bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reconstruction of the anterior cruciate ligament using allogeneic tendon
Authors: Shino Konsei , Inoue Masahiro , Horibe Shuji , Hamada Masayuki , Ono Keiro 
Published: June 2007

Eighty-four patients who underwent ACL reconstruc tion with fresh-frozen allogeneic tendon were reviewed and evaluated with subjective and functional rating scales, physical examinations, instrumented anterior drawer tests, isokinetic testing, and arthroscopy. The average followup was 57 months (range, 36 to 90 months) and the average age at operation was 22 years (range, 16 to 37 years). The subjective and functional results were rated as excellent in 48 patients (57%), good in 31 (37%), and fair in 2 (2%). Three patients (3%) experienced a retear of the ACL. Physical examinations and instrumented anterior drawer tests showed that satisfactory anterior stability was restored in 88% of the patients. Isokinetic evaluations demonstrated that the extension torque of the involved knee recovered to a slightly lower level than that of the controls, although the flexion torque recovered to a level equivalent to that of the controls. Arthroscopic evaluations revealed that the allografts were elaborately remodeled, viable, and taut. There was no sign of immunologic rejection at any time post operatively. Additional extraarticular procedures, con sisting of both pes anserinus transfer on the medial side and iliotibial band reinforcement on the lateral side, had no effect on the results.
The conservative treatment of the anterior cruciate deficient knee
Authors: Bonamo John J. , Fay Colleen , Firestone Theodore 
Published: June 2007

Seventy-nine recreational athletes (average age, 26 years) with complete ACL tears were treated with nonligamentous arthroscopic surgery, monitored reha bilitation, functional bracing, and activity modification. The average followup was 52 months (range, 36 to 102 months). Six (8%) patients ultimately underwent ligament re construction and were considered failures of nonrecon structive treatment. The remaining 73 patients were the subject of detailed analysis. There were 9 (11 %) excellent, 25 (32%) good, 17 (22%) fair, and 28 (35%) poor results. Although 71 patients (97%) were satisfied with their knee for activities of daily living, only 36 (49%) were satisfied with their knee for sports. Twenty-nine (40%) had significantly modified their athletic activities. Age, sex, interval from injury to treatment, associated meniscal tears (49 or 67%), and articular cartilage dam age (21 or 29%) had no apparent effect on the outcome. Poor results were noted in 29 (40%) patients with significant pivot shifts. Multiple repeat injuries, repeat arthroscopy, isokinetic deficits, and increased length of followup were also associated with poor results.
Arthroscopic acromioclavicular joint resection
Authors: Gartsman Gary M. , Combs Andrew H. , Davis Pamela F. , Tullos Hugh S. 
Published: June 2007

Distal clavicle resection has been an effective procedure for treatment of acromioclavicular arthritis. The conven tional open surgical technique involves deltoid detach ment and reattachment, which may cause postopera tive weakness and requires protection during the post operative period to allow for healing. Arthroscopic acromioclavicular joint resection has the theoretical ad vantages of no deltoid disruption and a shorter rehabil itation period. The purpose of this study was to com pare open versus arthroscopic acromioclavicular joint resection in a laboratory setting. The goals of acromioclavicular joint resection in this study were to remove 5 mm of the medial acromion and 10 mm of the distal clavicle. Acromioclavicular joint resections were performed on 10 cadaver shoulders (5 open resections and 5 arthroscopic resections). Open resection was successful at 10 of 15 distal clavicle locations and 14 of 15 medial acromial locations. Ar throscopic resection was successful at 14 of 15 distal clavicle locations and 10 of 15 medial acromial loca tions. The combined bone resection averaged 14.8 mm (±1.99 mm) for the open technique and 14.8 mm (± 2.58 mm) for the arthroscopic technique. The combined bone resection was 1.5 cm or more in all of the meas ured locations for the open technique and in 14 of 15 measure locations for the arthroscopic technique. There was no statistically significant difference between the two groups. In the laboratory setting, acromioclavicular joint re section was performed effectively and predictably with arthroscopic instruments. Arthroscopic bone resection was comparable to open bone resection.
Anterior cruciate ligament reconstruction using freeze-dried, ethylene oxide-sterilized, bone-patellar tendon-bone allografts
Authors: Roberts Thomas S. , Drez David , McCarthy William , Paine Russell 
Published: June 2007

Thirty-six of 44 patients (82%) who underwent ACL reconstruction using freeze-dried, ethylene oxide-steri lized, bone-patellar tendon-bone allografts were evalu ated at least 2 years postoperatively. A detailed sub jective evaluation using the Lysholm scale was re corded as well as a functional evaluation using the Tegner activity scale. All of the patients received a detailed physical examination that included testing with the KT-1000 ligament arthrometer and the Cybex dy namometer. Complete chart reviews and radiographic evaluations were also obtained. Only 17 patients were considered to be functionally successful and performing at their desired activity level. The average KT-1000 showed a side-to-side difference of 5.9 mm at 30 pounds for the successful group and 7.9 mm for those who had functional failure. The Ly sholm scores were 91.6/100 versus 61.1/100 in the failures. Eight patients (22%) at repeat surgery were noted to have complete dissolution of the graft. Large femoral cysts were noted radiographically in all of these patients. It was concluded that freeze-dried, ethylene oxide- sterilized, bone-patellar tendon-bone allografts have a high failure rate and cannot be recommended for ACL reconstruction.
Serial magnetic resonance imaging of hamstring anterior cruciate ligament autografts during the first year of implantation
Authors: Howell Stephen M. , Clark James A. , Blasier R. Dale 
Published: June 2007

A prospective, observational study was performed to document the serial changes in the magnetic resonance signal of devascularized, hamstring ACL autografts dur ing the 1 st year of implantation. Twenty-one ACL deficient knees (14 chronic, 7 acute) were reconstructed. Instability developed in five knees within the first 6 months of graft implantation (24%). Magnetic resonance examinations were performed at 1, 6, 12, 24, 36, and >48 weeks postoperatively (rep etition time 1500, echo delay time = 50). A total of 104 scans were reviewed (average, five per knee). The ACL graft was divided into four unequal size zones for analysis. The proximal, middle, and distal thirds of the intraarticular portion of the graft and the portion of the graft within the tibial tunnel were independently an alyzed. The magnetic resonance signal in each portion of the graft was graded on a scale with (I) being a normal signal, (II) >50% of the total volume of the graft having a normal signal, (III) <50% of the graft having a normal signal, and (IV) 100% of the graft having an increased signal. The increased magnetic resonance signal of the ACL graft was observed to be regionalized and confined to the distal two-thirds of the intraarticular portion of the graft. The portion of the graft exiting the femoral tunnel and within the tibial tunnel retained a normal magnetic resonance signal. The increases in magnetic resonance graft signal were time-dependent, became well estab lished by 3 months, and remained unchanged at 1 year. The clinical outcome could not be predicted based on the magnetic resonance signal of the graft.
Acute Grade III ulnar collateral ligament ruptures
Authors: Lane Lewis B. 
Published: June 2007

A review is presented here of 36 cases, seen since 1980, of acute Grade III (unstable) sports-related sprains of the thumb metacarpophalangeal joint. In all cases, the injury involved the ulnar collateral ligament. A Stener lesion was present in 97% of cases. Followup was from 2.0 to 8.5 years, the average being 3.9 years. All of the patients underwent repeat examination and radiography at followup. The first seven patients were treated by "traditional" pull-out suture and K-wire fixation, put into a cast for 4 weeks, and then gradually mobilized over 4 additional weeks. Thereafter, a "new method" was used. Avulsed ulnar collateral ligament stumps were sutured to the tendinous insertion of the adductor pollicis or to a soft tissue remnant using strong suture material. Large bony avulsions were pinned; small fragments were excised and the ligament was repaired. This latter method of repair was quite strong and allowed rapid mobilization: only 2 weeks in a cast, then a hand- mounted thumb spica orthosis was used while therapy progressed. Of the patients treated with the new method, 84% had excellent results and, overall, were able to return to sports sooner than patients treated with the tradi tional method. Pain, stability, and strength were cor rected equally between groups; however, strength was restored more rapidly in the new method group. Range of motion was reduced equally in both groups. Conclusion: Solid repair of complete ulnar collateral ligament avulsions, consisting of suturing the avulsed portion to the adductor pollicis insertion using strong suture material, combined with early hand therapy fa cilitated by the use of a removable hand-mounted thumb spica orthosis, is safe and allows a faster return to sports than the traditional method of repair.
Injuries among young soccer players
Authors: Schmidt-Olsen Søren , Jørgensen Uffe , Kaalund Søren , Sørensen John 
Published: June 2007

We registered all new injuries among 496 male youth soccer players, aged 12 to 18 years, during the course of one year. The incidence of injury was 3.7 injuries per 1000 hours of soccer per player. The incidence in creased with age, and at the higher ages within the youth players, approached the incidence rate of senior players (age ≥18 years). Seventy percent of the injuries were located in the lower extremities, particularly the knee (26%) and ankle (23%). Back pain occurred in 14% of players. Fractures, which accounted for 4% of injuries, were most often in the upper extremities. We conclude that youth soccer is a relatively low-risk sport with an injury pattern that differs slightly from that of senior players.
A rationale for predicting anterior cruciate graft impingement by the intercondylar roof
Authors: Howell Stephen M. , Clark James A. , Farley Timothy E. 
Published: June 2007

This study was designed to analyze how anterior tibial tunnel placement can result in graft impingement by the intercondylar roof. The relationship of the ACL to the intercondylar roof was studied using magnetic reso nance scans. An attempt was made to predict the amount of bone that may need to be removed from the intercondylar roof to prevent impingement on a 10 mm thick ACL graft. Magnetic resonance scans of 19 normal ACLs were analyzed. The amount of bone removal required to correct roof impingement was determined for a graft placed either eccentrically or centrally within the ACL insertion, and within the bulk of the normal ACL fibers. An eccentric tibial tunnel placement required approxi mately 5 to 6 mm and a central placement required 2 to 3 mm of bone removal from the intercondylar roof to prevent impingement. Placing the graft within the bulk of the ACL fibers, just 3 mm posterior to the center of the ACL insertion, required little bone resection to prevent impingement. To prevent ACL graft impingement, roofplasties need to be performed in both acute and chronic ACL recon structions if the presently accepted locations for posi tioning the tibial tunnel are used. A more anteriorly placed tibial tunnel requires more bone removal to prevent roof impingement than a more posteriorly po sitioned tibial tunnel.
In vivo measurement of anterior tibial translation using continuous passive motion devices
Authors: Drez David , Paine Russell M. , Neuschwander David C. , Young John C. 
Published: June 2007

Early motion protocols following anterior cruciate re construction often use continuous passive motion de vices. There is concern that these devices may induce undesired anterior translation of the tibia and resulting graft stretching or rupture. This study measured the amount of anterior tibial translation that occurred during one cycle in 10 different brands of continuous passive motion devices. Five patients with ACL deficient knees participated in this study. Anterior translation was re corded by using an electrogoniometer with four degrees of freedom (Knee Signature System). Anterior translation measurements were also re corded for a 20 pound Lachman test in these same five patients using the Knee Signature System. Two of the devices showed anterior translation measurements that approached the recorded 20 pound Lachman values. These two devices had a high calf bar for the primary support of the leg. The results indicate that, when using a continuous passive motion device for early postop erative management of the reconstructed ACL in a patient, use of a calf-supporting type of continuous passive motion could induce an undesired strain of the healing graft.
Anterior cruciate ligament reconstruction using quadriceps patellar tendon graft
Authors: Kaplan Michael J. , Howe James G. , Fleming Braden , Johnson Robert J. , Jarvinen Markku 
Published: June 2007

Eighty-three patients, from a 10 year follow-up study, who underwent ACL reconstruction with a quadriceps patellar tendon graft were reviewed. A questionnaire qualifying their sports performance in 20 possible sports compared their preinjury status to postinjury and postreconstructive surgery. Successful and unsuccess ful patients, as determined by our previous investiga tion, were likewise compared. Sports performance, regardless of the sport or level of competition, decreased substantially postinjury and then rose significantly to near but not equal to patient preinjury status. The most strenuous sports dipped to the lowest performance level after injury and returned with a correspondingly more modest gain after the reconstruction. Not surprisingly, successful patients had a more impressive return in performance than unsuccessful patients, mirroring their clinical grading. Of those deemed unsatisfactory (N = 20), graft failures were no worse off in performance rating than those that were classified as unsatisfactory because of per sistent symptoms.
Spine injuries in gymnasts and swimmers
Authors: Goldstein Jack D. , Berger Paul E. , Windler Gary E. , Jackson Douglas W. 
Published: June 2007

Three groups of top level female gymnasts of preelite, elite, national and Olympic caliber were studied without regard to back pain or injury. These athletes were compared to a similar group of national caliber female swimmers. Magnetic resonance imaging scans of each participant were used to document disk or bony abnor malities. The relationship between magnetic resonance imaging findings and age, height, weight, previous in juries, back symptoms, and hours of training per week each year was examined. Nine percent of preelite (1/11), 43% of elite (6/14), and 63% of Olympic level (5/8) gymnasts had spine abnormalities; 15.8% of all swimmers had spine abnor malities. Average hours of training per week and age were found to be associated with abnormalities seen on magnetic resonance imaging. Increased intensity and length of training correlated with previous data that suggests the female gymnast is prone to spine injuries.
Limitation of motion following anterior cruciate ligament reconstruction
Authors: Mohtadi Nicholas G.H. , Webster-Bogaert Susan , Fowler Peter J. 
Published: June 2007

Limitation of motion following ACL reconstruction is a well-recognized and disturbing complication. The pur poses of this study were to identify and characterize those patients who developed this complication from a series of 527 ACL reconstructions, determine etiologic factors, and make recommendations regarding preven tion and management. The case group included 37 patients who required a manipulation under anesthesia because of failure to gain a satisfactory range of motion after an ACL recon struction. Unsatisfactory motion was defined as a flex ion deformity of 10° or more and/or limitation of flexion to less than 120° by 3 months following ACL recon struction. The control group of patients were selected randomly from the overall series and all had a satisfac tory range of motion. The cases and controls were then compared by analyzing these variables: age, sex, knee, time from injury to reconstruction, type of tissue used, meniscal abnormalities or surgery, repair of the medial collateral ligament, and postoperative immobilization and rehabil itation. The cases were followed up to assess the range of motion compared to the opposite knee at an average of 26 months postmanipulation. Thirty-seven patients (7%) underwent a manipulation under anesthesia, 9 of these (24.3%) also had an arthroscopic arthrolysis. Reconstructions done less than 2 weeks postinjury showed a statistically signifi cant higher rate of knee stiffness. The same trend was also present for those reconstructed 2 to 6 weeks postinjury. All other variables failed to show a significant statistical difference. At followup, the average loss of extension was 4° and loss of flexion 5°. The authors suggest that it is prudent to avoid im mediate reconstructive surgery. The stiff knee requires early aggressive management with a manipulation and or arthroscopic arthrolysis.
Patellofemoral stress
Authors: O'Neill Daniel B. , Micheli Lyle J. , Warner Jon P. 
Published: June 2007

Thirty patients, 13 skeletally immature individuals and 17 adults, participated in a prospective study designed to evaluate the effect of isometric quadriceps strength ening exercises on patellofemoral pain. Of the 30 pa tients with anatomically normal lower extremity align ment and no history of previous knee trauma or sur gery, there were 34 knees that had a decrease in peripatellar knee pain with a structured exercise pro gram. One additional patient had a decrease in pain after an arthroscopic lateral release and with continued exercises. An equal number of skeletally immature patients and adults had a decrease in peripatellar knee pain. How ever, 5 of the 17 adults had to limit their activities, while no adolescent patient had to limit activity. Additionally, eight skeletally immature knees had greater than 5° change in their congruence angles, as measured on Merchant tangential radiographs, over the year-long course of this study. Only one adult knee had a similar radiographic improvement. We recommend immediate action to alleviate patel lofemoral pain syndrome, even when extremity align ment is normal. An isometric, progressive resistance quadriceps program with iliotibial band and hamstring stretching exercises is the preferred initial treatment.
The GORE-TEX anterior cruciate ligament prosthesis
Authors: Paulos Lonnie E. , Rosenberg Thomas D. , Grewe Scott R. , Tearse David S. , Beck Charles L. 
Published: June 2007

The GORE-TEX anterior cruciate ligament prosthesis has been implanted in 268 patients at our institution since April of 1984. Follow-up for this study was avail able on 70% of these patients (188). Eighty-one percent (152) of these had the ligament for chronic injuries, 14% (26) for acute, and 5% (10) for subacute injuries. The patient population had an average age of 27.6 years (SD = 8.4) and a Tegner activity score of 6.05 (SD = 1.53). Prior procedures had been performed on 56% (105) of the patients. Concomitant procedures were performed in 73% (137) and included iliotibial band tenodesis, partial meniscectomy, posterior oblique lig ament advancement, or meniscal repair. Followup av eraged 48 months (range, 24 to 68). Evaluation included a questionnaire, physical examination, radiographs, KT- 1000 arthrometer testing, and an activity score. Results were graded as excellent, good, fair, and poor. Acceptable results (good and excellent) were obtained in 83 patients (44%). Fifty-eight patients (32%) were rated excellent and 25 (13%) were rated good. Unacceptable results (fair and poor) were obtained in 105 patients (56%). Twenty-five patients (13%) were rated fair and 80 (42%) were rated poor. Subjective improvement was indicated by 166 patients (88%). Activity levels postoperatively as rated by the Tegner Scale improved in 2 (1 %), remained the same in 167 (89%), and decreased in 19 patients (10%). Effusions occurred in 63 patients (34%) and caused an unac ceptable result in 22 (12%). Rupture occurred in 23 patients (12%). Loosening greater than 3 mm occurred in 64 patients (34%) and led to unacceptable results in 37 (20%). Infection occurred in 5 patients (2.7%). Ex cellent results had a statistically significantly higher age and lower activity score than the poor results (P = 0.045 and 0.012, respectively). The patients with pre vious intraarticular reconstructions had a 76% unac ceptable rating (16 of 21).
In vitro comparison of over-the-top and through-the-condyle anterior cruciate ligament reconstructions
Authors: Brower Richard S. , Melby Arne , Askew Michael J. , Beringer Donald C. 
Published: June 2007

Knee kinematics, during standard knee examination maneuvers, were measured on 15 fresh cadaveric knees in their normal state and after isolated sectioning of the anterior cruciate ligament using a six degree of freedom electrogoniometer. Proximal iliotibial band au tografts were used to perform two anterior cruciate ligament reconstructions on the cadaveric knees: an over-the-top reconstruction and a through-the-condyle procedure. Both of these reconstructions reduced the abnormal anterior translation of the anterior cruciate ligament- deficient knee seen in Lachman testing. However, nei ther reconstruction restored the normal anterior trans lation. In addition, other motions remained uncorrected: 1) the internal rotation due to internal torque at full extension; 2) coupled anterior translation during internal rotation at full extension; and 3) coupled medial trans lation with anterior translation in Lachman testing. There were no statistical differences noted in the joint kinematics created by either reconstruction.
A prospective comparison of computerized arthrotomography and magnetic resonance imaging of the glenohumeral joint
Authors: Jahnke Arlon H. , Petersen Steve A. , Neumann Christian , Steinbach Lynn , Morgan Frank 
Published: June 2007

Twenty-five patients with shoulder instability or shoul der pain of undetermined etiology were prospectively evaluated with magnetic resonance imaging and com puterized arthrotomography. Actual lesions were de termined by arthroscopy or at the time of open surgical repair. The images obtained were interpreted independ ently by three radiologists blinded to both surgical results and the results of previous diagnostic tests. Sensitivity, specificity, and accuracy were determined for each imaging technique for a variety of pathologic entities, including anterior and posterior labral abnor malities, capsular redundancy, biceps-labral complex abnormalities, humeral head (Hill-Sachs) impression le sions, and glenohumeral loose bodies. Analysis of im aging techniques also included construction of receiver operator curves for labral abnormalities. Magnetic resonance imaging showed better diagnos tic results in the evaluation of glenoid labral and humeral head impression lesions (P < 0.05). Both imaging tech niques were equally successful in identifying biceps- labral lesions and intraarticular loose bodies within the glenohumeral joint. Neither imaging technique was con sistent in the evaluation of capsular redundancy. Re ceiver operator curve analysis confirmed that magnetic resonance imaging was the more accurate imaging study in evaluating anterior and posterior glenoid labral abnormalities.