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  • 1
    Electronic Resource
    Electronic Resource
    Arthroskopische Kapsel-Labrum-Refixation bei der vorderen Schulterluxation. Primär- oder Sekundärversorgung? (1996)
    Springer
    Der Unfallchirurg 99 (1996), S. 831-835 
    Details
    ISSN: 1433-044X
    Keywords: Schlüsselwörter Arthroskopische Kapsel-Labrum-Refixation ; Akute und chronische Schulterluxationen ; Isokinetik ; Key words Acute and chronic shoulder instability ; Arthrosopic suture repair ; Isokinetic
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: We examined 30 patients with an arthroscopic suture repair for anterior shoulder instability in a retrospective evaluation. The follow-up period ranged from 12 to 58 months with an average of 22 months. Arthroscopic suture repairs were done on 14 patients (acute group, average age 26.1 years) with acute detached glenoid labrum, confirmed on arthro-CT, within 10 days after the injury and on 16 patients (secondary group, average age 25 years) with chronic should dislocation. The evaluation according to the Rowe scale resulted in a mean score of 97.1 for the acute group, compared with 92.7 for the secondary group. In each group we found one recurrent dislocation, which in the acute group was due to an adequate trauma. Two of the 14 acute group patients showed a reduction in external rotation of up to 20°, compared with 6 patients in the secondary group. The external rotation of one patient in the secondary group was reduced to 40°. The isokinetic muscle strength was decreased in both groups, both for 60°/s and for 120°/s, to 85% compared with the healthy side. The primary surgical therapy of young patients (below 25 years) with an acute shoulder dislocation and a detached glenoid labrum is recommended owing to the lower redislocation rate, an overall shortened course of treatment and a trend to better postsurgical range of motion.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001130050062
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  • 2
    Electronic Resource
    Electronic Resource
    Ultrasound evaluation of gravity induced anterior drawer following anterior cruciate ligament lesion (1999)
    Springer
    Knee surgery, sports traumatology, arthroscopy 7 (1999), S. 166-172 
    Details
    ISSN: 1433-7347
    Keywords: Key words Clinical study ; Knee instability ; Anterior cruciate ; ligament ; Ultrasound evaluation ; KT 1000 arthrometer ; Prone evaluation of the knee
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Sports Science
    Notes: Abstract Ultrasound is not so far a standard procedure to visualize the anterior drawer following anterior cruciate ligament (ACL) lesions. This is because the described techniques are either technically difficult or depend on the experience of the performer and are not standardized. The purpose of this prospective analysis on ACL intact, ACL deficient and ACL reconstructed knees was to compare the diagnostic accuracy of prone ultrasonographic Lachman testing with KT-1000 measurements in the same study population. Our technique is based on a prone position of the patient. The thigh lies on the table surface such that the patella has no contact. The lower leg is placed on a roll in the ankle area and flexed to 30 °. The transducer (5 MHz) is positioned over the medial aspect of the popliteal fossa to visualize the femoral condyle as well as the tibial head. Under ultrasound control the lower leg is manually lifted as far the thigh stays in contact with the surface defining the startposition. The lower leg is then released and drawn by gravity into the anterior drawer position, the final position. The distance between the posterior tangent from the medial femoral condyle to the medial tibial plateau was registered by three independent ultrasound measurements of the injured knee. The uninvolved opposite knee served as an internal control. The same procedure was done using a KT-1000 device (89 and 133 Newton and manual maximum force). The patients were split into two groups: acute injury (A), and (B) 6 months following ACL repair with a patellar tendon graft. All patients then underwent arthroscopy. In group A with acute ACL lesions the anterior drawer resulted in 14.1 mm (± 3.5) and was significantly (P 〈 0.001) different from the contralateral knee (7.7 mm ± 2.9). The KT 1000 showed a comparable difference with 14.4 mm (± 3.9) for the injured knee and 8.3 mm (± 3.4) for the uninjured (P 〈 0.001). Sonometrically, group B patients showed no clear difference between the repaired (9.9 mm ± 2.7) knee and its control (8.1 mm ± 2.5). This was found for the KT-1000 results as well. The results derived from the ultrasound evaluation of the anterior drawer correlated well with those from the KT-1000 (r = 0.46). Based on a minimum intra-individual difference of 5 mm in the ultrasound measured anterior drawer, the sensitivity of the test in group A resulted in 0.96, and the specificity in 0.98. The described technique is reproducible, painless and easy to perform in order to evaluate acute ACL tears using any commercially available ultrasound device. The reproducibility is similar to the KT-1000 device. We recommend this technique for use in cases of acute ACL tears as well as in the follow-up of ACL repair.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001670050142
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    Paper (German National Licenses)
    Fulltext
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