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Biomedical subjects

P Diekstall

Publications and source records attributed to P Diekstall.

4 recordsLinked to original sources
PubMed1999

[Considerations for the indications for anterior cruciate ligament reconstruction. Results of conservative versus operative treatment].

Medium-term results with a follow-up of at least 3 years were done in 160 patients (average follow up 51 months) after ACL reconstruction using IKDC evaluation form and Noyes score and in 110 patients (average follow Up 53 months) after non-operative management. Unlike objective good parameters the subjective assessment of knee function according to the Noyes score reveals significantly worse results in cases with ACL reconstruction compared to the knees without surgery. The best functional results we found in professional athletes after ACL reconstruction. Comparable positive results of knee function is only achieved in approx. 15% of the patients from the natural history group, who can maintain high risk pivoting activity level feeling no giving way. In our opinion compensatory proprioceptive mechanism account for the surpassing results in these two groups of patients. It will be postulated that it is not the absolute power of the hamstring but the latency period of recruition that influences the compensation of anterior knee instability. We have modified our rehabilitation methods in order to improve proprioception and dynamic stability of the ACL-deficient knee. Based on our results we primarily limitate the ACL reconstruction on a group of patients practicing high-risk-pivoting sports. Only when menisceal lesions appear or patients suffer from giving way episodes we support secondary surgery. The pivot shift sign is reflecting the dynamic aspect of knee instability. In our opinion it is the decisive parameter to assess knee instability unless there are useful technical procedures.

Adult↗
PubMed1995

[Immobilization damage].

Prolonged immobilization can threaten the surgical result. The reduction of the muscle diameter is reported to be between 10 and 60% after four weeks of immobilization depending on the different muscle groups. Particularly the oxidative type-1 fibers, the "slow twitch fibers" are concerned. However, the sequelae of immobilization of muscle are reversible, which is in contrast to the detrimental effects immobilization has on the bone. Inactivity osteoporosis is occurring in three stages with bone loss as much as five to twenty times that of other calcipenic disorders. The physiological coupling of bone resorption and bone remodeling is lost. Immobilization leads to arthrosis changing the cartilage matrix composition quantitatively and qualitatively as well as cartilage morphology histologically and electron-microscopically. The result of immobilization is shortening of all fibrous tissues. The loss of the ligament-specific orientation of fibrils leads to significant reduction in tensile strength. The sequelae of immobilization emphasize the importance of early functional therapy. Continuous passive motion speeds up wound healing, and the tissue-structure is improved.

Animals↗
PubMed1987

Estimating frequency of Kallmann syndrome among hypogonadic and among anosmic patients.

The frequency of Kallmann syndrome (hypogonadotropic hypogonadism and anosmia, HHA) was estimated in patients presenting with hypogonadism and patients with anosmia. Of 791 hypogonadal males 19 had HHA. The frequency of HHA was about 1:25 (n = 8/189) in outpatients questioned about their sense of smell, about 1:50 (n = 11/579) in patients whose blood samples were sent to us for chromosome analysis, and about 1:30 (n = 19/605) in males with hypogonadism and 46,XY chromosomes. The relation of patients with HHA to those with Klinefelter syndrome was 1:10 (n = 19/186). From 24 patients presenting with anosmia we found 1 hitherto undiagnosed case of HHA. The mean age at diagnosis was 24.8 and 24.9 years in our cases and cases from literature, respectively. These data provide evidence that Kallmann syndrome is not infrequent and that most patients remain undiagnosed until the third decade of life. Earlier diagnosis is emphasized by questioning each hypogonadal patient about his sense of smell because therapeutic success seems to be age dependent.

Adolescent↗