bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary repair with semitendinosus tendon augmentation of acute anterior cruciate ligament injuries
Authors: Sgaglione Nicholas A. , Warren Russell F. , Wickiewicz Thomas L. , Gold David A. , Panariello Robert A. 
Published: June 2007

A retrospective review of 72 acute ACL injuries in 70 athletically active patients (50 recreational and 20 com petitive athletes) treated with primary repair and semi tendinosus tendon augmentation was conducted (mean follow-up time, 38.5 months). All patients had open primary multiple loop depth-varying suture repair and semitendinosus tendon augmentation at a mean injury to surgery interval of 9.1 days. Fifty-one cases (70.8%) were supplemented with an extraarticular procedure consisting in all cases of an iliotibial band lateral sling reinforcement. All patients underwent 6 weeks of post operative immobilization followed by a graduated re habilitation regimen lasting a mean 7.2 months. In 22 of the ACL tears, no other associated injury could be defined at arthrotomy, while in 27, significant medial collateral ligament injuries were noted. Lateral meniscal injuries (24) were more commonly noted than medial meniscal injuries (19). Good to excellent subjective results were reported in 82%, while 77.1 % returned to preinjury sport level and participation without limitation. One patient developed "giving way" symptoms and overall, only four patients did not return to sports participation. Objective exami nation revealed 93.1 % to have a 1 + or less Lachman test and 86.1 % to have a negative pivot shift. Of 60 knees tested, 93.3% had KT-1000 side-to-side differ ence values (measured at 25° ± 5° of flexion with an 89 N load) of ≤3 mm of anterior displacement. A 100 point Hospital for Special Surgery ligament rating score was used with 25 points assigned to subjective, 45 points to objective, and 30 points to functional assess ment. The mean score at followup was 93.1. Analysis of results in patients with or without an extraarticular reinforcement revealed no difference in objective out come. The incidence of patellofemoral pain was 27.8%. Thirty knees had some degree of loss of range of motion. Loss of terminal flexion was noted in 29, while 5 had loss of terminal extension. No correlation could be found between patellofemoral pain and diminished range of motion. Generalized ligamentous laxity was found in 37.1 % of the patients; this was not associated with a poor result. This study suggests that primary repair with semiten dinosus tendon augmentation of acute ACL injuries with a graduated rehabilitation regimen provides good subjective, and excellent functional and objective, re sults in active patients that were followed for more than 3 years.
The effects of passive warming on muscle injury
Authors: Strickler Timothy , Malone Terry , Garrett William E. 
Published: June 2007

This study investigated the effects of passive warming on the biomechanical properties of the musculotendi nous unit. Paired tibialis anterior (TA) and extensor digitorum longus (EDL) muscles in the rabbit hindlimb were passively heated to different temperatures and then subjected to controlled strain injury. The parame ters examined were: 1) percent increase in length to failure, 2) force to failure, 3) energy absorbed by the musculotendinous unit to failure, and 4) site of failure. Warmed (39°C ± 0.5°C) TA ( P ≤ 0.01) and EDL ( P ≤ 0.05) muscles achieved a greater increase in length from rest before failing than did their contralateral con trols at 35°C ± 0.5°C. In both the TA and EDL the force at failure was greater at 35°C than at 39°C, although the difference was significant for only the EDL ( P ≤ 0.05). The energy absorbed (area beneath the length-tension curve) by both the TA and EDL was greater at 39°C, but these differences were not signif icant. All muscles failed at the distal musculotendinous junction. These data suggest that passive warming increases the extensibility of the musculotendinous unit and may thereby reduce its susceptibility to strain in jury.
Strain measurement in lateral ankle ligaments
Authors: Colville Mark R. , Marder Richard A. , Boyle John J. , Zarins Bertram 
Published: June 2007

We measured strain in the lateral ligaments of 10 human cadaver ankles while moving the ankle joint and apply ing stress in a variety of ways. We studied the anterior talofibular, calcaneofibular, posterior talofibular, ante rior tibiofibular, and posterior tibiofibular ligaments. Strain measurements in the ligaments were recorded continuously while the ankle was moved from dorsiflex ion into plantar flexion. We then repeated measure ments while applying inversion, eversion, internal rota tion, and external rotation forces. Strain in the anterior talofibular ligament increased when the ankle was moved into greater degrees of plantar flexion, internal rotation, and inversion. Strain in the calcaneofibular ligament increased as the talus was dorsiflexed and inverted. These findings support the concept that the anterior talofibular and calcaneofibular ligaments function together at all positions of ankle flexion to provide lateral ankle stability. We measured maximum strain in the posterior talofibular ligament when the ankle was dorsiflexed and externally rotated. The strain in the anterior and posterior tibiofibular liga ments increased when the ankle was dorsiflexed. Ex ternal rotation increased strain in the anterior tibiofibular ligament and decreased strain in the posterior tibiofib ular ligament. Based upon strain measurements in the lateral ankle ligaments in various ankle joint positions, we believe the anterior talofibular ligament is most likely to tear if the ankle is inverted in plantar flexion and internally rotated. Theoretically, the calcaneofibular ligament tears primarily in inversion if the ankle is dorsiflexed; the anterior tibiofibular ligament tears in dorsiflexion, especially if combined with external rotation; and the posterior tibiofibular ligament tears with extreme dor siflexion.
Osteoid osteoma of the femoral neck in the young athlete
Authors: Ahlfeld Steven K. , Makley John T. , Derosa G. Paul , Fisher David A. , Mitchell James Q. 
Published: June 2007

The purpose of this paper is to present a progressive diagnostic and management program for osteoid os teoma of the femoral neck in the young athlete. Five young athletes with hip pain secondary to osteoid osteoma are presented. The average age of the pa tients was 15 years old, with an average followup of 4 years. Radioisotope bone scans, computed axial tom ograms, and linear tomograms were valuable diagnos tic aids. All five athletes were treated with a limited excisional biopsy via an anterior approach to the fem oral neck. Associated treatment modalities, such as bone grafting, internal fixation, and cast immobilization, were not necessary. There were no major complica tions. The five young athletes returned to sports at an average of 4 months postoperatively. Osteoid osteoma of the femoral neck should be in cluded in the differential diagnosis of hip pain in young athletes. A limited excisional biopsy provided a rapid return to sports for the young athlete without the po tential morbidity associated with internal fixation, bone grafting, and cast immobilization.
Surgical correction of the snapping iliopsoas tendon
Authors: Jacobson Thomas , Allen William C. 
Published: June 2007

Eighteen patients with 20 symptomatic hips underwent lengthening of the iliopsoas tendon for persistent painful snapping of this "internal" variety of snapping hip. We referred to the pathologic, painful snapping of the ilio psoas in the deep anterior groin as the "internal" snap ping hip. This is in contrast to the more common and better-known "external" snapping that involves the greater trochanter and its overlying soft tissues. The results of our iliopsoas lengthening procedure are pre sented here. Lengthening of the iliopsoas tendon was accom plished by step cutting of the tendinous portion of the iliopsoas. The pathoanatomy of this poorly understood symptom complex was described in a 1984 paper from this institution and is reviewed here. Iliopsoas bursography demonstrated a sudden jerk ing movement of the iliopsoas tendon between the anterior inferior iliac spine and iliopectineal eminence, synchronous with the patient's pain and often accom panied by an audible snap. The average preoperative duration of symptoms was 2.9 years, and the average length of postoperative followup was 25 months. All patients, except one, had a marked reduction in the frequency of snapping after tendon lengthening, and 14 of 20 hips had no snapping postoperatively. Of the six patients who had recurrence of snapping, all but one stated that this occurred much less frequently and was much less painful compared to the preoperative state. Two hips required reoperation. Postoperatively, only three patients complained of subjective weakness, and most patients were unlimited in physical activity with return to activities such as competitive football, pole vaulting, and long-distance running. A frequent complication has been transient or per manent sensory loss of the anterolateral thigh, yet no motor deficits have occurred. An operative approach through a cosmetic transverse inguinal incision, differ ent from our previous approach, is described. Nearly all patients felt that they were much better because of the procedure, and only one patient stated that she would not repeat the procedure for the same problem. We feel that judicious lengthening of the painful snap ping iliopsoas tendon near the brim of the pelvis can be of great benefit to symptomatic patients.
Secondary damage to the knee after isolated injury of the anterior cruciate ligament
Authors: Finsterbush A. , Frankl U. , Matan Y. , Mann G. 
Published: June 2007

Between 1978 and 1984, we examined and performed arthroscopy on 1000 consecutive patients. Ninety-eight of the 1000 had isolated ACL damage. These cases do not include patients with initial ACL injuries combined with other intraarticular damage. Diagnosis was by physical and arthroscopic examination. Examination took place an average 13.6 months after injury. Of the 98 isolated ACL injuries, 56 were complete ruptures and 42 were partial ruptures. In most cases of partial rupture, the clinical diagnosis was wrong. "Meniscal damage" was the usual diagnosis in these cases; the true diagnosis was made only by arthroscopic exami nation. Thirty-four of the 98 patients with isolated ACL injuries (30 men and 4 women) developed further intra articular damage. Of these 34, 20 had complete ACL rupture and 14 had partial ACL rupture. Treatment after primary injury included physiotherapy in all patients and bracing in those whose knee was unstable during daily activities. Reconstructive surgical procedures were not performed in those patients. The time lapse from the primary to the secondary injury varied from 1 month to 20 years, with an average of 28 months. The secondary damage was caused by a secondary injury that was mild (22 cases) or developed insidiously (12 cases). Five types of secondary damage were observed: partial ACL tears that became complete—11 cases; meniscal tear— 8 cases; loosening and subluxation of the anterior horn of the medial meniscus—14 cases; and fracture or damage to the articular condylar carti lage, with or without bone involvement—11 cases. It should be emphasized that the secondary damages were at times combined.
Prevention of common overuse injuries by the use of shock absorbing insoles
Authors: Schwellnus Martin P. , Jordaan Gerhard , Noakes Timothy D. 
Published: June 2007

Sedentary individuals, particularly new military recruits, who start a physical training program have a substantial risk of developing an overuse injury of the lower limb. In this study we investigated the effect of neoprene insoles on the incidence of overuse injuries during 9 weeks of basic military training. The experimental group consisted of 237 randomly selected new recruits, while 1151 recruits were the control group. Insoles were given to the experimental group and compliance was monitored. A panel of doctors documented and classi fied all injuries occurring during the 9 week period. A total of 54 (22.8%) and 237 (31.9%) injuries were reported in the experimental and control groups, re spectively. In both groups, the majority of injuries were overuse (experimental group, 90.7%; control group, 86.4%). The mean weekly incidence of total overuse injuries and tibial stress syndrome was significantly lower (P < 0.05) in the experimental group. The mean incidence of stress fractures was lower in the experimental group but not significantly so (0.05 < P < 0.1). This study shows that the incidence of total overuse injuries and tibial stress syndrome during 9 weeks of basic military training can be reduced by wearing insoles.
The stabilizing function of passive shoulder restraints
Authors: Terry Glenn C. , Hammon Dan , France Paul , Norwood Lyle A. 
Published: June 2007

The static restraints of the scapulohumeral joint provide stability for the humeral head in the glenoid cavity, limit extremes of motion of the glenohumeral joint, and guide positioning of the humerus during normal shoulder movement. Eleven fresh-frozen cadaver shoulders of unknown age were attached to a shoulder motion device that allowed measurement of motion in three planes with an accuracy to 0.5°. Four shoulders underwent motion analysis and seven were used for strain gauge analysis of the static scapulohumeral ligamentous restraints. The results of the motion analysis demonstrated that any attempt at simple motion (flexion, extension, ab duction, internal or external rotation) resulted in coupled motion in two additional planes. The strain gauge data, expressed as a percent of total tension for each ligament tested, demonstrated a reciprocal tension-sharing relationship among all liga ment components and a transference of tension among these components when original and new joint posi tions were compared. These data provide an in vitro model of shoulder restraint function to explain primary restraint, tension sharing, and transference of tension functions in the in vivo scapulohumeral joint. Clinical relevance: These principles of shoulder func tion have application in the treatment of instability and frozen shoulder syndrome, and provide an in vitro model to better understand static restraint function in the throwing mechanism.
Analysis of subjective knee complaints using visual analog scales
Authors: Flandry Fred , Hunt Jon P. , Terry Glenn C. , Hughston Jack C. 
Published: June 2007

A questionnaire using a system of visual analog scales was developed for analyzing subjective knee com plaints. This system was tested on 117 consecutive patients who had undergone knee surgery and 65 patients at their initial office evaluation of a knee disor der. The validity of and patient affinity for this type of questionnaire was compared with that of three other established subjective evaluation methods. The visual analog scale system was shown to be valid and comparable to other methods while offering several advantages. It brought greater sensitivity and greater statistical power to data collection and analysis by allowing a broader range of responses than did traditional categorical responses. It removed bias that was introduced by examiner questioning, and it allowed graphic temporal comparisons. Most importantly, pa tient affinity was higher for this type of subjective evaluation than for other methods.
Shoulder function in patients with unoperated anterior shoulder instability
Authors: Tsai LI , Wredmark Torsten , Johansson Christer , Gibo Karin , Engstrom Björn , Tornqvist Hans 
Published: June 2007

A functional analysis, including Rowe score and meas urements of isokinetic peak torque and range of motion of the shoulder, and a subjective assessment were performed in 26 consecutive patients (23 males and 3 females) with unoperated anterior shoulder instability. Patients experienced the initial dislocation at an av erage age of 23 ± 8 years and 58% occurred during sports activity. No patient had gone through any con trolled rehabilitation program. In this study, an average of 7 years (range, 1 to 28) had passed since the initial dislocation. Fifty-nine percent of the patients com plained of markedly reduced ability to perform in sports because of instability, impaired strength, decreased range of motion, and pain induced by activity. The majority (65%) of the patients reported instability only during physical activity. The average Rowe score was 68 ± 14 on a scale of 100. In comparison with the healthy side, the injured shoulder had a significantly lower isokinetic peak torque during abduction and in ternal rotation, as well as a reduced range of motion in extension, abduction, and external rotation, but not in flexion. The severity of impairment (Rowe score, deficit in range of motion, and peak torque) was not related to the number of dislocations sustained or to the du ration of instability.
Arthroscopic evaluation of meniscal repairs after anterior cruciate ligament reconstruction and immediate motion
Authors: Buseck Mark S. , Noyes Frank R. 
Published: June 2007

Sixty-six patients who had meniscal repair at the same time as an ACL reconstruction were followed-up with arthroscopy at an average of 12 months postopera tively. All patients underwent immediate postoperative range of motion from 20° to 90° and began partial weightbearing between the 1 st and 3rd postoperative weeks. The rate of meniscal healing was classified as complete, partial, or failed. We statistically analyzed the effect of rim width, length of the tear, type of meniscus, age of patient, length of time between injury and repair, length of time between surgery and follow-up arthros copy, and open versus arthroscopically assisted sur gical procedure on the rate of meniscal healing. The overall results showed that 63 (80%) of the menisci completely healed, 11 (14%) partially healed, and 5 (6%) failed. The only factor that had a statistically significant impact on the rate of healing was rim width. Repairs in the outer one-third region had a higher incidence of healing (98% retained menisci) than those in the central one-third region (79% retained menisci, P < 0.01). Still, the ability to repair a majority of central one-third meniscus tears that occur in the avascular zone (including flap tears and double longitudinal tears) suggest repair be considered when clinical grounds warrant preserving the meniscus. There were no com plications, nor were there any deleterious effects from immediate knee motion or early weightbearing on the meniscal repairs. This allows an aggressive, immediate motion program to be followed with ACL reconstruction when concomitant meniscus repair is performed.
Stress changes of the distal radial growth plate
Authors: Caine Dennis , Roy Steven , Singer Kenneth M. , Broekhoff Jan 
Published: June 2007

We conducted a radiographic survey to determine skel etal age and the nature and prevalence of stress-related changes affecting the distal radial growth plate in 60 young competitive gymnasts (39 females, 21 males). Comparison of results for chronological and skeletal age revealed a significant delay in maturation for girls (P < 0.001). Radiographic evaluation revealed 5 gym nasts (4 girls and 1 boy) with stress-related changes of the left wrist, and four of these were considered to be minimal. These results, in conjunction with our previous find ings and the review of related literature, reveal three important observations. First, the widening and irregu larities of the distal radial physis that we described previously appear to be the first in a spectrum of abnormal changes secondary to overuse and probably represent a stress fracture of the distal radial growth plate. The radiographic changes associated with this injury are not the normal adaptive changes seen in young, competitive gymnasts. Secondly, more serious long-term abnormality may result even though the injury may initially resemble a Salter-Harris type I or II stress fracture. Long-term complications may include symmetrical or asymmetrical retardation or halted growth at the affected site, posi tive ulnar variance, and associated pathoanatomic se quelae. Thirdly, the incidence of distal radial growth plate stress injury remains unclear; we recommend a further, large-scale prospective epidemiologic study in volving both male and female gymnasts. We urge that physicians and other health professionals associated with gymnastics clubs educate coaches about the pos sibility of significant injury to the distal radial physis, risk factors, and suggested preventive measures.
European soccer injuries
Authors: Høy Kristian , Lindblad Bent Erling , Terkelsen Carsten Juhl , Helleland Haakon Einar , Terkelsen Christian Juhl 
Published: June 2007

In 1 year, 715 patients with soccer injuries were regis tered and treated in the emergency department of Randers City Hospital. We did a prospective study of these patients using a questionnaire to determine the most common locations, types, mechanisms, and treat ments of injury. Financial costs for society and the individual were also examined. Forty-nine percent of the injuries were to the joints; sprains and contusions were the most common types of injury, accounting for 46% and 25%, respectively. The majority of patients (64% of the men and 58% of the women) were injured during physical contact with another player. Most (63%) of the patients were treated in the emergency department and then released. Thirty- one percent had to be absent from work, but only 8% of the patients had a loss of income because of their injury. The average amount of work time lost was 5 days.
Posterior shoulder instability
Authors: Hurley John A. , Anderson Thomas E. , Dear William , Andrish Jack T. , Bergfeld John A. , Weiker Garron G. 
Published: June 2007

We conducted a retrospective study on 50 patients with recurrent posterior shoulder instability. Twenty- five patients were treated conservatively with a specific rehabilitation program strengthening the rotator cuff. The other 25 patients, who did not improve with reha bilitation, underwent surgical reconstruction, the major ity of these being soft tissue repairs. Recurrence in the surgically treated group averaged 72% while that in the conservatively treated group was 96%. However, 50% of those patients treated surgically and 68% of those treated conservatively felt their symptoms were im proved. In view of the high recurrence rate with soft tissue reconstruction, computed tomography scans were ob tained to evaluate glenoid version. Those patients with posterior shoulder instability were found to have in creased glenoid retroversion when compared to an uninjured population (P < 0.05). Our conclusions based on this study were that 1) specific therapy in the form of rotator cuff strengthening should be the initial form of treatment in patients with posterior shoulder insta bility, 2) soft tissue surgery has a high rate of recur rence, 3) the return to sports is variable, 4) there appears to be an increased incidence of glenoid retro version in this patient population, and 5) the incidence of posttraumatic arthritis is low.