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Biomedical subjects

Kai Mithöfer

Publications and source records attributed to Kai Mithöfer.

7 recordsLinked to original sources
PubMed2005

Articular cartilage repair in soccer players with autologous chondrocyte transplantation: functional outcome and return to competition.

BACKGROUND: The ability of autologous chondrocyte transplantation to produce and maintain an effective articular cartilage repair under high mechanical demands has not been investigated. HYPOTHESIS: Autologous chondrocyte transplantation provides a reliable and durable repair of full-thickness knee articular cartilage lesions in high-demand athletes. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: A total of 45 soccer players were evaluated 41 +/- 4 months after autologous chondrocyte transplantation for their ability to return to soccer, the timing of their return, skill level, and functional outcome rating by the Tegner activity rating scale score and Brittberg score. The factors influencing the return to sport were analyzed. RESULTS: Of these players, 72% reported good to excellent results, with significant overall improvement of Tegner activity rating scale scores; 33% returned to soccer, including 83% of competitive-level players and 16% of recreational players. Of the returning players, 80% returned to the same skill level and 87% maintained their ability to play soccer at 52 +/- 8 months postoperatively. Players who successfully returned to soccer were significantly younger and had a shorter preoperative duration of symptoms than did patients who did not return to the sport. Concomitant adjuvant procedures did not adversely affect the ability to return to soccer. CONCLUSION: Repair of knee articular cartilage lesions by autologous chondrocyte transplantation in high-performance athletes is particularly successful in younger, competitive athletes with limited preoperative intervals.

Adolescent↗
PubMed2005

Functional outcome of knee articular cartilage repair in adolescent athletes.

BACKGROUND: Limited information exists about the treatment of full-thickness articular cartilage lesions of the knee in adolescent athletes. PURPOSE: To evaluate the functional outcome and athletic activity after articular cartilage repair in the knees of adolescent athletes. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Twenty adolescent athletes with full-thickness articular cartilage lesions of the knee were treated with autologous chondrocyte transplantation. Functional outcome was evaluated by subjective patient outcome rating, knee activity scores, and level of athletic participation. RESULTS: At a mean of 47 months after autologous chondrocyte transplantation, 96% of adolescents reported good or excellent results with significant increases in postoperative Tegner activity scores and Lysholm scores. Ninety-six percent returned to high-impact sports and 60% to an athletic level equal or higher than that before knee injury. Return to preinjury sports correlated with shorter preoperative symptoms and a lower number of prior operations. All adolescents with preoperative symptoms < or =12 months returned to preinjury-level athletics, compared to 33% with preoperative intervals longer than 12 months. CONCLUSION: Treatment of full-thickness articular injuries of the knee in adolescent athletes with autologous chondrocyte transplantation yields a high rate of functional success at a mean follow-up of 47 months. The rate of return to demanding athletic activities is higher in cases in which the preoperative duration of symptoms is 12 months or less.

Adolescent↗
PubMed2005

The docking technique for posterolateral corner reconstruction.

Posterolateral corner injuries of the knee are an uncommon but potentially debilitating injury. They are easily missed on physical examination and are often associated with alternate ligament pathology. When identified early, these injuries are best managed by primary repair with or without augmentation of the involved structures. However, chronic injuries are generally not amenable to primary repair and often require reconstruction. Experimental data suggest that the lateral collateral ligament and popliteofibular ligament present critical biomechanical restraints of the posterolateral aspect of the knee and should be incorporated into contemporary reconstruction techniques. We describe a novel method of reconstructing these critical components of the posterolateral corner using a new docking technique for fixation on the femur with a graft placed through a fibular head tunnel.

Humans↗
PubMed2004

Tibial plateau fracture following anterior cruciate ligament reconstruction.

A case is presented of a tibial plateau fracture after previous anterior cruciate ligament reconstruction using patellar tendon autograft. The tibial plateau fracture occurred through the transosseous tibial tunnel and followed a torsional injury to the involved extremity. The stress riser effect of the transosseous tibial tunnel and the anatomic location of the cortical defect probably facilitated development of the fracture. Minimally invasive fixation of the fracture was effective in preserving knee stability without need for revision anterior cruciate ligament reconstruction.

Accidental Falls↗
PubMed2004

Clinical spectrum of acute compartment syndrome of the thigh and its relation to associated injuries.

The reason for the described clinical variability of acute compartment syndrome of the thigh, with high morbidity and mortality in some patients and an uncomplicated clinical course in others, is not known. To better define the clinical spectrum and factors determining the clinical course of this rare clinical entity, we did a retrospective multicenter study of 28 patients with 29 thigh compartment syndromes. The leading cause of acute thigh compartment syndrome was blunt trauma from motor vehicle accidents (46%) or contusion (39%). Pain with passive motion was present in all patients who were conscious, followed by paresthesia (60%), and paralysis (42%). The anterior compartment was involved most frequently with mean compartment pressure of 58 +/- 3 mm Hg. Myonecrosis, sepsis, and need for skin grafting were observed more frequently in patients with ipsilateral femur fracture. Only 7% of patients with isolated thigh compartment syndromes had short-term complications compared with 57% of patients with ipsilateral femur fractures. The incidence of complications correlated with the time to fasciotomy. Mortality was limited to patients with high injury severity scores. The clinical spectrum of thigh compartment syndrome is comparable with that of other compartment syndromes and its clinical course is determined by its associated injuries.

Acute Disease↗
PubMed2002

Delayed presentation of acute compartment syndrome after contusion of the thigh.

Acute compartment syndrome has been described as a result of thigh contusion in several contact sports, and emergent fasciotomy has routinely been recommended. However, recent data suggest that thigh contusions in athletes presenting with isolated elevation of compartment pressures in the absence of neurovascular deficits may be treated expectantly. We describe a case of anterior thigh contusion, which initially presented with isolated compartmental hypertension without neurovascular symptoms. Under nonoperative treatment the patient developed delayed acute compartment syndrome from persistent muscular hemorrhage ten days after the initial trauma, requiring operative treatment. This case demonstrates that expanding hematoma formation may result in delayed increase of intramuscular pressures and compromise of myoneural perfusion in patients with severe thigh contusions. Early evacuation of the hematoma may help to prevent late development of compartment syndrome and reduce the risk for long-term complications.

Acute Disease↗