Diagnosis of knee instability using sonography.

OBJECTIVE: A sonographic method has been developed to diagnose knee joint instabilities and to gain exactly quantifiable and reproducible measurements. DESIGN: Based on biomechanical considerations, a new positioning device to analyse knee instabilities sonographically has been developed and tested in in vivo studies. BACKGROUND: Common instrumental testing techniques are difficult to reproduce and show a lack of reliability. METHOD: Using sonography the cortical line of the femur and tibia are observed. At the same time a translation of these two partners at the knee joint is provoked in a defined position using the special holding device and under a defined amount of stress. Using this method 142 healthy people, placed in different age groups, were tested to establish standard values for the physiological knee joint translation. A prearthroscopic stability analysis was performed on 101 patients. RESULTS: This study proves that the special device developed, together with the technique used, provides reliable and exact measurements for knee instability in different translation directions. In healthy subjects the lateral compartment always showed a larger translation than the medial compartment. A gradual increase in translation was determined in the age groups over 30 years. A significant difference of 0.0001 was shown between knee stability and instabilities. Moreover, a further differentiation between partial and total ACL ruptures and chronic instabilities was determined. This provides an important advantage not offered by usual instrumental testing techniques. CONCLUSIONS: The ability to diagnose even a very low extent of instability and to differentiate between different kinds of instabilities enables exact controls to be carried out for both conservative and operative treatment.

Endoscopic therapy in epicondylitis radialis humeri.

After making an exact diagnostic verification of tennis elbow and after intensive conservative treatment has been used without any signs of improvement, the Hohmann operative procedure involving the incision of the proximal extensor tendon has distinct advantages as far as the pathophysiological aspects are concerned. This operative treatment can be safely carried out using endoscopy. A normal 30 degrees endoscope, nonelectrolyte fluid, an exploratory probe, and an electrotome are necessary. The procedure is described in detail.

Significance of laser treatment in arthroscopic therapy of degenerative gonarthritis. A prospective, randomised clinical study and experimental research.

To ascertain the efficiency of different techniques of arthroscopic therapy for gonarthritis and establish the relevance of the extent of chondromalacia, clinical and experimental studies were performed. In principle, the process of chondromalacia determines the course of the disease. Treatment of additional meniscus lesions temporarily leads to better clinical results, but after only a few months the symptoms caused by the arthritic process reappear. Compared with the temporary relief of complaints after debridement and lavage, smoothing with a xenon chloride excimer laser in grade II chondromalacia leads to statistically significantly better clinical results. Scanning electron microscopic studies confirm the extremely good smoothing. These studies permit clear statements as to the various methods of treatment and their application in the different grades of chondromalacia, thus leading to differentiated arthroscopic treatment of degenerative gonarthritis.

[Bacterial colonization of the nasopharynx in a comparison of home reared and day care children]. / Bakterielle Besiedelung des Nasen-Rachenraumes im Vergleich von Haus- und Krippenkindern.

Differences of the bacterial population of home- and daycared children are more significant within the nose than in the pharynx. In vitro the efficiency of erythromycine against bacteria of the nose-pharynx-area is broader then that of Penicilline and the combination Trimethoprime plus Sulfonamide.