Norbert P Südkamp

University Medical Center Freiburg · Department of Orthopedics and Traumatology

Background Horizontal instability following acute acromioclavicular joint (ACJ) reconstruction still occurs with a high prevalence. Although the human acromioclavicular ligament complex (ACLC) represents the major horizontal ACJ stabilizer, experimental studies on healing characteristics are lacking. Therefore, the purpose of this histological stud...

Background Patients suffering cartilage defects of the medial compartment with underlying varus deformity do benefit from high tibial osteotomy (HTO) even in the long term. Nonetheless, kinematic and geometric changes especially in the patellofemoral joint have been described. Purpose of the present study was to evaluate the influence of patellofem...

Olecranon fractures are most frequently stabilized by tension band wiring (TBW), which unfortunately leads to relevant implant removal rates due to K-wire migration and soft tissue irritation. As lag screw osteosynthesis (LSO) might be a gentle and effective alternative in simple fracture patterns, the goal of the present study was to biomechanical...

Background Good-to-excellent midterm results after high tibial osteotomy (HTO) to treat medial compartment cartilage defects or osteoarthritis (OA) have been published, but little is known about long-term survival rates in terms of conversion to total knee arthroplasty (TKA) using angular stable internal plate fixation. Purpose To determine TKA-fr...

INTRODUCTION: Low back pain is the main reason for disability worldwide leading to an immense socioeconomic burden for the affected individuals and health care systems. Degeneration of the intervertebral disc (IVD) is known to be a major cause of low back pain. Recently, we showed that effector molecules of the tissue renin- angiotensin system (tRA...

Objectives: Low back pain is the main reason for disability worldwide, and degeneration of the intervertebral disc (IDD) is a major cause. Numerous recent studies have described local renin-angiotensin systems in human tissues and indicated that they contain pathological and protective components involved in balancing the cells' inflammatory state....

Objectives: Endoscopic spine surgery is a globally expanding minimally invasive technique for the treatment of disc herniation as well as spinal stenosis. However, literature on the efficiency of interlaminar endoscopic decompression (IED) versus conventional microsurgical technique (CMT) in patients with lumbar spinal stenosis is scarce. The prese...

Endoscopic spine surgery is a promising, minimally invasive technique for the treatment of foraminal and spinal stenosis • Literature on the efficiency of endoscopic lumbar laminoforaminotomy (ELF) versus conventional microsurgical technique (CMT) in patients with both, lumbar foraminal and spinal stenosis is scarce • The present study sought to co...

The integrity of the talus is crucial for the physiologic function of the feet. The present study sought to summarize the available evidence on clinical outcomes and complications following conservative and surgical treatment of talar fractures. We systematically searched Medline via OVID to find relevant studies with a follow-up of at least six mo...

Endoscopic spine surgery is a promising and minimally invasive technique for the treatment of disc herniation and spinal stenosis. However, the literature on the outcome of interlaminar endoscopic decompression (IED) versus conventional microsurgical technique (CMT) in patients with lumbar spinal stenosis is scarce. We analyzed 88 patients (IED: 36...

Evidence has arisen in recent years suggesting that a tissue renin-angiotensin system (tRAS) is involved in the progression of various human diseases. This system contains two regulatory pathways: a pathological pro-inflammatory pathway containing the Angiotensin Converting En- zyme (ACE)/Angiotensin II (AngII)/Angiotensin II receptor type 1 (AGTR1...

Background Skeletal-related events (SREs) due to bone metastases (BM) significantly impact the morbidity and mortality of cancer patients. The present study sought to investigate clinicopathological characteristics, metastasis-free survival (MFS), and SREs in patients referred to a tertiary orthopedic and trauma center. Methods Data were retrieved...

Symptomatic intervertebral disc (IVD) degeneration (IDD) is a major socioeconomic burden and is characterized by inflammation and tissue degradation. Due to the lack of causative therapies, there is an urgent need for innovative experimental organ culture models to study the mechanisms involved in the progression of the disease, find therapeutic ta...

Citation: Saravi, B.; Li, Z.; Pfannkuche, J.; Wystrach, L.; Häckel, S.; E. Albers, C.; Grad, S.; Alini, M.; Richards, R.G.; Lang, C.; et al. Publisher's Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Abstract: Our recent study detected the expression of a tissue renin-angiotensin syst...

Background: In the treatment of unstable olecranon fractures, anatomically preshaped locking plates exhibit superior biomechanical results compared to tension band wiring. However, posterior plating still is accompanied with high rates of plate removals because of soft tissue irritations and discomfort. Meanwhile, low-profile plates precontoured fo...

Background: Major trauma often comprises fractures of the thoracolumbar spine and these are often accompanied by relevant thoracic trauma. Major complications can be ascribed to substantial simultaneous trauma to the chest and concomitant immobilization due to spinal instability, pain or neurological dysfunction, impairing the respiratory system i...

Our recent study detected the expression of a tissue Renin-Angiotensin System (tRAS) in human intervertebral discs (IVDs). The present study sought to investigate the impact of angiotensin II receptor type 1 (AGTR1) antagonist losartan on human nucleus pulposus (NP) cell inflammation and degeneration induced by tumor necrosis factor-α (TNF-α). Huma...

Symptomatic intervertebral disc (IVD) degeneration accounts for significant socioeconomic burden. Recently, the expression of the tissue renin-angiotensin system (tRAS) in rat and bovine IVD was demonstrated. The major effector of tRAS is angiotensin II (AngII), which participates in proinflammatory pathways. The present study investigated the expr...

Purpose: Symptomatic horizontal instability is clinically relevant following acute acromioclavicular joint dislocations. However, the intrinsic healing response is poorly understood. The present study sought to investigate time-dependent healing responses of the human acromioclavicular ligament following acute traumatic rupture. Methods: Biopsie...

Aims Fixation of osteoporotic proximal humerus fractures remains challenging even with state-of-the-art locking plates. Despite the demonstrated biomechanical benefit of screw tip augmentation with bone cement, the clinical findings have remained unclear, potentially as the optimal augmentation combinations are unknown. The aim of this study was to...

BACKGROUND COVID-19 is an infection characterized by various different clinical presentations. Knowledge of possible symptoms and their distribution allows an early identification of infected patients. OBJECTIVE To determine the distribution pattern and possible unreported symptoms an app-based self-reporting tool was created. METHODS The COVID-1...

Background: COVID-19 is an infection characterized by various different clinical presentations. Knowledge of possible symptoms and their distribution allows an early identification of infected patients. Objective: To determine the distribution pattern and possible unreported symptoms an app-based self-reporting tool was created. Methods: The C...

Discogenic low back pain (LBP) is a main cause of disability and inflammation is presumed to be a major driver of symptomatic intervertebral disc degeneration (IDD). Anti-inflammatory agents are currently under investigation as they demonstrated to alleviate symptoms in patients having IDD. However, their underlying anti-inflammatory and regenerati...

Background Biodegradable implants gain increasing importance for the fixation of simple displaced radial head fractures to supersede implant removal and to minimize cartilage destruction. Commonly used polylactide pins still lead to higher rates of secondary loss of reduction compared to metal implants. Alternatively, implants made from a magnesium...

Background Displaced fractures of the humeral capitellum are commonly treated operatively and fixed by titanium screws (TSs) either directly or indirectly. In the case of direct transcartilaginous fixation, biodegradable screws with the ability to be countersunk can be favorable regarding implant impingement and cartilage destruction. Hence, the go...

Recreational sports include all kind of physical activities, played for fun, participation, or aiming at social engagement. Recreational activities are believed to be less psychologically or physically demanding as expectancies regarding performance and commitment to the sport are lower, compared with competitive sports. However, despite the positi...

PurposeCapsular volume reduction in the context of anterior arthroscopic shoulder stabilization represents an important but uncontrolled parameter. The aim of this study was to analyse capsular volume reduction by arthroscopic Bankart repair with an individualized capsular shift in patients with and without ligamentous hyperlaxity compared to a con...

Background Osteoarthritis of the acromioclavicular (AC) joint is a typical cause of anterior–superior shoulder pain. In case of persisting symptoms of the degenerative AC joint and after failure of conservative therapy, arthroscopic or open AC joint resection can be considered.Materials and methodsThe present review is based on a selective literatu...

Purpose : To date, surgically treated multifragmentary patellar fractures are still associated with high rates of complications, such as i.e. secondary fracture displacement. Osteosynthesis is most frequently performed with screws and cerclages. To increase primary stability, locking plates have been introduced. However, there is still a lack of bi...

Background: Arthrofibrosis is a painful and restraining complication that occurs after about 10% of total knee arthroplasty and cruciate ligament surgery. The pathogenesis of arthrofibrosis has not yet been fully understood. Stress signals stimulate immune cells, and fibroblast differentiates into myofibroblast, which produce a large amount of col...

Background: COVID-19 is an infectious disease characterized by various clinical presentations. Knowledge of possible symptoms and their distribution allows for the early identification of infected patients. Objective: To determine the distribution pattern of COVID-19 symptoms as well as possible unreported symptoms, we created an app-based self-re...

Introduction Ankle fusion is still considered as an established therapy for end-stage ankle osteoarthritis. To determine exact description of postoperative functioning, it is necessary to consult a variety of functional scores and quality of life questionnaires. Methods/Patients 34 patients with 34 ankle fusions were investigated on average 5.9 yea...

For radial head osteosynthesis, biodegradable implants are gaining in importance to minimize cartilage destruction and implant impingement and to supersede implant removal. Since loss of reduction and pseudarthrosis remain challenging complications, new implants should at least provide comparable biomechanical properties as commonly used metal impl...

High tibial medial open-wedge osteotomy (HTO) is an established treatment option for cartilage lesions in the medial compartment. It was this study’s aim to evaluate the effect of asymptomatic single or kissing lesions in the lateral compartment on functional outcome after medial open-wedge osteotomy. A total of 156 patients were enrolled in this r...

Introduction This study investigates the management of hip fractures in a German maximum care hospital and compares these data to evidence-based standard and practice in 180 hospitals participating in the UK National Hip Fracture Database (NHFD) and 16 hospitals participating in the Irish Hip Fracture Database (IHFD). This is the first study direct...

Background: There are many studies on osteoarthritis, but only a few studies deal with human arthrosis, comparing the mechanical properties of healthy and diseased samples. In most of these studies, only isolated areas of the tibia are examined. There is currently only one study investigating the complete mapping of cartilage tissue but not the di...

Background: Intramedullary fusion bolts (FB) were introduced to stabilize the medial column of the instable Charcot foot (ICF), but complications as bolt loosening or breakage are frequent. We compared the use of a standard FB and a high-profile threaded FB with a grit-blasted surface. We hypothesized that implant related complications occurred le...

Case: A 38-year-old man presented with recurrent chondroblastoma of the acromion after primary curettage and bone grafting. The patient underwent revision surgery with resection of the acromion and reconstruction using an autologous iliac crest graft. He had regained normal shoulder function without recurrence at a follow-up of 17 months. Conclus...

Aims and Objectives Failure of isolated primary meniscal repair must be expected in 14% - 28%. Patients requiring revision surgery may benefit from revision meniscal repair, however, the results of revision meniscal repair remain unclear. The purpose of this study was therefore to evaluate the clinical outcome and failure rates of revision meniscal...

Abstract Background Pelvic lateral compression fractures are the most stable of the unstable fractures. Therefore, decision making regarding operative or non-operative therapy is still a matter of debate. Methods Factors, influencing decision making for therapy, were explored based on prospectively collected register data of a single Level-1 trauma...

The aim of this study was the dynamic biomechanical evaluation of a ready-to-use oil-based calcium phosphate cement paste implanted to augment intramedullary nail fixation of a three-part humeral head fracture model. Fractures in the osteoporotic bone are often fractures of the proximal humerus. Secondary fracture displacements due to cut-out in os...

Purpose Accurate femoral tunnel placement is of great importance during medial patellofemoral ligament (MPFL) reconstruction. Purpose of the present study was to investigate the influence of trochlear dysplasia on the accuracy of fluoroscopic guided femoral tunnel placement. Methods CT-Scans of 30 knees (five with regular shaped trochlea, 10 with...

Background Higher‐resolution MRI of the patellofemoral cartilage under loading is hampered by subject motion since knee flexion is required during the scan. Purpose To demonstrate robust quantification of cartilage compression and contact area changes in response to in situ loading by means of MRI with prospective motion correction and regularized...

Introduction Focal cartilage defects are an increasingly relevant clinical problem especially in athletes. Cartilage regenerative surgery (CRS) including microfracture and autologous chondrocyte implantation (ACI) to treat such isolated cartilage defects in the knee joint has been well established in the last two decades. In contradiction to high-l...

Background The aim was to investigate the clinical results after autologous chondrocyte implantation (ACI) at the patella in a mid- to long-term course, and whether trochlear dysplasia has an influence on the outcome. Methods Inclusion criteria were ACI for focal patella cartilage defects and preoperative magnetic resonance imaging (MRI). Patients...

Background Postoperative delirium is a common disorder in older adults that is associated with higher morbidity and mortality, prolonged cognitive impairment, development of dementia, higher institutionalization rates, and rising healthcare costs. The probability of delirium after surgery increases with patients’ age, with pre-existing cognitive im...

Background Failure of isolated primary meniscal repair must be expected in approximately 10–25% of cases. Patients requiring revision surgery may benefit from revision meniscal repair, however, the results of this procedure remain underreported. The purpose of this study was therefore to evaluate the outcome and failure rates of isolated revision m...

Summary: Isolated cartilage defects of the knee joint are common orthopaedic problems in middle-aged patients. Typically, these come along with pain and loss of function of the affected joint [23, 38]. In addition, isolated cartilage defects tend to progress into osteoarthritis (OA), as spontaneous healing is rare and can therefore be considered a...

Introduction The differentiation between stiff-knee and low-grade periprosthetic joint infection (PJI) is the current diagnostic challenge in total knee (TKA) revision arthroplasty. The aim of this study was to investigate the additional value of dry biopsies, compared to wet biopsies, in patients presenting with knee stiffness following primary TK...

Objective Anatomic repair of the torn meniscal root using transosseous sutures through the proximal tibia. Indications Nontraumatic meniscal root tears without severe degenerative changes (Kellgren–Lawrence grade ≤ 2), good quality meniscal tissue, traumatic root tears with or without concomitant anterior cruciate ligament tears or multiligament i...

Purpose Valgus high tibial osteotomy (HTO) and a recently introduced extra-articular absorber have been shown to efficiently unload the medial compartment of the knee. However, only little is known about the influence of these treatment modalities on biomechanics of the patellofemoral joint. The purpose of this study was to investigate and compare...

Introduction: The purpose of this study is to identify patient, meniscus rupture and surgical characteristics that influence the outcome and clinical healing following operative repair of bucket handle tears. Methods: Between 02/2006 and 10/2012, a total of 38 patients (14 women, 24 men) with bucket handle tears underwent surgical meniscus repai...

Zusammenfassung Sehnenbeschwerden sind bei Nachwuchssportlern häufig für eine reduzierte körperliche Belastbarkeit verantwortlich. Der Goldstandard bildgebender Diagnostik von Tendinopathien ist die Sonographie, mit deren Hilfe sich native, funktionelle (Powerdoppler/Farbdoppler) wie auch viskoelastische Auffälligkeiten (Elastographie) darstellen l...

Background: Diffuse pigmented villonodular synovitis (PVNS) of the knee is a rare proliferative joint disease associated with high recurrence rates following surgical treatment. Intra-articular joint instability in conjunction with PVNS implies complex reconstructive strategies due to the destructive nature of the disease. Case presentation: Her...

Injuries in the pelvic region in children and adolescents are very rare and often associated with a high energy trauma. Aim of this prospective multicenter study was, by analyzing the data from the TraumaRegister Deutsche Gesellschaft für Unfallchirurgie (TRDGU), to evaluate any correlation between the severity of pelvic fractures and resulting mor...

Aims: The best method of treating unstable pelvic fractures that involve the obturator ring is still a matter for debate. This study compared three methods of treatment: nonoperative, isolated posterior fixation and combined anteroposterior stabilization. Patients and methods: The study used data from the German Pelvic Trauma Registry and compar...

PurposeTo compare the clinical and radiographical long-term outcome of microfracture (MFX) and first-generation periosteum-covered autologous chondrocyte implantation (ACI-P). Methods All subjects (n = 86) who had been treated with knee joint ACI-P or microfracture (n = 76) with a post-operative follow-up of at least ten years were selected. Clinic...

Purpose: To compare anatomic single-bundle (SB) with double-bundle (DB) anterior cruciate ligament reconstruction (ACL-R) and to evaluate the respective clinical outcome results. Methods: In a prospective randomized study, 64 patients were included and separated into 2 groups. Anatomic SB and DB ACL-Rs were performed with hamstring tendons. Five...

Purpose: Return to sports rates in amateur and professional athletes with chronic patellar tendinopathy following arthroscopic patellar release are unpredictable. The present study aims to analyse the effectiveness of arthroscopic patellar release in professional compared to amateur athletes. Methods: A total of 34 amateur and 20 professional at...

Background: Various diseases of the spine are treated by immobilization via orthoses, although detailed evidence on the efficiency of orthotic bracing remains elusive. The present study sought to investigate the impact of 3 different orthoses on spinal immobilization using 3-dimensional (3D) kinematic measurements. Methods: Twelve healthy volunt...

The high rate of fixation failure in osteoporotic proximal humerus fractures indicate the need for improved solutions. Computer simulations may help to overcome the limitations of the gold standard biomechanical testing in evaluating the performance of new implants and enhance the effectivity and outcome of the design process. This study presents a...