PubMed Health⌕ Search

Biomedical subjects

P Kjaersgaard-Andersen

Publications and source records attributed to P Kjaersgaard-Andersen.

At least 19 recordsLinked to original sources
PubMed1992

[Registration under the diagnosis of traumatic hip luxation in the national registry].

A national study of patients treated on account of traumatic dislocation of the hip in Denmark in 1989 and 1990 revealed that 755 cases had been registered under this diagnosis in the National Patient Register. A review of case reports from 71 departments with 755 registered identity numbers in the National Patient Register demonstrated that 121 patients had been treated for traumatic dislocation of the hip during the same period, and that seven of these had not been registered via the National Patient Register. The remaining 605 patients (80%) had either sustained dislocation of a hip prosthesis or had congenital dislocation of the hip. It is concluded that the Danish National Register, in its present form is of no value whatsoever in registration of traumatic dislocation of the hip nor congenital dislocation of the hip or dislocation of a total hip prosthesis.

Denmark↗
PubMed1992

Long-term results of total condylar knee arthroplasty in rheumatoid arthritis.

We have reviewed at an average period of ten years the results of 71 consecutive primary arthroplasties with the Insall-Burstein total condylar knee prosthesis in patients with rheumatoid arthritis. Their mean age at surgery was 52 years (24 to 72). At follow-up the overall results (Hospital for Special Surgery knee rating score) were excellent or good in 77%, fair in 11% and poor in 11%. There was residual pain in only 5% of patients with prostheses in situ; 58% could walk more than 500 m, and the median range of motion was 108 degrees. Eight knees had been revised. Five underwent arthrodesis because of deep infection and three needed revision arthroplasty for mechanical loosening. The crude survival rate of the arthroplasties was 89%. The presence of radiolucency around the tibial component correlated significantly with the severity of residual pain.

Adult↗
PubMed1992

Short-term treatment with nonsteroidal antiinflammatory medications to prevent heterotopic bone formation after total hip arthroplasty. A preliminary report.

The effect of short-term postoperative treatment with nonsteroidal antiinflammatory medication to prevent the formation of heterotopic ossification (HO) after total hip arthroplasty (THA) was studied in two groups of patients. Group A included 46 noncemented THAs in 40 men. Eight patients (13 hips) received prophylaxis with 25 mg of indomethacin three times daily for 14 days, and 32 patients (33 hips) received prophylaxis of 650 mg of aspirin twice daily for six weeks. Six to 12 months after surgery, only one hip (aspirin treated) developed HO, this being Grade I. In group B, 17 hips in 17 patients with cemented THA received prophylaxis of 25 mg of indomethacin three times daily. Of these, 12 patients were given indomethacin from one to nine days. One year after surgery, five hips had no HO and seven hips showed a Grade I or Grade II lesion. The remaining five patients in Group B received indomethacin from 19 to 26 days; one developed HO. This study demonstrated that treatment with either 650 mg of aspirin twice daily for six weeks or 25 mg of indomethacin three times daily for the first 14 postoperative days is sufficient to prevent the formation of severe HO after THA.

Adult↗
PubMed1991

[Long-term results of total condylar knee alloplasty by the Insall-Burstein method. A follow-up after 9-11 years].

A total of 118 patients (164 knees) participated in this investigation. These consisted of 23 males (31 knees) and 95 females (113 knees). The average age was 63 years (24-80 years) and the average period of observation was 10 years (9-11 years). The patients were examined clinically and radiographically preoperatively and also 8-12 weeks postoperatively and at intervals of one year thereafter. The Hospital for Special Surgery knee rating scale was employed in the clinical assessment and The Knee Society recognized radiolucency index in the radiographic assessment. At the most recent control examination, 82% of the knees assessed showed excellent or good results, 9% had fair results and 9% poor. The median total score was 84 points (quartiles: 76 and 98). Complete freedom from pain or slight pain were found in 91%. The range of motion was increased by an average of 12 degrees. A considerable improvement in the walking ability was found. A significantly positive correlation was found between the varus positioning of the tibial component and the occurrence of translucent zones. Serious complications occurred in 10% but none proved fatal.

Adult↗
PubMed1991

Early hemodynamic response to tibial osteotomy in rabbits: influence of indomethacin and prostaglandin E2.

The hemodynamic role of prostaglandins in the inflammatory phase of bone healing was studied on day 4 after creation of a nailed midtibial osteotomy in 40 rabbits, divided into groups of 10, treated with either indomethacin (oral dosage 10 mg/kg), subcutaneous (s.c.) prostaglandin E2 (PGE2) (dosage 1 mg/kg), or PGE2 infusion into the abdominal aorta (rate 20 ng/kg/min) for a 20-min period immediately before the animals were killed. The last group served as controls. Regional blood flow was measured by means of radioactive microspheres, and plasma volume was assessed by distribution of circulating [125I]fibrinogen. Neither indomethacin nor s.c. PGE2 treatment had any hemodynamic effects in the osteotomy area. PGE2 infusion caused increased blood flow in bone, bone marrow, and muscle of the lower limbs except in the osteotomy area. Thus, the influence of prostaglandins and indomethacin on bone healing of a rabbit midtibial osteotomy does not appear to be a direct vascular effect in the early healing phase.

Animals↗
PubMed1991

Heterotopic bone formation following hip arthroplasty. A retrospective study of 65 bilateral cases.

Heterotopic bone formation after two-stage bilateral cemented total hip arthroplasty was evaluated in 65 patients (23 women and 42 men) who had not received treatment with antiinflammatory drugs in the immediate postoperative weeks. The mean age at the first operation was 65 years, and the median interval between the two arthroplasties was 3 months. Fifty-two patients developed heterotopic ossification after the initial hip arthroplasty. Of these patients, 40 also developed ossifications after contralateral hip arthroplasty. Out of 11 males developing Grade-III heterotopic ossification after the initial hip arthroplasty, 8 also developed Grade-III ossification after contralateral hip arthroplasty. Two females developed Grade-III ossification after the initial arthroplasty, but neither of them developed a Grade-III lesion after contralateral total hip arthroplasty. Males with Grade-III heterotopic ossification after the initial hip arthroplasty were shown to be at a high risk of developing the same severe lesion after contralateral total hip arthroplasty, making them candidates for postoperative prophylaxis.

Aged↗
PubMed1991

Total hip arthroplasty. The role of antiinflammatory medications in the prevention of heterotopic ossification.

Postoperative prophylaxis with antiinflammatory medications, primarily indomethacin, is extremely effective in preventing the severest degrees of heterotopic ossification (HO) after a total hip arthroplasty (THA) and the recurrence of excised HO developed after a previous hip surgery. Prophylaxis with indomethacin should be given in 25-mg doses three times daily for at least three weeks, starting on the first postoperative morning. However, a shorter treatment period may be equally effective in preventing the severest degrees of HO, and a postoperative delay of five days before the initiation of prophylaxis does not seem to be followed by the development of severe HO. As evaluated one year after surgery, treatment with antiinflammatory medications in the immediate postoperative weeks did not increase the incidence of implant-bone interface radiolucencies, aseptic loosening, or revisions in cemented or cementless THAs when compared with cases that did not have postoperative treatment. However, although no major complications have been reported regarding the use of antiinflammatory medications in the prevention of HO after THA, orthopedic surgeons prescribing such treatment should be aware of their contraindications as well as early and late side effects. Since several antiinflammatory agents are reported to be effective in preventing HO, future reports dealing with HO after THA should always include information about the postoperative antiinflammatory treatment used.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1991

Instability of the hindfoot after lesion of the lateral ankle ligaments: investigations of the anterior drawer and adduction maneuvers in autopsy specimens.

The mobility patterns in the tibiotalocalcaneal joint complex with a solitary lesion of the anterior talofibular ligament (ATL) and a combined lesion of the ATL and calcaneofibular ligament (CFL) were studied in 22 human lower-extremity autopsy specimens mounted in a kinesiologic testing device. A solitary lesion of the ATL increased the anteroposterior (AP) laxity in the ankle joint in the entire range of flexion, with a maximum median of 3.1 mm in neutral flexion. Further cutting of the CFL increased AP laxity most obviously in dorsiflexion. A solitary lesion of the ATL resulted in a minor instability in adduction, whereas further lesion to the CFL increased adduction in the entire range of flexion, with a maximum median of 14.2 degrees in dorsiflexion. The anterior drawer maneuver can reveal a combined lesion of the ATL and CFL if performed with the tibiotalocalcaneal joint complex in dorsiflexion. Significant clinical instability in adduction will only take place when a combined lesion of the ATL and CFL is present.

Adolescent↗
PubMed1990

Combined treatment with indomethacin and low-dose heparin after total hip replacement. A double-blind placebo-controlled clinical trial.

We studied the safety of combining the postoperative use of a non-steroidal anti-inflammatory drug with low-dose heparin. In a double-blind, placebo-controlled clinical trial we reviewed the complications in 235 patients after total hip replacement, all treated with low-dose heparin and either indomethacin or a placebo. The incidence and type of complications in the two groups were nearly equal; indomethacin-treated patients had no increase in complications related to bleeding. Postoperative bleeding into drains was marginally greater in the indomethacin group, although the difference was not statistically significant. We conclude that treatment with indomethacin and low-dose heparin after hip replacement does not significantly increase the bleeding or other complications. We also found that patients receiving indomethacin were mobilised an average of one day before those on placebo.

Clinical Trials as Topic↗
PubMed1990

Indomethacin and bone trauma. Effects on remodeling of rabbit bone.

The influence of indomethacin on remodeling activity in normal trabecular and cortical bone and its influence on cortical bone close to a midtibial drill hole, 2 mm in diameter were histomorphometrically evaluated. Eight rabbits were treated with indomethacin (12.5 mg/kg/day), and another 8 rabbits served as controls. After 3 days, the mean plasma indomethacin level was 542 ng/mL, resulting in an almost complete inhibition of prostaglandin synthesis as reflected by the serum levels. In the control rabbits the remodeling activity after 6 weeks was increased 1 mm away from the drill hole but not at 3 and 8 mm. In conclusion, indomethacin had no effect on the activated remodeling process in cortical bone neighboring a small drill hole or on remodeling in nontraumatized cortical and cancellous bone. This suggests that the inhibitory effect of indomethacin on the remodeling process following local trauma to bone depends on the extent of the trauma.

Animals↗
PubMed1990

Heterotopic bone formation after total hip arthroplasty in patients with primary or secondary coxarthrosis.

Heterotopic bone formation was investigated in 392 Charnley low-friction total hip arthroplasties. A multivariate linear regression analysis was used to account for the influence of co-variables: sex, age at surgery, postoperative treatment with antiinflammatory drugs during at least the first 2 weeks, and previous ipsilateral hip surgery. A total of 232 hips had been treated for primary coxarthrosis, and 114 and 46 hips for secondary coxarthrosis due to congenital dislocation and fracture-dislocation of the hip, respectively. None of the hips with primary coxarthrosis previously had ipsilateral hip surgery, whereas 41 hips (36%) in patients with congenital dislocation of the hip and 28 hips (61%) in patients with fracture-dislocation of the hip had one or more ipsilateral surgical procedures prior to the arthroplasty. The sex ratio varied between the groups, with a male:female hip ratio of 1:1, 1:10, and 3:1 for the three groups, respectively. The risk of developing grades 2 or 3 heterotopic ossification after total hip arthroplasty were significantly higher in men, patients without postoperative treatment with antiinflammatory drugs, and patients above age 60. In contrast, the analysis documented that previous ipsilateral hip surgery and type of coxarthrosis did not influence lesion development, supporting the theory that a systemic, rather than local factor, is responsible for the development of heterotopic bone formation after total hip arthroplasty.

Adolescent↗
PubMed1990

Heterotopic bone formation after noncemented total hip arthroplasty. Location of ectopic bone and the influence of postoperative antiinflammatory treatment.

The regional-development of heterotopic bone around the hip and the influence of postoperative prophylaxis with antiinflammatory drugs were studied in 66 patients treated with 74 noncemented, porous-coated total hip arthroplasties (THA) using the McFarland approach. Thirty patients (34 hips) were treated with antiinflammatory drugs during the early postoperative period. Heterotopic bone developed in two different regions: central, around the neck of the femoral component, and lateral to the greater trochanter of the femur. Central ossifications were recorded in 53% of the hips and appeared significantly less frequently in patients postoperatively treated with antiinflammatory drugs. Lateral ossifications were recorded in 71% of the hips, and no significant prophylactic effect was found for postoperative antiinflammatory treatment. In response to the McFarland approach in THA, heterotopic ossifications may appear both centrally around the neck of the femoral component and lateral to the trochanter in the substance of the medial gluteal muscle. The latter may be comparable to post-traumatic myositis ossificans.

Adolescent↗
PubMed1990

Total knee arthroplasty in classic hemophilia.

Thirteen semiconstrained total knee arthroplasties (TKA) were performed in nine men with classic hemophilia. The average age at surgery was 38 years, the average Factor VIII administration during hospitalization was 84.222 units, and the average hospitalization time was 33 days. Four patients (44%) died during the observation period, three from acquired immunodeficiency syndrome (AIDS) contracted through contaminated Factor VIII plasma concentrates and one from sudden cardiac arrest. One of the patients who died from AIDS had a positive test for human immunodeficiency virus (HIV) at surgery. He died three months after the arthroplasty. The remaining two patients contracted AIDS one year and four years after the arthroplasty. All but one patient were followed for at least one year, with an average follow-up period of 43 months. Using The Hospital for Special Surgery Knee Rating Scale, the overall result was excellent in nine knees and good in three knees. All patients were completely relieved of pain. TKA in hemophiliacs is an effective treatment for otherwise intractable chronic knee pain due to severe joint degeneration. However, caution should be taken in HIV-positive patients owing to the challenge of the patient's immune system and the risk of transmitting the virus to the hospital staff.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Distal humeral migration as a component of multidirectional shoulder instability. An anatomical study in autopsy specimens.

The object of the present study of autopsy specimens was to evaluate distal humeral migration during abduction allowed by sequential severance of capsular and ligamentous structures stabilizing the shoulder joint. A kinesiologic testing device continuously registered distal humeral migration, abduction angle, rotation, and flexion-extension. No distally directed force was applied to the humerus except the weight of the apparatus. Significant distal migration was recorded in the entire range of abduction (0 degrees -60 degrees) after solitary severance of the coracohumeral ligament as well as the proximal part of the anterior joint capsule. Further sectioning of the proximal part of the posterior capsule did not significantly increase distal humeral migration. Maximum distal migration (25 mm) was measured at 20 degrees of abduction. Applying an internal torque to the humerus significantly prevented distal migration as long as the posterior capsule was kept intact. Clinical testing for distal humeral migration should be performed with the shoulder joint at 20 degrees of abduction and neutral rotation. Furthermore, distal humeral migration can be significantly reduced by internal rotation of the humerus when the posterior joint capsule is intact.

Aged↗
PubMed1989

[Postoperative analgesia with morphine versus morphine and paracetamol. A double-blind clinically controlled study with a placebo].

The effect of paracetamol on the postoperative employment of morphine was investigated in a double-blind clinically controlled investigation with a placebo. The operations concerned were elective gynaecological laparotomies and hip replacements. During the first 60 hours postoperatively, the employment of morphine was reduced significantly in the patients who received paracetamol. Reductions of 16, 22 and 26% were concerned. The differences between the various types of operation were not significant. Patients for joint replacements who had been treated preoperatively with non-steroid anti-inflammatory preparations did not have any significantly greater consumption of morphine postoperatively but the reduction in consumption of morphine in the paracetamol group was significantly greater with a saving of 43%. Patients who had received treatment with morphine preparations preoperatively had significantly greater consumption of morphine postoperatively but the additive analgesic effect of paracetamol remained unchanged at approximately 25%.

Acetaminophen↗
PubMed1989

Factors associated with heterotopic bone formation following total hip replacement.

In order to delineate groups of patients suitable for treatment to prevent heterotopic bone formation (HBF) following total hip replacement, 99 patients were examined to evaluate predisposing factors. One year after surgery, HBF was found in 73% of the patients. A significantly increased frequency of HBF was found among men. There was no correlation between age, severity of osteoarthritis, size of osteophytes, or preoperative hip movement and HBF. Previous ipsilateral hip surgery did not increase the risk of HBF. Although not significant, all patients who developed heterotopic bone after previous ipsi- or contralateral hip surgery showed HBF of the same or even a higher grade after the present replacement.

Adult↗