Eirik Solheim - Academia.edu (original) (raw)
Papers by Eirik Solheim
Journal of orthopaedic reports, Apr 1, 2023
Journal of Orthopaedic Reports
Journal of Orthopaedic Reports
Distal Radius Fractures, 2014
Until 10 years ago external fixation was a popular method for treating unstable distal radius fra... more Until 10 years ago external fixation was a popular method for treating unstable distal radius fractures, but now volar locking plates are the most commonly used treatment. There is still, however, a place for external fixation in unstable distal radius fractures, in multi-trauma management and in very comminuted fractures. In external fixation of distal radius fractures it is important to use adjuvant pin fixation in order to secure the volar tilt and it is also important to avoid overdistraction of the radiocarpal joint. The main complication of external fixation is pin site infection which is treated with pin care and antibiotics.
Poster: "ESSR 2013 / P-0062 / Estimation of radiation dose to patients undergoing postoperat... more Poster: "ESSR 2013 / P-0062 / Estimation of radiation dose to patients undergoing postoperative CT after ACL reconstruction surgery. " by: " A. P. Parkar 1, M. Adriaensen2, T. Strand1, E. Inderhaug1, E. Solheim1; 1Bergen/NO, 2Heerlen/NL"
A composite of a local, sustained, drug-release cartilage and bone formation at the same rate as ... more A composite of a local, sustained, drug-release cartilage and bone formation at the same rate as system, Alzamep bioerodible polyorthoester, and DEM when evaluated histologically and by 85Sr demineralized bone-matrix (DBM) particles implanted uptake. The composite implant was technically easier in the abdominal muscle of 89 Wistar rats induced to use than DBM alone.
A composite of a local, sustained, drug-release cartilage and bone formation at the same rate as ... more A composite of a local, sustained, drug-release cartilage and bone formation at the same rate as system, Alzamep bioerodible polyorthoester, and DEM when evaluated histologically and by 85Sr demineralized bone-matrix (DBM) particles implanted uptake. The composite implant was technically easier in the abdominal muscle of 89 Wistar rats induced to use than DBM alone.
Conclusions 1. The novel osteoquantum index was found to have a linear relationship to the area ... more Conclusions
1. The novel osteoquantum index was found to have a linear relationship to the area of the induced bone with a correlation coefficient (r) of 0.90 and high statistical significance (p<0.0001). Only weak linear relationships were found between the osteogenic index and the area of the bone (r=0.32, p=0.03) and between the os- teogenic index and the osteoquantum index (r=0.33, p=0.03) (paper I). The osteoquantum index and the area of the induced bone both increased with increasing mass of implanted DBM, whereas the osteogenic index did not change significantly (paper I).
2. Bioerodible polyorthoester did not inhibit heterotopic osteoinduction, it caused only a slight inflammation that subsided within 3 weeks postoperatively and it was mostly absorbed by week 4 (papers II, III and VI). In contrast, nonabsorbable bone wax and fibrin-collagen paste both were incompletely absorbed, induced a chronic inflammation and inhibited osteoinduction (paper III).
3. The composite of polyorthoester and DBM induced bony healing of large calvarial (paper IV) and radial defects (paper V) as DBM alone. Moreover, the composite was moldable and easily contoured, and technically easier to use than DBM alone. Finally, the polyorthoester provided local hemostasis when used either alone or in composites with demineralized bone (papers IV and V).
4. Polyorthoester with 5% indomethacin significantly inhibited DBM-induced heterotopic osteogenesis, probably by local mechanisms as indomethacin could not be detected in any blood sample (paper VI).
Tidsskrift for den Norske laegeforening
ABSTRACT
Tidsskrift for den Norske laegeforening
Chondrocytes in adult human cartilage have little mitotic capacity even after injuries. Deep inju... more Chondrocytes in adult human cartilage have little mitotic capacity even after injuries. Deep injuries penetrating the subchondral bone plate lead to the release of pluripotent mesenchymal stem cells which have the potential to differentiate into different types of connective tissue, including bone and cartilage. The release and stimulation of these stem cells can also be achieved by drilling or microfracture of the subchondral bone of cartilage lesions. When stimulated, periosteal cells may also differentiate into chondrocytes. However, non-chondrocyte determined cells seem to induce mainly fibrocartilage. In 1987 autologous chondrocyte implantation was introduced by a team in Gothenburg. This resulted in clinical improvement and the development of hyaline-like cartilage in patients who had undergone treatment. We first used the method in 1996 in a clinical trial. At a 6-month follow-up of our first 12 patients we found reduced symptoms and improved knee function. This method is pro...
Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, 2001
Revascularisation of bone grafts is in uenced by both the anatomical origin and the preimplantati... more Revascularisation of bone grafts is in uenced by both the anatomical origin and the preimplantation processing of the graft. We investigated the revascularisation by entrapment of 1 4 1 Ce (cerium)-labelled microspheres in large, fresh and demineralised syngeneic grafts of predominantly cancellous (iliac bone) or cortical (tibial diaphysis) bone three weeks after heterotopic implantation in rats. The mean (SD) 1 4 1 Ce deposition index (counts per minute (cpm) of mg recovered implant/cpm of mg host iliac bone) was higher in fresh iliac bone grafts, 0.98 (0.46) compared to that of demineralised iliac bone, 0.32 (0.20), p < 0.001, and fresh tibial bone grafts, 0.51 (0.27), p = 0.007. We found no signi cant difference in the mean 1 4 1 Ce deposition index between fresh tibial bone grafts and demineralised tibial bone grafts, 0.35 (0.42), p = 0.4, or between demineralised tibial grafts and demineralised iliac bone grafts, p = 0.8. The results suggest that whereas fresh cancellous grafts are revascularised more completely than fresh cortical grafts, there is no difference in the revascularisation of demineralised cancellous and cortical grafts. In addition, fresh cancellous bone is revascularised more completely than demineralised cancellous bone, whereas there is no difference between fresh and demineralised cortical bone.
Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række, Jan 10, 1999
Articular cartilage has little ability to regenerate. Cartilage lesions usually persist, may prov... more Articular cartilage has little ability to regenerate. Cartilage lesions usually persist, may provoke pain, swelling, locking and disability, and may predispose for development of osteoarthritis. Long-term results after traditional surgical techniques are unsatisfactory. In recent years, auto-transplantation of chondrocytes and osteochondral cylinder grafts aimed at reconstituting the chondral surface has been introduced. By the mosaicplasty technique, osteochondral grafts are transplanted from areas of little weight bearing at the outer limits of the trochlea to the focal lesion in the same knee. Since March 1998, 35 consecutive mosaicplasties in 33 patients (median age 35 years) have been performed at our hospital. The median area of the lesions was 2.8 sq. cm and the lesions were located at the femoral condyles, trochlea or patella. Six to twelve months post-operatively we found significant improvement of the Lysholm kneescore, from 40 (SD 14) pre-operatively to 84 (SD 14) (p <...
The American Journal of Sports Medicine, 2022
Background: Few studies have investigated the outcome ≥20 years after an anterior cruciate ligame... more Background: Few studies have investigated the outcome ≥20 years after an anterior cruciate ligament reconstruction (ACLR) with a bone–patellar tendon–bone autograft, and there is a wide range in the reported rates of radiographic osteoarthritis (OA). Purpose: To report on radiographic OA development and to assess risk factors of knee OA at a median 25 years after ACLR with a bone–patellar tendon–bone autograft. Study Design: Case-control study; Level of evidence, 3. Methods: Unilateral ACLRs performed at a single center from 1987 to 1994 were included (N = 235). The study population was followed prospectively with clinical testing and questionnaires. Results from the 3-month, 12-month, and median 25-year follow-up are presented. In addition, a radiographic evaluation was performed at the final follow-up. Radiographic OA was defined as Kellgren-Lawrence grade ≥2 or having undergone ipsilateral knee replacement surgery. Possible predictors of OA development included patient age, sex, ...
Orthopaedic Journal of Sports Medicine, 2020
Background: Failed anterior cruciate ligament (ACL) reconstruction (ACLR) can lead to reduced qua... more Background: Failed anterior cruciate ligament (ACL) reconstruction (ACLR) can lead to reduced quality of life because of recurrent episodes of instability, restrictions in level of activity, and development of osteoarthritis. A profound knowledge of the causes of a failed surgery can ultimately help improve graft survival rates. Purpose: To investigate the patient-related risks of inferior outcomes leading to revision surgery after ACLR. Study Design: Case-control study; Level of evidence, 3. Methods: From a prospective cohort of primary ACLRs performed at a single center, patients who required later revision surgery were matched with a control group of uneventful primary ACLRs. Patient characteristics, data from the preoperative examinations, KT-1000 arthrometer laxity testing, Tegner activity scale, International Knee Documentation Committee subjective score, Knee injury and Osteoarthritis Outcome Score, and perioperative data from the initial surgery were included. Results: A tot...
Arthroscopy Techniques, 2021
We report on the treatment of cases of painful subcutaneous pretibial cyst due to broken and disp... more We report on the treatment of cases of painful subcutaneous pretibial cyst due to broken and displaced materials of only partly absorbed bioabsorbable interference screws used for anterior cruciate ligament reconstruction. Ultrasound examination was used to both make the definite diagnosis and determine the exact localization of dislodged screw parts. The broken and loose bioabsorbable screw parts and surrounding cyst-like structure were removed endoscopically by a soft-tissue resector.
JBJS Essential Surgical Techniques, 2019
Disclosure: The authors indicated that no external funding was received for any aspect of this wo... more Disclosure: The authors indicated that no external funding was received for any aspect of this work. The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSEST/A266).
Journal of Orthopaedics, 2018
Some studies suggest a common degenerative path might contribute to a range of shoulder diseases ... more Some studies suggest a common degenerative path might contribute to a range of shoulder diseases involving subacromial pain syndrome and full-thickness rotator cuff tears. One could therefore theorize arthroscopic subacromial decompression and rotator cuff repair as interventions at different stages of a degenerative shoulder disease. Few studies have compared long-term outcomes after these two procedures. Method: Matched case-controls undergoing arthroscopic rotator cuff repair combined with subacromial decompression (N = 180) or subacromial decompression only (N = 180) were evaluated pre-and 7.5 years postoperatively using QuickDASH score, VAS of function, VAS of pain and VAS of satisfaction. New surgery and complications were recorded. Baseline characteristics were related to outcomes to investigate predictors of good/poor outcome. Results: A general improvement from baseline was seen − from 51 to 14 (QuickDASH) in the combined group and from 53 to 16 in the decompression only group. No differences in outcomes were seen between groups (n.s.). Age above 55 at surgery predicted better VAS of function (P = .04) while acute onset of symptoms predicted better QuickDASH in the combined group (P = 0.03). None in the decompression group had undergone later rotator cuff repair. Conclusion: Major improvements in pain/function were seen at mid-to long-term after isolated arthroscopic subacromial decompression and combined decompression/rotator cuff repair. Several patient-specific factors predicting worse outcomes were identified.
The Knee, 2017
Background: The purpose of this study was to evaluate the outcome after cartilage repair surgery ... more Background: The purpose of this study was to evaluate the outcome after cartilage repair surgery in focal defects of the knee by microfracture versus mosaicplasty. Methods: A cohort of 102 patients undergoing microfracture (n = 52) or mosaicplasty (n = 50) of a single articular cartilage defect in the medial femoral condyle of ≤50 mm 2 was evaluated by Lysholm score before surgery, at six months, 12 months, five years, 10 years, and 15-18 years after surgery. Results: Median age of patients at the time of surgery was 36 years (range 16-58) and median follow-up time was 16 years (range 14-18). Defects were treated with a median size of three square centimetres (range one to five). A significant increase was seen in the Lysholm score from mean 48 (SD 16) at baseline to 66 (SD 23; P b 0.001) at the 15-18 year follow-up. The Lysholm score was higher in the mosaicplasty group at six months, 12 months, five years and 10 years (P b 0.05 for all comparisons). These differences were clinically significant at all points (N10 points). However, at the final follow-up, the difference (eight points) did not reach statistical significance. Conclusions: In the short-term, medium-term and long-term (10 years), mosaicplasty in a single cartilage defect size one to five square centimetres of the femoral condyle resulted in clinically relevant better outcome than microfracture. However, at 15-18 years after the surgery such a difference could not be found. In the six month to 10-15 year (after surgery) perspective, the mosaicplasty procedure offered a better outcome in this type of lesion.
The Journal of Bone & Joint Surgery, 1992
The effect of a composite of demineralized bone mixed with polyorthoester on the healing of large... more The effect of a composite of demineralized bone mixed with polyorthoester on the healing of large segmental defects in the rat radius was studied. Sixty male Wistar rats were divided into four groups, A through D, and an osteoperiosteal diaphyseal defect of 50 per cent of the length of the bone was made in the right radius of each rat. In Group A, the defect was filled with polyorthoester and demineralized bone; in Group B, demineralized bone; and in Group C, polyorthoester. No material was implanted in the defects in the Group-D rats. The rats were killed fifty days postoperatively. The formation of bone in the defects was quantified with computer-assisted measurements of the area on radiographs. The host-tissue response was evaluated with light microscopy. Defects that had been filled with the composite of polyorthoester and demineralized bone or with demineralized bone alone showed regeneration of bone corresponding to 93.6 and 77.6 per cent of the area of the defect, respectively. Defects that had no implant or that had been filled with polyorthoester alone showed significantly less formation of bone. No inflammation was seen with light microscopy, and only traces of the polyorthoester could be detected in the defects that had been filled with the composite or with polyorthoester alone.
The International journal of oral & maxillofacial implants
Thirty 8-week-old male Wistar rats were randomly allocated into three groups of 10 rats each. A 5... more Thirty 8-week-old male Wistar rats were randomly allocated into three groups of 10 rats each. A 5-mm defect in the left parietal bone was made in each rat. In the defects of the first group of rats, no implant was used (control group). In the second group, polyorthoester membranes were placed in the defects without active substance. In the third group, polyorthoester membranes were placed with insulinlike growth factor I. The rats were sacrificed 6 weeks postoperatively. Bone formation in the defects was quantified by computer-assisted measurements of the area of the residual defect on radiographs. Host-tissue response was evaluated by light microscopy. The area of residual bone defect was greatest in the control group, less for the defects with polyorthoester membrane without active substance, and least for the defects with polyorthoester membranes with the growth factor. During histologic evaluation, no inflammation was seen, and only traces of the polyorthoester were detected in ...
Journal of orthopaedic reports, Apr 1, 2023
Journal of Orthopaedic Reports
Journal of Orthopaedic Reports
Distal Radius Fractures, 2014
Until 10 years ago external fixation was a popular method for treating unstable distal radius fra... more Until 10 years ago external fixation was a popular method for treating unstable distal radius fractures, but now volar locking plates are the most commonly used treatment. There is still, however, a place for external fixation in unstable distal radius fractures, in multi-trauma management and in very comminuted fractures. In external fixation of distal radius fractures it is important to use adjuvant pin fixation in order to secure the volar tilt and it is also important to avoid overdistraction of the radiocarpal joint. The main complication of external fixation is pin site infection which is treated with pin care and antibiotics.
Poster: "ESSR 2013 / P-0062 / Estimation of radiation dose to patients undergoing postoperat... more Poster: "ESSR 2013 / P-0062 / Estimation of radiation dose to patients undergoing postoperative CT after ACL reconstruction surgery. " by: " A. P. Parkar 1, M. Adriaensen2, T. Strand1, E. Inderhaug1, E. Solheim1; 1Bergen/NO, 2Heerlen/NL"
A composite of a local, sustained, drug-release cartilage and bone formation at the same rate as ... more A composite of a local, sustained, drug-release cartilage and bone formation at the same rate as system, Alzamep bioerodible polyorthoester, and DEM when evaluated histologically and by 85Sr demineralized bone-matrix (DBM) particles implanted uptake. The composite implant was technically easier in the abdominal muscle of 89 Wistar rats induced to use than DBM alone.
A composite of a local, sustained, drug-release cartilage and bone formation at the same rate as ... more A composite of a local, sustained, drug-release cartilage and bone formation at the same rate as system, Alzamep bioerodible polyorthoester, and DEM when evaluated histologically and by 85Sr demineralized bone-matrix (DBM) particles implanted uptake. The composite implant was technically easier in the abdominal muscle of 89 Wistar rats induced to use than DBM alone.
Conclusions 1. The novel osteoquantum index was found to have a linear relationship to the area ... more Conclusions
1. The novel osteoquantum index was found to have a linear relationship to the area of the induced bone with a correlation coefficient (r) of 0.90 and high statistical significance (p<0.0001). Only weak linear relationships were found between the osteogenic index and the area of the bone (r=0.32, p=0.03) and between the os- teogenic index and the osteoquantum index (r=0.33, p=0.03) (paper I). The osteoquantum index and the area of the induced bone both increased with increasing mass of implanted DBM, whereas the osteogenic index did not change significantly (paper I).
2. Bioerodible polyorthoester did not inhibit heterotopic osteoinduction, it caused only a slight inflammation that subsided within 3 weeks postoperatively and it was mostly absorbed by week 4 (papers II, III and VI). In contrast, nonabsorbable bone wax and fibrin-collagen paste both were incompletely absorbed, induced a chronic inflammation and inhibited osteoinduction (paper III).
3. The composite of polyorthoester and DBM induced bony healing of large calvarial (paper IV) and radial defects (paper V) as DBM alone. Moreover, the composite was moldable and easily contoured, and technically easier to use than DBM alone. Finally, the polyorthoester provided local hemostasis when used either alone or in composites with demineralized bone (papers IV and V).
4. Polyorthoester with 5% indomethacin significantly inhibited DBM-induced heterotopic osteogenesis, probably by local mechanisms as indomethacin could not be detected in any blood sample (paper VI).
Tidsskrift for den Norske laegeforening
ABSTRACT
Tidsskrift for den Norske laegeforening
Chondrocytes in adult human cartilage have little mitotic capacity even after injuries. Deep inju... more Chondrocytes in adult human cartilage have little mitotic capacity even after injuries. Deep injuries penetrating the subchondral bone plate lead to the release of pluripotent mesenchymal stem cells which have the potential to differentiate into different types of connective tissue, including bone and cartilage. The release and stimulation of these stem cells can also be achieved by drilling or microfracture of the subchondral bone of cartilage lesions. When stimulated, periosteal cells may also differentiate into chondrocytes. However, non-chondrocyte determined cells seem to induce mainly fibrocartilage. In 1987 autologous chondrocyte implantation was introduced by a team in Gothenburg. This resulted in clinical improvement and the development of hyaline-like cartilage in patients who had undergone treatment. We first used the method in 1996 in a clinical trial. At a 6-month follow-up of our first 12 patients we found reduced symptoms and improved knee function. This method is pro...
Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, 2001
Revascularisation of bone grafts is in uenced by both the anatomical origin and the preimplantati... more Revascularisation of bone grafts is in uenced by both the anatomical origin and the preimplantation processing of the graft. We investigated the revascularisation by entrapment of 1 4 1 Ce (cerium)-labelled microspheres in large, fresh and demineralised syngeneic grafts of predominantly cancellous (iliac bone) or cortical (tibial diaphysis) bone three weeks after heterotopic implantation in rats. The mean (SD) 1 4 1 Ce deposition index (counts per minute (cpm) of mg recovered implant/cpm of mg host iliac bone) was higher in fresh iliac bone grafts, 0.98 (0.46) compared to that of demineralised iliac bone, 0.32 (0.20), p < 0.001, and fresh tibial bone grafts, 0.51 (0.27), p = 0.007. We found no signi cant difference in the mean 1 4 1 Ce deposition index between fresh tibial bone grafts and demineralised tibial bone grafts, 0.35 (0.42), p = 0.4, or between demineralised tibial grafts and demineralised iliac bone grafts, p = 0.8. The results suggest that whereas fresh cancellous grafts are revascularised more completely than fresh cortical grafts, there is no difference in the revascularisation of demineralised cancellous and cortical grafts. In addition, fresh cancellous bone is revascularised more completely than demineralised cancellous bone, whereas there is no difference between fresh and demineralised cortical bone.
Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række, Jan 10, 1999
Articular cartilage has little ability to regenerate. Cartilage lesions usually persist, may prov... more Articular cartilage has little ability to regenerate. Cartilage lesions usually persist, may provoke pain, swelling, locking and disability, and may predispose for development of osteoarthritis. Long-term results after traditional surgical techniques are unsatisfactory. In recent years, auto-transplantation of chondrocytes and osteochondral cylinder grafts aimed at reconstituting the chondral surface has been introduced. By the mosaicplasty technique, osteochondral grafts are transplanted from areas of little weight bearing at the outer limits of the trochlea to the focal lesion in the same knee. Since March 1998, 35 consecutive mosaicplasties in 33 patients (median age 35 years) have been performed at our hospital. The median area of the lesions was 2.8 sq. cm and the lesions were located at the femoral condyles, trochlea or patella. Six to twelve months post-operatively we found significant improvement of the Lysholm kneescore, from 40 (SD 14) pre-operatively to 84 (SD 14) (p <...
The American Journal of Sports Medicine, 2022
Background: Few studies have investigated the outcome ≥20 years after an anterior cruciate ligame... more Background: Few studies have investigated the outcome ≥20 years after an anterior cruciate ligament reconstruction (ACLR) with a bone–patellar tendon–bone autograft, and there is a wide range in the reported rates of radiographic osteoarthritis (OA). Purpose: To report on radiographic OA development and to assess risk factors of knee OA at a median 25 years after ACLR with a bone–patellar tendon–bone autograft. Study Design: Case-control study; Level of evidence, 3. Methods: Unilateral ACLRs performed at a single center from 1987 to 1994 were included (N = 235). The study population was followed prospectively with clinical testing and questionnaires. Results from the 3-month, 12-month, and median 25-year follow-up are presented. In addition, a radiographic evaluation was performed at the final follow-up. Radiographic OA was defined as Kellgren-Lawrence grade ≥2 or having undergone ipsilateral knee replacement surgery. Possible predictors of OA development included patient age, sex, ...
Orthopaedic Journal of Sports Medicine, 2020
Background: Failed anterior cruciate ligament (ACL) reconstruction (ACLR) can lead to reduced qua... more Background: Failed anterior cruciate ligament (ACL) reconstruction (ACLR) can lead to reduced quality of life because of recurrent episodes of instability, restrictions in level of activity, and development of osteoarthritis. A profound knowledge of the causes of a failed surgery can ultimately help improve graft survival rates. Purpose: To investigate the patient-related risks of inferior outcomes leading to revision surgery after ACLR. Study Design: Case-control study; Level of evidence, 3. Methods: From a prospective cohort of primary ACLRs performed at a single center, patients who required later revision surgery were matched with a control group of uneventful primary ACLRs. Patient characteristics, data from the preoperative examinations, KT-1000 arthrometer laxity testing, Tegner activity scale, International Knee Documentation Committee subjective score, Knee injury and Osteoarthritis Outcome Score, and perioperative data from the initial surgery were included. Results: A tot...
Arthroscopy Techniques, 2021
We report on the treatment of cases of painful subcutaneous pretibial cyst due to broken and disp... more We report on the treatment of cases of painful subcutaneous pretibial cyst due to broken and displaced materials of only partly absorbed bioabsorbable interference screws used for anterior cruciate ligament reconstruction. Ultrasound examination was used to both make the definite diagnosis and determine the exact localization of dislodged screw parts. The broken and loose bioabsorbable screw parts and surrounding cyst-like structure were removed endoscopically by a soft-tissue resector.
JBJS Essential Surgical Techniques, 2019
Disclosure: The authors indicated that no external funding was received for any aspect of this wo... more Disclosure: The authors indicated that no external funding was received for any aspect of this work. The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSEST/A266).
Journal of Orthopaedics, 2018
Some studies suggest a common degenerative path might contribute to a range of shoulder diseases ... more Some studies suggest a common degenerative path might contribute to a range of shoulder diseases involving subacromial pain syndrome and full-thickness rotator cuff tears. One could therefore theorize arthroscopic subacromial decompression and rotator cuff repair as interventions at different stages of a degenerative shoulder disease. Few studies have compared long-term outcomes after these two procedures. Method: Matched case-controls undergoing arthroscopic rotator cuff repair combined with subacromial decompression (N = 180) or subacromial decompression only (N = 180) were evaluated pre-and 7.5 years postoperatively using QuickDASH score, VAS of function, VAS of pain and VAS of satisfaction. New surgery and complications were recorded. Baseline characteristics were related to outcomes to investigate predictors of good/poor outcome. Results: A general improvement from baseline was seen − from 51 to 14 (QuickDASH) in the combined group and from 53 to 16 in the decompression only group. No differences in outcomes were seen between groups (n.s.). Age above 55 at surgery predicted better VAS of function (P = .04) while acute onset of symptoms predicted better QuickDASH in the combined group (P = 0.03). None in the decompression group had undergone later rotator cuff repair. Conclusion: Major improvements in pain/function were seen at mid-to long-term after isolated arthroscopic subacromial decompression and combined decompression/rotator cuff repair. Several patient-specific factors predicting worse outcomes were identified.
The Knee, 2017
Background: The purpose of this study was to evaluate the outcome after cartilage repair surgery ... more Background: The purpose of this study was to evaluate the outcome after cartilage repair surgery in focal defects of the knee by microfracture versus mosaicplasty. Methods: A cohort of 102 patients undergoing microfracture (n = 52) or mosaicplasty (n = 50) of a single articular cartilage defect in the medial femoral condyle of ≤50 mm 2 was evaluated by Lysholm score before surgery, at six months, 12 months, five years, 10 years, and 15-18 years after surgery. Results: Median age of patients at the time of surgery was 36 years (range 16-58) and median follow-up time was 16 years (range 14-18). Defects were treated with a median size of three square centimetres (range one to five). A significant increase was seen in the Lysholm score from mean 48 (SD 16) at baseline to 66 (SD 23; P b 0.001) at the 15-18 year follow-up. The Lysholm score was higher in the mosaicplasty group at six months, 12 months, five years and 10 years (P b 0.05 for all comparisons). These differences were clinically significant at all points (N10 points). However, at the final follow-up, the difference (eight points) did not reach statistical significance. Conclusions: In the short-term, medium-term and long-term (10 years), mosaicplasty in a single cartilage defect size one to five square centimetres of the femoral condyle resulted in clinically relevant better outcome than microfracture. However, at 15-18 years after the surgery such a difference could not be found. In the six month to 10-15 year (after surgery) perspective, the mosaicplasty procedure offered a better outcome in this type of lesion.
The Journal of Bone & Joint Surgery, 1992
The effect of a composite of demineralized bone mixed with polyorthoester on the healing of large... more The effect of a composite of demineralized bone mixed with polyorthoester on the healing of large segmental defects in the rat radius was studied. Sixty male Wistar rats were divided into four groups, A through D, and an osteoperiosteal diaphyseal defect of 50 per cent of the length of the bone was made in the right radius of each rat. In Group A, the defect was filled with polyorthoester and demineralized bone; in Group B, demineralized bone; and in Group C, polyorthoester. No material was implanted in the defects in the Group-D rats. The rats were killed fifty days postoperatively. The formation of bone in the defects was quantified with computer-assisted measurements of the area on radiographs. The host-tissue response was evaluated with light microscopy. Defects that had been filled with the composite of polyorthoester and demineralized bone or with demineralized bone alone showed regeneration of bone corresponding to 93.6 and 77.6 per cent of the area of the defect, respectively. Defects that had no implant or that had been filled with polyorthoester alone showed significantly less formation of bone. No inflammation was seen with light microscopy, and only traces of the polyorthoester could be detected in the defects that had been filled with the composite or with polyorthoester alone.
The International journal of oral & maxillofacial implants
Thirty 8-week-old male Wistar rats were randomly allocated into three groups of 10 rats each. A 5... more Thirty 8-week-old male Wistar rats were randomly allocated into three groups of 10 rats each. A 5-mm defect in the left parietal bone was made in each rat. In the defects of the first group of rats, no implant was used (control group). In the second group, polyorthoester membranes were placed in the defects without active substance. In the third group, polyorthoester membranes were placed with insulinlike growth factor I. The rats were sacrificed 6 weeks postoperatively. Bone formation in the defects was quantified by computer-assisted measurements of the area of the residual defect on radiographs. Host-tissue response was evaluated by light microscopy. The area of residual bone defect was greatest in the control group, less for the defects with polyorthoester membrane without active substance, and least for the defects with polyorthoester membranes with the growth factor. During histologic evaluation, no inflammation was seen, and only traces of the polyorthoester were detected in ...