Peter Koch

Publications (3)5.64 Total impact

• Article: Novel measurement technique of the tibial slope on conventional MRI.

  Robert Hudek, Silvia Schmutz, Felix Regenfelder, Bruno Fuchs, Peter P Koch
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  ABSTRACT: The posterior inclination of the tibial plateau, which is referred to as posterior tibial slope, is determined routinely on lateral radiographs. However, radiographically, it is not always possible to reliably recognize the lateral plateau, making a separate assessment of the medial and lateral plateaus difficult. We propose a technique to measure the plateaus separately by defining a tibial longitudinal axis on a conventional MRI. The medial plateau posterior tibial slope obtained from radiographs was compared with MR images in 100 consecutive patients with knee pain when ligament or meniscal injury was assumed. The posterior tibial slope on MRI correlated with those on radiographs. The mean posterior tibial slope was 3.4 degrees smaller on MRI compared with radiographs (4.8 degrees +/- 2.4 degrees versus 8.2 degrees +/- 2.8 degrees , respectively). The reproducibility was slightly better on radiographs than MRI (+/- 0.9 degrees versus +/- 1.4 degrees ). Twenty-one of the 100 cases had more than a 5 degrees difference (range, -8.7 degrees to 8.9 degrees ) between the medial and lateral plateaus. The proposed technique allows measurement of the posterior tibial slope of the medial and lateral plateaus on a standard knee MRI. By using this novel measurement technique, a reliable assessment of the medial and lateral tibial plateaus is possible. LEVEL OF EVIDENCE: Level III, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence.
  Clinical Orthopaedics and Related Research 03/2009; 467(8):2066-72. · 2.53 Impact Factor
• Article: Simplified wound care and earlier wound recovery without closed suction drainage in elective total hip arthroplasty. A prospective randomized trial in 100 operations.

  Claudio Dora, Arndt von Campe, Bernhard Mengiardi, Peter Koch, Patrick Vienne
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  ABSTRACT: Evidence to support or refute closed suction drainage (CSD) in primary total hip replacement (THR) is not conclusive. Our anecdotical experience was that persistent ooze from the drainage hole often delayed wound recovery. We hypothesized that, without CSD, wound care would be simplified without short or long term disadvantage. Hundred patients scheduled for primary THR were randomly assigned for CSD or non-drainage. Drains were withdrawn at day 2. Pain, wound hematoma, number of dressing changes, time of persistent discharge from the operation site (skin incision and drain hole), total blood loss and number of blood transfusions were prospectively recorded. Hip function, presence of heterotopic ossifications (HTO) and complications were recorded at a follow visit 1 year after surgery. Wound sites managed without CSD needed significantly less wound dressings (P < 0.001) and were dry at an earlier time (P < 001). Despite a significant bigger subfascial hematoma in the non-drained group (P < 0.05), in terms of pain, thigh swelling, total blood loss, number of transfusions needed, hip function and HTO no difference was recorded between the groups (P = 0.2-0.82). To omit CSD in primary THR results in simplified and more rapid wound management without any disadvantage at short and long term.
  Archives of Orthopaedic and Trauma Surgery 01/2008; 127(10):919-23. · 1.37 Impact Factor
• Article: Femoral stress fracture after computer navigated total knee arthroplasty.

  Christian Ossendorf, Bruno Fuchs, Peter Koch
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  ABSTRACT: Computer navigation for total knee arthroplasty is increasingly used because it improves the accuracy of femoral and tibial components implantation. However, every new technique is associated with its own complications. Here, we report on a patient who developed a distal femoral stress fracture after two attempts at fixing the navigation tracker.
  The Knee 11/2006; 13(5):397-9. · 1.74 Impact Factor