Stig Brorson

Zealand University Hospital and University of Copenhagen · Department of Orthopaedic Surgery

Objective The aim of this study was to construct a grounded theory regarding patients' activity behaviour over time after referral to an outpatient clinic for diabetic foot ulcer (DFU) care. Method A constructivist grounded theory approach was used. Data from observations of and interviews with participants were collected and analysed using the co...

Ten questions to assess to what degree a clinical practice guideline is likely to be trustworthy: 1) Do the authors have conflicts of interests? 2) Is the clinical question relevant? 3) Have relevant stakeholders been involved? 4) Have methods for study selection been described? 5) Is there a link between evidence and recommendations (transparent m...

The DEXamethasone twice for pain treatment after Total Knee Arthroplasty (DEX‐2‐TKA) trial showed that adding one and two doses of 24 mg intravenous dexamethasone to paracetamol, ibuprofen and local infiltration analgesia, reduced morphine consumption (primary outcome) within 48 h after TKA. We aimed to explore the differences in the effect of dexa...

Background Network meta-analyses can be valuable for decision-makers in guiding clinical practice. However, for network meta-analysis results to be reliable, the assumptions of both transitivity and coherence must be met, and the methodology should adhere to current best practices. We aimed to assess whether network meta-analyses of randomized cont...

Background Treatment of displaced distal forearm fractures in children have traditionally been closed reduction and pin fixation, although they might heal and remodel without surgery with no functional impairment. No randomized controlled trials have been published comparing the patient-reported functional outcome following non-surgical or surgical...

Aim This study describes the development of a 12-week exercise therapy program for patients with diabetic foot ulcers and the preliminary feasibility of the program focusing on the program's inclusion, adherence, and safety. Methods The development process build on knowledge from a systematic review, and a grounded theory study and involved doctors...

Background and purpose Humeral shaft fractures (HSF) can be treated surgically or non-surgically. National trends and distributions are sparsely reported. We present the temporal trends in epidemiology of adult HSF in Denmark, with the primary aim of reporting HSF incidences, and the secondary aim of reporting on the primary treatment management....

Objectives The DEX‐2‐TKA trial demonstrated that one and two doses of 24 mg intravenous dexamethasone reduced opioid consumption and pain after total knee arthroplasty (TKA). We aimed to investigate the prolonged effects of dexamethasone after the 48‐h intervention period. Design This was a prospective, pre‐planned questionnaire follow‐up on posto...

Introduction: Orthopaedic practice is not always aligned with new evidence which may result in an evidence-practice gap. Our aim was to present and report the use of a new model for implementation of evidence-based practice using treatment of distal radius fractures (DRF) as an example. Methods: A new implementation model from the Centre for Evi...

Introduction: The purpose of this study was to validate the humeral fracture diagnoses for adults in the Danish National Patient Registry (DNPR). Methods: This was a population-based validity study, including adult patients (≥ 18 years) with a humeral fracture referred to the emergency department of hospitals in three Danish regions from March 2...

The aim of this study was to investigate surgeons’ reported change of treatment preference in response to the results and conclusion from a randomized controlled trial (RCT) and to study patterns of change between subspecialties and nationalities. Two questionnaires were developed through the Delphi process for this cross-sectional survey of surgic...

Objective: To assess how much protocols reduce methodological flexibility and variation of results in meta-analyses comparing operative with non-operative treatments for proximal humerus fractures. Study design and setting: Meta-epidemiological study. We searched four bibliographic databases for eligible meta-analyses. We contacted the authors o...

Exercise therapy helps improve glycaemic control and insulin sensitivity and may be relevant in treating patients with diabetic foot ulcers (DFUs). This study describes the development of a 12-week exercise therapy program for patients with DFUs and the preliminary feasibility of the program focusing on the program's inclusion, adherence, and safet...

Background The RECIPE trial systematically investigates effects of different combinations of paracetamol, ibuprofen and dexamethasone for pain treatment after total hip arthroplasty. To preserve transparency, minimize risk of bias, and to prevent data-driven analysis, we present this detailed statistical analysis plan. Methods The RECIPE trial is...

Introduction: An increasing number of patients with displaced proximal humerus fractures (PHF) are being offered non-surgical treatment, including short immobilisation and structured rehabilitation. There are no randomised controlled trials (RCTs) comparing structured rehabilitation with non-structured rehabilitation to investigate the benefits of...

Background and purpose: Proximal humeral fractures (PHF) can be managed surgically or non-surgically. Locking plates have been the preferred head-preserving surgical technique while hemiarthroplasty (HA) or reverse shoulder arthroplasty (RSA) have been used in joint replacement surgery. We describe the epidemiology and trends in management of acut...

Introduction Diabetic foot ulcers (DFUs) are associated with extensive consequences for the affected patients and treatment of these hard-to-heal ulcers is known for being challenging. New treatment methods to supplement the current standard care may improve the prognosis for these patients. A preceding feasibility trial with promising results, fac...

Introduction Multimodal analgesia with paracetamol, non-steroidal anti-inflammatory drug and glucocorticoid is recommended for hip arthroplasty, but with uncertain effects of the different combinations. We aim to investigate benefit and harm of different combinations of paracetamol, ibuprofen and dexamethasone following total hip arthroplasty. Met...

This article is based on a Cochrane Review published in the Cochrane Database of Systematic Reviews (CDSR) 2022, Issue 6, DOI: 10.1002/14651858.CD000434.pub5. (see www.cochranelibrary.com for information).

Introduction Humeral shaft fracture treatment can induce serious morbidities, and it is unclear how these morbidities impact patients. To gain in-depth knowledge, we explored how patients experience humeral shaft fractures and the subsequent treatment course. Method A qualitative study was performed using semi-structured individual interviews. A p...

Background Proximal humerus fractures (PHF) should be subject to standardized monitoring during treatment, whether non-operative or operative, to document and adequately assess bone healing. The purpose of this study was to develop a standardized protocol for an image-based monitoring of PHF for joint-preserving treatment options, including a minim...

Background: The outcome of non-surgical treatment is generally good, but the treatment course can be long and painful with approximately a quarter of the patients acquiring a nonunion. Both surgical and non-surgical treatment can have disabling consequences such as nerve injury, infection, and nonunion. The purpose of the study is to compare patie...

Background: Fractures of the proximal humerus, often termed shoulder fractures, are common injuries, especially in older people. The management of these fractures varies widely, including in the use of surgery. This is an update of a Cochrane Review first published in 2001 and last updated in 2015. Objectives: To assess the effects (benefits and...

Background The use of stemless total shoulder arthroplasty (TSA) for osteoarthritis increases, but there is a paucity on its safety and efficacy and how it performs in comparison with stemmed TSA. The aim was to compare the 5-year cumulative survival rate and patient-reported outcome after stemless and stemmed TSA for osteoarthritis. Methods We in...

Objective: The authors' objective was to investigate whether sagittal balance improves in patients with spinal stenosis after decompression alone. Methods: This prospective longitudinal cohort study compared preoperative and 6-month postoperative 36-inch full-length radiographs in patients aged older than 60 years. Patients underwent decompressi...

Objective To investigate the effects of one and two doses of intravenous dexamethasone in patients after total knee arthroplasty. Design Randomised, blinded, placebo controlled trial with follow-up at 90 days. Setting Five Danish hospitals, September 2018 to March 2020. Participants 485 adult participants undergoing total knee arthroplasty. Int...

Background Proximal humerus fracture (PHF) complications, whether following surgery or nonoperative management, require standardization of definitions and documentation for consistent reporting. We aimed to define an international consensus core event set (CES) of clinically-relevant unfavorable events of PHF to be documented in clinical routine pr...

Objective : To investigate the association between methodological quality and reported conclusions of meta-analyses comparing operative with non-operative treatments for proximal humeral fractures. Study design and setting : Cross-sectional meta-epidemiological study. We searched EMBASE, PubMed, The Cochrane Library, and Web of Science for systema...

Background: The outcome of non-surgical treatment is generally good, but the treatment course can be long and painful with approximately a quarter of the patients acquiring a nonunion. Both surgical and non-surgical treatment can have disabling consequences such as nerve injury, infection and nonunion. The purpose of the study is to compare patient...

Instability of the ulnar collateral ligament (UCL) is disabling and can occur at any age as an acute or chronic condition. A medical history and objective examination together with the radiological findings are sufficient to make the diagnosis in the majority of cases. Otherwise, an ultrasound or MRI scan should be considered for the acute and chro...

Background. Chronic foot ulcers are a major cause of morbidity in people with diabetes with a lifetime risk of 25%. Treatment is challenging and the recurrence rates of foot ulcers are >50% after 3 years. Vitamin D deficiency is more common in people with diabetes with chronic foot ulcers, compared to both people without diabetes as well as people...

Aims There is no consensus on the treatment of proximal humeral fractures. Hemiarthroplasty has been widely used in patients when non-surgical treatment is not possible. There is, despite extensive use, limited information about the long-term outcome. Our primary aim was to report ten-year patient-reported outcome after hemiarthroplasty for acute p...

Background and purpose — Extensive research and national multidisciplinary programs have striven to introduce uniform standards of treatment and mitigate mortality and adverse events after hip fracture surgery over the past decades. A large-scale overview of temporal developments in hip fracture surgery and care is warranted. Patients and methods —...

Chronic foot ulcers have extensive consequences for diabetic patients' quality of life and increase risks of amputation and death. The aim of this trial was to assess the feasibility of conducting a larger clinical trial to evaluate the clinical effect of inforatio technique on healing of diabetic foot ulcers (DFUs). Inforatio technique is a novel...

Objective: To study the effects of supervised training in adults with subacromial pain syndrome. Data sources: EMBASE, MEDLINE, Cochrane Library, Cinahl, and Pedro were searched from inception to March 2020. Study selection: Independent reviewers selected randomised controlled trials comparing supervised training with a) no training or b) self...

Study design: Propensity-matched retrospective study of patients prospectively enrolled in Danespine. Objective: The aim of this study was to report 5-year patient reported outcome in lumbar spinal stenosis (LSS) patients who underwent wide laminectomy (WL), segmental bilateral laminotomies (SBL), or unilateral hemilaminectomy (UHL) with bilater...

Background Peripheral nerve blocks (PNBs) are increasingly popular in acute ankle fracture surgery but rebound pain may outweigh the benefits. The AnAnkle Trial was designed to assess the postoperative pain profile of PNB anaesthesia compared with spinal anaesthesia (SA). Methods The AnAnkle Trial was a randomised, two-centre, blinded outcome anal...

Introduction Hip fractures lead to a substantial burden of disease and mortality among the elderly. Myocardial infarction (MI) and stroke are serious and overlooked complications, and their impact on mortality and morbidity may be underestimated. We investigated; 90-day absolute risk of stroke and MI following hip fracture surgery, and ii) anamnest...

Proximal humeral fractures are strongly correlated to osteoporosis and common among older patients. The goal of treatment is to reduce pain and regain function. Most proximal humeral fractures do not benefit from surgery, but surgery may be required in the most complex fractures. Patient comorbidity and poor bone quality seem to influence the overa...

Objective The frequent change in clinicians, and the emerging use of photographic documentation in wound management, could require a more diverse treatment of patients due to poor interobserver agreement. The aim of this study was to assess the interobserver agreement of a commonly used classification system for diabetic foot ulcers (DFUs), the Meg...

Study design: Validation study. Objectives: To translate and validate the Zurich Claudication Questionnaire (ZCQ) into a Danish version of the disease-specific patient-reported outcome measure (PROM) for patients with lumbar spinal stenosis (LSS), which assesses symptom severity, physical function, and satisfaction after surgery. Method: Trans...

Abstract Aim. Exercise therapy is a core element in the treatment of diabetes, but the benefits and harms for patients with a diabetic foot ulcer (DFU) are unknown. We therefore aimed to systematically review the benefits on health-related quality of life (HRQoL) and harms of exercise therapy for patients with DFU. Methods. We searched 6 major data...

BACKGROUND CONTEXT The optimal procedure for lumbar spinal stenosis remains controversial. Studies have shown no difference in short term outcomes among micro-laminectomy, hemi-laminotomies, broad laminectomy and laminectomy with instrumented fusion. PURPOSE To report on outcomes in lumbar spinal stenosis patients who underwent wide laminectomy, s...

BACKGROUND CONTEXT Patients with lumbar spinal stenosis present with low back pain, numbness and pain in the legs and gait difficulties due to neurogenic claudication. Patients often walk in a stooped posture to increase the spinal canal diameter by stretching out the ligamentum flavum. This stooped posture leads to a positive sagittal balance. Aft...

BACKGROUND CONTEXT Previous studies have failed to show a clinically significant association between Modic changes (MCs) and patient-reported outcomes (PROs) after discectomy. PURPOSE To assess whether Modic changes (MCs) are associated with health-related quality of life, long-term physical disability, back or leg pain after discectomy. STUDY DE...

Aims The aim of this study was to investigate surgeons’ reported change of treatment preference in response to the results and conclusion from a randomized contolled trial (RCT) and to study patterns of change between subspecialties and nationalities. Methods Two questionnaires were developed through the Delphi process for this cross-sectional sur...

Background: Patient-reported outcome measures (PROMs) are increasingly used to provide evidence for treatment effects and to guide rehabilitation. To our knowledge, no disease-specific PROM exists for the assessment of patients with flexor tendon lesions of the hand. We believe that PROMs used to assess hand function, regardless of diagnosis, cont...

Background and purpose — Proximal humerus fractures (PHF) may result in sequelae indicating arthroplasty. We report cumulative survival rates and reasons for revision after arthroplasty for proximal humerus fracture sequelae (PHFS). Patients and methods — Data were derived from the Nordic Arthroplasty Register Association. The Kaplan–Meier method w...

Study design: A registry-based comparative cohort study with two-year follow-up. Objective: To assess whether Modic Changes (MCs) are associated with health-related quality of life, long-term physical disability, back- or leg pain after discectomy. Summary of background data: Previous studies have failed to show a clinically significant associ...

Introduction Sustaining a hip fracture is a life changing event for many elderlies. While doctors and researchers tend to be preoccupied with mortality and complication rates, patients are more concerned by other aspects e.g. loss of independence and ability to remain in their own home. This study aimed to i) determine age-stratified one-year event...

Background: The most frequently used surgical procedures for treating a proximal humeral fracture (PHF) are plate osteosynthesis, nail osteosynthesis and arthroplasty. Evidence-based recommendations for an appropriate surgical procedure after PHF requires transparent and valid safety data. We performed a systematic review to examine reported terms...

Study Design Longitudinal cohort study with 13-year follow-up. Objective To assess whether long-term disability is associated with baseline degenerative magnetic resonance imaging (MRI) findings in patients with low back pain (LBP). Methods In 2004-2005, patients aged 18 to 60 years with chronic LBP were enrolled in a randomized controlled trial...

Study design: Registry based repeated-measures psychometric validation of the Danish Oswestry Disability Index (ODI) OBJECTIVE.: The goal was to use classical and modern psychometric validation methods to assess the measurement properties and the minimally clinical important difference (MCID) of the ODI in a Danish cohort of patients with chronic...

Background: Optimization of postoperative pain treatment is of upmost importance. Multimodal analgesia is the main postoperative pain treatment principle, but the evidence on optimal analgesic combinations is unclear. With the 'DEXamethasone twice for pain treatment after TKA' trial, we aim to investigate the role of one or two doses of glucocorti...

Background: Reverse shoulder arthroplasty (RSA) has gained popularity in the treatment of proximal humeral fractures (PHFs), especially in elderly patients. The purpose of this study was to investigate the use of RSA implants for acute PHFs and risk of revision, as well as risk factors for revision. Methods: RSA implants for acute PHFs were iden...

Aims The aim of this study was to investigate the difference in functional outcome after repair and non-repair of the pronator quadratus muscle in patients undergoing surgical treatment for a distal radial fracture with volar plating. Patients and Methods A total of 72 patients with a distal radial fracture were included in this randomized clinica...

Background: Reverse shoulder arthroplasty has been proven to improve function in shoulders with cuff-tear arthropathy, but existing studies are primarily single-center studies with a small number of patients, which limits their ability to identify patients who have an increased risk of revision or a worse functional outcome. Questions/purposes:...

Background and aims Peripheral nerve blocks (PNBs) are increasingly used in limb fracture surgery. However, recent studies suggest that rebound pain when the block wears off may outweigh the benefits on the postoperative pain course. the randomised ‘AnAnkle Trial’ compared postoperative pain profiles after spinal anaesthesia (SA) and PNB anaesthesi...

BACKGROUND CONTEXT Multiple MRI classifications are used to assess lumbar degenerative disease. The most widely used are the Pfirmann classification, the presence or absence of Modic change (MC) and the Fujiwara classification of facet joint degeneration. PURPOSE The purpose of this study was to examine the associations between long-term RMDQ and...

Background : Shoulder arthroplasty (SA) complications require standardization of definitions and are not limited to events leading to revision operations. We aimed to define an international consensus core set of clinically-relevant unfavorable events of SA to be documented in clinical routine practice and studies. Methods: A Delphi exercise was im...

Background: Multimodal analgesia is considered the leading principle for postoperative pain treatment, but no gold standard after total knee arthroplasty (TKA) exists. Aim: To investigate the beneficial and harmful effects of one or two doses of 24 mg intravenous dexamethasone as part of a multimodal analgesic regimen (paracetamol, NSAID and per...

Introduction Cuff tear arthropathy of the shoulder is a common indication for insertion of an increasing number of reverse shoulder arthroplasties. It is widely believed that this condition was unknown to medical practitioners and writers prior to the introduction of the term cuff tear arthropathy by Charles Neer in 1977. Purpose To search ninetee...

Background: Stemless shoulder arthroplasty systems with uncemented metaphyseal fixation have been used for glenohumeral osteoarthritis since 2004 (Hawi, et al. BMC Musculoskelet Disord 17:376, 2016). The stemless design has several theoretical advantages compared with the stemmed shoulder arthroplasty systems: restoring patients' anatomy; preservi...

Aims The aim of this study was to use national registry database information to estimate cumulative rates and relative risk of revision due to infection after reverse shoulder arthroplasty. Patients and Methods We included 17 730 primary shoulder arthroplasties recorded between 2004 and 2013 in The Nordic Arthroplasty Register Association (NARA) d...

Background This study reported the clinical outcomes and complications after elbow hemiarthroplasty (EHA) for acute distal humeral fractures Arbeitsgemeinschaft für Osteosynthesefragen (AO)/Orthopaedic Trauma Association (OTA) type C2 and C3. Method During a 6-year period, 24 active patients with acute intra-articular and multifragmentary distal h...

Background: Repair of the pronator quadratus (PQ) muscle with sutures has been reported durable after volar plating of distal radius fractures (DRF). It is unclear how the muscle reacts if not repaired and if a retracted muscle correlates to worse functional outcome or complications. In this study, we use ultrasound to investigate the anatomy of th...

Background: The purpose of this study was to compare the short-term survival rate of total stemless, metaphyseal fixated, shoulder arthroplasty with that of total stemmed shoulder arthroplasty in the treatment of osteoarthritis. Methods: Data were collected by the national arthroplasty registries in Denmark, Finland, Norway, and Sweden and merge...

Background and purpose — The revision rate of stemmed hemiarthroplasty (SHA) for acute proximal humeral fractures is low, but does not necessarily reflect the functional outcome. We report the revision rate of SHA for acute proximal humeral fractures and the proportion of arthroplasties that are not revised despite low functional outcome scores. Pa...

Background Stemless shoulder arthroplasty systems with uncemented metaphyseal fixation have been used in Europe for glenohumeral osteoarthritis since 2004 [1]. The stemless design has several theoretical advantages compared with the stemmed shoulder arthroplasty systems: restoring patients’ anatomy, preserving humeral bone stock, and few complicati...

Study Design. A comparative cohort study with 13-year follow-up. Objective. To assess whether Modic changes (MCs) are associated with long-term physical disability, back pain, and sick leave. Summary of Background Data. Previous studies have shown a conflicting association of low back pain (LBP) with MCs and disc degeneration. The long-term progn...

Background A majority of proximal humeral fractures can be managed without surgery. Recent randomized clinical trials and meta-analyses even question the benefit of surgical treatment for displaced 3-, and 4-part fractures. However, evidence-based treatment recommendations, balancing benefits and harms, presuppose a common reporting of complication...

Background and purpose — Reverse shoulder arthroplasty (RSA) has become the treatment of choice for cuff-tear arthropathy. There are, however, concerns about the longevity and the outcome of an eventual revision procedure. Thus, resurfacing hemiarthroplasty (RHA) with extended articular surface has been suggested for younger patients. We compared t...

Aim Chronic osteomyelitis (OM) is usually treated with surgical excision of infected bone and subsequent dead space management to prevent local recurrence. We report outcome after antibiotic loaded biocomposite (ALB)1 for management of infected bone defects. Method We report a consecutive series of 97 patients with chronic OM treated at one inst...