| 1. |
- 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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| 2. |
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| 3. |
- Axelsson, Paul, et al.
(författare)
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Posterolateral lumbar fusion. Outcome of 71 consecutive operations after 4 (2-7) years
- 1994
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Ingår i: Acta Orthopaedica Scandinavica. - 0001-6470. ; 65:3, s. 14-309
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Tidskriftsartikel (refereegranskat)abstract
- We report the outcome of 71 consecutive posterolateral lumbar fusions without spinal instrumentation. The indication for the operation was spondylolysis-olisthesis, degenerative disc disease/facet joint arthrosis, or pain after prior laminectomy. Concerning pain relief, 29/43 patients with spondylolysis-olisthesis were classified as good. The corresponding figures in the group with degenerative disc disease and/or facet joint arthrosis were 8/16 patients and in the group with pain post-laminectomy, 6/12 patients. No surgical complications were noted. In the total material 54 patients had a solid fusion, as defined by radiographic osseous trabecular bridging at all intended levels. One-level fusions tended to heal solidly in a higher frequency than two-level fusions. For the spondylolysis-olisthesis group, healed fusion correlated with a good clinical result. Such a correlation could not be verified for the other diagnostic groups. We conclude that non-instrumented posterolateral lumbar fusion is a valid method for treating low-grade spondylolysis-olisthesis, especially when the aim is to fuse a single level. Improved patient selection methods are required in fusion for degenerative disc disease and pain after laminectomy.
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| 4. |
- Bergenudd, H, et al.
(författare)
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The articular cartilage after osteotomy for medial gonarthrosis. Biopsies after 2 years in 19 cases
- 1992
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Ingår i: Acta Orthopaedica Scandinavica. - 0001-6470. ; 63:4, s. 413-416
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Tidskriftsartikel (refereegranskat)abstract
- In 19 consecutive patients with medial gonarthrosis, an arthroscopic examination with a biopsy of the load-bearing cartilage in the medial femoral condyle was undertaken at the same time as a proximal tibial osteotomy. A follow-up arthroscopic biopsy was performed on an average of 2 years after the osteotomy. In 9 knees there was an improvement in the cartilage quality, 8 knees were unchanged, whereas 2 knees had deteriorated. Radiographically, 6 knees had improved, 11 were unchanged and 2 had deteriorated. We found no correlation between cartilage improvement and the clinical and radiographic outcome. Our results confirm that an osteotomy has a beneficial effect on the load-bearing cartilage in the medial femoral condyle.
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| 5. |
- 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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| 6. |
- Flivik, Gunnar, et al.
(författare)
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Fracture of the tibial tray of the PCA knee. A case report of early failure caused by improper design
- 1990
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Ingår i: Acta Orthopaedica Scandinavica. - : Medical Journals Sweden AB. - 0001-6470. ; 61:1, s. 26-28
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Tidskriftsartikel (refereegranskat)abstract
- Knee prostheses with metal backing of the polyethylene tibial component are nowadays used almost universally. Eight cases of fracture of the metal tray are reported in the literature. We present a case in which the failure could be expected because of improper design of the tibial tray.
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| 7. |
- Franzén, Hans, et al.
(författare)
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Bony atrophy after mega total hip replacement for bone tumors.
- 1994
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Ingår i: Acta Orthopaedica Scandinavica. - : Medical Journals Sweden AB. - 0001-6470. ; 65:5, s. 6-513
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Tidskriftsartikel (refereegranskat)abstract
- We followed 11 patients 3-15 years after a cemented mega total hip replacement for a proximal femoral bone tumor. 7/8 survivors had good function and only occasional pain. 1 hip had been revised because of deep infection and in 1 case the cup had been exchanged because of aseptic loosening. 2 patients had been operated on because of local recurrence of the tumor. At follow-up, 1 patient had radiographic signs of loosening of the stem after 7 years. There was in 8 cases a pronounced athropy of the femoral cortical bone, not correlated to loosening of the stem.
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| 8. |
- Jonsson, Brynjolfur, et al.
(författare)
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Function 10 years after hip fracture. 74 patients after internal fixation
- 1993
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Ingår i: Acta Orthopaedica Scandinavica. - : Medical Journals Sweden AB. - 0001-6470. ; 64:6, s. 645-646
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Tidskriftsartikel (refereegranskat)abstract
- We examined the physical and social function of patients surviving 10 years after internal fixation of a hip fracture. 74 out of 362 patients were alive 10 years after their fracture. In 47 survivors after cervical fracture, secondary hip arthroplasties had been performed in 25, and nails had been extracted in 13. The implants had been removed in 8 of 27 with trochanteric fracture. 58 survivors were interviewed; three fourths were still living in their own homes, with more than half needing no home assistance. However, limitation of activities, caused by the fracture, was experienced by more than one third of the survivors.
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| 9. |
- Josefsson, Per Olof, et al.
(författare)
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Closed treatment of Jones fracture. Good results in 40 cases after 11-26 years
- 1994
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Ingår i: Acta Orthopaedica Scandinavica. - : Medical Journals Sweden AB. - 0001-6470. ; 65:5, s. 545-547
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Tidskriftsartikel (refereegranskat)abstract
- 40 patients with transversal or short oblique fractures of the proximal shaft of the fifth metatarsal bone (Jones fracture) were treated with full weight bearing with or without elastic bandage in 39 cases and plaster cast immobilization in one. 24 cases were acute traumatic fractures, 14 stress fractures and 2 refractures. After 17 (11-26) years, 33 of the fractures had healed primarily, evidence of refracture or delayed union was found in 7 and there were no non-unions. All but one of the patients were free of symptoms.
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| 10. |
- Karlsson, M K, et al.
(författare)
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Bone mineral loss after lower extremity trauma. 62 cases followed for 15-38 years
- 1993
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Ingår i: Acta Orthopaedica Scandinavica. - : Medical Journals Sweden AB. - 0001-6470. ; 64:3, s. 4-362
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Tidskriftsartikel (refereegranskat)abstract
- 62 former patients, who had been treated at our department for tibial shaft fracture (n 38) or knee ligament injury (n 24) 15-38 years earlier, were re-evaluated for post-traumatic osteopenia. 62 age- and sex-matched subjects without fracture served as controls. By means of a Lunar DEXA apparatus we measured the bone mineral density (BMD) in the total body, the hips and special regions of interest (ROI) in the lower extremities. We found a difference in the BMD between the injured and uninjured legs, most obvious in the femur condyle. Measurements of bone mineral loss early after the injury did not correlate with the present late measurements. The former fracture patients had at the time of follow-up the same BMD in the rest of their bodies as a whole, compared with controls. We conclude that post-traumatic osteopenia is still evident in the injured leg decades after the injury.
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| 11. |
- 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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| 12. |
- 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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| 13. |
- 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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| 14. |
- 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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| 15. |
- 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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| 16. |
- 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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| 17. |
- 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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| 18. |
- Nordqvist, Anders, et al.
(författare)
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The natural course of lateral clavicle fracture. 15 (11-21) year follow-up of 110 cases
- 1993
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Ingår i: Acta Orthopaedica Scandinavica. - : Medical Journals Sweden AB. - 0001-6470. ; 64:1, s. 87-91
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Tidskriftsartikel (refereegranskat)abstract
- 110 patients with non-operated on fracture of the lateral end of the clavicle were reviewed on an average 15 years after the injury. There were 73 undislocated Neer Type I fractures, 23 dislocated Type II fractures and 14 intraarticular Type III fractures. The patients' age at trauma was 36 (2-71) years. At follow-up 95 shoulders were asymptomatic. 15 shoulders had moderate pain and dysfunction and were rated fair; no patient had severe, residual shoulder disability. There were 10 nonunions, 8 of these asymptomatic. We conclude that fracture of the lateral end of the clavicle does not require operation.
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| 19. |
- 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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| 20. |
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| 21. |
- Sanfridson, Jan, et al.
(författare)
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Why is congenital dislocation of the hip still missed? Analysis of 96,891 infants screened in Malmo 1956-1987
- 1991
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Ingår i: Acta Orthopaedica Scandinavica. - : Medical Journals Sweden AB. - 0001-6470. ; 62:2, s. 87-91
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Tidskriftsartikel (refereegranskat)abstract
- During 1956 through 1987, 96,891 children have been screened for neonatal hip instability according to the tests of Ortolani and Barlow. In 1956 through 1972 only 4/58, 759 (0.07 permille) were missed, whereas during 1980 through 1987, 12/19, 398 (0.6 permille) were missed. This increase is not caused by any formal alteration of the screening programme. The screening has prevented a late diagnosis in all children born in breech presentation and in all boys except one. General factors such as female sex and joint laxity imply an increased risk for being missed in the screening, whereas mechanical factors such as breech presentation and the primogeniture effect likely facilitate an early diagnosis in the screening. The time between birth and the first examination is also of some importance.
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| 22. |
- Sernbo, Ingmar, et al.
(författare)
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Radiographic prediction of failure after fixation of cervical hip fracture
- 1994
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Ingår i: Acta Orthopaedica Scandinavica. - : Medical Journals Sweden AB. - 0001-6470. ; 65:3, s. 295-298
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Tidskriftsartikel (refereegranskat)abstract
- During 1984-1985, 410 patients with cervical hip fracture were randomized between 2 methods of internal fixation--a single nail (Rydell) or 2 LIH hook pins (LIH). The patients were followed-up prospectively for at least 2 years. Radiographs were taken after 1 week, 1, 3, 6, 12, and 24 months. The radiographs of the 295 patients alive 2 years postoperatively were examined by one of the authors. The sliding and the diversion of the pins and the nail in the anteroposterior projection and the diversion in the lateral projection were measured. In the failure group (non-union, late segmental collapse), the greatest sliding was noted within 1 month postoperatively and the diversion increased up to 3 months. Significant differences between the failure and the non-failure groups could be seen even after 1 week. We also found that the degree of sliding of the LIH pins and the Rydell nail 1 month postoperatively is comparable to the scintigraphic pattern 2 weeks postoperatively in predicting failure after internal fixation of cervical hip fractures.
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| 23. |
- Serre, Claire M, et al.
(författare)
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Osseointegration of titanium implants in the tibia. Electron microscopy of biopsies from 4 patients
- 1994
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Ingår i: Acta Orthopaedica Scandinavica. - : Medical Journals Sweden AB. - 0001-6470. ; 65:3, s. 323-327
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Tidskriftsartikel (refereegranskat)abstract
- We studied the ultrastructure of bone tissue around implants of pure titanium inserted into the tibia in 4 patients with arthrosis or rheumatoid arthritis. Three main appearances of the interface were noted. First, a close contact between titanium and calcified bone with living osteocytes inside the newly-formed bone was observed in all samples. Secondly, a close contact was also seen between the implant and osteoid, the newly formed collagenous matrix being either uncalcified or calcifying. Thirdly, a loose extracellular matrix with fibrillar and nonfibrillar materials was sometimes observed between bone mineral and implant. There was no inflammatory reaction at the interface. We concluded that the titanium implants were osseointegrated, but the calcification of the bone tissue was not complete even after 20 months. However, mineralization of osteoid and living bone cells revealed the presence of an active tissue.
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| 24. |
- Åkesson, Kristina, et al.
(författare)
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Periarticular bone in rheumatoid arthritis versus arthrosis. Histomorphometry in 103 hip biopsies
- 1994
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Ingår i: Acta Orthopaedica Scandinavica. - : Medical Journals Sweden AB. - 0001-6470. ; 65:2, s. 135-138
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Tidskriftsartikel (refereegranskat)abstract
- Histomorphologic differences of the periarticular bone in rheumatoid arthritis (RA) and osteoarthrosis (OA) may be of importance for long-term prosthetic fixation. We have evaluated bone specimens, obtained during total hip replacement from an acetabular and a femoral biopsy site, in 42 RA-hips and 61 OA-hips. In both groups the bone turnover was increased in the acetabulum compared to that in the femur. In the acetabulums the total trabecular bone volume was equal, but osteoid volume, osteoid surface, resorptive surface, and the appositional rate were increased in RA. On the femoral side, only the osteoid volume was higher in RA. The increased bone turnover with a greater amount of unmineralized tissue, as well as resorptive activity in the acetabulum, may be of importance for the higher rate of acetabular component migration and loosening after total hip replacement in RA.
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| 25. |
- Önsten, Ingemar, et al.
(författare)
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Periarticular bone mineral content in rheumatoid arthritis and arthrosis of the hip. Dual photon X-ray absorptiometry in 53 cases
- 1993
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Ingår i: Acta Orthopaedica Scandinavica. - : Medical Journals Sweden AB. - 0001-6470. ; 64:5, s. 530-532
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Tidskriftsartikel (refereegranskat)abstract
- The bone mineral content (BMC) was determined by dual photon X-ray absorptiometry prior to hip replacement in 22 patients with rheumatoid arthritis and 31 with arthrosis. Compared with the arthrosis patients, the rheumatoids had approximately 20 percent lower bone mineral content in the proximal femur, the lumbar spine, and in the innominate bone superior to the acetabulum.
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