207 results on '"Thomas, Tischer"'
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2. Möglichkeiten und Perspektiven zum Einsatz der künstlichen Intelligenz in der Sportorthopädie
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Jakub Oronowicz, Christophe Ley, Milena Pachowsky, Romain Seil, and Thomas Tischer
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Orthopedics and Sports Medicine ,Physical Therapy, Sports Therapy and Rehabilitation - Published
- 2023
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Catalog
3. Determination of Standard Values for Knee Version in a Healthy Population
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Felix Huettner, Christoph Lutter, Constantin Zuehlke, Mauricio Kfuri, Thomas Tischer, and Joerg Harrer
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Physical Therapy, Sports Therapy and Rehabilitation ,Orthopedics and Sports Medicine - Abstract
Background: Different measures are used to describe relevant anatomic variations that can result in patellofemoral instability and disorders. Knee version, the relative rotational alignment between the femur and tibia in the axial plane at the level of the knee, may have a decisive effect on the kinematics of the patellofemoral joint. However, data regarding the values of knee version are currently lacking. Purpose: This study aimed to determine standard values for knee version in a healthy population. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 100 healthy volunteers (50 male and 50 female) without patellofemoral disorders or lower extremity malalignment were included in this study and underwent knee magnetic resonance imaging. The torsion values of the femur and tibia were independently measured using the Waidelich and Strecker method. Knee version, defined as static rotation of the tibia with respect to the femur in full extension, was determined by measuring the angle between the tangent lines to the dorsal femoral condyle (DFC) and the dorsal tibial head (DTH; defined by the posterior point of the proximal tibial plateau). Supplementary measurements were obtained as follows: (1) femoral epicondylar line (FEL), (2) tibial ellipse center line (TECL), (3) tibial tuberosity–trochlear groove (TT-TG) distance, and (4) tibial tuberosity–posterior cruciate ligament (TT-PCL) distance. Results: In 200 analyzed legs of 100 volunteers (mean age, 26.5 ± 5.8 years [range, 18 to 40 years]), we identified a mean internal femoral torsion of −23.8°± 9.7° (range, −46.2° to 1.6°), external tibial torsion of 33.2°± 7.4° (range, 16.4° to 50.3°), and external knee version (DFC to DTH) of 1.3°± 3.9° (range, −8.7° to 11.7°). Other measurements were as follows: FEL to TECL, −0.9°± 4.9° (range, −16.8° to 12.1°); FEL to DTH, −3.6°± 4.0° (range, −12.6° to 6.8°); and DFC to TECL, 4.0°± 4.9° (range, −12.7° to 14.7°). The mean TT-TG distance was 13.4 ± 3.7 mm (range, 5.3-23.5 mm), and the mean TT-PCL distance was 11.5 ± 3.5 mm (range, 6.0-20.9 mm). Female participants had significantly greater external knee version than male participants. Conclusion: Coronal- and sagittal-plane alignments of the knee have a well-known effect on the biomechanics of this joint. Additional information about the axial plane may result in new decision-making algorithms for managing knee disorders. This study is the first to report standard values of knee version in a healthy population. As a subsequent step building on this work, we advocate for the measurement of knee version in patients with patellofemoral disorders, as this parameter may assist with new treatment guidelines in the future. more...
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- 2023
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4. Degenerative Meniskusläsionen – Neue therapeutische Ansätze
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Roland Becker, Thomas Tischer, Romain Seil, and Sebastian Kopf
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Orthopedics and Sports Medicine ,Physical Therapy, Sports Therapy and Rehabilitation - Published
- 2022
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5. Neuerungen in der Kniechirurgie – VKB-Revision
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Thomas Tischer, Roland Becker, Wolf Petersen, Chris Lutter, Romain Seil, and Matthias J. Feucht
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Orthopedics and Sports Medicine ,Physical Therapy, Sports Therapy and Rehabilitation - Published
- 2022
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6. Vergleichende Untersuchung der posturalen Kontrolle bei 20–40-Jährigen und Karate-Kaderathleten mittels eines neuromuskulären Trainingsgerätes
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Katrin Osmanski-Zenk, Amelie Ningel, Thomas Tischer, and Wolfram Mittelmeier
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Orthopedics and Sports Medicine - Abstract
Zusammenfassung Hintergrund Die posturale Kontrolle dient dem Erhalt der aufrechten Körperhaltung und trägt zur Gleichgewichtsregulation bei. Die im höheren Alter zunehmenden neuromuskulären Defizite führen zu einer Verschlechterung der posturalen Kontrolle, die durch neuromuskuläres Training verbessert werden kann. In der Annahme, dass neuromuskuläre Defizite bereits früh auftreten, wurden die posturalen Fähigkeiten von 20–40-Jährigen untersucht. Zudem wurde der Einfluss von Leistungssport auf die posturale Kontrolle durch die Untersuchung von Karate-Kaderathleten geprüft. Methodik Für einen Altersvergleich wurden 123 altershomogene Gesunde zwischen 20 und 40 Jahren untersucht. 24 Karate-Kaderathleten wurden mit den 20–25-jährigen Gesunden der „Normalbevölkerung“ verglichen. Zur Datenerhebung wurde ein neuromuskuläres Trainingsgerät, der Human Body Equilibrium 360 (Huber 360), verwendet. Ergebnisse Im Altersvergleich zeigten sich für alle 7 Messungen keine signifikanten Unterschiede. Die Probanden waren zu jung, um Defizite zu erkennen. Jedoch zeigten sich einige allgemeine Erkenntnisse. Im beidbeinigen Stand war bei allen Gruppen eine signifikante Zunahme der Körperschwerpunkt (KSP) -Schwankungen nach Augenschluss zu sehen. Der Einfluss der Füßigkeit bzw. Händigkeit zeigte sich im Einbeinstand und Krafttest. Geschlechtsspezifische Unterschiede waren zu verzeichnen. Bei der Untersuchung der Karate-Kaderathleten zeigten sich verschiedene trainingsspezifische Anpassungen. So konnten Karatesportler den Wegfall der visuellen Information besser kompensieren. Karatesportler wiesen außerdem ein signifikant breiteres Gangbild und ein größeres Stabilitätsareal auf. Sportler konnten ihren KSP weiter verlagern, ohne aus dem Gleichgewicht zu geraten. Diskussion Der Huber 360 ist als Rehabilitations- und Trainingsgerät aufgrund der geringen Trennschärfe der Tests in seinem gesamten Anwendungsspektrum nur bedingt geeignet, da signifikante Unterschiede zwischen den Gruppen schwer zu detektieren sind. Einzelne trainingsspezifische Anpassungen durch leistungsorientiertes Karatetraining sind erkennbar und unterstreichen den Einfluss des Trainings auf die posturale Kontrolle. Zusammenfassend lässt sich sagen, dass die Anwendung des Huber 360 zur Beurteilung von posturalen Fähigkeiten im Altersvergleich und bei Unterscheidung trainingsspezifischer Anpassungen einen differenzierten und selektiveren Einsatz der einzelnen Tests bedarf. Weitere Untersuchungen mit älteren Patienten mit unterschiedlichen Erkrankungen sind geplant. more...
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- 2022
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7. Knot tying in arthroplasty and arthroscopy causes lesions to surgical gloves: a potential risk of infection
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Andreas Enz, Annett Klinder, Lucas Bisping, Christoph Lutter, Philipp Warnke, Thomas Tischer, Wolfram Mittelmeier, and Robert Lenz
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Orthopedics and Sports Medicine ,Surgery - Abstract
Purpose Recent studies have shown that the incidence of glove lesions during arthroscopy is much lower than that during primary and revision arthroplasty. However, the rate of glove damage after knot tying has not yet been systematically recorded. Therefore, the aim of the study was to determine the impact of surgical knot tying on glove integrity. It was hypothesized that knot tying increases the rate of glove damage, especially in arthroscopic surgery, which could be of special relevance in the treatment of rotator cuff tears. Methods Gloves that were changed immediately before suturing and only worn during knot tying were investigated for their integrity by means of water tightening test according to EN455. A total of 234 gloves from 40 total hip arthroplasties (THAs), 42 total knee arthroplasties (TKAs) and 36 rotator cuff repairs (RCRs) were collected. A bacterial pass-through test (BPTT) on glove lesions was performed under simulated sterile surgical conditions for 3 surgeons after a wear duration of 45 min. Results Glove damage by knot tying occurred in 25% of THA, 36.6% of TKA and 25% of RCR surgeries. In THA, the pulling hand (PH) was affected in 46.2%, and the main area of damage (15.4%) was detected on the tip of the middle finger; in TKAs the PH was damaged in 75%, and in RCRs the PH was affected in 66.7%, with most of the lesions (20% each) occurring on the tip of the index finger and the ring finger. The BPTT showed Staphylococcus hominis and Bacillus cereus. Conclusion Intraoperative knot tying causes damage to gloves, which is of special relevance for arthroscopic surgery. Whereas knot tying is only partly responsible for glove damage in arthroplasty, the general rate of glove damage in arthroscopic surgery is low without knot tying. The surgical knot tying process must be understood as a possible damaging impact on the glove. Therefore, single gloving is not recommended, which is especially important in arthroscopic surgery, where double gloving is not yet standard. Level of Evidence IV. more...
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- 2022
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8. Comparison between dedicated MRI and symphyseal fluoroscopic guided contrast agent injection in the diagnosis of cleft sign in athletic groin pain and association with pelvic ring instability
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Norman Holl, Judith Sarah Gerhardt, Thomas Tischer, Jens Krüger, Andres Arevalo-Hernandez, Robert Lenz, and Marc-André Weber
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Radiology, Nuclear Medicine and imaging ,General Medicine - Abstract
Objective To compare dedicated MRI with targeted fluoroscopic guided symphyseal contrast agent injection regarding the assessment of symphyseal cleft signs in men with athletic groin pain and assessment of radiographic pelvic ring instability. Methods Sixty-six athletic men were prospectively included after an initial clinical examination by an experienced surgeon using a standardized procedure. Diagnostic fluoroscopic symphyseal injection of a contrast agent was performed. Additionally, standing single-leg stance radiography and dedicated 3-Tesla MRI protocol were employed. The presence of cleft injuries (superior, secondary, combined, atypical) and osteitis pubis was recorded. Results Symphyseal bone marrow edema (BME) was present in 50 patients, bilaterally in 41 patients and in 28 with an asymmetrical distribution. Comparison of MRI and symphysography was as followed: no clefts: 14 cases (MRI) vs. 24 cases (symphysography), isolated superior cleft sign: 13 vs. 10, isolated secondary cleft sign: 15 vs. 21 cases and combined injuries: 18 vs. 11 cases. In 7 cases a combined cleft sign was observed in MRI but only an isolated secondary cleft sign was visible in symphysography. Anterior pelvic ring instability was observed in 25 patients and was linked to a cleft sign in 23 cases (7 superior cleft sign, 8 secondary cleft signs, 6 combined clefts, 2 atypical cleft injuries). Additional BME could be diagnosed in 18 of those 23. Conclusion Dedicated 3-Tesla MRI outmatches symphysography for purely diagnostic purposes of cleft injuries. Microtearing at the prepubic aponeurotic complex and the presence of BME is a prerequisite for the development of anterior pelvic ring instability. Clinical relevance statement For diagnostic of symphyseal cleft injuries dedicated 3-T MRI protocols outmatch fluoroscopic symphysography. Prior specific clinical examination is highly beneficial and additional flamingo view x-rays are recommended for assessment of pelvic ring instability in these patients. Key Points • Assessment of symphyseal cleft injuries is more accurate by use of dedicated MRI as compared to fluoroscopic symphysography. • Additional fluoroscopy may be important for therapeutic injections. • The presence of cleft injury might be a prerequisite for the development of pelvic ring instability. more...
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- 2023
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9. Management of anterior cruciate ligament revision in adults: the 2022 ESSKA consensus part III—indications for different clinical scenarios using the RAND/UCLA appropriateness method
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Thomas Tischer, Luca Andriolo, Philippe Beaufils, Sufian S. Ahmad, Corrado Bait, Marco Bonomo, Etienne Cavaignac, Riccardo Cristiani, Matthias J. Feucht, Markas Fiodorovas, Alberto Grassi, Gijs Helmerhorst, Christian Hoser, Mustafa Karahan, George Komnos, Koen Carl Lagae, Vincenzo Madonna, Edoardo Monaco, Juan Carlos Monllau, Matthieu Ollivier, Mikko Ovaska, Wolf Petersen, Tomasz Piontek, James Robinson, Kristian Samuelsson, Sven Scheffler, Bertrand Sonnery-Cottet, Giuseppe Filardo, and Vincenzo Condello more...
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Orthopedics and Sports Medicine ,Surgery - Abstract
Purpose The aim of the ESSKA 2022 consensus Part III was to develop patient-focused, contemporary, evidence-based, guidelines on the indications for revision anterior cruciate ligament surgery (ACLRev). Methods The RAND/UCLA Appropriateness Method (RAM) was used to provide recommendations on the appropriateness of surgical treatment versus conservative treatment in different clinical scenarios based on current scientific evidence in conjunction with expert opinion. A core panel defined the clinical scenarios with a moderator and then guided a panel of 17 voting experts through the RAM tasks. Through a two-step voting process, the panel established a consensus as to the appropriateness of ACLRev for each scenario based on a nine-point Likert scale (in which a score in the range 1–3 was considered ‘inappropriate’, 4–6 ‘uncertain’, and 7–9 ‘appropriate’). Results The criteria used to define the scenarios were: age (18–35 years vs 36–50 years vs 51–60 years), sports activity and expectation (Tegner 0–3 vs 4–6 vs 7–10), instability symptoms (yes vs no), meniscus status (functional vs repairable vs non-functional meniscus), and osteoarthritis (OA) (Kellgren–Lawrence [KL] grade 0–I–II vs grade III). Based on these variables, a set of 108 clinical scenarios was developed. ACLRev was considered appropriate in 58%, inappropriate in 12% (meaning conservative treatment is indicated), and uncertain in 30%. Experts considered ACLRev appropriate for patients with instability symptoms, aged ≤ 50 years, regardless of sports activity level, meniscus status, and OA grade. Results were much more controversial in patients without instability symptoms, while higher inappropriateness was related to scenarios with older age (51–60 years), low sporting expectation, non-functional meniscus, and knee OA (KL III). Conclusion This expert consensus establishes guidelines as to the appropriateness of ACLRev based on defined criteria and provides a useful reference for clinical practice in determining treatment indications. Level of evidence II. more...
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- 2023
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10. The awareness of injury prevention programmes is insufficient among French- and German-speaking sports medicine communities in Europe
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Thomas Tischer, Géraldine Martens, Jan Cabri, Patricia Thoreux, Philippe Tscholl, Pascal Edouard, Suzanne Leclerc, Sébastien Le Garrec, François Delvaux, Jean-Louis Croisier, Jean-François Kaux, Didier Hannouche, Christoph Lutter, and Romain Seil more...
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Orthopedics and Sports Medicine ,Surgery - Published
- 2023
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11. Does non-surgical treatment after rupture of the anterior cruciate ligament lead to results that are as good as surgery?
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Wolf Petersen, Rüdiger von Eisenhart-Rothe, Thomas Tischer, and Philipp Niemeyer
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- 2022
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12. Führt eine nichtoperative Therapie nach Ruptur des vorderen Kreuzbandes zu ähnlich guten Ergebnissen wie eine Operation?
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Wolf Petersen, Rüdiger von Eisenhart-Rothe, Thomas Tischer, and Philipp Niemeyer
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Industrial and Manufacturing Engineering - Published
- 2022
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13. Leistenschmerz beim Sportler
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Robert Lenz, Norman Holl, Christoph Lutter, Jens Krüger, Marc-André Weber, and Thomas Tischer
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Orthopedics and Sports Medicine - Published
- 2022
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14. Das Knie im Spitzensport
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Amanda Magosch, Anouk P. Urhausen, Caroline Mouton, Thomas Tischer, and Romain Seil
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Orthopedics and Sports Medicine - Published
- 2022
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15. Machine learning and conventional statistics: making sense of the differences
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Christophe Ley, R. Kyle Martin, Ayoosh Pareek, Andreas Groll, Romain Seil, and Thomas Tischer
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Machine Learning ,Orthopedics ,Orthopédie, rééducation & médecine sportive [D17] [Sciences de la santé humaine] ,Humans ,Orthopedics and Sports Medicine ,Surgery ,Orthopedics, rehabilitation & sports medicine [D17] [Human health sciences] - Abstract
The application of machine learning (ML) to the field of orthopaedic surgery is rapidly increasing, but many surgeons remain unfamiliar with the nuances of this novel technique. With this editorial, we address a fundamental topic-the differences between ML techniques and traditional statistics. By doing so, we aim to further familiarize the reader with the new opportunities available thanks to the ML approach. more...
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- 2022
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16. Cell-based therapies have disease-modifying effects on osteoarthritis in animal models. A systematic review by the ESSKA Orthobiologic Initiative. Part 2: bone marrow-derived cell-based injectable therapies
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Angelo Boffa, Carlotta Perucca Orfei, Yosef Sourugeon, Lior Laver, Jérémy Magalon, Mikel Sánchez, Thomas Tischer, Laura de Girolamo, and Giuseppe Filardo
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Orthopedics and Sports Medicine ,Surgery - Abstract
Purpose Aim of this systematic review was to determine if bone marrow-derived cell-based injectable therapies induce disease-modifying effects in joints affected by osteoarthritis (OA) in animal models. Methods A systematic review was performed on three electronic databases (PubMed, Web of Science, Embase) according to PRISMA guidelines. A synthesis of the results was performed investigating disease-modifying effects in preclinical animal studies comparing injectable bone marrow-derived products with OA controls or other products, different formulations or injection intervals, and the combination with other products. The risk of bias was assessed according to the SYRCLE’s tool. Results Fifty-three studies were included (1819 animals) with an increasing publication trend over time. Expanded cells were used in 48 studies, point-of-care products in 3 studies, and both approaches were investigated in 2 studies. Among the 47 studies presenting results on the disease-modifying effects, 40 studies (85%) reported better results with bone marrow-derived products compared to OA controls, with positive findings evident in 14 out of 20 studies (70%) in macroscopic assessment, in 30 out of 41 studies (73%) in histological assessment, and in 10 out of 13 studies (77%) in immunohistochemical evaluations. Clinical evaluations showed positive results in 7 studies out of 9 (78%), positive imaging results in 11 studies out of 17 (65%), and positive biomarker results in 5 studies out of 10 (50%). While 36 out of 46 studies (78%) reported positive results at the cartilage level, only 3 out of 10 studies (30%) could detect positive changes at the synovial level. The risk of bias was low in 42% of items, unclear in 50%, and high in 8%. Conclusion This systematic review of preclinical studies demonstrated that intra-articular injections of bone marrow-derived products can induce disease-modifying effects in the treatment of OA, slowing down the progression of cartilage damage with benefits at macroscopic, histological, and immunohistochemical levels. Positive results have been also observed in terms of clinical and imaging findings, as well as in the modulation of inflammatory and cartilage biomarkers, while poor effects have been described on the synovial membrane. These findings are important to understand the potential of bone marrow-derived products and to guide further research to optimise their use in the clinical practice. Level of evidence II. more...
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- 2023
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17. The Top 100 Most Cited Articles on Platelet-Rich Plasma Use in Regenerative Medicine-A Bibliometric Analysis-From the ESSKA Orthobiologic Initiative
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Anouck Coulange Zavarro, Laura De Girolamo, Lior Laver, Mikel Sánchez, Thomas Tischer, Giuseppe Filardo, Florence Sabatier, Jérémy Magalon, Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Centre d'Investigation Clinique [Hôpital de la Conception - APHM] (CIC), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), IRCCS Istituto Ortopedico Galeazzi, Hillel Yaffe Medical Center, Technion - Israel Institute of Technology [Haifa], University of Rostock, Ente Ospedaliero Cantonale (EOC), Università della Svizzera italiana = University of Italian Switzerland (USI), IRCCS Istituto Ortopedico Rizzoli, Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and Remedex more...
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bibliometric analysis ,plasma rich in growth factors ,[SDV]Life Sciences [q-bio] ,platelet-rich plasma ,regenerative medicine ,Bioengineering - Abstract
International audience; Over the past few decades, more and more articles about platelet-rich plasma (PRP) use in regenerative medicine have been published. The aim of this study was to determine which articles have been most influential in this field by identifying and analyzing the characteristics of the 100 most cited articles. Articles on the use of PRP in regenerative medicine were identified via the Thomson ISI Web of Science database. A majority of the articles originated from the USA (36%). The top journal in terms of number of articles was American Journal of Sports Medicine (12%). Musculoskeletal system and orthopedics (54%) were the most popular fields of applications. Preclinical studies were the most represented study type, from which only 8 from 46 (17.4%) provided a complete numerical description of the injected product. Analysis showed a time-dependent trend of increasing quality of the clinical studies (p = 0.004), although none of them provided a complete biological characterization of the injected PRP. This study demonstrated that the use of PRP in regenerative medicine is a growing and popular area of research, mainly focused on orthopedic applications. Studies on PRP-derived exosomes, biological characterization, and correlation with clinical results might be areas of future trends. more...
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- 2022
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18. Management of anterior cruciate ligament revision in adults: the 2022 ESSKA consensus part I-diagnostics and preoperative planning
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Thomas Tischer, Philippe Beaufilis, Roland Becker, Sufian S. Ahmad, Marco Bonomo, David Dejour, Karl Eriksson, Giuseppe Filardo, Matthias J. Feucht, Alberto Grassi, Adrian Wilson, Jacques Menetrey, Nicolas Pujol, Martin Rathcke, Romain Seil, Marc J. Strauss, and Vincenzo Condello more...
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Orthopedics and Sports Medicine ,Surgery - Abstract
The aim of this ESSKA consensus is to give recommendations based on evidence and expert opinion to improve diagnosis, preoperative planning, indication and surgical strategy in ACL revision.The European expert surgeons and scientists were divided into four groups to participate in this consensus. A "literature group" (four surgeons); "steering group" (14 surgeons and scientists); "rating group" (19 surgeons) and finally "peer review group" (51 representatives of the ESSKA-affiliated national societies from 27 countries). The steering group prepared eighteen question-answer sets. The quality of the answers received grades of recommendation ranging from A (high-level scientific support), to B (scientific presumption), C (low level scientific support) or D (expert opinion). These question-answer sets were then evaluated by the rating group. All answers were scored from 1 to 9. The comments of the rating group were incorporated by the steering group and the consensus was submitted to the rating group a second time. Once a general consensus was reached between the steering and rating groups, the question-answer sets were submitted to the peer review group. A final combined meeting of all the members of the consensus was held to ratify the document.The literature review for the diagnosis and preoperative planning of ACL revision revealed a rather low scientific quality. None of the 18 questions was graded A and six received a grade B. The mean rating of all the questions by the rating group was 8.4 ± 0.3. The questions and recommendations are listed below.ACL revision surgery is a widely debated subject with many different opinions and techniques. The literature reveals a poor level of standardisation. Therefore, this international consensus project is of great importance.II. more...
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- 2022
19. Subacromial impingement syndrome: association of multiple magnetic resonance imaging parameters with shoulder function and pain
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Hans-Christian Köhler, Christoph Schulze, Malte Jäschke, Thomas Tischer, Claudia Hacke, and Marc-André Weber
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030222 orthopedics ,medicine.medical_specialty ,Bursitis ,business.industry ,Tendinosis ,General Medicine ,Joint effusion ,medicine.disease ,Sagittal plane ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Coronal plane ,Orthopedic surgery ,medicine ,Orthopedics and Sports Medicine ,Surgery ,Rotator cuff ,medicine.symptom ,Subacromial bursa ,business ,Nuclear medicine - Abstract
Introduction Shoulder pain is one of the most common complaints in orthopaedics. This study focusses on the relationship between shoulder function in subacromial impingement syndrome and imaging criteria in magnetic resonance imaging (MRI). Materials and methods This prospective clinical trial included 69 patients treated for subacromial impingement syndrome. Shoulder function (Constant Score, range of abduction, abduction force) and pain were correlated with the following MRI parameters: tendinosis of the rotator cuff, “halo-sign” around the biceps tendon, subacromial distance, critical shoulder angle, size of subacromial osteophytic spurs and maximum width of subacromial and subdeltoid bursa. Statistical analyses included Pearson’s and Spearman’s coefficients of correlation, multiple regression analysis and Student’s t-test. Results The Constant Score was correlated positively with the critical shoulder angle (r = 0.313; p = 0.009) and inversely with a “halo-sign” around the biceps tendon (rho = −0.384; p = 0.001). There was no significant correlation between spur size and shoulder function, but the size of the subacromial and subdeltoid bursae was positively correlated with the subacromial spur’s size (subacromial bursa: coronal plane: r = 0.327; p = 0.006; sagittal view: r = 0.305; p = 0.011; subdeltoid bursa coronal view: r = 0.333 p = 0.005). The width of the subdeltoid bursa in coronal plane was positively correlated with shoulder pain (r = 0.248; p = 0.004) and negatively with the range of abduction (r = −0.270; p = 0.025), as well as the mean (r = −0.332; p = 0.005) and maximum (r = −0.334; p = 0.005) abduction force. Conclusions Shoulder function and pain in subacromial impingement are best predicted by the width of the subdeltoid bursa measured in the coronal MRI plane as an indicator of bursitis as well as the presence of a “halo-sign” around the biceps tendon indicating glenohumeral joint effusion. Presence of a subacromial spur could lead to subacromial and subdeltoid bursitis, which impairs shoulder function. Shoulder function seems not to be compromised by the presence of a subacromial spur in absence of bursitis. This study was registered at the German Clinical Trials Register on 08 February 2013 (ID: DRKS00011548). more...
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- 2021
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20. Results of a tri-national online survey on the current status of sports injury prevention among members of the German-Speaking Orthopaedic Sports Medicine Society (GOTS)
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Christoph Lutter, T Patt, Thomas Tischer, W Krutsch, Romain Seil, A Gokeler, Casper Grim, and Raymond Best
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medicine.medical_specialty ,Sports injury ,Sports medicine ,MEDLINE ,Sports Medicine ,German ,03 medical and health sciences ,0302 clinical medicine ,Germany ,Injury prevention ,medicine ,Humans ,Orthopedics and Sports Medicine ,030212 general & internal medicine ,Reimbursement ,business.industry ,030229 sport sciences ,language.human_language ,Orthopedics ,Research strategies ,Austria ,Family medicine ,Athletic Injuries ,Orthopedic surgery ,language ,business ,Switzerland - Abstract
To assess the current opinions and state of knowledge in primary sports injury prevention among members of the On 21 August 2019, a web-based questionnaire was sent to the members of the tri-national society A total of 272 participants completed the survey, representing a total survey participation of 17.7 % of all members. The study population consisted of orthopaedic surgeons (55 % with surgical and 21 % with non-operative orientation), medical students (10 %), physical therapists (8 %) and sports scientists (4 %). Ninety-four percent of all participants stated that they considered the importance of sports injury prevention to be "very high" (68 %) or "high" (26 %). However, almost 70 % of all participants stated that they spend less than one hour per week on injury prevention work. The term "prevention" was clearly defined and practicable for only 40 %, understandable but difficult to implement for 51 %, and unclear and difficult to implement for 9 % of the participants. Seventy-two percent of respondents were aware of existing prevention programs such as "Stop-X" or "FIFA 11 +", whereas 28 % of participants were uninformed regarding these programs. A strong divergence was identified between participants' perception of the importance of sports injury prevention and the existing implementation of preventive measures. Future funding of prevention programs, expansion of research strategies for injury prevention and better financial reimbursement are of utmost importance. Erhebung und Beurteilung des aktuellen Meinungs- und Wissensstandes bzgl. der Prävention von Sportverletzungen unter den Mitgliedern der Gesellschaft für Orthopädisch-Traumatologische Sportmedizin (GOTS). Am 21. August 2019 wurde ein Online-Fragebogen an die Mitglieder der Gesellschaft (Österreich, Deutschland und Schweiz) verschickt. Die Umfrage war bis zum 21. November 2019 online und umfasste 22 Fragen, die in 5 Abschnitte unterteilt waren: 1. allgemeine Bedeutung der Prävention (n = 4), 2. Spezifikationen der Studienpopulation (n = 3), 3. Umsetzung von Prävention (n = 8), 4. Verbesserungsmöglichkeiten in der Prävention (n = 4) und 5. zukünftige Forschungsbereiche (n = 3). Insgesamt nahmen 272 Teilnehmer an der Umfrage teil, was einem Anteil von 17,7 % aller Mitglieder entspricht. Die Studienpopulation bestand aus orthopädischen Chirurgen (55 % operativer und 21 % konservativer Schwerpunkt), Medizinstudenten (10 %), Physiotherapeuten (8 %) und Sportwissenschaftlern (4 %). 94 % aller Teilnehmer gaben an, dass sie die Bedeutung der Prävention von Sportverletzungen als „sehr hoch“ (68 %) oder „hoch“ (26 %) einschätzen. Allerdings gaben fast 70 % aller Teilnehmer an, dass sie weniger als eine Stunde pro Woche für die Arbeit zur Verletzungsprävention aufwenden. Der Begriff „Prävention“ war nur für 40 % klar definiert und praktikabel, für 51 % verständlich, aber schwierig umzusetzen, und für 9 % der Teilnehmer unklar und schwierig umzusetzen. 72 % der Befragten gaben an, bestehende Präventionsprogramme wie „Stop-X“ oder „FIFA 11 +“ zu kennen, während 28 % der Teilnehmer über diese Programme nicht informiert waren. Es wurde eine starke Divergenz zwischen der Wahrnehmung der Bedeutung der Prävention von Sportverletzungen durch die Mitglieder und der bestehenden Umsetzung von Präventionsmaßnahmen festgestellt. Die künftige Finanzierung von Präventionsprogrammen, die Ausweitung von Forschungsstrategien zur Verletzungsprävention und eine bessere finanzielle Rückerstattung sind von größter Bedeutung. more...
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- 2021
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21. Quantifiable Contrast-Enhanced Ultrasound Explores the Role of Protection, Rest, Ice (Cryotherapy), Compression and Elevation (PRICE) Therapy on Microvascular Blood Flow
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Matthias W. Hoppe, Thilo Hotfiel, Jürgen Freiwald, Thomas Tischer, Raimund Forst, Casper Grim, Christoph Lutter, Martin Engelhardt, Rafael Heiss, and Christian M. Hammer
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Adult ,Male ,Acoustics and Ultrasonics ,Rest ,medicine.medical_treatment ,Biophysics ,Contrast Media ,Cryotherapy ,Patient Positioning ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Compression Bandages ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Muscle, Skeletal ,Reactive hyperemia ,Ultrasonography ,030222 orthopedics ,Radiological and Ultrasound Technology ,business.industry ,Microcirculation ,Ultrasound ,Skeletal muscle ,030229 sport sciences ,Blood flow ,Compression (physics) ,medicine.anatomical_structure ,Regional Blood Flow ,Anesthesia ,Athletic Injuries ,Female ,business ,Perfusion ,Contrast-enhanced ultrasound - Abstract
The aim of this randomized controlled laboratory study was to evaluate the role of standardized protection, rest, ice (cryotherapy), compression and elevation (PRICE) therapy on microvascular blood flow in human skeletal muscle. Quantifiable contrast-enhanced ultrasound was used to analyze intramuscular tissue perfusion (ITP) of the rectus femoris (RF) and vastus intermedius (VI) muscles in 20 healthy athletes who were randomly assigned to PRICE or control groups. Baseline perfusion measurements (resting conditions, T0) were compared with cycling exercise (T1), intervention (PRICE or control, T2) and follow-up at 60 min post-intervention (T3). The 20 min PRICE intervention included rest, cryotherapy (3°C), compression (35 mm Hg) and elevation. After intervention, PRICE demonstrated a decrease of ITP in VI (–47%, p = 0.01) and RF (–50%, p = 0.037) muscles. At T3, an ongoing decreased ITP for the RF (p = 0.003) and no significant changes for the VI were observed. In contrast, the control group showed an increased ITP at T2 and no significant differences at T3. PRICE applied after exercise led to a down-regulation of ITP, and the termination of PRICE does not appear to be associated with a reactive hyperemia for at least 60 min after treatment. more...
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- 2021
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22. Epicondylopathia humeri radialis
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Michael C. Glanzmann, Anna Katharina Doepfer, Marc Banerjee, Sebastian Siebenlist, Sven Reuter, Michael Hackl, Lars Peter Müller, Thomas Tischer, Tim Leschinger, Lars Lehmann, Ralf Theermann, and Klaus Wörtler more...
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030222 orthopedics ,medicine.medical_specialty ,business.industry ,Epicondylitis ,MEDLINE ,Tennis Elbow ,Treatment options ,030229 sport sciences ,Evidence-based medicine ,Guideline ,medicine.disease ,Chronic disorders ,03 medical and health sciences ,0302 clinical medicine ,Radiological weapon ,Chronic Disease ,Quality of Life ,medicine ,Tennis elbow ,Humans ,Orthopedics and Sports Medicine ,Surgery ,Registries ,Intensive care medicine ,business - Abstract
Lateral epicondylitis is a common orthopaedic condition often massively restricting the quality of life of the affected patients. There are a wide variety of treatment options - with varying levels of evidence.The following statements and recommendations are based on the current German S2k guideline Epicondylopathia radialis humeri (AWMF registry number: 033 - 2019). All major German specialist societies participated in this guideline, which is based on a systematic review of the literature and a structured consensus-building process.Lateral epicondylitis should be diagnosed clinically and can be confirmed by imaging modalities. The Guidelines Commission issues recommendations on clinical and radiological diagnostic workup. The clinical condition results from the accumulated effect of mechanical overload, neurologic irritation and metabolic changes. Differentiating between acute and chronic disorder is helpful. Prognosis of non-surgical regimens is favourable in most cases. Most cases spontaneously resolve within 12 months. In case of unsuccessful attempted non-surgical management for at least six months, surgery may be considered as an alternative, if there is a corresponding structural morphology and clinical manifestation. At present, it is not possible to recommend a specific surgical procedure.This paper provides a summary of the guideline with extracts of the recommendations and statements of its authors regarding the pathogenesis, prevention, diagnostic workup as well as non-surgical and surgical management.Die Epicondylopathia humeri radialis (Epicondylitis humeri radialis) ist ein Krankheitsbild, das häufig mit massiven Einschränkungen für die Lebensqualität der betroffenen Patienten einhergeht und für das eine Vielzahl an unterschiedlichen Therapien – mit schwankender Evidenz – existiert.Die nachfolgenden Ausführungen und Empfehlungen basieren auf der aktuellen S2k-Leitlinie Epicondylopathia radialis humeri (AWMF-Registernummer: 033-019). Diese Leitlinie wurde unter Beteiligung aller relevanten Fachgesellschaften, basierend auf einer systematischen Literaturanalyse und durch eine strukturierte Konsensusfindung, erstellt.Die Diagnose sollte klinisch gestellt werden und kann durch bildgebende Verfahren bestätigt werden. Empfehlungen zur klinischen und radiologischen Diagnostik werden durch die Leitlinienkommission gegeben. Das Krankheitsbild entsteht aufgrund eines kumulativen Effekts von mechanischer Überbelastung, neurologischer Irritation und metabolischen Veränderungen. Eine Unterscheidung einer akuten von einer chronischen Form ist sinnvoll. Die Prognose bei konservativer Therapie ist günstig. In der Mehrheit der Fälle kommt es innerhalb von 12 Monaten zur spontanen Beschwerderegredienz. Bei frustranem konservativen Therapieversuch von mindestens 6 Monaten kann bei einem strukturell-morphologischen und klinischen Korrelat über eine operative Therapiealternative diskutiert werden. Eine abschließende Empfehlung für ein spezifisches operatives Verfahren kann aktuell nicht ausgesprochen werden.Der vorliegende Artikel dient einer Zusammenfassung der Leitlinie mit daraus erzielten Auszügen der Empfehlungen und Statements der Autoren zur Pathogenese, Prävention, Diagnostik sowie konservativen und operativen Therapie. more...
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- 2021
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23. Generation 'Social Media' – Nutzung moderner Medien zum Informationsgewinn bezüglich Sportverletzungen
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Thomas Tischer, David Alexander Back, Volker Schöffl, Michael Simon, Andreas Enz, and Christoph Lutter
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Gynecology ,03 medical and health sciences ,medicine.medical_specialty ,0302 clinical medicine ,Sports injury ,Political science ,medicine ,Orthopedics and Sports Medicine ,030229 sport sciences ,030212 general & internal medicine - Abstract
ZusammenfassungHintergrund Die Nutzung digitaler Medien ist in nahezu allen Bereich des täglichen Lebens zur Normalität geworden. Ziel dieser Arbeit war es zu analysieren, inwieweit verletzte Sportler Online-Medien nutzen, um Informationen über Sportverletzungen oder deren Prävention zu erhalten.Material und Methoden Zwischen 07/2017 und 12/2019 wurden im Klettersport sowohl Freizeit- als auch Wettkampfsportler nach ihrer Nutzung verschiedener Medien mit Hinblick auf die Bereiche Sportmedizin und Prävention befragt.Ergebnisse 488 Athleten wurden in die Studie eingeschlossen (70,9 % männlich, 29,1 % weiblich, 33,2 ± 10,3 (13–71) Jahre). 69,9 % der Athleten nutzen online verfügbare medizinische Inhalte, wobei die Videoplattform YouTube am häufigsten zur spezifischen Suche verwendet wird (24,4 %). Jüngere Athleten ( 50 Jahre nutzt dieses Medium signifikant seltener (18,8 %; p = 0,013). Wettkampfathleten nutzen signifikant häufiger webbasierte medizinische Inhalte als Freizeitathleten (p = 0,005). Das generelle Interesse an Verletzungsprophylaxe ist groß, wobei Wettkampfathleten häufiger entsprechende Inhalte nutzen. Fast 9 % aller befragten Patienten begaben sich aufgrund ihrer Online-Recherchearbeit in eine entsprechende sportorthopädische Einrichtung.Zusammenfassung Internetbasierte medizinische Informationen werden von 69,9 % der Athleten genutzt, die Videoplattform YouTube wird am häufigsten verwendet. Videoplattformen und sportspezifische Literatur werden von jüngeren Athleten deutlich häufiger als von älteren Athleten genutzt. Webbasierte medizinische Inhalte werden von Wettkampfathleten signifikant häufiger aufgerufen als von Freizeitathleten. Das generelle Interesse an Verletzungsprophylaxe ist groß, wobei Wettkampfathleten häufiger entsprechende Inhalte nutzen bzw. suchen. more...
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- 2021
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24. Einfluss von Achsdeformitäten und deren Korrektur auf die Arthroseentstehung und -progression
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Florian B. Imhoff, Sandro F. Fucentese, Jörg Harrer, Thomas Tischer, University of Zurich, and Imhoff, Florian B
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Gynecology ,medicine.medical_specialty ,2732 Orthopedics and Sports Medicine ,business.industry ,medicine ,610 Medicine & health ,10046 Balgrist University Hospital, Swiss Spinal Cord Injury Center ,Orthopedics and Sports Medicine ,Osteoarthritis ,business ,medicine.disease - Abstract
ZusammenfassungDie Beachtung der Beinachse und die Möglichkeiten zur deren Korrektur stellen beim jungen Patienten mit Arthrose ein Grundpfeiler der Therapie dar. Die Kombination einer Gelenksverletzung und einer Achsdeviation führt unweigerlich, je nach Ausmaß und Komorbiditäten, schon nach wenigen Jahren zur fortschreitenden Gonarthrose. Neben der genauen Deformitätenanalyse zur Osteotomieplanung, gilt es, Normbereiche der entsprechenden Winkel zu kennen und eine Zielgröße zur Achskorrektur festzulegen. Aus dem Repertoire der verschiedenen kniegelenksnahen Osteotomien sind dann die Nebeneffekte in Bezug auf patellofemorales Maltracking, ligamentäres Balancing und die Beinlänge abzuschätzen. Gerade im Hinblick auf mögliche (und wahrscheinliche) Folgeoperationen beim jungen Patienten müssen neue knöcherne Deformitäten oder ligamentäre Insuffizienzen, welche potenziell bei Überkorrektur entstehen, unbedingt vermieden werden. more...
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- 2021
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25. The lack of retropatellar resurfacing at index surgery is significantly associated with failure in patients following patellofemoral inlay arthroplasty: a multi-center study of more than 260 patients
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Stephan Vogt, Johannes Holz, Christoph Becher, René Hutter, Matthias J. Feucht, Tim Daniel Rose, Geert Pagenstert, Thilo Patzer, Eva Bartsch, Matthias Cotic, Ulrich Haupt, Jonas Pogorzelski, Stefan Hinterwimmer, Gerrit Bode, Philipp Niemeyer, Thomas Tischer, Turlough O'Donnel, Marco C. Rupp, Andreas B. Imhoff, Theresa Diermeier, Holger Falk, Peter Behrens, René Kaiser, Tobias Knoblauch, Wolfgang Nebelung, and Arne J. Venjakob more...
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medicine.medical_specialty ,WOMAC ,Sports medicine ,Visual analogue scale ,medicine.medical_treatment ,Pain ,Osteoarthritis ,Arthroplasty ,Patellofemoral Joint ,Patient satisfaction ,Humans ,Medicine ,Orthopedics and Sports Medicine ,Retrospective Studies ,business.industry ,Patella ,Perioperative ,Osteoarthritis, Knee ,medicine.disease ,ddc ,Surgery ,Treatment Outcome ,Orthopedic surgery ,business ,Follow-Up Studies - Abstract
Purpose To evaluate the clinical outcomes of patients with a minimum 2-year follow-up following contemporary patellofemoral inlay arthroplasty (PFIA) and to identify potential risk factors for failure in a multi-center study. Methods All patients who underwent implantation of PFIA between 09/2009 and 11/2016 at 11 specialized orthopedic referral centers were enrolled in the study and were evaluated retrospectively at a minimum 2-year follow-up. Clinical outcomes included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, the Knee Injury and Osteoarthritis Outcome Score (KOOS), the Tegner Scale, the visual analogue scale (VAS) for pain, and subjective patient satisfaction. Pre- and perioperative risk factors were compared among failures and non-failures to determine potential risk factors. Results A total of 263 patients (85% follow-up rate) could be enrolled. The mean age at the time of index surgery was 49 ± 12 years with a mean postoperative follow-up of 45 ± 18 months. The overall failure rate was 11% (28 patients), of which 18% (5 patients) were patients with patella resurfacing at index surgery and 82% (23 patients) were patients without initial patella resurfacing. At final follow-up, 93% of the patients who did not fail were satisfied with the procedure with a mean transformed WOMAC Score of 84.5 ± 14.5 points, a mean KOOS Score of 73.3 ± 17.1 points, a mean Tegner Score of 3.4 ± 1.4 points and a mean VAS pain of 2.4 ± 2.0 points. An increased BMI was significantly correlated with a worse postoperative outcome. Concomitant procedures addressing patellofemoral instability or malalignment, the lack of patellofemoral resurfacing at the index surgery and a high BMI were significantly correlated with failure in our patient cohort. Conclusion Patellofemoral inlay arthroplasty shows high patient satisfaction with good functional outcomes at short-term follow-up and thus can be considered a viable treatment option in young patients suffering from isolated patellofemoral arthritis. Patellar resurfacing at index surgery is recommended to decrease the risk of failure. Level of evidence Retrospective case series, Level IV. more...
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- 2021
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26. Primärprävention von Sportverletzungen und -schäden
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Christoph Lutter, Eric Besenius, Thomas Tischer, and Romain Seil
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Orthopedics and Sports Medicine ,Physical Therapy, Sports Therapy and Rehabilitation - Abstract
Zusammenfassung Sport ist ein wichtiger Teil unserer Gesellschaft und hat weitreichende positive Wirkungen auf unsere Gesundheit. Leider geht ein Teil dieser positiven Wirkungen durch Sportverletzungen verloren. Inzwischen ist die Evidenz von Praventionsprogrammen zur Vermeidung von Sportverletzungen an Knie, Hufte, OSG und Schulter gut belegt. Am Kniegelenk ist die Datenlage am grosten, hier konnen bei Adoleszenten und jungen Frauen bis zu 67% der vorderen Kreuzbandverletzungen vermieden werden. Am schlechtesten untersucht ist die Schulter, hier gibt es nur wenige randomisierte Studien, die jedoch auch eine signifikante Verletzungsreduktion zeigen konnten. Somit ist vor allem eine Implementierung der Praventionsprogramme in das tagliche Training der Sportler zu fordern, gleichzeitig aber die Erfassung von Sportverletzungen und Ausbildung aller Akteure zu verbessern. Zukunftig werden neue Technologien (Sensoren, kunstliche Intelligenz) eine wichtige Rolle spielen. more...
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- 2021
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27. Risk factors and prevention strategies for shoulder injuries in overhead sports: an updated systematic review
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Matthias Wilhelm Hoppe, Joana Brochhagen, Thomas Tischer, Knut Beitzel, Romain Seil, and Casper Grim
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Orthopedics and Sports Medicine - Abstract
Purpose The aim of this systematic review was to update the knowledge on risk factors and prevention strategies for shoulder injuries in overhead sports with special emphasis on methodological quality. Methods All methodological procedures were performed in line with a previous systematic review by Asker et al. (2018). The literature search was conducted in the PubMed, Google Scholar, Cochrane, and SPORT-Discuss databases. Due to the risk of bias assessment, only studies with at least an acceptable methodological quality were included. A best-evidence synthesis was performed to clarify the evidence and direction of the risk factors and prevention strategies. Results A total of nine studies were included in the data extraction process. One study had a high and eight studies had an acceptable methodological quality. Seven cohort studies investigated risk factors and two randomised controlled trails evaluated prevention strategies. Moderate evidence was found for two non-modifiable (playing position, gender) and three modifiable factors (shoulder rotational strength, scapular dyskinesia, shoulder prevention programme) that were associated with the shoulder injury risk. All further risk factors had moderate and no association with risk (shoulder rotational ROM, joint position sense) or limited (history of shoulder/elbow pain, age, training experience, training volume, school grade, playing level), and conflicting evidence (setting). Conclusions There is moderate evidence for two non-modifiable (playing position, gender) and three modifiable factors (shoulder rotational strength, scapular dyskinesia, shoulder prevention programme) being associated with the shoulder injury risk in overhead sports. more...
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- 2022
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28. Lower extremity joint compensatory effects during the first recovery step following slipping and stumbling perturbations in young and older subjects
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Xiping, Ren, Christoph, Lutter, Maeruan, Kebbach, Sven, Bruhn, Rainer, Bader, and Thomas, Tischer
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Knee Joint ,Lower Extremity ,Humans ,Hip Joint ,Walking ,Geriatrics and Gerontology ,Gait ,Ankle Joint ,Aged - Abstract
Background The lower extremity may play a crucial role in compensating for gait perturbations. The study aimed to explore the mechanism of perturbation compensation by investigating the gait characteristics and lower extremity joint moment effects in young (YS) and older subjects (OS) during the first recovery gait following slipping (slipping_Rec1) and stumbling (stumbling_Rec1). Method An automatic perturbation-triggered program was developed using D-Flow software based on the Gait Real-time Analysis Interactive Lab to induce the two aforementioned perturbations. Marker trajectories and ground reaction forces were recorded from 15 healthy YS (age: 26.53 ± 3.04 years; body height: 1.73 ± 0.07 m; body mass: 66.81 ± 11.44 kg) and 15 healthy OS (age: 68.33 ± 3.29 years; body height: 1.76 ± 0.10 m; body mass: 81.13 ± 13.99 kg). The Human Body Model was used to compute the variables of interest. One-way analysis of variance and independent samples t-test statistical analyses were performed. Results In slipping_Rec1 and stumbling_Rec1, the change in gait pattern was mainly reflected in a significant increase in step width, no alterations in step length and stance/swing ratio were revealed. Based on perturbed task specificity, lower extremity joint moments increased or decreased at specific phases of the gait cycle in both YS and OS in slipping_Rec1 and stumbling_Rec1 compared to normal gait. The two perturbed gaits reflected the respective compensatory requirements for the lower extremity joints, with both sagittal and frontal joint moments producing compensatory effects. The aging effect was not reflected in the gait pattern, but rather in the hip extension moment during the initial stance of slipping_Rec1. Conclusions Slipping appears to be more demanding for gait recovery than stumbling. Gait perturbation compensatory mechanisms for OS should concentrate on ankle strategy in the frontal plane and counter-rotation strategy around the hip. more...
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- 2022
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29. Barefoot walking is more stable in the gait of balance recovery in older adults
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Xiping Ren, Maeruan Kebbach, Sven Bruhn, Qining Yang, Huijie Lin, Rainer Bader, Thomas Tischer, and Christoph Lutter
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Humans ,Walking ,Geriatrics and Gerontology ,Gait ,Aged ,Biomechanical Phenomena ,Shoes ,Walking Speed - Abstract
Background Perturbation-based balance training on a treadmill is an emerging method of gait stability training with a characteristic task nature that has had positive and sustained effects on balance recovery strategies and fall reduction. Little is known about the effects produced by shod and barefoot walking. We aimed to investigate which is more appropriate, shod or barefoot walking, for perturbation-based balance training in older adults. Methods Fourteen healthy older adults (age: 68.29 ± 3.41 years; body height: 1.76 ± 0.10 m; body mass: 81.14 ± 14.52 kg) performed normal and trip-like perturbed walking trials, shod and barefoot, on a treadmill of the Gait Real-time Analysis Interactive Lab. The marker trajectories data were processed by Human Body Model software embedded in the Gait Offline Analysis Tool. The outcomes of stride length variability, stride time variability, step width variability, and swing time variability were computed and statistically analyzed by a two-way repeated-measures analysis of variance (ANOVA) based on gait pattern (normal gait versus perturbed recovery gait) and footwear condition (shod versus barefoot). Results Footwear condition effect (p = 0.0310) and gait pattern by footwear condition interaction effect (p = 0.0055) were only observed in swing time variability. Gait pattern effects were detected in all four outcomes of gait variability. Conclusions Swing time variability, independent of gait speed, could be a valid indicator to differentiate between footwear conditions. The lower swing time variability in perturbed recovery gait suggests that barefoot walking may be superior to shod walking for perturbation-based balance training in older adults. more...
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- 2022
30. The German Arthroscopy Registry DART: what has happened after 5 years?
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Maximilian Hinz, Christoph Lutter, Ralf Mueller-Rath, Philipp Niemeyer, Oliver Miltner, and Thomas Tischer
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Orthopedics and Sports Medicine ,Surgery - Abstract
Purpose The German Arthroscopy Registry (DART) has been initiated in 2017 with the aim to collect real-life data of patients undergoing knee, shoulder, hip or ankle surgery. The purpose of this study was to present an overview of the current status and the collected data thus far. Methods Data entered between 11/2017 and 01/2022 were analyzed. The number of cases (each case is defined as a single operation with or without concomitant procedures) entered for each joint, follow-up rates and trends between different age groups (18–29 years, 30–44 years, 45–64 years, ≥ 65 years) and across genders, and quality of life improvement (pre- vs. 1 year postoperative EQ visual analogue scale [EQ-VAS]) for frequently performed procedures (medial meniscus repair [MMR] vs. rotator cuff repair [RCR] vs. microfracturing of the talus [MFX-T]) were investigated. Results Overall, 6651 cases were entered into DART, forming three distinct modules classified by joint (5370 knee, 1053 shoulder and 228 ankle cases). The most commonly entered procedures were: knee: partial medial meniscectomy (n = 2089), chondroplasty (n = 1389), anterior cruicate ligament reconstruction with hamstring autograft (n = 880); shoulder: sub acromial decompression (n = 631), bursectomy (n = 385), RCR (n = 359); ankle: partial synovectomy (n = 117), tibial osteophyte resection (n = 72), loose body removal (n = 48). In the knee and shoulder modules, middle-aged patients were the predominant age group, whereas in the ankle module, the youngest age group was the most frequent one. The two oldest age groups had the highest 1-year follow-up rates across all modules. In the knee and shoulder module, 1-year follow-up rates were higher in female patients, whereas follow-up rates were higher in male patients in the ankle module. From pre- to 1-year postoperative, MFX-T (EQ-VAS: 50.0 [25–75% interquartile range: 31.8–71.5] to 75.0 [54.3–84.3]; ∆ + 25.0) led to a comparably larger improvement in quality of life than did MMR (EQ-VAS: 70.0 [50.0–80.0] to 85.0 [70.0–94.0]; ∆ + 15.0) or RCR (EQ-VAS: 67.0 [50.0–80.0] to 85.0 [70.0–95.0]; ∆ + 18.0). Conclusion DART has been sufficiently established and collects high-quality patient-related data with satisfactory follow-up allowing for a comprehensive analysis of the collected data. The current focus lies on improving patient enrolment and follow-up rates as well as initiating the hip module. more...
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- 2022
31. Patella height influences patellofemoral contact and kinematics following cruciate-retaining total knee replacement
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Thomas Tischer, Andreas Geier, Christoph Lutter, Andreas Enz, Rainer Bader, and Maeruan Kebbach
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Orthopedics and Sports Medicine - Abstract
The role of patella height is discussed controversially in total knee arthroplasty (TKA). Therefore, this computational study aims to systematically analyze the biomechanical effect of different patella heights on patellofemoral (PF) forces and kinematics after cruciate-retaining (CR) TKA. We implemented a CR bicondylar TKA with a dome patellar button in a validated dynamic musculoskeletal multibody model of a male human knee joint. Retropatellar dynamics (contact force [N], shear force [N], patellar shift [mm], tilt [°], and rotation [°]) were evaluated during dual-limb squat motion (flexion from 0° to 90°) with simulated active muscle forces and the effects of different patella heights (Blackburne-Peel [BP] ratio of 0.39, 0.49, 0.65, 0.85, 1.01, and 1.1 were systematically examined). As active knee flexion increased, PF contact force also increased. Patella alta (BP = 1.1) resulted in higher PF contact forces compared to normal patella height (BP = 0.65) by up to 16%. Contrarily, patella baja was associated with decreased PF forces by 7%. Compared to patella baja (BP = 0.39), patella alta (BP = 1.1) considerably increased the contact force by up to 25%. Different patellar heights mainly affected PF shear forces during early knee flexion. Concerning PF kinematics, patella alta (BP = 1.1) yielded a greater lateral tilt of more than 4° and higher patellar rotation by up to 3° during deep knee flexion, compared to normal patella height (BP = 0.65). Our computational study indicates that patella alta is associated with the highest PF contact and shear force after the implantation of a CR bicondylar TKA. This should be considered in PF disorders following TKA. more...
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- 2022
32. Predictors for an unsuccessful conservative treatment of patients with medial patellar plica syndrome
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Thomas Tischer, Nicola Oehler, Robert Lenz, Stephan Vogt, Fabian Blanke, and Hasan Al Aidarous
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medicine.medical_specialty ,Visual analogue scale ,Conservative Treatment ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Orthopedics and Sports Medicine ,Range of Motion, Articular ,Plica syndrome ,Surgical treatment ,Retrospective Studies ,medial plica ,030222 orthopedics ,Synovitis ,business.industry ,Retrospective cohort study ,Patella ,030229 sport sciences ,General Medicine ,Lysholm Knee Score ,medicine.disease ,Surgery ,Conservative treatment ,predictors ,ddc: 610 ,Radiological weapon ,Medicine and health ,Orthopedic surgery ,conservative ,business ,Medial knee - Abstract
In several cases persistent medial knee pain remains after conservative treatment in patients with medial patellar plica syndrome. In recent literature accepted criteria for surgical indication are lacking. In this retrospective study patients after conservative treatment were evaluated to identify predictors for an unsuccessful outcome. 117 Patients with medial patellar plica syndrome between 2016 and 2019 were retrospectively evaluated. All patients received conservative treatment for three months. Surgery was indicated due to failed conservative treatment (n = 76) with persistent medial knee pain and restriction of activity after 3 months. Preoperative MRI analysis, Lysholm score, pain by the visual analog scale (VAS), postoperative sports participation (RTS) and Tegner activity score were collected at least 12 months after definite treatment. Statistical analysis was performed to evaluate differences between patients with successful and unsuccessful conservative treatment. There were significant differences in the clinical and radiological findings between patients with successful and unsuccessful conservative treatment. Patients with failed conservative treatment showed a significant larger diameter of the medial patellar plica (0.8 ± 0.3 mm vs. 1.6 ± 0.4 mm; p more...
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- 2020
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33. Vorzeitiger Verschleiß von Knieendoprothesen im Sport am Beispiel eines Golfers
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Andreas Enz, Thomas Tischer, Christoph Lutter, Daniel Kluess, and Wolfram Mittelmeier
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Gynecology ,030222 orthopedics ,medicine.medical_specialty ,Sports medicine ,business.industry ,Total knee replacement ,Physical activity ,Total knee arthroplasty ,Knee Joint ,03 medical and health sciences ,0302 clinical medicine ,Orthopedic surgery ,medicine ,Orthopedics and Sports Medicine ,030212 general & internal medicine ,business - Abstract
Sport mit Endoprothesen wird kontrovers diskutiert, wahrend Golfsport mit Knieendoprothese meist erlaubt wird. Dieser Fall zeigt, dass intensives Golfspielen zu starkem Verschleis der Knieprothese fuhren kann. Das Verschleismuster der Prothesenkomponenten lasst vermehrte Rotationsbelastungen vermuten. Ein Wechsel auf eine gekoppelte Prothese bei Metall-Metall-Kontakt musste durchgefuhrt werden. Wichtig ist die praoperative Aufklarung des Patienten uber Sportfahigkeit mit Endoprothese. Sportliche Belastung ist kein Bestandteil der Prothesenprufung nach ISO. more...
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- 2020
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34. Measuring lower limb circumference and volume – introduction of a novel optical 3D volumetric measurement system
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Sebastian Oye, Andreas Wolf, Anett Mau-Moeller, Rainer Bader, Wolfram Mittelmeier, Thomas Tischer, Frank Feldhege, and Robert Jacksteit
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Lower limb circumference ,medicine.diagnostic_test ,030231 tropical medicine ,Biomedical Engineering ,Healthy subjects ,Reproducibility of Results ,Computed tomography ,3d model ,Circumference ,Volumetric measurement ,03 medical and health sciences ,Imaging, Three-Dimensional ,0302 clinical medicine ,Lower Extremity ,Volume (thermodynamics) ,medicine ,Humans ,030212 general & internal medicine ,Tomography, X-Ray Computed ,Reliability (statistics) ,Biomedical engineering - Abstract
This study comprised two experiments: (1) the reliability of a novel optical three-dimensional (3D) volumetric measurement system (BODYTRONIC® 600) for the assessment of lower limb circumference and volume; (2) the comparison of data obtained from BODYTRONIC® 600 with that provided by computed tomography (CT) for accuracy estimation. Reliability was assessed in 20 healthy subjects. Accuracy was determined by comparing the deviations in the surface topology of two 3D models obtained from BODYTRONIC® 600 and CT. Reliability was very high for leg circumference measures [coefficient of variations (CVs) range 0.3%–1.3%] and slightly lower for foot circumference (CVs around 2.0%). Reliability of leg volume was also found to be very high (CVs ≤ 2.5%). Differences in surface topology between BODYTRONIC® 600 and CT were primarily below 1 mm indicating high accuracy. The volumes of the foot were higher (range 0.9%–1.7%) and that of the leg, lower (range 1.0%–1.3%) compared to CT. The BODYTRONIC® 600 system provides fast, highly reliable and accurate measures of lower limb circumference and volume and can be considered as a valuable measurement tool for use in various research and clinical applications. more...
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- 2020
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35. Sportmedizinische Aspekte des olympischen Wettkampfkarate
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Martin Ellenrieder, Björn Lembcke, Thomas Tischer, Robert Lenz, and Wolfram Mittelmeier
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030222 orthopedics ,03 medical and health sciences ,0302 clinical medicine ,Orthopedics and Sports Medicine ,Physical Therapy, Sports Therapy and Rehabilitation ,030229 sport sciences - Abstract
Zusammenfassung Karate ist eine moderne Kampfsportart, deren Wurzeln bis ins China vor etwa 500 Jahren zuruckreichen und die bei den Sommerspielen 2020 in Tokyo erstmals olympisch sein wird. Dabei unterscheidet man die Disziplinen Kumite-Karate (Freikampf) und Kata-Karate (Schattenkampf) mit unterschiedlichen Anforderungen an die Athleten. Die haufigsten Verletzungen finden sich beim Kumite-Karate im Bereich der Kopf- und Halsregion, des Rumpfes, der unteren und oberen Extremitaten, wobei die Inzidenz schwerer Verletzungen als eher gering eingeschatzt wird. Insbesondere Regelanderungen und Optimierung der Schutzausrustungen konnten nachweislich eine Verletzungsreduktion erreichen. Chronische Uberlastungsschaden durch wiederholte Mikrotraumata oder verschleppte Verletzungen sind in der Literatur bislang nur sparlich abgebildet, obwohl chronische Schaden infolge jahrelangen Karates auf Leistungssportniveau als nicht unerheblich einzuschatzen sind. Besondere Aufmerksamkeit verlangt auch die korrekte Behandlung von Schadelhirntraumata und Verletzungen im Wachstumsalter sowie Uberlastungsschaden bei Kindern und Jugendlichen aufgrund zu hoher Belastungsintensitaten. Nicht zuletzt hierin begrundet, gilt die Pravention von Verletzungen als einer der wichtigsten Aspekte in der sportmedizinischen Betreuung. more...
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- 2020
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36. Sportklettern als olympische Disziplin
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Christoph Lutter, Thomas Tischer, and Volker Schöffl
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Orthopedics and Sports Medicine ,Physical Therapy, Sports Therapy and Rehabilitation - Abstract
Zusammenfassung Mit der Aufnahme in das olympische Programm der kommenden Sommerspiele (Tokyo 2020) gipfelt der Aufwartstrend des Wettkampfkletterns und hebt die Sportart auf die grostmogliche Buhne. Wahrend die drei Disziplinen, „Lead“, „Boulder“ und „Speed“ normalerweise Einzelwettkampfformen darstellen, wurde fur die Olympiade, basierend auf den Vorgaben, dass es nur einen Medaillenwettkampf geben wird, ein Kombinationswettkampf aller drei Subdisziplinen geschaffen. Diese Tatsache veranderte unlangst das Anforderungsprofil der Spitzensportler sowie eine Anpassung der Trainingsprozesse. Wahrend im „Lead“-Klettern vor allem die Kraftausdauer der Fingerbeuger leistungsbestimmend ist, erfordert das athletische „Bouldern“ eher Maximalkraftfahigkeiten. „Speed“-Athleten zeichnen sich druch Schnellkraft und enorme koordinative Fahigkeiten aus. Das allgemeine Unfallrisiko beim Wettkampfklettern ist gering; Verletzungen betreffen meist die obere Extremitat und basieren oftmals auf chronischer Uberlastung. Dabei stehen im „Lead“ Finger- und Schulterbeschwerden an erster Stelle; beim „Bouldern“ resultieren Sprunggelenksverletzungen und Distorsionstraumata von Sturzen. Zudem haufen sich aktuell sog. „Heel-hook“ Verletzungen der ruckseitigen Oberschenkelmuskulatur und Kniegelenksverletzungen in dieser Sub-Disziplin. Beim „Speed“-Klettern treten aufgrund der Absicherungsform meist nur harmlose Hautabschurfungen auf. more...
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- 2020
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37. Direct Mapping of RAFT Controlled Macromolecular Growth on Surfaces via Single Molecule Force Spectroscopy
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Christopher Barner-Kowollik, Cornelia Lee-Thedieck, Robert Gralla-Koser, Leonie Barner, Vanessa Trouillet, and Thomas Tischer
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chemistry.chemical_classification ,Materials science ,Polymers and Plastics ,Organic Chemistry ,Force spectroscopy ,Chain transfer ,02 engineering and technology ,Polymer ,Raft ,(Hydroxyethyl)methacrylate ,010402 general chemistry ,021001 nanoscience & nanotechnology ,01 natural sciences ,0104 chemical sciences ,Inorganic Chemistry ,chemistry.chemical_compound ,Aminolysis ,chemistry ,Polymerization ,Chemical engineering ,Polymer chemistry ,Materials Chemistry ,0210 nano-technology ,Macromolecule - Abstract
Single molecule force spectroscopy (SMFS) is employed to gain insight into reversible addition–fragmentation chain transfer (RAFT) polymerization processes with living characteristics on glass surfaces. Surface-initiated (SI)-RAFT was selected to grow poly(hydroxyethyl methacrylate) (PHEMA). After aminolysis of the RAFT chain termini, thiol moieties serve as anchoring points for the gold tip of an atomic force microscope. The results allow to directly monitor the macromolecular growth of the surface-initiated polymerization. The obtained SMFS-based molecular weight distribution data of the polymers present on the surface indicate that the RAFT chain extension proceeds linearly with time up to high conversions. The current study thus adds SMFS as a valuable tool for the investigation of SI-RAFT polymerizations. more...
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- 2022
38. Time to focus on ACL revision: ESSKA 2022 consensus
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Thomas Tischer, Vincenzo Condello, Jacques Menetrey, David Dejour, Philippe Beaufils, and Roland Becker
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Orthopedics and Sports Medicine ,Surgery - Published
- 2022
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39. Compensatory Responses During Slip-Induced Perturbation in Patients With Knee Osteoarthritis Compared With Healthy Older Adults: An Increased Risk of Falls?
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Xiping Ren, Christoph Lutter, Maeruan Kebbach, Sven Bruhn, Qining Yang, Rainer Bader, and Thomas Tischer
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Histology ,Biomedical Engineering ,Bioengineering ,Biotechnology - Abstract
Background: Functional impairment of the knee joint affected by osteoarthritis and loss of muscle strength leads to a significant increase in the number of falls. Nevertheless, little is known about strategies for coping with gait perturbations in patients with knee osteoarthritis (KOA). Thus, this study aimed to examine the compensatory strategies of patients with KOA in response to a backward slip perturbation compared with healthy older adults.Methods: An automated perturbation program was developed by using D-Flow software based on the Gait Real-time Analysis Interactive Lab, and an induced backward slip perturbation was implemented on nine patients with severe KOA (68.89 ± 3.59 years) and 15 age-matched healthy older adults (68.33 ± 3.29 years). Step length, gait speed, range of motion, vertical ground reaction forces, lower extremity joint angles, and joint moments were computed and analyzed.Results: Compared with older adults, patients with KOA had significantly lower step length, gait speed, and vertical ground reaction forces in both normal walking and the first recovery step following backward slip perturbations. Inadequate flexion and extension of joint angles and insufficient generation of joint moments predispose patients with KOA to fall. Hip extension angle and flexion moment, knee range of motion, and vertical ground reaction forces are key monitoring variables.Conclusion: The risk of falls for patients with KOA in response to backward slip perturbations is higher. Patients with KOA should focus not only on quadriceps muscle strength related to knee range of motion but also on improving hip extensor strength and activation through specific exercises. Targeted resistance training and perturbation-based gait training could be better options. more...
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- 2022
40. Etiology, Classification, Diagnostics, and Conservative Management of Osteochondral Lesions of the Talus. 2023 Recommendations of the Working Group 'Clinical Tissue Regeneration' of the German Society of Orthopedics and Traumatology
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Markus Walther, Oliver Gottschalk, Henning Madry, Peter E. Müller, Matthias Steinwachs, Philipp Niemeyer, Thomas R. Niethammer, Thomas Tischer, Jan Petersen, Roman Feil, Stefan Fickert, Bernhard Schewe, Hubert Hörterer, Klaus Ruhnau, Christoph Becher, Kajetan Klos, Christian Plaass, Bernd Rolauffs, Peter Behrens, Gunter Spahn, Götz Welsch, Peter Angele, Marc-Daniel Ahrend, Philip Kasten, Christoph Erggelet, Sarah Ettinger, Daniel Günther, Daniel Körner, and Matthias Aurich more...
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Biomedical Engineering ,Immunology and Allergy ,Physical Therapy, Sports Therapy and Rehabilitation - Abstract
The working group, “Clinical Tissue Regeneration” of the German Society of Orthopedics and Traumatology (DGOU) issues this paper to update their guidelines. Methods Peer-reviewed literature was analyzed regarding different topics relevant to osteochondral lesions of the talus (OLTs) treatment. This process concluded with a statement for each topic reflecting the best scientific evidence available for a particular diagnostic or therapeutic concept, including the grade of recommendation. Besides the scientific evidence, all group members rated the statements to identify possible gaps between literature and current clinical practice. Conclusion In patients with minimal symptoms, OLT progression to ankle osteoarthritis is unlikely. Risk factors for progression are the depth of the lesion on MRI, subchondral cyst formation, and the extent of bone marrow edema. Conservative management is the adaptation of activities to the performance of the ankle joint. A follow-up imaging after 12 months helps not to miss any progression. It is impossible to estimate the probability of success of conservative management from initial symptoms and imaging. Cast immobilization is an option in OLTs in children, with a success rate of approximately 50%, although complete healing, estimated from imaging, is rare. In adults, improvement by conservative management ranges between 45% and 59%. Rest and restrictions for sports activities seem to be more successful than immobilization. Intra-articular injections of hyaluronic acid and platelet-rich plasma can improve pain and functional scores for more than 6 months. If 3 months of conservative management does not improve symptoms, surgery can be recommended. more...
- Published
- 2023
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41. Cell-based therapies have disease-modifying effects on osteoarthritis in animal models. A systematic review by the ESSKA Orthobiologic Initiative. Part 1: adipose tissue-derived cell-based injectable therapies
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Carlotta Perucca Orfei, Angelo Boffa, Yosef Sourugeon, Lior Laver, Jérémy Magalon, Mikel Sánchez, Thomas Tischer, Giuseppe Filardo, Laura de Girolamo, Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), and Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE) more...
- Subjects
Injection ,Cartilage ,Mesenchymal stromal cells (MSCs) ,[SDV]Life Sciences [q-bio] ,Osteoarthritis ,Adipose tissue ,Orthopedics and Sports Medicine ,Surgery ,Stem cells ,Intra-articular ,Disease-modifying - Abstract
Purpose The aim of this systematic review was to determine if adipose tissue-derived cell-based injectable therapies can induce disease-modifying effects in joints affected by osteoarthritis (OA). Methods A systematic review was performed on three electronic databases (PubMed, Web of Science, Embase) according to PRISMA guidelines. A synthesis of the results was performed investigating disease-modifying effects in preclinical studies comparing injectable adipose-derived products with OA controls or other products, different formulations or injection intervals, and the combination with other products. The risk of bias was assessed according to the SYRCLE’s tool. Results Seventy-one studies were included (2,086 animals) with an increasing publication trend over time. Expanded cells were used in 65 studies, 3 studies applied point of care products, and 3 studies investigated both approaches. Overall, 48 out of 51 studies (94%) reported better results with adipose-derived products compared to OA controls, with positive findings in 17 out of 20 studies (85%) in macroscopic, in 37 out of 40 studies (93%) in histological, and in 22 out of 23 studies (96%) in immunohistochemical evaluations. Clinical and biomarker evaluations showed positive results in 14 studies out of 18 (78%) and 12 studies out of 14 (86%), while only 9 studies out of 17 (53%) of the imaging evaluations were able to detect differences versus controls. The risk of bias was low in 38% of items, unclear in 51%, and high in (11%). Conclusion The current preclinical models document consistent evidence of disease-modifying effects of adipose-derived cell-based therapies for the treatment of OA. The high heterogeneity of the published studies highlights the need for further targeted research to provide recommendations on the optimal methodologies for a more effective application of these injective therapies for the treatment of OA in clinical practice. Level of evidence II. Graphical Abstract more...
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- 2022
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42. The APC/C targets the Cep152–Cep63 complex at the centrosome to regulate mitotic spindle assembly
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Thomas Tischer, Jing Yang, and David Barford
- Subjects
Centrosome ,Humans ,Mitosis ,Nuclear Proteins ,Cell Cycle Proteins ,Spindle Apparatus ,Cell Biology ,Microtubule-Associated Proteins ,Anaphase-Promoting Complex-Cyclosome ,HeLa Cells - Abstract
The control of protein abundance is a fundamental regulatory mechanism during mitosis. The anaphase-promoting complex/cyclosome (APC/C) is the main protein ubiquitin ligase responsible for the temporal regulation of mitotic progression. It has been proposed that the APC/C might fulfil other functions, including assembly of the mitotic spindle. Here, we show that the APC/C localizes to centrosomes, the organizers of the eukaryotic microtubule cytoskeleton, specifically during mitosis. Recruitment of the APC/C to spindle poles requires the centrosomal protein Cep152, and we identified Cep152 as both an APC/C interaction partner and an APC/C substrate. Previous studies have shown that Cep152 forms a complex with Cep57 and Cep63. The APC/C-mediated ubiquitylation of Cep152 at the centrosome releases Cep57 from this inhibitory complex and enables its interaction with pericentrin, a critical step in promoting microtubule nucleation. Thus, our study extends the function of the APC/C from being a regulator of mitosis to also acting as a positive governor of spindle assembly. The APC/C thereby integrates control of these two important processes in a temporal manner. more...
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- 2022
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43. Adressen
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Silvia Albrecht, RAin Andrea Amerschläger, Jürgen Barthofer, Martin J.M. Bauer, Artur Bergmann, Gregor Berrsché, Roland Biedert, Michael Bohnsack, Hans-Peter Boschert, Angelika Braun, Peter Braun, Paul Brinkmeier, Volker M.H. Broy, Peter U. Brucker, Gerd-Peter Brüggemann, Lars Brunnader, Michael P. Conze, Klaus Dann, Jens Dargel, Moritz Dau, Gregor Deitmer, Michael Dienst, Alexander C. Disch, Dominik Doerr, Roland Eisele, Hans-Georg Eisenlauer, Martin Engelhardt, Andreas Englert, Jens Enneper, Frank Fleischmann, Lukas Förster, Jürgen Freiwald, Anna-Maria Fritzsche, Wilfried Gfrörer, Ottmar Gorschewsky, Andreas Gösele-Koppenburg, Karlheinz Graff, Bernhard Greitemann, Casper Grim, Rolf Haaker, Georg Hackl, Berthold Hallmaier, Dietolf Hämel, Lutz Hänsel, Kornelius Heck, Bernd Hiller, Beat Hintermann, Anja Hirschmüller, Lena Hirtler, Hubert Hörterer, Jan Holger Holtschmit, Thilo Hotfiel, Michael Humenberger, Volker Jägemann, Axel Jäger, Jörg Jerosch, Thomas Jöllenbeck, Franz Kainberger, Antonius Kass, Max Daniel Kauther, Gino M.M.J. Kerkhoffs, Marlene Klein, Markus Knupp, Dieter Kohn, Winfried Koller, Rolf Michael Krifter, Karl-Heinz Kristen, Sabine Krüger, Michael Krüger-Franke, Andreas Kugler, PD Dr. med. Tim Leschinger, André Leumann, Ludwig Löffler, Bernhard Lukas, Christoph Lutter, Martin Majewski, Boris Mandryka, Marlene Mauch, Georg Mavridis, Alexander Mayer, Oliver Miltner, Norbert Möllers, Hans-Wilhelm Müller-Wohlfahrt, Stefan Nehrer, Georg Neumann, Elena Neunteufel, Stefan Nolte, Christian Nührenbörger, Gerhard Oberthaler, Patrick Orth, Geert Pagenstert, Markus Parzeller, Hans-Gerd Pieper, Christoph Raschka, Iris Reuter, Kirstin Richter, Dr. Mathias Ritsch, Lisette Rodt, Thomas Rodt, Bernd Rosemeyer†, Roxa Ruiz, Ralf Schauer, Anja Scheiff, Maximilian Schindler, Christoph Schlegel-Wagner, Peter Schmidt, Rüdiger Schmidt-Wiethoff, Holger Schmitt, Christian Schneider, Michaela M. Schneiderbauer, Dieter Schnell, Volker Schöffl, Benedikt Schöllkopf, Eckhart Schröter, Dr. Sarah Schröter, Claudia Schueller-Weidekamm, Philipp Schultes, René Schwall, Thomas Schwamborn, Prof. Dr. Romain, Christian H. Siebert, Stefanie Siebert, Volker Smasal, Robert Śmigielski, Gernot Sperner, Simon D. Steppacher, Gerhard W. Sybrecht, Stefanie Syré, Gabor Szalay, Carsten Temme, Sebastian Thormann, Thomas Tischer, Philippe M. Tscholl, Peter Ueblacker, Axel Urhausen, Victor Valderrabano, Niek van Dijk, Lisa Veith-Gruber, Kerstin Warnke, Luise Weinrich, Lukas Weisskopf, Meike Welz, Gernot Willscheid, Bernd Wolfarth, and Markus Zimmer more...
- Published
- 2022
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44. Prävention
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Romain Seil, Christian Nührenbörger, Christoph Lutter, and Thomas Tischer
- Published
- 2022
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45. Karate
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Holger Schmitt and Thomas Tischer
- Published
- 2022
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46. Die Wertigkeit von Endoprothesenregistern in der Schulterendoprothetik am Beispiel der inversen Endoprothese
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Fabian Blanke, Charlotte Enghusen, Andreas Enz, Florian Haasters, Christoph Lutter, Wolfram Mittelmeier, and Thomas Tischer
- Subjects
Orthopedics and Sports Medicine ,Surgery - Abstract
Zusammenfassung Einleitung Nach dem schwedischen Vorbild gewinnen Endoprothesenregister weltweit zunehmend an Bedeutung. Aufgrund der steigenden Zahlen endoprothetischer Eingriffe am Schultergelenk werden diese neben der Hüft- und Kniegelenksendoprothetik vermehrt in die Registerdatenbanken aufgenommen. In dieser Arbeit soll die Wertigkeit von Endoprothesenregistern am Beispiel der Schulterendoprothetik dargestellt und mit klinischen Studien verglichen werden. Material und Methodik Die Jahresberichte von 32 verschiedenen Endoprothesenregistern zwischen 2013 und 2019 mit Daten zur Hüft-, Knie- und/oder Schultergelenksendoprothetik wurden analysiert. Es wurden die Operationszahlen und demografischen Patientendaten für alle Bereiche der Endoprothetik untersucht. Zudem wurde eine weiterführende Betrachtung von Variablen wie der Primärdiagnose, der Revisionsursache, der Revisionsrate in Abhängigkeit von Risikofaktoren und Patient-reported Outcome Measures (PROM-Scores) ausschließlich für die Schultergelenksendoprothesen durchgeführt. Am Beispiel der inversen Schulterprothese wurden klinische Studien mit Registerdaten hinsichtlich der Revisionsrate verglichen. Ergebnisse 20 Endoprothesenregister konnten insgesamt eingeschlossen werden, 9 von diesen erfassten Daten zur Schulterendoprothetik. Die wesentlichen Primärdiagnosen stellten Osteoarthrose (40,6%), Rotatorenmanschetten-Defektarthropathie (30,2%) und Frakturen (17,6%) dar. Die am meisten verwendete Schultergelenksendoprothese war die inverse Prothese (47,3%). Der Anteil der Revisionen an den Gesamtoperationen in der Schulterendoprothetik lag in allen Registern unter 10%. Neben der Revisionsrate wurden in den Registern teilweise PROM-Scores zur Evaluation des Prothesenerfolges eingesetzt. Im Vergleich zu Registerdaten zeigten klinische Studien heterogenere Daten mit einer deutlich höheren Revisionsrate von über 10% im Langzeit-Follow-up am Beispiel der inversen Schulterprothese. Schlussfolgerung Registerdaten stellen eine wertvolle Informationsquelle in der Schulterendoprothetik dar und können einen erheblichen Beitrag zur Qualitätssicherung endoprothetischer Behandlungen leisten. Im Vergleich zu klinischen Studien liefern sie vordringlich Daten zu Standzeiten und stellen geringere Revisionsraten dar. Klinische Studien richten ihren Fokus mittels PROM-Scores und klinischen sowie radiologischen Untersuchungen einerseits nur auf einzelne Implantate und operative Zentren und andererseits weitaus stärker auf das funktionelle Ergebnis aus. more...
- Published
- 2021
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47. GOTS - we care about sports!
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Thomas Tischer
- Published
- 2022
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48. Does prevention pay off? Economic aspects of sports injury prevention: a systematic review
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Evert Verhagen, Christophe Jacquet, Christoph Lutter, Romain Seil, Thomas Tischer, Human Physiology and Sports Physiotherapy Research Group, and Physiotherapy, Human Physiology and Anatomy
- Subjects
medicine.medical_specialty ,business.industry ,Cost-Benefit Analysis ,Psychological intervention ,Physical Therapy, Sports Therapy and Rehabilitation ,General Medicine ,Evidence-based medicine ,Systematic review ,Bias ,Scale (social sciences) ,Data quality ,Economic evaluation ,Injury prevention ,Athletic Injuries ,Athletic Injuries/prevention & control ,Physical therapy ,Medicine ,Humans ,Orthopedics and Sports Medicine ,business ,Decision analysis - Abstract
ObjectiveTo identify, summarise and critically assess economic evaluation studies on sports injury prevention strategies.DesignSystematic review.Data sourcesPubMed, SportDiscuss.Eligibility criteria for selecting studiesThe current literature was searched following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Economic analyses published since 2010 were checked for inclusion. The methodological quality of the studies was assessed using the Oxford Level of Evidence for economic and decision analysis; underlying randomised controlled trials (RCTs) were rated according to the Physiotherapy Evidence Database (PEDro) Scale, and risk of bias was assessed using the Revised Cochrane risk-of-bias tool.ResultsTen studies fulfilled the inclusion criteria. The quality assessment revealed limited data quality. For trial-based analysis, underlying RCTs were of good quality and had a low risk of bias. Prevention concepts for general injury reduction showed effectiveness and cost savings. Regarding specific injury types, the analysis of the studies showed that the best data are available for ankle, hamstring and anterior cruciate ligament injuries. Measures using specific training interventions were the predominant form of prevention concepts; studies investigating these concepts showed cost-effectiveness with total cost savings between €24.82 and €462 per athlete.ConclusionInjury prevention strategies that were studied are cost-effective. However, estimates and outcomes vary throughout the included studies, and precluded pooling of existing data. Knowledge about the cost-effectiveness of evaluated prevention measures will help improve the acceptance and application of prevention initiatives. more...
- Published
- 2021
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49. Primärprävention von Sportverletzungen
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Thomas Tischer
- Published
- 2020
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50. Mechanisms of Acute Knee Injuries in Bouldering and Rock Climbing Athletes
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Carrie Cooper, Robert Lenz, Christoph Lutter, Thomas Tischer, Thilo Hotfiel, Luisa Frank, and Volker Schöffl
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Knee Joint ,Poison control ,Physical Therapy, Sports Therapy and Rehabilitation ,Knee Injuries ,Suicide prevention ,Occupational safety and health ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Injury prevention ,Humans ,Medicine ,Orthopedics and Sports Medicine ,ddc:610 ,Retrospective Studies ,030222 orthopedics ,biology ,business.industry ,Athletes ,Human factors and ergonomics ,030229 sport sciences ,Middle Aged ,biology.organism_classification ,Valgus ,Climbing ,Athletic Injuries ,Physical therapy ,Female ,business ,human activities ,Sports - Abstract
Background: There is limited insight into the mechanisms of knee injuries in rock climbing and bouldering in noncompetitive and competitive athletes. Purpose: To examine the traumatic mechanisms of injury, demographics, distribution, and severity of knee injuries in affected athletes. Study Design: Case series; Level of evidence, 4. Methods: During a 4-year period, we performed a retrospective multicenter analysis of acute knee injuries in competitive and noncompetitive climbing athletes. Traumatic mechanisms were inquired and severity levels, therapies, and outcomes recorded with visual analog scale, Tegner, Lysholm, and climbing-specific outcome scores. Results: Within the observation period, 71 patients (35% competitive athletes, 65% noncompetitive athletes) with 77 independent acute knee injuries were recorded. Four trauma mechanisms were identified: high step (20.8%), drop knee (16.9%), heel hook (40.3%), and (ground) fall (22.1%). The leading structural damage was a medial meniscal tear (28.6%), found significantly more often in the noncompetitive group. A specific climbing injury is iliotibial band strain during the heel hook position. Most injuries resulted from indoor bouldering (46.8%). Surgical procedures were predominantly necessary in noncompetitive climbers. One year after the injury, the Tegner score was 5.9 ± 0.8 (mean ± SD; range, 3-7); the Lysholm score was 97 ± 4.8 (range, 74-100); and the climbing-specific outcome score was 4.8 ± 0.6 (range, 2-5). Conclusion: Increased attention should be placed on the climber’s knee, especially given the worldwide rise of indoor bouldering. Sport-specific awareness and training programs for noncompetitive and competitive climbing athletes to reduce knee injuries should be developed, and sports medical supervision is mandatory. more...
- Published
- 2020
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