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Biomedical subjects

M H Hackenbroch

Publications and source records attributed to M H Hackenbroch.

At least 19 recordsLinked to original sources
PubMed1992

No physiologic age-related increase of circulating somatomedin-C during early stage of Perthes' disease: a longitudinal study in 21 boys.

Perthes' disease was originally viewed as a local ischaemic necrosis of the femoral head. Several authors, however, have presented data suggesting that children with this disease also suffer from a general disorder of skeletal maturation. Hormonal changes in the hypothalamus-pituitary-growth plate axis have been discussed as a possible underlying cause and contradictory results reported on the role of the somatomedins in this process. In this report for the first time sequential data are presented on plasma somatomedin-C (Sm-C/insulin-like growth factor I) levels in 21 boys with Perthes' disease. Values were compared with data from 105 control subjects. The physiologic increase with age of plasma Sm-C levels in the control group was either absent or diminished in children with early-stage Perthes' disease (P less than 10(-6), signs test). The Sm-C values in affected children were low. Our data correlate well with reports from others of retarded skeletal maturation in children with Perthes' disease and support the hypothesis of an accompanying disorder of the synthesis or release of Sm-C/IGF-I or its binding proteins.

Aging↗
PubMed1992

Intra-articular injections and articular cartilage metabolism. An experimental study in rabbits.

We studied the effects of repeated intra-articular injections of sterile 140 mM NaCl solution on articular cartilage in adult rabbits. After 20 injections into the knee joints over a period of 4 weeks, chondrocyte glucosaminoglycan synthesis was evenly reduced in all cartilage layers, accompanied by a significant proteoglycan depletion of the matrix which was most marked in the superficial half of the cartilage. These and other changes only partially reversed during a further 4-week period after the injections had been stopped. Our data underline the need for a clear-cut indication for intra-articular injections. The microtrauma caused by injection, in conjunction with the introduction of a carrier solution into the joint, may, at least when repeated at short intervals, lead to measurable damage to the articular cartilage.

Animals↗
PubMed1992

Low plasma levels of insulin-like growth factor I in Perthes' disease. A controlled study of 59 consecutive children.

We studied Insulin-like Growth Factor I (IGF I) plasma levels, standing height, and weight in 59 consecutive children with Perthes' disease and 59 matched controls. The plasma-IGF I levels, measured by radioimmunoassay after acid ethanol extraction, were reduced in affected children during the first 2 years after the diagnosis of Perthes' disease. Partially paralleling the alterations in IGF I plasma levels, there was a tendency towards growth arrest and impaired weight-gain during early-stage disease, followed by catch-up growth and increased weight-gain. No relation was found between degree of femoral head involvement, according to Catterall (1971), and IGF I plasma-levels or body mass. Our data may reflect an impaired synthesis or release of IGF I relative to age in Perthes' disease, or changes in the affinity or metabolism of IGF binding proteins. The observed changes seem to be of a temporary nature.

Adolescent↗
PubMed1989

Intertrochanteric osteotomy for the treatment of coxarthrosis.

Intertrochanteric osteotomy of the femur as a joint-preserving procedure for the treatment of coxarthrosis depends, according to Pauwels, on the idea of calculated lowering of mechanical stress and changing of the quality of joint strain. In order to meet this rationale it is necessary to provide for optimal joint congruity. This traditionally means the creation of a joint space that is as "symmetrical" as possible, which can be demonstrated by means of conventional radiograms. In fact, however, the largest possible areas of hyaline cartilage of the best possible quality need to be positioned so that they articulate upon each other. Unfortunately, as yet no adequate methods are available of picturing the actual and the intended congruity: at least the traditional imaging techniques applied in living persons do not fulfil this. Since therefore exact preoperative planning is presently impossible, the results, unfortunately, are to some extent a matter of chance. Nevertheless, clinical long-term follow-up examination revealed that about 50% of patients continue satisfied even after 10 years, since they have no pain at all or at most minimal pain. Thus, intertrochanteric osteotomy still offers good relief in properly selected cases and there is often no need for early alloarthroplasty.

Hip Joint↗
PubMed1979

[Contribution to the etiology of coxarthrosis. Radiographic and clinical evaluation of 976 arthrotic hip joints (author's transl)].

Radiograms and case histories of 654 randomized patients with 976 arthrotic hip joints have been reviewed in an attempt to make an etiological diagnosis. 98.3% of the patients and 98.8% of arthrotic hips, respectively, could be determined as to their underlying praearthrotic deformities according to Hackenbroch sen. The respective mean value gained from 6556 patients published in the world literature is 74.2% with marked individual variations. Most frequent praearthrotic condition was found to be congenital hip dislocation, followed by epiphyseolysis capitis femoris juvenilis, trauma, coxitis, M. Perthes, coxa vara, protrusio acetabuli, idiopathic femoral head necrosis, ankylosing spondylitis and several more rare basic conditions.--The most important reasons for differing results are discussed: Specific composition of clinic cases, completeness of documentation, experience of the reviewer and considerable space for personal interpretation. Relevant epidemiological data are also mentioned; they are in agreement with clinical experience and published data.--Finally it is stated that present diagnostic methods are not able to detect all praearthrotic conditions.

Adolescent↗
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

[Etiological assessment of aseptic femoral head necrosis from blood serum metabolic parameters (author's transl)].

The etiological assessment of aseptic femoral head necrosis in adults is facilitated by investigation of the uric acid level and of fat metabolism parameters. From 98 of our own patients it appears that femoral head necrosis after trauma, irradiation therapy and caisson disease and after massive doses of cortisone only exceptionally shows pathological serum levels. Femoral head necrosis with manifest metabolic diseases shows 53.3% hyperuricemias and hyperlipemias or dyslipidemias. Of femoral head necroses without concomitant diseases, prior physical effects and administration of cortisone, 91% had hyperuricemia and 65% hyperlipemia or dyslipidemia.

Adult↗
PubMed1976

[The indication for intertrochanteric osteotomy of the femur based on late results (author's transl)].

57 intertrochanteric osteotomies of the femur were performed in 43 patients during childhood. A statement about late radiographic results is made, based upon follow-up examination after cessation of growth of the upper end of the femur. Attention was given to the development of the CCD-angle, the AC-angle, the CE-angle as well as the development of antetorsion. Further-more the evaluation included the development of the caput-epiphyseal angle as well as the development deformities of the caput femoris. The data presented show that satisfactory results can be obtained through Bernbeck's method and also through the presently used derotation-varisation-osteotomy involving wedge removal. However, the results show that the correction of CCD-angle and antetorsion alone frequently is not sufficient. Thus the acetabulum deserve greater consideration is discussing intertrochanteric osteotomy in childhood.

Adolescent↗
PubMed1976

[Further experiences with total hip arthroplasty. Clinical and roentgenographic results after 3--6 years following implantation (author's transl)].

Report on 236 re-examined total hip arthroplasties performed between 3 and 6 years before (69 Huggler-Weber I and 167 McKee-Farrar joints). 76% of the patients were satisfied with their results on the base of acceptable pain control, increased joint mobility and improved functional capacity. Negative estimations usually could be verified by clinical and roentgenographic findings, the main reason for failures being aseptic loosening of one or both of the implant components in a present rate of 17.8%. Additional failures were due to infectious loosening (2.7%) and pararticular ossification (1.3%). Aseptic loosening of Weber-Huggler implants (33%) occured three times as often as with McKee-Farrar joints and usually was confined to the acetabulum. The influence of different factors such as patient's age and previous surgery, preoperative roentgenographic findings, etiology of coxarthrosis and operative technique has been evaluated. It is concluded that the present way of implant cementation with acrylics offers no sufficient long term anchorage and total hip arthroplasty therefore presently should be confined to the elderly. However, the results may be improved by strict indication and proper surgical technique.

Age Factors↗
PubMed1976

[Effect of distraction by various forces on the elbow joint in rabbits].

The elbow joints of 115 adult live rabbits have been subjected to experimental distraction by various forces and for different intervals. The forces applied were one tenth and one half, respectively, of the mean body weights; thus, a calculated reduction of one eleventh and five elevenths, respectively, of the force transmitted through the articulating joint surfaces was achieved. The distraction was performed for periods of 1, 2, 4 and 8 weeks. The forces were administered by means of an extraarticular device which allowed motion of the joints. Controls had been provided for to prove the noneffectiveness of the distraction device per se to the joint structures under study. Both upper limbs--one side always served as control--were subjected to radiological, histological/histochemical, angiographic and cytological examination; cartilage in addition was treated by vital staining or, alternatively, by producing splitting lines. The results were as follows: (1) Extensive local and more generalized hyperemia involving the whole limb in question was produced regardless of strength and duration of distraction. (2) Under all experimental conditions subsynovial hemorrhage and hemarthrosis developed. (3) Subsynovial hemorrhage caused the development of granulomatous and, subsequently, fibrous synovitis with simultaneously demonstrable hemosiderin depots. (4) Hemarthrosis was persistent during the entire period of observation. (5) Articular cartilage revealed moderate signs of degeneration and also irregularities of the usual pattern of splitting lines after continuous distraction for 8 weeks. At the same time, subchondral bone atrophy appeared. Vital staining revealed increased cartilage staining under mild distraction; moderate and marked distraction caused definitively less staining. Subsynovial hemorrhage and hemarthrosis are explained as partial vacuum effects. Concerning the moderate cartilage changes, a multifactorial genesis is presumed; the possible role of chemical, nutritional and mechanical factors is discussed. The widespread hyperemia most likely is caused by mechanical stimulation going along with joint distraction; capsular hyperemia might be a phenomenon immediately related to synovitis. Finally, the experimental results are discussed relative to observations made during clinical traction therapy.

Animals↗