F. von Lübken

Bundeswehrkrankenhaus Ulm, Ulm, Baden-Württemberg, Germany

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Publications (17)15 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Due to the negative effects of meniscectomy, there is a need for an adequate material to replace damaged meniscal tissue. To date, no material tested has been able to replace the meniscus sufficiently. Therefore, a new silk fibroin scaffold was investigated in an in vivo sheep model. Partial meniscectomy was carried out to the medial meniscus of 28 sheep, and a scaffold was implanted in 19 menisci (3-month scaffold group, n = 9; 6-month scaffold group, n = 10). In 9 sheep, the defect remained empty (partial meniscectomy group). Sham operation was performed in 9 animals. The silk scaffold was able to withstand the loads experienced during the implantation period. It caused no inflammatory reaction in the joint 6 months postoperatively, and there were no significant differences in cartilage degeneration between the scaffold and sham groups. The compressive properties of the scaffold approached those of meniscal tissue. However, the scaffolds were not always stably fixed in the defect, leading to gapping between implant and host tissue or to total loss of the implant in 3 of 9 cases in each scaffold group. Hence, the fixation technique needs to be improved to achieve a better integration into the host tissue, and the long-term performance of the scaffolds should be further investigated. These first in vivo results on a new silk fibroin scaffold provide the basis for further meniscal implant development. Whilst more data are required, there is preliminary evidence of chondroprotective properties, and the compressive properties and biocompatibility are promising.
    Knee Surgery Sports Traumatology Arthroscopy 04/2014; · 2.68 Impact Factor
  • Ultrasound in Medicine and Biology - ULTRASOUND MED BIOL. 01/2011; 37(8).
  • H-G Palm, C Laufer, F von Lübken, G Achatz, B Friemert
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    ABSTRACT: Meniscal lesions are known to cause a loss of proprioception, which plays an important role in the regulation of postural stability. It is unclear, however, whether meniscus injuries adversely affect not only the sense of joint position but also postural control. The objective of this study was to investigate the influence of meniscal lesions on postural stability. In this prospective study, postural stability was assessed by posturography in 27 patients with unilateral meniscal lesions. Both the injured and uninjured legs were tested and compared for significant differences using a t-test. Despite the presence of an arthroscopically confirmed meniscal lesion, none of the stability indexes that we calculated revealed significant differences in postural stability between the injured and uninjured sides. It was surprising to note that the loss of proprioception in patients with meniscus injuries did not influence postural stability. Patients with functional knee instability must therefore be examined for the presence of further injuries because a meniscal lesion alone cannot explain instability symptoms.
    Der Orthopäde 05/2010; 39(5):486-94. · 0.51 Impact Factor
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    ABSTRACT: Since 1992 the German Bundeswehr has been deployed for securing peace and peacekeeping abroad. Since then 83 German soldiers have been killed and overall 129 wounded in action as of 07.12.2009. In Northern Afghanistan the German Bundeswehr runs a combat support hospital (role 3) in Mazar-e-Sharif providing a multidisciplinary capability profile. Furthermore, there are two role 2 medical treatment facilities for primary surgical trauma care located in Kunduz and Feyzabad. In these role 2 facilities life saving procedures and damage control operations are performed in order to enable rapid evacuation to a higher level of care. Thereby military surgeons are often confronted with various medical and logistic challenges. The German Navy also has two equivalent role 2 medical treatment facilities (Naval Rescue Centers) aboard its two combat support ships (CSS) "Berlin" and "Frankfurt am Main" to support maritime task groups operating worldwide. These floating field hospitals provide an indispensable asset in the medical emergency care of naval operations with difficult space-time factors. Due to the specific operating alliance between CSS and Naval Rescue Center, special operations as well as evacuation and humanitarian missions following disasters near the coastline can be effectively accomplished.
    Der Unfallchirurg 02/2010; 113(2):91-8. · 0.64 Impact Factor
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    ABSTRACT: HintergrundMeniskusläsionen führen nachweislich zu einer reduzierten Gelenkpropriozeption, welche wiederum wichtiger Regulator der posturalen Standfähigkeit ist. Bisher ist aber völlig unklar, ob Meniskusverletzungen neben dem Gelenkstellungssinn auch die posturale Kontrolle beeinträchtigen. Ziel der Studie war daher, den Einfluss von Meniskusläsionen auf die posturale Stabilität zu untersuchen. Material und MethodenIm Rahmen dieser prospektiven Studie wurde bei 27Patienten mit unilateraler Meniskusläsion die posturale Stabilität des erkrankten und gesunden Kniegelenks mittels Posturographie bestimmt und auf signifikante Unterschiede (t-Test) untersucht. ErgebnisseBei allen Stabilitätsindizes wurde trotz arthroskopisch nachgewiesener Meniskusläsion keine signifikante Verschlechterung der posturalen Stabilität im Seitenvergleich beobachtet. SchlussfolgerungenDie bei Meniskusverletzungen eingeschränkte Gelenkpropriozeption bleibt erstaunlicherweise ohne Auswirkungen auf den stabilen Stand. Bei Patienten mit funktioneller Gelenkinstabilität muss daher unbedingt nach weiteren Verletzungen gesucht werden, da eine Meniskusläsion allein nicht die Beschwerden erklären kann. BackgroundMeniscal lesions are known to cause a loss of proprioception, which plays an important role in the regulation of postural stability. It is unclear, however, whether meniscus injuries adversely affect not only the sense of joint position but also postural control. The objective of this study was to investigate the influence of meniscal lesions on postural stability. Material and methodsIn this prospective study, postural stability was assessed by posturography in 27 patients with unilateral meniscal lesions. Both the injured and uninjured legs were tested and compared for significant differences using a t-test. ResultsDespite the presence of an arthroscopically confirmed meniscal lesion, none of the stability indexes that we calculated revealed significant differences in postural stability between the injured and uninjured sides. ConclusionsIt was surprising to note that the loss of proprioception in patients with meniscus injuries did not influence postural stability. Patients with functional knee instability must therefore be examined for the presence of further injuries because a meniscal lesion alone cannot explain instability symptoms. SchlüsselwörterPosturale Stabilität-Posturographie-Meniskus-Knie-Propriozeption KeywordsPostural stability-Posturography-Meniscus-Knee-Proprioception
    Der Orthopäde 01/2010; 39(5):486-494. · 0.51 Impact Factor
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    ABSTRACT: Seit 1992 wird die Bundeswehr zu friedenserhaltenden und -sichernden Maßnahmen außerhalb der Bundesrepublik Deutschland eingesetzt. Bei Auslandseinsätzen kamen bisher 83 Soldaten ums Leben, insgesamt 129 wurden durch Fremdeinwirkung verwundet (Stand 07.12.2009). Zur sanitätsdienstlichen Versorgung der Soldaten in Nordafghanistan betreibt die Bundeswehr in Mazar-i-Scharif ein Einsatzlazarett mit multidisziplinärem Leistungsspektrum, außerdem 2 Rettungszentren in Kunduz und Faizabad zur notfallchirurgischen Erstversorgung. In den Rettungszentren werden lebensrettende und stabilisierende Operationen durchgeführt, um die schnelle Evakuierung in eine Sanitätseinrichtung der nächsthöheren Versorgungsebene und schließlich die Rückführung in das Heimatland zu ermöglichen. Dabei sieht sich der Militärchirurg mit vielfältigen sowohl medizinischen als auch logistischen Herausforderungen konfrontiert. Eine Besonderheit ist das weltweit einsetzbare Marineeinsatzrettungszentrum (MERZ) zur sanitätsdienstlichen Versorgung maritimer Einsatzverbände, das containergestützt an Bord eines Einsatzgruppenversorgers (EGV) betrieben wird. Die „schwimmenden Lazarette“ stellen im Rahmen der medizinischen (Notfall-)Versorgung bei der Planung und Durchführung von Einsätzen in Seegebieten mit schwierigen Raum- und Zeitfaktoren ein unverzichtbares Element dar. Durch den besonderen Wirkverbund zwischen EGV und MERZ sind zudem Spezialoperationen, Evakuierungen und humanitäre Einsätze bei küstennahen Naturkatastrophen möglich. Since 1992 the German Bundeswehr has been deployed for securing peace and peacekeeping abroad. Since then 83 German soldiers have been killed and overall 129 wounded in action as of 07.12.2009. In Northern Afghanistan the German Bundeswehr runs a combat support hospital (role 3) in Mazar-e-Sharif providing a multidisciplinary capability profile. Furthermore, there are two role 2 medical treatment facilities for primary surgical trauma care located in Kunduz and Feyzabad. In these role 2 facilities life saving procedures and damage control operations are performed in order to enable rapid evacuation to a higher level of care. Thereby military surgeons are often confronted with various medical and logistic challenges. The German Navy also has two equivalent role 2 medical treatment facilities (Naval Rescue Centers) aboard its two combat support ships (CSS) “Berlin” and “Frankfurt am Main” to support maritime task groups operating worldwide. These floating field hospitals provide an indispensable asset in the medical emergency care of naval operations with difficult space-time factors. Due to the specific operating alliance between CSS and Naval Rescue Center, special operations as well as evacuation and humanitarian missions following disasters near the coastline can be effectively accomplished.
    Der Unfallchirurg 01/2010; 113(2):91-98. · 0.64 Impact Factor
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    ABSTRACT: Maintaining balance requires the integration of vestibular, proprioceptive and visual information and the translation of this input into appropriate motor responses. Although the role of the visual system has been widely investigated, there are no studies addressing the influence of non-specific distracting auditory inputs on postural stability. To analyze the role of the visual and auditory systems in the maintenance of postural stability and to assess potential interaction between the two sensory systems. Twenty-three healthy subjects were examined by computerized dynamic posturography. Stability index scores were calculated under each of six conditions: three visual conditions (sway feedback, eyes open without feedback, eyes closed) were combined with two auditory conditions (exposure or no exposure to non-specific auditory input). Analysis of variance (ANOVA) was used to test for differences among groups in the six test conditions. Postural stability was much poorer in the eyes-closed (overall stability index (OSI): 6.8+/-2.1 degrees) than in the eyes-open condition (OSI: 2.2+/-1.2 degrees). Balance control significantly improved with visual feedback (OSI: 1.2+/-0.5 degrees). Exposure to non-specific auditory input (music through headphones) did not have a significant influence (OSI: 6.4+/-2.3 degrees /2.0+/-0.9 degrees /1.1+/-0.5 degrees). Postural stability depended not only on whether the subjects were tested with their eyes open or closed but also on the presence or absence of visual feedback. Non-specific auditory information did not influence postural control. Since postural stability is regulated by multiple senses such as the vestibular system and proprioception, auditory stimuli may play an increasing role if one of the systems involved is impaired.
    Gait & posture 08/2009; 30(3):328-33. · 2.58 Impact Factor
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    ABSTRACT: Age-related changes in neuromuscular function may have adverse effects on hamstring reflex activity and may impair knee joint stability. The aim of this study was to investigate whether increasing age affects hamstring short latency responses (SLR), medium latency responses (MLR), and anterior tibial translation. In 40 healthy subjects ranging from 20 to 70 years of age we assessed hamstring muscle latencies and integrals for both hamstring reflex components (SLRs and MLRs) as well as anterior tibial translation in order to quantify knee joint stability in response to induced tibial translation during stance. The results showed no significant differences within the subject population in hamstring SLR and MLR latencies and integrals or anterior tibial translation. More precisely, regression analysis did not reveal any correlation between age and the aforementioned parameters. Our findings suggest that functional knee stability in terms of anterior tibial translation appears to be unaffected from people 20 to 70 years of age. Thus, as compared with younger people, older people - at least those under 70 years of age - do not appear to have a higher risk of ligamentous knee injuries associated with hamstring dysfunction. Further studies should be conducted to assess whether the present findings also apply to dynamic real-world situations. This would improve the understanding of the relationship between knee stability and ageing.
    Arbeitsphysiologie 08/2008; 103(5):523-7. · 2.66 Impact Factor
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    ABSTRACT: Measurement of the pressure during V.A.C.(R)-therapy in superficial parts of the affected soft tissue as well as at the soft tissue/foam-interface, measurement of pressure values along bigger distances in the foam and the comparison of pressure transfer between polyurethane and polyvinyl-alcohol foams. A multi-channel electronic transducer-tipped catheter system based on the piezo-resistant principle was used. Measurement was performed on a plain table surface, at a bovine muscle as well as in human tibial anterior muscle of a patient after fasciotomy. Applied pressure values by V.A.C.(R)-therapy-units were 50 to 200 mm Hg (continuous suction modus). 100 % pressure transition through vacuum-therapy-foams to wound surface, almost 100 % pressure transition even along 60 cm in very large polyurethane-foams using only one trac-pad connector. Pressure values > 125 mm Hg using polyvinyl-alcohol-foams showed a reduction of up to 25 % in distances > 15 cm from trac-pad-connector. On the surface of the affected soft tissue there are negative and positive pressure values (25 % quartile: - 25 mm Hg; 75 % quartile: + 15 mm Hg). Pore walls of the foam can produce positive pressure conditions resulting in soft tissue compression and consecutively hypoperfusion or ischemia. V.A.C.(R)-therapy seems to produce an heterogeneity of pressure distribution at the wound ground leading to pressure gradients and facilitating drainage of interstitial fluid. This mechanism could explain the anti-edema effects of V.A.C.(R)-therapy resulting indirectly in an increased nutritive perfusion.
    Zentralblatt für Chirurgie 05/2006; 131 Suppl 1:S50-61. · 0.69 Impact Factor
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    ABSTRACT: A ruptured anterior cruciate ligament (ACL) leads to both mechanical and functional instability. Functional instability is caused by proprioceptive deficit. The aim of this study was to determine whether the proprioceptive deficit can be reduced by using a controlled active motion (CAM) splint postoperatively. A total of 50 patients with ACL rupture were randomized into two groups. After ACL plasty the PT group received postoperative physiotherapy, while the CAM group were managed with a CAM splint and physiotherapy. Proprioceptive ability was measured with a passive angle-reproduction test. On the day of discharge 80% of the patients in the CAM group and 25% in the PT group had a reduced proprioceptive deficit. Overall the main measured value in the CAM group improved by 83.7%, but deteriorated by 39.3% in the PT group. There was no significant difference between the CAM group and a healthy control group. Using a CAM splint in addition to physiotherapy after ACL plasty in comparison to physiotherapy alone decreases the proprioceptive deficit significantly. We recommend the use of a CAM splint in the postoperative management following ACL plasty.
    Der Unfallchirurg 02/2006; 109(1):22-9. · 0.64 Impact Factor
  • Zentralblatt Fur Chirurgie - ZBL CHIR. 01/2006; 131:50-61.
  • Source
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    ABSTRACT: ZusammenfassungHintergrund Nach einer VKB-Ruptur besteht neben der mechanischen eine durch das propriozeptive Defizit bedingte funktionelle Instabilität. Es sollte überprüft werden, ob durch Einsatz von CAM-Schienen unmittelbar postoperativ das propriozeptive Defizit gesenkt werden kann.Patienten und Methoden In dieser prospektiv randomisierten Studie wurden 50 Patienten nach VKB-Plastik in eine PT-Gruppe (Physiotherapie) und eine CAM-Gruppe (Physiotherapie + aktive Bewegungsschiene) eingeteilt. Die propriozeptive Leistung wurde mit einem passiven Winkelreproduktionstest gemessen. Ergebnisse Bei Entlassung wurde bei 80% der CAM-Patienten und 25% der PT-Patienten eine Reduktion des propriozeptiven Defizits gemessen. Die CAM-Gruppe zeigte in der Hauptzielgröße eine Verbesserung um 83,7%. Die PT-Gruppe verschlechterte sich um 39,3%. Es bestand kein signifikanter Unterschied zwischen der CAM-Gruppe und einer gesunden Kontrollgruppe. Schlussfolgerung Durch den postoperativen Einsatz der CAM-Schiene kann das propriozeptive Defizit gegenüber einer alleinigen Physiotherapie signifikant reduziert werden.
    Der Unfallchirurg 01/2006; 109(1):22-29. · 0.64 Impact Factor
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    ABSTRACT: Conventional retrograde nailing of the femur causes two important disadvantages: the proximal locking of the nail is difficult because of the anatomic conditions and a chondral defect was left into the knee. After the retrograde implantation the new nail was lead through the greater trochanter. An additional proximal aiming device for proximal interlocking can be fixed. The entrance portal will be sealed by an osteochondral cylinder. 50 cases of femur fractures were selected for the prospective study. We recorded all intraoperative complications and technical difficulties. The cases were followed up for 52 weeks, both clinical and radiology examinations were performed. The mean follow up was 15.5+/-5 months. All fractures were healed. Knee movement was 125+/-14 degrees. The Leung Score was 84+/-12.6 points; HSS Score was 90+/-9 points. In two cases wound infections were developed. Mal-union was observed in three cases, in two cases nail brake down. The new retrograde interlocking nail could be used to manage femur fractures successfully. Two aiming devices enable a easy interlocking. Replacement of the osteochondral cylinder into the entry portal reduces cartilage damage.
    Der Unfallchirurg 04/2005; 108(3):189-99. · 0.64 Impact Factor
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    ABSTRACT: The retrospective results of carbon prostheses for ACL plasty from 1985 to 1989 are reported. The aim of this study was to determine the number and kind of necessary revisions and the rate of arthrosis and instability of the operated joints. 101 patients out of 136 patients with ACL plasty using a carbon prosthesis could be reviewed clinically in this retrospective study. All patients answered a questionnaire. Additionally, the tibial translation was examined with the KT1000 at maximum power. Conventional X-rays were taken of the knee joints. The results were evaluated using different scores. 70 % of the patients had pathological findings in the clinically tested tibial translation and had a positive Lachmann sign. 66 patients had a tibial translation of 2 mm or above when tested with the KT1000 at maximum power. Radiological studies had shown a gonarthrosis of grades III and IV in 93 patients. An average of 77 points was found using the Lysholm score. The results 13.5 years after ACL plasty using a carbon prosthesis are unsatisfactory concerning joint stability and development of secondary arthrosis. There is a discrepancy between the results of the clinical tests and the subjective complaints of the patients.
    Zeitschrift für Orthopädie 01/2005; 143(5):561-6. · 0.86 Impact Factor
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    ABSTRACT: Zusammenfassung
    Der Unfallchirurg 01/2005; 108(3):189-199. · 0.64 Impact Factor
  • Zeitschrift Fur Orthopadie Und Ihre Grenzgebiete - Z ORTHOP GRENZGEB. 01/2005; 143(5):561-566.
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    ABSTRACT: The aim of this study was to determine the pressure conditions in the tissue beneath and on the surface of wounds. This was done in vitro both on a plain surface and on a bovine muscle. In comparison we measured the pressure of the anterior tibial muscle of a patient with compartment syndrome. Besides, we applied negative pressure using just one drape connector and measured the pressure in different distances to look if the pressure is constant in large V.A.C.(R) dressings. Both polyurethane and polyvinyl alcohol foams were used.
    Zentralblatt für Chirurgie 06/2004; 129 Suppl 1:S95-7. · 0.69 Impact Factor

Publication Stats

39 Citations
15.00 Total Impact Points

Institutions

  • 2004–2011
    • Bundeswehrkrankenhaus Ulm
      Ulm, Baden-Württemberg, Germany
  • 2010
    • Bundeswehr Institute of Microbiology
      München, Bavaria, Germany
  • 2008
    • University of Freiburg
      • Institute of Sports and Sport Science
      Freiburg, Lower Saxony, Germany
    • Bundeswehrzentralkrankenhaus Koblenz
      Coblenz, Rheinland-Pfalz, Germany