M. Engelhardt

Klinikum Osnabrück, Osnabrück, Lower Saxony, Germany

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Publications (137)56.59 Total impact

  • K Keller · M Engelhardt
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    ABSTRACT: The menisci play an important role in normal function of the knee joint. Meniscal injuries are associated with pain, swelling, impairment in function and activity level as well as early arthrosis of the knee joint. Patients with meniscal tears have to undergo surgery frequently. The pathway from the beginning of meniscal surgery to the modern arthroscopic meniscal surgery was not straightforward. The clinical picture of meniscal injuries, which caused articular trouble, was controversial for a long time. Meniscal surgery developed from knee joint surgery of the loose articular bodies. The first meniscal tear was not described until 1731. More than 100 years later, in 1866 the first planned meniscal surgery was performed. The importance of surgical techniques of meniscal resection and meniscal repair was emphasised in 1885. The beginning of knee joint arthroscopy took place in the 2nd decade of the 20th century. However, arthroscopy did not start its triumphal phase not until the 1960s coursing from Japan over North America to Europe. Approximately 150 years had passed from the risky arthrotomy surgeries of the past to the modern arthroscopic meniscal surgeries with low complication rates. Today, arthroscopic knee surgeries and especially arthroscopic meniscal surgeries are one of the most frequently performed orthopaedic procedures. Georg Thieme Verlag KG Stuttgart · New York.
    No preview · Article · Apr 2015 · Zeitschrift fur Orthopadie und Unfallchirurgie
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    ABSTRACT: Purpose: The purpose of this study was the evaluation of knee laxity in the ACL-deficient knee with combined meniscal tear, meniscal suture and partial medial meniscectomy. Methods: Kinematics of the intact knee were determined in 18 human cadaver specimens in response to a 134-N anterior tibial load (aTT) as well as a combined rotatory load of 10 Nm valgus and 4 Nm internal tibial rotation using a robotic/universal force moment sensor testing system. The anterior cruciate ligament was resected. Subsequently, a vertical bucket-handle medial meniscal tear was created followed by a standard meniscus repair using horizontal inside-out stitches or a partial medial meniscectomy. Knee kinematics were calculated following every sub-step. Results: A significant increase of anterior tibial translation was found in the ACL-deficient knee compared to the intact knee at 30° and 90° of flexion (p = 0.001; p ≤ 0.001). Additional tear of the medial meniscus significantly increased anterior tibial translation (p = 0.01). In response to a simulated pivot shift, anterior tibial translation of the intact knee did not increase significantly after ACL resection (p = 0.067). However, ACL deficiency with an additional medial meniscus tear led to a significant increase compared to the intact knee at 0° of flexion (p = 0.009). Conclusions: Additional injury of the medial meniscus increased aTT as well as aTT under a combined rotatory load in the ACL-deficient knee whereas repair of the meniscus significantly decreased aTT. Therefore, the meniscus status does have a significant impact on knee kinematics in the ACL-deficient knee. The present biomechanical study further highlights the importance of preserving the meniscus especially in patients with additional ACL injuries.
    No preview · Article · Nov 2014 · International Orthopaedics
  • Karsten Keller · Meike Coldewey · Martin Engelhardt
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    ABSTRACT: Aging is associated with profound changes in body composition, especially with loss of muscle mass and muscle strength. The loss of muscle mass is caused by muscle atrophy with loss of muscle fibres and motor units. Atrophy and loss of muscle fibres with aging affect priorly the fast-twitch muscle fibres und their Motor units. Fast-twitch muscle fibres seem to be more prone to function failure or loss over time. Main causes of the development of muscle loss are hormonal changes with especially reduced release of androgen and estrogen hormones, increase of Synthesis and release of katabolic cytokines and decrease in physical activity. Treatment Options for muscle mass loss with aging comprise physical training, modifications of nutritional intake, and pharmacological treatment.
    No preview · Article · Sep 2014 · Gazzetta medica italiana
  • K Keller · M Engelhardt
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    ABSTRACT: Unlabelled: Backround: Knee trauma with arthrogenic muscle inhibition (AMI) lead to muscle weakness. The aim of this study was to analyse the intensity of AMI after meniscus and cartilage injuries and to investigate the association between age, BMI and severity of cartilage leasions with AMI. Patients and methods: 48 patients with meniscus or cartilage injury were preoperatively interviewed and examined for isometric maximum force values of the extension muscles of the knee joints. We analysed AMI as comparison of maximum isometric force values between healthy and injured leg by use of Wilcoxon matched pairs test. Moreover a regression analysis was done to assess the association between age, BMI and severity of cartilage lesion with AMI. Results: Trauma of the knee joint with meniscus or cartilage injuries led to a 23.6 % reduction of maximum force values of injured in comparison to healthy leg (460.1 ± 223.6 N vs. 601.9 ± 224.6 N, P < 0,000001) in mean. Regression analysis did not show associations between age (β -2.645, P = 0.345), BMI (β 2.268, P = 0.792) or severity of cartilage damage (β -13.527, P = 0.670) with AMI. Conclusions: Trauma of the knee joint with meniscus or cartilage damage cause an AMI with 23.6 % force reduction. We could not identify an association between age and AMI.
    No preview · Article · Aug 2014 · Sportverletzung · Sportschaden
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    ABSTRACT: Purpose: To evaluate knee laxity after anatomic ACL reconstruction with additional suture repair of a medial meniscus tear. Methods: Kinematics of the intact knee were determined in 12 human cadaver specimens in response to a 134-N anterior tibial load (aTT) and a combined rotatory load of 10 Nm valgus and 4 Nm internal tibial rotation (aTTPS) using a robotic/universal force moment sensor testing system. Subsequently, the ACL was resected following the creation of a standardized tear of the medial meniscus, a standard meniscus repair and an ACL reconstruction using an anatomic single-bundle (6) or an anatomic double-bundle technique (6). Knee kinematics were determined following every sub-step. Results: Significant increase of aTT in the ACL-deficient knee was found (p ≤ 0.001) with a further increase in the ACL-deficient knee with additional medial meniscal rupture (p ≤ 0.001). ACL reconstructions significantly decreased aTT compared with the ACL and meniscus-ruptured knee. No significant differences were seen between the intact knee and the ACL-reconstructed knee with additional meniscal repair (p < 0.05). In response to a simulated pivot shift, aTTPS in the intact knee significantly increased in the ACL-deficient knee and meniscus-ruptured knee (p = 0.005). No significant differences in knee kinematics were found between SB as well as DB ACL reconstruction with additional medial meniscal repair compared with the intact knee. Comparison of SB versus DB ACL reconstruction did not reveal any significant differences in a simulated Lachman test or simulated pivot shift test (n.s.). Conclusions: aTT as well as aTTPS significantly increased with ACL deficiency compared with the intact knee; additional medial meniscal rupture further increased aTT. Anatomic ACL reconstruction with medial meniscal repair did not reveal significant differences in knee kinematics compared with the intact knee. Comparison of anatomic SB versus DB ACL reconstruction with additional repair of the medial meniscus did not show significant differences neither in a simulated Lachman nor in a simulated pivot shift test.
    No preview · Article · May 2014 · Knee Surgery Sports Traumatology Arthroscopy
  • Gernot Willscheid · Martin Engelhardt · Casper Grim
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    ABSTRACT: In a retrospective questionnaire analysis 360 canoeists were asked about their sport-related complaints and injuries within the last four years. Finally 104 elite-canoeing-athletes could be included. The allocation of the injuries and overuse symptoms was carried out by body region. Shoulder problems have been reported with a frequency of 26%. Pain in the lumbar spine and the knee joint was reported in 33% and 27% of the athletes. Dysesthesia in the legs (32%) and wrist-pain (29%) were also reported in about one third of the athletes. The present paper shows that canoeing as obvious upperbody stressing sports can also lead to complaints like dysesthesia of the legs and pain in the lumbar spine, knee and wrist. These complaints occur almost as often as the expected shoulder complaints.
    No preview · Article · Feb 2014 · Sport-Orthopädie - Sport-Traumatologie - Sports Orthopaedics and Traumatology
  • Casper Grim · Martin Engelhardt
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    ABSTRACT: The treatment of glenohumeral joint instability plays an important role in sports medicine. The instability of the shoulder includes various degrees of severity from symptomatic hyperlaxity, to subluxation, to dislocations. In this article, specific aspects of adequate patient selection are discussed with regard to treatment options. Certainly, the different available classifications do not describe all forms of instability as also mixed forms occur frequently. Nevertheless, they provide a vital guide and assistance during the treatment finding process. Furthermore, different treatment options are discussed and the indications and limitations of surgical treatment highlighted.
    No preview · Article · Feb 2014 · Sport-Orthopädie - Sport-Traumatologie - Sports Orthopaedics and Traumatology
  • Karsten Keller · Martin Engelhardt
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    ABSTRACT: Fragestellung: Meniskustraumata des Kniegelenks sind mit einer Schwäche des Musculus quadriceps femoris (MQF) verbunden. Diese wird durch Muskelatrophie und arthrogene Muskelinhibition (AMI) verursacht. Ziel der vorliegenden Studie war, zu untersuchen, ob sich die AMI des MQF bei Innenmeniskus(IM)- und Außenmeniskus(AM)-Läsionen gleich stark auf die seitlichen Muskelanteile des MQF (Muskulus vastus medialis (MVM) und Muskulus vastus lateralis (MVL)) auswirkt. Patienten und Methoden: Von den 29 Patienten mit isolierter IM- oder AM-Läsion wurden 22 Pa­tienten anhand der intraoperativ festgestellten Meniskusläsionen der Gruppe mit alleiniger IM-Läsion und 7 der Gruppe mit alleiniger AM-Läsion zugeordnet. Kernuntersuchungen waren die Messung der Muskelströme mittels Oberflächenelektromyografie des MVM und des MVL während einer maximalen isometrischen Streckkraftanstrengung. Es erfolgte ein intra Gruppenvergleich zwischen verletztem Bein und dem der Gegenseite um die Ausprägung der AMI zu evaluieren und ein Gruppenvergleich zur Beurteilung, ob IM-Läsionen im medialen Kompartiment eine besonders stark ausgeprägte AMI des MVM und AM-Läsionen im lateralen Kompartiment zu einer besonders stark ausgeprägten AMI des MVL führen. Ergebnisse: Der Vergleich in den Gruppen zwischen verletztem Bein und der Gegenseite zur Beurteilung der Traumafolge zeigte in der IM-Gruppe keine signifikanten EMG-Wertminderung weder des MVL in 60° (86,09±80,01 µV vs. 92,12±54,46 µV, P=0,079) und in 30° Kniebeugung (92,34±76,05 µV vs. 127,40±96,86 µV, P=0,085) noch des MVM in 60° (80,39±66,55 µV vs. 82,21±46,09 µV, P=0,59) und in 30° Kniebeugung (95,28±91,01 µV vs. 108,77±87,60 µV, P=0,20). Die AM-Gruppe ließ auch keine signifikante EMG-Wertminderung des MVL weder in 60° (73,55±31,66 µV vs. 79,64±31,46 µV, P=0,58) noch in 30° Kniebeugung (94,67±34,44 µV vs. 97,26±47,01 µV, P=1,00) erkennen. Hinsichtlich des MVM zeigte sich sowohl in 60° (56,05±29,53 µV vs. 80,75±37,37 µV, P=0,031) als auch in 30° Kniebeugung (64,50±29,56 µV vs. 103,61±45,76 µV, P=0,016) eine signifikante Reduktion der EMG-Maximalwerte. Der Vergleich zwischen den Gruppen ließ keine signifikanten Unterschiede hinsichtlich der EMG-Werte des MVL und MVM beobachten. Schlussfolgerungen: Die AMI zeigt keine Kompartimentabhängigkeit. IM-Läsionen führen zu keiner vermehrten AMI des MVM und AM-Läsionen zu keiner vermehrten AMI des MVL.
    No preview · Article · Jan 2014 · Physikalische Medizin Rehabilitationsmedizin Kurortmedizin

  • No preview · Article · Oct 2013 · Arthroscopy The Journal of Arthroscopic and Related Surgery
  • K. Keller · M. Engelhardt
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    ABSTRACT: Background: aging process is associated with changes in muscle mass and strength with decline of muscle strength after the 30th life year. The aim of this study was to investigate these changes in muscle mass and strength. Patients & Methods: for this analysis 26 participants were subdivided in two groups. Group 1 comprises participants aged <40 years (n=14), group 2 those >40 years (n=12). We assessed anthropometrics, range of motions, leg circumferences and isometric strength values of the knee joints. Results: besides comparable anthropometrics, circumferences and strength were higher in group 1 than in group 2. Circumference of upper leg (20 cm above knee articular space) showed for right leg a trend to a significant (median: 54.45 cm (1st quartile: 49.35/ 3rd quartile: 57.78) vs 49.80 cm (49.50/50.75), p=0.0526) and for left leg a significant 54.30 cm (49.28/58.13) vs 49.50 cm (48.00/52.53), p=0.0356) larger circumference in group 1. Isometric strength was in 60° knee flexion significantly higher in group 1 than in group 2 for right (729.88N (561.47/862.13) vs 456.92N (304.67/560.12), p=0.00448) and left leg (702.49N (581.36/983.87) vs 528.49N (332.95/648.58), p=0.0234). Conclusions: aging process leads to distinct muscle mass and strength loss. Muscle strength declines from people aged <40 years to those >40 years between 16.6% and 40.9%.
    No preview · Article · Oct 2013
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    Karsten Keller · Martin Engelhardt
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    ABSTRACT: aging process is associated with changes in muscle mass and strength with decline of muscle strength after the 30(th) life year. The aim of this study was to investigate these changes in muscle mass and strength. for this analysis 26 participants were subdivided in two groups. Group 1 comprises participants aged <40 years (n=14), group 2 those >40 years (n=12). We assessed anthropometrics, range of motions, leg circumferences and isometric strength values of the knee joints. besides comparable anthropometrics, circumferences and strength were higher in group 1 than in group 2. Circumference of upper leg (20 cm above knee articular space) showed for right leg a trend to a significant (median: 54.45 cm (1(st) quartile: 49.35/3(rd) quartile: 57.78) vs 49.80 cm (49.50/50.75), p=0.0526) and for left leg a significant 54.30 cm (49.28/58.13) vs 49.50 cm (48.00/52.53), p=0.0356) larger circumference in group 1. Isometric strength was in 60° knee flexion significantly higher in group 1 than in group 2 for right (729.88N (561.47/862.13) vs 456.92N (304.67/560.12), p=0.00448) and left leg (702.49N (581.36/983.87) vs 528.49N (332.95/648.58), p=0.0234). aging process leads to distinct muscle mass and strength loss. Muscle strength declines from people aged <40 years to those >40 years between 16.6% and 40.9%.
    Full-text · Article · Oct 2013 · Muscles
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    Olaf Lorbach · Mirco Herbort · Martin Engelhardt · Matthias Kieb
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    ABSTRACT: Objectives: Biomechanical evaluation of knee laxity after single- and double-bundle ACL reconstruction with additional medial meniscus suture. Methods: Kinematics of the intact knee were determined in 12 human cadaver specimens in response to a 134-N anterior tibial load (aTT) and a combined rotatory load of 10 Nm valgus and 4 Nm internal tibial rotation using a robotic/universal force moment sensor testing system. Subsequently, the ACL was resected following the creation of a bucket-handle tear of the medial meniscus. A standard repair of the medial meniscus was performed using 3 inside-out horizontal sutures. Finally, The ACL was reconstructed using an anatomic single-bundle (6) or double-bundle technique (6). Knee kinematics were determined following every sub-step. Results: Significant increase of aTT in the ACL-deficient knee was found with significant increase in the ACL-deficient knee with additional medial meniscal injury (p=.003; p=.009). ACL reconstructions significantly decreased aTT compared to the ACL-deficient knee. No significant differences were found between the intact knee and the ACL reconstructed knee with additional meniscal repair. In response to a simulated pivot shift, aTT in the intact knee significantly increased in the ACL-deficient knee as well as in the meniscus injured/meniscus-sutured knee (p=.003;p=.007). No significant differences were found between the ACL-deficient and ACL reconstructed knee with additional meniscal repair. SB as well as DB ACL reconstruction with additional medial meniscal repair restored knee kinematics compared to the intact knee. Comparison of SB versus DB ACL reconstruction did not reveal any significant differences neither in a simulated Lachman test nor in response to a simulated pivot shift (p=.05). Conclusion: aTT as well as aTT in response to a combined rotatory load significantly increased with ACL deficiency compared to the intact knee, additional medial meniscal injury further increased aTT. Anatomic ACL reconstruction with medial meniscal repair restored knee kinematics compared to the intact knee. Comparison of anatomic SB vs. DB ACL reconstruction with additional repair of the medial meniscus did not reveal significant differences in aTT as well as aTT under a combined rotatory load.
    Preview · Article · Sep 2013
  • Karsten Keller · Martin Engelhardt
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    ABSTRACT: Hintergründe/Ziel: Schmerz und arthrogene Muskelinhibition (AMI) sind häufige Phänomene nach Kniegelenkoperationen. Die AMI ist ein neuromuskulärer Prozess mit einer Schwäche der Muskulatur. Ziel der vorliegenden Studie war die Untersuchung der Assoziation zwischen Schmerz und AMI. Methoden/Patienten: 32 Patienten mit elektiven arthroskopischen Kniegelenkeingriffen wurden prä- und postoperativ (2. Tag) befragt und mittels Maximalkraft- und Muskelstrommessung (EMG) untersucht. Zur Auswertung wurden die Patienten anhand der Belastungsschmerzeinstufung (VAS) postoperativ in 2 Gruppen untergliedert (Gruppe 1: VAS<3; Gruppe 2: VAS≥3). Maximalkraft-, EMG-, Streck- und Beugewerte der Gruppen wurden verglichen. Ein prä- zu postoperativer Vergleich wurde angestellt. Ergebnisse: Die Operation führte sowohl zu EMG-Wertreduktionen des Musculus rectus femoris (MRF) (-10,7%, p=0,00934), Musculus vastus lateralis (MVL) (-32,8%, p=0,00144) und Musculus vastus medialis (MVM) (-16,2%, p=0,0228) als auch der Maximalkraftwerte (-16,4%, p=0,000074) von prä- zu postoperativ. Gruppe 2 zeigte einen Rückgang der Maximalkraft (-16,9%, p=0,000656) und der EMGWerte des MVL (-44,6%, p=0,00385) und MVM (-19,5%, p=0,00665) von prä- zu postoperativ. Gruppe 1 ließ eine Muskelkraftreduktion von prä- zu postoperativ beobachten (-15,9%, p=0,0479). Die Beugefähigkeit (106,1° vs. 84,5°, p=0,00272), die EMG-Werte von MVL (72,0μV vs. 47,5 μV, p=0,0365), MVM (77,1μV vs. 38,3μV, p=0,0126) und die Maximalkraft (484,7N vs. 265,6N, p=0,00782) waren postoperativ in Gruppe 1 größer als in Gruppe 2. Diskussion/Schlussfolgerung: Arthroskopische Kniegelenkeingriffe können zu einer AMI führen. Es konnte ein Zusammenhang zwischen Schmerz und AMI nachgewiesen werden.
    No preview · Article · Jul 2013 · Deutsche Zeitschrift für Sportmedizin
  • Olaf Lorbach · Martin Engelhardt · Mirco Herbort · Matthias Kieb

    No preview · Article · Jun 2013 · Arthroscopy The Journal of Arthroscopic and Related Surgery
  • Olaf Lorbach · M. Kieb · M. Herbort · M. Raschke · M. Engelhardt

    No preview · Article · May 2013 · Sport-Orthopädie - Sport-Traumatologie - Sports Orthopaedics and Traumatology
  • K Keller · M Engelhardt
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    ABSTRACT: Background: Immobilisation and limited mobilisation are associated with negative adaptations of human body, like elevated risk for thrombosis, reduced fitness level and muscle atrophy. The objective of the presented study was to investigate the effect of limited, reduced mobility of a few days on the upper leg muscles. Patients and methods: 32 patients who underwent an elective arthroscopic surgery of the knee because of meniscus tear and/or cartilage damage were examined preoperatively and at days 4 and 7 after surgery. Examinations of the not injured and not treated leg focused on measurements of leg circumference and maximum strength of M. quadriceps femoris. Results: The measurements of circumferences of the upper leg at 20 cm above the knee joint line decreased significantly between preoperative and both postoperative examinations. Also the changing of circumference of the upper leg at 10 cm above the joint line between preoperative and day 4 postoperative was significant. The circumference of lower leg and strength measurements showed no significant changing. Conclusions: Limited, reduced mobility lasting a few days is followed by reduction of muscle cross section of load bearing upper leg muscles.
    No preview · Article · Mar 2013 · Sportverletzung · Sportschaden
  • J Freiwald · M Engelhardt

    No preview · Chapter · Jan 2013
  • J. Freiwald · M Engelhardt

    No preview · Chapter · Jan 2013
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    I Reuter · S Mehnert · G Sammer · M Oechsner · M Engelhardt
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    ABSTRACT: Mild cognitive impairment, especially executive dysfunction might occur early in the course of Parkinson's disease. Cognitive training is thought to improve cognitive performance. However, transfer of improvements achieved in paper and pencil tests into daily life has been difficult. The aim of the current study was to investigate whether a multimodal cognitive rehabilitation programme including physical exercises might be more successful than cognitive training programmes without motor training. 240 PD-patients were included in the study and randomly allocated to three treatment arms, group A cognitive training, group B cognitive training and transfer training and group C cognitive training, transfer training and psychomotor and endurance training. The primary outcome measure was the ADAS-Cog. The secondary outcome measure was the SCOPA-Cog. Training was conducted for 4 weeks on a rehabilitation unit, followed by 6 months training at home. Caregivers received an education programme. The combination of cognitive training using paper and pencil and the computer, transfer training and physical training seems to have the greatest effect on cognitive function. Thus, patients of group C showed the greatest improvement on the ADAS-Cog and SCOPA-COG and were more likely to continue with the training programme after the study.
    Full-text · Article · Sep 2012 · Journal of aging research

  • No preview · Article · Aug 2012

Publication Stats

532 Citations
56.59 Total Impact Points

Institutions

  • 2010-2015
    • Klinikum Osnabrück
      Osnabrück, Lower Saxony, Germany
    • Klinikum Osnabrück GmbH
      Osnabrück, Lower Saxony, Germany
  • 1970-2014
    • Goethe-Universität Frankfurt am Main
      Frankfurt, Hesse, Germany
  • 2013
    • Universität des Saarlandes
      Saarbrücken, Saarland, Germany
  • 1997-2012
    • Orthopädische Universitätsklinik Friedrichsheim
      Frankfurt, Hesse, Germany
    • Klinikum Stuttgart
      Stuttgart, Baden-Württemberg, Germany
    • Klinikum Uelzen GmbH
      Uelzen, Lower Saxony, Germany
  • 2005
    • University of Wuerzburg
      Würzburg, Bavaria, Germany
  • 1993-2004
    • Klinikum Bielefeld
      Bielefeld, North Rhine-Westphalia, Germany
  • 1999-2002
    • Klinikum Nürnberg
      Nuremberg, Bavaria, Germany
    • King's College London
      • Department of Clinical Neuroscience
      Londinium, England, United Kingdom
  • 1995
    • Humboldt-Universität zu Berlin
      Berlín, Berlin, Germany