ConMed (Finland)

The aim of this study was to examine the length of waiting time in elective knee, shoulder, hip, andlower back surgery, and how it was associated with sickness absence, use of health care, and work ability support services during 1year after the surgery. The patients (n = 429) were grouped by the elective surgery they had undergone. Waiting time was calculated as the time between the day of referral and the day of operation. The register data were analyzed with general linear regression. The median waiting time for a knee operation (n = 287) was 98days, for a shoulder operation (n = 105) 39days, for a hip operation (n = 19), 177days and for a lower back operation (n = 18) 114days. The use of work ability support services increased after all the operations. A prolonged waiting time (> 90days) for knee and shoulder operations was associated with the amount ofsickness absence (IRR: 1.09, 95% CI 1.06-1.12; IRR: 0.86, 95% CI 0.82-0.89, respectively), secondary health care visits (IRR: 1.81, 95% CI 1.33-2.47; IRR: 2.28, 95% CI 1.50-3.47, respectively), and occupational curative care visits (IRR: 2.06, 95% CI 1.30-3.29) for shoulder operations. No association was found between a prolonged waiting time and work ability service visits during the year after the surgery. The association of waiting time length with postoperative sickness absences and health care visits calls for taking actions to reduce the waiting times. Waiting should be considered as an active time aiming to prepare for the operation and the recovery.

Intensive research has demonstrated the clear biological potential of electrospun nanofibers for tissue regeneration and repair. However, nanofibers alone have limited mechanical properties. In this study we took poly(L-lactide-co-D-lactide) (PLDLA)-based 3D objects, one existing medical device (interference screws) and one medical device model (discs) as examples to form composites through coating their surface with electrospun PLDLA nanofibers. We specifically investigated the effects of electrospinning parameters on the improvement of adhesion of the electrospun nanofibers to the PLDLA-based substrates. To reveal the adhesion mechanisms, a novel peel test protocol was developed for the characterization of the adhesion and delamination phenomenon of the nanofibers deposited to substrates. The effect of incubation of the composites under physiological conditions on the adhesion of the nanofibers has also been studied. It was revealed that reduction of the working distance to 10 cm resulted in deposition of residual solvent during electrospinning of nanofibers onto the substrate, causing fiber–fiber bonding. Delamination of this coating occurred between the whole nanofiber layer and substrate, at low stress. Fibers deposited at 15 cm working distance were of smaller diameter and no residual solvent was observed during deposition. Delamination occurred between nanofiber layers, which peeled off under greater stress. This study represents a novel method for the alteration of nanofiber adhesion to substrates, and quantification of the change in the adhesion state, which has potential applications to develop better medical devices for orthopedic tissue repair and regeneration.