{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T17:16:39Z","timestamp":1782321399726,"version":"3.54.5"},"reference-count":39,"publisher":"BMJ","issue":"6","funder":[{"DOI":"10.13039\/501100006310","name":"Swedish Medical Research Council","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100006310","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Medical Research Council of Southeast Sweden FORSS"},{"DOI":"10.13039\/501100005350","name":"Swedish Research Council for Sport Science","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005350","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,5,14]]},"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Anterior cruciate ligament (ACL) injury can result in joint instability, decreased functional performance, reduced physical activity and quality of life and an increased risk for post-traumatic osteoarthritis. Despite the development of new treatment techniques and extensive research, the complex and multifaceted nature of ACL injury and its consequences are yet to be fully understood. The overall aim of the NACOX study is to evaluate the natural corollaries and recovery after an ACL injury.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and analysis<\/jats:title>\n                  <jats:p>The NACOX study is a multicentre prospective prognostic cohort study of patients with acute ACL injury. At seven sites in Sweden, we will include patients aged 15\u201340 years, within 6 weeks after primary ACL injury. Patients will complete questionnaires at multiple occasions over the 3 years following injury or the 3 years following ACL reconstruction (for participants who have surgical treatment). In addition, a subgroup of 130 patients will be followed with clinical examinations, several imaging modalities and biological samples. Data analyses will be specific to each aim.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Ethics and dissemination<\/jats:title>\n                  <jats:p>This study has been approved by the regional Ethical committee in Link\u00f6ping, Sweden (Dnr 2016\/44-31 and 2017\/221\u201332). We plan to present the results at national and international conferences and in peer-reviewed scientific journals. Participants will receive a short summary of the results following completion of the study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number<\/jats:title>\n                  <jats:p>\n                     <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"NCT02931084\" ext-link-type=\"clintrialgov\">NCT02931084<\/jats:ext-link>.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-020543","type":"journal-article","created":{"date-parts":[[2018,6,27]],"date-time":"2018-06-27T03:26:27Z","timestamp":1530069987000},"page":"e020543","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":24,"title":["Natural corollaries and recovery after acute ACL injury: the NACOX cohort study protocol"],"prefix":"10.1136","volume":"8","clinical-trial-number":[{"clinical-trial-number":"nct02931084","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3527-5488","authenticated-orcid":false,"given":"Joanna","family":"Kvist","sequence":"first","affiliation":[{"name":"Division of Physiotherapy, Department of Medical and Health Sciences, Link\u00f6ping University, Linkoping, Sweden"},{"name":"Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden"},{"name":"Department of Medical and Health Sciences, Center for Medical Image Science and Visualization (CMIV), Link\u00f6ping University, Link\u00f6ping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00e5kan","family":"Gauffin","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Link\u00f6ping University, Linkoping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanna","family":"Tigerstrand Grevnerts","sequence":"additional","affiliation":[{"name":"Division of Physiotherapy, Department of Medical and Health Sciences, Link\u00f6ping University, Linkoping, Sweden"},{"name":"Division of Physiotherapy, Department of Activity and Health, Link\u00f6ping University, Linkoping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clare","family":"Ardern","sequence":"additional","affiliation":[{"name":"Division of Physiotherapy, Department of Medical and Health Sciences, Link\u00f6ping University, Linkoping, Sweden"},{"name":"School of Allied Health, La Trobe University, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"H\u00e4gglund","sequence":"additional","affiliation":[{"name":"Division of Physiotherapy, Department of Medical and Health Sciences, Link\u00f6ping University, Linkoping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"St\u00e5lman","sequence":"additional","affiliation":[{"name":"Stockholm Sports Trauma Research Center, Capio ArtroClinic, Sophiahemmet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Frobell","sequence":"additional","affiliation":[{"name":"Department of orthopedics, clinical sciences, Lund University, Lund, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,6,27]]},"reference":[{"key":"2025101814180636000_8.6.e020543.1","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1111\/j.1600-0838.2006.00559.x","article-title":"Acute rotational trauma to the knee: poor agreement between clinical assessment and magnetic resonance imaging findings","volume":"17","author":"Frobell","year":"2007","journal-title":"Scand J Med Sci Sports"},{"key":"2025101814180636000_8.6.e020543.2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.M.01054"},{"key":"2025101814180636000_8.6.e020543.3","doi-asserted-by":"publisher","DOI":"10.1177\/0363546507307396"},{"key":"2025101814180636000_8.6.e020543.4","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513508376"},{"key":"2025101814180636000_8.6.e020543.5","doi-asserted-by":"publisher","DOI":"10.1177\/0363546516634325"},{"key":"2025101814180636000_8.6.e020543.6","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f232"},{"key":"2025101814180636000_8.6.e020543.7","doi-asserted-by":"publisher","DOI":"10.1177\/0363546512458424"},{"key":"2025101814180636000_8.6.e020543.8","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2013.4278"},{"key":"2025101814180636000_8.6.e020543.9","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1053\/j.otsm.2015.09.006","article-title":"Psychological aspects of anterior cruciate ligament injuries","volume":"24","author":"Ardern","year":"2016","journal-title":"Oper Tech Sports Med"},{"key":"2025101814180636000_8.6.e020543.10","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.L.01713"},{"key":"2025101814180636000_8.6.e020543.11","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0104681","article-title":"Cruciate ligament reconstruction and risk of knee osteoarthritis: the association between cruciate ligament injury and post-traumatic osteoarthritis. a population based nationwide study in Sweden, 1987-2009","volume":"9","author":"Nordenvall","year":"2014","journal-title":"PLoS One"},{"key":"2025101814180636000_8.6.e020543.12","doi-asserted-by":"publisher","DOI":"10.1177\/036354650933882"},{"key":"2025101814180636000_8.6.e020543.13","doi-asserted-by":"crossref","first-page":"1443","DOI":"10.1016\/j.joca.2017.05.009","article-title":"Surgical reconstruction of ruptured anterior cruciate ligament prolongs trauma-induced increase of inflammatory cytokines in synovial fluid: an exploratory analysis in the KANON trial","volume":"25","author":"Larsson","year":"2017","journal-title":"Osteoarthritis Cartilage"},{"key":"2025101814180636000_8.6.e020543.14","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2014-093707"},{"key":"2025101814180636000_8.6.e020543.15","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.N.00811"},{"key":"2025101814180636000_8.6.e020543.16","doi-asserted-by":"crossref","first-page":"1631","DOI":"10.1016\/j.arthro.2016.01.035","article-title":"Satisfaction with knee function after primary anterior cruciate ligament reconstruction is associated with self-efficacy, quality of life, and returning to the preinjury physical activity","volume":"32","author":"Ardern","year":"2016","journal-title":"Arthroscopy"},{"key":"2025101814180636000_8.6.e020543.17","doi-asserted-by":"crossref","first-page":"2538","DOI":"10.3109\/09638288.2015.1137981","article-title":"Patients' perspective on surgical intervention for Dupuytren\u2019s disease - experiences, expectations and appraisal of results","volume":"38","author":"Engstrand","year":"2016","journal-title":"Disabil Rehabil"},{"key":"2025101814180636000_8.6.e020543.18","doi-asserted-by":"crossref","first-page":"1375","DOI":"10.1007\/s00167-016-4294-8","article-title":"Psychological factors are important to return to pre-injury sport activity after anterior cruciate ligament reconstruction: expect and motivate to satisfy","volume":"25","author":"Sonesson","year":"2017","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"2025101814180636000_8.6.e020543.19","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2013-092299"},{"key":"2025101814180636000_8.6.e020543.20","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2016-097124"},{"key":"2025101814180636000_8.6.e020543.21","first-page":"1440","article-title":"[Individualized therapy is important in anterior cruciate ligament injuries]","volume":"111","author":"Ahld\u00e9n","year":"2014","journal-title":"Lakartidningen"},{"key":"2025101814180636000_8.6.e020543.22","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1111\/sms.12861","article-title":"Translation and testing of measurement properties of the Swedish version of the IKDC subjective knee form","volume":"27","author":"Tigerstrand Grevnerts","year":"2017","journal-title":"Scand J Med Sci Sports"},{"key":"2025101814180636000_8.6.e020543.23","doi-asserted-by":"publisher","DOI":"10.1177\/0363546512458576"},{"key":"2025101814180636000_8.6.e020543.24","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1111\/j.1600-0838.1998.tb00465.x","article-title":"Knee injury and Osteoarthritis Outcome Score (KOOS)-validation of a Swedish version","volume":"8","author":"Roos","year":"1998","journal-title":"Scand J Med Sci Sports"},{"key":"2025101814180636000_8.6.e020543.25","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2012-092075"},{"key":"2025101814180636000_8.6.e020543.26","doi-asserted-by":"crossref","first-page":"1249","DOI":"10.1007\/s11136-011-0030-5","article-title":"Validation of the Swedish translation of the General Self-Efficacy scale","volume":"21","author":"L\u00f6ve","year":"2012","journal-title":"Qual Life Res"},{"key":"2025101814180636000_8.6.e020543.27","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0838.2005.00472.x"},{"key":"2025101814180636000_8.6.e020543.28","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1111\/j.1600-0838.2011.01438.x","article-title":"Translation and measurement properties of the Swedish version of ACL-Return to Sports after Injury questionnaire","volume":"23","author":"Kvist","year":"2013","journal-title":"Scand J Med Sci Sports"},{"key":"2025101814180636000_8.6.e020543.29","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199612150-00023"},{"key":"2025101814180636000_8.6.e020543.30","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1177\/03635465980260030201","article-title":"Development and validation of the quality of life outcome measure (questionnaire) for chronic anterior cruciate ligament deficiency","volume":"26","author":"Mohtadi","year":"1998","journal-title":"Am J Sports Med"},{"key":"2025101814180636000_8.6.e020543.31","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.physio.2006.07.002","article-title":"The Sport Injury Rehabilitation Adherence Scale: a reliable scale for use in clinical physiotherapy","volume":"93","author":"Kolt","year":"2007","journal-title":"Physiotherapy"},{"key":"2025101814180636000_8.6.e020543.32","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1111\/sms.12588","article-title":"Factors associated with playing football after anterior cruciate ligament reconstruction in female football players","volume":"26","author":"F\u00e4ltstr\u00f6m","year":"2016","journal-title":"Scand J Med Sci Sports"},{"key":"2025101814180636000_8.6.e020543.33","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2012-091524"},{"key":"2025101814180636000_8.6.e020543.34","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2009.3143"},{"key":"2025101814180636000_8.6.e020543.35","doi-asserted-by":"publisher","DOI":"10.2522\/ptj.20060143"},{"key":"2025101814180636000_8.6.e020543.36","first-page":"1308","article-title":"Which is the best radiographic protocol for a clinical trial of a structure modifying drug in patients with knee osteoarthritis?","volume":"29","author":"Brandt","year":"2002","journal-title":"J Rheumatol"},{"key":"2025101814180636000_8.6.e020543.37","doi-asserted-by":"publisher","DOI":"10.1016\/S1063-4584(03)00030-X"},{"key":"2025101814180636000_8.6.e020543.38","doi-asserted-by":"publisher","DOI":"10.1002\/mrm.21635"},{"key":"2025101814180636000_8.6.e020543.39","unstructured":"Tabatchnick BG , Fidell LS . Using multivariate statistics. 4th edn. MA: Allyn & Bacon: Needham Heights, 2001."}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2017-020543","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T21:18:14Z","timestamp":1760822294000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2017-020543"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,6]]},"references-count":39,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2018,6,27]]},"published-print":{"date-parts":[[2018,6]]}},"alternative-id":["10.1136\/bmjopen-2017-020543"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2017-020543","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,6]]}}}