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Biomedical subjects

P Adolphson

Publications and source records attributed to P Adolphson.

18 recordsLinked to original sources
PubMed1997

Bone and muscle mass after femoral neck fracture. A controlled quantitative computed tomography study of osteosynthesis versus primary total hip arthroplasty.

The cortical bone mineral density (BMD), bone volume, bone mass and muscle volume of the thigh, and the BMD of the distal femur and proximal tibia were measured quantified by quantitative computed tomography (QCT) after an operation for a displaced femoral neck fracture. Twenty patients were randomized to osteosynthesis or total hip arthroplasty (THA). Both legs were scanned after 18 months, and the operated side was compared with the healthy side. Clinical assessment was performed with a Harris hip score. A reference group of 9 patients, who had undergone THA because of arthrosis, was chosen. In the fracture patients, we found a 9% decrease in bone mass and muscle volume of the middle femur. The BMD of the distal femur and proximal tibia showed a more marked osteopenia. There was no difference in these parameters between the two groups. In the reference group of operated arthrosis patients, we did not find any differences between sides postoperatively. After the operation, the fracture patients had a lower Harris score than the arthrosis patients, and this was most pronounced among those who had undergone osteosynthesis. The finding of a marked osteopenia after a femoral neck fracture, irrespective of treatment, but no bone loss after THA because of arthrosis, implies that patients with a femoral neck fracture are more sensitive to osteopenia, and that the bone loss is not proportional to the operative trauma.

Aged↗
PubMed1997

Femoral cortical remodeling after uncemented total hip arthroplasty. A prospective radiologic study of 26 hips followed for 2 to 4 years.

Twenty-six consecutive, hydroxyapatite-coated Bi-Metric femoral stem prostheses (Biomet, Warsaw, IN) were studied in 20 patients. The follow-up period averaged 37 months (range, 24-48 months). Clinical rating (Harris score) was determined and radiography were taken at regular intervals. Digital imaging and computer-assisted videodensitometry were used to quantify the cortical remodeling. The anteroposterior radiographs of the femur were scanned and digitized, and the pictures were analyzed by a digital image processing software program. The periosteal diameter, the cortices of the femur, and the total endosteal diameter in five regions were determined. The mean preoperative Harris score was 50 and improved to 97 at the latest follow-up evaluation. After surgery, there was hypertrophy of the periprosthetic cortical bone and an increase in the periosteal diameter. The medullary canal of the operated femur did not change.

Biocompatible Materials↗
PubMed1997

Decrease in bone mineral density and muscle mass after femoral neck fracture. A quantitative computed tomography study in 25 patients.

We performed a prospective, longitudinal, quantitative computed tomography (QCT) study of bone mineral density (BMD), cortical bone volume, bone mass and muscle volume in 25 patients who were operated on with osteosynthesis because of a displaced femoral neck fracture. Both legs were scanned within 3 days after the fracture, and 3 and 6 months after the operation. The measurements were performed by a computer tomograph equipped for bone mineral densitometry. We found some side differences among the patients at the time of fracture, but none of the differences was statistically significant. After 6 months, we found reductions in BMD in the distal femur and proximal tibia on the fractured side of 11% and 19%, respectively, as well as a reduction in BMD of 7% in the proximal tibia on the uninjured side. We found no changes in cortical bone mass, either on the fractured femur or on the uninjured femur. The muscles of the thigh showed a loss of 9% on the fractured side, but a gain of 12% on the uninjured side. The findings of a bone loss in the distal femur and proximal tibia of the fractured leg and in the proximal tibia of the healthy leg, but no cortical bone loss in the middle femur on any side 6 months after the fracture, indicate that the cancellous bone is more sensitive to osteopenia. Moreover, this bone loss is interpreted as mainly a posttraumatic effect, since we also found a decrease in bone mineral on the uninjured side, despite a gain in muscle volume on that side, an overuse which was not sufficient to counteract the posttraumatic effect on the bone of the uninjured side.

Bone Density↗
PubMed1996

Changes in femoral cortical dimensions after uncemented revision hip arthroplasty. Radiological results with the porous-coated bi-metric femoral stem prosthesis in 15 asymptomatic cases.

The radiographic results of 15 uncemented femoral revisions after a minimum follow-up period of 2 years are reported. Digital imaging was used to quantify the remodeling of the cortical bone. A method using computer-assisted video densitometry was developed and radiographs were scanned and digitized by a computer. The femoral cortex in five regions, as well as the endosteal diameter, was determined. After rearthroplasty, there was a significant loss in cortical bone with widening of the medullary canal. The periosteal diameter did not change. This endosteal resorption could contribute to further aseptic loosening. In addition, it could be an explanation of the primary prosthetic failure; one mode of failure could be an accelerated rate of endosteal expansion in a subgroup of the general population after hip arthroplasty.

Absorptiometry, Photon↗
PubMed1996

Vertebral bone density after hip rearthroplasty assessed by quantitative computed tomography.

An investigation of the bone mineral density of lumbar vertebrae L1 to L3 with quantitative computed tomography was undertaken in 12 patients who had undergone hip rearthroplasty because of aseptic prosthetic loosening. The same measurements were carried out in a control group of 13 patients who had undergone hip arthroplasty, but not rearthroplasty. A good correlation was found between the cancellous bone mineral density in lumbar vertebrae L1 to L3 in each patient. In contrast to earlier findings of a post-traumatic effect on the appendicular skeleton after rearthroplasty, no significant difference was found in vertebral bone mineral density after the rearthroplasty.

Aged↗
PubMed1995

Endosteal femoral bone loss after hip rearthroplasty. A controlled computed tomography study of 12 patients.

The cortical bone area of the middle femur was investigated with computed tomography in 12 patients after hip rearthroplasty due to aseptic prosthetic loosening. The patients had undergone their original arthroplasty because of unilateral arthrosis 11 years before these measurements. Both legs were scanned, and the reoperated side was compared with the healthy side. A control group was chosen of 13 patients with unilateral hip arthroplasty because of unilateral arthrosis, but without subsequent rearthroplasty. In the patients who had undergone rearthroplasty, there was an 11% loss in endosteal bone area of the middle femur compared with the contralateral side. In the control group (non-reoperated patients), only a loss of 6% was found compared with the contralateral side. The periosteal bone area of the reoperated femur and the non-reoperated femur showed no significant change compared with the corresponding healthy side. The larger endosteal resorption noted among patients in the rearthroplasty group could be ascribed to the primary prosthetic failure and could also contribute to further aseptic prosthetic loosening.

Aged↗
PubMed1994

Decrease in vertebral bone density after hip arthroplasty. A quantitative computed tomography study in 18 arthrosis cases.

We investigated the bone mineral density (BMD) of the lumbar vertebrae L1-3 with quantitative computed tomography (QCT) in 18 patients who had been operated on with hip arthroplasty because of unilateral arthrosis. In an earlier prospective study, we did not find any bone mineral changes in the femur or tibia after hip arthroplasty in spite of a large increase of the thigh muscle mass as a sign of a remobilization after the operation. The median BMD had decreased 5.3-8.4 percent in all the measured vertebrae after 6 months postoperatively. Because of the patients' improved walking ability after the operation, this decrease in cancellous vertebral BMD is interpreted as a sign of a post-traumatic osteopenia.

Aged↗
PubMed1993

Computer-assisted prediction of the instability of Colles' fractures.

Many Colles' fractures are unstable and have a tendency to redisplace when immobilised in plaster. In an earlier study, we found a high correlation between several parameters from the initial radiographs in 267 patients and the anatomical end results. The predictive power of a new computer programme designed from the data of these patients was investigated in a further group of 107 Colles' fractures. Prediction of the final radiological position was good, especially in the least and moderately displaced fractures. We have found that the initial radial shortening, the type of fracture according to Lidström's classification, and the age of the patients have the greatest value in predicting whether a Colles' fracture will displace to an unacceptable degree.

Aged↗
PubMed1993

No effects of piroxicam on osteopenia and recovery after Colles' fracture. A randomized, double-blind, placebo-controlled, prospective trial.

In a randomized double-blind study involving 42 postmenopausal women with a displaced Colles' fracture, we investigated whether piroxicam, a nonsteroid anti-inflammatory drug, can reduce posttraumatic osteopenia and improve the rate of recovery. In an earlier study [3] we found a bone-sparing effect caused by piroxicam after external fixation of the rabbit hindleg. The patients were treated with a below-elbow paster slab for 4 weeks after the reduction. The bone mineral content of the forearm bones was measured with a single-photon absorptiometer 8 weeks after the fracture. There was a mean 7% bone mineral decrease in the radius and 5% in the ulna among the patients treated with piroxicam versus 10% in the radius and 7% in the ulna in the placebo group. However, this difference was not significant. Piroxicam did not decrease the rate of fracture healing. The patients who received piroxicam had significantly less pain during plaster treatment, but there was no difference in the rate of functional recovery between the groups.

Aged↗
PubMed1993

Bone and muscle mass after hip rearthroplasty. Controlled CT study of 12 patients.

The cortical bone mineral density (BMD), bone volume, bone mass and muscle volume of the thigh and the cancellous BMD of the distal femur and proximal tibia were quantified by computed tomography (QCT) in 12 patients after hip rearthroplasty due to prosthetic loosening following arthroplasty for arthrosis. Both legs were scanned and the operated side was compared with the healthy side. A control group, 12 patients, had had unilateral hip arthroplasty without subsequent rearthroplasty. There was a 19 percent decrease in bone mass and 13 percent decrease in muscle volume in the middle femur, compared to the contralateral side, in the patients who had undergone rearthroplasty, and a reduction of 9 percent for the same variables in the control group. There was also a more marked osteopenia in the reoperated extremity in the distal femur and proximal tibia compared to the unoperated side.

Aged↗
PubMed1993

Cruciate ligament prosthesis vs. augmentation. A randomized, prospective 5-year follow-up of 41 cases.

In a prospective study, 18 patients were randomized to a prosthesis and 23 patients to the Kennedy Ligament Augmentation Device (LAD) because of functional instability due to old anterior cruciate ligament injuries. The operations were performed with use of a modified over-the-top technique. At the last follow-up (5 years), postoperative improvements in scores were maintained for both groups, but LAD-reconstructed patients had better Lysholm and activity scores than the Goretex group. The achieved postoperative improvement in anterior stability (KT-1000) did not deteriorate for either of the groups during the 5-year follow-up. The Goretex patients had more effusion and pain and more secondary operations.

Anterior Cruciate Ligament↗
PubMed1993

Bone and muscle mass after hip arthroplasty. A quantitative computed tomography study in 20 arthrosis cases.

We performed a prospective, quantitative computed tomography (QCT) study of bone mineral density (BMD), cortical bone volume, bone mass and muscle volume in 20 patients who were operated on with cemented total hip arthroplasty because of unilateral arthrosis. Both extremities were measured preoperatively, 3 and 6 months after the operation by a single-energy computer tomograph equipped for bone mineral densitometry. Preoperatively, we found a 25 percent decrease in muscle volume of the thigh on the arthrosis side compared to the contralateral side, but only a 6 percent decrease in bone mass, mainly of the cortical bone volume in the middle femur. In the cancellous bone of distal femur and proximal tibia there was a reduction in BMD of 11 and 14 percent, respectively, compared to the contralateral side. After 6 months, we found no changes in cortical bone mass, either on the operated femur or on the contralateral, control femur. The BMD of cancellous bone in distal femur and proximal tibia had not changed. However, the thigh muscle on the operated side showed a strong recovery; 6 months after the operation there was a 19 percent gain on the operated side.

Aged↗
PubMed1992

Traumatic rupture of the quadriceps tendon in a 16-year-old girl. A case report.

Traumatic rupture of the quadriceps tendon is well known to occur in middle-aged men in patients on hemodialysis for renal failure and in patients with diabetes, but only very rarely in young and healthy women. We report a case of traumatic rupture of the quadriceps tendon of a girl without any of the predisposing factors listed.

Accidental Falls↗
PubMed1991

Piroxicam-induced reduction in osteopenia after external fixation of rabbit tibia.

Twelve rabbits were treated with a unilateral external fixator in one tibia for 12 weeks, while the other tibia served as an intact control. Half of the animals were also treated with 10 mg/kg/day of piroxicam, given in two daily oral doses. Changes in bone mineral content were determined using single photon absorptiometry. After 12 weeks, we found a 3 percent decrease in the bone mineral content in the tibia of the animals treated with piroxicam versus 9 percent in the nonpiroxicam group (P = 0.04). In the femurs, there was an insignificant decrease in bone mineral, 2 percent (piroxicam) and 1 percent (nonpiroxicam) respectively. The results indicate that piroxicam may reduce the osteopenia caused by external fixation.

Absorptiometry, Photon↗
PubMed1991

Bone mineral loss after Colles' fracture. Plaster case and external fixation equivalent.

The bone mineral content of the radius and ulna was analyzed in 31 postmenopausal women with displaced Colles' fractures. Sixteen fractures were treated with a below-the-elbow plaster case and 15 with primary external fixation. The bone mineral content of the forearm bones was measured with a photon absorptiometer 9 (6-24) months later. There was a mean 15 percent mineral decrease in the radius, but no difference between the two treatment groups. The decrease did not correlate with the age of the patient, nor was there any correlation with grip strength or range of wrist motion. The more severe fractures, according to the Frykman classification, had a more pronounced mineral loss than the simpler fractures.

Aged↗
PubMed1990

Stress protection by external fixation of the rabbit tibia.

Osteopenia of the tibia and femur caused by an external fixator in the tibia was studied in 14 rabbits. Eight rabbits were treated with a complete unilateral external fixator in one tibia, whereas the other tibia served as control. The other 6 animals had one leg operated on with inserting of all the pins but without the frame. This technique was chosen to compare osteopenia caused by stress protection and the effect of the pins. After 6 weeks, we found a 7 percent reduction in the bone mineral content in the tibial diaphyseal segment between the pins of the external fixator and no bone loss in the tibia that were operated on with only pins. In the femurs, there was a smaller decrease in the bone mineral content: respectively 3.2 percent (complete frame) and 2.9 percent (only pins). On all the operated on tibiae, there was an increase in the bone mineral content around the pins both proximally and distally.

Animals↗
PubMed1987

Fractures of the ipsilateral femur after total hip arthroplasty.

The aim of this study was to investigate the predisposing factors, fracture location, treatment, and final outcome of femoral fractures after total hip arthroplasty (THA). From 1975 to 1983, 28 patients were seen with 29 fractures on the same side as the prosthesis. Most of the fractures were caused by minor trauma, and prior hip surgery was the most common predisposing factor. Two patients underwent early operation and six were treated with protected weight bearing. Twenty-one underwent initial skeletal traction, and 14 of these fractures united without further surgery. Six of the patients treated with initial skeletal traction were operated on early, mainly by osteosynthesis, due to poor fracture alignment. Three of these fractures united, but one subsequently required revision arthroplasty because of loosening of the femoral component. Two patients died and three had a permanent pseudarthrosis or a Girdlestone resection. Nineteen of the 21 fractures not operated on united and five of the eight operated united. The results indicate that when good fracture alignment is achieved with traction, union is not jeopardized by either the prosthesis or the cement.

Adult↗