Mirco Herbort

Mirco Herbort
OCM Clinic Munich

Prof. Dr. med.

About

183
Publications
33,658
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2,777
Citations
Additional affiliations
January 2009 - December 2011
Universitätsklinikum Münster
January 2006 - December 2012
University of Münster

Publications

Publications (183)
Article
Background Both the superficial medial collateral ligament (sMCL) and the deep MCL (dMCL) contribute to the restraint of anteromedial (AM) rotatory instability (AMRI). Previous studies have not investigated how MCL reconstructions control AMRI. Purpose/Hypothesis The purpose was to establish the optimal medial reconstruction for restoring normal k...
Conference Paper
Full-text available
After anterior cruciate ligament reconstruction (ACLR), continuous active motion (CAM) devices are part of knee rehabilitation programs over the last 20 years. These devices are usually prescribed in addition to physiotherapy. However, a standardised validated physiotherapy program after ACLR is lacking in clinical reality. Objectives: Explorative...
Article
Purpose: The 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 ruptur...
Article
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The main principles of the present medial collateral ligament (MCL) reconstruction techniques are (1) to approximate the natural anatomy and (2) to restore the main passive restraining structures in anteromedial and posteromedial knee instability. Therefore, we describe a technique using a flat tendon graft instead of tubular grafts with point-to-p...
Article
Objective: The goal of the modified Ellison operation as a supplement to a conventional anterior cruciate ligament (ACL) reconstruction is to decrease anterolateral rotational instability of a knee joint after ACL rupture, to improve the stability and prevent ACL re-rupture. Indications: An ACL rupture with high risk of re-rupture (young age, hi...
Article
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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...
Article
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Background The microvascular anatomy of the meniscus of the human knee is regarded as a crucial factor in the injury response. Previous studies have investigated the zone-dependent distribution pattern, but no quantitative data exist on vascular density and its age-related changes. Hypothesis/Purpose The aim of the present study was to histologica...
Article
Background Anterior cruciate ligament (ACL) surgery is the subject of intensive further development. Nevertheless, increased rates of rerupture in particularly active and young patients represent a major challenge. The drilling technique (transtibial versus medial portal technique), the choice of graft, and graft fixation are the most important fac...
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Background The use of the interference screw (IFS) for the cortical fixation of tendon grafts in knee ligament reconstruction may lead to converging tunnels in the multiligament reconstruction setting. It is unknown whether alternative techniques using modern suture anchor (SA) or bone staple (BS) fixation provide sufficient primary stability. Pur...
Conference Paper
Keywords: Active Motion Device, CAMOPED, ACL, Physiotherapy, Rehabilitation Background After anterior cruciate ligament (ACL) reconstruction, continuous active (CAM) or passive (CPM) motion devices are part of knee rehabilitation programs over the last 20 years. However, there is not a single high-quality clinical trial without severe bias investi...
Conference Paper
Keywords: Active Motion Device, CAMOPED, ACL, Use And Acceptance, Satisfaction Background Continuous active motion devices (CAM) are been used in daily routine as part of knee rehabilitation programs, especially after anterior cruciate ligament (ACL) reconstruction (ACLR) over the last 20 years. Despite their established use, there is no data avai...
Conference Paper
Full-text available
Aims and Objectives: Clinical assessment of knee joint effusion as part of routine physical knee examination is gold standard, but lacks criteria and accuracy that would make it suitable for quantitative objective and reproduceable assessment across centres in scientific context or for individual adaptations in knee rehabilitation after surgical in...
Article
Background Various meniscal suture systems and techniques are available for treatment of a ruptured meniscus. All-inside systems in particular have recently been increasingly criticized through legal decisions.Objective The objective of this study was to analyze the treatment reality among members of the AGA- Society for Arthroscopy and Joint Surge...
Article
The exact anatomy in relation to the individual fixation of the menisci in the knee joint and their vascular supply are the most important prerequisites for adequate surgical treatment. This article aims to give an up to date overview of the anatomical features of the menisci with a focus on these specific aspects. A zonal classification of the men...
Article
Background: In contrast to the majority of existing techniques for reconstruction of the medial patellofemoral ligament (MPFL), the technique described in this article uses the adductor magnus muscle tendon to gain a flat, broad graft, leaving its distal femoral insertion intact, and does not require drilling within or near the femoral physis. It...
Article
Purpose The goal of the present study was to evaluate a potential tunnel convergence in combined anterior cruciate ligament (ACL) reconstruction using the anteromedial portal (AMP) technique and lateral extra-articular tenodesis (LET). Methods Ten fresh frozen femora were dissected and a K-wires were inserted into the middle of the ACL stump accor...
Article
Full-text available
Purpose The purpose of this study was to examine the length change patterns of the native medial structures of the knee and determine the effect on graft length change patterns for different tibial and femoral attachment points for previously described medial reconstructions. Methods Eight cadaveric knee specimens were prepared by removing the ski...
Article
Peripheral ligamentous instabilities of the knee joint have received much attention in recent years. Especially, as concomitant lesions of anterior (ACL) or posterior cruciate ligament (PCL) injury, they seem to be of great importance for the successful therapy of these combined knee injuries. There is a synergistic function between the ligaments o...
Article
Background Graft rupture is a devastating outcome after anterior cruciate ligament (ACL) reconstruction (ACLR). Little is known about graft rupture rates as well as clinical and functional outcomes after ACLR with quadriceps tendon (QT) autografts. Purpose To compare QT with hamstring tendon (HT) autografts in terms of the rates of graft and contr...
Article
PurposeThis study aimed to compare the biomechanical properties of the popliteus bypass against the Larson technique for the reconstruction of a combined posterolateral corner and posterior cruciate ligament injury.Methods In 18 human cadaver knees, the kinematics for 134 N posterior loads, 10 Nm varus loads, and 5 Nm external rotational loads in 0...
Article
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Background Microfracture (MF) is an established operative treatment for small, localized chondral defects of the knee joint. There is evidence from animal studies that matrix augmentation of bone marrow stimulation (m-BMS) can improve the quality of the repair tissue formation. Purpose To evaluate the therapeutic outcome of a matrix made of polygl...
Article
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Aims and Objectives Microfracture is the gold standard for the treatment of small localized chondral defects of the knee joint. There is evidence from animal studies that the augmentation of bone marrow stimulation by a matrix improves the quality of the repair tissue (matrix-augmented bone marrow stimulation = m-BMS). Aim of this randomized contro...
Article
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Aims and Objectives Recently, due to the development of new techniques, ACL repair has returned back into focus of experimental and clinical research. Newer studies highlight the fact that ACL repair can lead to satisfying functional results and healing rates. Aim of the present study was to compare the functional results after ACL repair in compar...
Article
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Aims and Objectives The main goal of the presented study was to evaluate the anatomical and biomechanical properties of the proposed surgical technique for anatomical Medial Patellofemoral ligament (MPFL) reconstruction using the flat Adductor tendon (AT) graft in order to primarily determine its overall plausibility and application potential, as w...
Article
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Aims and Objectives Anteromedial rotatory instability (AMRI) may result from combined lesions to the medial capsuloligamentous structures and anterior cruciate ligament (ACL). However, the contribution made by individual structures to controlling AMRI remains controversial. The purpose of the present study was to determine how the medial structures...
Article
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Aims and Objectives Lateral extra-articular tenodesis (LET) procedures are being increasingly performed as concomitant procedures to both primary and revision intra-articular ACL reconstructions with the purpose of controlling excessive anterolateral rotatory instability and to reduce tension on the ACL graft. There is, however, a lack of evidence...
Article
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Aims and Objectives Chronic medial instability presents a severe problem both for the patient and the surgeon, and may result into anterior cruciate ligament graft failure in a combined anteromedial instability. Thus, reconstructions have been developed to conquer this problem. However, these are not capable of mimicking the flat anatomy of the med...
Article
The aim of this technique is to reconstruct the medial patellofemoral ligament using a distally attached strip of the quadriceps tendon. Minimally invasive instruments are used to harvest a strip of the quadriceps tendon using a superomedial incision. The isometric insertion site is determined using an image intensifier. This is crucial in order to...
Chapter
Many surgeons use quadriceps tendon (QT) graft for anterior cruciate ligament (ACL) revision surgery; however, despite excellent clinical results, the QT has not achieved universal acceptance for primary ACL reconstruction. One of the reasons for this may be that the QT is technically demanding to harvest, and the scar from open harvesting techniqu...
Article
PurposeThe purpose of the present study was to determine how the medial structures and ACL contribute to restraining anteromedial instability of the knee.Methods Twenty-eight paired, fresh-frozen human cadaveric knees were tested in a six-degree of freedom robotic setup. After sequentially cutting the dMCL, sMCL, POL and ACL in four different cutti...
Article
Background Arthroscopically assisted reduction and fixation (ARIF) of tibial plateau fractures offers advantages regarding visualization of the injury and use of minimally invasive fixation techniques.Objectives Identification of indications, techniques and limits of ARIF for the treatment of tibial plateau fractures.Materials and methodsAnalysis o...
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Introduction: The purpose of this study was to determine the variability of femoral tunnel positions applying two different lateral extra-articular tenodesis (LET) techniques, guiding on the tactile identification (1) of the lateral epicondyle (Lemaire procedure) and (2) of the Kaplan fibre attachments on the distal femur (MacIntosh procedure) and...
Article
Background Anterior cruciate ligament (ACL) repair has once again become a focus of research because of the development of new techniques. Purpose/Hypothesis The purpose of the present study was to compare the functional results and recurrent instability rates in patients undergoing ACL repair with dynamic intraligamentary stabilization (DIS) vers...
Article
The article describes a single stage surgical treatment of a complex knee injury of a 28-year-old professional football player and the clinical course. The patient suffered a rupture of the anterior cruciate ligament (ACL) with a medial meniscus bucket handle tear, a type 2 posterior meniscus root tear and a traumatic grade 4 cartilage injury cover...
Article
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According to recent anatomic studies, the anterior cruciate ligament (ACL) appears to be a flat, "ribbon-like" structure, with a thin, oval-shaped insertion on the femur and a C-shaped tibial insertion. According to this anatomy, we describe an ACL-reconstruction technique that aims to approximate this natural anatomy. The basic principle of this t...
Article
Background Anteromedial rotatory instability (AMRI) frequently occurs from combined injuries to the medial capsuloligamentous structures and anterior cruciate ligament (ACL). The purpose of the present study was to determine the contribution of each medial structure in restraining AMRI.Material and methodsA total of 28 paired human cadaveric knees...
Article
Die klinische Untersuchung des Kniegelenks stellt zum einen eine große Herausforderung, zum anderen aber auch eine große Chance dar. Insbesondere ligamentäre Verletzungen werden trotz ihrer Komplexität immer besser verstanden und somit auch differenzierter therapiert. Eine rein radiologische Diagnosestellung ist v. a. bei chronischen Verletzungen n...
Article
Prinzipiell kann man nach Ruptur des vorderen Kreuzbands (VKB) drei verschiedene Verhaltensmuster unterscheiden, nämlich „Coper“ („Kompensierer“), „Noncoper“ und „Adapter“. Bewegungsanalysen zeigen funktionelle Unterschiede zwischen „Coper“ und „Noncoper“ hinsichtlich Kraft, Propriozeption und Bewegungsmustern. Zur Unterscheidung zwischen „Coper“ u...
Article
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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...
Article
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Purpose: To evaluate the effects of different stitching methods and suture diameters on the graft fixation of soft tissue human quadriceps tendon grafts for anterior cruciate ligament (ACL) reconstruction. Methods: The Krackow locking stitch (K), whipstitch (W), and baseball stitch (B) were combined with either a 2× no. 2 (#2) or a 1× no. 5 (#5)...
Article
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Background: Lateral extra-articular tenodesis (LET) is being increasingly added to primary and revision anterior cruciate ligament (ACL) reconstruction to address residual anterolateral rotatory instability. However, currently there is a lack of knowledge on how close the femoral tunnels are when combining these procedures. Purpose/hypotheses: T...
Article
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Aims and Objectives Dynamic Intraligamentary Stabilisation (DIS) is an anterior cruciate ligament (ACL) preserving surgical procedure for acute ACL injuries. A braided suture and a threaded sleeve containing a preloaded spring fixed into the proximal tibia provides continuous biomechanical stability. In combination with mircofracturing, self-healin...
Article
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In den vergangenen Jahren ist zur Behandlung eines rupturierten vorderen Kreuzbandes (VKB) die Kreuzbandnaht und somit der Erhalt des Ligaments im Gegensatz zur VKB-Plastik erneut in den Fokus geraten. Diese Arbeit vermittelt einen aktuellen Überblick über den Entwicklungsstand diverser VKB-erhaltender Operationsverfahren sowie deren experimentelle...
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Background:: Little is known about the dynamic restraints of the semimembranosus muscle (SM). Purpose and hypothesis:: The goal of the present study was to elucidate the role of (1) passive and (2) active restraints to medial-side instability and to analyze (3) the corresponding tightening of the posteromedial structures by loading the SM. It wa...
Article
Objective Treatment of persistent anterolateral knee instability. Indications Subjective/objective (rotational) instability of the knee after anatomic anterior cruciate ligament (ACL) reconstruction. ACL re-rupture including special demands (e.g., high-performance athletes, hyperlaxity) Relative contraindications Osteoarthritis, additional instab...
Chapter
Acute patella dislocation makes up 2–3% of all acute knee injuries, with a higher incidence in younger and athletic patients [1–3]. Risk of re-dislocation following first-time injury is 17–49% [2], rising to 44–71% in patients younger than 20 years [1, 3].
Article
Purpose Despite good initial pullout strength, it is unclear whether adjustable button (AB) devices for anterior cruciate ligament (ACL) soft-tissue graft fixation, which are based on the Chinese finger trap technique, resist cyclic loading. Furthermore, they have never been tested in a cyclic protocol including complete unloading. It was hypothesi...
Article
Full-text available
Many surgeons use quadriceps tendon (QT) graft for anterior cruciate ligament (ACL) revision surgery; however, despite excellent clinical results, the QT has not achieved universal acceptance for primary ACL reconstruction. One of the reasons for this may be that the QT is technically demanding to harvest and the scar from open harvesting technique...
Article
Die Quadrizepssehne bietet sowohl im Revisionsfall als auch bei der primären Rekonstruktion des vorderen Kreuzbands (VKB) sehr gute Eigenschaften als Transplantat und erfreut sich somit zunehmender Akzeptanz. Insbesondere nach minimal-invasiver Entnahme weist die Quadrizepssehne gegenüber den Hamstringsehnen eine vergleichbar geringe Entnahmemorbid...
Article
Die Art der biologischen Einheilung nach vorderer Kreuzbandrekonstruktion ist ein möglicher Faktor, der Transplantatversagen durch Lockerung oder traumatische Rerupturen bewirken kann. Bei der Remnant-erhaltenden Augmentation sollen möglichst viele Fasern des ursprünglichen vorderen Kreuzbands (VKB) erhalten werden. Die gute Vaskularisierung und Be...
Chapter
Quadriceps or patellar tendon ruptures are rare but severe injuries in football. Most ruptures are the result of degenerative weakness of the tendon, and accordingly the incidence in young active football players is relatively low. Complete ruptures of these tendons should be operated on by direct repair of the tendon. The healing process of the te...
Article
PurposeStudies on dynamic intraligamentary stabilization (DIS) of acute anterior cruciate ligament (ACL) ruptures reported failure rates similar to those of conventional ACL reconstruction. This study aimed to determine whether surgeon experience with DIS is associated with revision rates or patient-reported outcomes. The hypothesis was that more e...
Article
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Purpose: Flexor tendon repair consists of circumferential peripheral sutures in combination with core sutures to avoid fraying and reduces the exposure of suture material on tendon surface. The peripheral suture adds up to a tenfold increase of the biomechanical stability compared to the core suture alone. The purpose of our study was to determine...