Publications by authors named "J Nowotny"

75 Publications

Monteggia fractures: analysis of patient-reported outcome measurements in correlation with ulnar fracture localization.

J Orthop Surg Res 2022 Jun 7;17(1):303. Epub 2022 Jun 7.

University Centre for Orthopaedic, Trauma- and Plastic Surgery (OUPC), University Hospital Carl Gustav Carus, Technical University Dresden, Fetscherstraße 74, 01307, Dresden, Germany.

Background: Monteggia fractures and Monteggia-like lesions result after severe trauma and have high complication rates. Preliminary biomechanical studies suggested a correlation between ulnar fracture localization and clinical result.

Objectives: Key objective was to evaluate whether the site of the ulnar fracture can be correlated to clinical outcome after open reduction and internal stabilization.

Methods: In a retrospective, monocentric study 35 patients who underwent surgical treatment after suffering a Monteggia injury or Monteggia-like lesion were included. Fractures were classified according to Bado and Jupiter, the site of the fracture location at the proximal ulna and regarding the potential accompanying ligamentary injury. In a follow-up examination validated patient-reported outcome measures and functional parameters were evaluated. Furthermore, treatment strategy and complications were analysed.

Results: Mean patient age was 51.9 years (± 18.0). 69% were females (n = 24). Follow-up took place after 50.5 months (± 22.1). Fractures were classified according to Bado (I:2, II:27, III:4, IV:2). Bado II-fractures were further classified according to Jupiter (A:7, B:16, C:3, D:1). Cases were divided into subgroups depending upon the distance of the ulnar fracture site in respect to its distal endpoint (A: < 7 cm and B: > 7 cm). Average overall MEPS was 84.1 (± 19.0). Oxford elbow score and DASH were 37.2 (± 10.5) and 20.4 (± 20.5). Average extension capability reached - 7° (± 7.5). Mean flexion was 134.8° (± 19.7). Average pain according to visual analogue scale was 1.6 (± 1.9). We found no differences between the subgroups regarding the PROMs. Subgroup A displayed a worse extension capability (p = 0.027) and patients were significantly older (p < 0.01). Comparing patients with and without fracture of the radial head, we observed no differences. Patients with an accompanying injury of the coronoid process displayed higher pain levels (p = 0.011), a worse functionality (p = 0.027) and overall lower scoring in PROM.

Conclusion: The presented results suggest that in Monteggia fractures and Monteggia-like lesions, the localization of the ulna fracture can give a hint for its postoperative outcome. However, we could not confirm the hypothesis of an increasing instability in ulnar fractures located further distally (high severity of the potential ligamentous injury). Intraarticular fractures or injuries with a close relation to the joint have a worse prognosis, especially if the coronoid process is injured. Trial registration Registration was done with ClinicalTrials.gov under NCT05325268.
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http://dx.doi.org/10.1186/s13018-022-03195-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9172148PMC
June 2022

Author Correction: Novel methods to establish whole‑body primary cell cultures for the cnidarians Nematostella vectensis and Pocillopora damicornis.

Sci Rep 2021 May 26;11(1):11473. Epub 2021 May 26.

Rosenstiel School of Marine and Atmospheric Science, University of Miami, 4600 Rickenbacker Causeway, Miami, FL, 33149, USA.

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http://dx.doi.org/10.1038/s41598-021-90241-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8155171PMC
May 2021

Cement pressurizing reduces radiolucent lines at glenoid: A randomized, multicentric study.

Shoulder Elbow 2021 Feb 1;13(1):59-65. Epub 2019 Aug 1.

OZS Orthopädisches Zentrum Spreebogen, Berlin, Germany.

Background: The hypothesis of this study is that cement pressurization into the glenoid reduces the rate of radiolucent lines in total shoulder arthroplasty in the mean 25.5 months after the operation.

Methods: To examine this effect, a multicentric prospective randomized study (level of evidence 1) was initiated: one group (group P, n = 24) received intraoperative pressurization of cement into the cancellous bone of the glenoid, the other cement without pressure (group NoP, n = 27). Inclusion criteria were an osteoarthritis with glenoid erosion <15° and an intact rotator cuff.

Results: There were no significant differences preoperatively between the groups regarding age (mean age 66 ± 10 years (range 44-81)), gender, range of motion, scores and pathomorphology. Both groups had a significant improvement of the scores, strength, motion and satisfaction 25.5 months after the intervention. The scores were similar between the groups (ns). However, cement pressurization at the glenoid side significantly reduced the incidence of radiolucent lines (p < 0.027).

Conclusion: This supports the use of this simple technique to improve long-term survival of total shoulder arthroplasty. 1.
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http://dx.doi.org/10.1177/1758573219864259DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7905518PMC
February 2021

Does preoperative antibiotic prophylaxis affect sonication-based diagnosis in implant-associated infection?

J Orthop Res 2021 12 8;39(12):2646-2652. Epub 2021 Mar 8.

University Centre for Orthopaedics, Traumatology and Plastic Surgery, Dresden, Germany.

As culture-negative implant-associated infection denote a diagnostic challenge, sonicate fluid cultures of the explanted endoprosthesis and osteosynthesis components are frequently used. However, the effect of antibiotic treatment on pathogen detection by sonication fluid cultures in implant-associated infection has not been investigated. Thus, the aim of this study was to evaluate the influence of preoperative antibiotic prophylaxis (PAP) and antibiotic therapy (AT) on sonicate fluid cultures in patients with implant-associated infection. In this retrospective study three groups were compared: (i) standard PAP, (ii) AT for at least one day, and (iii) no antibiotics before surgery. For the inclusion criteria, an established diagnostic protocol for implant-associated infection was used. Sonicate fluid cultures were validated by corresponding microbiological and histopathological samples. In 90 patients with single and multiple infections, 114 pathogens were detected. The detection rate by sonicate fluid cultures in patients receiving PAP (n = 27, 29 pathogens), AT before surgery (n = 33, 48 pathogens) and no antibiotics before surgery (n = 30, 37 pathogens) were 86.2%, 81.3%, and 86.5% (p = .778), respectively. Eleven of 114 infectious agents were detected exclusively by sonicate fluid cultures, while conventional tissue culture failed in these cases. PAP and AT do not affect intraoperative cultures in implant-associated infection. It is therefore not recommended to omit antibiotic prophylaxis in patients with implant-associated infection. Algorithms including both sonicate fluid cultures and tissue samples should be used for appropriate microbiological diagnosis of implant-associated infections.
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http://dx.doi.org/10.1002/jor.25015DOI Listing
December 2021

Novel methods to establish whole-body primary cell cultures for the cnidarians Nematostella vectensis and Pocillopora damicornis.

Sci Rep 2021 02 18;11(1):4086. Epub 2021 Feb 18.

Rosenstiel School of Marine and Atmospheric Science, University of Miami, 4600 Rickenbacker Causeway, Miami, FL, 33149, USA.

Cnidarians are emerging model organisms for cell and molecular biology research. However, successful cell culture development has been challenging due to incomplete tissue dissociation and contamination. In this report, we developed and tested several different methodologies to culture primary cells from all tissues of two species of Cnidaria: Nematostella vectensis and Pocillopora damicornis. In over 170 replicated cell cultures, we demonstrate that physical dissociation was the most successful method for viable and diverse N. vectensis cells while antibiotic-assisted dissociation was most successful for viable and diverse P. damicornis cells. We also demonstrate that a rigorous antibiotic pretreatment results in less initial contamination in cell cultures. Primary cultures of both species averaged 12-13 days of viability, showed proliferation, and maintained high cell diversity including cnidocytes, nematosomes, putative gastrodermal, and epidermal cells. Overall, this work will contribute a needed tool for furthering functional cell biology experiments in Cnidaria.
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http://dx.doi.org/10.1038/s41598-021-83549-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7893170PMC
February 2021
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