[Application of image-guided injection for cervical and lumbar syndromes].

The X‑ray image-guided injection methods are an important tool for the treatment of cervical and lumbar pain syndromes. For the application of these methods it is necessary to have a differentiated consideration of cervical and lumbar pain syndromes. This leads to a decoding of complaints to assignable pain generators, which enables a targeted injection method.

[Differential diagnosis of acute back pain and demarcation to other specialist fields].

The treatment of patients with acute back pain is becoming increasingly more important due to the high incidence; however, acute clinical pictures from other disciplines can also primarily be symptomatic with back pain and falsely lead to a consultation with an orthopedist. In order to assure an adequate treatment of potentially critical patients, it is absolutely necessary to exclude life-threatening differential diagnoses by a structured study of the patient history, investigations and diagnostics. Depending on the suspected diagnosis, necessary first aid measures and emergency referral to the appropriate specialist department should be initiated.

Total Hip Arthroplasty in Patients with Coagulopathy.

Prior to a surgical intervention, the examination of patient coagulation disorders is unfortunately often underestimated. While patients with a haemophilia A or B are usually aware of the congenital tendency to bleed, disorders of increased blood coagulation, thrombophilia, are frequently undetected. Therefore, complications caused by thromboses and embolisms after total hip arthroplasty are far more common than uncontrollable post-operative bleeding.

Long-term Results of Conservative Therapy of Adolescent Idiopathic Scoliosis Using the Cheneau Brace.

Adolescent idiopathic scoliosis is a disease of the growing skeleton. The goal in therapy is to decelerate or to prevent progression of the spinal curve. As part of a retrospective study the patient group of the scoliosis surgery from 1995-2016 was analysed according to the inclusion criteria of the Scoliosis research Society (SRS).

Movement Analysis in Orthopedics and Trauma Surgery - Measurement Systems and Clinical Applications.

Background: Technical development lead to an enhancement of clinical movement analysis in the last few decades and expanded its research and clinical applications. Since the mid 20th century, human movement analysis has made its way into clinical practice, e.g.

[Thromboembolic prophylaxis in orthopaedics: update on the current S3 guideline, effective 2015].

Background: Thromboembolism is one of the most significant complications in many orthopaedic treatments and illnesses. Therefore, prevention is of vital importance.

Current Status: The existing S3 guideline, revised in 2015, investigates the various symptoms and treatments in great detail, and thus provides very good recommendations.

[Growing Pains : Cause, Significance and Treatment].

Background: Leg pain is a common reason for consultation in the children's orthopedic clinic. It can occur across all age groups, although most patients are of pre-school or elementary school age. As there are a series of possibly severe differential diagnoses that might cause such pains in children and adolescents apart from benign pains that occur in the context of growth, a thorough patient history and physical examination are essential.

Total Hip Arthroplasty After Spinal Fusion Surgery.

Given the close functional connection between the hip and the spine, their simultaneous degenerative pathology is a common problem seen in orthopedic patients and has been termed the "hip spine syndrome". Demographic change and an increasing number of operations have led to more patients who have undergone both total hip arthroplasty and spondylodesis especially of the lumbar spine. Studies have shown significant dislocation rates in this cohort of as high as almost 30%.

[Geriatric patients in orthopedics].

The treatment of geriatric patients in orthopedics is increasing in importance due to the demographic changes. In order to ensure an adequate treatment it is absolutely necessary to address age-specific risk factors. The decision between conservative and surgical treatment has to be made with the patient and the relatives together, taking all comorbidities into consideration and with the objective of preserving the quality of life.

[Lumbar facet joint disease : Classification, clinical diagnostics, and minimally invasive treatment].

Background: The degeneration of the lumbar facet joint is a multi-factorial process that is closely linked to degeneration of the intervertebral discs and has been implicated as one of the causes of low-back pain of elderly patients in about 15 up to 40% of cases. Moreover, emerging data suggest that increased inflammatory features play an important role in the progression of lumbar facet joint disease and may serve as a link to the afferent pain nerve fibers.

Operative Techniques: Since the first description in 1975 of minimally invasive treatment of lumbar facet joint disease, different techniques have been developed and used with varying results.

Radiological evaluation of kyphoplasty with an intravertebral expander after osteoporotic vertebral fracture.

Spinal deformities due to osteoporotic vertebral compression fractures can be reduced by balloon kyphoplasty, but the correction may be partly lost when the balloon is deflated. The present study aimed to evaluate an intravertebral expander developed to reduce and maintain vertebral body height while cement is injected to correct spinal deformities due to osteoporotic vertebral fractures. The study included 31 osteoporotic vertebral body fractures in 31 patients, classified as A1 according to the AO classification, who underwent kyphoplasty using an intravertebral expander.

Heterotopic Ossification - Complication or Chance?

So far, there has been no clear explanation of the pathophysiological relationships in the development of HO. There is little experimental data dealing with the post-traumatic inflammatory response in terms of a balance between the repair of damaged muscle cells and the opposite response in its development. There are numerous indications regarding possible predisposing factors, such as existence of surrounding tissue hypoxia or the function of pro-angiogenic (VEGF e.

Combined extra-/intrathoracic correction of pectus carinatum and other asymmetric chest wall deformities : A novel technique.

Objective: Description of a novel technique to surgically correct (asymmetric) pectus carinatum and other chest deformities using a metal bar without fixation to the ribs.

Indications: Severe thoracic deformity, extensive psychological strain, social isolation, pain and respiratory complaints. Pseudarthrosis or insufficient correction of a thoracic deformity after prior surgery.

Identification of antibodies against extracellular matrix proteins in human osteoarthritis.

We investigated the presence of autoantibodies against the extracellular matrix proteins thrombospondin-4 (TSP-4), cartilage oligomeric matrix protein (COMP), C-type lectin domain family 3 member A (CLEC3A), collagen II, collagen VI, matrilin-3, and fibrillin-2 in the serum of osteoarthritis (OA) patients. We compared those results with the presence of such antibodies in rheumatoid arthritis (RA) patients and in healthy donors (HD). Our study examines whether antibodies against extracellular proteins can be used as potential biomarkers to support the clinical diagnosis of OA.

Patella alta and patellar subluxation might lead to early failure with inlay patello-femoral joint arthroplasty.

Purpose: With the growing interest in resurfacing procedures, several new implants have been recently introduced for isolated patello-femoral joint arthroplasty (PFA). However, not much data are available for these new techniques or about the right indications for each type of implant.

Methods: Out of a retrospective cohort of 20 inlay PFA, 11 PFA with an elevated Insall-Salvati index and an increased patello-femoral congruence angle showed an initial satisfactory result, but presented thereafter with recurrent pain and "clunk" phenomena.

[Are There any Differences in Quality or Complication Rate in Total Knee Arthroplasty after Establishing a Centre for Endoprosthesis?].

Background: The aim of the study is to show whether there are any changes in quality or incidence of complications in total knee arthroplasty (TKA) after establishing a centre for endoprothesis (EPZ).

Material And Methods: We conducted a retrospective study comparing 100 TKAs one year before establishing an EPZ (Group I) with 100 TKAs one year after establishing an EPZ (group II). Data were collected by analysing our electronic documentation system, and the report of the rehabilitation hospital.

Force plates may be used for dynamic analyses of endoprostheses explantation procedures.

The number of hip and knee arthroplasty replacement surgeries is increasing steadily. In combination with demographic aging and the number of periprosthetic complications, this development has lead to the phenomenon where the need for revision surgery is rising. The problem is, that, while implantation procedures of hip arthroplasties are more or less standardized, explantation is a non-standardized task for experienced specialists, due to the unpredictability of the adequate loosening method.

[Correction of kyphotic fixed lumbar segments and hypolordosis with the transforaminal lumbar interbody fusion technique].

Objective: Correction of a segmental or global lumbar hypolordosis to improve a sagittal imbalance.

Indications: Lumbar segments fixed in kyphosis; degenerative or posttraumatic hypolordotic deformity of the lumbar spine with sagittal imbalance.

Contraindications: Bechterew disease; extended adhesions in the retroperitoneum.

Micro-CT and micro-FE analysis of pedicle screw fixation under different loading conditions.

Anchorage of pedicle screw instrumentation in the elderly spine with poor bone quality remains challenging. In this study, micro finite element (µFE) models were used to assess the specific influence of screw design and the relative contribution of local bone density to fixation mechanics. These were created from micro computer tomography (µCT) scans of vertebras implanted with two types of pedicle screws, including a full region-or-interest of 10 mm radius around each screw, as well as submodels for the pedicle and inner trabecular bone of the vertebral body.

[Imaging diagnostics of the foot : What the orthopaedic surgeon expects from the radiologist].

Clinical/methodical Issue: Foot pain is in the case of long-term congenital, acquired or posttraumatic foot deformities a relevant clinical problem.

Standard Radiological Methods: On the basis of the clinical findings and the orthopaedic question, radiographs of the foot while standing in two planes are supplemented by radiographs of the ankle in an anterior-posterior plane. The imaging diagnostics of the foot are based on the conventional X‑ray diagnostic workup and becomes even more precise and differentiated by the possibility of intersecting imaging procedures.

[Leg ulcers (ulcus cruris): The frequent macrovascular causes].

Leg ulcers (ulcus cruris): The frequent macrovascular causes Four pathologies make up the macrovascular etiologies of leg uclers: Venous leg ulcers (50 %), mixed venous-arterial leg ulcers (20 %), arterial leg ulcers (5 %), and Martorell hypertensive ischemic leg ulcer (5 %). The remaining 20 % concern a large array of other etiologies. Every leg ulcer requires vascular (arterial and venous) work-up, that can be completed with microbiology, biopsy, and more in-depth internal diagnostics, as indicated.