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T Wredmark

Publications and source records attributed to T Wredmark.

At least 55 records · Page 3Linked to original sources
PubMed1990

Traumatic synovitis analysed by arthroscopy and immunohistopathology.

The synovitis induced in previously healthy subjects by knee joint trauma was investigated at arthroscopic surgery performed after 3-70 days. Synovitis was confined to the areas of the synovial membrane bordering the cartilage lesion and displayed a varied intensity of inflammation. Biopsies were sampled under direct vision from the area of the peak inflammatory intensity within each joint and analysed by immunohistopathology. Only sparse lymphocytic infiltration and a slight increase of lining cell layers were found in the biopsies after as long as 70 days. The restricted extent and limited intensity of the inflammatory changes contrast with previous findings in rheumatoid arthritis. However, the arthroscopic and immunohistopathological signs of synovitis were no different.

Adult↗
PubMed1989

Spinal sagittal configuration and mobility related to low-back pain in the female gymnast.

The purpose of this study was to correlate low-back complaints in 64 female gymnasts (mean age, 12 years) to spinal sagittal configuration and mobility as measured by two noninvasive methods. Measurements by Debrunner's kyphometer and Myrin's inclinometer were highly correlated. Average thoracic kyphosis was 32 degrees, lumbar lordosis 35 degrees. The mean range of sagittal motion was 57 degrees in the thoracic spine and 113 degrees in the lumbar spine. On average, 1 degree of the total sagittal lumbar mobility was lost for every 1 degree of increased lordosis. Low-back pain (LBP) was reported by 20% of the girls, and these girls had a significantly larger lordosis (41 degrees) than girls with no history of LBP (35 degrees).

Back Pain↗
PubMed1987

The influence of indomethacin on biomechanical and biochemical properties of the plantaris longus tendon in the rabbit.

It has previously been reported that indomethacin inhibits fracture healing and heterotopic bone formation. Stimulated by these reports, we undertook the present investigation to study the influence of indomethacin on biomechanical and biochemical properties of the plantaris longus tendon in the rabbit. Sixty-eight New Zealand White rabbits were used for the experiment. Half of them were treated with indomethacin, 10 mg/kg orally a day, and the other half with placebo. After 4, 8, and 16 weeks of treatment biomechanical and biochemical variables were determined and compared between the two groups. After 16 weeks there was a significant increase in tensile strength in the group treated with indomethacin. There was no certain concomitant change in the total collagen content, the amounts of soluble and insoluble collagen, or the water content. Further investigations concerning the influence of indomethacin on tendon healing are indicated.

Animals↗
PubMed1986

Biomechanical and biochemical studies of tendon healing after conservative and surgical treatment.

Based on clinical studies, it has been proposed that conservative treatment of Achilles tendon ruptures is feasible. However, no biomechanical or biochemical confirmation of this proposal has been presented. In the present investigation the biomechanical and biochemical properties of tendons treated surgically and conservatively after transverse tenotomy were studied. Sixty-eight New Zealand White rabbits were used. A transverse tenotomy of the plantaris longus tendon of the left hind leg was performed. In half of the animals the tenotomy was repaired with a criss-cross silk suture and the limb was immobilized; the other half were treated with immobilization alone. The immobilization was maintained for 4 weeks with a long-leg plastic splint in both groups. After 4, 8, and 16 weeks the tendons were examined regarding biomechanical and biochemical parameters. There were no detectable differences in biomechanical parameters or in tendon elongation between the groups, nor was there any difference in the total hydroxyproline content, the amount of mature and of immature collagen, or the water content. The present findings are compatible with previous favorable reports on conservative treatment of Achilles tendon ruptures and thus suggest interesting clinical possibilities.

Achilles Tendon↗
PubMed1986

The influence of indomethacin on tendon healing. A biomechanical and biochemical study.

The influence of indomethacin on the biomechanical and biochemical properties of tendons during their healing was investigated. In 68 New Zealand White rabbits a transverse tenotomy followed by repair with a criss-cross suture was performed in the plantaris longus tendon of the left hind limb. The leg was immobilized for 4 weeks postoperatively in a long-leg plastic splint. Half of the animals were treated with indomethacin, 10 mg/kg/day orally, and the other half with placebo. After 4, 8, and 16 weeks of treatment the animals were killed and biomechanical and biochemical parameters were measured. After 16 weeks there was a significant increase in tensile strength in the indomethacin group. There were only small biochemical differences between the groups. However, there was a slight but significant decrease in the amount of soluble collagen in the indomethacin group. This may indicate a higher degree of cross-linkage following indomethacin treatment, which might explain the increased tensile strength.

Animals↗
PubMed1986

The influence of indomethacin on collagen synthesis during tendon healing in the rabbit.

The influence of indomethacin on collagen synthesis in intact and healing plantaris longus tendons in the rabbit was investigated. Forty-four male New Zealand White rabbits were subjected to a standardized trauma (tenetomy + repair) on the left hindlimb. Half of the animals were subsequently treated with indomethacin, 10 mg/kg per day orally, and the other half with placebo. After 2 and 4 weeks the rabbits were injected intravenously with 3H-proline and killed 18 h later. Indomethacin affected the collagen metabolism differently depending on whether the tendons were involved in wound healing or not. In intact tendons the drug caused a small general inhibition of collagen synthesis. In the healing tendon there was a shift towards the synthesis of more insoluble collagen with little effect on the total synthesis. After 4 weeks there was also a slight but significant decrease in the amount of hydroxyproline in the most soluble collagen fraction from the tenotomized, indomethacin treated tendons.

Animals↗
PubMed1986

Arthroscopy of the temporomandibular joint. A clinical study.

Temporomandibular joint (TMJ) arthroscopy on 30 joints of 26 patients with different signs and symptoms of TMJ arthropathy was evaluated. Local anaesthesia was used and proved efficient. In 27 cases, the superior, and in 3 cases both, compartments were punctured. Successful examination was performed in 26 superior and 3 attempted inferior compartments. Functional impairment following arthroscopy was minor and rarely lasted more than one week. No postoperative bleeding, nerve damage, or infection was observed. Of the 2 systems tested, the rod-lens arthroscope showed superior optical quality.

Anesthesia, Local↗
PubMed1986

Calf muscle atrophy and muscle function after non-operative vs operative treatment of achilles tendon ruptures.

Fifteen operatively and eight non-operatively treated subcutaneous achilles tendon ruptures were randomly selected from 120 surgically and 35 non-surgically treated patients. Their calf muscle function was studied three to five years after treatment. Non-operatively treated patients were found to have a significantly impaired dynamic muscle function of the calf muscles when tested in a specially constructed heel-raise test device. Operatively treated patients did not show any significant impairment of their muscle function. Measurement of muscle area with CT-scanning showed a significant reduction of the calf muscle in the non-operatively treated patient while no such difference could be found in the operatively treated patients. Isokinetic muscle torque did not differ in the two groups of patients, thus Cybex-measurements do not seem to be a discriminating method in studying muscle function after achilles ruptures. On the basis of our findings we recommend that all athletes with achilles tendon ruptures be treated surgically. In non-athletes and older patients non-operative treatment might be considered.

Achilles Tendon↗
PubMed1984

Elongation of the plantaris longus tendon after surgical repair in the rabbit.

The purpose of this study was to investigate the elongation of the plantaris longus tendon in the rabbit after surgical repair. In 24 New Zealand white rabbits tenotomy of the plantaris longus tendon in the left hindlimb was performed. Surgical repair was undertaken with a criss-cross suture. The leg was immobilized in a long leg splint of Hexilite. The elongation of the tendon was measured by a photographic technique after preparation of the tendon. The elongation gradually increased during the observation time (r 0.03). No biphasic separation was found as indicated by other authors. For the clinical application of these findings further investigations are needed.

Animals↗
PubMed1984

Arthroscopy of the temporomandibular joint. Examination of 2 patients with suspected disk derangement.

2 patients with a history of reciprocal temporomandibular joint (TMJ) clicking were visually examined with arthroscopy of their right side TMJs. Clinical and radiographic examination revealed no signs of arthrosis deformans. One patient with significantly reduced opening ability combined with occasional disappearance of TMJ clicks showed advanced arthrotic changes of cartilage which were not visible radiographically. The other patient with unimpaired function also had a severe arthrotic lesion in the clicking joint. In neither case did the disk appear to be displaced. It is concluded that arthroscopy yields additional information for TMJ diagnosis which cannot be achieved by clinical and radiographic examination alone.

Adult↗
PubMed1984

Krogius tenoplasty for recurrent dislocation of the patella. Failure associated with joint laxity.

Thirty-three patients treated with a Krogius tenoplasty for recurrent dislocation of the patella have been followed for an average of 3 years; the knees were classified according to Rünow. In 14 of 34 operated knees dislocations had recurred. Most of the recurrences were found in patients with generalized joint laxity, whereas only one of nine knees with only a high Insall index had redislocated. Patients with generalized joint laxity should not be treated with the Krogius tenoplasty as the sole procedure.

Adolescent↗
PubMed1983

Bristow-Latarjet procedure for recurrent anterior dislocation of the shoulder. A 2-5 year follow-up study on the results of 112 cases.

A follow-up study of 111 out of 112 patients operated on for shoulder joint dislocation according to the Bristow-Latarjet procedure during the years 1975 through 1979 in four Swedish hospitals is presented. The average follow-up time was 30 months (range 24-60 months). There were seven cases of significant recurrences (6 per cent). During follow-up, further surgery had been performed on four of these. Another eight patients (7 per cent) had experienced occasional insignificant subluxations. In one case neurolysis of the musculocutaneous nerve was undertaken because of postoperative paresis of elbow flexors. The average limitation of outward rotation as compared with the nonoperated side was 19 degrees in adduction and 21 degrees in abduction. There was a measurable difference in strength between the operated and nonoperated shoulders. The results were considered excellent or good by 101 of the patients (90 per cent), fair by eight and bad by three. Of 12 cases with failed surgery before the Bristow-Latarjet procedure 10 regarded the result as good or excellent.

Adolescent↗
PubMed1983

The coracoid transfer for recurrent dislocation of the shoulder. Technical aspects of the Bristow-Latarjet procedure.

One hundred and twelve shoulders with recurrent anterior dislocation were treated with the Bristow-Latarjet procedure and had a two to five-year follow-up after surgery. The incidence of redislocation was 6 per cent, and an additional 7 per cent of the patients reported occasional subluxation. In 106 shoulders, a radiographic study was carried out in order to determine the importance of factors such as healing and position of the transferred coracoid process with regard to the postoperative clinical results. No redislocation or subluxation occurred in the forty patients in whom the transplant showed osseous or fibrous union at the scapula and was located inferior to the equator of the glenoid and less than one centimeter medial to its rim. In shoulders in which either the transplant had migrated more than 1.5 centimeters from that position or was placed one centimeter or more medial to the glenoid rim, the incidence of redislocation or subluxation was significantly increased.

Adolescent↗
PubMed1982

Arthroscopy under local anaesthesia using controlled pressure-irrigation with prilocaine.

One hundred and seventy-four consecutive patients with symptoms of derangement of the knee were examined with an arthroscope under local anaesthesia using a continuous pressure-irrigation system. A 0.2 per cent prilocaine-saline solution was used as irrigation fluid. In the first 19 patients the serum level of prilocaine was monitored for six hours after the start of irrigation. Eighteen of the 174 patients had a transcutaneous partial meniscectomy at the same time as the examination. All the patients tolerated the examination well. The distension of the knee produced by the pressure-irrigation system provided a high degree of diagnostic accuracy. The serum levels of prilocaine were low throughout the monitoring period reaching a mean peak value of 0.28 micrograms per millilitre after one hour. There were no adverse side-effects. This technique provides a safe and efficient method to meet the increasing demands of arthroscopic procedures of the knee.

Adolescent↗
PubMed1979

The treatment of total ruptures of the Achilles tendon by plaster immobilisation.

Twenty patients with total rupture of the achilles tendon were treated by immobilisation in plaster in the gravitation-equinus position for eight weeks. All were healthy persons with a mean age of forty-three years. After removal of the plaster, seven patients had a re-rupture, four of whom were treated by operation, whilst two others sustained a deep vein thrombosis with an associated pulmonary embolus in one case. At follow-up, between 6 and 29 months after the rupture, 16 patients had no complaints and the remaining four had only minor problems. The range of motion in the ankle joint was normal in all patients and the strength in the affected calf was restored to normal in the majority. However, the strength recovered less in those patients with re-rupture who were treated conservatively for the second time. Because of the high complication rate we consider plaster treatment inferior to surgical treatment of Achilles tendon rupture.

Achilles Tendon↗
PubMedDate not supplied

Intramuscular pressure and fluid absorption during arthroscopic acromioplasty.

During arthroscopic acromioplasty a high level of irrigation fluid pressure is sometimes required to obtain an adequate visual field. To evaluate the influence of bursa pressure level on the blood circulation of the shoulder muscles, we measured the intramuscular pressure (IMP) in the supraspinatus and deltoid muscles with the microcapillary infusion technique during surgery. Eleven patients with impingement syndromes Neer I-III and rotator cuff tendinitis were examined at subacromial bursa pressures of 100 or 150 mm Hg. In another 11 patients the amount of irrigation fluid absorbed into the circulatory system was evaluated with the use of 2% ethanol NaCl irrigation fluid. At bursal pressures of 100 or 150 mm Hg, the absorbed volume was calculated from the expiratory breath ethanol concentration at the termination of surgery. The IMP in both the supraspinatus and the deltoid muscle varied considerably regardless of bursal pressure. In 50% of the recordings a considerable increase was seen in IMP pressure (> 15 mm Hg) when the arthroscope was redirected from the intra-articular position to the subacromial bursa. The mean IMP in both muscles was less than 60 mm Hg during the major portion of the bursoscopy regardless of the infusion pressure level. The fluid absorption was 100 mL (0 to 229 mL) in the 100 mm Hg group and 37 mL (0 to 180 mL) in the 150 mm Hg group. All values were well below the 1000 mL absorption limit regarding the risk of development of a hyperhydration syndrome. In arthroscopic acromioplasty a bursal pressure of 100 or 150 mm Hg will result in similar IMP levels, in most cases below the threshold for muscle blood circulation. The amount of fluid absorbed to the circulatory system will be harmless.

Absorption↗
PubMedDate not supplied

Comparison of an arthroscopic and an open procedure for posttraumatic instability of the shoulder: a prospective, randomized multicenter study.

From 1993 through 1996, a multicenter study was conducted on the surgical treatment of patients with posttraumatic recurrent anterior shoulder dislocations. Fifty-six patients (40 men, 16 women; mean age 26 years [range 18-51 years]), were evaluated with shoulder arthroscopy. If a Bankart lesion was present, the patients were randomly allocated to either an arthroscopic reconstruction with the use of biodegradable tacks or an open reconstruction with suture anchors. The postoperative rehabilitation protocol for the two groups was identical. In all patients, the range of shoulder motion, stability, and the Constant and Rowe scores were evaluated at 3, 12, and 24 months postoperatively. Thirty patients were surgically treated with the arthroscopic technique and 26 patients with the open technique. In the arthroscopic group, there were recurrences in 7 (23%) of 30 patients at a mean of 13 months (range 5 to 21 months) after surgery. All patients with stable shoulders had a negative apprehension test result. In the open group, there were recurrences in 3 (12%) of 26 patients at a mean of 10 months (range 2 to 23 months) after surgery (P = not significant). In the arthroscopic group, 2 patients had new traumatic redislocations, whereas 1 patient redislocated during an epileptic seizure. In the open group, 1 traumatic redislocation occurred. The 2-year results in this study demonstrate a large number of redislocations after reconstruction, even in the open surgery group. Patient noncompliance with the rehabilitation protocol and predisposing disease may partially explain these results. A tendency was seen toward more redislocations in the arthroscopic group, which emphasizes the importance of correct patient selection and careful surgical technique in the difficult surgical procedure.

Adolescent↗