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Item type:Publication, Access status: without files , Belastung des Hüftgelenks nach Hüftgelenksersatz bei sportlichen Aktivitäten: Geht da noch mehr? Subjektive und Objektive AspekteHip joint replacement with total hip arthroplasty is a frequently performed and highly successful treatment option that is increasingly being offered to younger patients. Due to their longer life expectancy, the longevity expectations for the endoprosthesis have also increased. Physical activity and sports have a positive effect on the risk of loosening. There is no scientific evidence that participation in any specific sport adversely affects the longevity of a hip endoprosthesis. Nevertheless, recommendations to patients vary widely from surgeon to surgeon, and some types of sport are still generally discouraged. This article provides an overview of both recent and older studies addressing the question "What sports are still permissible with an artificial hip?" It attempts to clarify that high joint forces are not necessarily associated with high risk of damage, as the anatomy of muscles and bones, together with muscle function, is optimised to accomodate higher loads. High forces pose a risk only if they are applied in directions not physiologically intended or if the implant is poorly anchored in the bone. The principle that only sports which can be performed with sufficient coordination should be undertaken is therefore certainly correct. Overall, patients should be encouraged to engage in activities in which they feel comfortable and are aware of their own limitations and risks. Hip resurfacing represents an option for a carefully selected patient population, potentially allowing for a return to elite sports. However, the indication requires careful consideration of the local and systemic risks associated with metalon- metal articulations, as well as the patient's age and athletic aspirations. The extent to which new developments without a metal-on-metal articulation may allow for an expanded indication must be carefully evaluated. Clear guidance from the surgeon to the patient regarding the timeline and postoperative activity following hip replacement with an H-TEP or hip resurfacing is necessary to support patient confidence.Publicationtype: Review Article15 - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Access status: without files , "Basketball foot" : long-time prognosis after peritalar dislocation(Thieme, 2008-03); ; ; Subtalar dislocation is considered a severe injury but occurs rarely and studies generally refer to relatively small patient collectives. We investigated the functional outcome in 22 cases to determine the long-term prognosis. Since associated foot injury is common, we compared the outcome for 12 cases of isolated subtalar luxation with 10 cases of collateral fractures of the adjacent bones of the hind foot and Talus. 19 cases of complex, partially open injuries after high energy trauma have got excluded because of the apparently poor long-term results [2, 7, 8]. The Kitaoka-hind-foot-Score (AOFAS) after mean follow up of 8.3 years indicated a significantly better outcome for isolated luxation. Nearly 50% of isolated luxations had a excellent outcome (73%, mean score 89), luxations with associated fractures had mainly good and fair results (73%, mean score 74). Analysis of the gait pattern by dynamic plantar pressure measurement demonstrated lower pressures in the isolated luxation group and higher pressures in the group with associated fractures in the lateral region of the forefoot with shorter phases of weight bearing. © Georg Thieme Verlag KG Stuttgart.Publicationtype: Journal Article10