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Biomedical subjects

P Hamberg

Publications and source records attributed to P Hamberg.

29 records · Page 2Linked to original sources
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↗
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↗
PubMedDate not supplied

The effect of diagnostic and operative arthroscopy and open meniscectomy on muscle strength in the thigh.

In this study we measured the effect on the muscle strength in the thigh in connection with diagnostic arthroscopy with central approach, arthroscopy with arthroscopic operation of bucket-handle ruptures, flap tears, total arthroscopic meniscectomy, and open meniscectomy. Thirty-seven patients were tested preoperatively and 1, 4 and 8 weeks postoperatively with a Cybex II isokinetic dynamometer. The extensor muscles of the knee joint were most affected. The flexor muscles were generally recovered in all groups within a month. Diagnostic arthroscopy and arthroscopic operations for bucket-handle ruptures showed no significant effect on the thigh muscle torque. With the other arthroscopic operations there was a 40% decrease of quadriceps function 1 week after operation. After 8 weeks normal function returned. Open meniscectomy had a much more negative effect on the quadriceps muscle with a decrease of about 70% after 1 week. After 8 weeks, the rehabilitation was still not complete.

Adolescent↗
PubMedDate not supplied

Muscle rehabilitation after arthroscopic meniscectomy with or without tourniquet control. A preliminary randomized study.

Nineteen patients with isolated meniscus lesions were randomly assigned to operation with or without tourniquet. All patients underwent arthroscopic meniscectomy. Measurements of CK (creatinin-kinase), CK-B (isoenzymes MB of creatinin-kinase), LD (lactate dehydrogenase), ASAT (aspartate aminotransferase), and ALAT (alanine aminotransferase) were performed preoperatively and postoperatively over 6 days. The muscle torque was measured on a Cybex II isokinetic dynamometer preoperatively, 1 week and 4 weeks postoperatively. The mean CK level rose significantly in both groups, but did not pass the upper normal serum level. There was no effect on the other muscle enzymes. Quadriceps torque was significantly lowered in both groups 1 week after operation. Four weeks postoperatively, it was still lowered in the nontourniquet group, which also had a slower increase in torque between weeks 1 and 4 than the tourniquet groups. There was no effect from the operation on isometric or hamstrings torque. The slight rise in CK was similar to that seen after hard physical exercise. The decrease in muscle torque was, therefore, mostly due to pain inhibition. The slightly slower rehabilitation in the nontourniquet group may be caused by the technique of raising saline flow and pressure during the arthroscopy to control bleeding. This causes extravasation of fluid which may increase postoperative pain and stiffness.

Adult↗
PubMedDate not supplied

Healed meniscal tears in unstable knees. A long-term followup of seven years.

Peripheral vertical ruptures of the medial (N = 24) and the lateral (N = 4) meniscus were repaired in 28 patients (mean age, 27 years). They all had an ACL lesion, combined in 26 cases with a MCL tear. These injuries were reconstructed or sutured during the same session as the meniscus repairs. Approximately 1 year later, meniscal healing was proven arthroscopically in 20 and the other 8 had no clinical signs of meniscal rerupture. All patients were reexamined between 6 to 8 years after the initial repair. Instrumented stability testing, the Lysholm knee function score and an activity score (Tegner) were used. The patients' subjective evaluations were also recorded. In spite of the previous reconstruction, all knees were quite unstable (mean +5 mm increased laxity compared with the uninjured side). At followup, 3 of the 28 repaired menisci (11%) had reruptured in connection with a minor trauma during sports or daily activity. The knee function score averaged 88 points, the activity level dropped 2 steps compared with activities before injury (from 7 to 5). Twenty patients were satisfied with the results, 5 partly satisfied, and 3 not satisfied. A healed meniscal tear has a good chance of survival in an unstable knee. The most critical period of meniscal repair probably lies in the healing period just after surgery.

Adolescent↗