Publications by authors named "Franz Xaver Köck"

3 Publications

  • Page 1 of 1

Arthrodesis of the talonavicular joint using angle-stable mini-plates: a prospective study.

Int Orthop 2012 Dec 6;36(12):2491-4. Epub 2012 Oct 6.

Department of Orthopaedic Surgery, University of Regensburg, Bad Abbach, Germany.

Purpose: The talonavicular joint is a central connection of the human foot. Symptomatic talonavicular arthritis can be adequately addressed by isolated talonavicular fusion. However, non-union remains a relevant clinical challenge to the orthopaedic surgeon. The aim of this study was to analyse the clinicoradiological outcome of talonavicular fusion using angle-stable mini-plates.

Methods: We performed 30 talonavicular fusions in 30 patients (12 male, 18 female) with a mean age of 58.8 years (range, 22-74) between 2005 and 2007. Osseous joint fusion was achieved using mono- and multidirectional angle-stable mini-plates. The patients followed a standardised immobilisation and weight bearing protocol. The mean postoperative follow up was 15.8 months (6.1-23.8).

Results: The American Orthopedic Foot and Ankle Society AOFAS score increased significantly from 31.7 (19-42) to 82.3 points (55-97) (p < 0.001). Neither age at operation nor gender influenced the score results significantly, while the aetiology of talonavicular degeneration showed a significant effect. Mean visual analogue scale (VAS) pain intensity (0-10) reduced from 8.6 to 1.7 (p < 0.001). Good or excellent results were achieved in 26 patients, while two patients reported fair and another two poor results. Complete osseous fusion was observed at a mean of 10.9 weeks (8-13) postoperatively.

Conclusions: For the treatment of talonavicular arthritis, the application of mono- and multidirectional angle-stable mini-plates provided a strong fixation that led to high union rates and good to excellent overall outcome.
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December 2012

Clinical outcome after Chevron-Akin double osteotomy versus isolated Chevron procedure: a prospective matched group analysis.

Arch Orthop Trauma Surg 2012 Jan 28;132(1):9-13. Epub 2011 Aug 28.

Klinik und Poliklinik für Orthopädie und Orthopädische Chirurgie, für die Universität Regensburg, Asklepios Klinikum Bad Abbach, Kaiser Karl V Allee 3, 93077 Bad Abbach, Germany.

Background: Hallux valgus is a frequent condition of the forefoot, resulting in cosmetic deformity and pain. Chevron osteotomy (CO) is widely employed for the treatment of hallux valgus. Chevron-Akin double osteotomy (CAO) was previously described and superiority over an isolated Chevron procedure was assumed. The objective of this study was to compare the short-to-middle term outcomes of CO and CAO.

Patients And Methods: This study included 72 patients with established diagnosis of mild-to-moderate hallux valgus, treated by either isolated CO or CAO. The CO group included 46 patients (mean 51.5 years) with a mean hallux valgus angle of 27°, while the CAO group included 26 subjects (mean 53.1 years) and a mean hallux valgus angle of 32° preoperatively. All patients were reviewed by physical examination, and standardized questionnaire, and pre- and postoperative standing X-rays were performed. Matched group analysis was carried out to analyze statistical differences of both techniques.

Results: The patients were assessed and group matched at a mean of 1.37 years for the CO group and 1.04 years for the CAO group, postoperatively. Mean improvement of HVA (hallux valgus angle) was 10.6° in the CO group and the CAO group improved by 17.5°. DMAA (distal metatarsal articular angle) improved in the CO group by 5.4° and in the CAO by 13.7°. Mean AOFAS score improved by 27.9 (CO) and 21.5 (CAO). Patient satisfaction was high in both groups, with a tendency towards higher values within the CAO group.

Conclusions: These findings indicate that Chevron-Akin double osteotomy is a save and practicable procedure for the treatment of mild-to-moderate hallux valgus. Superiority of combined Chevron-Akin procedure over an isolated Chevron osteotomy might be limited to distinct clinical settings, but should not be generally assumed.
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January 2012

Dose-dependent efficacy of diclofenac-cholestyramine on pain and periarticular ossifications after total hip arthroplasty: a double-blind, prospective, randomised trial.

Arch Orthop Trauma Surg 2004 Sep 15;124(7):483-5. Epub 2004 Jun 15.

Department of Orthopedics, University Hospital, Regensburg, Germany.

Introduction: To investigate the efficacy of treatment with diclofenac-cholestyramine on postoperative pain and functional outcome after total hip arthroplasty, a randomised double-blind study was conducted.

Materials And Methods: A total of 245 patients received postoperative treatment with 75 mg or 150 mg diclofenac p.o. daily for 14 days.

Results: Patients who received 75 mg diclofenac per day needed paracetamol as an additional analgesic significantly more often (p=0.0162) than patients who were treated with 150 mg diclofenac daily (75 mg twice a day). The incidence of adverse gastrointestinal events was significantly lower in the group receiving 75 mg diclofenac daily than in the group receiving the higher dose (23.1% vs 37.1%; p=0.025). Six months after the operation, no differences were observed between the two groups with regard to pain or functionality measured in terms of overall mobility of the hip. No patient of either group developed clinically relevant heterotopic ossifications.

Conclusion: Treatment with a dose of 75 mg diclofenac once daily-if necessary with the additional use of paracetamol-is a favourable option for the postoperative care of THA.
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September 2004