@article{BoelchGurokGilbertetal.2021, author = {Boelch, Sebastian P. and Gurok, Anna and Gilbert, Fabian and Weißenberger, Manuel and Rudert, Maximilian and Barthel, Thomas and Reppenhagen, Stephan}, title = {Why compromise the patella? Five-year follow-up results of medial patellofemoral ligament reconstruction with soft tissue patellar fixation}, series = {International Orthopaedics}, volume = {45}, journal = {International Orthopaedics}, issn = {0341-2695}, doi = {10.1007/s00264-020-04922-1}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-235751}, pages = {1493-1500}, year = {2021}, abstract = {Purpose This study investigates the redislocation rate and functional outcome at a minimum follow-up of five years after medial patellofemoral ligament (MPFL) reconstruction with soft tissue patellar fixation for patella instability. Methods Patients were retrospectively identified and knees were evaluated for trochlea dysplasia according to Dejour, for presence of patella alta and for presence of cartilage lesion at surgery. At a minimum follow-up of five years, information about an incident of redislocation was obtained. Kujala, Lysholm, and Tegner questionnaires as well as range of motion were used to measure functional outcome. Results Eighty-nine knees were included. Follow-up rate for redislocation was 79.8\% and for functional outcome 58.4\%. After a mean follow-up of 5.8 years, the redislocation rate was 5.6\%. There was significant improvement of the Kujala score (68.8 to 88.2, p = 0.000) and of the Lysholm score (71.3 to 88.4, p = 0.000). Range of motion at follow-up was 149.0° (115-165). 77.5\% of the knees had patella alta and 52.9\% trochlear dysplasia types B, C, or D. Patellar cartilage legions were present in 54.2\%. Redislocations occurred in knees with trochlear dysplasia type C in combination with patella alta. Conclusion MPFL reconstruction with soft tissue patellar fixation leads to significant improvement of knee function and low midterm redislocation rate. Patients with high-grade trochlear dysplasia should be considered for additional osseous correction.}, language = {en} } @article{BoelchRueecklStrecketal.2021, author = {Boelch, Sebastian Philipp and R{\"u}eckl, Kilian and Streck, Laura Elisa and Szewczykowski, Viktoria and Weißenberger, Manuel and Jakuscheit, Axel and Rudert, Maximilian}, title = {Diagnosis of chronic infection at total hip arthroplasty revision is a question of definition}, series = {Biomed Research International}, volume = {2021}, journal = {Biomed Research International}, doi = {10.1155/2021/8442435}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-265762}, year = {2021}, abstract = {Purpose. Contradicting definitions of periprosthetic joint infection (PJI) are in use. Joint aspiration is performed before total hip arthroplasty (THA) revision. This study investigated the influence of PJI definition on PJI prevalence at THA revision. Test quality of prerevision aspiration was evaluated for the different PJI definitions. Methods. 256 THA revisions were retrospectively classified to be infected or not infected. Classification was performed according to the 4 different definitions proposed by the Musculoskeletal Infection Society (MSIS), the Infectious Diseases Society of America (IDSA), the International Consensus Meeting (ICM), and the European Bone and Joint Infection Society (EBJIS). Only chronic PJIs were included. Results. PJI prevalence at revision significantly correlated with the applied PJI definition (p=0.01, Cramer's V=0.093). PJI prevalence was 20.7\% for the MSIS, 25.4\% for the ICM, 28.1\% for the IDSA, and 32.0\% for the EBJIS definition. For synovial fluid white blood cell count, the best ROC-AUC for predicting PJI was 0.953 in combination with the MSIS definition. Conclusion. PJI definition significantly influences the rate of diagnosed PJIs at THA revision. Synovial fluid white blood cell count is a reliable means to rule out PJI. In cases with a borderline high synovial white blood cell count before THA revision as the only sign of chronic PJI, an extended diagnostic work-up should be considered.}, language = {en} }