PubMed Health⌕ Search

Biomedical subjects

Klemens Trieb

Publications and source records attributed to Klemens Trieb.

At least 19 recordsLinked to original sources
PubMed2006

Performance of the disabilities of the arm, shoulder and hand outcome questionnaire and the Moberg picking up test in patients with finger joint arthroplasty.

OBJECTIVE: To compare the performance of the Disabilities of the Arm, Shoulder and Hand Outcome (DASH) Questionnaire and the Moberg Picking Up Test (MPUT) with other outcome measurement tools in assessing both hand function and aspects of general health in finger joint arthroplasty in patients with rheumatoid arthritis (RA). DESIGN: Case series, with an average follow-up duration of 104.9 months. SETTING: Orthopedic outpatient clinic at a university hospital. PARTICIPANTS: Of 64 consecutive patients (21 dead, 6 lost to follow-up), 37 patients with 140 spacers in 107 metacarpophalangeal and 33 proximal interphalangeal joints of 51 hands were evaluated. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Hand function tests and general health measures. RESULTS: The DASH correlated with both hand function (Health Assessment Questionnaire: r=.72, P<.01; MPUT: r=0.6, P<.01) and general health (Medical Outcomes Study 36-Item Short-Form Health Survey subscales: r range, -.73 to -.31; P range, <.001 to <.05). The MPUT was a suitable tool for precision grip testing. CONCLUSIONS: The DASH has the advantage of being self-administered and assesses both functional and health aspects. It can be recommended as an instrument for a routine clinical follow-up for patients with hand surgery and RA. Additional tests should be applied when detailed information is needed.

Adult↗
PubMed2006

[Sports injury of the spine: imaging diagnosis].

Sports injuries, especially those due to trend sports, and overuse resulting from monotonous repetitive movement patterns may cause various spinal abnormalities. Indications for diagnostic imaging should be established more readily in this group of young patients than in adults, as there is a higher probability to find morphologic abnormalities. This diagnostic strategy should also be applied for MRI and CT investigations. Image findings should be interpreted with view on kinetic chains related to distinct sporting activities.

Athletic Injuries↗
PubMed2006

What affects the recurrence and clinical outcome of pigmented villonodular synovitis?

UNLABELLED: Studies investigating the outcome of pigmented villonodular synovitis have been restricted to certain locations or types of the disease and have not provided adequate documentation of followup. We asked the following questions: What were the recurrence rates especially when considering location and type of pigmented villonodular synovitis?; What was the long-term clinical outcome?; and Was MR imaging essential for the correct diagnosis? We retrospectively reviewed 42 of 53 consecutive patients primarily treated at our institution (19 diffuse lesions and 23 nodular lesions in 19 large joints and 23 digits of the hands or feet). Ten patients had recurrences after an average followup of 80 months (range, 26-293.8 months). Recurrences were more frequent for the diffuse type than the nodular type and in large joints rather than in digits. The average Enneking score was 92% of normal limb function indicating that surgical treatment led to good functional results. Preoperative magnetic resonance imaging results corresponded well with histologic diagnoses and intraoperative findings. LEVEL OF EVIDENCE: Therapeutic Level IV.

Adolescent↗
PubMed2006

Reconstructing the extensor apparatus with a new polyester ligament.

We analyzed the clinical outcome of patients who had reconstruction of the extensor apparatus with a new polyester ligament after extensive resection of malignant tumors around the knee. Twenty-two patients were included; 19 were evaluated after a mean followup of 44 months (range, 8-67 months) to assess active and passive knee range of motion, walking ability, need for revision, and TESS and Enneking scores. The patients were divided into two groups; patients in Group A had a weakened extensor mechanism and patients in Group B had a completely dissected extensor mechanism. Seven patients had excellent knee function with an extension lag less than 5 degrees. Five patients had an extension deficit less than 20 degrees, three patients had a deficit less than 40 degrees, and four patients could not extend their limb against gravity. However, all patients were able to walk without walking aids. They had a mean Enneking score of 83 points and a mean TESS score of 82 points. Patients who had distal femur resections had worse results than patients who had proximal tibia resections. The LARS ligament proved promising for augmentation and complete reconstruction of the extensor apparatus of the knee after extensive tumor resection, with excellent and good results in 59% of patients.

Adolescent↗
PubMed2006

Treatment of intravertebral pseudarthroses by balloon kyphoplasty.

OBJECTIVE: This paper presents an open prospective investigation of the efficacy of balloon kyphoplasty in the treatment of intravertebral pseudarthrosis. Several described intravertebral radiolucent lines-the so-called vacuum phenomenon-originated from degenerative diseases. Pain arose from intravertebral dynamic mobility and local kyphosis. METHODS: We reduced and stabilized 24 intravertebral pseudarthroses with the balloon kyphoplasty. Pain and disability showed a rapid and distinct decrease. Radiologic features and life quality were compared with respect to the different shapes of fractures type A1, A3.1, and A3.3. The follow up was 2 years. RESULTS: The patients with fractures type A3.3 were older than those of type A1 and A3.1. In pseudarthrosis of type A3.1 fractures, the kyphotic wedge could be reduced to 13 degrees and the height could be increased to 85% with balloon kyphoplasty. In the A3.3 group, the wedge could be reduced to 8 degrees but the height could be increased only to 75%. No restoration of deformity was achieved in fractures type A1. A long-lasting effect on pain and disability was seen only after balloon kyphoplasty of fractures type A3.1. CONCLUSIONS: The treatment of intravertebral dynamic mobility with balloon kyphoplasty is useful in fractures type A3.1. In pseudarthroses type A1, the negligible reduction and only short-lasting reduction of pain stands against the costs. In pseudarthroses type A3.3, the lack of a long-lasting benefit could be the consequence of the disadvantageous shape of the vertebral body, the higher age of patients or the primary diseases.

Aged↗
PubMed2006

Location modalities for focused extracorporeal shock wave application in the treatment of chronic plantar fasciitis.

BACKGROUND: Focused extracorporeal shock waves (ESWT) has been used in the treatment of plantar fasciitis with heel spurs. The optimal location for administering treatment, however, has not been determined. The purpose of this study was to determine whether fluoroscopy-guided location of a heel spur or patient location of the maximal point of tenderness is more effective in administering ESWT. METHODS: In a prospective, examiner-blinded trial, 41 patients were randomized into two groups for treatment by ESWT: group 1, location of the heel spur for ESWT by fluoroscopy, and group 2, patient location for ESWT by maximal point of tenderness. Each group had three session of ESWT at 1-week intervals. The success rates between the two groups were assessed at 6 and 12 weeks. RESULTS: No significant differences were noted between the groups. CONCLUSIONS: Despite the small number of patients in the study, patient location for positioning the focus in ESWT in treatment of plantar fasciitis with a heel spur is recommended.

Adult↗
PubMed2005

Extracorporeal shock wave therapy in the treatment of calcific tendinitis of the rotator cuff.

BACKGROUND: Low-energy extracorporeal shock wave therapy is an alternative treatment, with limited evidence for effectiveness, for calcific tendinitis of the rotator cuff. HYPOTHESIS: Objective localization of the calcium deposit by 3-dimensional, computer-assisted navigation reveals superior clinical and radiographic outcomes compared to localization through patient-to-therapist feedback. STUDY DESIGN: Randomized controlled clinical trial; Level of evidence, 1. METHODS: A prospective, randomized, single-blind study was carried out on 50 patients. The population was divided into 2 groups of equal numbers (navigation group and feedback group). In all patients, treatment-resistant pain was evident for longer than 6 months. A total of 3 therapy sessions of constant low-energy focused shock wave therapy was administered in weekly intervals in both groups. Local anesthesia was not applied. Radiographs and clinical assessment, including the Constant and Murley shoulder scoring system and the visual analog scale for pain, were performed both before therapy and after 12 weeks. In the navigation group, the calcium deposit was localized using a radiographically guided, 3-dimensional, computer-assisted device. The feedback group was treated after locating the point of maximum tenderness through palpation by the therapist with feedback from the patient. RESULTS: Both groups had significant improvements in the Constant and Murley score and the visual analog scale after 12 weeks. The results from the navigation group were statistically significantly superior to those of the feedback group. In the navigation group, 6 calcium deposits disappeared and 9 altered, compared to 1 disappearance and 12 alterations in the feedback group. No severe complications occurred. CONCLUSION: Three-dimensional, computer-assisted navigation reveals significantly better results and is therefore recommended when extracorporeal shock wave therapy is used in the treatment of calcific tendinitis of the rotator cuff.

Adult↗
PubMed2005

Prevalence of aneurysmal and solitary bone cysts in young patients.

Aneurysmal and solitary bone cysts develop most commonly during skeletal growth. The objective of our epidemiologic study was to evaluate the prevalence, recurrence rate, and probability of recurrence-free survival for aneurysmal and solitary bone cysts in young patients. We did a population-based analysis of 141 histologically confirmed cases. Seventy-three patients with aneurysmal bone cysts and 68 patients with solitary bone cysts were registered. The annual prevalence was 0.32 per 100,000 individuals (range, 0-1.238) for aneurysmal cysts, with a 1.8:1 male to female ratio and a median age of the patients of 11.1 years (range, 1-19.7 years). For solitary bone cysts, the calculated annual prevalence was 0.30 (range, 0-0.963) with a median age of the patients of 1.1 years (range, 0.5-19.9) and a 1.96:1 male to female ratio. Recurrent lesions occurred frequently in young males. Secondary aneurysmal bone cysts were observed only in females. During skeletal growth, aneurysmal and juvenile bone cysts more often occur in males with a peak prevalence at approximately 11 years of age. A greater prevalence of aneurysmal bone cysts in young individuals is associated with skeletal growth and immaturity. Young age and male gender are associated with an increased risk of local recurrence.

Adolescent↗
PubMed2005

Visualization of intraarticular structures of the acromioclavicular joint in an ex vivo model using a dedicated MRI protocol.

OBJECTIVE: The purpose of this study was to develop an MRI protocol that could visualize the intraarticular structures of the acromioclavicular (AC) joint. MATERIALS AND METHODS: Using six fresh specimens from cadaveric shoulders, several MRI sequences were performed on 1.0-T scanners with a superficial coil (the temporomandibular joint coil). After the radiologic examination, the specimens were prepared for histology and 300-microm-thick, toluidine blue-stained sections were prepared that corresponded to the MR images. In each series of sections, immunohistochemistry using a type II collagen antibody was performed to further characterize the intraarticular structures. RESULTS: The coronal 3D T1-weighted fast-field echo water-selective sequence allowed the identification of the intraarticular disk in all cases. Determination on MRI of other intraarticular structures--adipose tissue, synovial fluid, and the borders between neighboring tissues of different types--that corresponded to the histologic sections was possible. The use of a second plane in the 1.0-T sequences did not reveal additional information. CONCLUSION: The described MRI protocol allows the visualization of the intraarticular fibrocartilaginous disk and the border between articular cartilage and the disk. Future clinical studies will indicate the diagnostic value of this protocol. We assume that this MRI protocol could help us to better understand AC joint disorders, in particular those located intraarticularly, and dislocations.

Acromioclavicular Joint↗
PubMed2005

Minimal invasive stabilization of osteoporotic vertebral fractures: a prospective nonrandomized comparison of vertebroplasty and balloon kyphoplasty.

OBJECTIVE: During recent years, the benefits of balloon kyphoplasty and vertebroplasty have been frequently discussed for the treatment of osteoporotic vertebral compression fractures. Because of the lack of comparative studies, we performed an investigation to describe the mechanical effects and the impact on life quality during a follow-up period of 2 years. METHODS: Patients with nonrecent fractures of vertebral bodies, ongoing bone remodeling, and major kyphotic deformity were treated with minimal invasive stabilization. The median duration of pain was 8 weeks before surgery. Because of the availability of the equipment, 28 patients were nonrandomly assigned to balloon kyphoplasty and 23 patients to vertebroplasty. The follow-up was performed 2 years after surgery. RESULTS: The kyphotic wedge of the vertebral bodies was decreased 6 degrees by balloon kyphoplasty but not by vertebroplasty. With both methods, we found a rapid decrease of pain down to one-half of the preoperative value. A long-lasting effect on pain was found only after balloon kyphoplasty. In the kyphoplasty group, a decrease of the Oswestry Disability Index (ODI) score was found during the first postoperative year. After 2 years, the ODI was not different from preoperative values in both groups. CONCLUSIONS: In nonrecent fractures, the reduction of the kyphotic wedge by balloon kyphoplasty was superior in decreasing pain persisting over a period of 2 years. The ability to improve disability after kyphoplasty was limited to 1 year. In nonrecent fractures, the consequences of age and osteoporosis seem to equalize the effects of the restored sagittal profile on disability but not on pain.

Aged↗
PubMed2004

CD9 expression is not a prognostic factor in human osteosarcoma.

CD 9, also known as Motility-Related Protein-1 (MRP-1), is a member of the transmembrane four superfamily and plays a crucial role in cell adhesion, motility and signalling events. Downregulation of CD 9 has been reported to be associated with tumour progression, metastasis and clinical outcome in various kinds of solid tumours. Although prognosis of osteosarcoma has been improved by chemotherapy during the last decades, the problem of non-responders remains. At the present time prognostic factors at diagnosis have not been clearly identified. Furthermore, there is a need for markers that predict the response to chemotherapy at the time of biopsy, allowing stratification of osteosarcoma patients. In this study we investigated the effect of CD9 expression on the response to chemotherapy and survival in osteosarcoma. The expression of CD9 was examined immunohistochemically in 52 patients with high grade osteosarcoma and the results were correlated with histologic response to chemotherapy, 5 year disease free and 5 year overall survival. In patients with osteosarcoma 22 of 52 cases (42%) were positive for CD 9 expression, the rest were negative. CD 9 expression status showed no statistically significant correlation with response to chemotherapy; 41% had a poor response and 59% a good response in the CD9 positive group. In the CD9 negative group 57% had a good and 47% had a bad response. No significant difference was found when comparing disease free survival (58.9% in CD9 positive- versus 69.3% in CD9 negative tumours; P = 0.99) and overall survival of patients (54.0% in CD9 positive- versus 58.1% in CD9 negative tumours; P = 0.90) with CD9 expressing tumours to those with reduced CD9 expression. In conclusion our findings suggest that in contrast to solid tumours, CD9 is unlikely to provide any additional prognostic information for clinical purposes in osteosarcoma patients.

Adult↗
PubMed2003

Serum concentrations of sCD30 and sCD40L in patients with malignant bone tumours.

The aim of this study was to evaluate serum levels of both soluble CD30 (sCD30) and soluble CD40 ligand (sCD40L) in patients with malignant bone tumours and to determine their ability to serve as serum markers. Sera of 31 patients were taken at the time of diagnosis, analysed by ELISA, and the results were correlated with clinical features and compared with healthy controls. Soluble CD30 and sCD40L levels were significantly higher in all patient groups than in the healthy controls. Soluble CD30 levels showed statistically significant differences between high malignant osteosarcoma and Ewing sarcoma (P = 0.015), whereas no statistically significant correlation was seen between different types of tumours and sCD40L levels. Soluble CD30 and sCD40L seem to be of diagnostic value in osteosarcoma and Ewing sarcoma.

Adolescent↗
PubMed2003

[Orthopedic interventions in patients with hemophilia].

Patients with severe hemophilia A or B and von Willebrand Syndrome have recurrent joint bleedings, which can occur spontaneously or as a result of trauma. Resorption of intraarticular blood induces an inflammation of the synovium and cartilage damage, finally leading to severe changes of the joint with complete destruction. This process is called hemophilic arthropathy. After failure of substitution and intensive conservative therapy after 3 to 6 months, a synovectomy or a synoviorthesis are indicated. In some cases the progression of hemophilic arthropathy cannot be stopped and requires total joint arthroplasty. In some cases joint motion cannot be saved and requires arthrodesis. This paper presents methods and results of different operation concepts in patients (n = 39) with hemophilia or von-Willebrand-syndrome. Especially by implanting total knee (n = 17) and total hip joints (n = 6) we obtained very good functional results after an average follow-up period of 33.3 respectively 56.3 months. In a series of synovectomie of the knee performed before 1990 (n = 7) and followed after an average period of 21.4 years the progression of hemophilic arthropathy could not be stopped. In a second series of synovectomy of the knee performed after 1990 (n = 5) and follow after an average period of 5.6 years, at least the mobility of the knee could be saved. Only one patient of a series of supra- and infracondylar osteotomie (n = 9) achieved the wanted result. Further we performed 6 operations on the hindfoot with satisfying results.

Adolescent↗
PubMed2003

Expression of platelet-derived growth factor-AA is associated with tumor progression in osteosarcoma.

Platelet-derived growth factors are secreted by mesenchymal cells. The homodimer platelet-derived growth factor-AA especially stimulates bone cells through interaction with the platelet-derived growth factor-alpha receptor homodimer. In this study we wanted to determine the expression of the receptor and its ligand in human osteosarcomas and to correlate the expression of platelet-derived growth factor-AA and -alpha receptor with clinicopathological parameters. Fifty-seven osteosarcomas were immunohistochemically analyzed for expression of platelet-derived growth factor-AA and platelet-derived growth factor-alpha receptor. Spearman's correlation coefficient revealed a strong correlation between the expression of platelet-derived growth factor-AA and platelet-derived growth factor-alpha receptor (r = 0.867). No differences were observed relative to gender, age, tumor stage, tumor location, and response to neoadjuvant chemotherapy between high or low platelet-derived growth factor-AA and platelet-derived growth factor-alpha receptor expression. High platelet-derived growth factor-AA expression correlated with tumor progression in univariate analysis (P = .0415; log-rank test), whereas platelet-derived growth factor-alpha receptor expression showed a trend toward a shorter disease-free survival, which failed to reach significance (P = .0627, log-rank test). In multivariate analysis, platelet-derived growth factor-AA expression remained a significant independent predictor of tumor progression (P = .021, Cox regression). Immunohistochemical analysis of platelet-derived growth factor-AA expression in osteosarcoma may be a useful marker of prognosis and may be considered as a possible target for novel therapeutic strategies.

Adolescent↗
PubMed2002

Expression of osteopontin and vascular endothelial growth factor in benign and malignant bone tumors.

Osteopontin (OPN), one of the major non-collagenous proteins of bone matrix, is together with vascular endothelial growth factor (VEGF) a potent angiogenic protein. In this study we determined the expression of OPN in benign and malignant bone tumors and investigated the prognostic influence of OPN expression on the outcome of osteosarcoma patients. Fifty-seven osteosarcomas and 11 osteoblastomas as well as 5 bone specimens with remodeling sites were immunohistochemically analyzed for expression of OPN and VEGF. OPN was not detected in osteoblasts of remodeling sites. Osteoblastoma osteoblasts as well as osteoclastlike giant cells and osteosarcoma mononuclear cells showed variable staining. In osteosarcomas OPN and VEGF expression correlated with each other (r=0.390, P=0.003, Spearman's test). Although osteosarcoma patients with high VEGF expression showed a trend towards shorter overall survival ( P=0.0841, log-rank test), OPN expression had no influence on patients overall or on disease-free survival. Our data indicate that expression of this protein might be upregulated in bone neoplasia. Although OPN expression correlates with VEGF expression in osteosarcomas, OPN expression does not provide predictive information about the outcome of osteosarcoma patients.

Adolescent↗
PubMed2002

[Vaccine protection in the elderly: are Austrian seniors adequately protected by vaccinations?].

OBJECTIVE: The aim of the study was to evaluate, if elderly persons are sufficiently protected against infectious diseases by vaccination. PROBANDS AND METHODS: 300 elderly (> 60 years) and 300 young (< 35 years) persons from five Austrian cities were recruited according to the criteria of a field study. Antibody concentrations against tetanus, diphtheria, tickborne encephalitis and influenza were assessed by ELISA or by haemagglutination inhibition test. Disease and vaccination histories were recorded. RESULTS: The results of the study demonstrate that protection against infectious diseases was frequently insufficient in the elderly. This was partly due to the fact that old persons were not vaccinated according to recommended strategies. However, low antibody concentration and a short duration of protective humoral immunity were also observed in many elderly persons in spite of regular vaccination. This was not only the case in frail, but also in healthy elderlies. CONCLUSION: The data demonstrate that vaccination has a relatively weak and short-lasting effect in old age. The results of the study should stimulate discussions about strategies how vaccinations can be made more effective in old age. Improved campaigns, shortened vaccination intervals as well as the design of novel vaccines tailored to fulfill the specific demands of the aging immune system are imaginable.

Aged↗