Uwe Hanisch

Publications of Uwe Hanisch

• Histopathological, radiological and clinical aspects of the temporal assignment of scaphoid non-union.

  Authors: Susanne Rein, Uwe Hanisch, Stefan Rammelt, Günter Schmidt, Hans-Eberhardt Schaller, Hans Zwipp, Matthias Oehmke, Stefan Weindel

  Archives of orthopaedic and trauma surgery. 12/2009;

  OBJECTIVE: The aim of this study was to evaluate the correlation between clinical, radiological and histopathological signs of scaphoid non-unions (SNU) with regard to the age of the fracture,OBJECTIVE: The aim of this study was to evaluate the correlation between clinical, radiological and histopathological signs of scaphoid non-unions (SNU) with regard to the age of the fracture, primarily because this is relevant for therapy and compensation claims. MATERIALS AND METHODS: Thirty-eight patients with SNU underwent clinical and radiological examination of the wrist prior to surgery. Preoperative X-rays of the wrist were analysed using the scores of Herbert and Fisher, Filan and Herbert, Trojan and Jahna, Gupta as well as scaphoid non-union advanced collapse. Sclerotic bone of the SNU was resected during surgery. Resected material was evaluated histologically after staining with hematoxylin-eosin and periodic acid-Schiff reaction. Radiological and histological examinations were performed by independent investigators in a blinded fashion. RESULTS: The preoperative range of motion of the injured compared to the contralateral wrist was significantly reduced for the dorsi- and palmar flexion and for the radial and ulnar deviation; however, this reduction was not time dependent. There was no significant correlation between the radiological results and the age of the SNU, while fibrous tissue or fibrocartilage in the fracture gap was present in all cases. Significantly less fibrous or fibrocartilage bone cysts (p = 0.041) and bone remodelling (p = 0.031) were seen in older SNU (at 45 months). Definitive sclerotic bone covering of the fracture edges was significantly more common in older SNU (p = 0.035). CONCLUSION: Radiological and most of the conventional histological findings do not correlate with time after initial injury.

• In Vivo Wear Rate of the Birmingham Hip Resurfacing Arthroplasty A Review of 10 Retrieved Components.

  Authors: Wolf-Christoph Witzleb, Uwe Hanisch, Joerg Ziegler, Klaus-Peter Guenther

  The Journal of arthroplasty. 09/2008;

  The wear of 8 femoral and 2 acetabular components of the Birmingham Hip Resurfacing (Midland Medical Technologies Ltd, Birmingham, UK) was measured using a coordinate measuring machine (CMM5; SIP,The wear of 8 femoral and 2 acetabular components of the Birmingham Hip Resurfacing (Midland Medical Technologies Ltd, Birmingham, UK) was measured using a coordinate measuring machine (CMM5; SIP, Geneva, Switzerland). After a median in situ time of 13 months, measurements of the Birmingham Hip Resurfacing femoral heads revealed a median volumetric wear of 2.9 mm(3). In one case with a cup abduction angle of 70 degrees , a significantly higher wear of 17.8 mm(3) was found. The 2 acetabular components showed volumetric wear of 5.4 and 27.6 mm(3) after 14 and 15 months in vivo. The wear rates of the investigated femoral components were somewhat, but not significantly, higher than the previously investigated 28-mm Metasul heads (median, 0.8 mm(3); Zimmer GmbH, Winterthur, Switzerland).

• Neo-capsule tissue reactions in metal-on-metal hip arthroplasty.

  Authors: Wolf-Christoph Witzleb, Uwe Hanisch, Nicole Kolar, Frank Krummenauer, Klaus-Peter Guenther

  Acta orthopaedica. 05/2007; 78(2):211-20.

  BACKGROUND: Modern-generation metal-on-metal articulations have a high wear resistance and may therefore be able to improve the long-term performance of artificial joints. However, the biologicalBACKGROUND: Modern-generation metal-on-metal articulations have a high wear resistance and may therefore be able to improve the long-term performance of artificial joints. However, the biological effects are still under debate. This study was undertaken to review the histopathological changes in neo-capsule tissues of different metal-on-metal hip arthroplasties. METHODS: Neo-capsule tissue samples from 46 hips with modern second-generation metal-on-metal articulations (39 hip resurfacings and 7 non-cemented total hip replacements) with a variety of failure mechanisms were examined histopathologically and immunohistochemically. RESULTS: A distinct lymphocytic infiltration was found in all cases with in situ times of more than 7 months, consisting of CD20-positive B-lymphocytes and CD3-positive T-lymphocytes and sometimes thinly distributed CD138-positive plasma cells without dominant T-cell or plasma cell infiltrates. INTERPRETATION: This distinct lymphocytic infiltration has not been reported in tissue analyses of metal- or ceramic-on-polyethylene hip replacements, and may therefore be considered to be a characteristic histological pattern of tissue reactions on metal particles and/or ions around metal-on-metal bearings.

• Osteocalcin enhances bone remodeling around hydroxyapatite/collagen composites.

  Authors: Stefan Rammelt, Mirjam Neumann, Uwe Hanisch, Antje Reinstorf, Wolfgang Pompe, Hans Zwipp, Achim Biewener

  Journal of biomedical materials research. Part A. 07/2005; 73(3):284-94.

  The effect of osteocalcin (OC), an extracellular bone matrix protein, on bone healing around hydroxyapatite/collagen composites was investigated. Cylindrical nanocrystalline hydroxyapatite implantsThe effect of osteocalcin (OC), an extracellular bone matrix protein, on bone healing around hydroxyapatite/collagen composites was investigated. Cylindrical nanocrystalline hydroxyapatite implants of 2.5-mm diameter containing 2.5% biomimetically mineralized collagen type I were inserted press-fit into the tibial head of adult Wistar rats. To one implant group, 10 mug/g OC was added. Six specimens per group were analyzed at 2, 7, 14, 28, and 56 days. After 14 days, newly formed woven bone had reached the implant surface of the OC implants whereas a broad fibrous interface could still be observed around controls. Woven bone was formed directly around both implant groups after 28 days and had been replaced partially by lamellar bone around the OC implants only. No significant differences in total bone contact were seen between both groups after 56 days. The higher number of phagocytosing cells and osteoclasts characterized immunohistochemically with ED1, cathepsin D, and tartate-resistant alkaline phosphatase around the OC implants at the early stages of bone healing suggests an earlier onset of bone remodeling. The earlier and increased expression of bone-specific matrix proteins and multifunctional adhesion proteins (osteopontin, bone sialoprotein, CD44) at the interface around the OC implants indicates that OC may accelerate bone formation and regeneration. This study supports the observations from in vitro studies that OC activates both osteoclasts and osteoblasts during early bone formation.

• Coating of titanium implants with type-I collagen.

  Authors: Stefan Rammelt, Eva Schulze, Ricardo Bernhardt, Uwe Hanisch, Dieter Scharnweber, Hartmut Worch, Hans Zwipp, Achim Biewener

  Journal of orthopaedic research : official publication of the Orthopaedic Research Society. 09/2004; 22(5):1025-34.

  PURPOSE: Type-I collagen, the major structural protein in bone, has beneficial properties regarding bone regeneration. Little is known about the potential effects of collagen coating on orthopedicPURPOSE: Type-I collagen, the major structural protein in bone, has beneficial properties regarding bone regeneration. Little is known about the potential effects of collagen coating on orthopedic implants. METHODS: 3 to 6 microg/cm2 of lyophilized type-I collagen was absorbed on titanium rods. Six coated and uncoated pins of 0.9 mm diameter were inserted into the tibia of adult male Wistar rats for 1, 2, 4, 7, 14, and 28 days. Specimens were embedded in methacrylate-based Technovit 9100N resin. From one portion cutting and grinding sections were obtained. The implant was removed from the other half that was depolymerized, sectioned, and mounted for immunohistochemistry. RESULTS: At day 4, the interface around the collagen-coated implants displayed a granulation tissue with higher numbers of cathepsin D-positive mononucleated cells compared to the uncoated implants (p<0.05). Active osteoblasts, reactive for osteopontin, were increased around the collagen-coated pins at day 4 and 7 (p<0.01). After 28 days of implantation, direct bone contact averaged 74.9% around the collagen-coated implants and 62.1% around uncoated implants (NS). The amount of newly formed bone averaged 76.3% around the collagen-coated pins and 67.8% around the uncoated pins (NS). The histomorphometric findings were confirmed by SRmicroCT in two specimens. CONCLUSIONS: The earlier observation of mononuclear phagocytozing cells and the earlier and higher expression of bone-specific matrix proteins suggest an increased early bone remodeling around titanium pins through collagen coating. A tendency towards increased bone formation was observed around the coated implants.