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Biomedical subjects

M H Hackenbroch

Publications and source records attributed to M H Hackenbroch.

At least 37 records · Page 2Linked to original sources
PubMed1994

The Cenos hollow stem in total hip arthroplasty: first experiences in a prospective study.

Due to its hollow construction, which gives it elasticity, the Cenos hollow stem (Artos) reduces stress shielding in the intertrochanteric region and reduces bone remodelling at the distal tip after implantation of a cementless stem in the femoral canal. This should contribute to a longer implant survival time and reduce the number of revision procedures required for implant loosening. Its anatomical shape means that it fits well in the femoral canal and additionally improves load distribution. We prospectively studied patients in whom the Cenos hollow stem was implanted in our clinic. The clinical results after 1 year and 40 implantations are very satisfactory. No thigh pain has been reported so far, which is probably due to the effectiveness of the increased elasticity and the better fit of the stem. Preoperative planning with a special template is very accurate, and in combination with the anatomical shape of the stem makes the surgical procedure easy. The relatively high number of ectopic ossifications found in our series is obviously not related to the stem itself. In our opinion it is a result of the lateral approach. However, no clinical disadvantage resulted from these ossifications.

Adult↗
PubMed1993

Normal plasma levels of IGF binding protein in Perthes' disease. Follow-up of previous report.

Plasma levels of insulin-like growth factor binding protein-3 (IGFBP-3) were measured in 55 children with Perthes' disease and 55 age- and sex-matched controls. IGFBP-3 values did not differ between the 2 groups and corresponded well to normal values found by others. The IGF I/IGFBP-3 ratio was reduced during the first 2 years of Perthes' disease. Our findings indicate that low levels of circulating IGF I in Perthes' disease, as we have reported previously, are caused neither by altered concentrations of the principal IGF-binding protein, IGFBP-3, nor by an underlying growth hormone deficiency.

Adolescent↗
PubMed1992

No physiologic age-related increase of circulating somatomedin-C during early stage of Perthes' disease: a longitudinal study in 21 boys.

Perthes' disease was originally viewed as a local ischaemic necrosis of the femoral head. Several authors, however, have presented data suggesting that children with this disease also suffer from a general disorder of skeletal maturation. Hormonal changes in the hypothalamus-pituitary-growth plate axis have been discussed as a possible underlying cause and contradictory results reported on the role of the somatomedins in this process. In this report for the first time sequential data are presented on plasma somatomedin-C (Sm-C/insulin-like growth factor I) levels in 21 boys with Perthes' disease. Values were compared with data from 105 control subjects. The physiologic increase with age of plasma Sm-C levels in the control group was either absent or diminished in children with early-stage Perthes' disease (P less than 10(-6), signs test). The Sm-C values in affected children were low. Our data correlate well with reports from others of retarded skeletal maturation in children with Perthes' disease and support the hypothesis of an accompanying disorder of the synthesis or release of Sm-C/IGF-I or its binding proteins.

Aging↗
PubMed1992

Intra-articular injections and articular cartilage metabolism. An experimental study in rabbits.

We studied the effects of repeated intra-articular injections of sterile 140 mM NaCl solution on articular cartilage in adult rabbits. After 20 injections into the knee joints over a period of 4 weeks, chondrocyte glucosaminoglycan synthesis was evenly reduced in all cartilage layers, accompanied by a significant proteoglycan depletion of the matrix which was most marked in the superficial half of the cartilage. These and other changes only partially reversed during a further 4-week period after the injections had been stopped. Our data underline the need for a clear-cut indication for intra-articular injections. The microtrauma caused by injection, in conjunction with the introduction of a carrier solution into the joint, may, at least when repeated at short intervals, lead to measurable damage to the articular cartilage.

Animals↗
PubMed1992

Low plasma levels of insulin-like growth factor I in Perthes' disease. A controlled study of 59 consecutive children.

We studied Insulin-like Growth Factor I (IGF I) plasma levels, standing height, and weight in 59 consecutive children with Perthes' disease and 59 matched controls. The plasma-IGF I levels, measured by radioimmunoassay after acid ethanol extraction, were reduced in affected children during the first 2 years after the diagnosis of Perthes' disease. Partially paralleling the alterations in IGF I plasma levels, there was a tendency towards growth arrest and impaired weight-gain during early-stage disease, followed by catch-up growth and increased weight-gain. No relation was found between degree of femoral head involvement, according to Catterall (1971), and IGF I plasma-levels or body mass. Our data may reflect an impaired synthesis or release of IGF I relative to age in Perthes' disease, or changes in the affinity or metabolism of IGF binding proteins. The observed changes seem to be of a temporary nature.

Adolescent↗
PubMed1989

Intertrochanteric osteotomy for the treatment of coxarthrosis.

Intertrochanteric osteotomy of the femur as a joint-preserving procedure for the treatment of coxarthrosis depends, according to Pauwels, on the idea of calculated lowering of mechanical stress and changing of the quality of joint strain. In order to meet this rationale it is necessary to provide for optimal joint congruity. This traditionally means the creation of a joint space that is as "symmetrical" as possible, which can be demonstrated by means of conventional radiograms. In fact, however, the largest possible areas of hyaline cartilage of the best possible quality need to be positioned so that they articulate upon each other. Unfortunately, as yet no adequate methods are available of picturing the actual and the intended congruity: at least the traditional imaging techniques applied in living persons do not fulfil this. Since therefore exact preoperative planning is presently impossible, the results, unfortunately, are to some extent a matter of chance. Nevertheless, clinical long-term follow-up examination revealed that about 50% of patients continue satisfied even after 10 years, since they have no pain at all or at most minimal pain. Thus, intertrochanteric osteotomy still offers good relief in properly selected cases and there is often no need for early alloarthroplasty.

Hip Joint↗
PubMed1983

[Prolapse of the lumbar vertebral disk--correlation of CT and myelographic findings with surgical findings].

Side by side with myelography, computed tomography is growing in importance as far as the diagnosis of the lumbar compression syndrome is concerned. From May 1980 to the end of April 1982, the authors employed at the Cologne University Clinic of Orthopaedics in 176 patients operated either for the first time or several times, myelography alone in 54 cases, and myelography combined with computed tomography in 98 cases, whereas computed tomography alone was used 24 times, in each case for the purpose of preoperative diagnosis. An epicritical analysis of the two last-named groups of examinations, basing on the findings made as a result of the operation, showed that computed tomography was superior in respect of the accuracy in determining the level and affected side of the compression. Two CT examinations only could not be utilised for technical reasons. Nine false-positive or false-negative cases (plus two examinations which were useless for technical reasons) were seen among the 98 myelographies of the patient group in question. Besides the equivalent information given by computed tomography in respect of the level and side of the compression, CT supplies additional information regarding constriction of the vertebral canal, defined osseous stenoses, preference for a particular side and site of prolapsed disk tissue, and on the cause of the compression in case there is a considerable stoppage of contrast medium. Computed tomography is better suited than myelography in the immediate postoperative phase for follow-up examinations which are aimed at differentiating renewed prolapses, haemorrhages, or cicatrised changes. Provided there is enough capacity for examination, it seems possible that the noninvasive computed tomography will eventually replace invasive myelography as a routine examination method in case of relevant indications.

Diagnostic Errors↗
PubMed1983

[Surgically verified CT findings after previous lumbar discotomy].

Our experience has shown that computed tomography is superior to myelography as a diagnostic tool after lumbar discotomy. Provided the examination is carried out correctly, CT has always supplied a precise anatomic diagnosis in cases where the myelogram was ambiguous. In particular, it was possible to differentiate between discogenic, cicatrized, haematoma-conditioned and osseous compression. However, two facts have to be reiterated: 1. The reference method in the cases under report was exclusively the surgical finding, representing a relatively clearly defined part of the patient material. 2. It goes without saying that the indication for a repeat operation must be based on the clinical findings as well.

Adult↗
PubMed1979

[Contribution to the etiology of coxarthrosis. Radiographic and clinical evaluation of 976 arthrotic hip joints (author's transl)].

Radiograms and case histories of 654 randomized patients with 976 arthrotic hip joints have been reviewed in an attempt to make an etiological diagnosis. 98.3% of the patients and 98.8% of arthrotic hips, respectively, could be determined as to their underlying praearthrotic deformities according to Hackenbroch sen. The respective mean value gained from 6556 patients published in the world literature is 74.2% with marked individual variations. Most frequent praearthrotic condition was found to be congenital hip dislocation, followed by epiphyseolysis capitis femoris juvenilis, trauma, coxitis, M. Perthes, coxa vara, protrusio acetabuli, idiopathic femoral head necrosis, ankylosing spondylitis and several more rare basic conditions.--The most important reasons for differing results are discussed: Specific composition of clinic cases, completeness of documentation, experience of the reviewer and considerable space for personal interpretation. Relevant epidemiological data are also mentioned; they are in agreement with clinical experience and published data.--Finally it is stated that present diagnostic methods are not able to detect all praearthrotic conditions.

Adolescent↗
PubMed1979

[Gonarthrosis following persisting knee joint instability (author's transl)].

It is frequently assumed that persisting instability of the knee joint leads to gonarthrosis. We have reviewed recent and primary radiograms of 32 patients with old knee trauma resulting in prolonged capsular and ligamentous instability in order to study the eventual development of secondary gonarthrosis. Our results were as follows: All primarily intact joints developed gonarthrosis after an average of 46 months of permanent instability. Primarily existing gonarthrosis increased with exception of 3 cases. The tendency to develop an arthrosis seems to be proportional to the duration of instability; the type of instability apparently has no influence on the development of an instability gonarthrosis. Operative procedures having been performed prior to final stabilysing surgery obviously do not cause the development of secondary gonarthrosis. The persisting instability of the knee joint after combined discontinuation of capsule and ligaments therefore may be regarded as a prearthrotic factor.

Adult↗
PubMed1978

[Etiological assessment of aseptic femoral head necrosis from blood serum metabolic parameters (author's transl)].

The etiological assessment of aseptic femoral head necrosis in adults is facilitated by investigation of the uric acid level and of fat metabolism parameters. From 98 of our own patients it appears that femoral head necrosis after trauma, irradiation therapy and caisson disease and after massive doses of cortisone only exceptionally shows pathological serum levels. Femoral head necrosis with manifest metabolic diseases shows 53.3% hyperuricemias and hyperlipemias or dyslipidemias. Of femoral head necroses without concomitant diseases, prior physical effects and administration of cortisone, 91% had hyperuricemia and 65% hyperlipemia or dyslipidemia.

Adult↗