| 1. |
- Kamrad, Ilka, et al.
(författare)
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Good outcome scores and high satisfaction rate after primary total ankle replacement : 167 patients followed for 24 months in the Swedish Ankle Registry
- 2017
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682. ; 88:6, s. 675-680
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose — Total ankle replacement (TAR) is gaining popularity for treatment of end-stage ankle arthritis. Large patient-centered outcome studies are, however, few. Here, we report data from the Swedish Ankle Registry. Patients and methods — We examined outcomes after primary TAR in patients from the Swedish Ankle Registry using PROMs (Patient Reported Outcome Measures; generic: EQ-5D and SF-36, region specific: SEFAS (Self-Reported Foot and Ankle Score), and a question on satisfaction). We included 241 patients registered with primary TAR between 2008 and 2016 and who completed PROMs preoperatively and postoperatively up to 24 months. We evaluated changes in PROMs following surgery and estimated effects of age, diagnosis, prosthetic design, and preoperative functional score on the outcomes. Results — All absolute scores improved from preoperative to 24 months after surgery (p ≤ 0.001). 71% of the patients were satisfied or very satisfied at the latest follow-up and 12% dissatisfied or very dissatisfied. Postoperative SEFAS correlated with age (r = 0.2, p = 0.01) and preoperative SEFAS (r = 0.3, p < 0.001), as did patient satisfaction (r = −0.2; p ≤ 0.03). Postoperative SEFAS and EQ-5D were similar between different diagnoses or prosthetic designs. Preoperative SF-36 was associated with diagnosis (p ≤ 0.03), postoperative SF-36 with age (r = 0.2, p = 0.01) and diagnosis (p < 0.03). Interpretation — We found statistically and clinically significant improvements in patient-reported outcomes following TAR surgery. The postoperative region-specific SEFAS was positively associated with older age. Prosthetic design seemed not to influence patient-reported outcome, whereas diagnosis partly did. Studies with longer follow-up are necessary to establish the long-term outcome of TAR and to elucidate whether short- and mid-term outcomes may predict implant failure.
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| 2. |
- Kamrad, Ilka, et al.
(författare)
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Outcome After Salvage Arthrodesis for Failed Total Ankle Replacement.
- 2016
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Ingår i: Foot & Ankle International. - : SAGE Publications. - 1944-7876 .- 1071-1007. ; 37:3, s. 255-261
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Tidskriftsartikel (refereegranskat)abstract
- In cases with total ankle replacement (TAR) failure, a decision between revision TAR and salvage arthrodesis (SA) must be made. In a previous study, we analyzed revision TAR and found low functional outcome and satisfaction. The aims of the current study were to analyze SA concerning failure rate and patient-related outcome measures (PROMs).
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| 3. |
- Kamrad, Ilka, et al.
(författare)
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Poor prosthesis survival and function after component exchange of total ankle prostheses
- 2015
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3682 .- 1745-3674. ; 86:4, s. 407-411
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: In failed total ankle replacements (TARs), fusion is often the procedure of preference; the outcome after exchanging prosthetic components is debated. We analyzed prosthetic survival, self-reported function, and patient satisfaction after component exchange. Patients and methods We identified patients in the Swedish Ankle Registry who underwent exchange of a tibial and/or talar component between January 1, 1993 and July 1, 2013 and estimated prosthetic survival by Kaplan-Meier analysis. We evaluated the patient-reported outcome measures (PROMs) SEFAS, EQ-5D, EQ-VAS, SF-36, and patient satisfaction by direct questions.RESULTS: 69 patients underwent revision TAR median 22 (0-110) months after the primary procedure. 24 of these failed again after median 26 (1-110) months. Survival analysis of revision TAR showed a 5-year survival rate of 76% and a 10-year survival of 55%. 29 patients with first revision TAR in situ answered the PROMs at mean 8 (1-17) years after revision and had the following mean scores: SEFAS 22, SF-36 physical 37 and mental 49, EQ-5D index 0.6, and EQ-VAS 64. 15 of the patients were satisfied, 5 were neither satisfied nor dissatisfied, and 9 were dissatisfied.INTERPRETATION: Revision TAR had a 10-year survival of 55%, which is lower than the 10-year survival of 74% for primary TAR reported from the same registry. Only half of the patients were satisfied. Future studies should show which, if any, patients benefit from revision TAR and which patients should rather be fused directly.
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| 4. |
- Karlsson, Magnus, et al.
(författare)
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Patients With Knee Osteoarthritis Have a Phenotype With Higher Bone Mass, Higher Fat Mass, and Lower Lean Body Mass.
- 2015
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Ingår i: Clinical Orthopaedics and Related Research. - : Ovid Technologies (Wolters Kluwer Health). - 0009-921X. ; 473:1, s. 258-264
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Tidskriftsartikel (refereegranskat)abstract
- Although knee osteoarthritis (OA) is common, its etiology is poorly understood. Specifically, it is not known whether knee OA is associated with abnormal anthropometric and musculoskeletal characteristics known to be associated with OA in general. We recently studied this topic for patients with hip arthritis; however, it is important to evaluate it for knee OA separately, because there are reports indicating that patients with primary OA in different joints may have a different phenotype.
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| 5. |
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| 6. |
- Augustsson, Dennis, et al.
(författare)
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Att kunskapa i mellanrum och genom överlappningar
- 2014
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Vetenskap/konstnärsskap, lärande/lek, lärare/studenter är olika sidor av en dikotom verklighetsuppfattning bland många i den traditionella akademiska kulturen. Syftet med vår workshop är att reflektera över och utmana denna dikotomi genom att skapa ett kunskapens mellanrum där de olika sidorna av dikotomin överlappas. Vi workshopsledare kommer från olika ämnen med varierande bakgrunder och har olika akademiska positioner, men har gemensamt att vi har jobbat länge på högskolevärlden, arbetar både traditionellt akademiskt och konstnärligt och sedan 2,5 år arbetat med en forskningscirkel där vi tillsammans undersökt det gränsöverskridande mötet mellan teori och gestaltning (vetenskap och konstnärsskap). I varsitt mindre forskningsprojekt har vi undersökt hur man kan kunskapa genom reflekterande görande. Dessa forskningsprojekt har också blivit pedagogiska utvecklingsprojekt, då resultaten omsatts i kursutveckling. Teoretiskt ser vi den akademiska kulturen som en del av ett socialt konstruerat rum, både bildligt och bokstavligt, där även kunskapande är en socialt konstruerad aktivitet lärande i och med kroppen. Begreppen hexis, konstruerad kropp och performativitet (Bourdieu; Butler) har därför varit centrala begrepp för oss. Vårt övergripande pedagogiska perspektiv handlar om det reflekterande görandet (Dewey; Schön). Vi arbetar pedagogiskt med multimodalitet (Selander & Kress), sinnligt kunskapande (Polyani; Pink) och hämtar begreppen divicing (Kjølner, Oddey) och intra-aktiv pedagogik (Taguchi) från förskolepedagogik. Vi har även låtit oss inspireras av begreppet parallellek. Begreppet estetiska lärprocesser (Lindstrand & Selander) binder samman vår konstnärlig vetenskapliga och pedagogiska verksamhet. Vårt arbetssätt handlar emellertid framför allt om att omsätta teoretiska begrepp i praktiken. Och det vill vi göra genom workshopen. Vi riktar oss mot kollegor som är intresserade av att utmana traditionella akademiska kulturer och vill reflektera över det gränsöverskridande arbetet mellan teori och praktik. Vårt planerade upplägg är att tillsammans med workshopdeltagare skapa ett kunskapens mellanrum genom kollektiva överlappande vetenskapliga och gestaltande processer. Det tänkta upplägget är:1. En introduktion till projektet Kunskapens mellanrum.2. Övningen introduceras. Det handlar om att med olika enkla material gestalta kunskap genom devicingmetoden och parallellekmetoden.3. Vi genomför övningen genom att använda oss av varandra och rummet. Vetenskaplig kunskap, lärarroll, studentroll, akademisk kultur och akademiska maktrelationer är begrepp som leks med och problematiseras.4. Deltagarna arbetar i en växelverkan med leken, görandet och dokumentation. Vi använder oss av det framtagna gestaltade materialet och gör en analys av och reflektion över det som är dokumenterad kunskap.5. Ett presentations- och utställningsrum skapas, som förhoppningsvis kan vara kvar över konferensen, så att deltagarna och andra kan återkomma för reflektioner.
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| 7. |
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| 8. |
- Cöster, Maria C., et al.
(författare)
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Validation of Two Foot and Ankle Scores – SEFAS (Self-reported Foot And Ankle Score) and AOFAS
- 2014
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Konferensbidrag (refereegranskat)abstract
- INTRODUCTION: The American Orthopedic Foot and Ankle Score (AOFAS) is for many foot and ankle surgeons the gold standard for evaluation of foot and ankle disorders. The score comprises of four different questionnaires depending on which region is evaluated, and covers three different constructs; pain, function and range of motion and alignment. AOFAS however, requires clinical examination, and can therefore not be used as a patient-reported outcome measure (PROM). In contrast, the Self-Reported Foot and Ankle Score (SEFAS) is a PROM that recently has been validated with good results in patients with foot and ankle disorders. The SEFAS contains 12 questions and covers different constructs such as pain, function and limitation of function. The aim of this study was to compare the SEFAS and AOFAS in patients with disorders in the great toe, the hindfoot and ankle, taking psychometric properties for scores into account.PATIENTS AND METHODS: The SEFAS and AOFAS scores were completed by 73 patients with disorders in the great toe and by 89 patients with disorders in the hindfoot or ankle. The time it took to complete the questionnaire was measured in 17 patients. In all patients, construct validity for SEFAS versus AOFAS was estimated by Spearman´s correlation coefficient and we also evaluated if there were any floor and ceiling effects. Test-retest reliability (intra-observer reliability) was measured for SEFAS in 68 patients and for AOFAS in 33 patients with intra-class correlation coefficient (ICC). Inter-observer reliability was calculated in nine patients for AOFAS using ICC. Responsiveness, i.e. the ability of a score to detect changes after a surgical intervention, was estimated by effect size (ES) and standardized response mean (SRM) in 120 patients for SEFAS and in 112 patients for AOFAS.RESULTS: The SEFAS was completed more than three times faster than AOFAS (165 seconds versus 515 seconds). SEFAS had good convergent validity (strong correlation) with AOFAS with a Spearman´s correlation coefficient of 0.64 in patients with great toe disorders and 0.65 in patients with hind foot/ankle disorders. There were no floor or ceiling effects in either of the scores. ICC was in patients with great toe disorders 0.94 (95% CI: 0.87-0.97) for SEFAS and 0.77 (95% CI: 0.39-0.93) for AOFAS, and in patients with hindfoot/ankle disorders 0.92 (95%CI: 0.85-0.95) for SEFAS and 0.52 (95%CI: 0.13-0.77) for AOFAS. ES was 1.4 for SEFAS and 1.8 for AOFAS and SRM 1.4 for SEFAS and 1.6 for AOFAS in patients with great toe disorders. ES was 1.2 for SEFAS and 1.1 for AOFAS and SRM 1.1 for SEFAS and 0.9 for AOFAS in patients with hindfoot/ ankle disorders. Inter-observer reliability was 0.43 (95% CI: 0.0-0.84) for AOFAS.DISCUSSION AND CONCLUSION: In this study there was a strong correlation between SEFAS and AOFAS indicating good construct validity for SEFAS. Both scores had good responsiveness and no floor or ceiling effects. The test-retest reliability was better for SEFAS than AOFAS while the inter-observer reliability was low for AOFAS. Finally, SEFAS was completed three times faster than AOFAS. In conclusion we consider SEFAS at least equal to AOFAS for evaluation of patients with foot and ankle disorders, and as no clinical examination is demanded in SEFAS, it is an ideal instrument for evaluation of clinical patient outcome in national registers.
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| 9. |
- Cöster, Maria, et al.
(författare)
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Validity, reliability, and responsiveness of the Self-reported Foot and Ankle Score (SEFAS) in forefoot, hindfoot, and ankle disorders
- 2014
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Ingår i: Acta Orthopaedica. - London : Informa Healthcare. - 1745-3674 .- 1745-3682. ; 85:2, s. 187-194
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: The self-reported foot and ankle score (SEFAS) is a questionnaire designed to evaluate disorders of the foot and ankle, but it is only validated for arthritis in the ankle. We validated SEFAS in patients with forefoot, midfoot, hindfoot, and ankle disorders.PATIENTS AND METHODS: 118 patients with forefoot disorders and 106 patients with hindfoot or ankle disorders completed the SEFAS, the foot and ankle outcome score (FAOS), SF-36, and EQ-5D before surgery. We evaluated construct validity for SEFAS versus FAOS, SF-36, and EQ-5D; floor and ceiling effects; test-retest reliability (ICC); internal consistency; and agreement. Responsiveness was evaluated by effect size (ES) and standardized response mean (SRM) 6 months after surgery. The analyses were done separately in patients with forefoot disorders and hindfoot/ankle disorders.RESULTS: Comparing SEFAS to the other scores, convergent validity (when correlating foot-specific questions) and divergent validity (when correlating foot-specific and general questions) were confirmed. SEFAS had no floor and ceiling effects. In patients with forefoot disorders, ICC was 0.92 (CI: 0.85-0.96), Cronbach's α was 0.84, ES was 1.29, and SRM was 1.27. In patients with hindfoot or ankle disorders, ICC was 0.93 (CI: 0.88-0.96), Cronbach's α was 0.86, ES was 1.05, and SRM was 0.99.INTERPRETATION: SEFAS has acceptable validity, reliability, and responsiveness in patients with various forefoot, hindfoot, and ankle disorders. SEFAS is therefore an appropriate patient- reported outcome measure (PROM) for these patients, even in national registries.
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| 10. |
- Karlsson, Magnus, et al.
(författare)
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Groin pain and soccer players: male versus female occurrence.
- 2014
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Ingår i: Journal of Sports Medicine and Physical Fitness. - 0022-4707. ; 54:4, s. 487-493
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Tidskriftsartikel (refereegranskat)abstract
- Groin pain is common in soccer players. Comparison of results from different studies, especially between genders, is difficult as studies use different definitions and data collection procedures. Therefore we conducted a study of both male and female soccer players enabling direct gender comparison.
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