[Therapy relevant imaging in modern surgical treatment of arthrosis of the shoulder: interesting facts for orthopedic surgeons]. / Therapierelevante Bildgebung in der modernen Arthrosebehandlung am Beispiel des Schultergelenks: Wissenswertes für den Orthopäden.

CLINICAL/METHODICAL ISSUE: Imaging for shoulder surgery varies a lot nowadays. Advantages and disadvantages of possible imaging methods according to the pathology and treatment options are described. STANDARD RADIOLOGICAL METHODS: Digital projection radiography in 3 planes, ultrasonography, MRI, CT scanning and scintigrams. METHODICAL INNOVATIONS: Special axial view to visualize the glenoid situation, as well as 3-D CT scanning for larger defects and classification. PERFORMANCE: Imaging of the glenoid situation, the version and erosion in axial view x-ray is mandatory to plan and control glenoid replacement. ACHIEVEMENTS: Useful application of imaging methods for the daily routine of orthopedic surgeons. PRACTICAL RECOMMENDATIONS: Digital 3 plane x-ray imaging in arthroplasty surgery is the minimum requirement. For rotator cuff lesions ultrasonography is good. In order to gain information on fatty infiltration of rotator muscles MRI is needed as well as for intra-articular lesions. For bony defects CT and reconstruction 3-D are recommended.

[Therapy relevant imaging in modern surgical treatment of arthrosis of the shoulder : Interesting facts for orthopedic surgeons]. / Therapierelevante Bildgebung in der modernen Arthrosebehandlung am Beispiel des Schultergelenks : Wissenswertes für den Orthopäden.

CLINICAL/METHODICAL ISSUE: Imaging for shoulder surgery varies a lot nowadays. Advantages and disadvantages of possible imaging methods according to the pathology and treatment options are described. STANDARD RADIOLOGICAL METHODS: Digital projection radiography in 3 planes, ultrasonography, MRI, CT scanning and scintigrams. METHODICAL INNOVATIONS: Special axial view to visualize the glenoid situation, as well as 3-D CT scanning for larger defects and classification. PERFORMANCE: Imaging of the glenoid situation, the version and erosion in axial view x-ray is mandatory to plan and control glenoid replacement. ACHIEVEMENTS: Useful application of imaging methods for the daily routine of orthopedic surgeons. PRACTICAL RECOMMENDATIONS: Digital 3 plane x-ray imaging in arthroplasty surgery is the minimum requirement. For rotator cuff lesions ultrasonography is good. In order to gain information on fatty infiltration of rotator muscles MRI is needed as well as for intra-articular lesions. For bony defects CT and reconstruction 3-D are recommended.

[Hindfoot valgus. Diagnosis and therapy of flatfoot]. / Rückfußvalgus. Diagnose und Therapie des Knick-Senkfußes.

The clinical finding of flatfoot is characterized by a flattening of the medial longitudinal arch and valgus deformity of the hindfoot. The differential diagnosis of flatfoot is the physiological, flexible, contracted flatfoot, which occurs as a congenital or acquired deformity. Congenital flatfoot deformity requires early intensive therapy, while a flexible flatfoot in children has a good prognosis and conservative treatment usually leads to a stable and sufficient load-bearing foot. Severe flatfoot in children can be corrected successfully by simple, minimally invasive procedures. In adults with symptomatic flatfoot, which usually occurs due to an insufficiency of the tendon of the tibialis posterior, conservative therapy with insoles, shoe modifications and physiotherapeutic measures can lead to significant improvement, otherwise surgical correction is recommended. Early, stage-appropriate therapy helps to prevent an impending decompensation of the hindfoot.

Nonoperative treatment of muscle injuries - recommendations from the GOTS expert meeting.

BACKGROUND: Muscle injuries are some of the most common injuries in sports; they have a high recurrence rate and can result in the loss of ability to participate in training or competition. In clinical practice, a wide variety of treatment strategies are commonly applied. However, a limited amount of evidence-based data exists, and most therapeutic approaches are solely based on "best practice". Thus, there is a need for consensus to provide strategies and recommendations for the treatment of muscle injuries. METHODS: The 2016 GOTS Expert Meeting, initiated by the German-Austrian-Swiss Society for Orthopaedic Traumatologic Sports Medicine (GOTS), focused on the topic of muscle and tendon injuries and was held in Spreewald/Berlin, Germany. The committee was composed of twenty-two medical specialists. Nine of them were delegated to a subcommittee focusing on the nonoperative treatment of muscle injuries. The recommendations and statements that were developed were reviewed by the entire consensus committee and voted on by the members. RESULTS: The committee reached a consensus on the utility and effectiveness of the management of muscle injuries. MAIN RESULTS: the "PRICE" principle to target the first inflammatory response is one of the most relevant steps in the treatment of muscle injuries. Haematoma aspiration may be considered in the early stages after injury. There is presently no clear evidence that intramuscular injections are of use in the treatment of muscle injuries. The ingestion of non-steroidal anti-inflammatory drugs (NSAIDs) should be regarded critically because there is currently no hard evidence to support their use, although they are appropriate in exceptional cases. CONCLUSIONS: The present work provides a structured overview of the various nonoperative treatment strategies of muscle injuries and evaluates their effectiveness with respect to the existing scientific evidence and clinical expertise in the context of basic science on the healing process of muscle injuries. The committee agreed that there is a compelling need for further studies, including high-quality randomized investigations to completely evaluate the effectiveness of the existing therapeutic approaches. The given recommendations may be updated and adjusted as further evidence will be generated.