| 1. |
- Witwit, Wisam, et al.
(författare)
-
Young soccer players have significantly more spinal changes on MRI compared to non-athletes.
- 2020
-
Ingår i: Translational Sports Medicine. - : Hindawi Limited. - 2573-8488. ; 3:4, s. 288-295
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose Evidence-based facts regarding spinal abnormalities and back pain in young athletes are needed in order to be able to adapt rehabilitation programs and preventive measures accordingly. The aim of this study was therefore to identify MRI changes in the thoracolumbar spine and the lifetime prevalence of back pain in young football players compared to non-athletes. Methods Young elite football players (n = 27) and non-athletes (n = 26) completed MRI examinations of the thoracolumbar spine. MRI images were evaluated for disk signal, height, bulging, herniation, Schmorl's nodes, spondylolisthesis, and vertebral wedging. All participants answered questionnaires regarding training hours and back pain. Results Disk degenerative changes were more commonly displayed by 89% of the football players compared to 54% of the controls (P = .006). Schmorl's nodes (22%), disk herniation (30%), and reduced disk height (37%) were more prevalent in football players compared to controls (0%) (P = .023 and P = .001, respectively). The lifetime prevalence of back pain was reported by 52% of football players and 44% of controls, a difference that was not statistically significant. Conclusion Young male football (soccer) players have more degenerative disk changes compared to non-athletes. Both groups displayed high lifetime prevalence of back pain.
|
|
| 2. |
- Isberg, Jonas, 1965, et al.
(författare)
-
Will early reconstruction prevent abnormal kinematics after ACL injury? Two-year follow-up using dynamic radiostereometry in 14 patients operated with hamstring autografts.
- 2011
-
Ingår i: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. - : Springer Science and Business Media LLC. - 1433-7347.
-
Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Previous studies have reported that Anterior Cruciate Ligament (ACL) reconstruction does not restore normal tibial rotation in patients with chronic instability and repeated episodes of giving way. We hypothesised that early ACL reconstruction, using quadruple hamstring autografts, before the pivoting episodes had occurred, would protect the knee joint from developing abnormal kinematics with increased external tibial rotation during flexion. METHODS: Fourteen consecutive patients (8 men, 6 women) with a median age of 24years (18-43), with a complete, isolated unilateral ACL rupture and an intact contralateral knee, were studied. The operations were performed by one experienced surgeon, using quadruple hamstring autografts. We used dynamic radiostereometry (RSA) with tantalum markers inserted in both the injured and the intact contralateral knee to study the pattern of knee motion during active and weight-bearing knee extension. The patients were evaluated pre-operatively and followed for 2years after the ACL reconstruction. The anterior-posterior laxity was measured using the KT-1000. RESULTS: Before surgical repair of the ACL, the internal/external tibial rotation or abduction/adduction did not differ significantly between the injured and intact knees (P=0.27-0.91). Separate studies of the anterior-posterior translation of the medial and lateral femoral flexion facet centres (MFC and LFC) relative to a fixed tibia did not reveal any significant differences between the injured and intact knees (P=0.21-0.59). Pre-operatively, the KT-1000 laxity measurements showed a side-to-side difference of 2.5 (1.0-5.5) mm. At 2years, the laxity side-to-side difference was 0.5 (0-3.0) mm (P=0.001), and there were still no significant differences between the injured and intact knees in terms of internal/external tibial rotation and abduction/adduction (P=0.13-0.60). Nor did the anterior-posterior translation of the flexion facet centres differs (P=0.27-0.97). CONCLUSION: During the first 6-8weeks after the ACL injury, before pivoting episodes had occurred, the kinematics of the injured knee were normal and did not differ from those of the intact contralateral knee. Reconstruction of the ACL within 10weeks after injury using quadruple hamstring autografts resulted in unchanged knee kinematics for 2years and no difference compared with the intact contralateral knee. Surgical repair during the early phase after the injury appears to protect the knee from developing abnormal knee motion after an ACL rupture. LEVEL OF EVIDENCE: III.
|
|
| 3. |
- Laxdal, Gauti, 1966, et al.
(författare)
-
A prospective comparison of bone-patellar tendon-bone and hamstring tendon grafts for anterior cruciate ligament reconstruction in male patients
- 2007
-
Ingår i: Knee Surg Sports Traumatol Arthrosc. - : Springer Science and Business Media LLC. - 0942-2056 .- 1433-7347. ; 15:2, s. 115-25
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to compare the results after arthroscopic anterior cruciate ligament (ACL) reconstruction using central-third, bone-patellar tendon-bone (BPTB Group) (n = 45) and four-strand semitendinosus/gracilis (ST/G Group) (n = 78) autografts in male patients. The type of study is non-randomised, prospective consecutive series. A consecutive series of 126 male patients, all with unilateral ACL ruptures, was included in the study. In both groups, interference screw fixation of the graft was used at both ends and 123/126 (97%) of the patients returned for the follow-up examination after a period of 25 (23-33) months. The pre-operative assessments in both groups were similar in terms of the Tegner activity level, the Lysholm knee scoring scale, KT-1000 measurements, one-leg-hop test and knee-walking test. A significant reduction in knee laxity as measured with the KT-1000 arthrometer, compared with the pre-operative assessments, was found in both groups (P < 0.001). No significant differences in the post-operative knee-laxity measurements were found between the groups. Both groups had a significantly improved functional outcome at follow-up in terms of the Lysholm knee scoring scale, Tegner activity level and one-leg-hop test. The BPTB Group had a significantly higher Tegner activity level at follow-up, compared with the ST/G Group (P = 0.02). Moreover, the patients in the BPTB Group were significantly more likely to have a Tegner activity level of 6 or above (P = 0.03). Otherwise, no significant differences were found between the two study groups at the 2-year follow-up. Two years after an ACL reconstruction, the two groups displayed no significant differences in terms of functional outcome and knee laxity. However, more patients in the BPTB Group returned to a higher Tegner activity level than that in the ST/G Group.
|
|
| 4. |
- Laxdal, Gauti, 1966, et al.
(författare)
-
A prospective randomized comparison of bone-patellar tendon-bone and hamstring grafts for anterior cruciate ligament reconstruction
- 2005
-
Ingår i: Arthroscopy. - 1526-3231. ; 21:1, s. 34-42
-
Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The aim of this study was to compare the results after arthroscopic anterior cruciate ligament (ACL) reconstruction using central-third, bone-patellar tendon-bone (BPTB group), 3-strand semitendinosus (ST group), or 4-strand semitendinosus/gracilis (ST/G group) autografts. TYPE OF STUDY: Prospective randomized trial. METHODS: A randomized series of 134 patients, all with unilateral ACL rupture was included in the study. In all 3 groups, interference screw fixation of the graft was used at both ends and 125 of 134 (93%) of the patients returned for the follow-up examination after 26 months (range, 20 to 43 months). The preoperative assessments in all 3 groups were similar in terms of gender, Tegner activity level, Lysholm score, KT-1000 measurements, 1-leg hop test, and the knee-walking test. RESULTS: At follow-up, the knee-walking test was significantly worse in the BPTB group than in the ST group (P = .0004) and ST/G group (P < .0001). Furthermore, the knee-walking test was significantly worse at follow-up than preoperatively in the BPTB group (P < .0001). The corresponding findings were not made in the other 2 groups. A significant reduction in knee laxity and an increase in activity level compared with the preoperative assessments were found in all 3 groups, without any significant differences between the groups. CONCLUSIONS: Two years after ACL reconstruction, the use of ST and ST/G autografts rendered significantly less discomfort during the knee-walking test than the use of BPTB autografts. However, in terms of functional outcome and knee laxity, the groups displayed no significant differences. LEVEL OF EVIDENCE: Level I.
|
|
| 5. |
- Laxdal, Gauti, 1966, et al.
(författare)
-
Biodegradable and metallic interference screws in anterior cruciate ligament reconstruction surgery using hamstring tendon grafts: prospective randomized study of radiographic results and clinical outcome
- 2006
-
Ingår i: The American Journal of Sports Medicine. - : SAGE Publications. - 0363-5465 .- 1552-3365. ; 34:10, s. 1574-80
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The use of biodegradable screws in anterior cruciate ligament reconstruction has grown in popularity. PURPOSE: To compare the clinical and radiographic results in arthroscopically assisted anterior cruciate ligament reconstruction using 4-strand hamstring tendon grafts and either metallic (metal group) or biodegradable (PLLA group) interference screw fixation. STUDY DESIGN: Randomized controlled trial; Level of evidence, 1. METHODS: A randomized series of 77 patients, all with a unilateral anterior cruciate ligament rupture, was included in the study. The preoperative assessments in both groups were similar in gender, Tegner activity level, Lysholm score, KT-1000 arthrometer measurements, and single-legged hop test results. In both groups, interference screw fixation of the graft was used at both ends, and 68 of 77 (88%) patients returned for a radiographic examination at 6 and 24 months, respectively. RESULTS: At follow-up, no significant differences were found between the 2 groups in KT-1000 arthrometer laxity measurements, Tegner activity level, or Lysholm score. The PLLA group had a significantly better outcome in the single-legged hop test and the final International Knee Documentation Committee classification (P = .007 and P = .03, respectively). At 6 and 24 months after the index operation, the PLLA group displayed significantly larger drill holes on the radiographs than did the metal group on both the tibial (8.1 vs 6.6 mm at 6 months [P = .0007]; 6.0 vs 3.2 mm at 24 months [P < .0001]) and femoral sides (7.8 vs 5.6 mm at 6 months [P < .0001]; 6.3 vs 1.9 mm at 24 months [P < .0001]). CONCLUSION: There were significantly larger radiographically visible drill holes on both the tibial and femoral sides in the PLLA group compared with the metal group at 6 and 24 months. Clinical examination at 2 years revealed no major differences between the groups. The larger drill holes in the PLLA group did not correlate with inferior clinical results.
|
|
| 6. |
- Laxdal, Gauti, 1966, et al.
(författare)
-
Outcome and risk factors after anterior cruciate ligament reconstruction: a follow-up study of 948 patients
- 2005
-
Ingår i: Arthroscopy. - : Elsevier BV. - 1526-3231. ; 21:8, s. 958-964
-
Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The aim of the study was to assess the outcome and risk factors after anterior cruciate ligament (ACL) reconstruction in a large group of patients. TYPE OF STUDY: Case series. METHODS: Included in this retrospective study were 948 patients (323 female, 625 male) with a symptomatic unilateral ACL rupture, who underwent arthroscopic reconstruction using patellar tendon autograft and interference screw fixation at 3 Swedish hospitals. The median age of the patients at the time of the index operation was 26 years (range, 14 to 53 years). The patients underwent surgery at a median of 12 months (range, 0.5 to 360 months) after their injury. Independent physiotherapists performed the follow-up examinations at a median of 32 months (range, 21 to 117 months) postoperatively. RESULTS: Of the 948 patients, 550 (58%) underwent meniscal surgery before, during, or after the ACL reconstruction. The median Tegner activity level was 8 (range, 2-10) before injury, 3 (range, 0-9) preoperatively, and 6 (range, 1-10) at follow-up (P < .0001 preoperative v follow-up). At follow-up, the median Lysholm score was 90 points (range, 14-100), the median KT-1000 anterior side-to-side laxity difference was 1.5 mm (range, -6 to 13 mm), and the median 1-leg hop test quotient was 95% (0% to 167%) compared with the contralateral normal side. At follow-up, 69.3% of the patients were classified as normal or nearly normal according to the International Knee Documentation Committee evaluation system. However, 36% of the patients were unable to or had severe problems performing the knee-walking test. Inferior results correlated with increased time period between the index injury and reconstruction and concomitant joint damage found at the index operation. CONCLUSIONS: Overall, the results were good after ACL reconstruction using patellar tendon autograft and interference screw fixation. Concomitant joint damage and a long time period between the injury and reconstruction are major risk factors for inferior outcome after ACL reconstruction. LEVEL OF EVIDENCE: Level IV, case series.
|
|
| 7. |
|
|
| 8. |
- Lidén, Mattias, 1973, et al.
(författare)
-
Patellar tendon or semitendinosus tendon autografts for anterior cruciate ligament reconstruction: a prospective, randomized study with a 7-Year follow-up
- 2007
-
Ingår i: Am J Sports Med. - : SAGE Publications. - 0363-5465. ; 35:5, s. 740-8
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The aim of the study was to compare the results after arthroscopic anterior cruciate ligament (ACL) reconstruction using central-third bone-patellar tendon-bone (BTB) autografts and triple/quadruple semitendinosus (ST) autografts. HYPOTHESIS: In the long-term, ACL reconstruction using BTB autografts will render more donor-site problems than ST autografts. STUDY DESIGN: Randomized controlled trial; Level of evidence, 1. METHODS: A randomized series of 71 patients (22 women and 49 men) with a unilateral ACL rupture who underwent reconstructive surgery were included in the study. The BTB graft was used in 34 patients (BTB group) and the ST-tendon graft was used in 37 patients (ST group). The patients were examined a median of 86 months (range, 68 to 114 months) after the reconstruction. RESULTS: Sixty-eight of 71 patients (96%) were examined at follow-up. The clinical assessments at follow-up revealed no significant differences between the BTB group and the ST group in terms of the Lysholm score, Tegner activity level, International Knee Documentation Committee evaluation system, 1-legged hop test, KT-1000 arthrometer laxity measurements, manual Lachman test, and range of motion. A significant improvement was seen in both groups compared with the preoperative values in terms of most clinical assessments. Donor-site morbidity in the form of knee-walking ability, kneeling ability, and area of disturbed anterior knee sensitivity revealed no significant differences between the groups. CONCLUSION: Seven years after ACL reconstruction, the subjective and objective outcomes were similar after using the central-third BTB autograft and triple/quadruple ST autograft. Furthermore, no difference in terms of donor-site morbidity was found between the 2 groups.
|
|
| 9. |
- Stener, Sven, 1953, et al.
(författare)
-
A long-term, prospective, randomized study comparing biodegradable and metal interference screws in anterior cruciate ligament reconstruction surgery: radiographic results and clinical outcome.
- 2010
-
Ingår i: The American journal of sports medicine. - : SAGE Publications. - 1552-3365 .- 0363-5465. ; 38:8, s. 1598-605
-
Tidskriftsartikel (refereegranskat)abstract
- During the past decade, the use of biodegradable implants in anterior cruciate ligament surgery has increased.Poly-L-lactide acid (PLLA) interference screws would render the same clinical results but greater tunnel enlargement than metal screws 8 years after anterior cruciate ligament reconstruction using hamstring tendon (semitendinosus/gracilis) autografts.Randomized controlled trial; Level of evidence, 1.A randomized series of 77 patients, all with a unilateral anterior cruciate ligament rupture, were divided into 2 groups (PLLA and metal). In both groups, hamstring tendon autografts were used with interference screw fixation at both ends and the patients were examined with standard radiographs, Tegner activity level, Lysholm knee score, single-legged hop test, early C-reactive protein response, and KT-1000 arthrometer knee laxity measurements.The preoperative assessments in both groups were similar in terms of gender, clinical tests, and the time from injury to surgery. The patients returned for a radiographic and clinical examination a mean of 96 months (range, 78-120 months) after the index operation. The PLLA group displayed significantly larger bone tunnels on the radiographs than the metal group on the femoral side (mean, 11.4 mm [range, 0-17.8 mm] vs 8.0 mm [range, 0-16.3 mm]; P < .005) but not on the tibial side (mean, 10.7 mm [range, 7.8-14.1 mm] vs 10.5 mm [range, 0-20.3 mm]; difference not significant). At follow-up, no significant differences were found between the PLLA and metal groups in terms of knee laxity measurements (median, 1.0 mm [range, -2.0-4.0 mm] vs 1.0 mm [range, -3.0-6.5 mm]), Tegner activity level (median, 7 [range,3-9] vs 6 [range, 2-9]), or the Lysholm knee score (median, 90 points [range, 51-100] vs 89 points [range, 53-100]). The C-reactive protein values did not differ significantly between the 2 groups except for an increase in the PLLA group compared with the metal group at day 1 postoperatively-23 mg/L (range, <6-55) vs 9 mg/L (range, <6-55) (P < .001).There were significantly larger radiographically visible bone tunnels on the femoral side but not on the tibial side in the PLLA group compared with the metal group 8 years after anterior cruciate ligament reconstruction using hamstring tendon autografts. This finding did not correlate with inferior clinical results. Because of the results in the present study, the authors have discontinued the use of PLLA interference screws.
|
|
