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Biomedical subjects

W Schwägerl

Publications and source records attributed to W Schwägerl.

At least 19 recordsLinked to original sources
PubMed2003

Extra-large press-fit cups without screws for acetabular revision.

This retrospective study reports the 4- to 6-year results of clinical and radiologic follow-up of 60 acetabular revisions using extra-large hemispherical press-fit cups without additional screw fixation. Bone grafts were used in 17 cases. One cup loosened and required re-revision after 12 months. Initial migration was noted in 6 cases, but showed no progression after less than 2 years. In 2 hips that were revised for deep infection, the cups were found incorporated. At final follow-up, 57 hips (95%) were found firmly fixed radiologically. The Harris Hip score improved from a mean of 58.7 points preoperatively to 90.6 points. Provided a high friction coefficient is present, extra-large hemispherical cups offer sufficient stability even in severe cases. Most do not require additional screw fixation.

Acetabulum↗
PubMed2002

Lengthening of the iliotibial band by femoral detachment and multiple puncture. A cadaver study.

BACKGROUND: Lengthening of the iliotibial band by various methods such as distal detachment, Z-plasty, or multiple puncture are common procedures for balancing the contracted valgus knee in total knee arthroplasty. This study was performed to measure the lengthening effect of multiple puncture and release of the distal femoral attachment of the iliotibial tract. METHODS: In a cadaver study on 14 knees, we studied the possible elongation of the iliotibial band by distal femoral detachment (release of Kaplan's fibers) and multiple puncture of the distal half of the tract. Maximum elongation was measured under a constant tension of 60 N. RESULTS: The average gain in length of the combination of both procedures was 16.3 mm (range 12-23 mm) with a tension force of 60 N applied. CONCLUSION: The results show that a sufficient release of the iliotibial band can be achieved with the techniques except for severe cases of valgus deformation, where more effective methods to release the iliotibial band such as Z-plasty or complete dissection should be performed.

Arthroplasty, Replacement, Knee↗
PubMed1996

[Rheumatoid orthopedics and endoprosthetics of the shoulder joint].

The first part of the present article gives a comprehensive description of the pathology, diagnostics and forms of therapy of rheumatically impaired shoulder joints. Improved operative methods and methods such as bursectomy, synovectomy, reconstructive soft-tissue management and joint replacement depending on the stage of impediment have enhanced the use of surgery in the treatment of rheumatic shoulder joints. The second part gives a critical evaluation of indications, methods and results of modern shoulder joint replacement. A survey of written publications on the results of hemi- and total endoprostheses on the one hand, our own clinical experiences on the other, have shown that the use of modular hemiendoprostheses produces clinically excellent results with no problems of loosening of the glenoid part.

Arthritis, Rheumatoid↗
PubMed1995

[Orthopedic treatment of arthrosis of the large joints].

Osteoarthritis most frequently occurs in the hip and knee joints. The present state of art of its treatment considering orthopaedic and surgical measures recommended are discussed. Preoperative management of the patients advising them, amongst others, on joint-preserving behaviour after surgery seems particularly important. Medication and electro-medical therapy in early manifestations of arthritis are reviewed. The importance of joint-preserving interventions, which have been somewhat neglected in the past years, is particularly stressed. Advantages and disadvantages of total joint arthroplasty are discussed.

Adolescent↗
PubMed1991

Long-term results after implantation of McKee-Farrar total hip prostheses.

From 1973 to 1976, McKee-Farrar total hip arthroplasties were performed in the Orthopaedics Department at the Centre of Pulmology. In the present study, only patients with a complete record of radiological changes at the bone/implant or bone/cement interface were evaluated. A series of 81 patients with 100 total hip prostheses in situ according to the Mayo Clinic hip score and 36 patients who had undergone 36 revision operations were studied. The design of the metal cup with metal studs at the outer surface has a favourable effect on the stability of the implant/cement combination: loosening at the implant/cement interface did not occur in any of these cases and there were few cement fractures. In spite of the metal-to-metal combination, abrasion is slight and there is no danger of metallosis.

Activities of Daily Living↗
PubMed1991

[Radiologic and sonographic screening study of shoulder joints of patients with rheumatoid arthritis].

In the course of a prospective study at our department the shoulder joints of 50 RA-patients were examined. Two criteria have been applied: only righthanded patients have been examined in order to ascertain any prevalence of changes in the dominant extremity, and only patients who were primarily admitted to our department because of complaints other than those of the shoulder. Examination consisted of anamnesis, clinical tests, radiography and sonography. Reports in the literature concerning involvement of 60%. This percentage was confirmed in our clinical and radiological examinations. If, however, sonography is used, it increases to 96%. Lesions of the rotator cuff can be demonstrated, beginning on the synovial side above bone erosions, without any clinical signs or radiographic changes. Radiographic changes have been rated according to Larsen stages 0-5. Upward migration of the humeral head already before massive bone destruction of the shoulder seems to confirm an early involvement of the rotator cuff. Involvement of the acromioclavicular joint begins with Larsen stage 2 and often includes a distension of the joint cavity. The dominant extremity was not found to be affected predominantly. The therapeutic consequences resulting from this examination are discussed.

Adult↗
PubMed1990

The APS knee joint prosthesis. A review of 32 patients.

First clinical and radiographic results with a new knee joint prosthesis, implanted without cement, are reported and the characteristics of the implant (dowel fixation and special instrumentation) presented. The first series of 35 joints with a follow-up period of 1-3 years shows excellent results. Radiographically, primary osseous integration cannot be positively identified in all cases, but it could be proved in most instances. Cement-free implantation requires good preoperative bone quality and an operative technique which inserts the implant anatomically. If these two conditions are met, there is every probability of successful implantation. No problems specific to the implant have been encountered.

Adult↗
PubMed1988

Shaft fissures due to implantation of cementless total endoprostheses of the hip joint. An experimental study.

Since 1982, at the Orthopedic Department of the Pulmologic Center of the City of Vienna we have used the Zweymüller shaft system and the pyramidal threaded socket by Schwägerl when implanting cementless hip endoprostheses. Some patients repeatedly complained about pains in the shaft region within the first postoperative months, though these complaints could not be explained clinically or radiographically. On 15 human cadavers we implanted a total of 20 Zweymüller shafts and examined the femurs for ruptures of the shaft. Our special interest was the course of the fracture lines, their localization, and their display on roentgenograms. It appeared that fissures of the shaft are easily caused by the forced driving-in of the prosthesis. In about half of all cases the fissure cannot be seen on roentgenograms because of the site is covered by the implant itself. The fracture lines do not always begin intertrochanterally or from the calcar femoris; therefore, they cannot be recognized during surgery. This problem should be considered during implantation as well as during postoperative remobilization.

Aged↗
PubMed1986

[Rheumatoid hip joint and its orthopedic surgical treatment].

In the early stage of the disease, synovectomy of the hip seems to be a successful technique, but the timing of the operation is difficult because of interference with conservation treatment. Osteotomy in rheumatoid arthritis of the hip is not very successful; arthrodesis is not recommended. In the late stage of the disease the treatment of choice is joint replacement. Here osteoporosis and the protrusion of the acetabulum present more technical problems than in other hip diseases. Implants with various designs and various implantation techniques with or without bone cement are used. The use of bone grafts, especially for protrusion, represents real progress, and there is a trend toward using cementless implantation, especially for young patients. Failures are due to difficulties in morphology, but there are no more reoperations than in osteoarthritis, and mortality seems to be higher than in osteoarthritis.

Arthritis, Rheumatoid↗
PubMed1983

[Orthopedic problems of vitamin D-resistant rickets (phosphate diabetes)].

Results of the operative treatment of phosphate-diabetes are presented on the basis of our own patients. Deformations of the lower extremities need in case of a disturbed function and disfigurement of the gait picture a surgical correction, by which we should strive as much as possible for physiological axial proportions in both planes. For young children osteoclasis with fixation in plaster cast will suffice, for adolescents and grown-ups we prefer stable osteosynthesis. An adequate straightening, combined with a regular control of the mineral metabolism and an appropriate drug therapy, guarantee good long-term results and absence of recidivity.

Adolescent↗
PubMed1983

[Possibilities for orthopedico-surgical reconstruction in joint damage in elderly patients].

If no higher risk operation for the older patient is involved, indication for an arthroplastic joint prosthesis is given on the basis of today's large and world-wide experience. The postoperative mortality is naturally higher than with the younger patients and amounts to 2% in our statistics. A smooth cooperation between the internist and the orthopaedic surgeon enables also to the older patients with higher risk operations, especially thanks to the modern anaesthetic possibilities (f.i. lumbar anaesthetics), a functional recovery of the joint. We should, however, use already with the younger patients all possible joint preserving and supporting surgical operations in order to save the old patients in many cases from the need of implanting a prosthesis.

Aged↗
PubMed1981

[Serum hydroxyproline parameter of collagen metabolism (author's transl)].

The serum hydroxyproline level enables a clinical assessment to be made of bone metabolism. A clinical-chemical method, which is described in detail, was applied in 50 control persons as well as in 76 patients with diseases of bones and/or joints. This method, which is a modification of the standard ion-exchange method of Goverde and Veenkamp for the determination of free hydroxyproline in serum, is readily applicable to mass routine laboratory usage and may be repeated ad libitum, thereby facilitating control follow-up of therapeutic response. The mean value of serum free hydroxyproline in the normal control group was 11.9 mu mol/1 (range: 6.86 to 16 mu mol/1), i.e. 1.56 mg/1 (range: 0.9 to 21 mg/1). The upper limit of normal values was calculated to be 15.5 mu mol/1 (2.0 mg/1), allowing a clear-cut differentiation from pathologically raised levels above this value.

Adult↗