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- Akner, Gunnar, 1953-, et al.
(author)
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Vi står gärna bakom en utfallsbaserad vård
- 2017
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In: Dagens Samhälle. - 1652-6511.
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Journal article (pop. science, debate, etc.)abstract
- Jörgen Nordenström försöker få det till att vår kritik av värdebaserad vård egentligen handlar om att vi vill ha mer resurser. Han har helt missuppfattat oss, skriver 26 specialistläkare i en replik.
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- Iwase, Toshiki, et al.
(author)
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The ScanHip total hip arthroplasty: radiographic assessment of 72 hips after 10 years.
- 2002
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In: Acta Orthopaedica Scandinavica. - : Medical Journals Sweden AB. - 0001-6470. ; 73:1, s. 54-59
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Journal article (peer-reviewed)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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5. |
- Wingstrand, I, et al.
(author)
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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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In: International Orthopaedics. - : Springer Science and Business Media LLC. - 1432-5195 .- 0341-2695. ; 26:2, s. 69-71
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Journal article (peer-reviewed)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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6. |
- Akner, Gunnar, et al.
(author)
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Styrningen har blivit ett hot
- 2016
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In: Svenska Dagbladet. - 1101-2412. ; 25 jul
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Journal article (pop. science, debate, etc.)
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8. |
- Cserhati, P, et al.
(author)
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Hip fractures in Hungary and Sweden - differences in treatment and rehabilitation
- 2002
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In: International Orthopaedics. - : Springer Science and Business Media LLC. - 1432-5195 .- 0341-2695. ; 26:4, s. 222-228
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Journal article (peer-reviewed)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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9. |
- Hasegawa, Yukiharu, et al.
(author)
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Risk of mortality following hip fracture in Japan
- 2007
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In: Journal of Orthopaedic Science. - : Elsevier BV. - 1436-2023 .- 0949-2658. ; 12:2, s. 113-117
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Journal article (peer-reviewed)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.
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10. |
- Heikkinen, T, et al.
(author)
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Hemiarthroplasty or osteosynthesis in cervical hip fractures: matched-pair analysis in 892 patients
- 2002
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In: 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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Journal article (peer-reviewed)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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