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Biomedical subjects

H V Johannsen

Publications and source records attributed to H V Johannsen.

At least 19 recordsLinked to original sources
PubMed2006

Swimmers' painful shoulder arthroscopic findings and return rate to sports.

Shoulder pain is the most common musculo-skeletal complaint in competitive swimmers. It remains one of the shoulder pain syndromes in overhead athletes where no golden standard of treatment exists. Eighteen competitive swimmers who all had undergone shoulder arthroscopy for therapy-resistant shoulder pain were retrospectively evaluated with respect to operative findings and ability to return to their sport after the operation. The most common finding at arthroscopy was labral pathology in 11 (61%) and subacromial impingement in five shoulders (28%). Operative procedures included debridement in 11 swimmers, partial release of the coraco-acromial ligament in four, and bursectomy in four. Sixteen (89%) responded to the follow-up evaluation. Nine swimmers (56%) were able to compete at preinjury level after 4 (2-9) months. Findings at arthroscopy suggest that the term "Swimmer's shoulder" covers a variety of pathologies including labral wearing and subacromial impingement. Arthroscopic debridement of labral tears or bursectomy in swimmers with shoulder pain has a low success rate with regard to return to sport. Further understanding and investigation of this syndromes complex pathophysiology is needed.

Adolescent↗
PubMed2006

Revision of failed total elbow arthroplasty with use of a linked implant.

We studied retrospectively the results of revision arthroplasty of the elbow using a linked Coonrad-Morrey implant in 23 patients (24 elbows) after a mean follow-up period of 55 months. According to the Mayo Elbow Performance Score, 19 elbows were satisfactory, nine were excellent and ten good. The median total score had improved from 35 points (20 to 75) before the primary arthroplasty to 85 points (40 to 100) at the latest follow-up. There was a marked relief of pain, but the range of movement showed no overall improvement. Two patients had a second revision because of infection and two for aseptic loosening. The estimated five-year survival rate of the prosthesis was 83.1% (95% confidence interval 61.1 to 93.3). Revision elbow arthroplasty using the Coonrad-Morrey implant provided satisfactory results but with complications occurring in 13 cases.

Adult↗
PubMed1999

Late results of total shoulder replacement in patients with rheumatoid arthritis.

Rheumatoid arthritis of the shoulder is a progressive and destructive joint disease, and similar to arthritis in other joints, progression of the disease is unpredictable and may stop at any stage of involvement. Between 1983 and 1996, more than 500 shoulder prostheses were implanted in patients at the authors' institution. Total shoulder replacement yields satisfactory short and long term results even in patients with severely destructed joints. Pain relief is reliable and significant as reported in short and long term studies. In most patients the functional result is good or acceptable. Although range of motion is only slightly increased, a satisfactory overall range of motion is achieved by most patients because of the unaffected scapulothoracic motion. However, deteriorating results, emphasizing the complexity of shoulder arthroplasty, were seen with increasing observation time in patients with rheumatoid arthritis. Proximal migration of the humeral prosthesis attributable to rotator cuff failure, with secondary eccentric glenoid loading and progressive loosening, is latent in patients with chronic progressive rheumatoid disease and was by far the most common complication (42%) in the present series.

Adult↗
PubMed1997

[Arthroscopic subacromial decompression].

The aim of this prospective study was to evaluate the results of arthroscopic subacromial decompression (ASAD) in the treatment of impingement syndrome in patients without full thickness rotator cuff tears. Sixty patients (64 operative procedures) underwent ASAD during the study period; 37 men and 23 women, average age 46 years (range 28-63), average duration of symptoms 37 months (range 8-132). Patients with calcifying tendintis were not included. Evaluation preoperatively and one year postoperatively included: Constant score, clinical examination and radiological evaluation (supraspinatus outlet view). All follow-up examinations were done by an independent observer. Fifty-six patients (60 procedures) were available for follow-up. The average length of follow-up was 13 months (range 10-23). Forty-six patients (77%) achieved a good or excellent result according to Constant score criteria. Preoperatively twenty-four patients had applied for worker's compensation benefits (WCB). Only half of the patients in the WCB group achieved a satisfactory result, whereas 94% of the non-WCB patients had a good or an excellent result. Arthroscopic subacromial decompression is an effective procedure for the majority of patients with stage II impingement syndrome. In this study WCB claims were associated with inferior results.

Adult↗
PubMed1996

[Frozen shoulder. Arthroscopy and manipulation in general anesthesia, followed by early passive mobilization].

Over a 15 month period 20 patients with 20 arthroscopically verified frozen shoulders were treated with manipulation under general anaesthesia and early passive motion. The study had a minimum of six months follow-up. The average duration of the disease before treatment was eight months. Prior to treatment all patients suffered from moderate to severe pain and the average range of motion was less than 40% of the normal shoulder. During the follow-up period 55% had obtained a normal or almost full range of motion and 75% suffered from only slight pain or had no pain at all. Fourteen patients returned to prior work within a mean of nine weeks after treatment. We found no relation between the end-result and the prior pathology. We believe that manipulation with arthroscopy is an effective way of shortening the course of an apparently self-limiting disease and should be considered when conservative treatment fails.

Adult↗
PubMed1990

[Results after primary suture of rupture of the anterior cruciate ligament. A 4-5 year follow-up].

Forty patients (40 knees) with acute isolated or combined lesions of the anterior cruciate ligament treated by means of primary suture without reinforcement were followed-up 4-5 years postoperatively. In 75% of the patients, follow-up examination revealed clinical instability of the anterior cruciate ligament but only 25% of these had noteworthy subjective complaints (Lysholm knee score less than 83) and no significant difference was observed between the median knee scores for the group of patients with unstable knees and those with stable knees. On the other hand, however, a significant decrease in the level of activity (Tegner activity scale) was observed in patients with unstable knee joints as compared with patients with stable knees. These patients compensated for the defective stability by reducing the level of activity. Primary suture without plastic reinforcement cannot be recommended as the method of treatment of acute lesions of the anterior cruciate ligament because it does not provide long-term stability in the majority of patients.

Adolescent↗
PubMed1990

Outpatient arthroscopy of the knee under local anaesthesia.

Arthroscopy of the knee was carried out under local anaesthesia in 313 outpatients, with arthroscopic surgery in 81. The procedure had to be abandoned because of apprehension in only 0.9%. With increasing experience, the number of arthroscopic meniscectomies increased from 5% to 64% of the lesions found. The method was particularly valuable in the assessment of patello-femoral pain since dynamic evaluation of patellar alignment, and the localisation of sensitive structures by palpation, was possible. The method is a safe, reliable and inexpensive alternative to the use of spinal or general anaesthesia for arthroscopy.

Adolescent↗
PubMed1989

Exercise-induced knee joint laxity in distance runners.

The objectives of this study were to evaluate the effect of exercise on knee joint laxity. If exercise induced laxity is physiological, incorporation of this quality into a ligament replacement material would be indicated. Twenty recreational long distance runners average age 41 (range 24 to 50 yr) were tested before and immediately after 30 minutes of running. Using a computerized goniometer type instrument (Acufex KSS), knee flexion, axial tibial rotation and anterior-posterior tibial displacement were simultaneously recorded, while the runners underwent tests of static as well as dynamic knee joint laxity. At 30 degrees of knee flexion, a maximum increase of 16 per cent in mean total anterior-posterior laxity post-exercise was found. At the examination 30 minutes post-exercise, laxity at 30 degrees of knee flexion was still increased. However, laxity at 90 degrees of knee flexion had decreased to pre-exercise levels or below. Anterior tibial displacement, recorded during eccentric quadriceps activity (0 to 90 degrees of knee flexion) with weights attached to the foot, showed a maximum of 18 per cent increase in total anterior-posterior laxity post-exercise. It is suggested that the laxity increase is caused in part by a true ligamentous laxity increase, and in part by a decreased resting tone of the fatigued muscles.

Adult↗
PubMed1989

Incomplete ruptures of the anterior cruciate ligament.

In a prospective study, 41 consecutive patients with a partial tear of the anterior cruciate ligament, diagnosed by arthroscopy, were reviewed after an average of 17 months, having been in plaster for six weeks after injury. Their average age was 29 years and review included clinical examination, measurement of anterior and posterior laxity with the Stryker knee laxity tester as well as evaluation of knee function and activity level. Twenty-one patients had unstable knees at follow-up; the mean total anteroposterior laxity for these patients was 12.6 +/- 3.9 mm compared with 7.1 +/- 4.3 mm for the normal knee. Most patients had few symptoms, but there was a significant reduction in the mean level of activity in the unstable group.

Activities of Daily Living↗
PubMed1988

Arthroscopy in the diagnosis of acute injuries to the knee joint.

This study evaluates the role of arthroscopy in the diagnosis of acute injuries to the knee. One hundred and fifty four patients with a suspected ligament injury or effusion of the knee joint underwent arthroscopy. A haemarthrosis was present in 82% and a bloodless effusion in 10%. Meniscal tears were found in 19% of the knees. Fresh ligament ruptures were present in 71% and an associated haemarthrosis in 95% of these; 65% were partial tears. The commonest isolated lesion was a complete or partial tear of the anterior cruciate, which occurred in 15% of cases. More than one ligament injury occurred in 56%, the commonest combination being tears of the anterior cruciate and medial collateral ligaments. In a high percentage of cases, arthroscopy revealed unsuspected injuries of significance in management. In 39%, an open or closed procedure followed arthroscopy. There were no complications from the diagnostic arthroscopy. We conclude that arthroscopy provides a more accurate diagnosis than clinical examination alone, and is especially valuable for assessing the patient with a haemarthrosis of the knee.

Acute Disease↗
PubMed1988

Arthroscopic suture of peripheral meniscal tears.

Twenty-nine patients underwent meniscal repair using an inside-to-out technique and instruments developed in our department. The tears were more than 1.5 cm in length, vertical, and located in the outer third of the meniscus. The torn segment was mobile, the remainder of the meniscus stable. After six months, fourteen out of sixteen patients achieved a good or excellent Lysholm knee score. We conclude that the technique is safe and reliable and allows better access than an arthrotomy. Care must be taken to avoid neurovascular injury.

Adolescent↗
PubMed1988

Perineuronal morphine: a comparison with epidural morphine.

In a double-blind, randomised controlled cross-over study the effects of perineuronal (perifemoral) injections of morphine were compared with epidural injections with the same amount of morphine in patients after knee surgery. Better pain scores were achieved during treatment with epidural morphine. We have not been able to confirm the hypothesis of neuro-axonal transport of morphine from the periphery to the spinal cord.

Adolescent↗
PubMed1988

Prevention of injury in karate.

The purpose of the study was to analyse the effect of knuckle protection on the type and incidence of injuries in traditional karate contests. Knuckle protection was mandatory at the Danish karate championships 1983 and 1986 (290 matches, 0.26 injuries per match), and prohibited at the championships 1984 and 1985 (620 matches, 0.25 injuries per match). Head injuries were more common in the tournaments where fist pads were used. The incidences of transitory psychomotor disturbances following blows to the head were comparable. The severity of head injuries, however, decreased; minor head injuries dominated when fist pads were used (66%, compared with 44% without fist pads, p less than 0.01) and there were fewer lacerations and fractures. Injuries to the fingers or hands were also fewer--1.3% compared with 11% without protection (p less than 0.01). The use of fist pads reduced considerably the number of injuries requiring treatment (from 42% to 16%, p less than 0.01). In conclusion; fist pads offer some protection against injuries, especially to the hands, but additional measures are needed.

Athletic Injuries↗