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Biomedical subjects

L Engebretsen

Publications and source records attributed to L Engebretsen.

At least 19 recordsLinked to original sources
PubMed2006

Biomechanical analysis of anterior cruciate ligament injury mechanisms: three-dimensional motion reconstruction from video sequences.

BACKGROUND: Methods for analyzing the mechanisms of injuries in sports from video sequences of injury situations are so far limited to a simple visual inspection, which has shown poor accuracy. PURPOSE: To investigate whether a new model-based image-matching technique could successfully be applied to estimate kinematic characteristics of three typical anterior cruciate ligament (ACL) injury situations. METHODS: A four-camera basketballvideo, a three-camera European team handball video and a single-camera downhill skiing video were imported into the program Poser 4, where a skeleton model and a model of the surroundings were matched to the background image frame by frame. When the match was considered satisfactory, joint angles as well as velocity and acceleration of the center of mass were calculated using Matlab. RESULTS: In the basketball and handball matchings, the skeleton and surrounding models were successfully matched to the background through all frames in all camera angles. Detailed time courses for joint kinematics and ground reaction force were obtained, while less information could be acquired from the single-view skiing accident. CONCLUSION: The model-based image matching technique can be used to extract kinematic characteristics from videotapes of actual ACL injuries, and may provide valuable information on the mechanisms for ACL injuries in sports.

Anterior Cruciate Ligament Injuries↗
PubMed2006

Injury pattern in youth team handball: a comparison of two prospective registration methods.

The purpose of this study was to examine the injury incidence and pattern of injuries in youth female and male team handball players using two different prospective registration methods; match reports (90 teams, 1080 players) and coach reports (34 teams, 428 players). A total of 118 injuries were recorded by the coach report, of which 93 (79%) were acute injuries (incidence training: 0.9+/-0.16 injuries/1000 player hours; matches: 9.9+/-1.26; rate ratio vs training: 10.8 [95% confidence interval (CI) 7.0-16.6]; P<0.0001) and 25 (21%) were overuse injuries. Knee (26%) and ankle (24%) injuries accounted for half of the acute injuries (training: 0.5+/-0.12 injuries/1000/h; matches: 4.4+/-0.84; rate ratio vs training: 8.0 (95% CI 4.5-14.5); P<0.0001). No gender difference was found in the injury rate (rate ratio female vs male: 1.3 (95% CI 0.8-2.1); P=0.40). Most of the injuries occurred in the attacking phase by back or wing players doing a plant-and-cut, landing or turning movement, and more than half in contact situations with the opponent. Similar results were observed for acute match injuries in the match report. These results indicate that the rate of injuries in youth team handball is as high as at the senior level, and prevention should focus on knee and ankle injuries. The coach report seems to be the best method to register injuries in youth team handball to provide a full spectrum of injuries according to their type, incidence and severity.

Adolescent↗
PubMed2004

Video analysis of injuries and incidents in Norwegian professional football.

OBJECTIVES: This study describes the characteristics of injuries and high risk situations in the Norwegian professional football league during one competitive season using Football Incident Analysis (FIA), a video based method. METHODS: Videotapes and injury information were collected prospectively for 174 of 182 (96%) regular league matches during the 2000 season. Incidents where the match was interrupted due to an assumed injury were analysed using FIA to examine the characteristics of the playing situation causing the incident. Club medical staff prospectively recorded all acute injuries on a specific injury questionnaire. Each incident identified on the videotapes was cross referenced with the injury report. RESULTS: During the 174 matches, 425 incidents were recorded and 121 acute injuries were reported. Of these 121 injuries, 52 (43%) were identified on video including all head injuries, 58% of knee injuries, 56% of ankle injuries, and 29% of thigh injuries. Strikers were more susceptible to injury than other players and although most of the incidents and injuries resulted from duels, no single classic injury situation typical for football injuries or incidents could be recognised. However, in most cases the exposed player seemed to be unaware of the opponent challenging him for ball possession. CONCLUSIONS: This study shows that in spite of a thorough video analysis less than half of the injuries are identified on video. It is difficult to identify typical patterns in the playing events leading to incidents and injuries, but players seemed to be unaware of the opponent challenging them for ball possession.

Ankle Injuries↗
PubMed2004

Mechanisms of head injuries in elite football.

OBJECTIVES: The aim of this study was to describe, using video analysis, the mechanisms of head injuries and of incidents with a high risk of head injury in elite football. METHODS: Videotapes and injury information were collected prospectively for 313 of the 409 matches played in the Norwegian (2000 season) and Icelandic (1999 and 2000 season) professional leagues. Video recordings of incidents where a player appeared to be hit in the head and the match was consequently interrupted by the referee were analysed and cross referenced with reports of acute time loss injuries from the team medical staff. RESULTS: The video analysis revealed 192 incidents (18.8 per 1000 player hours). Of the 297 acute injuries reported, 17 (6%) were head injuries, which corresponds to an incidence of 1.7 per 1000 player hours (concussion incidence 0.5 per 1000 player hours). The most common playing action was a heading duel with 112 cases (58%). The body part that hit the injured player's head was the elbow/arm/hand in 79 cases (41%), the head in 62 cases (32%), and the foot in 25 cases (13%). In 67 of the elbow/arm/hand impacts, the upper arm of the player causing the incident was at or above shoulder level, and the arm use was considered to be active in 61 incidents (77%) and intentional in 16 incidents (20%). CONCLUSIONS: This study suggests that video analysis provides detailed information about the mechanisms for head injuries in football. The most frequent injury mechanism was elbow to head contact, followed by head to head contact in heading duels. In the majority of the elbow to head incidents, the elbow was used actively at or above shoulder level, and stricter rule enforcement or even changes in the laws of the game concerning elbow use should perhaps be considered, in order to reduce the risk of head injury.

Arm↗
PubMed2003

Shortening of the patellar tendon length does not influence the patellofemoral alignment in a cadaveric model.

INTRODUCTION: Anterior cruciate ligament (ACL) reconstruction with the use of autograft tissue represents the standard treatment. The use of a bone-patellar tendon-bone transplant for symptomatic ACL deficiency achieves good long-term results. The purpose of the study was to investigate in a cadaveric model whether reproducible patellar tendon shortening changes the patellofemoral alignment. MATERIALS AND METHODS: Using five cadaveric knees, an MRI investigation was performed with the patellar tendon left unchanged, shortened 5 mm and shortened 10 mm, respectively, in both 20 and 45 degrees of knee flexion. The lateral patellofemoral and the congruence angles were measured and compared using a one-way analysis of variance for repeated measurements. RESULTS: Shortening the patella tendon by approximately 20% did not significantly influence the patellofemoral alignment. CONCLUSION: Although anterior cruciate ligament-reconstruction using the patellar tendon has become a standard procedure, postoperative problems such as anterior knee pain, and patellofemoral osteoarthritis occur quite often. In this cadaver study we did not find a significant difference for the patellofemoral alignment, irrespective of the patellar tendon length.

Adult↗
PubMed2003

A clinical case and anatomical study of the innervation supply of the vastus medialis muscle.

The innervation supply to the vastus medialis (VM) muscle, a component of quadriceps femoris (QF), is provided by a branch of the femoral nerve (FN) running along the muscle. The course of the nerve from lumbar roots to the muscle has been described by many researchers. It is known to ride along the femoral vein, artery and saphenous nerve and enter the adductor canal (Hunter's canal), and then to divide into branches that supply vastus medialis and the knee joint. Femoral mononeuropathy is uncommon, and is usually due to compression in the spinal level. Hematoma in the psoas and iliacus muscles, drug abuse, lithotomy position and limb lengthening are the other associated reasons for a mononeuropathy of the femoral nerve. Isolated vastus lateralis (VL) atrophies have been reported by a few authors, suggesting that compression of the nerve and direct violation of the nerve with injections might be the reason for mononeuropathy. Isolated VM atrophy has not been previously reported. The purpose of the study was to identify the anatomical structures around the FN branch which innervates the VM muscle.

Adolescent↗
PubMed2003

Soft tissue problems in ankle fractures treated surgically. A prospective study of 154 consecutive closed ankle fractures.

We performed a prospective registration of primary soft tissue injuries and perioperative soft tissue complications the first 3 months after surgery in ankle fractures treated by open reduction and internal fixation. Open fractures and polytraumatized patients were excluded. The 154 consecutive patients (90 women) with an average age of 54.5 (S.D. 18.3) years were registered. Primary soft tissue injuries according to Tscherne's classification were noted in 22 patients (14.2%). Major perioperative soft tissue complications requiring revision occurred in five patients (3.2%). Minor perioperative soft tissue complications treated non-operatively occurred in 29 patients (18.8%). A significantly higher incidence of perioperative soft tissue complications occurred in alcohol abusers (P=0.043), after high-energy trauma (P=0.043), and after primary soft tissue injuries (P=0.004). Other possible risk factors such as age, gender, fracture type, diabetes, arteriosclerosis, coronary heart disease, and hypothyroidism had no statistically significant influence on the incidence of perioperative soft tissue complications.

Adolescent↗
PubMed2003

Relationship between floor type and risk of ACL injury in team handball.

The purpose of this study was to compare the ACL injury rate between two different floor types - wooden floors (parquet, generally having lower friction) and artificial floors (generally having higher friction). ACL injuries have been recorded prospectively from the three top divisions for men and women in Norwegian team handball during seven seasons (1989-2000). A total of 174 ACL injuries have been recorded, and of these 53 occurred in regular league games. The floor types for all regular games from the same seasons have been determined retrospectively based on match schedules. The matches were divided into two groups: those played on wooden floors and those played on artificial floors. A total of nine injuries occurred among men (incidence: 0.24+/-0.09 injuries per 1000 player hours) and 44 among women (0.77+/-0.04 injuries 1000 h(-1); OR vs. men: 3.21 (1.56-6.58); P=0.001). Among men, four injuries occurred on wooden floors (0.32+/-0.13 injuries 1000 h(-1)) and five injuries occurred on artificial floors (0.20+/-0.12 injuries 1000 h(-1); OR vs. wooden floors: 0.63 (0.17-2.37); ns). Among women, eight injuries occurred on wooden floors (0.41+/-0.09 injuries 1000 h(-1); OR vs. men: 1.29 (0.39-4.28); ns) and 36 on artificial floors (0.96+/-0.04 injuries 1000 h(-1); OR vs. wooden floors: 2.35 (1.09-5.07); P=0.03; OR vs. men: 4.77 (1.87-12.18); P=0.001). These results indicate that the risk of ACL injury for women is higher on artificial floors than on wooden floors.

Adolescent↗
PubMed2003

Football incident analysis: a new video based method to describe injury mechanisms in professional football.

OBJECTIVES: To develop and test a new video based method for match analysis that combines football specific and medical information to achieve a better understanding of the injury mechanisms and events leading up to high risk situations. METHODS: Football incident analysis (FIA) is a video based method describing incidents that may result in an injury using 19 variables and categories modified from match analysis. Videos from 35 of 76 (46%) official Norwegian under 21 matches played from 1994 to 1998 were analysed. Two football experts classified each incident on the basis of predetermined criteria, and their results were compared using interobserver and intraobserver reliability tests. RESULTS: kappa correlation coefficients for interobserver and intraobserver agreement were very good for 63% and 95% and good for 37% and 5% of the variables respectively. Fifty two incidents were recorded (1.6 incidents per team per match or 94 per 1000 player hours), and 16 (31%) led to injuries (0.5 injuries per match or 29 injuries per 1000 player hours). FIA results showed that 28 incidents occurred while attacking in midfield zone 2 or the attacking zone, and 24 took place while defending in the defensive zone or midfield zone 1. Midfielders were exposed in 67% of the incidents, mainly in breakdown attacks or during long attacks by the opposing team. Of the 28 incidents during offence, only one was classified as having great potential to score a goal. Most incidents (70%) were the result of tackling duels both in the offensive and defensive playing phases. Of the 21 offensive incidents resulting from tackling duels, in 19 cases the exposed player was unaware of the tackling (passive duellist). CONCLUSIONS: This study shows that football incident analysis is a potentially valuable tool for understanding the events leading up to injuries in football.

Athletic Injuries↗
PubMed2002

The use of MRI scan of knee injuries in an emergency department.

We present a retrospective study of the number of arthroscopically verified total meniscus and cruciate ligament tears seen in our Emergency department one year before, and one year after introducing magnetic resonance imaging (MRI) as a diagnostic tool. The number of total ruptures of the anterior cruciate ligament increased from 34 (1.7% of total 2003 patients) to 67 (2.9% of total 2277). The number of ruptures of the medial meniscus increased from 42 (2.1%) to 87 (3.8%). The number of ruptures of the lateral meniscus remained unchanged. In the first 12 months after introducing MRI we ordered 513 (23%) scans of the total number of 2277 patients with an acute knee condition. Thirty-nine (8%) of these were described with no pathology, 227 (44%) showed total meniscus or cruciate ligament tears. The remaining 247 (48%) were mainly degenerative or partial injuries. The cost per additional new diagnosis was approximately USD 800. The introduction of MRI has enabled us to identify a larger number of patients with meniscus and cruciate ligament injuries.

Acute Disease↗
PubMed2001

Inter- and intratester comparison of the Rolimeter knee tester: effect of tester's experience and the examination technique.

Clinical knee examination is imperative for the prognosis, follow-up, and scientific comparison of anterior cruciate ligament surgery results. A new device, the Rolimeter knee tester was studied in this study with respect to inter- and intratester reliability. We found no significant difference in the intratester evaluation, and data were reliable between repeated measurements and between different testers with the same examination technique. The tester's experience seems to play a role using use the Rolimeter knee tester, but even an inexperienced tester can use it and obtain data that are very close to the data obtained by an experienced tester when the same technique is used. Furthermore, it was found that the manual examination of anterior translation also provides a reliable measurement, at least in the hand of experienced testers. Further advantages are that the Rolimeter knee tester is cheap, can be sterilized, and is simple to use.

Adult↗
PubMed2001

Neonatal lethal dwarfism with distinct skeletal malformations--a separate entity?

We describe a case of neonatal lethal dwarfism characterised by short trunk, short, stick-like tubular bones, deficient ossification of the axial skeleton and broad, sclerotic horizontal ribs. Two similar cases have previously been reported as examples of the Neu-Laxova syndrome. However, the radiological findings of the Neu-Laxova syndrome, as reported in 16 out of 40 documented cases, show a heterogeneous pattern of minor features, which differ distinctively from those found in the previous two cases and by us. A literature research did not reveal similar cases, and we therefore suggest that our case, together with the two previous cases, may represent a new distinctive form of neonatal lethal dwarfism.

Bone Diseases, Developmental↗
PubMed2001

Accuracy of pressure and flow capacities of four arthroscopic fluid management systems.

PURPOSE: The present study was conducted to evaluate 4 different fluid delivery systems: Arthrex AR-6450, Stryker 1.5L High Flow Pump, Arthro FMS 4, and Acufex InteliJet. Their flow and pressure capacity, as specified by the manufacturer, and their accuracy, as measured in a standardized fashion, were compared with directly measured pressure values. TYPE OF STUDY: Experimental study. METHODS: Two experiments were performed: (1) the achieved pressure was measured with the pressure sensor within a ball and compared with the preset pressure values. The pressure was increased constantly while the flow was kept constant. (2) maximum flow per minute was tested using a beaker and a stopwatch. RESULTS: The highest measured pressures for the Arthrex and the Stryker pumps were 115 mm Hg (46% of published maximum pressure) and 113 mm Hg (57% of published maximum pressure), respectively. The highest measured pressures for the Arthro FMS 4 and the InteliJet pumps were 251 mm Hg (101% of published pressure) and 132 mm Hg (88% of published maximum pressure), respectively. The maximal flow values for the Arthrex and Stryker pumps were 900 mL/min (56.3%) and 675 mL/min (48%), respectively. The Arthro FMS 4 and InteliJet pumps reached a maximal flow of 450 mL/min (56%) and 1,250 mL/min (62.5%). CONCLUSIONS: In the simpler pumps (Arthrex AR-6450 and Stryker 1.5L High Flow Pump), the pressure on the display must be set to higher values compared with the outflow-controlling pumps (Arthro FMS 4 and InteliJet) to achieve the same intra-articular pressure. All pumps were able to maintain a pressure of 60 mm Hg very accurately. Therefore, a surgeon can trust all of the pumps when the pressure is set below 60 mm Hg.

Arthroscopy↗
PubMed2001

The influence of perioperative soft tissue complications on the clinical outcome in surgically treated ankle fractures.

The influence of perioperative soft tissue complications on the functional outcome after open reduction and internal fixation of closed ankle fractures was investigated. Eighty-eight consecutive patients were followed 3.7 years (SD +/- 0.6) after the injury. Two major and 21 minor soft tissue complications were registered. Average dorsal extension was 29.9 degrees (range four to 54, SD +/- 9.5) of the fractured ankles and 37.2 degrees (range eight to 60, SD +/- 9.1) of the non-fractured ankles. The average subjective functional score was 84.6 (range 40 to 100, SD +/- 14.9). A significant difference was found with respect to the subjective functional score (p = 0.048, Kruskal-Wallis test) but not with respect to dorsal extension (0.358, Kruskal-Wallis test) when comparing groups of minor, major and no soft tissue complications. This study suggests that major soft tissue complications have a negative effect on the long-term functional outcome after surgical repair of an ankle fracture. Minor soft tissue complications, primary skin problems, the timing of primary surgery and fracture types according to AO/ASIF have no or minor influence on the long-term functional result. This study confirms previous reports that the presence of osteoarthritis is frequently associated with a reduced functional outcome.

Adult↗
PubMed2000

The rolimeter: a new arthrometer compared with the KT-1000.

A new simple and portable arthrometer, the Rolimeter, was used to assess the anterior laxity of knees in 20 normal subjects and 18 subjects with chronic anterior cruciate ligament (ACL) deficiency. The subjects were tested by one examiner using maximum manual force. In order to assess the reliability of the device the same subjects were tested with the KT-1000. In ACL-deficient knees the absolute translation and the side-to-side difference did not differ significantly between the devices. In normal knees the Rolimeter measured slightly smaller translations than the KT, but with a high degree of correlation between devices. If a 3-mm or greater side-to-side difference is considered indicative of ACL deficiency, both arthrometers were successful in diagnosing 16 of 18 cruciate ruptures (sensitivity 89%) and 19 of 20 normal knees (specificity 95%). We conclude that the Rolimeter, when compared with the KT-1000, provides a valid measure of anterior knee laxity.

Adolescent↗