| 1. |
- Thomas, HS, et al.
(author)
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- 2019
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swepub:Mat__t
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| 2. |
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| 3. |
- Barenius, Björn, et al.
(author)
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Increased risk of osteoarthritis after anterior cruciate ligament reconstruction : a 14-year follow-up study of a randomized controlled trial.
- 2014
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In: American Journal of Sports Medicine. - : SAGE Publications. - 0363-5465 .- 1552-3365. ; 42:5
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Journal article (peer-reviewed)abstract
- BACKGROUND: The reported prevalence of radiological osteoarthritis (OA) after anterior cruciate ligament (ACL) reconstruction varies from 10% to 90%. Purpose/HYPOTHESIS: To report the prevalence of OA after ACL reconstruction and to compare the OA prevalence between quadrupled semitendinosus tendon (ST) and bone-patellar tendon-bone (BPTB) grafts. The hypothesis was that there would be no difference in OA prevalence between the graft types. The secondary aim was to study whether patient characteristics and additional injuries were associated with long-term outcomes.STUDY DESIGN: Randomized controlled trial; Level of evidence, 1.METHODS: Radiological examination results, Tegner activity levels, and Knee injury and Osteoarthritis Outcome Score (KOOS) values were determined in 135 (82%) of 164 patients at a mean of 14 years after ACL reconstruction randomized to an ST or a BPTB graft. Osteoarthritis was defined according to a consensus by at least 2 of 3 radiologists of Kellgren-Lawrence grade ≥2. Using regression analysis, graft type, sex, age, overweight, time between injury and reconstruction, additional meniscus injury, and a number of other variables were assessed as risk factors for OA 14 years after ACL reconstruction.RESULTS: Osteoarthritis of the medial compartment was most frequent, with 57% of OA cases in the ACL-reconstructed knee and 18% of OA cases in the contralateral knee (P < .001). There was no difference between the graft types: 49% of OA of the medial compartment for BPTB grafts and 65% for ST grafts (P = .073). The KOOS results were lower for patients with OA in all subscales, indicating that OA was symptomatic. No difference in the KOOS between the graft types was found. Meniscus resection was a strong risk factor for OA of the medial compartment (odds ratio, 3.6; 95% CI, 1.4-9.3) in the multivariable logistic regression analysis.CONCLUSION: A 3-fold increased prevalence of OA was found after an ACL injury treated with reconstruction compared with the contralateral healthy knee. No differences in the prevalence of OA between the BPTB and quadrupled ST reconstructions were found. An initial meniscus resection was a strong risk factor for OA; the time between injury and reconstruction was not.
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| 5. |
- Eriksson, Thomas, et al.
(author)
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Are low-dose CT scans a satisfactory substitute for stereoradiographs for migration studies? A preclinical test of low-dose CT scanning protocols and their application in a pilot patient.
- 2019
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In: Acta Radiologica. - : Sage Publications. - 0284-1851 .- 1600-0455.
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Journal article (peer-reviewed)abstract
- BACKGROUND: Computed tomography (CT) has the potential to acquire the data needed for migration studies of orthopedic joint implants of patients who have had tantalum beads implanted at the time of joint replacement surgery. This can be accomplished with the same precision as radiostereometric analysis (RSA). Switching to CT would increase availability without the need for the specific facilities required for RSA. However, higher effective dose is a concern.PURPOSE: To investigate if migration measurements can be done with CT with an accuracy and effective dose comparable to that of conventional RSA.MATERIAL AND METHODS: Fourteen scanning protocols were tested in a hip phantom that incorporated tantalum beads and an uncemented femoral stem. The protocols were graded for clinical practice according to the three parameters of image quality, effective dose, and robustness of numerical data. After grading, the two protocols that graded best overall were applied to a pilot patient.RESULTS: All protocols produced scans in which the numerical data were sufficient for a migration analysis at least as precise as would be expected using RSA. A protocol with an effective dose of 0.70 mSv was shown to be applicable in a pilot patient.CONCLUSION: Low-dose CT scans with an effective dose comparable to a set of routine plain radiographs can be used for precise migration measurements.
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| 6. |
- Eriksson, Thomas, et al.
(author)
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Low-dose CT of postoperative pelvic fractures : a comparison with radiography
- 2019
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In: Acta Radiologica. - : SAGE Publications. - 0284-1851 .- 1600-0455. ; 60:1, s. 85-91
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Journal article (peer-reviewed)abstract
- Background Computed tomography (CT) is superior to conventional radiography (CR) for assessing internal fixation of pelvic fractures, but with a higher radiation exposure. Low-dose CT (LDCT) could possibly have a sufficient diagnostic accuracy but with a lower radiation dose. Purpose To compare postoperative diagnostic accuracy of LDCT and CR after open reduction and internal fixation of pelvic fracture. Material and Methods Twenty-one patients were examined with LDCT and CR 0-9 days after surgery. The examinations were reviewed by two musculoskeletal radiologists. Hardware, degree of fracture reduction, image quality, and reviewing time were assessed, and effective radiation dose was calculated. Inter-reader agreement was calculated. Results LDCT was significantly better than CR in determining whether hardware positioning was assessable ( P < 0.001). Acetabular congruence was assessable in all fractured patients with LDCT. In 12 of the 32 assessments with CR of patients with an acetabular fracture, joint congruence was not assessable due to overlapping hardware ( P = 0.001). Image quality was significantly higher for LDCT. Median time to review was 240 s for LDCT compared to 180 s for CR. Effective dose was 0.79 mSv for LDCT compared to 0.32 mSv for CR ( P < 0.001). Conclusion LDCT is more reliable than CR in assessing hardware position and fracture reduction. Joint congruency is sometimes not possible to assess with CR, due to overlapping hardware. The image quality is higher, but also the effective dose, with LDCT than with CR.
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| 7. |
- Gardin, Anna, et al.
(author)
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Dynamic contrast enhanced magnetic resonance imaging in chronic Achilles tendinosis
- 2013
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In: BMC Medical Imaging. - : Springer Science and Business Media LLC. - 1471-2342. ; 13, s. 39-
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Journal article (peer-reviewed)abstract
- Background: Chronic Achilles tendinosis is a common problem. When evaluating and comparing different therapies there is a need for reliable imaging methods. Our aim was to evaluate if chronic Achilles tendinosis affects the dynamic contrast-enhancement in the tendon and its surroundings and if short-term eccentric calf-muscle training normalizes the dynamic contrast-enhancement. Methods: 20 patients with chronic Achilles tendinopathy were included. Median duration of symptoms was 31 months (range 6 to 120 months). Both Achilles tendons were examined with dynamic contrast enhanced MRI before and after a 12-week exercise programme of eccentric calf-muscle training. The dynamic MRI was evaluated in tendon, vessel and in fat ventrally of tendon. Area under the curve (AUC), time to peak of signal, signal increase per second (SI/s) and increase in signal between start and peak as a percentage (SI%) was calculated. Pain and performance were evaluated using a questionnaire. Results: In the fat ventrally of the tendon, dynamic contrast enhancement was significantly higher in the symptomatic leg compared to the contralateral non-symptomatic leg before but not after treatment. Despite decreased pain and improved performance there was no significant change of dynamic contrast enhancement in symptomatic tendons after treatment. Conclusion: In Achilles tendinosis there is an increased contrast enhancement in the fat ventrally of the tendon. The lack of correlation with symptoms and the lack of significant changes in tendon contrast enhancement parameters do however indicate that dynamic enhanced MRI is currently not a useful method to evaluate chronic Achilles tendinosis.
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| 8. |
- Geijer, Mats, et al.
(author)
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MR appearance of the temporal evolution and resolution of spontaneous osteonecrosis of the knee : a case report
- 2017
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In: Acta Radiologica Open. - : SAGE Publications. - 2058-4601. ; 6:2
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Journal article (peer-reviewed)abstract
- Spontaneous osteonecrosis of the knee (SONK) is a feared condition of unknown cause, in its classic form appearing in the medial femoral condyle in middle-aged or elderly subjects. Diagnosis with radiography is notoriously difficult with a long latency before typical changes appear. Magnetic resonance imaging (MRI) is regarded as a diagnostic tool with the possibility to give an earlier diagnosis with improved chances for treatment. However, also with MRI there may be an initial diagnostic blind spot before typical changes appear. Little is known about the temporal evolution of the MRI changes. In the current case report, a case of SONK is reported where serial imaging with MRI was performed, from initial symptoms to eventual resolution after almost three years.
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| 10. |
- Gärdin, Anna, et al.
(author)
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T2 * relaxation time in Achilles tendinosis and controls and its correlation with clinical score
- 2016
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In: Journal of Magnetic Resonance Imaging. - : Wiley. - 1053-1807 .- 1522-2586. ; 43:6, s. 1417-1422
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Journal article (peer-reviewed)abstract
- PURPOSE: To investigate if the T2 * of Achilles tendons can discriminate between chronic Achilles tendinosis and healthy controls; to correlate with clinical score; to evaluate its short-term repeatability; and to estimate minimal detectable change.MATERIALS AND METHODS: Twenty patients, with chronic mid-portion Achilles tendinosis, and 10 controls without history of Achilles tendon symptoms, were examined with a 3T MR scanner with a 3D flash ultrashort time to echo sequence with five different echo times. The sequence was run twice to test repeatability. The tendon border was delineated on axial slices at three different levels in the calculated T2 * maps. The clinical severity of Achilles tendinosis was measured by a VISA-A questionnaire.RESULTS: There was a significant difference in mean T2 * between symptomatic and control tendons (P < 0.001). In patients with unilateral symptoms no significant difference in T2 * was found between symptomatic and contralateral asymptomatic tendons (P = 0.19). There was no significant correlation between clinical severity and T2 * (r = -0.28, P = 0.22). The short-term repeatability of T2 * showed a coefficient of variation of 18%, a least significant change of 50%, and the intraclass correlation coefficient had an average consistency of 0.99.CONCLUSION: T2 * may help to differentiate between chronic Achilles tendinosis and healthy controls but was not associated with the clinical score. However, and notably, the reproducibility of the method was low and the number of patients was small.
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