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Article ; Online: Bilateral juvenile osteochondrosis dissecans in monozygotic twins: a case report.

Bausch, Luca / Probst, Monika / Fritsch, Lorenz / Mehl, Julian / Siebenlist, Sebastian / Willinger, Lukas

Journal of orthopaedic surgery and research

2024 Volume 19, Issue 1, Page(s) 208

Abstract: Introduction: The etiology of osteochondrosis dissecans (OCD), a chondropathy associated with detachment of the subchondral bone and the overlaying cartilage, is not yet fully understood. While repetitive physical exercise-related stress is usually ... ...

Abstract	Introduction: The etiology of osteochondrosis dissecans (OCD), a chondropathy associated with detachment of the subchondral bone and the overlaying cartilage, is not yet fully understood. While repetitive physical exercise-related stress is usually assumed to be the main risk factor for the occurrence of OCD, genetic predisposition could have an underestimated influence on the development of the disease. Case report: We report a case of monozygotic twins with almost identical stages of bilateral osteochondrosis dissecans of the knee joint. In both patients, initially, a unilateral lesion occurred; despite restricted physical exercise, in the further course of the disease a lesion also developed on the contralateral side. While the lesion found most recently demonstrated an ongoing healing process at a 6-month follow-up, the other three lesions showed a natural course of healing under conservative treatment with significant clinical as well as radiological improvements after one year and complete consolidation in magnetic resonance imaging (MRI) after 2 years. Conclusion: There could be a genetic component to the development of OCD, although this has not yet been proven. Based on a two-year MRI follow-up, we were able to show the self-limiting characteristics of juvenile osteochondrosis dissecans.
MeSH term(s)	Humans ; Knee Joint/pathology ; Magnetic Resonance Imaging ; Osteochondritis Dissecans/diagnostic imaging ; Osteochondritis Dissecans/genetics ; Osteochondrosis/diagnostic imaging ; Osteochondrosis/genetics ; Radiography ; Twins, Monozygotic
Language	English
Publishing date	2024-04-01
Publishing country	England
Document type	Case Reports ; Letter
ZDB-ID	2252548-8
ISSN	1749-799X ; 1749-799X
ISSN (online)	1749-799X
ISSN	1749-799X
DOI	10.1186/s13018-024-04683-2
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Article ; Online: Varus osteotomy as a salvage procedure for young patients with symptomatic patellofemoral arthritis and valgus malalignment at short- to mid-term follow-up: a case series.

Hinz, Maximilian / Weyer, Maximilian / Brunner, Moritz / Fritsch, Lorenz / Otto, Alexander / Siebenlist, Sebastian / Achtnich, Andrea

Archives of orthopaedic and trauma surgery

2024 Volume 144, Issue 4, Page(s) 1667–1673

Abstract: Purpose: The purpose of the study was to report the clinical, functional and radiological outcome following varus osteotomy as a salvage procedure in young to middle-aged patients with patellofemoral arthritis (PFA) and associated valgus malalignment. ... ...

Abstract	Purpose: The purpose of the study was to report the clinical, functional and radiological outcome following varus osteotomy as a salvage procedure in young to middle-aged patients with patellofemoral arthritis (PFA) and associated valgus malalignment. It was hypothesized that a significant improvement in knee function and reduction in pain would be achieved. Moreover, no conversion to patellofemoral joint arthroplasty could be observed. Material and methods: Patients (< 50 years of age) that underwent varus osteotomy between 08/2012 and 01/2020 for the treatment of symptomatic PFA and associated valgus malalignment were consecutively included (minimum follow-up: 24 months). Patient-reported outcome measures (PROM; International Knee Documentation Committee subjective knee form [IKDC]), Visual Analog Scale [VAS] for pain, Tegner Activity Scale [TAS], and satisfaction with the postoperative results (1-10-scale, 10 = highest satisfaction) and weight-bearing whole-leg anteroposterior radiographs were conducted pre- and postoperatively. The change in PROM and femorotibial angle (FTA) were tested for statistical significance. Results: In total, 12 patients (14 knees) were included (66.7% female; mean age: 33.8 ± SD 6.6 years). In ten cases, lateral opening-wedge distal femoral osteotomies (DFO) were performed, of which three cases included a concomitant femoral derotation. Three medial closing-wedge DFO and one medial closing-wedge high tibial osteotomy were performed. At follow-up (55.3 ± 29.3 months), a significant improvement in knee function (IKDC: 56.4 ± 14.4 to 69.1 ± 11.2, p = 0.015) and reduction in pain (VAS for pain: 3.5 [interquartile range 2.3-5.8] to 0.5 [0-2.0], p = 0.018) were observed. Patients were able to reach their preoperative sporting activity level (TAS: 3.0 [3.0-4.0] to 3.5 [3.0-4.0], p = 0.854) and were highly satisfied with the postoperative result (9.0 [6.5-10]). Additionally, a significant correction of valgus malalignment was observed (5.0° ± 2.9° valgus to 0.7° ± 3.2° varus, p < 0.001). Regarding complications, two re-osteosyntheses were performed due to loss of correction and delayed union. No conversion to patellofemoral arthroplasty occurred. Conclusion: In patients with symptomatic PFA and associated valgus malalignment, varus osteotomy as a salvage procedure achieved a significant improvement in knee function and reduction in pain. No conversion to patellofemoral joint arthroplasty occurred at short- to mid-term follow-up. Level of evidence: Retrospective case series, Level IV.
MeSH term(s)	Middle Aged ; Humans ; Female ; Adult ; Male ; Treatment Outcome ; Retrospective Studies ; Knee Joint/surgery ; Osteotomy/methods ; Pain ; Osteoarthritis, Knee/surgery ; Tibia/surgery
Language	English
Publishing date	2024-02-22
Publishing country	Germany
Document type	Journal Article
ZDB-ID	80407-1
ISSN	1434-3916 ; 0003-9330 ; 0344-8444
ISSN (online)	1434-3916
ISSN	0003-9330 ; 0344-8444
DOI	10.1007/s00402-024-05212-w
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Article: Verletzungen der proximalen und distalen Bizepssehne

Otto, Alexander / Fritsch, Lorenz / Kadantsev, Pavel / Siebenlist, Sebastian

OP-Journal

2023 Volume 39, Issue 02, Page(s) 104–111

Abstract: Der M. biceps brachii besitzt 2 proximale Ursprünge und einen distalen Ansatz. Dabei kann die lange Bizepssehne (LBS) häufig als Ursache für den vorderen Schulterschmerz identifiziert werden. Zahlreiche Pathologien wie eine Tendinitis, ( ... ...

Abstract	Der M. biceps brachii besitzt 2 proximale Ursprünge und einen distalen Ansatz. Dabei kann die lange Bizepssehne (LBS) häufig als Ursache für den vorderen Schulterschmerz identifiziert werden. Zahlreiche Pathologien wie eine Tendinitis, (Partial-)Risse oder Subluxation der LBS sind dafür grundlegend. Rupturen der Rotatorenmanschette stellen dabei auch ursächliche Veränderungen für Beschwerden der LBS dar. Scheitert die konservative Therapie, kann entsprechend dem körperlichen Anspruch eine Tenotomie resp. Tenodese der LBS erfolgen. Sowohl supra- als auch subpektorale LBS-Tenodesen führen dabei zu guten funktionellen Ergebnissen. Die LBS-Tenotomie kann bei Patienten mit geringeren funktionellen Anforderungen angewandt werden, jedoch mit einem höheren Risiko für eine postoperative Distalisierung des Muskelbauchs des Biceps brachii. Die distale Bizepssehne (DBS) ist der wichtigste Supinator des Unterarms und fungiert als sekundärer Flexor des Ellenbogens. Rupturen der DBS treten am häufigsten bei Männern mittleren Alters im Rahmen eines traumatischen Ereignisses auf. Bei körperlichem Anspruch mit relevantem Defizit von Supinationskraft und -ausdauer ist die chirurgische Versorgung indiziert. Verschiedene Operationstechniken sind zur Refixation der DBS beschrieben. In unserer Praxis hat sich die unikortikale Onlay-Refixation sowohl mit dem Kortikalis-Button als auch mit All-Suture-Ankern bewährt. Bei chronischen Rupturen der DBS kann eine Augmentation durch ein Transplantat durchgeführt werden. Dieser Artikel bietet einen umfassenden Überblick über Therapie von proximalen und distalen Sehnenrupturen des Biceps brachii.
Keywords	lange Bizepssehne ; distale Bizepssehne ; Musculus biceps brachii ; Sehnenruptur ; Therapie ; long head of the biceps tendon ; distal biceps tendon ; tendon rupture ; treatment
Language	German
Publishing date	2023-07-01
Publisher	Georg Thieme Verlag KG
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	2375266-X
ISSN	1439-2496 ; 0178-1715
ISSN (online)	1439-2496
ISSN	0178-1715
DOI	10.1055/a-1964-1233
Database	Thieme publisher's database

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Article ; Online: The Posterior Tibial Slope Is Not Associated With Graft Failure and Functional Outcomes After Anatomic Primary Isolated Anterior Cruciate Ligament Reconstruction.

Hinz, Maximilian / Brunner, Moritz / Winkler, Philipp W / Sanchez Carbonel, José Fernando / Fritsch, Lorenz / Vieider, Romed P / Siebenlist, Sebastian / Mehl, Julian

The American journal of sports medicine

2023 Volume 51, Issue 14, Page(s) 3670–3676

Abstract: Background: Biomechanical studies have shown that an increased medial posterior tibial slope (MPTS) may affect anteroposterior knee laxity and tibial shear forces, ultimately increasing the risk for graft failure after anterior cruciate ligament (ACL) ... ...

Abstract	Background: Biomechanical studies have shown that an increased medial posterior tibial slope (MPTS) may affect anteroposterior knee laxity and tibial shear forces, ultimately increasing the risk for graft failure after anterior cruciate ligament (ACL) reconstruction. Previous clinical studies have, however, reported inconclusive results. Purpose: The purpose of this study was to evaluate the relationship between the MPTS and graft failure as well as functional outcomes after anatomic primary isolated ACL reconstruction using a hamstring tendon autograft. It was hypothesized that an increased MPTS would be associated with a higher ACL graft failure rate. Furthermore, a higher MPTS would negatively correlate with functional outcomes in patients without ACL graft failure. Study design: Case-control study; Level of evidence, 3. Methods: Consecutive patients who underwent isolated primary ACL reconstruction with an anteromedial portal drilling technique between January 2011 and December 2019 were retrospectively reviewed. The MPTS was measured on preoperative lateral knee radiographs. At a minimum of 24 months postoperatively, the ACL graft failure rate and patient-reported outcome measures (PROM; International Knee Documentation Committee subjective knee form, Lysholm score, Tegner Activity Scale, visual analog scale for pain and subjective instability) were evaluated. Differences in the MPTS between patients with and without ACL graft failure as well as the frequency of graft failure between those with an MPTS <12° and those with an MPTS ≥12° were assessed for statistical significance. Binary logistic regression analysis was performed to stratify the risk of graft failure with the following variables: MPTS, age at surgery, and sex. Correlation analysis was performed to evaluate the relationship between the MPTS and PROM in patients without ACL graft failure. Results: In total, 326 patients were included (median follow-up, 71.0 months [IQR, 49.0-104.0 months]). There was no significant difference in the MPTS between patients with and without graft failure (10.6°± 3.2° vs 11.2°± 2.8°, respectively; Conclusion: In patients who underwent anatomic primary isolated ACL reconstruction, an increased MPTS was not associated with a higher rate of graft failure or inferior functional outcomes. Younger age was a significant nonmodifiable risk factor for ACL graft failure.
MeSH term(s)	Humans ; Case-Control Studies ; Retrospective Studies ; Anterior Cruciate Ligament Injuries/surgery ; Knee Joint/surgery ; Anterior Cruciate Ligament Reconstruction/methods
Language	English
Publishing date	2023-11-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	197482-8
ISSN	1552-3365 ; 0363-5465
ISSN (online)	1552-3365
ISSN	0363-5465
DOI	10.1177/03635465231209310
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Article ; Online: Validation of a novel 3-dimensional classification for degenerative arthritis of the shoulder.

Kleim, Benjamin D / Lappen, Sebastian / Kadantsev, Pavel / Degenhardt, Hannes / Fritsch, Lorenz / Siebenlist, Sebastian / Hinz, Maximilian

Archives of orthopaedic and trauma surgery

2023 Volume 143, Issue 10, Page(s) 6159–6166

Abstract: Introduction: A novel three-dimensional classification to comprehensively describe degenerative arthritis of the shoulder (DAS) was recently published by our group. The purpose of the present work was to investigate intra- and interobserver agreement as ...

Abstract	Introduction: A novel three-dimensional classification to comprehensively describe degenerative arthritis of the shoulder (DAS) was recently published by our group. The purpose of the present work was to investigate intra- and interobserver agreement as well as validity for the three-dimensional classification. Materials and methods: Preoperative computed tomography (CT) scans of 100 patients who had undergone shoulder arthroplasty for DAS were randomly selected. Four observers independently classified the CT scans twice, with an interval of 4 weeks, after prior three-dimensional reconstruction of the scapula plane using a clinical image viewing software. Shoulders were classified according to biplanar humeroscapular alignment as posterior, centered or anterior (> 20% posterior, centered, > 5% anterior subluxation of humeral head radius) and superior, centered or inferior (> 5% inferior, centered, > 20% superior subluxation of humeral head radius). Glenoid erosion was graded 1-3. Gold-standard values based on precise measurements from the primary study were used for validity calculations. Observers timed themselves during classification. Cohen's weighted κ was employed for agreement analysis. Results: Intraobserver agreement was substantial (κ = 0.71). Interobserver agreement was moderate with a mean κ of 0.46. When the additional descriptors extra-posterior and extra-superior were included, agreement did not change substantially (κ = 0.44). When agreement for biplanar alignment alone was analyzed, κ was 0.55. The validity analysis reached moderate agreement (κ = 0.48). Observers took on average 2 min and 47 s (range 45 s to 4 min and 1 s) per CT for classification. Conclusions: The three-dimensional classification for DAS is valid. Despite being more comprehensive, the classification shows intra- and interobserver agreement comparable to previously established classifications for DAS. Being quantifiable, this has potential for improvement with automated algorithm-based software analysis in the future. The classification can be applied in under 5 min and thus can be used in clinical practice.
MeSH term(s)	Humans ; Shoulder/surgery ; Shoulder Joint/diagnostic imaging ; Shoulder Joint/surgery ; Tomography, X-Ray Computed ; Arthroplasty ; Reproducibility of Results ; Observer Variation ; Osteoarthritis/surgery
Language	English
Publishing date	2023-06-12
Publishing country	Germany
Document type	Journal Article
ZDB-ID	80407-1
ISSN	1434-3916 ; 0003-9330 ; 0344-8444
ISSN (online)	1434-3916
ISSN	0003-9330 ; 0344-8444
DOI	10.1007/s00402-023-04890-2
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Article ; Online: Correction to: Validation of a novel 3‑dimensional classification for degenerative arthritis of the shoulder.

Kleim, Benjamin D / Lappen, Sebastian / Kadantsev, Pavel / Degenhardt, Hannes / Fritsch, Lorenz / Siebenlist, Sebastian / Hinz, Maximilian

Archives of orthopaedic and trauma surgery

2023 Volume 143, Issue 10, Page(s) 6167

Language	English
Publishing date	2023-08-01
Publishing country	Germany
Document type	Published Erratum
ZDB-ID	80407-1
ISSN	1434-3916 ; 0003-9330 ; 0344-8444
ISSN (online)	1434-3916
ISSN	0003-9330 ; 0344-8444
DOI	10.1007/s00402-023-04995-8
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Conference proceedings: Is patient age over 50 a contraindication for arthroscopic CC stabilization with a suspensory fixation for AC joint instability? – A comprehensive evaluation of clinical, activity and work related outcomes at a mean 6 year follow-up

Scheiderer, Bastian / Fritsch, Lorenz / Münch, Lukas N. / Ahlheit, Yannick / Lacheta, Lucca / Siebenlist, Sebastian / Rupp, Marco-Christopher

2023 , Page(s) AB47–2269

Event/congress	Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2023); Berlin; ; Berufsverband für Orthopädie und Unfallchirurgie; 2023
Keywords	Medizin, Gesundheit ; acromioclavicular joint instability ; arthroscopic coracoclavicular stabilization ; patient age
Publishing date	2023-10-23
Publisher	German Medical Science GMS Publishing House; Düsseldorf
Document type	Conference proceedings
DOI	10.3205/23dkou222
Database	German Medical Science

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Article ; Online: Conservative treatment of acute traumatic posterior shoulder dislocations (Type A) is a viable option especially in patients with centred joint, low gamma angle, and middle or old age.

Festbaum, Christian / Minkus, Marvin / Akgün, Doruk / Hupperich, Andreas / Maier, Dirk / Auffarth, Alexander / Mitterer, Marian / Hoffelner, Thomas / Tauber, Mark / Fritsch, Lorenz / Moroder, Philipp

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA

2022 Volume 30, Issue 7, Page(s) 2500–2509

Abstract: Purpose: Purpose of this study was to evaluate the mid- to long-term outcome after conservatively treated first-time posterior shoulder dislocations and to determine structural defects associated with failure.: Methods: In this multi-centric ... ...

Abstract	Purpose: Purpose of this study was to evaluate the mid- to long-term outcome after conservatively treated first-time posterior shoulder dislocations and to determine structural defects associated with failure. Methods: In this multi-centric retrospective study, 29 shoulders in 28 patients with first-time acute posterior shoulder dislocation (Type A1 or A2 according to the ABC classification) and available cross-sectional imaging were included. Outcome scores as well as radiological and magnetic resonance imaging were obtained at a mean follow-up of 8.3 ± 2.7 years (minimum: 5 years). The association of structural defects with redislocation, need for secondary surgery, and inferior clinical outcomes were analysed. Results: Redislocation occurred in six (21%) shoulders and nine shoulders (31%) underwent secondary surgery due to persistent symptoms. The posttraumatic posterior glenohumeral subluxation was higher in the redislocation group compared to the no redislocation group; however, statistical significance was not reached (61.9 ± 12.5% vs. 50.6 ± 6.4%). Furthermore, a higher adapted gamma angle was observed in the failed conservative treatment group versus the conservative treatment group, similarly without statistically significant difference (97.8° ± 7.2°, vs. 93.3° ± 9.7°). The adapted gamma angle was higher than 90° in all patients of failed conservative therapy and the redislocation group. An older age at the time of dislocation showed a significant correlation with better clinical outcomes (SSV: r = 0.543, p = 0.02; ROWE: r = 0.418, p = 0.035 and WOSI: r = 0.478, p = 0.045). Posterior glenohumeral subluxation after trauma correlated with a worse WOSI (r = - 0.59, p = 0.02) and follow-up posterior glenohumeral decentring (r = 0.68, p = 0.007). The gamma angle (r = 0.396, p = 0.039) and depth of the reverse Hill-Sachs lesion (r = 0.437, p = 0.023) correlated significantly with the grade of osteoarthritis at follow-up. Conclusion: Conservative treatment is a viable option in patients with an acute traumatic posterior shoulder dislocation with good outcome after mid- and long-term follow-up especially in patients with centred joint, low gamma angle, and middle or old age. Level of evidence: IV.
MeSH term(s)	Arthroscopy/methods ; Conservative Treatment ; Humans ; Joint Instability/surgery ; Recurrence ; Retrospective Studies ; Shoulder Dislocation/diagnostic imaging ; Shoulder Dislocation/surgery ; Shoulder Joint/surgery
Language	English
Publishing date	2022-01-29
Publishing country	Germany
Document type	Journal Article ; Multicenter Study
ZDB-ID	1159064-6
ISSN	1433-7347 ; 0942-2056
ISSN (online)	1433-7347
ISSN	0942-2056
DOI	10.1007/s00167-022-06883-x
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Article: Cardiac Arrhythmias in Survivors of Sudden Cardiac Death Requiring Impella Assist Device Therapy.

Abdullah, Khaled Q A / Roedler, Jana V / Vom Dahl, Juergen / Szendey, Istvan / Dimitroulis, Dimitrios / Eckardt, Lars / Topf, Albert / Ohnewein, Bernhard / Fritsch, Lorenz / Föttinger, Fabian / Brandt, Mathias C / Wernly, Bernhard / Motloch, Lukas J / Larbig, Robert

Journal of clinical medicine

2021 Volume 10, Issue 7

Abstract: In this retrospective single-center trial, we analyze 109 consecutive patients (female: 27.5%, median age: 69 years, median left ventricular ejection fraction: 20%) who survived sudden cardiac death (SCD) and needed hemodynamic support from an Impella ... ...

Abstract	In this retrospective single-center trial, we analyze 109 consecutive patients (female: 27.5%, median age: 69 years, median left ventricular ejection fraction: 20%) who survived sudden cardiac death (SCD) and needed hemodynamic support from an Impella assist device between 2008 and 2018. Rhythm monitoring is investigated in this population and associations with hospital survival are analyzed. Hospital mortality is high, at 83.5%. Diverse cardiac arrhythmias are frequently registered during Impella treatment. These include atrial fibrillation (AF, 21.1%) and ventricular tachycardia (VT, 18.3%), as well as AV block II°/III° (AVB, 7.3%), while intermittent asystole (ASY) is the most frequently observed arrhythmia (42.2%). Nevertheless, neither ventricular nor supraventricular tachycardias are associated with patients' survival. In patients who experience intermittent asystole, a trend towards a fatal outcome is noted (
Language	English
Publishing date	2021-03-31
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm10071393
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