In Vitro Biocompatibility of the Novel Ceramic Composite Baghdadite for Defect Augmentation in Revision Total Hip Arthroplasty.

Biological augmentation of bony defects in weight-bearing areas of both the acetabulum and the femur remains challenging. The calcium-silicate-based ceramic Baghdadite is a very interesting material to be used in the field of revision total hip arthroplasty for the treatment of bony defects in weight-bearing and non-weight-bearing areas alike. The aim of this study was to investigate the biocompatibility of Baghdadite utilizing an osteoblast-like, human osteosarcoma cell line (MG-63) and the human monocytic leukemia-derived cell line (THP-1).

Effects of Different Hemoglobin Levels on Near-Infrared Spectroscopy-Derived Cerebral Oxygen Saturation in Elderly Patients Undergoing Noncardiac Surgery.

Background: Near-infrared spectroscopy (NIRS) is a commonly used technique to evaluate tissue oxygenation and prevent harmful cerebral desaturation in the perioperative setting. The aims of the present study were to assess whether surgery-related anemia can be detected via NIRS of cerebral oxygen saturation and to investigate the effects of different perioperative transfusion strategies on cerebral oxygenation, potentially affecting transfusion decision-making.

Study Design And Methods: Data from the ongoing multicenter LIBERAL-Trial (liberal transfusion strategy to prevent mortality and anemia-associated ischemic events in elderly noncardiac surgical patients, LIBERAL) were used.

[Customized partial pelvis replacement: three-dimensional planning and management concepts].

The planning and implantation of a customized partial pelvis replacement places high demands on both the surgeon and the entire team (engineer, assistants, surgical team). Thanks to careful preoperative planning and meticulous perioperative execution, customized partial pelvic replacement represents a complex but reliable procedure for defect reconstruction even with highly complex acetabular bone defects or after multiple previous surgeries.

Temporary arthrodesis through static spacer implantation in two-stage treatment of periprosthetic joint infections of the knee.

Objective: Treatment of chronic periprosthetic joint infection of the knee requires the removal of the implant and thorough debridement, with reimplantation in a second stage surgery. Intramedullary spacers can be helpful during the interval between explantation and reimplantation and provide a temporary arthrodesis which fixes the knee in extension preserving leg length and administers local antibiotic therapy.

Indications: Periprosthetic joint infection of the knee with large bony defects and severe infection of the native joint with advanced destruction/infiltration of the cartilage and bone and/or ligament insufficiency.

COVID-19 measures as an opportunity to reduce the environmental footprint in orthopaedic and trauma surgery.

Background: Climate change and its consequences on our everyday life have also tremendous impacts on public health and the health of each individual. The healthcare sector currently accounts for 4.4% of global greenhouse gas emissions.

Commercially manufactured spacers for the treatment of periprosthetic joint infection of the hip.

Background: Periprosthetic joint infection remains a common and serious complication after hip arthroplasty. To improve function and patient comfort after joint removal in two-stage revision, commercially manufactured spacers for the hip joint allow retention of the anatomical joint geometry thereby limiting soft tissue contraction and allow mobilization.

Indications: Periprosthetic joint infection of the hip, septic arthritis with severe destruction of the hip cartilage and/or bone requiring arthroplasty.

Surgical technique and preliminary results of a moulded, mobile spacer for the treatment of periprosthetic joint infection of the knee.

Objective: Mobile knee spacers can be utilized in the first stage of a two-stage exchange in periprosthetic joint infection or septic arthritis of the knee to prevent soft tissue contraction, enable local antibiotic elution, and improve patient mobility. Commercially made moulds enable the surgeon to prepare a reproducible spacer design and match the preparation of the arthroplasty, which will be carried out in a second step.

Indications: Periprosthetic joint infection of the knee and severe cases of septic arthritis of the knee with advanced destruction/infiltration of the cartilage.

Ceramic Wear Particles: Can They Be Retrieved In Vivo and Duplicated In Vitro?

Background: Little is known about retrieved zirconia platelet toughened alumina (ZPTA) wear particles from ceramic-on-ceramic (COC) total hip arthroplasty. Our objectives were to evaluate clinically retrieved wear particles from explanted periprosthetic hip tissues and to analyze the characteristics of in vitro-generated ZPTA wear particles.

Methods: Periprosthetic tissue and explants were received for 3 patients who underwent a total hip replacement of ZPTA COC head and liner.

Periprosthetic joint infection caused by kytococcus schroeteri: The first reported case and a review of the literature.

Oftentimes, Gram-positive cocci are the cause for periprosthetic joint infections (PJI). Most of these infections include bacteria such as Staphylococcus aureus, Staphylococcus epidermidis or other coagulase-negative staphylococci. We here present the first case of a PJI caused by Kytococcus schroeteri.

Preoperative embolization of renal cell carcinoma metastases to the bone prior to stabilization procedures does not result in reduction in intraoperative blood loss.

Purpose: The effect of preoperative embolization of bone metastases prior to stabilization procedures in reducing intraoperative blood loss remains controversial. This study aimed to analyze the effect of preoperative embolization on orthopedic stabilization procedures of the extremities and spine in cases with bone metastases from renal cell carcinomas. In particular, do these patients suffer less blood loss during the operation and do they need lesser fluid replacements or packed red cell bags intra- and perioperatively? Does preoperative embolization reduce the duration of surgery?

Methods: We retrospectively reviewed stabilization procedures of the spine and extremities at our institution between 2011 and 2021 for group differences (embolization vs.

Microbiological Trends and Antibiotic Susceptibility Patterns in Patients with Periprosthetic Joint Infection of the Hip or Knee over 6 Years.

We sought to analyze trends of the causative pathogens and their antibiotic susceptibility patterns in patients with periprosthetic joint infections (PJI) of the hip and knee to get better insights and improve treatment. Retrospective evaluation of all consecutive patients with microbiological detection of a causative pathogen at a tertiary endoprothetic referral center between January 2016 and December 2021 in Germany was performed. Overall, 612 different microorganisms could be detected in 493 patients (hip: n = 293; knee: n = 200).

Pain levels and patient comfort after lower limb arthroplasty comparing i.v. patient-controlled analgesia, continuous peripheral nerve block and neuraxial analgesia: a retrospective cohort analysis of clinical routine data.

Background: Insufficient pain control after lower limb arthroplasty results in delayed recovery and increased risk for pain chronicization. The ideal kind of analgesia is still discussed controversially. We conducted a retrospective analysis of single-center routine data from a German university hospital, including patients receiving either total hip (THA) or knee arthroplasty (TKA).

Microbiological Profiles of Patients with Periprosthetic Joint Infection of the Hip or Knee.

Periprosthetic joint infections (PJI) are one of the most devastating consequences after total joint arthroplasty. We sought to analyze the causative pathogens of patients with PJI to get better insights and improve treatment. We performed a retrospective study of all patients with PJI of the hip and knee with microbiological detection of a causative pathogen at a tertiary endoprothetic referral center between January 2016 and March 2021.

Increased rate of enteric bacteria as cause of periprosthetic joint infections in patients with liver cirrhosis.

Introduction: Periprosthetic joint infections (PJI) are a major complication in joint-arthroplasty. Rifampicin is often used as an additional agent to treat PJI, because it penetrates bacterial biofilms. However, rifaximin, belonging to the same antibiotic class as rifampicin, is frequently used to prevent episodes of hepatic encephalopathy in patients with cirrhosis and may induce resistance to rifampicin.

[Use of custom-made acetabular components (CMAC) as part of a two-stage procedure in patients with severe periacetabular bone loss].

Objective: Implantation of custom-made acetabular components (CMAC) with load transmission onto the remaining bone stock and reconstruction of the "center of rotation" (COR) in cases of severe periacetabular bone defects.

Indications: Severe periacetabular bone loss (Paprosky type IIIA/B) with or without pelvic discontinuity after septic or aseptic loosening with inadequate load capacity of the dorsal pillar and/or large supraacetabular defects.

Contraindications: Acute or local infections, lack of compliance, taking into account the risks and complications: missing or limited expected postoperative functional gain, multimorbid patients with potential inoperability during the first and/or second intervention.

Open Access Redefined: Survey Data and Literature Study on the Impact of Sci-Hub in Orthopaedic Research.

Background: Since Alexandra Elbanyan founded Sci-Hub in 2011, the website has been used by a growing number of researchers worldwide. Sci-Hub is a so-called shadow library or guerrilla open access format bypassing publishers' paywalls, giving everyone free access to scientific papers. Until today, there have been no publications about usage by orthopaedic and trauma surgeons of Sci-Hub or other "pirate sites" and how it may influence their work.

Femoral defects in revision hip arthroplasty: a therapy-oriented classification.

Introduction: The complex field of femoral defects in revision hip arthroplasty displays a lack of standardized, intuitive pre- and intraoperative assessment. To address this issue, the femoral defect classification (FDC) is introduced to offer a reliable, reproducible and an intuitive classification system with a clear therapeutic guideline.

Materials And Methods: The FDC is based on the integrity of the main femoral segments which determine function and structural support.

sCD28, sCD80, sCTLA-4, and sBTLA Are Promising Markers in Diagnostic and Therapeutic Approaches for Aseptic Loosening and Periprosthetic Joint Infection.

Aseptic prosthetic loosening and periprosthetic joint infections (PJI) are among the most frequent complications after total knee/hip joint arthroplasty (TJA). Current research efforts focus on understanding the involvement of the immune system in these frequent complications. Different immune cell types have already been implicated in aseptic prosthetic loosening and PJI.

Risk factors for implant failure of custom-made acetabular implants in patients with Paprosky III acetabular bone loss and combined pelvic discontinuity.

Background: Severe acetabular bone loss in revision total hip arthroplasty (RTHA), both with or without pelvic discontinuity, remains a great challenge in orthopaedic surgery.

Objective: The aim of this study was to evaluate risk factors for failure of custom-made acetabular implants in RTHA.

Methods: Seventy patients with severe acetabular bone loss (Paprosky Type III) and pelvic discontinuity, who required RTHA, were included in our study.

Safety and Suitability of the SmartPill® after Abdominal Surgery: Results of the Prospective, Two-Armed, Open-Label PIDuSA Trial.

Introduction: Postoperative ileus (POI) is a common complication after abdominal surgery. Until today, an evidence-based treatment of prolonged POI is still lacking, which can be attributed to the poor quality of clinical trials. Various different surrogate markers used to define POI severity are considered to be the cause of low-quality trials making it impossible to derive treatment recommendation.

Synovial Complement Factors in Patients with Periprosthetic Joint Infection after Undergoing Revision Arthroplasty of the Hip or Knee Joint.

The role and diagnostic value of the synovial complement system in patients with low-grade periprosthetic joint infection (PJI) are unclear. We sought to evaluate, for the first time, the usefulness of synovial complement factors in these patients by measuring the individual synovial fluid levels of complement factors (C1q, C3b/iC3b, C4b, C5, C5a, C9, factor B, factor D, factor H, factor I, properdin, and mannose-binding lectin [MBL]). The patients ( = 74) were classified into septic ( = 28) and aseptic ( = 46).

Vertebral Bone Marrow-Derived Mesenchymal Stromal Cells from Osteoporotic and Healthy Patients Possess Similar Differentiation Properties In Vitro.

Osteoporosis is a disease characterized by low bone mass and an increased risk of fractures. Although several cellular players leading to osteoporosis have been identified, the role of mesenchymal stromal cells (MSC) is still not fully elaborated. The aim of this study was, therefore, to isolate and characterize MSCs from vertebral body of healthy non-osteoporotic and osteoporotic patients, with a particular focus on their osteogenic differentiation potential.

High-Dimensional Analysis of Immune Cell Composition Predicts Periprosthetic Joint Infections and Dissects Its Pathophysiology.

Accurate diagnosis of periprosthetic joint infections (PJI) is one of the most widely researched areas in modern orthopedic endoprosthesis. However, our understanding of the immunological basis of this severe complication is still limited. In this study, we developed a flow cytometric approach to precisely characterize the immune cell composition in periprosthetic joints.

Outcome of repeated multi-stage arthroplasty with custom-made acetabular implants in patients with severe acetabular bone loss: a case series.

Background: Failed reconstruction in cases of severe acetabular bone loss, with or without pelvic discontinuity, in revision total hip arthroplasty (rTHA) remains a great challenge in orthopaedic surgery. The aim of this study was to describe the outcome of a "second" rTHA with "custom-made acetabular components (CMACs)" after a previously failed reconstruction with CMACs.

Methods: 4 patients with severe acetabular bone loss (Paprosky Type IIIB), who required a second rTHA after a previously failed reconstruction with CMAC, due to prosthetic joint infection (PJI), were included in our retrospective study.