Biomedical subjects

Lars Engebretsen

Publications and source records attributed to Lars Engebretsen.

At least 19 recordsLinked to original sources

PubMed2006

Estimating 3D joint kinematics from video sequences of running and cutting maneuvers--assessing the accuracy of simple visual inspection.

Videos of sports injuries can potentially provide valuable information on non-contact ACL injuries. However, only the un-validated simple visual inspection approach has, so far, been used. Therefore, the purpose of this study was to test the accuracy and precision of researchers in estimating kinematics from video sequences of situations that typically lead to ACL injuries. We also tested if accuracy and precision could be improved through a training program. Using a routine surface marker based infrared, 240 Hz, 3D motion analysis system, we recorded running and cutting trials from three test subjects. Six observers were asked to provide estimates of kinematic variables from 27 video composites from one, two or three ordinary cameras, systematically varying viewing angles and time point of analysis. The observers thereafter went through a training program where 35 similar composites were analyzed, and feedback on the kinematics, as measured by the 3D motion analysis system, was provided on a group basis. Finally, the test was repeated to assess accuracy and precision. The mean error for knee flexion was -19 degrees, indicating a consistent underestimation. Hip flexion was underestimated by 7 degrees, but the standard deviation between the observers was 18 degrees on average, indicating poor consistency. Substantial errors were also found in the accuracy and precision of the other estimates. Only small group effects were seen from our training program. Based on these findings, results from studies using a simple visual inspection approach to describe joint motion must be interpreted with caution.

Adult↗

PubMed2006

Mechanisms of anterior cruciate ligament injury in basketball: video analysis of 39 cases.

BACKGROUND: The mechanisms of anterior cruciate ligament injury in basketball are not well defined. PURPOSE: To describe the mechanisms of anterior cruciate ligament injury in basketball based on videos of injury situations. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Six international experts performed visual inspection analyses of 39 videos (17 male and 22 female players) of anterior cruciate ligament injury situations from high school, college, and professional basketball games. Two predefined time points were analyzed: initial ground contact and 50 milliseconds later. The analysts were asked to assess the playing situation, player behavior, and joint kinematics. RESULTS: There was contact at the assumed time of injury in 11 of the 39 cases (5 male and 6 female players). Four of these cases were direct blows to the knee, all in men. Eleven of the 22 female cases were collisions, or the player was pushed by an opponent before the time of injury. The estimated time of injury, based on the group median, ranged from 17 to 50 milliseconds after initial ground contact. The mean knee flexion angle was higher in female than in male players, both at initial contact (15 degrees vs 9 degrees , P = .034) and at 50 milliseconds later (27 degrees vs 19 degrees , P = .042). Valgus knee collapse occurred more frequently in female players than in male players (relative risk, 5.3; P = .002). CONCLUSION: Female players landed with significantly more knee and hip flexion and had a 5.3 times higher relative risk of sustaining a valgus collapse than did male players. Movement patterns were frequently perturbed by opponents. CLINICAL RELEVANCE: Preventive programs to enhance knee control should focus on avoiding valgus motion and include distractions resembling those seen in match situations.

Adolescent↗

PubMed2006

Pronociceptive and antinociceptive neuromediators in patellar tendinopathy.

BACKGROUND: The occurrence of nerve ingrowth and its relation to chronic tendon pain (tendinopathy) are still largely unknown. In healthy tendons, the innervation is confined to the paratenon, whereas the tendon proper is devoid of nerve fibers. In this study on the pathogenesis of tendinopathy, the authors examined sensory and sympathetic nerve fiber occurrence in the patellar tendon. HYPOTHESIS: Nerve ingrowth and altered expression of sensory and sympathetic neuromediators play a major role in the pathophysiology of pain in patellar tendinopathy. STUDY DESIGN: Case control study; Level of evidence, 3. METHODS: Biopsies from the patellar tendon in patients with patellar tendinopathy (n = 10) were compared with biopsies from a control group (n = 10) without any previous or current knee symptoms compatible with patellar tendinopathy. The biopsies were stained immunohistochemically for sensory and autonomic nerve markers. The biopsies from the 2 groups were compared using subjective and semiquantitative methods. RESULTS: Chronic painful patellar tendons exhibited increased occurrence of sprouting nonvascular sensory, substance P-positive nerve fibers and a decreased occurrence of vascular sympathetic nerve fibers, positive to tyroxin hydroxylase, a marker for noradrenaline. CONCLUSION: The altered sensory-sympathetic innervation suggests a role in the pathophysiology of tendinopathy. Ingrowth of sprouting substance P fibers presumably reflects a nociceptive and maybe a proliferative role, possibly as reactions to repeated microtraumata, whereas the decreased occurrence of tyroxin hydroxylase may represent a reduced antinociceptive role. These findings could be used to develop targeted pharmacotherapy for the specific treatment of tendinopathy.

Adult↗

PubMed2006

Natural history of bone bruises after acute knee injury: clinical outcome and histopathological findings.

The purpose of this paper is to review the scientific literature on the natural history of bone bruises and the experimental studies regarding the histopathological effects of impaction load on articular cartilage and subchondral bone. Bone bruises with subchondral or osteochondral injuries, or geographic bone bruises seemed to be persistent for years after trauma on MRI. Biopsy samples of the articular cartilage overlying the bone bruise lesions showed degeneration or necrosis of chondrocytes and loss of proteoglycan. Experimental studies using a single impact load revealed chondrocytes death, alteration of the mechanical properties of cartilage explants and/or an increase in the thickness of subchondral bone. These data are indicative of a significant injury to normal articular cartilage homeostasis, and support the suggestion that severe bone bruise is a precursor of early degenerative changes. We recommend delaying return to full weightbearing status when a severe bone bruise is detected to prevent further collapse of subchondral bone and further aggravation of articular cartilage injury.

Acute Disease↗

PubMed2006

[Clinical use of COX inhibitors--a consensus].

BACKGROUND: Many physicians have been uncertain about treatment options following reports that linked cyclooxygenase (COX) inhibitors to serious cardiovascular events and the subsequent withdrawal of two selective COX-2 inhibitors. Therefore, on June 14, 2005, the Norwegian Medicines Agency and the Department of Pharmacotherapeutics, University of Oslo, held an expert meeting on COX inhibitors. METHODS: Presentations and discussions based on existing literature and statements from European (EMEA) and American (FDA) medicine authorities. This constitutes the basis for the current recommendations. RESULTS AND INTERPRETATION: COX inhibitors have solely symptomatic effects, and there are no differences in analgesic and anti-inflammatory efficacy between the various COX-inhibitors. These drugs should, if possible, be used at the lowest effective dose and for as short a time as possible. Some of the COX-2 selective inhibitors show a lower incidence of gastrointestinal side effects than unselective COX inhibitors, but this advantage can be outweighed by increased occurrence of cardiovascular side effects. Generally, the cardiovascular adverse effects are more serious, and more often irreversible, than the gastrointestinal adverse effects. Patients with established or increased risk of cardiovascular disease should not use COX-2-selective inhibitors. In general, COX inhibitors should, if possible, not be administered to individuals with previous peptic ulcer disease, hypertension, heart failure, or kidney disease. There is a need for more data on the effect and safety of COX inhibitors.

Adult↗

PubMed2006

Healing of articular cartilage defects. An experimental study of vascular and minimal vascular microenvironment.

The repair potential in a chondral defect with (treatment A) or without access to bone marrow elements (treatment B) at the basis of the defect sealed by a rim-sutured periosteal flap was studied using adult New Zealand rabbits (22 weeks) as an experimental model. At sacrifice, macroscopical changes, synovial fluid contents, degree of filling, thickness of the cartilage rim, and the subchondral bone were evaluated. Histomorphometric measurements of extent of filling (mainly fibrous tissue) of the defect at 36 weeks postoperatively, showed 50% filling in treatment A compared with 33% in treatment B (p = 0.011). A difference in height of the cartilage rim between the experimental groups and sham-control was measured ( p = 0.005). Cartilage degeneration was observed at the cartilage rim of the original defect, and included loss of chondrocytes and disruption of surface continuity in both experimental groups. In addition, treatment A resulted in a significantly increased thickness of the subchondral bone in the defect in comparison to treatment B at 2 weeks and at 36 weeks (p = 0.021). The increased thickness of the subchondral bone may be of concern for the bone marrow stimulation techniques regarding the long-term outcome.

Animals↗

PubMed2006

Understanding and preventing noncontact anterior cruciate ligament injuries: a review of the Hunt Valley II meeting, January 2005.

The incidence of noncontact anterior cruciate ligament injuries in young to middle-aged athletes remains high. Despite early diagnosis and appropriate operative and nonoperative treatments, posttraumatic degenerative arthritis may develop. In a meeting in Atlanta, Georgia (January 2005), sponsored by the American Orthopaedic Society for Sports Medicine, a group of physicians, physical therapists, athletic trainers, biomechanists, epidemiologists, and other scientists interested in this area of research met to review current knowledge on risk factors associated with noncontact anterior cruciate ligament injuries, anterior cruciate ligament injury biomechanics, and existing anterior cruciate ligament prevention programs. This article reports on the presentations, discussions, and recommendations of this group.

Anterior Cruciate Ligament↗

PubMed2006

A sixteen-year follow-up of three operative techniques for the treatment of acute ruptures of the anterior cruciate ligament.

BACKGROUND: This study compares three surgical procedures that we used in the past to treat ruptures of the anterior cruciate ligament: acute primary repair, acute repair augmented with a synthetic ligament-augmentation device, and acute repair augmented with autologous bone-patellar tendon-bone graft. METHODS: This is the third report on a group of patients who were randomized to the three different procedures between 1986 and 1988. There were fifty patients in each group. The patients were evaluated prospectively at one, two, five, and sixteen years with use of the Tegner activity score and the Lysholm functional score. Stability of the knee was assessed with clinical examination and with use of the KT-1000 arthrometer. RESULTS: One hundred and twenty-nine (88%) of the 147 patients who were available for follow-up completed the study. Eleven patients (24%) who had a primary repair, four patients (10%) who had repair with a ligament augmentation device, and one patient (2%) who had augmentation with autologous bone-patellar tendon-bone graft underwent anterior cruciate ligament revisions between the primary operation and the sixteen-year follow-up examination. The rate of revision was ten times higher in the group that had primary repair than in the group that had repair with bone-patellar tendon-bone graft (p = 0.003). In the remaining patients, those who had repair with a bone-patellar tendon-bone graft had significantly more stable knees than those who had repair with a ligament augmentation device, as measured by the Lachman test (p = 0.026). Nine (11%) of the eighty-five patients for whom data were available had osteoarthritis in the primarily reconstructed knee, and three patients (3.5%) had osteoarthritis in the contralateral knee at sixteen years (p = 0.001); no difference was noted among the three groups. The mean Lysholm score at sixteen years was 88 points for the knees that had primary repair, 85 points for those that had repair with the ligament augmentation device, and 90 points for those managed with a bone-patellar tendon-bone graft (p = 0.286). CONCLUSIONS: At long-term (sixteen-year) follow-up, the rate of revision anterior cruciate ligament surgery is much higher following primary repair than after primary repair augmented by a bone-patellar tendon-bone graft. It can be expected that approximately 10% of patients undergoing anterior cruciate ligament reconstruction acutely will have osteoarthritis develop in the reconstructed knee. We no longer perform any of these surgical techniques as open procedures.

Adolescent↗

PubMed2006

Surgical treatment compared with eccentric training for patellar tendinopathy (Jumper's Knee). A randomized, controlled trial.

BACKGROUND: Although the surgical treatment of patellar tendinopathy (jumper's knee) is a common procedure, there have been no randomized, controlled trials comparing this treatment with forms of nonoperative treatment. The purpose of the present study was to compare the outcome of open patellar tenotomy with that of eccentric strength training in patients with patellar tendinopathy. METHODS: Thirty-five patients (forty knees) who had been referred for the treatment of grade-IIIB patellar tendinopathy were randomized to surgical treatment (twenty knees) or eccentric strength training (twenty knees). The eccentric training group performed squats on a 25 degrees decline board as a home exercise program (with three sets of fifteen repetitions being performed twice daily) for a twelve-week intervention period. In the surgical treatment group, the abnormal tissue was removed by means of a wedge-shaped full-thickness excision, followed by a structured rehabilitation program with gradual progression to eccentric training. The primary outcome measure was the VISA (Victorian Institute of Sport Assessment) score (possible range, 0 to 100), which was calculated on the basis of answers to a symptom-based questionnaire that was developed specifically for patellar tendinopathy. The patients were evaluated after three, six, and twelve months of follow-up. RESULTS: There was no difference between the groups with regard to the VISA score during the twelve-month follow-up period, but both groups had improvement (p < 0.001). The mean combined VISA score for the two groups increased from 30 (95% confidence interval, 25 to 35) before the start of treatment to 49 (95% confidence interval, 42 to 55) at three months, 58 (95% confidence interval, 51 to 65) at six months, and 70 (95% confidence interval, 62 to 78) at twelve months. In the surgical treatment group, five knees had no symptoms, twelve had improvement but were still symptomatic, two were unchanged, and one was worse after twelve months (p = 0.49 compared with the eccentric training group). In the eccentric training group, five knees did not respond to treatment and underwent secondary surgery after three to six months. Of the remaining fifteen knees in the eccentric training group, seven had no symptoms and eight had improvement but were still symptomatic after twelve months. CONCLUSIONS: No advantage was demonstrated for surgical treatment compared with eccentric strength training. Eccentric training should be tried for twelve weeks before open tenotomy is considered for the treatment of patellar tendinopathy.

Adult↗

PubMed2005

Prevalence of jumper's knee among elite athletes from different sports: a cross-sectional study.

BACKGROUND: The prevalence of jumper's knee across different sports has not been examined, and it is not known if there is a gender difference. Data from surgical case series indicate that there may be a high prevalence in sports with high speed and power demands. HYPOTHESIS: The aim of this study was to estimate the prevalence of jumper's knee in different sports among female and male athletes and to correlate the prevalence to the loading characteristics of the extensor mechanism in these sports. STUDY DESIGN: Cross-sectional study; Level of evidence, 4. METHODS: The authors examined approximately 50 Norwegian male and female athletes at the national elite level from each of the following 9 sports: athletics (male athletes: high jump, 100- and 200-m sprint), basketball (male athletes), ice hockey (male athletes), volleyball (male athletes), orienteering (male athletes), road cycling (male athletes), soccer (male and female athletes), team handball (male and female athletes), and wrestling (male athletes). The examination included an interview on individual characteristics (weight, age, height, and training background), a clinical examination, and self-recorded Victorian Institute of Sport Assessment score from 0 (worst) to 100 (best). RESULTS: The overall prevalence of current jumper's knee was 14.2% (87 of 613 athletes), with a significant difference between sports with different performance characteristics (range, 0%-45%). In addition, 51 athletes (8%) reported previous symptoms. The prevalence of current symptoms was highest in volleyball (44.6%+/-6.6%) and basketball (31.9%+/-6.8%), whereas there were no cases in cycling or orienteering. The prevalence of current jumper's knee was lower among women (5.6%+/-2.2%) compared with men (13.5%+/-3.0%; chi2 test, P=.042). The duration of symptoms among athletes with current jumper's knee (n=87) was 32+/-25 (standard deviation) months, with a Victorian Institute of Sport Assessment score of 64+/-19. CONCLUSION: The prevalence of jumper's knee is high in sports characterized by high demands on speed and power for the leg extensors. The symptoms are often serious, resulting in long-standing impairment of athletic performance.

Athletic Injuries↗

PubMed2005

Exercises to prevent lower limb injuries in youth sports: cluster randomised controlled trial.

OBJECTIVE: To investigate the effect of a structured warm-up programme designed to reduce the incidence of knee and ankle injuries in young people participating in sports. DESIGN: Cluster randomised controlled trial with clubs as the unit of randomisation. SETTING: 120 team handball clubs from central and eastern Norway (61 clubs in the intervention group, 59 in the control group) followed for one league season (eight months). PARTICIPANTS: 1837 players aged 15-17 years; 958 players (808 female and 150 male) in the intervention group; 879 players (778 female and 101 male) in the control group. INTERVENTION: A structured warm-up programme to improve running, cutting, and landing technique as well as neuromuscular control, balance, and strength. MAIN OUTCOME MEASURE: The rate of acute injuries to the knee or ankle. RESULTS: During the season, 129 acute knee or ankle injuries occurred, 81 injuries in the control group (0.9 (SE 0.09) injuries per 1000 player hours; 0.3 (SE 0.17) in training v 5.3 (SE 0.06) during matches) and 48 injuries in the intervention group (0.5 (SE 0.11) injuries per 1000 player hours; 0.2 (SE 0.18) in training v 2.5 (SE 0.06) during matches). Fewer injured players were in the intervention group than in the control group (46 (4.8%) v (76 (8.6%); relative risk intervention group v control group 0.53, 95% confidence interval 0.35 to 0.81). CONCLUSION: A structured programme of warm-up exercises can prevent knee and ankle injuries in young people playing sports. Preventive training should therefore be introduced as an integral part of youth sports programmes.

Adolescent↗

PubMed2005

Articular cartilage defects in a rabbit model, retention rate of periosteal flap cover.

BACKGROUND: A periosteal flap is frequently used in procedures involving repair of articular cartilage defects. Hypertrophy of the repair tissue, probably from a retained periosteum, is a clinical problem but not much is known about this issue. The objective of the present experimental study was to investigate the retention rate of periosteal flaps with respect to various postoperative mobilization regimes and the introduction of bone marrow elements underneath the flap. METHOD: We created a chondral lesion (diameter 4 mm) in both patellas of 18 New Zealand white rabbits. The subchondral bone was left intact in one knee. In the other, the bone plate was perforated, allowing bone marrow elements to enter the defect. All defects were covered with a periosteal flap, sutured and glued to the rim of the cartilage defect. Postoperatively, the rabbits were allocated to one of three groups: A. rehabilitation in cages for 4 days, then killed; B. rehabilitation in cages for 7 days, then free activity on the floor of a 10 m2 room until the end of the second week, then killed; C. rehabilitation in cages for 2 weeks, then killed. RESULTS: 16 of 23 periosteal flaps became detached within 2 weeks (one knee was excluded because of clinical signs of infection), with no difference in the retention rate with respect to mobilization regime or established access to bone marrow elements in the defect. The periosteum still served as a cover of the defect in 10 of 12 knees at day 4. This figure decreased to 7 of 23 knees at day 14. CONCLUSION: Our study is the first to document the retention rate of periosteal flaps in a rabbit model. The low retention rate observed may explain why periosteal hypertrophy is not reported in experimental studies where the periosteal flap is sutured to the cartilage rim.

Animals↗

PubMed2005

No effect of a video-based awareness program on the rate of soccer injuries.

BACKGROUND: The injury rate in soccer is high, and effective injury prevention methods are needed. PURPOSE: To test the effect of a video-based awareness program on the incidence of acute injuries in soccer. STUDY DESIGN: Randomized control trial; Level of evidence, 1. METHODS: Participants were elite male soccer players from the top 2 divisions in Iceland. Fifteen of 20 teams completed the study: 7 intervention teams (127 players) and 8 control teams (144 players) chosen by random. Just before the start of the 2000 soccer season, the intervention teams were visited with an intervention program. The program included a 15-minute presentation with information on the injury risk of playing elite soccer, typical injuries, and their mechanisms. Then the players worked together in pairs and analyzed video sequences to develop preventive strategies. The 12 video sequences were selected from the previous Icelandic soccer season, representing 3 typical injury mechanisms that accounted for more than half of all incidents recorded. During the season, team physical therapists prospectively recorded all acute injuries, and coaches recorded training exposure on a special form. Injury incidence was compared between groups and between the 1999 and 2000 seasons for teams that participated in both seasons. RESULTS: No difference was observed in injury incidence between the intervention (6.6 +/- 0.7 injuries per 1000 player hours) and control groups (6.6 +/- 0.7 injuries per 1000 player hours). Furthermore, there was no difference in injury location or type. CONCLUSION: The video-based injury awareness program showed no effect on injury rate.

Adult↗

PubMed2005

An analysis of the quality of cartilage repair studies.

BACKGROUND: Most lesions of articular cartilage do not heal spontaneously and may lead to secondary osteoarthritis. It is not known whether the optimistic reports on the short and long-term results of several different cartilage repair techniques are based on sound methodological quality. METHODS: We performed a literature search in MEDLINE, CINAHL, the Cochrane Central Register, and EMBASE and included studies in which the primary aim of the investigation was to report the outcome after cartilage repair in the knee with use of microfracture, autologous osteochondral transplantation, autologous periosteal transplantation, or autologous chondrocyte implantation. We scored the quality of the studies using a modified Coleman Methodology Score with ten criteria, which results in a final score between 0 and 100. Studies were also assessed with use of the level-of-evidence rating used in the American Volume of The Journal of Bone and Joint Surgery. We collected data on the year of publication, the reported postoperative results, and the outcome measures used to assess the results. RESULTS: Sixty-one studies involving a total of 3987 surgical procedures were included. The average methodology score was 43.5 of 100. Methodological deficiencies were found with respect to five criteria: the type of study, description of the rehabilitation protocol, outcome criteria, outcome assessment, and subject selection process. Large variations in the reported outcome were seen within each treatment modality, and no significant differences were found between each kind of therapy (p = 0.11). The methodology score correlated positively with the level-of-evidence rating (r = 0.668, p < 0.0001), but there were large variations in the methodology score within each level. The linear regression analysis weighted by the number of patients demonstrated a negative yet not significant correlation between the methodology score and the results reported in nineteen studies with use of the Lysholm Scale (r = -0.29, p = 0.19). A total of twenty-seven different clinical outcome measurement scales were used to assess outcome. CONCLUSIONS: The generally low methodological quality found in the studies included in this analysis indicates that caution is required when interpreting results after surgical cartilage repair. Firm recommendations on which procedure to choose cannot be given at this time on the basis of these studies. More attention should be paid to methodological quality when designing, performing, and reporting clinical studies. LEVEL OF EVIDENCE: Therapeutic Level III.

Cartilage, Articular↗

PubMed2004

An analysis of an anatomical posterolateral knee reconstruction: an in vitro biomechanical study and development of a surgical technique.

BACKGROUND: To date, no surgical technique to treat posterolateral knee instability anatomically reconstructs the 3 major static stabilizing structures of the posterolateral knee: the fibular collateral ligament, the popliteus tendon, and the popliteofibular ligament. HYPOTHESIS: Static varus and external rotatory stability would be restored to the reconstructed knee with a posterolateral knee injury. METHODS: The anatomical locations of the original fibular collateral ligament, popliteus tendon, and popliteofibular ligament were reconstructed using a 2-graft technique. Ten cadaveric specimens were tested in 3 states: intact knee, knee with the 3 structures cut to simulate a grade III injury, and the reconstructed knee. RESULTS: For the varus loading tests, joint stability was significantly improved by the posterolateral reconstruction compared to the cut state at 0 degrees, 30 degrees, 60 degrees, and 90 degrees of flexion. There were no significant differences between the intact and reconstructed knees at 0 degrees, 60 degrees, and 90 degrees for varus translation. For the external rotation torque tests, external rotation was significantly higher for the cut state than for the intact or reconstructed posterolateral knee. There was no significant difference in external rotation between the intact and reconstructed posterolateral knees at any flexion angle. CONCLUSIONS: This 2-graft technique to reconstruct the primary static stabilizers of the posterolateral knee restored static stability, as measured by joint translation in response to varus loading and external rotation torque, to knees with grade III posterolateral injuries.

Aged↗

PubMed2004

A prospective video-based analysis of injury situations in elite male football: football incident analysis.

BACKGROUND: The mechanisms for football injuries are largely unknown. AIM: To describe the characteristics of injury situations in elite male football using a video-based method called football incident analysis. STUDY DESIGN: Prospective cohort study. METHODS: During the 1999 season, videotapes from 52 matches in the Icelandic elite football league were reviewed. Incidents (N = 95) were recorded when the match was interrupted by the referee because of a suspected injury. Team physical therapists recorded injuries prospectively (N = 28 time-loss injuries). RESULTS: Duels caused 84 of the incidents, mostly tackling duels (n = 54). The exposed player's attention appeared to be focused away from the opponent in 93% of the cases. The 3 main mechanisms observed were (1) breakdown attacks, tackling from the side or the front, attention focused on the ball (24%); (2) defensive tackling duels, attention focused on the ball or low ball control (20%); and (3) heading duels, attention focused on the ball in the air (13%). CONCLUSION: Most incidents and injuries occurred during breakdown attacks and when a player was involved in tackling duels. Player attention appeared to be focused mainly on the ball, not on the opponent challenging him to gain ball possession.

Adult↗

PubMed2004

[Knee luxation--follow-up after surgery].

BACKGROUND: Traumatic dislocation is the most severe ligamentous injury of the knee. The traditional definition of knee dislocations has been expanded to include bicruciate knee injuries with one or both lateral ligaments injured, even when the knee is reduced on initial presentation. Surgical treatment is internationally well accepted. MATERIAL AND METHODS: From 1996 to 2002, 87 patients with knee dislocation were treated in our department. In this prospective study, 55 patients were followed up with functional knee tests a minimum of one year (mean: 3.5 years) after surgical treatment. RESULTS: 59% of the injuries were high-energy traumas. Mean age was 34 (12-80). 57% of the patients achieved excellent to good results on the Lysholm Score. INTERPRETATION: Positive prognostic factors are likely to be age less than 40 at the time of the accident or sports-related injury. Fifty-four of the 55 patients in the follow-up study had returned to work or studies after one year. Dislocated knee is not only related to high-energy and traffic injuries; it also occurs in low-energy trauma and sports injuries.

Adolescent↗

PubMed2004

[Surgery for anterior cruciate ligament injuries in Norway].

BACKGROUND: There is limited knowledge about the incidence and type of anterior cruciate ligament surgery in Norway. MATERIAL AND METHODS: We sent a questionnaire to all surgical and orthopaedic departments in Norwegian hospitals and clinics (n = 83) on the status quo for anterior cruciate ligament surgery in 2002. All replied. RESULTS: 1876 anterior cruciate ligament operations were carried out in 2002 by 50 hospitals and clinics. More than half of the hospitals carried out 20 or more operations. Patellar tendon autograft or hamstring autograft were used in 1805 of the operations. Only four hospitals did all procedures as outpatient surgery; 11 hospitals still use continuous passive motion on patients after anterior cruciate ligament surgery. Large variations were found in time to return to full physical activity. INTERPRETATION: There are large variations between Norwegian hospitals in the practice of anterior cruciate ligament surgery.

Aged↗