Difficulty of diagnostic accuracy of periprosthetic joint infection: a retrospective analysis of revision surgery of total hip arthroplasty and total knee arthroplasty in a tertiary hospital.

Background: Diagnostic accuracy of periprosthetic joint infection still remains controversial and an unsolved problem with respect to clinical signs and laboratory measures. Influencing factors of diagnosis like age, sex, abnormal physical findings and comorbidities are published with different results. The aim of our study was to find factors strengthening the diagnosis.

Early and mid-term results with the ATTUNE total knee replacement system compared to PFC Sigma: a prospective comparative study.

Purpose: Up to 20% of all patients are not satisfied with the result after total knee arthroplasty (TKA). To improve patient satisfaction manufacturers have modified prosthesis design. The ATTUNE prosthesis is a modified version of the PFC Sigma.

Heterotopic ossification after total hip arthroplasty: When is development completed?

Background: Heterotopic ossifications (HO) are a common complication after total hip arthroplasty (THA). Nonsteroidal anti-inflammatory drugs have proven to reduce the occurrence of HO. It is still unclear when the formation of HO is finished.

Etoricoxib is safe and effective in preventing heterotopic ossification after primary total hip arthroplasty.

Background: Heterotopic ossifications are a common complication after total hip arthroplasty. Low-dose radiation therapy and non-steroidal anti-inflammatory drugs have proven to effectively reduce the rate of heterotopic ossification after total hip arthroplasty. However, a low number of studies describe an equal efficiency of etoricoxib.

Excellent midterm survival and functional outcomes of a fully hydroxyapatite-coated cementless stem: first results of a prospective multicenter study.

Background: The Polarstem (Smith & Nephew, Baar, Switzerland) is a tapered straight stem, an implant with an excellent survival rate. Although the most recent annual report of the National Joint Registry in the United Kingdom also reports excellent survivorship for the cementless Polarstem, no prospective studies have been published focusing on both its efficacy and clinical performance. Therefore, the present study was designed to prospectively evaluate its functional and radiographic outcomes at midterm.

Correction to: Mild Depression in Low Back Pain: the Interaction of Thought Suppression and Stress Plays a Role, Especially in Female Patients.

This article was updated to correct the author names. Family and given names are in the correct order.

Pilot study for the registry of complications in rheumatic diseases from the German Society of Surgery (DGORh): evaluation of methods and data from the first 1000 patients.

Objective: Most patients suffering with rheumatic diseases who undergo surgical treatment are receiving immune-modulating therapy. To determine whether these medications affect their outcomes a national registry was established in Germany by the German Society of Surgery (DGORh). Data from the first 1000 patients were used in a pilot study to identify relevant corisk factors and to determine whether such a registry is suitable for developing accurate and relevant recommendations.

Mild Depression in Low Back Pain: the Interaction of Thought Suppression and Stress Plays a Role, Especially in Female Patients.

Purpose: Mild depression has been shown as a precursor and as a consequence of low back pain, even in early phases of acute or subacute pain. Chronic daily life stress as well as dysfunctional pain-related cognitions such as thought suppression (TS) seem to play a role in the pain-depression cycle; however, the mechanisms of these associations are less understood. Experimentally induced TS, conceived as the attempt to directly suppress sensations such as pain, has been shown to paradoxically cause a delayed and non-volitional return of the suppressed thoughts and sensations and to increase affective distress.

10-Year Survival of Navigated Versus Conventional TKAs: A Retrospective Study.

The computer-assisted navigation of total knee arthroplasty (TKA) offers a radiologically demonstrated higher precision of implantation than conventional implantation in relation to the axis alignment. The impact on long-term clinical outcomes is currently unknown. In 1999, 217 consecutive TKAs were performed in a total of 213 patients (113 navigated and 104 conventional).

Combination of autologous chondrocyte implantation (ACI) and osteochondral autograft transfer system (OATS) for surgical repair of larger cartilage defects of the knee joint. A review illustrated by a case report.

Objectives: Modern orthopaedic surgery provides a variety of techniques for cartilage repair. Despite comprehensive scientific data about the single procedures, there is little experience with the combination of these methods. Inspired by a case from our clinic, we performed a PubMed based literature search about the combination of cartilage restoration principles.

Is the Kinect system suitable for evaluation of the hip joint range of motion and as a screening tool for femoroacetabular impingement (FAI)?

Background: In the clinical evaluation of femoroacetabular impingement (FAI), there is a lack of quantitative, reliable and informative assessment methods for the overall functional capability of an individual.

Objective: We compared clinical and radiological measurements of the hip joint with a new methodology based on the concept of 3-dimensional reachable workspace using Microsoft Kinect.

Methods: We assessed the correlation between the alpha angle of Nötzli on full-length radiographs and the clinical internal rotation.

Physical activity and low back pain: the role of subgroups based on the avoidance-endurance model.

Purpose: This study examines the relationship between low back pain, disability and fatigue and overt physical activity with respect to fear-avoidance and endurance-related subgroups.

Method: 49 patients completed questionnaires (Pain, Disability, Fatigue, Depression, Pain-responses pattern) 6 months after lumbar disc surgery and underwent an 8-hour accelerometer assessment measuring overall physical activity (PAL), constant strain postures (CSP), standing time (ST) and lying time (LT). Four subgroups, representing patterns of distress-endurance (DER), eustress-endurance (EER), fear-avoidance (FAR) and adaptive responses (AR) due to the avoidance-endurance model of pain-regulation were investigated.

Cortisol awakening response and pain-related fear-avoidance versus endurance in patients six months after lumbar disc surgery.

Recent research indicates that stress-induced, prolonged deviations in basal adrenocortical activity might contribute to ongoing/recurrent pain following lumbar disc surgery. Further, fear-avoidance and endurance responses to pain (FAR and ER) are regarded as important risk factors for pain after surgery. In patients with non-specific low back pain, FAR appear to possibly increase pain-related arousal, whereas ER may have an arousal-lowering effect, indicated by adrenocortical activity.

Pain-related avoidance versus endurance in primary care patients with subacute back pain: psychological characteristics and outcome at a 6-month follow-up.

Recent research has found individual differences in back pain patients due to behavioral avoidance vs persistence. However, there is a lack of prospective studies of nonspecific low back pain patients. The avoidance-endurance model (AEM) suggests at least 3 pathways leading to chronic pain: fear-avoidance response, distress-endurance response, and eustress-endurance response.

Efficacy of epidural perineural injections with autologous conditioned serum for lumbar radicular compression: an investigator-initiated, prospective, double-blind, reference-controlled study.

Study Design: Prospective, double-blind, reference-controlled, investigator-initiated, single center.

Objective: To evaluate the efficacy of Autologous Conditioned Serum (ACS; Orthokine) for the treatment of lumbar radicular compression in comparison to triamcinolone.

Summary Of Background Data: Evidence from animal studies indicates that cytokines such as interleukin-1 play a decisive role in the pathophysiology of lumbar radiculopathy.

The relationship between activity and pain in patients 6 months after lumbar disc surgery: do pain-related coping modes act as moderator variables?

Background: In LBP patients, the relationship between pain and physical activity remains unclear. Whereas a negative relationship between pain and self-reported physical activity was found, this relation disappeared in the case of overt behavioral data (e.g.

Clinical symptoms in lumbar disc herniations and their correlation to the histological composition of the extruded disc material.

Study Design: Fifty-five consecutive patients undergoing microdiskectomy due to lumbar disc herniation were included in this clinical study over 12 months.

Objectives: To investigate possible correlations between the histologic composition of the herniated disc fragments and pain, disability, clinical signs, and operative findings.

Summary Of Background Data: Previous studies have investigated the histologic composition of herniated lumbar disc fragments.

Participation of cyclooxygenase-1 in prostaglandin E2 release from synovitis tissue in primary osteoarthritis in vitro.

Objectives: To investigate the relative contribution of the cyclooxygenase (COX) isoenzymes COX-1 and COX-2 to prostaglandin E2 (PGE2) release from inflamed synovial tissue in N=10 patients with primary osteoarthritis (OA) in vitro and to determine possible effects of COX inhibitors on the gene expression of synovial COX-1 and COX-2.

Design: The effects of a COX-unspecific nonsteroidal anti-inflammatory drug (NSAID; diclofenac), a selective COX-1 inhibitor (SC-560) and a selective COX-2 inhibitor (SC-58125) on PGE2 release from inflamed synovial tissue (0.1-10 microM, 3 and 6 h incubation time) were compared.

Early results of endoscopic trochanter bursectomy.

Between 1995 and 2000, we performed 45 endoscopic bursectomies in 42 patients (average age 51, range 17-61 years). All patients had at least 6 months of failed conservative treatment, and all responded positively to a sonographic-guided injection with Mepivacaine 0.5%.

Lumbar disk herniation: correlation of histologic findings with marrow signal intensity changes in vertebral endplates at MR imaging.

Purpose: To compare findings at preoperative magnetic resonance (MR) imaging with data for tissue composition of herniated disks in patients after microsurgical removal of herniated material.

Materials And Methods: Fifty-one patients underwent MR imaging before microsurgical removal of extruded lumbar disk herniation material. Marrow signal intensity changes along the cartilaginous endplates were classified according to Modic types 1-3.

Validation and reliability of the German version of the Chronic Pain Grade questionnaire in primary care back pain patients.

In 1992 Von Korff and his co-workers developed a simple, brief questionnaire to assess the severity of chronic pain problems, the Chronic Pain Grade (CPG). The present study was conducted to analyse the psychometric properties of the translated German version of the CPG within a population of primary care back pain patients (n=130). Factor analysis yielded two factors which accounted for 72% of the variance of the questionnaire.