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Biomedical subjects

L Swärd

Publications and source records attributed to L Swärd.

At least 37 records · Page 2Linked to original sources
PubMed1992

Bad results after anterior advancement of the tibial tubercle for patello-femoral pain syndrome.

Seventy-one patients with patello-femoral pain syndrome were re-examined an average of 10 (range 8-12) years after anterior advancement of the tibial tuberosity. The clinical results were excellent in 8 (11%), good in 20 (28%), fair in 16 (23%), and poor in 27 (38%). Twenty patients had had a second operation. The results were worse in patients with Outerbridge grade III-IV cartilage damage. Since the clinical results deteriorated with time, this surgical procedure should no longer be used to treat patients with patello-femoral pain syndrome.

Adolescent↗
PubMed1992

Posterior internal compression arthrodesis of the ankle.

We have reviewed the results of 19 ankle arthrodeses in 18 patients by a new technique of posterior internal compression. Sixteen of the ankles fused at a mean time of 14 weeks and the other three after reoperation. Complications included one case each of infection, Sudeck's atrophy and non-fatal pulmonary embolism. Clinical assessment using Mazur's ankle score showed excellent or good results in nine ankles and three painfree ankles in patients who were wheelchair-bound for other reasons. The mean position of fusion was in 1.7 degrees equinus and 0.8 degrees varus, and the mean range of midtarsal movements was 15.8 degrees. Twelve patients showed radiographic signs of talonavicular or subtalar osteoarthritis.

Adolescent↗
PubMed1992

The thoracolumbar spine in young elite athletes. Current concepts on the effects of physical training.

Due to the increased interest in physical fitness and to the fact that athletes start their training at younger ages the risk for injuries to the growing individual has increased. The spine, as with the rest of the skeleton, is at greater risk of injury during growth, especially during the adolescent growth spurt. Back pain is more common among athletes participating in sports with high demands on the back than other athletes and nonathletes. Disc degeneration, defined as disc height reduction on conventional radiographs and reduced disc signal intensity on MRI, has been found in a higher frequency among wrestlers and gymnasts than nonathletes. Abnormalities of the vertebral bodies including abnormal configuration, Schmorl's nodes and apophyseal changes are common among athletes. These abnormalities are similar to those found in Scheuermann's disease. Athletes with these types of abnormalities have more back pain than those without. Spondylolysis has been found in higher frequencies than expected among athletes representing many different sports. Spondylolysis has been reported in up to 50% of athletes with back pain. Scoliosis has been found in up to 80% of athletes with an asymmetric load on the trunk and shoulders, such as javelin throwers and tennis players. The scoliosis, however, is a small curvature and does not cause back pain.

Athletic Injuries↗
PubMed1991

Ultrasonography in the detection of partial patellar ligament ruptures (jumper's knee).

The diagnostic performance of ultrasonography (US) in the detection of partial ruptures in the proximal part of the patellar ligament (jumper's knee) was studied. A total of 81 athletes with chronic localized pain suggestive of jumper's knee underwent US examination, and 25 of these received surgical treatment. Of 25 proven partial tendon ruptures at surgery, US correctly indicated the diagnosis in all cases. A cone-shaped, poorly echogenic area exceeding 0.5 cm in length in the center of the patellar tendon in combination with its localized thickening proved to be a reliable indicator of jumper's knee. One case was a true-negative. No false-negative or false-positive case was observed. Soft-tissue radiography in 14 cases showed a localized swelling but did not detect intratendinous soft-tissue abnormalities. US is the method of choice for the evaluation of jumper's knee, as it is cheap, non-invasive, repeatable, and accurate.

Adult↗
PubMed1991

Disc degeneration and associated abnormalities of the spine in elite gymnasts. A magnetic resonance imaging study.

The thoracolumbar spine was examined by magnetic resonance imaging (MRI) and the history of back pain was analyzed in 24 male elite gymnasts (age range, 19-29 years) and in 16 male nonathletes (age range, 23-36 years). Disc degeneration, defined as reduced disc signal intensity, was significantly more common in athletes (75%) than in nonathletes (31%). The gymnasts also had a higher incidence of other abnormalities of the thoracolumbar spine, and there was a significant correlation between reduced disc signal intensity and the other abnormalities among the gymnasts. There were also significant correlations between back pain and reduced disc signal intensity and abnormal vertebral configuration when the gymnasts run a high risk of developing severe abnormalities of the thoracolumbar spine, and they often have a history of back pain.

Adult↗
PubMed1990

Back pain and radiologic changes in the thoraco-lumbar spine of athletes.

Back pain and radiological changes of the thoraco-lumbar spine were investigated in 142 top athletes, representing wrestling, gymnastics, soccer and tennis (age range 14-25 years). All groups of athletes reported back pain at high frequencies (50-85%). Male gymnasts had significantly increased incidence and severity of back pain as compared to the rest of the athletes. Radiological abnormalities occurred in 36-55% of the athletes. Reduced disc height, Schmorl's nodes and change of configuration of vertebral bodies correlated with back pain (P less than 0.05, P less than 0.01 and P less than 0.05). Significant covariation between these types of abnormalities was found. Athletes with great demands on the back are thus subjected to an increased risk of symptomatic damage of the spine.

Adolescent↗
PubMed1990

Compression-traction radiography of lumbar segmental instability.

Compression-traction radiography was used to assess movements in the sagittal plane of the lumbosacral joint in a control group of asymptomatic normal individuals and in a patient group with a symptomatic lytic spondylolisthesis. Sagittal translatory movements were found in both groups, but the amount of displacement was significantly larger (P less than 0.001) in the patient group as compared with the controls. The average displacement in the patient group, using a relative measurement technique, was 5.2%, ranging from 0.2 to 15.4%; and the corresponding values in the controls resulted in a mean of 0.8% and a range of -2.3% to 3.6%. Eighteen of the 29 patients (62%) exhibited translations of the lytic vertebra exceeding the largest displacement (greater than 3.6%) detected in the control group. The translatory movements in the patients were composed of a predominant anterior displacement in the compression view and a smaller posterior movement in the traction view. Analysis of sagittal rotation, ie, angulatory movements in the L5-S1 segment, resulted in no significant difference between the two groups. Compression-traction radiography may detect pathologic translatory movements, indicative of lumbar segmental instability.

Adult↗
PubMed1990

Anthropometric characteristics, passive hip flexion, and spinal mobility in relation to back pain in athletes.

Anthropometric characteristics, passive hip flexion, and spinal mobility were examined and back pain was registered in 116 top Swedish male athletes representing four different sports (wrestling, gymnastics, soccer, tennis). Differences in stature, body weight, passive hip flexion, mobility of the spine in forward flexion, and asymmetry of the back were found when each group of athletes was compared with the rest of the athletes. These differences could be explained by a natural selection of individuals with the physical constitution required for the sport concerned, but they may also be a long-term effect of training. A small sacral inclination, defined as the sacrohorizontal angle, correlated significantly with back pain.

Adolescent↗
PubMed1990

Soft-tissue radiography, computed tomography, and ultrasonography of partial Achilles tendon ruptures.

Ultrasonography (US) was compared with soft-tissue radiography (STR) and computed tomography (CT) for demonstration of partial Achilles tendon ruptures. Thirty-nine patients suffering from chronic localized painful Achilles tendon swelling were examined. The patients had all undergone a previous clinical examination, resulting in a suspicion of a non-healed partial tear in 62 out of the 78 tendons. STR showed unspecific tendon pathology such as thickening and diffuse tendon margins. CT resulted in a better delineation of intra- as well as extratendinous abnormalities compared to STR. Various pathologic changes were seen on CT in 54 tendons and in 29 of these, localized intratendinous hypodensities indicated partial ruptures. At US, abnormal changes were observed in 69 tendons, of which 54 had discontinuity of tendon fibers, focal hypoechoic areas, and localized swelling indicating partial ruptures. In 9 cases with surgically proven partial ruptures, US was correct in all cases, while CT was false-negative in 3. STR only showed localized swelling. It was concluded that US was a better method than STR and CT for the detection of partial ruptures and the US findings correlated well with the surgical findings.

Achilles Tendon↗
PubMed1990

Radiologic abnormalities of the thoraco-lumbar spine in athletes.

A radiologic study of the thoraco-lumbar spine was performed in 143 (117 male and 26 female) athletes (wrestlers, gymnasts, soccer players and tennis players), aged 14 to 25 years and 30 male non-athletes, aged 19 to 25 years. Film interpretation was made after mixing the films from all groups and without knowledge of the individual's identity. Various types of radiologic abnormalities occurred in both athletes and non-athletes but were more common among athletes, especially male gymnasts and wrestlers. Abnormalities of the vertebral ring apophysis occurred exclusively in athletes. Combinations of different types of abnormalities were most common in male gymnasts and wrestlers.

Adolescent↗
PubMed1989

Stress views in the comparative assessment of spondylolytic spondylolisthesis.

Patients with spondylolytic spondylolisthesis were examined in six different positions to detect segmental instability. The amount of displacement was determined on lateral spot radiographs, taken in recumbent, standing, flexion, extension, axial compression, and traction positions in each patient. An error analysis was also performed. Examination in axial compression-traction was found to be a significantly better method for detection of segmental instability compared with standing-recumbent, or flexion-extension radiographs. In addition, the compression-traction method exhibited a higher sensitivity for identification of instability (73%) than standing-recumbent (33%) or flexion-extension (20%) views. The total error in the determination was small, +/- 2.5% (95% CL), providing a careful and controlled technique was used.

Humans↗
PubMed1988

Trunk muscle strength in athletes.

Maximal voluntary strength of the trunk muscles was measured in 57 male elite athletes (soccer players, wrestlers, tennis players, and gymnasts), 14 female elite gymnasts, and in a normal group of 87 conscripts. Mean ages in the different groups ranged from 18-22 yr. An isokinetic (constant velocity) technique was used to record maximal torque produced by trunk and hip muscles during flexion, extension, and lateral flexion over the range of motion. The constant angular velocities used were 15 deg.s-1 and 30 deg.s-1, respectively. Isometric strength was measured in a straight body position (0 deg. of flexion). The measurements were made with the subjects in a horizontal position with the pivot point at the hip and at the lumbar (L2-L3) level. All male athlete groups showed higher peak torque values than the normals. The differences were largest in hip extension and trunk flexion. The male gymnasts also showed significantly higher peak values in hip flexion as compared to all other categories. There was no difference in strength per kg body weight between female gymnasts and untrained males, except in trunk extension. The position for peak torque occurred earlier in the movements for the athletes, especially for the gymnasts in extension movements and for the tennis players in flexion movements. In isometric contractions essentially the same strength differences were present as in the slow isokinetic contractions. In lateral flexion wrestlers and tennis players showed significantly higher strength in movements toward the nondominant side. Thus, differences were present between the athletes and the normals, some of which appeared to be sport specific and related to long-term systematic training.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1986

Lowering of the patella secondary to anterior advancement of the tibial tubercle for the patellofemoral pain syndrome.

From a series of 72 patients treated with anterior advancement of the tibial tubercle for patellofemoral pain syndrome, secondary lowering of the patella was noted in eight. In all eight patients the results were poor following surgery, with severe disabling retro- and peripatellar pain and atrophy of the quadriceps muscle. We describe this complication and illustrate and discuss the biomechanical consequences. The shortening of the patellar ligament and lever arm of the ligament were determined from radiographs of the knee joints before and after surgery. A theoretical analysis was made of the compressive force in the patellofemoral joint in one of these patients. The Insall-Salvati index decreased from 0.88-1.25 (mean 1.07) preoperatively to 0.54-0.78 (mean 0.70) at follow-up, 1.0-2.5 years post-operatively. The lowering of the patella was correlated to a reduction of the lever arm of the patellar ligament in seven patients. The mechanism behind the lowering of the patella is obscure, but the reduced lever arm of the patellar ligament will increase the compressive force in the patellofemoral joint, and this might be one explanation of the poor results. Impaired congruity of the patellofemoral joint, increased tension in the patellar ligament, and increased pressure against the quadriceps tendon are other possible explanations.

Adult↗
PubMed1985

Anterior advancement of the tibial tuberosity in the treatment of the patellofemoral pain syndrome.

Seventy-two patients with disabling patellofemoral pain were treated with anterior advancement of the tibial tuberosity. In a follow-up examination 1-5 years (mean 2.5) postoperatively, 57% of the patients had improved, 19% were unchanged, and 24% were worse. The high failure rate is disturbing, and we warn against too frequent use of the anterior tuberosity advancement procedure. Patients with patellofemoral pain should be approached by establishing a specific diagnosis and applying a specific treatment. In this study we concluded that the only patients who might benefit from the operation were those with grade I-II changes of the patellar cartilage.

Adolescent↗
PubMedDate not supplied

Comparison of an arthroscopic and an open procedure for posttraumatic instability of the shoulder: a prospective, randomized multicenter study.

From 1993 through 1996, a multicenter study was conducted on the surgical treatment of patients with posttraumatic recurrent anterior shoulder dislocations. Fifty-six patients (40 men, 16 women; mean age 26 years [range 18-51 years]), were evaluated with shoulder arthroscopy. If a Bankart lesion was present, the patients were randomly allocated to either an arthroscopic reconstruction with the use of biodegradable tacks or an open reconstruction with suture anchors. The postoperative rehabilitation protocol for the two groups was identical. In all patients, the range of shoulder motion, stability, and the Constant and Rowe scores were evaluated at 3, 12, and 24 months postoperatively. Thirty patients were surgically treated with the arthroscopic technique and 26 patients with the open technique. In the arthroscopic group, there were recurrences in 7 (23%) of 30 patients at a mean of 13 months (range 5 to 21 months) after surgery. All patients with stable shoulders had a negative apprehension test result. In the open group, there were recurrences in 3 (12%) of 26 patients at a mean of 10 months (range 2 to 23 months) after surgery (P = not significant). In the arthroscopic group, 2 patients had new traumatic redislocations, whereas 1 patient redislocated during an epileptic seizure. In the open group, 1 traumatic redislocation occurred. The 2-year results in this study demonstrate a large number of redislocations after reconstruction, even in the open surgery group. Patient noncompliance with the rehabilitation protocol and predisposing disease may partially explain these results. A tendency was seen toward more redislocations in the arthroscopic group, which emphasizes the importance of correct patient selection and careful surgical technique in the difficult surgical procedure.

Adolescent↗
PubMedDate not supplied

Isometric muscle strength and quantitative electromyography of back muscles in wrestlers and tennis players.

The isometric motor performance of the trunk muscles was studied in 10 male wrestlers and 9 male tennis players, all of whom were elite athletes. Isometric flexion, extension, and lateral bending were performed. The motor output, including fatigue, was studied by means of a load cell and using electromyography. The wrestlers were found to have symmetrical strength and were stronger in all measured directions, especially in side bending (flexion, 852 N; extension, 951 N; right and left side bending, 759 N and 744 N, respectively), than the tennis players and normal subjects of any published study. The development of fatigue in the erector spinae muscles, as evaluated by spectral analysis of the myoelectric signal, was not symmetrical and was significant bilaterally at the lumbar level and on the right side at the thoracic level. As expected, the tennis players had asymmetrical isometric strength. They were stronger in left side bending than right side bending (643 N compared with 557 N, P less than 0.01), and stronger in extension than flexion (835 N compared with 638 N, P less than 0.01). The development of fatigue in the erector spinae muscles was significant bilaterally at the lumbar level and on the left side at the thoracic level. The development of fatigue in the tennis players was less than that of the wrestlers except for the left thoracic measurement site. Our conclusions are that tennis players appear to be relatively weak in trunk flexion. The wrestlers displayed a development of fatigue that was asymmetrical and was of nearly the same degree as the tennis players, but on the opposite side.

Adult↗
PubMedDate not supplied

Diagnostic value of ultrasonography in partial ruptures of the Achilles tendon.

We evaluated 37 patients with surgically treated Achilles tendon disorders, comparing findings of preoperative ultrasonography with findings at surgery, to investigate the reliability of ultrasonography in diagnosing partial ruptures of the Achilles tendon. Discontinuity of tendon fibers, focal sonolucencies, and localized tendon swelling were positive findings suggestive of partial ruptures. We found the use of ultrasonography to be safe and reliable, with a sensitivity of 0.94, a specificity of 1.00, and an overall accuracy of 0.95.

Achilles Tendon↗