@article{HacklWegmannKahmannetal.2017, author = {Hackl, Michael and Wegmann, Kilian and Kahmann, Stephanie Lucina and Heinze, Nicolai and Staat, Manfred and Neiss, Wolfram F. and Scaal, Martin and M{\"u}ller, Lars P.}, title = {Radial shortening osteotomy reduces radiocapitellar contact pressures while preserving valgus stability of the elbow}, series = {Knee Surgery, Sports Traumatology, Arthroscopy}, volume = {25}, journal = {Knee Surgery, Sports Traumatology, Arthroscopy}, number = {7}, publisher = {Springer}, address = {Berlin}, issn = {1433-7347}, doi = {10.1007/s00167-017-4468-z}, pages = {2280 -- 2288}, year = {2017}, language = {en} } @misc{HacklWegmannKahmannetal.2017, author = {Hackl, Michael and Wegmann, Kilian and Kahmann, Stephanie Lucina and Heinze, Nicolai and Staat, Manfred and Neiss, Wolfram F. and Scaal, Martin and M{\"u}ller, Lars P.}, title = {Reply to the letter to the editor: shortening osteotomy of the proximal radius}, series = {Knee Surgery, Sports Traumatology, Arthroscopy}, volume = {25}, journal = {Knee Surgery, Sports Traumatology, Arthroscopy}, number = {10}, doi = {10.1007/s00167-017-4666-8}, pages = {3328 -- 3329}, year = {2017}, language = {en} } @inproceedings{KahmannUschokWegmannetal.2018, author = {Kahmann, Stephanie Lucina and Uschok, Stephan and Wegmann, Kilian and M{\"u}ller, Lars-P. and Staat, Manfred}, title = {Biomechanical multibody model with refined kinematics of the elbow}, series = {6th European Conference on Computational Mechanics (ECCM 6), 7th European Conference on Computational Fluid Dynamics (ECFD 7), 11-15 June 2018, Glasgow, UK}, booktitle = {6th European Conference on Computational Mechanics (ECCM 6), 7th European Conference on Computational Fluid Dynamics (ECFD 7), 11-15 June 2018, Glasgow, UK}, pages = {11 Seiten}, year = {2018}, abstract = {The overall objective of this study is to develop a new external fixator, which closely maps the native kinematics of the elbow to decrease the joint force resulting in reduced rehabilitation time and pain. An experimental setup was designed to determine the native kinematics of the elbow during flexion of cadaveric arms. As a preliminary study, data from literature was used to modify a published biomechanical model for the calculation of the joint and muscle forces. They were compared to the original model and the effect of the kinematic refinement was evaluated. Furthermore, the obtained muscle forces were determined in order to apply them in the experimental setup. The joint forces in the modified model differed slightly from the forces in the original model. The muscle force curves changed particularly for small flexion angles but their magnitude for larger angles was consistent.}, language = {en} } @article{MeyerGaalenLeschingeretal.2019, author = {Meyer, Carolin and Gaalen, Kerstin van and Leschinger, Tim and Scheyerer, Max J. and Neiss, Wolfram F. and Staat, Manfred and M{\"u}ller, Lars P. and Wegmann, Kilian}, title = {Kyphoplasty of Osteoporotic Fractured Vertebrae: A Finite Element Analysis about Two Types of Cement}, series = {BioMed Research International}, journal = {BioMed Research International}, doi = {10.1155/2019/9232813}, pages = {Article ID 9232813}, year = {2019}, language = {en} } @article{KahmannRauschPluemeretal.2022, author = {Kahmann, Stephanie L. and Rausch, Valentin and Pl{\"u}mer, Jonathan and M{\"u}ller, Lars P. and Pieper, Martin and Wegmann, Kilian}, title = {The automized fracture edge detection and generation of three-dimensional fracture probability heat maps}, series = {Medical Engineering \& Physics}, volume = {2022}, journal = {Medical Engineering \& Physics}, number = {110}, publisher = {Elsevier}, address = {Amsterdam}, issn = {1350-4533}, pages = {7 Seiten}, year = {2022}, abstract = {With proven impact of statistical fracture analysis on fracture classifications, it is desirable to minimize the manual work and to maximize repeatability of this approach. We address this with an algorithm that reduces the manual effort to segmentation, fragment identification and reduction. The fracture edge detection and heat map generation are performed automatically. With the same input, the algorithm always delivers the same output. The tool transforms one intact template consecutively onto each fractured specimen by linear least square optimization, detects the fragment edges in the template and then superimposes them to generate a fracture probability heat map. We hypothesized that the algorithm runs faster than the manual evaluation and with low (< 5 mm) deviation. We tested the hypothesis in 10 fractured proximal humeri and found that it performs with good accuracy (2.5 mm ± 2.4 mm averaged Euclidean distance) and speed (23 times faster). When applied to a distal humerus, a tibia plateau, and a scaphoid fracture, the run times were low (1-2 min), and the detected edges correct by visual judgement. In the geometrically complex acetabulum, at a run time of 78 min some outliers were considered acceptable. An automatically generated fracture probability heat map based on 50 proximal humerus fractures matches the areas of high risk of fracture reported in medical literature. Such automation of the fracture analysis method is advantageous and could be extended to reduce the manual effort even further.}, language = {en} } @article{RauschHarbrechtKahmannetal.2020, author = {Rausch, Valentin and Harbrecht, Andreas and Kahmann, Stephanie Lucina and Fenten, Thomas and Jovanovic, Nebojsa and Hackl, Michael and M{\"u}ller, Lars P. and Staat, Manfred and Wegmann, Kilian}, title = {Osteosynthesis of Phalangeal Fractures: Biomechanical Comparison of Kirschner Wires, Plates, and Compression Screws}, series = {The Journal of Hand Surgery}, volume = {45}, journal = {The Journal of Hand Surgery}, number = {10}, publisher = {Elsevier}, address = {Amsterdam}, issn = {0363-5023}, doi = {10.1016/j.jhsa.2020.04.010}, pages = {987.e1 -- 987.e8}, year = {2020}, abstract = {Purpose The aim of this study was to compare several osteosynthesis techniques (intramedullary headless compression screws, T-plates, and Kirschner wires) for distal epiphyseal fractures of proximal phalanges in a human cadaveric model. Methods A total of 90 proximal phalanges from 30 specimens (index, ring, and middle fingers) were used for this study. After stripping off all soft tissue, a transverse distal epiphyseal fracture was simulated at the proximal phalanx. The 30 specimens were randomly assigned to 1 fixation technique (30 per technique), either a 3.0-mm intramedullary headless compression screw, locking plate fixation with a 2.0-mm T-plate, or 2 oblique 1.0-mm Kirschner wires. Displacement analysis (bending, distraction, and torsion) was performed using optical tracking of an applied random speckle pattern after osteosynthesis. Biomechanical testing was performed with increasing cyclic loading and with cyclic load to failure using a biaxial torsion-tension testing machine. Results Cannulated intramedullary compression screws showed significantly less displacement at the fracture site in torsional testing. Furthermore, screws were significantly more stable in bending testing. Kirschner wires were significantly less stable than plating or screw fixation in any cyclic load to failure test setup. Conclusions Intramedullary compression screws are a highly stable alternative in the treatment of transverse distal epiphyseal phalangeal fractures. Kirschner wires seem to be inferior regarding displacement properties and primary stability. Clinical relevance Fracture fixation of phalangeal fractures using plate osteosynthesis may have the advantage of a very rigid reduction, but disadvantages such as stiffness owing to the more invasive surgical approach and soft tissue irritation should be taken into account. Headless compression screws represent a minimally invasive choice for fixation with good biomechanical properties.}, language = {en} } @article{HacklBuessKammerlohretal.2021, author = {Hackl, Michael and Buess, Eduard and Kammerlohr, Sandra and Nacov, Julia and Staat, Manfred and Leschinger, Tim and M{\"u}ller, Lars P. and Wegmann, Kilian}, title = {A "comma sign"-directed subscapularis repair in anterosuperior rotator cuff tears yields biomechanical advantages in a cadaveric model}, series = {The american journal of sports medicine}, volume = {49}, journal = {The american journal of sports medicine}, number = {12}, publisher = {Sage}, address = {London}, issn = {1552-3365}, doi = {10.1177/03635465211031506}, pages = {3212 -- 3217}, year = {2021}, abstract = {Background: Additional stabilization of the "comma sign" in anterosuperior rotator cuff repair has been proposed to provide biomechanical benefits regarding stability of the repair. Purpose: This in vitro investigation aimed to investigate the influence of a comma sign-directed reconstruction technique for anterosuperior rotator cuff tears on the primary stability of the subscapularis tendon repair. Study Design: Controlled laboratory study. Methods: A total of 18 fresh-frozen cadaveric shoulders were used in this study. Anterosuperior rotator cuff tears (complete full-thickness tear of the supraspinatus and subscapularis tendons) were created, and supraspinatus repair was performed with a standard suture bridge technique. The subscapularis was repaired with either a (1) single-row or (2) comma sign technique. A high-resolution 3D camera system was used to analyze 3-mm and 5-mm gap formation at the subscapularis tendon-bone interface upon incremental cyclic loading. Moreover, the ultimate failure load of the repair was recorded. A Mann-Whitney test was used to assess significant differences between the 2 groups. Results: The comma sign repair withstood significantly more loading cycles than the single-row repair until 3-mm and 5-mm gap formation occurred (P≤ .047). The ultimate failure load did not reveal any significant differences when the 2 techniques were compared (P = .596). Conclusion: The results of this study show that additional stabilization of the comma sign enhanced the primary stability of subscapularis tendon repair in anterosuperior rotator cuff tears. Although this stabilization did not seem to influence the ultimate failure load, it effectively decreased the micromotion at the tendon-bone interface during cyclic loading. Clinical Relevance: The proposed technique for stabilization of the comma sign has shown superior biomechanical properties in comparison with a single-row repair and might thus improve tendon healing. Further clinical research will be necessary to determine its influence on the functional outcome.}, language = {en} } @article{RauschKahmannBaltschunetal.2020, author = {Rausch, Valentin and Kahmann, Stephanie Lucina and Baltschun, Christoph and Staat, Manfred and M{\"u}ller, Lars P. and Wegmann, Kilian}, title = {Pressure distribution to the distal biceps tendon at the radial tuberosity: a biomechanical study}, series = {The Journal of Hand Surgery}, volume = {45}, journal = {The Journal of Hand Surgery}, number = {8}, publisher = {Elsevier}, address = {Amsterdam}, issn = {0363-5023}, doi = {10.1016/j.jhsa.2020.01.006}, pages = {776.e1 -- 776.e9}, year = {2020}, abstract = {Purpose Mechanical impingement at the narrow radioulnar space of the tuberosity is believed to be an etiological factor in the injury of the distal biceps tendon. The aim of the study was to compare the pressure distribution at the proximal radioulnar space between 2 fixation techniques and the intact state. Methods Six right arms and 6 left arms from 5 female and 6 male frozen specimens were used for this study. A pressure transducer was introduced at the height of the radial tuberosity with the intact distal biceps tendon and after 2 fixation methods: the suture-anchor and the cortical button technique. The force (N), maximum pressure (kPa) applied to the radial tuberosity, and the contact area (mm²) of the radial tuberosity with the ulna were measured and differences from the intact tendon were detected from 60° supination to 60° pronation in 15° increments with the elbow in full extension and in 45° and 90° flexion of the elbow. Results With the distal biceps tendon intact, the pressures during pronation were similar regardless of extension and flexion and were the highest at 60° pronation with 90° elbow flexion (23.3 ± 53.5 kPa). After repair of the tendon, the mean peak pressure, contact area, and total force showed an increase regardless of the fixation technique. Highest peak pressures were found using the cortical button technique at 45° flexion of the elbow and 60° pronation. These differences were significantly different from the intact tendon. The contact area was significantly larger in full extension and 15°, 30°, and 60° pronation using the cortical button technique. Conclusions Pressures on the distal biceps tendon at the radial tuberosity increase during pronation, especially after repair of the tendon. Clinical relevance Mechanical impingement could play a role in both the etiology of primary distal biceps tendon ruptures and the complications occurring after fixation of the tendon using certain techniques.}, language = {en} } @article{HacklNacovKammerlohretal.2021, author = {Hackl, Michael and Nacov, Julia and Kammerlohr, Sandra and Staat, Manfred and Buess, Eduard and Leschinger, Tim and M{\"u}ller, Lars P. and Wegmann, Kilian}, title = {Intratendinous Strain Variations of the Supraspinatus Tendon Depending on Repair Technique: A Biomechanical Analysis Regarding the Cause of Medial Cuff Failure}, series = {The American Journal of Sports Medicine}, volume = {49}, journal = {The American Journal of Sports Medicine}, number = {7}, publisher = {Sage}, address = {London}, issn = {1552-3365}, doi = {10.1177/03635465211006138}, pages = {1847 -- 1853}, year = {2021}, language = {en} }