| 1. |
- Gustafsson, Johan, et al.
(författare)
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MRI of the knee after locked unreamed intramedullary nailing of tibia.
- 2008
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Ingår i: La Chirurgia degli organi di movimento. - : Springer Science and Business Media LLC. - 0009-4749 .- 1973-2538. ; 91:1, s. 45-50
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Tidskriftsartikel (refereegranskat)abstract
- We analysed the reason for knee pain after intramedullary (IM) nailing with standard MRI sequences at a mean of 27 months (range 2-45) after nail removal in eleven patients with a mean age of 30 years (range 15-52). Knee pain was assessed in four grades. All our patients had signal changes of fluid in the nail channel, areas of low signal intensity in Hoffa's fat pad and subcutaneous low signal nodes in front of a thickened patellar ligament. Ten patients had low signal adhesions from the nail insertion towards the patellar ligament. Six patients had severe knee pain and even marked adhesions. Two patients had no knee pain; one of these two had minimal adhesions and the other one no adhesions. Five of the patients had a meniscal tear and/or local cartilage reduction. The degree of adhesions from the nail insertion in the tibia towards the patellar ligament was proportional to the degree of knee pain. No sign of acute inflammation was found.
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| 2. |
- Harding, Anna Kajsa, et al.
(författare)
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A single bisphosphonate infusion does not accelerate fracture healing in high tibial osteotomies.
- 2011
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Ingår i: Acta orthopaedica. - : Medical Journals Sweden AB. - 1745-3682 .- 1745-3674.
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Tidskriftsartikel (refereegranskat)abstract
- Background Bisphosphonates increase the callus size and strength in animal fracture studies. In a human non-randomized pilot study of high tibial osteotomies in knee osteoarthritis, using the hemicallotasis (HCO) technique, bisphosphonates shortened the healing time by 12 days. In the present randomized study, we wanted to determine whether a single infusion of zoledronic acid reduces the time to clinical osteotomy healing. Results from the same trial, showing improved pin fixation with zoledronate, have been published separately. Methods 46 consecutive patients (aged 35-65 years) were operated. At 4 weeks postoperatively, the patients were randomized to an intravenous infusion of either zoledronic acid or sodium chloride. Dual-energy X-ray absorptiometry (DEXA) was performed 10 weeks postoperatively. Radiographs were taken at 10 weeks and every second week until there was radiographic and clinical healing. Healing was evaluated blind, with extraction of the external fixator as the endpoint. At 1.5 years, an additional radiograph was taken and the hip-knee-ankle (HKA) angle measured to evaluate whether correction had been retained. Results All osteotomies healed with no difference in healing time between the groups (77 (SD 7) days). Bone mineral density and bone mineral content, as assessed with DEXA, were similar between the groups. Radiographically, both groups had retained the acquired correction at the 1.5-year follow-up. Interpretation In this randomized comparison, a single infusion of zoledronic acid increased the pin fixation of the external frame but did not shorten the healing time. In both groups, the external fixator was extracted almost 2 weeks earlier than in previous studies. The early extraction did not cause a loss of correction in either group.
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| 3. |
- W-Dahl, Annette, et al.
(författare)
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Infection prophylaxis: a prospective study in 106 patients operated on by tibial osteotomy using the hemicallotasis technique.
- 2006
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Ingår i: Archives of Orthopaedic and Trauma Surgery. - : Springer Science and Business Media LLC. - 1434-3916 .- 0936-8051. ; 126:7, s. 441-447
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Tidskriftsartikel (refereegranskat)abstract
- Introduction Tibial osteotomy by the hemicallotasis technique is a clean elective operation. With external fixation pins inserted, close to the knee joint, the infection prophylaxis should be considered. The primary aim was to investigate the differences in the postoperative use of antibiotics during the time in external fixation between administrating prophylactic antibiotics for 3 days or as a single dose in patients operated on by the hemicallotasis technique for knee deformities. Secondary aims were to study the differences in pin-site infection rate and grade and complications. Material and methods A total of 106 consecutive patients of mean age 52 years (range 18-69) operated on by the hemicallotasis technique for knee deformities were included in this prospective study. Sixty patients were prescribed prophylactic antibiotics for 3 days and 46 patients as a single dose. Chlorhexidine (5 mg/ml) in alcohol (70% ethanol) was used as cleansing agent in the pin-site care. The power of the study was calculated to 80% to detect a difference in the postoperative use of antibiotics for 7 days during the treatment in external fixation. Results There were no differences in postoperative use of antibiotics between 3 days administration or a single dose of prophylactic antibiotics. This was the case with infection rate and grade, positive bacterial cultures, presence of Staphylococcus aureus, nor positive culturing from the tip of the pins at removal. Neither were there any differences in numbers of loose pins and complications. Conclusion There were no differences between 3 days of administration of prophylactic antibiotics and one single dose. One single dose of prophylactic antibiotics is appropriate together with a pin-site concept preventing pin-site infection in patients operated on by hemicallotasis osteotomy.
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| 4. |
- Broberg Palmgren, Karin, et al.
(författare)
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The tumor-associated gene HMGIC is expressed in normal and osteoarthritis-affected synovia
- 2001
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Ingår i: Modern Pathology. - : Elsevier BV. - 1530-0285 .- 0893-3952. ; 14:4, s. 311-317
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Tidskriftsartikel (refereegranskat)abstract
- Chromosomal rearrangements involving chromosome bands 12q13-15 are very frequent findings in benign solid tumors, and recently, the primary molecular target for these aberrations was identified as the gene HMGIC. However, mutations in this gene have also been observed in nonneoplastic tissues. In a previous study, we reported breakpoints within HMGIC of synovia affected by osteoarthritis (OA) in two cases with 12q15 aberrations. To analyze further the role of HMGIC in this disease, we have performed cytogenetic, fluorescent in situ hybridization (FISH), RNA, and protein expression analyses on synovial samples from patients with OA and individuals without signs of the disorder. Cytogenetic analysis of short-term cultured cells revealed clonal 12q13-15 aberrations in 2/36 cases of OA synovia and no rearrangement in any of the five controls. With FISH analysis, it was shown that the chromosomal breakpoints in the two aberrant cases were located outside the HMGIC locus. In contrast, at RNA and protein expression analyses, OA-affected as well as normal synovia displayed transcription and translation of the gene. We also analyzed whether immunoreactivity for HMGIC was associated with the proliferation-specific antigen Ki-67, but no correlation between the staining patterns of these proteins was observed. From the results of the present study, it is evident that expression of HMGIC cannot simply be considered a sign of neoplasia or an effect of proliferation.
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| 5. |
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| 6. |
- Catani, F, et al.
(författare)
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The stability of the cemented tibial component of total knee arthroplasty
- 2004
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Ingår i: Journal of Arthroplasty. - : Elsevier BV. - 0883-5403. ; 19:6, s. 775-782
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Tidskriftsartikel (refereegranskat)abstract
- Micromotion of the tibial component in 40 knee arthroplasties for gonarthrosis was studied rising Roentgen stereophotogrammetric analysis. The stability of this component was assessed for 2 years' postoperatively. in all arthroplasties, an attempt was made to reconstruct the preoperative posterior slope. Posterior cruciate-retaining (CR) and posterior-stabilized (PS) components showed at 2 years a maximum total point motion of 0.6 +/- 0.4 mm and 0.7 +/- 0.5 mm, respectively. Whereas 92.5% of the implants were determined to be stable, 1 of the CR group and 2 of the PS group displayed migration between the first and the second year of at least 0.2 mm. A negative correlation between subsidence of the tibial component at 2 years of follow-up and the difference between preoperative and postoperative tibial slope was found. Consequently, we suggest that restoring the original posterior slope of the tibial plateau must be a goal of tibial component implantation.
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| 7. |
- Hansson, Ulrik, et al.
(författare)
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A randomised RSA study of Peri-apatite((TM)) HA coating of a knee prosthesis
- 2004
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Ingår i: Key Engineering Materials. - 1013-9826. ; 254-2, s. 623-625
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Tidskriftsartikel (refereegranskat)abstract
- Fifty knees scheduled for a total knee prosthesis were randomized in two groups. Both groups had a noncemented fixation of the porous-coated implants but one group received a prosthesis with ceramic coating on the porous surface of the implant. The knees were evaluated with RSA technique regarding micromotion the first two years. There were less micromotion in the coated group. The results indicate that the technique for ceramic coating here studied provides a safe and stable fixation of the implants.
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| 8. |
- Hansson, Ulrik, et al.
(författare)
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Once-weekly oral medication with alendronate does not prevent migration of knee prostheses
- 2009
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3682 .- 1745-3674. ; 80:1, s. 41-45
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose Early migration of joint replacements is an effect of poor fixation and can predict late loosening. By reducing the bone resorption after implantation of a joint replacement, it should be possible to enhance the initial fixation of the implant. We studied the effect of once-weekly treatment with alendronate after knee replacement. Patients and methods We recruited 60 patients (60 knees) with gonarthrosis who were scheduled for a total knee replacement. They were operated on with identical implants and uncemented fixation. 30 patients were treated with a bisphosphonate (alendronate) and 30 patients underwent placebo treatment. The treatment started postoperatively and continued on a weekly basis for 6 months. The fixation of the implants was measured with repeated radiostereometry for 2 years. Results There was no difference in migration of implants between the two groups. Conclusion With uncemented fixation of knee implants, no benefit of once-weekly treatment with alendronate, starting postoperatively, could be seen during a 2-year follow-up period.
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| 9. |
- Harding, Anna Kajsa, et al.
(författare)
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A single dose zoledronic acid enhances pin fixation in high tibial osteotomy using the hemicallotasis technique. A double-blind placebo controlled randomized study in 46 patients.
- 2010
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Ingår i: Bone. - : Elsevier BV. - 1873-2763 .- 8756-3282. ; 46:3, s. 649-654
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Bisphosphonates have been shown to reduce osteoclastic activity and enhance pin fixation in both experimental and clinical studies. In this prospective, randomized study of high tibial osteotomy using the hemicallotasis (HCO) technique, we evaluate whether treatment by one single infusion of zoledronic acid can enhance the pin fixation. MATERIALS AND METHODS: 46 consecutive patients (35-65 years) were operated on for knee osteoarthritis by the HCO technique. After the osteotomy, two hydroxyapatite-coated pins were inserted in the metaphyseal bone and two non-coated pins in the diaphyseal bone. The insertion torque was measured by a torque force screw driver. Four weeks postoperatively, the patients were randomized to either one infusion of zoledronic acid or sodium chloride intravenously. At time for removal of the pins, the extraction torque forces of the pins were measured. RESULTS: All osteotomies healed and no difference was found in time to healing. The mean extraction torque force in the non-coated pins in the diaphyseal bone was doubled in the zoledronic treated group (4.5 Nm, SD 2.1) compared to the placebo group (2.4 (SD 1.0, p<0.0001). The mean extraction torque forces of the hydroxyapatite-coated pins in the metaphyseal bone were similar in the zoledronic acid group (4.7 Nm, SD 1.3) and in the placebo group (4.0 Nm, SD 1.3). DISCUSSION: A single infusion of zoledronic acid improved twofold the fixation of non-coated pins in diaphyseal bone. Bisphosphonates might be an alternative to hydroxyapatite-coated pins in nonosteoporotic bone.
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| 10. |
- Hasan, Shaho, et al.
(författare)
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All-polyethylene versus metal-backed posterior stabilized total knee arthroplasty : similar 2-year results of a randomized radiostereometric analysis study
- 2019
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682. ; 90:6, s. 590-595
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose — The all-polyethylene tibial (APT) component, introduced in the early 1970s, was surpassed by metal-backed tibial (MBT) trays as the first choice for total knee arthroplasty (TKA). With improved polyethylene, the modern APT components can reduce costs, and have shown equivalent results in survivorship and early migration of the cruciate-retaining and cruciate-stabilizing designs. This study compares the 2-year migration of a similarly designed APT-posterior stabilized (PS) and a MBT-PS TKA, using radiostereometric analysis (RSA). Patients and methods — 60 patients were randomized to receive either an APT Triathlon PS or an MBT Triathlon PS TKA (Stryker, NJ, USA). Migration measured by RSA and clinical scores were evaluated at baseline and at 3, 12, and 24 months postoperatively. Repeated measurements were analyzed with a linear mixed model and generalized estimating equations. Results — The mean maximum total point movement (MTPM) at 3, 12, and 24 months was 0.41 mm (95% CI 0.33–0.50), 0.57 mm (0.44–0.70), and 0.56 mm (0.42–0.69) respectively in the MBT group and 0.46 mm (0.36–0.57), 0.61 mm (0.49–0.73), and 0.64 mm (0.50–0.77) in the APT group. 2 MBT and 1 APT implant were considered unstable at the 2-year follow-up. The KSS Knee score and KSS Function across 3, 12, and 24 months were comparable in both groups. Interpretation — For an APT-PS designed component, MTPM measured with RSA is comparable to the MBT-PS component after 2 years of follow-up. No differences in complications or clinical outcomes were found.
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