| 1. |
- Iwase, Toshiki, et al.
(författare)
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The ScanHip total hip arthroplasty: radiographic assessment of 72 hips after 10 years.
- 2002
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Ingår i: Acta Orthopaedica Scandinavica. - : Medical Journals Sweden AB. - 0001-6470. ; 73:1, s. 54-59
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Tidskriftsartikel (refereegranskat)abstract
- We analyzed the radiographic and clinical outcome of the ScanHip total hip arthroplasty in 70 patients after 10 years. The Swedish National Hip Register, in which the end-point of the survival analysis is defined as revisions, reported a 10-year survival rate of 94% with the ScanHip, but in the present series 13% of the femoral stems and 29% of the sockets met the criteria for aseptic loosening. Focal osteolysis was found around 8 sockets (11%) and 23 stems (32%) and had occurred significantly oftener around loose sockets, but not around femoral stems. Linear polyethylene wear was significantly increased in loose sockets, but no relationship was noted between polyethylene wear and stem loosening or was there a correlation between clinical symptoms or patients' satisfaction and component loosening. Therefore precise serial long-term radiographic follow-up is the only satisfactory method for detecting aseptic loosening of total hip arthroplasty. It gives the surgeon more detailed information about each case than survival analysis alone.
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| 2. |
- Wingstrand, I, et al.
(författare)
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Total hip replacement with second generation cementing technique and the monobloc ScanHip: a 10-year follow-up
- 2002
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Ingår i: International Orthopaedics. - : Springer Science and Business Media LLC. - 1432-5195 .- 0341-2695. ; 26:2, s. 69-71
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Tidskriftsartikel (refereegranskat)abstract
- In 230 consecutive patients 244 hips were operated with a 32-mm cemented prosthesis. The mean age at surgery was 77 (46-96) years. At the 10-year follow-up 89 patients (95 hips) were dead and 33 patients (35 hips) did not attend because of old age or medical problems. Thirteen hips had been revised for aseptic loosening, two for infection, one for recurrent dislocations, and one for fracture. Four hips were found to be loose and seven had suspected radiographic loosening zones but only minor clinical symptoms. No or little limp was experienced by 52% of patients and 62% reported no or little pain. Eighty-seven percent were satisfied with the early postoperative result and 77% were still content at the time of follow-up. On the 10-year radiographs wear of the cups was, on average, 2.2 mm in loose hips and 1.5 mm in intact hips (P=0.02). There was no correlation between dissatisfaction and loosening visible by X-ray at follow-up.
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| 3. |
- Cserhati, P, et al.
(författare)
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Hip fractures in Hungary and Sweden - differences in treatment and rehabilitation
- 2002
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Ingår i: International Orthopaedics. - : Springer Science and Business Media LLC. - 1432-5195 .- 0341-2695. ; 26:4, s. 222-228
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Tidskriftsartikel (refereegranskat)abstract
- Data of 1,337 consecutive hip fracture patients were registered during I year within a prospective comparative multicenter study comparing osteosynthesis techniques and rehabilitation results in Budapest, Hungary, in Sundsvall, northern Sweden, and in Lund, southern Sweden. In Budapest the mean age was 4-5 years lower than in Sweden, and more patients lived in their own home (91% versus 70% and 62%). Less intracapsular (41% versus 54% and 54%) and more trochanteric fractures (52% versus 40% and 35%) were observed in Budapest. Many more Hungarian patients returned home (68% versus 54% and 33%); however, their mortality rate 4 months later significantly exceeded that of the Swedish centres (24% versus 15% and 13%), and more had severe pain in the operated hip (27% versus 17% and 15%). Four months after double nail osteosynthesis of displaced cervical fractures, more patients (28%) had severe hip pain than after hemiarthroplasty (16%) in Budapest as compared to Lund or Sundsvall (19% and 22%). Mortality rate after 4 months following hemiarthroplasty and nailing (36% and 20%) was significantly higher than in the Swedish centres (14% and 11%).
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| 4. |
- Heikkinen, T, et al.
(författare)
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Hemiarthroplasty or osteosynthesis in cervical hip fractures: matched-pair analysis in 892 patients
- 2002
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Ingår i: Archives of Orthopaedic and Trauma Surgery. - : Springer Science and Business Media LLC. - 1434-3916 .- 0936-8051. ; 122:3, s. 143-147
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Tidskriftsartikel (refereegranskat)abstract
- Our aim was to compare hemiarthroplasty (HA) and osteosynthesis (OS) in the treatment of cervical hip fractures using matched-pair analysis, especially with regard to different age groups. Data concerning all hip fractures (excluding pathological fractures) at the University Hospitals of Lund in Sweden, where osteosynthesis with LIH hook-pins was used exclusively, and of Oulu in Finland, using mainly cementless Austin-Moore hemiarthroplasty, were registered during 1989-1996 using the same standardized hip fracture forms filled in preoperatively and at 4 months follow-up. Altogether 446 pairs matched for age, sex, place of residence and walking ability at the time of fracture were found. Patients aged 55-80 years seemed to benefit more, with regard to function, from OS than older patients. At 4 months follow-up, 38% of HA and 48% of OS patients lived in their own homes, 16% and 27% were able to walk alone outdoors, and 11% versus 16% were able to walk without any aids, respectively. At I year follow-up, mortality was significantly lower among the OS patients, but the reoperation rate was significantly higher. In conclusion, OS is associated with a better function and lower mortality than HA, especially in younger patients, and it is recommended as the primary treatment for cervical hip fractures in patients younger than 80 years and with good ambulatory capacity, whereas the oldest patients can also be safely treated by HA.
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| 5. |
- Kesteris, Uldis, et al.
(författare)
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Contamination of polyethylene cups with polymethyl methacrylate particles: an experimental study
- 2001
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Ingår i: Journal of Arthroplasty. - : Elsevier BV. - 0883-5403. ; 16:7, s. 905-908
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Tidskriftsartikel (refereegranskat)abstract
- The articulating surfaces of 6 ultra-high molecular weight polyethylene cups were exposed to curing polymethyl methacrylate (PMMA) bone-cement and examined with scanning electron microscopy and laser ablation inductively coupled plasma mass spectrometry (LA-ICPMS). Three of the cups were exposed to blood and bone-cement, and the rest were exposed to bone-cement only. After removal of the bone-cement bulk, PMMA particles were found and identified in all 6 cups. The particles were verified by identifying zirconium with energy-dispersive x-ray fluorescence spectroscopy in 5 cups and with LA-ICPMS in 1 cup. The degree of surface contamination was estimated with LA-ICPMS. The number of zirconium-containing particles detected was on average 10 to 20/mm2. PMMA bone-cement left in polyethylene cups during polymerization can contaminate the articulating surface with adherent PMMA particles.
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| 6. |
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| 7. |
- Laurell, L, et al.
(författare)
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Capsular distance in the hip of the healthy child - normal values with sonography and MR imaging.
- 2002
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Ingår i: Acta Radiologica. - : SAGE Publications. - 1600-0455 .- 0284-1851. ; 43:2, s. 213-216
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To determine the normal values of the anterior and posterior capsular distances of the hip joint in healthy children by means of US, using MR imaging as reference, and to evaluate any possible correlation between age, length, weight and anterior capsular distance (ACD). MATERIAL AND METHODS: In our first study both hips in 14 healthy children (5-18 years old) were examined with US and MR to obtain measurements of the ACD and the posterior capsular distance (PCD). The distance from the anterior or posterior aspect of the femoral neck to the anterior or posterior aspect, respectively, of the outer limit of the capsule was determined. The distances were measured both with the hips in spontaneous external rotation of 10-15 degrees and in internal rotation of 45 degrees. In our second study, both hips in 28 healthy children (3-16 years old) were examined with US to determine the ACD. Age, length and weight were recorded. RESULTS: Study I: There was good correlation between the US and MR measurements in all positions. The ACD measured by US was significantly increased in inward rotation of the hip. Study II: There was no correlation between ACD and age, length or weight. CONCLUSION: The PCD of the hip joint can be accurately measured by US with the hip in internal rotation of 45 degrees. When compared with MR values, the ACD measured by US was dependent on the degree of rotation of the leg and increased significantly in internal rotation. Because the outer limit of the external layer of the joint capsule is sonographically more distinct, we suggest that the capsular distance should be measured from the outer limit of the joint capsule to the anterior or posterior aspect of the femoral neck. The measurement should be made perpendicular to the femoral neck, at the position where the greatest numerical value is obtained.
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| 8. |
- Partanen, J, et al.
(författare)
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Functional outcome after displaced femoral neck fractures treated with osteosynthesis or hemiarthroplasty - A matched-pair study of 714 patients
- 2002
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Ingår i: Acta Orthopaedica Scandinavica. - 0001-6470. ; 73:5, s. 496-501
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Tidskriftsartikel (refereegranskat)abstract
- Osteosynthesis (OS) and hemiarthroplasty (RA) are the commonest treatments for displaced cervical hip fractures in the elderly, but there is no consensus as to which is better. In this prospective matched-pair study we compared these methods as regards functional outcome. In 1989-1996, using the same standardized forms, all displaced cervical hip fractures were prospectively registered in the university hospitals of Oulu in Finland and Lund in Sweden. Osteosynthesis was performed in Lund and hemiarthroplasty in Oulu. Cross-matching, done for age, sex, preoperative residence, and ambulatory ability, resulted in 357 pairs of displaced fractures. More OS than HA patients could manage in their own homes or live semi-independently at 4 months after the fracture. OS patients had better ambulatory ability (p = 0.001) and used walking aids less than HA ones (p = 0.001). The reoperation rates at 4 months were the same among HA and OS patients, but at 1 year, OS patients had a higher reoperation rate (17%) than HA ones (9.5%).
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| 9. |
- Thorngren, Karl-Göran, et al.
(författare)
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Epidemiology of femoral neck fractures
- 2002
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Ingår i: Injury. - 1879-0267. ; 33:Suppl 3, s. 1-7
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Tidskriftsartikel (refereegranskat)abstract
- Fractures of the femoral neck, that is, "cervical hip fractures" constitute 53% of all fractures of the proximal femur (hip fractures) according to the Swedish National Hip Fracture Register linked to SAHFE (Standardised Audit of Hip Fractures in Europe). The most reproducible classification system divides cervical hip fractures into undisplaced (33%) and displaced (67%). Hip fractures are common and costly. Due to the expected increase in the number of elderly in the world during the coming decades the number of hip fractures will increase dramatically, particularly in developing countries. In Sweden three quarters of the patients are women, the mean age is now 81 years and half of the patients are living alone. Hip fractures are rare below 50 years of age. In recent years there has been an incidence increase in the oldest patients, i.e. those over 80 years of age. For these elderly, the incidence in Lund, Sweden, increased from 13.2/1000 in 1966 to 25.5/1000 in 1986. The high number of patients with hip fractures and the cost of treatment increases the need for prevention as well as optimization of operative treatment and rehabilitation. National guidelines are being developed in Europe. Linked with national audits like SAHFE they can improve the quality of care by audit and feedback.
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