Hybrid SPECT/CT for the assessment of a painful hip after uncemented total hip arthroplasty.

Background: The diagnosis of hip pain after total hip replacement (THR) represents a highly challenging question that is of increasing concern to orthopedic surgeons. This retrospective study assesses bone scintigraphy with Hybrid SPECT/CT for the diagnosis of painful THR in a selected cohort of patients.

Methods: Bone SPECT/CT datasets of 23 patients (mean age 68.

[Osteoidosteoma. From diagnosis to treatment].

An osteoid osteoma is a benign bone-forming tumor which usually presents in childhood and adolescence and is characterized by extensive nocturnal pain. Computed tomography (CT) is used to reveal the typical radiolucent nidus surrounded by a sclerotic reaction and in magnetic resonance imaging (MRI) a nidal enhancement and perifocal edema can confirm the diagnosis. Having shown excellent success rates radiofrequency ablation has become the treatment of choice which allows minimally invasive and precise destruction of nidal tumor tissue.

[Total ankle replacement in patients with bleeding disorders].

Background: Total ankle replacement (TAR) is a well-accepted treatment option in patients with end-stage ankle osteoarthritis. However, published literature on patients with bleeding disorders treated with TAR is limited. Therefore, we carried out this prospective study to analyze mid-term postoperative results in patients with bleeding disorders treated by TAR.

[Retention of the prosthesis in early periprosthetic infection after total hip arthroplasty].

Background: The rate of periprosthetic infection after total hip arthroplasty (THA) without patient-specific risk factors is about 1 %. The therapeutic challenges are control of infection, restoration of hip function and prevention of reinfection. In early infection, "irrigation and debridement" (I&D) with exchange of mobile components and retention of the prosthesis remains an attractive alternative to one- or two-stage revision.

[Comparison of stability of plate fixateurs with parallel and oblique screw directions].

Introduction: One of the main failure mechanisms of modern plate fixateurs is the tearing of the whole plate-screw construct out of the osteoporotic bone. The aim of this study was to show whether an oblique screw placement can improve the fixation of the plate to the bone.

Methods: A steel probe was fixed to a synthetic bone (Fa.

[Interbody fusion procedures. Development from a historical perspective].

Background: The development of interbody fusion now stretches over many decades and is still not complete.

Discussion: Due to the lack of appropriate implants, the initial fusions were performed via decortication of the dorsal and lateral structures of the spine, followed by placement of an autograft. Despite acceptable fusion results, better primary stability and higher fusion rates were desired.

[Posterior lumbar interbody fusion implants. Software assisted planning--preliminary results].

Background: Sagittal imbalance, adjacent segment degeneration, and loss of correction due to cage sintering are the main reasons for revision surgery after lumbar fusion. Based on the experience from hip and knee replacement surgery, preoperative software-assisted planning combined with the corresponding cages is helpful to achieve better long-term results.

Objectives: Evaluation of the procedure regarding intraoperative application of preoperative planning and examination to what extent the planning was correct.

[The PLIF and TLIF techniques. Indication, technique, advantages, and disadvantages].

Background: Posterior fusion procedures (posterior lumbar interbody fusion, PLIF; transforaminal lumbar interbody fusion, TLIF) are long-established surgical techniques for lumbar interbody fusion. They differ from anterior lumbar interbody fusion (ALIF) and extreme lateral interbody fusion (XLIF) procedures by approach and associated complications.

Objectives: The posterior fusion procedures PLIF and TLIF are presented and compared with other fusion methods, including advantages and disadvantages.

[Improve of surgical outcomes in spinal fusion surgery : evidence based peri- and intra-operative aspects to reduce complications and earlier recovery].

Objectives: Because international data have a low level of evidence, a variety of treatment approaches for lumbar spine fusion operations are justified based on long-established or safety aspects. The aim of this work is to present an overview of evidence-based peri- and intraoperative treatment measures to shorten the recovery and increase patient satisfaction.

Materials And Methods: This review article is based on a selective literature search that also included PubMed on peri- and intraoperative treatment measures for lumbar spinal surgery.

[Pre- and postoperative fast-track treatment concepts in spinal surgery : patient information and patient cooperation].

Background: Evidence-based procedures and pathways to reduce peri- and postoperative complications, while simultaneously achieving a high satisfaction rate of patients and lower costs are important goals in the treatment of orthopedic patients.

Purpose: This article describes the key factors to improve treatment of patients with indications for stabilization of one or two segments in the field of degenerative lumbar spine pathologies. A fast-track concept was developed to optimize the pathway of treatment, while increasing patient satisfaction and shortening the hospital stay.

[Perioperative pain management: what is evidence based?].

Background: Adequate post-operative acute pain therapy after spinal surgical procedures is essential for many patients. However, patients already receiving chronic opioid therapy pre-operatively present a special challenge for the treating physician during the post-operative period when managing their acute pain. The team must consider multiple approaches of acute pain management and it is important to proceed according to current evidence-based methods.

[Minimally invasive treatment of depression fractures of the tibial plateau using balloon repositioning and tibioplasty: video article].

Background: The aim of surgical treatment of fractures of the tibial head is an exact reconstruction of the joint plateau. For this purpose the method of balloon tibioplasty is now available in selected cases. This article and the accompanying video material illustrate the minimally invasive technique of tibioplasty using an actual example of patient treatment.

[Accuracy of hip stem migration measurement on plain radiographs: reliability of bony and prosthetic landmarks].

Background: In Germany, more than 150,000 total hip arthroplasties (THA) are performed annually. Early implant migration is supposed to be the best indicator for mechanical failure of femoral stems. Therefore, radiological evaluation of hip stems is routinely done by analyzing plain radiographs of THA.

[Association between Hindfoot Alignment and Localisation of Osteochondral Lesions of the Talus].

Background: Osteochondral lesions (OCL) of the talus show a distinct distribution pattern. Vascular, metabolic, idiopathic, and biomechanical factors have been proposed as influencing factors. However, the association of hindfoot alignment and the location of talar OCL is not known.

[Arthrogenic muscle inhibition after trauma - is there an age dependency of the intensity of arthrogenic muscle inhibition?].

Unlabelled: Backround: Knee trauma with arthrogenic muscle inhibition (AMI) lead to muscle weakness. The aim of this study was to analyse the intensity of AMI after meniscus and cartilage injuries and to investigate the association between age, BMI and severity of cartilage leasions with AMI.

Patients And Methods: 48 patients with meniscus or cartilage injury were preoperatively interviewed and examined for isometric maximum force values of the extension muscles of the knee joints.

[Turf toe injury--extension sprain of the first metatarsophalangeal joint].

Injuries of the first metatarsophalangeal (1MTP) joint in the performance of sports are normally rare. The term turf toe injury designates a sprain of the first metatarsophalangeal (1MTP) joint. The trauma mechanism describes a hyperextension in contrast to a "sand-toe"-injury which is caused by a hyperflexion.

[Three-dimensional planing and correction of osteotomies in the forearm and the hand].

New 3-dimensional supported technologies considerably improved accuracy of corrective osteotomies and allowed alignments of cuts not possible before. The introduction of simply applicable software made it possible also for not in informatics educated persons to segment CT data, generate 3D models of bones and compare them with the mirrored opposite side. Only this approach allows an exact analysis of deformation, the creation of an operation plan and the virtual performance of the procedure in 3D.

[Osteoarthritis of the knee in the young patient--who should receive total knee arthroplasty and who should not?].

The incidence of total knee arthroplasty in young patients continues to rise in certain countries despite evidence of decreased patient satisfaction and increased likelihood for revision in patients 55 years of age or less. As long as sufficient pain relief and functional improvement can be obtained by alternative means, total knee arthroplasty should be avoided whenever possible. In young patients with unicompartmental osteoarthritis, and a partially conserved joint space, correctional osteotomy around the knee accompanied by cartilage surgery should be preferred in the presence of the respective deformity.

[Musculoskeletal symptoms in patients with post-polio syndrome].

Background: The prevalence of the post-polio syndrome (PPS) is in estimated 50 % of persons with established poliomyelitis with a subsequently stable phase of at least 15 years. The basic mechanism is a loss of motoneuron cells in the spinal cord resulting in muscle weakness and fatigue. In addition pain, cold intolerance and a loss of stamina are frequently reported.

[Multisegmental posterior cervical fusion with en bloc laminectomy--surgical technique].

Purpose: In patients with cervical spinal stenosis, the posterior laminectomy represents a surgical alternative to anterior procedures. Whereas the majority of surgeons prefer anterior procedures to treat mono- to three-segmental pathologies, posterior procedures have several advantages if the pathology includes four or more segments.

Indication: In general, the indications for a posterior laminectomy resemble those for anterior procedures.