0000000000304942
AUTHOR
Ch. Hopf
The influence of lateral release on patello-femoral joint loading in knee arthroplasty
Eight fresh, cadaveric knees have been fitted with four different total knee cemented prostheses. Loading forces at the bone implant fixation interface of the patella component have been measured in a knee joint testing rig by four miniaturized force transducers, before and after a lateral release of the patellar retinaculum. The lateral release resulted in a significant local force reduction in the lateral and/or proximal quadrant of the patella resection plane depending on the knee flexion angle, quadriceps tensile force direction, and the patellar prosthesis design.
Metastatic spinal cord compression--options for surgical treatment.
Fourty-three cases with metastatic spinal cord compression were reviewed post-operatively to clarify the usefulness of the procedures concerning restoration of neurological function, and pain relief. Only patients with pathological spinal instability and neurological sequelae were included. Posterior decompression and stabilization was performed in all but six patients. All but four patients (91%) reported decrease of pain symptoms. Amelioration of neurological function was achieved in 58%. Re-establishment of walking ability was obtained in 57%. Post-surgery life expectancy averaged 11 months. In patients with widespread metastatic disease and/or multi-level instability of the spine restri…
The effect of cement fixation on initial micromotion of the femoral component in condylar knee replacement
Four fresh, cadaveric specimens were fitted with total knee replacements and mounted on a knee joint loading and measuring rig. Femoral component micromotion in the sagittal plane was measured with a transducer during flexion and extension of the specimen. Various condylar designs were used without and with cement. Movement followed a characteristic curve pattern and was less with cement fixation particularly for bone of low trabecular strength as determined by bone sample tests for stiffness. Cement fixation appears to be superior to cementless fixation.
ANALGESIC EFFECT OF EXTRACORPOREAL SHOCK-WAVE THERAPY ON CHRONIC TENNIS ELBOW
We report a controlled, prospective study to investigate the effect of treatment by low-energy extracorporeal shock waves on pain in tennis elbow. We assigned at random 100 patients who had had symptoms for more than 12 months to two groups to receive low-energy shock-wave therapy. Group I received a total of 3000 impulses of 0.08 mJ/mm2 and group II, the control group, 30 impulses. The patients were reviewed after 3, 6 and 24 weeks. There was significant alleviation of pain and improvement of function after treatment in group I in which there was a good or excellent outcome in 48% and an acceptable result in 42% at the final review, compared with 6% and 24%, respectively, in group II.
Mehrsegmentale Fusion der Skoliose bei Duchenne-Muskeldystrophie
Operations in scoliosis in patients suffering from an advanced stage of Duchenne muscular dystrophy are associated with a higher risk due to the extent of the curves, the respiratory insufficiency and frequent cardiomyopathia. Progressive scolioses in 20 wheelchair patients with an age between 10.5-18.3 years (mean 14.6 years) were treated by CDI. The mean preoperative angle in this group was 70.6 degrees, the postoperative angle 31.2 degrees (mean correction 39.4 degrees or 55.8%). The preoperative lordosis of the lumbar spine (mean angle 4.1 degrees) was corrected to 17.8 degrees postoperatively. The average intraoperative blood loss (2300 ccm) was evident more compared with idiopathic sc…
Die Aktivität der Rückenstreckmuskulatur beim aufrechten Stehen und beim Sitzen mit standidentischer Rumpfhaltung - eine elektromyographische Studie
Problem: There is a controversial discussion about the loading of the spine by the force of the extending muscles of the back in upright sitting with the back curved as in upright standing. Experimental studies investigating this issue are still lacking. Methods: In the study presented in this paper we measured in 30 subjects the activity of the extending back muscles both in a natural upright standing posture and in sitting with identical posture of the back as recommended in some back training programs. To this end we recorded the electromyographical surface activity of the back muscles at four levels of the spine in both postures. The EMG activities were intraindividually normalized with…
Die Hochenergetische Extrakorporale Stoßwellentherapie (ESWT) in der Behandlung von Pseudarthrosen
PROBLEM The success rate of high-energy extracorporal shock wave therapy in the treatment of non-unions in comparison to the "golden standard" surgery is still unclear. METHOD In a prospective study, 3000 impulses with an energy density of 0.6 mJ/mm2 were applied with an experimental device to the pseudarthrosis in 52 patients. RESULTS The mean duration of pseudarthrosis was 13 months. A mean of 2.5 surgical interventions had already been performed. Bony union was achieved in 52% of our patients after an average of 3.3 months. Failures especially were found in the atrophic type of pseudarthrosis as well as in congenital bone disorders like fibrous dysplasia or osteogenesis imperfecta. No se…
Gait analysis in idiopathic scoliosis before and after surgery: a comparison of the pre- and postoperative muscle activation pattern
In a prospective experimental study the level gait activity scores of the iliocostalis lumborum, glutaeus medius, tensor fasciae latae, vastus lateralis and peronaeus longus muscles of both body sides were examined by computerized electromyography in 23 patients with idiopathic scoliosis before and after CD instrumentation. The pre- and postoperative findings were examined as to asymmetric patterns in muscle requisition during gait and the respective changes induced by the spinal correction. These results were compared with the corresponding results obtained in healthy subjects in two independent sessions with identical experimental conditions. A muscle activity asymmetry coefficient was de…