Martina Hansens Hospital

Martina, Norway

Martina Hansens Hospital

Martina, Norway
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Ekeland A.,Martina Hansens Hospital | Nerhus T.K.,Martina Hansens Hospital | Dimmen S.,Lovisenberg Diaconal Hospital | Thornes E.,Martina Hansens Hospital | Heir S.,Martina Hansens Hospital
Knee | Year: 2017

Background To report time dependent functional improvement and predictive risk factors for failure when the load in varus knees with medial osteoarthritis is shifted from the medial to the lateral knee compartment. Methods Forty-nine consecutive patients (52 knees), mean age 47 (31–64) years, underwent a high tibial opening-wedge valgus osteotomy stabilized with a Puddu plate and bone grafting. The patients were evaluated with the Knee Injury and Osteoarthritis Outcome Score (KOOS) preoperatively and at three and six months, one, two, five and 10 years postoperatively with a mean follow-up time of 8.3 years (2.0–10.6). Results Mean angular correction was 8.0° (four to 12). The five subscores of KOOS increased significantly during the first year by 40–131% from preoperative values, the good results remaining throughout the 10-year follow-up for those with a surviving osteotomy. The outcome was related to the grade of preoperative osteoarthritis. Seven knees were converted to total knee arthroplasty (TKA) mean 6.2 years (two to nine) post-operatively, and had a lower KOOS preoperatively than those of surviving osteotomies. The osteotomy survival rate at five years was 94% and at 10 years 83%. Patients with KOOS subscore quality of life (QoL) < 44 at the two-year follow-up had a 11.7 times higher risk for later TKA than those with QoL ≥ 44 (P = 0.017). Conclusion High tibial opening-wedge osteotomy for medial knee osteoarthritis resulted in good functional recovery after one year and favorable mid-term results. It may be a good treatment option for middle-aged patients with varus knees and medial osteoarthritis in order to prevent or postpone TKA. © 2016 Elsevier B.V.


Moosmayer S.,Martina Hansens Hospital | Tariq R.,Unilab Diagnostics | Stiris M.G.,University of Oslo | Smith H.-J.,University of Oslo
Acta Orthopaedica | Year: 2010

Background and purpose Why some full-thickness rotator cuff tears are symptomatic and others are asymptomatic is not understood. By comparing MRI findings in symptomatic and asymptomatic tears we wanted to identify any tear characteristics that differed between groups. Patients and methods 50 subjects with asymptomatic and 50 subjects with symptomatic full-thickness tears were examined by MRI. Tear characteristics including tear size tear location the condition of the long head of the biceps atrophy and fatty degeneration of the muscles were compared between groups. Results Single factor logistic regression analysis showed that there were statistically significant associations between symptoms and tear size exceeding 3 cm in the medial-lateral plane positive tangent sign and fatty degeneration exceeding grade 1 of the supraspinatus and infraspinatus muscles. Interpretation We found associations between the symptomatic status of a rotator cuff tear and MRI-derived tear characteristics. The causal relationships are unclear. Copyright: © 2010 Nordic Orthopedic Federation.


Heiberg K.E.,Baerum Hospital | Heiberg K.E.,University of Oslo | Ekeland A.,Martina Hansens Hospital | Mengshoel A.M.,University of Oslo
BMC Musculoskeletal Disorders | Year: 2013

Background: In the field of rehabilitation, patients are supposed to be experts on their own lives, but the patient's own desires in this respect are often not reported. Our objectives were to describe the patients' desires regarding functional improvements before and after total hip arthroplasty (THA). Methods. Sixty-four patients, 34 women and 30 men, with a mean age of 65 years, were asked to describe in free text which physical functions they desired to improve. They were asked before surgery and at three and 12 months after surgery. Each response signified one desired improvement. The responses were coded according to the International Classification of Functioning, Disability and Health (ICF) to the 1§ssup§st§esup§, 2§ssup§nd§esup§ and 3§ssup§rd§esup§ category levels. The frequency of the codes was calculated as a percentage of the total number of responses of all assessments times and in percentage of each time of assessment. Results: A total of 333 responses were classified under Part 1 of the ICF, Functioning and Disability, and 88% of the responses fell into the Activities and Participation component. The numbers of responses classified into the Activities and Participation component were decreasing over time (p < 0.001). The categories of Walking (d450), Moving around (d455), and Recreation and leisure (d920) included more than half of the responses at all the assessment times. At three months after surgery, there was a trend that fewer responses were classified into the Recreation and leisure category, while more responses were classified into the category of Dressing (d540). Conclusions: The number of functional improvements desired by the patients decreased during the first postoperative year, while the content of the desires before and one year after THA were rather consistent over time and mainly concerned with the ability to walk and participate in recreation and leisure activities. At three months, however, there was a tendency that the patients were more concerned about the immediate problems with putting on socks and shoes. © 2013 Heiberg et al.; licensee BioMed Central Ltd.


Heiberg K.E.,University of Oslo | Heiberg K.E.,Baerum Hospital | Bruun-Olsen V.,University of Oslo | Ekeland A.,Martina Hansens Hospital | Mengshoel A.M.,University of Oslo
Arthritis Care and Research | Year: 2012

Objective. To investigate the effect of a 12-session walking skill training program of weight-bearing activities on physical functioning and self-efficacy initiated in patients 3 months after total hip arthroplasty (THA). Methods. Sixty-eight patients with THA, 35 women and 33 men, with a mean age of 66 years (95% confidence interval [95% CI] 64, 67 years), were randomized to a training group (n = 35) or a control group without physiotherapy (n = 33). Assessments were performed before the intervention at 3 months (pretest), at 5 months (posttest 1), and at 12 months (posttest 2) after surgery. The primary outcome was the 6-minute walk test (6MWT). The secondary outcomes were the stair climbing test (ST); figure-of-eight test; Index of Muscle Function (IMF); active hip range of motion (ROM) in flexion, extension, and abduction; Harris Hip Score (HHS); self-efficacy; and Hip Dysfunction and Osteoarthritis Outcome Score. Results. The training group had larger improvements than the control group at posttest 1 on the 6MWT with an adjusted mean difference of 52 meters (95% CI 29, 74 meters; P < 0.001) and on the ST of -1 second (95% CI -2, 0 seconds; P = 0.01).There were also improvements on the figure-of-eight test (P = 0.02), IMF (P = 0.001), active hip ROM in extension (P = 0.02), HHS (P = 0.05), and self-efficacy (P = 0.04). The difference between the groups persisted at posttest 2 on the 6MWT of 52 meters (95% CI 24, 80 meters; P < 0.001) and on the ST of -1 second (95% CI -3, 0 seconds; P = 0.05). Conclusion. The walking skill training program was effective, especially in improving walking both immediately after the intervention and 1 year after THA surgery. © 2012, American College of Rheumatology.


Heiberg K.E.,Baerum Hospital | Heiberg K.E.,University of Oslo | Ekeland A.,Martina Hansens Hospital | Bruun-Olsen V.,University of Oslo | Mengshoel A.M.,University of Oslo
Archives of Physical Medicine and Rehabilitation | Year: 2013

Objectives: To investigate recovery of physical functioning in patients during the first year after total hip arthroplasty (THA), and to predict postoperative walking distance outcomes from preoperative measures. Design: A longitudinal prospective design was used. Data were analyzed by repeated-measures analysis of variance and multivariate regression analyses. Setting: Two hospitals. Participants: Patients with hip osteoarthritis were consecutively included and assessed preoperatively (n=88), at 3 months (n=88), and at 12 months (n=64) after THA. Interventions: Not applicable. Main Outcome Measures: Physical functioning was assessed by objective measures - the 6-minute walk test (6MWT), stair climbing test, Index of Muscle Function, figure-of-eight, and active hip range of motion - and the subjective measures by Harris Hip Score and Hip dysfunction and Osteoarthritis Outcome Score. Results: In objective measures, improvements were found from preoperatively to 3 months in 6MWT (P<.01) and stair climbing test (P<.05) scores, while all measures had improved from 3 to 12 months (P≤.001). In contrast, all the subjective measures showed substantial improvements at 3 months, but small further improvements from 3 to 12 months (P<.001). Age, sex, preoperative 6MWT distance, and hip range of motion predicted 6MWT outcomes at 3 and 12 months (P≤.01). Conclusions: The objective measures of physical functioning improved gradually during the first postoperative year, while the subjective measures showed large early improvements, but little further improvements. Younger age, male sex, and better scores of walking distance and hip flexibility before surgery predicted better score in walking distance at both 3 and 12 months after surgery. © 2013 by the American Congress of Rehabilitation Medicine.


Rotterud J.H.,Akershus University Hospital | Rotterud J.H.,University of Oslo | Sivertsen E.A.,Akershus University Hospital | Sivertsen E.A.,Martina Hansens Hospital | And 6 more authors.
American Journal of Sports Medicine | Year: 2013

Background: The effect of concomitant intra-articular injury on patient-reported outcome after anterior cruciate ligament (ACL) reconstruction is debated. Purpose: To evaluate the effect of meniscal and articular cartilage lesions on patient-reported outcome 2 years after ACL reconstruction. Study Design: Cohort study (prognosis); Level of evidence, 2. Methods: The study included all patients with primary, unilateral ACL reconstruction registered in the Norwegian and the Swedish National Knee Ligament Registry from 2005 through 2008 who had completed the Knee Injury and Osteoarthritis Outcome Score (KOOS) Knee-Related Quality of Life subscale at a 2-year follow-up (mean ± SD, 2.1 ± 0.2 years) after surgery (n = 8476). Multiple linear regression analyses were used to evaluate the associations between each KOOS subscale (Pain, Other Symptoms, Activities of Daily Living, Sport and Recreation Function, Knee-Related Quality of Life) as the measure for patient-reported outcome and meniscal and cartilage lesions. Results: A total of 3674 (43%) patients had meniscal lesion(s), 1671 (20%) had partial-thickness (International Cartilage Repair Society [ICRS] grades 1-2) cartilage lesion(s), and 551 (7%) had full-thickness (ICRS grades 3-4) cartilage lesion(s). Multiple linear regression analyses detected no significant associations between meniscal lesions or partial-thickness cartilage lesions and the scores in any of the KOOS subscales at the 2-year follow-up. Full-thickness cartilage lesions were significantly associated with decreased scores in all of the KOOS subscales. Conclusion: Patients with concomitant full-thickness cartilage lesions reported worse outcome in all of the KOOS subscales compared with patients without cartilage lesions 2 years after ACL reconstruction. Meniscal lesions and partial-thickness cartilage lesions did not impair patient-reported outcome 2 years after ACL reconstruction. © 2013 The Author(s).


Moosmayer S.,Martina Hansens Hospital | Tariq R.,Unilabs Diagnostics | Stiris M.,Unilabs Radiology and Laboratory Services | Smith H.-J.,University of Oslo
Journal of Bone and Joint Surgery - Series A | Year: 2013

Background: Little is known about the clinical and anatomic progression of asymptomatic rotator cuff tears. The purpose of our study was to assess if deterioration in rotator cuff tear anatomy would be correlated to the development of symptoms. Methods: Fifty patients with initially asymptomatic full-thickness rotator cuff tears were followed clinically, sonographically, and bymagnetic resonance imaging over three years. Changes of tear size, muscle atrophy, fatty degeneration, and condition of the long head of the biceps tendon were compared between tears that developed symptoms and those that did not. Results: Eighteen of fifty tears developed symptoms during follow-up. There was a significantly larger increase (p = 0.02) in the mean tear size in the newly symptomatic group (10.6 mm) when compared with the still-asymptomatic group (3.3 mm). The rate of progressing to advanced muscle atrophy was higher (p = 0.08) in the newly symptomatic group (35% [six of seventeen subjects]) when compared with the still-asymptomatic group (12% [three of twenty-five subjects]). The rate of fatty degeneration was significantly higher (p = 0.02) in the newly symptomatic group (35% [six of seventeen subjects]) when compared with the still-asymptomatic group (4% [one of twenty-five subjects]). The rate of pathology of the long head of the biceps tendon was significantly higher (p = 0.02) in the newly symptomatic group (33% [six of eighteen subjects]) when compared with the still-asymptomatic group (6% [two of thirty-two subjects]). Conclusions: During a relatively short-term follow-up, a substantial percentage of asymptomatic rotator cuff tears became symptomatic and underwent anatomic deterioration. Increase in tear size and decrease of muscle quality were correlated to the development of symptoms. Subjects diagnosed with an asymptomatic rotator cuff tear should be informed about the natural history of the condition and follow-up with repeated imaging may be indicated to monitor tear progression. Level of Evidence: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence. Copyright © 2013 by The Journal of Bone and Joint Surgery, Incorporated.


Moosmayer S.,Martina Hansens Hospital | Lund G.,Martina Hansens Hospital | Seljom U.S.,Martina Hansens Hospital | Haldorsen B.,Martina Hansens Hospital | And 4 more authors.
Journal of Bone and Joint Surgery - American Volume | Year: 2014

Methods: A single-center, pragmatic, randomized controlled study with follow-ups after six months and one, two, and five years was conducted in a secondary-care institution. One hundred and three patients with a rotator cuff tear not exceeding 3 cm were randomized to primary tendon repair (n = 52) or physiotherapy (n = 51). The primary outcome measure was the Constant score. Secondary outcome measures included the self-report section of the American Shoulder and Elbow Surgeons score; the physical component summary measure of the Short Form 36 Health Survey; the measurement of pain, strength, and shoulder motion; patient satisfaction; and findings from magnetic resonance imaging and sonography. Analysis was by intention to treat.Results: The five-year follow-up rate was 98%. Twelve of the fifty-one patients in the physiotherapy group were treated with secondary tendon repair. The results from primary tendon repair were superior to those from physiotherapy plus secondary repair, with between-group mean differences of 5.3 points on the Constant score (p = 0.05), 9.0 points on the American Shoulder and Elbow Surgeons score (p 0.001), 1.1 cm on a 10-cm visual analog scale for pain (p 0.001), and 1.0 cm on a 10-cm visual analog scale for patient satisfaction (p = 0.03). In 37% of tears treated with physiotherapy only, there were increasing tear sizes on ultrasound of 5 mm, over five years, associated with an inferior outcome.Conclusions: Although primary repair of small and medium-sized rotator cuff tears was associated with better outcome than physiotherapy treatment, the differences were small and may be below clinical importance. In the physiotherapy treatment group, there were increasing tear sizes and inferior outcomes in one-third of patients who did not undergo repair.Level of Evidence: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence. © 2014 by The Journal of Bone and Joint Surgery, Incorporated.Background: There is limited Level-I evidence that compares operative and nonoperative treatment of rotator cuff tears. We compared outcomes of patients treated with primary tendon repair with outcomes of those treated with physiotherapy and optional secondary tendon repair if needed. © 2014 by The Journal of Bone and Joint Surgery, Incorporated.


Reikeras O.,University of Oslo | Borgen P.,Martina Hansens Hospital | Reseland J.E.,University of Oslo | Lyngstadaas S.P.,University of Oslo
BMC Research Notes | Year: 2014

Background: Trauma induces local and subsequent systemic inflammatory reactions, and when the cytokine production is deregulated, a systemic inflammatory response syndrome with a potentially lethal outcome can occur. The understanding of the physiological mechanism of the cytokine network would be useful to better comprehend pathological conditions. Methods. We analysed a panel of 30 cytokines in the serum of 20 patients operated with total hip replacement. Cytokine release was assessed postoperatively up to 6 days by a multiplex antibody bead kit and compared to pre-operative values. Results: Surgery induced significant increments in serum levels of IL-2R at 6 days after surgery, in levels of IL-6 at 6 hours after surgery and at 1 day after surgery, in levels of IL-8 at 6 hours after surgery, in levels of IL-16 at 6 hours and at 1 day after surgery. Significant decreases in serum levels of IL-1Rα were found at the end of surgery, in levels of IL-12 at the end of surgery and at 6 hours after, and in levels of Eotaxin during all phases of the postoperative course. Conclusions: The major findings were significant increases in systemic levels of the pro-inflammatory cytokines IL-6, IL-8, IL-16, while IL-12 was significantly decreased. Otherwise there were modest changes in the systemic cytokine kinetics and no significant expression of anti-inflammatory cytokines. © 2014 Reikeras et al.; licensee BioMed Central Ltd.


Slungaard B.,Martina Hansens Hospital | Mengshoel A.M.,University of Oslo
Disability and Rehabilitation | Year: 2013

Purpose: To discover whether there are differences between patients with RA with and without active motion deficit in the shoulder (passive ROM greater than active ROM) concerning disease characteristics and shoulder function, and examine the role of active motion deficit in explaining limitations of shoulder function in daily life. Methods: This cross-sectional study included 123 patients with RA having shoulder pain. Disease activity and duration of shoulder pain and disease were registered, active and passive shoulder ROM, pain and muscle strength were measured. Shoulder function in daily life was assessed by Disability of the Arm, Shoulder and Hand (DASH). Results: Patients with active motion deficit (36%) had statistical significant worse scores on disease activity, shoulder pain, muscle strength, and DASH function than those without active motion deficit (p ≤ 0.05). No differences between the groups were found for duration of shoulder pain or disease (p > 0.05). Active motion deficit, passive ROM, muscle strength and pain explained 33.7% of the variation in the DASH function score. Conclusion: Active motion deficit in the shoulder seems frequent in patients with RA. Together with passive ROM, muscle strength and pain, active motion deficit explained about one-third of the limitations in shoulder function in daily life. Implications for Rehabilitation Rheumatoid arthritis (RA) is a chronic inflammatory disease that primarily affects the joints and periarticular tissue. Pain, muscle weakness, and joint destruction may result in reduced range of motion (ROM), which in turn may affect the performance of activities in daily life. Shoulder affection is frequent in patients with RA. About one-third of the patients in the present study had an active motion deficit in the shoulders. Patients with active motion deficit had more shoulder pain and more impaired shoulder function than those without deficit. Active motion deficit associated with limitations in shoulder function in daily life. © 2013 Informa UK, Ltd.

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