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Background There are different procedures for both, the diagnosis and the therapy of a periprosthetic joint infection (PJI), however, national or international guidelines for a standardised treatment regime are still lacking. The present paper evaluates the use of the predominant treatment protocols for PJI in certified total joint replacement centres (EPZ) in Germany based on an EndoCert questionnaire. Materials and methods The questionnaire was developed in cooperation with the EndoCert Certification Commission to survey the treatment protocols for septic revision arthroplasties in EPZ. Questions targeted the various treatment options including prosthesis preserving procedures (DAIR - Debridement, antibiotics, irrigation, and retention of the prosthesis), one-stage revision, two-stage revision, removal of the endoprosthesis and diagnostic sampling prior to re-implantation. All certified EPZ participated (n = 504) and the results from the current survey in 2020 were compared to data from a previous analysis in 2015. Results The number of centres that performed DAIR up to a maximum of 4 weeks and more than 10 weeks after index surgery decreased since 2015, while the number of centres that provided a one-stage revision as a treatment option increased (hip: + 6.3%; knee: + 6.6%). The majority of the centres (73.2%) indicated a 4–8 week period as the preferred interval between prosthesis removal and re-implantation in two-stage revision in hip as well as knee revisions. Centres with a higher number of revision surgeries (> 200 revisions/year), opted even more often for the 4–8 week period (92.3%). In two-stage revision the use of metal-based spacers with/without reinforcement with antibiotic-containing cement as an interim placeholder was significantly reduced in 2020 compared to 2015. There was also a clear preference for cemented anchoring in two-stage revision arthroplasty in the knee in 2020, whereas the majority of hip replacements was cementless. Additionally, in 2020 the number of samples for microbiological testing during the removal of the infected endoprosthesis increased and 72% of the centres took five or more samples. Overall, the number of EPZ with a standardised protocol for the procedure expanded from 2015 to 2020. Conclusion While there was a trend towards standardised therapeutic algorithms for PJI with more uniform choices among the centres in 2020 compared to 2015, the treatment often remains an individual decision. However, since a consistent treatment regime is of vital importance with an expected rise of total numbers of revision arthroplasties, uniform definitions with regard to comparability and standardisation are necessary for the further development of the EndoCert system.

We have combined ultrasensitive force-based spin detection with high-fidelity spin control to achieve NMR diffraction (NMRd) measurement of ~2 million 31 P spins in a ( 50 n m ) 3 volume of an indium-phosphide (InP) nanowire. NMRd is a technique originally proposed for studying the structure of periodic arrangements of spins, with complete access to the spectroscopic capabilities of NMR. We describe two experiments that realize NMRd detection with subangstrom precision. In the first experiment, we encode a nanometer-scale spatial modulation of the z -axis magnetization of 31 P spins and detect the period and position of the modulation with a precision of

Background In total hip arthroplasty, acetabular press-fit cups require a proper bone stock for sufficient primary implant fixation. The presence of acetabular bone defects compromises the primary fixation stability of acetabular press-fit cups. The aim of the present study is to determine the fixation stability of a cementless acetabular cup regarding standardized bone defects in an experimental setup. Methods An acetabular defect model was developed and transferred to a biomechanical cup-block model. The lack of superior cup coverage was divided into 4 stages of superior rim loss (33%, 50%, 67%, and 83%) in the anterior-posterior direction and into 4 stages of mediolateral wall absence (11%, 22%, 33%, and 50%). This resulted in 11 different defect cavities, which were compared to the intact cavity in push-in and lever-out tests of one press-fit cup design (56 mm outer diameter). Thereby, push-in force, lever-out moment, lever-out angle, and interface stiffness were determined. Results The determined lever-out moments range from 15.53 ± 1.38 Nm (intact cavity) to 1.37 ± 0.54 Nm (83%/50% defect). Smaller defects (33%/11%, 33%/22%, and 50%/11%) reduce the lever-out moments by an average of 33.9% ± 2.8%. Conclusion The lack of mediolateral acetabular coverage of 50% was assessed as critical for cementless cup fixation, whereby the contact zone between implant and bone in the defect is lost. A lack of 20% to 30% mediolateral coverage appears to be acceptable for press-fit cup fixation in the presence of primary stability. A defect of 50%/50% was identified as the threshold for using additional fixation methods.

The annual report of EndoCert publishes the results of the quality indicators (QI) and key figures of all certified centres for joint replacement (EndoProthetikZentren - EPZ). For some results it seems that centres with fewer revisions might have higher complication rates. However, to avoid misinterpretation the results have to be evaluated in more detail. The influence of the quantity of the revisions or the revision quotient on the quality of outcome was investigated.This study included all certified EPZ and centres of excellence for joint replacement (EPXmax) (n = 492) and evaluated the data from 2016. Centres beyond the action limit were identified with the help of funnel plots and a confidence limit of 99.7% as action limit. Additionally data of the quality indicators were analysed with ANCOVA. The level of significance was p 0.05.The comparison by ANCOVA with number of revisions as co-variate showed no differences in the complication rates when related to the quantity of revisions. When considering a so called revision quotient (ratio of revision to all joint replacements) significant differences in the rate of fractures and fissures as well as in mortality for hip replacements and also in mortality for knee replacements were observed.EPZ with fewer revisions do not have higher complication rates than centers with high numbers of revisions. Thus, the quantity of revisions has no influence on the quality of the outcome, considering that on the basis of the data of the EndoCert system no risk adjustment of patient-specific data was performed. Therefore the revisioin quotient of an EPZ shows that quantity is not equal with quality.In dem Jahresbericht von EndoCert werden die Ergebnisse der Qualitätsindikatoren (QI) und Kennzahlen der zertifizierten EndoProthetikZentren (EPZ) veröffentlicht. Bei einigen Ergebnissen scheint es, dass Zentren mit wenigen Wechseleingriffen höhere Komplikationsraten haben. Um Fehlinterpretationen zu vermeiden, müssen diese Ergebnisse differenziert bewertet werden. Es ist zu prüfen, ob die Anzahl der Wechseleingriffe oder der Wechselquotient eines EPZ Auswirkungen auf die Ergebnisqualität hat.In diese Studie wurden alle zertifizierten EPZ und EPZmax (n = 492) eingeschlossen und das Datenjahr 2016 ausgewertet. Mithilfe von „funnel plots“ und den Grenzwerten von 99,7% als „action limit“ wurden Zentren außerhalb der Aktionsgrenze ermittelt. Zudem wurden die Daten für die QI mittels ANCOVA analysiert. Statistische Signifikanz wurde als p 0,05 festgelegt.Zentren mit unterschiedlicher Wechselrate weisen bei der Analyse mit ANCOVA mit „Anzahl an Wechseleingriffen“ als Kovariate im Wesentlichen keine signifikanten Unterschiede hinsichtlich der Komplikationsrate auf. Unter Berücksichtigung des Wechselquotienten hingegen (Verhältnis Wechsel- zur Gesamteingriffszahl) wurden bei den Hüftwechseln signifikante Unterschiede bei der Rate von Frakturen und Fissuren wie auch der Mortalität und bei den Kniewechseln bei der Mortalität nachgewiesen.EPZ mit wenigen Wechseleingriffen weisen keine höheren Komplikationsraten auf als Zentren mit hohen Wechselzahlen. Die Anzahl der Wechseleingriffe hat somit keinen Einfluss auf die Ergebnisqualität, wenn auf der Basis dieser Daten des EndoCert-Systems keine Risikoadjustierung der patientenspezifischen Daten erfolgt. Der Wechselquotient eines EPZ zeigt, dass dann Quantität nicht mit Qualität gleichzusetzen ist.

Background The periprosthetic joint infection (PJI) is a severe complication in the field of arthroplasty. Despite the rising number of primary joint replacements, no unified therapeutic standard has been established for the treatment of PJI yet. Methods A survey on the principles of treatment of PJI in Germany was conducted. A total of 515 EndoProthetikZentren (EPZ) were included, resulting in a response rate of 100%. Results For early infections 97.6% of the centers use prosthesis-preserving procedures (DAIR). A one-stage exchange was implemented by less than 50% of the centers. If implemented, this treatment entails a prior selection of patients for a successful treatment. The two-stage exchange is performed in all centers, and most centers proceed with the implantation of a cemented spacer between stages. 75% of the centers proceed with a center-based concept for the treatment of PJI. Conclusion The aim of a uniform PJI standard at the centers has not yet been fully achieved. Further improvements within the certification were initiated. The most relevant treatment options in Germany are displayed. The two-stage revision with a cemented spacer is the most widely implemented treatment. This exposition of principles could help for the further development of standardized treatment guidelines and definitions.

Adiabatic operations are powerful tools for robust quantum control in numerous fields of physics, chemistry and quantum information science. The inherent robustness due to adiabaticity can, however, be impaired in applications requiring short evolution times. We present a single versatile gradient-based optimization protocol that combines adiabatic control with effective Hamiltonian engineering in order to design adiabatic operations tailored to the specific imperfections and resources of an experimental setup. The practicality of the protocol is demonstrated by engineering a fast, 2.3 Rabi cycle-long adiabatic inversion pulse for magnetic resonance with built-in robustness to Rabi field inhomogeneities and resonance offsets. The performance and robustness of the pulse is validated in a nanoscale force-detected magnetic resonance experiment on a solid-state sample, indicating an ensemble-averaged inversion accuracy of $\sim 99.997\%$. We further showcase the utility of our protocol by providing examples of adiabatic pulses robust to spin-spin interactions, parameter-selective operations and operations connecting arbitrary states, each motivated by experiments., Comment: Main text: 14 pages, 6 figures; supplemental material: 6 pages, 2 figures

In 2016, the AG 11 (work group for implant-material-intolerance) of the German society for Orthopaedics and Orthopaedic Surgery (DGOOC) created a histopathologic implant register (HIR). The goal was to conduct a retrospective data analysis based on the revised SLIM-consensus-classification, which defines eight different failure mechanisms.The analysis of 4000 cases of endoprosthetic joint replacements addressed the following questions: 1. What is the frequency distribution of different SLIM-types? 2. How does durability of endoprosthetic joint replacements differ among SLIM-types? 3. What kind of periprosthetic malignant neoplasia can be detected and how often?SLIM-type I was diagnosed in 1577 cases (n = 1577, 39.4%), SLIM-type II in 577 cases (n = 577; 14.4%), SLIM-type III in 146 cases (n = 146; 3,7%), SLIM-type IV in 1151 cases (n = 1151; 28.8%), SLIM-type V in 361 cases (n = 361; 9.0%), SLIM-type VI in 143 cases (n = 143; 3.6%), SLIM-type VII in 42 cases (n = 42; 1.0%), and SLIM-type VIII in 3 cases (n = 3; 0.075%). There was statistical significance in implant durability between the different SLIM types. Among the different reasons for endoprosthetic joint replacement failure, non-infectious causes have the biggest share at 81%, with SLIM-type I (39.5%), and SLIM-type IV (29.4%) being the predominant SLIM types. Three cases of periprosthetic malignant neoplasia (SLIM-type VIII) were detected: one case of small B lymphocytic lymphoma/BCLL (C85.9; ICD-O: 9670/3), one case of diffuse large B‑cell lymphoma/DLBCL (C83.3; ICD‑O 9680/3), and one case of anaplastic large cell lymphoma (C84.7; ICD-O: 9714/3), with the latter ones being the causes for joint replacement , which indicates that malignant neoplasia is a very rare cause of endoprosthetic joint replacement (n = 2; 0.05%).These data are complete new, especially as concerns arthrofibrosis (SLIM-type V), adverse inflammatory reactions (SLIM-type VI), and the very rare cases of periprosthetic malignant neoplasia, SLIM-type VIII, as a reason for revision. Since neither the annual review (2017) of the EPRD, nor the national evaluation report (2017) of the IQTIG provide sufficient data, this indicates the relevance of the HIR of the AG 11 of the DGOOC.

Zusammenfassung Hintergrund Im Vorfeld einer elektiven Endoprothesenimplantation sind diagnostische Maßnahmen erforderlich. Diese haben das Ziel, die patientenbezogene und eingriffsbezogene Risikokonstellation zu erfassen und durch die Einleitung geeigneter prä- und perioperativer Maßnahmen mögliche Komplikationen zu vermeiden bzw. deren Auftretenswahrscheinlichkeit zu reduzieren. Daneben dient die klinische und bildgebende Untersuchung des Patienten der Indikationsstellung zum Eingriff, die jedoch nicht Thema des vorliegenden Beitrags ist. Ziel der Arbeit Die aktuelle Literatur zur präoperativen Diagnostik vor elektiven endoprothetischen Eingriffen wurde analysiert. Methode Eine selektive Literaturrecherche wurde durchgeführt. Ergebnisse Wir identifizierten studienbasierte Empfehlungen hinsichtlich (1) präoperativer Anämie, (2) Optimierung der Stoffwechsellage, (3) Gewichtskontrolle, (4) Schlafapnoesyndrom, (5) MRSA-Problematik und Hautdekontamination, (6) Harnwegsinfektion, (7) dentales Screening, (8) kardiologischer Diagnostik, (9) technisch-planerischen Vorbereitungen, insbesondere der Revisionsendoprothetik. Schlussfolgerung Auch wenn nicht zu allen präoperativen diagnostischen Maßnahmen belastbare evidenzbasierte Empfehlungen vorliegen, bestehen bereits klare Anforderungen an die präoperative Diagnostik elektiver Patienten vor endoprothetischen Eingriffen. Die zunehmende Fokussierung auf erweiterte Maßnahmen im Rahmen des perioperativen Managements wird den Umfang notwendiger Untersuchungen im Vorfeld dieser Operationen erhöhen.

We use above-bandgap optical excitation, via a 1047 nm laser, to hyperpolarize the $^{31}$P spins in low-doped (N$_D =6\times10^{15}$ cm$^{-3}$) natural abundance silicon at 4.2 K and 6.7 T, and inductively detect the resulting NMR signal. The $30$ kHz spectral linewidth observed is dramatically larger than the 600 Hz linewidth observed from a $^{28}$Si-enriched silicon crystal. We show that the observed broadening is consistent with previous ENDOR results showing discrete isotope mass effect contributions to the donor hyperfine coupling. A secondary source of broadening is likely due to variations in the local strain, induced by the random distribution of different isotopes in natural silicon. The nuclear spin T$_1$ and the build-up time for the optically-induced $^{31}$P hyperpolarization in the natural abundance silicon sample were observed to be $178\pm47$ s and $69\pm6$ s respectively, significantly shorter than the values previously measured in $^{28}$Si-enriched samples under the same conditions. We also measured the T$_1$ and hyperpolarization build-up time for the $^{31}$P signal in natural abundance silicon at 9.4 T to be $54\pm31$ s and $13\pm2$ s respectively. The shorter build-up and nuclear spin T$_1$ times at high field are likely due to the shorter electron-spin T$_1$, which drives nuclear spin relaxation via non-secular hyperfine interactions. At 6.7 T, the phosphorus nuclear spin T$_{2}$ was measured to be $16.7\pm1.6$ ms at 4.2 K, a factor of 4 shorter than in $^{28}$Si-enriched crystals. This was observed to further shorten to $1.9\pm0.4$ ms in the presence of the infra-red laser., 5 pages

We present a new method for high-resolution nanoscale magnetic resonance imaging (nano-MRI) that combines the high spin sensitivity of nanowire-based magnetic resonance detection with high spectral resolution nuclear magnetic resonance (NMR) spectroscopy. By applying NMR pulses designed using optimal control theory, we demonstrate a factor of $500$ reduction of the proton spin resonance linewidth in a $(50\text{-nm})^{\text{3}}$ volume of polystyrene and image proton spins in one dimension with a spatial resolution below $2~\text{nm}$., Comment: Main text: 8 pages, 6 figures; supplementary information: 10 pages, 10 figures

In the field of quantum control, effective Hamiltonian engineering is a powerful tool that utilises perturbation theory to mitigate or enhance the effect that a variation in the Hamiltonian has on the evolution of the system. Here, we provide a general framework for computing arbitrary time-dependent perturbation theory terms, as well as their gradients with respect to control variations, enabling the use of gradient methods for optimizing these terms. In particular, we show that effective Hamiltonian engineering is an instance of a bilinear control problem - the same general problem class as that of standard unitary design - and hence the same optimization algorithms apply. We demonstrate this method in various examples, including decoupling, recoupling, and robustness to control errors and stochastic errors. We also present a control engineering example that was used in experiment, demonstrating the practical feasibility of this approach., Comment: 54 pages, 8 figures; minor revisions: further explanations, typos corrected, references added, some figures merged, DOI link added

Unter dem Begriff ″patientenorientiertes Blutmanagement″ (PBM) versteht man einen multimodalen, evidenzbasierter Behandlungsansatz. Durch ein individualisiertes 3-Saulen-Konzept sollen Bluttransfusionen vermieden werden, sodass erst nach Optimierung aller anderen Aspekte Blutprodukte leitliniengerecht zur Anwendung kommen. Bei einem Hamoglobinwert unter 12 g/dl bei Frauen bzw. unter 13 g/dl bei Mannern liegt eine Anamie vor (WHO-Definition). Konsequentes PBM fuhrt zur Steigerung der Patientensicherheit, da die praoperative Anamie ein deutlich erhohtes Letalitats- und Komplikationsrisiko birgt und den grosten Pradiktor fur die perioperative Verabreichung von Blutkonserven darstellt.

Vor dem Hintergrund der grosen Zahl endoprothetischer Eingriffe und der damit verbundenen gesundheitspolitischen und volkswirtschaftlichen Bedeutung dieser Operationen hat die Deutsche Gesellschaft fur Orthopadie und Orthopadische Chirurgie im Jahr 2012 ein Verfahren mit dem Namen EndoCert eingefuhrt. Durch die Bewertung wissenschaftlich belegter Qualitatskriterien aus dem Bereich der Struktur- und Prozessqualitat sowie bestimmter Parameter der Ergebnisqualitat wird eine Zertifizierung spezialisierter Zentren ermoglicht. Das Verfahren steht unter der kontinuierlichen Kontrolle der Zertifizierungskommission, die in Abstimmung mit der Fachgesellschaft DGOOC fur die Weiterentwicklung und die Bearbeitung offener Fragen im Zusammenhang mit der Zertifizierung verantwortlich ist.

In 2009, the Stuttgart Region of Baden-Wurttemberg in Germany was awarded funding from the Federal Ministry of Transport, Building and Urban Development (BMVBS) as one of eight “E-Mobility Pilot Regions” and started to implement several projects—from 2 wheelers to buses, including the development of full electrical vehicles (e.g. Vito E-Cell). Meanwhile, Stuttgart Region’s LivingLab BWe mobil in April 2012 became one of four national “E-Mobility showcase regions” for 3 years, and is also hosting the “Leading Edge Cluster Electric Mobility South-West”. The LivingLab BWe mobil started 40 projects in and around the Stuttgart Region where the scale and scope is even broader than in the Pilot Region activities, including field tests of e-mobility business models. The more than 100 partners from business, science and public authorities are testing electric mobility in actual practice. In their activities the projects concentrate on the Stuttgart Region (Wurttemberg) and the city of Karlsruhe (Baden), and promote the visibility of their work right up to the international level. The project aims to put around 2000 electric vehicles on the road by 2015, and to install more than 1000 charging points. This paper highlights three select case studies on the projects Get eReady, Car2Go full electric and Stuttgart Services.

We experimentally demonstrate the inductive readout of optically hyperpolarized phosphorus-31 donor nuclear spins in an isotopically enriched silicon-28 crystal. The concentration of phosphorus donors in the crystal was 1.5 x 10$^{15}$ cm$^{-3}$, three orders of magnitude lower than has previously been detected via direct inductive detection. The signal-to-noise ratio measured in a single free induction decay from a 1 cm$^3$ sample ($\approx 10^{15}$ spins) was 113. By transferring the sample to an X-band ESR spectrometer, we were able to obtain a lower bound for the nuclear spin polarization at 1.7 K of 64 %. The $^{31}$P-T$_{2}$ measured with a Hahn echo sequence was 420 ms at 1.7 K, which was extended to 1.2 s with a Carr Purcell cycle. The T$_1$ of the $^{31}$P nuclear spins at 1.7 K is extremely long and could not be determined, as no decay was observed even on a timescale of 4.5 hours. Optical excitation was performed with a 1047 nm laser, which provided above bandgap excitation of the silicon. The build-up of the hyperpolarization at 4.2 K followed a single exponential with a characteristic time of 577 s, while the build-up at 1.7 K showed bi-exponential behavior with characteristic time constants of 578 s and 5670 s., 8 pages, 6 figures

Zum 1. Januar 2016 wurde in die Anforderungen zur Zertifizierung von EndoProthetikZentren bzw. Endo­ProthetikZentren der Maximalversorgung die Verpflichtung zur Durchfuhrung einer postoperativen Ganzbeinstandaufnahme aufgenommen. Dies hat eine intensive Diskussion uber die Berechtigung dieser Anforderung vor dem Hintergrund der Regelungen zur rechtfertigenden Indikation ausgelost. Die Zertifizierungskommission sieht sich deshalb veranlasst, die folgende Stellungnahme abzugeben.

Seit Aufnahme des Regelbetriebs im Oktober 2012 konnten Endoprothesen, die im Rahmen von Frakturen implantiert wurden, auf die Fallzahlen fur die Zertifizierung angerechnet werden. Nach erfolgreichem Abschluss der Gesprache mit der Deutschen Gesellschaft fur Unfallchirurgie (DGU) sind die Anforderungen nun spezifiziert worden. Zudem wurden Regelungen fur die Versorgung periprothetischer Frakturen in das System aufgenommen.

In previous work, we proposed a method for leveraging efficient classical simulation algorithms to aid in the analysis of large-scale fault tolerant circuits implemented on hypothetical quantum information processors. Here, we extend those results by numerically studying the efficacy of this proposal as a tool for understanding the performance of an error-correction gadget implemented with fault models derived from physical simulations. Our approach is to approximate the arbitrary error maps that arise from realistic physical models with errors that are amenable to a particular classical simulation algorithm in an "honest" way; that is, such that we do not underestimate the faults introduced by our physical models. In all cases, our approximations provide an "honest representation" of the performance of the circuit composed of the original errors. This numerical evidence supports the use of our method as a way to understand the feasibility of an implementation of quantum information processing given a characterization of the underlying physical processes in experimentally accessible examples., 34 pages, 9 tables, 4 figures

Fur die Zulassung und den Betrieb eines zertifizierten Endoprothetikzentrums bzw. eines Endoprothetikzentrums der Maximalversorgung gemas des EndoCert ® -Systems lautet eine der zentralen Anforderungen, dass einer der Hauptoperateure bzw. Senior-Hauptoperateure uber die Zusatzbezeichnung „Spezielle Orthopadische Chirurgie“ verfugen muss. Hierbei gelten zwei Sonderregelungen, nach denen von dieser Vorgabe abgewichen werden kann.

In this prospective study we compared clinical and radiological results and rehabilitation progress of 64 patients who underwent total hip arthroplasty using the standard lateral approach with 64 patients operated with a minimal-invasive (MIS) posterior approach. The outcome of our study did not show any significant differences with regard to patient's safety such as complication rate and radiological assessment of the cup position. There was no difference in the duration of surgery, blood loss, hospital stay and postoperative leg length discrepancy. Rehabilitation milestones were achieved earlier by MIS patients and three and six months postoperatively, the Harris Hip Score of the MIS group was significantly higher.

Objective Treatment options for rheumatoid arthritis range from symptomatic approaches to modern molecular interventions such as inhibition of inflammatory mediators. Inhibition of inflammation by platelet-rich plasma (PRP) has been proposed as a treatment for tendinitis and osteoarthritis. The present study was undertaken to investigate the effect of PRP on antigen-induced arthritis (AIA) of the knee joint in a large animal model. Methods Six-month-old pigs (n = 10) were systemically immunized by bovine serum albumin (BSA) injection, and arthritis was induced by intraarticular BSA injection. PRP was injected into the knee joints of 5 of the animals after 2 weeks. An additional 5 animals received no systemic immunization (controls). Signs of arthritis were documented by plain histologic analysis, Safranin O staining, and immunohistochemistry analysis for type II collagen (CII), interleukin-6 (IL-6), and vascular endothelial growth factor (VEGF). Interleukin-1β (IL-1β), IL-6, tumor necrosis factor α (TNFα), VEGF, and insulin-like growth factor 1 (IGF-1) protein content was measured by Luminex assay. Results In the pigs with AIA, plain histologic analysis revealed severe arthritic changes in the synovium. Safranin O and CII staining showed decreased proteoglycan and CII content in cartilage. Immunohistochemistry analysis revealed increased levels of IL-6 and VEGF in synovium and cartilage, and protein concentrations of IL-6, VEGF, IL-1β, and IGF-1 in synovium and cartilage were elevated as well; in addition, TNFα protein was increased in cartilage. Treatment with PRP led to attenuation of these arthritic changes in the synovium and cartilage. Conclusion We have described a porcine model of AIA. Experiments using this model demonstrated that PRP can attenuate arthritic changes as assessed histologically and based on protein synthesis of typical inflammatory mediators in the synovial membrane and cartilage.

Am 4.12.2014 verstarb Prof. Dr. med. Rolf Dederich im Alter von 93 Jahren. 1921 in Koblenz geboren, wurde er bereits in seiner Jugend medizinisch gepragt. Der Vater war Chefarzt der Inneren Abteilung am Bruderhaus in Koblenz, der Onkel Chefarzt in Viersen. Ab dem Wintersemester 1940 nahm er sein Medizinstudium zunachst in Berlin und dann in Innsbruck auf. Nach dem medizinischen Examen und der Promotion 1945 begann Professor Dederich seine arztliche Ausbildung in Marburg an der Klinik von Prof. Oskar Wiedhopf. Die weiteren Stationen auf dem Weg zum Facharzt fur Chirurgie (1950), als Orthopade (1955) und schlieslich als Unfallchirurg (1960) absolvierte er an verschiedenen Kliniken.

Gemeinsam mit dem Endoprothesenregister Deutschland ist die EndoCert Initiative eine der wesentlichen Saulen der Qualitatsoffensive der DGOOC im Bereich der Endoprothetik. Wesentliche Bestandteile des Systems betreffen die Struktur-, Prozess- und Ergebnisqualitat. Die aufgestellten Anforderungen sind samtlich wissenschaftlich begrundet. Fur die Weiterentwicklung und Uberwachung des Verfahrens liegt die Verantwortung bei der Zertifizierungskommission, die hierzu ein kontinuierliches Monitoring des Systems durchfuhrt. So sind die Einbeziehung qualitatsrelevanter Indikatoren einerseits und ein Schutz vor uberbordender Burokratie andererseits sichergestellt.

Magnetic resonance imaging (MRI) was used to control the short-term outcome of osteochondritis dissecans (OCD) of the femoral condyle depending on conservative or surgical treatment at the beginning of therapy.Case series.Treatment planning for OCD depended on the stage on MRI when analyzing the appearance of the interface between parent bone and fragment on T1- and T2-weighted images. Twenty-seven patients received conservative treatment and 46 patients underwent arthroscopic surgery. After 20 to 24 months, patients were re-evaluated by MRI to assess the condition of bony fragment, parent bone, and interface so as to determine partial or complete remission, no change, or progression of OCD.After conservative treatment, MRI showed partial or complete remission in 30% of patients and no change in 63%. Arthroscopic treatment led to remission in 37% and to no change in 57%. Progressive disintegration of OCD was found on MRI in 7% of conservatively treated patients and in 7% of the surgery patients. In 33.3% of the patients initially treated conservatively, it was decided to treat them arthroscopically because of ongoing, unacceptable clinical symptoms.The rates of remission and progression were not significantly different between the groups. The patients' age was significantly correlated to the rate of consolidation. OCD in juveniles under 16 years of age followed a milder course than in adults.

Die zur Zertifizierung von EndoProthetikZentren aufgestellten Anforderungen beinhalten unter anderem die Qualifikation als Spezieller Orthopadischer Chirurg. Aufgrund der Versorgungssituation in Deutschland gibt es Einrichtungen, die alle Anforderungen einer Zertifizierung erfullen, ohne jedoch die Qualifikation eines Hauptoperateurs als Spezieller Orthopadischer Chirurg nachweisen zu konnen.