| 1. |
- Ageberg, Eva, et al.
(författare)
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Knee extension and flexion muscle power after anterior cruciate ligament reconstruction with patellar tendon graft or hamstring tendons graft: a cross-sectional comparison 3 years post surgery
- 2009
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Ingår i: Knee Surg Sports Traumatol Arthrosc. - : Springer Science and Business Media LLC. - 1433-7347 .- 0942-2056. ; 17:2, s. 162-9
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Tidskriftsartikel (refereegranskat)abstract
- Hamstring muscles play a major role in knee-joint stabilization after anterior cruciate ligament (ACL) injury. Weakness of the knee extensors after ACL reconstruction with patellar tendon (PT) graft, and in the knee flexors after reconstruction with hamstring tendons (HT) graft has been observed up to 2 years post surgery, but not later. In these studies, isokinetic muscle torque was used. However, muscle power has been suggested to be a more sensitive and sport-specific measures of strength. The aim was to study quadriceps and hamstring muscle power in patients with ACL injury treated with surgical reconstruction with PT or HT grafts at a mean of 3 years after surgery. Twenty subjects with PT and 16 subjects with HT grafts (mean age at follow up 30 years, range 20-39, 25% women), who were all included in a prospective study and followed the same goal-based rehabilitation protocol for at least 4 months, were assessed with reliable, valid, and responsive tests of quadriceps and hamstring muscle power at 3 years (SD 0.9, range 2-5) after surgery. The mean difference between legs (injured minus uninjured), the hamstring to quadriceps (H:Q, hamstring divided by quadriceps) ratio, and the limb symmetry index (LSI, injured leg divided by uninjured and multiplied by 100) value, were used for comparisons between the groups (analysis of variance). The mean difference between the injured and uninjured legs was greater in the HT than in the PT group for knee flexion power (-21.3 vs. 7.7 W, p = 0.001). Patients with HT graft had lower H:Q ratio in the injured leg than the patients with PT graft (0.63 vs. 0.77, p = 0.012). They also had lower LSI for knee flexion power than those in the PT group (88 vs. 106%, p < 0.001). No differences were found between the groups for knee extension power. The lower hamstring muscle power, and the lower hamstring to quadriceps ratio in the HT graft group than in the PT graft group 3 years (range 2-5) after ACL reconstruction, reflect imbalance of knee muscles after reconstruction with HT graft that may have a negative effect on dynamic knee-joint stabilization.
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| 2. |
- Ageberg, Eva, et al.
(författare)
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Normalized motor function but impaired sensory function after unilateral non-reconstructed ACL injury: patients compared with uninjured controls.
- 2008
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Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy. - : Springer Science and Business Media LLC. - 1433-7347 .- 0942-2056. ; 16, s. 449-456
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Tidskriftsartikel (refereegranskat)abstract
- Improvement in motor function after anterior cruciate ligament (ACL) injury is achieved by appropriate rehabilitation. However, it has been questioned whether training after injury can lead to sensory improvement. We hypothesized that motor function can be restored after unilateral non-reconstructed ACL injury, whereas the sensory function cannot, i.e., there would be no difference in functional performance or knee muscle strength between subjects with ACL injury and uninjured controls, but the subjects with ACL injury would have poorer kinesthesia than the uninjured controls. This is a Cross-Sectional Study, wherein 56 (20 women and 36 men) individuals with unilateral non-reconstructed ACL injury were assessed at a mean of 15 years (SD 1.4 years) after the initial injury. All patients initially underwent rehabilitation and were advised to modify their activity level, in order to cope with the ACL insufficiency. At 15 years, they had good subjective function and acceptable activity level. Twenty-eight (14 women and 14 men) uninjured subjects served as controls. Patients and controls were assessed with the one-leg hop test for distance, isometric and isokinetic knee muscle strength, and kinesthesia (the threshold to detection of passive motion). The individuals with ACL injury had the same or better functional performance, measured by the one-leg hop test for distance, and knee muscle strength compared with the uninjured controls. Kinesthesia was poorer in the patient group than in the control group. The results indicate that motor function can be restored but that the sensory function is persistently disturbed after ACL injury.
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| 3. |
- Ahldén, Mattias, et al.
(författare)
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Knee laxity measurements after anterior cruciate ligament reconstruction, using either bone-patellar-tendon-bone or hamstring tendon autografts, with special emphasis on comparison over time
- 2009
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Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy. - : Springer Science and Business Media LLC. - 1433-7347 .- 0942-2056. ; 17:9, s. 1117-24
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Tidskriftsartikel (refereegranskat)abstract
- The aims of the study were to analyse the change in knee laxity over time after anterior cruciate ligament (ACL) reconstruction, using either bone-patellar-tendon-bone (BPTB) or hamstring (HS) tendon autografts, and to compare the knee laxity measurements between the study groups both pre-operatively and on multiple follow-up occasions. Another aim was to compare the radiographic findings in terms of degenerative changes between the study groups. A randomised series of 71 patients, who underwent ACL reconstruction using BPTB or HS tendon autografts and interference screw fixation, were included in the study. Of these patients, 47/71 (66%) attended a clinical examination, including laxity measurements using the KT-1000 arthrometer, pre-operatively and on four post-operative occasions; 6 months, 1 year, 2 years and 7 years after the reconstruction. The BPTB group consisted of 22 patients, while there were 25 patients in the HS group. There were no significant differences in the mean side-to-side knee laxity between the BPTB and the HS group pre-operatively or at the follow-up examinations. There was a tendency towards a reduction in side-to-side knee laxity over time in both groups, measured with the KT-1000 arthrometer. The decrease was significant when analysing the injured and uninjured knee separately (injured side p < 0.001 (BPTB) and p = 0.005 (HS), uninjured side p = 0.008 and p = 0.042, respectively). Forty-four patients (BPTB 21, ST 23) underwent a radiographic assessment at the 7-year follow-up, which revealed no significant differences between the study groups in terms of osteoarthritic findings classified according to the Fairbank and Ahlback rating systems. In overall terms, osteoarthritis was identified in 16% (BPTB 19%; ST 13%; n.s.) according to the Ahlback rating system and 68% (BPTB 67%; ST 70%; n.s.) according to the Fairbank rating system. There were no significant differences in knee laxity measurements between the two study groups pre-operatively or at 7 years. A decrease in knee laxity over time was seen in both groups. There were no significant differences between the BPTB and ST groups in terms of osteoarthritic findings at 7 years.
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| 4. |
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| 5. |
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| 6. |
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| 7. |
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| 8. |
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| 9. |
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| 10. |
- Andersson, Gustav, 1983-, et al.
(författare)
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Nerve-related characteristics of ventral paratendinous tissue in chronic Achilles tendinosis
- 2007
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Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy. - : Springer Science and Business Media LLC. - 0942-2056 .- 1433-7347. ; 15:10, s. 1272-1279
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Tidskriftsartikel (refereegranskat)abstract
- Ultrasound and Doppler examination has shown high blood flow-neovascularisation inside and outside the ventral Achilles tendon in chronic painful tendinosis, but not in pain-free normal Achilles tendons. In patients with Achilles tendinosis, injections with the sclerosing substance polidocanol, targeting the areas with increased blood flow, have been demonstrated to give pain relief. A drawback when interpreting these findings is the fact that the pattern of nerve supply in the target area, i.e. the ventral area of the tendon, is so far unknown. In this study, therefore, tissue specimens from this area, obtained during surgical treatment of patients with chronic painful midportion Achilles tendinosis, were examined. In the examined area, containing loose connective tissue, the general finding was a presence of large and small arteries and nerve fascicles. The nerve fascicles were distinguished in sections processed for the pan-neural marker protein gene-product 9.5. The nerve fascicles contain sensory nerve fibers, as shown via staining for the sensory markers substance P (SP) and calcitonin gene-related peptide, and sympathetic nerve fibers as seen via processing for tyrosine hydroxylase. In addition, there were immunoreactions for the SP-preferred receptor, the neurokinin-1 receptor, in blood vessel walls and nerve fascicles. Some of the blood vessels were supplied by an extensive peri-vascular innervation, sympathetic nerve fibers being a distinct component of this innervation. There was also a marked occurrence of immunoreactions for the alpha1-adrenoreceptor in arterial walls as well as in the nerve fascicles. Altogether, these findings suggest that the area investigated is under marked influence by the nervous system, including sympathetic and sensory components. Thus, sympathetic/sensory influences may be involved in the pain mechanisms from this area. In conclusion, the nerve-related characteristics of the area targeted by the polidicanol injection treatment for Achilles tendinosis, are shown here for the first time.
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| 11. |
- Baranto, Adad, 1966, et al.
(författare)
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Back pain and degenerative abnormalities in the spine of young elite divers: a 5-year follow-up magnetic resonance imaging study
- 2006
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Ingår i: Knee Surg Sports Traumatol Arthrosc. - : Springer Science and Business Media LLC. - 0942-2056 .- 1433-7347. ; 14:9, s. 907-14
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Tidskriftsartikel (refereegranskat)abstract
- Several studies have been published on disc degeneration among young athletes in sports with great demands on the back, but few on competitive divers; however, there are no long-term follow-up studies. Twenty elite divers between 10 and 21 years of age, with the highest possible national ranking, were selected at random without knowledge of previous or present back injuries or symptoms for an MRI study of the thoraco-lumbar spine in a 5-year longitudinal study. The occurrence of MRI abnormalities and their correlation with back pain were evaluated. Eighty-nine percent of the divers had a history of back pain and the median age at the first episode of back pain was 15 years. Sixty-five percent of the divers had MRI abnormalities in the thoraco-lumbar spine already at baseline. Only one diver without abnormalities at baseline had developed abnormalities at follow-up. Deterioration of any type of abnormality was found in 9 of 17 (53%) divers. Including all disc levels in all divers, the total number of abnormalities increased by 29% at follow-up, as compared to baseline. The most common abnormalities were reduced disc signal, Schmorl's nodes, and disc height reduction. Since almost all divers had previous or present back pain, a differentiated analysis of the relationship between pain and MRI findings was not possible. However, the high frequency of both back pain and MRI changes suggests a causal relationship. In conclusion, elite divers had high frequency of back pain at young ages and they run a high risk of developing degenerative abnormalities of the thoraco-lumbar spine, probably due to injuries to the spine during the growth spurt.
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| 12. |
- Baranto, Adad, 1966, et al.
(författare)
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Back pain and MRI changes in the thoraco-lumbar spine of top athletes in four different sports: a 15-year follow-up study
- 2009
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Ingår i: Knee surgery, Sports traumatology, Arthroscopy. - : Springer Science and Business Media LLC. - 0942-2056 .- 1433-7347. ; 17:9, s. 1125-1134
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Tidskriftsartikel (refereegranskat)abstract
- A total 71 male athletes (weight lifters, wrestlers, orienteers, and ice-hockey players) and 21 non-athletes were randomly selected, for a baseline MRI study. After 15 years all the participants at baseline were invited to take part in a follow-up examination, including a questionnaire on back pain and a follow-up MRI examination. Thirty-two athletes and all non-athletes had disc height reduction at one or several disc levels. Disc degeneration was found in more than 90% of the athletes and deterioration had occurred in 88% of the athletes, with the highest frequency in weight lifters and ice-hockey players. 78% of the athletes and 38% of the non-athletes reported previous or present history of back pain at baseline and 71 and 75%, respectively at follow-up. There was no statistically significant correlation between back pain and MRI changes. In conclusion, athletes in sports with severe or moderate demands on the back run a high risk of developing disc degeneration and other abnormalities of the spine on MRI and they report high frequency of back pain. The study confirmed our hypothesis, i.e. that most of the spinal abnormalities in athletes seem to occur during the growth spurt, since the majority of the abnormalities demonstrated at follow-up MRI after the sports career were present already at baseline. The abnormalities found at young age deteriorated to a varying degree during the 15-year follow-up, probably due to a combination of continued high load sporting activities and normal ageing. Preventive measures should be considered to avoid the development of these injuries in young athletes.
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| 13. |
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| 14. |
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| 15. |
- Brax-Olofsson, Lisbeth, et al.
(författare)
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Periosteal transplantation to the rabbit patella.
- 2007
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Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy. - Berlin : Springer Internat.. - 0942-2056 .- 1433-7347. ; 15:5, s. 560-563
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Tidskriftsartikel (refereegranskat)abstract
- Autologous periosteal transplantation (without chondrocyte cell transplantation) for treating traumatic articular cartilage defects of the patella gives pain relief in uncontrolled clinical studies. To study the whole transplanted area macroscopically and microscopically, animal studies are motivated. In this pilot study, we reproduce the surgical technique for periosteum transplantation on human patella to a rabbit model. A full-thickness cartilage defect of the whole patella was created in eight adult female rabbits. The defect was treated with autologous periosteal transplantation. After surgery, the rabbits were allowed free activity. This is the difference compared to the treatment in humans, where our group uses CPM for 5 days and non-weight-bearing for 12 weeks. After 21 weeks, there was a diffuse synovitis in all transplanted knees, and in five of eight knees there were signs of osteoarthritis in the patello-femoral joint. Histologically, in three animals, small islands of hyaline cartilage surrounded by fibrocartilage were seen in the transplanted area. In the other five animals, fibrocartilage was the predominant tissue. In contrast to previous experimental studies using a rabbit model, we did not achieve hyaline cartilage resurfacing.
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| 16. |
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| 17. |
- Brue, S, et al.
(författare)
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Idiopathic adhesive capsulitis of the shoulder: a review
- 2007
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Ingår i: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. - : Springer Science and Business Media LLC. - 0942-2056. ; 15:8, s. 1048-1054
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Tidskriftsartikel (refereegranskat)
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| 18. |
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| 19. |
- Clementson, Martin, et al.
(författare)
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Sclerosing injections in midportion Achilles tendinopathy: a retrospective study of 25 patients.
- 2008
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Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy. - : Springer Science and Business Media LLC. - 1433-7347 .- 0942-2056. ; Jun 13, s. 887-890
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Tidskriftsartikel (refereegranskat)abstract
- Sclerosing injections under ultrasonographic guidance is a new method of treatment for persistent pain in Achilles tendinosis. Good results, even superior to those of surgery, have been described. We report the outcome of 25 patients with midportion tendinosis receiving sclerosing treatment. Twenty-eight consecutive patients (29 tendons) with ultrasonographical findings of midportion tendinosis examined during the period November 2004 to November 2005 were identified in the database of the Department of Radiology, Malmö University Hospital. Twenty-five patients (26 tendons) were found suitable for treatment. Follow-up consisted of self-assessment questionnaire or phone interview. In 19 patients (20 tendons), results were good or excellent. Complications were few and mild. We conclude that sclerosing injections is a promising alternative to surgery in chronic Achilles midportion tendinosis. Our results are comparable to those obtained with surgery, but the procedure is less invasive. However, a few cases of tendinosis lack detectable neovessels and may still be candidates for surgery.
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| 20. |
- Danielson, Patrik, et al.
(författare)
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Distribution of general (PGP 9.5) and sensory (substance P/CGRP) innervations in the human patellar tendon.
- 2006
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Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy. - : Springer Science and Business Media LLC. - 0942-2056 .- 1433-7347. ; 14:2, s. 125-132
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Tidskriftsartikel (refereegranskat)abstract
- There is no information on the pattern of blood vessel innervation, and in principle no information on innervation in general, in the human patellar tendon. In the present study, biopsies from the proximal part of normal and pain-free patellar tendons (11 men, mean age 33 years) were examined. The specimens were evaluated by using antibodies against the general nerve marker protein gene-product 9.5 (PGP 9.5) and the sensory neuropeptides substance P (SP) and calcitonin gene-related peptide (CGRP), and immunohistochemistry. It was observed that the arteries, and to some extent the small vessels, in the loose paratendinous connective tissue were supplied with PGP 9.5- as well as SP- and CGRP-innervations. There was a marked PGP 9.5-like immunoreaction (LI), and to some extent also SP- and CGRP-LI, in the large nerve fascicles in this tissue. In the tendon tissue proper, PGP 9.5-LI was detected in nerve fibers located in the vicinity of some of the blood vessels and in thin nerve fascicles. There was a low degree of SP- and CGRP-innervation in the tendon tissue proper. The observations give a morphologic correlate for the occurrence of nerve-mediated effects in the patellar tendon. Particularly it seems as if there is a marked nerve-mediated regulation of the blood vessels supplying the tendon, at the level where they course in the loose paratendinous connective tissue.
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| 21. |
- Danielson, Patrik, et al.
(författare)
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Marked sympathetic component in the perivascular innervation of the dorsal paratendinous tissue of the patellar tendon in arthroscopically treated tendinosis patients.
- 2008
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Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy. - : Springer Science and Business Media LLC. - 0942-2056 .- 1433-7347. ; 16:6, s. 621-6
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Tidskriftsartikel (refereegranskat)abstract
- During the recent years, a few studies have shed new light on the innervation patterns of the human patellar tendon, but the area of the loose paratendinous connective tissue dorsal to the proximal tendon proper has yet not been investigated. That is a drawback, since this is the area targeted in promising treatment regimens of chronic painful patellar tendinosis, namely sclerosing Polidocanol injection therapy, and a new surgical method conforming to ultrasound and color Doppler guided arthroscopic shaving, directed at neovessels found in the region. The present study thus aimed at investigating the paratendinous area dorsal to the proximal patellar tendon proper in seven patients being operated for tendinosis. Biopsies were collected through the new arthroscopic technique, approaching the tendon from the dorsal side. Samples were investigated using immunohistochemistry with antibodies delineating general (PGP 9.5), sensory (SP/CGRP), and sympathetic (TH/NPY) nerve patterns, and also antibodies against alpha1- and alpha2A-adrenoreceptors. Both small and large blood vessels had a marked perivascular innervation (PGP 9.5). Surprisingly, this perivascular innervation was found only to a very limited extent to correspond to sensory nerves, while there were marked immunoreactions for sympathetic markers. Adrenoreceptor immunoreactions frequently occurred in blood vessel walls. In conclusion, this study demonstrates, for the first time, the innervation patterns of the area dorsal to the patellar tendon in man. It shows that the area investigated is under marked influence by the sympathetic nervous system. Thus, sympathetic effects are likely to occur for blood vessels of the area, which is interesting since color Doppler has revealed that vessels of this area ("neovessels") display a pathologically high blood flow in tendinosis. The findings are discussed in relation to aspects of vascular regulation, and to pain symptoms of tendinosis.
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| 22. |
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| 23. |
- Engebretsen, L, et al.
(författare)
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Why knee ligament registries are important..
- 2009
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Ingår i: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. - : Springer Science and Business Media LLC. - 1433-7347. ; 17:2, s. 115-116
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 24. |
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| 25. |
- Forssblad, M
(författare)
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About ACL registries
- 2007
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Ingår i: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. - : Springer Science and Business Media LLC. - 0942-2056. ; 15:5, s. 686-686
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 26. |
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| 27. |
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| 28. |
- Frobell, Richard, et al.
(författare)
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Self-reported activity level and knee function in amateur football players: the influence of age, gender, history of knee injury and level of competition.
- 2008
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Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy. - : Springer Science and Business Media LLC. - 1433-7347 .- 0942-2056. ; 16, s. 713-719
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study is to investigate if self-reported activity level or knee functions are influenced by subject characteristics, level of competition and history of knee injury. Cross-Sectional study using questionnaires distributed at a personal visit. One hundred and eighty-eight (65 women) amateur football players in 10 football clubs from each division below national level participated in the study. Self-reported Tegner Activity Scale, and the Knee injury and Osteoarthritis Outcome Score (KOOS) are the main outcome measures. Older age, female gender and lower level of competition (football division) were independently associated with lower self-reported Tegner Activity Scale (P < 0.001). Subjects reporting history of knee injury had significantly worse KOOS scores (P < 0.001 for all subscales). In future studies, a clear description of how the Tegner Activity Scale was administered is recommended. We suggest that self-reported Tegner Activity Scale scores should be adjusted for age, gender and level of competition. In amateur football players, KOOS scores do not need adjustment for age and gender.
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| 29. |
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| 30. |
- Grävare Silbernagel, Karin, 1965, et al.
(författare)
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Evaluation of lower leg function in patients with Achilles tendinopathy
- 2006
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Ingår i: Knee Surg Sports Traumatol Arthrosc. - : Springer Science and Business Media LLC. - 0942-2056 .- 1433-7347. ; 14:11, s. 1207-17
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Tidskriftsartikel (refereegranskat)abstract
- Achilles tendinopathy is considered to be one of the most common overuse injuries in elite and recreational athletes. However, the effect that the Achilles tendinopathy has on patients' physical performance is still unclear. The purpose of this study was to evaluate if Achilles tendinopathy caused functional deficits on the injured side compared with the non-injured side in patients. A test battery comprised of tests for different aspects of muscle-tendon function of the gastrocnemius, soleus and Achilles tendon complex was developed to evaluate lower leg function. The test battery's test-retest reliability and sensitivity (the percent probability that the tests would demonstrate abnormal lower limb symmetry index in patients) were also evaluated. The test battery consisted of three jump tests, a counter movements jump (CMJ), a drop counter movement jump (drop CMJ) and hopping, and two strength tests, concentric toe-raises, eccentric-concentric toe-raises and toe-raises for endurance. The reliability was evaluated through a test-retest design on 15 healthy subjects. The test battery's sensitivity and possible functional deficits in patients with Achilles tendinopathy were evaluated on 42 patients (19 women and 23 men). An excellent reliability was found between test days 1-2 and 2-3 for all tests (ICC = 0.76-0.94) except for concentric toe-raise, test 2-3, which had fair reliability (ICC = 0.73). The methodological error ranged from 8 to 17%. There were significant differences (P = 0.001-0.049) between the non-injured (or least symptomatic) side and injured (most symptomatic) side for hopping, drop CMJ, concentric and eccentric-concentric toe-raises, and significant differences (P = 0.000-0.012) in the level of pain during CMJ, hopping, and drop CMJ. The sensitivity of the test battery at a 90% capacity was 88. Achilles tendinopathy causes not only pain and symptoms in patients but also apparent impairments in various aspects of lower leg muscle-tendon function as measured with the test battery. This test battery is reliable and able to detect differences in lower leg function between the injured or "most symptomatic" and non-injured or "least symptomatic" side in patients with Achilles tendinopathy. The test battery has higher demand on patients' function compared with each individual test.
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| 31. |
- Gustavsson, Alexander, et al.
(författare)
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A test battery for evaluating hop performance in patients with an ACL injury and patients who have undergone ACL reconstruction
- 2006
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Ingår i: Knee Surg Sports Traumatol Arthrosc. - : Springer Science and Business Media LLC. - 0942-2056 .- 1433-7347. ; 14:8, s. 778-88
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to develop a test battery of hop tests with high ability to discriminate (i.e. high test-retest reliability, sensitivity, specificity and accuracy) between the hop performance of the injured and the uninjured side in patients with an ACL injury and in patients who have undergone ACL reconstruction. Five hop tests were analysed: three maximum single hop tests and two hop tests while developing fatigue. Fifteen healthy subjects performed the five hop tests on three separate occasions in a test-retest design. Thirty patients, mean 11 months after an ACL injury and 35 patients, mean 6 months after ACL reconstruction were tested. ICC values ranged from 0.85 to 0.97 for the five hop tests, indicating that all the tests had high test-retest reliability. Sixty-seven percent to 100% of the healthy subjects had normal symmetry (i.e. <10% side-to-side difference) in the five hop tests. Abnormal symmetry in the five hop tests ranged from 43 to 77% for patients with an ACL injury and from 51 to 86% for patients who had undergone ACL reconstruction respectively. The three tests with the highest ability to discriminate hop performance were chosen for the test battery; they were the vertical jump, the hop for distance and the side hop. The test battery revealed a high level of sensitivity and accuracy in patients with an ACL injury (87 and 84%) and in patients who had undergone ACL reconstruction (91 and 88%), when at least one of the three tests was classified as abnormal. To summarise, the test battery consisting of both maximum single hop performances: the vertical jump and the hop for distance and hop performance while developing fatigue: the side hop, produced high test-retest reliability, sensitivity and accuracy. Further, the test battery produced higher values compared with any of the three hop tests individually revealing that only one out of ten patients had restored hop performance 11 months after an ACL injury and 6 months after ACL reconstruction. It is concluded that this test battery showed a high ability to discriminate between the hop performance of the injured and the uninjured side both in patients with an ACL injury and in patients who have undergone ACL reconstruction.
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| 32. |
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| 33. |
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| 34. |
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| 35. |
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| 36. |
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| 37. |
- Isberg, Jonas, 1965, et al.
(författare)
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Early active extension after anterior cruciate ligament reconstruction does not result in increased laxity of the knee
- 2006
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Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy. - : Springer Science and Business Media LLC. - 0942-2056 .- 1433-7347. ; 14:11, s. 1108-1115
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Tidskriftsartikel (refereegranskat)abstract
- If permission of full active and passive extension immediately after an anterior cruciate ligament (ACL) reconstruction will increase the post-operative laxity of the knee has been a subject of discussion. We investigated whether a post-operative rehabilitation protocol including active and passive extension without any restrictions in extension immediately after an ACL reconstruction would increase the post-operative anterior-posterior knee laxity (A-P laxity). Our hypothesis was that full active and passive extension immediately after an ACL reconstruction would have no effect on the A-P laxity and clinical results up to 2 years after the operation. Twenty-two consecutive patients (14 men, 8 women, median age 21 years, range 17-41) were included. All the patients had a unilateral ACL rupture and no other ligament injuries or any other history of previous knee injuries. The surgical procedure was identical in all patients and one experienced surgeon operated on all the patients, using the bone-patellar tendon-bone autograft. The post-operative rehabilitation programme was identical in both groups, except for extension training during the first 4 weeks post-operatively. The patients were randomly allocated to post-operative rehabilitation programmes either allowing (Group A, n=11) or not allowing [Group B (30 to -10 degrees ), n=11] full active and passive extension immediately after the operation. They were evaluated pre-operatively and at 6 months and 2 years after the reconstruction. To evaluate the A-P knee laxity, radiostereometric analysis (RSA) and KT-1000 arthrometer (KT-1000) measurements were used, range of motion, Lysholm score, Tegner activity level, the International Knee Documentation Committee (IKDC) evaluation system and one-leg-hop test quotient were used. Pre-operatively, the RSA measurements revealed side-to-side differences in Group A of 8.6 mm (2.3-15.4), median (range) and in Group B of 7.2 mm (2.2-17.4) (n.s.). The corresponding KT-1000 values were for Group A, 2.0 mm (0-8.0) and Group B, 4.0 mm (0-10.0) (n.s.). At 2 years, the differences between the two groups were minimal, regardless of the method that had been used. The RSA measurements in Group A were 2.7 mm (0-10.7) and in Group B 2.8 (-1.8 to 9.5). The KT-1000 values were for Group A, 1.0 mm (-1.5 to 3.5), and for Group B, 0.5 mm (-1.0 to 4.0), without any significant differences between the groups. Nor did the Lysholm score, Tegner activity level, IKDC or one-leg-hop test differ. Early active and passive extension training, without any restrictions in extension, immediately after an ACL reconstruction using bone-patellar tendon-bone graft did not increase post-operative knee laxity up to 2 years after the ACL reconstruction.
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| 38. |
- Isberg, Jonas, 1965, et al.
(författare)
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KT-1000 records smaller side-to-side differences than radiostereometric analysis before and after an ACL reconstruction
- 2006
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Ingår i: Knee Surg Sports Traumatol Arthrosc. - : Springer Science and Business Media LLC. - 0942-2056 .- 1433-7347. ; 14:6, s. 529-535
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Tidskriftsartikel (refereegranskat)abstract
- The KT-1000 and similar non-invasive arthrometers are used as a complement to clinical examination in the diagnosis of anterior cruciate ligament (ACL) rupture and during the follow-up after surgery. We compared the two methods, KT-1000 and Radiostereometric analysis (RSA), when used to measure anterior-posterior knee laxity (A-P laxity) in patients with ACL rupture, before and after the reconstruction of this ligament, in a prospective, comparative study. Twenty-two consecutive patients (14 men, 8 women) with a median age of 24 years (range 16-41) were studied. All the patients had a unilateral ACL rupture and an intact contralateral knee. The patients were operated on by one experienced surgeon using the bone-patellar tendon-bone (BTB) autograft. Preoperatively and 2 years after the reconstruction, all the patients were evaluated using KT-1000 and RSA measurements of A-P laxity. The side-to-side differences between the injured and the intact knees, that is, total A-P laxity for both knees, are presented. Preoperatively, the median side-to-side differences using the two methods (KT-1000/RSA) were 4.0 (0-10)/7.4 mm (2.2-17.4) (P<0.0001). The total A-P laxity on the injured side was 11.0 (6.0-18.0)/10.9 mm (6.2-19.6) (n.s), while it was 8.0 (6.0-10.0)/3.1 mm (0.2-8.6) on the intact side (P<0.0001). A side-to-side difference of more than 3.0 mm was defined as the cut-off value for indicating ACL rupture. Using the KT-1000, 11 of 22 (50%) patients had a cut-off value above 3.0 mm, while the corresponding figure for RSA was 21/22 (95%) patients. At the 2-year follow-up, the median side-to-side differences using the two methods (KT-1000/RSA) were 0.5 (-1.5 to 4.0)/2.8 mm (-1.8 to 10.7) (P<0.0001). The total A-P laxity on the operated side was 9.5 (7.5-14.0)/6.5 mm (2.4-14.1) (P<0.0001). We conclude that the KT-1000 recorded significantly smaller side-to-side differences than did the RSA, both before and after the reconstruction of the ACL using a BTB autograft. Before it was mainly an effect of larger A-P laxity recordings with KT-1000 on the intact side, and after the reconstruction, the KT-1000 still recorded larger A-P laxity on the intact side and also larger A-P laxity on the reconstructed side than RSA.
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| 42. |
- Karlsson, Jón, 1953, et al.
(författare)
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Back to the future: thank you for 2009
- 2009
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Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy. - : Springer Science and Business Media LLC. - 0942-2056 .- 1433-7347. ; 17:12, s. 1401-1403
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 45. |
- Kvist, Joanna, 1967-, et al.
(författare)
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Fear of re-injury : A hindrance for returning to sports after anterior cruciate ligament reconstruction
- 2005
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Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy. - : Springer Science and Business Media LLC. - 0942-2056 .- 1433-7347. ; 13:5, s. 393-397
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Tidskriftsartikel (refereegranskat)abstract
- Unrestricted participation in sports activities and return to the pre-injury level is often reported as an indicator of the success of ACL reconstruction. The athletes' choice not to return to their pre-injury level may depend on the knee function, but some times, social reasons or psychological hindrances such as fear of re-injury may influence their return to sports. The aim of this study was to investigate whether fear of re-injury due to movement is of significance for returning to previous level of activity in patients who have undergone anterior cruciate ligament reconstruction. The Tampa Scale of Kinesiophobia (TSK), the Knee Injury and Osteoarthritis Outcome Score (KOOS) and some general questions were mailed to 87 patients who underwent ACL reconstruction 3-4 years before the study was conducted. Sixty-two patients (74%) answered the questionnaires (34 men and 28 women). Fifty-three percent of the patients returned to their pre-injury activity level. The patients who did not return to their pre-injury activity level had more fear of re-injury, which was reflected in the TSK. In addition, high fear of re-injury was correlated with low knee-related quality of life. Fear of re-injury must be considered in the rehabilitation and evaluation of the effects of an ACL reconstruction. © Springer-Verlag 2005.
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| 46. |
- Laxdal, Gauti, 1966, et al.
(författare)
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A prospective comparison of bone-patellar tendon-bone and hamstring tendon grafts for anterior cruciate ligament reconstruction in male patients
- 2007
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Ingår i: Knee Surg Sports Traumatol Arthrosc. - : Springer Science and Business Media LLC. - 0942-2056 .- 1433-7347. ; 15:2, s. 115-25
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to compare the results after arthroscopic anterior cruciate ligament (ACL) reconstruction using central-third, bone-patellar tendon-bone (BPTB Group) (n = 45) and four-strand semitendinosus/gracilis (ST/G Group) (n = 78) autografts in male patients. The type of study is non-randomised, prospective consecutive series. A consecutive series of 126 male patients, all with unilateral ACL ruptures, was included in the study. In both groups, interference screw fixation of the graft was used at both ends and 123/126 (97%) of the patients returned for the follow-up examination after a period of 25 (23-33) months. The pre-operative assessments in both groups were similar in terms of the Tegner activity level, the Lysholm knee scoring scale, KT-1000 measurements, one-leg-hop test and knee-walking test. A significant reduction in knee laxity as measured with the KT-1000 arthrometer, compared with the pre-operative assessments, was found in both groups (P < 0.001). No significant differences in the post-operative knee-laxity measurements were found between the groups. Both groups had a significantly improved functional outcome at follow-up in terms of the Lysholm knee scoring scale, Tegner activity level and one-leg-hop test. The BPTB Group had a significantly higher Tegner activity level at follow-up, compared with the ST/G Group (P = 0.02). Moreover, the patients in the BPTB Group were significantly more likely to have a Tegner activity level of 6 or above (P = 0.03). Otherwise, no significant differences were found between the two study groups at the 2-year follow-up. Two years after an ACL reconstruction, the two groups displayed no significant differences in terms of functional outcome and knee laxity. However, more patients in the BPTB Group returned to a higher Tegner activity level than that in the ST/G Group.
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| 47. |
- Lidén, Mattias, 1973, et al.
(författare)
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The course of the patellar tendon after reharvesting its central third for ACL revision surgery: a long-term clinical and radiographic study
- 2006
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Ingår i: Knee Surg Sports Traumatol Arthrosc. - 0942-2056. ; 14:11, s. 1130-8
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Tidskriftsartikel (refereegranskat)abstract
- The choice of the optimal graft for anterior cruciate ligament (ACL) revision surgery is still controversial. Reharvesting the patellar tendon has been suggested as one graft alternative. Our hypothesis was that in the long-term, ACL revision surgery using reharvested patellar tendon autografts would render a good clinical outcome and a normal patellar tendon at the donor site as seen on magnetic resonance imaging (MRI). Fourteen consecutive patients (five women, nine men), who underwent ACL revision surgery using reharvested ipsilateral patellar tendon grafts, were included in the study. They underwent bilateral MRI evaluations of the patellar tendon and were tested for clinical outcome 26 (20-35) and 115 months (102-127) after the revision procedure. On the second occasion, they also underwent standard weight-bearing X-ray examinations.The serial MRI evaluations revealed that the thickness of the patellar tendon at the donor site was significantly increased compared with the non-harvested, normal contralateral side and that the donor-site gap was still visible after 10 years. No significant differences were seen between the 2- and 10-year MRI evaluations. Standard weight-bearing X-ray examinations revealed signs of mild degenerative changes in all patients. Clinical results in terms of the Lysholm score, IKDC evaluation system, one-leg-hop test, KT-1000 laxity test and the knee-walking test revealed no significant differences between the 2- and 10-year assessments. In overall terms, the clinical results were considered to be poor on both occasions. The patellar tendon at the donor site had not normalised 10 years after the reharvesting procedure, as seen on MRI. Furthermore, the clinical results were poor after ACL revision surgery using reharvested patellar tendon autograft.
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| 48. |
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| 49. |
- Magnusson, Lennart, 1959, et al.
(författare)
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Absorbable implants for open shoulder stabilization. A 7-8-year clinical and radiographic follow-up
- 2006
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Ingår i: Knee Surg Sports Traumatol Arthrosc. - 0942-2056. ; 14:2, s. 182-8
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Tidskriftsartikel (refereegranskat)abstract
- Eighteen consecutive patients who had recurrent, unidirectional, post-traumatic shoulder instability were included. All these patients underwent surgery using an open Bankart technique involving absorbable suture anchors. The median age at the index operation was 27 (16-50) years. One subluxation and two re-dislocations occurred during the follow-up period of 90 (80-95) months. At the 90-month control, the Rowe and Constant scores were 94 (63-100) points and 88.5 (65-100) points, respectively. The strength measurements on the index side in 90 degrees abduction revealed 8.1 (3.7-17.2) kg compared with 7.6 (2.7-17.6) kg on the contra lateral side (n.s.). The external rotation in abduction was 80 (60-95) degrees compared with 100 (70-120) degrees for the contra lateral side (p = 0.0015). Signs of minor or moderate degeneration were found in five of 18 patients (28%) on the preoperative radiographs. There was a significant continuous increase in degenerative changes during the follow-up period as seen on the seven, 33 and 90-month radiographs (p = 0.01, 0.03 and 0.01, respectively). On the 90-month radiographs, 12 of 18 patients (67%) had minor, moderate or severe degenerative changes (p = 0.0004 preoperative vs. 90 months). On the 7-month radiographs, two of 18 patients (11%) had invisible or hardly visible drill holes in conjunction with the absorbable implants. On the 90-month radiographs, 12 of 18 patients (67%) had invisible or hardly visible drill holes (p = 0.003 7 months vs. 90 months). In the long term, the method resulted in stable, well-functioning shoulders in 15 of 18 patients (83%). The stabilisation was not, however, able to prevent further increases in radiographic degenerative changes during the 7-8-year follow-up. The drill holes used for the absorbable suture anchors appeared to heal in the majority of patients during the follow-up period.
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| 50. |
- Magnusson, Lennart, 1959, et al.
(författare)
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The value of ultrasonography in the preoperative diagnostic evaluation of patients with recurrent anterior shoulder dislocation: a prospective study of 44 patients.
- 2007
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Ingår i: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. - : Springer Science and Business Media LLC. - 0942-2056. ; 15:5, s. 649-53
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to investigate the value of ultrasonography in the pre-operative assessment of patients with recurrent post-traumatic, anterior shoulder instability. Forty-four consecutive patients, 44 men and 12 women, with unilateral, post-traumatic, recurrent instability of the shoulder were included in the study. One experienced radiologist examined all patients, using a 5.0 or 7.5 MHz linear-array transducer, with the arm in different positions, one of which was used to provoke apprehension of the shoulder. Special attention was paid to the evaluation of the joint capsule, the anterior labrum, especially in terms of the presence of a Bankart lesion. All patients were subsequently treated surgically. After a diagnostic arthroscopy either an open or arthroscopic stabilisation of the shoulder was performed. Ultrasonography disclosed an unstable anterior labrum (equivalent to a Bankart lesion) in 36 shoulders; the lesion was verified in all 36 shoulders during arthroscopy. In three shoulders, arthroscopy disclosed an injured labrum, which had healed in an anterio-medial position on the scapular neck. In these three shoulders, ultrasonography failed to show any lesion. In five shoulders no Bankart lesion was found at arthroscopy. All these patients had increased shoulder laxity, and ultrasonography did not show any Bankart lesion. Furthermore a judgement of the joint capsule was not possible either. A bony Bankart lesion was found in four shoulders, using both arthroscopy and ultrasonography. The sensitivity of the ultrasonographic evaluation was 92%, and the specificity 100%. The positive predictive value was 100%, and the negative predictive value 63%. Ultrasonography showed a high correlation with the arthroscopic findings, with a high sensitivity and specificity. Therefore, we conclude that US can give important pre-operative information in patients with recurrent, unilateral, post-traumatic, anterior shoulder instability.
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