| 1. |
- Ardern, Clare, et al.
(author)
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Comparison of patient-reported outcomes among those who chose ACL reconstruction or non-surgical treatment.
- 2017
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In: Scandinavian Journal of Medicine and Science in Sports. - : Wiley-Blackwell. - 0905-7188 .- 1600-0838. ; 27:5, s. 535-544
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Journal article (peer-reviewed)abstract
- The aim of our study was to cross-sectionally compare patient-reported knee function outcomes between people who chose non-surgical treatment for ACL injury and those who chose ACL reconstruction. We extracted Knee Injury and Osteoarthritis Outcome Score (KOOS) and EuroQoL-5D data entered into the Swedish National ACL Registry by patients with a non-surgically treated ACL injury within 180 days of injury (n = 306), 1 (n = 350), 2 (n = 358), and 5 years (n = 114) after injury. These data were compared cross-sectionally to data collected pre-operatively (n = 306) and at 1 (n = 350), 2 (n = 358), and 5 years (n = 114) post-operatively from age- and gender-matched groups of patients with primary ACL reconstruction. At the 1 and 2 year comparisons, patients who chose surgical treatment reported superior quality of life and function in sports (1 year mean difference 12.4 and 13.2 points, respectively; 2 year mean difference 4.5 and 6.9 points, respectively) compared to those who chose non-surgical treatment. Patients who chose ACL reconstruction reported superior outcomes for knee symptoms and function, and in knee-specific and health-related quality of life, compared to patients who chose non-surgical treatment.
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| 2. |
- Gauffin, Håkan, et al.
(author)
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Knee Arthroscopic Surgery in Middle-Aged Patients With Meniscal Symptoms A 3-Year Follow-up of a Prospective, Randomized Study
- 2017
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In: American Journal of Sports Medicine. - : SAGE PUBLICATIONS INC. - 0363-5465 .- 1552-3365. ; 45:9, s. 2077-2084
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Journal article (peer-reviewed)abstract
- Background: The optimal treatment for middle-aged patients with knee pain and meniscal lesions has been extensively debated. Most previous studies have revealed only short-term beneficial results of knee arthroscopic surgery. The authors have previously shown a positive benefit of knee arthroscopic surgery and an exercise program after 1 year when compared with an exercise program alone. Purpose: To evaluate if knee arthroscopic surgery combined with an exercise program provided an additional long-term benefit after 3 years compared with an exercise program alone in middle-aged patients with meniscal symptoms. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Of 179 eligible patients, aged 45 to 64 years, 150 were randomized to (1) a 3-month exercise program (nonsurgery group) or (2) the same as group 1 plus knee arthroscopic surgery within 4 weeks (surgery group). The primary outcome was the change in the Knee Injury and Osteoarthritis Outcome Score (KOOS) subscore of pain between baseline and the 3-year follow-up. Results from the 1-year follow-up have been published previously. Results: Both treatment groups improved significantly in the KOOS pain subscore at 3 years follow-up in the intention-to-treat and as-treated analyses (P amp;lt; .001). The between-group difference for the change in the KOOS pain subscore between baseline and the 3-year follow-up was no longer statistically significant, neither in the intention-to-treat analysis (7.6 points; 95% CI, -0.6 to 15.9; P = .068) nor in the as-treated analysis (5.3 points; 95% CI, -3.1 to 13.8; P = .216). The factorial analysis of the effect of the intervention and age, onset of pain, and mechanical symptoms indicated that older patients improved more, regardless of treatment, and surgery may be more beneficial for patients without mechanical symptoms (as-treated analysis). The effect of the predictive factors on the KOOS pain subscore was uncertain because of the small sample size in the subgroup analyses. Conclusion: The benefit of knee arthroscopic surgery, seen at 1 year in middle-aged patients with meniscal symptoms, was diminished at 3 years and was no longer statistically significant.
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| 3. |
- Kvist, Joanna, 1967-, et al.
(author)
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Changes in knee motion pattern after anterior cruciate ligament injury - A case report
- 2007
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In: Clinical Biomechanics. - : Pergamon Press. - 0268-0033 .- 1879-1271. ; 22:5, s. 551-556
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Journal article (peer-reviewed)abstract
- Background: After an anterior cruciate ligament injury, the contra-lateral non-injured leg has been found to adapt towards the injured leg. Accordingly, in order to study changes in knee motion pattern after an anterior cruciate ligament injury, the ideal is to compare the same leg prior to and after the injury. However, this is very seldom possible. The purpose of the present study was to describe changes in static and dynamic sagittal tibial translation, electromyographic activity and muscle torque relevant to an anterior cruciate ligament tear in one patient evaluated both before and after the injury.Methods: A male soccer player was examined 11 weeks before and eight weeks after an anterior cruciate ligament injury. Sagittal tibial translation was measured with the CA-4000 electrogoniometer, statically during Lachman's test, and dynamically during isokinetic muscle testing, one-legged squat and level walking. The electromyographic activity of mm. quadriceps and hamstrings, was registered simultaneously during the one-legged squat test.Findings: Static tibial translation was increased by ∼2 mm, while dynamic tibial translation was decreased by 0.4 mm at isokinetic testing, 0.9 mm at one-legged squat and 2.4 mm during level walking compared to before the injury. Muscle torque decreased 30% and 35% for the quadriceps and the hamstrings muscle, respectively. The electromyographic activity revealed similar activation levels in quadriceps and a doubled level of activation in hamstring compared to before the injury.Interpretation: In spite of an increase in static tibial translation eight weeks after an anterior cruciate ligament injury, the tibial translation decreased during activity, thus indicating that the patient could stiffen the knee in order to protect it against increased shear forces.
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| 4. |
- Sonesson (fd Tagesson), Sofi, 1977-, et al.
(author)
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Rehabilitation after ACL injury and reconstruction from the patients perspective
- 2022
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In: Physical Therapy in Sport. - : Elsevier. - 1466-853X .- 1873-1600. ; 53, s. 158-165
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Journal article (peer-reviewed)abstract
- Objectives: To describe and compare patients appraisal of the rehabilitation and adherence to the rehabilitation program after acute ACL injury treated with (ACLR) or without (non-ACLR) reconstruction.Design: Prospective cohort study.Participants: 275 patients (143 females; mean age 25 +/- 7 years) with acute ACL injury, of whom 166 patients had ACLR within 24 months.Main outcome: Adherence to rehabilitation was assessed using the modified Sports Injury Rehabilitation Adherence Scale (SIRAS).Results: Appraisal of rehabilitation was higher in the post-ACLR group compared to the non-ACLR group at 3 months (91% compared to 70% scored rehabilitation as necessary, p = 0.025) and at 6 months (87% compared to 70% scored it as necessary, p = 0.017). SIRAS score did not differ between 3 and 6 months for the non-ACLR group (median (IQR) 13 (2) vs 13 (2)) or the post-ACLR group (14 (1) vs 14 (2), p>0.05). The post-ACLR group had a higher SIRAS score than the non-ACLR group at 3 and 6 months (p ≤0.001).Conclusion: Patients treated with ACLR reported valuing their rehabilitation more and rated greater adherence to the rehabilitation programme than non-surgically treated patients. As rehabilitation is essential for good knee function, strategies to improve adherence after non-ACLR treatment should be implemented.
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| 5. |
- Tagesson (Sonesson), Sofi, 1977-, et al.
(author)
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Dynamic and static tibial translation in patients with anterior cruciate ligament deficiency initially treated with a structured rehabilitation protocol
- 2017
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In: Knee Surgery, Sports Traumatology, Arthroscopy. - : Springer. - 0942-2056 .- 1433-7347. ; 25:8, s. 2337-2346
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Journal article (peer-reviewed)abstract
- PURPOSE:To compare dynamic and static tibial translation, in patients with anterior cruciate ligament deficiency, at 2- to 5-year follow-up, with the tibial translation after 4 months of rehabilitation initiated early after the injury. Secondarily, to compare tibial translation in the injured knee and non-injured knee and explore correlations between dynamic and static tibial translation.METHODS:Twelve patients with ACL rupture were assessed at 3-8 weeks after ACL injury, after 4 months of structured rehabilitation, and 2-5 years after ACL injury. Sagittal tibial translation was measured during the Lachman test (static translation) and during gait (dynamic translation) using a CA-4000 electrogoniometer.RESULTS:Static tibial translation was increased bilateral 2-5 years after ACL injury, whereas the dynamic tibial translation was unchanged. Tibial translation was greater in the injured knee compared with the non-injured knee (Lachman test 134 N 9.1 ± 1.0 vs. 7.0 ± 1.7 mm, P = 0.001, gait 5.6 ± 2.1 vs. 4.7 ± 1.8 mm, P = 0.011). There were no correlations between dynamic and static tibial translation.CONCLUSION:Dynamic tibial translation was unchanged in spite of increased static tibial translation in the ACL-deficient knee at 2- to 5-year follow-up compared to directly after rehabilitation. Dynamic tibial translation did not correlate with the static tibial translation. A more normal gait kinematics may be maintained from completion of a rehabilitation programme to mid-term follow-up in patients with ACL deficiency treated with rehabilitation only.
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| 6. |
- Tagesson (Sonesson), Sofi, 1977-
(author)
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Dynamic knee stability after anterior cruciate ligament injury : Emphasis on rehabilitation
- 2008
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Doctoral thesis (other academic/artistic)abstract
- Anterior cruciate ligament injury leads to increased sagittal tibial translation, and perceptions of instability and low confidence in the knee joint are common. Many patients have remaining problems despite treatment and are forced to lower their activity level and prematurely end their career in sports. The effect of ACL reconstruction and/or rehabilitation on dynamic knee stability is not completely understood. The overall aim of this thesis was to study the dynamic knee stability during and after rehabilitation in individuals with ACL injury. More specific aims were 1) to elaborate an evaluation method for muscle strength, 2) to evaluate the effect of exercises in closed and open kinetic chain, and 3) to evaluate dynamic knee stability in patients with ACL deficiency or ACL reconstruction.Sagittal tibial translation and knee flexion angle were measured using the CA‐4000 computerised goniometer linkage. Muscle activation was registered with electromyography.The intra‐ and inter‐rater reliability of 1 repetition maximum (RM) of seated knee extension was clinically acceptable. The inter‐rater reliability of 1RM of squat was also acceptable, but the intra‐rater reliability was lower. The systematic procedure for the establishment of 1RM that was developed can be recommended for use in the clinic.One specific exercise session including cycling and a maximum number of knee extensions and heel raises did not influence static or dynamic sagittal tibial translation in uninjured individuals. A comprehensive rehabilitation program with isolated quadriceps training in OKC led to significantly greater isokinetic quadriceps strength compared to CKC rehabilitation in patients with ACL deficiency. Hamstring strength, static and dynamic translation, and functional outcome were similar between groups. Five weeks after ACL reconstruction, seated knee extension produced more anterior tibial translation compared to the straight leg raise and standing on one leg. All exercises produced less or equal amount of anterior tibial translation as the 90N Lachman test.Five weeks after the ACL reconstruction the static and dynamic tibial translation in the ACL reconstructed knee did not differ from the tibial translation on the uninjured leg. Patients in the early phase after ACL injury or ACL reconstruction used a joint stiffening strategy including a reduced peak knee extension angle during gait and increased hamstring activation during activity, which reduces the dynamic tibial translation. Patients with ACL deficiency that completed a four months rehabilitation program used a movement pattern that was more close to normal.
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| 7. |
- Tagesson (Sonesson), Sofi, 1977-, et al.
(author)
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Passive and dynamic translation in the knee is not influenced by knee exercises in healthy individuals
- 2005
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In: Scandinavian Journal of Medicine and Science in Sports. - : Wiley-Blackwell. - 0905-7188 .- 1600-0838. ; 15:3, s. 139-147
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Journal article (peer-reviewed)abstract
- No evidence exists that repeated isolated quadriceps contractions lead to increased sagittal plane tibial translation. The purpose was to analyze passive and dynamic tibial translation before, during and after a specific exercise session, including cycling and a maximum number of knee extensions and heel-raises, in healthy individuals. Passive and dynamic sagittal tibial translation was measured on 18 healthy individuals (nine men and nine women) before, during and after a specific exercise session with heavy load, including cycling and maximum number of knee extensions and heel-raises. Sagittal tibial translation during the Lachman test, maximal isometric quadriceps contraction, one-legged squat and gait was registered with the CA-4000 electrogoniometer. The electromyographic (EMG) activity of m. vastus medialis and lateralis, m. gastrocnemius and mm. hamstrings was registered. There was no difference in passive or dynamic sagittal tibial translation during or after the exercise session. No difference could be detected in EMG activity during squat after compared with before the exercise session. In conclusion, the knee exercises did not influence the amount of translation in healthy individuals. The findings indicate that isolated strength training of quadriceps may be included in anterior cruciate ligament rehabilitation programs, even if further specific studies on injured individuals most be performed.
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| 8. |
- Tagesson (Sonesson), Sofi, 1977-, et al.
(author)
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Psychological factors are important to return to pre-injury sport activity after anterior cruciate ligament reconstruction : expect and motivate to satisfy.
- 2017
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In: Knee Surgery, Sports Traumatology, Arthroscopy. - : Springer London. - 0942-2056 .- 1433-7347. ; 25:5, s. 1375-1384
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Journal article (peer-reviewed)abstract
- PURPOSE: To describe individuals' expectations, motivation, and satisfaction before, during, and after rehabilitation for ACL reconstruction and to explore how these factors were associated with return to pre-injury sport activity at 1-year follow-up.METHODS: Sixty-five individuals (34 males), median age 22 (15-45) years, scheduled for ACL reconstruction participated. Participants completed the International Knee Documentation Committee Subjective Knee Form (IKDC-SKF) and questions about expectations, satisfaction, and motivation pre-operatively and at 16 and 52 weeks after surgery.RESULTS: Prior to surgery, 86 % of participants stated that their goal was to return to their pre-injury sport activity. Those who had returned to their pre-injury sport activity at 52 weeks were more motivated during rehabilitation to return to their pre-injury activity level, more satisfied with their activity level and knee function at 52 weeks, and scored significantly higher on the IKDC-SKF [median 92.0 (range 66.7-100.0)] at 52 weeks, compared to those who had not returned [median 77.6 (range 50.6-97.7)].CONCLUSION: Prior to ACL reconstruction, most participants expected to return to their pre-injury activity level. Higher motivation during rehabilitation was associated with returning to the pre-injury sport activity. The participants who had returned to their pre-injury sport activity were more satisfied with their activity level and knee function 1 year after the ACL reconstruction. Facilitating motivation might be important to support individuals in achieving their participation goals after ACL reconstruction.LEVEL OF EVIDENCE: Prospective cohort study, Level II.
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| 9. |
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| 10. |
- Tagesson (Sonesson), Sofi, 1977-
(author)
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Stabilitet i knäleden efter främre korsbandsskada
- 2008
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In: Svensk idrottsmedicin. - : Svensk Förening för Fysisk Aktivitet och Idrottsmedicin. - 1103-7652. ; 2, s. 26-29
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Journal article (pop. science, debate, etc.)
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| 11. |
- Tigerstrand Grevnerts, Hanna, 1981-, et al.
(author)
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Translation and testing of measurement properties of the Swedish version of the IKDC subjective knee form
- 2017
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In: Scandinavian Journal of Medicine and Science in Sports. - : WILEY. - 0905-7188 .- 1600-0838. ; 27:5, s. 554-562
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Journal article (peer-reviewed)abstract
- To translate to Swedish language and cross-culturally adapt the IKDC-SKF and to test the measurement properties of the Swedish version of IKDC-SKF in ACL-injured patients undergoing reconstruction surgery.The translation and cross-cultural adaption was performed according to guidelines. Seventy-six patients with an ACL injury filled out the IKDC-SKF and other questionnaires before ACL reconstruction and at 4, 6, and 12months after surgery. A total of 203 patients from the Swedish ACL Registry participated at 8months post-operative. Measurement properties were tested according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines.The Swedish IKDC-SKF had high internal consistency (Cronbachs alpha=0.90) and test-retest reliability (ICC2,1=0.92, CI 95%: 0.81-0.97, P<.001). A single factor solution accounted for 46.1% of the variance in IKDC-SKF scores. Criterion validity was moderate to high. All ten predefined hypotheses for hypothesis testing were confirmed. The six hypotheses for responsiveness testing were confirmed. The effect size was 1.8, the standardized response mean was 1.9, the and minimal clinically important difference was 13.9 points.The Swedish version of the IKDC-SKF had good measurement properties and can be recommended for use in a population of ACL-deficient patients undergoing ACL reconstruction.
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