Ultrasound-assisted calcaneoplasty.

Purpose: The endoscopic technique for resection of a postero-superior part of calcaneus served as a golden standard during the last 10 years, and it has mostly replaced the open techniques. In an effort to reduce the morbidity and the recovery time, we had introduced the ultrasound-assisted technique.

Methods: In the period of 1 year, 15 patients with the prominent postero-superior part of calcaneus and retrocalcaneal bursitis were operated through the single skin incision using the ultrasound-assisted technique.

The "cello technique": a new technique for ultrasound-assisted calcaneoplasty.

The "cello technique" is a new calcaneoplasty technique for the treatment of Haglund disease. It is an ultrasound-assisted technique for resection of the posterosuperior part of the calcaneus. It is possible to resect the posterosuperior part of the calcaneus under direct ultrasound control with the patient in the prone position, with a dorsally positioned ultrasound probe, in line with the Achilles tendon fibers (sagittal line), and with the abrader in the posteromedial working portal.

New "L value" parameter simplifies and enhances hip ultrasound interpretation in the detection of developmental dysplasia of the hip.

Purpose: The purpose of this study was to simplify and enhance the ultrasound (US) analysis of the infant's hip by introducing a novel parameter named "L value" into the widely used Graf method.

Methods: We analysed 508 ultrasonographic images of the hips in infants aged three months. The images were first evaluated using the Graf measurements.

Fractionation of high-dose electron beam irradiation of BPTB grafts provides significantly improved viscoelastic and structural properties compared to standard gamma irradiation.

Purpose: Irradiation >30 kGy is required to achieve sterility against bacterial and viral pathogens in ACL allograft sterilization. However, doses >20 kGy substantially reduce the structural properties of soft-tissue grafts. Fractionation of irradiation doses is a standard procedure in oncology to reduce tissue damage but has not been applied in tissue graft sterilization.

Postoperative blood loss management in total knee arthroplasty: a comparison of four different methods.

Purpose: As the blood loss after the total knee arthroplasty (TKA) is not only a potentially serious medical problem but also an economical concern, the purpose of the study was to investigate the effectiveness of different combinations of knee positioning and the applied wound dressings on blood saving after TKA.

Methods: A randomized controlled trial including 147 TKA-operated patients was conducted. The subjects were assigned to one of the four groups; Group 1-controls, Group 2-flexion, Group 3-flexion and compression, Group 4-compression.

Effect of electron beam irradiation on biomechanical properties of patellar tendon allografts in anterior cruciate ligament reconstruction.

Background: Sterilization of anterior cruciate ligament (ACL) allografts is an important prerequisite to prevent disease transmission. However, mechanical tissue properties are compromised by most current sterilization procedures, so that uncompromised sterilization of allografts is difficult to achieve. Hypothesis/

Purpose: The aim of this study was to evaluate the effect of the novel electron beam sterilization procedure on the biomechanical properties of human patellar tendon allografts at various irradiation dosages.

The UniSpacer™: correcting varus malalignment in medial gonarthrosis.

While options for operative treatment of leg axis varus malalignment in patients with medial gonarthrosis include several established procedures, such as unicompartmental knee arthroplasty (UKA), total knee arthroplasty (TKA) or high tibial osteotomy (HTO), there has been little focus on a less invasive option introduced more recently: the UniSpacer™ implant, a self-centering, metallic interpositional device for the knee. This study evaluates clinical and radiological results of the UniSpacer™, whether alignment correction can be achieved by UniSpacer™ arthroplasty and alignment change in the first five postoperative years. Anteroposterior long leg stance radiographs of 20 legs were digitally analysed to assess alignment change: two relevant angles and the deviation of the mechanical axis of the leg were analysed before and after surgery.

Cocultures of rat sensorimotor cortex and spinal cord slices to investigate corticospinal tract sprouting.

Study Design: Experimental study of corticospinal axonal sprouting in an organotypic slice culture model.

Objective: To develop an in vitro model that simplifies the study of various factors regulating neuronal regeneration.

Summary Of Background Data: Spinal cord injury leads to permanent neurologic damage, mainly due to the inability of the adult central nervous system to regenerate.

A new symptomatic intra-articular cord-like structure associated with discoid meniscus.

We introduce a new, not yet described cord-like structure of the knee of children associated with discoid or enlarged menisci. This structure was responsible for knee pathology (loss of extension) in 3 cases. The patients (5 to 8 years of age) complained of knee pain without skeletal abnormality or trauma.

Prevention of epidural scarring after microdiscectomy: a randomized clinical trial comparing gel and expanded polytetrafluoroethylene membrane.

A randomized clinical trial compared two materials used to prevent epidural scarring after microdiscectomy. To determine whether ADCON-L Gel (ALG) or Preclude Spinal Membrane (PSM) was more effective in preventing scarring, reducing pain, and improving quality of life postoperatively. Postdiscectomy syndrome may result from epidural scarring.

Factors influencing cup orientation in 500 consecutive total hip replacements.

Unlabelled: We sought to establish the percentage of acetabular components used in total hip arthroplasties that were located outside a presumed safe range of cup orientation. Data were analyzed to assess whether dislocation in this series was different inside and outside that presumed safe zone. We also asked whether acetabular cup orientation depended on patient body mass index, the amount of preoperative acetabular head coverage, the surgeon, or the use of minimally invasive technique.

Triple osteotomy of the pelvis for acetabular dysplasia: age at operation and the incidence of nonunions and other complications influence outcome.

We investigated the variables which determine the outcome after triple osteotomy of the pelvis for the treatment of congenital dysplasia of the hip. We reviewed 51 patients (61 hips) with a median age at operation of 23 years who were treated with a Tönnis triple osteotomy. The median follow-up was six years with a minimum of two years.

Characterisation of transverse slice culture preparations of postnatal rat spinal cord: preservation of defined neuronal populations.

Spinal cord injury induces degenerative and regenerative processes and complex interactions of neurons with non-neuronal cells. In order to develop an in vitro tool for the investigation of such processes, we prepared and characterised spinal cord slice cultures (SCSC) from Wistar rats (p0-12). SCSC were sustained in vitro up to 12 days and characterised by immunohistochemistry.

Prosthetic replacement in secondary Girdlestone arthroplasty has an unpredictable outcome.

The functional outcome of hip replacement following a Girdlestone arthroplasty may be difficult to predict. We reviewed 39 hips in 39 patients with a minimum follow-up of 12 (range 12-208) months from re-implantation total hip arthroplasty. The patients were treated in one institution between 1983 and 2000, and their mean age at conversion was 65 (32-85) years.

Intraarticular lesions in primary frozen shoulder after manipulation under general anesthesia.

The aim of this study was to find intraarticular lesions after manipulation under general anesthesia in patients with primary frozen shoulder. In a prospective trial conducted between 2001 and 2003 in 30 patients with primary frozen shoulder, the affected shoulders were manipulated while the patients were under general anesthetia. Exclusion criteria were secondary stiffness caused by rotator cuff tears and glenohumeral arthritis.

Large lateral meniscal ganglion cyst extending into the intercondylar fossa of the knee.

We report the case of a 31-year-old, otherwise healthy man with a large intra-articular meniscal ganglion cyst (27.7 x 13.5 mm) originating from the dorsal horn of the lateral meniscus.

Ipsilateral dislocation of knee, foot and ankle.

We present a case of ipsilateral dislocation of the knee, ankle and midfoot. No previous report of this combination of injuries was found in a review of the literature. In spite of the type of injury, no neurovascular compromise or complications turned up.

Orthotics and insoles for the forefoot: the European way.

Technical aids in the treatment of foot problems have been known for hundreds of years. In the German-speaking countries, especially, shoemakers, prosthetists, and orthotists are well respected. They have great skills and provide the orthopedic surgeon with alternatives to surgery.

Evaluation of the predictive value of Her-2/neu gene expression on osteosarcoma therapy in laser-microdissected paraffin-embedded tissue.

Histologic response to chemotherapy is currently the strongest prognostic factor in high-grade osteosarcoma, but it can only be assessed after several weeks of therapy. Thus, detection of chemosensitivity at the time of diagnosis would be of great clinical importance. The expression of the proto-oncogene Her-2/neu has been shown to be of predictive value in breast cancer and has also been considered as prognostic marker for osteosarcomas, but reports of mainly immunohistochemical studies are controversial.

Inhibition of monocyte/endothelial cell interactions and monocyte adhesion molecule expression by the immunosuppressant mycophenolate mofetil.

Study Design: In vitro study on the effects of mycophenolate mofetil (MMF) on isolated human monocytes and endothelial cells.

Objectives: Haematogenous macrophages play an essential role in the development of secondary damage following spinal cord injury (SCI), and there is evidence that the use of immunosuppressants such as MMF can reduce monocyte invasion and neuronal damage.

Setting: University Hospital for Orthopaedic Surgery, Frankfurt am Main, Germany.

The bisphosphonate clodronate depletes microglial cells in excitotoxically injured organotypic hippocampal slice cultures.

The bisphosphonate clodronate, clinically used in the treatment of osteoporosis, is known to deplete cells of the monocytic lineage. Using an in vitro model of excitotoxic damage in organotypic hippocampal slice cultures (OHSC), we investigated whether clodronate can also prevent microglial activation that occurs in CNS pathologies. Lesioning of OHSC was performed by application of 50 microM N-methyl-D-aspartate (NMDA) for 4 h after 6 days in vitro (div).

Direct stabilization of lumbar spondylolysis with a hook screw: mean 11-year follow-up period for 113 patients.

Study Design: A retrospective study involving 113 patients with a spondylolysis who underwent direct repair with a hook screw was conducted.

Objectives: Spondylolysis with instability can produce low back pain. In adults, fusion of the affected level is the gold standard of treatment.

Interleukin-4, interleukin-10, and interleukin-1-receptor antagonist but not transforming growth factor-beta induce ramification and reduce adhesion molecule expression of rat microglial cells.

The activity of microglial cells is strictly controlled in order to maintain central nervous system (CNS) immune privilege. We hypothesized that several immunomodulatory factors present in the CNS parenchyma, i.e.

Arthroscopic all-inside meniscus repair using a new refixation device: a prospective study.

Purpose: To evaluate complications and clinical results after meniscus refixation using a new all-inside technique.

Type Of Study: Prospective clinical study.

Methods: This study reports clinical results of 37 patients after refixation of an unstable bucket-handle meniscus tear using a new all-inside technique (Mitek Meniscal Repair System; Mitek, Ethicon, Norderstedt, Germany).

The post-discectomy syndrome. Aetiology, diagnosis, treatment, prevention.

The post-discectomy syndrome (PDS) is a common diagnosis in patients with problems following a disc operation. The different causes of PDS make the establishment of the correct diagnosis and its corresponding efficient treatment difficult. A general overview published in the bibliographical data covering the entity of PDS is rare.