@article{NedopilShekharHowelletal.2021,
  author    = {Nedopil, Alexander J. and Shekhar, Adithya and Howell, Stephen M. and Hull, Maury L.},
  title     = {An insert with less than spherical medial conformity causes a loss of passive internal rotation after calipered kinematically aligned TKA},
  series = {Archives of Orthopaedic and Trauma Surgery},
  volume    = {141},
  journal   = {Archives of Orthopaedic and Trauma Surgery},
  number    = {12},
  issn      = {1434-3916},
  doi       = {10.1007/s00402-021-04054-0},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-266710},
  pages     = {2287-2294},
  year      = {2021},
  abstract  = {Introduction In total knee arthroplasty (TKA), the level of conformity, a medial stabilized (MS) implant, needs to restore native (i.e., healthy) knee kinematics without over-tensioning the flexion space when the surgeon chooses to retain the posterior cruciate ligament (PCL) is unknown. Whether an insert with a medial ball-in-socket conformity and lateral flat surface like the native knee or a less than spherical medial conformity restores higher and closer to native internal tibial rotation without anterior lift-off, an over-tension indicator, when implanted with calipered kinematic alignment (KA), is unknown. Methods and Materials Two surgeons treated 21 patients with calipered KA and a PCL retaining MS implant. Validated verification checks that restore native tibial compartment forces in passive flexion without release of healthy ligaments were used to select the optimal insert thickness. A goniometer etched onto trial inserts with the ball-in-socket and the less than spherical medial conformity measured the tibial rotation relative to the femoral component at extension and 90° and 120° flexion. The surgeon recorded the incidence of anterior lift-off of the insert. Results The insert with the medial ball-in-socket and lateral flat surface restored more internal tibial rotation than the one with less than spherical medial conformity, with mean values of 19° vs. 17° from extension to 90° flexion (p < 0.01), and 23° vs. 20°-120° flexion (p < 0.002), respectively. There was no anterior lift-off of the insert at 90° and 120° flexion. Conclusion An MS insert with a medial ball-in-socket and lateral flat surface that matches the native knee's spherical conformity restores native tibial internal rotation when implanted with calipered KA and PCL retention without over-tensioning the flexion space.},
  language  = {en}
}
@article{StratosScarlatRudert2021,
  author    = {Stratos, Ioannis and Scarlat, Marius M. and Rudert, Maximilian},
  title     = {Bibliometrics of orthopaedic articles published by authors of Germanophone countries},
  series = {International Orthopaedics},
  volume    = {45},
  journal   = {International Orthopaedics},
  number    = {5},
  doi       = {10.1007/s00264-021-05052-y},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-266343},
  pages     = {1121-1124},
  year      = {2021},
  abstract  = {No abstract available.},
  language  = {en}
}
@article{RamirezRodriguezPereiraHerrmannetal.2021,
  author    = {Ram{\´i}rez-Rodr{\´i}guez, Gloria Bel{\´e}n and Pereira, Ana Rita and Herrmann, Marietta and Hansmann, Jan and Delgado-L{\´o}pez, Jos{\´e} Manuel and Sprio, Simone and Tampieri, Anna and Sandri, Monica},
  title     = {Biomimetic mineralization promotes viability and differentiation of human mesenchymal stem cells in a perfusion bioreactor},
  series = {International Journal of Molecular Sciences},
  volume    = {22},
  journal   = {International Journal of Molecular Sciences},
  number    = {3},
  issn      = {1422-0067},
  doi       = {10.3390/ijms22031447},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-285804},
  year      = {2021},
  abstract  = {In bone tissue engineering, the design of 3D systems capable of recreating composition, architecture and micromechanical environment of the native extracellular matrix (ECM) is still a challenge. While perfusion bioreactors have been proposed as potential tool to apply biomechanical stimuli, its use has been limited to a low number of biomaterials. In this work, we propose the culture of human mesenchymal stem cells (hMSC) in biomimetic mineralized recombinant collagen scaffolds with a perfusion bioreactor to simultaneously provide biochemical and biophysical cues guiding stem cell fate. The scaffolds were fabricated by mineralization of recombinant collagen in the presence of magnesium (RCP.MgAp). The organic matrix was homogeneously mineralized with apatite nanocrystals, similar in composition to those found in bone. X-Ray microtomography images revealed isotropic porous structure with optimum porosity for cell ingrowth. In fact, an optimal cell repopulation through the entire scaffolds was obtained after 1 day of dynamic seeding in the bioreactor. Remarkably, RCP.MgAp scaffolds exhibited higher cell viability and a clear trend of up-regulation of osteogenic genes than control (non-mineralized) scaffolds. Results demonstrate the potential of the combination of biomimetic mineralization of recombinant collagen in presence of magnesium and dynamic culture of hMSC as a promising strategy to closely mimic bone ECM.},
  language  = {en}
}
@article{GenestClaussenRaketal.2021,
  author    = {Genest, F. and Claußen, L. and Rak, D. and Seefried, L.},
  title     = {Bone mineral density and fracture risk in adult patients with hypophosphatasia},
  series = {Osteoporosis International},
  volume    = {32},
  journal   = {Osteoporosis International},
  issn      = {0937-941X},
  doi       = {10.1007/s00198-020-05612-9},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-235793},
  pages     = {377-385},
  year      = {2021},
  abstract  = {Summary In adult hypophosphatasia (HPP) patients, elevated lumbar spine dual X-ray absorptiometry (DXA) values are associated with markers of disease severity and disease-specific fracture risk while femoral bone mineral density (BMD), being largely unaffected by the disease severity, may still be useful to monitor other causes of increased fracture risk due to low BMD. Introduction Hypophosphatasia (HPP) is a rare inherited metabolic disorder due to deficient activity of the tissue-nonspecific alkaline phosphatase (TNAP). Clinical manifestation in adult HPP patients is manifold including an increased risk for fractures, but data regarding clinical significance of DXA measurement and associations with fracture risk and disease severity is scarce. Methods Retrospective single-center analysis of DXA scans in patients with confirmed HPP (documented mutation, clinical symptoms, low alkaline phosphatase activity). Further data evaluation included disease-related fractures, laboratory results (alkaline phosphatase, pyridoxalphosphate, phosphoethanolamine), and medical history. Results Analysis included 110 patients (84 female, mean age of 46.2 years) of whom 37.3\% (n = 41) were harboring two mutations. Average T-Score level at the lumbar spine was - 0.1 (SD 1.9), and mean total hip T-Score was - 1.07 (SD 0.15). Both lower ALP activity and higher substrate levels (pyridoxalphosphate and phosphoethanolamine) were significantly correlated with increased lumbar spine T-Score levels (p < 0.001) while BMD at the hip was not affected by indicators of disease severity. Increased lumbar spine BMD was significantly associated with an increased risk for HPP-related fractures, prevalent in 22 (20\%) patients (p < 0.001) with 21 of them having biallelic mutations. Conclusion BMD in adult HPP patients is not systematically reduced. Conversely, increased lumbar spine BMD appears to be associated with severely compromised mineralization and increased risk for HPP-related fractures while BMD at the hip appears unaffected by indicators of disease severity, suggesting suitability of this anatomic location for assessing and discerning disorders with increased fracture risk owing to reduced BMD like osteoporosis. Trial registration number German register for clinical studies (DRKS00014022) Date of registration 02/10/2018 - retrospectively registered},
  language  = {en}
}
@article{SeefriedRakPetryketal.2021,
  author    = {Seefried, L. and Rak, D. and Petryk, A. and Genest, F.},
  title     = {Bone turnover and mineral metabolism in adult patients with hypophosphatasia treated with asfotase alfa},
  series = {Osteoporosis International},
  volume    = {32},
  journal   = {Osteoporosis International},
  number    = {12},
  doi       = {10.1007/s00198-021-06025-y},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-265310},
  pages     = {2505-2513},
  year      = {2021},
  abstract  = {Summary There is limited understanding of how asfotase alfa affects mineral metabolism and bone turnover in adults with pediatric-onset hypophosphatasia. This study showed that adults with hypophosphatasia treated with asfotase alfa experienced significant changes in biochemical markers of bone and mineral metabolism, possibly reflecting enhanced bone remodeling of previously osteomalacic bone. Introduction Hypophosphatasia (HPP), due to a tissue nonspecific alkaline phosphatase (TNSALP) deficiency, can cause impaired bone mineralization and turnover. Although HPP may be treated with asfotase alfa, an enzyme replacement therapy, limited data are available on how treatment with asfotase alfa affects mineral metabolism and bone turnover in adults with HPP. Methods ALP substrates, bone turnover and mineral metabolism markers, and bone mineral density (BMD) data from EmPATHY, a single-center, observational study of adults (≥ 18 years) with pediatric-onset HPP treated with asfotase alfa (NCT03418389), were collected during routine clinical care and analyzed from baseline through 24 months of treatment. Results Data from 21 patients showed significantly increased ALP activity and reduced urine phosphoethanolamine (PEA)/creatinine (Cr) ratios after baseline through 24 months of asfotase alfa treatment. There were significant transient increases in parathyroid hormone 1-84 (PTH), osteocalcin, and procollagen type 1 N-propeptide (P1NP) levels at 3 and 6 months and in tartrate-resistant acid phosphatase 5b (TRAP5b) levels at 3 months, with a significant decrease in N-terminal telopeptide of type 1 collagen (NTX) levels at 24 months. Lumbar spine BMD T scores continuously increased during treatment. Conclusion Significant changes in bone turnover and mineral metabolism markers after asfotase alfa treatment suggest that treatment-mediated mineralization may enable remodeling and bone turnover on previously unmineralized surfaces. Urine PEA/Cr ratios may be a useful parameter in monitoring treatment during routine care.},
  language  = {en}
}
@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}
}
@article{AchenbachKleinLuigetal.2021,
  author    = {Achenbach, Leonard and Klein, Christian and Luig, Patrick and Bloch, Hendrik and Schneider, Dominik and Fehske, Kai},
  title     = {Collision with opponents - but not foul play - dominates injury mechanism in professional men's basketball},
  series = {BMC Sports Science Medicine and Rehabilitation},
  volume    = {13},
  journal   = {BMC Sports Science Medicine and Rehabilitation},
  doi       = {10.1186/s13102-021-00322-z},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-261765},
  year      = {2021},
  abstract  = {Background To identify injury patterns and mechanisms in professional men's basketball by means of video match analysis. Methods In Germany, injuries are registered with the statutory accident insurance for professional athletes (VBG) by clubs or club physicians as part of occupational accident reporting. Moderate and severe injuries (absence of > 7 days) sustained during basketball competition in one of four seasons (2014-2017 and 2018-2019) in the first or second national men's league in Germany were prospectively analyzed using a newly developed standardized observation form. Season 2017-2018 was excluded because of missing video material. Results Video analysis included 175 (53\%) of 329 moderate and severe match injuries. Contact patterns categorized according to the different body sites yielded eight groups of typical injury patterns: one each for the head, shoulders, and ankles, two for the thighs, and three for the knees. Injuries to the head (92\%), ankles (76\%), shoulders (70\%), knees (47\%), and thighs (32\%) were mainly caused by direct contact. The injury proportion of foul play was 19\%. Most injuries (61\%) occurred in the central zone below the basket. More injuries occurred during the second (OR 1.8, p = 0.018) and fourth quarter (OR 1.8, p = 0.022) than during the first and third quarter of the match. Conclusion The eight identified injury patterns differed substantially in their mechanisms. Moderate and severe match injuries to the head, shoulders, knees, and ankles were mainly caused by collision with opponents and teammates. Thus, stricter rule enforcement is unlikely to facilitate safer match play.},
  language  = {en}
}
@article{WagenbrennerMayerWagnerRudertetal.2021,
  author    = {Wagenbrenner, Mike and Mayer-Wagner, Susanne and Rudert, Maximilian and Holzapfel, Boris Michael and Weissenberger, Manuel},
  title     = {Combinations of hydrogels and mesenchymal stromal cells (MSCs) for cartilage tissue engineering — a review of the literature},
  series = {Gels},
  volume    = {7},
  journal   = {Gels},
  number    = {4},
  issn      = {2310-2861},
  doi       = {10.3390/gels7040217},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-250177},
  year      = {2021},
  abstract  = {Cartilage offers limited regenerative capacity. Cell-based approaches have emerged as a promising alternative in the treatment of cartilage defects and osteoarthritis. Due to their easy accessibility, abundancy, and chondrogenic potential mesenchymal stromal cells (MSCs) offer an attractive cell source. MSCs are often combined with natural or synthetic hydrogels providing tunable biocompatibility, biodegradability, and enhanced cell functionality. In this review, we focused on the different advantages and disadvantages of various natural, synthetic, and modified hydrogels. We examined the different combinations of MSC-subpopulations and hydrogels used for cartilage engineering in preclinical and clinical studies and reviewed the effects of added growth factors or gene transfer on chondrogenesis in MSC-laden hydrogels. The aim of this review is to add to the understanding of the disadvantages and advantages of various combinations of MSC-subpopulations, growth factors, gene transfers, and hydrogels in cartilage engineering.},
  language  = {en}
}
@article{MeyerStoethMoratinetal.2021,
  author    = {Meyer, Till Jasper and St{\"o}th, Manuel and Moratin, Helena and Ickrath, Pascal and Herrmann, Marietta and Kleinsasser, Norbert and Hagen, Rudolf and Hackenberg, Stephan and Scherzad, Agmal},
  title     = {Cultivation of head and neck squamous cell carcinoma cells with wound fluid leads to cisplatin resistance via epithelial-mesenchymal transition induction},
  series = {International Journal of Molecular Sciences},
  volume    = {22},
  journal   = {International Journal of Molecular Sciences},
  number    = {9},
  issn      = {1422-0067},
  doi       = {10.3390/ijms22094474},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-258722},
  year      = {2021},
  abstract  = {Locoregional recurrence is a major reason for therapy failure after surgical resection of head and neck squamous cell carcinoma (HNSCC). The physiological process of postoperative wound healing could potentially support the proliferation of remaining tumor cells. The aim of this study was to evaluate the influence of wound fluid (WF) on the cell cycle distribution and a potential induction of epithelial-mesenchymal transition (EMT). To verify this hypothesis, we incubated FaDu and HLaC78 cells with postoperative WF from patients after neck dissection. Cell viability in dependence of WF concentration and cisplatin was measured by flow cytometry. Cell cycle analysis was performed by flow cytometry and EMT-marker expression by rtPCR. WF showed high concentrations of interleukin (IL)-6, IL-8, IL-10, CCL2, MCP-1, EGF, angiogenin, and leptin. The cultivation of tumor cells with WF resulted in a significant increase in cell proliferation without affecting the cell cycle. In addition, there was a significant enhancement of the mesenchymal markers Snail 2 and vimentin, while the expression of the epithelial marker E-cadherin was significantly decreased. After cisplatin treatment, tumor cells incubated with WF showed a significantly higher resistance compared with the control group. The effect of cisplatin-resistance was dependent on the WF concentration. In summary, proinflammatory cytokines are predominantly found in WF. Furthermore, the results suggest that EMT can be induced by WF, which could be a possible mechanism for cisplatin resistance.},
  language  = {en}
}
@article{vonHertzbergBoelchWagenbrennerArnholdtetal.2021,
  author    = {von Hertzberg-Boelch, Sebastian Philipp and Wagenbrenner, Mike and Arnholdt, J{\"o}rg and Frenzel, Stephan and Holzapfel, Boris Michael and Rudert, Maximilian},
  title     = {Custom Made Monoflange Acetabular Components for the Treatment of Paprosky Type III Defects},
  series = {Journal of Personalized Medicine},
  volume    = {11},
  journal   = {Journal of Personalized Medicine},
  number    = {4},
  issn      = {2075-4426},
  doi       = {10.3390/jpm11040283},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-236513},
  year      = {2021},
  abstract  = {Purpose: Patient-specific, flanged acetabular components are used for the treatment of Paprosky type III defects during revision total hip arthroplasty (THA). This monocentric retrospective cohort study analyzes the outcome of patients treated with custom made monoflanged acetabular components (CMACs) with intra- and extramedullary iliac fixation. Methods: 14 patients were included who underwent revision THA with CMACs for the treatment of Paprosky type III defects. Mechanism of THA failure was infection in 4 and aseptic loosening in 10 patients. Seven patients underwent no previous revision, the other seven patients underwent three or more previous revisions. Results: At a mean follow-up of 35.4 months (14-94), the revision rate of the implant was 28.3\%. Additionally, one perioperative dislocation and one superficial wound infection occurred. At one year postoperatively, we found a significant improvement of the Western Ontario and McMaster Universities Arthritis Index (WOMAC) score (p = 0.015). Postoperative radiographic analysis revealed good hip joint reconstruction with a mean leg length discrepancy of 3 mm (-8-20), a mean lateralization of the horizontal hip center of rotation of 8 mm (-8-35), and a mean proximalization of the vertical hip center of rotation of 6 mm (13-26). Radiolucency lines were present in 30\%. Conclusion: CMACs can be considered an option for the treatment of acetabular bone loss in revision THA. Iliac intra- and extramedullary fixation allows soft tissue-adjusted hip joint reconstruction and improves hip function. However, failure rates are high, with periprosthetic infection being the main threat to successful outcome.},
  language  = {en}
}
@article{StreckGaalForsteretal.2021,
  author    = {Streck, Laura Elisa and Gaal, Chiara and Forster, Johannes and Konrads, Christian and Hertzberg-Boelch, Sebastian Philipp von and Rueckl, Kilian},
  title     = {Defining a synovial fluid white blood cell count threshold to predict periprosthetic infection after shoulder arthroplasty},
  series = {Journal of Clinical Medicine},
  volume    = {11},
  journal   = {Journal of Clinical Medicine},
  number    = {1},
  issn      = {2077-0383},
  doi       = {10.3390/jcm11010050},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-252275},
  year      = {2021},
  abstract  = {Background: The diagnosis of periprosthetic shoulder infection (PSI) requires a thorough diagnostic workup. Synovial fluid aspiration has been proven to be a reliable tool in the diagnosis of joint infections of the lower extremity, but shoulder specific data is limited. This study defines a threshold for synovial fluid white blood cell count (WBC) and assesses the reliability of microbiological cultures. Methods: Retrospective study of preoperative and intraoperative fluid aspiration of 31 patients who underwent a revision of a shoulder arthroplasty (15 with PSI defined by IDSA criteria, 16 without infection). The threshold for WBC was calculated by ROC/AUC analysis. Results: WBC was significantly higher in patients with PSI than in other patients. A threshold of 2800 leucocytes/mm\(^3\) showed a sensitivity of 87\% and a specificity of 88\% (AUROC 0.92). Microbiological cultures showed a sensitivity of 76\% and a specificity of 100\%. Conclusions: A threshold of 2800 leucocytes/mm\(^3\) in synovial fluid can be recommended to predict PSI. Microbiological culture has an excellent specificity and allows for targeted antibiotic therapy. Joint aspiration presents an important pillar to diagnose PSI.},
  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}
}
@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{Schaefer2021,
  author    = {Sch{\"a}fer, Nina Valentina},
  title     = {Einfluss der pr{\"a}operativen An{\"a}mie auf die Transfusions- und Komplikationsrate nach Implantation einer prim{\"a}ren Endoprothese des Kniegelenks},
  doi       = {10.25972/OPUS-24219},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-242190},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2021},
  abstract  = {Die Implantation einer Endoprothese des Kniegelenks ist eine der h{\"a}ufigsten Operationen in Deutschland. In vielen Kliniken wurde im Rahmen des Patient-Blood-Managements ein pr{\"a}operatives An{\"a}mie Screening eingef{\"u}hrt, um mit Hilfe einer pr{\"a}operativen An{\"a}miebehandlung das Risiko f{\"u}r eine Bluttransfusion und andere An{\"a}mie assoziierte Risiken zu senken. In den bisherigen Publikationen variieren jedoch sowohl die An{\"a}miepr{\"a}valenz als auch das Bluttransfusionsrisiko erheblich, weshalb f{\"u}r eine gezielte Behandlung eine klinikspezifische Analyse von Risikofaktoren f{\"u}r eine Bluttransfusion erforderlich zu sein scheint. Ziel dieser retrospektiven, monozentrischen Studie war es, den Einfluss der pr{\"a}operativen An{\"a}mie und weiterer m{\"o}glicher Einflussfaktoren auf die Transfusions- und Komplikationsrate nach Implantation einer prim{\"a}ren Endoprothese des Kniegelenks zu untersuchen. Hierf{\"u}r wurden die Daten von 1811 Patienten, welche zwischen 2016 und 2018 eine prim{\"a}re Endoprothese des Kniegelenks erhalten hatten, erfasst und statistisch ausgewertet. 7,4\% der Patienten besaßen eine pr{\"a}operative An{\"a}mie. Patienten mit einer pr{\"a}operativen An{\"a}mie erhielten in 25,4\% ein Erythrozytenkonzentrat, nicht an{\"a}mische Patienten in 3,1\% der F{\"a}lle. Die gesamte Transfusionsrate f{\"u}r allogene Transfusionen lag bei 4,7\%. In der Gruppe der pr{\"a}operativ an{\"a}mischen Patienten zeigte sich dabei ein signifikant h{\"o}here Wahrscheinlichkeit f{\"u}r die Transfusion eines Erythrozytenkonzentrats, nicht jedoch f{\"u}r eine Komplikation w{\"a}hrend des station{\"a}ren Aufenthalts. Unsere logistischen Regressionsmodelle ermittelten neben der pr{\"a}operativen H{\"a}moglobinkonzentration auch die systemische Tranexams{\"a}uregabe als unabh{\"a}ngigen Einflussfaktor f{\"u}r Transfusionen. Das Geschlecht der Patienten hatte hingegen keinen Einfluss auf das Risiko f{\"u}r eine Bluttransfusion. M{\"a}nner und Frauen mit der gleichen pr{\"a}operativen H{\"a}moglobinkonzentration besaßen in etwa das gleiche individuelle Risiko f{\"u}r eine Bluttransfusion. Entsprechend erscheint es sinnvoll, f{\"u}r M{\"a}nner und Frauen die gleiche pr{\"a}operative Mindesth{\"a}moglobinkonzentration anzustreben. Da jedoch das individuelle Risiko auch durch die systemische Gabe der Tranexams{\"a}ure beeinflusst wird, k{\"o}nnte dies bei der Festlegung einer Schwelle zur pr{\"a}operativen Behandlung ber{\"u}cksichtigt werden.},
  subject      = {Gelenkendoprothese},
  language  = {de}
}
@article{MagesShojaaKohletal.2021,
  author    = {Mages, Michelle and Shojaa, Mahdieh and Kohl, Matthias and Stengel, Simon von and Becker, Clemens and Gosch, Markus and Jakob, Franz and Kerschan-Schindl, Katharina and Kladny, Bernd and Kl{\"o}ckner, Nicole and Lange, Uwe and Middeldorf, Stefan and Peters, Stefan and Schoene, Daniel and Sieber, Cornel C. and Tholen, Reina and Thomasius, Friederike E. and Uder, Michael and Kemmler, Wolfgang},
  title     = {Exercise effects on Bone Mineral Density in men},
  series = {Nutrients},
  volume    = {13},
  journal   = {Nutrients},
  number    = {12},
  issn      = {2072-6643},
  doi       = {10.3390/nu13124244},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-250247},
  year      = {2021},
  abstract  = {In contrast to postmenopausal women, evidence for a favorable effect of exercise on Bone Mineral Density (BMD) is still limited for men. This might be due to the paucity of studies, but also to the great variety of participants and study characteristics that may dilute study results. The aim of the present systematic review and meta-analysis was to evaluate the effect of exercise on BMD changes with rational eligibility criteria. A comprehensive search of six electronic databases up to 15 March 2021 was conducted. Briefly, controlled trials ≥6 months that determined changes in areal BMD in men >18 years old, with no apparent diseases or pharmacological therapy that relevantly affect bone metabolism, were included. BMD changes (standardized mean differences: SMD) of the lumbar spine (LS) and femoral neck (FN) were considered as outcomes. Twelve studies with 16 exercise and 12 control groups were identified. The pooled estimate of random-effect analysis was SMD = 0.38, 95\%-CI: 0.14-0.61 and SMD = 0.25, 95\%-CI: 0.00-0.49, for LS and FN, respectively. Heterogeneity between the trials was low-moderate. Funnel plots and rank and regression correlation tests indicate evidence for small study publication bias for LS but not FN-BMD. Subgroup analyses that focus on study length, type of exercise and methodologic quality revealed no significant difference between each of the three categories. In summary, we provided further evidence for a low but significant effect of exercise on BMD in men. However, we are currently unable to give even rough exercise recommendations for male cohorts.},
  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{GenestLindstroemSchereretal.2021,
  author    = {Genest, Franca and Lindstr{\"o}m, Sarah and Scherer, Sophia and Schneider, Michael and Seefried, Lothar},
  title     = {Feasibility of simple exercise interventions for men with osteoporosis - A prospective randomized controlled pilot study},
  series = {Bone Reports},
  volume    = {15},
  journal   = {Bone Reports},
  doi       = {10.1016/j.bonr.2021.101099},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-261434},
  year      = {2021},
  abstract  = {Background Aging is associated with progressive loss of musculoskeletal performance. Exercise interventions can improve physical function in the elderly but there is a paucity of comparative assessments in order to understand what specific goals can be achieved particularly with less demanding exercise interventions readily accessible for untrained men. Methods Prospective randomized, controlled, single center exploratory trial to compare four distinct exercise interventions, i.e. Resistance Training (RT), Whole Body Vibration Exercise (WBV), Qi Gong (QG) and wearing a Spinal orthosis (SO) for 6 months in men at risk for osteoporosis aged 65-90 years. Primary endpoint was change in isometric one repetition maximum force trunk strength for extension (TSE) and flexion (TSF) compared to baseline, secondary endpoints covered key parameters of geriatric functional assessment, including Handgrip Strength (HS), Chair-Rise-Test (CRT), Usual Gait Speed (UGS) and Timed-Up-and-Go (TUG). Results Altogether 47 men (mean age 77 ±6.1 years) were randomized to RT, (n = 11) WBV (n = 13), QG (n = 10) and SO(n = 13). RT, defined as reference exercise intervention, lead to significant improvements for TSE (p = 0.009) and TSF (p = 0.013) and was significantly superior in the between-group analysis for TSE (p = 0.038). Vibration exercise caused sign. Improvements in TSE (p = 0.014) and CRT (p = 0.005), the Spinal orthosis improved CRT (p = 0.003) and Gait Speed (p = 0.027), while the QG intervention did not attain any sig. Developments. Subgroup analyses revealed most pronounced musculoskeletal progress in vulnerable patients (age ≥ 80 years, pre-sarcopenia, multimorbidity ≥3chronic diseases). Irrespective of the type of exercise, participants ≥80 years experienced significant gains in TSE (p = 0.029) and CRT (p = 0.017). Presarcopenic subjects (Skeletal muscle Index (SMI) ≤10.75 kg/m2) improved in TSE (p = 0.003), CRT (p = 0.001) and UGS (p = 0.016). Multimorbid participants achieved sig. Gains in TSE (p < 0.001), TSF (p = 0.002), UGS (p = 0.036) and HS (p = 0.046). Conclusions In this exploratory trial we found that simple exercise interventions are feasible in elderly men eliciting specific benefits, i.e. improvements are attained in those tasks addressed with the respective exercise modality. While targeted resistance training is superior in increasing TSE, alternative simple exercise interventions also appear to elicit beneficial effects, even in vulnerable patients, i.e. those with low muscle mass, above 80 years of age or multimorbidity.},
  language  = {en}
}
@article{EidmannEwaldBoelchetal.2021,
  author    = {Eidmann, Annette and Ewald, Andrea and Boelch, Sebastian P. and Rudert, Maximilian and Holzapfel, Boris M. and Stratos, Ioannis},
  title     = {In vitro evaluation of antibacterial efficacy of vancomycin-loaded suture tapes and cerclage wires},
  series = {Journal of Materials Science: Materials in Medicine},
  volume    = {32},
  journal   = {Journal of Materials Science: Materials in Medicine},
  number    = {4},
  doi       = {10.1007/s10856-021-06513-x},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-260089},
  pages     = {42},
  year      = {2021},
  abstract  = {Usage of implants containing antibiotic agents has been a common strategy to prevent implant related infections in orthopedic surgery. Unfortunately, most implants with microbial repellent properties are characterized by accessibility limitations during daily clinical practice. Aim of this in vitro study was to investigate whether suture tapes and cerclage wires, which were treated with vancomycin, show a sustainable antibacterial activity. For this purpose, we used 24 stainless steel wire cerclages and 24 ultra-high molecular weight polyethylene and polyester suture tape test bodies. The test bodies were incubated for 30 min. in 100 mg/ml vancomycin solution or equivalent volumes of 0.9\% NaCl. After measuring the initial solution uptake of the test bodies, antibacterial efficacy via agar diffusion test with Staphylococcus aureus and vancomycin elution tests were performed 1, 2, 3, and 6 days after incubation. Vancomycin-loaded tapes as well as vancomycin-loaded cerclage wires demonstrated increased bacterial growth inhibition when compared to NaCl-treated controls. Vancomycin-loaded tapes showed an additional twofold and eightfold increase of bacterial growth inhibition compared to vancomycin-loaded wires at day 1 and 2, respectively. Elution tests at day 1 revealed high levels of vancomycin concentration in vancomycin loaded tapes and wires. Additionally, the concentration in vancomycin loaded tapes was 14-fold higher when compared to vancomycin loaded wires. Incubating suture tapes and cerclage wires in vancomycin solution showed a good short-term antibacterial activity compared to controls. Considering the ease of vancomycin application on suture tapes or wires, our method could represent an attractive therapeutic strategy in biofilm prevention in orthopedic surgery.},
  language  = {en}
}
@phdthesis{Wagenbrenner2021,
  author    = {Wagenbrenner, Mike Helmut},
  title     = {In vitro-Charakterisierung mesenchymaler Stromazellen aus dem menschlichen H{\"u}ftgelenk},
  doi       = {10.25972/OPUS-23711},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-237110},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2021},
  abstract  = {In dieser Arbeit konnte erstmals gezeigt werden, dass plastik-adh{\"a}rent wachsende, multipotente Vorl{\"a}uferzellen, die eine f{\"u}r MSCs charakteristische Kombination von Oberfl{\"a}chenantigenen tragen, aus allen vier untersuchten Geweben des arthrotischen H{\"u}ftgelenks isoliert werden konnten. MSC-{\"a}hnliche Zellen k{\"o}nnen somit nicht nur in der Spongiosa und im Gelenkknorpel, sondern auch in der anterioren Gelenkkapsel und dem Ligamentum capitis femoris (LCF) des arthrotisch ver{\"a}nderten menschlichen H{\"u}ftgelenks nachgewiesen werden. Die FACS Analyse der Oberfl{\"a}chenantigene auf Zellen, die aus den vier unterschiedlichen Geweben eines beispielhaft gew{\"a}hlten Spenders isoliert wurden, zeigte eine deutliche Expression der Antigene CD44, CD73, CD90 und CD105. Unabh{\"a}ngig vom Nativgewebe zeigten somit alle untersuchten Zellen ein f{\"u}r MSCs charakteristisches, aber nicht spezifisches Profil an Antigenen auf ihrer Oberfl{\"a}che. Eine {\"U}bereinstimmung mit den ISCT Kriterien f{\"u}r MSCs war aufgrund der fehlenden Kontrolle h{\"a}matopoetischer Marker nicht m{\"o}glich. Die multipotente Differenzierung der isolierten Zellen erfolgte mithilfe spezifischer Differenzierungsmedien in Monolayer-Kulturen oder f{\"u}r die chondrogene Differenzierung in dreidimensionalen Pellet-Kulturen. Nach 21 Tagen konnten in allen differenzierten Kulturen histologisch und immunhistochemisch klare Zeichen der Osteo- und Adipogenese detektiert werden, w{\"a}hrend die Auswertung spezifischer Markergene eine klare Steigerung der Expression dieser im Vergleich zu den Negativkontrollen zeigte. Histologische und immunhistochemische Auswertungen best{\"a}tigten auch eine erfolgreiche chondrogene Differenzierung der Zell-Pellets aus Spongiosa, Knorpel und Kapsel. Lediglich in den chondrogen differenzierten Zell-Pellets aus dem LCF konnte immunhistochemisch keine Bildung des knorpelspezifischen Matrixproteins Col II nachgewiesen werden. Mikroskopisch zeigten vor allem die differenzierten MSC-Pellets aus Spongiosa und Knorpel morphologisch eine starke {\"A}hnlichkeit zu hyalinem Knorpelgewebe. Trotz dieser Abstufungen zeigten sich f{\"u}r die relative Expression der chondrogenen Markergene AGG, Col II und Sox-9 keine signifikanten Unterschiede zwischen den differenzierten MSC-Kulturen der vier unterschiedlichen Nativgewebe. Ein positiver Nachweis des Markers Col X wies nach 27 Tagen sowohl in differenzierten als auch in undifferenzierten Pellet-Kulturen auf eine leichte chondrogene Hypertrophie hin. Zusammenfassend zeigten sich keine signifikanten Unterschiede im Hinblick auf das osteogene und adipogene Differenzierungspotential aller untersuchten Zellen. W{\"a}hrend das chondrogene Differenzierungspotential der Zellen aus Spongiosa, Knorpel und Kapsel sich aus histologischer und immunhistochemischer Sicht {\"a}hnelte, zeigten Pellets aus dem LCF ein schw{\"a}cheres chondrogenes Differenzierungspotential in vitro. Obwohl somit erstmals MSC-{\"a}hnliche Zellen aus dem LCF und Gewebsproben, die neben dem Stratum synoviale auch das Stratum fibrosum der H{\"u}ftgelenkskapsel beinhalteten, charakterisiert wurden, sind weitere wissenschaftliche Arbeiten notwendig, um das multipotente Differenzierungspotential dieser Zellen zu optimieren.},
  subject      = {H{\"u}ftgelenk},
  language  = {de}
}
@article{LuedemannJakuscheitEwaldetal.2021,
  author    = {L{\"u}demann, Martin and Jakuscheit, Axel and Ewald, Andrea and Fr{\"u}hmann, Leena and H{\"o}lscher-Doht, Stefanie and Rudert, Maximilian and von Hertzberg-Boelch, Sebastian Philipp},
  title     = {Influence of Tranexamic Acid on Elution Characteristics and Compressive Strength of Antibiotic-Loaded PMMA-Bone Cement with Gentamicin},
  series = {Materials},
  volume    = {14},
  journal   = {Materials},
  number    = {19},
  issn      = {1996-1944},
  doi       = {10.3390/ma14195639},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-246236},
  year      = {2021},
  abstract  = {Purpose: The topical application of tranexamic acid (TXA) into the joint space during total joint arthroplasty (TJA) with no increase of complications, has been widely reported. We investigated the influence of TXA on antibiotic release, activity of the released antibiotic against a clinical isolate of S. aureus, and compressive strength of a widely used commercially prepared gentamicin-loaded cement brand (PALACOS R + G). Method: 12 bone cement cylinders (diameter and height = 6 and 12 mm, respectively) were molded. After curing in air for at least 1 h, six of the cylinders were completely immersed in 5 mL of fetal calf serum (FCS) and the other six were completely immersed in a solution consisting of 4.9 mL of FCS and 0.1 mL (10 mg) of TXA. Gentamicin elution tests were performed over 7 d. Four hundred µL of the gentamicin eluate were taken every 24 h for the first 7 d without renewing the immersion fluid. The gentamicin concentration was determined in a clinical analyzer using a homogeny enzyme immuno-assay. The antimicrobial activity of the eluate, obtained after day 7, was tested. An agar diffusion test regime was used with Staphylococcus aureus. Bacteria were grown in a LB medium and plated on LB agar plates to get a bacterial lawn. Fifty µL of each eluate were pipetted on 12-mm diameter filter discs, which were placed in the middle of the agar gel. After 24 h of cultivation at 37 °C, the zone of inhibition (ZOI) for each specimen was measured. The compressive strength of the cements was determined per ISO 5833. Results: At each time point in the gentamicin release test, the difference in gentamicin concentration, obtained from specimens immersed in the FCS solution only and those immersed in the FCS + TXA solution was not significant (p = 0.055-0.522). The same trend was seen in each of the following parameters, after 7 d of immersion: (1) Cumulative gentamicin concentration (p < 0.297); (2) gentamicin activity against S. aureus (strongly visible); (3) ZOI size (mostly > 20 mm) (p = 0.631); and (4) compressive strength (p = 0.262). Conclusions: For the PALACOS R + G specimens, the addition of TXA to FCS does not produce significant decreases in gentamicin concentration, in the activity of the gentamicin eluate against a clinical isolate of S. aureus, the zone of inhibition of S. aureus, and in the compressive strength of the cement, after 7 d of immersion in the test solution.},
  language  = {en}
}