@article{GilbertKleinWengetal.2017, author = {Gilbert, Fabian and Klein, Detlef and Weng, Andreas Max and K{\"o}stler, Herbert and Schmitz, Benedikt and Schmalzl, Jonas and B{\"o}hm, Dirk}, title = {Supraspinatus muscle elasticity measured with real time shear wave ultrasound elastography correlates with MRI spectroscopic measured amount of fatty degeneration}, series = {BMC Muscoskeletal Disorders}, volume = {18}, journal = {BMC Muscoskeletal Disorders}, number = {549}, doi = {10.1186/s12891-017-1911-8}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-159378}, year = {2017}, abstract = {Background: Fatty Degeneration (FD) of the rotator cuff muscles influences functional and anatomical outcome after rotator cuff repair. The MRI based estimation of fatty degeneration is the gold standard. There is some evidence that Ultrasound elastography (EUS) can detect local differences of tissue stiffness in muscles and tendons. Shear-wave elastography (SWE) was evaluated to determine the extent to which shear wave velocity was associated with measures of fatty degeneration. MRI-spectroscopic fat measurement was used as a reference to quantify the amount of fat in the muscle belly. Methods: Forty-two patients underwent SWE of the supraspinatus muscles at its thickest diameter. After ultrasound evaluation an MRI-spectroscopic fat measurement of the supraspinatus muscle was performed using the SPLASH-technique. A gel filled capsule was used to locate the measured area in the MRI. The values of shear wave velocity (SWV) measured with SWE and spectroscopic fat measurement were correlated statistically using Pearson's correlation test. Results: Correlation of the fat amount measured with MRI-spectroscopy and the SWV measured with SWE was ρ =0.82. Spectroscopic measured fat ratio of the supraspinatus muscle ranged from 0\% to 77.41\% and SWV from 1.59 m/s to 5.32 m/s. In 4 patients no sufficient SWE could be performed, these individuals showed a larger diameter of the overlying soft tissue. SWV measured with SWE showed a good correlation with MRI spectroscopic fat amount of the supraspinatus muscle. Conclusion: These preliminary data suggest that SWE may be a sufficient tool in detecting and estimating the amount of fatty degeneration in the supraspinatus muscle in real time. Large overlying soft tissue may be a limitation in performing sufficient EUS.}, language = {en} } @article{JakubietzNickelNeshkovaetal.2017, author = {Jakubietz, Rafael G. and Nickel, Aljoscha and Neshkova, Iva and Schmidt, Karsten and Gilbert, Fabian and Meffert, Rainer H. and Jakubietz, Michael G.}, title = {Long-term patency of twisted vascular pedicles in perforator-based propeller flaps}, series = {Plastic and Reconstructive Surgery Global Open}, volume = {5}, journal = {Plastic and Reconstructive Surgery Global Open}, number = {10}, doi = {10.1097/GOX.0000000000001544}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-158870}, pages = {e1544}, year = {2017}, abstract = {Background: Propeller flaps require torsion of the vascular pedicle of up to 180 degrees. Contrary to free flaps, where the relevance of an intact vascular pedicle has been documented, little is known regarding twisted pedicles of propeller flaps. As secondary surgeries requiring undermining of the flap are common in the extremities, knowledge regarding the necessity to protect the pedicle is relevant. The aim of this study was a long-term evaluation of the patency of vascular pedicle of propeller flaps. Methods: In a retrospective clinical study, 22 patients who underwent soft-tissue reconstruction with a propeller flap were evaluated after 43 months. A Doppler probe was used to locate and evaluate the patency of the vascular pedicle of the flap. Results: The flaps were used in the lower extremity in 19 cases, on the trunk in 3 cases. All flaps had healed. In all patients, an intact vascular pedicle could be found. Flap size, source vessel, or infection could therefore not be linked to an increased risk of pedicle loss. Conclusions: The vascular pedicle of propeller flaps remains patent in the long term. This allows reelevation and undermining of the flap. We therefore recommend protecting the pedicle in all secondary cases to prevent later flap loss.}, language = {en} } @article{ArnholdtGilbertBlanketal.2017, author = {Arnholdt, J{\"o}rg and Gilbert, Fabian and Blank, Marc and Papazoglou, Jannis and Rudert, Maximilian and N{\"o}th, Ulrich and Steinert, Andre F.}, title = {The Mayo conservative hip: complication analysis and management of the first 41 cases performed at a University level 1 department}, series = {BMC Muskoskeletal Disorders}, volume = {18}, journal = {BMC Muskoskeletal Disorders}, number = {250}, doi = {10.1186/s12891-017-1613-2}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-157812}, year = {2017}, abstract = {Background: To prevent bone loss in hip arthroplasty, several short stem systems have been developed, including the Mayo conservative hip system. While there is a plethora of data confirming inherent advantages of these systems, only little is known about potential complications, especially when surgeons start to use these systems. Methods: In this study, we present a retrospective analysis of the patients' outcome, complications and the complication management of the first 41 Mayo conservative hips performed in 37 patients. For this reason, functional scores, radiographic analyses, peri- and postoperative complications were assessed at an average follow-up of 35 months. Results: The overall HHS improved from 61.2 pre-operatively to 85.6 post-operatively. The German Extra Short Musculoskeletal Function Assessment Questionnaire (XSFMA-D) improved from 30.3 pre-operatively to 12.2 post-operatively. The most common complication was an intraoperative non-displaced fracture of the proximal femur observed in 5 cases (12.1\%). Diabetes, higher BMI and older ages were shown to be risk factors for these intra-operative periprosthetic fractures (p < 0.01). Radiographic analysis revealed a good offset reconstruction in all cases. Conclusion: In our series, a high complication rate with 12.1\% of non-displaced proximal femoral fractures was observed using the Mayo conservative hip. This may be attributed to the flat learning curve of the system or the inherent patient characteristics of the presented cohort."}, language = {en} }