Adjacent level disk disease--is it really a fusion disease?

Adjacent segment degeneration (ASD) is a relatively common phenomenon after spinal fusion surgery. Whether ASD is a consequence of the previous fusion or an individual's predisposition to continued degeneration remains unsolved to date. This article summarizes the existing biomechanical and clinical literature on the causes and clinical impact of ASD, as well as possible risk factors.

Cumulative incidence of shoulder region tendon injuries in male former elite athletes.

Some types of sports are thought to include a high risk for shoulder region tendon injuries but little data exist on long-term cumulative incidence of these injuries. The aim of our study was to investigate shoulder region tendon injuries diagnosed by physicians in former elite male athletes participating in sports including maximal overhead manoeuvres (overhead athletes) and also other athletes before the age of 45 years and within the subjects' lifetime, compared to control subjects. A postal questionnaire was sent in 2002 to male former elite athletes (n=785; mean age 68 years when responding to the questionnaire; overhead athletes n=111, others n=674) and control subjects (n=416; mean age 67 years).

In vitro adhesion of staphylococci to diamond-like carbon polymer hybrids under dynamic flow conditions.

This study compares the ability of selected materials to inhibit adhesion of two bacterial strains commonly implicated in implant-related infections. These two strains are Staphylococcus aureus (S-15981) and Staphylococcus epidermidis (ATCC 35984). In experiments we tested six different materials, three conventional implant metals: titanium, tantalum and chromium, and three diamond-like carbon (DLC) coatings: DLC, DLC-polydimethylsiloxane hybrid (DLC-PDMS-h) and DLC-polytetrafluoroethylene hybrid (DLC-PTFE-h) coatings.

Long-term results of surgery for lumbar spinal stenosis: a randomised controlled trial.

We randomised a total of 94 patients with long-standing moderate lumbar spinal stenosis (LSS) into a surgical group and a non-operative group, with 50 and 44 patients, respectively. The operative treatment comprised undercutting laminectomy of stenotic segments, augmented with transpedicular-instrumented fusion in suspected lumbar instability. The primary outcome was the Oswestry disability index (ODI), and the other main outcomes included assessments of leg and back pain and self-reported walking ability, all based on questionnaire data from 85 patients at the 6-year follow-up.

Mid-term results for three contemporary total knee replacement designs - a comparative study of 104 patients with primary osteoarthritis.

Aims: The purpose of this study was to compare retrospectively the mid-term clinical and radiological results of three contemporary knee designs in cohorts operated on in the same hospital during the same time period.

Materials And Methods: We evaluated mid-term clinical and radiographic outcome of three contemporary total knee designs (the AGC V2, the Duracon and the Nexgen) in 104 consecutive patients (129 knees) operate on for primary knee osteoarthritis at our hospital. The mean indexed age at the time of the operation was 69.

Operative treatment of isthmic spondylolisthesis in children: a long-term, retrospective comparative study with matched cohorts.

The purpose of the present study was to compare the long-term clinical, functional and radiographic outcomes of young patients operated on before or at the onset of puberty (Children) and those operated on after that (Adolescents). The study group consisted of 298 patients operated on under the age of 20 years; 55 of them were operated on before or at the onset of growth spurt (29 females<12.5 years, 26 males<14.

Total joint arthroplasty patients' perception of received knowledge of care.

Background: The education of orthopaedic patients is an essential component of nursing, because it has been shown to have a positive impact on outcomes of care and treatment.

Purpose: To describe total joint arthroplasty patients' perceptions of received knowledge on discharge.

Design/method: Patients (n = 123, mean age 68 years) undergoing total hip or knee arthroplasty self-administered a structured instrument, including 6 different dimensions of knowledge.

Pain relief, motion, and function after rotator cuff repair or reconstruction may not persist after 16 years.

Background: Short- to medium-term rotator cuff repair reportedly relieves pain in 82% to 97% of patients and provides normal or almost normal shoulder function in 82% to 92%. However, it is unknown whether pain relief and function persist long term.

Questions/purposes: We asked whether, after rotator cuff repair or reconstruction, pain relief, ROM, shoulder strength, and function remained over the long term.

Dynamic kine magnetic resonance imaging in whiplash patients and in age- and sex-matched controls.

The multitude of symptoms following a whiplash injury has given rise to much discussion because of the lack of objective radiological findings. The ligaments that stabilize the upper cervical spine can be injured. Dynamic kine magnetic resonance imaging (dMRI) may reveal the pathological motion patterns caused by injury to these ligaments.

Hip fractures and femoral bone mineral density in male former elite athletes.

Introduction: We studied whether vigorous physical activity in young adulthood is associated with higher femoral bone density and lower risk of hip fracture at older age in men.

Materials: A cohort of former male elite athletes (n=2147) and matched control subjects (n=1467) were studied for their leisure physical activity, and for fragility fractures at the hip (proximal femur) by Cox regression. Areal bone mineral densities (aBMD) at femoral neck and trochanter region were measured using dual-energy X-ray absorptiometry in a subgroup of the former athletes (n=87; median age 59 years) and in a population-based control group (n=194) and compared by general linear models.

Muscle performance, work ability and physical functioning in middle-aged men.

Background: Limited data exist on the associations between muscle performance and work ability measures in working age adults.

Aims: To evaluate how the results of simple muscle performance tests correlate with self-reported work ability and physical functioning in middle-aged men.

Methods: Muscle performance was measured with handgrip, sit-up, arch-up, squatting and lifting tests.

Reproducibility of dual-energy x-ray absorptiometry total and regional body composition measurements using different scanning positions and definitions of regions.

Repeated dual-energy x-ray absorptiometry (DEXA) measurements are often performed both in clinical work and in research studies. The aims of the present study were to investigate the repeatability of DEXA total body measurements, to clarify the effect of the scanning positioning of the subject, and to compare the reliability of DEXA measurements of the extremities between automatically and manually defined regions of interest (ROIs). Three DEXA measurements of the total body composition, that is, fat tissue mass, lean tissue mass (LM), and bone mineral content, were performed on 30 male volunteers (mean age, 45.

Type of sport is related to injury profile: a study on cross country skiers, swimmers, long-distance runners and soccer players. A retrospective 12-month study.

This 12-month retrospective questionnaire compared the occurrence of sports injuries in 149 cross country skiers, 154 swimmers, 143 long-distance runners and 128 soccer players aged 15-35 years. Soccer had significantly more injuries (5.1 injuries/1000 exposure hour) than other sports (2.

Documentation of pain management with TT- 2000+ in May 2008 viewed from clinical nursing practice.

Background: Electronic Patient Record (EPR) TT- 2000+ was implemented in Hospital Orton in January 2008. The software TT 2000+ was implemented in 2005. TT- 2000+ enables structured and specifically defined documentation in clinical nursing practice.

The utilization of electronic patient record in pain management from the perspective of nursing management.

Unlabelled: The electronic patient record is becoming more common in Finland. Structured and classified documentation methods make it possible to utilize different reports from EPR in the nursing management.

Objectives: To describe how the knowledge of pain management in the EPR can be utilized in nursing management.

Effects of repeated whole-body cold exposures on serum concentrations of growth hormone, thyrotropin, prolactin and thyroid hormones in healthy women.

Cold therapy is used to relieve pain and inflammatory symptoms. Humoral changes may account for the pain alleviation related to the cold exposures. The aim of the present study was to examine the effects of two types of cold therapy, winter swimming in ice-cold water (WS) and whole body cryotherapy (WBC), on the serum levels of the growth hormone, prolactin, thyrotropin and free fractions of thyroid hormones (fT3, fT4).

Carbonic anhydrases in meningiomas: association of endothelial carbonic anhydrase II with aggressive tumor features.

Object: Carbonic anhydrase (CA) II and IX are enzymes involved in pH homeostasis and have been shown to be upregulated in several types of cancer. In this study, the authors evaluate the expression of CA II and IX in meningiomas and assess their relationship to patient age, tumor type and grade, tumor sex hormone receptor status, tumor cell proliferation, and tumor recurrence.

Methods: This study was conducted in consecutive patients who underwent meningioma surgeries at Tampere University Hospital between 1989 and 1999.

A prospective comparison of 3 hamstring ACL fixation devices--Rigidfix, BioScrew, and Intrafix--randomized into 4 groups with 2 years of follow-up.

Background: New devices for graft fixation in anterior cruciate ligament reconstruction are released to clinical use without clinical follow-up data.

Hypothesis: There is similar clinical outcome after either cross-pin or absorbable interference screw fixation in anterior cruciate ligament reconstruction with hamstring tendons.

Study Design: Randomized controlled clinical trial; Level of evidence, 1.

Gender differences in sport injury risk and types of inju-ries: a retrospective twelve-month study on cross-country skiers, swimmers, long-distance runners and soccer players.

This twelve months survey compared injury risk and injury types by genders (312 females, 262 males) in 15- to 35-year-old cross-country skiers, swimmers, long- distance runners and soccer players. More male than female athletes reported at least one acute injury (44% vs. 35%, p < 0.

Validation study of a Finnish version of the Western Ontario and McMasters University osteoarthritis index.

The aim of the study was to validate a Finnish version of the internationally used Western Ontario and McMasters University osteoarthritis index (WOMAC) questionnaire, by testing its reliability, validity and responsiveness. The subjects of the study were patients scheduled for elective total knee arthroplasty (TKA) or total hip arthroplasty (THA). The patients completed the WOMAC questionnaire twice prior to surgery and once postoperatively to enable reliability, construct validity and responsiveness analysis.

A simple grafting method to repair irreparable distal biceps tendon.

Unlabelled: Irreparable distal biceps tendon tears typically are treated using a free tendon graft. We asked whether our new method to fix the graft--using two suture anchors--yields similar results to our previous bone canal method. We compared the two methods for strength, endurance, and clinical findings.

Late hardware-induced sciatic nerve lesions after acetabular revision.

Unlabelled: We encountered late hardware-induced sciatic nerve lesions after acetabular revision in six patients. There were five female patients and one male patient. The mean age of the patients at the time of index acetabular revision was 59.

Ankle osteoarthritis is associated with knee osteoarthritis. Conclusions based on mechanical axis radiographs.

Introduction: Osteoarthritis (OA) of the ankle with an unknown etiology (primary OA) is rare, whereas a secondary OA due to a known cause is not uncommon. OA of the knee can, when it progresses, change the alignment of the whole extremity including the ankle joint. Since we had observed in patients coming for OA knee surgery coexisting OA in the ankle joint, our objective of this study was to assess the prevalence of abnormal alignment and degenerative changes in the ankle joint and to determine if degenerative changes in the knee and ankle correlated.

Arthrography for the diagnosis of abductor avulsion after total hip arthroplasty: a comparison of arthrographic and surgical findings in 33 patients.

Background: Weakness of the abductor muscles--or even their avulsion--is a potential risk when total hip arthroplasty (THA) is performed using the anterolateral approach. Avulsion of the re-attached gluteus medius leads to a limp, but can also provide an open canal for joint fluid to escape to the trochanteric region. Thus, our hypothesis was that arthrography can be used to diagnose such detachment.