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  • 1.
    Ericson, A
    et al.
    Department of Orthopaedics, Karolinska Institute, Karolinska Hospital, Stockholm, Sweden.
    Arndt, A
    Department of Orthopaedics, Karolinska Institute, Huddinge University, Stockholm, Sweden.
    Stark, A
    Department of Orthopaedics, Karolinska Institute, Karolinska Hospital, Stockholm, Sweden.
    Wretenberg, Per
    Örebro University Hospital. Department of Orthopaedics, Karolinska Institute, Karolinska Hospital, Stockholm, Sweden.
    Lundberg, A
    Department of Orthopaedics, Karolinska Institute, Huddinge University, Stockholm, Sweden.
    Variation in the position and orientation of the elbow flexion axis2003In: Journal of Bone and Joint Surgery, ISSN 0301-620X, E-ISSN 2044-5377, Vol. 85B, no 4, p. 538-544Article in journal (Refereed)
    Abstract [en]

    We analysed the axis of movement in the normal elbow during flexion in vivo using radiostereometric analysis (RSA). The results show an intraindividual variation in the inclination of the axis ranging from 2.1 degrees to 14.3 degrees in the frontal and from 1.6 degrees to 9.8 degrees in the horizontal plane analysed at 30 degrees increments. The inclination of the mean axis of rotation varied within a range of 12.7 degrees in the frontal and 4.6 degrees in the horizontal plane. In both planes, the mean axes were located close to a line joining the centres of the trochlea and capitellum. The intra- and interindividual variations of the axes of flexion of the elbow were greater than previously reported. These factors should be considered in the development of elbow prostheses.

  • 2.
    Grondal, L
    et al.
    Department of Molecular Medicine and Surgery, Karolinska Institute, Red Cross Hospital, Stockholm, Sweden.
    Broström, E
    Department of Woman and Child Health, Karolinska University Hospital, Stockholm, Sweden.
    Wretenberg, Per
    Örebro University Hospital. Department of Molecular Medicine and Surgery, Section of Orthopaedics, Karolinska Institute, Stockholm, Sweden.
    Stark, A
    Department of Molecular Medicine and Surgery, Section of Orthopaedics, Karolinska Institute, Stockholm, Sweden.
    Arthrodesis versus Mayo resection: the management of the first metatarsophalangeal joint in reconstruction of the rheumatoid forefoot2006In: Journal of Bone and Joint Surgery, ISSN 0301-620X, E-ISSN 2044-5377, Vol. 88B, no 7, p. 914-919Article in journal (Refereed)
    Abstract [en]

    In a prospective randomised study 31 patients were allocated to either arthrodesis or Mayo resection of the first metatarsophalangeal joint as part of a total reconstruction of the rheumatoid forefoot. Of these, 29 were re-examined after a mean of 72 months (57 to 80), the Foot Function Index was scored and any deformity measured. Load distribution was analysed using a Fscan mat in 14 cases, and time and distance were measured in 12 of these patients using a 3D Motion system. We found excellent patient satisfaction and a significant, lasting reduction of the Foot Function Index, with no statistically significant differences between the groups. There were no significant differences in recurrence of the deformity, the need for special shoes, gait velocity, step length, plantar moment, mean pressure or the position of the centre of force under the forefoot. The cadence was higher and the stance phase shorter in the fusion group.

    These results suggest that a Mayo resection may be an equally good option for managing the first metatarsophalangeal joint in reconstruction of the rheumatoid forefoot.

  • 3. Sandén, B.
    et al.
    Olerud, C.
    Petrén-Mallmin, M.
    Johansson, Carina B.
    Örebro University, Department of Technology.
    Larsson, C.
    The significance of radiolucent zones surrounding pedicle screws: definition of screw loosening in spinal instrumentation2004In: Journal of Bone and Joint Surgery, ISSN 0301-620X, E-ISSN 2044-5377, Vol. 86 B, no 3, p. 457-461Article in journal (Refereed)
    Abstract [en]

    We examined the radiographs from a prospective clinical study of fixation by pedicle screws and those from an experimental study in a sheep model. In the clinical study, instruments were removed from 21 patients after implantation for 11 to 16 months and the extraction torques of the screws were recorded. A structured protocol was used for the radiological examinations. In the experimental study, loaded pedicle screw instrumentations were implanted in the sheep for six or 12 weeks. After radiological examination the pull-out resistance and the histological characteristics were studied. In the clinical study, all screws with radiolucent zones had a significantly reduced mean extraction torque compared with screws without radiolucent zones (16 +/- 10 Ncm v 403 +/- 220 Ncm; p < 0.0001). In the experimental study the mean maximum pull-out resistance for the screws with radiolucent zones was significantly lower than for those with no radiolucency (243 +/- 156 N v2214 +/- 578 N; p = 0.0006) and the mean bone-to-screw contact was reduced for screws with zones compared with those without zones (8 +/- 9% v 55 +/- 29%; p = 0.0002). Our findings showed that all screws with radiolucent zones had low extraction torques or low pull-out resistance. A radiolucent zone is a good indicator of loosening of a pedicle screw.

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