Gerald Gruber
Research interests
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InterestsOrthopaedic Surgery, Orthopaedic Sports Medicine
Publications
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1.83Impact points
Sex-related outcome differences after implantation of low-contact-stress mobile-bearing total knee arthroplasty.
International orthopaedics. 01/2012;
PURPOSE: The aim of the study was to investigate outcome differences between female and male patients after implantation of low-contact-stress (LCS) mobile-bearing total knee prostheses at a minimum follow-up of five years with respect to clinical and radiological parameters. METHODS: We retrospecti... [more] PURPOSE: The aim of the study was to investigate outcome differences between female and male patients after implantation of low-contact-stress (LCS) mobile-bearing total knee prostheses at a minimum follow-up of five years with respect to clinical and radiological parameters. METHODS: We retrospectively analysed 128 prostheses in 126 patients (90 women and 34 men) using our hospital database. Data was extracted with respect to range of motion (ROM), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, the Knee Society Score (KSS) and radiolucent lines on conventional X-rays. RESULTS: At follow-up, we observed no significant differences between female and male patients after LCS total knee prostheses. Benefit after implantation of LCS total knee prostheses after five years of minimum follow-up was not significantly different between female and male patients in terms of clinical outcome or radiolucent lines. CONCLUSIONS: We found no factors in favour of gender-specific total knee prostheses.
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1.57Impact points
Surgery for liver metastases originating from sarcoma-case series.
Langenbeck's archives of surgery / Deutsche Gesellschaft für Chirurgie. 07/2011; 396(7):1083-91.
Liver metastases originating from various types of sarcoma are a rare reason for hepatic resection. So far, even multicentre studies do hardly provide statistically relevant sample sizes. Thus, review of available data can provide surgeons with useful information in similar cases. Therefore, this st... [more] Liver metastases originating from various types of sarcoma are a rare reason for hepatic resection. So far, even multicentre studies do hardly provide statistically relevant sample sizes. Thus, review of available data can provide surgeons with useful information in similar cases. Therefore, this study can be regarded more as a contribution to this pool of data than as a stand-alone paper. The study includes 10 women and five men who underwent subtotal hepatic resection for solitary (n = 4) and multiple (n = 11) liver metastases originating from sarcoma. The median tumour diameter was 60 mm (range 20-200 mm). Morbidity was 33%. One patient died within 30 days after surgery. Resection was complete (R0) in 67%. Median overall survival was 33.6 months, 5-year survival 27%. The use of Pringle manoeuvre was significantly associated with poorer outcome (p = 0.014) and shorter period of recurrence-free survival (p = 0.012). Diameter of liver lesion over 50 mm showed significantly shorter recurrence-free survival (p = 0.042). Hepatic resection may be beneficial in patients with isolated sarcoma metastasis in the liver.
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1.88Impact points
Radiolucent lines in low-contact-stress mobile-bearing total knee arthroplasty: a blinded and matched case control study.
BMC musculoskeletal disorders. 06/2011; 12:142.
Low-contact-stress (LCS) mobile-bearing total knee arthroplasty (TKA) (Johnson & Johnson, New Brunswick, NJ; previously: DePuy, Warsawa, USA) provides excellent functional results and wear rates in long-term follow-up analyses. Radiological analysis shows radiolucent lines (RLL) appearing immedi... [more] Low-contact-stress (LCS) mobile-bearing total knee arthroplasty (TKA) (Johnson & Johnson, New Brunswick, NJ; previously: DePuy, Warsawa, USA) provides excellent functional results and wear rates in long-term follow-up analyses. Radiological analysis shows radiolucent lines (RLL) appearing immediately or two years after primary implantation, indicative of poor seat. Investigations proved RLL to be more frequent in uncemented TKA, resulting in a consensus to cement the tibial plateau, but their association with clinical findings and patients discomfort and knee pain is still unknown. 553 patients with 566 low-contact-stress (LCS) total knee prostheses were screened for continuous moderate knee pain. We compared tibial stress shielding classified by Ewald in patients suffering from pain with a matched, pain-free control group on blinded X-rays. We hypothesized a positive correlation between pain and radiolucency and higher frequency of such radiolucent lines in the most medial and most lateral zones of the tibial plateau. Twenty-eight patients suffered from knee pain in total. Radiolucencies were detected in 27 of these cases and in six out of 28 matched controls without knee pain. We could demonstrate a significant correlation of knee pain and radiolucencies, which appeared significantly more frequently in the outermost zones of the tibial plateau. Our findings suggest that radiolucent lines, representing poor implant seat, about the tibial plateau are associated with knee pain in LCS patients. Radiolucencies are observed more often in noncemented LCS, and cementing the tibial plateau might improve implant seat and reduce both radiolucent lines and associated knee pain.
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1.34Impact points
TAPP repair in a giant bilateral scrotal hernia - limits of a method.
ANZ journal of surgery. 12/2010; 80(12):947-8.
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1.83Impact points
Surgery for pathological proximal femoral fractures, excluding femoral head and neck fractures: resection vs. stabilisation.
International orthopaedics. 12/2010; 35(10):1537-43.
Pathological femoral head and neck fractures are commonly treated by arthroplasty. Treatment options for the trochanteric region or below are not clearly defined. The purpose of this retrospective, comparative, double-centre study was to analyse survival and influences on outcome according to the su... [more] Pathological femoral head and neck fractures are commonly treated by arthroplasty. Treatment options for the trochanteric region or below are not clearly defined. The purpose of this retrospective, comparative, double-centre study was to analyse survival and influences on outcome according to the surgical technique used to treat pathological proximal femoral fractures, excluding fractures of the femoral head and neck. Fifty-nine patients with 64 fractures were operated up on between 1998 and 2004 in two tertiary referral centres and divided into two groups. One group (S, n = 33) consisted of patients who underwent intramedullary nailing alone, and the other group (R, n = 31) consisted of patients treated by metastatic tissue resection and reconstruction by means of different implants. Median survival was 12.6 months with no difference between groups. Surgical complications were higher in the R group (n = 7) vs. the S group (n = 3), with no statistically significant difference. Patients with surgery-related complications had a higher survival rate (p = 0.049), as did patients with mechanical implant failure (p = 0.01). Survival scoring systems did not correlate with actual survival. Resection of metastases in patients with pathological fractures of the proximal femur, excluding femoral head and neck fractures, has no influence on survival. Patients with long postoperative survival prognosis are at risk of implant-related complications.
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1.91Impact points
A new fine-needle aspiration system.
Surgical innovation. 06/2010; 17(2):136-41.
The main reasons for fine needle aspiration (FNA) failure are insufficient number of cells in the sample, nonrepresentative samples, and contamination of samples. The aim of this study was to measure the number of cells harvested by a new needle system with an aeration aperture (Thyrosampler) in com... [more] The main reasons for fine needle aspiration (FNA) failure are insufficient number of cells in the sample, nonrepresentative samples, and contamination of samples. The aim of this study was to measure the number of cells harvested by a new needle system with an aeration aperture (Thyrosampler) in comparison with a conventional FNA system (C-FNA). Under a double-blind setting, 30 aspirations, 15 with each system (C-FNA, Thyrosampler), were done in randomized order and recorded. The median total number of cells was 59 680 cells/mL with C-FNA and 396 400 cells/mL with Thyrosampler. The needle system with the aeration aperture led to a significantly higher cell amount (564% more cells than the conventional system; P < .005) in needle aspiration biopsy. The new system with the vacuum release feature leads to a significantly higher cell amount in needle aspiration biopsy, which is a well-defined benefit.
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3.43Impact points
Quality of life after volar plate fixation of articular fractures of the distal part of the radius.
The Journal of bone and joint surgery. American volume. 05/2010; 92(5):1170-8.
Outcome measurement following surgery is increasingly the focus of attention in current health-care debates because of the rising costs of medical care and the large variety of operative options. The purpose of the present study was to correlate quality of life after volar locked plate fixation of u... [more] Outcome measurement following surgery is increasingly the focus of attention in current health-care debates because of the rising costs of medical care and the large variety of operative options. The purpose of the present study was to correlate quality of life after volar locked plate fixation of unstable intra-articular distal radial fractures with functional and radiographic results as well as with quality-of-life data from population norms. Fifty-four consecutive patients with intra-articular distal radial fractures and a mean age of sixty-three years were managed with a volar locked plate system. Range of motion, grip strength, and radiographs were assessed at a mean of six years postoperatively. The wrist-scoring systems of Gartland and Werley and Castaing were adopted for the assessment of objective outcomes. The Disabilities of the Arm, Shoulder and Hand and Short Form-36 questionnaires were completed as subjective outcome measures, and the results were compared with United States and Austrian population norms. Functional improvement continued for two years postoperatively. At the time of the latest follow-up, >90% of all patients had achieved good or excellent results according to the scoring systems of Gartland and Werley and Castaing. The results of the Short Form-36 questionnaire were similar to the United States and Austrian population norms. The mean Disabilities of the Arm, Shoulder and Hand score was 5 points at two years, and it increased to 13 points at six years. The twenty patients with radiocarpal arthritis had significantly poorer results in the physical component summary measure of the Short Form-36 questionnaire (p = 0.012). The results of the present single-center study show that, following distal radial fracture fixation, wrist arthritis may affect the patient's subjective well-being, as documented with the Short Form-36, without influencing the functional outcome. Well-designed longitudinal clinical trials are needed to confirm the findings of the present investigation in terms of quality of life after surgical treatment of intra-articular distal radial fractures.
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1.34Impact points
Interdisciplinary resection of a giant retroperitoneal liposarcoma of 25 kg.
ANZ journal of surgery. 12/2009; 79(12):957.
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2.02Impact points
No midterm benefit from low intensity pulsed ultrasound after chevron osteotomy for hallux valgus.
Ultrasound in medicine & biology. 07/2009;
Chevron osteotomy is a widely accepted method for correction of symptomatic hallux valgus deformity. Full weight bearing in regular shoes is not recommended before 6 weeks after surgery. Low intensity pulsed ultrasound is known to stimulate bone formation leading to more stable callus and faster bon... [more] Chevron osteotomy is a widely accepted method for correction of symptomatic hallux valgus deformity. Full weight bearing in regular shoes is not recommended before 6 weeks after surgery. Low intensity pulsed ultrasound is known to stimulate bone formation leading to more stable callus and faster bony fusion. We performed a randomized, placebo-controlled, double-blinded study on 44 participants (52 feet) who underwent chevron osteotomy to evaluate the influence of daily transcutaneous low intensity pulsed ultrasound (LIPUS) treatment at the site of osteotomy. Follow-up at 6 weeks and 1 year included plain dorsoplantar radiographs, hallux-metatarsophalangeal-interphalangeal scale and a questionnaire on patient satisfaction. There was no statistical difference in any pre- or postoperative clinical features, patient satisfaction or radiographic measurements (hallux valgus angle, intermetatarsal angle, sesamoid index and metatarsal index) except for the first distal metatarsal articular angle (DMAA). The DMAA showed statistically significant (p = 0.046) relapse in the placebo group upon comparison of intraoperative radiographs after correction and fixation (5.2 degrees) and at the 6-week follow-up (10.6 degrees). Despite potential impact of LIPUS on bone formation, we found no evidence of an influence on outcome 6 weeks and 1 year after chevron osteotomy for correction of hallux valgus deformity.
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1.93Impact points
Measurement of the acromiohumeral interval on standardized anteroposterior radiographs: A prospective study of observer variability.
Journal of shoulder and elbow surgery / American Shoulder and Elbow Surgeons ... [et al.]. 06/2009;
BACKGROUND: An acromiohumeral interval narrower than 6 mm has been considered pathologic and strongly indicative for rotator cuff tears by numerous authors. This prospective study assessed interobserver and intraobserver variability in the radiographic measurement of the acromiohumeral interval. MAT... [more] BACKGROUND: An acromiohumeral interval narrower than 6 mm has been considered pathologic and strongly indicative for rotator cuff tears by numerous authors. This prospective study assessed interobserver and intraobserver variability in the radiographic measurement of the acromiohumeral interval. MATERIAL AND METHODS: Five board-certified orthopedic surgeons independently reviewed 58 blinded, standardized anteroposterior shoulder radiographs. The acromiohumeral interval was measured in millimeters. The 5 investigators classified each image a second time in random order. RESULTS: After the same 58 radiographs had been evaluated by the 5 investigators at both examination time points, no significant differences were noted in the interobserver and intraobserver measurements (P < .05). The respective maximum interobserver and intraobserver differences were 4 and 3 mm (range, 0-4 mm). CONCLUSION: The assessment of the acromiohumeral interval using standardized anteroposterior radiographs is a reliable and reproducible method of measurement. LEVEL OF EVIDENCE: Level 1; Investigating a diagnostic test.
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0.85Impact points
Bizarre parosteal osteochondromatous proliferation (Nora lesion): a report of 3 cases and a review of the literature.
Canadian journal of surgery. Journal canadien de chirurgie. 01/2009; 51(6):486-9.
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1.96Impact points
Predictive value of seven preoperative prognostic scoring systems for spinal metastases.
European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. 10/2008;
Predicting prognosis is the key factor in selecting the proper treatment modality for patients with spinal metastases. Therefore, various assessment systems have been designed in order to provide a basis for deciding the course of treatment. Such systems have been proposed by Tokuhashi, Sioutos, Tom... [more] Predicting prognosis is the key factor in selecting the proper treatment modality for patients with spinal metastases. Therefore, various assessment systems have been designed in order to provide a basis for deciding the course of treatment. Such systems have been proposed by Tokuhashi, Sioutos, Tomita, Van der Linden, and Bauer. The scores differ greatly in the kind of parameters assessed. The aim of this study was to evaluate the prognostic value of each score. Eight parameters were assessed for 69 patients (37 male, 32 female): location, general condition, number of extraspinal bone metastases, number of spinal metastases, visceral metastases, primary tumour, severity of spinal cord palsy, and pathological fracture. Scores according to Tokuhashi (original and revised), Sioutos, Tomita, Van der Linden, and Bauer were assessed as well as a modified Bauer score without scoring for pathologic fracture. Nineteen patients were still alive as of September 2006 with a minimum follow-up of 12 months. All other patients died after a mean period of 17 months after operation. The mean overall survival period was only 3 months for lung cancer, followed by prostate (7 months), kidney (23 months), breast (35 months), and multiple myeloma (51 months). At univariate survival analysis, primary tumour and visceral metastases were significant parameters, while Karnofsky score was only significant in the group including myeloma patients. In multivariate analysis of all seven parameters assessed, primary tumour and visceral metastases were the only significant parameters. Of all seven scoring systems, the original Bauer score and a Bauer score without scoring for pathologic fracture had the best association with survival (P < 0.001). The data of the present study emphasize that the original Bauer score and a modified Bauer score without scoring for pathologic fracture seem to be practicable and highly predictive preoperative scoring systems for patients with spinal metastases. However, decision for or against surgery should never be based alone on a prognostic score but should take symptoms like pain or neurological compromise into account.
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1.12Impact points
Surgical treatment of distal radius fractures with an angle fixed bar palmar plating system: a single center study of 102 patients over a 2-year period.
Archives of orthopaedic and trauma surgery. 01/2007; 126(10):680-5.
INTRODUCTION: Most fractures of the distal radius can be treated by conservative means; however, unstable distal radius fractures (DRFs) require surgical fixation. The purpose of this study was to evaluate functional and radiographic results of DRFs treated with a palmar plating system regarding pat... [more] INTRODUCTION: Most fractures of the distal radius can be treated by conservative means; however, unstable distal radius fractures (DRFs) require surgical fixation. The purpose of this study was to evaluate functional and radiographic results of DRFs treated with a palmar plating system regarding patient's quality of life. METHODS: This study reports a total number of 104 DRFs in 102 patients, operatively treated, over a 2-year period with a mean follow up time of 15.6 +/- 7.2 months The patient's average age was 59.9 +/- 18.0 years. The results were evaluated according to the scores of Gartland and Werley, Castaing and the disabilities of the arm, shoulder, and hand (DASH) outcome questionnaire. RESULTS: Ninety-three patients were evaluated at final examination. Excellent and good results were achieved for 92 (98.9%) patients according to score of Gartland and Werley and for 86 (92.5%) patients regarding the scoring system of Castaing. The DASH outcome questionnaire averaged 8.0 +/- 13.7 points. INTERPRETATION: This study shows, in a representative number of cases, that palmar plating of unstable fractures of the distal radius is a safe and effective treatment modality. Early surgical treatment results in optimal outcome regarding patient's quality of life.
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Minimal-invasive treatment of distal femoral fractures with the LISS (Less Invasive Stabilization System): a prospective study of 30 fractures with a follow up of 20 months.
Acta orthopaedica Scandinavica. 03/2004; 75(1):56-60.
BACKGROUND: There is no consensus on the best treatment of distal femoral fractures. PATIENTS AND METHODS: In a prospective study, we treated 29 patients with 30 distal femoral fractures with the Less Invasive Stabilization System (LISS) from 1997 to 2000. Almost 1/2 of them had open fractures, 1/3 ... [more] BACKGROUND: There is no consensus on the best treatment of distal femoral fractures. PATIENTS AND METHODS: In a prospective study, we treated 29 patients with 30 distal femoral fractures with the Less Invasive Stabilization System (LISS) from 1997 to 2000. Almost 1/2 of them had open fractures, 1/3 extraarticular type A and 2/3 articular fractures type C (AO classification) and these had been caused by high-energy trauma with concomitant severe injuries or osteoporosis. RESULTS: The follow-up examinations after mean 20 (13-42) months consisted of radiographs, and determination of the Lysholm Knee Score and Knee Society Score (KSS). The outcome correlated with the severity of the fracture, anatomic reduction, exact positioning and fixation of the LISS and concomitant injuries. INTERPRETATION: We found the LISS for treatment of distal femoral fractures of all types to be a safe procedure with good results after careful planning and experience with this surgical technique. There is usually no need for primary cancellous bone grafting.
Following (8)
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Johannes Zacherl
Medical University of Vienna -
Patrick Weber
Ludwig-Maximilians-Universität München -
Katharina Leithner
Medizinische Universität Graz -
Vilmos Vecsei
Medical University of Vienna -
Mathias Glehr
Medizinische Universität Graz
Topics (2)
