bluuebunny/crossref_metadata_2025_split huggingface dataset:
Herniated lumbar disk associated with running
Authors: Guten Gary 
Published: June 2007

This paper studies the courses of treatment and re covery in 10 runners with acute back and leg pain. All ran at least 20 miles/week, had pain during or shortly after running, and were diagnosed for herniated lum bar disk by myelogram, electromyogram (EMG), or objective motor weakness and reflex changes. Two or more high-risk factors contributed to the disk syn drome in each runner. These included being 30 to 50 years old (9 runners), being under 72 inches tall (6 runners), having tight joints (6 runners), changing running style (5 runners), and having a previous her niated lumbar disk (3 runners). Early diagnostic prob lems led to incorrect initial diagnosis in three runners. The conservative treatment program consisted of controlled rest, anti-inflammatory medication, alter native exercises, and a gradual return to running in 6 to 12 weeks. All runners were treated with Williams' exercises. Eight were put in traction as inpatients, and seven were given injections of epidural steroids. Three re quired laminectomies; two of these resumed active running. The return to sports participation was excel lent in this group. Eight returned to active running and one became a marathon bicyclist. Only one runner was unable to return actively to sports.
A surgical procedure for the Osgood-Schlatter lesion
Authors: King Andrew G. , Blundell-Jones G. 
Published: June 2007

Although the Osgood-Schlatter lesion (OSL) usually heals spontaneously, symptoms often continue for 2 or 3 years. Affected young people are often keen on sporting or strenuous activities, and enforced reduced physical activity may cause considerable frustration and emotional disruption. A simple procedure which had been advocated for severely affected children wanting to be active in sports was evaluated. The procedure promised to alleviate pain and allow pa tients to return to unrestricted sporting activities within a short period without fear of relapse. It involved splitting the quadriceps tendon vertically along the line of its fibers and removing the avulsed fragments by excising any attachment between the fragment and the cartilage or bone of the anterior portion of the proximal tibial apophysis. The results in 66 patients who underwent this pro cedure were reviewed, with an average follow-up time of 4.8 years. There were 11 bilateral cases, making 77 lesions. The average patient age was 13.5 years. Sixty patients indicated at the time of surgery that they had been keen on sporting activities. The average preoperative duration of symptoms was 13 months. Postoperatively, patients regained ability to participate in full sporting activities after an average 3.8 months. There were no relapses. The most frequent long-term complaints after surgery related to residual promi nence of the tibial tuberosity, reported in 25% of the cases. There were no cases of genu recurvatum. From these results, we recommend the operation for pa tients with OSL whose disability recurs after prolonged conservative treatment or as a primary procedure in severely affected young people especially keen on sporting activities.
Lateral roentgenographic projections of the acromioclavicular joint
Authors: Waldrop John I. , Norwood Lyle A. , Alvarez Richard G. 
Published: June 2007

Although the acromioclavicular joint is frequently in jured in both contact and noncontact sports, the treat ment is nonspecific, as demonstrated by the numerous methods of treatment currently employed. Despite treatment, some shoulders still develop chronic symp toms and disability during overhead lifting, throwing, and swinging. Perhaps these difficulties develop as a result of an incomplete evaluation of the joint and because the exact nature of the injury is not appreci ated. Therefore, the shoulder develops chronic prob lems. We have routinely utilized a lateral roentgenogram of the acromion to evaluate the acromioclavicular joint. This has significantly aided us in the diagnosis and treatment of acromioclavicular joint injuries, es pecially when there was posterior dislocation of the distal clavicle. This presentation reviews standard roentgenogra phy of the acromioclavicular joint and illustrates the method of obtaining the lateral projection as described by O. M. Alexander. We will also show how this method has helped us clinically in detecting posterior dislocations of the distal end of the clavicle.
The use of the medial head of the gastrocnemius muscle in the posterior cruciate-deficient knee
Authors: Kennedy J.C. , Galpin R.D. 
Published: June 2007

This review retrospectively analyzes a group of pa tients with chronic posterior cruciate insufficiency who were treated surgically with transfer of the medial head of the gastrocnemius muscle. Our indications, technique, and the results of this surgery are presented. Twenty-one patients (21 knees) over the last 3½ years, from January 1977 to June 1980, were treated by this procedure. Eighteen patients were followed up for more than 8 months after surgery and are included in the review. Subjectively, pain, swelling, reduction of activity, and functional instability were assessed and graded from 0+ to 3+. Postoperative examination showed improvement of these parameters in most patients. Objectively, assessment of effusion, patellofemoral joint symptoms, stability, and recurvatum were tabu lated and compared to preoperative information. Of greatest significance was improvement of the patient's overall functional classification in most cases. The posterior sag or drawer sign and patellofemoral com plaints were not altered by the operation. Gait analysis and isokinetic testing were performed as part of the followup on 50% of the patients. We advocate this as a safe, effective reconstructive procedure for the posterior cruciate deficient knee with significant advantages over alternative tech niques.
Percutaneous release of the epicondylar muscles for humeral epicondylitis
Authors: Baumgard Stuart H. , Schwartz Donald R. 
Published: June 2007

This paper describes 44 percutaneous epicondylar releases performed on 34 patients with humeral epi condylitis. There were 35 instances of lateral epicon dylitis and 6 of medial epicondylitis. Thirty-two of the lateral releases had an excellent result and 3 were unsatisfactory. Five of the medial procedures were rated as excellent and one unsatisfactory. Two of the three unsatisfactory lateral procedures were reoper ated upon with an excellent result. The one unsatis factory medial epicondylitis underwent reoperation and had excellent results. In our experience, percutaneous release has a high rate of success, is simple to perform, does not require hospitalization, and has been without complication.
Musculoskeletal injuries in theatrical dance students
Authors: Rovere George D. , Webb Lawrence X. , Gristina Anthony G. , Vogel Judith M. 
Published: June 2007

Three hundred and fifty-two injuries in 185 theatrical dance students at the North Carolina School of the Arts were diagnosed and treated from September 1981 through May 1982, the most recent academic year. The total number of dancers enrolled in the school was 218; thus, 84.9% of the dance students were evaluated for an injury by a physician, with 87.8% of the injuries sustained during dance. Approximately one-fourth of the dance-related inju ries involved the foot or ankle. The injuries were usually not severe, and proved amenable to treatment by con servative measures.
Medial collateral ligament replacement with a partially absorbable tissue scaffold
Authors: Aragona J. , Parsons J.R. , Alexander H. , Weiss A.B. 
Published: June 2007

The medial collateral ligaments and medial capsular structures of canines were resected and replaced with a carbon fiber-polylactic acid polymer tissue scaffold or allowed simply to "scar-in." After 4, 8, 12, and 26 weeks in vivo, the stability of the knees was quantitatively evaluated and the mechanical properties of the regrown structures determined. Histological sections of the re grown structures were examined after 26 weeks in vivo. At all time periods, the knees receiving tissue scaffold ligaments were signifiicantly more stable than those knees allowed to stabilize with scar tissue. Initial strength, rapid ingrowth, and benign tissue reaction suggest this new composite material may be useful in the treatment of joint instability.
Prognosis in anterior shoulder dislocation
Authors: Simonet William T. , Cofield Robert H. 
Published: June 2007

All patients treated for a first-time anterior glenohumeral dislocation in Olmsted County, Minnesota, from 1970 through 1979 were identified. Of these 124 patients, 116 were available for study at a mean followup of 4.63 years (range 2 to 11). Of the 116 patients, 38 (33%) had recurrence of dislocation: 21 of the 32 (66%) pa tients less than 20 years old,17 of the 43 (40%) patients 20 through 40 years old, and none of the 41 patients older than 40 years. Symptomatic instability remained a problem in 24 patients. Twenty-seven of 33 (82%) young athletes had recurrence of dislocation as com pared with only 8 of 27 (30%) nonathletes of similar ages. Patients restricted from resuming sports partici pation for 6 weeks or more had significantly better results than those restricted for less than 6 weeks. The recurrence rate of dislocation is not as high as previously reported. However, the rate in athletes is much higher than that in nonathletes. Many patients continue to complain of symptomatic instability without actual redislocation. In our younger patients, we now advise immobilization for from 3 to 6 weeks, followed by extensive rehabilitation before return to athletic ac tivity.
Discoid medial meniscus: Two cases of tears presenting as locked knee due to athletic trauma
Authors: Hermann George , Berson Burton L. 
Published: June 2007

Two patients with a rare, massive type of discoid medial meniscus have been described. Both presented with a locked knee due to athletic trauma in the third and fifth decade of life, respectively. Clinically, discoid meniscus has only nonspecific signs. The arthrogram has proved to be a helpful pre operative diagnostic tool. Definitive diagnosis and treat ment can be made with arthroscopy.
The acute pivot shift: Clinical correlation
Authors: Lucie R. Stephen , Wiedel Jerome D. , Messner Duane G. 
Published: June 2007

The pivot shift test and its various modifications has been well described for evaluation of chronic antero lateral rotatory insufficiency of the knee. Fifty knees with acute traumatic hemarthrosis were examined un der general anesthesia to assess the reliability of the pivot shift in the acute injury. The pivot shift test as described by Galway and Maclntosh was employed. No patients with a history of previous knee injuries were included. Arthrotomy or arthroscopy was per formed following the examination in all cases. There were 38 knees with positive shifts, 35 with complete anterior cruciate tears, and 3 with significant partial tears or attenuation of the ligament. The 12 knees with negative shift demonstrated five normal anterior cru ciates, five partial tears and two complete tears of the anterior cruciate. Both of the complete tears were associated with complete medial collateral ligament tears and were clinically apparent by drawer and Lach man tests. A positive pivot shift in this study was very accurate for significant anterior cruciate tears. A nega tive pivot shift ruled out complete anterior cruciate ligament tears but did not preclude the presence of a partial tear. Partial tears associated with a negative pivot shift retained ligament competence. We conclude that: (1) the pivot shift is a direct test of cruciate competence; (2) the pivot shift is present acutely in a very high percentage of cases and does not necessarily develop over time; (3) the pivot shift exam performed under general anesthesia is a very reliable test for significant tears of the anterior cruciate; and (4) the arthroscope remains a useful tool in the evaluation of acute traumatic hemarthrosis, but is not always necessary in establishing competence of the anterior cruciate ligament.
Quadriceps atrophy in the anterior cruciate insufficient knee
Authors: Baugher W. Hugh , Warren Russell F. , Marshall John L. , Joseph Alex 
Published: June 2007

Atrophy of the quadriceps musculature is frequently associated with chronic knee instability. This atrophy may persist despite the patient's ability to return to athletic competition. When open biopsies of the quadriceps muscle from unstable knees were compared with those from normal acutely injured knees, it was found that clinical evidence of atrophy correlated with a relative decrease in the size of Type II or fast twitch muscle fibers. This sup ports the subjective, clinical impression that the unsta ble knee is less effective in explosive push-off. The findings also indicate the necessity of including exercise specific for the training of Type II fast twitch fibers in any program designed to rehabilitate the injured knee.
The effect of continuous passive motion on anterior cruciate ligament reconstruction stability
Authors: Burks Robert , Daniel Dale , Losse Gary 
Published: June 2007

This study was undertaken to examine the immediate effect of continuous passive motion (CPM) on anterior cruciate ligament (ACL) reconstruction stability. Ca daver knees were tested with a knee arthrometer with the anterior cruciate intact and then with the anterior cruciate sectioned. One of three anterior cruciate re constructions was then performed and stability was restored to the knee and it was again tested with the knee arthrometer. Stability was defined as being within 2 mm of the intact measurement. The three operations selected were the Marshall-Maclntosh "over-the-top," (OTT) a patellar bone-patellar tendon-tubercle bone (BTB) graft, and a semitendinosis reconstruction. The specimens were placed on a CPM device in a cooler at 38°F and put through a range of motion of 20 to 70° at 10 cycles per minute for 3 days. A success was less than a 2 mm increase in the post-CPM measurement compared to pre-CPM. All three bone-tendon-bone op erations failed. The semitendinosis operation was suc cessful in only three out of eight specimens. The OTT operation was successful in eight out of nine speci mens. The possible reasons for success and failure are discussed. Because of the potential problems with failure of an ACL with CPM it is suggested that the particular tech nique being used for an anterior cruciate reconstruction be tested prior to it being used with CPM clinically.
Nontraumatic injuries in amateur long distance bicyclists
Authors: Weiss Barry D. 
Published: June 2007

All 132 participants in a 500 mile, 8 day bicycle tour were surveyed by questionnaire to characterize the demographics and bicycling experience of the riders, and to determine the frequency and severity of non traumatic injuries they experienced. Riders who devel oped significant symptoms were interviewed and/or examined. Eighty-six percent of ride participants re sponded to the survey. The average age of the riders was 41.4 years (±11.7 years). They rode an average of 95.8 miles per week on a routine basis, but the majority were new to long distance touring. Most were healthy, but 5% had seri ous cardiovascular disease and bicycled as part of a rehabilitation program. The most common nontraumatic injury was buttocks pain (experienced by 32.8% of riders); four had skin ulceration of the buttocks. Knee problems occurred in 20.7% of riders; patellar pain syndromes and lateral knee complaints were the most common knee prob lems. One cyclist withdrew from the tour because of knee pain. Neck-shoulder pain occurred in 20.4% of the riders. Groin numbness and palmar pain or paresthesias each occurred in approximately 10%. Other less common problems were foot and ankle symptoms and sunburn.
Anteroposterior tibiofemoral displacements during isometric extension efforts
Authors: Jurist Kenneth A. , Otis James C. 
Published: June 2007

Rehabilitation of knee extensors is a major considera tion in patients with cruciate injuries and repairs. Exten sion exercises, however, can produce undesirable loads on the injured or replaced anterior cruciate liga ment (ACL) resulting in permanent stretch of this re straint. Our study measures the tibiofemoral displace ments associated with proximal, middle, and distal lo cations of the external resisting force and knee flexion angles of 30°, 60°, and 90°. Our results show that tibiofemoral displacements are dependent on both location of the external resisting force and knee flexion angle, with anterior displace ments being associated with distal displacement of the resistance pad. The results suggest that patients with ACL injuries or repairs conduct extension exercises with a proximal position of the resistance pad to mini mize loads and prevent stretching of this constraint.
Stress changes of the distal radial epiphysis in young gymnasts
Authors: Roy Steven , Caine Dennis , Singer Kenneth M. 
Published: June 2007

Between 1980 and 1983, 21 young, high-performance gymnasts with stress changes related to the distal radial epiphysis, were treated and followed for a mean of 24 months (range, 6 to 42 months). Eleven of the gymnasts presented with roentgenographic changes of the distal radial epiphysis, and in these recovery took at least 3 months. This group was compared to a group of ten gymnasts who had similar symptoms but no roentgenographic changes, and who recovered within an average of 4 weeks. The roentgenographic changes, which are de scribed in detail, are considered to represent stress changes, possibly stress fractures, of the distal radial epiphysis. No residual growth-related problems have been observed. Possible etiologic factors are dis cussed, and the literature as it pertains to stress-related adaptation and injury in the growing athlete is reviewed.
Chondral fractures of the knee
Authors: Hopkinson William J. , Mitchell William A. , Curl Walton W. 
Published: June 2007

Knee pain in the athlete can pose difficulty in diagnosis. At the United States Military Academy at West Point we have had occasion to see a group of patients presenting with meniscal symptoms of locking, catch ing, giving way, and joint line tenderness who, on arthroscopic examination, have chondral fractures of the medial or lateral femoral condyle. These individuals have undergone arthroscopy and debridement of the chondral defect. Both retrospectively and prospectively we have been unable to find any defects on radiographs and there appears to be purely cartilaginous involvement. These individuals appear to have a relatively poor prognosis for recovery after arthroscopy. Treatment has been a standard course of range of motion exercises, strengthening, and antiinflammatory medications. How ever, the mean rehabilitation time has been almost triple the time associated with a routine meniscal injury. We feel that it is important to discuss the chondral fracture so that the orthopaedic surgeon can be aware of this possibility in the differential diagnosis of knee pain in the athlete.
Patterns of knee injuries in wrestling: A six year study
Authors: Wroble R.R. , Mysnyk M.C. , Foster D.T. , Albright J.P. 
Published: June 2007

Data on knee injuries sustained by the University of lowa wrestling team over a 6 year period were com piled. There were a total of 136 wrestlers during this time. Fifty-one different wrestlers sustained 136 injuries (64 knees). Multiple parameters were examined for each injury, including date of injury; days lost; diagnosis; side injured; mechanism; occurrence during competi tion or practice; whether the wrestler was in control, "on the bottom," or both wrestlers standing; type of move being made at the time of injury; how far into a match or practice the injury happened; initial versus recurrent injury; principal form of management; weight- bearing status; and presence of knee pads. Each wres tler's weight class, years of experience, rank on the team, lead leg, and compliance were noted. We found an incidence of 30 knee injuries per 100 wrestlers per year. There were 11.5 knee injuries per 100 wrestlers per year requiring a week or greater time loss. This comprises over one third of all serious wres tling injuries. Exposure data revealed injury rates in matches to be almost 40 times those of practice. Wres tlers with previous knee injuries were at high risk for reinjury. Early season competition is an extremely high risk period. The most frequent injuries were prepatellar bursitis, lateral and medial sprains, and lateral and medial men iscal tears. We noted a relatively higher rate of lateral versus medial meniscal tears compared to other sports and a somewhat common presentation of a meniscal tear resulting from minimal trauma. The lead leg was injured most often. The takedown was the most fre quent situation where any injury occurred. Defensive wrestlers appeared to be at higher risk during take downs. The wrestler "underneath" was also injured more often. Compliance correlated with decreased recurrence of injury. Approximately 50% of wrestlers were found to be noncompliant with medical recommendations. Junior varsity wrestlers lost significantly more time than varsity wrestlers with equivalent injuries. There was no correlation of injury rate with weight class, period of match, timing in practice, or years of experi ence.
Meniscal tears: The effect of meniscectomy and of repair on intraarticular contact areas and stress in the human knee
Authors: Baratz Mark E. , Fu Freddie H. , Mengato Richard 
Published: June 2007

The role of the meniscus in load transmission across the knee has long been a subject of debate. In this study, we examined the biomechanical consequences of the operative treatments for bucket-handle and pe ripheral meniscal tears. Contact areas and instanta neous intraarticular pressure distributions were meas ured in two groups of human cadaver knees. In Group I, consisting of four knees, we created a bucket-handle tear involving the inner one-third of the meniscus, followed by partial, and then total meniscec tomy. Knees were tested in an Instron testing machine after each procedure, using a 400 pound load at 0° or 30° flexion. Contact areas and local stresses were measured using Prescale, a pressure-sensitive film. After partial meniscectomy, contact areas decreased approximately 10%, and peak local contact stresses (PLCS) increased approximately 65%. After total men iscectomy, contact areas decreased approximately 75%, and PLCS increased approximately 235%. In Group II, consisting of three additional knees, we created a 2 cm peripheral tear of the posterior meniscal horn, followed by open repair, arthroscopic repair, seg mental, and then total meniscectomy. Repair of the tear was accomplished with either vertically placed sutures by an open technique or horizontally placed sutures by an arthroscopic technique. Knees were tested in the neutral position in the Instron machine and contact areas and local stresses measured using Prescale. PLCSs and contact areas were found to be the same using either repair technique. There was, however, a 110% increase in PLCS after segmental meniscectomy of that portion of the meniscus involved in the peripheral tear. These data suggest that the meniscus does have a weightbearing role. Contact stresses increased in pro portion to the amount of meniscus removed and the degree to which the structure of the meniscus was disrupted. Furthermore, there was no difference in the weightbearing characteristics of the meniscus when repaired by open versus arthroscopic technique when the knee is loaded at 0° flexion.