Ragnhild Gunderson

Oslo University Hospital, Kristiania (historical), Oslo, Norway

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Publications (39)79.75 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: There is no consensus regarding prophylactic fixation of the contralateral hip in slipped capital femoral epiphysis (SCFE). In order to further study this question, we evaluated the long-term natural history of untreated contralateral hips.
  • Osteoarthritis and Cartilage 04/2014; 22:S33. DOI:10.1016/j.joca.2014.02.081 · 4.66 Impact Factor
  • Terje Terjesen, Joachim Horn, Ragnhild B Gunderson
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    ABSTRACT: There is little knowledge concerning outcomes for middle-aged adults who were treated for late-detected developmental dislocation of the hip. The aims of this retrospective study were to evaluate the fifty-year clinical and radiographic results after closed reduction and to identify prognostic factors. Seventy-one patients (ninety hips) with late-detected hip dislocation treated between 1958 and 1962 were assessed clinically and radiographically. The primary treatment was skin traction to obtain a gradual closed reduction. The mean age of the patients at the time of the long-term radiographic examination was 51.6 years (range, forty-four to fifty-five years). A stable reduction was achieved in eighty-three hips. The mean age at reduction was 1.7 years (range, 0.3 to 5.4 years). Traction failed in six patients (seven hips [8%]), for whom an open reduction was necessary. Twenty-six patients (thirty hips) underwent late surgical procedures because of residual hip dysplasia. A good long-term clinical outcome (a Harris hip score of ≥85 points) after closed reduction was assessed for fifty-two (63%) of the hips. A satisfactory radiographic outcome (no osteoarthritis) was found for fifty-six (67%) of the hips. Osteoarthritis had developed in twenty-seven (33%) of the hips, of which nineteen had undergone total hip replacement, performed at a mean patient age of 43.7 years (range, thirty-one to fifty-four years). Risk factors for osteoarthritis were an older age at the time of reduction, osteonecrosis of the femoral head, residual subluxation, a high acetabular index during childhood, and a classification of Severin grades III or IV at skeletal maturity. A survival analysis showed a reduction in "surviving" hips (no total hip replacement) from 99% at a patient age of thirty years to 74% at the age of fifty-two years. With a mean follow-up of fifty years, the clinical and radiographic outcomes after gradual closed reduction by skin traction were satisfactory in approximately two-thirds of eighty-three hips. The most important independent risk factors for a poor long-term outcome were an age of eighteen months or older at the time of reduction, residual subluxation, and osteonecrosis. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
    The Journal of Bone and Joint Surgery 02/2014; 96(4):e28. DOI:10.2106/JBJS.M.00397 · 4.31 Impact Factor
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    Joachim Horn, Ragnhild Beate Gunderson, Harald Steen, Anders Wensaas
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    Olav Reikerås, Ragnhild B Gunderson
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    ABSTRACT: In a prospective manner to evaluate the range of acetabular component anteversion actually achieved by the use of a cup positioner in cementless revision and primary THA. We operated 71 patients with cementless primary THA, and 26 patients with cementless acetabular revision surgery. We aimed to obtain cup anteversion of 10 to 30° with an impactor-positioner. In all cases we used elevated liners and a ceramic head with diameter 28. At 3 months postoperatively the component versions were measured using CT with the patient in supine position. The acetabular component version in the primary hips ranged from 28° of retroversion to 42° of anteversion with a mean of 17.4 ± 14.0°, while the cup version in the revision hips ranged from 4° of retroversion to 32° of anteversion with a mean of 15.0 ± 9.6°(p=0.427). The anteversion of 40 (56%) of the primary acetabular components were within the target zone of 10 to 30°, while 19 (27%) were below the target zone and and 12 (17%) were above the target range. The anteversion of 19 (73%) of the revision acetabular components were within the target zone, while 6 (23%) were below the target zone and 1 (4%) were above the target range. The differences in distribution between the primary and revision operations were not significant (p=0.183). The intraoperative estimation of acetabular anteversion by free hand technique in many cases was not within the intended range of 10 to 30° in either primary or revision THA and with no differences between the two series.
    The Open Orthopaedics Journal 10/2013; 7(1):600-4. DOI:10.2174/1874325001307010600
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    Joachim Horn, Ragnhild Beate Gunderson, Anders Wensaas, Harald Steen
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    ABSTRACT: Purpose We modified the method for tibial epiphysiodesis by solely using a lateral approach to the physis. From this small-incision approach, the lateral as well as the medial part of the tibial physis were ablated. The aim of our study was to see if this operative technique might be as effective as a bilateral approach, and reduce the operation time and usage time of the image intensifier. The epiphysiodeses were monitored by radiostereometric analysis (RSA), which is a well-established method for the analysis of micro movements and has been used to monitor percutaneous epiphysiodesis with the bilateral approach. There are no reports in the literature comparing single- with double-portal approaches for percutaneous epiphysiodesis evaluated by RSA. Methods Twenty children were treated by percutaneous epiphysiodesis for leg length discrepancies ranging from 15 to 70 mm, comprising 14 boys and 6 girls with a mean age of 13 (11–15) years. The timing of epiphysiodesis was determined by using Moseley’s straight-line graph and Paley’s multiplier method. For the tibial epiphysiodesis, ten patients were operated with a single surgical approach from the lateral side (Group I) and ten patients were operated with a surgical approach from both the medial and the lateral sides (Group II). The percutaneous epiphysiodesis was monitored by RSA, a method which allows analysis of the three-dimensional dynamics of the epiphysis relative to the metaphysics. RSA examinations were performed postoperatively and after 6 weeks, 12 weeks, and 6 months. Results From 0 to 6 weeks after epiphysiodesis, the mean longitudinal growth across the operated physis in the tibia in Group I was 0.26 (0.01–0.6) mm. In Group II, the mean growth for the first 6 weeks after surgery was 0.17 (0.01–0.5) mm. During the time period from 6 weeks to 12 weeks after surgery, there was a mean growth of 0.06 (0.00–0.18) mm in Group I and 0.03 (0.00–0.2) mm in Group II. The mean growth from 0 to 6 weeks after epiphysiodesis for all patients was 0.22 mm, which corresponds to 30 % of the normal growth rate. From 6 to 12 weeks, the mean growth for all patients was 0.046 mm, i.e., 6 % of the normal growth rate. From 12 weeks to 24 weeks, no significant growth across the operated physis was observed in neither Group I nor Group II. The mean surgical time was 26 (21–30) min in Group I and 43 (35–48) min in Group II. This difference was statistically significant (p = 0.006). The mean time for use of the image intensifier during surgery was 202 (191–236) s in Group I and 229 (185–289) s in Group II (p = 0.013). Conclusions In our study, a single-portal technique from the lateral side for percutaneous epiphysiodesis of the proximal tibia was as effective as the double-portal technique. Actual growth arrest appeared within 12 weeks after surgery. A single-portal technique for epiphysiodesis of the tibia is a safe technique, with less surgical time and less time for image intensification compared to the double-portal technique.
    Journal of Children s Orthopaedics 10/2013; 7(4). DOI:10.1007/s11832-013-0502-y
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    ABSTRACT: Background and purpose Percutaneous physiodesis in the knee region is a well-established method for treating leg-length inequality. Longitudinal growth in the physis is believed to stop almost immediately after the operation. The extent of physis ablation required has never been investigated by any kind of tomography in humans. Using radiostereometric analysis (RSA), we determined when definite growth arrest occurred after surgery. We also studied the correlation between the extent of physis ablation and postoperative growth. Finally, we assessed any bone bridging across the physis. Methods 6, 12, and 30 weeks after surgery, we used RSA to measure longitudinal growth in 27 patients (37 physes) with a mean age of 13 years. CT scanning of the knee region was performed 12 weeks after surgery to measure the percentage of the ablated physis and to determine the distribution of bone bridges across the physis. Results RSA showed that growth rate was reduced to less than half of the expected rate after 6 weeks. During the next 6 weeks, the growth ceased completely. CT scans revealed a large variation in the extent of ablated physes (17–69%). In the ablated areas, tissues of various densities were mixed with mature bone. Bridges were found both laterally and medially across the physes in all of the patients. There was a negative correlation between the extent of ablation and total postoperative growth (rho = –0.37, p = 0.03). Interpretation Growth across the physis is effectively stopped by percutaneous physiodesis. RSA is well-suited for observation of this phenomenon. Volume CT scanning can be used to detect bone bridges that cross the physis and to calculate the extent of physis ablation.
    Acta Orthopaedica 06/2013; 84(4). DOI:10.3109/17453674.2013.810523 · 2.45 Impact Factor
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    JI Brox, JE Lange, RB Gunderson, H Steen
    Scoliosis 06/2013; 8(1). DOI:10.1186/1748-7161-8-S1-O43 · 1.31 Impact Factor
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    ABSTRACT: Deformity after slipped upper femoral epiphysis (SUFE) can cause cam-type femoroacetabular impingement (FAI) and subsequent osteoarthritis (OA). However, there is little information regarding the radiological assessment and clinical consequences at long-term follow-up. We reviewed 36 patients (43 hips) previously treated by in situ fixation for SUFE with a mean follow-up of 37 years (21 to 50). Three observers measured the femoral head ratio (FHR), lateral femoral head ratio (LFHR), α-angle on anteroposterior (AP) and frog-leg lateral views, and anterior femoral head-neck offset ratio (OSR). A Harris hip score < 85 and/or radiologically diagnosed osteoarthritis (OA) was classified as a poor outcome. Patients with SUFE had significantly higher FHR, LFHR and α-angles and lower OSR than a control group of 22 subjects (35 hips) with radiologically normal hips. The interobserver agreement was less, with wider limits of agreement (LOA), in hips with previous SUFE than the control group. At long-term follow-up abnormal α-angles correlated with poor outcome, whereas FHR, LFHR and OSR did not. We conclude that persistent deformity with radiological cam FAI after SUFE is associated with poorer clinical and radiological long-term outcome. Although the radiological measurements had quite wide limits of agreement, they are useful for the diagnosis of post-slip deformities in clinical practice.
    The Bone & Joint Journal 11/2012; 94(11):1487-93. DOI:10.1302/0301-620X.94B11.29569 · 2.80 Impact Factor
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    ABSTRACT: BACKGROUND:Although arthroscopic techniques are the most common procedures today when reconstructing the anterior cruciate ligament (ACL), many surgeons still prefer the open and/or 2-incision techniques. HYPOTHESIS:There are no differences in knee function or prevalence of knee osteoarthritis (OA) in patients who have undergone the open versus endoscopic technique for ACL reconstruction using the patellar tendon autograft. STUDY DESIGN:Randomized controlled trial; Level of evidence, 2. METHODS:Sixty-seven patients with subacute or chronic rupture of the ACL were randomly assigned to open (OPEN) (n = 33) or endoscopic (ENDO) (n = 34) reconstruction. Function was evaluated by the Cincinnati knee score, single-legged hop tests, and isokinetic muscle strength tests. The radiographs were classified according to the Kellgren and Lawrence (KL) classification system, defining grade 2 or more as the cutoff point for knee OA. The Insall-Salvati ratio and the Blackburne-Peel ratio were used to calculate the patellar position and height. RESULTS:Mean age at inclusion and at the 12-year follow-up evaluation was 27.9 ± 8.6 and 39.8 ± 8.6 years, respectively. At 12-year follow-up, 53 patients (79%) were eligible for evaluation. There were no significant differences between the 2 surgical procedures with respect to the pain, function, muscle strength, hop tests, patellar height, or the prevalence of OA. The prevalence of OA was high in the tibiofemoral joint on the operated side, 79% and 80% in the OPEN and ENDO groups, respectively. For the uninvolved knee, the corresponding numbers were 36% and 21%. CONCLUSION:This study suggests that the open procedure does not produce more functional problems or osteoarthritis compared with the endoscopic technique up to 12 years postoperatively.
    The American Journal of Sports Medicine 09/2012; 40(11). DOI:10.1177/0363546512458766 · 4.70 Impact Factor
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    ABSTRACT: PURPOSE: To investigate the prevalence of patellofemoral osteoarthritis (OA) and to explore the association between radiographic patellofemoral OA and symptoms and function 12 years after anterior cruciate ligament (ACL) reconstruction. METHODS: The study participants (n = 221) were consecutively included at the time of an ACL reconstruction in the period from 1990 to 1997. Knee laxity (KT-1000), isokinetic quadriceps strength, triple jump, stair hop, and the Cincinnati knee score were measured 6 months, 1 year, 2 years, and 12 years after surgery. At the 12-year follow-up, visual analogue scale for pain, the Knee injury and Osteoarthritis Outcome Score, the Tegner activity scale, and radiographic examination (Kellgren and Lawrence score) were added. To analyse the association between patellofemoral OA, symptoms, and function, binary regression analyses presenting odds ratios and 95 % confidence intervals were used. The analyses were adjusted for age, gender, and body mass index. RESULTS: One hundred and eighty-one of the 221 subjects (82 %), including 76 females (42 %) and 105 males (58 %), were evaluated at the 12.3 ± 1.2-year follow-up. Mean age at the follow-up was 39.1 ± 8.7 years. Additional meniscal or chondral injuries at the time of reconstruction or during the follow-up period were detected in 116 subjects (64 %). Radiographic patellofemoral OA was found in 48 subjects (26 %), including 3 subjects with isolated patellofemoral OA (1.5 %). Those with patellofemoral OA were older, had more tibiofemoral OA, and had significantly more symptoms and impaired function compared with those without patellofemoral OA. CONCLUSIONS: Patellofemoral OA was found in 26 % 12 years after ACL reconstruction. Patellofemoral OA was associated with increased age, tibiofemoral OA, increased symptoms, and reduced function. It is of clinical importance to include functional and radiographic assessment of the patellofemoral joint in the examination of long-term consequences following an ACL reconstruction. LEVEL OF EVIDENCE: II.
    Knee Surgery Sports Traumatology Arthroscopy 08/2012; 21(4). DOI:10.1007/s00167-012-2161-9 · 2.84 Impact Factor
  • Jens Ivar Brox, Johan Emil Lange, Ragnhild Beate Gunderson, Harald Steen
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    ABSTRACT: To examine the association between brace compliance and outcome. 495 (457 females) patients with late onset juvenile and adolescent idiopathic scoliosis were examined prospectively before bracing and at least 2 years after brace weaning. One spine surgeon examined all patients. 381 (353 females) answered a standardised questionnaire and 355 had radiological examination after median 24 years. Compliance was defined as brace wear >20 h daily until weaning. Main outcomes were curve progression and surgery. At weaning, 76/389 compliers and 59/106 non-compliers had curve progression ≥6° (OR 5.2, 95 % CI 3.3-8.2). At long-term the numbers were 68/284 and 46/71 (OR 5.8, 95 % CI 3.3-10.2), 10/284 versus 17/71 had been operated (OR 8.6, 95 % CI 3.7-19.9). We conclude that the risk for curve progression and surgery are reduced in patients with good brace compliance.
    European Spine Journal 06/2012; 21(10):1957-63. DOI:10.1007/s00586-012-2386-9 · 2.47 Impact Factor
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    Terje Terjesen, Ragnhild B Gunderson
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    ABSTRACT: Different methods have been used to classify osteoarthritis (OA) of the hip. We evaluated the reliability of different classifications in order to find which grading system is most appropriate for use in clinical practice. 49 patients (61 affected hips) with late-detected developmental dislocation of the hip (DDH) were studied. The mean age at follow-up was 45 (32-49) years. 3 classifications of OA were compared. The gradings by Kellgren and Lawrence (1957) (K&L) and Croft et al. (1990) are global visual assessments based on osteophytes, cysts, subchondral sclerosis, and narrowing of the joint space. The third classification is based on narrowing in the upper, weight-bearing part of the joint and defines as OA a minimum joint space width (JSW) of less than 2.0 mm at the narrowest part. 2 experienced observers, one radiologist and one orthopedic surgeon, assessed and measured the radiographs. Minimum JSW (< 2.0 mm in 9 hips) gave the best inter-observer agreement (kappa value = 0.87). Using the K&L grading, inter-observer agreement was moderate (kappa = 0.55), but kappa increased when the number of categories was reduced from 5 to 3 (no OA, mild OA, and severe OA). The Croft classification gave similar agreement as the K&L grading. The intra-observer agreement was better than inter-observer agreement, irrespective of the grading system. There was a good accordance between the minimum JSW and the 2 other methods. Joint space narrowing using a minimum JSW of < 2.0 mm as criterion for OA was the simplest and most reproducible classification in long-term follow-up of patients with DDH. A classification based on global visual assessment can be used in addition if only hips with severe OA are included.
    Acta Orthopaedica 02/2012; 83(2):185-9. DOI:10.3109/17453674.2012.665331 · 2.45 Impact Factor
  • Terje Terjesen, Ragnhild B Gunderson
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    ABSTRACT: To assess the reliability of radiographic measurements in adults previously treated for developmental dysplasia of the hip (DDH) and to clarify whether these parameters differ according to position of the patient (supine versus standing). Fifty-one patients (41 females and 10 males) with 63 affected hips were included in the study. The mean follow-up period was 45 (44-49) years in the patients who had not undergone total hip replacement (THR). Anteroposterior radiographs of the pelvis were taken with the patient in the supine and in the standing position. Measurements used for residual hip dysplasia were center-edge (CE) angle and migration percentage (MP). The joint space width (JSW) was measured at three or four locations of the upper, weight-bearing part of the joint, and the shortest distance was termed the minimum joint space width (minJSW). One radiologist and one orthopaedic surgeon, each with more than 30 years of experience, independently measured the radiographic parameters. The limits of agreement (LOA) of the CE angle (mean interobserver difference ± 2SD) were within the range -8 to 7°. The LOA of the MP were in the range -8 to 8% and of the minJSW -0.6 to 1.1 mm. The mean differences in CE angle between supine and standing radiographs (supine - standing) ranged from -1.1 to 0.0° and the mean differences in MP between supine and standing positions were below 1%. The mean positional differences in minJSW were below 0.1 mm and were not statistically significant. The interobserver variations with regard to CE angle, MP, and minJSW were moderate, indicating that these are reliable measurements in clinical practice. Femoral head coverage and JSW did not significantly differ between supine and weight-bearing positions.
    Skeletal Radiology 11/2011; 41(7):811-6. DOI:10.1007/s00256-011-1293-1 · 1.74 Impact Factor
  • O. Reikerås, R. B. Gunderson
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    ABSTRACT: Background The recommended range of anteversion of the components in total hip arthroplasty (THA) is between 10 and 30°, but the intraoperative estimation of these versions may be inadequate. Hypothesis The components anteversion in primary cementless THA using straight stem and hemispherical cup is not significantly different from the native anteversion of the hip joint. Objectives To evaluate in a prospective manner the range of anteversion currently achieved in cementless THA. Materials and methods Five senior surgeons operated 91 patients with primary cementless THA. We used a straight press fit stem and a hemispherical press fit cup. We aimed to obtain femoral anteversion of 10° to 30°, acetabular anteversion of 10° to 30° and a global combined anteversion of 25° to 55°. Cup position was checked with an impactor-positioner, and stem position was determined with the knee flexed 90°. In all cases we used elevated liners and 28 mm diameter ceramic heads. At 3 months postoperatively the component versions were measured using a General Electric LightSpeed Pro 16 (Milwaukee, Wi, USA) with the patient in supine position. Results Femoral component measurements ranged from 17° of retroversion to 60° of anteversion with a mean of 23.0° ± 11.8°. Similarly, acetabular component version ranged from 28° of retroversion to 46° of anteversion with a mean of 18.5° ± 13.7°. There were no correlations to the native femoral and acetabular versions. Only 55 hips (60.4 %) were within the accepted range of 25° to 55° of combined anteversion, but none of the cases dislocated during a follow-up of two years. Conclusion In cementless THA with our operative technique, the intraoperative estimation of femoral and acetabular anteversion, in many cases, resulted to be inadequate in relation to the intended range of 10° to 30° of anteversion. Level of evidence Level III prospective diagnostic.
    Resuscitation 10/2011; 97(6):600-601. DOI:10.1016/j.rcot.2011.07.011 · 3.96 Impact Factor
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    O Reikerås, R B Gunderson
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    ABSTRACT: The recommended range of anteversion of the components in total hip arthroplasty (THA) is between 10 and 30°, but the intraoperative estimation of these versions may be inadequate. The components anteversion in primary cementless THA using straight stem and hemispherical cup is not significantly different from the native anteversion of the hip joint. To evaluate in a prospective manner the range of anteversion currently achieved in cementless THA. Five senior surgeons operated 91 patients with primary cementless THA. We used a straight press fit stem and a hemispherical press fit cup. We aimed to obtain femoral anteversion of 10 to 30°, acetabular anteversion of 10 to 30° and a global combined anteversion of 25 to 55°. Cup position was checked with an impactor-positioner, and stem position was determined with the knee flexed 90°. In all cases we used elevated liners and 28 mm diameter ceramic heads. At 3 months postoperatively the component versions were measured using a General Electric LightSpeed Pro 16 (Milwaukee, Wi, USA) with the patient in supine position. Femoral component measurements ranged from 17° of retroversion to 60° of anteversion with a mean of 23.0±11.8°. Similarly, acetabular component version ranged from 28° of retroversion to 46° of anteversion with a mean of 18.5±13.7°. There were no correlations to the native femoral and acetabular versions. Only 55 hips (60.4%) were within the accepted range of 25 to 55° of combined anteversion, but none of the cases dislocated during a follow-up of 2 years. In cementless THA with our operative technique, the intraoperative estimation of femoral and acetabular anteversion, in many cases, resulted to be inadequate in relation to the intended range of 10 to 30° of anteversion.
    Orthopaedics & Traumatology Surgery & Research 09/2011; 97(6):615-21. DOI:10.1016/j.otsr.2011.02.014 · 1.17 Impact Factor
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    ABSTRACT: ABSTRACT: It is recommended that research in patients with idiopathic scoliosis should focus on short- and long-term patient-centred outcome. The aim of the present study was to evaluate outcome in patients with late-onset juvenile or adolescent idiopathic scoliosis 16 years or more after Boston brace treatment. 272 (78%) of 360 patients, 251 (92%) women, responded to follow-up examination at a mean of 24.7 (range 16 - 32) years after Boston brace treatment. Fifty-eight (21%) patients had late-onset juvenile and 214 had adolescent idiopathic scoliosis. All patients had clinical and radiological examination and answered a standardised questionnaire including work status, demographics, General Function Score (GFS) (100 - worst possible) and Oswestry Disability Index (ODI) (100 - worst possible), EuroQol (EQ-5D) (1 - best possible), EQ-VAS (100 - best possible), and Scoliosis Research Society - 22 (SRS - 22) (5 - best possible). The mean age at follow-up was 40.4 (31-48) years. The prebrace major curve was in average 33.2 (20 - 57)°. At weaning and at the last follow-up the corresponding values were 28.3 (1 - 58)° and 32.5 (7 - 80)°, respectively. Curve development was similar in patients with late-onset juvenile and adolescent start. The prebrace curve increased > 5° in 31% and decreased > 5° in 26%. Twenty-five patients had surgery. Those who did not attend follow-up (n = 88) had a lower mean curve at weaning: 25.4 (6-53)°. Work status was 76% full-time and 10% part-time. Eighty-seven percent had delivered a baby, 50% had pain in pregnancy. The mean (SD) GFS was 7.4 (10.8), ODI 9.3 (11.0), EQ-5D 0.82 (0.2), EQ-VAS 77.6 (17.8), SRS-22: pain 4.1 (0.8), mental health 4.1 (0.6), self-image 3.7 (0.7), function 4.0 (0.6), satisfaction with treatment 3.7 (1.0). Surgical patients had significantly reduced scores for SRS-physical function and self-image, and patients with curves ≥ 45° had reduced self-image. Long-term results were satisfactory in most braced patients and similar in late-onset juvenile and idiopathic adolescent scoliosis.
    Scoliosis 08/2011; 6:18. DOI:10.1186/1748-7161-6-18 · 1.31 Impact Factor
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    ABSTRACT: Reduced muscle strength and density observed at 1 year after lumbar fusion may deteriorate more in the long term. To compare the long-term effect of lumbar fusion and cognitive intervention and exercises on muscle strength, cross-sectional area, density, and self-rated function in patients with chronic low back pain (CLBP) and disc degeneration. Randomized controlled study with a follow-up examination at 8.5 years (range, 7-11 years). Patients with CLBP and disc degeneration randomized to either instrumented posterolateral fusion of one or both of the two lower lumbar levels or a 3-week cognitive intervention and exercise program were included. Isokinetic muscle strength was measured by a Cybex 6000 (Cybex-Lumex, Inc., Ronkonkoma, NY, USA). All patients had previous experience with the test procedure. The back extension (E) flexion (F) muscles were tested, and the E/F ratios were calculated. Cross-sectional area and density of the back muscles were measured at the L3-L4 segment by computed tomography. Patients rated their function by the General Function Score. Trunk muscle strength, cross-sectional area, density, and self-rated function. Fifty-five patients (90%) were included at long-term follow-up. There were no significant differences in cross-sectional area, density, muscle strength, or self-rated function between the two groups. The cognitive intervention and exercise group increased trunk muscle extension significantly (p<.05), and both groups performed significantly better on trunk muscle flexion tests (p<.01) at long-term follow-up. On average, self-rated function improved by 56%, cross-sectional area was reduced by 8.5%, and muscle density was reduced by 27%. Although this study did not assess the morphology of muscles likely damaged by surgery, trunk muscle strength and cross-sectional area above the surgical levels are not different between those who had lumbar fusion or cognitive intervention and exercises at 7- to 11-year follow-up.
    The spine journal: official journal of the North American Spine Society 08/2011; 11(8):718-25. DOI:10.1016/j.spinee.2011.06.004 · 2.80 Impact Factor
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    The American Journal of Sports Medicine 04/2011; 39(4):NP3; author reply NP3-4. DOI:10.1177/0363546511403704 · 4.70 Impact Factor
  • The American Journal of Sports Medicine 04/2011; 39(4):NP3-NP4. · 4.70 Impact Factor

Publication Stats

586 Citations
79.75 Total Impact Points

Institutions

  • 2010–2014
    • Oslo University Hospital
      • Department of Orthopaedic Surgery
      Kristiania (historical), Oslo, Norway
  • 2001–2011
    • University of Oslo
      • Department of Orthopaedics (ORTHO)
      Kristiania (historical), Oslo, Norway
  • 2008–2010
    • Diakonhjemmet Hospital (Norway)
      Kristiania (historical), Oslo, Norway