| 1201. |
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| 1202. |
- Svensson, Karin, et al.
(författare)
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Exchange of Modular Components Improves Success of Debridement, Antibiotics, and Implant Retention: An Observational Study of 575 Patients with Infection After Primary Total Hip Arthroplasty
- 2020
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Ingår i: JB & JS open access. - : The Journal of Bone and Joint Surgery Inc.. - 2472-7245. ; 5:4
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Tidskriftsartikel (refereegranskat)abstract
- Background: Debridement, antibiotics, and implant retention (DAIR) is a surgical treatment for periprosthetic joint infection (PJI). DAIR is a desirable treatment option from an economic and patient perspective, if successful. The aim of this observational study was to compare the rates of success, defined as no additional reoperations due to PJI, between DAIR with exchange of modular components and DAIR without exchange in patients who had first-time PJI after primary total hip arthroplasty (THA).Methods: Patients with PJI at the site of a primary THA who were treated with DAIR in Sweden between January 1, 2009, and December 31, 2016, were identified in the Swedish Hip Arthroplasty Register. Supplementary questionnaires were sent to orthopaedic departments for additional variables of interest related to PJI. The primary end point was another reoperation due to PJI within 2 years after the first-time DAIR. DAIR with exchange was compared with DAIR without exchange using Kaplan-Meier survival analysis and Cox regression analysis.Results: A total of 575 patients treated with DAIR for a first-time PJI at the site of a primary THA were analyzed; 364 underwent component exchange and 211 did not. The exchange of components was associated with a lower rate of reoperations due to PJI after DAIR (28.0%) compared with non-exchange (44.1%). The Kaplan-Meier implant survival estimate for exchange was 71.4% (95% confidence interval [CI] = 66.9% to 76.3%) compared with 55.5% (95% CI = 49.1% to 62.7%) for non-exchange. With the analysis adjusted for confounders, DAIR with exchange was associated with a significantly decreased risk of another reoperation due to PJI compared with non-exchange (hazard ratio [HR] = 0.51 [95% CI = 0.38 to 0.68]).Conclusions: In patients with a first-time PJI at the site of a primary THA, DAIR with exchange of modular components was superior to non-exchange DAIR. Surgeons should strive to exchange components when they perform DAIR, but there is a need to further identify how DAIR best should be practiced and which patients benefit from it.Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
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| 1203. |
- Svensson, Kerstin, et al.
(författare)
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Landscape epidemiology of tularemia outbreaks in Sweden
- 2009
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Ingår i: Emerging Infectious Diseases. - : Centers for Disease Control and Prevention (CDC). - 1080-6040 .- 1080-6059. ; 15:12, s. 1937-1947
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Tidskriftsartikel (refereegranskat)abstract
- Summer outbreaks of tularemia that occurred from 1995 through 2005 in 2 locations in Sweden affected 441 persons. We performed an epidemiologic investigation of these outbreaks using a novel strategy, involving high-resolution genotyping of Francisella tularensis isolates obtained from 136 patients (using 18 genetic markers developed from 6 F. tularensis genome sequences) and interviews with the patients. Strong spatial associations were found between F. tularensis subpopulations and the places of disease transmission; infection by some subpopulations occurred within areas as small as 2 km(2), indicating unidentified environmental point sources of tularemia. In both locations, disease clusters were associated with recreational areas beside water, and genetic subpopulations were present throughout the tularemia season and persisted over years. High-resolution genotyping in combination with patients' statements about geographic places of disease transmission provided valuable indications of likely sources of infection and the causal genotypes during these tularemia outbreaks.
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| 1204. |
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| 1205. |
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| 1206. |
- Svensson, Lars-Erik, 1951-, et al.
(författare)
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Strength and Impact Toughness of High Strength Steel Weld Metals : Influence of Welding Method, Dilution and Cooling Rate
- 2015
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Ingår i: Proceedings of IIW International Conference, High-Strength Materials. - Helsingfors. ; , s. 1-9
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Konferensbidrag (refereegranskat)abstract
- Producing welds with properties matching those of the steel is a challenge at high strength levels. The present study has investigated how the choice of welding method affects weld metal mechanical properties through effects on dilution and cooling rate. Butt welds were produced in 12 mm plates in 777 MPa and 1193 MPa yield strength steels. Conventional arc welding methods including manual metal arc, gas metal arc welding, rapid arc welding and submerged arc welding were used as well as laser-gas metal arc hybrid welding. Filler materials with nominal yield strengths between 810 and 1000 MPa were used. Cooling times between 800 C and 500 C were varied between 5s and 15s and measured by insertion of thermocouples into the weld pool.High quality welds were produced efficiently with all welding methods even though dilution varied between 3%, for manual metal arc welding, to 73% for laser-hybrid welding. Low dilution, rapid cooling and single pass welding contributed to higher strength. Overmatching weld metal strength was achieved for the less strong steel and weld yield strengths of >1000 MPa were recorded for the stronger steel. Fracture in transverse tensile testing was always located in base material or HAZ. Impact toughness was higher for lower strength and low dilution. Results are discussed relating choice of welding method and cooling rate to weld metal properties for different steel strength levels.
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| 1207. |
- Svensson, Lars-Erik, 1951-, et al.
(författare)
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Welding enabling light weight design of heavy vehicle chassis
- 2015
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Ingår i: Science and technology of welding and joining. - 1362-1718 .- 1743-2936. ; 20:6, s. 473-482
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Tidskriftsartikel (refereegranskat)abstract
- Development of lightweight cars for saving fuel and reducing emission has been a priority for more than a decade. A similar trend is now seen for heavy vehicles. Here, however, the chassis rather than the cab is in focus, since this is by far the heaviest part of the vehicle. Using welding fabrication has many advantages like larger freedom in choice of material and more compact design. However, there are also factors like fatigue strength, residual stresses and geometric distortion, which must be addressed. There are large potentials to save weight in heavy vehicles by utilising high strength steels or aluminium alloys. In general, existing joining methods can be used, but new filler materials or recently developed post-weld treatments may be necessary to fulfil the demands on the components. In this paper, two examples are given, showing possible weight reduction solutions. In both cases, welding plays a central role.
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| 1208. |
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| 1209. |
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| 1210. |
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