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Biomedical subjects

R Johnsson

Publications and source records attributed to R Johnsson.

At least 55 records · Page 3Linked to original sources
PubMed1992

Influence of spinal immobilization on consolidation of posterolateral lumbosacral fusion. A roentgen stereophotogrammetric and radiographic analysis.

To determine the influence of the duration of postoperative lumbar immobilization with the aid of a rigid lumbar orthosis on the consolidation of posterolateral lumbosacral fusions, 22 patients with no previous osseous spinal surgery and with fusion without osteosynthesis due to spondylolysis-olisthesis Grade 1 to 2 or intervertebral disc or facet joint disorder were examined by roentgen stereophotogrammetric analysis in supine and erect positions and by conventional radiography for 1 year after surgery. In Series 1, patients (n = 11) were instructed to keep the trunk straight with the aid of a molded, rigid lumbar orthosis for 5 months after surgery; and in Series 2 (n = 11), the same instructions were given, but for 3 months. In Series 1, osseous fusion was seen on radiographs in eight patients. In these patients, the intervertebral translations between the fused vertebrae began to decrease 3-6 months after surgery, and within 1 year, the fusions became rigid, as defined by roentgen stereophotogrammetric analysis, or intervertebral translations of mostly less than 1 mm persisted. In three patients with poor fusion still seen on radiographs 1 year after surgery, no rigid fusion was obtained and intervertebral translations of up to 10 mm persisted. In Series 2, a similar roentgen stereophotogrammetric analysis pattern was noted in two patients with osseous fusion and in seven with poor fusion seen on radiographs. The fusion was radiographically doubtful in two patients. In these patients, the intervertebral translations decreased, but translations of 1.5 mm persisted 1 year after surgery.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Effect of lumbar orthosis on intervertebral mobility. A roentgen stereophotogrammetric analysis.

To determine the stabilizing effect of external lumbar supports on the intervertebral mobility in the lower lumbar spine, seven patients with a posterolateral lumbosacral fusion without internal fixation were examined by roentgen stereophotogrammetric analysis in supine and erect positions 1 month after surgery, that is, after soft tissue healing but before fusion consolidation. Each patient was examined without lumbar support, with a molded, rigid orthosis and with a canvas corset with molded, plastic posterior support. Neither of the two types of lumbar support had any stabilizing effect on the sagittal, vertical, or transverse intervertebral translations. This study using roentgen stereophotogrammetric analysis confirms that lumbosacral orthosis has effect by restricting gross motions of the trunk rather than intervertebral mobility in the lumbar spine.

Adult↗
PubMed1992

Early intensive treatment of clubfoot. 75 feet followed for 6-11 years.

47 consecutive children with 28 bilateral and 19 unilateral clubfeet were treated during the neonatal period according to a strict protocol including physiotherapy and bracing from the first 2 weeks of life; further, in most of the children, an operation was performed at 3 (2-5) months of age. Physiotherapy was continued during the first year of life and bracing for 3 years. 27 feet had repeat operations. No peroperative or postoperative complications were seen. At follow-up at aged 8 (6-11) years, the cosmetic result was good in 62 feet, acceptable in 12 feet, and poor in 1 foot, whereas the functional result was excellent in 51 feet, good in 21 feet, and fair in 3 feet. The radiographs showed a higher lateral talocalcaneal angle in the control feet than in the treated feet; but in other radiographic aspects, no differences were seen. The need of a secondary or even tertiary operation did not indicate a poor result.

Age Factors↗
PubMed1991

Spinal canal remodeling after thoracolumbar fractures with intraspinal bone fragments. 17 cases followed 1-4 years.

The long-term fate of nonreduced intraspinal bone fragments in 17 thoracolumbar fractures--three not operated on and 14 stabilized with Harrington's rods or a Hartshill rectangle--was studied with CT. The reduction of the spinal canal area was measured in conjunction with the trauma in the nonoperated on cases and immediately after surgery in the other cases. The mean reduction was 29 (10-70) percent. The reduction had decreased to 14 (0-30) percent at the follow-up examination 31 (12-44) months later. The restitution of the spinal canal did not differ in the nonoperated and operated on patients. Our findings indicate that stable thoracolumbar fractures with intraspinal bone fragments, but without neurologic symptoms, can be treated nonoperatively, irrespective of the size of the fragment, without risk of subsequent symptomatic neural compression.

Adult↗
PubMed1990

Mobility of the lower lumbar spine after posterolateral fusion determined by roentgen stereophotogrammetric analysis.

To determine the time-table for intervertebral stabilization after posterolateral fusion without osteosynthesis in the lower lumbar spine, 11 patients with no previous spinal surgery and with fusion due to spondylolysisolisthesis Grade 1 to 2 or lumbar disc disorder/facet joint arthrosis were examined by roentgen stereophotogrammetric analysis (RSA) in supine and erect positions, and by conventional radiography for 1 year after surgery. In eight patients with osseous fusion radiographically, the sagittal and the vertical translations between the fused vertebral segments began to decrease after 3 to 6 months. However, the time for rigid fusion as defined by RSA varied between 3 months and 1 year, and in four patients sagittal/vertical translations of mostly less than 1 mm still persisted at 1 year postoperatively. In three patients with poor fusion radiographically, no rigid fusion as defined by RSA was obtained. Sagittal/vertical translations of 1 to 10 mm persisted at 1 year postoperatively in these patients. The preoperative pain disappeared in all patients except in one who had osseous fusion radiographically but persisting translations after 1 year.

Adult↗
PubMed1990

Secondary total hip replacement after fractures of the femoral neck.

We studied the rate of revision in 84 consecutive total hip replacements performed for failed osteosynthesis of femoral neck fractures and compared it with that for primary arthroplasty for osteoarthritis. The age and sex adjusted risk of prosthetic failure was 2.5 times higher after failure of fixation, but all the excess risk was in patients over 70 years of age. There were radiographic signs of loosening of the femoral component at five to 12 years after secondary arthroplasty in six of 33 survivors. In general, the results of secondary replacement were no worse than those obtained after primary arthroplasty for femoral neck fracture. We consider that internal fixation should be the primary procedure: total hip replacement is a safe secondary procedure when osteosynthesis fails.

Age Factors↗
PubMed1989

Function after total hip replacement for primary osteoarthritis.

We have reviewed 505 cases of surviving total hip replacement for primary osteoarthritis and studied the functional result and pain relief obtained between four and fourteen years after implantation. The risk factors were stratified and evaluated by multivariate statistical analysis. The patients were satisfied with the result of arthroplasty, and long-term function was improved in 95% of cases. The risk of postoperative hip pain was increased by knee pain, a snap-fit prosthesis with a 35 mm head, and a short wedge-shaped femoral stem, and by replacement at an early age. Function was impaired postoperatively by hip pain, bilateral hip disorders, intercurrent disease affecting locomotion and by old age at the time of surgery. The functional result was not related to the time from operation. The functional result after hip arthroplasty can be evaluated in a logical, unbiased and thorough way using multivariate statistical analysis.

Activities of Daily Living↗
PubMed1988

Ca2+ influx in normal and spherocytic red cells.

The influx of 45Ca2+ into normal red cells and various types of spherocytic red cells was studied after blocking active Ca2+ extrusion by vanadate. The measurements were performed with and without verapamil, a calcium antagonist. The influx of Ca2+ into red cells from unsplenectomized persons was 22 +/- 7 mumol/l packed red cells/h (mean +/- SD), and 17 +/- 7 mumol/l per h when incubated with verapamil. The influx of Ca2+ into red cells from four splenectomized normal controls was of the same magnitude as in the unsplenectomized controls but there was no effect of verapamil on the influx rate. The influx of Ca2+ into red cells from nine splenectomized patients with hereditary spherocytosis (HS) was 27 +/- 9 mumol/l per h without and 24 +/- 9 mumol/l per h with verapamil. In 9 normal red cell samples made spherocytic by thermal damage the corresponding values were 32 +/- 16 and 31 +/- 19 mumol/l per h, respectively. The uptake of Ca2+ in chlorpromazine-induced spherocytic red cells was 20 +/- 4 mumol/l per h without and 19 +/- 5 mumol/l per h with verapamil in 9 experiments. These results indicate that although in HS erythrocytes changes in the cell membrane lead to an increased Ca2+ influx, the slow calcium channels are not affected, whereas in spherocytes induced by thermal damage or by incubation with chlorpromazine the channels are blocked, at least partly.

Adult↗
PubMed1988

Revision of total hip replacement for primary osteoarthritis.

During the 11-year-period from 1970 to 1980, 799 total hip arthroplasties with metal-on-plastic prostheses were performed for primary osteoarthritis. In all cases high viscosity cement was used, but not under pressure; acetabular cartilage was removed, but the femoral canal was not plugged. The rate of revision and risk factors were evaluated by survivorship analysis. The overall cumulative revision rates were 11%, 14% and 19% after 8, 10, and 14 years respectively. When prophylactic antibiotics were not used, there was a significant risk of revision for infection. The risk of revision for mechanical loosening of both the acetabular and femoral components was significantly increased for men, younger patients, and if a snap-fit prosthesis with a 35 mm head and short wedged stem was used. The survivorship findings were validated by multivariate statistical analysis.

Adult↗
PubMed1988

Cost of sick leave for total hip replacement.

Totally, 42/92 nonretired patients between 50 and 59 years of age were on sick leave for more than 6 months before total hip replacement for primary arthrosis. Reductions of these periods of sick leave to 6 months each would have meant a productive gain to society of 41,000-653,000 Swedish kronor per patient. The range in the estimate is due to the degree of causal relationship between preoperative and postoperative sick leave/early retirement.

Absenteeism↗
PubMed1988

Physiotherapy after total hip replacement for primary arthrosis.

Organized physiotherapy starting two months after uncomplicated total hip replacements for primary arthrosis did not improve the rehabilitation. Six months after surgery there were no significant differences between 14 patients with and 16 patients without physiotherapy regarding improvement of passive hip motion, or hip or knee muscle strength of the operated limb. Neither were there any differences in walking ability or activities of daily living.

Activities of Daily Living↗
PubMed1987

Incidence of hip replacement in southern Sweden.

During the years 1981-1982, 1,729 hip replacements were performed in the population of 943,000 persons in the nine southernmost orthopedic districts of Sweden. This is equivalent to 7,600 hip replacements per annum in the 8.3 million Swedish population. Based on the highest annual district incidence, the national equivalent increases to 12,500. Arthrosis accounted for 57 per cent of the arthroplasties, hip fracture for 23 per cent, and failed total hip replacement for 10 per cent.

Arthritis↗
PubMed1986

Revision of total hip replacement with solid cortico-spongious bone graft for medial acetabular disruption.

In revision of failed total hip replacements with disruption of the medial acetabular wall the use of autogenous solid cortico-spongious bone graft proved to be a successful surgical procedure. In 7/8 revisions followed for 2-3 years, the bone grafts healed, as seen radiographically on plain film or by conventional tomography and no further acetabular protrusion occurred. Two of these seven hips had a radiolucent zone of 2-5 mm at the bone-cement interface at the inferior part of the cup. In the eighth hip the bone graft was resorbed/eroded and the cup had migrated 4 mm in the mediocranial direction.

Acetabulum↗
PubMed1986

Occupation after hip replacement for arthrosis.

After hip replacement for primary arthrosis, 69/104 patients younger than 60 years returned to work within 2 years. Long preoperative sick leave increased the risk of both retirement and long postoperative sick leave. The retirement rate was also influenced by occupation, whereas sex, age, or bilateral operations had no influence on postoperative retirement nor on postoperative sick leave.

Absenteeism↗