PubMed Health⌕ Search

Biomedical subjects

P Bösch

Publications and source records attributed to P Bösch.

At least 19 recordsLinked to original sources
PubMed2000

Hallux valgus correction by the method of Bösch: a new technique with a seven-to-ten-year follow-up.

Subcapital osteotomy of the first metatarsal is used as the treatment of choice for the correction of hallux valgus. The advantages are a short operation time, no soft tissue procedures, secure union, avoidance of metatarsal head (MTH) necrosis and a varus malalignment. An alternative temporary fixation of hallux valgus also having an arthrosis is performed with a specially developed angle plate (Synthes-Stratec, Austria) with the skin incision lengthened to 1-cm. Adequate displacement of the MTH over the sesamoid bones provides a permanent satisfying result even without an operation on the abductor or the adductor. This article reviews 98 feet of 64 patients who were examined in a follow-up study from the initial 114 cases that were operated. The mean follow-up time was 8 years and 9 months.

Adolescent↗
PubMed1997

A comparison of recombinant hirudin with a low-molecular-weight heparin to prevent thromboembolic complications after total hip replacement.

BACKGROUND: Patients who undergo total hip replacement have a high risk of thromboembolic complications. Recombinant hirudin (desirudin), a specific inhibitor of thrombin, represents a new development in antithrombotic therapy. We compared the efficacy and safety of desirudin with those of a low-molecular-weight heparin (enoxaparin) for the prevention of thromboembolic complications in patients undergoing primary total hip replacement. METHODS: Both treatments, which were assigned in a randomized, double-blind manner, were started preoperatively: enoxaparin on the evening before surgery, and desirudin within 30 minutes before the start of surgery. The dose of desirudin was 15 mg subcutaneously twice daily, and the dose of enoxaparin was 40 mg subcutaneously once daily. The duration of treatment was 8 to 12 days. Deep-vein thrombosis was verified by bilateral venography performed at the end of the treatment period or earlier, if there were clinical signs of deep-vein thrombosis. RESULTS: At 31 centers in 10 European countries, 2079 eligible patients were randomly assigned to receive desirudin or enoxaparin. A total of 1587 patients were included in the primary analysis of efficacy. In the desirudin group, as compared with the enoxaparin group, there was a significantly lower rate of proximal deep-vein thrombosis (4.5 vs. 7.5 percent, P=0.01; relative reduction in risk, 40.3 percent) and a lower overall rate of deep-vein thrombosis (18.4 vs. 25.5 percent, P=0.001; relative reduction in risk, 28.0 percent). The safety profiles were similar in the two treatment groups. CONCLUSIONS: When administered 30 minutes before total hip replacement surgery, desirudin is more effective than enoxaparin in preventing deep-vein thrombosis.

Adolescent↗
PubMed1988

[Is high-density polyethylene suitable as an implant material in cement-free anchoring of hip endoprostheses? A histomorphologic study of an explanted polyethylene screw-in acetabula].

Firmly attached screw-in polyethylene acetabula which had been implanted for between 16 and 54 months were explanted after autopsies and subjected to macroscopic, radiologic and histologic examination. Metaplasias were seen around the threads and on the floor of the acetabulum. Their tendency to ossify represents an attempt at secondary stabilization. Due to the low stability of the polyethylene this causes increased wear on the floor of the acetabulum. The small defects in the polyethylene found in the threads, resembling damage done by mice, may be a sign of biodegradation. In view of the tissue reactions pointed out, the material stability of the polyethylene needs to be improved or implantation must be restricted to a very limited range of indications.

Acetabulum↗
PubMed1987

Chronic osteomyelitis treated by cancellous homografts and fibrin adhesion.

Twenty-nine bone defects caused by chronic osteomyelitis have been treated by radical excision of necrotic bone followed by packing the cavities with cancellous homografts held in position by a fibrin sealant. At follow-up three years after operation all except one had healed, though one case had needed a repeat operation. Good incorporation and remodelling of the grafts was observed even when the osseous bed was severely sclerosed.

Adolescent↗
PubMed1986

Influence of trypsin on the regeneration of hyaline articular cartilage.

A purely chondral lesion was inflicted at the medial or lateral femoral condyle of the knee joints of 54 adult male rabbits in order to study hyaline cartilage regeneration. The experimental group was given a sequential intraarticular instillation of trypsin and autologous blood, the control groups were given trypsin or blood or nothing. Only the experimental group (trypsin and autologous blood) showed hyaline cartilage regeneration in 2/3 of the cases examined. Apparently neither the healthy cartilage nor the synovial membrane suffered damage from the trypsin injection. A possible mechanism of cartilage regrowth may be the inhibition of chalones by the fermentative effect of trypsin, which stimulates the aggregation of thrombocytes and fibrin from the injected blood on the chondral lesion, thus initiating the regeneration of hyaline cartilage.

Animals↗
PubMed1985

[A possibility of cutting frozen sections of bone tissue in routine pathology].

A low priced, efficient frozen section cutting device is described to produce 5 microns sections of frozen undecalcified bone specimen blocks in routine pathology. The device was developed by combining two commercially-available instruments, namely a frozen section microtome with methyl alcohol cooling and a hard tissue microtome. Bore holes were drilled in the hard tissue knife to permit cooling, using the methyl alcohol system of the other microtome.

Bone Neoplasms↗
PubMed1982

The efficiency of the Sudan-III-staining to identify wear particles of pmma-bone cement in tissue after total endoprostheses.

On the basis of the newly-formed capsular tissue of 80 cemented (Weber-Huggler, Müller-Charnley) and uncemented (ceramic/ceramic/titanium) total hip endoprostheses which had to be reoperated on because of aseptic loosening, the efficiency of the Sudan-III-staining reported in literature to identify polymethylmethacrylate (PMMA) bone cement particles is investigated, because the quantity as well as quality of the various wear products is discussed as possible factors of prostheses loosening. PMMA-, polyethylene and polyester particles show definite sudanophilia and orange-red coloration in the Sudan-III-stained frozen sections, so that only very large wear products utilizing the knowledge of the materials of the artificial joints used can be recognized by their forms, whereas the wear stored in the macrophages cannot be identified. Thus, Sudan-III-staining is not suitable for guaranteeing identification and determination of the amount of PMMA-wear.

Azo Compounds↗
PubMed1982

[Histological examinations of remodelling proceedings on the cement-bone surface of endoprosthesis after implantation from 3-10 years ].

The prosthesis loosening represents the main complication of an endoprosthesis. When using bone cement for an anchorage, the most important factors of loosening are the impairment of tissue during toxical and thermic influence, foreign body reaction on the abraded material of the prosthesis, the resorption effect through foreign body giant cells as well as the parallel effect of monomer impoverishment and the dissapearance of polymerization matrix material. Histological examinations of the reparation proceedings of not loosened cement-bone surfaces at total endoprostheses are rarely found in literature, and the extent of a long term effect of the cement on the bone layer has not been sufficiently ascertained. To obtain an insight into the reaction of the bone tissue to the bone cement, the bone-cement surface was examined histologically after 3-10 years TEP-implantation.

Aged↗
PubMed1981

[Does the fibrin glue accelerate the healing of tendons? (author's transl)].

The question of an accelerating influence of the fibrin adhesive (Immuno AG, Vienna) on healing has been investigated in the suture of heel tendons of 69 rabbits. The achilles-tendon cut through was anastomosed in typical way, but besides in the one group a homologous fibrinogen-cryoprecipitate was applied. The histological and biomechanical evaluations of the anastomosis were carried out after one, two and four weeks. By means of the fibrin adhesive the loading capacity of the healing tendons could not be accelerated. The data of rupture stress were in the control group after one week 1.65 kg (+/- 1.14) and after two weeks 8.66 kg (+/- 1.38) and in the fibrin group 2.13 kg (+/-1.28) respectively 7.76 kg (+/-2.19). The difference between the two groups is not significant. Four weeks postoperatively the test could not be carried out, for the anchorage of the tendons at the material testing machine was not possible for over 15 kg stress-strain. Histologically a distinct difference of the repair process of the tendons operated on could not be seen in the two groups either.

Achilles Tendon↗
PubMed1981

First clinical experience with heterologous cancellous bone grafting combined with the fibrin adhesive system (F.A.S.).

Heterologous bone grafts are mostly refused for bone transplantation because of the low osteogenic potency. The remodelling of the heterografts can be improved significantly by application of a fibrin-adhesive-system. Between 1977 and 1979 thirty-five bone defects caused by bone tumors resp. seven times by osteomyelitis were operated on and closed with cancellous Kiel-bone grafts (Braun, Melsungen) soaked thoroughly with fibrin-glue (Tissel/Tissucol TM, Immuno AG, Vienna). Postoperatively there were two infections, but none of them in our osteomyelitic cases. After an average follow-up period of 24.6 months (15-36), the highly satisfying, preliminary results were exactly analysed. Despite the relatively short postoperative time, in almost all cases the complete remodelling of the heterografts into new bone tissue could be observed. A formula to calculate the amount of fibrin-glue, necessary for the procedure, is given.

Adolescent↗
PubMed1980

An analysis of 119 loosenings in total hip endoprostheses.

One hundred nineteen loosenings of Müller total hip endoprostheses are analyzed. These arise from 1,407 operations performed between 1969 and October 1977. Deep infections occurred in 7 cases (0.5%). Loosening after a minimum of 5 years occurred in 15.3%. Of these the stem only was involved in 73.7%, stem and socket in 11.8% and the socket only in 14.5%. Seventy-eight per cent of the loose femoral components had been implanted in a varus position, with a long neck showing a higher incidence of failure, along with cases of implantation for osteoarthritis with cystic changes of the femoral head. In six cases the femoral component broke. This occurred twice in the acetabular component. Pain and loosening seemed to occur at the same time, and was unusual more than 5 years after the operation. When loosening occurred later, it was frequently caused by a fall.

Accidents, Home↗
PubMed1980

Experimental investigations of the effect of the fibrin adhesive on the Kiel heterologous bone graft.

The influence by a fibrin-adhesive on healing has been investigated in heterologous cancellous transplants in the rabbit ilum. After 8 and 12 weeks the radiologic and histologic results were evaluated. In the control group the fibrously surrounded transplants were resorbed and replaced by metaplastic bone only to a little degree. Applicating the fibrin-adhesive system (FKS) the transplants were osseously connected to the bone bearing. The trabeculae wre surrounded by newly built lamellar bone and resorbed during the following periods. The osteogenic potency of heterologous transplants resp. the efficiency of the bone bearing can be improved by application of the FKS.

Animals↗
PubMed1980

[Diastrophic dwarfism].

Description of a male and six female patients with diastrophic dwarfism. In one case the observation was possible since birth. The typical clinical features and roentgenographic characteristics of this epi-, metaphyseal dysostosis with an autosomal recessiv mode of inheritance are summarized and compared with reported cases in the medical literature. It is important to establish the diagnosis early in order to apprise the parents of the prognosis and the likelihood of subsequent children being affected. This demonstrates our report of two affected siblings in one family and three affected siblings in another family. In one case we found an aplasia of both patellae, this finding was not described in the combination with this entity until now.

Adolescent↗
PubMed1979

[Autologous cancellous bone grafting in rabbits using a fibrinogen adhesive system (author's transl)].

The changes in remodelling of autologous cancellous bone after reimplantation using a fibrinogen adhesive system (FAS) consisting of highly concentrated fibrinogen, thrombin and factor XIII were investigated in 23 rabbits. A 5 x 6 mm sized piece of bone was removed from the iliac crest and reimplanted in the same place with and without FAS. Histological, tetracycline fluorescence and radiological evaluation were carried out after 3, 6 and 9 weeks. The control group (without FAS) showed considerable breakdown of the bony trabeculae due to regression of the osteocytes in the centre of the reimplanted bone after 3 weeks, whereas in the FAS group bone was being built on to the vital trabeculae. After 6 weeks the reimplant in the FAS group was still clearly advanced in relation to the non-FAS group. The difference had almost disappeared after 9 weeks. Acceleration of remodelling and lack of regression of the osteocytes in the centre of autologous reimplants after the use of FAS indicates an earlier recommencement of nutrition as compared with the control group. New bone formation in autologous reimplants was clearly accelerated by the use of FAS.

Animals↗