Karsten Labs - Academia.edu (original) (raw)
Papers by Karsten Labs
Aim: The purpose of study was to analyse osseous changes of tibial spine in radiographs of knees ... more Aim: The purpose of study was to analyse osseous changes of tibial spine in radiographs of knees with aplasia of cruciate ligament. Methods: 13 patients with aplasia of cruciate ligament and respective x-rays were examined and analysed. Diagnosis were proofen by MRI or Arthroscopy. Moreover we checked patients with anterior and complete aplasia of cruciate ligament (s) separately. Results: We found typical signs of hypolasia and aplasia of intercondylar eminence in radiagraphs which correlate with anterior or complete aplasia of cruciate ligaments. These changes we classiþed in 3 types. Conclusion: Using this classiþcation it is possible to get a strong indication for aplasia of cruciate ligament only on the basis of x-rays.
Berlin, Humboldt-Univ., Habil.-Schr., 2002. Computerdatei im Fernzugriff.
Mikroreprod. e. Ms. 98, [19], 22 Bl. : Ill., graph. Darst. Auch Sekundärausg. Berlin, Humboldt-Un... more Mikroreprod. e. Ms. 98, [19], 22 Bl. : Ill., graph. Darst. Auch Sekundärausg. Berlin, Humboldt-Univ., Diss. : 1993.
Journal of Orthopaedic Science, 2001
but there are differences in the arrangement of the collagen fibrils, depending on the direction ... more but there are differences in the arrangement of the collagen fibrils, depending on the direction of force acting on the tissue. Investigations have also shown that there is a relationship between the synthesis of different collagen types and the tensile forces acting within a tissue. 9,15 The findings obtained to date show that the function of a tissue is mainly dependent upon its structure. Since the beginning of the 1980s, biochemical investigations have become the focus of interest. 2 It has become clear that the chemical structure, the amino acid composition and collagen type, and the quality and quantity of the crosslinking in the tendons and ligaments form the basis for the difference in histology and biomechanics and for the differences in their functional properties. Various methods were developed for collagen typing. The method most often referred to in the literature, but also the most complicated one, is analysis by highperformance liquid chromatography (HPLC) after cyanogen bromide or pepsin cleavage. 1-3,9,10,22 In 1981, Laurent et al. 13 developed an analytical method for collagen typing which is performed without prior cleaning by HPLC. This method is simpler and quicker and also gives fully reproducible results. Table 1 provides an overview of some of the results on the collagen typing of tendons and ligaments published in the literature. The purpose of this study was to develope a practicable, reliable micro-method for the semiquantitative analysis of types I and III collagen, and to define standard values for knee ligaments and selected tendons in a rabbit model, as a parameter for their biochemical properties. Materials and methods Materials Equipment. A centrifuge (model no. 5402) and a thermomixer (model no. 5436) were obtained from Eppendorf (Hamburg, Germany). Three-ml all-glass
JCR: Journal of Clinical Rheumatology, 2009
Giant cell tumor of the tendon sheath is a benign lesion of unclear etiology. It has characterist... more Giant cell tumor of the tendon sheath is a benign lesion of unclear etiology. It has characteristics that are consistent with chronic inflammation and neoplasm and is considered the most common true neoplasm of the hand and second most common tumor of the hand (after ganglia). The exact tissue of origin is unknown, but the lesion is thought to represent extra-articular extension of pigmented villonodular synovitis. Cases of giant cell tumors in the fingers of patients with rheumatoid arthritis have been reported and may be coincidental. Giant cell tumor of the tendon sheath are slow growing, persistent, and typically larger than rheumatoid tenosynovitis.
Journal of Clinical Anesthesia, 2007
Arthritis & Rheumatism, 2003
Objective. To determine the role of ultrasound and magnetic resonance imaging (MRI) compared with... more Objective. To determine the role of ultrasound and magnetic resonance imaging (MRI) compared with conventional radiography in the detection of chronic and acute inflammatory manifestations of rheumatoid arthritis (RA) of the shoulder joint. Methods. Forty-three consecutive patients with known RA prospectively underwent clinical examination, radiography, ultrasound, and MRI of the shoulder joints. Each patient was assigned a clinical/laboratory score consisting of 7 parameters, including measurements of shoulder mobility, the erythrocyte sedimentation rate, and C-reactive protein level. Conventional radiography was standardized and performed in 2 planes. Ultrasound was performed in 10 predefined planes using a 7.5-MHz linear transducer. MRI at 1.5T comprised transverse and oblique coronal T1-and T2*-weighted fast spin-echo, gradient-echo (GRE), and inversion-recovery sequences with a matrix size of up to 512 pixels. A dynamic T1-weighted GRE sequence was acquired with intravenous administration of contrast medium. Erosions were assessed using all 3 imaging techniques on a 4-point scale. Soft-tissue involvement was evaluated according to the presence of synovitis, tenosynovitis, and bursitis on ultrasound and MRI. The
Archives of Orthopaedic and Trauma Surgery, 1997
In a prospective study we evaluated with eight established scoring systems 56 patients who receiv... more In a prospective study we evaluated with eight established scoring systems 56 patients who received a Leeds-Keio ligament as an anterior cruciate ligament replacement. The systems were compared based upon their total results, as well as their subjective, objective and functional criteria. It was found that the diversity of both the results and cirteria within the systems made valid comparisons impossible. From this investigation it was concluded that the use of an internationally standardized evaluation system would provide the best possibility for comparison of surgical results. As a result, we recommend the IKDC Score system together with a visual analogue scale to evaluate subjective knee complaints.
American Journal of Physical Medicine & Rehabilitation, 2006
There are a number of complications associated with total knee-joint arthroplasty. These include ... more There are a number of complications associated with total knee-joint arthroplasty. These include deep venous thromboses, peroneal palsy, infection, anemia, and Ogilvie's syndrome. An uncommon but potentially limb-threatening complication is acute arterial occlusion. Approximately 35 cases have been reported in the orthopedic literature. Prompt recognition and treatment intervention are the keys to successful outcome. We describe the case of one patient who had mild peroneal palsy and developed acute arterial occlusion 9 days postoperatively while on the inpatient rehabilitation service. Prompt aggressive management restored arterial circulation to the lower limb. Careful management of patients after total knee arthroplasty requires an understanding that arterial occlusion is a rare limb-threatening complication of surgery, but that it is treatable with prompt, deliberate management. Physiatrists should be aware that this condition exists in postoperative knee-joint arthroplasty patients. They should pay careful attention to any patient with a history of peripheral vascular disease or postoperative peroneal palsy.
Der Orthopäde, 2001
Zusammenfassung Wir berichten über die Therapie einer kompletten ventrokranialen Luxation des K... more Zusammenfassung Wir berichten über die Therapie einer kompletten ventrokranialen Luxation des Kniegelenks mit Beinverkürzung von 20 cm, die nach einer diaphysären Kallusdistraktion am linken Oberschenkel im Alter von 7 Jahren aufgetreten war. Mit 14 Jahren stellte sich die Patientin in unserer Klinik vor. Nach Anlage eines gelenkübergreifenden Ringfixateurs erfolgte zunächst stufenweise die Reposition der Luxation, danach die Fixateurarthrodese des Kniegelenks. Nach Konsolidierung der Arthrodese entfernten wir den Ringfixateur und führten nun die unilaterale, diaphysäre Kallusdistraktion am linken Femur durch. Die Konsolidierung des Distraktionskallus von 12 cm war nach 9 Monaten abgeschlossen, der Fixateur wurde entfernt. Mit 18 Jahren, 2 Jahre nach Abschluss der Behandlung, sahen wir eine beschwerdefreie und sicher gehfähige Patientin. Die verbliebene Verkürzung am linken Bein betrug 2,5 cm und war im Schuh anteilig ausgeglichen.
Zentralblatt für Chirurgie, 2001
We report the treatment of chronic osteomyelitis of the iliac wing after autologous bone harvesti... more We report the treatment of chronic osteomyelitis of the iliac wing after autologous bone harvesting in a 17-year old boy with osteopetrosis. A partial resection of the iliac wing was performed followed by systemic antibiotic treatment. The wound healing was without complications. We consider autologous bone harvesting in patients with osteopetrosis to be a critical procedure due to the higher risk of infection.
Der Orthopäde, 2014
In recent years arthroscopic interventions of the hip joint have become increasingly more frequen... more In recent years arthroscopic interventions of the hip joint have become increasingly more frequent. An advantage of the procedure is that open surgery can be avoided in many cases by using minimally invasive procedures. The spectrum of indications is becoming increasingly broader and more differentiated. Complications are rare. According to the types of complications 13,154 cases from institutions having conducted approximately 470 hip arthroscopies per year between 2008 and 2012 were collated, observed and analysed. Intraoperative or postoperative complications were taken into account. According to our definition, the overall complication ratio came to 6.3%. Relatively frequent complications were damage caused by inadequate setup, nerve lesions and broken instruments. Severe complications such as vascular lesions, intra-or postoperative fractures, infections and avascular necrosis are rare. In hip arthroscopy special attention has to be paid to patient positioning, traction perform...
Orthopädie & Rheuma, 2013
Zentralblatt für Chirurgie, 2002
Revisionsoperationen nach fehlgeschlagener vorderer Kreuzbandplastik haben erheblich zugenommen. ... more Revisionsoperationen nach fehlgeschlagener vorderer Kreuzbandplastik haben erheblich zugenommen. Ursachen für Revisionen sind vor allem persistierende Bewegungsverluste, Rezidivinstabilitäten, Kniegelenkschmerzen und Infektionen. In einer retrospektiven Studie konnten 82 Patienten im Mittel 35,2 Monate nach Revisionseingriffen nachuntersucht werden. Sowohl Zeitpunkt der Revisionen, Revisionsursachen und die Verfahrenswahl wurden mit subjektiven, klinischen und radiologischen Ergebnissen verglichen. In allen Fällen konnte eine klinische Verbesserung erreicht werden. Der Tegner-Score verbesserte sich im Mittel von 2,4 auf 4,6 Punkte. Der Lysholm-Score erhöhte sich nach dem Revisionseingriff von durchschnittlich 54 auf 76 Punkte. Im IKDC-Gesamtresultat konnten die revidierten Patienten die Kategorie A ± 35,4 %, B ± 39 %, C ± 13,4 % und D ± 12,2 % erreichen. Die Ergebnisse nach Revisionsoperationen sind jedoch denen einer erfolgreichen Erstoperation unterlegen. Die Differenzierung zwischen Patienten mit einer präoperativen isolierten Bewegungslimitation oder einer isolierten Gelenkinstabilität erscheint sinnvoll. Bewegungsverbessernde Revisionsoperationen zeigten sowohl in der subjektiven Zufriedenheit der Patienten, der Gelenkstabilität als auch im IKDC-Gesamtresultat bessere Ergebnisse als Eingriffe bei Patienten mit einer präoperativen Gelenkinstabilität. Gleiches gilt für die Frührevision im Vergleich zu einer Spätrevision und für die Verwendung einer autologen versus alloplastischen Revisionsplastik. Eine transplantaterhaltende Revisionsmaûnahme ist nur in ausgewählten Fällen möglich und zeigte keine Überlegenheit der klinischen Resultate gegenüber der sekundären Ersatzplastik. Aus den eigenen Ergebnissen können die Frührevision und die Verwendung eines autologen Revisionstransplantates empfohlen werden. Der Operateur
Rheumatology International, 2003
In two renal failure patients, tumoral calcinoses were observed as a result of secondary hyperpar... more In two renal failure patients, tumoral calcinoses were observed as a result of secondary hyperparathyroidism. The primary conservative therapy conducted with dietetic measures and phosphate-binding medication could not prevent the progression of the massive polytopic foci. Therefore, a subtotal parathyroidectomy was performed in one case, after which a rapid complete regression of the tumours was observed, with the exception of one location where the finding remained progressive. The second patient declined surgical intervention on the parathyroid gland. Therefore, the foci were only resected, whereby local recurrences were observed. Renal failure patients with tumoral calcinosis should undergo subtotal parathyroidectomy after initial conservative therapy. In view of the high risk of recurrence, local excision is a treatment procedure to be considered in exceptional cases only.
Knee Surgery, Sports Traumatology, Arthroscopy, 2001
This study compared the efficacy of two approaches to treating therapy-resistant patellofemoral p... more This study compared the efficacy of two approaches to treating therapy-resistant patellofemoral pain syndrome. In a prospective randomized study 20 patients were treated for 8 weeks with 16 physiotherapeutic exercises on a neurophysiological basis (proprioceptive neuromuscular facilitation) while another 20 patients underwent a special training program using a special resistance-controlled knee splint for 15 min three times daily. We measured muscle activity on a Cybex 6000 and performed surface electromyography of the vastus medialis and vastus lateralis muscles. Anterior knee pain was assessed by the Bessette and Hunter score and a visual analogue scale. An increase in electromyographic activity in the vastus medialis muscle and significant improvement in individual comfort were observed only in those treated by knee splint. The knee splint thus proved more effective than proprioceptive neuromuscular facilitation for treating cases of patellofemoral pain syndrome resistant to conservative therapy.
Aim: The purpose of study was to analyse osseous changes of tibial spine in radiographs of knees ... more Aim: The purpose of study was to analyse osseous changes of tibial spine in radiographs of knees with aplasia of cruciate ligament. Methods: 13 patients with aplasia of cruciate ligament and respective x-rays were examined and analysed. Diagnosis were proofen by MRI or Arthroscopy. Moreover we checked patients with anterior and complete aplasia of cruciate ligament (s) separately. Results: We found typical signs of hypolasia and aplasia of intercondylar eminence in radiagraphs which correlate with anterior or complete aplasia of cruciate ligaments. These changes we classiþed in 3 types. Conclusion: Using this classiþcation it is possible to get a strong indication for aplasia of cruciate ligament only on the basis of x-rays.
Berlin, Humboldt-Univ., Habil.-Schr., 2002. Computerdatei im Fernzugriff.
Mikroreprod. e. Ms. 98, [19], 22 Bl. : Ill., graph. Darst. Auch Sekundärausg. Berlin, Humboldt-Un... more Mikroreprod. e. Ms. 98, [19], 22 Bl. : Ill., graph. Darst. Auch Sekundärausg. Berlin, Humboldt-Univ., Diss. : 1993.
Journal of Orthopaedic Science, 2001
but there are differences in the arrangement of the collagen fibrils, depending on the direction ... more but there are differences in the arrangement of the collagen fibrils, depending on the direction of force acting on the tissue. Investigations have also shown that there is a relationship between the synthesis of different collagen types and the tensile forces acting within a tissue. 9,15 The findings obtained to date show that the function of a tissue is mainly dependent upon its structure. Since the beginning of the 1980s, biochemical investigations have become the focus of interest. 2 It has become clear that the chemical structure, the amino acid composition and collagen type, and the quality and quantity of the crosslinking in the tendons and ligaments form the basis for the difference in histology and biomechanics and for the differences in their functional properties. Various methods were developed for collagen typing. The method most often referred to in the literature, but also the most complicated one, is analysis by highperformance liquid chromatography (HPLC) after cyanogen bromide or pepsin cleavage. 1-3,9,10,22 In 1981, Laurent et al. 13 developed an analytical method for collagen typing which is performed without prior cleaning by HPLC. This method is simpler and quicker and also gives fully reproducible results. Table 1 provides an overview of some of the results on the collagen typing of tendons and ligaments published in the literature. The purpose of this study was to develope a practicable, reliable micro-method for the semiquantitative analysis of types I and III collagen, and to define standard values for knee ligaments and selected tendons in a rabbit model, as a parameter for their biochemical properties. Materials and methods Materials Equipment. A centrifuge (model no. 5402) and a thermomixer (model no. 5436) were obtained from Eppendorf (Hamburg, Germany). Three-ml all-glass
JCR: Journal of Clinical Rheumatology, 2009
Giant cell tumor of the tendon sheath is a benign lesion of unclear etiology. It has characterist... more Giant cell tumor of the tendon sheath is a benign lesion of unclear etiology. It has characteristics that are consistent with chronic inflammation and neoplasm and is considered the most common true neoplasm of the hand and second most common tumor of the hand (after ganglia). The exact tissue of origin is unknown, but the lesion is thought to represent extra-articular extension of pigmented villonodular synovitis. Cases of giant cell tumors in the fingers of patients with rheumatoid arthritis have been reported and may be coincidental. Giant cell tumor of the tendon sheath are slow growing, persistent, and typically larger than rheumatoid tenosynovitis.
Journal of Clinical Anesthesia, 2007
Arthritis & Rheumatism, 2003
Objective. To determine the role of ultrasound and magnetic resonance imaging (MRI) compared with... more Objective. To determine the role of ultrasound and magnetic resonance imaging (MRI) compared with conventional radiography in the detection of chronic and acute inflammatory manifestations of rheumatoid arthritis (RA) of the shoulder joint. Methods. Forty-three consecutive patients with known RA prospectively underwent clinical examination, radiography, ultrasound, and MRI of the shoulder joints. Each patient was assigned a clinical/laboratory score consisting of 7 parameters, including measurements of shoulder mobility, the erythrocyte sedimentation rate, and C-reactive protein level. Conventional radiography was standardized and performed in 2 planes. Ultrasound was performed in 10 predefined planes using a 7.5-MHz linear transducer. MRI at 1.5T comprised transverse and oblique coronal T1-and T2*-weighted fast spin-echo, gradient-echo (GRE), and inversion-recovery sequences with a matrix size of up to 512 pixels. A dynamic T1-weighted GRE sequence was acquired with intravenous administration of contrast medium. Erosions were assessed using all 3 imaging techniques on a 4-point scale. Soft-tissue involvement was evaluated according to the presence of synovitis, tenosynovitis, and bursitis on ultrasound and MRI. The
Archives of Orthopaedic and Trauma Surgery, 1997
In a prospective study we evaluated with eight established scoring systems 56 patients who receiv... more In a prospective study we evaluated with eight established scoring systems 56 patients who received a Leeds-Keio ligament as an anterior cruciate ligament replacement. The systems were compared based upon their total results, as well as their subjective, objective and functional criteria. It was found that the diversity of both the results and cirteria within the systems made valid comparisons impossible. From this investigation it was concluded that the use of an internationally standardized evaluation system would provide the best possibility for comparison of surgical results. As a result, we recommend the IKDC Score system together with a visual analogue scale to evaluate subjective knee complaints.
American Journal of Physical Medicine & Rehabilitation, 2006
There are a number of complications associated with total knee-joint arthroplasty. These include ... more There are a number of complications associated with total knee-joint arthroplasty. These include deep venous thromboses, peroneal palsy, infection, anemia, and Ogilvie's syndrome. An uncommon but potentially limb-threatening complication is acute arterial occlusion. Approximately 35 cases have been reported in the orthopedic literature. Prompt recognition and treatment intervention are the keys to successful outcome. We describe the case of one patient who had mild peroneal palsy and developed acute arterial occlusion 9 days postoperatively while on the inpatient rehabilitation service. Prompt aggressive management restored arterial circulation to the lower limb. Careful management of patients after total knee arthroplasty requires an understanding that arterial occlusion is a rare limb-threatening complication of surgery, but that it is treatable with prompt, deliberate management. Physiatrists should be aware that this condition exists in postoperative knee-joint arthroplasty patients. They should pay careful attention to any patient with a history of peripheral vascular disease or postoperative peroneal palsy.
Der Orthopäde, 2001
Zusammenfassung Wir berichten über die Therapie einer kompletten ventrokranialen Luxation des K... more Zusammenfassung Wir berichten über die Therapie einer kompletten ventrokranialen Luxation des Kniegelenks mit Beinverkürzung von 20 cm, die nach einer diaphysären Kallusdistraktion am linken Oberschenkel im Alter von 7 Jahren aufgetreten war. Mit 14 Jahren stellte sich die Patientin in unserer Klinik vor. Nach Anlage eines gelenkübergreifenden Ringfixateurs erfolgte zunächst stufenweise die Reposition der Luxation, danach die Fixateurarthrodese des Kniegelenks. Nach Konsolidierung der Arthrodese entfernten wir den Ringfixateur und führten nun die unilaterale, diaphysäre Kallusdistraktion am linken Femur durch. Die Konsolidierung des Distraktionskallus von 12 cm war nach 9 Monaten abgeschlossen, der Fixateur wurde entfernt. Mit 18 Jahren, 2 Jahre nach Abschluss der Behandlung, sahen wir eine beschwerdefreie und sicher gehfähige Patientin. Die verbliebene Verkürzung am linken Bein betrug 2,5 cm und war im Schuh anteilig ausgeglichen.
Zentralblatt für Chirurgie, 2001
We report the treatment of chronic osteomyelitis of the iliac wing after autologous bone harvesti... more We report the treatment of chronic osteomyelitis of the iliac wing after autologous bone harvesting in a 17-year old boy with osteopetrosis. A partial resection of the iliac wing was performed followed by systemic antibiotic treatment. The wound healing was without complications. We consider autologous bone harvesting in patients with osteopetrosis to be a critical procedure due to the higher risk of infection.
Der Orthopäde, 2014
In recent years arthroscopic interventions of the hip joint have become increasingly more frequen... more In recent years arthroscopic interventions of the hip joint have become increasingly more frequent. An advantage of the procedure is that open surgery can be avoided in many cases by using minimally invasive procedures. The spectrum of indications is becoming increasingly broader and more differentiated. Complications are rare. According to the types of complications 13,154 cases from institutions having conducted approximately 470 hip arthroscopies per year between 2008 and 2012 were collated, observed and analysed. Intraoperative or postoperative complications were taken into account. According to our definition, the overall complication ratio came to 6.3%. Relatively frequent complications were damage caused by inadequate setup, nerve lesions and broken instruments. Severe complications such as vascular lesions, intra-or postoperative fractures, infections and avascular necrosis are rare. In hip arthroscopy special attention has to be paid to patient positioning, traction perform...
Orthopädie & Rheuma, 2013
Zentralblatt für Chirurgie, 2002
Revisionsoperationen nach fehlgeschlagener vorderer Kreuzbandplastik haben erheblich zugenommen. ... more Revisionsoperationen nach fehlgeschlagener vorderer Kreuzbandplastik haben erheblich zugenommen. Ursachen für Revisionen sind vor allem persistierende Bewegungsverluste, Rezidivinstabilitäten, Kniegelenkschmerzen und Infektionen. In einer retrospektiven Studie konnten 82 Patienten im Mittel 35,2 Monate nach Revisionseingriffen nachuntersucht werden. Sowohl Zeitpunkt der Revisionen, Revisionsursachen und die Verfahrenswahl wurden mit subjektiven, klinischen und radiologischen Ergebnissen verglichen. In allen Fällen konnte eine klinische Verbesserung erreicht werden. Der Tegner-Score verbesserte sich im Mittel von 2,4 auf 4,6 Punkte. Der Lysholm-Score erhöhte sich nach dem Revisionseingriff von durchschnittlich 54 auf 76 Punkte. Im IKDC-Gesamtresultat konnten die revidierten Patienten die Kategorie A ± 35,4 %, B ± 39 %, C ± 13,4 % und D ± 12,2 % erreichen. Die Ergebnisse nach Revisionsoperationen sind jedoch denen einer erfolgreichen Erstoperation unterlegen. Die Differenzierung zwischen Patienten mit einer präoperativen isolierten Bewegungslimitation oder einer isolierten Gelenkinstabilität erscheint sinnvoll. Bewegungsverbessernde Revisionsoperationen zeigten sowohl in der subjektiven Zufriedenheit der Patienten, der Gelenkstabilität als auch im IKDC-Gesamtresultat bessere Ergebnisse als Eingriffe bei Patienten mit einer präoperativen Gelenkinstabilität. Gleiches gilt für die Frührevision im Vergleich zu einer Spätrevision und für die Verwendung einer autologen versus alloplastischen Revisionsplastik. Eine transplantaterhaltende Revisionsmaûnahme ist nur in ausgewählten Fällen möglich und zeigte keine Überlegenheit der klinischen Resultate gegenüber der sekundären Ersatzplastik. Aus den eigenen Ergebnissen können die Frührevision und die Verwendung eines autologen Revisionstransplantates empfohlen werden. Der Operateur
Rheumatology International, 2003
In two renal failure patients, tumoral calcinoses were observed as a result of secondary hyperpar... more In two renal failure patients, tumoral calcinoses were observed as a result of secondary hyperparathyroidism. The primary conservative therapy conducted with dietetic measures and phosphate-binding medication could not prevent the progression of the massive polytopic foci. Therefore, a subtotal parathyroidectomy was performed in one case, after which a rapid complete regression of the tumours was observed, with the exception of one location where the finding remained progressive. The second patient declined surgical intervention on the parathyroid gland. Therefore, the foci were only resected, whereby local recurrences were observed. Renal failure patients with tumoral calcinosis should undergo subtotal parathyroidectomy after initial conservative therapy. In view of the high risk of recurrence, local excision is a treatment procedure to be considered in exceptional cases only.
Knee Surgery, Sports Traumatology, Arthroscopy, 2001
This study compared the efficacy of two approaches to treating therapy-resistant patellofemoral p... more This study compared the efficacy of two approaches to treating therapy-resistant patellofemoral pain syndrome. In a prospective randomized study 20 patients were treated for 8 weeks with 16 physiotherapeutic exercises on a neurophysiological basis (proprioceptive neuromuscular facilitation) while another 20 patients underwent a special training program using a special resistance-controlled knee splint for 15 min three times daily. We measured muscle activity on a Cybex 6000 and performed surface electromyography of the vastus medialis and vastus lateralis muscles. Anterior knee pain was assessed by the Bessette and Hunter score and a visual analogue scale. An increase in electromyographic activity in the vastus medialis muscle and significant improvement in individual comfort were observed only in those treated by knee splint. The knee splint thus proved more effective than proprioceptive neuromuscular facilitation for treating cases of patellofemoral pain syndrome resistant to conservative therapy.