Peter Habermeyer - Academia.edu (original) (raw)

Papers by Peter Habermeyer

Orthopade, 2004

Zusammenfassung Der Begriff der Schulterinstabilität fasst verschiedene Schweregrade von der schm... more Zusammenfassung Der Begriff der Schulterinstabilität fasst verschiedene Schweregrade von der schmerzhaften Hyperlaxität über die Subluxation bis zur Luxation zusammen. Bisher wurden verschiedene Klassifikationen mit dem Ziel der erleichterten Therapiefindung beschrieben. Keine der Klassifikationen hat sich jedoch durchsetzen können, da sich die oftmals vorliegenden Mischformen der Schulterinstabilität nicht in einer Klassifikation vollständig abbilden lassen. Nach Akutversorgung kann die Schulterluxation je nach

Aim: The aim of the study was to evaluate the in- fluence of radial shock wave therapy (RSWT) on ... more Aim: The aim of the study was to evaluate the in- fluence of radial shock wave therapy (RSWT) on the course of calcific tendinitis of the rotator cuff. Material and Methods: 35 patients with a mean age of 47.5 years suffering for an average of 28 months from calcific tendinitis with a Gaertner type 2 calcium deposit with a mean

Operative Orthopädie und Traumatologie, 1992

Journal of shoulder and elbow surgery / American Shoulder and Elbow Surgeons ... [et al.], 2015

Discrimination between acute traumatic and chronic degenerative rotator cuff lesions (RCLs) is an... more Discrimination between acute traumatic and chronic degenerative rotator cuff lesions (RCLs) is an important aid to decision making in therapeutic management. To date, no clinical signs or radiologic findings that enable confident differentiation between these distinct etiologic entities have been identified. The purpose of this investigation was to perform a systematic analysis of known radiographic and magnetic resonance imaging (MRI) features of RCLs and of further, not yet accurately described parameters. The hypothesis was that there are specific radiologic features that allow reliable discrimination between traumatic and nontraumatic RCLs. Fifty consecutive patients with RCLs confirmed by MRI were enrolled in this study. Group A was made up of 25 patients with a history of trauma within the previous 6 weeks and no pre-existing shoulder pain, whereas group B comprised 25 patients with shoulder pain for not more than 12 months and no history of relevant trauma. Radiographs and ma...

Zentralblatt für Chirurgie, 2002

The expectation of a functional shoulder joint, even in advanced age, the growing experience and ... more The expectation of a functional shoulder joint, even in advanced age, the growing experience and success in shoulder surgery have brought the operative treatment another step further. The goal of any advanced knowledge should be a proper treatment of the patients and the pathology. Complex rotator cuff tears can be repaired by means of muscle transfer and partial reconstruction. In cases of irreparable rotator cuff tear arthropathy prosthetic replacement of the gleno-humeral joint can be performed. In this article a review on the different techniques and indications for rotator cuff repair is given.

Journal of Shoulder and Elbow Surgery, 2015

Background: Cartilage biochemical imaging modalities that include the magnetic resonance imaging ... more Background: Cartilage biochemical imaging modalities that include the magnetic resonance imaging (MRI) techniques of T2* mapping (sensitive to water content and collagen fiber network) and delayed gadolinium-enhanced MRI of cartilage (dGEMRIC, sensitive to the glycosaminoglycan content) can be effective instruments for early diagnosis and reliable follow-up of cartilage damage. The purpose of this study was to provide T2* mapping and dGEMRIC values in various histologic grades of cartilage degeneration in humeral articular cartilage. Methods: A histologically controlled in vitro study was conducted that included human humeral head cartilage specimens with various histologic grades of cartilage degeneration. High-resolution, 3-dimensional (3D) T2* mapping and dGEMRIC were performed that enabled the correlation of MRI and histology data. Cartilage degeneration was graded according to the Mankin score, which evaluates surface morphology, cellularity, toluidine blue staining, and tidemark integrity. SPSS software was used for statistical analyses. Results: Both MRI mapping values decreased significantly (P < .001) with increasing cartilage degeneration. Spearman rank analysis revealed a significant correlation (correlation coefficients ranging from À0.315 to 0.784; P < .001) between the various histologic parameters and the T2* and T1 Gd mapping values. Conclusion: This study demonstrates the feasibility of 3D T2* and dGEMRIC to identify various histologic grades of cartilage damage of humeral articular cartilage. With regard to the advantages of these

Orthopaedics and Traumatology, 1993

Bateman [2] defined tears of the rotator cuff of more than 3 cm diameter to be "large tears" (gra... more Bateman [2] defined tears of the rotator cuff of more than 3 cm diameter to be "large tears" (grade III). "Massive tears" (grade IV) are those with a defect diameter of more than 5 cm involving two or more tendons of the cuff and exposing the humeral head. Peter Hahcrm¢~cr. Ulrich Brunner. Ernst Wicdcmann: Reconstruction tll Massive Rolator ('uff Tear Orthop. TraumatoL 2 { lt)03J. 210-226 (No 4) 211

Trauma und Berufskrankheit, 2003

Die Schulterinstabilität ist definiert als die Unfähigkeit, den Humeruskopf im Glenoid zu zentrie... more Die Schulterinstabilität ist definiert als die Unfähigkeit, den Humeruskopf im Glenoid zu zentrieren. Eine traumatische Instabilität liegt dann vor, wenn sie durch eine adäquate Gewalteinwirkung mit Schädigung der Kapsel-Band-Strukturen und des Labrums entstanden ist. Die Wahrscheinlichkeit, nach einer primär-traumatischen Erstluxation einer gesunden Schulter ein Rezidiv zu entwickeln, ist umso höher, je jünger der Patient ist. Nach einer Untersuchung von Rowe [31] liegt sie bei 94% für die bis 20jährigen, bei 79% für die 21-bis 30-jährigen und bei 50% für die 31-bis 40-jährigen Patienten. Die Rezidivquote wird zudem durch sportliche Aktivität auf bis zu 90% erhöht [33]. Schon bei 2 Rezidiven nach traumatischer Erstluxation liegt die Wahrscheinlichkeit weiterer Rezidive sehr hoch (78% nach Hovelius [15]), sodass sich eine klare Indikation zur operativen Stabilisierung ergibt. Diese kann auch bei einer fortbestehenden Instabilität im Sinn rezidivierender Subluxationen bzw. eines deutlichen Apprehensionphänomens gegeben sein. Die Klassifikation nach Gerber [9] (Tabelle 1) stellt die Grundlage zur Erstellung der Therapiestrategie dar. Sie unterscheidet zwischen uni-und multidirektionaler Instabilität mit oder ohne Hyperlaxität und beschreibt, dass bei der unidirektionalen Instabilität das Apprehensionzeichen nur in eine Richtung, bei der multidirektionalen nach anterior und posterior positiv ist. Das klinische Korrelat der Hyperlaxität sind das positive Sulcuszeichen, die vermehrte Außenrotationsfähigkeit über 90° und der positive Gagey-Test. Als Sonderformen werden die verhakte Luxation (Typ I) sowie die willkürliche Verrenkung des Schultergelenks (Typ VI) beschrieben. In diesem Beitrag soll die Indikation zur operativen Stabilisierung bei ventro-inferiorer Schulterinstabilität aufgezeigt werden. Außerdem wird ein Überblick über unterschiedliche operative Techniken zur Stabilisierung des Glenohumeralgelenks unter besonderer Berücksichtigung der arthroskopischen Technik gegeben. Trauma Berufskrankh 2003 · 5 [Suppl 1]: S114-S119

Journal of shoulder and elbow surgery / American Shoulder and Elbow Surgeons ... [et al.], Jan 11, 2015

This study evaluated the functional and radiologic results of shoulder arthroplasty using a singl... more This study evaluated the functional and radiologic results of shoulder arthroplasty using a single type of stemless humeral head implant with a minimum follow-up of 5 years. Stemless shoulder arthroplasties in 78 patients at a mean age of 58 years were prospectively evaluated at a mean clinical and radiologic follow-up of 72 months. Functional results were documented using the age- and sex-adjusted Constant score with standardized radiographic examination. The Constant score improved significantly from 38.1% to 75.3% (P < .0001). Active range of motion improved significantly for flexion (from 114° to 141°), abduction (from 74° to 130°), and external rotation (from 25° to 44°; P < .0001). Bone mineral density was reduced in 34.9% of the older population, without an influence on shoulder function (Constant score without lowering of bone density; 73%; Constant score with lowering of bone density 80%; P = .404). The overall complication rate was 12.8%, with an overall revision rat...

International journal of shoulder surgery, 2014

It is commonly accepted that the glenohumeral joint space remains unchanged until the onset of os... more It is commonly accepted that the glenohumeral joint space remains unchanged until the onset of osteoarthritis, at which point progressive degenerative changes, and joint space narrowing occur. The aim of this study was to evaluate the radiographic width of the glenohumeral joint space in patients of different ages: Those with otherwise normal radiographs, those with a history of instability, those with calcific tendonitis, and those with a radiologic diagnosis of osteoarthritis. In this retrospective study, two independent investigators measured the glenohumeral joint width on true anteroposterior and axillary views of standardized shoulder radiographs taken from 2002 to 2009. The digital image resolution was 0.01 mm. Group I comprised 60 patients with normal shoulder radiographs, Group II comprised 53 patients with instability but normal radiographs, Group III comprised 109 patients with radiologically proven calcific tendonitis, and Group IV comprised 120 patients with manifest os...

$Research paper thumbnail of Combination of microfracture and periostal-flap for the treatment of focal full thickness articular cartilage lesions of the shoulder: a prospective study$

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2003

Focal full-thickness articular cartilage lesions of the shoulder are less common than those of th... more Focal full-thickness articular cartilage lesions of the shoulder are less common than those of the lower extremity but are often symptomatic and may progress to degenerative osteoarthritis. This prospective study evaluated our clinical results for cartilage repair in five patients with chondral defects localized at the humeral head using a combination of microfracture and periostal flap, all by deltoidopectoral approach. Mean follow-up was 25.8 months (range 24-31) and consisted of a clinical examination, Constant score examination, radiography, and magnetic resonance imaging; three patients underwent a second-look arthroscopy an average of 8 months following cartilage repair. We found the Constant score significantly improved over the preoperative level, from 43.4% to 81.8%. Pain was reduced significantly to 18.6 points. Radiography and magnetic resonance imaging showed progression of the osteoarthritis in two patients. Second-look arthroscopy revealed a significantly reduced carti...

Der Begriff der Schulterinstabilität fasst verschiedene Schweregrade von der schmerzhaften Hyperl... more Der Begriff der Schulterinstabilität fasst verschiedene Schweregrade von der schmerzhaften Hyperlaxität über die Subluxation bis zur Luxation zusammen. Bisher wurden verschiedene Klassifikationen mit dem Ziel der erleichterten Therapiefindung beschrieben. Keine der Klassifikationen hat sich jedoch durchsetzen können, da sich die oftmals vorliegenden Mischformen der Schulterinstabilität nicht in einer Klassifikation vollständig abbilden lassen. Nach Akutversorgung kann die Schulterluxation je nach Indikation konservativ oder operativ behandelt werden. Der Artikel gibt eine Übersicht über die verschiedenen arthroskopischen und offenen Operationsverfahren in Abhängigkeit von der Indikation sowie deren Resultate.

Bei der operativen Behandlung von Rotatorenmanschettenrupturen war die offene Naht in transossäre... more Bei der operativen Behandlung von Rotatorenmanschettenrupturen war die offene Naht in transossärer Technik über Jahrzehnte als Goldstandard zu betrachten. Auch heute noch ist dieses Verfahren sehr weit verbreitet und hat nach wie seine Berechtigung. Allerdings wurde durch die Einführung der arthroskopischen Therapie des subacromialen Raumes 1987 durch Ellman das operative Spektrum erweitert. Durch die Einführung neuer technischer Verfahren haben sich

Obere Extremitat, 2010

Zusammenfassung Wir berichten über den seltenen Fall einer rezidivierenden antero-inferioren Sch... more Zusammenfassung Wir berichten über den seltenen Fall einer rezidivierenden antero-inferioren Schulterluxation bei einem 10-jährigen Mädchen mit begleitender Hyperlaxität. Nach geschlossener Reposition der verhakten Luxation und Einleitung der konservativen Therapie kam es, trotz Ruhigstellung im Schlingenverband, zu mehreren Rezidivluxationen. Aufgrund der rezidivierenden Luxationen und der funktionellen Beeinträchtigung wurde eine Arthroskopie mit antero-inferiorem und postero-inferioren Kapselshift durchgeführt. Die postoperative Nachbehandlung umfasste eine Immobilisation für 6 Wochen und anschließende Kräftigungsübungen. Im klinischen Nachuntersuchungszeitraum von bereits mehr als einem Jahr zeigte sich eine stabile Schulter mit freiem Bewegungsumfang, womit die junge Patientin ihren alltäglichen und sportlichen Aktivitäten in vollem Umfang nachgehen kann. Der vorliegende Fall zeigt, dass eine rezidivierende Schulterluxation auch bei Kindern mit begleitender Hyperlaxität, nach Versagen der konservativen Therapie, einen operativen Eingriff erfordern kann.

Zentralblatt Fur Chirurgie - ZBL CHIR, 2002

Surgical and Radiologic Anatomy, 1998

A reduction of the subacromial space and an increased subacromial pressure have been considered t... more A reduction of the subacromial space and an increased subacromial pressure have been considered to play an important role in the pathogenesis of rotator cuff lesions. The objective of the current study was to develop a CT based method for measuring the acromiohumeral distance and inferior acromial mineralization. In seven patients with unilateral rupture of the rotator cuff and two with impingement syndrome, transverse CT images were obtained at a section thickness of 1 mm with muscular relaxation in a standardized position. The bones were then reconstructed three-dimensionally, and the minimal vertical distance between the acromion and the humerus was determined in three secondary frontal images on both sides. The distribution of mineralization within the inferior surface of the acromion was assessed using CT osteoabsorptiometry. Although the Constant score was significantly reduced in the diseased shoulders, the width of the subacromial space was not routinely lower than on the contralateral side. In seven cases the maximal inferior acromial mineralization was identical in both shoulders, and in two cases it was lower on the affected side. These preliminary data suggest that with muscular relaxation no narrowing of the subacromial space can be detected in secondary frontal CT images, and that a potential increase of subacromial pressure is not high enough to cause a measurable increase in inferior acromial bone density. The method presented makes it possible to investigate the pathogenesis of the supraspinatus outlet syndrome in vivo with greater precision than has so far been possible with conventional radiography.

Knee Surgery, Sports Traumatology, Arthroscopy, 2006

Knee Surgery, Sports Traumatology, Arthroscopy, 2012

To evaluate the relationship of a large acromion index and calcifying tendinitis of the supraspin... more To evaluate the relationship of a large acromion index and calcifying tendinitis of the supraspinatus tendon at the shoulder. Between 2002 and 2008, 109 consecutive patients with isolated calcifying tendinitis of the supraspinatus tendon were prospectively analysed by clinical investigation and standardized radiographs. Deposit size and appearance were measured and classified according to Bosworth and Gartner. The acromion index (AI) was calculated based on measurements on true anteroposterior radiographs. Pain record on VAS scale, active and passive range of motion and the constant score (CS) were recorded. The mean age of the patients was 48.2 ± 8.0 (n = 46 male 48.6 ± 7.3; n = 63 female 47.9 ± 8.6; P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 0.05). Pain and function were not significantly correlated with deposit size or classification. The acromion index (mean 0.64 ± 0.08) was not significantly correlated with the affected or dominant side, gender, deposit size or classification or any functional parameter like pain and the CS or its subgroups. The theoretical concept of a high acromion index resulting in an increased resulting upward force against the subacromial space, which influences pain and function in calcifying tendinitis of the shoulder, was not supported.