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Articles by G Myklebust
Total Records ( 3 ) for G Myklebust
  A. H Engebretsen , G Myklebust , I Holme , L Engebretsen and R. Bahr

Background: This study was conducted to determine if risk factors for groin injuries among male soccer players could be identified.

Hypothesis: Previous groin injuries, reduced function scores, age, findings on clinical examination, and low isometric groin strength are associated with increased risk of new groin injuries.

Study Design: Cohort study; Level of evidence, 3.

Methods: A total of 508 players representing 31 amateur teams were tested during the 2004 preseason for potential risk factors for groin injury through a questionnaire on previous injury and function score (Groin Outcome Score [GrOS]) and a clinical examination of the groin. Generalized estimating equations were used in univariate analyses to identify candidate risk factors, and factors with a P value <.10 were then examined in a multivariate model.

Results: During the soccer season, 61 groin injuries affecting 55 legs (51 players) were registered. The total incidence of groin injuries was 0.6 injuries per 1000 playing hours (95% confidence interval [CI], 0.4-0.7), 0.3 injuries per 1000 training hours (95% CI, 0.2-0.4), and 1.8 injuries per 1000 match hours (95% CI, 1.2-2.5). In a multivariate analysis, previous acute groin injury (adjusted odds ratio [OR], 2.60; 95% CI, 1.10-6.11) and weak adductor muscles as determined clinically (adjusted OR, 4.28; 95% CI, 1.31-14.0) were significantly associated with increased risk of groin injuries. A multivariate analysis based only on acute time-loss injuries revealed the 40-m sprint test result (adjusted OR, 2.03 for 1 standard deviation change [injured group faster]; 95% CI, 1.06-3.88; P = .03) and functional testing of the rectal abdominal muscles (adjusted OR, 15.5 [painful in 19% of the players in the injured group compared to 16% in the uninjured group]; 95% CI, 1.11-217; P = .04) as significant risk factors.

Conclusion: A history of acute groin injury and weak adductor muscles are significant risk factors for new groin injuries.

  B. E Oiestad , I Holm , A. K Aune , R Gunderson , G Myklebust , L Engebretsen , M. A Fosdahl and M. A. Risberg

Background: Few prospective long-term studies of more than 10 years have reported changes in knee function and radiologic outcomes after anterior cruciate ligament (ACL) reconstruction.

Purpose: To examine changes in knee function from 6 months to 10 to 15 years after ACL reconstruction and to compare knee function outcomes over time for subjects with isolated ACL injury with those with combined ACL and meniscal injury and/or chondral lesion. Furthermore, the aim was to compare the prevalence of radiographic and symptomatic radiographic knee osteoarthritis between subjects with isolated ACL injuries and those with combined ACL and meniscal and/or chondral lesions 10 to 15 years after ACL reconstruction.

Study Design: Cohort study; Level of evidence, 2.

Methods: Follow-up evaluations were performed on 221 subjects at 6 months, 1 year, 2 years, and 10 to 15 years after ACL reconstruction with bone-patellar tendon-bone autograft. Outcome measurements were KT-1000 arthrometer, Lachman and pivot shift tests, Cincinnati knee score, isokinetic muscle strength tests, hop tests, visual analog scale for pain, Tegner activity scale, and the Kellgren and Lawrence classification.

Results: One hundred eighty-one subjects (82%) were evaluated at the 10- to 15-year follow-up. A significant improvement over time was revealed for all prospective outcomes of knee function. No significant differences in knee function over time were detected between the isolated and combined injury groups. Subjects with combined injury had significantly higher prevalence of radiographic knee osteoarthritis compared with those with isolated injury (80% and 62%, P = .008), but no significant group differences were shown for symptomatic radiographic knee osteoarthritis (46% and 32%, P = .053).

Conclusion: An overall improvement in knee function outcomes was detected from 6 months to 10 to 15 years after ACL reconstruction for both those with isolated and combined ACL injury, but significantly higher prevalence of radiographic knee osteoarthritis was found for those with combined injuries.

  H Koga , A Nakamae , Y Shima , J Iwasa , G Myklebust , L Engebretsen , R Bahr and T. Krosshaug

Background: The mechanism for noncontact anterior cruciate ligament injury is still a matter of controversy. Video analysis of injury tapes is the only method available to extract biomechanical information from actual anterior cruciate ligament injury cases.

Purpose: This article describes 3-dimensional knee joint kinematics in anterior cruciate ligament injury situations using a model-based image-matching technique.

Study Design: Case series; Level of evidence, 4.

Methods: Ten anterior cruciate ligament injury video sequences from women’s handball and basketball were analyzed using the model-based image-matching method.

Results: The mean knee flexion angle among the 10 cases was 23° (range, 11°-30°) at initial contact (IC) and had increased by 24° (95% confidence interval [CI], 19°-29°) within the following 40 milliseconds. The mean valgus angle was neutral (range, –2° to 3°) at IC, but had increased by 12° (95% CI, 10°-13°) 40 milliseconds later. The knee was externally rotated 5° (range, –5° to 12°) at IC, but rotated internally by 8° (95% CI, 2°-14°) during the first 40 milliseconds, followed by external rotation of 17° (95% CI, 13°-22°). The mean peak vertical ground-reaction force was 3.2 times body weight (95% CI, 2.7-3.7), and occurred at 40 milliseconds after IC (range, 0-83).

Conclusion: Based on when the sudden changes in joint angular motion and the peak vertical ground-reaction force occurred, it is likely that the anterior cruciate ligament injury occurred approximately 40 milliseconds after IC. The kinematic patterns were surprisingly consistent among the 10 cases. All players had immediate valgus motion within 40 milliseconds after IC. Moreover, the tibia rotated internally during the first 40 milliseconds and then external rotation was observed, possibly after the anterior cruciate ligament had torn. These results suggest that valgus loading is a contributing factor in the anterior cruciate ligament injury mechanism and that internal tibial rotation is coupled with valgus motion. Prevention programs should focus on acquiring a good cutting and landing technique with knee flexion and without valgus loading of the knee.

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