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1.
  • Abat, Ferran, et al. (creator_code:aut_t)
  • Clinical utility of diagnostic ultrasound in athletes with tendinopathy (ICL 22)
  • 2016
  • record:In_t: Esska instructional course lecture book. - Berlin, Heidelberg : Springer Berlin/Heidelberg. - 9783662491133 - 9783662569795 - 9783662491140 ; , s. 217-223
  • swepub:Mat_chapter_t (swepub:level_refereed_t)abstract
    • Chronic painful tendinopathy is common in elite and recreational athletes and in sedentary subjects; all may have to stop or decrease their level of physical activity [1, 2]. Midportion Achilles tendinopathy and for the younger and heavy loading population also patellar tendinopathy are problematic injuries. However, recent research on innervation patterns histopathology and pain mechanisms in Achilles and patellar tendons has led to an increased knowledge about the chronic painful tendon [3–6].
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2.
  • Abat, F, et al. (creator_code:aut_t)
  • Current trends in tendinopathy : consensus of the ESSKA basic science committee. Part II
  • 2018
  • record:In_t: Journal of experimental orthopaedics. - : Springer. - 2197-1153. ; 5:38
  • swepub:Mat_article_t (swepub:level_refereed_t)abstract
    • The treatment of painful chronic tendinopathy is challenging. Multiple non-invasive and tendon-invasive methods are used. When traditional non-invasive treatments fail, the injections of platelet-rich plasma autologous blood or cortisone have become increasingly favored. However, there is little scientific evidence from human studies supporting injection treatment. As the last resort, intra- or peritendinous open or endoscopic surgery are employed even though these also show varying results. This ESSKA basic science committee current concepts review follows the first part on the biology, biomechanics and anatomy of tendinopathies, to provide a comprehensive overview of the latest treatment options for tendinopathy as reported in the literature.
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3.
  • Abat, F., et al. (creator_code:aut_t)
  • Current trends in tendinopathy : consensus of the ESSKA basic science committee. Part I: biology, biomechanics, anatomy and anexercise-based approach
  • 2017
  • record:In_t: Journal of Experimental Orthopaedics. - : Springer. - 2197-1153. ; 4:1
  • swepub:Mat_researchreview_t (swepub:level_refereed_t)abstract
    • Chronic tendinopathies represent a major problem in the clinical practice of sports orthopaedic surgeons, sports doctors and other health professionals involved in the treatment of athletes and patients that perform repetitive actions. The lack of consensus relative to the diagnostic tools and treatment modalities represents a management dilemma for these professionals. With this review, the purpose of the ESSKA Basic Science Committee is to establish guidelines for understanding, diagnosing and treating this complex pathology.
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4.
  • Abat, Ferran, et al. (creator_code:aut_t)
  • Sonosurgery ultrasound-guided arthroscopic shaving for the treatment of patellar tendinopathy when conservative treatment fails
  • 2023. - 3
  • record:In_t: Anterior knee pain and patellar instability. - Cham : Springer Nature. - 9783031097676 - 9783031097669 ; , s. 403-413
  • swepub:Mat_chapter_t (swepub:level_refereed_t)abstract
    • Proximal patellar Tendinopathy, commonly denominated as Jumper´s Knee, is widely considered to be a challenge to treat (Abat et al. in J Exp Orthop. 3:34, 2016). The treatment of patellar tendinopathy focuses on reducing if not eliminating the pain and improving function. At present, there are a several distinct treatments oriented to that end, and a “gold-standard” treatment might be in sight. (Abat F, Alfredson H, Cucchiarini M, Madry H, Marmotti A, Mouton C, Oliveira JM, Pereira H, Peretti GM, Spang C, Stephen J, van Bergen CJA, de Girolamo L. Current trends in tendinopathy: consensus of the ESSKA basic science committee. Part II: treatment options. J Exp Orthop. 2018 Sep 24;5(1):38. https://doi.org/10.1186/s40634-018-0145-5.)
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5.
  • Abat, Ferran, et al. (creator_code:aut_t)
  • Ultrasound-guided versus blind interventions in patellar tendon lesions : a cadaveric study
  • 2021
  • record:In_t: Skeletal Radiology. - : Springer. - 0364-2348 .- 1432-2161. ; 50:5, s. 967-972
  • swepub:Mat_article_t (swepub:level_refereed_t)abstract
    • Purpose: The present study aims to analyze the accuracy of injections aimed to hit the proximal and depth part of the patellar tendon "target point" in patellar tendinopathy, comparing ultrasound-guided or non-ultrasound-guided (blind) injections.Methods: A cadaver randomized study was carried out. Injections were performed under ultrasound control, as well as blinded. There were 26 knees from fresh cadavers and injections were placed by 26 practitioners with experience in the use of musculoskeletal ultrasound and injection treatment. Each participant performed 6 ultrasound-guided and 6 blind punctures in different cadaveric specimens. This provided 312 injections that were analyzed in 2 different anatomical cuts, thus providing a database of 624 measurements for statistical analysis.Results: Statistically significant differences were observed (p < 0.0001) in the distance from the target point between the ultrasound-guided and the non-guided infiltrations. The "unguided" injections were considered to have been performed on average 10 mm away from the target point compared to the "ultrasound-guided" injections. The ultrasound-guided injections obtained an accuracy of 74.36% while the "non-ultrasound-guided" injections obtained an accuracy of 11.54% (p < 0.0001).Conclusion: The use of ultrasound to guide the positioning of injections on the dorsal side of the proximal patellar tendon had a significantly higher accuracy compared to blind injections. The finding provides knowledge of importance for injection treatment.
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6.
  • Alfredson, Håkan, et al. (creator_code:aut_t)
  • A treatment algorithm for managing Achilles tendinopathy : new treatment options.
  • 2007
  • record:In_t: British Journal of Sports Medicine. - : BMJ. - 0306-3674 .- 1473-0480. ; 41:4, s. 211-216
  • swepub:Mat_researchreview_t (swepub:level_refereed_t)abstract
    • Achilles tendinopathy affects athletes, recreational exercisers and even inactive people. The pathology is not inflammatory; it is a failed healing response. The source of pain in tendinopathy could be related to the neurovascular ingrowth seen in the tendon's response to injury. The treatment of Achilles tendinopathy is primarily conservative with an array of effective treatment options now available to the primary care practitioner. If conservative treatment is not successful, then surgery relieves pain in the majority of cases. Directing a patient through the algorithm presented here will maximise positive treatment outcomes.
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7.
  • Alfredson, Håkan (creator_code:aut_t)
  • Achilles and patellar tendon operations performed in local anestesia
  • 2018
  • record:In_t: American journal of Anesthesiology and Pain medicine. - New York : ONOMY. - 2640-5377. ; 1:1, s. 001-002
  • swepub:Mat_article_t (swepub:level_refereed_t)abstract
    • From 20 years of research on innervation patterns and pain mechanisms in chronic painful Achilles and patellar tendinopathy, we have learned that the nerves are located outside the affected tendon. With this background we use local anestetics in combination with Adrenaline when these patients are surgical treated. We have now more than 15 years of experience in treating Achilles tendinopathy, and 10 years of experience in treating patellar tendinopaty, in local anesthesia alone. I will present the scientific background and practi-cal techniques to use local anesthesia for treatment of chronic painful Achilles and patellar tendinopathy.
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8.
  • Alfredson, Håkan, et al. (creator_code:aut_t)
  • Achilles tendinosis and calf muscle strength : the effect of short-term immobilization after surgical treatment
  • 1998
  • record:In_t: American Journal of Sports Medicine. - 0363-5465 .- 1552-3365. ; 26:2, s. 166-71
  • swepub:Mat_article_t (swepub:level_refereed_t)abstract
    • We prospectively studied calf muscle strength in 7 men and 4 women (mean age, 40.9 +/- 10.1 years) who had surgical treatment for chronic Achilles tendinosis. Surgery was followed by immobilization in a weightbearing below-the-knee plaster cast for 2 weeks followed by a stepwise increasing strength training program. Strength measurements (peak torque and total work) were done preoperatively (Week 0) and at 16, 26, and 52 weeks postoperatively. We measured isokinetic concentric plantar flexion strength at 90 and 225 deg/sec and eccentric flexion strength at 90 deg/sec on both the injured and noninjured sides. Preoperatively, concentric and eccentric strength were significantly lower on the injured side at 90 and 225 deg/sec. Postoperatively, concentric peak torque on the injured side decreased significantly between Weeks 0 and 16 and increased significantly between Weeks 26 and 52 at 90 deg/sec but was significantly lower than that on the noninjured side at all periods and at both velocities. The eccentric strength was significantly lower on the injured side at Week 26 but increased significantly until at Week 52 no significant differences between the sides could be demonstrated. It seems, therefore, that the recovery in concentric and eccentric calf muscle strength after surgery for Achilles tendinosis is slow. We saw no obvious advantages in recovery of muscle strength with a short immobilization time (2 weeks) versus a longer (6 weeks) period used in a previous study.
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9.
  • Alfredson, Håkan, et al. (creator_code:aut_t)
  • Aerobic workout and bone mass in females
  • 1997
  • record:In_t: Scandinavian Journal of Medicine and Science in Sports. - : Wiley. - 0905-7188 .- 1600-0838. ; 7:6, s. 336-341
  • swepub:Mat_article_t (swepub:level_refereed_t)abstract
    • This cross-sectional study aimed to investigate bone mass in females participating in aerobic workout. Twenty-three females (age 24.1 +/- 2.7 years), participating in aerobic workout for about 3 hours/week, were compared with 23 age-, weight- and height-matched non-active females. Areal bone mineral density (BMD) was measured in total body, head, whole dominant humerus, lumbar spine, right femoral neck, Ward's triangle, trochanter femoris, in specific sites in right femur diaphysis, distal femur, proximal tibia and tibial diaphysis, and bone mineral content (BMC) was measured in the whole dominant arm and right leg, using dual energy X-ray absorptiometry. The aerobic workout group had significantly (P < 0.05-0.01) higher BMD in total body (3.7%), lumbar spine (7.8%), femoral neck (11.6%), Ward's triangle (11.7%), trochanter femoris (9.6%), proximal tibia (6.8%) and tibia diaphysis (5.9%) compared to the non-active controls. There were no differences between the groups concerning BMD of the whole dominant humerus, femoral diaphysis, distal femur and BMC and lean mass of the whole dominant arm and right leg. Leaness of the whole dominant arm and leg was correlated to BMC of the whole dominant arm and right leg in both groups. In young females, aerobic workout containing alternating high and low impact movements for the lower body is associated with a higher bone mass in clinically important sites like the lumbar spine and hip, but muscle strengthening exercises like push-ups and soft-glove boxing are not associated with a higher bone mass in the dominant humerus. It appears that there is a skeletal adaptation to the loads of the activity.
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10.
  • Alfredson, Håkan, et al. (creator_code:aut_t)
  • Autologous periosteum transplantation for the treatment of full thickness patellar cartilage defects.
  • 2001
  • record:In_t: Ortopedia, traumatologia, rehabilitacja. - 1509-3492. ; 3:2, s. 216-223
  • swepub:Mat_article_t (swepub:level_refereed_t)abstract
    • Full-thickness patellar cartilage defects are often, but not always, associated with disabling anterior knee-pain and inability to take part in regular daily activities. There is no treatment of choice for this condition. It is well known that the cells in the cambium layer of the periosteum are pluripotent and can differentiate into hyaline (or hyaline-like) cartilage, especially if in a joint environment and under the influence of continous passive motion. In a few clinical studies autologous periosteum transplants alone have been used in the treatment of full thickness patellar cartilage defects. The results are varying. At our clinic, autologous periosteum transplantation alone, followed by continous passive motion (CPM) in the immediate postoperative period and non-weight bearing loading for 3 months, has shown promising clinical results. The best clinical results have been achieved on traumatic (fracture, contusion, dislocation) cartilage defects, where 83% of patients have been clinically graded as excellent or good at follow-up (> 2 years postoperatively). For non-traumatic patellar cartilage defects (chondromalacia NUD) the results are poor, with only 35% of patients being graded as excellent or good. Therefore, we believe that no-traumatic patellar cartilage defects (chondromalacia NUD) are less suitable for treatment with autologous periosteum transplants, and are at our clinic not any longer included for this type of treatment.
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