Biomedical subjects

M B Hilding

Publications and source records attributed to M B Hilding.

5 recordsLinked to original sources

PubMed1999

Gait affects tibial component fixation.

The prognosis of fixation in patients with total knee arthroplasty was classified as either good or poor based on migration results over 4 to 8 years using roentgen stereophotogrammetry. Gait analysis with the Vicon system was performed in 27 asymptomatic patients (1 bilateral), selected according to gender, implant design, age, and fixation principle to form two equivalent groups with different prognoses. The poor prognosis group walked with a predominantly flexing moment and higher moment peaks in the sagittal plane compared with the good prognosis group, in which moments were abnormally small. We conclude that individual gait patterns and subsequent differences in joint loading affect tibial component fixation.

Aged↗

PubMed1997

Quality of life after knee arthroplasty. A randomized study of 3 designs in 42 patients, compared after 4 years.

We assessed different yardsticks for outcome 4 (3-5) years after surgery in a prospective, randomized study of 42 patients, where 3 designs of cemmentless knee prostheses were used. The prognosis with regard to loosening, previously obtained by radiostereometry after 2 years of follow-up, was utilized. Patients with a prognosis of stable implant fixation (two thirds) were compared with those where loosening was predicted (one third). Hospital for Special Surgery score and Visual Analogue Scales regarding pain at rest, "first step" pain, pain during activity and global function, showed consistent postoperative improvements, but no differences between the design and prognosis groups were found. Radiolucent lines were registered both as yes/no and number of zones. Lines and prognosis were associated, but not lines and design groups. Quality of life assessment by the Nottingham Health Profile questionnaire showed that the poor prognosis group had increased pain and significant disturbances of sleep and emotions, as well as difficulty in enjoying hobbies and holiday activities. No differences were found between the design groups. Altogether, the patients showed profiles comparable to a healthy reference group. We conclude that the Nottingham Health Profile is a sensitive, relevant and simple measure of outcome after knee arthroplasty.

Activities of Daily Living↗

PubMed1996

Knee joint loading and tibial component loosening. RSA and gait analysis in 45 osteoarthritic patients before and after TKA.

We report a prospective study of gait and tibial component migration in 45 patients with osteoarthritis treated by total knee arthroplasty (TKA). Migration was measured over two years using roentgen stereophotogrammetry. We used the previously established threshold of 200 microm migration in the second postoperative year to distinguish two groups: a risk group of 15 patients and a stable group of 28 patients. We performed gait analysis before operation and at six months and at two years after TKA. On all three occasions we found significant differences between the two groups in the mean sagittal plane moments of the knee joint. The risk group walked with higher peak flexion moments than the stable group. The two groups were not discriminated by any clinical or radiological criteria or other gait characteristics. The relationship which we have found between gait with increased flexion moments and risk of tibial component loosening warrants further study as regards the aetiology of prosthetic loosening and possible methods of influencing its incidence.

Aged↗

PubMed1995

The stability of three different cementless tibial components. A randomized radiostereometric study in 45 knee arthroplasty patients.

We conducted a prospective, randomized study of 45 patients to evaluate 3 different uncemented tibial component designs in total knee arthroplasty. The stability of the components was assessed by radiostereometry (RSA), both as migration during 2 years and as inducible displacement at 2 years. The PCA resurfacing, the Tricon stem and the Tricon-M prosthesis groups showed a similar level of migration at 2 years, about 1.4 mm. In response to externally applied rotatory forces, the Tricon groups rotated more than the PCA group, interpreted as a consequence of the more conforming articular surface in the Tricon design. The series was divided into one group of continuously migrating prostheses with a poor prognosis (unstable, one third) and another group of prostheses in which migration stopped after 1 year (stable, two thirds). With this classification, no differences between the prostheses design groups were revealed. However, the unstable group showed a larger inducible displacement by provocation, an association hitherto not established.

Aged↗

PubMed1995

A relationship between dynamic and static assessments of knee joint load. Gait analysis and radiography before and after knee replacement in 45 patients.

In a prospective study of 45 gonarthrosis patients treated with total knee arthroplasty, we performed gait analysis with the Vifor system preoperatively and 6 months and 2 years postoperatively. An evaluation was made of the relationship between dynamic measurements of knee joint load and static, radiographic measurements of alignment. Correlations were found between the knee joint moments in the frontal plane and the Hip-Knee-Ankle (HKA) angles on all measurement occasions, likewise between changes of moments and changes in HKA by the operation. Thus, static alignment reflects the loading conditions during gait.

Aged↗