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Biomedical subjects

C J Wirth

Publications and source records attributed to C J Wirth.

17 recordsLinked to original sources
PubMed1979

[Intra-articular or extra-articular substitution of cruciate ligament--a critical study (author's transl)].

Intra- and extra-articular methods of cruciate ligament substitution are available for treating old anteromedial knee-joint instability. Twelve patients with intra-articular cruciate ligament substitution (median third of the patellar ligaments as free transplant) and 24 patients with extra-articular cruicate ligament substitution (operation according to Nciholas) were examined with particular reference to improved stability as follow-up examinations, the results being subjected to comparative evaluation. Intra-artricular cruciate ligament substitution reduces or eliminates the pre-operative instability of the joint which is due to insufficiency of the cruciate liagment, whereas the extra-articular cruciate ligament substitution produces a significantly more frequent reduction of elimination of the instability of the valgus position and of the anteromedial instability. The combination of both methods to remove anteromedial instability of the knee joint may seem a very useful solution of the problem, but it should be limited to a restricted group of patients because it involves also contain disadvantages which make it unsuitable for indiscriminate application.

Aftercare↗
PubMed1979

[Experiences with the condition of resection of the hip joint following removal of the alloarthroplastic implantate (author's transl)].

30 patients whose total endoprosthesis of the hip joint had been removed without any replacement, thus creating a so-called state of secondary resection, were followed up 6 months to 6 years after the operation. It was found that in almost two-thirds of the cases a subjective feeling of improved mobility was reported. The objective findings consisted in restrictions of the total rotation, abduction and adduction of 1/3 rd of the normal extent of mobility. An average value of 74.7 degrees was recorded for flexion. 28 patients stated that their walking performance was satisfactory to very good when using a walking-stick as support. More than three-quarters of the patients questioned stated their pain had been positively influenced by the creation of the state of secondary resection. Another objective finding was a difference between the length of the legs amounting to 4.2 cm on the average. We could prove the existence of a relationship between the difference in leg length and the roentgenologically visualised supporting of the resection area of the coxal end of the femur at the lateral pelvis. Since all the patients with the exception of two could resume their customary daily routine activities, the state of secondary resection after unsuccessful total endoprosthesis of the hip joint must be considered a reasonably acceptable alternative.

Adult↗
PubMed1979

[Gonarthrosis following persisting knee joint instability (author's transl)].

It is frequently assumed that persisting instability of the knee joint leads to gonarthrosis. We have reviewed recent and primary radiograms of 32 patients with old knee trauma resulting in prolonged capsular and ligamentous instability in order to study the eventual development of secondary gonarthrosis. Our results were as follows: All primarily intact joints developed gonarthrosis after an average of 46 months of permanent instability. Primarily existing gonarthrosis increased with exception of 3 cases. The tendency to develop an arthrosis seems to be proportional to the duration of instability; the type of instability apparently has no influence on the development of an instability gonarthrosis. Operative procedures having been performed prior to final stabilysing surgery obviously do not cause the development of secondary gonarthrosis. The persisting instability of the knee joint after combined discontinuation of capsule and ligaments therefore may be regarded as a prearthrotic factor.

Adult↗
PubMed1978

[Isolated rupture of the anterior cruciate ligament. Clinical and experimental study (author's transl)].

The isolated rupture of the anterior cruciate ligament is possible. 5 own cases are described and compared with those of other authors. The mechanism of the injury is a forced inward rotation- and varus-stress of the knee joint under full pressure as a deceleration-twisting motion. Our own experimental measuremens on the ligaments of hte knee joint with strain gauges are proving this fact. The suspeced diagnosis of an isolated rupture of the anterior cruciate ligament is strengthened by a painful snapping or popping within the knee joint in the moment of the injury, a fast increasing swelling of the joint and a feeling of instability. Normaly an anterior dawer sign is not found. The treatment of choice is the suture of the ligament because unrepaired isolated anterior cruciate ligaments can lead to an increasing instability of the knee joint with time.

Adolescent↗
PubMed1978

[The effectiveness of pes anserinus transfer for old anteromedial knee instability (author's transl)].

Old anteromedial instability of the knee joint causes an increased external rotation of the tibia against the femur. To actively control this tendenoy to increased external rotation, Slocum and Larson advocated the pes anserinus transfer (1968). An increase of rotatory muscle function of 39% after this transfer could be demonstrated experimentally (Noyes and Sonstegard 1973). Contrary to these reports, an increase of rotatory muscle power was rather the exception than the rule in our dynamometric examinations of 49 patients after transfer of the pes anserinus for old anteromedial instability. The reasons for the lack of clinically effective increase in muscle power are discussed. The advancement of the tendon of the semimenbranaceus muscle seems more advantageous as an alternative measure.

Evaluation Studies as Topic↗
PubMed1975

[Synovectomy and prosthetic substitution of rheumatic knee joints (author's transl)].

Synovectomy and alloarthroplasty are the prinicpal forms of surgical treatment of rheumatoid arthritis (RA) of the knee joint. The aim of both procedures is the reduction or elimination of the painful condition, the quantitative reduction of analgesics and hormone preparations, and improvement of function. Synovectomy removes the principal pathogenetic area of RA. The indications, contra-indications, valve technique of the two methods are gone into. The problems of rehabilitation are referred to.

Aged↗