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Norlin, Rolf
Publications (10 of 15) Show all publications
Hoe-Hansen, C. & Norlin, R. (2003). Intramedullary cancellous screw fixation for nonunion of midshaft clavicular fractures. Acta Orthopaedica Scandinavica, 74(3), 361-364
Open this publication in new window or tab >>Intramedullary cancellous screw fixation for nonunion of midshaft clavicular fractures
2003 (English)In: Acta Orthopaedica Scandinavica, ISSN 0001-6470, Vol. 74, no 3, p. 361-364Article in journal (Refereed) Published
Abstract [en]

6 patients with symptomatic nonunion of midsnait clavicular fractures were treated by internal fixation with an intramedullary cancellous screw and autologous cancellous bone grafting.

At follow-up after median 21 (12–72) months, all nonunions had healed. The Constant score was median 98 (57–100) points. 1 patient, with shortening of the clavicle, had poor function.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-27918 (URN)10.1080/00016470308540853 (DOI)12679 (Local ID)12679 (Archive number)12679 (OAI)
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
Tillander, B., Franzen, L. & Norlin, R. (2002). Fibronectin, MMP-1 and histologic changes in rotator cuff disease. Journal of Orthopaedic Research, 20(6), 1358-1364
Open this publication in new window or tab >>Fibronectin, MMP-1 and histologic changes in rotator cuff disease
2002 (English)In: Journal of Orthopaedic Research, ISSN 0736-0266, E-ISSN 1554-527X, Vol. 20, no 6, p. 1358-1364Article in journal (Refereed) Published
Abstract [en]

This study was designed to investigate human surgical specimens from patients with impingement (n = 16), ruptured supraspinatus tendons (n = 7), frozen shoulder (n = 2) and controls (n = 9) with respect to histological changes and the presence of fibronectin and Matrix metalloprotease-1 (MMP-1). The biopsy of the middle part of the supraspinatus tendons was analyzed microscopically after staining with hematoxyline eosin, Van Giesons hematoxyline and Phospho Tungstic Acid Hematoxyline for visualization of fibrin. Immunofluorescent stainings for fibronectin and MMP-1 were performed. Histology and immunofluorescence were assessed blindly. Necrotic tendinous tissue and fibrin were found only in some specimens from ruptures. The staining for fibronectin was significantly increased among patients with a rupture. MMP-1 was, however, only infrequently found in specimens from patients with impingement and ruptures. Fibrosis and thinning of fascicles seemed to be a more non-specific finding, appearing in control, impingement and rupture specimens. In conclusion, necrotic tendinous tissue, fibrin and fibronectin appear to be signs of tendon degeneration, whereas fibrosis and thinning of fascicles were found also in controls. © 2002 Orthopaedic Research Society. Published by Elsevier Science Ltd. All rights reserved.

Keywords
Fibronectin, Impingement syndrome, Matrix metalloprotease-1 (MMP-1), Rotator cuff rupture
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-46791 (URN)10.1016/S0736-0266(02)00057-8 (DOI)
Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2017-12-13
Raske, A. & Norlin, R. (2002). Injury incidence and prevalence among elite weight and power lifters. American Journal of Sports Medicine, 30(2), 248-256
Open this publication in new window or tab >>Injury incidence and prevalence among elite weight and power lifters
2002 (English)In: American Journal of Sports Medicine, ISSN 0363-5465, E-ISSN 1552-3365, Vol. 30, no 2, p. 248-256Article in journal (Refereed) Published
Abstract [en]

The purpose of this study was to investigate the incidence and prevalence of injuries among elite weight lifters and power lifters, with a special focus on shoulder injuries and possible injury-provoking exercises. In 1995, a questionnaire was administered to 110 male and female elite lifters to evaluate injuries and training characteristics. A follow-up of the athletes from 1995 was conducted in 2000, and a new 2000 elite group was also queried. In 1995 and again in 2000, the athletes sustained, on average, 2.6 injuries per 1000 hours of activity. Most common in 1995 were low back injuries, with an injury rate of 0.43 per 1000 hours, and shoulder injuries, with a rate of 0.42 per 1000 hours. Shoulder injuries dominated in 2000, with an injury rate of 0.51 per 1000 hours of activity. There was a difference in injury pattern between weight lifters, who mostly sustained low back and knee injuries, and power lifters, in whom shoulder injuries were most common. No correlation was found between shoulder injuries and any specific exercise. Although the total injury rate was the same during the two periods of study, the rate of shoulder injuries had increased.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-48935 (URN)
Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2017-12-12
Tillander, B. & Norlin, R. (2002). Intraoperative measurements of the subacromial distance. Arthroscopy : the journal of arthroscopic & related surgery, 18(4), 347-352
Open this publication in new window or tab >>Intraoperative measurements of the subacromial distance
2002 (English)In: Arthroscopy : the journal of arthroscopic & related surgery, ISSN 0749-8063, Vol. 18, no 4, p. 347-352Article in journal (Refereed) Published
Abstract [en]

Purpose: The purpose of this study was 2-fold: to document the accuracy of a new measuring device and to intraoperatively compare the subacromial distance between controls and patients with impingement syndrome before and after arthroscopic subacromial decompression (ASD).

Type of Study: Clinical study.

Methods: When performing an ASD, it is important that bone resection is adequate. Today the correct subacromial distance after bone resection is only assessed by eye, directly or indirectly. The subacromial distance was measured between the anterolateral corner of the acromion and the supraspinatus tendon in the lateral decubitus position. The device was inserted 2 to 3 cm below the anterolateral acromion. There was no subacromial pathology among the controls (n = 15, mean age, 28 years). In 30 patients with impingement syndrome (average age, 53 years) an ASD was performed. The subacromial distance was measured after bursectomy and then after bone resection. Intraindividual and interindividual assessment was performed.

Results: The mean value of the subacromial distance in controls was 16 mm, the 95% confidence limits between 14 and 18 mm. The mean value in the group of patients with impingement syndrome was 8 mm before and 16 mm after the decompression. Due to the pressure within the subacromial space, the subacromial distance increased 1 mm. Intraindividual measurements never varied more than 1 mm (n = 5). The correlation coefficient between the measurements by both authors was 0.99.

Conclusions: In this study, we assessed and described the use of a measuring device that enables the surgeon to quantify the subacromial distance before and after bone resection. After bone resection, the mean value of the subacromial distance was well within the control values. The amount of bone resected varied from 5 to 13 mm. This new device enables documentation in clinical work as well as in research.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-13706 (URN)10.1053/jars.2002.30040 (DOI)
Available from: 2001-11-27 Created: 2001-11-27 Last updated: 2009-08-21
Tillander, B., Franzén, L., Nilsson, E. & Norlin, R. (2001). Carrageenan-induced subacromial bursitis caused changes in the rat's rotator cuff. Journal of Orthopaedic Research, 19(3), 441-447
Open this publication in new window or tab >>Carrageenan-induced subacromial bursitis caused changes in the rat's rotator cuff
2001 (English)In: Journal of Orthopaedic Research, ISSN 0736-0266, Vol. 19, no 3, p. 441-447Article in journal (Refereed) Published
Abstract [en]

This study was designed to investigate the histologic expression of the rat's supra- and infraspinatus tendons in carrageenan-induced subacromial bursitis. Thirty-two rats received subacromial injections with carrageenan (n = 28) or saline (n = 4). The tendons were analysed microscopically after staining with hematoxyline eosin, Van Giesons hematoxyline and immunofluorescent staining of fibronectin and fibrinogen. In the controls (saline × 10) and group A (carrageenan × 5) there were no changes in the tendons. In group B (carrageenan × 10) 3/8 rats showed macrophages between the collagen fibres and an increased staining of fibronectin. In group C (double dosis carrageenan) all rats had signs of fibrocartilaginous metaplasia in the supraspinatus tendon. In eight of these specimens even bony metaplasia was seen. The infraspinatus tendon showed fibrosis but no fibro-cartilaginous metaplasia. The results showed that iatrogenic bursitis after carrageenan subacromial injections was associated with marked changes of the supraspinatus tendon.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-13705 (URN)10.1016/S0736-0266(00)90022-6 (DOI)
Available from: 2001-11-27 Created: 2001-11-27 Last updated: 2009-08-21
Tillander, B. & Norlin, R. (2001). Intraoperative measurement of shoulder translation. Journal of shoulder and elbow surgery, 10(4), 358-364
Open this publication in new window or tab >>Intraoperative measurement of shoulder translation
2001 (English)In: Journal of shoulder and elbow surgery, ISSN 1058-2746, E-ISSN 1532-6500, Vol. 10, no 4, p. 358-364Article in journal (Refereed) Published
Abstract [en]

Assessing laxity of the shoulder joint in patients who are under anesthesia is a standard procedure before arthroscopy. The aim of this study was to evaluate a novel instrument for quick and reliable intraoperative measurement of glenohumeral translation. Previous testing of various designs has resulted in a device secured by 1 pin in the acromion and 1 pin in the proximal humerus. These pins are interconnected by a sliding ruler that gives translation values in millimeter increments as the laxity tests are performed. Comparison between manual arbitrary approximation of laxity and instrumented translation measurements showed that manual testing is reasonably good for assessment of anterior and posterior translation, without, however, providing values of translation in millimeter increments. The low correlation between manual assessment and instrumented inferior translation measurements indicates that inferior translation is more difficult to approximate manually. The shoulder translation tester was used in 102 patients. The mean values for clinically stable shoulders (n = 58) were 5 mm for anterior translation, 5 mm for posterior translation, and 4 mm for inferior translation. The corresponding values in unstable shoulders were significantly higher than in the stable shoulders, especially in patients with multidirectional instability. We conclude that the shoulder translation tester is easy and quick to use. It provides quantitative values of translation and will thus contribute information for correct diagnosis, therapy, and documentation.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-47336 (URN)10.1067/mse.2001.116651 (DOI)
Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2017-12-13
Ålund, M., Hoe-Hansen, C., Tillander, B., Héden, B.-Å. & Norlin, R. (2000). Outcome after cup hemiarthroplasty in the rheumatoid shoulder: A retrospective evaluation of 39 patients followed for 2-6 years. Acta Orthopaedica Scandinavica, 71(2), 180-184
Open this publication in new window or tab >>Outcome after cup hemiarthroplasty in the rheumatoid shoulder: A retrospective evaluation of 39 patients followed for 2-6 years
Show others...
2000 (English)In: Acta Orthopaedica Scandinavica, ISSN 0001-6470, Vol. 71, no 2, p. 180-184Article in journal (Refereed) Published
Abstract [en]

33 rheumatoid patients, treated with hemispherical cup resurfacing hemiarthroplasty of the shoulder without medullary fixation (6 bilaterally), were reviewed after mean 4.4 (2-6) years. The median Constant score was 30 (15-79), mean proximal migration of the humerus 5.5 (SD 5.2) mm and mean glenoid erosion 2.6 (SD 1.7) mm. Proximal migration and glenoid erosion did not correlate with shoulder function or pain. Radiographic signs of loosening (changes in cup inclination combined with changes in cup distance above the greater tuberosity) occurred in one quarter of the shoulders. At follow-up, 26 patients were satisfied with the procedure, despite poor shoulder function and radiographic deterioration.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-26951 (URN)10.1080/000164700317413166 (DOI)11583 (Local ID)11583 (Archive number)11583 (OAI)
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
Tillander, B., Franzén, L., Karlsson, M. H. & Norlin, R. (1999). Effect of steroid injections on the rotator cuff: An experimental study in rats. Journal of shoulder and elbow surgery, 8(3), 271-274
Open this publication in new window or tab >>Effect of steroid injections on the rotator cuff: An experimental study in rats
1999 (English)In: Journal of shoulder and elbow surgery, ISSN 1058-2746, Vol. 8, no 3, p. 271-274Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to evaluate the effects of repeated steroid injections into the subacromial space. Thirty rats were injected either 3 or 5 times with triamcinolone in a dosage equivalent to that given to human beings or 3 or 5 times with saline into the subacromial space. One rat received no injection. The supraspinatus and infraspinatus tendons were evaluated macroscopically and microscopically. Two different staining methods were used on each sample including hematoxylin eosin and Miller's elastin/van Gieson's solution. After 5 steroid injections, we found focal inflammation, necrosis, and fragmentation of collagen bundles in the tendon in 4 of 7 rats. The tendons of the controls showed a normal structure (P < .05). There were no pathologic changes among the rats that were injected with triamcinolone 3 times. These results show that repeated subacromial injections of triamcinolone may cause damage to the rotator cuff of the rat. This finding may indicate cautious use of subacromial steroid injections in human beings.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-13704 (URN)10.1016/S1058-2746(99)90141-6 (DOI)
Available from: 2001-11-27 Created: 2001-11-27 Last updated: 2009-08-21
Hoe-Hansen, C. & Norlin, R. (1999). The Clinical Effect of Ketoprofen After Arthroscopic Subacromial Decompression: A Randomized Double-Blind Prospective Study. Arthroscopy: The Journal of Arthroscopy And Related, 15(3), 249-252
Open this publication in new window or tab >>The Clinical Effect of Ketoprofen After Arthroscopic Subacromial Decompression: A Randomized Double-Blind Prospective Study
1999 (English)In: Arthroscopy: The Journal of Arthroscopy And Related, ISSN 0749-8063, E-ISSN 1526-3231, Vol. 15, no 3, p. 249-252Article in journal (Refereed) Published
Abstract [en]

The purpose of the study was to evaluate the clinical effect of ketoprofen after arthroscopic subacromial decompression (ASD). The design was randomized, prospective, and double-blind, with a placebo control group. Forty-one consecutive patients with subacromial impingement syndrome, were randomized to treatment with ketoprofen 200 mg once daily or placebo for 6 weeks following ASD. For additional analgesia, patients used paracetamol if necessary. Clinical follow-up was performed at 6 weeks and at 2 years postoperatively. At the 6-week follow-up, the patients treated with ketoprofen had a statistically significant increase in UCLA total score (P < .05), range of movement (P < .05), and satisfaction (P < .05), and they had significantly less pain (P < .05). There was no statistical difference between the ketoprofen and placebo groups regarding strength. Patients receiving ketoprofen had significantly less need for additional analgesia (P < .05). At the 2-year follow-up, there were no differences in the scores between the ketoprofen and placebo group.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-27821 (URN)10.1016/S0749-8063(99)70029-0 (DOI)12573 (Local ID)12573 (Archive number)12573 (OAI)
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
Hoe-Hansen, C., Palm, L. & Norlin, R. (1999). The influence of cuff pathology on shoulder function after arthroscopic subacromial decompression: A 3- and 6-year follow-up study. Journal of shoulder and elbow surgery, 8(6), 585-589
Open this publication in new window or tab >>The influence of cuff pathology on shoulder function after arthroscopic subacromial decompression: A 3- and 6-year follow-up study
1999 (English)In: Journal of shoulder and elbow surgery, ISSN 1058-2746, E-ISSN 1532-6500, Vol. 8, no 6, p. 585-589Article in journal (Refereed) Published
Abstract [en]

In the literature operative management of rotator cuff ruptures in the shoulder varies, from tendon repair to debridement of the cuff lesion combined with subacromial decompression. This study was made to evaluate whether patients with intact rotator cuff differed from patients with rotator cuff ruptures regarding functional outcome after arthroscopic subacromial decompression. We performed a clinical review of 39 patients with subacromial impingement who all underwent arthroscopic subacromial decompression; no other surgery was performed. There were 13 patients with intact cuff, 13 patients with partial-thickness supraspinatus ruptures, and 13 patients with full-thickness supraspinatus ruptures <2 cm. Selection was based solely on the status of the supraspinatus tendon. Patients with other pathologic conditions were excluded. Follow-up was performed after 3 and 6 years. The clinical evaluation was performed with the Constant score and the visual analog pain score. The 3- and 6-year follow-up (100% follow-up rate) revealed no significant difference between the groups regarding the Constant scores and the visual analog scale values. Also, no significant difference was seen among the 3 groups in active range of motion or strength, and the patients had no appreciable pain. We conclude that the functional outcome 6 years after arthroscopic subacromial decompression is not obviously related to the preoperative degree of cuff pathology, even if a total rupture of small size is present.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-49917 (URN)10.1016/S1058-2746(99)90094-0 (DOI)
Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2017-12-12Bibliographically approved
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