bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anterior cruciate ligament arthroplasty
Authors: Kieffer David A. , Curnow Robert J. , Southwell Richard B. , Tucker William F. , Kendrick Katherine K. 
Published: June 2007

A unique augmentation arthroplasty has evolved from a retrospective review of 150 anterior cruciate ligament (ACL) repairs, extracapsular substitutions, and pes an serine transfers. This coincided with a proposed patho logic relationship seen in surgical exposures of the femoral intercondylar notch. From 1976 to 1983, 544 cases with known ACL insufficiency were selected for study. In 397 subsequent anterior cruciate stabiliza tions arthroplasties were performed. Patients with less than a 2 year followup were not included in this retro spective study. One hundred nine arthroplasties are reported: 80 isolated ACL tears and 29 multiple liga ment injuries. Statistically significant relationships between elapsed time from ACL tear to surgery and meniscal tears, and elapsed time and degenerative changes in the articular surfaces were seen. Surgical techinque was arthroplasty, graft harvest, graft placement, graft set, and postoperative care. Functional score followup has occurred for an average of 3 years (range 2 to 5 years). No patient has failed to return to his or her original sport or occupational de mands. Pivot shift, disengagement, or spontaneous rupture of the arthroplasty has not occurred postoper atively. Full participation has occurred with bilateral ACL arthroplasties and arthroplasty performed for previous intraarticular augmentation failure. The operative success in the preliminary follow-up period was based on: ligamentous substitution, ana tomical placement, femoral intercondylar notch compli ance in full range of motion, revascularization of the ligament substitute, and histologic support of the pro cedure.
Patellar and quadriceps tendon ru p tures— jumper's knee
Authors: Kelly Douglas W. , Carter Vincent S. , Jobe Frank W. , Kerlan Robert K. 
Published: June 2007

We reviewed 13 patients with end stage jumper's knee, 10 with patellar tendon ruptures, and 3 with ruptures of the quadriceps tendon to evaluate our long-term results in treating these tendon ruptures in an athletic population. The focus was on the natural history, the time until return, and the level of return, to athletic activity. Jumper's knee affected all patients to a varying degree prior to rupture. Basketball was the most com mon sport involved. At followup, averaging 4½ years, patients underwent functional and clinical, as well as Cybex and roentgen ographic, evaluations. Results indicated patellar tendon ruptures, where the ruptures are complete, have a more favorable prognosis than those of the quadriceps ten don which are incomplete. All of the latter patients continued to have quadriceps tendinitis following repair. In both groups, the poor results were obtained in patients with chondromalacia and/or patella alta. Cybex testing yielded results of greater than 100% strength in three patients with patellar tendon ruptures, but no patient with quadriceps rupture had comparable test results. There was no apparent relationship between ruptures and cortisone injections. Patellar and quadriceps tendon ruptures from indirect injury in athletes represent the end stage of jumper's knee and result from repetitive microtrauma. Excellent function usually follows repair of patellar tendon rup tures when surgery is performed early and care is taken to restore normal patellar tendon length. Results of quadriceps ruptures are less satisfactory since these ruptures are usually incomplete and all degenerative tissue may not be involved in the healing response.
Repairable posterior menisco-capsular disruption in anterior cruciate ligament injuries
Authors: Woods G. William , Chapman D. Robert 
Published: June 2007

Two hundred thirty-four consecutive patients with a positive Lachman test underwent examination under anesthesia and diagnostic arthroscopy to include com plete evaluation of both posterior menisco-capsular attachments. Knees which had had previous arthrot omy were excluded. Complete repairable posterior menisco-capsular dis ruptions occurred in 31 of 112 (27.7%) acute cases and 36 of 122 (29.5%) knees in the chronic group. These lesions are not predictable by physical exami nation or by routine clinical grading of instability. Thor ough arthroscopic examination to include direct visual ization of the posterior menisco-capsular junction is necessary for complete diagnosis in anterior cruciate ligament injuries.
The effect of heel pads on the treatment of Achilles tendinitis: A double blind trial
Authors: Lowdon Alison , Bader Daniel L. , Mowat Alastair G. 
Published: June 2007

Thirty-three subjects entered a blind-observer, random, prospective study of three forms of conservative treat ment of sports-induced Achilles tendinitis, results being assessed by clinical and biomechanical parameters. Two patient groups received heel pads, ultrasound, and exercises, while the third received only ultrasound and exercises. All three groups showed some improve ment at both 10 day and 2 month assessment, but the claimed benefit of viscoelastic pads widely used by athletes was not substantiated. The more striking bene fit from ultrasound and exercises alone occurred in patients with a shorter history; a comparison of duration of injury in all three groups suggested this was an important factor influencing outcome. The study has highlighted the need for biomechanical outcome measures as well as for more objective clinical outcome measures in the assessment of physical ther apy.
Review of meniscal injury and associated sports
Authors: Baker Bruce E. , Peckham Arthur C. , Pupparo Frank , Sanborn John C. 
Published: June 2007

Meniscal injuries produce disability in a large portion of the population, and sports injuries are a common cause. Nicholas emphasized the importance of epidemiologic studies in an effort to better define the risk of various sports. There are significant regional differences in sports-related meniscal injuries depending upon the popularity of specific sports. Although publications in the European literature document some of these vari ations, there is little epidemiologic documentation of the variation in specific areas of the United States. Meniscectomies performed in Syracuse, New York, from 1973 to 1982 were reviewed. Sports-related men iscal injuries were tabulated and compared against all other causes. Our results indicate that the incidence of meniscal injury resulting in meniscectomy is 61 per 100,000 population. The sex ratio was three males to one female. Medial versus lateral meniscus injury was 81 versus 19%. Football had a 75% predominance of medial meniscectomy; basketball, 75%; wrestling, 55%; skiing, 78%; and baseball, 90%. Our data indicate that there are differences in the ratio of medial versus lateral meniscal disruption associated with specific sports activities. Medial meniscal injuries were, never theless, consistently more common in all of our cate gories except wrestling, where the frequency of lateral meniscal tear is nearly equal to that of medial meniscal tear. Additionally, the right knee is at a greater risk of meniscal injury in basketball than in other sports or the general population, and female skiers are at equal or greater risk of meniscal injury compared to male skiers.
Pelvic stress fractures in long distance runners
Authors: Noakes Timothy D. , Smith James A. , Lindenberg Graeme , Wills Clive E. 
Published: June 2007

We describe five cases of radiographically proven stress fracture of the pubic ramus in serious runners, three of whom were elite female marathoners. In a further two cases in which radiography failed to support the clinical diagnosis, there was bone scintigraphic evidence of stress fracture. Another five cases had the identical clinical presentation, but the diagnosis was not confirmed radiologically and bone scanning was not performed. Most patients experienced persistent groin discomfort during any activity for the first 4 weeks after injury, but all recovered completely after 8 to 12 weeks of rest, in particular, avoidance of running. In common with other studies, we found that the injury occurred in competitive runners, especially females, and was likely to develop during competitive races or intensive training sessions. We suggest that a diagnosis of pelvic stress fracture or stress fracture syndrome can be made with confi dence, even in the absence of radiographic evidence, if the following three features are present in a long dis tance runner presenting with groin pain: First, activity causes such severe discomfort in the groin that running is impossible. Second, the athlete develops discomfort in the groin when standing unsupported on the leg corresponding to the injured side (positive standing test). In some cases the pain is so severe that standing on one leg is impossible. Third, deep palpation reveals extreme, exquisite nauseating tenderness localized to the pubic ramus and not to the overlying soft tissues. The diagnosis can be confirmed by bone scintigraphy where such facilities exist.
Osgood-Schlatter's disease in adolescent athletes
Authors: Kujala Urho M. , Kvist Martti , Heinonen Olli 
Published: June 2007

During the period of 1976 to 1981, a total of 412 young athletes contacted the Turku Sports Medical Research Unit's (TSMRU) Outpatient Sports Clinic with 586 com plaints. These records included 68 athletes with Os good-Schlatter's disease (OSD), who were initially pre scribed an average of 2 months' rest from any physical activity causing pain. Symptoms of tibial tuberosity pain occurred first at the average age of 13.1 years. Accord ing to the retrospective questionnaire, the pain caused complete cessation of training for an average of 3.2 months, and the disease interfered with fully effective training for an average of 7.3 months. According to a retrospective questionnaire given to 389 students (191 girls and 198 boys), 50 (12.9%) had suffered from OSD. Nearly one-half of the students, 193 (49.6%), had been active in sports at the age of 13, and 41 (21.2%) of them had suffered from OSD. In those students who were not active in sports, the incidence was only nine (4.5%; P < 0.001). The incidence (32%) was higher in the siblings of the OSD patients of TSMRU who were active in sports than in the corresponding student group (21.2%). In a group of 22 patients from the TSMRU who had suffered from Sever's disease (calcaneal apophysitis), the inci dence of OSD (68%) was significantly higher than in students who were active in sports (P < 0.001).
The operative treatment of scapulothoracic bursitis in professional pitchers
Authors: Sisto Domenick J. , Jobe Frank W. 
Published: June 2007

Four professional pitchers with resistant scapulotho racic bursitis who have required surgical excision of the thickened bursa are reported. The average time dura tion of symptoms prior to surgery was 18.8 months. Conservative therapy consisting of rest, shoulder ex ercises, antiinflammatory medications, and cortisone injections failed to resolve the bursitis, and each pitcher was unable to compete secondary to pain. The incision was posterior, just distal to the tip of the scapula. The specimens contained cleft-like spaces lined by synovial tissue consistent with a bursa. All four pitchers returned to professional baseball the year following surgical excision of the bursa. We rec ommend early, aggressive, conservative therapy for scapulothoracic bursitis in the throwing athlete. Pitch ers with a thickened, resistant scapulothoracic bursitis should have the bursa surgically excised.
Anterior cruciate ligament allograft transplantation
Authors: Nikolaou Pantelis K. , Seaber Anthony V. , Glisson Richard R. , Ribbeck Beth M. , Bassett Frank H. 
Published: June 2007

In recent years much effort has been devoted to finding a satisfactory replacement for the injured ACL. None of the reconstruction techniques used in the past can be considered ideal because of their inability to dupli cate the complex geometry, structure, and function of the ligament. Current advances in allograft transplan tation and cryopreservation have led us to design and implement an experimental model for testing the feasi bility of cryopreserved ACL allotransplantation. Groups of dogs were used to evaluate the effect of cryopreservation on ligament strength and to compare the relative performance of both autograft and allograft ACL transplants up to 18 months after implantation. The ligaments were examined mechanically, histologi cally, and microangiographically. The cryopreservation process and duration of stor age had no effect on the biomechanical or structural properties of the ligament. The mechanical integrity of the allografts was similar to that of the autografts, with both achieving nearly 90% of control ligament strength by 36 weeks. Revascularization approached normal by 24 weeks in both autograft and allograft. No evidence of structural degradation or immunological reaction was seen. Based on these results, we believe that a cryopre served ACL allograft can provide the ideal material for ACL reconstruction. We have outlined a surgical tech nique for harvesting and implanting this graft clinically.
Rotator cuff function during a golf swing
Authors: Jobe Frank W. , Moynes Diane R. , Antonelli Daniel J. 
Published: June 2007

A study of bilateral shoulder muscle activity during the golf swing was undertaken using electromyography and high-speed photography. Understanding of the muscle firing patterns could lead to injury prevention and development of appropriate training and condition ing regimens. The swings of seven adult male right- handed professional golfers without shoulder problems were examined. Indwelling electrodes were inserted into the supraspinatus, subscapularis, infraspinatus, latissimus dorsi, pectoralis major, anterior deltoid, mid dle deltoid, and posterior deltoid on the right side. Each subject was allowed to warm up until he felt comfort able. Films of each subject were taken at 450 frames per second. The swing was broken into four segments to which electromyographic signals were synchronized electronically. The EMG tracings were subjected to analog-to-digital conversion and a relative measure of quantity obtained. All tests were repeated on the left side for each subject. Results indicate that all portions of the deltoid were inactive on the right side throughout the swing. The deltoid was likewise inactive on the left except for a brief spurt from the anterior portion during the millisec onds immediately preceding ball contact. Of the rotator cuff muscles, on the left the supraspinatus fired at a low level throughout the swing, as did the infraspinatus. The latter had a slightly larger burst of activity immedi ately after ball contact. The subscapularis was more active than any other muscle throughout the swing. The cuff muscles on the right side showed as much activity overall as those on the left. In addition, the latissimus dorsi and pectoralis major seemed to provide power bilaterally, with marked activity during the accel eration phase. Contrary to the information presented in a number of golf instruction manuals, the left shoulder of a right- handed golfer does not provide more "drive" than does the right. To achieve greater distance it would seem that a golfer should concentrate on exercising the ro tator cuff bilaterally as well as the latissimus dorsi and pectoralis major.
Gymnastic injuries: The Virginia experience 1982-1983
Authors: Pettrone Frank A. , Ricciardelli Edward 
Published: June 2007

Gymnastics has undergone a tremendous increase in popularity largely due to exposure during the Olympics. The injury rate in gymnastics is exceeded only by football, wrestling, and softball. A prospective analysis of club level gymnastic injuries over one season (1982- 83) was conducted. Complete responses from 15 clubs (2,558 participants) were obtained. Parameters of clubs followed were: skill level, student, instructor ratio, safety equipment, and conditioning and warm-up ex ercises. Data obtained from each participant were: injuries sustained, event in which injury occurred, set ting of injury, type of injury, and duration of disability. Results were 62 injuries among 542 competitive and 2,016 noncompetitive level athletes (5.3 per 100 com petitors and 0.7 per 100 beginners). Of the 62 injuries, 51 were acute and 11 chronic. Twenty-one injuries occurred during floor exercises, 13 on beam, 9 on vault, 6 on uneven parallel bars, and 2 on springboard. Acute injuries included 21 sprains, 16 fractures, 6 contusions, 4 dislocations, and 4 muscle strains. A significant find ing was the increased frequency of acute injury seen at dismount. Also there was a positive correlation be tween duration of frequency of practice (fatigue) and injury rate. We would define a high risk gymnast as one who is 1) performing at an advanced competitive level, 2) performing floor or beam exercises, and 3) practicing more than 20 hours per week.
Breaststroker's knee
Authors: Vizsolyi Peter , Taunton Jack , Robertson Gordon , Filsinger Lynda , Shannon Harry S. , Whittingham Diane , Gleave Martin 
Published: June 2007

Competitive swimmers have a high incidence of breast stroke-related knee injuries. Although previous investi gators have implicated the terminal phase of the kick in the injury mechanism, athletes often complain of pain during the initial phase of rearward thrust. Disagree ment in the current literature surrounds the precise anatomical derangement(s) constituting "breaststrok er's knee." The purpose of this investigation was to delineate the epidemiology, anatomy, and pathobiome chanics of breaststroke knee injuries. Descriptive data were obtained by surveying 391 athletes. An extremely high incidence of knee pain was documented both among breaststroke specialists (73%) and nonbreaststrokers (48%). Age, years of com petitive swimming, and specific training characteristics were positively correlated with knee pain. Both the medial collateral ligament and the inferomedial patellar border were involved. A further 21 swimmers were assessed in detail using four methods: interview, physical examination, Cybex II isokinetic quadriceps and hamstring testing, and cin ematographic analyses. The interview and physical ex amination data supported the conclusions derived from the descriptive data, while Cybex testing and kinematic film analyses failed to demonstrate statistical differ ences between the injured and noninjured groups. Although kinematic film analyses did not demonstrate statistical differences between cases and controls, dra matic differences in the injury rate were noted when hip abduction angles at kick initiation were less than 37° or greater than 42°. This bimodal increase in injury rates suggests that modification of hip abduction at kick initiation, in conjunction with altered training regi mens, will lead to a reduction in medial knee joint stress and hence fewer breaststroke injuries.
Computerized recording of visits to an outpatient sports clinic
Authors: Kannus Pekka , Aho Heikki , Järvinen Markku , Nttymäki Seppo 
Published: June 2007

At the Tampere Research Station of Sports Medicine (TRSSM) a continuous coding system of patient visits was started on March 1, 1985. The registration form contained 25 variables including all essential informa tion about the patient's identification, sports, time of and reason for the visit, physician, examinations, diag nosis, treatment, and possible further measures. To classify and number the diagnosis, a specific classifi cation of sports injuries and diseases was drawn up. The data were stored and analyzed using a DEC-2060 computer at the University of Tampere. During 6 months a total of 814 visits were recorded. The three most common sports were soccer, long- distance running, and orienteering. Competitive ath letes totalled 337 (62%); 43 of these were top-ranking athletes. The most common reasons for visits were problems of the knee (266 visits, 33%), ankle (80, 10%), and low back (71, 9%). Knee sprains accounted for 10% of all visits. Problems related to the musculoskeletal system were the reason for 751 (92%) of all visits. Operative treatment was needed by 49 patients (6%). The continuous coding system of patient visits at an outpatient sports clinic showed great advantages as a basic data bank for scientific research, annual statistics, and patient identification and filing. The system de scribed has been adopted as part of the daily routine at the TRSSM.
Radionuclide imaging in internal derangements of the knee
Authors: Mooar Pekka , Gregg John , Jacobstein Jerome 
Published: June 2007

The clinical specificity and sensitivity of imaging with 99mTC was evaluated prospectively in 104 consecutive patients admitted to the hospital for diagnostic/surgical arthroscopy. Four distinct patterns of radionuclide ac tivity were seen that correlated with observed arthros copic findings. These patterns of activity were seen with 1 ) degenerative joint disease (DJD) or severe ro tational instability, 2) meniscal pathology, 3) fracture of the subchondral plate or full thickness cartilaginous ulceration, and 4) synovitis. Radionuclide imaging was seen to be extremely sensitive and highly specific for all four patterns of activity. The observed association of subchondral plate injury with meniscal pathology may present an explanation for the observed poor outcome in a limited number of patients following meniscectomy.
Long-term prognosis of nonoperatively treated acute knee distortions having primary hemarthrosis without clinical instability
Authors: Kannus Pekka , Järvinen Markku 
Published: June 2007

The purpose of the study was to examine the long- term prognosis of nonoperatively treated acute knee distortions having primary hemarthrosis without clinical instability. A multidimensional follow-up analysis was performed on 84 patients an average 8 years after injury. The analysis included four standardized knee scoring scales for subjective, objective, functional, and radiological evaluations, as well as isokinetic and iso metric strength measurements. In the great majority of the patients (86%) the long- term results were excellent or good. The main reason for failure was ACL insufficiency, an obvious outcome of overlooked rupture of that ligament in the primary situation. If the injured knee is indeed stable, if there is no suspicion of ACL injury or patella luxation in the pa tient's history or clinical findings, and if routine radio graphs are negative, primary arthroscopy is not needed. However, a close followup with repeated clin ical examinations and a well-planned rehabilitation pro gram is obligatory.