
Ludger GerdesmeyerUniversitätsklinikum Schleswig - Holstein | UKSH · Department of Orthopaedics
Ludger Gerdesmeyer
Professor, MD, PhD
About
171
Publications
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Introduction
Additional affiliations
Position
- Chair
July 2009 - present
July 2007 - present
Macquarie University NSW 2109, Sydney
Position
- Research Associate
Description
- research associate Prof. Munjed Al Muderis
Publications
Publications (171)
Background
The Vega System® PS (Aesculap AG, Tuttlingen, Germany) is an advanced, third generation fixed implant that aims to mimic natural knee kinematics by optimizing pivotal motion while reducing surface stress. This study evaluated mid-term survival and clinical outcomes, including range of motion (ROM) of the modern posterior stabilized impla...
Background: Topical NSAIDs are widely used to treat ankle sprains. Traumed (Tr14) gel is a multicomponent formulation, demonstrating inflammation-resolution properties. Methods: This multicenter, double-blind trial investigated the efficacy and safety of Tr14 gel versus placebo gel and non-inferiority versus 1% diclofenac gel, applied 3×/day for 7...
Many different pulsed electromagnetic field (PEMF) devises have been clinically used to stimulate healing processes, but many procedures are still without supporting basic research data. The aim of this study was to investigate a new modified pulsed electromagnetic field therapy: electromagnetic transduction therapy (EMTT). EMTT is technically base...
Surgical repair of acute mid-substance Achilles tendon ruptures is performed in active patients, but the postoperative rehabilitation program is often based on the experience of the surgeon or therapist, rather than on evidence-based protocols. The aim of the study is to establish an evidence-based protocol for rehabilitation. This study is a conse...
Background:
No long-term follow-up data exist in any treatment for chronic radicular pain occurring with disc pathology and after failed back surgery. A previous randomized controlled trial (RCT) has proven efficacy in short-term follow-up as an evidence-based effective therapeutic option.
Objectives:
Long term data is needed to determine the ef...
We present an outline of common stress fractures of the foot incurred by athletes. Specific non-surgical and surgical treatment recommendations for such injuries including for Jones, navicular and sesamoid injuries, which can be career ending, are described.
The increased incidence of bone defects, especially in cases of comminuted fractures or bone tumor resections demands suitable bone grafts and substitutes. The aim of this study was to establish an ex vivo bone defect model to evaluate new bone substitutes and associated repair processes under controlled conditions. Femoral heads derived from patie...
Background Periprosthetic joint infection (PPI) is one of the most common reasons for revision in total knee arthroplasty (TKA). Percutaneous synovial biopsy is considered as a well-established diagnostic tool in ambiguous cases of chronic pain after TKA. The exact number of undetected low-grade infections remains unclear.
Objectives The aim of thi...
Background/aim:
The aim of this study was to analyze survivorship and functional outcome of cementless spongy metal structured total hip arthroplasty (THA) after ultra-long-term follow-up.
Patients and methods:
A total of 100 THAs in patients under 65 years at initial surgery were performed between 1985 and 1989 at our Department. Twenty patient...
Rotator cuff (RC) tendinopathy is the most common cause of shoulder pain. The effectiveness of electromagnetic transduction therapy (EMTT), a high energetic pulsed electromagnetic field therapy in this field has not been tested yet in combination with extracorporeal shock wave therapy (ESWT).
A total of 86 patients with RC tendinopathy were randomi...
Background
Bone and soft tissue masses of the foot and ankle are not particularly rare but true neoplasia has to be strictly differentiated from pseudotumorous lesions. Diagnosis is often delayed as diagnostic errors are more common than in other regions. Awareness for this localization of musculoskeletal tumors is not very high and neoplasia is of...
Aims:
Asphericity of the femoral head-neck junction is common in cam-type femoroacetabular impingement (FAI) and usually quantified using the alpha angle on radiographs or MRI. The aim of this study was to determine the natural alpha angle in a large cohort of patients by continuous circumferential analysis with CT.
Methods:
CT scans of 1312 fem...
Background:
Several surgical options for the reconstruction of massive bone defects have been described and include biologic methods with autografts and allografts, and the use of tumor endoprostheses (total femoral replacement, TFR). Several types of modular TFR are available, but nevertheless unpredictable outcomes and high complication rates ha...
Objective: Chronic aseptic osteitis pubis is a common cause for groin pain in athletes and is associated with unit or bilateral inguinal pain. MRI images document bony stress of the pubis, however the pathophysiological mechanism has not been clarified. Therapy is difficult and often frustrating because of insufficient specific treatment options. M...
Two case reports of high-level athletes with medial tibial stress syndrome (MTSS), 1 an Olympian with an actual stress fracture, are presented. Successful treatment included radial soundwave therapy, pneumatic leg braces, relative rest using an antigravity treadmill, and temporary foot orthoses. Radial soundwave therapy has a high level of evidence...
Extracorporeal shock wave therapy/radial soundwave therapy has been predominantly used for chronic or recalcitrant plantar fasciitis with strong scientific evidence of reliable outcomes. Most of the studies included patients with plantar fasciitis with symptoms >6 months in duration. Only 2 known studies have investigated acute plantar fasciitis, w...
A parallel prospective feasibility study was performed on 53 patients with chronic mid-portion Achilles tendinopathy (age 44.7 ± 9.1 years). Of the 53 patients, 28 (active group) were treated using a new electromagnetic (pulsed electromagnetic field) transduction therapy device (Cellactor® MT1) and heel cushions. The device produces an electromagne...
Ischiofemoral impingement (IFI) is a rare cause of hip pain defined by a narrowing of the space between the lateral aspect of the os ischium and the lesser trochanter of the femur. Several underlying anatomic, functional and iatrogenic pathologies have been identified for symptomatic IFI in native hip joints and after total hip arthroplasty. Clinic...
Background:
It is the gold standard to use a placebo treatment as the control group in prospective randomized controlled trials (RCTs). Although placebo-controlled trials can reveal an effect of an active treatment, the pure effect of a placebo treatment alone has never been presented or evaluated. No evidence-based, placebo-therapeutic options ar...
The majority of cases of upper ankle joint (UAJ) osteoarthritis are due to secondary causes. Clinically, osteoarthritis is usually characterized by an increasing limitation in dorsal extension of the UAJ with often relatively mild symptoms. In the course of time the full scale of the typical symptoms and the progressive restriction of the global fu...
Objectives:
A prospective randomised controlled trial to investigate the efficacy of electromagnetic transduction therapy (EMTT) for treatment of patients with non-specific low back pain.
Design:
Two groups with non-specific low back pain were either treated with conventional therapy alone over 6 weeks or in combination with 8 sessions of EMTT....
Nicht selten haben Patienten nach Hüft-TEP noch Restbeschwerden. Bisher wurden die Symptome unter Sammeldiagnosen wie „chronische Bursitis trochanterica“ oder „Trochantersyndrom“ zusammengefasst. In der modernen Endoprothetik werden diese Begriffe jedoch zunehmend durch die Diagnose „gluteale Insuffizienz“ ersetzt. Was verbirgt sich hinter diesem K...
Background
The aim of this study was to compare the functional outcomes and complication rates after distal femoral replacement (DFR) performed with the modular Munich-Luebeck (MML) modular prosthesis (ESKA/Orthodynamics, Luebeck, Germany) in patients being treated for malignant disease or failed total knee arthroplasty.
Methods
A retrospective re...
Background:
Compromised bone stock and heavily impaired structural integrity after multiple endoprosthetic revision surgeries can lead to a comparable condition as encountered in musculoskeletal tumor surgery. Total femoral replacement (TFR) can restore femoral integrity and allow patients to resume ambulation. Even though several authors reported...
Background:
Both unicameral bone cysts and intra-osseous lipoma of the calcaneus are rare entities which are mostly diagnosed due to unspecific heel pain, pathologic fracture or as an incidental finding. Minimally-invasive ossoscopy with endoscopic resection of the tumor followed by grafting can potentially minimize risks of open surgery and speed...
Background
Cementless fixation of total hip arthroplasties (THAs) is often favored in young, high-demanding patients due to the conservation of valuable bone-stock and easier revision if loosening has occurred. Long-term outcome data of the spongy metal structured implant used in the present study in patients younger than 65 years are still lacking...
The purpose of the present study was to evaluate the efficacy of radial soundwave therapy (RSW) for the management of sesamoiditis, symptomatic bipartite sesamoids, and avascular necrosis in athletic patients. The data from 10 patients undergoing RSW for sesamoiditis were retrospectively studied. Three treatments at 2.4 Bar and 13 Hz, for a total o...
Background: Pathological fractures can be caused by numerous local and systemic processes. The humerus is one of the commonest sites of pathological, tumour-associated fractures. Patients and Methods: In a retrospective study, 76 cases of pathological fractures of the humerus were analysed; 57 (75 %) were caused by a malignant disease, 19 fractures...
Lower limb amputees often experience complications with the use of conventional socket-type prostheses, which further reduce their already compromised ability to perform the activities of daily living, or to participate in sporting activities. During the last two decades, a new technology of direct skeletal attachment (osseointegration) of prosthes...
Background:
Chronic refractory low back and lower extremity pain is frustrating to treat. Percutaneous adhesiolysis and spinal endoscopy are techniques which can treat chronic refractory low back and lower extremity pain.Percutaneous adhesiolysis is performed by placing the catheter into the tissue plane at the ventrolateral aspect of the foramen...
Extracorporeal shockwave therapy (ESWT) has gained acceptance in the medical field and in the treatment of non-unions and delayed bone healing. ESWT has been used effectively for many years as a noninvasive surgical procedure. The idea of treating Osteochondritis dissecans of knee and talus arose in the middle of the 1990's. OCD is known as a pre-a...
Extracorporeal shockwave therapy (ESWT) is used in a number of indications in the medical field. A number of tendinopathies show good and excellent results due to evidence based medicine. The treatment of lateral epicondylitis is known to show conflicting results. This overview of the published RCT's on ESWT for lateral epicondylitis tries to show...
Fracture non-unions are still a challenging problem in orthopedics. The treatment of non-unions remains highly individualized, complex, and demanding. In most countries the surgical approach with debridement of the non-union gap, anatomical reduction and appropriate osteosynthesis along with autologous bone grafting is considered as the standard of...
Shoulder pain is one of the most common musculoskeletal pathologies. Treatment by ESWT (extracorporeal shockwave therapy) has emerged as an alternative when conservative treatment fails in rotator cuff calcific tendinopathy, prior to invasive procedures. The clinical efficacy of ESWT in non-calcific tendinopathy remains controversial. The good resu...
Background:
The effectiveness of extracorporeal shock wave therapy in the treatment of plantar fasciitis is controversial. The objective of the present study was to test whether focused extracorporeal shock wave therapy is effective in relieving chronic heel pain diagnosed as plantar fasciitis.
Methods:
Two hundred and fifty subjects were enroll...
Avulsion fractures of the lesser trochanter in adolescents are uncommon. This injury is a result of a sudden forceful contraction
of the iliopsoas tendon. It usually occurs during vigorous sport activity. Historically, these injuries were treated non-operatively,
with guarded results, including weak hip flexor strength and non-union, hindering retu...
Bei der Entstehung von Enthesiopathien steht ätiologisch eine Überbelastung mit begleitenden repetitiven Mikrotraumen im Vordergrund. Bestimmte Sehnenansätze wie die der Achilles-, Patellar- und Supraspinatussehne sowie die der Unterarmextensoren/-flexoren sind besonders anfällig. Durch die Erkenntnis, dass es sich bei chronischen Enthesiopathien n...
The majority of insertional and noninsertional tendinopathy cases are associated with repetitive or overuse injuries. Certain tendons are particularly vulnerable to degenerative pathology; these include the Achilles and patella tendon, the rotator cuff, and forearm extensors/flexors. Disorders of these tendons are often chronic and can be difficult...
Greater trochanteric pain is one of the common complaints in orthopedics. Frequent diagnoses include myofascial pain, trochanteric bursitis, tendinosis and rupture of the gluteus medius and minimus tendon, and external snapping hip. Furthermore, nerve entrapment like the piriformis syndrome must be considered in the differential diagnosis. This art...
Die Gonarthrose ist eine degenerative Erkrankung des Kniegelenks, die durch einen fortschreitenden, irreversiblen Verlust an hyalinem Gelenkknorpel mit Umbau des subchondralen Knochens gekennzeichnet ist. Symptome sind je nach Stadium Morgensteifigkeit, belastungsabhängige Schmerzen bis hin zum Ruheschmerz mit Bewegungseinschränkung und Ergussbildu...
Die Gonarthrose ist eine degenerative Erkrankung des Kniegelenks, die durch einen fortschreitenden, irreversiblen Verlust an hyalinem Gelenkknorpel mit Umbau des subchondralen Knochens gekennzeichnet ist. Symptome sind je nach Stadium Morgensteifigkeit, belastungsabhängige Schmerzen bis hin zum Ruheschmerz mit Bewegungseinschränkung und Ergussbildu...
Osteoarthritis of the knee is a degenerative joint disease with progressive degradation of articular cartilage and subchondral bone. Symptoms may include joint pain, tenderness, stiffness, locking and joint effusion depending on the stage of the disease. In an effort to delay major surgery, patients with knee osteoarthritis are offered a variety of...
Background:
Chronic radicular pain can occur after disc pathology and failed back surgery. An evidence-based effective therapeutic option is not available nor does a gold standard exist.
Objectives:
A randomized controlled trial to analyze the clinical efficacy of percutaneous epidural lysis of adhesions in chronic radicular pain.
Study design:...
The aim of this study was to investigate if radial extracorporeal shock wave therapy (rESWT) induces new bone formation and to study the time course of ESWT-induced osteogenesis. A total of 4000 impulses of radial shock waves (0.16 mJ/mm²) were applied to one hind leg of 13 New Zealand white rabbits with the contralateral side used for control. Tre...
Plantar fasciitis can be a chronic and debilitating condition affecting athletes of all levels. The aim of this study is to compare treatment outcomes for the treatment of chronic plantar fasciitis in athletes, comparing focused extra corporeal sound wave therapy (ESWT) and the surgical endoscopic plantar fasciotomy (EPF). A total of 37 eligible pa...
Bone and soft tissue tumors of the foot and ankle are not rare in the foot specialist’s practice. Although masses are usually
seen early with early symptoms due to compact anatomy with thin soft tissue coverage (e.g., pain on weight-bearing), diagnosis
is often delayed. Diagnostic errors are more common than in other regions, since neoplasia is oft...
Zusammenfassung
Die Planung von Operationen bei Patienten mit entzündlich rheumatischen Erkrankungen stellt eine große Herausforderung dar. Neben den unterschiedlichen zugrundeliegenden rheumatischen Erkrankungen, deren Aktivität und Befallsmuster und nicht zuletzt deren begleitende medikamentöse Therapie, muss großen Wert auf die richtige Terminie...
Die Tendinosis calcarea der Rotatorenmanschette ist eine häufige Ursache von Schulterbeschwerden, v. a. bei Patienten im Alter zwischen 30 und 50 Jahren. Sie beginnt meist plötzlich, ohne erhöhte vorangegangene Belastung der Schulter, mit starken bewegungsunabhängigen Schmerzen. Die Diagnose wird durch Anamnese, klinische Untersuchung, Ultraschall...
Calcific tendinitis of the shoulder is a process involving crystal calcium deposition in the rotator cuff tendons, which mainly affects patients between 30 and 50 years of age. The etiology is still a matter of dispute. The diagnosis is made by history and physical examination with specific attention to radiologic and sonographic evidence of calcif...
Hip resurfacing in young patients has been increasingly performed within the last decade. In comparison to standard total hip arthroplasty the failure rate remains high. Age and implant size have a significant effect on the risk of revision for primary total resurfacing and the risk of revision increases with increasing age. At 7 years the cumulati...
The present manuscript provides an overview of current evidence-based data and new clinically relevant developments in the field of hip arthroplasty. A multitude of current clinical trials have focussed on tribology with special interest on metal-on-metal implants. Large trials from implant registries have defined specific risk factors for early im...
The number of total hip replacement (THR) surgeries has increased significantly over the last few years and patients undergoing surgery are of decreasing age. In consequence the question of the influencing factors for the survival of artificial hip joints becomes more and more urgent. The expected survival time of an implant is nowadays 15-20 years...
Hip resurfacing in young patients has been increasingly performed within the last decade. In comparison to standard total hip arthroplasty the failure rate remains high. Age and implant size have a significant effect on the risk of revision for primary total resurfacing and the risk of revision increases with increasing age. At 7 years the cumulati...
We present the results of cementless total hip arthroplasty performed with use of an anatomically adapted femoral stem and hemispherical cup with a fully coated Spongiosa-I metal surface, which was designed to achieve a surface similar to human cancellous bone. The purpose of the present retrospective case series was to determine the long-term outc...
Achilles tendinopathy is common and extracorporeal shockwaves have become a popular treatment for this condition, even though previous research has not provided conclusive results regarding its efficacy in cases of Achilles tendinopathy. Our aim was to evaluate 3 weekly shockwave treatments in patients with Achilles tendinopathy, as quantified by t...
Hip resurfacing is used as an alternative option for young patients suffering from osteoarthritis. Standard implants used for resurfacing have similar designs and biomechanical properties. We present a hip resurfacing system that restores the surface with minimal bone loss and preserves the subchondral bone stock of the femoral head by reaming the...
Antibacterial effects of extracorporeal shockwaves (ESWs) have been demonstrated in vitro against bacteria under static and dynamic growth conditions. This study assessed the effects of ESWs on the cell wall integrity of bacteria.
Standardized suspensions of Staphylococcus aureus were exposed to various shockwave impulses (2000-12,000) of different...
We studied a consecutive series of 81 cementless total hip arthroplasties in 80 patients using the second generation ESKA cementless spongy metal hip replacement. The study end-point was implant revision and both function as well as satisfaction with treatment outcome were assessed.
Mean age at the time of surgery was 50.9 years [range 23–73]. No p...
Local infection is considered a contraindication for extracorporeal shock wave (ESW) application, although the antibacterial effects of ESW have been clearly demonstrated in vitro. This study aimed to assess the effects of ESW on bacteria under growth-promoting conditions and to evaluate interactions with the activity of gentamicin.
Standardized su...
Extracorporeal shockwave therapy (ESWT) is applied successfully in various orthopedic disorders. Since shockwaves have demonstrated significant bactericidal effectiveness in vitro, safety and effectiveness of ESWT in vivo were evaluated in a rabbit model of osteomyelitis. Chronic osteomyelitis was induced by injecting sodium morrhuate and Staphyloc...
Minimally invasive anterolateral approach in hip resurfacing with complete preservation of muscular integrity.
Primary or secondary osteoarthritis of the hip.
Approach: None. Onlay implant: Females>55 years with osteoporosis. Males>60 years with osteoporosis. Severe varus deformity (CCD [collodiaphyseal] angle<100 degrees). History of metal allergy...
Autoclaving, heat, irradiation or chemical detergents are used to disinfect autografts, allografts and biomaterials for tissue reconstruction. These methods are often associated with deterioration of mechanical, physical, and biological properties of the bone grafts and synthetic implants. High hydrostatic pressure has been proposed as a novel meth...