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Biomedical subjects

A Lindstrand

Publications and source records attributed to A Lindstrand.

At least 37 records · Page 2Linked to original sources
PubMed1999

Rearrangement of the neoplasia-associated gene HMGIC in synovia from patients with osteoarthritis.

The occurrence of clonal chromosome aberrations in short-term cultures from synovia, osteophytes, and cartilage from patients with osteoarthritis (OA) was recently reported. Among these aberrations, a recurrent involvement of chromosome bands 12q13-15 in structural rearrangements was detected in both synovia and osteophytes. Chromosomal abnormalities of 12q13-15 are frequent among malignant and benign mesenchymal tumors, and it was recently demonstrated that the molecular target in these neoplasms is the HMGIC gene. In this study, we show by fluorescence in situ hybridization that HMGIC was disrupted by rearrangements of 12q15 in synovia from two patients with OA. The finding of HMGIC rearrangement in a lesion that is not traditionally regarded as neoplastic not only widens the spectrum of disorders that may be associated with altered function of this gene, but also provides further support for the notion that genetically rearranged cell populations are part of the OA process.

Aged↗
PubMed1998

Early rehabilitation of acute anterior cruciate ligament injury--a randomized clinical trial.

UNLABELLED: The efficacy of a 6-week rehabilitation program was evaluated in 100 consecutive patients, age 15-42 years, with acute anterior cruciate ligament (ACL) injury. Arthroscopy revealed associated lesions in 82% of the patients. Except for resections on menisci with large and unstable lesions, no surgery was performed. The patients were randomly assigned to supervised training or self-monitored training after instruction. RESULTS: At the 6-week follow-up there was no difference between the groups with regard to pain at rest, pain during walking, or experience of giving-way episodes, Tegner activity level of Lysholm knee score. Only 2 of the 100 patients were observed without joint mobility restriction. The only significant difference between the groups was the improvement of muscle function in men in the supervised training group. CONCLUSION: Six weeks' rehabilitation is too short a time period from original injury to obtain normal mobility and restored knee function.

Adolescent↗
PubMed1998

Polyclonal expansion of cells with trisomy 7 in synovia from patients with osteoarthritis.

Trisomy 7 as the single chromosome aberration has been found in a variety of neoplasms and in normal tissue in the proximity of tumors, as well as in non-neoplastic lesions. Recently, we described a nonrandom pattern of chromosome aberrations, in particular, a gain of chromosome 7, in synovia, cartilage, and osteophytes from patients with osteoarthritis. To study the clonal origin of trisomy 7 in osteoarthritis, multiple synovial samples were collected from five women, all of whom were informative heterozygotes with regard to the X-linked human androgen receptor gene (AR). From each case, three to four independent cell cultures were initiated. Trisomic cell populations were subcloned from the individual cultures, and it was established whether or not the same allele of AR was inactivated in trisomic cells from different parts of the same joint. The finding of a polyclonal X-inactivation pattern in two of the cases provides strong evidence that gain of an extra copy of chromosome 7 occurs independently in multiple cells.

Aged↗
PubMed1998

Simultaneous measurements of sagittal knee laxity with an external device and radiostereometric analysis.

We obtained simultaneous measurements of sagittal knee laxity in 12 consecutive patients after reconstruction of the anterior cruciate ligament (ACL), using the Stryker laxity tester and radiostereometric analysis (RSA). The mean anteroposterior (AP) displacement when a 90 N load was applied in both directions was 5.3 +/- 2.7 mm with RSA and 9.8 +/- 1.6 mm with the external device (p < 0.001). The corresponding measurements at a load of 180 N were 5.7 +/- 2.4 mm and 13.8 +/- 3.7 mm, respectively (p < 0.001). More than 50% of the sagittal knee movement, as measured by the external device at a load of 180 N, was not true femorotibial displacement of the joint but was due to soft-tissue deformation.

Adolescent↗
PubMed1998

Fixation of the tibial component of total knee arthroplasty after high tibial osteotomy: a matched radiostereometric study.

To assess migration of the tibial component we used roentgen stereophotogrammetric analysis in 40 patients who had had a total knee arthroplasty after failure of a closing wedge osteotomy and compared them with 40 matched patients after primary total knee arthroplasty. We found no difference in migration over time or in the tendency for continuous migration between the two groups. There were no differences in alignment or position of the knee prosthesis or in the clinical outcome. Our findings show that revision of a failed high tibial osteotomy to a total knee arthroplasty is effective.

Aged↗
PubMed1998

Open wedge tibial osteotomy by callus distraction in gonarthrosis. Operative technique and early results in 36 patients.

Proximal tibial osteotomy is indicated in cases of medial gonarthrosis with varus deformity in the active, younger patient. We report our experience of the hemicallotasis technique in 36 patients and the early clinical results after a median follow-up of 14 (11-16) months. The median patient age was 54 (33-64) years. The median hip-knee-ankle (HKA) angle was 172 (161-179) degrees preoperatively, 184 (178-187) degrees after completed correction and 183 (175-190) degrees at follow-up. The median fixation time was 88 (61-146) days. Complications were minor. Superficial pin-site inflammation/infections occurred in one fifth of the pins. The HSS score increased from a median 71 preoperatively to 94 at follow-up, the Lysholm score from 56 to 91 and the Tegner activity score from 6 to 10. The Nottingham Health Profile showed significant improvements as regards pain and physical mobility.

Adult↗
PubMed1998

Early inducible displacement of tibial components in total knee prostheses inserted with and without cement: a randomized study with roentgen stereophotogrammetric analysis.

The fixation of tibial components randomized to insertion with or without cement in twenty-six knees was examined for inducible displacement at six weeks and one year postoperatively with use of roentgen stereophotogrammetric analysis. Furthermore, migration was studied during the first two postoperative years. Inducible displacement was found in all knees at both the six-week and the one-year follow-up examination, but no differences were detected with respect to the type of fixation (p > 0.05). All tibial components migrated for as long as one year postoperatively, after which most stabilized. No difference was found between the groups with respect to migration during the first two years postoperatively (p > 0.05), with the exception of subsidence of the component, which was found to be 0.0+/-0.1 millimeter (mean and standard error of the mean) for the components inserted with cement and 0.5+/-0.1 millimeter for the components inserted without cement (p < 0.01). Migration after one year was the same for both groups. We found a relationship between inducible displacement at six weeks and at one year as well as one between inducible displacement and migration at one year. To our knowledge, the present study is the first in which the micromotion of an interference-fit prosthesis was found to be similar to that of a device inserted with cement. The results of the present study emphasize the importance of the initial prosthetic fixation.

Aged↗
PubMed1998

Prevention of deep vein thrombosis in knee arthroplasty. Preliminary results from a randomized controlled study of low molecular weight heparin vs foot pump compression.

BACKGROUND: We evaluated in a randomized controlled study the possibility to use foot pump mechanical compression compared to routine LMWH as prophylaxis against deep vein thrombosis during knee arthroplasty. METHODS: Forty patients were included in this preliminary report. Eleven patients withdrew, usually during the early phase of the study. RESULTS: Among the 29 patients completing a venography, 27% in the compression group and none in the LMWH group had a DVT. This difference was statistically significant (p<0.05). One further patient in the compression group died from pulmonary embolism 17 days postoperatively. CONCLUSIONS: With the present study protocol, mechanical foot pump compression failed to be as efficient as LMWH prophylaxis.

Aged↗
PubMed1997

Proprioception after an acute knee ligament injury: a longitudinal study on 16 consecutive patients.

A defect in proprioception has been found in selected patient groups that have an anterior cruciate ligament deficient knee at different times after the original injury. The time of development and the extent of such defects were studied longitudinally on 16 consecutive patients. During the first year after a primary knee injury, which included a complete rupture of the anterior cruciate ligament, we repeatedly performed three tests of proprioception: (a) one to determine the threshold for detecting a passive motion from starting positions of 20 and 40 degrees, (b) an active reproduction of a passive angular change, and (c) a visual estimation of a passive angular change. The injured limb was compared with the uninjured limb and with the limbs of an age-matched reference group of healthy subjects. The population did not have a normal distribution, and some patients had consistently extreme recordings in the threshold tests at the various times of testing. Significant differences were found between the groups at the starting position of 20 degrees, when the injured knee was compared with the uninjured knee, after 1 month (p = 0.05), and after 2 months (p = 0.03). There was a trend toward a higher threshold for detecting a passive motion when the injured side was compared with the knees of the reference group at 1 month (p = 0.06) but not later on. A similar pattern was found for the injured knee at the starting position of 40 degrees, but it was not significant. An impaired ability to detect a passive motion was registered for the nearly extended knee 1 and 2 months after a primary injury. In the active reproduction and visual estimation tests, no significant defects were found at any time during the first year in these consecutively studied patients.

Adolescent↗
PubMed1997

Clonal chromosome aberrations are present in vivo in synovia and osteophytes from patients with osteoarthritis.

We have previously reported recurrent clonal chromosomal aberrations in synovia, osteophytes and articular cartilage from patients with osteoarthritis (OA). In particular, gain of chromosomes 5 and 7 was found to be strongly associated with OA. In order to exclude the possibility of in vitro artefacts, we studied three to four parallel, independent cultures from ten samples of synovia and three samples of osteophytes from ten women with primary OA. In all, 40 cultures were cytogenetically analysed, 39 of which had clonal chromosomal aberrations. The most common aberrations were +7 and +5 which were found in 38 and 12 cultures, respectively. There were striking karyotype similarities among the parallel cultures from each case. Out of a total of 83 clones, only 11 were unique for one culture, 7 from synovia and 4 from osteophytes. The genetic homogeneity among different cultures from the same patients excludes the possibility of in vitro artefacts and indicates a widespread distribution of the cytogenetically aberrant clones in vivo.

Aged↗
PubMed1997

Selective compartmentalization of gammadelta-T lymphocytes in human breastmilk.

In human breastmilk, T lymphocytes with gammadelta-receptor (TCR) are more frequent than those with alphabeta-TCR, in comparison with peripheral blood. Differential representation has also been demonstrated for subpopulations of gammadelta-T cells. Reactivity was visualized with three monoclonal antibodies against Vdelta1, Vdelta2 and Vgamma2 on T cells from the breastmilk and peripheral blood of 12 women who had recently given birth. Confirming the results with Vdelta1, it was found that Vdelta1 (p < 0.01) and Vgamma2 (p < 0.05) but not Vdelta2 were overrepresented on T cells in milk as compared with blood. This selective compartmentalization seems to reflect the homing of certain cells to the mammary gland.

Antibodies, Monoclonal↗
PubMed1997

Persistent stability 3 years after reconstruction of the anterior cruciate ligament. A radiostereometric analysis (RSA) of 20 patients.

We measured, by radiostereometric analysis (RSA), the sagittal knee laxity in 20 consecutive patients with chronic anterior cruciate ligament injuries before, 1 year and 3 years after reconstruction with a free bone-patellar tendon-bone graft. The grafts had been perioperatively tensioned, using a 10-15 N load. An increased displacement with increasing load was present before reconstruction, but we found no differences between 100 and 150 N stress load 1 and 3 years after the operation. The total anteroposterior displacement decreased from 12.7 mm before the reconstruction to 5.1 mm 1 year and 5.6 mm 3 years postoperatively, using a stress load of 150 N. Thus, we found both a definite end-point of joint displacement and persistent stability without elongation of the graft with time, when care was taken not to over-constrain the knee by a high initial graft tension.

Adult↗
PubMed1996

Proprioception in the nearly extended knee. Measurements of position and movement in healthy individuals and in symptomatic anterior cruciate ligament injured patients.

Proprioception of the knee was measured in 19 healthy individuals to evaluate whether there were any differences between extension and flexion movements from two different starting positions. The threshold before detecting a passive movement, visual estimation on a protractor of a passive change in position (30 degrees angular change) and active reproduction of the same angular change were registered. The reference population was tested twice to study normal variation and reproducibility, followed by the evaluation of 20 patients with chronic, symptomatic and unilateral anterior cruciate ligament (ACL)-deficient knees. In the normal population no differences were found between the right and the left leg, men and women, or measurements made at the first and at the second test occasion. The thresholds from a starting position of 20 degrees were lower for extension than for flexion. When comparing the thresholds for extension between the 20 degrees and the 40 degrees starting position, lower values were found in the more extended position. The thresholds for flexion were lower from the 40 degrees starting position than from the 20 degrees starting position. The active reproduction of an angular change of 30 degrees was more accurate during flexion (30 degrees-60 degrees) than during extension (60 degrees-30 degrees). There were no differences in the reproduction tests or in thresholds from the 40 degrees starting position between the patients and the normal group, but the patients had higher thresholds from the 20 degrees starting position, in movements towards both extension 1.0 degree (range 0.5 degree-12.0 degrees) and flexion 1.5 degrees (range 0.5 degree-10.0 degrees) than the normal group 0.75 degree (range 0.5 degree-2.25 degrees) (P = 0.01) and 1.0 degree (range 0.5 degree-3.0 degrees) (P = 0.06), respectively. Thus, information of passive movements in the nearly extended knee position was more sensitive towards extension than towards flexion in threshold tests and the sensitivity improved closer to full extension, which implies a logical joint protective purpose. In this nearly extended knee position, which is the basis for most weight-bearing activities, patients with symptomatic ACL-deficient knees had an impaired awareness in detecting a passive movement. There were no differences in the more flexed position or in the reproduction tests between the patients and the normal group, and reproduction tests in the present form seem less appropriate to use in the evaluation of ACL injuries.

Adult↗
PubMed1996

Evidence of somatic mutations in osteoarthritis.

We examined, cytogenetically and by in situ hybridization (ISH) techniques, the synovia, osteophytes, and articular cartilage from 32 patients with pronounced osteoarthritis (OA), a prevalent form of arthropathy characterized by progressive reduction of articular cartilage, and synovial samples from 17 control patients. In short-term cultures, clonal chromosome aberrations, in particular the gain of chromosomes 7 (+7) and 5 (+5), were found to be strongly associated with OA. These aberrations were found in almost 90% of the cultures from synovia and osteophytes, whereas only 1/11 synovial samples from joints unequivocally unaffected by OA had cells with +5 or +7. The in vivo nature of trisomy 7 was demonstrated by ISH on uncultured cells, and serial passaging showed that cells with +7 had a proliferative advantage in vitro. Thus, the combined data indicate that cells with somatic mutations appear early and may be influential in the disease process leading to OA.

Adult↗
PubMed1996

The Porous-Coated Anatomic total knee experience. Special emphasis on complications and wear.

One hundred sixty knees in 141 patients with the Primary Porous-Coated Anatomic prosthesis (Howmedica, Rutherford, NJ) were evaluated after a follow-up period of 5.6 years (range, 1-10 years). One hundred six knees were in the latest follow-up evaluation, including clinical examination and a defined standing radiograph with a follow-up period of 6.3 years (range, 3-10 years). Survivorship analysis regarding the cumulative revision rate (including completion with a patellar component) was 0.88 at the 8-year and 0.84 at the 10-year follow-up examination. The clinical result was satisfying/good, with a mean Hospital for Special Surgery score of 83 (range, 39-97). Five percent had thinning greater than 30% of the tibial component. The wear was calculated to be 1.0 mm (range, 0-9 mm), including three revised tibial components with heavy wear. Excluding the revised cases, the wear was 0.7 mm.

Aged↗
PubMed1995

Fixation of the tibial component in knee arthroplasty after six weeks.

The fixation of cemented and uncemented PCA modular cruciform-stemmed tibial components was examined 6 weeks after operation using roentgenstereophotogrammetric analysis in 26 randomly selected patients. Physiological external forces were applied in external/internal rotation and eccentric posterior loading generated by squatting. All cases showed inducible displacement, but there were no statistically significant differences between the 2 groups in inducible displacement or in the initial migration, except for subsidence between the lying and standing position. In some, the greatest movement was found when changing from resting to standing, or during rotational stress; in others, the greatest movement was found during squatting. There was a statistical difference in subsidence on squatting which was greater in the uncemented group. The design of the cruciform stem and the use of an internally cooled saw may explain this small differences between the 2 groups.

Aged↗
PubMed1995

Compression or distraction of the anterior cruciate injured knee. Variations in injury pattern in contact sports and downhill skiing.

100 consecutive patients with a recent anterior cruciate ligament injury were examined with respect to type of sports activity that caused the injury, mechanism of injury and the occurrence of collateral ligament and meniscal lesions. There were 53 medial collateral ligament injuries, 12 medial, 35 lateral and 11 bicompartmental meniscal lesions. 59 patients were injured during contact sports, 30 in downhill skiing and 11 in other recreational activities, traffic accidents or at work. An associated medial collateral ligament tear was more common in skiing (22/30) than during contact sports (23/59), whereas a bicompartmental meniscal lesion was found more frequently in contact sports (9/59) than in skiing (0/30). Weightbearing was reported by 56/59 of the patients with contact sports injuries and by 8/30 of those with skiing injuries. Non-weightbearing in the injury situation led to the same rate of MCL tears (18/28) as those reporting weightbearing (35/72) but significantly more intact menisci (19/28 vs 23/72). Thus, contact sports injuries were more often sustained during weightbearing, with a resultant joint compression of both femuro-tibial compartments as shown by the higher incidence of bicompartmental meniscal lesions. This might be an important prognostic factor for future joint disease and arthrosis. The classic "unhappy triad" was a rare finding (8/100) and we suggest that this entity should be replaced by the "unhappy compression injury".

Anterior Cruciate Ligament↗