Ch. Hopf

Bio: Ch. Hopf is an academic researcher from University of Mainz. The author has contributed to research in topics: Scoliosis & Sitting. The author has an hindex of 10, co-authored 25 publications receiving 695 citations.

Analgesic effect of extracorporeal shock-wave therapy on chronic tennis elbow

Abstract: We report a controlled, prospective study to investigate the effect of treatment by low-energy extracorporeal shock waves on pain in tennis elbow. We assigned at random 100 patients who had had symptoms for more than 12 months to two groups to receive low-energy shock-wave therapy. Group I received a total of 3000 impulses of 0.08 mJ/mm 2 and group II, the control group, 30 impulses. The patients were reviewed after 3, 6 and 24 weeks. There was significant alleviation of pain and improvement of function after treatment in group I in which there was a good or excellent outcome in 48% and an acceptable result in 42% at the final review, compared with 6% and 24%, respectively, in group II.

Low-energy extracorporal shock wave therapy for persistent tennis elbow

Abstract: Fifty patients who suffered from persistent tennis elbow for more than 12 months, and were referred for surgical treatment, were assigned at random to 2 groups of low-energy extracorporal shock wave therapy. Group I received a total of 3000 impulses of 0.08 mJ/mm2; group II (controls) 30 impulses of 0.08 mJ/mm2. Follow up was after 3 and 12 weeks. We found no significant differences between the 2 groups before treatment, there was but significant relief of pain and improvement of function in group I with good or excellent outcome in 56% at the last evaluation.

Primary stable anterior instrumentation or dorsoventral spondylodesis in spondylodiscitis? Results of a comparative study.

Abstract: The operative results of 23 patients with a specific or unspecific spondylodiscitis were documented over 2 years after the focus of the inflammation had been eradicated, bone chip had been interposed and a CDH instrumentation had been performed by an anterior approach only. These outcomes were compared with the results of 32 patients in whom the focus had been removed and the defect had been filled with bone graft from an anterior approach, followed by stabilisation with CD instrumentation through an additional dorsal approach. In the cases where CDH instrumentation was applied, the range of fusion averaged 1.3 segments. This was clearly less extensive than in dorsoventral stabilisation, in which on average 3.5 segments were fused. In 47 of 55 cases mobilisation was achieved without orthesis. Eight months after the operations bony fusion could be observed radiologically in all patients. The mean preoperative kyphotic angle of the affected segments was 14.4°, compared to 4° after the operation. The mean loss of reposition was measured to be about 2.7° in both groups. Average operation time and blood loss were about 50% higher in the patients treated dorsoventrally. We conclude that even in the case of florid spondylodiscitis, a short-range anterior fusion of the affected spinal segment may be performed by use of a stable-angle implant without an increased risk of infection-related loosening.

Langzeitergebnisse der konservativen Behandlung der Skoliose mit dem Chêneau-Korsett

Abstract: At present, we survey 52 patients who had been fitted with Cheneau braces in the years 1978 to 1980. The average primary correction of the single curved thoracic, single curved lumbar, and double curved scolioses amounted to 41%. The best late results are to be expected in the single curved thoracic and single curved lumbar scolioses that presented corrections of 14.2% and 9.2%. In the double curved scoliosis we found a correction of 5.5% of the thoracic and 5.6% of the lumbar curves. The Cheneau orthosis was well accepted by the patients. A final valuation, however, will not be possible till some years have passed.

[High-energy extracorporeal shock-wave therapy (ESWT) in the treatment of pseudarthrosis].

Abstract: PROBLEM The success rate of high-energy extracorporal shock wave therapy in the treatment of non-unions in comparison to the "golden standard" surgery is still unclear. METHOD In a prospective study, 3000 impulses with an energy density of 0.6 mJ/mm2 were applied with an experimental device to the pseudarthrosis in 52 patients. RESULTS The mean duration of pseudarthrosis was 13 months. A mean of 2.5 surgical interventions had already been performed. Bony union was achieved in 52% of our patients after an average of 3.3 months. Failures especially were found in the atrophic type of pseudarthrosis as well as in congenital bone disorders like fibrous dysplasia or osteogenesis imperfecta. No serious complications were observed. CONCLUSIONS Even after numerous surgical interventions high-energy extracorporal shock wave therapy as a noninvasive method for the treatment of bony non-unions showed a fair success rate. A higher success rate can be expected by strict selection criteria.

The skeletal attachment of tendons--tendon "entheses".

Abstract: Tendon entheses can be classed as fibrous or fibrocartilaginous according to the tissue present at the skeletal attachment site. The former can be "bony" or "periosteal", depending on whether the tendon is directly attached to bone or indirectly to it via the periosteum. At fibrocartilaginous entheses, the uncalcified fibrocartilage dissipates collagen fibre bending and tendon narrowing away from the tidemark; calcified fibrocartilage anchors the tendon to the bone and creates a diffusion barrier between the two. Where there are additional fibrocartilaginous specialisations in the tendon and/or bone next to the enthesis, an "enthesis organ" is created that reduces wear and tear. Little attention has been paid to bone at entheses, despite the obvious bearing this has on the mechanical properties of the interface and the clinical importance of avulsion fractures. Disorders at entheses (enthesopathies) are common and occur in conditions such as diffuse idiopathic skeletal hyperostosis and the seronegative spondyloarthropathies. They are also commonly seen as sporting injuries such as tennis elbow and jumper's knee.

Pedicle screw instrumentation of the thoracic spine in idiopathic scoliosis.

Abstract: Study design A prospective study of the accuracy of thoracic pedicle screw placement in patients with idiopathic scoliosis. Objectives To evaluate the accuracy of thoracic pedicle screw placement in the surgical management of idiopathic scoliosis and to establish its risks and benefits. Summary of background data Lumbar pedicle screw instrumentation has proven to be reliable and effective in the surgical management of scoliosis. No reports exist on the accuracy and benefits of pedicle screw instrumentation of the thoracic spine in scoliosis surgery. Methods One hundred and twenty thoracic pedicle screws in 32 consecutively treated patients with idiopathic scoliosis were investigated immediately after surgery by computed tomography scans that were analyzed by three examiners. Results Thirty (25%) of the screws penetrated the pedicle cortex or the vertebral body anterior cortex. Ten screws (8.3%) penetrated the medial cortex of the pedicle by an average of 1.5 mm and a maximum of 3.0 mm. Seventeen screws (14.2%) penetrated laterally by an average of 2.1 mm. There were two cases of caudad penetration. Three screws penetrated the anterior vertebral cortex, of which two also penetrated the pedicle cortex. Also, one of these three screws was replaced because of its direct proximity to the thoracic aorta. There were no neurologic complications. The correlation between the pedicle cortical penetration rate and the preoperative Cobb angle, vertebral rotation or level, or site of screw insertion was statistically insignificant (P > 0.05). Curve correction in the cases of mainly hook instrumentation averaged 52.5% versus 59.2% in the cases of mainly screw instrumentation. This difference was statistically insignificant (P > 0.05). Conclusions Pedicle or vertebral body cortical penetration occurred with 25% of the screws but with no neurologic compromise. Curve correction was slightly greater than with hooks, but not to a statistically significant extent.

Chapter 2. European guidelines for prevention in low back pain : November 2004.

Abstract: Summary of the concepts of prevention in low back pain (LBP): • The general nature and course of commonly experienced LBP means that there is limited scope for preventing its incidence (first-time onset). Prevention, in the context of this guideline, is focused primarily on reduction of the impact and consequences of LBP. • Primary causative mechanisms remain largely undetermined: risk factor modification will not necessarily achieve prevention. • There is considerable scope, in principle, for prevention of the consequences of LBP – e.g. episodes (recurrence), care seeking, disability, and workloss. • Different interventions and outcomes will be appropriate for different target populations (general population, workers, and children) yet inevitably there is overlap. • Interventions that are essentially treatments in the clinical environment, focused on management of current symptoms, are not considered as ‘prevention’ for the purposes of this guideline: they are covered in the accompanying clinical guidelines

A systematic review and meta-analysis of clinical trials on physical interventions for lateral epicondylalgia

Abstract: A systematic review of the literature on the effectiveness of physical interventions for lateral epicondylalgia (tennis elbow) was carried out. Seventy six randomised controlled trials were identified, 28 of which satisfied the minimum criteria for meta-analysis. The evidence suggests that extracorporeal shock wave therapy is not beneficial in the treatment of tennis elbow. There is a lack of evidence for the long term benefit of physical interventions in general. However, further research with long term follow up into manipulation and exercise as treatments is indicated.