Clinical, radiological outcomes, and plantar pressure distribution following isolated talonavicular arthrodesis: a retrospective analysis.

Background: Isolated talonavicular arthritis is relatively uncommon and remains understudied. Furthermore, the alterations in plantar pressure distribution (PPD) following isolated talonavicular arthrodesis (TNA) have not been thoroughly investigated. This study aimed to evaluate PPD, clinical outcomes, and radiographic changes in patients undergoing unilateral isolated TNA.

The role of PD-1/PD-L1 in overshooting osteoclastogenesis in periprosthetic joint infections.

Periprosthetic joint infection (PJI) is a critical complication following arthroplasty, leading to increased prosthesis failure rates post-treatment. This study explores the role of PD-1/PD-L1 signaling in osteoclastogenesis associated with PJI. Peripheral blood, bone, and bone marrow of 65 patients (20 primary osteoarthritis, 21 PJI septic explantation, 24 PJI prosthesis reimplantation) were analyzed for their bone microstructure and cell composition.

Water and ions binding to extracellular matrix drives stress relaxation, aiding MRI detection of swelling-associated pathology.

Swelling-associated changes in extracellular matrix (ECM) occur in many pathological conditions involving inflammation or oedema. Here we show that alterations in the proportion of loosely bound water in ECM correlate with changes in ECM elasticity and stress relaxation, owing to the strength of water binding to ECM being primarily governed by osmolality and the electrostatic properties of proteoglycans. By using mechanical testing and small-angle X-ray scattering, as well as magnetic resonance imaging (MRI) to detect changes in loosely bound water, we observed that enhanced water binding manifests as greater resistance to compression (mechanical or osmotic), resulting from increased electrostatic repulsion between negatively charged proteoglycans rather than axial contraction in collagen fibrils.

Risk-Adapted Use of Vancomycin in Secondary Scoliosis Surgery May Normalize SSI Risk in Surgical Correction of High-Risk Patients.

Intrawound application of vancomycin is becoming increasingly controversial for the prevention of surgical site infection (SSI). As children undergoing spinal fusion for secondary scoliosis are at high risk for SSIs, evidence regarding the impact of intraoperative vancomycin installation on SSI rates in these patients is of utmost importance. A single surgeon cohort of patients under 18 years of age undergoing surgery for secondary scoliosis in 2017 was analyzed with regard to the development of SSIs requiring surgical revision and adverse events.

Increased β-adrenergic signaling promotes fracture healing through callus neovascularization in mice.

Traumatic brain injury (TBI) leads to skeletal changes, including bone loss in the unfractured skeleton, and paradoxically accelerates healing of bone fractures; however, the mechanisms remain unclear. TBI is associated with a hyperadrenergic state characterized by increased norepinephrine release. Here, we identified the β-adrenergic receptor (ADRB2) as a mediator of skeletal changes in response to increased norepinephrine.

The dual pro-inflammatory and bone-protective role of calcitonin gene-related peptide alpha in age-related osteoarthritis.

Background: The vasoactive neuropeptide calcitonin gene-related peptide alpha (αCGRP) enhances nociception in primary knee osteoarthritis (OA) and has been shown to disrupt cartilage and joint integrity in experimental rheumatoid arthritis (RA). Little is known about how αCGRP may alter articular structures in primary OA. We investigated whether αCGRP modulates local inflammation and concomitant cartilage and bone changes in a murine model of age-dependent OA.

The selective norepinephrine reuptake inhibitor reboxetine promotes late-stage fracture healing in mice.

Impaired fracture healing is of high clinical relevance, as up to 15% of patients with long-bone fractures display non-unions. Fracture patients also include individuals treated with selective norepinephrine reuptake inhibitors (SNRI). As SNRI were previously shown to negatively affect bone homeostasis, it remained unclear whether patients with SNRI are at risk of impaired bone healing.

Increased beta2-adrenergic signaling is a targetable stimulus essential for bone healing by promoting callus neovascularization.

Traumatic brain injury (TBI) is associated with a hyperadrenergic state and paradoxically causes systemic bone loss while accelerating fracture healing. Here, we identify the beta2-adrenergic receptor (Adrb2) as a central mediator of these skeletal manifestations. While the negative effects of TBI on the unfractured skeleton can be explained by the established impact of Adrb2 signaling on bone formation, Adrb2 promotes neovascularization of the fracture callus under conditions of high sympathetic tone, including TBI and advanced age.

Emergency thoracotomies in traumatic cardiac arrests following blunt trauma - experiences from a German level I trauma center.

Purpose: Resuscitative thoracotomies (RT) are the last resort to reduce mortality in patients suffering severe trauma. In recent years, indications for RT have been extended from penetrating to blunt trauma. However, discussions on efficacy are still ongoing, as data on this rarely performed procedure are often scarce.

Inactivation of the gene encoding procalcitonin prevents antibody-mediated arthritis.

Background: Procalcitonin (PCT) is applied as a sensitive biomarker to exclude bacterial infections in patients with rheumatoid arthritis (RA) flare-ups. Beyond its diagnostic value, little is known about the pathophysiological role of PCT in RA.

Methods: Collagen antibody-induced arthritis (CAIA) was induced in Calca-deficient mice (Calca), lacking PCT (n = 15), and wild-type (WT) mice (n = 13), while control (CTRL) animals (n = 8 for each genotype) received phosphate-buffered saline.

Inflammation of Bone in Patients with Periprosthetic Joint Infections of the Knee.

Unlabelled: Despite the general success of total knee arthroplasty (TKA), addressing periprosthetic joint infection (PJI) and the resulting long-term complications is a growing medical need given the aging population and the increasing demand for arthroplasty. A larger proportion of patients face revision surgery because of the long-term complication of aseptic loosening despite clearance of the infection. The pathomechanisms leading to prosthetic loosening are not understood as it has been widely assumed that the bone stock recovers after explantation revision surgery.

Routine laboratory parameters predict intensive care unit admission and hospitalization in patients suffering stab injuries.

Background: Knife crime has increased considerably in recent years in Northern Europe. Affected patients often require immediate surgical care due to traumatic organ injury. Yet, little is known about clinically relevant routine laboratory parameters in stab injury patients and how these are associated with intensive care unit (ICU) admission, hospitalization and number of surgeries.

The FRISK (Fracture Risk)-A New Tool to Indicate the Probability of Fractures.

Increasing patient inflow into the emergency department makes it necessary to optimize triage management. The scope of this work was to determine simple factors that could detect fractures in patients without the need for specialized personnel. Between 2014 and 2015, 798 patients were admitted to an orthopedic emergency department and prospectively included in the study.

The decisive early phase of bone regeneration.

Bone has a remarkable endogenous regenerative capacity that enables scarless healing and restoration of its prior mechanical function, even under challenging conditions such as advanced age and metabolic or immunological degenerative diseases. However - despite much progress - a high number of bone injuries still heal with unsatisfactory outcomes. The mechanisms leading to impaired healing are heterogeneous, and involve exuberant and non-resolving immune reactions or overstrained mechanical conditions that affect the delicate regulation of the early initiation of scar-free healing.

Acquired Factor XIII Deficiency in Patients with Multiple Trauma.

Introduction: Fibrin stabilizing factor (FXIII) plays a crucial role in blood clotting, tissue repair, and immune defense. FXIII deficiency after trauma can lead to prolonged wound healing due to persistent infections or coagulation disorders. The aim of this study was to describe the prevalence of acquired FXIII deficiency after trauma and to provide a description of the time-course changes of important coagulation parameters in relation to FXIII activity.

Joint and Functional Examinations in the Orthopaedic and Traumatological Video Consultation - What is Currently Possible?

Background: In the context of the COVID-19 pandemic, video consultations have gained importance in orthopaedic and traumatological departments. In current literature, different adaptations of classic joint and functional examinations have been described for the virtual examination.

Methodology: A systematic review of current literature on adaptations for the virtual joint and functional examination in orthopaedics and trauma surgery was performed over PubMed (January 2010 to April 2021).

Proposal of a New Rating Concept for Digital Health Applications in Orthopedics and Traumatology.

Background: Health-related mobile applications (apps) are rapidly increasing in number. There is an urgent need for assessment tools and algorithms that allow the usability and content criteria of these applications to be objectively assessed. The aim of this work was to establish and validate a concept for orthopedic societies to rate health apps to set a quality standard for their safe use.

Standardized protocol and outcome measurements for the collagen antibody-induced arthritis mouse model.

The murine collagen antibody-induced arthritis (CAIA) model resembles various features of human rheumatoid arthritis and is based on the intraperitoneal or intravenous injection of autoantibodies against type II collagen. Here, we present a standardized protocol for the intraperitoneal injection of arthritis-inducing autoantibodies in mice, followed by a description of daily arthritis assessments. We then detail the steps to harvest joint and bone tissues for histological, radiological, and molecular analyses.

The calcitonin receptor protects against bone loss and excessive inflammation in collagen antibody-induced arthritis.

Pharmacological application of teleost calcitonin (CT) has been shown to exert chondroprotective and anti-resorptive effects in patients with rheumatoid arthritis (RA). However, the role of endogenous CT that signals through the calcitonin receptor (CTR) remains elusive. Collagen II antibody-induced arthritis (CAIA) was stimulated in wild type (WT) and CTR-deficient (Calcr) mice.

Clinical and Patient-Related Outcome After Stabilization of Dorsal Pelvic Ring Fractures: A Retrospective Study Comparing Transiliac Fixator (TIFI) and Spinopelvic Fixation (SPF).

Aim of this retrospective cohort study was the comparison of the transiliac fixator (TIFI) and spinopelvic fixation (SPF) for fixation of dorsal pelvic ring fractures in terms of clinical outcome, complications, and quality of life. Thirty-eight patients (23 men, 15 women; mean age 47 ± 19 years) with dorsal pelvic ring fractures (type-C-injuries after AO/OTA) that have been stabilized by either TIFI (group TIFI, = 22) or SPF (group SPF, = 16) between May 2015 and December 2018 were retrospectively reviewed. Outcome measurements included demographic data, perioperative parameters, and complications and were obtained from the medical information system.

Epidemiology, Injury Severity, and Pattern of Standing E-Scooter Accidents: 6-Month Experience from a German Level I Trauma Center.

Background: E-scooter usage was lawfully approved in Germany in June 2019. Since then, a marked increase of e-scooter drivers has been noticed. Evidence concerning factors that may affect the severity of these injuries is limited.