Asbjørn Årøen

• Randsborg, Per-Henrik; Brinchmann, Jan Engelsen; Owesen, Christian; Engebretsen, Lars; Birkenes, Thomas & Hanvold, Heidi Andreassen [Vis alle 8 forfattere av denne artikkelen] (2024). Autologous Chondrocyte Implantation Is Not Better Than Arthroscopic Debridement for the Treatment of Symptomatic Cartilage Lesions of the Knee: Two-Year Results From a Randomized-Controlled Trial. Arthroscopy, Sports Medicine, and Rehabilitation (ASMAR). ISSN 2666-061X. 6(2). doi: 10.1016/j.asmr.2024.100909.
• Birkenes, Thomas; Furnes, Ove Nord; Lygre, Stein Håkon Låstad; Solheim, Eirik Johan; Årøen, Asbjørn & Knutsen, Gunnar [Vis alle 11 forfattere av denne artikkelen] (2024). Previous cartilage surgery is associated with inferior patient-reported outcomes after knee arthroplasty. Knee Surgery, Sports Traumatology, Arthroscopy. ISSN 0942-2056. 32(2), s. 361–370. doi: 10.1002/ksa.12050.
• Årøen, Asbjørn; Løken, Sverre Bertrand & Devitt, Brian M. (2024). Cartilage Injuries: Prevention, Diagnosis, Treatment, and Rehabilitation. I Doral, Mahmut Nedim & Karlsson, Jon (Red.), Sports Injuries : Prevention, Diagnosis, Treatment and Rehabilitation. Springer. ISSN 978-3-642-36801-1. s. 1–7. doi: 10.1007/978-3-642-36801-1_318-1.
• Årøen, Asbjørn; Brinchmann, Jan Engelsen; Engen, Cathrine N.; Randsborg, Per-Henrik; Engebretsen, Lars & Jakobsen, Rune Bruhn (2023). The Need for Pragmatic Registry-Based Trials in Cartilage Research. Cureus. ISSN 2168-8184.
• Nilsgård, Tina Løkken; Øiestad, Britt Elin; Randsborg, Per-Henrik; Årøen, Asbjørn & Straume-Næsheim, Truls Martin (2023). Association between single leg hop tests and patient reported outcome measures and patellar instability in patients with recurrent patellar dislocations. BMJ Open sport & exercise medicine. ISSN 2055-7647. 9(4). doi: 10.1136/bmjsem-2023-001760.
• Øiestad, Britt Elin; Årøen, Asbjørn; Røtterud, Jan H; Østerås, Nina; Jarstad, Even & Grotle, Margreth [Vis alle 7 forfattere av denne artikkelen] (2023). The efficacy of strength or aerobic exercise on quality of life and knee function in patients with knee osteoarthritis. A multi-arm randomized controlled trial with 1-year follow-up. BMC Musculoskeletal Disorders. ISSN 1471-2474. 24(1). doi: 10.1186/s12891-023-06831-x. Fulltekst i vitenarkiv Vis sammendrag

  Objective: To evaluate the efficacy of strength exercise or aerobic exercise compared to usual care on knee-related quality of life (QoL) and knee function at 4 months and 1 year in individuals with knee osteoarthritis. Methods: A three-arm randomized controlled trial (RCT) compared 12 weeks of strength exercise or aerobic exercise (stationary cycling) to usual care supervised by physiotherapists in primary care. We recruited 168 participants aged 35–70 years with symptomatic knee osteoarthritis. The primary outcome was The Knee Injury and Osteoarthritis Outcome Score (KOOS) QoL at 1 year. Secondary outcomes were self-reported function, pain, and self-efficacy, muscle strength and maximal oxygen uptake (VO2max) at 4 months and 1 year. Results: There were no differences between strength exercise and usual care on KOOS QoL (6.5, 95% CI -0.9 to 14), or for aerobic exercise and usual care (5.0, 95% CI -2.7 to 12.8), at 1 year. The two exercise groups showed better quadriceps muscle strength, and VO2max at 4 months, compared to usual care. Conclusion: This trial found no statistically significant effects of two exercise programs compared to usual care on KOOS QoL at 1 year in individuals with symptomatic and radiographic knee osteoarthritis, but an underpowered sample size may explain lack of efficacy between the intervention groups and the usual care group.

• Birkenes, Thomas; Furnes, Ove Nord; Lygre, Stein Håkon Låstad; Solheim, Eirik Johan; Årøen, Asbjørn & Knutsen, Gunnar [Vis alle 11 forfattere av denne artikkelen] (2023). The Long-Term Risk of Knee Arthroplasty in Patients with Arthroscopically Verified Focal Cartilage Lesions : A Linkage Study with the Norwegian Arthroplasty Register, 1999 to 2020. Journal of Bone and Joint Surgery. American volume. ISSN 0021-9355. 105(12), s. 951–961. doi: 10.2106/JBJS.22.01174. Fulltekst i vitenarkiv Vis sammendrag

  Background: Focal cartilage lesions are common in the knee. The risk of later ipsilateral knee arthroplasty remains unknown. The purposes of the present study were to evaluate the long-term cumulative risk of knee arthroplasty after arthroscopic identification of focal cartilage lesions in the knee, to investigate the risk factors for subsequent knee arthroplasty, and to estimate the subsequent cumulative risk of knee arthroplasty compared with that in the general population. Methods: Patients who had undergone surgical treatment of focal cartilage lesions at 6 major Norwegian hospitals between 1999 and 2012 were identified. The inclusion criteria were an arthroscopically classified focal cartilage lesion in the knee, an age of ≥18 years at the time of surgery, and available preoperative patient-reported outcomes (PROMs). The exclusion criteria were osteoarthritis or “kissing lesions” at the time of surgery. Demographic data, later knee surgery, and PROMs were collected with use of a questionnaire. A Cox regression model was used to adjust for and investigate the impact of risk factors, and Kaplan-Meier analysis was performed to estimate cumulative risk. The risk of knee arthroplasty in the present cohort was compared with that in the age-matched general Norwegian population. Results: Of the 516 patients who were eligible, 322 patients (328 knees) consented to participate. The mean age at the time of the index procedure was 36.8 years, and the mean duration of follow-up was 19.8 years. The 20-year cumulative risk of knee arthroplasty in the cartilage cohort was 19.1% (95% CI, 14.6% to 23.6%). Variables that had an impact on the risk of knee arthroplasty included an ICRS grade of 3 to 4 (hazard ratio [HR], 3.1; 95% CI, 1.1 to 8.7), an age of ≥40 years at time of cartilage surgery (HR, 3.7; 95% CI, 1.8 to 7.7), a BMI of 25 to 29 kg/m2 (HR, 3.9; 95% CI, 1.7 to 9.0), a BMI of ≥30 kg/m2 (HR, 5.9; 95% CI, 2.4 to 14.3) at the time of follow-up, autologous chondrocyte implantation (ACI) at the time of the index procedure (HR, 3.4; 95% CI, 1.0 to 11.4), >1 focal cartilage lesion (HR, 2.1; 95% CI, 1.1 to 3.7), and a high preoperative visual analog scale (VAS) score for pain at the time of the index procedure (HR, 1.1; 95% CI, 1.0 to 1.1). The risk ratio of later knee arthroplasty in the cartilage cohort as compared with the age-matched general Norwegian population was 415.7 (95% CI, 168.8 to 1,023.5) in the 30 to 39-year age group. Conclusions: In the present study, we found that the 20-year cumulative risk of knee arthroplasty after a focal cartilage lesion in the knee was 19%. Deep lesions, higher age at the time of cartilage surgery, high BMI at the time of follow-up, ACI, and >1 cartilage lesion were associated with a higher risk of knee arthroplasty.

• Kulseng, Carl Petter Skaar; Nainamalai, Varatharajan; Grøvik, Endre; Geitung, Jonn Terje; Årøen, Asbjørn & Gjesdal, Kjell Inge (2023). Automatic segmentation of human knee anatomy by a convolutional neural network applying a 3D MRI protocol. BMC Musculoskeletal Disorders. ISSN 1471-2474. 24, s. 1–12. doi: 10.1186/s12891-023-06153-y. Fulltekst i vitenarkiv Vis sammendrag

  Background: To study deep learning segmentation of knee anatomy with 13 anatomical classes by using a magnetic resonance (MR) protocol of four three-dimensional (3D) pulse sequences, and evaluate possible clinical usefulness. Methods: The sample selection involved 40 healthy right knee volumes from adult participants. Further, a recently injured single left knee with previous known ACL reconstruction was included as a test subject. The MR protocol consisted of the following 3D pulse sequences: T1 TSE, PD TSE, PD FS TSE, and Angio GE. The DenseVNet neural network was considered for these experiments. Five input combinations of sequences (i) T1, (ii) T1 and FS, (iii) PD and FS, (iv) T1, PD, and FS and (v) T1, PD, FS and Angio were trained using the deep learning algorithm. The Dice similarity coefficient (DSC), Jaccard index and Hausdorff were used to compare the performance of the networks. Results: Combining all sequences collectively performed significantly better than other alternatives. The following DSCs (±standard deviation) were obtained for the test dataset: Bone medulla 0.997 (±0.002), PCL 0.973 (±0.015), ACL 0.964 (±0.022), muscle 0.998 (±0.001), cartilage 0.966 (±0.018), bone cortex 0.980 (±0.010), arteries 0.943 (±0.038), collateral ligaments 0.919 (± 0.069), tendons 0.982 (±0.005), meniscus 0.955 (±0.032), adipose tissue 0.998 (±0.001), veins 0.980 (±0.010) and nerves 0.921 (±0.071). The deep learning network correctly identified the anterior cruciate ligament (ACL) tear of the left knee, thus indicating a future aid to orthopaedics. Conclusions: The convolutional neural network proves highly capable of correctly labeling all anatomical structures of the knee joint when applied to 3D MR sequences. We have demonstrated that this deep learning model is capable of automatized segmentation that may give 3D models and discover pathology. Both useful for a preoperative evaluation.

• Randsborg, Per-Henrik; Årøen, Asbjørn & Owesen, Christian (2022). The Effect of Lesion Size on Pain and Function in Patients Scheduled for Cartilage Surgery of the Knee. Cartilage. ISSN 1947-6035. 13(2), s. 1–7. doi: 10.1177/19476035221109242. Fulltekst i vitenarkiv
• Straume-Næsheim, Truls Martin; Randsborg, Per-Henrik; Mikaelsen, Jan Rune & Årøen, Asbjørn (2022). Medial patellofemoral ligament reconstruction is superior to active rehabilitation in protecting against further patella dislocations. Knee Surgery, Sports Traumatology, Arthroscopy. ISSN 0942-2056. 30(10), s. 3428–3437. doi: 10.1007/s00167-022-06934-3. Fulltekst i vitenarkiv Vis sammendrag

  Purpose: Isolated reconstruction of the medial patellofemoral ligament (MPFL-R) has become the predominant stabilizing procedure in the treatment of recurrent lateral patellar dislocation (LPD). To minimize the risk of re-dislocations, isolated MPFL-R is recommended in patients with no significant trochlea dysplasia and tibial tuberosity trochlear groove distance < 20 mm on computed tomography (CT). Incidentally, these criteria are the same that are used to identify first time LPD patients where conservative treatment is recommended. The purpose of this study was therefore to compare MPFL-R with active rehabilitation for patients with recurrent LPD (RLPD) in absence of the above mentioned underlying anatomical high-risk factors for further patellar dislocations. Methods: RLPD-patients aged 12–30 without underlying anatomical high-risk factors for further LPD were randomized into treatment either with isolated MPFL-R or active rehabilitation provided and instructed by a physiotherapist. All patients underwent diagnostic arthroscopy for concomitant problems. The main outcome measure was persistent patellar instability at 12 months. Knee function at baseline and 12 months was asses using the following patient reported outcomes measures (PROMS); KOOS, Kujala, Cincinnati knee rating, Lysholm score and Noyes sports activity rating scale. Results: Between 2010 and 2019, 61 patients were included in the study (MPFL-R, N = 30, Controls, N = 31). Persistent patellar instability at 12 months was reported by 13 (41.9%) controls, versus 2 (6.7%) in the MPFL-group (RR 6.3 (95% CI 1.5–25.5). No statistically significant differences in activity level were found between the MPFL-group and the Controls at neither baseline nor follow up. The patients with persistent instability at 12 months did not score significantly lower on any of the PROMs compared to their stable peers, regardless of study group. Conclusion: Patients with recurrent patellar dislocations have a six-fold increased risk of persistent patellar instability if treated with active rehabilitation alone, compared to MPFL-R in combination with active rehabilitation, even in the absence of significant anatomical risk factors. Active rehabilitation of the knee without MPFL-R improves patient reported knee function after one year, but does not protect against persistent patellar instability.

• Birkenes, Thomas; Furnes, Ove Nord; Årøen, Asbjørn; Solheim, Eirik; Knutsen, Gunnar & Drogset, Jon Olav [Vis alle 10 forfattere av denne artikkelen] (2021). Langtidsresultater etter bruskkirurgi i Norge - PROM hos pasienter uten senere kneprotese eller osteotomi. I Hansen, Ann Kristin (Red.), Høstmøteboka 2021. Norsk Ortopedisk Forening. ISSN 978-82-994275-3-1.
• Wang, Katherine; Esbensen, Qin Ying; Karlsen, Tommy Aleksander; Eftang, Cathrine Nørstad; Owesen, Christian & Årøen, Asbjørn [Vis alle 7 forfattere av denne artikkelen] (2021). Low-Input RNA-Sequencing in Patients with Cartilage Lesions, Osteoarthritis, and Healthy Cartilage. Cartilage. ISSN 1947-6035. 13, s. 550S–562S. doi: 10.1177/19476035211057245. Fulltekst i vitenarkiv Vis sammendrag

  Objective: To analyze and compare cartilage samples from 3 groups of patients utilizing low-input RNA-sequencing. Design: Cartilage biopsies were collected from patients in 3 groups (n = 48): Cartilage lesion (CL) patients had at least ICRS grade 2, osteoarthritis (OA) samples were taken from patients undergoing knee replacement, and healthy cartilage (HC) was taken from ACL-reconstruction patients without CLs. RNA was isolated using an optimized protocol. RNA samples were assessed for quality and sequenced with a low-input SmartSeq2 protocol. Results: RNA isolation yielded 48 samples with sufficient quality for sequencing. After quality control, 13 samples in the OA group, 9 in the HC group, and 9 in the CL group were included in the analysis. There was a high degree of co-clustering between the HC and CL groups with only 6 genes significantly up- or downregulated. OA and the combined HC/CL group clustered significantly separate from each other, yielding 659 significantly upregulated and 1,369 downregulated genes. GO-term analysis revealed that genes matched to cartilage and connective tissue development terms. Conclusion: The gene expression profiles from the 3 groups suggest that there are no major differences in gene expression between cartilage from knees with a cartilage injury and knees without an apparent cartilage injury. OA cartilage, as expected, showed markedly different gene expression from the other 2 groups. The gene expression profiles resulting from this low-input RNA-sequencing study offer opportunities to discover new pathways not previously recognized that may be explored in future studies.

• Ulstein, Svend; Årøen, Asbjørn; Engebretsen, Lars; Forssblad, Magnus & Røtterud, Jan Harald (2021). Effect of Concomitant Meniscal Lesions and Meniscal Surgery in ACL Reconstruction With 5-Year Follow-Up: A Nationwide Prospective Cohort Study From Norway and Sweden of 8408 Patients. Orthopaedic Journal of Sports Medicine (OJSM). ISSN 2325-9671. 9(10), s. 1–9. doi: 10.1177/23259671211038375. Fulltekst i vitenarkiv Vis sammendrag

  Background: Increased knowledge of the factors predicting outcome after anterior cruciate ligament reconstruction (ACLR) is needed. Purpose: To determine the effect of concomitant meniscal lesions, and the surgical management thereof, on patient-reported outcomes 5 years after ACLR. Study Design: Prospective cohort study; Level of evidence, 2. Methods: A total of 15,706 patients who underwent primary unilateral ACLR between 2005 and 2008 were enrolled prospectively and evaluated longitudinally. All patients were part of the Norwegian and Swedish national knee ligament registries. Outcomes at 5-year follow-up were evaluated with the Knee injury and Osteoarthritis Outcome Score (KOOS). A multivariable linear regression model was used to assess possible effects on prognosis, as measured by KOOS, of a concomitant meniscal lesion and its associated surgical treatment. Results: At a mean follow-up of 5.1 ± 0.2 years, KOOS data were available from 8408 patients: 4774 (57%) patients with no and 3634 (43%) patients with concomitant meniscal lesions (mean patient age, 33.8 ± 10.7 years). Patients with concomitant meniscal lesions reported equal crude mean scores compared with patients without meniscal lesions in all KOOS subscales 5 years after ACLR. The mean improvement in scores from preoperative to the 5-year follow-up was greater for patients with a concomitant meniscal lesion for the KOOS Pain, Activities of Daily Living (ADL), and Sport and Recreation subscales. In the adjusted regression analyses, using patients without concomitant meniscal lesions as the reference, neither no treatment nor resection or repair of medial meniscal lesions were significantly associated with KOOS scores 5 years after ACLR. Except for the ADL subscale, in which a repaired lateral meniscal lesion was associated with better outcome, no significant associations between any of the lateral meniscal lesion treatment categories and KOOS outcome at 5-year follow-up were identified. Conclusion: Concomitant meniscal lesions at the time of ACLR conferred no negative effects on patient-reported outcomes 5 years after ACLR. The improvement in selected KOOS subscales from preoperative to the 5-year follow-up was significantly greater for patients with concomitant meniscal lesions than for patients without such lesions.

• Wang, Katherine; Eftang, Cathrine Nørstad; Ulstein, Svend; Årøen, Asbjørn & Jakobsen, Rune B. (2021). Concomitant full-thickness cartilage lesions do not affect patient-reported outcomes at minimum 10-year follow-up after ACL reconstruction. Knee Surgery, Sports Traumatology, Arthroscopy. ISSN 0942-2056. doi: 10.1007/s00167-021-06757-8. Fulltekst i vitenarkiv Vis sammendrag

  Purpose: To compare patients with a concomitant full-thickness cartilage lesion and anterior cruciate ligament (ACL) injury to patients with an isolated ACL injury at 10–15 years post ACL reconstruction. Methods: This is a longitudinal follow-up of a cohort of 89 patients that were identified in the Norwegian National Knee Ligament Registry and included in the index study in 2007. The study group consisted of 30 patients that underwent ACL reconstruction and had a concomitant, isolated full-thickness cartilage lesion (International Cartilage Repair Society [ICRS] grade 3–4). Each study patient was matched with two control patients who underwent ACL reconstruction but had no cartilage lesions (ICRS grade 1–4) (n = 59). At a median follow-up of 10.2 years (range 9.9–15.6), 65 patients (74%) completed the Knee Injury and Osteoarthritis Outcome Score (KOOS), which was the main outcome measure, resulting in 23 pairs after matching. Results: At a follow-up of 10–15 years after ACL reconstruction, no significant differences in KOOS were found between patients with a concomitant full-thickness cartilage lesion and patients without cartilage lesions. There was also no significant difference between the two groups when comparing the change over time in KOOS scores from preoperative to follow-up. Both groups showed significant improvement in all KOOS subscales from preoperative to follow-up, except for in the Symptoms subscale for the control group. The greatest improvement was in the QoL subscale for the study group. Conclusion: ACL-reconstructed patients with a full-thickness cartilage lesion did not report worse outcomes at 10–15 years after surgery compared with patients with an isolated ACL injury. Our findings support that there is no long-term negative effect of a concomitant cartilage lesion in an ACL-reconstructed knee. These findings should be considered when discussing treatment and informing about the expected long-term outcome after ACL reconstruction to patients with such combined injuries.

• Pollmann, Christian Thomas; Mellingsæter, Marte; Neerland, Bjørn Erik; Straume-Næsheim, Truls Martin; Årøen, Asbjørn & Watne, Leiv (2021). Orthogeriatric co-management reduces incidence of delirium in hip fracture patients. Osteoporosis International. ISSN 0937-941X. 32, s. 2225–2233. doi: 10.1007/s00198-021-05974-8. Fulltekst i vitenarkiv Vis sammendrag

  Summary: Hip fracture patients often display an acute confusional state (delirium) which is associated with worse outcomes. In this observational study, we found that co-management of hip fracture patients by a multidisciplinary team including a geriatrician and an orthopaedic surgeon could reduce the incidence of delirium. Introduction: Delirium after hip fracture is common and is associated with negative outcomes. We investigated if orthogeriatric co-management reduced the incidence of delirium in hip fracture patients. Methods: In this single-centre, prospective observational study, we compared the incidence of delirium and subsyndromal delirium (SSD) before (usual care group, n = 94) and after (orthogeriatric group, n = 103) the introduction of orthogeriatric co-management as an integrated care model. The outcome measure ‘no delirium/SSD/delirium’ was treated as an ordinal variable and analysed using the chi-squared test and multivariable ordinal logistic regression. Results: The groups had similar baseline characteristics except for a higher proportion of patients with pre-existing cognitive impairment in the usual care group (51% vs. 37%, p = 0.045). Fewer patients in the orthogeriatric group developed SSD or delirium (no delirium: 59% vs. 40%/SSD: 6% vs. 13%/delirium: 35% vs. 47%; p = 0.021). The number needed to treat (NNT) to avoid one case of SSD or delirium was 5.3 (95% CI: 3.1 to 19.7). In a multivariable analysis adjusted for age, sex, ASA class, pre-existing cognitive impairment, time to surgery, type of surgery, and medical or surgical complications, the odds ratio for the development of SSD/delirium was lower in the orthogeriatric group (OR = 0.46, 95% CI: 0.23–0.89, p = 0.023). Conclusion: Orthogeriatric co-management as an integrated care model reduced the incidence of SSD/delirium in hip fracture patients.

• Banitalebi, Hasan; Owesen, Christian; Årøen, Asbjørn; Tran, Hang Thi; Myklebust, Tor Åge & Randsborg, Per-Henrik (2021). Is T2 mapping reliable in evaluation of native and repair cartilage tissue of the knee? Journal of Experimental Orthopaedics. ISSN 2197-1153. 8, s. 1–10. doi: 10.1186/s40634-021-00350-1. Fulltekst i vitenarkiv Vis sammendrag

  Purpose: To evaluate the effect of imaging plane and experience of observers on the reliability of T2 mapping of native and repair cartilage tissue of the knee. Methods: Fifteen consecutive patients from two randomised controlled trials (RCTs) were included in this crosssectional study. Patients with an isolated knee cartilage lesion were randomised to receive either debridement or microfracture (RCT 1) or debridement or autologous chondrocyte implantation (RCT 2). T2 mapping was performed in coronal and sagittal planes two years postoperatively. A musculoskeletal radiologist, a resident of radiology and two orthopaedic surgeons measured the T2 values independently. Intraclass Correlation Coefficient (ICC) with 95% Confidence Intervals was used to calculate the inter- and intraobserver agreement. Results: Mean age for the patients was 36.8 ± 11 years, 8 (53%) were men. The overall interobserver agreement varied from poor to good with ICCs in the range of 0.27– 0.76 for native cartilage and 0.00 – 0.90 for repair tissue. The lowest agreement was achieved for evaluations of repair cartilage tissue. The estimated ICCs suggested higher interand intraobserver agreement for radiologists. On medial femoral condyles, T2 values were higher for native cartilage on coronal images (p < 0.001) and for repair tissue on sagittal images (p < 0.001). Conclusions: The reliability of T2 mapping of articular cartilage is influenced by the imaging plane and the experience of the observers. This influence may be more profound for repair cartilage tissue. This is important to consider when using T2 mapping to measure outcomes after cartilage repair surgery.

• Wang, Katherine; Engen, Cathrine Nørstad; Jakobsen, Rune Bruhn & Årøen, Asbjørn (2020). Review of response rates over time in registry-based studies using patient-reported outcome measures. BMJ Open. ISSN 2044-6055. 10. doi: 10.1136/bmjopen-2019-030808. Fulltekst i vitenarkiv Vis sammendrag

  Objectives: Gain an overview of expected response rates (RRs) to patient-reported outcome measures (PROMs) in clinical quality registry-based studies and long-term cohorts in order to better evaluate the validity of registries and registry-based studies. Examine the trends of RRs over time and how they vary with study type, questionnaire format, and the use of reminders. Design: Literature review with systematic search. Data sources: PubMed, MEDLINE, EMBASE, kvalitetsregistre. no, kvalitetsregister. se and sundhed. dk. Eligibility criteria: Articles in all areas of medical research using registry-based data or cohort design with at least two follow-up time points collecting PROMs and reporting RRs. Annual reports of registries including PROMs that report RRs for at least two time points. Primary outcome measure: RRs to PROMs. Results: A total of 10 articles, 12 registry reports and 6 registry articles were included in the review. The overall RR at baseline was 75%±22.1 but decreased over time. Cohort studies had a markedly better RR (baseline 97%±4.7) compared with registry-based data at all time points (baseline 72%±21.8). For questionnaire formats, paper had the highest RR at 86%±19.4, a mix of electronic and paper had the second highest at 71%±15.1 and the electronic-only format had a substantially lower RR at 42%±8.7. Sending one reminder (82%±16.5) or more than one reminder (76%±20.9) to non-responders resulted in a higher RR than sending no reminders (39%±6.7). Conclusions: The large variation and downward trend of RRs to PROMs in cohort and registry-based studies are of concern and should be assessed and addressed when using registry data in both research and clinical practice.

• Kjennvold, Stian; Randsborg, Per-Henrik; Jakobsen, Rune Bruhn & Årøen, Asbjørn (2020). Fixation of acute chondral fractures in adolescent knees. Cartilage. ISSN 1947-6035. s. 1–9. doi: 10.1177/1947603520941213.
• Aae, Tommy Frøseth; Lian, Øystein Bjerkestrand; Årøen, Asbjørn; Engebretsen, Lars & Randsborg, Per-Henrik (2020). Compensation claims after knee cartilage surgery is rare. A registry-based study from Scandinavia from 2010 to 2015. BMC Musculoskeletal Disorders. ISSN 1471-2474. 21, s. 1–8. doi: 10.1186/s12891-020-03311-4. Fulltekst i vitenarkiv Vis sammendrag

  Background: Focal cartilage defects (FCDs) in the knee joint has a high prevalence. A broad range of treatment options exists for symptomatic patients. Knowledge of patient compensation claims following surgical treatment of FCDs is missing. The purpose of this study is to evaluate compensation claims filed to the Scandinavian registries for patient compensation following treatment of FCDs in the knee joint from 2010 to 2015 and identify possible areas of improvement. Methods: A cross-sectional study design was used to obtain all complaints following surgical treatment of FCDs from the Scandinavian registries from 2010 to 2015. Data such as age, gender, type of treatment, type of complaint, reason of verdict and amount of compensation were collected and systematically analyzed. Results: 103 patients filed a compensation claim. 43 had received debridement (41.7%), 54 microfracture (MF) (52.4%), 3 mosaicplasty (2.9%) and 3 autologous chondrocyte implantation (ACI) (2.9%). Of the 103 claims, 36 were granted (35%). 21 following debridement (58.3%), 13 after MF (36.1%), 1 following mosaicplasty (2.8%) and 1 after ACI (2.8%). The most common reason for complaint was infection (22.1%), of which 89% were granted. The average compensation was €24.457 (range €209 – €458.943). Conclusion: Compensation claims following surgical treatment of knee cartilage injuries in Scandinavia are rare. Establishing nationwide cartilage registries can add further knowledge on this troublesome disease.

• Pollmann, Christian Thomas; Dahl, Fredrik Andreas; Røtterud, Jan H; Gjertsen, Jan Erik & Årøen, Asbjørn (2020). Surgical site infection after hip fracture – mortality and risk factors: an observational cohort study of 1,709 patients. Acta Orthopaedica. ISSN 1745-3674. 91(3), s. 347–352. doi: 10.1080/17453674.2020.1717841. Fulltekst i vitenarkiv Vis sammendrag

  Background and purpose — Surgical site infection (SSI) is a devastating complication of hip fracture surgery. We studied the contribution of early deep SSI to mortality after hip fracture surgery and the risk factors for deep SSI with emphasis on the duration of surgery. Patients and methods — 1,709 patients (884 hemi­arthroplasties, 825 sliding hip screws), operated from 2012 to 2015 at a single center were included. Data were obtained from the Norwegian Hip Fracture Register, the electronic hospital records, the Norwegian Surveillance System for Antibiotic Use and Hospital-Acquired Infections, and the Central Population Register. Results — The rate of early (≤ 30 days) deep SSI was 2.2% (38/1,709). Additionally, for hemiarthroplasties 7 delayed (> 30 days, ≤ 1 year) deep SSIs were reported. In patients with early deep SSI 90-day mortality tripled (42% vs. 14%, p

• Straume-Næsheim, Truls Martin; Persson, Andreas & Årøen, Asbjørn (2019). Patellainstabilitetsregister - noe å bruke tid og ressurser på? 2019: Høstmøteboken - vitenskapelig program og abstrakter. Norsk Ortopedisk Forening. ISSN 978-82-994275-1-7. s. 98–98.
• Sailer, Monica Alessandra & Årøen, Asbjørn (2019). Bruk av lokal antibiotika ved rekonstruksjon av fremre korsbånd i Norge, 2019: Høstmøteboken - vitenskapelig program og abstrakter. Norsk Ortopedisk Forening. ISSN 978-82-994275-1-7. s. 86–86.
• Straume-Næsheim, Truls Martin; Randsborg, Per-Henrik; Mikaelsen, Jan Rune; Sivertsen, Einar; Devitt, Brian M. & Granan, Lars-Petter [Vis alle 7 forfattere av denne artikkelen] (2019). Recurrent lateral patella dislocation affects knee function as much as ACL deficiency – however patients wait five times longer for treatment. BMC Musculoskeletal Disorders. ISSN 1471-2474. 20. doi: 10.1186/s12891-019-2689-7. Fulltekst i vitenarkiv Vis sammendrag

  Background: Surgical treatment of young patients with recurrent lateral patella dislocation (RLDP) is often recommended because of loss of knee function that compromises their level of activity or even their daily life functioning. This situation is comparable to young patients with an anterior cruciate ligament (ACL) rupture. The purpose of this study was therefore to explore the time from injury to surgery and the pre-operative symptoms and knee function of young RLPD patients scheduled for stabilizing surgery and compare this group to age and sex-matched ACL-deficient patients. Method: Forty-seven patients with unilateral RLPD listed for isolated medial patellofemoral ligament reconstruction were included in the study (RLPD-group). This group was compared to an age, sex and BMI matched ACL patient group obtained from the Norwegian knee ligament registry (ACL-group) for the following outcome measures: the knee injury and osteoarthritis outcome score (KOOS) assessed on the day of surgery and time from injury to surgery. Results: The RLPD-group scored significantly lower than the ACL-group for the three KOOS subscales “Pain” (73.6 vs. 79.8, p < 0.05), “Symptoms” (71.7 vs. 79.3, p < 0.05) and “ADL” (84.7 vs 89.5, p < 0.05). The lowest KOOS values were found for Sports/Recreation (53.5 vs. 51.3, p = 0.65) and Quality of life (37.6 vs. 36.7, p = 0.81). The average time from primary injury to surgery was 6 months for the ACL group and 31 months for the RLPD group. Conclusion: RLPD affected knee function as much as ACL deficiency, and was associated with more pain. Still the RLDP patients waited on average 5 times longer for surgery.

• Pollmann, Christian Thomas; Røtterud, Jan H; Gjertsen, Jan-Erik; Dahl, Fredrik Andreas; Lenvik, Olav & Årøen, Asbjørn (2019). Fast track hip fracture care and mortality – an observational study of 2230 patients. BMC Musculoskeletal Disorders. ISSN 1471-2474. 20. doi: 10.1186/s12891-019-2637-6. Fulltekst i vitenarkiv Vis sammendrag

  Background: Hip fracture patients are frail and have a high mortality. We investigated whether the introduction of fast track care reduced the 30-day mortality after hip fractures. Methods: Fast track hip fracture care was established at our institution in October 2013. Data from the Norwegian Hip Fracture Register and electronic hospital records were merged for 2230 hip fracture patients operated in our department from January 2012 through December 2015. 1090 of these patients were operated before (conventional treatment group) and 1140 patients were operated after the introduction of fast track care (fast track group). Data were analysed by univariate analysis and binary logistic regression. Results: Mortality did not differ significantly between the conventional treatment group and the fast track group at 30 days (7.9% vs. 6.5%), 90 days (13.5% vs. 12.5%) and one year (22.8% vs. 22.8%). Median admission time and time to surgery were significantly shorter in the fast track group than in the conventional treatment group (1.1 h vs. 3.9 h and 23.6 h vs. 25.7 h, both p < 0.0001). The 30-day reoperation rate was significantly lower in the fast track group compared to the conventional treatment group (odds ratio = 0.35 (95% CI: 0.15–0.84), p = 0.019). A composite 30- day outcome (reoperation, surgical site infection and/or death) was significantly less frequent in the fast track group (8.1%) than in the conventional treatment group (10.7%) in unadjusted analysis (p = 0.006), but not after adjusting for age, gender, cognitive impairment and ASA score (odds ratio = 0.85 (95% CI: 0.63–1.16), p = 0.31, 8.0% missing). Reoperations within 1 year, surgical site infections, 30-day readmissions and length of hospital stay did not differ significantly between the conventional treatment group and the fast track group. Conclusions: Fast track hip fracture care is safe. However, we observed no statistically significant change in 30-day, 90-day or 1-year mortality after the introduction of fast track hip fracture care

• Owesen, Christian; Røtterud, Jan H; Engebretsen, Lars & Årøen, Asbjørn (2018). Effect of Activity at Time of Injury and Concomitant Ligament Injuries on Patient- Reported Outcome After Posterior Cruciate Ligament Reconstruction. Orthopaedic Journal of Sports Medicine (OJSM). ISSN 2325-9671. 6(12). doi: 10.1177/2325967118817297. Fulltekst i vitenarkiv
• Ulstein, Svend; Årøen, Asbjørn; Engebretsen, Lars; Forssblad, Magnus; Lygre, Stein Håkon Låstad & Røtterud, Jan H (2018). A Controlled Comparison of Microfracture, Debridement, and No Treatment of Concomitant Full-Thickness Cartilage Lesions in Anterior Cruciate Ligament-Reconstructed Knees: A Nationwide Prospective Cohort Study From Norway and Sweden of 368 Patients With 5-Year Follow-up. Orthopaedic Journal of Sports Medicine (OJSM). ISSN 2325-9671. 6(8). doi: 10.1177/2325967118787767. Fulltekst i vitenarkiv Vis sammendrag

  Background: The effect of microfracture (MF) or surgical debridement of concomitant full-thickness cartilage lesions in anterior cruciate ligament–reconstructed knees on patient-reported outcomes remains to be determined. Purpose: To evaluate the effect of debridement or MF compared with no surgical treatment of concomitant full-thickness cartilage lesions on patient-reported outcomes 5 years after anterior cruciate ligament reconstruction (ACLR). Study Design: Cohort study; Level of evidence, 2. Methods: Included in this study were 644 patients who were registered in the Norwegian and the Swedish National Knee Ligament Registries from 2005 to 2008 as having undergone unilateral primary ACLR and having a concomitant full-thickness cartilage lesion (International Cartilage Repair Society [ICRS] grades 3-4). Of these patients, 129 were treated with debridement, 164 were treated with MF, and 351 received no surgical treatment simultaneously with ACLR. At 5-year follow-up, 368 (57%) patients completed results on the Knee injury and Osteoarthritis Outcome Score (KOOS).Multivariable linear regression was used to estimate the effect of surgical debridement or MF of concomitant full-thickness cartilage lesions on patient-reported outcomes 5 years after ACLR. Results: Compared with no surgical treatment, there were no unadjusted or adjusted effects of debridement or MF of concomitant full-thickness cartilage lesions on KOOS scores at 5-year follow-up. Conclusion: Compared with leaving concomitant full-thickness cartilage lesions untreated at the time of ACLR, debridement and MF showed no effect on patient-reported outcomes 5 years after surgery.

• Ulstein, Svend; Årøen, Asbjørn; Engebretsen, Lars; Forssblad, Magnus; Lygre, Stein Håkon Låstad & Røtterud, Jan H (2018). Effect of concomitant cartilage lesions on patient-reported outcomes after anterior cruciate ligament reconstruction. A Nationwide chohort study from Norway and Sweden of 8470 patients With 5 year follow-up. Orthopaedic Journal of Sports Medicine (OJSM). ISSN 2325-9671. 6:2325967118786219(7), s. 1–7. doi: 10.1177/2325967118786219. Fulltekst i vitenarkiv
• Aae, Tommy Frøseth; Randsborg, Per-Henrik; Lurås, Hilde; Årøen, Asbjørn & Lian, Øystein Bjerkestrand (2017). Microfracture is more cost-effective than autologous chondrocyte implantation: a review of level 1 and level 2 studies with 5 year follow-up. Knee Surgery, Sports Traumatology, Arthroscopy. ISSN 0942-2056. 26(4), s. 1044–1052. doi: 10.1007/s00167-017-4802-5. Fulltekst i vitenarkiv
• Owesen, Christian; Aas, Eline & Årøen, Asbjørn (2017). Surgical reconstruction is a cost-efficient treatment option for isolated PCL injuries. Knee Surgery, Sports Traumatology, Arthroscopy. ISSN 0942-2056. s. 1–6. doi: 10.1007/s00167-017-4632-5.
• Engen, Cathrine Nørstad; Årøen, Asbjørn & Engebretsen, Lars (2017). Development of a pilot cartilage surgery register. BMC Musculoskeletal Disorders. ISSN 1471-2474. 18(282), s. 1–8. doi: 10.1186/s12891-017-1638-6. Fulltekst i vitenarkiv Vis sammendrag

  Background: Norway has no prospective surveillance system to monitor the outcome of knee cartilage surgery. In 2004 the Norwegian Registry of Knee Ligament (NKLR) was successfully established, and has yielded useful information on the treatment of patients with both knee ligament and combined knee injuries. Patients with focal cartilage defects (FCDs) in their knees have reduced function and the treatment is difficult. There are geographical variations in treatment, and the generalizability from randomized controlled studies is low. These patients would benefit from a standardized long-time follow-up through a cartilage surgery register. The aim of the present study was to describe the development and report baseline challenges during the setting up of a pilot of a knee cartilage surgery register. Methods: The study was designed as a prospective cohort study in the form of a register. Patients with full-thickness FCDs in the knee with International Cartilage Repair Society (ICRS) grade 3–4 on arthroscopy were included. The pilot included two hospitals; Oslo University Hospital (OUS), Ullevål and Akershus University Hospital (Ahus). Results: We registered 58 patients with isolated FCDs, whereas 16 additional patients with full-thickness FCDs were registered through the NKLR. The patient cohort of patients with isolated FCDs consisted of 65% men and had a mean age of 29.8 years. The data are incomplete and the compliance varies from 18 to 73%. The distribution of mean KOOS scores were similar to previous patient cohorts with FCDs, with low scores for the KOOS Sport/Recreation and Quality of Life subscales. Conclusion: The level of compliance demonstrated a large difference between the two participating hospitals. The compliance for the isolated FCDs were low in both locations, although it reached an acceptable level in one hospital when patients with combined injuries from the NKLR were included. The forms were incompletely filled out by the surgeons postoperatively and need to be revised prior the establishment of a nation-wide register.

• Engen, Cathrine Nørstad; Løken, Sverre Bertrand; Årøen, Asbjørn; Ho, Charles & Engebretsen, Lars (2017). No degeneration found in focal cartilage defects evaluated with dGEMRIC at 12-year follow-up. Acta Orthopaedica. ISSN 1745-3674. 88(1), s. 82–89. doi: 10.1080/17453674.2016.1255484. Vis sammendrag

  Background and purpose: The natural history of focal cartilage defects (FCDs) is still unresolved, as is the long-term cartilage quality after cartilage surgery. It has been suggested that delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) is a biomarker of early OA. We aimed to quantitatively evaluate the articular cartilage in knees with FCDs, 12 years after arthroscopic diagnosis. Patients and methods: We included 21 patients from a cohort of patients with knee pain who underwent arthroscopy in 1999. Patients with a full-thickness cartilage defect, stable knees, and at least 50% of both their menisci intact at baseline were eligible. 10 patients had cartilage repair performed at baseline (microfracture or autologous chondrocyte implantation), whereas 11 patients had either no additional surgery or simple debridement performed. Mean follow-up time was 12 (10–13) years. The morphology and biochemical features were evaluated with dGEMRIC and T2 mapping. Standing radiographs for Kellgren and Lawrence (K&L) classification of osteoarthritis (OA) were obtained. Knee function was assessed with VAS, Tegner, Lysholm, and KOOS. Results: The dGEMRIC showed varying results but, overall, no increased degeneration of the injured knees. Degenerative changes (K&L above 0) were, however, evident in 13 of the 21 knees. Interpretation: The natural history of untreated FCDs shows large dGEMRIC variations, as does the knee articular cartilage of surgically treated patients. In this study, radiographic OA changes did not correlate with cartilage quality, as assessed with dGEMRIC.

• Owesen, Christian; Sandven-Thrane, Stine; Lind, Martin; Forssblad, Magnus; Granan, Lars-Petter & Årøen, Asbjørn (2017). Epidemiology of surgically treated posterior cruciate ligament injuries in Scandinavia. Knee Surgery, Sports Traumatology, Arthroscopy. ISSN 0942-2056. 25(8), s. 2384–2391. doi: 10.1007/s00167-015-3786-2.
• Aae, Tommy Frøseth; Randsborg, Per-Henrik; Breen, Anne Berg; Visnes, Håvard; Vindfeld, Søren & Sivertsen, Einar [Vis alle 10 forfattere av denne artikkelen] (2016). Norwegian Cartilage Project - a study protocol for a double-blinded randomized controlled trail comparing arthroscopic microfracture with debridement in focal cartilage defects in the knee. BMC Musculoskeletal Disorders. ISSN 1471-2474. 17:292. doi: 10.1186/s12891-016-1156-y.
• Ulstein, Svend; Bredland, Karin; Årøen, Asbjørn; Engebretsen, Lars & Røtterud, Jan H (2016). No negative effect on patient-reported outcome of concomitant cartilage lesions 5–9 years after ACL reconstruction. Knee Surgery, Sports Traumatology, Arthroscopy. ISSN 0942-2056. 24, s. 340–341. doi: 10.1007/s00167-016-4163-5. Vis sammendrag

  Purpose: To compare patient-reported outcome 5–9 years after anterior cruciate ligament (ACL) reconstruction in patients with and without a concomitant full-thickness [International Cartilage Repair Society (ICRS) grade 3–4] cartilage lesion. Methods: This is a prospective follow-up of a cohort of 89 patients that were identified in the Norwegian National Knee Ligament Registry and included in the current study in 2007, consisting of 30 primary ACL-reconstructed patients with a concomitant, isolated full-thickness cartilage lesion (ICRS grade 3 and 4) and 59 matched controls without cartilage lesions (ICRS grade 1–4). At a median follow-up of 6.3 years (range 4.9–9.1) after ACL reconstruction, 74 (84 %) patients completed the Knee Injury and Osteoarthritis Outcome Score (KOOS), which was used as the main outcome measure. Secondary outcomes included radiographic evaluation according to the Kellgren– Lawrence criteria of knee osteoarthritis (OA). Results At follow-up, 5–9 years after ACL reconstruction, no statistically significant differences in KOOS were detected between patients with a concomitant full-thickness cartilage lesion and patients without concomitant cartilage lesions. Radiographic knee OA of the affected knee,defined as Kellgren and Lawrence ≥2, was significantly more frequent in subjects without a concomitant cartilage lesion (p = 0.016). Conclusion: ACL reconstruction performed in patients with an isolated concomitant full-thickness cartilage lesion restored patient-reported knee function to the same level as ACL reconstruction performed in patients without concomitant cartilage lesions, 5–9 years after surgery. This should be considered in the preoperative information given to patients with such combined injuries, in terms of the expected outcome after ACL reconstruction and in the counselling and decision-making on the subject of surgical treatment of the concomitant cartilage lesion. Level of evidence: Prognostic; prospective cohort study, Level I.

• Randsborg, Per-Henrik; Brinchmann, Jan E.; Løken, Sverre Bertrand; Hanvold, Heidi Andreassen; Aae, Tommy Frøseth & Årøen, Asbjørn (2016). Focal cartilage defects in the knee -a randomized controlled trial comparing autologous chondrocyte implantation with arthroscopic debridement. BMC Musculoskeletal Disorders. ISSN 1471-2474. 17(1). doi: 10.1186/s12891-016-0969-z. Vis sammendrag

  Background: Focal cartilage injuries in the knee might have devastating effect due to the predisposition of early onset osteoarthritis. Various surgical treatment options are available, however no statistically significant differences have been found between the different surgical treatments. This supports the suggestion that the improvement might be a result of the post-operative rehabilitation rather than the surgery itself. Autologous chondrocyte implantation (ACI) has become a recognized treatment option for larger cartilage lesions in the knee. Although ACI has been compared to other surgical treatment such as microfracture and mosaicplasty, it has never been directly compared to simple arthroscopic debridement and rehabilitation alone. In this study we want to increase clinical and economic knowledge about autologous chondrocyte implantation compared to arthroscopic debridement and physical rehabilitation in the short and long run. Methods/Design: We will conduct a randomized controlled trial to compare ACI with simple arthroscopic debridement (AD) and physiotherapy for the treatment of cartilage lesions in the knee. The study will include a total of 82 patients, both men and non-pregnant women, with a full thickness cartilage defect in the weight bearing area of the femoral condyles or trochlea larger than 2 cm2. The lesion must be symptomatic, with a Lysholm score less than 75. The two treatment groups will receive identical rehabilitation protocol according to a modification of Wondrasch et al., which is an active rehabilitation and education program divided into 3 phases: accommodation, rehabilitation and return to activity. The patients will be followed for 24 months, with additional late follow-ups at 5 and 10 years to monitor the potential onset of osteoarthtitis. The primary outcome measure will be the difference in the KOOS knee-related quality of life (QoL) subscore in the ACI group compared to the AD group at 2 years. A combination of self-explanatory questionnaires, clinical parameters, clinical hop tests and radiographs and Magnetic Resonance Imaging (MRI) will be used as secondary endpoints. Discussion: This is the first study with a high level of evidence to compare ACI with simple debridement and physiotherapy for the treatment of isolated symptomatic full thickness lesions of the knee.

• Årøen, Asbjørn; Brøgger, Helga Marie; Røtterud, Jan H; Sivertsen, Einar Andreas; Engebretsen, Lars & Risberg, May Arna (2016). Evaluation of focal cartilage lesions of the knee using MRI T2 mapping and delayed Gadolinium Enhanced MRI of Cartilage (dGEMRIC). BMC Musculoskeletal Disorders. ISSN 1471-2474. 17(1). doi: 10.1186/s12891-016-0941-y.
• Røtterud, Jan H; Sivertsen, Einar; Forssblad, Magnus; Engebretsen, Lars & Årøen, Asbjørn (2016). Effect on Patient-Reported Outcomes of Debridement or Microfracture of Concomitant Full-Thickness Cartilage Lesions in Anterior Cruciate Ligament-Reconstructed Knees: A Nationwide Cohort Study from Norway and Sweden of 357 Patients with 2-Year Follow-up. American Journal of Sports Medicine. ISSN 0363-5465. 44(2), s. 337–344. doi: 10.1177/0363546515617468. Vis sammendrag

  Background: The treatment of concomitant cartilage lesions in anterior cruciate ligament (ACL)–injured knees is debatable. Purpose: To evaluate the effect of debridement or microfracture (MF) compared with no treatment of concomitant full-thickness (International Cartilage Repair Society [ICRS] grades 3-4) cartilage lesions on patient-reported outcomes after ACL reconstruction. Study Design: Cohort study; Level of evidence, 2. Methods: Six hundred forty-four patients who underwent primary unilateral ACL reconstruction and had a concomitant fullthickness cartilage lesion treated simultaneously by debridement (n = 129) or MF (n = 164), or underwent no treatment (n = 351) of the cartilage lesion, registered in the Norwegian and Swedish National Knee Ligament Registries from 2005 to 2008 were included. The Knee Injury and Osteoarthritis Outcome Score (KOOS) was used to measure patient-reported outcomes. At a mean follow-up of 2.1 6 0.2 years after surgery, 357 (55%) patients completed the KOOS. Linear regression analyses were used to evaluate the effect of debridement or MF on the KOOS. Results: No significant effects of debridement were detected in the unadjusted or adjusted regression analyses on any of the KOOS subscales at 2-year follow-up. The MF treatment of the cartilage lesions had significant negative effects at 2-year follow-up on the KOOS Sport and Recreation (Sport/Rec) (regression coefficient [b] = –8.9; 95% confidence interval [CI], –15.1 to –1.5) and Knee-Related Quality of Life (QoL) (b = –8.1; 95% CI, –14.1 to –2.1) subscales in the unadjusted analyses. When adjusting for confounders, MF had significant negative effects on the same KOOS subscales of Sport/Rec (b = –8.6; 95% CI, –16.4 to –0.7) and QoL (b = –7.2; 95% CI, –13.6 to –0.8). For the remaining KOOS subscales of Pain, Symptoms, and Activities of Daily Living, there were no significant unadjusted or adjusted effects of MF. Conclusion: MF of concomitant full-thickness cartilage lesions showed adverse effects on patient-reported outcomes at 2-year follow-up after ACL reconstruction. Debridement of concomitant full-thickness cartilage lesions showed neither positive nor negative effects on patient-reported outcomes at 2-year follow-up after ACL reconstruction.

• Engen, Cathrine Nørstad; Årøen, Asbjørn & Engebretsen, Lars (2015). Incidence of knee cartilage surgery in Norway, 2008-2011. BMJ Open. ISSN 2044-6055. 5(11). doi: 10.1136/bmjopen-2015-008423. Fulltekst i vitenarkiv Vis sammendrag

  Objective: A systematic and long-term data collection on the treatment of focal cartilage defects (FCDs) of the knee is needed. This can be achieved through the foundation of a National Knee Cartilage Defect Registry. The aim of this study was to establish the nationwide burden of knee cartilage surgery, defined as knee surgery in patients with an FCD. We also aimed to identify any geographical differences in incidence rates, patient demographics or trends within this type of surgery. Setting: A population-based study with retrospective identification of patients undergoing knee cartilage surgery in Norway through a mandatory public health database from 2008 to 2011. Participants: We identified all patients undergoing cartilage surgery, or other knee surgery in patients with an FCD. All eligible surgeries were assessed for inclusion on the basis of certain types of ICD-10 and NOMESKO Classification of Surgical Procedures codes. Primary and secondary outcome measures: The variables were diagnostic and surgical codes, geographic location of the performing hospital, age and sex of the patients. Yearly incidence and incidence rates were calculated. Age-adjusted incidences for risk ratios and ORs between geographical areas were also calculated. Results: A total of 10 830 cases of knee cartilage surgery were identified, with slight but significant decreases from 2008 to 2011 (p<0.0003). The national incidence rate was 56/100 000 inhabitants and varied between regions, counties and hospitals. More than 50% of the procedures were palliative and nearly 400 yearly procedures were reparative or restorative. Conclusions: Knee cartilage surgery is common in Norway, counting 2500 annual cases with an ageadjusted incidence rate of 68.8/100 000 inhabitants. There are significant geographical variations in incidence and trends of surgery and in trends between public and private hospitals. We suggest that a national surveillance system would be beneficial for the future evaluation of the treatment of these patients.

• Owesen, Christian; Sandven-Thrane, Stine; Lind, M; Granan, Lars-Petter & Årøen, Asbjørn (2015). Epidemiology of surgically treated posterior cruciate ligament injuries in scandinavia. I Vagstad, Terje (Red.), Høstmøteboken - Vitenskapelig program og abstrakter 2015. Norsk Ortopedisk Forening. doi: 10.1007/s00167-015-3786-2.
• Straume-Næsheim, Truls Martin; Mikaelsen, JR; Sivertsen, EA; Devitt, Brian M.; Brand, J & Granan, Lars-Petter [Vis alle 7 forfattere av denne artikkelen] (2015). Symptomer og funksjon hos pasienter med residiverende patellaluksasjon sammenlignet med pasienter med fremre korsbåndsskade. I Vagstad, Terje (Red.), Høstmøteboken - Vitenskapelig program og abstrakter 2015. Norsk Ortopedisk Forening.
• Engen, Cathrine Nørstad; Løken, Sverre Bertrand; Årøen, Asbjørn & Engebretsen, Lars (2015). Elleve år gamle fokale bruskskader i knær, bedømt med dgermic. I Vagstad, Terje (Red.), Høstmøteboken - Vitenskapelig program og abstrakter 2015. Norsk Ortopedisk Forening.
• Owesen, Christian; Sivertsen, Einar Andreas; Engebretsen, Lars; Granan, Lars-Petter & Årøen, Asbjørn (2015). Patients With Isolated PCL Injuries Improve From Surgery as Much as Patients With ACL Injuries After 2 Years. Orthopaedic Journal of Sports Medicine (OJSM). ISSN 2325-9671. 3(8). doi: 10.1177/2325967115599539. Vis sammendrag

  Background: Reports on outcome after posterior cruciate ligament (PCL) reconstruction often contain both isolated PCL and combined knee ligament injuries. This makes it difficult to conclude on the outcome after reconstruction of isolated PCL injuries. Purpose: To investigate the outcome after PCL reconstruction in patients with an isolated PCL injury and to compare this with the outcome of patients treated with reconstruction after isolated anterior cruciate ligament (ACL) injuries. Study Design: Cohort study; Level of evidence, 3. Methods: Seventy-one patients with an isolated PCL injury that was reconstructed surgically and who had registered in the Norwegian Knee Ligament Registry between 2004 and 2010 were included in this study. Patients with isolated ACL reconstructions (n ¼ 9661) who had registered in the same period were included for comparison. Knee Injury and Osteoarthritis Outcome Score (KOOS) was used as the patient-reported outcome measure. Preoperative and 2-year postoperative KOOS scores were compared. Changes in KOOS score reported by the PCL patients were compared with changes reported by the ACL patients. Results: At the 2-year postoperative follow-up of the PCL-reconstructed patients, the patient-reported outcome was improved, measured by KOOS as follows: pain, 15.1 (95% CI, 8.5-21.8; P < .001); symptoms, 0.9 (95% CI, –6.6 to 8.3; P ¼ .82); activities of daily living, 13.2 (95% CI, 6.6-13.9; P < .001); sports, 20.7 (95% CI, 11.8-29.4; P < .001); and quality of life, 26.6 (95% CI, 18.9-34.2; P < .001). According to the KOOS, the incremental improvements were similar for PCL and ACL patients. Time from injury to surgery was longer for the PCL patients compared with ACL patients (median, 21.5 vs 8.0 months; P < .001). Conclusion: Patients undergoing PCL reconstruction can expect the same improvements in KOOS score as patients undergoing ACL reconstruction. However, PCL patients start out with an inferior score on average and consequently end up at a lower score compared with ACL patients for all KOOS subscales.

• Ulstein, Svend; Bredland, K; Årøen, Asbjørn; Engebretsen, Lars & Røtterud, Jan H (2014). Ingen negativ effekt av fulltykkelse bruskskade hos fremre korsbånd rekonstruerte pasienter ved 5-9 års oppfølging. I Drogset, Jon Olav (Red.), Høstmøteboken : vitenskapelig program og abstrakter 2014. Norsk ortopedisk forening.
• Sivertsen, Einar; Wagner, LR; Lind, M; Granan, Lars-Petter; Skråmm, Inge & Årøen, Asbjørn (2014). Infeksjon etter ACL rekonstruksjon. Data fra de norske og danske korsbåndregistrene. I Drogset, Jon Olav (Red.), Høstmøteboken : vitenskapelig program og abstrakter 2014. Norsk ortopedisk forening.
• Skråmm, Inge; Moen, Aina Elisabeth Fossum; Årøen, Asbjørn & Bukholm, Geir (2014). Surgical Site Infections in Orthopaedic Surgery Demonstrate Clones Similar to Those in Orthopaedic Staphylococcus aureus Nasal Carriers. Journal of Bone and Joint Surgery. American volume. ISSN 0021-9355. 96, s. 882–888. doi: 10.2106/JBJS.M.00919.

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• Øiestad, Britt Elin; Årøen, Asbjørn; Røtterud, Jan Harald; Østerås, Nina; Jarstad, Even & Grotle, Margreth [Vis alle 7 forfattere av denne artikkelen] (2023). The efficacy of strength or aerobic exercise on quality of life and knee function in patients with knee osteoarthritis. A multi-arm randomized controlled trial with 1-year follow-up.
• Birkenes, Thomas; Furnes, Ove Nord; Lygre, Stein Håkon Låstad; Solheim, Eirik Tveit; Årøen, Asbjørn & Knutsen, Gunnar [Vis alle 11 forfattere av denne artikkelen] (2023). Tidligere fokal bruskskade er assosiert med dårligere pasientrapportert resultat etter kneprotese .
• Straume-Næsheim, Truls Martin; BANITALEBI, HASAN; Årøen, Asbjørn & Randsborg, Per-Henrik (2023). Endring i rotasjonsforholdet mellom femur og tibia under den pubertalen veksspurten hos pasienter med patellaluksasjonsproblematikk.
• Randsborg, Per-Henrik; Brinchmann, Jan Engelsen; Owesen, Christian; Engebretsen, Lars; Birkenes, Thomas & Hanvold, Heidi Andreassen [Vis alle 8 forfattere av denne artikkelen] (2023). Bruskcelletransplantasjon vs. artroskopisk debridement av isolerte bruskskader i kneleddet. En RCT med 2 års oppfølging.
• Birkenes, Thomas; Furnes, Ove Nord; Lygre, Stein Håkon Låstad; Solheim, Eirik; Årøen, Asbjørn & Knutsen, Gunnar [Vis alle 10 forfattere av denne artikkelen] (2022). The long-term risk of knee arthroplasty after arthroscopically verified focal cartilage lesions in the knee.
• Øiestad, Britt Elin; Årøen, Asbjørn; Røtterud, Jan H; Østerås, Nina; Jarstad, Even & Grotle, Margreth [Vis alle 7 forfattere av denne artikkelen] (2022). Effekt av to ulike treningsprogram for pasienter med symptomatisk kneartrose. En klinisk randomisert kontrollert studie.
• Nilsgård, T.L; Årøen, Asbjørn & Straume-Næsheim, Truls Martin (2022). Association between single leg hop tests and knee function in patients with recurrent lateral patellar dislocation.
• Straume-Næsheim, Truls Martin; Randsborg, Per-Henrik & Årøen, Asbjørn (2022). Medial patellofemoral ligament reconstruction vs conservative treatment for recurrent lateral patellar dislocation - 3 years results from a randomized control trail.
• Årøen, Asbjørn (2021). Brusk, bruskskade, stamcellebehandling og brusktransplantasjon.
• Birkenes, Thomas; Furnes, Ove Nord; Årøen, Asbjørn; Solheim, Eirik; Knutsen, Gunnar & Drogset, Jon Olav [Vis alle 10 forfattere av denne artikkelen] (2021). Langtidsresultater etter bruskkirurgi i Norge - PROM hos pasienter utensenere kneprotese eller osteotomi.
• Kjennvold, Stian; Randsborg, Per-Henrik; Jakobsen, Rune Bruhn & Årøen, Asbjørn (2020). Fiksasjon av akutte chondrale frakturer i kne. I Hansen, Ann Kristin (Red.), Høstmøteboka 2020. Norsk Ortopedisk Forening. ISSN 978-82-994275-2-4.
• Birkenes, Thomas; Furnes, Ove; Årøen, Asbjørn; Solheim, Eirik; Knutsen, Gunnar & Drogset, Jon Olav [Vis alle 10 forfattere av denne artikkelen] (2020). Langtidsresultater etter fokal bruskskade i kne. I Hansen, Ann Kristin (Red.), Høstmøteboka 2020. Norsk Ortopedisk Forening. ISSN 978-82-994275-2-4.
• Årøen, Asbjørn (2020). Fixation of acute chondral fractures in adolescent knees.
• Wang, Katherine; Esbensen, Qin Ying; Karlsen, Tommy Aleksander; Årøen, Asbjørn & Jakobsen, Rune Bruhn (2019). Low-input RNA-sequencing in patients with cartilage lesions, osteoarthritis, and healthy cartilage - a reference for tissue engineering.
• Straume-Næsheim, Truls Martin; Persson, Andreas & Årøen, Asbjørn (2019). Patellainstabilitetsregister – noe å bruke tid og resurser på?
• Årøen, Asbjørn (2019). Cartilages injuries to the knee- The ultimate challenge for the orthopedic surgeon.
• Årøen, Asbjørn; Kjennvold, Stian; Brinchmann, Jan E.; Randsborg, Per-Henrik; Reinholt, Finn P. & Engebretsen, Lars (2019). Bone marrow derived mesenchymal stem cells in a human clinical trial to repair articular cartilage defects of the knee .
• Årøen, Asbjørn; Kjennvold, Stian; Brinchmann, Jan E.; Randsborg, Per-Henrik; Reinholt, Finn P. & Engebretsen, Lars (2018). Bone marrow derived mesenchymal stem cells in a human clinical trial to repair articular cartilage defects of the knee .
• Ulstein, Svend; Årøen, Asbjørn; Forssblad, Magnus; Engebretsen, Lars & Røtterud, Jan H (2018). Effect of concomitant cartilage lesions on patient-reported outcome after ACL-reconstruction - a nationwide cohort study from Norway and Sweden of 8470 patients with 5-year follow-up. Orthopaedic Journal of Sports Medicine (OJSM). ISSN 2325-9671. 6(7). doi: 10.1177/2325967118S00058.
• Ulstein, Svend; Årøen, Asbjørn; Forssblad, Magnus; Engebretsen, Lars & Røtterud, Jan H (2018). Effect of concomitant cartilage lesions on patient-reported outcome after ACL-reconstruction – a nationwide cohort study from Norway and Sweden of 8,470 patients with 5-Year follow-up.
• Aae, Tommy Frøseth; Lian, Øystein Bjerkestrand; Årøen, Asbjørn & Randsborg, Per-Henrik (2018). Pasienterstatning etter bruskkirurgi i kneleddet i Skandinavia fra 2010 til 2015.
• Årøen, Asbjørn (2018). OCD: an unsolved puzzle in articular cartilage problems. Osteoarthritis and Cartilage. ISSN 1063-4584. s. 1–2. doi: 10.1016/j.joca.2018.09.008.
• Årøen, Asbjørn & Devitt, Brian M. (2018). Penny-wise and pound-foolish. Knee Surgery, Sports Traumatology, Arthroscopy. ISSN 0942-2056. 26(4), s. 985–988. doi: 10.1007/s00167-018-4852-3.
• Aae, Tommy Frøseth; Randsborg, Per-Henrik; Lurås, Hilde; Årøen, Asbjørn & Lian, Øystein Bjerkestrand (2017). MIKROFRAKTUR VERSUS AUTOLOG CHONDROCYTTIMPLANTASJON – EN KOSTNADSEFFEKTIV ANALYSE.
• Ulstein, Svend; Årøen, Asbjørn; Forssblad, Magnus; Engebretsen, Lars; Lygre, Stein Håkon Låstad & Røtterud, Jan H (2017). Effekt av mikrofraktur eller debridement av ledsagende dyp bruskskade ved ACL-rekonstruksjon - en landsomfattende kohortestudie fra Norge og Sverige med 368 pasienter med 5-års oppfølging. I Lorentzen, Karl-Ivar (Red.), Høstmøteboken - Vitenskapelig program og abstract 2017. Norsk ortopedisk forening.
• Ulstein, Svend; Årøen, Asbjørn; Forssblad, Magnus; Engebretsen, Lars; Lygre, Stein Håkon Låstad & Røtterud, Jan H (2017). Effekt av mikrofraktur eller debridement av ledsagende dyp bruskskade ved ACL-rekonstruksjon - en landsomfattende kohortestudie fra Norge og Sverige med 368 pasienter med 5-års oppfølging.
• Ulstein, Svend; Årøen, Asbjørn; Forssblad, Magnus; Engebretsen, Lars; Lygre, Stein Håkon Låstad & Røtterud, Jan H (2017). ACL-rekonstruksjon i knær med ledsagende bruskskade - en landsomfattende kohortestudie fra Norge og Sverige med 8470 pasienter med 5-års oppfølging. I Lorentzen, Karl-Ivar (Red.), Høstmøteboken - Vitenskapelig program og abstract 2017. Norsk ortopedisk forening.
• Ulstein, Svend; Årøen, Asbjørn; Forssblad, Magnus; Engebretsen, Lars; Lygre, Stein Håkon Låstad & Røtterud, Jan H (2017). ACL-rekonstruksjon i knær med ledsagende bruskskade - en landsomfattende kohortestudie fra Norge og Sverige med 8470 pasienter med 5 års oppfølging.
• Årøen, Asbjørn (2017). CORR Insights: High interspecimen variability in engagement of the anterolateral ligament: An in vitro cadaveric study. Clinical Orthopaedics and Related Research. ISSN 0009-921X. 475(10), s. 2445–2446. doi: 10.1007/s11999-017-5416-4.
• Årøen, Asbjørn (2016). Utfordringer ved bruskkirurgi.
• Ulstein, Svend; Bredland, Karin; Årøen, Asbjørn; Engebretsen, Lars & Røtterud, Jan H (2016). No negative effect on patient-reported outcome of cartilage lesions 5-9 years after ACL-reconstruction. Knee Surgery, Sports Traumatology, Arthroscopy. ISSN 0942-2056. 24, s. S340–S341.
• Ulstein, Svend; Bredland, Karin; Årøen, Asbjørn; Engebretsen, Lars & Røtterud, Jan H (2016). No negative effect on patient-reported outcome of cartilage lesions 5-9 years after ACL-reconstruction.
• Engen, Cathrine Nørstad; Løken, Sverre Bertrand; Årøen, Asbjørn & Engebretsen, Lars (2015). Elleve år gamle fokale bruskskader i knær, bedømt med dgemric. Norsk idrettsmedisin. ISSN 0806-9328. 30(3).
• Engen, Cathrine Nørstad; Løken, Sverre Bertrand; Årøen, Asbjørn & Engebretsen, Lars (2015). Elleve år gamle fokale bruskskader i knær, bedømt med dgemric.
• Owesen, Christian; Sandven-Thrane, Stine; Lind, Martin; Forssblad, Magnus; Granan, Lars-Petter & Årøen, Asbjørn (2015). Epidemiology of surgically treated posterior cruciate ligament injuries in scandinavia. Norsk idrettsmedisin. ISSN 0806-9328. 30(3). doi: 10.1007/s00167-015-3786-2.
• Owesen, Christian; Sandven-Thrane, Stine; Lind, Martin; Forssblad, Magnus; Granan, Lars-Petter & Årøen, Asbjørn (2015). Epidemiology of surgically treated posterior cruciate ligament injuries in scandinavia.
• Røtterud, Jan H; Sivertsen, Einar; Forssblad, M; Engebretsen, Lars & Årøen, Asbjørn (2015). Effect on patient-reported outcome of debridement or microfracture of concomitant full-thickness cartilage lesions in anterior cruciate ligament reconstructed knees: a nationwide cohort study from Norway and Sweden of 357 pasients with 2-year-follow-up.
• Owesen, Christian; Sivertsen, Einar; Engebretsen, Lars; Granan, Lars-Petter & Årøen, Asbjørn (2015). Patients with an isolated PCL injury improve as much as the ACL patioens from surgery measured by KOOS after 2 years.
• Owesen, Christian; Sandven-Thrane, Stine; Lind, M; Forssblad, M; Granan, Lars-Petter & Årøen, Asbjørn (2015). Epidemiology surgically treated posterior cruciate ligament injuries in Scandinavia. Vis sammendrag

  Innledning: Bakre korsbånd (PCL) er kneets sterkeste ligament og hindrer i hovedsak posterior translasjon av tibia i forhold til femur, men PCL har også en sekundær stabiliserende funksjon. Det er stor variasjon i rapportert insidens av og årsak til PCL-skader. Det er også uoverensstemmelse i litteraturen når det gjelder forekomst av ledsagende skader. Hensikten med denne studien var å gi en oversikt over skademekanismer, ledsagende skader og andre epidemiologiske data for PCL-skader i de skandinaviske kneligamentregistrene. Materialer og Metoder: Totalt 1287 pasienter som gikk gjennom PCL-rekonstruksjon fra 2004-2013 i de Skandinaviske landene ble inkludert fra de nasjonale ligamentregistrene. Variablene alder, kjønn, aktivitet og graft benyttet ved rekonstruksjon ble samlet inn. Deretter ble skadene sortert basert på ledsagende skader. Til slutt ble data fra de forskjellige landene sammenliknet. Resultater: Pasientenes gjennomsnittsalder var 32.7 år. Kjønnsfordelingsratio var mann kvinne 66.7 %:33.3 %. Avhengig av definisjon var 26-37 % av de behandlede skadene isolerte skader. PCLskader var oftest forekommende i idrett med 35.4 % av det totale antallet PCL-skader. Fotball var den idretten med høyest antall skader (13.1 %). Minimum ett annet ligament var skadet hos 62.2 %. 26.1 % av PCL-skadene hadde en ledsagende bruskskade, 21.0 % hadde meniskskade. Hamstring autograft var det graftet som ble benyttet hyppigst ved rekonstruksjon. Diskusjon: Om lag 1/3 av PCL-skadene er isolerte skader, og er derfor klinisk viktig. Dette er ny informasjon når det gjelder kneligamentskader. Det er høy prevalens av ledsagende brusk- og meniskskader assosiert med PCL-skader, spesielt der minst ett annet ligament også er skadet. Dette kan muligvis forklares ut fra skademekanisme, men dette er fremdeles usikkert. Idrett er den aktivitet som oftest forårsaker PCL-skader som behandles kirurgisk. Dette er i kontrast til den tradisjonelle oppfatningen at PCL-skader forårsakes av dashboard-traume i bilulykker. Det er noen forskjeller i aktiviteter som fører til PCL-skade i de forskjellige landene, og forskjellene kan for en stor del tilskrives antallet utøvere av de forskjellige idrettene. Betydning/Relevans: Grunnleggende kunnskap mangler når det gjelder etiologien til PCL-skader og ledsagende skader. Dette gjør det vanskelig å vurdere hvor representativt materialet som publiseres i ulike ortopediske journaler i virkeligheten er. Epidemiologiske data er en nødvendig del av skadeforebygging i fremtiden. Prevalensen av ledsagende skader er avgjørende for valg av kirurgisk prosedyre og for de forventede resultatene etter kirurgi. De senere år er stadig flere PCL-skader behandlet kirurgisk. Denne studien sikter på å dekke huller i den eksisterende litteraturen ettersom de skandinaviske registrene inneholder et relativt stort antall PCL-skader. Det store antallet gjør det mulig å analysere skademekanismer og ledsagende skader.

• Straume-Næsheim, Truls Martin; Mikaelsen, JR; Sivertsen, EA; Devitt, Brian M.; Brand, J & Granan, Lars-Petter [Vis alle 7 forfattere av denne artikkelen] (2015). Symptomer og funksjon hos pasienter med residiverende patellaluksasjon sammenlignet med pasienter med fremre korsbåndskade. Vis sammendrag

  Innledning: Patellaluksasjon er en betydelig kneskade med høyest forekomst i alderen 10-17 år. Opp mot 40 % av disse får vedvarende plager med re-dislokasjoner og vedvarende frykt for nye hendelser. Dette gjør at de ikke stoler på kneet og det er en følelse de deler med pasienter som har røket fremre korsbånd. Den siste gruppen har tradisjonelt fått mer fokus i og denne studien ønsket derfor å sammenligne symptomene hos de med residiverende patellaluksasjon med korsbåndpasienter som er satt opp til korsbåndrekonstruksjon. Materialer og metoder: Patellaluksasjonsgruppen bestod av pasienter med to eller flere unilaterale patellaluksasjoner som var søkt inn til rekonstruksjon av mediale patellofemorale ligament (MPFL) fra mai 2010 til mai 2014. Hver av disse ble matchet etter alder, kjønn, og BMI med to pasienter fra Korsbåndregisteret (ACL). Preoperativ Knee injury and Osteoarthritis Outcome Score (KOOS) ble brukt for å vurdere og funksjon for begge grupper. Gruppene ble også sammenlignet i forhold til forekomst av bruskskader og tid fra skade til operasjon. Resultater: I alt 33 pasienter (10 menn og 23 kvinner, snittalder 18,9 (SD=5,0)) ble inkludert i MPFL gruppen. Disse ble matchet med 66 ACL pasienter. MPFL-gruppen hadde signifikant lavere resultat enn ACL gruppen for de tre første underkategoriene av KOOS (MPFL/ACL); smerte; 72,1/80,7 (p=0,021), symptomer; 68,3/79,2 (p<0,01) og daglige aktiviteter; 83,3/90,3 (p<0,01). De laveste resultatene for KOOS var for underkategoriene sport; 51,4/54,5 og livskvalitet; 37,5/38,4, men her var det ingen forskjell mellom MPFL og ACL gruppen. I MPFL-gruppen hadde 36,4 % bruskskade ved operasjonstidspunktet mens tilsvarende tall for ACL-gruppen var kun 7,6 % (p<0,001). Samtidig var gjennomsnittstiden fra første skade til operasjon 32,5 måneder for MPFL-gruppa mot 6,5 måneder for ACL-gruppen. Diskusjon og klinisk relevans: Pasienter med residiverende patellaluksajsoner er like plaget funksjonelt og oppgir mer smerter enn pasienter med sviktende knefunksjon som følge av fremre korsbåndsskade. Patelaluksasjonsgruppen har også 5 ganger så hyppig bruskskade ved operasjonstidspunktet og man venter i snitt 5 ganger så lenge med operasjon fra første skadetidspunkt sammenlignet med de med korsbåndskade

• Engen, Cathrine Nørstad; Løken, S; Årøen, Asbjørn & Engebretsen, Lars (2015). Elleve år gamle fokale bruskskader i knær, bedømt med dgemric. Vis sammendrag

  Innledning: Den naturlige utviklingen av fokale bruskskader i knærne er uavklart. Ikke-kirurgisk behandlede pasienter og pasienter som har gjennomgått bruskkirurgi har tilsvarende langtidsresultater. Resultatene fra kliniske studier innen bruskkirurgi er sprikende. For å avdekke prognostiske faktorer som fører til økt bruskdegenerasjon/artrose på sikt, trenger vi metoder for å vurdere tidlige degenerative forandringer. Prognostiske faktorer kan være etiologi, størrelse, dybde eller lokalisasjon av defekten, pasientens alder, BMI eller aktivitetsnivå eller ulike behandlingsteknikker. Det har vært en stor utvikling innen MR-teknikker de siste tiårene, og man kan nå vurdere innholdet i og kvaliteten av leddbrusk. Målet med denne studien er å evaluere bruskkvaliteten 11 år etter diagnostiserte fokale bruskdefekter i knær. Materialer og metode: Pasientene ble inkludert fra en kohorte av pasienter som ble artroskopert i 1999. Vi inkluderte pasienter med fulltykkelses fokale bruskskader som var under 50 år ved baseline, ikke hadde totalrupturerte ligamenter og minst 50 % av meniskene intakt. Vi inkluderte både pasienter som ble behandlet med avansert bruskkirurgi og pasienter som ikke gjennomgikk ikke-kirurgisk behandling. Evalueringen ble gjort med dGEMRIC, en MR-metode som kvantifiserer innholdet av glykosaminoglykaner og dermed avdekker tidlige artroseforandringer i leddbrusk. Vi registrerte subjektive scorer for vurdering av symptomer og knefunksjon, og røntgenbilder for vurdering av langtkomne artroseforandringer. Resultater: 42 pasienter matchet inklusjonskriteriene og 21 samtykket til deltagelse. Resultatene fra dGEMRIC varierte og demonstrerte både knær med normal leddbrusk og knær med etablert artrose. Vi fant en ikke-signifikant lavere score i dGEMRIC-index når den opprinnelige skaden befant seg på mediale femurkondyl. Vi fant ingen forskjell i knær som ble behandlet med kirurgi sammenlignet med ikke-kirurgi. Totalt sett var de subjektive scorene gode. Ni pasienter hadde Lysholm score over 70. Median KOOS score for sport var 45 og 56 for livskvalitet. Diskusjon: Vi fant varierende resultater i bruskkvalitet og ingen signifikant forskjell mellom kirurgi og ikke-kirurgi. Vi hadde imidlertid få pasienter og det er en sannsynlig seleksjonsbias mellom pasienter som gjennomgikk kirurgi sammenlignet med ikke-kirurgi. Noen pasienter klarer seg fint uten avansert bruskkirurgi, både vurderte med subjektive score og med dGEMRIC. Betydning: Kirurgi er kanskje ikke rett for alle pasienter, og vi må identifisere de som får best utfall med aktiv rehabilitering. Resultatene tyder på at det er behov for en mer systematisk kartlegging for å identifisere prognostiske faktorer hos pasienter med fokale bruskskader. dGEMRIC kan være et nyttig verktøy i arbeidet med å avdekke hvordan kirurgisk og ikke-kirurgisk behandling påvirker utfallet. Dette vil bidra til å skreddersy behandlingen av disse pasientene og dermed utsette, eller unngå, redusert knefunksjon og artrose.

• Årøen, Asbjørn (2015). Hvorfor er ACL revisjon vanskelig?
• Owesen, Christian; Sivertsen, Einar; Engebretsen, Lars; Granan, Lars-Petter & Årøen, Asbjørn (2015). Patients With An Isolated PCL Injury Improve As Much As The ACL Patients From Surgery Measured By KOOS After 2 Years. Orthopaedic Journal of Sports Medicine (OJSM). ISSN 2325-9671. 3(7). doi: 10.1177/2325967115S00072.
• Årøen, Asbjørn (2015). What adjuncts can improve microfracture (stem cells, Scaffolds, PRP)?
• Ulstein, Svend; Bredland, K; Årøen, Asbjørn; Engebretsen, Lars & Røtterud, Jan H (2014). Ingen negativ effekt av fulltykkelse bruskskade hos fremre korsbånd rekonstruerte pasienter ved 5-9 års oppfølging.
• Sivertsen, Einar; Wagner, LR; Lind, M; Granan, Lars-Petter; Skråmm, Inge & Årøen, Asbjørn (2014). Infeksjon etter ACL rekonstruksjon. Data fra de norske og danske korsbåndregistrene.
• Årøen, Asbjørn (2014). Siste nytt om bakre korsbåndskader - Singel eller double bundle kirurgi?
• Årøen, Asbjørn (2014). Diagnostikk, testing og operasjonsindikasjoner.
• Årøen, Asbjørn (2014). The infected ACL reconstructed knee - Introduction (epidemiology, incidence).
• LaPrade, Robert; Kennedy, Nicholas I.; Goldsmith, Mary; Michalski, Max P.; Devitt, Brian M. & Årøen, Asbjørn [Vis alle 8 forfattere av denne artikkelen] (2014). Kinematic analysis of the posterior cruciate ligament; the individual and collective function of the anterolateral and posteromedial bundles. Knee Surgery, Sports Traumatology, Arthroscopy. ISSN 0942-2056. 22.
• LaPrade, Robert; Kennedy, Nicholas I.; Goldsmith, Mary; Michalski, Max P.; Devitt, Brian M. & Årøen, Asbjørn [Vis alle 8 forfattere av denne artikkelen] (2014). Kinematic analysis of the posterior cruciate ligament; the individual and collective function of the anterolateral and posteromedial bundles.
• Årøen, Asbjørn; Brøgger, Helga Marie; Røtterud, Jan H; Sivertsen, Einar; Engebretsen, Lars & Risberg, May Arna (2014). Evaluation of surrounding articular cartilage in 28 patients knees with a focal cartilage lesion of the knee: using MRI T2 mapping and delayed gadolinium enhanced MRI of cartilage (dGEMRIC). Knee Surgery, Sports Traumatology, Arthroscopy. ISSN 0942-2056. 22, s. S78–S79.
• Årøen, Asbjørn; Brøgger, Helga Marie; Røtterud, Jan H; Sivertsen, Einar; Engebretsen, Lars & Risberg, May Arna (2014). Evaluation of surrounding articular cartilage in 28 patients knees with a focal cartilage lesion of the knee: using MRI T2 mapping and delayed gadolinium enhanced MRI of cartilage (dGEMRIC).
• Owesen, Christian & Årøen, Asbjørn (2017). Symptoms, diagnosis and outcomes in PCL injuries. Universitetet i Oslo. ISSN 9788283770902.
• Røtterud, Jan H & Årøen, Asbjørn (2015). Focal cartilage lesions in anterior cruciate ligament-injured knees. Akademika forlag. ISSN 978-82-8264-946-9.

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