Philip Kasten

Carl Gustav Carus-Institut, Pforzheim, Baden-Württemberg, Germany

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Publications (126)242.86 Total impact

  • P. Kasten · S. Zwingenberger · J. Nowotny · M. Maier
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    ABSTRACT: Die Verwendung eines zementierten Glenoids beim Schultergelenkersatz hat im Gegensatz zur zementfreien Versorgung entsprechend der aktuellen Datenlage die längeren Überlebensraten. Deshalb wird das zementierte Glenoid als der Goldstandard betrachtet. Ob Polyethylenpfannen mit einem Kiel oder Zapfen überlegen sind, kann aufgrund mangelnder Langzeitergebnisse von Stiftglenoiden nicht abschließend entschieden werden: beide haben gute kurz- und mittelfristige Überlebensraten, für das Kielglenoid existieren auch Langzeitergebnisse (> 15 Jahre). Entscheidend für das Langzeitüberleben sind die korrekte Platzierung der Pfanne unter Vermeidung einer zu starken Retroversion und der Erhalt der Knochensubstanz. Weitere Faktoren sind eine sorgfältige Zementiertechnik, um einen Zementmantel von 1,0–1,5 mm Dicke ohne Zementdefekte zu erreichen. Eine standardisierte Zementiertechnik unter Verwendung einer Jetlavage und eines Zementverdichters kann das Zementierergebnis vereinheitlichen und dieses Ziel zuverlässiger erreichen. Abstract Long-term studies support the use of cemented glenoids in the treatment of osteoarthritis of the shoulder in total shoulder arthroplasty. Therefore, the cemented glenoid currently is referred to as the gold standard. Both keeled and pegged glenoids have good midterm outcome, whereby keeled glenoids also have long-term results (> 15 years). Exact placement of the glenoid component and a careful cementation technique are cruciate for good long-term survival. Reaming of the glenoid should avoid retroversion and removing too much bone. Cementation should result in a cement mantle of 1–1.5 mm thickness without cement defects. This can be achieved by good surgical exposure and with a standardized cementation technique using, e.g., jet lavage and a cement pressurizer.
    Obere Extremität 05/2015; DOI:10.1007/s11678-015-0316-2
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    ABSTRACT: Failed shoulder arthroplasty and failed internal fixation in fractures of the proximal humerus can benefit from implantation of a reverse total shoulder arthroplasty (RSA). While there is some evidence that RSA can improve function regarding range of motion (ROM), pain, satisfaction, and strength, there is sparse data how this translates into activities of daily living (ADLs). A marker-based 3D video motion analysis system has recently been designed that can measure changes of ROM in dynamic movements in every plane. The hypothesis was that a gain of maximum ROM also translates into the ability to perform ADLs and into a significant increase of ROM in ADLs.
    Revue de Chirurgie Orthopédique et Traumatologique 04/2015; 101(2). DOI:10.1016/j.rcot.2015.01.001
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    Christian Kopkow · Toni Lange · Jochen Schmitt · Philip Kasten
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    ABSTRACT: Prospective, blinded interrater reliability study. To determine the interrater reliability of the modified Scapular Assistance Test (mSAT) with and without the use of additional handheld weights. 110 Shoulder patients with various shoulder pathologies were consecutively recruited. Tests were performed independently and randomly on each participant by 2 different examiners, which were blinded to further clinical information (e.g. patient history, former diagnostic results). Percent agreement, Cohen's kappa (Κ), proportion of positive/negative agreement, maximum Κ, prevalence and bias indexes and prevalence-adjusted-bias-adjusted kappa (PABAK) were calculated as estimates of interrater reliability of the mSAT with and without additional handheld weights. Weights were chosen according to body weight. The reliability measures for the mSAT (Cohen's Κ: 0.68, confidence interval (CI): 0.51-0.85; PABAK: 0.78, CI: 0.67-0.90) as well as for the mSAT with handheld weights (Cohen's Κ: 0.63, CI: 0.44-0.81; PABAK: 0.76, CI: 0.64-0.88) showed substantial agreement according to the classification system proposed by Landis and Koch. Based on the results of this study, the mSAT with and without additional weights can be considered as reliable for clinical use. Since both tests showed substantial agreement, the use of additional handheld weights might not be necessary in case of obvious scapula dyskinesis. However, to perform the mSAT with/without additional weights should depend not only on its reliability values. Name of the public trials registry and the registration number: German Clinical Trials Register, protocol number DRKS00005377. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Manual therapy 04/2015; DOI:10.1016/j.math.2015.04.012 · 1.76 Impact Factor
  • J. Nowotny · P. Kasten
    Orthopädie und Unfallchirurgie up2date 02/2015; 10(01):75-87. DOI:10.1055/s-0033-1358106
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    ABSTRACT: Failed shoulder arthroplasty and failed internal fixation in fractures of the proximal humerus can benefit from implantation of a reverse total shoulder arthroplasty (RSA). While there is some evidence that RSA can improve function regarding range of motion (ROM), pain, satisfaction, and strength, there is sparse data how this translates into activities of daily living (ADLs). A marker-based 3D video motion analysis system has recently been designed that can measure changes of ROM in dynamic movements in every plane. The hypothesis was that a gain of maximum ROM also translates into the ability to perform ADLs and into a significant increase of ROM in ADLs.
    Orthopaedics & Traumatology Surgery & Research 02/2015; 101(2). DOI:10.1016/j.otsr.2014.12.007 · 1.17 Impact Factor
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    ABSTRACT: Background Total shoulder arthroplasty (TSA) can improve function in osteoarthritic shoulders, but the ability to perform activities of daily living (ADLs) can still remain impaired. Routinely, shoulder surgeons measure range of motion (ROM) using a goniometer. Objective data are limited, however, concerning functional three-dimensional changes in ROM in ADLs after TSA in patients with degenerative glenohumeral osteoarthritis. Methods This study included ten consecutive patients, who received TSA for primary glenohumeral osteoarthritis. The patients were examined the day before, 6 months, and 3 years after shoulder replacement as well. We compared them with a control group (n = 10) without any shoulder pathology and measured shoulder movement by 3D motion analysis using a novel 3 D model. The measurement included static maximum values, the ability to perform and the ROM of the ADLs “combing the hair”, “washing the opposite armpit”, “tying an apron”, and “taking a book from a shelf”. Results Six months after surgery, almost all TSA patients were able to perform the four ADLs (3 out of 40 tasks could not be performed by the 10 patients); 3 years postoperatively all patients were able to carry out all ADLs (40 out of 40 tasks possible). In performing the ADLs, comparison of the pre- with the 6-month and 3-year postoperative status of the TSA group showed that the subjects did not fully use the available maximum flexion/extension ROM in performing the four ADLs. The ROM used for flexion/extension did not change significantly (preoperatively 135°-0° -34° vs. 3 years postoperatively 131° -0° -53°). For abduction/adduction, ROM improved significantly from 33°-0° -27° preoperatively to 76° -0° -35° postoperatively. Compared to the controls (118°) the TSA group used less ROM for abduction to perform the four ADLs 3 years postoperatively. Conclusion TSA improves the ability to perform ADL and the individual ROM in ADLs in patients with degenerative glenohumeral osteoarthritis over the course of 3 years. However, TSA patients do not use their maximum available abduction ROM in performing ADLs. This is not related to limitations in active ROM, but rather may be caused by pathologic motion patterns, impaired proprioception or both.
    BMC Musculoskeletal Disorders 07/2014; 15(1):244. DOI:10.1186/1471-2474-15-244 · 1.90 Impact Factor
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    ABSTRACT: Reverse total shoulder arthroplasty (RSA) can improve function in cuff tear arthropathy (CTA) shoulders, but limited exact data are available about the maximum values in 3D motion analysis, and as to how improvements translate into the normal range of motion (ROM) in activities of daily living (ADLs). This study included nine consecutive patients (n = 9) who received RSA for CTA without muscle transfers. We measured shoulder movement by a novel 3D motion analysis using the Heidelberg upper extremity model (HUX) which can eliminate compensatory movements of the scapula, and the trunk. The measurement included active maximum values, and four ADLs. Comparing the pre- to the 1-year postoperative status, RSA was associated with a significant increase in the mean maximum values for active flexion of about 43A degrees (SD +/- A 31) from 66A degrees to 109A degrees (p = 0.001), for active abduction of about 37A degrees (SD +/- A 26) from 57A degrees to 94A degrees (p = 0.001), and for the active adduction of about 28A degrees (SD +/- A 10) from 5A degrees to 33A degrees (p = 0.002). Comparing the preoperative to the postoperative ROM in the ADLs in flexion/extension, ROM improved significantly in all ADLs, in abduction/adduction in three of four ADLs. No significant changes were observed in internal/external rotation in any ADLs. RSA improves the active maximum ROM for flexion, abduction, and adduction. The patients are able to take advantage of this ROM increase in ADLs in flexion and in most ADL in abduction, but only in trend in internal and external rotation. Level IV, Case Series with no comparison group.
    Archives of Orthopaedic and Trauma Surgery 06/2014; 134(8). DOI:10.1007/s00402-014-2015-7 · 1.31 Impact Factor
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    ABSTRACT: The study aimed to investigate the prognosis of osteochondral affection (e. g., osteochondritis dissecans (OCD), cartilage lesions, fractures and bone edema in the elbows of high-performance gymnasts (n=30) compared to prognosis results with athletes not undergoing excessive stress on the upper extremity (n=29). The study also tested a novel isotropic 3D-FSE-sequence (CUBE) technique as an early diagnostic modality. Standard protocol was used to conduct the MRI examinations, which were then compared to results from the CUBE - sequence. The gymnast group (p=0.012) presented a significantly higher prevalence of complaints in the elbow joint compared to the other athlete group. Furthermore, osteochondral lesions in MRIs appeared more frequently in the group of gymnasts (n=10, 33%, p=0.033), including 7 cases (23%) of OCD. In the control athlete group 2 asymptomatic cases of OCD and one case of bone edema were detected. The MRI investigation with the CUBE - sequence showed similar results as the standard MRI protocol in terms of the diagnosis sensitivity. The current study indicates that juvenile gymnasts are at a higher risk for osteochondral lesions of the elbow than athletes without excessive stress on the upper extremities.
    International Journal of Sports Medicine 05/2014; 35(11). DOI:10.1055/s-0034-1371835 · 2.37 Impact Factor
  • J Dexel · C Kopkow · P Kasten
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    ABSTRACT: A key element for movement of the arm is the position and motion of the scapula. A stable basis for efficient arm function is only possible if the scapula makes three dimensional movements coordinated with the upper arm. This article presents a discussion of causes, diagnosis and therapy options for scapular dyskinesis. The article is based on a literature search in the PubMed database and taking own experience into account. Soft tissue and bony injuries, muscle insufficiency and dysbalance can alter the position and function of the scapula. This pathological position and motion is called scapular dyskinesis. This clinically presents as a prominent medial border and malrotation (lacking external rotation and posterior tilt) of the scapula when raising the arm. The clinical examination includes a visual inspection followed by clinical tests of the scapula at rest and during movement. Specific exercises of the musculature surrounding the scapula and specific techniques for schooling the senses for positioning and movement can harmonize the sequence of movements and restore the dynamic scapular stability. A conservative stepwise and stage-adapted exercise program can be used to treat scapular dyskinesis with good results.
    Der Orthopäde 03/2014; · 0.67 Impact Factor
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    J. Dexel · C. Kopkow · P. Kasten
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    ABSTRACT: Die Skapula hat eine zentrale Funktion beim Bewegungsablauf des Arms. Sie kann nur dann als stabile Basis für eine effiziente Armfunktion dienen, wenn sie eine mit dem Oberarm koordinierte, dreidimensionale Bewegung durchführt.Darstellung der Ursachen, Diagnostik und Therapieempfehlungen der skapulothorakalen Dysbalance bei Überkopfsportlern.Diese Arbeit basiert auf einer Literaturrecherche in der Datenbank PubMed und der Berücksichtigung eigener Erfahrungen.Die Skapulaposition kann durch knöcherne und weichteilige Verletzungen, Muskelinsuffizienzen und -dysbalancen beeinflusst werden. Die veränderte Position bzw. Bewegung wird als Skapuladyskinesie bezeichnet. Sie imponiert klinisch durch ein Abheben des medialen Randes der Skapula und durch eine Fehlrotation (fehlende Außenrotation und posteriore Kippung) beim Bewegen des Arms. Die klinische Untersuchung beinhaltet eine optische Prüfung gefolgt von klinischen Tests der Skapula in Ruhe und bei Bewegung. Durch gezieltes Beüben der Muskulatur, die die Skapula umgibt, sowie durch gezielte Techniken zur Schulung des Positions- und Bewegungssinns kann eine verbesserte Positionierung und Bewegung des Schulterblatts erlernt werden.Skapuläre Muskeldysbalancen können im Rahmen eines konservativen stufenförmigen Trainingsprogramms stadienadaptiert mit gutem Erfolg behandelt werden.
    Der Orthopäde 03/2014; 43(3). DOI:10.1007/s00132-013-2143-8 · 0.67 Impact Factor
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    ABSTRACT: Low back pain (LBP) is a common symptom in the populations of western countries, and adolescent athletes seem to be prone to LBP. The main objective of this study was to analyze the point (LBP within the last 48 h), 1-year (LBP within the last 12 months) and lifetime (LBP within the entire life) prevalence rates of LBP in adolescent athletes participating in various sports. We also assessed the characteristics of LBP and its association with potential risk factors. To this end, 272 competitive adolescent athletes involved in 31 different sports (158 males, 113 females, 15.4±2.0 years, body mass index [BMI] 20.3±2.4 kg/m2) were enrolled in a 10-month prospective clinical trial that included a questionnaire and physical examination. We found a point prevalence of 14%, a 1-year prevalence of 57%, and a lifetime prevalence of 66% for LBP. The mean age of first appearance of LBP was 13.1±2.0 years. The lifetime prevalence was significantly higher in volleyball than in biathletes (74.3 vs. 45.7%, p=0.015). Our findings confirm that LBP is a common symptom in adolescent athletes; LBP prevalence correlates with sports participation and individual competitive level. Adolescent athletes with LBP should receive a thorough diagnostic work-up and adapt training and technique correspondingly when indicated.
    International Journal of Sports Medicine 01/2014; 35(8). DOI:10.1055/s-0033-1358731 · 2.37 Impact Factor
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    ABSTRACT: Die autologe Chondrozytentransplantation (ACT) hat sich seit ihrer Einführung in den klinischen Alltag zu einem Standardverfahren zur Behandlung von großen umschriebenen Knorpeldefekten im Kniegelenk etabliert. Trotz der zunehmenden Ausweitung des Verfahrens bestehen noch viele Fragen hinsichtlich der optimalen postoperativen Therapie. Ziel unserer Untersuchung war eine Bestandserhebung der Nachbehandlung bei den Mitgliedern der AG Klinische Geweberegeneration und basierend auf den Ergebnissen die Erstellung einer Empfehlung auf der Basis einer Expertenmeinung (Level IVb nach EBM).Alle Mitglieder der AG Klinische Geweberegeneration wurden anhand eines standardisierten Fragebogens zu Nachbehandlungsschemata, Nachsorgeuntersuchungen und Empfehlungen zur Wiederaufnahme der sportlichen Betätigung nach ACT am Kniegelenk befragt.Keiner der Befragten wendete die konventionelle ACT mit der Periostlappenplastik an, alle verwenden zellbesiedelte Matrices (MACT). 94% der Befragten wenden in Abhängigkeit von der Lage des Defekts (femoral vs. patellar) spezifische Belastungs- und Bewegungseinschränkungen an. Die breiteste Übereinstimmung fand sich bei der Entlastung für durchschnittlich 6 Wochen nach femoraler MACT (78%). Hinsichtlich der Behandlung nach patellarer MACT variierten die Angaben zum Belastungsaufbau und der Bewegungslimitierung am stärksten. Regelmäßige postoperative MRT-Kontrollen werden durchgeführt, jedoch waren auch diese in Bezug auf Zeitpunkt und angewendete MRT-Sequenz starken Variationen unterworfen. Routinemäßige Second-look-Arthroskopien werden nicht durchgeführt. Circa 75% der Operateure empfehlen ihren Patienten eine Sportkarenz für 6–12 Monate nach MACT. Am häufigsten werden knieschonende Sportarten wie Radfahren (94%), Schwimmen (83%) oder Nordic Walking (44%) empfohlen.Klare Nachbehandlungsschemata existieren bisher nicht, obgleich eine Übereinstimmung zu elementaren Fragen wie der lokalisationsabhängigen differenzierten Bewegungseinschränkung und Belastung besteht. Die Magnetresonanztomographie (MRT) besitzt eine zentrale Rolle bei der routinemäßigen Nachkontrolle, aber auch hier liegen erheblich Unterschiede bei der Durchführung vor. Es bedarf einer weiteren Verbesserung der Empfehlungen zur Nachbehandlung nach MACT am Kniegelenk, um einen Standard zu entwickeln, der den behandelnden Ärzten Sicherheit gibt und einen besseren Vergleich der Ergebnisse nach MACHT zwischen verschiedenen Patientengruppen ermöglicht.
    Der Unfallchirurg 01/2014; 117(3). · 0.61 Impact Factor
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  • Gait & Posture 11/2013; 38:S31-S32. DOI:10.1016/j.gaitpost.2013.07.065 · 2.30 Impact Factor
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    ABSTRACT: Associated with the trend towards increased health consciousness and fitness, triathlon has established itself as a sport for the masses. The goals of this study were to evaluate injury risk factors of non-professional triathletes and to compare prospective and retrospective evaluation methods. Using an online survey, 212 triathletes retrospectively answered a questionnaire about their training habits and injuries during the past 12 months. Forty-nine of these triathletes participated in a 12-month prospective trial. Injuries were classified with regard to the anatomical location, type of injury, incidence and associated risk factors. Most injuries occurred during running (50%) followed by cycling (43%) and swimming (7%). Fifty-four per cent (retrospective) and 22% (prospective) of the injuries were contusions and abrasions, 38% (retrospective) and 46% (pro- spective) were ligament and capsular injuries, 7% (retrospective) and 32% (prospective) were muscle and tendon injuries and 1% (retrospective) and 0% (prospective) were fractures. The incidence of an injury per 1000 training hours was 0.69 (retrospective) and 1.39 (prospective) during training and 9.24 (retrospective) and 18.45 (prospective) during competition. The main risk factor for injury in non-professional triathlon is participation in a competitive triathlon event. A retrospective design may underestimate the rate of overuse injuries.
    Journal of Sports Sciences 10/2013; 32(6). DOI:10.1080/02640414.2013.843018 · 2.10 Impact Factor
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    ABSTRACT: Associated with the trend towards increased health consciousness and fitness, triathlon has established itself as a sport for the masses. The goals of this study were to evaluate injury risk factors of non-professional triathletes and to compare prospective and retrospective evaluation methods. Using an online survey, 212 triathletes retrospectively answered a questionnaire about their training habits and injuries during the past 12 months. Forty-nine of these triathletes participated in a 12-month prospective trial. Injuries were classified with regard to the anatomical location, type of injury, incidence and associated risk factors. Most injuries occurred during running (50%) followed by cycling (43%) and swimming (7%). Fifty-four per cent (retrospective) and 22% (prospective) of the injuries were contusions and abrasions, 38% (retrospective) and 46% (prospective) were ligament and capsular injuries, 7% (retrospective) and 32% (prospective) were muscle and tendon injuries and 1% (retrospective) and 0% (prospective) were fractures. The incidence of an injury per 1000 training hours was 0.69 (retrospective) and 1.39 (prospective) during training and 9.24 (retrospective) and 18.45 (prospective) during competition. The main risk factor for injury in non-professional triathlon is participation in a competitive triathlon event. A retrospective design may underestimate the rate of overuse injuries.
    Journal of Sports Sciences 10/2013; · 2.10 Impact Factor
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    J. Dexel · C. Kopkow · Philip Kasten
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    ABSTRACT: A key element for movement of the arm is the position and motion of the scapula. Only if the scapula performs a coordinated three dimensional movement with the upper limp, a stabile basis for the arm movement is created. Soft tissue and bony injuries, muscle insufficiencies and dysbalancies can alter the position and function of the scapula. The pathologic position and motion is called scapula dyskinesis. The clinical examination presents with a lift of the medial border and malrotation (missing external rotation and posterior tilt) of the scapula during raising the arm. Scapula dyskinesis can be found at asymptomatic patients, too. Furthermore, it can be an unspecific reaction secondary to shoulder pathologies and it is not associated with a specific glenohumeral pathology. The clinical examination includes the visualization of the scapula at rest and in motion followed by specific clinical tests. Specific excercises may harmonize the sequence of movements and restore the dynamic scapular stability. A stepwise exercise program starts with core stabilization, followed by stabilization exercises and translational motion exercises of the scapula without movement in the shoulder. When these exercises can be performed without pain, dynamic stabilization exercises and finally sports specific exercises are added.
    Deutsche Zeitschrift für Sportmedizin 09/2013; 64(09-9):267-272. DOI:10.5960/dzsm.2012.084 · 0.58 Impact Factor
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    Philip Kasten · Christian Kopkow · Julian Dexel
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    ABSTRACT: A key element for a harmonic movement of the arm is the position and motion of the scapula. A pathologic position and movement of the scapula what is called scapula dyskinesia may irritate the tendons and cause pain in high performing athletes. Scapula dyskinesia, however, may also occur in asymptomatic patients. Harmonizing the sequence of movements and restoration of the dynamic scapular stability are basic steps to regenerate the irritated tendons (e.g. biceps tendon, rotator cuff). Electrophysiological studies have shown that the scapula bilizing muscles can effectively be exercised. These exercises are part of a step by step program which is described in this article. In the first place, core stability is essential. Furthermore, proprioception, stability and translational movement exercises are in the focus initially. If these exercises can be performed without pain, complex movements and finally sports specific exercises are added.
    Obere Extremität 09/2013; DOI:10.1007/s11678-012-0199-4
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    ABSTRACT: Although shoulder hemiarthroplasty (SHA) can improve function in osteoarthritic shoulders, the ability to perform activities of daily living (ADL) may remain impaired. Shoulder surgeons routinely measure parameters such as range of motion, pain, satisfaction and strength. A common subjective assessment of ADL is part of the Constant Score (CS). However, there is limited objective evidence on whether or not shoulder hemiarthroplasty can restore normal range of motion (ROM) in ADL. The study included eight consecutive patients (n=8; seven women, one man), who underwent SHA for glenohumeral osteoarthritis. The patients were examined the day before, as well as 6 months and 3 years after shoulder replacement. They were compared with a control group with no shoulder pathology, and shoulder movement was measured with 3D motion analysis using the "Heidelberg Upper Extremity" (HUX) model. Measurements included static maximum values and four ADL. Comparing the preoperative to the 3-year postoperative static maximum values, there were significant improvements for abduction from 50.5° (SD ±32.4°) to 72.4° (SD ±38.2°; p=0.031), for adduction from 6.2° (SD ±7.7°) to 66.7° (SD ±18.0°; p=0.008), for external rotation from 15.1° (SD ±27.9°) to 50.9° (SD ±27.3°; p=0.031), and for internal rotation from -0.6° (SD ±3.9°) to 35.8° (SD ±28.2°; p=0.031). There was a trend of improvement for flexion from 105.8° (SD ±45.7°) to 161.9° (SD ±78.2°; p=0.094) and for extension from 20.6° (SD ±17.0°) to 28.0° (SD ±12.5°; p=0.313). The comparison of the 3-year postoperative ROM between the SHA group and controls showed significant differences in abduction; 3-year postoperative SHA ROM 72.4° (SD ±38.2°) vs. 113.5° (SD ±29.7°) among controls (p=0.029). There were no significant differences compared to the control group in adduction, flexion/extension and rotation 3 years after SHA surgery. In performing the ADL, the pre- to the 6-month and 3-year postoperative status of the SHA group resulted in a significant increase in ROM in all planes (p<0.05). Comparing the preoperative to the 3-year postoperative ROM used in ADL, there was an improvement in the flexion/extension plane, showing an improvement trend from preoperative 85°-0°-25° to postoperative 127°-0°-38° (p=0.063). In comparison, controls used a significantly greater ROM during ADL with mean flexion/extension of 139°-0°-63° (p=0.028). For the abduction/adduction plane, ROM improved significantly from preoperative 25°-0°-19° to postoperative 78°-0°-60° (p=0.031). In comparison to controls with abduction/adduction of 118°-0°-37° 3 years postoperative, the SHA group also used significantly less ROM in the abduction/adduction plane (p=0.028). While SHA improves ROM in ADL in patients with degenerative glenohumeral osteoarthritis, it does not restore the full ROM available for performing ADL compared to controls. 3D motion analysis with the HUX model is an appropriate measurement system to detect surgery-related changes in shoulder arthroplasty.
    Gait & posture 08/2013; 39(1). DOI:10.1016/j.gaitpost.2013.07.111 · 2.30 Impact Factor
  • PD Dr. W. Schneiders · P. Kasten · H. Zwipp
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    ABSTRACT: Chronische Ellenbogenluxationen sind selten. Eine häufige Ursache ist ein Osteosyntheseversagen bzw. knöcherne Fehlstellungen nach komplexen Ellenbogenluxationen bzw. -luxationsfrakturen. Aufgrund der erheblichen Funktionsminderung, Schmerzsymptomatik und Gefahr einer Arthrose erfolgt die Behandlung meist operativ. Zur Planung der Operation sollte eine CT-Untersuchung durchgeführt werden. Da ein erhöhtes Risiko einer Ulnarisneuropraxie besteht, sollte zunächst der N. ulnaris dargestellt und neurolysiert werden. Prinzipiell sollte eine offene Gelenkreposition und Arthrolyse erfolgen. Anschließend werden eine eventuell notwendige knöcherne Rekonstruktion und additiv Bandplastiken durchgeführt. Bei einer persistierenden Instabilität sollte ein Bewegungsfixateur angelegt werden, in dem eine frühfunktionelle Behandlung gewährleistet werden kann. Bei schon erheblichen degenerativen Veränderungen kann auch die primäre Implantation einer Ellenbogenprothese indiziert sein.
    Arthroskopie 08/2013; 26(3). DOI:10.1007/s00142-012-0731-y

Publication Stats

2k Citations
242.86 Total Impact Points

Institutions

  • 2010–2015
    • Carl Gustav Carus-Institut
      Pforzheim, Baden-Württemberg, Germany
    • Universitätsklinikum Freiburg
      • Department of Orthopedics and Traumatology
      Freiburg an der Elbe, Lower Saxony, Germany
  • 2009–2014
    • Technische Universität Dresden
      • Institute of Chemistry and Laboratory Medicine
      Dresden, Saxony, Germany
  • 2013
    • Universitätsklinikum Dresden
      • Klinik und Poliklinik für Unfall- und Wiederherstellungschirurgie
      Dresden, Saxony, Germany
  • 2002–2012
    • Universität Heidelberg
      • • Orthopedic and Trauma Surgery Center
      • • Orthopädische Universitätsklinik
      Heidelberg, Baden-Wuerttemberg, Germany
    • Hannover Medical School
      • Trauma Department
      Hannover, Lower Saxony, Germany
  • 2004–2009
    • Orthopädische Universitätsklinik Friedrichsheim
      Frankfurt, Hesse, Germany
  • 2006
    • University of Freiburg
      • Department of Orthopedics and Traumatology
      Freiburg, Baden-Württemberg, Germany