| 1. |
|
|
| 2. |
- Hasegawa, Yukiharu, et al.
(författare)
-
Risk of mortality following hip fracture in Japan
- 2007
-
Ingår i: Journal of Orthopaedic Science. - : Elsevier BV. - 1436-2023 .- 0949-2658. ; 12:2, s. 113-117
-
Tidskriftsartikel (refereegranskat)abstract
- Background. Excessive mortality and morbidity are serious problems after hip fracture in the elderly. Methods. Hip fractures in persons aged 50 years or older were prospectively registered in Japan in 2000. Questionnaires regarding both the first onset and the second 120-day period after hip fracture were obtained from 759 patients, 546 of whom were female and 213 male. Results. Their average age at the time of fracture was 80 years. Altogether, 68 people (9%) died within 120 days after fracture; and 25 patients died within 30 days. Those dying within 120 days and those alive after hip fracture were compared. By univariate analysis, risk factors were poor walking ability, need for a walking aid, low body mass index, history of falls, and lack of active exercise; however, none of these factors was identified as a risk factor by multivariate analysis. By multivariate analysis, the five risk factors associated with mortality were male sex, older age, high American Academy of Anesthesiology (ASA) grade, dementia, and residence in an institution. Conclusions. During the treatment and rehabilitation period special attention should be paid to patients with chronic diseases and reduced mental status.
|
|
| 3. |
- Jørgsholm, Peter, et al.
(författare)
-
Outcome of carpal tunnel release in patients with normal nerve conduction studies
- 2021
-
Ingår i: Journal of Orthopaedic Science. - : Elsevier BV. - 0949-2658. ; 26:5, s. 798-803
-
Tidskriftsartikel (refereegranskat)abstract
- Background: We evaluated outcome after carpal tunnel release (CTR) in patients with clinically diagnosed carpal tunnel syndrome (CTS) but normal results in nerve conduction studies (NCS), and compared these results with those from a prospective group of patients with NCS-verified CTS. Methods: Over a 5-year period, we prospectively included 103 patients with clinical CTS. NCS were done at inclusion, with surgeon and patient being kept blind regarding the result. The patients underwent endoscopic CTR. QuickDASH and satisfaction score were recorded preoperatively and 4 months after surgery. 94 patients, 47 of whom had NCS-verified CTS, completed the study. Results: A significant improvement in QuickDASH score (18 and 20 points respectively, p < 0.01) was found for both groups. Satisfaction score was significantly higher in the group with NCS-verified CTS. However, the overall satisfaction rates were 87% in the normal NCS group and 95% in the group with abnormal NCS. Conclusions: Clinical outcome after CTR in patients with normal NCS was favourable and similar to that obtained in patients with NCS-verified CTS. Nonetheless, patients with normal result in NCS gave a lower satisfaction score.
|
|
| 4. |
- Lauge-Pedersen, Henrik, et al.
(författare)
-
Synovial fluid depletion : Successful arthrodesis without operative cartilage removal
- 2003
-
Ingår i: Journal of Orthopaedic Science. - : Elsevier BV. - 0949-2658 .- 1436-2023. ; 8:4, s. 591-595
-
Tidskriftsartikel (refereegranskat)abstract
- Operative arthrodesis has been thought to require surgical removal of remaining joint cartilage, but we have found in rabbits that even a joint with intact cartilage can fuse if rigidly fixed. This may enable new percutaneous techniques for arthrodesis. Rigid adaptation of the joint surfaces deprives the cartilage of mechanical stimulation and depletes the cells of synovial fluid transport of oxygen and nutrition. To better understand the requirements for successful arthrodesis, we studied the histological consequences of the complete absence of mechanical stimulation alone or in combination with synovial depletion by placing a metal cap over part of the joint cartilage in rabbits. The cap was either closed or had an opening to permit synovial fluid to reach the cartilage. We also studied if penetration of the bone-cartilage junction by a drill hole would facilitate cartilage resorption. Synovial fluid depletion in combination with a drill hole through the bone-cartilage junction led to disappearance of all cartilage matrix after 7 weeks. Synovial fluid depletion with an intact bone-cartilage junction led to complete disappearance of the cartilage matrix in four of seven rabbits after 7 weeks. With a hole in the cap for synovial fluid, the cartilage matrix was still present to varying degrees after 7 weeks in all the rabbits. In conclusion, percutaneous arthrodesis by rigid adaptation may lead to cartilage disappearance due to synovial depletion rather than due to the absence of mechanical stimulation. A combination with perforation of the bone-cartilage junction appears to lead to reasonably quick removal of the cartilage matrix.
|
|
| 5. |
- Nakamae, T., et al.
(författare)
-
Relationship between clinical symptoms of osteoporotic vertebral fracture with intravertebral cleft and radiographic findings
- 2017
-
Ingår i: Journal of Orthopaedic Science. - : Elsevier BV. - 0949-2658. ; 22:2, s. 201-206
-
Tidskriftsartikel (refereegranskat)abstract
- Background: With aging of the population, the numbers of osteoporotic vertebral fractures with intravertebral cleft have been increasing. However, the details of clinical symptoms of osteoporotic vertebral fractures with intravertebral cleft are poorly understood. The purpose of this study was to evaluate the relationship between clinical symptoms of osteoporotic vertebral fractures with intravertebral cleft and radiographic findings. Methods: Two hundred seventeen patients with single-level osteoporotic vertebral fractures with intravertebral cleft were examined. Clinical symptoms were evaluated using Numerical Rating Scale for back pain and the Oswestry Disability Index for physical disability. The presence of delayed neurologic deficit was also detected. Radiography and computed tomography were used to measure local kyphotic angle and vertebral instability and to detect the presence of posterior wall fracture of the vertebral body. Correlations between clinical symptoms of osteoporotic vertebral fractures with intravertebral cleft and radiographic findings were investigated. Results: Mean Numerical Rating Scale and Oswestry Disability Index were 7.4 and 58.0%, respectively. Delayed neurologic deficit occurred in 41 patients (19%). The mean local kyphotic angle, vertebral instability, and rate of posterior wall fracture of the vertebral body were 19.4 degrees, 7.3 degrees, and 91%, respectively. Numerical Rating Scale and Oswestry Disability Index were statistically correlated with vertebral instability but not with local kyphotic angle and presence of posterior wall fracture. In the patients with delayed neurologic deficit, vertebral instability was significantly higher and posterior wall fractures were significantly more frequent than in the patients without delayed neurologic deficit. Local kyphotic angle was not correlated with delayed neurologic deficit. Conclusions: Vertebral instability is a factor causing symptoms of osteoporotic vertebral fractures with intravertebral cleft. In addition, vertebral instability may be the predominant cause of delayed neurologic deficit. To manage osteoporotic vertebral fractures with intravertebral cleft and delayed neurologic deficit efficiently, it may be important to control vertebral instability of osteoporotic vertebral fractures. (C) 2016 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.
|
|
| 6. |
- Rosberg, Hans Eric, et al.
(författare)
-
Age does not affect the outcome after digital nerve repair in children – A retrospective long term follow up
- 2017
-
Ingår i: Journal of Orthopaedic Science. - : Elsevier BV. - 0949-2658. ; 22:5, s. 915-918
-
Tidskriftsartikel (refereegranskat)abstract
- Background Digital nerve injuries in children are not common, but they are considered to have an excellent prognosis, compared to adults, after nerve injury and repair. In studies including both children and adults age have been found to have an effect on outcome after nerve repair. Methods We investigated in a retrospective follow up study the long-time result after digital nerve injury and repair in children, 1–16 years of age (n = 38), and evaluate if age influences outcome. A group with young children, 1–10 years of age (n = 18), was compared with a group with older children, 11–16 years of age (n = 20). A clinical evaluation to evaluate sensation and grip strength was performed and questionnaires were used [Disability of the Arm, Shoulder and Hand (DASH), Cold Sensitivity Severity Scale (CISS), VAS-function and VAS-cosmetic] in median 40 months (range 12–131 months) after the injury and repair. Results All patient regained normal sensation. No correlations between age and monofilaments were found. Twenty children (52%) reported some problems with cold intolerance (i.e. CISS), but no other abnormal disability was found (i.e. DASH, VAS); again with no differences between the two groups. Conclusions Children have an excellent long-term recovery after a digital nerve repair and without any influence of age.
|
|
| 7. |
- Skripitz, R, et al.
(författare)
-
Effect of alendronate and intermittent parathyroid hormone on implant fixation in ovariectomized rats
- 2009
-
Ingår i: JOURNAL OF ORTHOPAEDIC SCIENCE. - : Elsevier BV. - 0949-2658. ; 14:2, s. 138-143
-
Tidskriftsartikel (refereegranskat)abstract
- Intermittent administration of parathyroid hormone (PTH) leads to bone formation by increasing osteoblast numbers and activity levels. Animal studies have shown that intermittent PTH administration increases implant fixation in normal rats. The purpose of this study was to analyze the osseous incorporation of an implant in osteoporotic rats while treating them with intermittent PTH (1-34) or alendronate. A total of 36 ovariectomized (OVX) Wistar rats were randomized into three groups. Polymethylmethacrylate cement rods were implanted in one tibia in each rat. The three groups received daily PTH (60 mu g/kg body weight [BW]), alendronate (200 mu g/kg BW), or saline (0.5 ml/kg BW). A sham-ovariectomized group (n = 12) was treated with saline. After 2 weeks, the area around the implants was analyzed by histomorphometry for bone volume density (BVD) and implant bone contact. Bone mineral density (BMD) was evaluated by dual-energy X-ray absorptiometry. The BVD was higher in the specimens treated with PTH than in the other groups. PTH improved the BVD, BMD, and implant bone contact. Alendronate doubled the implant bone contact compared to the OVX and sham groups but did not improve BVD or BMD. These findings confirm that intermittent PTH enhances implant fixation in osteoporotic bone. The clinical significance of these findings is that application of intermittent PTH may be beneficial for early implant fixation in fractures, nonunions, and prosthetic replacements when bone density is decreased.
|
|
| 8. |
- Skripitz, Ralf, et al.
(författare)
-
Parathyroid hormone (1-34) increases attachment of PMMA cement to bone
- 2001
-
Ingår i: Journal of Orthopaedic Science. - : Elsevier BV. - 0949-2658 .- 1436-2023. ; 6:6, s. 540-544
-
Tidskriftsartikel (refereegranskat)abstract
- The attachment of an implant material to bone is related to the surface of the implanted material and the ability of the bone to form around the implant. Intermittent parathyroid (PTH) administration increases bone formation by stimulating osteoblastic activity. Little is known about the effect of PTH administration on orthopedic implant incorporation. The present study determined how PTH (1-34) administration influenced bone bonding, i.e., the bone-cement interfacial tensile strength, of vacuum-mixed polymethylmethacrylate (PMMA) bone cement (surface roughness, Ra, 4.8╡m). Bone bonding was evaluated by a detachment test. We used unloaded cement surfaces, which could be detached from the bone. Titanium plates were developed such that a cement fill was contained within a plate that was contained within a titanium holder. Thus. a flat cement surface came into contact with traumatized bone only, and the rest of the plate had no contact with tissue. After implantation of the plate in the left tibia, 20 adult male rats were injected daily with human PTH (1-34) at 60╡g/kg per injection (n = 10) or vehicle (n = 10), the animals were killed after 4 weeks. The plates were detached from the bone by a perpendicular force. PTH treatment increased the median pull-away strength (0.21MPa), compared with that in the vehicle-treated rats, (0.04MPa) (P = 0.02). The results suggest that PTH treatment may have the potential to enhance the incorporation of cemented orthopedic implants.
|
|
| 9. |
|
|
