The worldwide COVID-19 pandemic is directly impacting the field of orthopaedic surgery and traumatology with postponed operations, changed status of planned elective surgeries and acute emergencies in patients with unknown infection status. To this point, Germany's COVID-19 infection numbers and death rate have been lower than those of many other nations. This article summarizes the current regimen used in the field of orthopaedics in Germany during the COVID-19 pandemic. Internal university clinic guidelines, latest research results, expert consensus, and clinical experiences were combined in this article guideline.Aims
Methods
The use of trabecular metal (TM) shells supported by augments has provided good mid-term results after revision total hip arthroplasty (THA) in patients with a bony defect of the acetabulum. The aim of this study was to assess the long-term implant survivorship and radiological and clinical outcomes after acetabular revision using this technique. Between 2006 and 2010, 60 patients (62 hips) underwent acetabular revision using a combination of a TM shell and augment. A total of 51 patients (53 hips) had complete follow-up at a minimum of seven years and were included in the study. Of these patients, 15 were men (29.4%) and 36 were women (70.6%). Their mean age at the time of revision THA was 64.6 years (28 to 85). Three patients (5.2%) had a Paprosky IIA defect, 13 (24.5%) had a type IIB defect, six (11.3%) had a type IIC defect, 22 (41.5%) had a type IIIA defect, and nine (17%) had a type IIIB defect. Five patients (9.4%) also had pelvic discontinuity.Aims
Patients and Methods
Severe acetabular bone loss and pelvic discontinuity (PD) present particular challenges in revision total hip arthroplasty. To deal with such complex situations, cup-cage reconstruction has emerged as an option for treating this situation. We aimed to examine our success in using this technique for these anatomical problems. We undertook a retrospective, single-centre series of 35 hips in 34 patients (seven male, 27 female) treated with a cup-cage construct using a trabecular metal shell in conjunction with a titanium cage, for severe acetabular bone loss between 2011 and 2015. The mean age at the time of surgery was 70 years (42 to 85) and all patients had an acetabular defect graded as Paprosky Type 2C through to 3B, with 24 hips (69%) having PD. The mean follow-up was 47 months (25 to 84).Aims
Patients and Methods
The objective of this study was to develop a test for the rapid (within 25 minutes) intraoperative detection of bacteria from synovial fluid to diagnose periprosthetic joint infection (PJI). The 16s rDNA test combines a polymerase chain reaction (PCR) for amplification of 16s rDNA with a lateral flow immunoassay in one fully automated system. The synovial fluid of 77 patients undergoing joint aspiration or primary or revision total hip or knee surgery was prospectively collected. The cohort was divided into a proof-of-principle cohort (n = 17) and a validation cohort (n = 60). Using the proof-of-principle cohort, an optimal cut-off for the discrimination between PJI and non-PJI samples was determined. PJI was defined as detection of the same bacterial species in a minimum of two microbiological samples, positive histology, and presence of a sinus tract or intra-articular pus.Objectives
Methods
This study sought to establish the prevalence of the cross over
sign (COS) and posterior wall sign (PWS) in relation to the anterior
pelvic plane (APP) in an asymptomatic population through reliable
and accurate 3D-CT based assessment. Data from pelvic CT scans of 100 asymptomatic subjects (200 hips)
undertaken for conditions unrelated to disorders of the hip were
available for analysis in this study. A previously established 3D
analysis method was applied to assess the prevalence of the COS
and PWS in relation to the APP.Aims
Materials and Methods
We have investigated the effect of using tranexamic
acid (TXA) during peri-acetabular osteotomy (PAO) on peri-operative
blood loss and blood transfusion requirements. In addition we analysed
whether the use of TXA was associated with an increased risk of
venous thromboembolism (VTE) following this procedure. A consecutive series of 96 PAOs, performed by a single surgeon,
were reviewed. A total of 48 patients received TXA and 48 did not.
The TXA group received a continuous infusion of TXA at a rate of
10 mg/kg/h. The primary outcome measure was the requirement for
blood transfusion. Secondary outcomes included total blood loss,
the decrease in the level of haemoglobin in the blood, the length
of hospital stay, and the complications of this treatment. The mean rate of transfusion was significantly lower in the TXA
group (62.5% The use of TXA reduced the blood loss and the rate of transfusion
after PAO significantly, without adverse effects such as an increased
rate of VTE. Cite this article:
