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Background/Objectives: To evaluate the use of encircling scleral buckling for treating retinal detachment (RD) and its complications as well as success rate within the last decade. Subjects/Methods: This retrospective observational study included 163 eyes receiving encircling scleral buckling (ESB) or ESB combined with vitrectomy (SBV) between 2009 and 2018. Main outcome measures include usage rate of ESB and SBV, indications and mean age. Furthermore, intra-/postoperative complications, intraocular tamponades as well as influences on functional outcome (BCVA) and central retinal thickness (CRT) were evaluated. For statistical analysis, patients were divided into five groups of two years each. Results: ESB and SBV surgeries decreased from initially 32% of all RD-operations between 2009-2010 to 9.2% between 2017-2018 (p phakic > aphakic, p ESB, p=0.017) and macula on/off (off > on, p=0.036). Conclusion: After an initial decrease, a rebound in ESB and SBV surgeries was noticed, with a significant reduction in mean age. Indications for surgery shifted over our observational period. No significant differences in functional outcome as well as intra- and postoperative complications were observed.

Infection represents probably the most challenging complication in shoulder arthroplasty and all other surgical procedures of the shoulder. A deep infection of the shoulder is often combined with a destruction of the joint and a loss of function. In many cases the arthroplasty is the last resort for these patients to obtain a satisfactory function. The objective of this study was to determine outcome data on microbiota and clinical results of a two-stage shoulder arthroplasty procedure after deep infection of the shoulder. Twenty-six patients with a deep shoulder infection after arthroplasty, osteosynthesis, or rotator-cuff repair were included, while two patients had an empyema without prior surgery. All underwent initial surgical debridement with implantation of an antibiotic-loaded spacer, followed by postoperative systemic antibiotics. The patients obtained definitive shoulder arthroplasty in a second surgery. None of the patients had to undergo more than two surgeries before the arthroplasty. The follow-up analysis including microbiota results, complication rates, and functional outcomes could be determined after at least 1 year in 60% of patients (n = 16). The most frequently detected microorganisms were S. epidermidis (31%, n = 10) and Cutibacterium acnes (19%, n = 6). In 28% (n = 9) of cases multi-drug resistant bacteria were detected and in 35% (n = 8) of cases more than one microorganism was found. The overall revision rate was 42%, 11 of 26 patients, in the first 8 weeks after arthroplasty. Reasons for revision were joint dislocations in 23% (n = 6), 15% (n = 4) postoperative hematomas, one (4%) re-infection and one (4%) periprosthetic fracture. At follow-up after 19.3 ± 5.5 months postoperatively, a mean abduction of 113.4°, anteversion of 122.8° and external rotation of 14° was found, with an average age and gender-adjusted Constant Score of the affected shoulder of 63. The subjects’ pain and impairment in normal life measured by a questionnaire with school grades were significantly reduced (p

Background The treatment of fracture- or non-union-related infections has persistently been a major challenge for both patients and treating surgeons. With rising aging of patients and increasing comorbidities, combined with the heterogeneity of germs and any number of multi-resistance against standard antibiotics, a successful treatment is increasingly difficult. One potential solution could be a custom-made individualized antibacterial coating of standard implants with a biphasic degradable biocarrier (Cerament G/V, supplied by Bonesupport AB, Lund, Sweden) that releases high doses of antibiotics around the bone-implant-interface. Here, we describe our technique of coating intramedullary nails, plates and press-fit shoulder endoprostheses which may prevent bacterial adhesion and biofilm formation. So far, there is very limited experience in individual coating of implants in hip or knee endoprostheses to prevent reoccurrence of surgical-site infection. Currently, no reports are available for coating of stems of shoulder prosthesis and nails or plates for fracture fixation. Methods Here, we show our first experiences with a new individualized surgical technique of coating these implants with a resorbable antibiotic-loaded hydroxyapatite/calcium sulphate biocomposite to prevent biofilm formation and thereby recurrence of bone or joint infection. We describe three cases for coating of plates and nails for fracture fixation and coating of stems of a shoulder prosthesis. Results No adverse events of the resorbable bone graft substitute were observed. In all of the cases, no recurrence of the infection was observed and osseointegration was achieved. After implant coating of the shoulder prosthesis, no radiological signs of loosening were detected. Conclusion We present a new surgical approach of a surface coating of plates, intramedullary nails or prostheses. The osteoconductive- and anti-inflammatory effect of the gentamicin- or vancomycin-loaded hydroxyapatite/calcium sulphate bone graft substitutes shows promising results.