Philip P Roessler

Gelenkzentrum Mittelrhein

Purpose: Implant-associated osteomyelitis still represents a demanding challenge due to unfavourable biological conditions, bacterial properties and incremental resistance to antibiotic treatment. Therefore different bactericide or bacteriostatic implant coatings have been developed recently to control local intramedullary infections. Controlled l...

Abstract Evidence for the efficacy of extracorporeal shock wave therapy (ESWT) in supraspinatus tendinopathy without calcification is sparse, and therefore this treatment option is often controversial. Patients of a randomized placebo-controlled study to analyze the effects of ESWT on function and pain were revisited 10 years after the initial cons...

Meniscal injury resulting in segmental loss of meniscal tissue is a major risk factor for the development of osteoarthritis. Tissue engineering strategies have provided scaffolds for meniscal regeneration in order to establish a treatment option for patients with limited opportunities for meniscal reconstruction. The purpose of this study was to as...

We aimed to evaluate the influence of cyclical mechanical loading on osteoblasts and fibroblasts, and co-cultures of both in vitro, simulating the conditions of the tendon-to-bone interface in anterior cruciate ligament reconstruction. Osteoblast-like cells (OBL) and tendon-derived rodent fibroblasts (TDF) were cultured alone or in co-culture to si...

Purpose: Articular cartilage defects of the knee are a common condition for which several repair techniques have been described. The aim of the present study was to assess medium-term results of a one-step procedure using a cell-free collagen type I matrix. Methods: Fifteen patients with articular cartilage defects of the knee were treated with...

Guideline-conform surgical treatment of focal cartilage damage provides highly effective possibilities for sustainably reducing patients’ complaints and preventing or at least delaying the development of premature osteoarthritis. In the knee joint it has the potential to prevent nearly one quarter of the cases of arthrosis requiring joint replaceme...

The subjective patient outcome and satisfaction are becoming not only increasingly more important scientifically but also for health policy in the treatment of musculoskeletal diseases. For the knee joint in particular, there are many questionnaires (scores or patient reported outcome measures, PROMs), which can be found in the current literature i...

Zusammenfassung Die Arbeitsgemeinschaft „Klinische Geweberegeneration“ hat bereits in den Jahren 2004, 2013 und 2016 Empfehlungen in Bezug auf die Indikation für verschiedene knorpelregenerative Verfahren zur Behandlung von Knorpelschäden am Kniegelenk publiziert. Auf Basis neuer wissenschaftlicher Erkenntnisse sollen in der vorliegenden Arbeit die...

Purpose To determine the current status and demand of meniscal allograft transplantation (MAT) in Germany among members of the German Knee Society (= Deutsche Kniegesellschaft; DKG). Methods An online survey was conducted between May 2021 and June 2021 and sent to all members of the DKG. The survey questionnaire consisted of 19 questions to determ...

Introduction Cartilage defects in the knee can be caused by injury, various types of arthritis, or degeneration. As a long-term consequence of cartilage defects, osteoarthritis can develop over time, often leading to the need for a total knee replacement (TKR). The treatment alternatives of chondral defects include, among others, microfracture, and...

Application of systemic antibiotics plays an important role in the perioperative management of knee revision arthroplasty. Concepts may vary, depending on the corresponding surgical approach and the underlying pathogen. Biofilm prevention or disruption for example requires an appropriate and well-timed application of antibiotics. The management of...

Meniscus root tears are radial tears in the region of the posterior insertion zones. Medial root injuries usually occur in individuals > 50 years of age without adequate trauma and are associated with obesity and varus deformities. The root lesion leads to a loss of ring tension, which results in extrusion of the meniscus and a strong increase in j...

Introduction The complex field of femoral defects in revision hip arthroplasty displays a lack of standardized, intuitive pre- and intraoperative assessment. To address this issue, the femoral defect classification (FDC) is introduced to offer a reliable, reproducible and an intuitive classification system with a clear therapeutic guideline. Mater...

Meniscus root tears are radial tears in the region of the posterior insertion zones. Medial root injuries usually occur in individuals > 50 years of age without adequate trauma and are associated with obesity and varus deformities. The root lesion leads to a loss of ring tension, which results in extrusion of the meniscus and a strong increase in j...

Ziel einer Pfannenrevision mit Abstützschale ist die Rekonstruktion der Lockerungs-bedingten Knochendefekte unter Wiederherstellung des physiologischen Hüftdrehzentrums bei gleichzeitig primärstabiler Verankerung des Revisionsimplantates. Es werden drei verschiedene Systeme und ihre wesentlichen Unterschiede vorgestellt: Abstützschalen ohne bzw. mi...

Zusammenfassung Randomisierte kontrollierte klinische Studien stellen für chirurgische Fachdisziplinen eine Herausforderung dar. Dieser Artikel beschreibt die Besonderheiten und Schwierigkeiten solcher Studien. Wann immer möglich, sollte das höchste Evidenzlevel angestrebt werden. Ist ein hohes Evidenzlevel allerdings methodisch nicht korrekt errei...

Background As our understanding of anterior cruciate ligament (ACL) anatomy has evolved, surgical techniques to better replicate the native anatomy have been developed. It has been proposed that the introduction of a rectangular socket ACL reconstruction to replace a ribbon-shaped ACL has the potential to improve knee kinematics after ACL reconstru...

Zusammenfassung Dieser Artikel gibt einen Überblick über das Prinzip des „intention to treat“ (ITT; Patienten werden so ausgewertet, wie sie randomisiert wurden), „per protocol“ (PP; nicht protokollgemäß behandelte Patienten werden von der Analyse ausgeschlossen) und „as treated“ (AT; Patienten werden unter der Behandlung ausgewertet, die sie tatsä...

PurposeVarious reconstruction techniques have been employed to restore normal kinematics to PCL-deficient knees; however, studies show that failure rates are still high. Damage to secondary ligamentous stabilizers of the joint, which commonly occurs concurrently with PCL injuries, may contribute to these failures. The main objective of this study w...

Clinical outcomes following posterior cruciate ligament (PCL) reconstruction are often suboptimal. A better understanding of the biomechanical contributions of the PCL to knee stability under physiologic, clinically-relevant loading conditions could improve reconstruction techniques and outcomes. We employed a servohydraulic joint motion simulator...

Cartilage regeneration with cell-free matrices has developed from matrix-associated autologous cartilage cell transplantation (MACT) over ten years ago. Adjustments to the legal framework and higher hurdles for cell therapy have led to the procedures being established as an independent alternative to MACT. These procedures, which can be classified...

Cartilage regeneration with cell-free matrices has developed from matrix-associated autologous cartilage cell transplantation (MACT) over ten years ago. Adjustments to the legal framework and higher hurdles for cell therapy have led to the procedures being established as an independent alternative to MACT. These procedures, which can be classified...

Objectives Approximately 95% of PCL injuries are multi-ligament injuries, yet it remains unclear if simultaneous injuries sustained to medial-side knee stabilizers such as the posterior oblique ligament (POL) and deep medial collateral ligament (dMCL) also need to be addressed. Pathomechanical kinematics that still exists after PCL reconstructions...

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...

IntroductionThe treatment of severe acetabular bone loss remains a difficult challenge. No classification system is available that combines intuitive use, structured design and offers a therapeutic recommendation according to the current literature and modern state of the art treatment options. The goal of this study is to introduce an intuitive, r...

While most procedures in the treatment of patellofemoral instability address the static or dynamic stabilizers of the patella, there are still other factors that need to be considered during the process of preoperative decision-making. Limb malalignment and its resultant force vectors are one such important factor for normal biomechanical function...

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...

Purpose The purpose of this study was to compare the biomechanical differences between quadriceps tendon (QT) repair with high-strength suture (HSS) versus suture tape (ST) with varying number of suture passes. Methods 28 fresh-frozen QTs were randomized into two groups: i) HSS; or ii) ST; specimens were then further randomized into subgroups of e...

Dr. Philip P. Roessler’s name had been missed out in chapter 11. The authors’ name has now been updated.

Objective: Optimal reconstruction of acetabular anatomy and primarily stable bridging even of large bone defects in hip revision surgery by intraoperative cementless application of highly modular components of the MRS-TITAN Comfort (MRS-C) system according to the augment-and-modular-cage principle. Indications: Acetabular defect situations in hip r...

Chronic valgus instability with concomitant valgus malalignment is a challenging diagnosis that cannot be successfully treated with ligament surgery alone. Hyperextension valgus thrust may be a symptom of this configuration, expressing the need for thorough diagnosis and treatment. The present article will help to understand pathoanatomy and mechan...

Musculoskeletal injuries occur as a result of forces that are applied to the body. The science of biomechanics tries to explain these forces and their momentum and puts musculoskeletal injuries in the context of physics. The present chapter explains basic biomechanical terms and principles of importance while dealing with sports-related injuries. T...

Background The influence of trauma-related kinematics on the injury pattern of the cervical spine is currently not considered in the available classification systems, only the force vector. Whether the strength of the trauma has an additional influence on the number and complexity of the injuries and whether this can be classified, has not yet been...

Introduction Cartilage defects of the knee remain a challenging problem in orthopedic surgery despite the ongoing improvements in regenerative procedures such as the autologous chondrocyte transplantation. Due to the lack of donor-site morbidity and the single-stage procedure cell-free scaffolds are an interesting alternative to cell-based procedur...

Knee osteotomies are a very powerful tool for addressing biomechanical deficiencies that result from a variety of knee pathologies. Distal femoral, proximal tibial, and tibial tubercle osteotomies all have their indications for usage, and they are associated with a number of specific complications. A number of strategies exist to mitigate the risk...

Purpose Acetabular revision of failed total hip arthroplasty (THA) is often associated with severe bone loss. Therefore, a variety of revision implant systems has been developed during recent years, with the augment-and-modular-cage system being one of the newest additions to this portfolio. Together with biologic downsizing by means of impaction b...

Background: Conventional radiography (CR) is the imaging method of choice in monitoring bone remodelling and other stability parameters after total hip arthroplasty (THA). Quantitative roentgen- or computed-tomography-based methods to determine bone density are prone to metal artifacts and often very costly, which is why they are not used as stand...

Zusammenfassung Bislang gibt es keine eindeutigen Erklärungen der pathophysiologischen Zusammenhänge in der Entstehung der heterotopen Ossifikation (HO). Es gibt nur wenig experimentelle Daten, die sich mit der posttraumatischen Entzündungsreaktion in Bezug auf die Balance zwischen der Reparatur beschädigter Muskelzellen und der entgegengesetzten R...

Purpose: Medial patellofemoral ligament reconstruction (MPFL-R) is the gold standard in patella soft tissue surgery for patellofemoral instability. Although claimed, recent reports indicate that MPFL-R may fail to distalize the patella in mild cases of patella alta. The present study is a retrospective case-control study to compare radiographic pat...

Erratum to:Oper Orthop Traumatol 2018 https://doi.org/10.1007/s00064-018-0559-3 The article was wrongly published under the article type "Review". Please note that the article is an "Original Paper".The publisher apologizes to authors and ….

Objective: The aim is to stabilize the thoracolumbar spine with a thoracoscopically implanted vertebral body replacement (VBR). To improve intraoperative depth perception and orientation, implantation is performed under three-dimensional (3D) thoracoscopic vision. Indications: Vertebral burst fractures at the thoracolumbar junction (A4 AOSpine c...

Purpose Patellar resurfacing (PR) in total knee arthroplasty (TKA) is still one of the major controversies in orthopaedic surgery today. The aim of the present retrospective case-control study was to identify predictors for secondary patellar resurfacing (SPR) after initial TKA to create a rationale for surgeons to decide which patients to resurfac...

Objectives: To review the surgical results and to identify possible parameters influencing the clinical outcomes in an unselected patient collective undergoing minimally invasive lumbar interbody fusion in a spinal care unit. Methods: A total of 229 adult patients who underwent minimally invasive lumbar spinal fusion between 2008 and 2016 were i...

Zusammenfassung Die Spondylodiszitis ist eine Infektion der Bandscheiben mit einer nachfolgenden Infektion der benachbarten Wirbelkörper. Hauptursache sind 3 Erregergruppen: Bakterien (pyogene Infektion), Tuberkuloseerreger und Pilze (granulomatöse Infektion) und Parasiten. Bei der pyogenen Spondylodiszitis dominieren meist Monoinfektionen mit Stap...

Zusammenfassung Hintergrund Dreidimensionale (3-D) endoskopische Optiken können durch 2 Kameras die unterschiedliche Perspektive des rechten und linken Auges simulieren und somit die Illusion einer räumlichen Tiefe erzeugen. Im laparoskopischen Einsatz konnte eine optimierte Orientierung und ein exakteres Handling gegenüber 2-D-Optiken nachgewiesen...

Background: In endoscopic operations, direct binocular view, tissue sensation and depth perception get lost. It is still unclear whether the novel three-dimensional (3D) high-definition (HD) cameras are able to compensate the limited senses and how this affects the skill set of users with different endoscopic experience. This study aimed first to...

Zusammenfassung Zielsetzung Die erfolgreiche Behandlung von Kniegelenkserkrankungen erfordert eine exakte Diagnose. Neben einer differenzierten Anamneseerhebung stellt die klinische Untersuchung dabei den wichtigsten Bestandteil in der Diagnostik von Kniegelenkserkrankungen dar. Methode Das vorliegende Video erklärt die gängigen Provokationstests u...

Zusammenfassung Zielsetzung Die erfolgreiche Behandlung von Schultererkrankungen erfordert eine exakte Diagnose. Neben einer differenzierten Anamneseerhebung stellt die klinische Untersuchung dabei den wichtigsten Bestandteil in der Diagnostik dar. Methode Das vorliegende Video erklärt die gängigen Funktionsprüfungen und Provokationstests, die in d...

Introduction: Recurrent shoulder instability after arthroscopic Bankart repair is still a common complication. For primary Bankart repair studies have shown that the rotator cuff can recover completely. The ability of muscles to regenerate after arthroscopic revision Bankart repair (ARBR) has not been studied. Does the ARBR using a three-portal me...

Background Recurrent instability following primary arthroscopic stabilization of the shoulder is a common complication. Young, athletic patients are at the greatest risk of recurring instability. To date, the literature contains insufficient description regarding whether return to sports is possible after revision arthroscopic Bankart repair. Hypo...

Background: Low vitamin D is a major risk factor for osteoporotic fractures. Evidence also suggests correlation between deficiency and musculoskeletal pain. Objective: Non-interventional study in patients undergoing spine surgery to investigate links between vitamin D levels and clinical features. Methods: 25-OH vitamin D levels were assessed...

Zusammenfassung Zielsetzung Entwicklung einer Präparationstechnik für Hamstring-Sehnen zur Gewährleistung maximaler intraoperativer Flexibilität im Rahmen der individualisierten Kreuzbandchirurgie. Indikationen Primäre VKB- oder HKB-Rekonstruktion sowie deren Revisionsoperationen. Methode Drei- oder 5-strängige Transplantate können mithilfe der Sem...

Background: Vertebral body fractures (VBF) can be caused by various trauma mechanisms. The AOSpine classification system differentiates three main types of fractures according to the grade of instability. How the increasing energy of various accident mechanisms changes the complexity of the individual fracture, its localization and the occurrence...

Introduction: Medial patello-femoral ligament (MPFL) reconstruction is a standard procedure in the armamentarium for the treatment of patella instability. While tunnel widening is a well studied phenomenon following anterior cruciate ligament reconstruction, only few data is available concerning tunnel enlargement after MPFL reconstruction. Methods...

Purpose: The consolidation of the acromioclavicular (AC) and coracoclavicular (CC) ligament complex after arthroscopically assisted stabilization of acute acromioclavicular joint (ACJ) separation is still under consideration. Methods: Fifty-five consecutive patients after arthroscopically assisted double-CC-bundle stabilization within 14 days af...

Introduction: The stabilization of an atlantoaxial (C1-C2) instability is demanding due to a complex atlantoaxial anatomy with proximity to the spinal cord, a variable run of the vertebral artery (VA) and narrow C2 pedicles. We perfomed the Goel & Harms fusion in combination with an intraoperative 3D imaging to ensure correct screw placement in th...

Background: Spinal fusion surgery has become one of the most common spinal procedures during the recent years. Searching for an optimum structural stability of the vertebral interspace, surgical implants which can be inserted via a posterior lumbar interbody fusion (PLIF) approach have been enhanced recently. Objective: Evaluation of safety and...

Background: Vertebral compression fractures (VCF) change the natural spinal alignment and inevitably lead to a decreased quality of life. Objective: The aim of the study was to evaluate changes in pulmonary function after VCF were treated by radiofrequency kyphoplasty (RF-TVA). Methods: Twenty-five patients were treated with RF-TVA and analyze...

Pain coming from the sacroiliac (SI) joints can explain up to 25 % of all chronic low back pain. A careful differential diagnosis is required to avoid misdiagnosis of low back pain. In addition to historical findings, positive findings on physical examination maneuvers that stress the SI joint are a key component diagnosis. The SI joint is confirme...

Background: Kyphoplasty is a proven minimally invasive procedure for the treatment of patients with osteoporotic fractures. By augmentation of fractured vertebral body, however, a very large portion of the intervertebral structures will be destroyed. With the help of a new device (Vertect Jack Device), the erection of the vertebral body will be ca...

Aims and Objectives In current literature only one study investigates femoral tunnel enlargement after medial patello-femoral ligament (MPFL) reconstruction. Aim of the present study was to investigate the occurrence of femoral tunnel enlargement after MPFL reconstruction and a possible correlation to femoral tunnel position as well as clinical out...

Introduction: Different dissection studies as well as comparative studies about the anterolateral ligament of the knee (ALL) already exist and the structure's topology and properties have been shown. However, most of the studies investigating the ligament were performed in embalmed knees, which is thought to change the structural integrity of liga...

Background: 30% of myeloma patients suffer from vertebral compression fractures (VCF). Consequently, augmentation often becomes inevitable to prevent further problems. This study evaluated the interaction of radiation therapy (RT) and radiofrequency kyphoplasty (RFK) in the treatment of myeloma associated VCF. Methods: Eighty-six myeloma patient...

Background: Sacroiliac joint (SIJ) syndrome can cause various symptoms and may also be one reason for persistent low back pain, especially in patients with prior spinal fusions. If conservative treatments fail to improve symptoms, arthrodesis surgery can be considered. Minimally invasive approaches have emerged recently providing a good alternativ...

Zusammenfassend stellen die zellfreien Knorpelverfahren eine auch zukünftig inte-ressante Therapieoption dar. Unter dem zunehmenden Kos-tendruck im Gesundheitssystem, der mit der ACI verbunde-nen Notwendigkeit zum zweizeitigen Vorgehen und dem unvermeidbaren Entnahmedefekt, könnten die zellfreien Ver-fahren eine sinnvolle Alternative zur ACI darste...

Background: When deciding upon the best treatment strategy in revision arthroplasty, it is absolutely crucial to use the best possible preoperative detection whether a periprosthetic joint infection (PJI) is present or not. New molecular markers investigated in serum samples and synovial fluid can help to improve the preoperative diagnosis. In 200...

Background: Myeloma patients often suffer from painful vertebral fractures (VCF) which impair their quality of life. Common methods for augmentation of the vertebrae are vertebroplasty, kyphoplasty and radiofrequency-targeted vertebral augmentation (RF-TVA). Objective: This study evaluates the long-term effectiveness and safety of RF-TVA in the...

Background: Radiofrequency ablation (RFA) temperatures reaching 45°C in adjacent tissues are cytotoxic to the spinal cord, nerves and surrounding tissues. Objective: This study compares different RFA electrodes with regard to the temperature distribution during ablation of spinal metastases. Methods: In vitro experimental study in isolated lum...

Background: Smoking is a risk factor in the process of bone healing after lumbar spondylodesis, often associated with complications that occur intraoperatively or during follow-up periods. Objective: To assess if smokers yield worse results concerning lumbar interbody fusion than non-smokers in a clinical comparative setting. Methods: Spondylo...

Introduction: Treatment of implant-associated osteomyelitis regularly involves the use of systemic antibiotics in addition to surgical intervention. However, it remains unclear if perioperative systemic application of bactericide substances can improve overall outcome in models of severe intramedullary infection. The present study investigated the...

Aims and Objectives: The preservation of meniscal structure and function after segmental meniscal loss is of crucial importance to prevent early development of osteoarthritis. Implantation of artificial meniscal implants has been reported as a feasible treatment option. The purpose of this study was to assess the clinical and magnetic resonance ima...