| 1. |
- Andersson, Jonny K, 1972, et al.
(författare)
-
Open versus arthroscopic repair of the triangular fibrocartilage complex: a systematic review.
- 2018
-
Ingår i: Journal of experimental orthopaedics. - : Springer Science and Business Media LLC. - 2197-1153. ; 5:1
-
Tidskriftsartikel (refereegranskat)abstract
- To investigate the outcome of open versus arthroscopic repair of injuries of the triangular fibrocartilage complex (TFCC).An electronic literature search of articles published between January 1, 1985, and May 26, 2016, in PubMed, Embase, and the Cochrane Library was carried out in May 2016 and updated in March and December 2017. Studies comparing open and arthroscopic repair of TFCC injury with a mean follow up of more than 1year were eligible for inclusion. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist guided the extraction and reporting of data. The methodological quality of the included articles was assessed with the Cochrane Collaboration's tool for assessing risk of bias. The primary outcome measure was the rate of postoperative distal radioulnar joint (DRUJ) re-instability. Secondary outcome measures were range of motion (ROM), grip strength, residual pain, functional wrist scores and the rates of complications and re-operations.A total of 868 articles were identified by the electronic search. After duplicate removal and subsequent study selection, a total of two studies were included in this systematic review. The methodological quality of the included articles displayed risks of bias. There was no difference in DRUJ re-instability between open and arthroscopic repair of the TFCC. There were no differences in obtained postoperative ROM, grip strength or values in functional outcome scores, between open and arthroscopic TFCC repair in the two included studies, except for the Disability of the Arm Shoulder and Hand (DASH) questionnaire - in favor of arthroscopic surgery - in one of the included studies.This systematic review shows comparable results between open and arthroscopic repair of the TFCC, in terms of DRUJ re-instability and functional outcome scores. There is insufficient evidence to recommend one technique over the other in clinical practice. There is an immense lack of comparison studies with high level of evidence in the area of wrist ligament repair and reconstruction, including TFCC-injuries and DRUJ-instability.
|
|
| 2. |
- Andersson, Lenastina, et al.
(författare)
-
Mälsåker Revisited: Museum och Iscensättning. : Kungl Konsthögskolan. Restaureringskonst 2015-2016
- 2016
-
Rapport (populärvet., debatt m.m.)abstract
- Rapporten redovisar arbeten från kursen Restaureringskonst på Konsthögskolan som under läsåret 2015-2016 har arbetat med tema Museum och Iscensättning. Hur kulturmiljöer påverkas när de blir museum, hur man restaurerar för museum, hur man bevarar och utvecklar en plats för kunskapsutbyte, bildning och upplevelser. Mälsåkers slott, utanför Mariefred, förvaltat av Statens Fastighetsverk, var studieobjekt för 20 studenter, (yrkesverksamma arkitekter, antikvarier, ingenjörer, konservatorer m fl) där utbildningens olika studiemoment som uppmätning, inventering, dokumentation har tillämpats. Fältarbetet har följts av studier i historik, kulturhistorisk värdering och analyser som gett visioner och gestaltningsförslag på ny verksamhet i slottet. Rapporten presenterar förslagen, med text, skisser, foton och ritningar. Fyra olika typer av museum med varierande grad av åtgärder, förändringar och utveckling av slottet. Restaureringsexperiment redovisas utifrån traditionella och digitala dokumentationsmetoder. Dessutom finns arbeten om barockens ljus, bladguld, brandskydd, pod-radio, kraftstation, engelska parken, dekorationsmålade tak, Gustavianum, Julius Kronbergs ateljé och barockträdgård m m. Förslagen visar att det är möjligt att transformera Mälsåkers barockslott till ett museum av idag med bibehållen historik och synliga tidslager.
|
|
| 3. |
- Chevalley, Sara, et al.
(författare)
-
Passive Mobilization With Place and Hold Versus Active Motion Therapy After Flexor Tendon Repair: A Randomized Trial
- 2022
-
Ingår i: Journal of Hand Surgery. - : Elsevier BV. - 0363-5023. ; 47:4, s. 348-357
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: Mobilization after flexor tendon repair in fingers has been a subject of debate for several years. Many hand surgery clinics have turned to early active mobilization. However, there is no strong scientific evidence suggesting that early active mobilization produces a better range of motion (ROM) than the Kleinert regimen when place and hold is added. Therefore, the purpose of this prospective randomized trial was to investigate whether active mobilization is superior to passive mobilization with place and hold after flexor tendon repair in the fingers. Our hypothesis was that patients who follow the active mobilization protocol have a better ROM than those who follow the passive protocol with place and hold. Methods: Sixty-four patients with a flexor tendon injury in zone I or II were included. After surgery, randomization to undergo either active mobilization or passive mobilization with place and hold was performed. The patients were followed-up for 12 months using outcome measurements, including ROM, strength, rupture frequency, Disabilities of the Arm, Shoulder and Hand score, ABILHAND questionnaire, and performance on the Purdue Pegboard test. Results: We were unable to find any significant difference between the 2 groups for any of the outcome measurements, ROM, grip strength, key pinch, rupture frequency, Disabilities of the Arm, Shoulder and Hand score, ABILHAND questionnaire, and performance on the Purdue Pegboard test. Conclusions: The outcomes were equivalent for both the mobilization groups. Type of study/level of evidence: Therapeutic I. © 2021 American Society for Surgery of the Hand
|
|
| 4. |
- Ellegård, Lars, 1958, et al.
(författare)
-
Bioelectric impedance spectroscopy underestimates fat-free mass compared to dual energy X-ray absorptiometry in incurable cancer patients.
- 2009
-
Ingår i: European journal of clinical nutrition. - : Springer Science and Business Media LLC. - 0954-3007 .- 1476-5640. ; 63:6, s. 794-801
-
Tidskriftsartikel (refereegranskat)abstract
- Background/Objectives:Weight loss is frequently seen in advanced cancer. Bioelectrical impedance spectroscopy (BIS) is a convenient method for estimating body composition. We examined in a prospective, comparative study if BIS could accurately estimate fat-free mass (FFM) in cancer patients compared to dual-energy X-ray absorptiometry (DXA).Subjects/Methods:The study was based on 132 consecutive incurable cancer patients with solid tumours in a University hospital outpatient clinic. Comparison of FFM from DXA and BIS with standard and revised equations. Bland-Altman plots, t-tests and linear regression analysis were used to evaluate agreement and differences between methods.Results:BIS significantly underestimated mean FFM with 7.6+/-4.7 kg compared to DXA (P<0.001). Bias was significantly correlated to % weight loss (r=0.32), systemic inflammation as measured by C-reactive protein (r=0.29), malnutrition as assessed by low insulin-like growth factor-1 (r=-0.23) and inversely to the per cent body fat estimated by DXA (P=-0.61) and body mass index (BMI; r=-0.30). Revised BIS equations taking BMI into account reduced bias significantly but still with great individual variation.Conclusions:BIS by standard equations grossly underestimates FFM compared to DXA in cancer patients. This bias is related to weight loss, malnutrition and systemic inflammation. Revised equations improved FFM estimates, but with large individual variation. Thus, BIS with standard equations is not suitable to estimate FFM in patients with cachexia, inflammation and malnutrition.European Journal of Clinical Nutrition advance online publication, 14 May 2008; doi:10.1038/ejcn.2008.35.
|
|
| 5. |
- Karikis, Ioannis, 1985, et al.
(författare)
-
The Long-Term Outcome After Early and Late Anterior Cruciate Ligament Reconstruction.
- 2018
-
Ingår i: Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association. - : Elsevier BV. - 1526-3231. ; 34:6, s. 1907-1917
-
Tidskriftsartikel (refereegranskat)abstract
- To compare long-term clinical and radiographic outcomes in patients undergoing either early (group A) or late (group B) surgery after anterior cruciate ligament (ACL) injury.ACL reconstruction using hamstring tendon autografts was performed in 30 patients in group A (median age, 23years; range, 17-49years) and 31 patients in group B (median age, 27years; range, 17-38years). The patients in group A were operated on within 5months (median, 3months; range, 2-5months) of injury, whereas those in group B were operated on more than 24months (median, 30months; range, 24-48months) after injury. The follow-up period was 10years (median, 117months [range, 77-222months] in group A and 129months [range, 77-206months] in group B; P= .44). Multiple objective clinical evaluation tests and patient-reported outcome measures were obtained preoperatively and at follow-up. At follow-up, radiographic assessments of knee osteoarthritis (OA) bilaterally were performed.The frequency of meniscectomy at the index operation was significantly lower in group A (20%) than in group B (52%) (P= .01). There were no significant differences between the groups in terms of Tegner and Lysholm scores and laxity tests both preoperatively and at follow-up. Both groups improved over time in terms of Tegner and Lysholm scores (P < .05). At follow-up, significantly more medial-compartment OA in the index knee was found in group B than in group A (P= .037) according to the Ahlbäck classification system. The index knee showed significantly more OA than the contralateral knee in both groups (P< .01).Patients who underwent early ACL reconstruction required significantly fewer meniscectomies at the index operation than patients who underwent late reconstruction and showed significantly less OA on the medial side of the knee 10years after reconstruction. However, no significant differences were found between the groups in terms of clinical assessments.Level III, retrospective comparative study.
|
|
| 6. |
|
|
| 7. |
- Åhlén, Martina, et al.
(författare)
-
A comparison of the clinical outcome after anterior cruciate ligament reconstruction using a hamstring tendon autograft with special emphasis on the timing of the reconstruction.
- 2011
-
Ingår i: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. - : Springer Science and Business Media LLC. - 0942-2056. ; 19:3, s. 488-94
-
Tidskriftsartikel (refereegranskat)abstract
- Abstract: The aim of the study was to compare the results 2 years after anterior cruciate ligament (ACL) reconstruction using a hamstring tendon (HT) autograft in patients operated within 5 months after the injury (Group A) and patients operated more than 24 months after the injury (Group B). Sixty-one patients (27 women, 34 men), with a unilateral ACL rupture, underwent reconstructive surgery using semitendinosus (ST) or semitendinosus and gracilis (ST/G) autografts. Thirty patients (Group A) were operated on within 5 months median 3 (2-5) after the injury, and 31 patients (Group B) were operated on more than 24 months median 30 (24-48) after the injury. The follow-up examination was performed after a median of 25 months (18-43) after the reconstruction. A significantly higher Lysholm score was registered in Group A 90 (58-100) than in Group B 81 (38-100), P = 0.01, as well as a higher Tegner activity level 6 (2-9) versus 5 (0-9), P = 0.01. The clinical assessments revealed no significant differences between the groups in terms of the one-leg-hop test, KT-1000 arthrometer laxity measurements, manual Lachman test and range of motion (ROM). Furthermore, there was no significant difference between the groups in terms of meniscal and cartilage damage at the index operation. At 2 years post-operatively, patients who underwent subacute reconstruction had a significantly better outcome in terms of the Lysholm score and Tegner activity level than patients who underwent delayed reconstruction. The clinical relevance of the present study is that if the patient wishes to continue doing sports on a higher level, subacute reconstruction appears beneficial.
|
|
| 8. |
- Åhlén, Martina
(författare)
-
Anterior cruciate ligament reconstruction using semitendinosus and gracilis autograft. Evaluation of the clinical outcome, radiographic findings, histology and biochemistry
- 2015
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The present thesis focuses on different aspects of anterior cruciate ligament (ACL) reconstruction using hamstring tendon (HT) autografts. In Study I, two groups of patients were compared. One group underwent surgery in the sub-acute setting, a median of three months after injury (30 patients), and one group underwent delayed surgery a median of 30 months after the injury (31 patients). At clinical evaluation two years post-operatively, the patients in the sub-acute group had a significantly better clinical outcome in terms of the Tegner activity level and Lysholm knee scoring scale. In Study II, 19 patients underwent examination a minimum of six years after ACL reconstruction using HT autografts. MRI of the operated and the contralateral non-operated knee was performed to investigate the cross-sectional area and insertion site of the regenerated tendons. Furthermore, the patients underwent muscle strength measurements using a Biodex dynamometer. The semitendinosus tendon regenerated in 17 of 19 (89%) of the patients and the gracilis in 18/19 (95%). The tendons regained an almost normal point of insertion at the pes anserinus and a cross-sectional area similar to that of the non-operated contralateral side. There was a significant strength deficit in deep knee flexion but not in internal rotation. In Study III, 18 patients underwent bilateral biopsies under ultrasonographic guidance to investigate whether the regenerated tendon-like tissue seen on MRI in Study II is histologically real tendon tissue and/or scar tissue. The biopsies revealed tendon tissue similar to the normal tendon, but, in some of the regenerated tendons, “scar tissue formations” were seen. In Study IV, synovial fluid was aspirated from both knees in 11 patients to evaluate inflammatory components and disturbed cartilage metabolism in the long term (eight years) after unilateral ACL injury and reconstruction. The patients underwent bilateral weight-bearing radiographs and bilateral MRI to evaluate degenerative changes and meniscal and cartilage damage. There were no significant differences between injured and non-injured knees in terms of cartilage markers and inflammatory cytokines, but there were significantly more degenerative changes on radiographs and MRI in the reconstructed knees.
|
|
| 9. |
- Åhlén, Martina, et al.
(författare)
-
Histological evaluation of regenerated semitendinosus tendon a minimum of 6 years after harvest for anterior cruciate ligament reconstruction.
- 2014
-
Ingår i: Orthopaedic Journal of Sports Medicine. - : SAGE Publications. - 2325-9671. ; 2
-
Tidskriftsartikel (refereegranskat)abstract
- Semitendinosus (ST) and/or gracilis (G) autografts are the most used grafts for anterior cruciate ligament (ACL) surgery. The tendons have been shown to be able to regenerate but with focal areas of scar tissue in the short term. There are no long-term histological studies of the regenerated tendons. Hypothesis: In the long term, the regenerated ST tendon normalizes and has a similar histology as the contralateral nonharvested tendon. Study Design: Case-control study; Level of evidence, 3. Methods: Eighteen patients (8 female, 10 male) who underwent ACL surgery using ipsilateral ST/G tendon autografts were included in this study. Percutaneous specimens were obtained from the regenerated ST tendon and the contralateral nonharvested ST tendon under ultrasonographic guidance at a median of 8.4 years (100.5 months; range, 77-129 months) after the harvest procedure. Specimens from the nonoperated side served as controls. The histology and presence of glycosaminoglycans (GAGs) were assessed using a light microscope and a semiquantitative grading system. Results: Thirty-six biopsies were obtained (2 biopsies from each patient). In 5 biopsies, the amount of tissue was too small to analyze in the light microscope, and 1 patient had been operated on bilaterally and was therefore excluded. In total, 24 biopsies were included in the histological analysis. In overall terms, there were no significant differences between the regenerated and nonharvested ST tendon in terms of fiber structure, cellularity, vascularity, and level of GAGs a minimum 6 years after harvest of the ST tendon. However, 3 of the regenerated tendons displayed a loss of fiber structure. Conclusion: The ST tendon regenerates and may regain a histological appearance similar to that of the nonharvested contralateral tendon, as seen in this study a median of 8.4 years after harvesting. However, in some tendons, loss of fiber structure was found.
|
|
| 10. |
- Åhlén, Martina, et al.
(författare)
-
Inflammatory Cytokines and Biomarkers of Cartilage Metabolism 8 Years After Anterior Cruciate Ligament Reconstruction: Results From Operated and Contralateral Knees.
- 2015
-
Ingår i: The American journal of sports medicine. - : SAGE Publications. - 1552-3365 .- 0363-5465. ; 43:6, s. 1460-1466
-
Tidskriftsartikel (refereegranskat)abstract
- Patients who sustain an acute anterior cruciate ligament (ACL) rupture are at increased risk to develop posttraumatic arthritis (PTA) in the injured knee whether the ACL is reconstructed or treated nonoperatively. Inflammatory cytokines and cartilage degradation biomarkers are elevated at the time of acute injury and postoperatively. This suggests that one mechanism for PTA may be an inflammatory degradative process initiated on the acute injury and sustained for some length of time independent of whether adequate joint stability is restored.
|
|
