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Biomedical subjects

T Visuri

Publications and source records attributed to T Visuri.

At least 37 records · Page 2Linked to original sources

Carbon fiber for repair of the rotator cuff. A 4-year follow-up of 14 cases.

Thirteen patients with 14 large rotator cuff tears were operated on using carbon fiber to cover the defect. The median follow-up time was 4 years. In 11, 1, and 2 cases the results were respectively excellent or good, fair, and poor. In 2 cases where the carbon fiber was anchored to the major tuberosity, a bone cyst was seen, but it did not influence the result. A carbon fiber tow application combined with Neer's anterior acromioplasty seems useful in the reconstruction of large tears of the rotator cuff.

Acromion↗

Cancer risk after Mckee-Farrar total hip replacement.

Cancer incidence in 433 McKee-Farrar total hip replacement patients, operated on between 1967 and 1973, was examined for 5729 person-years, to the end of 1981. The expected number of natural deaths was slightly higher than observed, suggesting some selection of the operated patients. The risk of total cancer incidence did not increase, but the risk for site-specific cancer did because there were no cases of kidney or bladder cancer, or rare forms of cancer. The risk of leukemias and lymphomas increased, and the risk of breast cancer decreased; these results were surprisingly similar to those of a study from New Zealand. This study concluded that patients with total hip prostheses have a cancer morbidity differing from the general population. The role of chrome-cobalt-molybdenum alloy in carcinogenesis requires further investigation.

Aged↗

Displaced stress fractures of the femoral neck in young male adults: a report of twelve operative cases.

The results of 12 operatively treated displaced stress fractures of the femoral neck in young male adults are reported. The mean age of the patients was 19.8 years (range, 19-24 years) and the mean followup period 4.0 years (range, 1-9 years). Sliding hip compression screw was used in ten cases, Jewett nail in one and 130 degrees angled A0-plate in one case. Aseptic necrosis (AN) of the femoral head developed in five cases treated by sliding hip compression screw. It was correlated with increased operative trauma in four patients: open reduction in two, reoperation in one, and osteotomy in one case. Nonunion developed in three cases and it was combined with AN in two cases. In six cases the results were acceptable, but for the last three patients the followup period was only 1-2 years.

Adult↗

Long-term results and survivorship of the McKee-Farrar total hip prosthesis.

Five hundred and eleven McKee-Farrar prostheses implanted at the Orthopedic Hospital of the Invalid Foundation (Helsinki, Finland) between 1967 and 1973 were analyzed for long-term survivorship, clinical results, and the risk factors leading to aseptic loosening of the prosthesis. Reoperation was necessary for aseptic loosening of 91 prostheses and for septic loosening of 19 prosthesis. Ten-year survivorship was 76% and the annual failure rate 2.3%. The failure rate correlated with time. Acetabular cup loosening occurred 1.2 times more often than stem loosening. The retained prostheses remained clinically stable with respect to pain and mobility, but some deterioration was observed in walking ability. In addition to the follow-up period, prosthetic design, right-sided prosthesis, and lengthening of the operated leg proved to be significant factors for aseptic loosening in multiple stepwise regression analysis. After exclusion of the unmeasured leg length inequalities, the lengthening of the operated leg proved to be the most important factor explaining aseptic loosening of the prosthesis. Surgeon's inexperience, operation time, post-traumatic coxarthrosis, and previous operations were correlated to aseptic loosening of the prosthesis.

Adult↗

Arthroscopic volume of the knee joint in young male adults.

'Arthroscopic volume' and resorption of normal saline was measured in 35 young males during routine arthroscopic examination. The average mean volume of the knee joint cavity was 103.4 ml and this volume was observed to correlate with the midpatellar circumference of the knee and the height of the patients. Mean resorption of normal saline was 4.1 ml/min, this resorption correlating with the volume of the joint cavity. No correlation with the underlying disease of the knee was observed.

Absorption↗

The influence of total hip replacement on hip pain and the use of analgesics.

The influence of total hip replacement (THR) on pain and use of analgesics was evaluated in 511 patients with McKee-Farrar and Brunswik prostheses. The mean age of the patients was 63.8 years and the mean follow-up time 4.2 years. The average grade of pain decreased from 1.8 to 4.9 as evaluated according to Charnley. The proportion of regular users of all analgesics decreased from 75% to 17% (P less than 0.001). Indomethacin was the most common preoperative drug and the proportion of its regular use decreased from 47 to 12% (P less than 0.001). The preoperative association which existed between the grade of pain and the regular drug users in each pain grade decreased more than expected by the preoperative figures. Postoperatively those with previous hip operations, McKee-Farrar prosthesis, one hip replaced, reapplications and removal of the prosthesis gave inferior results with respect to pain than those without previous surgery, with Brunswik prosthesis, both hips replaced and with the original prosthesis in situ. In addition to previous THR operations, type of the hip prosthesis, bilateral or unilateral surgery, primary or secondary coxarthrosis and reapplication of the prosthesis influenced the use of drugs. THR, however, brought a marked drop in the use of analgesics and this effect should be taken into account when assessing the costs and benefits of THR.

Adrenal Cortex Hormones↗

The role of alcohol in accidental falls.

Fifty-three percent of patients injured in accidental falls in the evening in Helsinki and 15% of time-, site- and sex-matched control pedestrians were alcohol-involved. Relative risk of injury, if 1.0 at zero BAC, was 3 at BACS 60-100 mg/100 ml, 10 at 101-150 mg/100 ml and about 60 at BACS above that.

Accident Proneness↗

The role of socio-economic status and place of residence in total hip replacement.

The influence of socio-economic status and place of residence on walking ability, performance of daily activities and the aid required in these activities were evaluated among 539 total hip replacement (THR) patients. The walking ability of patients of higher socioeconomic status and of urban origin was better than that of patients of lower socio-economic status and of rural origin, both before and after THR. There were no significant interclass differences in the improvement in walking ability. The same pattern was valid as regards preoperative and postoperative performance of daily activities and the need for assistance. Neither socio-economic status nor place of residence had any significant influence on the improvement in the performance of daily activities or on the decrease in use of an aid. Earlier total hip replacement is recommended for patients of lower socio-economic status and for those living in rural areas.

Activities of Daily Living↗

Total hip replacement: its influence on spontaneous recreation exercise habits.

The effect of total hip replacement (McKee-Farrar or Brunswik prosthesis) on recreational exercise habits was evaluated with a retrospective interview of 539 patients operated on at the orthopaedic Hospital of the Invalid Foundation, Helsinki, Finland. The mean age of the patients was 63.8 years and the mean follow-up time 4.2 years. The proportion of those who engaged in regular walking increased from 2 to 55%, in cycling from 7 to 29%, in swimming from 13 to 30% and in skiing from 0 to 9%. Prolonged use of the prosthesis (up to 9 years) had no significant deteriorating effect on the intensity of the recreation exercises. The number of those who were able to cycle or swim preoperatively was greater than that of those who were able to walk at that time. Cycling and swimming are especially valuable forms of physical exercise after total hip replacement because the load placed by the body weight on the hip joint is reduced.

Adult↗

Pulsating shortwave diathermy: value in treatment of recent ankle and foot sprains.

The effects of 2 pulsating shortwave diathermy treatments (Diapulse and Curapuls) were compared with placebo treatment in recent ligamentous injuries of ankle and foot in 300 outpatients. The areas of comparison were reduction in swelling, recovery of strength and range of motion of the injured ankle, improvement of walking ability, and duration of disability. There were only slight differences between Diapulse and Curapuls treatment groups. No statistically significant differences could be observed in the recovery of strength and range of motion or in the duration of disability among the 3 groups, although walking ability in the Diapulse group recovered better than in the placebos (p less than 0.01) and reduction of swelling was significantly better for Curapuls (p less than 0.001 than for placebos.

Adult↗

The influence of total hip replacement on selected activities of daily living and on the use of domestic aid.

The effect of total hip replacement (McKee-Farrar and Brunswik prostheses) on selected activities of daily living and on the use of domestic aid in these activities was evaluated by interviewing 539 patients operated on. The mean age of the patients was 64.7 years and the mean follow-up time 4.2 years. After eliminating other diseases affecting mobility, a "proper" series of 294 patients was obtained. There was marked improvement in all activities. Walking ability was limited in 95% before and in 12% after the operation. The proportion of those unable to clean their homes decreased from 67% to 16%, to shop from 46% to 10%, to tie their shoes from 75% to 29%, to pull on stockings from 43% to 3% and to dress in other ways from 30% to 1%. The proportion of patients who were able to take care of themselves increased from 21% to 62%. The reliability of the interview was tested by comparing some objective observations with the information given by the patients. Thus a correlation was observed between the ability to walk and shop on the one hand, and pull on stockings and the flexion range of the hip, on the other.

Activities of Daily Living↗

Total hip replacement by the Brunswik prosthesis. A preliminary report of 189 operations.

The results of 189 Brunswik total hip replacements, performed at the Orthopaedic Hospital of the Invalid Foundation, Helsinki, Finland, and followed up for 2-3 years, are presented. According to the modified system of Merle D'Aubigne & Postel excellent results were achieved in 11.1 per cent (21/189), good in 56.6 per cent (107/189) and fair in 27.5 per cent (52/189). The failure rate was 4.8 per cent (9/189) and consisted of four deep infections, four cases of aseptic loosening and one case of allergic loosening. Local complications occurred after primary operations in 7.5 per cent (12/159) and after revision operations in 26.7 per cent (8/30) and the difference was statistically significant (P less than 0.01). Among the complications, deep infections were encountered in 2.6 per cent (5/189), aseptic loosenings in 2.1 per cent (4/189). Other local complications were: ectopic ossification in 1.6 per cent (3/189), nerve injuries in 1.6 per cent (3/189), dislocations in 1.1 per cent (2/189), and peroperative fractures in 1.1 per cent (2/189). General complications were observed in 8.9 per cent (17/189). Thromboembolic complications were only seen in 2.6 per cent (5/189). A possible explanation for this low figure was the early ambulation of the patients on the first postoperative day. No deaths related to the operation occurred.

Adult↗

A comparison of dicloxacillin and ampicillin in the antibiotic prophylaxis of total hip replacement.

The effect of two semi-synthetic penicillins, dicloxacillin and ampicillin was compared in systemic antibiotic prophylaxis in total hip replacement patients. The drugs were given in routine oral dosage for eight days to two patient groups each consisting of 50 patients. There was no fatality. In the ampicillin group there were three staphylococcal infections but no infections in the dicloxacillin group. Two of the infections occurred in reapplication cases leading to the loosening of the prosthesis. One infection appeared after a primary operation with a superficial recurrence 10 months later. In the ampicillin group, side effects were diagnosed in 12 cases and in the dicloxacillin group in one case.

Administration, Oral↗

A comparison of dicloxacillin and ampicillin in the antibiotic prophylaxis of total hip replacement.

The effect of two semi-synthetic penicillins, dicloxacillin and ampicillin was compared in systemic antibiotic prophylaxis in total hip replacement patients. The drugs were given in routine oral dosage for eight days to two patient groups each consisting of 50 patients. There was no fatality. In the ampicillin group there were three staphylococcal infections but no infections in the dicloxacillin group. Two of the infections occurred in reapplication cases leading to the loosening of the prosthesis. One infection appeared after a primary operation with a superficial recurrence 10 months later. In the ampicillin group, side effects were diagnosed in 12 cases and in the dicloxacillin group in one case.

Adult↗

A case-control study on alcohol as a risk factor in pedestrian accident. A preliminary report.

Alcohol as a risk factor in pedestrian accidents was studied so that the BACs were measured by gas chromatography in 341 accident patients and by ASD-breathalyzers in 682 sex-, site-, and time-matched pedestrians not involved in accidents. Alcohol was found in the blood in 53% of the accident cases and in 15% of the controls. The RR, if 1.0 at zero BAC, was 0.59 at BAC 0.3-0.5, 2.2 at 0.6-1.0, 6.8 at 1.1-1.5, 13 at 1.6-2.0, and 29 at BACs of over 2.0 g/l.

Accidents, Traffic↗

Blood alcohol levels in a series of injured patients with special reference to accident and type of injury.

Blood alcohol was determined in 1012 injury victims. It was found that the alcohol involvement (AI) rate was 37% in the total number of patients, 19% in industrial, 38% in traffic, 36% in home, 45% in other freetime accidents, and 69% in the victims of fights, assaults, and suicide attempts. The most common external cause of injury was falling (447 cases) with an AI rate of 38%, while the 172 other nontraffic true accident cases had a rate of 24%. The road and stairs were the usual places of falls while intoxicated. Head injuries had a high (47%) and upper extremity injuries a low (25%) AI rate. Tibial and ankle fractures were also very often associated with alcohol intake. Contrarily to traffic and industrial accidents the slightly injured at home and in other freetime environments had been drinking more frequently than the severely injured. The data suggest that alcohol is a powerful contributing factor in leisure-time injuries. Head and low leg are especially vulnerable in drunken persons. Not only driving but even when walking while intoxicated means taking risks.

Accidents↗