| 1. |
- Ek, Arne, 1950-
(författare)
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Att konstruera en uppslutning kring den enda vägen : Om folkrörelsers modernisering i skuggan av det östeuropeiska systemskiftet
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis is about some Swedish organizations that are connected to the labour movement and their actions to cope with the new hegemony around market liberalism. After the fall of the Soviet Union in the early 90-ties, the liberal order, meaning market economy and democracy reduced to the election of elites, has become totally domineering both in the western and in the former communist world. Even left wing oriented organizations have adopted their operations and activities accordingly, especially in their internal governing structure. The organizations that I have studied, mainly the Swedish Tenants organization at its local level of Stockholm, developed during the 70-ties and the 80-ties a participatorier member structure. The “Swedish model” of consensus/corporative decision-making and agreement, used by them on the national level for decades, was during that period introduced also on local and regional levels. In the 90-ties these organizations, according to earlier studies, have instead adapted a more costumer-oriented and elite-democratic way of operating and governing. These later changes could be seen as contradicting both the development of the 80-ties and the basic values of those organizations. My questions are therefore how these changes became possible and my aim is to study how the active members have contributed to this development. Using a constructionist theoretical perspective and discourse analysis, I am showing how this potential conflict between a participatory and an elite-democratic model can be reconciled by a discursive construction. The active members have in fact been able see these changes just as a modernization of their organization. From their point-of-view their organization still works in a participatory democratic way. My analysis shows how this ambiguousness and potential paradox became possible thru internal discourses and under influence from the liberal hegemony.
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| 2. |
- Jacobsson, Sven-Arne, 1953-
(författare)
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Clinical and experimental studies on total hip arthroplasty
- 1995
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In a 12-year follow-up study, a low-friction, metal-on-plastic hip prosthetic system (Charnley) was compared with a high-friction, metal-on-metal prosthetic system (McKeeFarrar) in a consecutive series of 169 patients, mean age 67 at the start. Satisfactory results were reported in 92 percent of the patients. One-third of the prostheses showed radiographic signs of loosening. The cumulative aseptic failure rate was 8 percent for the Charnley prosthesis and 15 percent for the MKF prosthesis. The difference was not statistically significant.The performance of a flexible (Bute!) and a rigid (PCA) cementless femoral component was studied in a prospective, randomized study of 28 matched pairs of patients (mean age 52 years). A high rate of stem loosening was observed for the flexible prosthesis and 4 cases of fatigue breakage occurred within the 3- to 5-year follow-up period. Proximal resorption and distal hypertrophy of the femur were frequently noted on the radiographs for the rigid stem. The scintigraphic activity around stems well fixed to bone became normalized in the calcar region. In contrast, it was about 50 percent increased around the prosthetic tip. For loose prostheses, the bony uptake was more intense and did not show the same time-related decrease. The scintimetric results did not correlate well with the signs of bone remodeling seen on the radiographs. Repeated at different time intervals, bone scintimetry may be informative in the followup of noncemented THA.In a consecutive series of THAs, the straight ITI-I stem (n=65), made of titanium alloy, was compared at a 5-year review with the Lubinus femoral component (n=77), curved and made of cobalt-chrome alloy. The ITH stem showed a high frequency of surrounding radiolucent lines. Six of the stems were considered loose as compared with none of the Lubinus stems. To date, 5 have been revised and 2 more are in need of revision operations, all in the ITH group. Although the initial costs were somewhat reduced with the use of the cheaper ITH prosthesis, the estimated accumulated costs turned out to be higher in the ITH than in the Lubinus group due to the increased need for revisions.In a study of THA performed on patients 80 years and older, good pain relief was achieved but at the cost of increased postoperative complications and hospital expenses as compared with patients around 65 years of age at operation. Functional improvement was not as evident as pain alleviation. The procedure did not result in decreased use of welfare services in the elderly group of patients.An experimental study was performed on 10 rabbits. Hydroxyapatite coated titanium plugs were implanted in both femora of each animal. Five were treated for seven days with an NSAID (diclofenac) and five were used as controls, receiving no treatment. A significantly lower force was required to pull out the implants 3 weeks after surgery in the group treated with diclofenac than in the untreated group. The results indicate that even short-term treatment with NSAIDs might interfere with the process of bony ingrowth and thereby endanger primary fixation of the implant despite the presence of a hydroxyapatite coating.A new cementless prosthesis was designed in titanium alloy in order to integrate the principles ofpressfit and flexibility. In a special test set-up the endurance properties of the stem were determined. Prototypes of the prosthesis were subjected to load cycles of 4,000 N in one ·test and to a more physiologic load pattern in another test. In both tests the prostheses broke after approximately 600,000 cycles without showing any material defects. It was concluded that considerable difftculty exists in constructing an "isoelastic" stem with reasonable safety limits to fatigue failure when using titanium alloy.
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| 3. |
- Johansson, Torsten, et al.
(författare)
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Internal fixation versus total hip arthroplasty in the treatment of displaced femoral neck fractures
- 2000
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Ingår i: Acta Orthopaedica Scandinavica. - 0001-6470. ; 71:6, s. 597-602
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Tidskriftsartikel (refereegranskat)abstract
- 100 patients 75 years or older, with displaced femoral neck fractures, were randomly assigned to osteosynthesis with two parallel and percutaneously inserted screws (Olmed) or total hip arthroplasty (Lubinus IP). Mean age was 84 (75-101) years, 74% were women and 45% had mental dysfunction. General complications were commoner in the arthroplasty group but the mortality rates did not differ. In the osteosynthesis group, fracture complications were seen in 27/50 hips. In the arthroplasty group, dislocation was the main complication and occurred in 11/50 cases. At 3 months and after 1 year, the Harris Hip Scores were significantly better in the arthroplasty group. When mental dysfunction was present, the dislocation rate after arthroplasty was 32%, whereas the reoperation rate after osteosynthesis was 5%. The opposite pattern of complications was found in patients with normal mental function, 12% versus 60%. The 2-year mortality rate among those with mental dysfunction was 26/45, compared to 7/55 of those with normal function (p < 0.001). We conclude that total hip arthroplasty should be considered for a displaced femoral neck fracture in old patients with normal mental function and high functional demands.
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| 4. |
- Palm, Lars, et al.
(författare)
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Acetabular revision with extensive allograft impaction and uncemented hydroxyapatite-coated implants. Results after 9 (7-11) years follow-up
- 2007
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Ingår i: The Journal of Arthroplasty. - : Elsevier BV. - 0883-5403 .- 1532-8406. ; 22:8, s. 1083-1091
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Tidskriftsartikel (refereegranskat)abstract
- This is a clinical and radiographic review of 87 hips in 79 patients 9 (7-11) years after acetabular revision with extensive use of morselized allograft firmly impacted into localized defects as well as the entire acetabular cavity, followed by insertion of an uncemented hydroxyapatite-coated cup with supplementary screw fixation. The 9-year survival rate for the acetabular implant was 90.5% (95% CI, 83.4%-97.6%) with revision for any reason as end point and 94% (95% CI, 89%-99.1%) with revision for aseptic loosening as end point. Acetabular revision with massive allograft impaction and hydroxyapatite-coated implants show very promising results. The limited contact between implant and host bone does not seem to compromise implant survival in the 7- to 11-year perspective.
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| 5. |
- Palm, Lars, et al.
(författare)
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Hydroxyapatite coating improves 8- to 10-year performance of the Link RS cementless femoral stem
- 2002
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Ingår i: The Journal of Arthroplasty. - : Elsevier BV. - 0883-5403. ; 17:2, s. 172-175
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Tidskriftsartikel (refereegranskat)abstract
- In a prospective randomized clinical study, 12 hydroxyapatite (HA)-coated and 8 identical but noncoated stems were implanted in 20 patients. At 8- to 10-year follow-up, the HA-coated stems displayed excellent clinical and radiographic results in 11 out of 12 patients, whereas 7 out of 8 noncoated stems were failures and had been subject to revision. Despite the small number of patients in this series, HA coating seems to improve the long-term stable fixation of uncemented femoral implants.
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| 6. |
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