Lennart Hovelius

Rupture of the Distal Biceps Tendon: Report of Five Cases

Five cases of rupture of the distal biceps tendon are described. Three were operated on--two in the acute stage and one after 3 months--and the other two were managed conservatively. The literature on this condition is reviewed and alternative forms of treatment are discussed.

An Alternative Method for Exchange Operation of Infected Arthroplasty

The use of bone cement balls in chains loaded with gentamycin (gentamycin-PMMA-ketten) as part of a two-stage exchange operation has proven to be a good method of treatment for infected arthroplasty. The procedure is illustrated by three case reports.

Acromioclavicular Separations Treated Conservatively: A 5-year Follow-up Study

Seventy patients with acute acromio-clavicular separation were examined retrospectively after treatment with a minimum of immobilization. the mean interval between injury and follow-up was 6 years. in 37 patients with partial separation, the results were excellent in 24 and good in 13. in 30 patients with complete separation, the results were excellent in 7, good in 23 and unsatisfactory in 3. the radiographic findings are discussed. At follow-up, complete separation had often caused remodeling with stability of the joint.

Function after tibial osteotomy for medial gonarthrosis below aged 50 years.

Twenty-seven patients (28 knees), with a median age of 42 (27-50) years treated with a high tibial osteotomy for early medial gonarthrosis (Ahlbäcks Stage I) were examined after 11 (7-18) years. Twenty-four were men; 18 knees had had previous meniscus and ligament lesions. At follow-up, 22 knees were satisfactory and 9 patients managed high-activity sports or heavy work. In 25/28 knees, the arthrotic process had not progressed radiographically.

Acromioplasty for impingement syndrome.

In 51 patients (27-67 years) with subacromial impingement syndrome, an acromioplasty according to Neer was performed. In 11 patients, acromioclavicular arthrosis was found, and in these patients the lateral end of the clavicle was resected as well. The patients have been followed for an average of 21 (6-42) months. The result was excellent or good in 33 patients. In seven patients there was no improvement.

Impacted morsellized allograft and cement for revision total knee arthroplasty : a preliminary report of 3 cases

In 3 cases we have revised a failed knee arthroplasty with intramedullary impaction of morsellized allograft similar to the technique described for the hip. Follow-up after 18, 21 and 28 months showed good clinical and radiographic results.

Aneurysm of Popliteal Artery Caused by Cartilaginous Exostosis: A Case Report

A case is reported of traumatic aneurysm in a young man, caused by cartilaginous exostosis distally in the femur. An analysis is given of 18 similar cases from the literature.

Reduced bleeding through temporary balloon occlusion in hip and knee revision surgery

We used temporary balloon occlusion of the iliac or femoral artery to reduce blood loss in major hip or knee operations in 15 cases in 13 patients. The balloon was introduced by an interventional radiologist in the afternoon of the day before surgery or in the morning before. A latex occlusion balloon was inserted via the transfemoral ipsi- or contralateral route. The patients received two 40 mg doses of low molecular weight heparin. At the beginning of the operation, saline was injected into the predetermined volume to inflate the balloon. The balloons were inflated during 1-6 hours. In each case, the balloon occlusion clearly reduced bleeding in the surgical field and facilitated surgery. The perioperative bleeding was reduced by half, as compared to a retrospective control group. We measured the intraarterial blood pressures distally to the balloon in 2 patients. They decreased from 120 to 40 mm Hg and 155 to 50 mm Hg, respectively, after inflation. Two complications occurred, one bleeding due to catheter dislocation the night before surgery and one postoperative necrosis of the tip of a toe in a patient in whom the deflated balloon was not extruded until the day after surgery and the dose of heparin was too low.

Pes anserinus transfer for the unstable knee: A 7-year follow-up of 43 cases of ruptured anterior cruciate ligament

On average 7 years postoperatively, we evaluated 43 consecutive patients who had had pesoplasty for chronic injury of the anterior cruciate ligament. Fourteen patients had undergone further surgery during the follow-up period; ten of these had extra- or intra-articular stabilizing procedures, and eight meniscectomies were performed after the index operation. At follow-up of the 33 knees that had not had additional stabilizing surgery, only one-third of the knees had normal radiograms, and the majority had anterolateral rotational instability (pivot shift) which, however, did not exclude satisfactory knee function. We conclude that improvement after transfer of the pes anserinus tendons was due to the simultaneous meniscectomy; we do not believe that the pesoplasty changed the natural course of the chronic rupture of the anterior cruciate ligament.