[Value of digital subtraction arthrography and radionuclide arthrography in determination of indications and planning of revision surgery in total hip replacement]. / Stellenwert der digitalen Subtraktionsarthrografie und Arthroszintigrafie in der Indikationsstellung und Planung der Hüft-TEP-Wechseloperation.

PURPOSE: Clinical and radiographic findings are of little value in the diagnosis of hip endoprothesis loosening. Refined contrast and radionuclide arthrographic techniques are more precise in predicting endoprothesis loosening. Here we compare both techniques with respect to the surgical result. MATERIAL AND METHODS: 68 patients with hip pain after various arthroplasty procedure were investigated by clinical examination, X-ray, DSAr and AS. Surgical proof was obtained in 73.5%. RESULTS: An acetabular component loosening was detected in 89% by DSAr and in 86% by AS with a specificity for both methods of 93%. The femoral component loosening was seen with a sensitivity of 89% by DSAr and 100% by AS, respectively. Specificity of DSAr in the femoral compartment was 94%, of AS 88%. CONCLUSIONS: DSAr and AS are useful tools in the diagnosis of hip endoprothesis loosening and in planning surgical treatment. Both methods are comparable concerning the acetabular component, whereas AS is more sensitive in detecting femoral stem loosening. Combination of both methods is not recommended for routine diagnosis.

[Abrasion arthroplasty]. / Abrasionsarthroplastik.

The removal of areas of chondromatous hyaline cartilage and the attempt to create new lod capacities for articular surfaces remain an encore in miscellaneous variations, pursued over decades in the last century. Recent research findings describe the biochemical interrelations and the three-dimensional structures of the collagenic matrix much more exactly. It was not until now a better insight into the metabolism and the dependent "state of aggregation" of the cartilage under changing mechanical exertion was made possible. From it prove, that the hyaline cartilage of the articulations represent a highly differentiated structure that is susceptible to mechanical and metabolic noxa and avails of remarkably minimal capability of regeneration. The results of repair are not within reach to approximate to functional ability of the original. This lights up that the amititious beginning to get to qualitative comparable regeneration by repair is not completed yet. Previous and furthermore differentiated and with restrictions of chondrocytes in compound with other protective and stimulating substances. Hitherto it seems advisable to refrain from steps being too active therapeutically. The unadulterated open abrasion of pathological articular cartilage has to be marked obsolete, today. Also the effect of abrasive arthroplasty, inductive character suggested, remains in the opinion of well-known authors in no proportion to expenditure of operation and rehabilitation and the expenses, because a sustaining success is not be expected in the long run, no matter whether drilling is done merely subcortical or subchondral, or use of spongiosa or microfracturing procedures. A more positive perspective in therapy appears with the holmium YAG-laser paving the way for gently treatment merely for degenerated cartilage: Regenerative beginnings to build hyaline cartilage have been reported. The abrasive arthroplasty probably will establish as a joint-conserving procedure in combination with the possibility of transplantation of chondrocyxtes to improve specific construction of the collagen matrix.

[Effect of a fibrin-antibiotic compound in bone and soft tissue infections]. / Zur Wirkung eines Fibrin-Antibiotikum-Verbundes bei Knochen- und Weichteil-Infektionen.

It is reported on experimental experiences in the use of a biological adhesive system--highly concentrated native fibrinogen, thrombin and clotting factor XIII--in conjunction with local antibiotics. The results in animals are: Antibiotics in conjunction with the mentioned adhesive system give a high local concentration for a short time. The activity of the antibiotics decreases quickly within some activity of the antibiotics decreases quickly within some hours, there is no more antibiotic effect after 36 hours.

[The ulnar nerve compression syndrome]. / Die Ulnaris-Kompressions-Syndrome.

The ulnar nerve has to bear a large amount of compression, especially in the cubital tunnel, which can be deducted from the topographic relation of this nerve to the elbow. Apart from tightness of the tunnel, intraarticular changes can also cause compression of the nerve. A further narrow tunnel in the course of the ulnar nerve is the "loge de GUYON", situated in the hypothenar region. A careful neurological examination of sensory and motor signs as well as an accurate electromyographical examination differentiate compression syndromes from other neuropathies. Two unusual cases of a functional cubital tunnel syndrome are demonstrated: their cause was primarily a chondromatosis of the elbow joint in one case a functional vasal compression in the other case.

[Operative treatment of recurrent dislocation of the patella by Brückner (author's transl)]. / Die operative Behandlung der sogenannten habituellen Patellaluxation nach Brückner

It is reported on the experiences of 43 patients, which surgery was performed on because of recurrent dislocation of the patella. In all these cases we applied the restraining operation by Brückner. The advantage of this method is the earlier training without a cast. The operative method and the postoperative training are explained. Until now recidives were not discovered.