Biomedical subjects

O Miltner

Publications and source records attributed to O Miltner.

21 records · Page 2Linked to original sources

PubMedDate not supplied

[First clinical experiences with a novel 3D-collagen gel (CaReS) for the treatment of focal cartilage defects in the knee].

AIM: In this prospective study we present a novel technique of matrix-based chondrocyte transplantation for the treatment of focal cartilage defects. METHOD: 22 patients with chondral or osteochondral femoral defects were treated with 3D-collagen type-I gel seeded with autologous chondrocytes (CaReS). Overall handling of this novel method is described, and results after 2 years follow-up with regard to the ICRS-score are presented. RESULTS: 14 patients were treated because of a focal chondral lesion, in 8 cases subchondral bone had to be reestablished. The average defect size was 6 cm(2). In all cases cell-seeded matrix samples could be fixed with fibrin glue without any problems. The average surgery time was 69 min, length of the surgical approach was 8.2 cm. No surgery-specific problems had to be observed. A significant improvement in IKDC-score, functional score and overall rating after 3 or 6 months up to 2 years follow-up was detected. After 2 years post-OP 13 Patients were evaluated and matrix-based defect treatment by CaReS was rated good to excellent by 84.6 % of the patients. CONCLUSION: Defect treatment with cell-seeded 3D-collagen gel is easy to handle with a good clinical outcome after 2 years follow-up. Further investigations with higher patient number, longer follow-up time and histological and biomechanical sample analysis are needed in order to establish this method as an improvement of conventional ACT.

Adolescent↗

PubMedDate not supplied

[Intra-articular oxygen partial pressure measurements under functional conditions].

Oxygen partial pressure is directly related to the vascularisation of different tissues. Different investigations in tissue (muscle, kidney, brain, heart, bone etc.) proved this correlation. The development of a special flexible microcatheter named Licox enables us to do measurements of intraarticular oxygen partial pressure under physiological and pathological conditions for the first time. The aim of this study was to examine the influence of different knee joint stresses on the intraarticular oxygen partial pressure under normal conditions and in osteoarthritis. The results showed that the different exercise patterns influence the intraarticular oxygen partial pressure. Patients with osteoarthritis showed a lower increase of the intraarticular oxygen partial pressure compared to the control group. This phenomenon is directly correlated to degree velocity of the isokinetic exercises. The same findings occur under ergometric conditions. The method permits functional, intraarticular in vivo measurements under different exercise patterns. For the very first time we were able to measure the influence of the joint movement on the intraarticular process of nutrition under physiological and pathological conditions. Different therapy concepts in osteoarthritis can be evaluated directly in vivo for the first time.

Adult↗

PubMedDate not supplied

[Mechanism of action of hyaluronic acid in gonarthrosis of both knee joints in a right/left comparison. Study with dynamometry, oxygen partial pressure, temperature and Lequesne score].

In a controlled prospective randomized study we evaluated the effectiveness of intraarticular injected hyaluronic acid regarding the changes in the parameters dynamometry, synovial oxygen partial pressure, intraarticular temperature and the knee joint function (Lequesne score). We examined 18 patients with osteoarthritis in both knee joints (Kellgren classification II or III according to x-ray) in right/left comparison. The evaluated parameters were measured before and after a 5-week treatment phase with 5 intraarticular injections (one injection per week). With regard to the efficacy results changes in dynamometric measurement for flexion and extension (for all angular velocities) and Lequesne-score indicate a marked improvement after treatment with hyaluronic acid. The differences between treated and untreated knee were significant. In extension the p-value was 0.0008 and in flexion p = 0.0015. The p-value of the Lequesne-index between the verum and control group was p = 0.0002. After treatment values for oxygen pressure were higher than at baseline and for the intraarticular temperature a small decrease at the end of the treatment phase was documented. 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↗