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Biomedical subjects

A Reichelt

Publications and source records attributed to A Reichelt.

At least 37 records · Page 2Linked to original sources
PubMed1996

[Arthrodesis of the shoulder joint].

If strict indications are adhered to, shoulder arthrodesis is a valuable method in the operative treatment of restoring function to a chronically painful joint in a physically hard-working patient. Functional failure, especially because of rotation loss occurs often and is frequently the cause of unsatisfactory results. The main problem is the position of the arthrodesis. After numerous contradictory proposals, the most favorable approach is an abduction of 20-25 degrees and flexion of 30 degrees with an internal rotation of 45 degrees. Of all of the previous methods of fixation, today compression arthrodesis with one or two AO plates is preferred.

Adolescent↗
PubMed1996

[Revision surgery of knee endoprosthesis].

Thirty-one revisions for aseptic or septic loosening of knee arthroplasty have been performed between 1983 and 1995. In 18 cases we had loosening of uni- or bicondylar prosthesis and in 13 cases a tricompartmental revision arthroplasty. With an average of 53 months (1.5 to 13 years) after the last operation 21 patients could be examined. Main reasons for failure of uni- and bicondylar prosthesis were as well a proceeding of the arthritis in other compartments, instability, incorrect alignment and other reasons depending on the surgical technique. We found similar reasons in aseptic loosening of total knee arthroplasties including wrong choice of non-constrained condylar prosthesis. Seven cases of late infection affected semi-constrained prosthesis. Two of the reimplantations in a 2-stage procedure failed. Using the Insall-Score in the follow-up the patients reached 71.9 points in the knee score and 58.9 points in the functional score. Patients with former aseptic loosening reached better results than these with septic loosening. 38% were absolutely painfree, 14% complained about permanent pain. Unlimited walking was found 5 times, none of the examined persons was unable to walk. Main problems in revision surgery concern reconstruction of a good alignment and the management of bone loss.

Aged↗
PubMed1995

Massive osteolysis of the pelvis, femur and sacral bone with a Gorham-Stout syndrome.

We report a case of a 49-year-old white woman with Gorham-Stout syndrome. This very rare massive osteolysis occurred in the left pelvis and included the femur and the sacral bone. Histology study revealed typical ectatic vessels covered with endothelium. The therapy of choice in this region is radiotherapy with a dose of 40 Gy. However, in our case this therapy only led to short-term pain relief and cessation of the osteolysis. Stabilization with corticospongious bone did not seem to be effective against the progressing osteolysis.

Female↗
PubMed1994

Osteoarthritis after the Eden-Hybbinette-Lange procedure for anterior dislocation of the shoulder. A 15 year follow up.

We have quantified the rate and severity of osteoarthritis after the Eden-Hybbinette-Lange procedure. With a mean follow up of 15 years, 44/56 (79%) of operated shoulders showed osteoarthritic changes on radiographic review. Of the contralateral non-operated shoulders the rate of osteoarthritis was 8/60 (8%). Only shoulders in the operated group demonstrated severe osteoarthritis. In our hands the rate of osteoarthritis for the Eden-Hybbinette-Lange procedure is higher than for the Eden-Hybbinette procedure or for rival operations for recurrent dislocation. We recommend careful evaluation of the Eden-Hybbinette-Lange procedure. The high rate of late osteoarthritis indicates that other operations with an equally low rate of redislocation may be of greater long term benefit to the patient.

Adolescent↗
PubMed1994

Efficacy and safety of intramuscular glucosamine sulfate in osteoarthritis of the knee. A randomised, placebo-controlled, double-blind study.

Glucosamine sulfate (Dona, CAS 29031-19-4) is a drug used in the treatment of osteoarthritis. When orally given, it is more effective than placebo and at least as effective as non-steroidal anti-inflammatory drugs in relieving osteoarthritis symptoms. The aim of this multicentre, randomised, placebo-controlled, double-blind, parallel-group study was to assess the efficacy and safety of glucosamine sulfate intramuscularly given on the same parameters. 155 out-patients with knee osteoarthritis (Lequesne's criteria), radiological stage between I and III, Lequesne's severity index of at least 4 points and symptoms for at least 6 months, were treated with i.m. glucosamine sulfate (or placebo) 400 mg twice a week for 6 weeks. Clinic visits were performed at enrollment, after a 2-week baseline, at weekly intervals during treatment and 2 weeks after drug discontinuation. Responders to treatment were considered those patients with a reduction of at least 3 points in the Lequesne index, together with a positive overall judgement by the investigator. The Lequesne index was slightly over 10 points in average in both groups at the beginning of treatment. A significant decrease in the index was observed for glucosamine compared to placebo (3.3 vs. 2.0 points in average, respectively; p < 0.05, Student's t-test). The responder rate in the evaluable patients was 55% with glucosamine (n = 73) and only 33% (n = 69) with placebo (p = 0.012, Fisher's Exact Test). According to the intention-to-treat approach, considering also drop-outs, these proportions were 51% vs. 30% (p = 0.015).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Late results of the Keller-Brandes operation for hallux valgus.

Evaluating the late results of the Keller-Brandes operation for hallux valgus in 100 feet on average 5.5 years after surgery, these were functionally and cosmetically satisfying to the patient in 90% of cases. In 97% pain was relieved completely or partially. On examination, however, 23% of the feet still had a clinical hallux valgus angle of more than 30 degrees. A dorsal extension-contracture which was found together with 50% or more of phalangeal resection was present in 6%. The power of plantar flexion of the big toe decreased with the extent of resection of the proximal phalanx. Resection of more than half of the proximal phalanx seems to be disadvantageous and should be avoided.

Adult↗
PubMed1992

[The prognosis of conservatively treated lumbar intervertebral disk displacement].

72 out of 120 patients who where treated conservatively for proven lumbar disc prolapse over a seven-year-period were reexamined. Questionnaires could be obtained and evaluated for 91 patients. The date of reexamination was an average of 44.5 months after the end of inpatient-treatment. Results are given for the duration of inability to work and the "return to work" (RTW)-rate. The ability to work of 54 patients was regained after an average of 11.1 weeks, 95% of patients could return to their previous workplace.

Female↗
PubMed1992

[Lumbar intervertebral disk displacement. Results of conservative treatment].

Among 120 patients with lumbar disk prolapse treated conservatively over a seven-year period, 72 patients were submitted to follow-up examination, and questionnaires completed by 92 patients were evaluated. Some 23.8% of the patients reported freedom from pain following treatment in hospital. Sciatica cleared up in 43.2%. After discharge from hospital, the average working time lost in 54 patients was 11.1 weeks. Ninety-five percent of the patients reported a return to work within one year. Eighty percent were able to return to their original workplaces. Some 73.8% of the patients surveyed were satisfied or very satisfied with the results of treatment. With respect to sensory disorders 37%, and with respect to paresis 32%, of the patients, reported improvement. Overall, the general and local symptoms, such as changes in gait and posture, percussion pain and tenderness, all showed an appreciably greater tendency to regress than did the neurological deficits.

Adult↗
PubMed1992

Complications of high tibial osteotomy and internal fixation with staples.

Osteotomy for osteoarthritis of the knee has established itself well since its first description by Jackson and Waugh [8, 9]. Internal fixation with staples allows early functional treatment with only a minimum of operative intervention. Removal of the metal is optional. In the 5-year period from 1986 to 1990, 182 high tibial osteotomies were performed at the Orthopaedic Department of the University Hospital of Freiburg. In four cases internal fixation was done with plates; in 178 cases two or more staples were used; in 3 cases a screw was additionally inserted for better hold. The staples became loose intraoperatively in eight cases (4.5%); only once did a dislocated staple have to be reoperated on post-operatively. Further complications which are independent of the method of internal fixation are summarized in the article. Complications of surgery on the long bones of the leg are inevitable, but with only one postoperatively dislocated staple and one case of non-infected pseudarthrosis (i.e. a method-related complication rate of 1.1%), internal fixation with staples for high tibial osteotomy presents itself as a reliable and safe procedure.

Adolescent↗
PubMed1991

[Tuberculosis of the larynx, oral cavity and pharynx].

A 44-year-old man, a heavy smoker over many years, complained of hoarseness for 8 weeks with weight loss and dysphagia. Malignant tumour of the pharynx was suspected. Examination revealed a swelling of the right upper lip, tumorous changes in the right buccal mucosa, about 6 x 6 cm in size, as well as enlargement of the cervical lymph-nodes. Microlaryngoscopy revealed a three-level tumour of the entire side of the right larynx. Histological examination of biopsies of the right false and true vocal cords as well as the buccal mucosa demonstrated numerous, partly caseous epithelioid granulomas with Langhans giant cells. Ziehl-Neelsen staining showed acid-fast rods. Combined tuberculostatic treatment with isoniazid, rifampicin, ethambutol and pyrazinamide achieved regression of all signs and symptoms within two months. This case emphasizes the need for including laryngeal tuberculosis in the differential diagnosis of seemingly malignant laryngeal tumours.

Adult↗
PubMed1991

[The effect of Federal Public Health Service guidelines on air, surface and floor germ count in a general surgery and an orthopedic operating room].

In a prospective study the environmental contamination in an old and a new operating theatre was investigated. The old operating rooms were constructed in 1936 whereas the new rooms were built in 1986. The study was conducted in surgical and orthopedic surgical operating rooms. There was a slight increase in floor as well as in surface contamination in the new operating rooms. On the other hand there was a slight decrease in the airborne microorganisms in the orthopedic surgery and nearly identical colony counts in the general surgery operating rooms. All the differences were statistically not significant. The spectrum of microorganisms and the occurrence of Staphylococcus aureus in the old and the new operating rooms showed no difference.

Air Microbiology↗
PubMed1989

[The importance of imaging technics in the diagnosis of sports related periarticular shoulder lesions].

Numerous kinds of sports lead to lesions of the periarticular tissue of the shoulder, which can result in the supraspinatus syndrome or incomplete and complete rupture of the rotator cuff. Standard radiography is of limited use in the diagnosis of periarticular diseases of the shoulder. Osseous alterations in the greater tubercle and undersurface of the acromion can be explained as a supraspinatus syndrome or a long-standing rupture of the rotator cuff in connection with high positioning of the head of the humerus. A rupture of the rotator cuff is demonstrated by arthrography of the shoulder joint, a diagnostic method that we think is necessary despite regular examinations with ultrasonography.

Aged↗
PubMed1988

[Clinical results using the PM type of hip endoprosthesis].

The results of clinical follow-up examinations of cement-free PM total hip replacements implanted between March 1981 and December 1985 are reported. Of 231 PM hips, 125 were re-examined. Questionnaires were completed by 58 patients who were not examined. With an average value of 15.7 points according to Merle d'Aubigné, the overall clinical results may be regarded as good. A total of 86.4% of the patients stated that their condition was better than before surgery. However, almost 20% had severe complaints. These included on the one hand soft-tissue complaints, in particular in the immediate postoperative phase; on the other, in cases with initially minor sinking-in of the shaft and subsequently more than 5 mm, there was a high level of significance in the correlation to the complaints which occurred. No problems occurred with the screw-in acetabulum.

Arthritis, Rheumatoid↗
PubMed1988

[The function of the coracoacromial ligament].

The function of the coracoacromial ligament was investigated in 8 dissecting-room scapulae. Strain gauges were attached around the coracoid process and the acromion, and tension (50 or 100 N) applied through the remaining muscle stumps. The results showed that, after division of the ligament, significantly more distortion could be measured in the acromion than in the coracoid process, which suggests that the 'stay' effect of the coracoacromial ligament is stronger for the former. Since the degree of distortion is largely dependent on the direction of pull, the ligament is interpreted as a dynamic brace between the two processes of the scapula.

Acromion↗