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Biomedical subjects

T Visuri

Publications and source records attributed to T Visuri.

At least 19 recordsLinked to original sources
PubMed2004

Primary cartilage lesions of the knee joint in young male adults. Overweight as a predisposing factor. An arthroscopic study.

BACKGROUND AND AIMS: This study was undertaken to evaluate the relationship between overweight and severity of arthroscopically confirmed primary cartilage lesions of the knee. MATERIAL AND METHODS: The hospital records of 88 young male adults (98 knees), who underwent arthroscopy of the knee and were diagnosed of primary cartilage lesion during 1997-98, were reviewed. The depth of the lesions was graded according to Beguin and Locker classification. RESULTS: 73.5 % of the lesions were patellar and 12.0 % in the medial condyle of the femur. 74.5 % of the patients had superficial (grade I-II) and 25.5 % deep (grade III-IV) lesions. Patients with deep lesions had a significantly higher body mass index (BMI 25.3 vs. 22.9, p < 0.001) and they were older (20.8 vs. 19.7 years, p = 0.023) than other patients. Similarly, patients with overweight (BMI > or = 25.0) had significantly more often deep lesions than other patients (50 % vs. 10.4 %, p < 0.001). CONCLUSIONS: These results suggest, that overweight may predispose young patients to more severe cartilage lesions independent of other etiologic factors, and support the hypothesis of the cumulative effect of overweight on cartilage injuries during early adult life.

Adult↗
PubMed2001

Impact of chronic low back pain on military service.

The performance of 245 male conscripts with chronic low back pain (CLBP) during military service was compared with their pre-conscription performance and with that of 126 age-matched male controls without low back pain (LBP). The frequency of LBP in the conscripts with CLBP increased significantly during their service period compared to risk before service (odds ratio, 10.35; 95% confidence interval, 3.61-29.52). The same factors that induced LBP before entering service, mainly lifting and carrying, also caused LBP during military service. Of the conscripts with CLBP, 120 had experienced an accidental back injury and 125 had injured their backs during lifting or carrying before entering service. During service, back problems were caused by accidents in 88 cases and by lifting or carrying in 157 cases. The frequency of LBP injuries, measured as the need for medical consultation or treatment, increased 2.4-fold (95% confidence interval, 1.41-4.10) during the term of service. Conscripts with CLBP served significantly more frequently as ordinary soldiers than the controls. There was no difference in participation in leisure time or competitive sports activities between the two groups. The future expectations of the CLBP conscripts were pessimistic: only one-fifth believed in complete recovery, and two-fifths thought that they would need substantial outside help in the future.

Adolescent↗
PubMed1999

Cancer incidence in Finnish hip replacement patients from 1980 to 1995: a nationwide cohort study involving 31,651 patients.

Nationwide, computer-based reporting of all arthroplasties performed in Finland was started in January 1980. Using data from these records, a cohort of 31,651 polyethylene-on-metal total hip arthroplasty (THA) patients was followed up for cancer, using Finnish Cancer Registry data, from 1980 to 1995. During follow-up, 2,367 cancers were observed. There were statistically significantly fewer cancers among the THA patients (standardized incidence ratio [SIR], 0.90; 95% confidence interval [CI], 0.87-0.93). SIRs for cancers of the lung (0.69) and stomach (0.77) were significantly below unity. There was no significantly increased risk at any site. The SIR for cancer overall in male THA patients was below unity during the first 3 years after THA but returned to unity thereafter. The low SIR among men during the first 3 years was largely because the lung cancer SIR was 0.47 (95% CI, 0.35-0.62). In women, the SIR remained around 0.93 throughout follow-up. The SIR for stomach cancer was below unity only in women (SIR, 0.67; 95% CI, 0.51-0.86). For cancer of the urinary bladder, the SIR during the first 3 years after THA was below unity but later slightly above it (SIR, 1.24 in relation to > or =3 years of follow-up; 95% CI, 0.99-1.52). For myeloma and leukemia, SIRs were greater than unity only for THA patients followed up for 3 to 9 years. The study findings, in contrast to previously reported findings, do not indicate that there is any increased risk of hematopoietic cancers after THA using polyethylene-on-metal prostheses. SIRs relating to soft tissue cancers and bone sarcomas did not differ significantly from unity. No sarcoma was observed at the site of a prosthesis. THA seems to play no major role in cancer causation.

Arthroplasty, Replacement, Hip↗
PubMed1999

Cancer incidence after total knee arthroplasty: a nationwide Finnish cohort from 1980 to 1996 involving 9,444 patients.

A nationwide, computer-based survey of all total joint arthroplasties performed in Finland has been carried out since January 1980. From these records, a cohort of 9,444 patients, with 51,756 person-years, after primary operation with a total polyethylene-on-metal knee arthroplasty (TKA) was followed up for cancer through the Finnish Cancer Register up to December 31, 1996. During the follow-up, 706 cancers were observed. The expected number, based on national rates, was 719; therefore, the standardized incidence ratio (SIR) for all cancers was 0.98. The SIRs for non-Hodgkin's lymphoma (1.40), Hodgkin's disease (1.24) and multiple myeloma (1.54) were increased, but only that of non-Hodgkin's lymphoma was statistically significant 3-10 years after the operation. The numbers of observed cases of prostate cancer exceeded that of expected, with a SIR value of 1.49. A low SIR of lung cancer was observed among men, especially during the first 3 years (0.61), but not in women. The SIR for colon cancer was below unity in women only (SIR 0.70). The SIR for cancer of the urinary organs was close to unity (0.97). SIR relating to soft tissue and bone cancer did not differ significantly from unity, and none of the 6 sarcomas was observed at the site of a prosthesis. The overall cancer risk after TKA done for primary osteoarthrosis seems not to be increased. The increases in lymphoma and prostate cancer risk, however, are observations that could be related to TKA and justify further follow-up of the cohort.

Adult↗
PubMed1997

Causes of death after hip arthroplasty in primary arthrosis.

The causes of death in 1,018 patients operated on for primary osteoarthrosis with cemented total hip arthroplasty (THA) were compared with those of age- and sex-matched orthopaedic control patients and those of the general population in Finland. The mean follow-up period was 12 years for the THA patients and 11 years for the control patients. During the first 4 years after surgery, the mortality of the THA patients from circulatory diseases was significantly increased compared with that of the orthopaedic control patients; the number of deaths in patients with THA was 34 compared with 17 for orthopaedic control patients, the relative risk being 2.00 (95% confidence interval, 1.13-3.54). During the 10-year period after the surgery, the relative risk of death of the THA patients compared with the orthopaedic control patients was 1.50 for death from circulatory diseases (95% confidence intervals, 1.11-2.00), 0.42 for accidental death (95% confidence interval, 0.55-1.08), 0.74 for death from cancer, and 0.77 for death from other causes. The observed numbers of deaths from circulatory diseases or by accidents for patients with THA during a postoperative time frame of 5 to 23 years did not differ from the numbers expected for an age- and sex-matched subgroup of the Finnish population. The number of deaths from cancer was less than expected (P = .046).

Accidents↗
PubMed1997

Stress osteopathy of the femoral head. 10 military recruits followed for 5-11 years.

I present 10 cases of spongious bone injury of the femoral head induced by physical stress. All patients were young military recruits who complained of hip pain from weight bearing which had started during physical exertion. Increased uptake in a radionuclide bone scan was regarded as the criterion for stress osteopathy. 7 hips were radiographically normal. In 3 cases a subcortical lateral cystic lesion of the femoral head was observed. MRI was performed in 6 cases. A decreased signal intensity in T1-weighted images in 5 cases and high signals in T2-weighted and IR signals (2 patients) indicated bone marrow edema. A lateral osteophyte of the femoral head developed in 1 case during 8 years' follow-up. After a median of 6 years, 9 patients still had occasional slight hip pain.

Adult↗
PubMed1996

Reconstruction of the anterior cruciate ligament with carbon fibres: unsatisfactory results after 8 years.

A total of 37 patients were operated on for anterior cruciate ligament (ACL) insufficiency between 1980 and 1989 using two types of carbon fibre ligament substitutes. The average age of the population was 23.6 years. The carbon fibre prostheses were covered with either a strip of medial joint capsule or lyophilized dura. Follow-up averaged 8.1 years (range 4-13 years), most of the operations being done from 1983 to 1985. Evaluation included a questionnaire, physical examination, Lysholm scoring, radiographs and cruciometer testing. The operated ACLs were looser than those in the contralateral healthy knees. The Lysholm scoring system gave acceptable results (excellent and good) in 43.5%, fair in 31.4% and poor in 24.1% of cases. Acceptable results provided better stability and muscle strength. During the follow-up there was an evident deterioration in stability as well as in Lysholm score. The results between the two types of ligaments did not become statistically different. Osteoarthrosis increased in all the knees examined radiographically (28/37). The results indicate that the ACL reconstructions using these types of carbon fibre prostheses lead to unacceptable results in the long-term follow-up.

Adolescent↗
PubMed1996

Cancer risk after metal on metal and polyethylene on metal total hip arthroplasty.

The incidence of cancer after metal on metal total hip arthroplasty (McKee-Farrar) and polyethylene on metal total hip arthroplasty (Brunswik, Lubinus) was compared with that of the general population in Finland. The mean followup time for the patients who had metal on metal total hip arthroplasty was 15.7 (9092 person years) and for the patients who had polyethylene on metal total hip arthroplasty it was 12.5 years (19,846 person years). One hundred thirteen malignant cancers were observed in patients who had metal on metal total hip arthroplasty and 212 were observed in patients who had polyethylene on metal total hip arthroplasty. The standardized incidence ratio for all cancers of the metal on metal arthroplasty group was 0.95 (95% confidence limits 0.79-1.13) and that of the polyethylene on metal arthroplasty group was 0.76 (95% confidence limits 0.68-0.86). The risk of total cancer in the patients who had metal on metal total hip arthroplasty was 1.23-fold compared with that of the patients who had polyethylene on metal total hip arthroplasty. Both groups had significantly less lung cancer than the general population: the leukemia incidence in the patients who had metal on metal total hip arthroplasty was slightly increased (observed to experienced 7/3.03, standardized incidence ratio 0.61; 95% confidence limits 0.17-1.56). The leukemia rate of the patients who had metal on metal total hip arthroplasty was 3.77-fold compared with that of the patients who had polyethylene on metal total hip arthroplasty, but this difference was not statistically significant. No sarcomas were observed at the site of the prosthesis. The incidence of the other forms of cancers did not differ significantly from those in the general population. The observed variation in the incidence of different cancers among patients who had total hip arthroplasty compared with the general population suggests that factors other than total hip arthroplasty play a major role in the origin of cancer.

Aged↗
PubMed1994

Life expectancy after hip arthroplasty. Case-control study of 1018 cases of primary arthrosis.

The long-term survival of 1018 total hip arthroplasty (THA) patients (237 McKee-Farrar, 449 Brunswik and 332 Lubinus patients) operated on for primary arthrosis was compared with pair-matched controls (i.e., patients operated on for other orthopedic indications) and with a normal population. The 10-year survival after surgery for the McKee-Farrar patients was 85 percent, for the Brunswik patients 82 percent, for the Lubinus patients 82 percent and for the orthopedic control patients 84 percent, respectively. The 10-year survival after 65 years of age for the THA patients was 78 percent and for the normal population 73 percent. The long-term life expectancy of our patients with a cemented THA was equal to that of our orthopedic control group and better than the life expectancy of the Finnish population.

Age Factors↗
PubMed1994

Bilateral distal biceps tendon avulsions with use of anabolic steroids.

A case of a young body-builder who had ingested megadoses of anabolic-androgenic steroids (AAS) for 6 yr and who sustained bilateral avulsions of the distal biceps tendon is presented. Explosive behavior, painful gynecomastia, and a slight hypertrophy of both the left and right ventricular walls of the heart were other possible adverse effects of AAS in this patient. Reinsertion of both distal biceps tendons to the radial tuberosity was performed according to the Boyd-Anderson technique and a good result was achieved.

Adult↗
PubMed1994

Cervical disk bulges in fighter pilots.

This paper reports three cases of bulging cervical disks among fighter pilots flying high-performance aircraft who experienced acute in-flight neck pain during aerial combat maneuvers under high +Gz forces. Radiographic investigations (magnetic resonance imaging/computed tomography/myelography) revealed that disk bulges were the cause of the pain. One pilot underwent decompressive surgery, and two were treated conservatively. Acute in-flight neck pain and related problems, such as bulging cervical disks, may become more common, since the modern fighter aircraft of the future will be better able to create and sustain high +Gz forces than the fighter aircraft in use today. Further, the increasing number of helmet-mounted devices will make flight helmets heavier, thus placing increased stress on cervical structures.

Adult↗
PubMed1993

Acute dislocation of the patella: MR findings.

PURPOSE: The authors describe magnetic resonance (MR) imaging findings of acute traumatic dislocation of the patella. MATERIALS AND METHODS: MR imaging at 0.1 T was performed in 25 patients with an acute patellar dislocation, 24 of whom underwent surgery. All patients were young male conscripts, aged 18-22 years. RESULTS: Signal intensity abnormalities of bone, seen as areas of decreased signal intensity on T1-weighted images, were found in all 25 patients (100%). The lateral femoral condyle was involved in all cases. Signal intensity changes also appeared in the patella in eight patients and in the lateral tibial plateau in three. Osteochondral fragments seen at plain radiography and cartilage fissuring noted at arthroscopy were not visible at MR imaging. Injury of the medial patellar retinaculum was seen at MR in each case. All patients had a joint effusion. Lateral subluxation of the patella was a common finding. CONCLUSION: Constant findings at MR imaging were (a) contusion of the lateral femoral condyle, (b) tear of the medial retinaculum, and (c) joint effusion.

Acute Disease↗
PubMed1993

Hemarthrosis of the clinically stable knee due to sports and military training in young recruits: an arthroscopic analysis.

Findings of an early arthroscopy performed in 108 consecutive hemarthrotic and clinically stable knees were analyzed. The patients were young conscripts, the mean age being 19.9 years. Fifty-seven of the knees were injured during military training, 36 in different sports activities, 9 at falls, and 6 in motorbike accidents. The lesions were divided into "primary" (lesions needing operative treatment or the supposed most common lesions in incidence) and "secondary" (other lesions). An average of 1.6 lesions were observed per knee. Dislocation of the patella was the most common diagnosis in 38 (35%) cases. Dislocation of the patella was associated with military exercise (p < 0.001). Lesions of the anterior cruciate ligament (ACL) were observed in 37 (34%) cases. ACL ruptures were related to sport activities (p < 0.0001).

Adolescent↗
PubMed1993

The role of overlength of the leg in aseptic loosening after total hip arthroplasty.

A study was done on the role of postoperative leg length inequality (LLI) in aseptic loosening after total hip arthroplasty (THA). Data on 405 McKee-Farrar hip replacements performed at the Invalid Foundation, Helsinki, Finland were available for the study. The mean lengthening of the operated leg was 0.8 cm after an average follow-up of 7.7 years. Of these hips, 63 (15.6%) subsequently underwent revision due to aseptic loosening of the prosthesis. Several risk factors were analysed using multivariate stepwise regression analysis to find factors which predispose patients to loosening: overlength of the operated limb proved to be the most important. Our conclusion is that overlengthening should be avoided by careful preoperative and intraoperative length measurements and proper selection of prostheses. If there is marked overlengthening of the replaced hip postoperatively, it should be corrected.

Follow-Up Studies↗
PubMed1992

Cardiovascular functional disorder in primary fibromyalgia: a noninvasive study in 17 young men.

Cardiovascular functional stability was studied in 17 young men (20-year-old conscripts) with the symptoms of primary fibromyalgia (PF). They were compared to 20 medical students of the same age. The subjects underwent an orthostatic test, deep breathing test, Valsalva maneuver, and a handgrip test. They were evaluated by an autoanamnestic questionnaire on vegetative symptoms and laboratory tests on blood chemistry. The heart rate of the PF group after 8 min of active standing was 32 +/- 15 beats/min greater than at supine rest. The corresponding figure for the controls was 23 +/- 7 beats/min (p = 0.001). Twelve conscripts with PF (71%) presented sympathicotonic cardiovascular reaction on the orthostatic test (p < 0.001). Four of these sympathicotonic conscripts and two other conscripts (total 35%) had an abnormal high index of dystonic symptoms (p = 0.01). The results suggest that young men with symptoms of PF have not only cardiovascular dystonic symptoms but also increased sympathetic nervous reactivity of the cardiovascular system.

Adolescent↗
PubMed1992

Injuries associated with the use of ejection seats in Finnish pilots.

During the years 1958-91 17 Finnish pilots were forced to use ejection seats. The aircraft types were as follows: a) BA Hawk in 6 instances; b) a Mig 21-F-13 in 4; c) a Mig-21-Bis in 3; d) a Gnat Folland in 2; e) a Vampire Trainer in 1; and f) a MU-3 in 1 case. There were 3 ejections completed successfully, 12 pilots sustained slight injuries, and 5 pilots suffered major injuries--3 from compression fractures of the thoracic spine, 1 from fracture of the femur, and 1 from rupture of the medial collateral ligament of the knee. All major injuries were associated with Soviet aircraft. One BA-Hawk pilot died due to a direct impact against a tree after a low-altitude ejection. Two pilots launched the seat under negative G-forces. One of these became temporarily blind, and suffered a partial loss of vision for 3 months. Four Hawk pilots were saved during landing phase by a tandem ejection, receiving only minor injuries.

Accidents, Aviation↗
PubMed1992

Displaced stress fracture of the femoral shaft: a report of three cases.

Three cases of displaced stress fracture of the femoral shaft are reported. All patients were young conscripts. Before displacement, the patients had suffered from knee and distal femoral pains for 2-6 weeks. All fractures were located at the border of the middle and distal third of the femoral shaft and had a short oblique form. Plating was performed in two and intramedullary nailing in one case. A fast bony union into a good position was achieved in all cases. Scintigraphy is indicated for an early diagnosis, which enables conservative treatment and prevention of the fracture displacement.

Adult↗