Long-term consequences of anterior cruciate ligament injury

.................................................................................................. 7 SVENSK SAMMANFATTNING ....................................................................... 9 ABBREVIATIONS ...................................................................................... 11 ORIGINAL PAPERS ................................................................................... 12 INTRODUCTION ........................................................................................ 13 ANTERIOR CRUCIATE LIGAMENT INJURY ................................................... 13 Treatment ............................................................................................ 14 LONG-TERM CONSEQUENCES OF AN ACL INJURY.......................................... 15 Self-reported knee function, physical activity level and fear of movement/reinjury ................................................................................................... 15 Physical capacity ................................................................................... 16 Osteoarthritis ........................................................................................ 16 MOVEMENT PATTERN ......................................................................... 20 MEASURING KNEE FUNCTION ................................................................ 20 RATIONALE FOR THIS THESIS ................................................................ 22 AIMS OF THE THESIS ................................................................................ 24 METHODS.................................................................................................. 25 OVERVIEW OF THE PAPERS................................................................... 25 PARTICIPANTS ................................................................................ 25 Study sample ....................................................................................... 25 Treatment in the ACLR group .................................................................. 27 Treatment in ACLPT group ....................................................................... 28 Controls ............................................................................................... 28 TEST PROCEDURE ............................................................................. 28 ASSESSMENT AND DATA ANALYSIS .......................................................... 29 Self-reported knee function, physical activity level and fear of movement/reinjury ................................................................................................... 29 Physical capacity ................................................................................... 30 Movement pattern ................................................................................. 32 Knee OA and knee joint laxity ................................................................. 32 ETHICS ........................................................................................ 33 STATISTICS ................................................................................... 33 RESULTS ................................................................................................... 35 SELF-REPORTED KNEE FUNCTION, PHYSICAL ACTIVITY LEVEL AND FEAR OF MOVEMENT/RE-INJURY ....................................................................... 35 PHYSICAL CAPACITY .......................................................................... 35 MOVEMENT PATTERN DURING ONE-LEG HOP ............................................... 39 CONTROLS .................................................................................... 39 DISCUSSION ............................................................................................. 42 LONG-TERM CONSEQUENCES OF AN ACL INJURY.......................................... 42 Self-reported knee function, physical activity level and fear of movement/reinjury ................................................................................................... 42 Physical capacity ................................................................................... 45 Movement pattern ................................................................................. 48 MEASURING KNEE FUNCTION ................................................................ 50 METHODOLOGICAL CONSIDERATIONS ...................................................... 51 CLINICAL IMPLICATIONS AND FURTHER RESEARCH ........................................ 53 CONCLUSIONS .......................................................................................... 55 TACK ......................................................................................................... 56 REFERENCES ............................................................................................. 58 APPENDIX................................................................................................. 68 DISSERTATIONS ....................................................................................... 69