bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reconstruction of the anterior cruciate ligament
Authors: Elmqvist Lars-Gunnar , Lorentzon Ronny , Langström Mats , Fugl-Meyer Axel R. 
Published: June 2007

The clinical results in 29 patients who had undergone ACL reconstruction with quadriceps-patellar tendon graft over-the-top were studied at an average of 28 months postoperatively. Postoperative immobilization was at either 30° (N = 17) or 70° (N = 12) of knee flexion for 6 weeks. All patients then followed a com mon preparatory training program for 8 weeks. In the 14th postoperative week the patients were put on either progressive resistance training (N = 12) or isokinetic training (N = 17) for 6 weeks, after which all had identical training. Independent of primary knee immobilization angle or training regimens, no differences could be demon strated with respect to stability, range of motion, func tion, or isokinetic mechanical output. For all patients, Lysholm knee function score improved from 60.5 to 93.6 (P < 0.001) and activity level from 3.9 to 6.3 (P < 0.001). Isokinetic peak torque, contractional work, and mean power of the quadriceps at 30, 90, and 180 deg/ sec were lower in the injured compared to the nonin jured leg (78% to 90%; P < 0.01) both preoperatively and at followup, and there were no significant differ ences between the preoperative and follow-up values. Clinical stability improved (P < 0.001) in 19 of the 29 patients (66%) and in 11 of those 17 patients with early isokinetic training (65%). Performance tests were nor mal in 23 of 29 patients (79%), with minor abnormalities in the rest. We conclude that immobilization at a higher tension of the quadriceps or early isokinetic training did not results in any advantages in the long run, and that patients with early isokinetic training did not show any increased incidence of remaining instability.
An electromyographic analysis of shoulder function in tennis players
Authors: Ryu Richard K.N. , McCormick John , Jobe Frank W. , Moynes Diane R. , Antonelli Daniel J. 
Published: June 2007

Shoulder injuries in tennis players are common because of the repetitive, high-magnitude forces generated around the shoulder during the various tennis strokes. An understanding of the complex sequences of muscle activity in this area may help reduce injury, enhance performance, and assist the rapid rehabilitation of the injured athlete. The supraspinatus, infraspinatus, subscapularis, mid dle deltoid, pectoralis major, latissimus dorsi, biceps brachii, and serratus anterior muscles were studied in six uninjured male Division II collegiate tennis players using dynamic electromyography (EMG) and synchro nized high-speed photography. Each subject performed the tennis serve and the forehand and backhand groundstrokes, and each stroke was divided into stages. The tennis serve contains four stages. Three stages characterize the forehand and backhand ground strokes. Our results indicate that the subscapularis, pectoralis major, and serratus anterior display the greatest activity during the serve and forehand. The middle deltoid, supraspinatus, and infraspinatus are most active in the acceleration and follow-through stages of the backhand. The biceps brachii increases its activity during cocking and follow-through in the serve with a similar pattern noted in the acceleration and follow-through stages of the forehand and back hand. The serratus anterior demonstrates intense activ ity in the serve and forehand, thus providing a stable platform for the humeral head and assisting in gleno humeral-scapulothoracic synchrony. The tennis serve and forehand and backhand ground strokes are accomplished by complex sequences of muscle activity that incorporate contributions from the lower extremities and trunk into smooth, coordinated patterns. Although our study focused on shoulder function in the uninjured tennis player, it may provide a basis for understanding abnormal shoulder biomechanics that contribute to pain and dysfunction. The serratus anterior deserves special emphasis, for our study showed that its activity is essential to each of the three tennis strokes. Because of the similarities between the tennis serve and overhead throw, a conditioning program comparable to one pitchers use many be appropriate for tennis players.
Chronic Achilles paratenonitis
Authors: Kvist Martti H. , Lehto Matti U.K. , Jozsa Laszlo , Järvinen Markku , Kvist Helmer T. 
Published: June 2007

Pathological alterations in chronic Achilles paratenonitis were studied histologically and using immunofluores cence techniques for fibronectin and fibrinogen in tissue samples obtained operatively from 11 athletes with this complaint and from 4 male cadavers serving as con trols. The average duration of the paratenonitis was 20.4 months. The paratendineal fatty areolar tissue was clearly thickened and edematous, showing widespread fat necrosis and considerable connective tissue prolif eration. The blood vessels were often obliterated and degenerated. Fibronectin and fibrinogen were com monly found in the proliferating connective tissue areas and in the vascular walls. Exudates rich in fibrinogen and fibronectin were seen in the inflamed paratendineal tissues, but not in the controls. The results indicate that increased vascular permea bility and fibrin formation still persist in chronic Achilles paratenonitis and that marked obliterative and degen erative alterations of the blood vessels are frequent. The presence of fibronectin and fibrinogen points to an immature nature of scar tissue in chronic paratenonitis.
Jumper's knee and ultrasonography
Authors: Fritschy Daniel , de Gautard René 
Published: June 2007

Twenty-five patients, aged between 15 and 45 years old, who were athletically active, presented with jump er's knee (patellar tendinitis). By use of ultrasono graphic examination, new and precise information was obtained that benefited the diagnosis, choice of treat ment, and monitoring of the evolution of jumper's knee in our patients. In 18 of the 25 patients, only 1 knee was affected; in 7 of the patients, both knees were affected, thus making a total of 32 painful tendons. These 25 patients were compared with a control group of 15 healthy, athletically active subjects between the ages of 25 and 35 years old. In all of the 32 painful tendons, ultrasonographic anomalies were observed: thickening or swelling of the tendon (15 knees) appeared in acute cases; a hetero geneous structure of the tendon (24 knees); and thick ening and irregularities of the tendinous envelope (8 knees). The 15 acute patients all responded to classic con servative treatment including physical therapy and elec trotherapy. Four of the remaining 10 patients were treated successfully with various conservative treat ments, including deep transverse friction massage with ice. The other six patients were treated surgically, with tenolysis and "carding" of the patellar tendon. In one patient, this procedure failed, and 12 months later a second operation was performed, in which the distal pole of the patella was resected and the patellar tendon reinserted into bone. Recovery was uneventful. Now, at least 2 years after treatment, all of the patients consider themselves healed.
Nonoperative treatment of Grade II and III sprains of the lateral ligament compartment of the knee
Authors: Kannus Pekka 
Published: June 2007

The purpose of the study was to learn the long-term results of nonoperatively treated sprains of the lateral compartment of the knee joint, generally known to be relatively rare injuries. A multidimensional follow-up analysis was performed on an average 8 years after the injury in 11 patients with Grade II sprains and in 12 patients with Grade III sprains, including four standard ized knee scoring scales for subjective, objective, func tional, and radiographic evaluation, as well as isokinetic and isometric strength evaluations. The result in Grade II sprains of the lateral ligament compartment (LAT) was generally good, although resid ual lateral laxity was common. In Grade III sprains, the results were much worse, with a high frequency of persisting severe or gross lateral laxity, insufficiency of the ACL, muscle weakness, and posttraumatic osteoar thritis of the injured knee. Grade II sprains of the LAT respond successfully to nonoperative treatment; in Grade III sprains, however, such treatment cannot be recommended as a method of choice.
Cidex-induced synovitis
Authors: Harner C.D. , Fu F.H. , Mason G.C. , Wissinger H.A. , Rabin B.S. 
Published: June 2007

Microscopic evidence of inflammation was observed in the synovium of rabbit knees that had been injected with 10 ppm of Cidex (2% glutaraldehyde). Initial changes were synovial hypertrophy, subsynovial edema, and vascular congestion. At concentrations of 100 ppm or greater, focal synovial necrosis, hemor rhage, and gross diffuse synovitis were observed. The degree of synovial inflammation was proportional to the concentration of Cidex. Observation of synovial re sponse versus time demonstrated this reaction to be a chemical synovitis without histologic evidence of a de layed hypersensitivity allergic component. Significant intraoperative levels of Cidex were noted in the rinse solutions at several hospitals. When a single rinse is used, the concentration of Cidex present in the rinse basin is 100 to 300 ppm. If the same rinse is used for subsequent cases, the Cidex concentration is on the order of 1,000 ppm by the fifth arthroscopic pro cedure. If a double rinse is used and the rinse changed with each operative case, the Cidex concentration in the second rinse is less than 10 ppm. After irrigation of the knee joint with 1 liter of saline, the intraarticular concentration of Cidex is less than 10 ppm regardless of the rinse technique.
Factors affecting the region of most isometric femoral attachments
Authors: Grood Edward S. , Hefzy Mohamed S. , Lindenfield Thomas N. 
Published: June 2007

We measured how the distance between selected tibial and femoral attachments of the PCL changes with knee flexion in six intact cadaver knees. The femoral location was the primary determinant of whether the distance increased, decreased, or remained nearly constant. The proximal-distal location of a fiber's femoral attachment had a stronger effect than had the anterior-posterior location. The tibial location had only a small statistically significant effect. These results suggest that the func tion of fibers within the PCL is determined primarily by their femoral attachment location. We determined all femoral attachments whose tibio femoral distance changed 0, 2, 4, 6, 8, and 10 mm during flexion from 0° to 90°. No absolutely isometric point existed. Attachments whose separation distance changed less than 2 mm formed a bullet-shaped region whose base was against the roof of the intercondylar notch and whose nose pointed posteriorly and slightly distally. The axis of the "bullet" was near the proximal edge of the femoral insertion of the PCL. Along the axis, anterior attachments, located near the roof of the intercondylar notch, were more isometric than were posterior attachments, located near the cartilage. At tachments located distal to the axis moved away from the tibial insertion of the PCL when the knee was flexed. The more distal the femoral attachment, the larger the increase in tibiofemoral distance that occurred with flexion. The opposite was true of attachments proximal to the 2 mm region.
Surgical treatment of chronic lateral instability of the ankle joint
Authors: Karlsson Jón , Bergsten Tommy , Lansinger Olle , Peterson Lars 
Published: June 2007

Sixty patients with chronic lateral functional and me chanical instability of the ankle joint were treated with shortening and reinsertion of the lateral ankle ligaments. All patients were followed prospectively for 2 to 5 years (mean, 3 years 6 months). We found the functional results to be excellent or good in 53 patients (88%). Patients with unsatisfactory results had either general ized joint hypermobility or long-standing ligament insuf ficiency. Anterior talar translation (ATT) and talar tilt (TT) were measured radiologically on standardized radiographs. Patients with excellent and good functional results had better mechanical stability, both ATT and TT, than those with fair and poor functional results. A good correlation was found between clinical, functional, and radiological results. In conclusion we found that reconstruction of the ankle stability by shortening and reinsertion of the lateral ankle ligaments is a safe and simple method and is a good alternative to other more complex methods of ligament reconstruction. The method should, how ever, be used with great care in patients with general ized joint hypermobility or in patients with long-standing ligament insufficiency.
An unusual ankle injury in top skiers
Authors: Fritschy Daniel 
Published: June 2007

Although skiers' feet are immobilized in extremely rigid boots, ligamentous lesions of the ankle may occur, especially in world class slalom skiers. The lesion arises when a sudden external rotation of the ankle causes the talus to press against the fibula and thus open the distal tibiofibular articulation. This study reports on a group of 10 skiers recruited between 1975 and 1986. These are professional skiers participating in World Cup races. Three patients under went an operation for lesion of the tibiofibular syndes mosis, while the other seven were treated conserva tively. All were able to resume their previous level of competition and only one skier later complained of painful instability in distal tibiofibular joint.
An in vitro study of the Müller anterolateral femorotibial ligament tenodesis in the anterior cruciate ligament deficient knee
Authors: Draganich Louis F. , Reider Bruce , Miller Paul R. 
Published: June 2007

The biomechanical effectiveness of the Müller antero lateral femorotibial ligament (ALFTL) iliotibial band ten odesis on anterior stability and internal rotational sta bility of the ACL deficient knee was investigated in six cadaver knees. Anterior drawer and internal rotation of the tibia were measured at 15° increments from 0° to 90° in response to 50 N of anteriorly applied tibial force and 3 Nm of internally applied internal torque, respec tively, in the intact knee, the ACL excised knee, and following the ALFTL reconstruction. A strain gage was used to measure the resting graft tension and to meas ure strain in the graft during the load-displacement tests. The Müller ALFTL tenodesis failed to return normal anterior stability to the ACL deficient knee (P < 0.05). The tenodesis did, however, reduce the anterior laxity of the ACL deficient knee from 30° to 90° of knee flexion (P < 0.05). The tenodesis overconstrained inter nal tibial rotation of the ACL excised knee from 30° to 90° (P < 0.05). Measurements of strain in the tenodesis supported the load-displacement findings that the ten odesis was most effective in constraining anterior drawer and internal tibial rotation from 30° to 90° of knee flexion.
An analysis of the sidestep cutting manoeuvre
Authors: Cross Mervyn J. , Gibbs Nathan J. , Bryant Grace J. 
Published: June 2007

The sidestep cutting manoeuvre is a common mecha nism of noncontact or isolated ACL ruptures in athletes. We analyzed the amount and direction of tibial rotation that occurred at the knee joint with a triaxial electro goniometer on 11 male subjects who performed the sidestep cutting manoeuvre. The mean total tibial ro tation was 19.84 ± 5.63° and the mean maximum point of internal tibial rotation occurred at 34.77 ± 5.30% of the stance phase. However, greater values for internal tibial rotation occurred in the swing phase in association with a greater angle of knee flexion. Therefore, in our subjects, during the sidestep cutting manoeuvre, inter nal tibial rotation did occur at the knee but was not maximal. Under normal circumstances when performing the sidestep cutting manoeuvre, maximum internal tibial rotation does not occur and so the ACL is not placed under excessive strain in such a manoeuvre. If the ACL ruptures during a sidestep cutting manoeuvre then a possible cause may be the athlete's loss of the ability to control internal tibial rotation of the knee.
A multicenter study on the results of anterior cruciate ligament reconstruction using a Dacron ligament prosthesis in "salvage" cases
Authors: Lukianov Alexis V. , Richmond John C. , Barrett Gene R. , Gillquist Jan 
Published: June 2007

A multicenter study is presented on 80 patients who underwent ACL reconstruction using a Dacron (E.I. Du Pont de Nemours and Co., Wilmington, DE) ligament prosthesis. Patient selection was based on a history of a failed autologous reconstruction and/or primary repair of the ACL. These selection criteria are unique and have not been previously reported in the literature. The frequency of prior intraarticular ACL surgery was 1.24 procedures per patient and 1.68 when combined with prior extraarticular reconstructions. Forty-one patients had a mean followup of 28 months (24 to 42 months). The mean followup for all of the patients was 21 months. The graft was augmented with autologous tissue in 59 cases and used as a pure prosthesis in the rest. Functionally, the mean Lysholm score improved from 40 to 81 points. The percentage of a combined excellent/good Lysholm rating increased from 6% to 60%. The Tegner activity rating level im proved from 2 to 4. The percentage of a negative Lachman sign, anterior drawer, and pivot shift was approximately 75% at followup. There was no significant difference between the re sults of augmentation and nonaugmentation cases, indicating that the graft acts as a permanent prosthesis rather than as a scaffold or stint. The patients showed a significant improvement considering their preopera tive global instability.
Diagnostic and operative arthroscopy of the knee under local anesthesia with parenteral medication
Authors: Martin Robert C. , Brown David E. , Zell Brian K. , Lichtman David M. 
Published: June 2007

Arthroscopy of the knee under local anesthesia was performed on 102 patients for operative and diagnostic purposes between January and December of 1985. The procedures were performed on a same day basis without a pneumatic tourniquet. The operative record of each patient was reviewed to determine postopera tive diagnosis and treatment. The data was matched to a patient questionnaire that measured individual reaction to local anesthesia. The effectiveness and level of patient acceptance of this anesthetic technique for operative arthroscopy was then evaluated. Ninety-one patients responded to the questionnaire, 82 of whom had prior anesthetic experience. Ninety- five percent of the patients had minimal or no discomfort during the procedure. Eighty percent indicated a pref erence for local anesthesia in the event of subsequent arthroscopy. No complications relating to the anesthetic agent were noted. Arthroscopy of the knee under local anesthesia for routine operative arthroscopy was found to be safe, reliable, practical, and to have a high patient acceptance rate.
Carbon fiber as a prosthetic anterior cruciate ligament
Authors: Mäkisalo S. , Paavolainen P. , Holmström T. , Skutnabb K. 
Published: June 2007

Connective tissue ingrowth into a carbon fiber prosthe sis inserted as a substitute for the ACL was biochemi cally quantified in an experimental pig model with a followup of 16 weeks. During this time, the net collagen amount expressed as hydroxyproline increased to only half that of the normal control ligament. Histological studies revealed relatively few fibroblasts capable of producing collagen inside the alloplastic ligament. When these results are considered in conjunction with those of our earlier report of the disappointing mechanical strength of the carbon fiber substitutes, it seems evident that carbon fiber is not a suitable re placement for the ACL, mainly because of its failure to produce a "neoligament" before it disintegrates.
Passive tension of the ankle before and after stretching
Authors: Toft Egon , Espersen Geert T. , Kålund Søren , Sinkjær Thomas , Hornemann Birte C. 
Published: June 2007

The passive tension resulting from dorsiflexion of the ankle was measured in relation to stretching in six handball players and six soccer players. Corresponding values of ankle angle and passive tension were meas ured by a strain gauge and a potentiometer connected to a pedal system. The passive tension versus ankle angle was meas ured before and 90 minutes after a single contract- relax stretching program of the plantar flexors. Stretch ing lowered the passive tension by up to 18%. Contract- relax stretching performed twice a day for 3 weeks lowered the passive tension in the plantar flexors by up to 36%. Before the last measurements, no stretching was performed for 20 hours or more. Stretching thus had both a short-term effect, matching the length of a training session, and a long-term effect, shown in a reduction of passive tension after 3 weeks. The relative decrease in passive tension after stretching exercises was constant from a neutral position of the ankle to maximal dorsiflexion. There was no correlation between 1) flexibility and the short-term effect of stretching, 2) flexibility and the long-term effect of stretching, or 3) the short-term and long-term effects of stretching. This indicates that pas sive tension was decreased in all subjects irrespective of their flexibility, and that subjects who had short-term effects after stretching did not necessarily demonstrate a long-term effect.
Arthroscopic shoulder capsulorraphy: Does it work?
Authors: Gross R. Michael 
Published: June 2007

The purpose of this project was to answer the question, "Can shoulder instability be dealt with safely and effec tively arthroscopically?" This study, which began in December 1982 and concluded in February 1985, in volved 12 patients, 3 females and 9 males whose ages ranged from 14 to 40 years. Followup ranged from 31 to 63 months, the average being 44.8 months. The arthroscopic procedure was based on the use of a tool designed to capture the capsule, thus allowing place ment of either one or two low profile extraarticular staples in the capsule. Two cases were failures. The remaining 10 patients were pleased with their operation. Based on the clas sification of Rowe et al., functional results were six excellent, two good, two fair, and two poor. The six patients with excellent results had shoulders of normal appearance. They were fully active and had neither pain nor limitation of motion. All six patients had negative apprehension signs. The two patients with good results had similar outcomes, but they had occasional morning stiffness and intermittent mild pain, as well as a 10° limitation of external rotation in both adduction and abduction. One patient who had a fair result had a positive apprehension sign and occasional pain with quick motion. The other patient with a fair result was hampered by more significant pain on an intermittent basis, yet the pain was not a constant issue. None of these patients had radiographic evidence of increased degenerative changes of the shoulder or staple migra tion. There were two complications and two failures. The answer to the question, "Can shoulder instability be dealt with safely and effectively arthroscopically?", is a qualified yes. For patients who want to avoid the morbidity of an open operation, the results of study suggest that arthroscopic shoulder stabilization can be a safe and reasonably effective alternative to open surgery.