Publications by authors named "Thomas Jakobsen"

Purpose: This review explores the role of pigment epithelium-derived factor (PEDF) in retinal degenerative and vascular disorders and assesses its potential both as an adjunct to established vascular endothelial growth factor inhibiting treatments for retinal vascular diseases and as a neuroprotective therapeutic agent.

Methods: A comprehensive literature review was conducted, focusing on the neuroprotective and anti-angiogenic properties of PEDF. The review evaluated its effects on retinal health, its dysregulation in ocular disorders, and its therapeutic application in preclinical models.

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Background: Following the implementation of the fast-track protocol in total hip arthroplasty (THA), total knee arthroplasty (TKA), and unicompartmental knee arthroplasty (UKA), the median length of stay (LOS) has been significantly reduced without an increase in readmissions. However, it is unclear if the reduction in LOS is at the expense of an increase in nonhome discharge. The aim of this study was to investigate the discharge destination among THA, TKA, and UKA patients.

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Background: The role of physical activity (PA) monitoring during the recovery after orthopaedic surgeries is unclear. This study aimed to explore early changes in the pattern and level of PA following orthopedic surgeries.

Methods: This observational feasibility study included 11 hip replacement patients (four females) with a mean age of 66 years and five knee replacement patients (four females) with a mean age of 65 years.

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Article Synopsis
  • - The study aimed to assess day-case surgery success rates for primary total hip arthroplasty (THA), total knee arthroplasty (TKA), and medial unicompartmental knee arthroplasty (mUKA), investigating the reasons for patients not being discharged on the same day despite eligibility.
  • - Conducted over a year with 6,142 patients, the study found that 34% of THA and TKA patients and 52% of mUKA patients were eligible for day-case surgery, with mUKA showing the highest success rates (72%) when surgeries were completed before 1:00 pm.
  • - Key reasons for day-case failures included issues with patient mobilization,
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Article Synopsis
  • Preoperative psychopharmacological treatment (PPT) was analyzed to see if it negatively impacts patient-reported outcomes following hip and knee surgeries, focusing on a multicenter fast-track study in Denmark.
  • The study included over 7,200 patients and tracked their health improvements for up to 24 months through various scoring systems.
  • Results indicated that while PPT did not correlate with worse outcomes at the 12-month mark, patients receiving PPT had consistently lower scores both at baseline and after surgery compared to those who did not.
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Introduction: In recent years, different factors such as population aging have caused escalating demand for hip and knee arthroplasty straining already limited hospitals' resources. To address this challenge, focus is put on medical and operational efficiency improvements. This includes an increased use of machine learning (ML) to predict duration of surgery (DOS) and length of stay (LOS) for total knee and total hip arthroplasty, which can be utilized for optimizing resource allocation to satisfy medical and operational limitations.

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Background: Hip and knee osteoarthritis (OA) patients demonstrate distinct gait patterns, yet detecting subtle abnormalities with wearable sensors remains uncertain. This study aimed to assess a predictive model's efficacy in distinguishing between hip and knee OA gait patterns using accelerometer data.

Method: Participants with hip or knee OA underwent overground walking assessments, recording lower limb accelerations for subsequent time and frequency domain analyses.

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Article Synopsis
  • * A prospective study involved 2,756 patients, where 37% were eligible for same-day discharge based on specific criteria, and 21% were actually discharged that day, marking a significant increase compared to pre-pandemic discharge rates.
  • * The findings suggest that outpatient procedures are feasible in public healthcare settings, with expectations that success rates will improve as hospitals gain more experience with the protocol.
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Article Synopsis
  • The study focuses on understanding the impact of perioperative diabetes management on patient outcomes after hip and knee surgeries, considering the complexity of diabetes treatment guidelines and the limited existing data.
  • A multicenter observational study will be conducted across 8 Danish arthroplasty centers, involving 1400 diabetic patients undergoing fast-track surgeries from September 2022 to December 2025, with follow-up lasting 90 days post-surgery.
  • The primary goals are to evaluate hospital length of stay and readmission rates, while secondary outcomes include the relationship between diabetes treatment and other factors related to patient recovery and complications.
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Neovascular age-related macular degeneration (nAMD) is a frequent cause of vision loss among the elderly in the Western world. Current disease management with repeated injections of anti-VEGF agents accumulates the risk for adverse events and constitutes a burden for society and the individual patient. Sustained suppression of VEGF using gene therapy is an attractive alternative, which we explored using adeno-associated virus (AAV)-based delivery of novel RNA interference (RNAi) effectors in a porcine model of choroidal neovascularization (CNV).

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Background: Biomechanical reconstruction of the hip significantly impacts the clinical outcome and implant survival. Our knowledge is limited of the ability of neck-stabilised prostheses to restore hip biomechanics. We hypothesised that hip biomechanics, specifically leg length and global offset (GO), may be restored to an acceptable range using the Primoris™ stem.

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Introduction: Digital body mapping can be used to document and quantify the area and location (distribution) of pain and discomfort and support assessment, monitoring, and treatment in clinical populations. This study determines the test-retest reliability of drawings detailing pain and pins and needles using digital body charts and their relationship to pain intensity and patient-reported shoulder function.

Methods: Sixty-two participants with shoulder disorder completed pain and pins and needles drawings with test-retest interval of 30 minutes.

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Article Synopsis
  • This study explores the effectiveness of a machine-learning model in predicting postoperative morbidity and length of stay (LOS) for patients undergoing fast-track total hip (THA) and knee (TKA) arthroplasties in Denmark.
  • Data was collected from 2014-2017, with a focus on preoperative comorbidities and medications, using machine-learning techniques and traditional logistic regression for prediction analysis.
  • Results showed that the machine-learning model slightly outperformed the logistic regression model in precision and predictive capability, highlighting the potential for improved postoperative care.
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Implementation of therapeutic in vivo gene editing using CRISPR/Cas relies on potent delivery of gene editing tools. Administration of ribonucleoprotein (RNP) complexes consisting of Cas protein and single guide RNA (sgRNA) offers short-lived editing activity and safety advantages over conventional viral and non-viral gene and RNA delivery approaches. By engineering lentivirus-derived nanoparticles (LVNPs) to facilitate RNP delivery, we demonstrate effective administration of SpCas9 as well as SpCas9-derived base and prime editors (BE/PE) leading to gene editing in recipient cells.

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Introduction: A feared complication after total hip arthroplasty (THA) is prosthetic joint infection (PJI), associated with high morbidity and mortality. Prophylactic antibiotics can reduce the risk of PJI. However, there is no consensus on the dosages and current recommendations are based on a low evidence level.

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The year 2023 marks the 25th anniversary of the discovery of RNAi. RNAi-based therapeutics enable sequence-specific gene knockdown by eliminating target RNA molecules through complementary base-pairing. A systematic review of published and ongoing clinical trials was performed.

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Animal models of choroidal neovascularization (CNV) are extensively used in translational studies of CNV formation and to evaluate angiostatic treatment strategies. However, the current paucity of large animal models compared with rodent models constitutes a knowledge gap regarding the clinical translation of findings. Ocular anatomical and physiological similarities to humans suggest the pig as a relevant model animal.

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Purpose: To investigate the level and localization of the multifunctional receptor sortilin in the diabetic retina, as well as the effect of sortilin inhibition on retinal neurodegeneration in experimental diabetes.

Methods: The localization of sortilin and colocalization with the p75 neurotrophin receptor (p75NTR) and Müller cell (MC) markers were determined using immunofluorescence on retinal sections from human patients with diabetes and streptozotocin-induced diabetic C57BL/6J male mice. In the diabetic mice, levels were further quantified using Western blot and quantitative PCR.

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Introduction: Gastrointestinal complications after total hip (THA) and knee arthroplasty (TKA) have been reported to be between 0.3 and 2.6% with bleeding and C.

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Background And Purpose: Hip precautions are routinely prescribed to patients with osteoarthritis to decrease dislocation rates after total hip arthroplasty (THA) using a posterior approach. However, recommendations have been based on very low certainty of evidence. We updated the evidence on the influence of hip precautions on early recovery following THA by this systematic review.

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Background And Purpose: Limited data exists on the implementation process and safety of discharge on the day of surgery after primary hip and knee arthroplasty in a multicenter setting. We report our study protocol on the investigation of the feasibility, safety, and socioeconomic aspects following discharge on day of surgery after hip and knee arthroplasty across 8 fast-track centers.

Patients And Methods: This is a study protocol for a prospective cohort study on discharge on day of surgery from the Center for Fast-track Hip and Knee Replacement.

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Background And Purpose: The incidence of primary and revision total hip arthroplasty (THA) has increased over the last decades. Previous forecasts from different healthcare systems have predicted a continuous increase. We present a forecast of both primary and revision surgery from 2020 to 2050 based on 25 years data from the healthcare system in Denmark.

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Background: Peripheral nerve blocks (PNB) have recently been recommended in total hip (THA) and knee (TKA) arthroplasty as they may reduce pain, morphine consumption, length of stay (LOS) and complications. However, whether PNBs are associated with early discharge within an enhanced recovery protocol including multimodal analgesia is uncertain.

Methods: An observational multicenter study from January to August 2017 in six Danish Arthroplasty Centers with established fast-track protocols.

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Purpose: Blood flow restriction - low load strength training (BFR-LLST) is theoretically superior to traditional heavy strength training when rehabilitating patients who cannot heavily load tissues following surgery. The main purpose of this study was to examine the feasibility of BFR-LLST added to usual care exercise early after cartilage or meniscus repair in the knee joint.

Methods: We included 42 patients with cartilage (n = 21) or meniscus repair (n = 21) of the knee joint.

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