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Orthopaedic Proceedings
Vol. 105-B, Issue SUPP_17 | Pages 85 - 85
24 Nov 2023
Wetzel K Mueller A Mathys M Morgenstern M Clauss M
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Aim

Musculoskeletal infection is a serious complication, however literature is lacking prospective data on its impact on mental health. The study aimed to assess mental health in patients with musculoskeletal infections and how they experience the possible mental and physical impairment.

Method

All patients treated in our unit for musculoskeletal infections between July 2020 and March 2022 were prospectively included. To assess specific patient reported outcomes the following questionnaires were used: World-Health-Organization Quality-Of-Life (WHOQOL)-BREF and the Veterans-RAND-12Item Health Survey (VR-12) for mental & physical health; Patient-Health-Questionnaire (PHQ-8) for depression symptoms; Generalized-Anxiety-Disorder-Scale-7 (GAD-7) for anxiety symptoms and Somatic-Symptom-Disorder-B Criteria Scale (SSD-12) for experience of mental & physical impairment. The surveys were conducted at baseline, 6 and 12-weeks and 1-year.


Orthopaedic Proceedings
Vol. 98-B, Issue SUPP_9 | Pages 8 - 8
1 May 2016
Lorenz A Mueller A Lange B Herzog Y Schnauffer P Wuelker N Leichtle U
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Introduction

Persistent anterior knee pain, subluxation or dislocation of the patella as well as early aseptic loosening and increased polyethylene wear of the patella implant are common clinical problems after total knee arthroplasty (TKA) which are associated with the patellofemoral joint. In addition to patellar resurfacing, the design of the patellofemoral joint surfaces is attributed a large influence. While for patients without patella resurfacing, the native patella is sliding on the standardized femoral component and therefore the possibility of a reduced surface matching is high, patella resurfacing has been shown to decrease the joint contact area and yield to increased patellofemoral pressure. With regard to a further design optimization, the current study examined patellar biomechanics after TKA without and with resurfacing, comparing 5 differently designed patellofemoral joint surfaces of the femoral implant.

Methods

The femoral implant of the Genesis II prosthesis (Smith & Nephew) was scanned and an adaptable CAD-model was built using CATIA. Five different designs of the patellofemoral groove were created:

original

completely flat

laterally elevated (+2mm lateral, −1mm medial)

medially elevated (+2mm medial, −1mm lateral)

laterally & medially elevated (+3mm lateral+medial)

The tibiofemoral joint as well as patellofemoral groove path and radius remained unchanged. Rapid Prototyping was used to produce prototypes made of polyamide.

A dynamic muscle loaded knee squat was simulated on 10 fresh frozen knee specimens with an upright knee simulator. The patellofemoral pressure distribution was measured using a flexible, resistive force sensor (TEKSCAN) while tibiofemoral and patellofemoral kinematics were recorded with an ultrasonic motion tracking system (ZEBRIS). In addition, patellar stability was measured in different flexion angles on another 10 specimens using a robot (KUKA). Measurements were taken on the native knee as well as after TKA and after additional patellar resurfacing with alternating femoral implant.


Orthopaedic Proceedings
Vol. 97-B, Issue SUPP_11 | Pages 8 - 8
1 Oct 2015
Mueller A Tew S Clegg P Canty-Laird E
Full Access

Introduction

The two-dimensional (2D) monolayer culture paradigm has limited translational potential to physiological systems; chondrocytes and tenocytes in monolayer lose expression of hallmarks of differentiated status (dedifferentiation). Qualitative assessment of three-dimensional (3D) cultures in musculoskeletal biology relative to native tissues has been limited. An understanding of prevailing gene regulatory networks is required to define whether 3D culture systems faithfully restitute the native tissue phenotype (redifferentiation). Using a systems biology approach to explore the gene networks associated with de- and re-differentiation may define targetable regulators associated with phenotypic plasticity of adult musculoskeletal cells.

Materials and Methods

Global transcriptomic and proteomic profiling of matrix-depleted chondrocytes and tenocytes from the rat was performed for each of three conditions (native tissue, monolayer at passage three, or tissue-appropriate 3D cultures). Differential analysis of mRNA and protein abundance, gene ontology annotation, pathway topology impact analysis, and derivation of common mechanistic networks was undertaken to define consensus expression profiles, signalling pathways, and upstream regulators for de- and re-differentiation in each cell type.


Orthopaedic Proceedings
Vol. 97-B, Issue SUPP_11 | Pages 16 - 16
1 Oct 2015
Mueller A Clegg P
Full Access

Introduction

The rabbit common calcanean (Achilles) tendon is a compound apparatus frequently used in studies considering novel interventions to facilitate tendon regeneration. These studies often employ complete surgical transection of the apparatus. Due consideration of the translational relevance to human tendinopathy is often lacking and refinement of this injury model, consistent with the principles of the 3Rs, has not been forthcoming.

Materials and Methods

Wild rabbit cadavers (n=10) were obtained from a licensed game dealer. For gross anatomy studies the caudal crus was dissected and transverse sections obtained every 5 mm. Ultrasongraphic examination of the entire apparatus was peformed with a 15 Hz transducer in transverse sections.


Orthopaedic Proceedings
Vol. 88-B, Issue SUPP_I | Pages 90 - 90
1 Mar 2006
Claus A Roessing S Mueller-Falcke A Scharf H
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Introduction: Minimal-invasive techniques in total joint replacement are perceived to reduce soft tissue trauma. In TKR, reduced exposure during surgery bares the risk of component malpositioning. Therefore we have combined minimal invasive surgical techniques with non-CT based navigation in TKR. The purpose of this observational study is to describe first results of a controlled observational study comparing minimal invasive navigated total knee arthroplasty (MINI-NAV-TKR) to open navigated total knee arthroplasty (NAV-TKR) with respect to component positioning, surgery time and immediate postoperative complications.

Materials and Methods: From June to September 2004, 26 MINI-NAV-TKR and 33 NAV-TKR have been performed by five surgeons in an unselected group of patients. In both groups, preoperative deformation of the mechanical leg axis was compared to postoperative mechanical leg axis using total one-leg standing radiographs. To control the safety and reproducibility of both procedures, time of surgery and postoperative complications were compared among both groups.

Results: Given informed consent, 17 females and 9 males received 26 MINI-NAV-TKR, mean age was 71,06 years (ranging from 56,24 years to 84, 35 years), mean BMI was 28,8 kg/m2 and preoperative mechanical leg axis ranged from 18o varus to 16 o valgus. In NAV-TKR group, 12 males and 21 females at a mean age of 68,75 (range 51,97 to 86,73 years) received 33 TKR, mean BMI was 30,6 kg/m2 and preoperative mechanical axis ranged from 11 varus to 20 valgus. Postoperative radiographic leg alignment in the MINI-NAV-TKR group ranged from 1 degree valgus to 3 degree varus mechanical axis as compared to the NAV-TKR that ranged from 1 valgus to one outlayer of 4 degree varus. Time of surgery significantly differed among the groups (mean time Mini-NAV-TKR 115,23 min versus mean time NAV-TKR 98,15 minutes, p=0,002). In the MINI-NAV-TKR group 1 postoperative pin-infection and one conversion to an open procedure have been reported, in the NAV-TKR group 2 hematomas have been described.

Conclusion: Despite increased mean time of surgery in the MINI-NAV-TKR group, component positioning and complications are comparable between both groups. These preliminary results indicate, that MINI-NAV-TKR combined with navigation is a safe and reproducible method.