Synovial fluid D-lactate - a pathogen-specific biomarker for septic arthritis: a prospective multicenter study.

Objectives: The performance of synovial fluid biomarker D-lactate to diagnose septic arthritis (SA) and differentiate it from crystal-induced arthritis (CA), other non-infectious rheumatic joint diseases (RD) and osteoarthrosis (OA) was evaluated.

Methods: Consecutive adult patients undergoing synovial fluid aspiration due to joint pain were prospectively included in different German and Swiss centers. Synovial fluid was collected for culture, leukocyte count and differentiation, detection of crystals, and D-lactate concentration.

Systemically administered zoledronic acid activates locally implanted synthetic hydroxyapatite particles enhancing peri-implant bone formation: A regenerative medicine approach to improve fracture fixation.

Fracture fixation in an ageing population is challenging and fixation failure increases mortality and societal costs. We report a novel fracture fixation treatment by applying a hydroxyapatite (HA) based biomaterial at the bone-implant interface and biologically activating the biomaterial by systemic administration of a bisphosphonate (zoledronic acid, ZA). We first used an animal model of implant integration and applied a calcium sulphate (CaS)/HA biomaterial around a metallic screw in the tibia of osteoporotic rats.

Use of a collagen-elastin matrix with split-thickness skin graft for defect coverage in complex wounds.

Objective: Severe soft tissue damage with destruction of the dermis requires plastic reconstructive treatment. For multimorbid patients or patients unable to undergo major reconstructive surgery, use of dermal substitutes, such as a collagen-elastin matrix (CEM) with a split-thickness skin graft (STSG), instead of local or free flap surgery, may be a valid and easy treatment option. We aimed to investigate and compare the outcomes and rate of successful defect reconstruction using CEM plus STSG, using either a one-step approach (simultaneous CEM and STSG) or a two-step approach (CEM and negative wound pressure therapy (NPWT), with secondary STSG transplantation).

The Influence of Anthropometric Variables and Filtering Frequency on Center of Pressure Data.

Good postural control is considered to be a key component of an active lifestyle, and numerous studies have investigated the Center of Pressure (CoP) as a way of identifying motor deficits. However, the optimal frequency range for assessing CoP variables and the effect of filtering on the relationships between anthropometric variables and CoP are unclear. The aim of this work is to show the relationship between anthropometric variables and different ways of filtering the CoP data.

Sustained delivery of a heterodimer bone morphogenetic protein-2/7 via a collagen hydroxyapatite scaffold accelerates and improves critical femoral defect healing.

Despite the glimmer of hope provided by the discovery and commercialization of bone morphogenetic protein-2 (BMP-2) as a bone graft substitute, side effects related to the use of supraphysiological doses have hindered its clinical usage. In this study, we compared the osteoinductive potential of BMP-2 homodimer with a heterodimer of BMP-2/7, both delivered via a collagen-hydroxyapatite (CHA) scaffold delivery system, with the aim to reduce the overall therapeutic BMP doses and the associated side-effects. We first show that the incorporation of hydroxyapatite in collagen-based BMP delivery systems is pivotal for achieving efficient BMP sequestration and controlled release.

Application of fibrin glue for hematoma prophylaxis in selective aponeurectomy in Dupuytren's disease.

Introduction: Fibrin glue (FG) can be applied in several surgical procedures at wound closure to reduce postoperative complications such as hematoma formation and wound impairment. The purpose of this study is to assess these preventive surgical benefits in Dupuytren's disease of the hand.

Patients And Methods: We performed a monocentric retrospective cohort study.

Individualized Exercise in Chronic Non-Specific Low Back Pain: A Systematic Review with Meta-Analysis on the Effects of Exercise Alone or in Combination with Psychological Interventions on Pain and Disability.

This systematic review, meta-analysis and meta-regression investigated the effects of individualized interventions, based on exercise alone or combined with psychological treatment, on pain intensity and disability in patients with chronic non-specific low-back-pain. Databases were searched up to January 31, 2022 to retrieve respective randomized controlled trials of individualized and/or personalized and/or stratified exercise interventions with or without psychological treatment compared to any control. Fifty-eight studies (n = 10084) were included.

Semi-occlusive management of fingertip injuries with finger caps: A randomized controlled trial in children and adults.

Background: Human fingertips can regenerate functionally and cosmetically excellent skin and soft tissues. Physiological conditions suppress scar formation and are thus a prerequisite for regenerative healing. Self-adhesive film dressings can provide such favorable conditions.

The INDICATE Knee expectations survey detects general patient treatment goals for total knee arthroplasty and the influence of demographic factors on patients expectations.

Purpose: Post-operative outcome after total knee arthroplasty (TKA) in the treatment of end-stage osteoarthritis correlates strongly with pre-operative impairment-driven patient treatment goals. However, a clinical tool for measuring patient treatment goals in correlation to impairments is still missing, which impedes patient-oriented indication in TKA.

Methods: Patients scheduled for TKA were recruited in four German hospitals.

Indication Criteria for Total Hip Arthroplasty in Patients with Hip Osteoarthritis-Recommendations from a German Consensus Initiative.

Osteoarthritis of the hip (hip OA) is a leading cause of pain and disability in elderly people. If non-surgical therapies become ineffective, patients may consider total hip arthroplasty (THA). The biggest challenge in recommending a THA is identifying patients for whom the benefits of this procedure outweigh the potential risks.

Ask Patients What They Expect! A Survey Among Patients Awaiting Total Hip Arthroplasty in Germany.

Background: Total hip arthroplasty (THA) is an elective surgery. Therefore, patient satisfaction with the results of surgery is paramount. The association between fulfillment of patients' expectations and satisfaction is well known.

An individualized decision aid for physicians and patients for total knee replacement in osteoarthritis (Value-based TKR study): study protocol for a multi-center, stepped wedge, cluster randomized controlled trial.

Background: Total knee replacement (TKR) is one of the most commonly performed routine procedures in the world. Prognostic studies indicate that the number of TKR will further increase constituting growing burden on healthcare systems. There is also substantial regional heterogeneity in TKR rates within and between countries.

Acetabular- and femoral orientation after periacetabular osteotomy as a predictor for outcome and osteoarthritis.

Background: Periacetabular osteotomy is a successful treatment for hip dysplasia. The results are influenced, however, by optimal positioning of the acetabular fragment, femoral head morphology and maybe even femoral version as well as combined anteversion have an impact. In order to obtain better insight on fragment placement, postoperative acetabular orientation and femoral morphology were evaluated in a midterm follow-up in regard to functional outcome and osteoarthritis progression.

Thumb Reconstruction after Severe Trauma Using the Masquelet Technique and the Foucher Neurovascular Flap.

Complex injuries of fingers with bone and soft tissue loss often result in amputation. We present here a case of thumb reconstruction in a severely injured thumb with bone and dorsal soft tissue loss. Primarily a radical debridement of devascularized tissue was performed and a spacer was implanted, to ensure tissue decontamination and induce a Masquelet's bone membrane.

MRI-based static and functional assessment of complex hip deformities in comparison with CT: a validation study.

Objective: This study aimed at investigating the agreement between predefined quantitative parameters of hip morphology derived from magnetic resonance imaging (MRI) and virtual range of motion (ROM) analysis using computed tomography (CT) as standard of reference.

Methods: Twenty patients (13 females, 7 males, 16-59 years) with hip deformities underwent MRI prior to surgery. Clockwise alpha angle, femoral head and neck diameter, collum caput diaphysis angle, femoral torsion, center-edge angles, acetabular coverage of the femoral head, sourcil angle, and acetabular anteversion were measured.

Stress and Self-Efficacy as Long-Term Predictors for Chronic Low Back Pain: A Prospective Longitudinal Study.

Purpose: Psychosocial variables are known risk factors for the development and chronification of low back pain (LBP). Psychosocial stress is one of these risk factors. Therefore, this study aims to identify the most important types of stress predicting LBP.

CT controlled results of direct reduction and fixation of posterior malleolus in ankle fractures.

Purpose: The aim of this study was to present outcomes of operative treatment of the posterior malleolus fractures of type four of the Bartoníček/Rammelt classification.

Methods: In 19 patients, direct reduction and fixation of the posterior malleolus was performed from the posterolateral or posteromedial approaches. The accuracy of reduction was assessed with the use of postoperative CT scans.

The influence of drugs on peripheral nerve regeneration.

Currently, there are no established adjuvant drugs for the acceleration of peripheral nerve regeneration. In this paper, we reviewed the literature from the last 10 years and described the drugs proved to accelerate the functional and histological regeneration of the peripheral nerves, either after trauma or in neuropathy experimental models. The vast majority of the studies were experimental with very few small clinical studies, which indicates the need for prospective randomized studies to identify the best drugs to use as adjuvants for nerve regeneration.

Pathoanatomy of Maisonneuve fracture based on radiologic and CT examination.

Introduction: Although Maisonneuve fracture (MF) is a well-known type of ankle fracture-dislocation, there is still a lack of information about the epidemiology and the extent of all associated injuries. The aim of study is to describe MF pathoanatomy on the basis of radiographs, CT scans and intraoperative findings.

Materials And Methods: The study comprised 54 adult patients.

Is MRI an adequate replacement for CT scans in the three-dimensional assessment of acetabular morphology?

Background: Appropriate three-dimensional imaging of the hip joint is a substantial prerequisite for planning and performing surgical correction of deformities. Although surgeons still use computed tomography (CT), modern and fast acquisition techniques of volumetric imaging using magnetic resonance imaging (MRI) for pelvic measurements enable similar resolution.

Purpose: This study was designed to determine if already described measures of acetabular morphology are comparable in both techniques and if assessment can be performed with equal intra-observer and inter-observer reliability.

Head Taper Corrosion Causing Head Bottoming Out and Consecutive Gross Stem Taper Failure in Total Hip Arthroplasty.

Background: Taper corrosion in total hip arthroplasty for bearings with metal heads against polyethylene has developed from an anecdotal observation to a clinical problem. Increased taper wear and even gross taper failure have been reported for one particular design. It is hypothesized that corrosion of the female head taper results in taper widening, allowing the cobalt-chromium head to turn on the stem and wear down the softer titanium alloy by abrasive wear, ultimately causing failure.

Differential effects of high-fat diet and exercise training on bone and energy metabolism.

Bone microarchitecture and strength are impaired by obesity and physical inactivity, but the underlying molecular regulation of bone metabolism in response to these factors is not well understood. Therefore, we analyzed bone and energy metabolism in male mice fed a high-fat or standard chow diet for 12 weeks with or without free access to running wheels. High-fat diet (HFD) mimicked the human condition of obesity and insulin resistance, including symptoms such as elevated serum glucose and insulin levels and reduced insulin-stimulated glucose uptake into muscle and adipose tissue.

Electrical injury - a dual center analysis of patient characteristics, therapeutic specifics and outcome predictors.

Background: Electrical injuries represent life-threatening emergencies. Evidence on differences between high (HVI) and low voltage injuries (LVI) regarding characteristics at presentation, rhabdomyolysis markers, surgical and intensive burn care and outcomes is scarce.

Methods: Consecutive patients admitted to two burn centers for electrical injuries over an 18-year period (1998-2015) were evaluated.

Recent advances in gene-enhanced bone tissue engineering.

The loss of bone tissue represents a critical clinical condition that is frequently faced by surgeons. Substantial progress has been made in the area of bone research, providing insight into the biology of bone under physiological and pathological conditions, as well as tools for the stimulation of bone regeneration. The present review discusses recent advances in the field of gene-enhanced bone tissue engineering.