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Biomedical subjects

A Mølster

Publications and source records attributed to A Mølster.

At least 19 recordsLinked to original sources
PubMed1998

Lateral ligament injuries of the knee.

Between 1982 and 1994 28 patients were treated for acute lateral knee ligament injuries; 25 patients, with a median age of 25.5 (range 16-75) years at injury, appeared for follow-up. Seven patients had isolated injury of the lateral collateral ligament/capsular structures, the remaining 19 patients had concomitant ligament injuries in the knee. Eight patients were treated conservatively, 1 with plaster immobilization and 7 with early mobilization. Eighteen patients underwent surgery, 17 of these within 3 weeks of injury. Repair/reconstruction of the cruciate ligaments was done at the same time as the lateral collateral ligament repair in 10 patients. At follow-up after a median of 7.5 years (range 6 months to 13 years), 11 had no varus instability, 7 had 1+, 5 had 2+, and 2 patients had 3+ varus instability. All patients with a final result of 2+ or 3+ had combined ligament injuries. The surgically treated lateral collateral ligament injuries all had a primary instability of 2+ or more. These patients showed an improvement in varus instability from a mean of 2.83+ preoperatively to a mean of 1.17+ postoperatively. Two-thirds of the surgically treated patients were stable or had a 1+ instability at follow-up. One conservatively treated patient with a 2+ varus instability and 1 with 1+ showed no improvement. Five conservatively treated patients with initial varus instability of 1+ were stable at follow-up. One patient with a 1+ varus instability had anterior cruciate ligament (ACL) rupture. He had a primary ACL reconstruction without lateral repair. He had no varus instability at follow-up. Our study supports the notion that operation performed at an early stage in fresh injuries with a varus instability of 2+ or more gives improved stability as a final result. Conservative treatment may not be expected to give an improved stability, but is sufficient in mild varus instability (1+) without additional cruciate ligament injuries.

Adolescent↗
PubMed1996

A prospective, randomized study of three operations for acute rupture of the anterior cruciate ligament. Five-year follow-up of one hundred and thirty-one patients.

A five-year, prospective, randomized follow-up study was done to compare three methods for repair of a rupture of the anterior cruciate ligament of the knee; acute primary repair (Group 1), acute repair with a synthetic ligament-augmentation device (Group 2), and acute repair augmented with an autologous bone-patellar ligament-bone graft (Group 3). One hundred and fifty patients who had an acute rupture of the anterior cruciate ligament were randomized to one of the three repair groups, with fifty patients in each group. The patients were between sixteen and fifty years old (mean, twenty-nine years old). All patients had the operation within ten days after the injury. The rehabilitation protocol was identical for each group. The patients were evaluated prospectively at one, two, and five years with use of the Tegner scoring system for level of activity and the scoring system of Lysholm and Gillquist for function, and the stability of the knee was assessed with clinical examination and with use of the KT-1000 arthrometer. One hundred and thirty-one patients completed the study and ten other patients were known to have had a failure of the procedure, a 94 percent rate of follow-up. All three groups had a lower level of activity at the five-year follow-up evaluation than they had had before the injury. The patients who had had augmentation with a patellar-ligament graft had a significantly higher mean level of activity at two years than those who had had non-augmented repair with (p = 0.002) and those who had had repair with a synthetic ligament-augmentation device (p = 0.01). They also had a significantly higher mean level of function at two years than those who had had non-augmented repair (p = 0.0001) and those who had had repair with a synthetic ligament-augmentation device (p = 0.03) and a significant higher mean level of function at five years than those who had had non-augmented repair (p = 0.004). The ability to attain full extension improved significantly in all three groups during the five-year follow-up period; the highest gains occurred in the group that had had augmentation with a patellar-ligament graft. Rotatory and anterior instability progressively increased during the follow-up period for all three groups. At one, two, and five years, the knees that had had repair with a patellar-ligament graft were significantly more stable than those that had had non-augmented repair and those that had had repair with a ligament-augmentation device (p < 0.0001 to p = 0.03). The findings of this study reinforce the conclusions of our two-year follow-up report that a non-augmented primary repair should not be performed, a repair with a ligament-augmentation device has an unacceptably high rate of failure (more than one-third of the patients), and a repair that is augmented with the patellar ligament has the best outcome.

Adolescent↗
PubMed1994

Meniscal lesions treated with suture: a follow-up study using survival analysis.

Fifty-seven patients, 45 males and 12 females with a median age of 23 years (range 8-56), underwent meniscal refixation by suture from 1986 through 1991. We used an arthroscopic outside-in technique with PDS sutures through injection cannulas. Thirty-six knees were stable and 21 had anterior cruciate insufficiency, five of which were subjected to surgery concomitantly with patellar tendon reconstruction and two of which were subjected to surgery at a later occasion. Fifty-one patients could be evaluated at a follow-up time of 2 months to 5.5 years (median 1.5, mean 2), and calculations were made using the BMDP statistical package and the Kaplan-Meier survival analysis. No serious complications were encountered. Twenty patients (39%) have undergone reoperation because of meniscal rerupturing. At 5 years, the cumulative survival rate is 50%. Smaller (posterior) lesions healed better than did more extensive lesions. No statistical influence of factors such as medial or lateral localization, age of patient or lesion, present displacement of meniscus, instability of the knee, or experience of the surgeon was evident.

Adolescent↗
PubMed1993

[Follow-up of sutured meniscus by means of survival analysis].

We describe a retrospective study of patients operated by meniscal suture at our hospital from 1986 through 1992. 63 patients were operated, 50 males and 13 females. Mean age was 26 years. Complete data were retrieved at follow-up for 57 patients. Mean observation time was two years. 90% were operated using the arthroscopical technique. 25 patients have been re-operated because of meniscal rerupture. The cumulative survival rate was 44% five years after operation. Survival analysis revealed no significant differences by variables such as sex, age, instability and lateral or medial location revealed. Experienced surgeons achieved only insignificantly better long-term results than did trainees. There was no significant difference in healing rate between displaced bucket-handle and non-displaced tears, nor between chronic and acute tears.

Adolescent↗
PubMed1993

[Surgical treatment of fractures of the acetabulum].

Since January 1988, 18 patients with acetabular fractures were operated on. Seven fractures were "both columns", six were posterior wall fractures, four were of the transverse/single column types, and one was unclassified. Four patients were operated by ileo-inguinal incision alone, three by combined ileo-inguinal and posterior Kocher-Langenbeck, ten by Kocher-Langenbeck, and one by triradiate incision. Early complications were 1 DVT and 1 infection (subsided after removal of the plate from crista iliaca). One patient with brain injury developed cerebral infarction, and one multi-traumatized patient died of lung embolus after transfer to another hospital. 11 patients are back at work, one has retired, and two are seeking new education after the injury. We conclude that operative treatment is indicated for these fractures, and that the results and rate of complications are acceptable. This treatment should be centralized.

Acetabulum↗
PubMed1992

[Primary suture of the posterior cruciate ligament].

23 acute midsubstance ruptures of the posterior cruciate ligament were treated by primary suture. 20 patients returned for follow-up. Four of them had an isolated rupture of the PCL. The remaining 16 patients had sustained combined injuries to ligaments, including eight total ruptures of the anterior cruciate ligament. All ruptured ligaments were sutured. At follow-up (median = 5.5, range 3-10 years) median knee score according to Lysholm was 81 (range 53-100). Five were rated excellent, six good, three fair and six poor. KT-1000 arthrometer measurements revealed a posterior instability of between 5 and 10 mm in five patients and below 5 mm in 14 patients. Thus, in most patients, some instability remained in spite of operative treatment.

Adolescent↗
PubMed1992

[Arthroscopy of the elbow].

We present experience from 37 arthroscopies of the elbow. 15 surgical procedures were performed, nine of which were extractions of free bodies. One deep infection occurred (in the first patient, on whom arthrotomy was performed as well), but no neurovascular complications occurred. Three preoperative diagnoses were changed, and a diagnosis could be made in 14 cases of unknown etiology. Exploratory arthrotomy was avoided in 13 patients. In our view the method is indicated in cases of pain of unknown cause, free intraarticular bodies and/or osteochondritis, and locking episodes where no reason could be established preoperatively. Morbidity is minimal and visualization is better than in open surgery.

Adolescent↗
PubMed1987

Sliding of the compression hip screw in femoral neck fractures.

Backing out of the compression screw in the sliding screw-plate hip osteosynthesis was analyzed in a series of 71 hips with medial femoral neck fractures during an observation period of 12-42 months, with a median of 26 months. In addition to the compression screw device, a parallel cranial lag screw was used. A postoperative primary diastasis in the fracture space of 1-5 mm in 11 cases did not predispose to major sliding of the screws or to healing problems. Thirteen of 27 fractures with late screw telescoping of 4 mm or more showed healing disturbances, 11 late segmental collapses, and 2 nonunions, compared with 7 disturbances, 6 late segmental collapses, and 1 nonunion among 39 cases with screw gliding of 3 mm or less. The difference was significant (p less than 0.05, Mann-Whitney). Five early mechanical failures were excluded from this analysis.

Adolescent↗
PubMed1984

Stability of femoral neck osteotomies fixed by von Bahr screws or by compression hip screw.

Subcapital cadaveric femoral neck osteotomies were internally fixed either by a compression hip screw and a lag screw or by two von Bahr screws. The specimens were then subjected to mechanical testing. Continuously increasing axial compression loads were applied on the femoral head until failure and simultaneously the displacement of the osteotomies was measured. With loads up to 2 kN (about 3 times the body weight) no differences were found between the two groups in the displacement of the osteotomies.

Aged↗
PubMed1982

Effect of instability of experimental fracture healing.

Bilateral tibial osteotomy with fracturing of the fibula was performed on ten Wistar rats weighing 300--350 g. Intramedullary nailing was performed with 1.4 mm nails after reaming. On the left side solid stainless rods were used, while on the right side the nails had a middle part made of titanium-nickel wire covered with polyvinylchloride (PVC), giving the nail a high degree of flexibility. After 8 weeks, nine of the ten flexible nails showed fracture of the central wire. The continuity was, however, maintained by the PVC tube. The bones with flexible nailing always showed hypertrophic callus while there was only scanty callus on the side with rigid nailing. Strength, deformation at fracture and stiffness were measured in a three-point bending test after removal of the solid nails and the fibulae. The strength of the tibiae was greatest on the side with flexible nailing, as was the deformation at fracture. The mean stiffness was higher in the bones with rigid nails, but the difference here was not statistically discernible.

Animals↗