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- Hasserius, Ralph, et al.
(author)
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Long-term outcomes after different types of Horne and Tanzer olecranon fractures
- 2021
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In: Archives of Orthopaedic and Trauma Surgery. - : Springer Science and Business Media LLC. - 0936-8051 .- 1434-3916. ; 141:5, s. 709-716
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Journal article (peer-reviewed)abstract
- Background: It is unclear whether the outcomes differ after different Horne and Tanzer types of olecranon fractures. Materials and methods: We evaluated 40 men and 55 women with isolated olecranon fractures, journals and radiographs from fracture event. The fractures were classified according to Horne and Tanzer. After a mean 19 years after the fracture events, we evaluated subjective, clinical and radiographic outcomes, using the uninjured arms as controls. Results: 95% of patients with type I fractures reported, at follow-up, no differences between the elbows, 80% with type II fractures and 95% with type III fractures (p = 0.43). The three types of fractures had no differences in elbow range of motion or hand grip strength (when comparing injured and uninjured arms) and the proportions of individuals with radiographic elbow degenerative changes or joint space reduction were no different (all p > 0.05). Individuals with elbow degenerative changes had no inferior subjective elbow function compared to individuals with normal radiographs (p = 0.66), in contrast to those with joint space reduction compared to individuals with normal radiographs (p < 0.001). Interpretation: All types of Horne and Tanzer olecranon fractures have favourable long-term outcome. Elbow joint space reduction is associated with inferior subjective elbow function while degenerative changes are not.
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| 4. |
- Karlsson, Magnus, et al.
(author)
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Prevention of falls in the elderly: A review.
- 2013
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In: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 41:5, s. 442-454
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Research review (peer-reviewed)abstract
- Aims: Falls often result in soft tissue injuries, dislocations, fractures, longstanding pain and reduced quality of life. Therefore, fall preventive programmes have been developed. Methods: In this review, we evaluate programmes that in randomized controlled trials (RCT) have been shown with fall reducing effect. Results: Physical exercise that includes several training modalities, especially balance and strength training, is the only intervention programme that reduces both the number of fallers and the number of falls in community dwellers. Home hazards modification reduces the fall risk in community-living elderly but has the best effects in high risk groups when the programme is led by occupational therapists. Vitamin D supplement in those with low levels of vitamin D, adjustment of psychotropic medication and modification of multi-pharmacy are drug-related programmes that reduce the fall risk. Anti-slip shoe devices in elderly who walk outdoors during icy conditions and multifaceted podiatry to patients with specific foot disability are interventions targeted at the lower extremities with a fall-reducing effect. First eye cataract surgery and pacemakers in patients with cardio-inhibitory carotid sinus hypersensitivity are surgical procedures with fall-reducing effect. Multifactorial standardized preventive programmes that include an exercise component and individually-designed subject-specific programmes also reduce the number of falls. Conclusions: Fall preventive interventions should be provided to elderly by a structured approach, especially to high risk groups, as to reduce the number of falls and fallers.
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| 5. |
- Karlsson, Magnus, et al.
(author)
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Prevention of falls in the elderly-a review.
- 2013
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In: Osteoporosis International. - : Springer Science and Business Media LLC. - 1433-2965 .- 0937-941X. ; 24:3, s. 747-762
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Journal article (peer-reviewed)abstract
- The proportion of elderly in the society increases and fall frequency increases with advancing age. Many falls result in fractures and also soft tissue injuries, longstanding pain, functional impairment, reduced quality of life, increased mortality, and excess in healthcare costs. Due to the magnitude of these negative effects, a variety of single- and multicomponent fall-preventive intervention programs has been initiated.This review identifies programs that, in randomized controlled trials (RCTs), have been shown with fall-reductive effects.The most effective strategies in community-dwelling elderly include regular physical training with program that includes several different training modalities. Modification of the overall or patient-specific risk factor profile in home hazard modification program has been proven to decrease fall risk in community-living elderly. The elderly in the community benefit also from wearing antislip shoe devices when walking in icy conditions, from adjustment of psychotropic medication, and from structured modification of multipharmacy. If vitamin D levels in blood are low, supplementation is beneficial as is the first eye cataract surgery and pacemaker implantation in patients with cardioinhibitory carotid sinus hypersensitivity. In addition to modification of specific risk factors, generalized and individualized multifactorial preventive programs, all including some sort of physical training, have been found to decrease the fall risk. In summary, there is now strong evidence in the literature that structured fall-preventive programs in the elderly, especially in high-risk groups, are beneficial in reducing both the number of fallers and the number of falls in community.
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| 8. |
- Tsukanaka, Masako, et al.
(author)
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Identification of femoral head center of bipolar hemiarthroplasy in radiostereometric analysis with elementary geometrical shape models.
- 2016
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In: Journal of Biomechanics. - : Elsevier BV. - 1873-2380 .- 0021-9290. ; 49:3, s. 469-473
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Journal article (peer-reviewed)abstract
- Elementary geometrical shape (EGS) models are useful in radiostereometric analysis (RSA) on hip stems because tantalum markers attached to the stems can be omitted. In order to create an EGS model of a femoral stem, the center of the femoral head has to be identified. The contour of the femoral head is recommended to be used. However, the contour of the femoral head cannot be detected exclusively by computer if it is combined with a bipolar head or a metal cup. We therefore hypothesized that the contour of the outer head of bipolar hemiarthroplasty can be included in the EGS model as well as the femoral head contour. We calculated the time required for the detection of the contour, the precision of analysis and the stem micromotion at 2 years using the two different methods in the same picture set and compared the results. The detection of the bipolar head contour was 10 times faster than that of the femoral head contour. The precision for subsidence was 0.16mm in EGS RSA with the femoral head contour, and 0.15mm with the bipolar head contour (p=0.68). The precisions were comparable and clinically acceptable. There was no significant difference between the results of the 2-year micromotion with the two different methods. We conclude that this new method is applicable to measure stem micromotion of hemi-arthoplasty with EGS RSA and the method facilitates the Radiostereometric analysis.
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| 9. |
- von Schewelov, Thord, et al.
(author)
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A clinical and radiostereometric study of the cemented PFC-sigma prosthesis: a 5-year study of 29 cases with a fixed bearing.
- 2009
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In: Journal of Knee Surgery. - 1538-8506. ; 22:3, s. 231-236
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Journal article (peer-reviewed)abstract
- The press-fit condylar (PFC) cruciate-retaining total knee prosthesis is well documented in the literature. In 1997, a modification of the femoral component was introduced, and the prosthesis was renamed PFC-Sigma. The alteration may influence the migratory and rotational pattern of the tibial component and thus long-time survival rate. In this radiostereometric analysis, we found that the micromotion of the PFC-Sigma prosthesis differs slightly from the original PFC design, an advantage of the PFC-Sigma prosthesis. The median maximum total point motion at 5 years was 0.64 mm for the PFC-Sigma design and 0.79 mm for the previous version of PFC (P = .9). However, the PFC-Sigma rotated less around the transverse (x) axis than did the PFC (medians, 0.22 mm and 0.48 mm, respectively; P = .04). From the radiostereometric, radiographic, and clinical data, we conclude that the PFC-Sigma knee prosthesis can be used with confidence.
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| 10. |
- von Schewelov, Thord, et al.
(author)
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Accuracy of radiographic and radiostereometric wear measurement of different hip prostheses: an experimental study.
- 2004
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In: Acta Orthopaedica Scandinavica. - : Medical Journals Sweden AB. - 0001-6470. ; 75:6, s. 691-700
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Journal article (peer-reviewed)abstract
- Background In vivo measurement of wear in the ball and socket articulation of total hip arthroplasties is of interest in the evaluation of both existing and new implants. Controversy reigns regarding the accuracy of different radiological measurement techniques and in particular how accuracy has been assessed. Material and methods We assessed the accuracy of 2 radiostereometric (RSA) techniques for wear measurement and 3 standard radiographic techniques, namely Imagika (image analyzing software), Imagika corrected for head center displacement, and the Charnley Duo method. 5 custom-made adjustable phantoms with different prosthetic components were used. Results In 20 measurements of all 5 phantoms at 3 levels of simulated wear (0.2 mm, 1.0 mm and 1.5 mm), the mean measurement error of the digital RSA examinations was 0.010 mm (accuracy 0.42). The corresponding error values for the three radiographic techniques were 0.19 (accuracy 1.3) for Charnley Duo, 0.13 (accuracy 1.3) for Imagika corrected, and 1.021 (accuracy 2.99) for Imagika. Measurement error decreased from 0.011 mm with ordinary RSA to 0.004 with RSA digital measurement. Head size, direction of wear in relation to the cup or type of prosthetic component did not influence the measurement error. The results of Charnley Duo and Imagika corrected were similar but the latter had an inexplicable systematic error in measuring one of the phantoms. Imagika had the worst results due to its inability to compensate for the out-of-head center effect. Alumina heads were difficult to analyze with all methods. Interpretation By using the ISO standard for assessing accuracy, RSA can be expected to measure wear with an accuracy of about 0.4 mm irrespective of prosthetic component studied or direction of wear, whereas the best technique, in our study, based on standard radiographs can be accurate to about 1.3 mm.
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