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Biomedical subjects

O Miltner

Publications and source records attributed to O Miltner.

At least 19 recordsLinked to original sources
PubMed2005

[Risk of injury in and adolescent and junior competitive karate].

Increasing professionalism in competitive karate has led to a specific injury pattern. The aim of our study was to investigate the injury pattern in junior competitive karate and to evaluate the prophylactic effect of fist padding. During the 4 (th) Junior World Championships of the World Karate Confederation (WKC) 2004 235 karate fights were observed and injury-related data were recorded. Fist padding was used in 183 fights, 52 fights were carried out without. In 22 % of all fights we saw an injury. Most of them were mild injuries of the head and face: 32 bruises of the face (13 with epistaxis), 7 facial lacerations and 3 concussions (mild brain injury). 14 fights were stopped due to an injury. Only in the category male 18 - 20 years a higher rate of injuries was seen without fist padding (shobu ippon) compared to shobu sanbon (with fist padding). The injury pattern of junior competitive karate is comparable to senior karate. Fist padding does not generally reduce the incidence or severity of injuries.

Adolescent↗
PubMed2004

Upper trapezius muscle conduction velocity during fatigue in subjects with and without work-related muscular disorders: a non-invasive high spatial resolution approach.

The development of fatigue at the muscle fibre level can be assessed in terms of a decrease in conduction velocity (CV). The present study aimed to investigate if work-related muscular disorders in occupations characterised by static loads of long duration affect fatigue resistance in the painful muscle. A group of eight secretaries suffering from bilateral chronic muscle pain in the shoulder/neck region was compared to a group of healthy subjects. The upper trapezius muscle was studied under isometric contractions, holding the arm in the horizontal plane up to the endurance point. Changes in CV estimated at the motor unit level were investigated using a non-invasive high spatial resolution electromyographic (EMG) approach. In addition, the number of motor unit potentials per second (PPS), and the root mean square (RMS) of bipolar signals were assessed, and the results reported as the mean and standard error for each value. Subjects with work-related disorders showed less pronounced changes in CV with respect to healthy subjects. No differences between subjects with and without work-related disorders were encountered for the PPS and RMS. The present findings on CV indicate an increased fatigue-related recruitment of MUs in the painful muscle with respect to a healthy muscle. The fact that this recruitment is not reflected in the PPS and RMS estimates might be due to a fatigue-induced decrease in the firing rate and/or the de-recruitment of fatigued MUs. Furthermore, methodological limitations of the adopted method in the estimation of 'global' parameters such as the PPS and RMS have to be considered.

Adult↗
PubMed2004

[Competitive karate and the risk of HIV infection--review, risk analysis and risk minimizing strategies].

Bleeding facial injuries are not uncommon in competitive karate. Nevertheless, the risk of an infection with HIV is extremely low. Guidelines about the prevention of HIV infections are presented. Especially in contact sports and martial arts the athletes, judges and staff have to recognize and employ these recommendations. Bleeding wounds of the hands due to contact with the opponents teeth can be minimized by fist padding.

Athletic Injuries↗
PubMed2003

Patellar hypertension syndrome in adolescence: a three-year follow up.

INTRODUCTION: Anterior knee pain is one of the major causes of knee pain in an adolescent population. It has been suggested that raised intraosseous pressure may play an important role in the development of anterior knee pain in the young patient. MATERIAL AND METHODS: A prospective clinical multicentre study with 27 adolescent patients presenting with anterior knee pain was performed. After failure to respond to conservative treatment, all patients agreed to undergo minimally invasive intraosseous pressure measurements in local anaesthesia. All 27 patients demonstrated a positive "pain provocation test" as a response to increased intrapatellar pressure and were decompressed with a new intraosseous drilling technique. RESULTS: The repeat intraosseous pressure measurement in 27 patients 1 year postoperatively revealed a significant reduction from 43.3+/-13.4 preoperatively to 24.1+/-4.2 mmHg (p<0.001). The pain relief was documented in the form of a reduced VAS from 7.6+/-1.4 to 2.1+/-1.1 cm after 3 years (p<0.001). CONCLUSION: Patients with anterior knee pain and a positive "pain provocation test" were diagnosed as suffering from a hypertension syndrome of the patella. We conclude that simple extraarticular patellar decompression may offer a valuable new form of treatment in this select group of adolescent patients with anterior knee pain.

Arthralgia↗
PubMed2003

Transient osteoporosis of the navicular bone in a runner.

INTRODUCTION: Transient osteoporosis or the bone marrow oedema syndrome is described as a self-limiting disorder. Transient osteoporosis usually affects only one bone, predominantly the proximal femur. Involvement of the foot is rare and often overlooked. A disorder of the navicular bone of the foot can be found twice in the literature. MATERIALS AND METHODS: We report a case of transient osteoporosis of the navicular bone of the foot in a 20-year-old, female, top-level track athlete (400 m sprinter) treated with alendronate, and a review of the literature. RESULTS: The therapeutic options are limited, frequently consisting of non-specific, symptomatic therapy. Some authors report favourable results with core decompression, while others have reported good results with a conservative regime of symptomatic treatment and avoidance of weight-bearing until the clinical and radiological changes have resolved. In the described case, the patient had a favourable result after a short course of treatment with alendronate. She experienced almost immediate pain reduction and presented a complete resolution of the abnormal signal intensity on MRI. CONCLUSION: This rapid result makes the use of alendronate seem promising in athletes with transient osteoporosis, permitting an early return to high-level activities.

Adult↗
PubMed2002

Efficacy of intraarticular hyaluronic acid in patients with osteoarthritis--a prospective clinical trial.

AIM: The goal of this study was to determine whether or not the intraarticular administration of hyaluronic acid can improve functional parameters, such as isokinetic muscle strength or total work and clinical test results in patients with osteoarthritis (OA) of the knee. METHOD: As part of a prospective, controlled study 43 patients with osteoarthritic changes of both knees (radiographic Kellgren stage II-III) were followed in a right/left comparison. The influence of intraarticularly injected hyaluronic acid (20mg hyaluronic acid/2ml Hyalart) on functional and clinical parameters was analysed. We used the isokinetic system Cybex 600 for measuring maximal isokinetic muscle strength and total work. A total of 20 males and 23 females fulfilled the inclusion criteria with an age between 55-78 years and underwent five injections of hyaluronic acid (one injection per week). The injected knee represented the treatment group, while the contralateral knee served as the control. RESULTS: The maximum peak torque of the knee extensors in the treatment group was measured between 57+/-26.15/32.33+/-19.63Nm prior to the injections and 77.17+/-32.54/47.83+/-21.43Nm following the hyaluronic acid therapy (P< 0.01). The analysis of the knee flexors at angular velocities of 60 degrees /s and 180 degrees /s revealed values of 40.44+/-21.58/22.89+/-16.64Nm and 53.55+/-24.26/34.05+/-17.37Nm (P< 0.01) respectively. The evaluation of the total work of the knee flexors and extensors revealed a significant difference (P< 0.01) between the treatment and control group. The Lequesne score was reduced from 13.57+/-1.88 prior to the injections to 7.94+/-2.53 after the treatment (P< 0.01). The pain score was documented with the help of a visual analog scale. The VAS values were reduced at rest from 3.83+/-1.72cm to 1.36+/-1.42cm and during weight bearing from 7.57+/-1.34cm to 3.75+/-1.32cm in the treatment group (P< 0.01). CONCLUSIONS: This controlled prospective clinical trial confirmed that 5 weekly intraarticular injections of HA (Hyalart) in patients with OA of the knee provide pain relief and functional improvements.

Aged↗
PubMed2002

Recurrent focal myositis of the peroneal muscles.

Recurrent focal myositis is a rare entity and can be difficult to diagnose and treat. A long-term follow-up and diagnostic evaluation was carried out in a patient who presented with ankle stiffness secondary to a painful mass within the calf. This process was diagnosed as focal myositis of the peroneal muscles, which recurred over a period of 7 yr. A review of the literature regarding focal myositis, treatment options and a successful conservative therapy regimen, as an alternative to a surgical protocol, are presented. After making the diagnosis with the help of a muscle biopsy, long-term therapy should be considered. Conservative treatment of focal myositis with anti-inflammatory drugs and physical therapy can be successful but recurrence may occur if the medical treatment is interrupted.

Adult↗
PubMed2001

Septic arthritis of the knee in adults: treatment by arthroscopy or arthrotomy.

Fifty-one patients with septic arthritis of the knee were reviewed retrospectively. Twenty-seven patients had been treated by arthroscopic lavage and debridement, 24 patients by open arthrotomy with subtotal synovectomy. The patients were staged according to the duration of preoperative symptoms and to the intraoperative spread of the inflammatory process. With early onset of therapy (less than 5 days) and without osseous involvement arthroscopic treatment led to an effective resolution of infection with better functional results than open arthrotomy.

Adult↗
PubMed2000

Interleukin-6: a potential inflammatory marker after total joint replacement.

In a prospective study C-reactive protein (CRP) and interleukin-6 (IL-6) measurements were taken serially in 30 patients before and after 20 total hip arthroplasties (THR) and 10 total knee arthroplasties (TKR). There were no peri- and postoperative complications. Postoperatively the IL-6 serum concentration increased rapidly and peaked 6 h postoperatively at maximum levels (399+/-140 pg/ml). There was a mean half-life of 15 h and thereafter a rapid return to normal concentrations. In comparison, the postoperative CRP concentration rose more slowly and reached maximum levels (138+/-54 mg/l) on the second postoperative day. There was thereafter a slow descent with a mean half-life of 62 h. There was no significant difference between the patients with THR and those with TKR (P>0.05). IL-6 is therefore a superior marker for the inflammatory phase after THR and TKR.

Aged↗
PubMed1997

Influence of isokinetic and ergometric exercises on oxygen partial pressure measurement in the human knee joint.

We conducted the first in vivo investigation on the influence of joint movement on intraarticular oxygen partial pressure. The development of a special flexible microcatheter allowed measurements of intraarticular oxygen partial pressure under both physiological and pathological conditions. The aim of this study was to evaluate the influence of different knee joint stresses on intraarticular oxygen partial pressure under physiological (healthy patients) and pathological (patients with osteoarthritis) conditions. The results show that the different exercise patterns influence the intraarticular oxygen partial pressure. Patients with osteoarthritis showed a lower increase of intraarticular oxygen partial pressure compared with healthy patients. This phenomenon is directly correlated to the degree velocity of the isokinetic exercises. We found the same results under ergometric conditions. This method allows functional, intraarticular in vivo measurements under different exercise patterns. For the first time, we were able to measure the influence of joint movement on the intraarticular process of nutrition under physiological and pathological conditions. Also, to evaluate for the first time in vivo different concepts for osteoarthritis therapy.

Adult↗
PubMedDate not supplied

[Strengthening lumbar extensors--therapy of chronic back pain--an overview and meta-analysis].

AIM: Low back pain ranks high among the reasons for physician office visits and is costly in terms of medical treatment. A number of studies have shown that low back pain patients have significantly lower trunk strength when compared with healthy controls. The working hypothesis at the beginning of the 1990's was that low back pain patients could be treated effectively using lumbar extension exercise. METHOD: 21 papers and abstracts reporting on lumbar extension training are rated. Validation was performed for each paper according to the internationally accepted system of the American Association of Spine Surgery in types A-E. RESULTS: 1100 cases from 21 publications and abstracts dealing with lumbar extension training were evaluated. We did not find a single type A study in our search. The clinical outcome of the studies was a reduction of pain, improvement of range of motion, improvement of spinal condition and of the lumbar extension strength. CONCLUSION: Prospective, randomized, controlled studies with long-term results should help to delineate further the role of isolated lumbar extension exercise for the treatment of low back pain and to test the efficacy compared to other methods of care.

Exercise Therapy↗
PubMedDate not supplied

[Measuring isokinetic force in patients with gonarthrosis before and after hyaluronic acid therapy].

AIM: In the study we evaluated the effectiveness of intraarticular injected hyaluronic acid (Hyalart) with regard to the changes in the parameters maximal isokinetic muscle strength, total work, pain at rest, and pain under toad. METHOD: We examined 43 patients with osteoarthritis in both knee joints (Kellgren II or II according to X-ray) in right/left comparison. We used the isokinetic system Cybex 600 for measuring the maximal isokinetic muscle strength and the total work. We used the visual analog scale for the pain. The evaluated parameters were measured before and after a 5-week treatment phase with 5 intraarticular injections (one injection per week with 20 mg hyaluronic acid). RESULTS: In knees treated with hyaluronic acid the mean peak torque of the knee extensor was 57 +/- 26.15/32 +/- 19.63 Nm vs. 77.17 +/- 32.54/47.83 +/- 21.43 Nm after (p < 0.01), the mean peak torque of the knee flexor was 40.44 +/- 21.58/22.89 +/- 16.64 Nm vs. 53.55 +/- 24.26/34.05 +/- 17.37 Nm after treatment (p < 0.01) at the angular velocities of 60 degrees/s and 180 degrees/s. Significant differences (p > 0.01) between treated and untreated knee were found for total work of the extensor and flexor of the knee. The pain at rest decreased from 3.83 +/- 1.72 cm to 1.36 +/- 1.42 cm and the pain under load decreased from 7.57 +/- 1.34 cm to 3.75 +/- 1.32 cm in the treated knee group (p < 0.01). CONCLUSION: The intraarticular injection of hyaluronic acid is effective and safe in the treatment of patients with gonarthrosis. The treatment resulted in a functional improvement of the knee joint and had a good pain lowering effect in patients suffering from gonarthrosis.

Aged↗
PubMedDate not supplied

[Healing of osteochondral transplants--animal experiment studies using a sheep model].

AIM: Autologous grafting has developed into one of the preferred methods of treatment for focal osteochondral lesions, although basic research on this topic remains sparse. In an animal study, questions regarding the healing of such osteochondral transplants are clarified. METHOD: An autologous osteochondral transplantation was performed on the ovine knee using the standard operative protocol. Two groups, consisting of 10 sheep each, were evaluated after 3 and 6 months, respectively. RESULTS: During the clinical evaluation of the specimens, neither osteophytes nor synovial changes were observed. The consistency of the cartilaginous tissue began to reach a level equivalent to the surrounding tissue only after 6 months. Macroscopically, the superficial border of the transplanted osteochondral plug could easily be outlined at both time points. Radiographically, a solid osteointegration of the graft could already be documented at 3 months. In contrast, integration of the chondral surface of the OAT was not seen macro- or microscopically at any point in time. A firm physical interdigitation of the reconstructed joint surface could not be demonstrated. CONCLUSIONS: The lack of integration of the cartilaginous portion of the transplanted plugs into the reconstructed joint surface leads to questions regarding the long-term survival of the joint itself.

Animals↗
PubMedDate not supplied

[Arm motion analysis: a new method and its clinical application].

AIM: An investigation into the objective criteria of shoulder mobility possesses special meaning for diagnostic documentation, the evaluation of therapy and the effects of rehabilitation in the treatment of diseases of the shoulder. In order to ascertain the criteria which characterise shoulder mobility, it is necessary to have a tool available that is objective, comparable and allows the complexity, variability and range of motion to be recorded. Motion analysis represents one such standard procedure used to measure joint movement. METHOD: Accordingly, a marker- based motion analysis of the wrist and elbow, a marker-based three-dimensional motion analysis system for the upper extremities was developed. We evaluated 10 healthy subjects without shoulder conditions and 8 patients with impingement syndrome (7 operative, 1 conservative therapy). RESULTS: The healthy subjects revealed a reproducible motion curve for the specific motion tested. The curves were defined as the normal standard and we used them for comparative purposes. In the treatment group, an improvement of the 3D range of motion could be documented for the affected shoulder following rehabilitation. CONCLUSION: It can be stated that this newly developed marker-based procedure for the three-dimensional motion analysis is suitable for recording complex unconstrained movements. This was found to be more relevant for the assessment of the ability of patients to manage the physical demands of daily living than traditional clinical tests. Furthermore, the information gained from motion analysis of the upper extremities will play a valuable role in the future for quality control during diagnosis and treatment, as well as for the design of shoulder rehabilitation programs.

Adult↗
PubMedDate not supplied

[Filling of osteochondral donor site defects. Experimental study with tricalcium phosphate cement and BMP-2].

AIM: Osteochondral grafting procedures have developed into one of the preferred methods of treatment for focal osteochondral lesions, although the management of the donor site remains problematic. In this animal study, an attempt at sealing the donor site with a fully-resorbable tricalcium phosphate bone cement was evaluated. METHOD: Autologous osteochondral transplantation of the medial and lateral condyle was performed on the ovine knee using a standard operative protocol. The ensuing defect was filled with the original beta-TCP cement laterally, while medially the cement was augmented with 50 micro g BMP-2. Two groups, consisting of 10 sheep each, were evaluated after three and 6 months, respectively. RESULTS: The clinical evaluation of the specimens revealed an improved reconstruction of the joint surface following the application of the augmented biomaterial. Macroscopically, the superficial border of the original donor site could easily be outlined at both time periods in both groups. Solid osteointegration of the bone cement could be documented radiographically as early as three months following implantation. CONCLUSION: The beta-TCP bone cement represents a promising resorbable filler for osteochondral defects. The augmentation with BMP-2 seems to expedite the remodelling process and improve the surface reconstruction.

Animals↗
PubMedDate not supplied

[Portable NMR-MOUSE: a new method and its evaluation of the Achilles tendon].

AIM: The increased demands placed on the Achilles tendon in recreational and professional sports have led to a rise in pathological changes in this anatomic region. Magnetic resonance evaluations of the tendon have proven to be a valid but expensive and stationary diagnostic tool. In this study, a new mobile NMR sensor was to be tested in the evaluation of the Achilles tendon. METHOD: The technical development of the so-called NMR-MOUSE ( Mobile Universal Surface Explorer) represents a novelty with an open and portable sensor. To appraise its diagnostic efficacy, healthy athletes (professional soccer players, track and field, as well as aquatic athletes), healthy controls and patients with Achilles tendon lesions were evaluated. As an accessible, sensitive and reproducible parameter for the study the transverse relaxation time T2 with its angular dependency was chosen. As part of the examination, the relaxation times of the skin, the tendon and the surrounding soft tissue were determined. RESULTS: During the evaluation with the NMR-MOUSE, the skin and peritendineous tissue exhibited relatively long T2 relaxation times, while the tendon itself had significantly shorter T2 times, allowing for a clear differentiation of the structures. The T2 relaxation time of the Achilles tendon in the control group averaged 5.8 ms. The MRI-MOUSE was able to demonstrate an increase in the T2 relaxation times in patients with pathological lesions of the tendon due to the increased water retention of the tissue. CONCLUSION: The novel NMR-MOUSE represents a cost efficient and portable sensor, which allows for a reliable evaluation of surface structures, such as the Achilles tendon. The anisotropic structure of the tendon and the surrounding soft tissue can be reliably differentiated with the help of the NMR-MOUSE.

Achilles Tendon↗
PubMedDate not supplied

[Meniscus replacement: current aspects in the field of tissue engineering].

Tissue engineering offers new opportunities for meniscus repair and replacement. In this field different approaches are being studied to genererate a meniscus subsitute by a combination of a matrix scaffold, cells and specific stimuli. MENISCUS REPLACEMENT BY ACELLUAR MATRICES: For meniscus replacement the matrix material has to meet high biomechanical demands. Besides implant geometry, the material properties and a secure intraarticular attachment are important preconditions for implant function. A collagen scaffold has already been applied clinically for partial meniscus replacement. Scaffolds made of synthetic, bioabsorbable polymers and small intestine submucosa have been employed in animal studies. Following implantation, matrices are invaded by cells and undergo a process of remodeling. Formation of fibrocartilage repair tissue has been observerd. The biomechanical quality of implants and their effect on cartilage preservation have to be studied further. CELLULAR SEEDING OF MATRICES FOR MENSICUS REPLACEMENT: Advanced biological and biomechanical implant quality might be achieved by seeding matrices with cells in vitro. However, the ideal type of cell for this purpose has not yet been identified. Autologous mensicus cells, articular chondrocytes and mesenchymal stem cells represent possible cellular sources. Additional stimuli, such as cytokines and mechanical forces, and techniques of genetic engineering might further contribute to enhance the quality of engineered tissue.

Biocompatible Materials↗