Angiogenesis is increased in advanced haemophilic joint disease and characterised by normal pericyte coverage.

Background: Repeated intra-articular bleedings in patients with haemophilia results in a crippling arthropathy for which no specific treatment is currently available. Recent studies have shown that neoangiogenesis is involved in the pathologic process. The aim of this study was to determine whether angiogenesis is dysregulated in haemophilic joint disease (HJD).

Scapula fractures: interobserver reliability of classification and treatment.

Objectives: There is substantial variation in the classification and management of scapula fractures. The first purpose of this study was to analyze the interobserver reliability of the OTA/AO classification and the New International Classification for Scapula Fractures. The second purpose was to assess the proportion of agreement among orthopaedic surgeons on operative or nonoperative treatment.

2006: the value of pelvic and femoral osteotomies in hip surgery.

Hip problems are frequent and can represent a therapeutic challenge for the orthopaedic surgeon. In the wide spectrum of hip pathologies, coxarthrosis still remains the most common cause of hip disability. The treatment of hip disorders in adult patients has rapidly evolved during the past decades because of the enhanced understanding of osteoarthritis (OA) aetiology combined with improved imaging, better patient selection and refinements in surgical procedures.

Continuous infusion of recombinant factor VIIa for surgery in patients with deficiency of factor VII.

The administration of recombinant activated factor VII (rFVIIa) by continuous infusion has provided a safe and convenient alternative to bolus injections in haemophiliacs with inhibitors, but it has only been reported in a single case with congenital factor VII (FVII) deficiency. The results of 12 consecutive surgical procedures in 7 patients with congenital FVII deficiency are reported here. rFVIIa was always given in continuous infusion,aiming at plasma FVII activity of 0.

Periacetabular osteotomy. Good pain relief in symptomatic hip dysplasia, 32 patients followed for 4 years.

Background: When surgical treatment of dysplastic hip osteoarthrosis is necessary, osteotomy is preferable to fusion or THR. We evaluated periacetabular osteotomy as a method of choice.

Patients And Methods: We treated 36 symptomatic dysplastic hip joints (32 patients) with the Bernese periacetabular osteotomy (PAO) between 1994 and 2001.

Minimizing factor requirements for surgery without increased risk.

The most common type of surgical procedure in patients with haemophilia is orthopaedic surgery on the lower limb. These procedures are of great importance for the improvement of the function and quality of life of patients with haemophilia, but in many countries resources are lacking to provide the factor concentrates needed for these operations. We have attempted to reduce the level of replacement during and after total hip or total knee replacement without jeopardizing the outcome of the procedures.

Periacetabular osteotomy of the hip: the ilioinguinal approach.

Developmental hip dysplasia (DDH) is characterized by an anomalous growth of the hipjoint. Without adequate treatment, the natural history of DDH is development of secondary osteoarthritis in adulthood. The correction of the deformities modifies the biomechanics of the hip, which is important in order to slow down the progression of osteoarthritis and maybe to prevent and postpone this development.

The Wagner revision prosthesis consistently restores femoral bone structure.

The short-term results are reported for 43 hip revision operations with the long-stemmed Wagner prosthesis. The patients were followed-up for an average of 25 months. The Charnley scores were; pain 5.

The Kessel total shoulder arthroplasty. A 13- to 16-year retrospective followup.

Between 1982 and 1985, 23 Kessel total shoulder arthroplasties were performed on 22 patients with rheumatoid arthritis. A clinical and radiographic review of the 5-year experience was evaluated in 1988 and published in 1992. Ten years later a followup study was done.

Efficacy of a high purity, chemically treated and nanofiltered factor IX concentrate for continuous infusion in haemophilia patients undergoing surgery.

We have evaluated the haemostatic efficacy of plasma derived, highly purified, solvent-detergent treated factor IX concentrate (Nanotiv), to which a nanofiltration step has recently been added to improve safety with regard to parvovirus B19, hepatitis A and other nonlipid enveloped viruses. Thirteen surgical procedures, including eight orthopaedic operations, were carried out using continuous infusion of Nanotiv in 10 haemophilia B patients (nine severe and one mild). Tranexamic acid was used for 11 of the 13 procedures.

Can we predict the outcome of a partial rupture of the anterior cruciate ligament? A prospective study of 43 cases.

The concept of partial rupture of the anterior cruciate ligament (ACL) has been confirmed by arthroscopic examination and palpation. We present a prospective study of 43 patients who were diagnosed arthroscopically as suffering from a partial rupture of the ACL by the same surgeon. The patients followed a rehabilitation protocol and were examined by an independent observer after 5 years.

Surgical treatment of patellar tendinitis.

Patellar tendinitis is an overuse syndrome affecting the origin of the patellar tendon and its underlying part. Ultrasonography is useful to investigate tendinous pathology. It describes the anatomical lesions and their extent.

The Kessel prosthesis in total shoulder arthroplasty. A five-year experience.

Between 1982 and 1985, 23 Kessel total shoulder arthroplasties were performed on 22 patients. A clinical and roentgenographic review was performed by an independent observer. Three patients had their prostheses removed and three had revision surgery, leaving 17 shoulders in 16 patients available for study, all with rheumatoid arthritis (RA).

Should the glenoid be replaced in shoulder arthroplasty with an unconstrained Dana or St. Georg prosthesis?

Twenty-six patients, 11 with rheumatoid arthritis and 15 with osteoarthritis, have been operated on with an unconstrained total shoulder arthroplasty. Mean follow-up was 47 months. Three prostheses have been extracted.

Shoulder function after prosthetic replacement of proximal humerus.

Between 1973 and 1985 eighteen patients with bone tumours and two patients with comminuted fractures had their proximal humerus replaced with a custom made isoelastic hemiendoprosthesis. In 1987 a clinical and radiographical review was performed of eleven patients with a mean follow up time of seven years, range 3-10 years. Four patients had pain at rest and six patients experienced severe pain on exertion.

Venous circulation after fasciotomy of the lower leg in man.

The study was performed in order to evaluate the effect of fasciotomy of the lower leg on venous circulation and venous muscle pump function. Twenty patients with unilateral fasciotomy were investigated with photoplethysmography (PPG), strain-gauge plethysmography, foot volumetry and Doppler ultrasound. In the operated legs shorter venous refilling times were registered both with PPG (P less than 0.

MR imaging of syringohydromyelia and Chiari malformations in myelomeningocele patients with scoliosis.

The brain and spinal cord were examined with MR imaging in 30 myelomeningocele patients 3-32 years old to study the prevalence of syringohydromyelia and Chiari malformations and to correlate these conditions with developmental scoliosis and spontaneously arrested hydrocephalus. Twelve patients had neurologic deficits above the level of the myelomeningocele and 10 had spontaneously arrested hydrocephalus. MR visualized syringohydromyelia in four patients with widened or focally bulging spinal cords and in eight patients with atrophic spinal cords.

Histochemical and metabolic changes in lower leg muscles in exercise-induced pain.

Intramuscular pressure, fiber type distribution, relative cross-sectional area of slow-twitch muscle fibers, muscle lactate, and water content were studied in eight patients with medial tibial syndrome and in eight patients with chronic anterior compartment syndrome. The variables were determined before and after standardized exercise that provoked lower leg pain. In patients with medial tibial syndrome, the intramuscular pressures in the deep posterior compartment were not elevated before or 10 min after exercise.

Intramuscular pressures in exercise-induced lower leg pain.

Intramuscular pressures were measured in 12 patients with symptoms of medial tibial syndrome and in 12 patients with chronic anterior compartment syndrome. Measurements were performed with the wick catheter technique simultaneously in the deep posterior and the anterior tibial muscle compartments before, during, and after exercise. In the deep posterior compartment there was no pressure increase during or after exercise as compared to controls in either patient group.