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[Principles of treatment for deep infections of the diabetic foot.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Infections are the typical complications of ulcers related to the neuropathic diabetic foot. The loss of the foot or sepsis is the consequence due to the progression of an untreated infection. Therefore, prophylaxis of ulcer formation is the key to lower the rate of amputation. If infection has occurred antibiotics and non-weight bearing are indicated. Abscesses and phlegmons can be localized by the clinical findings, ultrasound, x-rays, computer tomography and MRI and immediate surgical treatment is necessary to prevent further spreading. In the chronic phase dead tissue, necrotic tendons and bones need to be resected...
Source: Der Orthopade - November 19, 2009 Category: Orthopaedics Authors: Kessler S, Delhey P, Volkering C Tags: Orthopade Source Type: journals

[Reconstructive surgery for Charcot foot : Long-term 5-year outcome.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
CONCLUSION: By using a fixateur externe many amputations could be avoided and patient's activity could be improved. The interdisciplinary teamwork between an orthopedic surgeon, orthopedic shoemaker and orthopedic technician is essential for long term success. PMID: 19921507 [PubMed - as supplied by publisher] (Source: Der Orthopade)
Source: Der Orthopade - November 19, 2009 Category: Orthopaedics Authors: Illgner U, Podella M, Rümmler M, Wühr J, Büsch HG, Wetz HH Tags: Orthopade Source Type: journals

[Rehabilitation and prosthetic fitting in patients suffering from diabetic foot syndrome.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Rehabilitation of patients suffering from diabetic foot syndrome requires a holistic team approach. Besides the treatment of the local problems the treatment of the basic disease with education, correct nutrition and best possible drug treatment is of importance to prevent subsequent complications. A diabetic foot schooling is of importance to prevent secondary ulcers. Correct wound care with broad knowledge of wound healing stages, a variety of wound dressings and skilled knowledge in prosthetic and orthopedic shoe fitting plays a predominant role. The treatment is completed by physiotherapeutic gait training includin...
Source: Der Orthopade - November 14, 2009 Category: Orthopaedics Authors: Greitemann B Tags: Orthopade Source Type: journals

[Preserving foot surgery for diabetics.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The reconstruction of a diabetic foot is still a challenge for the orthopedic surgeon. Untreated fractures, dislocations and foot and ankle deformities with consequent ulcerations may increase the risk of limb amputation. For patients who refuse a major amputation a surgical reconstruction can be started using bone grafts, angle stable locking plates and ankle arthrodesis nails. The goal of reconstruction in all patients is to avoid amputation. PMID: 19908026 [PubMed - as supplied by publisher] (Source: Der Orthopade)
Source: Der Orthopade - November 13, 2009 Category: Orthopaedics Authors: Müller S, Wenz W Tags: Orthopade Source Type: journals

[Preventive measures and organization of a regional shared-care system for foot treatment.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A shared-care system should be established to treat diabetic foot wounds. This means including different professions and institutions to optimize the treatment of these patients in respect of medical, psychological and social aspects. This procedure is very well described in the national guidelines of treatment of type 2 diabetes to prevent and treat diabetic foot complications. In the treatment of the diabetic foot syndrome the establishment of such a shared-care system has to recognize the wound classification and the underlying risk of patients. In this article the stage-adjusted approach and the duties of the diffe...
Source: Der Orthopade - November 12, 2009 Category: Orthopaedics Authors: Zink K, Haak T Tags: Orthopade Source Type: journals

[Diagnostics and therapy of the diabetic foot syndrome from a vascular surgery perspective.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article describes the diagnostics and therapy of the diabetic foot syndrome from a vascular surgical point of view. The importance of endovascular, vascular surgical as well as combined (hybrid) procedures of revascularization is emphasized. PMID: 19898833 [PubMed - as supplied by publisher] (Source: Der Orthopade)
Source: Der Orthopade - November 8, 2009 Category: Orthopaedics Authors: Rümenapf G, Morbach S, Lang W Tags: Orthopade Source Type: journals

["Und was wir alleine nicht schaffen, das schaffen wir dann zusammen" (Xavier Naidoo) : Interdisciplinary therapy of diabetic foot syndrome.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19898834 [PubMed - as supplied by publisher] (Source: Der Orthopade)
Source: Der Orthopade - November 8, 2009 Category: Orthopaedics Authors: Sabo D Tags: Orthopade Source Type: journals

[Drug-induced osteopathies : Drugs, pathogenesis, forms, diagnosis, prevention and therapy.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A number of drugs can have "side effects" on bone metabolism and formation, causing bone atrophy, impaired mineralisation, as well as osteonecrosis. In both clinical and general practitioner settings, these forms of bone damage have been hitherto considered as adverse drug side effects and have received insufficient attention; moreover, they have not been the subject of patient information. Preventive measures are not instigated prior to initiation of medication and even after onset of bone damage, therapeutic strategies are poorly implemented. Even fracture healing with its complex, staged course can be both positivel...
Source: Der Orthopade - November 5, 2009 Category: Orthopaedics Authors: Bartl R, Bartl C, Gradinger R Tags: Orthopade Source Type: journals

[Tenocytes and the extracellular matrix : A reciprocal relationship.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The characteristic cells in tendons and ligaments are called tenocytes, which are responsible for the formation and turnover of the extracellular matrix. They react to external stimuli and facilitate the functional adaptation of the proteoglycan and collagen network to mechanical requirements. Via numerous cellular processes they form a complex communicating network which demonstrates coordinated directional reactions. As is common to all tissues in the human body, tendons are subject to age changes which influence the tenocytes, but additionally the structural organization and hence the function of the extracellular m...
Source: Der Orthopade - October 30, 2009 Category: Orthopaedics Authors: Milz S, Ockert B, Putz R Tags: Orthopade Source Type: journals

[Molecular tools to remodel osteoarthritic articular cartilage : Growth, transcription, and signaling factors.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In conclusion, recent experimental findings permit cautious optimism, holding promise for treating human OA in the future. PMID: 19876615 [PubMed - as supplied by publisher] (Source: Der Orthopade)
Source: Der Orthopade - October 30, 2009 Category: Orthopaedics Authors: Cucchiarini M, Heiligenstein S, Kohn D, Madry H Tags: Orthopade Source Type: journals

[Tissue engineering of cartilage and bone : Growth factors and signaling molecules.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article discusses some important growth factors in the process of endochondral ossification and demonstrates how this information could be translated into a controlled release system for different tissue engineering strategies. PMID: 19851750 [PubMed - as supplied by publisher] (Source: Der Orthopade)
Source: Der Orthopade - October 23, 2009 Category: Orthopaedics Authors: Brochhausen C, Lehmann M, Zehbe R, Watzer B, Grad S, Meurer A, Kirkpatrick CJ Tags: Orthopade Source Type: journals

[Tissue engineering - state of the art and in future.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19851751 [PubMed - as supplied by publisher] (Source: Der Orthopade)
Source: Der Orthopade - October 23, 2009 Category: Orthopaedics Authors: Meurer A, Brochhausen C, Kirkpatrick CJ Tags: Orthopade Source Type: journals

[Minor amputations for diabetic foot syndrome.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Minor amputations are frequently performed for neuroischemic or neuropathic lesions of the diabetic foot. Depending on the definition used, minor amputations can range from toe to Syme amputations. Minor amputations are often combined with necrosectomy and débridement. For early and optimal rehabilitation, as much vital tissue as possible should be conserved, especially considering the skeletal structures of the foot (borderline amputation). Minor amputations are of utmost importance for the prevention of ascending infections and reduce the duration of clinical and outpatient treatment.Minor amputations should be ...
Source: Der Orthopade - October 21, 2009 Category: Orthopaedics Authors: Rümenapf G, Lang W, Morbach S Tags: Orthopade Source Type: journals

[In vitro trials with single and co-cultures of osteoblasts and endothelial cells : Evaluation of new biomaterials for bone reconstruction and regeneration.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Many different types of bone substitute biomaterials are being developed for different applications in the body. The current dogma is that if osteoblasts and endothelial cells grow and exhibit normal cell functions on these materials in vitro as single cultures or in co-cultures, then the biomaterials are suitable for implantation for bone reconstruction and regeneration. Generally, only in vivo animal studies will prove whether this is the case. However, in vitro studies offer a good pre-screening and selection basis to evaluate the biocompatibility of novel biomaterials prior to animal studies. Multicell type co-cult...
Source: Der Orthopade - October 17, 2009 Category: Orthopaedics Authors: Unger RE, Halstenberg S, Günther H, Sartoris A, Brochhausen C, Kirkpatrick CJ Tags: Orthopade Source Type: journals

[Acetabular revision surgery with the oblong revision cup : Clinical and radiological results of 217 cases.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
CONCLUSION: We recommend this component in revision surgery on the basis of satisfactory clinical and radiological results at a mean of 48 months of follow-up. We identified the number of revisions as a predictor of survival rate. PMID: 19838666 [PubMed - as supplied by publisher] (Source: Der Orthopade)
Source: Der Orthopade - October 16, 2009 Category: Orthopaedics Authors: Fickert S, Pfeiffer S, Walter A, Günther KP, Witzleb WC Tags: Orthopade Source Type: journals

[Bone tissue engineering in clinical application : Assessment of the current situation.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Treatment of severe bone defects remains a challenge in orthopaedic surgery and traumatology. Surgical techniques should provide primary stability to reach osseous integration and secondary remodeling of bone grafts and substitute materials. None of the currently available substitute materials provides osteoconduction and osteogenesis comparable to those of human allografts and autografts. To enhance osteoinductive and osteogenetic properties of these implants mesenchymal stem cells are used successfully in bone tissue engineering approaches. The aim of this report is to summarize the currently available data on bone t...
Source: Der Orthopade - October 16, 2009 Category: Orthopaedics Authors: Bernstein P, Bornhäuser M, Günther KP, Stiehler M Tags: Orthopade Source Type: journals

[Osteoblasts : Cellular and molecular regulatory mechanisms in fracture healing.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Bone tissue possesses a unique regeneration ability, translating mechanical and metabolic stimuli into a biological response. The perpetual regeneration processes allow continuous self-renewal and adaptation to prevailing mechanical forces. The complex regulation of osteoblastic differentiation during fracture repair has not been completely defined. Two different transcription factors - RUNX2 and SP7 - are considered to be master genes of osteoblastic differentiation. Furthermore, the canonical WNT pathway plays an essential role in the activation of osteoblastic differentiation during both bone growth and fracture hea...
Source: Der Orthopade - October 14, 2009 Category: Orthopaedics Authors: Hofmann A, Mattyasovszky SG, Brüning C, Ritz U, Mehling I, Meurer A, Rommens PM Tags: Orthopade Source Type: journals

[Chondrocytes - one cell type, different subpopulations : Characteristics and behavior of different types of chondrocytes and implications for tissue engineering applications.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Chondrocytes represent the most important cell source for engineering of cartilaginous tissues. Depending on the tissue type and the localization within the tissue, these cells may behave differently. Numerous studies have been done to compare articular, nasal, auricular, and costal chondrocytes in order to evaluate differences between knee and ankle joint cartilage and to investigate topographical variations within an articular joint. Moreover, the zonal structure of articular cartilage needs to be considered because it leads to phenotypical differences between chondrocytes of the superficial and the deeper zones. Sev...
Source: Der Orthopade - October 3, 2009 Category: Orthopaedics Authors: Grad S, Salzmann GM Tags: Orthopade Source Type: journals

[Biomaterial for autologous chondrocyte transplantation.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Autologous chondrocyte transplantation (ACT) is a cell-based biological cartilage repair procedure for the regeneration of injured articular cartilage. The further modification of classical ACT to matrix-associated autologous chondrocyte transplantation (MACT) includes the use of biomaterials as cell carriers and has biological and surgical advantages. The use of biomaterials as cell carriers for chondrocytes requires the analysis of cell culture conditions, cell-cell and cell-matrix interactions and also the determination of chondrocytic differentiation. The biomaterials used preserve the specific cellular architectur...
Source: Der Orthopade - September 30, 2009 Category: Orthopaedics Authors: Marlovits S, Aldrian S, Tichy B, Albrecht C, Nürnberger S Tags: Orthopade Source Type: journals

[Possibilities and limits in tissue engineering of the anterior cruciate ligament.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Although current concepts of cruciate ligament reconstruction using tendon transplants provide midterm knee joint stabilization, a single-bundle or double-bundle tendon cannot adequately restore the complex three-dimensional structure of the anterior cruciate ligament. Therefore, researchers are attempting to develop alternatives using tissue engineering technology. The basic principle includes seeding of suitable cells on a resorbable carrier construct, in vitro biological and mechanical stimulation to generate a ligament-like extracellular matrix, and subsequent implantation as a cruciate ligament bioprosthesis. Seve...
Source: Der Orthopade - September 30, 2009 Category: Orthopaedics Authors: Ignatius A, Dürselen L Tags: Orthopade Source Type: journals

[Physical movement - Is it good for the back? : Nationwide representative study on different effects of physical activity at the workplace and in leisure time.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study provides population-based epidemiologic data on the prevalence of back pain among employed German citizens for the first time since the reunification. Although causal conclusions cannot principally be derived from cross-sectional data, the results of this analysis allow the multifactorial conditional structure to be unraveled. Our data demonstrate that manual physical employment does not represent a substitute for fitness leisure sports, but physically demanding working conditions themselves represent a significant risk factor for back pain. PMID: 19787333 [PubMed - as supplied by publisher] (Source: Der Orthopade)
Source: Der Orthopade - September 29, 2009 Category: Orthopaedics Authors: Schneider S, Zoller S Tags: Orthopade Source Type: journals

[From GRIP to multimodal pain therapy : A concept asserts itself.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Low back pain is still a big medical and social problem. During the last few decades a change of paradigm in treating non-specific low back pain has happened: physical activity and exercise therapy are now recommended as the first-line treatment in all relevant national and international guidelines. In chronic cases only biopsychosocial treatment concepts are successful, which have been introduced in Germany in 1990 in the form of the GRIP (Göttingen intensive low back program) for the first time. Meanwhile, this treatment has now been recommended by all evidence-based guidelines but we are still in the beginning ...
Source: Der Orthopade - September 26, 2009 Category: Orthopaedics Authors: Hildebrandt J, Pfingsten M Tags: Orthopade Source Type: journals

[Exercise therapy in the treatment of chronic back pain : An integral part of interdisciplinary therapy.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Chronic low back pain requires interdisciplinary and biopsychosocial treatment. Apart from the medical, psychological, and physiotherapeutic aspects of therapy, exercise therapy is an important component. Together with"work hardening," it represents the elements for reconditioning. The isolated effect is scientifically difficult to specify with the available data, but in most analytical studies, exercise therapy is an important component in an interdisciplinary setting. A nonspecific, diversified training program is superior to exercise solely of the trunk muscles. The primary tasks are to recover load capacity and dim...
Source: Der Orthopade - September 25, 2009 Category: Orthopaedics Authors: Maier A, Weh L, Klein A, Hamel M, Lucan S, Marnitz U Tags: Orthopade Source Type: journals

["Work hardening" for chonic back pain : An integral component of multimodal therapy programs.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Work hardening is aimed at a reestablishment of the potentials needed in occupational everyday life. Fundamental motor abilities, such as strength, stability, flexibility and persistence, are restored and merged into the everyday life so that psychological contents, such as fear avoidance behavior will be positively affected. The design of work hardening is interdisciplinary in the sense of a holistic approach to back pain. Handling the pain under load requires sophisticated treatment and the training demands a high degree of individual design. A trusting and mutual agreement between therapist and patient is essential....
Source: Der Orthopade - September 24, 2009 Category: Orthopaedics Authors: Hamel M, Maier A, Weh L, Klein A, Lucan S, Marnitz U Tags: Orthopade Source Type: journals

[Orthopedic specialists in an interdisciplinary setting : Multimodal therapy for chronic back pain.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Chronic back pain compels a new therapeutic strategy. A therapeutic team setting and consequent consideration of proven treatments are required. The orthopedic specialist should manage a cooperating team with a psychologist and a physiotherapist, and information should be continuously exchanged according to the criteria for interdisciplinary multimodal pain therapy. The team's therapeutic tasks should be determined and distributed according to the individual patient's problems. Questionably relevant - in particular, somatic-oriented - diagnostic and therapeutic measures should be avoided. The team setting facilitates o...
Source: Der Orthopade - September 24, 2009 Category: Orthopaedics Authors: Weh L, Marnitz U Tags: Orthopade Source Type: journals

[Cementless humeral surface replacement arthroplasty in patients less than 55 years of age.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
CONCLUSION: Cementless humeral surface replacement arthroplasty is a viable bone-preserving treatment option for young and active patients. Later conversion to total shoulder replacement is possible. Good clinical results, a low complication rate, and high patient satisfaction were found in the short and mid term. Long-term investigations are necessary to confirm these observations. PMID: 19768450 [PubMed - as supplied by publisher] (Source: Der Orthopade)
Source: Der Orthopade - September 19, 2009 Category: Orthopaedics Authors: Raiss P, Pape G, Becker S, Rickert M, Loew M Tags: Orthopade Source Type: journals

[From natural growth to artificial composition : The use of artificial materials in endoprosthetics from a cultural-historical perspective.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The use of artifical materials in joint replacement is not self-evident. A paradigm change can be observed. Beginning in the 18th century orthopedic surgery became possible because of a change of the idea of man. Natural growth was seen as ideal solution in orthopedic surgery until the 19th century. Yet in the aftermath the point of view changed to a more technical determined approach. Until the middle of the 20th century the terms "efficieny" and "ability" became more and more important. Joint replacement with artificial materials was generally accepted and led to an enormous accelaration in the development of new mat...
Source: Der Orthopade - September 19, 2009 Category: Orthopaedics Authors: Koch HE, Schofer MD, Fuchs-Winkelmann S, Lakemeier S Tags: Orthopade Source Type: journals

[Cervical spine osteoblastoma in children : Selective diagnostics as the basis for effective surgical management.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Expansively growing cervical spine osteoblastomas are rare but can cause severe neurological damage as a result of their anatomical relationship to nerve structures. Also, cerebral vessels, especially the vertebral artery in its transvertebral position, are often covered by tumor tissue. In complete resection of the tumor, it is sometimes possible to retain the affected vessel. In addition to conventional radiographic diagnostics, computed tomography, and magnetic resonance imaging, angiography and Doppler sonography of the intracranial arteries executed in parallel can provide evidence of the dimension of the neurolog...
Source: Der Orthopade - September 17, 2009 Category: Orthopaedics Authors: Gutteck N, Mendel T, Held A, Wohlrab D Tags: Orthopade Source Type: journals

[Interdisciplinary treatment : Long-lasting, effective, and cost-effective.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The efficacy of intensive interdisciplinary pain management programs for patients with chronic low back pain has been repeatedly demonstrated. A controversial issue in previous studies is the cost-effectiveness of this treatment. Between 2001 and 2006, a total of 575 patients with chronic nonspecific back pain took part in an outpatient pain management program at the German Red Cross Pain Center (DRK Schmerz-Zentrum Mainz) in Mainz, Germany. Complete follow-up data were available for 351 patients 1 year after the end of treatment and were included in the study. No differences between these patients and the dropouts wer...
Source: Der Orthopade - September 11, 2009 Category: Orthopaedics Authors: Nagel B, Korb J Tags: Orthopade Source Type: journals

[Conservative strategies for treating low back pain.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article discusses the importance of a careful patient history and a detailed clinical assessment to differentiate etiologic factors concerning the cause and continuation of low back pain. The indications and efficacy of various physiotherapeutic and balneological strategies are presented, with emphasis on the economic necessity of a targeted plan of care. PMID: 19756491 [PubMed - as supplied by publisher] (Source: Der Orthopade)
Source: Der Orthopade - September 5, 2009 Category: Orthopaedics Authors: Heisel J Tags: Orthopade Source Type: journals

[Risks and side effects of blood transfusion.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article addresses the incidence, clinical picture, and etiology of adverse effects of transfusion. It also reports on current knowledge concerning transfusion-associated acute lung injury, which has gained much attention in the last few years. Besides hepatitis and human immunodeficiency viruses, cytomegalovirus, parvovirus B19, prion transmission, and the risk of variant Creutzfeld-Jakob disease are also discussed. PMID: 19756492 [PubMed - as supplied by publisher] (Source: Der Orthopade)
Source: Der Orthopade - September 5, 2009 Category: Orthopaedics Authors: Fölsch B, Cassens U Tags: Orthopade Source Type: journals

[Peri-operative adjustment and treatment of diabetes mellitus.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In all disciplines of operative medicine the number of patients who suffer from diabetes mellitus is increasing dramatically. The reason is that nowadays up to 10% of the population is suffering from this disease. These patients must be treated with respect to the diabetes and also subsequent related conditions to prevent peri-operative complications. A special problem is that many patients do not know that they are suffering from diabetes. Pre-operatively and during the peri-operative course the coordinated efforts of surgeons, anaesthesiologists and diabetes specialists are essential to reach an optimal result. In al...
Source: Der Orthopade - September 5, 2009 Category: Orthopaedics Authors: Zander JF, Risse A Tags: Orthopade Source Type: journals

[Treatment of postoperative thrombosis.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
For the treatment of deep vein thrombosis (DVT), rapid diagnosis and prompt therapy are crucial to minimize the risk of fatal pulmonary embolism and long-term complications, including the postthrombotic syndrome and recurrent thromboembolism. The treatment of acute DVT remains controversial. In this review, treatment options in relation to exposing and predisposing risk factors are discussed. Evidence-based data and recommendations from official guidelines are presented. PMID: 19756494 [PubMed - as supplied by publisher] (Source: Der Orthopade)
Source: Der Orthopade - September 5, 2009 Category: Orthopaedics Authors: Linke LC Tags: Orthopade Source Type: journals

[Diagnosis and treatment of foreign-body-associated infection in orthopaedic surgery.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article gives some basic information for better understanding of foreign-body-associated infection in order to improve diagnostics and therapy in the clinical routine. PMID: 19756495 [PubMed - as supplied by publisher] (Source: Der Orthopade)
Source: Der Orthopade - September 5, 2009 Category: Orthopaedics Authors: Frommelt L Tags: Orthopade Source Type: journals

[Deformity-associated treatment of the hallux valgus complex.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Hallux valgus represents a combined deformity with malpositioning of the big toe in the metatarsophalangeal joint and metatarsal splaying due to metatarsus primus varus formation. It is defined on the basis of joint condition of the metatarsophalangeal and tarsometatarsal (TMT) joints, the extent and congruence or incongruence of malposition, mobility of the metatarsophalangeal joint and TMT stability. Basic resection appears to be indicated only in exceptional cases. Depending on the degree of severity, deformities can be corrected by means of distal, diaphyseal or proximal osteotomies and TMT arthrodeses. Any correct...
Source: Der Orthopade - September 3, 2009 Category: Orthopaedics Authors: Wanivenhaus A, Bock P, Gruber F, Ivanic G, Klein C, Siorpaes R, Schneider W, Steinböck G, Trieb K, Trnka HJ Tags: Orthopade Source Type: journals

[Accompanying diseases and complications in orthopedic surgery.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19727669 [PubMed - as supplied by publisher] (Source: Der Orthopade)
Source: Der Orthopade - September 2, 2009 Category: Orthopaedics Authors: Katthagen BD Tags: Orthopade Source Type: journals

[Perioperative management of patients with Parkinson's disease.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Ageing patients reveal an increasing coincidence of orthopaedic disorders and Parkinson's disease (PD). In addition, parkinsonian motor symptoms predispose individuals for orthopaedic diseases. PD patients have a higher risk of perioperative complications than patients without PD; this higher risk is based on motor and autonomous deficits in PD as well as on interactions between antiparkinsonian and anaesthesia medications. The elevated perioperative risk in PD can be reduced by appropriate perioperative management and no longer represents a contraindication to surgery in PD patients. PMID: 19727670 [PubMed - as su...
Source: Der Orthopade - September 2, 2009 Category: Orthopaedics Authors: Spiegel J Tags: Orthopade Source Type: journals

[Complications after hip operations.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
From 1999 to 2008, according to a prospective and sequential compilation of data, the 12,590 hip operations (11,059 in adults and 1,531 in children) performed in our hospital showed a postoperative complication rate of 4.96% (5.2% in adults and 1.96% in children). The most frequent complications were 110 thromboses (0.87%), which were clinically apparent and proven by Doppler ultrasonography or phlebography; 191 superficial and deep disorders of wound healing (1.5%), including 57 (0.45%) infections; 88 peripheral nerve lesions (0.7%); and 53 hematoma revisions (0.42%). Operation-specific statistics for complications (t...
Source: Der Orthopade - September 2, 2009 Category: Orthopaedics Authors: Katthagen BD, Zahedi AR Tags: Orthopade Source Type: journals

[We must fundamentally change the care of chronic back pain patients!]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19727666 [PubMed - as supplied by publisher] (Source: Der Orthopade)
Source: Der Orthopade - September 1, 2009 Category: Orthopaedics Authors: Weh L Tags: Orthopade Source Type: journals

[Long-term results of uncemented stems in total hip arthroplasty : Analysis of survival rates with a minimum 15-year follow-up.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
CONCLUSION: The long-term results with a minimum follow-up of 15 years are good or excellent for most studied uncemented femoral stems and are comparable to the outcomes of cemented femoral components. The existing data confirm the previously reported promising midterm results. Therefore, the clinical use of uncemented femoral stems should be considered a reliable treatment option for all patients with adequate bone quality. PMID: 19727667 [PubMed - as supplied by publisher] (Source: Der Orthopade)
Source: Der Orthopade - September 1, 2009 Category: Orthopaedics Authors: Merle C, Clarius M, Aldinger PR Tags: Orthopade Source Type: journals

[Five-year survival rate of the Allofit titanium press-fit cup.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
CONCLUSION: We confirm the excellent survival rates of the Allofit cup as reported by the development centres, supporting the ongoing use of the cup at our institution. PMID: 19727668 [PubMed - as supplied by publisher] (Source: Der Orthopade)
Source: Der Orthopade - August 29, 2009 Category: Orthopaedics Authors: Schroeder K, Moehlenbruch A, Zimmermann-Stenzel M, Parsch D Tags: Orthopade Source Type: journals

[Cost analysis for navigation in knee endoprosthetics.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
CONCLUSIONS: Computer-assisted TKA is associated with additional costs. From an economical point of view an amount of more than 50 procedures per year appears to be favourable. The cost-effectiveness could be estimated if long-term results will show a reduction of revisions or a better clinical outcome. PMID: 19690831 [PubMed - as supplied by publisher] (Source: Der Orthopade)
Source: Der Orthopade - August 19, 2009 Category: Orthopaedics Authors: Cerha O, Kirschner S, Günther KP, Lützner J Tags: Orthopade Source Type: journals

[Histopathological diagnosis of periprosthetic joint infection following total hip arthroplasty : Use of a standardized classification system of the periprosthetic interface membrane.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
CONCLUSION: In the diagnosis of PJI, histopathological evaluation of the periprosthetic interface membrane proved very effective. To analyse the cause of prosthesis loosening, tissue samples of the periprosthetic interface membrane should be evaluated on the basis of the consensus classification in all revision surgeries. PMID: 19690832 [PubMed - as supplied by publisher] (Source: Der Orthopade)
Source: Der Orthopade - August 19, 2009 Category: Orthopaedics Authors: Müller M, Morawietz L, Hasart O, Strube P, Perka C, Tohtz S Tags: Orthopade Source Type: journals

[Modification of the Blackburne-Peel ratio for improved application in total knee arthroplasty.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
CONCLUSION: We can therefore recommend the modified BlackburnePeel ratio for measuring patella height in relation to the tibiofemoral joint line after total knee arthroplasty. PMID: 19685035 [PubMed - as supplied by publisher] (Source: Der Orthopade)
Source: Der Orthopade - August 14, 2009 Category: Orthopaedics Authors: Claßen T, Wegner A, von Knoch M Tags: Orthopade Source Type: journals

[Fractures of the upper ankle.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Upper ankle injuries are the most common reason for presentation in emergency departments. The initial treatment is often left in the hands of young clinical professionals. While the mechanism of injury might appear banal, insufficient diagnosis and treatment can lead to long periods of disability and functional impairment of the joint. Therefore, it is the aim of this work to provide a thorough understanding of the anatomy, biomechanics, mechanism of injury, diagnostic and operative procedures of ankle joint fractures. PMID: 19685036 [PubMed - as supplied by publisher] (Source: Der Orthopade)
Source: Der Orthopade - August 14, 2009 Category: Orthopaedics Authors: Frank M, Bauwens K, Ekkernkamp A Tags: Orthopade Source Type: journals

[Acetabular defect reconstruction in revision surgery of the hip : Autologous, homologous or metal?]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article reviews the various options for the reconstruction of acetabular bone defects taking into consideration the current findings in the scientific literature. PMID: 19672576 [PubMed - as supplied by publisher] (Source: Der Orthopade)
Source: Der Orthopade - August 12, 2009 Category: Orthopaedics Authors: Gravius S, Pagenstert G, Weber O, Kraska N, Röhrig H, Wirtz DC Tags: Orthopade Source Type: journals

[Hip implant revision : Avoiding mistakes and managing risk.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Hip revision surgery may lead to unexpected complications, with a negative impact on the treatment outcome. To refer to possible difficulties as"mistakes" is less helpful than defining ways to foresee such difficulties and developing possible strategies to avoid them. This approach requires a comprehensive amount of personal experience, which may follow consideration of some basic"rules" and possible surgical scenarios before an intervention. The author presents an individual risk management approach that includes hints on how to foresee the occurrence of certain intraoperative difficulties and how to help avoid errors...
Source: Der Orthopade - August 12, 2009 Category: Orthopaedics Authors: Volkmann R Tags: Orthopade Source Type: journals

[Regenerative medicine in orthopaedics : Cell therapy - tissue engineering - in situ regeneration.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Therapeutic approaches in regenerative medicine, irrespective of specific fields, comprise cell therapy, tissue engineering and in situ regeneration. Regenerative orthopaedics often leads the way on the path to clinical application. In cell therapy primary cells could be replaced by adult mesenchymal stem cells exhibiting almost unlimited regeneration capacity. More sophisticated biomaterial design allowing specific control of cell morphology and tissue organisation is the current focus of advancements in tissue engineering, while signalling to cells by intelligent biomaterials is a main focus of in situ regeneration. ...
Source: Der Orthopade - August 6, 2009 Category: Orthopaedics Authors: Richter W, Diederichs S Tags: Orthopade Source Type: journals

[Revision strategy for periprosthetic infection.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Periprosthetic infection remains a major complication in arthroplasty; increasing numbers of primary and revision arthroplasties are being followed by increasing numbers of periprosthetic infections. In cases of possible infection, the surgeon must have a treatment concept that can be individually adjusted. Diagnosis is a challenge and should include a variety of investigations. In early and secondary infections, component retention can be successful. Surgical debridement is the key to success. All late and chronic infections should be treated by explantation of all components because of infection with biofilm-producin...
Source: Der Orthopade - August 6, 2009 Category: Orthopaedics Authors: Lehner B, Witte D, Suda A, Weiss S Tags: Orthopade Source Type: journals

[Implant wear and aseptic loosening : An overview.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Wear of total joint implants is multifactorial in nature. Even for identical materials and geometries, the interaction of those parameters can generate different numbers of particles as well as different particle sizes and shapes. These different wear-particle characteristics will directly influence the biological response to an implant and thereby its clinical success. The long-term success of a total joint replacement requires an optimized compromise among implant material, design, surgical procedure, and biological performance. PMID: 19657620 [PubMed - as supplied by publisher] (Source: Der Orthopade)
Source: Der Orthopade - August 6, 2009 Category: Orthopaedics Authors: Kaddick C, Catelas I, Pennekamp PH, Wimmer MA Tags: Orthopade Source Type: journals