bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Prospective Randomized Study of Patellar versus Hamstring Tendon Autografts for Anterior Cruciate Ligament Reconstruction
Authors: Jansson Kim A. , Linko Eric , Sandelin Jerker , Harilainen Arsi 
Published: July 2017

Background Bone-patellar tendon-bone graft has been the most commonly used graft material in anterior cruciate reconstructions, but there has been increasing use of hamstring tendon grafts. However, no existing clinical studies show adequate support for the choice of one graft over the other. Hypothesis Hamstring tendons are equally as good as patellar tendon in anterior cruciate ligament reconstructions. Study Design Prospective randomized clinical trial. Methods Ninety-nine patients with laxity caused by a torn anterior cruciate ligament underwent arthroscopically assisted reconstruction with graft randomization according to their birth year. Grafts were either bone-patellar tendon-bone with metal interference screw fixation or double-looped hamstring tendons with metal plate fixation. There were no significant differences between the two groups preoperatively or at operation. Standard rehabilitation included immediate postoperative mobilization without a knee brace, protected weightbearing for 2 weeks, and return to full activity at 6 to 12 months. Results Forty-three patients in the patellar tendon group and 46 patients in the hamstring tendon group were available for clinical evaluation at a minimum of 21 months after surgery. No statistically significant differences were seen with respect to clinical and instrumented laxity testing, International Knee Documentation Committee Score ratings, isokinetic muscle torque measurements, and Kujala patellofemoral, Lysholm, and Tegner scores. Conclusion Equal results were seen for patellar and hamstring tendon autograft anterior cruciate ligament reconstructions at 2 years after surgery. Both techniques seem to improve patients' performance.
Subscapularis Muscle Activity during Selected Rehabilitation Exercises
Authors: Decker Michael J. , Tokish John M. , Ellis Henry B. , Torry Michael R. , Hawkins Richard J. 
Published: July 2017

Background The upper and lower portions of the subscapularis muscle are independently innervated and activated. Hypothesis Upper and lower portions of the subscapularis muscle demonstrate different activation levels and require different exercises for rehabilitation. Study Design Controlled laboratory study. Methods Fifteen healthy subjects performed seven shoulder-strengthening exercises. Electromyographic data were collected from the latissimus dorsi, teres major, pectoralis major, infraspinatus, supraspinatus, and upper and lower subscapularis muscles. Results Upper subscapularis muscle activity was greater than lower subscapularis muscle activity for all exercises except for internal rotation with 0° of humeral abduction. The push-up plus and diagonal exercises consistently stressed the upper and lower subscapularis muscles to the greatest extent. Conclusions Humeral abduction was found to have a strong influence on the selective activation of the upper versus the lower subscapularis muscle and thus supported the design of different exercise continuums. In addition, the push-up plus and diagonal exercises were found to be superior to traditional internal rotation exercises for activating both functional portions of the subscapularis muscle. Clinical Relevance Our results showing that the upper and lower portions of the subscapularis muscle are functionally independent may affect training or rehabilitation protocols for the rotator cuff muscles.
Capsular Elongation in Shoulders with Recurrent Anterior Dislocation
Authors: Urayama Masakazu , Itoi Eiji , Sashi Ryuji , Minagawa Hiroshi , Sato Kozo 
Published: July 2017

Background Elongation of the shoulder capsule is often noticed on arthrograms or during surgery in shoulders of patients who have experienced recurrent anterior dislocations. Hypothesis We can quantify the elongation of the capsule in shoulders with recurrent anterior dislocations by using magnetic resonance arthrography. Study Design Retrospective review of prospectively collected data. Methods Twelve patients with unilateral recurrent anterior shoulder dislocations were enrolled in this study. Magnetic resonance images in the axial and coronal oblique planes were obtained from both shoulders (involved and uninvolved sides) after 10 ml of gadolinium/saline solution was injected into the glenohumeral joint. The length of the anteroinferior, inferior, and posteroinferior portions of the capsule was measured by using image analyzing software and normalized to the humeral head diameter. Results The anteroinferior capsule was significantly elongated in the involved shoulder at 4 mm (16% elongation) and 10 mm (19% elongation) superior to the inferior margin of the glenoid. The inferior capsule was also significantly elongated in the involved side both at the center (12% elongation) and at 4 mm anterior to the center of the glenoid (29% elongation). The posteroinferior capsule did not show any significant elongation. Conclusions The anteroinferior and inferior portions of the shoulder capsule are elongated an average of 19% in shoulders with recurrent anterior dislocation.
Effect of Preexisting Back Pain on the Incidence and Severity of Back Pain in Intercollegiate Rowers
Authors: O'Kane John W. , Teitz Carol C. , Lind Bonnie K. 
Published: July 2017

Background Back pain is a common problem among rowers. Purpose To determine whether preexisting back pain is a significant risk factor for back pain in intercollegiate rowers and how it relates to the ability of athletes to participate in college rowing. Study Design Survey. Methods Surveys from 1829 former intercollegiate rowing athletes were analyzed. The surveys included questions concerning back pain before the subjects' college career, back pain during intercollegiate rowing, missed practices, the duration of time lost from college rowing because of back pain, and career-ending back pain. Back pain was defined as pain lasting longer than 1 week. Results More subjects with preexisting back pain developed back pain during their college rowing career than subjects without preexisting back pain (57.1% versus 36.6%). Of those with preexisting pain, 55% missed practice because of back pain and 8% ended their college rowing careers; for those without preexisting pain, the percentages were 62% and 17%, respectively. For subjects with pain before their college rowing career, 78.8% missed less than 1 week and 5.9% missed more than 1 month. For subjects with no preexisting pain, 61.9% missed less than 1 week and 18.1% missed more than 1 month. Conclusions While rowers with preexisting back pain are more likely to have back pain in college, they are less likely to miss extended periods of practice time or end their college rowing careers because of back pain.
Reproducibility and Reliability of the Outerbridge Classification for Grading Chondral Lesions of the Knee Arthroscopically
Authors: Cameron Michelle L. , Briggs Karen K. , Steadman J. Richard 
Published: July 2017

Background Few studies have investigated the accuracy and reproducibility of the Outerbridge classification system for classification of chondral damage in the knee. Hypothesis Arthroscopically assigned Outerbridge grades are accurate, reliable, and reproducible. Study Design Cadaver study. Methods Six cadaveric knees underwent diagnostic arthroscopy, which was videotaped. An arthrotomy was then performed and the arthroscopically identified lesions were measured with calipers. Nine orthopaedic surgeons reviewed each video and graded each chondral lesion two separate times. Accuracy of observations was calculated based on the percentage of agreement between the grades determined during arthroscopy and arthrotomy. Results The overall accuracy was 68% but varied by location. The kappa coefficient between the two scores was 0.602; the arthroscopy grade was higher than the arthrotomy grade 63% of the time. The intraobserver and interobserver kappa coefficients were 0.80 and 0.52, respectively. The mean interobserver kappa between the two physicians in practice 5 years or more was 0.72, compared with 0.50 for physicians in practice less than 5 years. Conclusions The Outerbridge classification was moderately accurate when used to grade chondral lesions arthroscopically. Clinical Relevance Orthopaedic surgeons can accurately grade chondral lesions of the knee with the Outerbridge classification, regardless of their level of experience.
The Incidence of Injuries in Elite Junior Figure Skaters
Authors: Dubravcic-Simunjak Sanda , Pecina Marko , Kuipers Harm , Moran Jane , Haspl Miroslav 
Published: July 2017

Background There has been rapid growth in the technical and physiologic demands made on skaters who perform more and more difficult jumps, spins, lifts, throws, and free skating movements. Purpose To investigate the frequency of injuries and overuse syndromes in elite junior skaters. Study Design Questionnaire. Methods During four consecutive Junior World Figure Skating Championships and the Croatia Cup, we interviewed 236 female and 233 male skaters by questionnaire to determine the frequency of injuries and overuse syndromes. Results Fifty-nine of the female skaters (25%) and 65 of the male skaters (27.9%) reported sustaining acute injuries; 101 female (42.8%) and 106 male (45.5%) skaters reported overuse syndromes. Low back pain was reported by 19 female and 23 male skaters. The most frequent acute injury was ankle sprain. In singles female skaters, the most frequent overuse injury was stress fracture (19.8%), followed by jumper's knee (14.9%). In singles male skaters, jumper's knee (16.1%) was the most frequent injury, followed by Osgood-Schlatter disease (14.2%). More than 50% of injuries in young singles figure skaters involved overuse syndromes. Pairs skaters and ice dance skaters had a higher risk of acute injury than overuse syndrome because of falls from lifts and throw jumps. Conclusions Programs to improve postural alignment, flexibility, and strength, especially during the asynchronous period of bone and soft tissue development, should be instituted to prevent and reduce overuse syndromes.
Influence of Medial Hamstring Tendon Harvest on Knee Flexor Strength after Anterior Cruciate Ligament Reconstruction
Authors: Tashiro Toshiyuki , Kurosawa Hisashi , Kawakami Akira , Hikita Atsuhiko , Fukui Naoshi 
Published: July 2017

Background The advantages of hamstring tendon autografts for anterior cruciate ligament reconstruction are well known; however, concerns have arisen regarding the influence of hamstring tendon harvest on postoperative weakness in knee flexion. Purpose To evaluate the influence of hamstring tendon harvest on knee flexion strength in patients undergoing anterior cruciate ligament reconstruction. Study Design Prospective randomized study. Methods Ninety patients were randomly assigned at surgery to undergo anterior cruciate ligament reconstruction with either a semitendinosus tendon autograft or a semitendinosus and gracilis tendon autograft. Quadriceps and hamstring muscle strength was tested before surgery and at 6, 12, and 18 months after surgery. Results There was no significant difference in clinical results between the groups and neither group showed a significant decrease in isokinetic hamstring muscle strength. However, when the subjects’ knees were at positions of 70° or more of flexion, both isokinetic and isometric measurements revealed a significant decrease in hamstring muscle strength in both groups. The strength in the group with semitendinosus and gracilis tendons was considerably less than that in the group with semitendinosus tendon alone at 18 months. Conclusions Tendon harvest causes significant weakness of hamstring muscle strength at high knee flexion angles, but such weakness can be minimized if the gracilis tendon is preserved.
Poly-L-lactic Acid Tack Synovitis after Arthroscopic Stabilization of the Shoulder
Authors: Freehill Michael Q. , Harms Dana J. , Huber Shane M. , Atlihan Dogan , Buss Daniel D. 
Published: July 2017

Background Progress has been made in the design of bioabsorbable implants, with reduced complication rates and slower degradation times. Purpose To report on complications related to use of poly-L-lactic acid implants after arthroscopic shoulder stabilization procedures. Study Design Retrospective cohort study. Methods Between 1997 and 1999, 52 patients underwent arthroscopic stabilization at one institution with an average of 2.2 poly-L-lactic acid tacks. Ten patients (19%), with an average age of 30 years, developed delayed onset of symptoms at an average of 8 months after surgery, including pain in all 10 and progressive stiffness in 6. The patients underwent magnetic resonance imaging and arthroscopic evaluation and debridement. Results Nine patients had gross implant debris. Evidence of glenohumeral synovitis was seen arthroscopically in all 10 patients. Three patients had significant full-thickness chondral damage on the humeral head. All preexisting labral lesions were healed. One year after arthroscopic debridement, loose body removal, and synovectomy, seven patients reported no or minimal pain and full return of motion. Two patients continued to have persistent pain and stiffness, and one patient reported discomfort with overhand throwing; all three had chondral lesions. Conclusions Patients with symptoms of delayed pain and progressive stiffness after arthroscopic stabilization with poly-L-lactic acid implants should be evaluated for synovitis and chondral injury. Arthroscopic treatment provides a significant decrease in symptoms and increased range of motion.
The Effects of Compressive Load and Knee Joint Torque on Peak Anterior Cruciate Ligament Strains
Authors: Fleming Braden C. , Ohlén Goran , Renström A. , Peura Glenn D. , Beynnon Bruce D. , Badger Gary J. 
Published: July 2017

Background High graft strains incurred during rehabilitation after anterior cruciate ligament reconstruction may be minimized if an external compressive load is simultaneously applied to the joint during closed kinetic chain exercises. Hypotheses Peak anterior cruciate ligament strains will 1) increase with an increase in resistance torque during an exercise that involves concentric contraction of the extensor mechanism, 2) decrease with an increase in resistance torque during an exercise that involves concentric contraction of the flexors, and 3) decrease when an external compressive load is applied to the knee during both exercises relative to the no external compressive load condition. Study Design Controlled laboratory study. Methods Strains in the anteromedial bundle were measured in 10 subjects with normal ligaments. Flexor and extensor exercises were performed against controlled resistance torques with and without a compressive load applied to the foot. Results An increase in resistance produced an increase in peak anterior cruciate ligament strain for the extensor exercise with no compressive load applied. During the flexor exercise without a compressive load, an increase in resistance produced a decrease in peak strains. During the extensor exercise, the peak anterior cruciate ligament strain was not reduced with the application of the external compressive force. Conclusions Extensor and flexor exercises that incorporate an external compressive load do not shield the anterior cruciate ligament from strain. However, no additional increase in strain occurs with an increase in resistance when the external compressive load is applied. Thus, it may be possible to increase the activity of the quadriceps muscles without increasing the strain by applying a compressive load (as with closed kinetic chain exercises).
Meniscal Repair Compared with Meniscectomy for Bucket-Handle Medial Meniscal Tears in Anterior Cruciate Ligament-Reconstructed Knees
Authors: Shelbourne K. Donald , Carr Donald R. 
Published: July 2017

Background Repair of meniscal tears is generally preferred over meniscectomy. Hypothesis Repair of unstable bucket-handle tears of the medial meniscus leads to better outcomes than partial meniscectomy. Study Design Retrospective review of prospectively collected data. Methods We reviewed the records of 155 patients who had isolated bucket-handle medial meniscal tears and anterior cruciate ligament tears. Fifty-six menisci were repaired; 99 that were degenerative and crushed beyond repair were removed. Patients were evaluated at a mean follow-up of 6 to 8 years after surgery with the International Knee Documentation Committee examination and a modified Noyes questionnaire. Results The mean subjective scores were similar for patients in both the repair (N = 51) and meniscectomy (N = 87) groups. However, in the repair group, the mean subjective score of 93.9 for nondegenerative menisci was significantly better than the 87.1 for degenerative menisci. Objective grades for 25 patients in the repair group were normal or nearly normal in 22 patients (88%) and for 51 of 56 patients (91%) in the removal group. Radiographic subscores for the repair group were normal or nearly normal in 23 patients in the repair group and 49 in the removal group. Conclusion Outcomes from meniscal repair were not superior to those from partial removal. Patients with repaired degenerative tears had significantly lower subjective scores than those with nondegenerative tears.
Thumb Amputations from Team Roping
Authors: Moneim Moheb S. , Firoozbakhsh Keikhosrow , Gross Dominic , Young Steven D. , Omer George 
Published: July 2017

Background Thumb injuries during team roping have elements of both avulsion and crush, resulting in a poor prognosis for replantation success. Purpose To review 19 cases of thumb amputation from team roping at our institution since 1983. Study Design Retrospective cohort study. Methods Cases were included in the study only if a microvascular repair of artery and vein was needed for the thumb to survive. Vein grafts were used to span the damaged vessel segment. Of the 19 thumb amputation cases, 15 attempts were made to replant the thumb. In the remaining four cases, patients had bone shortening and primary closure. The force of injury was calculated based on mechanism. Results Of the 15 attempts at replantation, only 5 (33%) were successful, despite meticulous technique. One patient subsequently had an emergency toe-to-thumb transfer after an unsuccessful replant, and the remaining nine underwent amputation. Nine of the 10 patients with failed replants had poor flow intraoperatively. In the group of patients younger than 15, the success was 3 of 5 (60%) and in the group 15 years or older the success was 2 of 10 attempts (20%.) Follow-up was available in 13 of the 15 cases of replanted thumbs. Conclusions All patients were subjectively satisfied with their results, and all patients with successful replants and seven patients with no thumb returned to rodeo. Biomechanical analysis showed a huge amount of force and pressure, several times larger than that of ring avulsion injury, results when a steer pulls on the thumb.
Partial Tears of the Subscapularis Tendon Found during Arthroscopic Procedures on the Shoulder
Authors: Kim Tae Kyun , Rauh Peter B. , McFarland Edward G. 
Published: July 2017

Background Prevalence and clinical significance of partial tears of the subscapularis tendon have not been widely studied. Purpose To determine prevalence of and clinical factors associated with partial tears of the subscapularis tendon at arthroscopy. Study Design Case control study. Methods During arthroscopic procedures on 314 consecutive shoulders, the arthroscopically visible portion of the subscapularis tendon was probed. Patients with and without partial tears were compared for prospectively identified variables. Results Partial tears were found in 60 of the 314 patients (19%). Increasing age and dominant arm involvement were significant variables for partial tears. Significantly associated factors included supraspinatus tendon tears (54 of 60; 90%), rotator cuff disease (44 of 60, 73%), and posterosuperior labral fraying (34 of 47, 72%). Increasing age, dominant arm involvement, and coexisting infraspinatus tendon tears were strong independent risk factors for partial tears. Conclusion Partial tears of the subscapularis tendon are not uncommon findings during shoulder arthroscopic procedures and are associated with extensive rotator cuff disease. They do not appear to be associated with glenohumeral instability, but a possible association with atypical forms of instability (subclinical or superior instability) cannot be excluded by this study. The absence of a significant association between the lesion and specific subjective symptoms or physical findings suggests that caution should be taken when attributing a specific symptom to this condition.
Is Psychosis a Neurobiological Syndrome?
Authors: Fujii Daryl E , Ahmed Iqbal 
Published: July 2017

Objective: To describe theoretical weaknesses in the DSM-IV criteria for psychotic disorders and to argue that schizophrenia-like psychosis is a neurobiological syndrome similar to aphasia or apraxia. Method: We outline the criteria for the concept of neurobiological syndrome and present supporting evidence for schizophrenia-like psychosis as a neurobiological syndrome. Results: There is evidence in the literature to support the hypothesis that schizophrenia-like psychosis is a neurobiological syndrome. Conclusion: Conceptualizing schizophrenia-like psychosis as a neurobiological syndrome has important implications for both clinicians and researchers.
PET and SPECT Imaging in Psychiatric Disorders
Authors: Zipursky Robert B , Meyer Jeffrey H , Verhoeff N Paul 
Published: July 2017

Objectives: To review recent findings from positron emission tomography (PET) and single photon emission computed tomography (SPECT) studies that investigate the pathophysiology and treatment of schizophrenia, depression, and dementia. Methods: We carried out a review of the literature. Results: PET and SPECT studies have provided evidence of dopamine system dysregulation in patients with schizophrenia and variable loss of monoamines in patients with depression. Antipsychotic response has been demonstrated to be associated with blockade of dopamine D2 receptors, and antidepressant response has now been linked to blockade of serotonin transporter receptors. PET and SPECT have been extensively evaluated as diagnostic procedures for dementia. Substantial progress has been made in developing radioligands that bind to amyloid deposits in the brain, which should provide new opportunities for early diagnosis and treatment monitoring in Alzheimer's disease. Conclusion: Advances in PET and SPECT imaging have provided new insights into the biology of major psychiatric disorders and their treatment. In the future, we can expect that these imaging techniques will become more central to the management of psychiatric disorders.