bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prospective evaluation of arthroscopically assisted anterior cruciate ligament reconstruction
Authors: Marder Richard A. , Raskind John R. , Carroll Michael 
Published: June 2007

Eighty consecutive patients with chronic laxity due to a torn ACL underwent arthroscopically assisted recon struction with either autogenous patellar tendon or doubled semitendinosus and gracilis tendons. Recon structions were performed on a one-to-one alternating basis. Preoperatively, no significant differences be tween the two groups were noted with respect to age, sex, level of activity, and degree of laxity (chi square analysis). A standard rehabilitation regimen was used for all patients after surgery including immediate pas sive knee extension, early stationary cycling, protected weightbearing for 6 weeks, avoidance of resisted ter minal knee extension until 6 months, and return to activity at 10 to 12 months postoperatively. Seventy-two patients were evaluated at a minimum of 24 months postoperatively (range, 24 to 40 months). No significant differences were noted between groups with respect to subjective complaints, functional level, or objective laxity evaluation, including KT-1000 meas urements. Seventeen of 72 patients (24%) experienced anterior knee pain after ACL reconstruction. Overall, 46 of 72 patients (64%) returned to their preinjury level of activity. Mean KT-1000 scores were 1.6 ± 1.4 mm for the patellar tendon group and 1.9 ± 1.3 mm for the semitendinosus and gracilis tendons group. This study did find a statistically significant weakness in peak hamstrings torque at 60 deg/sec when recon struction was performed with double-looped semiten dinosus and gracilis tendons.
Reproducibility of the Knee Signature System
Authors: Riederman Robert , Wroble Randall R. , Grood Edward S. , VanGinkel Laura , Shaffer Brian L. 
Published: June 2007

To assess trial-to-trial, installation-to-installation, and day-to-day effects of the Knee Signature System, we studied anterior/posterior translation measurements in six normal subjects. The protocol consisted of testing both knees on 6 days with three installations per day and three trials per installation. We recorded anterior, posterior, and total anterior/posterior translation at ±20 and ±40 pounds of force at 30° of flexion. Addi tionally, after measuring anterior/posterior translation during passive knee extension, active extension, and active extension with 15 pounds of weight at the ankle, we calculated the difference in anterior translation at 30° of flexion between each of these three conditions. We analyzed the size of the effects and computed 90% confidence limits using analysis of variance. Means and 90% confidence limits for total anterior/ posterior translation measured at ±20 pounds of force were: right knee, 6.8 ± 2.3; left knee, 8.2 ± 2.0; and right/left difference, 1.5 ± 2.7 mm. Left knee translation means were significantly greater than right knee means in all tests. Day-to-day effects, while statistically signif icant for right and left knee measurements, showed no significant effects for right/left differences. Trial-to-trial and installation-to-installation effects were not signifi cant for any parameter. Right/left differences during knee extension testing were smaller than for the stress test, measuring 0.1 mm or less, but confidence limits were larger, being ±3.7 mm for active extension-pas sive knee extension, ±1.5 mm for 15 pounds of weight at the ankle-active extension, and ±4.6 mm for 15 pounds of weight at the ankle-passive knee extension. Active extension produced 6.3 mm more anterior trans lation at 30° of flexion than passive extension. Active
Anterior cruciate reconstruction using a Dacron ligament prosthesis
Authors: Richmond John C. , Manseau Christopher J. , Patz Robert , McConville Owen 
Published: June 2007

A single-center prospective study is presented on 35 patients who underwent anterior cruciate ligament re construction using a Dacron ligament prosthesis. All of the reconstructions were performed by the same sur geon, using the same technique. All of the patients had a history of symptomatic chronic ACL insufficiency. The mean follow-up interval for all patients was 50 months. There was an overall failure rate of 37.1% (13 patients), based on the presence of at least one of the following criteria: the presence of a pivot shift; a 2+ or greater anterior drawer or Lachman; instrumented laxity of >3 mm side-to-side translation in 20° of flexion at 89 N; or by arthroscopic documentation. Six of these 13 patients were documented by arthroscopy and 7 were clinical failures. There were 26 patients with only anterior cruciate ligament laxity, and 9 patients with multiple instabilities or failed previous ACL reconstruction ("salvage"). In the group with isolated anterior cruciate ligament insuffi ciency, the failure rate was 23% (6 patients). In the salvage group, the failure rate was 78% (7 patients). There was a significant improvement in patient perform ance with respect to clinical laxity, Lysholm scores, and Tegner activity levels at 2 years postoperatively. There has been a subsequent deterioration in the performance of these patients through time.
Meniscal regeneration with copolymeric collagen scaffolds
Authors: Stone Kevin R. , Rodkey William G. , Webber Richard , McKinney LuAn , Steadman J. Richard 
Published: June 2007

We sought to create a regeneration template for the meniscal cartilage of the knee to induce complete men iscal regeneration, and to develop the technique for implanting the prosthetic appliance in vivo. We de signed a resorbable collagen-based scaffold and con ducted in vitro and in vivo studies. In vivo, the scaffold was implanted in the knees of immature swine and mature canines and evaluated clinically, histologically, and biochemically. Because the canine stifle joint me niscus is more clinically relevant to the human menis cus, this paper emphasizes those results. We studied 24 mixed breed dogs (14 males and 10 females) with an average weight of 25.5 kg (range, 20 to 35) that were obtained from a USDA-licensed sup plier. The dogs were deemed clinically and radiograph ically skeletally mature. None of the dogs had a preex isting knee joint abnormality. All dogs underwent an 80% subtotal resection of the medial meniscus bilater ally. A collagen template was implanted in one stifle (N = 24). The contralateral side served as a control: 12 dogs had a total resection alone and the other 12 dogs had an immediate replantation of the autologous meniscus. Results were tabulated at 3, 6, 9, and 12 months. At final evaluation, before the animals were euthanized, the results were submitted for statistical analysis as well as histologic and biochemical analyses. The results demonstrated that a copolymeric collagen-based scaf fold can be constructed that is compatible with meniscal fibrochondrocyte growth in vitro and in vivo, that does not inhibit meniscal regeneration in an immature pig, and that may induce regeneration of the meniscus in the mature dog. Although additional studies are necessary to perfect the scaffold and to evaluate the implant in the environ ment of the knee, these studies suggest that effective meniscal regeneration can be supported by an im planted collagen-based scaffold designed to support cellular ingrowth.
The results of fresh-frozen patellar tendon allografts for chronic anterior cruciate ligament deficiency of the knee
Authors: Indelicato Peter A. , Linton Russell C. , Huegel Marty 
Published: June 2007

This prospective study was done to evaluate the clinical outcome of fresh-frozen patellar bone-tendon-bone al lograft tissue used as a substitute for chronic insuffi ciency of the anterior cruciate ligament. Forty-one pa tients were followed at a mean of 27 months after surgery. The mean time from injury to reconstruction was 34 months. The same operative procedure and postoperative rehabilitation was performed on each patient. The evaluation method consisted of subjective, objective, and instrumented laxity testing. Thirty-seven patients (90%) thought their knee was normal or im proved after surgery and had no further episodes of giving way. The combined modified Hughston Knee Score re vealed 30 patients (73%) with an excellent or good result and 9 patients (22%) with a fair or poor result. The mean postoperative Lysholm Knee Score was 91 (range, 56 to 100). Thirty-two had a negative pivot shift (78%). The postoperative KT-1000 arthrometer re vealed 37 patients had an injured-to-uninjured differ ence of 5 mm or less (mean, 1.32 mm; range, 0 to 5). There were three traumatic failures at 24 months post operatively in this group. There was no rejection phe nomenon noted postoperatively. In addition, clinical observation showed less postoperative morbidity when compared to a matched autogenous patellar tendon control group.
A biomechanical evaluation of taping and bracing in reducing knee joint translation and rotation
Authors: Anderson Kyle , Wojtys Edward M. , Loubert Peter V. , Miller Russell E. 
Published: June 2007

We used five randomly selected cadaver specimens to evaluate the Anderson Knee Stabler and the Lenox Hill Knee Brace, individually and in combination with an anterior cruciate ligament protective tape method. Re duction of total laxity, as well as a defined pathologic anterior-posterior translation and internal-external ro tation, was tested after the anterior cruciate and medial collateral ligaments of the specimens had been sec tioned. Displacements were produced pneumatically; loads were applied to the tibia with the knee in 50° of flexion. The tape and Lenox Hill Brace combination showed the greatest reduction in both anterior-posterior trans lation and internal-external rotation. The Lenox Hill Brace and the tape method used individually both re stricted anterior-posterior translation and internal-ex ternal rotation better than the Stabler Brace alone. This study provides objective evidence of the restraining capabilities of these protective systems that may prove to be beneficial in the clinical setting.
Loss of motion after anterior cruciate ligament reconstruction
Authors: Harner Christopher D. , Irrgang James J. , Paul Jonathan , Dearwater Steven , Fu Freddie H. 
Published: June 2007

We did a retrospective review and follow-up examina tion to investigate the incidence, risk factors, and out come of patients who developed loss of motion after arthroscopic anterior cruciate ligament reconstruction. Two hundred forty-four patients with a minimum fol lowup of 1 year were reviewed. Loss of motion (defined as a loss of extension of more than I0° or flexion of less than 125°) was identified in 27 patients for an overall incidence of 11.1%. Factors associated with loss of motion included acute reconstruction (less than 1 month from initial injury), male sex, and concomitant medial collateral ligament repair or posterior oblique ligament reefing or both. Twenty-one patients required surgery to regain their motion; three patients required a second procedure. Twenty-one of 27 patients with loss of motion under went a detailed followup and were compared with 24 randomly chosen controls who had a normal range of motion after anterior cruciate ligament reconstruction. At followup, patients who experienced loss of motion had a significant decrease in noninvolved to involved knee extension and flexion compared to the control patients. There was no difference between our patients and the controls regarding patellofemoral problems, anterior knee laxity, and functional strength. Sixty- seven percent of patients with loss of motion had a good or excellent result in comparison to 80% of the controls.
Extensor mechanism function after patellar tendon graft harvest for anterior cruciate ligament reconstruction
Authors: Rosenberg Thomas D. , Franklin Jonathan L. , Baldwin G. Nicholas , Nelson Kim A. 
Published: June 2007

We evaluated extensor mechanism function in 10 pa tients after they had arthroscopically assisted ACL reconstruction using the central third of the patellar tendon. The patients were randomly selected 12 to 24 months after reconstruction. All had rehabilitation where range of motion was initiated within the 1 st postoperative week. All patients stated that they were satisfied and considered their knee to be stable. The KT-1000 maximum measurements (30 to 40 pounds) averaged an increase of 1.7 mm when compared with the opposite knee. Subjective complaints, such as an terior knee pain, grating, and weakness, were common and only 3 of 10 patients returned to all of their preinjury sports. Persistent radiographic abnormalities were common. Physical examination and functional testing also re vealed persistent dysfunction of the extensor mecha nism in patients with radiographic abnormalities. Isoki netic testing at 60 deg/sec showed an average quad riceps deficit of 18% compared to the normal extremity. Axial computed tomography scans revealed significant decrease in quadriceps cross-sectional area. Magnetic resonance imaging and computed tomography con firmed persistent defects at the harvest site; there was significant anterior knee scar formation in these pa tients. Despite achieving ligamentous stability, patients still experienced permanent weakness, functional deficits, patellar chondrosis, and pain after ACL reconstruction using the central one-third of the patellar tendon.
Patterns of meniscal injury associated with acute anterior cruciate ligament injury in skiers
Authors: Paletta George A. , Levine David S. , O'Brien Stephen J. , Wickiewicz Thomas L. , Warren Russell F. 
Published: June 2007

To determine if the incidence and patterns of meniscal injury associated with acute anterior cruciate ligament injury in skiers are different from those seen in individ uals injured in nonskiing athletic activities, we reviewed the records of 150 patients with acute anterior cruciate ligament injuries. All patients had undergone arthro scopic evaluation within 21 days from the time of injury. There were 75 individuals who were injured while skiing and 75 individuals who sustained an injury in some other high-load athletic activitiy. Associated meniscal injury was documented at the time of arthroscopy and characterized by location, region, zone, depth, shape, size, and stability. Thirty-one of 75 skiers had an associated meniscal injury as compared to 47 of 75 of the nonskiers. This suggested a strong trend of decreased incidence of meniscal injury in the skier group, but the nonskiers had a higher incidence of major meniscal tears that required repair or partial meniscectomy. The location of the meniscal tear was also significantly different. The incidence of isolated lateral meniscal injury in skiers was higher than in nonskiers. There was a strong trend of increased incidence of medial meniscal involvement in the nonskiers than in the skiers. While there was no difference in the zone or region of tear between the two groups, the skier group was more likely to have a longitudinal tear of the posterior horn of the lateral meniscus. In both groups, lateral meniscal tears were more likely to require conservative treatment or partial meniscectomy while medial meniscal tears were more likely to be repaired than excised.
Outcome of conservative and surgical management of navicular stress fracture in athletes
Authors: Khan Karim M. , Fuller Peter J. , Brukner Peter D. , Kearney Chris , Burry Hugh C. 
Published: June 2007

Eighty-two athletes with 86 clinical navicular stress fractures, all imaged with computerized tomography, were followed for an average of 33 months (range, 6 to 108) after diagnosis. Initial treatment consisted of at least 6 weeks of nonweightbearing cast immobilization for 22 fractures, at least 6 weeks of limitation of activity with continued weightbearing for 34 fractures, and a period of less than 6 weeks of conservative treatment for another 19 fractures. Five patients attempted to continue playing sports. Six patients had immediate surgery. Nineteen of 22 patients (86%) who had initial non weightbearing cast immobilization treatment returned to sports, compared with only 9 of 34 patients (26%) who initially continued weightbearing with limited activ ity (P < 0.001 ). After failure of the latter treatment, successful outcomes were seen for 6 of 7 patients (86%) treated with nonweightbearing cast immobiliza tion, while 11 of 15 patients (73%) who had one surgical procedure were able to return to sports. These results indicate that nonweightbearing cast immobilization is the treatment of choice for navicular stress fractures. Also, this treatment compares favor ably with surgical treatment for patients who present after failed weightbearing treatments. Computerized tomographic appearances of healing fractures do not necessarily mirror clinical union, and postimmobilization management should be monitored clinically.
Osteochondral lesions of the talus
Authors: Loomer Richard , Fisher Carol , Lloyd-Smith Robert , Sisler John , Cooney Tom 
Published: June 2007

We report demographic, clinical, and imaging data on 92 patients with osteochondral lesions of the talus collected in one center between 1981 and 1992. All patients reported pain as their primary symptom. Ninety-four percent of the patients reported pain with activity. Physical examination was unhelpful. Using newer imaging techniques (bone scan and computed tomography) and with increased awareness, we have observed a sevenfold increase in the diagnostic fre quency of osteochondral lesions of the talus between the years 1981 to 1986 and 1987 to 1992. Bone scan is an excellent screening tool for patients with chronic ankle pain and has 99% sensitivity in depicting osteo chondral lesions.16 Computed tomography demon strated a previously unclassified lesion, the radiolucent defect, which accounts for 77% of the lesions in this series. We have therefore modified the Berndt and Harty classification system, basing it on radiographic appearance (principally computed tomography) and adding the radiolucent lesion. Fifty-eight patients were treated surgically. Anterior and midtalar lesions are now approached arthroscopi cally. Surgical treatment of the radiolucent lesion, con sisting of curettage and drilling, gives 42% excellent and 32% good results. Pain relief often occurs within months of surgery, but healing of the lesion requires years, and some may persist indefinitely.
An in vitro dynamic evaluation of prophylactic knee braces during lateral impact loading
Authors: Erickson Ann R. , Yasuda Kazunori , Beynnon Bruce , Johnson Robert , Pope Malcolm 
Published: June 2007

To determine the ability of prophylactic knee braces to reduce or limit medial collateral and anterior cruciate ligament elongation under dynamic loading conditions, we used cadaveric specimens that had a surrogate soft tissue material that matched the tissue compliance of in vivo contracted muscles. Eight cadaveric specimens were fitted with four pro phylactic knee braces and instrumented with Hall Effect Strain Transducers on both the medial collateral and anterior cruciate ligament. Each specimen was mounted in a testing frame while a lateral impact was applied to the knee joint by a pendulum at levels below the injury threshold. Legs were tested at 0° and 30° of knee flexion, both with and without an intact anterior cruciate ligament. The maximum elongation for each ligament was cal culated as a percentage of the initial measured length. The addition of a prophylactic knee brace significantly reduced the level of impact force at the point of impact, but this did not result in a significant reduction of anterior cruciate ligament elongation for any test. Al though not significant, all braces tested were more effective at reducing medial collateral ligament elonga tion during a lateral impact with the knee flexion at 30° than at 0°.
The strength characteristics of internal and external rotator muscles in professional baseball pitchers
Authors: Wilk Kevin E. , Andrews James R. , Arrigo Christopher A. , Keirns Michael A. , Erber Donna J. 
Published: June 2007

The purpose of this study was to establish a data base regarding the isokinetic muscular performance charac teristics of the external/internal rotator muscles of professional baseball pitchers. One hundred fifty healthy professional baseball pitchers were evaluated by use of a Biodex isokinetic dynamometer. The sub jects tested had a mean age of 23.4 years and a mean body weight of 199 pounds. Isokinetic tests were per formed concentrically at 180 and 300 deg/sec for both the throwing and nonthrowing shoulders. Testing pro cedures regarding positioning and stabilization followed established guidelines. The testing protocol and actual test repetitions were standardized for each subject. Statistical analysis was performed using the Pearson Product Moment Correlation and paired t-tests. Deter mination of the correlation coefficient was made at the P < 0.05 level of significance. Test results for bilateral comparison of mean peak torque for the throwing and nonthrowing shoulders indicated no statistically significant difference between the internal rotators at both test speeds, or for the external rotators at 300 deg/sec. There was a signifi cant statistical difference at the 180 deg/sec test speed for the external rotators. The external/internal rotator strength ratio indicated a 65% ratio at 180 deg/sec and a 61 % ratio at 300 deg/sec. Data were also collected for mean peak torque/body weight ratios of the throw ing shoulder to establish a data base in professional throwers. This study offers clinical relevance in establishing a muscle performance profile for the professional thrower. This data base can therefore be used as criteria that should be met before an injured pitcher can be returned to throwing at the professional baseball level.
Arthroscopic treatment of synovial impingement of the ankle
Authors: Meislin Robert J. , Rose Donald J. , Parisien J. Serge , Springer Stuart 
Published: June 2007

Twenty-nine cases of operative arthroscopy of the an kle were done between 1985 and 1989 for synovial impingement of the ankle. The average age of the patients was 37 years. All patients (17 men, 12 women) reported an earlier history of injury, with 24 of the patients (83%) noting chronic ankle pain after an inver sion injury and 5 of the patients (17%) reporting a previous ankle fracture. Physical examination elicited anterolateral tenderness at the ankle in all cases with associated anteromedial pain in 4 patients. A demon strable "click" was evident in 6 of the patients (21 %) on forced dorsiflexion of the ankle. All patients failed conservative treatment including physical therapy and nonsteroidal antiinflammatory drugs. Surgery was performed at an average of 36 months postinjury. Ankle arthroscopy revealed exten sive hypertrophic synovial thickening and scar tissue anterolaterally, indicating synovial impingement in all patients. Associated chondromalacia of the distal tibia was seen in 21 % of the patients. Operative arthroscopy included partial synovectomy and debridement of the hypertrophic tissue and partial shaving chondroplasty of the tibia when indicated. Postoperatively, patients were weightbearing as tolerated. Results were as sessed subjectively and objectively. At 25-month followup 26 patients had excellent or good results and 3 had fair results; there were no poor results. There were no major complications, including infection or neurovascular compromise. The 3 patients with associated ankle instability comprised the "fair" result group and eventually required lateral ankle recon struction. Thus, chronic ankle pain due to synovial impingement can be safely, predictably, and effectively treated by operative ankle arthroscopy.