| 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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| 11. |
- Axelsson, Paul, et al.
(författare)
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Radiostereometry in lumbar spine research.
- 2006
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Ingår i: Acta Orthopaedica. Supplementum. - : Medical Journals Sweden AB. - 1745-3690 .- 1745-3674 .- 1745-3682. ; 77:323, s. 3-42
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Forskningsöversikt (refereegranskat)
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| 12. |
- Berg, S
(författare)
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On total disc replacement
- 2011
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Ingår i: Acta orthopaedica. Supplementum. - : Medical Journals Sweden AB. - 1745-3704 .- 1745-3674 .- 1745-3682. ; 82:343, s. 5-
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Tidskriftsartikel (refereegranskat)
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| 13. |
- Bylander, Birger, et al.
(författare)
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Stapling for tibial-growth deformity : A case report on roentgen stereophotogrammetric analysis
- 1989
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 0001-6470. ; 60:4, s. 487-490
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Tidskriftsartikel (refereegranskat)abstract
- A 9-year-old boy sustained a Salter-Harris Type IV fracture in the proximal tibia. the injury resulted in a progressive valgus deformity, detected already after 3 months by roentgen stereophotogrammetry. After temporary stapling medially, the growth rate increased laterally and the deformity was corrected. Unilateral stapling is an alternative procedure for correcting angular deformity following a physeal injury.
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| 14. |
- Dahlberg, Leif, et al.
(författare)
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Proteoglycan fragments in joint fluid : Influence of arthrosis and inflammation
- 1992
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 0001-6470. ; 63:4, s. 417-423
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Tidskriftsartikel (refereegranskat)abstract
- We determined the concentration of proteoglycan fragments in knee joint fluid collected from knee-ligament injured patients more than 6 months after the trauma and from patients with acute pyrophosphate arthritis and arthrosis or with arthrosis only. Injured patients with normal or only mildly altered cartilage at arthroscopy and with normal radiographs, had twice the average concentration of healthy volunteers. Other injured patients with advanced, radiographic signs of arthrosis, had synovial fluid proteoglycan fragment concentrations within the range of healthy volunteers. Patients with pyrophosphate arthritis had the highest concentrations, substantially increased compared with both arthrosis patients, with or without knee injury and healthy volunteers. Likewise, there was an inverse relation between the degree of arthrosis and the concentration of proteoglycan fragments in the joint fluid in patients with pyrophosphate arthritis and arthrosis or with arthrosis only. We conclude that synovial fluid levels of proteoglycan fragments are influenced by the mass of cartilage matrix remaining in the joint, the inflammatory activity in the joint, and the metabolic activity of the cartilage cells.
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| 15. |
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| 16. |
- Hansson, Bengt-Göran, et al.
(författare)
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Overview of 345 Supplements published 1934-2011.
- 2012
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Ingår i: Acta Orthopaedica. Supplementum. - : Medical Journals Sweden AB. - 1745-3704 .- 1745-3674 .- 1745-3682. ; 83:348, s. 1-23
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Tidskriftsartikel (refereegranskat)
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| 17. |
- Hägglund, Gunnar, et al.
(författare)
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A case of bilateral duplication of the patella
- 1989
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 0001-6470. ; 60:6, s. 725-727
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Tidskriftsartikel (refereegranskat)abstract
- A boy with bilateral duplication of his patellae was radiographically examined between 8 and 11 years of age. the duplication was probably caused by a disrupted fusion of two ossification centra.
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| 18. |
- Hägglund, Gunnar, et al.
(författare)
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Growth of children with physiolysis of the hip
- 1987
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 0001-6470. ; 58:2, s. 117-120
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Tidskriftsartikel (refereegranskat)abstract
- Growth during adolescence was analyzed in 40 children with slipped capital femoral epiphysis using the Infancy Childhood Puberty growth model. the advantage of this model is that reference values for height can be adjusted for the individual age at pubertal maturation. In both sexes an above average height was found before the onset of the pubertal growth spurt. However, the pubertal gain in height was less than normal, and at maturity the heights were only slightly above the reference mean values. Most of the children had their first hip symptoms during the period of increasing gain in height at the initial stage of the pubertal growth spurt. Both boys and girls were overweight before puberty and remained so during puberty and at maturity.
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| 19. |
- Karlsson, Magnus K., et al.
(författare)
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Bone mineral normative data in Malmö, Sweden : Comparison with reference data and hip fracture incidence in other ethnic groups
- 1993
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 0001-6470. ; 64:2, s. 168-172
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Tidskriftsartikel (refereegranskat)abstract
- The bone mineral mass was measured in 324 residents of the city of Malmö Sweden, by dual energy roentgen absorptiometry (DEXA) using the Lunar DPX equipment - total body, hip, and lumbar vertebrae. the bone mineral content of the wrist was also measured with single photon absorptiometry (SPA) in 88 of the individuals. Weight, height, and vertebral height, as well as body fat, lean body mass, menarcheal age, menopausal age, and hand grip strength were determined. Measurements were compared with reference bone mineral content values from the United States, Japan, and France - also hip fracture incidence was compared. All bone mineral values decreased with age. A good correlation was found between the DEXA technique of total body bone mineral and the forearm SPA values. the bone mineral content was correlated with lean body mass and weight. the Malmö bone mineral content was on the same level as in the United States, but higher than in Japan and France. the comparatively high risk of fragility fractures in the Scandinavian countries compared with most other settings cannot be explained by low bone mass.
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| 20. |
- Karlsson, Magnus K., et al.
(författare)
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The ankle fracture as an index of future fracture risk : A 25-40 year follow-up of 1063 cases
- 1993
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 0001-6470. ; 64:4, s. 482-484
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Tidskriftsartikel (refereegranskat)abstract
- In 1992 a retrospective case control study was performed, based on all patients with ankle fractures (n 1063) treated at the Department of Orthopedics in Malmö Sweden, between 1950-1951 and 1961-1965. As all radiographic examinations have been saved in Malmö we were able to study all subsequent fractures that this group had sustained. 260 patients from 1961-1965 who were still living in Malmö today were also compared with an age-and gender-matched control group regarding the location and type of subsequent fractures. the group with former ankle fractures continued to have a two-fold increased incidence of all sorts of fractures. the same result was found when looking at the upper and lower extremities separately. However, the risk of sustaining new fractures in the once-fractured extremity was not increased compared to the uninjured side.
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| 21. |
- Knutson, Kaj, et al.
(författare)
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The Swedish knee arthroplasty register. A nation-wide study of 30,003 knees 1976-1992
- 1994
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Ingår i: Acta Orthopaedica Scandinavica. - : Medical Journals Sweden AB. - 0001-6470 .- 1745-3674. ; 65:4, s. 375-386
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Tidskriftsartikel (refereegranskat)abstract
- 1976 through 1992, 30,003 primary knee arthroplasties and their revisions have been recorded in a nation-wide Swedish study. We report on the structure of the register, demographic data and survivorship. We found that operations for osteoarthrosis (OA) counted for the increase in number of arthroplasties in contrast to rheumatoid arthritis (RA), where the number had slightly declined. For primary operations, the total knee prostheses have practically eliminated other types in RA and are steadily gaining popularity in OA at the expense of the unicompartmental prostheses. Total knee replacements showed gradually improving survival even in unchanged designs while the unicompartmental prostheses don't, partly because of newly introduced inferior designs. We also found that failed unicompartmental prostheses were best replaced with a tricompartmental prosthesis and that a total revision was to be preferred when a tricompartmental tibial component failed. The risk of the most devastating complications, e.g., infection, leading to extraction of the prosthesis or arthrodesis has decreased considerably also in the last years.
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| 22. |
- Lark, Michael W., et al.
(författare)
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Aggrecan degradation in osteoarthritis and rheumatoid arthritis
- 1995
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Ingår i: Acta Orthopaedica. - : Informa UK Limited. - 1745-3674 .- 0001-6470. ; 66:S266, s. 92-97
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Tidskriftsartikel (refereegranskat)abstract
- Aggrecan turnover is critically important to maintain extracellular matrix homeostasis in articular cartilage. Cartilage aggrecan metabolism has been studied in chondrocyte cell cultures, cartilage explant cultures, and in whole animal models. In many of these studies, matrix metalloproteinases (MMPs) are proposed to degrade cartilage aggrecan. MMP expression appears elevated in joint tissues from patients with osteoarthritis (OA) and rheumatoid arthritis (RA) (Dean et al. 1989, Wolfe et al. 1993) and inhibitors of both MMPs and thiol proteinases have been shown to block aggrecan (Buttle et al. 1992) and type II collagen (Mort et al. 1993) degradation in cartilage explant cultures. Using antibodies and cDNA probes, elevations in expression and concentration of many of these enzymes in animal models and in OA and RA have been described. Human cartilage aggrecan has now been cloned and sequenced (Doege et al. 1991). This information, in combination with the ability to sequence aggrecan and aggrecan fragments at the protein level, has resulted in the identification of several aggrecan fragments which appear to result from proteinase degradation. In this report, we describe data which suggest that MMPs may in part be responsible for aggrecan catabolism in normal articular cartilage, as well as in the elevated catabolism seen in OA and RA.
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| 23. |
- Larsson, Jan, et al.
(författare)
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Local signs and symptoms in relation to final amputation level in diabetic patients. A prospective study of 187 patients with foot ulcers
- 1994
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Ingår i: Acta Orthopaedica Scandinavica. - : Medical Journals Sweden AB. - 0001-6470 .- 1745-3674. ; 65:4, s. 387-393
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Tidskriftsartikel (refereegranskat)abstract
- Local signs and symptoms were evaluated in 187 consecutively presenting diabetic patients undergoing amputation for foot ulcers. From admission until final outcome the patients were treated by the same multidisciplinary team both as in- and out-patients. At the time of amputation, the types of lesions were superficial/deep ulcer (n 17), ulcer with deep infection, but without gangrene (n 40), and gangrene with or without infection (n 130). Healing after a minor amputation (below the ankle) occurred in 74 patients, while 88 patients healed after a major amputation (above the ankle), and 25 patients died before healing had occurred. Deep infection and presence of popliteal or pedal pulses were associated with healing after minor amputation and so were ulcers on the small toes, metatarsal head area and midfoot. Pain, progressive gangrene, intermittent claudication, and decubital and multiple ulcers were related to healing after major amputation. In a logistic regression analysis, pain, progressive gangrene and intermittent claudication remained. However, none of these factors excluded healing of a minor amputation and thus selection of amputation level in diabetic patients with foot ulcers cannot be based upon these factors exclusively.
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| 24. |
- Lohmander, L. Stefan, et al.
(författare)
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Knee ligament injury, surgery and osteoarthrosis : Truth or consequences?
- 1994
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 0001-6470. ; 65:6, s. 605-609
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Tidskriftsartikel (refereegranskat)abstract
- We reviewed reports that describe development of osteoarthrosis of the knee after anterior cruciate ligament or meniscus injury. the occurrence of posttraumatic osteoarthrosis varied considerably from one report to another. the literature does not lend support to the efficacy of cruciate ligament repair or reconstruction in retarding the progression of osteoarthrosis after knee injury. We encourage prospective, controlled, randomized and masked studies that aim to evaluate the utility of ligament reconstruction, meniscus suture or meniscus transplantation for preventing posttraumatic osteoarthrosis.
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| 25. |
- Lohmander, Stefan
(författare)
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Markers of cartilage metabolism in arthrosis
- 1991
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 0001-6470. ; 62:6, s. 623-632
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Tidskriftsartikel (refereegranskat)abstract
- The mechanisms involved in the disease process in arthrosis are largely unknown, with genetics, joint malalignment, overload or trauma, obesity, and aging as some of the known or suspected contributing factors. Even less well known is how these general factors are translated into disease mechanisms at the cell and tissue levels. However, it may be argued that degradation of cartilage matrix is a key event at some time in the development of arthrosis. During this process, fragments of matrix molecules and other chondrocyte products are released into the joint fluid and eventually into other body fluids. These molecules can be used as markers of cartilage metabolism to monitor joint disease. In addition, by identifying the proteases and the structure of the released matrix fragments, we may improve our understanding of the cellular mechanisms active in cartilage degradation. Such information offers improved diagnostic and prognostic tools for rational treatment aimed at retarding cartilage destruction in arthrosis.
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| 26. |
- Messner, Karola, et al.
(författare)
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Proteoglycan fragments in rabbit joint fluid correlated to arthrosis stage
- 1993
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 0001-6470. ; 64:3, s. 312-316
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Tidskriftsartikel (refereegranskat)abstract
- Proteoglycan fragment concentrations in joint fluid of rabbit knees with various degrees of secondary arthrosis after meniscal resection, meniscal substitution, and anterior cruciate ligament transection, were related to the gross appearance of the articular cartilage. Knees with normal cartilage were distinguishable by the concentration of proteoglycan fragments in joint fluid from knees with arthrosis. We found a correlation (r 0.61) between increasing arthrosis and increasing concentrations of proteoglycan fragments.
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| 27. |
- Odenbring, Sten, et al.
(författare)
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Proteoglycan epitope in synovial fluid in gonarthrosis : 28 cases of tibial osteotomy studied prospectively for 2 years
- 1991
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 0001-6470. ; 62:2, s. 169-173
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Tidskriftsartikel (refereegranskat)abstract
- High tibial osteotomy was performed for medial gonarthrosis in 28 patients. Preoperatively, and at 3, 12, and 24 months after surgery, clinical and radiographic examinations were made, and joint-fluid samples were aspirated. Arthroscopy was performed preoperatively and at 24 months. Immunoassay of proteoglycan epitope in joint fluid showed an increase in concentration at all times as compared with a reference population with normal knee joints. An increase in both the concentration and the total amount of proteoglycan epitope in joint fluid was noted at 3 months postoperatively with a return to preoperative values at later times. Regrowth of fibrocartilage did not correlate with proteoglycan epitope data
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| 28. |
- Roos, Harald, et al.
(författare)
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Soccer after anterior cruciate ligament injury - An incompatible combination? A national survey of incidence and risk factors and a 7-year follow-up of 310 players
- 1995
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 0001-6470. ; 66:2, s. 107-112
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Tidskriftsartikel (refereegranskat)abstract
- All players in Swedish soccer teams are required to have insurance in the same company. from the archives of the insurance company, all 3,735 injuries reported in 1986 in 188,152 Swedish soccer players were reviewed. of these, 937 were knee injuries. All players were asked by mail to fill in a questionnaire and 83 percent replied. the patient records from the different hospitals were requested. the anterior cruciate injuries represented one third of the reported knee injuries. the relative risk of sustaining an anterior cruciate ligament Injury was increased in female players, in elite players, and in players in the forward position. the odds ratios were 1.6 (1.3-2.1), 3.3 (1.7-6.1) and 1.8 (1.4-2.5), respectively. the injuries occurred at a younger age in females than in males. 50 percent of the injured players were treated with anterior cruciate ligament surgery, predominantly as a reconstructive procedure, with use of a patellar tendon transplant. 30 (20) percent of the players with anterior cruciate ligament injury were active in soccer after 3 (7) years, compared to 80 (50) percent of an uninjured control population of soccer players. None of the elite players was active at the same level after 7 years. A comparison of anterior cruciate ligament-injured players, whether treated by surgical reconstruction or not, revealed no difference with regard to the proportion of players still playing soccer after 7 years.
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| 29. |
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| 30. |
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| 31. |
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| 32. |
- Aagaard, Knut, et al.
(författare)
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High incidence of acute full-thickness rotator cuff tears. A population-based prospective study in a Swedish Community.
- 2015
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3682 .- 1745-3674. ; 86:5, s. 558-562
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose - Epidemiological studies of full-thickness rotator cuff tears (FTRCTs) have mainly investigated degenerative lesions. We estimated the population-based incidence of acute FTRCT using a new diagnostic model. Patients and methods - During the period November 2010 through October 2012, we prospectively studied all patients aged 18-75 years with acute onset of pain after shoulder trauma, with limited active abduction, and with normal conventional radiographs. 259 consecutive patients met these inclusion criteria. The patients had a median age of 51 (18-75) years. 65% were males. The patients were divided into 3 groups according to the clinical findings: group I, suspected FTRCT; group II, other specific diagnoses; and group III, sprain. Semi-acute MRI was performed in all patients in group I and in patients in group III who did not recover functionally. Results - We identified 60 patients with FTRCTs. The estimated annual incidence of MRI-verified acute FTRCT was 16 (95% CI: 11-23) per 105 inhabitants for the population aged 18-75 years and 25 (CI: 18-36) per 105 inhabitants for the population aged 40-75 years. The prevalence of acute FTRCT in the study group was 60/259 (23%, CI: 18-28). The tears were usually large and affected more than 1 tendon in 36 of these 60 patients. The subscapularis was involved in 38 of the 60 patients. Interpretation - Acute FTRCTs are common shoulder injuries, especially in men. They are usually large and often involve the subscapularis tendon.
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| 33. |
- Abbott, Allan, et al.
(författare)
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Analgesic prescriptions received by patients before commencing the BOA model of care for osteoarthritis: a Swedish national registry study with matched reference and clinical guideline benchmarking
- 2022
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682. ; 93, s. 51-58
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose - Swedish clinical guidelines for osteoarthritis (OA) prioritize patient education, exercise, and-if necessary-weight reduction before considering adjunct pharmacological intervention. Contrariwise, we investigated the proportion and type of dispensed analgesic prescriptions in Sweden received by patients during 3 years before commencing non-pharmacological primary care interventions for OA (2008-2016) compared with the general population. Furthermore, we analyzed the proportion of analgesic prescriptions dispensed before (2008-2012) compared with after (2012-2016) guideline publication in terms of concordance with clinical guideline recommendations. Patients and methods - Patients with hip or knee OA (n = 72,069) from the Better Management of OA national quality register receiving non-pharmacological interventions in primary care between 2008 and 2016 were included (OA cohort). An age, sex, and residence matched reference cohort (n = 216,207) was formed from the Swedish Total Population Register. Based on a period 3 years prior to inclusion in the OA cohort, Swedish Prescribed Drug Register data was linked to both the OA and reference cohorts. Results - Compared with the reference cohort, a distinctly larger proportion of the OA cohort had dispensed prescriptions for most types of analgesics, increasing exponentially each year prior to commencing non-pharmacological intervention. Since guideline publication, the proportion of the OA cohort having no dispensed prescription analgesics prior to non-pharmacological primary care intervention concordantly increased by 5.0% (95% CI 4.2-5.9). Furthermore, dispensed prescriptions concordantly decreased for non-selective NSAIDs -8.6% (CI -9.6 to -7.6), weak opioids -6.8% (CI -7.7 to -5.9), glucosamine -9.5% (CI -9.8 to -8.8). and hyaluronic acid -1.6% (CI -1.8 to -1.5) but discordantly increased for strong opioids 2.8% (CI 2.1-3.4) and glucocorticoid intra-articular injection for hip OA 2.1% (CI 1.0-3.1). Interpretation - In Sweden, dispensed prescription of analgesics commonly occurred before initiating non-pharmacological primary care interventions for OA but reduced modestly after guideline publication, which prioritizes non-pharmacological before pharmacological interventions. Additional modest improvements occurred in the stepped-care prioritization of analgesic prescription types. However, future strategies are required to curb an increase of strong opioids prescription for OA and glucocorticoid intra-articular injection for hip OA.
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| 34. |
- Abdulghani, Saba, et al.
(författare)
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The influence of initial pressurization and cup introduction time on the depth of cement penetration in an acetabular model.
- 2007
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3682 .- 1745-3674. ; 78:3, s. 333-339
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Tidskriftsartikel (refereegranskat)abstract
- Background Acetabular cementation during total hip arthroplasty is considered difficult mainly due to the appearance and anatomy of the acetabulum. Improved cementation technique has been shown to improve the longevity of acetabular components. Method We designed a ceramic model to investigate the effect of varying the initial cement pressurization and cup introduction times on the depth of cement penetration. 4 groups were prepared, 2 of which involved varying initial cement pressurization and cup introduction times. Group 3 involved initial cement pressurization with no cup introduction, while group 4 involved cup introduction with no prior cement pressurization. Results and interpretation Most cement penetration occurred in the early pressurization phase, and we conclude that a relatively early and longer cement pressurization time and late cup introduction are positive factors for increased cement penetration in the acetabulum model.
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| 35. |
- Abramo, Antonio, et al.
(författare)
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Evaluation of a treatment protocol in distal radius fractures: a prospective study in 581 patients using DASH as outcome.
- 2008
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3682 .- 1745-3674. ; 79:3, s. 376-385
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: Distal radius fractures are most often treated nonoperatively, but sometimes they are treated surgically when deemed unstable. Based on the literature, a consensus protocol for treatment has been developed in southern Sweden to aid clinicians in their decision making. We evaluated the results of this protocol prospectively using a validated outcome instrument (DASH) in a large consecutive and population based series of unselected patients. METHODS: 581 patients were treated according the protocol. Age, sex, fracture side, and type of treatment were registered. The subjective outcome was measured by DASH. 133 patients were operated. RESULTS: 75% of the patients returned the questionnaire. The median DASH score at 3 months was 18.3 and at 12 months it was 7.5. All treatment groups had low DASH scores at the final follow-up. Reduced, nonoperated fractures had a worse score (11.6) than undisplaced (4.2) or operated fractures (6.0). Age was the only other predictor, with older patients having a worse score. A correlation was found between the short-version 11-item QuickDASH questionnaire and the full 30-item DASH, both at 3 months (r = 0.98) and at 1 year (r = 0.97) (p< 0.001 for both). INTERPRETATION: Most patients have residual symptoms at 3 months after the fracture but are normalized at 1 year. Good final subjective result was achieved with the proposed protocol regardless of initial severity and treatment of the fracture, as indicated by a low median DASH score in all groups. There was correlation between QuickDASH and the full DASH, and the former could be used in future studies.
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| 36. |
- Abramo, Antonio, et al.
(författare)
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Open reduction and internal fixation compared to closed reduction and external fixation in distal radial fractures A randomized study of 50 patients
- 2009
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3682 .- 1745-3674. ; 80:4, s. 478-485
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose In unstable distal radial fractures that are impossible to reduce or to maintain in reduced position, the treatment of choice is operation. The type of operation and the choice of implant, however, is a matter of discussion. Our aim was to investigate whether open reduction and internal fixation would produce a better result than traditional external fixation. Methods 50 patients with an unstable or comminute distal radius fracture were randomized to either closed reduction and bridging external fixation, or open reduction and internal fixation using the TriMed system. The primary outcome parameter was grip strength, but the patients were followed for 1 year with objective clinical assessment, subjective outcome using DASH, and radiographic examination. Results At 1 year postoperatively, grip strength was 90% (SD 16) of the uninjured side in the internal fixation group and 78% (17) in the external fixation group. Pronation/supination was 150 degrees (15) in the internal fixation group and 136 degrees (20) in the external fixation group at 1 year. There were no differences in DASH scores or in radiographic parameters. 5 patients in the external fixation group were reoperated due to malunion, as compared to 1 in the internal fixation group. 7 other cases were classified as radiographic malunion: 5 in the external fixation group and 2 in the internal fixation group. Interpretation Internal fixation gave better grip strength and a better range of motion at 1 year, and tended to have less malunions than external fixation. No difference could be found regarding subjective outcome.
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| 37. |
- Abramo, Antonio, et al.
(författare)
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Osteotomy of dorsally displaced malunited fractures of the distal radius: no loss of radiographic correction during healing with a minimally invasive fixation technique and an injectable bone substitute.
- 2008
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3682 .- 1745-3674. ; 79:2, s. 262-268
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: Malunion after a distal radius fracture can be treated with an osteotomy of the distal radius. Often autologous iliac crest bone graft is used to fill the gap, but this is associated with donor site morbidity. Instead of bone graft, we have used a slow-resorbing bone substitute in combination with a minimally invasive fixation technique. PATIENTS AND METHODS: 25 consecutive patients with a dorsal malunion after a distal radius fracture underwent an osteotomy. A TriMed buttress pin and a radial pin plate were used for fixation, and Norian SRS as bone substitute. The patients were followed for a minimum of 1 year and range of motion, grip strength, DASH scores, and the radiographic correction were measured. RESULTS: Forearm rotation improved from 137 degrees to 155 degrees , flexion/extension from 102 degrees to 120 degrees , and radioul-nar deviation from 32 degrees to 43 degrees . Grip strength increased from 62% of the contralateral hand to 82%. DASH scores decreased from 36 to 23. Radiographically, all osteotomies but 1 healed and the radiographic correction achieved was consistent over the first year. INTERPRETATION: Osteotomy of the distal radius is effective in increasing motion and grip strength after a malunited distal radial fracture. Patient satisfaction is high and subjective results measured with DASH are good. Using a bone substitute, the operation can be performed as an outpatient procedure and donor-site pain avoided. No loss of the radiographic correction achieved was noted during osteotomy healing.
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| 38. |
- Abul-Kasim, Kasim, et al.
(författare)
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The rate of screw misplacement in segmental pedicle screw fixation in adolescent idiopathic scoliosis.
- 2011
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3682 .- 1745-3674. ; 82, s. 50-55
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose There are no reports in the literature on the influence of learning on the pedicle screw insertion. We studied the effect of learning on the rate of screw misplacement in patients with adolescent idiopathic scoliosis treated with segmental pedicle screw fixation. Method We retrospectively evaluated low-dose spine computed tomography of 116 consecutive patients (aged 16 (12-24) years, 94 females) who were operated during 4 periods over 2005-2009 (group 1: patients operated autumn 2005-2006; group 2: 2007; group 3: 2008; and group 4: 2009). 5 types of misplacement were recorded: medial cortical perforation, lateral cortical perforation, anterior cortical perforation of the vertebral body, endplate perforation, and perforation of the neural foramen. Reslts 2,201 pedicle screws were evaluated, with an average of 19 screws per patient. The rate of screw misplacement for the whole study was 14%. The rate of lateral and medial cortical perforation was 7% and 5%. There was an inverse correlation between the occurrence of misplacement and the patient number, i.e. the date of operation (r = -0.35; p < 0.001). The skillfulness of screw insertion improved with reduction of the rate of screw misplacement from 20% in 2005-2006 to 11% in 2009, with a breakpoint at the end of the first study period (34 patients). Interpretation We found a substantial learning curve; cumulative experience may have contributed to continued reduction of misplacement rate.
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| 39. |
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| 40. |
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| 41. |
- Adolfsson, Lars, et al.
(författare)
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Elbow hemiarthroplasty for acute reconstruction of intraarticular distal humerus fractures : A preliminary report involving 4 patients
- 2006
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682. ; 77:5, s. 785-787
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Tidskriftsartikel (refereegranskat)abstract
- We treated 4 female patients (mean age 80) with complex intraarticular acute fracture of the distal humerus with a Kudo humeral component, i.e. a hemiarthroplasty. All fractures were considered impossible to treat with open reduction and internal fixation. At mean 10 (3-14) months, 3 patients had an excellent result and 1 a good result according to the Mayo elbow performance score. We conclude that a hemiarthroplasty may be a valuable alternative in eldery patients with complex fractures of the distal humerus. Copyright© Taylor & Francis 2006.
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| 42. |
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| 43. |
- Affas, Fatin, et al.
(författare)
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Pain control after total knee arthroplasty : a randomized trial comparing local infiltration anesthesia and continuous femoral block
- 2011
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Ingår i: Acta Orthopaedica. - New York : Taylor & Francis. - 1745-3674 .- 1745-3682. ; 82:4, s. 441-447
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: Pain after total knee arthroplasty (TKA) is usually severe, and epidural analgesia or femoral nerve block has been considered to be an effective pain treatment. Recently, local infiltration analgesia (LIA) has become increasingly popular but the outcome of this method regarding the analgesic effect has not been fully evaluated. We compared local infiltration analgesia and femoral block with regard to analgesia and morphine demand during the first 24 h after TKA.METHODS: 40 patients undergoing TKA under spinal anesthesia were randomized to receive femoral nerve block (group F) or peri- and intraarticular infiltration analgesia (group LIA) with a mixture containing ropivacaine, ketorolac, and epinephrine. All patients had access to intravenous patient-controlled analgesia (PCA) with morphine postoperatively. Pain intensity at rest and upon movement was assessed on a numeric rating scale (0-10) on an hourly basis over 24 h if the patients were awake.RESULTS: The average pain at rest was marginally lower with LIA (1.6) than with femoral block (2.2). Total morphine consumption per kg was similar between the 2 groups. Ancillary analysis revealed that 1 of 20 patients in the LIA group reported a pain intensity of > 7 upon movement, as compared to 7 out of 19 in the femoral block group (p = 0.04).INTERPRETATION: Both LIA and femoral block provide good analgesia after TKA. LIA may be considered to be superior to femoral block since it is cheaper and easier to perform.
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| 44. |
- Agholme, Fredrik, et al.
(författare)
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Anti-sclerostin antibody and mechanical loading appear to influence metaphyseal bone independently in rats
- 2011
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Ingår i: Acta Orthopaedica. - : Taylor and Francis. - 1745-3674 .- 1745-3682. ; 82:5, s. 628-632
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose: Sclerostin is produced by osteocytes and is an inhibitor of bone formation. Thus, inhibition of sclerostin by a monoclonal antibody increases bone formation and improves fracture repair. Sclerostin expression is upregulated in unloaded bone and is downregulated by loading. We wanted to determine whether an anti-sclerostin antibody would stimulate metaphyseal healing in unloaded bone in a rat model.Methods: 10-week-old male rats (n = 48) were divided into 4 groups, with 12 in each. In 24 rats, the right hind limb was unloaded by paralyzing the calf and thigh muscles with an injection of botulinum toxin A (Botox). 3 days later, all the animals had a steel screw inserted into the right proximal tibia. Starting 3 days after screw insertion, either anti-sclerostin antibody (Scl-Ab) or saline was given twice weekly. The other 24 rats did not receive Botox injections and they were treated with Scl-Ab or saline to serve as normal-loaded controls. Screw pull-out force was measured 4 weeks after insertion, as an indicator of the regenerative response of bone to trauma.Results: Unloading reduced the pull-out force. Scl-Ab treatment increased the pull-out force, with or without unloading. The response to the antibody was similar in both groups, and no statistically significant relationship was found between unloading and antibody treatment. The cancellous bone at a distance from the screw showed changes in bone volume fraction that followed the same pattern as the pull-out force.Interpretation: Scl-Ab increases bone formation and screwfixation to a similar degree in loaded and unloaded bone.
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| 45. |
- Agholme, Fredrik, et al.
(författare)
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Wnt signaling and orthopedics, an overview
- 2011
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Ingår i: ACTA ORTHOPAEDICA. - : Informa Healthcare. - 1745-3674 .- 1745-3682. ; 82:2, s. 125-130
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Tidskriftsartikel (refereegranskat)abstract
- Wnt signaling is a ubiquitous system for intercellular communication, with multiple functions during development and in homeostasis of the body. It comprises several ligands, receptors, and inhibitors. Some molecules, such as sclerostin, appear to have bone-specific functions, and can be targeted by potential drugs. Now, ongoing clinical trials are testing these drugs as treatments for osteoporosis. Animal studies have also suggested that these drugs can accelerate fracture healing and implant fixation. This brief overview focuses on currently available information on the effects of manipulations of Wnt signaling on bone healing.
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| 46. |
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| 47. |
- Ali, Abdulemir, et al.
(författare)
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Dissatisfied patients after total knee arthroplasty
- 2014
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682. ; 85:3, s. 229-233
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose - In 2003, an enquiry by the Swedish Knee Arthroplasty Register (SKAR) 2-7 years after total knee arthroplasty (TKA) revealed patients who were dissatisfied with the outcome of their surgery but who had not been revised. 6 years later, we examined the dissatisfied patients in one Swedish county and a matched group of very satisfied patients. Patients and methods - 118 TKAs in 114 patients, all of whom had had their surgery between 1996 and 2001, were examined in 2009-2010. 55 patients (with 58 TKAs) had stated in 2003 that they were dissatisfied with their knees and 59 (with 60 TKAs) had stated that they were very satisfied with their knees. The patients were examined clinically and radiographically, and performed functional tests consisting of the 6-minute walk and chair-stand test. All the patients filled out a visual analog scale (VAS, 0-100 mm) regarding knee pain and also the Hospital and Anxiety and Depression scale (HAD). Results - Mean VAS score for knee pain differed by 30 mm in favor of the very satisfied group (p < 0.001). 23 of the 55 patients in the dissatisfied group and 6 of 59 patients in the very satisfied group suffered from anxiety and/or depression (p = 0.001). Mean range of motion was 11 degrees better in the very satisfied group (p < 0.001). The groups were similar with regard to clinical examination, physical performance testing, and radiography. Interpretation - The patients who reported poor response after TKA continued to be unhappy after 8-13 years, as demonstrated by VAS pain and HAD, despite the absence of a discernible objective reason for revision.
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| 48. |
- Ali, Abdulemir, et al.
(författare)
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Doubtful effect of continuous intraarticular analgesia after total knee arthroplasty.
- 2015
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3682 .- 1745-3674. ; 86:3, s. 373-377
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose - Local infiltration analgesia (LIA) is well established for effective postoperative pain relief in total knee arthroplasty (TKA). To prolong the effect of LIA, infusion pumps with local intraarticular analgesia can be used. We evaluated the effect of such an infusion pump for the first 48 h postoperatively regarding pain, knee function, length of stay (LOS) in hospital, and complications. Patients and methods - 200 patients received peroperative LIA and a continuous intraarticular elastomeric infusion pump set at 2 mL/h. The patients were randomized either to ropivacaine (7.5 mg/mL) or to NaCl (9 mg/mL) in the pump. Visual analog scale (VAS) pain (0-100 mm), analgesic consumption, side effects of medicine, range of motion (ROM), leg-raising ability, LOS, and complications during the first 3 months were recorded. Results - On the first postoperative day, the ropivacaine group had lower VAS pain (33 vs. 40 at 12 noon and 36 vs. 43 at 8 p.m.; p = 0.02 and 0.03, respectively), but after that all recorded variables were similar between the groups. During the first 3 months, the ropivacaine group had a greater number of superficial and deep surgical wound infections (11 patients vs. 2 patients, p = 0.02). There were no other statistically significant differences between the groups. Interpretation - Continuous intraarticular analgesia (CIAA) with ropivacaine after TKA has no relevant clinical effect on VAS pain and does not affect LOS, analgesic consumption, ROM, or leg-raising ability. There may, however, be a higher risk of wound-healing complications including deep infections.
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| 49. |
- Ali, Abdulemir, et al.
(författare)
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Similar patient-reported outcomes and performance after total knee arthroplasty with or without patellar resurfacing : A randomized study of 74 patients with 6 years of follow-up
- 2016
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Ingår i: Acta Orthopaedica. - : Informa UK Limited. - 1745-3674 .- 1745-3682. ; 87:3, s. 274-279
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose — Knee pain after total knee arthroplasty (TKA) is not uncommon. Patellar retention in TKA is one cause of postoperative knee pain, and may lead to secondary addition of a patellar component. Patellar resurfacing in TKA is controversial. Its use ranges from 2% to 90% worldwide. In this randomized study, we compared the outcome after patellar resurfacing and after no resurfacing. Patients and methods — We performed a prospective, randomized study of 74 patients with primary osteoarthritis who underwent a Triathlon CR TKA. The patients were randomized to either patellar resurfacing or no resurfacing. They filled out the VAS pain score and KOOS questionnaires preoperatively, and VAS pain, KOOS, and patient satisfaction 3, 12, and 72 months postoperatively. Physical performance tests were performed preoperatively and 3 months postoperatively. Results — We found similar scores for VAS pain, patient satisfaction, and KOOS 5 subscales at 3, 12, and 72 months postoperatively in the 2 groups. Physical performance tests 3 months postoperatively were also similar in the 2 groups. No secondary resurfacing was performed in the group with no resurfacing during the first 72 months Interpretation — Patellar resurfacing in primary Triathlon CR TKA is of no advantage regarding pain, physical performance, KOOS 5 subscales, or patient satisfaction compared to no resurfacing. None of the patients were reoperated with secondary addition of a patellar component within 6 years. According to these results, routine patellar resurfacing in primary Triathlon TKA appears to be unnecessary.
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| 50. |
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