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  • 1
    Online Resource
    Online Resource
    Georg Thieme Verlag KG ; 2021
    In:  Zeitschrift für Orthopädie und Unfallchirurgie Vol. 159, No. 04 ( 2021-08), p. 459-475
    In: Zeitschrift für Orthopädie und Unfallchirurgie, Georg Thieme Verlag KG, Vol. 159, No. 04 ( 2021-08), p. 459-475
    Abstract: Fokale Knorpelschäden gehen mit Schwellung, Funktionsverlust der betroffenen Gelenke und starker Schmerzsymptomatik einher. Zudem werden sie mit der Entstehung einer späteren Arthrose in Verbindung gebracht. Oftmals betroffen sind hierbei junge, sportlich aktive Patienten, die einen hohen funktionellen Anspruch haben. Die Behandlungsmöglichkeiten des Orthopäden in Bezug auf knorpelregenerative Therapiemöglichkeiten an Knie, Hüfte, Schulter, Ellenbogen und Sprunggelenk sind mannigfaltig.
    Type of Medium: Online Resource
    ISSN: 1864-6697 , 1864-6743
    Language: German
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2021
    detail.hit.zdb_id: 2280747-0
    detail.hit.zdb_id: 2304338-6
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  • 2
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2023
    In:  Archives of Orthopaedic and Trauma Surgery Vol. 143, No. 8 ( 2023-02-27), p. 5199-5206
    In: Archives of Orthopaedic and Trauma Surgery, Springer Science and Business Media LLC, Vol. 143, No. 8 ( 2023-02-27), p. 5199-5206
    Abstract: Posterior lateral meniscus root (PLMR) tears are injuries that commonly occur together with anterior cruciate ligament (ACL) tears. The aim of this study was to evaluate the clinical and radiological outcome of PLMR repair accompanying ACL reconstruction. Specifically, PLMR healing rates, meniscal extrusion behavior and their influence on patient-reported outcome measures (PROMs) were analyzed. It was hypothesized that PLMR repair shows satisfactory healing rates and coronal meniscal extrusion does not increase significantly following PLMR repair. Methods Patients that underwent PLMR repair between 2014 and 2019 were evaluated at least 12 months postoperatively. At follow-up, magnetic resonance imaging (MRI) was performed in order to evaluate the PLMR healing behavior (complete vs. partial vs. no healing) as well as the coronal and sagittal meniscal extrusion in comparison with the preoperative MRI. Additionally, patient-reported outcome measures (PROMs; Lysholm score, International Knee Documentation Committee subjective knee form [IKDC]) were compiled. Pre- and postoperative meniscal extrusion were tested for statistical significance using the paired t test. The Kruskal–Wallis test was used to compare extrusion values and PROMs in relation to different healing states. A correlation analysis was conducted using the Pearson correlation coefficient between differences in meniscal extrusion and PROMs. Results Out of 25 patients, 18 patients (72.0%; 11 male and seven female) were available for final assessment at a mean follow-up of 40.8 ± SD 17.5 months. One revision PLMR repair was performed five months after the initial repair. In 14 cases (77.8%), healing of the lateral meniscus was observed (6 × complete, 8 × partial). Coronal extrusion of the lateral meniscus did not increase significantly following PLMR repair (2.0 ± 1.5 mm vs. 2.1 ± 1.3 mm ; p  = 0.645). Sagittal extrusion increased significantly (25.7 ± 2.4 mm vs. 27.0 ± 1.4 mm ; p   〈  0.001). The healing status of the PLMR showed no significant association with meniscal extrusion or PROMs ( p   〉  0.05). But a higher increase in coronal meniscal extrusion negatively affected PROMs (Lysholm score: p  = 0.046, r  = − 0.475; IKDC: p  = 0.003, r  = − 0.651). Conclusion High healing rates of the PLMR and no significant increase in coronal extrusion may be expected following combined PLMR repair and ACL reconstruction. But a greater increase in postoperative coronal meniscal extrusion correlates with less favorable clinical results. A greater increase in sagittal extrusion was observed, but this did not influence the clinical outcome. Level of evidence Retrospective Case Series; IV.
    Type of Medium: Online Resource
    ISSN: 1434-3916
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 1458452-9
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  • 3
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2021
    In:  Der Chirurg Vol. 92, No. 10 ( 2021-10), p. 904-906
    In: Der Chirurg, Springer Science and Business Media LLC, Vol. 92, No. 10 ( 2021-10), p. 904-906
    Type of Medium: Online Resource
    ISSN: 0009-4722 , 1433-0385
    RVK:
    Language: German
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 3120893-9
    detail.hit.zdb_id: 1458505-4
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  • 4
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2021
    In:  Der Unfallchirurg Vol. 124, No. 11 ( 2021-11), p. 951-956
    In: Der Unfallchirurg, Springer Science and Business Media LLC, Vol. 124, No. 11 ( 2021-11), p. 951-956
    Abstract: Rupture of the pectoralis major muscle (PMR) is a rare injury that occurs primarily during strength training. The case of a 31-year-old professional basketball player who suffered a rupture of the pectoralis major muscle (PM) at the myotendinous junction while performing bench presses is presented. Due to persistent pain and decreased muscle function, surgery was performed 3 weeks after the initial trauma. The patient returned to playing basketball pain-free with full range of motion 3 months following refixation of the PM. This article discusses the distinct characteristics of this injury in the context of the current literature and the operative approach is presented in detail.
    Type of Medium: Online Resource
    ISSN: 0177-5537 , 1433-044X
    Language: German
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 3120926-9
    detail.hit.zdb_id: 1461952-0
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  • 5
    In: Knee Surgery, Sports Traumatology, Arthroscopy, Springer Science and Business Media LLC, Vol. 30, No. 11 ( 2022-11), p. 3862-3870
    Abstract: To evaluate clinical outcomes as well as return to sports (RTS) and return to work (RTW) rates following anatomic lateral ankle ligament reconstruction with a tendon autograft for chronic lateral ankle instability (CLAI) in a high-risk population, and to compare these outcome parameters between patients having received a gracilis tendon autograft (GT) and free split peroneus brevis tendon (PBT) autograft. Methods Twenty-eight consecutive patients, who were diagnosed with CLAI, presenting with ≥ 1 risk factor (ligamentous hyperlaxity, insufficient substance of native ligament and/or high-demand athlete), who underwent ankle ligament reconstruction with a tendon autograft between January 2011 and December 2018, were included in this retrospective study. At 63.7 ± 28.0 months (24–112), 23 patients with a mean age of 29.7 ± 10.9 years were available for follow-up. The Karlsson Score, the Foot and Ankle Outcome Score (FAOS), the Tegner Activity Scale and the visual analog scale (VAS) for pain were collected at a minimum follow-up of 24 months. RTS and RTW were evaluated by questionnaire. A subgroup analysis with regard to the graft used for ankle ligament reconstruction (GT versus PBT) was performed. Results Patients reported a Karlsson score of 82.1 ± 17.5 (37–100), a FAOS score of 87.8 ± 8.4 (73–99), a median Tegner activity scale of 5.0 (IQR 4–6) and a VAS for pain of 0.5 ± 0.9 (0–4) at rest and of 2.0 ± 2.1 (0–7) during activities at final follow-up. Postoperatively, 96% of patients had returned to sports after 8.3 ± 6.2 months. All patients (100%) had returned to work at 3.5 ± 5.7 (0–24) months, with 87% reporting an equal or improved working ability compared to that preoperatively. Postoperatively, exercise hours per week were significantly reduced compared to preoperatively in patients with a split PBT ( n  = 12; 13.0 ± 12.9 to 5.6 ± 6.4 h, p  = 0.038) autograft as opposed to patients with a GT autograft ( n  = 11; 13.1 ± 8.7 to 12.4 ± 7.1 h, n.s.). No other group differences were observed. Conclusion Good patient-reported outcomes as well as excellent RTS and RTW rates can be achieved in high-risk patients undergoing ankle ligament reconstruction with a tendon autograft for CLAI. These results may be helpful in preoperatively managing patients’ expectations regarding sports- and work-related outcomes and provide tangible data on the expectable time frame of the individual return to sports and work trajectory. Level of evidence IV.
    Type of Medium: Online Resource
    ISSN: 0942-2056 , 1433-7347
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 1473170-8
    SSG: 31
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  • 6
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2022
    In:  Operative Orthopädie und Traumatologie Vol. 34, No. 1 ( 2022-02), p. 45-54
    In: Operative Orthopädie und Traumatologie, Springer Science and Business Media LLC, Vol. 34, No. 1 ( 2022-02), p. 45-54
    Type of Medium: Online Resource
    ISSN: 0934-6694 , 1439-0981
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2001071-0
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  • 7
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2023
    In:  European Journal of Orthopaedic Surgery & Traumatology Vol. 33, No. 8 ( 2023-05-26), p. 3569-3576
    In: European Journal of Orthopaedic Surgery & Traumatology, Springer Science and Business Media LLC, Vol. 33, No. 8 ( 2023-05-26), p. 3569-3576
    Abstract: Patellar tendon ruptures (PTR) occur predominantly in middle-aged patients following indirect trauma. The aim of this study was to quantify the short-term results using a suture tape augmentation technique for the repair of PTR. Methods All consecutive patients with acute ( 〈 6 weeks) PTR who underwent suture tape augmentation between 03/2014 and 11/2019 at a single institution with a minimum follow-up of 12 months were retrospectively evaluated. Outcome measures included Visual Analog Scale (VAS) for pain, Tegner Activity Scale (TAS) and return to sport rates, Lysholm score, International Knee Documentation Committee subjective knee form (IKDC) as well as Knee Injury and Osteoarthritis Outcome Score (KOOS). Additionally, a standardized clinical examination and an isometric strength evaluation of knee extension and flexion were performed. It was hypothesized that high return to sport rates and good functional outcome would be observed and that the majority of patients would not present with a severe ( 〉 20%) knee extension strength deficit when compared to the contralateral side. Results A total of 7 patients (mean age 37.0 ± SD 13.5 years; 6 male/1 female) were available for final assessment at a median follow-up of 17.0 (25–75% IQR 16.0–77.0) months. Three injuries occurred during ball sports, two injuries occurred during winter sports, and one injury each occurred during a motorcycling and skateboarding accident. The average time between trauma and surgery was 4.7 ± 2.6 days. At follow-up, patients reported little pain (VAS: 0 [0–0.4]). Return to sport was possible for all patients 8.9 ± 4.0 months postoperatively at a high level (TAS: 7.0 [6.0–7.0] ). Five patients (71.4%) returned to the preinjury level of play, and 2 (28.6%) did not return to the preinjury level of play. Patient-reported outcome measures were moderate to good (Lysholm score: 80.4 ± 14.5; IKDC: 84.2 ± 10.6; KOOS subscales: pain 95.6 ± 6.0, symptoms 81.1 [64.9–89.1], activities of daily living 98.5 [94.1–100] , sport and recreation function 82.9 ± 14.1 and knee-related quality of life 75.9 ± 16.3). All patients were very satisfied (57.1%) or satisfied (42.9%) with the postoperative result. No postoperative complications were reported. Strength measurements revealed a severe knee extension deficit in 3 patients (42.9%), but no significant deficit of isometric knee extension or flexion strength in comparison with the contralateral side was observed overall ( p 〉 0.05). Conclusion Suture tape augmentation in acute PTR repair leads to good functional outcome without major complications. Although a severe knee extension strength deficit may occur in some patients postoperatively, an excellent return to sports rate and high patient satisfaction can be expected nonetheless. Level of evidence Retrospective cohort study; III.
    Type of Medium: Online Resource
    ISSN: 1432-1068
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 1478935-8
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  • 8
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2022
    In:  European Journal of Orthopaedic Surgery & Traumatology Vol. 33, No. 4 ( 2022-02-09), p. 869-875
    In: European Journal of Orthopaedic Surgery & Traumatology, Springer Science and Business Media LLC, Vol. 33, No. 4 ( 2022-02-09), p. 869-875
    Abstract: Quadriceps tendon ruptures (QTR) occur predominantly in middle-aged patients through violent eccentric contraction that occurs either when trying to regain balance or during a fall on the hyperflexed knee. The aim of this study was to quantify midterm postoperative results, including strength potential measured via standardized strength tests following acute ( 〈  six weeks) quadriceps tendon refixation using suture anchors. Methods All consecutive patients with QTR who underwent surgical suture anchor refixation between 2012 and 2019 at a single institution with a minimum follow-up of 12 months were retrospectively evaluated. Outcome measures included Tegner Activity Scale (TAS), Lysholm score, International Knee Documentation Committee subjective knee form (IKDC), Knee injury and Osteoarthritis Outcome Score (KOOS) subscales, return to work rates, and Visual Analog Scale (VAS) for pain. Additionally, a standardized clinical examination and an isometric strength assessment of knee extension and flexion were performed. Results A total of 17 patients (median age 61.0 [25–75% IQR 50.5–72.5]) were available for final assessment at a mean follow-up of 47.1 ± SD 25.4 months. The majority of patients were male (82.4%) and most injuries occurred due to a fall on the hyperflexed knee (76.5%). The average time interval between trauma and surgery was 12.7 ± 7.5 days. Patients achieved a moderate level of activity postoperatively with a median TAS of 4 (3–5.5) and reported good to excellent outcome scores (Lysholm score: 97 (86.5–100); IKDC: 80.7 ± 13.5; KOOS subscales: pain 97.2 (93.1–100), symptoms 92.9 (82.5–100), activities of daily living 97.1 (93.4–100), sport and recreation function 80 (40–97.5) and knee-related quality of life 87.5 (62.5–100). All patients were able to fully return to work and reported little pain [VAS: 0 (0–0)] . No postoperative complications were reported. Strength measurements revealed a significant deficit of knee extension strength in comparison to the contralateral side ( p  = 0.011). Conclusion Suture anchor refixation of acute QTR leads to good functional results and high patient satisfaction without major complications. Isometric knee extension strength, however, may not be fully restored compared to the unaffected side.
    Type of Medium: Online Resource
    ISSN: 1432-1068
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 1478935-8
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  • 9
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2022
    In:  Archives of Orthopaedic and Trauma Surgery Vol. 143, No. 6 ( 2022-11-22), p. 3271-3278
    In: Archives of Orthopaedic and Trauma Surgery, Springer Science and Business Media LLC, Vol. 143, No. 6 ( 2022-11-22), p. 3271-3278
    Abstract: The aim of this study was to retrospectively evaluate the clinical outcome of double intramedullary all-suture anchors’ fixation for distal biceps tendon ruptures. Materials and methods A retrospective case series of patients who underwent primary distal biceps tendon repair with all-suture anchors was conducted. Functional outcome was assessed at a minimum follow-up of at 12 months based on the assessments of the Mayo Elbow Performance Score (MEPS), Andrews–Carson Score (ACS), Quick Disabilities of the Arm, Shoulder, and Hand questionnaire (QuickDASH), and the Visual Analog Scale (VAS) for pain. Maximum isometric strength test for flexion and supination as well as postoperative range of motion (ROM) were determined for both arms. Results 23 patients treated with all-suture anchors were assessed at follow-up survey (mean age 56.5 ± 11.4 years, 96% male). The follow-up time was 20 months (range Q 0.25 – Q 0.75 , 15–23 months). The following outcome results were obtained: MEPS 100 (range Q 0.25 – Q 0.75 , 100–100); ACS 200 (range Q 0.25 – Q 0.75 , 195–200); QuickDASH 31 (range Q 0.25 – Q 0.75 , 30–31); VAS 0 (range Q 0.25 – Q 0.75 , 0–0). The mean strength compared to the uninjured side was 95.6% (range Q 0.25 – Q 0.75 , 80.9–104%) for flexion and 91.8 ± 11.6% for supination. There was no significant difference in ROM or strength compared to the uninjured side and no complications were observed in any patient. Conclusion Distal biceps tendon refixation using all-suture anchors provides good-to-excellent results in terms of patient-reported and functional outcome. This repair technique appears to be a viable surgical option, although further long-term results are needed. Level of evidence Level IV (case series)
    Type of Medium: Online Resource
    ISSN: 1434-3916
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 1458452-9
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  • 10
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2021
    In:  Archives of Orthopaedic and Trauma Surgery Vol. 142, No. 9 ( 2021-10-18), p. 2263-2270
    In: Archives of Orthopaedic and Trauma Surgery, Springer Science and Business Media LLC, Vol. 142, No. 9 ( 2021-10-18), p. 2263-2270
    Abstract: Proximal rectus femoris avulsions (PRFA) are relatively rare injuries that occur predominantly among young soccer players. The aim of this study was to evaluate midterm postoperative results including strength potential via standardized strength measurements after proximal rectus femoris tendon refixation. It was hypothesized that the majority of competitive athletes return to competition (RTC) after refixation of the rectus femoris tendon without significant strength or functional deficits compared to the contralateral side. Methods Patients with an acute ( 〈  6 weeks) PRFA who underwent surgical refixation between 2012 and 2019 with a minimum follow-up of 12 months were evaluated. The outcome measures compiled were the median Tegner Activity Scale (TAS) and mean RTC time frames, Harris Hip Score (HHS), Hip and Groin Outcome Score (HAGOS) subscales, International Hip Outcome Tool-33 (iHOT-33), and Visual Analog Scale (VAS) for pain. In addition, a standardized isometric strength assessment of knee flexion, knee extension, and hip flexion was performed to evaluate the functional result of the injured limb in comparison to the uninjured side. Results Out of 20 patients, 16 (80%) patients were available for final assessment at a mean follow-up of 44.8 ± SD 28.9 months. All patients were male with 87.5% sustaining injuries while playing soccer. The average time interval between trauma and surgery was 18.4 ± 8.5 days. RTC was possible for 14 out of 15 previously competitive athletes (93.3%) at a mean 10.5 ± 3.4 months after trauma. Patients achieved a high level of activity postoperatively with a median (interquartile range) TAS of 9 (7–9) and reported good to excellent outcome scores (HHS: 100 (96–100); HAGOS: symptoms 94.6 (89.3–100), pain 97.5 (92.5–100), function in daily living 100 (95–100), function in sport and recreation 98.4 (87.5–100), participation in physical activities 100 (87.5–100), quality of life 83.1 ± 15.6; iHot-33: 95.1 (81.6–99.8)). No postoperative complications were reported. Range of motion, isometric knee flexion and extension, as well as hip flexion strength levels were not statistically different between the affected and contralateral legs. The majority of patients were “very satisfied” (56.3%) or “satisfied” (37.5%) with the postoperative result and reported little pain (VAS 0 (0–0.5)). Conclusion Surgical treatment of acute PRFA yields excellent postoperative results in a young and highly active cohort. Hip flexion and knee extension strength was restored fully without major surgical complications. Level of evidence Retrospective cohort study; III.
    Type of Medium: Online Resource
    ISSN: 1434-3916
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 1458452-9
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