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  • 1
    Electronic Resource
    Electronic Resource
    Magnetic resonance imaging in lateral epicondylitis of the elbow (1998)
    Springer
    Archives of orthopaedic and trauma surgery 118 (1998), S. 121-125 
    Details
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The purpose of the study was to determine the changes that might be detected using magnetic resonance imaging (MRI) on patients with chronic lateral epicondylitis of the elbow and to judge its value concerning the clinical treatment. Thirty-four patients with chronic lateral epicondylitis were included in a prospective study. All individuals underwent MRI of the elbow on a 0.2-T dedicated system. The MRI findings were interpreted by an independent radiologist without knowledge of the clinical findings. In 6 surgical cases an additional histological study was done. The biopsy of the extensor tendon was performed for correlation with the MRI. In 21 of 34 symptomatic patients, increased signal changes in T1- and T2-weighted images were seen. In a further 11 cases, the morphology and signal intensity were normal. The histopathological analysis of 6 surgical cases confirmed the preoperative MRI findings by showing either focal fibrous degenerative tendon tissue or microruptures of collagenous fibres. MRI in patients with chronic lateral epicondylitis can help to differentiate the disease and may be of use in clinical management, preoperative planning, and in the evaluation of the degree of degeneration at the common extensor tendon insertion.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004020050330
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  • 2
    Electronic Resource
    Electronic Resource
    Shockwave application in calcifying tendinitis of the shoulder – prediction of outcome by imaging (2000)
    Springer
    Archives of orthopaedic and trauma surgery 120 (2000), S. 493-498 
    Details
    ISSN: 1434-3916
    Keywords: Key words Shoulder ; Calcifying tendinitis ; Shock wave ; MRI ; Prediction parameters ; Clinical outcome
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This prospective study examined 62 patients (65 shoulders) with chronic courses of calcifying tendinitis of the shoulder before and after low-energy extracorporeal shockwave application (ESWA) in order to identify variables associated with the outcome of this treatment. Before ESWA, radiographs and contrast-enhanced magnetic resonance imaging (MRI) of the affected shoulders were obtained in order to document the size and morphology of the calcifications and the contrast media reactions in areas of interest (deposit, synovia, bursae), respectively. In addition, a clinical evaluation was performed. After ESWA (mean follow-up 18.2 months), clinical evaluations of all 65 shoulders revealed an increase in the Constant score from 44% to 78% (p 〈 0.0001). While size (p = 0.61) and morphology (p = 0.7) of the deposits before ESWA were not associated with the clinical outcome, negative contrast reactions around the deposits (p = 0.0001), synovia (p = 0.0049) and bursae (p 〈 0.01) were associated with improved clinical outcomes. After the total study group was divided into two groups, one with Constant scores ≥ 75% (n = 43) and the other with scores 〈 75% (n = 22), the positive predictive value (ppv), specificity (sp) and sensitivity (se) were determined for the negative reaction around the deposit (ppv: 0.94; sp: 0.95; se: 0.38), synovia (ppv: 0.84; sp: 0.82; se: 0.49) and bursae (ppv: 0.86; sp: 0.86; se: 0.44). In 5 cases (7.7%), surgery of the affected shoulder during the follow-up period was performed. No major side-effects were seen in the study group. In conclusion, our results suggest that in patients with chronic calcifying tendinitis, the absence of contrast enhancement, especially around the deposit, is a strong predictive parameter of a positive clinical outcome of ESWA.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004020000154
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  • 3
    Electronic Resource
    Electronic Resource
    Role of internal and external fixation in ankle fusion (1996)
    Springer
    Archives of orthopaedic and trauma surgery 115 (1996), S. 146-148 
    Details
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Between August 1980 and September 1993, 35 tibiotalar arthrodeses in 34 patients with primary and secondary osteoarthritis of the ankle were performed. Two different surgical techniques were employed. Internal screw fixation according to Wagner and Pock [20] and an external fixation method ccording to the resection compression arthrodesis by Charnley and Müller [14]. Twenty patients with 21 fusions could be investigated retrospectively. For evaluation we used self-assessment, clinical examination and radiographic analysis in combination with the score described by McGuire et al. [12]. In 80% the results were good and satisfactory with a median improvement of 23 score points on a scale of 100% 95 points, respectively. The most important advantages were pain relief and increase of walking distance. The fusion rate was 95%. We found osteoarthritis in the neighbouring joints did not have any influence on the surgical result. With respect to the two surgical techniques, the internal screw fixation method achieved fusion earlier with fewer complications and better improvement according to the McGuire score. Tibiotalar fusion is a safe therapy with reproducible good results involving pain relief, full weight-bearing and increase of walking distance.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00434542
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  • 4
    Electronic Resource
    Electronic Resource
    Evaluation of imaging in loosening of hip arthroplasty in 326 consecutive cases (1998)
    Springer
    Archives of orthopaedic and trauma surgery 117 (1998), S. 205-207 
    Details
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Between 1989 and 1995, 326 hip arthroplasties were surgically revised in our clinic because of loosening. For evaluation of loosening, we used history, clinical examination, radiographs, bone scans and arthrography with digital subtraction technique. In 130 cases (40%), surgery was planned by plain radiographs. In 116 cases (89%) a correct diagnosis of loosened components was made. Of the 72 patients (22%) with an additional bone scan, 87% (63 patients) had a correct diagnosis. Fifty-four patients (17%) with different findings were examined by hip arthrography; in 83% (45 patients) the diagnosis was confirmed intraoperatively. In 93% (65 patients) of 70 patients (21%) with bone scans and arthrography, surgery confirmed the diagnosis. Sensitivity for loosening of the socket was 61% by bone scan and 85% by digital subtraction arthrography; specificity was 75% in each case. Sensitivity for loosening of the stem was 71% by bone scan and 65% by digital subtraction arthrography; specificity was 80% and 88%, respectively. Our results showed that in most cases of suspected loosening of total hip arthroplasties, analysis of plain radiograph series can lead to an accurate diagnosis in 85%–90%. In cases of uncertainty, we suggest the additional use of digital subtraction arthrography, which has a similarly high diagnostic quality. Because of the low sensitivity of nuclide bone scanning (about 60%) and its dependence on prosthetic material and fixation, we do not recommend primary scintigraphy. It can be helpful in problematic cases with additional questions like activity of ectopic bone formation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004020050230
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  • 5
    Electronic Resource
    Electronic Resource
    Surgical treatment of acromioclavicular dislocation (1994)
    Springer
    Archives of orthopaedic and trauma surgery 113 (1994), S. 308-311 
    Details
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Sixty-five patients were operated on for acromioclavicular dislocation between 1980 and 1991. Seventeen type II and 48 type III dislocations according to the criteria of Tossy et al. [15] were treated. Three different surgical techniques were employed. (1) tension band wiring, (2) a modification of the Bosworth repair [3], (3) reconstruction of the ligaments with augmentation by a PDS (polydioxanon) cord. Forty-four patients could be investigated retrospectively, and an additional 12 were recorded by questionnaire. The Taft score [14] was used, representing self-assessment, clinical statements and radiological findings. Of all investigated patients 87.5% had a normal range of motion without any loss of strength, and 32% suffered an osteoarthritis of the acromioclavicular joint. The average Taft score was 9.8. With respect to the three surgical techniques, reconstruction of the ligaments augmented by a PDS cord produced the best result, an average Taft score of 10.8.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00426177
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