Olaf Lorbach

Universität des Saarlandes, Saarbrücken, Saarland, Germany

Are you Olaf Lorbach?

Claim your profile

Publications (78)105.38 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of this study was the evaluation of knee laxity in the ACL-deficient knee with combined meniscal tear, meniscal suture and partial medial meniscectomy.
    International Orthopaedics 11/2014; · 2.02 Impact Factor
  • Source
    Olaf Lorbach, Philipp Mosser, Dietrich Pape
    [Show abstract] [Hide abstract]
    ABSTRACT: uni­ kompartimentellen Kniegelenkar­ throse beim aktiven Patienten stellt den Orthopäden vor schwierige Ent­ scheidungen. Vor den operativen Ver­ sorgungsmöglichkeiten mittels ar­ throskopischem Débridement, knor­ pelerhaltenden Prozeduren, der Um­ stellungsosteotomie sowie der uni­ und bikompartimentellen Kniege­ lenkprothese steht zunächst die kon­ servative Therapie. Neben dem Ein­ satz von physiotherapeutischer Übungsbehandlung, nonsteroidalen Antiphlogistika, Analgetika, intraar­ tikulären Injektionen mittels Gluko­ kortikoiden, Lokalanästhetika und Hy­ aluronsäure werden verschiedene symptomatischen Therapien wie Ultra­ schalltherapie, Akkupunktur, Elek­ trotherapie eingesetzt. Darüber hi­ naus stellt der Einsatz valgisieren­ der Knieorthesen (sog. "unloader bra­ ces") eine weitere Möglichkeit der Be­ handlung dar. Ein wichtiger Einflussfaktor sowohl für die Entstehung, als auch für die Progres-sion der medialen Gonarthrose ist das Ausmaß der Varusdeformität [5, 26]. Ein vergrößertes Adduktionsmoment (Va-rus) des Kniegelenks führt zu einer me-dialen Verschiebung der Belastungsach-se, wodurch die einwirkende Kraft und die Kompression des medialen Kompar-timents erhöht werden [8]. Die daraus resultierende Überlastung des medialen Kompartiments kann den medialen Knie-gelenkschmerz verstärken und zu einer Progression des medialen Kniegelenkar-throse führen [2, 12, 15, 20]. Bereits ein Varus von 4–6° kann den Druck im medialen Kompartiment wäh-rend des Einbeinstands zwischen 70 und 90 % erhöhen [14]. Behandlungsmetho-den zur Reduktion der Druckbelastung im medialen Kniegelenkkompartiment sind daher von großem Interesse.
    Der Orthopäde 11/2014; · 0.51 Impact Factor
  • Olaf Lorbach, Philipp Mosser, Dietrich Pape
    [Show abstract] [Hide abstract]
    ABSTRACT: Unloader knee braces are a viable and cost-effective alternative in for treatment of medial osteoarthritis of the knee in selected patients. They provide the potential to predict which patients could benefit from a high tibial osteotomy (HTO) and which patients should better be treated which a unicondylar or bicondylar knee replacement.
    Der Orthopade. 10/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Biomechanical comparison of three different fixation techniques for a proximal biceps tenodesis.
    Arthroscopy The Journal of Arthroscopic and Related Surgery 10/2014; · 3.19 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Unicondylar knee replacement (UKA) is a viable alternative to high tibial osteotomy (HTO) and total knee replacement in the treatment of medial osteoarthritis of the knee. With the correct indication, the results of UKA and HTO are comparable.
    Der Orthopade. 09/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Changes of patellar position (height, tilt, and shift) and arthritis of the patellofemoral joint might potentially influence outcome after unicompartmental knee replacement.
    Der Orthopade. 08/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: To evaluate knee laxity after anatomic ACL reconstruction with additional suture repair of a medial meniscus tear.
    Knee Surgery Sports Traumatology Arthroscopy 05/2014; · 2.84 Impact Factor
  • Arthroscopy The Journal of Arthroscopic and Related Surgery 06/2013; 29(6):e30–e31. · 3.10 Impact Factor
  • Dr. O. Lorbach, K. Anagnostakos, D. Kohn
    [Show abstract] [Hide abstract]
    ABSTRACT: Im vorliegenden Beitrag stellen wir drei Osteotomien vor, die im Rahmen operativer Zugänge am Kniegelenk verwendet werden. Sie ermöglichen bei vertretbarer Morbidität eine breite Übersicht und kommen dort zum Einsatz, wo ein weichteiliger Zugang nicht ausreicht oder mit einem zu großen Gewebetrauma verbunden wäre. In jedem Fall ist eine sichere Refixierung des abgelösten Knochenstückes erforderlich. Die Osteotomie der Tuberositas tibiae erlaubt eine sinnvolle Erweiterung des operativen Zugangs bei kontrakten Gelenken zur primären, insbesondere aber zur Revisionsknieendoprothetik. Mit der Osteotomie kann eine bessere Sicht ohne Gefahr eines Patellarsehnenabrisses erreicht werden. Die Durchblutung der Patella und der Weichteile an der Knievorderkante wird geschont. Das funktionelle Ergebnis ist im Vergleich zu alternativen weichteiligen Erweiterungen wie der „VY-Plastik“ oder dem „quadriceps snip“ besser, da eine Durchtrennung von Sehnen und Muskeln des Streckapparats unterbleibt. Die Osteotomie des Epicondylus femoris lateralis mit temporärer Desinsertion von Außenband und Popliteussehne erlaubt eine exzellente Darstellung von dorsolateraler Gelenkecke und nach Eröffnung der Kapsel auch des lateralen Tibiaplateaus. Dies ist zur Versorgung mancher lateraler Tibiakopffrakturen von Vorteil. Eine weitere Anwendung dieses Zugangs findet sich bei Patienten, bei denen eine Transplantation des Außenmeniskus durchgeführt wird. Die Osteotomie des Fibulaköpfchens erlaubt eine übersichtliche Darstellung der dorsolateralen Gelenkecke und des lateralen Tibiaplateaus. Bei Beachtung und Schonung des N. peroneus besitzt auch dieses Verfahren eine geringe Morbidität und eine entsprechend niedrige Komplikationsrate.
    Der Orthopäde 05/2013; 42(5). · 0.67 Impact Factor
  • Sport-Orthopädie - Sport-Traumatologie - Sports Orthopaedics and Traumatology 05/2013; 29(2):149.
  • O Lorbach, K Anagnostakos, D Kohn
    [Show abstract] [Hide abstract]
    ABSTRACT: The present article summarizes the different osteotomy techniques for an extension of standard surgical approaches to the knee joint in selected patients. The aim is to achieve satisfactory exposure and reduce potential postoperative complications compared to alternative techniques, such as the V-Y plasty or the quadriceps snip procedures. Osteotomy of the tibial tubercle is a reasonable extension of the anteromedial or the anterolateral surgical approach in selected patients undergoing revision total knee replacement. This osteotomy will provide excellent surgical exposure of the knee without the risk of avulsion of the patellar tendon and will preserve the blood supply of the patella and the surrounding soft tissue. Moreover, functional clinical outcome will be improved by minimizing damage to the extensor mechanism. Osteotomy of the lateral femoral condyle gives excellent exposure of the posterolateral aspect of the knee joint which might be necessary in some patients with fractures of the posterolateral tibial plateau as well as patients undergoing open allograft transplantation of the lateral meniscus. An alternative option for an extended exposure to the posterolateral knee joint is accomplished by osteotomy or partial resection of the fibular head which is also described as having good clinical results and a low complication rate.
    Der Orthopäde 05/2013; · 0.51 Impact Factor
  • Sport-Orthopädie - Sport-Traumatologie - Sports Orthopaedics and Traumatology 05/2013; 29(2):141–142.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Mit der zunehmenden Zahl implantierter Hüftendoprothesen stieg auch die Anzahl der Revisionsoperationen. Die Trochanterosteotomie bietet sich als Zugang für die Revisionsendoprothetik an, falls mit weichteiligen Standardzugängen keine genügende Übersicht geschaffen werden kann oder falls der weichteilige Zugang mit einer Traumatisierung funktionell wichtiger Strukturen verbunden wäre. Die Trochanterosteotomien sind muskelschonende Verfahren. Sie werden deshalb auch in der Traumachirurgie und der gelenkerhaltenden Hüftchirurgie (chirurgische Hüftluxation) erfolgreich eingesetzt. Neben einer präzisen Osteotomietechnik ist die stabile Refixierung von besonderer Bedeutung, aber gleichzeitig aufgrund der hohen auf den Trochanter major einwirkenden Muskelkräfte und der in diesem Bereich zarten Kortikalis technisch anspruchsvoll. Es existiert eine Vielzahl an Operationstechniken und Implantaten. Im vorliegenden Beitrag werden gängige traditionelle und neue Osteotomieverfahren am Trochanter major wie die „klassische“ Trochanterosteotomie nach Charnley, die Trochanterverschiebeosteotomie, die erweiterte Trochanterosteotomie und die stufenförmige Trochanterosteotomie sowie die jeweilige Refixationstechnik beschrieben.
    Der Orthopäde 05/2013; 42(5). · 0.67 Impact Factor
  • D Kohn, O Lorbach
    Der Orthopäde 04/2013; · 0.51 Impact Factor
  • K Anagnostakos, D Kohn, O Lorbach
    [Show abstract] [Hide abstract]
    ABSTRACT: The increasing number of total hip arthroplasty procedures lead to an increasing number of revision surgeries. The trochanteric osteotomy technique is an established procedure in selected cases with the necessity of extending the usual surgical approach. Trochanteric osteotomy is also successfully performed in other areas, such as trauma surgery and joint-preserving surgery (surgical dislocation). Several techniques for trochanteric osteotomy are availably employing various fixation techniques and implants. This article presents the most common trochanteric osteotomy techniques for extension of the surgical approach (the classical according to Charnley, the trochanter slide, the extended trochanteric, and the stepped osteotomy) as well as clinical results and biomechanical experiences.
    Der Orthopäde 03/2013; · 0.51 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The decrease of femoral offset might play a role in the emergence of hip spacer dislocations, but it has not been discussed in the literature yet. The present work describes a technique for femoral offset adjustment. Either a bended blade plate or a dynamic hip screw can be used. The depth of the insertion and the angle of the particular implant are defined by the size of the offset adjustment required in each case. The described technique is feasible to produce a customized hip spacer, allowing for the preservation of an adequate muscle tension by individual adjustment of the femoral offset between stages.
    Journal of surgical technique and case report. 01/2013; 5(1):18-20.
  • [Show abstract] [Hide abstract]
    ABSTRACT: BACKGROUND:The double-row suture bridge repair was recently introduced and has demonstrated superior biomechanical results and higher yield load compared with the traditional double-row technique. It therefore seemed reasonable to compare this second generation of double-row constructs to the modified single-row double mattress reconstruction. HYPOTHESIS:The repair technique, initial tear size, and tendon subregion will have a significant effect on 3-dimensional (3D) cyclic displacement under additional static external rotation of a modified single-row compared with a double-row rotator cuff repair. STUDY DESIGN:Controlled laboratory study. METHODS:Rotator cuff tears (small to medium: 25 mm; medium to large: 35 mm) were created in 24 human cadaveric shoulders. Rotator cuff repairs were performed as modified single-row or double-row repairs, and cyclic loading (10-60 N, 10-100 N) was applied under 20° of external rotation. Radiostereometric analysis was used to calculate cyclic displacement in the anteroposterior (x), craniocaudal (y), and mediolateral (z) planes with a focus on the repair constructs and the initial tear size. Moreover, differences in cyclic displacement of the anterior compared with the posterior tendon subregions were calculated. RESULTS:Significantly lower cyclic displacement was seen in small to medium tears for the single-row compared with double-row repair at 60 and 100 N in the x plane (P = .001) and y plane (P = .001). The results were similar in medium to large tears at 100 N in the x plane (P = .004). Comparison of 25-mm versus 35-mm tears did not show any statistically significant differences for the single-row repairs. In the double-row repairs, lower gap formation was found for the 35-mm tears (P ≤ .05). Comparison of the anterior versus posterior tendon subregions revealed a trend toward higher anterior gap formation, although this was statistically not significant. CONCLUSION:The tested single-row reconstruction achieved superior results in 3D cyclic displacement to the tested double-row repair. Extension of the initial rupture size did not have a negative effect on the biomechanical results of the tested constructs. CLINICAL RELEVANCE:Single-row repairs with modified suture configurations provide comparable biomechanical strength to double-row repairs. Furthermore, as increased gap formation in the early postoperative period might lead to failure of the construct, a strong anterior fixation and restricted external rotation protocol might be considered in rotator cuff repairs to avoid this problem.
    The American journal of sports medicine 11/2012; · 3.61 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: PURPOSE: Biplanar open-wedge high tibial osteotomy (HTO) is thought to promote rapid bone healing due to the increased cancellous bone surface compared to other HTO techniques. However, precise data on the bone surface area and wedge volume resulting from both open- and closed-wedge HTO techniques remain unknown. We hypothesized that biplanar rather than uniplanar HTO better reflects the ideal geometrical requirements for bone healing, representing a large cancellous bone surface combined with a small wedge volume. METHODS: Tibial saw bones were assigned to 4 different groups of valgisation high tibial osteotomies: group 1: open-wedge uniplanar HTO; group 2: open-wedge biplanar HTO with ascending frontal cut; group 3: open-wedge biplanar HTO with descending frontal cut (retrotubercule osteotomy technique), and group 4: closed-wedge uniplanar HTO. Bone surface areas of all osteotomy planes were quantified. Wedge volumes were determined using a prism-based algorithm, applying standardized wedge heights of 5, 10, and 15 mm. RESULTS: The open-wedge biplanar osteotomy with a descending frontal cut (group 3) created significantly larger bone surfaces compared to the "classic" biplanar technique with an ascending frontal cut (group 2) and compared to all uniplanar techniques. Bone surfaces after the classic open-wedge technique (group 2) were slightly larger compared to all uniplanar techniques (group 1 and 4). No significant differences of wedge volumes were found between the retrotubercle (group 3) and classic open-wedge techniques (group 2). Wedge volumes were significantly higher in the uniplanar open-wedge technique (group 1) compared to the biplanar open-wedge techniques (group 2 and 3). CONCLUSION: Bone geometry following HTO suggests that the biplanar open-wedge techniques simultaneously create smaller wedge volumes and larger bone surface areas compared to the uniplanar open-wedge techniques. The relatively neglected closed-wedge technique still offers in theory the best healing potential, characterized by an almost absent wedge volume and a large bone-to-bone contact area. Although this idealized geometric view on bony geometry excludes all biologic factors that influence bone healing, the current data suggest a general rule for the applied standard osteotomy techniques and all of their surgical modifications: reducing the amount of slow gap healing and simultaneously increasing the area of faster contact healing may be beneficial for osteotomy healing. Thus, a biplanar rather than a uniplanar osteotomy may be performed for high tibial osteotomy in clinical practice.
    Knee Surgery Sports Traumatology Arthroscopy 02/2012; · 2.68 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: PURPOSE: Influence of the initial rotator cuff tear size and of different subregions of the SSP tendon on the cyclic loading behavior of a modified single-row reconstruction compared to a suture-bridging double-row repair. METHODS: Artificial tears (25 and 35 mm) were created in the rotator cuff of 24 human cadaver shoulders. The reconstructions were performed as a single-row repair (SR) using a modified suture configuration or a suture-bridge double-row repair (DR). Radiostereometric analysis was used under cyclic loading (50 cycles, 10-180 N, 10-250 N) to calculate cyclic displacement in three different planes (anteroposterior (x), craniocaudal (y) and mediolateral (z) level). Cyclic displacement was recorded, and differences in cyclic displacement of the anterior compared to the posterior subregions of the tendon were calculated. RESULTS: In small-to-medium tears (25 mm) and medium-to-large tears (35 mm), significant lower cyclic displacement was seen for the SR-reconstruction compared to the DR-repair at 180 N (p ≤ 0.0001; p = 0.001) and 250 N (p = 0.001; p = 0.007) in the x-level. These results were confirmed in the y-level at 180 N (p = 0.001; p = 0.0022) and 250 N (p = 0.005; p = 0.0018). Comparison of the initial tear sizes demonstrated significant differences in cyclic displacement for the DR technique in the x-level at 180 N (p = 0.002) and 250 N (p = 0.004). Comparison of the anterior versus the posterior subregion of the tendon revealed significant lower gap formation in the posterior compared to the anterior subregions in the x-level for both tested rotator cuff repairs (p ≤ 0.05). CONCLUSIONS: The tested single-row repair using a modified suture configuration achieved superior results in three-dimensional measurements of cyclic displacement compared to the tested double-row suture-bridge repair. The results were dependent on the initial rupture size of the rotator cuff tear. Furthermore, significant differences were found between tendon subregions of the rotator cuff with significantly higher gap formation for the anterior compared to the posterior subregions.
    Knee Surgery Sports Traumatology Arthroscopy 01/2012; 20(11). · 2.68 Impact Factor
  • Olaf Lorbach, Marc Tompkins
    [Show abstract] [Hide abstract]
    ABSTRACT: The present article summarizes current trends in arthroscopic rotator cuff repairs focusing on the used repair technique, potential influencing factors on the results, and long-term outcome after reconstruction of the rotator cuff. Moreover, different treatment options for the treatment for irreparable rotator cuff ruptures were described, and the results of additional augmentation of the repairs with platelet-rich plasma were critically analyzed. Based on the current literature, double-row repairs did not achieve superior clinical results compared to single-row repairs neither in the clinical results nor in the re-rupture rate. Multiple factors such as age, fatty infiltration, and initial rupture size might influence the results. If the rupture is not repairable, various options were described including cuff debridement, partial repair, tuberoplasty, or tendon transfers. The additional augmentation with platelet-rich plasma did not reveal any significant differences in the healing rate compared to conventional rotator cuff repairs. LEVEL OF EVIDENCE: IV.
    Knee Surgery Sports Traumatology Arthroscopy 01/2012; 20(6):1003-11. · 2.68 Impact Factor

Publication Stats

394 Citations
105.38 Total Impact Points

Institutions

  • 2008–2013
    • Universität des Saarlandes
      • Klinik für Orthopädie und Orthopädische Chirurgie
      Saarbrücken, Saarland, Germany
  • 2008–2011
    • Centre Hospitalier de Luxembourg
      Letzeburg, Luxembourg, Luxembourg
  • 2010
    • Klinikum Osnabrück GmbH
      Osnabrück, Lower Saxony, Germany
  • 2009
    • Klinikum Osnabrück
      Osnabrück, Lower Saxony, Germany
  • 2007
    • Universitätsklinikum des Saarlandes
      Homburg, Saarland, Germany