[Treatment Strategies for Septic Arthritis of the Sternoclavicular Joint].

Septic arthritis of the sternoclavicular joint (SCJ) is a relatively rare disease. Due to serious complications including mediastinitis and generalised sepsis early diagnosis and rapid onset of treatment are mandatory. The disease often affects immunocompromised patients, diabetics, or patients with other infectious diseases.

[Use of a pediculed pectoralis major flap for the treatment of septic arthritis of the sternoclavicular joint].

Objective: Closure of the wound defect with a pedicled pectoralis major muscular flap after successful surgical treatment of septic arthritis of the sternoclavicular joint (SCJ).

Indications: Defect of the thoracic wall after septic arthritis of the SCJ.

Contraindications: Persistent infection of bony or soft tissue structures; persistent septicemia; persistent mediastinitis.

Cell-free repair of small cartilage defects in the Goettinger minipig: the effects of BMP-7 continuously released by poly(lactic-co-glycolid acid) microspheres.

Objective: Cartilage repair of full-thickness chondral defects in the knees of Goettinger minipigs was assessed after treatment with cell-free collagen type-I gel with or without additional BMP-7 loaded poly(lactic-co-glycolid acid) microspheres.

Methods: Two full-thickness chondral defects were created in the trochlear groove of one hind leg knee in six Goettinger minipigs. Six defects were treated with a cell-free collagen type-I gel plug of 10 mm, the corresponding six defects were treated with a cell-free collagen type-I plug with poly(lactic-co-glycolid acid) microspheres loaded with recombinant BMP-7 (100 ng/ml gel).

[Septic arthritis of the sternoclavicular joint: radical resection and treatment with a pectoralis flap].

After infection of a vascular prosthesis with generalised sepsis, a 59-year-old male patient suffered from an increasing swelling of his right sternoclavicular joint. We performed an incision and debridement of the SC joint and harvested material for microbiological diagnosis. However, we were not able to overcome the inflammation until we performed a radical resection including the medial aspect of the clavicle and parts of the manubrium followed by coverage with a pectoralis flap.

Outcome after thoracoscopic ventral stabilisation of thoracic and lumbar spine fractures.

Background And Purpose: Thoracoscopic-assisted ventral stabilisation for thoracolumbar fractures has been shown to be associated with decreased recovery time and less morbidity when compared with open procedures. However, there are a limited number of studies evaluating late clinical and radiological results after thoracoscopic spinal surgery.

Methods: We performed an analysis of the late outcomes of thoracolumbar fractures after minimally invasive thoracoscopic ventral instrumentation.

Reoperation rate after internal fixation of intertrochanteric femur fractures with the percutaneous compression plate: what are the risk factors?

Objective: The aim was this study was to analyze the risk factors for reoperation after internal fixation of intertrochanteric fractures of the femur using the percutaneous compression plate (PCCP).

Design: This was a retrospective cohort study.

Setting: The study was conducted at the University Hospital.

[Osteomyelitis in adults. Diagnostic principles and therapeutic strategies].

This review focuses on the presentation of the diagnostic and therapeutic principles for treatment of chronic osteomyelitis of long bones in adults. Early detection of the offending bacteria is a crucial step which has to be performed with tissue and fluids from the depth of the wound. Superficial samples and swaps from fistulas should be avoided and are not considered to be representative.

Cell-free repair of small cartilage defects in the Goettinger minipig: which defect size is possible?

Purpose: Cartilage repair of full-thickness chondral defects in the knees of Goettinger minipigs was assessed by treatment with cell-free collagen type-I gel plugs of three different sizes.

Methods: In 6 adult Goettinger minipigs, three full-thickness chondral defects were created in the trochlear groove of one knee of the hind leg. These defects were treated with a cell-free collagen type-I gel plug of 8, 10, or 12 mm diameter.

[A false aneurysm as a rare complication of knee arthroscopy].

We present the rare case of a false aneurysm of the genus lat which occurred after knee arthroscopy. Apart from a pulse-synchronic swelling in close proximity to the former anterolateral portal there were no complaints and no pain. The diagnostic and therapeutic strategies - in this case performed with coiling of the involved vessel - are presented and discussed.

Vascular injury accompanying displaced proximal humeral fractures: two cases and a review of the literature.

We present two cases in which displaced proximal humeral fractures are accompanied by vascular injury. These Injuries are very rare but severe and the accompanying vascular impairment can have great clinical consequences. Therefore, we try to emphasize on the importance of thorough and accurate diagnostics, because it is obligatory for early diagnosis and improving the eventual outcome of these injuries.

[Kyphoplasty and vertebroplasty. Indications, techniques, complications and results].

The indications, technical principals, and results after vertebroplasty and kyphoplasty are presented in detail. We focus on the complications of both procedures. The benefit of vertebroplasty has been fundamentally questioned by two papers which have recently been published in the New England Journal of Medicine.

A comparative study of 3 different cartilage repair techniques.

Purpose: The value of cell-free techniques in the treatment of cartilage defects remains under debate. In this study, cartilage repair of full-thickness chondral defects in the knees of Goettinger minipigs was assessed by treatment with a cell-free collagen type-I gel or a collagen type-I gel seeded with autologous chondrocytes. As a control, abrasion arthroplasty was included.

[Electromagnetic fields, electric current and bone healing - what is the evidence?].

For more than 30 years the potential effects of electrical stimulation on bone healing have been investigated. Up to now this therapy is controversial and not established as a standardised treatment option. This systematic review and metaanalysis focuses on the potential effects of electromagnetic fields and high-frequency electric fields on bony healing.

Scoring systems for outcome after knee injuries.

Outcome assessment after knee injuries and periarticular fractures are not well described in the literature. This review focuses on outcome assessment, specifically surveying various scoring systems after knee trauma. Additionally, we include a report on a series of 637 patients with multiple injuries that were re-examined at least 10 years after the inciting incident.

Effects of low concentration BMP-7 on human osteoarthritic chondrocytes: comparison of different applications.

While BMP-7 (OP-1) is one of the most potent growth factors in cartilage tissue engineering, the effects of exogenous low concentration BMP-7 on osteoarthritic chondrocytes are still unknown. Human osteoarthritic chondrocytes obtained from the femoral condyles of 10 patients were grown either in monolayer or in 3D collagen type-I gel culture in vitro. The growth factor was either given as a single dose of 50 ng/mL, a repeated dose, or continuously released from PGLA microspheres.

Millicurrent stimulation of human articular chondrocytes cultivated in a collagen type-I gel and of human osteochondral explants.

Background: Here we investigate the effect of millicurrent treatment on human chondrocytes cultivated in a collagen gel matrix and on human osteochondral explants.

Methods: Human chondrocytes from osteoarthritic knee joints were enzymatically released and transferred into a collagen type-I gel. Osteochondral explants and cell-seeded gel samples were cultivated in-vitro for three weeks.

Effects of low concentrated BMP-7 administered by co-cultivation or plasmid transfection on human osteoarthritic chondrocytes.

Introduction: While BMP-7 has proven to be one of the most potent growth factors in cartilage tissue engineering, protein concentration and route of administration remain a matter of debate. Here we investigated the effects of a low concentration of BMP-7 on human osteoarthritic chondrocytes administered by protein co-cultivation and plasmid transfection.

Methods: Freshly released (P0) or in vitro propagated chondrocytes (P2) were cultivated in a collagen type-I gel for 3 weeks in vitro or in nude mice.

Effects of controlled released BMP-7 on markers of inflammation and degradation during the cultivation of human osteoarthritic chondrocytes.

The aim of the present study is to investigate the effects of BMP-7 released from polylactide microspheres on the appearance of various catabolic and inflammatory cytokines secreted by osteoarthritic chondrocytes cultivated in a collagen gel. Articular chondrocytes of 15 patients suffering from osteoarthritis are transferred to a collagen type-I gel. Additionally, BMP-7 encapsulated into polylactide microspheres (50 ng BMP-7/mL gel) is added.

BMP-7-loaded PGLA microspheres as a new delivery system for the cultivation of human chondrocytes in a collagen type I gel: the common nude mouse model.

Purpose: Bone morphogenic protein 7 (BMP-7) released from polylactide (PLGA) microspheres has proven to be a potent system in cartilage tissue engineering in vitro. However, in vivo data are still lacking. The aim of this study was to investigate this BMP-7 release system utilizing the nude mouse as a small animal model.

A cell-free collagen type I device for the treatment of focal cartilage defects.

The purpose of this study was to evaluate the potential value of a cell-free collagen type I gel plug for the treatment of focal cartilage defects. Cellular migration and proliferation was addressed in vitro, and the formation of repair tissue in a nude mouse-based defect model. A cell-free plug made of collagen type I was placed in the center of an incubation plate.

[Fractures of the acetabulum. Diagnostic and therapeutic strategies].

Fractures of the acetabulum are a challenge in terms of orientation and the surgical skills of the orthopedic trauma surgeon. Due to the surrounding soft tissues and because of the indirect reduction control, operative treatment of acetabular fractures can be very demanding. This review includes the anatomical and clinical features, the radiological diagnostic approach, the classification systems, and, in particular, the surgical approaches and treatment principles.

Peer teaching: a randomised controlled trial using student-teachers to teach musculoskeletal ultrasound.

Objectives: This study (a post-intervention assessment) was designed to assess the effectiveness of peer-assisted learning (PAL) using student-teachers (STs) with limited training to teach complicated technical skills for interpreting ultrasound images of the shoulder.

Methods: Students in Years 3 and 4 of medical school were randomly assigned to two groups. In the PAL group (PG), teaching was delivered by a group of nine STs from Years 3 and 4, who undertook a 30-minute general training and 1 week of self-teaching.

[Corrective growth after vertebral body fracture in the adolescence].

We present the case of a 13-year-old female patient who sustained an incomplete burst fracture of the 1st lumbar vertebral body and an impression fracture of the 3rd vertebral body. Using a dorsal instrumentation the kyphosis of the thoracolumbar junction was treated. The radiographical follow-up indicated a correction of the involved vertebral bodies.

Ablation of articular cartilage with an erbium:YAG laser: an ex vivo study using porcine models under real conditions-ablation measurement and histological examination.

Background And Objectives: The use of an erbium:YAG laser in arthroscopic surgery has the advantage of a precise treatment of soft tissue. Due to the high absorption in water, the laser energy is perfectly matched to smoothing the hydrous, fibrillated articular cartilage surface. In minimal invasive surgery, the workspace is filled with aqueous liquids for enlargement.

[Tissue engineering of bone tissue. Principles and clinical applications].

Complex fractures are still a major clinical challenge. The treatment options of large bony defects either with autografts or allografts are limited in terms of material availability and tissue in-growth. Tissue engineering might offer a solution to this problem.