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Biomedical subjects

P Griss

Publications and source records attributed to P Griss.

125 records · Page 7Linked to original sources
PubMedDate not supplied

[Valgisation tibial head alignment osteotomy--results of a comparative follow-up of Coventry interligament tibial head osteotomy and Wagner oblique osteotomy].

In the follow-up study presented the results of 33 high tibia-osteotomies (Coventry) are compared with 51 oblique lower tibia-osteotomies (Wagner). Both techniques guarantee a safe improvement of function, pain relief, and biomechanic situation of the arthrotic joint. The results are mainly independent of the grade of joint involvement and the age of the patient. The Coventry-osteotomy tends to accentuate femoropatellar arthrotic destruction, while the Wagner-osteotomy does so in 20% fewer cases. The functional improvements of the Wagner-osteotomy are more than 20% better, up to 5 years postoperatively, when compared with the high tibia-osteotomy. Indication, technical performance of the operation, and the postoperative care are discussed in the light of the results presented.

Adolescent↗
PubMedDate not supplied

[Diagnosis and therapy of coxitis fugax with special reference to the value of ultrasonographY-assisted diagnosis and hip joint puncture].

Between 1984 to 1991 55 children (mean age 7.0 years) were observed with a painful effusion of the hip examined by ultrasound. Children with radiologically diagnosed hip diseases were excluded. In 47 cases we found a transient synovitis of the hip which started at an average interval of 4 days in mean before admission. All children were reexamined 6 weeks after the end of treatment sonographically and clinically, 4 of those revealing incipient Perthes diseases. The primary sonographic right/left difference in amount of effusion (mean) was 4.0 +/- 1.7 mm and after aspiration 1.5 +/- 1.4 mm with a significantly correlation with the amount of aspirated synovial fluid. The radiological findings for a diagnosis of an effusion of the hip were not reliable. Beside the diagnostic signs of the appearance of the aspirated fluid the sonographic assisted aspiration of the hip is an important treatment mode to reduce the intracapsular pressure and the pain of a hip effusion in children.

Adolescent↗
PubMedDate not supplied

[Implant fixation strength and osseointegration following systemic administration of recombinant factor XIII and factor XIII concentrate. Animal experiment with implant fixation strength and osseointegration of porous surface implants].

30 cylindrical commercially pure titanium fiber porous coated Ti6A14V implants were inserted press-fit into the proximal humeral portion of 30 sheep humeri to determine the systemic effect of recombinant factor XIII and placenta-derived factor XIII concentrate on bone ingrowth and on strength of fixation. For both the recombinant factor XIII and the factor XIII concentrate group the volume fraction of bone ingrowth and the strength of fixation was higher when compared with the control specimens. However the difference was only significant for the factor XIII concentrate group.

Alloys↗
PubMedDate not supplied

[Standardized infection model for the study of bony ingrowth dynamics of hydroxyapatite-coated and uncoated pure titanium mesh in swine femur].

The authors studied the ingrowth dynamics of bone tissue into the pores of Hydroxyapatite-coated (plasma-spraying technique) and uncoated wiremeshs of pure titanium in an infected implantation site. Samples of the tested materials were implanted into the femora of 15 adult Göttingen minipigs. Just before implantation they were contaminated with Staphylococcus aureus. The animals were sacrificed after 4, 8, 12 and 24 weeks. Undecalcified ground-sections of bone tissue were prepared (app. 100 microns) and stained with toluidine blue for comparative histological evaluation. The HA-coated implants demonstrated advanced new bone formation already after 4 weeks and nearly complete osseointegration after 12 weeks although all samples showed gross and histological signs of persisting infection. Comparable reactions of the uncoated implants could only be observed after 24 weeks. Signs of degradation of the Hydroxyapatite-coating could be seen in contact to soft tissue and were more extensive compared to the behaviour in an uninfected site. The results and possible clinical consequences are discussed.

Animals↗
PubMedDate not supplied

[Established aspects and current knowledge in biomaterials research].

A review of the currently clinically established biomaterials UHMWPE, Al2O3-ceramic, CoCr- and Ti-based alloys and HA-coatings is given on the basis of recognized and new insights. Advantages and disadvantages as well as prospectives (PE-disease, Ti wear, HA-resorption in vivo etc.) are discussed and documented with results from experimental and clinical experience. New surface hardening techniques for Ti-based alloys are mentioned. Experimental results and singular experience from clinical retrieval study of new plastics (PAEK, Triazin-resin) are presented. Composite materials as a basis for a new generation of isoelastic hip prosthesis stems are described at the end of this paper.

Absorption↗
PubMedDate not supplied

[Cement-free cup and cemented shaft--concept of a hybrid solution and results of a 3-to-6-year clinical experience].

Report about the Marburg Hybrid THA using a cementless cup and a cemented stem. The acetabular component consists of an hemispheric inner polyethylene cup and an outer five-layer sintered titanium wire mesh fused together. The socket is primarily anchored by one peg as well as 2 self-stabilizing titanium nails. The forged titanium alloy stems are meeting all the requirements of the latest biomechanic research. A total of 292 Hybrid THA were implanted in 273 patients from 1. 8. 1986 to 1. 1. 1989. 6 patients (2.1%) had to undergo THA exchange surgery (1 early, 3 late infections, 1 acetabular fracture after fall, 1 loosened stem). The clinical data of 62 patients (21.2%) had to be disregarded for various reasons. Thus the data of 212 (72.6%) implanted THA in 194 patients were analyzed. 204 of the analyzed THA (96.2%) judged the result of the operation as good or very good. Radiolucency at the bone-titanium-interface of the cementless cups was present in 60 of 212 cases (28.3%), in revision operations twice as often as in primary implantations. There were no signs of progression. Radiolucency at the bone-cement-interface of the cemented stems was present in 27 of 212 cases (12.8%), with radiolucencies > 1 mm only occurring in area 7 of Gruen (1979). The overall results are thus very promising and support the concept of a hybrid solution for THA.

Adult↗
PubMedDate not supplied

[Autologous cartilage-bone transplantation in the therapy of osteochondrosis dissecans of the knee joint].

This study presents the results of twelve patients, treated by an autologous bone and cartilage transplant for an advanced stage (stage IV and V referring to Rodegerdts and Gleissner, 14) of osteochondritis dissecans of the knee. In a follow up examination after an average time of 3.7 years all patients could be reviewed clinically and radiologically. The clinical results have been very satisfying in all but one patient. Radiologically all patients showed early signs of gonarthrosis, but only in 4 of 12 patients more advanced signs of arthrosis were found. In their own opinion all patients were satisfied with the outcome of the operation, and two of them regarded the result as excellent. Besides the operative technique the indications practising autologous bone-cartilage-transplantation in large osteochondral defects of osteochondritis dissecans are described as well. Furthermore the advantages of autologous against homologous bone-cartilage-transplants are discussed.

Adolescent↗
PubMedDate not supplied

[Biomechanic study of the tensile strength of lyophilized and deep frozen human Achilles tendons following gamma and ethylene oxide sterilization].

By a failed first operation allogenic tissues, as human Achilles tendons are offered for anterior cruciate ligament replacement. The effects of freeze-drying and primary Gamma- or EO-sterilization on the mechanical properties of 62 complete and 74 bisected tendons again fresh frozen controls were investigated under axial tension. A significant decrease of tensile strength for the freeze-dried preparations of 33% for the whole and 43% for the bisected tendons were observed, while Gamma- or EO-sterilizations showed a smaller deleterious effect on the tendons. Considering only the primary mechanical strength complete freeze-dried or complete and bisected irradiated Achilles tendons show sufficient tensile strength for anterior cruciate ligament replacement.

Achilles Tendon↗
PubMedDate not supplied

[Is conservative treatment of partial or complete anterior cruciate ligament rupture still justified? An analysis of the recent literature and a recommendation for arriving at a decision].

In a review of the recent literature after conservative treatment of the complete anterior cruciate ligament (acl) rupture good results were found in an average (av) of 56% (12-80%) of all cases. In comparison the conservative treatment of partial tears showed in 84% (60-100%) of all cases good results. 79% (32-100%) of the patients with complete acl ruptures and 90% (66-100%) of the cases with partial acl tears were able to continue their sport activities. Secondary acl replacement or meniscus surgery were later necessary in 20% and 14% of the cases (av) with complete acl ruptures and in only 6% and 5% (av) of the cases with partial tears. Most of the patients who were operated later were young and ambitiously engaged in sports. The results of the mostly retrospective studies display a high variability. For this reason it is necessary to perform more prospective, controlled and randomized studies to verify the preventive effect of an early operative treatment to protect the joint form osteoarthritis and progressive instability. Arthrocopy is essential for all cases of acute hemartrosis. Partial acl tears are predominantly treated conservatively, while complete acl ruptures should be treated following an individual decision regimen. A tree for decision making of the treatment of acute acl-injuries is proposed.

Anterior Cruciate Ligament↗
PubMedDate not supplied

[Harrington's operative treatment of scoliosis in combination with segmental transverse stabilization with Luque cerclage (the Harrington-Luque operation). Early results of the first 31 personal cases].

Early postoperative results in 31 cases of scolioses of varying etiology using the new combination of Harrington's distraction system together with Luque's segmental wiring are presented. Starting from an average preoperative COBB angle of 70 degrees (40 degrees-120 degrees), postoperative average correction to 35 degrees (15 degrees-80 degrees) could be achieved. This represents an average correction of 49.7% (28%-73%). One deep wound infection (cleared by removal of the material) and one transient monoradicular nerve irritation complicated the follow-up in total. The superior stability of the Harrington-Luque-combination (detailed description of the operative procedure) allows the reduction of the postoperative time of external splinting to only 6 months. The Technique described can be estimated as a considerable improvement of the classical Harrington-operation and has already replaced it in our department.

Adolescent↗
PubMedDate not supplied

[Experimental results of stepped titanium shafts for hip endoprostheses].

Among the materials which can be used for hip prostheses to be implanted without bone cement, ceramics and titanium possess the best overall properties for insuring long-term stability in the light of present knowledge. However, considered separately, the two materials are most suitable for different special requirements. Results of long-term animal experiments conducted by different working groups on functionally stressed hip and tooth-root implants made of bio-inert Al2O3 ceramic and titanium have furnished knowledge of the possibilities and limitations of the adaptation reaction of the bone tissue. The present authors investigated whether, by combining Al2O3 ceramic and titanium, a cement-free total hip replacement can be adapted to specific local stresses, taking biomechanical rules and anatomical factors into account. In recent experimental series it proved possible to limit the problems which had occurred in previous series, reported elsewhere. Positive results in dogs led to a human implant which has so far been used 15 times, with Al2O3 (FRIALIT) acetabula and heads, which have been implanted successfully for a number of years, in combination with the new stepped titanium shaft. In addition to a short review of follow-up findings thus far, the results of the experimental investigations are presented.

Animals↗
PubMedDate not supplied

[Straightening operations in juvenile kyphosis. Results in 31 cases using Harrington's dorsal compression spondylodesis or its combination with ventral osteodiskectomy and clip insertion].

Results of operative treatment in 31 cases of juvenile kyphosis are presented. In 23 cases a posterior Harrington spondylodesis, in 6 cases a combined staged anterior and posterior spondylodesis, in two cases an anterior spondylodesis alone were performed. The average preoperative angle in the first group was 50 degrees (15 degrees-83 degrees), the average postop, angle was 22 degrees representing an 56% average improvement of the initial angle. At reevaluation, however, an average loss of correction of 13.9 degrees or 49.6% reduction of the initial improvement was registered. The combined procedures started with an average preoperative angle of 60 degrees, the postsurgery value was 22 degrees representing 63% of improvement. In 6 cases the average loss of correction at reevaluation was only 7% or 18.9% of early improvement was lost. The results favor strongly a combined staged anterior and posterior procedure for correction. When the behaviour of the wedge vertebrae is included as well, this study offers clear indications for a differentiated treatment of choice in each case of severe juvenile kyphosis.

Adolescent↗
PubMedDate not supplied

[Aneurysmal bone cyst of the thoracic and lumbar spine. Report of 4 personal cases and description of an improved radical operation technic].

This report presents results in 4 cases of aneurysmal bone cyst of the thoracic- and lumbar spine with inclusion of the vertebral body. A new own modified radical method of resection (transthoracic or retroperitoneal) for the total resection of the lesion is described. The defect created after vertebral body resection is filled with a homologous femoral head transplant (prepared from material removed during total hip replacement). For correction of the deformity (kyphosis) and stabilisation of the area of VDS-Implant System of Zielke is used. The results thus obtained are excellent, complications or recurrences of the lesion have not been observed.

Adolescent↗