H Trouillier

Franziskus Hospital Bielefeld, Bielefeld, North Rhine-Westphalia, Germany

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Publications (12)13.5 Total impact

  • Hans-Heinrich Trouillier · Christof Birkenmaier · Tamara Seidl · Volkmar Jansson
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    ABSTRACT: The possibilities offered by kyphoplasty in the treatment of osteoporotic vertebral fractures have been widely described. Kyphoplasty is technically not very demanding, it can be easily learned and it is minimally invasive when compared to open surgical fracture treatment. Like many other simple surgical methods, it has spread rapidly and as a consequence of the above factors combined with its good reimbursement in many countries, it has experienced a widening in the indications for which it is being employed. The intial purpose of kyphoplasty was pain relief based on vertebral body stabilisation combined with restoration of vertebral body height. An increasingly uncritical use of the method can be observed and as a consequence, an increase in serious complications. During recent years, spinal surgery departments have received an increasing number of patients with serious complications following kyphoplasty, requiring major reconstructive spinal surgery. On the basis of 12 cases treated over the past 36 months, we aim to provide guidelines for the indications of the kyphoplasty procedure.
    No preview · Article · Oct 2013 · Acta orthopaedica Belgica
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    ABSTRACT: Background: Recent literature has shown a persistently high rate of aseptic loosening of the tibial component in total ankle prostheses. Methods: We analyzed the interface between the tibial bone and tibial component with a thermoelastic stress analysis to demonstrate load transmission onto the distal tibia. In this regard, we used two established ankle prostheses, which were implanted in two human cadaveric and in two third-generation composite tibia bones (Sawbones®, Sweden). Subsequently, the bones were attached to a hydropulser and a sinusoidal load of 700 N was applied. Results: Both prostheses had an inhomogeneous load transmission onto the distal tibia. Instead of distributing load equally to the subarticular bone, forces were focused around the bolting stem, accumulating as stress maxima with forces up to 90 MPa. Furthermore, we were able to demonstrate load transmission into the metaphysis of the bone. Conclusion: As demonstrated in this study, anchoring systems with stems used in all established total ankle prostheses lead to an inhomogeneous load transmission onto the distal tibia, and furthermore, to a distribution of load into the weaker metaphyseal bone. For these reasons, we favor a prosthetic design with minimal bone resection and without any stem or stem-like anchoring system, which facilitates a homogeneous load transmission onto the distal tibia. Thermoelastic stress analysis proved to be a fast and easy-to-perform method to visualize load transmission.
    Full-text · Article · Mar 2013 · Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery: TJTES
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    ABSTRACT: Facet joint pain is an important aspect of degenerative lumbar spine disease, and radiofrequency medial branch neurotomy remains an established therapy, while cryodenervation has still been poorly examined. This study was undertaken to examine the effects of medial branch cryodenervation in the treatment of lumbar facet joint pain. This was a prospective clinical case series. Patient selection was based on the history, physical examination and positive medial branch blocks. Percutaneous medial branch cryodenervation was performed using a Lloyd Neurostat 2000. Target parameters were low back pain (VAS), limitation of activity (McNab) and overall satisfaction. Fifty patients were recruited, and 46 completed the study. The follow-up time was 1 year. At 6 weeks, 33 patients (72%) were pain free or had major improvement of low back pain; 13 (28%) had no or little improvement. Including failures, mean low back pain decreased significantly from 7.7 preoperatively to 3.2 at 6 weeks, 3.3 at 3 months, 3.0 at 6 months and 4.2 at 12 months (P<0.0001). Limitation of the activities of daily living improved parallel to reduced pain. Our results suggest that medial branch cryodenervation is a safe and effective treatment for lumbar facet joint pain.
    Full-text · Article · Aug 2007 · International Orthopaedics
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    ABSTRACT: At many institutions, it is not practically feasible to perform a series of controlled or placebo-controlled medial branch blocks on several facet joints in order to select patients for facet joint rhizotomy. As for uncontrolled blocks, there is no proof that medial branch blocks are superior to other types of blocks. This study was performed to compare medial branch blocks to simple pericapsular blocks for the selection of patients for lumbar facet joint cryodenervation. Patient selection was based on history, imaging, and physical examination. Diagnostic blocks were either medial branch blocks or pericapsular blocks. Percutaneous medial branch cryodenervation was performed by use of a Lloyd Neurostat 2000. Outcome parameters were low back pain (visual analog scale [VAS]), limitation of activity (Macnab), and overall satisfaction. A total of 26 patients were recruited, 13 for each group. Follow-up was 6 months. Patients who had been selected by medial branch blocks had better pain relief than did patients who had been diagnosed by use of pericapsular blocks. At 6 weeks and at 3 months after treatment, these results reached statistical significance (VAS 2.2 v 4.2, P < .05). Our results suggest that uncontrolled medial branch blocks are superior to pericapsular blocks in selecting patients for facet joint cryodenervation, but both blocks work. If serial controlled blocks cannot be used, lumbar facet joint pain remains a diagnostic dilemma.
    No preview · Article · Jan 2007 · Regional Anesthesia and Pain Medicine
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    ABSTRACT: Epidural neuroplasty seems to be one of the promising minimally invasive techniques for adhesiolysis in patients with chronic sciatica with or without low back pain. However, because no data exist from randomized studies the aim was to investigate whether this procedure is superior to conservative treatment with physiotherapy. A total of 99 patients with chronic low back pain were enrolled in this study and randomly assigned into either a group with physiotherapy (n = 52) or a second group undergoing epidural neuroplasty (n = 47). Patients were assessed before and 3, 6, and 12 months after treatment by a blinded investigator. After 3 months, the visual analog scale (VAS) score for back and leg pain was significantly reduced in the epidural neuroplasty group, and the need for pain medication was reduced in both groups. Furthermore, the VAS for back and leg pain as well as the Oswestry disability score were significantly reduced until 12 months after the procedure in contrast to the group that received conservative treatment. Epidural neuroplasty results in significant alleviation of pain and functional disability in patients with chronic low back pain and sciatica based on disc protrusion/prolapse or failed back surgery on a short-term basis as well as at 12 months of follow-up.
    Full-text · Article · Aug 2006 · Journal of Orthopaedic Science
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    ABSTRACT: The problem of metal sensitivity (Ni, Cr, and Co) in arthroplasty is still unsolved. To prevent the risk of allergy in cases with proved metal allergy in an epicutaneous test, a Natural Knee total knee arthroplasty, made totally from titanium (Ti-6Al-4V) and polyethylene, can be implanted. The results of this device have to be compared to the results of normal knee arthroplasty designed with a femoral component out of CrCoNi alloy. The mechanical resistance of this alloy is much higher than that of titanium, and therefore it is the standard for the femoral components of most knee-resurfacing devices. Thirty-five patients with a titanium Natural Knee were examined retrospectively after a mean follow-up of 2 years and 5 months (range 6 months to 5 years and 4 months). In comparison, 36 patients with a Genesis-I knee with a CrCoNi alloy femoral component were studied after a mean follow-up of 2 years and 4 months (range 8 months to 6 years and 2 months). In spite of the lower mechanical resistance of titanium, the Natural Knee showed better results (knee score 84.1 points, function score 77.7 points, HSS score 80.1 points, 82.9% excellent and good results) than the Genesis-I knee (knee score 80.6 points, function score 76.4 points, HSS score 76.4 points, 68.5% excellent and good results), although these differences had no statistical significance. The titanium Natural Knee prosthesis has proven to be a reliable knee joint replacement in the medium term.
    No preview · Article · Jun 2003 · Archives of Orthopaedic and Trauma Surgery
  • H Trouillier · L Hänsel · P Schaff · B Rosemeyer · H J Refior
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    ABSTRACT: In a retrospective study the results of operatively treated ankle joints were critically discussed. In a period from January 1, 1977 to December 31, 1994, a total of 35 arthrodeses were carried out. Seventeen patients were followed up clinically, radiologically and with a gait analysis. Not only the radiological surgical result was of interest, but also the heel-toe movement of the stiffened foot in the individually adapted orthopedic footwear compared to standard footwear. A significantly improved heel-toe movement was found in orthopedic shoes, although there is a reduction of movement in the hindfoot in the sagittal plane.
    No preview · Article · Jan 2003 · Foot & Ankle International

  • No preview · Article · Nov 2002 · Zeitschrift für Orthopädie
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    ABSTRACT: Open surgical removal of calcifications in chronic courses of calcifying tendinitis of the shoulder can be combined with acromioplasty. Independent of the surgical procedure not all patients achieve satisfactory surgical results. The aim of the study was to investigate whether preoperatively known epidemiologic, social, clinical and radiologic factors or intraoperative findings might influence the therapeutic outcome. Following diagnostic arthroscopy, open removal of the calcifications was done as an isolated procedure (group A, n = 12) or combined with open acromioplasty (group/B, n = 24). Follow-up was 33 months for both groups. Clinical outcomes were comparable in both groups (Group A, 74.9 points; Group B 73.4 points, Constant-Murley score) and independent of gender, age, profession, duration of anamnesis, hospital-stay period, follow-up period, dominance of arm, preoperative Constant-Murley score, calcification morphology and size and acromial type. 20 patients in total achieved a clinical outcome of </= 75 points (Constant-Murley score). 12 of these demonstrated lesions of the rotator cuff and joint cartilage combined with synovialitis. In 6 patients an adverse preoperative Constant-Murley score or the wish to receive a pension was recorded. Both surgical procedures lead to overall good and satisfactory clinical results. Below average clinical outcomes are associated with pathologic findings of the glenohumeral joints, adverse preoperative clinical situation or the wish to receive a pension.
    No preview · Article · Jan 2002 · Zeitschrift für Orthopädie
  • H R Dürr · A Krödel · H Trouillier · A Lienemann · H J Refior
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    ABSTRACT: Plantar fibromatosis is a rare, benign lesion involving the plantar aponeurosis. Eleven patients (13 feet) underwent 24 operations, including local excision, wide excision, or complete plantar fasciectomy. Clinical results were evaluated retrospectively. There were no differences among the subgroups in postoperative complications. Two primary fasciectomies did not recur. Three of six revised fasciectomies, seven of nine wide excisions, and six of seven local excisions recurred. Our results indicate that recurrence of plantar fibromatosis after surgical resection can be reduced by aggressive initial surgical resection.
    No preview · Article · Feb 1999 · Foot & Ankle International
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    H. Trouillier · C. Weiler · H. J. Refior
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    ABSTRACT: Despite X-ray and computed tomography signs of osseous stability after posterior lumbar interbody fusion (PLIF) procedures, the examination of two patients after 28 and 24 months respectively, revealed that the cages were wandering and consolidation had not taken place. Revision surgery was required in both cases.
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Publication Stats

150 Citations
13.50 Total Impact Points

Institutions

  • 2006-2013
    • Franziskus Hospital Bielefeld
      Bielefeld, North Rhine-Westphalia, Germany
  • 2007
    • Franziskus Hospital
      Linz, Rheinland-Pfalz, Germany
  • 1999-2003
    • Ludwig-Maximilian-University of Munich
      • Department of Orthopaedic Surgery
      München, Bavaria, Germany