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Knee Function after ACL Injury - genetic predisposition, clinical and laboratory assessment and long term consequences.

Title of Project

Knee Function after ACL Injury – genetic predisposition, clinical and laboratory assessment and long term consequences in relation to treatment, development of ostheoarthritis and quality of life.

Project Period

01/01/2010 - 12/31/2017

Subject areas

Orthopaedics, Physiotherapy

Head of research

Charlotte Häger, Department of Community Medicine and Rehabilitation

Kinematic recording of a one-leg-hop transformed to a biomechanical model of a skeleton Injury of the anterior cruciate ligament (ACL) in the knee is common, and treated with physiotherapy with or without surgery. There is still no evidence which is the best option, with respect to long term function and the risk of developing osteoarthritis (OA). This is partly due to a lack of gold standard on how to assess knee function and our lack of understanding of possible hereditary risk factors. Our aims are 1) to comprehensively evaluate knee function after ACL injury regarding the long term consequences and impact on daily life, and how the treatment given initially relates to the outcome; 2) to provide new and improved clinical knee assessment, as well as protocols for laboratory based movement assessment targeting the functional control of the knee, which do not currently exist; 3) explore genetic predisposition with respect to ligament tissue structure, development of OA, and physical risk taking, all extremely novel. We study a unique cohort with two groups who had ACL injury on average 23 (17-31) years ago: one group had physiotherapy and surgery and the other physiotherapy alone, and compare to healthy controls. Significance: There is no equivalent study with extensive data collection including movement analysis so long after injury. We strive to meet the highlighted need for improved physiotherapy tools to guide and evaluate treatment, tailored to the individual. The genetic approach may shed a completely new light on injury prevention.

Project members

Name Title Exam Funding
Charlotte Häger Professor, Leg fysioterapeut PhD, Fysioterapeut
Jonas Selling Forskningsingenjör Civilingenjör tekn fysik Vetenskapsrådet, Spjutspetsmedel,
Helena Grip Forskare, MTI, NUS PhD, Civilingenjör tekn fysik Vetenskapsrådet
Lina Schelin Universitetslektor i statistik PhD Vetenskapsrådet
Johan Strandberg Doktorand Statistik ALF medel
Jonas Markström Doktorand MSc Idrottsmedicin Vetenskapsrådet, CIF, Idrottshögskolan,
Andrew Strong Forskningsassistent Bachelor in Sports Science, UK Vetenskapsrådet
Eva Tengman Post doc, Leg fysioterapeut PhD, Fysioterapeut Post doc tjänst SFO-V

External Funding (1000SEK)

Head of Project Sponsoring Institution 2011 2012 2013 2014 2015 2016 2017
Charlotte Häger Vetenskapsrådet 800 800 800 1000 1000 1000 1000
Charlotte Häger VLL spjutspetsmedel 900 900 900
Charlotte Häger Centrum för idrottsforskning 54 100
Charlotte Häger Reumatikerförbundet 200

Selected publications

  1. Tengman, E., Brax Olofsson, L., Nilsson, KG., Tegner, Y., Lundgren, L. Häger, CK. (2014) Anterior cruciate ligament injury after more than 20 years: I. Physical activity level and knee function. Scand J Sport and Science in Medicine Article first published online: 27 MAR 2014DOI: 10.1111/sms.12212

  2. Tengman, E., Brax Olofsson, L., Stensdotter, AK., Nilsson, KG., Häger, CK. (2014) Anterior cruciate ligament injury after more than 20 years: II. Concentric and eccentric knee muscle strength. Scand J Sport and Science in Medicine. Article first published online: 27 MAR 2014DOI: 10.1111/sms.12212

  3. Grip H, Häger C (2013). A new approach to measure functional stability of the knee based on changes in knee axis orientation. J Biomechanics 46(5):855-62

  4. Stensdotter A-K, Tengman E, Brax Olofsson L, Häger, C (2013) Deficits in single-limb stance more than 20 years after ACL injury. European Journal of Physiotherapy 15(2):78-85

  5. Tengman, E., Grip, H. Stensdotter, A-K, Häger, CK. (2015) Anterior cruciate ligament injury about 20 years post-treatment: A kinematic analysis of one-leg hop. Scand J Med Sci Sports (In press)

Local Partners

Professor Kjell G Nilsson, Institutionen för kirurgisk och perioperativ vetenskap
Professor emeritus Jack Lysholm, Institutionen för folkhälsa och klinisk medicin
Docent Patrik Rydén, Institutionen för matematisk statistik

National Partners

Docent Eva-Lena Stattin, Uppsala universitet
Professor Yelverton Tegner, Luleå tekniska universitet
Dr Divya Srinivasan, University of Gävle

International Partners

Associate professor Ann-Katrin Stensdotter, Högskolan i Sör-Trondelag, Trondheim, Norge
Dr Gisela Sole, University of Dunedin, Dunedin, New Zealand
Professor Malcolm Collins, University of Cape Town, South Africa
Dr Michael Posthummus, University of Cape Town, South Africa
Dr Kim Hébert-Losier, National Sports Institute of Malaysia, Malaysia
Dr Dario Liebermann, University of Tel Aviv, Israel

Externally financed team members

Eva Tengman, Post doc, Medel för Strategiska forskningsområden Vårdvetenskap

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