@article{ChaudryGrimmFriedbergeretal.2020,
  author    = {Chaudry, Oliver and Grimm, Alexandra and Friedberger, Andreas and Kemmler, Wolfgang and Uder, Michael and Jakob, Franz and Quick, Harald H. and von Stengel, Simon and Engelke, Klaus},
  title     = {Magnetic Resonance Imaging and Bioelectrical Impedance Analysis to Assess Visceral and Abdominal Adipose Tissue},
  series = {Obesity},
  volume    = {28},
  journal   = {Obesity},
  number    = {2},
  doi       = {10.1002/oby.22712},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-213591},
  pages     = {277 -- 283},
  year      = {2020},
  abstract  = {Objective This study aimed to compare a state-of-the-art bioelectrical impedance analysis (BIA) device with two-point Dixon magnetic resonance imaging (MRI) for the quantification of visceral adipose tissue (VAT) as a health-related risk factor. Methods A total of 63 male participants were measured using a 3-T MRI scanner and a segmental, multifrequency BIA device. MRI generated fat fraction (FF) maps, in which VAT volume, total abdominal adipose tissue volume, and FF of visceral and total abdominal compartments were quantified. BIA estimated body fat mass and VAT area. Results Coefficients of determination between abdominal (r\(^{2}\) = 0.75) and visceral compartments (r\(^{2}\) = 0.78) were similar for both groups, but slopes differed by a factor of two. The ratio of visceral to total abdominal FF was increased in older men compared with younger men. This difference was not detected with BIA. MRI and BIA measurements of the total abdominal volume correlated moderately (r\(^{2}\) = 0.31-0.56), and visceral measurements correlated poorly (r\(^{2}\) = 0.13-0.44). Conclusions Visceral BIA measurements agreed better with MRI measurements of the total abdomen than of the visceral compartment, indicating that BIA visceral fat area assessment cannot differentiate adipose tissue between visceral and abdominal compartments in young and older participants.},
  language  = {en}
}
@article{WagenbrennerHeinzHorasetal.2020,
  author    = {Wagenbrenner, Mike and Heinz, Tizian and Horas, Konstantin and Jakuscheit, Axel and Arnholdt, Joerg and Mayer-Wagner, Susanne and Rudert, Maximilian and Holzapfel, Boris M. and Weißenberger, Manuel},
  title     = {Impact of Tranexamic Acid on Chondrocytes and Osteogenically Differentiated Human Mesenchymal Stromal Cells (hMSCs) In Vitro},
  series = {Journal of Clinical Medicine},
  volume    = {9},
  journal   = {Journal of Clinical Medicine},
  number    = {12},
  issn      = {2077-0383},
  doi       = {10.3390/jcm9123880},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-219410},
  year      = {2020},
  abstract  = {The topical application of tranexamic acid (TXA) helps to prevent post-operative blood loss in total joint replacements. Despite these findings, the effects on articular and periarticular tissues remain unclear. Therefore, this in vitro study examined the effects of varying exposure times and concentrations of TXA on proliferation rates, gene expression and differentiation capacity of chondrocytes and human mesenchymal stromal cells (hMSCs), which underwent osteogenic differentiation. Chondrocytes and hMSCs were isolated and multiplied in monolayer cell cultures. Osteogenic differentiation of hMSCs was induced for 21 days using a differentiation medium containing specific growth factors. Cell proliferation was analyzed using ATP assays. Effects of TXA on cell morphology were examined via light microscopy and histological staining, while expression levels of tissue-specific genes were measured using semiquantitative RT-PCR. After treatment with 50 mg/mL of TXA, a decrease in cell proliferation rates was observed. Furthermore, treatment with concentrations of 20 mg/mL of TXA for at least 48 h led to a visible detachment of chondrocytes. TXA treatment with 50 mg/mL for at least 24 h led to a decrease in the expression of specific marker genes in chondrocytes and osteogenically differentiated hMSCs. No significant effects were observed for concentrations beyond 20 mg/mL of TXA combined with exposure times of less than 24 h. This might therefore represent a safe limit for topical application in vivo. Further research regarding in vivo conditions and effects on hMSC functionality are necessary to fully determine the effects of TXA on articular and periarticular tissues.},
  language  = {en}
}
@article{LiedtkeHofmannJakobetal.2020,
  author    = {Liedtke, Daniel and Hofmann, Christine and Jakob, Franz and Klopocki, Eva and Graser, Stephanie},
  title     = {Tissue-Nonspecific Alkaline Phosphatase—A Gatekeeper of Physiological Conditions in Health and a Modulator of Biological Environments in Disease},
  series = {Biomolecules},
  volume    = {10},
  journal   = {Biomolecules},
  number    = {12},
  publisher = {MDPI},
  issn      = {2218-273X},
  doi       = {10.3390/biom10121648},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-220096},
  year      = {2020},
  abstract  = {Tissue-nonspecific alkaline phosphatase (TNAP) is a ubiquitously expressed enzyme that is best known for its role during mineralization processes in bones and skeleton. The enzyme metabolizes phosphate compounds like inorganic pyrophosphate and pyridoxal-5′-phosphate to provide, among others, inorganic phosphate for the mineralization and transportable vitamin B6 molecules. Patients with inherited loss of function mutations in the ALPL gene and consequently altered TNAP activity are suffering from the rare metabolic disease hypophosphatasia (HPP). This systemic disease is mainly characterized by impaired bone and dental mineralization but may also be accompanied by neurological symptoms, like anxiety disorders, seizures, and depression. HPP characteristically affects all ages and shows a wide range of clinical symptoms and disease severity, which results in the classification into different clinical subtypes. This review describes the molecular function of TNAP during the mineralization of bones and teeth, further discusses the current knowledge on the enzyme's role in the nervous system and in sensory perception. An additional focus is set on the molecular role of TNAP in health and on functional observations reported in common laboratory vertebrate disease models, like rodents and zebrafish.},
  language  = {en}
}
@article{HerrmannDiederichsMelniketal.2021,
  author    = {Herrmann, Marietta and Diederichs, Solvig and Melnik, Svitlana and Riegger, Jana and Trivanović, Drenka and Li, Shushan and Jenei-Lanzl, Zsuzsa and Brenner, Rolf E. and Huber-Lang, Markus and Zaucke, Frank and Schildberg, Frank A. and Gr{\"a}ssel, Susanne},
  title     = {Extracellular Vesicles in Musculoskeletal Pathologies and Regeneration},
  series = {Frontiers in Bioengineering and Biotechnology},
  volume    = {8},
  journal   = {Frontiers in Bioengineering and Biotechnology},
  issn      = {2296-4185},
  doi       = {10.3389/fbioe.2020.624096},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-222882},
  year      = {2021},
  abstract  = {The incidence of musculoskeletal diseases is steadily increasing with aging of the population. In the past years, extracellular vesicles (EVs) have gained attention in musculoskeletal research. EVs have been associated with various musculoskeletal pathologies as well as suggested as treatment option. EVs play a pivotal role in communication between cells and their environment. Thereby, the EV cargo is highly dependent on their cellular origin. In this review, we summarize putative mechanisms by which EVs can contribute to musculoskeletal tissue homeostasis, regeneration and disease, in particular matrix remodeling and mineralization, pro-angiogenic effects and immunomodulatory activities. Mesenchymal stromal cells (MSCs) present the most frequently used cell source for EV generation for musculoskeletal applications, and herein we discuss how the MSC phenotype can influence the cargo and thus the regenerative potential of EVs. Induced pluripotent stem cell-derived mesenchymal progenitor cells (iMPs) may overcome current limitations of MSCs, and iMP-derived EVs are discussed as an alternative strategy. In the last part of the article, we focus on therapeutic applications of EVs and discuss both practical considerations for EV production and the current state of EV-based therapies.},
  language  = {en}
}
@article{GenestRakPetryketal.2020,
  author    = {Genest, Franca and Rak, Dominik and Petryk, Anna and Seefried, Lothar},
  title     = {Physical Function and Health-Related Quality of Life in Adults Treated With Asfotase Alfa for Pediatric-Onset Hypophosphatasia},
  series = {JBMR Plus},
  volume    = {4},
  journal   = {JBMR Plus},
  number    = {9},
  doi       = {10.1002/jbm4.10395},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-218410},
  year      = {2020},
  abstract  = {Hypophosphatasia (HPP) is a rare, inherited, metabolic disease characterized by tissue-nonspecific alkaline phosphatase deficiency resulting in musculoskeletal and systemic clinical manifestations. This observational study evaluated the effectiveness of enzyme replacement therapy with asfotase alfa on physical function and health-related quality of life (HRQoL) among adults with pediatric-onset HPP who received asfotase alfa for 12 months at a single center (ClinicalTrial.gov no.: NCT03418389). Primary outcomes evaluated physical function with the 6-minute walk test (6MWT), timed up-and-go (TUG) test, Short Physical Performance Battery (SPPB), and handheld dynamometry (HHD). Secondary outcome measures included the Lower Extremity Functional Scale (LEFS), pain prevalence/intensity, and pain medication use; HRQoL was evaluated using the 36-Item Short-Form Health Survey version 2 (SF-36v2). Safety data were collected throughout the study. All 14 patients (11 women) had compound heterozygous ALPL gene mutations and ≥1 HPP bone manifestation, including history of ≥1 fracture. Mean (min, max) age was 51 (19 to 78) years. From baseline to 12 months of treatment, median 6MWT distance increased from 267 m to 320 m (n = 13; p = 0.023); median TUG test time improved from 14.4 s to 11.3 s (n = 9; p = 0.008). Specific components of the SPPB also improved significantly: median 4-m gait speed increased from 0.8 m/s to 1.1 m/s (n = 10; p = 0.007) and median repeated chair-rise time improved from 22 s to 13 s (n = 9; p = 0.008). LEFS score improved from 24 points to 53 points (n = 10; p = 0.002). Improvements in HHD were not clinically significant. SF-36v2 Physical Component Score (PCS) improved after 12 months of treatment (n = 9; p = 0.010). Pain level did not change significantly from baseline to 12 months of treatment. There were significant improvements on chair-rise time and SF-36v2 PCS by 3 months, and on TUG test time after 6 months. No new safety signals were identified. These results show the real-world effectiveness of asfotase alfa in improving physical functioning and HRQoL in adults with pediatric-onset HPP. © 2020 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.},
  language  = {en}
}
@phdthesis{Huber2021,
  author    = {Huber, Simon},
  title     = {Klinisch-radiologische Evaluation des Merete® BioBall™-Adapter-Systems in der H{\"u}ftendoprothetik},
  doi       = {10.25972/OPUS-22864},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-228643},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2021},
  abstract  = {Die Revisionsendoprothetik des H{\"u}ftgelenkes ist eine große Herausforderung, insbesondere bei Teilwechseln von Komponenten bei fest-implantiertem Schaft. In einer retrospektiven Analyse wurde eine Implantat-Komponente des Medizinprodukteherstellers Merete Medical (Berlin) untersucht. Ziel der Untersuchung war es, eine Aussage {\"u}ber die Stabilit{\"a}t des Implantats und den klinischen Versorgungserfolg bei dessen Verwendung treffen zu k{\"o}nnen. Es wurden Daten von insgesamt 72 Patienten erhoben. Es erfolgte eine klinische und radiologische Nachuntersuchung. Die Daten wurden einer deskriptiven und explorativen Analyse unterzogen, eine {\"U}berlebenszeitanalyse wurde durchgef{\"u}hrt. Das Implantat zeigte mechanische Stabilit{\"a}t in einem mittelfristigen Zeitraum. Der Versorgungserfolg (gemessen am Harris Hip Score) war durchschnittlich bis gut. Es zeigten sich Zusammenh{\"a}nge zwischen dem pr{\"a}operativen Zustand der Patienten und dem Versorgungerfolg.},
  subject      = {Endoprothetik},
  language  = {de}
}
@article{ProdingerLazicHorasetal.2020,
  author    = {Prodinger, Peter Michael and Lazic, Igor and Horas, Konstantin and Burgkart, Rainer and von Eisenhart-Rothe, R{\"u}diger and Weissenberger, Manuel and Rudert, Maximilian and Holzapfel, Boris Michael},
  title     = {Revision Arthroplasty Through the Direct Anterior Approach Using an Asymmetric Acetabular Component},
  series = {Journal of Clinical Medicine},
  volume    = {9},
  journal   = {Journal of Clinical Medicine},
  number    = {9},
  issn      = {2077-0383},
  doi       = {10.3390/jcm9093031},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-213184},
  year      = {2020},
  abstract  = {Despite increasing numbers of primary hip arthroplasties performed through the direct anterior approach (DAA), there is a lack of literature on DAA revision arthroplasty. The present study was performed in order to evaluate outcomes and revision rates after revision through the DAA using an asymmetric acetabular component with optional intra- and extramedullary fixation. In a retrospective cohort study, we analyzed prospectively collected data of 57 patients (61 hips, 43 female, 18 male) who underwent aseptic acetabular component revision through the DAA with the abovementioned implant system between January 2015 and December 2017. The mean follow-up was 40 months (12-56). Survival rates were estimated using the Kaplan-Meier method. All complications were documented and functional outcomes were assessed pre- and postoperatively. Kaplan-Meier analysis revealed an estimated five-year implant survival of 97\% (confidence interval CI 87-99\%). The estimated five-year survival with revision for any cause was 93\% (CI 83-98\%). The overall revision rate was 6.6\% (n = 4). Two patients had to undergo revision due to periprosthetic infection (3.3\%). In one patient, the acetabular component was revised due to aseptic loosening four months postoperatively. Another patient suffered from postoperative iliopsoas impingement and was treated successfully by arthroscopic iliopsoas tenotomy. Two (3.3\%) of the revised hips dislocated postoperatively. The mean Harris Hip Score improved from 35 (2-66) preoperatively to 86 (38-100) postoperatively (p < 0.001). The hip joint's anatomical center of rotation was restored at a high degree of accuracy. Our findings demonstrate that acetabular revision arthroplasty through the DAA using an asymmetric acetabular component with optional intra- and extramedullary fixation is safe and practicable, resulting in good radiographic and clinical midterm results.},
  language  = {en}
}
@phdthesis{Schillinger2021,
  author    = {Schillinger, Judith Hanna},
  title     = {Schmerzen und ihre Therapie in der H{\"u}ftendoprothetik. Eine retrospektive Studie zum Vergleich des minimal-invasiven direkt anterioren mit dem transglutealen Zugang nach Bauer},
  doi       = {10.25972/OPUS-22574},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-225745},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2021},
  abstract  = {Hintergrund: Die Entwicklung minimal-invasiver gewebeschonender Zugangswege in der H{\"u}ftendoprothetik ist im Allgemeinen mit einer schnelleren Rehabilitation, einer Verringerung der postoperativen Schmerzen und einem erh{\"o}hten Patientenkomfort verbunden. Das Ziel dieser Studie war es, einen anterioren minimal-invasiven mit einem transglutealen lateralen Zugangsweg f{\"u}r H{\"u}ftgelenksersatzoperationen in Bezug auf postoperatives Schmerzniveau, den Schmerzmittelgebrauch, die L{\"a}nge des Krankenhausaufenthalts und die Zeit bis zum Erreichen eines definierten physiotherapeutischen Therapiezieles zu vergleichen. Methoden: In dieser retrospektiven Kohortenstudie untersuchten wir 200 Patienten, die sich einer H{\"u}ftendoprothesenimplantation unterzogen. Gruppe I (n = 100) erhielt einen minimal-invasiven anterioren H{\"u}ftzugang (modifiziert nach Smith-Peterson), Gruppe II (n = 100) erhielt einen lateralen transglutealen Zugang (nach Bauer). Die Untersuchungsziele waren der Schmerz in Ruhe und w{\"a}hrend der Physiotherapie, der Schmerzmittelgebrauch, die L{\"a}nge des station{\"a}ren Aufenthaltes sowie die Zeitdauer bis zum Erreichen des physiotherapeutischen Therapiezieles. Ergebnisse: Die Patienten der Gruppe I konsumierten weniger Schmerzmedikamente (19,6 ± 6,9 mg Piritramid gegen{\"u}ber 23,6 ± 11,3 mg; p = 0,005) und hatten in der fr{\"u}hen postoperativen Phase weniger Schmerzen (Operationstag: VAS 1,3 ± 1 gegen{\"u}ber 2,3 ± 1,3, p = 0,0001, erster postoperativer Tag: VAS 0,41 ± 0,8 vs. 0,66 ± 1,1, p = 0,036). Die Zeit bis zum Erreichen des definierten Therapiezieles (6,4 ± 2 Tage gegen{\"u}ber 7,4 ± 2,1 Tagen; p = 0,001) und die Dauer des Krankenhausaufenthalts waren k{\"u}rzer (10,2 ± 1,9 Tage gegen{\"u}ber 13,4 ± 1,6 Tagen; p = 0,0001) f{\"u}r Gruppe I. Die Schmerzen w{\"a}hrend der Physiotherapie waren jedoch am dritten und sechsten bis neunten Tag nach der Operation im Vergleich zu Gruppe II h{\"o}her (p = 0,001-0,013). Schlussfolgerung: Die Implantation einer H{\"u}ftprothese {\"u}ber einen minimal-invasiven anterioren Zugang f{\"u}hrt in der direkt postoperativen Phase zu einer Reduktion des Schmerzniveaus und des Schmerzmittelgebrauchs. Zus{\"a}tzlich werden das Erreichen des physiotherapeutischen Therapiezieles und die L{\"a}nge des station{\"a}ren Aufenthaltes positiv beeinflusst. Den h{\"o}heren Schmerzen w{\"a}hrend der Physiotherapie k{\"o}nnte durch eine Reduktion der erlaubten Gewichtsbelastung in der fr{\"u}hen postoperativen Phase entgegengewirkt werden.},
  language  = {de}
}
@phdthesis{Kramer2021,
  author    = {Kramer, Lisa Sophie},
  title     = {Charakterisierung des Einflusses von Estrogenrezeptoren auf mechanoresponsive Reporter},
  doi       = {10.25972/OPUS-22270},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-222709},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2021},
  abstract  = {Osteoporose wird definiert als erworbene, generalisierte Skeletterkrankung, die durch eine verminderte Knochenfestigkeit und einen pathologischen Knochenverlust charakterisiert wird. Durch die St{\"o}rung der Mikroarchitektur kommt es zu strukturellen und funktionellen Defiziten im Sinne von Fragilit{\"a}tsfrakturen. Mechanische Stimulation erh{\"a}lt die Gewebemasse und stimuliert deren kontinuierliche Anpassung. {\"O}strogene spielen bei der Entwicklung, dem Wachstum und der Regeneration des Knochens eine bedeutende Rolle und wirken {\"u}ber Bindung an die {\"O}strogenrezeptoren ER und ER in bestimmten Zielgeweben. {\"O}strogenrezeptoren sind unver{\"a}ndert sehr geeignete Targets f{\"u}r die Entwicklung von Medikamenten im Rahmen der Osteoporosetherapie wie z.B. die selektiven {\"O}strogen-Rezeptor-Modulatoren (SERMs). Die molekulare Kl{\"a}rung der Einfl{\"u}sse von ER und ER ist unver{\"a}ndert von großer klinischer Bedeutung. Die Herstellung stabiler Zelllinien mit {\"U}berexpression von Reportergenkonstrukten und Rezeptoren kann dabei hilfreich sein. In dieser Arbeit wurde eine stabile Zelllinie mit {\"U}berexpression von ERβ etabliert, die unterschiedliche Wirkung von ER und ER wurden analysiert und die Effekte von zyklischer Dehnung auf Reportergenexpression unter der Kontrolle von mechanosensitiven responsiven Elementen wurden charakterisiert.},
  subject      = {{\"O}strogene},
  language  = {de}
}
@phdthesis{Streck2021,
  author    = {Streck, Laura Elisa},
  title     = {Zweizeitige Implantation reverser Schulterendoprothesen bei Infektionen des Glenohumeralgelenks - Diagnostik und Ergebnisse -},
  doi       = {10.25972/OPUS-22262},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-222626},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2021},
  abstract  = {Infektionen des Schultergelenks gehen mit hoher Mortalit{\"a}t und Morbidit{\"a}t einher. Ihre Diagnostik und Therapie stellen h{\"a}ufig eine Herausforderung dar. Zudem ist - im Gegensatz zu Infektionen von H{\"u}fte und Knie - die schulterspezifische Datenlage sp{\"a}rlich, es mangelt an evidenzbasierten Diagnose- und Therapiealgorithmen. Diese Arbeit evaluiert unter anderem 1) den Erfolg der mehrzeitigen Implantation reverser Schulterendoprothesen zur Therapie von Infektionen des Glenohumeralelenks, 2) das schulterspezifische Keimspektrum, 3) den Stellenwert einer pr{\"a}operativen Gelenkpunktion und 3) den Stellenwert einer Gelenkspunktion bei einliegendem Spacer. Es handelt sich um eine retrospektive Studie mit prospektiver Datenerfassung an insgesamt 41 Patienten, welche zwischen 2007-2015 in der Orthop{\"a}dischen Klinik K{\"o}nig-Ludwig-Haus (W{\"u}rzburg) die mehrzeitige Implantation einer Schulterendoprothese mit zwischenzeitlicher Implantation eines PMMA-Spacers auf Grund einer Infektion des Glenohumeralgelenks erhalten haben. Die vorliegende Arbeit konnte zeigen, dass Infektionen des Glenohumeralgelenks geh{\"a}uft multimorbide, voroperierte Patienten betreffen. Die Haupterreger waren Cutibakterien und koagulasenegative Staphylokokken, insbesondere S. epidermidis. Diese Erreger sollten bei einer kalkulierten Antibiotikatherapie immer ber{\"u}cksichtigt werden. Mikrobiologische Kulturen der pr{\"a}operative Gelenkpunktion zeigten eine m{\"a}ßige Sensitivit{\"a}t (58\%) bei guter Spezifit{\"a}t (89\%). Die Punktion kann somit keinen sicheren Infektionsausschluss bieten, erm{\"o}glicht im Falle eines Keimnachweises jedoch die gezielte antibiotische Therapie sowie die Anpassung der Antibiotika im Spacer und hat somit einen berechtigten Stellenwert in der Infektionsdiagnostik. Die Punktion bei einliegendem Spacer zeigte eine Sensitivit{\"a}t von 0\%, ihre routinem{\"a}ßige Durchf{\"u}hrung sollte daher sehr kritisch hinterfragt werden. F{\"u}r die Therapie mit mehrzeitiger Implantation einer reversen Schulterendoprothese zeigte sich eine Infektionseradikationsrate von 87\% und ein kumulatives infektionsfreies {\"U}berleben von 91\% nach 128 Monaten. Die Funktionalit{\"a}t der Schulter blieb hinter der Funktion der Gegenseite zur{\"u}ck, war jedoch ausreichend um die eigenst{\"a}ndige Versorgung und die Durchf{\"u}hrung von Alltagsaktivit{\"a}ten zu erm{\"o}glichen. Die große Mehrzahl der Patienten hatte keine/minimale Schmerzen.},
  subject      = {Endoprothese},
  language  = {de}
}
@phdthesis{Roth2021,
  author    = {Roth, Magnus Ulrich Maria},
  title     = {Die persistierende periprothetische Kniegelenkinfektion - Nutzen der Synovia-Analyse bei einliegendem Zement-Spacer},
  doi       = {10.25972/OPUS-22027},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-220276},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2021},
  abstract  = {Der zweizeitige Endoprothesenwechsel gilt als Goldstandard der Therapie periprothetischer Gelenkinfektionen. Ein sicherer Ausschluss einer Infektpersistenz ist f{\"u}r den Therapieerfolg essentiel. Es wurde der diagnostische Nutzen synovialer Marker zum Ausschluss einer Infektpersistenz bei einliegendem Kniegelenksspacer untersucht. Weder mikrobiologische noch zytologische Synovia-Analysen sind zum Ausschluss einer Infektpersistenz im Rahmen des zweizeitigen Knieendoprothesenwechsels geeignet.},
  subject      = {Knie},
  language  = {de}
}
@phdthesis{Swalve2020,
  author    = {Swalve, Enno},
  title     = {Wirksamkeit von niedrig dosierter Tranexams{\"a}ure bei Implantation von Knie - Endo - Prothesen},
  doi       = {10.25972/OPUS-21744},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-217446},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2020},
  abstract  = {Eine retrospektive Studie anhand von Patientenunterlagen zum Blutverlust, Transfusionsh{\"a}ufigkeit und postoperativen Komplikationen bei Knie-Endo-Prothesen mit systemischer Gabe von 500 mg Tranexams{\"a}ure kurz vor Er{\"o}ffnung der Blutleere! 229 Patienten in der Studiengruppe, von denen 9 eine erlaubte Wiederholungsdosis erhalten hatten, wurden verglichen mit 231 Patienten, die keine Tranexams{\"a}ure erhalten hatten. 3 Patienten der Studiengruppe gegen{\"u}ber 14 Patienten der Kontrollgruppe ben{\"o}tigten eine Bluttransfusion. In der Studiengruppe war der niedrigste postoperative Hb bei 71,2\% der Patienten 10 g/dl oder h{\"o}her. In der Kontrollgruppe war es nur bei 49,4\% der Patienten der Fall. Durch die Gabe von Tranexams{\"a}ure konnte der durchschnittliche, berechnete Blutverlust bei M{\"a}nnern von etwa 1850 ml auf 1450 ml und bei Frauen von etwa 1300 ml auf etwa 1000 ml gesenkt werden. Die Unterschiede waren signifikant! Im beobachteten Kollektiv konnte keine Steigerung der Rate an Thrombosen oder thrombembolischen Ereignissen festgestellt werden. Das Antifibrinolytikum Tranexams{\"a}ure ist in dieser niedrigen Dosierung effektiv und scheint sicher zu sein.},
  subject      = {Knieprothese},
  language  = {de}
}
@phdthesis{Mausolf2020,
  author    = {Mausolf, Nils Henrik},
  title     = {Klinische und radiologische Ergebnisse nach H{\"u}ftprothesenwechsel durch Implantation eines kranial aufgesockelten Revisionspfannensystems},
  doi       = {10.25972/OPUS-21721},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-217218},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2020},
  abstract  = {Background and issue: During the last years there was an increase of acetabular cup revisions. Furthermore the quality of life in elderly patients gains importance. Particularly challenging for orthopaedic surgeons is the treatment of extended acetabular defects. This study examines the clinical and radiological outcome of acetabular cup revisions by using a cranial raised press-fit cup. Additionally potential influencing factors were surveyed. Methods: In a retrospective monocentric study 155 patients, who underwent an acetabular cup revision by implanting an oval press-fit cup between 2009 and 2016 were reviewed and scored. An ethical clearance certificate of the University of Wuerzburg was given. Results: The mean follow-up was 53 months. 9 AAOS I defects, 25 AAOS II defects, 100 AAOS III defects and 21 AAOS IV defects were examined. The cumulative cup survival rate by using the Kaplan-Meier-Method was 93,4\% (CI 89,1-97,6\%). The survival rate without any revision was 84,0\% (CI 77,9-90,1\%). A significant reduction of pain on a numeric analogue scale could be proven (5,9 preoperative vs. 1,1 postoperative). The Harris-Hip Score increased significantly from 56,4 preoperative to 73,2 postoperative. In addition an improvement of all dimensions of the Euroqol could be confirmed. The overall state of health was measured by using the SF-12. As a result there was a slightly lower physical health and a slightly higher mental health compared to the reference population. Significant factors of influence on the outcome were detected: Male gender is associated with a higher functional outcome (HHS 87,7 vs. 74,2). Moreover, men numbered their level of pain lower than women did (NAS 0,65 vs. 1,5). Furthermore an association between more extended types of acetabular defects and a lower functional outcome could be confirmed. Additionally the factor age was found to create a significant influence on the functional outcome of the surgery. Patients below the age of 70 years upon the time of surgery reached higher results in Harris-Hip Score than older patients (82,2 vs. 77,3). Septic loosening was associated with a lower functional outcome than aseptic loosening (HHS 74,6 vs. 81,9). Conclusion: By analysing the survival rate, the improvement of function and the reduction of pain, good short- to midterm results were calculated for the surveyed implant system. Factors with a significant influence on the functional outcome were found to be: Gender, underlying type of defect, age upon surgery, septic or aseptic loosening.},
  subject      = {H{\"u}ftprothese},
  language  = {de}
}
@phdthesis{Hacker2020,
  author    = {Hacker, Dorothee},
  title     = {Prospektiv randomisierte Untersuchungen zum klinischen Outcome nach Knierevisionen mit den Endoprothesen „EnduRo" im Vergleich zur Prothese „Endo-Modell"},
  doi       = {10.25972/OPUS-21565},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-215658},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2020},
  abstract  = {Aufgrund des demographischen Wandels mit einer zunehmend {\"a}lter werdenden Bev{\"o}lkerung ist die Zahl der Knieprothesen und vor allem auch der Revisionsoperationen in den letzten Jahren deutlich gestiegen. Mit ebenfalls zunehmendem medizinischem Anspruch wurden die bestehenden Prothesenmodelle stetig weiter entwickelt. Ziel der vorliegenden Studie war es, in einer prospektiv angelegten einfach verblindeten Studie zwei verschiedene Rotating-Hinge-Revisionsprothesen unterschiedlicher Hersteller miteinander zu vergleichen und sie auf ihr klinisches Outcome zu {\"u}berpr{\"u}fen. Von Juni 2012 bis Mai 2013 wurden insgesamt 25 Patienten in die Studie aufgenommen und dann bis zu 12 Monate nach erfolgter Revisionsoperation nachuntersucht. Die Zuteilung der Prothesenarten erfolgte randomisiert, sodass 13 Patienten die Prothese „EnduRo" und 12 Patienten die Prothese „Endo-Modell" erhielten. Als Vergleichswerte wurden klinische Scores herangezogen. In der Untersuchung zeigten beiden Vergleichsgruppen insgesamt eine deutliche Schmerzreduktion sowie eine Funktionsverbesserungen in allen erhobenen Scores. Zwar erreichten die Patienten der Gruppe „Endo-Modell" etwas h{\"o}here Punktwerte, jedoch waren die Unterschiede im Vergleich zur Patientengruppe „EnduRo" im durchgef{\"u}hrten Zweistichproben-T-Test nicht statistisch signifikant.},
  subject      = {Kniegelenk},
  language  = {de}
}
@phdthesis{Braun2020,
  author    = {Braun, Clemens Michael},
  title     = {Regenerative Kapazit{\"a}t Mesenchymaler Stammzellen bei aseptischer Prothesenlockerung},
  doi       = {10.25972/OPUS-21392},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-213926},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2020},
  abstract  = {Trotz st{\"a}ndiger Weiterentwicklung der modernen Endoprothetik weist ein k{\"u}nstliches Gelenk auch heute eine begrenzte Haltbarkeit auf. Insbesondere bei der Versorgung j{\"u}ngerer Patienten mit gestiegener Lebenserwartung wird h{\"a}ufig die Prothesenstandzeit aufgebraucht und ein komplizierter Revisionseingriff notwendig. Hierbei ist die aseptische Prothesenlockerung der h{\"a}ufigste Grund f{\"u}r den Austausch eines Implantates. Das Knochenmark des betreffenden Knochens enth{\"a}lt humane Mesenchymale Stammzellen (hMSC), die zur Aufrechterhaltung und Regeneration des Bindegewebes und des Knochens selbst beitragen. Ob diese Zellen z.B. durch ein Proliferations- oder Differenzierungsdefizit eine Rolle in der {\"A}tiologie einer aseptischen Prothesenlockerung spielen, ist bisher nicht abschließend gekl{\"a}rt. In der vorliegenden Arbeit wurde die regenerative Kapazit{\"a}t von hMSC von zwei Spendergruppen untersucht und verglichen: Als Wechselgruppe dienten Patienten, bei denen es zu einer aseptischen Prothesenlockerung und der Notwendigkeit eines Revisionseingriffes (Wechseloperation) gekommen war. Patienten, denen prim{\"a}r eine H{\"u}ft- oder Kniegelenksendoprothese eingesetzt wurde, bildeten die Kontrollgruppe. Zur Beurteilung der regenerativen Eigenschaften der hMSC wurde zum einen das Wachstums- und Alterungsverhalten in Zellkultur zum anderen die in vitro Differenzierungskapazit{\"a}t untersucht.},
  subject      = {Aseptische Lockerung},
  language  = {de}
}
@phdthesis{Doerries2020,
  author    = {D{\"o}rries, Susanne},
  title     = {Analyse der Gr{\"u}nde f{\"u}r Revisionsoperationen bei einliegender Knieprothese},
  doi       = {10.25972/OPUS-21403},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-214034},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2020},
  abstract  = {Die Knieendoprothetik verzeichnet in den letzten Jahren steigende Zahlen, was wiederum steigende Zahlen an Revisionen zur Folge hat. Diese Studie hat die Gr{\"u}nde f{\"u}r Revisionen ermittelt. Hierzu wurden 1245 Operationen gesammelt und ausgewertet. Instabilit{\"a}t, Infektion und aseptische Lockerungen stellen die Hauptgr{\"u}nde f{\"u}r eine Revisionsoperation dar. Es wurden zus{\"a}tzlich verschiedene Zeitr{\"a}ume zwischen Prim{\"a}rimplantation und Revision unterteilt und die jeweiligen Gr{\"u}nde ermittelt.},
  subject      = {Reoperation},
  language  = {de}
}
@phdthesis{Veith2020,
  author    = {Veith, Marina},
  title     = {Langzeitergebnisse nach Versorgung proximaler Humerusfrakturen mittels intramedull{\"a}rer Drahtosteosynthese nach Kapandji},
  doi       = {10.25972/OPUS-20990},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-209906},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2020},
  abstract  = {In vorliegender Dissertation wurden die Langzeitergebnisse hinsichtlich der Lebensqualit{\"a}t der Patienten, die sich im Zeitraum 2002-2010 eine proximale Humerusfraktur zuzogen und mittels intramedull{\"a}rer Drahtosteosynthese nach Kapandji im K{\"o}nig Ludwig Haus in W{\"u}rzburg operiert wurden, untersucht. Die Nachuntersuchung erfolgte mittels klinischer, radiologischer und sonografischer Untersuchung sowie durch Verwendung des DASH-Fragebogens, Constant Murley Score und der Visuellen Analogskala.},
  subject      = {proximale Humerusfraktur},
  language  = {de}
}
@phdthesis{Gloeckner2020,
  author    = {Gl{\"o}ckner, Frederik Paul Vincent},
  title     = {Signalwege und Biomarker f{\"u}r die Adaptation mesenchymaler Gewebe an physikalische Kr{\"a}fte},
  doi       = {10.25972/OPUS-20891},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-208918},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2020},
  abstract  = {Der menschliche K{\"o}rper besitzt Anpassungsmechanismen, die es ihm erm{\"o}glichen, sich an verschiedene Belastungssituationen anzupassen. Es gab in letzter Zeit mehrere Hinweise darauf, dass diese Mechanismen durch die Aussch{\"u}ttung von Zytokinen, bzw. Myokinen durch die betroffenen Zellen selbst ausgel{\"o}st werden. In dieser Arbeit wurden die Serumkonzentration von Myostatin, Follistatin, Follistatin-like-3, Interleukin 6, Interleukin 8 und Klotho vor und nach einer kurzen k{\"o}rperlichen Belastung bestimmt. Dabei konnte allerdings keine signifikante {\"A}nderung der Konzentrationen nachgewiesen werden, was die Frage aufwirft, ob mesenchymales Gewebe, insbesondere Muskelgewebe, {\"u}berhaupt {\"u}ber einen klassischen endokrinen Sekretionsmechanismus verf{\"u}gt.},
  subject      = {Fahrradergometer},
  language  = {de}
}
@phdthesis{Koschitzki2020,
  author    = {Koschitzki, Kim Christine Cornelia},
  title     = {Evaluation of preclinical animal models in bone tissue engineering and their success in clinical translation},
  doi       = {10.25972/OPUS-20759},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-207593},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2020},
  abstract  = {Autologous bone still represents today's gold standard for the treatment of critical size bone defects and fracture non-unions despite associated disadvantages regarding limitations in availability, donor site morbidity, costs and efficacy. Bone tissue engineered constructs would present a promising alternative to currently available treatments. However, research on preclinical animal studies still fails to provide clinical applicable results able to allow the replacement of currently applied methods. It seems that the idea of bone tissue engineering, which has now been integral part of academic studies for over 30 years, got somehow stuck at an intermediate level, in between intense preclinical research and striven stages of initial clinical trial phases. A clear discrepancy exists between the number of studies with preclinical animal models for bone tissue engineering and the number of clinically approved bone tissue engineered constructs available to patients. The aim of this thesis was hence to evaluate preclinical animal models for bone tissue engineering as well as the perception of scientists and clinicians towards these models. Moreover, the general role of bone tissue engineering and its clinical need assessed by scientists and surgeons was investigated. A survey was conducted questioning both scientific and clinical opinions on currently available study designs and researchers' satisfaction with preclinical animal models. Additionally, a literature research was conducted, resulting in 167 papers from the last 10 years that report current designs of preclinical orthotopic animal studies in bone tissue engineering. Thereby, the focus lied on the description of the models regarding animal species, strain, age, gender and defect design. The outcome of the literature search was evaluated and compared to the outcome obtained from the survey. The survey data revealed that both scientists and surgeons generally remain positive about the future role of bone tissue engineering and its step to clinical translation, at least in the distant future, where it then might replace the current gold standard, autologous bone. Moreover, most of the participants considered preclinical animal models as relevant and well developed but the results as not yet realizable in the clinics. Surgeons thereby demonstrated a slightly more optimistic perception of currently conducted research with animal models compared to scientists. However, a rather inconsistent description of present preclinical study designs could be discerned when evaluating the reported study designs in the survey and the papers of the literature search. Indeed, defining an appropriate animal species, strain, age, gender, observation time, observation method and surgical design often depends on different indications and research questions and represents a highly challenging task for the establishment of a preclinical animal model. The existing lack of valid guidelines for preclinical testing of bone tissue engineering leads hence to a lack of well standardized preclinical animal models. Moreover, still existing knowledge gaps regarding aspects that affect the process of fracture healing, such as vascularization or immunological aspects, were found to hinder clinical translation of bone tissue engineered constructs. Using literature review and survey, this thesis points out critical issues that need to be addressed to allow clinical translation of bone tissue engineered constructs. It can be concluded that currently existing study designs with preclinical animal models cannot live up to the claim of providing suitable results for clinical implementation. The here presented comprehensive summary of currently used preclinical animal models for bone tissue engineering reveals a missing consensus on the usage of models such as an apparent lack of reporting and standardization regarding the study designs described in both papers from the literature review and the survey. It thereby indicates a crucial need to improve preclinical animal models in order to allow clinical translation. Despite the fact that participants of the survey generally revealed a positive perception towards the use of bone tissue engineered constructs and affirmed the clinical need for such novel designs, the missing standardization constitutes a main weak point for the provision of reliable study outcome and the translational success of the models. The optimization of reproducibility and reliability, as well as the further understanding of ongoing mechanisms in bone healing in order to develop effective tissue engineered constructs, need to form the basis of all study designs. The study outcomes might then fulfill the requirements of maybe today's and hopefully tomorrow's aging population.},
  language  = {en}
}
@article{DotterweichSchlegelmilchKelleretal.2016,
  author    = {Dotterweich, Julia and Schlegelmilch, Katrin and Keller, Alexander and Geyer, Beate and Schneider, Doris and Zeck, Sabine and Tower, Robert J. J. and Ebert, Regina and Jakob, Franz and Sch{\"u}tze, Norbert},
  title     = {Contact of myeloma cells induces a characteristic transcriptome signature in skeletal precursor cells-implications for myeloma bone disease},
  series = {Bone},
  volume    = {93},
  journal   = {Bone},
  doi       = {10.1016/j.bone.2016.08.006},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-186688},
  pages     = {155-166},
  year      = {2016},
  abstract  = {Physical interaction of skeletal precursors with multiple myeloma cells has been shown to suppress their osteogenic potential while favoring their tumor-promoting features. Although several transcriptome analyses of myeloma patient-derived mesenchymal stem cells have displayed differences compared to their healthy counterparts, these analyses insufficiently reflect the signatures mediated by tumor cell contact, vary due to different methodologies, and lack results in lineage-committed precursors. To determine tumor cell contact-mediated changes on skeletal precursors, we performed transcriptome analyses of mesenchymal stem cells and osteogenic precursor cells cultured in contact with the myeloma cell line INA-6. Comparative analyses confirmed dysregulation of genes which code for known disease-relevant factors and additionally revealed upregulation of genes that are associated with plasma cell homing, adhesion, osteoclastogenesis, and angiogenesis. Osteoclast-derived coupling factors, a dysregulated adipogenic potential, and an imbalance in favor of anti-anabolic factors may play a role in the hampered osteoblast differentiation potential of mesenchymal stem cells. Angiopoietin-Like 4 (ANGPTL4) was selected from a list of differentially expressed genes as a myeloma cell contact-dependent target in skeletal precursor cells which warranted further functional analyses. Adhesion assays with full-length ANGPTL4-coated plates revealed a potential role of this protein in INA6 cell attachment. This study expands knowledge of the myeloma cell contact-induced signature in the stromal compartment of myelomatous bones and thus offers potential targets that may allow detection and treatment of myeloma bone disease at an early stage.},
  language  = {en}
}