bluuebunny/crossref_metadata_2025 huggingface dataset:
The relationship of strength and jump height in figure skaters
Authors: Podolsky Anatol , Kaufman Kenton R. , Cahalan Thomas D. , Aleshinsky Sergei Y. , Chao Edmund Y.S.
Published: June 2007

Eighteen junior elite figure skaters were filmed while performing axel and double axel jumps. These same skaters were assessed for strength of the shoulders, knees, and hips at multiple angular velocities using a Cybex II system. The height of the jumps was signifi cantly correlated with the strength data. Knee exten sion at 240 deg/sec and shoulder abduction at 300 deg/sec were shown to be the most important strength parameters in determining the height of the jump. This information may be useful for designing strength train ing programs for figure skaters.
Illicit anabolic steroid use in athletes
Authors: Perry Paul J. , Andersen Kathleen H. , Yates William R.
Published: June 2007

Because of recent anabolic steroid abuse scandals at all levels of athletic competition ranging from high school sports to the 1988 Olympics in Seoul, Korea, the investigators closely examined the anabolic steroid use histories of 20 competitive and noncompetitive weight lifters. Steroid efficacy studies only examine the anabolic effects of individual drugs. However, these 20 steroid users consistently practiced polypharmacy. During steroid use cycles lasting between 7 and 14 weeks, athletes commonly used two or three oral agents and two long-acting injectable products. Dos ages of oral preparations tended to be similar to those used in efficacy studies, whereas dosages of the long- acting injectable agents were approximately three to eight times greater than those used in controlled stud ies. Subjects reported significant increases in body weight and strength. In addition, mental status changes were reported that included symptoms of depression, hostility, aggression, and paranoia. Based on the pat tern of anabolic steroid use currently being practiced in the United States, it is apparent that past efficacy and toxicology studies are of limited value in delineating the benefits and hazards of these drugs.
Reconstruction of the anterior cruciate ligament using allogeneic tendon
Authors: Shino Konsei , Inoue Masahiro , Horibe Shuji , Hamada Masayuki , Ono Keiro
Published: June 2007

Eighty-four patients who underwent ACL reconstruc tion with fresh-frozen allogeneic tendon were reviewed and evaluated with subjective and functional rating scales, physical examinations, instrumented anterior drawer tests, isokinetic testing, and arthroscopy. The average followup was 57 months (range, 36 to 90 months) and the average age at operation was 22 years (range, 16 to 37 years).

The subjective and functional results were rated as excellent in 48 patients (57%), good in 31 (37%), and fair in 2 (2%). Three patients (3%) experienced a retear of the ACL. Physical examinations and instrumented anterior drawer tests showed that satisfactory anterior stability was restored in 88% of the patients. Isokinetic evaluations demonstrated that the extension torque of the involved knee recovered to a slightly lower level than that of the controls, although the flexion torque recovered to a level equivalent to that of the controls. Arthroscopic evaluations revealed that the allografts were elaborately remodeled, viable, and taut. There was no sign of immunologic rejection at any time post operatively. Additional extraarticular procedures, con sisting of both pes anserinus transfer on the medial side and iliotibial band reinforcement on the lateral side, had no effect on the results.
On the importance of planned health education
Authors: Kok Gerjo , Bouter Lex M.
Published: June 2007

The planning of health education aimed at preventing sports injuries is often incomplete and not stated ex plicitly. In most instances, the evaluation is incomplete or nonexistent. We present a theoretical framework for planning and evaluating health education, illustrating the main points by using as an example the health education for downhill skiers. Systematic planning con sists of analyzing the magnitude of the problem and the behavioral risk factors, studying behavior determi nants, designing an optimal intervention, and imple menting the intervention. The evaluation phase deals with the effects on these five levels (implementation, intervention, determinants, behavior, and incidence of injury). Some common pitfalls are mentioned and spe cial attention is given to the study of determinants of behavior and to the design of the intervention. The importance of pretesting health education material and the community approach in educating sports partici pants is underlined. Health education, together with regulations and facilities, constitutes the health pro motion strategy in the prevention of sports injuries. For most sports, there seems to be a strong need for further research on the etiology and determinants of behavior before effective prevention can be realized.
The conservative treatment of the anterior cruciate deficient knee
Authors: Bonamo John J. , Fay Colleen , Firestone Theodore
Published: June 2007

Seventy-nine recreational athletes (average age, 26 years) with complete ACL tears were treated with nonligamentous arthroscopic surgery, monitored reha bilitation, functional bracing, and activity modification. The average followup was 52 months (range, 36 to 102 months).

Six (8%) patients ultimately underwent ligament re construction and were considered failures of nonrecon structive treatment. The remaining 73 patients were the subject of detailed analysis. There were 9 (11 %) excellent, 25 (32%) good, 17 (22%) fair, and 28 (35%) poor results.

Although 71 patients (97%) were satisfied with their knee for activities of daily living, only 36 (49%) were satisfied with their knee for sports. Twenty-nine (40%) had significantly modified their athletic activities.

Age, sex, interval from injury to treatment, associated meniscal tears (49 or 67%), and articular cartilage dam age (21 or 29%) had no apparent effect on the outcome. Poor results were noted in 29 (40%) patients with significant pivot shifts. Multiple repeat injuries, repeat arthroscopy, isokinetic deficits, and increased length of followup were also associated with poor results.
Arthroscopic acromioclavicular joint resection
Authors: Gartsman Gary M. , Combs Andrew H. , Davis Pamela F. , Tullos Hugh S.
Published: June 2007

Distal clavicle resection has been an effective procedure for treatment of acromioclavicular arthritis. The conven tional open surgical technique involves deltoid detach ment and reattachment, which may cause postopera tive weakness and requires protection during the post operative period to allow for healing. Arthroscopic acromioclavicular joint resection has the theoretical ad vantages of no deltoid disruption and a shorter rehabil itation period. The purpose of this study was to com pare open versus arthroscopic acromioclavicular joint resection in a laboratory setting.

The goals of acromioclavicular joint resection in this study were to remove 5 mm of the medial acromion and 10 mm of the distal clavicle. Acromioclavicular joint resections were performed on 10 cadaver shoulders (5 open resections and 5 arthroscopic resections). Open resection was successful at 10 of 15 distal clavicle locations and 14 of 15 medial acromial locations. Ar throscopic resection was successful at 14 of 15 distal clavicle locations and 10 of 15 medial acromial loca tions. The combined bone resection averaged 14.8 mm (±1.99 mm) for the open technique and 14.8 mm (± 2.58 mm) for the arthroscopic technique. The combined bone resection was 1.5 cm or more in all of the meas ured locations for the open technique and in 14 of 15 measure locations for the arthroscopic technique. There was no statistically significant difference between the two groups.

In the laboratory setting, acromioclavicular joint re section was performed effectively and predictably with arthroscopic instruments. Arthroscopic bone resection was comparable to open bone resection.
Anterior cruciate ligament reconstruction using freeze-dried, ethylene oxide-sterilized, bone-patellar tendon-bone allografts
Authors: Roberts Thomas S. , Drez David , McCarthy William , Paine Russell
Published: June 2007

Thirty-six of 44 patients (82%) who underwent ACL reconstruction using freeze-dried, ethylene oxide-steri lized, bone-patellar tendon-bone allografts were evalu ated at least 2 years postoperatively. A detailed sub jective evaluation using the Lysholm scale was re corded as well as a functional evaluation using the Tegner activity scale. All of the patients received a detailed physical examination that included testing with the KT-1000 ligament arthrometer and the Cybex dy namometer. Complete chart reviews and radiographic evaluations were also obtained.

Only 17 patients were considered to be functionally successful and performing at their desired activity level. The average KT-1000 showed a side-to-side difference of 5.9 mm at 30 pounds for the successful group and 7.9 mm for those who had functional failure. The Ly sholm scores were 91.6/100 versus 61.1/100 in the failures. Eight patients (22%) at repeat surgery were noted to have complete dissolution of the graft. Large femoral cysts were noted radiographically in all of these patients.

It was concluded that freeze-dried, ethylene oxide- sterilized, bone-patellar tendon-bone allografts have a high failure rate and cannot be recommended for ACL reconstruction.
Serial magnetic resonance imaging of hamstring anterior cruciate ligament autografts during the first year of implantation
Authors: Howell Stephen M. , Clark James A. , Blasier R. Dale
Published: June 2007

A prospective, observational study was performed to document the serial changes in the magnetic resonance signal of devascularized, hamstring ACL autografts dur ing the 1 st year of implantation.

Twenty-one ACL deficient knees (14 chronic, 7 acute) were reconstructed. Instability developed in five knees within the first 6 months of graft implantation (24%). Magnetic resonance examinations were performed at 1, 6, 12, 24, 36, and >48 weeks postoperatively (rep etition time 1500, echo delay time = 50). A total of 104 scans were reviewed (average, five per knee). The ACL graft was divided into four unequal size zones for analysis. The proximal, middle, and distal thirds of the intraarticular portion of the graft and the portion of the graft within the tibial tunnel were independently an alyzed. The magnetic resonance signal in each portion of the graft was graded on a scale with (I) being a normal signal, (II) >50% of the total volume of the graft having a normal signal, (III) <50% of the graft having a normal signal, and (IV) 100% of the graft having an increased signal.

The increased magnetic resonance signal of the ACL graft was observed to be regionalized and confined to the distal two-thirds of the intraarticular portion of the graft. The portion of the graft exiting the femoral tunnel and within the tibial tunnel retained a normal magnetic resonance signal. The increases in magnetic resonance graft signal were time-dependent, became well estab lished by 3 months, and remained unchanged at 1 year. The clinical outcome could not be predicted based on the magnetic resonance signal of the graft.
The Gore-Tex anterior cruciate ligament prosthesis
Authors: Woods Gregory A. , Indelicato Peter A. , Prevot Troy J.
Published: June 2007

A prospective clinical study of the results of prosthetic ligament replacement of the ACL with the Gore-Tex polytetrafluoroethylene prosthesis was undertaken. Thirty-three (80%) of 41 patients were available at a minimum 36 month followup (mean, 48 months; range, 36 to 62). Kaplan-Meier survival analysis revealed an 82% probability of survival of the polytetrafluoroethyl ene ligament at the 48 month followup. When compared to the same data at a minimum 24 month followup, the results appeared to have deterioriated somewhat over time. Three possible "predictors" of failure at later fol lowup were identified: preoperative subjective symp toms of swelling, subjective symptoms of giving way at 2 years, and an increased anterior drawer sign at 2 years.
Preseason strength and flexibility imbalances associated with athletic injuries in female collegiate athletes
Authors: Knapik Joseph J. , Bauman Connie L. , Jones Bruce H. , Harris John McA. , Vaughan Linda
Published: June 2007

One hundred thirty-eight female collegiate athletes, par ticipating in eight weightbearing varsity sports, were administered preseason strength and flexibility tests and followed for injuries during their sports seasons. Strength was measured as the maximal isokinetic torque of the right and left knee flexors and knee extensors at 30 and 180 deg/sec. Flexibility was meas ured as the active range of motion of several lower body joints. An athletic trainer evaluated and recorded injuries occurring to the athletes in practice or compe tition. Forty percent of the women suffered one or more injuries. Athletes experienced more lower extremity injuries if they had: 1) a right knee flexor 15% stronger than the left knee flexor at 180 deg/sec; 2) a right hip extensor 15% more flexible than the left hip extensor; 3) a knee flexor/knee extensor ratio of less than 0.75 at 180 deg/sec. There was a trend for higher injury rates to be associated with knee flexor or hip extensor imbalances of 15% or more on either side of the body. These data demonstrate that specific strength and flexibility imbalances are associated with lower extrem ity injuries in female collegiate athletes.
Sports-related Kienböck's disease
Authors: Nakamura Ryogo , Imaeda Toshihiko , Suzuki Kiyoshi , Miura Takayuki
Published: June 2007

Ten patients with Kienbock's disease who were actively engaged in sports activities involving repeated minimal trauma to the wrist are presented. Comparative studies between the 10 patients with sports-related Kienböck's disease and 82 manual laborers with Kienböck's dis ease showed no difference in clinical presentation or radiographic findings. The history of repeated minimal trauma appeared to be similar in the two groups. There fore, sports activities in which the wrist suffers repeated impact can lead to the development of Kienböck's disease identical to that occurring in manual laborers, although the sports group was younger and had smaller ulnar variance. Radial osteotomy improved clinical symptoms even in sports-related Kienböck's disease.
Isometric and isokinetic endurance testing of the forearm complex
Authors: Motzkin Neil E. , Cahalan Thomas D. , Morrey Bernard F. , An Kai-Nan , Chao Edmund Y.S.
Published: June 2007

The purpose of this study was to investigate the rela tionship of isometric and isokinetic endurance of the forearm complex under maximum effort in a healthy population. Isometric and isokinetic endurance meas urements of elbow flexion and extension of the domi nant and nondominant sides were made in 32 healthy male subjects (age range, 21 to 39 years). Both fatigue rates and the amount of time elapsed in reaching fatigue were determined. Analysis of these data reveals that 1) isometric endurance of the forearm complex cannot be used as a predictor of isokinetic endurance, as there is no relationship between the two, 2) dominant and non dominant endurance are related, a result that supports the belief that in the assessment of the endurance of a single diseased upper extremity, the best available comparison is with the contralateral healthy extremity, and 3) healthy males in the age range tested have greater endurance in elbow extension than in flexion.
Comparative reflex response times of vastus medialis obliquus and vastus lateralis in normal subjects and subjects with extensor mechanism dysfunction
Authors: Voight Michael L. , Wieder Deborah L.
Published: June 2007

Reflex response times of the vastus medialis obliquus and vastus lateralis were evaluated in 41 normal sub jects and 16 patients with extensor mechanism dys function. The reflex response times for both muscles to a patellar tendon tap were evaluated by electro myography. The latencies of the muscles were statis tically analyzed in both groups. In normal subjects, one- tailed paired-sample t-tests determined that the vastus medialis obliquus fired significantly faster than the vas tus lateralis (P < 0.001). In the patients, the vastus lateralis fired significantly faster than the vastus medi alis obliquus (P < 0.001). A chi square goodness of fit test demonstrated a dependency between the order of muscle firing and the type of subject (P < 0.001). Two- tailed independent-sample t-tests revealed that the pa tients demonstrated a significantly faster vastus later alis response time than the normal subjects (P < 0.001), whereas the vastus medialis obliquus times were not significantly different. This increase in vastus lateralis reflex response time may indicate a motor control prob lem in the patient with extensor mechanism dysfunc tion. Results indicate that there is a reversal of the normal muscular firing order between the two muscles in these patients. Patients with extensor mechanism dysfunction may be demonstrating a neurophysiologic motor control imbalance that may account for or con tribute to their anterior knee pain.
Acute Grade III ulnar collateral ligament ruptures
Authors: Lane Lewis B.
Published: June 2007

A review is presented here of 36 cases, seen since 1980, of acute Grade III (unstable) sports-related sprains of the thumb metacarpophalangeal joint. In all cases, the injury involved the ulnar collateral ligament. A Stener lesion was present in 97% of cases. Followup was from 2.0 to 8.5 years, the average being 3.9 years. All of the patients underwent repeat examination and radiography at followup.

The first seven patients were treated by "traditional" pull-out suture and K-wire fixation, put into a cast for 4 weeks, and then gradually mobilized over 4 additional weeks. Thereafter, a "new method" was used. Avulsed ulnar collateral ligament stumps were sutured to the tendinous insertion of the adductor pollicis or to a soft tissue remnant using strong suture material. Large bony avulsions were pinned; small fragments were excised and the ligament was repaired. This latter method of repair was quite strong and allowed rapid mobilization: only 2 weeks in a cast, then a hand- mounted thumb spica orthosis was used while therapy progressed.

Of the patients treated with the new method, 84% had excellent results and, overall, were able to return to sports sooner than patients treated with the tradi tional method. Pain, stability, and strength were cor rected equally between groups; however, strength was restored more rapidly in the new method group. Range of motion was reduced equally in both groups.

Conclusion: Solid repair of complete ulnar collateral ligament avulsions, consisting of suturing the avulsed portion to the adductor pollicis insertion using strong suture material, combined with early hand therapy fa cilitated by the use of a removable hand-mounted thumb spica orthosis, is safe and allows a faster return to sports than the traditional method of repair.
Electromyographic analysis of the glenohumeral muscles during a baseball rehabilitation program
Authors: Townsend Hal , Jobe Frank W. , Pink Marilyn , Perry Jacquelin
Published: June 2007

Many exercises are used to strengthen the glenohu meral muscles, but there have been limited studies to evaluate the exercises. Thus, the purpose of this study was to decide how the muscles responsible for humeral motion can best be exercised in a rehabilitation program for the throwing athlete. Dynamic, fine wire, intramus cular electromyography was carried out in 15 normal male volunteers performing 17 shoulder exercises de rived from a shoulder rehabilitation program used by professional baseball clubs. The four rotator cuff mus cles were studied, as well as other positioners of the humerus, including the pectoralis major, latissimus dorsi, and three portions of the deltoid. The electro myographic activity was synchronized with cinematog raphy and averaged over 30° arcs of motion. An exer cise was considered to be a significant challenge for a muscle if it generated at least 50% of its predetermined maximum contraction over three consecutive arcs (i.e., a 90° range). Four exercises were consistently found to be among the most challenging exercises for every muscle. These shoulder exercises consisted of 1) ele vation in the scapular plane with thumbs down, 2) flexion, 3) horizontal abduction with arms externally rotated, and 4) press-up. This study documents that the minimum for an effective and succinct rehabilitation protocol for the glenohumeral muscles would include these exercises.
Injuries among young soccer players
Authors: Schmidt-Olsen Søren , Jørgensen Uffe , Kaalund Søren , Sørensen John
Published: June 2007

We registered all new injuries among 496 male youth soccer players, aged 12 to 18 years, during the course of one year. The incidence of injury was 3.7 injuries per 1000 hours of soccer per player. The incidence in creased with age, and at the higher ages within the youth players, approached the incidence rate of senior players (age ≥18 years).

Seventy percent of the injuries were located in the lower extremities, particularly the knee (26%) and ankle (23%). Back pain occurred in 14% of players. Fractures, which accounted for 4% of injuries, were most often in the upper extremities. We conclude that youth soccer is a relatively low-risk sport with an injury pattern that differs slightly from that of senior players.
A rationale for predicting anterior cruciate graft impingement by the intercondylar roof
Authors: Howell Stephen M. , Clark James A. , Farley Timothy E.
Published: June 2007

This study was designed to analyze how anterior tibial tunnel placement can result in graft impingement by the intercondylar roof. The relationship of the ACL to the intercondylar roof was studied using magnetic reso nance scans. An attempt was made to predict the amount of bone that may need to be removed from the intercondylar roof to prevent impingement on a 10 mm thick ACL graft.

Magnetic resonance scans of 19 normal ACLs were analyzed. The amount of bone removal required to correct roof impingement was determined for a graft placed either eccentrically or centrally within the ACL insertion, and within the bulk of the normal ACL fibers. An eccentric tibial tunnel placement required approxi mately 5 to 6 mm and a central placement required 2 to 3 mm of bone removal from the intercondylar roof to prevent impingement. Placing the graft within the bulk of the ACL fibers, just 3 mm posterior to the center of the ACL insertion, required little bone resection to prevent impingement.

To prevent ACL graft impingement, roofplasties need to be performed in both acute and chronic ACL recon structions if the presently accepted locations for posi tioning the tibial tunnel are used. A more anteriorly placed tibial tunnel requires more bone removal to prevent roof impingement than a more posteriorly po sitioned tibial tunnel.
Dynamic joint forces during knee isokinetic exercise
Authors: Kaufman Kenton R. , An Kai-Nan , Litchy William J. , Morrey Bernard F. , Chao Edmund Y.S.
Published: June 2007

This study analyzed forces in the tibiofemoral and pa tellofemoral joints during isokinetic exercise using an analytical biomechanical model. The results show that isokinetic exercise can produce large loads on these joints, especially during extension exercises. The tibio femoral compressive force (4.0 body weight) is approx imately equal to that obtained during walking but it occurs at 55° of knee flexion. Anterior shear forces (resisting force to anterior drawer) exist during exten sion exercise at less than 40° of knee flexion, with a maximum of 0.3 body weight. Posterior shear forces (resisting force to posterior drawer) exist during exten sion exercise at knee joint angles greater than 40° and during the flexion portion of isokinetic exercise. The maximum posterior shear force is 1.7 body weight. The patellofemoral joint can encounter loads as high as 5.1 body weight which are 10 times higher than during straight leg raises. These results suggest that isokinetic exercise should be used cautiously in patients with knee lesions.
The axial load teardrop fracture
Authors: Torg Joseph S. , Pavlov Helene , O'Neill Mary Jane , Nichols Claude E. , Sennett Brian
Published: June 2007

The anteroinferior cervical vertebral body corner frac ture was originally described by Schneider and Cann as the "teardrop" fracture. This report analyzes the biomechanical, clinical, and roentgenographic features of 55 such fractures obtained from the National Football Head and Neck Injury Registry. Teardrop fractures resulting from tackle football characteristically occurred in players attempting to make a tackle in which initial contact was made with the top or crown of the helmet. There were two fracture patterns associated with the anteroinferior corner (teardrop) fracture fragment: 1) the isolated fracture, which is usually not associated with permanent neurologic sequelae; and 2) the three- part, two-plane fracture in which there is an associated sagittal vertebral body fracture as well as fracture of the posterior neural arch. This latter pattern was almost always associated with permanent neurologic se quelae, specifically quadriplegia. Axial loading of the cervical spine was clearly identified as a mechanism of injury for both fracture patterns. Roentgenographic ex amination must include both anteroposterior and lateral views with computed tomography or tomography as necessary to determine the presence of the sagittal vertebral body fracture and the integrity of the posterior neural arch.
Neuropsychologic test performance in amateur boxers
Authors: Heilbronner Robert L. , Henry George K. , Carson-Brewer Martiece
Published: June 2007

Cognitive functions of 23 amateur boxers were as sessed immediately before and after an amateur boxing event. A range of cognitive measures were employed including tasks of verbal, figural, and incidental memory, motor functions, attention and concentration, and infor mation processing speed. Compared to their prefight performance, boxers demonstrated impairments in ver bal and incidental memory, but enhanced executive and motor functions postfight. There were no observed differences between winners and losers on any of the measures. The results are compared to other studies that have shown only minor changes in cognitive func tions in amateur boxers compared to controls.
In vivo measurement of anterior tibial translation using continuous passive motion devices
Authors: Drez David , Paine Russell M. , Neuschwander David C. , Young John C.
Published: June 2007

Early motion protocols following anterior cruciate re construction often use continuous passive motion de vices. There is concern that these devices may induce undesired anterior translation of the tibia and resulting graft stretching or rupture. This study measured the amount of anterior tibial translation that occurred during one cycle in 10 different brands of continuous passive motion devices. Five patients with ACL deficient knees participated in this study. Anterior translation was re corded by using an electrogoniometer with four degrees of freedom (Knee Signature System).

Anterior translation measurements were also re corded for a 20 pound Lachman test in these same five patients using the Knee Signature System. Two of the devices showed anterior translation measurements that approached the recorded 20 pound Lachman values. These two devices had a high calf bar for the primary support of the leg. The results indicate that, when using a continuous passive motion device for early postop erative management of the reconstructed ACL in a patient, use of a calf-supporting type of continuous passive motion could induce an undesired strain of the healing graft.
An experimental evaluation of isometric placement for extraarticular reconstructions of the anterior cruciate ligament
Authors: Kurosawa Hideki , Yasuda Kazunori , Yamakoshi Ken-Ichi , Kamiya Akira , Kaneda Kiyoshi
Published: June 2007

We measured the changes in distance between the tibial and femoral attachment points of the extraarticular ACL substitute during knee motion. To measure the changes in distance continuously and directly, a com puter-assisted experimental system was developed using an electrolyte-in-rubber transducer. We used 6 cadaveric knees to measure changes in distance of 15 combinations during a simple flexion and extension knee motion. The distance became longer with flexion in each pair of attachment locations. Although the small est change in distance was obtained between the pos terolateral site of the femoral distal metaphysis and a point posterior to the Gerdy tubercle (percent average of the maximum strain was about 12%), it was con cluded that the extraarticular ACL reconstruction is not recommended from a standpoint of isometry of the substitute.
Influence of local steroid injections on traumatized tendon properties
Authors: McWhorter J. Wesley , Francis R.S. , Heckmann R.A.
Published: June 2007

We investigated the effects of peritendon injections of hydrocortisone acetate on the separation force required to completely avulse a posttraumatized Achilles tendon of the adult male rat. One hundred thirty-five rats were randomly assigned to 3 groups and subsequently trau matized, treated, and sacrificed. One group was used to examine the effect of trauma; the second to examine effects of trauma and injections of hydrocortisone ace tate on the tension to failure strength of tendons; the third group was the control group. Injected animals received one, three, or five injections of 0.10 cc (125 mg/ml) hydrocortisone acetate and were sacrificed 3, 6, or 9 weeks following initial injection. Experimental animals (anesthetized) were traumatized by dropping a weight onto the Achilles tendon. The tendon was tested in tension to failure employing a soft tissue linear dis seminator. Histologic analysis using light microscopy was performed. We concluded that hydrocortisone ace tate has no deleterious effect on the rat Achilles tendon as measured biomechanically or histologically.
Anterior cruciate ligament reconstruction using quadriceps patellar tendon graft
Authors: Howe James G. , Johnson Robert J. , Kaplan Michael J. , Fleming Braden , Jarvinen Markku
Published: June 2007

Eighty-three patients with ACL reconstructions using the quadriceps patellar tendon graft were evaluated in a 10 year (mean, 5.5 years) follow-up study. A five-part analysis, consisting of physical examination, question naire, Genucom analysis, operative note review, and radiographs, was performed. Seventy-six percent were categorized as satisfactory. Ninety-two percent were content with their results, while only 4% were unsatis fied. Ninety-three percent of the patients had no signif icant pain and 95% had no giving way postreconstruc tion. Ninety-two percent had no more than a mild functional deficit. Eighty-seven percent and 90% of the patients had no significant Lachman or pivot shift by examination, respectively. Our results showed no in crease in failure over time (1 to 10 years), although those operated on during the initial 5 years showed more radiographic degenerative changes. Plotting our results in classification systems of other authors yielded success rates as good as or better than those using our own criteria. An objective means by which to quan tify laxity did not reliably correlate with the quantifying of laxity made by physical examination. Only the lack of a formal rehabilitation program greater than 4 months postoperatively and repaired tears of the medial or lateral collateral ligaments proved to be significant risk factors for poor recovery.
Anterior cruciate ligament reconstruction using quadriceps patellar tendon graft
Authors: Kaplan Michael J. , Howe James G. , Fleming Braden , Johnson Robert J. , Jarvinen Markku
Published: June 2007

Eighty-three patients, from a 10 year follow-up study, who underwent ACL reconstruction with a quadriceps patellar tendon graft were reviewed. A questionnaire qualifying their sports performance in 20 possible sports compared their preinjury status to postinjury and postreconstructive surgery. Successful and unsuccess ful patients, as determined by our previous investiga tion, were likewise compared.

Sports performance, regardless of the sport or level of competition, decreased substantially postinjury and then rose significantly to near but not equal to patient preinjury status. The most strenuous sports dipped to the lowest performance level after injury and returned with a correspondingly more modest gain after the reconstruction. Not surprisingly, successful patients had a more impressive return in performance than unsuccessful patients, mirroring their clinical grading. Of those deemed unsatisfactory (N = 20), graft failures were no worse off in performance rating than those that were classified as unsatisfactory because of per sistent symptoms.
Spine injuries in gymnasts and swimmers
Authors: Goldstein Jack D. , Berger Paul E. , Windler Gary E. , Jackson Douglas W.
Published: June 2007

Three groups of top level female gymnasts of preelite, elite, national and Olympic caliber were studied without regard to back pain or injury. These athletes were compared to a similar group of national caliber female swimmers. Magnetic resonance imaging scans of each participant were used to document disk or bony abnor malities. The relationship between magnetic resonance imaging findings and age, height, weight, previous in juries, back symptoms, and hours of training per week each year was examined.

Nine percent of preelite (1/11), 43% of elite (6/14), and 63% of Olympic level (5/8) gymnasts had spine abnormalities; 15.8% of all swimmers had spine abnor malities. Average hours of training per week and age were found to be associated with abnormalities seen on magnetic resonance imaging. Increased intensity and length of training correlated with previous data that suggests the female gymnast is prone to spine injuries.
Reliability of an isokinetic dorsiflexion and plantar flexion apparatus
Authors: Wennerberg Dean
Published: June 2007

The insufficient amount of research to support high reliability of isokinetic ankle joint adaptations indicates a need for study in this area. Certain brands of isokinetic machinery and specific joint apparatuses have been studied for consistency in adequate numbers of inves tigations, while there has been little research done on other brands and all other joint adaptations besides the knee. We studied the Biodex B-2000 dorsiflexion and plantar flexion adaptation for reliability between two trials of contractions measuring peak torque. Our re sults showed generally low reliability coefficients be tween trials in every condition tested with respect to each ankle motion and two different isokinetic speeds. No connection was seen between ankle motion and isokinetic speed with respect to reliability. Attempts to pinpoint reasons behind inconsistencies concentrate upon such areas as the subject testing position, time between trials, and machine structure. Areas of further study might deal with different brands of isokinetic devices and also the different joint adaptations.
Comparative biomechanical effects of the standard method of ankle taping and a taping method designed to enhance subtalar stability
Authors: Wilkerson Gary B.
Published: June 2007

The purpose of this study was to compare the restric tive effects of the widely recognized standard method of ankle taping with those of a modified ankle taping method that incorporates an additional component, the subtalar sling. Both ankles of 30 college football players were measured for maximal passive motion before taping, immediately after taping, and after a 2 to 3 hour football practice session. Downward and inward mo tions of the foot within the sagittal and frontal planes were induced separately and in combination with each other to allow quantification of four ankle motions. The data were analyzed by a 2 x 4 x 2 multivariate analysis of variance, a separate 2 x 3 analysis of variance for each of the four ankle motions, and the Newman-Keuls method of multiple comparisons of cell means. The results of this study suggest that the incorporation of the subtalar sling greatly enhances the protective func tion of ankle taping, but may impede performance of certain athletic skills.
Biomechanical analysis of rehabilitation in the standing position
Authors: Ohkoshi Yasumitsu , Yasuda Kazunori , Kaneda Kiyoshi , Wada Tatsuhiko , Yamanaka Masatomo
Published: June 2007

Biomechanical analysis of the two-dimensional models composed from roentgenographic pictures and electro myographic analysis of the shear force exerted on the tibia during standing on both legs were conducted in 21 young adult males. The simultaneous contraction of the quadriceps and hamstrings was observed in all electromyograms. Amplitude observed on electromy ograms of the hamstrings increased as the trunk flexion angle increased. The calculated average values of shear force were negative at every knee flexion angle (nega tive value means posteriorly directed force). As the trunk flexion angle increased, posterior drawer force increased at knee flexion angles of 30° and 60°. The simultaneous contraction of the quadriceps and the hamstrings was considered to be the main factor that influenced these results. Standing on both legs with knee and trunk flexion was considered to be applicable in the early stages after anterior cruciate ligament re construction.
Limitation of motion following anterior cruciate ligament reconstruction
Authors: Mohtadi Nicholas G.H. , Webster-Bogaert Susan , Fowler Peter J.
Published: June 2007

Limitation of motion following ACL reconstruction is a well-recognized and disturbing complication. The pur poses of this study were to identify and characterize those patients who developed this complication from a series of 527 ACL reconstructions, determine etiologic factors, and make recommendations regarding preven tion and management.

The case group included 37 patients who required a manipulation under anesthesia because of failure to gain a satisfactory range of motion after an ACL recon struction. Unsatisfactory motion was defined as a flex ion deformity of 10° or more and/or limitation of flexion to less than 120° by 3 months following ACL recon struction. The control group of patients were selected randomly from the overall series and all had a satisfac tory range of motion.

The cases and controls were then compared by analyzing these variables: age, sex, knee, time from injury to reconstruction, type of tissue used, meniscal abnormalities or surgery, repair of the medial collateral ligament, and postoperative immobilization and rehabil itation. The cases were followed up to assess the range of motion compared to the opposite knee at an average of 26 months postmanipulation.

Thirty-seven patients (7%) underwent a manipulation under anesthesia, 9 of these (24.3%) also had an arthroscopic arthrolysis. Reconstructions done less than 2 weeks postinjury showed a statistically signifi cant higher rate of knee stiffness. The same trend was also present for those reconstructed 2 to 6 weeks postinjury. All other variables failed to show a significant statistical difference. At followup, the average loss of extension was 4° and loss of flexion 5°.

The authors suggest that it is prudent to avoid im mediate reconstructive surgery. The stiff knee requires early aggressive management with a manipulation and or arthroscopic arthrolysis.
Arthroscopic meniscal repair evaluated by second-look arthroscopy
Authors: Morgan Craig D. , Wojtys Edward M. , Casscells Christopher D. , Casscells S. Ward
Published: June 2007

Of 353 arthroscopic peripheral meniscal repairs per formed using the "outside to inside" suturing technique with rasp preparation of the tear region, 74 repairs (50 medial and 24 lateral) were assessed by second-look arthroscopy and are the basis of this report. Results were graded as either healed, incompletely healed, or failed; these findings were correlated with clinical symp toms and associated ACL deficiency. Overall, asymp tomatic healing occurred in 84%, with 65% healed and 19% incompletely healed. The failure rate was 16%. All failures were symptomatic while all healed and incom pletely healed menisci were asymptomatic. Failure was associated with ACL deficiency in all cases. No failures occurred in either an ACL uninjured knee or an ACL reconstructed knee. Failure was also associated with tear location in the posterior horn of the medial menis cus. Eleven of 12 failures (92%) involved posterior medial meniscal tears with only 1 failure located pos terolaterally. Visual evidence of healing required a 4 month time interval.
Stress fractures
Authors: Giladi Michael , Milgrom Charles , Simkin Ariel , Danon Yehuda
Published: June 2007

To answer the question why such large differences in stress fracture morbidity rates (2% to 64%) exist in different countries, we prospectively evaluated 312 re cruits for possible risk factors for stress fractures. Prior to training, each recruit underwent an evaluation includ ing the following: orthopaedic examination, foot and tibial radiographs, measurements of tibial bone width, bone mineral content, bone density, aerobic physical fitness and leg power, assessments of somatotype and smoking habits, and evaluation of sociological and psy chological factors. Using a multivariate analysis, two risk factors were identified: recruits with stress frac tures had significantly narrower tibiae (P < 0.001), and a higher degree of external rotation of the hip (P = 0.016). These two variables were independent and cumulative. Stress fracture morbidity was 17%, 29%, and 45% when neither, one, or both risk factors were present, respectively (P < 0.001). Identification of these risk factors might explain the susceptibility of some people to stress fractures.
Arthrography, clinical examination, and stress radiograph in the diagnosis of acute injury to the lateral ligaments of the ankle
Authors: Raatikainen Timo , Putkonen Mikko , Puranen Jaakko
Published: June 2007

We examined 188 consecutive patients, each of whom had an acute ankle sprain, using clinical stability as sessment, stress radiographs, and arthrography to compare the reliability of these methods used in diag nosing lateral ligament ruptures of the ankle. Sixty-six of the ankles were treated operatively. Arthrography accurately detected ligament damage in all of the pa tients with this injury and revealed the extent of the injury in about 85%, whereas clinical examination and stress radiographs detected only about half of the injuries. The injuries and the results of these two meth ods were often controversial, as our study will show.
Treatment of acute isolated and combined ruptures of the anterior cruciate ligament
Authors: Andersson Christer , Gillquist Jan
Published: June 2007

From a total of 293 patients who had an acute, com plete anterior cruciate ligament rupture, we selected all patients (N = 55) who had an anterior cruciate ligament rupture without associated meniscal or ligamentous injuries, and all patients (N = 52) who had an anterior cruciate ligament rupture combined with a rupture, and subsequent primary repair, of the medial collateral lig ament. Initially, all patients were assigned to one of two groups: conservative treatment of the'anterior cruciate ligament or augmented anterior cruciate ligament repair with the iliotibial band. In the 52 patients who had an anterior cruciate ligament rupture combined with a me dial collateral ligament rupture, the associated injuries to the medial collateral ligament and sometimes the posterior oblique ligament, meniscus, and arcuate lig ament complex were treated in a similar fashion, with out regard to the treatment of the anterior cruciate ligament. Ninety-nine patients (93%) were reexamined 35 to 74 months after the injury, and knee function was evaluated with subjective and objective criteria, includ ing functional tests. Patients who had been treated with augmented anterior cruciate ligament repair had supe rior stability with better subjective results and returned to strenuous activities more frequently than patients who had undergone conservative treatment. In those patients who had augmented repair, the prognosis did not differ between those who had isolated lesions and those who had combined lesions. Conservative treat ment of the anterior cruciate ligament with repair of the medial collateral ligament and other associated injuries, when present, resulted in an almost equally unfavorable outcome for patients with combined and isolated an terior cruciate ligament lesions.
The injury experience and training history of the competitive skier with a disability
Authors: Ferrara Michael S. , Buckley William E. , Messner Duane G. , Benedict Jack
Published: June 2007

The purpose of this investigation was to describe the training history and injury experience of the competitive skier with a disability. A retrospective survey was ad ministered to 68 athletes who participated in the Na tional Handicapped Sports and the United States As sociation for Blind Athletes Winter National Games held in March 1989. The frequency, length, and specific components of the practice session were obtained. The definition of injury was any trauma to the participant that occurred during any practice, training, or competi tive session that resulted in the cessation, limitation, or modification of the athlete's participation for at least 24 hours. The athletes practiced aerobic, anaerobic, and strength training activities two times a week or less. Upper extremities were injured 1.4 times more often than the lower extremities. The number of chronic injuries was greater than the number of acute injuries for both the upper and lower extremity. The thigh and knee were involved in 30% of the acute injuries, fol lowed by the shoulder (25%), and neck and spine (15%). For chronic injuries, the shoulder, thigh/knee complex, and arm and elbow accounted for 73.3% of the total injuries reported. The skier with a disability incurred approximately the same proportion of injuries as the skier without a disability. Conditioning programs should be developed to emphasize both the aerobic and anaerobic energy systems to reduce the number of injuries.
An algorithm for arthroscopy in the over-50 age group
Authors: Wouters Erich , Bassett Frank H. , Hardaker William T. , Garrett William E.
Published: June 2007

We conducted a retrospective study to identify the preoperative variables that correlated with a successful outcome for knee arthroscopy in patients over the age of 50. We mailed questionnaires to 94 patients (57 responded) and reviewed their medical records and radiographs. A modified Hospital for Special Surgery knee rating system was devised. The average followup was 33 months. The percentage of those who felt they had successful results decreased with time: 82.8% felt their knees had improved immediately after postoper ative rehabilitation; this decreased to 78.1% at 6 months, 73.5% at 1 year, 65.5% at 2 years, and 50.0% at 3 years. Therefore, the subjective success rate was 67%. We performed statistical analysis of all variables to determine which had a beneficial or detrimental effect on outcome. In addition, we devised an equation to allow postoperative prediction of score. We found that age was not a factor and that radiographic findings had the greatest impact on postoperative results.