Lars Engebretsen

Lars Engebretsen
University of Oslo · Department of Orthopaedics (ORTHO)

MD PhD

About

777
Publications
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Publications

Publications (777)
Article
Background Anterior cruciate ligament reconstruction (ACLR) is often recommended for treatment of an ACL injury; however, the literature reports similar outcomes for those undergoing rehabilitation alone. We assessed the clinical, functional, sports participation, and osteoarthritis outcomes following our treatment algorithm, and compared 10-year o...
Article
With the WHO stating that nearly 99% of the global population is exposed to air pollution levels that increase the risk of chronic diseases, the question of exercising in polluted environments is relevant to the health of athletes. Major sporting events held under conditions of poor air quality (AQ) have highlighted the lack of answers to concerns...
Article
Background A lateral extra-articular tenodesis (LET) is increasingly being utilized to augment an anterior cruciate ligament reconstruction because it has been shown to reduce the risk of postreconstruction graft failure or recurrent rotatory instability. Various femoral fixation techniques are available, including the use of an interference screw,...
Article
Background Multiligament knee injuries (MLKIs) are heterogeneous, and bicruciate knee ligament injuries are considered a serious form of this injury. The current literature tends not to distinguish between single and bicruciate MLKI when reporting outcomes. Purpose To investigate patient-reported outcomes after surgical treatment of MLKI comparing...
Chapter
Although artificial intelligence (AI) is a valuable tool, intelligent technologies in orthopedics also present potential risks and ethical issues that must be considered. Accuracy and reliability of algorithms and systems must be ensured to mitigate the risk of misinterpretation ultimately leading to incorrect diagnoses and outcomes. Bias and discr...
Article
Purpose The purpose of this study was to compare the incidence of knee osteoarthritis (OA) between the anatomic single‐bundle (SB) and anatomic double‐bundle (DB) anterior cruciate ligament (ACL) reconstruction technique after 5‐year follow‐up (FU). Secondary objectives were to compare patient‐reported outcome measures (PROMs), clinical examination...
Article
Full-text available
The International Olympic Committee’s (IOC) consensus statement on ‘methods for recording and reporting of epidemiological data on injury and illness in sport’ recommended standardising methods to advance data collection and reporting consistency. However, additional aspects need to be considered when these methods are applied to specific sports se...
Article
Objectives Machine learning has emerged as a potential tool for improving outcome prediction accuracy in anterior cruciate ligament (ACL) reconstruction (ACLR). A machine learning-based ACL revision prediction model has been developed using data from the Norwegian Knee Ligament Register (NKLR) but lacks external validation outside of Scandinavia. T...
Article
Objective To evaluate radiographic knee osteoarthritis (OA) progression, development of knee OA, patient-reported outcomes and knee muscle strength at 10-year follow-up after arthroscopic partial meniscectomy (APM) or exercise therapy for degenerative meniscal tears. Methods Randomised controlled trial including 140 participants, with a degenerati...
Article
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Background: Focal cartilage lesions (FCLs) are frequently found during knee arthroscopies and may impair quality of life (QoL) significantly. Several treatment options with good short-term results are available, but the natural history without any treatment is largely unknown. The aim of this study was to evaluate patient-reported outcome measures...
Article
Full-text available
OBJECTIVE: To describe rehabilitation and decision-making from ACL reconstruction to return to sport (RTS), characteristics and RTS proportions for pivoting sports athletes undergoing usual care. DESIGN: Cross-sectional study. METHODS: We invited people with ACL reconstruction who were aged 16-40 years, and injured during soccer, handball, or baske...
Article
Sports medicine physicians and physiotherapists commonly use cryotherapy (eg, ice application) postinjury to decrease tissue temperature with the objective of reducing pain, limiting secondary injury and inflammation, and supporting healing. However, besides the analgesic effect of cryotherapy, a literature search revealed no evidence from human st...
Article
Multiligament knee injuries (MLKIs) represent a broad spectrum of pathology with potentially devastating consequences. Currently, disagreement in the terminology, diagnosis and treatment of these injuries limits clinical care and research. This study aimed to develop consensus on the nomenclature, diagnosis, treatment and rehabilitation strategies...
Article
With the pronounced ongoing growth of global youth sports, opportunities for and participation of youth athletes on the world sports stage, including the Olympic Games, are expected to escalate. Yet, adolescence is a vulnerable period of development and inherently dynamic, with non-linear and asynchronous progression of physical, physiological, psy...
Article
Objectives The purpose of this study was to radiographically assess changes in 1) patellar height, 2) anterior tibial translation (ATT), and 3) posterior tibial slope following supratubercle ACW-PTO and to compare changes in patellar height to a cohort of medial opening proximal tibial osteotomies (MOW-PTO). Methods Patients who underwent supratub...
Article
Anterior cruciate ligament (ACL) injury is a concerning problem in the paediatric population, impacting joint health and longevity. Moreover, ACL injury hampers physical activity, which is important for children's social network and general well‐being. Recent data demonstrates a rise in paediatric ACL reconstructions, affecting both girls and boys....
Article
Objective To evaluate the characteristics of patients who visited the Polyclinic during the Tokyo 2020 Olympics and analyze geographical and economic correlations with the number of clinic visits. Design Cross-sectional study. Setting Polyclinic during the Tokyo 2020 Olympics. Participants Patients who visited the Polyclinic. Intervention Data...
Article
Background Because of the increased prevalence of revision anterior cruciate ligament (ACL) reconstruction, there has been a desire to understand the role of posterior tibial slope on increased anterior tibial translation and increased ACL graft forces. One potential concern in supratubercle anterior closing wedge proximal tibial osteotomy (ACW-PTO...
Article
Purpose The purpose of this study was to perform a scoping review of clinical practice guidelines (CPGs) concerning the use of functional anterior cruciate ligament (ACL) braces and to clarify the nomenclature for bracing relevant to ACL injury treatment in order to support prescribing clinicians. Methods A PubMed search for CPGs for the use of br...
Article
Background Outcomes after posterior cruciate ligament (PCL) reconstruction (PCLR) have been reported to be inferior to those of anterior cruciate ligament reconstruction. Furthermore, combined ligament injuries have been reported to have inferior outcomes compared with isolated PCLR. Purpose/Hypothesis The purpose of this study was to report on PC...
Article
Knee dislocations are complex and devastating injuries that are potentially limb threatening. A high level of suspicion is required to diagnose and treat these injuries properly and timely because some of the knee dislocations spontaneously reduce, and the seriousness of the injury might not be appreciated early. Early diagnosis of concomitant vasc...
Article
Full-text available
Purpose Bone patella‐tendon bone (BPTB) and hamstring tendon (HT) autografts are the most used grafts in primary anterior cruciate ligament (ACL) reconstructions (ACLR) in Norway. Quadriceps tendon (QT) autograft has gained more popularity during the past years. The purpose of this study is to compare revision rates and patient‐reported outcomes of...
Article
Background Most clinical machine learning applications use a supervised learning approach using labeled variables. In contrast, unsupervised learning enables pattern detection without a prespecified outcome. Purpose/Hypothesis The purpose of this study was to apply unsupervised learning to the combined Danish and Norwegian knee ligament register (...
Article
Full-text available
Purpose To compare the functional and patient-reported outcome measures after autologous chondrocyte implantation (ACI) and arthroscopic debridement (AD) in symptomatic, isolated cartilage injuries larger than 2 cm² in patients aged 18 to 50 years. Methods Twenty-eight patients were included and randomized to ACI (n = 15) or AD (n = 13) and follow...
Article
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Purpose Patient‐reported outcomes were compared between participants who followed the treatment algorithm of the Delaware‐Oslo ACL Cohort, consisting of progressive preoperative and postoperative rehabilitation, patient education, clinical testing and shared decision‐making about treatment choice, and those who followed usual care 9–12 years after...
Article
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Purpose A machine learning‐based anterior cruciate ligament (ACL) revision prediction model has been developed using Norwegian Knee Ligament Register (NKLR) data, but lacks external validation outside Scandinavia. This study aimed to assess the external validity of the NKLR model ( https://swastvedt.shinyapps.io/calculator_rev/ ) using the STABILIT...
Preprint
Full-text available
Introduction: Cartilage injury represents a major challenge for the orthopedic surgeon. Currently no treatment demonstrates superior results despite numerous attempts to improve existing and develop new methods. The Norwegian Cartilage Project tested some of the most critical unanswered questions in the field of cartilage repair in two randomized c...
Article
Purpose: In order to better understand the imaging of severe trauma in sport, this study describes the imaging modalities utilized to image athletes who experienced severe traumatic injuries at the Beijing Winter Olympic Games 2022, the distribution of these modalities in relation to the sporting facilities, and the types of injuries imaged in each...
Conference Paper
Bakgrunn: Majoriteten av ACL-rekonstruerte pasienter er utøvere på lavere nivåer som skader seg i vridningsidrett. Andelen av disse som returnerer til idrett, og hva som skjer mellom rekonstruksjon og retur, er uviss. Formålet med studien var å beskrive retur-til-idrett andeler og elementer i rehabiliteringen for utøvere registrert i Nasjonalt Kors...
Article
Full-text available
Objective The objective of this study is to describe the incidence of injuries and illnesses sustained during the Beijing Winter Olympic Games from 4 February 2022 to 20 February 2022. Methods We recorded the daily number of athlete injuries and illnesses (1) through the reporting of all National Olympic Committee (NOC) medical teams and (2) in th...
Chapter
An understanding of anatomy and mechanisms of injury are important for proper identification and treatment of knee ligament tears. The anterior cruciate ligament (ACL) resists anterior translation and internal rotation of the tibia and is most commonly injured via noncontact mechanisms. Patellar tendon autograft is the gold standard graft choice fo...
Article
Full-text available
Relative Energy Deficiency in Sport (REDs) was first introduced in 2014 by the International Olympic Committee’s expert writing panel, identifying a syndrome of deleterious health and performance outcomes experienced by female and male athletes exposed to low energy availability (LEA; inadequate energy intake in relation to exercise energy expendit...
Article
Background Posterolateral corner (PLC) knee injuries associated with different injury mechanisms are not well known. Purpose/Hypothesis This study sought to assess the patterns of associated injuries in the setting of PLC injury. The hypothesis was that there are recognizable injury patterns in PLC injuries that may correlate with injury mechanism...
Article
Background: The incidence of pediatric and adolescent anterior cruciate ligament reconstruction (ACLR) is increasing in several countries. It is uncertain whether this trend applies to countries that traditionally prefer an initial nonoperative treatment approach whenever possible, like Norway. Nationwide, long-term patient-reported outcomes and r...
Article
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Non-communicable diseases (NCDs), including coronary heart disease, stroke, hypertension, type 2 diabetes, dementia, depression and cancers, are on the rise worldwide and are often associated with a lack of physical activity (PA). Globally, the levels of PA among individuals are below WHO recommendations. A lack of PA can increase morbidity and mor...
Article
In 2019, the International Olympic Committee (IOC) published a consensus statement outlining the principles for recording and reporting injury and illness in elite sport. The authors encouraged sport federations to adapt the framework to their sport-specific context. Since this publication, several sports have published extensions to the IOC consen...
Article
Background: Clinical tools based on machine learning analysis now exist for outcome prediction after primary anterior cruciate ligament reconstruction (ACLR). Relying partly on data volume, the general principle is that more data may lead to improved model accuracy. Purpose/hypothesis: The purpose was to apply machine learning to a combined data...
Article
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Fifteen-a-side rugby union (“rugby”) is a full-contact sport played separately by men and women, with large injury incidences reported previously. Context specific injury surveillance fulfils governing bodies’ duty of care to understand risks to player welfare, yet no contemporary match injury epidemiology studies exist for international players in...
Article
Full-text available
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 k...
Article
Case A 17-year-old male tennis player presented with persistent and increasing posterior neck pain. An overuse of tennis stroke motion resulted in a clay-shoveler fracture at the first thoracic vertebra. The patient was able to fully return to tennis after discontinuation of the causative motion and conservative treatment. Conclusions This report...
Article
Full-text available
Injury to the anterior cruciate ligament (ACL) of the knee is common and often requires surgical reconstruction. There are numerous graft options available to the operating surgeon, to each of which a growing body of dedicated literature exists. Each of these potential choices of ACL graft specimen has a distinctive set of biomechanical properties,...
Conference Paper
Full-text available
Introduction Better two-year outcomes are achieved when anterior cruciate ligament reconstruction (ACLR) is combined with progressive preoperative and postoperative rehabilitation than with usual care, but long-term outcomes are not investigated. We therefore compared patient-reported outcomes 10 years after ACLR in patients who followed progressiv...
Conference Paper
Full-text available
Introduction The Delaware-Oslo ACL treatment algorithm is distinct as it includes progressive rehabilitation with repeated functional testing, patient education and shared decision-making about treatment. We described and compared 10-year knee osteoarthritis and patient-reported outcomes in athletes who followed our treatment algorithm and chose ea...
Article
Full-text available
Objective: To perform a scoping literature review evaluating and reporting on outcomes and return to pivoting sports after cartilage procedures. For this review, the following cartilage procedures were evaluated: microfracture, osteochondral autograft transplantation (OAT), osteochondral allograft transplantation (OCA), and autologous chondrocyte...
Article
Full-text available
Objective To describe the incidence of injuries and illnesses sustained during the Tokyo Summer Olympic Games from 23 July to 8 August 2021. Methods We recorded the daily number of athlete injuries and illnesses (1) through the reporting of all National Olympic Committee (NOC) medical teams and (2) in the polyclinic and medical venues by the Tokyo...
Article
Full-text available
Objectives At present, there is no cure for osteoarthritis (OA), but severe hip joint degeneration can require total hip arthroplasty (THA). The literature on OA after elite sport is limited. We hypothesise that elite athletic activity increases the risk of receiving a THA later in life. Methods We linked a cohort of former Norwegian world-class a...
Article
Full-text available
Objective Muscle injury is one of the most common injuries occurring at the Olympic Games often with devastating consequences. Epidemiological injury surveillance is recognised by the IOC as essential for injury prevention and management. We aimed to describe the incidence, anatomical location and classification of MRI-detected muscle injuries in a...
Article
Zusammenfassung Verletzungen des vorderen Kreuzbandes (VKB) bei Kindern und Jugendlichen sind eine bedeutsame gesundheitliche und ökonomische Belastung und ihre Inzidenz steigt schneller als die in der erwachsenen Bevölkerung. Diese Verletzung beeinträchtigt die Lebensqualität, indem sie sich auf die Entwicklung des Kniegelenkes ebenso wie auf sein...
Article
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This document presents the recommendations developed by the IOC Medical and Scientific Commission and several international federations (IF) on the protection of athletes competing in the heat. It is based on a working group, meetings, field experience and a Delphi process. The first section presents recommendations for event organisers to monitor...
Article
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Background Impairments and dysfunction vary considerably after anterior cruciate ligament (ACL) injury, and distinct subgroups may exist. Purpose (1) To identify subgroups of patients with ACL injury who share common trajectories of patient-reported knee function from initial presentation to 5 years after a treatment algorithm where they chose eit...
Article
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Objectives (1) To determine the prevalence of spine and upper limb osteoarthritis (OA) and pain in retired Olympians; (2) identify risk factors associated with their occurrence and (3) compare with a sample of the general population. Methods 3357 retired Olympians (44.7 years) and 1735 general population controls (40.5 years) completed a cross-sec...
Article
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Background Prevention and early detection of injuries are essential in optimising sport participation and performance. The aim of this study is to investigate the epidemiology, athlete injury history, and competition withdrawal rate of imaging-detected bone stress injuries during the Tokyo 2020 Olympic Games. Methods We collected and analysed imag...
Article
Full-text available
Objectives This study aims (1) to determine the prevalence of lower limb osteoarthritis (OA) and pain in retired Olympians; (2) to identify factors associated with their occurrence and (3) to compare with a sample of the general population. Methods 3357 retired Olympians (median 44.7 years) and 1735 general population controls (40.5 years) complet...
Article
Objectives The purpose of this study was to compare clinical outcomes between randomized groups who underwent MCL augmentation repair versus MCL autograft reconstruction. Methods Patients were prospectively enrolled from 2013 to 2019 from 3 centers (United States, Norway, Denmark). Grade III superficial (sMCL) injuries were confirmed by stress rad...
Article
Full-text available
Background:. Anterior cruciate ligament (ACL) injury is considered a risk factor for osteoarthritis. The primary aim of the present study was to investigate the cumulative risk of, and risk factors associated with, a subsequent knee arthroplasty after an ACL reconstruction at up to 15 years of follow-up. The secondary aim was to compare the relativ...
Article
Full-text available
Acute respiratory illness (ARill) is common and threatens the health of athletes. ARill in athletes forms a significant component of the work of Sport and Exercise Medicine (SEM) clinicians. The aim of this consensus is to provide the SEM clinician with an overview and practical clinical approach to non-infective ARill in athletes. The Internationa...
Preprint
Full-text available
Background Prevention and early detection of injuries are essential in optimising sport participation and performance. The aim of this study is to investigate the epidemiology, history, and competition withdrawal rate of imaging-detected bone stress injuries during the Tokyo 2020 Olympic Games. Methods We collected and analysed imaging and patient...
Article
Full-text available
Background The Norwegian Knee Ligament Register was founded in 2004 to provide representative and reliable data on cruciate ligament surgery. The aim of this study was to evaluate the validity of key variables in the Norwegian Knee Ligament Register to reveal and prevent systematic errors or incompleteness, which can lead to biased reports and stud...
Article
Calcaneal stress fracture is an injury that particularly affects athletes and runners owing to repeated stress on the lower extremities without sufficient recovery time. Medial and lateral heel pain during activity raises suspicion of the injury, but radiological examinations are required for a definitive diagnosis. The treatment is usually conserv...
Article
Coronal plane alignment deformities of the lower extremity are often neglected in the evaluation and treatment of chronic posteromedial (PMC) and posterolateral corner (PLC) injuries. Genu varus, valgum, and recurvatum deformities can increase the likelihood of graft failure following knee ligament reconstruction. Abnormal and excessive vector forc...
Article
Background: Although previous studies have reported good short-term results for superficial medial collateral ligament (sMCL) reconstruction, whether an augmented MCL repair is clinically equivalent remains unclear. Purpose/Hypothesis: The purpose of this study was to compare clinical outcomes between randomized groups that underwent sMCL augmenta...