| 1. |
- Cöster, Maria, et al.
(författare)
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Baseline and 1-Year Follow-Up Data of Patients with End-Stage Hallux Rigidus Treated with an Arthrodesis Reported to Swefoot
- 2023
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Ingår i: Medical Research Archives. - 2375-1916. ; 11:6
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Tidskriftsartikel (refereegranskat)abstract
- Background: Hallux rigidus (HR) affects the first metatarsophalangeal joint and is the most common osteoarthritic condition in the foot. The most used surgical treatment for severe cases of HR is an arthrodesis. The aim of this study is to describe patient characteristics, surgical treatment and the patient-reported outcomes for patients treated with arthrodesis for HR using data from Swefoot, the Swedish quality register for foot and ankle surgery.Methods: From Swefoot we extracted data on patients who underwent surgery for HR between January 2014 and December 2019. We included 419 patients with end-stage HR, who had not previously been treated surgically for HR on the same side.The outcome was measured with the Self-reported Foot and Ankle Score (SEFAS) (summary score 0-48) and EuroQol 5 Dimensions (EQ5D) (index 0-1) together with questions regarding appearance, shoe wear and satisfaction. We extracted surgical and patient-reported data preoperatively and 1 year postoperatively.Results: Our patient-population is predominantly female, around 61 years old, and slightly overweight. The arthrodeses are most often fixated with screws and most of the patients are allowed to bear weight immediately after surgery. The mean SEFAS score is 22 preoperatively and 38 postoperatively, the corresponding values for EQ5D index are 0.56 and 0.81 which means that the health-related quality of life (HrQoL) improves significantly after surgery.Conclusion: Patients with severe HR treated with an arthrodesis have reduced pain, improved function and HrQoL according to the patient-reported outcome measures SEFAS and EQ5D. The mean postoperative SEFAS value was close to the mean SEFAS value of the Swedish general population in the same age category. Fixation techniques and postoperative regimen differ among surgeons in the country. This is the first report from Swefoot regarding this patient population.
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| 2. |
- Cöster, Maria C., et al.
(författare)
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Hallux rigidus – Osteoarthritis of the first MTP-joint. Surgical and patient-reported results from Swefoot
- 2021
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Ingår i: Foot and Ankle Surgery. - : Elsevier BV. - 1268-7731. ; 27:5, s. 555-558
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Tidskriftsartikel (refereegranskat)abstract
- Background: Swefoot is a Swedish national registry, that covers surgery in the foot and ankle. Surgical treatment of hallux rigidus (HR) vary within and between countries. The aim of this study was to report baseline variables for patients with HR. Methods: We extracted baseline characteristics, surgical procedures and patient-reported data for patients with HR entered in the registry during the period January 2014 to August 2019. Results: By August 2019, 1818 patients were reported in the registry. 68.9% of the patients were women, the average age was 58 years, the mean BMI was 26.4 kg/m2. 41.9% of the patients underwent a cheilectomy,19.8% a metatarsal osteotomy, 34.3% a fusion, 0.2% an arthroplasty, 0.3% Keller's procedure and 3.5% other methods. The preoperative summary score for SEFAS (Self-reported Foot and Ankle Score) was 26 and for EQ-5D (Euroqol-5 Dimension) 0.60. Conclusion: This study is the first report from Swefoot regarding HR.
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| 3. |
- Cöster, Marcus E., et al.
(författare)
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Patient-reported outcomes of joint-preserving surgery for moderate hallux rigidus : a 1-year follow-up of 296 patients from Swefoot
- 2021
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682. ; 92:1, s. 109-113
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose — Hallux rigidus (HR) may cause decreased range of motion, joint pain, and gait disturbances. There is a lack of evidence regarding the outcome of different surgical procedures for moderate HR. We report patient-reported outcomes after joint-preserving surgical procedures for moderate HR. Patients and methods — We included 296 patients registered in Swefoot (Swedish national registry of foot and ankle surgery) who underwent primary surgery for moderate HR 2014 through 2018. We extracted information on anthropometrics, grading of HR, chosen surgical procedure, and patient-reported data including the PROMs SEFAS (summary score 0–48) and EQ-5D-3L (index 0–1) preoperatively and 1 year postoperatively. Results — 115 patients underwent metatarsal decompression (i.e., Youngswick) osteotomy (YOT) and 181 underwent cheilectomy. The mean improvement in SEFAS score 1 year after surgery was 12 points (95% CI 10 − 13) for YOT and 10 points (CI 9 − 12) for cheilectomy. Also, EQ-5D improved in both groups. Patients who underwent YOT were more satisfied with the procedure (84% vs. 70% for cheilectomy, p = 0.02). Interpretation — Surgically treated patients with moderate HR improved after both YOT and cheilectomy, according to patient-reported data from Swefoot. Patients who underwent a YOT were more satisfied with their procedure. One possible explanation may be that more patients in the YOT group had a concomitant hallux valgus; however, we have no information on this.
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| 4. |
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| 5. |
- Cöster, Marcus E., et al.
(författare)
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Effects of an 8-year childhood physical activity intervention on musculoskeletal gains and fracture risk
- 2016
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Ingår i: Bone. - : Elsevier BV. - 8756-3282. ; 93, s. 139-145
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Tidskriftsartikel (refereegranskat)abstract
- Background Physical activity (PA) in childhood is associated with musculoskeletal benefits while the effect on fracture risk is yet to be determined. The aim of this study was to evaluate whether extension of a PA intervention leads to improvement in musculoskeletal traits with an accompanied reduced fracture risk. We hypothesized that the PA program would have beneficial effects in both sexes, but more so in girls since they tend to be less physically active than boys during this time frame. Methods In one elementary school we increased physical education (PE) from 60 to 200 min per school week and followed 65 girls and 93 boys from a mean age of 7 years until a mean age of 15 years. Thirty-nine girls and 37 boys in three other schools continued with 60 min of PE per week during the same years and served as controls. We measured bone mineral content (BMC), areal bone mineral density (aBMD), and bone area annually with dual energy X-ray absorptiometry, and leg muscle strength with a computerized dynamometer. In 3534 children within the same PE program (1339 in the intervention and 2195 in the control group) we registered incident fractures during the 8-year study period and estimated annual sex-specific fracture incidence rate ratios (IRRs). Results Girls in the intervention group annually gained more total body less head aBMD, spine aBMD (p < 0.01), femoral neck BMC (p < 0.05), lumbar vertebrae size (p < 0.05), and knee flexion strength (p < 0.05) than girls in the control cohort. In boys we found no group differences. There was an inverse correlation between number of years with extra PE and the annual IRR of sustaining fractures in both girls (r = − 0.90 (95% CI − 0.98 to − 0.51); p < 0.001) and boys (r = − 0.74 (95% CI − 0.94 to − 0.02); p < 0.05). Conclusion In this 8-year pediatric school-based moderate exercise intervention program there is an inverse correlation in both sexes between annual IRR and each additional year of extra PA. A sub-cohort of girls in the intervention group had greater gains in bone mass, bone size, and muscle strength, which could possibly explain the inverse correlation between years within the PA program and fracture risk, while in boys the reason for the inverse correlation remains unknown. It should be noted that differences in unreported factors such as skeletal maturity status, diet, and spare time PA could confound our inferences. That is, true causality cannot be stated.
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| 6. |
- Cöster, Marcus E., et al.
(författare)
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How does a physical activity programme in elementary school affect fracture risk? : A prospective controlled intervention study in Malmo, Sweden
- 2017
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 7:2
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Recent evidence from the 7-year followup of the Pediatric Osteoporosis Prevention (POP) study indicates an inverse correlation between years of participation in a physical activity (PA) intervention and fracture risk in children. However, we could not see a statistically significant reduction in fracture risk, which urged for an extension of the intervention. Setting: The study was conducted in 4 neighbouring elementary schools, where 1 school functioned as intervention school. Participants: We included all children who began first grade in these 4 schools between 1998 and 2012. This resulted in 1339 children in the intervention group and 2195 children in the control group, all aged 6-8 years at the state of the study. Intervention: We launched an 8-year intervention programme with 40 min of moderate PA per school day, while the controls continued with the Swedish national standard of 60 min of PA per week. Primary outcome measure: We used the regional radiographic archive to register objectively verified fractures and we estimated annual fracture incidences and incidence rate ratios (IRRs). Results: During the first year after initiation of the intervention, the fracture IRR was 1.65 (1.05 to 2.08) (mean 95% CI). For each year of the study, the fracture incidence rate in the control group compared with the intervention group increased by 15.7% (5.6% to 26.8%) (mean 95% CI). After 8 years, the IRR of fractures was 52% lower in the intervention group than in the control group (IRR 0.48 (0.25 to 0.91) (mean 95% CI))]. Conclusions: Introduction of the school-based intervention programme is associated with a higher fracture risk in the intervention group during the first year followed by a gradual reduction, so that during the eighth year, the fracture risk was lower in the intervention group.
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| 7. |
- Cöster, Marcus E., et al.
(författare)
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Physical function tests predict incident falls : A prospective study of 2969 men in the Swedish Osteoporotic Fractures in Men study
- 2020
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 48:4, s. 436-441
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Falls are common in the elderly population, and fall-related injuries are a major health issue. We investigated the ability of simple physical tests to predict incident falls. Methods: The Swedish Osteoporotic Fractures in Men (MrOS) study includes 3014 population-based men aged 69–81 years at the start of the study. These men performed five different physical tests at baseline: right-hand grip strength, left-hand grip strength, timed stand test, 6 m walking test (time and steps) and narrow walking test. During the first study year, we asked participants to fill out questionnaires regarding falls 4, 8 and 12 months after baseline. A total of 2969 men completed at least one questionnaire and were included in this study. We used generalised estimating equations and logarithmic regression models to estimate odds ratios for fallers and recurrent fallers (more than one fall during the one-year examination period) in each quartile of men for each physical test. Results: The proportions of fallers and recurrent fallers were higher in the lowest quartile of the physical tests than in the other three quartiles combined for all physical tests. A reduction of one standard deviation in respective physical test resulted in a 13–21% higher risk of becoming a faller and a 13–31% higher risk of becoming a recurrent faller. Conclusions: Low results on simple physical tests is a risk factor for incident falls in elderly Swedish men and may facilitate identification of high-risk individuals suitable for fall-intervention programs.
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| 8. |
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| 9. |
- Fritz, Jesper, et al.
(författare)
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A 5-year exercise program in children improves muscle strength without affecting fracture risk.
- 2016
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Ingår i: European Journal of Applied Physiology. - : Springer Science and Business Media LLC. - 1439-6327 .- 1439-6319. ; 116:4, s. 707-715
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Tidskriftsartikel (refereegranskat)abstract
- High level of physical activity (PA) is associated with great muscle strength and high fracture risk. This prospective controlled population-based study evaluated how a pediatric PA intervention program influenced muscle strength and fracture risk.
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