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  • 1.
    Ardern, Clare L.
    et al.
    Linkoping Univ, Div Physiotherapy, Linkoping, Sweden.;Aspetar Orthopaed & Sports Med Hosp, Doha, Qatar.;La Trobe Univ, Sch Allied Hlth, Melbourne, Vic, Australia..
    Österberg, Annika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Linkoping Univ, Div Physiotherapy, Linkoping, Sweden..
    Sonesson, Sofi
    Linkoping Univ, Div Physiotherapy, Linkoping, Sweden..
    Gauffin, Håkan
    Linkoping Univ, Dept Orthopaed, Linkoping, Sweden..
    Webster, Kate E.
    La Trobe Univ, Sch Allied Hlth, Melbourne, Vic, Australia..
    Kvist, Joanna
    Linkoping Univ, Div Physiotherapy, Linkoping, Sweden..
    Satisfaction With Knee Function After Primary Anterior Cruciate Ligament Reconstruction Is Associated With Self-Efficacy, Quality of Life, and Returning to the Preinjury Physical Activity2016In: Arthroscopy: The Journal of Arthroscopy And Related, ISSN 0749-8063, E-ISSN 1526-3231, Vol. 32, no 8, p. 1631-+Article in journal (Refereed)
    Abstract [en]

    Purpose: To assess whether patient-reported outcomes (psychological factors, appraisals of knee function, and physical activity participation) were associated with satisfaction with knee function after anterior cruciate ligament (ACL) reconstruction. Methods: Participants who were aged 18 to 45 years and a minimum 12 months post primary ACL reconstruction completed a questionnaire battery evaluating knee self-efficacy, knee-related quality of life, self-reported function, and physical activity participation. Participants' responses to the question "If you were to spend the rest of your life with your knee just the way it has been in the last week, would you feel.... (7-point ordinal scale; 1 = happy, 7 = unhappy)" were categorized as satisfied, mostly satisfied, or dissatisfied and used as the primary outcome. Ordinal regression was used to examine associations between independent variables and the primary outcome. Results: A total of 177 participants were included at an average of 3 years after primary ACL reconstruction. At follow-up, 44% reported they would be satisfied, 28% mostly satisfied, and 28% dissatisfied with the outcome of ACL reconstruction. There were significant differences in psychological responses and appraisal of knee function between the 3 groups (P = .001), and significantly more people in the satisfied group had returned to their preinjury activity (58%) than in the mostly satisfied (28%) and dissatisfied (26%) groups (P = .001). Multivariable analysis demonstrated that the odds of being satisfied increased by a factor of 3 with higher self-efficacy, greater knee-related quality of life, and returning to the preinjury activity. Conclusions: People who had returned to their preinjury physical activity and who reported higher knee-related self-efficacy and quality of life were more likely to be satisfied with the outcome of ACL reconstruction.

  • 2. Schollin-Borg, Maria
    et al.
    Michaëlsson, Karl
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
    Rahme, Hans
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
    Presentation, outcome, and cause of septic arthritis after anterior cruciate ligament reconstruction: a case control study2003In: Arthroscopy: The Journal of Arthroscopy And Related, ISSN 0749-8063, E-ISSN 1526-3231, Vol. 19, no 9, p. 941-7Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The objective of this study was to examine clinical presentation and medium-term outcome of patients with septic arthritis of the knee after anterior cruciate ligament (ACL) reconstruction. TYPE OF STUDY: Matched case control study. METHODS: From a consecutive case series of 575 patients who underwent ACL reconstruction from 1996 through 1999, we report on 10 patients (1.7%) with postoperative septic arthritis. These patients were compared with individually matched patients without infection, on average, 3 years after surgery. The examination included physical and radiographic evaluation, functional testing, KT-1000, Lysholm and Tegner scales, and the International Knee Documentation Committee (IKDC) and Knee Injury and Osteoarthritis Outcome Score (KOOS) form. RESULTS: The predominant clinical presentation among patients with septic arthritis was modest classic signs of local infection. However, all had fever and elevated sedimentation rate or high C-reactive protein. Bacterial cultures showed coagulase-negative Staphylococcus species in 6, Staphylococcus aureus in 1, and Propionibacteriaceae species in 1 patient. The diagnosis was established with a delay of approximately 5 days. All patients underwent arthroscopic debridement and lavage (2 cases) or continuous irrigation (8 cases), as well as antibiotic treatment. One experienced graft rupture caused by the infection. At the end of the follow-up evaluation, the infected patients reported significantly lower activity levels than the control subjects (mean Tegner score, 5.3 v 7.2, P =.03). No statistically significant differences were noted in mean Lysholm, IKDC, or KOOS scores, or in KT-1000 difference. Two infected patients scored lower on the Tegner and Lysholm scales postoperatively than they did preoperatively. When examining the causes of infection, we found contamination by coagulase-negative Staphylococcus on supposedly sterile suture clamps on 3 graft preparation boards. CONCLUSIONS: In cases of suspected septic arthritis after ACL reconstruction, laboratory studies and aspiration followed by culture testing should be performed liberally to avoid the otherwise frequently delayed diagnosis. The inferior postoperative activity level noted in infected patients appeared not to be secondary to graft failure but may be related to arthrofibrosis, cartilage damage, or recurring postinfectious meniscal tears.

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