Purpose: While injuries among elite tennis athletes are extensively documented, a notable research gap exists regarding tennis injuries among club-level players. This study examines tennis injuries in German league players, with a particular emphasis on the impact of racquet properties and court surfaces, distinguishing between chronic and acute injuries. Patients and Methods: Retrospectively analyzing data from 600 tennis players over a 1.5-year period, a standardized questionnaire covered anthropometrics, injury characteristics, equipment usage, and court surface conditions. Results: The study identified 1012 tennis-related injuries, averaging 1.7 per player. Acute injuries predominantly affected the lower extremity (56%), with ankle injuries being the most prevalent, and ligaments were the most commonly affected structures (36.4%). Chronic complaints (reported by 364 athletes) focused on the upper extremity (63.2%), primarily tendon injuries (56.8%). Racket properties exhibited no significant impact on chronic upper extremity injuries. Conclusion: This study highlights a high incidence of acute lower extremity injuries, especially ankle ligament injuries, among German league tennis players. It offers crucial insights for devising targeted injury prevention strategies applicable to amateur, semi-professional, and professional tennis players, despite finding no significant link between racquet material and chronic upper extremity injuries.

Background: While MRI is the primary diagnostic tool for the diagnosis of spondylodiscitis, the role of [¹⁸F]-fluorodeoxyglucose ([¹⁸F]FDG) PET/CT is gaining prominence. This study aimed to determine the frequency of [¹⁸F]FDG PET/CT usage and its impact on the in-hospital mortality rate in patients with spondylodiscitis, particularly in the geriatric population. Methods: We conducted a Germany-wide cross-sectional study from 2019 to 2021 using an open-access, Germany-wide database, analyzing cases with ICD-10 codes M46.2-, M46.3-, and M46.4- (‘Osteomyelitis of vertebrae’, ‘Infection of intervertebral disc (pyogenic)’, and ‘Discitis unspecified’). Diagnostic modalities were compared for their association with in-hospital mortality, with a focus on [¹⁸F]FDG PET/CT. Results: In total, 29,362 hospital admissions from 2019 to 2021 were analyzed. Of these, 60.1% were male and 39.9% were female, and 71.8% of the patients were aged 65 years and above. The overall in-hospital mortality rate was 6.5% for the entire cohort and 8.2% for the geriatric subgroup (p < 0.001). Contrast-enhanced (ce) MRI (48.1%) and native CT (39.4%) of the spine were the most frequently conducted diagnostic modalities. [¹⁸F]FDG PET/CT was performed in 2.7% of cases. CeCT was associated with increased in-hospital mortality (OR = 2.03, 95% CI: 1.90–2.17, p < 0.001). Cases with documented [¹⁸F]FDG PET/CT showed a lower frequency of in-hospital deaths (OR = 0.58, 95% CI: 0.18–0.50; p = 0.002). This finding was more pronounced in patients aged 65 and above (OR = 0.42, 95% CI: 0.27–0.65, p = 0.001). Conclusions: Despite its infrequent use, [¹⁸F]FDG PET/CT was associated with a lower in-hospital mortality rate in patients with spondylodiscitis, particularly in the geriatric cohort. This study is limited by only considering data on hospitalized patients and relying on the assumption of error-free coding. Further research is needed to optimize diagnostic approaches for spondylodiscitis.

Acute traumatic spinal cord injury (tSCI) is a serious condition that significantly impairs sensory, motor, and autonomic functions. It has a substantial impact on both the physical and psychological well-being of patients. Primary spinal cord injury...

Background: Platelet-rich plasma (PRP) therapy is increasingly used for musculoskeletal conditions, yet patients seeking supplementary information online encounter resources of variable quality. Large language models (LLMs) such as ChatGPT and Google Gemini may support patient education, but their performance in answering common patient questions about PRP therapy has not been well characterized. Methods: This study compared the quality of responses generated by ChatGPT-4, ChatGPT-3.5, and Google Gemini to common PRP-related patient questions. Ten frequently asked PRP-related questions were identified through a structured search of online sources, PubMed, Google Trends, and AI-assisted query generation. Each question was submitted to the three LLMs using a standardized prompt designed to elicit clear and empathetic responses. Five orthopedic surgeons, blinded to model identity, assessed each answer using a previously published four-tier rating framework. Secondary metrics included exhaustiveness, clarity, empathy, and response length. Results: All models produced mostly satisfactory answers. ChatGPT-3.5 received the highest proportion of excellent ratings (70%), compared with 40% for ChatGPT-4 and 22% for Gemini, and outperformed both models in overall quality. The most common limitation across models was insufficient detail. ChatGPT-4 and Gemini performed similarly in several categories, although Gemini was rated lower in empathy and comprehensiveness. Overall differences between models were statistically significant. Conclusions: Commonly available LLMs were able to provide mostly satisfactory responses to patient questions about PRP. However, important limitations remained, particularly with respect to detail and individualization. These tools may support initial patient information-seeking, but they should complement rather than replace expert medical counseling.

Population-based data on incidence and mortality risk factors, particularly in very elderly patients with traumatic subarachnoid hemorrhage (tSAH) are limited. This study analyzed epidemiology, comorbidities, complications, age-specific incidence rates, and predictors of in-hospital mortality in patients with tSAH in Germany, with a focus on those aged ≥80 years. This retrospective cross-sectional study included all hospitalized patients with tSAH (ICD-10 S06.6) in Germany from 2019 to 2022, using nationwide administrative data from the Institute for the Hospital Remuneration System (InEK-GmbH). Demographics, comorbidities, complications, diagnostic procedures, ICU treatment, and in-hospital mortality were analyzed. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using univariable analyses. Age-specific incidence rates were derived from Federal Statistical Office (Destatis) population data. In a nationwide cohort of 67,684 tSAH patients, in-hospital mortality was 9.1%. The incidence of tSAH was 34.4 per 100,000 and increased sharply with age. Hypertension (44.5%) and atrial fibrillation (14.8%) were common. Mortality was higher in patients with atrial fibrillation (OR 1.86), cardiac pacemakers (OR 1.65), and three-vessel coronary artery disease (OR 1.54). Prolonged unconsciousness (>24 h) was the strongest predictor of death (OR 16.32), followed by cerebral edema (OR 4.70). Septic shock, renal failure, and traumatic shock carried the highest mortality risk. tSAH is associated with substantial in-hospital mortality, particularly in very elderly patients and those with cardiac comorbidities. These predictors/associations may support risk stratification and early intensive care management.

Background: Pyogenic vertebral osteomyelitis (PVO) presents an escalating clinical challenge due to rising incidence, high mortality, and significant bone destruction. Objective quantification of vertebral body (VB) bone loss for assessing the disease severity and guiding therapeutic decisions is yet to be established. Methods: We retrospectively identified patients with confirmed PVO between 2010 and 2020. Volumetric assessments of VBs were performed using 3D Slicer, and pre-infection volumes were estimated by linear regression based on adjacent, non-infected vertebrae. A “Destruction Quotient” (DQ) was calculated (measured volume/estimated original volume) to quantify VB loss. In a subgroup analysis VB bone loss was evaluated, depending on sex, spinal location and pathogen group. Results: Thirty-one patients met the inclusion criteria for 3D volumetry (16 males, 15 females; mean age: 67.0 ± 9.2 years; mean BMI 32.4 kg/m²). In total, n = 267 VBs were segmented. Linear regression models demonstrated a high mean coefficient of determination (R²>0.95), with mean slopes of m = 2.3 (95% CI = 1.94–2.75) in males and m = 1.8 (95% CI = 1.46–2.19) in females. The mean measured volume of infected VBs (17.8 ± 9.3 cm³) was significantly lower than the estimated original volume (24.1 ± 10.5 cm³; p < 0.001). VBs at the lumbar spine experienced a median volume loss of 30%, whereas thoracic VBs showed 18% loss of volume. Female patients demonstrated a significantly higher median VB loss (32%) than males (12%; p < 0.05). No significant variation in DQs was observed among different pathogen groups, with Staphylococcus aureus being the most prevalent; however, within the Staphylococcus aureus subgroup, the measured VB volume was significantly smaller than the original estimated volume with a mean difference of 6.13 ± 4.9 cm³ (p < 0.01). Conclusion: A 3D-volumetric approach and linear regression modeling offers an individualized method for quantifying VB destruction in PVO. Integrating automated segmentation and densitometric data may further enhance predictive accuracy and improve patient-specific treatment strategies.