| 1. |
- Hommel, Ami, et al.
(författare)
-
Influence of optimised treatment of people with hip fracture on time to operation, length of hospital stay, reoperations and mortality within 1 year
- 2008
-
Ingår i: Injury. - : Elsevier. - 0020-1383 .- 1879-0267. ; 39:10, s. 1164-1174
-
Tidskriftsartikel (refereegranskat)abstract
- Hip fractures are a major cause of hospital stay among the elderly, and result in increased disability and mortality. In this study from 1 April 2003 to 31 March 2004, the influence of optimised treatment of hip fracture on time to operation, length of hospital stay, reoperations and mortality within 1 year were investigated. Comparisons were made between the first 210 patients in the period and the last 210 patients, who followed the new clinical pathway introduced at the University Hospital in Lund, Sweden. Early surgery, within 24h, was not associated with reduced mortality, but was significantly associated with reduced length of stay (p<0.001). Significantly more cases of osteosynthesis for femoral neck fracture were reoperated compared with all other types of surgery (p<0.001) when reoperations with extraction of the hook pins in healed fractures were excluded. Mortality was significantly higher among men than women at 4 (p=0.025) and 12 (p=0.001) months after fracture and among medically fit patients with administrative delay to surgery compared with patients with no delay (p<0.001).
|
|
| 2. |
- Hommel, Ami, et al.
(författare)
-
Influence of optimised treatment of people with hip fracture on time to operation, length of hospital stay, reoperations and mortality within 1 year.
- 2008
-
Ingår i: Injury. - : Elsevier BV. - 1879-0267 .- 0020-1383. ; 39, s. 1164-1174
-
Tidskriftsartikel (refereegranskat)abstract
- Hip fractures are a major cause of hospital stay among the elderly, and result in increased disability and mortality. In this study from 1 April 2003 to 31 March 2004, the influence of optimised treatment of hip fracture on time to operation, length of hospital stay, reoperations and mortality within 1 year were investigated. Comparisons were made between the first 210 patients in the period and the last 210 patients, who followed the new clinical pathway introduced at the University Hospital in Lund, Sweden. Early surgery, within 24h, was not associated with reduced mortality, but was significantly associated with reduced length of stay (p<0.001). Significantly more cases of osteosynthesis for femoral neck fracture were reoperated compared with all other types of surgery (p<0.001) when reoperations with extraction of the hook pins in healed fractures were excluded. Mortality was significantly higher among men than women at 4 (p=0.025) and 12 (p=0.001) months after fracture and among medically fit patients with administrative delay to surgery compared with patients with no delay (p<0.001).
|
|
| 3. |
|
|
| 4. |
- Robertsson, Otto, et al.
(författare)
-
Intracapsular pressure and loosening of hip prostheses. Preoperative measurements in 18 hips
- 1997
-
Ingår i: Acta Orthopaedica Scandinavica. - : Medical Journals Sweden AB. - 0001-6470. ; 68:3, s. 231-234
-
Tidskriftsartikel (refereegranskat)abstract
- We measured the intracapsular pressure preoperatively in 18 hips (17 patients) before revision of a total hip arthroplasty because of aseptic loosening. Distension of the joint capsule was measured with sonography in 13 cases. In extension, the mean intracapsular pressure was 26 (0-60) mmHg, in extension and inward rotation it was 159 (24-280) mmHg, in extension and outward rotation it was 30 (3-67) mmHg and in 45 degrees of flexion it was 12 (0-28) mmHg. A mean of 6 (0.5-20) mL of joint fluid was aspirated after the pressure measurements. Sonography showed increased joint fluid/synovial edema and/or increased capsular thickness, as compared to 34 unrevised, radiographically not loose prosthetic hips, and that the capsular distension correlated to intracapsular pressure during extension and inward rotation. We conclude that the intracapsular pressure usually is elevated in a hip joint with loose prosthetic components, that the intracapsular pressure varies with the position of the hip and that capsular distension reflects increased intracapsular pressure. The increased and often very high pressure, varying during gait, may pump debris away from the joint along the interfaces and even by itself cause osteolysis and loosening.
|
|
| 5. |
- Cserhati, P, et al.
(författare)
-
Hip fractures in Hungary and Sweden - differences in treatment and rehabilitation
- 2002
-
Ingår i: International Orthopaedics. - : Springer Science and Business Media LLC. - 1432-5195 .- 0341-2695. ; 26:4, s. 222-228
-
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%).
|
|
| 6. |
- Hasegawa, Yukiharu, et al.
(författare)
-
Risk of mortality following hip fracture in Japan
- 2007
-
Ingår i: Journal of Orthopaedic Science. - : Elsevier BV. - 1436-2023 .- 0949-2658. ; 12:2, s. 113-117
-
Tidskriftsartikel (refereegranskat)abstract
- Background. Excessive mortality and morbidity are serious problems after hip fracture in the elderly. Methods. Hip fractures in persons aged 50 years or older were prospectively registered in Japan in 2000. Questionnaires regarding both the first onset and the second 120-day period after hip fracture were obtained from 759 patients, 546 of whom were female and 213 male. Results. Their average age at the time of fracture was 80 years. Altogether, 68 people (9%) died within 120 days after fracture; and 25 patients died within 30 days. Those dying within 120 days and those alive after hip fracture were compared. By univariate analysis, risk factors were poor walking ability, need for a walking aid, low body mass index, history of falls, and lack of active exercise; however, none of these factors was identified as a risk factor by multivariate analysis. By multivariate analysis, the five risk factors associated with mortality were male sex, older age, high American Academy of Anesthesiology (ASA) grade, dementia, and residence in an institution. Conclusions. During the treatment and rehabilitation period special attention should be paid to patients with chronic diseases and reduced mental status.
|
|
| 7. |
- Heikkinen, T, et al.
(författare)
-
Hemiarthroplasty or osteosynthesis in cervical hip fractures: matched-pair analysis in 892 patients
- 2002
-
Ingår i: Archives of Orthopaedic and Trauma Surgery. - : Springer Science and Business Media LLC. - 1434-3916 .- 0936-8051. ; 122:3, s. 143-147
-
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.
|
|
| 8. |
- Iwase, Toshiki, et al.
(författare)
-
The ScanHip total hip arthroplasty: radiographic assessment of 72 hips after 10 years.
- 2002
-
Ingår i: Acta Orthopaedica Scandinavica. - : Medical Journals Sweden AB. - 0001-6470. ; 73:1, s. 54-59
-
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.
|
|
| 9. |
- Kesteris, Uldis, et al.
(författare)
-
Contamination of polyethylene cups with polymethyl methacrylate particles: an experimental study
- 2001
-
Ingår i: Journal of Arthroplasty. - : Elsevier BV. - 0883-5403. ; 16:7, s. 905-908
-
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.
|
|
| 10. |
- Kesteris, Uldis, et al.
(författare)
-
Polyethylene wear and synovitis in total hip arthroplasty: a sonographic study of 48 hips
- 1999
-
Ingår i: Journal of Arthroplasty. - 0883-5403. ; 14:2, s. 138-143
-
Tidskriftsartikel (refereegranskat)abstract
- Forty-six patients (48 hips), operated on with cemented total hip arthroplasty (THA) because of arthrosis, were examined radiographically and sonographically at 10-year follow-up. Polyethylene wear of acetabular cups was measured on conventional non-weight-bearing pelvic radiographs, and the volume of polyethylene debris was calculated. Radiographic signs of loosening were identified. The capsular distance (ie, thickness of the synovium or synovial contents) was measured sonographically. We found a significant correlation between increased volumetric wear and increased capsular distance. Hips with radiographically loose acetabular components had significantly greater volumetric wear and capsular distance than those without signs of acetabular loosening. This relationship was not observed in hips with radiographically loose femoral components. In cemented THA, the volume of polyethylene wear debris and the thickness of the synovium and the synovial contents are related. In the event of radiographic loosening of the acetabular component, they are both increased.
|
|
