| 31. |
- Bedrin, M. D., et al.
(författare)
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Prospective Evaluation of Posterior Glenoid Bone Loss After First-time and Recurrent Posterior Glenohumeral Instability Events
- 2022
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Ingår i: American Journal of Sports Medicine. - : SAGE Publications. - 0363-5465 .- 1552-3365. ; 50:11, s. 3028-3035
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Tidskriftsartikel (refereegranskat)abstract
- Background: Although posterior glenohumeral instability is becoming an increasingly recognized cause of shoulder pain, the role of posterior glenoid bone loss on outcomes remains incompletely understood. Purposes: To prospectively determine the amount of bone loss associated with posterior instability events and to determine predisposing factors based on preinstability imaging. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 1428 shoulders were evaluated prospectively for >= 4 years. At baseline, a subjective history of shoulder instability was ascertained for each patient, and bilateral noncontrast magnetic resonance imaging (MRI) scans of the shoulders were obtained regardless of any reported history of shoulder instability. The cohort was prospectively followed during the study period, and those who were diagnosed with posterior glenohumeral instability were identified. Postinjury MRI scans were obtained and compared with the screening MRI scans. Glenoid version, perfect-circle-based bone loss was measured for each patient's pre- and postinjury MRI scans using previously described methods. Results: Of the 1428 shoulders that were prospectively followed, 10 shoulders sustained a first-time posterior instability event and 3 shoulders sustained a recurrent posterior instability event. At baseline, 11 of 13 shoulders had some amount of glenoid dysplasia and/or bone loss. The change in glenoid bone loss was 5.4% along the axis of greatest loss (95% CI, 3.8%-7.0%; P = .009), 4.4% at the glenoid equator (95% CI, 2.7%-6.2%; P = .016), and 4.2% of total glenoid area (95% CI, 2.9%-5.3%; P = .002). Recurrent glenoid instability was associated with a greater amount of absolute bone loss along the axis of greatest loss compared with first-time instability (recurrent: 16.8% +/- 1.1%; 95% CI, 14.6%-18.9%; first-time: 10.0% +/- 1.5%; 95% CI, 7.0%-13.0%; P = .005). Baseline glenoid retroversion >= 10 degrees was associated with a significantly greater percentage of bone loss along the axis of greatest loss (>= 10 degrees of retroversion: 13.5% +/- 2.0%; 95% CI, 9.6%-17.4%; <10 degrees of retroversion: 8.5% +/- 0.8%; 95% CI, 7.0%-10.0%; P = .045). Conclusions: Posterior glenohumeral instability events were associated with glenoid bone loss of 5%. The amount of glenoid bone loss after a recurrent posterior glenohumeral instability event was greater than that after first-time instability. Glenoid retroversion >= 10 degrees was associated with a greater amount of posterior glenoid bone loss after a posterior instability event.
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| 32. |
- Beischer, Susanne, et al.
(författare)
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How Is Psychological Outcome Related to Knee Function and Return to Sport Among Adolescent Athletes After Anterior Cruciate Ligament Reconstruction?
- 2019
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Ingår i: American Journal of Sports Medicine. - : SAGE Publications. - 0363-5465 .- 1552-3365. ; 47:7, s. 1567-1575
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Tidskriftsartikel (refereegranskat)abstract
- Background: Adult patients who succeed in returning to their preinjury levels of sport after anterior cruciate ligament (ACL) reconstruction have been characterized by a more positive psychological response. It is not known whether this relationship is valid for adolescent athletes. Purpose: To investigate psychological readiness to return to sport, knee-related self-efficacy, and motivation among adolescent (15-20 years old) and adult (21-30 years old) athletes after ACL reconstruction. A further aim was to compare athletes (15-30 years old) who had recovered their muscle function and returned to sport with athletes who had not. Study Design: Case-control study; Level of evidence, 3. Methods: Data were extracted from a rehabilitation-specific register 8 and 12 months after ACL reconstruction. Athletes previously involved in knee-strenuous sport who had undergone primary ACL reconstruction were included. Data comprised psychological patient-reported outcomes and results from 5 tests of muscle function. Comparisons were performed between age groups, between athletes who had and had not recovered their muscle function, and between patients who had returned to sport and not. Results: In all, 384 (50% females) and 271 athletes (52% females) were included at the 8- and 12- month follow-ups, respectively. Enhanced self-efficacy was reported at both follow-ups by adolescents and by athletes who had recovered their muscle function. Athletes who had recovered their muscle function reported higher (P = .0007) motivation to achieve their goals. Subgroup analyses on patient sex revealed findings similar to those in the main analyses for females but not for males. Moreover, adolescent and adult athletes who had returned to sport reported significantly higher levels on the Knee Self-Efficacy Scale and the ACL-Return to Sport After Injury scale at both follow-ups. Conclusion: Adolescent athletes, especially females, perceived enhanced self-efficacy, had a higher return-to-sport rate, and were more motivated to reach their goals after ACL reconstruction compared with adults. Regardless of age, athletes who had returned to sport and athletes with more symmetrical muscle function had a stronger psychological profile.
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| 33. |
- Bengtsson, Hakan, et al.
(författare)
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Match Injury Rates in Professional Soccer Vary With Match Result, Match Venue, and Type of Competition
- 2013
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Ingår i: American Journal of Sports Medicine. - : SAGE Publications (UK and US): No SAGE Choice. - 0363-5465 .- 1552-3365. ; 41:7, s. 1505-1510
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Tidskriftsartikel (refereegranskat)abstract
- Background: Player activities in soccer matches are influenced by the match result and match venue. It is not known whether injury rates are influenced by these factors. Purpose: To investigate whether there are associations between injury rates and the match result, venue, and type of competition in male soccer. Study Design: Cohort study; Level of evidence, 3. Methods: Twenty-six professional clubs from 10 countries were followed prospectively during 9 seasons (2001-2002 to 2009-2010). All matches, and injuries occurring in these matches, were registered by the teams medical staff. An injury was registered if it resulted in player absence from training or matches. Information about match result, venue, and type of competition for all reported matches was gathered by the authors from online databases. Injury rates in matches with varying match characteristics were compared by use of generalized estimating equations. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Results: A total of 2738 injuries during 6010 matches were registered. There were no associations between odds of 1 injury occurrence and match result or type of competition, whereas the odds were decreased in matches played away compared with home matches (OR, 0.89; 95% CI, 0.80-0.99). The odds of 2 or more injury occurrences in a match were increased in matches resulting in a draw (OR, 1.39; 95% CI, 1.15-1.69) or loss (OR, 1.66; 95% CI, 1.38-1.98) compared with matches won and were decreased in other cup matches compared with league matches (OR, 0.57; 95% CI, 0.39-0.84) and in matches played away compared with home matches (OR, 0.70; 95% CI, 0.60-0.82). Finally, injuries with more than 1 weeks absence occurred more frequently in Champions League matches compared with league matches both for matches with 1 injury (OR, 1.26; 95% CI, 1.09-1.45) and matches with 2 or more injuries (OR, 1.57; 95% CI, 1.13-2.20). Conclusion: The odds of 2 or more injury occurrences in professional soccer were higher in matches resulting in a loss or a draw compared with a win, whereas the odds of injury occurrences were lower in matches played away compared with home matches. The rate of moderate and severe injuries increased with the importance of the match.
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| 34. |
- Bergerson, Emma, et al.
(författare)
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Superior Outcome of Early ACL Reconstruction versus Initial Non-reconstructive Treatment With Late Crossover to Surgery A Study From the Swedish National Knee Ligament Registry
- 2022
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Ingår i: American Journal of Sports Medicine. - : SAGE Publications. - 0363-5465 .- 1552-3365. ; 50:4, s. 896-903
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Tidskriftsartikel (refereegranskat)abstract
- Background: Although comparable clinical and functional outcomes have been reported after nonsurgical and surgical anterior cruciate ligament (ACL) treatment, few studies have investigated the effects of early versus late ACL reconstruction with initial rehabilitation. Purpose: To determine patient-reported knee function in patients who initially undergo nonreconstructive treatment after an ACL injury but who later choose to undergo ACL reconstruction as compared with (1) patients undergoing ACL reconstruction close to the index injury and (2) patients treated nonreconstructively at 1 to 10 years of follow-up. Study Design: Cohort study; Level of evidence, 2. Methods: Results from the Knee injury and Osteoarthritis Outcome Score (KOOS) were extracted from the Swedish National Knee Ligament Registry for patients treated with nonreconstruction, early ACL reconstruction, and initial nonreconstruction but subsequent ACL reconstruction (crossover group). The KOOS4 (a mean of 4 KOOS subscales) was analyzed cross-sectionally at baseline and at the 1-, 2-, 5-, and 10-year follow-ups. Additionally, the Patient Acceptable Symptom State (PASS) was applied to all KOOS subscales from baseline to the 10-year follow-up. Results: A total of 1,074 crossover, 484 nonreconstruction, and 20,352 early ACL reconstruction cases were included. The crossover group reported lower KOOS4 values than the group undergoing early ACL reconstruction at baseline and at all follow-ups (mean difference [95% CI]): baseline, -6.5 (-8.0 to -5.0); 1 year, -9.3 (-10.9 to -7.7); 2 years, -4.8 (-6.3 to -3.2); 5 years, -6.1 (-8.8 to -3.4); and 10 years, -10.9 (-16.3 to -5.2). Additionally, a smaller proportion of the crossover cohort achieved a PASS on KOOS subscales at baseline and through the 1-, 2-, 5-, and 10-year follow-ups as compared with the early ACL reconstruction cohort. No differences were observed between crossover and nonreconstruction cases on either the KOOS4 or the PASS at any follow-up. Conclusion: A greater proportion of patients treated with early ACL reconstruction reported acceptable knee function and superior overall knee function as compared with patients who decided to cross over from nonreconstructive treatment to ACL reconstruction.
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| 35. |
- Berglund, Henrik, 1973, et al.
(författare)
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Opportunities as Artifacts and Entrepreneurship as Design
- 2020
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Ingår i: Academy of Management Review. - : Academy of Management. - 0363-7425 .- 1930-3807. ; 45:4, s. 825-846
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Tidskriftsartikel (refereegranskat)abstract
- We combine Herbert Simon’s view of design with the common distinction between reality as discovered or created to develop experimentation and transformation as ideal types of entrepreneurial design. Building on the design tradition’s view of artifacts, we describe how opportunities-as-artifacts iteratively develop at the interface between organized individuals and their environments, where more or less concrete instantiations are used to drive the process forward. By conceptualizing entrepreneurship as artifact-centered design, we provide an alternative to accounts inspired by economic theory, which have proven conceptually problematic and of limited practical use. We conclude by discussing how uncertainty can be defined and managed, the value of design as a conceptual anchor for entrepreneurship studies, opportunities for future research, and how entrepreneurship seen as design naturally bridges theory and practice.
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| 36. |
- Beynnon, BD, et al.
(författare)
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A prospective, randomized clinical investigation of the treatment of first-time ankle sprains
- 2006
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Ingår i: The American journal of sports medicine. - : SAGE Publications. - 0363-5465 .- 1552-3365. ; 34:9, s. 1401-1412
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Tidskriftsartikel (refereegranskat)abstract
- Acute ankle ligament sprains are treated with the use of controlled mobilization with protection provided by external support (eg, functional treatment); however, there is little information regarding the best type of external support to use. Hypothesis There is no difference between elastic wrapping, bracing, bracing combined with elastic wrapping, and casting for treatment of acute, first-time ankle ligament sprains in terms of the time a patient requires to return to normal function. Study Design Randomized controlled clinical trial; Level of evidence, 1. Methods Patients suffering their first ligament injury were stratified by the severity of the sprain (grades I, II, or III) and then randomized to undergo functional treatment with different types of external supports. The patients completed daily logs until they returned to normal function and were followed up at 6 months. Results Treatment of grade I sprains with the Air-Stirrup brace combined with an elastic wrap returned subjects to normal walking and stair climbing in half the time required for those treated with the Air-Stirrup brace alone and in half the time required for those treated with an elastic wrap alone. Treatment of grade II sprains with the Air-Stirrup brace combined with the elastic wrap allowed patients to return to normal walking and stair climbing in the shortest time interval. Treatment of grade III sprains with the Air-Stirrup brace or a walking cast for 10 days followed by bracing returned subjects to normal walking and stair climbing in the same time intervals. The 6-month follow-up of each sprain severity group revealed no difference between the treatments for frequency of reinjury, ankle motion, and function. Conclusion Treatment of first-time grade I and II ankle ligament sprains with the Air-Stirrup brace combined with an elastic wrap provides earlier return to preinjury function compared to use of the Air-Stirrup brace alone, an elastic wrap alone, or a walking cast for 10 days.
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| 37. |
- Beynnon, Bruce D, et al.
(författare)
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Rehabilitation After Anterior Cruciate Ligament Reconstruction: A Prospective, Randomized, Double-Blind Comparison of Programs Administered Over 2 Different Time Intervals.
- 2005
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Ingår i: The American journal of sports medicine. - : SAGE Publications. - 1552-3365 .- 0363-5465. ; 33:3, s. 347-359
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Tidskriftsartikel (refereegranskat)abstract
- There are adverse effects associated with immobilization of the knee after anterior cruciate ligament reconstruction, yet very little is known about how much activity will promote adequate rehabilitation without permanently elongating the graft, producing graft failure, or creating damage to articular cartilage. Hypothesis Rehabilitation with either an accelerated or nonaccelerated program produces no difference in anterior-posterior knee laxity, clinical assessment, patient satisfaction, functional performance, and the synovial fluid biomarkers of articular cartilage metabolism. Study Design Randomized controlled clinical trial; Level of evidence, 1. Methods Twenty-five patients who tore their anterior cruciate ligament were enrolled and underwent anterior cruciate ligament reconstruction. Patients were randomized to accelerated rehabilitation or nonaccelerated rehabilitation. At the time of surgery and 3, 6, 12, and 24 months later, measurements of anterior-posterior knee laxity, clinical assessment, patient satisfaction, functional performance, and cartilage metabolism were completed. Results At the 2-year follow-up, there was no difference in the increase of anterior knee laxity relative to the baseline values that were obtained immediately after surgery between the 2 groups (2.2-mm vs 1.8-mm increase relative to the normal knee). The groups were similar in terms of clinical assessment, patient satisfaction, activity level, function, and response of the bio-markers. After 1 year of healing, synthesis of collagen and turnover of aggrecan remained elevated in both groups. Conclusion Anterior cruciate ligament reconstruction with a bone-patellar tendon-bone graft followed by either accelerated or nonaccelerated rehabilitation produces the same increase of anterior knee laxity. Both programs had the same effect in terms of clinical assessment, patient satisfaction, functional performance, and the biomarkers of articular cartilage metabolism. There is concern that the cartilage biomarkers remained elevated for an extended period.
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| 38. |
- Björnsson, Haukur, et al.
(författare)
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A Randomized Controlled Trial With Mean 16-Year Follow-up Comparing Hamstring and Patellar Tendon Autografts in Anterior Cruciate Ligament Reconstruction
- 2016
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Ingår i: American Journal of Sports Medicine. - : SAGE Publications. - 0363-5465 .- 1552-3365. ; 44:9, s. 2304-2313
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Tidskriftsartikel (refereegranskat)abstract
- Background: There is no consensus in the current literature on which surgical options render the best long-term results after anterior cruciate ligament (ACL) reconstruction in terms of clinical outcomes and the development of radiographic osteoarthritis (OA). Purpose: To investigate the long-term clinical and radiographic results after ACL reconstruction using either a patellar tendon (PT) autograft or a hamstring tendon (HT) autograft. Methods: This multicenter study was based on 2 previous randomized cohorts consisting of 193 patients who underwent unilateral primary ACL reconstruction using either a PT autograft or an HT autograft. The index surgical procedure was performed between September 1995 and January 2000. Clinical assessments, including knee laxity measurements, functional outcomes, patient-reported outcomes, and bilateral standing radiographs, were performed at the final follow-up examination. Results: At the long-term follow-up, 147 (76%) patients were examined: 61 in the PT group and 86 in the HT group. The mean (SD) follow-up time was 191.9 +/- 15.1 months for the HT group and 202.6 +/- 10.4 months for the PT group. Knee laxity measurements revealed significantly more patients with a normal pivot-shift test finding in the HT group compared with the PT group (71% vs 51%, respectively; P = .048); however, no significant differences were found in terms of the manual Lachman test or the KT-1000 arthrometer manual maximum test. The patients in the PT group had significantly more difficulty knee walking (P = .049). There were no significant differences between the study groups in terms of patient-reported outcomes or range of motion in the reconstructed knee. In both groups, significantly more signs of radiographic OA were found in the reconstructed knee than in the contralateral healthy knee. However, there were no significant differences between the groups in terms of radiographic OA. Conclusion: Only minor and mostly insignificant differences were found between the PT and HT autograft groups in this long-term randomized controlled trial. In both groups, significantly more signs of radiographic OA were found in the reconstructed knee than in the contralateral knee.
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| 39. |
- Briggs, Karen K, et al.
(författare)
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The reliability, validity, and responsiveness of the Lysholm score and Tegner activity scale for anterior cruciate ligament injuries of the knee
- 2009
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Ingår i: American Journal of Sports Medicine. - : Sage Publications. - 0363-5465 .- 1552-3365. ; 37:5, s. 890-897
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Tidskriftsartikel (refereegranskat)abstract
- Background: In 1982, the Lysholm score was first published as a physician-administered score in the American Journal of Sports Medicine. The Tegner activity scale was published in 1985.Hypothesis: The Lysholm and Tegner scores are valid as patient-administered scores and responsive at early time points after treatment of anterior cruciate ligament tears.Study Design: Cohort study (Diagnosis); Level of evidence, 1. Methods: All patients were treated for an anterior cruciate ligament tear. For responsiveness, the Lysholm score (n = 1075) and Tegner activity level (n = 505) were measured preoperatively and 6, 9, 12, and 24 months postoperatively. For test-retest (n = 50), scores were measured at 2 years postoperatively and again within 4 weeks by questionnaire. For criterion validity (n = 170), patients completed the Short Form-12 and the International Knee Documentation Committee score in addition to Lysholm and Tegner instruments. For all other analyses, preoperative Lysholm score (n = 1783) or Tegner activity levels (n = 687) were collected.Results: There was acceptable test-retest reliability for both the Lysholm (intraclass correlation coefficient = 0.9) and Tegner (intraclass correlation coefficient = 0.8) scores. The minimum detectable change for Lysholm was 8.9 and for Tegner was 1. The Lysholm demonstrated acceptable internal consistency. The Lysholm correlated with the International Knee Documentation Committee (r = .8) and the Short Form-12 (r = .4), and Tegner correlated with the Short Form-12 (r = .2). Both scores had acceptable floor and ceiling effects and all hypotheses were significant. The Lysholm and Tegner were responsive to change at each of the time points.Conclusion: After 25 years of changes in treatment of anterior cruciate ligament injuries, the Lysholm knee score and the Tegner activity scale demonstrated acceptable psychometric parameters as patient-administered scores and showed acceptable responsiveness to be used in early return to function after anterior cruciate ligament treatment.
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| 40. |
- Brittberg, Mats, 1953
(författare)
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Cell carriers as the next generation of cell therapy for cartilage repair: a review of the matrix-induced autologous chondrocyte implantation procedure
- 2010
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Ingår i: The American Journal of Sports Medicine. - : SAGE Publications. - 1552-3365 .- 0363-5465. ; 38:6, s. 1259-1271
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Since the first patient was implanted with autologous cultured chondrocytes more than 20 years ago, new variations of cell therapies for cartilage repair have appeared. Autologous chondrocyte implantation, a first-generation cell therapy, uses suspended autologous cultured chondrocytes in combination with a periosteal patch. Collagen-covered autologous cultured chondrocyte implantation, a second-generation cell therapy, uses suspended cultured chondrocytes with a collagen type I/III membrane. Today's demand for transarthroscopic procedures has resulted in the development of third-generation cell therapies that deliver autologous cultured chondrocytes using cell carriers or cell-seeded scaffolds. PURPOSE: To review the current evidence of the matrix-induced autologous chondrocyte implantation procedure, the most widely used carrier system to date. Also discussed are the characteristics of type I/III collagen membranes, behavior of cells associated with the membrane, surgical technique, rehabilitation, clinical outcomes, and quality of repair tissue. STUDY DESIGN: Systematic review. METHODS: Relevant publications were identified by searching Medline from its inception (1949) to December 2007; peer-reviewed publications of preclinical and clinical cell behavior, manufacturing process, surgical technique, and rehabilitation protocols were identified. Preclinical and clinical studies were included if they contained primary data and used a type I/III collagen membrane. RESULTS: Data from these studies demonstrate that patients treated with matrix-induced autologous chondrocyte implantation have an overall improvement in clinical outcomes. Reduced visual analog scale pain levels (range, 1.7-5.32 points) and improvements in the modified Cincinnati (range, 3.8-34.2 points), Lysholm-Gillquist (range, 23.09-47.6 points), Tegner-Lysholm (range, 1.39-3.9 points), and International Knee Documentation Classification scale (P <.05) were observed. Patients had good-quality (hyaline-like) repair tissue as assessed by arthroscopic evaluation (including International Cartilage Repair Society score), magnetic resonance imaging, and histology, as well as a low incidence of postoperative complications. CONCLUSION: The findings suggest that matrix-induced autologous chondrocyte implantation is a promising third-generation cell therapy for the repair of symptomatic, full-thickness articular cartilage defects.
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