tissue, and promote tissue regeneration. To analyse whether the positive effects of PRP injections are associated with the level of cartilage damage, patient satisfaction with the treatment was correlated with the level of knee joint osteoarthritis quantified by MRI.

Indicated trauma emergency department utilization - A comparison between patients' self-assessment and professional evaluation.

Introduction: Patient visits to emergency departments (EDs) increase in many countries. As a result, these facilities are often congested and the socioeconomic burden of growing workload is a well-known problem. In this study, patients' reasons attending an ED with non-emergent needs were analyzed.

Influence of Time to Surgery in Ankle Fractures on the Rate of Complications and Length of Stay - a Multivariate Analysis.

Background: With an incidence of 9/1000 per year, ankle fracture is one of the most common skeletal injuries. It is currently unclear whether time to surgery affects the complication rate or the hospital length of stay and whether there are confounders in patient characteristics or comorbidities.

Material And Methods: In a retrospective cohort study (n = 421), the risk of perioperative complications in patients with a primary operative fracture treatment within 6 hours of trauma was compared to a secondary surgical treatment.

Biomechanics of common fixation devices for first tarsometatarsal joint fusion-a comparative study with synthetic bones.

Background: Hallux valgus disease is a common deformity of the forefoot. There are currently more than 100 surgical approaches for operative treatment. Because hypermobility of the first tarsometatarsal joint is considered to be causal for hallux valgus disease, fusion of the tarsometatarsal joint is an upcoming surgical procedure.

Computer-aided planning with exact implementation into surgical technique in TKA is as accurate as intraoperative navigation.

Background: Exact positioning of implants and accuracy of alignment are important parameters to provide an long survivorship of endoprostheses after total knee arthroplasty. It was suggested that an alignment within 3∘ from centerline provides the best long-term survivorship of TKA. Therefore, computer-assisted navigation became more important in TKAs.

Risk perception of blood transfusions - a comparison of patients and allied healthcare professionals.

Background: Due to an increasing demand in health care services plans to substitute selective physician-conducted medical activities have become attractive. Because administration of a blood transfusion is a highly standardized procedure, it might be evaluated if obtaining a patient's consent for a blood transfusion can be delegated to allied healthcare professionals. Physicians and patients perceive risks of transfusions differently.

Intramedullary nailing in opening wedge high tibial osteotomy-in vitro test for validation of a method of fixation.

Purpose: Opening wedge high tibial osteotomy (HTO) as a treatment in unicompartimental osteoarthritis of the knee can significantly relieve pain and prevent or at least delay an early joint replacement. The fixation of the osteotomy has undergone development and refinements during the last years. The angle-stable plate fixator is currently one of the most commonly used plates in HTOs.

School sport-associated injuries in adolescents: A single center experience.

Background: Each year, on average 1.26 million students face physical injuries at German schools and universities. Implementation of systematic prevention programs against school-associated injuries in adolescents is poor.

Recovery and prediction of postoperative muscle power - is it still a problem?

Background: In the postoperative period, immediate recovery of muscular power is essential for patient safety, but this can be affected by anaesthetic drugs, opioids and neuromuscular blocking agents (NMBA). In this cohort study, we evaluated anaesthetic and patient-related factors contributing to reduced postoperative muscle power and pulse oximetric saturation.

Methods: We prospectively observed 615 patients scheduled for minor surgery.

Bone preserving level of osteotomy in short-stem total hip arthroplasty does not influence stress shielding dimensions - a comparing finite elements analysis.

Background: The main objective of every new development in total hip arthroplasty (THA) is the longest possible survival of the implant. Periprosthetic stress shielding is a scientifically proven phenomenon which leads to inadvertent bone loss. So far, many studies have analysed whether implanting different hip stem prostheses result in significant preservation of bone stock.

Volumetric measurement of periprosthetic bone remodeling: prospective 5 years follow-up after cemented total hip arthroplasty.

Introduction: Periprosthetic bone remodeling after total hip arthroplasty (THA) is a well recognized phenomenon. Many authors have published osteodensitometric data with DEXA analysis. This study based on computerized tomography (CT).

Femoral strain changes after total hip arthroplasty--patient-specific finite element analyses 12 years after operation.

Periprosthetic stress-shielding after total hip arthroplasty (THA) is a well-known phenomenon. Many authors have used the finite element (FE) method to show the effects of THA on animal or human femora. In most cases they have performed cadaver experiments.