Biomedical subjects

M Rittmeister

Publications and source records attributed to M Rittmeister.

40 records · Page 3Linked to original sources

PubMedDate not supplied

[A posterior mini-incision for total hip arthroplasty -- results of 76 consecutive cases].

AIM: A refinement of the classic surgical approaches to the hip for total hip arthroplasty (THA) is presently being developed with a drastic shortening of the skin incision. The aim of this study was to explore if a minimal-invasive posterior approach (1) is technically feasible regardless of varying patient anatomy and (2) is associated with such results that do not suggest increased patient risk. We sought to find out how surgical time, blood loss, requirement for pain medication, pain perception and implant position were affected by a posterior mini-incision approach for THA. METHODS: Prospectively, the results of 76 consecutive THAs operated by the same surgeon via a posterior mini-incision approach were recorded. RESULTS: The length of skin incision ranged from 6.0 to 11.0 cm. On average, surgical time was 83 minutes, intraoperative blood loss was 343 ml, and the amount of PCA-administered Piritramid i. v. in the first 24 hours was 21.4 mg. Pain-free (defined as a 0-10 self rating on a VAS) were 8 % of the patients on day one following mini-incision THA, 41 % on day three, 54 % on day five and 71 % of patients on day seven. The average cup inclination and anteversion were 46 and 13 degrees, stem position was regarded as neutral in 76 %. Complications occurred in 7 patients (9 %). CONCLUSION: Our posterior mini-incision approach allowed for the placement of 76 consecutive THAs through a skin incision of equal to or less than 11.0 cm in a non-selected population without jeopardising patient safety.

Adult↗

PubMedDate not supplied

[Validation of computerized tomography antetorsion angle measurement of the femur].

AIM OF THE STUDY: Several CT-procedures exist to determine rotational variances of the femur. However, solely on the basis of few CT-scans and without a three-dimensional reconstruction of the femur, it is impossible to define the exact course of the femoral neck axis. Looking for determination of the exact course of the femoral neck axis, auxiliary constructions need to be called upon. Aim of the study was to validate several existing CT-procedures and analyse their respective error rates. METHOD: Fourty-five femora were CT-scanned and subsequently reconstructed three-dimensionally in this study. Femoral anteversion was measured using three different CT-methods in each of these femora and in addition, the respective anatomical anteversion was determined in each femur. In order to test the reliability of such methods, flexion of the femora around the center of the femoral head as well as a varus deformity of the longitudinal axis of the femora were simulated and anteversion measurements were repeated in such simulated positions. Results were statistically analysed using SPSS. RESULT: All tested CT-methods, when compared to the anatomical anteversion of a femur, showed differing anteversion-angles with statistical significance (p < 0.001). Equally, the results of the individual methods tested differed with significance. Due to a high correlation with the anatomical anteversion, all methods examined expressed trend of anteversion. Under simulated hip flexion, the "Ulmer Method" produced different values with statistical significance which were, however, without correlation to anteversion values in joint extension. With statistical significance, the "Essener Method" produced different anteversion values when the longitudinal axis of the femur was modified; however, these values highly correlated to anteversion values of femora with unchanged longitudinal axis. CONCLUSION: Our results lead us to conclude that the "Essener Method" being an interindividual method and independent from positioning, is the most suitable procedure as it allows for the correction of errors with respect to anatomical anteversion.

Femur↗

PubMedDate not supplied

[Artificial hip joint implantation in stiff-man syndrome].

UNLABELLED: AIM AND METHOD OF THE STUDY: The Stiff-Man syndrome is characterized by progressive, usually symmetric rigidity of the axial muscles of the trunk with superimposed painful spasms precipitated by various stimuli. The neurologic disorder of SMS is discussed with respect to its symptoms of orthopedic interest including treatment modalities for total hip replacement. RESULTS: An increased incidence of hip disease in patients with SMS seems unlikely according to our analysis. CONCLUSION: SMS-patients should, however, be defined at risk for heterotopic bone formation following hip arthroplasty requiring a perioperative prophylaxis.

Adult↗

PubMedDate not supplied

Grammont reverse total shoulder arthroplasty in patients with rheumatoid arthritis and nonreconstructible rotator cuff lesions.

This study was undertaken to determine whether patients with severe rheumatoid arthritis and irreparable rotator cuff rupture can be treated successfully with the Grammont shoulder arthroplasty. Seven patients with rheumatoid arthritis (8 shoulders) with nonreconstructible rotator cuff lesions and Larsen stage-V radiographic changes of the glenoid and the humeral head underwent a Grammont reverse shoulder arthroplasty. The Constant score improved from a mean of 17 points (range 4 to 25) preoperatively to a mean of 63 points (range 41 to 79) at a mean of 54 months (range 48 to 73) after shoulder arthroplasty. The mean strength at 90 degrees of abduction measured 3.6 kg (range 1 to 6). Shoulder instability was not observed. Complications included septic implant loosening (1 shoulder), aseptic glenoid loosening (2), and failed acromion osteosynthesis following the transacromial approach (3). These data of Grammont arthroplasty are encouraging with respect to restoration of stability and satisfactory function in rheumatoid, cuff-deficient shoulders. However, glenoid loosening remained a serious problem, and transacromial approaches were complicated by failure of acromial fixation.

Adult↗