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Biomedical subjects

A Wanivenhaus

Publications and source records attributed to A Wanivenhaus.

At least 37 records · Page 2Linked to original sources
PubMed1992

Polygonal triple osteotomy of the pelvis. A correction for dysplastic hip joints.

A new triple osteotomy, polygonal pelvic osteotomy (PPO), is described for use in dysplastic hips. The hip joint must be congruous with a centre-edge (CE) angle between +20 degrees and -10 degrees. Templates are used before and during operation which allow precise correction of the position of the acetabulum. The geometry of the osteotomy and a special compression plate achieve sufficient stability to permit early mobilisation. Surgery is indicated in adolescents and young adults if pain persists for at least two months. The surgical exposure, operative technique and postoperative management are presented, with the two-year results in nine cases.

Acetabulum↗
PubMed1992

The arterial supply of the sesamoid bones of the hallux: the course and source of the nutrient arteries as an anatomical basis for surgical approaches to the great toe.

The arterial supply of the hallux sesamoids was studied in 29 human feet by anatomical dissection. Eight of them underwent radiographic analysis prior to dissection. The sesamoid arteries branch off from the digital plantar arteries of the hallux, which, in turn, are derived from the medial plantar artery and the plantar arch (type A), the plantar arch (type B), or the medial plantar artery (type C). The respective frequencies of types A, B, and C were 52%, 24%, and 24%. The number of sesamoid arteries varied from one (55%) to three (10%) and the number increased with the size of the sesamoid bones. Anatomical knowledge of the course and distribution of these vessels may be of great help to the orthopedist in the understanding of the pathogenesis of avascular necrosis and may provide insight into several technical aspects regarding surgery of the hallux.

Aged↗
PubMed1991

Increased proteolytic activity on the surface of monocytes from patients with rheumatoid arthritis.

Studies on the expression and localization of the urokinase receptor on peripheral blood monocytes of patients with rheumatoid arthritis (RA), patients with osteoarthritis, and healthy volunteers showed a significant increase in the total number of urokinase receptors on monocytes of patients with RA, compared with osteoarthritis patients or with healthy subjects. The increase in the total number of urokinase receptors in RA was due to an elevation in the number of endogenously occupied urokinase receptors. These data provide evidence that increased proteolytic activity might contribute to the pronounced degradation of cartilage and connective tissue in patients with RA.

Adult↗
PubMed1991

Long-term reaction of the osseous bed around silicone implants.

Between 1970 and 1987, 94 patients received 208 silicone implants at the Department of Orthopaedics, University Hospital, Vienna. Of these, 62.5% were clinically followed up. At follow-up after an average of 116 months, the implant bed was found to be intact in only 41% of cases; in all others we observed lyses around the implant and cysts even in bones at a distance from the operated joint. Histological findings obtained from revision arthroplasty showed a homogeneous picture with foreign-body granulation tissue. These changes were usually clinically inconspicuous and had little effect on patients' subjective well-being. Despite the low discomfort caused, however, the use of such implants in only recommended in critical and severe causes because of the progressive destruction of the osseous bed during the time the implant is in the body.

Adult↗
PubMed1991

[Recurrent epicondylitis after Wilhelm's operation and its treatment].

Three patients among 107 operated on before 1985 according to Wilhelm's procedure for epicondylitis humero radialis showed no therapeutic response due to insufficient discission of the extensor carpi radialis brevis. We successfully used Garden's procedure at reoperation, with lengthening of the extensor carpi radialis brevis at the distal part of the forearm. As a direct result of our experience with these cases of recurrent epicondylitis we now consider a combination of the Garden and Wilhelm procedures the method of choice in treating patients suffering from the primary ligamentum anulare syndrome with shortened musculus extensor carpi radialis brevis. Two patients primarily treated according to the combined procedure have shown a successful result on follow-up over 60 and 55 months, respectively.

Adult↗
PubMed1990

Declines in the range of motion and malalignment in hands of patients with juvenile rheumatoid arthritis studied over 6 years.

Quantitative total joint scores including range of motion, malalignment, opposition of the thumb to the digits and combined distal-proximal-metacarpophalangeal joint flexion were determined in the hands and wrists of 56 patients with juvenile rheumatoid arthritis over six years. Most of the patients with duration of disease less than 5 years showed relatively normal hand function, reflected by low total and subtotal scores. However, significant declines of the respective variables reflected by pathological total and subtotal scores were seen in patients with duration of disease longer than 5 years. Decrease of the range of motion, total joint scores and malalignment were significantly correlated with the duration of disease.

Adolescent↗
PubMed1989

First tarsometatarsal joint: anatomical biomechanical study.

We studied the function of the first tarsometatarsal joint in 100 specimens of 53 cadavers. The study showed that an adduction and abduction movement described earlier was present only in approximately 10% of the specimens. Moreover, eversion of an average of 6.2 degrees often only occurs as a result of dorsal displacement of the joint surfaces of the first metatarsal in relation to the first cuneiform by an average of 2.6 mm. All other movements in the frontal, horizontal, and sagittal plane can be disregarded or are the result of this movement. New conclusions may be drawn from these results, especially with regard to subcapital osteotomies of the first metatarsal and the adductor transfer according to McBride in metatarsus primus varus. These findings challenge the value of the McBride transfer.

Adult↗
PubMed1988

[So-called minimal intervention in hallux valgus].

A comparison between isolated removal of the pseudoexostosis (Schede) and the combined procedure of proximal transfer of the adductor tendon added to pseudoexostosis removal proved the importance of dissection of the adductor, but failed to demonstrate any advantage of the transfer and shortening of this muscle. Neither procedure improved the metatarsal angle permanently. The hallux valgus angle showed a strong tendency of recurrence after the Schede procedure. Both procedures produced a high rate of subjective satisfaction of over 90%, notwithstanding the objective results.

Bursitis↗
PubMed1986

[Epicondylitis humeri radialis with special reference to the Wilhelm operation].

48 cases of epicondylitis humeroradialis were treated by means of an operation described by Wilhelm at the Orthopaedic Department of the University of Vienna between 1975 and 1979. They received a POP back slab for the upper arm for one week. Average time required to reach a pain-free state was three months (minimum two weeks, maximum six months). The follow-up examination at least five years later, taking clinical and subjective parameters into consideration, showed very good the satisfactory results in 93.2% and non-satisfactory results in the remaining 6.6% of cases.

Adult↗
PubMedDate not supplied

[Long-term results after uni- and bilateral high tibial osteotomies].

AIM: This study compares the long-term results of uni- and bilateral high tibial osteotomies. METHOD: 94 osteotomies (72 patients) were followed for 12.7 +/- 2.4 years after osteotomy. Long-term results of 21 patients with bilateral osteotomies (42 osteotomies) were compared with 52 patients who had a unilateral high tibial osteotomy. Endpoint of survival, was defined as implantation of a knee endoprosthesis (Kaplan-Meier analysis). At follow-up clinical results were evaluated by the knee society score and X-rays were analysed for axis and grade of arthrosis. RESULTS: Out of 94 high tibial osteotomies 22 (23 %) ended 1 - 13 years later in a knee endoprosthesis. In 11 of the 42 bilateral high tibial osteotomies (26 %; after 2 - 13 years, median 8 years) and 11 of 52 (21 %; after 1 - 11 years, median 8 years) unilateral osteotomies an endoprosthesis was implanted. Kaplan-Meier analysis resulted in no statistical difference in survival between the two groups (p = 0.6517). Additionally, clinical and radiological results were equal. CONCLUSIONS: We conclude that there is no long-term difference between uni- and bilateral high tibial osteotomies and both indications can be recommended due their satisfactory long-term results.

Aged↗
PubMedDate not supplied

[Intermediate results following subcapital metatarsal osteotomy in the therapy of hallux valgus with metatarsus primus varus].

71 feet were investigated after subcapital modified osteotomy of the metatarsus according to Kramer for an average follow-up period of 19 months. Mean improvement of the Hallux valgus angle was 10 degrees whereas the intermetatarsal angle was improved by 4 degrees on average. The high degree of satisfaction of patients (83%) with the outcome of this surgical method suggest its application in cases of medium metatarsus primus varus within hallux valgus deformations when the metatarso-phalangeal joint is not affected. In patients aged 50 years and older as well as in cases of MT I varus exceeding 18-20 degrees this operation should strictly be limited to the cases indicated above.

Adolescent↗
PubMedDate not supplied

[Significance of transverse forefoot stabilization in the treatment of hallux valgus. Comparative study of clinical/radiologic short-term results].

72 feet of 56 patients were treated by Brandes operation, modified by using a distally attached capsular-periosteal flap from 1984 till 1986 at the Orthopedic Clinic of the University of Vienna. On 41 of these feet an additional cerclage fibreuse according to Lelievre was done. This group had a significantly better correction of the hallux valgus angle with 17 degrees as compared to 8 degrees in the group without cerclage fibreuse. The correction of the intermetatarsal angle was also significantly better with 5 degrees as compared to 1 degree. Only through cerclage fibreuse was it possible to stabilize the sesamoids in the transversal as well as in the longitudinal direction. We found no improvement of subjective well-feeling after the cerclage fibreuse, but a significantly better correction and mobility in the metatarsal-sesamoid joint and the metatarsal-phalangeal joint.

Adult↗
PubMedDate not supplied

[Sliding axis endoprosthesis in severe unstable gonarthrosis and as revision prosthesis].

42 patients with 45 implanted total knee endoprostheses (sliding axis endoprosthesis Lübeck, Rp. SG implant) were investigated clinically according to the score of the Knee Joint Society in mean 27.9 months postoperatively. Mean total knee score increased from 34.9 +/- 14.7 to 72.5 +/- 3.1 and mean total functional score could be ameliorated from 40.2 +/- 25.7 to 55.7 +/- 4.5 (maximum points: 100). Evaluation of X-rays (anterior-posterior and lateral views) exhibited a satisfactory position of the prosthesis. Comparison between cemented and cementless implants as well as between primary implants and revision did not reveal any statistically significant differences. Patients with a longer follow-up period (59.8 months) showed results comparable to the mean of the total group. Frequently observed malposition of the axis of more than 3 degrees requires modifications of the orientation instruments. For revision surgeries a modular system for elongation of the stem would be desirable.

Aged↗
PubMedDate not supplied

[2-to-4-year results of the cementless application of the PCA unicondylar knee prosthesis. Clinico-radiological histomorphological study].

Since 1984 35 PCA unicondylar endoprostheses of the knee joint were implanted due to unicondylar high grade osteoarthritis or Morbus Ahlbäck. 19 endoprostheses with a minimum follow up of two years were investigated. Three implants had to be changed because of an aseptic loosening and were retrieved for histomorphological analysis. The implants which were found clinically stable were graded from the patients point of view as excellent to fair. Only in 5 cases, however, no seam at the implants interface was found in the radiological screening. These radiological lucencies can only be seen in x-ray amplifier controlled x-rays. No correlation has been seen of the clinical performance to the type of anchorage. The position of the implants which had revision was fair in one case and poor in two cases, although a correlation between the radiological seam and the position of the implant was not found. The histological analysis showed up a well developed osseointegration on the femoral component in the area of the porous coated pegs. At the interface to the bone of the tibial components intervening connective tissue has been found. 3 implants still in function have to be seen as endangered to loosening and further 8 prostheses with partial radiolucencies might become potential failures.

Aged↗
PubMedDate not supplied

[Epiphysiodesis as a means of controlling growth (calculation of angle function for planning the correction of axis errors)].

At the Orthopedic clinic of the university of Vienna epiphysiodeses have been used for treatment of leg-length-discrepancies and varus and valgus malformation. A physiological state was achieved in twelve joints out of 24 operated in sixteen patients. Bone age was to advanced in some of the other cases, while the staples were removed too late in the rest. We found the exclusive use of the growth prognosis for planning of the surgical procedure to be extremely difficult, which is why we now use fixed parameters (epiphyseal distance and growth prognosis) to define the ctg for exact mathematical evaluation. Not the surgical procedure is the problem in epiphysiodeses but planning of the operation.

Adolescent↗
PubMedDate not supplied

[Therapy and prevention in children with inflammatory rheumatic diseases].

Since 1981, annual four-week holidays have been arranged for children with juvenile rheumatic arthritis, during which the children are cared for by a team of pediatricians, orthopedists, ergotherapists, physiotherapists and assistants trained in psychology. With systematic splint therapy, physiotherapy, and by enhancing drug awareness during these therapeutic holidays significant improvements in joint mobility and subjective wellbeing were achieved. Of the 103 children treated (209 places were available), the majority spent several holidays, with a resulting improvement in joint mobility lasting several years. Through systematic training, adaptation to splints, and physiotherapy acceptance was also enhanced, with a preventive effect for the rest of the year. The success of these measures has encouraged the authors to continue the project.

Adolescent↗
PubMedDate not supplied

[5- to 10-year results of an acetabulum with ceramic pegs for cement-free bone implantation. Material and analysis of design].

The authors report on the follow-up results of a hemispherical acetabular cup with small pegs, which is designed for cementless implantation in human beings. At an average time of 89 months after implantation, these results reveal a high percentage of 60% loosenings and seam formations of more than 2 mm which could constitute the basis for subsequent loosening. An analysis of these failures attributes the cause to material-engineering as well as design problems associated with the bone pathology. A ceramic cup of this shape is apparently unsuitable for osteointegration. It would appear that the design favours tilting movements and, due to its high E-module, it is unable to compensate for the relative movements of the pelvis.

Acetabulum↗