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DerOrthopaede.70260606.eng.abstr
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DerOrthopaede.70260606.eng.abstr
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"Neurotization procedures represent an important therapeutic option in patients with complete root avulsion due to traumatic brachial plexus injuries . A variety of normal donor nerves can be used , including intercostal nerves , accessory nerve , parts of the cervical plexus , phrenic nerve , and/or the contralateral C7 nerve root . The reconstructive neurotization procedure should be performed within 3-6 months following the trauma and , when successful , can lead to substantial improvement in motor function for the shoulder and upper arm and in sensory function for the forearm , hand and finger region . Neurotization can also be combined with neurolysis and/or transplantation to restore upper limb motor and sensory function in order to achieve greater therapeutic benefit for patients with posttraumatic brachial plexus lesions ."
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DerOrthopaede.70260612.eng.abstr
|
DerOrthopaede.70260612.eng.abstr
|
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"Autologous transplantation in brachial plexus injuries has become significantly more efficacious through increased knowledge of the microtopographic anatomy of the fascicle structures and the refinement of microneurosurgical techniques . Recovery of shoulder and upper arm functions can be achieved with autologous transplantation in the majority of patients under optimized conditions . However , attempts to restore forearm , hand and finger functions in this way have been disappointing so far . Therapeutic success is primarily governed by early decision making , selection of adequate surgical strategies and intensive and longlasting postoperative management ."
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[] |
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DerOrthopaede.70260630.eng.abstr
|
DerOrthopaede.70260630.eng.abstr
|
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"type": "abstract",
"text": [
"After loss of active glenohumeral motion the arm cannot be positioned in space and function is impaired . Fusion of the glenohumeral joint creates a new platform for the movement of elbow , hand and fingers and leads to an improvement of function . The use of the reconstructive plate makes the operation easier . Shoulder fusion is especially suited if the function of elbow and hand is well preserved and if the patient is physically active . But fusion is definite and the options of muscle transfer operations and above elbow amputation have to be considered ."
],
"offsets": [
[
0,
564
]
]
}
] |
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},
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"id": "DerOrthopaede.70260630.eng.abstr-s3-t1",
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] |
[] |
[] |
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DerOrthopaede.70260634.eng.abstr
|
DerOrthopaede.70260634.eng.abstr
|
[
{
"id": "DerOrthopaede.70260634.eng.abstr-passage-0",
"type": "abstract",
"text": [
"In most cases the genesis of brachial plexus palsy is traumatic , often because of bike accidents . If physiotherapy and neurosurgical procedures such as nerve repair do not have the desired outcome , muscle transfer operations are possible . The results of our favored transfer of the trapezius muscle to compensate paralysis of the deltoid muscle will be presented . Preoperatively radiological , clinical and electromyographic examinations are necessary . Our results are based upon the clinical and radiological check ups and the subjective assessment of the patients . Thirty-one patients ( 7 female , 24 male ) underwent a trapezius transfer between March 1994 and December 1996. The average age was 29 years ( range 18-46 years ) . We performed the operations using a modification of Saha's technique . With the patient in lateral decubitus position and protection of the opposite plexus , a sagital skin incision is the first step , followed by the preparation of trapezius and deltoid muscle as well as the bony parts of the shoulder ( acromion , clavicle , scapular spine ) . The deltoid origin is cut from the lateral third of the clavicle , the acromion and the lateral half of the scapular spine . The next step is transection of the root of the acromion and the lateral clavicle . After elevation of the remaining trapezius insertions from the clavicle and scapular spine , the proximal humerus is exposured by splitting the partly detached deltoid muscle longitudinally . Then the acromion fragment and humerus are prepared for the bone-to-bone contact . In 90 ° of abduction the acromion fragment with its trapezius insertion is transferred and fixed to the humerus with two 4.5-mm screws . Finally the deltoid is sutured on the top of the trapezius and the skin is closed over two suction drains . Postoperatively we immobilize the operated arm in an abduction support for 6 weeks . The physiotherapy program starts on the first postoperative day with active training of elbow , hand and fingers and electrostimulation of the transferred trapezius muscle . Six weeks after the procedure we take an X-ray and start with progressive adduction of the arm . The preoperative subluxation of the humeral head was abolished in all cases . We achieved an average increase of active abduction from 7.3 ° ( range 0-45 ° ) preoperatively to 39.2 ° ( range 25 °-80 ° ) 1 year after the operation ; the increase of forward flexion was from 20 ° ( range 0 °-85 ° ) to 43 ° ( range 20 °-90 ° ) . All patients were satisfied with the improvement of stability and function of the operated shoulder . Finally we can conclude that the trapezius transfer for flail shoulder gives a satisfactory outcome regarding shoulder function and stability as well as the subjective situation of the patients ."
],
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0,
2795
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}
] |
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DerOrthopaede.70260643.eng.abstr
|
DerOrthopaede.70260643.eng.abstr
|
[
{
"id": "DerOrthopaede.70260643.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Elbow flexion plays a key role in the overall function of the upper extremity . In the case of unilateral complete brachial plexus lesion , restoration of elbow flexion will dramatically increase the patient's chances of regaining bimanual prehension . Furthermore , depending on the type of reconstruction , stability of the glenohumeral joint as well as some supination function of the forearm can be restored to a varying degree at the same time . Depending on the level of brachial plexus lesion and/or reinnervation , different reconstructive procedures are available . In order to select the best treatment option for the patient it is necessary to known the extent of the lesion of the brachial plexus and/or ventral upper arm muscles , to time the operation appropriately , to be aware of all treatment possibilities and to recall the special problems of tendon transfer for brachial plexus patients . Our concept is based on our experience with more than 1100 patients presenting a brachial plexus lesion between 1981 and 1996 and treated in our institution . There were 528 operative revisions of the brachial plexus . Some 225 patients underwent secondary muscle/tendon transfers . In 35 patients elbow flexion was reconstructed by bipolar latissimus dorsi transfer ( n = 10 ) , triceps-to-biceps transfer ( n = 15 ) , modified flexor/pronator muscle mass proximalization ( n = 6 ) and multiple-stage free functional muscle transfer after intercostal nerve transfer ( n = 4 ) ."
],
"offsets": [
[
0,
1488
]
]
}
] |
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DerOrthopaede.70260673.eng.abstr
|
DerOrthopaede.70260673.eng.abstr
|
[
{
"id": "DerOrthopaede.70260673.eng.abstr-passage-0",
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"text": [
"The aim of this electromyographic study was to evaluate the functional result of tendon transfers for radial palsy . Eighteen patients were compared to 16 healthy volunteers . The intramuscular emg of four muscles was recorded in parallel during extension-flexion movements of the wrist and fingers . The data were stored on FM tape and evaluated off-line . Contrary to expectations , transferred flexor muscles revealed only part of their overall emg activity during extension . Therefore , an \" extensor quota \" ( EQ ) was calculated for each muscle . It reflects its emg activity during extension as part of its entire emg activity . In non-transferred flexors EQ was low ( 11-27 % ) . High EQ values ( 69-91 % ) were seen in genuine extensors of healthy persons . In only 6 of 18 patients did transferred flexors show an EQ equivalent to genuine extensors ( > = 69 % ) . Best functional results were seen in transferred flexor carpi ulnaris ( median EQ 68 % ) . The EQ of transferred pronator teres was low ( median 18 % ) and minor to flexor carpi ulnaris in each patient ( P 0.05 ) . It is concluded that in cases of radial palsy , pronator teres is not suitable for replacing extensor muscles . Superficial flexors of the fingers , however , work in synergy with extensors of the wrist . According to the Ia reflex connections involved , these muscles should be a good choice for regaining extension of the wrist ."
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]
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}
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] |
[] |
[] |
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DerOrthopaede.70260684.eng.abstr
|
DerOrthopaede.70260684.eng.abstr
|
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{
"id": "DerOrthopaede.70260684.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Many modifications of tendon transfers have been described in the treatment of radial nerve palsy . Controversy persists over the muscles of choice to get the best results in motion of wrist and fingers . Patients with radial nerve palsy and treated by the methode of Merle d ' Aubigne in neurophysiological tests showed that the pronator teres did not work very well for extending the wrist . Thinking about the neurophysiologic principles it seemed that the flexor digitorum superficialis of the middle and ring fingers would make a better substitute for the wrist extension . From 1994 to 1997 four patients with radial nerve palsy had a transfer of the flexor digitorum superficialis tendons from the middle and ring fingers to the tendons of extensor carpi radialis longus and brevis additional the flexor carpi ulnaris and palmaris longus transfers . The functional recovery of two patients has been tested . The functional range of wrist motion of this two patients has been better than in patients with pronator teres transfers . It can be concluded that the new modification of tendon transfers is a good way of treatment of radial nerve palsy and should be done further ."
],
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0,
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]
]
}
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DerOrthopaede.70260690.eng.abstr
|
DerOrthopaede.70260690.eng.abstr
|
[
{
"id": "DerOrthopaede.70260690.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Irreparable damage to the motor function of the ulnar nerve results primarily in paralysis of the intrinsic muscles and reduces the functional capacity of the hand by about one-half . Tendon transfers are therefore indicated when the following grasp functions are impaired : ( 1 ) claw hand with dyskinetic finger movements ; ( 2 ) impaired thumb adduction with limited key pinch power ; ( 3 ) instability of the index MP joint ; ( 4 ) adduction weakness of the little finger . The various procedures and transposition techniques are discussed and the author's preferred methods of tendon transfer are presented ."
],
"offsets": [
[
0,
613
]
]
}
] |
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"Tendon"
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"id": "DerOrthopaede.70260690.eng.abstr-s2-t2",
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"id": "DerOrthopaede.70260690.eng.abstr-s2-t3",
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},
{
"id": "DerOrthopaede.70260690.eng.abstr-s2-t5",
"type": "umlsterm",
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281,
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{
"id": "DerOrthopaede.70260690.eng.abstr-s2-t6",
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"hand"
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"id": "DerOrthopaede.70260690.eng.abstr-s2-t7",
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"id": "DerOrthopaede.70260690.eng.abstr-s2-t9",
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"id": "DerOrthopaede.70260690.eng.abstr-s2-t10",
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[] |
[] |
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DerOrthopaede.70260696.eng.abstr
|
DerOrthopaede.70260696.eng.abstr
|
[
{
"id": "DerOrthopaede.70260696.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Brachial plexus lesions generate complex paralysis and deficient sensitivity in the concerned upper extremity . The clinical features are represented in numberless variations , and in any case several nerves will be involved . Isolated median nerve palsies can only be produced by a lesion of its single terminal branch . For this reason , any secondary surgery aiming at restoring muscle function in the median nerve area should consider the entire upper extremity as a functional unit . Using special \" charts \" will give a better overview and simplify the choice for the most convenient muscles to transfer ."
],
"offsets": [
[
0,
611
]
]
}
] |
[
{
"id": "DerOrthopaede.70260696.eng.abstr-s1-t1",
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],
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41,
50
]
],
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},
{
"id": "DerOrthopaede.70260696.eng.abstr-s1-t2",
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],
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76
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] |
DerOrthopaede.70260701.eng.abstr
|
DerOrthopaede.70260701.eng.abstr
|
[
{
"id": "DerOrthopaede.70260701.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Following augmentation of the upper extremity muscles necessitated by damage to the brachial plexus , special post-operative care programs are required to provide the patient with the best possible results . Proper care requires cooperation between the orthopedic surgeon , physical therapists and nurses . Only then can postoperative rehabilitation and functional control of the extremity improve . We describe interdisciplinary postoperative care programs for augmentation of the deltoid muscle with trapezius transfer , arthrodesis of the glenohumeral joint , biceps augmentation with the latissimus dorsi transfer , Steindler flexorplasty and augmentation of flexors/extensors muscles in the hand ."
],
"offsets": [
[
0,
702
]
]
}
] |
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"extremity"
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36,
45
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{
"id": "DerOrthopaede.70260701.eng.abstr-s1-t2",
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"id": "DerOrthopaede.70260701.eng.abstr-s2-t3",
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{
"id": "DerOrthopaede.70260701.eng.abstr-s3-t3",
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"id": "DerOrthopaede.70260701.eng.abstr-s3-t4",
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"id": "DerOrthopaede.70260701.eng.abstr-s4-t5",
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"id": "DerOrthopaede.70260701.eng.abstr-s4-t12",
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}
] |
[] |
[] |
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DerOrthopaede.70260719.eng.abstr
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DerOrthopaede.70260719.eng.abstr
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DerOrthopaede.70260723.eng.abstr
|
DerOrthopaede.70260723.eng.abstr
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DerOrthopaede.70260750.eng.abstr
|
DerOrthopaede.70260750.eng.abstr
|
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"id": "DerOrthopaede.70260750.eng.abstr-passage-0",
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"text": [
"The commonly accepted hypothesis set up by Brocher in 1950 that the dysplasia of the pars interarticularis vertebrae is an essential requirement for the occurrence of spondylolysis should be thought over in light of recent findings . Newly published investigations show that disturbed spinal growth leads to dysplasia of the vertebral arch and to spondylolysis . Disturbances that play an important role are biomechanical stress factors that result from the evolution from a quadripedal to a bipedal human locomotion as well as stress fractures of the vertebral pars interarticularis and defects in vertebral maturation in small infants ."
],
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0,
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]
]
}
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[] |
[] |
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DerOrthopaede.70260755.eng.abstr
|
DerOrthopaede.70260755.eng.abstr
|
[
{
"id": "DerOrthopaede.70260755.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Spondylolysis and spondylolisthesis occur predominantly in the lower lumbar spine . Besides congenital defects such as predisposition of spondylolysis the correlation between competitive sports activities and an increased incidence of spondylolysis is proved . In early stages , complete healing can be achieved by conservative treatment ( abstinence from sports activities for 3 months , orthesis ) . Persistence of pain , neurologic symptoms and progression of vertebral slipping are indications for operative treatment ( reconstruction of the isthmus , dorso-ventral spondylodesis ) . The exercise tolerance depends on the extent of instability , progression of vertebral slipping and clinical symptoms . The limits of exercise tolerance vary among the individual athletes and require the decision of the physician . Backstroke swimming , abdominal and back muscle strengthening exercises , and types of sport involving smooth movements are advisable . Sports education in school is possible without restriction in patients with stable spondylolysis and in those with spondylolisthesis without unfavourable concomitant factors ."
],
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]
]
}
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DerOrthopaede.70260769.eng.abstr
|
DerOrthopaede.70260769.eng.abstr
|
[
{
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"text": [
"The majority of patients with symptomatic spondylolysis can be treated conservatively . Only when symptoms persist in spite of conservative treatment surgery may be indicated . In young patients , however , fusion of a mobile segment should be avoided , but a direct repair of the pars defect can be attempted . This procedure allows complete healing and possibly avoids degeneration of the intervertebral disk . For this purpose Morscher developed the hook screw , which connects the arch with the anterior articular process . It allows compression of the defect without crossing the defect with the screw . A follow-up study of the first 33 patients with a follow-up time of 3.5 years on average showed a good subjective result in 79 % of the patients . In patients younger than 20 years of age , however , the result was good in 87.5 % of cases . The reason for the better results in young patients is that in older patients the origin of the pain is often not the pars defect , but the degeneration of the intervertebral disk . Direct repair of spondylolysis is therefore indicated when pain persists after 6 months of conservative treatment or there is a progressive olisthesis of not more than 10 mm . After the end of growth an MRI study of the intervertebral discs should show whether there is degeneration or not . Direct repair is indicated only in the absence of disc degeneration . After the age of 25 years this procedure should not be carried out ."
],
"offsets": [
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1462
]
]
}
] |
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[] |
[] |
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] |
DerOrthopaede.70260774.eng.abstr
|
DerOrthopaede.70260774.eng.abstr
|
[
{
"id": "DerOrthopaede.70260774.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The deformity in severe spondylolisthesis consists of two components : the parallel anterocaudad slip of the spondylolisthetic vertebra , and its tilt into kyphotic malposition . The influence of the two components is very different : the anterocaudad slippage has not much impact on the sagittal profile of the spine and is easily compensated for by a slight increase in lumbar lordosis . The kyphotic deformity has a high impact on trunk imbalance and the sagittal profile . There are two compensation mechanisms : hyperlordosis of the lumbar spine to its anatomical extremes and - if that is not sufficient - verticalisation of the sacral bone , performed by contracture of the hamstrings and uprighting of the pelvis around the hip joints . The latter mechanism is followed by functional disadvantages . Therefore , correction of the kyphosis of L5 may be considered during operative treatment if the lumbosacral kyphosis ( angle delta ) is less than 85 ° and the sacral inclination less than 35 ° ."
],
"offsets": [
[
0,
1003
]
]
}
] |
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"id": "DerOrthopaede.70260774.eng.abstr-s1-t2",
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"id": "DerOrthopaede.70260774.eng.abstr-s4-t3",
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"spine"
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DerOrthopaede.70260781.eng.abstr
|
DerOrthopaede.70260781.eng.abstr
|
[
{
"id": "DerOrthopaede.70260781.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The indication for operative treatment in spondylolisthesis results from pain , progressive sliding and , in up to 60 % of the patients with progressive dislocation , from radicular malfunction . The posterolateral fusion in situ is a safe procedure , but the deformation remains and in spondyloptosis plastic deformation of the fusion mass can lead to further dislocation . With the external fixator as an instrument for reduction and the internal fixator for stabilization the reduction of even serious spondyloptosis and the recovery of a normal spine alignement and posture is possible , with an acceptable neurological risk . Therefore a concept of treatment is suggested , which as a rule is aiming at the anatomical reduction of the dislocated vertrebra beside stabilization and nerveroot decompression . Depending on the extent of the slip , reduction and stabilization is to be performed in one , two or three stages . An anterior or posterior fusion is sufficient in grade I dislocation . In grade II-V a combined posterior and anterior surgical proceedure is recommended ."
],
"offsets": [
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0,
1083
]
]
}
] |
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[] |
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DerOrthopaede.70260790.eng.abstr
|
DerOrthopaede.70260790.eng.abstr
|
[
{
"id": "DerOrthopaede.70260790.eng.abstr-passage-0",
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"text": [
"In spondylolisthesis with an indication for fusion and with a slipping of more than 50 % at least a partial reposition should be reached in general because the incidence of pseudarthrosis would increase with a fusion in situ and a large disturbance of the spinal statics would persist . Hereby with almost all methods an enlarged operative morbidity and often a longer fusion range has to be taken in account compared to the fusion in situ . Therefore , in smaller slippages the fusion in situ will be favoured because the disturbance of the statics is not so important , that such an effort combined with such methods is necessary . If the operation method with small spondylolisthesis and pseudospondylolisthesis allows the reposition without much effort and if the operative morbidity in comparison with the fusion in situ is not higher , then it is reasonable to fuse the cases with a spondylolisthesis Meyerding grade 1 and 2 in the anatomic corrected position too . Because the spinal fixator we use fills out these criteria we combine the correction of the position with the fusion also in cases of small spondylolisthesis . The incidence of neurologic complications correlates with the amount of the reposition distance and can be caused by preforaminal or extraforaminal lesions . The reduction of small malpositions could only produce preforaminal lesions . Using the spine fixator with its reposition instruments linked outside the wound and with it's uninhibited access to the segment and to the preforaminal neural structures during the whole repositioning these lesions can be avoided ."
],
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[
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1600
]
]
}
] |
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DerOrthopaede.70260820.eng.abstr
|
DerOrthopaede.70260820.eng.abstr
|
[
{
"id": "DerOrthopaede.70260820.eng.abstr-passage-0",
"type": "abstract",
"text": [
"In acute osteomyelitis of childhood a rapid diagnosis and initiation of antibiotic therapy is necessary in order to prevent late sequelae . Thus , diagnostic imaging plays a crucial role . If acute osteomyelitis is suspected in a child , imaging starts with conventional radiography in order to exclude other differential diagnoses . This is followed by sonography for the purpose of diagnosing a subperiosteal abscess or joint fluid from which the causative organism could be isolated . If the diagnosis is unclear , the next step should be either MRI or 99m Tc-MDP bone scan , depending on the possibility of clinical localization and the site of the suspected lesion . MRI is superior to bone scan in depicting the exact anatomy , which is extremely important in spinal osteomyelitis and preoperatively . The bone scan can show the whole skeleton in one examination and should be favored if there is no definite localization or in suspected multifocal osteomyelitis . Rarely scintigraphy with labeled white blood cells is indicated . The 67 Ga scan , however , should not be used in children because of the high level of radiation exposure . The different imaging modalities are described in detail and an imaging diagnostic workup is outlined ."
],
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] |
DerOrthopaede.70260830.eng.abstr
|
DerOrthopaede.70260830.eng.abstr
|
[
{
"id": "DerOrthopaede.70260830.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The efficiency of ultrasound was tested in septic arthritis . A total of 259 children with hip pain , septic arthritis ( n = 14 ) , transient synovitis ( n = 120 ) , juvenile rheumatoid arthritis ( n = 12 ) , Legg-Calvé-Perthes disease ( n = 92 ) and slipped capital femoral epiphysis ( n = 21 ) were examined by ultrasound . By using the standard planes described by the DEGUM , it is possible to analyze the joint capsule , the surface of the femoral head and the periarticular structures . In cases with synovitis or joint effusion , capsular distention can be diagnosed by ultrasound . This distention is typical in septic arthritis , transient synovitis , juvenile rheumatoid arthritis , and in the onset phase of Perthes disease . Because capsular distention and osseous abnormalities in the various diseases are similar differentiation is not possible . Therefore , ultrasound cannot distinguish between septic and non-specific arthritis ; capsular distention is a non-specific ultrasound sign . Immediate diagnostic puncture is necessary if septic arthritis is suspected ( possible by ultrasound control ) . In cases with both capsular distention and osseous abnormalities , ultrasound usually allows differentiation between slipped capital femoral epiphysis/Perthes disease and septic/non-specific arthritis ."
],
"offsets": [
[
0,
1318
]
]
}
] |
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DerOrthopaede.70260838.eng.abstr
|
DerOrthopaede.70260838.eng.abstr
|
[
{
"id": "DerOrthopaede.70260838.eng.abstr-passage-0",
"type": "abstract",
"text": [
"From 1985 to 1996 ( 12 years ) we saw 24 neonates and small infants with septic arthritis of the hip joint . A minority of these infants was simultaneously affected by osteomyelitis of the femoral neck or the acetabulum . Clinical signs are a painful leg , pseudoparalysis , uneasiness and refusal to drink . Quantitative measurements of C-reactive protein ( CRP ) are more reliable then leucocyte count and sedimentation rate . Ultrasound images yield early information about capsular swelling and septic effusion ; in late cases US can visualize femoral neck necrosis . Emergency arthrotomy to relieve the joint from septic effusion , bacteriological specimens and capsular biopsy are mandatory . Intravenous application of a second-generation cephalosporin as antibiotic has proven effective . We have been using cefuroxim for the past 10 years , changed if necessary according to the antibiogram . Parenteral antibiotic treatment is continued for an average of 3 weeks , followed by oral treatment for another 3 weeks . CRP normalisation monitors the cure from the disease . Our 24 cases included 7 with group B streptococci 2 with Staphylococcus aureus , 2 with Staphylococcus epidermidis and 2 with Escherichia coli . In 8 cases no germs could be cultured ; 6 of them had outside antibiotic treatment before being transferred . If treatment was initiated within 3 days , healing without residuals was the rule . In 18 cases with early and sufficient treatment no sequelae were observed . With delay of treatment for several days , moderate osteomyelitic changes of the neck and the acetabulum were observed . In a case with delay of surgical treatment for 5 weeks , complete destruction of the hip joint occurred , causing a poor final result ."
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[] |
[] |
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DerOrthopaede.70260848.eng.abstr
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DerOrthopaede.70260848.eng.abstr
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"Septic arthritis of the hip joint is a condition that can often lead to partial or complete destruction of the hip joint , causing severe functional disability . Reports in the literature indicate that optimal management of these patients is unclear . Our report presents a follow-up of 37 patients ( 44 hips ) who had septic arthritis during infancy or childhood . In general , patients at follow-up had a poor anatomical appearance radiographically , although pain and activity restriction were minimal . Results suggest that surgical efforts should be directed primarily at correcting limb length discrepancy and malalignment of the mechanical axes . In general , patients with a hip deformity of type I-III had a good functional outcome , whereas patients with hip deformity type IV with an instable hip joint had an unsatisfactory outcome . Any indication for hip replacement in these patients should be based not only on radiological findings , but also on the functional situation ."
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[] |
[] |
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DerOrthopaede.70260858.eng.abstr
|
DerOrthopaede.70260858.eng.abstr
|
[
{
"id": "DerOrthopaede.70260858.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Between 1990 and 1996 , 129 children ( mean age 4.8 years ) with hip pain were examined consecutively . In group I ( n = 100 , mean age 4.14 +/- 2.2 ) , transient synovitis of the hip was diagnosed ; group II ( n = 29 , mean age 7.3 +/- 2.1 ) showed the following diagnoses : Perthes ' disease ( n = 12 ) , early slipped capital femoral epiphysis ( n = 5 ) , Meyer's dysplasia ( n = 2 ) , septic arthritis of the hip ( n = 2 ) , osteomyelitis of the acetabulum ( n = 1 ) , abscess of the psoas ( n = 1 ) , chondromatosis of the hip joint ( n = 1 ) , Ewing's sarcoma of the os pubis ( n = 1 ) , hip dysplasia ( n = 1 ) . Three patients who had synovitis developed Perthes ' disease and were assigned to group II . The efficiency of ultrasound , scintigraphy and MRI as diagnostic tools was tested in the examination of painful hip . A capsular distension was present in 73 cases and showed a significant statistical difference ( t-test , P 0.001 ) in group I between affected and unaffected hips . There were no differences in the measurements of the epiphyseal and metaphyseal width in group I between the affected and the non-affected side ( t-test , P = 0.91 , P = 0.57 ) and between the first sonographic evaluation at presentation and at the follow-up ( t-test , P = 0.053 , P = 0.75 ) . MRI was performed , because of persistent joint effusion , in 10 cases in group I , and Perthes ' disease was excluded . In group II the use of an MRI allowed the diagnosis in 89 % of the cases . Sonographic examination , together with X-ray examination and serological testing , represent the first choices in the evaluation of a painful hip at presentation and in the follow-up of transient synovitis . MRI should always be performed when abnormalities are present at the clinical and sonographic examination , and when the X-ray does not allow a clear diagnosis ."
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DerOrthopaede.70260879.eng.abstr
|
DerOrthopaede.70260879.eng.abstr
|
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"The clinical features , diagnosis and treatment of haematogenous multifocal osteomyelitis , a rare illness , are described . Of clinical note are the pain , pseudoparalyses and restriction of movement . Staphylococcus aureus was the pathogen in both of the cases we described . Sonography is a useful diagnostic tool for the localization of subperiosteal abscesses ; scintigraphy is a supplementary examination for cases where it is difficult to establish a diagnosis . MR-tomography is the most reliable method for examination of proximal infected foci ( spondylitis , pelvis osteomyelitis ) . In our view , the earliest possible removal of all infected foci by means of operation and parenteral antibiotics mare the most important treatment ."
],
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]
]
}
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DerOrthopaede.70260889.eng.abstr
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DerOrthopaede.70260889.eng.abstr
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"id": "DerOrthopaede.70260889.eng.abstr-passage-0",
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"The term primary chronic osteomyelitis covers a heterogeneous spectrum of clinical features that should be separated for therapeutic reasons . Unifocal manifestations should be distinguished from multifocal ones . While bacteria are often found in the first group , bacteriological investigations are usually negative in the second group . Additionally , multifocal forms often recur ( chronic multifocal recurrent osteomyelitis ) , possess a long clinical course and may be combined with dermatological disorders ( SAPHO syndrome ) . A biopsy is often necessary for tumor exclusion and obtaining material for bacteriology . Histology cannot differentiate between the respective forms of chronic osteomyelitis ."
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[] |
[] |
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DerOrthopaede.70260894.eng.abstr
|
DerOrthopaede.70260894.eng.abstr
|
[
{
"id": "DerOrthopaede.70260894.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Chronic lymphoplasmacellular osteomyelitis may occur in children , adolescents and adults , but has not been found in newborns or babies either in our series or in the literature . Symptoms suggesting an acute disease like fever are uncommon , but a primary chronic course with symptomatic and asymptomatic periods is typical . Pain and swelling are the main symptoms ; painless masses are rare . In children and adolescents the clavicle and metaphyseal regions of long bones are typical sites of chronic abacterial osteomyelitis . In adults the clavicles or the first two ribs are mainly affected with synovitis of the adjacent joints , but the long bones are rarely involved . Laboratory findings are non-specific but important for the differential diagnosis . The sedimentation rate and c-reactive protein might be elevated . The X-ray examination shows osteolytic , sclerotic or mixed bony changes and , in case of a diaphyseal involvement , onionskinlike periosteal bone formation may be present , suggesting a malignant process . In late stages sclerotic bone formations may be seen as a rest . Uni- or multifocal lesions can be detected by bonescan , as can asymptomatic lesions . Magnetic resonance imaging shows gross signal intensity differences both in the bone and perifocal soft tissue and involvement of the synovium with gadolinium DPTA enhancement in T1-weighted images . In early stages of the disease granulocytes , microabscesses and new bone formations might suggest bacterial osteomyelitis that cannot be differentiated by histology . In intermediate phases lymphocytic and plasmacellular infiltrates are found , whereas in late phases sclerotic bone formations and fibrosis of the bone marrow are seen histologically . In chronic lymphoplasmacellular osteomyelitis , all clinical , radiological and histological findings , as well as negative bacteriological cultures , are mandatory and will allow a definitive diagnosis to be made . The disease may be uni- or multifocal , and new bone lesions may occur over time , as well as skin manifestations , which can be found years before or after bone involvement . The association with dermatological diseases and/or synovitis led to the acronym SAPHO syndrome ( synovitis , acne , pustulosis , hyperostosis , osteomyelitis ) . For the treatment non-steroidal anti-inflammatory drugs are effective for pain relief , reduction of swelling and dysfunction . Antibiotics have been used in several series and are not effective . Major surgery is not recommended even for recurrences , and the prognosis for growth and function is excellent in the long term despite recurrences over several years ."
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DerOrthopaede.70260916.eng.abstr
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DerOrthopaede.70260916.eng.abstr
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DerOrthopaede.70260920.eng.abstr
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DerOrthopaede.70260920.eng.abstr
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"Orthopedists beeing more engaged in surgery are often asked about problems concerning exercise science . This article will summarize the existing basic knowledge , very close to practice , and put down the leading steps of how to build up a ( therapeutical ) training programme . A lab block is recommended acting on a preventive as well as on a sportive medical base ."
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},
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"id": "DerOrthopaede.70260920.eng.abstr-s1-r3-t1.1-t2.1",
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},
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"id": "DerOrthopaede.70260920.eng.abstr-s1-r6-t2.2-t4.1",
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},
{
"id": "DerOrthopaede.70260920.eng.abstr-s1-r7-t2.2-t1.1",
"type": "affects",
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}
] |
DerOrthopaede.70260926.eng.abstr
|
DerOrthopaede.70260926.eng.abstr
|
[
{
"id": "DerOrthopaede.70260926.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Aquajogging consists of simulated running in deep water aided by a flotation device ( vest or belt ) that maintains the head above water . In sports , Aquajogging is used as a training for regeneration or a low impact training alternative . In rehabilitation Aquajogging is well used in rheumatology diseases , in the pre- and postoperative management of musculoskeletal diseases and in endurance and power training in cardiorespiratory diseases ."
],
"offsets": [
[
0,
447
]
]
}
] |
[
{
"id": "DerOrthopaede.70260926.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"Aquajogging"
],
"offsets": [
[
0,
11
]
],
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"db_id": "C0022400"
}
]
},
{
"id": "DerOrthopaede.70260926.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"simulated"
],
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[
24,
33
]
],
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{
"db_name": "UMLS",
"db_id": "C0284447"
}
]
},
{
"id": "DerOrthopaede.70260926.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"running"
],
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[
34,
41
]
],
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{
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"db_id": "C0035953"
}
]
},
{
"id": "DerOrthopaede.70260926.eng.abstr-s1-t4",
"type": "umlsterm",
"text": [
"water"
],
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[
50,
55
]
],
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{
"db_name": "UMLS",
"db_id": "C0020311"
},
{
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}
]
},
{
"id": "DerOrthopaede.70260926.eng.abstr-s1-t5",
"type": "umlsterm",
"text": [
"device"
],
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[
77,
83
]
],
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{
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"db_id": "C0699733"
},
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"db_id": "C0220819"
}
]
},
{
"id": "DerOrthopaede.70260926.eng.abstr-s1-t6",
"type": "umlsterm",
"text": [
"head"
],
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[
120,
124
]
],
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{
"db_name": "UMLS",
"db_id": "C0018670"
}
]
},
{
"id": "DerOrthopaede.70260926.eng.abstr-s1-t7",
"type": "umlsterm",
"text": [
"water"
],
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131,
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]
],
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}
]
},
{
"id": "DerOrthopaede.70260926.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"sports"
],
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142,
148
]
],
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"db_id": "C0038039"
}
]
},
{
"id": "DerOrthopaede.70260926.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"Aquajogging"
],
"offsets": [
[
151,
162
]
],
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{
"db_name": "UMLS",
"db_id": "C0022400"
}
]
},
{
"id": "DerOrthopaede.70260926.eng.abstr-s2-t3",
"type": "umlsterm",
"text": [
"training"
],
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[
176,
184
]
],
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{
"db_name": "UMLS",
"db_id": "C0040607"
},
{
"db_name": "UMLS",
"db_id": "C0220931"
}
]
},
{
"id": "DerOrthopaede.70260926.eng.abstr-s2-t4",
"type": "umlsterm",
"text": [
"regeneration"
],
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[
189,
201
]
],
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"db_id": "C0034963"
}
]
},
{
"id": "DerOrthopaede.70260926.eng.abstr-s2-t5",
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"training"
],
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]
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}
]
},
{
"id": "DerOrthopaede.70260926.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"rehabilitation"
],
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"db_id": "C0034991"
},
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}
]
},
{
"id": "DerOrthopaede.70260926.eng.abstr-s3-t2",
"type": "umlsterm",
"text": [
"Aquajogging"
],
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],
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}
]
},
{
"id": "DerOrthopaede.70260926.eng.abstr-s3-t3",
"type": "umlsterm",
"text": [
"rheumatology"
],
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],
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]
},
{
"id": "DerOrthopaede.70260926.eng.abstr-s3-t4",
"type": "umlsterm",
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},
{
"id": "DerOrthopaede.70260926.eng.abstr-s3-t5",
"type": "umlsterm",
"text": [
"postoperative"
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]
},
{
"id": "DerOrthopaede.70260926.eng.abstr-s3-t6",
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"diseases"
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]
},
{
"id": "DerOrthopaede.70260926.eng.abstr-s3-t7",
"type": "umlsterm",
"text": [
"power"
],
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401,
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]
],
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]
},
{
"id": "DerOrthopaede.70260926.eng.abstr-s3-t8",
"type": "umlsterm",
"text": [
"training"
],
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407,
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]
],
"normalized": [
{
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"db_id": "C0040607"
},
{
"db_name": "UMLS",
"db_id": "C0220931"
}
]
},
{
"id": "DerOrthopaede.70260926.eng.abstr-s3-t9",
"type": "umlsterm",
"text": [
"diseases"
],
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[
437,
445
]
],
"normalized": [
{
"db_name": "UMLS",
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}
]
},
{
"id": "DerOrthopaede.70260926.eng.abstr-s3-t10",
"type": "umlsterm",
"text": [
"musculoskeletal diseases"
],
"offsets": [
[
355,
379
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0026857"
}
]
}
] |
[] |
[] |
[
{
"id": "DerOrthopaede.70260926.eng.abstr-s1-r1-t2.1-t4.2",
"type": "interacts_with",
"arg1_id": "DerOrthopaede.70260926.eng.abstr-s3-t2",
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},
{
"id": "DerOrthopaede.70260926.eng.abstr-s1-r2-t7.2-t2.1",
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{
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},
{
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},
{
"id": "DerOrthopaede.70260926.eng.abstr-s1-r6-t7.1-t5.1",
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},
{
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{
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},
{
"id": "DerOrthopaede.70260926.eng.abstr-s2-r1-t5.1-t3.1",
"type": "affects",
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{
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{
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},
{
"id": "DerOrthopaede.70260926.eng.abstr-s3-r6-t1.2-t4.1",
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},
{
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},
{
"id": "DerOrthopaede.70260926.eng.abstr-s3-r9-t1.2-t10.1",
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},
{
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},
{
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},
{
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},
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},
{
"id": "DerOrthopaede.70260926.eng.abstr-s3-r15-t7.1-t10.1",
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},
{
"id": "DerOrthopaede.70260926.eng.abstr-s3-r16-t1.1-t6.1",
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},
{
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},
{
"id": "DerOrthopaede.70260926.eng.abstr-s3-r18-t7.1-t4.1",
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},
{
"id": "DerOrthopaede.70260926.eng.abstr-s3-r19-t7.1-t8.1",
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{
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},
{
"id": "DerOrthopaede.70260926.eng.abstr-s3-r21-t1.2-t8.1",
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},
{
"id": "DerOrthopaede.70260926.eng.abstr-s3-r22-t1.1-t10.1",
"type": "associated_with",
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"arg2_id": "DerOrthopaede.70260926.eng.abstr-s3-t10",
"normalized": []
}
] |
DerOrthopaede.70260930.eng.abstr
|
DerOrthopaede.70260930.eng.abstr
|
[
{
"id": "DerOrthopaede.70260930.eng.abstr-passage-0",
"type": "abstract",
"text": [
"After orthopedic surgery , skeletal muscle will enter the rehabilitation process in weakened condition due to the following characteristics . After use of a tourniquet during surgery , the muscle suffers ischemia/reperfusion damage due to oxidative stress , resulting in structural impairment . The resulting immobilization leads to muscular atrophy , with a loss of calcium homeostasis and oxidative stress being of etiological significance . Degeneration of muscle fibers as well as regeneration occurs in muscle while still immobilized . After remobilization , the muscle has impaired functional capacity and frequently shows disturbances in its innervation pattern . High mechanical loading should therefore be avoided , and electrical stimulation may be applied to facilitate recovery . Considering the role of oxygen radicals , supplementation with vitamin E appears generally recommendable ."
],
"offsets": [
[
0,
898
]
]
}
] |
[
{
"id": "DerOrthopaede.70260930.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"orthopedic"
],
"offsets": [
[
6,
16
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0029355"
}
]
},
{
"id": "DerOrthopaede.70260930.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"surgery"
],
"offsets": [
[
17,
24
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0038894"
},
{
"db_name": "UMLS",
"db_id": "C0038895"
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DerOrthopaede.70260935.eng.abstr
|
DerOrthopaede.70260935.eng.abstr
|
[
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"id": "DerOrthopaede.70260935.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The risk to health posed by a sedentary lifestyle is a problem of our times . In contrast to the previous assumption that only fairly high-intensity sporting exercise undertaken over a minimum period of 20 min produces health-related benefits , recent studies have shown that even everyday activitites ( climbing stairs , brisk walking and cycling ) can have a benedicial effects on health , particularly in those who take little exercise . So now the recommendation is : exercise of moderate intensity lasting 30 min at least 5 times a week , corresponding to an energy consumption of about 150 kacl/day or 1000 kcal/week . The results of experimental studies on sport and arthritis and sport and osteoporosis point to the advisability of taking up or maintaining an active sporting lifestyle . For one thing , it can be assumed that a moderate amount of movement does not increase the risk of developing arthritis : for another , sporting activity during early and late childhood produces a high maximum bone mass , therby delaying the development of osteoporosis in later life . The new guidelines on the extent and intensity of health-giving exercise make it easier to advocate exercise and sport for disease prevention and health promotion because they appear to implement . More difficult , however , is deciding on a suitable method for motivating inactive individuals to increase their level of physical acitivity . A model that has proved effective in smoking cessation programmes , and one that can also be applied to exercise counselling ( transtheoretical model ) , can help in the selection of an appropriate counselling strategy . Depending on whether an individual is inactive , or sporadically or regularly active , each one employs his or her own strategies primarily to maintain this lifestyle . Assuming that the counselling is adapted to the level of activity , the patient's attitude and behaviour can be influenced both more effectively and more economically ."
],
"offsets": [
[
0,
1982
]
]
}
] |
[
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],
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DerOrthopaede.70260942.eng.abstr
|
DerOrthopaede.70260942.eng.abstr
|
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"The relation between nutrition and sport has been studied extensively during recent decades . Nevertheless , research interest was focused mainly on the role of dietary macro- and micronutrients as ergogenic aids . Today , there is increasing support for the hypothesis that the nutrient status also has relevance for the prevention and rehabilitation of systemic and muscular stress induced by intense physical exercise . The increase in muscular stress is indicated by the rise in creatine kinase and myoglobin ; the systemic stress is associated with characteristic immunological and hormonal changes and an acute-phase response . During and following exercise , the course of cytokines ( especially interleukin 6 ) and acute-phase proteins ( C-reactive protein , fibrinogen ) as well as cortisol levels are an indirect measure of the exercise intensity and the individual ability to cope with physical stress . It has been shown that the dietary intake and , consequently , the systemic or intracellular concentrations of minerals such as magnesium and zinc , vitamins with antioxidant capacity ( vitamin E , C , E , and carotin ) , and the composition of fatty acids can be related to the exercise-induced stress response . Therefore , this review deals specifically with the impact of these nutritional components on the reduction of sports-specific muscular damage and systemic stress , especially under the aspect of increased losses during and following intense physical exercise ."
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DerOrthopaede.70260955.eng.abstr
|
DerOrthopaede.70260955.eng.abstr
|
[
{
"id": "DerOrthopaede.70260955.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Numerous studies show that ( high ) performance sport may reduce the ovarian function by disturbing the distribution of the hormones at the level of the hypothalamic-pituitary axis . Before puberty a delay in sexual maturity ( in particular delayed menarche ) and after menarche oligomenorrhoea or secondary amenorrhoea may result , most frequently in aerobic-type activities associated with lower body weight such as running , aerobics and gymnastics . Body composition and specificity of sport , intensity of training , previous menstrual history and eating disorders are all important factors . After stopping with performance sport , the regular menstrual cycle will return , but the chronic lack of oestrogen may reduce bone density and increase the prevalence of stress fractures . In conclusion , female performance athletes require medical facts about training and nutrition and individual information and guiding if a long-term hormone substitution is needed ."
],
"offsets": [
[
0,
969
]
]
}
] |
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DerOrthopaede.70260961.eng.abstr
|
DerOrthopaede.70260961.eng.abstr
|
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"Stress fractures are one of the most common overuse injuries seen in athletes , accounting for up to 20 % of all injuries presented to sports medicine clinics . Runners are particularly prone to these injuries , however , it is difficult to predict injury as there is usually a critical interplay between the athlete's biomechanical predisposition , training methods , and other factors such as diet , and muscle strength and flexibility . This article will discuss the key clinical findings for the majority of stress fractures encountered in a sports medicine practice . A classification scheme will also be described that will allow the clinician to make appropriate treatment decisions based on the degree of risk for each injury ."
],
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}
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[] |
[] |
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DerOrthopaede.70260976.eng.abstr
|
DerOrthopaede.70260976.eng.abstr
|
[
{
"id": "DerOrthopaede.70260976.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Acute exercise is followed by a mobilization of white blood cells , mainly induced by increased levels of catecholamines and cortisol . NK-cells react the most intensive , they can increase fivefold after intensive exercise . Additionally a weak acute-phase reaction occurs . Most of these changes normalize during twenty-four hours . Parameters of the humoral immune system may be different from the pre-exercise levels up to seventy-two hours . Repeated physical exercise , which is typical for sports , is followed only by small changes of immunologic parameters under conditions of rest . Epidemiological studies give clues that the rate of upper respiratory tract infections in athletes can be described by a j-shaped curve . Moderately active subjects have the lowest rate of infection . For this influence of exercise on health mainly functional changes seem to be important . Especially after exccentric exercise immunological cells can be seen in the muscle tissue , which remove destructed tissue . Not very much is known about the role of the immune system in the regeneration of tendons and other bradytrophic tissues ."
],
"offsets": [
[
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1131
]
]
}
] |
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DerOrthopaede.70260981.eng.abstr
|
DerOrthopaede.70260981.eng.abstr
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"Static stretching exercises have become very popular over the past fifteen years both in professional and amateur sports . In the fields of physical therapy and in manual therapy , in particular , static stretching has become part of a standard and successful treatment modality . Together with an appropriate strengthening program , static stretching techniques have become the therapy of choice for treatment of muscle imbalances associated with functional disturbances of the musculoskeletal system . Specific muscle length testing procedures have been developed to determine muscle shortening in clinical practice . In this article , the fundamental principles of the different types of muscle stretching techniques are described , including the dynamic stretching and static stretching techniques . The exercises are organized along the concepts of passive static or neuromuscular stretching principles . The pertaining neurophysiologic fundamentals are discussed , as are the benefits of the individual methods of a functional exercise program . Examples are provided for the most important muscle groups ."
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[] |
[] |
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DerOrthopaede.70260987.eng.abstr
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DerOrthopaede.70260987.eng.abstr
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"Athletes who need high endurance capacity often use training at moderately high altitude ( 1500-3000 m ) to improve oxygen delivery and utilization because of a hypoxia-induced increase of the red blood cell volume and adaptations at the muscular level . As maximal heart rates decrease at high altitude and plasma lactate levels for a given workload change during prolonged exposure to high altitude , it can be difficult to control and adapt the intensity and duration of the work-outs . Furthermore , maximal performance capacity decreases and therefore training intensity at high altitude is usually reduced compared to training at sea level . To avoid these disadvantages at high altitude a concept of living at moderately high altitude and training at lower elevations , termed \" live high - train low \" evolved , opposing the conventional concept of \" live high - train high \" . A third option using a hypobaric chamber ( \" live low - train low \" ) is hardly used anymore for training athletes . Studies on the effects of conventional high-altitude training for the improvement of athletic performance often lack a rigorous controlled design and yield controversial results . Regarding the new concept of \" live high - train low \" there is only one controlled study on college athletes and it shows a minor advantage of this new approach compared to conventional high-altitude training . However , training concepts are especially important for elite competitive athletes , and controlled studies with such individuals are very difficult to perform . Therefore , it appears that today we cannot answer the question of whether altitude-specific physiologic factors or non-altitude-related benefits of training camps account for the success of individual athletes ."
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DerOrthopaede.70260993.eng.abstr
|
DerOrthopaede.70260993.eng.abstr
|
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"Load on the human body can be influenced by shoes and surfaces which is important both in sports and rehabilitation . The loading which can primarily be influenced are impact situations and friction as well as the stability of the foot . This stability is of main interest in the prevention of pain and injury . However , a certain amount of loading is necessary to improve strength and structure of biological materials . In the past , the development of shoe and surface materials has hardly been perceived under this aspect , but may be increasingly important in the future ."
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}
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] |
[] |
[] |
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DerOrthopaede.70261014.eng.abstr
|
DerOrthopaede.70261014.eng.abstr
|
[
{
"id": "DerOrthopaede.70261014.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Complex joint trauma is a term reserved for specific and severe injuries that include two or more structural elements of the joint . These structural elements are the articulating bones , the major ligaments of the joint , the local soft tissue envelope and the neurovascular structures . Complex joint trauma has a high risk for complications and requires a special treatment algorhythm . A staged surgical protocol with initial soft tissue debridement , closed joint reduction and external fixation of the extremity followed by secondary recontructive surgery after soft tissue recovery is suggested ."
],
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]
}
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] |
DerOrthopaede.70261020.eng.abstr
|
DerOrthopaede.70261020.eng.abstr
|
[
{
"id": "DerOrthopaede.70261020.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The complex injury is characterized by a fracture and/or dislocation of the elbow in association with a serial injury of the upper extremity , or a severe soft tissue trauma , or a prolonged ischemia caused by vascular injury or compartment syndrom . They are defined as complex injuries because their treatment differs from that of a simple fracture implying that standardized concepts usually cannot be employed . The results of primary treatement show a high rate of complications . They are accompanied by functional deficits including pseudarthrosis and ankylosis . As a consequence , ulnar neuropathy may occur . Inadequate treatment leads to delayed rehabilitation and several secondary operations . The main goal points at the reconstruction of the elbow joint to restore function . Therefore , the logistical pathway of individual therapy is the key for success . The operation has to include fracture stabilisation of all injuries of the upper extremity . Only stable osteosynthesis makes early mobilisation possible . Transfixation of the elbow joint should be reserved for exceptional cases . The principals of AO have proven to be practical both for the distal humerus and the proximal forearm . Successful reconstruction of the elbow joint often demands extended approaches . ORIF of the proximal ulna can be achieved by indirect reposition techniques . Dynamic stabilisation should be established by conservation of the radial head and coronoid process . For treatment of soft tissue injury it is necessary to undertake local reconstructive measures . Operative treatment is widely indicated for forearm compartment syndrom . Diagnosis and therapy of possible accompanying vascular injury should be made early to avoid prolonged ischemia . Operative treatement of nerve injury is only indicated in case of sharp dissection of the nerve . Otherwise the reconstruction should be performed , but not earlier than three months . Rehabilitation outcome depends on primary therapy . Sufficient functional results are only achieved after early mobilisation and intensive physiotherapy . If necessary , arthrolysis is planned early and combined with removal of implants at 6 months post injury ."
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DerOrthopaede.70261030.eng.abstr
|
DerOrthopaede.70261030.eng.abstr
|
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[] |
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DerOrthopaede.70261046.eng.abstr
|
DerOrthopaede.70261046.eng.abstr
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[
{
"id": "DerOrthopaede.70261046.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Following complex foot injuries ( incidence up to 52 % ) in the multiply-injured patient the ultimate goal remains the same as for all significant foot injuries : the restoration of a painless , stable and plantigrade foot to avoid corrective procedures with moderate results . In the case of a complex trauma of the foot ( 5 point-score ) - e . g . a crush injury - primary amputation in the multiply-injured patient ( PTS 3-4 ) is indicated . Limb salvage ( PTS 1-2 ) depends on the intraoperative aspect during the second look ( within 24-48 hours after injury ) : the debridement has to be radical , the selection of amputation level should be at the most distal point compatible with tissue viability and wound healing . A free tissue transfer should be done early if necessary . Single lesions presenting with a compartment syndrome need an immediate dorsal fasciotomy , in the case of a multiply-injured patient as soon as possible . Open fractures are reduced following radical debridement and temporarily stabilized with K-wires and/or tibiotarsal transfixation with an external fixateur until the definitive ORIF . Dislocation-fractures of the talus type 3 and 4 according to Hawkins ' classification need open reduction and internal fixation by screws ( titan ) . Open fractures of the calcaneus are stabilized temporarily by a medial external fixateur after debridement until the definitive treatment . If there is a compartment syndrome an immediate dermatofasciotomy is essential . Like closed , calcanear fractures in multiply-injured patients dislocation-fractures of the Chopart's joint need immediate open reduction only if it is an open fracture or associated with a compartment syndrome . The incidence of a compartment syndrome in the case of dislocation fractures of the Lisfranc's joint is high and therefore a dorsal dermatofasciotomy without delay is critical . Open reduction and internal fixation are achieved either by 1.8 mm K-wires or 3.5 mm cortical screws . To avoid further soft tissue damage a delayed primary closure can be necessary and a temporary tibio-tarsal transfixation is useful . Despite the life-threatening injuries of the multiply-injured patient one must insist on an exact diagnosis of the foot trauma ( radiographs in 3 standard projections : exact lateral , dorso-plantar , 45 ° oblique ) if long-term disability due to articular incongruities and complex derangement of the arc geometry of the foot is to be avoided ."
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DerOrthopaede.80270002.eng.abstr
|
DerOrthopaede.80270002.eng.abstr
|
[
{
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"text": [
"Complex injuries of the shoulder require differentiated management . Interestingly there is a relative lag of warranted information on this subject . Generally the different lesions are discussed separately . However it is not acceptable to simply add the standard diagnostic and therapeutic measures , because major tactic , strategic and rehabilitation incompatibilities could occur . Diagnostic and therapeutic difficulties are frequent for the following injuries : complex proximal humerus dislocation fractures , dislocation fractures with associated lesions of the rotator cuff , posterior dislocation fractures , peri- and intraarticular segmental fractures and fractures or dislocations associated with major neurovascular lesions . Increased awareness of the most relevant diagnostic and therapeutic aspects should contribute to optimize treatment protocols ."
],
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0,
868
]
]
}
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[] |
[] |
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DerOrthopaede.80270011.eng.abstr
|
DerOrthopaede.80270011.eng.abstr
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"The hand is very exposed to injuries in the daily man's work . The multiple functions of the hand are based on vitality , sensibility , motor function and stability . In severe hand injuries the functional results of the repair are often very poor . In a complex injury of the hand we are faced with the damage of the soft tissue and bone and the loss of vitality and function of the hand . The cause of hand injuries are mainly a crush trauma or the rotating saw . Basically , we recommend an extended primary repair . After the radical debridement we have to reconstruct the damaged structures . We start doing the osteosynthesis and stabilization of the joints . Thereafter , suturing of extensor and flexor tendons . Then , we do the microsurgical reconstructions of vessels and nerves . In case tendons and bones are exposed we have to cover the defect with a pedicled or a free flap . In a long ischemic time we have to change our concept and do the reconstruction of the vessels first . Our results in vitality and sensibility are listed . In the result of a complex hand injury each single functional restoration is very important . Therefore , it is necessary that severe hand injuries are treated at well established centres for hand surgery ."
],
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] |
DerOrthopaede.80270017.eng.abstr
|
DerOrthopaede.80270017.eng.abstr
|
[
{
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"type": "abstract",
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"3 different types of complex spinal trauma are defined : Type I means a multilevel contiguous or non contiguous unstable injury , type II is described as a spinal injury with concommitant thoracic or abdominal lesion , typ III stands for the coincidence of spinal injury and polytrauma . Overlapping of different types occurs . Type I : The incidence amounts according a german multicenter study to about 2,5 % . Multilevel injuries need to be stabilized for a long distance from posterior . With a thoroughful analysis the segments to be fused are determined . Typ II : The leading thoracic injury is a lung contusion which occurs in up to 50 % of the cases . A CT scan of the thorax during the first diagnostic screening is recommended . Early reduction and stabilization from posterior should be aimed at . During the first two weeks anterior procedures are contraindicated . Abdominal injuries are to be found in 3-4 % of all spinal injuries . All organs could be affected . A typical constallation is the \" seat-belt syndrome \" with lesions of the upper abdominal organs and a flexiondistraction injury of the upper lumbar spine . The main problem is to make the diagnosis of both components initially . Most of the patients may be treated in one operation by first taking care of the abdominal injury and than stabilazing the spine . The prognosis of this combination is favorable . Typ III : In 17-18 % of all polytraumatized patients lesions of the spine are to be diagnosed . From these only one third need surgical care . From 680 patients with operatively treated fractures of the thoracolumbar junction 6,2 % were polytraumatized according to the multicenter study mentioned above . The risk of missing a spinal injury in polytrauma totals approximately 20 % . Surgical stabilization should be performed in the primary phase ( day-1-surgery). Additional injuries , potentially time consuming operations with a high blood loss sometimes necessitate a different approach . Non stabilized spinal injuries apparently do not have the same negative effect on the whole organism as long bone fractures . In the early phase of treatment on the C-spine only anterior procedures and on the thoraco-lumbar spine only posterior techniques should be applied ."
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DerOrthopaede.80270032.eng.abstr
|
DerOrthopaede.80270032.eng.abstr
|
[
{
"id": "DerOrthopaede.80270032.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Injuries of the joints of the pelvis and of the acetabulum are still a problem even today . When the joints of the pelvis are damaged the risk of complicated pelvic injuries , that is to say pelvic injuries with damage to the soft tissues in and around the pelvis , is increased threefold . The lethality , the overall gravity of the injuries , the probability of haemorrhagic complications and the proportion of associated pelvic injuries are also increased . Even when anatomical reconstruction of the lower limb girdle is achieved , long-term secondary conditions such as pain and genitourinary and neurological scquelae frequently persist . Complicated pelvic injuries , i . e . pelvic injury with concomitant damage to organs and soft tissues in the pelvis and pelvic injuries with ipsilateral femoral fracture ( floating hip ) are special cases . Haemodynamic stabilization of the patient and the treatment of organic lesions must be the first priorities in the interdisciplinary therapy . Even when these priorities are correctly observed , the lethality is almost three times as high as in the case of pelvic injuries not involving soft-tissue damage . Acetabular fractures are a particular challenge even compared with other joint fractures . Operative treatment with anatomical joint reconstruction and stable internal fixation has been shown to have the best results . In addition to the type of fracture and the personal experience of the surgeon concerned , such fracture-specific factors as the presence of further fractures of the posterior wall , comminuted fractures , joint depression fractures and intra-articular fragments increasingly play a part. The long-term result worsens with increasing number of these additional pathologies . The primary cartilaginous damage caused by the accident seems to have a considerable influence on the long-term result following acetabular fractures ."
],
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DerOrthopaede.80270045.eng.abstr
|
DerOrthopaede.80270045.eng.abstr
|
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[] |
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DerOrthopaede.80270072.eng.abstr
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DerOrthopaede.80270072.eng.abstr
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"For the treatment of bony defects of the human skeleton there are different options . If a defect has to be filled up , autogenous cancellous bone is recommended as the ' golden standard ' , i . e . the material of choice for such procedures , ignorant to the fact that autogenous bone transplants are not without consequences to the patient and that their harvesting and transplantation might be connected to certain complications . As an alternative , there have been attempts to implant bone replacement materials as a substitute for the autogenous tissue . Despite a longstanding history of research in this field up to now a clinically applicable alternative could not have been found . Aim of the articel is to classify the different compounds recommended for bone replacement . After a description of the development of the materials in the different classes , the state of the art and todays knowledge of how the different materials elicite their effects , an outlook into possible future developments is given for each class . Finally recommendations for todays clinical use of the bone substitutes are presented ."
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[] |
[] |
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DerOrthopaede.80270080.eng.abstr
|
DerOrthopaede.80270080.eng.abstr
|
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"The aim of this study was to evaluate the bone stimulation forced by Demineralized Bone Matrix ( DBM ) -Chips and - Gel in comparison to the bone -ingrowth into a porous hydroxylapatite ceramic ( Endobon ) in mini pigs . The following results were obtained : ..."
],
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[] |
[] |
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DerOrthopaede.80270089.eng.abstr
|
DerOrthopaede.80270089.eng.abstr
|
[
{
"id": "DerOrthopaede.80270089.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Calciumphosphate-ceramics have been intensively investigated as bone replacement materials for more than twenty years . In consequence to numerous experimental as well as clinical implantations Tricalciumphosphate-ceramic and Hydroxyapatite-ceramic proved to be the most suitable substances . Nevertheless , due to several shortcomings , these synthetic bone replacement materials can up to now in no way replace autogenous bone , the ' golden standard ' , for all indications of the clinical setting . The reason for this is that despite our ever increasing knowledge of materials ' and host bed properties we still are unable to securely predict the outcome after the implantation of such synthetic substitutes . The article reviews the most important biological reactions in mammals and explains the underlying causes ."
],
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[] |
[] |
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] |
DerOrthopaede.80270118.eng.abstr
|
DerOrthopaede.80270118.eng.abstr
|
[
{
"id": "DerOrthopaede.80270118.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Prompted by severe problems in autogeneic and allogeneic bone transplantation , intensive efforts were made to find sufficient substitutes . A main demand on these materials , especially in healing of osseous defects , is to achieve results comparable to those of auto- or allografts . These must be related to their biomechanical and particularly to their biological properties , i . e . the ability to form new bone , osseous integration and physiological remodeling . Within different trials in the tibiae of sheep we investigated bone substitutes like hydroxyapatite ceramics ( HA ) or partially demineralized bone matrix ( pDBM ) and compared them to the gold standards of autogeneic and allogeneic bone transplantation . Therefore we used two different models : the drill hole model with small size defects of 6 mm in diameter and the shaft defect model as a true-to-life defect with a 5 cm large diaphyseal defect . Evaluation was done by X-rays , histology , microradioraphy , fluorescent microscopy and morphometry of the small size defects . HA showed only small effects on new bone formation and works merely as an osteoconductor . However , excellent new bone formation was regularly achieved by pDBM in the small defects , whereas it was limited in the large size defects . But considering their mechanism of action , it is possible to bridge large bone defects by pDBM ."
],
"offsets": [
[
0,
1384
]
]
}
] |
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] |
[] |
[] |
[
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DerOrthopaede.80270126.eng.abstr
|
DerOrthopaede.80270126.eng.abstr
|
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}
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] |
[] |
[] |
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DerOrthopaede.80270136.eng.abstr
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DerOrthopaede.80270136.eng.abstr
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[
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"Xenogenic bone biomaterials have been proposed as an alternative to autografts or allografts in human bone restoring or in complement of prosthetic surgery . When appropriate treatments were applied , immunological , inflammatory , bacteriological or virological adverse responses can be prevented . However , these treatments may interact with type I collagen , the major component of the organic bone matrix . Type I collagen can bind osteoblasts via specific cell surface receptors , the integrins . In this work , two different xenogenic biomaterials were studied . Both biomaterials have a bovine bone origin . They displayed similar architectural organization with connected plates and rods and similar surface topography and roughness . They differed by the presence or not of collagen type I. The first one was characterized by preservation of the type I collagen matrix associated with spindle-shaped hydroxyapatite crystals and the second was solely composed by heat-modified apatite crystals . Osteoblast-like cells ( Saos-2) were cultured on both biomaterials and examined in scanning and transmission electron microscopy after 7 and 14 days . Both biomaterials were cytocompatible as demonstrated by good ultrastructural cell preservation . ( 1 ) At the surface of the collagen containing biomaterial , cells were elongated in shape and oriented according to the trabecular architecture and to the superficial collagen network . After 14 days of culture , cells were confluent and the biomaterial surface was hidden by the cell sheet . The 1 integrin subunit was detected by immunogold in transmission electron microscopy in close relationship with the superficial collagen fibres of the biomaterial and with the outer cell surface . When cultures were carried out in presence of anti 1 integrin subunit , cells were packed and piled up with lack of specific orientation . ( 2 ) At the surface of the deproteinized biomaterial , cells were globular without specific disposition and often partially attached to the surface . After 14 days of culture , large areas of the biomaterial surface remained uncovered . Anti 1 subunits conjugated with gold particles were detected around the cells but with no specific association with the deproteinized biomaterial . These results strongly suggest that presence of type I collagen fibres in the matrix of a bone biomaterial is of major interest to determine cell attachment , spreading and orientation via interaction between type I collagen and 1 integrin subunit of osteoblasts ."
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DerOrthopaede.80270143.eng.abstr
|
DerOrthopaede.80270143.eng.abstr
|
[
{
"id": "DerOrthopaede.80270143.eng.abstr-passage-0",
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"In this study the outcome of autologous bone cell transplantation in artificial femur defects was tested within an animal study in sheeps . The bone cells were harvested by a small ileum biopsy and cultivated in an individual medium with 10 % autogenous serum and 90 % X-Vivo 10. After two weeks 4 millions of the cultured bone cells were transplanted in artificial femur defects with bone gelantine as carrier . The remaining cells were characterized by various tests ( Alkaline phosphatase , osteocalcin , collagen type I , calcification ) . This procedure was tested in 24 adult male sheeps . The side of transplantation was randomized by plan . The corresponding femur side represents the control side . After 10 days , 4 , 8 and 12 weeks animals were killed and the femura were taken for the following evaluation : histology , radiology , bonedensity and mechanical testing . The results show that the autologous bone transplantation leads to a significant higher bone regeneration in the bone defects . After ten days there was a lower migration of inflamation cells . After 4 weeks we find a significant increase of new bone formation on the transplantated side in the histological examination . After 8 weeks this significant difference was found even in the bonedensity . This difference increased in the 12 weeks group further on . The autogenous bone cell transplantation in the discribed way seems to be an potent method in the treatment of bone defects ."
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DerOrthopaede.80270160.eng.abstr
|
DerOrthopaede.80270160.eng.abstr
|
[
{
"id": "DerOrthopaede.80270160.eng.abstr-passage-0",
"type": "abstract",
"text": [
"During the past few years the treatment of rheumatoid arthritis , the most frequent of the rheumatic inflammatory systemic diseases has improved a great deal . The treatment strategy is based on the one hand on the so-called prognostic factors and on the other hand on the extent of the inflammatory activities , especially during the first phase . Numerous controlled studies and meta-analyses have enabled optimal application of the basic disease-modifying drugs , with regard to efficacy and side effects . During the first stage of these disease , the immunobiological substances against pro-inflammatory cells are employed . Improved knowledge of physiotherapeutic treatment , correct diet and careful observation of the patient's progress with the aid of questionnaires enable optimal care with regard to life quality ."
],
"offsets": [
[
0,
825
]
]
}
] |
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DerOrthopaede.80270167.eng.abstr
|
DerOrthopaede.80270167.eng.abstr
|
[
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"id": "DerOrthopaede.80270167.eng.abstr-passage-0",
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"The hand ( wrist and fingers ) is one of the regions most frequently affected by rheumatic arthritis ( RA ) . The nature of the alterations involved means it is possible to interpret the clinical picture as RA even from the external appearance . Obviously the functional handicap affects activities of daily living , and the insult to the patient's aesthetic sensibilities imposes an additional , psychological , burden . A generally satisfactory limitation of damage can only be expected from professionals who work well together as a team . The ability to devise a therapy plan with the right priorities is the mark of those who have mastered the art of surgery for rheumatic conditions . Operative treatment presupposes failure of a conservative therapy carried out according to modern views . In addition to operations on the affected joints , operations on the tendons of the hand are also highly significant in terms of function . The interventions that can be performed on the joints embrace synovectomies , arthroplasties and arthrodeses . In the last 20 years the absolute number of joint synovectomies has fallen , since at least in treatment of the early stages radiosynoviorthesis has become increasingly important , especially for the metacarpophalangeal ( MP ) and proximal interphalangeal ( PIP ) joints . Operative synovectomy is now considered when radiosynoviorthesis fails or in more advanced stages ( Larsen 3 ) and when reconstruction procedures ( especially on the tendons ) are necessary . The chances are also better with open synovectomy ( with or without resection of the head of the ulna ) at the wrist . The results of synovectomy are not so impressive from the radiological aspect as from the clinical viewpoint , since as a result of the removal or attenuation of pain the function is often improved to the status of more than 10 years before and valuable time is thus gained . When the destruction is too far advanced arthroplasty is considered , especially for the MP joints but increasingly also for the PIP joints . Arthrodesis is a still highly valuable procedure for the wrist , since there is no really satisfactory artificial joint . An arthroplasty can only be successful if the tendons are intact . Tenosynovectomy and repair of ruptures have a good prognosis if appropriate techniques are used . The correction of such typical deformities of the fingers as buttonhole and swan neck deformity requires some of the technically more demanding operations ."
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DerOrthopaede.80270177.eng.abstr
|
DerOrthopaede.80270177.eng.abstr
|
[
{
"id": "DerOrthopaede.80270177.eng.abstr-passage-0",
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"Patients with rheumatoid arthritis suffer frequently from instabilities and deformities of the cervical spine which require surgical treatment . The most frequent indication for surgery represents the transverse atlantoaxial instability . As long the atlantoaxial instability remains reducible in extension a limited posterior exposure and screw fixation is adequate . Only situations with fixed dislocations and signs of myelopathy require anterior transoral decompression with simultaneous occipitocervical fusion . In the lower cervical spine , kyphotic deformities require anterior decompression and posterior stabilization in the case of electrophysiologically confirmed neurological deficits . A combined procedure with anterior vertebrectomy and decompression and posterior plate fixation is indicated since the poor bone quality rarely allows anterior stable fixation ."
],
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877
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]
}
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[] |
[] |
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DerOrthopaede.80270183.eng.abstr
|
DerOrthopaede.80270183.eng.abstr
|
[
{
"id": "DerOrthopaede.80270183.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Thirty-seven patients with 20 cemented Thompson-Richards prostheses and 19 cementless S. T. A. R. prostheses ( 2 bilateral cases ) were followed up after 1-12 years . Rheumatoid arthritis was the main diagnosis in both populations , with females dominating . The investigation was based on the Kofoed ankle score . At follow-up the total scoring improved to 86.9 pts . in S. T. A. R. and to 77.7 pts . in T. R. P. replacement . The radiological examination showed a high rate of radiolucency for the tibial component ( 53.3 % ) in cemented T. R. P. ; subsidence of talar component was seen in 3 cases with T. R. P. In cementless S. T. A. R. prosthesis only 3 cases showed small radiolucent lines of the flat tibial component . Talar subsidence was not seen at all . In T. R. P. we had two revisions due to prosthesis loosening and one maleollar fracture , giving a cumulative estimated survival rate of 87 % at 12 years . In the S. T. A. R. prosthesis group two revisions had to be performed because of one meniscal breakage and correction of meniscal height . The estimated survival rate at 6 years was 94.3 % ."
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[] |
[] |
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DerOrthopaede.80270188.eng.abstr
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DerOrthopaede.80270188.eng.abstr
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[
{
"id": "DerOrthopaede.80270188.eng.abstr-passage-0",
"type": "abstract",
"text": [
"In rheumatoid arthritis of the knee joint good results are obtained using arthroscopic synovectomy or radiation synovectomy . Aim of our study was to investigate , wether the combination of these two minimal invasive interventions achieves better results . First we performed arthroscopic synovectomy of the knee joint followed by radiation synovectomy with application of 111-222 MBq Yttrium-90 6 weeks later . In a prospective randomised clinical trial between 1987 and 1991 we performed radiation synovectomy on 22 knee joints and combined arthroscopic and radiation synovectomy on 26 knee joints . We explored the patients preoperatively , 6 weeks and 6 months postoperatively . In 1996 we evaluated 141 knee joints in a retrospective clinical trial . 90 Knee joints had been treated with the combined therapy , 39 only with radiation synovectomy and 12 only with arthroscopic synovectomy . Depending on the three different therapeutic interventions , the patients were classified into mid-term ( 3-5 years ) and long-term ( 6-8 years ) observation groups . The trials are based on the standardized ARO-Questionnaire of the knee joint , the modified ARO Knee-Score and the radiological grading according to Larsen , Dale and Eek . In the prospective clinical trial we found significant better results for patients treated with the combined therapy than for patients treated with radiation synovectomy only regarding the parameter swelling , effusion , range of motion , pain and Knee-Score . In the long-term results of the retrospective clinical trial the patients treated with the combined therapy showed a significant better outcome for the parameters pain , swelling and Knee-Score , than the patients treated with radiation synovectomy . Although no statistically significant difference was found comparing the results of the combined therapy with arthroscopic synovectomy , an improvement of the clinical outcome can be observed performing arthroscopic synovectomy followed by radiation synovectomy . In the treatment of rheumatoid arthritis of the knee joint a better outcome is achieved performing combined arthroscopic and radiation synovectomy than performing only one of the methods ."
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DerOrthopaede.80270231.eng.abstr
|
DerOrthopaede.80270231.eng.abstr
|
[
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"Bisphosphonates are a new therapeutic option in the treatment of bone diseases . They inhibit osteoclastic bone resorption and are established in the treatment of osteoporosis , Paget's disease of bone and especially in tumor bone disease . The effects of pamidronate , clodronate and ibandronate in the treatment of hypercalcemia of malignancy and osteolytic bone disease have been extensively studied . These drugs represent the treatment of choice in hypercalcemia of malignancy . The regular application of bisphosphonates reduces skeletal-related events like pathologic fracture , bone pain or hypercalcemia of malignancy , especially in breast cancer and multiple myeloma . Of great interest are the ongoing studies concerning prophylactic application of bisphosphonates in tumors bearing a high risk for bone metastases , especially since the first results suggest a significant reduction in the development of bone metastases in breast cancer patients ."
],
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0,
961
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}
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] |
DerOrthopaede.80270240.eng.abstr
|
DerOrthopaede.80270240.eng.abstr
|
[
{
"id": "DerOrthopaede.80270240.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Bone is among the most common sites of metastatic disease in cancers of the breast , prostate , and lung . The decision about systemic therapy depends on the histology , presence and extent of extraskeletal disease , and the performance status of the patient . For patients with estrogen-receptor-positive breast cancer or prostate cancer , hormonal treatment represents the treatment of choice . In estrogen-receptor-negative breast cancer , and for patients who have failed hormonal therapy or have liver metastases , chemotherapy should be initiated . All patients with small-cell lung cancer should receive chemotherapy . Bone metastases of differentiated thyroid cancers can be treated with radioisotopes . In non-small-cell lung cancer or renal cell cancer , systemic chemotherapy should be confined to younger patients and patients in good general condition . Radiologic assessment of responses of skeletal metastases to systemic therapy is often difficult . New approaches in measuring bone metabolites in urine might prove helpful ."
],
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0,
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}
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DerOrthopaede.80270245.eng.abstr
|
DerOrthopaede.80270245.eng.abstr
|
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"Local radiotherapy plays an important role in the palliative management of bone metastases . Different concepts of dose fractionation are in use . A judgement of the efficacy of these concepts should be based on their different palliative treatment endpoints . The efficacy of radiotherapy using published data can be analysed with respect to pain relief and re-establishment of bone integrity as treatment endpoints . Trials stratifiying radiooncological techniques according to an optimization of quality of life are missing . Nevertheless , the rationale for individual treatment in daily work is based on systemic tumor extent , life expectancy , the kind of symptoms and the location of the metastasis in question . In patients with reduced live expectancy a remarkably high chance of pain relief ( 70 % ) could be achieved with single doses of 8 Gy . The latency period until pain relief is shorter with higher single doses . In case of recurrence of pain reirradiation with a single dose results in an equally high response rate . Patients with a solitary metastasis , patients with longer live expectancy and patients with pathological fractures should be treated with ' curative ' doses , aimed to cause maximum tumor cell killing . Impaired bone stability in patients who are not suitable for surgical intervention requires orthetic supply . Apart from the effect of pain relief , remineralization is the important treatment goal for these patients . Conventional radiotherapy with doses of 40-50 Gy resulted in remineralization in 60-80 % of the patients 4-8 weeks after irradiation . Remineralization could not be acceierated by short course fractionation courses ."
],
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]
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DerOrthopaede.80270269.eng.abstr
|
DerOrthopaede.80270269.eng.abstr
|
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"text": [
"Therapeutic interventions in the skeletal system are an essential part of interventional radiology . Although in terms of figures these procedures are applied less frequently , they are very effective . Percutaneous transarterial embolization of a spinal tumor is well-established interventional treatment . It is primary treatment for preoperative devascularization , but also for palliation of pain and for reduction of tumor volume . As an alternative access for embolization , direct percutaneous puncture of a vertebra is used . A new and promising technique is vertebroplasty , the percutaneous injection of acrylic surgical cement in destroyed vertebrae . The present paper discusses indications , technique , results and complications of these interventional therapeutic modalities in the treatment of primary and secondary spinal tumors ."
],
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}
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DerOrthopaede.80270274.eng.abstr
|
DerOrthopaede.80270274.eng.abstr
|
[
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"Operations on skeletal metastases of the extremities represent the most frequent surgical treatment in orthopedic oncology . From 1970 to 1997 , 340 patients were operated on in 383 surgical procedures in the Orthopedic Department of the University of Heidelberg . Carcinoma of the breast and renal cell carcinoma were the most common primary tumors . Operations concerned mainly the femur with acetabulum ( 55 % ) and the humerus with glenoid ( 25 % ) . A pathologic fracture occurred in 51 % . While in these cases surgical treatment is absolutely necessary , it is contraindicated in preterminal patients . In imminent fractures or peripheral compression syndromes , the indication is relative and has to be justified on a multidisciplinary basis . Marginal resection of the tumor is allowed because of the limited life expectancy of most patients . Only in patients with solitary metastases and a better prognosis the resection of metastasis margin can be more extensive . Intensification of local therapy by adjuvant irradiation is indicated in an R2 situation , depending on the patient's prognosis . An analysis of our cases from 1994 to 1996 exemplifies the increasing use of modular tumor endoprostheses ( 52 % ) . In meta-diaphyseal and diaphyseal cases , cement-augmented osteosynthesis is mainly used ( 34 % ) . The application of these established reconstruction techniques after metastasis resection in cases with adjuvant radiotherapy assures a pain-free extremity capable of weight bearing ."
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] |
DerOrthopaede.80270282.eng.abstr
|
DerOrthopaede.80270282.eng.abstr
|
[
{
"id": "DerOrthopaede.80270282.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Bone metastases of the vertebral spine occur frequently after breast cancer , hypernephroma or thyroid carcinoma . Located commonly in the lumbar and thoracic spine , half of the lesions are found in the vertebral body , but in many cases lamina and pedicles are also involved . Pain resistant to conservative treatment , vertebral compression fracture and segmental instability , together with progredient neurologic deficits and para- or tetraplegia , all make operative intervention mandatory . In this article dorsal decompression and stabilization are compared to ventral decompression and compound osteosynthesis . Segmental stability and life-time prognosis of the patient are important factors to decide on the best surgical procedure . Dorsal decompression without stabilization should only be performed as a palliative procedure in patients with an inoperative tumor , poor prognosis , or if the estimated postoperative segmental stability seems to be sufficient . In cases of a solitary metastasis , after radical resection of the primary tumor and when the prognosis is good total vertebrectomy can be performed . In addition to surgical treatment , adjuvant chemotherapy and/or radiation therapy should be performed in a multidisciplinary setting ."
],
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[
0,
1261
]
]
}
] |
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DerOrthopaede.80270287.eng.abstr
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DerOrthopaede.80270287.eng.abstr
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"Due to a rise in life expectancy as well as improved adjuvant and diagnostic measures the incidence of clinically symptomatic metastases has significantly increased . In terms of indication and operative technique in the treatment of these lesions the biologic age , general condition , diagnosis , stage and activity of the disease and the patient's prognosis are highly important . Different techniques of joint replacement have been described to treat patients suffering from metastatic disease of the periacetabular region , beeing resistant to any kind of adjuvant therapy . From 1977-1996 21 patients with a periacetabular lesion received a tumor prosthesis following internal hemipelvectomy ( average age 60 years ; average survival 23,1 months ) . Perioperative complication rate was 42 % , functional results were good ( n = ) , fair ( n = 9 ) and poor ( n = 2 ) . Mobilisation and analgesia are the most important therapeutic goals . The quality of the patient's life postop is the major point ."
],
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[] |
[] |
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DerOrthopaede.80270294.eng.abstr
|
DerOrthopaede.80270294.eng.abstr
|
[
{
"id": "DerOrthopaede.80270294.eng.abstr-passage-0",
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"Surgical resection of osseous metastases is becoming more and more important in obtaining longer overall survival in carcinoma patients . In 228 cases surgically treated at our institution between 1980 and 1993 , the survival was 49 % after 1 year , 32 % after 2 years , 22 % after 3 years and , finally , 11 % after 5 years . Retrospectively evaluated , breast and thyroid carcinoma proved to be of positive prognostic influence and lung cancer of negative significance . As a main significant parameter , further extraosseous metastases were evaluated . The prognostic influence of the number of osseous lesions could only be demonstrated in breast and renal cell carcinoma without involvement of further organs . Age and location of the skeletal lesions proved to be of no prognostic influence . Based on these prognostic parameters , three subgroups of patients with worse , median and good long-term survival could be defined . In conclusion , the indication and amount of surgery can be based on these prognostic factors , leading to a decrease in morbidity and hospitalization time in patients with limited survival ."
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}
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[] |
[] |
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DerOrthopaede.80270324.eng.abstr
|
DerOrthopaede.80270324.eng.abstr
|
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"The ARO multicenter study intended to show clinical and radiological differences with regard to different systems of fixation and designs of the prothesis in total hip replacement in patients with hip dysplasia , osteoarthritis and rheumatoid arthritis . In 1987 and 1988 5255 total hip prothesis were implanted by the 24 hospitals which took part in the study . 3133 prothesis ( 95,6 % ) were clinically and radiologically examined . The follow-up period averaged 6.9 years . The results of the Aro multicenter-study showed that despite difficult preoperative conditions especially in cases of rheumatoid arthritis the satisfaction rate improved remarkably . During the operation less complications arose in comparison to patients with hip dysplasia and osteoarthritis . Regarding the rate of infection after operation there were no differences between the 3 groups . Only the rate of postoperative luxation concerning rheumatoid patients turned out to be twice the number of the others . In our opinion this is due to the fact that these rheumatics were operated by posterior approach . Patients with rheumatoid arthritis were satisfied most with their surgeries . Results of rheumatic patients according to Harris hip score were slightly worse than the results of the two other groups . This was due to systemic involvement and bad preoperative function of the hip . As a result of the study there were no differences in using cemented or cementless techniques for rheumatic hip replacement . The decision for the method of fixation should depend on the patient's ability to relief the prothesis after operation . The study has shown that cementless implantation can also be used for young rheumatics provided that a suitable design of prothesis will be selected ."
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DerOrthopaede.80270341.eng.abstr
|
DerOrthopaede.80270341.eng.abstr
|
[
{
"id": "DerOrthopaede.80270341.eng.abstr-passage-0",
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"text": [
"The analysis of THR-failures showed that the acetabular component still is the main problem of total hip replacement . The acetabular cup fails more often than the stem . In the midterm analysis the failure rate is a little bit higher in cementless than in cement fixed cups . The known effect that the failure rate of cups fixed with cement increases exponentially 8 to 10 years after implantation , could of course not be seen in this study . The success of the cementless fixation was negatively influenced by the diagnosis rheumatoid arthritis , age over 70 and the fixation manner : the failure rate of threaded cups was higher than the one of pressfit cups although the Zweymueller-cup as well as the Link type V-cup showed good results . The midterm results of the stem were very good for the cementless as for the cemented technique . Some implants showed compared to others significantly worse results . The further implantation should be thought of , what partially has already happened . The results of cementless stem fixation in patients with rheumatoid arthritis , osteoarthrosis and dysplastic osteoarthritis is comparable , so that cementless fixation should be thought of in case of adequate conditions ( ability of partial weight bearing for some weeks , age under 60 ) ."
],
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}
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[] |
[] |
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] |
DerOrthopaede.80270349.eng.abstr
|
DerOrthopaede.80270349.eng.abstr
|
[
{
"id": "DerOrthopaede.80270349.eng.abstr-passage-0",
"type": "abstract",
"text": [
"In a retrospective analysis the migration profile of 73 cementless total hip implants ( Zweymueller Alloclassic ) in 54 patients with rheumatoid arthritis were compared with the results of 58 implants of the same design in 50 patients undergoing cementless revision after loosening of an Endler cup . 258 conventional radiographs of the rheumatoid patients and 164 radiographs of the revision group were digitized . The migration analysis was performed using a modified Dickob's technique that allows for correction of different X-ray magnifications as well as horizontal and vertical tilting of the pelvis . The analysis of migration exceeded 2 mm in eight rheumatoid patients . In three of them clinical loosening of the acetabular cup was obvious . In the group of patients after cup revision a significantly higher amount of cranial migration was detected compared with the rheumatoid patients . This phenomenon could be explained by the destruction of the weight-bearing cranial acetabular sclerosis after reaming ."
],
"offsets": [
[
0,
1020
]
]
}
] |
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18
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"id": "DerOrthopaede.80270349.eng.abstr-s1-t3",
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32,
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"hip"
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"id": "DerOrthopaede.80270349.eng.abstr-s1-t9",
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}
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"id": "DerOrthopaede.80270349.eng.abstr-s2-t1",
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"radiographs"
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"id": "DerOrthopaede.80270349.eng.abstr-s3-t1",
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"id": "DerOrthopaede.80270349.eng.abstr-s3-t4",
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"X-ray"
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},
{
"id": "DerOrthopaede.80270349.eng.abstr-s3-t5",
"type": "umlsterm",
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] |
[] |
[] |
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DerOrthopaede.80270354.eng.abstr
|
DerOrthopaede.80270354.eng.abstr
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[
{
"id": "DerOrthopaede.80270354.eng.abstr-passage-0",
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"From 1986 to 1996 , we implanted a total of 92 hip arthroplasties ( 86 cementless , 4 hybrid and 2 cemented ) in 65 patients with rheumatoid arthritis . Of the 89 uncemented cups , 59 were threaded cups ( Hofer-Imhof n = 45 , Zweymueller n = 7 , Mecring n = 5 , PM n = 2 ) and 30 were hemispherical cups of the Harris Galante type I and II . 87 stems were implanted without cement ( Zweymueller SL n = 58 , Uni n = 16 , Schenker n = 9 , Zweymueller I n = 4 ) and 5 with cement . One patient died postoperatively and three ( 4 implants ) within the first year . To date , one cup of each threaded type had to be revised because of loosening ( revision rate approx . 6.8 % ) ; Up to now , three of 87 ( approx . 3.4 % ) stem revisions ( 1 x Zweymueller I , 1 x Schenker , 1 x Zweymueller SL ) have been undertaken . Ten patients with twelve hip arthroplasties did not return for follow-up ; some of them had a poor general health status . The clinical and radiological results of the arthroplasties of 52 patients showed a Harris Hip Score averaging 72 after an average of 54 months ( min . 12-max . 132 ) . Ten patients had minor complaints in the hip region . 79 % of the uncemented implants ( 70 out of 89 cups , 69 out of 87 stems ) were assessed radiologically . Two threaded cups showed slight migration after cancellous bone grafting in the presence of acetabular protrusion that was present in a total of 13 hip joints . This subsided markedly after filling with cancellous bone and recentering of the hip joint . Homogeneous incorporation of the bone grafting und thus remodelling of the medial wall was achieved , with the bone graft exhibiting marked reduction . At final follow-up , approx . 75 % of the cementless cups had complete bone ingrowth without any evidence of radiolucency ( type I ) , approx . 19 % had near-complete bone ingrowth with minimal radiolucencies in one zone or in a maximum of 50 % of the bone contact area ( type II ) and approx . 6 % had radiolucencies in more than 50 % of the bone contact area ( type III ) . The radiographic evaluation of the most frequently used stem ( Zweymueller SL ) showed approx . 47 % with only slight remodelling of the calcar ( type I ) , approx . 33 % with moderate loss of femoral density ( type II ) and approx . 20 % with severe bone loss and thinning of cortical bone ( type III ) ."
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DerOrthopaede.80270366.eng.abstr
|
DerOrthopaede.80270366.eng.abstr
|
[
{
"id": "DerOrthopaede.80270366.eng.abstr-passage-0",
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"text": [
"Reviewing the literature the revision arthroplasty of the hip joint with acetabular reinforcement rings shows good results concerning a follow-up period of six years in comparison with cemented or non-cemented primary implants . We use different acetabular reinforcement rings with differentiated indications . The primary assignment is the secure fixation of the ring to the vital bone . The acetabular bone defect is filled with autogenous or homogenous bone grafts . The increasing number of massive acetabular defects made us develop a new acetabular reinforcement ring . It allows a better fixation than the Burch-Schneider Ring and is cheaper than the individual acetabular implant . Since 1988 we performed 262 revision arthroplasty with acetabular reinforcement rings . Until 1996 we evaluated 174 reinforcement rings ( 41 Mueller rings , 72 Ganz rings , 41 Burch-Schneider rings , 6 RS or RSH rings , 5 individual acetabular implants ) . After an average follow-up period of 5,6 years a radiological or clinical loosening of the acetabular component occurred in only 6 patients ( 3,4 % ) . To reach a better comparison of the surgical results we developed a score , which differentiately checks the operative goals . On plane pelvic radiographs we checked the reconstruction of the rotationcenter , the demarcation of the acetabular component and the outcome of the bone transplant ."
],
"offsets": [
[
0,
1392
]
]
}
] |
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] |
[] |
[] |
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"id": "DerOrthopaede.80270366.eng.abstr-s11-r1-t2.1-t3.2",
"type": "location_of",
"arg1_id": "DerOrthopaede.80270366.eng.abstr-s11-t2",
"arg2_id": "DerOrthopaede.80270366.eng.abstr-s11-t3",
"normalized": []
}
] |
DerOrthopaede.80270375.eng.abstr
|
DerOrthopaede.80270375.eng.abstr
|
[
{
"id": "DerOrthopaede.80270375.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Pronounced osteoporosis of and surrounding the acetabulum commonly leads to early loosening of endoprosthetic hip replacements following implantation . Large osseous defects in the subimplant bed are the result and the reason why multiple revisions of loosened acetabular cups have to be performed so often in rheumatic surgery . The defects extend from the cranial to the central ; ventral and dorsal anchorage losses may occur in addition to this . The anchorage of a new implant must be adapted to the individual circumstances . The new implant must be selected in accordance with point of surgical access , the patient's general status and osseous regenerationability . In the optimum case , osseous buildup of lost anatomical structures is the preferred method . If this is not possible , special implants , mostly custom-made prostheses , have to be incorporated . However , the survival time of the implants is much shorter than in patients with degenerative diseases ."
],
"offsets": [
[
0,
976
]
]
}
] |
[
{
"id": "DerOrthopaede.80270375.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"osteoporosis"
],
"offsets": [
[
11,
23
]
],
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"db_name": "UMLS",
"db_id": "C0029456"
}
]
},
{
"id": "DerOrthopaede.80270375.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"acetabulum"
],
"offsets": [
[
47,
57
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0000962"
}
]
},
{
"id": "DerOrthopaede.80270375.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"hip"
],
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[
110,
113
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0019552"
}
]
},
{
"id": "DerOrthopaede.80270375.eng.abstr-s1-t4",
"type": "umlsterm",
"text": [
"implantation"
],
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[
137,
149
]
],
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"db_name": "UMLS",
"db_id": "C0029976"
}
]
},
{
"id": "DerOrthopaede.80270375.eng.abstr-s1-t5",
"type": "umlsterm",
"text": [
"hip replacements"
],
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[
110,
126
]
],
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{
"db_name": "UMLS",
"db_id": "C0392806"
}
]
},
{
"id": "DerOrthopaede.80270375.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"defects"
],
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[
166,
173
]
],
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{
"db_name": "UMLS",
"db_id": "C0243067"
}
]
},
{
"id": "DerOrthopaede.80270375.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"subimplant"
],
"offsets": [
[
181,
191
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0021533"
}
]
},
{
"id": "DerOrthopaede.80270375.eng.abstr-s2-t3",
"type": "umlsterm",
"text": [
"bed"
],
"offsets": [
[
192,
195
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0004916"
},
{
"db_name": "UMLS",
"db_id": "C0596170"
}
]
},
{
"id": "DerOrthopaede.80270375.eng.abstr-s2-t4",
"type": "umlsterm",
"text": [
"surgery"
],
"offsets": [
[
320,
327
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0038894"
},
{
"db_name": "UMLS",
"db_id": "C0038895"
}
]
},
{
"id": "DerOrthopaede.80270375.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"defects"
],
"offsets": [
[
334,
341
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0243067"
}
]
},
{
"id": "DerOrthopaede.80270375.eng.abstr-s5-t1",
"type": "umlsterm",
"text": [
"surgical"
],
"offsets": [
[
593,
601
]
],
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{
"db_name": "UMLS",
"db_id": "C0038895"
}
]
},
{
"id": "DerOrthopaede.80270375.eng.abstr-s5-t2",
"type": "umlsterm",
"text": [
"regenerationability"
],
"offsets": [
[
652,
671
]
],
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{
"db_name": "UMLS",
"db_id": "C0034963"
}
]
},
{
"id": "DerOrthopaede.80270375.eng.abstr-s5-t3",
"type": "umlsterm",
"text": [
"regenerationability"
],
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[
652,
671
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0085732"
}
]
},
{
"id": "DerOrthopaede.80270375.eng.abstr-s6-t1",
"type": "umlsterm",
"text": [
"anatomical"
],
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[
720,
730
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0220784"
}
]
},
{
"id": "DerOrthopaede.80270375.eng.abstr-s6-t2",
"type": "umlsterm",
"text": [
"method"
],
"offsets": [
[
759,
765
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0025663"
},
{
"db_name": "UMLS",
"db_id": "C0025664"
}
]
},
{
"id": "DerOrthopaede.80270375.eng.abstr-s7-t1",
"type": "umlsterm",
"text": [
"implants"
],
"offsets": [
[
802,
810
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0013183"
}
]
},
{
"id": "DerOrthopaede.80270375.eng.abstr-s7-t2",
"type": "umlsterm",
"text": [
"prostheses"
],
"offsets": [
[
832,
842
]
],
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"db_name": "UMLS",
"db_id": "C0525024"
},
{
"db_name": "UMLS",
"db_id": "C0175649"
}
]
},
{
"id": "DerOrthopaede.80270375.eng.abstr-s8-t1",
"type": "umlsterm",
"text": [
"survival"
],
"offsets": [
[
885,
893
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0220921"
},
{
"db_name": "UMLS",
"db_id": "C0038952"
}
]
},
{
"id": "DerOrthopaede.80270375.eng.abstr-s8-t2",
"type": "umlsterm",
"text": [
"time"
],
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[
894,
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]
],
"normalized": [
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"db_id": "C0040223"
}
]
},
{
"id": "DerOrthopaede.80270375.eng.abstr-s8-t3",
"type": "umlsterm",
"text": [
"patients"
],
"offsets": [
[
939,
947
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0030705"
}
]
},
{
"id": "DerOrthopaede.80270375.eng.abstr-s8-t4",
"type": "umlsterm",
"text": [
"diseases"
],
"offsets": [
[
966,
974
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0012634"
}
]
}
] |
[] |
[] |
[
{
"id": "DerOrthopaede.80270375.eng.abstr-s1-r1-t4.1-t1.1",
"type": "result_of",
"arg1_id": "DerOrthopaede.80270375.eng.abstr-s8-t4",
"arg2_id": "DerOrthopaede.80270375.eng.abstr-s8-t1",
"normalized": []
},
{
"id": "DerOrthopaede.80270375.eng.abstr-s1-r2-t2.1-t4.1",
"type": "location_of",
"arg1_id": "DerOrthopaede.80270375.eng.abstr-s8-t2",
"arg2_id": "DerOrthopaede.80270375.eng.abstr-s8-t4",
"normalized": []
},
{
"id": "DerOrthopaede.80270375.eng.abstr-s1-r3-t3.1-t2.1",
"type": "adjacent_to",
"arg1_id": "DerOrthopaede.80270375.eng.abstr-s8-t3",
"arg2_id": "DerOrthopaede.80270375.eng.abstr-s8-t2",
"normalized": []
},
{
"id": "DerOrthopaede.80270375.eng.abstr-s1-r4-t3.1-t5.1",
"type": "location_of",
"arg1_id": "DerOrthopaede.80270375.eng.abstr-s8-t3",
"arg2_id": "DerOrthopaede.80270375.eng.abstr-s1-t5",
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},
{
"id": "DerOrthopaede.80270375.eng.abstr-s1-r5-t2.1-t1.1",
"type": "location_of",
"arg1_id": "DerOrthopaede.80270375.eng.abstr-s8-t2",
"arg2_id": "DerOrthopaede.80270375.eng.abstr-s8-t1",
"normalized": []
},
{
"id": "DerOrthopaede.80270375.eng.abstr-s1-r6-t2.1-t3.1",
"type": "adjacent_to",
"arg1_id": "DerOrthopaede.80270375.eng.abstr-s8-t2",
"arg2_id": "DerOrthopaede.80270375.eng.abstr-s8-t3",
"normalized": []
},
{
"id": "DerOrthopaede.80270375.eng.abstr-s1-r7-t1.1-t5.1",
"type": "associated_with",
"arg1_id": "DerOrthopaede.80270375.eng.abstr-s8-t1",
"arg2_id": "DerOrthopaede.80270375.eng.abstr-s1-t5",
"normalized": []
},
{
"id": "DerOrthopaede.80270375.eng.abstr-s1-r8-t5.1-t4.1",
"type": "affects",
"arg1_id": "DerOrthopaede.80270375.eng.abstr-s1-t5",
"arg2_id": "DerOrthopaede.80270375.eng.abstr-s8-t4",
"normalized": []
},
{
"id": "DerOrthopaede.80270375.eng.abstr-s1-r9-t3.1-t4.1",
"type": "location_of",
"arg1_id": "DerOrthopaede.80270375.eng.abstr-s8-t3",
"arg2_id": "DerOrthopaede.80270375.eng.abstr-s8-t4",
"normalized": []
},
{
"id": "DerOrthopaede.80270375.eng.abstr-s1-r10-t1.1-t4.1",
"type": "result_of",
"arg1_id": "DerOrthopaede.80270375.eng.abstr-s8-t1",
"arg2_id": "DerOrthopaede.80270375.eng.abstr-s8-t4",
"normalized": []
},
{
"id": "DerOrthopaede.80270375.eng.abstr-s1-r11-t3.1-t1.1",
"type": "location_of",
"arg1_id": "DerOrthopaede.80270375.eng.abstr-s8-t3",
"arg2_id": "DerOrthopaede.80270375.eng.abstr-s8-t1",
"normalized": []
},
{
"id": "DerOrthopaede.80270375.eng.abstr-s1-r12-t5.1-t1.1",
"type": "associated_with",
"arg1_id": "DerOrthopaede.80270375.eng.abstr-s1-t5",
"arg2_id": "DerOrthopaede.80270375.eng.abstr-s8-t1",
"normalized": []
},
{
"id": "DerOrthopaede.80270375.eng.abstr-s1-r13-t2.1-t5.1",
"type": "location_of",
"arg1_id": "DerOrthopaede.80270375.eng.abstr-s8-t2",
"arg2_id": "DerOrthopaede.80270375.eng.abstr-s1-t5",
"normalized": []
},
{
"id": "DerOrthopaede.80270375.eng.abstr-s2-r1-t3.1-t3.2",
"type": "causes",
"arg1_id": "DerOrthopaede.80270375.eng.abstr-s8-t3",
"arg2_id": "DerOrthopaede.80270375.eng.abstr-s2-t3",
"normalized": []
},
{
"id": "DerOrthopaede.80270375.eng.abstr-s2-r2-t3.1-t3.2",
"type": "issue_in",
"arg1_id": "DerOrthopaede.80270375.eng.abstr-s8-t3",
"arg2_id": "DerOrthopaede.80270375.eng.abstr-s2-t3",
"normalized": []
},
{
"id": "DerOrthopaede.80270375.eng.abstr-s2-r3-t3.2-t1.1",
"type": "produces",
"arg1_id": "DerOrthopaede.80270375.eng.abstr-s2-t3",
"arg2_id": "DerOrthopaede.80270375.eng.abstr-s8-t1",
"normalized": []
},
{
"id": "DerOrthopaede.80270375.eng.abstr-s2-r4-t1.1-t3.2",
"type": "affects",
"arg1_id": "DerOrthopaede.80270375.eng.abstr-s8-t1",
"arg2_id": "DerOrthopaede.80270375.eng.abstr-s2-t3",
"normalized": []
},
{
"id": "DerOrthopaede.80270375.eng.abstr-s2-r5-t4.2-t3.2",
"type": "issue_in",
"arg1_id": "DerOrthopaede.80270375.eng.abstr-s2-t4",
"arg2_id": "DerOrthopaede.80270375.eng.abstr-s2-t3",
"normalized": []
},
{
"id": "DerOrthopaede.80270375.eng.abstr-s2-r6-t1.1-t3.2",
"type": "issue_in",
"arg1_id": "DerOrthopaede.80270375.eng.abstr-s8-t1",
"arg2_id": "DerOrthopaede.80270375.eng.abstr-s2-t3",
"normalized": []
},
{
"id": "DerOrthopaede.80270375.eng.abstr-s5-r1-t1.1-t3.1",
"type": "affects",
"arg1_id": "DerOrthopaede.80270375.eng.abstr-s8-t1",
"arg2_id": "DerOrthopaede.80270375.eng.abstr-s8-t3",
"normalized": []
},
{
"id": "DerOrthopaede.80270375.eng.abstr-s5-r2-t3.1-t1.1",
"type": "measurement_of",
"arg1_id": "DerOrthopaede.80270375.eng.abstr-s8-t3",
"arg2_id": "DerOrthopaede.80270375.eng.abstr-s8-t1",
"normalized": []
},
{
"id": "DerOrthopaede.80270375.eng.abstr-s7-r1-t2.1-t2.2",
"type": "uses",
"arg1_id": "DerOrthopaede.80270375.eng.abstr-s8-t2",
"arg2_id": "DerOrthopaede.80270375.eng.abstr-s7-t2",
"normalized": []
},
{
"id": "DerOrthopaede.80270375.eng.abstr-s8-r1-t4.1-t3.1",
"type": "occurs_in",
"arg1_id": "DerOrthopaede.80270375.eng.abstr-s8-t4",
"arg2_id": "DerOrthopaede.80270375.eng.abstr-s8-t3",
"normalized": []
},
{
"id": "DerOrthopaede.80270375.eng.abstr-s8-r2-t3.1-t1.1",
"type": "performs",
"arg1_id": "DerOrthopaede.80270375.eng.abstr-s8-t3",
"arg2_id": "DerOrthopaede.80270375.eng.abstr-s8-t1",
"normalized": []
}
] |
DerOrthopaede.80270381.eng.abstr
|
DerOrthopaede.80270381.eng.abstr
|
[
{
"id": "DerOrthopaede.80270381.eng.abstr-passage-0",
"type": "abstract",
"text": [
"As a part of a long-term follow up ( I ) of 544 cemented Mueller-curved stem total hip replacements ( THR ) , implanted 1977 to 1983 , 207 THR in 163 patients with rheumatoid arthritis ( RA ) were evaluated 9 to 15 years ( 11 on an average ) postoperatively . The feed back rate was 96.9 % so the results are very reliable . 18 cups were loosened ( 13 already changed ) , but no stem had to be changed for aseptic loosening . 2 THR ( 1.0 % ) had to be revised because of deep infection . Survival rate of Kaplan and Meier for aseptic loosening was 94.6 % after 10 years , 83.5 % after 15 years ."
],
"offsets": [
[
0,
595
]
]
}
] |
[
{
"id": "DerOrthopaede.80270381.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"hip"
],
"offsets": [
[
83,
86
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0019552"
}
]
},
{
"id": "DerOrthopaede.80270381.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"patients"
],
"offsets": [
[
150,
158
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0030705"
}
]
},
{
"id": "DerOrthopaede.80270381.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"arthritis"
],
"offsets": [
[
175,
184
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0003864"
}
]
},
{
"id": "DerOrthopaede.80270381.eng.abstr-s1-t4",
"type": "umlsterm",
"text": [
"hip replacements"
],
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[
83,
99
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0392806"
}
]
},
{
"id": "DerOrthopaede.80270381.eng.abstr-s1-t5",
"type": "umlsterm",
"text": [
"rheumatoid arthritis"
],
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[
164,
184
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0003873"
}
]
},
{
"id": "DerOrthopaede.80270381.eng.abstr-s1-t6",
"type": "umlsterm",
"text": [
"total hip replacements"
],
"offsets": [
[
77,
99
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0040508"
}
]
},
{
"id": "DerOrthopaede.80270381.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"feed"
],
"offsets": [
[
264,
268
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0015751"
}
]
},
{
"id": "DerOrthopaede.80270381.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"stem"
],
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[
379,
383
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0162731"
}
]
},
{
"id": "DerOrthopaede.80270381.eng.abstr-s4-t1",
"type": "umlsterm",
"text": [
"infection"
],
"offsets": [
[
476,
485
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0021311"
}
]
},
{
"id": "DerOrthopaede.80270381.eng.abstr-s5-t1",
"type": "umlsterm",
"text": [
"Survival"
],
"offsets": [
[
488,
496
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0220921"
},
{
"db_name": "UMLS",
"db_id": "C0038952"
}
]
},
{
"id": "DerOrthopaede.80270381.eng.abstr-s5-t2",
"type": "umlsterm",
"text": [
"Survival rate"
],
"offsets": [
[
488,
501
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0038954"
}
]
}
] |
[] |
[] |
[
{
"id": "DerOrthopaede.80270381.eng.abstr-s1-r1-t6.1-t5.1",
"type": "associated_with",
"arg1_id": "DerOrthopaede.80270381.eng.abstr-s1-t6",
"arg2_id": "DerOrthopaede.80270381.eng.abstr-s1-t5",
"normalized": []
},
{
"id": "DerOrthopaede.80270381.eng.abstr-s1-r2-t6.1-t2.1",
"type": "affects",
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"arg2_id": "DerOrthopaede.80270381.eng.abstr-s5-t2",
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},
{
"id": "DerOrthopaede.80270381.eng.abstr-s1-r3-t3.1-t4.1",
"type": "associated_with",
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"arg2_id": "DerOrthopaede.80270381.eng.abstr-s1-t4",
"normalized": []
},
{
"id": "DerOrthopaede.80270381.eng.abstr-s1-r4-t1.1-t6.1",
"type": "location_of",
"arg1_id": "DerOrthopaede.80270381.eng.abstr-s5-t1",
"arg2_id": "DerOrthopaede.80270381.eng.abstr-s1-t6",
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DerOrthopaede.80270392.eng.abstr
|
DerOrthopaede.80270392.eng.abstr
|
[
{
"id": "DerOrthopaede.80270392.eng.abstr-passage-0",
"type": "abstract",
"text": [
"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 ) . Matching variables were year of implantation , age , follow-up'eight , weight , gender and type of implant . At follow-up ( cases : 58 +/- 27 months ; controls : 56 +/- 26 Monate ) no signs of loosening or migration of the stem were found , neither in the cases nor in the controls . Loose and/or migrated cups were found in 4 patients with rheumatic diseases ( after 44 , 65 , 65 and 107 months ) and in 3 patients with osteoarthritis ( after 63 , 84 and 100 months ) . Two cups were revised within 18 months in the control group , in the case group one revision was necessary after 5 years . Loosening and revision rates did not differ significantly ( p > 0.20 ) . Clinically , those with Osteoarthritis had a better extension ( p 0.02 ) , were more satisfied with their ( artificial ) hips ( p 0.05 ) and did better in some activities of daily living ( climbing stairs , dressing , sitting/standing up ) . Within a mean follow-up of 5 years the results of patients with chronic rheumatic diseases seem to be comparable to those of a matched control-group of patients with Osteoarthritis . Differences between the groups concern areas , in which rheumatic patients are handicapped due to their chronic illness . Nevertheless , we need long-term-results , before we can recommend cementless implants for these patients ."
],
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] |
[] |
[] |
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DerOrthopaede.80270422.eng.abstr
|
DerOrthopaede.80270422.eng.abstr
|
[
{
"id": "DerOrthopaede.80270422.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Since the invention of microsurgical techniques the free toe-to-hand transplantation is an established method for reconstruction of hand function . The indication for this method following thumb and finger amputations as well as congenital defects with aplasia of the fingers and the thumb is discussed in comparism to alternative operations . The operative technique as well as the functional and aesthetic results that can be expected are described by presentation of clinical cases . Since 1992 we performed 18 free toe-to-hand transplantations for the above mentioned indications . Depending on the primary situation the elementary hand function with grip and pinch could be restored in all our patients using this method . Restoring sensibility next to length , mobility and strength in one operation has to be considered as an advantage compared to alternative methods ."
],
"offsets": [
[
0,
876
]
]
}
] |
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"id": "DerOrthopaede.80270422.eng.abstr-s1-t2",
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"transplantation"
],
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]
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"id": "DerOrthopaede.80270422.eng.abstr-s2-t2",
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{
"id": "DerOrthopaede.80270422.eng.abstr-s2-t4",
"type": "umlsterm",
"text": [
"amputations"
],
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[
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DerOrthopaede.80270433.eng.abstr
|
DerOrthopaede.80270433.eng.abstr
|
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[] |
[] |
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}
] |
DerOrthopaede.80270445.eng.abstr
|
DerOrthopaede.80270445.eng.abstr
|
[
{
"id": "DerOrthopaede.80270445.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Free muscle transplantation with motor innervation offers the posibility to add contractile elements to upper extremities with extensive loss of musculature due to direct trauma or untreated compartment syndrome ( Volkmann's contracture ) . The functional cross section area and the mean resting fiber length determine the maximum power and the contracting amplitude of the donor muscle . Although considerably weaker than the finger flexors to be replaced , the gracilis muscle was the preferred donor muscle because of its neurovascular pedicle and the minimal donor site morbidity . In a series of 15 gracilis transplantations , all 13 muscles that survived regained function . Finger motion was dependent on the preoperative condition of tendons and joints . Even after complete loss of the flexor and extensor compartment a useful upper extremity could be restored , which was preferable to the only alternative - amputation ."
],
"offsets": [
[
0,
931
]
]
}
] |
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}
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},
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"id": "DerOrthopaede.80270445.eng.abstr-s1-t2",
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"text": [
"transplantation"
],
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12,
27
]
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{
"db_name": "UMLS",
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}
]
},
{
"id": "DerOrthopaede.80270445.eng.abstr-s1-t3",
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"innervation"
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},
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"elements"
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},
{
"id": "DerOrthopaede.80270445.eng.abstr-s1-t5",
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"extremities"
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"direct"
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]
},
{
"id": "DerOrthopaede.80270445.eng.abstr-s1-t9",
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"Volkmann's"
],
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214,
224
]
],
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}
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},
{
"id": "DerOrthopaede.80270445.eng.abstr-s1-t10",
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"contracture"
],
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{
"id": "DerOrthopaede.80270445.eng.abstr-s1-t12",
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}
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},
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"id": "DerOrthopaede.80270445.eng.abstr-s2-t1",
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"text": [
"power"
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},
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"id": "DerOrthopaede.80270445.eng.abstr-s2-t2",
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},
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"id": "DerOrthopaede.80270445.eng.abstr-s3-t1",
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"id": "DerOrthopaede.80270445.eng.abstr-s3-t2",
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}
] |
[] |
[] |
[
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"type": "associated_with",
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{
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}
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DerOrthopaede.80270451.eng.abstr
|
DerOrthopaede.80270451.eng.abstr
|
[
{
"id": "DerOrthopaede.80270451.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Microsurgery has entered its third generation . Functional and aesthetic requirements have been steadily increased with the refinements of microsurgery . The new principle of prefabricated flaps are another step to match these requirements . These prefabricated flaps can either be created by expanding known flap donor sites or creating entirely new flaps by implanting AV-loops or vascularized fascia . Principles and indications of this new technique will be elucidated by clinical examples ."
],
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[
0,
495
]
]
}
] |
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12
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}
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"id": "DerOrthopaede.80270451.eng.abstr-s3-t1",
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}
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}
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"id": "DerOrthopaede.80270451.eng.abstr-s4-t3",
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] |
[] |
[] |
[
{
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"type": "surrounds",
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{
"id": "DerOrthopaede.80270451.eng.abstr-s4-r2-t2.1-t5.1",
"type": "surrounds",
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},
{
"id": "DerOrthopaede.80270451.eng.abstr-s4-r3-t2.1-t3.1",
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},
{
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{
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{
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{
"id": "DerOrthopaede.80270451.eng.abstr-s4-r9-t1.1-t5.1",
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"arg2_id": "DerOrthopaede.80270451.eng.abstr-s4-t5",
"normalized": []
}
] |
DerOrthopaede.80270457.eng.abstr
|
DerOrthopaede.80270457.eng.abstr
|
[
{
"id": "DerOrthopaede.80270457.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The frequency of lumbar disc hemiation amounts to 5.1 % with the male and 3.7 % with the female population . Because of the often long-time pain-conditional impairment of the patients as well as the varied therapy-possibilities , the treatment of the ruptured lumbar intervertebral disc represents a special challenge . The indication to the operation for the lumbar disk-herniation results from the malfunctions of the nerve roots , the pains , as well as the temporal course of the symptoms . New and important developments have given the introduction of micro-surgical operation-techniques into the orthopedics . This development has led to it that many orthopedists and neurosurgeons the micro-surgical operation-technique prefers . Important for the micro-surgical lumbar discectomy is the operation-microscope , a good praeoperative diagnostics as well as a particular micro-surgical operation-instrument . Through the different enlargement-possibilities of the operation-microscope , all anatomical structures can increase and are done visibly for the surgeon as well as the assistant . Intraoperative injuries of the dura as well as the spinal-nerves are certainly avoided hereby . The micro-surgical discectomie requires no longer time like the conventional operation of the disk . The postoperative stay in the hospital as well as the time of the work-incompetence is reduced . Postoperative inflammations of the disk-area as well as renewed operations are rarer with the microchirurgischen technique . If an operation is necessary , so this should not be out-hesitated too long in order to avoid bad results ."
],
"offsets": [
[
0,
1620
]
]
}
] |
[
{
"id": "DerOrthopaede.80270457.eng.abstr-s1-t1",
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"frequency"
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4,
13
]
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"db_id": "C0376249"
}
]
},
{
"id": "DerOrthopaede.80270457.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"male"
],
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65,
69
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],
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"db_id": "C0024554"
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]
},
{
"id": "DerOrthopaede.80270457.eng.abstr-s1-t3",
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95
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106
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140,
156
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175,
183
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243
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}
]
},
{
"id": "DerOrthopaede.80270457.eng.abstr-s2-t4",
"type": "umlsterm",
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267,
286
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"db_id": "C0021815"
}
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{
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351
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}
]
},
{
"id": "DerOrthopaede.80270457.eng.abstr-s3-t2",
"type": "umlsterm",
"text": [
"nerve"
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420,
425
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[] |
[] |
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DerOrthopaede.80270466.eng.abstr
|
DerOrthopaede.80270466.eng.abstr
|
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"text": [
"Due to the decreased trauma in anterior as well as posterior surgical approaches to the spine , microsurgical techniques have been used more frequently in recent years . This article describes two new microsurgical techniques to approach the anterior lumbar spine for interbody fusion as part of a posterior-anterior stabilization concept in various diseases like spondylolisthesis , degenerative instability ; failed back surgery syndrome , fractures etc. The lumbar segments L 2-5 are approached through a blunt muscle-splitting retroperitoneal technique . The antero-lateral circumference of the motion segment is exposed with a frame-type retractor which is anchored in the adjacent vertebral bodies with anchoring screws . The lumbosacral junction is exposed via a mini-laparotomy using a special soft tissue spreader . Interbody fusion is described with autogeneous bone grafts . Preliminary experience with 83 patients treated between 1995 and 1996 show that peri- and postoperative morbidity is low . Clinical as well as radiological results are comparable to the standard techniques . Spectrum as well as rate of complications so far do not differ from those described in the literature for non-microsurgical approaches ."
],
"offsets": [
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1230
]
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}
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[] |
[] |
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] |
DerOrthopaede.80270477.eng.abstr
|
DerOrthopaede.80270477.eng.abstr
|
[
{
"id": "DerOrthopaede.80270477.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Besides the microsurgical ventral decompression for treatment of cervical disc prolapses , combined with an intercorporal fusion using an autologous bone graft from the iliac crest and a plate osteosynthesis , the microsurgical , transoral approach to the craniocervical junction has proven to be an effective procedure for adequate indications . Even for surgical treatment of diseases and injuries of the craniocervical junction ventral , anterolateral , lateral and dorsal approaches are applicable alone or in combination . The special anatomic and functional conditions of this region , however , obviously require that the indicational criteria for the various approaches differ from those selected for the other cervical segments . The postoperative complication risk requires that particulary critical consideration be given to the question of isolated transoral interventions . The same holds true for the question as the necessity for additional ventral stabilisation in combined dorsoventral interventions . This report is about 20 patients who underwent transoral decompression , about the indications and the procedure typical problems ."
],
"offsets": [
[
0,
1150
]
]
}
] |
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DerOrthopaede.80270482.eng.abstr
|
DerOrthopaede.80270482.eng.abstr
|
[
{
"id": "DerOrthopaede.80270482.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Various therapeutic options have been proposed in the treatment of femoral head necrosis ranging from conservative management to total hip arthroplasty . Since microsurgical techniques are routinely used in orthopaedic surgery , the importance of revascularization has increased in recent years . Vascularized bone grafting as well as various osteotomies have been considered for the stages II and III according to Ficat and II , III and IV of the criteria of the ARCO system respectively , which also bases on MRI-findings . We investigated the results of 80 patients with avascular necrosis of the femoral head treated with a vascular pedicled iliac bone graft , perfused by the A. circumflexa ilium profunda , between 1988 and 1996. Mean follow-up was 5,6 years . The evaluation was based on the harris hip score , clinical and radiological examination as well as a subjective assessment using a VAS ( visual analog scale ) . The clinical results according to the harris hip score were good or excellent in 86,1 % . These results correlate with the subjective assessment of pain and of the hip joint function with an average of 7,9 points using the VAS ( max . 10 points ) . Unchanged radiological appearance over the follow-up period was observed in 47,5 % using the ARCO criterias . Reviewing the studies using vascularized grafts , about 50 % of the patients with a stage II and III according to Ficat and II , III and IV of the ARCO respectively show an unchanged stage of the disease 5-6 years after the procedure . Therefore , transplantation of a vascular pedicled iliac bone graft possibly offers the chance to intervene causally in the course of the disease with only little alteration of the biomechanics of the hip joint ."
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] |
DerOrthopaede.80270510.eng.abstr
|
DerOrthopaede.80270510.eng.abstr
|
[
{
"id": "DerOrthopaede.80270510.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Purpose of this study was the evaluation of distribution and morphology of mechanoreceptors in the glenohumeral joint capsule and rotator cuff in comparison to the coracoacromial ligament by means of specific immunfluorescence microscopy . The complemente joint capsules , rotator cuffs and coracoacromial ligaments of three fresh cadaver shoulder were harvested . Serial cryostate sections were taken and alternately incubated with antiserum against neurofilament , lamin or myelin of peripheral nerves . The antibody-reaction was visualized with fluorescin Ig-G . The nerve endings were photographed and computer-aided 3-dimensional reconstructions were performed . Three types of corpuscular and free nerve endings of different morphology were found in different distributions : whereas the Ruffini corpuscles were much more frequent in the coracoacromial ligament and rotator cuff , Pacini endings were predominantly found in the joint capsule . Generally corpuscular nerve endings were more frequent in the coracoacromial ligament and the rotator cuff than in the antero-inferior capsule and the number of corpuscles increased from medial to lateral within the anterior and inferior parts of the capsule . The dense ligamentous tissue was almost aneural whereas the periarticular fatty or loose connective tissue contained nerve fibres and nerve endings . In view of the results of other experimental and clinical studies the high frequency of Ruffini and Pacini endings in the rotator cuff and coracoacromial ligament suggest , that both are involved in the neurosensory control of glenohumeral stability and subacromial impingement . In contrast our findings in the joint capsule do not clearly proove , that those joint receptors predominantly maintain joint stability ."
],
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0,
1778
]
]
}
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DerOrthopaede.80270518.eng.abstr
|
DerOrthopaede.80270518.eng.abstr
|
[
{
"id": "DerOrthopaede.80270518.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The goal for arthroscopic stabilization of anterior glenohumeral instability is to achieve an outcome equivalent to or better than open procedures . A number of arthroscopic procedures have been advocated to reestablish continuity of the inferior glenohumeral ligament complex ( IGHLC ) with the glenoid . Implantable suture anchors were developed to avoid the problems associated with arthroscopic staple capsulorrhaphy like iatrogenic injury of the glenoid or humeral surface , loosening and migration of the staple . Several transosseous techniques include the need for an accessory posterior incision , the possibility of neurovascular injury ( Suprascapular or axillary nerve ) , and the loosening of the repair after tying over the fascia of the infraspinatus posteriorly . The preferred techniques are cannulated , absorbable fixation device ( Suretac ) and easy implantable suture anchors made of titanium ( Fastak ) . Even in the hands of experienced arthroscopists , unacceptably high recurrence rates for arthroscopic shoulder stabilization have been reported , due to the steep learning curve for both technical performance and patient selection . Our experience suggests , that if proper selection criteria are employed , normal patients and overhead-athletes may benefit from the advantages of an arthroscopic repair without accepting an increased risk for recurrence . We performed a prospective analysis of 105 shoulders , who underwent arthroscopic stabilization with Suretac or Fastak between 4/96 and 7/98 . 48 shoulders were available for followup at least one year . The redislocation rate was 6.25 % ( 3 shoulders ) and the rate of subluxation without dislocation also was 6.25 % , but none of the shoulders required a second open stabilization . The reason for redislocation or subluxation were 5/6 traumatic injuries , participating in contact sports or in one case a generalized ligamentous laxity . In combination with the LACS-Procedure or the Electro thermally assisted capsular shift ( ETACS ) not only the capsular detachment but also the capsular redundancy may be adressed and a lower failure rate can be expected ."
],
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]
]
}
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] |
DerOrthopaede.80270532.eng.abstr
|
DerOrthopaede.80270532.eng.abstr
|
[
{
"id": "DerOrthopaede.80270532.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The arthroscopic extraarticular Bankart procedure tries to imitate the open Bankart procedure . An anterior-inferior transmuscular approach through the subscapular muscle permits to implant self-locking tacks into the anterior inferior third of the glenoid rim . The extraarticular location of the implants makes a superomedial capsular shift possible , if required . A total of 257 arthroscopic repairs following traumatic recurrent anterior shoulder dislocation have been carried out between 1992 and 1996. 177 patients were treated only with bioabsorbable Suretac device . Clinical and radiological follow up was possible in 165 patients . According to the Rowe score 69,7 % were classified as excellent , 10,9 % as good , 9,7 % fair and 9,7 % poor . Postoperative complications : the recurrence rate was 9,7 % , allergic reactions representing a foreign body reaction to the synthetic material were seen in 5 cases ( 3 % ) and a frozen shoulder in 6 cases 3,6 % ) . 61 % of the patients involved in overhead or contact sports returned to their preoperative sport activities ."
],
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[
0,
1079
]
]
}
] |
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[] |
[] |
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DerOrthopaede.80270556.eng.abstr
|
DerOrthopaede.80270556.eng.abstr
|
[
{
"id": "DerOrthopaede.80270556.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Resection arthroplasty of the AC joint was performed in 42 cases of osteoarthrosis and residual instability of traumatic origin including 26 shoulders with horizontal instability of more than half of the width of the clacicula and lesions of the deltotrapezoid fascial complex ( Rockwood type II : 7 ; type III : 9 ; type IV : 17 ; type V : 9 ) . 23 cases were treated with a sole Weaver-Dunn procedure . 26 cases with horizontal instability and lesions of the deltotrapezoid fascia ( Rockwood IV and V type ) were treated in 7 cases with the standard Weaver-Dunn procedure and in 19 cases with a modified Weaver-Dunn procedure in combination with a coracoclavicular ( 3 x 1 ) and acromio-clavicular ( 1 x 1 ) 1 mm PDS string augmentation and double breasting fascioplasty of the deltotrapezoid complex ."
],
"offsets": [
[
0,
804
]
]
}
] |
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"arthroplasty"
],
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10,
22
]
],
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}
]
},
{
"id": "DerOrthopaede.80270556.eng.abstr-s1-t2",
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"joint"
],
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38
]
],
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}
]
},
{
"id": "DerOrthopaede.80270556.eng.abstr-s1-t3",
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"text": [
"osteoarthrosis"
],
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68,
82
]
],
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}
]
},
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"id": "DerOrthopaede.80270556.eng.abstr-s1-t4",
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"origin"
],
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121,
127
]
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}
]
},
{
"id": "DerOrthopaede.80270556.eng.abstr-s1-t5",
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"text": [
"shoulders"
],
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[
141,
150
]
],
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{
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"db_id": "C0037004"
}
]
},
{
"id": "DerOrthopaede.80270556.eng.abstr-s2-t1",
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"sole"
],
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380
]
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}
]
},
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"id": "DerOrthopaede.80270556.eng.abstr-s2-t2",
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]
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}
]
},
{
"id": "DerOrthopaede.80270556.eng.abstr-s3-t1",
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"text": [
"fascia"
],
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476,
482
]
],
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"db_id": "C0015641"
}
]
},
{
"id": "DerOrthopaede.80270556.eng.abstr-s3-t2",
"type": "umlsterm",
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"standard"
],
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543,
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]
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},
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}
]
},
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"id": "DerOrthopaede.80270556.eng.abstr-s3-t3",
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"procedure"
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564,
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]
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]
},
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"id": "DerOrthopaede.80270556.eng.abstr-s3-t4",
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}
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}
] |
[] |
[] |
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},
{
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},
{
"id": "DerOrthopaede.80270556.eng.abstr-s1-r3-t4.1-t1.1",
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},
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"id": "DerOrthopaede.80270556.eng.abstr-s1-r6-t4.1-t3.1",
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{
"id": "DerOrthopaede.80270556.eng.abstr-s1-r7-t2.1-t3.1",
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},
{
"id": "DerOrthopaede.80270556.eng.abstr-s1-r8-t4.1-t2.1",
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},
{
"id": "DerOrthopaede.80270556.eng.abstr-s1-r9-t1.1-t3.1",
"type": "associated_with",
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"arg2_id": "DerOrthopaede.80270556.eng.abstr-s3-t3",
"normalized": []
}
] |
DerOrthopaede.80270567.eng.abstr
|
DerOrthopaede.80270567.eng.abstr
|
[
{
"id": "DerOrthopaede.80270567.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Instability of the sternoclavicular joint is a rare diagnosis and will mostly be found after motor vehicle accidents or sports injuries . Depending on the severity of the trauma open reduction is rarely required , and most cases will be treated successfully with conservative management . Associated injuries to the surrounding anatomic structures are not rare , and can be found in posteriorly directed injuries ."
],
"offsets": [
[
0,
414
]
]
}
] |
[
{
"id": "DerOrthopaede.80270567.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"joint"
],
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[
36,
41
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0022417"
}
]
},
{
"id": "DerOrthopaede.80270567.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"diagnosis"
],
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[
52,
61
]
],
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{
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}
]
},
{
"id": "DerOrthopaede.80270567.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"vehicle"
],
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[
99,
106
]
],
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}
]
},
{
"id": "DerOrthopaede.80270567.eng.abstr-s1-t4",
"type": "umlsterm",
"text": [
"accidents"
],
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[
107,
116
]
],
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{
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"db_id": "C0000924"
}
]
},
{
"id": "DerOrthopaede.80270567.eng.abstr-s1-t5",
"type": "umlsterm",
"text": [
"sports"
],
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[
120,
126
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0038039"
}
]
},
{
"id": "DerOrthopaede.80270567.eng.abstr-s1-t6",
"type": "umlsterm",
"text": [
"injuries"
],
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[
127,
135
]
],
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{
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"db_id": "C0175677"
},
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}
]
},
{
"id": "DerOrthopaede.80270567.eng.abstr-s1-t7",
"type": "umlsterm",
"text": [
"sternoclavicular joint"
],
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[
19,
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]
],
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"db_id": "C0038291"
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DerOrthopaede.80270571.eng.abstr
|
DerOrthopaede.80270571.eng.abstr
|
[
{
"id": "DerOrthopaede.80270571.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Instability is one of the most common complications after shoulder arthroplasty . The literature cites subluxation or luxation to occure between 0 % and 38 % in various studies . Instabilities may present either as subluxation or frank dislocation , and may be directed in an anterior , posterior , inferior or , depending on the state of the rotator cuff , cranial direction . The stability of any shoulder joint is given by the balance of the muscles directing the forces around the shoulder joint in association with the passive stabilizers of the shoulder joint capsule as well as the bony contours between glenoid and humeral head . Any disturbance of this delicate balance will lead the shoulder into instability , particular so if bony errosion patterns such as posterior glenoid wear in osteoarthritics will develop subluxation early on . Therefore implantation of any prosthesis is required to be done in the appropriate version as to avoid secondary instability through the prosthetic components . In the study undertaken here instability was found to be the most common complication in 44 shoulder revision surgeries . The result with an avarage Score of 41.9 recorded after Constant demonstrates that the excellent and good results obtained with primary arthroplasties can not be expected in revision surgery . Posterior instability may be present just as well as the more easily observed anterior instability . Separate to frank luxation or instability is the late cranialisation of the rotator cuff deficient shoulder which , although resulting in many cases in a superior anterior subluxation , will mostly be seen as a late complication after arthroplasty ."
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DerOrthopaede.80270600.eng.abstr
|
DerOrthopaede.80270600.eng.abstr
|
[
{
"id": "DerOrthopaede.80270600.eng.abstr-passage-0",
"type": "abstract",
"text": [
"This article reviews the current controversy of resurfacing the patella in total knee arthroplasty . Up-to-date knowledge of experimental and biomechanical studies as well as the different types of implants and specifics of the patella preaparation are described in detail . The author furthermore discusses the relevant clinical studies dealing with patellar resurfacing and tries to guide the reader in evaluating the results . Finally is summarized why the indication for resurfacing the patella is so controversial and how a differentiated indication for resurfacing the patella could be specified ."
],
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603
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]
}
] |
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],
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"knee arthroplasty"
],
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],
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}
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"knowledge"
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}
]
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],
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]
],
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}
]
}
] |
[] |
[] |
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},
{
"id": "DerOrthopaede.80270600.eng.abstr-s1-r2-t1.1-t3.1",
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] |
DerOrthopaede.80270612.eng.abstr
|
DerOrthopaede.80270612.eng.abstr
|
[
{
"id": "DerOrthopaede.80270612.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Problems associated with the patellofemoral joint account for nearly half of all total knee arthroplasty ( TKA ) revisions . Under in vivo conditions , we previously determined that TKA subjects experience patellofemoral separation while performing dynamic , weightbearing activities . This study investigates the impulse loading conditions that may exist at the time the patella impacts the femur during knee flexion . Fifty-seven subjects ( 68 knees ) performed three successive deep knee bends under fluoroscopic surveillance . Eleven subjects ( 14 knees ) had a posterior cruciate retaining ( PCR ) TKA , 19 subjects ( 25 knees ) had a posterior cruciate substituting ( PS ) TKA , 15 subjects ( 17 knees ) had a normal knee , and 12 subjects ( 12 knees ) had an anterior cruciate ligament deficient ( ACLD ) knee . Velocities of each subjects ' patella relative to a fixed point on the tibia were used as input to a mathematical model incorporating the impulse-momentum equation . At full extension , 12 of 14 PCR knees , 11 of 25 PS knees , 1 of 12 ACLD knees , and none of the 17 normal knees exhibited patellofemoral joint separation . The maximum separation , detected in a PCR knee , was 12 mm . The relative force determined upon patellofemoral impact was minimal ( 1.0 N ) . Simulated walking conditions for each subject were then entered into the mathematical model at a rate of 100 Hz and the calculated patellofemoral impact forces ranged from 78 N to 213 N. Since impulse loading conditions occur over a very small period of time , it was concluded that capturing fluoroscopy images at a rate of 30 Hz was too slow . Under simulated walking conditions , the impact forces due to impulse loading could contribute to polyethylene failure if these conditions induce fatigue of the polyethylene ."
],
"offsets": [
[
0,
1807
]
]
}
] |
[
{
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"joint"
],
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49
]
],
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"db_id": "C0022417"
}
]
},
{
"id": "DerOrthopaede.80270612.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"knee"
],
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]
],
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}
]
},
{
"id": "DerOrthopaede.80270612.eng.abstr-s1-t3",
"type": "umlsterm",
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"arthroplasty"
],
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]
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{
"id": "DerOrthopaede.80270612.eng.abstr-s1-t4",
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],
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"id": "DerOrthopaede.80270612.eng.abstr-s1-t5",
"type": "umlsterm",
"text": [
"total knee arthroplasty"
],
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]
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}
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},
{
"id": "DerOrthopaede.80270612.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"separation"
],
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]
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[] |
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},
{
"id": "DerOrthopaede.80270612.eng.abstr-s7-r4-t7.1-t1.1",
"type": "performs",
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},
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},
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},
{
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},
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},
{
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},
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},
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}
] |
DerOrthopaede.80270625.eng.abstr
|
DerOrthopaede.80270625.eng.abstr
|
[
{
"id": "DerOrthopaede.80270625.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The alignement and size of the components of a knee-prosthesis is most important for a sucessful and durable total knee arthroplasty . The effect of positioning the components on the patellafemoral joint is described in detail ."
],
"offsets": [
[
0,
228
]
]
}
] |
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"id": "DerOrthopaede.80270625.eng.abstr-s1-t1",
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"knee"
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}
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{
"id": "DerOrthopaede.80270625.eng.abstr-s1-t2",
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"arthroplasty"
],
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"id": "DerOrthopaede.80270625.eng.abstr-s1-t3",
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"knee arthroplasty"
],
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115,
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]
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"db_id": "C0086511"
}
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"id": "DerOrthopaede.80270625.eng.abstr-s1-t4",
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"total knee arthroplasty"
],
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}
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{
"id": "DerOrthopaede.80270625.eng.abstr-s2-t1",
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"patellafemoral"
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"joint"
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}
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}
] |
[] |
[] |
[
{
"id": "DerOrthopaede.80270625.eng.abstr-s1-r1-t1.1-t2.1",
"type": "location_of",
"arg1_id": "DerOrthopaede.80270625.eng.abstr-s2-t1",
"arg2_id": "DerOrthopaede.80270625.eng.abstr-s2-t2",
"normalized": []
},
{
"id": "DerOrthopaede.80270625.eng.abstr-s1-r2-t1.1-t3.1",
"type": "location_of",
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"arg2_id": "DerOrthopaede.80270625.eng.abstr-s1-t3",
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},
{
"id": "DerOrthopaede.80270625.eng.abstr-s1-r3-t1.1-t4.1",
"type": "location_of",
"arg1_id": "DerOrthopaede.80270625.eng.abstr-s2-t1",
"arg2_id": "DerOrthopaede.80270625.eng.abstr-s1-t4",
"normalized": []
},
{
"id": "DerOrthopaede.80270625.eng.abstr-s2-r1-t1.1-t2.1",
"type": "interconnects",
"arg1_id": "DerOrthopaede.80270625.eng.abstr-s2-t1",
"arg2_id": "DerOrthopaede.80270625.eng.abstr-s2-t2",
"normalized": []
},
{
"id": "DerOrthopaede.80270625.eng.abstr-s2-r2-t2.1-t1.1",
"type": "connected_to",
"arg1_id": "DerOrthopaede.80270625.eng.abstr-s2-t2",
"arg2_id": "DerOrthopaede.80270625.eng.abstr-s2-t1",
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}
] |
DerOrthopaede.80270629.eng.abstr
|
DerOrthopaede.80270629.eng.abstr
|
[
{
"id": "DerOrthopaede.80270629.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Resurfacing the patella or not in total knee arthroplasty is generally still a quite controversial topic . In that context we felt a necessity to get more informations about the natural history of a non resurfaced patella in the prosthetic surrounding than only in comparison with a replaced patella . By the fact that we haven ' t been replacing patellae apart from special cases since up to five years , we have available a patient selection on which this question can be studied . Thirty primary total knee replacements with documented 2 year's follow up have been investigated by calculation of the radiological patellar shift and tilt relative to the natural groove on preoperative X-rays and to the prosthetic groove in the postoperative evolution . These results were matched with the range of motion obtained after two years and with persisting pain . Only mobile polyethylene inlays had been used . With regard to the patella no difference was found for one single complete tibial tray or two separately implanted unicompartimental tibial trays . As a rule an adaptation of the bony patellar contour to the prosthetic groove was observed with an increased density of the bony contact area with or without a fibrous interstitial layer . Based on their clinical follow up examination seven patients had to be adjoined to a \" residual problem group \" , as they presented persisting pain ( 3 ) or a poor range of motion of 90/0/0 ° of flexion/extension or less . Only in this group we found cases with a postoperative shift over 5mm ( 2 ) and a postoperative tilt over 15 ° ( 3 ) . Inside this group , also with a significant difference from the group without residual problems , there was furthermore a correlation between persisting pain and an important preoperative tilt and between a diminished range of motion and a considerable preoperative shift . lt has to be pointed out that even the cases without long lasting severe malposition before the arthroplasty but with unsatisfactory realignement referring to the patellar tilt ( 7 °-15 ° ) have been found pain free at the last follow up . One patient with a severe secondary increase of disalignement ( 16 mm/139 ° ) due to an aseptic tibial loosening represents a particular case . After corrective revision of the tibial implants this patient also got again a complete pain relief and a good range of motion without any surgical measure to the patella and inspite of an evident residual tilt . Thus we have to conclude that it is justified to take important pains with the realignement to obtain a residual patellar shift of less than 5 mm . Apart from usual operative steps during the implantation to favour a good patellar tracking , e . g . a high quadriceps release or a medially transposed refixation of the detached tibial tubercle can get necessary . On the other hand a residual tilt up to 15 ° is well tolerated , as the unresurfaced patella presents an astonishing ability of adaptation to the prosthetic groove by remodelling of the bony contour and structure . Nevertheless in the included cases of severe preoperative malposition , in which we didn ' t replace the patella because of a good intraoperative bone quality , we had to put up with an increased incidence of late problems even with normalized patellar tracking . In such cases an extended indication to a patellar resurfacing may be considered ."
],
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[
0,
3383
]
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}
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40,
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"id": "DerOrthopaede.80270629.eng.abstr-s1-t5",
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"text": [
"total knee arthroplasty"
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34,
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"history"
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"id": "DerOrthopaede.80270629.eng.abstr-s2-t2",
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"type": "location_of",
"arg1_id": "DerOrthopaede.80270629.eng.abstr-s20-t1",
"arg2_id": "DerOrthopaede.80270629.eng.abstr-s20-t3",
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},
{
"id": "DerOrthopaede.80270629.eng.abstr-s19-r3-t5.1-t3.1",
"type": "affects",
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}
] |
DerOrthopaede.80270637.eng.abstr
|
DerOrthopaede.80270637.eng.abstr
|
[
{
"id": "DerOrthopaede.80270637.eng.abstr-passage-0",
"type": "abstract",
"text": [
"As shown in long term follow-up studies of Total Knee Arthroplasty ( TKA ) , the femoropatellar joint is an important problem . We report our experience over the past seven years not having resurfaced the patella at the primary TKA at all . Between 1990 and 1997 more than 700 consecutive TKA with the De Puy New Jersey LCS prosthesis were performed . A standardised lateral approach with osteotomy of the tibial tuberosity was used . The patella was redressed , either denervated or left untouched . In no case a primary patellar resurfacing was performed . X-rays of the patello-femoral joint showed a remodelling of the patella over the years , nicely matching the condylar design of the femoral prosthesis . Using a blood-supply-preserving approach and a biomechanically adequate implant , TKA without patellar replacement gives excellent long-term results ."
],
"offsets": [
[
0,
862
]
]
}
] |
[
{
"id": "DerOrthopaede.80270637.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"Knee"
],
"offsets": [
[
49,
53
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0022742"
}
]
},
{
"id": "DerOrthopaede.80270637.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"Arthroplasty"
],
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[
54,
66
]
],
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{
"db_name": "UMLS",
"db_id": "C0003893"
}
]
},
{
"id": "DerOrthopaede.80270637.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"joint"
],
"offsets": [
[
96,
101
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0022417"
}
]
},
{
"id": "DerOrthopaede.80270637.eng.abstr-s1-t4",
"type": "umlsterm",
"text": [
"follow-up studies"
],
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[
22,
39
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0016441"
}
]
},
{
"id": "DerOrthopaede.80270637.eng.abstr-s1-t5",
"type": "umlsterm",
"text": [
"Knee Arthroplasty"
],
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[
49,
66
]
],
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"db_name": "UMLS",
"db_id": "C0086511"
}
]
},
{
"id": "DerOrthopaede.80270637.eng.abstr-s1-t6",
"type": "umlsterm",
"text": [
"Total Knee Arthroplasty"
],
"offsets": [
[
43,
66
]
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"db_name": "UMLS",
"db_id": "C0086511"
}
]
},
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"id": "DerOrthopaede.80270637.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"patella"
],
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205,
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]
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"db_id": "C0030647"
}
]
},
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"id": "DerOrthopaede.80270637.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"prosthesis"
],
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[
324,
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]
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"db_id": "C0525024"
},
{
"db_name": "UMLS",
"db_id": "C0175649"
}
]
},
{
"id": "DerOrthopaede.80270637.eng.abstr-s3-t2",
"type": "umlsterm",
"text": [
"New Jersey"
],
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[
309,
319
]
],
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{
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"db_id": "C0027971"
}
]
},
{
"id": "DerOrthopaede.80270637.eng.abstr-s4-t1",
"type": "umlsterm",
"text": [
"osteotomy"
],
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[
389,
398
]
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"db_id": "C0029468"
}
]
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"id": "DerOrthopaede.80270637.eng.abstr-s5-t1",
"type": "umlsterm",
"text": [
"patella"
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439,
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"db_id": "C0030647"
}
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},
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"id": "DerOrthopaede.80270637.eng.abstr-s7-t1",
"type": "umlsterm",
"text": [
"X-rays"
],
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[
559,
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"db_id": "C0043309"
}
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},
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"id": "DerOrthopaede.80270637.eng.abstr-s7-t2",
"type": "umlsterm",
"text": [
"joint"
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]
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"db_id": "C0022417"
}
]
},
{
"id": "DerOrthopaede.80270637.eng.abstr-s7-t3",
"type": "umlsterm",
"text": [
"patella"
],
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623,
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]
],
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"db_id": "C0030647"
}
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},
{
"id": "DerOrthopaede.80270637.eng.abstr-s7-t4",
"type": "umlsterm",
"text": [
"prosthesis"
],
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[
699,
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]
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"normalized": [
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"db_name": "UMLS",
"db_id": "C0525024"
},
{
"db_name": "UMLS",
"db_id": "C0175649"
}
]
}
] |
[] |
[] |
[
{
"id": "DerOrthopaede.80270637.eng.abstr-s1-r1-t1.1-t3.1",
"type": "adjacent_to",
"arg1_id": "DerOrthopaede.80270637.eng.abstr-s7-t1",
"arg2_id": "DerOrthopaede.80270637.eng.abstr-s7-t3",
"normalized": []
},
{
"id": "DerOrthopaede.80270637.eng.abstr-s1-r2-t1.1-t6.1",
"type": "location_of",
"arg1_id": "DerOrthopaede.80270637.eng.abstr-s7-t1",
"arg2_id": "DerOrthopaede.80270637.eng.abstr-s1-t6",
"normalized": []
},
{
"id": "DerOrthopaede.80270637.eng.abstr-s1-r3-t1.1-t2.1",
"type": "location_of",
"arg1_id": "DerOrthopaede.80270637.eng.abstr-s7-t1",
"arg2_id": "DerOrthopaede.80270637.eng.abstr-s7-t2",
"normalized": []
},
{
"id": "DerOrthopaede.80270637.eng.abstr-s1-r4-t3.1-t1.1",
"type": "adjacent_to",
"arg1_id": "DerOrthopaede.80270637.eng.abstr-s7-t3",
"arg2_id": "DerOrthopaede.80270637.eng.abstr-s7-t1",
"normalized": []
},
{
"id": "DerOrthopaede.80270637.eng.abstr-s1-r5-t3.1-t5.1",
"type": "location_of",
"arg1_id": "DerOrthopaede.80270637.eng.abstr-s7-t3",
"arg2_id": "DerOrthopaede.80270637.eng.abstr-s1-t5",
"normalized": []
},
{
"id": "DerOrthopaede.80270637.eng.abstr-s1-r6-t3.1-t6.1",
"type": "location_of",
"arg1_id": "DerOrthopaede.80270637.eng.abstr-s7-t3",
"arg2_id": "DerOrthopaede.80270637.eng.abstr-s1-t6",
"normalized": []
},
{
"id": "DerOrthopaede.80270637.eng.abstr-s1-r7-t3.1-t2.1",
"type": "location_of",
"arg1_id": "DerOrthopaede.80270637.eng.abstr-s7-t3",
"arg2_id": "DerOrthopaede.80270637.eng.abstr-s7-t2",
"normalized": []
},
{
"id": "DerOrthopaede.80270637.eng.abstr-s1-r8-t1.1-t5.1",
"type": "location_of",
"arg1_id": "DerOrthopaede.80270637.eng.abstr-s7-t1",
"arg2_id": "DerOrthopaede.80270637.eng.abstr-s1-t5",
"normalized": []
},
{
"id": "DerOrthopaede.80270637.eng.abstr-s3-r1-t1.1-t1.2",
"type": "uses",
"arg1_id": "DerOrthopaede.80270637.eng.abstr-s7-t1",
"arg2_id": "DerOrthopaede.80270637.eng.abstr-s3-t1",
"normalized": []
},
{
"id": "DerOrthopaede.80270637.eng.abstr-s7-r1-t3.1-t4.1",
"type": "location_of",
"arg1_id": "DerOrthopaede.80270637.eng.abstr-s7-t3",
"arg2_id": "DerOrthopaede.80270637.eng.abstr-s7-t4",
"normalized": []
},
{
"id": "DerOrthopaede.80270637.eng.abstr-s7-r2-t2.1-t3.1",
"type": "connected_to",
"arg1_id": "DerOrthopaede.80270637.eng.abstr-s7-t2",
"arg2_id": "DerOrthopaede.80270637.eng.abstr-s7-t3",
"normalized": []
},
{
"id": "DerOrthopaede.80270637.eng.abstr-s7-r3-t2.1-t4.1",
"type": "location_of",
"arg1_id": "DerOrthopaede.80270637.eng.abstr-s7-t2",
"arg2_id": "DerOrthopaede.80270637.eng.abstr-s7-t4",
"normalized": []
},
{
"id": "DerOrthopaede.80270637.eng.abstr-s7-r4-t3.1-t2.1",
"type": "interconnects",
"arg1_id": "DerOrthopaede.80270637.eng.abstr-s7-t3",
"arg2_id": "DerOrthopaede.80270637.eng.abstr-s7-t2",
"normalized": []
}
] |
DerOrthopaede.80270642.eng.abstr
|
DerOrthopaede.80270642.eng.abstr
|
[
{
"id": "DerOrthopaede.80270642.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The mid-term results of this prospective randomized study illustrate why it is difficult to define a clear position concerning the issue of patellar resurfacing in total knee arthroplasty . In both groups of 20 patients typical complications for the respective procedures have occured . One patient from group A with patellar resurfacing had to be revised for loosening of the patellar implant . In group B without resurfacing 3 patellae subluxated , 2 having been revised . Furthermore 4 patients complained about mild to moderate anterior knee pain . The Knee and Function Scores of the patients without revision were not significantly different except for the parameter pain ( Knee Score Gr . A : 84.8 , Gr . B : 77.8 ; pain Gr . A : 46.9 , Gr . B : 41.9 ; Function Score Gr . A : 78.5 , Gr . B : 71.9 ; climbing stairs Gr . A : 38.5 , Gr . B : 33.8 ) . The radiological measurements found the patellae with resurfacing significantly less tilted with 3.8 ° than the patellae without resurfacing with 6.4 ° . With the correct implantation technique patellar resurfacing guarantees a good clinical result within the first 5 years . Leaving the patella unresurfaced was associated with a higher rate of anterior knee pain and revison in our study ."
],
"offsets": [
[
0,
1248
]
]
}
] |
[
{
"id": "DerOrthopaede.80270642.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"knee"
],
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[
170,
174
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0022742"
}
]
},
{
"id": "DerOrthopaede.80270642.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"arthroplasty"
],
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[
175,
187
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0003893"
}
]
},
{
"id": "DerOrthopaede.80270642.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"knee arthroplasty"
],
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[
170,
187
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0086511"
}
]
},
{
"id": "DerOrthopaede.80270642.eng.abstr-s1-t4",
"type": "umlsterm",
"text": [
"total knee arthroplasty"
],
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[
164,
187
]
],
"normalized": [
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"db_name": "UMLS",
"db_id": "C0086511"
}
]
},
{
"id": "DerOrthopaede.80270642.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"patients"
],
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211,
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]
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"db_name": "UMLS",
"db_id": "C0030705"
}
]
},
{
"id": "DerOrthopaede.80270642.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"complications"
],
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[
228,
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],
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"db_id": "C0009566"
}
]
},
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"id": "DerOrthopaede.80270642.eng.abstr-s2-t3",
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"text": [
"procedures"
],
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}
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"type": "umlsterm",
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291,
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]
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"db_id": "C0030705"
}
]
},
{
"id": "DerOrthopaede.80270642.eng.abstr-s4-t1",
"type": "umlsterm",
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"patellae"
],
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}
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}
]
},
{
"id": "DerOrthopaede.80270642.eng.abstr-s5-t2",
"type": "umlsterm",
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"anterior"
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532,
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}
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"id": "DerOrthopaede.80270642.eng.abstr-s5-t3",
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"id": "DerOrthopaede.80270642.eng.abstr-s5-t4",
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"id": "DerOrthopaede.80270642.eng.abstr-s6-t2",
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"Function"
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"db_id": "C0031843"
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"id": "DerOrthopaede.80270642.eng.abstr-s6-t3",
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"patients"
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"id": "DerOrthopaede.80270642.eng.abstr-s6-t4",
"type": "umlsterm",
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"pain"
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673,
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}
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},
{
"id": "DerOrthopaede.80270642.eng.abstr-s6-t5",
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"Knee"
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680,
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]
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"id": "DerOrthopaede.80270642.eng.abstr-s10-t1",
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760,
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}
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},
{
"id": "DerOrthopaede.80270642.eng.abstr-s15-t1",
"type": "umlsterm",
"text": [
"measurements"
],
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874,
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"db_id": "C0242485"
}
]
},
{
"id": "DerOrthopaede.80270642.eng.abstr-s15-t2",
"type": "umlsterm",
"text": [
"patellae"
],
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}
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},
{
"id": "DerOrthopaede.80270642.eng.abstr-s15-t3",
"type": "umlsterm",
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"patellae"
],
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969,
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{
"id": "DerOrthopaede.80270642.eng.abstr-s16-t1",
"type": "umlsterm",
"text": [
"implantation"
],
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"id": "DerOrthopaede.80270642.eng.abstr-s16-t2",
"type": "umlsterm",
"text": [
"technique"
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"db_id": "C0025664"
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{
"id": "DerOrthopaede.80270642.eng.abstr-s17-t1",
"type": "umlsterm",
"text": [
"patella"
],
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1145,
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],
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"db_name": "UMLS",
"db_id": "C0030647"
}
]
},
{
"id": "DerOrthopaede.80270642.eng.abstr-s17-t2",
"type": "umlsterm",
"text": [
"anterior"
],
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[
1203,
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]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0032008"
}
]
},
{
"id": "DerOrthopaede.80270642.eng.abstr-s17-t3",
"type": "umlsterm",
"text": [
"knee"
],
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1212,
1216
]
],
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"db_name": "UMLS",
"db_id": "C0022742"
}
]
},
{
"id": "DerOrthopaede.80270642.eng.abstr-s17-t4",
"type": "umlsterm",
"text": [
"pain"
],
"offsets": [
[
1217,
1221
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0030193"
}
]
}
] |
[] |
[] |
[
{
"id": "DerOrthopaede.80270642.eng.abstr-s1-r1-t1.1-t2.1",
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DerOrthopaede.80270675.eng.abstr
|
DerOrthopaede.80270675.eng.abstr
|
[
{
"id": "DerOrthopaede.80270675.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The acetabular labrum appears as a bundle of distinctly circular lined up collagenous fibers . It surrounds the limbus tangentially and is separated from the cartilagenous covered facies lunata through a thin gap ( fissure ) except of a small zone in the craniocaudal part. The labrum is strongly fixed with the transverse acetabular ligament . A vascular anastomotic ring surrounds the capsular attachement . It derives its blood supply especially from the superior gluteal vessels , the obturator artery and one ascending branch of the medial femoral circumflex artery . The innervation of the acetabular labrum is coming from a branch of the nerve to the quadratus femoris muscle and from the obturator nerve . There are all types of mechanoreceptors in the labrum . The acetabular labrum is able to exert a high tensional force on the rim of the acetabulum . This plays a very important role in view of the physiological , load depending incongruity of the articulating parts of the hip-joint ."
],
"offsets": [
[
0,
998
]
]
}
] |
[
{
"id": "DerOrthopaede.80270675.eng.abstr-s2-t1",
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"facies"
],
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180,
186
]
],
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"db_id": "C0282631"
}
]
},
{
"id": "DerOrthopaede.80270675.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"fissure"
],
"offsets": [
[
215,
222
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0016167"
}
]
},
{
"id": "DerOrthopaede.80270675.eng.abstr-s2-t3",
"type": "umlsterm",
"text": [
"ligament"
],
"offsets": [
[
334,
342
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0023685"
},
{
"db_name": "UMLS",
"db_id": "C0023686"
}
]
},
{
"id": "DerOrthopaede.80270675.eng.abstr-s4-t1",
"type": "umlsterm",
"text": [
"blood"
],
"offsets": [
[
425,
430
]
],
"normalized": [
{
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"db_id": "C0005767"
},
{
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},
{
"db_name": "UMLS",
"db_id": "C0005835"
}
]
},
{
"id": "DerOrthopaede.80270675.eng.abstr-s4-t2",
"type": "umlsterm",
"text": [
"supply"
],
"offsets": [
[
431,
437
]
],
"normalized": [
{
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"db_id": "C0243163"
},
{
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}
]
},
{
"id": "DerOrthopaede.80270675.eng.abstr-s4-t3",
"type": "umlsterm",
"text": [
"vessels"
],
"offsets": [
[
475,
482
]
],
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"db_id": "C0005847"
},
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}
]
},
{
"id": "DerOrthopaede.80270675.eng.abstr-s4-t4",
"type": "umlsterm",
"text": [
"artery"
],
"offsets": [
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499,
505
]
],
"normalized": [
{
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"db_id": "C0003842"
}
]
},
{
"id": "DerOrthopaede.80270675.eng.abstr-s4-t5",
"type": "umlsterm",
"text": [
"artery"
],
"offsets": [
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564,
570
]
],
"normalized": [
{
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}
]
},
{
"id": "DerOrthopaede.80270675.eng.abstr-s4-t6",
"type": "umlsterm",
"text": [
"blood supply"
],
"offsets": [
[
425,
437
]
],
"normalized": [
{
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"db_id": "C0005839"
}
]
},
{
"id": "DerOrthopaede.80270675.eng.abstr-s5-t1",
"type": "umlsterm",
"text": [
"innervation"
],
"offsets": [
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577,
588
]
],
"normalized": [
{
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"db_id": "C0021516"
}
]
},
{
"id": "DerOrthopaede.80270675.eng.abstr-s5-t2",
"type": "umlsterm",
"text": [
"nerve"
],
"offsets": [
[
645,
650
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0027769"
}
]
},
{
"id": "DerOrthopaede.80270675.eng.abstr-s5-t3",
"type": "umlsterm",
"text": [
"muscle"
],
"offsets": [
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676,
682
]
],
"normalized": [
{
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"db_id": "C0026845"
}
]
},
{
"id": "DerOrthopaede.80270675.eng.abstr-s5-t4",
"type": "umlsterm",
"text": [
"nerve"
],
"offsets": [
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706,
711
]
],
"normalized": [
{
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"db_id": "C0027769"
}
]
},
{
"id": "DerOrthopaede.80270675.eng.abstr-s5-t5",
"type": "umlsterm",
"text": [
"obturator nerve"
],
"offsets": [
[
696,
711
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0028783"
}
]
},
{
"id": "DerOrthopaede.80270675.eng.abstr-s6-t1",
"type": "umlsterm",
"text": [
"mechanoreceptors"
],
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737,
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]
],
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"db_id": "C0025032"
}
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},
{
"id": "DerOrthopaede.80270675.eng.abstr-s7-t1",
"type": "umlsterm",
"text": [
"acetabulum"
],
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]
],
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]
},
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"id": "DerOrthopaede.80270675.eng.abstr-s8-t1",
"type": "umlsterm",
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],
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}
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},
{
"id": "DerOrthopaede.80270675.eng.abstr-s8-t2",
"type": "umlsterm",
"text": [
"hip-joint"
],
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]
],
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"db_id": "C0019552"
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"id": "DerOrthopaede.80270675.eng.abstr-s8-t3",
"type": "umlsterm",
"text": [
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],
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]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0022417"
}
]
}
] |
[] |
[] |
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DerOrthopaede.80270681.eng.abstr
|
DerOrthopaede.80270681.eng.abstr
|
[
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"Labral lesions are common findings in residual hip dysplasia , indicating biomechanical decompensation of the hip joint . MR-Arthrography has shown an excellent accuracy of over 90 % to detect these lesions . Nevertheless , so far clinical sings , radiological diagnosis and therapeutical consequences are not well known . In a prospective study , patients suspicious for labral lesions were evaluated using a standard clinical protocol , including history , clinical signs , radiography and MR-Arthrography . Clinical signs were tested by six criteria and two provocation tests . In 11 % patients clinical suspicious was wrong . Best agreement with MR-Arthrography was found for \" knife sharp \" groin pain ( 100 % ) , impingement test ( 100 % ) and painful giving way ( 83 % ) . 35 % of patients showed minor ( grade 2 ) and 52 % severe ( grade 3 and 4 ) dysplasia . Independent from grade of dysplasia , no or only slight arthrosis ( grade 0 and 1 ) was found in 64 % of patients . In 16 % a single acetabular cyst could be detected on radiographs , which all could be identified as intraosseous ganglia on MR-Arthrography . Labral lesions type A ( post traumatic ) were found in 23 % of the patients with only no or minor dysplasia ( grade 1 and 2 ) , whereas labral lesions type B ( dysplastic ) were found in 67 % of the patients with severe dysplasia ( grade 3 and 4 ) . Clinical signs for labral lesions are typical but can also be observed in other pathologies of the hip joint . Based on the findings of this study , we recommend radiographic evaluation for dysplasia and MR-Arthrography in patients with clinical suspicion for labral lesions of the hip joint ."
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[] |
[] |
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DerOrthopaede.80270691.eng.abstr
|
DerOrthopaede.80270691.eng.abstr
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"Magnetic Resonance imaging with its excellent soft tissue contrast represents the method of choice for examination of intraarticular and periarticular structures of joints . However , conventional MR-imaging without intraarticular contrast application is not suitable for the diagnosis of labral lesions . MR-arthrography ( MRA ) of the hip clearly demonstrates labral pathology by distension of the joint space and entrance of the contrast medium into the lesion . Multiplanar 3-D-gradient echo sequences enable visualisation of the most important cranio-ventral portion of the labrum . With the MRA labral lesions can be subdivided into different , clinically relevant stages . Furthermore accompanying lesions ( intra- and extraosseous ganglia , stress-bone marrow-edema ) can be demonstrated . In our study including operatively verified cases , MRA showed excellent sensitivity ( 90 % ) and accuracy ( 91 % ) in detecting labral lesions . So far no complication occurred with more than 100 MRA's . Therefore this technique represents the method of choice for the radiological evaluation of labral lesions of the hip joint . In this review the technical details and results of our MRA method will be presented ."
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[] |
[] |
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DerOrthopaede.80270699.eng.abstr
|
DerOrthopaede.80270699.eng.abstr
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"The torn acetabular labrum is a classical indication for hip arthroscopy . Clinical and imaging diagnosis are not so reliable compared to hip arthroscopy , which also allows therapeutic intervention . Advances in the technique of arthroscopic examination of the hip joint enable an accurate diagnosis of a torn acetabular labrum as well as arthroscopic resection of such pathology . During 267 consecutive hip arthroscopies , 37 labral lesions ( 13,9 % ) could be identified and were resected successfully . The morphological classification of labral tears , and their frequency was allocated to radial flap tears ( 57 % ) , fibrillated radial tears ( 22 % ) , longitudinal peripheral tears ( 16 % ) and unstable labra ( 5 % ) . One year after surgery , 78 % of the patients were improved , whereas 5 were not improved and 3 had worsened . Larger series with longer follow-up should be reported enabling scientific assessment of the procedure . At this early stage , however , we would recommend that all patients with a suspected labral tear should undergo hip arthroscopy ."
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"id": "DerOrthopaede.80270699.eng.abstr-s8-r7-t4.1-t2.1",
"type": "affects",
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] |
DerOrthopaede.80270733.eng.abstr
|
DerOrthopaede.80270733.eng.abstr
|
[
{
"id": "DerOrthopaede.80270733.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Lesions of the acetabular labrum should be treated by correcting the causes . In a steep acetabulum where the femoral head brings the acetabular labrum under tension and traction , the acetabulum should be rotated by triple pelvic osteotomy to slightly overcorrected acetabular measurements . Severely diminished acetabular and femoral anteversion can also lead to tears and impingement of the labrum . Then rotation of the femoral neck and/or rotations of the acetabulum by triple osteotomy to 15-20 ° of anteversion are indicated . Our triple osteotomy technique differs from that of others mainly in the ischial osteotomy . It is performed from the posterior approach between the sciatic notch next to the ischial spine and the obturator foramen and is directed 20-30 ° anteriorly from the frontal ( coronal ) plane . The osteotomies therefore are placed close enough to the acetabulum to allow free rotation , but they do not interfere with the circulation of the acetabulum , and the ligaments between the sacrum and ischium are left in normal tension . Our normal values of the acetabular position were tested by correlating the measurements with the absence of pain . The optimum is reached with a CE angle and a VCA angle of 30-35 ° , an angle of the weight-bearing zone of +5 to -5 ° and a migration index of 10-15 % . Overcorrections again caused pain and should be avoided . Diminished anteversion of femur and acetabulum towards 0 ° also caused pain and should be corrected by triple and femoral osteotomy to 15-20 ° of anteversion . In earlier follow-ups of 216 hips 5-10 years postoperatively , 82.3 % of the joints showed no change in the degree of osteoarthrosis . Survival rate curves regarding the absence of pain demonstrated that pain was experienced again when joints were corrected insufficiently or overcorrected , while in good corrections the joints were free of pain in about 75 % ."
],
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0,
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}
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] |
[] |
[] |
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}
] |
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