[Case report on metal allergy].
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Biomedical subjects
Publications and source records attributed to L Brückner.
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In order to answer the question whether certain biochemical reactions may influence the date of metal removal after osteosynthesis, plasmaprotein and immunoglobulin levels were checked.
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Metal allergy is surveyed in detail. Especially the development of eczema by means of metallic implantates containing chromium or nickel. The results from two series of experiments on guinea-pigs are presented. The first series proves that after preceding sensibilization by potassium bichromate or nickel-II-sulfate eczemas may be induced in the guinea-pig by X 5 Cr Ni Mo 18.10 steel implantates. Positive skin reactions in the patch test prove the possibility of sensibilization by X 5 Cr Ni Mo 18.10 steel in a second series of animals preoperatively negative.
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QUESTION: Disorders of coordination, strength and proprioception are frequently described after surgery of the knee joint. These muscular coordination disorders have not yet been studied sufficiently. The purpose of this study was the objective-quantitative characterization of muscular coordination disorders of the M. quadriceps femoris by means of EMG mapping in the arthrotic knee joint and their progress after the implantation of a total knee arthroplasty and after in-patient rehabilitation. METHODS: The extent and pattern of activation (EMG mapping) of the M. quadriceps femoris were investigated by means of a 16-channel EMG technique in 38 patients before and after the implantation of a total knee arthroplasty (type LCS). RESULTS: EMG mapping permitted an objective-quantitative characterization of the extent and pattern of activation in the M. quadriceps femoris before and after the implantation of a total knee arthroplasty and therefore the objectivation of muscular coordination disorders. Muscular coordination disorders were present already before surgery and were also caused by the implantation of a total knee arthroplasty. These coordination disorders can be improved by an inpatient rehabilitation. CONCLUSIONS: The development of exercise programs adequate for everyday life is necessary to remove quickly and actually the demonstrated coordination disorders.
AIM: The objective of the present study was to evaluate the long-term functional results after implantation of a total knee arthroplasty (TKA) objectively and quantitatively. METHOD: Functional parameters (muscular coordination, strength and range of motion) and the subjective satisfaction of the patients were measured by means of EMG mapping, isokinetics, ultrasound and a questionnaire in 21 patients with TKA 5.1 years after implantation of the TKA. RESULTS: 81 % of the investigated patients were subjectively satisfied. The isokinetic results showed a significant improvement of the extensor strength and of the relation between flexors and extensors. Patients who had been more physically active over these 5 years reached significantly better results. The results of EMG mapping showed good overall retention of the satisfactory coordination levels resulting from the initial in-patient rehabilitation. But the coordination patterns demonstrated clear changes showing highly activated areas in the region of the M. vastus medialis. The range of motion and the contraction capacity showed no further improvement compared with the results 26 weeks after implantation of the TKA. CONCLUSION: Long-term results after implantation of a TKA showed a good muscular coordination, strength and range of motion. A higher physical activity level led to better functional results and greater overall satisfaction of TKA patients 5 years after implantation.