| 1. |
- Hamrin Senorski, Eric, 1989, et al.
(författare)
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Preoperative knee laxity measurements predict the achievement of a patient-acceptable symptom state after ACL reconstruction: a prospective multicenter study
- 2017
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Ingår i: Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine. - : Elsevier BV. - 2059-7754 .- 2059-7762. ; 3:1
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Tidskriftsartikel (refereegranskat)abstract
- Objective To determine whether patient-related factors, concomitant injuries and preoperative knee laxity could predict a patient acceptable symptom state (PASS) in the International Knee Documentation Committee Subjective Knee Form (IKDC-SKF) at 1 and 2 years follow-up after anterior cruciate ligament (ACL) reconstruction in a multicentre cohort. Methods Patients between 14 and 50 years of age who underwent single-bundle ACL reconstruction with hamstring tendon autograft within 1 year from the index injury were eligible. Additionally, only patients who completed the IKDC-SKF questionnaire at 1 or 2 years of follow-ups were included. Preoperative knee laxity assessment of patients in the awake state was performed using rolimeter, the Lachman and the pivot-shift test. The pivot shift was graded according to the IKDC criteria and also quantified by the use of non-invasive technology for (1) lateral tibial translation and (2) tibial acceleration. The quantitative pivot shift (QPS) was examined in the awake state and under anaesthesia (EUA). Univariable logistic regression models were performed with achieving PASS in the IKDC as the dependent variable. Results A total of 86 patients had complete data on the IKDC-SKF score at 1-year follow-up, of which 67 patients (77.9%) achieved PASS (age 24.8±9.3 years, 43% females). Two-year data were available for 50 patients, of which 39 patients (78.9%) achieved PASS (age 23.9±9.2 years, 42.0% females). A low-grade manual pivot shift according to IKDC grading had increased odds of achieving PASS at 1 year (OR=2.96 (95% CI 1.01 to 8.66), P<0.05) compared with patients who displayed a high-grade pivot shift preoperatively. However, this was not confirmed by the preoperative QPS measures (awake: tibial translation; OR=0.99,(95% CI 0.72 to 1.35), (n.s.), acceleration; OR=1.04,(95% CI 0.68 to 1.59), (n.s.) EUA: tibial translation; OR=1.02 (95% CI 0.78 to 1.31), (n.s.), acceleration; OR=1.14 (95% CI 0.93 to 1.40), (n.s.)). None of the studied variables of patient characteristics, concomitant injuries or knee joint laxity predicted PASS at the 2-year follow-up. Conclusion Almost four in every five patients were able to achieve PASS 1 and 2 years after anatomic single-bundle ACL reconstruction. The presence of preoperative low-grade pivot shift increased the odds of achieving an acceptable level of knee function 1 year after ACL reconstruction compared with high-grade pivot shift; however, QPS did not confirm achievement of PASS in this study. Level of evidence Level III, prospective cohort.
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| 2. |
- Lian, Jayson, et al.
(författare)
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Rotatory Knee Laxity Exists on a Continuum in Anterior Cruciate Ligament Injury.
- 2020
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Ingår i: The Journal of bone and joint surgery. American volume. - 1535-1386. ; 102:3, s. 213-220
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this investigation was to compare the magnitude of rotatory knee laxity in patients with a partial anterior cruciate ligament (ACL) tear, those with a complete ACL tear, and those who had undergone a failed ACL reconstruction. It was hypothesized that rotatory knee laxity would increase with increasing injury grade, with knees with partial ACL tears demonstrating the lowest rotatory laxity and knees that had undergone failed ACL reconstruction demonstrating the highest rotatory laxity.A prospective multicenter study cohort of 354 patients who had undergone ACL reconstruction between 2012 and 2018 was examined. All patients had both injured and contralateral healthy knees evaluated using standardized, preoperative quantitative pivot shift testing, determined by a validated, image-based tablet software application and a surface-mounted accelerometer. Quantitative pivot shift was compared with the contralateral healthy knee in 20 patients with partial ACL tears, 257 patients with complete ACL tears, and 27 patients who had undergone a failed ACL reconstruction. Comparisons were made using 1-way analysis of variance (ANOVA) with post hoc 2-sample t tests with Bonferroni correction. Significance was set at p < 0.05.There were stepwise increases in side-to-side differences in quantitative pivot shift in terms of lateral knee compartment translation for patients with partial ACL tears (mean [and standard deviation], 1.4 ± 1.5 mm), those with complete ACL tears (2.5 ± 2.1 mm), and those who had undergone failed ACL reconstruction (3.3 ± 1.9 mm) (p = 0.01) and increases in terms of lateral compartment acceleration for patients with partial ACL tears (0.7 ± 1.4 m/s), those with complete ACL tears (2.3 ± 3.1 m/s), and those who had undergone failed ACL reconstruction (2.4 ± 5.5 m/s) (p = 0.01). A significant difference in lateral knee compartment translation was found when comparing patients with partial ACL tears and those with complete ACL tears (1.2 ± 2.1 mm [95% confidence interval (CI), 0.2 to 2.1 mm]; p = 0.02) and patients with partial ACL tears and those who had undergone failed ACL reconstruction (1.9 ± 1.7 mm [95% CI, 0.8 to 2.9 mm]; p = 0.001), but not when comparing patients with complete ACL tears and those who had undergone failed ACL reconstruction (0.8 ± 2.1 [95% CI, -0.1 to 1.6 mm]; p = 0.09). Increased lateral compartment acceleration was found when comparing patients with partial ACL tears and those with complete ACL tears (1.5 ± 3.0 m/s [95% CI, 0.8 to 2.3 m/s]; p = 0.0002), but not when comparing patients with complete ACL tears and those who had undergone failed ACL reconstruction (0.1 ± 3.4 m/s [95% CI, -2.2 to 2.4 m/s]; p = 0.93) or patients with partial ACL tears and those who had undergone failed ACL reconstruction (1.7 ± 4.2 m/s [95% CI, -0.7 to 4.0 m/s]; p = 0.16). An increasing lateral compartment translation of the contralateral, ACL-healthy knee was found in patients with partial ACL tears (0.8 mm), those with complete ACL tears (1.2 mm), and those who had undergone failed ACL reconstruction (1.7 mm) (p < 0.05).A progressive increase in rotatory knee laxity, defined by side-to-side differences in quantitative pivot shift, was observed in patients with partial ACL tears, those with complete ACL tears, and those who had undergone failed ACL reconstruction. These results may be helpful when assessing outcomes and considering indications for the management of high-grade rotatory knee laxity.Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
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| 3. |
- Lian, Jayson, et al.
(författare)
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Younger age and greater preoperative function predict compliance with 2-year follow-up visits after ACL reconstruction: an analysis of the PIVOT multicentre trial
- 2018
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Ingår i: Journal of ISAKOS. - : Elsevier BV. - 2059-7754. ; 3:5, s. 251-257
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Tidskriftsartikel (refereegranskat)abstract
- Objectives The purpose of this investigation was to identify clinical and demographic variables that may predict compliance, defined as patient follow-up at 1-year and 2-year postoperative appointments, after anterior cruciate ligament reconstruction (ACLR). Methods A total of 107 patients undergoing primary ACLR across four centres were prospectively followed for 2 years. Demographic and clinical data were recorded preoperatively and postoperatively, including patient-reported outcomes such as the Marx Activity Rating Scale, Cincinnati Occupational Rating Scale (CORS), International Knee Documentation Committee Subjective Knee Evaluation Form and Activities of Daily Living Scale (ADLS). Compliance was retrospectively defined using the presence or lack of outcome measures at 1-year and 2-year postoperative visits. Univariate analysis was done to compare demographic and clinical variables between compliant and non-compliant patients at 1-year and 2-year follow-up. Significant variables were entered into a logistic regression model. Significance was set at p<0.05. Results The overall rate of compliance at 1-year and 2-year postoperative appointments was 83.2% (89/107) and 57.0% (61/107), respectively. Regression analysis showed that residence in Kobe, Japan compared with Pittsburgh, USA (OR 10.28; 95% CI 1.0003 to 105.28), and ‘very strenuous’ (OR 16.74; 95% CI 3.21 to 87.43) and ‘strenuous’ (OR 18.78; 95% CI 2.01 to 175.78) preinjury activity level were independent factors associated with compliance at 1-year follow-up. At 2 years follow-up, younger age (OR 0.95; 95% CI 0.91 to 0.997), and greater preoperative score on CORS (OR 1.03; 95% CI 1.01 to 1.06) and on ADLS (OR 1.04; 95% CI 1.01 to 1.07) were independently associated with compliance. Conclusion While patients with greater level of strenuous activity were more likely to follow-up after ACL surgery at 1 year, patients who were younger and had higher preoperative function measured by CORS and ADLS were more likely to follow-up at 2 years. Differences in follow-up rates among the USA, Italy, Sweden and Japan may highlight important cultural, socioeconomic and infrastructural differences across international healthcare systems. Orthopaedic surgeons may consider the results of this study during preoperative discussion with their patients and design of future ACL clinical research trials. Level of evidence Level III, prospective cohort.
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| 4. |
- Lopomo, Nicola, et al.
(författare)
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Analysis of the influence of anaesthesia on the clinical and quantitative assessment of the pivot shift: a multicenter international study.
- 2017
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Ingår i: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. - : Springer Science and Business Media LLC. - 1433-7347. ; 25:10, s. 3004-3011
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Tidskriftsartikel (refereegranskat)abstract
- The main goal of this work was to evaluate the pivot shift test in awake and anesthetized patients by using two different quantitative methodologies and comparing the results with the standard clinical grading, taking advantage of a multicenter international study.Patients between 16 and 50years of age undergoing primary unilateral single-bundle anterior cruciate ligament (ACL) reconstruction were considered eligible. The pivot shift test was performed pre-operatively, with the patient awake and again with the patient under general anaesthesia. The pivot shift test was clinically graded as defined by the International Knee Documentation Committee. The instrumented assessment was performed by using two non-invasive acquisition systems; specifically, a system exploiting an inertial sensor and a video-based application developed on a commercial tablet using skin markers. Lateral compartment translation and the tibial acceleration reached during joint reduction were used as quantitative parameters.A total of 103 patients were enrolled in the study. Statistically significant difference was found between the distributions of clinical grade evaluated in awake patients and those under general anaesthesia (P<0.01). Comparing awake patients to those under general anaesthesia, lower values were found both for tibial acceleration (3.7±1.5 vs 6.0±4.6m/s(2), P<0.01) and lateral compartment translation of the involved limb (2.2±1.7 vs 3.0±2.2mm, P<0.01).This study indicated that significant differences in the grading of the pivot shift test exist between awake and anesthetized patients, regardless of the use of quantitative instruments during the evaluation. Actual clinical assessment reported indeed its weakness, presenting subjective variability and dependence on tester's experience. However, several factors might influence the validity of awake examination such as experience level of examiner and cultural factors, as seen in this international multicenter study.Prospective comparative study, Level II.
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| 5. |
- Meredith, Sean J., et al.
(författare)
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Return to Sport After Anterior Cruciate Ligament Injury: Panther Symposium ACL Injury Return to Sport Consensus Group
- 2020
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Ingår i: Orthopaedic Journal of Sports Medicine. - : SAGE Publications. - 2325-9671. ; 8:6
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Tidskriftsartikel (refereegranskat)abstract
- Background: A precise and consistent definition of return to sport (RTS) after anterior cruciate ligament (ACL) injury is lacking, and there is controversy surrounding the process of returning patients to sport and their previous activity level. Purpose: The aim of the Panther Symposium ACL Injury Return to Sport Consensus Group was to provide a clear definition of RTS after ACL injury and a description of the RTS continuum as well as provide clinical guidance on RTS testing and decision-making. Study Design: Consensus statement. Methods: An international, multidisciplinary group of ACL experts convened as part of a consensus meeting. Consensus statements were developed using a modified Delphi method. Literature review was performed to report the supporting evidence. Results: Key points include that RTS is characterized by achievement of the preinjury level of sport and involves a criteria-based progression from return to participation to RTS and, ultimately, return to performance. Purely time-based RTS decision-making should be abandoned. Progression occurs along an RTS continuum, with decision-making by a multidisciplinary group that incorporates objective physical examination data and validated and peer-reviewed RTS tests, which should involve functional assessment as well as psychological readiness. Consideration should be given to biological healing, contextual factors, and concomitant injuries. Conclusion: The resultant consensus statements and scientific rationale aim to inform the reader of the complex process of RTS after ACL injury that occurs along a dynamic continuum. Research is needed to determine the ideal RTS test battery, the best implementation of psychological readiness testing, and methods for the biological assessment of healing and recovery.
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| 6. |
- Morokuma, Tomoki, et al.
(författare)
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Kiso Supernova Survey (KISS) : Survey strategy
- 2014
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Ingår i: Nippon Tenmon Gakkai obun kenkyu hokoku. - : Oxford University Press (OUP). - 0004-6264. ; 66:6
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Tidskriftsartikel (refereegranskat)abstract
- lThe Kiso Supernova Survey (KISS) is a high-cadence optical wide-field supernova (SN) survey. The primary goal of the survey is to catch the very early light of a SN, during the shock breakout phase. Detection of SN shock breakouts combined with multi-band photometry obtained with other facilities would provide detailed physical information on the progenitor stars of SNe. The survey is performed using a 2 degrees.2 x 2 degrees.2 field-of-view instrument on the 1.05-m Kiso Schmidt telescope, the Kiso Wide Field Camera (KWFC). We take a 3-min exposure in g-band once every hour in our survey, reaching magnitude g similar to 20-21. About 100 nights of telescope time per year have been spent on the survey since 2012 April. The number of the shock breakout detections is estimated to be of the order of 1 during our three-year project. This paper summarizes the KISS project including the KWFC observing setup, the survey strategy, the data reduction system, and CBET-reported SNe discovered so far by KISS.
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| 7. |
- Morokuma, Tomoki, et al.
(författare)
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OISTER optical and near-infrared monitoring observations of peculiar radio-loud active galactic nucleus SDSSJ110006.07+442144.3
- 2017
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Ingår i: Nippon Tenmon Gakkai obun kenkyu hokoku. - : Oxford University Press (OUP). - 0004-6264. ; 69:5
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Tidskriftsartikel (refereegranskat)abstract
- We present monitoring campaign observations at optical and near-infrared (NIR) wavelengths for a radio-loud active galactic nucleus (AGN) at z = 0.840, SDSSJ110006.07+442144.3 (hereafter, J1100+4421), which was identified during a flare phase in late 2014 February. The campaigns consist of three intensive observing runs from the discovery to 2015 March, mostly within the scheme of the OISTER collaboration. Optical-NIR light curves and simultaneous spectral energy distributions (SEDs) are obtained. Our measurements show the strongest brightening in 2015 March. We found that the optical-NIR SEDs of J1100+4421 show an almost steady shape despite the large and rapid intranight variability. This constant SED shape is confirmed to extend to similar to 5 mu m in the observed frame using the archival WISE data. Given the lack of absorption lines and the steep power-law spectrum of alpha(upsilon) similar to -1.4, where f(v) proportional to v(alpha upsilon), synchrotron radiation by a relativistic jet with no or small contributions from the host galaxy and the accretion disk seemsmost plausible as an optical-NIR emission mechanism. The steep optical-NIR spectral shape and the large amplitude of variability are consistent with this object being a low.peak jet-dominated AGN. In addition, sub-arcsecond resolution optical imaging data taken with Subaru Hyper Suprime-Cam does not show a clear extended component and the spatial scales are significantly smaller than the large extensions detected at radio wavelengths. The optical spectrum of a possible faint companion galaxy does not show any emission lines at the same redshift, and hence a merging hypothesis for this AGN-related activity is not supported by our observations.
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| 8. |
- Sundemo, David, et al.
(författare)
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Correlation between quantitative pivot shift and generalized joint laxity: a prospective multicenter study of ACL ruptures
- 2018
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Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy. - : Springer Science and Business Media LLC. - 0942-2056 .- 1433-7347. ; 26:8, s. 2362-2370
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Tidskriftsartikel (refereegranskat)abstract
- © 2017 The Author(s) Purpose: To investigate whether an increased magnitude of quantitative rotatory knee laxity is associated with a greater level of generalized joint laxity in ACL-injured and contralateral knees. Methods: A total of 103 patients were enrolled across four international centers to undergo anatomic ACL reconstruction. Rotatory knee laxity was evaluated preoperatively, both in the awake state and under anesthesia, using the standardized pivot shift test. Two devices were used to quantify rotatory knee laxity; an inertial sensor, measuring the joint acceleration, and an image analysis system, measuring the lateral compartment translation of the tibia. The presence of generalized joint laxity was determined using the Beighton Hypermobility Score. The correlation between the level of generalized joint laxity and the magnitude of rotatory knee laxity was calculated for both the involved knee and the non-involved knee. Further, patients were dichotomized into low (0–4) or high (5–9) Beighton Score groups. Alpha was set at < 0.05. Results: Ninety-six patients had complete datasets, 83 and 13 in the low and high Beighton Score groups respectively. In anesthetized patients, there was a significant correlation between the degree of Beighton Score and quantitative pivot shift when analyzing the non-involved knee using the image analysis system (r = 0.235, p < 0.05). When analyzing the same knee, multivariate analysis adjusted for meniscal injury, age and gender revealed an increased odds ratio for patients with increased lateral compartment translation to be part of the high Beighton Score group (OR 1.86, 95% CI 1.10–3.17, p < 0.05). No other correlation was significant. When analyzing the dichotomized subgroups, no significant correlations could be established. Conclusion: The findings in this study suggest that there is a weak correlation between generalized joint laxity and the contralateral healthy knee, indicating increased rotatory knee laxity in these patients. Generalized joint laxity does not appear to correlate with rotatory knee laxity in ACL-injured knees. Level of evidence: Prospective cohort study; level of evidence, 2.
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| 9. |
- Svantesson, Eleonor, et al.
(författare)
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Clinical Outcomes After Anterior Cruciate Ligament Injury: Panther Symposium ACL Injury Clinical Outcomes Consensus Group.
- 2020
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Ingår i: Orthopaedic journal of sports medicine. - 2325-9671. ; 8:7
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Tidskriftsartikel (refereegranskat)abstract
- A stringent outcome assessment is a key aspect of establishing evidence-based clinical guidelines for anterior cruciate ligament (ACL) injury treatment. To establish a standardized assessment of clinical outcome after ACL treatment, a consensus meeting including a multidisciplinary group of ACL experts was held at the ACL Consensus Meeting Panther Symposium, Pittsburgh, Pennsylvania, USA, in June 2019. The aim was to establish a consensus on what data should be reported when conducting an ACL outcome study, what specific outcome measurements should be used, and at what follow-up time those outcomes should be assessed. The group reached consensus on 9 statements by using a modified Delphi method. In general, outcomes after ACL treatment can be divided into 4 robust categories: early adverse events, patient-reported outcomes (PROs), ACL graft failure/recurrent ligament disruption, and clinical measures of knee function and structure. A comprehensive assessment after ACL treatment should aim to provide a complete overview of the treatment result, optimally including the various aspects of outcome categories. For most research questions, a minimum follow-up of 2 years with an optimal follow-up rate of 80% is necessary to achieve a comprehensive assessment. This should include clinical examination, any sustained reinjuries, validated knee-specific PROs, and health-related quality of life questionnaires. In the midterm to long-term follow-up, the presence of osteoarthritis should be evaluated. This consensus paper provides practical guidelines for how the aforementioned entities of outcomes should be reported and suggests the preferred tools for a reliable and valid assessment of outcome after ACL treatment.
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| 10. |
- Svantesson, Eleonor, et al.
(författare)
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Static anteroposterior knee laxity tests are poorly correlated to quantitative pivot shift in the ACL-deficient knee: a prospective multicentre study
- 2018
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Ingår i: Journal of ISAKOS: Joint Disorders & Orthopaedic Sports Medicine. - : Elsevier BV. - 2059-7762. ; 3:2, s. 83-88
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Tidskriftsartikel (refereegranskat)abstract
- Objective To determine the relationship between preoperative static knee joint laxity and non-invasive quantitative pivot shift (QPS) in patients with anterior cruciate ligament (ACL) rupture. Methods Patients with an ACL injury participating in a multicentre trial were analysed if they had complete preoperative data on the following laxity tests: the rolimeter, the KT-1000 (134N and manual maximum force), the Lachman, the anterior drawer and QPS. The QPS was assessed via a non-invasive inertial sensor system and an image analysis system for tibial acceleration and lateral tibial translation, respectively. Awake examination and examination under anaesthesia (EUA) were performed. Correlation between absolute values of static laxity and the QPS for each leg was assessed by Spearman’s rho. The Lachman and the anterior drawer were dichotomised into low- and high-grade, and differences between the groups in terms of continuous values of QPS were assessed. Results A total of 58 patients were included (41.4% women, mean age 27.1±9.8 years). Awake static laxity and QPS acceleration were negatively correlated in the ACL-deficient knee, meaning that a greater acceleration correlated to a lesser static tibial translation, and vice versa. The mean QPS acceleration correlated with the static tests as follows: the rolimeter r=−0.30 (P=0.024), the KT-1000 134N r=−0.25 (P=0.06) and the KT-1000 manual maximum r=−0.37 (P=0.004). A negative correlation between awake QPS acceleration and the static tests was also shown for the non-involved knee. Patients with a high-grade Lachman’s test in the EUA had significantly greater QPS acceleration (P=0.0002) and QPS translation (P<0.001) compared with patients with a low-grade. The corresponding analysis for the anterior drawer showed a significantly greater QPS translation in the high-grade group (P=0.01), while no differences were found in the QPS acceleration. Conclusion Static anteroposterior and dynamic knee laxities, as presented by QPS, are poorly correlated in the ACL-deficient knee and should therefore be considered as separate entities of the knee examination. These findings strengthen the implementation of non-invasive technology for quantification of the pivot shift when establishing treatment algorithms for ACL reconstruction.
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