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  • 1
    Electronic Resource
    Electronic Resource
    Ein neues resorbierbares Knochen-Knorpel-Ersatztransplantat (2000)
    Springer
    Der Orthopäde 29 (2000), S. 151-157 
    Details
    ISSN: 1433-0431
    Keywords: Schlüsselwörter Bioimplantat • Biomechanik •¶Knorpeldefekt • Knorpelregeneration •¶Mesenchymale Zelldifferenzierung ; Key words Bioimplant • Biomechanics • Cartilage ¶defect • Cartilage repair • Mesenchymal cell differentiation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Hyaline cartilage is thought to be unable to regenerate. All efforts so far – including autologous chondrocyte cell transplantation – to reconstruct cartilage defects in joints have not been totally convincing. However, mesenchymal cells are able to differentiate into chondrocytes under mechanical pressure conditions. In this study, an open porous resorbable two-layer “bioimplant” was constructed in which mechanical pressure was exerted onto mesenchymal cells when migrated into the open porous structure of the bioimplant. Differentiation of the cells into chondrocytes was thus induced. The bioimplants were implanted into the medial condyles of nine rabbits and left in place for eight or twelve weeks, respectively. In seven of these cases, cartilage formation was found, in contrary to the controls in which only connective tissue and bone had grown into the empty holes. The new bioimplants have proven their effectiveness in cartilage defect repair and might evolve in the future as a new alternative treatment of full thickness defects of joint surfaces.
    Notes: Zusammenfassung Gelenkknorpel gilt in der Regel als nicht regenerationsfähig. Bis jetzt durchgeführte Versuche zur Wiederherstellung des Gelenkknorpels, inklusive der Knorpelzelltransplantation, zeigten wenig erfolgversprechende Ergebnisse. Jedoch gibt es Hinweise, dass unter Druckbelastung mesenchymale Stammzellen sich in Knorpelzellen differenzieren können. In der vorliegenden Studie wurde ein offenporiges resorbierbares, zweischichtiges „Bioimplantat“ konstruiert, das nach Implantation in einen Knochen-Knorpel-Defekt die physiologischen Druckverhältnisse nachahmt und so eine Differenzierung von mesenchymalen Stammzellen zu hyalinem Knorpel ermöglicht. An 9 Kaninchen wurde dieses Bioimplantat an Knochenknorpeldefekten des Femurkondylus über 2 verschiedene Zeiträume erprobt und mit Leerlochversuchen verglichen. Durch die Bioimplantate gelang es im Gegensatz zu den Leerlochversuchen in 7 von 9 Fällen Bereiche mit hyalinartigem Knorpel zu induzieren. Die Methode scheint einen neuen erfolgsversprechenden Ansatz zur Reparation von Knorpeldefekten darzustellen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00003710
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  • 2
    Electronic Resource
    Electronic Resource
    Tissue engineering in der Orthopädie – ein zukunftsträchtiges Konzept (2000)
    Springer
    Der Orthopäde 29 (2000), S. 73-74 
    Details
    ISSN: 1433-0431
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001320050011
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  • 3
    Electronic Resource
    Electronic Resource
    Operative or conservative treatment of the acutely torn anterior cruciate ligament in middle-aged patients (2000)
    Springer
    Archives of orthopaedic and trauma surgery 120 (2000), S. 59-64 
    Details
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In all, 133 patients with an acute rupture of the anterior cruciate ligament (ACL) were reviewed (aged ¶40 to 59 years). Average follow-up was 29 ± 10 months. Thirty-one patients underwent conservative therapy, 35 patients were treated by primary suture, while in 67 the primary suture was augmented with the semitendinosus tendon. The patients with primary repair and semitendinosus tendon augmentation showed significantly better results according to OAK and Lysholm scores, the Lachman test, pivot-shift testing, and KT-1000 arthrometer measurements than those treated conservatively or with primary suture. The physical activity level was significantly higher in the patients with augmented ACL repair than in the conservatively treated patients. There was no significant difference between the patients with augmented ACL repair and conservative treatment in the assessment of range of motion, while the patients with primary suture had a significantly greater loss of flexion than those in the other two treatment groups. Increasing age was not found to have a negative effect on either operative or conservative treatment. The results indicate that patients between the ages of 40 and 59 years can be treated successfully by ACL surgery.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004020050012
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  • 4
    Electronic Resource
    Electronic Resource
    Chondromyxoid fibroma of bone (2000)
    Springer
    Archives of orthopaedic and trauma surgery 120 (2000), S. 42-47 
    Details
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Chondromyxoid fibroma is a benign, although potentially aggressive tumor, with a cartilage-like matrix, accounting for approximately 1% of all bone tumors. It usually affects the metaphyseal region of long bones of patients in their first or second decade of life. An additional peak of incidence has been observed between 50 and 70 years of age. Three cases are presented here: 10-, 13-, and 52-year-old patients, with lesions in the proximal tibia, the proximal humerus, and the proximal femur, respectively. The literature is reviewed in terms of clinical behavior, diagnostic procedures, prognostic factors, treatment, and outcome. Preferred treatment is complete local excision with tumor-free margins. Intralesional curettage with or without local adjuvants shows a local recurrence rate of approximately 25%. Radiation therapy may be useful in nonresectable cases but bears the well documented risk of radiation-induced malignancies.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004020050009
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  • 5
    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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  • 6
    Electronic Resource
    Electronic Resource
    Malignant hemangiopericytoma of the bone (2000)
    Springer
    Langenbeck's archives of surgery 385 (2000), S. 207-212 
    Details
    ISSN: 1435-2451
    Keywords: Key words Hemangiopericytoma ; Bone neoplasms ; Diagnosis ; Therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Hemangiopericytoma is a rare vascular tumor of pericyte origin with variable malignant potential. Very rarely, this tumor occurs as a primary bone lesion. We present a case of a highly malignant hemangiopericytoma of the proximal tibia. Current therapy consists of radical resection of the tumor with postoperative radiation therapy being recommended. Chemotherapy seems to be useful in disseminated disease. The prognosis correlates to the histological grading of the tumor. Early or late recurrence and distant metastases with fatal outcome, as shown in our case study, are not uncommon.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004230050266
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