Daniel Smolen

Etzelclinic · Shoulder and Elbow Surgery

Purpose: The ideal treatment strategy for traumatic anterior shoulder instability with glenoid bone loss in young, physically active patients is still controversial. This study examines sporting activity, the ability to practice sports and the ability to return to sports after the arthroscopic Latarjet procedure. Methods: A total of 47 physicall...

The aim of the study was to identify factors that influence and facilitate scientific studies during and parallel to resident training. For this purpose, a total of 769 online questionnaires with 30 questions were sent to residents in university teaching hospitals in Germany, Switzerland and Austria. The questionnaire contained 13 variable factors...

Management of large symptomatic rotator cuff (RC) tears remains a challenge, especially in younger and active patients. If complete tension-free reconstruction of the rotator cuff is too problematic, augmentation may be used. Various graft types are available on the market: autogeneic, allogeneic, xenogeneic, and synthetic. Although reports of intr...

PurposeThe purpose of this study was to identify modifiable factors associated with research activity among residents working in orthopedic surgery and traumatology.Methods Residents at 796 university-affiliated hospitals in Austria, Germany, and Switzerland were invited to participate. The online survey consisted of questions that ascertained 13 m...

Background: Massive rotator cuff (RC) tears still present a clinically challenging problem, with reported rerupture rates in up to 94%. The study objective was to determine the impact of synthetic patch augmentation for massive RC tears. Methods: Between June 2012 and 2014, we performed 50 arthroscopic RC reconstructions augmented with a synthet...

Background: The optimal technique for arthroscopic rotator cuff repair is still controversial. Large tears with a high grade of retraction have an especially high risk of retearing. This study reports the clinical and radiologic results of a triple-row modified suture bridge technique for the treatment of full-thickness rotator cuff tears with med...

Purpose: To analyze the learning curves of 5 experienced, fellowship-trained shoulder surgeons and their respective 25 first arthroscopic Latarjet cases in regard to surgical time, graft placement, complication rates, and recurrent instability. Methods: The first 25 arthroscopic Latarjet procedures of 5 surgeons were retrospectively analyzed in...

Purpose Traumatic acromion fractures are rare and typically occur in patients with multiple fractures, which often delays diagnosis. Limited guidance exists on the treatment of these fractures. We present a review of the literature from the last 20 years and describe our experience in treating five patients—two conservatively and three with open re...

Background The treatment of anterior glenohumeral instability with a Bankart repair combined with a capsular plication is a frequently used arthroscopic technique. Latarjet created an open bone block procedure in 1954 for the treatment of anteroinferior glenohumeral instability. This procedure has been further developed by Lafosse in 2003 for arthr...

Numerous studies have proven that extracorporeal shockwave therapy (ESWT) is effective in the noninvasive treatment of delayed healing fractures and nonunions. Imposing shockwave therapy as first-line treatment for the above-mentioned indications could significantly reduce costs and surgery associated complications. Further applications comprising...

Introduction: Complex scapula with ipsilateral clavicle fracures remains a challange and treatment recommendations are still missing. This review provides an overview of the evolution of the definition, classification and treatment strategies for complex scapula and ipsilateral clavicle fractures. As with other rare conditions, consensus has not b...

Purpose: Scapular fractures after reverse shoulder arthroplasty (RSA) are often associated with substantial shoulder impairment. Patient outcomes following either conservative or operative treatment have not been favourable, and consensus is lacking on the best treatment approach. We describe a technique for anatomic reconstruction of fractured la...

Rotator cuff repairs are the most common procedures in shoulder surgery, but still show long-term retear rates of up to 70%. Nonanatomic reconstruction is one possible cause of repair failure. The rotator cuff histologically consists of 5 separate layers of which 2 are macroscopically identifiable: the superior or tendinous layer and the inferior o...

This chapter will focus on principles of fracture healing. The reader is introduced to epidemiology, physiology, and pathophysiology of fracture healing, experimental models, as well as principles of conservative and operative fracture treatments.

Background: The number of arthroscopic rotator cuff surgeries is consistently increasing. Although generally considered successful, the reported number of retears after rotator cuff repair is substantial. Short-term clinical outcomes are reported to be rarely impaired by tendon retears, whereas to our knowledge, there is no study documenting long-...

Purpose: To macroscopically, histologically, and radiologically describe a time-dependent remodeling process of a neo-tendon or -ligament in the shoulder after the arthroscopic Latarjet procedure. Methods: During follow-up surgery after the arthroscopic Latarjet procedure, 17 shoulders in 16 patients were evaluated for a remodeled tendon-like st...

Hintergrund: Massive Rupturen (2 und mehr Sehnen) der Rotatorenmanschette haben vor allem bei älteren Patienten eine sehr schlechte Prognose. Zur Senkung der Rerupturrate wird seit einigen Jahren in der orthopädischen Praxis die Verstärkung der Nahtstelle durch Patches (Augmentation) angewandt. Material und Methoden: In einer klinischen Studie (Ope...

Background: Massive rotator cuff tendon tears have a poor clinical prognosis. This holds especially true in older patients and after revision surgery. In order to reduce tears and increase long term shoulder parameters, patches made of a variety of materials have been applied to reinforce sutures in current orthopaedic practice. Material and Metho...

Statement of significance: In our experimental study we elucidated recombinant platelet derived growth factor (PDGF) as a potential candidate in inducing angiogenesis. To avoid preterm growth factor degradation in vivo PDGF.AB was covalently linked to a fibrin scaffold using a bi-domain functionalized peptide (FXIII substrate site and plasmin clea...

Fracture non-unions are still a challenging problem in orthopedics. The treatment of non-unions remains highly individualized, complex, and demanding. In most countries the surgical approach with debridement of the non-union gap, anatomical reduction and appropriate osteosynthesis along with autologous bone grafting is considered as the standard of...