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Biomedical subjects

U Jørgensen

Publications and source records attributed to U Jørgensen.

At least 19 recordsLinked to original sources
PubMed2002

Arthroscopy of the proximal interphalangeal joints of the finger.

Cadaveric studies were carried out to evaluate the technique, portals and possible indications for arthroscopy of the proximal interphalangeal joints of the finger. We suggest horizontal placement of the hand instead of using a traction tower, as it is important to be able to flex the joint freely. The recommended arthroscopic portals are either between the central slip and the lateral bands of the extensor mechanism or between the lateral band and the collateral ligament. A blunt technique of introduction is used to avoid iatrogenic cartilage damage and possible digital nerve injury.

Adult↗
PubMed2001

Reconstruction of the anterior cruciate ligament with the iliotibial band autograft in patients with chronic knee instability.

We performed combined internal and external anterior cruciate ligament (ACL) reconstruction with the iliotibial band autograft in 169 consecutive patients with chronic ACL insufficiency who were followed up for 24-61 months. Of these, 155 (91%) agreed to an additional independent observer follow-up after 24-92 months. Eight patients (5%) had sustained a rerupture/elongation of the graft and were operated on again; nine (6%) had sustained a tear of the contralateral ACL. Knee function and activity increased after the reconstruction. Lysholm scores improved from median 81 preoperatively to 99 at follow-up and Tegner scores from median 4 to 7. At follow-up 97 (71%) were active at the same level as prior to injury. In 17 of the 40 patients (12%) dropping to a lower activity level this was due to knee problems. The side-to-side difference in anterior-posterior knee laxity was more than 3 mm in 18 knees (13%) and more than 5 mm in 3 knees (2%). Including eight reruptures, this results in a "stability" failure rate of 8.8%. The overall IKCD rating showed normal knee function in 88 (73%) and nearly normal knee function in 30 (25%). Anterior knee pain was present in 14 (10%) of the patients at follow-up. Patients with isolated ACL injury had higher Lysholm scores and Tegner scores than patients with associated injuries. No clinical signs of varus knee development were seen. Of the 155 patients 94% would have the procedure repeated if necessary with the knowledge that they have today. The combined internal and external iliotibial band procedure can restore knee stability and function in the majority of chronic ACL-insufficient knees.

Activities of Daily Living↗
PubMed2001

Reconstruction of anterior cruciate ligament deficient knees in soccer players with an iliotibial band autograft. A prospective study of 132 reconstructed knees followed for 4 (2-7) years.

One hundred and thirty-two consecutive soccer players (117 males and 15 females, median age 23, range 16-39 years) underwent primary reconstruction of the anterior cruciate ligament (ACL) with an iliotibial band (ITB) autograft. All patients were followed prospectively for a minimum of 2 years. One hundred and eighteen patients (89%) attended an independent observer follow-up after a median of 47 (24-92) months. The time before participating in soccer was a median of 7 (5-24) months. At a median of 4 years, 80 (68%) were still active soccer players, while 38 had changed activity to a lower level. Twenty-five gave up soccer playing for reasons unrelated to the knee, and 13 (11%) gave up due to problems from the reconstructed knee. The Lysholm score improved from a median of 82 (range 42-99, mean [SD] 80.5 [+/-11.9]) points prior to the operation to a median of 99 (range 57-100, mean [SD] 94.6 [+/-8.5]) at follow-up. The Tegner score improved from a median of 3.5 (0-7) preoperatively to 9 (1-10). Four patients (3%) sustained a rupture of the graft: three ruptures occurred among the 15 females (20%), and one was seen among the 117 males (0.8%) (P=0.01). Eight per cent had predominantly minor cosmetic complaints from the donor-site hernia, while 51% had temporary discomfort from the staples used for graft fixation. Using the ITB autograft for ACL reconstruction, we found excellent and good results in soccer players with ACL deficiency and high demands for optimal knee function. The failure rate in general was comparable with other methods, and the majority was still active in soccer sports at a median of 4 years after surgery. An unacceptably high rerupture rate was registered in female players.

Adolescent↗
PubMed2000

Behavior of the graft within the bone tunnels following anterior cruciate ligament reconstruction, studied by cinematic magnetic resonance imaging.

The behavior of a ligament graft following cruciate ligament reconstruction is still an area of limited knowledge. Cinematic magnetic resonance imaging (MRI) offers the possibility of visualizing the graft, including the graft tunnels and fixation during knee motion. Twenty-three patients underwent cinematic MRI (0. 2 T; Artoscan) mean 23.4 months (range 14-39 months) after autologous anterior cruciate ligament reconstruction (eight bone-tendon-bone, seven semitendinosus-gracilis, and eight iliotibial band). The images were read without knowledge of the clinical condition or the type of surgery performed. Signal intensity and continuity of the anterior cruciate ligament reconstruction and movement of the graft in the tibial or femoral tunnel anteriorly and posteriorly were noted. In two of the 23 patients the graft (semitendinosus-gracilis) moved in the tibial canal. The initial 9-mm tunnel had expanded by 2 mm in the anteroposterior direction at the entrance to the joint space. Only these two had a slight knee laxity, with a side-to-side difference in anterior translation measured by the KT-2000 of 4 and 5 mm. No movement was observed in any of the femoral tunnels. Cinematic MRI thus makes it possible to study graft behavior within the bone tunnels.

Anterior Cruciate Ligament↗
PubMed2000

Olfactory and quantitative analysis of aroma compounds in elder flower (Sambucus nigra L.) drink processed from five cultivars.

Fresh elder flowers (Sambucus nigra L.) were extracted with an aqueous solution containing sucrose, peeled lemon slices, tartaric acid, and sodium benzoate to make elder flower syrup. Aroma compounds emitted from the elder flower syrup were collected by the dynamic headspace technique and analyzed by GC-FID and GC-MS. A total of 59 compounds were identified, 18 of which have not previously been detected in elder flower products. The concentrations of the identified volatiles were measured in five elder cultivars, Allesoe, Donau, Sambu, Sampo, and Samyl, and significant differences were detected among cultivars in the concentration levels of 48 compounds. The odor of the volatiles was evaluated by the GC-sniffing technique. cis-Rose oxide, nerol oxide, hotrienol, and nonanal contributed to the characteristic elder flower odor, whereas linalool, alpha-terpineol, 4-methyl-3-penten-2-one, and (Z)-beta-ocimene contributed with floral notes. Fruity odors were associated with pentanal, heptanal, and beta-damascenone. Fresh and grassy odors were primarily correlated with hexanal, hexanol, and (Z)-3-hexenol.

Beverages↗
PubMed2000

Secondary impingement in the shoulder. An improved terminology in impingement.

Non-traumatic shoulder pain in the overhead athlete is a diagnostic challenge. In the last decade shoulder arthroscopy and magnetic resonance imaging (MRI) techniques have extended our knowledge. Previously unknown pathologic changes in the glenohumeral joint have been demonstrated and it is recognized that impingement symptoms and instability are often related. Shoulder dysfunction in overhead athletes may be caused by shoulder instability. However, a possible instability in the shoulder is often "silent" and difficult to demonstrate by ordinary tests and has therefore by some been termed "functional instability". It is now thought that functional instability in the shoulder may lead to a vicious cycle involving microtraumata and attenuation of the capsular complex, and may eventually lead to shoulder pain. Changes in shoulder proprioception, measured by testing kinaesthetic sense and position sense, can be related to different pathologic changes in the shoulder, and sensory motor control may be an important factor for functional stability in the shoulder. MRI and arthroscopical findings in athletes with shoulder pain are changes in the glenoid labrum, the humeral head, the rotator cuff, biceps tendon and the capsular complex. However, these findings often present other clinical entities than impingement and are not always associated with instability. Clinically, there are tests that can objectively distinguish some of the pathological findings. However, we need more exact methods to further improve our clinical diagnoses of the painful shoulder. One of the keys could be an extended knowledge about the pathophysiology behind functional instability. This review focuses on an improved terminology in impingement based on the current knowledge of impingement and instability in the shoulder.

Adult↗
PubMed1999

Results of reconstruction of acute ruptures of the anterior cruciate ligament with an iliotibial band autograft.

Forty patients with an acute complete tear of the anterior cruciate ligament (ACL) underwent primary reconstruction with an iliotibial band autograft after median 15 (range 0-90) days. Objective and functional evaluation was performed after median 37 (range 24-87) months by two independent observers using the International Knee Documentation Committee (IKDC) knee evaluation form, the Lysholm knee function score, and the Tegner activity score. During the observation period 5 patients sustained an ACL tear in the contralateral knee, and 1 patient (2.5%) sustained a graft rupture and underwent re-reconstruction. For the remaining 34 knees the Lysholm score at follow-up was median 100 (range 84-100, mean 97 [+/- 4]), all patients scoring excellent (n = 28) or good (n = 6). Three patients (9%) had more than 3 mm side-to-side difference in anteroposterior laxity. All 4 ligament failures occurred in patients operated on within the first 2 weeks after the injury. Twenty-six patients (76%) returned to the same level of activity as prior to the injury. Of 8 who dropped to a lower activity level, only one ascribed this to problems with the operated knee, meaning that 26 of 27 (96%) returned to their desired level of activity. According to the overall IKDC evaluation, 14 patients (40%) had a normal knee (A), 13 (37%) had a nearly normal knee (B), 5 (14%) had an abnormal knee (C), and 2 (9%) had a severely abnormal knee (D). Ten patients (25%) had the staples removed due to local irritation, and further 6 (15%) had local symptoms from the tibial staples. The harvest site gave 8 (20%) patients cosmetic complaints, but all graded this as slight, and 3 (8%) had slight pain during activity from the lateral muscular hernia. In selected individuals performing vigorous knee activities, autologous reconstruction of acute ACL disrupted knees with a combined internal and external iliotibial band transfer demonstrates excellent results after median 3 years. The failure rate is comparable to other techniques.

Acute Disease↗
PubMed1999

Recurrent post-traumatic anterior shoulder dislocation--open versus arthroscopic repair.

A total of 41 consecutive patients (11 women and 30 men, median age 29 (18-51) years) with unilateral, isolated, posttraumatic, recurrent anterior shoulder dislocation and a Bankart lesion were operatively repaired, either by an arthroscopic technique including a capsular plication, or by an open procedure with Mitec anchors. All the patients were followed prospectively and evaluated after a median of 36 (30-52) months follow-up by a "blind" observer. Nineteen patients in each group had excellent or good results, and one in each group was graded as fair. One patient in the arthroscopic group had a traumatic dislocation 5 months after the operation and was graded as poor. Three patients experienced subluxations postoperatively, one in the arthroscopic and two in the open group. There was no significant difference in anterior-posterior shoulder laxity measured objectively with Donjoy. The open Bankart repair group had a statistically significantly longer hospitalization (P = 0.001), a slight decrease in external range of motion, and more frequent cosmetic complaints. Apart from this, the results revealed no major differences between the two methods after a median of 36 months in this selected group of patients with longstanding problems.

Adolescent↗
PubMed1999

Isolated total ruptures of the anterior cruciate ligament--a clinical study with long-term follow-up of 7 years.

Seventy patients met our inclusion criteria in this retrospective study, all with an arthroscopic/arthrotomic-verified isolated total anterior cruciate ligament (ACL)-rupture and a minimum follow-up period of 3 years and no associated lesions. Due to emigration/death, 3 patients were not available for follow-up. Of the remaining 67, 25 patients underwent secondary ACL-reconstruction, equivalent to a failure rate of the initial non-operative treatment of 37%. All patients were initially treated conservatively. This left 42 patients for follow-up--9 answered a questionnare and 33 went through follow-up examination after a median of 7.1 years (range 3.3 14.6) including IKDC-evaluation form, Lysholm & Tegner score, ES-SKA-score, clinical examination and Stryker Laxity test. In the present study all values represent the 33 patients available for follow-up. Soccer, handball and alpine skiing were most frequently responsible for the injury. We observed in the 33 patients a decline in median Lysholm score from 100 (90-100) pretraumatic to 86 (42-100) at follow-up, and a decrease in median Tegner values from 7 (3-9) pretraumatic to 5 (2-7) at follow-up. All but 2 patients demonstrated a decline in Lysholm score, and only 3 patients returned to their preinjury level. According to the ESSKA-classification, the number of "cutting-sports performers" declined dramatically from 24 to 2. All but one patient ascribed their decline in activity to their knee status. The Stryker-measured AP-translocations were significantly higher on the injured knee (7.27) compared to the healthy knee (4.80) (P < 0.05). Intermittant rest pain was suffered by 63% of the patients. During the time from inclusion until follow-up, 13 (39%) patients sustained an additional ipsilateral knee lesion, most commonly a tear of the medial meniscus. The overall outcome was expressed in a low frequency of return to unrestricted preinjury level of function, and a high level of instability complaints resulting in many secondary ACL-reconstructions. Naturally some have adapted to their ultimate functional disability, but only through modification of activities, and the overall outcome after conservative therapy of these ACL-ruptures was not satisfactory.

Adolescent↗
PubMed1998

The immediate postoperative kinematic state after anterior cruciate ligament reconstruction with increasing peroperative tension.

The last steps in anterior cruciate ligament (ACL) reconstruction are tensioning and fixation of the ligament. However, how much tension should be applied to the ligament in general or in each individual and in which position the ligament should be fixed remain unanswered questions. The purpose of this study was to investigate the effect of increasing ligament tension on the immediate postoperative kinematic state of the ACL-reconstructed knee. Nine cadaver knees were mounted in a mechanical measuring device based on a redesign of the Genucom knee testing system, so that the femur was fixed to a force plate and the moving tibia to a goniometer arm for registration of movement. The ligament was attached on the tibial side to a Kistler load cell and a turn-buckle for adjustment of ligament tension. The ligament was tensioned at 30 degrees of flexion with 5, 33, 66, 99 and 132 N. The cadaver knees were tested with an intact ACL, after sacrifice of the ACL and after reconstruction of the ACL with an ABC ligament. Results showed that there was a significant decrease in knee motion when the tension was higher than 33 N. This resulted in an overconstrained knee with less anteroposterior translation, internal-external rotation and varus-valgus movement compared with the uninjured knee.

Anterior Cruciate Ligament↗
PubMed1998

The value of ultrasonography in the diagnosis of labral lesions in patients with anterior shoulder dislocation.

OBJECTIVE: To evaluate the ability of ultrasonography to detect labral lesions in patients with anterior shoulder dislocation. METHODS: We examined 29 patients with anterior shoulder dislocation with ultrasonography prior to arthroscopy. RESULTS: Twenty-six patients had labral lesions diagnosed by arthroscopy. These lesions were detected by ultrasonography with a sensitivity of 88% and a specificity of 67%. All lesions affected the anterior labrum, while six extended to the posterior labrum. The latter were not visualized by ultrasonography. CONCLUSION: Ultrasonography is valuable in the detection of anterior labral lesions even in patients with recent shoulder dislocation.

Adolescent↗
PubMed1998

Post-mortem ultrasonographic assessment of the anterior glenoid labrum.

OBJECTIVE: The purpose of this study was to investigate the identification of the anterior glenoid labrum with ultrasonography. METHODS: Twelve cadaveric shoulders from subjects 74 to 85 years of age were examined by ultrasonography. Under ultrasonographic guidance, a small amount of dye was injected on the structure believed to be the anterior glenoid labrum, whereafter the shoulders were dissected. RESULTS: In 11 shoulders the dye was found in close relation to the glenoid labrum. Comparing the labrum to a watch face numbered clockwise in the left shoulder, and counter clockwise in the right, the part seen was located between 1 and 5 o'clock. Signs of degeneration were found in six labra by ultrasonography and verified by blindfolded dissection. CONCLUSIONS: Ultrasonography can identify the anterior glenoid labrum and distinguish degenerated from normal labra.

Aged↗
PubMed1998

The effect of bracing on extension strength in patients with ACL insufficiency.

One of the problems following an anterior cruciate ligament (ACL) injury is to regain strength. We tested 11 patients (5 men, 6 women), mean age 28.4 years, with unilateral ACL insufficiency, with two braces (Donjoy Legend, and Bledsoe Brace Force III) versus a placebo brace. The patients were tested on a Biodex Dynamometer at 60 and 180 deg/s in an isokinetic mode. The experiment was designed as a comparative study in a cross-over design with the stable knee as the patient's own control. We found no statistically significant effect of the two braces compared to a placebo brace under the test conditions, and no correlation between knee laxity and the effect of bracing.

Adult↗
PubMed1997

Isolated partial rupture of the anterior cruciate ligament. Long-term follow-up of 56 cases.

The majority of previous studies on partial ruptures of the anterior cruciate ligament (ACL) include a relatively large proportion of knees with associated intra-articular injury or collateral ligament tear that contributes to an increase in the symptoms of instability and further deterioration of knee function. In the present study only patients with isolated, partial ruptures of the ACL were evaluated. Fifty-six patients with one injured knee were examined after a median of 5.3 (range 2.0-12.7) years using the IKDC evaluation form, Lysholm knee function score and Tegner activity score. Of the 56 knees, 6 underwent autologous reconstruction due to early progression to complete rupture. Of 34 knees evaluated for laxity, 25 had a negative Lachman test and 7 a positive (+) Lachman. In 2 knees a Lachman ++ result and a positive pivot shift were found. With instrumented laxity testing 24 knees had 2 mm or less difference in laxity compared with the contralateral uninjured knee. The largest side-to-side difference in knee laxity was 4.5 mm. Lysholm score was median 86 (range 52-100) points, and 62% had good or excellent knee function. A significant decline in activity was seen. Only 10 patients (30%) resumed their preinjury activities. We find that the majority of patients with an isolated, partial rupture of the ACL have an acceptable knee function and a stable knee after a median 5 years follow-up. There is, however, a marked reduction in activity.

Adolescent↗
PubMed1997

An epidemiological analysis of the injury pattern in indoor and in beach volleyball.

This study was designed to evaluate the injuries in indoor and in beach volleyball, and to compare the injury pattern in the two different types of volleyball. Injuries in 295 volleyball players were recorded during the beach volleyball season 1993 and during the following indoor volleyball season 1993 to 1994. The method of enquiry was two identical questionnaires. Equal numbers of men and women, elite and recreational players were represented. In beach volleyball 24 injuries were reported and 286 in indoor volleyball, representing an incidence of 4.9 injuries per 1000 volleyball hours in beach volleyball and 4.2 in indoor volleyball. The most frequent injuries were acute injuries located in the ankle and finger and overuse injuries in the knee and shoulder. The injury pattern was different in indoor and in beach volleyball. In beach volleyball most injuries occurred in field defence and in spiking, with overuse injuries in the shoulder as the major site. In indoor volleyball most injuries occurred during blocking and spiking, resulting most frequently in acute finger and ankle injuries, respectively.

Adult↗
PubMed1996

Injuries in elite volleyball.

During the 1993-1994 volleyball season, injuries to players in the two Danish elite divisions were registered by means of a questionnaire survey. Eighty per cent of the players returned the questionnaire. A total of 70 female players reported 79 injuries and 67 male players reported 98 injuries, representing an overall incidence of 3.8 injuries per player per 1000 volleyball hours played. The injury incidence was the same for female and male players. Most injuries occurred in spiking (32%) and in blocking (28%). The injuries were predominantly either acute injuries to fingers (21%) and ankles (18%) or overuse injuries to shoulders (15%) and knees (16%). Shoulder injuries seemed to be a more serious problem in females. During the past 10 years the rate of overuse injuries has increased from 16% to 47% in male elite volleyball, corresponding to a significant increase in the incidence of these injuries from 0.5 to 1.8 injuries per player per 1000 played hours (P < 0.001). A possible explanation for this could be a 50% increase in training activity during this period.

Adolescent↗
PubMed1995

Are hard-copy prints from peroperative fluoroscopy images useful as documentation?

We have examined the applicability of peroperative image documentation, in promoting early mobilization after osteosynthesis and saving the standard X-ray examination. One hundred and twenty-three patients with proximal femoral fractures were included in the investigation. Hard-copy reprints were recorded from peroperative fluoroscopy images by Fuji Film Thermal Imaging System FTI 200. These reprints were compared with the standard X-rays to assess the quality of the osteosynthesis and possible restriction in mobilization. The specificity of finding an unstable osteosynthesis was 0.40, whereas the sensitivity of finding a stable osteosynthesis was 0.96. In all, four unstable osteosyntheses were overlooked on the hard copy reprints. The specificity of finding patients in need of restricted mobilization was 0.44 and the sensitivity of finding patients allowed free mobilization was 0.93. Eight patients needing restricted mobilization were overlooked on the reprints. Hard-copy images do not safely reveal unstable osteosynthesis and cannot replace the standard X-rays taken postoperatively.

Fluoroscopy↗