Lars Engebretsen

• Trøan, Ingrid; Holm, Inger; Moatshe, Gilbert; LaPrade, Robert F.; Engebretsen, Lars & Bere, Tone (2026). Quadriceps and Hamstring Muscle Strength Recovery After a Multiligament Knee Injury: A Long-term Follow-up. American Journal of Sports Medicine. ISSN 0363-5465. 54(11), p. 2722–2731. doi: 10.1177/03635465261466381. Full text in Research Archive Show summary

  Background: Multiligament knee injuries (MLKIs) are serious and heterogeneous injuries that often lead to long-term functional limitations. There is limited literature regarding objective muscle strength and functional recovery after surgical treatment of MLKIs. Purpose: To investigate long-term quadriceps and hamstring muscle strength and functional recovery after surgical treatment of MLKI and to compare postoperative outcomes between single cruciate MLKI and bicruciate MLKIs. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Patients surgically treated for an MLKI at a single level 1 trauma center between January 2013 and December 2020 were included. Isokinetic quadriceps and hamstring muscle strength were assessed using a Biodex dynamometer, and physical function was measured by single-leg hop, triple hop, crossover hop, and 6-m timed hop tests, with the limb symmetry index (LSI) calculated. Results: Of 124 eligible patients, 90 (72%) participated at a mean follow-up time of 7 years (SD, 2.1) since surgery to evaluation. The median age at the time of testing was 49 years (range, 21-72) and 59% were male. In total, 54% of the patients had not regained full quadriceps strength (LSI <90%), and 46% had persistent hamstring deficits for peak torque/body weight (PT/BW) at 60 deg/s. Across the entire cohort, there was a significant difference between the uninvolved and involved sides for quadriceps and hamstrings for PT/BW ( P = .01). The mean LSI for quadriceps PT/BW was 88% at 60 deg/s and 90% at 240 deg/s, while for the hamstrings, the mean LSI was 93% at 60 deg/s and 97% at 240 deg/s. Median LSIs for the hop tests ranged from 93% (range, 41%-187%) for single leg to 99% (42%-141%) for crossover; however, 44% of patients failed to reach the 90% threshold for the single-leg hop. The 6-m timed hop test and quadriceps muscle strength were significantly lower for patients with bicruciate injuries than those with single cruciate injuries ( P < .05). Conclusion: Persistent deficits in quadriceps and hamstring muscle strength were observed 7 years after MLKI surgery, with a substantial proportion of patients failing to regain full functional symmetry in muscle strength and hop test performance. Patients with bicruciate injuries demonstrated significantly more pronounced deficits in muscle strength and hop test scores as compared with those with single cruciate injuries.

• Guilfoyle, Lauren; MacPherson, Alan; Cooper, Dale; Crossley, Kay M.; Donaldson, Amber T. & Elliott, Niall [Show all 17 contributors for this article] (2026). The Legacy of Olympic Sport: A Cross-Sectional Comparison of the Musculoskeletal and General Health of 1488 Retired Female Summer and Winter Olympians and 998 Female General Population Controls. Sports Medicine. ISSN 0112-1642. doi: 10.1007/s40279-026-02497-2. Full text in Research Archive Show summary

  Abstract Background Little is known about the long-term health outcomes associated with sustained elite performance once female Olympians retire from their Olympic careers. Objective The aim of this study was to determine and compare (1) musculoskeletal health, (2) general health and (3) current physical activity (PA) behaviours between a global sample of female retired Olympians and general population controls. Methods A cross-sectional survey comprised four sections: (1) background information, (2) injury history, (3) current musculoskeletal health and (4) general health. A total of 1488 retired female Olympians and 998 female controls completed the survey. Poisson regression analysis was used to determine prevalence ratios (aPR) with 95% confidence intervals (CI) adjusted for age, body mass index (BMI) and/or previous significant injury or current persistent pain. Results Adjusting for age, BMI and previous significant injury, more retired female Olympians reported stiffness, pain and/or osteoarthritis (OA) (aPR [95% CI]) in the cervical spine (stiffness 1.42 [1.08–1.86]; OA 1.85 [1.01–3.39]), lumbar spine (stiffness 1.41 [1.18–1.67], pain 1.41 [1.15–1.73]) and hip (OA 1.82 [1.08–3.06]) compared with controls. Stiffness, pain and OA at the knee were also higher for Olympians, but not when adjusting for prior injury. No differences were observed between groups for self-reported disease states, however the prevalence of most health conditions increased among Olympians following retirement, except for depression which decreased. Both groups rated their health-related quality of life (retired female Olympians: 88/100; Controls: 89/100) and mental health similarly, while the prevalence of participation in weekly sport (aPR: 0.75 [0.66–0.85]) and physical activity (aPR: 0.91 [0.87–0.95]) was slightly lower in retired Olympians when adjusted for age, BMI and current persistent musculoskeletal pain. Conclusions Retired female Olympians report poorer musculoskeletal health than the general population, a difference only partly attributable to previous significant injury, which suggests elements of elite athletic exposure may underlie some of these outcomes. Primary and secondary prevention of shoulder, hip and knee injuries remains a priority with consideration to long-term outcomes. Future research should broaden our understanding of retired female athlete health by exploring the largely under-researched domains of cognitive, reproductive, breast and pelvic floor health.

• Spörri, Jörg; Müller, Philippe O.; Monsonís, Oriol Bonell; Bahr, Roald; Beck, Lisa & Brucker, Peter U. [Show all 23 contributors for this article] (2026). International Ski and Snowboard Federation (FIS) consensus statement on return-to-performance in competitive alpine and freestyle skiers and snowboarders. BMJ Open sport & exercise medicine. 12(1). doi: 10.1136/bmjsem-2025-002908. Full text in Research Archive
• Bangsbo, Jens; Hostrup, Morten; Hellsten, Ylva; Hansen, Mette; Melin, Anna & Kjær, Michael [Show all 28 contributors for this article] (2025). Consensus Statements—Optimizing Performance of the Elite Athlete. Scandinavian Journal of Medicine & Science in Sports. ISSN 0905-7188. 35(8). doi: 10.1111/sms.70112. Full text in Research Archive
• Mountjoy, Margo; Sloan, Scott; Ali-Zada, Msomah; Bindra, Abhinav; Blauwet, Cheri & Budgett, Richard [Show all 19 contributors for this article] (2025). International Olympic Committee consensus-driven guidelines for athlete mental health support at sporting events. British Journal of Sports Medicine. ISSN 0306-3674. doi: 10.1136/bjsports-2025-109646. Full text in Research Archive
• LaPrade, Robert F.; Gerhold, Cameron; Kunze, Kyle N.; Geeslin, Andrew G.; Tollefson, Luke V. & Dave, Udit [Show all 45 contributors for this article] (2025). A Contemporary International Expert Consensus Statement on the Evaluation, Diagnosis, Treatment, and Rehabilitation of Injuries to the Posterolateral Corner of the Knee. Arthroscopy: The Journal of Arthroscopy And Related. ISSN 0749-8063. 41(11), p. 4630–4640. doi: 10.1016/j.arthro.2025.04.055. Full text in Research Archive
• Zhang, Shurong; Xia, Tian; Dai, Xuesong; Difelice, Gregory S.; Engebretsen, Lars & Gobbi, Alberto [Show all 13 contributors for this article] (2025). Primary repair of proximal anterior cruciate ligament injury: a global expert consensus statement. Burns and Trauma. 13. doi: 10.1093/burnst/tkae079. Full text in Research Archive
• Spörri, Jörg; Monsonís, Oriol Bonell; Balsiger, Peter; Bahr, Roald; Dios, Caitlin & Engebretsen, Lars [Show all 20 contributors for this article] (2025). International Ski and Snowboard Federation (FIS) consensus statement on training and testing in competitive alpine and freestyle skiers and snowboarders. BMJ Open sport & exercise medicine. 11(3). doi: 10.1136/bmjsem-2025-002623. Full text in Research Archive Show summary

  To enhance performance, increase resilience and prevent injuries, training and testing (T&T) are the most important strategies for preparing athletes for the demands of their sport. However, for competitive snow sports such as alpine skiing, freestyle skiing and snowboarding, there is little evidence and a lack of international harmonisation of current best practices. This consensus statement, commissioned by the International Ski and Snowboard Federation (FIS), aims to provide recommendations for the physical and psychological T&T of competitive alpine and freestyle skiers and snowboarders within National Ski and Snowboard Associations. A diverse international consensus panel was selected to represent the subject matter regarding gender, nationality, expertise/background, level of competition and skiing and snowboarding discipline. Researchers, officials, physicians, physiotherapists, coaches and former athletes with extensive experience in the field were among the experts. However, the panel had a limited gender balance (seven women and 13 men) and was over-represented by European members (65%) and North American members (20%), whereas there was limited representation of perspectives from South American (5%), Australasian (5%) and African (5%) experts and a lack of experts from Asia. In the first step, the panel established an overarching structure of topics and questions to be addressed by the consensus statement. Following the RAND-UCLA appropriateness method, the consensus process subsequently included panellist ratings, discussions and revisions informed by statements derived from the literature or expert/panellist opinions. These two outcomes served as the basis for manuscript writing, which was finalised through two iterative rounds of manuscript feedback and revision. This consensus statement aims to help athletes, coaches and medical staff of international and national federations plan and implement effective T&T activities for competitive alpine and freestyle skiers and snowboarders.

• Chahla, Jorge; Garcia, Jose Rafael; Tollefson, Luke; Dzidzishvili, Lika; Allende, Felicitas & Gerhold, Cameron [Show all 61 contributors for this article] (2025). International Delphi Consensus on Medial Meniscal Root Tears Shows High Agreement on Diagnosis, Treatment, and Rehabilitation but Lack of Agreement on Treatment of Asymptomatic Tears. Arthroscopy: The Journal of Arthroscopy And Related. ISSN 0749-8063. 41(11), p. 4683–4698. doi: 10.1016/j.arthro.2025.06.028. Full text in Research Archive Show summary

  Purpose To develop an expert consensus statement on the diagnosis, management, and rehabilitation of medial meniscal root tears (MMRTs) using a modified Delphi technique. Methods A working group developed statements on MMRT diagnosis, nonoperative management, surgical indications, surgical management, alignment, and rehabilitation using modified Delphi techniques. Fifty-six experts were surveyed over 3 rounds to reach consensus, with agreement measured on a 5-point Likert scale. Statements were included, revised, or excluded on the basis of predefined thresholds (≥75% agreement, <20% disagreement). Experts suggested revisions or new statements in the first 2 rounds, and final consensus statements were included. Results All 56 experts completed 3 survey rounds. Experts agreed that root tears may occur with no known history of trauma, typically in older patients, and that it should be diagnosed with an magnetic resonance imaging. In symptomatic patients with MMRTs without advanced osteoarthritis should be repaired using an anatomic transtibial pull-out technique (performing a pie-crusting technique can be helpful for visualization). Nonoperative management is advised for patients with advanced osteoarthritis. High tibial osteotomy may be considered for significant varus malalignment during MMRT repair. The only statement without consensus was the management of asymptomatic MMRTs with mild medial compartment cartilage wear, indicating ongoing debate. Conclusions Overall, 98% of statements reached consensus. There is agreement that magnetic resonance imaging is the gold standard for diagnosis. Symptomatic MMRTs without advanced osteoarthritis should be repaired early using an anatomic transtibial pull-out technique. End-stage knee osteoarthritis warrants nonoperative management of MMRTs, and a structured postoperative protocol with limited weightbearing and range of motion is essential after repair. No agreement was reached on managing asymptomatic MMRTs in patients without significant medial compartment degeneration. Meniscal centralization sutures may help in cases of substantial extrusion, but their routine use is debated.

• Palmer, Debbie; Soligard, Torbjørn; Fernandes, Gwen; Collins, Dave; Elliott, Niall & Kelly, Paul [Show all 8 contributors for this article] (2025). Insights from the first IOC Olympian Health Cohort: injury and illness in Olympians preparing for the Tokyo 2020 Summer and Beijing 2022 Winter Olympic Games. BMJ Open sport & exercise medicine. 11(3). doi: 10.1136/bmjsem-2025-002545. Full text in Research Archive
• Zachovajevas, Vilius; Engebretsen, Lars; Moatshe, Gilbert; Zachovajevas, Pavelas & Røise, Olav (2025). Injuries in Mixed Martial Arts After Adoption of the Unified Rules of MMA: A Systematic Review. Orthopaedic Journal of Sports Medicine (OJSM). 13(7). doi: 10.1177/23259671251342578. Full text in Research Archive Show summary

  Background: The existing literature on injuries in mixed martial arts (MMA) is sparse and lacks a summarized review of injuries in the sport after the adoption of the new rule set in 2009. Purpose: To assess the injury characteristics in terms of injury rates and types in MMA after the adoption of the Unified Rules of MMA (URM) by the Association of Boxing Commissions and compare them with preadoption trends. Study Design: Systematic review; Level of evidence, 4. Methods: Under PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, primary literature in English examining injuries in MMA after URM adoption was scanned in Medline, Embase, and PubMed from the inception of these databases until December 27, 2023. Reports providing relevant information on injury rates and characteristics, with data solely on MMA athletes rather than in a combination of athletes from other combat sports, were reviewed and analyzed. In total, 191 reports were identified after the initial search. Descriptive statistics were employed to summarize injury rates, types, and locations, as well as variations across subgroups. Results: A total of 43 reports were included in the analysis. The reports varied widely in design, injury definitions, and data collection methods. Post-URM competition injury rates ranged from 23.6 to 54.5 injuries per 100 athlete-exposures (AEs), with soft tissue injuries (lacerations/abrasions/contusions) being the most common type of injury (20.7%-56.9% of all injuries). The most common location of injury was the head and neck area (29.5%-75.9% of all injuries). Concussion rates varied from 14.7 to 16.1 per 100 AEs, and heavier fighters experienced more knockouts and technical knockouts. There is some evidence suggesting higher injury rates among professional fighters. Conclusion: The review demonstrated that the most common injuries reported in MMA athletes are soft tissue injuries including lacerations, abrasions, and contusion mainly in the head and neck area. Professional athletes seem to have higher injury rates than amateur athletes, while heavier weight fighters sustain more knockouts and technical knockouts. Current injury rates and types seem to remain similar to those before the adoption of the URM. Analysis of current literature emphasizes a lack of standardized definitions, data on training injuries, and female injuries, which are required to fully evaluate injury characteristics in MMA and ensure the long-term well-being of those participating in the sport.

• Kjennvold, Stian; Røtterud, Jan H; Forssblad, Magnus; Engebretsen, Lars; Årøen, Asbjørn & Ulstein, Svend (2025). Debridement or Microfracture for Full-Thickness Cartilage Lesions in Anterior Cruciate Ligament Reconstruction: A 10-Year Cohort Study of 326 Patients in Norway and Sweden. Orthopaedic Journal of Sports Medicine (OJSM). 13(10). doi: 10.1177/23259671251381340. Full text in Research Archive Show summary

  Background: It is well-established that patients undergoing anterior cruciate ligament reconstruction (ACLR) have a less favorable prognosis if a concomitant full-thickness cartilage lesion is present at the time of surgery. However, the long-term benefits of surgically addressing these cartilage lesions remain uncertain. Purpose: To evaluate whether the most used surgical treatments for cartilage lesions influenced patient-reported outcomes 10 years after ACLR. Study Design: Cohort study; Level of evidence, 2. Methods: This study was based on a cohort of all patients with primary unilateral ACLR in the Norwegian and Swedish knee ligament registries from January 2005 through December 2008 (n = 15,783). A total of 1012 (6.4%) patients had ≥1 full-thickness cartilage lesion (International Cartilage Regeneration & Joint Preservation Society grade 3 or 4) at the time of reconstruction. Of these, 644 patients met the inclusion criteria. At a mean (± SD) follow-up of 10.1 ± 0.2 years, 326 (51%) of the patients had completed the Knee injury and Osteoarthritis Outcome Score (KOOS). The treatment categories documented in the Scandinavian knee ligament registries were microfracture, debridement, no treatment, or other/unknown. Patients who did not receive surgical treatment for their full-thickness cartilage lesions served as the reference group and were compared with those who underwent microfracture or debridement. Multiple linear regression, with adjustment for possible confounders, was used to evaluate associations between surgical treatment of cartilage lesions and patient-reported outcomes for all KOOS subscales 10 years after ACLR. Results: Of the 326 patients available at the 10-year follow-up, 182 (56%) had not received surgical treatment for their cartilage lesions. A total of 68 (21%) patients had been treated with debridement, and 76 (23%) patients had been treated with microfracture. No significant association with KOOS scores was observed for debridement or microfracture compared with the reference group without surgical treatment of their cartilage lesion. The unadjusted data showed a trend toward poorer outcomes with microfracture compared with debridement, but this difference was not statistically significant. Conclusion: Debridement and microfracture showed no significant association with patient-reported outcomes 10 years after ACLR in patients with concomitant full-thickness cartilage lesions, compared with those who did not receive surgical treatment for their cartilage lesion.

• Tveiten, Caroline Emilie Van Woensel Ko; Jakobsen, Rune Bruhn; Fenstad, Anne Marie; Persson, Andreas; Engebretsen, Lars & Moksnes, Håvard [Show all 7 contributors for this article] (2025). Non-operative treatment of anterior cruciate ligament injuries: two-thirds avoid surgery at 2-year follow-up in a nationwide cohort. British Journal of Sports Medicine. ISSN 0306-3674. 59(24), p. 1743–1751. doi: 10.1136/bjsports-2025-109890. Full text in Research Archive Show summary

  Objective To describe the nationwide population of anterior cruciate ligament (ACL) injured patients initially managed non-operatively, quantify the proportion undergoing delayed ACL reconstruction (ACLR) and describe both intraoperative findings and patient-reported outcomes. Methods Primary ACL injuries treated non-operatively were prospectively registered in the Norwegian Knee Ligament Register (2017–2023). We collected baseline characteristics, injury details, surgical details if delayed ACLR was performed and patient-reported outcomes (Knee injury and Osteoarthritis Outcome Score, KOOS). Treatment survival was analysed with Kaplan-Meier curves, and factors associated with ACLR were assessed with Cox regression. Results Of 485 patients included (mean age at injury (SD) 35 (12), 25%<25 years), 93% (n=452) were physically active in sports preinjury. At 2 years, 63% remained non-operatively treated. Of the delayed ACLR patients (n=178), 56% underwent concurrent meniscal repair, and 18% partial resection. Instability was the main reason for ACLR (85%). Patients younger than 25 years, those active in pivoting sports preinjury and those with meniscal injuries at baseline were more likely to undergo delayed ACLR (HR (95% CI) 1.95 (1.2 to 3.2), 1.54 (1.1 to 2.2) and 1.63 (1.2 to 2.2), respectively. Both non-operative and delayed ACLR patients showed moderate impairment on KOOS Sport/Recreation and Quality of Life subscales at 2-year follow-up (mean scores 69.8 vs 61.0 and 68.6 vs 63.4), with no statistically significant between-group differences. Conclusion In this active population of ACL injured patients treated non-operatively, two-thirds remained non-operatively treated at 2 years. Younger patients, those engaged in pivoting sports preinjury and those with baseline meniscal injuries had higher risks of undergoing delayed ACLR. KOOS scores were similar between non-operative and delayed ACLR patients.

• Trøan, Ingrid; Bere, Tone Tufte; Holm, Inger; Løken, Sverre Bertrand; LaPrade, Robert F. & Engebretsen, Lars [Show all 7 contributors for this article] (2025). Return to sport and work after multiligament knee injury. Knee Surgery, Sports Traumatology, Arthroscopy. ISSN 0942-2056. 34(1), p. 329–337. doi: 10.1002/ksa.70175. Full text in Research Archive Show summary

  Abstract Purpose Multiligament knee injuries (MLKIs) are complex and often associated with significant functional impairments. Data on return to sport (RTS) and return to work (RTW) remain limited, particularly for recreational athletes and the general population. The purpose of the study was to evaluate RTS, RTW and physical activity levels after surgical treatment of MLKIs. Methods Patients surgically treated for MLKI at a single Level 1 Trauma centre from 2013 to 2020 were included. Patient‐reported outcomes included the Tegner score and work status before and after injury. Physical activity was assessed using the activity questionnaire from the Nord‐Trøndelag Health Study (HUNT 1). Health‐related quality of life was measured with the EuroQol 5‐Dimension Questionnaire (EQ‐5D). Results Out of 191 eligible patients, 124 (65%) participated (mean age 37 ± 13.7 years, range 17–70). RTS: 77% ( n  = 84) returned to some level of sport, 37% ( n  = 31) returned to their pre‐injury sport at any level, and only seven of 28 (25%) resumed high‐level pivoting sports. The mean Tegner score declined from 5.2 to 3 ( p  < 0.001). RTW: 90% ( n  = 112) returned to work, but 15% required task modifications or became disabled. Work participation significantly declined (2.1–1.9, p  < 0.04). Patients with single cruciate injuries had better outcomes, including higher Tegner (3.6 vs. 3, p  = 0.043) and EQ‐5D scores (0.931 vs. 0.893, p  = 0.012) than those with bicruciate injuries. Conclusion A significant number of patients with an MLKI were unable to return to their former sports activities, with only 37% returning to the same level as before the injury. Although most patients were able to return to their pre‐injury work levels, 15% had to adapt to less demanding tasks or became disabled due to the injury. Despite significant reductions in activity levels, most patients reported good health‐related quality of life. Level of Evidence Level IV, cross‐sectional cohort study.

• Bailey, Stuart John; Martindale, Russell; Engebretsen, Lars; Robson, James Peter & Palmer, Debbie (2025). Match and Training Injuries Sustained by Professional Male Rugby Union Players in Scotland. International Journal of Sports Medicine (IJSM). ISSN 0172-4622. doi: 10.1055/a-2640-9131. Full text in Research Archive Show summary

  Abstract Rugby union (‘rugby’) is a full-contact sport, with previous studies across the globe reporting a high incidence of injury. However, no injury surveillance study of professional male players in Scotland exists in contemporary literature. The current study therefore aimed to describe the incidence, severity, burden and nature of match and training injuries sustained by male professional club rugby players in Scotland. A prospective cohort study of injuries sustained during matches and training across the 2017/18 and 2018/19 seasons was undertaken, with injury and exposure definitions in line with the international consensus statements. Injury incidence was 136.2/1,000 player match hours and 4.1/1,000 player training hours, the median injury severity was 7.0 days (match) and 7.5 days (training) and injury burden was 2,887.0/1,000 player match hours and 102.3/1,000 player training hours. Concussion (match) and posterior thigh muscle injuries (training) were the most common specific diagnoses. Injury incidence in this population was higher than reported elsewhere in previous studies. However, high incidences of tackle injuries and concussion injuries agree with previous literature, reinforcing the need for mitigation strategies targeting these areas.

• Kjennvold, Stian; Ulstein, Svend; Årøen, Asbjørn; Forssblad, Magnus; Engebretsen, Lars & Røtterud, Jan H (2025). Effect of Focal Cartilage Lesions on Patient-Reported Outcomes After Anterior Cruciate Ligament Reconstruction: A 10-Year Nationwide Cohort Study of 7040 Patients. American Journal of Sports Medicine. ISSN 0363-5465. 53(10), p. 2407–2414. doi: 10.1177/03635465251350398. Full text in Research Archive Show summary

  Background: Focal cartilage lesions are commonly associated with anterior cruciate ligament injuries. The long-term effect of these lesions on patient-reported outcomes after anterior cruciate ligament reconstruction (ACLR) remains unclear. Purpose: To determine the effect of cartilage lesions—partial thickness (International Cartilage Regeneration and Joint Preservation Society grades 1 and 2) and full thickness (grades 3 and 4)—on patient-reported outcomes 10 years after ACLR. Study Design: Cohort study; Level of evidence, 3. Methods: The study included all patients with primary unilateral ACLR enrolled in the Norwegian Knee Ligament Registry and Swedish Knee Ligament Registry from 2005 through 2008 (n = 15,783). At a mean follow-up of 10.1 years (SD, 0.2), 7040 (45%) patients completed the Knee injury and Osteoarthritis Outcome Score (KOOS). Multiple linear regression analyses were used to evaluate any associations between concomitant cartilage lesions and KOOS outcomes 10 years after ACLR. Results: Of the 7040 patients available at 10-year follow-up, 1425 (20.3%) had partial-thickness cartilage lesions at the time of ACLR, and 495 (7.0%) had full-thickness cartilage lesions. Multiple linear regression analyses revealed that partial- and full-thickness cartilage lesions were associated with significantly inferior scores across all KOOS subscales as compared with patients without cartilage lesions. Patients with full-thickness lesions had less postoperative improvement after ACLR in all KOOS subscales as compared with patients with partial-thickness lesions. Conclusion: Patients with concomitant partial- or full-thickness cartilage lesions reported significantly worse outcomes in all KOOS subscales 10 years after ACLR as compared with patients without cartilage lesions.

• Torvaldsson, Kalle; Fagher, Kristina; Derman, Wayne; Engebretsen, Lars; Lindblom, Hanna & Lopes, Alexandre Dias [Show all 12 contributors for this article] (2025). Injury and illness epidemiology in elite athletes during the Olympic, Youth Olympic and Paralympic Games: a systematic review and meta-analysis. British Journal of Sports Medicine. ISSN 0306-3674. 59(18), p. 1302–1314. doi: 10.1136/bjsports-2025-109980. Full text in Research Archive Show summary

  Objective To systematically review and synthesise the incidence and characteristics of injuries and illnesses among athletes participating in the Olympic, Youth Olympic and Paralympic Games. Design Systematic review and meta-analysis. Data sources PubMed, Embase, CINAHL, Scopus and Web of Science were searched up to 2 July 2024, and Google Scholar, ClinicalTrials.gov and WHO International Clinical Trials Registry Platform up to 12 December 2023. Eligibility criteria for selecting studies Cohort studies conducted during the Games reporting injuries and illnesses among athletes. Risk of bias was assessed using the Joanna Briggs Institute critical appraisal tool for prevalence studies, and certainty of evidence using the Grading of Recommendations, Assessment, Development and Evaluation framework. Results 27 articles were included (10 Olympic, 4 Youth Olympic and 13 Paralympic Games). 23 articles had low, 3 moderate and 1 high risk of bias. Certainty of evidence was high to moderate for Olympic, high to low for Youth Olympic and low for Paralympic Games. Injury incidences per 1000 athlete-days were 6.5 (95% CI 5.9 to 7.2) during Olympic, 10.5 (95% CI 9.4 to 11.8) during Youth Olympic and 14.3 (95% CI 9.9 to 20.7) during Paralympic Games. Illness incidences per 1000 athlete-days were 3.6 (95% CI 2.8 to 4.7), 6.9 (95% CI 6.1 to 7.8) and 9.7 (95% CI 6.5 to 14.4), respectively. Lower limb injuries were frequent during Olympic and Youth Olympic Games, upper limb injuries during Paralympic Games and respiratory illnesses across all Games cohorts. Conclusions Injury and illness incidences were highest in Paralympic Games, followed by Youth Olympic and Olympic Games. Incidences and patterns of injury and illness were sport and context specific, which could inform future prevention strategies. PROSPERO registration number CRD42023475334.

• Trøan, Ingrid; Bere, Tone Tufte; Holm, Inger; LaPrade, Robert F.; Engebretsen, Lars & Moatshe, Gilbert (2025). Patient-Reported Outcomes of Bicruciate Multiligament Versus Single Cruciate Multiligament Knee Injuries. American Journal of Sports Medicine. ISSN 0363-5465. 53(1), p. 138–146. doi: 10.1177/03635465241293743. Full text in Research Archive
• Urhausen, Anouk; Pedersen, Marie; Grindem, Hege; Ito, Naoaki; Arhos, Elanna K. & Gunderson, Ragnhild B. [Show all 13 contributors for this article] (2025). Clinical, Functional, Sports Participation, and Osteoarthritis Outcomes After ACL Injury: Ten-Year Follow-up Study of the Delaware-Oslo ACL Cohort Treatment Algorithm. Journal of Bone and Joint Surgery. American volume. ISSN 0021-9355. doi: 10.2106/JBJS.24.00243. Full text in Research Archive
• Tandberg, Alexander Nagel; Zegzdryn, Marek Walerian; Aga, Cathrine; Lygre, Stein Håkon Låstad; Gifstad, Tone & Drogset, Jon Olav [Show all 10 contributors for this article] (2025). Comparison of Outcomes Between a Fixed-Loop Cortical Suspensory Device and Metal Interference Screw for Femoral Fixation of Bone–Patellar Tendon–Bone Grafts in Anterior Cruciate Ligament Reconstruction: A Scandinavian Registry Study. Orthopaedic Journal of Sports Medicine (OJSM). 13(5). doi: 10.1177/23259671251335978. Full text in Research Archive Show summary

  Background:Use of a cortical suspensory device (CSD) is an alternative fixation method for bone–patellar tendon–bone (BPTB) in the femur. To the authors’ knowledge, no study has compared revision outcomes and patient-reported outcomes (PROs) with the traditional interference screw (IS) fixation. Purpose:To compare the survival rate of grafts fixated on the femoral side with either a fixed-loop CSD or IS for primary anterior cruciate ligament reconstructions (ACLRs) with BPTB autograft 2 and 5 years after index surgery, as well as to compare PROs between the same 2 treatment groups based on data from 3 National Knee Ligament Registers (NKLRs) in Scandinavia. Study Design:Cohort study; Level of evidence, 2. Methods:The study included patients registered in the NKLRs of Norway, Denmark, and Sweden who underwent primary ACLR from 2005 to 2021. Patients undergoing additional surgery for concomitant injuries to the posterior cruciate ligament, lateral collateral ligament, or medial collateral ligament and patients with major cartilage lesions were excluded. Cox regression models with and without adjustment for possible confounding from age, sex, meniscal and chondral injury, tibial fixation, surgical time, time from injury to surgery, injury mechanism, and country were used to calculate hazard ratios (HRs) and 95% confidence intervals. The possible effects of femoral fixation on 1-year postoperative KOOS QoL and on change from preoperative to 1-year postoperative KOOS QoL were analyzed using multiple linear regression with adjustment from possible confounding from the same variables. P values <.05 were considered significant. Results:A total of 13,955 primary ACLRs met the inclusion criteria during the study period; 1852 patients (13%) had a femoral CSD fixation and 12,103 patients (87%) a femoral IS fixation. No significant difference was observed in overall risk of revision between CSD and IS (HR, 1.10; 95% CI, 0.83 to 1.47; P = .5), and differences in cumulative survival at 2 years (CSD: 98.3% vs IS: 98.6%) and 5 years (CSD: 96.3% vs IS: 96.4%) were not statistically significant. No difference was found for mean KOOS QoL delta (1 year minus baseline) when adjusting for possible confounders (mean difference, –1.60; 95% CI, –3.83 to 0.63; P = .16). Conclusion:Data from the Scandinavian NKLRs showed no difference in the risk of revision and no difference in the KOOS QoL for fixed-loop CSD fixation compared with IS fixation on the femoral side with BPTB grafts in primary ACL reconstruction.

• Tollefson, Luke V.; Shoemaker, Evan P.; Slette, Erik L.; Carlson, Mitchell; LaPrade, Robert F. & Engebretsen, Lars [Show all 8 contributors for this article] (2025). Adequate Failure Loads for Modified Lemaire Lateral Extra-articular Tenodesis Are Achieved With an Interference Screw, Staple, and Suture Anchor: A Biomechanical Study of Structural Properties. American Journal of Sports Medicine. ISSN 0363-5465. 53(2), p. 327–332. doi: 10.1177/03635465241305739. Full text in Research Archive
• Spörri, Jörg; Beck, Lisa; Monsonís, Oriol Bonell; Alhammoud, Marine; Bahr, Roald & Bekker, Sheree [Show all 20 contributors for this article] (2025). International Ski and Snowboard Federation consensus statement on warm-up and cool-down in competitive alpine and freestyle skiers and snowboarders. BMJ Open sport & exercise medicine. 11(2). doi: 10.1136/bmjsem-2024-002351. Full text in Research Archive
• Palmer, Debbie; Soligard, Torbjørn; Fernandes, Gwen; Collins, Dave; Elliott, Niall & Kelly, Paul [Show all 8 contributors for this article] (2024). IOC Olympian Health Cohort: a study protocol for a 15-year, prospective, Olympian health study across Summer and Winter Olympic sports. BMJ Open sport & exercise medicine. 10(2). doi: 10.1136/bmjsem-2024-002061. Full text in Research Archive
• Randsborg, Per-Henrik; Brinchmann, Jan Engelsen; Owesen, Christian; Engebretsen, Lars; Birkenes, Thomas & Hanvold, Heidi Andreassen [Show all 8 contributors for this article] (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). 6(2). doi: 10.1016/j.asmr.2024.100909. Full text in Research Archive Show summary

  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 followed for 2 years. The primary outcome was the change in the Knee injury and Osteoarthritis Outcome Score (KOOS) Quality of Life (QoL) subscale. Results: The mean age at inclusion was 34.1 (standard deviation [SD] 8.5) years. There were 19 (68%) male patients. The mean size of the lesion was 4.2 (SD 1.7) cm2. There was a statistically significant and clinically meaningful improvement in patient-reported outcome measures from baseline to 2 years in both groups. The improvement from baseline to final follow-up for the primary endpoint (the KOOS QoL subscale) was larger for the AD group (39.8, SD 9.4) compared with the ACI group (23.8, SD 6.7), but this difference was not statistically significant (P = .17). However, according to a mixed linear model there were statistically significantly greater scores in the AD group for several KOOS subscales at several time points, including KOOS QoL, KOOS pain, and KOOS sport and recreation at 2 years. Conclusions: This study indicates that AD followed by supervised physiotherapy is equal to or better than ACI followed by supervised physiotherapy in patients with isolated cartilage lesions of the knee larger than 2 cm2. The improvement in KOOS QoL score from baseline to 2 years was clinically meaningful for both groups (23.8 points for ACI and 39.8 points AD), and larger for the AD group by 16 points.

• Geeslin, Andrew G.; Moatshe, Gilbert; Engebretsen, Lars; Lind, Martin; Hansson, Frida & Stalman, Anders [Show all 8 contributors for this article] (2024). Functional anterior cruciate ligament braces may have a role in select patient groups although there is presently limited evidence supporting or refuting their routine use: A scoping review of clinical practice guidelines and an updated bracing classification. Knee Surgery, Sports Traumatology, Arthroscopy. ISSN 0942-2056. doi: 10.1002/ksa.12203. Full text in Research Archive Show summary

  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 braces following ACL injury or reconstruction was performed. CPGs on the treatment of ACL injuries with sufficient attention to postoperative braces were included in this scoping review. The references used for supporting the specific CPG recommendations were reviewed. Specific indications for brace use including brace type, period of use following surgery and activities requiring brace use were collected. Results Six CPGs were identified and included this this review. Three randomised trials provided the evidence for recommendations on functional brace use following ACL reconstruction in the six CPGs. Functional ACL braces were the primary focus of the three randomised trials, although extension braces (postoperative knee immobilisers) were also discussed. A novel dynamic ACL brace category has been described, although included CPGs did not provide guidance on this brace type. Conclusions Guidance on the use of functional ACL braces following ACL reconstruction is provided in six CPGs supported by three randomised trials. However, the brace protocols and patient compliance in the randomised trials render these CPGs inadequate for providing guidance on the use of functional ACL braces in the general and high-risk patient populations when returning to sport after ACL reconstruction. Functional ACL braces are commonly utilised during the course of ACL injury treatment although there is presently limited evidence supporting or refuting the routine use of these braces. Future studies are, therefore, necessary in order to provide guidance on the use of functional and dynamic ACL braces in high-risk patient populations.

• Zegzdryn, Marek Walerian; Moatshe, Gilbert; Engebretsen, Lars; Drogset, Jon Olav; Lygre, Stein Håkon Låstad & Visnes, Håvard [Show all 7 contributors for this article] (2024). Increased risk for early revision with quadriceps graft compared with patellar tendon graft in primary ACL reconstructions. Knee Surgery, Sports Traumatology, Arthroscopy. ISSN 0942-2056. 32(3), p. 656–665. doi: 10.1002/ksa.12081. Full text in Research Archive Show summary

  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 primary QT with BPTB and HT autograft ACL reconstructions in Norway at 2-year follow-up. It was hypothesized that there would be no difference in 2-year revision rates between all three autografts. Methods: Data included primary ACLR without concomitant ligament surgeries, registered in the Norwegian Knee Ligament Register from 2004 through 2021. Revision rates at 2 years were calculated using Kaplan–Meier analysis. Hazard ratios (HR) for revision were estimated using multivariable Cox regression analysis with revision within 2 years as endpoint. Mean change in patient-reported outcome was recorded preoperatively and at 2 years through the Knee Injury and Osteoarthritis Outcome Score (KOOS) subcategories ‘Sport’ and ‘Quality of Life’ was measured for patients that were not revised and analysed with multiple linear regression. Results: A total of 24,790 primary ACLRs were identified, 10,924 with BPTB, 13,263 with HT and 603 with a QT graft. Patients in the QT group were younger (23.5 years), more of them were women (58.2%) and over 50% had surgery

• Engebretsen, Lars; Møller, Merete; Kooy, Caroline; Yamaguchi, Tetsuo & Moatshe, Gilbert (2024). The gender and sex data gap in anterior cruciate ligament injuries in paediatric patients. Knee Surgery, Sports Traumatology, Arthroscopy. ISSN 0942-2056. 32(10), p. 2500–2504. doi: 10.1002/ksa.12397. Full text in Research Archive Show summary

  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. However, it is unclear whether this rise reflects a higher injury rate or a more proactive approach towards surgery, as information on nonoperated patients is lacking. Regarding gender differences, increasing evidence implies that girls engaged in pivoting sports experience a higher incidence of ACL injuries and reinjuries compared to boys. Furthermore, data suggest that girls have inferior outcomes and lower return-to-sport rates than boys. The social context in which girls compete in sports is likely a significant contributing factor to the risk of serious knee injuries. Lack of attention and insufficient data on gender-based differences in ACL injuries, outcomes and evidence-based treatment guidelines highlight the need for further research on this topic.

• Martin, Richard Kyle; Wastvedt, Solvejg; Pareek, Ayoosh; Persson, Andreas; Visnes, Håvard & Fenstad, Anne Marie [Show all 10 contributors for this article] (2024). Unsupervised Machine Learning of the Combined Danish and Norwegian Knee Ligament Registers: Identification of 5 Distinct Patient Groups With Differing ACL Revision Rates. American Journal of Sports Medicine. ISSN 0363-5465. 52(4), p. 881–891. doi: 10.1177/03635465231225215. Full text in Research Archive
• Birkenes, Thomas; Furnes, Ove Nord; Lygre, Stein Håkon Låstad; Solheim, Eirik Johan; Årøen, Asbjørn & Knutsen, Gunnar [Show all 11 contributors for this article] (2024). Previous cartilage surgery is associated with inferior patient-reported outcomes after knee arthroplasty. Knee Surgery, Sports Traumatology, Arthroscopy. ISSN 0942-2056. 32(2), p. 361–370. doi: 10.1002/ksa.12050. Full text in Research Archive Show summary

  Purpose: The hypothesis of the present study assumed that a history of focal cartilage lesions would not affect Knee Injury and Osteoarthritis Outcome scores (KOOSs) following knee arthroplasty compared to a matched national cohort of knee arthroplasty patients. Methods: Fifty-eight knee arthroplasty patients with previous surgery for focal cartilage lesions (cartilage cohort) were compared to a matched cohort of 116 knee arthroplasty patients from the Norwegian Arthroplasty Register (control group). Age, sex, primary or revision arthroplasty, type of arthroplasty (total, unicondylar or patellofemoral), year of arthroplasty surgery and arthroplasty brand were used as matching criteria. Demographic data and KOOS were obtained through questionnaires. Regression models were employed to adjust for confounding factors. Results: Mean follow-up post knee arthroplasty surgery was 7.6 years (range 1.2–20.3) in the cartilage cohort and 8.1 (range 1.0–20.9) in the control group. The responding patients were at the time of surgery 54.3 versus 59.0 years in the cartilage and control group, respectively. At follow-up the control group demonstrated higher adjusted Knee Injury and Osteoarthritis Outcome subscores than the previous focal cartilage patients with a mean adjusted difference (95% confidence interval in parentheses): Symptoms 8.4 (0.3, 16.4), Pain 11.8 (2.2, 21.4), Activities of daily living (ADL) 9.3 (−1.2, 18.6), Sport and recreation 8.9 (−1.6, 19.4) and Quality of Life (QoL) 10.6 (0.2, 21.1). The control group also demonstrated higher odds of reaching the patient-acceptable symptom state threshold for the Knee Injury and Osteoarthritis Outcome subscores with odds ratio: Symptoms 2.7 (1.2, 6.4), Pain 3.0 (1.3, 7.0), ADL 2.1 (0.9, 4.6) and QoL 2.4 (1.0, 5.5). Conclusion: Previous cartilage surgery was associated with inferior patient-reported outcomes after knee arthroplasty. These patients also exhibited significantly lower odds of reaching the patient-acceptable symptom state threshold for the Knee Injury and Osteoarthritis Outcome subscores.

• Urhausen, Anouk; Grindem, Hege; Engebretsen, Lars; Silbernagel, Karin Grävare; Axe, Michael J. & Snyder-Mackler, Lynn [Show all 7 contributors for this article] (2024). The Delaware-Oslo ACL Cohort treatment algorithm yields superior outcomes to usual care 9-12 years after anterior cruciate ligament reconstruction. Knee Surgery, Sports Traumatology, Arthroscopy. ISSN 0942-2056. 32(2), p. 214–222. doi: 10.1002/ksa.12039. Full text in Research Archive
• Martin, Richard Kyle; Marmura, Hana; Wastvedt, Solvejg; Pareek, Ayoosh; Persson, Andreas & Moatshe, Gilbert [Show all 10 contributors for this article] (2024). External validation of the Norwegian anterior cruciate ligament reconstruction revision prediction model using patients from the STABILITY 1 Trial. Knee Surgery, Sports Traumatology, Arthroscopy. ISSN 0942-2056. 32(2), p. 206–213. doi: 10.1002/ksa.12031. Full text in Research Archive Show summary

  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 STABILITY 1 randomized clinical trial (RCT) data set. The hypothesis was that model performance would be similar. Methods: The NKLR Cox Lasso model was selected for external validation owing to its superior performance in the original study. STABILITY 1 patients with all five predictors required by the Cox Lasso model were included. The STABILITY 1 RCT was a prospective study which randomized patients to receive either a hamstring tendon autograft (HT) alone or HT plus a lateral extra-articular tenodesis (LET). Since all patients in the STABILITY 1 trial received HT ± LET, three configurations were tested: 1: all patients coded as HT, 2: HT + LET group coded as bone-patellar tendon-bone (BPTB) autograft, 3: HT + LET group coded as unknown/other graft choice. Model performance was assessed via concordance and calibration. Results: In total, 591/618 (95.6%) STABILITY 1 patients were eligible for inclusion, with 39 undergoing revisions within 2 years (6.6%). Model performance was best when patients receiving HT + LET were coded as BPTB. Concordance was similar to the original NKLR prediction model for 1- and 2-year revision prediction (STABILITY: 0.71; NKLR: 0.68–0.69). Concordance 95% confidence interval (CI) ranged from 0.63 to 0.79. The model was well calibrated for 1-year prediction while the 2-year prediction demonstrated evidence of miscalibration. Conclusion: When patients in STABILITY 1 who received HT + LET were coded as BPTB in the NKLR prediction model, concordance was similar to the index study. However, due to a wide 95% CI, the true performance of the prediction model with this Canadian and European cohort is unclear and a larger data set is required to definitively determine the external validity. Further, better calibration for 1-year predictions aligns with general prediction modelling challenges over longer periods. While not a large enough sample size to elicit the true accuracy and external validity of the prediction model when applied to North American patients, this analysis provides more support for the notion that HT plus LET performs similarly to BPTB reconstruction. In addition, despite the wide confidence interval, this study suggests optimism regarding the accuracy of the model when applied outside of Scandinavia. Level of Evidence: Level 3, cohort study.

• Murray, Iain Robert; Makaram, Navnit S.; Neo, Chryssa; Geeslin, Andrew G.; Chahla, Jorge & Moatshe, Gilbert [Show all 43 contributors for this article] (2024). Infographic.Multiligament knee injury (MLKI): an expert consensus statement on nomenclature, diagnosis, treatment and rehabilitation. British Journal of Sports Medicine. ISSN 0306-3674. 58(23), p. 1463–1465. doi: 10.1136/bjsports-2024-109051. Full text in Research Archive
• Aga, Cathrine; Trøan, Ingrid; Heir, Stig; Risberg, May Arna; Tariq, Rana & Johansen, Steinar [Show all 8 contributors for this article] (2024). No difference in osteoarthritis, but less graft failures after 5 years, comparing anatomic double-bundle to anatomic single-bundle ACL reconstruction. Knee Surgery, Sports Traumatology, Arthroscopy. ISSN 0942-2056. doi: 10.1002/ksa.12528. Full text in Research Archive Show summary

  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, activity level, functional tests and graft failures between the two groups. Methods: The study was a secondary analysis after 5-year FU of a randomized controlled trial (RCT) (Clinical Trials NCT01033188). One hundred and twenty patients between 18 and 40 years were randomized to either anatomic SB or anatomic DB reconstruction. The Kellgren–Lawrence (KL) classification grade ≥2 and the Osteoarthritis Research Society International (OARSI) atlas criteria score ≥2 were used for defining OA. Additionally, PROMs were obtained and clinical examinations of the knees were performed. Finally, the number of patients experiencing graft failure in each group was recorded. Results: Radiographic imaging was performed in 39 patients in the SB group and in 37 patients in the DB group. Four patients (10%) in the SB group and two (5%) in the DB group developed osteoarthritis according to the KL classification (p = 0.28). Five (13%) in the SB group and three (8%) in the DB group developed osteoarthritis according to the OARSI atlas criteria (p = 0.59; difference 5.0% [95% confidence interval, CI: −0.10 to 0.20]). There were no significant differences in the PROMs, clinical examinations, activity levels, or functional tests when comparing the two groups. Of initially 62 SB patients, 14 (23%) experienced graft failure compared to 4 (7%) of the 58 DB patients (p = 0.015; difference 0.016 [95% CI: 0.03–0.29]). Conclusion: At 5-year FU, there were no significant differences in the incidence of OA, PROMS, or other clinical findings comparing the anatomic DB to anatomic SB ACL reconstructed patients. There were fewer graft failures among patients treated with anatomic DB ACL reconstruction.

• Bergeron, Michael F.; Côté, Jean; Cumming, Sean P.; Purcell, Rosemary; Armstrong, Neil & Basilico, Luca [Show all 25 contributors for this article] (2024). IOC consensus statement on elite youth athletes competing at the Olympic Games: essentials to a healthy, safe and sustainable paradigm. British Journal of Sports Medicine. ISSN 0306-3674. 58, p. 946–965. doi: 10.1136/bjsports-2024-108186. Full text in Research Archive Show summary

  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, psychological and social attributes. These non-concurrent changes within and between individuals are accompanied by irregular and unpredictable threats and impediments. Likewise, the evident age-based criteria and conventional path for those youth athletes deemed eligible candidates for the Olympic Games are not well or consistently defined. Furthermore, the unstructured and largely varying policies and practices across the sporting International Federations specific to youth participation underscore the need to establish a contemporary universal paradigm that would enable elite youth athletes to navigate an individualised healthy pathway to personal, athletic and sport success. First, we reviewed and summarised key challenges facing elite youth athletes and the relevant evidence fundamental to facilitating and supporting central aspects of health and well-being, while empowering safe, sustainable and positive engagement during athletic and personal advancement and competition. Second, we developed and present a modern elite youth athlete model that emphasises a child-centred, practical framework with corresponding guidelines and recommendations to protect health and well-being while safely and favourably managing international sport competition. Our proposed evidence-informed paradigm will enable and support individualised pathways for healthy, well-rounded and sustainable positive engagement while achieving sport success for youth contending or aiming to compete at world-class international sporting events.

• Geeslin, Andrew G.; Tollefson, Luke V.; Slette, Erik L.; Shoemaker, Evan P.; Carlson, Mitchell & LaPrade, Robert F. [Show all 8 contributors for this article] (2024). The Fibular Collateral Ligament Is a More Important Restraint to Varus Laxity Compared to the Anterolateral Complex in the Anterior Cruciate Ligament–Deficient Knee in a Cadaveric Biomechanical Study. Arthroscopy: The Journal of Arthroscopy And Related. ISSN 0749-8063. doi: 10.1016/j.arthro.2024.09.025. Full text in Research Archive
• Moatshe, Gilbert; LaPrade, Christopher M.; Fenstad, Anne Marie; Persson, Andreas; LaPrade, Matthew D. & Martin, Richard Kyle [Show all 8 contributors for this article] (2024). Rates of Subjective Failure After Both Isolated and Combined Posterior Cruciate Ligament Reconstruction: A Study From the Norwegian Knee Ligament Registry 2004-2021. American Journal of Sports Medicine. ISSN 0363-5465. 52(6), p. 1491–1497. doi: 10.1177/03635465241238461. Full text in Research Archive Show summary

  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 PCLR outcomes and failure rates and compare these outcomes between isolated PCLR and multiligament knee surgery involving the PCL. The hypothesis was that combined PCL injury reconstruction would have higher rates of subjective failure and revision relative to isolated PCLR. Study Design: Cohort study; Level of evidence, 3. Methods: Patients with primary PCLR with or without concomitant ligament injuries registered in the Norwegian Knee Ligament Registry between 2004 and 2021 were included. Knee injury and Osteoarthritis Outcome Score (KOOS) totals were collected preoperatively and at 2 years and 5 years postoperatively. The primary outcome measure was failure, defined as either a revision surgery or a KOOS Quality of Life (QoL) subscale score ﹤44. Results: The sample included 631 primary PCLR procedures, with 185 (29%) isolated PCLR procedures and 446 (71%) combined reconstructions, with a median follow-up time of 7.3 and 7.9 years, respectively. The majority of patients had poor preoperative knee function as defined by a KOOS QoL score ﹤44 (90.1% isolated PCLR, 85.7% combined PCL injuries; P = .24). Subjective outcomes improved significantly at 2- and 5-year follow-up compared with preoperative assessments in both groups (P ﹤ .001); however, at 2 years, 49.5% and 46.5% had subjective failure (KOOS QoL ﹤44) for isolated PCLR and combined PCLR, respectively (P = .61). At 5 years, the subjective failure rates of isolated and combined PCLR were 46.7% and 34.2%, respectively (P = .04). No significant difference was found in revision rates between the groups at 5 years (1.9% and 4.6%, respectively; P = .07). Conclusion: Patients who underwent PCLR had improved KOOS QoL scores relative to their preoperative state. However, the subjective failure rate was high for both isolated and multiligament PCLR. Within the first 2 years after surgery, patients who undergo isolated PCLR can be expected to have similar failure rates to patients who undergo combined ligament reconstructions.

• Berg, Bjørnar; Roos, Ewa M.; Englund, Martin Trøan; Kise, Nina Jullum; Engebretsen, Lars & Eftang, Cathrine Nørstad [Show all 7 contributors for this article] (2024). Arthroscopic partial meniscectomy versus exercise therapy for degenerative meniscal tears: 10-year follow-up of the OMEX randomised controlled trial. British Journal of Sports Medicine. ISSN 0306-3674. doi: 10.1136/bjsports-2024-108644. Full text in Research Archive Show summary

  Objectives: 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 degenerative meniscal tear, and no or minimal radiographic OA changes. Participants were randomised to either APM or 12 weeks of exercise therapy (1:1 ratio). The primary outcome was knee OA progression assessed by the Osteoarthritis Research Society International (OARSI) atlas sum score (sum of medial and lateral compartment joint space narrowing and osteophyte score). Secondary outcomes included incidence of radiographic and symptomatic knee OA, patient-reported pain and knee function, and isokinetic knee muscle strength. Results: The adjusted mean difference in change in the OARSI sum score was 0.39 (95% CI -0.19 to 0.97), with more progression in the APM group. The incidence of radiographic knee OA was 23% in the APM group and 20% in the exercise group (adjusted risk difference 3% [95% CI -13% to 19%]). No clinically relevant differences were found in patient-reported outcomes or isokinetic knee muscle strength. Conclusion: No essential differences in radiographic knee OA progression and comparable rates of knee OA development were observed 10 years following APM and exercise therapy for degenerative meniscal tears. Both treatments were associated with improved patient-reported pain and knee function.

• Birkenes, Thomas; Furnes, Ove Nord; Lygre, Stein Håkon Låstad; Solheim, Eirik Johan; Årøen, Asbjørn & Knutsen, Gunnar [Show all 11 contributors for this article] (2024). Long-Term Outcomes of Arthroscopically Verified Focal Cartilage Lesions in the Knee: A 19-Year Multicenter Follow-up with Patient-Reported Outcomes. Journal of Bone and Joint Surgery. American volume. ISSN 0021-9355. 106(21), p. 1991–2000. doi: 10.2106/JBJS.23.00568. Full text in Research Archive Show summary

  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 (PROMs), the need for subsequent cartilage surgery, and the risk of treatment failure 20 years after diagnosis of an FCL in the knee. Methods: Patients undergoing any knee arthroscopy for an FCL between 1999 and 2012 in 6 major Norwegian hospitals were identified. Inclusion criteria were an arthroscopically classified FCL in the knee, patient age of ≥18 years at surgery, and any preoperative PROM. Exclusion criteria were lesions representing knee osteoarthritis or “kissing lesions” at surgery. Demographic data, later knee surgery, and PROMs were collected by questionnaire. Regression models were used to adjust for and evaluate the factors impacting the long-term PROMs and risk factors for treatment failure (defined as knee arthroplasty, osteotomy, or a Knee injury and Osteoarthritis Outcome Score-Quality of Life [KOOS QoL] subscore of 1 FCL (OR, 1.9 [CI, 1.1 to 3.3]), a full-thickness lesion (OR, 2.5 [95% CI, 1.3 to 5.0]), and a lower level of education (OR, 1.8 [95% Cl, 1.1 to 2.8]). Autologous chondrocyte implantation (ACI) was associated with significantly higher KOOS QoL, by 17.5 (95% CI, 3.2 to 31.7) points, and a lower risk of treatment failure compared with no cartilage treatment, microfracture, or mosaicplasty. Conclusions: After a mean follow-up of 19 years, patients with an FCL who did not require a subsequent knee arthroplasty had significantly higher PROM scores than preoperatively. Nonsurgical treatment of FCLs had results equal to those of the surgical FCL treatments except for ACI, which was associated with a better KOOS and lower risk of treatment failure. Full-thickness lesions, >1 FCL, a lower level of education, and a greater BMI were the main risk factors associated with poorer results.

• Tollefson, Luke V.; Kennedy, Nicholas I.; Banovetz, Mark T.; Homan, Morgan D.; Engebretsen, Lars & Moatshe, Gilbert [Show all 9 contributors for this article] (2024). Supratubercle Anterior Closing Wedge Osteotomy: No Changes in Patellar Height and Significant Decreases in Anterior Tibial Translation at 6 Months Postoperatively. American Journal of Sports Medicine. ISSN 0363-5465. doi: 10.1177/03635465241252982. Full text in Research Archive
• Murray, Iain Robert; Makaram, Navnit S.; Geeslin, Andrew G.; Chahla, Jorge; Moatshe, Gilbert & Crossley, Kay [Show all 42 contributors for this article] (2024). Multiligament knee injury (MLKI): an expert consensus statement on nomenclature, diagnosis, treatment and rehabilitation. British Journal of Sports Medicine. ISSN 0306-3674. doi: 10.1136/bjsports-2024-108089. Full text in Research Archive Show summary

  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 for patients with MLKI, while identifying important research priorities for further study. An international consensus process was conducted using validated Delphi methodology in line with British Journal of Sports Medicine guidelines. A multidisciplinary panel of 39 members from 14 countries, completed 3 rounds of online surveys exploring aspects of nomenclature, diagnosis, treatment, rehabilitation and future research priorities. Levels of agreement (LoA) with each statement were rated anonymously on a 5-point Likert scale, with experts encouraged to suggest modifications or additional statements. LoA for consensus in the final round were defined ‘a priori’ if >75% of respondents agreed and fewer than 10% disagreed, and dissenting viewpoints were recorded and discussed. After three Delphi rounds, 50 items (92.6%) reached consensus. Key statements that reached consensus within nomenclature included a clear definition for MLKI (LoA 97.4%) and the need for an updated MLKI classification system that classifies injury mechanism, extent of non-ligamentous structures injured and the presence or absence of dislocation. Within diagnosis, consensus was reached that there should be a low threshold for assessment with CT angiography for MLKI within a high-energy context and for certain injury patterns including bicruciate and PLC injuries (LoA 89.7%). The value of stress radiography or intraoperative fluoroscopy also reached consensus (LoA 89.7%). Within treatment, it was generally agreed that existing literature generally favours operative management of MLKI, particularly for young patients (LoA 100%), and that single-stage surgery should be performed whenever possible (LoA 92.3%). This consensus statement will facilitate clinical communication in MLKI, the care of these patients and future research within MLKI.

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• Steinacker, Jürgen M.; Mechelen, Willem van; Engebretsen, Lars; Verhagen, Evert; Börjesson, Mats & González-Gross, Marcela [Show all 149 contributors for this article] (2026). Precision Prevention for Health: The Global Alliance Framework for the Promotion of Physical Activity. Sports Medicine. ISSN 0112-1642. doi: 10.1007/s40279-026-02495-4. Full text in Research Archive Show summary

  Abstract This conceptual, implementation-oriented paper proposes a framework for precision prevention centred on physical activity promotion and early risk mitigation, aiming to support a shift from reactive disease management toward proactive prevention. The proposed framework focuses on the early identification of risk trajectories by integrating biological, environmental, and social determinants of health through systems thinking, multi-omics technologies, digital health, and behavioural science. It aims to inform tailored, context-sensitive interventions that will help to mitigate chronic non-communicable diseases (NCDs), while supporting lifelong resilience. Within this framework, physical activity is positioned as the central, modifiable anchor behaviour through which personalised prevention strategies may be operationalised. Building on the 2025 Hamburg Declaration and the Global Alliance for the Promotion of Physical Activity’s (GA@PA) mission, this conceptual paper proposes a multidimensional model, combining personalised strategies for physical activity, nutrition, sleep, and mental health with contextual environmental adaptations. By bringing together stakeholders across multiple sectors, including healthcare, education, urban planning, sport organisations, industry, and community groups, GA@PA aims to strengthen global collaboration and to accelerate the implementation of evidence-based strategies for physical activity promotion. Emerging technologies, including digital twins, wearable biosensors and artificial intelligence (AI)-driven analytics, are discussed as potential enabling tools for real-time monitoring and for providing input for adaptive interventions, while mobile health platforms may extend access to underserved populations. Rather than providing prescriptive solutions, the paper outlines key implementation fundamentals. These include technological infrastructure with interoperable biosensors and AI aligned with prevailing ethical frameworks such as the AI Act and UNESCO recommendations; interdisciplinary research on resilience and outlier populations; policy and education reform, including routine assessment of physical activity as a vital sign within healthcare encounters; and cross-sector collaboration spanning urban design to sport-for-development initiatives such as the International Olympic Committee (IOC)’s Olympism365. Sports organisations may support broader participation through sport-for-all programmes. The framework emphasises equity, cultural adaptation, and community co-design as critical features for scalability across diverse global contexts, highlighting the role of sport, fitness, and public health partnerships in creating a context where healthy choices become accessible and sustainable. Overall, this conceptual paper outlines a practice-informed framework proposing precision prevention as an evolving and testable implementation framework for supporting sustainable and equitable prevention systems. By integrating science, technology and policy through a multisectoral lens, precision prevention is proposed as a testable pathway to reduce the NCD burden, to enhance the health span and to foster resilient societies.

• Thiébat, Gabriele; Engebretsen, Lars; Delladio, Marco; Pegoretti, Leonardo; Bristot, Federico & Panzeri, Andrea (2026). A ‘potential coper’ in elite freestyle skiing: an Olympic bronze to confirm that surgery is not the “only way” to win. Full text in Research Archive
• Engebretsen, Lars (2026). The IOC strategy to handle injuries and illness in the Olympic Games. Full text in Research Archive
• Engebretsen, Lars (2026). Multiligament injuries, diagnoses, treatment and results among high level skiers. Full text in Research Archive
• Engebretsen, Lars (2026). Medical and surgical issues during the Winter Olympic. Full text in Research Archive
• Engebretsen, Lars (2026). My research journey in sports medicine and with the IOC. Full text in Research Archive
• Engebretsen, Lars (2026). The wicked problems in pediatric ACL injuries. Full text in Research Archive
• Engebretsen, Lars; Thoreux, Patricia & Monllau, Joan Carles (2026). Welcome and presentation of the Team Physician Course. Full text in Research Archive
• Engebretsen, Lars (2026). Stress fractures and REDS. Full text in Research Archive
• Engebretsen, Lars (2026). General epidemiology. Full text in Research Archive
• Engebretsen, Lars (2026). Current situation of access to doping substances in Europe. Full text in Research Archive
• Engebretsen, Lars (2026). Skiing and knee injuries - where do we come from? Full text in Research Archive
• Engebretsen, Lars & Steffen, Kathrin (2026). Summary and review of the course. Full text in Research Archive
• Engebretsen, Lars (2026). Opening & overview of the IOC projects to protect the health of the athletes. Full text in Research Archive
• Engebretsen, Lars (2026). WADA på godt og vondt, erfaring etter 10 år som leder av Health, Medicine og Research Committee. Full text in Research Archive
• Årøen, Asbjørn; Engebretsen, Lars; Drogset, Jon Olav & Jevremovic, Diko (2026). Bucket-handle meniscal tears in anterior cruciate ligament reconstruction - prevalence, predictors, and 2-year patient-reported outcomes from the Norwegian Knee Ligament Register. Full text in Research Archive
• Trøan, Ingrid; Bere, Tone Tufte; Holm, Inger; Moatshe, Gilbert; Engebretsen, Lars & LaPrade, Robert (2025). Quadriceps- og hamstringstyrke gjenvinnes ikke fullstendig etter en multiligamentskade i kneet - en langtidsoppfølging. Full text in Research Archive
• Engebretsen, Lars; Soligard, Torbjørn & Steffen, Kathrin (2025). Development of sports medicine in the International Olympic Committee. Full text in Research Archive
• Moatshe, Gilbert; Owesen, Christian; Løken, Sverre Bertrand; Trøan, Ingrid; Årøen, Asbjørn & Engebretsen, Lars (2025). Det er ingen forskjell i aktivitetsnivå 1 år etter bakre korsbåndskade, etter rehabilitering med eller uten PCL-ortose. Full text in Research Archive
• Engebretsen, Lars (2025). What's new on PCL. Full text in Research Archive
• Engebretsen, Lars (2025). Health, medical and research committee and contamination working group. Full text in Research Archive
• Lind, Martin; Engebretsen, Lars; Hansson, Frida & Mikkelsen, Christina (2025). ACL-surgery - technique, graft choice and rehabilitation. Full text in Research Archive
• Engebretsen, Lars; Lind, Martin & Barenius, Björn (2025). The Scandinavian National Knee Ligament Registries 20 years - what is the benefit? Full text in Research Archive
• Engebretsen, Lars (2025). Multi-ligament injury history – one-stage and two-stage approach – my journey from two to one-stage. Full text in Research Archive
• Engebretsen, Lars (2025). Live demo – key surgical PLC anatomy and biomechanics. Full text in Research Archive
• Engebretsen, Lars (2025). Live demo – anatomic MCL and POL reconstruction. Full text in Research Archive
• Engebretsen, Lars (2025). Welcome – review of course goals day 2. Full text in Research Archive
• Engebretsen, Lars (2025). Course goals and review – Evidence-based anatomic repairs and reconstructions. Full text in Research Archive
• Engebretsen, Lars (2025). Summary and review of the course. Full text in Research Archive
• Engebretsen, Lars (2025). Roles and responsibilities of sport medicine professionals. Full text in Research Archive
• Engebretsen, Lars (2025). Pre-travel preparation and medical issues during travel – what the team physician should do. Full text in Research Archive
• Engebretsen, Lars (2025). Opening & overview of the IOC projects to protect the health of the athletes. Full text in Research Archive
• Engebretsen, Lars (2025). Tailored approach to acute musculoskeletal pain – where are we heading? Full text in Research Archive
• Engebretsen, Lars (2025). Fem tiår med ACL-kirurgi – banebrytende teknikker og veien videre. Full text in Research Archive
• Engebretsen, Lars (2025). Sport medicine roundtable. Prevention techniques of sports injuries. Full text in Research Archive
• Årøen, Asbjørn; Straume-Næsheim, Truls Martin; Visnes, Håvard; Engebretsen, Lars & Jakobsen, Rune Bruhn (2025). Number of meniscus sutures for a bucket handle meniscus in the ACL injured knee – a real-life review from nklr-data. Full text in Research Archive
• Engebretsen, Lars (2025). Bone health and the female athlete triad – why ortho surgeons should care: IOC consensus statement – the IOC point of view. Full text in Research Archive
• Engebretsen, Lars (2025). A lifetime of ACL injury research: can we finally prevent secondary osteoarthritis? Full text in Research Archive
• Tveiten, Caroline Emilie Van Woensel Ko; Jakobsen, Rune Bruhn; Fenstad, Anne Marie; Persson, Andreas; Engebretsen, Lars & Moksnes, Håvard [Show all 7 contributors for this article] (2025). The other side of the ACL injury story – a nationwide, prospective cohort of non-operated patients and their outcomes. Full text in Research Archive
• Trøan, Ingrid; Moatshe, Gilbert; Bere, Tone Tufte; Holm, Inger & Engebretsen, Lars (2025). Return to sport and to work after mulitligament knee injury. Full text in Research Archive
• Kjær, Michael; Petersen, Jesper; Dünweber, Michael Ries; Andersen, Jesper Løvind; Engebretsen, Lars & Magnusson, Stig Peter (2025). Dilemma in the Treatment of Sports Injuries in Athletes: Tendon Overuse, Muscle Strain, and Tendon Rupture. Scandinavian Journal of Medicine & Science in Sports. ISSN 0905-7188. 35(2). doi: 10.1111/sms.70026. Full text in Research Archive
• Engebretsen, Lars; Steffen, Kathrin & Soligard, Torbjørn (2025). Olympic Sports Injuries and Prevention. In Doral, Mahmut Nedim & Karlsson, Jon (Ed.), Sports Injuries : Prevention, Diagnosis, Treatment and Rehabilitation. Springer. ISSN 9783642368011. doi: 10.1007/978-3-642-36801-1_297-1. Full text in Research Archive Show summary

  Nine hundred physicians attend each Olympic Summer Game and the majority are sports medicine physicians. Although the International Olympic Committee has a two-year diploma course in sports medicine available online with practical training, assignments, and a final exam, many of our sports medicine colleagues are doing the Olympic Games without other skills than the medical school and specialty training and experience. Thus, this chapter is written to prepare you for the tasks of being an Olympic Games physician. The chapter will reference the most important epidemiology papers from the Olympic Games as well as give you numbers on high-risk and low-risks sports. It will inform you of the periodic health exams and discuss translations challenges in applying the positive results of the prevention studies (overall 50% reduction in injuries) to your team. Finally, it will look at future directions in this field. An increasing number of sport physicians work more than 50% of their time for national teams. This increases the knowledge base both from research and practical experience. This put demands on physicians from smaller national teams and increases the need for cooperation between colleagues and national teams.

• Mountjoy, Margo L.; Ackerman, Kathryn E.; Bailey, David M.; Burke, Louise M.; Constantini, Naama & Hackney, Anthony C. [Show all 17 contributors for this article] (2025). Yes: Relative Energy Deficiency in Sport (REDs) Does Exist! Sports Medicine. ISSN 0112-1642. doi: 10.1007/s40279-025-02219-0. Full text in Research Archive
• Toyooka, Seikai; Pareek, Ayoosh; Persson, Andreas; Engebretsen, Lars & Martin, Richard Kyle (2025). Artificial intelligence and healthcare decision-making. In Doral, Mahmut Nedim & Karlsson, Jon (Ed.), Sports Injuries : Prevention, Diagnosis, Treatment and Rehabilitation. Springer. ISSN 9783642368011. doi: 10.1007/978-3-642-36801-1_316-1. Full text in Research Archive Show summary

  Artificial intelligence, and more specifically, its subset machine learning, have been increasingly impacting the field of orthopedic surgery. The number of machine learning-related publications within the orthopedic literature has been increasing every year. Models can primarily be used to help clinicians with both diagnostic and prognostic tasks and will likely play a major role in clinical practice in the near future. Despite the many obstacles to overcome in order to achieve the ultimate goal of improved patient care through AI-powered advancements, the future is promising and clinicians should familiarize themselves with the basics of clinical artificial intelligence. Unfortunately, at this time, there has been little widespread adoption of machine learning algorithms into daily practice and many orthopedic surgeons remain cautious regarding these novel statistical techniques. The purpose of this chapter is to introduce artificial intelligence as it relates to orthopedic surgery and sports medicine, providing examples from the literature along the way.

• Becker, Roland; Engebretsen, Lars & Patricia, Thoreux (2024). Welcome and presentation of the Team Physician Course. Full text in Research Archive
• Engebretsen, Lars (2024). The team physician as a leader, mentor AND mentee! How to develop a team. Full text in Research Archive
• Engebretsen, Lars (2024). What is different in Olympic Winter Games - Epidemiology. Full text in Research Archive
• Rodriguez, Ariel N.; Falaas, Kari; Moatshe, Gilbert & Engebretsen, Lars (2024). Posterior Oblique Ligament. In Espregueira-Mendes, João; Karlsson, Jón; Musahl, Volker & Ayeni, Olufemi R. (Ed.), Orthopaedic sports medicine: An encyclopedic review of diagnosis, prevention, and management. Springer. doi: 10.1007/978-3-030-65430-6_95-1. Full text in Research Archive Show summary

  Knee dislocations have historically been severe and potentially limb-threatening injuries. Over the last several decades, the diagnosis, treatment, and rehabilitation for knee dislocations have improved, leading to improved patient outcomes and knee function. A thorough physical examination including assessment of neurovascular status and the integrity of all ligaments and soft tissue structures of the knee is necessary for a comprehensive treatment plan. The use of stress radiographs, in combination with magnetic resonance imaging, is recommended to assess the functional status of the cruciate and collateral ligaments of the knee. An anatomic-based reconstruction approach within the acute treatment period following injury is recommended. In order to allow early functional rehabilitation, Patients who undergo anatomic-based reconstructions, followed by early postoperative rehabilitation focusing on protected range of motion and quadriceps strengthening, have shown optimal outcomes. With these principles, improved knee function and activity level can be expected; however, return to preinjury activity level cannot be expected.

• Moatshe, Gilbert & Engebretsen, Lars (2024). Knee dislocations with vascular injuries – a review article. Danish Medical Journal. 71(3). doi: 10.61409/A08230529. Full text in Research Archive Show summary

  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 vascular injuries is imperative to avoid limb loss because the risk of amputation is high when diagnosis and timely intervention are delayed. It is recommended that serial ankle-brachial index (ABI) be performed in all patients with suspected knee dislocation. This is particularly important in fracture dislocations, high-energy trauma, morbidly obese patients, lateral sided injuries, concomitant peroneal nerve injuries and fracture in the ipsilateral limb because these were demonstrated to be associated with a high risk of concomitant vascular injuries in knee dislocations. In cases where serial ABI cannot be performed, in high-risk patients and ABI

• Soligard, Torbjørn; Steffen, Kathrin; Budgett, Richard & Engebretsen, Lars (2024). Development of sports medicine in the International Olympic Committee. British Journal of Sports Medicine. ISSN 0306-3674. doi: 10.1136/bjsports-2024-108201. Full text in Research Archive
• Engebretsen, Lars (2024). Team Physician Course Epidemiology. Full text in Research Archive
• Braaten, Jacob; Rodriguez, Ariel; Engebretsen, Lars & Moatshe, Gilbert (2024). Posterior oblique ligament. In Espregueira-Mendes, João; Karlsson, Jón; Musahl, Volker & Ayeni, Olufemi R. (Ed.), Orthopaedic sports medicine: An encyclopedic review of diagnosis, prevention, and management. Springer. doi: 10.1007/978-3-030-65430-6_46-1. Full text in Research Archive
• Putukian, Margot; Blauwet, Cheri; Currie, Alan; Gouttebarge, Vincent; McDuff, David & Mountjoy, Margo L [Show all 11 contributors for this article] (2024). Social media impact on athlete mental health: #RealityCheck. British Journal of Sports Medicine. ISSN 0306-3674. doi: 10.1136/bjsports-2023-107651. Full text in Research Archive
• Soligard, Torbjørn & Engebretsen, Lars (2024). The scientific activities of the IOC Medical and Scientific Department. Full text in Research Archive
• Engebretsen, Lars (2024). Lesions multiligamentaires du genou et sport de haut nivau. Full text in Research Archive
• Engebretsen, Lars (2024). The academic programme in the Paris Games. Full text in Research Archive
• Engebretsen, Lars (2024). Quelles sont les actions du CIO pour la santé des athlétes? Full text in Research Archive
• Engebretsen, Lars (2024). I & I surveillance - preliminary numbers. Full text in Research Archive
• Engebretsen, Lars (2024). Mitt drømmeforedrag om i går, i dag og i morgen. Full text in Research Archive
• Engebretsen, Lars (2024). How we started OSTRC. Full text in Research Archive

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