Abstract:
:In recent years, increasing concern has been raised regarding potential systemic toxicity of metals released from arthroplasty implants. A lack of valid metal thresholds for human (organ) toxicity and the prospect of multi-decade survival of modern hip and knee replacements pose special challenges. Indeed, evidence of systemic effects of metals released from such implants is largely missing. Systemic cobalt exposure has repeatedly been associated with cardiotoxic and neurotoxic effects, and also with thyroid dysfunction. The toxic potential of chromium is considered less pronounced. Yet, in arthroplasty there is usually a co-exposure to chromium and cobalt which complicates evaluation of element-specific effects. Toxicity of titanium dioxide nanoparticles has been subject to debate among international regulatory authorities. Their wide use in a variety of products in everyday life, such as toothpaste, cosmetics and food colorants, hampers the assessment of an arthroplasty-induced systemic titanium exposure. To date there is no clear evidence for systemic complications due to titanium dioxide released from arthroplasty implants. Release of further metals such as tantalum, niobium, nickel, vanadium and zirconium from hip and knee replacement implants has been described occasionally, but systemic effects of respective long-term exposure scenarios are unknown. Generally, the characterization of all released metals regarding their chemical and physical specifications is critical for the evaluation of potential systemic risks. Systematic studies investigating the accumulation of metals relevant in arthroplasty in different organs/organ systems and the biological consequences of such accumulations are urgently needed. :Systemische Effekte von aus Endoprothesen freigesetzten Metallen rücken zunehmend in den Fokus des Interesses von Patienten, Ärzten, Wissenschaftlern und Legislative. Besondere Herausforderungen stellen das Fehlen valider Schwellenwerte für (Organ-)Toxizität und die zunehmend langen Standzeiten moderner Hüft- und Knietotalendoprothesen dar. Tatsächlich ist die Evidenz für systemische Komplikationen einer Metallbelastung durch solche Implantate jedoch sehr schwach. Eine systemische Exposition gegenüber Cobalt wurde wiederholt vor allem mit kardio- und neurotoxischen Effekten, aber auch mit thyreoidalen Funktionsstörungen in Verbindung gebracht. Das toxische Potenzial von freigesetztem Chrom gilt als weitaus weniger ausgeprägt, ist allerdings im Kontext der Endoprothetik schwer zu evaluieren, da hier quasi regelhaft eine simultane Exposition gegenüber Chrom und Cobalt erfolgt. Die Toxizität nanopartikulären Titandioxids ist Gegenstand internationaler regulatorischer Debatten, sein vielfältiges Vorkommen in unserem Alltag, etwa als Weißmacher in Zahnpasta, Kosmetika oder Lebensmitteln, erschwert die Einschätzung einer möglichen zusätzlichen Belastung durch Endoprothesen. Bislang gibt es keine eineindeutige Evidenz für systemische Komplikationen durch die Freisetzung von Titandioxid aus Endoprothesen. Die Freisetzung von weiteren Metallen wie Tantal, Niob, Nickel, Vanadium und Zirkonium aus Endoprothesen wurde in einzelnen Fällen beschrieben, systemische Effekte entsprechender Langzeitexpositionen sind noch nicht bekannt. Generell ist die Charakterisierung freigesetzter Metalle hinsichtlich ihrer chemischen und physikalischen Spezifikationen für die Bewertung eines möglichen systemischen Risikos entscheidend. Systematische Studien, die die Akkumulation von in der Endoprothetik relevanten Metallen in verschiedenen Organen bzw. Organsystemen und deren biologische Konsequenzen untersuchen, sind dringend erforderlich.
journal_name
Z Orthop Unfalljournal_title
Zeitschrift fur Orthopadie und Unfallchirurgieauthors
Rakow A,Schoon Jdoi
10.1055/a-1187-1751subject
Has Abstractpub_date
2020-10-01 00:00:00pages
501-507issue
5eissn
1864-6697issn
1864-6743journal_volume
158pub_type
杂志文章abstract:BACKGROUND:Brace treatment prevents the progression of scoliosis and reduces surgical treatment rates. However, the efficacy of brace treatment varies depending on the patient's age, gender, curve magnitude and type, structure of the curve, and patient compliance at the beginning of treatment. METHODS:Between January ...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/a-1269-0000
更新日期:2020-11-24 00:00:00
abstract:AIM:Whole body spiral CT scans have become a routine method in the radiological imaging of severely injured patients in emergency rooms of an increasing number of hospitals. The routine use of CT scans is, however, still discussed controversially, especially with regard to its use in children. This is mainly due to the...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-2007-989438
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:Total hip and knee replacements are very frequently performed operative procedures in German hospitals. Despite the high number of cases, only few data on treatment procedures of the clinical routine and their impact on postoperative length of stay and clinical outcome are available. The aim of our survey wa...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章,多中心研究
doi:10.1055/s-0034-1383023
更新日期:2014-10-01 00:00:00
abstract::The present refresher article highlights the current role of pedicled flaps in the reconstruction of complex wounds at the lower extremity. Due to the increasing standardization and ongoing improvements in microsurgery and in view of the fact that local tissue limitation and elevated rates of wound healing disorders r...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0043-124091
更新日期:2019-02-01 00:00:00
abstract::In contrast to periprosthetic fractures of the femur, periprosthetic fractures of the acetabulum are rare complications - both primary fractures and fractures in revision surgery. This topic is largely under-reported in the literature; there are a few case reports and no long term results. Due to an increase in life e...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-0042-113196
更新日期:2016-12-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to evaluate the impact of students preexisting anatomic proficiency to address the fundamental problems related to musculoskeletal ultrasound (MSUS) training by assessing the peer-assisted learning (PAL) system. METHODS:Students without anatomic knowledge (first semester, n = 38) an...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0030-1250378
更新日期:2010-12-01 00:00:00
abstract:BACKGROUND:Cement leakage is regarded as a typical complication of cement-based augmentation of vertebral fractures. The gold standard is balloon kyphoplasty (BK). Recent methods, such as radiofrequency kyphoplasty (RFK), must be compared with BK in terms of therapeutic success and complication rates. It is unclear whe...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章,随机对照试验
doi:10.1055/s-0042-104069
更新日期:2016-08-01 00:00:00
abstract:AIM:Loosening of the glenoid component is one of the major causes of failure in total shoulder arthroplasty. Possible risk factors for loosening of cemented components include an eccentric loading, poor bone quality, inadequate cementing technique and insufficient cement penetration. The application of a modern cementi...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0030-1249986
更新日期:2010-12-01 00:00:00
abstract::Fractures of the scapula are rare and have an incidence of 1% of all fractures. Publications highlight glenoid rim fractures. Classification by Ideberg and Euler and Rüdi are accepted. Euler and Rüdi describe three extra-articular and two intra-articular fracture patterns. The indications for surgery are displaced gle...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/a-0576-2036
更新日期:2018-08-01 00:00:00
abstract::Historically pediatric scoliosis represents a condition deeply rooted within the origins of orthopedic surgery. Today only a few subspecialized surgeons treat pediatric scoliosis patients. In severe cases surgery can hold progression of and correct pathologic spinal curvature. The goal of this article is to provide an...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/a-0965-7760
更新日期:2020-10-01 00:00:00
abstract:AIM:Navigated implantation of the cup and stem components enables additional parameters to be recorded for joint reconstruction. The results and reproducibility of the implant position were studied in a consecutive series of implantations with femoral transmitter (femoral C-clamp) close to the hip joint. METHOD:107 co...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-2007-965650
更新日期:2007-09-01 00:00:00
abstract:AIM OF THE STUDY:Maintaining segmental motion is one of the most reported theoretical advantages of total disc replacement (TDR). Several inlay sizes are available for reconstruction of the physiological disc height. The influence of the implant height on the range of motion (ROM) was investigated in a biomechanical st...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-2008-1038400
更新日期:2008-07-01 00:00:00
abstract:AIM:The aim of this prospective clinical trial was to analyse the ventral fusion rate following circumferential fusion for degenerative spine disease using a radiolucent carbon fibre cage (Brantigan, Fa. DePuy-Acromed) loaded with either autogeneous bone graft (iliac crest) or with the tricalcium phosphate Cerasorb wit...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章,随机对照试验
doi:10.1055/s-2007-965252
更新日期:2007-07-01 00:00:00
abstract:BACKGROUND:Hallux valgus is one of the most prevalent foot deformities, and surgical treatment of Hallux valgus is one of the most common procedures in foot and ankle surgery. Diagnostic and treatment standards show large variation despite medical guidelines and national foot and ankle societies. The aim of this nation...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0043-120352
更新日期:2018-04-01 00:00:00
abstract:AIM:This study evaluated the image quality of two different cone beam CT scanners used in the operation theatre in pelvic trauma surgery in relation to their radiation dosage. Furthermore, the assumption that a higher dosage would result in better image quality was analysed by using the different acquisition scanner mo...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0030-1271136
更新日期:2011-12-01 00:00:00
abstract:AIM:The aim of this study was to make a mid-term evaluation of an unconstrained pyrocarbon prosthesis (Ascension®) in the treatment of idiopathic degenerative arthritis of the proximal interphalangeal joint of the hand. METHOD:13 implants (10 patients) were clinically and radiologically studied after a follow-up perio...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 临床试验,杂志文章
doi:10.1055/s-0031-1298389
更新日期:2012-06-01 00:00:00
abstract:AIM:The expert committee of the German Ministry for Labour and Social Affairs suggested carpal tunnel syndrome (CTS) as an "occupational disease". This systematic literature review and metaanalysis was aimed at identifying associated and risk factors for CTS. Part II addresses the occupational factors of CTS. MATERIAL...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章,meta分析,评审
doi:10.1055/s-0032-1315346
更新日期:2012-10-01 00:00:00
abstract:AIM:Dynamic gait analysis of blocked distal tibiofibular joint (TFJ) has not performed yet. This prospective study investigated patients treated for ankle fractures with combined syndesmotic complex lesions after surgery including tibiofibular positioning screw using CT data detecting fibular maltorsion and dynamic gai...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 临床试验,杂志文章
doi:10.1055/s-0029-1185695
更新日期:2009-07-01 00:00:00
abstract::Bone sarcomas are extremely rare representing approximately 0.2% among all cancer types. Due to the rarity of these tumors both the patients and the physicians can overlook or misinterpret the first often unspecific symptoms of these tumors (pain, limping and swelling). Therefore, radiographic examination (X-ray and/o...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-0043-117905
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:Analysis of the regional development of spine surgery in Germany between 2005 and 2014. MATERIAL AND METHODS:A secondary data analysis of inpatient data from the Scientific Institute of the AOK (WIdO) was carried out for the period 2005 to 2014. The number of spinal procedures was determined on the basis of...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0043-124768
更新日期:2018-02-07 00:00:00
abstract:BACKGROUND:The developments towards a combined specialty of orthopaedic and trauma surgery requires not only the consolidation and revision of the postgraduate education training programme but also the development of a catalogue of learning objectives as a uniform basis for undergraduate medical training in the new spe...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-2008-1038899
更新日期:2008-07-01 00:00:00
abstract:AIM:The aim of this study was to investigate hyaline cartilage defects treated with cell-seeded artificial matrix systems (two different collagen type I gels) with the method of optical coherence tomography (OCT) and to correlate the results with conventional histological and immunocytochemical staining. METHOD:Osteoc...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-2008-1038948
更新日期:2008-11-01 00:00:00
abstract::Anterior dynamic scoliosis correction is an innovative non-fusion option in the treatment of patients with severe adolescent scoliosis. Growth modulation and sometimes intraoperative curve correction is achieved by convex insertion of segmental screws and a flexible polyethylene cord. The present review analyses and d...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/a-0983-1265
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:The dislocated posterolateral fragment of the distal tibia is considered as a key fragment for the successful reduction of comminuted ankle fractures. The reduction of this fragment can either be achieved indirectly by joint reduction using the technique of closed anterior-posterior screw fixation, or direct...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0035-1545706
更新日期:2015-06-01 00:00:00
abstract:AIM:The objective of this systematic review and meta-analysis is to obtain information about risks and associated factors for knee symptoms and the progression of osteoarthritis in idiopathic bone marrow lesion (BML). MATERIALS AND METHODS:The primary search on 31. 12. 2013 included the databases PubMed, EMBASE, Web o...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章,meta分析,评审
doi:10.1055/s-0042-101560
更新日期:2016-08-01 00:00:00
abstract::During the last years, the prosthetic replacement in upper limb amputees has undergone different developments. The use of new nerve surgical concepts improved the control strategies tremendously, especially for high-level amputees. Technological innovation in the field of pattern recognition enables the control of mul...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-0042-108910
更新日期:2016-08-01 00:00:00
abstract::Background: Osteochondral lesions (OCL) of the ankle are a common cause of ankle pain. Although the precise pathophysiology has not been fully elucidated, it can be assumed that a variety of factors are responsible, mainly including traumatic events such as ankle sprains. Advances in arthroscopy and imaging techniques...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章,实务指引,评审
doi:10.1055/s-0042-116330
更新日期:2017-02-01 00:00:00
abstract::A young woman had subcutaneous bleeding at the retinaculum of the left knee after minor trauma. A small vein was attached to the scar and repeatedly ruptured after several other small traumas. Conservative therapy had no impact on the genesis of the bleeding. Having gone through severe bleeding situations with massive...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0029-1240786
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND:The aim of this study was to assess the impact of Peyton's 4-step approach on musculoskeletal ultrasound skills in a peer-teaching environment as compared to traditional "see one, do one" training and to evaluate students' acceptance of the training strategy. MATERIAL AND METHODS:A total of 491 second year ...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章,随机对照试验
doi:10.1055/a-0715-2435
更新日期:2019-06-01 00:00:00
abstract:AIM:In this prospective study we have analysed the clinical outcome of complex distal radius fractures that were reduced by a dorsal approach and fixed with 2 dorsal locking plates. METHODS:In the period from January 2006 to June 2008 60 patients with a distal intra-articular instable radius fracture, who were treated...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0029-1186156
更新日期:2010-01-01 00:00:00