bluuebunny/crossref_metadata_2025_split huggingface dataset:
Postoperative return of motion in anterior cruciate ligament and medial collateral ligament injuires
Authors: Robins Anthony J. , Newman Alan P. , Burks Robert T. 
Published: June 2007

Twenty consecutive patients with combined anterior cruciate/medial collateral ligament injuries were ana lyzed to determine if a correlation exists between the location of medial collateral ligament disruption and postoperative return of motion. All patients were treated operatively by autogenous patellar tendon an terior cruciate ligament reconstruction and primary me dial collateral ligament repair. The mean followup was 379 days. The patients (12 men and 8 women; mean age, 23 years) were divided into two groups based on the location of superficial medial collateral ligament rupture. Group P consisted of 13 patients with lesions at or proximal to the joint line; Group D consisted of 7 patients with disruptions distal to the joint line. Group D patients had a more rapid return of motion for both flexion and extension. At the conclusion of followup, patients from Group D also achieved 8° more flexion and 3° more extension. There were eight addi tional procedures performed on five patients, all from Group P, required to treat difficulty regaining motion. Among those patients with anterior cruciate/medial collateral ligament injuries there are two distinct groups, each with different prognoses related to return of mo tion based on the location of the medial collateral liga ment disruption. We suggest that patients with double- ligament injuries, where the medial collateral ligament lesion is proximal, should be managed very aggres sively to regain motion.
A comparison of patellar tendon autograft and allograft used for anterior cruciate ligament reconstruction in the goat model
Authors: Jackson Douglas W. , Grood Edward S. , Goldstein Jack D. , Rosen Mark A. , Kurzweil Peter R. , Cummings John F. , Simon Timothy M. 
Published: June 2007

Similar-sized patellar tendon autografts and fresh-fro zen allografts were used to reconstruct the anterior cruciate ligament of one knee in 40 female goats. Evaluations of the reconstructions and contralateral controls at the 6-week and 6-month postoperative pe riods included anterior-posterior translation, mechanical properties determined during tensile failure tests, meas urement of cross-sectional area, histology, collagen fibril size and area distribution, and associated articular cartilage degenerative changes. Six months after anterior cruciate ligament recon struction, the autografts demonstrated a smaller in crease in anterior-posterior displacement, values of maximum force to failure two times greater, a significant increase in cross-sectional area, a more rapid loss of large-diameter collagen fibrils, and an increased density and number of small-diameter collagen fibrils compared to the allografts. Clinical significance . More surgeons are allowing their patients to return to running and sports 6 months after anterior cruciate ligament reconstruction. While the structural and material properties of autografts and allografts at time zero are similar, in the goat model during the first 6 months they differ. The allografts demonstrate a greater decrease in their implantation structural properties, a slower rate of biologic incorpo ration, and the prolonged presence of an inflammatory response. At 6 months the autograft demonstrates a more robust biologic response, improved stability, and increased strength to failure values.
The effect of early versus late return to vigorous activities on the outcome of anterior cruciate ligament reconstruction
Authors: Glasgow Steven G. , Gabriel Josue P. , Sapega Alexander A. , Glasgow Michele T. , Torg Joseph S. 
Published: June 2007

The effect of early (mean, 5 months) versus late (mean, 9 months) return to vigorous cutting activity on the long-term outcome of anterior cruciate ligament recon struction was evaluated retrospectively. Sixty-four re constructions, using a distally attached medial one-third patellar tendon, were reviewed on an average of 46 months postoperatively. After surgery, the timing of return to vigorous activity was based on biologic fixa tion of the graft, a negative Lachman test, absence of effusion, and the patient's desire to return to previous activity. The 64 patients were retrospectively separated into two groups. The early group consisted of 31 patients who returned to activity 2 to 6 months after reconstruc tion, and the late group consisted of 33 patients who returned to activity 7 to 14 months after reconstruction. By clinical examination, KT-1000 arthrometer meas urements, subjective evaluation, and Cybex testing, there were no differences between the early and late return groups except for reestablishment of final range of motion. At an average followup of 46 months, this study indicates that an early return to vigorous physical cut ting activities after ACL reconstruction does not predis pose patients to reinjury or a less satisfactory long- term result.
The role of the lateral extraarticular restraints in the anterior cruciate ligament-deficient knee
Authors: Wroble Randall R. , Grood Edward S. , Cummings John S. , Henderson Joel M. , Noyes Frank R. 
Published: June 2007

We measured the increases in tibiofemoral motion when lateral structures were sectioned in anterior cru ciate ligament-deficient knees of 20 unembalmed ca daveric whole lower limbs. Motion was measured with a six degrees-of-freedom electrogoniometer. The lateral structures investigated were the iliotibial band and mid- lateral capsule, lateral collateral ligament, and popliteus tendon and the posterolateral capsule. Cutting the anterolateral structures increased anterior translation and internal rotation, particularly in flexion. Increases in motions were highly variable, reflecting the variation in function in the lateral collateral ligament and posterolateral structures. Cutting the lateral collateral ligament produced small changes in anterior translation and external rotation and larger increases in adduction. Cutting the posterolateral structures produced small increases in external rotation. Large increases in exter nal rotation were found only if the lateral collateral ligament was also sectioned. The posterolateral struc tures act in concert with the lateral collateral ligament in restraining internal and external rotation. External rotation was affected at all flexion angles; internal ro tation was affected mainly in extension. Our results can be used in the diagnosis of complex knee ligament injuries. Findings of increased anterior translation in both flexion and extension and increased internal rotation at 90° of flexion are consistent with combined injury to the anterior cruciate ligament and the anterolateral structures. The anterior cruciate liga ment-deficient knee with significant posterolateral com promise (posterolateral structures/lateral collateral lig ament) would exhibit larger anterior translation in ex tension than in flexion, increased adduction, and increased external rotation in both flexion and exten sion.
Women's gymnastics injuries
Authors: Sands William A. , Shultz Barry B. , Newman Alan P. 
Published: June 2007

A 5-year prospective study on the time course of wom en's gymnastics injuries was conducted on a successful NCAA Division I team. Gymnasts recorded injuries on a computer terminal or via computer dot sheets imme diately before each training session, including the in jured body part, the event or activity, and the date of the injury. The definition of injury was "any damaged body part that would interfere with training." Athletes recorded injuries on the 1 st day of onset and subse quently until the injury was healed. The initial onset of injury was considered a new injury. Subsequent rec ords of the injury were considered continuing injury. Thirty-seven athletes participated through five colle giate seasons. They accounted for 5602 total training exposures with an average of 151.4 exposures per athlete. The analyses showed that gymnasts trained with an injury approximately 71% of the exposures, and a new injury could be expected from a gymnast during approximately 9% of the exposures. The largest number of injuries were of the repetitive stress syn drome type. The time series information showed that total injuries tended to increase until the middle of the competitive season, while new injuries showed promi nent increases during specific training periods and dur ing competition preparation and performance.
Arthroscopic treatment of glenoid labral tears
Authors: Cordasco Frank A. , Steinmann Scott , Flatow Evan L. , Bigliani Louis U. 
Published: June 2007

We reviewed 52 consecutive patients who had under gone arthroscopic labral debridement. The average age was 29 and there were 35 men and 17 women. At operation, 27 patients had superior labrum anterior and posterior (SLAP) lesions, 20 patients had anteroinferior labral lesions, and 5 patients had posterior labral le sions. Despite the fact that, preoperatively, none of these patients had a history of dislocations or clinically evident instability, 70% of the patients with superior labral lesions, and all of those with anteroinferior and posterior lesions had instability on examination under anesthesia. The average followup was 36 months. At 1 year after arthroscopy, 78% of the patients with superior lesions had excellent relief compared with 30% of the patients in the anteroinferior group. At 2 years followup, these results decreased to 63% and 25%, respectively, and only 45% of the patients with superior labral lesions and 25% of those with anteroinferior lesions had re turned to their previous athletic performance level. Four patients required a reoperation: 2 for instability and 2 for impingement. We conclude that occult instability is frequently present in patients with glenoid labral tears. The overall results are not encouraging, but this pro cedure may have an indication for short-term goals in competitive athletes or those who are willing to accept some compromise in function.
Isolated arthroscopic partial meniscectomy
Authors: Bolano Luis E. , Grana William A. 
Published: June 2007

Fifty patients who underwent isolated arthroscopic par tial meniscectomy with a minimum followup of 5 years were analyzed retrospectively. To analyze the factors associated with a satisfactory or an unsatisfactory clin ical result, we looked at the patient's age, duration of symptoms, type of meniscal lesion, and articular carti lage abnormalities. The patients were graded with a functional knee score (Lysholm-Gillquist), and activity level before surgery and at followup was determined. The data also included radiographic evaluation of 29 of the 50 patients. Tibiofemoral alignment was measured, and osteoarthritic changes were graded and correlated with the type of meniscal abnormality and functional result. Eighty-two percent of our patients had satisfactory knee function, and the activity level was maintained. The factors associated with a satisfactory result after a partial meniscectomy included age less than 40 years, symptoms less than 12 months duration, type of tear, and chondromalacia less than grade II. Fairbank's changes were present in 50% of the patients, with significant grade III and IV changes identified in 30%. Although the radiographic changes did not necessarily correlate with the functional result, we felt that the changes were significant and indicative of abnormal stress transfer to articular cartilage and bone.
Injuries in recreational adult fitness activities
Authors: Requa Ralph K. , DeAvilla L. Nicole , Garrick James G. 
Published: June 2007

Volunteers (986) from fitness clubs and studios were recruited and followed for a 3-month period to docu ment the injury consequences of adult recreational fitness participation. Participants were telephoned each week and their activities as well as any injuries that occurred were recorded. Of the 525 injuries and complaints reported during 60,629 hours of activity, 475 occurred as a result of sports participation for an overall rate of 7.83 per 1000 hours of participation. Seventy-six percent of these episodes caused the patient to alter or miss 1 or more activities, while 9.5% involved a physician visit. The rate for time-loss injuries was less than 2 per person per year (1.76 per 298 hours) or 5.92 per 1000 hours. Running had a higher risk of injury compared with most other individual sports. Cardiovascular fitness activities had low to medium rates, as did weight work; compet itive sports were higher. For 6 of the most commonly injured areas, the reinjury rate was about twice that reported for those with no history of previous injury. The risks of injury from most recreational fitness activities were relatively modest, particularly if the ac tivities were not competitive. Physicians might help patients reduce their risks of injury by encouraging suitable activities and by reducing the risks of reinjury by implementing appropriate rehabilitation programs.
Cell survival after transplantation of fresh meniscal allografts
Authors: Jackson Douglas W. , Whelan Jeffery , Simon Timothy M. 
Published: June 2007

Fibrochondrocytes synthesize and maintain the extra cellular matrix responsible for the distinctive material and structural properties of a normal meniscus. Viable meniscal cells are believed to be necessary for the long- term maintenance of these properties in meniscal allo grafts. The purpose of this study was to determine if the donor cells (fibrochondrocytes) survive after a fresh meniscal allograft transplantation. A DNA probe technique was used to clearly distin guish the DNA patterns in donor cells from the host cells in the Spanish goat. No remaining donor DNA could be demonstrated at 4 weeks in transplanted meniscal tissue; it was all of host origin. The host DNA content at 4 weeks approached or exceeded the amount present in the contralateral control meniscus. Clinical significance: The results of this study dem onstrate that viable cells in medial meniscal allografts transplanted from one animal to another do not survive. Host cells rapidly repopulate the transplanted menis cus. There is no evidence these new cells will maintain on a long-term basis the extracellular matrix of the meniscus. The evidence in this paper, that the fibro chondrocytes do not survive transplantation, suggests further justification is necessary for using grafts with living cells. Allografts with living cells have an increased expense, more complicated surgical logistics, and have a higher potential risk of disease transmission.
Comparison of arthroscopic and open reconstruction of the anterior cruciate ligament
Authors: Raab David J. , Fischer David A. , Smith J. Patrick , Markman Alan W. , Steubs John A. 
Published: June 2007

The purpose of this study was to determine in a prospective, randomized, blinded design whether ar throscopically assisted anterior cruciate ligament reconstruction offered any significant immediate or short-term advantages over traditional open recon struction through a limited arthrotomy. Patients with a diagnosis of deficiency of the anterior cruciate ligament were randomly assigned to one of two treatment groups: the open group (limited open reconstruction) or the arthroscopic group (fully arthroscopic reconstruc tion). Postoperatively, both groups were treated iden tically. Intra- and postoperative observations included length of surgery, duration of hospitalization, and amount of pain medication. Follow-up evaluations were performed at 1, 6, 12, 16, 20, and 24 weeks to record crepitus, swelling, range of motion, ligament laxity, and thigh atrophy. Lysholm scores were obtained at the 16 and 24 week followups. At 24 weeks, 86% of the open group and 89% of the arthroscopic group had good-to-excellent results. Intra operative, postoperative, and follow-up findings indi cated no statistically significant differences or relation ships between the two groups in any of the variables measured, except that operative time was 13 minutes longer in the arthroscopic group (P < 0.001). The results do not substantiate a clinical advantage for either technique.
Complications of arthroscopic meniscal repair
Authors: Austin Kenneth S. , Sherman Orrin H. 
Published: June 2007

The results of 101 consecutive arthroscopic meniscal repairs were studied to determine the nature and fre quency of associated complications. All arthroscopic repairs were done by the senior author (OS) between November 1984 and June 1991. Our data include 65 patients with associated anterior cruciate ligament in juries, of which 49 underwent concurrent arthroscopic anterior cruciate ligament reconstruction. There was an overall complication rate of 18%. There was a 20% risk of complication with meniscal repair when associated with anterior cruciate ligament injury and 14% without anterior cruciate ligament injury. There was a 10% incidence of arthrofibrosis when meniscal repair was performed with anterior cruciate ligament reconstruction and a 6% incidence when per formed in an anterior cruciate ligament-deficient, non- reconstructed knee. Overall, there was a 13% risk of complication with lateral repairs compared with 19% with medial repairs. In the subset of patients with intact anterior cruciate ligaments and isolated meniscal le sions, there were no complications associated with lateral repair and an 18% risk of complication with medial repair. Female patients demonstrated a higher likelihood of complication (29%) than male patients (13%). Excluding repair failures, there was an 8% re operation or rehospitalization rate.
Preoperative Evaluation of the Ulnar Collateral Ligament by Magnetic Resonance Imaging and Computed Tomography Arthrography
Authors: Timmerman Laura A. , Schwartz Martin L. , Andrews James R. 
Published: June 2007

A prospective study was completed on 25 baseball play ers with medial side elbow pain. They were evaluated preoperatively with both computed tomography arthro gram and magnetic resonance imaging examinations of the elbow to assess the ulnar collateral ligament. At surgery, 16 of 25 patients had an abnormal ulnar col lateral ligament and 9 patients had a normal ulnar col lateral ligament. The computed tomography arthrogram detected abnormalities in 12 of the 14 patients with ulnar collateral ligament tearing (sensitivity, 86%). The mag netic resonance imaging scan indicated abnormalities in 8 of 14 patients (sensitivity, 57%). The specificity of the computed tomography arthrogram was 91 % and the magnetic resonance imaging was 100%. A newly described "T-sign" was seen on the com puted tomography arthrogram in the patients with an undersurface tear of the ulnar collateral ligament. This represented the dye leaking around the detachment of the ulnar collateral ligament from its bony insertion but remaining contained within the intact superficial layer of the ulnar collateral ligament and capsule. Both the computed tomography arthrogram and the magnetic resonance imaging scan were accurate in di agnosing a complete tear of the ulnar collateral ligament preoperatively in all cases. The main advantage of the computed tomography arthrogram was in evaluating the partial undersurface tear.
An Evaluation of the Shoulder Relocation Test
Authors: Speer Kevin P. , Hannafin Jo A. , Altchek David W. , Warren Russell F. 
Published: June 2007

The purpose of this study was to evaluate the sensitivity, specificity, negative and positive predictive values, and accuracy of the shoulder relocation test in 100 patients who underwent shoulder surgery. Based on operative data and examination under anesthesia, the diagnoses were grouped into six categories: anterior instability (without cuff disease), posterior instability, rotator cuff disease (without associated anterior instability), acro mioclavicular disorder, osteoarthrosis, and instability of the biceps tendon. The test was performed on the day of surgery by placing the arm in a position of 90° of humerothoracic abduction and 90° of external rotation (90°/90°). Patient responses of pain and apprehension (considered separately) were assessed in this position both with and without application of an anterior force to the proximal humerus. The relocation test assessed diminution of pain and apprehension after application of a posteriorly directed force to the proximal humerus relative to the position of 90°/90° alone and to the po sition of an anterior force being applied to the proximal humerus. Overall, 63 patients reported pain with 90°/90°; 74 reported pain when an anterior force to the proximal humerus was applied: the anterior instability group alone had 46 and 63 reports of pain, respectively; the rotator cuff group alone had 82 and 88 reports of pain, respectively. The only positive responses for apprehen sion were in the anterior instability group, of which 63% had apprehension with 90°/90° alone and 74 had ap prehension when an anterior humeral force was ap plied. The overall accuracy of the shoulder relocation test was <50% when the response of pain alone was considered and >80% when the response of apprehen sion alone was considered. The performance of the test was contrasted within the anterior instability and rotator cuff disease groups. A positive relocation test for pain was observed in 30% (14 of 46) of the anterior instability group and in 44% (15 of 34) of the rotator cuff disease group; this increased to 54% (25 of 46) and 56% (19 of 34), respectively, with reference to the position of an anterior force on the proximal humerus.
Comparison of Lateral Ankle Ligamentous Reconstruction Procedures
Authors: Liu Stephen H. , Baker Champ L. 
Published: June 2007

The static restraints of various surgical procedures for chronic lateral ankle instability were compared. Forty cadaveric ankles were divided equally into the follow ing five groups: 1) ankles with intact anterior talo fibular and calcaneofibular ligaments, 2) ankles with incised anterior talofibular and calcaneofibular liga ments, 3) ankles with Chrisman-Snook procedure, 4) ankles with Watson-Jones procedure, or 5) ankles with modified Broström procedure. All ankles were placed in a mechanical apparatus for anterior drawer stress and inversion stress tests. After each applica tion of force, a radiograph of the ankle joint was taken, and the anterior talar displacement and the ta lar tilt angle were measured. All procedures reduced anterior drawer and talar tilt when compared with the ankles with incised anterior talofibular and calcaneofibular ligaments. Significant differences were found among the groups for both in version and anterior drawer stress at all forces, except for the third and fourth groups. The modified Broström group had the least amount of anterior talar displace ment and talar tilt angle at all forces. There were no significant differences between the Watson-Jones and the Chrisman-Snook procedures in anterior talar dis placement and talar tilt. The modified Broström proce dure produced a greater mechanical restraint than either of the other procedures.