@article{BoelchWeissenbergerSpohnetal.2018,
  author    = {Boelch, Sebastian Philipp and Weissenberger, Manuel and Spohn, Frederik and Rudert, Maximilian and Luedemann, Martin},
  title     = {Insufficient sensitivity of joint aspiration during the two-stage exchange of the hip with spacers},
  series = {Journal of Orthopedic Surgery and Research},
  volume    = {13},
  journal   = {Journal of Orthopedic Surgery and Research},
  number    = {7},
  doi       = {10.1186/s13018-017-0703-z},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-175576},
  year      = {2018},
  abstract  = {Background: Evaluation of infection persistence during the two-stage exchange of the hip is challenging. Joint aspiration before reconstruction is supposed to rule out infection persistence. Sensitivity and specificity of synovial fluid culture and synovial leucocyte count for detecting infection persistence during the two-stage exchange of the hip were evaluated. Methods: Ninety-two aspirations before planned joint reconstruction during the two-stage exchange with spacers of the hip were retrospectively analyzed. Results: The sensitivity and specificity of synovial fluid culture was 4.6 and 94.3\%. The sensitivity and specificity of synovial leucocyte count at a cut-off value of 2000 cells/μl was 25.0 and 96.9\%. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) values were significantly higher before prosthesis removal and reconstruction or spacer exchange (p = 0.00; p = 0.013 and p = 0.039; p = 0.002) in the infection persistence group. Receiver operating characteristic area under the curve values before prosthesis removal and reconstruction or spacer exchange for ESR were lower (0.516 and 0.635) than for CRP (0.720 and 0.671). Conclusions: Synovial fluid culture and leucocyte count cannot rule out infection persistence during the two-stage exchange of the hip.},
  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{SchmalzlPlumhoffGilbertetal.2019,
  author    = {Schmalzl, Jonas and Plumhoff, Piet and Gilbert, Fabian and Gohlke, Frank and Konrads, Christian and Brunner, Ulrich and Jakob, Franz and Ebert, Regina and Steinert, Andre F.},
  title     = {Tendon-derived stem cells from the long head of the biceps tendon},
  series = {Bone \& Joint Research},
  volume    = {8},
  journal   = {Bone \& Joint Research},
  number    = {9},
  doi       = {10.1302/2046-3758.89.BJR-2018-0214.R2},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-200370},
  pages     = {414-424},
  year      = {2019},
  abstract  = {Objectives The long head of the biceps (LHB) is often resected in shoulder surgery and could therefore serve as a cell source for tissue engineering approaches in the shoulder. However, whether it represents a suitable cell source for regenerative approaches, both in the inflamed and non-inflamed states, remains unclear. In the present study, inflamed and native human LHBs were comparatively characterized for features of regeneration. Methods In total, 22 resected LHB tendons were classified into inflamed samples (n = 11) and non-inflamed samples (n = 11). Proliferation potential and specific marker gene expression of primary LHB-derived cell cultures were analyzed. Multipotentiality, including osteogenic, adipogenic, chondrogenic, and tenogenic differentiation potential of both groups were compared under respective lineage-specific culture conditions. Results Inflammation does not seem to affect the proliferation rate of the isolated tendon-derived stem cells (TDSCs) and the tenogenic marker gene expression. Cells from both groups showed an equivalent osteogenic, adipogenic, chondrogenic and tenogenic differentiation potential in histology and real-time polymerase chain reaction (RT-PCR) analysis. Conclusion These results suggest that the LHB tendon might be a suitable cell source for regenerative approaches, both in inflamed and non-inflamed states. The LHB with and without tendinitis has been characterized as a novel source of TDSCs, which might facilitate treatment of degeneration and induction of regeneration in shoulder surgery.},
  language  = {en}
}
@article{MeyerHessenauerReicheletal.2020,
  author    = {Meyer, Julian S. and Hessenauer, Florian M. and Reichel, Thomas and Pham, Mirko and Plumhoff, Piet and Rueckl, Kilian},
  title     = {Isolated mononeuropathy of the suprascapular nerve: traumatic traction injury as an important differential diagnosis to the entrapment syndrome},
  series = {JSES International},
  volume    = {4},
  journal   = {JSES International},
  number    = {3},
  doi       = {10.1016/j.jseint.2020.04.008},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-229322},
  pages     = {499-502},
  year      = {2020},
  abstract  = {No abstract available.},
  language  = {en}
}
@phdthesis{Heinz2022,
  author    = {Heinz, Tizian},
  title     = {Das Knorpelregister DGOU zur systematischen Patientenerfassung nach knorpelchirurgischen Eingriffen des Kniegelenkes - Analyse und wissenschaftliche Aufarbeitung der ersten 100 Patienten an der Orthop{\"a}dischen Klinik K{\"o}nig-Ludwig-Haus},
  doi       = {10.25972/OPUS-28288},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-282882},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2022},
  abstract  = {Die stark limitierte intrinsische Regenerationsf{\"a}higkeit des hyalinen Gelenkknorpels stellt auch in der modernen Medizin eine große Herausforderung dar. W{\"a}hrend eine Vielzahl von knorpelchirurgischen Techniken am Kniegelenk koexistieren, bleibt die Selektion des am besten geeigneten Therapieverfahrens eine zentrale Herausforderung des orthop{\"a}dischen Chirurgen. Hierzu bieten in Zeiten evidenzbasierter Medizin medizinische Register die M{\"o}glichkeit, klinische Behandlungsdaten systematisch in einem breiten Patientenkollektiv zu erfassen, die klinische Versorgungsrealit{\"a}t ad{\"a}quat abzubilden sowie neue Behandlungsstrategien und Hypothesen zu generieren. Das Knorpelregister der DGOU bietet als webbasierte Registerform eine besonders moderne, effiziente und unb{\"u}rokratische Form der Patientennachverfolgung {\"u}ber subjektiv bewertete und validierte Funktionsscores. F{\"u}r das gesamte Registerkollektiv von 100 Patienten an der Orthop{\"a}dischen Klinik-K{\"o}nig-Ludwig Haus ergaben sich bereits sechs Monate nach dem knorpelchirurgischen Eingriff signifikant h{\"o}here Funktionsscores im IKDC und KOOS, welche sich auch im mittelfristigen Verlauf von zw{\"o}lf Monaten noch signifikant erh{\"o}ht gegen{\"u}ber ihren pr{\"a}operativen Werten zeigten. Die mediale Femurkondyle und knorpelige Patellar{\"u}ckfl{\"a}che waren im Registerkollektiv am h{\"a}ufigsten von Defekten betroffen. Meist handelte es sich hierbei um drittgradige Defekte nach ICRS degenerativer Genese. W{\"a}hrend das mechanische D{\´e}bridement bei großfl{\"a}chigem, arthrotischem Gelenkknorpelverschleiß keine suffiziente Therapieoption bietet, ist zum Nutzen und Effektivit{\"a}t des D{\´e}bridements bei fokalen, umschriebenen Gelenkknorpeldefekten bisher nur wenig bekannt. Im Registerkollektiv zeigte sich f{\"u}r das isoliert mechanische D{\´e}bridement von Gelenkknorpeldefekten eine signifikante Verbesserung der subjektiven Funktionsscores. Im Falle begleitend durchgef{\"u}hrter meniskuschirurgischer Eingriffe zeigt sich die Datenlage deutlich heterogener und bietet Anlass f{\"u}r weiteren wissenschaftlichen Diskurs.},
  subject      = {Hyaliner Knorpel},
  language  = {de}
}
@article{PrasseStratosNiehoffetal.2022,
  author    = {Prasse, Tobias and Stratos, Ioannis and Niehoff, Anja and Christ, Hildegard and Heck, Vincent and Meyer, Carolin and Mittlmeier, Thomas},
  title     = {Bisphenol A-related effects on bone morphology and biomechanical properties in an animal model},
  series = {Toxics},
  volume    = {10},
  journal   = {Toxics},
  number    = {2},
  issn      = {2305-6304},
  doi       = {10.3390/toxics10020086},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-262216},
  year      = {2022},
  abstract  = {Bisphenol A (BPA), which is contained in numerous plastic products, is known to act as an endocrine-disruptive, toxic, and carcinogenic chemical. This experimental series sought to determine the influence of BPA exposure on the femoral bone architecture and biomechanical properties of male and female Wistar rats. BPA was applied subcutaneously by using osmotic pumps. After 12 weeks, the bones were analyzed by micro-computed tomography (micro-CT) and a three-point bending test. Comparing the female low- and high-dose groups, a significantly greater marrow area (p = 0.047) was identified in the group exposed to a higher BPA concentration. In addition, the trabecular number tended to be higher in the female high-dose group when compared to the low-dose group (p > 0.05). The area moment of inertia also tended to be higher in the male high-dose group when compared to the male low-dose group (p > 0.05). Considering our results, BPA-related effects on the bone morphology in female Wistar rats are osteoanabolic after high-dose exposure, while, in male rats, a tendency toward negative effects on the bone morphology in terms of a reduced cross-sectional cortical area and total area could be demonstrated.},
  language  = {en}
}
@phdthesis{LoerlergebSichermann2022,
  author    = {L{\"o}rler [geb. Sichermann], Anna Ramona},
  title     = {Versagensanalyse prim{\"a}rer H{\"u}ftendoprothesen},
  doi       = {10.25972/OPUS-27533},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-275331},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2022},
  abstract  = {Einleitung: Der endoprothetische H{\"u}ftgelenksersatz z{\"a}hlt in Deutschland und weltweit zu den am h{\"a}ufigsten praktizierten operativen Eingriffen, wobei die Erfolgszahlen gleichzeitig sehr hoch sind bei stetiger Verbesserung der verwendeten alloplastischen Materialien und angewandten operativen Technik. Daher ist in Zukunft weiter mit einer steigenden Implantationszahl zu rechnen, was das Gesundheitssystem vor weitere sozio{\"o}konomische Herausforderungen stellt. Vor diesem Hintergrund ist es bedeutsam, die Ursachen f{\"u}r das Versagen von H{\"u}ftendoprothesen weiter im Auge zu behalten und n{\"a}her zu erl{\"a}utern. Material und Methoden: Es handelt sich um eine retrospektive Datenanalyse. Eingeschlossen wurden Daten von 785 Patienten, davon 440 weiblich und 345 m{\"a}nnlich, die im Zeitraum von 2007 bis 2016 im K{\"o}nig-Ludwig-Haus, der orthop{\"a}dischen Klinik der Universit{\"a}t W{\"u}rzburg, eine prim{\"a}re Revision ihrer H{\"u}ftendoprothese erhielten. Folgende Daten wurden erhoben: Patientenalter, Standzeit der Prothese, Indexdiagnose, Revisionsgrund, Prothesentyp und Art der Revision. Ergebnisse: Das mittlere Alter bei der Indexdiagnose der Gesamtpopulation betrug 62,2 Jahre, bei der Revision 69,5 Jahre. Es ergab sich eine durchschnittliche Standzeit der Prothese von 88,0 Monaten im Gesamtkollektiv. Die h{\"a}ufigste Indexdiagnose, die zur Implantation der H{\"u}ftprothese f{\"u}hrte, war Coxarthrose mit 81,4\%. Der h{\"a}ufigste Grund f{\"u}r ein Versagen der Prothese war mit 39,4\% die Lockerung der Prothese. Zu 67,7\% wurde die Prothese zementfrei implantiert. Am h{\"a}ufigsten wurde eine Revision am femoralen Prothesenanteil durchgef{\"u}hrt mit 34,1\%. Zusammenfassung: Insgesamt ergab sich aus den Daten, dass die Prothesen eine vergleichbar gute Standzeit im internationalen Vergleich aufwiesen. Es zeigte sich, dass die meisten Versagensursachen bereits fr{\"u}h nach Implantation der prim{\"a}ren Prothese in Erscheinung treten, jedoch die Prothesenlockerung als h{\"a}ufigster Grund erst sp{\"a}ter im Verlauf bedeutsam f{\"u}r die Revisionsendoprothetik wird.},
  subject      = {H{\"u}ftendoprothese},
  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}
}
@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{ArnholdtKamawalHorasetal.2020,
  author    = {Arnholdt, J{\"o}rg and Kamawal, Yama and Horas, Konstantin and Holzapfel, Boris M. and Gilbert, Fabian and Ripp, Axel and Rudert, Maximilian and Steinert, Andre F.},
  title     = {Accurate implant fit and leg alignment after cruciate-retaining patient-specific total knee arthroplasty},
  series = {BMC Musculoskeletal Disorders},
  volume    = {21},
  journal   = {BMC Musculoskeletal Disorders},
  doi       = {10.1186/s12891-020-03707-2},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-230012},
  year      = {2020},
  abstract  = {Background For improved outcomes in total knee arthroplasty (TKA) correct implant fitting and positioning are crucial. In order to facilitate a best possible implant fitting and positioning patient-specific systems have been developed. However, whether or not these systems allow for better implant fitting and positioning has yet to be elucidated. For this reason, the aim was to analyse the novel patient-specific cruciate retaining knee replacement system iTotal (TM) CR G2 that utilizes custom-made implants and instruments for its ability to facilitate accurate implant fitting and positioning including correction of the hip-knee-ankle angle (HKA). Methods We assessed radiographic results of 106 patients who were treated with the second generation of a patient-specific cruciate retaining knee arthroplasty using iTotal\(^{TM}\) CR G2 (ConforMIS Inc.) for tricompartmental knee osteoarthritis (OA) using custom-made implants and instruments. The implant fit and positioning as well as the correction of the mechanical axis (hip-knee-ankle angle, HKA) and restoration of the joint line were determined using pre- and postoperative radiographic analyses. Results On average, HKA was corrected from 174.4 degrees +/- 4.6 degrees preoperatively to 178.8 degrees +/- 2.2 degrees postoperatively and the coronal femoro-tibial angle was adjusted on average 4.4 degrees. The measured preoperative tibial slope was 5.3 degrees +/- 2.2 degrees (mean +/- SD) and the average postoperative tibial slope was 4.7 degrees +/- 1.1 degrees on lateral views. The joint line was well preserved with an average modified Insall-Salvati index of 1.66 +/- 0.16 pre- and 1.67 +/- 0.16 postoperatively. The overall accuracy of fit of implant components was decent with a measured medial overhang of more than 1 mm (1.33 mm +/- 0.32 mm) in 4 cases only. Further, a lateral overhang of more than 1 mm (1.8 mm +/- 0.63) (measured in the anterior-posterior radiographs) was observed in 11 cases, with none of the 106 patients showing femoral notching. Conclusion The patient-specific iTotal\(^{TM}\) CR G2 total knee replacement system facilitated a proper fitting and positioning of the implant components. Moreover, a good restoration of the leg axis towards neutral alignment was achieved as planned. Nonetheless, further clinical follow-up studies are necessary to validate our findings and to determine the long-term impact of using this patient- specific system.},
  language  = {en}
}