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Biomedical subjects

S Bengtson

Publications and source records attributed to S Bengtson.

12 recordsLinked to original sources
PubMed1993

Prosthetic osteomyelitis with special reference to the knee: risks, treatment and costs.

The overall incidence of osteomyelitis following primary knee arthroplasty is 1-2%. Major risk factors are large prostheses, rheumatoid arthritis, postoperative wound-healing complications, skin infections, and prior deep infections. The major infecting organism is Staphylococcus aureus. Healing of the infection is to be expected in 20% when systemic antibiotics alone are used, in 24% when soft tissue surgery is used, in 50% when resection arthroplasty is used, in 76% when revision arthroplasty is used, in 90% when arthrodesis is used, and in 100% when amputation is used. The direct medical costs average US$ 62,100 for an infected patient and US$ 8600 for a non-infected patient. Attention should focus on prophylactic measures directed towards the soft tissue problems: by avoiding conflicting skin incisions, by gentle handling of the periarticular soft tissues, by avoiding the use of constrained prostheses and oversized compartmental prostheses, by letting wound healing take priority over motion in knees with compromised soft tissues, and by using prophylactic antibiotic treatment for skin ulcers until these have healed.

Anti-Bacterial Agents↗
PubMed1991

Acute compartment syndrome from anterior thigh muscle contusion: a report of eight cases.

Eight patients with an anterior thigh muscle contusion or rupture developed an acute anterior compartment syndrome. All patients had an increased pressure in the quadriceps muscle, ranging between 41 and 80 mm Hg. At fasciotomy, three cases had a hematoma in the rectus femoris and four in the vastus intermedius, and in one case only, edema of the anterior compartment was found. Postoperatively, there was immediate pain relief in all cases, and after about 4 weeks, all patients had normal function. We recommend broad indications for fasciotomy and evacuation of hematoma after thigh muscle contusion or rupture.

Acute Disease↗
PubMed1991

The infected knee arthroplasty. A 6-year follow-up of 357 cases.

The incidence of deep infection after 12,118 primary knee arthroplasties performed in Sweden from October 1, 1975 through 1985 with a median follow-up of 6 years was 1.7 percent for arthrosis and 4.4 percent for rheumatoid arthritis. Risk factors for infection were large prostheses, postoperative wound-healing complications, rheumatoid arthritis, a prior deep infection, and skin infections. We have analyzed the treatment of 357 knee arthroplasties with a deep infection. Systemic antibiotics alone were primarily used in 225 knees, with healing of the infection in 44 knees, 20 of which had a functioning prosthesis at the final follow-up; the treatment did not compromise later revision surgery. Soft-tissue surgery was used in 154 knees--37 healed, 15 of which had a functioning prosthesis. Resection arthroplasty resulted in healing of the infection in 11 of 22 knees. Revision arthroplasty was performed in 107 knees, with eventual healing of the infection in 81 knees, 36 of which had a functioning prosthesis; there were no differences in the outcome of one-stage and two-stage procedures. Arthrodesis was attempted in 135 knees, with eventual healing of the infection in 120 knees and fusion in 105. Twenty-two patients were amputated. Thus, the infection healed in 315 knees (88 percent), but only 71 (20 percent) recovered with a functioning prosthesis, and 8 patients died of the infection. Attention should therefore focus on prophylactic measures directed towards the soft-tissue problems--by avoiding conflicting skin incisions, by gentle handling of the periarticular soft tissues, by avoiding the use of constrained prostheses and oversized compartmental prostheses, by letting wound healing take priority over motion in knees with compromised soft tissues, and by using prophylactic antibiotic treatment for skin ulcers until these have healed.

Adolescent↗
PubMed1990

External fixation of femoral fractures: experience with 15 cases.

We report our experience with external fixation in 15 femoral fractures in 14 patients. Follow-up times ranged from 4 to 56 months. Thirteen patients had multiple injuries. All but two fractures healed. In one patient with a supracondylar fracture, a knee arthrodesis had to be performed. One septic osteomyelitis of the femur led to amputation. The range of active knee joint motion was greater than or equal to 90 degree in 13 knees. Only six knees, however, regained a flexion of greater than or equal to 120 degrees. Pin tract infection occurred in one case and resolved uneventfully after revision and systemic antibiotics. External fixation should not be routinely used for fixation of femoral fractures, but may be considered in multiply injured and critically ill patients or in case of extensive soft tissue injury.

Adolescent↗
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↗
PubMed1987

Treatment of the exposed knee prosthesis.

Ten knees with early tissue breakdown after knee arthroplasty resulting in exposed prostheses were treated with different plastic surgical techniques. Six knees were successfully covered: four using a gastrocnemius musculocutaneous flap, one using a fasciocutaneous flap, and one using split-skin grafts. Four knees failed: two using local skin flaps and two using split-skin grafts. A gastrocnemius musculocutaneous flap seems to provide a reliable coverage of the exposed knee joint.

Aged↗
PubMed1986

Revision of infected knee arthroplasty.

Sixteen infected knee arthroplasties were revised and followed for 5 (1-10) years. There were nine recurrences of infections, but in one of these a second revision was successfully carried out. The remaining seven revisions resulted in only four functioning prostheses. The results were poor for hinged and stabilized prostheses for which arthrodesis, after eradication of the infection, is recommended. Infected compartmental prostheses with good bone stock could be treated with a two-stage procedure using tricompartmental revision prostheses.

Aged↗