| 1. |
- Aspenberg, Per, et al.
(författare)
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Platelet concentrate injection improves Achilles tendon repair in rats
- 2004
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Ingår i: Acta Orthopaedica Scandinavica. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682 .- 0001-6470. ; 75:1, s. 93-99
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Tidskriftsartikel (refereegranskat)abstract
- Background:Blood platelets release a cocktail of growth factors when activated, some of which are thought to initiate and stimulate repair.Experiment and findings: We studied whether a platelet concentrate injection would improve Achilles tendon repair in an established rat model. The Achilles tendon was transected and a 3 mm segment removed. After 6h, a platelet concentrate was injected percutaneously into the hematoma. This increased tendon callus strength and stiffness by about 30 % after 1 week, which persisted for as long as 3 weeks after the injection. At this time, the mechanical testing indicated an improvement in material characteristics - i.e., greater maturation of the tendon callus. This was confirmed by blinded histological scoring.Interpretation: Platelet concentrate may prove useful for the treatment of Achilles tendon ruptures.
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| 2. |
- Buciuto, Robert, et al.
(författare)
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RAB-plate vs Richards CHS plate for unstable trochanteric hip fractures : A randomized study of 233 patients with 1-year follow-up
- 1998
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682 .- 0001-6470. ; 69:1, s. 25-28
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Tidskriftsartikel (refereegranskat)abstract
- We prospectively randomized 233 patients with unstable trochanteric hip fractures for treatment with a 120° fixed angle blade-plate having a buttress rod (group A, n 111) or a 135° compression hip screw (group B, n 122). the minimum follow-up time was 1 year. the ratio of technical failure was 9% in group A and 19% in group B (p = 0.06). 79 (87%) fractures in group A and 65 (68%) fractures in group B healed without any complication (p = 0.003). Malunion occurred in 2 cases in group A and in 15 cases in group B (p = 0.002).
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| 3. |
- Reigo, Thomas, et al.
(författare)
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Pain drawing evaluation–the problem with the clinically biased surgeon : Intra- and interobserver agreement in 50 cases related to clinical bias
- 1998
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682 .- 0001-6470. ; 69:4, s. 408-411
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Tidskriftsartikel (refereegranskat)abstract
- To assess whether the clinical knowledge of the treating surgeon had any effect on the reliability of the pain-drawing evaluation, drawings from 50 low-back pain patients were evaluated by the treating surgeon and by three colleagues who had no clinical knowledge of the patient. The evaluation was repeated after 10 days. The treating surgeons were also blinded to clinical data. The kappa value in the evaluation when the surgeon had clinical knowledge of the patient was lower (0.29 (95% CI 0.13–0.45)) than the kappa value in the evaluations made without clinical knowledge (0.60 (CI 0.45–0.75)). The differences observed in interobserver reliability between open and blind evaluations suggest that clinical knowledge of a patient influences the evaluation of the pain drawings.
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| 4. |
- Rockborn, Peter, et al.
(författare)
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Outcome of arthroscopic meniscectomy : A 13-year physical and radiographic follow-up of 43 patients under 23 years of age
- 1995
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682 .- 0001-6470. ; 66:2, s. 113-117
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Tidskriftsartikel (refereegranskat)abstract
- We reexamined 43 patients with stable knees at a mean of 13 years after arthroscopic meniscectomy. The patients had a maximum age of 22 years at the operation and no patient had had previous surgery on the involved knee. At the follow-up examination, no differences in range of motion, muscle strength or tibial A/P displacement were seen between the operated and the nonoperated knees and 36 patients had no problem with their knee in daily life. Radiographic changes were found in the operated knee in 20 patients and in the nonoperated knee in 5 patients. 8 patients had a reduction of the joint space on the involved side, but none had more severe changes. Cartilage fibrillation at the index arthroscopy did not increase the radiographic changes at follow-up, but radiographic changes were commoner after subtotal meniscectomy (7/8) than after partial meniscectomy (17/35). These findings are similar to previous studies of arthroscopic meniscectomy of medium duration and do not differ considerably from studies of open meniscectomy.
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| 5. |
- Öhlund, Carl, et al.
(författare)
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Calf compression for prevention of thromboembolism following hip surgery
- 1983
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Ingår i: Acta Orthopaedica. - : Informa Healthcare. - 1745-3674 .- 1745-3682 .- 0001-6470. ; 54:6, s. 896-899
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Tidskriftsartikel (refereegranskat)abstract
- A prospective, randomized trial of the effect of graded compression of the calf was done in 62 patients operated on electively for hip disease. After total hip arthroplasty, compression reduced the number of positive fibrinogen uptake tests by two-thirds, significant only in males, who seem to run a higher risk of thrombosis than females.
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| 6. |
- Schilcher, Jörg, 1978-
(författare)
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Epidemiology, Radiology and Histology of Atypical Femoral Fractures : Development of understanding
- 2013
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Ingår i: Acta Orthopaedica. - Linköping : Linköping University Electronic Press. - 1745-3674 .- 1745-3682. ; 84:S352, s. 1-26
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Bisphosphonates have been used successfully in the prevention of osteoporosis-related fractures for over two decades. Only recently an association between bisphosphonate use and femoral insufficiency fractures – atypical femoral fractures – has been found.Bone remodeling is necessary to maintain a healthy skeleton. With age this process can get out of balance and bone resorption can outweigh formation of new bone. This can lead to osteoporosis and fractures that occur after minor trauma. Almost half of all women 50 years of age or older will suffer an osteoporosis related fracture during their remaining life. Bisphosphonates inhibit bone resorption, and after some years of treatment an increase in bone mass can be noted. This increase in bone mass can reduce fracture risk by as much as half. However, bisphosphonate use seems associated with the development of femoral insufficiency fractures, so called atypical femoral fractures. This thesis aimed to estimate the risk of atypical femoral fractures in the population and its association with bisphosphonate use. It also describes the radiographic and histologic features of these fractures in order to improve our understanding of the pathophysiological background.Study 1) All women 55 years of age and older, who had sustained a femoral shaft fracture during 2008, were identified through the Swedish National Patient Register. Radiographs of 1234 women were reviewed, and 59 patients with atypical fractures and 263 control patients with common femoral shaft fractures were identified. Atypical femoral fractures were defined by their stress fracture-like appearance. In a cohort analysis, we estimated an age-adjusted relative risk of 47 for bisphosphonate users to suffer an atypical femoral fracture compared to non-users. A total of 78% of the patients with an atypical fracture and 10% of the controls had received bisphosphonates, corresponding to a multivariable-adjusted odds ratio of 33. The risk was independent of coexisting conditions and of concurrent use of other drugs with known effects on bone. These results indicate that bisphosphonate use is strongly associated with atypical femoral fractures. The absolute risk is low and benefits of treatment will outweigh the risks.Study 2) A transverse fracture line and a small but visible callus reaction are well established radiographic features of stress fractures. Radiographs from 59 atypical fracture patients and 218 control patients from Study 1 were re-reviewed to measure fracture angles and to detect callus reactions. The majority of the patients with a transverse fracture angle used bisphosphonates. Fracture angle and callus reaction had a high specificity to detect bisphosphonate treatment. When an oblique fracture line was chosen to define atypical femoral fractures in the cohort from Study 1, the association of atypical femoral fractures to bisphosphonate use became attenuated. Therefore, a correct case definition of atypical femoral fractures is necessary for adequate risk calculations.Study 3) Bone biopsies from 8 patients with atypical femoral fractures were obtained during surgical fixation. The histological analysis of the fracture site itself showed a thin fracture line running perpendicular to the long axis of the femur. Despite ongoing remodeling in the bone adjacent to the fracture gap, no healing occurred within the gap itself. Necrotic material in the gap suggests that strains within the gap might prohibit ingrowth of cells necessary for healing. This mechanism of inhibited healing might share similarities with that of stress fractures in athletes. Although it is highly likely that bisphosphonates play a causative role, the pathogenesis of these fractures is still unclear. It may involve a reduced capacity for targeted remodeling.
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| 7. |
- Abrahamsson, Sven Olof, et al.
(författare)
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Dehydration inhibits matrix synthesis and cell proliferation : An in vitro study of rabbit flexor tendons
- 1991
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 0001-6470. ; 62:2, s. 159-162
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Tidskriftsartikel (refereegranskat)abstract
- Segments of the deep flexor tendon of the rabbit were exposed to air; the effects of dehydration on in vitro synthesis of proteoglycan, collagen, non-collagenous protein, and cell proliferation were compared with tendon segments that were kept moist with physiologic saline. After 20 min of expo-sure to air, the tendons lost half and after 40 min all of their ability to synthesize matrix components and to proliferate, whereas irrigated tendons remained viable during the entire experiment.
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| 8. |
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| 9. |
- Aspenberg, Per, et al.
(författare)
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Fibroblast growth factor stimulates bone formation bone induction studied in rats
- 1989
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 0001-6470. ; 60:4, s. 473-476
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Tidskriftsartikel (refereegranskat)abstract
- Implantation of demineralized bone matrix in rodents elicits a series of cellular events leading to the formation of new bone inside and adjacent to the implant. This process is believed to be initiated by an inductive protein present in bone matrix. It has been suggested that local growth factors may further regulate the process once it has been initiated. This investigation was designed to study the effect of adding a growth factor to the inductive implant. Pairs of demineralized rat femoral diaphyses were implanted intramuscularly in rats. the marrow canal of one implant in each pair was filled with a carboxymethyl cellulose gel containing 75 ng of recombinant human basic fibroblast growth factor (FGF). the other implant in each pair served as a control. It was either filled with the gel without FGF or left untreated. Bone formation was induced by all the implants after 3 weeks. the amount of mineralized tissue in the FGF-treated implants was 25 percent greater than in untreated controls. the carboxymethyl cellulose gel alone did not affect the bone yield.
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| 10. |
- Aspenberg, Per, et al.
(författare)
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Rabbit bone matrix induces bone formation in the athymic rat
- 1988
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 0001-6470. ; 59:3, s. 276-278
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Tidskriftsartikel (refereegranskat)abstract
- Rabbit and rat bone matrix were implanted in athymic rat muscle, and the bone yield was measured as total calcium content after 4, 6, and 8 weeks. Matrix from both species induced equal amounts of new bone in the athymic rat. In rabbit and normal rat, the xenogenic matrix induced little or no bone formation. Thus, in the case of rabbit and rat, bone induction is species specific due to immunogenic mechanisms. the athymic rat can be used to measure inductive properties of bone matrix from different species.
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