17607
2018
eng
241
19
article
1
2019-02-06
--
--
A prospective randomized comparison of the minimally invasive direct anterior and the transgluteal approach for primary total hip arthroplasty
Background:
The presented prospective randomized controlled single-centre study compares the clinical outcome up to 12 months after total hip arthroplasty using a minimally invasive single-incision direct anterior (DAA) and a direct transgluteal lateral approach.
Methods:
A total of 123 arthroplasties were evaluated utilizing the Harris Hip Score (HHS), the extra short musculoskeletal functional assessment questionnaire (XSFMA), the Short Form 36 (SF-36) health survey, a Stepwatch™ Activity Monitor (SAM), and a timed 25 m foot walk (T25-FW). Postoperative x-ray images after THA were reviewed to determine inclination and stem positioning.
Results:
At final follow-up, the XSFMA functional index scores were 10.3 (anterior) and 15.08 (lateral) while the bother index summed up to a score of 15.8 (anterior) and 21.66 (lateral) respectively, thus only differing significantly for the functional index (p = 0.040 and p = 0.056). The SF-36 physical component score (PCS) was 47.49 (anterior) and 42.91 (lateral) while the mental component score (MCS) summed up to 55.0 (anterior) and 56.23 (lateral) with a significant difference evident for the PCS (p = 0.017; p = 0.714). Patients undergoing THA through a DAA undertook a mean of 6402 cycles per day while those who had undergone THA through a transgluteal approach undertook a mean of 5340 cycles per day (p = 0.012). Furthermore, the obtained outcome for the T25-FW with 18.4 s (anterior) and 19.75 s (lateral) and the maximum walking distance (5932 m and 5125 m) differed significantly (p = 0.046 and p = 0.045). The average HHS showed no significant difference equaling 92.4 points in the anterior group and 91.43 in the lateral group (p = 0.477). The radiographic analysis revealed an average cup inclination of 38.6° (anterior) and 40.28° (lateral) without signs of migration.
Conclusion:
In summary, our outcomes show that after 1 year THA through the direct anterior approach results in a higher patient activity compared to THA utilizing a transgluteal lateral approach while no differences regarding hip function are evident.
BMC Musculoskeletal Disorders
10.1186/s12891-018-2133-4
urn:nbn:de:bvb:20-opus-176072
BMC Musculoskeletal Disorders (2018) 19:241. DOI: 10.1186/s12891-018-2133-4
false
true
CC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International
Johannes C. Reichert
Eberhard von Rottkay
Franz Roth
Tim Renz
Johannes Hausmann
Julius Kranz
Lars Rackwitz
Ulrich Nöth
Maximilian Rudert
eng
uncontrolled
total hip arthroplasty
eng
uncontrolled
direct anterior approach
eng
uncontrolled
minimally invasive
eng
uncontrolled
transgluteal approach
eng
uncontrolled
prospective study
Chirurgie und verwandte medizinische Fachrichtungen
open_access
Lehrstuhl für Orthopädie
Förderzeitraum 2018
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/17607/Reichert_BMC_Musculoskeletal_Disorders.pdf
13541
2012
eng
7
3
article
1
2016-06-24
--
--
Stem cell- and growth factor-based regenerative therapies for avascular necrosis of the femoral head
Avascular necrosis (AVN) of the femoral head is a debilitating disease of multifactorial genesis, predominately affects young patients, and often leads to the development of secondary osteoarthritis. The evolving field of regenerative medicine offers promising treatment strategies using cells, biomaterial scaffolds, and bioactive factors, which might improve clinical outcome. Early stages of AVN with preserved structural integrity of the subchondral plate are accessible to retrograde surgical procedures, such as core decompression to reduce the intraosseous pressure and to induce bone remodeling. The additive application of concentrated bone marrow aspirates, ex vivo expanded mesenchymal stem cells, and osteogenic or angiogenic growth factors (or both) holds great potential to improve bone regeneration. In contrast, advanced stages of AVN with collapsed subchondral bone require an osteochondral reconstruction to preserve the physiological joint function. Analogously to strategies for osteochondral reconstruction in the knee, anterograde surgical techniques, such as osteochondral transplantation (mosaicplasty), matrix-based autologous chondrocyte implantation, or the use of acellular scaffolds alone, might preserve joint function and reduce the need for hip replacement. This review summarizes recent experimental accomplishments and initial clinical findings in the field of regenerative medicine which apply cells, growth factors, and matrices to address the clinical problem of AVN.
Stem Cell Research & Therapy
10.1186/scrt98
urn:nbn:de:bvb:20-opus-135413
Stem Cell Research & Therapy 2012, 3:7. doi:10.1186/scrt98
242175
Deutsches Urheberrecht
Lars Rackwitz
Lars Eden
Stephan Reppenhagen
Johannes C. Reichert
Franz Jakob
Heike Walles
Oliver Pullig
Rocky S. Tuan
Maximilian Rudert
Ulrich Nöth
eng
uncontrolled
osteochondral allografts
eng
uncontrolled
autologous chondrocyte implantation
eng
uncontrolled
osteogenesis imperfecta
eng
uncontrolled
segmental collapse
eng
uncontrolled
mesenchymal cells
eng
uncontrolled
progenitor cells
eng
uncontrolled
stromal cells
eng
uncontrolled
sheep model
eng
uncontrolled
colony-stimulating factor
eng
uncontrolled
core depression
Humanphysiologie
open_access
Lehrstuhl für Orthopädie
Lehrstuhl für Tissue Engineering und Regenerative Medizin
OpenAIRE
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/13541/Rackwitz_scrt98_2012.pdf
1930
2007
deu
doctoralthesis
1
2007-05-15
--
2007-02-26
In-vitro-Untersuchungen zur chondrogenen Differenzierung von humanen mesenchymalen Stammzellen in einem Kollagen I Hydrogel für den Gelenkknorpelersatz
Chondrogenic differentiation of human mesenchymal stem cells in collagen I hydrogels for articular cartilage repair
No abstract available
urn:nbn:de:bvb:20-opus-22547
2254
X121329
Lars Rackwitz
deu
uncontrolled
mesenchymale Stammzellen
deu
uncontrolled
Chondrogenese
deu
uncontrolled
Hydrogel
deu
uncontrolled
Tissue Engineering
deu
uncontrolled
Gelenkknorpelrekonstruktion
eng
uncontrolled
mesenchymal stem cell
eng
uncontrolled
chondrogenesis
eng
uncontrolled
tissue engineering
eng
uncontrolled
hydrogel
eng
uncontrolled
articular cartilage repair
Medizin und Gesundheit
open_access
Lehrstuhl für Orthopädie
Universität Würzburg
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/1930/D-Arbeit_part1.pdf
https://opus.bibliothek.uni-wuerzburg.de/files/1930/D-Arbeit_part2.pdf
https://opus.bibliothek.uni-wuerzburg.de/files/1930/D-Arbeit_part3.pdf