| 1. |
- Andernord, Daniel, et al.
(author)
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Surgical Predictors of Early Revision Surgery After Anterior Cruciate Ligament Reconstruction: Results From the Swedish National Knee Ligament Register on 13,102 Patients.
- 2014
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In: The American journal of sports medicine. - : SAGE Publications. - 1552-3365 .- 0363-5465. ; 42:7, s. 1574-1582
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Journal article (peer-reviewed)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.
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| 2. |
- Brorsson, Annelie, 1963, et al.
(author)
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Development and evaluation of a new seated heel-rise test in the early stages of rehabilitation after an acute Achilles tendon rupture.
- 2014
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In: 16th ESSKA (European Society of Sports Traumatology, Knee Surgery and Arthroscopy) Congress, 14-17 May 2014, Amsterdam, Netherlands.
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Conference paper (other academic/artistic)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.
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| 3. |
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| 4. |
- Lindqvist, Ann-Sophie, 1973, et al.
(author)
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Increased mortality rate and suicide in Swedish former elite male athletes in power sports.
- 2014
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In: Scandinavian journal of medicine & science in sports. - : Wiley. - 1600-0838 .- 0905-7188. ; 24:6, s. 1000-1005
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Journal article (peer-reviewed)abstract
- Physical training has been shown to reduce mortality in normal subjects, and athletes have a healthier lifestyle after their active career as compared with normal subjects. Since the 1950s, the use of anabolic androgenic steroids (AAS) has been frequent, especially in power sports. The aim of the present study was to investigate mortality, including causes of death, in former Swedish male elite athletes, active 1960-1979, in wrestling, powerlifting, Olympic lifting, and the throwing events in track and field when the suspicion of former AAS use was high. Results indicate that, during the age period of 20-50 years, there was an excess mortality of around 45%. However, when analyzing the total study period, the mortality was not increased. Mortality from suicide was increased 2-4 times among the former athletes during the period of 30-50 years of age compared with the general population of men. Mortality rate from malignancy was lower among the athletes. As the use of AAS was marked between 1960 and 1979 and was not doping-listed until 1975, it seems probable that the effect of AAS use might play a part in the observed increased mortality and suicide rate. The otherwise healthy lifestyle among the athletes might explain the low malignancy rates.
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| 5. |
- Nilsson-Helander, Katarina, 1957, et al.
(author)
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Individualiserad behandling viktig vid akut hälseneruptur. : Individualized treatment important in acute Achilles tendon ruptures
- 2014
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In: Läkartidningen. - 0023-7205. ; 111:34-35
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Research review (peer-reviewed)abstract
- An acute Achilles tendon rupture is a common sports-related injury in middle-aged men. The diagnosis is always clinical and it is very important that the diagnosis is not missed or delayed. The time period for tendon healing and rehabilitation is long and commonly results in functional deficits. Only half of the patients return to the preinjury lev-el of physical activity. There is no consensus in terms of the optimal treatment for patients with acute Achilles tendon rupture. Both surgical and non-surgical treatment with modern rehabilitation protocols are valid alternatives in the clinical day-by-day work. There is a need for future studies to optimize the treatment and identify predictors in order to individualize the optimal treatment.
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| 6. |
- Olsson, Niklas, et al.
(author)
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Ability to perform a single heel-rise is significantly related to patient-reported outcome after Achilles tendon rupture.
- 2014
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In: Scandinavian journal of medicine & science in sports. - : Wiley. - 1600-0838 .- 0905-7188. ; 24:1, s. 152-158
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Journal article (peer-reviewed)abstract
- This study evaluated the short-term recovery of function after an acute Achilles tendon rupture, measured by a single-legged heel-rise test, with main emphasis on the relation to the patient-reported outcomes and fear of physical activity and movement (kinesiophobia). Eighty-one patients treated surgically or non-surgically with early active rehabilitation after Achilles tendon rupture were included in the study. Patient's ability to perform a single-legged heel-rise, physical activity level, patient-reported symptoms, general health, and kinesiophobia was evaluated 12 weeks after the injury. The heel-rise test showed that 40 out of 81 (49%) patients were unable to perform a single heel-rise 12 weeks after the injury. We found that patients who were able to perform a heel-rise were significantly younger, more often of male gender, reported a lesser degree of symptoms, and also had a higher degree of physical activity at 12 weeks. There was also a significant negative correlation between kinesiophobia and all the patient-reported outcomes and the physical activity level. The heel-rise ability appears to be an important early achievement and reflects the general level of healing, which influences patient-reported outcome and physical activity. Future treatment protocols focusing on regaining strength early after the injury therefore seem to be of great importance. Kinesiophobia needs to be addressed early during the rehabilitation process.
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| 7. |
- Olsson, Niklas, et al.
(author)
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Predictors of Clinical Outcome After Acute Achilles Tendon Ruptures.
- 2014
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In: The American journal of sports medicine. - : SAGE Publications. - 1552-3365 .- 0363-5465. ; 42:6, s. 1448-1455
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Journal article (peer-reviewed)abstract
- BACKGROUND:In patients with an acute Achilles tendon rupture, it has not been possible to determine the superiority of a single specific treatment modality over other treatments with respect to symptoms and function. When several pertinent treatment protocols are available for an injury, it is of interest to understand how other variables, such as age, sex, or physical activity level, affect outcome to better individualize the treatment. PURPOSE:To investigate predictors of both symptomatic and functional outcomes after an acute Achilles tendon rupture. STUDY DESIGN:Cohort study (Prognosis); Level of evidence, 2. METHODS:Ninety-three patients (79 men and 14 women; mean age, 40 years) were evaluated prospectively at 3, 6, and 12 months. The main outcome measures in this study were the Achilles tendon Total Rupture Score (ATRS) for symptoms and maximum heel-rise height for function. The independent variables evaluated as possible predictors of outcome included treatment, sex, age, body mass index (BMI), physical activity level, symptoms, and quality of life. RESULTS:Treatment, age, BMI, physical activity level, heel-rise height at 6 months, and the ATRS at 3 months were eligible for further analysis. Only male sex was included for the prediction models. The 4 different multiple linear regression models (predicting the ATRS at 6 and 12 months and heel-rise height at 6 and 12 months) were significant (P < .001-.002), and the R(2) values for the models were 0.222 to 0.409. Surgical or nonsurgical treatment is a moderate predictor of symptoms and a weak predictor of heel-rise height after an acute Achilles tendon rupture. At the 6-month follow-up, surgical treatment was associated with a larger heel-rise height, but the opposite was seen at 12 months. Surgical treatment resulted in a lower degree of symptoms. Increasing age was a strong predictor of reduced heel-rise height, and an increase in age of 10 years reduced the expected heel-rise height by approximately 8%. A higher BMI was also a strong predictor of a greater degree of symptoms, and a 5-unit higher BMI predicted a reduction of approximately 10 points in the ATRS. CONCLUSION:The present study identified important possible predictors of outcome. Despite having a wide range of clinically relevant variables, the models had a limited ability to predict the final individual outcome. In general, the models appear to be better at predicting function than symptoms.
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| 8. |
- Palmblad, Eva, et al.
(author)
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Kropp och politik : Hälsoupplysning som samhällsspegel
- 2014. - 2
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Book (other academic/artistic)abstract
- Bockar, ribbstolar, plintar och blå gymnastikskor. Det är föremål som väcker ångestladdade minnen hos många svenskar. Skolgymnastik har sina rötter i det sena 1800-talet då man började intressera sig för hälsan hos befolkningen. Under hela 1900-talet har det intresset bara ökat. På 40-talet förde Arbetarrörelsen kampanj för folkhälsan, som var en viktig del i folkhemmet och det demokratiska projektet. Det moderna Sverige har byggts upp kring normer om rätt kost, rätt motion och de riktiga förhållningssätten till kropp och själ. Och det är myndigheterna som gett råd om hur det ska gå till.I dag är intresset för hälsa lika stort, men med fokus på individen. Det är individen som definierar sitt välbefinnande, inte staten.Boken Kropp och politik tar upp hur hälsoidealet har skiftat från andra världskriget och fram till idag. Detta är den andra reviderade upplagan. Boken kom första gången 1995.
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| 9. |
- Ramos, Telmo, et al.
(author)
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Ilizarov external fixation or locked intramedullary nailing in diaphyseal tibial fractures: a randomized, prospective study of 58 consecutive patients.
- 2014
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In: Archives of orthopaedic and trauma surgery. - : Springer Science and Business Media LLC. - 1434-3916 .- 0936-8051. ; 134:6, s. 793-802
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Journal article (peer-reviewed)abstract
- The aim of this study was to compare the Ilizarov circular fixator (IL) and locked intramedullary nailing (IM). Patients with isolated tibia shaft fractures were randomly allocated to either the IL (n = 31) or IM (n = 27) method. Conventional radiographs, postoperative pain assessment, self-appraisal scores and complications were evaluated. At the clinical 1-year follow-up, the patients were also evaluated by an independent observer. The minority of patients had open fractures, two and nine patients in the IM and IL groups, respectively. Eight patients in the IM group and four in the IL group sustained major complications (p = 0.107). In the IM group, two patients developed compartment syndrome, one deep infection, one hardware failure, one delayed union, one pseudarthrosis and two had a malunion. In the IL group, two patients developed pseudarthrosis and two had a malunion. Superficial pin-site infections were observed in 16 patients in the IL group. The fractures had healed radiographically at 12 weeks in both groups. At the 1-year follow-up, there were differences in pain (VAS) and satisfaction (VAS) scores in favor of IL treatment (VAS, p = 0.03 and p = 0.02, respectively). There were no differences between the groups with regard to range of motion (ROM) in the knee and ankle joints. The registration of local tenderness and pain revealed that there were 19 patients with anterior knee pain in the IM group and one in the IL group at the 1-year follow-up (p < 0.001). The IL is a safe and reliable alternative to IM for the treatment of tibial shaft fractures, with a low complication rate and good clinical outcome. Both treatments were well tolerated, but at the 1-year follow-up the patients in the IM group had more pain and were less satisfied. Finally, there was a high frequency of anterior knee pain in the IM group.
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| 10. |
- Dahlin, Johanna, et al.
(author)
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Bokbyggare : Carlsson Bokförlag under trettio år
- 2013. - 1
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Book (other academic/artistic)abstract
- Läsandets, författarnas och bokens kulturella betydelser är kontinuerligt föremål för diskussion. Betydligt mindre uppmärksamhet har ägnats den verksamhet som är förutsättningen för en god bokutgivning, bokförlagen. Kanske till och med att kunskapen om vad ett bokförlag, med sina förläggare, redaktörer och formgivare, egentligen gör inte är så spridd. I den här boken beskrivs ett svenskt bokförlag och dess verksamhet under en trettioårsperiod. Vi får inblickar i hur manuskript tas emot, vad det är som formar en inriktning på utgivningen, hur det vardagliga arbetet på förlaget ser ut, vad som väntar böckerna när de publiceras och hur ett bokförlag kan resonera kring sin roll som kulturellt projekt. Ett drygt tjugotal författare redovisar dessutom sina erfarenheter av bokförlag och vad dessa kan betyda för det egna författarskapet.
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