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Biomedical subjects

T Niinimäki

Publications and source records attributed to T Niinimäki.

At least 19 recordsLinked to original sources
PubMed2001

A proximal fixed anatomic femoral stem reduces stress shielding.

In 24 patients with total hip replacement using a short anatomic femoral stem, bone mineral density (BMD) was measured after a 7-year follow-up using dual-energy X-ray absorptiometry. The contralateral side was used as a control. The BMD on the side of the prosthesis was lower by a mean of 7% than that on the control side. The difference was greatest in the area of the calcar and laterally and proximally around the stem. BMD at the metaphyseal and diaphyseal areas were the same as on the contralateral side. The bone loss around the proximal aspect of the stem may be related to the proximal porous coating. It is concluded that stress shielding can be diminished by appropriate design of the femoral component.

Absorptiometry, Photon↗
PubMed1997

Epidural abscess after lumbar discography. A case report.

STUDY DESIGN: The patient who suffered from pain in both lower legs and in whom discography was performed experienced a rare complication after discography. The findings and method of discography is described, as is usefulness of magnetic resonance imaging to image this rare complication. OBJECTIVES: To establish the possibility of getting a spinal epidural abscess after discography, how to make the diagnosis, and how to treat the complication. SUMMARY OF BACKGROUND DATA: Discitis after discography is a well-known complication, but epidural abscess is rare. METHODS: C-reactive protein concentration was measured and was more than 100 mg/L. Infection was suspected, and antibiotic therapy was started immediately. Magnetic resonance imaging was performed, and the diagnosis became clear. A laminotomy was performed. RESULTS: Symptoms due to epidural abscess disappeared soon after laminotomy. CONCLUSIONS: Some harmful and unpleasant complications are possible after discography. Antibiotic prophylaxis and stiletted needles should be used. Magnetic resonance imaging is the best radiologic procedure to image the complication, and surgery must be performed as soon as possible.

Abscess↗
PubMed1995

Pocket-size, portable surface EMG device in the differentiation of low back pain patients.

The relevance of surface EMG of the paraspinal muscles measured by a portable, pocket-size device with a special amplifier was evaluated in different low back pain groups. Patients with only local low back pain had significantly higher EMG activities than those with unilateral radiating pain without verified disc herniation, those with verified disc herniation, and controls, but there were no differences between the latter three groups. Pain clearly modified paravertebral muscle activity, as the patients experiencing pain during the recording showed significantly higher EMG activities than those with no pain. It is concluded that surface EMG is a valid tool for indirectly assessing pain in low back pain patients but not for classification into different diagnostic groups.

Adolescent↗
PubMed1995

Bone loss from the proximal femur after arthroplasty with an isoelastic femoral stem. BMD measurements in 25 patients after 9 years.

To quantify the bone loss from the proximal femur after total hip arthroplasty with an isoelastic femoral stem, the bone mineral densities (BMD) around 25 such stems were measured after an 8.5 (7.5-9.5)-year follow-up. The contralateral, healthy side was used as a control. The BMD on the prosthesis side was lower by a mean of 14 percent than on the control side. The difference was greatest in the calcar area and smallest in the cortex medially of the prosthesis stem. The decreases in BMD around the metaphyseal and diaphyseal areas of the stem were smaller than those reported for stiff stems. The marked bone loss in the calcar region is possibly due to stress bypass-i.e., the axial load is transmitted directly into the metaphyseal area of the femoral shaft, causing an increase in its stiffness and in the jamming of the prosthesis stem.

Adult↗
PubMed1994

Results of the surgical treatment of Morton's neuralgia in 58 operated intermetatarsal spaces followed over 6 (2-12) years.

In 45 patients (52 feet), 58 intermetatarsal spaces were operated on for Morton's neuralgia. The procedure included dorsal incision, division of the deep intermetatarsal ligament, and resection of the common digital nerve including the neuroma. The outcome of the operation was excellent in 13 clefts good in 20, fair in 14, and poor in 11 after a mean follow-up period of 6 years. Five clefts were reoperated, with improvement in four. The feet with Morton's neuralgia displayed a significantly higher rate of other foot pathologies than feet in a randomly selected control group. The results show the efficacy of the surgical treatment of Morton's neuralgia over a long follow-up period, with an improvement in 80% of cases.

Adult↗
PubMed1994

Function after primary hemiarthroplasty and secondary total hip arthroplasty in femoral neck fracture.

Four to 12 years after primary treatment of femoral neck fracture with hemiarthroplasty in a group of Finnish patients and secondary total hip arthroplasty as a salvage procedure for healing complication after primary osteosynthesis in a group of Swedish patients, function was classified and the Nottingham Health Profile questionnaire was applied. The two groups were comparable with regard to age, sex, and social status. The patients with secondary total hip arthroplasty used walking aids to a lesser extent than the patients with hemiarthroplasty and experienced less problems in several aspects of life. Walking ability was considered unchanged, compared to prefracture, to a larger extent in the secondary total hip arthroplasty group. Thus, secondary total hip arthroplasty in patients with healing complication following primary osteosynthesis gives better long-term functional capacity than that obtained with a primary hemiarthroplasty.

Activities of Daily Living↗
PubMed1994

Total hip arthroplasty using isoelastic femoral stems. A seven- to nine-year follow-up in 108 patients.

From 1983 to 1985 we performed 114 primary hip replacements in 108 consecutive osteoarthritic patients using a non-cemented RM isoelastic femoral stem. After a mean follow-up of 8.2 years, ten patients had died, 11 hips had been revised, six patients had been lost to follow-up and two had been excluded due to severe general illnesses. Of 85 arthroplasties (in 79 patients) 14 could not be assessed because of other illness or disability. The 71 remaining were reviewed by questionnaire and radiography; an excellent or good overall functional result was found in 31, 16 were fair and 24 were poor. Radiographically, 21 of 71 stems were judged to be loose and ten showed osteolytic foci, six of these without obvious loosening. We conclude that the isoelastic RM stem shows a high rate of loosening, but that this is not always associated with a poor subjective result. Regular radiographic review is necessary. The results are worse than those reported for other uncemented stems and for cemented stems.

Aged↗
PubMed1991

Is DRG useful in orthopedics?

The increasing hospital costs have provoked discussions about Diagnose Related Groups (DRG) and its role in controlling the growth of hospital budgets. The relevance to current operation statistics and the structure of DRG in orthopedics are analyzed. The direct application of DRG to Scandinavian statistics does not appear to be reliable.

Diagnosis-Related Groups↗
PubMed1991

Increasing demands on orthopedic services.

In Finland, waiting lists have been analyzed country-wide several times during the last two decades. In this presentation, the data obtained are reviewed. The orthopedic waiting lists grew threefold from 1969 to 1987, more rapidly than the total waiting list to hospitals in the country. Meanwhile, the average duration of hospitalization decreased. The reliability and problems of data bases available are discussed; it is concluded that especially the studies on waiting lists need new objective methods.

Arthritis, Rheumatoid↗
PubMed1991

Acute acromioclavicular dislocations treated by fixation of the joint and ligament repair or reconstruction.

We reviewed 55 patients, median age 34 years, who had had acute complete acromioclavicular dislocation treated by transient acromioclavicular fixation with a Knowles pin and ligament repair by suturing or reconstruction of the superior acromioclavicular ligament with transfer of the coracoid end of the coracoacromial ligament onto the clavicle. At followup examination 50 patients showed at least a satisfactory result. Five cases, two of which had had subsequent resection of the distal end of the clavicle, were classified as poor, mainly because of pain, even though the functional result was good in three. Reconstruction of the superior acromioclavicular ligament, although it improved the anatomic result, was shown to be of no advantage and may even have caused discomfort. The numerous radiological findings of residual subluxation or dislocation, deformity of the distal end of the clavicle, soft tissue calcification and osteoarthritis or pathological physical findings did not correlate significantly with the clinical outcomes. In general this operation gave results comparable with those achieved by other operative methods. It is useful if surgery is preferred to conservative treatment.

Acromioclavicular Joint↗
PubMed1989

The significance of residual stenosis after decompression for lumbar spinal stenosis.

Thirty-one patients with degenerative or combined degenerative and developmental lumbar spinal stenosis diagnosed by myelography and at subsequent surgery were thoroughly examined by computed tomography (CT) to reveal the completeness of the decompression and its correlation with the outcome. Complete elimination of the stenosis was achieved in 10 cases (32%) of whom 9 (90%) showed improvement. Various combinations of residual stenosis (some type of stenosis of the lateral part of vertebral canal at the laminectomy sites and also central stenosis outside the laminectomy field) were observed in 21 cases (68%). Of these, 14 (67%) had nearly complete, subtotal decompression with minimal or some residual stenosis, 7 (33%) had only minor decompression of the most constricted part of the spinal canal with a considerable amount of residual stenosis. The latter groups showed improvement in 8 cases (57%) and 6 cases (86%), respectively. Three patients (10%) with increased postoperative symptoms had only minimal or some residual stenosis. The significance of these findings is discussed.

Female↗
PubMed1988

Coracoid tendon transposition a.m. Bristow-Latarjet.

Twenty-three shoulders on which a Bristow-Latarjet operation had been performed on account of anterior glenohumeral instability were followed up for an average of 24 months (range 15-36). The series consisted of 12 recurrent dislocations, 5 chronic subluxations + 3 with occasional dislocations, and 3 anterior + inferior (multidirectional) subluxations. Four shoulders were classified as poor at follow-up. The reason for failure was excessively proximal attachment of the coracoid transplant in one case, while an objective diagnosis of multidirectional instability by reference to the autotraction test and stress roentgenograms was reached in the other three.

Adult↗