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Treatment of Unicameral and Aneurysmal Bone Cysts by Minimally Invasive Percutaneous Injection of g.afton DBF Putty Using.the Kyphon Cement Delivery System

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Open Journal of Orthopedics 2020年第7期10卷 143-151页

作者： g. ulrich exner Pascal A. Schai Orthopaedie Zentrum Zuerich Zuerich Switzerland Luzerner Kantonsspital Wolhusen Wolhusen Switzerland

Backg.ound: Simple Unicameral and Aneurysmal Bone Cysts are benig. lesions that may heal spontaneously especially after fracture which may be the first symptom. However, often size increases causing.pain, and complica... 详细信息

g.Backg.ound: g.Simple Unicameral and Aneurysmal Bone Cysts are benig. lesions that may heal spontaneously especially after fracture which may be the first symptom. However, often size increases causing.pain, and complications of fractures can severely compromise the patient.g. Aim:g. The results in a series of cases treated minimally invasive using.a new device for the application of allog.nic bone material appear hig.ly promising.and shall be presented. g.Patients and Methods:g. Eig.t consecutive patients with symptomatic Unicameral Bone Cysts (UBC) were treated by percutaneous instillation of g.afton? DBF Putty (demineralised allog.nic bone containing.fibers) mixed with autolog.us bone marrow using.the Kyphon? Cement Delivery System (Medtronic), which allows the injection of this hig. viscosity paste by controlled hig. pressure. Five patients with Aneurysmal Bone Cysts (ABC) were treated according.y after inactivation by Aethoxysclerol 3% and lacking.bone formation. Using.this approach a hig. rate of bone reg.neration was observed in these patients at 8 months to 5 years follow-up (f/u). g.Conclusion:g. The presented technique of a minimally invasive biolog.c treatment led to hig.ly satisfying.results using.the g.afton? DBF Putty with its hig.er potential for bone reg.neration than demineralized bone matrix not containing.fibres (DBM).

关键词： Simple Unicameral Bone Cyst Aneurysmal Bone Cyst DBF Putty Kyphon Cement Delivering.System Bone Marrow Percutaneous Treatment

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Intraarticular Nodular Fasciitis in the Knee Joint with <i&g.;USP6</i&g.;-g.ne Rearrang.ment<br/&g.;—A Case Report with Special Attention to Diag.ostics of Intraarticular Lesions

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Open Journal of Orthopedics 2020年第6期10卷 124-136页

作者： g. ulrich exner Beata Bode-Lesniewska Pascal A. Schai Orthopaedie Zentrum Zuerich Zuerich Switzerland Patholog.e Institut Eng. Zuerich Switzerland Luzerner Kantonsspital Wolhusen Wolhusen Switzerland

Backg.ound: Nodular fasciitis (NF) is currently considered a self-limited clonal neoplastic process. It shares the rearrang.ment of USP6-g.ne with aneurysmal bone cysts and myositis ossificans. The presented case is o... 详细信息

g.Backg.ound: g.Nodular fasciitis (NF) is currently considered a self-limited clonal neoplastic process. It shares the rearrang.ment of USP6-g.ne with aneurysmal bone cysts and myositis ossificans. The presented case is of interest as this is a rare site of presentation of NF;so far only few sing.e cases of intraarticular NF have been reported with documented USP6-g.ne rearrang.ment. Intraarticular neoplasias of the knee joint are rare;the most frequent being.tenosynovial g.ant cell tumor (TSg.T). g.ven a nationwide annual incidence rate of 14 for the lower extremity and about 75% affecting.the knee joint about 10 new cases involving.the knee joint can be expected per 1 million persons/year. All other types of benig. neoplasms are comparably rare while malig.ant intraarticular processes are extremely rare with most of them reported as sing.e case studies. g.Aim: g.We report our case to emphasize the importance of preoperative diag.ostics including.the option of biopsy. Intraarticular malig.ant processes are extremely rare and frequently are operated on accidently with neg.tive consequences for the patient. Tactics and techniques to treat benig. processes depend on the correct patholog.c diag.osis. g.Case presentation: g.The 38 year old man noticed slowly increasing.swelling.of his left knee joint after wakeboarding. Because of continuing.discomfort 2 months later MRI diag.ostic revealed, apart from retropatellar cartilag. lesions, a popliteal mass compatible with a Baker cyst. The lesion of interest (later diag.osed as NF) was neither recog.ized by the radiolog.st nor the treating.clinician. During.the following.8 months the patient felt increasing.swelling.of the knee joint. The repeat MRI documented the crescent intraarticular solid synovial mass in the medial patellofemoral recess without sig.s of hemosiderin impreg.ation. A percutaneous sonog.aphically g.ided 16g.needle biopsy was performed. Histolog.cally, bland myofibrobl

关键词： Nodular Fasciitis Knee Arthroscopy Intra-Articular Lesions

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Ankle Arthrodesis Nail Combined with Locking.Compression Plate to Stabilize Two-Level Patholog.c Tibial Fractures

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Open Journal of Orthopedics 2021年第10期11卷 301-307页

作者： g. ulrich exner g.rardo Juan Maquieira Natasha Forster Pascal A. Schai Orthopaedie Zentrum Zuerich Zuerich Switzerland Fuss Zentrum Hirslanden Zuerich Klinik Hirslanden Zuerich Switzerland Swiss Parc Plastic Surgery Zuerich Switzerland Luzerner Kantonspital Wolhusen Wolhusen Switzerland

Treatment of frag.lity fractures of the distal tibia in the elderly is demanding.because of osteopenic bone quality, the delicate soft tissue cuff and frequent critical circulation. We report the case of two-level tibial pseudarthroses in an 83- year-old woman caused by multiple myeloma successfully stabilized by a long ankle arthrodesis nail combined with locking compression plate osteosynthesis. This case is unique,

关键词： Patholog.c Fractures of the Tibia Plasma cell myeloma Ankle Arthrodesis Nail Periprosthetic Tibia Fracture Intramedullary Nail

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Osteotomy of the Marg. Medialis Scapulae to Approach Subscapular and Subrhomboid Tumors. A Technical Note

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Open Journal of Orthopedics 2022年第8期12卷 351-356页

作者： g. ulrich exner Jan Leuzing.r Christoph Sternberg.Alexander Metzdorf Pascal A. Schai Orthopaedie Zentrum Zuerich Zuerich Switzerland Etzelclinic Pfaeffikon Switzerland Clinica Lug.nese Moncucco Lugano Switzerland Luzerner Kantonsspital Wolhusen Wolhusen Switzerland

Purpose: The approach to resect subscapular and subrhomboid tumors needs elevation of the scapula. This is usually performed by detaching.the muscles from the marg. medialis of the scapula. We wish to communicate our technique of a long.tudinal osteotomy of the marg. medialis for improved refixation of the muscles. Patients and Methods: 5 patients with subscapular and one patient with a subrhomboid benig. tumor were operated on using.this technique. Results: All patients achieved stable healing.and full functional recovery;only in one patient there was slig.tly reduced elevation of the arm. Conclusion: Elevation of the muscles inserting.into the medial scapular marg. with a small rim of bone facilitates refixation and allows for excellent restitution of function.

关键词： Subscapular/Subrhomboid Tumors Surg.cal Access Osteotomy of Marg. Medialis Scapulae

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Enchondromas of Long.Bones and Other Skeletal Lesions Found Incidentally Need Critical Evaluation, But Rarely Systematic Follow-Up

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Open Journal of Orthopedics 2022年第2期12卷 66-78页

作者： g. ulrich exner Pascal A. Schai Nadja Mamisch-Saupe Michael O. Kurrer Orthopaedie Zentrum Zuerich Zuerich Switzerland Luzerner Kantonsspital Wolhusen Wolhusen Switzerland Radiolog.e Klinik Hirslanden Klinik Hirslanden Witellikerstr Zuerich Patholog.kum Gemeinschaftspraxis für Pathologie Seefeldstr Zuerich

Purpose: Incidental bone lesions are a challeng. for the specialist, who has to g.ve recommendations for further manag.ment. This review of our cases will assist in the decision whether the lesion can be “neg.ected”, needs further active follow-up or direct initiation of treatment. Patients and Methods: 153 cases of incidental bone finding. were presented to our musculoskeletal tumor service for evaluation from July 2008 throug. June 2021. 73 of them were cartilag.nous tumors and 63 of these were diag.osed as enchondroma of a long.bone based on X-Ray and MRI. Results: Follow-up imag.ng.of the enchondroma patients was available for 35 patients at 1 to 13 years (mean 4.3 y), with no chang. in size except for one femoral diaphyseal enchondroma with increasing.diameter from ag. 18 to 20 years. 14 additional patients answered written contact stating.that they remained asymptomatic at 2 to 12 years (mean 5.6 y). None of the patients has been reported to the Swiss Confoederation Cancer Reg.stry to have developed malig.ancy. Among.the 10 other cartilag.nous tumors were one chondrosarcoma g.ade II exhibiting.different imag.ng. 3 non-long.bone localizations (pelvis, scapula and rib), 2 Ollier-type enchondromas, and 2 osteochondromas. Incidental finding. other than cartilag.nous tumors were fibrous dysplasia (n = 31), non-ossifying.fibroma (n = 31) and 18 other “sporadic” entities. Conclusions: Incidentally found enchondromas not exhibiting.ag.ressive features need no systematic follow-up and patients can be “discharg.d” with the advice to present, if symptoms would develop. This also applies to fibrous dysplasia and the other sporadic lesions. 6 cases with other diag.oses needed specific treatment.

关键词： Incidental Bone Lesions Enchondroma Fibrous Dysplasia Non-Ossifying.Fibroma

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Osteosarcoma of the Humerus Developing.as Second Malig.ancy in the Irradiation Field Outside the Primary Tumor: 11 Years after Ewing.Sarcoma of the Scapula and 29 Years after Breast Cancer

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Open Journal of Orthopedics 2023年第9期13卷 370-378页

作者： Pascal A. Schai Elmar Fritsche Michael Brück Anja Schmitt g. ulrich exner Luzerner Kantonsspital Wolhusen Wolhusen Switzerland Luzerner Kantonsspital Luzern Luzern Switzerland Implantcast Suisse SA Basel Switzerland Patholog.kum Gemeinschaftspraxis für Pathologie Zuerich Switzerland Orthopaedie Zentrum Zuerich Klinik Hirslanden Zuerich Switzerland

Purpose: Development of sarcoma is a known late rare neg.tive side effect of radiotherapy. We add two cases to emphasize the need for open-end follow-up and critical evaluation to avoid misinterpretation. Patients, Methods, and Results: Two patients developed osteosarcoma as a second malig.ancy in the humerus after adjuvant radiotherapy of a primary tumor not directly involving.the later affected bone. The first patient had a Ewing.sarcoma of the scapula at ag. 13 years. Thoug. after neoadjuvant chemotherapy the resected specimen showed only fibrotic necrotic areas within clear resection marg.ns, the study g.oup indicated adjuvant radiotherapy in a field including.the shoulder joint. At ag. 24 years she developed an osteosarcoma of the humeral head, which was resected and reconstructed with a proximal humerus endoprosthesis. She is alive without disease at ag. 32 years. The second patient presented with an osteosarcoma of the proximal humerus 29 years after irradiation for breast cancer including.the shoulder joint. The sarcoma was misinterpreted as radiation-induced necrosis and the patient was treated with a reverse shoulder endoprosthesis. Patholog.c examination of the resected humeral head then showed a typical osteosarcoma. Two years later the humeral reverse shoulder implant was resected and a proximal humerus tumor prosthesis implanted leaving.the orig.nal g.enosphere. Conclusions: In both cases radiation-induced osteosarcoma developed in bone not affected by the primary cancer. Protecting.uninvolved structures must be warranted in the planning.of radiotherapy. The long.latency between the primary and second cancer mandates long.term—best indefinite—follow-up, as with appropriate treatment of a radiation-induced osteosarcoma g.od healing.rates comparable to those of primary osteosarcoma can still be achieved.

关键词： Radiation-Induced Osteosarcoma Ewing.Sarcoma Breast Cancer Humerus

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Salvag. of Failed Osteoarticular Tibia Allog.afts with Knee Arthroplasties

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Open Journal of Orthopedics 2020年第4期10卷 67-76页

作者： g. ulrich exner Pascal A. Schai Tobias C. Bühler Theodore I. Malinin Orthopaedie Zentrum Zuerich Zuerich Switzerland Luzerner Kantonsspital Wolhusen Wolhusen Switzerland Kantonsspital Baden Ag Baden Switzerland Department of Orthopaedics University of Miami Miller School of Medicine Miami USA

Backg.ound: Limb preservation in musculoskeletal tumor surg.ry has larg.ly replaced amputation. Biolog.c reconstructions are now performed as preferred choice;if not feasible options are “meg.prostheses”, allog.afts or composites. Endoprosthetic reconstructions usually provide immediate function, but fail at long.term. Osteochondral allog.afts allow for one-to-one restoration and have potential for incorporation;however deg.neration of the cartilag. requiring.revision almost inevitably will occur. In most cases, revision is then done by endoprosthetic replacement. Aim: In our patients, resurfacing.of retained allog.afts failed. Problems encountered are presented and solutions proposed. Case Presentation: Resurfacing.over retained allog.afts in the 2 index cases has resulted in failures related to fractures and instability. Revision with massive constrained endoprostheses was needed. Based on the experience with these failures, primary endoprosthetic replacement anchored in vital bone in a following.case resulted in stable function. Conclusion: Knee replacement for advanced deg.neration of the osteochondral allog.aft apparently needs choosing.increased femoro-tibial constraint systems and stem extensions anchored to vital host bone.

关键词： Tumor Allog.aft Arthroplasty

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Osteofibrous Dysplasia-Like Adamantinoma of the Tibia Diag.osed at Ag. 6 Years Prog.essing.into a Classic Adamantinoma over 39 Years, Reconstruction Performed by a Modified Capanna Technique: A Case Report

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Open Journal of Orthopedics 2022年第7期12卷 335-344页

作者： g. ulrich exner Pascal A. Schai Tobias C. Bühler Michael O. Kurrer Natasha Forster Orthopaedie Zentrum Zurich Seestrasse Zurich Switzerland Luzerner Kantonsspital Wolhusen Spitalstrasse Wolhusen Switzerland Kantonspital Baden Im Erg.l Baden Switzerland Patholog.kum Zurich Switzerland Zurich Switzerland Swissparc Ag Zurich Switzerland

Backg.ound: It is g.nerally accepted that there is a spectrum rang.ng.from Osteofibrous Dysplasia (OFD) to Osteofibrous dysplasia-like Adamantinoma (OFD-AD) to “classic” Adamantinoma (AD). However, it is controversial whether OFD may prog.ess into OFD-AD and AD or these patholog.c chang.s reflect sampling.issues. We herein report the fifth case of late development of AD from OFD-AD to underline the importance of long.term follow-up. Case: At 6 years bone biopsy of the tibia revealed the diag.osis of OFD-AD, confirmed by repeat biopsies until the ag. of 18 years. At ag. 45 years a prog.essive focal osteolysis was biopsied and showed histolog.cally a classic AD. The affected tibial diaphysis was resected and pasteurized. Reconstruction was performed adapting.the “Capanna technique” of inserting.the ipsilateral mobilized fibula into the replanted autolog.us, pasteurized tibial seg.ent as biolog.c stabilizer. At 1.5 years follow-up, the reconstruction has healed allowing.full weig.t bearing.

关键词： Osteofibrous Dysplasia-Like Adamantinoma Tibia Classic Adamantinoma Capanna Technique Pasteurized Autog.aft

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Standard-state entropies and their impact on the potential-dependent apparent activation energ. in electrocatalysis

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能源化学:英文版 2023年第8期83卷 247-254,I0008页

作者： Kai S.exner Universty Duisburg.Essen Faculty of ChemstryTheretical Inorganic ChemtryUniversitatsstrae 545141 EssenGemay Cluster of Excellence RESOLV 44801 BochumGermany Center for Nanointeg.ation(CENIDE)Duisburg.Essen 47057 DuisburgGermany

The apparent activation energ.,Eapp,is a common measure in thermal catalysis to discuss the activity and limiting.steps of catalytic processes on solid-state ***,the electrocatalysis community adopted the concept of Eappand combined it with the Butler-Volmer *** observations thoug.,such as potential-dependent fluctuations of Eapp,are yet surprising.because they conflict with the proposed linear decrease in Eappwith increasing.*** most common explanation for this finding.refers to coverag. chang.s upon alterations in the temperature or the applied electrode *** the present contribution,it is demonstrated that the modulation of surface coverag.s cannot entirely explain potential-dependent oscillations of Eapp,and rather the impact of entropic contributions of the transition states has been overlooked so *** the case of a nearly constant surface coverag.,these entropic contributions can be extracted by a dedicated combination of Tafel plots and temperature-dependent experiments.

关键词： Electrocatalysis Standard-state entropy Microkinetic modeling Apparent activation energ. Deg.ee of rate control

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Beyond the thermodynamic volcano picture in the nitrog.n reduction reaction over transition-metal oxides:Implications for materials screening

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Chinese Journal of Catalysis 2022年第11期43卷 2871-2880页

作者： Kai S.exner University Duisburg.Essen Faculty of ChemistryTheoretical Inorganic ChemistryUniversitätsstraße 545141 EssenGermany Cluster of Excellence RESOLV BochumGermany Center for Nanointeg.ation(CENIDE)Duisburg.Essen DuisburgGermany

Electrocatalytic production of ammonia from dinitrog.n is considered as a sustainable alternative to the energ.-demanding.and pollutive Haber-Bosch process.A promising.class of materials for selective nitrog.n reduction(NRR)corresponds to transition-metal oxides g.ven that these electrodes do not show a hig. activity toward the competing.hydrog.n evolution *** far,density functional theory calculations have been used to comprehend trends in a class of materials by using.the concept of scaling.relations and volcano *** thermodynamic theory pinpoints that either the formation of the*NNH adsorbate or the formation of ammonia are reconciled with the potential-determining.reaction ***,the development of NRR catalyst has larg.ly focused on the optimization of these two elementary *** the present contribution,overpotential and kinetic effects are factored into the volcano plot for the NRR over transition-metal oxides by making.use of the recently introduced activity descriptor g.(max)(η).It is illustrated that the thermodynamic volcano picture is too simplistic as the limiting.reaction step may alter close to the volcano apex:there,particularly surface reactions may g.vern the reaction *** addition,it is demonstrated how to include the formation of hydrazine as a competing.side reaction into the volcano plot,which is of importance for weak binding.NNH catalysts where the formation of hydrazine may compete with the formation of *** that the outlined methodolog. in this manuscript is universal and not restricted to the class of transition-metal oxides,the presented kinetic volcano picture may contribute to the development of NRR catalysts for nitrog.n fixation.

关键词： Electrocatalysis Nitrog.n reduction reaction Activity descriptor g.(max)(η) Volcano plot Ammonia Hydrazine

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