A. Stöhr

OCM Clinic · Knee Surgery and Sports Traumatology

Purpose The aim of this consensus project was to give recommendations regarding surgical treatment of the anterior cruciate ligament (ACL) injured patient. Methods For this consensus process, an expert, steering and rating group was formed. In an initial online meeting, the steering group, together with the expert group, formed various key topic c...

Objective : To rate athletes’ functional ability and return to sport (RTS) success at the end of their individual, formal, medically prescribed rehabilitation after anterior anterior cruciate ligament (ACL) reconstruction. Methods : In our prospective multicenter cohort study, 88 (42 females) adults aged 18–35 years after acute unilateral ACL ruptu...

Abstract Numerous functional factors may interactively contribute to the course of self-report functional abilities after anterior cruciate ligament (ACL)-reconstruction. This study purposes to identify these predictors using exploratory moderation-mediation models in a cohort study design. Adults with post unilateral ACL reconstruction (hamstring...

Purpose Aim of this systematic review was to analyze the outcome after transphyseal ACL reconstruction in children and adolescents regarding the femoral drilling technique. Methods A systematic literature search was carried out in various databases on studies on transphyseal ACL reconstruction in children and adolescents. The literature search was...

PurposeThe aim of this consensus project was to create a treatment algorithm for the management of the ACL-injured patient which can serve as an aid in a shared decision-making process.Methods For this consensus process, a steering and a rating group were formed. In an initial face-to-face meeting, the steering group, together with the expert group...

PurposeThe aim of this consensus project was to validate which endogenous and exogenous factors contribute to the development of post-traumatic osteoarthritis and to what extent ACL (anterior cruciate ligament) reconstruction can prevent secondary damage to the knee joint. Based on these findings, an algorithm for the management after ACL rupture s...

Alpine racing and recreational skiing have gained increasing popularity in recent years. With growing commercialization and professionalization, there are new challenges for athletes and the care environment. In addition to the treatment of injuries and illnesses, the prevention of medical problems is becoming increasingly important.KeywordsAlpine...

Background Different indications and treatment options for combined injuries to the anterior cruciate ligament (ACL) and medial collateral ligament complex (MCL) are not clearly defined. Purpose To perform a modified Delphi process with the Committee for Ligament Injuries of the German Knee Society (DKG) in order to structure and optimize the proc...

Objective: The aim of the present paper is to analyze mid-term and long-term alterations of human anterior cruciate ligament (ACL) grafts during the remodeling process with special regards to cellularity, α-smooth muscle protein (αSMP) expression, and crimp length in comparison to the native ACL. Methods: A total of 34 patients were included (23 ma...

Alpine racing as well as recreational skiing is attracting increasing publicity. With growing commercialization and professionalization, there are also new challenges for the athletes and the care environment. In addition to the treatment of injuries and illnesses, the prevention of medical problems is becoming increasingly important.

Arthrofibrose ist eine schwerwiegende Komplikation nach VKB-Rekonstruktion. Ziel der vorliegenden Studie war es, die langfristigen klinischen und radiologischen Ergebnisse nach arthroskopischer Arthrolyse bei Arthrofibrose nach VKB-Rekonstruktion zu bewerten. Durch eine frühzeitige arthroskopische Arthrolyse kann eine langfristige Verbesserung der...

Background There are no clear therapeutic recommendations for anterior cruciate ligament (ACL) rupture in skeletally immature patients. Objective The aim of the present systematic review was to compare operative and conservative treatment with regard to objective clinical outcome and complications in children with mid-substance ACL tears. Materia...

Background Although anterior cruciate ligament (ACL) tear prevention programmes may be effective in the (secondary) prevention of a subsequent ACL injury, little is known, yet, on their effectiveness and feasibility. This study assesses the effects and implementation capacity of a secondary preventive motor control training (the Stop-X-program) aft...

Purpose Purpose of the current study was to compare early effectiveness of pain relieve of 3 in 1 regional pain catheter to local infiltration anesthesia (LIA) in primary total knee arthroplasty (TKA). Secondary endpoint was quadriceps muscle strength after both procedures. Material and methods A single-center, prospective, randomized controlled t...

Introduction Arthrofibrosis (AF) is the result of increased cell proliferation and synthesis of matrix proteins (collagen I, III, and VI). Especially after invasive knee surgery, e.g., ligament reconstruction or knee replacement, abnormal fibroblast proliferation with pathological periarticular fibrosis can be observed leading to severely limited j...

Systematic reviews now play a key role in evidence-based medicine, summarizing empirical findings from evaluated studies on a specific problem and examining the variability of those. These reviews help scientists integrate and evaluate relevant information in their research and support practitioners in decision-making processes. Since the early yea...

Introduction The differentiation between stiff-knee and low-grade periprosthetic joint infection (PJI) is the current diagnostic challenge in total knee (TKA) revision arthroplasty. The aim of this study was to investigate the additional value of dry biopsies, compared to wet biopsies, in patients presenting with knee stiffness following primary TK...

Purpose: To compare anatomic single-bundle (SB) with double-bundle (DB) anterior cruciate ligament reconstruction (ACL-R) and to evaluate the respective clinical outcome results. Methods: In a prospective randomized study, 64 patients were included and separated into 2 groups. Anatomic SB and DB ACL-Rs were performed with hamstring tendons. Five...

Re-rupture rates after anterior cruciate ligament (ACL) reconstruction vary between 2% and 23% for the operated knee and 7% and 24% for the contralateral side. One cause for re-ruptures could be persisting neuromuscular deficits. For this reason the German Knee Society has complied criteria as part of a consensus process to enable athletes to retur...

Zusammenfassung Hintergrund Der ideale Zeitpunkt für das „Return to play“ nach vorderer Kreuzbandrekonstruktion (VKB) wird aufgrund hoher Rerupturraten (0-23%) sowie auch häufiger Verletzungen der Gegenseite (7-24%) nach wie vor kontrovers diskutiert. Dabei scheinen die bis zu 2 Jahre andauernden Remodelingprozesse des Transplantats sowie postoper...

Objective: Reduction of the load to the medial compartment in patients with medial knee osteoarthritis and varus malalignment. Unloading of the posterolateral complex in varus deformity with complex ligamentous laxity. Indications: Medial knee osteoarthritis and varus malalignment with largely intact lateral and patellofemoral joint aspect. Comp...

Purpose: The current study was conducted to evaluate the long-term clinical and radiological outcomes after arthroscopic arthrolysis for arthrofibrosis after anterior cruciate ligament reconstruction (ACLR). Methods: All patients treated with arthrolysis between 1990 and 1998 were included. Indication was arthrofibrosis in at least one knee comp...

Zusammenfassung: Verschiedene Studien haben ge-zeigt, dass die dynamische Valgusstellung ein Risiko-faktor für das Erleiden einer Knie-und VKB-Verletzung ist. Ri-sikoathleten landen nach einem Sprung zudem aufrechter mit einem nur wenig gebeugten Kniegelenk. In dieser Position ist das vordere Kreuzband nur schlecht durch die isc hio-krurale Muskula...

Purpose To prospectively evaluate the prevalence and characteristics of meniscal injuries in children and adolescents undergoing surgical treatment for tibial eminence fractures and to test for possible relationships between associated meniscal lesions and patient demographics or injury characteristics. Methods A prospective multicenter study was c...

An essential step in successful ACL reconstruction is achieving appropriate tunnels or sockets for graft placement and fixation. Several drilling techniques have been described, all of which have their justification in respect to different operation and fixation strategies [6]. For single-bundle ACL reconstruction, one bone tunnel is needed in the...

Zusammenfassung: Reruptur-Raten nach Ersatzplastik des vorderen Kreuzbands (VKB) variieren zwischen 0 und 19 % für die operierte Seite; die Prävalenz für eine Verletzung der unverletzten Gegenseite wird auf etwa 7–24% eingeschätzt. Als Ursache für traumatische Rerupturen nach VKB-Rekonstrukti-on werden u.a. verbliebene neuromuskuläre Defizite geseh...

The purpose of this chapter is to highlight arthroscopic and supplementation treatment options in osteoarthritis of the knee. Respective therapies are described with indications, contraindications, and literature workup. Arthroscopic knee osteoarthritis treatment comprises lavage, debridement, abrasion arthroplasty, and microfractures. While stand-...

Background Today, knee arthroscopy is one of the standard interventions performed by an orthopaedist and usually has a low potential for complications. Purpose The surgeon should still be aware of possible problems, and be able to control and explain them to the patient in detail before surgery. Materials and methods The possible relevant peri-, in...

To compare anatomic single-bundle (SB) versus double-bundle (DB) anterior cruciate ligament (ACL) reconstruction and to determine possible differences in clinical outcomes. In this prospective randomized study, 64 patients were divided into 2 equal groups. Anatomic SB and DB ACL reconstructions were performed using hamstring tendons. A follow-up ex...

An increasing number of all operative procedures in orthopedic surgery are performed arthroscopically (Pedowitz et al. 2002). Simultaneously, there are a steadily rising number of residents. The task is to maintain high-quality standards and to guarantee an adequate training in arthroscopic surgery (Morris et al. 1993). Fortunately, arthroscopic sk...

In a retrospective study with a population over 65 years, sports activity was conducted 6 years after cruciate retaining (CR) total condylar knee arthroplasty (TKA) with rotating platform (RP). 81 patients with a mean age of 71.8 ± 5.4 years were examined at the follow-up 6.4 ± 0.9 years postoperative. The mean of patients practiced active sport fo...

Anterior cruciate ligament (ACL) rupture is an injury that puts an athlete at high risk of future osteoarthritis. Identification of potential risk factors and development of ACL prevention programs may decrease the risk of injury [43].

The successful and fast return of an athlete to his pre-injury level of sports strongly depends on the rehabilitation protocol [3]. From animal trials, we got information on the remodeling process and the mechanical strength of various ligament grafts after ACL reconstruction during the healing period. The stability of synovialized ligament grafts...

The aim of this study was to evaluate laxity in knees with pre-operative (preop) valgus alignment compared to knees with pre-operative varus alignment after total knee arthroplasty (TKA). This was a retrospective study including 81 patients, with six years follow-up, for pre-operative valgus- or varus alignment of the leg. All patients had been sup...

Restoration of free knee motion taking into account knee extension, knee flexion, and patella mobility. Prolonged knee motion restriction after anterior cruciate ligament (ACL) reconstruction, persistent decreased patella mobility, or extension deficit. Existing significant joint irritation or active reflex dystrophy with persistent distinctive pai...

Wiederherstellung einer möglichst freien Kniebeweglichkeit unter Beachtung der Kniestreckung, Kniebeugung und Patellamobilität.Protrahierte Bewegungseinschränkung nach Rekonstruktion des vorderen Kreuzbandes (VKB), langanhaltend verminderte Patellamobilität oder bestehendes endgradiges Streckdefizit.Bestehender erheblicher Reizzustand oder aktive R...

A controversial discussion is held on using stabilizing knee braces after anterior cruciate ligament (ACL) surgery. The current study investigated the influence of a stabilizing knee brace on results after ACL reconstruction using patellar tendon autografts. A prospective randomized study was started including 64 patients divided into two equal gro...

Purpose: The place of arthroscopic treatment in osteoarthritis of the knee has generated much controversy. A survey was initiated to collect the opinion of experienced surgeons. Methods: Of the 211 surgeons interviewed, 170 (80.6%) replied to the electronic questionnaire. Respondents had at least ten years of experience in arthroscopy and curren...

Die Therapie von Knochendefekten stellt immer wieder eine Herausforderung für Orthopäden und Unfallchirurgen dar. Die autologe Spongiosaplastik gilt auch heute noch als Goldstandard in der Behandlung von Knochendefekten. Daneben kommen neuere Methoden wie die RIA-Technik („reamer-irrigator-aspirator system“) zur biologischen Knochenaugmentation zum...

The most common failure reasons of an anterior cruciate ligament (ACL) graft are incorrect positioning of the drill channels and insufficient fixation. In many cases, one-stage revision with patellar tendon graft and the appropriate corrections are possible. For previous use of the ipsilateral patellar tendon third, an allograft seems favorable for...

The structural properties of the healing ligament are the determining factor for the stability of the reconstruction before, during, and after osseous integration of anterior cruciate ligament grafts. Over the course of ligamentization, the stability of synovialized grafts seems lower than that of non-synovialized patellar tendon grafts. In an anim...

A test setup for clinical use in the awake and non-anesthetized patient measuring anteroposterior translation and rotation of the knee joint is the subject of validation. A measuring device featuring fixation of the foot at 30° of knee flexion with varus/valgus stress posts for the knee was developed. Tibial rotation (external/internal) was imposed...

The clinical examination is a basic language of orthopaedics; it is how orthopaedic surgeons communicate with one another. However, each surgeon speaks a different dialect that has been influenced by where and with whom that surgeon trained, as well as that person's own experiences. Because of the inherent variability in the magnitude, direction, a...

Um die subjektiven manuellen Untersuchungsergebnisse bei Knieinstabilität zu objektivieren und neue Operationstechniken überprüfen zu können, werden zuverlässige apparative Messverfahren zur Bestimmung der Laxität unter Berücksichtigung der Rotation und a.p.-Translation benötigt. Die bisher häufig verwendeten kommerziell verfügbaren Arthrometer sin...