Spatial separation of different drug substances in one microneedle array patch by combining inkjet printing and micromolding technology.

Transdermal drug delivery using microneedle array patches has been investigated using a wide range of drug substances. Inkjet printing and micromolding are established methods for the production of microneedle array patches and both were used to combine lisinopril embedded in povidone and ibuprofen in Eudragit® RS / RL in a single patch. Dissolution studies, visual inspection, mechanical strength and insertion into an artificial skin membrane model were investigated.

Psychosocial Interventions to Reduce Post operative Pain in Total Knee Arthroplasty: A Systematic Review.

Total knee arthroplasty (TKA) is a common surgical remedy for patients with end-stage osteoarthritis. Although TKA is generally effective, a significant number of patients experience chronic post-surgical pain. Psychosocial interventions have increasingly become an area of interest in pain management following surgical procedures.

Accuracy of adult height predictions in patients with axial leg deviations using the Modified and the Abbreviated Modified Fels Knee System.

Background: The accurate estimation of residual growth is crucial for the appropriate timing of growth-guiding surgery in patients with axial leg deviations. Skeletal age methods such as the Modified and the Abbreviated Modified Fels Knee System were developed on historical patient cohorts and the applicability to the modern pediatric population with axial leg deviation has not yet been evaluated.

Questions/purposes: Are both final adult height prediction methods (the Modified Fels Knee System (FKS) and the Abbreviated Modified Fels Knee System (aFKS)) accurate to determine SA and the final adult height on long leg radiographs in patients with axial leg deviations?Which multiplier table shows highest association between predicted and true final adult body height?Do FKS- and aFKS- skeletal age determination methods improve final adult body height prediction accuracy compared to the simple use of chronological age?

Methods: A single center, retrospective study of 31 patients who underwent temporary hemiepiphysiodesis due to axial leg deviations in the frontal plane between 2018 and 2020 was conducted.

Evaluating Patient Participation in Clinical Trials for CLL and SLE in Germany-A Mixed-Methods Study on Enrollment Potential Based on Claims Data.

In recent years, the pharmaceutical industry in Germany has faced a significant decline in the number of clinical trials conducted. This study evaluates patient participation in clinical trials for oncology and chronic diseases in Germany, integrating quantitative and qualitative research. Data from the Institute for Applied Health Research Berlin (InGef (Institut für angewandte Gesundheitsforschung, Berlin, Germany)), covering about 88% of the German population, and expert interviews were used.

Rotating Hinge Revision Total Knee Arthroplasty Provides Greater Arc of Motion Gains for Patients Who Have Severe Arthrofibrosis.

Background: Arthrofibrosis is a common postoperative total knee arthroplasty (TKA) complication that results in limited range of motion (ROM). There is limited literature on outcomes after revision TKA (rTKA) for arthrofibrosis based on preoperative ROM restriction. The aims of this study were to: (1) examine ROM trajectory after rTKA for arthrofibrosis patients who have severe versus nonsevere limitations; (2) compare ROM gains and final arc of motion (AOM) between severe and nonsevere cohorts; (2a) compare ROM gain in a severe cohort treated with a rotating hinge (RH) versus a non-RH (NRH) construct; and (3) assess the impact of arthrofibrosis severity on patient-reported outcome measures.

Relevance of instrumented gait analysis in the prediction of the rebound phenomenon after guided growth intervention.

Predictors of rebound after correction of coronal plane deformities using temporary hemiepiphysiodesis (TH) are not well defined. The following research questions were tested: (1) Is the dynamic knee joint load useful to improve rebound prediction accuracy? (2) Does a large initial deformity play a critical role in rebound development? (3) Are BMI and a young age risk factors for rebound? Fifty children and adolescents with idiopathic knee valgus malalignment were included. A deviation of the mechanical femorotibial angle (MFA) of ≥ 3° into valgus between explantation and the one-year follow-up period was chosen to classify a rebound.

A unique case report of a revision extensor mechanism reconstruction using Marlex mesh in the setting of proximal tibial bone deficiency: The tantalum clamshell technique.

Extensor mechanism (EM) disruption is a rare but severe complication of total knee arthroplasty (TKA) that can greatly impair function. Treatment options for chronic patella tendon ruptures include primary repair, autograft augmentation, and reconstruction with allograft or synthetic material. Despite various techniques, failures can occur, and options for reconstruction after a failed allograft or mesh are limited, especially if the tibial component is well-fixed and cannot be easily removed, and if there is proximal tibial deficiency from a previous failed EM allograft.

Osteoarthritis patients exhibit an autonomic dysfunction with indirect sympathetic dominance.

Background: Osteoarthritis (OA) is a chronic degenerative joint disease causing limited mobility and pain, with no curative treatment available. Recent in vivo studies suggested autonomic alterations during OA progression in patients, yet clinical evidence is scarce. Therefore, autonomic tone was analyzed in OA patients via heart rate variability (HRV) measurements.

Reconstruction of Chronic Quadriceps Tendon Rupture: The Quadriceps Advancement and Imbrication Technique.

Background: Chronic extensor mechanism disruption after total knee arthroplasty (TKA) is a rare but challenging condition. There are several surgical approaches for quadriceps tendon repairs. In this report, we present a modified surgical technique for quadriceps tendon repair in chronic extensor mechanism disruption without the use of allografts or mesh augmentation.

Imaging in revision total knee arthroplasty: A novel 3D classification system for tibial bone defects.

Purpose: The primary purpose of the study was to use pre-revision total knee arthroplasty (TKA) computer-tomography (CT)-images to analyse typical tibial bone defects and create a new schematic three-dimensional (3D)-classification system. The secondary purpose was to investigate the association between defect size and implant selection at the time of revision surgery.

Methods: Eighty-four patients with preoperative CT-scans underwent revision of a primary TKA.

Activity Following Total Hip Arthroplasty: Which Patients Are Active, and Is Being Active Safe?

Background: Younger and physically active patients demand a return to sport after total hip arthroplasty (THA). However, because of the risk of implant wear and loosening, high-impact activities are often not recommended. The current study evaluates predictive factors and revision rates in patients with higher activity levels.

Validation of central peak height method for final adult height predictions on long leg radiographs.

Aims: Accurate skeletal age and final adult height prediction methods in paediatric orthopaedics are crucial for determining optimal timing of growth-guiding interventions and minimizing complications in treatments of various conditions. This study aimed to evaluate the accuracy of final adult height predictions using the central peak height (CPH) method with long leg X-rays and four different multiplier tables.

Methods: This study included 31 patients who underwent temporary hemiepiphysiodesis for varus or valgus deformity of the leg between 2014 and 2020.

Association Between Osteoarthritis Burden and Intervertebral Disk Degeneration in Patients Undergoing Lumbar Spine Surgery for Degenerative Lumbar Spondylolisthesis.

Study Design: A retrospective analysis of prospectively collected data.

Objective: To assess the association between intervertebral disk degeneration and hip and knee osteoarthritis (OA) in patients with degenerative lumbar spondylolisthesis.

Background: The co-occurrence of hip OA and degenerative spinal pathologies was first described as the "hip-spine syndrome" and has also been observed in knee OA.

How safe are intra-articular corticosteroid injections to the hip?

Background: Intra-articular corticosteroid injections (ICSI) are an effective symptomatic treatment for osteoarthritis of the hip. However, the safety of ICSI has been questioned and a relatively high risk for septic arthritis, rapidly progressive osteoarthritis (RPIO) and periprosthetic joint infections (PJI) in patients undergoing subsequent total hip arthroplasty (THA) have been suggested.

Methods: This is a retrospective evaluation of 682 hips that underwent ICSI with 40 mg of Triamcinolone for primary osteoarthritis of the hip.

Tibial bone defect prediction based on preoperative artefact-reduced CT imaging is superior to standard radiograph assessment.

Purpose: The purpose of this study was to evaluate the accuracy of preoperative CT-based Anderson Orthopaedic Research Institute (AORI)-grading and to correlate Computed tomography (CT)-based volumetric defect measurements with intraoperative AORI findings.

Methods: 99 patients undergoing revision total knee arthroplasty (rTKA) with preoperative CT-images were identified in an institutional revision registry. CT-image segmentation with 3D-Slicer Software was used to create 3D tibial bone defects which were then graded according to the AORI-classification.

Patellar malalignment correlates with increased pain and increased synovial stress hormone levels-A cross-sectional study.

Purpose: Risk factors for the development of pain in the context of knee osteoarthritis (KOA) remain unclear. Radiological findings often do not correlate with clinical findings, so other pathomechanisms in the development and perception of pain must play a role. The purpose of this study is to investigate the correlation of increased sympathetic nervous system (SNS) activity (measured by subjective and objective chronic stress parameters) with KOA severity, patellofemoral malalignment, and pain.

[Spondylodiscitis].

Spondylodiscitis is a severe infectious disease of the spine that affects the intervertebral discs and adjacent vertebrae. It can lead to nonspecific pain, limited mobility, and destruction of spinal structures. Various pathogens, such as bacteria, fungi, or parasites, can trigger the disease.

De Novo Synovial Chondromatosis following Primary Total Knee Arthroplasty: A Case Report.

In this case report, we present a rare case of a female patient who developed pain and swelling after a total knee arthroplasty. An extensive diagnostic workup including serum and synovial testing to rule out infection was performed in addition to advanced imaging including an MRI of the knee, but it was only after an arthroscopic synovectomy that the diagnosis of secondary synovial chondromatosis was confirmed. The purpose of this case report is to highlight the occurrence of secondary synovial chondromatosis as a rare cause of pain and swelling after total knee arthroplasty, thereby assisting clinicians in providing prompt diagnosis, surgical treatment, and efficient recovery in the setting of secondary synovial chondromatosis after total knee arthroplasty.

Surgical Treatment of Spinal Deformities in Pediatric Orthopedic Patients.

Scoliosis and Scheuermann's disease are common spinal deformities that affect a substantial population, particularly adolescents, often impacting their quality of life. This comprehensive review aims to present a detailed understanding of these conditions, their diagnosis, and various treatment strategies. Through an extensive exploration of current literature, the review discusses the etiology of these spinal deformities and the use of diagnostic tools such as X-rays and MRI.

Synthesis and In Vitro Biological Evaluation of -Carborane-Based Di--butylphenol Analogs.

Targeting inflammatory mediators and related signaling pathways may offer a rational strategy for the treatment of cancer. The incorporation of metabolically stable, sterically demanding, and hydrophobic carboranes in dual cycloxygenase-2 (COX-2)/5-lipoxygenase (5-LO) inhibitors that are key enzymes in the biosynthesis of eicosanoids is a promising approach. The di--butylphenol derivatives , , , and represent potent dual COX-2/5-LO inhibitors.

Factors for Prolonged Pain and Restriction of Movement Following Hemiepiphysiodesis Plating for the Correction of Lower Limb Malalignment in the Frontal Plane: An Explorative Analysis.

The correction of valgus leg malalignment in children using implant-mediated growth guidance is widely used and effective. Despite the minimal invasive character of the procedure, a relevant number of patients sustain prolonged pain and limited mobility after temporary hemiepiphysiodesis. Our aim was to investigate implant-associated risk factors (such as implant position and screw angulation), surgical- or anesthesia-related risk factors (such as type of anesthesia, use, and duration), and pressure of tourniquet or duration of surgery for these complications.

Carborane-Based Tebufelone Analogs and Their Biological Evaluation In Vitro.

The presence of inflammatory mediators in the tumor microenvironment, such as cytokines, growth factors or eicosanoids, indicate cancer-related inflammatory processes. Targeting these inflammatory mediators and related signal pathways may offer a rational strategy for the treatment of cancer. This study focuses on the incorporation of metabolically stable, sterically demanding, and hydrophobic dicarba-closo-dodecaboranes (carboranes) into dual cyclooxygenase-2 (COX-2)/5-lipoxygenase (5-LO) inhibitors that are key enzymes in the biosynthesis of eicosanoids.

Intra- and interobserver reliability analysis of pediatric lower limb parameters on digital long leg radiographs.

Background: Malalignments of the lower extremity are common reasons for orthopedic consultation because it may lead to osteoarthritis in adulthood. An accurate and reliable radiological assessment of lower limb alignment in children and adolescents is essential for clinical decision-making on treatment of limb deformities and for regular control after a surgical intervention.

Objective: First, does the analysis of full-length standing anteroposterior radiographs show a good intra- and interobserver reliability? Second, which parameter is most susceptible to observer-dependent errors? Third, what is the Standard Error of Measurement (SEM) of the absolute femoral and tibial length?

Methods: Two observers evaluated digital radiographs of 144 legs from 36 children and adolescents with pathological valgus alignment before a temporary hemiepiphysiodesis and before implant removal.

Correlation between Adrenoceptor Expression and Clinical Parameters in Degenerated Lumbar Intervertebral Discs.

Despite advanced knowledge of the cellular and biomechanical processes of intervertebral disc degeneration (IVDD), the trigger and underlying mechanisms remain unclear. Since the sympathetic nervous system (SNS) has been shown to exhibit catabolic effects in osteoarthritis pathogenesis, it is attractive to speculate that it also influences IVDD. Therefore, we explored the adrenoceptor (AR) expression profile in human IVDs and correlated it with clinical parameters of patients.

Clinical outcomes in patients receiving edoxaban or phenprocoumon for prevention of stroke in atrial fibrillation: a German real-world cohort study.

Background: Appropriate and timely anticoagulant therapy with vitamin K antagonists (VKAs) or non-vitamin K oral antagonists (NOACs) is essential for stroke prevention in non-valvular atrial fibrillation (NVAF). Comparative data regarding effectiveness and safety for edoxaban vs phenprocoumon, the predominant VKA in Germany, are scarce.

Objectives: The study evaluates effectiveness and safety of edoxaban vs phenprocoumon in NVAF patients in a German real-world setting.