@article{WeiderSchlagenhaufSeefried2022, author = {Weider, Margareta and Schlagenhauf, Ulrich and Seefried, Lothar}, title = {Oral health status of adult hypophosphatasia patients: A cross-sectional study}, series = {Journal of Clinical Periodontology}, volume = {49}, journal = {Journal of Clinical Periodontology}, number = {12}, doi = {10.1111/jcpe.13718}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-293777}, pages = {1253 -- 1261}, year = {2022}, abstract = {Aim This study evaluated the oral health status of adult patients with hypophosphatasia (HPP). Materials and Methods Parameters of oral health assessment comprised decayed/missing/filled teeth (DMFT) index, probing pocket depth and clinical attachment level (CAL) as well as documentation of tooth loss and periodontal health status according to CCD/AAP criteria. Findings were compared with national reference data (DMS V survey) reporting oral health status in age-related controls. Within-group comparisons were made between the HPP patients harbouring one versus two alkaline phosphatase liver/bone/kidney type (ALPL) gene variants. Results Of 80 HPP patients (64 female) with a mean age of 46.4 years (range 24-78) and one (n = 55) or two (n = 18) variants (n = 7 lacking testing) within the ALPL gene, those with two variants displayed substantially higher tooth loss rate (14.0 ± 9.3) than those affected by only one ALPL variant (4.1 ± 5.4), who did not differ substantially from healthy DMS V controls. While DMFT score and severe periodontal diseases (PDs) of HPP patients with one variant only increased with progressing age, the two-variant sub-cohort age independently exhibited increased DMFT scores and a higher rate of severe PDs. Conclusions HPP patients affected by two variants of the ALPL gene exhibited a higher risk of periodontitis and tooth loss than the general population, while patients with one variant developed clinically relevant oral disease symptoms with progressing ageing.}, language = {en} } @article{ScorcellettiKaraZangeetal.2022, author = {Scorcelletti, Matteo and Kara, Serhan and Zange, Jochen and Jordan, Jens and Semler, Oliver and Sch{\"o}nau, Eckhard and Rittweger, J{\"o}rn and Ireland, Alex and Seefried, Lothar}, title = {Lower limb bone geometry in adult individuals with X-linked hypophosphatemia: an observational study}, series = {Osteoporosis International}, volume = {33}, journal = {Osteoporosis International}, number = {7}, doi = {10.1007/s00198-022-06385-z}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-324655}, pages = {1601-1611}, year = {2022}, abstract = {Summary We assessed lower-limb geometry in adults with X-linked hypophosphatemia (XLH) and controls. We found large differences in multiple measures including femoral and tibial torsion, bowing and cross-sectional area and acetabular version and coverage which may contribute to clinical problems such as osteoarthritis, fractures and altered gait common in XLH. Purpose Individuals with X-linked hypophosphatemia (XLH) are at risk of lower-limb deformities and early onset of osteoarthritis. These two factors may be linked, as altered biomechanics is a risk factor for osteoarthritis. This exploratory evaluation aims at providing clues and concepts for this association to facilitate future larger-scale and longitudinal studies on that aspect. Methods For this observational study, 13 patients with XLH, aged 18-65 years (6 female), were compared with sex-, age- and weight-matched healthy individuals at a single German research centre. Femoral and hip joint geometry, including femoral and tibial torsion and femoral and tibial shaft bowing, bone cross-sectional area (CSA) and acetabular version and coverage were measured from magnetic resonance imaging (MRI) scans. Results Total femoral torsion was 29° lower in individuals with XLH than in controls (p < 0.001), mainly resulting from lower intertrochanteric torsion (ITT) (p < 0.001). Femoral lateral and frontal bowing, tibial frontal bowing, mechanical axis, femoral mechanical-anatomical angle, acetabular version and acetabular coverage were all greater and tibial torsion lower in individuals with XLH as compared to controls (all p < 0.05). Greater femoral total and marrow cavity CSA, greater tibial marrow cavity CSA and lower cortical CSA were observed in XLH (all p < 0.05). Discussion We observed large differences in clinically relevant measures of tibia and particularly femur bone geometry in individuals with XLH compared to controls. These differences may plausibly contribute to clinical manifestations of XLH such as early-onset osteoarthritis, pseudofractures and altered gait and therefore should be considered when planning corrective surgeries.}, language = {en} } @article{StreckSeefriedGenestetal.2022, author = {Streck, Laura Elisa and Seefried, Lothar and Genest, Franca and Reichel, Thomas and Rudert, Maximilian and Rueckl, Kilian}, title = {Insuffizienzfraktur der Klavikula nach Implantation einer inversen Schulterendoprothese}, series = {Der Orthop{\"a}de}, volume = {51}, journal = {Der Orthop{\"a}de}, number = {3}, doi = {10.1007/s00132-021-04205-6}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-265286}, pages = {246-250}, year = {2022}, abstract = {Wir stellen den seltenen Fall einer Insuffizienzfraktur der Klavikula nach Implantation einer inversen Schulterendoprothese (RSA) vor. Als Ursache solcher Frakturen wird eine vermehrte Zugbelastung durch den Musculus deltoideus nach RSA diskutiert. In den wenigen verf{\"u}gbaren Fallberichten zeigten die betroffenen Patienten deutliche Funktionseinschr{\"a}nkungen. Die Versorgung erfolgte im vorliegenden Fall mit Plattenosteosynthese. Trotz intraoperativ gutem Korrekturergebnis kam es im Verlauf ohne Trauma zum Osteosyntheseversagen mit weiterer Dislokation der Fraktur.}, language = {de} } @article{SeefriedGenestBaumannetal.2022, author = {Seefried, Lothar and Genest, Franca and Baumann, Jasmin and Heidemeier, Anke and Meffert, Rainer and Jakob, Franz}, title = {Efficacy of Zoledronic Acid in the Treatment of Nonmalignant Painful Bone Marrow Lesions: A Triple-Blind, Randomized, Placebo-Controlled Phase III Clinical Trial (ZoMARS)}, series = {Journal of Bone and Mineral Research}, volume = {37}, journal = {Journal of Bone and Mineral Research}, number = {3}, doi = {10.1002/jbmr.4493}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-276368}, pages = {420 -- 427}, year = {2022}, abstract = {Bone marrow lesions (BML) represent areas of deteriorated bone structure and metabolism characterized by pronounced water-equivalent signaling within the trabecular bone on magnetic resonance imaging (MRI). BML are associated with repair mechanisms subsequent to various clinical conditions associated with inflammatory and non-inflammatory injury to the bone. There is no approved treatment for this condition. Bisphosphonates are known to improve bone stability in osteoporosis and other bone disorders and have been used off-label to treat BML. A randomized, triple-blind, placebo-controlled phase III trial was conducted to assess efficacy and safety of single-dose zoledronic acid (ZOL) 5 mg iv with vitamin D 1000 IU/d as opposed to placebo with vitamin D 1000 IU/d in 48 patients (randomized 2:1) with BML. Primary efficacy endpoint was reduction of edema volume 6 weeks after treatment as assessed by MRI. After treatment, mean BML volume decreased by 64.53\% (±41.92\%) in patients receiving zoledronic acid and increased by 14.43\% (±150.46\%) in the placebo group (p = 0.007). A decrease in BML volume was observed in 76.5\% of patients receiving ZOL and in 50\% of the patients receiving placebo. Pain level (visual analogue scale [VAS]) and all categories of the pain disability index (PDI) improved with ZOL versus placebo after 6 weeks but reconciled after 6 additional weeks of follow-up. Six serious adverse events occurred in 5 patients, none of which were classified as related to the study drug. No cases of osteonecrosis or fractures occurred. Therefore, single-dose zoledronic acid 5 mg iv together with vitamin D may enhance resolution of bone marrow lesions over 6 weeks along with reduction of pain compared with vitamin D supplementation only.}, language = {en} }