Andreas Leithner
Publications
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2.07Impact points
Letter to the Editor: Treatment of Early Postoperative Infections After THA: A Decision Analysis.
Clinical orthopaedics and related research. 04/2012;
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1.88Impact points
Metal ion levels in large-diameter total hip and resurfacing hip arthroplasty - Preliminary results of a prospective five year study after two years of follow-up.
BMC musculoskeletal disorders. 04/2012; 13(1):56.
ABSTRACT: BACKGROUND: Metal-on-metal hip resurfacing is an alternative to metal-on-metal total hip arthroplasty, especially for young and physically active patients. However, wear which might be detected by increased serum ion levels is a matter of concern. METHODS: The aims of this preliminary stud... [more] ABSTRACT: BACKGROUND: Metal-on-metal hip resurfacing is an alternative to metal-on-metal total hip arthroplasty, especially for young and physically active patients. However, wear which might be detected by increased serum ion levels is a matter of concern. METHODS: The aims of this preliminary study were to determine the raise of metal ion levels at 2-years follow-up in a prospective setting and to evaluate differences between patients with either resurfacing or total hip arthroplasty. Furthermore we investigated if the inclination of the acetabular component and the arc of cover would influence these findings. Therefore, 36 patients were followed prospectively. RESULTS: The results showed increments for Co and Cr in both implant groups. Patients treated with large-diameter total hip arthroplasty showed fourfold and threefold, respectively, higher levels for Co and Cr compared to the resurfacing group (Co: p<0,001 and Cr: p=0,005). Nevertheless, we observed no significant correlation between serum ion levels, inclination and arc of cover. CONCLUSION: In order to clarify the biologic effects of ion dissemination and to identify risks concerning long-term toxicity of metals, the exposure should be monitored carefully. Therefore, long-term studies have to be done to determine adverse effects of Co and Cr following metal-on-metal hip replacement.
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1.24Impact points
No adverse affect after harvesting of free fibula osteoseptocutaneous flaps on gait function.
Microsurgery. 03/2012;
The aim of this study was to analyze gait function and muscular strength on donor site after harvesting of a vascularized fibula osteoseptocutaneous flap. Nine patients with a mean follow-up of 33 months (range, 7-59) and a mean resection length of the middle portion of the fibula of 18.0 cm (range,... [more] The aim of this study was to analyze gait function and muscular strength on donor site after harvesting of a vascularized fibula osteoseptocutaneous flap. Nine patients with a mean follow-up of 33 months (range, 7-59) and a mean resection length of the middle portion of the fibula of 18.0 cm (range, 14.0-23.0) underwent an instrumented three-dimensional gait analysis to evaluate gait function. Furthermore, CYBEX II extremity system was used for muscular strength measurements. Subjective muscle strength measurements were performed according to Kendall et al. and were classified according to the British Medical Research Council. Intraindividual comparison between the operated and the nonoperated leg revealed no significant differences for gait function parameters (cadence, velocity, and stride length, P > 1.00) and for muscular strength measurements for flexion (knee: P = 0.93, ankle: P = 0.54) and extension (knee: P = 0.97, ankle: P= 0.21), respectively. In conclusion, intraindividual comparison of the operated and nonoperated sides after harvesting of the middle portion of the fibula for gaining a free fibula osteoseptocutaneous flap has no adverse affect on gait function or muscular flexion and extension strength on donor site at a mean follow-up of 33 months. © 2012 Wiley Periodicals, Inc. Microsurgery, 2012.
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1.83Impact points
Initial Achilles tendon repair strength-synthesized biomechanical data from 196 cadaver repairs.
International orthopaedics. 03/2012;
PURPOSE: The study aim was to describe what kind of operative technique performs best with respect to initial strength after the surgical repair of acute Achilles tendon ruptures. METHODS: We performed a systematic search of the keywords "Achilles tendon AND (suture strength OR biomechanics) AN... [more] PURPOSE: The study aim was to describe what kind of operative technique performs best with respect to initial strength after the surgical repair of acute Achilles tendon ruptures. METHODS: We performed a systematic search of the keywords "Achilles tendon AND (suture strength OR biomechanics) AND (cadaver NOT animal)" in the online databases PubMed, EMBASE, CINAHL, and the Cochrane Library. We included studies that employed open, mini-open, or percutaneous Achilles tendon repair in human cadavers, and assessed some measure of tensile strength as a primary outcome. RESULTS: Our search produced 11 relevant papers reporting results for Kessler, Bunnell, and Krackow sutures in open repair, as well as the Achillon device, the Ma-Griffith repair technique, the triple bundle technique and the "giftbox" technique. The weighted tensile strengths ranged from 81 to 453 N (mean 222.7 N) with the Triple Bundle technique in combination with # 2 Ethibond performing best with a mean of 453 N. CONCLUSIONS: Due to the small sample sizes, different study designs, and heterogeneity of strength measurement techniques, definite recommendations on surgical technique cannot be made but presented information might help in the decision making process for foot and ankle surgeons.
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0.59Impact points
In Vivo Testing of Knee Stability After Rotating-hinge Total Knee Arthroplasty: A Comparison of 2 Knee Systems.
Orthopedics. 03/2012; 35(3):e335-42.
Rotating-hinge knee prostheses are used for reconstruction in cases of severe articular compromise and major bone loss. Biomechanical studies revealed that rotating-hinge designs with long and cylindrical pegs are more stable than devices with short and more tapered ones. Twenty-five patients underw... [more] Rotating-hinge knee prostheses are used for reconstruction in cases of severe articular compromise and major bone loss. Biomechanical studies revealed that rotating-hinge designs with long and cylindrical pegs are more stable than devices with short and more tapered ones. Twenty-five patients underwent clinical examination using ultrasound, radiographs, and 3 different rating systems to examine the in vivo stability and functional outcome of 2 rotating-hinge knee systems.Overall, the study revealed that a stable reconstruction could be achieved with both tested devices, with good functional outcome. The results for medial and lateral lift-off during flexion and extension in ultrasonography were comparable, whereas the measured distraction of the Limb Preservation System (LPS/M.B.T.; DePuy, Warsaw, Indiana) was lower compared with the S-ROM Noiles prostheses (DePuy).The implant, the new formed capsule, and the remaining soft tissues have to maintain joint stability. Soft tissue reconstruction, especially the medial gastrocnemius flap, and the newly formed periprosthetic scar seems to prevent distraction of several millimeters. In addition, determining the lift-off with ultrasonography showed that the shape of the peg does not influence implant's stability against lateral directed forces.
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1.83Impact points
Initial Achilles tendon repair strength-synthesized biomechanical data from 196 cadaver repairs.
International Orthopaedics. 03/2012;
Abstract PURPOSE: The study aim was to describe what kind of operative technique performs best with respect to initial strength after the surgical repair of acute Achilles tendon ruptures. METHODS: We performed a systematic search of the keywords "Achilles tendon AND (suture strength OR biome... [more] Abstract PURPOSE: The study aim was to describe what kind of operative technique performs best with respect to initial strength after the surgical repair of acute Achilles tendon ruptures. METHODS: We performed a systematic search of the keywords "Achilles tendon AND (suture strength OR biomechanics) AND (cadaver NOT animal)" in the online databases PubMed, EMBASE, CINAHL, and the Cochrane Library. We included studies that employed open, mini-open, or percutaneous Achilles tendon repair in human cadavers, and assessed some measure of tensile strength as a primary outcome. RESULTS: Our search produced 11 relevant papers reporting results for Kessler, Bunnell, and Krackow sutures in open repair, as well as the Achillon device, the Ma-Griffith repair technique, the triple bundle technique and the "giftbox" technique. The weighted tensile strengths ranged from 81 to 453 N (mean 222.7 N) with the Triple Bundle technique in combination with # 2 Ethibond performing best with a mean of 453 N. CONCLUSIONS: Due to the small sample sizes, different study designs, and heterogeneity of strength measurement techniques, definite recommendations on surgical technique cannot be made but presented information might help in the decision making process for foot and ankle surgeons.
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1.83Impact points
Initial Achilles tendon repair strength-synthesized biomechanical data from 196 cadaver repairs.
International Orthopaedics. 03/2012;
PURPOSE: The study aim was to describe what kind of operative technique performs best with respect to initial strength after the surgical repair of acute Achilles tendon ruptures. METHODS: We performed a systematic search of the keywords "Achilles tendon AND (suture strength OR biomechanics) ... [more] PURPOSE: The study aim was to describe what kind of operative technique performs best with respect to initial strength after the surgical repair of acute Achilles tendon ruptures. METHODS: We performed a systematic search of the keywords "Achilles tendon AND (suture strength OR biomechanics) AND (cadaver NOT animal)" in the online databases PubMed, EMBASE, CINAHL, and the Cochrane Library. We included studies that employed open, mini-open, or percutaneous Achilles tendon repair in human cadavers, and assessed some measure of tensile strength as a primary outcome. RESULTS: Our search produced 11 relevant papers reporting results for Kessler, Bunnell, and Krackow sutures in open repair, as well as the Achillon device, the Ma-Griffith repair technique, the triple bundle technique and the "giftbox" technique. The weighted tensile strengths ranged from 81 to 453 N (mean 222.7 N) with the Triple Bundle technique in combination with # 2 Ethibond performing best with a mean of 453 N. CONCLUSIONS: Due to the small sample sizes, different study designs, and heterogeneity of strength measurement techniques, definite recommendations on surgical technique cannot be made but presented information might help in the decision making process for foot and ankle surgeons.
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3.86Impact points
Does insulin-like growth factor 1 receptor (IGF-1R) targeting provide new treatment options for chordomas? A retrospective clinical and immunohistochemical study.
Histopathology. 02/2012;
Scheipl S, Froehlich E V, Leithner A, Beham A, Quehenberger F, Mokry M, Stammberger H, Varga P P, Lazáry A, Windhager R, Gattenloehner S & Liegl B (2012) Histopathology Does insulin-like growth factor 1 receptor (IGF-1R) targeting provide new treatment options for chordomas? A retrospective clin... [more] Scheipl S, Froehlich E V, Leithner A, Beham A, Quehenberger F, Mokry M, Stammberger H, Varga P P, Lazáry A, Windhager R, Gattenloehner S & Liegl B (2012) Histopathology Does insulin-like growth factor 1 receptor (IGF-1R) targeting provide new treatment options for chordomas? A retrospective clinical and immunohistochemical study Aims: The overall prognosis of chordoma is poor, and current treatment options are limited. The insulin-like growth factor 1 receptor (IGF-1R) pathway is important for cell signalling, and attractive for selective inhibition. We investigated the expression of IGF-1R and its ligands, IGF-1 and IGF-2, in a series of 50 chordomas, in order to assess whether IGF-1R-signalling could be a potential target for specific inhibition in chordomas. Methods and results: Fifty chordomas (34 primary tumours, 16 recurrences) from 44 patients were evaluated immunohistochemically for the expression of IGF-1R, IGF-1 and IGF-2. Thirty-eight chordomas (76%) expressed IGF-1R, 46 (92%) expressed IGF-1 and 25 (50%) expressed IGF-2. Semi-quantitative analyses revealed a moderate to strong staining intensity in ≥50% of tumour cells for IGF-1R, IGF-1 and IGF-2 in 18 (36%), 32 (64%) and eight (16%) chordomas, respectively. Tumour volume correlated significantly with IGF-1R-staining intensity in primary chordomas (P = 0.042). Conclusions: IGF-1R and IGF-1 are expressed in the majority of chordomas. IGF-1 expression is much stronger than IGF-2 expression. Patients whose chordomas show a moderate to strong staining intensity in ≥50% of tumour cells for IGF-1R (36%) might benefit most from IGF-1R targeting, particularly if they suffer from large and surgically non-resectable chordomas.
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2.45Impact points
Establishment and detailed functional and molecular genetic characterisation of a novel sacral chordoma cell line, MUG-Chor1.
International journal of oncology. 02/2012; 40(2):443-51.
Chordomas are rare, low to intermediate grade malignant bone tumors of the axial skeleton. Current treatment options are limited to surgical procedures, as chordomas are largely resistant to conventional radiation and chemotherapy. Cell lines are valuable tools for exploring molecular mechan-isms in... [more] Chordomas are rare, low to intermediate grade malignant bone tumors of the axial skeleton. Current treatment options are limited to surgical procedures, as chordomas are largely resistant to conventional radiation and chemotherapy. Cell lines are valuable tools for exploring molecular mechan-isms involved in tumorigenesis and they have a fundamental impact on the development of new anticancer agents. To date, only two chordoma cell lines exist world-wide. In the present study we report a third chordoma cell line, MUG-Chor1, as well as corresponding cultured fibroblasts established from a recur-rent morphologically 'classic' sacrococcygeal chordoma of a 58-year-old Caucasian female. The cells are brachyury-positive and have the characteristics of chordoma. The genetic profile of the primary chordoma and the established chordoma cell line was investigated during the culturing period (early and late passage). MUG-Chor1 is karyotypically, <2n>43-47,XX,del(3)(q1?)[11], +7,del(9)(p1?),der(9;15)(q10;q10),-10,+der(12)t(9;12)(p2?;q1?),der (12)t(12;19)(p;p)t(17;19)(q;q),-15,der(17;21)(q10;q10),der(20)t(10;20) (q25?26?;q11?12?),-21,-22[20]/idemx2[5] and displays known, chordoma-typical genetic changes, such as chromosomal gains at T/brachyury locus (6q27), losses at 9p24.3-p13.1 (includes the CDKN2a/CDKN2b locus), 10p15.3-q23.32 (includes the PTEN locus) and losses of 10q25.2 (includes the PDCD4 locus). MUG-Chor1 bears a marked resemblance to chordomas in vivo and is, therefore, an optimal in vitro chordoma model.
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0.96Impact points
[Consensus diagnosis and therapy of soft tissue sarcoma].
Wiener klinische Wochenschrift. 02/2012; 124(3-4):85-99.
Soft tissue sarcomas are heterogeneous tumours and relatively uncommon. There have been advances over the past years concerning pathology, clinical behaviour, diagnosis strategies and the treatment. To summarize these advances as well as making it public is one of the goals of the following consensu... [more] Soft tissue sarcomas are heterogeneous tumours and relatively uncommon. There have been advances over the past years concerning pathology, clinical behaviour, diagnosis strategies and the treatment. To summarize these advances as well as making it public is one of the goals of the following consensus guidelines. But why do we need special guidelines for Austria? There are international guidelines published by the European Society of Medical Oncology (ESMO) and the National Comprehensive Cancer Network (NCCN). The cause is that we need an explanation of the matrix the ESMO and the NCCN gave according to our clinical practice, the local requirements and facilities in Austria. The following recommendations were drawn up following a consensus meeting of sarcoma specialists from the three high volume centres located at the medical universities in Austria. All fields of involved physicians from diagnosis to therapy worked together to know that soft tissue sarcomas are an interdisciplinary challenge and multimodal treatment is essential. For this reason, these guidelines not only explain but also give the state of the art and clear recommendations. One of the most important guidelines is that any patient with a suspected soft tissue sarcoma should be referred to one of the three university centres and managed by a specialist sarcoma multidisciplinary team. We hope that the consensus is helpful for the clinical practice and improves the quality of care for patients with soft tissue sarcomas in Austria.
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1.83Impact points
Sex-related outcome differences after implantation of low-contact-stress mobile-bearing total knee arthroplasty.
International orthopaedics. 01/2012;
PURPOSE: The aim of the study was to investigate outcome differences between female and male patients after implantation of low-contact-stress (LCS) mobile-bearing total knee prostheses at a minimum follow-up of five years with respect to clinical and radiological parameters. METHODS: We retrospecti... [more] PURPOSE: The aim of the study was to investigate outcome differences between female and male patients after implantation of low-contact-stress (LCS) mobile-bearing total knee prostheses at a minimum follow-up of five years with respect to clinical and radiological parameters. METHODS: We retrospectively analysed 128 prostheses in 126 patients (90 women and 34 men) using our hospital database. Data was extracted with respect to range of motion (ROM), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, the Knee Society Score (KSS) and radiolucent lines on conventional X-rays. RESULTS: At follow-up, we observed no significant differences between female and male patients after LCS total knee prostheses. Benefit after implantation of LCS total knee prostheses after five years of minimum follow-up was not significantly different between female and male patients in terms of clinical outcome or radiolucent lines. CONCLUSIONS: We found no factors in favour of gender-specific total knee prostheses.
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2.62Impact points
Expression of Ezrin, Mmp-9 and Cox-2 in 50 Chordoma Specimens: A Clinical and Immunohistochemical Analysis.
Spine. 01/2012;
Study Design. Retrospective studyObjective. To investigate the immunohistochemical expression profile of ezrin,MMP-9 and COX-2 in chordomas.Summary of Background Data. Ezrin, MMP-9 and COX-2 are expressed in different solid tumors, including chordomas. The present study investigates the immunohistoc... [more] Study Design. Retrospective studyObjective. To investigate the immunohistochemical expression profile of ezrin,MMP-9 and COX-2 in chordomas.Summary of Background Data. Ezrin, MMP-9 and COX-2 are expressed in different solid tumors, including chordomas. The present study investigates the immunohistochemical expression of the aforementioned biomarkers and the clinical outcome in regard to immunohistochemistry, tumor volume and localisation.Methods. 50 brachyury-verified chordoma specimens of 34 primary and 16 recurrent tumors of 44 patients were tested for ezrin, MMP-9 and COX-2 as possible therapeutical targets by immunohistochemistry. The clinical evaluation concentrated on tumor location, volume, and age-related data.Results. Ezrin-expression was detected in 33/34 of the primary chordomas and in 16/16 of the recurrent cases. The primary chordomas located in the sacrum and the spine demonstrated a significantly higher percentage of positive stained tumor cells (p = 0.034) than the skull base chordomas. An expression of MMP-9 and COX-2 was observed in 33/34 of primary chordomas and in 16/16 recurrences, in 13/34 primary chordomas and in 11/16 recurrences, respectively.Patients survival was significantly influenced by age (p = 0.01), tumor location (p = 0.029) and tumor volume (p = 0.002). A significant positive correlation between tumor volume and the anatomical distance of the chordoma from the skull was calculated (p = 0.00002).Conclusion. En bloc resection with tumor-free margins is seldom feasible, particularly in the sacrum. Intralesional excisions mostly end in early local recurrence, therefore the demand for further treatment options is frequently posed.The marked trend of the investigated biomarkers of the present study may build a starting point for further investigations as molecular targets for future adjuvant therapies in chordomas Future multicenter studies on larger patients' series are necessary to elucidate these preliminary data and to test new treatment options for patients suffering from chordomas.
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1.83Impact points
Failure rate of a rotating hinge knee design due to yoke fracture of the hinged tibial insert: a retrospective data analysis and review of the literature.
International orthopaedics. 12/2011;
PURPOSE: Rotating hinge knee prostheses are known to provide inherent stability. Yoke fractures of the hinged tibial insert of modern generation rotating hinge devices are a matter of continued concern. The aim of this study was to describe incidence and management of yoke fracture of the LPS™ hinge... [more] PURPOSE: Rotating hinge knee prostheses are known to provide inherent stability. Yoke fractures of the hinged tibial insert of modern generation rotating hinge devices are a matter of continued concern. The aim of this study was to describe incidence and management of yoke fracture of the LPS™ hinged tibial insert. METHODS: Retrospective data analysis of two institutions identified 40 patients with a LPS™ total knee arthroplasty. Implant survival and prosthetic complications was calculated according to Kaplan-Meier. RESULTS: Out of the group of 40 patients, four fractures of the metal yoke occurred in four cases (failure rate: 10%). Furthermore, a second fracture occurred in two patients. The overall revision-free prosthetic survival was 57% at 38 months, while prosthetic survival until yoke fracture was 86% at 38 months. CONCLUSION: Handling yoke fractures as mechanical complication includes replacing the hinged insert, stabilization of the joint and joint line height preservation in order to decrease the cantilever effect at the insert-base plate interface.
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6.70Impact points
Incidence, predictive factors, and prognosis of chondrosarcoma in patients with Ollier disease and Maffucci syndrome: an international multicenter study of 161 patients.
The oncologist. 12/2011; 16(12):1771-9.
Enchondromatosis is characterized by the presence of multiple benign cartilage lesions in bone. While Ollier disease is typified by multiple enchondromas, in Maffucci syndrome these are associated with hemangiomas. Studies evaluating the predictive value of clinical symptoms for development of secon... [more] Enchondromatosis is characterized by the presence of multiple benign cartilage lesions in bone. While Ollier disease is typified by multiple enchondromas, in Maffucci syndrome these are associated with hemangiomas. Studies evaluating the predictive value of clinical symptoms for development of secondary chondrosarcoma and prognosis are lacking. This multi-institute study evaluates the clinical characteristics of patients, to get better insight on behavior and prognosis of these diseases. A retrospective study was conducted using clinical data of 144 Ollier and 17 Maffucci patients from 13 European centers and one national databank supplied by members of the European Musculoskeletal Oncology Society. Patients had multiple enchondromas in the hands and feet only (group I, 18%), in long bones including scapula and pelvis only (group II, 39%), and in both small and long/flat bones (group III, 43%), respectively. The overall incidence of chondrosarcoma thus far is 40%. In group I, only 4 patients (15%) developed chondrosarcoma, in contrast to 27 patients (43%) in group II and 26 patients (46%) in group III, respectively. The risk of developing chondrosarcoma is increased when enchondromas are located in the pelvis (odds ratio, 3.8; p = 0.00l). Overall incidence of development of chondrosarcoma is 40%, but may, due to age-dependency, increase when considered as a lifelong risk. Patients with enchondromas located in long bones or axial skeleton, especially the pelvis, have a seriously increased risk of developing chondrosarcoma, and are identified as the population that needs regular screening on early detection of malignant transformation.
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1.82Impact points
Auto-aggressive metallic mercury injection around the knee joint: a case report.
BMC surgery. 11/2011; 11:31.
Accidental or intentional subcutaneous and/or intramuscular injection of metallic mercury is an uncommon form of poisoning. Although it does not carry the same risk as mercury vapour inhalation, it may cause destructive early and late reactions. Herein we present the case of a 29-year-old male patie... [more] Accidental or intentional subcutaneous and/or intramuscular injection of metallic mercury is an uncommon form of poisoning. Although it does not carry the same risk as mercury vapour inhalation, it may cause destructive early and late reactions. Herein we present the case of a 29-year-old male patient who developed an obsessive-compulsive disorder causing auto-aggressive behaviour with injection of elemental mercury and several other foreign bodies into the soft tissues around the left knee about 15 years before initial presentation. For clinical examination X-rays and a CT-scan of the affected area were performed. Furthermore, blood was taken to determine the mercury concentration in the blood, which showed a concentration 17-fold higher than recommended. As a consequence, the mercury depots and several foreign bodies were resected marginally. Blood levels of mercury will decrease rapidly following surgery, especially in combination with chelating therapy. In case of subcutaneous and intramuscular injection of metallic mercury we recommend marginal or wide excision of all contaminated tissue to prevent migration of mercury and chronic inflammation. Nevertheless, prolonged clinical and biochemical monitoring should be performed for several years to screen for chronic intoxication.
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2.51Impact points
Regulation of MMP3 by laminin alpha 4 in human osteoarthritic cartilage.
Scandinavian journal of rheumatology. 11/2011; 40(6):494-6.
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1.58Impact points
Human Intraoral Harvested Mesenchymal Stem Cells: Characterization, Multilineage Differentiation Analysis, and 3-Dimensional Migration of Natural Bone Mineral and Tricalcium Phosphate Scaffolds.
Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. 09/2011;
PURPOSE: The aim of this study was the establishment of a minimally invasive technique of mesenchymal stem cell (MSC) harvesting and a predictable isolation and cultivation method on 2 different bone substitutes used as potential scaffolds. MATERIALS AND METHODS: Human MSCs isolated from the posteri... [more] PURPOSE: The aim of this study was the establishment of a minimally invasive technique of mesenchymal stem cell (MSC) harvesting and a predictable isolation and cultivation method on 2 different bone substitutes used as potential scaffolds. MATERIALS AND METHODS: Human MSCs isolated from the posterior maxilla were characterized by flow cytometric analysis. After in vitro expansion, cells were cultured and differentiated toward osteogenic, adipogenic, and chondrogenic lineages in 2-dimensional cultures and on natural bone mineral of bovine origin and β-tricalcium phosphate scaffolds. Three-dimensional growth was analyzed using live cell staining and confocal laser scanning microscopy. RESULTS: MSCs from all patients demonstrated the same immunophenotype, with expression of CD73, CD90, and CD105 but no expression of CD45, CD34, CD14, CD11, and HLA-DR. The potential of MSCs for multilineage differentiation along osteogenic, adipogenic, and chondrogenic lines was shown. Based on knowledge of the characteristics of the cells, a method was established to increase MSC expansion efficiency and seeding conditions on each scaffold. Results of the in vitro characterization and laser scanning microscopy visualized the 3-dimensional growth of MSCs on the 2 scaffold types. CONCLUSIONS: The present data showed that intraoral MSCs can be cultured predictably under 2- and 3-dimensional conditions, have proved multiple potencies, and thus seem to be potential candidates for tissue engineering approaches in maxillofacial reconstructions.
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4.56Impact points
A reappraisal of current dosing strategies for intravenous fosfomycin in children and neonates.
Clinical pharmacokinetics. 08/2011; 50(8):493-503.
The rising incidence of multi-drug resistant bacterial pathogens has renewed interest in the long-known antibacterial fosfomycin. Not least because of its low toxicological potential, there is good clinical experience with intravenous fosfomycin for various Gram-positive and Gram-negative infections... [more] The rising incidence of multi-drug resistant bacterial pathogens has renewed interest in the long-known antibacterial fosfomycin. Not least because of its low toxicological potential, there is good clinical experience with intravenous fosfomycin for various Gram-positive and Gram-negative infections in the treatment of children and neonates. However, the current dosing recommendations for intravenous fosfomycin vary widely in paediatric patients. In the present review, we summarized available plasma pharmacokinetic data derived from neonates or children following intravenous administration of fosfomycin. Subsequently, we used this information for recalculation of different dosing strategies and simulated a variety of clinically applied dosing regimens. The percentage of time above the minimal inhibitory concentration (T>MIC) was calculated for each dosing strategy, as this pharmacokinetic-pharmacodynamic parameter was shown to be most predictive of antimicrobial and clinical success of fosfomycin treatment. Our data corroborate the current practice of selecting the dosage of intravenous fosfomycin primarily on the basis of bodyweight and age in paediatric patients. As with other 'time-dependent' antibacterials, a dosing interval of 6-8 hours should be preferred over 12 hours except for immature neonates. Given a T>MIC target of 40-70%, currently recommended dosing strategies appear to be insufficient in children aged 1-12 years, if pathogens with MICs of ≥32 mg/L are suspected and subjects are presenting with normal renal function. Likewise, the lowest recommended daily dose for neonates and infants (aged up to 12 months) of 100 mg/kg bodyweight of fosfomycin should be considered only for pre-term neonates with a postmenstrual age below 40 weeks.
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1.83Impact points
Serum metal ion levels after rotating-hinge knee arthroplasty: comparison between a standard device and a megaprosthesis.
International orthopaedics. 07/2011; 36(3):539-44.
The effects of systemic metal ion exposure in patients with implants made of common prosthetic alloys continue to be a matter of concern. The aim of the study was to determine the measurement values of cobalt (Co), chromium (Cr) and molybdenum (Mo) in serum following rotating-hinge knee arthroplasty... [more] The effects of systemic metal ion exposure in patients with implants made of common prosthetic alloys continue to be a matter of concern. The aim of the study was to determine the measurement values of cobalt (Co), chromium (Cr) and molybdenum (Mo) in serum following rotating-hinge knee arthroplasty. Blood was taken from 25 patients [mean follow-up 35 (range nine to 67) months] treated with megaprostheses (n=17) or standard rotating-hinge devices (n=8) and analysed using electrothermal graphite furnace atomic absorption spectrometry (ET-ASS). Determining the concentrations of metal ions following rotating-hinge knee arthroplasty revealed increments for Co and Cr but not Mo. Metal ion release was significantly higher in patients with megaprostheses compared to a standard rotating-hinge knee device (Co p=0,024; Cr p=0.025). The authors believe there might be an additional metal ion release from the surface of the prosthesis and not only from the articulating surfaces because, in cases of rotating-hinge knee prosthesis, there is a metal-on-polyethylene articulation and not a direct metal-on-metal junction. Nevertheless, long-term studies are required to determine adverse effects of Co, Cr and Mo following total hip replacement and total knee arthroplasty.
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1.88Impact points
Radiolucent lines in low-contact-stress mobile-bearing total knee arthroplasty: a blinded and matched case control study.
BMC musculoskeletal disorders. 06/2011; 12:142.
Low-contact-stress (LCS) mobile-bearing total knee arthroplasty (TKA) (Johnson & Johnson, New Brunswick, NJ; previously: DePuy, Warsawa, USA) provides excellent functional results and wear rates in long-term follow-up analyses. Radiological analysis shows radiolucent lines (RLL) appearing immedi... [more] Low-contact-stress (LCS) mobile-bearing total knee arthroplasty (TKA) (Johnson & Johnson, New Brunswick, NJ; previously: DePuy, Warsawa, USA) provides excellent functional results and wear rates in long-term follow-up analyses. Radiological analysis shows radiolucent lines (RLL) appearing immediately or two years after primary implantation, indicative of poor seat. Investigations proved RLL to be more frequent in uncemented TKA, resulting in a consensus to cement the tibial plateau, but their association with clinical findings and patients discomfort and knee pain is still unknown. 553 patients with 566 low-contact-stress (LCS) total knee prostheses were screened for continuous moderate knee pain. We compared tibial stress shielding classified by Ewald in patients suffering from pain with a matched, pain-free control group on blinded X-rays. We hypothesized a positive correlation between pain and radiolucency and higher frequency of such radiolucent lines in the most medial and most lateral zones of the tibial plateau. Twenty-eight patients suffered from knee pain in total. Radiolucencies were detected in 27 of these cases and in six out of 28 matched controls without knee pain. We could demonstrate a significant correlation of knee pain and radiolucencies, which appeared significantly more frequently in the outermost zones of the tibial plateau. Our findings suggest that radiolucent lines, representing poor implant seat, about the tibial plateau are associated with knee pain in LCS patients. Radiolucencies are observed more often in noncemented LCS, and cementing the tibial plateau might improve implant seat and reduce both radiolucent lines and associated knee pain.
Following (20)
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Thomas Kroneis
Medical University Graz -
Birgit Lohberger
Medical University Graz -
Susanne Scheipl
Medizinische Universität Graz -
Andrea Berghold
Medizinische Universität Graz -
Andreas Weinhäusel
AIT Austrian Institute of Technology
73
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