The prevalence of locomotor complaints in middle age and their relationship to health and socioeconomic factors.

The prevalence and coincidence of symptoms or signs or both of degenerative changes in the back, shoulders, hips, and knees were analyzed in 575, 55-year-old residents of Malmö, Sweden, and the relationship of these complaints to smoking and alcohol habits, nervous problems, body weight, social background, intelligence test in 1938, education, job satisfaction, income, life success, employment, and occupational workload were analyzed. Back pain was the most common complaint--nearly 1/3--in men and women. Locomotor discomfort coincided more often and was more frequent in women.

Locking and compression of the lag screw in trochanteric fractures is not beneficial. A prospective, randomized study of 153 cases.

153 patients with a trochanteric hip fracture were operated on with a compression hip screw (CHS) and followed for 4 months. They were randomized into 2 groups, with or without a key and compression of the lag screw. Greater sliding of the lag screw was noted in cases where the compression screw and the key were used, especially in women over 80 years of age and in patients with a previous fracture indicating osteoporotic bone.

Bone mineral loss after lower extremity trauma. 62 cases followed for 15-38 years.

62 former patients, who had been treated at our department for tibial shaft fracture (n 38) or knee ligament injury (n 24) 15-38 years earlier, were re-evaluated for post-traumatic osteopenia. 62 age- and sex-matched subjects without fracture served as controls. By means of a Lunar DEXA apparatus we measured the bone mineral density (BMD) in the total body, the hips and special regions of interest (ROI) in the lower extremities.

The articular cartilage after osteotomy for medial gonarthrosis. Biopsies after 2 years in 19 cases.

In 19 consecutive patients with medial gonarthrosis, an arthroscopic examination with a biopsy of the load-bearing cartilage in the medial femoral condyle was undertaken at the same time as a proximal tibial osteotomy. A follow-up arthroscopic biopsy was performed on an average of 2 years after the osteotomy. In 9 knees there was an improvement in the cartilage quality, 8 knees were unchanged, whereas 2 knees had deteriorated.

Autologous blood transfusion in revision hip arthroplasty. A prospective, controlled study of 30 patients.

In a prospective, randomized study of the efficacy and effects of autologous blood transfusion in revision hip arthroplasty, 30 patients were randomly allocated into two groups. The Control Group received homologous blood transfusion. The Study Group deposited 2-3 units of blood preoperatively, intraoperative blood salvage was used, and no homologous blood was transfused intraoperatively.

Intraoperative autotransfusion in hip arthroplasty. A retrospective study of 214 cases with matched controls.

The transfusion requirements in 214 patients who received intraoperatively collected autologous blood during total hip arthroplasty (Study Group) were compared with 214 age- and sex-matched controls who received homologous bank blood (Control Group). There were 132 patients with primary operations, 27 bilateral, and 55 revisions in each group. In the Study Group, there was a reduction in the amount of homologous blood transfusion, intraoperatively as well as totally, and also in postoperative blood loss in all three operation subsets.

Intraoperative autotransfusion in primary hip arthroplasty. A randomized comparison with homologous blood.

To study the quality and effect of blood produced by the cell saver compared with homologous blood in total hip arthroplasty, 40 patients were randomly divided into two groups. One group received autologous blood using the cell saver, whereas the second group served as a control, and received homologous bank blood. Hematologic and coagulation parameters of the patients were assessed both preoperatively and postoperatively.

Cost effectiveness of blood substitution in elective orthopedic operations.

Cost effectiveness was compared between substitution with autologous blood, implying no risk of transmission of diseases, and homologous blood, with a definite risk of transmission. Primary and revision hip arthroplasties were included in this study, as well as scoliosis operations. The risk of contracting chronic non-A, non-B hepatitis (NANBH) was included in the calculations of the long-term economic consequences of a transmittable disease.

Predonation autologous blood in hip arthroplasty.

In a prospective randomized study of elderly patients, a total of 130 units of blood were donated by 45 patients prior to a total hip arthroplasty. Fifteen patients served as controls (no phlebotomy). The average age was 71 (60-82) years.

Distal tibial osteochondroma deforming the fibula.

Three children had osteochondromata in the lateral part of the distal metaphysis of the tibia causing impingement with erosion and deformity of the fibula. The osteochondromata were removed through an anterior approach without osteotomy of the fibula. At reexamination 1.

Internal fixation of 410 cervical hip fractures. A randomized comparison of a single nail versus two hook-pins.

Totally, 410 patients with a cervical hip fracture were randomized between two methods of osteosynthesis: a single nail (Rydell) and two hook-pins (LIH). Seventy-five percent of the patients were women. Sixty-nine percent were alive after 2 years.

An internally cooled saw blade for bone cuts. Lower temperatures in 30 knee arthroplasties.

A saline-cooled saw, which has been shown to give good control of the heat generation during bone cutting under laboratory conditions, was tested in in vivo. With a saline flow of 80 mL/min, the maximum cutting temperature in 30 knee prosthetic operations was 32 (25-37) degrees C in the saw blade and respectively 30 (26-35) degrees C and 29 (26-34) degrees C 2 and 3 mm underneath the cut surface. Because the temperature generated by conventional osteotomy equipment may exceed 70 degrees C, the use of our cooled double saw blade during joint replacement prevents heat osteonecrosis.

Incidence of femoral and tibial shaft fractures. Epidemiology 1950-1983 in Malmö, Sweden.

We studied 362 fractures of the femur that had occurred during the years 1950-57 and 1973-83, and 849 fractures of the tibia that occurred during the the years 1950-55 and 1980-83. There was an increase in age-specific incidence over aged 60 years. The risk of low-energy femoral shaft fractures also had increased in elderly women.

Loosening of the Lubinus hip. 202 cases followed for 3-6 years.

Survivorship methods were applied to a consecutive series of 202 primary Lubinus total hip arthroplasties followed for 3 to 6 years. After 5 years, the revision rate was 3 percent, and the radiographic loosening rate was 13 percent for the socket and 10 percent for the stem.

Early knee mobilization after osteotomy for gonarthrosis.

In a prospective study, 32 knees in 32 patients were randomized to either a cylinder plaster cast (17 knees) or hinged cast-brace (15 knees) after high tibial osteotomy for medial gonarthrosis. At 6 weeks, 3 months, and still 1 year after surgery, the range of motion was better in the cast-brace group. There was no difference in the other clinical results at 3 months and at 1 year after surgery, nor in changes of osseous correction or in the final knee alignment.

Patellar fractures. A 30-year follow-up.

Forty patients who had had a patellar fracture during the years 1950-58 were reevaluated 30 years later. A clinical and radiographic examination was performed. Fourteen patients had subjective complaints.

Thromboprophylaxis in hip arthroplasty. Dextran with graded compression or preoperative dextran compared in 150 patients.

Totally, 150 patients, subjected to total hip arthroplasty, were randomly allocated into three prophylactic groups with either conventional dextran alone or with additional graded compression stockings or with additional preoperative administration of dextran. The overall frequency of deep venous thrombosis (DVT), as studied by radioactive fibrinogen uptake test and ascending phlebography of the operated on thigh was in the conventional dextran group 46 percent, the additional stockinged group 30 percent, and in the additional preoperative dextran group 52 percent. In the stockinged group, there was a lower frequency of DVT in the nonoperated on leg as well as, on an average, about 350 mL less peroperative bleeding as compared with the other two groups.

Stapling for tibial-growth deformity. A case report on roentgen stereophotogrammetric analysis.

A 9-year-old boy sustained a Salter-Harris Type IV fracture in the proximal tibia. The injury resulted in a progressive valgus deformity, detected already after 3 months by roentgen stereophotogrammetry. After temporary stapling medially, the growth rate increased laterally and the deformity was corrected.

Pseudomalignant myositis ossificans. Clinical, radiologic, and cytologic diagnosis in 5 cases.

In five cases of pseudomalignant myositis ossificans a benign diagnosis was suggested by fine-needle aspiration cytology and confirmed by radiographs and the clinical course. Hence, the need of biopsy to exclude malignancy was obviated. The symptoms rapidly resolved in all the patients.

Lateral meniscal lesions in patients with clinically suspected medial lesions.

Double-contrast arthrography and arthroscopy were performed in a prospective study on 46 consecutive patients clinically suspected of having a medial meniscal tear only. At arthrography, 38 torn medial menisci were found; four of them were, however, false-positive and another false-negative as compared with arthroscopic examination. Moreover, seven unsuspected lateral meniscal tears were diagnosed at both arthrography and arthroscopy.

Prognosis of brace-treated scoliosis. Comparison of the Boston and Milwaukee methods in 244 girls.

Totally, 244 females with adolescent idiopathic scoliosis treated by brace were followed for at least 2 years after treatment. The initial curve magnitude correlated with failure, notably thoracic curves. The Boston brace was more successful than the Milwaukee brace irrespective of initial curve magnitude and skeletal maturity.