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21. Impaired gastric acidification negatively affects calcium homeostasis and bone mass

Author

Schinke, Thorsten, Schilling, Arndt F., Baranowsky, Anke, Seitz, Sebastian, Marshall, Robert P., Linn, Tilman, Blaeker, Michael, Huebner, Antje K., Schulz, Ansgar, Simon, Ronald, Gebauer, Matthias, Priemel, Matthias, Kornak, Uwe, Perkovic, Sandra, Barvencik, Florian, Beil, F. Timo, Del Fattore, Andrea, Frattini, Annalisa, Streichert, Thomas, Pueschel, Klaus, Villa, Anna, Debatin, Klaus-Michael, Rueger, Johannes M., Teti, Anna, Zustin, Jozef, Sauter, Guido, and Amling, Michael

Subjects
Diagnosis, Care and treatment, Research, Genetic aspects, Health aspects, Osteoporosis -- Diagnosis -- Genetic aspects -- Care and treatment -- Research, Bone density -- Health aspects -- Genetic aspects -- Research, Gastric acid -- Health aspects -- Research, Peptide hormones -- Research -- Genetic aspects -- Health aspects, Bones -- Density
Abstract

Bone is constantly remodeled through the balanced activities of osteoblasts and osteoclasts. Whereas genetic defects of bone-forming osteoblasts typically result in delayed bone development and osteoporosis, mutational inactivation of bone-resorbing [...], Activation of osteoclasts and their acidification-dependent resorption of bone is thought to maintain proper serum calcium levels. Here we show that osteoclast dysfunction alone does not generally affect calcium homeostasis. Indeed, mice deficient in Src, encoding a tyrosine kinase critical for osteoclast activity, show signs of osteopetrosis, but without hypocalcemia or defects in bone mineralization. Mice deficient in Cckbr, encoding a gastrin receptor that affects acid secretion by parietal cells, have the expected defects in gastric acidification but also secondary hyperparathyroidism and osteoporosis and modest hypocalcemia. These results suggest that alterations in calcium homeostasis can be driven by defects in gastric acidification, especially given that calcium gluconate supplementation fully rescues the phenotype of the Cckbr-mutant mice. Finally, mice deficient in Tcirg1, encoding a subunit of the vacuolar proton pump specifically expressed in both osteoclasts and parietal cells, show hypocalcemia and osteopetrorickets. Although neither Src- nor Cckbr-deficient mice have this latter phenotype, the combined deficiency of both genes results in osteopetrorickets. Thus, we find that osteopetrosis and osteopetrorickets are distinct phenotypes, depending on the site or sites of defective acidification.

Published
2009

24. Adressen

Author

Hildebrand, Frank, primary, Pape, Hans-Christoph, additional, Andermahr, Jonas, additional, Balke, Maurice, additional, Banerjee, Marc, additional, Banke, Ingo J., additional, Bauer, Gerhard, additional, Bouillon, Bertil, additional, Fuß, Bernhard, additional, Gaulke, Ralph, additional, Gebauer, Matthias, additional, Gehrke, Thorsten, additional, Gerich, Torsten, additional, Grützner, Paul A., additional, Haasper, Carl, additional, Imhoff, Andreas B., additional, Leichtle, Ulf G., additional, Lipka, Wolfram, additional, Meier, Reinhard, additional, Pape, Dietrich, additional, Rammelt, Stefan, additional, Rixen, Dieter, additional, Rühmann, Oliver, additional, Rueth, Markus-Johannes, additional, Simanski, Christian J.P., additional, Wölfl, Christoph G., additional, Wülker, Nikolaus, additional, Wünsch, Markus, additional, Zeichen, Johannes, additional, and Zwipp, Hans, additional

Published
2014
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27. Mouse models in skeletal physiology and osteoporosis: experiences and data on 14839 cases from the Hamburg Mouse Archives

Author

Pogoda, Pia, Priemel, Matthias, Schilling, Arndt F., Gebauer, Matthias, Catalá-Lehnenf, Philip, Barvencik, Florian, Beil, F. Timo, Münch, Christian, Rupprecht, Martin, Müldner, Cordula, Rueger, Johannes M., Schinke, Thorsten, Amling, Michael, Pogoda, P., Priemel, M., Schilling, A. F., Gebauer, M., Catalá-Lehnen, P., Barvencik, F., Beil, F. T., Munch, C., Rupprecht, M., Miildner, C., Rueger, J. M., Schinke, T., and Amling, M.

Published
2005
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40. 10-year results following impaction bone grafting of major bone defects in 29 rotational and hinged knee revision arthroplasties

Author

Hilgen, Verena, Citak, Mustafa, Vettorazzi, Eik, Haasper, Carl, Day, Kimberly, Amling, Michael, Gehrke, Thorsten, and Gebauer, Matthias

Subjects
musculoskeletal diseases, Adult, Aged, 80 and over, Reoperation, Bone Transplantation, Knee Joint, Middle Aged, musculoskeletal system, Survival Analysis, Radiography, Treatment Outcome, Humans, Knee, Treatment Failure, Arthroplasty, Replacement, Knee, Aged, Follow-Up Studies
Abstract

Background and purpose — Substantial bone loss in revision total knee arthroplasty (TKA) is a challenging problem. We studied whether impaction bone grafting provides long-term restoration of bone stock in the treatment of major bone defects in revision surgery of rotational and hinged knee arthroplasties (LINK Endo-Model). Patients and methods — Between 1996 and 2006, 29 knees in 29 patients underwent revision procedures of rotational and hinged knee arthroplasties using impaction bone grafting (IBG) to reconstruct major bone defects. At the latest follow-up, the clinical examination included the Knee Society score (KSS), standardized radiographs, and a questionnaire for the WOMAC score. Results — After a mean follow-up of 10 (6–13) years, 14 knees with 19 IBG reconstructions (5 total, 9 partial revisions) had failed. 12 knees were treated with re-revision surgery mean 5 (1–12) years after the first revision, due to mechanical failure and aseptic loosening of the components. In all these failed cases, the surgeon observed a lack of incorporation with bone graft resorption in the femur or tibia during the re-revision procedure. In all 15 knees that were not re-revised, with 21 reconstructions (6 total, 9 partial revisions), an improvement in the combined KSS score (knee score + function score) of 60 points (p < 0.001) was found at the latest follow-up. In 12 of these knees, a clear incorporation with no visible radiolucent lines around the component and no sign of substantial graft resorption was noted, while unclear radiographic graft incorporation was seen in 3 knees. Interpretation — Our results clearly indicate that IBG alone is not a methodologically sound technique in the revision of rotational and hinged knee arthroplasties.

Published
2013

42. Konfektionierter vs. individualisierter totaler Kniegelenkersatz - ein matched-pair Vergleich

Author

Rueth, Markus-Johannes, Beier, Alexander, Schnurr, Christoph, Huth, Jochen, Gebauer, Matthias, and Beckmann, Johannes

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Fragestellung: Die K-TEP stellt ein weltweit etabliertes Verfahren in der orthopädischen Chirurgie dar. Dennoch sind etwa 20% der Patienten mit ihrer Versorgung postoperativ nicht zufrieden, haben Schmerzen oder eine reduzierte Aktivität. Ein neuerer Ansatz sind Systeme, die näher[zum vollständigen Text gelangen Sie über die oben angegebene URL], Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2015)

Published
2015

43. Elevated HbA1c is not a risk factor for wound complications following total joint arthroplasty: a prospective study

Author

Kendoff, Daniel, Sandiford, N Amir, Citak, Mustafa, Toussaint, Bastian, Abdelaziz, Hussein, Klebig, Felix, Dobinsky, Alexandra, Gebauer, Matthias, and Gehrke, Thorsten

Abstract

Background: Controversies exist regarding the association of elevated serum glycated haemoglobin (HbA1c) levels and postoperative surgical site infection (SSI) or prosthetic joint infection (PJI) in the setting of total hip and knee arthroplasty (THA and TKA). The purpose of the current study was to determine the prevalence of unknown and uncontrolled diabetes mellitus (DM) in a consecutive series and to investigate the association between postoperative wound complications or SSI/PJI and elevated HbA1c in patients undergoing TJA.Methods: In this prospective single-centre study, HbA1c was determined for patients undergoing elective primary, aseptic or septic revision THA and TKA, between September 2017 and March 2018. Prevalence of DM, unknown and uncontrolled diabetes were reported. Occurrence of 90-day wound healing disorders (WHD) as well as SSI or PJI were observed. Considering the HbA1c threshold ⩾6.5%, a comparative analysis between patients with and without WHD and SSI or PJI for the whole study cohort, as well as for each arthroplasty group, was performed. Receiver operating characteristic (ROC) curves were developed to quantify the predictive power of HbA1c with regard to WHD and infection complications. A total of 1488 patients were included for final analysis. There were 1127 primary THA and TKA (75.7%), 272 aseptic revisions (18.3%) and 89 septic revisions (6.0%). The known diabetic patients constituted 9.9% of the whole study cohort.Results: The majority had uncontrolled DM (67%). Prevalence of unknown DM was 11.1%. The results reveal the prevalence for the German population and might be different in other regions. A total of 57 patients (3.7%) experienced postoperative wound or infectious complications. PJI occurred in only 5 patients (0.03%). There was no significant difference between patients with HbA1c <6.5% and patients with HbA1c ⩾6.5% (p= 0.092).Conclusions: We demonstrated that prevalence of unknown and uncontrolled DM in patients undergoing TJA is increasing, however; routine preoperative determination of the HbA1c value to prevent possible postoperative wound or infectious complications remains debatable. Larger studies investigating the optimal HbA1c level, as well as other predictors are required.

Published
2020
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44. How reliable is the next generation of multiplex-PCR for diagnosing prosthetic joint infection compared to the MSIS criteria? Still missing the ideal test

Author

Kendoff, Daniel, Sandiford, N Amir, Lausmann, Christian, Kolle, Kim Niklas, Citak, Mustafa, Abdelaziz, Hussein, Schulmeyer, Juan, Delgado, Gio D, Gehrke, Thorsten, Gebauer, Matthias, and Zahar, Akos

Abstract

Introduction: Identification of the pathogen in case of a periprosthetic joint infection (PJI) remains 1 of the greatest challenges in septic surgery. Rapid germ identification enables timely, specific, antimicrobial therapy. The first multiplex PCR (polymerase chain reaction) generation (Unyvero-i60) enables germ detection within 5 hours with a sensitivity of 78.8% and a specificity of 100%. The aim of this study is to investigate the performance of the new generation of cartridges (Unyvero-ITI) of multiplex PCR in the case of a PJI.Methods: In a prospective study, intraoperatively aspirated synovial fluid from 97 patients with aseptic or septic hip or knee revision surgery (49 aseptic, 48 septic) was examined with the multiplex PCR system (Unyvero-ITI) and the results were compared with the MSIS criteria. In addition, the time until the microbiological result was obtained in the event of a germ detection was documented.Results: The multiplex PCR showed a germ detection with a sensitivity of 85.1% and a specificity of 98.0%. In 7 cases a false negative result was found and in one patient a false positive result was found. The general accuracy of this test procedure was 91.8%. The detection of germs was carried out within 5 hours with the multiplex PCR compared to 4.9 days in conventional microbiological diagnostics.Conclusions: The new generation of multiplex-PCR was able to improve germ detection. The possibility of prompt detection of germs offers the option of faster, targeted antimicrobial therapy. This diagnostic tool offers significant advantages, particularly in the context of an acute periprosthetic infection.

Published
2020
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46. Insuffizienz der Hüftgelenksabduktoren nach Hüftprothesenimplantation - Klinische Ergebnisse nach modifiziertem Gluteus-maximus-Transfer nach Whiteside

Author

Jakobs, Oliver, Schmidl, Stefan, Schoof, Benjamin, Fensky, Florian, Gehrke, Thorsten, and Gebauer, Matthias

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Fragestellung: Eine mögliche Komplikation der Hüftgelenksendoprothetik, insbesondere im Falle einer Revision, liegt in der Affektion der Hüftgelenksabduktoren. Als Ursache gelten primäre Verletzungen als auch osteolytische, bzw. inflammatorische Prozesse im Bereich des proximalen[for full text, please go to the a.m. URL], Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2014)

Published
2014

50. Ungenügende Korrelation zwischen Singh Index und Knochendichte

Author

Klatte, Till Orla, Stark, Olaf, Vettorazzi, Eik, Beckmann, Johannes, Püschel, Klaus, Amling, Michael, and Gebauer, Matthias

Subjects
DXA, ddc: 610, Singh Index, 610 Medical sciences, Medicine, Osteoporose, pQCT, Knochendichte
Abstract

Fragestellung: Der Singh Index (SI) ist eine einfache und kostengünstige Methode um die Knochenqualität anhand eines nativ radiologischen Bildes des proximalen Femurs zu bestimmen. Ziel dieser Studie war es die Korrelation zwischen Singh Index und der mittels Dual energy X-ray Absorptiometry[for full text, please go to the a.m. URL], Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2013)

Published
2013

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