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Background: The tibialis posterior muscle has an important role both in stabilizing the foot and in inversion, plantar flexion, and adduction of the foot. Impaired function can lead to tibialis posterior dysfunction. A clinical test that can objectively measure tibialis posterior strength is warranted.

Objectives: The aim of this study was to investigate the interrater, test-retest, and intersession reliability of a test designed to measure tibialis posterior strength with a hand-held dynamometer.

Design: Interrater, between-day test-retest and intersession reliability.

Setting: University laboratory.

Participants: The participants comprised 20 healthy individuals (mean age 28.8 years, n = 10 women) without foot problems.

Method: A test was designed to test tibialis posterior strength with a hand-held dynamometer (HHD). The test was performed on two occasions 5–15 days apart and was carried out by two raters. The intraclass correlation coefficient (ICC), 95 % confidence interval, standard error of measurement (SEM), and minimal detectable change were calculated.

Results: Interrater reliability was good on both occasions (ICC: 0.769, 0.794), test-retest reliability was moderate for both raters (ICC: 0.671, 0.672), and intersession reliability was excellent (ICC: 0.934–0.967). However, the confidence interval had a large variation (-0.027–0.986) and the SEM was relatively high (2.356–3.863 N).

Conclusions: This test seems to be reliable, but has some limitations. The results suggest that the current version of the test could be used to compare strength between feet, but that further development of the test is needed to achieve increased interrater and test-retest reliability.

Foot drop (FD) can be caused by a variety of diseases and injuries. FD leads to walking difficulties and reduced balance which also can lead to a higher risk of falling. Patient with a stroke often have an equinovarus deformity of the foot together with the DF. There is a need to optimize and standardize the treatment for patients with FD across different medical specialities. Surgical interventions, with goals of producing a balanced functional foot, have been shown to improve the function and quality of life and decrease the use of braces and walking aids in patients with FD after a CVI. In Sweden data regarding FD surgery is collected in the National Quality Registry for Foot and Ankle Surgery (Riksfot), but there is also an ongoing multicentre study, investigating the patient-reported and functional results of surgery due to FD caused by a CVI.

Little is known about physical activity level and knee function including jump capacity and fear of movement/reinjury more than 20 years after injury of the anterior cruciate ligament (ACL). Seventy persons with unilateral ACL injury participated (23 ± 2 years post-injury): 33 treated with physiotherapy in combination with surgical reconstruction (ACL_R), and 37 treated with physiotherapy alone (ACL_PT). These were compared with 33 age- and gender-matched controls. Assessment included knee-specific and general physical activity level [Tegner activity scale, International Physical Activity Questionnaire (IPAQ)], knee function [Lysholm score, Knee injury and Osteoarthritis Outcome Score (KOOS)], jump capacity (one-leg hop, vertical jump, side hops), and fear of movement/reinjury [Tampa Scale for Kinesiophobia (TSK)]. Outcomes were related to degree of osteoarthritis (OA). ACL-injured had lower Lysholm, KOOS, and Tegner scores than controls (P < 0.001), while IPAQ score was similar. ACL-injured demonstrated inferior jump capacity in injured compared with noninjured leg (6–25%,P < 0.001–P = 0.010 in the different jumps), while noninjured leg had equal jump capacity as controls. ACL groups scored 33 ± 7 and 32 ± 7 of 68 on TSK. Lower scores on Lysholm and KOOS symptom were seen for persons with moderate-to-high OA than for no-or-low OA, while there were no differences for physical activity and jump capacity. Regardless of treatment, there are still negative knee-related effects of ACL injury more than 20 years later.

The long-term consequences on knee muscle strength some decades after rupture of the anterior cruciate ligament (ACL) are not established. The aims of our study were to examine peak torque more than 20 years after ACL injury and to compare their knee muscle strength to that of healthy controls. We tested 70 individuals with unilateral ACL injury 23 ± 2 years after injury, whereof 33 (21 men) were treated with physiotherapy in combination with ACL reconstruction (ACL_R) and 37 (23 men) with physiotherapy alone (ACL_PT). These were compared with 33 age- and gender-matched controls (21 men). A Kin-Com^® dynamometer (90°/s) was used to measure peak torque in knee flexion and extension in both concentric and eccentric contractions. Knee extension peak torque, concentric and eccentric, was ∼10% lower for the injured leg compared with the non-injured leg for both ACL_R (P < 0.001; P < 0.001) and ACL_PT (P = 0.007; P = 0.002). The ACL_PT group also showed reduced eccentric knee flexion torque of the injured leg (P = 0.008). The strength of the non-injured leg in both ACL groups was equal to that of controls. No difference was seen for those with no-or-low degree of knee osteoarthritis compared to those with moderate-to-high degree of osteoarthritis. ACL injury may lead to a persistent reduction of peak torque in the injured leg, which needs to be considered across the lifespan.

Aim: To investigate the long-term effect on balance during single-limb stance after unilateral anterior cruciate ligament (ACL) injury across two groups who had rehabilitation including ACL reconstruction (ACL_R) or a tailored physiotherapy program (ACL_TPP), compared with knee-healthy controls.

Methods: Single-limb stance was monitored for floor-supports with the contralateral foot. Single-limb stance without floor-supports was assessed with analyses of center of pressure (CoP) for further discrimination. Comparisons were made between ACL_R (n = 28) and ACL_TPP (n = 28) and with controls (n = 18). The injured and uninjured legs were compared within ACL-injured subjects.

Results: Single-limb balance was equally inferior in both ACL-injured groups and on both legs compared with knee-healthy controls. In ACL_R and ACL_TPP, 39% and 50%, respectively, failed to stand on one leg without floor-supports with the contralateral foot. No contralateral supports occurred in knee-healthy controls. CoP measures for subjects who stood without contralateral floor-supports did not reveal any further differences. Older age and higher body mass index (BMI) correlated with larger migration of CoP.

Conclusion: Inability to stand without contralateral supports showed that balance in single-limb stance was inferior in ACL-injured subjects, independently of which initial treatment that was given. Age and BMI need consideration in studies assessing balance in single-limb stance.

Autologous periosteal transplantation (without chondrocyte cell transplantation) for treating traumatic articular cartilage defects of the patella gives pain relief in uncontrolled clinical studies. To study the whole transplanted area macroscopically and microscopically, animal studies are motivated. In this pilot study, we reproduce the surgical technique for periosteum transplantation on human patella to a rabbit model. A full-thickness cartilage defect of the whole patella was created in eight adult female rabbits. The defect was treated with autologous periosteal transplantation. After surgery, the rabbits were allowed free activity. This is the difference compared to the treatment in humans, where our group uses CPM for 5 days and non-weight-bearing for 12 weeks. After 21 weeks, there was a diffuse synovitis in all transplanted knees, and in five of eight knees there were signs of osteoarthritis in the patello-femoral joint. Histologically, in three animals, small islands of hyaline cartilage surrounded by fibrocartilage were seen in the transplanted area. In the other five animals, fibrocartilage was the predominant tissue. In contrast to previous experimental studies using a rabbit model, we did not achieve hyaline cartilage resurfacing.