Christopher Bliemel

Bio: Christopher Bliemel is an academic researcher from University of Marburg. The author has contributed to research in topics: Hip fracture & Osteosynthesis. The author has an hindex of 18, co-authored 55 publications receiving 1089 citations. Previous affiliations of Christopher Bliemel include University of Giessen.

Management of pulmonary cement embolism after percutaneous vertebroplasty and kyphoplasty: a systematic review of the literature

Abstract: Balloon kyphoplasty and percutaneous vertebroplasty are relatively recent procedures in the treatment of painful vertebral fractures. There are, however, still some uncertainties about the incidence and treatment strategies of pulmonary cement embolisms (PCE). In order to work out a treatment strategy for the management of this complication, we performed a review of the literature. The results show that there is no clear diagnostic or treatment standard for PCE. The literature research revealed that the risk of a pulmonary embolism ranges from 3.5 to 23% for osteoporotic fractures. In cases of asymptomatic patients with peripheral PCE we recommend no treatment besides clinical follow-up; in cases of symptomatic or central embolisms, however, we recommend to proceed according to the guidelines regarding the treatment of thrombotic pulmonary embolisms, which includes initial heparinization and a following 6-month coumarin therapy. In order to avoid any types of embolisms, both procedures should only be performed by experienced surgeons after critical determination of the indications.

Knee function and prevalence of osteoarthritis after isolated anterior cruciate ligament reconstruction using bone-patellar tendon-bone graft: long-term follow-up.

Abstract: The aim of this investigation was to study patient-reported long-term clinical outcome, instrumental stablitity and prevalence of radiological osteoarthritis (OA) a minimum of ten years after isolated anterior cruciate ligament (ACL) reconstruction. An average of 13.5 years after ACL reconstruction with bone–patellar tendon–bone (BTB) autograft, 73 patients were evaluated. Inclusion criteria consisted of an isolated ACL rupture and reconstruction with BPTB graft with no associated intra-articular lesions, in particular, cartilage alterations or meniscal lesions. Clinical assessment was performed using the International Knee Documentation Committee (IKDC) and Tegner and Lysholm scores. Instrumental anterior laxity testing was carried out with the KT–1000™ arthrometer. Degree of degenerative changes and prevalence of OA were determined using the Kellgren- Lawrence scale. Mean follow-up was 13.5 years. Mean age was 43.8 years. About 75% of patients were graded A or B according to the IKDC score. The Lysholm score was 90.2 ± 4.8. Radiological assessment reported degenerative changes of grade II OA in 54.2% of patients. Prevalence of grades III or IV OA was found in 20%. The incidence of OA was significantly correlated with stability and function at long-term follow-up. Arthroscopic ACL reconstruction using BPTB autograft resulted in a high degree of patient satisfaction and good clinical results on long-term follow-up. A higher degree of OA developed in 20% of patients and was significantly correlated with increased anterior laxity at long-term follow-up.

Early orthogeriatric treatment of trauma in the elderly: a systematic review and metaanalysis.

Abstract: As a result of demographic change, with the number of elderly persons in industrialized countries rising, the number of fractures in geriatric patients is also increasing. Typical geriatric fractures are fractures of the proximal femur, the proximal humerus, the distal radius, vertebral bodies, and the pelvis, and increasingly also periprosthetic fractures (1). These fractures, which are associated with osteoporosis and falls, pose great challenges to treating physicians. On the one hand, altered bone structure complicates surgical care, and on the other comorbidities often lead to complications (2). The most significant socio-economic factor in this setting is proximal femoral fractures. These are fractures of the neck of the femur and pertrochanteric and subtrochanteric fractures (ICD-10 S72.0 to S72.2 [3]). In 2009 more than 125 000 patients over the age of 70 years received inpatient treatment for the principal diagnosis proximal femoral fracture in Germany alone (4). Despite great advances in surgical care, treatment outcomes remain disappointing (5). One-year mortality for proximal femoral fractures is approximately 25% (6), and around one-third of patients lose their independence within the same period (7). The direct annual costs of illness are estimated at €2.5 billion in Germany alone (8). Clearly, then, optimum patient care is important. In order to be able to deal better with these patients’ multimorbidity, various models for collaborative orthogeriatric care of patients with proximal femoral fractures have been developed worldwide in recent years (9). To date it has only been shown that patients with proximal femoral fractures benefit from orthogeriatric care during rehabilitation (10). It has not yet been possible to provide unambiguous evidence of an advantage for interdisciplinary orthogeriatric care begun perioperatively, although individual studies have been published, some of the results of which are promising (9). This systematic review and metaanalysis is intended to represent the current state of scientific knowledge on the possible benefit for patients with typical geriatric fractures of orthogeriatric care begun perioperatively.

Early or delayed stabilization in severely injured patients with spinal fractures? Current surgical objectivity according to the Trauma Registry of DGU: treatment of spine injuries in polytrauma patients.

Abstract: BACKGROUNDBecause of a lack of evidence, the appropriate timing of surgical stabilization of thoracic and lumbar spine injuries in severely injured patients is still controversial. Data of a large international trauma register were analyzed to investigate the medical care situation of unstable spina

Clinical outcome and prevalence of osteoarthritis after isolated anterior cruciate ligament reconstruction using hamstring graft: follow-up after two and ten years

Abstract: Purpose The aim of this study was to evaluate patient-reported clinical outcome, instrumental stability and prevalence of radiological osteoarthritis (OA) based on a homogeneous patient sample after two years and on average ten years after isolated anterior cruciate ligament (ACL) reconstruction.

Single-incision anterior approach for total hip arthroplasty on an orthopaedic table : The treatment of osteoarthritis of the hip 1920

Abstract: Dislocation remains the leading early complication of total hip arthroplasty; surgical approach and implant positioning have been recognized as factors influencing total hip arthroplasty stability. We describe a total hip arthroplasty technique done through a single, tissue sparing anterior approach that allows implantation of the femoral and acetabular components without detaching or sectioning any of the muscles and tendons around the hip joint. A series of 437 consecutive, unselected patients who had 494 primary total hip arthroplasty surgeries done through an anterior approach on an orthopaedic table from September 1996 to September 2004 was reviewed. There were 54 hybrid and 442 uncemented hips in the 437 patients (57 bilateral). The average patient age was 64 years. Radiographic analysis showed an average abduction angle of 42°, with 96% in the range of 35° to 50° abduction. The average cup anteversion was 19° with 93% within the target range of 10° to 25°. Postoperative leg length discrepancy averaged 3 ± 2 mm (range, 0-26 mm). Three patients sustained dislocations for an overall dislocation rate of 0.61%, and no patients required revision surgery for recurrent dislocation. There were 17 operative complications, including one deep infection, three wound infections, one transient femoral nerve palsy, three greater trochanter fracture, two femoral shaft fractures four calcar fractures, and three ankle fractures. Operative time averaged 75 minutes (range 40-150 minutes), and the average blood loss was 350 mL (range, 100-1300 mL). The mean hospital stay was 3 days (range, 1-17 days). The anterior approach on the orthopaedic table is a minimally invasive technique applicable to all primary hip patients. This technique allows accurate and reproducible component positioning and leg-length restoration and does not increase the rate of hip dislocation.

Management of Sepsis.

Abstract: pus was available for culture.) The results in Bristol further supported a impression that the phage type of the staphylococcus was related to the severity 01 infection. Thus the troublesome Phage Type 80 Staphylococcus which was n isolated in 1953 by Rountree and Freeman (1955) in Australia3 has enhanced virulen. and so infection with it leads to sloughs and tissue damage with considerable toxaetf1 t 0S A little boy was admitted with a partial-thickness burn of about twenty per cent^

Anterior cruciate ligament injury and radiologic progression of knee osteoarthritis: a systematic review and meta-analysis.

Abstract: Background:Knee osteoarthritis after anterior cruciate ligament (ACL) injury has previously been reported. However, there has been no meta-analysis reporting the development and progression of osteoarthritis.Purpose:We present the first meta-analysis reporting on the development and progression of osteoarthritis after ACL injury at a minimum mean follow-up of 10 years, using a single and widely accepted radiologic classification, the Kellgren & Lawrence classification.Study Design:Meta-analysis.Method:Articles were included for systematic review if they reported radiologic findings of ACL-injured knees and controls using the Kellgren & Lawrence classification at a minimum mean follow-up period of 10 years. Appropriate studies were then included for meta-analysis.Results:Nine studies were included for systematic review, of which 6 studies were further included for meta-analysis. One hundred twenty-one of 596 (20.3%) ACL-injured knees had moderate or severe radiologic changes (Kellgren & Lawrence grade III ...

Increased Risk of Osteoarthritis After Anterior Cruciate Ligament Reconstruction A 14-Year Follow-up Study of a Randomized Controlled Trial

Abstract: Background:The reported prevalence of radiological osteoarthritis (OA) after anterior cruciate ligament (ACL) reconstruction varies from 10% to 90%.Purpose/Hypothesis:To report the prevalence of OA after ACL reconstruction and to compare the OA prevalence between quadrupled semitendinosus tendon (ST) and bone–patellar tendon–bone (BPTB) grafts. The hypothesis was that there would be no difference in OA prevalence between the graft types. The secondary aim was to study whether patient characteristics and additional injuries were associated with long-term outcomes.Study Design:Randomized controlled trial; Level of evidence, 1.Methods:Radiological examination results, Tegner activity levels, and Knee injury and Osteoarthritis Outcome Score (KOOS) values were determined in 135 (82%) of 164 patients at a mean of 14 years after ACL reconstruction randomized to an ST or a BPTB graft. Osteoarthritis was defined according to a consensus by at least 2 of 3 radiologists of Kellgren-Lawrence grade ≥2. Using regressio...

Simulation in medical education

Abstract: Studies in cognitive psychology inform us that the recall of information and its application are best when it is taught and rehearsed in environments similar to workplace. The healthcare profession...