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Objective: To describe a surgical technique, and outcome, for treatment of proximal tibial deformity (varus, valgus, excessive tibial plateau angle [eTPA], tibial torsion and patellar luxation) by combined tibial plateau leveling osteotomy (TPLO) and transverse corrective osteotomy. Study Design: Cases series. Animals: Dogs (n=12; 19 stifle joints). Methods: Medical records of dogs that had combination TPLO and transverse corrective osteotomy, were reviewed. Pre- and postoperative tibial angulation, tibial torsion, tibial plateau angle (TPA), corrective osteotomy technique, method of fixation, and complications were recorded. In hospital re-evaluation of limb function and alignment and length of time to radiographic healing were reviewed. Long-term outcome was assessed by visual analog scale (VAS) questionnaire and owner telephone interview. Results: Proximal tibial varus or valgus was present in 68.4%; 73.7% had eTPA; and 47.4% had both. Medial patellar luxation (MPL) was present in 57.9%, of which 47.4% had tibial tuberosity displacement. Severe tibial torsion was present in 68.4%. Mean pre- and postoperative TPA was 37.5° and 5.7°, respectively. The mean postoperative mechanical medial proximal tibial angle (mMPTA) and mechanical medial distal tibial angle (mMDTA) were 92.2° (range, 88–96°) and 96.1° (range, 94–101°), respectively. Postoperative surgical complications were documented in 21.0%, which included implant loosening or breakage (5.3%), seroma (5.3%), septic arthritis (5.3%), and infection of the proximal tibia (5.3%). All complications were considered major because they required additional surgery. Mean time to document radiographic healing was 10.4 weeks. In-hospital re-evaluation of lameness was obtained at the same time; 82.4% were not lame or had a mild lameness, 17.6% had severe lameness (2/3 with infection). The VAS evaluation revealed excellent results and owner satisfaction in all ten dogs in which long-term follow-up was obtained. Conclusions: Long-term clinical outcome of combination TPLO and transverse corrective osteotomy was excellent, and had a high owner satisfaction. Healing times were comparable to standard TPLO with a similar complication rate.

The effect of interdisciplinary multimodal therapy of chronic back pain is well documented. With elapsing time changing diagnostic focuses, therapeutic strategies and objectives have to be considered. The chronicity leads to a modification of the relevance of structure-related diagnosis and therapy and changes the significance of the classic orthopedic instruments. The requirement of a rational causal therapy in chronic back pain still remains but the focal points shift to the consideration of somatic, psychological and social disposing and supporting factors.The aim of this paper is to reflect the necessary orthopedic expertise in the context of the pathomechanics of chronic back pain and the interdisciplinary teamwork.

Chronic low back pain requires interdisciplinary and biopsychosocial treatment. Apart from the medical, psychological, and physiotherapeutic aspects of therapy, exercise therapy is an important component. Together with"work hardening," it represents the elements for reconditioning. The isolated effect is scientifically difficult to specify with the available data, but in most analytical studies, exercise therapy is an important component in an interdisciplinary setting. A nonspecific, diversified training program is superior to exercise solely of the trunk muscles. The primary tasks are to recover load capacity and diminish pain-avoidance behaviors, with consideration of the principles of"functional restoration." Thorough information and cooperation with the patient, continuous motivation, ratio control, a systematic increase in load, and permanent feedback are necessary. Close communication within the team makes immediate accompanying interventions of other specialized groups possible.

Chronische Ruckenschmerzsyndrome erzwingen eine therapeutische Neuorientierung. Gefordert werden eine Teambehandlung und konsequente Berucksichtigung des Spektrums einschlagig wirksamer Therapieformen. Vom Arzt sollte ein kooperierendes Team mit einem Psychologen und einem Physio-/Sporttherapeuten organisiert und ein enger diagnostisch/therapeutischer Informationsaustausch entsprechend der Kriterien einer „interdisziplinaren multimodalen Schmerztherapie“ institutionalisiert werden. Je nach individuellem Problemmuster werden die therapeutischen Aufgaben im Team gewichtet und verteilt. Auf fraglich relevante, vorwiegend korperbezogene diagnostische und therapeutische Masnahmen sollte strikt verzichtet werden. Das Setting im Team ermoglicht in idealer Weise arbeitsteilig und zeitgleich den professionellen Einsatz der effektivsten Therapie in enger Abstimmung: der pharmakologischen Therapie durch den Arzt inklusive wirbelsaulennaher Infiltrationen, der systematischen kontrollierten Belastungssteigerung durch den Sporttherapeuten und der psychosozialen Hilfestellung durch den Psychologen.

Work hardening is aimed at a reestablishment of the potentials needed in occupational everyday life. Fundamental motor abilities, such as strength, stability, flexibility and persistence, are restored and merged into the everyday life so that psychological contents, such as fear avoidance behavior will be positively affected. The design of work hardening is interdisciplinary in the sense of a holistic approach to back pain. Handling the pain under load requires sophisticated treatment and the training demands a high degree of individual design. A trusting and mutual agreement between therapist and patient is essential. Work hardening represents an important part of the therapy of chronic back pain and greatly supports regaining confidence in the physical efficiency and the ability to control the body.

Die konventionelle Behandlung chronischer Ruckenschmerzen ist unbefriedigend. Dekonditionierung, psychosoziale Beeintrachtigungen und uberlange Arbeitsunfahigkeitszeiten sind die Folge. Die Deutsche Angestellten-Krankenkasse (DAK) bietet Versicherten mit langer dauernder Arbeitsunfahigkeit (AU) wegen Ruckenschmerzen ein interdisziplinares standardisiertes Assessment beim Berlin-Brandenburger Ruckennetz (DAK-BBR) an. Nach arztlicher, physiotherapeutischer und psychologischer Untersuchung wird ein therapeutisches Programm ausgewahlt. Dieses kann aus gezielter Diagnostik, ambulanter monomodaler Therapie, tagesklinischem Programm mit 2 Intensitaten oder einer stationaren Behandlung bestehen. Ausgewertet wurden die Daten von 394 Wirbelsaulenkranken mit der fuhrenden Diagnosegruppe „Ruckenschmerzen“ (M54, 65,7%) und einer durchschnittlichen Arbeitsunfahigkeitsdauer von 92,7 Tagen. Korperliche und psychosoziale Beeintrachtigungen der Gruppe waren erheblich, die Chronifizierung mittelgradig. Es wurden Verlaufsdaten 6 Monate nach dem Assessment dargestellt. Die Ergebnisse der multimodalen Therapie zeigen eine wesentliche Reduzierung der empfundenen Schmerzen, von Angst und Depression sowie eine erhebliche Steigerung des Wohlbefindens. Die Wiederaufnahmequote von Alltagsaktivitaten einschlieslich der Arbeit war hoch. Die Selektion von Patienten mit chronischem Ruckenschmerz durch die Krankenkasse, ein interdisziplinares Assessment und eine abgestufte interdisziplinare Therapie sind sehr effizient bzgl. Schmerz-, Angst- und Depressionsreduktion. Sie fuhren zu einer hohen sozialen Reintegrationsrate.

Functional Independence Measure (FIM) is a method for uniformly recording functional status in rehabilitation patients. It has been under development in the USA since 1985. In this study, the prognostic value of function tests by FIM on admission to the rehabilitation clinic was investigated in two groups (45 patients in all). Thirty-three patients were admitted for rehabilitation following apoplectic shock, the remaining 12 following treatment of fractures of the femoral neck by total hip replacement. A highly significant correlation was found between the total FIM score on admission and the patient's status on discharge. Of the individual functions studied, the activities "dressing and undressing" and "walking/riding in wheelchair" were found have the highest predictive value.

Studies were performed in order to obtain information on the pathogenesis of patellar tip syndrome (PTS). Using a finger hyperextensiometer, ligamental laxity tests were performed on athletes, non-athletes and controls. Ninety-eight PTS patients who did not indulge regularly in sports, 39 patients from the German federal volleyball league, and 400 healthy controls were examined. No difference in the extensibility of ligaments was found between the patients from the group of competitive athletes and the controls. However, a significantly increased extensibility of the finger joints was found in all age and sex groups with "spontaneous" PTS. The authors conclude that 1) constitutional laxity of the ligaments is a key predisposing factor for PTS, and 2) PTS is triggered by physical stress. Susceptibility to microtrauma at the insertion of the patellar ligament is a function of the constitutional strength of the ligaments.

The elasticity of the joint surface was measured at defined points on a freshly removed patella which had no macroscopically apparent degenerative changes. The chondrocyte volume density of the stressed points was determined planimetrically. A correlation was found between the cell volume density and the viscoelastic properties of the joint cartilage, indicative of an increase in elasticity where the cell volume density was reduced. The mean chondrocyte volume under a defined joint surface was found to be almost constant, with varying cartilage thickness.

The influence of the shape of the patella and of the plica medialis parapatellaris on cartilage changes was studied in 161 knee joints (autopsy material). The cartilage changes were cartographically recorded and transferred to a computer matrix. The type and size of the plica were documented. The material studied was classified according to age, patellar shape, and degree of prominence of the plica. Cartilage lesions were found on the odd facet even in younger material. The cartilage damage depended on the shape of the patella. The more convex the medial facet, the less cartilage damage had occurred. The odd facet was found to be the point of origin of chondromalacial changes on the medial side of the patella. It is assumed that the plica medialis parapatellaris and the fat fold located there encourage the development of chondromalacia, especially where the medial facet is convex in shape.

The mechanical behaviour of anulus fibrosus is dependent on collagen fibers and influences the prolapse disposition. The aim of study was the comparison of constitutional mechanical tissue properties between a group of patients with disk herniation and normal. A computerized finger hyperextensiometer was developed which was able to analyse the viscoelastic tissue properties. In the disc herniation group the hyperextension angle of the metacarpophalangeal joint was smaller (p < 0.001), the relative integral area of the force/angle regression was larger (p < 0.001), the relative area under the secant of the curve (p < 0.01) and the recover value were smaller (p < 0.01). The results suggest that a anulus fibrosus with constitutional reduced extensibility, stress absorption capacity and recovery is disposed to herniation.

In cases of spontaneously occurring patellar pain, there is generally some slight damage to the nerve roots and anterior horn cells of segments L3 and L4. Divergent patellar movement can be measured roentgenologically. When the quadriceps is contracted the patella normally medialward in varus joints, and lateralward in valgus joints and when the leg position is axially correct. In peripatellar pain syndrome, however, lateral movement can be demonstrated in varus joints. Additionally, there is a tendency for the rotation of the patella to depend on the innervation disorder. The discrepancy between the muscular guidance of the patella and the performed guide bed may be one of the factors causing patellar pain. Etiologically, axial malpositions of the leg appear to be important predisposing factors and innervation disorders of the quadriceps muscle realization factors.

In a group of patients with typical histories of chondropathy, but in whom no other criteria of selection were applied, evidence of neurogenic damage in the quadriceps muscle was found. Innervational damage was also found regularly in the corresponding segments of the paravertebral musculature. Only in three cases, in which horn cell damage was suspected, were there no changes in the paravertebral musculature. There were abnormal structural or functional findings in the lumbar spine in all the patients. A disequilibrium between the median and lateral vastus groups, attributable to innervation, was postulated and subsequently confirmed by electromyography. The nature of chondropathia patellae as an insertion tendopathy is discussed, taking the lack of concomitance of chondropathy and chondromalacia into consideration as well as the findings in the group of patients examined. Phenomena associated with chondropathy which have hitherto incongruous may be explained on the basis of an asymmetrical innervation disturbance.

BCG-osteomyelitis is a rare complication of BCG-vaccination. The diagnosis is difficult and undiagnosed cases can be assumed. After adequate treatment a benign course is typical. There is quite a difference of morbidity in various European countries. Possible reasons are discussed.

Theories concerning the influence of function disturbances of the cervical spine on the development of sudden hearing loss should be re-examined. Forty-eight patients with unilateral sudden hearing loss and 94 controls were examined. X-rays of the cervical spine were made in lateral projection in normal position, and in maximum flexion and extension. The posture and movement of the vertebrae were recorded using a computer digitalization program. Overall mobility of the cervical spine was reduced in the group with sudden hearing loss: reduced movement was found in segments C2/C3, C5/C6, and C6/C7. Segments P0/P1 and C1/C2 were conspicuous by very high standard deviations in the group with sudden hearing loss. The results indicate that sudden hearing loss and function disorders of the cervical spine are related.

Aim A systematic review was performed to evaluate the clinical effects of specific back muscle and non-specific physical fitness training in chronic low back pain. Method A computer-aided Medline research (19861999) of randomised clinical trials concerning both rehabilitation concepts was conducted. A rating system was used to assess the methodological score of each study. The results were analysed and a final statement for evidence according to three main parameters (back pain, physical capacity, and patients comfort) was postulated. Results Twelve randomised clinical trials were identified. Nine studies were determined as high-quality trials. For chronic low back pain specific back muscle exercises as well as non-specific fitness training were able to improve the patients' conditions sufficiently. In comparison with passive treatment or no treatment there is strong evidence for pain and physical capacity in both groups, but only a positive influence for patient' comfort in fitness groups. Nevertheless, a confrontation of both concepts in two studies did not reveal any notable differences in all three parameters. Conclusion Principally, a specific strength training for back rnuscles as well as a non-specific fitness training are comparably effective to rehabilitate chronic low back pain.

When thin layers of polymer solutions dry by solvent evaporation and/or heating from below, the layers can become hydrodynamically instable. As a result various surface structures occur. A great pattern manifold of such structures has been found. By self-organization small surface motions caused by surface tension differences can be amplified, when the ratio of the driving forces to the damping ones characterized by the Marangoni-number exceeds a critical value. Besides greater and hierarchic subdivided cell patterns, periodic line structures with peak-valley-differences of down to 1 nm have been found in the solidified layers. The surface profiles (3D- and line profiles) have been measured by means of a microscope interferometer.

Report of a case with dislocated fracture of the clavicle and dysplasia of the first rib with consecutive armplexus paresis and thrombosis of the axillar and brachial vein. In such cases operative treatment is advised.

To describe a surgical technique, and outcome, for treatment of proximal tibial deformity (varus, valgus, excessive tibial plateau angle [eTPA], tibial torsion and patellar luxation) by combined tibial plateau leveling osteotomy (TPLO) and transverse corrective osteotomy.Cases series.Dogs (n=12; 19 stifle joints).Medical records of dogs that had combination TPLO and transverse corrective osteotomy, were reviewed. Pre- and postoperative tibial angulation, tibial torsion, tibial plateau angle (TPA), corrective osteotomy technique, method of fixation, and complications were recorded. In hospital re-evaluation of limb function and alignment and length of time to radiographic healing were reviewed. Long-term outcome was assessed by visual analog scale (VAS) questionnaire and owner telephone interview.Proximal tibial varus or valgus was present in 68.4%; 73.7% had eTPA; and 47.4% had both. Medial patellar luxation (MPL) was present in 57.9%, of which 47.4% had tibial tuberosity displacement. Severe tibial torsion was present in 68.4%. Mean pre- and postoperative TPA was 37.5° and 5.7°, respectively. The mean postoperative mechanical medial proximal tibial angle (mMPTA) and mechanical medial distal tibial angle (mMDTA) were 92.2° (range, 88-96°) and 96.1° (range, 94-101°), respectively. Postoperative surgical complications were documented in 21.0%, which included implant loosening or breakage (5.3%), seroma (5.3%), septic arthritis (5.3%), and infection of the proximal tibia (5.3%). All complications were considered major because they required additional surgery. Mean time to document radiographic healing was 10.4 weeks. In-hospital re-evaluation of lameness was obtained at the same time; 82.4% were not lame or had a mild lameness, 17.6% had severe lameness (2/3 with infection). The VAS evaluation revealed excellent results and owner satisfaction in all ten dogs in which long-term follow-up was obtained.Long-term clinical outcome of combination TPLO and transverse corrective osteotomy was excellent, and had a high owner satisfaction. Healing times were comparable to standard TPLO with a similar complication rate.

The effect of interdisciplinary multimodal therapy of chronic back pain is well documented. With elapsing time changing diagnostic focuses, therapeutic strategies and objectives have to be considered. The chronicity leads to a modification of the relevance of structure-related diagnosis and therapy and changes the significance of the classic orthopedic instruments. The requirement of a rational causal therapy in chronic back pain still remains but the focal points shift to the consideration of somatic, psychological and social disposing and supporting factors.The aim of this paper is to reflect the necessary orthopedic expertise in the context of the pathomechanics of chronic back pain and the interdisciplinary teamwork.

Chronic low back pain requires interdisciplinary and biopsychosocial treatment. Apart from the medical, psychological, and physiotherapeutic aspects of therapy, exercise therapy is an important component. Together with"work hardening," it represents the elements for reconditioning. The isolated effect is scientifically difficult to specify with the available data, but in most analytical studies, exercise therapy is an important component in an interdisciplinary setting. A nonspecific, diversified training program is superior to exercise solely of the trunk muscles. The primary tasks are to recover load capacity and diminish pain-avoidance behaviors, with consideration of the principles of"functional restoration." Thorough information and cooperation with the patient, continuous motivation, ratio control, a systematic increase in load, and permanent feedback are necessary. Close communication within the team makes immediate accompanying interventions of other specialized groups possible.

Chronic back pain compels a new therapeutic strategy. A therapeutic team setting and consequent consideration of proven treatments are required. The orthopedic specialist should manage a cooperating team with a psychologist and a physiotherapist, and information should be continuously exchanged according to the criteria for interdisciplinary multimodal pain therapy. The team's therapeutic tasks should be determined and distributed according to the individual patient's problems. Questionably relevant - in particular, somatic-oriented - diagnostic and therapeutic measures should be avoided. The team setting facilitates optimal task sharing and simultaneous professional application of the most effective therapy for chronic back pain: pharmaceutical therapy, including peridural infiltrations by the medical doctor; systematic and controlled increased load by the physiotherapist; and psychosocial assistance from the psychologist.

Work hardening is aimed at a reestablishment of the potentials needed in occupational everyday life. Fundamental motor abilities, such as strength, stability, flexibility and persistence, are restored and merged into the everyday life so that psychological contents, such as fear avoidance behavior will be positively affected. The design of work hardening is interdisciplinary in the sense of a holistic approach to back pain. Handling the pain under load requires sophisticated treatment and the training demands a high degree of individual design. A trusting and mutual agreement between therapist and patient is essential. Work hardening represents an important part of the therapy of chronic back pain and greatly supports regaining confidence in the physical efficiency and the ability to control the body.

A 17-year-old castrated male domestic shorthair cat was diagnosed with bilateral perinephric pseudocysts (PNPs). Bilateral subtotal resection of the PNPs was performed via a laparoscopic approach. There was no regrowth or reformation of the PNPs after the procedure and the cat's serum concentration of creatinine remained stable for 6 months after surgery. Laparoscopic bilateral subtotal resection of PNPs appears to have been an effective treatment option in this cat with the advantages of being minimally invasive and requiring only a brief hospital stay.

The results of conventional chronic back pain therapy are unsatisfactory. Deconditioning, psychosocial disorders and prolonged disability are common sequelae.The health insurance fund Deutsche Angestellten Krankenkasse (DAK) offers an interdisciplinary assessment by the Berlin-Brandenburg back pain network (BBR) to its members with ongoing work disability on account of back pain. After medical, physiotherapeutic and psychological exploration one of the following four options is suggested: further diagnostics, outpatient monomodal treatment, day-care pain management program of two intensities or inpatient pain treatment. The data of 394 patients with the leading diagnostic group of back pain (M54, ICD 10, 65.7%) and disability for 92.7 days (mean) are presented.The patients were severely impaired in physical and psychosocial aspects. The chronification was moderate (stage II-III of Mainz Staging System, MPSS). The success of treatment was evaluated 6 months after the initial assessment. All groups showed a significant reduction of pain, anxiety and depression whereas the wellbeing and daily activities improved, but best in the day-care pain management groups.Patient selection by a health fund, interdisciplinary assessment and severity adapted treatment resulted in significant reduction in pain and functional improvement in disabled back pain patients.

It seems likely that the tightness of tissue influences a patient's disposition to disc hernia. The aim of this study was to compare the mechanical behaviour of tissue from disc hernia patients with that of controls. A computerized finger hyperextensometer was constructed, which allowed the measurement of the viscoelastic properties of the capsule and ligaments at the metacarpophalangeal (MCP) joint. The disc group showed a reduced maximal extension angle of MCP joint II (P < 0.01), reduced tissue recovery value (P < 0.05), reduced relative subsecant area (P < 0.01) and relative integral of the regression curve (P < 0.01). The results indicate that an anulus fibrosus with reduced extension properties, reduced capacity of energy absorption and retarded shape recovery disposes to rupture.

A systematic review was performed to evaluate the clinical effects of specific back muscle and non-specific physical fitness training in chronic low back pain.A computer-aided Medline research (19861999) of randomised clinical trials concerning both rehabilitation concepts was conducted. A rating system was used to assess the methodological score of each study. The results were analysed and a final statement for evidence according to three main parameters (back pain, physical capacity, and patients comfort) was postulated.Twelve randomised clinical trials were identified. Nine studies were determined as high-quality trials. For chronic low back pain specific back muscle exercises as well as non-specific fitness training were able to improve the patients' conditions sufficiently. In comparison with passive treatment or no treatment there is strong evidence for pain and physical capacity in both groups, but only a positive influence for patient' comfort in fitness groups. Nevertheless, a confrontation of both concepts in two studies did not reveal any notable differences in all three parameters.Principally, a specific strength training for back rnuscles as well as a non-specific fitness training are comparably effective to rehabilitate chronic low back pain.

The mechanical behaviour of anulus fibrosus is dependent on collagen fibers and influences the prolapse disposition. The aim of study was the comparison of constitutional mechanical tissue properties between a group of patients with disk herniation and normal. A computerized finger hyperextensiometer was developed which was able to analyse the viscoelastic tissue properties. In the disc herniation group the hyperextension angle of the metacarpophalangeal joint was smaller (p0.001), the relative integral area of the force/angle regression was larger (p0.001), the relative area under the secant of the curve (p0.01) and the recover value were smaller (p0.01). The results suggest that a anulus fibrosus with constitutional reduced extensibility, stress absorption capacity and recovery is disposed to herniation.

Functional Independence Measure (FIM) is a method for uniformly recording functional status in rehabilitation patients. It has been under development in the USA since 1985. In this study, the prognostic value of function tests by FIM on admission to the rehabilitation clinic was investigated in two groups (45 patients in all). Thirty-three patients were admitted for rehabilitation following apoplectic shock, the remaining 12 following treatment of fractures of the femoral neck by total hip replacement. A highly significant correlation was found between the total FIM score on admission and the patient's status on discharge. Of the individual functions studied, the activities "dressing and undressing" and "walking/riding in wheelchair" were found have the highest predictive value.

Studies were performed in order to obtain information on the pathogenesis of patellar tip syndrome (PTS). Using a finger hyperextensiometer, ligamental laxity tests were performed on athletes, non-athletes and controls. Ninety-eight PTS patients who did not indulge regularly in sports, 39 patients from the German federal volleyball league, and 400 healthy controls were examined. No difference in the extensibility of ligaments was found between the patients from the group of competitive athletes and the controls. However, a significantly increased extensibility of the finger joints was found in all age and sex groups with "spontaneous" PTS. The authors conclude that 1) constitutional laxity of the ligaments is a key predisposing factor for PTS, and 2) PTS is triggered by physical stress. Susceptibility to microtrauma at the insertion of the patellar ligament is a function of the constitutional strength of the ligaments.

Morphological alterations of the craniocervical junction as basilar impressions, a ponticulus posterior, an atlas assimilation, an intervertebral narrowing and spondylosis deformans, were found radiologically in patients with sudden hearing loss. There were no radiological differences to a healthy population. No relationship could be established between static morphological changes of the craniocervical junction of the upper cervical spine and the sudden hearing loss. However, there was a statistically significant reduction of the mobility in the upper cervical spine in patients suffering from sudden hearing loss. Very high standard deviations in the atlanto-occipital and the atlanto-odontoid joints are interpreted as hyper- as well as hypomobile joints. These results indicate a possible correlation between sudden hearing loss and a functional pathology of the craniocervical junction.

Morphological alterations of the cranio-cervical junction as a basilar impression, a ponticulus posterior, an atlas assimilation, an intervertebral narrowing, and spondylosis deformans were found radiologically. There was no difference to a healthy population. This means there are no correlations between static morphological changes of the craniocervical junction and sudden deafness. However, there was a statistically significant reduced mobility in the upper cervical spine in patients suffering from sudden deafness. Especially very high standard deviations in the atlanto-occipital and the atlanto-dental joint are interpreted as hypermobile as well hypomobile atlas joints. These results indicate a correlation between sudden deafness and functional pathology of the craniocervical junction.

Das Bruchverhalten von 25 frischen isolierten Leichenwirbelkorpern unterschiedlicher Hohe wurde im statischen Kompressionsversuch analysiert und mit den computertomographisch ermittelten Absorptionswerten verglichen.

Twenty-four infants and children aged five days to three years had their hips examined by ultrasound, and in 17 the findings were compared with the radiographic appearances. Real-time sonography, because of its flexibility, is a suitable screening method for the early diagnosis of hip dysplasia. It has the typical characteristics of a screening method: so far there have been no false negative findings. False positive results are rare, but cannot be completely excluded. The patients examined so far were mostly abnormal, and a final assessment of false positive findings will have to await larger clinical material, including normals.

Im Rahmen dieser Untersuchung wurde der biomechanische Effekt intraartikular applizierbarer Pharmaka auf den Gelenkknorpel in vitro untersucht. Verwendet wurden arthrotische Knorpelzylinder, welche im Rahmen einer endoprothetischen Versorgung entnommen wurden. Vor und nach einer 12 tagigen Inkubation dieser Proben in Hank's Losung und Kalberserum wurden Indentermessungen der Zylinder vorgenommen. Es wurden jeweils 5 Be- und Entlastungszyklen von 0 bis 10N mittels eines Indenters von 3 mm Durchmesser aufgebracht. Die Prufgeschwindigkeit betrug 0,2 mm/sec. Medikamente unterschiedlicher postulierter Wirkungsweise und unterschiedlicher Konzentration wurden der Nahrlosung hinzugefugt.

In this study the biomechanical effect of intra-articularly applicable drugs on the articular cartilage was analyzed in vitro. Arthrotic cartilage cylinders from tibia plateaus were used, which were removed during endoprosthetic joint replacement. The elasticity of these specimens were measured before and after a 12-day incubation in a medium containing Hank's solution and serum. Five successive loading and unloading cycles from 0 to 10 N were applied, using an indenter with a diameter of 3 mm. The indentation velocity was 0.2 mm/s. Drugs with different postulated influence on the cartilage metabolism were added in various concentrations. A change in the mechanical behavior of the cartilage in relation to drug concentration could be seen in most of the medications; the change could be described using a 3rd-degree polynoma. The possible influence of this biomechanical alteration on arthrotic pain and arthrotic progression is discussed.

Theories concerning the influence of function disturbances of the cervical spine on the development of sudden hearing loss should be re-examined. Forty-eight patients with unilateral sudden hearing loss and 94 controls were examined. X-rays of the cervical spine were made in lateral projection in normal position, and in maximum flexion and extension. The posture and movement of the vertebrae were recorded using a computer digitalization program. Overall mobility of the cervical spine was reduced in the group with sudden hearing loss: reduced movement was found in segments C2/C3, C5/C6, and C6/C7. Segments P0/P1 and C1/C2 were conspicuous by very high standard deviations in the group with sudden hearing loss. The results indicate that sudden hearing loss and function disorders of the cervical spine are related.