bluuebunny/crossref_metadata_2025_split huggingface dataset:
Augmented Feedback Supports Skill Transfer and Reduces High-Risk Injury Landing Mechanics
Authors: Myer Gregory D. , Stroube Benjamin W. , DiCesare Christopher A. , Brent Jensen L. , Ford Kevin R. , Heidt Robert S. , Hewett Timothy E. 
Published: February 2013

Background: There is a current need to produce a simple, yet effective method for screening and targeting possible deficiencies related to increased anterior cruciate ligament (ACL) injury risk. Hypothesis: Frontal plane knee angle (FPKA) during a drop vertical jump will decrease upon implementing augmented feedback into a standardized sport training program. Study Design: Controlled laboratory study. Methods: Thirty-seven female participants (mean ± SD: age, 14.7 ± 1.5 years; height, 160.9 ± 6.8 cm; weight, 54.5 ± 7.2 kg) were trained over 8 weeks. During each session, each participant received standardized training consisting of strength training, plyometrics, and conditioning. They were also videotaped running on a treadmill at a standardized speed and performing a repeated tuck jump for 10 seconds. Study participants were randomized into 2 groups and received augmented feedback on either their jumping (AF) or sprinting (CTRL) form. Average (mean of 3 trials) and most extreme (trial with greatest knee abduction) FPKA were calculated from 2-dimensional video captured during performance of the drop vertical jump. Results: After testing, a main effect of time was noted, with the AF group reducing their FPKA average by 37.9% over the 3 trials while the CTRL group demonstrated a 26.7% reduction average across the 3 trials ( P < .05). Conversely, in the most extreme drop vertical jump trial, a significant time-by-group interaction was noted ( P < .05). The AF group reduced their most extreme FPKA by 6.9° (pretest, 18.4° ± 12.3°; posttest, 11.4° ± 10.1°) on their right leg and 6.5° (pretest, 16.3° ± 14.5°; posttest, 9.8° ± 10.7°) on their left leg, which represented a 37.7% and 40.1% reduction in FPKA, respectively. In the CTRL group, no similar changes were noted in the right (pretest, 16.9° ± 14.3°; posttest, 14.0° ± 12.3°) or left leg (pretest, 9.8° ± 11.1°; posttest, 7.2° ± 9.2°) after training. Conclusion: Providing athletes with augmented feedback on deficits identified by the tuck jump assessment has a positive effect on their biomechanics during a different drop vertical jump task that is related to increased ACL injury risk. The ability of the augmented feedback to support the transfer of skills and injury risk factor reductions across different tasks provides exciting new evidence related to how neuromuscular training may ultimately cross over into retained biomechanics that reduce ACL injuries during sport. Clinical Relevance: The tuck jump assessment’s ease of use makes it a timely and economically favorable method to support ACL prevention strategies in young girls.
Isolation and Characterization of Human Mesenchymal Stem Cells Derived From Shoulder Tissues Involved in Rotator Cuff Tears
Authors: Utsunomiya Hajime , Uchida Soshi , Sekiya Ichiro , Sakai Akinori , Moridera Kuniaki , Nakamura Toshitaka 
Published: February 2013

Background: Recent studies report a relatively high failure rate for tendon-bone healing after rotator cuff repair. Several studies have investigated biologically augmented rotator cuff repair; however, none has shown the application of synovial mesenchymal stem cells for such repair. Purpose: To demonstrate whether cells derived from shoulder tissues have mesenchymal stem cell properties and to identify which tissue is the best source of the mesenchymal stem cells. Study Design: Controlled laboratory study. Methods: Forty-two patients with a diagnosed rotator cuff tear preoperatively were enrolled in this study. Human mesenchymal tissues were obtained during arthroscopic surgery for rotator cuff tears from 19 donors who met the inclusion criteria and had investigable amounts of tissue. Colony-forming units, yield obtained, expandability, differentiation potential, epitope profile, and gene expression were compared among the cells from 4 shoulder tissues: synovium of the glenohumeral joint, subacromial bursa, margin of the ruptured supraspinatus tendon, and residual tendon stump on the greater tuberosity (enthesis). Results: The number of live passage 0 cells from whole tissue was significantly higher in cells derived from the subacromial bursa ( P < .05). Subacromial bursa–derived cells retained their expandability even at passage 10. In adipogenesis experiments, the frequency of Oil Red O–positive colonies was significantly higher for synovium- and subacromial bursa–derived cells than for tendon- and enthesis-derived cells ( P < .0001). In studies of osteogenesis, the rate of von Kossa– and alkaline phosphatase–positive colonies was highest in subacromial bursa–derived cells ( P < .0001). The chondrogenic potential was highest in cells derived from the enthesis. For epitope profiling, 11 surface antigens were measured, and most had similar epitope profiles, irrespective of cell source. Conclusion: The findings indicate that the subacromial bursa is a good candidate for the source of mesenchymal stem cells in rotator cuff tears. Clinical Relevance: Synovial cells from the subacromial bursa in patients with rotator cuff tears are a superior cell source in vitro, suggesting that mesenchymal stem cells from this tissue could be good candidates for biological augmentation of rotator cuff repair.
Arthroscopically Assisted 2-Bundle Anatomic Reduction of Acute Acromioclavicular Joint Separations
Authors: Venjakob Arne J. , Salzmann Gian M. , Gabel Florian , Buchmann Stefan , Walz Lars , Spang Jeffrey T. , Vogt Stephan , Imhoff Andreas B. 
Published: February 2013

Background: Currently, no clinical midterm results have been reported on arthroscopically assisted reduction of the acutely dislocated acromioclavicular (AC) joint using suture-button devices for fixation. Hypothesis: Athroscopically assisted reduction of the acutely dislocated AC joint yields satisfactory clinical outcomes without loss of reduction, clavicle migration, or AC joint degeneration at midterm follow-up evaluation. Study Design: Case series; Level of evidence, 4. Methods: The clinical and radiographic outcomes of 23 of 30 consecutive patients (21 men, 2 women) who underwent anatomic reduction for acute AC joint dislocation using 2 suture-button devices between 2006 and 2007 were reviewed. Radiographic evaluation was performed by measurement of coracoclavicular (CC) distance and AC displacement. Clinical evaluation included a visual analog scale (VAS) for pain, the Constant score, the simple shoulder test, and the Short Form–36. Previously, this same patient collective was reviewed after 2 years of follow-up using similar methods. Results: All 23 patients were available for midterm follow-up examination 58 months postoperatively. There were 3 Rockwood type III, 3 type IV, and 17 type V acromioclavicular joint separations. Mean ± SD follow-up was 58 ± 5.6 months (range, 51-67 months). Most patients (96%) remained very satisfied or satisfied with the procedure outcome. The VAS and Constant score improved significantly when compared with baseline (0.3 ± 0.6 and 91.5 ± 4.7 at 58 months postoperatively vs 4.5 ± 1.9 and 34.5 ± 6.9 at baseline) and remained essentially unchanged when compared with the 2-year outcome scores (0.3 ± 0.6 and 91.5 ± 4.7 at 58 months postoperatively vs 0.25 ± 0.5 and 94.3 ± 3.2 at 2 years). Radiographs showed 8 radiographic failures (undercorrection, posterior displacement, or both) and 4 additional overcorrections of the CC distance. When comparing with 24-month data, 17 of 20 radiographs remained unchanged; 1 case of previous overcorrection drifted into normal AC alignment and 2 cases increased in posterior subluxation of the clavicle. Conclusion: Arthroscopically assisted reduction of the acutely dislocated AC joint provides satisfactory clinical results 58 months after surgery. Compared with the baseline, all patients improved significantly. Two of 23 patients revealed an increased posterior dislocation compared with evaluation 24 months after surgery. No further migration of the clavicle or AC joint degeneration was observed.
Effect of Meniscal and Focal Cartilage Lesions on Patient-Reported Outcome After Anterior Cruciate Ligament Reconstruction
Authors: Røtterud Jan Harald , Sivertsen Einar A. , Forssblad Magnus , Engebretsen Lars , Årøen Asbjørn 
Published: February 2013

Background: The effect of concomitant intra-articular injury on patient-reported outcome after anterior cruciate ligament (ACL) reconstruction is debated. Purpose: To evaluate the effect of meniscal and articular cartilage lesions on patient-reported outcome 2 years after ACL reconstruction. Study Design: Cohort study (prognosis); Level of evidence, 2. Methods: The study included all patients with primary, unilateral ACL reconstruction registered in the Norwegian and the Swedish National Knee Ligament Registry from 2005 through 2008 who had completed the Knee Injury and Osteoarthritis Outcome Score (KOOS) Knee-Related Quality of Life subscale at a 2-year follow-up (mean ± SD, 2.1 ± 0.2 years) after surgery (n = 8476). Multiple linear regression analyses were used to evaluate the associations between each KOOS subscale (Pain, Other Symptoms, Activities of Daily Living, Sport and Recreation Function, Knee-Related Quality of Life) as the measure for patient-reported outcome and meniscal and cartilage lesions. Results: A total of 3674 (43%) patients had meniscal lesion(s), 1671 (20%) had partial-thickness (International Cartilage Repair Society [ICRS] grades 1-2) cartilage lesion(s), and 551 (7%) had full-thickness (ICRS grades 3-4) cartilage lesion(s). Multiple linear regression analyses detected no significant associations between meniscal lesions or partial-thickness cartilage lesions and the scores in any of the KOOS subscales at the 2-year follow-up. Full-thickness cartilage lesions were significantly associated with decreased scores in all of the KOOS subscales. Conclusion: Patients with concomitant full-thickness cartilage lesions reported worse outcome in all of the KOOS subscales compared with patients without cartilage lesions 2 years after ACL reconstruction. Meniscal lesions and partial-thickness cartilage lesions did not impair patient-reported outcome 2 years after ACL reconstruction.
Endoscopic Anterior Cruciate Ligament Reconstruction in Children Using Living Donor Hamstring Tendon Allografts
Authors: Goddard Martin , Bowman Nicholas , Salmon Lucy J. , Waller Alison , Roe Justin P. , Pinczewski Leo A. 
Published: February 2013

Background: The incidence of anterior cruciate ligament (ACL) injuries in children is increasing, but ACL reconstruction with traditional autograft sources is associated with high rates of further ACL injury when compared with adult populations. The outcome of ACL reconstruction using an alternative graft source, the living donor hamstring tendon (HT) allograft, has not been reported. Purpose: To determine the outcome of endoscopic transphyseal single-tunnel ACL reconstruction using living donor HT allografts. Study Design: Case series; Level of evidence, 4. Methods: Between 2007 and 2008, 32 children underwent endoscopic transphyseal single-tunnel ACL reconstruction using living donor HT allografts. The HT allograft was harvested from a parent. At a minimum 2 years’ follow-up, full International Knee Documentation Committee (IKDC) knee ligament examination was performed on the children including instrumented testing using the KT-1000 arthrometer. Donors underwent subjective review at a minimum 2 years’ follow-up. Results: Thirty-one children (97%) were able to be contacted for review. Of these, 2 (6%) sustained an ACL graft rupture within 2 years after surgery. Twenty-nine children completed clinical and subjective review. The mean age at ACL reconstruction was 13 years (range, 8-16 years). The mean HT graft size was 7.2 mm (range, 6-8 mm). The mean IKDC subjective score was 97 (range, 84-100). Twenty-eight patients (97%) had a normal or nearly normal IKDC ligament grade. At 2 years after surgery, 27 patients (93%) reported regularly participating in very strenuous or strenuous activities. There were no cases of limb malalignment. Twenty eight (97%) of the donors reported that they would undergo the same procedure again under the same circumstances. Conclusion: Excellent clinical and subjective outcomes were achieved with high levels of return to desired activities. This technique allows a more predictable size of the HTs compared with an autograft from the child and maintains an intact neuromuscular hamstring structure in the child. Finally, the child’s own HTs are reserved for future use. Anterior cruciate ligament reconstruction using living donor allografts should be considered a viable choice in children.
Does Computed Tomography Add Information on Radiographic Analysis in Detecting Periprosthetic Osteolysis After Total Ankle Arthroplasty?
Authors: Kohonen Ia , Koivu Helka , Pudas Tomi , Tiusanen Hannu , Vahlberg Tero , Mattila Kimmo 
Published: February 2013

Background: The major longer term complications of ankle arthroplasty are periprosthetic osteolysis and aseptic loosening. Follow-up studies of total hip arthroplasties show that measurements of periprosthetic osteolytic lesions on radiographs underestimate the size compared with those made on computed tomography (CT), and some of the lesions may even remain undetected on radiographs. However, it is unclear whether the same applies to total ankle arthroplasty (TAA). Methods: We retrospectively reviewed the radiographs of 123 patients who had undergone TAA with the Ankle Evolutive System (AES) implant. Of these, 43 (34.9%) had at least 1 large (greater than 10 mm) osteolytic lesion on radiographs at a minimum follow-up of 14 months (mean, 43.1 months; range, 14-85 months). Forty of the 43 patients underwent helical CT imaging. Results: Computed tomography showed more osteolytic lesions than radiographs around both tibial and talar components. CT also showed larger lesions than radiographs in 9 of 10 zones around prosthetic components. The difference was highly significant in 3 zones around the talar component. Conclusion: Computed tomography showed more and larger periprosthetic lesions than radiographs around an ankle prosthesis. Because osteolysis is progressive in nature, it presumably leads to component failure. Considering our results, we recommend adding CT imaging to postoperative follow-up after TAA for patients with suspected or known periprosthetic lucencies on radiographs. Level of Evidence: Level III, diagnostic study.
The Contribution of Medializing Calcaneal Osteotomy on Hindfoot Alignment in the Reconstruction of the Stage II Adult Acquired Flatfoot Deformity
Authors: Chan Jeremy Y. , Williams Benjamin R. , Nair Pallavi , Young Elizabeth , Sofka Carolyn , Deland Jonathan T. , Ellis Scott J. 
Published: February 2013

Background: Successful correction of hindfoot alignment in adult acquired flatfoot deformity (AAFD) is likely influenced by the degree of medializing calcaneal osteotomy (MCO) performed, but it is not known if other reconstruction procedures significantly contribute as well. The purpose of this study was to evaluate the correlation between common preoperative and postoperative variables and hindfoot alignment. Methods: Thirty patients with stage II AAFD undergoing flatfoot reconstruction were followed prospectively. Preoperative and postoperative radiographs were reviewed to assess for correction in hindfoot alignment as measured by the change in hindfoot moment arm. Nineteen variables were analyzed, including age, gender, height, weight, body mass index (BMI), medial cuneiform-fifth metatarsal height, anteroposterior (AP) talonavicular coverage, AP talus-first metatarsal, lateral talus-first metatarsal and calcaneal pitch angles as well as intraoperative use of the MCO, lateral column lengthening (LCL), Cotton osteotomy, first tarsometatarsal fusion, flexor digitorum longus transfer, spring ligament reconstruction, and gastrocnemius recession or Achilles lengthening. Mean age was 57.3 years (range, 22-77). Final radiographs were obtained at a mean of 47 weeks (range, 25-78) postoperatively. Results: Seven variables were found to significantly affect hindfoot moment arm. These were gender ( P < .05), the amount of MCO performed (P < .001), LCL (P < .01), first tarsometatarsal fusion (P < .01), spring ligament reconstruction (P < .01), medial cuneiform-fifth metatarsal height (P < .001), and calcaneal pitch angle (P < .05). Multivariate regression analysis revealed that MCO was the only significant predictor of hindfoot moment arm. The final regression model for MCO showed a good fit (R2 = .93, P < .001). Conclusion: Correction of hindfoot valgus alignment obtained in flatfoot reconstruction is primarily determined by the MCO procedure and can be modeled linearly. We believe that the hindfoot alignment view can serve as a valuable preoperative measurement to help surgeons adjust the proper amount of correction intraoperatively. Level of Evidence: Level IV, prospective case series.
Large and Deep Diabetic Heel Ulcers Need not Lead to Amputation
Authors: Shojaiefard Abolfazl , Khorgami Zhamak , Mohajeri-Tehrani Mohammad Reza , Larijani Bagher 
Published: February 2013

Background: Management of large and deep heel ulcers (LDHUs) is a challenge in patients with diabetic foot lesions. We assessed outcomes of a treatment protocol to save feet with LDHUs from amputation. Methods: We managed LDHUs (larger than 3 cm2) in diabetic feet using a multidisciplinary approach consisting of medical and surgical management, including revascularization and amputation, if necessary. For deep heel infection and/or gangrene, we frequently debrided and drained the deep spaces of the heel, as needed. In patients with non-ischemic feet, we made a flap from the heel pad with a broad pedicle. When satisfactory granulation tissue covered the base of the heel and the inner surface of the flap, we sutured the heel flap to its base. Results: We managed 37 feet with LDHUs among 384 patients. Twenty-nine patients (78.4%) had neuropathy, 6 (16.2%) had ischemic diabetic feet, and 2 (5.4%) had both neuropathy and ischemia. Twelve (32.4%) had septic diabetic feet. We performed two femoropopliteal bypasses, 2 infrapopliteal bypasses, and 1 distal bypass (crural) for ischemic heel ulcers. Thirty-three of the 37 feet with heel lesions (89.2%) were salvaged using this multidisciplinary approach. These 33 LDHUs healed after 4 to 7 months (median, 6 months). Transtibial amputation was performed for 4 feet (10.8%; 2 ischemic and 2 neuropathic cases). Conclusions: Diabetic patients with LDHUs can be managed with a multidisciplinary approach to prevent amputation. If necessary, deep spaces of the heel can be debrided by elevating the heel pad like a flap and then performing satisfactory reconstruction. Level of Evidence: Level IV, retrospective case series.
Chevron Osteotomy of the First Metatarsal Stabilized With an Absorbable Pin
Authors: Morandi Alberto , Ungaro Emanuele , Fraccia Andrea , Sansone Valerio 
Published: February 2013

Background: The potential requirement for hardware removal originally fueled the development of bioabsorbable pins as an alternative to metal screws for fixing osteotomy sites in foot surgery. More recently, the concern regarding the adverse effects of metal implants may provide further grounds for using bioabsorbable rather than metal fixation. Methods: This is a prospective study of 383 consecutive patients (439 feet) who underwent a chevron osteotomy to correct a hallux valgus deformity performed between 2005 and 2010. In the study group of 251 patients (285 feet), the distal metatarsal osteotomy was fixed with a bioabsorbable pin made of poly-L-lactide and poly-DL-lactide (70:30 ratio). In the control group of 132 patients (154 feet), the osteotomy was fixed with a metal screw. The average follow-up was 27 months for the study group and 31 months for the control group. Results: We observed statistically significant improvements in the mean intermetatarsal angle of 6.1 ± 2.7 degrees in the study group and 5.2 ± 1.6 degrees in the control group ( P < .001) and in the mean hallux valgus angle of 14.8 ± 4.7 degrees and 15.5 ± 3.7 degrees, respectively ( P < .001). The mean ± SD improvement on the American Orthopaedic Foot and Ankle Society 100-point scale was 45 ± 11 points for the study group and 49 ± 15 points for the control ( P < .001). Our complication rate was 0.7% for the study group. Conclusion: Our study found that fixation with a bioabsorbable pin was as reliable as fixation with a metal screw and allowed major angular corrections. The bioabsorbable polymer was well tolerated, and the complication rate was low. Level of Evidence: Level IV, retrospective case series.
Recurrence of Acute Charcot Neuropathic Osteoarthropathy After Conservative Treatment
Authors: Osterhoff Georg , Böni Thomas , Berli Martin 
Published: February 2013

Background: Charcot neuropathic osteoarthropathy (CN) is a chronic, progressive-destructive process affecting the feet of patients with sensory neuropathy. Data on CN recurrence are underrepresented in the literature. The aim of the present study was to evaluate the rate of CN recurrence after its treatment and to find predisposing factors. Methods: Fifty-two patients (age 59 ± 11 years, 16 female) with acute CN with 57 affected feet were enrolled. Comorbidities, localization, and stage of disease at first diagnosis as well as ulcerations, need for surgery, noncompliance, and subsequent treatment (orthopedic footwear or orthotic treatment) during the course of therapy were recorded. During follow-up, the incidence of recurrence of CN was observed. Mean follow-up was 47 ± 40 months. Results: Diabetes was the most common reason for sensory neuropathy (79%). Recurrence of CN was seen in 13 feet (23%) with an interval of 27 ± 31 months (range, 3-102 months) after the end of initial immobilization. Patients with recurrence were immobilized for a shorter period of time and had a more advanced stage of CN at time of first diagnosis. Predictors of recurrence were noncompliance (odds ratio 19.7; confidence interval, 4.1-94.4; P < .001) and obesity (odds ratio 6.4; confidence interval, 1.6-25.9; P = .06). Conclusions: Recurrence of osteoarthropathic activity is a possible complication after conservative treatment of CN. Obesity and noncompliance are strong predictors for the recurrence of CN. Level of Evidence: Level III, retrospective comparative study.