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1.
Glob Chang Biol ; 21(12): 4673-84, 2015 Dec.
Article in English | MEDLINE | ID: mdl-26146813

ABSTRACT

Variations in photosynthesis still cause substantial uncertainties in predicting photosynthetic CO2 uptake rates and monitoring plant stress. Changes in actual photosynthesis that are not related to greenness of vegetation are difficult to measure by reflectance based optical remote sensing techniques. Several activities are underway to evaluate the sun-induced fluorescence signal on the ground and on a coarse spatial scale using space-borne imaging spectrometers. Intermediate-scale observations using airborne-based imaging spectroscopy, which are critical to bridge the existing gap between small-scale field studies and global observations, are still insufficient. Here we present the first validated maps of sun-induced fluorescence in that critical, intermediate spatial resolution, employing the novel airborne imaging spectrometer HyPlant. HyPlant has an unprecedented spectral resolution, which allows for the first time quantifying sun-induced fluorescence fluxes in physical units according to the Fraunhofer Line Depth Principle that exploits solar and atmospheric absorption bands. Maps of sun-induced fluorescence show a large spatial variability between different vegetation types, which complement classical remote sensing approaches. Different crop types largely differ in emitting fluorescence that additionally changes within the seasonal cycle and thus may be related to the seasonal activation and deactivation of the photosynthetic machinery. We argue that sun-induced fluorescence emission is related to two processes: (i) the total absorbed radiation by photosynthetically active chlorophyll; and (ii) the functional status of actual photosynthesis and vegetation stress.


Subject(s)
Chlorophyll/physiology , Photosynthesis , Remote Sensing Technology/methods , Spectrometry, Fluorescence , Sunlight , Fluorescence
2.
Article in English | MEDLINE | ID: mdl-25679632

ABSTRACT

We describe formation of defect-colloidal superstructures induced by microspheres with normal surface anchoring dispersed in chiral nematic liquid crystals in confinement-unwound homeotropic cells. Using three-dimensional nonlinear optical imaging of the director field, we demonstrate that some of the induced defects have nonsingular solitonic nature while others are singular point and line topological defects. The common director structures induced by individual microspheres have dipolar symmetry. These topological dipoles are formed by the particle and a hyperbolic point defect (or small disclination loop) of elementary hedgehog charge opposite to that of a sphere with perpendicular boundary conditions, which in cells with thickness over equilibrium cholesteric pitch ratio approaching unity are additionally interspaced by a looped double-twist cylinder of continuous director deformations. The long-range elastic interactions are probed by holographic optical tweezers and videomicroscopy, providing insights to the physical underpinnings behind self-assembled colloidal structures entangled by twisted solitons. Computer-simulated field and defect configurations induced by the colloidal particles and their assemblies, which are obtained by numerically minimizing the Landau-de Gennes free energy, are in agreement with the experimental findings.

3.
Article in English | MEDLINE | ID: mdl-25019708

ABSTRACT

We describe dipolar nematic colloids comprising mutually bound solid microspheres, three-dimensional skyrmions, and point defects in a molecular alignment field of chiral nematic liquid crystals. Nonlinear optical imaging and numerical modeling based on minimization of Landau-de Gennes free energy reveal that the particle-induced skyrmions resemble torons and hopfions, while matching surface boundary conditions at the interfaces of liquid crystal and colloidal spheres. Laser tweezers and videomicroscopy reveal that the skyrmion-colloidal hybrids exhibit purely repulsive elastic pair interactions in the case of parallel dipoles and an unexpected reversal of interaction forces from repulsive to attractive as the center-to-center distance decreases for antiparallel dipoles. The ensuing elastic self-assembly gives rise to colloidal chains of antiparallel dipoles with particles entangled by skyrmions.


Subject(s)
Colloids/chemistry , Anisotropy , Computer Simulation , Elasticity , Imaging, Three-Dimensional , Microscopy, Video , Models, Chemical , Nonlinear Dynamics , Optical Imaging , Optical Tweezers
4.
Plant Biol (Stuttg) ; 16(2): 503-7, 2014 Mar.
Article in English | MEDLINE | ID: mdl-24138093

ABSTRACT

The two widespread tropical Solanum species S. paniculatum and S. stramoniifolium are highly dependent on the visits of large bees that pollinate the flowers while buzzing them. Both Solanum species do not offer nectar reward; the rewarding of bees is thus solely dependent on the availability of pollen. Flower visitors are unable to visually assess the amount of pollen, because the pollen is hidden in poricidal anthers. In this study we ask whether and how the amount of pollen determines the attractiveness of flowers for bees. The number of pollen grains in anthers of S. stramoniifolium was seven times higher than in S. paniculatum. By contrast, the handling time per five flowers for carpenter bees visiting S. paniculatum was 3.5 times shorter than of those visiting S. stramoniifolium. As a result foraging carpenter bees collected a similar number of pollen grains per unit time on flowers of both species. Experimental manipulation of pollen availability by gluing the anther pores showed that the carpenter bees were unable to detect the availability of pollen by means of chemical cues before landing and without buzzing. Our study shows that the efficiency of pollen collecting on S. paniculatum is based on large inflorescences with short between-flower search times and short handling time of individual flowers, whereas that of S. stramoniifolium relies on a large amount of pollen per flower. Interestingly, large carpenter bees are able to adjust their foraging behaviour to drastically different strategies of pollen reward in otherwise very similar plant species.


Subject(s)
Bees , Behavior, Animal , Flowers , Plant Nectar , Pollen , Pollination , Solanum , Animals , Inflorescence , Reward
6.
Orthopade ; 32(7): 586-94, 2003 Jul.
Article in German | MEDLINE | ID: mdl-12883757

ABSTRACT

There are difficulties in diagnosing pathologies of the labrum-biceps tendon complex (LBTC) because of the great individual variability of this structure. Anatomical variations, such as the sublabral recess, are frequently found and can also be misinterpreted as Andrews or SLAP II lesions. The etiology and mechanisms of creating such a sublabral recess are not exactly known. The examination of 31 cadaveric shoulder specimens from an age group between 49.3 and 83.6 years showed a sublabral recess in 63.6-85%. This high frequency of sublabral detachment of the labrum in older patients indicates that according to the high range of motion of the humeral head and therefore the changing angle of the long biceps tendon (LBS) a certain mobility of the superior LBTC is physiological and should not necessarily be seen as a sign of instability. Besides mobility-increasing factors such as overhead professions and sports with high repetitive maximal abduction and external rotation and the individual age, the type of insertion of the LBT at the glenoid influences the development of sublabral recess. Accordingly, posterior oriented insertion types of the LBT determine deeper and more posterior oriented sublabral recesses whereas in cases of anterior directed types of insertions no or less deep recesses can be found. Anamnestic aspects, such as the mechanism of injury and overhead activities, these macroscopic and functional associations in MR arthrography and arthroscopic inspection have to be considered in order to differentiate between physiological and traumatic changes of the labrum-biceps tendon complex.


Subject(s)
Arthrography , Cartilage, Articular/anatomy & histology , Magnetic Resonance Imaging , Shoulder Joint/anatomy & histology , Tendons/anatomy & histology , Aged , Aged, 80 and over , Arthroscopy , Female , Frozen Sections , Humans , Male , Middle Aged , Reference Values
7.
Orthopade ; 32(7): 600-7, 2003 Jul.
Article in German | MEDLINE | ID: mdl-12883759

ABSTRACT

Superior labral anterior-to-posterior (SLAP) lesions can cause shoulder pain partly by causing glenohumeral instability. The purpose of this study was to examine the effect of a simulated type II SLAP lesion and subsequent repair on glenohumeral translation of the vented shoulder. In eight cadaver joints, a robotic/UFS testing system was used to measure joint translation by applying an anterior, posterior, or inferior load of 50 N to each shoulder. The "apprehension tests" for anterior and posterior instability were simulated by applying an anterior load of 50 N with an external rotation torque of 3 Nm or a posterior load of 50 N with an internal rotation torque of 3 Nm. Each loading condition was applied at 30 degrees and 60 degrees of glenohumeral abduction with a constant joint compressive load (44 N) to the intact, simulated SLAP lesion, and repaired shoulder. Repair of the type II SLAP was then performed by placing a Suretac through the labrum both anterior and posterior to the biceps anchor and testing was repeated. ANOVA was used to compare translation of the intact joint, the joint after the type II SLAP lesion had been simulated, and after repair. At 30 degrees of abduction, anterior translation of the intact vented shoulder joint from anterior loading was 18.7+/-8.5 mm and increased to 26.2+/-6.5 mm after simulation of the type II SLAP lesion ( p< or =0.05). The arthroscopic repair did not restore anterior translation (23.9+/-8.6 mm) to the same degree as the intact joint ( p> or =0.05). At 60 degrees of abduction, anterior translation of 16.6+/-9.6mm in the intact joint was not significantly increased at 19.4+/-10.1 after simulation of the type II SLAP lesion ( p=0.0527). AP loading also resulted in inferior translation. At 30 degrees of abduction it was 3.8+/-4.0 mm in the intact joint and increased to 8.5+/-5.4 mm after the type II SLAP lesion ( p< or =0.05. After repair the inferior translation decreased significantly to 6.7+/-5.3 mm ( p< or =0.05). Although inferior translations were less at 60 degrees of abduction, results were similar to those at 30 degrees after repair. There were no significant increases in translation after SI/AP combined external rotation torque or posterior-anterior combined internal rotation torque loading. In this study the repair of a type II SLAP lesion only partially restored translations to the same degree as an intact vented shoulder joint. Therefore, improved repair techniques or an anteroinferior capsulolabral procedure in addition to the type II SLAP lesion repair might be needed to restore normal joint function.


Subject(s)
Arthroscopy , Cartilage, Articular/injuries , Cartilage, Articular/physiopathology , Postoperative Complications/physiopathology , Range of Motion, Articular/physiology , Shoulder Dislocation/physiopathology , Shoulder Dislocation/surgery , Shoulder Injuries , Shoulder Joint/physiopathology , Tendon Injuries , Tendons/physiopathology , Biomechanical Phenomena/instrumentation , Cartilage, Articular/surgery , Humans , Robotics/instrumentation , Rotator Cuff/physiopathology , Rotator Cuff/surgery , Rotator Cuff Injuries , Shoulder Dislocation/classification , Shoulder Joint/surgery , Tendons/surgery , Treatment Outcome , Weight-Bearing/physiology
8.
Orthopade ; 32(7): 608-15, 2003 Jul.
Article in German | MEDLINE | ID: mdl-12883760

ABSTRACT

The superior labral-biceps-tendon-complex forms an anatomical and functional unit and combines static and dynamic elements of shoulder stability. At present, only theoretical hypotheses exist on the etiology of the microtraumatic SLAP-II-lesion. To gain further insight into this, an instrument was developed to simulate throwing motions such as the late-cocking/early acceleration phase as well as deceleration/follow-through. Sixteen freshly frozen shoulder specimens were tested, varying the loads on the biceps tendon (25 N, 50 N, 100 N) and the compression of the humeral head against the glenoid (25 N, 50 N, 80 N). Each shoulder had to run through a certain number of cycles during the particular phase of throwing. The tests were stopped after a SLAP-II-lesion was observed, or after a limit of 15,000 cycles. Every 1,000 cycles the results of the tests were checked arthroscopically. A SLAP-II-lesion developed in only 10% of the specimens during the acceleration/ late cocking phase whereas in the deceleration/ follow-through phase 83% developed such a lesion. According to our results, the deceleration/follow-through of the throwing motion seems to be responsible for creating microtraumatic SLAP-II-lesions. One reason is the loss of the centering function of the long head of the biceps tendon during total internal rotation, another is the increased posterosuperior translation of the humeral head in this position, which leads to a non-physiological contact, creating lesions in this area due to the large sheering forces.


Subject(s)
Athletic Injuries/physiopathology , Cartilage, Articular/injuries , Cartilage, Articular/physiopathology , Cumulative Trauma Disorders/physiopathology , Range of Motion, Articular/physiology , Shoulder Dislocation/physiopathology , Shoulder Injuries , Shoulder Joint/physiopathology , Tendon Injuries , Tendons/physiopathology , Acceleration , Adult , Aged , Athletic Injuries/classification , Biomechanical Phenomena/instrumentation , Cumulative Trauma Disorders/classification , Female , Humans , Male , Middle Aged , Models, Biological , Rotator Cuff/physiopathology , Rotator Cuff Injuries , Shoulder Dislocation/classification , Weight-Bearing/physiology
9.
Orthopade ; 32(7): 627-31, 2003 Jul.
Article in German | MEDLINE | ID: mdl-12883762

ABSTRACT

Lesions of the superior glenoid labrum and the insertion of the biceps tendon are a common cause for shoulder pain in patients performing overhead sports. The therapeutic management depends on the type of lesion, and should be carried out using an arthroscopic procedure. While type I SLAP lesions should be treated conservatively or with simple debridement, SLAP II, IV, and V lesions, with a detachment of the labrumanchor- complex, should be refixed with suture anchors. Only in cases of type III lesions with a bucket handle-like lesion of the labrum, but stable insertion of the biceps tendon, a simple debridement can be performed. From the biomechanical point of view, large type III lesions should also be reconstructed. To improve the arthroscopic view for preparation of the glenoid neck, an intraarticular loop ("Imhoff-suspension sling") can prevent the posterosuperior labrum from falling into the joint. The arthroscopic SLAP refixation is a technically highly demanding procedure which provides good clinical results for the patient.


Subject(s)
Arthroscopy , Athletic Injuries/surgery , Cartilage, Articular/injuries , Shoulder Dislocation/surgery , Shoulder Injuries , Suture Techniques , Tendon Injuries , Adult , Athletic Injuries/classification , Cartilage, Articular/surgery , Debridement , Follow-Up Studies , Humans , Shoulder Dislocation/classification , Shoulder Joint/surgery , Surgical Instruments , Tendons/surgery , Treatment Outcome
10.
Orthopade ; 32(7): 642-6, 2003 Jul.
Article in German | MEDLINE | ID: mdl-12883765

ABSTRACT

SLAP lesions disrupt the perilabral architecture, but so far there have been no reports about posterior instability due to SLAP lesions. In a prospective study of 30 patients with recurrent posterior instability, we found SLAP lesions as a reason for instability in three cases. The purpose of this study is to point out that SLAP lesions can be a cause of posterior instability. Thirty patients with clinical posterior shoulder instability underwent diagnostic arthroscopy before operative stabilization procedures, three of whom (three males, aged 29-51 years) showed a SLAP lesion (once case each of types II, III, and IV) as a cause of posterior instability. All three patients had a history of a fall on the outstretched arm. All patients underwent arthroscopic refixation of the labrum. After arthroscopic refixation of the SLAP lesions, two patients were completely stable (SLAP II and III), whereas one patient (SLAP IV) reported microinstability during overhead activity but complete stability during activity of daily living. The same patient complained about moderate pain in extreme external-flexion rotation with slightly reduced range of motion in external-flexion position. All other patients were free of pain and showed free range of motion. Our results demonstrate that SLAP lesions can be a cause for posterior shoulder instability. In our cases, posterior shoulder instability caused by SLAP lesions was successfully treated by arthroscopic refixation of the torn biceps anchor. When treating posterior shoulder instability, SLAP lesions should be taken into account.


Subject(s)
Athletic Injuries/diagnosis , Cartilage, Articular/injuries , Joint Instability/diagnosis , Shoulder Dislocation/diagnosis , Shoulder Injuries , Skiing/injuries , Tendon Injuries , Adult , Arthroscopy , Athletic Injuries/surgery , Cartilage, Articular/pathology , Cartilage, Articular/surgery , Follow-Up Studies , Humans , Joint Instability/pathology , Joint Instability/surgery , Magnetic Resonance Imaging , Male , Middle Aged , Range of Motion, Articular/physiology , Shoulder Dislocation/pathology , Shoulder Dislocation/surgery , Shoulder Joint/pathology , Shoulder Joint/surgery , Suture Techniques , Tendons/pathology , Tendons/surgery
11.
Z Orthop Ihre Grenzgeb ; 141(2): 143-7, 2003.
Article in German | MEDLINE | ID: mdl-12695949

ABSTRACT

AIM: The measurement or, respectively, the correction of the tibial slope is an important subject in the field of knee arthroplasty and in the procedure of cruciate ligament reconstruction. However, a valid value of the tibial slope cannot be obtained from the conventional plain X-rays in a reproducible way. The aim of this study was to evaluate the proximal tibial slope with a new CT measurement system and to compare the values with the X-ray method. METHOD: Using 6 cadaver tibiae, the antero-posterior slope of the proximal tibia was measured at 0 degrees, 2.5 degrees, 5 degrees, 10 degrees, 15 degrees, 20 degrees, 30 degrees internal rotation using the plain X-ray and spiral CT (3D-MPR reconstruction). Both methods were compared. RESULTS: The variation of the measurement of the tibial slope with the X-ray method was > 5 degrees even if the optimal 0 degrees rotation in the lateral view was applied. Moreover, the measurement error increased to 14 degrees while increasing the rotation of the tibia. Using the new CT system, the error was less than 3 degrees in all measurements. CONCLUSION: The measurement of the tibial slope in the conventional X-ray technique showed a high variation of the values depending on the rotation of the tibia in the lateral view. In contrast, the measurements with the new CT system represented a precise method with a small variation of the tibial slope values. For this reason detailed questions regarding the precise anatomy of the proximal tibia cannot be answered precisely with plain X-rays.


Subject(s)
Anterior Cruciate Ligament/surgery , Arthroplasty, Replacement, Knee , Bone Malalignment/diagnostic imaging , Imaging, Three-Dimensional/methods , Knee Injuries/surgery , Tibia/diagnostic imaging , Tomography, Spiral Computed/methods , Anterior Cruciate Ligament/diagnostic imaging , Biomechanical Phenomena , Bone Malalignment/prevention & control , Humans , Knee Injuries/diagnostic imaging , Knee Joint/diagnostic imaging , Postoperative Complications/diagnostic imaging , Postoperative Complications/prevention & control , Reference Values , Rotation
12.
Neuroscience ; 116(2): 349-57, 2003.
Article in English | MEDLINE | ID: mdl-12559091

ABSTRACT

In addition to being the major site of cerebrospinal fluid formation, the choroid plexus epithelium emerges as an important source of polypeptides in the brain. Physiologically regulated release of some polypeptides synthesized by the choroid plexus has been shown. The molecular mechanisms underlying this polypeptide secretion have not been characterized, however. In the present study, synaptosome-associated protein of 25 kDa and vesicle-associated membrane protein, two membrane fusion proteins playing a critical role in exocytosis in neurons and endocrine cells, were found to be expressed in the choroid plexus epithelium. It was also shown that in choroidal epithelium, synaptosome-associated protein of 25 kDa and vesicle-associated membrane protein stably interact. Two members of the vesicle-associated membrane protein family, vesicle-associated membrane protein-1 and vesicle-associated membrane protein-2, were expressed in the rat choroid plexus at the messenger RNA and protein level. However, their newly discovered isoforms, vesicle-associated membrane protein-1b and vesicle-associated membrane protein-2b, produced by alternative RNA splicing, were not detected in choroidal tissue. Immunohistochemistry demonstrated that vesicle-associated membrane protein is confined to the cytoplasm of choroidal epithelium, whereas synaptosome-associated protein of 25 kDa is associated with plasma membranes, albeit with a varied cellular distribution among species studied. Specifically, in the rat choroid plexus, synaptosome-associated protein of 25 kDa was localized to the basolateral membrane domain of choroidal epithelium and was expressed in small groups of cells. In comparison, in ovine and human choroidal tissues, apical staining for synaptosome-associated protein of 25 kDa was found in the majority of epithelial cells. These species-related differences in cellular synaptosome-associated protein of 25 kDa distribution suggested that the synaptosome-associated protein of 25 kDa homologue, synaptosome-associated protein of 23 kDa, is also expressed in the rat choroid plexus, which was confirmed by reverse-transcriptase polymerase chain reaction. Our findings suggest that synaptosome-associated protein of 25 kDa and vesicle-associated membrane protein are involved in secretion of polypeptides from the choroid plexus epithelium. The presence of synaptosome-associated protein of 25 kDa and its homologue as well as multiple isoforms of vesicle-associated membrane protein in choroidal epithelium may play a role in the apical versus basolateral targeting of secretory vesicles.


Subject(s)
Choroid Plexus/physiology , Membrane Proteins/genetics , Nerve Tissue Proteins/genetics , Animals , Blotting, Western , Choroid Plexus/chemistry , Epithelium/chemistry , Epithelium/physiology , Exocytosis/physiology , Immunohistochemistry , Male , Membrane Fusion/physiology , Membrane Proteins/analysis , Nerve Tissue Proteins/analysis , Precipitin Tests , R-SNARE Proteins , RNA, Messenger/analysis , Rats , Rats, Sprague-Dawley , Reverse Transcriptase Polymerase Chain Reaction , Synaptosomal-Associated Protein 25
13.
Unfallchirurg ; 105(5): 443-9, 2002 May.
Article in German | MEDLINE | ID: mdl-12132206

ABSTRACT

Big osteochondral defects in the weight-bearing zone of the medial respectively the lateral femoral condyle are still an unsolved problem especially in younger patients. The transfer of the posterior aspect of the femoral condyle was described as a salvage procedure. Mega-OATS is a technical improvement of the transfer of the posterior condyle-procedure. Essential advantages of the conventional OATS-technique are integrated in the Mega-OATS procedure, so that iatrogenic lesions of the transferred cartilage by press-fit-fixation and secondary hardware removal can be avoided. However, the Mega-OATS procedure itself remains a salvage procedure and should only be reserved for younger patients. The results of the first series of 17 patients (average follow-up 12 (5-19) months) showed an improvement of quality of life and a significant (p = 0.003) increase in the Lysholm-score.


Subject(s)
Bone Transplantation/instrumentation , Cartilage, Articular/surgery , Cartilage/transplantation , Knee/surgery , Osteochondritis Dissecans/surgery , Osteotomy/instrumentation , Adult , Cartilage, Articular/pathology , Equipment Design , Female , Humans , Knee/pathology , Male , Middle Aged , Osteochondritis Dissecans/pathology , Outcome and Process Assessment, Health Care , Surgical Instruments
14.
Z Orthop Ihre Grenzgeb ; 140(2): 185-93, 2002.
Article in German | MEDLINE | ID: mdl-12029592

ABSTRACT

AIM: Osteochondral lesions and osteoarthritis in young patients are often caused by chronic knee instability in varus malangulated knees. We present the indication, planning of the osteotomy as well as the operative technique and the results of our patients with simultaneous osteotomy and cruciate ligament reconstruction. MATERIALS/METHODS: From 4/96 until 12/00 58 patients ( 33 years) received simultaneous osteotomy (r = 57 correcting valgus, r = 1 varus malalignement) and cruciate ligament plasty (e = 49 ACL, n = 7 PCL, n = 2 ACL & PCL which routinely was performed in the arthroscopic technique after completion of the osteotomy (closed-wedge technique). Average correction angle of the osteotomy was 7 (4 - 10) degrees with a mean malalignement of 5 (0 - 10) degrees. 13 patients underwent additional cartilage surgery (osteochondral autograft transplantation, autologous chondrocyte transplantation, microfracturing), 2 patients received an implanted Collagen Meniscus (CMI) at the same time. RESULTS: Preoperatively the Lysholm score was 66 (35 - 81) points and increased to 81 (74 - 95), 87 (79 - 99) and 93 (88 - 99) points at 3, 6, and 12 months after surgery, respectively. Subjectively all patients reported an improvement of preoperative swelling, pain and instability. Additional cartilage surgery or meniscus implantation did not significantly alter the clinical score values. Complications were noted in 4 patients. CONCLUSIONS: Unstable varus malangulated knees can be sufficiently treated by osteotomy and cruciate ligament plasty at the same time, suggesting that unicompartimental decompression and treatment of instability is a causal and cost effective therapy delaying the progression of osteoarthritis and minimising clinical symptoms. Performing both operations in one procedure facilitates early rehabilitation and return of these patients to the activities of daily living and sports.


Subject(s)
Anterior Cruciate Ligament Injuries , Bone Malalignment/surgery , Joint Instability/surgery , Knee Injuries/surgery , Osteotomy , Adolescent , Adult , Anterior Cruciate Ligament/diagnostic imaging , Anterior Cruciate Ligament/surgery , Bone Malalignment/diagnostic imaging , Bone Plates , Female , Follow-Up Studies , Humans , Joint Instability/diagnostic imaging , Knee Injuries/diagnostic imaging , Male , Middle Aged , Postoperative Complications/diagnostic imaging , Postoperative Complications/surgery , Radiography , Reoperation
15.
Unfallchirurg ; 105(3): 237-45, 2002 Mar.
Article in German | MEDLINE | ID: mdl-11995219

ABSTRACT

BACKGROUND: Osteochondral lesions and osteoarthritis in young patients are often caused by chronic knee instability and varus malalignment. We present the indications, operative technique, and results for the combined operation of high tibial osteotomy and cruciate ligament reconstruction. MATERIALS AND METHODS: From April 1996 until December 2000, 58 patients (average age: 33 years) underwent simultaneous osteotomy (57 correcting valgus, 1 valgus malalignment) and cruciate ligament reconstruction (49 ACL, 7 PCL, 2 ACL & PCL) which was routinely performed with an arthroscopic technique after completion of the osteotomy (closed wedge technique). Average correction angle of the osteotomy was 7 degrees (4-10 degrees) with a mean malalignment of 5 degrees (0-10 degrees). Thirteen patients underwent additional cartilage surgery (osteochondral autograft transplantation, autologous chondrocyte transplantation, microfracturing), and two patients were implanted with a collagen meniscus (CMI) at the same time. RESULTS: Preoperatively the Lysholm score was 66 (35-81) points and increased to 81 (74-95), 87 (79-99), and 93 (88-99) points 3, 6, and 12 months after surgery, respectively. Subjectively all patients reported an improvement of preoperative swelling, pain, and instability. Additional cartilage surgery or meniscus implantation did not significantly alter the clinical score values. Complications were noted in four patients. CONCLUSIONS: Unstable knees with varus malalignment can be sufficiently treated by osteotomy and cruciate ligament reconstruction at the same time, suggesting that unicompartimental decompression and treatment of instability is a causal and cost-effective therapy delaying the progression of osteoarthritis and minimizing clinical symptoms. Performing both operations in one procedure facilitates early rehabilitation and the return of these patients to the activities of daily living and sports.


Subject(s)
Anterior Cruciate Ligament Injuries , Bone Malalignment/surgery , Cartilage, Articular/injuries , Knee Injuries/surgery , Osteotomy , Posterior Cruciate Ligament/injuries , Adult , Anterior Cruciate Ligament/pathology , Anterior Cruciate Ligament/surgery , Bone Malalignment/complications , Bone Malalignment/diagnosis , Cartilage/transplantation , Cartilage, Articular/pathology , Cartilage, Articular/surgery , Female , Follow-Up Studies , Humans , Knee Injuries/complications , Knee Injuries/diagnosis , Magnetic Resonance Imaging , Male , Middle Aged , Osteoarthritis, Knee/complications , Osteoarthritis, Knee/diagnosis , Osteoarthritis, Knee/surgery , Posterior Cruciate Ligament/pathology , Posterior Cruciate Ligament/surgery , Prostheses and Implants
18.
Unfallchirurg ; 104(9): 798-807, 2001 Sep.
Article in German | MEDLINE | ID: mdl-11572120

ABSTRACT

Therapy of cartilage damage is a frequent problem, especially in the young and active patient. For the treatment of a cartilage damage we have to consider the size of the defect, age and weight of the patient, meniscal tears, ligament instabilities and varus-/valgus-malalignment. Lavage, shaving and debridement are only sufficient for a short time and have no long term effect. Abrasio and drilling could be useful in eldery people. Microfracturing seems to be an effective alternative for small defects. The restoration of the cartilage surface with the use of autologous chondrocyte transplantation, osteochondral autograft transplantation and posterior condyle transfer seems to be an adequate treatment for younger patients.


Subject(s)
Cartilage, Articular/injuries , Knee Injuries/surgery , Arthroscopy , Bone Transplantation , Cartilage, Articular/surgery , Chondrocytes/transplantation , Debridement , Humans , Menisci, Tibial/surgery , Tibial Meniscus Injuries , Tissue Engineering
19.
Comput Aided Surg ; 6(5): 270-8, 2001.
Article in English | MEDLINE | ID: mdl-11892003

ABSTRACT

The objective of this study was to examine the precision of ACL tunnel placement using: (1) CASPAR (orto MAQUET GmbH Co. KG)--an active robotic system, and (2) four orthopedic surgeons with various levels of experience (between 100 and 3,500 ACL reconstructions). The robotic system and each surgeon drilled tunnels for ACL reconstruction in 10 plastic knees (total n = 50) that included a reference cube in the medial aspect of the proximal tibia and distal femur. For the robotic system, the placement of each tunnel was planned preoperatively using custom software and CT data for each femur and tibia. The robotic system then drilled the tunnels in the femur and tibia based on the preoperative plan. For the surgeons, tunnel placement was accomplished using their preferred technique, which was based on the one-incision arthroscopic technique. The distribution of intra-articular points on the tibia was contained within a sphere of radius 2.0 mm (robot system), 2.1 mm (Fellow 1), 2.4 mm (Fellow 2), 3.4 mm (Experienced Surgeon 1), or 2.0 mm (Experienced Surgeon 2). On the femur, no significant differences in the distribution of intra-articular points could be demonstrated between the robotic system (2.1 mm), Fellow 1 (4.5 mm), Fellow 2 (4.1 mm), Experienced Surgeon 1 (2.3 mm), and Experienced Surgeon 2 (3.0 mm). The direction of the tunnels drilled in the femur and tibia was different with the robotic and traditional techniques. However, the robotic system had the most consistent tunnel directions, while the surgeons' tunnels were more dispersed. Variation in surgeon precision of tunnel placement for ACL reconstruction is greater on the femur than the tibia, and this can be correlated with experience. Our data also suggest that the robotic system has the same precision as the most experienced surgeons.


Subject(s)
Anterior Cruciate Ligament/surgery , Orthopedic Procedures/methods , Robotics/methods , Humans , Knee Joint/surgery , Orthopedic Procedures/standards , Robotics/instrumentation , Robotics/standards , Surgery, Computer-Assisted
20.
Orthopade ; 29(2): 135-44, 2000 Feb.
Article in German | MEDLINE | ID: mdl-10743635

ABSTRACT

Autologous chondrocyte transplantation (ACT) is a newly therapy option for treatment of cartilage damage. Since 1996 we performed the ACT in 10 patients with 14 cartilage damages. Magnetic resonance imaging (MRI) is a non-invasive method for postoperative controlling the transplantation area. The MRI showed in the first 3-6 months postoperatively signal irregularities with partial gadolinium uptake at the transplantation site. Arthroscopically the transplantation site was spongy, when it was probed and at the histological examination there was a hyalinlike appearance of the cells. 1 year postoperatively it seemed that process of reparation was finished. There was no more Gadolinium-uptake at the transplantation site and the borders of the transplant were hardly visible. The histological examination revealed hyalinlike repair tissue with a more columnar appearance of the cells. The Lysholm Score improved from 78 to 92 points, 1 year postoperatively.


Subject(s)
Arthroscopy , Chondrocytes/transplantation , Magnetic Resonance Imaging , Postoperative Complications/pathology , Wound Healing/physiology , Adult , Chondrocytes/pathology , Female , Follow-Up Studies , Humans , Hyalin/metabolism , Knee Joint/pathology , Male , Transplantation, Autologous
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