Refine
Has Fulltext
- yes (151)
Is part of the Bibliography
- yes (151)
Year of publication
Document Type
- Journal article (151) (remove)
Keywords
- total knee arthroplasty (11)
- osteoporosis (9)
- kinematic alignment (8)
- hypophosphatasia (7)
- osteoarthritis (7)
- tissue engineering (6)
- bone (5)
- bone mineral density (4)
- cartilage (4)
- fracture (4)
- knee (4)
- mechanotransduction (4)
- periprosthetic infection (4)
- revision (4)
- sarcopenia (4)
- total knee replacement (4)
- MSCs (3)
- Medizin (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)
- Germany (2)
- HPP (2)
- LMHFV (2)
- MSC (2)
- Mesenchymal stem cells (2)
- Multiple myeloma (2)
- TKA (2)
- TNAP (2)
- alkaline phosphatase (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)
- chondrocytes (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 stem cells (2)
- mesenchymal stromal cells (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)
- total joint arthroplasty (2)
- training (2)
- two-stage exchange (2)
- 2',7'-dichlorofluorescin (1)
- 3D models (1)
- 3D organoids (1)
- 3D printing (1)
- ADAMTS (1)
- ALPL (1)
- Acute osteomyelitis (1)
- Adenovirus (1)
- Anatomic reattachment (1)
- Angiopoietin-like 4 (1)
- Aseptic loosening (1)
- Bioreaktor (1)
- Bisphosphonates (1)
- Bone Mineral Density (1)
- Bone disease (1)
- Bone tumor (1)
- Breast cancer cells (1)
- CCN1 (1)
- COVID-19 (1)
- CT (1)
- CYP24A1 (1)
- Cartilage (1)
- Cartilage regeneration (1)
- Case report (1)
- Caspase 3/7 activity (1)
- Cell viability, (1)
- Chondrogenesis (1)
- Chondrosarcoma (1)
- Copal\(^®\) spacem (1)
- Desmoplastic fibroma (1)
- Distal biceps tendon repair (1)
- ECM remodeling (1)
- EQ-5D (1)
- ER signaling (1)
- Elderly patients (1)
- Endothelial growth-factor (1)
- Fraktur (1)
- GDF-5 (1)
- Gene expression profiling (1)
- Gene therapy (1)
- Glenohumeralgelenk (1)
- HIP osteoarthritis (1)
- Haematogenous (1)
- Hip joint (1)
- Hueter interval (1)
- Hypertrophy (1)
- Hypophosphatasia (1)
- ICM (1)
- ICRS (1)
- IDSA (1)
- IL1RA (1)
- Immunodeficiency (1)
- Interleukin (1)
- Joint capsule (1)
- KOOS (1)
- Knee (1)
- Knieschmerzen (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 cell (1)
- Mesenchymal stem/stromal cells (1)
- Non-simultaneous bilateral distal biceps tendon rupture (1)
- Novobiocin (1)
- Osteoarthritis (1)
- Osteogenic precursor cells (1)
- Osteomyelitis of the humerus (1)
- Osteoporose (1)
- Osteoporosis (1)
- Osteosynthese (1)
- Oxford knee score (1)
- PA-flexed view (1)
- PCL retention (1)
- PMMA (1)
- PMMA bone cement (1)
- PROM (1)
- Paprosky (1)
- Pedicled perforator flap (1)
- Probenecid (1)
- Propeller flap (1)
- Pycnogenol (1)
- Qi gong (1)
- R57A (1)
- RT-PCR (1)
- Radiographs (1)
- Resistance training (1)
- SIRT1 (1)
- SOX9 (1)
- Sarcopenia (1)
- Schulterendoprothetik (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)
- VDR (1)
- Valgus osteoarthritis (1)
- Vancomycin / administration & dosage (1)
- Vancomycin / chemistry (1)
- Vancomycin / pharmacology (1)
- View (1)
- WBC (1)
- WNT pathway (1)
- WNT signaling pathway (1)
- WNT5A (1)
- Whole Body Vibration (1)
- Wnt (1)
- Wnt signalling (1)
- Wnt-signalling (1)
- Wnt/β-catenin signaling (1)
- XLH (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)
- apoptosis (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 proliferation (1)
- cell-based therapies (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)
- 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)
- 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)
- 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 torque measurement (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)
- 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 Komplikationen (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)
- 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)
- suprascapular notch (1)
- surgery (1)
- sutures (1)
- synovial fluid (1)
- systems (1)
- tapered stem (1)
- teeth (1)
- tendon tissue engineering (1)
- tendon-derived stem cell (1)
- tenogenic differentiation (1)
- therapy (1)
- three-point bending (1)
- tibial rotation (1)
- tissue (1)
- tissue regeneration (1)
- toll-like receptor (1)
- tooth loss (1)
- total HIP-arthroplasty (1)
- toxicity (1)
- trabecular bone (1)
- transcription factors (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)
Institute
- Lehrstuhl für Orthopädie (151) (remove)
Sonstige beteiligte Institutionen
Background:
Sarcopenic obesity (SO) is characterized by a combination of low muscle and high fat mass with an additive negative effect of both conditions on cardiometabolic risk. The aim of the study was to determine the effect of whole-body electromyostimulation (WB-EMS) on the metabolic syndrome (MetS) in community-dwelling women aged ≥70 years with SO.
Methods:
The study was conducted in an ambulatory university setting. Seventy-five community-dwelling women aged ≥70 years with SO living in Northern Bavaria, Germany, were randomly allocated to either 6 months of WB-EMS application with (WB-EMS&P) or without (WB-EMS) dietary supplementation (150 kcal/day, 56% protein) or a non-training control group (CG). WB-EMS included one session of 20 min (85 Hz, 350 µs, 4 s of strain–4 s of rest) per week with moderate-to-high intensity. The primary study endpoint was the MetS Z-score with the components waist circumference (WC), mean arterial pressure (MAP), triglycerides, fasting plasma glucose, and high-density lipoprotein cholesterol (HDL-C); secondary study endpoints were changes in these determining variables.
Results:
MetS Z-score decreased in both groups; however, changes compared with the CG were significant (P=0.001) in the WB-EMS&P group only. On analyzing the components of the MetS, significant positive effects for both WB-EMS groups (P≤0.038) were identified for MAP, while the WB-EMS group significantly differed for WC (P=0.036), and the WB-EMS&P group significantly differed for HDL-C (P=0.006) from the CG. No significant differences were observed between the WB-EMS groups.
Conclusion:
The study clearly confirms the favorable effect of WB-EMS application on the MetS in community-dwelling women aged ≥70 years with SO. However, protein-enriched supplements did not increase effects of WB-EMS alone. In summary, we considered this novel technology an effective and safe method to prevent cardiometabolic risk factors and diseases in older women unable or unwilling to exercise conventionally.
Background and purpose - Due to the relative lack of reports on the medium- to long-term clinical and radiographic results of modular femoral cementless revision, we conducted this study to evaluate the medium- to long-term results of uncemented femoral stem revisions using the modular MRP-TITAN stem with distal diaphyseal fixation in a consecutive patient series.
Patients and methods - We retrospectively analyzed 163 femoral stem revisions performed between 1993 and 2001 with a mean follow-up of 10 (5-16) years. Clinical assessment included the Harris hip score (HHS) with reference to comorbidities and femoral defect sizes classified by Charnley and Paprosky. Intraoperative and postoperative complications were analyzed and the failure rate of the MRP stem for any reason was examined.
Results - Mean HHS improved up to the last follow-up (37 (SD 24) vs. 79 (SD 19); p < 0.001). 99 cases (61%) had extensive bone defects (Paprosky IIB-III). Radiographic evaluation showed stable stem anchorage in 151 cases (93%) at the last follow-up. 10 implants (6%) failed for various reasons. Neither a breakage of a stem nor loosening of the morse taper junction was recorded. Kaplan-Meier survival analysis revealed a 10-year survival probability of 97% (95% CI: 95-100).
Interpretation - This is one of the largest medium- to longterm analyses of cementless modular revision stems with distal diaphyseal anchorage. The modular MRP-TITAN was reliable, with a Kaplan-Meier survival probability of 97% at 10 years.
Background: We present a descriptive and retrospective analysis of revision total hip arthroplasties (THA) using the MRP-TITAN stem (Peter Brehm, Weisendorf, GER) with distal diaphyseal fixation and metaphyseal defect augmentation. Our hypothesis was that the metaphyseal defect augmentation (Impaction Bone Grafting) improves the stem survival.
Methods: We retrospectively analyzed the aggregated and anonymized data of 243 femoral stem revisions. 68 patients with 70 implants (28.8%) received an allograft augmentation for metaphyseal defects; 165 patients with 173 implants (71.2%) did not, and served as controls. The mean follow-up was 4.4 +/- 1.8 years (range, 2.1-9.6 years). There were no significant differences (p > 0.05) between the study and control group regarding age, body mass index (BMI), femoral defects (types I-III as described by Paprosky), and preoperative Harris Hip Score (HHS). Postoperative clinical function was evaluated using the HHS. Postoperative radiologic examination evaluated implant stability, axial implant migration, signs of implant loosening, periprosthetic radiolucencies, as well as bone regeneration and resorption.
Results: There were comparable rates of intraoperative and postoperative complications in the study and control groups (p > 0.05). Clinical function, expressed as the increase in the postoperative HHS over the preoperative score, showed significantly greater improvement in the group with Impaction Bone Grafting (35.6 +/- 14.3 vs. 30.8 +/- 15.8; p <= 0.05). The study group showed better outcome especially for larger defects (types II C and III as described by Paprosky) and stem diameters >= 17 mm. The two groups did not show significant differences in the rate of aseptic loosening (1.4% vs. 2.9%) and the rate of revisions (8.6% vs. 11%). The Kaplan-Meier survival for the MRP-TITAN stem in both groups together was 93.8% after 8.8 years. [Study group 95.7% after 8.54 years; control group 93.1% after 8.7 years]. Radiologic evaluation showed no significant change in axial implant migration (4.3% vs. 9.3%; p = 0.19) but a significant reduction in proximal stress shielding (5.7% vs. 17.9%; p < 0.05) in the study group. Periprosthetic radiolucencies were detected in 5.7% of the study group and in 9.8% of the control group (p = 0.30). Radiolucencies in the proximal zones 1 and 7 according to Gruen occurred significantly more often in the control group without allograft augmentation (p = 0.05).
Conclusion: We present the largest analysis of the impaction grafting technique in combination with cementless distal diaphyseal stem fixation published so far. Our data provides initial evidence of improved bone regeneration after graft augmentation of metaphyseal bone defects. The data suggests that proximal metaphyseal graft augmentation is beneficial for large metaphyseal bone defects (Paprosky types IIC and III) and stem diameters of 17 mm and above. Due to the limitations of a retrospective and descriptive study the level of evidence remains low and prospective trials should be conducted.
Background: Revision in failed shoulder arthroplasty often requires removal of the humeral component with a significant risk of fracture and bone loss. Newer modular systems allow conversion from anatomic to reverse shoulder arthroplasty with retention of a well-fixed humeral stem. We report on a prospectively evaluated series of conversions from hemiarthroplasty to reverse shoulder arthroplasty.
Methods: In 14 cases of failed hemiarthroplasty due to rotator cuff deficiency and painful pseudoparalysis (in 13 women), revision to reverse shoulder arthroplasty was performed between October 2006 and 2010, with retention of the humeral component using modular systems. Mean age at the time of operation was 70 (56-80) years. Pre- and postoperative evaluation followed a standardized protocol including Constant score, range of motion, and radiographic analysis. Mean follow-up time was 2.5 (2-5.5) years.
Results: Mean Constant score improved from 9 (2-16) to 41 (17-74) points. Mean lengthening of the arm was 2.6 (0.9-4.7) cm without any neurological complications. One patient required revision due to infection. Interpretation Modular systems allow retainment of a well-fixed humeral stem with good outcome. There is a risk of excessive humeral lengthening.
Purpose
Despite much improved preoperative planning techniques accurate intraoperative assessment of the high tibial valgus osteotomy (HTO) remains challenging and often results in coronal over- and under-corrections as well as unintended changes of the posterior tibial slope. Noyes et al. reported a novel method for accurate intraoperative coronal and sagittal alignment correction based on a three-dimensional mathematical model. This is the first study examining preliminary data via the proposed Noyes approach for accurate intraoperative coronal and sagittal alignment correction during HTO.
Methods
From 2016 to 2020 a total of 24 patients (27 knees) underwent HTO applying the proposed Noyes method (Noyes-Group). Radiographic data was analyzed retrospectively and matched to patients that underwent HTO using the conventional method, i.e., gradual medial opening using a bone spreader under fluoroscopic control (Conventional-Group). All operative procedures were performed by an experienced surgeon at a single orthopaedic university center.
Results
From the preoperative to the postoperative visit no statistically significant changes of the posterior tibial slope were noted in the Noyes-Group compared to a significant increase in the Conventional-Group (p = 0.01). Regarding the axial alignment no significant differences between both groups were observed pre- and postoperatively. The number of over- and under-corrections did not differ significantly between both groups. Linear regression analysis showed a significant correlation of the postoperative medial proximal tibial angle (MPTA) with the position of the weightbearing line on the tibial plateau.
Conclusion
The 3-triangle method by Noyes seems to be a promising approach for preservation of the posterior tibial slope during HTO.
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.
Objective
As native cartilage consists of different phenotypical zones, this study aims to fabricate different types of neocartilage constructs from collagen hydrogels and human mesenchymal stromal cells (MSCs) genetically modified to express different chondrogenic factors.
Design
Human MSCs derived from bone-marrow of osteoarthritis (OA) hips were genetically modified using adenoviral vectors encoding sex-determining region Y-type high-mobility-group-box (SOX)9,transforming growth factor beta (TGFB) 1or bone morphogenetic protein (BMP) 2cDNA, placed in type I collagen hydrogels and maintained in serum-free chondrogenic media for three weeks. Control constructs contained unmodified MSCs or MSCs expressing GFP. The respective constructs were analyzed histologically, immunohistochemically, biochemically, and by qRT-PCR for chondrogenesis and hypertrophy.
Results
Chondrogenesis in MSCs was consistently and strongly induced in collagen I hydrogels by the transgenesSOX9,TGFB1andBMP2as evidenced by positive staining for proteoglycans, chondroitin-4-sulfate (CS4) and collagen (COL) type II, increased levels of glycosaminoglycan (GAG) synthesis, and expression of mRNAs associated with chondrogenesis. The control groups were entirely non-chondrogenic. The levels of hypertrophy, as judged by expression of alkaline phosphatase (ALP) and COL X on both the protein and mRNA levels revealed different stages of hypertrophy within the chondrogenic groups (BMP2>TGFB1>SOX9).
Conclusions
Different types of neocartilage with varying levels of hypertrophy could be generated from human MSCs in collagen hydrogels by transfer of genes encoding the chondrogenic factorsSOX9,TGFB1andBMP2. This technology may be harnessed for regeneration of specific zones of native cartilage upon damage.
Background
Surgical reattachment of the tendon is still the gold standard for ruptures of the distal biceps brachii tendon. Several fixation techniques have been described in the literature, with suture anchors being one of the most common fixation techniques. Currently, there is no data available on how many anchors are required for a safe and stable refixation. In this case report clinical data of a patient with non-simultaneous bilateral distal biceps tendon ruptures treated with a different number of suture anchors for each side (one vs. two) are demonstrated.
Case presentation
A 47-year-old factory worker suffered a rupture of the distal biceps tendon on both arms following two different occasions. The left side was fixed using a single suture anchor, while refixation on the right side was performed with two anchors. The patient was prospectively followed for one year. Functional outcome was assessed using the Andrews Carson Score (ACS), the Oxford Elbow Score (OES), and the Disabilities of Arm, Shoulder and Hand (DASH) Score after six, twelve, 24 and 48 weeks. Furthermore, an isokinetic strength measurement for flexion strength was performed after 24 and 48 weeks. After 48 weeks the patient presented with excellent functional outcome scores and no follow-up complications. During the follow-up period, no differences in the functional scores nor in the isokinetic flexion strength measurement could be detected. Furthermore, no radiological complications (like heterotopic ossifications) could be detected in the postoperative radiographs after one year.
Conclusions
Anatomic reattachment of the distal biceps tendon is a successful operative treatment option for distal biceps tendon ruptures. Suture anchor fixation remains one of the most common techniques, as it allows fast surgery and provides good results with respect to range of motion (ROM) and functional scoring according to the current literature. However, the number of anchors required for a stable fixation remains unclear. As indicated by our presented case, we hypothesize, that there are no significant differences between a one-point or a two-point fixation. In the presented case report, no intraindividual differences between the usage of one versus two suture anchors were evident in the short-term follow-up.
Background
Mesenchymal stem cell (MSC) based-treatments of cartilage injury are promising but impaired by high levels of hypertrophy after chondrogenic induction with several bone morphogenetic protein superfamily members (BMPs). As an alternative, this study investigates the chondrogenic induction of MSCs via adenoviral gene-delivery of the transcription factor SOX9 alone or in combination with other inducers, and comparatively explores the levels of hypertrophy and end stage differentiation in a pellet culture system in vitro.
Methods
First generation adenoviral vectors encoding SOX9, TGFB1 or IGF1 were used alone or in combination to transduce human bone marrow-derived MSCs at 5 x 10\(^2\) infectious particles/cell. Thereafter cells were placed in aggregates and maintained for three weeks in chondrogenic medium. Transgene expression was determined at the protein level (ELISA/Western blot), and aggregates were analysed histologically, immunohistochemically, biochemically and by RT-PCR for chondrogenesis and hypertrophy.
Results
SOX9 cDNA was superior to that encoding TGFB1, the typical gold standard, as an inducer of chondrogenesis in primary MSCs as evidenced by improved lacuna formation, proteoglycan and collagen type II staining, increased levels of GAG synthesis, and expression of mRNAs associated with chondrogenesis. Moreover, SOX9 modified aggregates showed a markedly lower tendency to progress towards hypertrophy, as judged by expression of the hypertrophy markers alkaline phosphatase, and collagen type X at the mRNA and protein levels.
Conclusion
Adenoviral SOX9 gene transfer induces chondrogenic differentiation of human primary MSCs in pellet culture more effectively than TGFB1 gene transfer with lower levels of chondrocyte hypertrophy after 3 weeks of in vitro culture. Such technology might enable the formation of more stable hyaline cartilage repair tissues in vivo.
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.