Abstract:
BACKGROUND:Potential adverse and unknown long-term effects as well as additional costs limit the use of BMPs (Bone morphogenetic proteins) in primary fusion procedures. However, the proven osteoinductive properties render BMPs attractive for the attempt to reach fusion of symptomatic non-unions. The aim of this study is to evaluate the fusion rate and potential disadvantages of eptotermin alfa (rhBMP-7) used with autologous bone graft in revision procedures for lumbar pseudoarthrosis. MATERIALS AND METHODS:At our institution, rhBMP-7 has been used to improve fusion rates in revision surgery for symptomatic pseudoarthrosis during the past 10 years. Eighty-four fusion procedures using rhBMP-7 between 08/2003 and 07/2011 were revisions due to symptomatic lumbar pseudoarthrosis. The surgical approach was posterior in three and combined anterior-posterior in 71 patients. Of those, 74 patients had either reached fusion or had follow-up of at least 39.5 months (range 21-80 months) in the case of pseudoarthrosis. These 74 patients have been included in a retrospective follow-up study. RESULTS:In 60 patients (81.1 %) the rhBMP-7 procedure was successful. In 14 patients, pseudoarthrosis persisted or fusion was questionable. Of those patients 12 accounted for persisting L5-S1 non-union. Persisting non-unions were found in 26.7 % of the study after four or more segment instrumentations compared to the 16.9 % after mono-, bi-, or three-segment instrumentation, and in four of 14 patients with spondylodesis of three or more levels above a pseudoarthrotic lumbosacral junction. Adverse effects related to the use of eptotermin alfa were rare in this group with symptomatic ectopic bone formation in one patient. CONCLUSIONS:Using rhBMP-7 with autologous bone graft in revisions for lumbar pseudoarthrosis via an anterior approach is safe and can lead to fusion even under unfavorable biomechanical conditions. However, successful outcome depends on the individual constellation. Treatment of non-unions of the lumbosacral junction remains especially difficult in cases with solid fusions above those pseudoarthrotic levels. LEVEL OF EVIDENCE:4; retrospective follow-up study.
journal_name
Arch Orthop Trauma Surgjournal_title
Archives of orthopaedic and trauma surgeryauthors
Werle S,AbuNahleh K,Boehm Hdoi
10.1007/s00402-016-2485-xsubject
Has Abstractpub_date
2016-08-01 00:00:00pages
1041-9issue
8eissn
0936-8051issn
1434-3916pii
10.1007/s00402-016-2485-xjournal_volume
136pub_type
杂志文章abstract:BACKGROUND:Although long bone defects may be treated by callus distraction, frequent complications arise from the long duration of external fixation. To reduce such complications, bone transport over an intramedullary nail (BTON) has been done for tibial bone defect. METHODS:In 12 patients (mean age, 46.1 years) of ch...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-007-0491-8
更新日期:2008-08-01 00:00:00
abstract:INTRODUCTION:Only few procedures for Lisfranc ligaments reconstruction to treat subtle injury of the Lisfranc joint have been reported. We have developed a novel technique for Lisfranc ligaments reconstruction, which was applied to treat chronic symptomatic subtle injuries that had failed to respond to initial treatmen...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-015-2250-6
更新日期:2015-08-01 00:00:00
abstract::We describe a case of a 68-year-old patient presenting with pathological hip fracture and multiple pulmonary metastases, who has been operated without a prior histological diagnosis. The hip lesion was thought to be a metastasis of an unknown primary tumor. The proximal part of the femur was resected and replaced by a...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/BF00936214
更新日期:1989-01-01 00:00:00
abstract::Extended thromboprophylaxis is vital in patients undergoing total hip arthroplasty (THA) because of the prolonged risk of venous thromboembolism (VTE). Despite evidence that extended prophylaxis can reduce the incidence of symptomatic VTE in this high-risk patient population and the evidence-based guideline recommenda...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-009-0930-9
更新日期:2010-05-01 00:00:00
abstract:BACKGROUND:Scant evidence exists to support antibiotic use for low velocity ballistic fractures (LVBF). We therefore sought to define current practice patterns. We hypothesized that most surgeons prescribe antibiotics for LVBF, prescribing is not driven by institutional protocols, and that decisions are based on protoc...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-016-2450-8
更新日期:2016-06-01 00:00:00
abstract::Self-reinforced poly-L-lactide (SR-PLLA) and self-reinforced polyglycolide (SR-PGA) pins were implanted intra-articularly and directly into the bone of the distal femur of rats at three levels: above, on the same level, and under the surface. For the controls only channels were drilled, or the controls were not operat...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s004020050336
更新日期:1998-01-01 00:00:00
abstract:INTRODUCTION:The present study investigates the reaction of bone density as well as the possible factors influencing this reaction following a cement-free total knee arthroplasty (TKA). MATERIALS AND METHODS:Osteodensitometry scan data from 50 prospective patients with TKA was evaluated. The patients were split into t...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-012-1601-9
更新日期:2012-11-01 00:00:00
abstract::A series of 14 total hip arthroplasties with a Müller acetabular supporting ring including 3 primary and 11 revision arthroplasties is reviewed. This device was used in cases of acetabular bone deficiency, and bone graft was added in 11 cases. The mean length of follow-up was 39.9 months. Twelve patients had good or s...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/BF00393718
更新日期:1997-01-01 00:00:00
abstract:INTRODUCTION:We present a single-surgeon series of 14 acute ruptured distal biceps tendons repaired using a biotenodesis screw through a single anterior incision. PATIENTS:The demographics of this population reveal a typical injury pattern and reflect the preponderance of distal biceps ruptures in the middle aged, act...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章,评审
doi:10.1007/s00402-009-0974-x
更新日期:2010-07-01 00:00:00
abstract:BACKGROUND:Anterior knee pain (AKP) is a major complication that occurs after anterior cruciate ligament reconstruction (ACLR), even when hamstring tendon (HT) grafts are used. Damage to the infrapatellar fat pad (IPFP) during arthroscopy can cause AKP. The purpose of this study was to evaluate the influence of IPFP pr...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-020-03520-5
更新日期:2020-11-01 00:00:00
abstract:INTRODUCTION:Bankart repair laxity may contribute to pathologic joint instability. This biomechanical study compared two screw-in suture anchor-suture combinations under tensile loads. METHODS:Twelve pairs of scapulae were implanted with either a 3 mm diameter, 14 mm long poly-L/D-lactide suture anchor with a suture e...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-009-0926-5
更新日期:2010-03-01 00:00:00
abstract::For the treatment of infected joints, bones and soft tissues, either an instillation drainage therapy or the use of gentamicin-polymethyl-methacrylate (PMMA) chains (Septopal) in addition to surgical revision and systemically given antibiotics is currently in clinical use. We investigated 102 patients treated in our c...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章,评审
doi:10.1007/BF00434543
更新日期:1996-01-01 00:00:00
abstract:BACKGROUND:Since self-limited repair ability of the necrotic lesion may be a cause for failure of the technique, the possibility has been raised that bone marrow mononuclear cells (BMMCs) containing BMSCs implanted into a necrotic lesion of the femoral head with core decompression (CD) may be of benefit in the treatmen...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-009-0939-0
更新日期:2010-07-01 00:00:00
abstract::Seventy-two patients with neoplastic involvement of the vertebral column were operated on between 1986 and 1991. In the course of 79 operations anterior decompression and stabilization alone were performed in 3 cases, while ventrodorsal spondylodesis was carried out in 10 individuals. The remainder of the patients und...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/BF00572907
更新日期:1994-01-01 00:00:00
abstract:INTRODUCTION:Patients with knee osteoarthritis tend to modify spatial and temporal parameters during walking to reduce the pain. Total knee arthroplasty (TKA) is considered the gold standard treatment for end-stage knee osteoarthritis. However, reduced physical function of the knee is partly, but apparently not fully, ...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-017-2629-7
更新日期:2017-03-01 00:00:00
abstract:BACKGROUND:The iliotibial band (ITB) is used in anterior cruciate ligament (ACL) reconstruction in skeletally immature patients as well as several other orthopedic reconstructions. The purpose of this study is to determine the size of the ITB as an autograft option in ACL reconstruction surgery or other orthopedic soft...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-019-03208-5
更新日期:2020-01-01 00:00:00
abstract::Total knee arthroplasty (TKA) has been shown to have good long-term outcomes and survivorship. Nonetheless, dissatisfied patients are frequently reported in the literature. Bi-cruciate retaining total knee prostheses (BCR TKA) were designed to address the demand for more kinematically functional implants that better r...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章,评审
doi:10.1007/s00402-020-03622-0
更新日期:2020-10-13 00:00:00
abstract:INTRODUCTION:Rotator cuff tears are common and good-to-excellent clinical outcome is reported after subsequent repair. However, the retear rate of rotator cuff repairs has been shown to be as high as 20%. The reasons for retear seem to be multifactorial, mainly comprised by mechanical and biological aspects. Regarding ...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-017-2823-7
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:Demand for revision total hip arthroplasty (RTHA) continues to grow worldwide and is expected to more than double within the next 1-2 decades. The primary aim of this study was to examine return to function following revision THA in a UK population. PATIENTS AND METHODS:We assessed 118 patients (132 RTHAs, ...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-018-3090-y
更新日期:2019-03-01 00:00:00
abstract::Nineteen severely affected hips in 12 young patients with ankylosing spondylitis were treated with bipolar hip arthroplasty followed by a comprehensive postoperative rehabilitation programme. Additional operative procedures of adductor tenotomy, knee flexion release, supracondylar femoral osteotomy for genu valgum and...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/BF00573449
更新日期:1996-01-01 00:00:00
abstract:STUDY DESIGN:Radiological study. PURPOSE:To asses standard values, intra- and interobserver reliability and reproducibility of sacral slope (SS) and lumbar lordosis (LL) and the correlation of these parameters in patients with lumbar spinal stenosis (LSS). METHODS:Anteroposterior and lateral X-rays of the lumbar spin...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-015-2184-z
更新日期:2015-05-01 00:00:00
abstract::From March 1984 to April 1996, 60 consecutive patients with spinal metastasis underwent palliative surgery by anterior corpectomy and Zielke instrumentation. Their ages ranged from 21 to 76 years (mean 54 years). Thirty-two patients had metastasis to the thoracic spine, 20 to the lumbar spine, and 8 had both thoracic ...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/pl00021238
更新日期:2000-01-01 00:00:00
abstract::The purpose of our study was to evaluate the value of MRI for preoperative arthroscopical planning in patients with osteochondritis dissecans. Based on the experience from 136 patients with osteochondritis dissecans of the knee or the ankle who were arthroscopically operated by retrograde drilling a follow-up study wa...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s004020050235
更新日期:1998-01-01 00:00:00
abstract:INTRODUCTION:The osteosynthesis of intracapsular hip fractures results in a 19-48% failure rate. Only when the anatomical reduction is secured by stable fixation, revascularisation of the femoral head can take place and the fracture can heal by primary osteonal reconstruction. The common implants lack rotational and/or...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-010-1195-z
更新日期:2011-04-01 00:00:00
abstract::Dorsal dislocation of the interphalangeal (IP) joint of the thumb is a rare injury, and closed dislocation without fracture is especially unusual. We present here two cases of closed dislocation of the thumb which were reduced by manipulation. ...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/BF00434563
更新日期:1996-01-01 00:00:00
abstract:INTRODUCTION:Superior capsule reconstruction (SCR) has been used for the tendon grafting of massive rotator cuff tears when primary repair is difficult. We examined the postoperative outcomes of SCR for massive rotator cuff tears and the risk factors for postoperative retear. MATERIALS AND METHODS:Through this retrosp...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-019-03316-2
更新日期:2020-10-01 00:00:00
abstract:INTRODUCTION:The purpose of the study was to determine the surgical outcomes of intramedullary nailing in diaphyseal atypical femoral fractures (AFFs) and to evaluate the clinical outcomes of nail entry modification technique. MATERIALS AND METHODS:We retrospectively reviewed diaphyseal AFFs treated with IMN at nine i...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-017-2764-1
更新日期:2017-11-01 00:00:00
abstract:INTRODUCTION:The purpose of this study was to review the clinical and radiographic outcomes and report the major complications in a group of hips with Crowe type IV developmental dysplasia that underwent reconstruction with a cementless total hip arthroplasty and a transverse subtrochanteric shortening osteotomy fixed ...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-012-1560-1
更新日期:2012-10-01 00:00:00
abstract::One hundred sixty-two neonates with sonographically diagnosed developmental dysplasia of the hip (200 hips) according to the method of Graf were treated with a Pavlik harness until sonographic maturation was reached. Eight patients (12 hips) treated with closed reduction and retention in a bilateral hip spica cast wer...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/BF00443818
更新日期:1994-01-01 00:00:00
abstract::Perthes' disease was originally viewed as a local ischaemic necrosis of the femoral head. Several authors, however, have presented data suggesting that children with this disease also suffer from a general disorder of skeletal maturation. Hormonal changes in the hypothalamus-pituitary-growth plate axis have been discu...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/BF00388093
更新日期:1992-01-01 00:00:00