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Jörg Jerosch

Publications and source records attributed to Jörg Jerosch.

5 recordsLinked to original sources

Antero-lateral minimal invasive (ALMI) approach for total hip arthroplasty technique and early results.

INTRODUCTION: Minimally invasive surgery represents one of the most recent techniques to have emerged within THA. In conventional THA, the incision typically measures 15-20 cm. Minimal invasive approach defined as less invasive to the skin, muscles, or bone may reduce complications and improve recovery time. A number of different approaches and methods have been described in literature. PURPOSE: This is a prospective study describing the technique and early results of the modified antero-lateral minimal invasive (ALMI) approach and comparing our results to the results of other investigators interested in minimal invasive THA. MATERIALS AND METHODS: Seventy-five consecutive primary total hip arthroplasties (cemented and cementless) were done through a modified ALMI approach (6-8 cm), in which we kept the hip abductors intact. Neither special instruments nor specially designed prostheses were needed. Minimum follow-up was 12 months. RESULTS: The mean Harris hip score for patients after 12-month follow-up was 90 while the mean Merle d'Abugine mean score was 16.5. Both scores reached almost the maximum values within 3 months after surgery. The cup abduction angle for 70% patients was between 35 degrees and 45 degrees. No femoral stem mal-alignment was recorded. The mean operative time of cemented prosthesis was 65 min while that of the cementless prosthesis was 55 min. No wound complications or dislocations were recorded. All the patients were allowed to weight bear in the second post-operative day and involved in an early rehabilitation program. CONCLUSION: ALMI hip approach with sparing of hip abductors is safe and gives excellent orientation for positioning of prosthesis components. It also allows early and smooth post-operative rehabilitation with fast recovery of the patient in terms of weight bearing.

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Arthroscopic treatment of lateral epicondylitis: indication, technique and early results.

The purpose of this study is to present the results of the arthroscopic treatment of lateral epicondylitis. Twenty patients with lateral epicondylitis (mean age 42 years) were treated arthroscopically. The average duration of symptoms prior to surgery was 14 months. The arthroscopic joint inspection showed an intact capsule in seven patients (type-I lesion), in eight patients a linear capsule tear (type-II lesion) and in six patients a complete rupture of the capsule (type-III lesion). An associated intraarticular pathology was documented in eight patients. Within an average follow-up period of 1.8 years, local pain and function were documented and analyzed. Subjective pain at rest was reduced from 5.0 to 0.5 points, pain at daily living activities from 6.0 to 1.0 points and pain at athletic activities from 7.3 to 1.2 points in the VAS score. Function increased from 5.2 to an average value of 10.9 (max. 12 points). Patients returned back to work after 3.2 weeks. In conclusion, the arthroscopic release in patients with radial epicondylitis is a reproducible method with a marked postoperative increase in function within a short rehabilitation period.

Activities of Daily Living↗

Indication, surgical technique and results of endoscopic fascial release in plantar fasciitis (E FRPF).

The purpose of the present study is to present the surgical technique for, and review our indications and results after, endoscopic fascial release in patients with plantar fasciitis. In five thiel-embalmed human specimens, a biportal technique for endoscopic release of the plantar fascia was established. The aim was here to evaluate the relation between the plantar fascia and the heel spur and to perform a release that would not exceed 50-70% of the diameter of the calcaneoplantar fascia. The endoscopic technique was performed within the last 5 years in ten male and seven female patients. All patients with the clinical entity of plantar fasciitis underwent conservative treatment for at least 6 months. The average age at surgery was 35 years (24-56 years). In the first five patients, surgery was performed under c-arm control. In all patients the operation could be finished endoscopically. The endoscopic portals healed without complications. The time for surgery during the learning curve ranged between 21 and 74 min (average 41 min) and was still longer compared to the open technique. The clinical follow-up ranged between 4 and 48 months (average 18.5 months). Out of 17 patients, 13 improved clinically, and they would choose the treatment option again. In the Ogilvie-Harris score, seven patients showed good and six excellent results. In two patients, the initial results were not satisfactory, because of a bony stress reaction of the calcaneus. This complication was treated by 6 weeks of partial weight bearing, without any further problems. Two other patients developed secondary pain in the lateral column. In spite of the minimal invasive approach it seems to be important to be careful in increasing the weight bearing in early rehabilitation. The technique of the endoscopic plantar fascia release (E FRPF) can be performed in a standardised and reproducible procedure. The follow-up examination showed good midterm results, but a loss of stability of the plantar arch has to be strictly avoided.

Adult↗

Management of infected shoulder replacement.

BACKGROUND: The purpose of the present work is to present treatment options and our own results for patients with infected shoulder alloarthroplasties. METHODS: Twelve patients with an infected shoulder replacement were treated. Their age ranged from 56 to 82 years. Indications for surgical revision were clinical symptoms compatible with an infection or positive serologic tests, especially an elevated C-reactive protein. Aspirated intra-articular fluid with a white blood cell count above 30,000 or positive for bacterial growth was also an important diagnostic feature. Retrospective analysis differentiated three groups with three different treatment regimens. Group 1 with early infection but without soft-tissue involvement (n=1): this particular patient underwent arthroscopic synovectomy. Group 2 with early infection and soft-tissue involvement within 4 weeks after index surgery (n=1): this patient underwent open synovectomy. The largest group was group 3 with late infection (n=10): these patients were treated with two-stage revision and a temporary spacer. RESULTS: The time between explantation and reimplantation ranged between 4 weeks and 6 months. With the temporary spacer, an anatomically stable condition could be established for all patients, and reconstruction of the humeral length even in long implants was possible. All patients underwent physiotherapy with the temporary spacer in place. A positive intraoperative microbiologic specimen was only found in 4 patients. In both group 1 and 2 patients, the infection healed, and thus the original implant could be kept in situ. In 8 patients, the temporary spacer was removed and exchanged for a regular implant. The postoperative raw Constant score at the time of the last follow-up examination was 48, due mainly to a loss of motion and power. All shoulders were stable, and the elbow function was good. CONCLUSION: Use of an antibiotic-loaded spacer allows successful treatment of infected shoulder replacements.

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