Reconstruction of the patella with an autogenous iliac graft: clinical and radiologic results in thirteen patients.

Purpose: Extension lag, quadriceps weakness and subluxation of the extensor apparatus are known complications of patellectomy. In the case of total knee joint replacement with a nonconstrained system an instability may be encountered. Reconstruction of the patella allows restoration of the moment arm to improve quadriceps leverage.

[Muscular torticollis].

Objective: Correction of malalignment of the cervical spine with the head tilted to the side of the shortened muscle and rotation to the opposite side due to a contract sternocleidomastoid muscle. Attainment of an increased range of motion of the cervical spine and a better cosmetic appearance. Regression of a facial asymmetry.

The effect of tourniquet release timing on perioperative blood loss in simultaneous bilateral cemented total knee arthroplasty: a prospective randomized study.

Today the use of pneumatic tourniquet is commonly accepted in total knee arthroplasty (TKA) to reduce perioperative blood loss. There are a few prospective randomised and nonrandomised studies that compare the effect of tourniquet release timing in cementless or cemented unilateral TKA. However, many of these studies show an inadequate reporting and methodology.

The influence of nonanatomical insertion and incongruence of meniscal transplants on the articular cartilage in an ovine model.

Background: Adequate size matching and anatomically correct positioning must be recognized as essential factors influencing the outcome of meniscal transplantation.

Hypothesis: Nonanatomical insertion and incongruence of meniscal transplants has an influence on the development of degenerative changes.

Study Design: Controlled laboratory study.

[Reconstruction of the medial patellofemoral ligament by tunnel transfer of the semitendinosus tendon].

Objective: Stabilization of the patella by reconstruction of the medial patellofemoral ligament.

Indications: Chronic recurrent lateral dislocation or subluxation of the patella. Habitual lateral dislocation of the patella.

Twenty-year results of combined meniscal allograft transplantation, anterior cruciate ligament reconstruction and advancement of the medial collateral ligament.

The purpose of this study was to determine the objective and subjective long-term outcomes of the first free meniscal allograft transplantations in five patients with complete absence or non-repairable lesion of the medial meniscus after 20 years. Between 1984 and 1986 five patients underwent concomitant medial meniscal transplantation with a deep frozen meniscal allograft, ACL reconstruction and femoral advancement or temporary detachment of the MCL. The clinical outcome of the patients was evaluated 20 years postoperatively using clinical assessment, Lysholm-score, KOOS, IKDC-score, radiographs and magnetic resonance imaging.

Dynamic measurement of patellofemoral contact pressure following reconstruction of the medial patellofemoral ligament: an in vitro study.

Background: Surgical reconstruction of the medial patellofemoral ligament used to stabilize the patella against lateral dislocation may concomitantly produce alteration of the patellofemoral contact pressure distribution. Two different tendon transfer techniques of reconstructing the medial patellofemoral ligament, one dynamic and one static, as well as a proximal soft tissue realignment of the patella were investigated.

Methods: Eight human knee specimens were mounted in a kinematic knee simulator and isokinetic extension motion was simulated.

Influence of an infrapatellar fat pad edema on patellofemoral biomechanics and knee kinematics: a possible relation to the anterior knee pain syndrome.

Introduction: An edema of the infrapatellar fat pad following knee arthroscopy or in case of chronic anterior knee pain syndrome is suspected to increase the patellofemoral pressure by a modification of the patellofemoral glide mechanism. The study was performed to evaluate this hypothesis.

Materials And Methods: Isokinetic knee extension from 120 degrees of flexion to full extension was simulated on 10 human knee cadaver specimens (six males, four females, average age at death 42 years) using a knee kinemator.

In vitro measurement of patellar kinematics following reconstruction of the medial patellofemoral ligament.

This study compares the effects of two different techniques of medial patellofemoral ligament (MPFL) reconstruction, and proximal soft tissue realignment on patellar stabilization against lateral dislocation. Eight human cadaver knee specimens with no radiological pathomorpholgy on a straight lateral view, contributing to patellofemoral instability, were mounted in a kinematic knee simulator and isokinetic extension was simulated. Patellar kinematics were measured with an ultrasound positioning system (zebris) while a 100 N laterally directed force was applied to the patella.

Improved implantation technique for resurfacing arthroplasty of the hip.

Objective: Prevention of incorrect positioning of the surface replacement, whereby the center of the femoral head for the implantation of the replacement surface is ascertained by central drilling of the femoral neck under image intensifier control.

Indications: An arthritically damaged, but not too severely deformed femoral head that can be reamed without injuring the femoral neck.

Contraindications: Hip ankylosis.

In vitro investigation of the effect of medial patellofemoral ligament reconstruction and medial tibial tuberosity transfer on lateral patellar stability.

Purpose: Two different operative techniques for stabilizing the patella against lateral displacement movement were investigated.

Type Of Study: In vitro experimental study.

Methods: Five human cadaver knee specimens with a normal Q-angle were mounted in a kinematic knee simulator and investigated under simulated isokinetic extension motions.

The popliteal cyst.

A popliteal cyst, originally called Baker's cyst, is a synovial fluid-filled mass located in the popliteal fossa. The most common synovial popliteal cyst is considered to be a distension of the bursa located beneath the medial head of the gastrocnemius muscle. Usually, in an adult patient, an underlying intra-articular disorder is present.

Distribution of substance-P nerves inside the infrapatellar fat pad and the adjacent synovial tissue: a neurohistological approach to anterior knee pain syndrome.

Introduction: The purpose of the study was to determine the distribution and number of nerves inside the infrapatellar fat pad and the adjacent synovium, in particular with regards to nociceptive substance-P nerves.

Materials And Methods: The infrapatellar fat pad of the knee was resected from 21 patients (4 male, 17 female, mean age 69 years) during the course of standard total knee arthroplasty operations performed in our clinic. The fat pad was dissected into five standardized segments, fixed in formalin and embedded in paraffin.

Infrapatellar fat pad pressure and volume changes of the anterior compartment during knee motion: possible clinical consequences to the anterior knee pain syndrome.

This biomechanical study was performed to measure tissue pressure in the infrapatellar fat pad and the volume changes of the anterior knee compartment during knee flexion-extension motion. Knee motion from 120 degrees of flexion to full extension was simulated on ten fresh frozen human knee specimens (six from males, four from females, average age 44 years) using a hydraulic kinematic simulator (30, 40, and 50 Nm extension moment). Infrapatellar tissue pressure was measured using a closed cell sensor.

Primary stability of shoulder arthrodesis using cannulated cancellous screws.

There are no biomechanical studies available concerned with the primary stability of shoulder arthrodesis. The aim of our biomechanical investigations was to ascertain a minimal material combination with high primary stability for shoulder arthrodesis. For that purpose, the primary stability of 6 different forms of screw arthrodesis was investigated under the stress of abduction, adduction, anteversion, and retroversion.

Shoulder arthrodesis: indications, technique, results, and complications.

Complications after shoulder arthrodesis are frequent. Through results and comparisons with the literature, the presented article analyzes the correlation of complications with the specific operative techniques, indications, and postoperative treatment. Between 1964 and 2001, a total of 43 cases of shoulder arthrodesis (13 screw and 30 plate arthrodeses) were performed and then analyzed after a mean of 6.

Biomechanical and kinematic influences of a total infrapatellar fat pad resection on the knee.

Background: This biomechanical study was performed to evaluate the consequences of total infrapatellar fat pad resection on knee kinematics and patellar contact pressure.

Hypothesis: Resection of the infrapatellar fat pad produces significant changes in knee kinematics and patellar contact pressure.

Study Design: Biomechanical cadaveric study.

Reconstructive operations for the upper limb after brachial plexus palsy.

Limited function due to paralysis following brachial plexus lesions can be improved by secondary operations of the bony and soft tissue. Between April 1994 and December 2000, 109 patients suffering from arm-plexus lesions underwent a total of 144 reconstructive operations guided by our concept of integrated therapy. The average age at the time of surgery was 32 years (range: 15-59).

Clinical results of arthroscopic meniscal repair using biodegradable screws.

This study was performed to assess the clinical results of meniscus refixation using biodegradable Clearfix meniscal screws. Between July 1999 and June 2001 this technique was performed on 65 patients, of whom 60 (27 women, 33 men; 92%) were followed up by clinical examination after an average of 18 months (range 8-34). The average age of the patients at the time of surgery was 30 years (15-58).

The influence of limited postoperative weight-bearing on the outcome of drilling in osteochondritis dissecans tali.

Introduction: This prospective study was performed to assess the influence of limited weight-bearing on the outcome of osteochondral drilling in the treatment of an osteochondritis dissecans tali.

Materials And Methods: Of a total of 85 patients, 68 (80%; 37 male, 31 female, average age 28 years) were followed up after open or arthroscopic drilling between July 1990 and March 2000. The total outcome of 6 weeks limited postoperative weight-bearing (n=26) was compared with the outcome of 12 weeks limited weight-bearing (n=42).

The current state of meniscal allograft transplantation and replacement.

This review details current efforts to transplant or to replace a meniscus. Different substitutes for meniscal transplantation or replacement have been used with varying experimental and clinical success. Meniscal transplantation emerges as a useful option for selected patients with a stable knee and appropriate alignment.

Osteotomy of the humerus to improve external rotation in nine patients with brachial plexus palsy.

Malfunction of the infraspinatus muscle and teres minor muscle illustrate the typical clinical picture in patients with brachial plexus palsy. The arm hangs down in an inwardly rotated position and elbow flexion is hindered by striking of the lower arm against the thorax. Between 1995 and 2000, we have done external rotational osteotomy of the humerus for nine patients with brachial plexus palsy.