bluuebunny/crossref_metadata_2025_split huggingface dataset:
Allograft anterior cruciate ligament reconstruction in a sheep model
Authors: Amendola Annunziato , Fowler Peter 
Published: June 2007

The purpose of this study was to assess the effect of synthetic augmentation of a bone-patellar tendon-bone allograft on the basis of biomechanical, morphologic, and histologic evaluation. The anterior cruciate ligament was reconstructed in the left knee of 66 adult sheep. Half the knees received bone-patellar tendon-bone grafts alone, while the other half were augmented. All of the knees, including the contralateral controls, had gross and histologic examination, hydroxyproline assay for collagen content, and biomechanical testing in groups at 0, 4, 16, and 52 weeks postoperatively. Biomechanical testing included anteroposterior trans lation, ultimate tensile strength, energy to failure, stiff ness, and mode of failure. Eight fresh bone-patellar tendon-bone allografts were compared to eight cryo preserved bone-patellar tendon-bone allografts for baseline data on the effects of the cryopreservation. Cryopreservation did not have any effect on graft characteristics. Gross and histologic examination did not reveal any significant difference between the aug mented and nonaugmented groups at any of the time periods. In addition, hydroxyproline content of the al lograft was not altered by augmentation throughout the study period. Biomechanical laboratory evaluation dem onstrated the augmented group had significantly re duced anteroposterior translation (P < 0.05) at 52 weeks compared to the nonaugmented group. The ultimate tensile strength was significantly higher (P < 0.05) in the augmented group at 4 weeks, but at 52 weeks both groups had attained only 50% of the normal anterior cruciate ligament strength. Stiffness and en ergy to failure were similar in both groups at all time periods. From the results of this study, synthetic augmentation appears to improve initial strength and prevent late allograft laxity while allowing normal remodeling proc esses to occur in the bone-patellar tendon-bone allo graft anterior cruciate ligament reconstruction.
Spontaneous fractures of the humerus during pitching
Authors: Branch Thomas , Partin Clyde , Chamberland Patricia , Emeterio Elizabeth , Sabetelle Michael 
Published: June 2007

We report the recent occurrence of spontaneous hu meral shaft fractures in 12 pitchers. The subjects were interviewed over the telephone using a standard ques tionnaire. Radiographs and medical records were solic ited from their physicians. Their average age was 36 years and they had pitched an average of 11.4 years with an average layoff of 14 years (range, 7 to 24). Mean time between games pitched was 21 days (range, 3 to 56). The average number of pitches before the fracture occurred was 38 (range, 10 to 100). Pain was experienced at some point before the fracture in 75% of the pitchers and 75% of the fractures were spiral. These fractures were most probably spontaneous fractures brought on by accumulated fatigue damage. The period of buildup after a prolonged period of layoff was probably insufficient time for proper bone remod eling to occur in these men. While a large percentage of these men had pain before their injury, suggesting a predisposing stress fracture, there is no doubt that their fractures could still be caused by a sudden torsional load without the presence of a stress fracture.
Os trigonum impingement in dancers
Authors: Marotta Joseph J. , Micheli Lyle J. 
Published: June 2007

Sixteen patients underwent surgical excision of an im pinging ossicle through a posterior lateral approach. Twelve of these patients (15 ankles) were available for followup and were retrospectively surveyed at an av erage of 28 months after surgery. There were 9 women and 3 men. Nine were professional ballet dancers and 3 were students of advanced ballet schools. Preoper ative symptoms included pain localized to the posterior ankle, limitation of motion, weakness, swelling, or neu rologic changes associated with dance activities. All patients were severely hampered in their dance partic ipation and had failed nonsurgical therapies. Postoperatively, all patients followed an aggressive rehabilitation protocol. All had improvement in their impingement symptoms; eight (67%) still had occa sional discomfort. All professional dancers returned to unrestricted dance activity. The mean time to full activity was 3 months. One patient had a superficial wound infection requiring antibiotic treatment and another suf fered a transient tibial nerve neurapraxia. Both of these complications resolved without sequelae. We conclude that posterior ankle impingement in ballet dancers, caused by an os trigonum and resistant to nonsurgical therapies, is effectively treated with sim ple excision of the offending structure.
Fluoroscopic evaluation for subtle shoulder instability
Authors: Papilion John A. , Shall Larry M. 
Published: June 2007

Fifty patients with unilateral shoulder symptoms and a variety of diagnoses were evaluated with stress testing of both shoulders under general anesthesia using fluo roscopic documentation just before surgery. An axillary lateral view of the glenohumeral joint was taken in neutral rotation and 90° of abduction; this was termed "neutral position." Anterior and posterior translational stresses were then applied and spot radiographs taken. Measurements were made and the translation was expressed as a percentage of displacement of the humeral head with respect to the glenoid. The asymp tomatic side was used as a control. We determined that up to 14% anterior translation and up to 37% posterior translation is normal. Using these guidelines, attempts were made to con firm or predict the presence of stability or instability. Thirty-one patients were correctly identified as stable; 14 were correctly identified as unstable. Three patients with anterior shoulder pain were classified as unstable and found to have Bankart lesions at surgery. Overall, specificity was 100% and sensitivity was 93%. Using discriminant function analysis, a difference score of 10% between the symptomatic and control shoulder was generated. This was useful in eliminating interob server variations in the examination for predicting sta bility or instability. We recommend this examination as a valuable ad junct to confirm the presence and direction of shoulder instability and predict subtle instability patterns in pa tients with recalcitrant undiagnosed shoulder pain.
Ultrasound examination of soft tissue injury of the lower limb in athletes
Authors: Aspelin Peter , Ekberg Olle , Thorsson Ola , Wilhelmsson Mats , Westlin Nils 
Published: June 2007

We performed ultrasonography on 32 athletes com plaining of intense pain in a swollen and tender thigh or calf after a contusion or stretching trauma. The ultra sonogram was used to visualize the presence and size of a suspected hematoma. The findings included the following: 7 patients with a circumscribed, anechoic lesion compatible with a liquefied hematoma; 10 pa tients with a circumscribed lesion of mixed echogenicity compatible with areas of liquefied hematoma, coagu lated blood, and edema; and 15 patients with a diffuse change in echogenicity of the whole muscle. The cir cumscribed liquefied, and mixed hematoma were more common after contusion trauma, while the diffuse type was more common after injury caused by stretching. Ultrasonography is useful in localizing the hematoma and in characterizing the different types. Differentiation is important in diagnosis and choice of treatment.
A biomechanical analysis of solvent-dehydrated and freeze-dried human fascia lata allografts
Authors: Hinton Richard , Jinnah Riyaz H. , Johnson Carl , Warden Karen , Clarke Hugh J. 
Published: June 2007

This study compares the basic mechanical properties of two groups of commercially available fascia lata allografts processed by different means (solvent-dehy drated and sterilized via gamma radiation, and freeze- dried without secondary sterilization). The results reveal significantly ( P < 0.05) higher stiffness, higher maxi mum load to failure, and higher maximum load per unit width of graft with the solvent-dried as opposed to the freeze-dried fascia lata. Subsections of individual sol vent-dried specimens were also more uniform in their mechanical properties than those of the freeze-dried allografts. Clinical relevance: Fascia lata is used as a graft material in a variety of orthopaedic procedures. Allo graft fascia lata offers an increased cross-sectional area of material and eliminates the morbidity associated with the harvesting of autologous tissues. However, the structural uniformity of such large grafts has been questioned. Processing techniques used in the sterili zation and storage of such grafts is varied and repre sents a potential source of variation in the mechanical properties of allograft specimens. The results of this study suggest that a commercially available solvent- dehydrated form of fascia lata provides a more suitable grafting material than freeze-dried specimens obtained from tissue banks.
Tenotomy of the adductor longus tendon in the treatment of chronic groin pain in athletes
Authors: Akermark Christian , Johansson Christer 
Published: June 2007

Eighteen tenotomies of the adductor longus tendon were performed in 16 consecutive male athletes (aged 20 to 42) as treatment for chronic groin pain. The criteria for surgery was a history of long-standing (range, 2.5 to 48 months) and distinct pain at the origin of the adductor longus muscle, refractory to conservative treatment. At followup 35 months (range, 4 to 84) after surgery, all patients were improved or free of symptoms. All but 1 of the athletes returned to the same sport within a mean of 6.6 weeks, and 12 of 16 returned to competi tive sports within a mean of 14 weeks after surgery. A majority of the patients (10 of 16) returned to full athletic activity, whereas 5 of 16 performed at a reduced level. One patient discontinued his sports activity due to other causes. In conclusion, when conservative treatment fails, te notomy of the adductor longus tendon gives good long- term functional results in the treatment of chronic groin pain that is localized at the origin of the adductor longus muscle. A decreased muscle strength was observed in this study and did not seem to influence participation in sports.
A multivariate risk analysis of selected playing surfaces in the National Football League: 1980 to 1989
Authors: Powell John W. , Schootman Mario 
Published: June 2007

This study focuses on the injury rates for natural grass and AstroTurf surfaces and the risk factors of game position and type of play. We examined the game- related knee sprains, medial collateral ligament sprains, and anterior cruciate ligament sprains that occurred in the National Football League during the 1980 to 1989 seasons. The findings are controlled for categories of severity (number of games missed due to injury), posi tion, and situation (rushing or passing) at the time of injury. The analysis of the data incorporates epidemio logic techniques associated with incidence density ra tios. The data show that there is a statistically significant difference between the higher AstroTurf injury rates for knee sprains. When knee sprains are separated into medial collateral ligament sprains and anterior cruciate ligament sprains, only the anterior cruciate ligament sprains show a statistically significant higher injury rate for AstroTurf. When simultaneous control variables are considered, significantly more knee sprains occurred to backs on rushing plays and linemen on passing plays. When controlling the data for severity, only the Cate gory II injuries (three or more games missed) sustained by linemen on passing plays had statistically significant higher injury rates for the AstroTurf. For medial collat eral ligament sprains, only the Category II injuries for linemen on passing plays remain statistically significant. The data for the ACL sprains show statistically signifi cant differences between the injury rate on natural grass and the injury rate on AstroTurf under conditions of special teams play.
Arthroscopic labral debridement
Authors: Altchek David W. , Warren Russell F. , Wickiewicz Thomas L. , Ortiz Gerald 
Published: June 2007

This is a retrospective review of 40 patients who under went arthroscopic labral debridement of the shoulder. All patients were active participants in sports involving use of the shoulder. All patients presented with shoul der pain. Only 40% were found to have distinct gleno humeral instability on examination. At surgery, all pa tients had labral injury. Ten patients had anterosuperior labral tears, 20 had anteroinferior labral tears or de tachments, and 10 had posteroinferior labral tears or detachments. Outcome was assessed at a minimum of 2 years (average, 43 months) postoperatively. Overall, only 7% of the patients had significant symptomatic relief at followup. However, 72% noted relief of symptoms dur ing the 1 st year after surgery, but there was deterio ration over time. Conclusion: Arthroscopic labral debridement is not an effective long-term solution for symptomatic relief in the overhead athlete.
How iliotibial tract injuries of the knee combine with acute anterior cruciate ligament tears to influence abnormal anterior tibial displacement
Authors: Terry Glenn C. , Norwood Lyle A. , Hughston Jack C. , Caldwell Kenneth M. 
Published: June 2007

A knowledge of the patterns of injury to the compo nents of the iliotibial tract allows a clearer interpretation of motion limits testing in patients with abnormal ante rior tibial translation of the knee (anterior cruciate liga ment-deficient knees). Eighty-two consecutive patients with acute knee in juries were classified as anteromedial-anterolateral ro tatory instability (anterior cruciate ligament-deficient) based on the abnormal motion demonstrated by clinical examination tests for instability. At surgery, injuries to the intraarticular and extraarticular anatomic structures were identified and correlated to the abnormal grades of motion demonstrated by the knee motion limits ex amination. Tears of the anterior cruciate ligament occurred in 80 (98%) of the knees. However, the grade of abnormal motion demonstrated by the Lachman and pivot shift tests was quite variable. This variation did not correlate statistically with anterior cruciate ligament tears. Injuries to the anatomic components of the iliotibial tract were confirmed in 76 (93%) of the knees. These injuries correlated highly with variations in grades of abnormal motion detected by the following tests: lateral joint line opening at 30° ( r2 = 0.05); Lachman test ( r2 = 0.08); pivot shift ( r2 = 0.16); and anterior translation at 90° of flexion ( r2 = 0.34). Thus, injuries to the components of the iliotibial tract are thought to contrib ute to the variation in grades of abnormal motion ob served in this complex subgroup of anterior tibial trans lation instabilities.
Radiographic imaging of muscle strain injury
Authors: Speer Kevin P. , Lohnes John , Garrett William E. 
Published: June 2007

We reviewed our experience with computed tomogra phy and magnetic resonance imaging of acute muscle strain injury. We imaged 50 athletes (average age, 28 years; range, 17 to 42) who had an acute muscle strain involving either the adductor, hamstring, quadriceps, or triceps surae muscles. Computed tomography (axial imaging) was used from 1982 to 1987 for 27 athletes. Spin-echo magnetic resonance imaging (axial, coronal, sagittal imaging) was used from 1987 to 1991 for 23 athletes. Computed tomography and magnetic resonance im aging localize the strain injury to a single muscle within a group of synergists; the adductor longus, rectus femoris, and medial head of gastrocnemius muscles are most prone to strain injury. A disruption occurs predictably at the myotendinous junction; fluid collects at the disruption site and dissects along the epimysium and subcutis. Muscle tissue remote from the myoten dinous junction clearly demonstrates extensive injury with abundant magnetic resonance imaging signal changes consistent with edema and inflammation. Fol low-up computed tomographic and magnetic reso nance imaging studies can clearly demonstrate atrophy, fibrosis, and calcium deposition.
Does amateur boxing lead to chronic brain damage?
Authors: Haglund Yvonne , Eriksson Ejnar 
Published: June 2007

Fifty former amateur boxers were examined and com pared with two control groups of soccer players and track and field athletes. All subjects were interviewed regarding their sports career, medical history, and so cial variables. They underwent a physical and a neuro logic examination. Personality traits were investigated and related to the platelet monoamine oxidase activity. Cerebral morphologic changes were evaluated using computed tomography and magnetic resonance imag ing. Further, clinical neurophysiologic tests were made as well as neuropsychologic tests. No significant differences were found between the groups in any of the physical or neurologic examinations or in platelet monoamine oxidase activity. Socially, the boxers had a lower degree of education and had cho sen less intellectual professions, but they were less impulsive and more socialized. The computed tomog raphy images and magnetic resonance imaging studies showed no significant differences between the groups. There was a significantly higher incidence of slight or moderate electroencephalography deviations among the boxers. Neuropsychologically, the boxers had an inferior finger-tapping performance. Thus, no signs of serious chronic brain damage were found among any of the groups studied. However, the electroencepha lography and finger-tapping differences between the groups might indicate slight brain dysfunction in some of the amateur boxers.
Repair of distal biceps tendon ruptures in athletes
Authors: D'Alessandro Donald F. , Shields Clarence L. , Tibone James E. , Chandler Robert W. 
Published: June 2007

Ten athletes with distal biceps tendon ruptures that had been anatomically repaired with a double-incision technique were reviewed to determine their functional recovery. All of the patients were men, with an average age of 40 years (range, 25 to 49). Eight of the 10 patients were weight lifters or body builders, and 7 had participated on a competitive level at some point in their athletic careers. Six injured their dominant extremity, and 4 their nondominant extremity. Isokinetic muscle testing of supination and flexion was performed in 8 patients and the results were compared to a control group. Followup averaged 50 months (range, 12 to 105). Patients uniformly graded their subjective results as excellent, with a group mean rating of 9.75 on a 10- point scale. All athletes returned to full, unlimited activ ity. The contour of the biceps muscle was restored in all cases. Isokinetic muscle testing demonstrated that in those patients with a repaired dominant extremity, supination strength and endurance was normal; in flex ion, they had normal strength, but averaged 20% less endurance. Testing of the group that had the nondom inant extremity repaired revealed a supination strength deficit of 25%, but normal endurance. Flexion strength and endurance were essentially normal in this group. Anatomic repair of a distal biceps tendon rupture gives consistently excellent subjective and good objec tive results in athletes, particularly for those sports with high strength demands such as weight lifting and body building. Rehabilitation of the operated arm, especially the repaired nondominant extremity, should be empha sized.
Articular cartilage lesions in ankles with lateral ligament injury
Authors: Taga Ichiro , Shino Konsei , Inoue Masahiro , Nakata Ken , Maeda Akira 
Published: June 2007

To investigate intraarticular lesions producing persist ent postoperative pain, we arthroscopically examined 31 ankles in 31 patients (15 women and 16 men) with lateral ligament injury. The patients ranged in age from 15 to 33 years, with a mean of 20 years. Nine patients were freshly injured, and 22 patients had chronic inju ries. All of the patients underwent arthroscopic exami nation immediately before the ligament operation. Chondral lesions were found in 89% of the freshly injured ankles and 95% of the ankles with chronic injuries. Most of these lesions were in the medial half of the ankle joint, especially in the anteromedial edge of the tibial plafond. After followup for 1 year postop eratively, persistent pain was noted in 4 patients who had chondral lesions of greater than one-half the thick ness of the articular cartilage. Pain and tenderness were localized at the anteromedial joint line, corre sponding to the location of the chondral lesions. Chon dral lesions of greater than one-half the thickness of the articular cartilage were found in 8 ankles in the chronic injury group, but there were none in the fresh injury group. Thus, in lateral ligament injuries of the ankle, the longer the time elapsed from the initial injury, the more severe the associated chondral lesions became. These chondral lesions appear to cause persistent pain.
Incidence and nature of sports injuries in Ireland
Authors: Watson Anthony W.S. 
Published: June 2007

The objectives of this study were to investigate the incidence of sports injuries in Ireland and to analyze various ways of quantifying the seriousness of these injuries. A 12-month, prospective study was carried out on 324 Irish athletes involved at a high level of sports participation in one of the following categories: endur ance, contact, noncontact, or explosive sports. Results were expressed in four ways: 1) number of injuries per year; 2) days injured per year; 3) number of injuries per 10,000 hours of participation; and 4) duration of injury per 1000 hours of participation. The average athlete sustained 1.17 acute and 0.93 overuse injuries per year and suffered the effects of sports injury for 52 days. More time was lost through overuse injuries than acute injuries. The incidence of acute injuries per 10,000 hours of participation was lowest in the noncontact sports and highest in the contact sports, but there was no difference in the incidence of overuse injuries between any of the four categories of sport. The injury rate per 10,000 hours of participation was lowest in noncontact and explosive sports and highest in contact sports. However, when expressed in terms of days lost per 1000 hours of participation, endurance sports had the lowest inci dence of time loss and explosive sports the highest.
An in vitro analysis of patellofemoral contact areas and pressures following procurement of the central one-third patellar tendon
Authors: D'Agata Samuel D. , Pearsall Albert W. , Reider Bruce , Draganich Louis F. 
Published: June 2007

Patients have complained of pain after the use of the central one-third patellar tendon for reconstruction of the anterior cruciate ligament-deficient knee. This study investigated the effect on patellofemoral contact areas and pressures of harvesting the central 10 mm of the patellar tendon in five cadaveric knees. Isometric quad riceps forces were applied to produce approximately 30% of reported maximum voluntary extension mo ments at the knee. Using Fuji pressure-sensitive film, measurements were recorded for three states: the normal knee, after the graft removal, and after the tendon was closed. Contact areas and pressures were measured at 20°, 30°, 60°, and 80° of knee flexion in each specimen. Tests of the reproducibility of our meth ods were performed. Average patellofemoral contact areas for three states ranged from 1.6 cm2 at 20° of knee flexion to 3.0 cm2 at 60°. The average patellofemoral contact pressures ranged from 1.9 MPa at 20° of knee flexion to 3.0 MPa at 30°. At each flexion angle there were no significant differences in average patellar contact area or pressure for the three states ( P < 0.05). These results suggest that neither harvesting the central 10 mm of the patellar tendon, nor closing the gap, significantly alters patello femoral contact area or pressure.