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oai:gupea.ub.gu.se:2077/331082013-11-05T02:30:19Zcom_2077_284com_2077_17com_2077_10556col_2077_305col_2077_310col_2077_10557

Östberg Elmlund, Anna 2013-11-04T10:10:33Z 2013-11-04T10:10:33Z 2013-11-04 978-91-628-8755-1 (pdf) 978-91-628-8754-4 (tryckt) http://hdl.handle.net/2077/33108 ABSTRACT The aim of the thesis was to explore the clinical and radiographic results after post- traumatic anterior shoulder instability treated with arthroscopic Bankart surgery using absorbable tacks with different compositions. Further aims were to explore possible effects on bone mineral in the heel bone and health-related quality of life after a shoulder-stabilising surgical procedure. Study I was a clinical long-term study of 81 patients (84 shoulders) operated on using tacks made of PGA (polygluconate B polymer). The majority of patients had good functional results after eight years, although 18% had recurrent instability. Study II was a randomised, controlled study (RCT) using two different tacks, PGA and PLLA (poly-L-lactate acid polymer), with a clinical and radiographic evaluation after seven years. The drill holes after implanting PLLA tacks (18 patients) had healed to a lesser extent (55% unhealed) than those after implanting PGA tacks (17 patients), (0% unhealed), seven years after the operation. There were no differences between the groups regarding radiographic degenerative findings or functional results. Study III (32 patients, 34 shoulders) was a clinical and radiographic two- and eight-year follow-up after reconstruction using PGA implants. As in Study II, the radiographs were classified with regard to the drill-hole appearance and degenerative changes. In Study III, the radiological degenerative changes increased from no changes preoperatively to 24% mild and 18% moderate degenerative changes eight years postoperatively. In Study IV (23 patients), bone mineral was evaluated using Dual-Energy X-ray Absorptiometry (DEXA) combined with laser measurement in the heel bone preoperatively and until five years postoperatively. Activity level was classified according to Tegner activity level and health-related quality of life was classified with the Euroqol 5-dimension (EQ-5D) instrument. The bone mineral had decreased by 6% in the calcaneus five years after the operation. The activity level did not increase, but the EQ-5D increased after the operation. eng I. A long-term clinical follow-up study after arthroscopic intra-articular Bankart repair using absorbable tacks. Elmlund A, Kartus C, Sernert N, Hultenheim I, Ejerhed L. Knee Surg Sports Traumatol Arthrosc. 2008 Jul;16(7):707-12. ::doi::10.1007/s00167-008-0534-x II. A 7-year prospective, randomized, clinical, and radiographic study after arthroscopic Bankart reconstruction using 2 different types of absorbable tack. Elmlund AO, Kartus J, Rostgård-Christensen L, Sernert N, Magnusson L, Ejerhed L. Am J Sports Med. 2009 Oct;37(10):1930-7. ::doi::10.1177/0363546509335197 III. Dislocation arthropathy and drill hole appearance in a mid- to long-term follow-up study after arthroscopic Bankart repair. Elmlund AO, Ejerhed L, Sernert N, Rostgård LC, Kartus J. Knee Surg Sports Traumatol Arthrosc. 2012 Nov;20(11):2156-62. ::doi::10.1007/s00167-012-2076-5 IV. Bone mineral decreases in the calcanei after arthroscopic Bankart reconstruction: a prospective study over five years Anna O. Elmlund, Jüri Kartus, Lars Ejerhed Manuscript shoulder dislocation arthroscopic dislocation arthropathy BMA Arthroscopic Bankart reconstruction using different absorbable tacks. The clinical results, radiographic findings and effect on calcaneal bone mineral text Doctoral thesis Doctor of Philosophy anna.ostberg-elmlund@ds.se Mitt korrekta namn i rätt ordning är: Anna Östberg Elmlund. Det är två ISBN nummer för enligt ISBN centralen ska den tryckta boken ha ett ISBN nummer (Tryckta boken ISBN 978-91-628-8754-4) och den e-publicerade ett annat (e-publicerade ISBN 978-91-628-8755-1) University of Gothenburg. Sahlgrenska Academy Institute of Clincial Sciences. Department of Orthopaedics Onsdagen den 20 november 2013, kl. 9.00, Mölndalsaulan, V-huset, Sahlgrenska Universitetssjukhuset/Mölndal 2013-11-20 SA open.access