Igor Lazic

Technical University of Munich | TUM · Abteilung für Sportorthopädie

Aim In Two-Stage Revision, utilizing temporary antibiotic spacers is widely accepted. These spacers are available prefabricated or can be individually moulded intraoperatively. In this study, we analysed the efficacy of prefabricated and individual spacers in infection eradication of periprosthetic joint infection in knee and hip arthroplasties. M...

Artificial intelligence (AI) is very likely to be a pioneering technology in arthroplasty, with a wide range of pre-, intra- and postoperative applications. The opportunities for patients, physicians and healthcare policy are considerable, especially in the context of optimized and individualized patient care. Despite these diverse possibilities, t...

Bei der Entwicklung neuartiger Hüftimplantate sind vor der Durchführung klinischer Studien biomechanische Prüfungen erforderlich. Häufig werden diese mit humanen Spenderpräparaten oder Kunststoffknochen durchgeführt, um den Einfluss der Implantatverankerung zu analysieren. Aus ethischen Gründen und wegen der begrenzten Verfügbarkeit sind Prüfungen...

Background/aim: Synovial calprotectin has been demonstrated as a promising biomarker for periprosthetic joint infections (PJI) in painful total hip (THA) and knee arthroplasties (TKA). However, its diagnostic utility has not been evaluated explicitly in cases with marked loosening or migration of the implant. Concerns have already been raised in c...

Purpose: Robotic arm-assisted total knee arthroplasty (raTKA), currently a major trend in knee arthroplasty, aims to improve the accuracy of implant positioning and limb alignment. However, it is unclear whether and to what extent manual radiographic and navigation measurements with the MAKO™ system correlate. Nonetheless, a high agreement would b...

Purpose The diagnostic criteria of prosthetic joint infection (PJI) recommended by the most commonly used diagnostic algorithms can be obscured or distorted by other inflammatory processes or aseptic pathology. Furthermore, the most reliable diagnostic criteria are garnered during revision surgery. A robust, reliable addition to the preoperative di...

The diagnosis of periprosthetic joint infection (PJI) requires a combination of various clinical, laboratory, microbiological and histopathological parameters. A concomitant periprosthetic fracture (PPF) further complicates the diagnosis as it causes a confounding local inflammatory response. Synovial calprotectin has been demonstrated as a promisi...

For the development of new types of hip implants for acetabulum revision, it is beneficial to analyse the acetabular defects of the indication group in advance. In order to be able to specially compare the bone defects with each other, a normalisation and accompanying scaling of the pelvis is necessary. Uniform scaling is required so that the bone...

The number of primary total knee arthroplasty (TKA) procedures is expected to continue to increase. Early detection of risk factors will become more crucial for individuals and healthcare professionals. So far, prediction models are not practical for clinical use, and new comprehensive approaches are urgently needed. Machine learning (ML) algorithm...

Purpose In revision total knee arthroplasty (RTKA) zonal fixation methods with a combination of augments, press-fit stems, and sleeves are popular. We hypothesized that high distal femoral augmentation with diaphyseal press-fit stems leads to an increased rate of early aseptic loosening and that femoral metaphyseal sleeves improve implant survival....

Purpose Diagnosing periprosthetic joint infections (PJI) are challenging and may be hampered by the presence of other causes of local inflammation. Conventional synovial and serum markers are not reliable under these circumstances. Synovial calprotectin has been recently shown as a promising biomarker for PJI in total hip (THA) and total knee arthr...

Background: Machine Learning (ML) in arthroplasty is becoming more popular, as it is perfectly suited for prediction models. However, results have been heterogeneous so far. We hypothesize that an accurate ML model for outcome prediction in THA must be able to compute arthroplasty-specific data. In this study, we evaluate a ML approach applying da...

Purpose The number of primary total knee arthroplasties (TKA) is expected to rise constantly. For patients and healthcare providers, the early identification of risk factors therefore becomes increasingly fundamental in the context of precision medicine. Others have already investigated the detection of risk factors by conducting literature reviews...

Predicting Complications In Primary TKA Using Machine Learning With Arthroplasty-Specific Data

Vascular graft infections (VGI) are severe complications in prosthetic vascular surgery with an incidence ranging from 1 to 6%. In these cases, synthetic grafts are commonly used in combination with antimicrobial agents. Expanded polytetrafluoroethylene (ePTFE) is in clinical use as a synthetic graft material and shows promising results by influenc...

Purpose Artificial intelligence (AI) in healthcare is rapidly growing and offers novel options of data analysis. Machine learning (ML) represents a distinct application of AI, which is capable of generating predictions and has already been tested in different medical specialties with various approaches such as diagnostic applications, cost predicti...

Background/aim: The aim of the study was to analyze operative time and restoration of hip biomechanics in total hip arthroplasty (THA) via direct anterior approach (DAA) with and without the use of a traction table. Patients and methods: We retrospectively compared 97 cases where a traction table was used to 92 cases without a table. Ninety-seve...

In most cases, a standard access via a medial parapatellar arthrotomy with a carefully performed release technique is sufficient for a good exposure of the knee joint in the revision situation. Crucial steps are targeted scar removal, sufficient soft tissue release and recreation of the shifting layers. Tuberosity osteotomy is an effective option f...

The diagnosis and treatment of periprosthetic joint infection (PJI) currently relies on cultures, which are time-consuming and often fail. Multiplex PCR assays promise reliable and prompt results, but have been heterogeneously evaluated. In this study, we analyse multiplex PCR in pathogen identification using only tissue biopsies. 42 patients after...

The number of revision interventions in total knee arthroplasty is clearly increasing. Hence, complex bone defects also increase and must be adequately treated. The Anderson Orthopaedic Research Institute (AORI) classification is suitable for treatment planning. The main target is secure fixation of the implant components. In this context, three fe...

Prosthetic joint infection (PJI) is among the most common differential diagnoses of total knee arthroplasty failure. It is a challenging complication, not at least because of the difficulty of establishing the correct diagnosis. The fact that no single diagnostic parameter or test has been identified that can accurately rule in or out PJI has led t...

Purpose Arthroscopic lateral retinacular release (LRR) has long been considered the gold standard for the treatment for anterior knee pain caused by lateral retinacular tightness (LRT). However, one-third of patients experience continuous pain postoperatively, which is thought to be related to persistent maltracking of the patella and altered femor...

Total knee arthroplasty (TKA) is a successful treatment for osteoarthritis with good clinical outcomes 1,2. Periprosthetic joint infection (PJI) in TKA has a low incidence between 0.5 and 3% but it is nevertheless one of the most dreadful complications ³⁻⁶. Two-staged revisions are considered to be the gold standard for revision in chronic PJI with...

Despite increasing numbers of primary hip arthroplasties performed through the direct anterior approach (DAA), there is a lack of literature on DAA revision arthroplasty. The present study was performed in order to evaluate outcomes and revision rates after revision through the DAA using an asymmetric acetabular component with optional intra- and e...

In orthopedic surgery amputations are most frequently indicated in cases of musculoskeletal tumors or failed total knee arthroplasty. An interdisciplinary team should even preoperatively commence to adapt the treatment to the patient-specific requirements. Recommendations on the level of amputation depend on the possibilities of treatment with an e...

Background Prevention of severe bleeding is critical for sufficient patient blood management because endoprosthetic surgery is associated with a substantial risk for intraoperative and postoperative bleeding. Tranexamic acid is a synthetic, antifibrinolytic agent, which is used for the treatment and prevention of bleeding.PurposeWhich recommendatio...

Background Periprosthetic joint infection (PPI) is one of the most common reasons for revision in total knee arthroplasty (TKA). Percutaneous synovial biopsy is considered as a well-established diagnostic tool in ambiguous cases of chronic pain after TKA. The exact number of undetected low-grade infections remains unclear. Objectives The aim of thi...

Background: Unicompartmental knee arthroplasty is an established treatment option for anteromedial osteoarthritis. However, large registry studies report higher rates of aseptic loosening compared to total knee arthroplasty. The objective of this study was to assess the impact of bone density on morphological cement penetration. Moreover, an alter...

Durch Fortschritte in der Diagnostik und Therapie primär maligner Knochentumoren kann heute in den allermeisten Fällen ein Extremitätenerhalt erreicht werden. Mithilfe moderner modularer Tumorprothesen können hierbei alle großen Gelenke und sogar ganze Extremitätenabschnitte wie das Femur, der Humerus oder die Tibia endoprothetisch ersetzt werden....

Background/aim: The aim of this study was to analyze survivorship and functional outcome of cementless spongy metal structured total hip arthroplasty (THA) after ultra-long-term follow-up. Patients and methods: A total of 100 THAs in patients under 65 years at initial surgery were performed between 1985 and 1989 at our Department. Twenty patient...