bluuebunny/crossref_metadata_2025_split huggingface dataset:
Technical Errors during Medial Patellofemoral Ligament Reconstruction Could Overload Medial Patellofemoral Cartilage
Authors: Elias John J. , Cosgarea Andrew J. 
Published: May 2006

Background The influence of reconstruction of the medial patellofemoral ligament on the patellofemoral force and pressure distributions has not yet been investigated. Hypothesis Technical errors can cause tension to develop within a reconstructed medial patellofemoral ligament, which will adversely alter the normal patellofemoral force distribution by increasing the load applied to the medial cartilage. Study Design Controlled laboratory study. Methods Four computational knee models were used to simulate knee function from 30° to 90° of flexion with (1) an intact medial patellofemoral ligament, (2) an anatomically correct reconstruction using a double hamstring tendon autograft, (3) a 5-mm proximally malpositioned femoral attachment site, (4) a graft that is 3 mm shorter than the intact medial patellofemoral ligament, and (5) combined proximal malpositioning and a short graft. Results The results were similar for the intact and anatomically reconstructed medial patellofemoral ligament. Proximal malpositioning of the femoral attachment and using a short graft increased the graft tension during flexion, which decreased the lateral force and the lateral tilt moment acting on the patella. When a short graft was combined with proximal malpositioning, the compressive force applied to the medial cartilage at least doubled at low flexion angles, which increased the peak medial pressure by more than 50% at low flexion angles. Conclusion When the medial patellofemoral ligament is reconstructed, small errors in graft length and position can dramatically increase the force and pressure applied to medial patellofemoral cartilage. Clinical Relevance Overloading the medial cartilage after medial patellofemoral ligament reconstruction could lead to degradation, pain, and arthrosis.
Path of Glenohumeral Articulation Throughout the Rotational Range of Motion in a Thrower's Shoulder Model
Authors: Huffman G. Russell , Tibone James E. , Mcgarry Michelle H. , Phipps Brinceton M. , Lee Yeon Soo , Lee Thay Q. 
Published: May 2006

Background Overhead-throwing athletes have increased external and diminished internal glenohumeral rotation that may alter glenohumeral kinematics. Purpose To quantify the kinematic changes present in a cadaveric model of a thrower's shoulder. Study Design Controlled laboratory study. Methods In 8 fresh-frozen cadaveric shoulders, the rotator cuff and overlying muscles were removed, and the glenohumeral capsule, coracoacromial ligament, and coracohumeral ligament were left intact. The scapula was fixed, and the humerus was placed in 90° of shoulder abduction in a 6 degrees of freedom testing device. A compressive force of 44 N was applied. A thrower's shoulder model was created, and sequential conditions were examined: intact, after anterior stretching, and after the addition of posterior-inferior capsular plication. Kinematic measurements were obtained through a complete range of glenohumeral rotation. Results Glenohumeral external rotation increased 16%, from 149° to 173° (P <. 001), after stretching in external rotation and remained increased by 11% to 166° (P <. 001) after posterior-inferior capsular plication. With the addition of the posterior-inferior capsular plication, internal rotation averaged 7°, which was not significantly different from the intact state (11°, P =. 55) or the stretched state (16°, P =. 07). The total glenohumeral rotation after stretching followed by posterior-inferior capsular plication did not differ significantly from intact state (P =. 25). At maximum external rotation, the humeral head apex was shifted posteriorly in the stretched (P =. 003) and plicated (P <. 001) states compared with the intact state. The humeral head apex was posteriorly displaced at 135° and 150° of external rotation compared with the intact condition (P =. 039 and. 049, respectively). In maximum internal rotation, anterior stretching had no significant effect on the humeral head apex position. However, after posterior-inferior capsular plication, the humeral head apex was significantly shifted inferiorly (P =. 005) and anteriorly (P =. 03) in maximum internal rotation compared with the intact state. Conclusion Significant changes in glenohumeral motion occur in this model during the simulated late-cocking and follow through phases of throwing. In this model, posterior capsular tightness alters the humeral head position most profoundly during the deceleration and follow-through phases of throwing.
An Analysis of the Causes of Failure in 57 Consecutive Posterolateral Operative Procedures
Authors: Noyes Frank R. , Barber-Westin Sue D. , Albright Jay C. 
Published: May 2006

Purpose To investigate 57 failed posterolateral procedures in 30 consecutive knees to determine factors that may have contributed to the failure. Study Design Case series; Level of evidence, 4. Methods Thirty patient records were reviewed by an independent surgeon. The index posterolateral operations were done for 13 acute and 17 chronic knee injuries. The anterior cruciate ligament was ruptured in 17 knees, the posterior cruciate ligament was torn in 5 knees, and both cruciates were ruptured in 8 knees. In 25 knees, 46 revision posterolateral procedures had been performed, of which 27 had also failed (in 21 knees). Five knees did not undergo revision of the posterolateral structures. Results In 22 knees, multiple factors were identified that most likely contributed to the failure of the posterolateral procedures. The most common factors were nonanatomical graft reconstruction (23 knees), untreated varus malalignment (10 knees), and failure to successfully reconstruct all ruptured knee ligaments, including cruciates (27 knees). Thirty-nine anterior cruciate ligament procedures were done in 24 knees, including 24 primary and 15 revision operations. Seventeen posterior cruciate ligament procedures were done in 13 knees, including 13 primary and 4 revision operations. At the time of writing, 16 of 24 knees had a functional anterior cruciate ligament graft and 5 of 13 had a functional posterior cruciate ligament graft. Conclusion The results suggest greater emphasis during the index operation for anatomical graft reconstruction of one or more of the posterolateral structures as necessary, restoration of all ruptured cruciate ligaments, and correction of varus malalignment.
Meniscal Tear Characteristics in Young Athletes with a Stable Knee
Authors: Terzidis Ioannis P. , Christodoulou Anastasios , Ploumis Avraam , Givissis Panagiotis , Natsis Konstantinos , Koimtzis Miltiadis 
Published: May 2006

Background There has been great interest in the literature regarding meniscal tears in unstable knees, but there is not as much information available on stable knees. Purpose To report the characteristics of isolated meniscal tears (type and location) in athletes with intact cruciate ligaments. Study Design Case series; Level of evidence, 4. Methods Arthroscopic surgery was performed on 314 (83.1%) knees in the acute phase (<6 weeks) of injury and on 64 (16.9%) knees more than 6 weeks after injury for a total of 364 athletes (378 knees). Cooper's classification was used to classify the meniscal tears according to the type and location. Results Overall, 262 of 378 tears (69.3%) were located in the medial meniscus and 116 (30.7%) in the lateral meniscus. Vertical tears (77.5%) were significantly more frequent than were horizontal tears (22.5%; ϰ2 test, P < .001). A total of 23.2% of tears involved the peripheral zones (zone 0 or 1), and tears that extended into the posterior horn accounted for 75.7%. Regarding the tear shape between male and female athletes, on both sides there were no statistically significant differences in the percentage of horizontal, bucket-handle, longitudinal, or radial tears. Conclusion The characteristics of isolated meniscal tears differ with regard to the sport, sex, and tear location and type from those seen in unstable knees. This knowledge is useful in knee injury management.
Biomechanical and Anatomical Effects of an External Rotational Torque Applied to the Knee
Authors: Csintalan Rick P. , Ehsan Amirhesam , McGarry Michelle H. , Fithian Donald F. , Lee Thay Q. 
Published: May 2006

Background External rotational torque is one of the mechanisms that may occur during a pivoting or twisting injury to the knee. Hypothesis Simulated external rotational injury by applying external rotational torque will increase knee laxity and cause soft tissue damage to the knee. Study Design Controlled laboratory study. Methods Six cadaveric knees and a custom testing system were used to produce external rotational torque of 30°, 45°, and 60° with the knee at 30° of flexion. Anterior-posterior, valgus-varus, and rotational knee laxity were quantified. After sequential rotational torque to 60°, the specimens were dissected to identify injured structures. Results External rotational torque of 45° and 60° significantly increased knee joint laxity in all directions (P <. 05). Dissection showed that all posterior cruciate ligaments were intact; all medial collateral and anterior cruciate ligaments revealed either partial or complete tears. The lateral collateral ligaments were torn in all specimens. The popliteus tendon was attenuated in 1 specimen and was completely torn in 1 specimen. The popliteofibular ligament was torn in 3 specimens. Conclusion External rotational torque to 60° increased knee laxity, and dissection revealed a consistent pattern of injury to the medial and lateral collateral and anterior cruciate ligaments and posterolateral corner. Clinical Relevance Because isolated ligament injuries are rare, recognizing these combined ligamentous injuries early is essential for repair in the acute stage.
Revision Anterior Cruciate Ligament Reconstruction with Hamstring Tendon Autograft
Authors: Salmon Lucy J. , Pinczewski Leo A. , Russell Vivianne J. , Refshauge Kathryn 
Published: May 2006

Background The results of revision anterior cruciate ligament reconstruction are limited in the current literature, and no studies have previously documented the outcome of revision anterior cruciate ligament reconstruction using solely hamstring tendon grafts. Hypothesis Revision anterior cruciate ligament reconstruction with 4-strand hamstring tendon graft affords acceptable results and is comparable to reported outcomes with the bone–patellar tendon–bone graft. Study Design Case series; Level of evidence, 4. Methods Fifty-seven consecutive revision anterior cruciate ligament reconstructions with the hamstring tendon graft and interference screw fixation were assessed a mean time of 89 months (range, 60-109 months) after surgery. Assessment included the International Knee Documentation Committee knee ligament evaluation, instrumented laxity testing, and radiologic examination. Results Of the 50 knees reviewed, 5 (10%) had objective failure of the revision anterior cruciate ligament reconstruction. Of the 45 patients with functional grafts, knee function was normal or nearly normal in 33 patients (73%). An overall grade of normal or nearly normal was found in 56% of patients. The mean side-to-side difference on manual maximum testing was 2.5 mm (range,–1 to 4 mm). Degenerative changes on radiographs were identified in 23% of patients at the time of surgery, increasing to 56% of patients at review. The status of the articular cartilage at the time of revision surgery was the most significant contributor to successful outcome. Conclusion Revision anterior cruciate ligament reconstruction with hamstring tendon graft and interference screw fixation affords acceptable results at a minimum of 5 years’ follow-up. Good objective results can be obtained, but subjectively, the results appear inferior to those of primary anterior cruciate ligament reconstruction in the literature, which may be related to the high incidence of articular surface damage in this patient population. We recommend that, when available, hamstring tendon autografts should be considered for revision anterior cruciate ligament reconstruction.
Lateral Epicondylitis
Authors: Cummins Craig A. 
Published: May 2006

Background Surgical management of lateral epicondylitis has traditionally consisted of an open incision with debridement of the affected extensor tendon tissue. More recently, arthroscopy has been reported as a surgical option for this condition. Purpose To evaluate the effectiveness of arthroscopic debridement in excising the characteristic tendinopathy of chronic lateral epicondylitis and determine if residual tendinopathy correlated with poorer patient outcomes. Study Design Case series; Level of evidence, 4. Methods Data were prospectively collected on all patients who underwent arthroscopic debridement of chronic lateral epicondylitis during a 2-year period. The arthroscopic debridement was assessed in regard to its effectiveness in excising the characteristic tendinopathy through a traditional open procedure by gross and histologic analysis. Outcomes data were collected on all patients preoperatively and at a minimum of 1 year postoperatively. Patient outcomes were then correlated with the residual histologic tendinopathy after arthroscopic debridement. Results Eighteen patients were enrolled in the investigation. Gross evidence of residual tendinopathy was identified in 6 patients, with all 6 cases occurring during the first year of the study. Of the 18 patients, 10 had residual histologic evidence of tendinopathy after arthroscopic debridement. Poorer outcomes were identified in those patients who had residual histologic tendinopathy on their rating of worst level of pain (P = .03). Conclusion Residual microscopic tendinopathy is often present after arthroscopic debridement. Clinically, residual microscopic tendinopathy correlated with poorer surgical outcomes in regard to patient's rating of their worst level of pain.
Risk Factors for Injury in Indoor Compared with Outdoor Adolescent Soccer
Authors: Emery Carolyn A. , Meeuwisse Willem H. 
Published: May 2006

Background There are limited data on the epidemiology of indoor soccer injuries. Purpose Injury rates and risk factors for injury in adolescent indoor and outdoor soccer in the same cohort of players will be identified and compared. Study Design Cohort study (prevalence); Level of evidence, 2. Methods The study population was a random sample of 21 adolescent (ages 13-17 years) outdoor soccer teams (N = 317). The subcohort included players continuing to play in the indoor soccer season (n = 142). The injury definition included any injury occurring in soccer that resulted in medical attention, the inability to complete a session, and/or missing a subsequent session. Results The overall injury rate found in indoor soccer over 20 weeks was 4.45 injuries per 1000 player hours (95% confidence interval, 3.1–6.19). The overall injury rate found in the 13-week outdoor soccer season among a similar cohort was 5.59 injuries per 1000 player hours (95% confidence interval, 4.42–6.97). The relative risk of injury suggests that there was no significant difference between injury rates by age group or gender in indoor soccer compared with outdoor soccer. The risk of injury in the most elite division of play was greater in outdoor compared with indoor soccer (relative risk, 3.22; 95% confidence interval, 1.8-6.12). The most commonly injured body part in both indoor and outdoor soccer was the ankle, followed by the groin in indoor and the knee in outdoor soccer. Conclusion There were no significant differences in overall injury rates found by gender or age group for indoor compared with outdoor soccer. Future research should focus on injury prevention strategies to reduce lower extremity injury in indoor and outdoor adolescent soccer.
Optimizing search strategies to identify randomized controlled trials in MEDLINE
Authors: Zhang Li , Ajiferuke Isola , Sampson Margaret 
Published: May 2006

Abstract

Background
The Cochrane Highly Sensitive Search Strategy (HSSS), which contains three phases, is widely used to identify Randomized Controlled Trials (RCTs) in MEDLINE. Lefebvre and Clarke suggest that reviewers might consider using four revisions of the HSSS. The objective of this study is to validate these four revisions: combining the free text terms volunteer, crossover, versus, and the Medical Subject Heading CROSS-OVER STUDIES with the top two phases of the HSSS, respectively.

Methods
We replicated the subject search for 61 Cochrane reviews. The included studies of each review that were indexed in MEDLINE were pooled together by review and then combined with the subject search and each of the four proposed search strategies, the top two phases of the HSSS, and all three phases of the HSSS. These retrievals were used to calculate the sensitivity and precision of each of the six search strategies for each review.

Results
Across the 61 reviews, the search term versus combined with the top two phases of the HSSS was able to find 3 more included studies than the top two phases of the HSSS alone, or in combination with any of the other proposed search terms, but at the expense of missing 56 relevant articles that would be found if all three phases of the HSSS were used. The estimated time needed to finish a review is 1086 hours for all three phases of the HSSS, 823 hours for the strategy versus, 818 hours for the first two phases of the HSSS or any of the other three proposed strategies.

Conclusion
This study shows that compared to the first two phases of the HSSS, adding the term versus to the top two phases of the HSSS balances the sensitivity and precision in the reviews studied here to some extent but the differences are very small. It is well known that missing relevant studies may result in bias in systematic reviews. Reviewers need to weigh the trade-offs when selecting the search strategies for identifying RCTs in MEDLINE.
The incidence of smoking and risk factors for smoking initiation in medical faculty students: cohort study
Authors: Senol Yesim , Donmez Levent , Turkay Mehtap , Aktekin Mehmet 
Published: May 2006

Abstract

Background
Medical education requires detailed investigation because it is a period during which the attitudes and behaviors of physicians develop. The purpose of this study was to calculate the yearly smoking prevalence and incidence rates of medical faculty students and to identify the risk factors for adopting smoking behaviour.

Methods
This is a cohort study in which every student was asked about their smoking habits at the time of first registration to the medical faculty, and was monitored every year. Smoking prevalence, yearly incidence of initiation of smoking and average years of smoking were calculated in analysis.

Results
At the time of registration, 21.8% of the students smoked. At the end of six years, males had smoked for an average of 2.6 ± 3.0 years and females for 1.0 ± 1.8 years (p < 0.05). Of the 93 medical students who were not smokers at the time of registration, 30 (32.3%) were smokers at the end of the 6 years of the course.

Conclusion
The first 3 years of medical education are the most risky period for initiation of smoking. We found that factors such as being male, having a smoking friend in the same environment and having a high trait anxiety score were related to the initiation of smoking. Targeted smoking training should be mandatory for students in the Medical Faculty.
Absinthism: a fictitious 19th century syndrome with present impact
Authors: Padosch Stephan A , Lachenmeier Dirk W , Kröner Lars U 
Published: May 2006

AbstractAbsinthe, a bitter spirit containing wormwood (Artemisia absinthiumL.), was banned at the beginning of the 20thcentury as consequence of its supposed unique adverse effects. After nearly century-long prohibition, absinthe has seen a resurgence after recent de-restriction in many European countries. This review provides information on the history of absinthe and one of its constituent, thujone. Medical and toxicological aspects experienced and discovered before the prohibition of absinthe are discussed in detail, along with their impact on the current situation. The only consistent conclusion that can be drawn from those 19thcentury studies about absinthism is that wormwood oil but not absinthe is a potent agent to cause seizures. Neither can it be concluded that the beverage itself was epileptogenic nor that the so-called absinthism can exactly be distinguished as a distinct syndrome from chronic alcoholism.The theory of a previous gross overestimation of the thujone content of absinthe may have been verified by a number of independent studies. Based on the current available evidence, thujone concentrations of both pre-ban and modern absinthes may not have been able to cause detrimental health effects other than those encountered in common alcoholism. Today, a questionable tendency of absinthe manufacturers can be ascertained that use the ancient theories of absinthism as a targeted marketing strategy to bring absinthe into the spheres of a legal drug-of-abuse. Misleading advertisements of aphrodisiac or psychotropic effects of absinthe try to re-establish absinthe's former reputation. In distinction from commercially manufactured absinthes with limited thujone content, a health risk to consumers is the uncontrolled trade of potentially unsafe herbal products such as absinthe essences that are readily available over the internet.
Autoimmune Polyendocrinopathy-Candidiasis-Ectodermal Dystrophy
Authors: Perheentupa Jaakko 
Published: May 2006

Abstract
Context: Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy is known as a rare hereditary disease with classic triad of mucocutaneous candidiasis, hypoparathyroidism, and adrenocortical failure, two of which, diagnostic dyad, are required for the diagnosis. Evidently many patients suffer unrecognized because the condition is more variable and complex.
Objective: The objective of the study was to describe the variability of autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy for promoting recognition and adequate follow-up of patients.
Setting: The Finnish series of patients is the largest internationally.
Patients: The study population was all 91 known Finnish patients.
Results: Besides the classical triad, a dozen autoimmune endocrine and other components occurred variably, several of them dangerous. The initial manifestation appeared within the age range of 0.2–18 yr, mucocutaneous candidiasis being part of it in 60% of the patients, hypoparathyroidism in 32%, and adrenocortical failure in 5%. But 23% of the patients had one to six other components before the diagnostic dyad: hepatitis, keratoconjunctivitis, chronic diarrhea, periodic rash with fever. The dyad appeared 0.2–20 yr later. Prevalence of most components increased with age, diabetes mellitus, hypothyroidism, and testicular failure becoming common toward middle age. Tubulointerstitial nephritis occurred in 9% of the patients, apparent mineralocorticoid excess in 9%, asplenia in 19% of adults, and oral or esophageal squamous cell carcinoma in 10% of patients older than 25 yr.
Conclusions: Any child or young adult with one of the many disease components should be examined for others and consideration of AIRE mutation assay.