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Biomedical subjects

P Hamberg

Publications and source records attributed to P Hamberg.

At least 19 recordsLinked to original sources
PubMed1997

Local NSAID gel (eltenac) in the treatment of osteoarthritis of the knee. A double blind study comparing eltenac with oral diclofenac and placebo gel.

In a randomized, double blind, multicentre study with 4 weeks follow-up of 290 patients with osteoarthritis of the knee joint, a topical NSAID (eltenac) was compared with oral diclofenac and placebo. The main outcome, Lequesne's Index and pain by VAS showed no statistically significant differences between neither of the active treatments and placebo for the total study population. However, in patients with more severe symptoms, both active groups showed statistically significant differences to placebo. No severe adverse drug reactions were seen but the number of GI reactions were three times higher in the diclofenac group compared to the topical treatment. Local skin reactions were twice as frequent in the eltenac than in the placebo group. Taking into account the nature of the treatment for a chronic disease like OA, our results indicate that eltenac gel could be a safe alternative to oral NSAIDs.

Administration, Oral↗
PubMed1992

Knee arthroscopy using local anesthesia.

This study confirms the feasibility of performing arthroscopy and arthroscopic surgery with patients under local anesthesia. Seventy patients underwent arthroscopy under local anesthesia using mepivacaine with adrenaline. In 49 patients, arthroscopic surgery was performed. It is important to wait at least 20 min after the injection of the anesthetic before surgery to anesthetize the medial part of the joint. There were few complications. Diagnostic and surgical arthroscopy can be successfully performed in the majority of patients with local anesthesia.

Adult↗
PubMed1989

Non-operative treatment of meniscal tears.

In a retrospective review of the results of 3,612 arthroscopic procedures that were performed for the treatment of an acute or a chronic meniscal lesion, with or without an associated ligamentous lesion, we identified eighty meniscal tears (in seventy-five patients) that had been assumed to be stable. Seventy were vertical longitudinal tears and ten were vertical radial tears. The seventy longitudinal tears included fifty-two lateral and eighteen medial meniscal lesions. All of the radial tears were in the lateral meniscus. Of the seventy-five patients, fifty-two had been followed for two to ten years. At the time of follow-up, only six of these fifty-two patients had needed additional intervention because of symptoms that were related to the meniscal tear. Four of them had the intervention after a sports-related traumatic extension of a stable tear, and two, because persistent symptoms were caused by the original meniscal lesion. A repeat arthroscopy was performed on thirty-two patients (twenty-six of whom had a longitudinal tear and six of whom had a radial tear), at an average of twenty-six months after the original arthroscopy. Seventeen of the twenty-six longitudinal tears had completely healed. Five of the six radial tears had no evidence of healing and one had extended. Neither ligamentous laxity nor a meniscal tear that was chronic at the time when it was discovered appeared to preclude healing of the stable longitudinal tears. No localized degenerative changes in the adjacent articular cartilage were found in association with any of the stable vertical longitudinal or radial meniscal lesions. Excluding the six patients who had had additional surgical treatment, none of the fifty-two patients who filled out a questionnaire reported that they had symptoms of a meniscal lesion, and none of the forty-two patients who were re-examined two years or more after the operation had signs of a meniscal lesion. Stable vertical longitudinal tears, which tend to occur in the peripheral vascular portions of the menisci, have great potential for healing. The tear should be left alone unless it is the only abnormality that is found and it is causing symptoms that warrant treatment. Stable radial tears, which tend to occur in the avascular inner one-third of the meniscus, have little potential for healing. Whether it is best to leave these lesions alone or to fashion an intact rim by contouring the meniscus was not established by this study.

Adolescent↗
PubMed1987

The correlation between osteoarthrosis as seen on radiographs and on arthroscopy.

The correlation between arthroscopic and radiographic osteoarthrosis was studied in 63 patients (51 +/- 12 years) with degenerative changes in the medial compartment of the knee involving the medial meniscus with or without chondral damage. Chondral damage on arthroscopy was classified in grades 1-3 modified after Outerbridge. The radiographic evaluation was done according to Ahlbäck classification. Twenty-eight patients (44%) did not show any significant chondral damage on arthroscopy (grades 0-1). The radiographic findings in this group were usually normal. Three patients, however, showed a slight narrowing of the medial joint space (Ahlbäck I). All three had severely degenerated menisci, and two of them showed superficial fibrillation of both the tibia and the femur. Twenty-four patients (38%) showed a partial thickness chondral damage with fragmentation of the surface (grade 2). Radiographic findings were usually normal; however, patients with involvement of both the tibia and the femur often showed a joint space narrowing on radiographs. Eleven patients (18%) showed destruction of the cartilage down to subchondral bone (grade 3). The typical radiographic finding was a joint space obliteration (Ahlbäck II). Involvement also of the lateral compartment as assessed on arthroscopy was significantly more common in patients with 2nd and 3rd degree chondral disease and Ahlbäck II and III on radiographs than in those with 2nd and 3rd degree chondral damage and normal radiographs. In all but one of the patients with involvement of both compartments, the lateral compartment was considered normal on radiographic examination.

Adult↗
PubMed1985

Surgical or conservative treatment of the acutely torn anterior cruciate ligament. A randomized study with short-term follow-up observations.

In a prospective study, 90 consecutive patients with total midstructural tears of the anterior cruciate ligament (ACL) were assigned at random to surgical (Group I) or conservative (Group II) treatment. Within 18.2 months of operation, 95% of the patients in Group I and 11% of those in Group II had a stable knee. The mean knee function score in Group I was 89 points, and 75% achieved more than 84 points (good or excellent). In Group II the mean score was 85; only 53% achieved more than 84 points (p less than .05). Group II patients showed greater mean quadriceps strength than those in Group I. The ability to perform a one-leg jump and to run a figure eight was similar in both groups. Early primary suture of the acutely torn ACL usually resulted in a stable knee, whereas conservatively treated patients showed knee instability. At the 18-month interval, however, the patients' functional performance seemed to be comparable in the two groups.

Adolescent↗
PubMed1984

A comparison between arthroscopic meniscectomy and modified open meniscectomy. A prospective randomised study with emphasis on postoperative rehabilitation.

Arthroscopy is now well established as a method of diagnosing meniscal lesions, and its advantages have been pointed out in several reports. Arthroscopic surgery, however, is difficult to master, so that for meniscectomy open methods remain commoner. By taking advantage of the new instruments and equipment developed for arthroscopic operations, a modified technique of open meniscectomy, designed to improve the postoperative course, has been developed. In a prospective randomised study, the results after this modified open meniscectomy were comparable with those obtained after arthroscopic operation and were significantly better than those after conventional meniscectomy. The best results of all, however, were those after partial arthroscopic meniscectomy.

Adult↗
PubMed1984

Knee function after arthroscopic meniscectomy. A prospective study.

In a prospective study, operation under arthroscopy was done in 100 consecutive patients (11 women and 89 men) with a lesion of one meniscus. Meniscectomy was done in 86 patients with medial meniscus tears and in 14 with lateral tears. After 2 weeks, 85 patients were back at work.

Adolescent↗
PubMed1984

Arthroscopy of the knee in children.

A review was carried out of arthroscopy of the knee in children. During a 34-month period, 2,378 arthroscopies were performed, 80 of these on children less than 16 years of age. Seventy-one cases were reviewed, which is approximately 2% of all children seen at the clinic. Thirty procedures were carried out in patients with hemarthrosis. Eleven patients required operative repair or reconstruction. There were 13 ruptures of the anterior cruciate ligament (43%), 4 ruptures of the posterior cruciate ligament, 14 ruptures of the medial collateral or posterior oblique ligament, and 5 ruptures of the lateral meniscus. Forty-one arthroscopies were done in patients without hemarthrosis or history of acute trauma. A clinical diagnosis of meniscus tear was correct in only 20%. Only one meniscectomy was performed and another meniscus tear was repaired. The most common diagnostic finding was abnormality of the patellofemoral articulation, which was diagnosed in 31 patients. Arthroscopic shaving of the patella was rarely indicated. As in adults, hemarthrosis indicates significant injury to the knee. Meniscus lesions are rare.

Adolescent↗
PubMed1984

Comparison of open and endoscopic meniscectomy.

Fifty-eight patients who had undergone meniscal surgery were reviewed. Half had undergone conventional open meniscectomy, and half had been treated by arthroscopic meniscectomy. Each patient in the open group was matched with a patient in the endoscopic group by age, sex, and type of meniscal lesion. Patients with ligamentous injuries were excluded. Twelve patients in the endoscopic group were operated on as outpatients; the mean post-operative hospital stay in the 17 hospitalized patients in the endoscopic group was one day as compared with a mean of 3.3 days for the patients in the open group. Sick leave for the endoscopic group was only one-third of that of the open group. Operating time was 74.5 +/- 38.7 minutes in the open group compared with 55.9 +/- 25.0 minutes in the endoscopic group. At follow-up evaluation (mean follow-up period, 38 months) the percutaneous group showed a knee function score (88.7 points) similar to that of the open group (85.3 points) at 51 months. A three-year follow-up study of patients operated on endoscopically for a single meniscal lesion demonstrated that results with endoscopy are as satisfactory as those obtained by conventional surgery. Advantages of endoscopy include decreased hospitalization and shorter sick leave, with a corresponding reduction in the cost of patient care.

Adolescent↗
PubMed1984

Instruments for routine arthroscopic surgery of the knee.

The use of operating instruments for routine arthroscopic operations was analysed on 2397 arthroscopies with 986 operations. The biggest group was meniscectomy (n = 358). The most common instrument combination was knife, a straight 4 mm grasper, a 3-4 mm basket forceps and a suction device, which was used in 53% of the cases. Instrument breakage rates were analysed and found to be rather high especially for straight basket forceps (2/100 operations) and grasping forceps (3.6/100 operations). In two cases arthrotomy had to be done to retrieve a broken piece of grasping forceps. 30 degree telescopes used together with a TV-system had to be replaced at a rate of 0.8/100 operations and 70 degree telescopes at 0.2/100 operations.

Arthroscopes↗
PubMed1983

Suture of new and old peripheral meniscus tears.

A prospective study of repaired vertical peripheral tears of the meniscus in fifty patients (nine women and forty-one men) was carried out from January 1977 to June 1980. All tears were confirmed preoperatively by arthroscopy. Forty-three medial and seven lateral menisci were repaired. Fifteen tears were treated within two weeks and thirty-five were operated on as long as seven years after injury. Only eight patients had a meniscal tear that was not accompanied by injuries of either the anterior cruciate ligament or the collateral ligaments, or both. At a mean follow-up of eighteen months (range, six to thirty-nine months), forty-two patients (84 per cent) had clinically apparent healing of the sutured meniscal tear. Repeat arthroscopy was done in twenty-seven (64 per cent) of these patients, four to twenty-nine months (mean, twelve months) after the operation. The arthroscopy proved that all of these repaired tears had healed. Eight patients had a second tear after the initial repair: four were reruptures at the sutured area and four were new ruptures in another area of the meniscus and were associated with fresh trauma. All of these patients subsequently had an arthroscopic meniscectomy.

Adolescent↗
PubMed1982

Endoscopic partial and total meniscectomy. A comparative study with a short term follow up.

The results of partial endoscopic meniscectomy in 89 patients were compared with the results of total endoscopic meniscectomy in 78 patients. Total meniscectomy was the more time consuming and there were intraoperative technical problems in 16 patients, the most common being rupture of the meniscus during extraction. All complications were, however, successfully handled and did not affect the end result. There were nine reoperations after partial and only one after total meniscectomy. The patients were followed up on the average 16 months after operation with a special knee function questionnaire. There was no difference between the groups in score distribution, indicating similar knee function. However, patients in the total meniscectomy group with a follow up longer than 1 year had significantly higher scores than those with a shorter follow up. No such difference was noted in the partial group, possibly indicating that the final level of knee function is reached earlier after partial than after total meniscectomy.

Absenteeism↗