Infiltration therapy in the context of cartilage surgery.

Guideline-based surgical cartilage therapy for focal cartilage damage offers highly effective possibilities to sustainably reduce patients' complaints and to prevent or at least delay the development of early osteoarthritis. In the knee joint, it has the potential to reduce almost a quarter of the arthroses requiring joint replacement caused by cartilage damage. Biologically effective injection therapies could further improve these results.

[Intra-articular injury patterns as evidence of mechanical hip disorders].

FAIS is a well-defined clinical entity with morphological alterations, whether constitutional or acquired, that can lead to damage of the labrum and acetabular cartilage following distinct injury patterns with subsequent osteoarthritis. The combination pathology of cam and pincer deformity is the most common variant. The characteristic changes of the chondrolabral complex that are caused by the dysplasia differ from these FAIS changes.

[The meaning of cartilage therapy in the treatment of FAIS : Is a specific cartilage therapy necessary or is deformity correction sufficient?].

Femoroacetabular impingement syndrome (FAIS) surgery aims to restore the natural anatomical relationships between bones and the soft tissues comprising the hip joint. Most cartilage repair methods for the hip are based on basic science and strategies that were developed for the knee. Currently, there is a lack of information in the literature regarding systematic reviews on evidence-based options in treating cartilage injuries of the hip joint.

Surgically Relevant Morphological Parameters of Proximal Human Femur: A Statistical Analysis Based on 3D Reconstruction of CT Data.

Objectives: Recently, more accurate description of the femoral geometry has become of interest to engineers and orthopedic surgeons. However, an appropriate database is lacking. Therefore, the aim of this study is to present morphological parameters and their correlations, which are relevant for medical issues such as impingement after total hip replacement, as well as for implant design and the etiology of hip fractures.

Primary stability of total hip stems: does surgical technique matter?

Background: With this preliminary study we hypothesized a modified implantation technique may lead to higher primary stability than the conventional one.

Methods: In the conventional technique we used a sharp spoon to open the femoral cavity. Subsequently the opening was extended by increasing sizes of a sensing device to approve the final size.

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.

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.

Comparison of the subjective elbow value and the Mayo elbow performance score.

Background: The aim of this study was to evaluate the subjective elbow value (SEV) and compare it with the Mayo Elbow Performance Score (MEPS). The SEV is defined as the patient's subjective estimation of the elbow as a percentage of a normal elbow, which would correspond to 100%.

Methods: The MEPS and the SEV were prospectively assessed in all patients treated for any elbow pathology.

Reverse total shoulder arthroplasty after failed deltoid flap reconstruction.

Hypothesis: Reverse shoulder arthroplasty (RSA) yields unsatisfactory results after deltoid flap reconstruction due to defect of the deltoid muscle.

Methods: We retrospectively reviewed the outcome of 19 patients after failed deltoid flap reconstruction treated with RSA. Follow-up was after a mean of 4.

Injection-induced low-grade infection of the shoulder joint: preliminary results.

Background: Purulent arthritis of the shoulder has been widely reported. Low-grade post-operative infections of the shoulder have also been observed. Low-grade infections of the shoulder without prior surgery have not been reported in the literature.

[Cementless femoral neck prosthesis CUT--clinical and radiological results after 5 years].

Aim: With regard to total replacement of the hip, revision arthroplasty poses a challenge especially for younger patients. In spite of substantial improvements, new materials and operation techniques are still not able to prevent a shorter running life of prostheses in this group. The present work aims at evaluating clinical and radiological mid-term results of the femoral neck prosthesis CUT (ESKA Orthodynamics Lübeck) to answer the question of whether this implant is recommendable for younger patients.

[The bipolar cup Avantage in hip revision surgery].

Background: Luxations in revision arthroplasty are a serious complication with an incidence of up to 30 percent. In particular in patients with previous operation and resection of bone and soft tissue, the instability increases significantly. The use of the bipolar revision cup Avantage has to be proven valuable to avoid recurrent luxation.

Bone remodeling in proximal HA-coated versus uncoated cementless SL-Plus((R)) femoral components: a 5-year follow-up study.

Background And Purpose: Bone resorption at the femoral stem due to stress shielding has been particularly observed secondary to cementless hip replacement. This prospective study of 126 total-hip replacements was performed to examine clinical outcomes and changes in peri-prosthetic bone density after implantation of a double-tapered cementless femoral component manufactured with versus without hydroxyapatite (HA) coating.

Methods: Sixty-seven femoral components with and 59 femoral components without proximal HA coating were implanted and examined after a mean follow-up of 5.

Clinical and radiological mid-term results of the thrust plate prosthesis.

The purpose of this study was to perform an objective clinical and radiological assessment of the thrust plate prosthesis (TPP). Fifty-three prostheses were evaluated clinically using the Harris hip score (HHS), visual analog scale (VAS), and radiographically before surgery, at the time of discharge, and postoperatively after on average of 8.09 (range 4.

Is there a need of custom-made prostheses for total hip arthroplasty? Gait analysis, clinical and radiographic analysis of customized femoral components.

Introduction: Custom-made prosthesis in primary hip arthroplasty based on the concept of a better press-fitting to reach superior clinical results in comparison to conventional implants. Mid-term results provide a more complete picture with respect to gait and electromyographic analyses.

Materials And Methods: The custom-made femoral component (Adaptiva) was implanted in 24 hips and compared to 23 hips with a conventional implant (Alloclassic-SL).

Morselized bone grafting in revision arthroplasty of the knee: a retrospective analysis of 34 reconstructions after 2-9 years.

Background And Purpose: Loosening of a total knee replacement may lead to loss of bone, requiring biological reconstruction at revision arthroplasty. Good results have been reported from revision arthroplasty of the hip using impaction bone grafting. We report our results of revision total knee arthroplasty using the same technique.

Malpositioning of radial head prostheses: an in vitro study.

Nonanatomic insertion of radial head prostheses may result in maltracking and capitellar erosion. The purpose of this study was to analyze the ability to perform anatomic radial head replacement and to study radiocapitellar prosthetic subluxation under unstable conditions. In vitro measurements were performed in 10 intact elbows and after insertion of radial head prostheses (rigid uncemented, rigid cemented, bipolar).

[The influence of reduced bone density on primary stability of cementless femoral stems. A biomechanical in vitro study].

Objective: The aim of the present in vitro study is to examine the influence of bone density on the primary stability of cementless femoral stems in nine pairs of human cadaveric femurs.

Method: The human proximal femurs were evaluated with regard to their bone density by dual-energy X-ray absorptiometry. Two pairs of human cadaveric femurs had an osteoporotic and two pairs an osteopenic bone stock.

The influence of arthroscopic subscapularis tendon and anterior capsular release on glenohumeral translation: a biomechanical model.

The effect of an arthroscopic release of the intraarticular portion of the subscapularis tendon and the anterior capsule on glenohumeral translation was investigated in a cadaveric model. Ten human cadaveric shoulders with a mean age of 63.5 years (range, 52-79 years) were tested in a robot-assisted shoulder simulator.

[Chronic cobalt poisoning in endoprosthetic replacement].

This article outlines symptoms and therapeutic options in chronic cobalt poisoning including a case report in which metallosis caused by a ceramic-metal articular pairing led to almost complete loss of sight and hearing after revision of a total hip prosthesis. At primary revision the firmly incorporated stem was left in place. For a better offset only the head was exchanged from a ceramic to a metal model which articulated with a socket containing a ceramic inlay.

Clinical and functional outcome of the Thrust Plate Prosthesis: short- and medium-term results.

Objectives: The purpose of this study was to objectively assess the functional outcome after implantation of a Thrust Plate Prosthesis.

Design: This retrospective study compared the gait patterns of 33 patients to a control group.

Background: Few studies have been published about this type of prosthesis describing clinical and radiographic outcome.

Primary stability in cementless femoral stems: custom-made versus conventional femoral prosthesis.

Objective: To compare a custom-made femoral stem with a conventional cementless stem for initial stability in human femurs.

Design: The bone-femoral prosthesis interface motion was measured in vitro using displacement transducers. Combined axial and torsional loads simulating single-leg stance, loading were applied.