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- Abbott, Allan
(författare)
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Evidence base and future research directions in the management of low back pain
- 2016
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Ingår i: World Journal of Orthopedics. - Pleasanton, CA, USA : Baishideng Publishing Group Inc. - 2218-5836. ; 7:3, s. 156-161
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Tidskriftsartikel (refereegranskat)abstract
- Low back pain (LBP) is a prevalent and costly condition. Awareness of valid and reliable patient history taking, physical examination and clinical testing is important for diagnostic accuracy. Stratified care which targets treatment to patient subgroups based on key characteristics is reliant upon accurate diagnostics. Models of stratified care that can potentially improve treatment effects include prognostic risk profiling for persistent LBP, likely response to specific treatment based on clinical prediction models or suspected underlying causal mechanisms. The focus of this editorial is to highlight current research status and future directions for LBP diagnostics and stratified care.
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| 4. |
- Mjöberg, Bengt
(författare)
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Hip prosthetic loosening : A very personal review
- 2021
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Ingår i: World journal of orthopedics. - : Baishideng Publishing Group Inc.. - 2218-5836. ; 12:9, s. 629-639
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Tidskriftsartikel (refereegranskat)abstract
- Hip prosthetic loosening is often difficult to detect at an early stage, and there has been uncertainty for a long time as to when the loosening occurs and thus to the basic causes. By comparing different diagnostic methods, we found that loosening is best defined as prosthetic migration and measured by radiostereometric analysis. Convincing evidence indicates that poor interlock, poor bone quality, and resorption of a necrotic bone bed may initiate loosening during or shortly after surgery; this forms the basis of the theory of early loosening. Biomechanical factors do affect the subsequent progression of loosening, which may increase subclinically during a long period of time. Eventually, the loosening may be detected on standard radiographs and may be interpreted as late loosening but should to be interpreted as late detection of loosening. The theory of early loosening explains the rapid early migration, the development of periprosthetic osteolysis and granulomas, the causality between wear and loosening, and largely the epidemiology of clinical failure of hip prostheses. Aspects discussed are definition of loosening, the pattern of early migration, the choice of migration threshold, the current understanding of loosening, a less exothermic bone cement, cemented taper-slip stems, a new exciting computed tomography-based technique for simpler implant migration studies, and research suggestions.
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| 5. |
- Mjöberg, Bengt
(författare)
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Hip prosthetic loosening and periprosthetic osteolysis : A commentary
- 2022
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Ingår i: World journal of orthopedics. - : Baishideng Publishing Group Inc.. - 2218-5836. ; 13:6, s. 574-577
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Forskningsöversikt (refereegranskat)abstract
- Prosthetic loosening and periprosthetic osteolysis have been debated for decades, both in terms of the timing and nature of the triggering events. The hypothesis of wear-particle-induced loosening states that wear particles cause a foreign-body response leading to periprosthetic osteolysis and ultimately to late prosthetic loosening, i.e., that the osteolysis precedes the loosening. The theory of early loosening, on the other hand, postulates that the loosening is already initiated during or shortly after surgery, i.e., that the osteolysis is secondary to the loosening. This commentary focuses on the causal relationship between prosthetic loosening and periprosthetic osteolysis.
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| 7. |
- Petersson, Martin, et al.
(författare)
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Lumbar interspinous pressure pain threshold values for healthy young men and women and the effect of prolonged fully flexed lumbar sitting posture : An observational study
- 2020
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Ingår i: World Journal of Orthopedics. - Pleasanton, CA, United States : Baishideng Publishing Group Co., Limited. - 2218-5836. ; 11:3, s. 158-166
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUNDLow back pain (LBP) is a common condition with large burden worldwide. Exposure to prolonged sitting with a flexed lumbar posture has been suggested in the literature to be a potential risk factor for self-reported LBP. No study has previously investigated whether exposure to prolonged flexed sitting posture provokes discomfort/pain and decreased interspinous pressure pain thresholds for healthy young men and women without back pain, despite this being a suggested risk factor for LBP.AIMTo investigate whether sitting in a prolonged flexed lumbar posture provokes discomfort and lowers interspinous pressure pain thresholds in the lumbar spine for healthy young men and women without previous LBP.METHODSThis is a an observational before and after study of 26 participants (13 men, 13 women) between 20-35 years old. Algometry was used to examine the pain threshold for pressure applied between spinous processes of the lumbar spine L1-L5. Pressure algometer measures were performed in prone before and after participants were instructed to sit in a fully flexed posture for a maximum of 15 min or until discomfort was experienced in the low back (Borg CR10 = 7/10). Wilcoxon signed-rank test was used for analyze values from the before and after test conditions. Mann-Whitney U test was used to investigate potential gender difference.RESULTSFully flexed lumbar spine sitting posture up to 15 min provoked temporary discomfort but the proportion of participants experiencing discomfort 7/10 in the low back was 62%. For all pain pressure threshold locations tested, there was a significant difference for the study population with moderate-large decreased (r = -0.56) pressure pain threshold after exposure to prolonged flexed sitting posture (P < 0.01). Comparisons between gender did not show any significant difference.CONCLUSIONThe result showed that exposure to fully flexed lumbar sitting posture for up to 15 min produced temporary discomfort in the low back in young healthy adults with no previous history of LBP and significantly reduced lumbar interspinous pressure pain thresholds. No gender-based differences were observed.
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| 8. |
- Prowse, Ashleigh, et al.
(författare)
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Reliability and concurrent validity of postural asymmetry measurement in adolescent idiopathic scoliosis.
- 2017
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Ingår i: World Journal of Orthopedics. - : Baishideng Publishing Group Co., Limited. - 2218-5836. ; 8:1, s. 68-76
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To investigate the reliability and concurrent validity of the Baseline(®) Body Level/Scoliosis meter for adolescent idiopathic scoliosis postural assessment in three anatomical planes.METHODS: This is an observational reliability and concurrent validity study of adolescent referrals to the Orthopaedic department for scoliosis screening at Karolinska University Hospital, Stockholm, Sweden between March-May 2012. A total of 31 adolescents with idiopathic scoliosis (13.6 ± 0.6 years old) of mild-moderate curvatures (25° ± 12°) were consecutively recruited. Measurement of cervical, thoracic and lumbar curvatures, pelvic and shoulder tilt, and axial thoracic rotation (ATR) were performed by two trained physiotherapists in one day. The intraclass correlation coefficient (ICC) was used to determine the inter-examiner reliability (ICC2,1) and the intra-rater reliability (ICC3,3) of the Baseline(®) Body Level/Scoliosis meter. Spearman's correlation analyses were used to estimate concurrent validity between the Baseline(®) Body Level/Scoliosis meter and Gold Standard Cobb angles from radiographs and the Orthopaedic Systems Inc. Scoliometer.RESULTS: There was excellent reliability between examiners for thoracic kyphosis (ICC2,1 = 0.94), ATR (ICC2,1 = 0.92) and lumbar lordosis (ICC2,1 = 0.79). There was adequate reliability between examiners for cervical lordosis (ICC2,1 = 0.51), however poor reliability for pelvic and shoulder tilt. Both devices were reproducible in the measurement of ATR when repeated by one examiner (ICC3,3 0.98-1.00). The device had a good correlation with the Scoliometer (rho = 0.78). When compared with Cobb angle from radiographs, there was a moderate correlation for ATR (rho = 0.627).CONCLUSION: The Baseline(®) Body Level/Scoliosis meter provides reliable transverse and sagittal cervical, thoracic and lumbar measurements and valid transverse plan measurements of mild-moderate scoliosis deformity.
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