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Biomedical subjects

A Wigren

Publications and source records attributed to A Wigren.

At least 19 recordsLinked to original sources
PubMed1991

Erythrocyte sedimentation rate in infection of total hip replacements.

Erythrocyte sedimentation rate was studied in 79 patients who underwent reoperations for prosthetic hip failures. Fifty-one patients had infected prostheses, confirmed on the basis of sinus formation and cultures taken at the revision operation. Twenty-eight had proven mechanical loosening of their hip prostheses, as five out of five intraoperative cultures were negative. An ESR level of 35 mm was found to represent an acceptable borderline between infected and non-infected prostheses.

Adult↗
PubMed1990

Resection arthroplasty of the shoulder.

Destruction of the gleno-humeral joint is a well-known and common feature of progressive rheumatoid arthritis. The most striking symptoms are pain and limited motion. Very occasionally spontaneous ankylosis occurs. The impact often relegates the patient to the second and third functional class according to the ARA classification system. The most commonly used surgical methods are endoprosthetic arthroplasty, double osteotomy and early and late synovectomy. Resection interpositioning arthroplasty (RIAP) of the rheumatic elbow joint using lyophilized dura mater has shown excellent results. This encouraged us to apply the same surgical principles to the shoulder joint in rheumatoid arthritis and this report presents the surgical procedure and the primary results of our first 13 patients. Very good results were achieved concerning immediate pain relief and mobility gain, while the muscle strength improved significantly after approximately one year. The surgical technique is fairly simple and postoperative exercises are preferably performed with the help of relatives.

Arthritis, Rheumatoid↗
PubMed1987

Hematogenous infection after knee arthroplasty.

Twenty-five hematogenously infected knee arthroplasties in 20 patients (17 with rheumatoid arthritis and 3 with arthrosis) were followed for 3 years. Staphylococcus aureus was the major infecting organism. Three patients with four arthroplasties died of sepsis. Two patients had removal of the arthroplasty, one of which resulted in an above-the-knee amputation. Four out of five arthrodeses fused. Two knees healed after early debridement and two healed without surgery. Ten knees had successful revision arthroplasty. Rheumatoid arthritis and constrained prostheses increase the risk of hematogenous infection. Any infection and especially cutaneous lesions in a patient with a knee arthroplasty should be treated vigorously.

Adult↗
PubMed1983

Isometric muscle strength and endurance after knee arthroplasty with the modular knee in patients with osteoarthrosis and rheumatoid arthritis.

Maximum isometric muscle strength and endurance were used in an investigation of knee extension and knee flexion in patients with rheumatoid arthritis (RA) and osteoarthrosis (OA) with such severe changes of the joint that arthroplasty with the Modular prosthesis was performed. The measurements were done preoperatively and 3, 12, 24 and 36 months postoperatively. Muscle strength preoperatively was very weak compared with that of a group of healthy persons. The muscle strength 3 months postoperatively remained unchanged, which could mean a very slight trauma from the operation, very good pain relief and efficient physiotherapy. During the first 2 years the maximum isometric muscle strength was significantly increased both in patients with RA and in those with OA. Thereafter there was no increase in the RA patients, whereas in women with OA there was an improvement up to 3 years postoperatively. The improvement in the flexion strength was greater than that of the extension strength, thus indicating the importance of postoperative training of extension strength. Isometric muscle strength measurements show that there is an equalization between the non-diseased knee and the one operated with the Modular knee.

Aged↗
PubMed1983

Isometric strength and endurance in patients with severe rheumatoid arthritis or osteoarthrosis in the knee joints. A comparative study in healthy men and women.

Maximum isometric muscle strength on extension and flexion of the knee joints and endurance on extension has been studied in patients with rheumatoid arthritis (RA) and osteoarthrosis (OA), with such severe degeneration of the knees that arthroplasty was indicated. This material was compared with a group of healthy volunteers. The reduction in muscle strength was most pronounced in the RA group, which had 30-45% of the strength of the healthy volunteers. In the OA group the strength, similarly compared, was 55-70%. The difference is explained by the effect of the rheumatic disease on the muscles. The results indicate that in therapeutic measures due to trauma or in joint surgery, methods that contribute to a further decrease in muscle strength, e.g. immobilization with casts, bandages, or traction treatment, should be avoided.

Arthritis, Rheumatoid↗
PubMed1982

Immune functions of human synovial cells. Phenotypic and T cell regulatory properties of macrophage-like cells that express HLA-DR.

Normal and rheumatoid synovial cells have been analyzed in frozen sections and in suspension. HLA-DR-expressing, macrophage-like cells are demonstrated in normal synovial intima and in rheumatoid tissue. Suspended normal synoviocytes equaled peripheral blood non-T lymphocytes as stimulators of mixed lymphocyte reactions, whereas adherent rheumatoid synovial cells were extremely efficient as such stimulators and in presenting soluble antigens to autologous T lymphocytes. This HLA-DR-dependent T lymphocyte regulation might provide a cellular basis for the HLA-D haplotype-arthritis associations.

Antibodies, Monoclonal↗
PubMed1982

Marmor knee arthroplasty. Clinical results and complications during an observation period of at least 3 years.

During the period October 1975--June 1977, Marmor arthroplasties were performed on 70 knees, 52 of which had rheumatoid arthritis (RA) and 18 osteoarthritis (OA). These patients were followed up in a prospective study. Following arthroplasty, all knees in this material showed primary improvement with respect to pain, walking ability, stability, and extension deficit. The pain in the contralateral knees was studied postoperatively and within 1 year 9 out of 25 RA knees and 6 out of 10 OA knees showed a spontaneous improvement amounting to at least two steps on the pain scale. Four patients died in the course of the observation period and none of them suffered from knee pain. The late complications of the arthroplasties have been analysed separately. During the observation period, which now averages 45 months (36--55), five knees in the RA group and one in the OA group deteriorated to such an extent as to call for reoperation. Of the remaining 60 knee joints 57 have only initial pain or no pain at all, and the other three knees have pain only after physical efforts.

Adult↗
PubMed1982

Gait analysis with an angle diagram technique: application in healthy persons and in studies of Marmor knee arthroplasties.

Normal step dimension data were obtained from six healthy subjects by recording step length and step frequency at different walking speeds. In addition, an externally applied goniometer system was used to measure the sagittal knee and hip joint movements in eleven persons with healthy joints. The movements were recorded on an oscilloscope in the form of a so-called angle diagram during walking. In seven patients undergoing Marmor knee arthroplasty the same gait analysis as in the healthy subjects was performed before and after operation. The results were compared by a clinical scoring system for pain and walking ability and by measurement of passive knee mobility and passive extension deficit. The angle diagram permitted recording of functional sagittal mobility and functional extension deficit during walking. The functional knee mobility during walking was found to be pain-dependent; thus increasing pain is accompanied by a gradual decrease in functional mobility despite good passive knee joint motion. In several patients the functional extension deficit during walking was increased compared with the extension deficit on passive movement. The clinical improvements after knee arthroplasty corresponded very well to the increased functional knee mobility during walking measured on the angle diagram.

Adolescent↗
PubMed1982

The spherocentric knee prosthesis (long term results in 18 cases).

The authors report the clinical and radiographic results at from six months to two years after the insertion of spherocentric knee prostheses in fourteen patients with rheumatoid arthritis and four patients with arthrosis of the knee. The results were satisfactory and there were no complications. This type of prosthesis has therefore become the treatment of choice in cases of varus or valgus deformity in excess of 30 degrees and those involving extreme instability. It is also an alternative after failures with other types of prosthesis.

Adult↗
PubMed1982

The Marmor knee prosthesis: long term results in 135 cases.

The authors report the results of clinical and radiological follow up examinations carried out between six months and four years after the insertion of Marmor knee prostheses in 135 patients (ninety-three with rheumatoid arthritis and forty-two with osteoarthrosis) operated on at the Orthopaedic Clinic of the University of Uppsala between 1975 and 1979. The results were very good and the few complications that arose were easily resolved. The authors have therefore adopted the Marmor prosthesis for routine use. The only valid alternative to this type of prosthesis is the spherocentric prosthesis, which was applied after failures with the Marmor or other types of prosthesis, in cases involving varus or valgus deformity exceeding 30 degrees, and in cases of severe bone destruction.

Adult↗
PubMed1981

Appearance of anti-HLA-DR-reactive cells in normal and rheumatoid synovial tissue.

The reactivity of rabbit anti-HLA-DR antigen antibodies with cells in normal and rheumatoid synovial tissue was investigated by indirect immunofluorescence on frozen sections of tissue. The antibodies reacted with a significant proportion of the synovial lining cells of both normal and rheumatoid synovial tissue, with endothelial cells, and with a number of, most probably, migratory cells. After dispersion of cells from rheumatoid synovial tissue by digestion with collagenase and DNase, adherent cells of both a macrophage-like and a dendritic appearance reacted with the anti-HLA-DR antigen antibodies. The adherent cells were also found to be potent stimulators in the allogeneic MLR. In addition, it was found that a high percentage of T lymphocytes from both peripheral blood and synovial tissue of rheumatoid patients bound anti-HLA-DR antibodies. The present data suggest a role for synovial lining cells in HLA-D-locus-dependent events of importance in the pathogenesis of rheumatoid arthritis and other joint diseases and point to the need for further investigations on T lymphocytes derived from the site of inflammation in the study of rheumatoid arthritis.

Animals↗
PubMed1981

Relationship between HLA-DR-expressing cells and T lymphocytes of different subsets in rheumatoid synovial tissue.

An immunohistochemical double staining technique was used to study the relationships between HLA-DR-expressing, mostly macrophage-like cells, and different populations of T lymphocytes in frozen sections of synovial tissue from patients with inflammatory joint disease, particularly rheumatoid arthritis. Substantial T-lymphocyte infiltration as measured by Leu 1 antibody binding was found, especially adjacent to HLA-DR-expressing cells near the synovial cavity and around small vessels. Most of the T cells reacted with Leu 3a ('helper/inducer'-cell-specific) antibodies, whereas relatively few cells were Leu 2a ('cytotoxic/suppressor' T-cell-specific)-positive.

Adult↗