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Article: Mid-Term Migration Behavior of an Uncemented Proximally Anchored Straight Stem-A Retrospective EBRA Migration Analysis.

Blum, Philipp / Neugebauer, Johannes / Keiler, Alexander / Putzer, David / Watrinet, Julius / Biermeier, Sebastian / Dammerer, Dietmar

Journal of clinical medicine

2023 Volume 12, Issue 13

Abstract: Background: Aseptic loosening is one of the most-common causes of the failure of cementless stems. Einzel Bild Röntgen Analyse-Femoral Component Analysis (EBRA-FCA) allows the diagnosis of stem migration, which can be considered a factor in predicting ... ...

Abstract	Background: Aseptic loosening is one of the most-common causes of the failure of cementless stems. Einzel Bild Röntgen Analyse-Femoral Component Analysis (EBRA-FCA) allows the diagnosis of stem migration, which can be considered a factor in predicting implant survival. The current study aimed to present the migration behavior of a tapered proximally anchored straight stem. Methods: This retrospective study reviewed all consecutive patients who received a cementless CBC straight stem (Mathys AG, Bettlach, Switzerland) between 2005 and 2019. We analyzed the migration pattern using the EBRA-FCA software and reviewed their medical histories. In addition, periprosthetic radiolucency was rated according to the Gruen zones and femoral configuration according to Dorr. Results: A total of 333 stems in 332 patients (female 191; male 141) met our inclusion criteria. The mean age at surgery was 63 (range 21-87) years. Migration analysis by EBRA-FCA showed a mean subsidence of 1.6 mm at final follow-up at 96 months with a maximum noted mean subsidence of 2.0 mm at 72 and 84 months. Dorr Type A showed a tendency of less subsidence than did Dorr Type B and was statistically significant at 6 ( Conclusions: The results showed migration behavior in cementless stems with initial increased migration and subsequent secondary stabilization, suggesting an excellent long-term outcome. Stem migration of this tapered proximally anchored stem might be lower in Dorr Type A than in Dorr Type B femurs without being statistically significant at all time points.
Language	English
Publishing date	2023-06-28
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm12134335
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Multiple Intraosseous Lipomatosis - A Case Report and a Review of the Literature.

Dammerer, Dietmar / Neugebauer, Johannes / Putzer, David / Henninger, Benjamin

In vivo (Athens, Greece)

2021 Volume 35, Issue 2, Page(s) 959–964

Abstract: Background: Intraosseous lipomatosis is a rare and uncommon entity with only a few cases reported in the literature.: Case report: We report a severe case where post-traumatic radiographs showed multiple cystic osseous lesions and a pathological ... ...

Abstract	Background: Intraosseous lipomatosis is a rare and uncommon entity with only a few cases reported in the literature. Case report: We report a severe case where post-traumatic radiographs showed multiple cystic osseous lesions and a pathological fracture. The findings were expanded with whole-body magnetic resonance imaging (MRI), which showed multiple osseous lesions with typical MRI characteristics of intraosseous lipomas. Conclusion: Our case, together with very few other cases described in the literature, emphasizes that multiple intraosseous lipomatosis is an important differential diagnosis for multiple radiolucent lesions on plain radiographs. Multiple intraosseous lipomatosis can lead to pathological fractures and severe impairment of life quality. The presence of well-defined, osteolytic lesions in the bone calls for an MRI or computed tomography scan.
MeSH term(s)	Bone Neoplasms ; Humans ; Lipoma/diagnostic imaging ; Lipomatosis/diagnostic imaging ; Magnetic Resonance Imaging ; Whole Body Imaging
Language	English
Publishing date	2021-03-12
Publishing country	Greece
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	807031-3
ISSN	1791-7549 ; 0258-851X
ISSN (online)	1791-7549
ISSN	0258-851X
DOI	10.21873/invivo.12337
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Article ; Online: Emerging from the shade of p53 mutants: N-terminally truncated variants of the p53 family in EMT signaling and cancer progression.

Engelmann, David / Pützer, Brigitte M

Science signaling

2014 Volume 7, Issue 345, Page(s) re9

Abstract: The prevailing view has been that N-terminally truncated p53 family isoforms (ΔNp53, ΔNp63, and DNp73) predominantly counteract cell cycle arrest and apoptosis. Recent progress in the field extend these well-known functions and place these isoforms in ... ...

Abstract	The prevailing view has been that N-terminally truncated p53 family isoforms (ΔNp53, ΔNp63, and DNp73) predominantly counteract cell cycle arrest and apoptosis. Recent progress in the field extend these well-known functions and place these isoforms in the center of a comprehensive regulatory network controlling major epithelial-to-mesenchymal transition (EMT)-relevant signaling pathways [such as transforming growth factor-β (TGF-β), wingless-int (WNT), insulin-like growth factor (IGF), and signal transducer and activator of transcription (STAT)], microRNAs, and EMT-associated transcription factors that promote invasion, loss of tumor cell polarity, and metastatic behavior in conjunction with a chemoresistant phenotype. These observations add new weight to the concept that currently underappreciated truncated forms of this tumor suppressor family play an equally important role in promoting cancer aggressiveness as do mutant p53 proteins, and illustrate how the consequences of ΔN/DN expression depend on cellular contexts. The tumor microenvironment contributes to the emergence of these variants, thereby linking inflammation to the activation of the mesenchymal program. In addition, molecular connections between ΔN/DN forms and self-renewal have arisen, suggesting their potential function in the generation of cancer stem cells (CSCs) from bulk tumor cells. These intriguing insights provoke a new understanding of the acquisition of aggressive traits by carcinoma cells in the absence of p53 mutations, and may help direct the development of new therapies for a broad range of cancers.
MeSH term(s)	Carcinoma/genetics ; Carcinoma/physiopathology ; Epithelial-Mesenchymal Transition/genetics ; Gene Expression Regulation, Neoplastic/genetics ; Humans ; Models, Biological ; Multigene Family/genetics ; Protein Isoforms/genetics ; Signal Transduction/genetics ; Tumor Suppressor Protein p53/genetics
Chemical Substances	Protein Isoforms ; Tumor Suppressor Protein p53
Language	English
Publishing date	2014-09-30
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	2417226-1
ISSN	1937-9145 ; 1945-0877
ISSN (online)	1937-9145
ISSN	1945-0877
DOI	10.1126/scisignal.2005699
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Impact of the Covid-19 Pandemic on Orthopaedic and Trauma Surgery - A Systematic Review of the Current Literature.

Blum, Philipp / Putzer, David / Liebensteiner, Michael C / Dammerer, Dietmar

In vivo (Athens, Greece)

2021 Volume 35, Issue 3, Page(s) 1337–1343

Abstract: Background/aim: The Coronavirus disease 2019 (COVID-19) has led to significant disruptions in various medical specialties. We herein aimed to provide a systematic review of the published literature on the impact by the Covid-19 pandemic on orthopaedic ... ...

Abstract	Background/aim: The Coronavirus disease 2019 (COVID-19) has led to significant disruptions in various medical specialties. We herein aimed to provide a systematic review of the published literature on the impact by the Covid-19 pandemic on orthopaedic and traumatological care by focusing on the number of clinical visits, surgeries and reasons for consultation. Materials and methods: The published literature was reviewed using PubMed. Of 349 studies published between December 1, 2019 and October 1, 2020, 36 original articles met the inclusion criteria. Articles were selected on the basis of the PRISMA guidelines. October 1, 2020 was used as the concluding date of publication. Results: The number of elective visits declined by 50.0% to 74.0%. The number of emergency and trauma visits showed a decrease of 37.7% to 74.2%. Trauma surgery decreased by 21.2% to 66.7% and elective surgeries by 33.3% to 100%. Conclusion: Orthopaedic and trauma surgery is clearly influenced by the pandemic. It will be important to maintain treatment and surgical care of patients in order to avoid negative effects on treatment progress.
MeSH term(s)	COVID-19 ; Humans ; Orthopedics ; Pandemics ; SARS-CoV-2 ; Traumatology
Language	English
Publishing date	2021-04-28
Publishing country	Greece
Document type	Journal Article ; Review ; Systematic Review
ZDB-ID	807031-3
ISSN	1791-7549 ; 0258-851X
ISSN (online)	1791-7549
ISSN	0258-851X
DOI	10.21873/invivo.12386
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Zs.A 2288: Show issues

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Jg. 1995 - 2021: Lesesall (2.OG)
ab Jg. 2022: Lesesaal (EG)

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Article: EBRA Migration Analysis of a Modular, Distally Fixed Stem in Hip Revision Arthroplasty: A Clinical and Radiological Study.

Blum, Philipp / Putzer, David / Neugebauer, Johannes / Neubauer, Markus / Süß, Markus / Dammerer, Dietmar

Journal of clinical medicine

2022 Volume 11, Issue 19

Abstract: Background: Massive osteolysis of the proximal femur makes stem revision a challenging procedure. EBRA-FCA provides the opportunity to determine stem migration, which is considered a predictive factor for implant survival. In this study, we aimed to ... ...

Abstract	Background: Massive osteolysis of the proximal femur makes stem revision a challenging procedure. EBRA-FCA provides the opportunity to determine stem migration, which is considered a predictive factor for implant survival. In this study, we aimed to analyze the migration behavior of a modular, distally fixed reconstruction prosthesis. Methods: Applying a retrospective study design, we reviewed all consecutive patients who received a cementless MP reconstruction prosthesis (Waldemar Link GmbH & Co. KG, Hamburg, Germany) at our Department between 2005 and 2019. We reviewed medical histories and performed radiological measurements using EBRA-FCA software. Results: A total of 67 stems in 62 patients (female 26; male 36) fulfilled our inclusion criteria. Mean age at surgery was 68.0 (range 38.7−88.44) years. EBRA migration analysis showed a median subsidence of 1.6 mm (range 0.0−20.6) at 24 months. The angle between stem and femur axis was 0.3° (range 0.0°−2.9°) at final follow-up. No correlation between body mass index and increased subsidence was found (p > 0.05). Overall revision-free rate amounted to 92.5% and revision-free rate for aseptic loosening to 98.5%. Furthermore, no case of material breakage was detected. Conclusions: In summary, the MP reconstruction prosthesis showed low subsidence and reduction in the migration rate over the investigated follow-up. Based on this, the modular stem can be considered as a good therapy option in challenging stem revisions offering various options to address the individual anatomical situation.
Language	English
Publishing date	2022-10-03
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm11195857
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Article ; Online: Aerosol morphology and particle size distribution in orthopaedic bone machining: a laboratory worst-case contamination simulation. Is high-speed bone machining potentially harmful by pollution and quality schemes and what measures could be taken for prevention?

Putzer, David / Dammerer, Dietmar / Huber, Cora / Boschert, Harald / Thaler, Martin / Nogler, Michael

International orthopaedics

2022 Volume 46, Issue 7, Page(s) 1647–1655

Abstract: Aim of the study: High-speed bone machining devices with irrigation fluid were used in surgery to spread aerosols and toss tissue particles of varying morphology into the operating room. Based on measurements taken on a phantom object, the shape, size, ... ...

Abstract	Aim of the study: High-speed bone machining devices with irrigation fluid were used in surgery to spread aerosols and toss tissue particles of varying morphology into the operating room. Based on measurements taken on a phantom object, the shape, size, and spatial contamination distribution of such particles were assessed. Method: Cadaveric femoral heads were continuously machined with a spherical bur, manually held at a fixed attack angle. The irrigation fluid used during bone machining was enriched with bacteria to act as a tracer to quantify the spatial contamination. A vertical board equipped with snippets served as a phantom object to assess contamination load and morphology of airborne particles. Results: Eight-nine percent of the particles had a non-circular cross section. The detected particle size ranged across six orders of magnitude, from 0.006 to 4 mm2 with a median particle size of 0.125 mm2. The CFU counts observed after the standard machining time ranged from 7 to 240, with a median of 2 CFUs. The highest median contamination was seen at the upper right corner of the phantom. Discussion: The experiments show that contaminating particles of a wide variety of shapes and sizes are part of the aerosol created by high-speed burring. While protection of personnel and equipment is always important, surgical helmets should be worn, especially at contamination hotspots, and gloves should be replaced at the end of machining. Sensitive instruments and measuring devices-such as optical sensors-should also be protected effectively, as the optical measurement may be obstructed by aerosol particles.
MeSH term(s)	Aerosols/adverse effects ; Humans ; Operating Rooms ; Orthopedics ; Particle Size
Chemical Substances	Aerosols
Language	English
Publishing date	2022-04-18
Publishing country	Germany
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	80384-4
ISSN	1432-5195 ; 0341-2695
ISSN (online)	1432-5195
ISSN	0341-2695
DOI	10.1007/s00264-022-05398-x
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Article: Characterizing the Mechanical Behavior of Bone and Bone Surrogates in Compression Using pQCT.

Pallua, Johannes D / Putzer, David / Jäger, Elias / Degenhart, Gerald / Arora, Rohit / Schmölz, Werner

Materials (Basel, Switzerland)

2022 Volume 15, Issue 14

Abstract: Many axial and appendicular skeleton bones are subjected to repetitive loading during daily activities. Until recently, the structural analysis of fractures has been limited to 2D sections, and the dynamic assessment of fracture progression has not been ... ...

Abstract	Many axial and appendicular skeleton bones are subjected to repetitive loading during daily activities. Until recently, the structural analysis of fractures has been limited to 2D sections, and the dynamic assessment of fracture progression has not been possible. The structural failure was analyzed using step-wise micro-compression combined with time-lapsed micro-computed tomographic imaging. The structural failure was investigated in four different sample materials (two different bone surrogates, lumbar vertebral bodies from bovine and red deer). The samples were loaded in different force steps based on uniaxial compression tests. The micro-tomography images were used to create three-dimensional models from which various parameters were calculated that provide information about the structure and density of the samples. By superimposing two 3D images and calculating the different surfaces, it was possible to precisely analyze which trabeculae failed in which area and under which load. According to the current state of the art, bone mineral density is usually used as a value for bone quality, but the question can be raised as to whether other values such as trabecular structure, damage accumulation, and bone mineralization can predict structural competence better than bone mineral density alone.
Language	English
Publishing date	2022-07-20
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2487261-1
ISSN	1996-1944
ISSN	1996-1944
DOI	10.3390/ma15145065
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Article ; Online: Mid-Term Migration Behavior of an Uncemented Proximally Anchored Straight Stem—A Retrospective EBRA Migration Analysis

Philipp Blum / Johannes Neugebauer / Alexander Keiler / David Putzer / Julius Watrinet / Sebastian Biermeier / Dietmar Dammerer

Journal of Clinical Medicine, Vol 12, Iss 4335, p

2023 Volume 4335

Abstract	Background: Aseptic loosening is one of the most-common causes of the failure of cementless stems. Einzel Bild Röntgen Analyse-Femoral Component Analysis (EBRA-FCA) allows the diagnosis of stem migration, which can be considered a factor in predicting implant survival. The current study aimed to present the migration behavior of a tapered proximally anchored straight stem. Methods: This retrospective study reviewed all consecutive patients who received a cementless CBC straight stem (Mathys AG, Bettlach, Switzerland) between 2005 and 2019. We analyzed the migration pattern using the EBRA-FCA software and reviewed their medical histories. In addition, periprosthetic radiolucency was rated according to the Gruen zones and femoral configuration according to Dorr. Results: A total of 333 stems in 332 patients (female 191; male 141) met our inclusion criteria. The mean age at surgery was 63 (range 21–87) years. Migration analysis by EBRA-FCA showed a mean subsidence of 1.6 mm at final follow-up at 96 months with a maximum noted mean subsidence of 2.0 mm at 72 and 84 months. Dorr Type A showed a tendency of less subsidence than did Dorr Type B and was statistically significant at 6 ( p = 0.0396) and 72 months ( p = 0.0127). The body mass index (BMI) and increased subsidence were not found to correlate ( p > 0.05). For this cohort, the overall femoral revision-free rate was 95.2% and the revision-free rate for aseptic loosening was 99.1%. Conclusions: The results showed migration behavior in cementless stems with initial increased migration and subsequent secondary stabilization, suggesting an excellent long-term outcome. Stem migration of this tapered proximally anchored stem might be lower in Dorr Type A than in Dorr Type B femurs without being statistically significant at all time points.
Keywords	total hip arthroplasty ; Einzel Bild Röntgen Analyse ; cementless ; subsidence ; Medicine ; R
Subject code	337
Language	English
Publishing date	2023-06-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Midterm Results of High-Dose-Rate Intraoperative Brachytherapy in the Treatment of Soft Tissue Sarcomas.

Dammerer, Dietmar / Neugebauer, Johannes / Braito, Matthias / Wagner, Moritz / Neubauer, Markus / Moser, Lukas / Süß, Markus / Liebensteiner, Michael / Putzer, David

Cancers

2023 Volume 15, Issue 10

Abstract: Introduction: According to the literature only sparse data are available on the use of high-dose-rate intraoperative brachytherapy (IOHDR-BT) as a boost to external-beam irradiation (EBRT) in combination with a wide resection in patients with high-grade ...

Abstract	Introduction: According to the literature only sparse data are available on the use of high-dose-rate intraoperative brachytherapy (IOHDR-BT) as a boost to external-beam irradiation (EBRT) in combination with a wide resection in patients with high-grade soft tissue sarcomas (STS). Materials and methods: Applying a retrospective study design, we investigated all patients who between 2010 and 2016 underwent marginal resection of a high-grade STS and intraoperative radiotherapy, followed by EBRT. We included only patients with a traceable follow-up time of at least two years. Of 89 patients, 35 met our inclusion criteria and showed an average follow-up of four years. Results: We found an overall 2-year local control rate of 94.3%. The local recurrence rate for R0 resections was 6%, whereas recurrences occurred in 13% of R1 resections and in 100% of R2 resections. One affected patient received only intraoperative radiotherapy. The recurrence rate by tumour entity was 36% for LPS, 11% for myxofibrosarcoma and 17% for undifferentiated pleomorphic sarcoma. Conclusion: The treatment regimen consisting of limb-preserving surgery, IORT and pre- or postoperative radiotherapy consistently shows excellent local control rates.
Language	English
Publishing date	2023-05-21
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers15102854
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Conference proceedings: EBRA migration analysis of a modular, distally fixed stem in hip revision arthroplasty: a clinical and radiological study

Blum, Philipp / Putzer, David / Neugebauer, Johannes / Süß, Markus / Dammerer, Dietmar

2022 , Page(s) AB57–1225

Event/congress	Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2022); Berlin; ; Berufsverband für Orthopädie und Unfallchirurgie; 2022
Keywords	Medizin, Gesundheit ; Einzel-Bild-Röntgen-Analyse (EBRA) ; stem subsidence ; revision ; total hip arthroplasty
Publishing date	2022-10-25
Publisher	German Medical Science GMS Publishing House; Düsseldorf
Document type	Conference proceedings
DOI	10.3205/22dkou440
Database	German Medical Science

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