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Background Neurogenic drop foot may be caused by central or peripheral lesions of the nervous system. Depending on whether the first or second motor neuron is damaged, a flaccid or spastic drop foot develops. Spastic drop foot persists as a residual long-term complication after stroke in about 14 % of patients. Various conservative and surgical treatment options are available. Methods This article is based on a systematic literature review for medical evidence of functional electrical stimulation (FES) with the keywords "functional electrical stimulation AND drop foot" and "functional electrical stimulation AND gait AND stroke" in PubMed and Cochrane databases. Randomised controlled trials and cohort studies of the past 10 years were selected according to specific criteria. Additionally, four guidelines were included. Results Current guidelines provide little guidance for practical treatment and fail to give due consideration to new surgical procedures such as neural implants. In 18 randomised controlled trials on FES in stroke patients with drop foot, the FES-treated population showed either significant superiority or non-inferiority versus control. Two cohort studies confirmed significant improvements by FES. Conclusion The analysis demonstrates the importance of considering causes and severity of drop foot as well as patients' pre- and post-operative conditions for choosing treatment options. For active, high-demand patients, neural implants are valuable treatment options., Competing Interests: Interessenkonflikt: Der Autor K. Daniilidis war als Medical Advisor für die Firma nstim Services GmbH tätig. Die Autoren K. Daniillidis und D. Yao erhielten finanzielle Unterstützung für Kongressteilnahmen und Reisekosten. Alle anderen Autoren erklären, dass kein Interessenkonflikt besteht., (Georg Thieme Verlag KG Stuttgart · New York.)

Background: Currently, short cementless femoral stems are alternative implants to treat osteoarthritis in young patients with sufficient bone quality in order to get a more proximal load transfer. The purpose of the present study was to biomechanically compare joint reconstructions resulting from implantations of a short-stemmed and a conventional hip replacement., Methods: 100 patients (50 short-stemmed and 50 conventional) were retrospectively examined. For evaluation of biomechanical parameters standardised pre- and postoperative X-rays (pelvic AP views) were used and digitally analysed., Results: The horizontal femoral off-set increased within both groups (short: 2.0 mm and conventional: 3.3 mm), with a significant increase in the conventional group. The hip centre of rotation was significantly medialised after both procedures (short: 6.0 mm and conventional: 4.2 mm). Limb length was shorter preoperatively at the arthroplasty side, but increased thereafter (short: 2.1 mm and conventional: 2.6 mm). Compared to the native contralateral side the limb length was almost equal after THA (short: 0.7 mm and conventional: 0.8 mm)., Conclusions: Our study shows that an almost anatomic reconstruction of hip joint biomechanics is possible with a short-stemmed prosthesis compared to a conventional stem, regarding limb length, centre of rotation and offset., (Georg Thieme Verlag KG Stuttgart · New York.)

Background: The design and the surgical technique of the Silent Micro Hip™ are different compared to other hip stems due to a conical shape for fixation within the metaphyseal femur. The purpose of the present study was to evaluate hip joint biomechanics of the Silent Micro Hip™ in comparison to other implants. Implant-specific differences are highlighted., Material and Method: 150 consecutive patients (each group 50 Silent Micro Hip™, Nanos™ and SL-Plus™ MIA) were analysed retrospectively. For evaluation of biomechanical parameters pre- and postoperative X-rays (pelvic AP views) were used., Results: The horizontal femoral offset and the limb length showed no significant difference between the Silent Micro Hip™ and the Nanos™ or SL-Plus™ MIA stem at the reconstructed hip. An almost anatomic reconstruction of hip joint biomechanics was reached with all three types of implants., Conclusions: The Silent Micro Hip™ allows for almost anatomic reconstruction of hip joint biomechanics. Short-term results support the bone-preserving reconstruction with a proximal femoral load transfer. Further studies on the mid- and long-term outcomes are ongoing., (Georg Thieme Verlag KG Stuttgart · New York.)

Introduction: The chronic lateral epicondylitis (EHR) as a common pathology of the elbow is often associated with posterolateral rotatory instability of the elbow (PLRI). After evaluation of intra-articular pathology by prior diagnostic arthroscopy, we aimed to build patient groups regarding the stability of the elbow joint. In patients with a stable elbow joint, open surgery with a debridement to the origin of the common extensor tendon and transosseous refixation was performed. Patients with relevant posterolateral rotatory instability, however, underwent an additional LUCL complex stabilisation using triceps tendon graft besides debridement as mentioned above. The purpose of this study was to evaluate and compare the clinical functional outcome between these groups., Material and Methods: 101 patients were included in our study. Arthroscopies were first performed on all patients to identify intra-articular pathological changes. In 26 patients with stable elbows, open surgery with debridement to the origin of the common extensor tendon and transosseous refixation was performed. For the other 75 patients who were found presenting a relevant posterolateral rotatory instability, a stabilisation of the LUCL in addition to the open procedure mentioned above was performed. Examinations and questionnaires were used for retrospective evaluation at follow-up., Results: Both groups of patients revealed significant improvement in pain relief and elbow function. We observed no significant difference between the two methods concerning clinical and functional outcome., Conclusion: We recommend diagnostic arthroscopy with assessment of stability prior to the open performance to offer a more reliable evidence for surgical technique selection and therefore to achieve a better clinical outcome., (Georg Thieme Verlag KG Stuttgart · New York.)