1
|
Langensiepen S, Nielsen S, Madi M, Siebert M, Körner D, Elissen M, Meyer G, Stephan A. [User-oriented needs assessment of the potential use of assistive robots in direct nursing care: A mixed methods study]. Pflege 2024; 37:69-78. [PMID: 36468879 DOI: 10.1024/1012-5302/a000925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
User-oriented needs assessment of the potential use of assistive robots in direct nursing care: A mixed methods study Abstract. Background: So far, hardly any robots have been used in nursing that take over patient-related activities and thereby reduce the physical strain on the caregivers. Using user-centered design approaches, the interdisciplinary project "PfleKoRo" was therefore developing a robotic assistance system that can be used in the direct care of bedridden patients requiring intensive or very intensive care. Aim: The aim of this study was to identify nursing activities with the greatest support potential for an assistant robot for the direct care of bedridden patients. Method: Focus groups (n = 3) with nursing professionals (n = 14) from acute and long-term care were conducted first in an explorative mixed method design and then evaluated by means of content analysis. A selection of nursing activities was then prioritized by the participants of the focus groups (n = 10) with regard to their potential for support from an assistant robot in a standardized survey. Results: The highest priority was given to turning and holding patients in a lateral position as well as holding their legs in order to perform nursing tasks. Further support was needed, among other things, for repositioning the patient to the head of the bed and for tasks such as the transfer of patients. Conclusion: Turning patients and holding them in a lateral position as well as holding the leg are seen as target activities with the greatest support potential for "PfleKoRo", presenting the starting point for further development.
Collapse
Affiliation(s)
- Sina Langensiepen
- Pflegedirektion, Stabsstelle Pflegewissenschaft, Uniklinik RWTH Aachen, Deutschland
| | - Svenja Nielsen
- Pflegedirektion, Stabsstelle Pflegewissenschaft, Uniklinik RWTH Aachen, Deutschland
| | - Murielle Madi
- Pflegedirektion, Stabsstelle Pflegewissenschaft, Uniklinik RWTH Aachen, Deutschland
| | | | - Daniel Körner
- Institut für Angewandte Medizintechnik, RWTH Aachen, Deutschland
| | - Maurice Elissen
- Klinik für Operative Intensivmedizin und Intermediate Care, Uniklinik RWTH Aachen, Deutschland
| | - Gabriele Meyer
- Institut für Gesundheits- und Pflegewissenschaft, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Deutschland
| | - Astrid Stephan
- Pflegedirektion, Stabsstelle Pflegewissenschaft, Uniklinik RWTH Aachen, Deutschland
| |
Collapse
|
2
|
Madi M, Nielsen S, Schweitzer M, Siebert M, Körner D, Langensiepen S, Stephan A, Meyer G. Acceptance of a robotic system for nursing care: a cross-sectional survey with professional nurses, care recipients and relatives. BMC Nurs 2024; 23:179. [PMID: 38486244 PMCID: PMC10938668 DOI: 10.1186/s12912-024-01849-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 03/05/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND The end-users' acceptance is a core concept in the development, implementation and evaluation of new systems like robotic systems in daily nursing practice. So far, studies have shown various findings concerning the acceptance of systems that are intended to assist people with support or care needs. Not much has been reported on the acceptance of robots that provide direct physical assistance to nurses in bedside care. Therefore, this study aimed to investigate the acceptance along with ethical implications of the prototype of an assistive robotic arm aiming to support nurses in bedside care, from the perspective of nurses, care recipients and their relatives. METHODS A cross-sectional survey design was applied at an early stage in the technological development of the system. Professional nurses, care recipients and relatives were recruited from a university hospital and a nursing home in Germany. The questionnaire was handed out following either a video or a live demonstration of the lab prototype and a subsequent one-to-one follow-up discussion. Data analysis was performed descriptively. RESULTS A total of 67 participants took part in the study. The rejection of specified ethical concerns across all the respondents was 77%. For items related to both perceived usefulness and intention to use, 75% of ratings across all the respondents were positive. In the follow-up discussions, the participants showed interest and openness toward the prototype, although there were varying opinions on aspects such as size, appearance, velocity, and potential impact on workload. CONCLUSIONS Regarding the current state of development, the acceptance among the participants was high, and ethical concerns were relatively minor. Moving forward, it would be beneficial to explore the acceptance in further developmental stages of the system, particularly when the usability is tested.
Collapse
Affiliation(s)
- Murielle Madi
- Institute of Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany.
- Department of Nursing Science, Uniklinik RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany.
| | - Svenja Nielsen
- Institute of Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany.
| | - Mona Schweitzer
- Institute of Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany
| | - Maximilian Siebert
- Institute of Applied Medical Engineering, Uniklinik RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Daniel Körner
- Institute of Applied Medical Engineering, Uniklinik RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Sina Langensiepen
- Department of Nursing Science, Uniklinik RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Astrid Stephan
- Department of Nursing Science, Uniklinik RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Gabriele Meyer
- Institute of Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany
| |
Collapse
|
3
|
Matthias A, Becher C, Ettinger S, Gottschalk O, Guenther D, Klos K, Ahrend MD, Körner D, Plaass C, Walther M. Postoperative Management of Osteochondral Lesions of the Ankle: A Survey Among German-Speaking Foot and Ankle Surgeons. Cartilage 2023:19476035231213184. [PMID: 38044500 DOI: 10.1177/19476035231213184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2023] Open
Abstract
OBJECTIVE To assess the current treatment of osteochondral lesions of the ankle (OCLA) by German-speaking foot and ankle surgeons, focusing on the management of postoperative care and rehabilitation. DESIGN A questionnaire was created by a panel of 4 experienced foot and ankle surgeons on behalf of the "Clinical Tissue Regeneration" (CTR) working group of the German Society of Orthopaedics and Trauma Surgery (DGOU), and distributed electronically to members of the CTR, participants of the German Cartilage Registry (Knorpelregister DGOU©), and members of 6 German-speaking orthopedics or sports medicine societies. Results were classified depending on the consensus within the answers (agreement ≥75% "strong tendency," 50%-74% "tendency," 25%-49% "weak tendency," <25% "no tendency"). RESULTS A total of 60 participants returned the questionnaire. The main results are as follows: regarding the frequency of surgical procedures for OCLA, refixation of the fragment, retrograde drilling, and bone marrow stimulation with or without using a matrix were performed by at least 75% of the surgeons and was considered a strong tendency. There was a strong tendency to stabilize the ankle (76.7%) and perform corrective osteotomies (51.7%). In total, 75.5% and 75% of the surgeons performed bone marrow stimulation with and without using a matrix, respectively. Corrective osteotomy and ankle stabilization were performed in 64.5% and 65.2% cases, respectively. Most participants included published recommendations on postoperative rehabilitation and the return to sports activities in their postoperative management. The main surgical procedures were considered the most critical factor in influencing the postoperative management by 81% of the participants (strong tendency). Adjunct surgical procedures such as corrective osteotomy and stabilization of the ankle were considered important by 67.8% of the respondents (tendency). CONCLUSIONS The management of OCLA varies among German-speaking foot and ankle surgeons. Therefore, guidelines remain essential to standardize the management of OCLA, to achieve improved and stable results. This survey will assist clinicians and patients with rehabilitation to return to sports after treating the ankle's cartilage injury.
Collapse
Affiliation(s)
- Aurich Matthias
- DOUW, Section of Trauma- and Reconstructive Surgery, University Hospital Halle (Saale), Halle, Germany
- BG Trauma Center Bergmannstrost Halle, Department of Trauma- and Reconstructive Surgery, Halle, Germany
| | - Christoph Becher
- Department of Orthopaedic Surgery, Hannover Medical School, Diakovere Annastift, Hannover, Germany
| | - Sarah Ettinger
- University Hospital for Orthopedic Surgery, Pius Hospital Oldenburg, Oldenburg, Germany
| | - Oliver Gottschalk
- Hospital München Harlaching, Department of Foot and Ankle Surgery, München, Germany
- Department of Orthopaedics and Trauma Surgery, Muskuloskelettal University Center Munich (MUM), Hospital of the University Munich, LMU Munich, Germany
| | - Daniel Guenther
- Department of Orthopaedic Surgery, Trauma Surgery, and Sports Medicine, Cologne Merheim Medical Center, Cologne, Germany
| | - Kajetan Klos
- Joint Center Rhein-Main, Hochheim am Main, Germany
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Jena, Jena, Germany
| | - Marc-Daniel Ahrend
- BG Trauma Center Tübingen, Eberhard-Karls-University Tübingen, Tübingen, Germany
| | - Daniel Körner
- BG Trauma Center Tübingen, Eberhard-Karls-University Tübingen, Tübingen, Germany
| | | | - Markus Walther
- Schön Hospital München Harlaching-FIFA Medical Centre of Excellence, Munich, Germany
- Ludwig Maximilian University Munich, Department of Orthopaedics and Trauma Surgery, Muskuloskelletal University Center Munich (MUM), Munich, Germany
- Justus Maximilian University Wuerzburg, König-Ludwig-Haus, Würzburg, Germany
- Paracelsus Medical Private Universität, Salzburg, Austria
| |
Collapse
|
4
|
Walther M, Gottschalk O, Madry H, Müller PE, Steinwachs M, Niemeyer P, Niethammer TR, Tischer T, Petersen J, Feil R, Fickert S, Schewe B, Hörterer H, Ruhnau K, Becher C, Klos K, Plaass C, Rolauffs B, Behrens P, Spahn G, Welsch G, Angele P, Ahrend MD, Kasten P, Erggelet C, Ettinger S, Günther D, Körner D, Aurich M. Etiology, Classification, Diagnostics, and Conservative Management of Osteochondral Lesions of the Talus. 2023 Recommendations of the Working Group "Clinical Tissue Regeneration" of the German Society of Orthopedics and Traumatology. Cartilage 2023; 14:292-304. [PMID: 37082983 PMCID: PMC10601568 DOI: 10.1177/19476035231161806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 02/18/2023] [Accepted: 02/19/2023] [Indexed: 04/22/2023] Open
Abstract
METHODS Peer-reviewed literature was analyzed regarding different topics relevant to osteochondral lesions of the talus (OLTs) treatment. This process concluded with a statement for each topic reflecting the best scientific evidence available for a particular diagnostic or therapeutic concept, including the grade of recommendation. Besides the scientific evidence, all group members rated the statements to identify possible gaps between literature and current clinical practice. CONCLUSION In patients with minimal symptoms, OLT progression to ankle osteoarthritis is unlikely. Risk factors for progression are the depth of the lesion on MRI, subchondral cyst formation, and the extent of bone marrow edema. Conservative management is the adaptation of activities to the performance of the ankle joint. A follow-up imaging after 12 months helps not to miss any progression. It is impossible to estimate the probability of success of conservative management from initial symptoms and imaging. Cast immobilization is an option in OLTs in children, with a success rate of approximately 50%, although complete healing, estimated from imaging, is rare. In adults, improvement by conservative management ranges between 45% and 59%. Rest and restrictions for sports activities seem to be more successful than immobilization. Intra-articular injections of hyaluronic acid and platelet-rich plasma can improve pain and functional scores for more than 6 months. If 3 months of conservative management does not improve symptoms, surgery can be recommended.
Collapse
Affiliation(s)
- Markus Walther
- Schön Klinik München Harlaching, FIFA Medical Centre of Excellence, Munich, Germany
- Department of Orthopeadics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, Ludwig Maximilian University Munich, Munich, Germany
- König-Ludwig-Haus, Julius Maximilian University of Würzburg, Würzburg, Germany
- Paracelsus Medizinische Privatuniversität, Salzburg, Austria
| | - Oliver Gottschalk
- Schön Klinik München Harlaching, FIFA Medical Centre of Excellence, Munich, Germany
- Department of Orthopeadics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, Ludwig Maximilian University Munich, Munich, Germany
| | - Henning Madry
- Institute of Experimental Orthopaedics and Department of Orthopaedic Surgery, Saarland University, Homburg, Germany
| | - Peter E. Müller
- Department of Orthopeadics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, Ludwig Maximilian University Munich, Munich, Germany
| | - Matthias Steinwachs
- SportClinic Zürich, Klinik Hirslanden, Zürich, Switzerland
- ETH Zürich, Zürich, Switzerland
- Albert-Ludwigs-Universität Freiburg, Freiburg, Germany
| | - Philipp Niemeyer
- Albert-Ludwigs-Universität Freiburg, Freiburg, Germany
- OCM—Hospital for Orthopedic Surgery Munich, Munich, Germany
| | - Thomas R. Niethammer
- Department of Orthopeadics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, Ludwig Maximilian University Munich, Munich, Germany
| | - Thomas Tischer
- Klinik für Orthopädie und Unfallchirurgie, Malteser Waldkrankenhaus St. Marien, Erlangen, Germany
| | | | - Roman Feil
- Klinik für Unfallchirurgie und Orthopädie, Kath. Marienkrankenhaus gGmbH, Hamburg, Germany
| | - Stefan Fickert
- Sporthopaedicum Straubing, Straubing, Germany
- Sporthopaedicum Regensburg, Regensburg, Germany
| | - Bernhard Schewe
- Orthopädisch Chirurgisches Centrum Tübingen, Tübingen, Germany
| | - Hubert Hörterer
- Schön Klinik München Harlaching, FIFA Medical Centre of Excellence, Munich, Germany
- Department of Orthopeadics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, Ludwig Maximilian University Munich, Munich, Germany
| | | | - Christoph Becher
- Internationales Zentrum für Orthopädie, ATOS Klinik Heidelberg, Heidelberg, Germany
| | | | - Christian Plaass
- Orthopedic Clinic of Medical School Hannover, DIAKOVERE Annastift, Hannover, Germany
| | - Bernd Rolauffs
- Klinik für Orthopädie und Unfallchirurgie and G.E.R.N. Forschungszentrum, Universitätsklinikum Freiburg, Freiburg, Germany
| | | | - Gunter Spahn
- Center of Trauma and Orthopaedic Surgery Eisenach, Eisenach, Germany
| | | | - Peter Angele
- Sporthopaedicum Straubing, Straubing, Germany
- Sporthopaedicum Regensburg, Regensburg, Germany
- Department of Trauma and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Marc-Daniel Ahrend
- BG Unfallklinik Tübingen, Klinik für Unfall- und Wiederherstellungschirurgie, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - Philip Kasten
- Orthopädisch Chirurgisches Centrum Tübingen, Tübingen, Germany
| | - Christoph Erggelet
- Albert-Ludwigs-Universität Freiburg, Freiburg, Germany
- alphaclinic zürich, Zürich, Switzerland
| | - Sarah Ettinger
- Orthopedic Clinic of Medical School Hannover, DIAKOVERE Annastift, Hannover, Germany
| | - Daniel Günther
- Department of Orthopaedic Surgery, Trauma Surgery, and Sports Medicine, Cologne-Merheim Medical Center, Witten/Herdecke University, Cologne, Germany
| | - Daniel Körner
- BG Unfallklinik Tübingen, Klinik für Unfall- und Wiederherstellungschirurgie, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - Matthias Aurich
- BG Klinikum Bergmannstrost Halle, Halle (Saale), Germany
- Abteilung für Unfall- und Wiederherstellungschirurgie, Martin-Luther-University Halle-Wittenberg, Universitätsklinikum Halle (Saale), Halle, Germany
| |
Collapse
|
5
|
Gottschalk O, Körner D, Aurich M, Plaass C, Günther D, Hörterer H, Bruder J, Walther M. Descriptive analysis and short-term follow-up clinical results of osteochondral lesions of the distal tibia based on data of the German Cartilage Register (Knorpelregister ® DGOU). Arch Orthop Trauma Surg 2023; 143:809-815. [PMID: 34585304 DOI: 10.1007/s00402-021-04167-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 09/01/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION An increasing number of ankle injuries with osteochondral lesions (OCL) also include lesions of the distal tibia. Therefore, the German Cartilage Society database is used to describe and examine the characteristics of these lesions and, early on, the results of different surgical therapies on the clinical outcome. MATERIALS AND METHODS Forty-seven patients out of 844 registered in the German Cartilage Society database met the inclusion criteria showing an OCL of the distal tibia (OLDT). Sixteen of them also presented a 1-year follow-up regarding the Foot and Ankle Ability Measure (FAAM). Further evaluations were included in the follow-up, such as the Foot and Ankle Outcome Score (FAOS) and the Visual Analogue Scale for pain (VAS). RESULTS The patients' mean age was 35 ± 11 with a mean BMI in the range of overweight (26/27 ± 5 kg/m2). The lesions were equally distributed on the articular surface of the distal tibia. Most patients were operated using anterior ankle arthroscopy [nT 34 (72%); nS 13 (81%)], while some (nT 9; nS 4) converted to open procedures. Almost 90% staged III and IV in the ICRS classification. Debridement, bone marrow stimulation, solid scaffolds, and liquid filler were the treatment choices among the subgroup. All therapies led to a clinical improvement between pre-op and 1-year follow-up but not to a significant level. CONCLUSION This study presents baseline data of OLDT based on data from a large database. BMS and scaffolds were the treatment of choice but did not present significant improvement after a 1-year follow-up.
Collapse
Affiliation(s)
- Oliver Gottschalk
- Center for Foot and Ankle Surgery, Schön Klinik München Harlaching, Harlachinger Str. 51, 81547, Munich, Germany. .,Department of General, Trauma and Reconstructive Surgery, University Hospital, LMU Munich, Munich, Germany.
| | - Daniel Körner
- Department of Traumatology and Reconstructive Surgery, BG Trauma Centre Tübingen, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Matthias Aurich
- Department of Orthopaedics, Trauma- and Reconstructive Surgery, University Hospital Halle (Saale), Halle (Saale), Germany.,Department of Trauma- and Reconstructive Surgery, BG Trauma Center Bergmannstrost, Halle (Saale), Germany
| | - Christian Plaass
- Department for Foot and Ankle Surgery, Diakovere Annastift, Orthopedic Clinic of the Hannover Medical School, Hannover, Germany
| | - Daniel Günther
- Department of Orthopedic Surgery, Trauma Surgery, and Sports Medicine, Cologne Merheim Medical Center, Witten/Herdicke University, Witten, Germany
| | - Hubert Hörterer
- Center for Foot and Ankle Surgery, Schön Klinik München Harlaching, Harlachinger Str. 51, 81547, Munich, Germany.,Department of General, Trauma and Reconstructive Surgery, University Hospital, LMU Munich, Munich, Germany
| | - Jan Bruder
- Department of General, Trauma and Reconstructive Surgery, University Hospital, LMU Munich, Munich, Germany
| | - Markus Walther
- Center for Foot and Ankle Surgery, Schön Klinik München Harlaching, Harlachinger Str. 51, 81547, Munich, Germany
| |
Collapse
|
6
|
Hemmann P, Friederich M, Bahrs C, Jacoby J, Körner D. Substantial changes in fracture rates in German hospitals in 2018 compared with 2002: an epidemiological study. Arch Orthop Trauma Surg 2022; 142:1847-1857. [PMID: 33844053 DOI: 10.1007/s00402-021-03874-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 03/23/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The aim of this study was to present recent epidemiological data on extremity and axial skeletal fractures in German hospitals and to compare them with older data to detect time trends. MATERIALS AND METHODS Inpatient data from the German National Hospital Discharge Registry were used. The absolute number and age-standardized incidence of fractures in 2002 and 2018 were analysed by fracture location according to the International Classification of Disease. Data were analysed according to age group. Male: female ratios (MFRs) and incidence rate ratios (IRRs) were calculated to compare the 2018 and 2002 data. RESULTS The absolute number of fractures of the nine analysed locations was 15.2% higher in 2018 than in 2002. By fracture location, the changes were as follows (absolute change + IRR): "neck" (S12): + 172%, IRR = 2.6; "rib(s), sternum, thoracic spine" (S22): + 57%, IRR = 1.3; "lumbar spine and pelvis" (S32): + 66%, IRR = 1.3; "shoulder and upper arm" (S42): + 36%, IRR = 1.2; "forearm" (S52): + 13%, IRR = 1.0; "wrist and hand level" (S62): - 32%, IRR = 0.7; "femur" (S72): + 24%, IRR = 0.9; "lower leg, including ankle" (S82): - 24%, IRR = 0.7; "foot, except ankle" (S92): - 4%, IRR = 0.9. The overall MFR changed from 0.7 in 2002 to 0.6 in 2018. The age group of 45-54 years represented a turning point, males were more often affected than females in the younger age groups, and the opposite trend was observed in the older age groups. CONCLUSIONS The increase in the absolute fracture rates was due to increased rates of femur, shoulder, upper arm, forearm, and axial skeletal fractures, with elderly women being the main contributors. Femur fractures were found to be the most common fractures treated in German hospitals.
Collapse
Affiliation(s)
- Philipp Hemmann
- Department of Traumatology and Reconstructive Surgery, BG Trauma Centre Tuebingen, Eberhard Karls University Tuebingen, Schnarrenbergstr. 95, 72076, Tuebingen, Germany
| | - Maximilian Friederich
- Eberhard Karls University Tuebingen, Tuebingen Medical School, Geissweg 5, 72076, Tuebingen, Germany
| | - Christian Bahrs
- Department of Orthopaedics and Trauma Surgery, Schön Klinik Neustadt, Am Kiebitzberg 10, 23730, Neustadt in Holstein, Germany.
| | - Johann Jacoby
- Institute for Clinical Epidemiology and Applied Biostatistics (IKEaB), Eberhard Karls University Tuebingen, Silcherstr. 5, 72076, Tuebingen, Germany
| | - Daniel Körner
- Department of Traumatology and Reconstructive Surgery, BG Trauma Centre Tuebingen, Eberhard Karls University Tuebingen, Schnarrenbergstr. 95, 72076, Tuebingen, Germany
| |
Collapse
|
7
|
Ettinger S, Gottschalk O, Kostretzis L, Plaas C, Körner D, Walther M, Becher C. One-year follow-up data from the German Cartilage Registry (KnorpelRegister DGOU) in the treatment of chondral and osteochondral defects of the talus. Arch Orthop Trauma Surg 2022; 142:205-210. [PMID: 33047231 DOI: 10.1007/s00402-020-03631-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 09/30/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Chondral and osteochondral lesions of the talus (OLTs) remain a challenging issue with numerous operative treatments proposed to date. The aim of this study was to evaluate 1-year follow-up data in the German Cartilage Registry (KnorpelRegister DGOU). METHODS Among 401 patients in the database, 114 patients with a complete 1-year Foot and Ankle Outcome (FAOS) score for subscale Pain as the primary variable were included. A total of 12 different surgical treatments were performed. However, 8 techniques were carried out in negligible numbers of patients (n = 1-3), leaving 89 patients treated with the following techniques: arthroscopic antegrade bone marrow stimulation (group A; n = 32), autologous chondrocyte implantation with autologous cancellous bone grafting (group B; n = 9), matrix-augmented bone marrow stimulation (group C; n = 22), and matrix-augmented bone marrow stimulation with autologous cancellous bone grafting (group D; n = 26). Group differences and possible influencing variables such as age and sex were evaluated. Level of significance was set at p < 0.05 for all statistical tests. RESULTS All four treatment groups showed significant improvement of the FAOS scores at 1 year postoperatively compared with their preoperative scores. No significant differences were found with respect to score changes among the groups. A positive correlation between FAOS subscale Pain improvement and defect size volume and negative correlations between increasing age and FAOS subscales Sports/Rec and QoL were found. Concomitant ankle stabilization led to greater improvement in FAOS subscales Symptoms and ADL than in patients with no stabilization. FAOS subscale Pain showed greater improvement in women than in men. CONCLUSION All analyzed treatment options were effective for treatment of OLTs. In particular, large defects appeared to benefit from treatment. In the presence of concomitant ankle instability, a stabilizing procedure appeared to have a positive impact on the outcome.
Collapse
Affiliation(s)
- S Ettinger
- Orthopädische Klinik der Medizinischen Hochschule Hannover (MHH) im Diakovere Annastift, Anna-von-Borries-Str. 1-7, 30625, Hannover, Germany
| | - O Gottschalk
- Zentrum für Fuss- and Sprunggelenkchirurgie, (MHA) Schön Klinik München Harlaching, Harlachinger Str. 51, 81547, München, Germany
| | - L Kostretzis
- International Center for Orthopedics, ATOS Clinic Heidelberg, Bismarckstr. 9-15, 69115, Heidelberg, Germany
| | - C Plaas
- Orthopädische Klinik der Medizinischen Hochschule Hannover (MHH) im Diakovere Annastift, Anna-von-Borries-Str. 1-7, 30625, Hannover, Germany
| | - D Körner
- Department of Traumatology and Reconstructive Surgery, BG Trauma Center Tübingen, Eberhard Karls University Tübingen, Schnarrrenbergstr. 95, 72076, Tübingen, Germany
| | - M Walther
- Zentrum für Fuss- and Sprunggelenkchirurgie, (MHA) Schön Klinik München Harlaching, Harlachinger Str. 51, 81547, München, Germany
| | - C Becher
- Orthopädische Klinik der Medizinischen Hochschule Hannover (MHH) im Diakovere Annastift, Anna-von-Borries-Str. 1-7, 30625, Hannover, Germany. .,International Center for Orthopedics, ATOS Clinic Heidelberg, Bismarckstr. 9-15, 69115, Heidelberg, Germany.
| |
Collapse
|
8
|
Gottschalk O, Baumbach SF, Altenberger S, Körner D, Aurich M, Plaass C, Ettinger S, Guenther D, Becher C, Hörterer H, Walther M. Influence of the Medial Malleolus Osteotomy on the Clinical Outcome of M-BMS + I/III Collagen Scaffold in Medial Talar Osteochondral Lesion (German Cartilage Register/Knorpelregister DGOU). Cartilage 2021; 13:1373S-1379S. [PMID: 33030049 PMCID: PMC8808948 DOI: 10.1177/1947603520961169] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Osteochondral lesions of the talus are common injuries, with one of the leading treatment options being the M-BMS (matrix-augmented bone marrow stimulation) + I/III collagen scaffold. Osteotomy of the medial malleolus is not unusual but presents the risk of malunion or irritation by hardware. The aim of the study was to analyze data from the German Cartilage Society (Knorpelregister DGOU) to evaluate the influence of medial malleolar osteotomy on clinical results of M-BMS + I/III collagen scaffold. DESIGN The ankle module of the Cartilage Register includes a total of 718 patients, while 45 patients met the inclusion criteria. Patients were treated with an M-BMS + I/III collagen scaffold of the medial talus, 30 without and 15 with an osteotomy of the medial malleolus. The follow-up evaluations included FAAM (Foot and Ankle Ability Measure), FAOS (Foot and Ankle Outcome Score), and VAS (visual analogue scale). RESULTS Forty-five patients (22 male, 23 female) aged between 18 and 69 years (mean: 34 years) were included in this study. Between preoperative and 12 months postoperative, we noted a significant improvement in FAAM-ADL (Activity of Daily Living) (P = 0.004) as well as FAOS-Pain (P = 0.001), FAOS-Stiffness (P = 0.047), FAOS-ADL (P = 0.002), FAOS-Sport (P = 0.001), and FAOS Quality of Life (P = 0.009). There was no significant difference between patients who underwent an osteotomy or not. CONCLUSION The results show a significant improvement in patients' outcome scores following a M-BMS + I/III collagen scaffold. No statistical difference was noted among those undergoing medial malleolar osteotomy.
Collapse
Affiliation(s)
- Oliver Gottschalk
- Center for Foot and Ankle Surgery, Schön Klinik München Harlaching, Munich, Germany,Department of General, Trauma and Reconstructive Surgery, University Hospital, LMU Munich, Munich, Germany,Oliver Gottschalk, Center for Foot and Ankle Surgery, Schön Klinik München Harlaching, Harlachinger Straße 51, Munich, 81547, Germany
| | - Sebastian Felix Baumbach
- Center for Foot and Ankle Surgery, Schön Klinik München Harlaching, Munich, Germany,Department of General, Trauma and Reconstructive Surgery, University Hospital, LMU Munich, Munich, Germany
| | | | - Daniel Körner
- Department of Traumatology and Reconstructive Surgery, BG Trauma Centre Tübingen, Eberhard Karls University, Tübingen, Germany
| | - Matthias Aurich
- Center for Orthopedics and Trauma Surgery, Klinikum Mittleres Erzgebirge, Zschopau, Germany
| | - Christian Plaass
- Department for Foot and Ankle Surgery, Diakovere Annastift, Orthopedic Clinic of the Hannover Medical School, Hannover, Germany
| | - Sarah Ettinger
- Department for Foot and Ankle Surgery, Diakovere Annastift, Orthopedic Clinic of the Hannover Medical School, Hannover, Germany
| | - Daniel Guenther
- Department of Orthopedic Surgery, Trauma Surgery, and Sports Medicine, Cologne Merheim Medical Center, Witten/Herdecke University, Witten, Germany
| | - Christoph Becher
- Center for Knee, Hip, and Foot Surgery, ATOS Clinic, Heidelberg, Germany
| | - Hubert Hörterer
- Center for Foot and Ankle Surgery, Schön Klinik München Harlaching, Munich, Germany,Department of General, Trauma and Reconstructive Surgery, University Hospital, LMU Munich, Munich, Germany
| | - Markus Walther
- Center for Foot and Ankle Surgery, Schön Klinik München Harlaching, Munich, Germany
| |
Collapse
|
9
|
|
10
|
Hemmann P, Friederich M, Körner D, Klopfer T, Bahrs C. Changing epidemiology of lower extremity fractures in adults over a 15-year period - a National Hospital Discharge Registry study. BMC Musculoskelet Disord 2021; 22:456. [PMID: 34011331 PMCID: PMC8135150 DOI: 10.1186/s12891-021-04291-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 04/19/2021] [Indexed: 01/05/2023] Open
Abstract
Background Demographic changes led to an increasingly ageing population in Germany and thus to possible changes in the frequency of fractures. The primary aim of this study was to report changes in fracture rates of the lower extremities in Germany in 2002 compared to 2017 and to evaluate those changes. Methods Inpatient data from the German National Hospital Discharge Registry (ICD10) for 2002 and 2017 were evaluated. Changes in total counts and incidence rates were analysed for fractures in the following locations: femoral neck, pertrochanteric, subtrochanteric, distal femur, femoral shaft, proximal and distal tibia, tibial shaft, medial and lateral malleolus, and other parts of the lower leg (including bi- and trimalleolar fractures), calcaneus, talus, other tarsal bones, metatarsal bones, greater toe, lesser toe, other fractures of foot or unspecific fractures of foot and toe. Patients were classed into age groups by sex: 15–24, 25–34,35–44, 45–54, 55–64, 65–74, 75–84, 85–90 and > 90 years. Results The total count for lower extremity fractures in men and women increased slightly by 4.5% from 305,764 in 2002 to 319,422 in 2017. Hip and femur fractures increased by 23.5% from 150,565 in 2002 to 185,979 in 2017. The number of these fractures among men increased by 46% and among women by 15.3%. The total count of lower leg fractures decreased by 15.4% from 131,162 in 2002 to 110,924 in 2017. Especially, younger age groups showed a decline for all tibial segments and ankle fractures. For both sexes, the number of lower leg fractures in those 75 years or older increased in all lower leg fracture locations. Most femur and lower leg fractures occurred in women. The incidence of fractures rose sharply from 2002 to 2017, especially for older cohorts. Conclusion The total numbers of lower extremity fractures increased slightly in 2017 compared to 2002 – especially hip and femur fractures among men. The incidence of almost all lower extremity fracture types among older people increased during this time. Women were particularly affected. Therefore, focused prevention programmes should be considered including an extended fracture spectrum in the elderly.
Collapse
Affiliation(s)
- Philipp Hemmann
- Department of Traumatology and Reconstructive Surgery, BG Trauma Centre Tuebingen, Eberhard Karls University Tuebingen, Schnarrenbergstrasse 95, 72076, Tuebingen, Germany.
| | - Maximilian Friederich
- Eberhard Karls University Tuebingen, Medical School, Geissweg 5, 72076, Tuebingen, Germany
| | - Daniel Körner
- Department of Traumatology and Reconstructive Surgery, BG Trauma Centre Tuebingen, Eberhard Karls University Tuebingen, Schnarrenbergstrasse 95, 72076, Tuebingen, Germany
| | - Tim Klopfer
- Orthopädische Chirurgie Bayreuth, Parsifalstraße 5, 95445, Bayreuth, Germany
| | - Christian Bahrs
- Department of Orthopaedics and Trauma Surgery, Schön Klinik Neustadt, Am Kiebitzberg 10, 23730, Neustadt in Holstein, Germany
| |
Collapse
|
11
|
Körner D, Gonser CE, Döbele S, Konrads C, Springer F, Keller G. Matrix-associated autologous chondrocyte implantation with autologous bone grafting of osteochondral lesions of the talus in adolescents: patient-reported outcomes with a median follow-up of 6 years. J Orthop Surg Res 2021; 16:243. [PMID: 33832525 PMCID: PMC8028759 DOI: 10.1186/s13018-021-02384-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 03/24/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND This study presents patient-reported outcome measures after combined matrix-associated autologous chondrocyte implantation and autologous bone grafting in high-stage osteochondral lesions of the talus in adolescents. METHODS A total of 12 adolescent patients (13 ankles) received matrix-associated autologous chondrocyte implantation and autologous bone grafting for a solitary osteochondral lesion of the talus at a single centre. The Foot and Ankle Outcome Score and Foot and Ankle Ability Measure were defined as outcome measures (median follow-up 80 months [range 22-107 months]). Pre- and postoperative ankle radiographs were evaluated according to the van Dijk ankle osteoarthritis scale. RESULTS The study population consisted of four male and nine female cases (mean age at the time of surgery, 17.7 ± 2.1 years). Eight lesions were classified as traumatic and five as idiopathic. Twelve lesions were located medial vs one lateral in the coronal plane and all central in the sagittal plane. The median lesion size and depth were 1.3 cm2 (range 0.9-3.2 cm2) and 5 mm (range 5-9 mm), respectively. There were no perioperative complications in any of the cases. In 9 cases patient-reported outcome measures were available. The results of the Foot and Ankle Outcome Score subscales were symptoms, 70 ± 14; pain, 83 ± 10; activities of daily living, 89 ± 12; sports/recreational activities, 66 ± 26; and quality of life, 51 ± 17. The mean overall Foot and Ankle Outcome Score was 78 ± 13. The results of the Foot and Ankle Ability Measure subscales were activities of daily living, 81 ± 20; function/activities of daily living, 84 ± 13; sports, 65 ± 29; and function/sports, 73 ± 27. According to the function overall subscale of the Foot and Ankle Ability Measure, in two cases, the patients assessed the ankle function as normal, in three as nearly normal, and in three as abnormal (missing data, n = 1). Preoperative van Dijk scale: stage 0 in five cases and stage I in eight cases; postoperative van Dijk scale: stage 0 in four cases, stage I in 9 cases CONCLUSIONS: Patient-reported outcome measures following matrix-associated autologous chondrocyte implantation and autologous bone grafting for high-stage osteochondral lesions of the talus in adolescents show heterogeneous results. Long-term limitations mainly affect sports and recreational activities. Osteochondral lesions of the talus are associated with osteoarthritis, even preoperatively. However, we did not find significant osteoarthritis progression after matrix-associated autologous chondrocyte implantation and autologous bone grafting in the long term.
Collapse
Affiliation(s)
- Daniel Körner
- Department of Traumatology and Reconstructive Surgery, BG Trauma Center Tübingen, Eberhard Karls University Tübingen, Schnarrenbergstr. 95, 72076, Tübingen, Germany.
| | - Christoph E Gonser
- Department of Traumatology and Reconstructive Surgery, BG Trauma Center Tübingen, Eberhard Karls University Tübingen, Schnarrenbergstr. 95, 72076, Tübingen, Germany
| | - Stefan Döbele
- Department of Traumatology and Reconstructive Surgery, BG Trauma Center Tübingen, Eberhard Karls University Tübingen, Schnarrenbergstr. 95, 72076, Tübingen, Germany
| | - Christian Konrads
- Department of Traumatology and Reconstructive Surgery, BG Trauma Center Tübingen, Eberhard Karls University Tübingen, Schnarrenbergstr. 95, 72076, Tübingen, Germany
| | - Fabian Springer
- Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Eberhard Karls University Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
- Department of Radiology, BG Trauma Center Tübingen, Eberhard Karls University Tübingen, Schnarrenbergstr. 95, 72076, Tübingen, Germany
| | - Gabriel Keller
- Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Eberhard Karls University Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| |
Collapse
|
12
|
Körner D, Gonser CE, Döbele S, Konrads C, Springer F, Keller G. Re-operation rate after surgical treatment of osteochondral lesions of the talus in paediatric and adolescent patients. J Orthop Surg Res 2021; 16:187. [PMID: 33722244 PMCID: PMC7958698 DOI: 10.1186/s13018-021-02282-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 02/08/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The aim of this study is to analyse the re-operation rate after surgical treatment of osteochondral lesions of the talus (OCLTs) in children and adolescents. METHODS Between 2009 and 2019, 27 consecutive patients with a solitary OCLT (10 male, 17 female; mean age 16.9 ± 2.2 years; 8 idiopathic vs. 19 traumatic) received primary operative treatment (arthroscopy + bone marrow stimulation [BMS], n = 8; arthroscopy + retrograde drilling, n = 8; autologous chondrocyte implantation [ACI]/autologous bone grafting, n = 9; arthroscopy + BMS + retrograde drilling; n = 1; flake fixation, n = 1). Seventeen OCLTs were located at the medial and ten at the lateral talus. 'Re-operation' as the outcome measure was evaluated after a median follow-up of 42 months (range 6-117 months). Patients were further subdivided into groups A (re-operation, n = 7) and B (no re-operation, n = 20). Groups A and B were compared with respect to epidemiological, lesion- and therapy-related variables. RESULTS Seven of 27 patients needed a re-operation (re-operation rate 25.9% after a median interval of 31 months [range 13-61 months]). The following operative techniques were initially used in these seven patients: arthroscopy + BMS n = 2, arthroscopy + retrograde drilling n = 4, ACI + autologous bone grafting n = 1. A comparison of group A with group B revealed different OCLT characteristics between both groups. The intraoperative findings according to the International Cartilage Repair Society (ICRS) classification revealed significantly more advanced cartilage damage in group B than in group A (p = 0.001). CONCLUSIONS We detected a re-operation rate of 25.9% after primary surgical OCLT treatment. Patients with re-operation had significantly lower ICRS classification stages compared to patients without re-operation.
Collapse
Affiliation(s)
- Daniel Körner
- Department of Traumatology and Reconstructive Surgery, BG Trauma Center Tübingen, Eberhard Karls University Tübingen, Schnarrenbergstr. 95, 72076, Tübingen, Germany.
| | - Christoph E Gonser
- Department of Traumatology and Reconstructive Surgery, BG Trauma Center Tübingen, Eberhard Karls University Tübingen, Schnarrenbergstr. 95, 72076, Tübingen, Germany
| | - Stefan Döbele
- Department of Traumatology and Reconstructive Surgery, BG Trauma Center Tübingen, Eberhard Karls University Tübingen, Schnarrenbergstr. 95, 72076, Tübingen, Germany
| | - Christian Konrads
- Department of Traumatology and Reconstructive Surgery, BG Trauma Center Tübingen, Eberhard Karls University Tübingen, Schnarrenbergstr. 95, 72076, Tübingen, Germany
| | - Fabian Springer
- Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Eberhard Karls University Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
- Department of Radiology, BG Trauma Center Tübingen, Eberhard Karls University Tübingen, Schnarrenbergstr. 95, 72076, Tübingen, Germany
| | - Gabriel Keller
- Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Eberhard Karls University Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| |
Collapse
|
13
|
Schleer P, Körner D, Vossel M, Drobinsky S, Radermacher K. Conceptual design of force reflection control for teleoperated bone surgery. Current Directions in Biomedical Engineering 2020. [DOI: 10.1515/cdbme-2020-0014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Bilateral control of teleoperated robots still poses a challenge, especially if environment properties vary over a large degree. Most currently available systems do not provide force feedback and consequently surgeons still have to estimate contact forces predominantly visually. During drilling or milling in bone surgery, visual estimation is virtually impossible due to hardly any deformations. However, the force progression contains important complimentary information for the surgeon. Therefore, a concept for a force-reflecting controller for drilling or milling during teleoperated bone surgery was developed and tested on a one degree of freedom (DOF) test setup. First, the desired behavior and control architectures were derived based on the context of bone surgery. The resulting controller combines three control architectures in a switching controller, depending on the tool actuation and environment properties. Experimental results with a 1-DOF test setup showed the desired control and switching behavior, while remaining stable. Therefore, the developed control concept seems promising for teleoperated bone surgery.
Collapse
Affiliation(s)
- Philipp Schleer
- Chair of Medical Engineering, Helmholtz Institute for Biomedical Engineering , Pauwelsstraße 20 , 52074 Aachen , Germany
| | - Daniel Körner
- Chair of Medical Engineering, Helmholtz Institute for Biomedical Engineering , 52074 Aachen , Germany
| | - Manuel Vossel
- Chair of Medical Engineering, Helmholtz Institute for Biomedical Engineering , 52074 Aachen , Germany
| | - Sergey Drobinsky
- Chair of Medical Engineering, Helmholtz Institute for Biomedical Engineering , 52074 Aachen , Germany
| | - Klaus Radermacher
- Chair of Medical Engineering, Helmholtz Institute for Biomedical Engineering , 52074 Aachen , Germany
| |
Collapse
|
14
|
Gonser CE, Bahrs C, Hemmann P, Körner D. Substantial decrease in paediatric lower extremity fracture rates in German hospitals in 2017 compared with 2002: an epidemiological study. BMC Musculoskelet Disord 2020; 21:357. [PMID: 32513148 PMCID: PMC7282178 DOI: 10.1186/s12891-020-03393-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 06/02/2020] [Indexed: 12/27/2022] Open
Abstract
Background There are no recent studies on the frequency of paediatric lower extremity fractures in Germany. The aims of this study were to report fracture rates of paediatric lower extremity fractures treated in German hospitals in 2002 and 2017 and to detect changes over time as well as to evaluate the gender and age distribution for each fracture location. Methods Data from the German National Hospital Discharge Registry, which covers over 99% of all German hospitals, were used for this study. The absolute frequencies and incidence of lower extremity fractures as well as age at the time of fracture and gender were included in the data. The population was subdivided into four age groups: 0–4, 5–9, 10–14, and 15–19 years. The boy: girl ratio (BGR) for all fracture locations was calculated by dividing the absolute frequency of boys by that of girls. The fracture incidence in 2017 was compared with 2002 by calculating the incidence rate ratio (IRR). Results The total number of fractures decreased by 39.9% from 2002 to 2017. The most common fracture locations in 2002 were femoral shaft, tibial shaft, distal tibia, and lateral and medial malleolus; the absolute number of all these fractures was lower in 2017 than in 2002 in all age groups. The incidence of hip and thigh fractures, knee and lower leg fractures, and foot fractures decreased by 39.0, 41.1, and 33.3%. Proximal tibial fractures increased both in absolute numbers and in incidence in the age groups 0–4, 10–14, and 15–19 years (IRR ≥ 1.1). The overall BGR was 2.3 in 2002 and 2.0 in 2017, indicating that the number of girls relative to that of boys who suffered a lower extremity fracture was higher in 2017 than in 2002. Furthermore, the BGR of all fracture locations increased with age in both years. Conclusions The number of paediatric lower extremity fractures treated in German hospitals in 2017 was significantly lower than that in 2002. However, the fracture frequency in girls decreased to a lesser extent than that in boys. The incidence of proximal tibial fractures increased.
Collapse
Affiliation(s)
- Christoph Emanuel Gonser
- Department of Traumatology and Reconstructive Surgery, BG Trauma Centre Tübingen, Eberhard Karls University Tübingen, Schnarrenbergstr. 95, 72076, Tübingen, Germany
| | - Christian Bahrs
- Department of Traumatology and Reconstructive Surgery, BG Trauma Centre Tübingen, Eberhard Karls University Tübingen, Schnarrenbergstr. 95, 72076, Tübingen, Germany.
| | - Philipp Hemmann
- Department of Traumatology and Reconstructive Surgery, BG Trauma Centre Tübingen, Eberhard Karls University Tübingen, Schnarrenbergstr. 95, 72076, Tübingen, Germany
| | - Daniel Körner
- Department of Traumatology and Reconstructive Surgery, BG Trauma Centre Tübingen, Eberhard Karls University Tübingen, Schnarrenbergstr. 95, 72076, Tübingen, Germany
| |
Collapse
|
15
|
Körner D, Laux F, Stöckle U, Gonser C. Factors influencing the complication rate in pediatric supracondylar humerus fractures. Orthop Rev (Pavia) 2019; 11:7949. [PMID: 31210912 PMCID: PMC6551456 DOI: 10.4081/or.2019.7949] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Accepted: 03/22/2019] [Indexed: 11/22/2022] Open
Abstract
The aim of the study was to identify influencing factors on the complication rate in pediatric supracondylar humerus fractures (PSHF). 22 male and 19 female patients with an extension type PSHF underwent conservative and operative treatment at a single trauma department and were reviewed retrospectively. The complications were assessed and the groups of patients with and without complications were compared according to patient- and therapy-related factors. The overall complication rate was 19.5%. Two patients had a primary and 4 patients a postoperative neurological deficit. One patient developed a pin infection after open reduction and crossed pin fixation. One patient underwent early revision surgery because of insufficient initial reduction after closed reduction and crossed pin fixation. All complications appeared in the surgical treatment group. The appearance of complications was significantly associated with a higher Gartland stage. The median time between trauma and operation was significantly longer in patients without compared to patients with complications. PSHF are associated with a high rate of neurological complications. The Gartland stage and the necessity of surgical treatment are the major influencing factors on the complication rate.
Collapse
Affiliation(s)
- Daniel Körner
- Department of Traumatology and Reconstructive Surgery, BG Trauma Center Tübingen, Eberhard Karls University of Tübingen, Germany
| | - Florian Laux
- Department of Traumatology and Reconstructive Surgery, BG Trauma Center Tübingen, Eberhard Karls University of Tübingen, Germany
| | - Ulrich Stöckle
- Department of Traumatology and Reconstructive Surgery, BG Trauma Center Tübingen, Eberhard Karls University of Tübingen, Germany
| | - Christoph Gonser
- Department of Traumatology and Reconstructive Surgery, BG Trauma Center Tübingen, Eberhard Karls University of Tübingen, Germany
| |
Collapse
|
16
|
Körner D, Gueorguiev B, Niemeyer P, Bangert Y, Zinser W, Aurich M, Walther M, Becher C, Ateschrang A, Schröter S. Correction to: Parameters influencing complaints and joint function in patients with osteochondral lesions of the ankle-an investigation based on data from the German Cartilage Registry (KnorpelRegister DGOU). Arch Orthop Trauma Surg 2018; 138:1333-1334. [PMID: 30027481 DOI: 10.1007/s00402-018-2998-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The original version of this article contained an error.
Collapse
Affiliation(s)
- Daniel Körner
- Department of Traumatology and Reconstructive Surgery, BG Trauma Center Tübingen, Eberhard Karls University Tübingen, Schnarrrenbergstr. 95, 72076, Tübingen, Germany.
| | | | - Philipp Niemeyer
- Department of Orthopedics and Trauma Surgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,OCM Klinik Munich, Munich, Germany
| | - Yannic Bangert
- Department of Orthopedics and Trauma Surgery, Heidelberg University Hospital, Ruprecht Karls University Heidelberg, Heidelberg, Germany
| | - Wolfgang Zinser
- Department of Orthopedics and Trauma Surgery, St. Vinzenz Hospital Dinslaken, Dinslaken, Germany
| | - Matthias Aurich
- Department of Orthopedics and Trauma Surgery, Sana Kliniken Leipziger Land, Borna, Germany
| | - Markus Walther
- Department of Foot and Ankle Surgery, Schön Klinik Munich Harlaching, Munich, Germany
| | - Christoph Becher
- International Center for Hip, Knee and Foot Surgery, ATOS Klinik Heidelberg, Heidelberg, Germany
| | - Atesch Ateschrang
- Department of Traumatology and Reconstructive Surgery, BG Trauma Center Tübingen, Eberhard Karls University Tübingen, Schnarrrenbergstr. 95, 72076, Tübingen, Germany
| | - Steffen Schröter
- Department of Traumatology and Reconstructive Surgery, BG Trauma Center Tübingen, Eberhard Karls University Tübingen, Schnarrrenbergstr. 95, 72076, Tübingen, Germany
| |
Collapse
|
17
|
Körner D, Kohler P, Schröter S, Naumann A, Walther M, Niemeyer P, Bangert Y, Aurich M, Ateschrang A. Pain in Osteochondral Lesions of the Ankle - an Investigation Based on Data from the German Cartilage Registry (KnorpelRegister DGOU). Z Orthop Unfall 2018; 156:160-167. [PMID: 29665603 DOI: 10.1055/s-0043-124597] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND The aim of the study was to investigate parameters influencing the preoperative pain intensity in patients with osteochondral lesions of the ankle. The evaluation covered patient-related parameters such as age, sex, body mass index (BMI), as well as defect-related parameters, such as localisation, size and stage (according to the classification of the International Cartilage Repair Society [ICRS] and the Berndt-Harty-Loomer classification). We also examined the correlation between the different surgical techniques and additional factors, such as debridement of an impingement or stabilisation of the ankle on the one hand, and the preoperative pain intensity on the other. MATERIAL AND METHODS 259 patients with osteochondral lesions of the ankle were operated in 32 clinical centres between October 2014 and December 2016 and enrolled consecutively in the German Cartilage Registry (KnorpelRegister DGOU). 151 patients were available for analysis. The preoperative pain intensity was assessed at the time of surgery with online questionnaires, using the Numeric Rating Scale for pain (NRS). RESULTS The median preoperative pain intensity in the complete study population (n = 151) was 3 (range 0 - 10). There was no correlation between the age and the preoperative pain intensity (ρ = - 0.06). Further, there was not detected a difference between the two genders according to the preoperative pain intensity (p = 0.31). In female patients a higher BMI correlated with a higher preoperative pain intensity (ρ = 0.16). Within the group of patients with a solitary treated talus lesion there was no difference according to the preoperative pain intensity between the different localizations of the defect (medial vs. lateral talus) (p = 0.82). Within the group of patients with a solitary treated talus or tibia lesion there was no correlation between the defective area or the lesion stage according to the ICRS classification on the one hand, and the preoperative pain intensity on the other (ρ = 0.09, and ρ = 0.04, respectively). According to the Berndt-Harty-Loomer classification a higher lesion stage (stage four and five) was associated with a higher preoperative pain intensity (ρ = 0.13). There was no difference according to the preoperative pain intensity between the group of patients that received a debridement of a bony or soft tissue impingement in addition to the cartilage therapy and the group of patients without this kind of additional therapy (p = 0.10). Further, there was no difference according to the preoperative pain intensity between the group of patients that received a stabilisation of the ankle joint in addition to the cartilage therapy and the group of patients without a stabilisation procedure (p = 0.83). CONCLUSION Osteochondral lesions of the ankle can be associated with a moderate and in some cases high pain intensity. In female patients a higher BMI is associated with a higher pain intensity. Further, a higher lesion stage according to the Berndt-Harty-Loomer classification is associated with a higher pain intensity, which highlights the clinical relevance of this classification.
Collapse
Affiliation(s)
- Daniel Körner
- Klinik für Unfall- und Wiederherstellungschirurgie, BG Unfallklinik Tübingen
| | - Philipp Kohler
- Klinik für Unfall- und Wiederherstellungschirurgie, BG Unfallklinik Tübingen
| | - Steffen Schröter
- Klinik für Unfall- und Wiederherstellungschirurgie, BG Unfallklinik Tübingen
| | - Aline Naumann
- Institut für Klinische Epidemiologie und angewandte Biometrie, Universitätsklinikum Tübingen
| | - Markus Walther
- Zentrum für Fuß- und Sprunggelenkchirurgie, Schön Klinik München-Harlaching, München
| | - Philipp Niemeyer
- Orthopädische Chirurgie München (OCM), München.,Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Freiburg
| | - Yannic Bangert
- Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Heidelberg
| | - Matthias Aurich
- Zentrum Orthopädie und Unfallchirurgie, Klinikum Ingolstadt GmbH, Ingolstadt
| | - Atesch Ateschrang
- Klinik für Unfall- und Wiederherstellungschirurgie, BG Unfallklinik Tübingen
| |
Collapse
|
18
|
Ateschrang A, Körner D, Joisten K, Ahrend MD, Schröter S, Stöckle U, Riedmann S. Incidence and risk factors for postoperative Achilles tendon calcifications after percutaneous repair. Arch Orthop Trauma Surg 2018; 138:203-210. [PMID: 29094200 DOI: 10.1007/s00402-017-2829-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Numerous publications are dealing with acute Achilles tendon rupture. To our knowledge, no systematic trial has been published analyzing the incidence, risk factors and the potential clinical impact of postoperative tendon calcifications (PTC) after percutaneous Achilles tendon repair. Therefore, the aim of this study was to analyze these relevant aspects. MATERIALS AND METHODS Between March 2003 and November 2010, a total of 126 patients with an acute, complete Achilles tendon rupture were treated with a percutaneous technique according to Ma and Griffith at a single university-based trauma department. The follow-up included a detailed clinical and sonographic examination. To assess the functional outcome and possible impact of PTC after percutaneous Achilles tendon repair, the Thermann and AOFAS scores were used. 81 patients (65 men and 16 women) with a median age of 46 years (range 24-76) were available for a follow-up examination. The median time of follow-up was 64 months (range 15-110 months). RESULTS PTC occurred in nine out of 81 patients (11.1%). All patients with PTC were male with a median age of 52 years (range 26-76 years). In the group of patients with PTC, the median overall Thermann score was 94 (range 68-100) and the median overall AOFAS score was 97 (range 85-100). In the group of patients without PTC, the median overall Thermann score was 88.5 (range 60-100) and the median overall AOFAS score was 97 (range 85-100). No significant differences were detected between the group of patients with PTC and the group of patients without PTC and the clinical outcome according to the Thermann (p = 0.21) and the AOFAS scores (p = 0.37). None of the patients with PTC sustained a re-rupture. The overall re-rupture rate was 4.9%. PTC was no risk factor for wound and neurological complications. CONCLUSION The incidence of PTC after percutaneous Achilles tendon repair was 11.1%. Male gender and advanced age seem to be risk factors for PTC. In this study, PTC had no negative impact on the postoperative clinical outcome.
Collapse
Affiliation(s)
- Atesch Ateschrang
- Department of Traumatology and Reconstructive Surgery, BG Trauma Center Tübingen, Eberhard Karls University Tübingen, Schnarrrenbergstr. 95, 72076, Tübingen, Germany
| | - Daniel Körner
- Department of Traumatology and Reconstructive Surgery, BG Trauma Center Tübingen, Eberhard Karls University Tübingen, Schnarrrenbergstr. 95, 72076, Tübingen, Germany.
| | - Konrad Joisten
- Department of Oral and Maxillofacial Surgery, Marien Hospital, Stuttgart, Germany
| | - Marc-Daniel Ahrend
- Department of Traumatology and Reconstructive Surgery, BG Trauma Center Tübingen, Eberhard Karls University Tübingen, Schnarrrenbergstr. 95, 72076, Tübingen, Germany
| | - Steffen Schröter
- Department of Traumatology and Reconstructive Surgery, BG Trauma Center Tübingen, Eberhard Karls University Tübingen, Schnarrrenbergstr. 95, 72076, Tübingen, Germany
| | - Ulrich Stöckle
- Department of Traumatology and Reconstructive Surgery, BG Trauma Center Tübingen, Eberhard Karls University Tübingen, Schnarrrenbergstr. 95, 72076, Tübingen, Germany
| | - Stephan Riedmann
- Orthopedic Clinic Paulinenhilfe, Diakonie Clinic, Stuttgart, Germany
| |
Collapse
|
19
|
Schabus M, Körner D, Gnjezda MT, Heib DP, Blume C, Hödlmoser K. 0270 ON THE INCONSISTENCY OF SLEEP EFFECTS ON DECLARATIVE AND PROCEDURAL MEMORY CONSOLIDATION - AN EEG STUDY ACROSS MULTIPLE SLEEP LABORATORY NIGHTS. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
20
|
Körner D, Gueorguiev B, Niemeyer P, Bangert Y, Zinser W, Aurich M, Walther M, Becher C, Ateschrang A, Schröter S. Parameters influencing complaints and joint function in patients with osteochondral lesions of the ankle-an investigation based on data from the German Cartilage Registry (KnorpelRegister DGOU). Arch Orthop Trauma Surg 2017; 137:367-373. [PMID: 28168643 DOI: 10.1007/s00402-017-2638-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Patients with osteochondral lesions of the ankle represent a heterogeneous population with traumatic, posttraumatic and idiopathic forms of this pathology, where the etiology of the idiopathic form is principally unknown. The aim of this study was to classify the heterogeneous patient population according to the patients' complaints and joint function. Data from the German Cartilage Registry (KnorpelRegister DGOU) was analyzed for this purpose to investigate whether traumatic and posttraumatic lesions cause more complaints and loss of joint function than idiopathic lesions. Moreover, it was sought to determine if lesion localization, defective area, stage, patient age, gender, and body mass index (BMI) are related to patients' complaints and loss of joint function. MATERIALS AND METHODS A 117 patients with osteochondral lesions of the ankle were operated in 20 clinical centers in the period between October 2014 and January 2016. Data collection was performed by means of a web-based Remote Data Entry system at the time of surgery. Patients' complaints and joint function were assessed with online questionnaires using the German versions of the Foot and Ankle Ability Measure (FAAM) and the Foot and Ankle Outcome Score (FAOS), followed by statistical data evaluation. RESULTS No significant difference was indicated between the groups with traumatic/posttraumatic lesions and idiopathic lesions with regard to most of the patients' complaints and joint function, excluding the category Life quality of the FAOS score, where patients with idiopathic lesions had a significantly better quality of life (p = 0.02). No significant association was detected between lesion localization, defective area, patient age, gender, and BMI on the one hand, and patients' complaints and joint function on the other. Similarly, no significant association was found between lesion stage according to the International Cartilage Repair Society (ICRS) classification and patients' complaints and joint function. However, a higher lesion stage according to the classification of Berndt and Harty, modified by Loomer, was significantly associated with more complaints and loss of joint function in some categories of the FAAM and FAOS scores (p ≤ 0.04). CONCLUSIONS Etiology of the lesion, lesion localization, defective area, lesion stage according to the ICRS classification, patient age, gender, and BMI do not seem to be of considerable relevance for prediction of patients' complaints and loss of joint function in osteochondral lesions of the ankle. Using the classification of Berndt and Harty, modified by Loomer, seems to be more conclusive.
Collapse
Affiliation(s)
- Daniel Körner
- Department of Traumatology and Reconstructive Surgery, BG Trauma Center Tübingen, Eberhard Karls University Tübingen, Schnarrrenbergstr. 95, 72076, Tübingen, Germany.
| | | | - Philipp Niemeyer
- Department of Orthopedics and Trauma Surgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,OCM Klinik Munich, Munich, Germany
| | - Yannic Bangert
- Department of Orthopedics and Trauma Surgery, Heidelberg University Hospital, Ruprecht Karls University Heidelberg, Heidelberg, Germany
| | - Wolfgang Zinser
- Department of Orthopedics and Trauma Surgery, St. Vinzenz Hospital Dinslaken, Dinslaken, Germany
| | - Matthias Aurich
- Department of Orthopedics and Trauma Surgery, Sana Kliniken Leipziger Land, Borna, Germany
| | - Markus Walther
- Department of Foot and Ankle Surgery, Schön Klinik Munich Harlaching, Munich, Germany
| | - Christoph Becher
- International Center for Hip, Knee and Foot Surgery, ATOS Klinik Heidelberg, Heidelberg, Germany
| | - Atesch Ateschrang
- Department of Traumatology and Reconstructive Surgery, BG Trauma Center Tübingen, Eberhard Karls University Tübingen, Schnarrrenbergstr. 95, 72076, Tübingen, Germany
| | - Steffen Schröter
- Department of Traumatology and Reconstructive Surgery, BG Trauma Center Tübingen, Eberhard Karls University Tübingen, Schnarrrenbergstr. 95, 72076, Tübingen, Germany
| |
Collapse
|
21
|
Belharazem D, Grass A, Paul C, Vitacolonna M, Schalke B, Rieker RJ, Körner D, Jungebluth P, Simon-Keller K, Hohenberger P, Roessner EM, Wiebe K, Gräter T, Kyriss T, Ott G, Geserick P, Leverkus M, Ströbel P, Marx A. Increased cFLIP expression in thymic epithelial tumors blocks autophagy via NF-κB signalling. Oncotarget 2017; 8:89580-89594. [PMID: 29163772 PMCID: PMC5685693 DOI: 10.18632/oncotarget.15929] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 12/26/2016] [Indexed: 12/12/2022] Open
Abstract
The anti-apoptotic cellular FLICE-like inhibitory protein cFLIP plays a pivotal role in normal tissues homoeostasis and the development of many tumors, but its role in normal thymus (NT), thymomas and thymic carcinomas (TC) is largely unknown. Expression, regulation and function of cFLIP were analyzed in biopsies of NT, thymomas, thymic squamous cell carcinomas (TSCC), thymic epithelial cells (TECs) derived thereof and in the TC line 1889c by qRT-PCR, western blot, shRNA techniques, and functional assays addressing survival, senescence and autophagy. More than 90% of thymomas and TSCCs showed increased cFLIP expression compared to NT. cFLIP expression declined with age in NTs but not in thymomas. During short term culture cFLIP expression levels declined significantly slower in neoplastic than non-neoplastic primary TECs. Down-regulation of cFLIP by shRNA or NF-κB inhibition accelerated senescence and induced autophagy and cell death in neoplastic TECs. The results suggest a role of cFLIP in the involution of normal thymus and the development of thymomas and TSCC. Since increased expression of cFLIP is a known tumor escape mechanism, it may serve as tissue-based biomarker in future clinical trials, including immune checkpoint inhibitor trials in the commonly PD-L1high thymomas and TCs.
Collapse
Affiliation(s)
- Djeda Belharazem
- Institute of Pathology and Medical Research Center (ZMF), University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany
| | - Albert Grass
- Institute of Pathology and Medical Research Center (ZMF), University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany
| | - Cornelia Paul
- Institute of Pathology and Medical Research Center (ZMF), University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany
| | - Mario Vitacolonna
- Department of Thoracic Surgery, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany
| | - Berthold Schalke
- Department of Neurology, University of Regensburg, Regensburg, Germany
| | - Ralf J Rieker
- Institute of Pathology, University Hospital Heidelberg, University of Heidelberg, Heidelberg, Germany.,Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Daniel Körner
- Department of Thoracic Surgery, Thorax Clinic, University of Heidelberg, Heidelberg, Germany
| | - Philipp Jungebluth
- Department of Thoracic Surgery, Thorax Clinic, University of Heidelberg, Heidelberg, Germany
| | - Katja Simon-Keller
- Institute of Pathology and Medical Research Center (ZMF), University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany
| | - Peter Hohenberger
- Department of Thoracic Surgery, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany
| | - Eric M Roessner
- Department of Thoracic Surgery, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany
| | - Karsten Wiebe
- Department of Thoracic Surgery, University of Münster, Münster, Germany
| | - Thomas Gräter
- Department of Thoracic Surgery, Clinic Löwenstein, Löwenstein, Germany
| | - Thomas Kyriss
- Department of Thoracic Surgery, Clinic Schillerhöhe, Robert-Bosch-Hospital, Gerlingen, Germany
| | - German Ott
- Department of Clinical Pathology, Robert-Bosch-Hospital, Stuttgart, Germany.,Dr. Margarete Fischer-Bosch Institute for Clinical Pharmacology, Stuttgart, Germany
| | - Peter Geserick
- Department of Dermatology, Venereology, and Allergology, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Martin Leverkus
- Department of Dermatology, Venereology, and Allergology, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.,Department for Dermatology and Allergology, University Hospital Aachen, RWTH Aachen, Aachen, Germany
| | - Philipp Ströbel
- Institute of Pathology, University Medical Center Göttingen, University of Göttingen, Göttingen, Germany
| | - Alexander Marx
- Institute of Pathology and Medical Research Center (ZMF), University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany
| |
Collapse
|
22
|
Meister U, Ohnesorge B, Körner D, Boevé MH. Evaluation of ultrasound velocity in enucleated equine aqueous humor, lens and vitreous body. BMC Vet Res 2014; 10:250. [PMID: 25312851 PMCID: PMC4205291 DOI: 10.1186/s12917-014-0250-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 10/06/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sonographic ophthalmic examinations have become increasingly important in veterinary medicine. If the velocity of ultrasound in ocular tissues is known, the A-mode ultrasound method may be used to determine the axial intraocular distances, such as anterior chamber depth, lens thickness, axial length of the vitreous and axial globe length, which are required for intraocular lens (IOL) power calculations. To the authors' knowledge, the velocity of ultrasound in the ocular tissues of the horse was not previously determined. In the present study, 33 lenses, 29 samples of aqueous and 31 of vitreous from 35 healthy equine eyes have been examined. The corresponding ultrasound velocities are reported in dependence of age, temperature, gender and elapsed time after enucleation. RESULTS The velocity of ultrasound at 36°C in equine aqueous, lens and vitreous are 1529 ±10 m/s, 1654± 29 m/s and 1527 ±16 m/s respectively, and the corresponding conversion factors are 0.998± 0.007, 1.008 ±0.018 and 0.997 ±0.010. A linear increase of the speed of ultrasound with increasing temperature has been determined for aqueous and vitreous. No temperature dependence was found for the speed of ultrasound in the lens. The ultrasound velocity did not significantly differ (95%) on the basis of gender, age or time after enucleation during the first 72 hours after death. CONCLUSIONS Compared to human eyes, the ultrasound velocity in equine lental tissue deviates by one percent. Therefore, axial length measurements obtained with ultrasound velocities for the human eye must be corrected using conversion factors. For the aqueous and vitreous, deviations are below one percent and can be neglected in clinical settings.
Collapse
Affiliation(s)
- Ulrike Meister
- Stiftung Tierärztliche Hochschule Hannover, Klinik für Pferde, Bünteweg 9, 30559, Hannover, Germany.
| | - Bernhard Ohnesorge
- Stiftung Tierärztliche Hochschule Hannover, Klinik für Pferde, Bünteweg 9, 30559, Hannover, Germany.
| | - Daniel Körner
- Theoretisch-Physikalisches Institut, Friedrich-Schiller-Universität Jena, 07743, Jena, Germany.
| | - Michael H Boevé
- Stiftung Tierärztliche Hochschule Hannover, Klinik für Pferde, Bünteweg 9, 30559, Hannover, Germany.
| |
Collapse
|
23
|
Körner D, Zabeck H, Rieker RJ, Muley T, Dienemann H. Die chirurgische Therapie von Thymomen und Thymuskarzinomen. Eine retrospektive Auswertung von 84 Patienten. Zentralbl Chir 2014. [DOI: 10.1055/s-0034-1389304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
24
|
Huang B, Belharazem D, Li L, Kneitz S, Schnabel PA, Rieker RJ, Körner D, Nix W, Schalke B, Müller-Hermelink HK, Ott G, Rosenwald A, Ströbel P, Marx A. Anti-Apoptotic Signature in Thymic Squamous Cell Carcinomas - Functional Relevance of Anti-Apoptotic BIRC3 Expression in the Thymic Carcinoma Cell Line 1889c. Front Oncol 2013; 3:316. [PMID: 24427739 PMCID: PMC3876280 DOI: 10.3389/fonc.2013.00316] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Accepted: 12/11/2013] [Indexed: 12/24/2022] Open
Abstract
The molecular pathogenesis of thymomas and thymic carcinomas (TCs) is poorly understood and results of adjuvant therapy are unsatisfactory in case of metastatic disease and tumor recurrence. For these clinical settings, novel therapeutic strategies are urgently needed. Recently, limited sequencing efforts revealed that a broad spectrum of genes that play key roles in various common cancers are rarely affected in thymomas and TCs, suggesting that other oncogenic principles might be important. This made us re-analyze historic expression data obtained in a spectrum of thymomas and thymic squamous cell carcinomas (TSCCs) with a custom-made cDNA microarray. By cluster analysis, different anti-apoptotic signatures were detected in type B3 thymoma and TSCC, including overexpression of BIRC3 in TSCCs. This was confirmed by qRT-PCR in the original and an independent validation set of tumors. In contrast to several other cancer cell lines, the BIRC3-positive TSCC cell line, 1889c showed spontaneous apoptosis after BIRC3 knock-down. Targeting apoptosis genes is worth testing as therapeutic principle in TSCC.
Collapse
Affiliation(s)
- Bei Huang
- Pathologisches Institut der Universität Würzburg , Würzburg , Germany
| | - Djeda Belharazem
- Pathologisches Institut und Zentrum für Medizinische Forschung (ZMF), Universitätsmedizin Mannheim der Universität Heidelberg , Mannheim , Germany
| | - Li Li
- Pathologisches Institut und Zentrum für Medizinische Forschung (ZMF), Universitätsmedizin Mannheim der Universität Heidelberg , Mannheim , Germany ; Pathologisches Institut der Universitätsmedizin Göttingen , Göttingen , Germany
| | - Susanne Kneitz
- Pathologisches Institut der Universität Würzburg , Würzburg , Germany
| | | | - Ralf J Rieker
- Pathologisches Institut, Universität Heidelberg , Heidelberg , Germany
| | - Daniel Körner
- Abteilung Thoraxchirurgie, Thoraxklinik Rohrbach, Universität Heidelberg , Heidelberg , Germany
| | - Wilfred Nix
- Neurologische Universitätsklinik Mainz , Mainz , Germany
| | - Berthold Schalke
- Neurologische Universitätsklink Regensburg , Regensburg , Germany
| | | | - German Ott
- Pathologisches Institut, Robert-Bosch-Krankenhaus , Stuttgart , Germany
| | - Andreas Rosenwald
- Pathologisches Institut der Universität Würzburg , Würzburg , Germany
| | - Philipp Ströbel
- Pathologisches Institut und Zentrum für Medizinische Forschung (ZMF), Universitätsmedizin Mannheim der Universität Heidelberg , Mannheim , Germany ; Pathologisches Institut der Universitätsmedizin Göttingen , Göttingen , Germany
| | - Alexander Marx
- Pathologisches Institut und Zentrum für Medizinische Forschung (ZMF), Universitätsmedizin Mannheim der Universität Heidelberg , Mannheim , Germany
| |
Collapse
|
25
|
Körner D. [Miracle healers of the Weimar Republic. Protagonists, methods of healing and status within the health care system]. Neuere Med Wiss Quellen Stud 2012; 29:11-40. [PMID: 22586883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- Daniel Körner
- Universität Köln sowie an der Ruprecht-Karls-Universität Heidelberg
| |
Collapse
|
26
|
Körner D. [Miracle healers of the Weimar Republic. Protagonists, methods of healing and status within the health care system. The miracle healers]. Neuere Med Wiss Quellen Stud 2012; 29:41-147-discusion 159. [PMID: 22586884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- Daniel Körner
- Universität Köln sowie an der Ruprecht-Karls-Universität Heidelberg
| |
Collapse
|
27
|
|
28
|
|
29
|
|
30
|
Kretschmer S, Körner D, Strohbach G, Klingenberg P, Jacob HE, Gumpert J, Ruttloff H. Physiologischer und zellbiologische Charakterisierung des Proteasebildners Thermoactinomyces vulgaris während Langzeit-Kultivation im Rührfermentor. J Basic Microbiol 2007. [DOI: 10.1002/jobm.19820221003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
31
|
Körner D, Palluck E. [Animal model for the study of the biocompatibility of root filling materials]. Dtsch Z Mund Kiefer Gesichtschir 1991; 15:395-400. [PMID: 1816974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The aim of this study was to investigate the influence of different pins usually used for intraoperative root filling on periapical bone healing. In a specially designed animal experiment it was possible to evaluate biocompatibility simultaneously with the influence of varying materials on bone regeneration in standardized defects. Bioincompatible silver, acrylate and gutta percha root filling delay and impede bone regeneration. Biocompatible aluminium oxide ceramic and titanium pins do not have any influences on spontaneous bone regeneration. Reducing the defect, however, they do improve the conditions for complete bony regeneration.
Collapse
Affiliation(s)
- D Körner
- Klinik und Poliklinik für Mund-Kiefer-Gesichtschirurgie der Friedrich-Alexander-Universität Erlangen-Nürnberg
| | | |
Collapse
|
32
|
Schüle H, Körner D. [Traffic as a medical problem in high-risk patients]. Dtsch Zahnarztl Z 1986; 41:409-11. [PMID: 3461959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
|
33
|
Körner D. Experimentelle und klinische Untersuchungen zur Entwicklung einer Innenbogenplatte für die Rekonstruktion von Unterkieferkontinuitätsdefekten. BIOMED ENG-BIOMED TE 1985. [DOI: 10.1515/bmte.1985.30.s1.56] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
34
|
Ruttloff H, Körner D, Jacob H. Importance of carbon dioxide for the cultivation of Thermoactinomyces vulgaris from spores. Enzyme Microb Technol 1983. [DOI: 10.1016/0141-0229(83)90047-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
35
|
|
36
|
Kretschmer S, Körner D, Strohbach G, Klingenberg P, Jacob HE, Gumpert J, Ruttloff H. [Physiological and cell biological characterization of the protease producer Thermoactinomyces vulgaris during prolonged culture in a stirred fermenter]. Z Allg Mikrobiol 1982; 22:693-703. [PMID: 6188286 DOI: 10.1002/jobm.3630221003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The physiological behaviour of Thermoactinomyces vulgaris - producing a thermostable serine-protease - was analyzed during fermentation. During 38 h the consumption of nutrients and oxygen as well as the rates of macromolecular and protease synthesis were measured. The morphological and ultrastructural changes of the mycelia were also studied. The mycelia grew exponentially for about 5 hours. After a short lag and a second slower growth phase, growth continued about linearly until the end, as was indicated by a constant rate of incorporation of labelled thymidine. However, at the same time a changing portion of hyphae - up to 45% - underwent lysis. According to the changing ratio of growing and lysing material, regarding the physiological activity of the culture the fermentation process could be divided into 4 periods. The formation of the protease started at the transition to the slow growth phase and continued linearly. The ability to produce the protease was attributed to a mycelium being formed after the shift down caused by limitation of supply of utilizable nitrogen compounds. The end of protease production 10 h later was correlated to a drastic decrease of the respiratory activity of the mycelia, probably caused by exhaustion of easily utilizable carbohydrates.
Collapse
|
37
|
|