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A comparison of the clinical outcome after anterior cruciate ligament reconstruction using a hamstring tendon autograft with special emphasis on the timing of the reconstruction.

https://arctichealth.org/en/permalink/ahliterature139416
Source
Knee Surg Sports Traumatol Arthrosc. 2011 Mar;19(3):488-94
Publication Type
Article
Date
Mar-2011
Author
Martina Ahlén
Mattias Lidén
Author Affiliation
Department of Orthopaedics, NU-Hospital Organisation, 461 85, Trollhättan, Uddevalla, Sweden. martina.ahlen@vgregion.se
Source
Knee Surg Sports Traumatol Arthrosc. 2011 Mar;19(3):488-94
Date
Mar-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Anterior Cruciate Ligament - injuries - surgery
Chi-Square Distribution
Cohort Studies
Female
Follow-Up Studies
Graft Rejection
Graft Survival
Humans
Knee Injuries - surgery
Male
Muscle, Skeletal - surgery - transplantation
Pain Measurement
Range of Motion, Articular - physiology
Reconstructive Surgical Procedures - adverse effects - methods
Recovery of Function
Risk assessment
Statistics, nonparametric
Sweden
Tendons - transplantation
Time Factors
Transplantation, Autologous
Treatment Outcome
Waiting Lists
Young Adult
Abstract
The aim of the study was to compare the results 2?years after anterior cruciate ligament (ACL) reconstruction using a hamstring tendon (HT) autograft in patients operated within 5?months after the injury (Group A) and patients operated more than 24?months after the injury (Group B).
Sixty-one patients (27 women, 34 men), with a unilateral ACL rupture, underwent reconstructive surgery using semitendinosus (ST) or semitendinosus and gracilis (ST/G) autografts. Thirty patients (Group A) were operated on within 5?months median 3 (2-5) after the injury, and 31 patients (Group B) were operated on more than 24?months median 30 (24-48) after the injury. The follow-up examination was performed after a median of 25?months (18-43) after the reconstruction.
A significantly higher Lysholm score was registered in Group A 90 (58-100) than in Group B 81 (38-100), P?=?0.01, as well as a higher Tegner activity level 6 (2-9) versus 5 (0-9), P?=?0.01. The clinical assessments revealed no significant differences between the groups in terms of the one-leg-hop test, KT-1000 arthrometer laxity measurements, manual Lachman test and range of motion (ROM). Furthermore, there was no significant difference between the groups in terms of meniscal and cartilage damage at the index operation.
At 2?years post-operatively, patients who underwent subacute reconstruction had a significantly better outcome in terms of the Lysholm score and Tegner activity level than patients who underwent delayed reconstruction. The clinical relevance of the present study is that if the patient wishes to continue doing sports on a higher level, subacute reconstruction appears beneficial.
PubMed ID
21063680 View in PubMed
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Dacron ligament reconstruction for chronic anterior cruciate ligament insufficiency.

https://arctichealth.org/en/permalink/ahliterature221150
Source
Am J Sports Med. 1993 May-Jun;21(3):374-9; discussion 379-80
Publication Type
Article
Author
R M Wilk
J C Richmond
Author Affiliation
Department of Orthopaedic Surgery, Lahey Clinic Medical Center, Burlington, Massachusetts.
Source
Am J Sports Med. 1993 May-Jun;21(3):374-9; discussion 379-80
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Anterior Cruciate Ligament - surgery
Female
Follow-Up Studies
Humans
Knee Injuries - surgery
Male
Polyethylene Terephthalates
Prospective Studies
Prostheses and Implants
Prosthesis Failure
Sweden
United States
Abstract
We report the 5-year follow-up results of a prospective, multicenter study evaluating the use of a Dacron prosthetic ligament in reconstruction of anterior cruciate-deficient knees. The study group consisted of 84 patients, followed for at least 5 years. The patients were divided into 2 groups: 50 patients with isolated anterior cruciate ligament laxity (Group 1) and 34 patients with a failed previous anterior cruciate ligament surgery or combined laxities (Group 2). Two surgical techniques were employed: reconstruction through drill holes in the tibia and femur (30 patients) and reconstruction using the over-the-top position with the Dacron ligament wrapped in a strip of iliotibial band (54 patients). The overall failure rate was 35.7% at 5 years. The failure rate at 2 years was 20%, illustrating a significant deterioration of results between the two follow-up intervals. Evaluation of subjective criteria using the Lysholm score showed an improvement from preoperative status at the 2-year followup; however, there was a slight decline when 5-year results were evaluated. Tegner activity levels increased from a mean of 2.9 +/- 2.1 at the preoperative visit, to a mean of 4.9 +/- 2.0 at the 2-year followup and a mean of 5.0 +/- 2.0 at the 5-year visit. These results show that the Dacron ligament prosthesis achieves the short-term goal of restoring stability and improving function and may be sufficient to provide long-term stability for the anterior cruciate-deficient knee.
PubMed ID
8346750 View in PubMed
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Equivalent Knee Injury and Osteoarthritis Outcome Scores 12 and 24 Months After Anterior Cruciate Ligament Reconstruction: Results From the Swedish National Knee Ligament Register.

https://arctichealth.org/en/permalink/ahliterature290380
Source
Am J Sports Med. 2017 Jul; 45(9):2085-2091
Publication Type
Journal Article
Date
Jul-2017
Author
Kristian Samuelsson
Robert A Magnussen
Eduard Alentorn-Geli
Ferid Krupic
Kurt P Spindler
Christer Johansson
Magnus Forssblad
Jón Karlsson
Author Affiliation
Department of Orthopaedics, Sahlgrenska University Hospital, Mölndal, Sweden.
Source
Am J Sports Med. 2017 Jul; 45(9):2085-2091
Date
Jul-2017
Language
English
Publication Type
Journal Article
Keywords
Activities of Daily Living
Adolescent
Adult
Anterior Cruciate Ligament - surgery
Anterior Cruciate Ligament Injuries - surgery
Anterior Cruciate Ligament Reconstruction - methods
Cohort Studies
Female
Follow-Up Studies
Humans
Knee Injuries - surgery
Knee Joint - surgery
Male
Middle Aged
Osteoarthritis, Knee - surgery
Quality of Life
Sweden
Treatment Outcome
Young Adult
Abstract
It is not clear whether Knee injury and Osteoarthritis Outcome Score (KOOS) results will be different 1 or 2 years after anterior cruciate ligament (ACL) reconstruction.
To investigate within individual patients enrolled in the Swedish National Knee Ligament Register whether there is equivalence between KOOS at 1 and 2 years after primary ACL reconstruction.
Cohort study; Level of evidence, 2.
This cohort study was based on data from the Swedish National Knee Ligament Register during the period January 1, 2005, through December 31, 2013. The longitudinal KOOS values for each individual at the 1- and 2-year follow-up evaluations were assessed through the two one-sided test (TOST) procedure with an acceptance criterion of 4. Subset analysis was performed with patients classified by sex, age, graft type, and type of injury (meniscal and/or cartilage injury).
A total of 23,952 patients were eligible for analysis after exclusion criteria were applied (10,116 women, 42.2%; 13,836 men, 57.8%). The largest age group was between 16 and 20 years of age (n = 6599; 27.6%). The most common ACL graft was hamstring tendon (n = 22,504; 94.0%), of which the combination of semitendinosus and gracilis was the most common. A total of 7119 patients reported on the KOOS Pain domain at both 1- and 2-year follow-ups, with a mean difference of 0.21 (13.1 SD, 0.16 SE [90% CI, -0.05 to 0.46], P
PubMed ID
28714793 View in PubMed
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Health-related quality of life after anterior cruciate ligament reconstruction.

https://arctichealth.org/en/permalink/ahliterature139285
Source
Knee Surg Sports Traumatol Arthrosc. 2011 Mar;19(3):479-87
Publication Type
Article
Date
Mar-2011
Author
Olle Månsson
Jüri Kartus
Ninni Sernert
Author Affiliation
Department of Orthopaedics, NU-Hospital Organisation, Uddevalla, Sweden.
Source
Knee Surg Sports Traumatol Arthrosc. 2011 Mar;19(3):479-87
Date
Mar-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Anterior Cruciate Ligament - injuries - surgery
Bone-Patellar Tendon-Bone Grafting - methods
Case-Control Studies
Chi-Square Distribution
Female
Follow-Up Studies
Humans
Knee Injuries - surgery
Male
Middle Aged
Pain Measurement
Patient satisfaction
Quality of Life
Questionnaires
Reconstructive Surgical Procedures - adverse effects - methods
Recovery of Function
Reference Values
Risk assessment
Sex Factors
Statistics, nonparametric
Sweden
Tendons - transplantation
Time Factors
Treatment Outcome
Young Adult
Abstract
Recently the patients' own evaluation has become an important complement to post-operative clinical assessments. For many patients, there is a change in life situation after an anterior cruciate ligament reconstruction (ACL), which may affect the health-related quality of life in many ways. The aims of the study were to evaluate the results in terms of health-related quality of life 2-7 years after an ACL reconstruction and to compare the results with a gender- and age-matched control group. Furthermore, to compare the results for males and females using either the bone-patellar tendon-bone autograft (BPTB) or hamstring tendon autograft (HT).
The SF-36 questionnaire was send by mail to 793 consecutive patients after an ACL reconstruction. Five hundred and forty-four (69%) patients returned the questionnaires leaving 419 patients (161 female, 258 male) who were analysed and matched to a Swedish control group (n = 2,410).
The patient group obtained significantly higher scores for General Health (GH), Social Function (SF), Role Emotional (RE) and Mental Health (MH). The control group obtained significantly higher scores for Physical Function (PF) compared with the total ACL group and with the BPTB and HS subgroups. There were no significant differences between males and females.
After ACL reconstruction, the patients reported good health-related quality of life in comparison with a matched sample of the general population. To incorporate non-disease-specific health assessment measures are important to further refine the disease-specific outcome measurements to evaluate the effect of the treatments and provide cost-effective treatment algorithms.
PubMed ID
21079918 View in PubMed
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The importance of sports medicine for the Olympic Games and the value of ESSKA.

https://arctichealth.org/en/permalink/ahliterature143974
Source
Knee Surg Sports Traumatol Arthrosc. 2010 Jun;18(6):707-9
Publication Type
Article
Date
Jun-2010
Author
Lars Engebretsen
Source
Knee Surg Sports Traumatol Arthrosc. 2010 Jun;18(6):707-9
Date
Jun-2010
Language
English
Publication Type
Article
Keywords
Athletic Injuries - surgery
Canada
Europe
Humans
International Cooperation
Knee Injuries - surgery
Reference Books, Medical
Societies, Medical
PubMed ID
20422400 View in PubMed
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Knee arthroscopy in local versus general anaesthesia. The incidence of rearthroscopy.

https://arctichealth.org/en/permalink/ahliterature14142
Source
Knee Surg Sports Traumatol Arthrosc. 1999;7(5):323-6
Publication Type
Article
Date
1999
Author
M. Forssblad
L. Weidenhielm
Author Affiliation
Artro Clinic, St. Görans Hospital, S-11281 Stockholm, Sweden.
Source
Knee Surg Sports Traumatol Arthrosc. 1999;7(5):323-6
Date
1999
Language
English
Publication Type
Article
Keywords
Adult
Anesthesia, General - statistics & numerical data
Anesthesia, Local - contraindications - statistics & numerical data
Arthroscopy - statistics & numerical data
Comparative Study
Female
Follow-Up Studies
Humans
Incidence
Intraoperative Complications
Knee Injuries - surgery
Knee Joint - surgery
Ligaments, Articular - injuries - surgery
Male
Menisci, Tibial - injuries - surgery
Osteoarthritis, Knee - surgery
Osteochondritis Dissecans - surgery
Pain - etiology
Retreatment
Retrospective Studies
Sweden
Time Factors
Abstract
The choice of anaesthesia in routine knee arthroscopy varies considerably. Concerns about local anaesthesia include the fear that it will take longer to perform surgery and that the anaesthesia will be inadequate, leading to patient discomfort. In this study, data from all patients (n = 6519) who had undergone a knee arthroscopy at St Göran Hospital Artro Clinic, in Stockholm, Sweden, during a 3.5 year period, between January 1993 and July 1996, were reviewed. Of these 6519 primary arthroscopies, 4101 were performed under local anaesthesia and 2418 under general anaesthesia. The purpose of the study was first to identify those arthroscopies that could not be successfully performed because the local anaesthesia was inadequate, and second, to investigate if arthroscopy under local anesthesia was associated with an increased number of rearthroscopies compared to general anaesthesia. The total number of rearthroscopies, performed within 180 days from the primary arthroscopy, was 214. Of these 214 rearthroscopies, 146 were due to a new indication for surgery and 30 were due to persisting clinical symptoms (true rearthroscopies). The remaining 38 rearthroscopies were due to an incomplete examination (because of patient discomfort) in a primary procedure where local anaesthesia was used. Of the 30 true rearthroscopies, 19 originated from the 4101 primary arthroscopies performed under local anaesthesia (0.46%) and 11 originated from the 2418 primary arthroscopies performed under general anaesthesia (0.45%). It is concluded that 0.9% of the primary arthroscopies performed under local anaesthesia could not be performed safely due to patient discomfort. There was no difference in the frequency of rearthroscopy between the arthroscopies performed under local anaesthesia compared to those performed under general anaesthesia.
PubMed ID
10525703 View in PubMed
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Knee function and prevalence of knee osteoarthritis after anterior cruciate ligament reconstruction: a prospective study with 10 to 15 years of follow-up.

https://arctichealth.org/en/permalink/ahliterature141515
Source
Am J Sports Med. 2010 Nov;38(11):2201-10
Publication Type
Article
Date
Nov-2010
Author
Britt Elin Oiestad
Inger Holm
Arne Kristian Aune
Ragnhild Gunderson
Grethe Myklebust
Lars Engebretsen
Merete Aarsland Fosdahl
May Arna Risberg
Author Affiliation
Britt Elin Øiestad,Hjelp24 NIMI, Pb 3843, Ullevaal Station, Oslo 0805, Norway. oiestad@hotmail.com
Source
Am J Sports Med. 2010 Nov;38(11):2201-10
Date
Nov-2010
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Adolescent
Adult
Analysis of Variance
Anterior Cruciate Ligament - injuries - radiography
Female
Health status
Health Status Indicators
Humans
Knee - radiography
Knee Injuries - surgery
Male
Middle Aged
Norway - epidemiology
Osteoarthritis, Knee - epidemiology - radiography
Pain Measurement
Prevalence
Prospective Studies
Reconstructive Surgical Procedures
Time Factors
Treatment Outcome
Young Adult
Abstract
Few prospective long-term studies of more than 10 years have reported changes in knee function and radiologic outcomes after anterior cruciate ligament (ACL) reconstruction.
To examine changes in knee function from 6 months to 10 to 15 years after ACL reconstruction and to compare knee function outcomes over time for subjects with isolated ACL injury with those with combined ACL and meniscal injury and/or chondral lesion. Furthermore, the aim was to compare the prevalence of radiographic and symptomatic radiographic knee osteoarthritis between subjects with isolated ACL injuries and those with combined ACL and meniscal and/or chondral lesions 10 to 15 years after ACL reconstruction.
Cohort study; Level of evidence, 2.
Follow-up evaluations were performed on 221 subjects at 6 months, 1 year, 2 years, and 10 to 15 years after ACL reconstruction with bone-patellar tendon-bone autograft. Outcome measurements were KT-1000 arthrometer, Lachman and pivot shift tests, Cincinnati knee score, isokinetic muscle strength tests, hop tests, visual analog scale for pain, Tegner activity scale, and the Kellgren and Lawrence classification.
One hundred eighty-one subjects (82%) were evaluated at the 10- to 15-year follow-up. A significant improvement over time was revealed for all prospective outcomes of knee function. No significant differences in knee function over time were detected between the isolated and combined injury groups. Subjects with combined injury had significantly higher prevalence of radiographic knee osteoarthritis compared with those with isolated injury (80% and 62%, P = .008), but no significant group differences were shown for symptomatic radiographic knee osteoarthritis (46% and 32%, P = .053).
An overall improvement in knee function outcomes was detected from 6 months to 10 to 15 years after ACL reconstruction for both those with isolated and combined ACL injury, but significantly higher prevalence of radiographic knee osteoarthritis was found for those with combined injuries.
Notes
Comment In: Am J Sports Med. 2011 Apr;39(4):NP3; author reply NP3-421460071
PubMed ID
20713644 View in PubMed
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Knee immobilization in the immediate post-operative period following ACL reconstruction: a survey of practice patterns of Canadian orthopedic surgeons.

https://arctichealth.org/en/permalink/ahliterature168785
Source
Clin J Sport Med. 2006 May;16(3):199-202
Publication Type
Article
Date
May-2006
Author
Laurie A Hiemstra
Kim Veale
Treny Sasyniuk
Author Affiliation
Mineral Springs Hospital, Banff, AB, Canada. hiemstra@banffsport-med.ca
Source
Clin J Sport Med. 2006 May;16(3):199-202
Date
May-2006
Language
English
Publication Type
Article
Keywords
Anterior Cruciate Ligament - injuries - surgery
Canada
Cross-Sectional Studies
Health Care Surveys
Health Knowledge, Attitudes, Practice
Humans
Immobilization - methods - utilization
Knee Injuries - surgery
Orthopedic Procedures - methods
Orthopedics
Physician's Practice Patterns
Postoperative Care - methods
Reconstructive Surgical Procedures - methods
Abstract
This study was designed to determine the practice patterns and rationale for knee immobilizer use in immediate post-operative period following an anterior cruciate ligament (ACL) reconstruction.
Descriptive cross-sectional survey.
Canada.
A random sample of 50% of Canadian orthopedic surgeons registered with the Canadian Orthopaedic Association (COA).
Self-reported survey responses regarding knee immobilizer use, surgeon characteristics, graft type and type of practice.
Complete survey response rate was 36.1% (122/338). There was a lack of consensus regarding knee immobilizer use; 47.7% of responding surgeons use a knee immobilizer in the immediate post-operative period while 52.3% do not. There were no trends in characteristics such as fellowship training, number of years in practice and type of practice between surgeons who use and do not use a knee immobilizer. The reported reasons for immobilization were: pain reduction in the post-operative period (51.6%), graft site protection (38.7%), maintaining full extension (19.4%) and habit (12.9%). The length of time the immobilizer was used ranged from 5-42 days.
The lack of consensus reported in the current study and published literature reflects a lack of scientific evidence in the area of post-operative knee immobilization. The need for a randomized clinical trial to assess the efficacy of knee immobilizer use after ACL reconstruction is evident. The authors recommend using peri-operative pain as an outcome measure in future studies investigating immobilization in the immediate post-operative period.
PubMed ID
16778538 View in PubMed
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Nationwide study highlights a second peak in ACL tears for women in their early forties.

https://arctichealth.org/en/permalink/ahliterature294190
Source
Knee Surg Sports Traumatol Arthrosc. 2018 Feb; 26(2):648-654
Publication Type
Journal Article
Date
Feb-2018
Author
Micah Nicholls
Thor Aspelund
Thorvaldur Ingvarsson
Kristin Briem
Author Affiliation
Faculty of Medicine, Research Centre for Movement Sciences, University of Iceland, Reykjavík, Iceland. mkn1@hi.is.
Source
Knee Surg Sports Traumatol Arthrosc. 2018 Feb; 26(2):648-654
Date
Feb-2018
Language
English
Publication Type
Journal Article
Keywords
Adult
Anterior Cruciate Ligament Injuries - epidemiology - surgery
Anterior Cruciate Ligament Reconstruction
Female
Humans
Iceland - epidemiology
Incidence
Knee Injuries - surgery
Knee Joint - surgery
Magnetic Resonance Imaging
Medical Records
Risk factors
Rupture - epidemiology
Sports
Abstract
Anterior cruciate ligament (ACL) rupture continues to be a focus of research on knee injuries. Despite this, data on the total number of ruptures on a national basis including both reconstructed (ACLR) and non-reconstructed injuries are limited. The purpose of this study was to describe the national incidence of MRI diagnosed ACL ruptures in Iceland and its subsequent rate of operation with regard to sex and age.
All MRI knee reports taken in Iceland between 2006 and 2011 were gathered to identify ACL ruptures. Software was written to search for phrases relating to ACL rupture. Duplicate records were removed and yearly incidence for sex and age groups was determined. Data from the Icelandic Social Insurance Administration were used identify all those who were operated and to determine the yearly incidence of ACLR. General additive models were used assuming either a Poisson or binomial distribution to model ACL rupture incidence and ACLR rate, respectively.
The average age was 33.9 (95% CI 33.1-34.6; Table 1). The average incidence of ACL tears per year was 75.1 (95% CI 71.3-79.1) per 100,000 person-years. For males the peak incidence was in their early twenties. Females showed two peaks, one in their teens and another in their forties resulting in an older average age at rupture compared to males (35?±?16 vs 33?±?13, p?=?0.06). The main effects of age and sex and their interaction were significant (p?
Notes
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PubMed ID
29164266 View in PubMed
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Outcomes after ACL reconstruction with focus on older patients: results from The Swedish National Anterior Cruciate Ligament Register.

https://arctichealth.org/en/permalink/ahliterature257834
Source
Knee Surg Sports Traumatol Arthrosc. 2014 Feb;22(2):379-86
Publication Type
Article
Date
Feb-2014
Author
Neel Desai
Haukur Björnsson
Kristian Samuelsson
Jón Karlsson
Magnus Forssblad
Author Affiliation
Department of Orthopaedics, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, 431 80, Mölndal, Sweden, neel@desai.nu.
Source
Knee Surg Sports Traumatol Arthrosc. 2014 Feb;22(2):379-86
Date
Feb-2014
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Anterior Cruciate Ligament - injuries - surgery
Anterior Cruciate Ligament Reconstruction
Child
Female
Humans
Knee Injuries - surgery
Male
Middle Aged
Registries
Sweden
Treatment Outcome
Young Adult
Abstract
To investigate and analyse outcomes of patients over the age of 40 who had undergone anterior cruciate ligament (ACL) reconstruction and to compare them to their younger counterparts. We analysed patient-reported outcomes measured using the knee injury and osteoarthritis outcome score (KOOS) as well as aetiology of injury, concomitant intra-articular injuries and time from injury to surgery.
Data were extracted from the Swedish National Knee Ligament Register during the period of 2005 through 2012. The following data were extracted and analysed: patient age, gender, activity at the time of injury, time between injury and reconstruction, concomitant intra-articular injuries, graft size used for reconstruction and KOOS measured pre-operatively as well as 1, 2 and 5 years post-operatively. The cohort was stratified into age groups of 0-19, 20-29, 30-39 and = 40 years of age.
Pivoting sports were dominating as the cause of ACL injury in the younger age groups (up to 39 years). Alpine skiing and other non-specified activities were the most common causes in the older age group (= 40 years). Pre-operative KOOS was significantly lower in older age groups (p
PubMed ID
24318509 View in PubMed
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18 records – page 1 of 2.