High prevalence of hip arthrosis in former elite javelin throwers and high jumpers: 41 athletes examined more than 10 years after retirement from competitive sports.

We studied the occurrence of hip arthrosis in 19 former elite javelin throwers and 22 former elite high jumpers 10 years or more after their retirement from competitive sports. Any restriction in the activities of daily living was assessed with an ADL-questionnaire. We compared the radiographic findings with male, age- and body mass index-matched controls (non-athletes).

Analysis of injuries in long-distance triathletes.

Triathlon is an individual sport consisting of three disciplines - swimming, cycling and running. Triathlon has changed from a novel appearance to a very popular Olympic sport within the last fifteen years. Nevertheless, there is not sufficient data about injuries in triathlon.

Degenerative changes in the ankle in former elite high jumpers.

Objective: The object of this study was to find what degenerative changes are present in the ankle (talotibiofibular) joints in former elite high jumpers at least 10 years after their retirement from competition, whether there are differences between takeoff and swinging leg, and whether correlations between any particular training history parameters, former injuries, and the degenerative changes can be recognized.

Design: A cross-sectional case control study with matched controls for radiological outcomes

Setting: The Orthopedic Department at the University of Heidelberg, Germany.

Participants: The subjects were 40 male high jumpers (required personal best at least 2.

Sports activity of patients with idiopathic scoliosis at long-term follow-up.

Objective: The aim of the study was to assess long-term the sports activities of operatively and nonoperatively treated patients with idiopathic scoliosis and compare these activities with those of controls.

Study Design: Cross-sectional case-control study, performed at The Orthopaedic University Hospital Heidelberg.

Patients And Methods: The study enrolled 59 patients (53 female, 6 male; mean age 43 years) with idiopathic scoliosis and a minimum follow-up of 5 years (mean 22 years) since treatment (28 nonoperative, 31 operative).

[Acupuncture treatment of low back pain].

Objectives: This prospective, non-controlled pilot-study examines the potential benefit of acupuncture in patients with low back pain and radicular symptoms.

Methods: 60 patients with low back pain and lumbar disc herniation diagnosed by magnetic resonance imaging or computed tomography were treated by acupuncture. Pain intensity was assessed before and after treatment on a 100 mm visual analogue scale.

The effect of spinal fusion on the long-term outcome of idiopathic scoliosis. A case-control study.

We have investigated the effect of multisegmental spinal fusion on the long-term functional and radiological outcome in patients with scoliosis. We compared these patients both with those whose spine had not been fused, and with a control group. We studied 68 patients with idiopathic scoliosis (34 operative and 34 non-operative) who had been followed up for a minimum of five years after treatment.

Comparison of results of core decompression and intertrochanteric osteotomy for nontraumatic osteonecrosis of the femoral head using Cox regression and survivorship analysis.

Different surgical procedures have been recommended for osteonecrosis of the femoral head to prevent or delay the need for arthroplasty. Core decompression is a commonly used treatment in the early stages of the disease, but the published efficacy has varied markedly. Only a few comparisons of different techniques have been reported.

Dependency of cement mantle thickness on femoral stem design and centralizer.

Deficient cement mantles may be detrimental with regard to long-term outcome of cemented femoral stems. We performed a cadaver study on 48 left femora with 4 different stem designs (1 anatomic, 3 straight) to study the influence of stem design, centralizer, and femur type on cement mantle thickness. A radiographic and microradiograhic analysis was done.

Long term changes of the throwing arm of former elite javelin throwers.

The aim of this study was to determine long term changes in shoulder and elbow joints of former elite javelin throwers. Twenty-one elite javelin throwers were examined at an average of 19 years after the end of their high performance phase. Mean age at examination was 50 years.

Long-term review of the lumbar spine in javelin throwers.

We studied 21 former top-class competitive javelin throwers to investigate radiological and clinical symptoms in the lumbar spine many years after the end of their athletic careers. The athletes underwent clinical and radiological examinations at an average of 20 years after retiring from athletics. The Hannover questionnaire was used to evaluate functional restrictions in daily living.

Surgical management of paralytic scoliosis in myelomeningocele.

A retrospective analysis of 54 patients with paralytic scoliosis due to myelomeningocele, who underwent surgical treatment, was performed. The aim of this study was to compare different surgical techniques and to identify clinical parameters influencing primary and midterm results. Three surgical techniques were used: 1) group I, posterior fusion/instrumentation; 2) group II, anterior fusion/no instrumentation combined with posterior fusion/instrumentation; and 3) group III, anterior and posterior fusion/instrumentation.

Influence of extracorporeal irradiation on the reintegration of autologous grafts of bone and joint. Study in a canine model.

We studied the effects of irradiation on the reintegration of autologous osteoarticular grafts over a period of 24 weeks in a canine model. In 16 foxhounds the medial femoral condyle was resected, irradiated and immediately replanted. In the control group resection and replantation were performed without irradiation.

Epidural corticosteroid injection in the conservative management of sciatica.

In this prospective randomized clinical trial, the results of epidural corticosteroid injections were evaluated in patients with lumbosciatic pain caused by herniated nucleus pulposus. Thirty-six patients with radicular lumbosciatic pain and positive straight leg raising test because of confirmed prolapsed intervertebral lumbar discs were randomized into two groups with (17 patients) and without (19 patients) epidural corticosteroid injection. Members of the treatment groups received three injections of 100 mg methylprednisolone in 10 mL bupivacaine 0.

[Effect of extracorporeal shockwave administration on biological behavior of bone cells in vitro].

Aim: Osteo-destructive effects as well as stimulation of bone growth are often described after extracorporeal shock-wave application (ESWA). A correlation between the applicated energy and outcome is assumed. The purpose of this study was to analyze, whether ESWA has an influence on growth and proliferation of bone cells in vitro.

Core decompression in osteonecrosis of the femoral head: risk-factor-dependent outcome evaluation using survivorship analysis.

The results of core decompression of the femoral head in the treatment of osteonecrosis are analyzed. This study includes 94 hips in 74 patients with a follow-up time ranging between 18 months and 15 years (average 6 years). There had been no need for further surgery 2 years postoperatively in 85% of the hips with preoperative Steinberg stages 0, I and II when compared with 66% with preoperative stages III, IV and V.

Loss of laminin and of the laminin receptor integrin subunit alpha 6 in situ correlates with cytokine induced down regulation of alpha 6 on fibroblast-like synoviocytes from rheumatoid arthritis.

Objective: To investigate in situ the expression of the integrin receptor subunits alpha 6 and beta 1 and the distribution of the ligand laminin in the synovia from osteoarthritis (OA) and rheumatoid arthritis (RA) patients and to study the effect of cytokines and antirheumatic drugs on the expression of the alpha 6 and beta 1 integrin subunits on long term cultures of fibroblast-like synoviocytes (FBS) derived from OA and RA.

Methods: The expression of the alpha 6 and beta 1 integrin subunits and the distribution of laminin were examined immunohistochemically in normal synovia and in synovia from patients with OA and RA. The effect of proinflammatory cytokines (IL1 beta and TNF alpha), and of antirheumatic drugs (salicylic acid, dexamethasone, and methotrexate) on the alpha 6 and beta 1 expression of cultured normal FBS and FBS from patients with OA and RA was determined by flow cytometry.

[Effectiveness of intra-articular application of hyaluronic acid on early forms of femoropatellar arthrosis--an experimental study in dogs].

Purpose: We investigated the effects of intraarticularly applied hyaluronic acid on the cartilage-integrity with early-forms of retropatellar cartilage degeneration (chondromalacia patellae) in dogs.

Methods: We used the Pond-Nuki model (tenotomy and resection of the anterior cruciate ligament = ACL) in 27 dogs (foxhounds) (3 groups of 9 animals) PILOT STUDY: ACL-tenotomy and resection, no therapy, specimens retrieval after 3, 6, 12 weeks (3 animals each period). VERUM: ACL-tenotomy and resection, hyaluronic acid (start after 3, 6, 12 weeks), 5 injections in 4 weeks, specimens retrieval after 5 weeks following final injection (12, 15, 21 weeks postoperatively, 3 dogs each period).

Increased urinary crosslink levels in aseptic loosening of total hip arthroplasty.

The diagnosis of aseptic loosening in total hip arthroplasty is predominantly based on clinical and radiographic evaluation. Loosening is usually associated with increased bone resorption at the interface. In this study we wanted to evaluate the diagnostic value of bone markers in aseptic loosening.

[Cementless hip prosthesis in inflammatory rheumatic diseases].

We compared the outcome of cementless hip arthroplasty in patients with chronic rheumatic diseases (cases) and patients with osteoarthritis (controls). Between 1985 and 1993 we implanted 26 cementless hips in 22 patients with Rheumatoid Arthritis, Psoriatic Arthritis or Ankylosing Spondylitis. From a pool of more than 600 patients with Osteoarthritis we chose 40 matched controls (41 hips).

[Biometric planning of clinical-orthopedic studies. The optimal test].

A determinant for the evidence of a clinical trial is the magnitude of the sample size. The proper sample size can be easily computed with the knowledge of alpha, power and effect size. Standard values for alpha and power in clinical trials are 5% and 90%, respectively.

[Diagnosis of hip prosthesis loosening--sensitivity of clinical parameters].

Aim: In order to establish a strategy for early diagnosis of aseptic loosening of total hip arthroplasty (THA) physical examination, patient's assessment and radiographs were analysed.

Method: Pain, self assessment, physical examination and mobility were examined according to a standard examination protocol in 428 hips of 297 patients after cementless total hip arthroplasty (THA). These findings were compared with the radiographic finding of the hip.

[Use of new biochemical markers in diagnosis of aseptic hip endoprosthesis loosening].

Aseptic loosening of endoprosthesis is the most important problem in total hip arthroplasty. The diagnosis of aseptic loosening is based on anamnesis, the clinical findings, the radiography and scintigraphy. Despite the multitude of diagnostic possibilities it is still a problem to get an exact and early diagnosis.

Middle-term results of threaded acetabular cups. High failure rates five years after surgery.

We report our results using three different threaded acetabular components (Mecring A, Mecring B and Weill) in 715 hips with a follow-up of between one and ten years (median: 99.1, 56.5, 38.

Development of pathological lumbar kyphosis in myelomeningocele.

We analysed the cases of lumbar kyphosis in 151 (21%) of a series of 719 patients with myelomeningocele. Three different types were distinguished: paralytic, sharp-angled and congenital. In a cross-sectional and partly longitudinal study the size and magnitude of the kyphosis, the apex of the curve and the level of paralysis of each group were recorded and statistically analysed.