Expression of Estrogen Receptor Alpha and Evaluation of Histological Degeneration Scores in Fibroblasts of Hypertrophied Ligamentum Flavum: A Qualitative Study.

The most common spinal disorder in elderly is lumbar spinal stenosis (LSS), resulting partly from ligamentum flavum (LF) hypertrophy. Its pathophysiology is not completely understood. The present study wants to elucidate the role of estrogen receptor α (ER α) in fibroblasts of hypertrophied LF.

Nicotine consumption may lead to aseptic loosening in proximal mega-prosthetic femoral replacement.

Background: Aseptic loosening after total hip arthroplasty is likely related to nicotine ingestion. However, aseptic loosening as a direct consequence of smoking habits has not been described with regard to proximal mega-prosthetic femoral replacement. The aim of the present study was to evaluate the association between nicotine consumption and aseptic loosening rates after proximal mega-prosthetic femoral replacement.

Systemic antibiotic therapy does not significantly improve outcome in a rat model of implant-associated osteomyelitis induced by Methicillin susceptible Staphylococcus aureus.

Introduction: Treatment of implant-associated osteomyelitis regularly involves the use of systemic antibiotics in addition to surgical intervention. However, it remains unclear if perioperative systemic application of bactericide substances can improve overall outcome in models of severe intramedullary infection. The present study investigated the use of systemic gentamicin in addition to a controlled local release from a highly lipophilic gentamicinpalmitate compound while the previous study showed efficacy of sole antibiotic implant-coating.

Acute leg pain with suspected beginning leg compartment syndrome and deep vein thrombosis as differential diagnoses in an unusual presentation of Brodie's abscess: a case report.

Background: Brodie's abscess is an uncommon form of subacute osteomyelitis where the main presenting symptom is mild to moderate pain of insidious onset for several months' duration. We report a case of a patient presenting with acute leg pain resembling that of a deep vein thrombosis, and a beginning leg compartment syndrome following a suspected ruptured Baker's cyst. Our case is unusual because of the acute presentation of the Brodie's abscess with acute leg pain and acute swelling without any preceding trauma; to the best of our knowledge, this presentation has not been reported before.

Hip-joint congruity after Dega osteotomy in patients with cerebral palsy: long-term results.

Introduction: Neurogenic hip dislocation is quite common in children with cerebral palsy (CP). The purpose of this study was to evaluate the long-term outcome of single-event multilevel surgery (SEMLS) in combination with hip reconstruction by using a periacetabular osteotomy as described by Dega concerning post-operative remodeling and plasticity of the femoral head post-operatively.

Methods: A total of 72 patients with CP as the primary disease and in whom a complex surgical hip reconstruction was performed during SEMLS between 1998 and 2004 were included in the study.

Set screw fracture with cage dislocation after two-level transforaminal lumbar interbody fusion (TLIF): a case report.

Introduction: Transforaminal lumbar interbody fusion is a popular procedure used to achieve spondylodesis in patients with degenerative lumbar spinal diseases. We present a rare case of a patient with a set screw fracture with cage dislocation after an open transforaminal lumbar interbody fusion procedure. To the best of our knowledge, this case is the first of its kind to be reported.

A comparison of intraarticular lumbar facet joint steroid injections and lumbar facet joint radiofrequency denervation in the treatment of low back pain: a randomized, controlled, double-blind trial.

Background: Lumbar facet joint degeneration is a source of chronic low back pain, with an incidence of 15% to 45% among patients with low back pain. Various therapeutic techniques in the treatment of facet-related pain have been described in the literature, including intraarticular lumbar facet joint steroid injections and radiofrequency denervation. In this study, we compared the effectiveness of intraarticular facet joint steroid injections and radiofrequency denervation.

Correlation of pull-out strength of cement-augmented pedicle screws with CT-volumetric measurement of cement.

Background: Cement augmentation of pedicle screws increases fixation strength in an osteoporotic spine. This study was designed to determine the cement distribution and the correlation between the pull-out strength of the augmented screw and the cement volume within polyurethane (PU) foam.

Methods: Twenty-eight cannulated pedicle screws (6×45 mm) (Peter Brehm, Erlangen, Germany) with four holes at the distal end of the screw were augmented with the acrylic Stabilit ER Bone Cement Vertebral Augmentation System (DFine Inc.

Does probe frequency influence diagnostic accuracy in newborn hip ultrasound?

Ultrasonography of the hip has gained wide acceptance as reliable method for diagnosing developmental hip dysplasia in infants. This blinded study was conducted to investigate the influence of two linear probes with different frequency on diagnostic accuracy and reproducibility. In 206 consecutive newborns, the bony roof angle (α-angle) and cartilage roof angle (β-angle) were assessed by three investigators according to Graf.

Test-retest reliability of 3D ultrasound measurements of the thoracic spine.

Objective: To explore the reliability of the Zebris CMS 20 ultrasound analysis system with pointer application for measuring end-range flexion, end-range extension, and neutral kyphosis angle of the thoracic spine.

Setting: The study was performed within the School of Physiotherapy in cooperation with the Orthopedic Department at a University Hospital.

Participants: The thoracic spines of 28 healthy subjects were measured.

Expression of hypoxia-inducible factor-1α, vascular endothelial growth factor, and matrix metalloproteinases 1, 3, and 9 in hypertrophied ligamentum flavum.

Study Design: Immunohistological study.

Objective: To elucidate the role of matrix metalloproteinases (MMPs), hypoxia-inducible factor-1α (HIF), and vascular endothelial growth factor (VEGF) in the hypertrophied ligamentum flavum (LF) obtained from patients with lumbar spinal stenosis (LSS).

Summary Of Background Data: The most common spinal disorder in the elderly is LSS, which results in part from LF hypertrophy.

Anterior cruciate ligament deficiency leads to early instability of scaffold for cartilage regeneration: a controlled laboratory ex-vivo study.

Purpose: The affect of anterior cruciate ligament (ACL) integrity on the early postoperative stability of a collagen type-I gel scaffold was investigated. The value of fibrin glue for graft fixation in ACL deficient porcine knees over a simulated early postoperative period was also studied.

Methods: Full-thickness articular cartilage defects (11 × 6 mm) were created on the medial femoral condyle of 80 porcine knees.

Increased expression of CD44 in hypertrophied ligamentum flavum and relevance of splice variants CD44v5 and CD44v6.

Background: The most common spinal disorder in the elderly is lumbar spinal stenosis (LSS), which results in part from ligamentum flavum (LF) hypertrophy. Although prior histologic and immunochemical studies have been performed in this area, the pathophysiology of loss of elasticity and hypertrophy is not completely understood. The purpose of this immunohistological study is to elucidate the role of CD44 and its splice variants CD44v5 and CD44v6 in the hypertrophied LF obtained from patients with lumbar spinal stenosis (LSS).

Objective assessment of shoulder mobility with a new 3D gyroscope--a validation study.

Background: Assessment of shoulder mobility is essential for clinical follow-up of shoulder treatment. Only a few high sophisticated instruments for objective measurements of shoulder mobility are available. The interobserver dependency of conventional goniometer measurements is high.

MRI after patellofemoral replacement: the preserved compartments.

Introduction: The aim of this study was to assess the reproducibility of magnet resonance imaging (MRI) analysis of preserved anatomic structures of the knee after patellofemoral replacement (PFR). It was hypothesized that evaluation of cartilage, ligaments, meniscus and tendons would result in high inter-observer reliability after PFR.

Material And Methods: MRI, tailored to reduce metallic artefacts of the knee, after PFR was performed in seven patients.

Acute central canal dilatation after minimally invasive lateral cervical decompression through the Frykholm approach.

Study Design: A case report to describe the first case of an acute central canal dilatation after minimally invasive lateral cervical decompression.

Objective: To emphasize the need of being aware of this rare spinal disorder.

Summary Of Background Information: A holocord syrinx is known as a complication of Chiari malformation.

Primary pyogenic spondylitis following kyphoplasty: a case report.

Introduction: Only ten cases of primary pyogenic spondylitis following vertebroplasty have been reported in the literature. To the best of our knowledge, we present the first reported case of primary pyogenic spondylitis and spondylodiscitis caused by kyphoplasty.

Case Presentation: A 72-year old Caucasian man with an osteoporotic compression fracture of the first lumbar vertebra after kyphoplasty developed sensory incomplete paraplegia below the first lumbar vertebra.

Closing-wedge high tibial osteotomy: survival and risk factor analysis at long-term follow up.

Background: Closing-wedge high tibial osteotomy (HTO) is successful for the treatment of medial osteoarthritis with varus malalignment. Preoperative risk factors for HTO failure are still controversial. The aim of this study was to elucidate the outcome and assess the influence of risk factors on long term HTO survival.

Expression of matrix metalloproteinases 1, 3, and 9 in differing extents of tendon retraction in the torn rotator cuff.

Purpose: Differing extents of tendon retraction are found in full-thickness rotator cuff tears. The pathophysiologic context of tendon degeneration and the extent of tendon retraction are unclear. Tendon integrity depends on the extracellular matrix, which is regulated by matrix metalloproteinases (MMP).

Reproducibility of different screening classifications in ultrasonography of the newborn hip.

Background: Ultrasonography of the hip has gained wide acceptance as a primary method for diagnosis, screening and treatment monitoring of developmental hip dysplasia in infants. The aim of the study was to examine the degree of concordance of two objective classifications of hip morphology and subjective parameters by three investigators with different levels of experience.

Methods: In 207 consecutive newborns (101 boys; 106 girls) the following parameters were assessed: bony roof angle (α-angle) and cartilage roof angle (β-angle) according to Graf's basic standard method, "femoral head coverage" (FHC) as described by Terjesen, shape of the bony roof and position of the cartilaginous roof.

Expression of matrix metalloproteinases 1, 3, and 9 in degenerated long head biceps tendon in the presence of rotator cuff tears: an immunohistological study.

Background: Long head biceps (LHB) degeneration, in combination with rotator cuff tears, can be a source of chronic shoulder pain. LHB tenotomy reduces pain and improves joint function although the pathophysiological context is not well understood. Tendon integrity depends on the extracellular matrix (ECM), which is regulated by matrix metalloproteinases (MMP).

The association between retraction of the torn rotator cuff and increasing expression of hypoxia inducible factor 1α and vascular endothelial growth factor expression: an immunohistological study.

Background: Differing levels of tendon retraction are found in full-thickness rotator cuff tears. The pathophysiology of tendon degeneration and retraction is unclear. Neoangiogenesis in tendon parenchyma indicates degeneration.

The relevance of long head biceps degeneration in the presence of rotator cuff tears.

Background: Long head biceps (LHB) degeneration in combination with rotator cuff tears can be a source of chronic shoulder pain. LHB tenotomy is an approved surgical procedure for pain reduction and improvement of joint function, however, the pathophysiology of LHB degeneration is not fully understood. In the literature, neoangiogenesis in tendon tissue has previously been shown to be associated with tendon degeneration.

[Current status of revision total hip arthroplasty in Germany].

Background: Revision total hip arthroplasty (THA) has gained importance over the past few years. However, in the literature, there are many recommendations for both surgical intervention and postoperative rehabilitation. The purpose of this nationwide German survey was to identify the actual treatment of revision THA and to compare the findings of this study with guidelines in the current literature.

Results of the cementless Plasmacup in revision total hip arthroplasty: a retrospective study of 72 cases with an average follow-up of eight years.

Background: There are multiple revision implant systems currently available for socket revision in revision total hip arthroplasty. Up until now, not all of these systems have been followed up with regards to their long-term use as a revision implantation.For the first time, this study presents the hemispherical porous-coated socket Plasmacup SC, produced by Aesculap, Tuttlingen, Germany, and the clinical and radiological mid-term results of this revision cup implant.