| 1. |
- Ahldén, Mattias, et al.
(författare)
-
A Prospective Randomized Study Comparing Double- and Single-Bundle Techniques for Anterior Cruciate Ligament Reconstruction.
- 2013
-
Ingår i: American Journal of Sports Medicine. - : SAGE Publications. - 0363-5465 .- 1552-3365. ; 41:11, s. 2484-2491
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:The aim of the study was to compare the results after arthroscopic anterior cruciate ligament (ACL) reconstruction using either the double-bundle or single-bundle technique with hamstring tendon autografts in an unselected group of patients. HYPOTHESIS:Double-bundle ACL reconstruction will render a better outcome on the pivot-shift test. STUDY DESIGN:Randomized controlled trial; Level of evidence, 1. METHODS:A randomized series of 103 patients (33 women, 70 men; median age, 27 years; range, 18-52 years) with a unilateral ACL rupture underwent anatomic ACL reconstruction. The double-bundle technique was used in 53 patients, and the single-bundle technique was used in 50 patients. The ACL footprint was visualized, and the femoral tunnel was drilled through the anteromedial portal; interference screw fixation was used at both ends. The patients were examined preoperatively and at a median of 26 months (range, 22-42 months) after the reconstruction by a blinded observer. The primary variable was the pivot-shift test. RESULTS:At 2-year follow-up, 98 patients (93%) were examined. Clinical assessments at follow-up revealed no significant differences between the double-bundle and single-bundle groups in terms of the pivot-shift test, KT-1000 arthrometer laxity measurements, manual Lachman test, range of motion, Lysholm knee scoring scale, Tegner activity scale, Knee Injury and Osteoarthritis and Outcome Score (KOOS), 1-legged hop test, and square hop test. A significant improvement was seen in both groups compared with the preoperative values in terms of most clinical assessments. CONCLUSION:In this prospective randomized study, the primary variable, the pivot-shift test, and other subjective and objective outcome variables revealed no significant differences between the double-bundle and single-bundle techniques at 2 years after ACL reconstruction in an unselected group of patients.
|
|
| 2. |
|
|
| 3. |
- Ahldén, Mattias, et al.
(författare)
-
Individualiserad terapi viktigt vid främre korsbandsskada. : Individualiserad terapi viktigt vid främre korsbandsskada.
- 2014
-
Ingår i: Lakartidningen. - 0023-7205. ; 111:39
-
Tidskriftsartikel (refereegranskat)abstract
- Anterior cruciate ligament (ACL) injury is a common injury and is often associated with concomitant injuries to the menisci and cartilage and, in the long term, osteoarthritis. Preventive training programs have shown to be highly effective in terms of reducing the risk for ACL injury in sports. ACL reconstruction is indicated when the patient experiences symtoms of instability (»giving way«) despite rehabilitation with a physiotherapist aiming to gain neuromuscular control of the knee. Early ACL reconstruction may be indicated, for example when the patient desires to return to pivoting contact-sports at high level. Modern surgical technique for ACL reconstruction has evolved rapidly and includes »anatomic reconstruction« and individualized treatment, where each patient's unique anatomy, injury and requests on knee function are taken into consideration. In Sweden, more than 90% of all ACL reconstructions performed are included into the Swedish National ACL Register.
|
|
| 4. |
- Ahldén, Mattias, et al.
(författare)
-
Outcome of anterior cruciate ligament reconstruction with emphasis on sex-related differences.
- 2012
-
Ingår i: Scandinavian journal of medicine & science in sports. - : Wiley. - 1600-0838 .- 0905-7188. ; 22:5, s. 618-626
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this retrospective study was to compare the results after arthroscopic anterior cruciate ligament (ACL) reconstruction using the four-strand semitendinosus-gracilis (ST/G) autograft in male (n=141) vs female (n=103) patients. The patients were operated on between 1996 and 2005, using interference screw fixation and drilling the femoral tunnel through the anteromedial portal. The pre-operative assessments and demographics, apart from age (males 29 years, females 26 years; P=0.02), were comparable at the time of surgery. At 25 (23-36) months post-operatively, no significant differences were found between the study groups in terms of anterior side-to-side knee laxity, manual Lachman test, Tegner activity level, Lysholm knee score, range of motion or donor-site morbidity. Both study groups improved significantly in most clinical assessments and functional scores compared with their pre-operative values. Two years after ACL reconstruction using ST/G autografts, there were no significant differences between male and female patients in terms of clinical outcome or functional scores.
|
|
| 5. |
- Ahldén, Mattias, et al.
(författare)
-
Rotatory knee laxity.
- 2013
-
Ingår i: Clinics in sports medicine. - : Elsevier BV. - 1556-228X .- 0278-5919. ; 32:1, s. 37-46
-
Tidskriftsartikel (refereegranskat)abstract
- Evaluation of injured-knee laxity is essential for treatment selection, clinical follow-up, and research. Interest in rotatory knee laxity increased with implementation of anatomic anterior cruciate ligament reconstruction. The pivot shift test represents a link between static testing with 1° of freedom and dynamic testing during functional activity. Difficulties lie in standardizing the performance of the pivot shift test and extracting measurable and relevant kinematic data. Noninvasive methodologies based on electromagnetic or acceleration sensors can evaluate the pivot shift in a quantitative and reliable manner. Further validation and reliability testing of devices for examination of rotatory laxity is warranted.
|
|
| 6. |
- Ahldén, Mattias, et al.
(författare)
-
The Swedish National Anterior Cruciate Ligament Register A Report on Baseline Variables and Outcomes of Surgery for Almost 18,000 Patients
- 2012
-
Ingår i: American Journal of Sports Medicine. - : SAGE Publications. - 0363-5465 .- 1552-3365. ; 40:10, s. 2230-2235
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The Swedish National Anterior Cruciate Ligament Register provides an opportunity for quality surveillance and research. Purpose: The primary objective was to recognize factors associated with a poorer outcome at an early stage. Study Design: Case series; Level of evidence, 4. Methods: Registrations are made using a web-based protocol with 2 parts: a patient-based section with self-reported outcome scores and a surgeon-based section, where factors such as cause of injury, previous surgery, time between injury and reconstruction, graft selection, fixation technique, and concomitant injuries are reported. The self-reported outcome scores are registered preoperatively and at 1, 2, and 5 years. Results: Approximately 90% of all anterior cruciate ligament (ACL) reconstructions performed annually in Sweden are reported in the register. Registrations during the period 2005-2010 were included (n = 17,794). After excluding multiligament reconstructions and reoperations, the male: female ratio was 57.5: 42.5 for both primary (n = 15,387) and revision (n = 964) surgery. The cause of injury was soccer in approximately half the male patients and in one third of the female patients. All subscales of the Knee injury and Osteoarthritis Outcome Score (KOOS) were significantly improved 1, 2, and 5 years postoperatively in patients undergoing primary reconstructions. In terms of the KOOS, revisions did significantly less well than primary reconstructions on all follow-up occasions, and smokers fared significantly less well than nonsmokers both preoperatively and at 2 years. Patients who had concomitant meniscal or chondral injuries at reconstruction did significantly less well preoperatively and at 1 year in terms of most KOOS subscales compared with patients with no such injuries. At 5 years, a significant difference was only found in terms of the sport/recreation subscale. Double-bundle reconstructions revealed no significant differences in terms of all the KOOS subscales at 2 years compared with single-bundle reconstructions (114 double-bundle vs 5109 single-bundle). During a 5-year period, 9.1% (contralateral, 5.0%; revision, 4.1%) of the patients underwent a contralateral ACL reconstruction or revision reconstruction of the index knee. The corresponding figure for 15- to 18-year-old female soccer players was 22.0%. Conclusion: Primary ACL reconstruction significantly improves all the subscales of the KOOS. Young female soccer players run a major risk of reinjuring their ACL or injuring the contralateral ACL; revision ACL reconstructions do less well than primary reconstructions, and smokers do less well than nonsmokers.
|
|
| 7. |
- Andernord, Daniel, et al.
(författare)
-
ABC om Axelsmärta
- 2013
-
Ingår i: Läkartidningen. - 0023-7205. ; 110:6, s. 286-9
-
Tidskriftsartikel (refereegranskat)
|
|
| 8. |
- Andernord, Daniel, et al.
(författare)
-
Surgical Predictors of Early Revision Surgery After Anterior Cruciate Ligament Reconstruction: Results From the Swedish National Knee Ligament Register on 13,102 Patients.
- 2014
-
Ingår i: The American journal of sports medicine. - : SAGE Publications. - 1552-3365 .- 0363-5465. ; 42:7, s. 1574-1582
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:An important objective of anterior cruciate ligament (ACL) registries is to detect and report early graft failure and revision surgery after ACL reconstruction. PURPOSE:To investigate surgical variables and identify predictors of revision surgery after ACL reconstruction. STUDY DESIGN:Prospective cohort study; Level of evidence, 2. METHODS:This prospective cohort study was based on data from the Swedish National Knee Ligament Register during the years 2005 through 2011. Eight surgical variables were investigated: graft selection, graft width, single-bundle or double-bundle techniques, femoral graft fixation, tibial graft fixation, injury-to-surgery interval, injuries to menisci, and injuries to cartilage. The primary endpoint was the 2-year incidence of revision surgery. Relative risks (RRs) and 95% confidence intervals (CIs) were calculated and adjusted for confounders by use of multivariate statistics. RESULTS:A total of 13,102 patients were included (5541 women [42%] and 7561 men [58%]; P < .001). Hamstring tendon autografts accounted for 90% (11,764 patients) of all reconstructions, of which 96% were performed with a single-bundle technique (11,339 patients). Patellar tendon autografts accounted for the remaining 10% (1338 patients). At index reconstruction, observed injuries to menisci and cartilage were common (40% and 28%, respectively). The overall 2-year incidence of revision surgery was 1.60% (women, 1.57%; men, 1.63%; P = .854). Patients with metal interference screw fixation of a semitendinosus tendon autograft on the tibia had a significantly reduced risk of early revision surgery (RR = 0.32; 95% CI, 0.12-0.90; P = .031). CONCLUSION:Metal interference screw fixation of a semitendinosus tendon autograft on the tibia was an independent predictor of significantly lower 2-year incidence of revision surgery. Graft selection, graft width, a single-bundle or a double-bundle technique, femoral graft fixation, the injury-to-surgery interval, and meniscus injury were not predictors of early revision surgery.
|
|
| 9. |
- Andersson, Jonny K, 1972, et al.
(författare)
-
Distal radio-ulnar joint instability in children and adolescents after wrist trauma.
- 2014
-
Ingår i: Journal of Hand Surgery, European Volume. - : SAGE Publications. - 1753-1934 .- 2043-6289. ; 39:6, s. 653-661
-
Tidskriftsartikel (refereegranskat)abstract
- This study retrospectively evaluated the medical records and radiographs of patients younger than aged 25 that were referred for a second opinion due to ulnar-sided wrist pain and persistent distal radio-ulnar (DRU) joint instability. We identified 85 patients with a major wrist trauma before the age of 18. Median age at trauma was 14 years. Median time between trauma and diagnosis of DRUJ instability was 3 years. Sixty-seven patients (79%) had sustained a fracture at the initial trauma. The two most common skeletal injuries related to the DRUJ instability were Salter-Harris type II fractures (24%) and distal radius fractures (19%). In 19 patients (22%), the secondary DRUJ instability was caused by malunion or growth arrest. Eighteen patients (21%) had no fracture; in spite of this, they presented with subsequent symptomatic DRUJ instability. Fourteen of these 18 patients had a triangular fibrocartilage complex (TFCC) tear, confirmed by arthroscopy, open surgery, or magnetic resonance imaging. In conclusion, late DRUJ instability due to wrist fractures or isolated TFCC tears was found to be common in children and adolescents.Level of evidence: IV.
|
|
| 10. |
- Askling, Carl Magnus, 1951-, et al.
(författare)
-
High-speed running type or stretching-type of hamstring injuries makes a difference to treatment and prognosis
- 2012
-
Ingår i: British Journal of Sports Medicine. - : BMJ. - 0306-3674 .- 1473-0480. ; 46:2, s. 86-87
-
Tidskriftsartikel (refereegranskat)abstract
- The article focuses on the two distinct types of hamstring muscle strains, highlighting the applicable rehabilitation approaches. It notes that acute hamstring strains are distinguished by the injury situations, namely the high-speed running type, and the stretching type, with the former requiring shorter rehabilitation period than the latter. It cites a comparative study of two rehabilitation protocols, pointing out that rehabilitation is shorter with lengthening exercises.
|
|
| 11. |
|
|
| 12. |
- Atesok, Kivanc, et al.
(författare)
-
An emerging cell-based strategy in orthopaedics: endothelial progenitor cells.
- 2012
-
Ingår i: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. - : Springer Science and Business Media LLC. - 1433-7347. ; 20:7, s. 1366-1377
-
Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The purpose of this article was to analyze the results of studies in the literature, which evaluated the use of endothelial progenitor cells (EPCs) as a cell-based tissue engineering strategy. METHODS: EPCs have been successfully used in regenerative medicine to augment neovascularization in patients after myocardial infarction and limb ischemia. EPCs' important role as vasculogenic progenitors presents them as a potential source for cell-based therapies to promote bone healing. RESULTS: EPCs have been shown to have prominent effects in promoting bone regeneration in several animal models. Evidence indicates that EPCs promote bone regeneration by stimulating both angiogenesis and osteogenesis through a differentiation process toward endothelial cell lineage and formation of osteoblasts. Moreover, EPCs increase vascularization and osteogenesis by increased secretion of growth factors and cytokines through paracrine mechanisms. CONCLUSION: EPCs offer the potential to emerge as a new strategy among other cell-based therapies to promote bone regeneration. Further investigations and human trials are required to address current questions with regard to biology and mechanisms of action of EPCs in bone tissue engineering.
|
|
| 13. |
- Augustsson Ryman, Sofia, 1975, et al.
(författare)
-
Performance Enhancement Following a Strength and Injury Prevention Program: A 26-Week Individualized and Supervised Intervention in Adolescent Female Volleyball Players
- 2011
-
Ingår i: INTERNATIONAL JOURNAL OF SPORTS SCIENCE & COACHING. - : SAGE Publications. - 1747-9541 .- 2048-397X. ; 6:3, s. 399-417
-
Tidskriftsartikel (refereegranskat)abstract
- Abstract: The aim of this study was to evaluate the effects of a 26-week individualized and supervised strength and injury prevention program on performance enhancement in young female volleyball players who completed resistance training with either a supervised and individualized training program (experimental group, n=10) or an unsupervised non-individualized training program (control group, n=17). Exposure and injury data were collected during the 2006-2007 season (baseline season) and the 26-week program was conducted during the 2007-2008 season (intervention season). All players were tested for physical performance. At post-test, the players in the experimental group had improved significantly more than the players in the control group for squat (p<0.0001), bench press (p=0.048), push-ups (p=0.02) and sit-ups (p<0.0001) but not for the vertical jump test. Thirty-five percent (6/17) of the players from the control group and 80% (8/10) of the players in the experimental group completed the resistance training with compliance of no less than 50%. The present study shows the importance of individualization and supervision for resistance training in young female athletes when it comes to compliance, strength gains and performance.
|
|
| 14. |
- Ayeni, Olufemi R, 1976, et al.
(författare)
-
Diagnosing femoroacetabular impingement from plain radiographs: Do radiologists and orthopaedic surgeons differ?
- 2014
-
Ingår i: Orthopaedic Journal of Sports Medicine. - : SAGE Publications. - 2325-9671. ; 2:7
-
Tidskriftsartikel (refereegranskat)abstract
- Background: A diagnosis of femoroacetabular impingement (FAI) requires careful history and physical examination, as well as an accurate and reliable radiologic evaluation using plain radiographs as a screening modality. Radiographic markers in the diagnosis of FAI are numerous and not fully validated. In particular, reliability in their assessment across health care providers is unclear. Purpose: To determine inter- and intraobserver reliability between orthopaedic surgeons and musculoskeletal radiologists. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: Six physicians (3 orthopaedic surgeons, 3 musculoskeletal radiologists) independently evaluated a broad spectrum of FAI pathologies across 51 hip radiographs on 2 occasions separated by at least 4 weeks. Reviewers used 8 common criteria to diagnose FAI, including (1) pistol-grip deformity, (2) size of alpha angle, (3) femoral head-neck offset, (4) posterior wall sign abnormality, (5) ischial spine sign abnormality, (6) coxa profunda abnormality, (7) crossover sign abnormality, and (8) acetabular protrusion. Agreement was calculated using the intraclass correlation coefficient (ICC). Results: When establishing an FAI diagnosis, there was poor interobserver reliability between the surgeons and radiologists (ICC batch 1 = 0.33; ICC batch 2 = 0.15). In contrast, there was higher interobserver reliability within each specialty, ranging from fair to good (surgeons: ICC batch 1 = 0.72; ICC batch 2 = 0.70 vs radiologists: ICC batch 1 = 0.59; ICC batch 2 = 0.74). Orthopaedic surgeons had the highest interobserver reliability when identifying pistol-grip deformities (ICC = 0.81) or abnormal alpha angles (ICC = 0.81). Similarly, radiologists had the highest agreement for detecting pistol-grip deformities (ICC = 0.75). Conclusion: These results suggest that surgeons and radiologists agree among themselves, but there is a need to improve the reliability of radiographic interpretations for FAI between the 2 specialties. The observed degree of low reliability may ultimately lead to missed, delayed, or inappropriate treatments for patients with symptomatic FAI. © The Author(s) 2014.
|
|
| 15. |
- Bindler, Richard, et al.
(författare)
-
Mining, Metallurgy and the Historical Origin of Mercury Pollution in Lakes and Watercourses in Central Sweden
- 2012
-
Ingår i: Environmental Science and Technology. - : American Chemical Society (ACS). - 0013-936X .- 1520-5851. ; 46:15, s. 7984-7991
-
Tidskriftsartikel (refereegranskat)abstract
- In Central Sweden an estimated 80% of the lakes contain fish exceeding health guidelines for mercury. This area overlaps extensively with the Bergslagen ore region, where intensive mining of iron ores and massive sulfide ores occurred over the past millennium. Although only a few mines still operate today, thousands of mineral occurrences and mining sites are documented in the region. Here, we present data on long-term mercury pollution in 16 sediment records from 15 lakes, which indicate that direct release of mercury to lakes and watercourses was already significant prior to industrialization (
|
|
| 16. |
- Bredvold, Randi, 1957-
(författare)
-
Entreprenørers fortellinger : en identitetsstudie i det opplevelsesbaserte reiselivet
- 2011
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This is a narrative study in which five entrepreneurs in the experience-based tourist industry have told their life-stories in connection with their establishing and running their own enterprises. Over the last decades the number of adventure-based companies has markedly increased in tourist industry, but the knowledge gained through the research on the persons who establish these companies is scant. Through focusing on the constructions of identity of the entrepreneurs, this study gives nuanced pictures of the chain of events that had lead an individual to establish one`s own company. In addition, these pictures offer deeper understanding of how these individuals perceive themselves as the founder and manager of an experience-based company. Over the last decades research in entrepreneurship has criticized the imbalanced focus on the entrepreneurs' personal characteristics and it's use as an explanation of their entrepreneurial activities. In the same critical vein I question whether motivational studies are able to explain why certain individuals choose to establish their own business. Indeed, these five stories show that an entrepreneur is not something one is but something one becomes. Although the concept of an experiential economy appeared at the end of the 1990s, the production of experiences has a long tradition in the tourist industry. Norwegian tourism has faced an uphill struggle for several decades, which worries both the authorities and the industry itself. In recent decades the focus has been directed more and more on the dimension of experience. One hopes that the creation of new and attractive adventures will help to reverse the negative trend in the industry. Effecting this reversal places a heavy responsibility on the entrepreneurs since they are to be the driving force in this process. Tourist adventures have been one of several core themes within the field of research in tourism for decades, but this focus has mainly been on the perspective of the consumer. In contrast, this study concentrates on the producers, a group about whom we know much less. The five entrepreneurs who tell their story in this study give detailed descriptions of their life until the establishment of their businesses, and we see that each of them describes a number of causal chains that are interwoven and together create a meaningful picture of their choice. Through focusing on their reflexive identity-constructions and viewing these in light of the concrete situations they were in, before they established their enterprises, we gain a deeper understanding of this choice. Through the process of categorizing these reflexive identity-constructions, three distinct ontological positions emerge, that is, different ways in understanding reality. The study shows that there is a connection between these ontological positions and the ways that the entrepreneurs run their businesses, as well as their understanding of how they create and produce adventures for their guests.
|
|
| 17. |
- Brorsson, Annelie, 1963, et al.
(författare)
-
Development and evaluation of a new seated heel-rise test in the early stages of rehabilitation after an acute Achilles tendon rupture.
- 2014
-
Ingår i: 16th ESSKA (European Society of Sports Traumatology, Knee Surgery and Arthroscopy) Congress, 14-17 May 2014, Amsterdam, Netherlands.
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The early stages of rehabilitation appear to be of great importance for outcome after an Achilles tendon rupture. It is a challenge to evaluate the patients’ calf muscle endurance at this stage in a safe and adequate way. The aim of our study was to develop a seated heel-rise test suitable for evaluating calf muscle endurance three months after an Achilles tendon rupture. Furthermore we wanted to evaluate how the seated heel-rise test correlated to the ability to perform one-legged standing heel-rise and patient-reported symptoms. Method: Ninety-three patients, 79 men and 14 women, mean age of 40 (20-63) years, were included from a cohort of 100 patients participating in a prospective, randomized controlled trial comparing non-surgical and surgical treatment after Achilles tendon rupture. Forty-seven were treated with surgery and 46 with non-surgery. They were evaluated after 3, 6 and 12 months. Patient reported outcome was evaluated with Achilles Tendon Rupture Score (ATRS) and functional outcome with seated and standing heel-rise test. The seated heel-rise test was performed with the patient sitting with hip and knee in 90°. A leg extension weight-training machine was used to provide load onto the patient’s thigh at 50% body weight. The limb symmetry index (LSI=injured/healthy x 100) was calculated in order to compare the results from the seated and standing heel-rise test. Results: Ninety-one patients out of 93 (98%) could perform the seated heel-rise test. At the 3-month follow-up there was a significant difference (p<0.01) in the seated heel-rise test between the injured and the healthy side. There were no significant differences between the surgical and non-surgical treatment groups. There were significant differences in the seated heel-rise test and in ATRS (p<0.01) when comparing the group who could perform a standing heel-rise test at the 3-months follow-up, with the group who could not. There were significant correlations between the LSI-values in the seated heel-rise height at the 3-month follow-up and the standing heel-rise height at the 6-month (r=0.36, p<0.001, n= 91) and the 12-month follow-up (r=0.35, p=0.001, n=85). There were also significant correlations (r=0.22-0.37, p=<0.04) between the seated heel-rise test and ATRS. Conclusions: The seated heel-rise-test has the capacity to identify differences between the injured and the healthy side three months after injury. This test also correlates with patient reported outcomes and the heel-rise ability at 6 and 12 months. This test appears to be a safe and suitable test for evaluating calf muscle endurance and function in the early stages of rehabilitation after an Achilles tendon rupture.
|
|
| 18. |
- Brynolfsson, Patrik, et al.
(författare)
-
ADC texture-An imaging biomarker for high-grade glioma?
- 2014
-
Ingår i: Medical physics (Lancaster). - : Wiley. - 0094-2405. ; 41:10, s. 101903-
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose:Survival for high-grade gliomas is poor, at least partly explained by intratumoral heterogeneity contributing to treatment resistance. Radiological evaluation of treatment response is in most cases limited to assessment of tumor size months after the initiation of therapy. Diffusion-weighted magnetic resonance imaging (MRI) and its estimate of the apparent diffusion coefficient (ADC) has been widely investigated, as it reflects tumor cellularity and proliferation. The aim of this study was to investigate texture analysis of ADC images in conjunction with multivariate image analysis as a means for identification of pretreatment imaging biomarkers.Methods:Twenty-three consecutive high-grade glioma patients were treated with radiotherapy (2 Gy/60 Gy) with concomitant and adjuvant temozolomide. ADC maps and T1-weighted anatomical images with and without contrast enhancement were collected prior to treatment, and (residual) tumor contrast enhancement was delineated. A gray-level co-occurrence matrix analysis was performed on the ADC maps in a cuboid encapsulating the tumor in coronal, sagittal, and transversal planes, giving a total of 60 textural descriptors for each tumor. In addition, similar examinations and analyses were performed at day 1, week 2, and week 6 into treatment. Principal component analysis (PCA) was applied to reduce dimensionality of the data, and the five largest components (scores) were used in subsequent analyses. MRI assessment three months after completion of radiochemotherapy was used for classifying tumor progression or regression.Results:The score scatter plots revealed that the first, third, and fifth components of the pretreatment examinations exhibited a pattern that strongly correlated to survival. Two groups could be identified: one with a median survival after diagnosis of 1099 days and one with 345 days, p = 0.0001.Conclusions:By combining PCA and texture analysis, ADC texture characteristics were identified, which seems to hold pretreatment prognostic information, independent of known prognostic factors such as age, stage, and surgical procedure. These findings encourage further studies with a larger patient cohort. (C) 2014 Author(s).
|
|
| 19. |
- Börjesson, Mats, et al.
(författare)
-
Ethical dilemmas faced by the team physician : overlooked in sports medicine education?
- 2014
-
Ingår i: British Journal of Sports Medicine. - : BMJ. - 0306-3674 .- 1473-0480. ; 48:19, s. 1398-1399
-
Tidskriftsartikel (refereegranskat)abstract
- The authors reflect on the ethical issues facing team physicians in soccer. They argue that sports ethics may have been overlooked in sports medicine education. The ethical issues highlighted by the authors include the substitution of star players, the return of soccer players following concussion and the importance of collaboration between team physicians and team managers.
|
|
| 20. |
- Börjesson, Mats, 1965-, et al.
(författare)
-
Lagläkarens många dilemman
- 2014
-
Ingår i: I gråzonen. - Stockholm : Centrum för Idrottsforskning. - 9789198183313 ; , s. 179-91
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)
|
|
| 21. |
- Börjesson, Mats, et al.
(författare)
-
Lagläkarens många dilemman
- 2014
-
Ingår i: Svensk Idrottsforskning. - 1103-4629. ; 23:2, s. 38-42
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Hur hanterar egentligen en lagläkare sin dubbla lojalitet, mellan omsorgen om spelarnas hälsa och en förståelse för klubbens sportsliga ambitioner? En lagläkare möter många och skilda etiska dilemman både på och utanför planen. Du gör en läkarundersökning i samband med att en ny spelare ska skriva på för klubben. Du vet att styrelsen och tränaren har stora förväntningar på spelaren. Det lukrativa kontraktet är redan påskrivet. Endast läkarundersökningen återstår. Vid undersökningen hittar du en korsbandsskada i ena knät. Det visar sig att spelaren skadade sig vid den sista seriematchen tre månader tidigare. Spelaren förbjuder dig att prata om detta med klubben och hänvisar till sekretess. Hur gör du nu? Den här artikeln tar upp ett antal etiska problem inom idrottsmedicinen. Det finns i dag ingen specifik utbildning i hur läkare ska hantera den här typen av frågor, men de diskuteras ofta när fotbollens lagläkare träffas. Artikeln är ett utdrag ur antologin I gråzonen utgiven av Centrum för idrottsforskning. Författarna har båda lång erfarenhet av rollen som lagläkare i fotboll, både på nationell och på internationell nivå. Jón Karlsson har varit läkare för IFK Göteborgs juniorer och A-lag sedan år 1984, och för de svenska U21- och OS-landslagen för herrar under en tioårsperiod. Mats Börjesson har varit lagläkare för herrlaget GAIS sedan 1995, för svenska damlandslaget sedan 2009, för damlaget Tyresö FF 2012-2013 samt för Elfenbenskustens lag i VM för herrar 2010.
|
|
| 22. |
- Börjesson, Mats, 1965, et al.
(författare)
-
Pain
- 2010
-
Ingår i: Physical Activity in the Prevention and Treatment of Disease. - 9789172577152
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)
|
|
| 23. |
- Börjesson, Mats, et al.
(författare)
-
Swedish sports medicine is alive and well!
- 2014
-
Ingår i: British Journal of Sports Medicine. - : BMJ. - 0306-3674 .- 1473-0480. ; 48:19, s. 1397-1397
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- An introduction is presented in which the authors discuss various reports within the issue on topics including exercise, concussion and sports ethics.
|
|
| 24. |
|
|
| 25. |
- Caesar, Ulla, et al.
(författare)
-
Incidence and root causes of cancellations for elective orthopaedic procedures : a single center experience of 17,625 consecutive cases.
- 2014
-
Ingår i: Patient Safety in Surgery. - : Springer Science and Business Media LLC. - 1754-9493. ; 8:24
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The purpose of the Swedish public health-care system is to provide care on equal terms for all citizens. In this, as in most other systems where taxes and/or insurances pay for most of the care, normal market forces are set aside at least in part. At times, this has, for example, resulted in long waiting lists, particularly in terms of elective orthopaedic surgery, with several negative consequences, such as cancellations of planned surgery.METHODS: The main purpose of this retrospective observational single center study was to evaluate and describe the number and reasons for cancellations in elective orthopaedic surgery. Studied were all the elective patients scheduled for joint replacement, arthroscopy and foot & ankle surgery, January 1, 2007 to December 31, 2011, whose procedure was cancelled at least once.RESULTS: Of all 17,625 patients scheduled for elective surgery 6,911 (39%) received at least one, some several cancellations. The most common reason for cancelling a planned surgery was different patient-related factors 3,293 (33%). Cancellations due to treatment guarantee legislation reached 2,885 (29%) and 1,181 (12%) of the cancellations were related to incomplete pre-operative preparation of the patients. Organisational reasons were the cause of approximately 869 (9%) of the cancellations.CONCLUSIONS: In this study of patients waiting for elective orthopaedic surgery 6,911(39%) had their surgical procedure cancelled at least once, some several times. It appears that it should be possible to eliminate many of these cancellations, while others are unavoidable or caused by factors outside the responsibility of the individual clinic or even hospital. One possible way of influencing the high rate of cancellations might be to change the view of the patients and involve them in the overall planning of the care process.
|
|
| 26. |
- Carmont, Michael R, 1972, et al.
(författare)
-
Cross cultural adaptation of the Achilles tendon Total Rupture Score with reliability, validity and responsiveness evaluation.
- 2012
-
Ingår i: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. - 1433-7347. ; 21:6, s. 1356-1360
-
Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The Achilles tendon Total Rupture Score (ATRS) was developed because of the need for a reliable, valid and sensitive instrument to evaluate symptoms and their effects on physical activity in patients following either conservative or surgical management of an Achilles tendon rupture. Prior to using the score in larger randomized trial in an English-speaking population, we decided to perform reliability, validity and responsiveness evaluations of the English version of the ATRS. Even though the score was published in English, the actual English version has not be validated and compared to the results of the Swedish version. METHODS: From 2009 to 2010, all patients who received treatment for Achilles tendon rupture were followed up using the English version of the ATRS. Patients were asked to complete the score at 3, 6 and 12months following treatment for Achilles tendon rupture. The ATRS was completed on arrival in the outpatient clinic and again following consultation. RESULTS: The outcomes of 49 (13 female and 36 male) patients were assessed. The mean (SD) age was 49 (12) years, and 27 patients had treatment for a left-sided rupture, 22 the right. All patients received treatment for ruptured Achilles tendons: 38 acute percutaneous repair, 1 open repair, 5 an Achilles tendon reconstruction using a Peroneus Brevis tendon transfer for delayed presentation, 1 gracilis augmented repair for re-rupture and 4 non-operative treatment for mid-portion rupture. The English version of ATRS was shown to have overall excellent reliability (ICC=0.986). There was no significant difference between the results with the English version and the Swedish version when compared at the 6-month- or 12-month (n.s.) follow-up appointments. The effect size was 0.93. The minimal detectable change was 6.75 points. CONCLUSIONS: The ATRS was culturally adapted to English and shown to be a reliable, valid and responsive method of testing functional outcome following an Achilles tendon rupture.
|
|
| 27. |
- de Meijer, P P G, et al.
(författare)
-
A guideline to medical photography: a perspective on digital photography in an orthopaedic setting.
- 2012
-
Ingår i: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. - : Springer Science and Business Media LLC. - 1433-7347. ; 20:12, s. 2606-2611
-
Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Quality photographs are essential for clinical documentation, research, and publication in scientific journals and teaching. Oftentimes, non-ideal lighting and a sterile environment restrict the medical photographer, resulting in lower-quality photographs. This article aims to provide a clear and comprehensible guideline for medical photography in an orthopaedic setting. METHODS: This article is based on extensive photographic involvement in operating and laboratory settings, in close collaboration with medical professionals from the Steadman Clinic (Vail, Colorado, USA), Gothenburg University (Göteborg, Sweden) and Erasmus MC (Rotterdam, the Netherlands). Background literature was searched through Google Scholar and PubMed. RESULTS: Three relevant journal articles, and one book on medical photography, were used to write this paper. Seventeen Internet articles were used for background information. CONCLUSION: A relevant, up-to-date and comprehensive guideline to medical photography for medical professionals, with or without photographic experience, is provided. LEVEL OF EVIDENCE: Expert opinion, Level V.
|
|
| 28. |
- Desai, Neel, et al.
(författare)
-
Outcomes after ACL reconstruction with focus on older patients: results from The Swedish National Anterior Cruciate Ligament Register.
- 2014
-
Ingår i: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. - : Springer Science and Business Media LLC. - 1433-7347. ; 22:2, s. 379-86
-
Tidskriftsartikel (refereegranskat)abstract
- To investigate and analyse outcomes of patients over the age of 40 who had undergone anterior cruciate ligament (ACL) reconstruction and to compare them to their younger counterparts. We analysed patient-reported outcomes measured using the knee injury and osteoarthritis outcome score (KOOS) as well as aetiology of injury, concomitant intra-articular injuries and time from injury to surgery.
|
|
| 29. |
- Einarsson, Fredrik, 1968, et al.
(författare)
-
Muscle biopsies from the supraspinatus in retracted rotator cuff tears respond normally to passive mechanical testing: a pilot study
- 2011
-
Ingår i: Knee surgery, sports traumatology, arthroscopy. - : Springer Science and Business Media LLC. - 1433-7347 .- 0942-2056. ; 19:3, s. 503-507
-
Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The aim of the present study was to assess the function of the isolated muscle component in retracted rotator cuff tears. METHODS: Muscle biopsies were harvested from the supraspinatus and the ipsilateral deltoid in seven patients undergoing surgery for a large, retracted rotator cuff tear. Single fibres and fibre bundles were subjected to passive stretching in vitro with subsequent recordings of tension and sarcomere lengths using the laser diffraction technique. Stress-strain curves were plotted, and the elastic modulus was calculated for all preparations. Morphology was evaluated with regard to collagen fraction, ratio between fast and slow fibres, fibre size and fibre size variability using standard staining techniques. RESULTS: Intra-individual comparisons of the stress-strain curves showed a high degree of conformity in terms of both shape and tangent values, and there were no statistically significant differences in the elastic modulus for single fibres and bundles in the deltoid and supraspinatus muscles, respectively, supported by the analysis of the observed confidence interval of the differences between the paired values of the elastic modulus. There were no differences in collagen content, fibre size and ratio between fast and slow fibres in the deltoid and supraspinatus muscles, respectively. CONCLUSION: We conclude that muscle biopsies from the supraspinatus in retracted rotator cuff tears respond normally to mechanical testing in vitro.
|
|
| 30. |
|
|
| 31. |
- Erichsen Andersson, Annette, 1966, et al.
(författare)
-
Patients' experiences of acquiring a deep surgical site infection : An interview study
- 2010
-
Ingår i: American Journal of Infection Control. - : Mosby, Inc.. - 0196-6553 .- 1527-3296. ; 38:9, s. 711-717
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The negative impact of surgical site infection (SSI) in terms of morbidity, mortality, additional costs, and length of stay (LOS) in the hospital is well described in the literature, as are risk factors and preventive measures. Given the lack of knowledge regarding patients’ experiences of SSI, the aim of the present study was to describe patients’ experiences of acquiring a deep SSI. Methods: Content analysis was used to analyze data obtained from 14 open interviews with participants diagnosed with a deep SSI. Results: Patients acquiring a deep SSI suffer significantly from pain, isolation, and insecurity. The SSI changes physical, emotional, social, and economic aspects of life in extremely negative ways, and these changes are often persistent. Conclusion: Health care professionals should focus on strategies to enable early diagnosis and treatment of SSIs. The unacceptable suffering related to the infection, medical treatment, and an insufficient patient-professional relationship should be addressed when planning individual care, because every effort is needed to support this group of patients and minimize their distress. All possible measures should be taken to avoid bacterial contamination of the surgical wound during and after surgery to prevent the development of SSI.
|
|
| 32. |
- Erichsen Andersson, Annette, 1966, et al.
(författare)
-
The application of evidence-based measures to reduce surgical site infections during orthopedic surgery - report of a single-center experience in Sweden.
- 2012
-
Ingår i: Patient safety in surgery. - : Springer Science and Business Media LLC. - 1754-9493. ; 6:11
-
Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT: BACKGROUND: Current knowledge suggests that, by applying evidence-based measures relating to the correct use of prophylactic antibiotics, perioperative normothermia, urinary tract catheterization and hand hygiene, important contributions can be made to reducing the risk of postoperative infections and device-related infections. The aim of this study was to explore and describe the application of intraoperative evidence-based measures, designed to reduce the risk of infection. In addition, we aimed to investigate whether the type of surgery, i.e. total joint arthroplasty compared with tibia and femur/hip fracture surgery, affected the use of protective measures. METHOD: Data on the clinical application of evidence-based measures were collected structurally on site during 69 consecutively included operations involving fracture surgery (n = 35) and total joint arthroplasties (n = 34) using a pre-tested observation form. For observations in relation to hand disinfection, a modified version of the World Health Organization hand hygiene observation method was used. RESULTS: In all, only 29 patients (49%) of 59 received prophylaxis within the recommended time span. The differences in the timing of prophylactic antibiotics between total joint arthroplasty and fracture surgery were significant, i.e. a more accurate timing was implemented in patients undergoing total joint arthroplasty (p = 0.02). Eighteen (53%) of the patients undergoing total joint arthroplasty were actively treated with a forced-air warming system. The corresponding number for fracture surgery was 12 (34%) (p = 0.04).Observations of 254 opportunities for hand hygiene revealed an overall adherence rate of 10.3% to hand disinfection guidelines. CONCLUSIONS: The results showed that the utilization of evidence-based measures to reduce infections in clinical practice is not sufficient and there are unjustifiable differences in care depending on the type of surgery. The poor adherence to hand hygiene precautions in the operating room is a serious problem for patient safety and further studies should focus on resolving this problem. The WHO Safe Surgery checklist "time out" worked as an important reminder, but is not per se a guarantee of safety; it is the way we act in response to mistakes or lapses that finally matters.
|
|
| 33. |
- Erichsen Andersson, Annette, 1966, et al.
(författare)
-
Traffic flow in the operating room : An explorative and descriptive study on air quality during orthopedic trauma implant surgery
- 2012
-
Ingår i: American Journal of Infection Control. - : Elsevier. - 0196-6553 .- 1527-3296. ; 40:8, s. 750-755
-
Tidskriftsartikel (refereegranskat)abstract
- Background:Understanding the protective potential of operating room (OR) ventilation under different conditions is crucial to optimizing the surgical environment. This study investigated the air quality, expressed as colony-forming units (CFU)/m³, during orthopedic trauma surgery in a displacementventilated OR; explored how traffic flow and the number of persons present in the OR affects the air contamination rate in the vicinity of surgical wounds; and identified reasons for door openings in the OR.Methods:Data collection, consisting of active air sampling and observations, was performed during 30 orthopedic procedures.Results:In 52 of the 91 air samples collected (57%), the CFU/m³ values exceeded the recommended level of <10 CFU/m³. In addition, the data showed a strongly positive correlation between the total CFU/m³ per operation and total traffic flow per operation (r=0.74;P=.001; n=24), after controlling for duration of surgery. A weaker, yet still positive correlation between CFU/m³ and the number of persons present in the OR (r=0.22;P=.04; n=82) was also found. Traffic flow, number of persons present, and duration of surgery explained 68% of the variance in total CFU/m³ (P=.001).Conclusions:Traffic flow has a strong negative impact on the OR environment. The results of this study support interventions aimed at preventing surgical site infections by reducing traffic flow in the OR.
|
|
| 34. |
|
|
| 35. |
- Fu, Freddie H., et al.
(författare)
-
A long journey to be anatomic
- 2010
-
Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy. - : Springer Science and Business Media LLC. - 1433-7347 .- 0942-2056. ; 18:9, s. 1151-1153
-
Tidskriftsartikel (refereegranskat)abstract
|
|
| 36. |
- Garpebring, Anders, 1980-
(författare)
-
Contributions to quantitative dynamic contrast-enhanced MRI
- 2011
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Dynamic contrast-enhanced MRI (DCE-MRI) has the potential to produce images of physiological quantities such as blood flow, blood vessel volume fraction, and blood vessel permeability. Such information is highly valuable, e.g., in oncology. The focus of this work was to improve the quantitative aspects of DCE-MRI in terms of better understanding of error sources and their effect on estimated physiological quantities. Methods: Firstly, a novel parameter estimation algorithm was developed to overcome a problem with sensitivity to the initial guess in parameter estimation with a specific pharmacokinetic model. Secondly, the accuracy of the arterial input function (AIF), i.e., the estimated arterial blood contrast agent concentration, was evaluated in a phantom environment for a standard magnitude-based AIF method commonly used in vivo. The accuracy was also evaluated in vivo for a phase-based method that has previously shown very promising results in phantoms and in animal studies. Finally, a method was developed for estimation of uncertainties in the estimated physiological quantities. Results: The new parameter estimation algorithm enabled significantly faster parameter estimation, thus making it more feasible to obtain blood flow and permeability maps from a DCE-MRI study. The evaluation of the AIF measurements revealed that inflow effects and non-ideal radiofrequency spoiling seriously degrade magnitude-based AIFs and that proper slice placement and improved signal models can reduce this effect. It was also shown that phase-based AIFs can be a feasible alternative provided that the observed difficulties in quantifying low concentrations can be resolved. The uncertainty estimation method was able to accurately quantify how a variety of different errors propagate to uncertainty in the estimated physiological quantities. Conclusion: This work contributes to a better understanding of parameter estimation and AIF quantification in DCE-MRI. The proposed uncertainty estimation method can be used to efficiently calculate uncertainties in the parametric maps obtained in DCE-MRI.
|
|
| 37. |
|
|
| 38. |
- Grävare Silbernagel, Karin, 1965, et al.
(författare)
-
A new measurement of heel-rise endurance with the ability to detect functional deficits in patients with Achilles tendon rupture.
- 2010
-
Ingår i: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. - : Springer Science and Business Media LLC. - 1433-7347. ; 18:2, s. 258-64
-
Tidskriftsartikel (refereegranskat)abstract
- Studies evaluating treatment effects on muscle function after an Achilles tendon rupture often use various tests for evaluating calf muscle strength. However, these tests rarely demonstrate the difference between treatment groups; therefore, new tests with a higher ability to detect possible differences in outcome are needed. The purpose of this study was to evaluate the validity and ability to detect differences in outcome of a heel-rise work test that would measure both the height of each heel-rise and the number of repetitions. Seventy-eight patients (65 men and 13 women) at a mean (standard deviation) age of 42 (9) years with Achilles tendon ruptures were included. The patients were evaluated with the new heel-rise test at 6 and 12 months after injury. The limb symmetry index (LSI = involved/uninvolved x 100) was calculated to determine the size of the difference in function between the injured and the uninjured side. The heel-rise height differed significantly between the injured and uninjured sides at the 6- and 12-month evaluations (P < 0.001). At the 6-month evaluation, the patients had achieved a mean LSI of 84% on the number of repetitions parameter but only a mean LSI of 61% on the work parameter. At the 12-month evaluation the mean, LSI of the heel-rise repetition parameter was 95%, indicating that the patients had fully recovered function, but on the work parameter the mean LSI was only 76%. The heel-rise work test in the present study has good validity and greater ability to detect differences between the injured and the uninjured sides than a test that measures only the number of heel-rise repetitions in patients with Achilles tendon rupture.
|
|
| 39. |
- Grävare Silbernagel, Karin, 1965, et al.
(författare)
-
Rehabiliteringsträning ger bäst effekt vid akillestendinopati. : Rehabiliteringsträning ger bäst effekt vid akillestendinopati.
- 2014
-
Ingår i: Lakartidningen. - 0023-7205. ; 111:39
-
Tidskriftsartikel (refereegranskat)abstract
- Achilles tendinopathy is a clinical syndrome characterized by a combination of pain, swelling, morning stiffness and difficulty with physical activity. This is a common overuse injury in sports that include running and jumping. The recovery from Achilles tendinopathy can take between 3 and 12 months. Exercise as treatment has the highest level of evidence and should consist of both concentric and eccentric exercises. For exercises to give a favorable outcome, they are allowed to cause pain and should be performed daily. The use of a pain-monitoring model helps with the balance between overloading and loading enough to achieve a positive response to the exercises. Other treatments, such as injection therapies, shock wave treatment, laser treatment and ultrasound treatment, have not been consistently found to be beneficial but might be useful in conjunction with the exercise treatment.
|
|
| 40. |
|
|
| 41. |
|
|
| 42. |
|
|
| 43. |
- Hellstrand Tang, Ulla, 1956, et al.
(författare)
-
Comparison of plantar pressure in three types of insole given to patients with diabetes at risk of developing foot ulcers – A two-year, randomized trial
- 2014
-
Ingår i: Journal of Clinical and Translational Endocrinology. - : Elsevier BV. - 2214-6237. ; 1:4, s. 121-132
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Special insoles and shoes designed to prevent foot ulcers caused by repetitive high pressures are recommended for patients with diabetes who have any of the following risk factors: neuropathy; peripheral vascular disease; foot deformities; previous ulcers; amputation; and skin pathologies. However, there is a need for increased knowledge regarding: a) differences in the peak pressure (PP) and pressure time integral (PTI) for different types of insoles; and b) the properties of the pressure distribution for insoles used over a period of several months. We present the results of a randomized trial to compare the plantar pressures of three commonly used insoles. Objectives: The primary objective was to compare the PP and PTI between three types of insoles. The secondary objective was to explore the long-term pattern of peak plantar pressure distribution and variations in specific regions of interest (ROI). The tertiary objective was to investigate the impacts of insole adjustments, how much the insoles were used, and the levels of patient satisfaction. Methods In a 2-year trial, 114 patients with type 1 (N = 31) or type 2 (N = 83) diabetes (62 men and 52 women; mean age, 57.7 ± 15.4 years; duration of diabetes, 12.3 ± 11.2 years; neuropathy, 38%), were randomized to be supplied with one of three different insoles. The ethylene vinyl acetate (EVA) insoles were used in outdoor walking shoes. The 35 EVA group (N = 39) received soft custom-made insoles composed of EVA of 35 shore A hardness, the 55 EVA group (N = 37) received custom-made insoles composed of EVA of 55 shore hardness, and the control group (N = 38) received prefabricated insoles composed of a hard core with a top layer of soft 12 shore hardness microfiber. Using F-Scan®, the in-shoe plantar pressures were measured at seven ROI (hallux, metatarsal head 1, metatarsal head 2, metatarsal head 4, metatarsal head 5, lateral aspect of the mid-foot, heel) on five occasions during the study period. The plantar-pressure variables used were PP (main outcome) and PTI. The plantar patterns of load were explored, satisfaction and usage of the insoles were rated by the participants, and insole adjustments were recorded. Results:A mixed model analysis estimated lower PP values in the heel regions for the 35 EVA and 55 EVA insoles (171 ± 13 and 161 ± 13 kPa, respectively) than for the prefabricated insoles (234 ± 10 kPa) (p
|
|
| 44. |
- Holmgren, Theresa, 1974-
(författare)
-
Exercise treatment of patients with long-standing subacromial pain
- 2013
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Subacromial pain is the most common problem among patients with shoulder complaints seeking primary care. The recommended treatment for these patients is primarily non-surgical with a focus on exercise treatment. If this treatment fails arthroscopic subacromial decompression (ASD) followed by exercise treatment is recommended. Surgical treatment with ASD has increased substantially in Sweden in recent years even though studies comparing exercise treatment with surgery report equally positive results. Still, there is a need of evidence based preand postoperative exercise treatments, standardised and described in detail, to guide treatment of these patients in clinical practice.The overall aim of this thesis was to evaluate the efficacy of pre- and postoperative exercise strategies on shoulder function and how the preoperative strategy affects the need for surgery in patients with long-standing subacromial pain.This thesis comprises four papers which are based on two randomised controlled trials. In study A, patients were randomised after ASD surgery to either physical therapist (PT) supervised strength-endurance exercises for the rotator cuff and scapula stabilisers or to home-based movement exercises for a period of three months. Shoulder function and pain, health related quality of life and return to work was evaluated for 6 months (paper I). In study B, patients on the waiting list for surgery were randomised to either specific exercise strategy with strengthendurance exercises for the rotator cuff and the scapula stabilisers or to control exercises with movement exercises for the neck and shoulders for a period of three months. After completing the exercise program and also after 12 months, shoulder function and pain, need for surgery and health related quality of life was evaluated. Baseline shoulder function, rotator cuff status and radiological findings were analysed in relation to the choice of surgery (paper II, III). The minimal important clinical change (MIC) of the Constant-Murley (CM) score, used as primary outcome in this thesis, was determined by using a visual anchor-based MIC distribution method (paper IV).Six months after ASD surgery, patients who performed PT-supervised strength-endurance exercises improved significantly more in shoulder function and pain compared to patients who had performed home-based movement exercises (paper I). Patients on the waiting list for surgery who performed specific strength-endurance exercises had significantly greater improvements in shoulder function and pain compared to patients performing movement exercises (paper II). A significantly lower proportion of those performing specific strength-endurance exercises chose surgery at the three- and 12 months follow-ups (paper II, paper III). Low baseline values in shoulder function and pain measured with the CM score and/or having a full thickness rotator cuff rupture were associated with an increased risk of choosing surgery (paper III). Regarding the CM score, a change between 17-24 points seems to be clinically important for patients with long-standing subacromial pain (paper IV).Supervised strength-endurance exercises seem to be more effective than home-based movement exercises after ASD surgery. For patients on the waiting list for surgery, the specific strategy of strength-endurance exercises was effective in improving shoulder function and pain and the need for surgery was reduced at 12 months. Low baseline values for shoulder function and pain measured with the CM score and/or having a full thickness rotator cuff tear seem to be predictors for choosing surgery. The CM score is able to detect the MIC in individual patients with long-standing subacromial pain when the rotator cuff is intact. In all patients with longstanding subacromial pain, the MIC value was dependent on the subgroup as well as the choice of statistical analysis.
|
|
| 45. |
- Hultenheim Klintberg, Ingrid, 1959, et al.
(författare)
-
Health-related quality of life, patient satisfaction, and physical activity 8-11 years after arthroscopic subacromial decompression.
- 2011
-
Ingår i: Journal of shoulder and elbow surgery / American Shoulder and Elbow Surgeons ... [et al.]. - : Elsevier BV. - 1532-6500. ; 20:4, s. 598-608
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was to report health-related quality of life, patient satisfaction with present shoulder function, and physical activity 8-11 years after arthroscopic subacromial decompression (ASD) in patients with primary impingement syndrome stage II and early stage III. Ninety-five patients (105 shoulders, 48 female), mean age 54 years (range, 26-69) were included.
|
|
| 46. |
- Hultenheim Klintberg, Ingrid, 1959, et al.
(författare)
-
Long-term patient satisfaction and functional outcome 8-11 years after subacromial decompression
- 2010
-
Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy. - 0942-2056. ; 18:3, s. 394-403
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this investigation was to evaluate the long-term outcome of arthroscopic subacromial decompression (ASD) in patients with primary impingement syndrome stage II and early stage III. Ninety-five patients (105 shoulders, 48 female), mean age 54 years (range 26–69), who had undergone surgery between 1996 and 1999, were included. Pain intensity during activity and at rest, patient satisfaction, active range of motion (ROM), muscular strength and shoulder function using the Constant score were evaluated. Fifty-three (50%) shoulders were pain-free (Visual Analogue Scale ≤ 10 mm) during activity and 72 (68%) shoulders were pain-free at rest. Sixty-one (58%) patients stated that they were very satisfied and 27 (25%) were quite satisfied with regard to their current shoulder function. Shoulders were divided into Group 1: Pain-free patients (n = 53), Group 2: Patients with shoulder pain and no arthropathy (n = 41) and Group 3: Patients with shoulder pain and arthropathy (n = 11). The groups had average active ROM of 157°, 135° and 117°, respectively, in abduction and 97°, 79°, and 68° in external rotation. The average strength in elevation in the scapular plane was 7.4, 5.8 and 3.9 kg, respectively, whereas the mean value in external rotation was 8.4, 7.9 and 5.3 kg, respectively. The Constant score had a mean value of 87, 69 and 59 points in the three groups, respectively. Eleven shoulders have undergone re-operation, one after a new trauma. We conclude that ASD is a valuable procedure. Patients expressed a high degree of satisfaction with shoulder function 8–11 years after ASD.
|
|
| 47. |
- Hägglund, Martin, et al.
(författare)
-
VM ökar skaderisken
- 2014
-
Ingår i: Svensk Idrottsforskning. - Stockholm : Centrum för idrottsforskning. - 1103-4629. ; :2, s. 6-9
-
Tidskriftsartikel (refereegranskat)abstract
- Colombias Falcao är skadad och missar VM. Samma öde drabbade flera stjärnor redan före avresan till Brasilien. En hög skaderisk i mästerskap innebär sannolikt att fler får åka hem innan turneringen är över. Det visar 13 års erfarenhet av skadestudier inom europeisk toppfotboll. Sedan år 2001 har 27 olika fotbollslag från tio professionella ligor i Europa deltagit i den så kallade UEFA Elite Club Injury Study (2).Det medicinska teamet i varje lag, oftast läkare och fysioterapeuter, rapporterar på månadsbasis in tränings och matchtid för samtliga spelare i A-truppen samt information om de skador som har inträffat. För studien registreras de skador som skett i samband med träning eller match och som innebär att spelaren avbryter eller tvingas avstå från kommande träning eller match, så kallade frånvaroskador. Till dags dato har över 10 000 skador registrerats under drygt en miljon tränings- och matchtimmar. Det är troligen världens största skadedatabas inom elitfotboll.FaktaSedan år 2001 har Football Research Group i Linköping bedrivit skadestudier inom elitfotboll i samarbete med Europeiska fotbollförbundet (Uefa) och nationella förbund och organisationer, till exempel Svenska Fotbollförbundet och engelska Premier League (1). I ett temanummer om fotbollsmedicin i tidskriften British Journal of Sports Medicine i augusti 2013 presenterade gruppen flera studier från det pågående forskningsprojektet. Den här artikeln sammanfattar några av studierna och lärdomar som vi kan ta med oss under VM-slutspelet i Brasilien.
|
|
| 48. |
-
Höftfraktur hos äldre- Att bevara patientens förmåga
- 2010
-
Samlingsverk (redaktörskap) (övrigt vetenskapligt/konstnärligt)abstract
- Höftfraktur hos äldre - Att bevara patientens förmåga Området höftfrakturer är väl dokumenterat i den vetenskapliga litteraturen, men kunskapen är spridd och svår att överblicka. I Höftfraktur hos äldre samlar man därför aktuell kunskap och beskriver vård och behandling på ett enhetligt sätt, vilket gör boken till den första i sitt slag. Boken redogör på ett lättillgängligt sätt för hur det akuta mottagandet ska se ut och hur den postoperativa vården och rehabiliteringen ska vara uppbyggd. I alla dessa sammanhang sätter man individen och dennes självständighet i centrum. Höftfraktur hos äldre är avsedd för sjukvårdspersonal inom ortopedi och geriatrik, blivande sjuksköterskor, sjukgymnaster, arbetsterapeuter och läkare. Den kan också med fördel användas av verksamhetschefer och administrativ personal. I boken medverkar flera experter inom geriatrik och ortopedi. Den är redigerad av Jón Karlsson, Lars-Eric Olsson och Ewa Waern, alla verksamma vid Sahlgrenska Universitetssjukhuset i Göteborg.
|
|
| 49. |
- 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.
|
|
| 50. |
- Jon, Bjärkefur, et al.
(författare)
-
Submap joining smoothing and mapping for camera-based indoor localization and mapping
- 2011
-
Konferensbidrag (refereegranskat)abstract
- Personnel positioning is important for safety in e.g. emergency response operations. In GPS-denied environments, possible positioning solutions include systems based on radio frequency communication, inertial sensors, and cameras. Many camera-based systems create a map and localize themselves relative to that. The computational complexity of most such solutions grows rapidly with the size of the map. One way to reduce the complexity is to divide the visited region into submaps. This paper presents a novel method for merging conditionally independent submaps (generated using e.g. EKF-SLAM) by the use of smoothing. Using this approach it is possible to build large maps in close to linear time. The method is demonstrated in two indoor scenarios, where data was collected with a trolley-mounted stereo vision camera.
|
|
