Differences in Microorganism Profile in Periprosthetic Joint Infections of the Knee in Patients Affected by Chronic Kidney Disease.

Background: Periprosthetic joint infections (PJIs) are one of the most devastating complications of total knee arthroplasty (TKA). Patients who have chronic kidney disease (CKD) are more vulnerable to PJI. We aimed to answer the following questions: 1) What are the commonly observed pathogens in PJI after TKA in CKD patients, and do they differ from those in non-CKD patients? and 2) What are the risk factors for PJI after TKA in CKD patients?

Methods: Patients who underwent surgery due to a chronic PJI of the TKA were retrospectively enrolled.

Anatomical risk factors for aseptic loosening of full hinge knee prosthesis in primary and revision TKAs.

Introduction: Risk factors (RF) associated with aseptic loosening (AL) in total knee arthroplasty (TKA) are poorly understood. Therefore, the aim of this study was to investigate the anatomical shape variations in relation to the inner-diameter of the femur and the tibia as prognostic RF for AL of full hinge prosthesis (FHP) in primary and revision TKA.

Materials And Methods: We retrospectively examined all patients, who underwent revision surgery (2003-2018) due to AL of the FHP in primary (n = 38) and revision TKA (n = 46).

Effect of angular correction during posterior instrumentation of spinal fractures on postoperative outcomes and quality of life.

Background: Posterior instrumentation using pedicle screws and rods is the most commonly used technique for the treatment of thoracolumbar fractures of the spine. The procedure aims to restore the neurologic and biomechanical functions of the spine and allows for early mobilization and rapid reintegration into society. It is unclear whether the magnitude of correction has an effect on postoperative outcomes.

Correlation between EFAS- and MOCART score and clinical outcome after AMIC-procedure for osteochondral lesion of the talus.

Introduction: Even though an increased interest in the use of the EFAS Score (European Foot and Ankle Society) has been observed, no data comparing it with radiological findings has been presented in the literature. Accordingly, the aim of this study is to investigate how the post-operative integration of the AMIC (autologous matrix-induced chondrogenesis)-membrane for osteochondral lesion of the talus using the MOCART (Magnetic Resonance Observation of Cartilage Repair Tissue) - Score is related to the clinical satisfaction of the patients.

Material And Methods: A group of 24 patients aged between 17 and 63 (with a mean age of 35.

A Novel Device for Closed Reduction and Percutaneous Fixation of Thoracolumbar Fractures.

Background/aim: Open surgical reduction/fixation of thoracolumbar fractures results in significant soft-tissue trauma and related complications. Minimally-invasive technical developments could deliver similar radiological outcomes, while avoiding the related complications. We evaluated radiological and perioperative outcomes in thoracolumbar fractures by using a novel minimally-invasive device.

The Use of Computer Navigation and Patient Specific Instrumentation in Shoulder Arthroplasty: Everyday Practice, Just for Special Cases or Actually Teaching a Surgeon?

Background: The use of computer assisted surgery, navigation (NAV) in shoulder arthroplasty is still under discussion, regarding the clinical outcome and prosthesis longevity, especially when combining these factors with cost, time and surgeon's experience. Beside the NAV, there has been in use patient-specific instrumentation (PSI) as an additional tool for more precise glenoid implant position. Surgical NAV and PSI for glenoid implant positioning in anatomic and reverse total shoulder arthroplasty are in last years under observation and discussion.

Radiographic cortical thickness parameters as predictors of rotational alignment in proximal tibial shaft fractures: a cadaveric study.

Aim: The treatment of tibial fractures with an intramedullary nail is an established procedure. However, torsional control remains challenging using intraoperatively diagnostic tools. Radiographic tools such as the Cortical Step Sign (CSS) and the Diameter Difference Sign (DDS) may serve as tools for diagnosing a relevant malrotation.

Leukocyte Esterase and Glucose Reagent Test Can Rule in and Rule out Septic Arthritis.

Background/aim: Septic arthritis (SA) requires rapid diagnosis and therapy to avoid joint damage. This study evaluated the diagnostic accuracy of leukocyte esterase (LE) and glucose (GLC) strip tests for diagnosing SA.

Patients And Methods: Synovial fluids from 455 patients with atraumatic joint effusions were assessed prospectively over a 5-year period with LE and glucose strip tests.

A novel radiological classification system of the distal femur.

Introduction: In our previous studies, we were able to identify anatomical differences as a predictor for aseptic loosening following primary and revision surgery with the use of rotating hinge prosthesis. This study was performed to answer following question: can a novel radiological classification system of the distal femur be identified?

Materials And Methods: A total of 200 patients who received standardized anteroposterior (AP) and lateral views of the knee joint were included in this study. On AP radiographs, we measured the distance between inner diameter of the femur at 20 cm proximally from the knee and at a point 2 cm proximally from the adductor tubercle.

Intraoperative torsion control using the cortical step sign and diameter difference in tibial mid-shaft fractures.

Aim: Intramedullar nailing of tibial mid-shaft fractures is a common surgical treatment. Fracture reduction, however, remains challenging and maltorsion is a common discrepancy which aggravates functional impairment of gait and stability. The use of radiographic tools such as the cortical step sign (CSS) and the diameter difference sign (DDS) could improve fracture reduction.

Risk Factors for Aseptic Loosening After Total Knee Arthroplasty with a Rotating-Hinge Implant: A Case-Control Study.

Background: Successful results have been reported in association with the use of a rotating-hinge prosthesis for primary total knee arthroplasty (TKA). The objective of the present study was to identify risk factors for aseptic loosening in patients who underwent primary TKA with rotating-hinge knee prostheses.

Methods: The records of 1,235 patients who underwent primary TKA with a rotating-hinge prosthesis at our center were evaluated.

Risk factors for aseptic loosening in complex revision total knee arthroplasty using rotating hinge implants.

Purpose: This study aimed to determine the risk factors of aseptic loosening (AL) in complex revision total knee arthroplasty (TKA) cases using rotating hinge knee prosthesis.

Methods: Patients who had undergone re-revision rotating hinge prosthesis surgery between January 2012 and December 2017 were included. Parameters related to AL were retrospectively reviewed.

A comparison of short term complication rate between 44 two- and 385 one-stage septic exchange arthroplasties in chronic periprosthetic joint infections.

Background: Periprosthetic joint infection is a serious disease with severe consequences for the patient's life. It is not known whether one-stage or two-stage replacement arthroplasty is superior. So far, there have been no studies on short-term complications between both surgical procedures.

Resomer C212© in vertebroplasty or kyphoplasty: A feasibility study on artificial bones with biomechanical and thermal evaluation.

Background: Vertebroplasty and kyphoplasty are now well-established methods for treating compression fractures of vertebral bodies (AO type A) as well as vertebral body metastases [1, 2, 3]. However, polymethylmethacrylate (PMMA) augmented vertebrae show fractures of subsequent vertebral bodies due to the increased stability of the augmented vertebral body [4]. Resorbable cements are currently only used experimentally.

The T-pod is as stable as supraacetabular fixation using 1 or 2 Schanz screws in partially unstable pelvic fractures: a biomechanical study.

Introduction: Unstable fractures of the pelvis remain the predominant cause of severe hemorrhage, shock and early death in severely injured patients. The use of pelvic binders has become increasingly popular, particularly in the preclinical setting. There is currently insufficient evidence available about the stability of the pelvic binder versus supraacetabular fixation using 1 or 2 Schanz screws.

The 2018 International Consensus Meeting Minor Criteria for Chronic Hip and Knee Periprosthetic Joint Infection: Validation From a Single Center.

Background: Recently, a revised definition of the minor criteria scoring system for diagnosing periprosthetic joint infection (PJI) was developed by the second International Consensus Meeting on musculoskeletal infection. The new system combines preoperative and intraoperative findings, reportedly achieving high sensitivity and specificity. We aimed to validate the modified scoring system at a high-volume center.

Development and biomechanical evaluation of a new biodegradable intramedullary implant for osteosynthesis of midshaft fractures of small hollow bones.

Background: Up to date there is no intramedullary, biodegradable osteosynthesis commercially available to treat non-comminuted midshaft fractures of small hollow bones applying not only a stable osteosynthesis but an additional axial compression to the fracture site.

Objective And Methods: Therefore we (1) designed different implant profiles and simulated the inner tension/volume using CAD. (2) Thereafter we manufactured a prototype with the best volume/tension-ratio using 70:30 poly-(L-lactide-co-D, L-lactide) (PLLA/PDLLA) and poly-ε-caprolactone (PCL) by injection moulding.

Biomechanical stability of sacroiliac screw osteosynthesis with and without cement augmentation.

Background: Percutaneous sacroiliac (SI) screw fixation is the standard operative treatment of traumatic disruptions to the posterior pelvic ring. The technique offers good outcomes and early postoperative mobilization, which is vital in elderly patients with fragility fractures of the pelvis. While a double-screw technique has been shown to provide optimal biomechanical stability compared to a single-screw construct, anatomic variations and patient-specific characteristics may prevent the safe insertion of two SI screws.

An alternative treatment option for Paprosky Type IIIb acetabular defect using multiple tantalum wedges - A case report.

The treatment of severe acetabular defects in revision total hip arthroplasty (Paprosky type IIIa and IIIb) is demanding and choosing the appropriate surgical technique remains controversial. The introduction of trabecular metal augments has led to a variety of new treatment options. The authors present a case of a Paprosky Type IIIb acetabular defect due to eight subsequent revisions of the left hip.

3D printing method for next-day acetabular fracture surgery using a surface filtering pipeline: feasibility and 1-year clinical results.

Introduction: In orthopedic surgery, 3D printing is a technology with promising medical applications. Publications show promising results in acetabular fracture surgery over the last years using 3D printing. However, only little information about the workflow and circumstances of how to properly derive the 3D printed fracture model out of a CT scan is published.

Tape suture for stabilization of incomplete posterior pelvic ring fractures-biomechanical analysis of a new minimally invasive treatment for incomplete lateral compression pelvic ring fractures.

Background: Incomplete lateral compression fractures (including AO Type B2.1) are among the most common pelvic ring injuries. Although the treatment of choice remains controversial, sacroiliac (SI) screws are commonly used for the operative treatment of incomplete lateral compression fractures of the pelvic ring.

Fluoroscopic Marker-Based Guidance System Improves Gamma Lag Screw Placement During Nailing of Intertrochanteric Fractures: A Randomized Controlled Trial.

Objectives: To determine whether a fluoroscopy-based navigation system would improve tip-apex distance (TAD) compared with the conventional technique.

Design: Randomized controlled trial.

Setting: Level 1 trauma center.