bluuebunny/crossref_metadata_2025 huggingface dataset:
Biomechanics of a Less Invasive Procedure for Reconstruction of the Ulnar Collateral Ligament of the Elbow
Authors: Hechtman Keith S. , Tjin-A-Tsoi Evert W. , Zvijac John E. , Uribe John W. , Latta Loren L.
Published: July 2017

A reconstruction of the anterior bundle of the ulnar collateral ligament of the elbow using bone anchors was compared regarding strain and valgus load strength with the intact ulnar collateral ligament and the reconstructed ulnar collateral ligament using bone tunnels. In both normal and reconstructed elbows, the anterior band and posterior band were tight during only a portion of the range of motion. Toward extension, the mean peak strain in the anterior band was tight for the normal and bone anchor groups, but lax in the bone tunnel group. Toward extension, the mean peak strain in the posterior band was lax in all elbows. Toward flexion, the strain in the anterior band was lax in the normal and bone anchor groups, but tight in the bone tunnel group. The mean of the peak strains for the posterior band toward flexion was tight for all elbows. Mean valgus load strength of normal elbows was 22.7 9.0 N m. The bone tunnel and bone anchor mean strengths were 76.3% and 63.5%, respectively, of normal elbow strength. We concluded that the bone anchor reproduced the normal anatomy and mechanical function of the ulnar collateral ligament more closely than the bone tunnel, and that both reconstruction methods were significantly weaker than the normal ulnar collateral ligament. However, we found no significant difference in reconstruction strength between bone anchor and bone tunnel.
Upper Extremity Weight-Training Modifications for the Injured Athlete
Authors: Fees Martin , Decker Tony , Snyder-Mackler Lynn , Axe Michael J.
Published: July 2017

The ability of the health care professional to make correct decisions about the progression of weight-training is critical to the rehabilitation process. The purpose of this article is to describe our approach to modification of weight-lifting techniques using the injured shoulder as a model. Additionally, the impact of various upper extremity weight-training techniques on healthy athletes is discussed. The effects of grip, hand spacing, bar trajectory, and start and finishing positions on microtraumatic injury and return to weight-training activities after injury are considered. Several weight-training functional progressions for common multijoint exercises (such as bench press, shoulder press, power clean) are presented. Adaptations for periodization are also presented for implementation in the rehabilitation sequence. The weight-training modifications described in this paper will assist the health professional to safely return athletes to the weight room after shoulder injury.
Injury of the Suprascapular Nerve at the Spinoglenoid Notch
Authors: Ferretti Andrea , De Carli Angelo , Fontana Michele
Published: July 2017

From 1985 to 1996, we observed 38 cases of isolated atrophy of the infraspinatus muscle in athletes; all were involved in volleyball at a competitive level. There were 20 men and 18 women with a mean age of 26 years (range, 15 to 27). At the time of the first examination, 35 of these athletes had no pain and were treated with exercises to strengthen the external rotators. The remaining three patients underwent surgery because of pain at the posterior aspect of the shoulder. Sixteen of the 35 players treated nonoperatively were reviewed at a mean follow-up of 5.5 years (range, 3 to 10). Thirteen were still involved in volleyball and three had retired symptom-free at the end of their careers. On physical examination, atrophy of the infraspinatus muscle was unchanged in all cases. The patients treated surgically were reviewed at a mean follow-up of 2 years. All of them were able to play volleyball at their preinjury levels, but one had pain at the anterior aspect of the shoulder after strenuous activity. Physical examination showed a notable reduction of the atrophy in one patient. Entrapment of the suprascapular nerve at the spinoglenoid notch is a usually painless syndrome that is frequently observed in volleyball players. Surgical treatment is indicated in the rare cases of painful neuropathies after careful patient selection.
Early Full Weightbearing and Functional Treatment After Surgical Repair of Acute Achilles Tendon Rupture
Authors: Speck Matthias , Klaue Kay
Published: July 2017

We prospectively evaluated the clinical outcomes of 20 patients (mean age, 42.8 years) with early full weightbearing and functional treatment after surgical repair of acute Achilles tendon rupture according to a prospective intra- and postoperative protocol. All patients underwent open repair using a Kessler-type suture and simple apposition sutures. The postoperative regimen included a plantigrade splint for 24 hours and 6 weeks of early full weightbearing in a removable walker. All patients were evaluated with clinical and ultrasound examination and according to a new scoring system at 3, 6, and 12 months after repair. After 3 months, the score averaged 73 of 100 points; after 6 months, 86; and after 1 year, 94. All patients reached the same level of sports activities as preoperatively and demonstrated no significant difference in ankle mobility and isokinetic strength. There were no reruptures. One patient had a deep venous thrombosis 3 weeks after the operation after having prematurely stopped thromboprophylaxis. We believe that early careful ankle mobilization and full weightbearing in a removable walker after primary Achilles tendon repair does not increase the risk of rerupture. An accelerated rehabilitation program improves early foot function with excellent recovery of plantar flexion strength and amplitude.
Early Active Motion and Weightbearing After Cross-Stitch Achilles Tendon Repair
Authors: Aoki Mitsuhiro , Ogiwara Naoshi , Ohta Takayuki , Nabeta Yuki
Published: July 2017

Twenty-two closed Achilles tendon ruptures caused by sports injuries in 22 patients (average age, 37.6 years) were repaired with Kirschmayer core suture and cross-stitch epitenon suture, and early active ankle motion with weightbearing was implemented after surgery. This study was undertaken to evaluate the effectiveness of the repair technique and rehabilitation protocol by assessing clinical results and magnetic resonance imaging findings. The follow-up period averaged 24.6 months. Twenty of the tendons (91%) healed without rerupture, and two tendons (9%) suffered a partial rerupture at 23 and 56 days, respectively. Active ankle extension reached from the minus range to 0° in an average of 9.7 days, and ankle motion recovered to normal in an average of 6.0 weeks. Full weightbearing without heel raising became possible in an average of 16.4 days, and heel raising with both legs became possible in an average of 7.3 weeks. The patients returned to full sports activity in 13.1 weeks. The interval until the area of high-intensity signal at the tendon repair site on T2-weighted magnetic resonance imaging scans became intermediate-intensity signal averaged 6.9 weeks, and the tendon repair site became low-intensity signal in an average of 12.6 weeks, demonstrating excellent tendon healing. Treatment employing Kirschmayer core suture and cross-stitch epitenon suture may help athletes return to sports activity in a shorter period than that allowed by previous methods of repair for Achilles tendon ruptures.
Dynamic Impact Response of Human Cadaveric Forearms Using a Wrist Brace
Authors: Greenwald Richard M. , Janes Peter C. , Swanson Stephen C. , McDonald Thomas R.
Published: July 2017

The purpose of this study was to compare the dynamic impact response of braced and unbraced cadaveric wrists using a commercially available wrist guard. Twelve arms were harvested from six cadavers. Each pair of forearms, one with and one without a brace, were impacted using a modified guillotine-type drop fixture placed over a force platform. Using a piece-wise linear regression analysis, we identified four phases of dynamic loading in the vertical force profile before fracture. These phases included an initial linear loading phase starting at impact, followed by a nonlinear phase, a second rapid linear loading phase, and a final nonlinear loading phase to failure. Three transition points were identified that defined the boundaries of the linear loading phases. Vertical force and impulse were significantly higher (P 0.01) at each transition point and at failure in all braced specimens compared with unbraced specimens. However, the most noticeable differences were found during the initial two loading phases. Time to each transition point and to failure was not significantly different (P 0.27) between the braced and unbraced wrists. The results of this study differ from those obtained under more quasistatic loading conditions. Dynamic impact testing suggests that wrist guards may have a prophylactic effect during low-energy dynamic impact situations.
Evaluation of the Anatomy of the Common Peroneal Nerve
Authors: Deutsch Allen , Wyzykowski Richard J. , Victoroff Brian N.
Published: July 2017

A two-part study was undertaken to clarify the anatomy of the common peroneal nerve at the level of the lateral joint line and risk factors associated with arthroscopically assisted inside-out lateral meniscus repair. In part I, 70 legs in 35 preserved cadavera were dissected to evaluate the relevant anatomy of the common peroneal nerve; 7 (10%) manifested division of the common peroneal nerve into deep and superficial branches proximal to the knee joint. A cutaneous branch not previously described in the literature emanated from the common peroneal trunk in 21 of the legs (30%). In part II, arthroscopically assisted inside-out lateral meniscus repair was performed on 10 fresh-frozen cadaveric knees. Divergence between suture arms increased as suture position was sequentially posterior. Capture of a nerve branch occurred in 2 knees (20%) when posterior retraction was not used. Nerve involvement was eliminated when a retractor was employed. There was significant anatomic variability in the course and branching pattern of the common peroneal nerve at the level of the lateral joint line. During arthroscopically assisted inside-out lateral meniscus repair, risk of injuring the peroneal nerve was related to suture position because of the proximity of anatomic structures and the tendency for suture divergence with soft tissue tethering.
Neuromuscular Properties and Functional Aspects of Taped Ankles
Authors: Lohrer Heinz , Alt Wilfried , Gollhofer Albert
Published: July 2017

We used electromyographic and goniometric methods to test 40 subjects to describe the neuromuscular and biomechanical adaptation of the ankle with respect to application of two different adhesive tapes and to exercises. The neuromuscular responses to inversion injury simulation, together with the mechanical displacements of the joint complex, were analyzed before and after controlled athletic exercises. The proprioceptive amplification ratio was calculated on the basis of the integrated reflex electromyographic results and on the maximum inversion amplitude. Relevant stability gains were achieved immediately after applying tape. There was reduced tape stability after athletic exercise for one of the two tape materials tested. No further loosening was detected, even after prolonged wearing of tape (24 hours). Compared with the unprotected ankle, the taped ankle had a significant increase in the proprioceptive amplification ratio. Both fatigue and mechanical loosening may be responsible for the significant reduction in this ratio immediately after exercise. After the 24-hour interval, the ratio was increased, which could be explained by physiologic neuromuscular regeneration and mechanical restabilization of the tape itself. The sensitivity of the proprioceptive amplification ratio, both to external stabilization and to internal fatigue, supports its potential value to quantify functional joint stability.
The Effect of Exercise and Rehabilitation on Anterior-Posterior Knee Displacements After Anterior Cruciate Ligament Autograft Reconstruction
Authors: Barber-Westin Sue D. , Noyes Frank R. , Heckmann Timothy P. , Shaffer Brian L.
Published: July 2017

We studied the effect of rehabilitation strength training and return to activities on anterior-posterior knee displacements after patellar tendon autogenous anterior cruciate ligament reconstruction. A total of 938 measurements were sequentially collected for 142 patients with the KT-2000 arthrometer. Rehabilitation included immediate knee motion and early weightbearing, light sports at 6 months, and competitive sports at 8 months or later. At a minimum of 2 years after surgery, 121 patients (85%) had normal displacements (less than 3 mm of increase at 134 N), 14 (10%) had 3 to 5.5 mm of increase (partial function), and 7 (5%) had more than 5.5 mm of increase (failed). There was no association found between the initial onset of the abnormal displacements in the 21 knees and either the amount of time after surgery or the rehabilitation program. Six of the seven grafts that failed did so in the 1st postoperative year. Serial displacement measurements allow early detection of graft stretching and subsequent modification of rehabilitation or delay in return to strenuous activities. These measurements showed that the rehabilitation program used in this study was not itself injurious and resulted in an acceptable failure rate of 5%.
Rupture of the Distal Biceps Tendon
Authors: Rantanen Jussi , Orava Sakari
Published: July 2017

We present a series of 19 avulsions of the distal tendon of the biceps brachii muscle after a follow-up of 2 to 11 years. Ten patients with delayed diagnosis and treatment (3 weeks to 5 months) were compared with nine patients treated early (within 8 days after injury). Excellent or good results at follow-up were obtained in 9 of 10 patients in the delayed-treatment group and in all 9 patients in the early-treatment group. Nine of 10 patients in the delayed-treatment group and all patients in the early-treatment group had been able to return to their preinjury levels of activity. For reference, a meta-analysis of 147 cases reported previously was performed. Ninety percent of the patients treated with an anatomic reinsertion had excellent or good results after an average follow-up of 3 years, while similar results after 3 years were seen in 60% of the patients who had nonanatomic tendon reinsertion and in 14% of the patients who were treated nonoperatively. The delay of up to 3 years between injury and anatomic reinsertion had not compromised the result. From these data we concluded that anatomic reinsertion of the avulsed distal biceps tendon to the radius is the preferred treatment in acute as well as chronic injuries.
Increasing Hamstring Flexibility Decreases Lower Extremity Overuse Injuries in Military Basic Trainees
Authors: Hartig Donald E. , Henderson John M.
Published: July 2017

The purpose of this intervention study was to prove that increasing flexibility of the hamstring musculotendinous unit would decrease the number of lower extremity overuse injuries that occur in military infantry basic trainees. Two different companies going through basic training at the same time were used. Hamstring flexibility was checked at the beginning and at the end of the 13-week infantry basic training course. The control company (N 148) proceeded through normal basic training. The intervention company (N 150) followed the same program but added three hamstring stretching sessions to their already scheduled fitness program. All subsequent lower extremity overuse injuries were recorded through the troop medical clinic. Hamstring flexibility increased significantly in the intervention group compared with the control group. The number of injuries was also significantly lower in the intervention group. Forty-three injuries occurred in the control group for an incidence rate of 29.1%, compared with 25 injuries in the intervention group for an incidence rate of 16.7%. Thus, in this study, the number of lower extremity overuse injuries was significantly lower in infantry basic trainees with increased hamstring flexibility.
A Biomechanical Analysis of Matched Bone-Patellar Tendon-Bone and Double-Looped Semitendinosus and Gracilis Tendon Grafts
Authors: Wilson Tad W. , Zafuta Michael P. , Zobitz Mark
Published: July 2017

Biomechanical testing was done on 15 matched pairs of central-third bone-patellar tendon-bone and double-looped semitendinosus-gracilis grafts harvested from 15 cadaveric knees. Load to failure, composite graft stiffness, and the modulus of elasticity were calculated for each graft. Specimens were from 2 female and 13 male donors (average age, 40 years; range, 17 to 53). Average load to failure for the patellar tendon grafts was 1784 N ( 580), compared with 2422 N ( 538) for the hamstring tendon grafts (significantly different). There was no statistically significant difference in stiffness between grafts (patellar tendon, 210 N/mm; hamstring tendon, 238 N/mm). The elastic modulus was 225 MPa ( 129) for the patellar tendon grafts and 145 MPa ( 58) for the hamstring tendon grafts (significantly different). The average cross-sectional area for the hamstring tendon grafts was 57 mm2, compared with the 45 mm2 for the patellar tendon grafts. The hamstring tendon grafts were significantly stronger than the matched central-third patellar tendon grafts, but the two grafts were similar in stiffness. The patellar tendon grafts had a higher modulus than the hamstring tendon grafts.
Comparison of the Single Assessment Numeric Evaluation Method and Two Shoulder Rating Scales
Authors: Williams Glenn N. , Gangel Timothy J. , Arciero Robert A. , Uhorchak John M. , Taylor Dean C.
Published: July 2017

The purpose of this study was to determine the correlation between the Single Assessment Numeric Evaluation method and the Rowe and American Shoulder and Elbow Surgeons scores. Between April 1993 and December 1996, 209 follow-up examinations were performed on 163 United States Military Academy cadets after shoulder surgery. These 209 examinations were divided into five follow-up categories: 3 months, 6 months, 1 year, 2 years, and greater than 2 years. The Rowe and American Shoulder and Elbow Surgeons scores from each subject's follow-up questionnaire were correlated with his or her Single Assessment Numeric Evaluation rating, which is determined by the subject's written response to the following question: “How would you rate your shoulder today as a percentage of normal (0% to 100% scale with 100% being normal)?” Correlation coefficients between the Single Assessment Numeric Evaluation and the two scores were 0.51 to 0.79 for the Rowe score and 0.46 to 0.69 for the American Shoulder Elbow Surgeons score. The results of this study indicate that the Single Assessment Numeric Evaluation correlates well with these two scores after shoulder surgery. This study suggests that this new evaluation method provides clinicians with a mechanism to gather outcomes data with little demand on their time and resources.
Biceps Load Test: A Clinical Test for Superior Labrum Anterior and Posterior Lesions in Shoulders With Recurrent Anterior Dislocations
Authors: Kim Seung-Ho , Ha Kwon-Ick , Han Kye-Young
Published: July 2017

We describe the biceps load test for evaluating the integrity of the superior glenoid labrum in shoulders with recurrent anterior dislocations. With the shoulder in an abducted, externally rotated position and the forearm supinated, active flexion of the elbow against resistance relieves the discomfort of a standard apprehension test for anterior shoulder instability. A group of 75 patients with proven unilateral anterior shoulder dislocations were prospectively examined in a double-blind fashion with arthroscopic examination and the biceps load test. Sixty-three patients had a negative test and 62 of these had an intact biceps tendon-superior labrum complex; the remaining patient had a type II superior labral anterior and posterior lesion. Twelve patients had positive tests, and 10 had superior labral lesions; the other 2 patients had intact superior labra. Therefore, the biceps load test revealed a sensitivity of 90.9%, a specificity of 96.9%, a positive predictive value of 83%, a negative predictive value of 98%, and a kappa coefficient of 0.846.
Rigorous Statistical Reliability, Validity, and Responsiveness Testing of the Cincinnati Knee Rating System in 350 Subjects with Uninjured, Injured, or Anterior Cruciate Ligament-Reconstructed Knees
Authors: Barber-Westin Sue D. , Noyes Frank R. , McCloskey John W.
Published: July 2017

Although many instruments are used to assess outcome after knee ligament reconstruction, their reliability, validity, and responsiveness have not been adequately proven. Our purpose was to assess these statistical measures in a commonly used instrument, the Cincinnati Knee Rating System. Reliability was determined from the responses of 100 subjects who completed the instrument twice, a mean of 7 days apart. Validity and responsiveness were assessed from 250 patients observed for at least 2 years after autogenous ACL reconstruction. Questionnaire items included symptoms, functional limitations with sports and daily activities, patient perception of the knee condition, and sports- and occupational-activity levels. The items demonstrated high test-retest reliability, supporting their use in evaluating groups of patients between two different treatment periods (all intraclass correlation coefficients 0.70). In addition, the questionnaire demonstrated good content validity, construct validity, and item-discriminant validity. For the overall rating score, no “floor effects” (worst score possible) were found before or after surgery. No “ceiling effects” (best score possible) were found before surgery, and, at follow-up, these effects were calculated in only 22 patients (9%). The questions were found to be highly responsive to detecting changes between evaluations. The data demonstrated that this rating system has acceptable reliability, validity, and responsiveness for use in outcome studies after knee ligament reconstruction.
Age-Related Changes in the Cervical Spines of Front-Line Rugby Players
Authors: Berge Jérôme , Marque Bertrand , Vital Jean-Marc , Sénégas Jacques , Caillé Jean-Marie
Published: July 2017

Cervical spine trauma occurs frequently in front-line rugby players. To evaluate the accumulative effects of this trauma, magnetic resonance imaging scans of the cervical spine were performed on 47 rugby players and 40 age-matched control subjects. The aim of this study was to compare the changes in the cervical spine of players at different points in their careers. A study of cervical spine changes, including spinal curve, spinal constituents, posttraumatic deformities, and degenerative modifications, was completed by a study of cervical measurements. Front-line rugby players showed more early degenerative alterations on magnetic resonance imaging scans than did the control subjects of the same age. These changes correlated with age and were probably linked with repetitive cervical trauma throughout the players' careers. Particular attention should be paid to the data confirming cervical spine canal stenosis in front-line players, which may place these athletes at risk for acute neurapraxia while playing this collision sport.
Use of Recombinant Human Bone Morphogenetic Protein-2 to Enhance Tendon Healing in a Bone Tunnel
Authors: Rodeo Scott A. , Suzuki Katsunori , Deng Xiang-hua , Wozney John , Warren Russell F.
Published: July 2017

This study examines the hypothesis that recombinant human bone morphogenetic protein-2 can enhance bone ingrowth into a tendon graft placed into a bone tunnel. We transplanted the long digital extensor tendon into a drill hole in the proximal tibia in 65 adult mongrel dogs. We applied two different doses of the bone morphogenetic protein to the tendon-bone interface in one limb using an absorbable type I collagen sponge carrier and only the collagen sponge to the contralateral (control) limb. The healed tendon-bone attachment was evaluated at serial times between 3 days and 8 weeks using radiography, histologic examination, and biomechanical testing. At all time points, histologic and radiographic examination demonstrated more extensive bone formation around the tendon with closer apposition of new bone to the tendon in the protein-treated limb than in the paired control limb. Biomechanical testing demonstrated higher tendon pull-out strength in the protein-treated side at all time points, with a statistically significant difference between the low-dose-treated side and the control side at 2 weeks. The histologic and biomechanical data suggested superior healing at the lower protein dose. This study demonstrated that bone morphogenetic protein can accelerate the healing process when a tendon graft is transplanted into a bone tunnel.
Pulmonary Air Leaks Resulting From Outdoor Sports
Authors: Kizer Kenneth W. , MacQuarrie Michael B.
Published: July 2017

The occurrence of pulmonary air leaks consequent to recreational sports is considered to be rare. We performed a retrospective records review for cases of pulmonary air leaks for the 5-year period 1993 to 1997 at a community hospital that serves a popular tourist destination area having intense year-round outdoor recreational activities. We identified 20 patients who had sustained a spontaneous or traumatic pulmonary air leak while engaged in an outdoor sport. All but one case (95%) were due to blunt chest trauma. A total of nine different sports were involved, but the majority of cases (11, or 55%) occurred during skiing or snowboarding. Three (15%) patients died. Nine (53%) of the surviving 17 patients sustained injuries serious enough to require hospitalization for tube thoracostomy and other trauma care. We concluded that pulmonary air leaks due to blunt chest trauma occur more frequently in outdoor sports than the literature suggests.
Comparative Injury Rates of Uninjured, Anterior Cruciate Ligament-Deficient, and Reconstructed Knees in a Skiing Population
Authors: Oates Kenneth M. , Van Eenenaam D. Peter , Briggs Karen , Homa Karen , Sterett William I.
Published: July 2017

To evaluate the risks of skiing after anterior cruciate ligament injury with or without reconstruction, we performed a 3-year study of 5646 skiers employed by a large ski resort. All skiers underwent knee ligament examinations before entering the study. The participants were divided into three groups based on whether they had never had an anterior cruciate ligament injury (N 4748), were unilaterally deficient of the ligament (N 138), or had undergone a unilateral reconstruction of the ligament at least 1 year before (N 274). The rates of knee injuries requiring evaluation by a physician or time off work were calculated. The results of the reconstructed knees were further evaluated to determine whether ligament repair with semitendinosus/gracilis or patellar tendon autograft had a higher injury rate. Compared with knees with intact anterior cruciate ligaments, ligament-deficient knees had a 6.2-times higher rate of injuries, and knees in which the ligament had been reconstructed had a 3.1-times higher rate. The differences between each of the three groups were significant. Injuries to ligament-intact knees were less severe, with 13% requiring surgery, while 39% of the injuries in the ligament-deficient and 41% of the injuries in the reconstructed-ligament knees required surgery. The rates of injury for the graft types were not significantly different, but skiers with a semitendinosus/gracilis tendon autograft were significantly more likely to rupture their graft than skiers with a patellar tendon autograft.
Evidence of Inappropriate Application of Autologous Cartilage Transplantation Therapy in an Uncontrolled Environment
Authors: Mont Michael A. , Jones Lynne C. , Vogelstein Barry N. , Hungerford David S.
Published: July 2017

Autologous chondrocyte transplantation is a new procedure developed for the treatment of focal articular cartilage defects of the knee. The exact indications and limitations of this procedure have not yet been completely defined through prospective, randomized studies. The purpose of this study was to examine the indications and contraindications for surgery in consecutive cases initially rejected for reimbursement of surgical expenses by insurance companies, but now on appeal, to assess whether patients referred by the physicians met the procedure criteria. Twenty-four consecutive candidates were referred for adjudication when the recommending orthopaedic surgeon appealed a rejection by a medical reviewer. The factors examined included the number and size of the cartilage lesions, the presence of tricompartmental arthritis, transplantation proposed for patellar lesions, patient age, and sagittal plane deformity. In 23 of 24 cases (96%) the indications for the procedure were not met or specific contraindications were present. In 15 of 24 cases (63%) there were multiple contraindications. The results of this study underscore the importance of controlled, application-limited experience before the release of new procedures for widespread clinical applications. The uncontrolled use of this procedure may negatively skew the overall results for this technique, prejudicing a procedure that may be successful for the correct indications.
The Incidence of Deep Venous Thrombosis After Arthroscopic Knee Surgery
Authors: Jaureguito John W. , Greenwald Ann E. , Wilcox Joseph F. , Paulos Lonnie E. , Rosenberg Thomas D.
Published: July 2017

We retrospectively reviewed the records of 2050 arthroscopic knee surgeries performed at The Orthopedic Specialty Hospital from January 1993 to December 1994. The number of clinically detected deep venous thromboses, with confirmation by duplex ultrasonography, was determined. Prospectively, preoperative and postoperative duplex ultrasonographic images were completed on 239 patients divided into 2 groups: those undergoing nonligament, intraarticular arthroscopic surgery (N 131) and those undergoing arthroscopically assisted ligament surgery and extraarticular or osteotomy surgery (N 108). For the retrospective study, the incidence of deep venous thrombosis was 0.24%. Prospectively, seven total deep venous thromboses were identified (rate, 2.9%), with five being identified within 8 days of surgery in asymptomatic patients (rate, 2.1%). There were no statistically significant associations or correlations between the development of deep venous thrombosis and patient personal data or surgical variables, respectively. The difference in the rate of deep venous thrombosis between the two prospective groups was not statistically significant; however, patients who had more invasive surgery tended to be at higher risk for developing deep venous thrombosis. A cost-benefit analysis did not support the routine use of duplex ultrasonography to detect deep venous thrombosis in patients undergoing arthroscopic knee surgery.
Nonabsorbable Versus Absorbable Suture Anchors for Open Bankart Repair
Authors: Warme Winston J. , Arciero Robert A. , Savoie Felix H. , Uhorchak John M. , Walton Mark
Published: July 2017

Suture anchors facilitate the surgical repair of capsuloligamentous structures to bone. Bioabsorbable suture anchors, which obviate potential pitfalls in the periarticular use of permanent implants, have recently become available. We randomly assigned 40 patients to undergo modified Bankart shoulder repairs with either nonabsorbable or absorbable suture anchors. The patients had a history of recurrent traumatic anterior instability that had not improved with nonoperative management. The average patient age was 22 years (range, 17 to 46), and the average preoperative Rowe score was 47 points in the nonabsorbable anchor group and 47 points in the absorbable anchor group. Average postoperative Rowe scores were 96 and 93 points, respectively. There was one failed result in the nonabsorbable anchor group and two in the absorbable anchor group. No statistically significant subjective or objective differences were found at an average of 25 months postoperatively. Our results reveal that, in this application, bioabsorbable suture anchors are a viable option for the repair of soft tissue to bone.
Serratus Anterior Muscle Activity During Selected Rehabilitation Exercises
Authors: Decker Michael J. , Hintermeister Robert A. , Faber Kenneth J. , Hawkins Richard J.
Published: July 2017

The purpose of this study was to document the electromyographic activity and applied resistance associated with eight scapulohumeral exercises performed below shoulder height. We used this information to design a continuum of serratus anterior muscle exercises for progressive rehabilitation or training. Five muscles in 20 healthy subjects were studied with surface electrodes for the following exercises: shoulder extension, forward punch, serratus anterior punch, dynamic hug, scaption (with external rotation), press-up, push-up plus, and knee push-up plus. Electromyographic data were collected from the middle serratus anterior, upper and middle trapezius, and anterior and posterior deltoid muscles. Each exercise was partitioned into phases of increasing and decreasing force and analyzed for average and peak electromyographic amplitude. Resistance was provided by body weight, an elastic cord, or dumbbells. The serratus anterior punch, scaption, dynamic hug, knee push-up plus, and push-up plus exercises consistently elicited serratus anterior muscle activity greater than 20% maximal voluntary contraction. The exercises that maintained an upwardly rotated scapula while accentuating scapular protraction, such as the push-up plus and the newly designed dynamic hug, elicited the greatest electromyographic activity from the serratus anterior muscle.
Validity Issues in Direct Behavioral Observation: Applications for Behavioral Assessment in the Classroom
Authors: Merrell Kenneth W.
Published: July 2017

Although behavioral assessment has become a widely employed and accepted technology in the field of school psychology, relatively little attention has been given to the issue of validity. This article examines validity issues and concerns as they relate to a specific aspect of behavioral assessment, direct behavioral observation. Specific emphasis is placed on the valid use of this technology in classroom situations with children.
The Effects of Prior Special Education Placement and Current Test Data on School Psychologists' Decisions
Authors: Huebner E. Scott
Published: July 2017

This study investigated the possible biasing effects of prior special education involvement (and associated diagnostic label) and current psychoeducational test data on 82 school psychologists' prognostic, diagnostic, and placement decisions for a case study child. The findings indicated that the school psychologists' decisions were not influenced by the child's prior special education placement but were influenced by current psychological test results. School psychologists who reevaluated a child who had been previously placed in a resource program for learning disabled students, but who currently demonstrated normal academic functioning, were likely to re-classify the child as non-handicapped and recommend return to regular class programs. The findings suggested that school psychologists are not biased by knowledge of previous special program involvement and diagnostic label and that individual psychological test data may act to minimize potential bias effects.
A Correlational Study of the Stanford-Binet IV and the Wisc-R
Authors: Janzen H. , Andrews J. , Fritzke B. , Clarke L. , Boersma F.
Published: July 2017

This study examined the correlation of scores from the Stanford-Binet Intelligence Scale, 4th Edition (SBIV) with scores from the Wechsler Intelligence Scale for Children - Revised (WISC-R) in a heterogeneous sample of 168 school children across three age groups (6.0 to 8.11, 9.0 to 12-11 and 13.0 to 16.11 years of age). The results of this study indicated that the SBIV has a significant positive relationship with the WISC-R and this is consistent with findings reported by the test authors for the SBIV.
Students' Errors on the Administration of the WAIS-R
Authors: Gilbert Thomas B.
Published: July 2017

The study investigated the effectiveness of repeated observations in teaching the administration of the WAIS-R. Previous research has examined instructional procedures involving test demonstrations and test protocol evaluations. Errors detected on WAIS-R administrations at the end of instruction raised concerns about the competence of student examiners and about the method of teaching the WAIS-R. The results of this study suggest that observing and evaluating student administrations during and at the end of an assessment course reduces administration errors significantly. Students completing course requirements are competent WAIS-R examiners. Their administrations differ very little, if at all, from the standard administration procedures.
My Last Lecture
Authors: O’Donnell Michael P.
Published: July 2017

In celebration of my final comments as editor in chief of the American Journal of Health Promotion, I offer reflections on the importance of workplace health promotion, the impact of financial incentives on program effectiveness and financial sustainability, return on investment (ROI) analysis, reducing the federal debt by improving health, balancing high technology approaches with human touch, focusing on passions and sense of purpose, and nurturing a loving and caring community of professionals.
Financial Management and Accountability in Small, Religiously Affiliated Nonprofit Organizations
Authors: Nitterhouse Denise
Published: July 2017

Although small, religiously affiliated nonprofit organizations share financial management and accountability challenges with other small nonprofit organizations, they tend to face issues and problems that differ from those of small secular nonprofit organizations. Exploratory research methods were used to develop hypotheses about the nature and likely origins of the financial management challenges of small, religiously affiliated nonprofit organizations. The article delineates financial management and accountability challenges common to all small nonprofit organizations and contrasts them to small businesses. It then proposes and discusses the hypothesized origins of financial management and accountability issues unique to or different in small, religiously affiliated nonprofit organizations. A life-cycle framework for small religious nonprofits is developed and differentiated from the life cycle of small secular nonprofit organizations. A small survey provided supportive, but not statistically significant, results, showing that larger small, religiously affiliated nonprofit organizations are more likely to have separate budgets and accounting records.
Memory and Narrative in Social Theory
Authors: Santos Myrian Sepúlveda
Published: July 2017

The author argues that contemporary social theories cannot simultaneously accommodate the diachronic and synchronic dimensions of time within their frameworks, because they reduce the complexities of social life in order to cope with them. Jacques Derrida's and Walter Benjamin's writings on memory open up the possibility of thinking about the relation between memory and narrative in multiple ways. These two theorists affirm the discontinuity and the non-recognition between past events and present discourses and analyse a broad range of possibilities in the reading of history. The author argues that the simultaneity of the diachronic and synchronic dimensions of time becomes possible only when past and present are not thought of as two separate entities, as is common practice in social theory.
Mediating Time
Authors: Hoskins Andrew
Published: July 2017

Television is the medium of time. Television news continually recontextualizes times as it remediates the past in the present. What has yet to be more fully implicated, however, is the modulation - the variance in pace - of the temporal features of the televisual environment. I consider some of the sites of the temporization of war by television news through the interplay of sound and vision, temporal references in television news talk, and in the recombination of previously `used' news fragments into new (immediate) contexts. In this way, television can be said to intersect with the event it is purportedly covering, as it tracks it in time and across time. I draw on data predominantly from the beginning of the 1991 Gulf War - perhaps the most mediated television news events of modern times - when CNN was already geared to consume and celebrate these, the `most live', moments of the war in different times and spaces.
Nature's Temporalities and the Manufacture of Vulnerability
Authors: Murphy Raymond
Published: July 2017

The freezing rain of January 1998 in Northeastern North America seemed to be a natural disaster, but it in fact initiated a technological disaster because of decisions to superimpose vulnerable infrastructures on this region and make society dependent on them. This study investigates the interaction of manufactured risks and nature's risks, which is crucial now that modern society is generating creeping dangers such as global climate change that threaten to provoke sudden calamities. Examining the problematic relationship between ever-increasing knowledge and the obduracy of ignorance from a realist perspective captured the vulnerabilities of modern society in its context of nature's autonomous dynamics.
Sustainable Development from a Temporal Perspective
Authors: Held Martin
Published: July 2017

Sustainable development is an inherently temporal concept that includes future generations and their needs. We can improve the understanding of the concept if we explicitly start with a temporal perspective. The timescape framework is demonstrated as a useful tool to see the relevance of temporal diversity to direct our economy and way of life into the direction of sustainable development.
Searching a Political Solution for Syria
Authors: Rath Saroj Kumar
Published: July 2017

Syria’s sudden plunge into civil struggle is directly linked with United States’ Middle East policy. The 2011 pull-out of American troops from the smouldering provinces of Iraq and the subsequent refusal of the US to take sides in the ‘Arab Spring’ have weakened the incumbent governments and produced too many unsuitable civil claimants to rule ‘Arab Spring’-affected countries. The so-called US neutrality left a vacuum, which was filled by a swarm of Islamist extremists. The resultant internecine wars sparked by contending parties in Iraq, Syria and Yemen had taken these countries to the very verge of chaos. The outcome among other things included a revival of al-Qaeda, which was soon eclipsed by Islamic State in Iraq and Syria (ISIS), and an unending spiral of civil war in Syria, the major result of the anti-Western blowback. This article argues that the fight against extremist forces in Syria is doomed if there is absence of a strong, functional and acceptable government. Lasting peace under President Bashar al-Assad looks impossible but it is essential to have the core of Ba’athist regime in place in any transitional or post-transition mechanism. A new interpretation of political solution is required. Else, the state will collapse, which will only help the jihadists. Despite its limitations and challenges, federalisation of Syria and the establishment of a federal structure of the government, it seems, is the only viable solution.
Bonn's Ostpolitik at the Crossroads?
Authors: Banerjee Jyotirmoy
Published: July 2017

In September 1982 the Social and Free Democratic coalition1 collapsed after thirteen years' rule; the conservative Union parties coalesced with the Free Democrats to return to power in Bonn. Two months later Brezhnev died in Moscow amidst an ongoing new Cold War with the Reagan Administration. His successor, as the Chief of the Communist Party of the Soviet Union (CPSU), turned out to be the former KGB chief, Yuri Vladimirovich Andropov. With time running out for NATO's deployment of new missiles in the Federal Republic of Germany (FRG) and other West European states, and a significant conservative victory in the United Kingdom elections in June 1983, elements of uncertainty in the crucial relations between Bonn and Moscow may have increased. Between 1969 and 1982 the (SPD) had managed to reverse the (CDU's) twenty years of hardline approach to the Soviet bloc. Despite irritations, Bonn under SPD-led governments managed to keep its ostpolitik on an even keel. Central European detente seemed to have survived the collapse of the larger, superpower rapprochement. The critical question in mid-1983, following the conservative election victories in Bonn and London and against the background of significant US-USSR rivalry, is whether the latter rivalry would also suck into its vortex relative peace in Central Europe. Should that happen, the Cold War would return to Europe, reinforce the anomalies emanating from a divided Germany as well as the superpower adversary relationship in turn. In this context the present article will, first, take a retrospective look at ostpolitik, its causes and achievements, then explore Bonn's relations with Moscow as they evolved while the SPD was in power and, finally analyze the implications of the leadership changes in Bonn and Moscow for the future of ostpolitik.
The Indian Nationalist Movement and the League of Nations: Prologue to the United Nations
Authors: Keenleyside T.A.
Published: July 2017

Prior to 1947, India, despite its dependence upon Great Britain, was represented in most of the bonafide international conferences and organizations that evolved especially during the inter-war years. For example, India participated in the Paris Peace Conference of 1919, the Washington Conference on Naval Armaments of 1921, the London Naval Conference of 1930, the Disarmament Conference of 1932 and the annual inter-war conferences of the International Labour Organization. In addition, India was represented in two important international organizations of the inter-war period—the British Commonwealth, in whose deliberations it was included from 1917 onwards and the League of Nations, of which it was a founding member. For a variety of reasons; Indians involved in the independence movement disassociated themselves from and were critical of official Indian diplomacy conducted through the major international conferences and institutions of the world community and tended to attach greater importance to those non-governmental organizations in which the voice of nationalist India could be fully heard—that is to the deliberations of such bodies as the League Against Imperialism, 1927–1930, the Anti-War Congress of 1932, the World Peace Congress of 1936 and the International Peace Campaign Conference of 1938. Nevertheless, despite the nationalist antipathy for official Indian diplomacy, an examination of such governmental institutions as the League of Nations from the perspective of nationalist India is still important in order to understand some aspects of independent India's foreign policy and more specifically its approach to international organization. Further, even though Indian delegations to the League were unrepresentative, there were subtle ways in which they reflected national Indian opinions and exhibited specifically Indian traits, so that a study of the official Indian role is useful in drawing attention to what were to prove to be some of the earliest and most persisting elements of independent Indian diplomacy via such bodies as the United Nations. It is thus the purpose of this article first to explore nationalist Indian attitudes towards the League (especially the reasons for opposition to the organization), second to analyze the extent to which the official Indian role in the League reflected nationalist Indian concerns, and third to comment upon the impact of the League of Nations on independent India's foreign policy, especially its role in the United Nations.