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Biomedical subjects

J Gillquist

Publications and source records attributed to J Gillquist.

At least 199 records · Page 11Linked to original sources

The frequency of muscle tightness and injuries in soccer players.

One hundred-eighty players in a male, senior soccer division were examined for past injuries, persisting symptoms from past injuries, and muscular tightness in the lower extremities. Soccer players were in general less flexible than a group of nonplayers of the same age (n = 86). No correlation was found between past injuries and existing muscle tightness. Sprains of the lower extremity, especially of knees and ankles, predominated among the injuries. Persistent instability symptoms were common sequels to knee and ankle injuries. It is proposed that intensive care of acute injuries will improve the late results.

Adolescent↗

Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale.

We have designed a scoring scale for knee ligament surgery follow-up emphasizing evaluation of symptoms of instability. Instability is defined as "giving way" during activity. Our scoring scale was compared to a slightly modified Larson scale in patients with anteromedial and/or anterolateral instability, posterolateral and straight posterior instability, chondromalacia patellae, and meniscus lesion. The two scales gave basically the same results in patients with meniscus rupture. In patients with unstable knees, the new scale gave a significantly lower total score. Thus, the new scale evaluates functional impairment due to clinical instability better than the modified Larson scale. The total score, with the new scoring scale, corresponded to the patients' own opinion of function and to the presence or absence of signs of instability.

Athletic Injuries↗

Incidence of soccer injuries and their relation to training and team success.

One hundred-eighty players in a male soccer senior division of 12 teams were observed prospectively for 1 year to study the risk of soccer injuries in relation to exposure and to establish the connection between training, injuries, and team success. Totally, more than 100 hours of practice were analyzed. All injuries were examined by the same orthopaedic surgeon. On the average, each team played 36 games and had 95 practice sessions with 66% attendance of selected players. A direct correlation was noted between team success and the amount of training. Teams with more than average training showed a diminishing number of injuries. A high practice-to-game ratio seems to be advantageous. One injury every third game and every ninth practice session was documented. For the individual player the incidence of injury was 7.6/1000 practice hours and 16.9/1000 game hours. The incidence of injury was higher at training camps. Correlation was noted between the design of the training and the incidence of injuries. The duration of warming up seemed adequate, but its content did not appear to be satisfactory from a clinical point of view. Redesign of the warm-up with more emphasis on flexibility and the addition of a cool-down is suggested to reduce injuries.

Adolescent↗

Prevention of soccer injuries. Supervision by doctor and physiotherapist.

To study the efficacy of an injury prevention program in a randomized trial, 12 teams (180 players) in a male senior soccer division were followed up for 6 months. The 12 teams were allocated at random to two groups of six teams, one being given a prophylactic program and the other serving as control. The program was based on previous studies of injury mechanisms. It comprised (1) correction of training, (2) provision of optimum equipment; (3) prophylactic ankle taping; (4) controlled rehabilitation; (5) exclusion of players with grave knee instability; (6) information about the importance of disciplined play and the increased risk of injury at training camps; and (7) correction and supervision by doctor(s) and physiotherapist(s). The injuries in the test teams were 75% fewer than in the controls. The most common types of soccer injuries, sprains and strains to ankles and knees, were all significantly reduced. It is concluded that the proposed prophylactic program, including close supervision and correction by doctors and physiotherapists, significantly reduces soccer injuries.

Adolescent↗

Effects of warming up, massage, and stretching on range of motion and muscle strength in the lower extremity.

The effects of general warming up, massage, and stretching on ranges of motion (ROM) and strength of quadriceps and hamstring muscles were measured in eight male volunteers. Thigh muscle strength was not influenced by the experimental procedures. Stretching resulted in a significantly increased range of hip flexion/extension, hip abduction, knee flexion, and ankle dorsiflexion; the effect was significantly greater than that obtained by massage and warming up separately or combined. Only ankle dorsiflexion was influenced by massage or warming up, whereas stretching affected all muscle groups tested. Stretching was, therefore, superior to the other methods tested for increasing flexibility in the lower extremity.

Biomechanical Phenomena↗

The effect of diagnostic and operative arthroscopy and open meniscectomy on muscle strength in the thigh.

In this study we measured the effect on the muscle strength in the thigh in connection with diagnostic arthroscopy with central approach, arthroscopy with arthroscopic operation of bucket-handle ruptures, flap tears, total arthroscopic meniscectomy, and open meniscectomy. Thirty-seven patients were tested preoperatively and 1, 4 and 8 weeks postoperatively with a Cybex II isokinetic dynamometer. The extensor muscles of the knee joint were most affected. The flexor muscles were generally recovered in all groups within a month. Diagnostic arthroscopy and arthroscopic operations for bucket-handle ruptures showed no significant effect on the thigh muscle torque. With the other arthroscopic operations there was a 40% decrease of quadriceps function 1 week after operation. After 8 weeks normal function returned. Open meniscectomy had a much more negative effect on the quadriceps muscle with a decrease of about 70% after 1 week. After 8 weeks, the rehabilitation was still not complete.

Adolescent↗

Arthroscopic meniscectomy in athletes.

Twenty arthroscopic meniscectomies were done in 19 patients (mean age 24 years). Twelve medial and eight lateral meniscus lesions were treated. In one patient, both a medial and a lateral meniscus tear were treated at the same time. There were 9 total meniscectomies and 11 partial. All patients were international or national top athletes. Arthroscopy was performed using the anterior midline approach. Arthroscopic meniscectomy was done by means of triangulation technique. Sixty-eight percent resumed their full athletic training and competition in 2 weeks or less. At followup 14.3 +/- 9.4 months after surgery, 74% had an excellent result (full activity, no symptoms) and 21% a good result (full activity, minimal symptoms). One international top weight lifter had to be reoperated on twice because of tearing of the meniscus remnant after partial meniscectomy. Our conclusion is that the result after arthroscopic meniscectomy in athletes is good with a short rehabilitation period. Under extreme circumstances, early strenuous activities might lead to a retear in the meniscus remnant after partial meniscectomy.

Adult↗

The effect of a patella brace on performance in a knee extension strength test in patients with patellar pain.

The object of this study was to analyze the quadriceps muscle peak strength with the Cybex-II isokinetic dynamometer in patients with patellofemoral arthralgia with and without a patella brace. Twenty-four patients, 18 women and 6 men, were studied. All had patellofemoral arthralgia. The diagnosis was made on typical clinical findings, but was supplemented with arthroscopy in seven patients with pain also over the medial joint line. After a 2 week adaptation period with the brace, a Cybex-II test was done with and without the brace. The other leg was tested as control. Twenty-one patients (88%) improved their performance in the strength test with the brace (mean difference 13.7 +/- 9.1%). With the brace, 14 patients (58%) performed at 95% of their control leg or more compared to 6 (25%) without the brace. Patients under the age of 30 years had a better effect than patients over that age.

Adolescent↗

Factors affecting stabilometry recordings of single limb stance.

Stabilometry is an objective method for the quantitative study of postural equilibrium and has previously been shown to correlate to functional instability of the ankle joint. Stabilometric recordings of 25 soccer players did not confirm existing theories that an ankle joint injury itself produces a functional instability. Stabilometric recordings of 38 soccer players with and without ankle taping did not show that taping influenced the stabilometric values. In 10 soccer players with functional instability, a significant improvement of stabilometric results and subjective "giving way" feelings were found after 6 weeks of coordination on an ankle disk.

Acute Disease↗

Muscle rehabilitation after arthroscopic meniscectomy with or without tourniquet control. A preliminary randomized study.

Nineteen patients with isolated meniscus lesions were randomly assigned to operation with or without tourniquet. All patients underwent arthroscopic meniscectomy. Measurements of CK (creatinin-kinase), CK-B (isoenzymes MB of creatinin-kinase), LD (lactate dehydrogenase), ASAT (aspartate aminotransferase), and ALAT (alanine aminotransferase) were performed preoperatively and postoperatively over 6 days. The muscle torque was measured on a Cybex II isokinetic dynamometer preoperatively, 1 week and 4 weeks postoperatively. The mean CK level rose significantly in both groups, but did not pass the upper normal serum level. There was no effect on the other muscle enzymes. Quadriceps torque was significantly lowered in both groups 1 week after operation. Four weeks postoperatively, it was still lowered in the nontourniquet group, which also had a slower increase in torque between weeks 1 and 4 than the tourniquet groups. There was no effect from the operation on isometric or hamstrings torque. The slight rise in CK was similar to that seen after hard physical exercise. The decrease in muscle torque was, therefore, mostly due to pain inhibition. The slightly slower rehabilitation in the nontourniquet group may be caused by the technique of raising saline flow and pressure during the arthroscopy to control bleeding. This causes extravasation of fluid which may increase postoperative pain and stiffness.

Adult↗

The course of partial anterior cruciate ligament ruptures.

In a prospective study 21 consecutive patients were followed up for an average of 6 years after partial tear of the anterior cruciate ligament (ACL) diagnosed by clinical examination and arthroscopy. The ACL tear was treated conservatively and associated lesions were sutured. At followup a knee function score was recorded. The maximum possible score was 100 points. The mean score at followup was 93 +/- 6 points. All patients were classified as good or excellent. Three knees were unstable at followup, but the score was not impaired. With a partial tear of the ACL the course is benign and the long-term result good, in contrast to total ruptures of ACLs. It is, therefore, important to make an accurate diagnosis in order to choose the proper treatment.

Accidents, Occupational↗

Prevention of ankle sprains.

Two different methods for the prevention of ankle joint injuries in soccer were tested. Coordination training on an ankle disk improves functional stability and postural control, whereas an orthosis provides mechanical support. Both techniques reduce the frequency of ankle sprains in soccer players with previous ankle problems. The orthosis is an alternative to taping, and can be used during the rehabilitation period after injury or when playing on uneven ground. Coordination training on an ankle disk ought to be included in the rehabilitation of ankle injuries to prevent functional instability. It may also be done prophylactically by players with previous ankle problems in order to break the vicious circle of recurrent sprains and feeling of giving way.

Ankle Injuries↗

A performance test to monitor rehabilitation and evaluate anterior cruciate ligament injuries.

A performance test simulating components of sports was devised to evaluate dysfunction after ACL injury. The test included a one-leg hop, running in a figure of eight (straight running and turn running measured separately), running up and down a spiral staircase, and running up and down a slope. Twenty-six men with ACL injury, most of them soccer players, and 66 uninjured male soccer players were studied. Patients with ACL injury performed significantly less well than the uninjured players. Test items of special interest were turn running in the figure of eight, stair running, and slope running, all of which place high demand on the knee. It is concluded that a performance test of this design is useful for monitoring rehabilitation and for evaluating the patient's condition. Before sports can be resumed at the original level, normal strength and normal performance should be regained.

Adolescent↗

A multicenter study on the results of anterior cruciate ligament reconstruction using a Dacron ligament prosthesis in "salvage" cases.

A multicenter study is presented on 80 patients who underwent ACL reconstruction using a Dacron (E.I. Du Pont de Nemours and Co., Wilmington, DE) ligament prosthesis. Patient selection was based on a history of a failed autologous reconstruction and/or primary repair of the ACL. These selection criteria are unique and have not been previously reported in the literature. The frequency of prior intraarticular ACL surgery was 1.24 procedures per patient and 1.68 when combined with prior extraarticular reconstructions. Forty-one patients had a mean followup of 28 months (24 to 42 months). The mean followup for all of the patients was 21 months. The graft was augmented with autologous tissue in 59 cases and used as a pure prosthesis in the rest. Functionally, the mean Lysholm score improved from 40 to 81 points. The percentage of a combined excellent/good Lysholm rating increased from 6% to 60%. The Tegner activity rating level improved from 2 to 4. The percentage of a negative Lachman sign, anterior drawer, and pivot shift was approximately 75% at followup. There was no significant difference between the results of augmentation and nonaugmentation cases, indicating that the graft acts as a permanent prosthesis rather than as a scaffold or stint. The patients showed a significant improvement considering their preoperative global instability.

Adult↗

The long-term course after treatment of acute anterior cruciate ligament ruptures. A 9 to 16 year followup.

Acute total ACL (N = 60) and concomitant medial collateral ligament (N = 46) ruptures were repaired in 60 patients (mean age, 28 years) without augmentation. Menisci were removed in 23 knees. Fifty-three (88%) of the patients were reexamined 9 to 16 years later with special emphasis on manual and instrumented stability testing (Stryker, Genucom), knee function score (Lysholm), and activity level (Tegner). Standing roentgenograms (30 degrees of knee flexion) were taken in 69% of the patients. At followup, an ACL reconstruction had been performed in seven patients (12%) due to symptomatic instability. Sixty-four percent of the knees had a positive Lachman sign and 40% a positive pivot shift. Sagittal laxity difference was +3 mm or more in 57%. Knee function score was a mean of 86 +/- 12 points. The mean activity level had changed from recreational team sports (Level 7) to recreational individual sports (Level 5). Only patients with good knee stability were able to perform demanding sports and could continue at their desired activity level. Osteoarthritis of slight to moderate degree (Fairbank I/II) was found in 58% of the patients younger than 35 years of age at the time of trauma and in 87% of the older patients. Knees with intact menisci had less osteoarthritis than knees with removed menisci (P less than 0.05).

Adolescent↗

Treatment of acute isolated and combined ruptures of the anterior cruciate ligament. A long-term follow-up study.

From a total of 293 patients who had an acute, complete anterior cruciate ligament rupture, we selected all patients (N = 55) who had an anterior cruciate ligament rupture without associated meniscal or ligamentous injuries, and all patients (N = 52) who had an anterior cruciate ligament rupture combined with a rupture, and subsequent primary repair, of the medial collateral ligament. Initially, all patients were assigned to one of two groups: conservative treatment of the anterior cruciate ligament or augmented anterior cruciate ligament repair with the iliotibial band. In the 52 patients who had an anterior cruciate ligament rupture combined with a medial collateral ligament rupture, the associated injuries to the medial collateral ligament and sometimes the posterior oblique ligament, meniscus, and arcuate ligament complex were treated in a similar fashion, without regard to the treatment of the anterior cruciate ligament. Ninety-nine patients (93%) were reexamined 35 to 74 months after the injury, and knee function was evaluated with subjective and objective criteria, including functional tests. Patients who had been treated with augmented anterior cruciate ligament repair had superior stability with better subjective results and returned to strenuous activities more frequently than patients who had undergone conservative treatment. In those patients who had augmented repair, the prognosis did not differ between those who had isolated lesions and those who had combined lesions. Conservative treatment of the anterior cruciate ligament with repair of the medial collateral ligament and other associated injuries, when present, resulted in an almost equally unfavorable outcome for patients with combined and isolated anterior cruciate ligament lesions.

Acute Disease↗

The effect of a meniscal prosthesis on knee biomechanics and cartilage. An experimental study in rabbits.

A meniscal prosthesis made of Dacron with polyurethane coating was tested as a substitute for the medial meniscus in a rabbit experimental model concentrating on biomechanical behavior of the knee joint and gross and histologic evaluation 3 months after surgery. The results were compared to sham-operated knees, knees with a peripheral incision of the medial meniscus, and knees with a total meniscectomy. Knees with prosthesis implantation had the same stiffness as knees with sham-operation or meniscal incision, but knees with meniscectomy were stiffer (P less than 0.05). Knees with prosthesis showed lower energy storage during relaxation than knees with sham-operation or meniscal incision (P less than 0.05). Energy storage in the prosthesis group was similar to the meniscectomy group. Partial or total ingrowth of synovial tissue into the prosthesis was present in 93%, and 63% of the incised menisci had healed. Cartilage changes were present in 70% of the prosthesis group, in 25% of the knees with meniscal incision, and in all knees with meniscectomy. The sham-operated knees were free from cartilage degeneration. Knees with prosthesis had the same frequency of cartilage changes on the femur, but had less changes on the tibia compared to knees with meniscectomy. A high rate of osteophyte formation was observed after prosthesis implantation as well as following meniscectomy, but the osteophytes were larger in the prosthesis group (P less than 0.01). The most frequent and severe effect on the synovium was found in the prosthesis group (92%), but no foreign body reaction or loose Dacron particles were found.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗