Mathias Glehr
Research interests
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InterestsArthroplasty, Orthopaedic Surgery, Spine Surgery, Back Pain, Manual Therapy, Rehabilitation, Rehabilitation Sciences, Sports Injuries, Sports Biomechanics
Publications
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1.24Impact points
No adverse affect after harvesting of free fibula osteoseptocutaneous flaps on gait function.
Microsurgery. 03/2012;
The aim of this study was to analyze gait function and muscular strength on donor site after harvesting of a vascularized fibula osteoseptocutaneous flap. Nine patients with a mean follow-up of 33 months (range, 7-59) and a mean resection length of the middle portion of the fibula of 18.0 cm (range,... [more] The aim of this study was to analyze gait function and muscular strength on donor site after harvesting of a vascularized fibula osteoseptocutaneous flap. Nine patients with a mean follow-up of 33 months (range, 7-59) and a mean resection length of the middle portion of the fibula of 18.0 cm (range, 14.0-23.0) underwent an instrumented three-dimensional gait analysis to evaluate gait function. Furthermore, CYBEX II extremity system was used for muscular strength measurements. Subjective muscle strength measurements were performed according to Kendall et al. and were classified according to the British Medical Research Council. Intraindividual comparison between the operated and the nonoperated leg revealed no significant differences for gait function parameters (cadence, velocity, and stride length, P > 1.00) and for muscular strength measurements for flexion (knee: P = 0.93, ankle: P = 0.54) and extension (knee: P = 0.97, ankle: P= 0.21), respectively. In conclusion, intraindividual comparison of the operated and nonoperated sides after harvesting of the middle portion of the fibula for gaining a free fibula osteoseptocutaneous flap has no adverse affect on gait function or muscular flexion and extension strength on donor site at a mean follow-up of 33 months. © 2012 Wiley Periodicals, Inc. Microsurgery, 2012.
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0.59Impact points
In Vivo Testing of Knee Stability After Rotating-hinge Total Knee Arthroplasty: A Comparison of 2 Knee Systems.
Orthopedics. 03/2012; 35(3):e335-42.
Rotating-hinge knee prostheses are used for reconstruction in cases of severe articular compromise and major bone loss. Biomechanical studies revealed that rotating-hinge designs with long and cylindrical pegs are more stable than devices with short and more tapered ones. Twenty-five patients underw... [more] Rotating-hinge knee prostheses are used for reconstruction in cases of severe articular compromise and major bone loss. Biomechanical studies revealed that rotating-hinge designs with long and cylindrical pegs are more stable than devices with short and more tapered ones. Twenty-five patients underwent clinical examination using ultrasound, radiographs, and 3 different rating systems to examine the in vivo stability and functional outcome of 2 rotating-hinge knee systems.Overall, the study revealed that a stable reconstruction could be achieved with both tested devices, with good functional outcome. The results for medial and lateral lift-off during flexion and extension in ultrasonography were comparable, whereas the measured distraction of the Limb Preservation System (LPS/M.B.T.; DePuy, Warsaw, Indiana) was lower compared with the S-ROM Noiles prostheses (DePuy).The implant, the new formed capsule, and the remaining soft tissues have to maintain joint stability. Soft tissue reconstruction, especially the medial gastrocnemius flap, and the newly formed periprosthetic scar seems to prevent distraction of several millimeters. In addition, determining the lift-off with ultrasonography showed that the shape of the peg does not influence implant's stability against lateral directed forces.
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1.83Impact points
Failure rate of a rotating hinge knee design due to yoke fracture of the hinged tibial insert: a retrospective data analysis and review of the literature.
International orthopaedics. 12/2011;
PURPOSE: Rotating hinge knee prostheses are known to provide inherent stability. Yoke fractures of the hinged tibial insert of modern generation rotating hinge devices are a matter of continued concern. The aim of this study was to describe incidence and management of yoke fracture of the LPS™ hinge... [more] PURPOSE: Rotating hinge knee prostheses are known to provide inherent stability. Yoke fractures of the hinged tibial insert of modern generation rotating hinge devices are a matter of continued concern. The aim of this study was to describe incidence and management of yoke fracture of the LPS™ hinged tibial insert. METHODS: Retrospective data analysis of two institutions identified 40 patients with a LPS™ total knee arthroplasty. Implant survival and prosthetic complications was calculated according to Kaplan-Meier. RESULTS: Out of the group of 40 patients, four fractures of the metal yoke occurred in four cases (failure rate: 10%). Furthermore, a second fracture occurred in two patients. The overall revision-free prosthetic survival was 57% at 38 months, while prosthetic survival until yoke fracture was 86% at 38 months. CONCLUSION: Handling yoke fractures as mechanical complication includes replacing the hinged insert, stabilization of the joint and joint line height preservation in order to decrease the cantilever effect at the insert-base plate interface.
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2.10Impact points
Misdiagnosis of an atypically located inflamed proctodeal gland mimicking deep infiltrating endometriosis.
International journal of colorectal disease. 11/2011;
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2.51Impact points
Regulation of MMP3 by laminin alpha 4 in human osteoarthritic cartilage.
Scandinavian journal of rheumatology. 11/2011; 40(6):494-6.
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2.51Impact points
Recording of risk-factors and lifestyle counselling in patients at high risk for cardiovascular diseases in European primary care.
European journal of cardiovascular prevention and rehabilitation : official journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology. 03/2011;
Background: Detection and registration of high risk for cardiovascular diseases (CVD) by assessing individual's absolute cardiovascular risk is recommended in clinical guidelines. Effective interventions to reduce cardiovascular risk are available, but not optimally implemented. The aim of this ... [more] Background: Detection and registration of high risk for cardiovascular diseases (CVD) by assessing individual's absolute cardiovascular risk is recommended in clinical guidelines. Effective interventions to reduce cardiovascular risk are available, but not optimally implemented. The aim of this study was to assess the quality of cardiovascular risk-factor recording and lifestyle counselling in high-risk patients in European primary care and to identify factors related to these clinical processes. Methods: An international cross-sectional observational study was conducted in stratified samples of primary care practices in nine European countries. Patient records were audited, using a structured data-abstraction tool based on internationally developed quality indicators. To identify factors associated with the recording, additional data were collected in a patient survey. Descriptive and multilevel data analyses were conducted. Results: In 268 general practices across Europe, 3723 records of individuals at high risk for cardiovascular diseases were audited. We found important variations in the quality of documentation of risk factors and lifestyle interventions. Recording of risk factors was best for blood pressure (92.5% of audited records, 95% CI 0.89-0.96). Lifestyle advice was recorded best for smoking cessation (65.6%, 95% CI 0.58-0.73) and worst for physical activity (38.8%, 95% CI 0.31-0.47). Of the study population, 50.6% (0.42-0.59) had elevated blood pressure levels, 59.8% (0.51-0.69) had total cholesterol >5 mmol/l, and 30.5% (0.22-0.39) were smokers. Multivariate analyses showed that recording of risk factors and counselling were related to specific patient characteristics more than to country effects. Conclusions: Analysis of different country results can be helpful for developing quality-improvement strategies.
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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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0.31Impact points
[Clinical and radiological outcome after trapezium resection with suspension and interposition arthroplasty].
Zeitschrift für Orthopädie und Unfallchirurgie. 02/2010; 148(3):326-31.
Trapezium resection with suspension and interposition arthroplasty of the thumb-carpometacarpal joint is a common method for treatment of severe osteoarthritis of the 1st carpometacarpal joint. We performed a single center retrospective data analysis after trapezium resection with suspension and int... [more] Trapezium resection with suspension and interposition arthroplasty of the thumb-carpometacarpal joint is a common method for treatment of severe osteoarthritis of the 1st carpometacarpal joint. We performed a single center retrospective data analysis after trapezium resection with suspension and interposition arthroplasty of the thumb-carpometacarpal joint with emphasis on quality of life and radiological parameters 3.4 years (1.2-8.7 years) after operation in 60 patients. Pre- and postoperative pain was analysed with VAS, function was measured using the DASH score, pinch grip power with a pinchmeter. Subjective outcome was rated excellent in 42 cases (64.6%), good in 17 (26.2%), fair in 3 (4.6%) and 3 times (4.6%) poor. 56 patients (93.3%) would like to be operated again; 4 patients (6.7%) would deny an operation retrospectively. In the VAS pain was reduced by about 75% compared to the preoperative value. The pinch grip was increased by 46.6% compared to the preoperative value. The rate of major complications was 1.5% and of minor complications 9.2 %. Trapezium resection with suspension and interposition arthroplasty can increase the quality of life and reduce pain in patients with severe osteoarthritis of the 1st carpometacarpal joint. The rate of complications is low. Outcome assessment is possible by subjective parameters. Objective values like the range of movement or the decrease of the distance between metacarpal I and scaphoid do not correlate with outcome.
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1.12Impact points
The threat of misdiagnosis of primary osteosarcoma over the age of 60: a series of seven cases and review of the literature.
Archives of orthopaedic and trauma surgery. 11/2009;
BACKGROUND: Osteosarcoma is the most common, non-haematopoietic, primary malignant bone tumour with an incidence of 0.3-0.5 per 100,000. There is some discrepancy in literature concerning the peaks of incidence of osteosarcoma. Some describe only one peak which arises in adolescence, whilst others r... [more] BACKGROUND: Osteosarcoma is the most common, non-haematopoietic, primary malignant bone tumour with an incidence of 0.3-0.5 per 100,000. There is some discrepancy in literature concerning the peaks of incidence of osteosarcoma. Some describe only one peak which arises in adolescence, whilst others report a bimodal age distribution with a second peak over the age of 60. In this retrospective study, we evaluated osteosarcoma patients over age 60 treated at our department and reviewed previous studies from the literature. PATIENTS AND METHODS: Sixty-four patients (40 male, 24 female) with a mean age of 29 years (from 7 to 82) were treated for primary osteosarcomas. At the time of diagnosis, seven patients (two male and five female) were over 60 years of age with a mean follow-up of 46 months after definite diagnosis. RESULTS: Three out of seven osteosarcomas were primarily radiologically or histologically misdiagnosed, but only one was mistreated with intramedullary nailing at a trauma centre. At last follow-up, two patients had died from the disease, three were alive with disease, and two had no evidence of osteosarcoma. CONCLUSIONS: We did not find an increased incidence of primary osteosarcoma in the elderly; yet, older patients had a higher rate of misdiagnosis due to untypical radiological findings in combination with longer times from the onset of first symptoms to definite diagnosis. In cases of pathological fracture, it is essential to assess whether it is caused by mechanical stress or a primary or secondary tumour before leading into mistreatment, especially in older patients.
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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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0.54Impact points
[Surgical treatment of pathologic fractures of the humerus and femur.]
Der Orthopäde. 05/2009; 38(4):324-34.
The life expectancy of patients with malignant tumours and the incidence of osseous metastases have increased over the last decades. Operations for skeletal metastases of the extremities represent the most frequent surgery in orthopaedic oncology. The purpose of this study was to evaluate and compar... [more] The life expectancy of patients with malignant tumours and the incidence of osseous metastases have increased over the last decades. Operations for skeletal metastases of the extremities represent the most frequent surgery in orthopaedic oncology. The purpose of this study was to evaluate and compare the different operative treatment options for patients with pathologic fractures of the humerus and femur in terms of complications, postoperative recovery, and survival.From 2000 to 2005, 109 patients were surgically treated for pathologic fractures of the humerus (n=19) or femur (n=90). The study group consisted of 60 women and 43 men, with a mean age of 67 years (13-88). Breast carcinoma (36%) was the most common primary tumour, followed by kidney (17%) and bronchial (16%) carcinoma. Of all patients, 75 (73%) had numerous skeletal metastases, and 38 (37%) had visceral metastases.Wide or marginal resection was performed in seven fractures of the humerus and 14 fractures of the femur; intralesional resection was done in seven humeral and 73 femoral fractures; and stabilisation alone was done in five fractures of the humerus and three fractures of the femur. The median survival time for all patients was 6 months (0-102). The survival rate at 1 year was 25% (25% for both humeral and femoral fractures), 15% at 2 years (17% for humeral and 15% for femoral fractures), and 8% at 3 years (16% for humeral and 7% for femoral fractures). The overall complication rate was 11%, and revision surgeries were performed in seven patients (6.4%). The majority of patients (n=65; 60%), especially those with fractures close to the articular joint, were successfully treated with endoprosthetic replacement. Patients with fractures stabilised by intramedullary nails had shorter operating times, a shorter hospital stay, and fewer complications than patients treated with plating systems. Therefore, we recommend intralesional resection of the metastasis and stabilisation with intramedullary devices, supported by bone cement, as the treatment of choice for pathologic fractures of the diaphysis and metaphysis of the humerus and femur. Wide resection should be reserved for selected cases, such as solitary bone metastasis of kidney carcinoma.
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0.65Impact points
[Evaluation of macroamputations of the upper extremity in the management of primary malignant bone and soft-tissue tumours using the DASH score]
Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft für Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft für Mikrochirurgie der Peripheren Nerven und Gefässe : Organ der Vereinigung der Deutschen Plastischen Chirurgen. 03/2008; 40(1):19-22.
PURPOSE/BACKGROUND: The purpose of this retrospective analysis was to identify patients with macroamputations of the upper extremity due to malignant bone or soft-tissue tumours at a single institution. The German DASH score (Disability of Arm, Shoulder, Hand) was obtained in order to measure how pa... [more] PURPOSE/BACKGROUND: The purpose of this retrospective analysis was to identify patients with macroamputations of the upper extremity due to malignant bone or soft-tissue tumours at a single institution. The German DASH score (Disability of Arm, Shoulder, Hand) was obtained in order to measure how patients manage their daily activities. PATIENTS AND METHODS: Between 1998 and 2005, 1652 patients were operated due to a bone or soft-tissue tumour, 370 of these due to a malignant one (22 %). The tumour was localised in the lower extremity or in the pelvis in 246 cases, in the trunk in 38 and in the upper extremity in 86 cases. These 86 primary malignant tumours comprised 22 bone and 64 soft tissue tumours. Amputations had to be performed in the lower extremity in 14 % (35/246) and in the upper extremity in 7 % (6/86). Six patients with macroamputations of the upper extremity were identified and in five of these the DASH score was obtained. RESULTS: The mean DASH score for the module 1 (disability/symptom) was 75.1 points ([sum of responses - 30]/1.2), for module 2 (work) 92.4 ([sum of responses - 4]/0.16), and for module 3 (sports/performing arts) 90 points ([sum of responses - 4]/0.16). Only two patients worked again and only one played an instrument. CONCLUSION: Despite neo-/adjuvant therapeutic options and modified reconstructive procedures 7 % of patients with malignant bone or soft tissue tumours of the upper extremity had to undergo an amputation. The DASH score is an appropriate instrument to measure the disability after upper limb amputation due to tumour.
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0.42Impact points
[A case of a tumorsimulating expansion caused by anabolic androgen steroids in body building]
Sportverletzung Sportschaden : Organ der Gesellschaft für Orthopädisch-Traumatologische Sportmedizin. 01/2008; 21(4):195-8.
Despite intensive information on possible side effects and complications of performance-enhancing substances in sports, the use of AAS (anabolic androgen steroids) is far common. Particularly in sports like bodybuilding or weight lifting AAS are used for setting up muscle mass and increasing muscle ... [more] Despite intensive information on possible side effects and complications of performance-enhancing substances in sports, the use of AAS (anabolic androgen steroids) is far common. Particularly in sports like bodybuilding or weight lifting AAS are used for setting up muscle mass and increasing muscle power. We present the case of a 27 year old bodybuilder, who was transferred due to suspected malignant expansion of the upper limb to a department of orthopaedic surgery, not knowing that the patient had injected AAS. At biopsy the tumor was found to be an abscess formation, that had to be treated surgically with curettage. The microbiological analysis detected an infection with Pseudomonas fluorescens and Erwinia species. Erwinia species are associated with plants, Pseudomonas fluorescens is found in feces, sewage and soil. It is obvious, that the infection is caused by an inappropriate injection of AAS or by the contamination of the injected substances.
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Soft tissue sarcomas: evaluation of a new aspiration-cytology-system
20th Annual EMSOS Meeting; 05/2007
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3.97Impact points
Wikipedia and osteosarcoma: a trustworthy patients' information?
Journal of the American Medical Informatics Association : JAMIA. 17(4):373-4.
The English version of the online encyclopedia, Wikipedia, has been recently reported to be the prominent source of online health information. However, there is little information concerning the quality of information found in Wikipedia. Therefore, we created a questionnaire asking for scope, comple... [more] The English version of the online encyclopedia, Wikipedia, has been recently reported to be the prominent source of online health information. However, there is little information concerning the quality of information found in Wikipedia. Therefore, we created a questionnaire asking for scope, completeness, and accuracy of information found on osteosarcoma. Three independent observers tested the English version of Wikipedia, as well as the patient version and the health professional version of the US National Cancer Institute (NCI) website. Answers were verified with authoritative resources and international guidelines. The results of our study demonstrate that the quality of osteosarcoma-related information found in the English Wikipedia is good but inferior to the patient information provided by the NCI. Therefore, non-peer-reviewed commonly used websites offering health information, such as Wikipedia, should include links to more definitive sources, such as those maintained by the NCI and professional international organizations on healthcare treatments. Furthermore, frequent checks should make sure such external links are to the highest quality and to the best-maintained aggregate sites on a given healthcare topic.
Following (8)
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Koppany Bodo
Medical Universitiy Graz -
Florentine Fürst
Medizinische Universität Graz -
Katharina Leithner
Medizinische Universität Graz -
Gerwin Alexander Bernhardt
Medizinische Universität Graz -
Joerg Friesenbichler
Medizinische Universität Graz
Topics (11)
