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Biomedical subjects

R Haaker

Publications and source records attributed to R Haaker.

11 recordsLinked to original sources
PubMed2004

[Osteomyelitis after endoprostheses].

Today over 170,000 total hip arthroplasties and about 70,000 total knee arthroplasties are performed in Germany. An overall infection rate of 0.5-1.4% is reported in the literature. This means that 800-1700 infections after total hip arthroplasty and 300-850 infections after total knee arthroplasty can occur. The surgical treatment of early or late infections after arthroplasty of the hip or knee needs different intervention. Depending on when the infection develops, a simple Débridement, an allinone exchange arthroplasty, or the explantation of the endoprosthesis with implantation of a spacer followed by the reimplantation of a new prosthesis must be performed. The first hint of postoperative infection is the increase of the C-reactive protein. By correct treatment of the postoperative wound the first sign of an infection can be detected early.

Anti-Bacterial Agents↗
PubMed2001

[Intervertebral disk displacement and trauma].

It is difficult to find medical evidence of a correlation between a lumbar disk disease and trauma. One should consider whether the individual degeneration of lumbar disks or the trauma lead to the typical complaints. Disk disease in the population are very common. Therefore the relevance of the individual affection before trauma has to be considered. Spinal trauma with its sudden, incidental onset needs to be differentiated from purposeful and conscious movements. An intervertebral disk disease can be classified as accident related only in cases involving adequate trauma, with no previous complains, and a sudden onset of pain.

Diagnosis, Differential↗
PubMed1997

A prioritization and analysis strategy for environmental surveillance results.

DOE facilities are required to conduct environmental surveillance to verify that facility operations are operated within the approved risk envelope and have not caused undue risk to the public and the environment. Given a reduced budget, a strategy for analyzing environmental surveillance data was developed to set priorities for sampling needs. The radiological and metal data collected at Sandia National Laboratories, New Mexico, were used to demonstrate the analysis strategy. Sampling locations were prioritized for further investigation and the needs for routine sampling. The process of data management, analysis, prioritization, and presentation has been automated through a custom-designed computer tool. Data collected over years can be analyzed and summarized in a short table format for prioritization and decision making.

Cesium Radioisotopes↗
PubMed1995

External fixation of open femoral shaft fractures.

OBJECTIVE: To determine whether external fixation proves to be a sensible technique for definitive stabilization in open femoral fractures. DESIGN: Retrospective clinical study. MATERIALS AND METHODS: From 1985 to 1989, 18 patients (mean ISS 25.4) with open femoral fractures (type II 11%, type III 89%) were treated by primary and definitive external fixation. After failure of closed reduction procedures, open reduction via debrided soft tissue wounds was employed in 72%. Supplemental internal fixation of large wedge fragments was required in 66%. External fixators were removed after a mean of 166 days. Early deep infections developed in 11%. Additional cast, brace, or traction were not required. MEASUREMENTS AND MAIN RESULTS: After a mean follow-up period of 58 months, 88% of the surviving 17 patients were clinically and radiologically evaluated and 12% were interviewed by telephone. Eleven percent developed late deep infection of the femur concerned. Eighty percent have had full or slightly restricted knee motion. The mean knee flexion amounted to 130 degrees. Relevant shortening of the femur was diagnosed in 7%. Nonunions or relevant malunions were not observed in our series. CONCLUSIONS: These morphologic and functional results compare with those published for alternative stabilization techniques of femoral fractures. For special indications, external fixation is considered to be a sensible technique for primary and definitive treatment of open femoral fractures.

Adolescent↗
PubMedDate not supplied

[Computer-assisted navigated cup placement in primary and secondary dysplastic hips].

AIM: The positioning of an acetabular implant has great influence on the range of motion as well as the charger of dislocation of total hip arthroplasty. Using modern CAS systems the reproduction of the cup position after three-dimensional planning based on computed tomography is possible. We investigated the reliability of the position of the acetabular implant in primary and secondary dysplastic cases. METHOD: Within a prospective randomised study in a total of 100 hip replacements with postoperatively controlled cup position using a computed tomography, we reinvestigated especially the 18 dysplastic and two secondary dysplastic cases. RESULTS: In the dysplastic cases we could realise nearly the same anteversion angles (22.4 degrees to 21.5 degrees) with a bigger standard deviation (+/- 7.68 degrees to +/- 7.29) than in the normal collective. Even the inclination angles (44.5 degrees +/- 5.47 degrees) could be realized nearly the same as in the normal cases (42.3 degrees +/- 4.31 degrees). The depth of the cup implantation could be realised in 15 of 18 cases. CONCLUSION: The CAS system is helpful even in dysplastic cases. The advantage of three-dimensional preoperative CT-based planning is apparent. The surgeon is not able to plan and realise the ideal cup position in some individual.

Acetabulum↗
PubMedDate not supplied

[Side effects and complications of injection therapy for degenerative spinal disorders].

AIM: The type and frequency of side effects due to treatment of vertebral pain syndromes with local injections were examined. Risks and complications were evaluated and precautions are presented in order to avoid these problems. METHODS: The medical records of 453 patients who had undergone injection therapy in hospital for spinal pain syndromes were investigated retrospectively. RESULTS: Paravertebral injections with cervical and lumbar spinal nerve analgesia, facet joint injections, lumbar epidural-perineural injections, epidural-dorsal and epidural-sacral injections, and injections next to the ileosacral joint were administered, amounting to a total of 7 963 injections. In 25 cases (0.3 %) unfavourable side effects were observed. Epidural-perineural injections led to headache in 10 cases and paravertebral lumbar nerve analgesia in 3 cases. Five times after epidural-perineural injections circulatory dysregulation with vertigo, nausea and decreased blood pressure was observed. One patient fell after an epidural-perineural injection, and one patient developed a sensory block up to the thoracic segment 6. Five patients showed local allergic reactions at the injection site after Mepivacain. All complications could be treated with simple symptomatic measures and had no severe effects. CONCLUSION: Compared to other studies, only few side effects were observed. The injections described above may thus be regarded as low-risk therapy.

Adolescent↗
PubMedDate not supplied

[Optimization of cup positioning in THA--comparison between conventional mechanical instrumentation and computer-assisted implanted cups by using the orthopilot navigation system].

AIM: The goal of the current study was to determine the accuracy of free-hand and computer-assisted cup replacement. MATERIAL AND METHODS: We analysed the cup positions after 50 conventional instrumented THAs and compared them with the positions of 50 navigated cups. The operations were done between October 2002 and November 2004. To determine the accuracy of the cup position, the author developed a special measurement tool. With the help of the method it was ensured that the radiograph central beam reached the pelvis in a horizontal position. The central beam was focused directly on the head. We calculated the anteversion and the inclination. RESULTS: The variability of the cup position was significantly higher in the free-hand implanted group. The standard deviation for antetorsion in the navigation group was 5.0 and for inclination angles 2.8. In the conventionally implanted group the standard deviation was 7.4 for inclination and 6.9 for antetorsion. In particular, the anteversion cannot be exactly calculated without a navigation tool since the individual position of the patient's pelvis cannot be assessed by the surgeon without aids. Clinical long-term studies for the clarification of a higher stand-time of the computer-navigated cups are still necessary.

Adult↗
PubMedDate not supplied

[A case report: ochronosis in combination with chondrocalcinosis].

We report the case of a 70 year old female patient suffering from Cox- and Gonarthrosis, a massive loss of function of the whole vertebral spine caused by a combination of Ochronosis and Chondrocalcinosis. The patient's anamnesis, the clinical findings and the pathology with the possible clinical manifestations are being described with a review on the existing literature.

Aged↗
PubMedDate not supplied

[Comparative study of surgically treated shoulder injuries with or without metal implants].

In 36 patients with acromioclavicular fracture type III, IV and V following the Rockwood classification, different surgical procedures without using metal implants were compared. Augmentation of both, the coracoclavicular and acromioclavicular ligaments was done by Vicryl-threads (5 mm) in 26 cases (group I). Solitary augmentation of coracoclavicular ligaments were done in 6 cases (group II), of acromioclavicular ligaments in 4 cases (group III). Twenty-four patients underwent follow-up regarding clinical, ultrasonic and radiological results after 30 month in average. Dislocations of more than 10 mm we found once in group I and II, three times in group III. Using the Taft score, regarding clinical, ultrasonic and radiological findings, five patients had an excellent, 15 a good five patients a satisfying result and the remaining patient had a poor reconstruction of the acromioclavicular joint. Comparing these results with previous 75 patients who underwent surgical reconstruction of acromioclavicular joint, using metal implants between 1980 and 1985, the results were nearly equal. Although severe complications like migration or fracture of the implant and the necessity for another surgical intervention for explantation were not given in patients who were treated without using metal implants. Solitary augmentation of acromioclavicular ligament showed insufficient results, therefore this therapy should not be recommended anymore.

Acromioclavicular Joint↗