Filtern
Gehört zur Bibliographie
- ja (161)
Erscheinungsjahr
Dokumenttyp
- Artikel / Aufsatz in einer Zeitschrift (150)
- Dissertation (9)
- Buch (1)
- Sonstiges (1)
Sprache
- Englisch (161) (entfernen)
Schlagworte
- total knee arthroplasty (11)
- osteoporosis (9)
- kinematic alignment (8)
- hypophosphatasia (7)
- osteoarthritis (7)
- bone (6)
- mesenchymal stem cells (6)
- tissue engineering (6)
- bone mineral density (4)
- cartilage (4)
- fracture (4)
- knee (4)
- mechanotransduction (4)
- periprosthetic infection (4)
- revision (4)
- sarcopenia (4)
- total knee replacement (4)
- MSC (3)
- MSCs (3)
- Medizin (3)
- Tissue Engineering (3)
- chondrocytes (3)
- chondrogenesis (3)
- extracellular vesicles (3)
- inflammation (3)
- knee arthroplasty (3)
- mineralization (3)
- osteogenesis (3)
- phenotype (3)
- reoperation (3)
- spacer (3)
- stem cells (3)
- total hip arthroplasty (3)
- tranexamic acid (3)
- vitamin D (3)
- AMADEUS (2)
- Bone marrow (2)
- Genexpression (2)
- Germany (2)
- HPP (2)
- Knorpelzelle (2)
- LMHFV (2)
- Mesenchymal stem cells (2)
- Mesenchymale Stammzellen (2)
- Mesenchymzelle (2)
- Multiple myeloma (2)
- TKA (2)
- TNAP (2)
- XLH (2)
- Zelldifferenzierung (2)
- adipocytes (2)
- alkaline phosphatase (2)
- apoptosis (2)
- arthritis (2)
- back pain (2)
- bone marrow (2)
- bone marrow stromal cells (2)
- bone metastasis (2)
- bone-mineral density (2)
- breast cancer (2)
- calipered (2)
- cartilage regeneration (2)
- cement (2)
- clinical study (2)
- differentiation (2)
- direct anterior approach (2)
- enzyme replacement therapy (2)
- epidemiology (2)
- exercise (2)
- follow-up (2)
- fracture healing (2)
- hip (2)
- immunomodulation (2)
- implant positioning (2)
- in vitro (2)
- in-vitro (2)
- joint aspiration (2)
- knee osteoarthritis (2)
- knee replacement (2)
- mesenchymal stem cell (2)
- mesenchymal stromal cells (2)
- mesenchymale Stammzellen (2)
- metabolism (2)
- model (2)
- morphogenetic protein (2)
- muscle (2)
- nervous system (2)
- oestrogen receptor signalling (2)
- osteogenic differentiation (2)
- patient-specific (2)
- periprosthetic joint infection (2)
- physical performance (2)
- prospective study (2)
- prosthesis (2)
- quality of life (2)
- replacement (2)
- revision arthroplasty (2)
- roentgenographic assessment (2)
- rotation (2)
- scaffolds (2)
- senescence (2)
- stemness (2)
- stromal cells (2)
- teriparatide (2)
- tissue (2)
- total joint arthroplasty (2)
- training (2)
- two-stage exchange (2)
- .................................................................... (1)
- 2',7'-dichlorofluorescin (1)
- 3D models (1)
- 3D organoids (1)
- 3D printing (1)
- ACL (1)
- ADAMTS (1)
- ALPL (1)
- Acute osteomyelitis (1)
- Adenovirus (1)
- Adipogenesis (1)
- Adipozyten (1)
- Anatomic reattachment (1)
- Angiopoietin-like 4 (1)
- Apoptose (1)
- Apoptosis (1)
- Aseptic loosening (1)
- Biofabrication (1)
- Biomechanik (1)
- Bioreaktor (1)
- Bisphosphonates (1)
- Bone Mineral Density (1)
- Bone disease (1)
- Bone marrow stromal cell (BMSC) (1)
- Bone tumor (1)
- Breast cancer cells (1)
- CCN-proteins (1)
- CCN1 (1)
- COVID-19 (1)
- CT (1)
- CYP24A1 (1)
- CYR61 (1)
- Cartilage (1)
- Cartilage regeneration (1)
- Case report (1)
- Caspase 3/7 activity (1)
- Cell viability, (1)
- Chondrogenese (1)
- Chondrogenesis (1)
- Chondrosarcoma (1)
- Copal\(^®\) spacem (1)
- Desmoplastic fibroma (1)
- Differentiation (1)
- Distal biceps tendon repair (1)
- Dysplasie (1)
- ECM remodeling (1)
- EQ-5D (1)
- ER signaling (1)
- Elderly patients (1)
- Endothel (1)
- Endothelial growth-factor (1)
- Extrazelluläre Matrix (1)
- Fettzelle (1)
- Fibroblastenwachstumsfaktor (1)
- GDF-5 (1)
- Galectin 1 (1)
- Galectine (1)
- Gelenkknorpel (1)
- Gene expression profiling (1)
- Gene therapy (1)
- Gentherpie (1)
- Glycocalyx (1)
- Glykobiologie (1)
- Glykokalyx (1)
- HIP osteoarthritis (1)
- Haematogenous (1)
- Hip joint (1)
- Hueter interval (1)
- Hydrogel (1)
- Hypertrophy (1)
- Hypophosphatasia (1)
- Hypophosphatemia (1)
- ICM (1)
- ICRS (1)
- IDSA (1)
- IL1RA (1)
- Immunodeficiency (1)
- Interleukin (1)
- Joint capsule (1)
- KOOS (1)
- Knee (1)
- Knieschmerzen (1)
- Kollagen-Hydrogel (1)
- Kreuzband (1)
- Ligamentum capitis femoris (1)
- Long bones (1)
- Lower extremity reconstruction (1)
- MPFL (1)
- MR neurography (1)
- MRI (1)
- MSIS (1)
- Mechanical strain (1)
- Mesenchymal Stem Cells (1)
- Mesenchymal stem cell (1)
- Mesenchymal stem/stromal cells (1)
- Mesenchymale Stammzelle (1)
- Metabolic Glycoengineering (1)
- Metaplasie (1)
- Muscle (1)
- NMR-Bildgebung (1)
- Non-simultaneous bilateral distal biceps tendon rupture (1)
- Novobiocin (1)
- Osteoarthritis (1)
- Osteoblasten (1)
- Osteogenesis (1)
- Osteogenic precursor cells (1)
- Osteomyelitis of the humerus (1)
- Osteoporose (1)
- Osteoporosis (1)
- Oxford knee score (1)
- PA-flexed view (1)
- PCL retention (1)
- PMMA (1)
- PMMA bone cement (1)
- PPD (1)
- PROM (1)
- Paprosky (1)
- Pedicled perforator flap (1)
- Probenecid (1)
- Propeller flap (1)
- Pycnogenol (1)
- Qi gong (1)
- R57A (1)
- RNAi (1)
- RT-PCR (1)
- Radiographs (1)
- Resistance training (1)
- SIRT1 (1)
- SOX9 (1)
- Sarcopenia (1)
- Scherstress (1)
- Sehne (1)
- Shear Stress (1)
- Soft-tissue sarcoma (1)
- Spinal Orthosis (1)
- Splicing (1)
- Staphylococcus aureus / drug effects (1)
- Suprascapular nerve (1)
- Suture anchor (1)
- Synovial Fluid Aspiration (1)
- Tissue engineering (1)
- Total knee arthroplasty (1)
- Transdifferenzierung (1)
- VDR (1)
- Valgus osteoarthritis (1)
- Vancomycin / administration & dosage (1)
- Vancomycin / chemistry (1)
- Vancomycin / pharmacology (1)
- View (1)
- WBC (1)
- WISP1/CCN4 (1)
- WISP3 (1)
- WNT pathway (1)
- WNT signaling pathway (1)
- WNT5A (1)
- Werk (1)
- Whole Body Vibration (1)
- Wnt (1)
- Wnt signalling (1)
- Wnt-signalling (1)
- Wnt/β-catenin signaling (1)
- Zell-basierte Therapie (1)
- Zellmarkierung (1)
- accelerometer (1)
- accuracy (1)
- acetabular bone defect (1)
- additive manufacturing (1)
- adipogenic differentiation (1)
- adult stem cells (1)
- age (1)
- age-related osteoporosis (1)
- aging (1)
- alendronate (1)
- algorithm (1)
- alkaline-phosphatase (1)
- allografts (1)
- alpha (1)
- anatomic center of rotation (1)
- anatomical landmark (1)
- anatomy (1)
- angiogenic cytokines (1)
- ankle (1)
- anterior approach (1)
- anti-bacterial agents / administration & dosage (1)
- anti-bacterial agents / chemistry (1)
- anti-bacterial agents / pharmacology (1)
- antibiotic elution (1)
- apatite nanoparticles (1)
- approach (1)
- arthroplasty (1)
- arthroscopic simulator training (1)
- artifact (1)
- aseptic loosening (1)
- asfotase alfa (1)
- assistive devices (1)
- asymmetric implant (1)
- autograft (1)
- autologous chondrocyte implantation (1)
- autophagy (1)
- autosomal-dominant osteopetrosis (1)
- axial alignment (1)
- benige tumor (1)
- benign bone tumor (1)
- bi-compartmental (1)
- bi-compartmental knee arthoplasty (1)
- biceps tendinitis (1)
- biceps tendon (1)
- biocompatible Materials (1)
- biodegradable polymers (1)
- biomarkers Myelomas (1)
- biomolecular processes (1)
- bioreactor (1)
- bisphenol A (1)
- bisphosphonates (1)
- bone QCT (1)
- bone biology (1)
- bone cement (1)
- bone colonization (1)
- bone formation (1)
- bone fractures (1)
- bone imaging (1)
- bone loss (1)
- bone marrow edema (1)
- bone marrow lesion/edema (1)
- bone marrow mesenchymal stromal cells (BM-MSCs) (1)
- bone model (1)
- bone morphology (1)
- bone regeneration (1)
- bone remodeling (1)
- bone tissue engineering (1)
- bone tumour (1)
- bone turnover (1)
- bone wires (1)
- calcaneus (1)
- calcification (1)
- calcium phosphate (1)
- cancer microenvironment (1)
- cardiovascular (1)
- cartilage defect (1)
- cartilage defects (1)
- case report (1)
- cell death (1)
- cell labeling (1)
- cell proliferation (1)
- cell-based therapies (1)
- cell-based therapy (1)
- cell-free therapeutics (1)
- cell-matrix interaction (1)
- cells (1)
- cellular origin (1)
- cellular signalling networks (1)
- chondral defect (1)
- chondrogenic differentiation (1)
- chondrogenic hypertrophy (1)
- cisplatin resistance (1)
- click chemistry (1)
- clinical outcome (1)
- collagen (1)
- collagen hydrogel (1)
- collarless (1)
- colony-stimulating factor (1)
- community-dwelling (1)
- compression syndrome (1)
- compressive load (1)
- compressive strength (1)
- computer modelling (1)
- computer navigation (1)
- conforming (1)
- congruency (1)
- consensus (1)
- contact (1)
- coracohumeral distance (1)
- coracohumeral impingement (1)
- core depression (1)
- correlation (1)
- craniosynostosis (1)
- cultures (1)
- curettage (1)
- custom made implant (1)
- custom-made implant (1)
- cutibacteria (1)
- database (1)
- decellularization (1)
- defects (1)
- dental status (1)
- dermal fibroblasts (1)
- dexamethasone (1)
- differentiation capacity (1)
- distal fixation (1)
- drain (1)
- drug liberation (1)
- dual-room trauma suite (1)
- dynamometer (1)
- dyskinesia (1)
- early stage (1)
- efficiency (1)
- elution (1)
- endochondral ossification (1)
- endocrine disruption (1)
- endoprothesis (1)
- endothelial progenitor cells (1)
- engineering (1)
- entrapment, traction (1)
- epidermal growth factor (1)
- epithelial-mesenchymal transition (1)
- etiology (1)
- exosomes (1)
- expression (1)
- extracellular vesicles (EVs) (1)
- failed hemiarthroplasty (1)
- failure (1)
- failure load (1)
- fast track rehabilitation (1)
- fast-track-concepts (1)
- femoral head (1)
- femoral revision (1)
- femur (1)
- fibrin (1)
- fixation (1)
- fluid simulation (1)
- fluorescence microscopy (1)
- fluorescent dyes (1)
- foamy virus (1)
- foot (1)
- force (1)
- forgotten joint score (1)
- fracture risk (1)
- fractures (1)
- gait (1)
- gene (1)
- gene constructs (1)
- gene-expression (1)
- genetherapy (1)
- genetics (1)
- gentamicin-loaded poly (methyl methacrylate) bone cement (1)
- geometry (1)
- germanophone (1)
- glycocalyx (1)
- grading system of chondral defects (1)
- growth factor (1)
- gyroscope (1)
- hMSC-TERT (1)
- hMSCs (1)
- haemoglobin (1)
- hand dominance (1)
- handball (1)
- head and neck squamous cell carcinoma (1)
- health-related quality of life (1)
- hematoma (1)
- high tibial osteotomy (1)
- high tibial valgus osteotomy (1)
- high-bone-mass (1)
- hip fracture (1)
- hip joint (1)
- hip replacement (1)
- homeostasis (1)
- human atherosclerotic lesions (1)
- human mesenchymal stem cell (1)
- human movement (1)
- human prostate-cancer (1)
- human trabecular bone decellularization (1)
- humanized bone models (1)
- humanized xenograft model (1)
- hydrogels (1)
- hypovitaminosis D (1)
- iMP (1)
- iTotal (1)
- iliac crest (1)
- imaging (1)
- immunotherapy (1)
- impact (1)
- impaction bone grafting (1)
- implant design (1)
- implant fit (1)
- implant survival (1)
- in situ guided tissue regeneration (1)
- in situ hybridization (1)
- in vitro modeling (1)
- in vitro models (1)
- in vivo (1)
- in-vivo (1)
- inbound medical tourism (1)
- inflammatory gene (1)
- infliximab (1)
- injury (1)
- injury prevention (1)
- inpatient rehabilitation (1)
- insert (1)
- interleukin (1)
- interleukin 1 receptor antagonist (1)
- interstage aspiration (1)
- joint infection (1)
- junction (1)
- kinematic analysis (1)
- knee alignment (1)
- knee axis (1)
- knee joint (1)
- knee rotator cuff (1)
- lateral process of the talus (1)
- lateral trochlear undercoverage (1)
- learning curve (1)
- leucocyte count (1)
- level mechanical vibrations (1)
- level of evidence III (1)
- lines (1)
- long head of biceps tendon (1)
- low back pain (1)
- lower extremity (1)
- lower extremity amputation (1)
- magnesium (1)
- major amputation (1)
- malignancy (1)
- malnourishment (1)
- maritime pine bark extract (1)
- marrow stromal cells (1)
- match load (1)
- materials testing (1)
- mayo stem (1)
- mechanical alignment (1)
- mechanical property (1)
- mechanical stimulation (1)
- mechanical torque measurement (1)
- mechanische Stimulation (1)
- mechanism (1)
- mechanosensing (1)
- mechanosensitive reporter (1)
- medial patellofemoral ligament (1)
- medial pivot (1)
- medial stabilized (1)
- medical collateral ligament (1)
- melt electrospinning (1)
- men (1)
- mesenchymal cells (1)
- mesenchymal stem-cells (1)
- mesenchymal stromal cell (1)
- mesenchymal tissues (1)
- metaanalysis (1)
- metabolic glycoengineering (1)
- metabolic risk (1)
- metabolic syndrome (1)
- micro-CT (1)
- micro-computed tomography (1)
- micro-traumatic (1)
- microbiological culture (1)
- microenvironment (1)
- microstructures (1)
- mineraliztion (1)
- minimal invasive surgery (1)
- minimally invasive (1)
- minimally invasive surgery (1)
- minimally-invasive (1)
- minor amputation (1)
- modified monosaccharides (1)
- modular (1)
- monoclonial gammopathy (1)
- mouse model (1)
- movable sliding gantry (1)
- multicomponent stretching (1)
- multimodal pain management (1)
- multiple myeloma Lesions (1)
- muscle injury (1)
- muscle strength (1)
- musculoskeletal diseases (1)
- musculoskeletal sarcoma (1)
- mutant mice (1)
- mutations (1)
- myeloma (1)
- myeloma cells (1)
- myokines (1)
- nanostructures (1)
- nerve compression (1)
- neurolysis (1)
- neuropathy (1)
- neurotransmission (1)
- niche (1)
- non-contact´ (1)
- nonspecific alkaline-phosphae (1)
- nutritional status (1)
- obesity (1)
- older people (1)
- open surgical repair (1)
- orthopaedic surgery (1)
- orthopaedics (1)
- orthopedic surgery (1)
- orthopedics (1)
- osteoblastic cells (1)
- osteoblasts (1)
- osteochondral allografts (1)
- osteoclasts (1)
- osteogenesis imperfecta (1)
- osteogenic potential (1)
- osteokines adaptation (1)
- osteomalacia (1)
- osteopenia (1)
- osteoprogenitor cells (1)
- osteotropism (1)
- outcome (1)
- ovariectomized rats (1)
- ovariectomy (1)
- overview (1)
- oxidative stress (1)
- oxygen tension (1)
- pain (1)
- pain generator (1)
- pandemic (1)
- parathyroid-hormone (1)
- partial knee arthroplasty (1)
- patella alta (1)
- patella dislocation (1)
- patella instability (1)
- patellofemoral relationship (1)
- patient blood management (1)
- patient reported outcome measures (1)
- patient specific implant (1)
- patient-specific implant (1)
- patient-specific instruments (1)
- patient-specific knee arthroplasty (1)
- pellet culture (1)
- pelvic discontinuity (1)
- people (1)
- perforator (1)
- perfusion bioreactor (1)
- pericytes (1)
- periodontal disease (1)
- perioperative management (1)
- peripheral nerve (1)
- peripheral-blood (1)
- persistence (1)
- personalised orthopaedic implantation (1)
- perspectives (1)
- physical therapy (1)
- plasticity (1)
- platelet-rich plasma (1)
- polymethylmethacrylate (1)
- porous-coated stems (1)
- posterior cruciate ligament (1)
- posterior tibial slope (1)
- postoperative rehabilitation (1)
- precedes multiple-myeloma (1)
- prevalent fractures (1)
- progenitor cells (1)
- proliferation (1)
- promotes (1)
- prostheses and implants (1)
- prosthetic design (1)
- prothesis (1)
- proximal humerus (1)
- pseudofracture (1)
- pseudofractures (1)
- qPCR (1)
- rare bone disease (1)
- rare bone tumor (1)
- real-world evidence (1)
- receptor beta (1)
- receptor related protein (1)
- reerse shoulder arthoplasty (1)
- regeneration (1)
- regenerative capacity (1)
- regenerative medicine (1)
- regenerative potential (1)
- regional transient osteoporosis (1)
- register (1)
- rehabilitation (1)
- repair (1)
- replacement therapy (1)
- replicative senescence (1)
- resistance exercise (1)
- responsiveness (1)
- revision hip (1)
- rickets (1)
- robotic (1)
- rotator cuff tear (1)
- sanders (1)
- scaffold (1)
- scaffold-free (1)
- scapula alata (1)
- scapular winging (1)
- scientific publications (1)
- scoping review (1)
- screw (1)
- segmental collapse (1)
- senescence‐associated secretory phenotype (1)
- septic (1)
- serratus anterior (1)
- serum (1)
- serum amyloid A (1)
- shRNA (1)
- shape (1)
- shear stress (1)
- sheep model (1)
- short hip stem (1)
- shoulder (1)
- shoulder arthroplasty (1)
- shoulder infection (1)
- shoulder injuries (1)
- shoulder neurolysis (1)
- shoulder pain (1)
- signaling (1)
- skeletal metastases (1)
- skeletal overexpression (1)
- skeletal progenitor cells (1)
- slope (1)
- snowboarder's ankle (1)
- snowboarder's fracture (1)
- spherical (1)
- sports medicine (1)
- sports therapy (1)
- stem cell niche (1)
- stem-cell niche (1)
- stimulation (1)
- subscapularis tear (1)
- superparamagnetic iron oxide particles (1)
- superparamagnetische Eisenoxidnanopartikel (1)
- suprascapular notch (1)
- surgery (1)
- sutures (1)
- synovial fluid (1)
- systems (1)
- tapered stem (1)
- teeth (1)
- tendon (1)
- tendon tissue engineering (1)
- tendon-derived stem cell (1)
- tenogenic differentiation (1)
- therapy (1)
- three-point bending (1)
- tibial rotation (1)
- tissue regeneration (1)
- toll-like receptor (1)
- tooth loss (1)
- total HIP-arthroplasty (1)
- toxicity (1)
- trabecular bone (1)
- transcription factors (1)
- transdifferentiation (1)
- transgluteal approach (1)
- translational research (1)
- transplantation (1)
- triangle method (1)
- tricompartmental knee osteoarthritis (1)
- trochlear dysplasia (1)
- tumor necrosis factor alpha (1)
- tumour malignancy (1)
- two stage (1)
- undetermined significance (1)
- unicompartmental knee arthroplasty (1)
- upper extremity (1)
- variation (1)
- vertebral body (1)
- vertebral fractures (1)
- vertebrate (1)
- virus vectors (1)
- vitamin C (1)
- vitamin D deficiency (1)
- vitamin D receptor (1)
- vitamin D3 (cholecalciferol, VD3) (1)
- vitamin-D-receptor (1)
- water sports (1)
- weight bearing line (1)
- white blood cell count (1)
- whole body vibration (1)
- whole-body electromyostimulation (1)
- whole-body vibration (1)
- wound fluid (1)
- zebrafish (1)
- zoledronic acid (1)
- β1 integrin (1)
Institut
- Lehrstuhl für Orthopädie (161) (entfernen)
Sonstige beteiligte Institutionen
Purpose
Hypertrophic cartilage is an important characteristic of osteoarthritis and can often be found in patients suffering from osteoarthritis. Although the exact pathomechanism remains poorly understood, hypertrophic de-differentiation of chondrocytes also poses a major challenge in the cell-based repair of hyaline cartilage using mesenchymal stromal cells (MSCs). While different members of the transforming growth factor beta (TGF-β) family have been shown to promote chondrogenesis in MSCs, the transition into a hypertrophic phenotype remains a problem. To further examine this topic we compared the effects of the transcription growth and differentiation factor 5 (GDF-5) and the mutant R57A on in vitro chondrogenesis in MSCs.
Methods
Bone marrow-derived MSCs (BMSCs) were placed in pellet culture and in-cubated in chondrogenic differentiation medium containing R57A, GDF-5 and TGF-ß1 for 21 days. Chondrogenesis was examined histologically, immunohistochemically, through biochemical assays and by RT-qPCR regarding the expression of chondrogenic marker genes.
Results
Treatment of BMSCs with R57A led to a dose dependent induction of chondrogenesis in BMSCs. Biochemical assays also showed an elevated glycosaminoglycan (GAG) content and expression of chondrogenic marker genes in corresponding pellets. While treatment with R57A led to superior chondrogenic differentiation compared to treatment with the GDF-5 wild type and similar levels compared to incubation with TGF-ß1, levels of chondrogenic hypertrophy were lower after induction with R57A and the GDF-5 wild type.
Conclusions
R57A is a stronger inducer of chondrogenesis in BMSCs than the GDF-5 wild type while leading to lower levels of chondrogenic hypertrophy in comparison with TGF-ß1.
The AMADEUS score is not a sufficient predictor for functional outcome after high tibial osteotomy
(2023)
Purpose
The Area Measurement And Depth Underlying Structures (AMADEUS) classification system has been proposed as a valuable tool for magnetic resonance (MR)-based grading of preoperatively encountered chondral defects of the knee joint. However, the potential relationship of this novel score with clinical data was yet to determine. It was the primary intention of this study to assess the correlative relationship of the AMADEUS with patient reported outcome scores in patients undergoing medial open-wedge high tibial valgus osteotomy (HTO). Furthermore, the arthroscopic ICRS (International Cartilage Repair Society) grade evaluation was tested for correlation with the AMADEUS classification system.
Methods
This retrospective, monocentric study found a total of 70 individuals that were indicated for HTO due to degenerative chondral defects of the medial compartment between 2008 and 2019. A preoperative MR image as well as a pre-osteotomy diagnostic arthroscopy for ICRS grade evaluation was mandatory for all patients. The Knee Osteoarthritis Outcome Score (KOOS) including its five subscale scores (KOOS-ADL, KOOS-QOL, KOOS-Sports, KOOS-Pain, KOOS-Symptoms) was obtained preoperatively and at a mean follow-up of 41.2 ± 26.3 months. Preoperative chondral defects were evaluated using the AMADEUS classification system and the final AMADEUS scores were correlated with the pre- and postoperative KOOS subscale sores. Furthermore, arthroscopic ICRS defect severity was correlated with the AMADEUS classification system.
Results
There was a statistically significant correlation between the AMADEUS BME (bone marrow edema) subscore and the KOOS Symptoms subscore at the preoperative visit (r = 0.25, p = 0.04). No statistically significant monotonic association between the AMADEUS total score and the AMADEUS grade with pre- and postoperative KOOS subscale scores were found. Intraoperatively obtained ICRS grade did reveal a moderate correlative relation with the AMADEUS total score and the AMADEUS grade (r = 0.28, p = 0.02).
Conclusions
The novel AMADEUS classification system largely lacks correlative capacity with patient reported outcome measures in patients undergoing HTO. The MR tomographic appearance of bone marrow edema is the only parameter predictive of the clinical outcome at the preoperative visit.
The treatment landscape in multiple myeloma (MM) is shifting from genotoxic drugs to immunotherapies. Monoclonal antibodies, immunoconjugates, T-cell engaging antibodies and CART cells have been incorporated into routine treatment algorithms, resulting in improved response rates. Nevertheless, patients continue to relapse and the underlying mechanisms of resistance remain poorly understood. While Impaired death receptor signaling has been reported to mediate resistance to CART in acute lymphoblastic leukemia, this mechanism yet remains to be elucidated in context of novel immunotherapies for MM. Here, we describe impaired death receptor signaling as a novel mechanism of resistance to T-cell mediated immunotherapies in MM. This resistance seems exclusive to novel immunotherapies while sensitivity to conventional anti-tumor therapies being preserved in vitro. As a proof of concept, we present a confirmatory clinical case indicating that the FADD/BID axis is required for meaningful responses to novel immunotherapies thus we report impaired death receptor signaling as a novel resistance mechanism to T-cell mediated immunotherapy in MM.
Purpose
To compare the performance of the dominant and nondominant hand during fundamental arthroscopic simulator training.
Methods
Surgical trainees who participated in a 2-day simulator training course between 2021 and 2023 were classified, according to their arthroscopic experience in beginners and competents. Only right-handed individuals with complete data sets were included in the study. Ambidexterity was trained using a box trainer (Fundamentals of Arthroscopic Surgery Training, Virtamed AG, Schlieren, Switzerland).Two tasks, periscoping for learning camera guidance and triangulation for additional instrument handling, were performed 4 times with the camera in the dominant hand and then in the nondominant hand. For each task, exercise time, camera path length, and instrument path length were recorded and analyzed.
Results
Out of 94 participants 74 right-handed individuals (22 females, 52 males) were classified to novices (n = 43, less than 10 independently performed arthroscopies) and competents (n = 31, more than 10 independently performed arthroscopies). Competents performed significantly better than novices. No significant difference was found after changing the guiding hand for the camera from the dominant to the nondominant hand regarding the camera path length and the instrument path length. Notably, tasks were performed even faster when using the camera in the nondominant hand.
Conclusions
Our data demonstrate that the learned manual skills during basic arthroscopic training are quickly transferred to the contralateral side. In consequence, additional fundamental skills training for camera guidance and instrument handling of the nondominant hand are not necessary.
Clinical Relevance
For skillful arthroscopy, camera guidance and instrument handing must be equally mastered with both hands. It is important to understand how hand dominance may affect learning during arthroscopic simulator training.
The pro-inflammatory phase of bone healing, initiated by platelet activation and eventually hematoma formation, impacts bone marrow mesenchymal stromal cells (MSCs) in unknown ways. Here, we created platelet-rich plasma (PRP) hydrogels to study how platelet-derived factors modulate functional properties of encapsulated MSCs in comparison to a non-inflammatory fibrin (FBR) hydrogel environment. MSCs were isolated from human bone marrow, while PRP was collected from pooled apheresis thrombocyte concentrates and used for hydrogel preparation. After their encapsulation in hydrogels for 72 h, retrieved MSCs were analyzed for immunomodulatory activities, apoptosis, stem cell properties, senescence, CD9\(^+\), CD63\(^+\) and CD81\(^+\) extracellular vesicle (EV) release, and metabolism-related changes. PRP-hydrogels stimulated immunosuppressive functions of MSCs, along with their upregulated susceptibility to cell death in communication with PBMCs and augmented caspase 3/7 activity. We found impaired clonal growth and cell cycle progression, and more pronounced β-galactosidase activity as well as accumulation of LC3-II-positive vacuoles in PRP-MSCs. Stimuli derived from PRP-hydrogels upregulated AKT and reduced mTOR phosphorylation in MSCs, which suggests an initiation of survival-related processes. Our results showed that PRP-hydrogels might represent a metabolically stressful environment, inducing acidification of MSCs, reducing polarization of the mitochondrial membrane and increasing lipid accumulation. These features were not detected in FBR-MSCs, which showed reduced CD63\(^+\) and CD81\(^+\) EV production and maintained clonogenicity. Our data revealed that PRP-derived hematoma components cause metabolic adaptation of MSCs followed by increased immune regulatory functions. For the first time, we showed that PRP stimuli represent a survival challenge and “apoptotic priming” that are detrimental for stem cell-like growth of MSCs and important for their therapeutic consideration.
Lower limb bone geometry in adult individuals with X-linked hypophosphatemia: an observational study
(2022)
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.
In total knee arthroplasty (TKA), functional knee phenotypes are of interest regarding surgical alignment strategies. Functional knee phenotypes were introduced in 2019 and consist of limb, femoral, and tibial phenotypes. The hypothesis of this study was that mechanically aligned (MA) TKA changes preoperative functional phenotypes, which decreases the 1-year Forgotten Joint (FJS) and Oxford Knee Score (OKS) and increases the 1-year WOMAC. All patients included in this study had end-stage osteoarthritis and were treated with a primary MA TKA, which was supervised by four academic knee arthroplasty specialists. To determine the limb, femoral, and tibial phenotype, a long-leg radiograph (LLR) was imaged preoperatively and two to three days after TKA. FJS, OKS, and WOMAC were obtained 1 year after TKA. Patients were categorized using the change in functional limb, femoral, and tibial phenotype measured on LLR, and the scores were compared between the different categories. A complete dataset of preoperative and postoperative scores and radiographic images could be obtained for 59 patients. 42% of these patients had a change of limb phenotype, 41% a change of femoral phenotype, and 24% a change of tibial phenotype of more than ±1 relative to the preoperative phenotype. Patients with more than ±1 change of limb phenotype had significantly lower median FJS (27 points) and OKS (31 points) and higher WOMAC scores (30 points) relative to the 59-, 41-, and 4-point scores of those with a 0 ± 1 change (p < 0.0001 to 0.0048). Patients with a more than ±1 change of femoral phenotype had significantly lower median FJS (28 points) and OKS (32 points) and higher WOMAC scores (24 points) relative to the 69-, 40-, and 8-point scores of those with a 0 ± 1 change (p < 0.0001). A change in tibial phenotype had no effect on the FJS, OKS, and WOMAC scores. Surgeons performing MA TKA could consider limiting coronal alignment corrections of the limb and femoral joint line to within one phenotype to reduce the risk of low patient-reported satisfaction and function at 1-year.
Unicompartmental knee arthroplasty (UKA) in isolated medial or lateral osteoarthritis leads to good clinical results. However, revision rates are higher in comparison to total knee arthroplasty (TKA). One reason is suboptimal fitting of conventional off-the-shelf prostheses, and major overhang of the tibial component over the bone has been reported in up to 20% of cases. In this retrospective study, a total of 537 patient-specific UKAs (507 medial prostheses and 30 lateral prostheses) that had been implanted in 3 centers over a period of 10 years were analyzed for survival, with a minimal follow-up of 1 year (range 12 to 129 months). Furthermore, fitting of the UKAs was analyzed on postoperative X-rays, and tibial overhang was quantified. A total of 512 prostheses were available for follow-up (95.3%). Overall survival rate (medial and lateral) of the prostheses after 5 years was 96%. The 30 lateral UKAs showed a survival rate of 100% at 5 years. The tibial overhang of the prosthesis was smaller than 1 mm in 99% of cases. In comparison to the reported results in the literature, our data suggest that the patient-specific implant design used in this study is associated with an excellent midterm survival rate, particularly in the lateral knee compartment, and confirms excellent fitting.
Background
The aim of this study was to review the patient rated outcome (PROM) of surgically treated fractures to the lateral process of the talus (LPTF) and identify factors influencing the outcome.
Methods
Retrospective study with a current follow-up. Eligible were all patients treated surgically for a LPTF (n = 23) with a minimum follow-up of one year. Demographics, medical history, trauma mechanism, fracture characteristics, concomitant injuries, treatment details, complications, return to work and sports were assessed retrospectively. The current follow-up included the VAS FA, Karlsson Score, and SF-12. The primary outcome was the VAS FA. Secondary aim was the identification of parameters influencing the PROMs.
Results
22 patients (96% follow-up) with a mean age of 32 ± 9 (18 to 49) years were included. 73% suffered a Hawkins Type 1, 23% a Type 2, and one patient a Type 3 fracture. 82% suffered concomitant injuries. 9% suffered minor surgical side infections, 50% developed symptomatic subtalar osteoarthritis. At final follow-up (44 ± 2 (12 to 97) months), the mean VAS FA Overall was 77 ± 21 (20 to 100), the Karlsson Score 72 ± 21 (34 to 97), and for the SF 12 the PCS 53 ± 8 (36 to 64) and the MCS 53 ± 7 (32 to 63). 50% of patients returned to their previous level of sports. Hawkins Type 1 fractures resulted in better VAS FA Overall score than Type 2 fractures. Posttraumatic subtalar osteoarthritis was the independent factor associated to a poor patient rated outcome (VAS FA, Karlsson Score).
Conclusion
After a follow-up of over 3.5 years, surgically treated LPTF resulted in only moderate results. 50% suffered posttraumatic symptomatic subtalar osteoarthritis, which was the primary independent parameter for a poor outcome following LPTF.
Level of evidence
Level III.