bluuebunny/crossref_metadata_2025 huggingface dataset:
The Ecological Challenge to Biblical Studies
Authors: Horrell David G.
Published: July 2017

The increasing prominence of environmental issues, together with the suspicion that the Bible, both through its creation stories and its eschatological expectations, may discourage a sense of Christian environmental responsibility, raise a challenge to which biblical scholars have responded in various ways. Some attempt to recover a positive ecological message from the Bible, while others read the Bible critically through the framework of a set of ecojustice principles. This essay reviews some of these contributions and argues for a theological approach to interpretation which avoids some of the weaknesses of either of these two alternatives.
Celebrating Edinburgh 1910
Authors: Tanner Mary
Published: July 2017

The modern ecumenical movement, generally regarded as born out of the 1910 Edinburgh World Missionary Conference, has transformed relationships between the churches throughout the world and in Britain, and has created organizations which have been crucial in promoting dialogue, united witness and service. Today, however, there is uncertainty about the future direction of the movement both at home and abroad, and a new passion for unity is called for. The most creative possibilities lie in a renewed understanding of unity as a growth in communion, nourished by participation in the triune life of God.
Intratympanic gentamicin injections for the treatment of Ménière's disease
Authors: Katzenell Udi , Gordon Michael , Page Mark
Published: July 2017

Objective

To assess the success rate and complications of treatment with injections of intratympanic gentamicin to the middle ear of patients with Ménière's disease.

Study Design

Case series with chart review.

Setting

A tertiary otologic private ENT clinic.

Subjects and Methods

Patients with Ménière's disease, who had not responded to medical treatment. Included in the sample were patients with Ménière's disease who had been treated with injections of gentamicin into the middle ear. After each gentamicin application, patients were monitored for their symptoms and hearing. If symptoms persisted, they received another intratympanic injection of gentamicin. This method is referred to as the variable titration method. A retrospective chart review was performed, and questionnaires were used to assess hearing, functional status, tinnitus, ear fullness sensation, and the control of vertigo attacks in response to treatment.

Results

Nineteen patients were sampled. Eighteen patients (94%) had complete or substantial control of vertigo. Five patients (26%) had worse hearing results on their post‐treatment audiogram, averaging 13 dB hearing loss (range, 5‐25 dB). In response to the questionnaires, all patients reported a significant improvement in the quality of life after treatment.

Conclusion

The treatment was found to be highly effective. The variable titration method of injection prevents unnecessary injections for patients whose symptoms have already subsided.
Book Review: Scheer, Hermann, The Solar Economy
Authors: Tewari D.D.
Published: July 2017

Scheer, Hermann, The Solar Economy: Renewable Energy for a Sustainable Global Future, London: Earthscan Publications, 2002, 347 pp.
Applying a Holistic Approach to Agricultural Sustainability Research: A Methodological Synthesis of Ecological Economics and System Dynamics
Authors: Shi Tian
Published: July 2017

This paper advocates a holistic approach to the study of agricultural sustainability. Alternative approaches to sustainability must address both methods of analysis and policy-making. However, current agricultural research and practice suffer from the lack of appropriate analytical framework and policy-making tool to substantiate the notion of sustainable agricultural development. To narrow the gap between the rhetoric and the practice of agricultural sustainability, it is urgent to seek alternative approaches that can provide effective information and at the same time, facilitate improved policy-making processes. An ecological economics framework, which recognises the fundamental interdependence of human-natural interactions, is proposed for the transdisciplinary analysis of agricultural policy. A system dynamics modelling approach, which attempts to help decision-makers identify the knowledge gap and select a preferred course of action among several feasible alternatives, is regarded as a workable template from which the necessary transdisciplinary analysis is articulated and the gained insight is integrated into the policy-making process. It is highlighted in this paper that the methodological synthesis of the transdisciplinary analytical framework of ecological economics and the computer precision of system dynamics modelling may offer a holistic approach for effective policy analysis and improved policy-making towards the realisation of agricultural sustainability.
Incorporating Ethical and Trust-based Behaviour into Economics: A Transaction Cost Exploration
Authors: de Bruin Anne , Moore Chris
Published: July 2017

This paper explores ethical activity within a transaction cost (TC) framework. It discusses the theoretical and practical links between TC economisation and ethical and trust-based behaviour. By engendering a climate of trust at the micro/firm level, ethical behaviour can reduce TCs associated with monitoring and protection against broken contracts. At the macro/societal level, considerations such as stakeholders’ increasing ethical expectations, may also have TC implications. To distinguish these latter TCs from those at the more micro level, the paper terms them social transaction costs (STCs). While it might be possible to internalise TCs to achieve economisation, STCs cannot be reduced through internalisation.
An Integrated View of Strategic Management
Authors: Stegmann Juan Pablo
Published: July 2017

Strategic management has produced an amazing number of theories and models in the last decades. However, so far it has not succeeded in producing a good integrative model that can synthesize all the existing models.

In a previous paper I proposed such a model (from now on we will refer to it as the GEMK model, in relation to Growth-EVA-Market Power-Knowledge). It is based on the two drivers of stock value creation, Economic Value Added (EVA) and growth of capital, and proposes two new testable variables, market power and knowledge.

This paper is the application of the GEMK model. It shows how most of existing strategic management models impact stock value creation. It produces a valuable simplification of the discipline, eliminates confrontations, shows that several different theories are complementary, provides a new powerful critical thinking, and shows that the different theories are contingent to these four variables. Most importantly, it shows that the different theories have different levels of impact on stock value creation.
Cluster Development and Global Competitiveness: Prospects of the Nano Sector in Hsinchu Science Park
Authors: Yih-Luan Chyi,
Published: July 2017

The Taiwanese government has heavily invested in infrastructure to support nanotechnology related academic research and industrial applications since 2003. This study surveys nano patent counts and projections of nano industrial output have been surveyed to assess prospects of the Taiwan nano sector in revitalizing Hsinchu Science Park. Quantitative measures of competitiveness and linkages indicate that the competitiveness of certain high-tech clusters is positively linked to strong cross-cluster linkages among Hsinchu Science Park firms. Based on the empirical evidence, this study proposes that nano science and technology may provide opportunities for Hsinchu Science Park firms to strengthen existing or creating new business linkages, and advance their global competitiveness. This study also presents a case study involving the Taiwan Semiconductor Manufacturing Corporation, a flagship Hsinchu Science Park firm.
Actors, Agendas, Arenas and Institutional Change Processes: A Social Science Approach to Sustainability
Authors: Söderbaum Peter
Published: July 2017

Sustainable Development is a challenge not only for natural science but also for the social sciences. In the case of social science, positivism has a role but also hermeneutics and other perspectives that emphasize the subjective aspects of human behaviour. The subjective perceptions and value orientation of different actors play a central role in influencing development patterns and institutional change processes.

It is argued that the conceptual framework of economics plays a key role in the ‘mental maps’ of influential actors. But mainstream neoclassical economics was designed for other purposes and does not go well with the present sustainability challenge. An alternative conceptual framework more in line with institutional economics is proposed. Individuals are understood as Political Economic Persons and organizations as Political Economic Organizations. Individuals and organizations are actors with their specific agendas, appearing on arenas to exchange ideas and commodities. Analysis is multidimensional and there is a role for ethics and ideology in economic behaviour and action. Institutional change is understood in terms of the processes of interpreting a phenomenon, naming it, its manifestations and acceptance (legitimacy achievement). A scheme of analysis for actor-institution studies is proposed.
Book Review: Forgotten Continent: The Battle for Latin America’s Soul
Authors: Gallo Andrés , Steagall Jeffrey W.
Published: July 2017

Reid, Michael. 2007. Forgotten Continent: The Battle for Latin America’s Soul.Yale University Press, New Haven.
The European Union and the Consolidation of Democracy in Turkey
Authors: Alpay Şahin
Published: July 2017

One of the great ironies of the Turkish politics is that Turkey which has a relatively long history of constitutional government and multi-party politics that go back to at least 1908, has held 15 fair and free elections since 1950, is a member of most of the international organizations of market democracies, and is since 2005 negotiating membership with the European Union can still not be considered as a fully consolidated democracy. This paper discusses the main reasons for this irony, and also looks at the dynamics at play, including the accession process to the European Union, which raise the prospect of the consolidation of the democratic regime.
Determinants of the employment status of New Durban University of Technology graduates
Authors: van der Merwe Alex
Published: July 2017

The attitude that the primary purpose of education is to prepare individuals to play a productive role in society seems almost instinctive. This appears to be the received view of countless multitudes either contemplating higher education or already enrolled in such institutions, of parents and sponsors, of governments and higher education institutions and, of course, employers. And yet, in truth, it will be admitted by many who have had anything to do with the business of, especially, higher education that they have entertained doubts as to its real value. This paper, on the strength of a binomial logistic regression analysis of new graduates’ employment status, proposes that individual higher education enrolment choice can be explained by a mix of both human capital and screening theory interpretations of the perceived value of the commodity of higher education. This finding is supported in the literature.

JEL classification: 120, 121
U.S. Vertical and Horizontal Intra-Industry Trade Patterns with the Middle East
Authors: Sussan Aysar Philip , Ekanayake E. M. , D’Souza Sabrina , Halawi Leila
Published: July 2017

The main objective of this paper is to examine the extent of the U.S. vertical and horizontal intra-industry trade patterns with the countries in the Middle Eastern region. To deepen our understanding of the development of trade and investment relations between the U.S. and the Middle Eastern countries, we consider both the commodity structure of trade as well as the structure of investment. Based on the hypothesis that intra-industry trade is closely related to offshore production by multinational enterprises, then a model have been develop to capture the main determinants of vertical and horizontal intra-industry trade that explicitly includes the role of the U.S. foreign investment in the region. The model is tested empirically using detailed trade and investment data. The findings of the study indicated that foreign investment plays a significant role in the increase in intra-industry trade in recent years.
The Meaning of Homeownership
Authors: Forrest R
Published: July 2017

The notion of a property-owning democracy has exerted considerable influence on contemporary British politics. Much of the political and theoretical debate has focussed on the social divisions between owners and renters. This paper explores the connections between mass home ownership and the relations of production. It is argued that meanings, attitudes, and material interests are highly varied between different types of owner occupation and that basic class divisions are being reshaped, rather than fundamentally transformed, by the restructuring of housing tenures.
Christian Responses to Islamism and Violence in the Name of Islam
Authors: Chapman Colin
Published: July 2017

The capture of Mosul in Iraq by ISIS (the Islamic State in Iraq and Syria) in June 2014 focused the world’s attention on Islamism, or political Islam. In addition to all the political issues faced by the rest of the world, Christians are faced with some special challenges and have not always responded with a single voice. If we are to think in a distinctively Christian way about Islamism and violence carried out in the name of Islam, what are the key questions that we need to be asking?
Sensory Nerves in Man and Their Role in Primary Headaches
Authors: Edvinsson L
Published: July 2017

The sensory innervation of intracranial vessels originate in the trigeminal ganglion and comprise the following signal substances; calcitonin gene-related peptide (CGRP), substance P, neurokinin A, pituitary adenylate cyclase activating peptide (PACAP) and nitric oxide (NO). Studies in patients have revealed a clear association between head pain and the release of CGRP. In cluster headache and in a case of chronic paroxysmal headache there is in addition release of vasoactive intestinal peptide (VIP), which was associated with the facial symptoms (nasal congestion, rhinorrhea). In parallel with triptan administration, acting via 5-HT1B/1D receptors, head pain subside and neuropeptide release normalise. These data show the involvement of sensory and parasympathetic mechanisms in the pathophysiology of primary headaches.
The Lateral Notch Sign Associated with Acute Anterior Cruciate Ligament Disruption
Authors: Garth William P. , Greco John , House Michael A.
Published: July 2017

We prospectively studied all of the patients with anterior cruciate ligament disruptions who sought treatment at the senior author's office during a 36-month period. Plain radiographs identified depressions measuring 2 mm or more in the lateral femoral condyle (lateral notch sign) in 9 of 120 knees (7.5%) with acute anterior cruciate ligament disruption and in 2 of 44 knees (4.5%) with chronic pivot shift instability. The depression ranged from 2 to 6 mm deep and from 20 to 25 mm long. The mean age for acutely injured patients with lateral notch signs was 17.2 years, 6 years younger than the mean age of the group with acutely injured anterior cruciate ligaments as a whole. Ten of the 11 patients (91%) with lateral notch signs were men, and all 6 patients with depressions shallower than prior descriptions of the notch sign were men. In contrast, 67% (N 110) of the entire group of patients who had anterior cruciate ligament disruption were men. Ten of the 11 patients (91%) with the lateral notch signs and 4 of the 6 patients (66%) with minimal depressions also had lateral meniscus tears, while 58 of 147 patients (39%) without lateral femoral condyle depression had lateral meniscus tears. Previous reports that the lateral notch is a sign of chronic anterior cruciate ligament deficiency with recurrent pivot shifts are not supported by the number of prospectively recognized acute lateral femoral notch signs in this series. We found the presence of radiographic changes in the lateral femoral condyle to have statistically significant correlations with young age, male sex, lateral meniscus tears in general and anterior-horn lateral meniscus tears specifically, and lateral femoral chondral lesions.
Sagittal Plane Knee Translation and Electromyographic Activity during Closed and Open Kinetic Chain Exercises in Anterior Cruciate Ligament-Deficient Patients and Control Subjects
Authors: Kvist Joanna , Gillquist Jan
Published: July 2017

Using electrogoniometry and electromyography, we measured tibial translation and muscle activation in 12 patients with unilateral anterior cruciate ligament injury and in 12 control subjects. Measurements were made during an active extension exercise with 0-, 4-, and 8-kg weights and during squats on two legs and on one leg where the projection of the center of gravity was placed over, behind, and in front the feet. In the uninjured subjects, tibial translation increased with increasing load except during the squat with the center of gravity behind the feet, which produced the smallest translation. For the active extension exercises, translation was greater during eccentric activity. In the anterior cruciate ligament-injured knees, all squats resulted in similar translation, which was smaller than that during the active extension exercise. The highest muscle activation was seen during squats. Hamstring muscle activity was low. Increased static laxity in the anterior cruciate ligament-deficient knee can be controlled during closed but not during open kinetic chain exercises. Coactivation of the quadriceps and gastrocnemius muscles seems to be important for knee stability, whereas hamstring muscle coactivation was insignificant. To minimize sagittal translation during nonoperative management of anterior cruciate ligament-deficient knees, closed kinetic chain exercises are preferable to open kinetic chain exercises, and importance should be attached to the spontaneous coactivation of the quadriceps and gastrocnemius muscles.
Inversion and Eversion Strengths in the Weightbearing Ankle of Young Women
Authors: Ottaviani Robert A. , Ashton-Miller James A. , Wojtys Edward M.
Published: July 2017

Maximum isometric ankle inversion and eversion muscle strengths were measured under full unipedal weightbearing in 20 healthy young adult women. When the women wore a low-top shoe, the mean (standard deviation) maximum external eversion moments resisted with the foot in 0° and 32° of ankle plantar flexion were 24.1 (7.6) and 24.1 (8.1) N m, respectively, while the corresponding values for maximum inversion moments resisted were 14.7 (6.8) and 17.4 (6.4) N m, respectively. Both shoe height and ankle plantar flexion affected the overall inversion moment resisted by 17% (P=0.03) at 0° of ankle plantar flexion to 11.9% (P=0.003) at 32° of ankle plantar flexion. However, neither shoe height nor ankle plantar flexion significantly affected the maximum eversion moment resisted. Although eversion muscle strength of the young women averaged 39% less than the corresponding value found in young men, the sex difference was not significant when ankle strengths were normalized by body size (body weight × height). Thus, when data from healthy young men and women were averaged, eversion and inversion strengths averaged 1.6% and 2.7%, respectively, of body weight × height.
Disability Days in Major League Baseball
Authors: Conte Stan , Requa Ralph K. , Garrick James G.
Published: July 2017

We have examined the injury experience in Major League Baseball as reflected by the disabled list, based on data presented by American Specialty Companies in their publications, to examine any changes in injury rates over the past 11 years. It is reasonable to expect that improvements in training and conditioning, diagnostic methods, and surgical treatment over the last 11 years would have reduced injuries and resulted in fewer players on the disabled list. Yet, such does not appear to be the case. There is no evidence that the number of injuries in Major League Baseball has declined over the last decade; on the contrary, it appears that both the number of players and player days on the disabled list have increased. Team membership, injury location, and position do not appear to be related to the increase. Nor does it appear that the increase in injuries is a result of more sensitive diagnostic tests allowing the diagnoses of previously unrecognized injuries. Whatever the reason, it is significant that publicly available data, when viewed over an 11-year period, reveal a gradual and consistent increase in reported injuries—suggesting a problem that deserves attention.
Patellofemoral Stresses during Open and Closed Kinetic Chain Exercises
Authors: Cohen Zohara A. , Roglic Hrvoje , Grelsamer Ronald P. , Henry Jack H. , Levine William N. , Van Mow C. , Ateshian Gerard A.
Published: July 2017

Rehabilitation of the symptomatic patellofemoral joint aims to strengthen the quadriceps muscles while limiting stresses on the articular cartilage. Some investigators have advocated closed kinetic chain exercises, such as squats, because open kinetic chain exercises, such as leg extensions, have been suspected of placing supraphysiologic stresses on patellofemoral cartilage. We performed computer simulations on geometric data from five cadaveric knees to compare three types of open kinetic chain leg extension exercises (no external load on the ankle, 25-N ankle load, and 100-N ankle load) with closed kinetic chain knee-bend exercises in the range of 20° to 90° of flexion. The exercises were compared in terms of the quadriceps muscle forces, patellofemoral joint contact forces and stresses, and “benefit indices” (the ratio of the quadriceps muscle force to the contact stress). The study revealed that, throughout the entire flexion range, the open kinetic chain stresses were not supraphysiologic nor significantly higher than the closed kinetic chain exercise stresses. These findings are important for patients who have undergone an operation and may feel too unstable on their feet to do closed chain kinetic chain exercises. Open kinetic chain exercises at low flexion angles are also recommended for patients whose proximal patellar lesions preclude loading the patellofemoral joint in deeper flexion.
Two- versus Three-Portal Technique for Routine Knee Arthroscopy
Authors: Stetson William B. , Templin Kevin
Published: July 2017

The purpose of this study was to compare the results of a two-portal versus a three-portal technique for knee arthroscopy and to determine differences in patient and muscle recovery time and postoperative pain. We prospectively evaluated 16 patients undergoing routine knee arthroscopy in a randomized, double-blinded study. Six patients underwent arthroscopy with the standard three-portal technique, with the superomedial portal established through the vastus medialis obliquus muscle. Ten patients underwent the procedure with only two portals, the anteromedial and anterolateral. A third incision was created in the area of the vastus medialis obliquus muscle, but a portal was not created and the muscle was not violated. The same surgeon performed all procedures. Quadriceps muscle strength, total strength, and Lysholm scores were consistently greater for patients in the two-portal group than for patients in the three-portal group. Patients in the three-portal group returned to work and normal activities at a mean of 19 days after surgery, compared with 9 days for patients in the two-portal group. Standard knee arthroscopy with a two-portal technique does not violate the vastus medialis obliquus muscle and allows an earlier return of quadriceps muscle function and strength, earlier rehabilitation, and a faster return to activity.
Endoscopically Assisted Fasciotomy
Authors: Leversedge Fraser J. , Casey Patrick J. , Seiler John G. , Xerogeanes John W.
Published: July 2017

We describe a reliable method of endoscopically assisted fasciotomy for treating chronic exertional compartment syndrome in the lower leg and for assessing compartment decompression in an in vitro model. Endoscopically assisted fasciotomy was performed in the anterior and lateral compartments of 14 matched, fresh-frozen, through-the-knee amputation specimens using a 30° endoscope. A one-incision technique used in 4 specimens failed to provide complete visualization, and a two-incision technique was then performed in 10 specimens. After decompression, the skin and subcutaneous tissues were removed to assess adequacy of release, nerve decompression, anatomic course of the superficial peroneal nerve, and potential complications. Endoscopic visualization of the fascial layer and subcutaneous neurovascular structures permitted consistent compartment decompression. Fascial release, expressed as a percentage of length from the proximal origin of the fascia to the inferior retinaculum, was 99.8% (range, 98.4% to 100%) for the anterior compartment and 96.4% (range, 82% to 100%) for the lateral compartment. There were no retained fascial bands, unrecognized fascial defects, or neurovascular injuries. Optimal visualization with endoscopically assisted fasciotomy may improve clinical outcome through 1) reliable compartment decompression, 2) identification of fascial defects, 3) decompression of nerve branches at the fascial foramen, and 4) reduction of iatrogenic risk to neurovascular and muscular structures.
Comparison of Two Procedures for Meniscal Cysts: A Report of 35 Patients with a Mean Follow-up of 33 Months
Authors: Sarimo Janne , Rainio Petri , Rantanen Jussi , Orava Sakari
Published: July 2017

Background:

The cause, pathogenesis, and appropriate treatment of meniscal cysts remain controversial.

Purpose:

We wanted to evaluate the results of treatment of meniscal cysts with two different operative procedures.

Study Design:

Prospective cohort study.

Methods:

Two different operative procedures were compared. Sixteen patients (group 1) had an open excision of the cyst performed in addition to arthroscopic examination of the knee. Nineteen patients (group 2) were treated entirely arthroscopically. The postoperative treatment course was the same for both groups. The mean length of follow-up was 33 months.

Results:

The results were excellent or good in 86% of the patients (30 of 35) and were equally good for both procedures. Patients with degenerative changes of the knee joint seemed to have a less favorable outcome.

Conclusions:

Good or excellent results can be expected from either open or arthroscopic treatment of meniscal cysts.
The Effect of Initial Graft Tension in Anterior Cruciate Ligament Reconstruction on the Mechanical Behaviors of the Femur-Graft-Tibia Complex during Cyclic Loading
Authors: Numazaki Hironori , Tohyama Harukazu , Nakano Hideaki , Kikuchi Shinichi , Yasuda Kazunori
Published: July 2017

Background

Initial graft tension influences clinical results of anterior cruciate ligament reconstruction.

Hypothesis

Under repetitive loading conditions, the effect of initial graft tension on the biomechanical behavior of the femur-graft-tibia complex may depend on the graft and the fixation.

Study Design

Ex vivo biomechanical laboratory study.

Methods

After anterior cruciate ligament reconstruction, initial graft tension of 20, 80, or 140 N was applied to the complex for 2 minutes. Then, a cyclic force-relaxation test was performed for 5000 cycles so that the graft was stretched by 2 mm.

Results

In a patellar tendon graft with interference screws, the average peak load values at the 5000th cycle were 105, 157, and 205 N for the complexes with initial tension of 20, 80, and 140 N, respectively. In a flexor tendon graft with interference screws, the values were 27, 41, and 39 N. In a flexor tendon graft with Endobutton fixation, the values were 17, 40, and 77 N.

Conclusions

Considering the tension of the normal anterior cruciate ligament (16 to 87 N), an initial tension of 20 N appears to be high enough for a patellar tendon graft. For a flexor tendon graft with interference screws, an increase in initial tension above 80 N has no biomechanical advantages.
When Food Becomes a Drug: Nonanabolic Nutritional Supplement Use in Athletes
Authors: Schwenk Thomas L. , Costley Chad D.
Published: July 2017

The use of nonanabolic nutritional supplements for the sake of improving athletic performance is common, and the types of supplements used can have significant implications for the medical care of athletes. This review will address the most common and most controversial nonanabolic nutritional supplements, including recommendations regarding their use. Many supplements are marketed and promoted based on various theoretical benefits, often derived from limited animal studies, without any basis for recommending their human use. Physicians are trained to not recommend a nutritional supplement unless it is known to be effective, whereas athletes are oriented toward trying any supplement or ergogenic aid as long as it is safe, with the hope that it may be effective. The built-in error in most study designs is larger than the difference between winning and not qualifying at elite levels of competition, such that research may not always answer the questions raised by athletes. An honest discussion of the limitations of most supplements, and acknowledgment that some supplements may work some of the time in some athletes, may lead the physician to be more credible and useful to athletes in providing medical care and guidance that support their desire to improve their performance.
The Fixation Strength of Six Hamstring Tendon Graft Fixation Devices in Anterior Cruciate Ligament Reconstruction: Part I: Femoral Site
Authors: Kousa Petteri , Järvinen Teppo L. N. , Vihavainen Mika , Kannus Pekka , Järvinen Markku
Published: July 2017

Background:

Strength of graft fixation is the weakest link in anterior cruciate ligament reconstruction.

Hypothesis:

There is no difference in initial fixation strength between different hamstring tendon graft femoral fixation devices.

Study Design:

Randomized experimental study.

Methods:

Each of six devices was used in the fixation of 10 quadrupled human semitendinosus-gracilis tendon grafts in tunnels drilled in porcine femora and tested 10 times with a single-cycle load-to-failure test at a rate of 50 mm/min and 10 times with a 1500-cycle loading test between 50 and 200 N at one cycle every 2 seconds. The specimens that survived the cyclic loading were subjected to a single-cycle load-to-failure test.

Results:

The Bone Mulch Screw (1112 N) was strongest in the single-cycle load-to-failure test, followed by EndoButton CL (1086 N), RigidFix (868 N), SmartScrew ACL (794 N), BioScrew (589 N), and RCI screw (546 N). It also showed the lowest residual displacement (2.2 mm) and was strongest in the single-cycle load-to-failure test after cyclic loading.

Conclusions:

The Bone Mulch Screw was superior to all other devices.

Clinical Relevance:

Caution may be warranted in employing aggressive rehabilitation after reconstruction with these devices. Preconditioning of the graft-implant complex before fixation is important.
Anatomic Reconstruction of the Posterior Cruciate Ligament after Multiligament Knee Injuries: A Combination of the Tibial-Inlay and Two-Femoral-Tunnel Techniques
Authors: Stannard James P. , Riley Reneé S. , Sheils Todd M. , McGwin Gerald , Volgas David A.
Published: July 2017

Background:

Neither operative nor nonoperative treatment of posterior cruciate ligament rupture after multiligament knee injuries have shown very favorable outcomes.

Hypothesis:

Reconstruction of the posterior cruciate ligament by combining the tibial-inlay and two-femoral-tunnel techniques will result in improved stability and functional outcomes.

Study Design:

Prospective cohort study.

Methods:

Twenty-nine patients with 30 posterior cruciate ligament ruptures and multiligament knee injuries treated with the combined technique were evaluated with clinical, radiographic, and functional outcome measures.

Results:

All patients had a clinical examination result indicating joint stability (0 or 1+) at an average follow-up of 25 months (range, 15 to 39). Twenty-three knees had no laxity, and seven had 1+ laxity. The KT-2000 arthrometer data documented less than 0.5 mm of side-to-side mean difference for both posterior displacement and total anterior-posterior displacement at both 30° and 70° of knee flexion. Knee range of motion was a mean extension of 1° (range, 0° to 10°) and a mean flexion of 124° (range, 75° to 145°). Mean Lysholm knee score was 89.4.

Conclusions:

Reconstruction with a combination tibial-inlay and two-femoral-tunnel technique provides good results after multiligament knee injuries. All patients had a stable posterior cruciate ligament at most recent clinical follow-up, and 77% had no laxity at all.
Shock Wave Application for Chronic Plantar Fasciitis in Running Athletes: A Prospective, Randomized, Placebo-Controlled Trial
Authors: Rompe Jan D. , Decking Jens , Schoellner Carsten , Nafe Bernhard
Published: July 2017

Background:

Recent articles have reported success with repeated low-energy shock wave application for treatment of chronic plantar fasciitis in runners.

Hypothesis:

Shock wave treatment for chronic plantar fasciitis is safe and effective.

Study Design:

Prospective, randomized, placebo-controlled trial.

Methods:

Forty-five running athletes with intractable plantar heel pain for more than 12 months were enrolled; half were assigned to a treatment group that received three applications of 2100 impulses of low-energy shock waves, and half received sham treatment. Follow-up examinations were performed at 6 months and at 1 year by a blinded observer.

Results:

After 6 months, self-assessment of pain on first walking in the morning was significantly reduced from an average of 6.9 to 2.1 points on a visual analog scale in the treatment group and from an average of 7.0 to 4.7 points in the sham group. The mean difference between groups was 2.6 points. After 12 months, there was a further reduction of pain in both groups, to an average 1.5 points in the treatment group, and to 4.4 points in the sham group.

Conclusion:

Three treatments with 2100 impulses of low-energy shock waves were a safe and effective method for treatment of chronic plantar fasciitis in long-distance runners.
Comparison of Three Techniques of Anterior Cruciate Ligament Reconstruction with Bone-Patellar Tendon-Bone Graft: Differences in Anterior Tibial Translation and Tunnel Enlargement with Each Technique
Authors: Otsuka Hironori , Ishibashi Yasuyuki , Tsuda Eiichi , Sasaki Kazuhiro , Toh Satoshi
Published: July 2017

Background:

Anatomic fixation of the graft in anterior cruciate ligament reconstruction has improved stability of the reconstructed knee joint in experimental studies.

Hypothesis:

Anatomic fixation of the bone-patellar tendon-bone autograft will reduce tunnel enlargement and improve clinical results.

Study Design:

Prospective cohort study.

Methods:

Sixty patients were randomly divided into three groups: a nonanatomic fixation group (traditional single-incision reconstruction), an anatomic fixation group (reconstruction in which a bone plug was grafted into the tibial tunnel), and an anatomic fixation group with all-inside reconstruction. Stability of the knee joint was examined with a KT-1000 arthrometer at 2, 4, 6, 12, and 24 months after surgery. At 12 months, anteroposterior and lateral radiographs were made to assess tunnel enlargement.

Results:

Although the magnitude of tibial displacement gradually increased after reconstruction in all three groups, the anatomic fixation group had significantly better stability than the groups undergoing nonanatomic fixation or all-inside anatomic fixation at 4 and 6 months after anterior cruciate ligament reconstruction. However, there was no significant difference between the three groups at 24 months. Regarding the tibial tunnel, residual rates and enlargement of tunnels were different between the reconstruction techniques. The nonanatomic reconstruction group had significantly greater tunnel enlargement.

Conclusion:

Anatomic fixation of the graft decreased the tunnel enlargement but had no effect on knee stability at 2-year follow-up.
The Effect of Ankle Braces on the Prevention of Dynamic Forced Ankle Inversion
Authors: Ubell Matthew L. , Boylan James P. , Ashton-Miller James A. , Wojtys Edward M.
Published: July 2017

Background: Athletes often employ prophylactic braces to reduce the risk of ankle injuries.

Hypothesis: Ankle braces do not significantly decrease the risk of forced inversion on a standardized one-footed jump landing.

Study Design: Controlled laboratory study.

Methods: Fourteen healthy men with a mean age of 25.1 years were tested. Three braces, two semirigid (Aircast and Bledsoe) and one lace-up (Swede-O), were fitted to each subject. Forced dynamic ankle inversion of 24° was to be resisted as the subjects landed on one foot with a force of two body weights on a stimulus presented randomly in 5 of 15 jump trial blocks onto a hard, level force plate. Subjects first completed 1 no-brace block of 5 trials to establish baseline performance, then 3 randomly ordered 15-trial blocks testing performance with each of the braces, and then finally a no-brace 5-trial block.

Results: The average no-brace success rate was 24%, which demonstrated the challenging nature of the task. All three braces increased the success rate (average, 44%); however, only the two semirigid braces proved to be significantly better than the unbraced state.

Conclusion: This test holds promise for evaluating brace efficacy when landing with one foot unexpectedly on an object that acts to forcibly invert the ankle.
Preoperative Evaluation and Anterior Cruciate Ligament Reconstruction Technique for Skeletally Immature Patients in Tanner Stages 2 and 3
Authors: Guzzanti Vincenzo , Falciglia Francesco , Stanitski Carl L.
Published: July 2017

Background: Transphyseal anterior cruciate ligament reconstruction in skeletally immature patients carries the risk of adverse sequelae.

Purpose: 1) To provide clinical and radiographic methods to identify skeletally immature patients with significant remaining lower limb growth. 2) To provide a method for calculating the percent area lesion created by a 6-mm distal femoral physeal tunnel. 3) To present a method of partial transphyseal intraarticular anterior cruciate ligament reconstruction with bipolar graft fixation in these patients. 4) To report on clinical, functional, and radiographic results at skeletal maturity.

Methods: Fourteen adolescents with symptomatic anterior cruciate ligament instability who were identified as being in Tanner stages 2 and 3 underwent partial transphyseal intraarticular anterior cruciate ligament reconstruction with the use of hamstring tendon grafts (transphyseal only in the femur and through the epiphysis in the tibia).

Results: At skeletal maturity, 10 patients were asymptomatic and fully active in sports. No patient had significant leg-length inequality or angular deformity after use of a 6-mm femoral physeal tunnel, which represented 1) less than 7% of the frontal plane and 2) less than 1% of the transverse plane cross-sectional femoral physeal areas.

Conclusions: The choice of the exposed technique and the method used to select patients permitted us to avoid adverse sequelae.
Acute Achilles Tendon Rupture in Badminton Players
Authors: Fahlström Martin , Björnstig Ulf , Lorentzon Ronny
Published: July 2017

All patients with badminton-related acute Achilles tendon ruptures registered during 1990 to 1994 at the University Hospital of Umeå were retrospectively followed up using a questionnaire. Thirty-one patients (mean age, 36.0 years), 27 men and 4 women, were included. Thirty patients (97%) described themselves as recreational players or beginners. The majority of the injuries (29 of 31, 94%) happened at the middle or end of the planned game. Previous local symptoms had been noticed by five patients (16%). Long-term results showed that patients treated with surgery had a significantly shorter sick leave absence than patients treated without surgery (50 versus 75 days). There was no obvious selection favoring any treatment modality. None of the surgically treated patients had reruptures, but two reruptures occurred in the nonsurgically treated group. There seemed to be fewer remaining symptoms and a higher sports activity level after the injury in the surgically treated group. Our results indicate that local muscle fatigue may interfere with strength and coordination. Preventive measures such as specific treatment of minor injuries and adequate training of strength, endurance, and coordination are important. Our findings also indicate that surgical treatment and careful postoperative rehabilitation is of great importance among badminton players of any age or sports level with Achilles tendon ruptures.
Reconstruction of the Lateral Collateral Ligament of the Knee With Patellar Tendon Allograft
Authors: Latimer Harrison A. , Tibone James E. , ElAttrache Neal S. , McMahon Patrick J.
Published: July 2017

This is a retrospective study of 10 patients with combined cruciate ligament and posterolateral instability who underwent surgical reconstruction between 1991 and 1994. All knees had at least 20° increased external rotation at 30° of knee flexion and from 1 to 3 varus instability. Five knees with posterior cruciate ligament ruptures had at least a 2 Lachman test result. (One knee had both anterior and posterior cruciate ligament injuries.) In all cases the lateral collateral ligament was reconstructed with a bone-patellar tendon-bone allograft secured with interference screws. Fixation tunnels were placed in the fibular head and at the isometric point on the femur. The cruciate ligaments were reconstructed with autograft or allograft material. The average follow-up was 28 months. Excessive external rotation at 30° of flexion was corrected in all but one knee. Six patients had no varus laxity, and four patients had 1 varus laxity at 30° of flexion. The posterior drawer test result decreased, on average, to 1 , and the Lachman test result decreased to between 0 and 1 . The average Tegner score was 4.6, with five patients returning to their preinjury level of activity and four returning to one level lower. These results indicate that this is a promising new procedure for patients with instability resulting from lateral ligament injuries of the knee.
Isometry of the Posterior Cruciate Ligament
Authors: Ortiz Gerald J. , Schmotzer Hans , Bernbeck Johanness , Graham Scott , Tibone James E. , Vangsness C. Thomas
Published: July 2017

The effects of functional load and muscle force application on isometry of the posterior cruciate ligament were determined. Eight fresh-frozen cadaver knees were mounted in a custom-designed rig. A full range of motion and muscle forces were applied through the quadriceps, hamstring, and gastrocnemius tendons during a simulated static squat maneuver. The low-load isometric posterior cruciate ligament point was located 5.63 mm proximal and 0.18 mm anterior to the anatomic center of the posterior cruciate ligament origin on the femur. The high-load state, with no gastrocnemius and hamstring muscle forces applied, shifted the isometric point 6.32 mm proximal and 6.72 mm anterior (P 0.05). Loading the hamstring and gastrocnemius muscles also shifted the isometric point (P 0.05). This study indicated that the most isometric region of the posterior cruciate ligament femoral attachment changed significantly when functional loads and muscle forces were applied to the knee. This finding may have implications for both surgical reconstruction and rehabilitation of the posterior cruciate ligament-injured knee.
Static and Dynamic Roentgenographic Analysis of Ankle Stability in Braced and Nonbraced Stable and Functionally Unstable Ankles
Authors: Vaes Peter H. , Duquet William , Casteleyn Pierre-Paul , Handelberg Frank , Opdecam Pierre
Published: July 2017

Patients suffering from functional ankle instability were selected based on a structured interview. Talar tilt was measured using supine ankle stress roentgenographs and standing talar tilt was measured using erect ankle stress roentgenographs. A digital roentgenocinematographic analysis of a 50° ankle sprain simulation was performed to measure dynamic talar tilt and inversion distance between two video images (inversion speed). A significant decrease in pathologic supine talar tilt in unstable ankles was found in the braced compared with the nonbraced situation (talar tilt 13.1° versus 4.8° with brace). The talar tilt with the brace after activity was still significantly lower than the initial value without the brace. The standing talar tilt of unstable ankles was shown to be significantly lower with the orthosis than without (standing talar tilt 16.6° versus 12.0° with brace). Roentgenocinematographic evaluation of ankle sprain simulation showed that the mean dynamic talar tilt during simulated sprain decreased significantly in the braced ankles compared with the nonbraced ankles (dynamic talar tilt 9.8° versus 6.4° braced). A significant decrease in the digital measurement of inversion distance (from 110.6 pixels to 92.4 pixels) was observed in the total sample of 39 ankles during the initial high-speed phase of the simulated sprain. The brace significantly slows down the inversion speed.
A New Pain Provocation Test for Superior Labral Tears of the Shoulder
Authors: Mimori Kou , Muneta Takeshi , Nakagawa Teruhiko , Shinomiya Kenichi
Published: July 2017

We prospectively evaluated the usefulness of a new pain provocation test to diagnose superior labral tears in 32 patients with diagnosed throwing injuries of the shoulder. Results of the pain provocation test were compared with findings on magnetic resonance arthrography (all 32 patients) and arthroscopic examination (15 patients). In 22 patients, detachment of the superior labrum was observed on arthrograms, and all of them had positive results on the new pain provocation test. Nine of the other 10 patients had negative results on the new pain provocation test. However, 1 of the 10 patients had a positive result. Eleven of 15 patients were found to have superior labral lesions arthroscopically, and all of them were classified as type II superior labral anterior posterior lesions. All the 11 patients had positive pain provocation tests. The other four patients without superior labral tears on arthroscopic findings had negative results on the new pain provocation test. The new pain provocation test identified all patients with detachment of the superior labrum confirmed by magnetic resonance arthrography, for a sensitivity of 100%, a specificity of 90%, and an accuracy of 97%. Results of the new pain provocation test were in accord with arthroscopic findings in the 15 patients who underwent arthroscopic examination.