{"id":33590,"date":"2024-09-17T16:45:17","date_gmt":"2024-09-17T14:45:17","guid":{"rendered":"https:\/\/artiqo.de\/prof-zeichen-in-an-interview-the-relationship-between-standard-and-short-shafts-will-be-reversed\/"},"modified":"2024-11-19T10:45:21","modified_gmt":"2024-11-19T09:45:21","slug":"prof-zeichen-in-an-interview-the-relationship-between-standard-and-short-shafts-will-be-reversed","status":"publish","type":"post","link":"https:\/\/artiqo.de\/en\/prof-zeichen-in-an-interview-the-relationship-between-standard-and-short-shafts-will-be-reversed\/","title":{"rendered":"Prof. Zeichen in an interview: The relationship between standard and short shafts will be reversed."},"content":{"rendered":"<div class=\"wpb-content-wrapper\" id=\"wpb-content-root\"><p>[vc_row css_animation=&#8221;&#8221; row_type=&#8221;row&#8221; use_row_as_full_screen_section=&#8221;no&#8221; type=&#8221;full_width&#8221; angled_section=&#8221;no&#8221; text_align=&#8221;left&#8221; background_image_as_pattern=&#8221;without_pattern&#8221;][vc_column][vc_column_text css=&#8221;.vc_custom_1726474050024{padding-bottom: 30px !important;}&#8221;]<\/p>\n<h6><strong>Prof. Dr. Johanneszeichen in an interview<br \/>\n<\/strong><\/h6>\n<h1>\u201cThe relationship between standard and short shafts will be reversed.\u201d<\/h1>\n<p>[\/vc_column_text][vc_column_text css=&#8221;.vc_custom_1726473674203{padding-bottom: 30px !important;}&#8221;]<strong>Old patients are a challenge for endoprosthetics in many ways, be it the perioperative management of comorbidities or the follow-up of the outcome in old patients within the framework of studies. Now there is a new option with the cemented A2\u00ae short stem that could be relevant for older patients. Prof. Dr. Johanneszeichen, director of the Clinic for Orthopedics and Trauma Surgery at the Johannes Wesling Clinic in Minden, has been involved in the care of older patients for many years. He has a clear vision of what role short stem care could play in elderly patients in the future.<\/strong>[\/vc_column_text][\/vc_column][\/vc_row][vc_row css_animation=&#8221;&#8221; row_type=&#8221;row&#8221; use_row_as_full_screen_section=&#8221;no&#8221; type=&#8221;full_width&#8221; angled_section=&#8221;no&#8221; text_align=&#8221;left&#8221; background_image_as_pattern=&#8221;without_pattern&#8221; z_index=&#8221;&#8221;][vc_column width=&#8221;2\/3&#8243; css=&#8221;.vc_custom_1613035748057{margin-bottom: 30px !important;}&#8221;][vc_column_text css=&#8221;.vc_custom_1726473723639{padding-bottom: 30px !important;}&#8221;]Looking at demographic developments has shaped the everyday life of orthopedists and trauma surgeons for decades. Almost 20 years ago, this led to the introduction of orthogeriatric co-management: \u201cThe challenges with old patients lie less in the endoprosthetic procedure itself than in the perioperative care of concomitant diseases or multimorbidity,\u201d explains Prof.zeichen. In Minden, as in many other German clinics, the particular vulnerability of these patients is addressed in an interdisciplinary manner &#8211; with the concept of geriatric complex treatment in order to enable the greatest possible patient autonomy postoperatively.<\/p>\n<h3>Individual interpretation of the EPRD recommendation<\/h3>\n<p>The endoprosthetic procedure itself is largely standardized &#8211; thanks, among other things, to the registry data. The German Endoprosthesis Register (EPRD) recommends a cemented restoration from the age of 75. However, age as the sole decision-making criterion is not sufficient for Prof.zeichen and his team. There are older patients who are still very physically fit and whose x-rays show no evidence of osteoporosis. \u201cA cement-free prosthesis can also be implanted in these patients,\u201d says Prof. Zeichen.<\/p>\n<p>For a long time, the EPRD recommendation automatically meant a restoration with a cemented straight shaft. Until the end of 2020. Since then, a cemented short shaft has expanded the A2\u00ae implant system and thus opened up new supply options. \u201cThis is an important addition and further development for the patient clientele of older people aged 70 and over, the proportion of whom is constantly increasing in our clinic,\u201d says Prof.zeichen.<\/p>\n<h3>The limitation of established scores in elderly patients<\/h3>\n<p>In order to measure the importance of the new implant, Minden&#8217;s own cases were tracked from January 2021 to December 2022: During this period, 117 patients (f:m = 84:33) received cemented A2\u00ae short stems type B after a medial femoral neck fracture (aft =93) and coxarthrosis (n=24). The average age of the patients was 81 years (55-91 years). Follow-up by telephone and\/or post was carried out approximately one year postoperatively based on the Forgotten Joint Score (FJS-12) and the Hip Disability and Osteoarthritis Outcome Score-Physical Function Short (HOOS-PS). The HOOS-PS is a shortened version with 5 questions (walking down stairs; getting in and out of the bathtub; sitting; walking; turning on the operated leg).<\/p>\n<p>There were no dislocations, infections, or periprosthetic fractures at the time of follow-up. The drop-out was as expected and corresponding to the age of the patients: only the questionnaires from 59 patients could be evaluated. By the time contact was made, 20% of the patients had died &#8211; unrelated to the surgical procedure. 20 patients could not be reached or did not respond, 14 patients had dementia. \u201cWe see a certain limitation of the established scores \u2013 such as the FJS \u2013 in elderly patients who may also suffer from dementia. Scores should be used here that meaningfully reflect the patient outcome and can be used in telephone follow-up. It is also advisable to think about shorter follow-up intervals,\u201d suggests Prof. Zeichen.<\/p>\n<p>In the cases tracked in Minden, the evaluation of the HOOS-PS showed that 88% of the patients had little or no problems with sitting, 57% with going down the stairs, 55% with turning on the operated leg, 45% with getting in and out Getting out of the bath and 30% while walking. After evaluating the FJS score, 57% of the patients (n = 33) achieved a percentage between 60-100%.<\/p>\n<h3>Good prospects for short stem care<\/h3>\n<p>\u201cIn our results, we see a very good implant with few complications and the restoration of an age-appropriate quality of life with an appropriate rate of patients who die within a year due to the accompanying diseases,\u201d concludes Prof.zeichen. \u201cFrom the user\u2019s perspective, the new implant is easy to insert and easier to learn compared to the standard shaft. In addition to the lower blood loss and fewer complications, these are also important safety aspects for the patient.\u201d Comparative studies and further clinical results are still pending. Prof.zeichen is nevertheless convinced: \u201cThe relationship between the use of standard and short shafts will be reversed in the future. And I am sure that in the future we will provide older patients with cemented short stems more than with the currently established long stems.\u201d[\/vc_column_text][\/vc_column][vc_column width=&#8221;1\/3&#8243;][vc_single_image image=&#8221;33494&#8243; img_size=&#8221;full&#8221; css=&#8221;.vc_custom_1726474246319{margin-bottom: 10px !important;border-top-width: 1px !important;border-right-width: 1px !important;border-bottom-width: 1px !important;border-left-width: 1px !important;background-color: #ffffff !important;border-left-style: solid !important;border-right-style: solid !important;border-top-style: solid !important;border-bottom-style: solid !important;border-color: #dbdbdb !important;}&#8221; qode_css_animation=&#8221;&#8221;][vc_column_text css=&#8221;.vc_custom_1726474012335{padding-bottom: 30px !important;}&#8221;]<span style=\"color: #999999;\">Prof. Dr. Johanneszeichen, director of the clinic for orthopedics and trauma surgery at the Johannes Wesling Clinic in Minden<\/span>[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>Old patients present a challenge for arthroplasty in many ways. Now there is a new option with the cemented A2\u00ae short stem that could be relevant for older patients.<\/p>\n","protected":false},"author":1,"featured_media":33497,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[361,376,353],"tags":[],"class_list":["post-33590","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-hip","category-home-en","category-news"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.7 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Prof. Zeichen in an interview: The relationship between standard and short shafts will be reversed. - ARTIQO Endoprothetik<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/artiqo.de\/en\/prof-zeichen-in-an-interview-the-relationship-between-standard-and-short-shafts-will-be-reversed\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Prof. Zeichen in an interview: The relationship between standard and short shafts will be reversed.\" \/>\n<meta property=\"og:description\" content=\"Old patients present a challenge for arthroplasty in many ways. 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