632 results on '"Jon Karlsson"'
Search Results
152. Osteochondral lesions of the talus
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Jon Karlsson, Gino M. M. J. Kerkhoffs, Orthopedic Surgery and Sports Medicine, and AMS - Sports & Work
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Text mining ,business.industry ,MEDLINE ,Medicine ,Dentistry ,Orthopedics and Sports Medicine ,Surgery ,business - Published
- 2019
153. Measuring sustainability in healthcare: an analysis of two systems providing insoles to patients with diabetes
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Roland Zügner, L Sundberg, Jon Karlsson, Stefan Hellstrand, Roy Tranberg, and Ulla Hellstrand Tang
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Economics and Econometrics ,2019-20 coronavirus outbreak ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Geography, Planning and Development ,Psychological intervention ,Sustainable Development Goals ,030209 endocrinology & metabolism ,Management, Monitoring, Policy and Law ,Article ,03 medical and health sciences ,0302 clinical medicine ,Environmental health ,Health care ,Medicine ,030212 general & internal medicine ,Non-communicable diseases ,business.industry ,Mean value ,Healthcare ,Diabetes ,Diabetic foot ,Sustainability ,Cost of treatment ,business ,Healthcare system - Abstract
There is an increasing demand to quantify the footprints, ecological, economic and social, in terms of the effect of different interventions in healthcare. The aim of this study was to compare two systems providing patients with diabetes with insoles in terms of their ecological, economic and social footprints. Prefabricated insoles (PRI) were compared with custom-made insoles (CMI). Using a welfare-economic monetary approach, costs were estimated for (1) treatment, (2) travelling to and from the hospital in terms of both fuel and time consumed by the patients and (3) society through emissions contributing to climate change. The proportion of patients/year that could be supplied within the same budget, for each individual treatment, was calculated. The cost of the insoles was 825 SEK (PRI) and 1450 SEK (CMI), respectively. The cost, mean value/patient due to the consumption of patients’ time at the department, was 754 SEK (PRI) and 1508 SEK (CMI), respectively. Emissions, in terms of CO2 equivalent, were 13.7 (PRI) and 27.4 (CMI), respectively. Using PRI, a total of 928 patients could be provided/year compared with 500 patients if CMI are used. By using PRI, the cost/treatment was reduced by 46%. The cost of treatment dominated and the cost of time consumed by patients were also substantial. The societal cost of contributing to climate change was of low importance. By using PRI, the needs of 86% more patients could be met within the same budget. Using these methods, the contribution of healthcare systems to the 17 Sustainable Development Goals approved by the UN can be quantified.
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- 2019
154. Assessment of neuromuscular activity during maximal isometric contraction in supine vs standing body positions
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Annelie Gutke, Per Aagaard, Jon Karlsson, Roy Tranberg, and K Huseth
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Adult ,Male ,medicine.medical_specialty ,Supine position ,Biophysics ,Neuroscience (miscellaneous) ,Isometric exercise ,Electromyography ,Standing Positions ,03 medical and health sciences ,0302 clinical medicine ,Physical medicine and rehabilitation ,Isometric Contraction ,Supine Position ,Medicine ,Humans ,Muscle, Skeletal ,medicine.diagnostic_test ,biology ,business.industry ,Body position ,030229 sport sciences ,biology.organism_classification ,Trunk ,Medius ,Standing Position ,Female ,Neurology (clinical) ,business ,Neuromuscular activity ,030217 neurology & neurosurgery - Abstract
BACKGROUND: When comparing neuromuscular activity between different individuals or different conditions by use of surface electromyography (sEMG) it is necessary to apply standardized assessment protocol. Most frequently used method is the maximum voluntary isometric contraction (MVIC). However, the influence of body posture on sEMG activity during MVIC testing remains largely unknown.AIM: To evaluate the MVIC method for sEMG normalization in supine versus standing positions for selected muscles of the lower extremity and trunk.METHODS: Twelve healthy individuals participated; five females and seven males (age 22-51 yrs). sEMG signals were recorded bilaterally from mm tibialis anterior, gluteus medius, adductor longus, rectus abdominus, external oblique and internal oblique/transversus abdominus according to standardized test protocol. Two different body positions were used: supine and standing position.RESULTS: MVIC peak sEMG signal amplitudes did not differ systematically between supine and standing test positions. Pronounced inter-subject variability in MVIC reference sEMG activity were observed between participants, during both supine and standing test positions.CONCLUSION: Present data demonstrate that MVIC EMG normalization is a biomechanically stable procedure that can be performed in a reproducible manner for the major leg and trunk muscles when comparing supine vs. standing test positions.
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- 2019
155. 20 The achilles tendon total rupture score should be used with caution the first 6 months after injury
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Jon Karlsson, Katarina Nilsson Helander, Maria Swennergren Hansen, and Kristoffer Weisskrichner Barfod
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Achilles tendon ,medicine.medical_specialty ,medicine.anatomical_structure ,business.industry ,Registry study ,medicine ,Mann–Whitney U test ,Physical therapy ,In patient ,Patient-reported outcome ,Achilles tendon rupture ,medicine.symptom ,business - Abstract
Introduction The Achilles tendon Total Rupture Score (ATRS) is the most commonly used patient reported outcome in patients with an acute Achilles tendon rupture. The score contains ten items of which the last three concerns tasks that some patients cannot and some do not perform. No manual for the use of ATRS has been developed. The purpose was to investigate how ATRS responds at 4, 6 and 12 months after rupture and develop a manual for the use of ATRS. Materials and methods This study was performed as a retrospective registry study analysing prospectively gathered data from the Danish Achilles tendon Database. The data was gathered 4, 6 and 12 months after rupture. The original score based on 10 items was compared with a score based on the first 7 items adjusted to the same scale as the original score. Density- and scatterplots were made and differences between the scores were tested by t-test or Mann–Whitney U test. Results 2790 completed ATRS scores were included. The 7-item score statistically significantly overestimated the value of the 10 items score at all time points (p Conclusion The ATRS cannot be recommended for use at 4 months past rupture, as the last 3 items skew the score. If the ATRS is used before 6 months the last three items could be omitted. A manual for the use of the ATRS will be developed defining how and when the score should be applied.
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- 2019
156. Older Age Predicts Worse Function 1 Year After an Acute Achilles Tendon Rupture: A Prognostic Multicenter Study on 391 Patients
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Paul Ackerman, Simon Svedman, Kristian Samuelsson, Eleonor Svantesson, Katarina Nilsson-Helander, Jon Karlsson, Eric Hamrin Senorski, and Olof Westin
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030222 orthopedics ,medicine.medical_specialty ,Achilles tendon ,treatment ,business.industry ,Treatment outcome ,heel-rise height ,predictor ,030229 sport sciences ,ATRS ,Article ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Multicenter study ,Medicine ,rupture ,Orthopedics and Sports Medicine ,Limited evidence ,Achilles tendon rupture ,medicine.symptom ,business - Abstract
Background: There is limited evidence regarding the patient-related factors that influence treatment outcomes after an acute Achilles tendon rupture. Purpose/Hypothesis: The purpose of this study was to determine the predictors of functional and patient-reported outcomes 1 year after an acute Achilles tendon rupture using a multicenter cohort and to determine patient characteristics for reporting within the top and bottom 10% of the Achilles tendon Total Rupture Score (ATRS) and heel-rise height outcomes. The hypothesis was that older age, greater body mass index (BMI), and female sex would lead to inferior outcomes. Study Design: Cohort study; Level of evidence, 2. Methods: Patients were selected by combining 5 randomized controlled trials from 2 different centers in Sweden. Functional outcomes were assessed using validated heel-rise tests (height, number of repetitions, total work, and concentric power) for muscular endurance and strength, and the relationship between injured and uninjured legs was calculated as the limb symmetry index (LSI). Patient-reported outcomes were measured using the ATRS. All outcomes were collected at the 1-year follow-up. Independent predictors included were patient sex, smoking, BMI, age, and surgical versus nonsurgical treatment. Results: Of the 391 included patients, 307 (79%) were treated surgically. The LSI of heel-rise height at the 1-year follow-up decreased by approximately 4% for every 10-year increment in age (beta, –3.94 [95% CI, –6.19 to –1.69]; P = .0006). In addition, every 10-year increment in age resulted in a 1.79-fold increase in the odds of being in the lowest 10% of the LSI of heel-rise height. Moreover, a nonsignificant superior LSI of heel-rise height was found in patients treated surgically compared with nonsurgical treatment (beta, –4.49 [95% CI, –9.14 to 0.16]; P = .058). No significant predictor was related to the ATRS. Smoking, patient sex, and BMI did not significantly affect the 1-year results for the LSI of the heel-rise tests. Conclusion: Older age at the time of injury negatively affected heel-rise height 1 year after an Achilles tendon rupture. Irrespective of age, a nonsignificant relationship toward the superior recovery of heel-rise height was seen in patients treated surgically. None of the factors studied affected patient-reported outcomes.
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- 2019
157. Personalised medicine in knee arthroplasty: we need more science!
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Niklaus F. Friederich, Michael T. Hirschmann, Roland Becker, and Jon Karlsson
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medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Orthopedic surgery ,medicine ,Physical therapy ,Knee replacement ,Orthopedics and Sports Medicine ,Surgery ,Personalized medicine ,business ,Arthroplasty - Published
- 2019
158. Treatment of Achilles Tendinopathies
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Unnur Sædís Jónsdóttir, Annelie Brorsson, Karin Grävare Silbernagel, and Jon Karlsson
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medicine.medical_specialty ,Rehabilitation ,Exercise treatment ,business.industry ,medicine.medical_treatment ,Orthotics ,medicine.disease ,Positive response ,Shock wave therapy ,medicine ,Physical therapy ,Eccentric ,Tendinopathy ,business ,Balance (ability) - Abstract
Achilles tendinopathy is a common problem and often difficult to treat. The best-known and best-researched treatment is mechanical loading, either with eccentric or concentric-eccentric exercises or with a heavy-load, slow-speed (concentric-eccentric) rehabilitation program. To experience a favorable outcome from exercise, the exercises are allowed to cause pain. Therefore, the use of a pain-monitoring model together with a training log will help the patient and the clinician in the balance between overloading and loading enough to achieve a positive response to the exercises. The exercise program needs to continue for at least 12 weeks, and often it needs to be continued for up to a year. It might also be beneficial to combine the exercise treatment with other treatments, such as shock wave therapy, laser therapy, and the use of orthotics. Surgery is considered to be the last option. Patients with insertional Achilles tendinopathy are more likely to need surgery compared with patients with midportion Achilles tendinopathy.
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- 2019
159. Achilles Tendon Ruptures
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Jon Karlsson, Katarina Nilsson-Helander, Michael R. Carmont, and Olof Westin
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Weakness ,Achilles tendon ,medicine.medical_specialty ,Rehabilitation ,business.industry ,medicine.medical_treatment ,Incidence (epidemiology) ,Biomechanics ,Surgery ,medicine.anatomical_structure ,medicine ,Etiology ,medicine.symptom ,Achilles tendon rupture ,business ,Surgical treatment - Abstract
Achilles tendon ruptures are increasing in incidence, with the greatest incidence in the over 60s age group. The rehabilitation time following this injury is prolonged and patients have calf weakness of up to 30%.
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- 2019
160. 2018 International Olympic Committee consensus statement
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Romain Seil, Lars Engebretsen, Clare L Ardern, Magnus Forssblad, Nicholas G. H. Mohtadi, Lyle J. Micheli, Julian A. Feller, Theodore J. Ganley, Robert F. LaPrade, Jon Karlsson, Franck Chotel, Rainer Siebold, Holly J. Silvers-Granelli, Allen F. Anderson, Håvard Moksnes, Mininder S. Kocher, Justin P. Roe, Moises Cohen, Guri Ranum Ekås, Erik Witvrouw, Mike McNamee, Bruce Reider, Hege Grindem, Bert R. Mandelbaum, and Torbjørn Soligard
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030222 orthopedics ,medicine.medical_specialty ,Sports injury ,medicine.diagnostic_test ,Sports medicine ,business.industry ,Statement (logic) ,Arthroscopy ,Physical Therapy, Sports Therapy and Rehabilitation ,Traumatology ,030229 sport sciences ,medicine.disease ,Expert group ,ACL injury ,03 medical and health sciences ,0302 clinical medicine ,Arthroscopy knee ,Family medicine ,medicine ,Orthopedics and Sports Medicine ,business ,human activities - Abstract
Summary In October 2017, the International Olympic Committee hosted an international expert group of physiotherapists and orthopaedic surgeons who specialise in treating and researching paediatric ACL injuries. Representatives from the American Orthopaedic Society for Sports Medicine, European Paediatric Orthopaedic Society, European Society for Sports Traumatology, Knee Surgery & Arthroscopy, International Society of Arthroscopy Knee Surgery and Orthopaedic Sports Medicine, Pediatric Orthopaedic Society of North America and Sociedad Latinoamericana de Artroscopia, Rodilla y Deporte attended. Physiotherapists and orthopaedic surgeons with clinical and research experience in the field, and an ethics expert with substantial experience in the area of sports injuries also participated. Injury management is challenging in the current landscape of clinical uncertainty and limited scientific knowledge. Injury management decisions also occur against the backdrop of the complexity of shared decision-making with children and the potential long-term ramifications of the injury. This consensus statement addresses six fundamental clinical questions regarding the prevention, diagnosis and management of paediatric ACL injuries. The aim of this consensus statement is to provide a comprehensive, evidence-informed summary to support the clinician, and help children with ACL injury and their parents/guardians make the best possible decisions.
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- 2019
161. Medial collateral ligament injuries of the knee in male professional football players: a prospective three-season study of 130 cases from the UEFA Elite Club Injury Study
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Martin Hägglund, Matilda Lundblad, Christoffer Thomeé, Markus Waldén, Jon Karlsson, Jan Ekstrand, and Eric Hamrin Senorski
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Male ,Injection ,PRP ,medicine.medical_specialty ,Epidemiology ,Medial Collateral Ligament, Knee ,Football ,Physical examination ,Injections, Intralesional ,03 medical and health sciences ,0302 clinical medicine ,Soccer ,medicine ,Humans ,Knee ,Orthopedics and Sports Medicine ,MCL ,Bracing ,MRI ,Prospective Studies ,Grading (education) ,Prospective cohort study ,030222 orthopedics ,Medial collateral ligament ,Braces ,Trauma Severity Indices ,medicine.diagnostic_test ,Platelet-Rich Plasma ,business.industry ,Kirurgi ,Magnetic resonance imaging ,Recovery of Function ,030229 sport sciences ,Magnetic Resonance Imaging ,Surgery ,Europe ,Athletic Injuries ,Orthopedic surgery ,Seasons ,business ,human activities - Abstract
Purpose Medial collateral ligament (MCL) injury is the single most common traumatic knee injury in football. The purpose of this study was to study the epidemiology and mechanisms of MCL injury in men’s professional football and to evaluate the diagnostic and treatment methods used. Methods Fifty-one teams were followed prospectively between one and three full seasons (2013/2014–2015/2016). Individual player exposure and time-loss injuries were recorded by the teams’ medical staffs. Moreover, details on clinical grading, imaging findings and specific treatments were recorded for all injuries with MCL injury of the knee as the main diagnosis. Agreement between magnetic resonance imaging (MRI) and clinical grading (grades I–III) was described by weighted kappa. Results One hundred and thirty of 4364 registered injuries (3%) were MCL injuries. Most MCL injuries (98 injuries, 75%) occurred with a contact mechanism, where the two most common playing situations were being tackled (38 injuries, 29%) and tackling (15 injuries, 12%). MRI was used in 88 (68%) of the injuries, while 33 (25%) were diagnosed by clinical examination alone. In the 88 cases in which both MRI and clinical examination were used to evaluate the grading of MCL injury, 80 (92% agreement) were equally evaluated with a weighted kappa of 0.87 (95% CI 0.77–0.96). Using a stabilising knee brace in players who sustained a grade II MCL injury was associated with a longer lay-off period compared with players who did not use a brace (41.5 (SD 13.2) vs. 31.5 (SD 20.3) days, p = 0.010). Conclusion Three-quarter of the MCL injuries occurred with a contact mechanism. The clinical grading of MCL injuries showed almost perfect agreement with MRI grading, in cases where the MCL injury is the primary diagnosis. Not all grade II MCL injuries were treated with a brace and may thus indicate that routine bracing should not be necessary in milder cases. Level of evidence Prospective cohort study, II.
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- 2019
162. Common Mistakes in Manuscript Writing and How to Avoid Them
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Kristian Samuelsson, Jon Karlsson, Eleonor Svantesson, and Eric Hamrin Senorski
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Presentation ,Work (electrical) ,media_common.quotation_subject ,ComputerApplications_COMPUTERSINOTHERSYSTEMS ,Engineering ethics ,Affect (linguistics) ,Psychology ,media_common - Abstract
Manuscript writing is a crucial step for presentation of research. In fact, a readable and well-composed manuscript may be the difference between getting your work published or not. It takes time and dedication to master the art of writing. However, with discipline and some straight-forward tools for writing, it may not be that complicated. This chapter aims to provide such tools. Furthermore, this chapter presents common mistakes in manuscript writing that may negatively affect the chances of publication and how you can avoid making such mistakes.
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- 2019
163. Elite female footballers stories of sociocultural factors, emotions, and behaviours prior to anterior cruciate ligament injury
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Mats Börjesson, Martin Hägglund, Jon Karlsson, Mark B. Andersen, Urban Johnson, Andreas Ivarsson, and Markus Waldén
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Social Psychology ,Idrottsvetenskap ,Anterior cruciate ligament ,media_common.quotation_subject ,05 social sciences ,Cognition ,030229 sport sciences ,Interpersonal communication ,050105 experimental psychology ,Developmental psychology ,03 medical and health sciences ,anterior cruciate ligament ,athletic injuries ,elite athletes ,female athletes ,psychosocial factors ,soccer ,0302 clinical medicine ,medicine.anatomical_structure ,Perception ,Elite ,medicine ,0501 psychology and cognitive sciences ,Elite athletes ,Psychology ,Sociocultural evolution ,human activities ,Applied Psychology ,Sport and Fitness Sciences ,media_common - Abstract
The aim of the study was to examine how players perceptions of sociocultural factors and intra- and interpersonal aspects of sporting experiences may have influenced the emotions, cognitions, and behaviours of elite female soccer players prior to the occurrence of ACL injuries. The research questions guiding the study were: (a) how did female elite soccer players perceive that their psychosocial experiences were related to their cognitive, physiological, and emotional states prior to their ACL injuries, and (b) how did the players feel their perceived states influenced their behaviours prior to injury occurrence. The participants consisted of the total population of female players (N = 18) competing in the Swedish womens elite league, who incurred a total ACL tear during the 2012 season. Using a semi-structured interview guide, all players were interviewed post-season. We represented the data using a storytelling approach of aggregated creative nonfiction. The aggregated stories showed sociocultural rules and expectations of overtraining and placing pressure on athletes to play even if they were not physically or psychologically fit. Responding to pressures with potentially risk-increasing behaviours might raise the probability of becoming injured through a number of pathways. Team managers, coaches, and members of the medical team are recommended to develop environments that stimulate the players to engage in adaptive stress-recovery and risk-decreasing behaviours. Funding Agencies|Swedish Football Association
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- 2019
164. What Is Evidence-Based Medicine?
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Eric Hamrin Senorski, Olufemi R. Ayeni, Kristian Samuelsson, Jon Karlsson, and Eleonor Svantesson
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Critical appraisal ,Clinical work ,Process (engineering) ,Paradigm shift ,Credibility ,Engineering ethics ,Evidence-based medicine ,Obligation ,Psychology ,Scientific evidence - Abstract
The introduction of the term “evidence-based medicine” (EBM) has been regarded as one of the most important paradigm shifts throughout medical history. The concept originally aimed to educate clinicians on how to perform and interpret scientific evidence in terms of assessment of credibility, critical appraisal of the results, and integration of scientific evidence in the everyday work. The practice of EBM entails the integration of the current best evidence in the clinical decision-making process in terms of the care of every individual patient. Today, finding the best possible evidence is closer than ever, and as researchers and clinicians of today, a deepened understanding of the EBM concept should be considered an obligation. This chapter presents the fundamental principles of EBM, provides methods for incorporating the EBM in the clinical work, and discusses future directions of EBM.
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- 2019
165. Decreased physical health-related quality of life-a persisting state for older women with clinical vertebral fracture
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Lars-Eric Olsson, Dan Mellström, Mattias Lorentzon, Jon Karlsson, Daniel Sundh, Lena Johansson, and H. K. Svensson
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0301 basic medicine ,Time Factors ,Endocrinology, Diabetes and Metabolism ,VFA ,Older women ,Grip strength ,0302 clinical medicine ,Absorptiometry, Photon ,Quality of life ,Bone Density ,Back pain ,Registries ,Stroke ,Aged, 80 and over ,education.field_of_study ,Hip fracture ,Lumbar Vertebrae ,Anthropometry ,Vertebral fractures ,Spinal Fractures ,Female ,Original Article ,medicine.symptom ,medicine.medical_specialty ,Psychometrics ,Population ,030209 endocrinology & metabolism ,Nursing ,HRQoL ,03 medical and health sciences ,medicine ,Humans ,Medical history ,education ,Exercise ,Aged ,Sweden ,business.industry ,Hip Fractures ,Omvårdnad ,medicine.disease ,Cross-Sectional Studies ,Physical Fitness ,Orthopedic surgery ,Physical therapy ,Quality of Life ,030101 anatomy & morphology ,Self Report ,business ,Osteoporotic Fractures - Abstract
In a population-based study of older Swedish women, we investigated if clinical vertebral fracture was associated with lower health-related quality of life (HRQoL) and determined whether the association remained over time. Clinical vertebral fracture was associated with lower HRQoL and the effect persisted for up to 18.9 years. Introduction Vertebral fractures are often associated with back pain and reduced physical function, which might result in isolation and depression. As a result, women with vertebral fractures often have lower health-related quality of life (HRQoL), but during what time frame the decrease lingers is unclear. Therefore, the aim of this study was to investigate if clinical vertebral fracture and hip fracture were associated with lower HRQoL and to determine whether the associations remained over time. Methods Vertebral fracture assessments (VFA) were performed using dual-energy X-ray absorptiometry. Data regarding prior fractures, medications, medical history, and physical activity was collected using a questionnaire. Self-rated physical HRQoL was assessed using the 12-Item Short-Form Health Survey (SF-12). Women with clinical vertebral fractures were divided into tertiles according to time since fracture onset and their HRQoL was compared with non-fractured women. Results In a population-based cross-sectional study of 3028 women aged 77.8 ± 1.63 (mean ± SD), a total of 130 (4.3%) women reported at least one clinical vertebral fracture. Women with a clinical vertebral fracture, divided into tertiles (T1–T3) depending on time since the fracture occurred, had lower HRQoL (T1: 36.3 ± 10.8; T2: 41.0 ± 9.94; and T3:41.6 ± 11.4) than women without fracture (46.2 ± 10.6; p L. Johansson and H. K. Svensson contributed equally to this work. Funding: This study was funded by the ALF/LUA grant from the Sahlgrenska University Hospital, the Swedish Research Council (VR), the Lundberg foundation, Agneta Prytz-Folk’s and Gösta Folke’s Foundation, and King Gustaf V’s and Queen Victoria’s Freemason Foundation. SUPERB
- Published
- 2018
166. Clinical applications of allografts in foot and ankle surgery
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Jon Karlsson, Jácome Pacheco, Pedro C. Diniz, Sjoerd A.S. Stufkens, Miguel Flora, Gino M. M. J. Kerkhoffs, Hélder Pereira, Jorge Batista, and Diego Quintero
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Cartilage, Articular ,Joint Instability ,medicine.medical_specialty ,Arthrodesis ,Bone Neoplasms ,Tendons ,03 medical and health sciences ,Hallux rigidus ,Fractures, Bone ,0302 clinical medicine ,Calcaneal fracture ,Tendon Injuries ,Hallux Rigidus ,medicine ,Humans ,Orthopedics and Sports Medicine ,030222 orthopedics ,Achilles tendon ,Bone Transplantation ,business.industry ,Foot ,Arthritis ,Foot and ankle surgery ,030229 sport sciences ,medicine.disease ,Allografts ,Tendon ,Surgery ,medicine.anatomical_structure ,Cartilage ,Orthopedic surgery ,Ligament ,Ankle ,business ,Ankle Joint - Abstract
Purpose: The purpose of this review is to systematically analyse current literature on the use of allografts in the surgical treatment of foot and ankle disorders in adult patients. Based on this study, we propose evidence-based recommendations. Methods: The database for PubMed was searched for all published articles. No timeframe restrictions were applied. Clinical studies eligible for inclusion met the following criteria: performed on patients over 18 years old; subject to surgical treatment of foot and ankle disorders; with report on the outcome of the use of allografts; with a report and assessment of pain and function, or equivalent; minimum follow-up of 1 year was required. Two reviewers independently screened and selected studies for full-text analysis from title and abstract. 107 studies were included from 1113 records. Studies were grouped according to surgical indications into ten categories: musculoskeletal tumours (n = 16), chronic ankle instability (n = 15), ankle arthritis (n = 14), osteochondral lesions of the talus (n = 12), Achilles tendon defects (n = 11), other tendon defects (n = 9), fusions (n = 9), fractures (n = 8), hallux rigidus (n = 3) and other indications (n = 10). Results: Most studies displayed evidence level of IV (n = 57) and V (n = 39). There was one level I, one level II and nine level III studies. Most studies reported allografting as a good option (n = 99; 92.5%). Overall complication rate was 17% (n = 202). Conclusions: Fair evidence (Grade B) was found in favour of the use of allografts in lateral ankle ligament reconstruction or treatment of intra-articular calcaneal fracture. Fair evidence (Grade B) was found against the use of allogeneic MSCs in tibiotalar fusions. Level of evidence: V.
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- 2018
167. No difference in Achilles Tendon Resting Angle, Patient-reported outcome or Heel-rise height Index between Non- and Early-weightbearing the First Year after an Achilles Tendon Rupture
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Jon Karlsson, Katarina Nilsson-Helander, Michael R. Carmont, and Annelie Brorsson
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medicine.medical_specialty ,Achilles tendon ,Heel ,medicine.anatomical_structure ,business.industry ,medicine ,Orthopedics and Sports Medicine ,Patient-reported outcome ,Achilles tendon rupture ,medicine.symptom ,business ,Surgery - Published
- 2020
168. Intraarticular Fractures : Minimally Invasive Surgery, Arthroscopy
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Mahmut Nedim Doral, Jón Karlsson, John Nyland, Karl Peter Benedetto, Mahmut Nedim Doral, Jón Karlsson, John Nyland, and Karl Peter Benedetto
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- Joints--Fractures--Surgery, Joints--Fractures, Diagnostic imaging
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This superbly illustrated book is a comprehensive and detailed guide to the contemporary arthroscopic management of intraarticular fractures. The opening section addresses a variety of basic aspects and key issues, including the difficulties posed by intraarticular fractures, principles of fixation, cartilage healing, and rehabilitation. The minimally invasive surgical techniques appropriate to individual types of fracture are then fully described and depicted, covering fractures of the shoulder and elbow, wrist, pelvis and hip, knee, and ankle. Guidance is also provided on avoidance and management of complications and rehabilitation. The closing section addresses relevant miscellaneous issues, including arthroscopic management of temporomandibular joint fractures and extended indications for endoscopy-assisted fracture fixation. This volume will be of value for both trainee and experienced surgeons when treating patients with these complex fractures.
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- 2019
169. Basic Methods Handbook for Clinical Orthopaedic Research : A Practical Guide and Case Based Research Approach
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Volker Musahl, Jón Karlsson, Michael T. Hirschmann, Olufemi R. Ayeni, Robert G. Marx, Jason L. Koh, Norimasa Nakamura, Volker Musahl, Jón Karlsson, Michael T. Hirschmann, Olufemi R. Ayeni, Robert G. Marx, Jason L. Koh, and Norimasa Nakamura
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- Orthopedic surgery, Orthopedics--Handbooks, manuals, etc, Sports medicine
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This book is designed to meet the needs of both novice and senior researchers in Orthopaedics by providing the essential, clinically relevant knowledge on research methodology that is sometimes overlooked during training. Readers will find a wealth of easy-to-understand information on all relevant aspects, from protocol design, the fundamentals of statistics, and the use of computer-based tools through to the performance of clinical studies with different levels of evidence, multicenter studies, systematic reviews, meta-analyses, and economic health care studies. A key feature is a series of typical case examples that will facilitate use of the volume as a handbook for most common research approaches and study types. Younger researchers will also appreciate the guidance on preparation of abstracts, poster and paper presentations, grant applications, and publications. The authors are internationally renowned orthopaedic surgeons with extensive research experience and the book is published in collaboration with ISAKOS.
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- 2019
170. Return to knee-strenuous sport after anterior cruciate ligament reconstruction: a report from a rehabilitation outcome registry of patient characteristics
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Eric Hamrin Senorski, Susanne Beischer, Roland Thomeé, Jon Karlsson, Christoffer Thomeé, and Kristian Samuelsson
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Adult ,Male ,musculoskeletal diseases ,Registry ,medicine.medical_specialty ,Adolescent ,Knee Joint ,Anterior cruciate ligament reconstruction ,Anterior cruciate ligament ,medicine.medical_treatment ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Knee ,Orthopedics and Sports Medicine ,Prospective Studies ,Registries ,Anterior Cruciate Ligament ,Young adult ,Prospective cohort study ,Exercise ,030222 orthopedics ,Lysholm Knee Score ,Rehabilitation ,Anterior Cruciate Ligament Reconstruction ,Physical therapy modalities ,business.industry ,Anterior Cruciate Ligament Injuries ,musculoskeletal, neural, and ocular physiology ,030229 sport sciences ,musculoskeletal system ,Self Efficacy ,Return to Sport ,Treatment Outcome ,surgical procedures, operative ,medicine.anatomical_structure ,Orthopedic surgery ,Physical therapy ,Female ,Surgery ,Reconstruction ,business ,human activities - Abstract
Purpose To characterise patients who returned to knee-strenuous sports after an anterior cruciate ligament (ACL) reconstruction. Methods Data from isotonic tests of muscle function and patient-reported outcome measures, Tegner activity scale (Tegner and Lysholm in Clin Orthop Relat Res 198:43–49, 1985), physical activity scale, knee injury and osteoarthritis scale and knee self-efficacy scale were extracted from a registry. The 157 included patients, 15–30 years of age, had undergone primary ACL reconstruction and were all involved in knee-strenuous sports, i.e. pre-injury Tegner of 6 or higher. Return to sport was studied in two different ways: return to pre-injury Tegner and return to knee-strenuous sport (Tegner 6). Results Fifty-two patients (33 %), who returned to pre-injury Tegner, 10 months after surgery, were characterised by better subjective knee function measured with the knee injury and osteoarthritis outcome score (p
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- 2016
171. Product Differences in Intra-articular Hyaluronic Acids for Osteoarthritis of the Knee
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Parag Sancheti, Roy D. Altman, Asheesh Bedi, Emil H. Schemitsch, and Jon Karlsson
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medicine.medical_specialty ,Viscosupplements ,MEDLINE ,Pain ,knee ,Physical Therapy, Sports Therapy and Rehabilitation ,Osteoarthritis ,Injections, Intra-Articular ,Chondroprotection ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Intra articular ,hyaluronic acid ,Hyaluronic acid ,Medicine and Health Sciences ,Humans ,Medicine ,Orthopedics and Sports Medicine ,030212 general & internal medicine ,Hyaluronic Acid ,030203 arthritis & rheumatology ,business.industry ,Osteoarthritis, Knee ,medicine.disease ,Molecular Weight ,osteoarthritis ,chemistry ,Physical therapy ,Joint disorder ,Viscosupplementation ,business ,viscosupplementation - Abstract
Background: Knee osteoarthritis (OA) is a common and often disabling joint disorder among adults that may result in impaired activity and daily function. A variety of treatment options are currently available and prescribed for knee OA depending on the severity of the disorder and physician preference. Intra-articular hyaluronic acid (IA-HA) injection is a treatment for knee OA that reportedly provides numerous biochemical and biological benefits, including shock absorption, chondroprotection, and anti-inflammatory effects within the knee. Clarity is needed as to whether the available IA-HA products should be considered for therapy as a group or whether there are significant differences in the products that need to be considered in treatment of OA of the knee. Purpose: To determine whether there are differences in efficacy and safety with respect to intrinsic properties of available IA-HA injections for knee OA. Study Design: Meta-analysis. Methods: A comprehensive literature search of the Medline, EMBASE, and PubMed databases was conducted for all existing randomized trials of IA-HA. The primary outcome measure analyzed was the mean pain score at the reported follow-up nearest to 26 weeks after injection. Pooled efficacy and safety results were recorded for subgroupings of HA product characteristics. Results: A total of 68 studies were included for analysis. Products with an average molecular weight ≥3000 kDa provided favorable efficacy results when compared with products of an average molecular weight Conclusion: Despite similarities, IA-HA products should not be treated as a group, as there are differences in IA-HA products that influence both efficacy and safety. In the available literature, IA-HA products with a molecular weight ≥3000 kDa and those derived from biological fermentation relate to superior efficacy and safety—factors that may influence selection an IA-HA product for OA of the knee.
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- 2016
172. A Randomized Controlled Trial With Mean 16-Year Follow-up Comparing Hamstring and Patellar Tendon Autografts in Anterior Cruciate Ligament Reconstruction
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Haukur Björnsson, Kristian Samuelsson, Jüri Kartus, David Sundemo, Ninni Sernert, Jon Karlsson, Lars Rostgård-Christensen, and Neel Desai
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Anterior cruciate ligament reconstruction ,Radiography ,medicine.medical_treatment ,Anterior cruciate ligament ,Physical Therapy, Sports Therapy and Rehabilitation ,Osteoarthritis ,law.invention ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,Patellar Ligament ,law ,Humans ,Medicine ,Orthopedics and Sports Medicine ,Range of Motion, Articular ,Autografts ,030222 orthopedics ,Anterior Cruciate Ligament Reconstruction ,business.industry ,Patellar ligament ,Hamstring Tendons ,030229 sport sciences ,Middle Aged ,musculoskeletal system ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Female ,business ,Hamstring ,Follow-Up Studies - Abstract
Background: There is no consensus in the current literature on which surgical options render the best long-term results after anterior cruciate ligament (ACL) reconstruction in terms of clinical outcomes and the development of radiographic osteoarthritis (OA). Purpose: To investigate the long-term clinical and radiographic results after ACL reconstruction using either a patellar tendon (PT) autograft or a hamstring tendon (HT) autograft. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: This multicenter study was based on 2 previous randomized cohorts consisting of 193 patients who underwent unilateral primary ACL reconstruction using either a PT autograft or an HT autograft. The index surgical procedure was performed between September 1995 and January 2000. Clinical assessments, including knee laxity measurements, functional outcomes, patient-reported outcomes, and bilateral standing radiographs, were performed at the final follow-up examination. Results: At the long-term follow-up, 147 (76%) patients were examined: 61 in the PT group and 86 in the HT group. The mean (±SD) follow-up time was 191.9 ±15.1 months for the HT group and 202.6 ± 10.4 months for the PT group. Knee laxity measurements revealed significantly more patients with a normal pivot-shift test finding in the HT group compared with the PT group (71% vs 51%, respectively; P = .048); however, no significant differences were found in terms of the manual Lachman test or the KT-1000 arthrometer manual maximum test. The patients in the PT group had significantly more difficulty knee walking ( P = .049). There were no significant differences between the study groups in terms of patient-reported outcomes or range of motion in the reconstructed knee. In both groups, significantly more signs of radiographic OA were found in the reconstructed knee than in the contralateral healthy knee. However, there were no significant differences between the groups in terms of radiographic OA. Conclusion: Only minor and mostly insignificant differences were found between the PT and HT autograft groups in this long-term randomized controlled trial. In both groups, significantly more signs of radiographic OA were found in the reconstructed knee than in the contralateral knee.
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- 2016
173. Surgical management of osteonecrosis of the humeral head: a systematic review
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Guglielmo Torre, Kristian Samuelsson, Edoardo Franceschetti, Michele Paciotti, Jon Karlsson, Vincenzo Denaro, Francesco Franceschi, and Rocco Papalia
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Shoulder ,medicine.medical_specialty ,Shoulder surgery ,medicine.medical_treatment ,MEDLINE ,Avascular necrosis ,Cochrane Library ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Orthopedics and Sports Medicine ,Prospective Studies ,Physical Therapy Modalities ,Retrospective Studies ,030222 orthopedics ,Shoulder Joint ,business.industry ,Osteonecrosis ,Retrospective cohort study ,030229 sport sciences ,Decompression, Surgical ,medicine.disease ,Arthroplasty ,Surgery ,Treatment Outcome ,Systematic review ,Orthopedic surgery ,Humeral Head ,Hemiarthroplasty ,business - Abstract
Osteonecrosis of the humeral head is a rare diagnosis. The aim of this systematic review was to identify published studies and analyse the best clinical evidence available related to the surgical management of osteonecrosis of the humeral head. A systematic electronic search was performed using the PubMed (MEDLINE), EMBASE and Cochrane Library databases. Published studies that reported the outcomes for adult patients treated surgically for osteonecrosis of the humeral head were included. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement was followed. Twelve studies were included: five prospective case series and seven retrospective case series. A total of 309 patients, comprising 382 shoulders, were included. Three main surgical procedures were evaluated: core decompression, hemi-arthroplasty and total shoulder arthroplasty. Based on the current available data, core decompression is a safe and effective option for treating low-grade osteonecrosis of the humeral head, while hemi-arthroplasty and total shoulder arthroplasty should be considered for high-grade osteonecrosis. More studies and better-designed trials are needed in order to enrich the evidence and enable researchers to draw stronger conclusions. Since osteonecrosis is an uncommon, though challenging disease, a proper knowledge of its treatment is needed. IV.
- Published
- 2016
174. Tracing a bog-iron bloomery furnace in an adjacent lake-sediment record in Ängersjö, central Sweden, using pollen and geochemical signals
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Eva-Maria Nordström, Ulf Segerström, Richard Bindler, Jon Karlsson, Harald Biester, Philine Thöle, and Johan Rydberg
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010506 paleontology ,Archeology ,Bog iron ,technology, industry, and agriculture ,Paleontology ,Sediment ,Plant Science ,010501 environmental sciences ,medicine.disease_cause ,01 natural sciences ,Archaeology ,Bloomery ,Pollen ,Smelting ,medicine ,Iron production ,Biogeosciences ,Geology ,0105 earth and related environmental sciences - Abstract
Recent studies of bloomery sites in Sweden indicate the amount of iron produced with this early low-technology smelter was greater than previously thought, which implies greater economic importance ...
- Published
- 2016
175. New perspectives on femoroacetabular impingement syndrome
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Asheesh Bedi, Freddie H. Fu, Moin Khan, Mohit Bhandari, Jon Karlsson, and Olufemi R. Ayeni
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Cartilage, Articular ,musculoskeletal diseases ,medicine.medical_specialty ,Radiography ,Femoracetabular Impingement ,law.invention ,Arthroscopy ,03 medical and health sciences ,0302 clinical medicine ,Rheumatology ,Randomized controlled trial ,law ,Early Medical Intervention ,medicine ,Humans ,Femoroacetabular impingement ,030222 orthopedics ,Labrum ,medicine.diagnostic_test ,Femoroacetabular Impingement Syndrome ,business.industry ,Fibrocartilage ,Acetabulum ,Femur Head ,030229 sport sciences ,Plastic Surgery Procedures ,medicine.disease ,Magnetic Resonance Imaging ,Surgery ,Debridement ,Hip Joint ,business - Abstract
Femoroacetabular impingement (FAI) is characterized by an abnormality in the shape of the femoral head-neck or acetabulum that results in impingement between these two structures. Arthroscopic treatment has become the preferred method of management of FAI owing to its minimally invasive approach. Surgical correction involves resection of impinging osseous structures as well as concurrent management of the associated chondral and labral pathology. Research from the past 5 years has shown that repair of the labrum results in a better anatomic correction and improved outcomes compared with labral debridement. Research is underway to improve cartilage assessment by using innovative imaging techniques and biochemical tests to inform predictions of prognosis. Several ongoing randomized controlled trials, including the Femoroacetabular Impingement Trial (FAIT) and the Femoroacetabular Impingement Randomized Controlled Trial (FIRST), will provide critical information regarding the diagnosis, management and prognosis of patients undergoing arthroscopic management of FAI.
- Published
- 2016
176. Efficacy of Nonsteroidal Anti-inflammatory Drug Prophylaxis for Heterotrophic Ossification in Hip Arthroscopy: A Systematic Review
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Olufemi R. Ayeni, Nolan S. Horner, Jon Karlsson, Nicole Simunovic, Sahab Jamshidi, and Marco Yeung
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030222 orthopedics ,medicine.medical_specialty ,business.industry ,Ossification, Heterotopic ,Incidence (epidemiology) ,Anti-Inflammatory Agents, Non-Steroidal ,030229 sport sciences ,Odds ratio ,medicine.disease ,Confidence interval ,Surgery ,Arthroscopy ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Statistical significance ,Internal medicine ,medicine ,Humans ,Orthopedics and Sports Medicine ,Heterotopic ossification ,Hip arthroscopy ,Prospective cohort study ,Adverse effect ,business - Abstract
Purpose The purpose of this systematic review was to investigate the efficacy of nonsteroidal anti-inflammatory drug (NSAID) prophylaxis for preventing heterotopic ossification (HO) in the setting of hip arthroscopy. Methods A systematic search was performed in duplicate for studies comparing the use of NSAID prophylaxis for HO in the setting of hip arthroscopy until March 2015. Study parameters—including sample size, incidence of HO, adverse effects, and level of symptoms—were obtained. Furthermore, the level of evidence of studies was collected and quality assessment was performed. The difference in incidence as well as pooled odds ratios were calculated and analyzed to compare no prophylaxis versus NSAID prophylaxis. Results This systematic review identified 5 studies, consisting of 1,662 patients, investigating NSAID prophylaxis in hip arthroscopy. HO was diagnosed with the use of postoperative hip radiographs at follow-up, with 95% of cases classified using the Brooker classification. The incidence of HO was 13.4% without NSAID prophylaxis and 3.3% with NSAID prophylaxis. Pooled odds ratios from the prospective studies were 0.07 (95% confidence interval [CI], 0.02 to 0.28; P = .0002; I 2 = 0%), showing with statistical significance that NSAID prophylaxis decreased the incidence of HO. The retrospective data similarly showed pooled odds ratios of 0.03 (95% CI, 0.00 to 1.43); P = .08; I 2 = 84%), although it was not statistically significant. Most of the patients who experienced HO in both groups were not reported to be symptomatic. Adverse effects and compliance were not consistently reported. Conclusions The available orthopaedic literature suggests that the incidence of postoperative HO may be decreased with the use of NSAID prophylaxis in hip arthroscopy. However, the evidence is unclear regarding NSAID drug regimen choice, drug compliance, and adverse effects. Level of Evidence Level III, systematic review of Level I, Level II, and Level III studies.
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- 2016
177. Changes in Muscle Oxygen Saturation Have Low Sensitivity in Diagnosing Chronic Anterior Compartment Syndrome of the Leg
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Jorma Styf, Kajsa Rennerfelt, Jon Karlsson, and Qiuxia Zhang
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Male ,medicine.medical_specialty ,Time Factors ,Electromyography ,03 medical and health sciences ,Oxygen Consumption ,0302 clinical medicine ,Musculoskeletal Pain ,Reference Values ,Internal medicine ,Humans ,Medicine ,Orthopedics and Sports Medicine ,In patient ,cardiovascular diseases ,Muscle, Skeletal ,Intramuscular pressure ,Pain Measurement ,Peak exercise ,Leg ,030222 orthopedics ,Exercise Tolerance ,Spectroscopy, Near-Infrared ,medicine.diagnostic_test ,business.industry ,nutritional and metabolic diseases ,Skeletal muscle ,Leg pain ,030229 sport sciences ,General Medicine ,Surgery ,Anterior Compartment Syndrome ,medicine.anatomical_structure ,Case-Control Studies ,Chronic Disease ,Exercise Test ,Cardiology ,Female ,Level ii ,business - Abstract
Background: Near-infrared spectroscopy measures muscle oxygen saturation (StO2) in the skeletal muscle and has been proposed as a noninvasive tool for diagnosing chronic anterior compartment syndrome (CACS). The purpose of this study was to investigate the diagnostic value of changes in StO2 during and after exercise in patients with CACS. Methods: The study comprised 159 consecutive patients with exercise-induced leg pain. Near-infrared spectroscopy was used to measure StO2 continuously before, during, and after an exercise test. One minute post-exercise, intramuscular pressure was recorded in the same muscle. The cohort was divided into patients with CACS (n = 87) and patients without CACS (n = 72) according to the CACS diagnostic criteria. Reoxygenation at rest after exercise was calculated as the time period required for the level of muscular StO2 to reach 50% (T50), 90% (T90), and 100% (T100) of the baseline value. Results: The lowest level of StO2 during exercise was 1% (range, 1% to 36%) in the patients with CACS and 3% (range, 1% to 54%) in the patients without CACS. The sensitivity was 34% and the specificity was 43% when an StO2 level of ≤8% at peak exercise was used to indicate CACS. The sensitivity and the specificity were only 1% when an StO2 level of ≤50% at peak exercise was used to indicate CACS. The time period for reoxygenation was seven seconds (range, one to forty-three seconds) at T50, twenty-eight seconds (range, seven to seventy-seven seconds) at T90, and forty-two seconds (range, seven to 200 seconds) at T100 in the patients with CACS and ten seconds (range, one to forty-nine seconds) at T50, thirty-two seconds (range, four to 138 seconds) at T90, and forty-eight seconds (range, four to 180 seconds) at T100 in the patients without CACS. When thirty seconds or more at T90 was set as the cutoff value for a prolonged time for reoxygenation, indicating a diagnosis of CACS, the sensitivity was 38% and the specificity was 50%. Conclusions: Changes in muscle oxygen saturation during and after an exercise test that elicits leg pain cannot be used to distinguish between patients with CACS and patients with other causes of exercise-induced leg pain. Level of Evidence: Diagnostic Level II. See Instructions for Authors for a complete description of levels of evidence.
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- 2016
178. Outcome of hip arthroscopy in patients with mild to moderate osteoarthritis—A prospective study
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Roland Thomeé, Mikael Sansone, Leif Swärd, David Collin, Christoffer Thomeé, Mattias Ahldén, Adad Baranto, Pall Jonasson, and Jon Karlsson
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030222 orthopedics ,medicine.medical_specialty ,medicine.diagnostic_test ,Groin ,business.industry ,Visual analogue scale ,Arthroscopy ,030229 sport sciences ,Osteoarthritis ,medicine.disease ,Preoperative care ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Quality of life ,Physical therapy ,Medicine ,Hip arthroscopy ,business ,Prospective cohort study ,Research Articles - Abstract
Osteoarthritis (OA) of the hip is a common cause of hip pain. The arthroscopic management of patients with femoro-acetabular impingement (FAI) has been reported to yield good outcomes. The purpose of this study was to report on outcome following the arthroscopic treatment of patients with FAI in the presence of mild to moderate OA. Seventy-five patients undergoing arthroscopic surgery for FAI, all with preoperative radiological signs of mild to moderate OA were prospectively included in this study. A 2-year follow-up, using web-based patient-reported outcome measures, including the International Hip Outcome Tool (iHOT-12), Copenhagen Hip and Groin Outcome (HAGOS), EQ-5D, Hip Sports Activity Scale (HSAS) for physical activity level and a visual analogue scale (VAS) for overall hip function, was performed, complemented by a radiographic evaluation. At follow-up (mean 26 months, SD 5), five patients (7%) had undergone total hip arthroplasty, leaving 70 patients for the analysis. Preoperative scores compared with those obtained at the 2-year follow-up revealed significant improvements (P
- Published
- 2015
179. Same procedure as last year, James … same procedure as every year …
- Author
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Volker Musahl, Roland Becker, Michael T. Hirschmann, and Jon Karlsson
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Impact factor ,Operations research ,business.industry ,Humans ,Medicine ,Orthopedics and Sports Medicine ,Surgery ,Journal Impact Factor ,Periodicals as Topic ,Public relations ,business ,Editorial Policies - Abstract
Another year has come to an end, it’s strange how time flies. And, it is time for the same procedure as last year, i.e. the journal has grown, submissions have increased, the Impact Factor has increased. We are happy and proud to be the journal’s leadership. Again, we would like to start by thanking all the reviewers listed below. You are extremely valuable to us, and without you, the journal would not be the same. Most probably, there would be no journal at all. We are aware of the fact that reviewing a manuscript is timeconsuming, sometimes boring and it is unpaid. A second problem is that many of you as good reviewers serve several journals. KSSTA is still an European journal, but as of today, we are more and more international. Therefore, we have increasingly tried to find new reviewers from outside Europe. We are aware that all too often the best reviewers are hit with review requests from several journals at the same time. We, therefore, try to limit the number of reviews assigned to the same reviewer as * Jon Karlsson jon.karlsson@telia.com
- Published
- 2015
180. Adhesive capsulitis of the hip: a review addressing diagnosis, treatment and outcomes
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Jon Karlsson, Mark Phillips, Darren de Sa, Etienne L. Belzile, Olufemi R. Ayeni, Nicole Simunovic, and Michael Catapano
- Subjects
030222 orthopedics ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Arthroscopy ,MEDLINE ,030229 sport sciences ,medicine.disease ,medicine.disease_cause ,Weight-bearing ,03 medical and health sciences ,0302 clinical medicine ,Capsulitis ,Physical therapy ,Medicine ,Hip pain ,Hip arthroscopy ,business ,Range of motion ,Review Articles ,Manipulation under anesthesia - Abstract
Adhesive capsulitis (AC) of the hip (i.e. 'Frozen Hip'), in part due to its difficulty in diagnosis, is an often overlooked and underappreciated entity of hip morbidity. This review aimed to elucidate a diagnostic approach and the surgical treatment options (with associated outcomes) of employing hip arthroscopy in the setting of AC. Electronic databases (EMBASE, MEDLINE and PubMed) were searched for available sources for all relevant clinical studies addressing the surgical management of AC. Additionally, reference lists of studies were hand-searched to find all relevant articles. Articles were systematically screened in duplicate, with agreement and descriptive statistics presented. Ten studies satisfied inclusion criteria. A total of 40 patients (mean age of 47.1 ± 14.8 years) were included. Diagnosis of AC of the hip commonly encompassed a combination of: decreased joint capacity; hip pain exacerbated by weight bearing or activity; and progressive decrease in global range of motion. Diagnostic arthroscopy was utilized in nine patients, and successful diagnosis of AC was achieved in all nine patients. Common treatments included pressure dilation (11 cases) and manipulation under anesthesia (11 cases). AC continues to be a difficult clinical entity to diagnose. Similarities are seen between hip AC and shoulder AC as diagnosis is often a result of ruling out all other possible conditions, and treatment options and outcomes resemble those of the shoulder counterpart. With successful outcomes harping on timely diagnosis and effective treatment, the use of hip arthroscopy may be of benefit to achieving this.
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- 2015
181. Correction to: Treatment after anterior cruciate ligament injury: Panther Symposium ACL Treatment Consensus Group
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Volker Musahl, Eleonor Svantesson, Thomas Rauer, Mark V. Paterno, John W. Xerogeanes, Benjamin B. Rothrauff, Eric Hamrin Senorski, Freddie H. Fu, Theresa Diermeier, Andrew D. Lynch, Lars Engebretsen, Olufemi R. Ayeni, Jon Karlsson, and Sean J. Meredith
- Subjects
medicine.medical_specialty ,medicine.anatomical_structure ,business.industry ,Anterior cruciate ligament ,Orthopedic surgery ,MEDLINE ,Medicine ,Orthopedics and Sports Medicine ,Surgery ,business - Abstract
The author decided to opt for Open Choice and to make the article an Open Access publication.
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- 2020
182. Age and Tightness of Repair Are Predictors of Heel-Rise Height After Achilles Tendon Rupture
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Karin Grävare Silbernagel, Jennifer A. Zellers, Annelie Brorsson, Jon Karlsson, Katarina Nilsson-Helander, and Michael R. Carmont
- Subjects
Achilles tendon rupture ,Weakness ,medicine.medical_specialty ,Heel ,business.industry ,operative repair ,Article ,heel-rise ,Surgery ,medicine.anatomical_structure ,outcome ,medicine ,Orthopedics and Sports Medicine ,medicine.symptom ,Ankle ,business - Abstract
Background:Achilles tendon rupture leads to weakness of ankle plantarflexion. Treatment of Achilles tendon rupture should aim to restore function while minimizing weakness and complications of management.Purpose:To determine the influence of factors (age, sex, body mass index [BMI], weight, time from injury to operative repair, and tightness of repair) in the initial surgical management of patients after an acute Achilles tendon rupture on 12-month functional outcome assessment after percutaneous and minimally invasive repair.Study Design:Cohort study; Level of evidence, 3.Methods:From May 2012 to January 2018, patients sustaining an Achilles tendon rupture receiving operative repair were prospectively evaluated. Tightness of repair was quantified using the intraoperative Achilles tendon resting angle (ATRA). Heel-rise height index (HRHI) was used as the primary 12-month outcome variable. Secondary outcome measures included Achilles tendon total rupture score (ATRS) and Tegner score. Stepwise multiple regression was used to create a model to predict 12-month HRHI.Results:A total of 122 patients met the inclusion criteria for data analysis (mean ± SD age, 44.1 ± 10.8 years; 78% male; mean ± SD BMI, 28.1 ± 4.3 kg/m2). The elapsed time to surgery was 6.5 ± 4.0 days. At 12-month follow-up, patients had an HRHI of 82% ± 16% and performed 82% ± 17% of repetitions compared with the noninjured side. Participants had a mean ATRS of 87 ± 15 and a median Tegner score of 5 (range, 1-9), with a reduction in Tegner score of 2 from preinjury levels. The relative ATRA at 12 months was –4.8° ± 3.9°. Multiple regression identified younger age (B = ±0.006; P < .001) and greater intraoperative ATRA (B = 0.005; P = .053) as predictors of more symmetrical 12-month HRHI ( R2= 0.19; P < .001; n = 120).Conclusion:Age was found to be the strongest predictor of outcome after Achilles tendon rupture. The most important modifiable risk factor was the tightness of repair. It is recommended that repair be performed as tight as possible to optimize heel-rise height 1 year after Achilles tendon rupture and possibly to reduce tendon elongation.
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- 2020
183. No difference in strength and clinical outcome between early and late repair after Achilles tendon rupture
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Jon Karlsson, Jennifer A. Zellers, Michael R. Carmont, Annelie Brorsson, Katarina Nilsson-Helander, and Karin Grävare Silbernagel
- Subjects
Adult ,Male ,medicine.medical_specialty ,Time Factors ,Sural nerve ,Achilles Tendon ,03 medical and health sciences ,0302 clinical medicine ,Suture (anatomy) ,Tendon Injuries ,Medicine ,Humans ,Minimally Invasive Surgical Procedures ,Orthopedics and Sports Medicine ,Orthopedic Procedures ,Knee ,Muscle Strength ,Retrospective Studies ,Rupture ,030222 orthopedics ,business.industry ,Suture Techniques ,Retrospective cohort study ,030229 sport sciences ,Delayed treatment ,Middle Aged ,Surgery ,Tendon ,medicine.anatomical_structure ,Treatment Outcome ,Orthopedic surgery ,Female ,Achilles tendon rupture ,medicine.symptom ,business ,Complication - Abstract
Purpose This retrospective study aimed to determine the patient-reported and functional outcome of patients with delayed presentation, who had received no treatment until 14 days following injury of Achilles tendon rupture repaired with minimally invasive surgery and were compared with a group of sex- and age-matched patients presenting acutely. Based on the outcomes following delayed presentation reported in the literature, it was hypothesized that outcomes would be inferior for self-reported outcome, tendon elongation, heel-rise performance, ability to return to play, and complication rates than for acutely managed patients. Methods Repair was performed through an incision large enough to permit mobilisation of the tendon ends, core suture repair consisting of a modified Bunnell suture proximally and a Kessler suture distally and circumferential running suture augmentation. Results Nine patients presented 21.8 (14.9) days (range 14–42 days) after rupture. The rate of delayed presentation was estimated to be 1 in 10. At 12 months following repair, patients with delayed treatment had median (range) ATRS score of 90 (69–99) compared with 94 (75–100) in patients treated acutely presenting 0.66 (1.7) (0–5) days. There were no significant differences between groups: ATRA [mean (SD) delayed: − 6.9° (5.5), acute: − 6° (4.7)], heel-rise height index [delayed: 79% (20), acute: 74% (14)], or heel-rise repetition index [delayed: 77% (20), acute: 71% (20)]. In the delayed presentation group, two patients had wound infection and one iatrogenic sural nerve injury. Conclusions Patients presenting more than 2 weeks after Achilles tendon rupture may be successfully treated with minimally invasive repair. Level of evidence III. Electronic supplementary material The online version of this article (10.1007/s00167-018-5340-5) contains supplementary material, which is available to authorized users.
- Published
- 2018
184. 15 years of the Scandinavian knee ligament registries: lessons, limitations and likely prospects
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Lars Engebretsen, Jon Karlsson, Magnus Forssblad, Martin Lind, Kristian Samuelsson, Eleonor Svantesson, and Eric Hamrin Senorski
- Subjects
medicine.medical_specialty ,Anterior cruciate ligament ,Physical Therapy, Sports Therapy and Rehabilitation ,Scandinavian and Nordic Countries ,ligament ,cohort study ,medicine ,Humans ,Orthopedics and Sports Medicine ,Registries ,Intensive care medicine ,knee ACL ,business.industry ,ACL ,Anterior Cruciate Ligament Injuries ,anterior cruciate ligament ,Confounding ,General Medicine ,medicine.disease ,ACL injury ,Systematic review ,Knee ligament ,medicine.anatomical_structure ,Treatment Outcome ,Ligament ,Registry data ,business ,Cohort study ,Systematic Reviews as Topic - Abstract
High-quality national health registries provide the opportunities to: (1) improve patient outcomes by giving medical units and clinicians relevant feedback about their work; (2) detect inferior treatments and (3) identify prognostic factors associated with both good and bad outcomes. The Scandinavian knee ligament registries were established in 2004 and 2005, include data from 70 000 patients,1 and have led to more than 70 studies publications already (2019). This editorial reflects on lessons learnt, limitations identified and what the future may hold. Two systematic reviews including all studies from the registries focused on factors associated with (1) additional anterior cruciate ligament (ACL) reconstruction and (2) patient-reported outcomes after ACL injury and reconstruction are summarised in table 1.2 3 View this table: Table 1 Primary findings of the systematic reviews on the Scandinavian knee ligament registries There is a balance in health registry studies between the large number of patients that decrease the type-II error (false negative) risk, and the multiple analyses and similar questions that are addressed which increase the type-I error (false positive) risk. Registry data are also susceptible to confounding interactions, some of which are unknown. Nevertheless, the registries produce results that reflect day-to-day practice owing to two key factors, a high rate of coverage (proportion of medical units who participate in relation to all eligible medical units) and completeness (proportion of target population in the registry). However, it must be remembered that the response rates from patient-reported follow-ups are a persistent challenge for health registries, where at …
- Published
- 2018
185. The effect of pelvic tilt and cam on hip range of motion in young elite skiers and nonathletes
- Author
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Adad Baranto, Mikael Sansone, Carl Todd, Jon Karlsson, Pall Jonasson, Olof Thoreson, Cecilia Agnvall, Leif Swärd, and Aminoff Swärd Aminoff
- Subjects
Pelvic tilt ,musculoskeletal diseases ,hip ,cross-sectional studies ,pelvis ,rotation ,03 medical and health sciences ,0302 clinical medicine ,medicine ,magnetic resonance imaging ,Open Access Journal of Sports Medicine ,posture ,Pelvis ,Orthodontics ,030222 orthopedics ,business.industry ,Flexed posture ,hip joint ,030229 sport sciences ,range of motion (articular) ,Neutral spine ,Hip rotation ,medicine.anatomical_structure ,External rotation ,Clinical Trial Report ,Background current ,Range of motion ,business - Abstract
Anna Swärd Aminoff,1 Cecilia Agnvall,2,3 Carl Todd,1 Páll Jónasson,4 Mikael Sansone,1 Olof Thoreson,1 Leif Swärd,1 Jon Karlsson,1 Adad Baranto1 1Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden; 2Sports Medicine Åre, Åre, Sweden; 3Åre Ski Academy, Åre, Sweden; 4Orkuhúsið Orthopedic Clinic, Reykjavik, Iceland Background: Current knowledge of the effect of changes in posture and the way cam morphology of the hip joint may affect hip range of motion (ROM) is limited. Purpose: To determine the effect of changes in pelvic tilt (PT) on hip ROM and with/without the presence of cam. Study design: This was a cross-sectional study. Materials and methods: The hip ROM of 87 subjects (n=61 young elite skiers, n=26 nonathletes) was examined using a goniometer, in three different seated postures (flexed, neutral, and extended). The hips of the subjects were further subgrouped into cam and no-cam morphology, based on the magnetic resonance imaging findings in the hips. Results: There was a significant correlation between the hip ROM and the seated posture in both extended and flexed postures compared with the neutral posture. There was a significant decrease in internal hip rotation when the subjects sat with an extended posture with maximum anterior PT (p
- Published
- 2018
186. Study protocol of a 52-week Prospective Running INjury study in Gothenburg (SPRING)
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Jonatan, Jungmalm, Stefan, Grau, Pia, Desai, Jon, Karlsson, and Rasmus Østergaard, Nielsen
- Subjects
injury ,education ,Protocol ,running ,prospective ,biomechanics - Abstract
Introduction It is assumed that a running-related (overuse) injury occurs when a specific structure of the human body is exposed to a load that exceeds that structures’ load capacity. Therefore, monitoring training load is an important key to understanding the development of a running-related injury. Additionally, other distribution, magnitude and capacity-related factors should be considered when aiming to understand the causal chain of injury development. This paper presents a study protocol for a prospective cohort study that aims to add comprehensive information on the aetiology of running-related injuries and present a new approach for investigating changes in training load with regard to running-related injuries. Methods and analysis This study focused on recreational runners, that is, runners exposed to a minimum weekly average of 15 km for at least 1 year. Participants will undergo baseline tests consisting of a clinical/anthropometrical examination and biomechanical measurements. Furthermore, participants will log all training sessions in a diary on a weekly basis for 1 year. The primary exposure variable is changes in training load. A medical practitioner will examine runners suffering from running-related pain and, if possible, make a clear diagnosis. Finally, additional time-varying exposure variables will be included in the main analysis, whereas the analysis for the secondary purpose is based on time-fixed baseline-related risk factors. Ethics and dissemination Ethical approval (DNR: 712–15) for the study and its design was obtained from the Gothenburg regional ethical review board. The results of the study will be published in peer-reviewed journals.
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- 2018
187. Prevention, diagnosis and management of paediatric ACL injuries
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Magnus Forssblad, Theodore J. Ganley, Hege Grindem, Erik Witvrouw, Allen F. Anderson, Franck Chotel, Justin P. Roe, Håvard Moksnes, Romain Seil, Julian A. Feller, Guri Ranum Ekås, Robert F. LaPrade, Lyle J. Micheli, Rainer Siebold, Mininder S. Kocher, Holly J. Silvers-Granelli, Bert R. Mandelbaum, Lars Engebretsen, Bruce Reider, Mike McNamee, Moises Cohen, Jon Karlsson, Torbjørn Soligard, Clare L Ardern, and Nicholas G. H. Mohtadi
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030222 orthopedics ,03 medical and health sciences ,0302 clinical medicine ,business.industry ,Medicine ,Physical Therapy, Sports Therapy and Rehabilitation ,Orthopedics and Sports Medicine ,030229 sport sciences ,General Medicine ,business - Published
- 2018
188. Low 1-Year Return-to-Sport Rate After Anterior Cruciate Ligament Reconstruction Regardless of Patient and Surgical Factors: A Prospective Cohort Study of 272 Patients
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Roland Thomeé, Kristian Samuelsson, Susanne Beischer, Jon Karlsson, Christoffer Thomeé, Eric Hamrin Senorski, and Eleonor Svantesson
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Adult ,Male ,medicine.medical_specialty ,Anterior cruciate ligament reconstruction ,Adolescent ,Knee Joint ,Anterior cruciate ligament ,medicine.medical_treatment ,Physical Therapy, Sports Therapy and Rehabilitation ,Knee Injuries ,Return to sport ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Sex Factors ,medicine ,Humans ,Orthopedics and Sports Medicine ,Meniscus ,Prospective Studies ,Prospective cohort study ,Exercise ,Sweden ,030222 orthopedics ,Anterior Cruciate Ligament Reconstruction ,business.industry ,Anterior Cruciate Ligament Injuries ,Age Factors ,030229 sport sciences ,Lysholm Knee Score ,Surgery ,Return to Sport ,medicine.anatomical_structure ,Concomitant ,Case-Control Studies ,Female ,business ,human activities - Abstract
Background:There is insufficient knowledge about the way that concomitant injuries affect the short-term likelihood of a return to a knee-strenuous sport after anterior cruciate ligament (ACL) reconstruction.Hypotheses/Purpose:The purpose was to study whether patient characteristics, concomitant injuries, and graft choice at primary ACL reconstruction can predict return to sport (RTS) 1 year after surgery. The hypotheses were that younger age at the time of ACL reconstruction would positively affect RTS, while the presence of concomitant injuries would negatively affect RTS 1 year after surgery.Study Design:Case-control study; Level of evidence, 3.Methods:Data were extracted from a rehabilitation-specific register and the Swedish National Knee Ligament Register. Twelve months after surgery, all patients were evaluated for RTS via the Tegner Activity Scale. The primary outcome was a return to knee-strenuous sport, defined as a Tegner Activity Scale ≥6. Univariable and multivariable logistic regression analyses were performed with patient characteristics, concomitant knee injuries, and graft choice as independent variables.Results:A total of 272 patients (51% female) with a mean ± SD age of 25.0 ± 9.2 years were included. In the multivariable analysis, a favorable odds ratio (OR) for returning to sport was found for patients of male sex (OR, 2.58; 95% CI, 1.43-4.65; P = .0016), younger age at the time of ACL reconstruction (OR, 2.32; 95% CI, 1.59-3.33; P < .0001), a higher preinjury score on the Tegner Activity Scale (OR, 1.45; 95% CI, 1.13-1.87; P = .0038), and an absence of injury to the meniscus (OR, 1.92; 95% CI, 1.10-3.36; P = .023) and medial collateral ligament (OR, 7.61; 95% CI, 1.42-40.87; P = .018). In addition, the absence of cartilage injury was favorable in terms of RTS in the univariable analysis (OR, 2.48; 95% CI, 1.40-4.39; P = .0018).Conclusion:Positive predictors of a return to knee-strenuous sport 1 year after ACL reconstruction were male sex, younger age, a high preinjury level of physical activity, and the absence of concomitant injuries to the medial collateral ligament and meniscus.
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- 2018
189. 2 10-year risk-factors of knee function after anterior cruciate ligament reconstruction – a study from the swedish national knee ligament register
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Kristian Samuelsson, Eleonor Svantesson, Jon Karlsson, Eric Hamrin Senorski, and Kurt P. Spindler
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Knee function ,medicine.medical_specialty ,Anterior cruciate ligament reconstruction ,business.industry ,medicine.medical_treatment ,Osteoarthritis ,musculoskeletal system ,medicine.disease ,Knee ligament ,Quality of life ,Concomitant ,medicine ,Physical therapy ,Risk factor ,business ,Knee injuries ,human activities - Abstract
Introduction Long-term individual prognosis and risk factors for quality of life and disability following ACL reconstruction remain unknown. To determine 10 year predictors of knee function after anterior cruciate ligament reconstruction. Material and methods Prospectively collected data were extracted on patients who underwent ACL reconstruction between January 2005 and January 2007 from the Swedish National Knee Ligament Register. Patients who had no 10 year follow-up of the Knee injury and Osteoarthritis Outcome Score (KOOS) were excluded. Conditional multivariable regression modelling was used to assess 10 year patient-related and surgery-related risk factors across all KOOS subscales including KOOS4. Result In total, 874 patients with a median age of 27.5 years (11.2–61.5) at ACL reconstruction were included. No patient-related or surgery-related predictor was significant across all subscales of the KOOS. The presence of a concomitant articular cartilage injury resulted in decreased odds OR=0.639–0.796 (p Conclusion This 10 year risk factor analysis identified several factor than can effect long-term knee function after ACL reconstruction. Most of the risk factors were surgery-related and unfortunately non-modifiable. Nevertheless, this information can be helpful to physicians counselling patients’ expectations of outcome after ACL reconstruction.
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- 2018
190. Adolescent elite skiers with and without cam morphology did change their hip joint range of motion with 2 years follow-up
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Adad Baranto, Olof Thoreson, Josefin Abrahamson, Cecilia Agnvall, Anna Swärd Aminoff, Carl Todd, Pall Jonasson, and Jon Karlsson
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musculoskeletal diseases ,Male ,medicine.medical_specialty ,Supine position ,Adolescent ,Rotation ,Follow-up studies ,Sitting ,Patient Positioning ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Lumbar ,Skiing ,Femoracetabular Impingement ,Medicine ,Humans ,Orthopedics and Sports Medicine ,Range of Motion, Articular ,Physical Examination ,Range of motion ,Femoroacetabular impingement ,Orthodontics ,030222 orthopedics ,Sitting Position ,Hip ,Lumbar Vertebrae ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,030229 sport sciences ,medicine.disease ,Magnetic Resonance Imaging ,Athletes ,Orthopedic surgery ,Surgery ,Lumbar spine ,Female ,Hip Joint ,business ,human activities ,Articular - Abstract
Purpose To investigate how range of motion of the hips and the lumbar spine are affected by continued elite, alpine skiing in young subjects, with and without a magnetic resonance imaging verified cam morphology, in a 2-year follow-up study. The hypothesis is that skiers with cam morphology will show a decrease in hip joint range of motion as compared with skiers without cam, after a 2-year follow-up. Method Thirty adolescent elite alpine skiers were examined at the baseline (mean age 17.3 ± 0.7 years) and after 2 years. All skiers were examined for the presence of cam morphology (α-angle > 55°) using magnetic resonance imaging at the baseline. Clinical examinations of range of motion in standing lumbar flexion and extension, supine hip flexion, internal rotation, FABER test and sitting internal rotation and external rotation were performed both at the baseline and after 2 years. Results Skiers with and without cam morphology showed a significant decrease from baseline to follow-up in both hips for supine internal rotation (right: mean − 13.3° and − 10.9° [P
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- 2018
191. Cost-effectiveness analysis of surgical versus non-surgical management of acute Achilles tendon ruptures
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Mikael Svensson, Nicklas Olsson, Jon Karlsson, Katarina Nilsson Helander, Olof Westin, Elisabeth Hansson Olofsson, Kristian Samuelsson, and Karin Grävare Silbernagel
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Cost-Benefit Analysis ,Achilles Tendon ,HRQoL ,03 medical and health sciences ,Indirect costs ,Young Adult ,QALY ,0302 clinical medicine ,Quality of life ,Recurrence ,Tendon Injuries ,Surgical ,Health care ,Medicine ,Humans ,Orthopedics and Sports Medicine ,Patient Reported Outcome Measures ,Aged ,Rupture ,Achilles tendon rupture ,030222 orthopedics ,Achilles tendon ,business.industry ,ICER ,030229 sport sciences ,Cost-effectiveness analysis ,Middle Aged ,Sensitivity analyses ,Treatment ,medicine.anatomical_structure ,Non-surgical ,Orthopedic surgery ,Sick leave ,Physical therapy ,Quality of Life ,Surgery ,Female ,Quality-Adjusted Life Years ,medicine.symptom ,Ankle ,business ,Follow-Up Studies - Abstract
Purpose An Achilles tendon rupture is a common injury that typically affects people in the middle of their working lives. The injury has a negative impact in terms of both morbidity for the individual and the risk of substantial sick leave. The aim of this study was to investigate the cost-effectiveness of surgical compared with non-surgical management in patients with an acute Achilles tendon rupture. Methods One hundred patients (86 men, 14 women; mean age, 40 years) with an acute Achilles tendon rupture were randomised (1:1) to either surgical treatment or non-surgical treatment, both with an accelerated rehabilitation protocol (surgical n = 49, non-surgical n = 51). One of the surgical patients was excluded due to a partial re-rupture and five surgical patients were lost to the 1-year economic follow-up. One patient was excluded due to incorrect inclusion and one was lost to the 1-year follow-up in the non-surgical group. The cost was divided into direct and indirect costs. The direct cost is the actual cost of health care, whereas the indirect cost is the production loss related to the impact of the patient’s injury in terms of lost ability to work. The health benefits were assessed using quality-adjusted life years (QALYs). Sampling uncertainty was assessed by means of non-parametric boot-strapping. Results Pre-injury, the groups were comparable in terms of demographic data and health-related quality of life (HRQoL). The mean cost of surgical management was €7332 compared with €6008 for non-surgical management (p = 0.024). The mean number of QALYs during the 1-year time period was 0.89 and 0.86 in the surgical and non-surgical groups respectively. The (incremental) cost-effectiveness ratio was €45,855. Based on bootstrapping, the cost-effectiveness acceptability curve shows that the surgical treatment is 57% likely to be cost-effective at a threshold value of €50,000 per QALY. Conclusions Surgical treatment was more expensive compared with non-surgical management. The cost-effectiveness results give a weak support (57% likelihood) for the surgical treatment to be cost-effective at a willingness to pay per QALY threshold of €50,000. This is support for surgical treatment; however, additionally cost-effectiveness studies alongside RCTs are important to clarify which treatment option is preferred from a cost-effectiveness perspective. Level of evidence I.
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- 2018
192. Foot and Ankle Problems in Handball
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Bojan Bukva, Hélder Pereira, Nasef Abdellatif, Jon Karlsson, Michael R. Carmont, Jean-François Kaux, and Pieter D'Hooghe
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medicine.medical_specialty ,Rehabilitation ,biology ,Athletes ,business.industry ,medicine.medical_treatment ,030209 endocrinology & metabolism ,030229 sport sciences ,biology.organism_classification ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Physical medicine and rehabilitation ,medicine ,Ankle ,Foot Injury ,business ,Foot (unit) - Abstract
Handball has a resounding impact on the osteoarticular apparatus of the foot/ankle, and that is predominantly linked with trauma. This chapter aims to present relevant epidemiological data on ankle injuries and tackle the most common foot injuries in handball along with practical key aspects of skin, surface, material, alignment features, and rehabilitation guidelines. We hope that the information presented will serve as a useful tool for all athletes, coaches, physiotherapists, and medical doctors dealing with handball and meanwhile minimize the disadvantages to players in case of injury.
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- 2018
193. Return to Play Following Achilles Tendon Rupture
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Jon Karlsson, Jennifer A. Zellers, Michael R. Carmont, Hermann Mayr, Karin Grävare Silbernagel, and Clare L Ardern
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Weakness ,medicine.medical_specialty ,business.industry ,Tendon elongation ,medicine ,medicine.symptom ,Achilles tendon rupture ,business ,Complication ,Return to play ,Surgery - Abstract
The incidence of Achilles tendon rupture is increasing. Even when ruptures are “successfully” managed without any complication, patients almost always demonstrate objective calf strength weakness.
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- 2018
194. Is there a correlation between coaches leadership styles and injuries in elite football teams? : A study of 36 elite teams in 17 countries
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Daniel Lundqvist, Jon Karlsson, Jan Ekstrand, Lars Lagerbäck, Niki Papadimitiou, and Marc Vouillamoz
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Male ,football ,soccer ,injury ,behaviour ,psychology ,media_common.quotation_subject ,Applied psychology ,education ,Poison control ,Physical Therapy, Sports Therapy and Rehabilitation ,Football ,Affect (psychology) ,Leadership ,03 medical and health sciences ,0302 clinical medicine ,Injury prevention ,Leadership style ,Humans ,Orthopedics and Sports Medicine ,030212 general & internal medicine ,health care economics and organizations ,Sport and Fitness Sciences ,media_common ,Idrottsvetenskap ,Communication ,Incidence ,Mentors ,Human factors and ergonomics ,030229 sport sciences ,General Medicine ,Europe ,Athletes ,Elite ,Athletic Injuries ,Original Article ,Psychology ,human activities - Abstract
BackgroundDo coaches’ leadership styles affect injury rates and the availability of players in professional football? Certain types of leadership behaviour may cause stress and have a negative impact on players’ health and well-being.AimTo investigate the transformational leadership styles of head coaches in elite men’s football and to evaluate the correlation between leadership styles, injury rates and players’ availability.MethodsMedical staff from 36 elite football clubs in 17 European countries produced 77 reports at four postseason meetings with a view to assessing their perception of the type of leadership exhibited by the head coaches of their respective teams using the Global Transformational Leadership scale. At the same time, they also recorded details of individual players’ exposure to football and time-loss injuries.ResultsThere was a negative correlation between the overall level of transformational leadership and the incidence of severe injuries (rho=−0.248; n=77; p=0.030); high levels of transformational leadership were associated with smaller numbers of severe injuries. Global Transformational Leadership only explained 6% of variation in the incidence of severe injuries (r2=0.062). The incidence of severe injuries was lower at clubs where coaches communicated a clear and positive vision, supported staff members and gave players encouragement and recognition. Players’ attendance rates at training were higher in teams where coaches gave encouragement and recognition to staff members, encouraged innovative thinking, fostered trust and cooperation and acted as role models.ConclusionsThere is an association between injury rates and players’ availability and the leadership style of the head coach.
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- 2018
195. Correlation between quantitative pivot shift and generalized joint laxity: a prospective multicenter study of ACL ruptures
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David Sundemo, James J. Irrgang, Volker Musahl, Ryosuke Kuroda, Yuichi Hoshino, Jon Karlsson, Kristian Samuelsson, Nicola Lopomo, Anna Blom, Stefano Zaffagnini, Sundemo, David, Blom, Anna, Yuichi, Hoshino, Ryosuke, Kuroda, Lopomo, Nicola Francesco, Zaffagnini, Stefano, Volker, Musahl, Irrgang, James J., Karlsson, Jã³n, and Samuelsson, Kristian
- Subjects
Male ,Image analysis system ,Knee Joint ,Anterior cruciate ligament reconstruction ,medicine.medical_treatment ,Inertial sensor ,0302 clinical medicine ,Rotatory knee laxity ,Orthopedics and Sports Medicine ,Prospective Studies ,Anterior Cruciate Ligament ,Range of Motion, Articular ,Child ,Prospective cohort study ,Orthodontics ,Pivot shift test ,030222 orthopedics ,Pivot-shift test ,Beighton Score ,Generalized joint hypermobility ,Generalized joint laxity ,musculoskeletal system ,Biomechanical Phenomena ,medicine.anatomical_structure ,Female ,Adult ,Joint Instability ,musculoskeletal diseases ,medicine.medical_specialty ,Adolescent ,Rotation ,Anterior cruciate ligament ,Young Adult ,03 medical and health sciences ,medicine ,Humans ,Knee ,Tibia ,Physical Examination ,Rupture ,business.industry ,Anterior Cruciate Ligament Injuries ,030229 sport sciences ,Orthopedic surgery ,Surgery ,business ,human activities - Abstract
Purpose: To investigate whether an increased magnitude of quantitative rotatory knee laxity is associated with a greater level of generalized joint laxity in ACL-injured and contralateral knees. Methods: A total of 103 patients were enrolled across four international centers to undergo anatomic ACL reconstruction. Rotatory knee laxity was evaluated preoperatively, both in the awake state and under anesthesia, using the standardized pivot shift test. Two devices were used to quantify rotatory knee laxity; an inertial sensor, measuring the joint acceleration, and an image analysis system, measuring the lateral compartment translation of the tibia. The presence of generalized joint laxity was determined using the Beighton Hypermobility Score. The correlation between the level of generalized joint laxity and the magnitude of rotatory knee laxity was calculated for both the involved knee and the non-involved knee. Further, patients were dichotomized into low (0-4) or high (5-9) Beighton Score groups. Alpha was set at < 0.05. Results: Ninety-six patients had complete datasets, 83 and 13 in the low and high Beighton Score groups respectively. In anesthetized patients, there was a significant correlation between the degree of Beighton Score and quantitative pivot shift when analyzing the non-involved knee using the image analysis system (r = 0.235, p < 0.05). When analyzing the same knee, multivariate analysis adjusted for meniscal injury, age and gender revealed an increased odds ratio for patients with increased lateral compartment translation to be part of the high Beighton Score group (OR 1.86, 95% CI 1.10-3.17, p < 0.05). No other correlation was significant. When analyzing the dichotomized subgroups, no significant correlations could be established. Conclusion: The findings in this study suggest that there is a weak correlation between generalized joint laxity and the contralateral healthy knee, indicating increased rotatory knee laxity in these patients. Generalized joint laxity does not appear to correlate with rotatory knee laxity in ACL-injured knees. Level of evidence: Prospective cohort study; level of evidence, 2.
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- 2018
196. Factors that affect patient reported outcome after anterior cruciate ligament reconstruction-a systematic review of the Scandinavian knee ligament registers
- Author
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Eleonor Svantesson, Olufemi R. Ayeni, Lars Engebretsen, Angelo Baldari, Kristian Samuelsson, Francesco Franceschi, Jon Karlsson, and Eric Hamrin Senorski
- Subjects
Cartilage, Articular ,Male ,medicine.medical_specialty ,Anterior cruciate ligament reconstruction ,Anterior cruciate ligament ,medicine.medical_treatment ,review ,Physical Therapy, Sports Therapy and Rehabilitation ,Cochrane Library ,Scandinavian and Nordic Countries ,Affect (psychology) ,Transplantation, Autologous ,03 medical and health sciences ,0302 clinical medicine ,Sex Factors ,Medicine ,Humans ,Orthopedics and Sports Medicine ,030212 general & internal medicine ,Patient Reported Outcome Measures ,Registries ,knee ACL ,Anterior Cruciate Ligament Reconstruction ,business.industry ,Anterior Cruciate Ligament Injuries ,ACL ,Hamstring Tendons ,anterior cruciate ligament ,Age Factors ,030229 sport sciences ,General Medicine ,musculoskeletal system ,Checklist ,Tibial Meniscus Injuries ,medicine.anatomical_structure ,Concomitant ,Physical therapy ,Patient-reported outcome ,Female ,business ,human activities - Abstract
ObjectiveTo perform a systematic review of findings from the Scandinavian knee ligament registers with regard to factors that affect patient reported outcome after anterior cruciate ligament (ACL) reconstruction.DesignSystematic review.Data sourcesFour electronic databases: PubMed, EMBASE, the Cochrane Library and AMED were searched, and 157 studies were identified. Two reviewers independently screened the titles, abstracts and full text articles for eligibility. A modified version of the Downs and Black checklist was applied for quality appraisal.Eligibility criteria for selecting studiesStudies published from the Scandinavian registers from their establishment in 2004 and onwards that documented patient reported outcome and provided information on concomitant injuries were eligible.ResultsA total of 35 studies were included. Younger age at ACL reconstruction, male sex, not smoking and receiving a hamstring tendon autograft positively influenced patient reported outcome. Patients with concomitant cartilage and meniscal injuries reported inferior subjective knee function compared with patients with an isolated ACL tear. One study reported that patients treated non-reconstructively reported inferior knee function compared with patients who had ACL reconstruction.ConclusionYounger age, male sex, not smoking, receiving a hamstring tendon autograft and the absence of concomitant injuries were associated with superior patient reported outcomes after ACL reconstruction.
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- 2018
197. The role of arthroscopy in ankle instability treatment
- Author
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Stéphane Guillo, Pietro Spennacchio, Gwen Vuurberg, Jon Karlsson, Hélder Pereira, Jordi Vega, AMS - Sports & Work, Graduate School, AGEM - Endocrinology, metabolism and nutrition, and Orthopedic Surgery and Sports Medicine
- Subjects
030222 orthopedics ,Lateral ankle ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Arthroscopy ,Anterior tibiofibular ligament ,030229 sport sciences ,3. Good health ,Surgery ,03 medical and health sciences ,Inversion (linguistics) ,0302 clinical medicine ,medicine.anatomical_structure ,medicine.ligament ,Medicine ,Ankle ,business ,Ankle instability - Abstract
Acute injuries of the ankle are one of the most common injuries seen by general practitioners and emergency departments [1]. They involve approximately 25% of all injuries of the musculoskeletal system. Inversion trauma, also referred to as lateral ankle sprains, constitutes a large proportion of these injuries [2-4].
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- 2018
198. Handball Injuries: Epidemiology and Injury Characterization: Part 1
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Patrick Luig, Lior Laver, Grethe Myklebust, Jon Karlsson, and Leonard Achenbach
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03 medical and health sciences ,0302 clinical medicine ,Body contact ,Applied psychology ,Adaptive change ,030229 sport sciences ,030212 general & internal medicine ,Psychology ,Team handball ,Popularity ,Throwing ,Pace - Abstract
Handball (also referred to as “team handball”) is an Olympic team ball sport of worldwide popularity. The sport has continuously developed during recent years, with major evolutions in players’ speed, strength, and technique, and as a consequence adaptive changes in tactics and rules of the game. Handball is characterized by intense body contact, frequent intermittent running, pace changes, one-on-one confrontations, and quick direction changes in combination with challenging technique and coordination elements like catching, throwing, passing, and dribbling.
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- 2018
199. Match-Related Factors Influencing Injury Risk
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Mats Börjesson, Jaakko Ryynänen, and Jon Karlsson
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Related factors ,030222 orthopedics ,medicine.medical_specialty ,Football match ,030229 sport sciences ,Football ,03 medical and health sciences ,0302 clinical medicine ,Environmental health ,Epidemiology ,Injury prevention ,medicine ,Injury risk ,Psychology ,Regional differences - Abstract
A lot of epidemiological research has been conducted in order to identify the most important risk factors for football injuries. These risk factors are often referred to as intrinsic (player related) or extrinsic (related to the environment). Factors that appear to increase the risk of injury during a football match include foul play, player exposure, fatigue, match events, fixture congestion, and environmental variables. Also, some degree of regional differences between players’ risk of suffering injuries between different regions have been observed, perhaps reflecting the influence of playing culture and/or climatic conditions, among many other factors, on the risk of injury. The reasons behind a football player’s risk of suffering an injury at a given moment are, thus, multifactorial, and more research is necessary in order to deepen our knowledge on the topic. Recognizing the circumstances when the risk of injury is elevated can, at best, lead to injury prevention.
- Published
- 2018
200. Erratum to: Contributions of the anterolateral complex and the anterolateral ligament to rotatory knee stability in the setting of ACL Injury: a roundtable discussion
- Author
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Bertrand Sonnery-Cottet, Cécile Batailler, Jeremy M. Burnham, Jon Karlsson, Alan Getgood, Volker Musahl, Philippe Neyret, Andrew A. Amis, Steven Claes, Stefano Zaffagnini, Andy Williams, Musahl, Volker, Getgood, Alan, Neyret, Philippe, Claes, Steven, Burnham, Jeremy M., Batailler, Cecile, Sonnery-Cottet, Bertrand, Williams, Andy, Amis, Andrew, Zaffagnini, Stefano, and Karlsson, Jón
- Subjects
Anterolateral ligament ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Arthroscopy ,Traumatology ,medicine.disease ,ACL injury ,Surgery ,medicine.anatomical_structure ,Knee surgery ,medicine ,Orthopedics and Sports Medicine ,business - Abstract
No abstract available
- Published
- 2018
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