| 1. |
- Bindler, Richard, et al.
(författare)
-
Copper-ore mining in Sweden since the pre-Roman Iron Age : lake-sediment evidence of human activities at the Garpenberg ore field since 375 BCE
- 2017
-
Ingår i: Journal of Archaeological Science. - : Elsevier BV. - 2352-409X .- 2352-4103. ; 12, s. 99-108
-
Tidskriftsartikel (refereegranskat)abstract
- Historical documents, archaeological evidence and lake-sediment records indicate thus far that significant mining of iron and copper ores in the Berglsagen mining region in central Sweden did not begin until the late 12th century -first with iron in Norberg - and thereafter spreading rapidly throughout the region during the 13th century when also copper was included (e.g. Falun). Prior to this, iron was produced domestically from secondary sources such as bog iron, while geochemical analyses of bronze artefacts indicate copper was imported. The parish of Garpenberg was at the intersection between historical iron-and copper-mining districts, and consequently we expected our sediment record from the lake Gruvsjon ('mine lake') to follow the established 13th century development. However, a 2-3-fold enrichment in copper and lead occurred already during 375-175 BCE (pre-Roman Iron Age), together with small increases in zinc, magnesium and charcoal particles, and changes in pollen. Together these indicate a clear pattern of human disturbance connected with the ore body bordering the lake. A second distinct phase occurred 115-275 CE, but with an 8-9-fold increase in copper and lead along with other indicators. From 400 CE a permanent increase in copper and lead occurred, which then accelerated from the 13th century as seen elsewhere in the region. Our results push back the evidence for early ore mining in Sweden from the Middle Ages to the pre-Roman Iron Age.
|
|
| 2. |
- Michels, F., et al.
(författare)
-
Searching for consensus in the approach to patients with chronic lateral ankle instability: ask the expert
- 2018
-
Ingår i: Knee Surgery Sports Traumatology Arthroscopy. - : Springer Science and Business Media LLC. - 0942-2056 .- 1433-7347. ; 26:7, s. 2095-2102
-
Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study is to propose recommendations for the treatment of patients with chronic lateral ankle instability (CAI) based on expert opinions. A questionnaire was sent to 32 orthopaedic surgeons with clinical and scientific experience in the treatment of CAI. The questions were related to preoperative imaging, indications and timing of surgery, technical choices, and the influence of patient-related aspects. Thirty of the 32 invited surgeons (94%) responded. Consensus was found on several aspects of treatment. Preoperative MRI was routinely recommended. Surgery was considered in patients with functional ankle instability after 3-6 months of non-surgical treatment. Ligament repair is still the treatment of choice in patients with mechanical instability; however, in patients with generalized laxity or poor ligament quality, lateral ligament reconstruction (with grafting) of both the ATFL and CFL should be considered. Most surgeons request an MRI during the preoperative planning. There is a trend towards earlier surgical treatment (after failure of non-surgical treatment) in patients with mechanical ligament laxity (compared with functional instability) and in high-level athletes. This study proposes an assessment and a treatment algorithm that may be used as a recommendation in the treatment of patients with CAI.
|
|
| 3. |
- Snaebjörnsson, Thorkell, 1982, et al.
(författare)
-
Graft Diameter and Graft Type as Predictors of Anterior Cruciate Ligament Revision: A Cohort Study Including 18,425 Patients from the Swedish and Norwegian National Knee Ligament Registries
- 2019
-
Ingår i: The Journal of bone and joint surgery. American volume. - 1535-1386. ; 101:20, s. 1812-1820
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: It is important to investigate and compare graft diameters as well as graft types to identify risk factors for revision after an anterior cruciate ligament (ACL) reconstruction. We performed the current study in order to analyze the early ACL revision rate among patients treated with hamstring tendon (HT) autografts or patellar tendon (PT) autografts of different diameters. Our hypothesis was that an increase in both HT and PT autograft diameters would reduce the risk of early ACL revision. METHODS: This retrospective study was based on prospectively collected data from the national knee ligament registries of Norway and Sweden and included patients who underwent primary ACL reconstruction during the period of 2004 through 2014. The primary end point was the 2-year incidence of ACL revision. The impact of graft type and diameter on the incidence of revision surgery was reported as relative risks (RRs) with 95% confidence intervals (CIs), estimated by using generalized linear models with a binomial distribution and log-link function. RESULTS: Of 58,692 patients identified, a total of 18,425 patients were included in this study. The 2-year rate of ACL revision was 2.10% (PT autografts, 2.63%; HT autografts, 2.08%; RR = 0.93 [95% CI = 0.60 to 1.45]). There was an increased risk of ACL revision among patients treated with HT autografts with a diameter of <8 mm compared with larger HT autografts (RR = 1.25 [95% CI = 1.01 to 1.57]). Patients treated with HT autografts with a diameter of ≥9.0 mm or ≥10.0 mm had a reduced risk of early ACL revision compared with patients treated with PT autografts. CONCLUSIONS: Patients treated with larger-diameter HT autografts had a lower risk of early ACL revision compared with those treated with HT autografts of <8 mm. Patients treated with HT autografts of ≥9 or ≥10 mm had a reduced risk of early ACL revision compared with patients treated with PT autografts. LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
|
|
| 4. |
- Sundemo, David, et al.
(författare)
-
Generalised joint hypermobility increases ACL injury risk and is associated with inferior outcome after ACL reconstruction: A systematic review
- 2019
-
Ingår i: BMJ Open Sport and Exercise Medicine. - : BMJ. - 2055-7647. ; 5:1
-
Forskningsöversikt (refereegranskat)abstract
- Objectives To investigate the association between generalised joint hypermobility (GJH) and ACL injury risk. Secondary aims involved evaluating associations between GJH and postoperative outcome (including graft-failure risk, knee laxity and patient-reported outcome). Furthermore, we aimed to compare the performance of different grafts in patients with GJH. Methods Databases MEDLINE/PubMed, EMBASE and the Cochrane Library were searched, including 2760 studies. Two reviewers independently screened studies for eligibility. A modified version of the MINORS score was applied for quality appraisal. Studies assessing GJH while reporting the risk of ACL injury and/or postoperative outcome were included. Results Twenty studies were included, using several different methods to determine GJH. There was consistent evidence showing that GJH is a risk factor for unilateral ACL injury in males, while in females, the results were conflicting. There was limited evidence associating GJH with increased knee laxity 5 years postoperatively. There was consistent evidence of inferior postoperative patient-reported outcome in patients with GJH. Moreover, there was limited yet consistent evidence indicating that patellar-tendon autografts are superior to hamstring-tendon autografts in patients with GJH in terms of knee laxity and patient-reported outcome. There was insufficient evidence to draw conclusions regarding the outcomes of bilateral ACL injury and graft failure. Conclusions In men, GJH was associated with an increased risk of unilateral ACL injury. Moreover, GJH was associated with greater postoperative knee laxity and inferior patient-reported outcome. Based on the available evidence, a patellar-tendon autograft appears to be superior to a hamstring-tendon autograft in patients with GJH. However, the included studies were heterogeneous and there is a need for consensus in the assessment of GJH within sports medicine. © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
|
|
| 5. |
- Abrahamson, Josefin, et al.
(författare)
-
Adolescent elite skiers with and without cam morphology did change their hip joint range of motion with 2 years follow-up
- 2019
-
Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy. - : Springer Science and Business Media LLC. - 0942-2056 .- 1433-7347. ; 27:10, s. 3149-3157
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: To investigate how range of motion of the hips and the lumbar spine are affected by continued elite, alpine skiing in young subjects, with and without a magnetic resonance imaging verified cam morphology, in a 2-year follow-up study. The hypothesis is that skiers with cam morphology will show a decrease in hip joint range of motion as compared with skiers without cam, after a 2-year follow-up. Method: Thirty adolescent elite alpine skiers were examined at the baseline (mean age 17.3 ± 0.7 years) and after 2 years. All skiers were examined for the presence of cam morphology (α-angle > 55°) using magnetic resonance imaging at the baseline. Clinical examinations of range of motion in standing lumbar flexion and extension, supine hip flexion, internal rotation, FABER test and sitting internal rotation and external rotation were performed both at the baseline and after 2 years. Results: Skiers with and without cam morphology showed a significant decrease from baseline to follow-up in both hips for supine internal rotation (right: mean − 13.3° and − 10.9° [P < 0.001]; left: mean − 7.6° [P = 0.004] and − 7.9° [P = 0.02]), sitting internal rotation (right: mean − 9.6° and − 6.3° [P < 0.001]; left: mean − 7.6° [P = 0.02] and − 3.3° [P = 0.008]) and sitting external rotation (right: mean − 16.9° and − 11.4° and left: mean − 17.9° and − 14.5° [P < 0.001]) and were shown to have an increased left hip flexion (mean + 8.4° and + 4.6° [P = 0.004]). Skiers with cam were also shown to have an increased right hip flexion (mean + 6.4° [P = 0.037]). Differences were found between cam and no-cam skiers from baseline to follow-up in the sitting internal rotation in both hips (right: mean 3.25°, left: mean 4.27° [P < 0.001]), the right hip flexion (mean 6.02° [P = 0.045]) and lumbar flexion (mean − 1.21°, [P = 0.009]). Conclusion: Young, elite alpine skiers with cam morphology decreased their internal rotation in sitting position as compared with skiers without the cam morphology after 2 years of continued elite skiing. Level of evidence: II.
|
|
| 6. |
- Agnvall, C., et al.
(författare)
-
Range of Hip Joint Motion Is Correlated With MRI-Verified Cam Deformity in Adolescent Elite Skiers
- 2017
-
Ingår i: Orthopaedic Journal of Sports Medicine. - : SAGE Publications. - 2325-9671. ; 5:6
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Radiologically verified cam-type femoroacetabular impingement (FAI) has been shown to correlate with reduced internal rotation, reduced passive hip flexion, and a positive anterior impingement test. Purpose: To validate how a clinical examination of the hip joint correlates with magnetic resonance imaging (MRI)-verified cam deformity in adolescents. Methods: The sample group consisted of 102 adolescents with the mean age 17.7 +/- 1.4 years. The hip joints were examined using MRI for measurements of the presence of cam (alpha-angle >55) and clinically for range of motion (ROM) in both supine and sitting positions. The participants were divided into a cam and a noncam group based on the results of the MRI examination. Passive hip flexion, internal rotation, anterior impingement, and the FABER (flexion, abduction, and external rotation) test were used to test both hips in the supine position. With the participant sitting, the internal/external rotation of the hip joint was measured in 3 different positions of the pelvis (neutral, maximum anteversion, and retroversion) and lumbar spine (neutral, maximum extension, and flexion). Results: Differences were found between the cam and noncam groups in terms of the anterior impingement test (right, P = .010; left, P = .006), passive supine hip flexion (right: mean, 5; cam, 117; noncam, 122 [P = .05]; and left: mean, 8.5; cam, 116; noncam, 124.5 [P = .001]), supine internal rotation (right: mean, 4.9; cam, 24; noncam, 29 [P = .022]; and left: mean, 4.8; cam, 26; noncam, 31 [P = .028]), sitting internal rotation with the pelvis and lumbar spine in neutral (right: mean, 7.95; cam, 29; noncam, 37 [P = .001]; and left: mean, 6.5; cam, 31.5; noncam, 38 [P = .006]), maximum anteversion of the pelvis and extension of the lumbar spine (right: mean, 5.2; cam, 20; noncam, 25 [P = .004]; and left: mean, 5.85; cam, 20.5; noncam, 26.4 [P = .004]), and maximum retroversion of the pelvis and flexion of the spine (right: mean, 8.4; cam, 32.5; noncam, 41 [P = .001]; and left: mean, 6.2; cam, 36; noncam, 42.3 [P = .012]). The cam group had reduced ROM compared with the noncam group in all clinical ROM measures. Conclusion: The presence of cam deformity on MRI correlates with reduced internal rotation in the supine and sitting positions, passive supine hip flexion, and the impingement test in adolescents.
|
|
| 7. |
- Alentorn-Geli, E., et al.
(författare)
-
Sports participation and risk of ankle osteoarthritis
- 2015
-
Ingår i: Sports Injuries: Prevention, Diagnosis, Treatment and Rehabilitation, Second Edition. - Berlin : Springer. - 9783642365690 ; , s. 2491-2498
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Sports provide physical, psychological, and social well-being to individuals. However, there may be a potentially damaging effect on articular cartilage with mid- and long-term exposure to sports. This chapter is aimed to critically review the existing literature regarding the association between sports participation and ankle osteoarthritis. This review demonstrates that in general, there is not enough evidence to conclude that sports increase the risk of ankle osteoarthritis. The existing literature related to this topic is scarce, and most of the studies have not controlled the risk analysis for the presence of other potentially associated risk factors for ankle osteoarthritis. Further research is needed on this topic with prospective comparative studies controlling for, at least, age, sex, body mass index, occupational workload, and previous ankle injuries. © Springer-Verlag Berlin Heidelberg 2012, 2015, All Rights Reserved.
|
|
| 8. |
- Alentorn-Geli, E., et al.
(författare)
-
The Association of Recreational and Competitive Running With Hip and Knee Osteoarthritis: A Systematic Review and Meta-analysis
- 2017
-
Ingår i: Journal of Orthopaedic & Sports Physical Therapy. - : Journal of Orthopaedic & Sports Physical Therapy (JOSPT). - 0190-6011 .- 1938-1344. ; 47:6, s. 373-390
-
Tidskriftsartikel (refereegranskat)abstract
- STUDY DESIGN: Systematic review and meta-analysis. BACKGROUND: Running is a healthy and popular activity worldwide, but data regarding its association with osteoarthritis (OA) are conflicting. OBJECTIVES: To evaluate the association of hip and knee OA with running and to explore the influence of running intensity on this association. METHODS: PubMed, Embase, and Cochrane Library databases were used to identify studies investigating the occurrence of OA of the hip and/or knee among runners. A meta-analysis of studies comparing this occurrence between runners and controls (sedentary, nonrunning individuals) was conducted. Runners were regarded as "competitive" if they were reported as professional/elite athletes or participated in international competitions. Recreational runners were individuals running in a nonprofessional (amateur) context. The prevalence rate and odds ratio (with 95% confidence interval [CI]) for OA between runners (at competitive and recreational levels) and controls were calculated. Subgroup analyses were conducted for OA location (hip or knee), sex, and years of exposure to running (less or more than 15 years). RESULTS: Twenty-five studies (n = 125 810 individuals) were included and 17 (n = 114 829 individuals) were meta-analyzed. The overall prevalence of hip and knee OA was 13.3% (95% CI: 11.6%, 15.2%) in competitive runners, 3.5% (95% CI: 3.4%, 3.6%) in recreational runners, and 10.2% (95% CI: 9.9%, 10.6%) in controls. The odds ratio for hip and/or knee OA in competitive runners was higher than that in recreational runners (1.34; 95% CI: 0.97, 1.86 and 0.86; 95% CI: 0.69, 1.07, respectively; controls as reference group; for difference, P<.001). Exposure to running of less than 15 years was associated with a lower association with hip and/or knee OA compared with controls (OR = 0.6; 95% CI: 0.49, 0.73). CONCLUSION: Recreational runners had a lower occurrence of OA compared with competitive runners and controls. These results indicated that a more sedentary lifestyle or long exposure to high-volume and/or high-intensity running are both associated with hip and/or knee OA. However, it was not possible to determine whether these associations were causative or confounded by other risk factors, such as previous injury.
|
|
| 9. |
- Altman, Roy D, et al.
(författare)
-
Product Differences in Intra-articular Hyaluronic Acids for Osteoarthritis of the Knee.
- 2016
-
Ingår i: The American journal of sports medicine. - : SAGE Publications. - 1552-3365 .- 0363-5465. ; 44:8, s. 2158-2165
-
Tidskriftsartikel (refereegranskat)abstract
- Knee osteoarthritis (OA) is a common and often disabling joint disorder among adults that may result in impaired activity and daily function. A variety of treatment options are currently available and prescribed for knee OA depending on the severity of the disorder and physician preference. Intra-articular hyaluronic acid (IA-HA) injection is a treatment for knee OA that reportedly provides numerous biochemical and biological benefits, including shock absorption, chondroprotection, and anti-inflammatory effects within the knee. Clarity is needed as to whether the available IA-HA products should be considered for therapy as a group or whether there are significant differences in the products that need to be considered in treatment of OA of the knee.
|
|
| 10. |
- Aminoff, Amina Swärd, et al.
(författare)
-
The effect of pelvic tilt and cam on hip range of motion in young elite skiers and nonathletes
- 2018
-
Ingår i: Open Access Journal of Sports Medicine. - : Informa UK Limited. - 1179-1543. ; 9, s. 147-156
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Current knowledge of the effect of changes in posture and the way cam morphology of the hip joint may affect hip range of motion (ROM) is limited. Purpose: To determine the effect of changes in pelvic tilt (PT) on hip ROM and with/without the presence of cam. Materials and methods: The hip ROM of 87 subjects (n=61 young elite skiers, n=26 nonathletes) was examined using a goniometer, in three different seated postures (flexed, neutral, and extended). The hips of the subjects were further subgrouped into cam and no-cam morphology, based on the magnetic resonance imaging findings in the hips. Results: There was a significant correlation between the hip ROM and the seated posture in both extended and flexed postures compared with the neutral posture. There was a significant decrease in internal hip rotation when the subjects sat with an extended posture with maximum anterior PT (p<0.0001). There was a significant increase in internal hip rotation when the subjects sat with a flexed posture with maximum posterior PT (p<0.001). External rotation was significantly decreased in an extended posture with maximum anterior PT (p<0.0001), but there was no difference in flexed posture with maximum posterior PT. The hips with cam morphology had reduced internal hip rotation in all three positions, but they responded to the changes in position in a similar manner to hips without cam morphology. Conclusion: Dynamic changes in PT significantly influence hip ROM in young people, independent of cam or no-cam morphology.
|
|
| 11. |
- Andernord, Daniel, et al.
(författare)
-
Anterior cruciate ligament graft selection and fixation
- 2015
-
Ingår i: Sports Injuries: Prevention, Diagnosis, Treatment and Rehabilitation, Second Edition. - Berlin : Springer. - 9783642365690 ; , s. 817-822
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- This chapter presents a nonanatomical double-bundle ACL reconstruction technique. The reconstruction is performed using hamstring tendons that are harvested, maintaining intact the tibial insertion. The anteromedial bundle is restored placing the graft in the “over-the-top position, while the posterolateral bundle is replaced retrieving the graft from a femoral tunnel. Graft fixation is obtained using metal staples. Hundreds of patients have been treated with this technique during the last 10 years, including athletes with high functional requests. Furthermore, in vivo analysis of knee kinematic confirmed the effectiveness of the technique. © Springer-Verlag Berlin Heidelberg 2012, 2015, All Rights Reserved.
|
|
| 12. |
|
|
| 13. |
|
|
| 14. |
- Andersson, Jonny K, 1972, et al.
(författare)
-
Cost description of clinical examination and MRI in wrist ligament injuries
- 2018
-
Ingår i: Journal of Plastic Surgery and Hand Surgery. - : Medical Journals Sweden AB. - 2000-656X .- 2000-6764. ; 52:1, s. 30-36
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: The total number and cost of wrist MRIs in the catchment area of the Vastra Gotaland Region in Sweden (population 1 723 000) during 1 year was analysed, together with the number and content of referrals. Methods: Six radiology departments reported the numbers and rate of all MRI investigations intended to diagnose wrist ligament injuries (n=411) and other injuries to the wrist. Results: The additional cost of the difference between MRIs and a clinical examination by a hand surgeon, plus indirect costs for patients with suspected wrist ligament injuries, was calculated as 957 000 euros. Conclusions: It is recommended that MRI should only be used in patients in whom there are clinical difficulties in terms of diagnosing wrist ligament injuries. It is suggested that patients with suspected wrist ligament injuries should be referred directly to an experienced hand surgeon, capable of performing a standardised wrist examination and, when needed, diagnostic arthroscopy and final treatment. The proposed algorithm for the diagnosis and treatment of suspected wrist ligament injuries presented in the present study could save time for the patient and for the radiology departments, as well as reducing costs. The ability to implement the early and appropriate treatment of acute ligament injuries could be improved at the same time.
|
|
| 15. |
- Andersson, Jonny K, 1972, et al.
(författare)
-
Efficacy of Magnetic Resonance Imaging and Clinical Tests in Diagnostics of Wrist Ligament Injuries: A Systematic Review.
- 2015
-
Ingår i: Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association. - : Elsevier BV. - 1526-3231. ; 31:10
-
Tidskriftsartikel (refereegranskat)abstract
- To investigate the diagnostic performance of magnetic resonance imaging (MRI) and clinical provocative tests on injuries to the triangular fibrocartilage complex (TFCC), the scapholunate (SL) ligament, and the lunotriquetral (LT) ligament.
|
|
| 16. |
- Andersson, Jonny K, et al.
(författare)
-
Level of evidence in wrist ligament repair and reconstruction research: a systematic review.
- 2018
-
Ingår i: Journal of experimental orthopaedics. - : Springer Science and Business Media LLC. - 2197-1153. ; 5:1
-
Forskningsöversikt (refereegranskat)abstract
- There have been numerous studies on surgery of wrist ligament injuries, but a quick assessment reveals few with a high level of evidence (LoE). The primary aim of this study was to categorize the study type and LoE of studies on repair and reconstruction of the scapholunate ligament, the lunotriquetral ligament and the triangular fibrocartilage complex by applying the LoE rating system proposed by the Oxford Centre for Evidence-Based Medicine. The secondary aims were to evaluate the journal- and geographic- distribution of the included studies.An electronic literature search of articles published 1985-2016, in PubMed, Embase, and Cochrane Library was carried out in May 2016 and updated in April 2017. Therapeutic studies written in English were included. The PRISMA checklist guided the extraction and reporting of data.A total of 1889 studies were analyzed, of which 362 were included. Three journals represented 40% of the included studies and American authors dominated.Most studies (97%) had low LoE (IV-V). No studies of LoE I-II were found. There is insufficient evidence to recommend one technique over the other in terms of wrist ligament surgery in clinical practice. There is an immense lack of comparison studies with high level of evidence in the area of wrist ligament repair and reconstruction.
|
|
| 17. |
- Andersson, Jonny K, 1972, et al.
(författare)
-
Patients with triangular fibrocartilage complex injuries and distal radioulnar joint instability have reduced rotational torque in the forearm.
- 2016
-
Ingår i: The Journal of hand surgery, European volume. - : SAGE Publications. - 2043-6289. ; 41:7, s. 732-8
-
Tidskriftsartikel (refereegranskat)abstract
- A total of 20 patients scheduled for wrist arthroscopy, all with clinical signs of rupture to the triangular fibrocartilage complex and distal radioulnar joint instability, were tested pre-operatively by an independent observer for strength of forearm rotation. During surgery, the intra-articular pathology was documented by photography and also subsequently individually analysed by another independent hand surgeon. Arthroscopy revealed a type 1-B injury to the triangular fibrocartilage complex in 18 of 20 patients. Inter-rater reliability between the operating surgeon and the independent reviewer showed absolute agreement in all but one patient (95%) in terms of the injury to the triangular fibrocartilage complex and its classification. The average pre-operative torque strength was 71% of the strength of the non-injured contralateral side in pronation and supination. Distal radioulnar joint instability with an arthroscopically verified injury to the triangular fibrocartilage complex is associated with a significant loss of both pronation and supination torque.
|
|
| 18. |
- Ardern, Clare, et al.
(författare)
-
2018 International Olympic Committee consensus statement on prevention, diagnosis and management of paediatric anterior cruciate ligament (ACL) injuries
- 2018
-
Ingår i: Knee Surgery Sports Traumatology Arthroscopy. - : Springer Science and Business Media LLC. - 0942-2056 .- 1433-7347. ; 26:4, s. 989-1010
-
Tidskriftsartikel (refereegranskat)abstract
- In October 2017, the International Olympic Committee hosted an international expert group of physiotherapists and orthopaedic surgeons who specialise in treating and researching paediatric anterior cruciate ligament (ACL) injuries. Representatives from the American Orthopaedic Society for Sports Medicine, European Paediatric Orthopaedic Society, European Society for Sports Traumatology, Knee Surgery and Arthroscopy, International Society of Arthroscopy Knee Surgery and Orthopaedic Sports Medicine, Pediatric Orthopaedic Society of North America, and Sociedad Latinoamericana de Artroscopia, Rodilla y Deporte attended. Physiotherapists and orthopaedic surgeons with clinical and research experience in the field, and an ethics expert with substantial experience in the area of sports injuries also participated. Injury management is challenging in the current landscape of clinical uncertainty and limited scientific knowledge. Injury management decisions also occur against the backdrop of the complexity of shared decision-making with children and the potential long-term ramifications of the injury. This consensus statement addresses six fundamental clinical questions regarding the prevention, diagnosis, and management of paediatric ACL injuries. The aim of this consensus statement is to provide a comprehensive, evidence-informed summary to support the clinician, and help children with ACL injury and their parents/guardians make the best possible decisions.
|
|
| 19. |
- Ardern, Clare, et al.
(författare)
-
2018 International Olympic Committee consensus statement on prevention, diagnosis and management of paediatric anterior cruciate ligament (ACL) injuries
- 2018
-
Ingår i: British Journal of Sports Medicine. - : BMJ. - 0306-3674 .- 1473-0480. ; 52:7, s. 422-438
-
Tidskriftsartikel (refereegranskat)abstract
- In October 2017, the International Olympic Committee hosted an international expert group of physiotherapists and orthopaedic surgeons who specialise in treating and researching paediatric ACL injuries. Representatives from the American Orthopaedic Society for Sports Medicine, European Paediatric Orthopaedic Society, European Society for Sports Traumatology, Knee Surgery & Arthroscopy, International Society of Arthroscopy Knee Surgery and Orthopaedic Sports Medicine, Pediatric Orthopaedic Society of North America and Sociedad Latinoamericana de Artroscopia, Rodilla y Deporte attended. Physiotherapists and orthopaedic surgeons with clinical and research experience in the field, and an ethics expert with substantial experience in the area of sports injuries also participated. Injury management is challenging in the current landscape of clinical uncertainty and limited scientific knowledge. Injury management decisions also occur against the backdrop of the complexity of shared decision-making with children and the potential long-term ramifications of the injury. This consensus statement addresses six fundamental clinical questions regarding the prevention, diagnosis and management of paediatric ACL injuries. The aim of this consensus statement is to provide a comprehensive, evidence-informed summary to support the clinician, and help children with ACL injury and their parents/guardians make the best possible decisions.
|
|
| 20. |
- Ardern, C. L., et al.
(författare)
-
2018 International Olympic Committee Consensus Statement on Prevention, Diagnosis, and Management of Pediatric Anterior Cruciate Ligament Injuries
- 2018
-
Ingår i: Orthopaedic Journal of Sports Medicine. - : SAGE Publications. - 2325-9671. ; 6:3
-
Tidskriftsartikel (refereegranskat)abstract
- In October 2017, the International Olympic Committee hosted an international expert group of physical therapists and orthopaedic surgeons who specialize in treating and researching pediatric anterior cruciate ligament (ACL) injuries. The purpose of this meeting was to provide a comprehensive, evidence-informed summary to support the clinician and help children with ACL injury and their parents/guardians make the best possible decisions. Representatives from the following societies attended: American Orthopaedic Society for Sports Medicine; European Paediatric Orthopaedic Society; European Society for Sports Traumatology, Knee Surgery, and Arthroscopy; International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine; Pediatric Orthopaedic Society of North America; and Sociedad Latinoamericana de Artroscopia, Rodilla, y Deporte. Physical therapists and orthopaedic surgeons with clinical and research experience in the field and an ethics expert with substantial experience in the area of sports injuries also participated. This consensus statement addresses 6 fundamental clinical questions regarding the prevention, diagnosis, and management of pediatric ACL injuries. Injury management is challenging in the current landscape of clinical uncertainty and limited scientific knowledge. Injury management decisions also occur against the backdrop of the complexity of shared decision making with children and the potential long-term ramifications of the injury.
|
|
| 21. |
|
|
| 22. |
- Atesok, Kivanc, et al.
(författare)
-
Multilayer scaffolds in orthopaedic tissue engineering.
- 2016
-
Ingår i: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. - : Springer Science and Business Media LLC. - 1433-7347. ; 24:7, s. 2365-2373
-
Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to summarize the recent developments in the field of tissue engineering as they relate to multilayer scaffold designs in musculoskeletal regeneration.
|
|
| 23. |
- Augustsson, Jesper, Docent, 1964-, et al.
(författare)
-
Styrketräning för idrott, motion och rehabilitering
- 2019. - 2
-
Bok (övrigt vetenskapligt/konstnärligt)abstract
- Styrketräning kan utövas som en egen idrott i form av tyngdlyftning och styrkelyft. Styrketräning bedrivs också i prestationshöjande syfte som ett viktigt komplement till andra träningsformer eller idrotter. Många styrketränar för att orka mer och klara vardag och fritid bättre. Sist men inte minst spelar styrketräning en viktig roll i att förebygga och behandla skador och sjukdomar.Styrketräning är inkluderande och kan utformas så att vem som helst, oberoende av ålder och fysisk status kan utföra den. Styrketräning är också skonsam och anpassningsbar och därför alltid ett alternativ när andra träningsformer blivit för krävande och inte längre fungerar att utföra. Styrketräning är dessutom en effektiv och utmanande träningsform, på kort tid kan man pressas till total utmattning.Det är alltså inte så konstigt att styrketräning är en av de vanligaste träningsformerna och idag har mer än två miljoner utövare i Sverige. Och i takt med att intresset för styrketräning ökar, så bidrar forskningen till att kunskapen om kropp och muskler också ökar. Denna bok är den mest heltäckande och ambitiösa om styrketräning som skrivits i Sverige och ger såväl kunskap som vägledning kring hur styrketräning ska bedrivas för att ge optimal effekt utifrån träningens syfte. Boken är indelad i olika kapitel som behandlar många olika aspekter av styrketräning. För att öka förståelsen och för att göra läsningen så stimulerande som möjligt är boken rikt illustrerad och försedd med faktarutor och sammanfattningar.Den nya upplagan av boken har både uppdaterats och utökats med nya forskningsrön, aktuella referenser och information i samtliga kapitel. Den tillämpade delen av boken har ytterligare fördjupats med nya bilder där de mest betydelsefulla styrketräningsövningarna demonstreras på ett unikt och pedagogiskt sätt för läsaren. Kapitlen Styrketräning för unga, gravida och äldre, Förebyggande och rehabiliterande styrketräning och Kostens betydelse vid styrketräning har alla nytt innehåll. Ett helt nytt kapitel, Träningsplanering och tester för styrketräning, har tillkommit.Styrketräning – för idrott, motion och rehabilitering riktar sig bland annat till aktiva och ledare inom idrottsrörelsen, hälso-, friskvårds-, gym- och fitnessbranschens aktörer och till utbildningar av fysioterapeuter, idrottsvetare, hälsovetare, biomedicinare, idrottslärare med flera.
|
|
| 24. |
- Ayeni, O. R., et al.
(författare)
-
Diagnostic accuracy of physical examinations for ACL injury
- 2017
-
Ingår i: Diagnostic Accuracy of Physical Examinations for ACL Injury. In: Nakamura N., Zaffagnini S., Marx R., Musahl V. (eds) Controversies in the Technical Aspects of ACL Reconstruction.. - Berlin, Heidelberg : Springer Berlin Heidelberg. - 9783662527429 ; , s. 35-43
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- The three common physical examinations that are used to aid in the diagnosis of anterior cruciate ligament (ACL) injury are the anterior drawer test, Lachman’s test, and the pivot shift test. The anterior drawer test is the oldest and easiest maneuver to learn; however, various limitations contribute to a relatively low accuracy of this examination. The poor sensitivity of the anterior drawer test is improved when anesthesia is used and for patients with chronic, rather than acute, ACL injuries. Lachman’s test has the highest sensitivity of all three tests and is useful for ruling out complete ACL ruptures with a negative test result. The specificity of Lachman’s test is high, but the pivot shift test has the highest specificity of all three physical examinations. Thus a positive pivot shift test is most accurate in diagnosing an ACL insufficiency. Studies, particularly those before the year 2000, indicate that a negative pivot shift test does not provide useful information for exclusion, and improved results of the test performed with anesthesia indicate that these false-negative results are partially caused by muscle guarding.
|
|
| 25. |
- Ayeni, Olufemi R, 1976, et al.
(författare)
-
Femoro-acetabular impingement clinical research: is a composite outcome the answer?
- 2016
-
Ingår i: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. - : Springer Science and Business Media LLC. - 1433-7347. ; 24:1, s. 295-301
-
Tidskriftsartikel (refereegranskat)abstract
- Femoro-acetabular impingement (FAI) is increasingly recognized as an important cause of hip pain in the young adult. However, the methods of evaluating the efficacy of surgical intervention are often not validated and/or inconsistently reported. Important clinical, gait, radiographic and biomarker outcomes are discussed. This article (1) presents the rationale for considering a composite outcome for FAI patients; (2) examines a variety of important end points currently used to evaluate FAI surgery; (3) discusses a strategy to generate a composite outcome by combining these end points; and (4) highlights the challenges and current areas of controversy that such an approach to evaluating symptomatic FAI patients may present.
|
|
| 26. |
- Björnsson, Haukur, et al.
(författare)
-
A Randomized Controlled Trial With Mean 16-Year Follow-up Comparing Hamstring and Patellar Tendon Autografts in Anterior Cruciate Ligament Reconstruction
- 2016
-
Ingår i: American Journal of Sports Medicine. - : SAGE Publications. - 0363-5465 .- 1552-3365. ; 44:9, s. 2304-2313
-
Tidskriftsartikel (refereegranskat)abstract
- Background: There is no consensus in the current literature on which surgical options render the best long-term results after anterior cruciate ligament (ACL) reconstruction in terms of clinical outcomes and the development of radiographic osteoarthritis (OA). Purpose: To investigate the long-term clinical and radiographic results after ACL reconstruction using either a patellar tendon (PT) autograft or a hamstring tendon (HT) autograft. Methods: This multicenter study was based on 2 previous randomized cohorts consisting of 193 patients who underwent unilateral primary ACL reconstruction using either a PT autograft or an HT autograft. The index surgical procedure was performed between September 1995 and January 2000. Clinical assessments, including knee laxity measurements, functional outcomes, patient-reported outcomes, and bilateral standing radiographs, were performed at the final follow-up examination. Results: At the long-term follow-up, 147 (76%) patients were examined: 61 in the PT group and 86 in the HT group. The mean (SD) follow-up time was 191.9 +/- 15.1 months for the HT group and 202.6 +/- 10.4 months for the PT group. Knee laxity measurements revealed significantly more patients with a normal pivot-shift test finding in the HT group compared with the PT group (71% vs 51%, respectively; P = .048); however, no significant differences were found in terms of the manual Lachman test or the KT-1000 arthrometer manual maximum test. The patients in the PT group had significantly more difficulty knee walking (P = .049). There were no significant differences between the study groups in terms of patient-reported outcomes or range of motion in the reconstructed knee. In both groups, significantly more signs of radiographic OA were found in the reconstructed knee than in the contralateral healthy knee. However, there were no significant differences between the groups in terms of radiographic OA. Conclusion: Only minor and mostly insignificant differences were found between the PT and HT autograft groups in this long-term randomized controlled trial. In both groups, significantly more signs of radiographic OA were found in the reconstructed knee than in the contralateral knee.
|
|
| 27. |
|
|
| 28. |
- Brorsson, Annelie, 1963, et al.
(författare)
-
Long-term follow up after acute Achilles tendon rupture.
- 2015
-
Ingår i: Danish Sports Medicine Congress, Copenhagen, January 22-24, 2015. - : Danish Association of Sports Medicine.
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- It is still unknown why many patients never fully recover after an Achilles tendon rupture (ATR). The aim of this study was to perform a long-term follow-up (5-9 years) of patients treated either surgically or non-surgically after an ATR. Furthermore, we wanted to examine if the patients had a tendon elongation on the injured side and evaluate if this correlated to function, symptoms and foot structure. Material and Method Sixty-seven patients (13 women) mean age of 50 years were evaluated 5-9 years after injury. Thirty-five patients were treated with surgery and 32 with non-surgery. Patient reported outcome and activity level, lower leg function, tendon length, and foot-structure were evaluated. Both the healthy and the injured side were examined and the limb symmetry index (LSI=injured/healthy x 100) was calculated. Results There were significant differences between the healthy and injured side in all function tests (p<0.001-0.015) and the tendon was significantly longer on the injured side (p<0.001) independent of treatment. There were no significant correlations between tendon length and patient reported outcome, function or foot structure. The heel-rise height increased significantly (p<0.000) from the 1 year- to the 5-9-years-follow up. The mean Achilles tendon Total Rupture Score (ATRS) was 91/100, indicating minor symptoms. Conclusion: Patients with an Achilles tendon rupture continues to have significant deficits in tendon structure and function 5-9 years after injury. There is, however continued improvement between the 1 and 5-9 year follow-up.
|
|
| 29. |
- Brorsson, Annelie, 1963, et al.
(författare)
-
Recovery of calf muscle endurance 3 months after an Achilles tendon rupture.
- 2016
-
Ingår i: Scandinavian journal of medicine & science in sports. - : Wiley. - 1600-0838 .- 0905-7188. ; 26:7, s. 844-853
-
Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to evaluate calf muscle endurance in a seated position 3 months after an Achilles tendon rupture and to evaluate how the ability to perform standardized seated heel-rises correlated to the single-leg standing heel-rise test and to patient-reported symptoms evaluated with the Achilles tendon Total Rupture Score (ATRS) 3 and 6 months after the injury. Ninety-three patients were included from a cohort of 101 patients participating in a prospective, randomized controlled trial comparing surgical and nonsurgical treatment after Achilles tendon rupture. Forty-seven patients were treated surgically and 46 nonsurgically. Ninety-one patients out of 93 (98%) could perform the standardized seated heel-rises. At the 3-month follow-up, there was a significant difference (P<0.001) between the injured and the healthy side performing standardized seated heel-rises. There were also significant correlations (r=0.29-0.37, P=<0.05) between the standardized seated heel-rises and ATRS 3 and 6 months after injury in the group who could not perform single-leg standing heel-rises. There were no significant differences between the surgical and nonsurgical treatment groups. The evaluation of standardized seated heel-rises appears to be a useful tool to quantify progress and predict future functional performance and patient-reported symptoms.
|
|
| 30. |
- Brorsson, Annelie, 1963, et al.
(författare)
-
Återhämtning av vadmuskelfunktion tre månader efter hälseneruptur -utvärdering av standardiserade sittande tåhävningar
- 2015
-
Ingår i: Vägen till Framgång. Idrottsmedicinskt Vårmöte. Linköping 7-9 maj 2015. - Linköping : Svensk Förening För Fysisk Aktivitet och Idrottsmedicin.
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Bakgrund/syfte: Hälseneruptur drabbar ofta medelålders, fysiskt aktiva kvinnor och män och har ökat de senaste decennierna. Skador i senor läker oftast långsamt och det är inte klarlagt hur rehabiliteringen efter denna skada kan optimeras. Syftet med denna studie var att undersöka vadmuskelns uthållighet i en sittande position och att utvärdera hur förmågan att utföra standardiserade sittande tåhävningar korrelerade med förmågan att utföra stående enbenta tåhävningar tre månader efter skadan samt med patientrapporterade symtom tre och sex månader efter skadan. Metod: Nittiotre patienter inkluderades från en kohort av 101 patienter som deltog i en prospektiv, randomiserad kontrollerad studie där behandling med kirurgi jämfördes med behandling med icke kirurgi efter akut hälseneruptur. Fyrtiosju patienter behandlades med kirurgi och 46 med icke-kirurgi. Vadmuskelfunktion utvärderades med standardiserade sittande tåhävningar samt enbenta stående tåhävningar tre månader efter hälsenerupturen. Patientrapporterade symptom utvärderades med Achilles tendon Total Rupture Score (ATRS) tre och sex månader efter hälsenerupturen. Resultat: Nittioen patienter av 93 (98 %) kunde utföra standardiserade sittande tåhävningar och 46 av 93 patienter (49 %) kunde utför enbenta stående tåhävningar tre månader efter hälsenerupturen. Det var signifikant skillnad mellan den skadade och den friska sidan i tåhävningshöjd (6,1 cm respektive 8,9 cm, p<0.000) och i antal repetitioner (58 st respektive 90 st, p<0.000) vid utförandet av de sittande tåhävningarna tre månader efter skadan. Det var också signifikant skillnad i tåhävningshöjd samt antal repetitioner (p<0.001 resp. p=0.011) i de standardiserade sittande tåhävningarna på den skadade sidan vid jämförelse mellan de som kunde utföra enbenta stående tåhävningar tre månader efter skadan och de som inte klarade det. Det förelåg signifikanta korrelationer (r=0.29-0.37, p=<0.05) mellan standardiserade sittande tåhävningar och ATRS tre och sex månader efter skadan i gruppen som inte klarade att utföra enbenta stående tåhävningar tre månader efter hälsenerupturen. Det fanns inga signifikanta skillnader mellan de två behandlingsgrupperna som behandlades med kirurgi respektive icke kirurgi. Konklusion: Standardiserade sittande tåhävningar verkar vara ett kliniskt användbart verktyg i det tidiga skedet efter hälseneruptur för att kunna utvärdera vadmuskelfunktionen och förutsäga framtida funktion och patientrapporterade symptom.
|
|
| 31. |
- Börjesson, Mats, et al.
(författare)
-
Can you feel the real paper?
- 2015
-
Ingår i: British Journal of Sports Medicine. - : BMJ. - 0306-3674 .- 1473-0480. ; 49:22, s. 1419-1420
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
|
|
| 32. |
|
|
| 33. |
- Börjesson, Mats, 1965, et al.
(författare)
-
Match related factors influencing injury risk
- 2018
-
Ingår i: Return to Play in Football. - Berlin, Heidelberg : Springer Verlag. - 9783662557129 ; , s. 63-72
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)
|
|
| 34. |
- Caesar, Ulla, 1964, et al.
(författare)
-
Incidence and root causes of delays in emergency orthopaedic procedures: a single-centre experience of 36,017 consecutive cases over seven years
- 2018
-
Ingår i: Patient Safety in Surgery. - : Springer Science and Business Media LLC. - 1754-9493. ; 12:2
-
Tidskriftsartikel (refereegranskat)abstract
- Background Emergency surgery is unplanned by definition and patients are scheduled for surgery with minimal preparation. Some patients who have sustained emergency orthopaedic trauma or other conditions must be operated on immediately or within a few hours, while others can wait until the hospital’s resources permit and/or the patients’ health status has been optimised as needed. This may affect the prioritisation procedures for both emergency and elective surgery and might result in waiting lists, not only for planned procedures but also for emergencies. Method The main purpose of this retrospective, observational, single-centre study was to evaluate and describe for the number and reasons of delays, as well as waiting times in emergency orthopaedic surgery using data derived from the hospital’s records and registers. All the emergency patients scheduled for emergency surgery whose procedures were rescheduled and delayed between 1 January 2007 and 31 December 2013 were studied. Result We found that 24% (8474) of the 36,017 patients scheduled for emergency surgeries were delayed and rescheduled at least once, some several times. Eighty per cent of these delays were due to organisational causes. Twenty-one per cent of all the delayed patients had surgery within 24 h, whilst 41% waited for more than 24 h, up to 3 days. Conclusion A large number of the clinic’s emergency orthopaedic procedures were rescheduled and delayed and the majority of the delays were related to organisational reasons. The results can be interpreted in two ways; first, organisational reasons are avoidable and the potential for improvement is great and, secondly and most importantly, the delays might negatively affect patient outcomes.
|
|
| 35. |
- Carmont, Michael R, 1972, et al.
(författare)
-
Free Hamstring Open Augmentation for Delayed Achilles Tendon Rupture
- 2017
-
Ingår i: The Achilles Tendon An Atlas of Surgical Procedures. Editors: Thermann, H., Becher, C., Carmont, M.R., Karlsson, J., Maffulli, N., Calder, J., van Dijk, C.N.. - : Springer. - 9783662540749
-
Bokkapitel (refereegranskat)
|
|
| 36. |
- Carmont, Michael R, 1972, et al.
(författare)
-
Functional Outcomes of Achilles Tendon Minimally Invasive Repair Using 4- and 6-Strand Nonabsorbable Suture: A Cohort Comparison Study
- 2017
-
Ingår i: Orthopaedic Journal of Sports Medicine. - : SAGE Publications. - 2325-9671. ; 5:8
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of management of Achilles tendon rupture is to reduce tendon lengthening and maximize function while reducing the rerupture rate and minimizing other complications. Purpose: To determine changes in Achilles tendon resting angle (ATRA), heel-rise height, patient-reported outcomes, return to play, and occurrence of complications after minimally invasive repair of Achilles tendon ruptures using nonabsorbable sutures. Methods: Between March 2013 and August 2015, a total of 70 patients (58 males, 12 females) with a mean age of 42 8 years were included and evaluated at 6 weeks and 3, 6, 9, and 12 months after repair of an Achilles tendon rupture. Surgical repair was performed using either 4-strand or 6-strand nonabsorbable sutures. After surgery, patients were mobilized, fully weightbearing using a functional brace. Early active movement was permitted starting at 2 weeks. Results: There were no significant differences in the ATRA, Achilles Tendon Total Rupture Score (ATRS), and Heel-Rise Height Index (HRHI) between the 4- and 6-strand repairs. The mean (SD) relative ATRA was -13.1 degrees (6.6 degrees) (dorsiflexion) following injury; this was reduced to 7.6 degrees (4.8 degrees) (plantar flexion) directly after surgery. During initial rehabilitation at 6 weeks, the relative ATRA was 0.6 degrees (7.4 degrees) (neutral) and -7.0 degrees (5.3 degrees) (dorsiflexion) at 3 months, after which ATRA improved significantly with time to 12 months (P = .005). At 12 months, the median ATRS was 93 (range, 35-100), and the mean (SD) HRHI and Heel-Rise Repetition Index were 81% (0.22%) and 82.9% (0.17%), respectively. The relative ATRA at 3 and 12 months correlated with HRHI (r = 0.617, P < .001 and r = 0.535, P < .001, respectively). Conclusion: Increasing the number of suture strands from 4 to 6 does not alter the ATRA or HRHI after minimally invasive Achilles tendon repair. The use of a nonabsorbable suture during minimally invasive repair when used together with accelerated rehabilitation did not prevent the development of an increased relative ATRA. The ATRA at 3 months after surgery correlated with heel-rise height at 12 months.
|
|
| 37. |
- Carmont, Michael R, 1972, et al.
(författare)
-
Tendon end separation with loading in an Achilles tendon repair model: comparison of non-absorbable vs. absorbable sutures.
- 2017
-
Ingår i: Journal of experimental orthopaedics. - : Springer Science and Business Media LLC. - 2197-1153. ; 4:1
-
Tidskriftsartikel (refereegranskat)abstract
- Rupture of the Achilles tendon often leads to long-term morbidity, particularly calf weakness associated with tendon elongation. Operative repair of Achilles tendon ruptures leads to reduced tendon elongation. Tendon lengthening is a key problem in the restoration of function following Achilles tendon rupture. A study was performed to determine differences in initial separation, strength and failure characteristics of differing sutures and numbers of core strands in a percutaneous Achilles tendon repair model in response to initial loading.Nineteen bovine Achilles tendons were repaired using a percutaneous/minimally invasive technique with a combination of a modified Bunnell suture proximally and a Kessler suture distally, using non-absorbable 4-strand 6-strand repairs and absorbable 8-strand sutures. Specimens were then cyclically loaded using phases of 10cycles of 100N, 100cycles of 100N, 100cycles of 190N consistent with early range of motion training and weight-bearing, before being loaded to failure.Pre-conditioning of 10cycles of 100N resulted in separations of 4mm for 6-strand, 5.9mm for 4-strand, but 11.5mm in 8-strand repairs, this comprised 48.5, 68.6 and 72.7% of the separation that occurred after 100cycles of 100N. The tendon separation after the third phase of 100cycles of 190N was 17.4mm for 4-strand repairs, 16.6mm for 6-strand repairs and 26.6mm for 8-strand repairs. There were significant differences between the groups (p<0.0001). Four and six strand non-absorbable repairs had significantly less separation than 8-strand absorbable repairs (p=0.017 and p=0.04 respectively). The mean (SEM) ultimate tensile strengths were 4-strand 464.8N (27.4), 6-strand 543.5N (49.6) and 8-strand 422.1N (80.5). Regression analysis reveals no significant difference between the overall strength of the 3 repair models (p=0.32) (4 vs. 6: p=0.30, 4 vs. 8: p=0.87; 6 vs. 8: p=0.39). The most common mode of failure was pull out of the Kessler suture from the distal stump in 41.7% of specimens.The use of a non-absorbable suture resulted in less end-to-end separation when compared to absorbable sutures when an Achilles tendon repair model was subject to cyclical loading. Ultimate failure occurred more commonly at the distal Kessler suture end although this occurred with separations in excess of clinical failure. The effect of early movement and loading on the Achilles tendon is not fully understood and requires more research.
|
|
| 38. |
- Carmont, Michael R, 1972, et al.
(författare)
-
The Achilles tendon resting angle as an indirect measure of Achilles tendon length following rupture, repair, and rehabilitation
- 2015
-
Ingår i: Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and Technology. - : Elsevier BV. - 2214-6873. ; 2:2, s. 49-55
-
Tidskriftsartikel (refereegranskat)abstract
- Background Rupture of the Achilles tendon may result in reduced functional activity and reduced plantar flexion strength. These changes may arise from elongation of the Achilles tendon. An observational study was performed to quantify the Achilles tendon resting angle (ATRA) in patients following Achilles tendon rupture, surgical repair, and rehabilitation, respectively. Methods Between May 2012 and January 2013, 26 consecutive patients (17 men), with a mean (standard deviation, SD) age of 42 (8) years were included and evaluated following injury, repair, and at 6 weeks, 3 months, 6 months, 9 months, and 12 months, respectively (rehabilitation period). The outcome was measured using the ATRA, Achilles tendon total rupture score (ATRS), and heel-rise test. Results Following rupture, the mean (SD) absolute ATRA was 55 (8)° for the injured side compared with 43 (7)°(p < 0.001) for the noninjured side. Immediately after repair, the angle reduced to 37 (9)°(p < 0.001). The difference between the injured and noninjured sides, the relative ATRA, was -12.5 (4.3)°following injury; this was reduced to 7 (7.9)°following surgery (p < 0.001). During initial rehabilitation, at the 6-week time point, the relative ATRA was 2.6 (6.2)°(p = 0.04) and at 3 months it was -6.5 (6.5)°(p < 0.001). After the 3-month time point, there were no significant changes in the resting angle. The ATRS improved significantly (p < 0.001) during each period up to 9 months following surgery, where a score of 85 (10)°was reported. The heel-rise limb symmetry index was 66 (22)% at 9 months and 82 (14)% at 12 months. At 3 months and 6 months, the absolute ATRA correlated with the ATRS (r = 0.63, p = 0.001, N = 26 and r = 0.46, p = 0.027, N = 23, respectively). At 12 months, the absolute ATRA correlated with the heel-rise height (r = -0.63, p = 0.002, N = 22). Conclusion The ATRA increases following injury, is reduced by surgery, and then increases again during initial rehabilitation. The angle also correlates with patient-reported symptoms early in the rehabilitation phase and with heel-rise height after 1 year. The ATRA might be considered a simple and effective means to evaluate Achilles tendon function 1 year after the rupture. © 2015, Asia Pacific Knee, Arthroscopy and Sports Medicine Society. Published by Elsevier (Singapore) Pte Ltd. All rights reserved.
|
|
| 39. |
- Concoff, A., et al.
(författare)
-
A Comparison of Treatment Effects for Nonsurgical Therapies and the Minimum Clinically Important Difference in Knee Osteoarthritis: A Systematic Review
- 2019
-
Ingår i: JBJS reviews. - 2329-9185. ; 7:8
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The minimum clinically important difference (MCID) was developed to ascertain the smallest change in an outcome that patients perceive as beneficial. The objectives of the present review were (1) to compare the MCIDs for pain assessments used among guidelines and meta-analyses investigating different nonsurgical therapies for knee osteoarthritis and (2) to compare the effect estimates of different nonsurgical interventions against a single commonly-utilized MCID threshold. METHODS: Systematic and manual searches were conducted to identify guidelines and meta-analyses evaluating pain outcomes for nonsurgical knee osteoarthritis interventions. Individual treatment effects for pain were presented on a common scale (the standardized mean difference [SMD]). To evaluate the perception of the relative benefit of each nonsurgical treatment, the variation in MCIDs selected from the published MCID literature was assessed. RESULTS: Thirty-seven guidelines and meta-analyses were included. MCIDs were often presented as an SMD or a mean difference (MD) on a validated scale and varied in magnitude across sources. This analysis demonstrated that intra-articular hyaluronic acid, intra-articular corticosteroids, and acetaminophen all had relatively larger effect sizes than topical nonsteroidal anti-inflammatory drugs (NSAIDs). Higher-molecular-weight intra-articular hyaluronic acid had a greater relative effect compared with both non-selective and cyclooxygenase-2-selective oral NSAIDs. Evaluating the treatment effect estimates against a commonly utilized MCID revealed similarities in which observations attained clinical significance among treatments; however, this observation varied across the range of reported MCIDs. CONCLUSIONS: The present review confirmed the variability in the MCIDs for pain assessments that are used across guidelines and meta-analyses evaluating nonsurgical interventions for knee osteoarthritis. This variability may yield conflicting treatment recommendations, ranging from rejecting treatments that are indeed efficacious to accepting treatments that may not be beneficial. Additional research is required to determine why some nonsurgical therapies are more consistently recommended in knee osteoarthritis guidelines than others as these findings suggest similarities in their effect estimates for pain. Relevant stakeholders need to reach a consensus on a standard approach to determining the MCIDs for these therapies to ensure that appropriate and effective treatment options are available to patients prior to invasive surgical intervention. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
|
|
| 40. |
- Dalmau-Pastor, M., et al.
(författare)
-
Anatomy of the inferior extensor retinaculum and its role in lateral ankle ligament reconstruction: a pictorial essay
- 2016
-
Ingår i: Knee Surgery Sports Traumatology Arthroscopy. - : Springer Science and Business Media LLC. - 0942-2056 .- 1433-7347. ; 24:4, s. 957-962
-
Tidskriftsartikel (refereegranskat)abstract
- The inferior extensor retinaculum (IER) is an aponeurotic structure, which is in continuation with the anterior part of the sural fascia. The IER has often been used to augment the reconstruction of the lateral ankle ligaments, for instance in the Brostrom-Gould procedure, with good outcomes reported. However, its anatomy has not been described in detail and only a few studies are available on this structure. The presence of a non-constant oblique supero-lateral band appears to be important. This structure defines whether the augmentation of the lateral ankle ligaments reconstruction is performed using true IER or only the anterior part of the sural fascia. It is concluded that the use of this structure will have an impact on the resulting ankle stability.
|
|
| 41. |
- de Sa, D., et al.
(författare)
-
A Comparison of Supine and Lateral Decubitus Positions for Hip Arthroscopy: A Systematic Review of Outcomes and Complications
- 2016
-
Ingår i: Arthroscopy-the Journal of Arthroscopic and Related Surgery. - : Elsevier BV. - 0749-8063. ; 32:4
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: This systematic review examines outcomes and risk profiles of the hip arthroscopy in the supine versus lateral decubitus positions to elucidate any superiority of one approach over the other. Methods: Three databases (Embase, PubMed, and Medline) were searched for studies that addressed hip arthroscopy performed in either position, and were subsequently screened by two reviewers with data abstracted in duplicate. Results: Similar outcomes were observed. Supine studies showed a greater mean postoperative improvement for modified Harris hip score (33.74), visual analog scale (-3.99), nonarthritic hip score (29.61), Harris hip score (35.73), and hip outcome score (31.4). Lateral decubitus studies showed greater improvement using the Western Ontario and McMaster University Osteoarthritis (14.76) score. Supine studies reported more neuropraxic injuries (2.06% v 0.47%), labral penetration (0.65% v 0%), and heterotopic ossification (0.21% v 0%). Lateral decubitus studies reported more fluid extravasation (0.21% v 0.05%) and missed loose bodies (0.08% v 0.01%). Similar rates of revision (1.8% lateral, 1.4% supine) and conversion to open procedures (2.6% in lateral, 2.0% in supine) were also identified. Conclusions: Because of quality of evidence, direct comparisons are currently limited; however, the supine position is associated with more neuropraxic injuries, labral penetration, and heterotopic ossification, whereas lateral decubitus has increased risk of fluid extravasation and missed loose bodies. At this time, no evidence exists to establish superiority of one position.
|
|
| 42. |
- de Sa, Darren, et al.
(författare)
-
Evaluating healthcare resource utilization and outcomes for surgical hip dislocation and hip arthroscopy for femoroacetabular impingement.
- 2016
-
Ingår i: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. - : Springer Science and Business Media LLC. - 1433-7347. ; 24:12, s. 3943-3954
-
Tidskriftsartikel (refereegranskat)abstract
- Surgical hip dislocation (SHD) and hip arthroscopy are surgical methods used to correct deformity associated with femoroacetabular impingement (FAI). Though both of these approaches appear to benefit patients, no studies exist comparing healthcare resource utilization of the two surgical approaches. This systematic review examines the literature and the records of two surgeons to evaluate the resource utilization associated with treating symptomatic FAI via these two methods.
|
|
| 43. |
|
|
| 44. |
- D'Hooghe, P., et al.
(författare)
-
Chronic ligament injuries of the ankle joint
- 2015
-
Ingår i: Sports Injuries: Prevention, Diagnosis, Treatment and Rehabilitation, Second Edition. - Berlin : Springer. ; , s. 1711-1725
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Ankle sprains are the most frequently encountered injuries in athletic activities. Early diagnosis, functional treatment, and rehabilitation are the key issues in preventing a potential evolution towards chronic ligament insufficiency. Ankle joint instability is defined as either mechanical instability or functional instability. Mechanical instability refers to an objective measurement, e.g., standardized stress radiographs, while functional instability is a description of the subjective symptoms of the patient, i.e., repeated giving way in some cases combined with pain. Functional instability is the most common residual disability after acute (lateral) ligament ruptures. This chapter will elaborate on the prevention, diagnosis, treatment, and rehabilitation of the athlete's medial and lateral ankle ligament problems. © Springer-Verlag Berlin Heidelberg 2012, 2015, All Rights Reserved.
|
|
| 45. |
- D'Hooghe, P., et al.
(författare)
-
Total achilles tendon ruptures: Current trends
- 2015
-
Ingår i: Sports Injuries: Prevention, Diagnosis, Treatment and Rehabilitation, Second Edition. - Berlin : Springer. - 9783642365690 ; , s. 2321-2334
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Achilles tendon rupture occurs relatively common (De Jonge, Br J Sports Med 45:1026-1028, 2011). Although it is the thickest and strongest tendon in the human body, it remains susceptible to injury. During the last decades, the incidence of spontaneous ruptures has been rising, which may be due to the increasing keep-fit culture. Ruptures occur most frequently in patients between the age of 30 and 50 years old, with a male predominance. Approximately 75 % of Achilles tendon ruptures occur during sports activities, especially racket games, soccer, and handball. Diagnosis is primarily clinical. However, there is still a lack of consensus on the best management of the Achilles tendon rupture. Generally, open surgical management is advocated, although over the past few years, percutaneous techniques are performed more commonly. Nonsurgical management appears to be a good alternative for those with comorbidity or patients who do not wish to have surgery. Recent systematic reviews have concluded that operative management has a lower re-rupture rate but must be balanced by the risks associated with surgery (Khan and Carey Smith, Cochrane Database Syst Rev CD003674, 2010). © Springer-Verlag Berlin Heidelberg 2012, 2015, All Rights Reserved.
|
|
| 46. |
- Diniz, P., et al.
(författare)
-
Clinical applications of allografts in foot and ankle surgery
- 2019
-
Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy. - : Springer Science and Business Media LLC. - 0942-2056 .- 1433-7347. ; 27:6, s. 1847-1872
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: The purpose of this review is to systematically analyse current literature on the use of allografts in the surgical treatment of foot and ankle disorders in adult patients. Based on this study, we propose evidence-based recommendations. Methods: The database for PubMed was searched for all published articles. No timeframe restrictions were applied. Clinical studies eligible for inclusion met the following criteria: performed on patients over 18years old; subject to surgical treatment of foot and ankle disorders; with report on the outcome of the use of allografts; with a report and assessment of pain and function, or equivalent; minimum follow-up of 1year was required. Two reviewers independently screened and selected studies for full-text analysis from title and abstract. 107 studies were included from 1113 records. Studies were grouped according to surgical indications into ten categories: musculoskeletal tumours (n = 16), chronic ankle instability (n = 15), ankle arthritis (n = 14), osteochondral lesions of the talus (n = 12), Achilles tendon defects (n = 11), other tendon defects (n = 9), fusions (n = 9), fractures (n = 8), hallux rigidus (n = 3) and other indications (n = 10). Results: Most studies displayed evidence level of IV (n = 57) and V (n = 39). There was one level I, one level II and nine level III studies. Most studies reported allografting as a good option (n = 99; 92.5%). Overall complication rate was 17% (n = 202). Conclusions: Fair evidence (Grade B) was found in favour of the use of allografts in lateral ankle ligament reconstruction or treatment of intra-articular calcaneal fracture. Fair evidence (Grade B) was found against the use of allogeneic MSCs in tibiotalar fusions. Level of evidence: V. © 2019, European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA).
|
|
| 47. |
- Ekstrand, Jan, 1944-, et al.
(författare)
-
Is there a correlation between coaches' leadership styles and injuries in elite football teams? A study of 36 elite teams in 17 countries
- 2018
-
Ingår i: British Journal of Sports Medicine. - London, United Kingdom : BMJ. - 0306-3674 .- 1473-0480. ; 52:8, s. 527-531
-
Tidskriftsartikel (refereegranskat)abstract
- Background Do coaches' leadership styles affect injury rates and the availability of players in professional football? Certain types of leadership behaviour may cause stress and have a negative impact on players' health and well-being. Aim To investigate the transformational leadership styles of head coaches in elite men's football and to evaluate the correlation between leadership styles, injury rates and players' availability. Methods Medical staff from 36 elite football clubs in 17 European countries produced 77 reports at four postseason meetings with a view to assessing their perception of the type of leadership exhibited by the head coaches of their respective teams using the Global Transformational Leadership scale. At the same time, they also recorded details of individual players' exposure to football and time-loss injuries. Results There was a negative correlation between the overall level of transformational leadership and the incidence of severe injuries (rho=-0.248; n=77; p=0.030); high levels of transformational leadership were associated with smaller numbers of severe injuries. Global Transformational Leadership only explained 6% of variation in the incidence of severe injuries (r 2 =0.062). The incidence of severe injuries was lower at clubs where coaches communicated a clear and positive vision, supported staff members and gave players encouragement and recognition. Players' attendance rates at training were higher in teams where coaches gave encouragement and recognition to staff members, encouraged innovative thinking, fostered trust and cooperation and acted as role models. Conclusions There is an association between injury rates and players' availability and the leadership style of the head coach.
|
|
| 48. |
- Fahlström, Karl, 1986-, et al.
(författare)
-
Effect of Laser Welding Parameters on Porosity of Weldsin Cast Magnesium Alloy AM50
- 2018
-
Ingår i: Modern Approaches on Material Science. - 2641-6921. ; 1:2, s. 25-32
-
Tidskriftsartikel (refereegranskat)abstract
- Pores in the weld metal lower the mechanical properties of the weld. It is therefore important to understand the pore formation mechanisms and find procedures that could reduce porosity. This study focused on laser welding of 3 mm thick magnesium alloy AM50, investigating how different parameters affect porosity formation. Low levels of porosity content were achieved by either increasing the welding speed or using a two-pass welding approach. It was found that higher welding speeds did not allow pores,which were pre-existing from the die-casting process, to have sufficient time to coalesce and expand. In the two-pass welding technique, pores were removed as a result of a degassing process which occurred through the second pass.
|
|
| 49. |
- Fahlström, Karl, 1986-, et al.
(författare)
-
Low Porosity in Cast Magnesium Welds by Advanced Laser Twin-Spot Welding
- 2019
-
Ingår i: Materials Sciences and Applications. - : Scientific Research Publishing, Inc.. - 2153-117X .- 2153-1188. ; 10:1, s. 53-64
-
Tidskriftsartikel (refereegranskat)abstract
- Porosity is reported to be a major issue when welding cast magnesium. Therefore, it is important to understand the pore formation mechanisms and find procedures that could be used to reduce porosity. This study investigated the possibility of using twin-spot optics for reducing the porosity in laser welded cast magnesium. Two twin-spot welding setups were compared using either a beam splitter or twin-spot welding with primary and secondary (placed in front of the primary optic) optics. The results showed that welding with a dual optic setup with a defocused secondary beam reduced the volumetric porosity in the weld to 5%. The highest levels of volumetric porosity were 30%, and were a result of using the dual optic setup, but with a defocused primary beam. No clear relation between the level of porosity and power or welding speed was found. It was found that the amount of porosity depended on the balance of the energy input (controlled by defocusing) between the two beams. Porosity formation can be reduced if the energy from the first beam results in the nucleation and initial growth of pores. Reheating by the second beam then allows the pores to grow and escape from the molten material without melting additional base material. Furthermore, twin-spot welding is shown to be a promising combination of a production friendly solution and high quality welding.
|
|
| 50. |
- Franceschetti, Edoardo, et al.
(författare)
-
No difference between cemented and cementless total knee arthroplasty in young patients: a review of the evidence
- 2017
-
Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy. - : Springer Science and Business Media LLC. - 0942-2056 .- 1433-7347. ; 25:6, s. 1749-1756
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: The present piece of work provides improved knowledge about the evidence related to TKA in patients 60 years of age or younger, with special focus on fixation methods. Main concern of the review is to analyse the difference of survival rate and complications of cemented and cementless implants. Methods: An electronic search was carried out between October and December 2015, through CINAHL, PubMed and the Cochrane Central Registry of Controlled Trials web databases. Articles in English, Italian, French and Spanish were considered for inclusion. Only peer-reviewed studies with adult patients aged 60 years or less, with diagnosis of osteoarthritis in more than 90% of the subjects, were considered for inclusion. All studies had to report outcomes after TKA with either cemented or cementless fixation technique. Results: No significant differences in terms of clinical, functional and radiological outcomes were found between cemented and cementless implants. Good clinical and functional results were obtained in terms of the Knee Society score and Western Ontario and McMaster Universities Osteoarthritis Index for both techniques. Radiographic results showed that radiolucent lines of <2 mm in width were detected at radiographs, without difference between cemented or cementless implants. Well-conducted trials on cemented versus cementless TKA were carried out in few papers. A survival rate of over 90% was reported in the majority of the studies at a mean follow-up of 8.6 years (range 5–18 years). Conclusion: Similar results were observed in terms of functional outcome and survival rates for both cemented and cementless TKAs. High survival rates were reported for both operative techniques and cemented TKA did not offer additional benefit. Assuming that cementless prosthesis allows a stable fixation and reduces the time of operation, the authors recommend the cementless fixation as a primary choice in the investigated patient population. However, evidence is low, and further research is needed. Level of evidence: IV.
|
|
