Šupane, Withasen, Vethenici, Witsassen – formy reprezentacji wspólnot wiejskich na obszarach Zachodnich Słowian

Im Rahmen des hoch- und spätmittelalterlichen Landesausbaus in Ostmitteleuropa entstanden nicht nur in den Städten mit ihren Räten und Schöffengremien Repräsentanten kommunaler Gemeinschaften, sondern auch ländliche Siedlungen waren durch Personen nach außen vertreten, die im Gebiet östlich der Saale häufig als „Schulte“ bezeichnet wurden. Aber schon die slawischen Siedlungen der Zeit vor dem Beginn der westlichen Zuwanderung hatten Repräsentanten, die sie gegenüber Fürsten und neuen Herren vertraten. Sie wurden „Supane“ und „Withasen“ genannt. Ihnen und der Wandlung ihrer Funktionen und Aufgaben ist der folgende Aufsatz gewidmet.In the course of High and Late Medieval settlement expansion in East Central Europe, towns with their councils and jury panels were not the only ones to develop systems of community representation. In rural settlements, too, representatives took over certain dealings with the outside world, for instance the so-called “Schults” in the area east of the Saale River. Indeed, Slavic settlements prior to immigration from the west also had representatives, called “Supans” and “Withasi”, who championed their interests in front of princes and new rulers. The present contribution deals with these Slavic representatives, as well as their changing functions and duties.W trakcie przeobrażeń osadniczych w Europie Środkowo-Wschodniej w okresie dojrzałego i późnego średniowiecza nie tylko miasta, wraz z ich radami i ławami sądowymi, rozwinęły system reprezentacji wspólnot. Również w przypadku osadnictwa wiejskiego wyłonili się przedstawiciele lokalnych społeczności, którzy reprezentowali je względem świata zewnętrznego, tak jak miało to miejsce w przypadku ludzi często określanych jako „Schultowie” (Sołtysi?) na obszarach wschodniego pobrzeża rzeki Soławy. Osady słowiańskie przed przybyciem osadników z zachodu także miały swoich przedstawicieli, zwanych „Šupani” (Żupanie) lub „Withasi” (Vethenici, Witsassen), którzy wyrażali ich interesy przed panami ziemskimi. Niniejszy artykuł dotyczy tych słowiańskich przedstawicieli wspólnot lokalnych oraz ich zmieniających się funkcji i obowiązków

Gold und Herrschaft

Eine genaue Untersuchung von Gestalt und Funktion frühmittelalterlicher Königsschätze stellte bislang ein Desiderat der Mittelalterforschung dar. Auf der Basis historischer, archäologischer und literarischer Quellen untersucht M. Hardt die Kontexte, in denen königliche Schätze überliefert sind. Zunächst unternimmt er den Versuch, eine Vorstellung vom Inhalt frühmittelalterlicher Königsschätze und von der unterschiedlichen Beschaffenheit der darin angehäuften Gegenstände und Materialien zu vermitteln. Anschließend beschreibt er Herkunft und Aufbewahrung sowie die Bewegung des in den Schatz gelangenden und aus ihm abfließenden Edelmetalls und untersucht Wirkung und Wechselwirkung von königlichen Gaben im Umfeld des Herrschers, in denen neben der königlichen Repräsentation die hauptsächliche Funktion des Schatzes als Herrschaftsmittel evident wird. Material und Fragestellung erlauben einen europäischen Vergleich der Objekte und Einzelergebnisse

Two-stage revision for periprosthetic joint infection in cemented total hip arthroplasty: an increased risk for failure?

Background: The impact of the prior fixation mode on the treatment outcome of chronic periprosthetic joint infection (PJI) of the hip is unclear. Removal of cemented total hip arthroplasty (THA) is particularly challenging and residual cement might be associated with reinfection. This study seeks to compare the results of two-stage revision for PJI in cemented and cementless THA. Methods: We reviewed 143 consecutive patients undergoing two-stage revision THA for PJI between 2013 and 2018. Thirty-six patients with a fully cemented (n = 6), hybrid femur (n = 26) or hybrid acetabulum (n = 4) THA (cemented group) were matched 1:2 with a cohort of 72 patients who underwent removal of a cementless THA (cementless group). Groups were matched by sex, age, number of prior surgeries and history of infection treatment. Outcomes included microbiological results, interim re-debridement, reinfection, all-cause revision, and modified Harris hip scores (mHHS). Minimum follow-up was 2 years. Results: Compared with PJI in cementless THA, patients undergoing removal of cemented THA had increasingly severe femoral bone loss (p = 0.004). Patients in the cemented group had an increased risk for positive cultures during second-stage reimplantation (22% compared to 8%, p = 0.043), higher rates of reinfection (22% compared to 7%, p = 0.021) and all-cause revision (31% compared to 14%, p = 0.039) compared to patients undergoing two-stage revision of cementless THA. Periprosthetic femoral fractures were more frequent in the group of patients with prior cementation (p = .004). Mean mHHS had been 37.5 in the cemented group and 39.1 in the cementless group, and these scores improved significantly in both groups (p < 0.01). Conclusion: This study shows that chronic infection in cemented THA might be associated with increased bone loss, higher rates of reinfection and all-cause revision following two-stage revision. This should be useful to clinicians counselling patients with hip PJI and can guide treatment and estimated outcomes

Total hip arthroplasty for destructive septic arthritis of the hip using a two-stage protocol without spacer placement

Introduction: The optimal treatment of patients with a degenerative joint disease secondary to an active or chronic septic arthritis of the hip is unclear. The aim of the present study was to report on our experience with two-stage total hip arthroplasty (THA) using a contemporary treatment protocol without spacer insertion. Materials and methods: Our prospective institutional database was used to identify all patients with degenerative septic arthritis treated with a non-spacer two-stage protocol between 2011 and 2017. Clinical outcomes included interim revision, periprosthetic infection (PJI) and aseptic revision rates. Restoration of leg-length and offset were assessed radiographically. Modified Harris hip score (mHHS) were obtained. Treatment success was defined using the modified Delphi consensus criteria. Mean follow-up was 62 months (13-110). Results: A total of 33 patients with a mean age of 60 years (13-85) were included. 55% of the cohort was male and average Charlson Comorbidity Index (CCI) was 3.7 (0-12). 21 patients (64%) had an active/acute infection and 12 patients (36%) were treated for chronic/quiescent septic arthritis. Overall, 11 patients (33%) had treatment failure, including 5 patients who failed to undergo THA, 2 interim re-debridement for persistent infection, and 4 patients who developed PJI after an average of 7 months (0.3-13) following THA. The most common identified pathogen was Staphylococcus aureus (42.4%). No aseptic revision was recorded following THA. Leg-length and offset were successfully restored. Mean mHHS improved from 35.2 points to 73.4 points. Conclusion: Two-stage THA without spacer placement is a viable treatment option for destructive septic arthritis of the hip, demonstrating comparable rates of infection control and functional outcome. However, definitive resection arthroplasty is not uncommon in these often critically ill patients

Extended Trochanteric Osteotomy with Intermediate Resection Arthroplasty Is Safe for Use in Two-Stage Revision Total Hip Arthroplasty for Infection

Background: This study sought to compare the results of two-stage revision total hip arthroplasty (THA) for periprosthetic infection (PJI) in patients with and without the use of an extended trochanteric osteotomy (ETO) for removal of a well-fixed femoral stem or cement. Methods: Thirty-two patients who had undergone an ETO as part of a two-stage revision without spacer placement were matched 1:2 with a cohort of sixty-four patients of the same sex and age who had stem removal without any osteotomy. Clinical outcomes including interim revision, reinfection and aseptic failure rates were evaluated. Modified Harris hip scores (mHHS) were calculated. Minimum follow-up was two years. Results: Patients undergoing ETO had a significantly lower rate of interim re-debridement compared to non-ETO patients (0% vs. 14.1%, p = 0.026). Reinfection following reimplantation was similar in both groups (12.5% in ETO patients vs. 9.4% in non-ETO patients, p = 0.365). Revision for aseptic reason was necessary in 12.5% in the ETO group and 14.1% in the non-ETO group (p = 0.833). Periprosthetic femoral fractures were seen in three patients (3.1%), of which all occurred in non-ETO patients. Dislocation was the most common complication, which was equally distributed in both groups (12.5%). The mean mHHS was 37.7 in the ETO group and 37.3 in the non-ETO group, and these scores improved significantly in both groups following reimplantation (p < 0.01). Conclusion: ETO without the use of spacer is a safe and effective method to manage patients with well-fixed femoral stems and for thorough cement removal in two-stage revision THA for PJI. While it might reduce the rate of repeated debridement in the interim period, the use of ETO appears to lead to similar reinfection rates following reimplantation

Hip replacement improves lumbar flexibility and intervertebral disc height — a prospective observational investigation with standing and sitting assessment of patients undergoing total hip arthroplasty

Purpose: The pathogenic mechanism of the hip-spine syndrome is still poorly elucidated. Some studies have reported a reduction in low back pain after total hip arthroplasty (THA). However, the biomechanical mechanisms of THA acting on the lumbar spine are not well understood. The aim of the study is to evaluate the influence of THA on (1) the lumbar lordosis and the lumbar flexibility and (2) the lumbar intervertebral disc height. Methods: A total of 197 primary THA patients were prospectively enrolled. Pre- and post-operative biplanar stereoradiography was performed in standing and sitting positions. Spinopelvic parameters (lumbar lordosis (LL), pelvic tilt, sacral slope, pelvic incidence), sagittal spinal alignment (sagittal vertical axis, PI-LL mismatch (PI-LL)) and lumbar disc height index (DHI) for each segment (L1/2 to L5/S1) were evaluated. The difference between standing and sitting LL (Delta LL=LLstanding - LLsitting) was determined as lumbar flexibility. Osteochondrosis intervertebralis was graded according to Kellgren and Lawrence (0-4), and patients were assigned to subgroups (mild: 0-2; severe: 3-4). Results: Lumbar flexibility increased significantly after THA (pre: 22.04 +/- 12.26 degrees; post: 25.87 +/- 12.26 degrees; p < 0.001), due to significant alterations in LL in standing (pre: 51.3 +/- 14.3 degrees; post: 52.4 +/- 13.8 degrees; p < 0.001) and sitting (pre: 29.4 +/- 15.4 degrees; post: 26.7 +/- 15.4 degrees; p = 0.01). Delta LL increased significantly in both subgroups stratified by osteochondrosis (pre/post: Delta LLmild: 25.4 (+/- 11.8)/29.4 +/- 12.0 degrees; p < 0.001; Delta LLsevere: 17.5 (+/- 11.4)/21.0 +/- 10.9 degrees; p = 0.003). The DHI increased significantly from pre-operatively to post-operatively in each lumbar segment. PI-LL mismatch decreased significantly after THA (pre: 3.5 degrees; post: 1.4 degrees; p <0.001). Conclusion: The impact of THA on the spinopelvic complex was demonstrated by significantly improved lumbar flexibility and a gain in post-operative disc height. These results illustrate the close interaction between the pelvis and the vertebral column. The investigation provides new insights into the biomechanical patterns influencing the hip-spine syndrome

Spinopelvic mobility is influenced by pre-existing contralateral hip arthroplasty: a matched-pair analysis in patients undergoing hip replacement

Background: Spinopelvic mobility gained increased attention as a contributing factor for total hip arthroplasty (THA) instability. However, it is unknown how a pre-existing THA affects spinopelvic mobility. Therefore, a propensity-score-matched analysis of primary THA patients comparing the individual segments of spinopelvic mobility between patients with pre-existing THA and no-existing THA was conducted. Consequently, the study aimed to discuss (1) whether patients with a pre-existing THA have altered spinopelvic mobility compared to the control group and (2) if spinopelvic mobility changes after THA. Methods: A prospective observational study enrolled 197 elective primary THA patients, including N = 44 patients with a pre-existing unilateral THA. Using propensity-score matching adapted for age, sex, and BMI, N = 44 patients without a pre-existing THA were determined. The patients received stereoradiography in standing and relaxed sitting position pre- and postoperatively. Assessed parameters were lumbar lordosis (LL), pelvic tilt (PT), and pelvic femoral angle (PFA). Key parameters of the spinopelvic mobility were defined as lumbar flexibility ( increment LL = LLstanding - LLsitting), pelvic mobility ( increment PT = PTstanding - PTsitting) and hip motion ( increment PFA = PFA(standing) - PFA(sitting)). Pelvic mobility was classified as stiff ( increment PT = 10 degrees-30 degrees) and hypermobile ( increment PT > 30 degrees). The Wilcoxon rank sum test for dependent samples was used. Results: Pelvic mobility was significantly increased in the pre-existing THA group ( increment PT 18.2 degrees +/- 10.7) compared to the control group ( increment PT 7.7 degrees +/- 8.0; p < 0.001) preoperatively and postoperatively (pre-existing: 22.2 degrees +/- 9.3; control: 17.0 degrees +/- 9.2, p = 0.022). Lumbar flexibility was significantly increased in the pre-existing THA group ( increment LL 21.6 degrees +/- 11.8) compared to the control group ( increment LL 12.4 degrees +/- 7.8; p < 0.001) preoperatively and postoperatively (pre-existing: 25.7 degrees +/- 11.0; control: 19.0 degrees +/- 10.2; p = 0.011). The contribution of stiff pelvic mobility is distinctly smaller in the pre-existing THA group (25%) than in the control group (75%) preoperatively. Conclusions: Pre-existing THA is associated with significantly enhanced pelvic mobility and lumbar flexibility. Accordingly, we identified the patients without a pre-existing THA as risk candidates with higher likelihood for pathological spinopelvic mobility. This information will assist arthroplasty surgeons in deciding which THA candidates require preoperative radiological screening for pathologic spinopelvic mobility

Functional Assessment and Patient-Related Outcomes after Gluteus Maximus Flap Transfer in Patients with Severe Hip Abductor Deficiency

(1) Background: Degeneration of the hip abductor mechanism, a well-known cause of functional limitation, is difficult to treat and is associated with a reduced health-related quality of life (HRQOL). The gluteus maximus muscle flap is a treatment option to support a severely degenerative modified gluteus medius muscle. Although several reports exist on the clinical outcome, there remains a gap in the literature regarding HRQOL in conjunction with functional results. (2) Methods: The present study consists of 18 patients with a mean age of 64 (53‒79) years, operatively treated with a gluteus maximus flap due to chronic gluteal deficiency. Fifteen (83%) of these patients presented a history of total hip arthroplasty or revision arthroplasty. Pre and postoperative pain, Trendelenburg sign, internal rotation lag sign, trochanteric pain syndrome, the Harris Hip Score (HHS), and abduction strength after Janda (0‒5) were evaluated. Postoperative patient satisfaction and health-related quality of life, according to the Short Form 36 (SF-36), were used as patient-reported outcome measurements (PROMs). Postoperative MRI scans were performed in 13 cases (72%). (3) Results: Local pain decreased from NRS 6.1 (0-10) to 4.9 (0-8) and 44% presented with a negative Trendelenburg sign postoperatively. The overall HHS results (p = 0.42) and muscular abduction strength (p = 0.32) increased without significance. The postoperative HRQOL reached 46.8 points (31.3-62.6) for the mental component score and 37.1 points (26.9-54.7) for the physical component score. The physical component results presented a high level of positive correlation with HHS scores postoperatively (R = 0.88, p < 0.001). Moreover, 72% reported that they would undergo the operative treatment again. The MRI overall showed no significant further loss of muscle volume and no further degeneration of muscular tissue. (4) Conclusions: Along with fair functional results, the patients treated with a gluteus maximus flap transfer presented satisfying long-term PROMs. Given this condition, the gluteus maximus muscle flap transfer is a viable option for selected patients with chronic gluteal deficiency

App-based rehabilitation program after total knee arthroplasty: a randomized controlled trial

Introduction: New app-based programs for postoperative rehabilitation have been developed, but no long-term study has been published to date. Thus, a prospective randomized control trial with 2-year follow-up was performed to evaluate the effectiveness of app-based rehabilitation (GenuSport) compared to a control group after total knee arthroplasty (TKA). Methods: Between April and October 2016, 60 patients were enrolled in the study. Twenty-five patients were lost to follow-up, leaving 35 patients undergoing TKA for inclusion. In this group, twenty patients received app-based exercise program and 15 were randomized to the control group. The mean age was 64.37 +/- 9.32 years with a mean follow-up of 23.51 +/- 1.63 months. Patients in the app group underwent an app-based knee training starting on the day of surgery; whereas, patients in the control group underwent regular physiotherapy. Functional outcome scores using the Knee Injury and Osteoarthritis Outcome Score (KOOS), Knee Society Score (KSS) and VAS of pain were analyzed. Results: In the short term, significant differences between the app group and control group in time of 10-m walk (19.66 +/- 7.80 vs. 27.08 +/- 15.46 s; p = 0.029), VAS pain at rest and activity (2.65 +/- 0.82 vs. 3.57 +/- 1.58, respectively 4.03 +/- 1.26 vs. 5.05 +/- 1.21; p < 0.05) were observed. In the long term, a variety of different tendencies was found, highest in KSS Function with 76.32 +/- 16.49 (app group) vs. 67.67 +/- 16.57 (control group) (p = 0.130). Additionally, patients in the app group required less painkillers (10.0% vs. 26.7%) and more likely to participate in sports (65.0% vs. 53.3%). Conclusions: An app-based knee trainer is a promising tool in improving functional outcomes such as KSS function score and VAS after TKA

Beiträge zur Tagung "Entgrenzte Räume? Konstruktion und Relevanz von Grenzen im Wandel" an der Otto-Friedrich-Universität Bamberg vom 14. bis 15. Januar 2011

Die Grenze als abstraktes Phänomen wird in den einzelnen wissenschaftlichen Disziplinen sehr differenziert betrachtet. Die Herangehensweisen und Schwerpunkte reichen von fiktiven Räumen über historische Grenzziehungen bis hin zu konkret physischen Barrieren. In den verschiedenen geistes- und sozialwissenschaftlichen Fachdisziplinen erfahren Grenzphänomene derzeit eine Renaissance. Auch in Öffentlichkeit und Politik findet, gerade vor dem Hintergrund der häufig unter dem Schlagwort der Globalisierung zusammengefassten Prozesse, eine neue Auseinandersetzung mit physischen Räumen und Grenzen statt. Angesichts dieser gesellschaftspolitischen Relevanz ist es erstaunlich, wie wenig sich die Forschungsdisziplinen um interdisziplinäre Ansätze bemühen. Der Tagungsband vereint sechs Beiträge, die einzelne Facetten des Themenkomplexes aus soziologischer, politikwissenschaftlicher, sprach- und medienwissenschaftlicher, historischer und archäologischer Perspektive beleuchten