bluuebunny/crossref_metadata_2025_split huggingface dataset:
A comparison of acute anterior cruciate ligament examinations
Authors: Donaldson William F. , Warren Russell F. , Wickiewicz Thomas 
Published: June 2007

The preoperative examination, the examination under anesthesia, and the findings at surgery were compared for acutely injured knees that were found at surgery to have anterior cruciate ligament (ACL) tears. The pivot shift was initially positive in only 35% of the knees; however, under anesthesia 98% were pos itive. The Lachman test was initially positive in 99% of the knees, and under anesthesia, 100%. The anterior drawer sign was present initially in 70% of the knees, and under anesthesia this increased to 91 %. Of the 37 patients with isolated ACL tears, only 20 (54%) had initially positive anterior drawer signs. In the knees in which secondary restraints to anterior-poste rior motion were injured, this percentage increased to 69% in medial meniscus injury, 82% in lateral meniscus injury and 89.5% in rupture of the medial collateral ligament (MCL). The Lachman test seems relatively unaffected by associated ligamentous or meniscal in juries, but the end point in the Lachman test is absent in all complete ACL tears. The pivot shift phenomenon, which was demonstrable in 98% of patients when tested under anesthesia, may be diminished when there is a MCL injury or absent in partial ACL tears. Experience in performing the Lachman test and in appreciating the quality of the end point will give the examiner a high degree of accuracy in making the diagnosis of an ACL tear without resorting to anesthe sia, arthroscopy, or arthrography in most patients.
Fracture separation of the olecranon ossification center in adults
Authors: Kovach John , Baker Bruce E. , Mosher John F. 
Published: June 2007

Traumatic disruption of an incompletely fused olecra non physis in adults has been reported on only one occasion by O'Donoghue in 1942, while stress frac tures of the olecranon physis have been well-recog nized and reported. A series of three adult males with traumatic disruption of an incompletely fused olecranon physis was studied. Two were competing in football at the time of the injury, while a third patient sustained the injury during a fall. All of our patients were former throwing athletes and all sustained a direct blow to the dominant elbow at the time of the fracture. In our study, as well as O'Donoghue's reported case, sclerotic fracture margins were noted. Open reduction, internal fixation (ORIF) required and subsequent fibrous union occurred. Two patients chose bone grafting and returned to competitive athletics, while the third patient functioned well at a sedentary level with a fibrous union. These cases suggest a high incidence of fibrous union following ORIF. Primary bone grafting is recommended in an effort to restore normal function with one primary procedure, particularly, in the competitive athlete.
Surgical treatment of anterolateral rotatory instability
Authors: Andrews James R. , Sanders Richard A. , Morin Benoit 
Published: June 2007

Anterolateral rotatory instability in 31 acutely injured knees and 31 chronically unstable knees was surgically stabilized with a previously unreported method of ilioti bial band tenodesis. The anterior cruciate ligament was stretched, torn, or absent in all 62 knees. Thirty-one patients, 20 with acute injury and 11 with chronic instability, were reviewed at a minimum of 2 years. A meniscal tear was present in 80% of the acute and in 91 % of the chronic injuries. The anterior cruciate ligament was repaired, in addition to the iliotibial band tenodesis in 16 of the 20 acute injuries; there was no difference in the overall results between those repaired and not repaired. The evaluation of the patients was based on four subjective criteria (including functional parameters) and five objective criteria. Niney-three percent of the patients had returned to competitive or recreational athletic activities involving cutting or pivoting movements. Both subjective and objective results were excellent or good in 93.6% of the patients. These results, based on our evaluation, warrant contin ued use of this procedure, according to the prescribed indications and technique.
A review of scaphoid fracture healing in competitive athletes
Authors: Riester John N. , Baker Bruce E. , Mosher John F. , Lowe Donald 
Published: June 2007

A fractured scaphoid is a common disabling injury occurring in contact sports. Plaster immobilization is the most frequently used form of therapy. However, the rules governing most amateur sports do not allow an unyielding form of immobilization distal to the elbow. We describe a method of treating scaphoid fractures with custom-made Silastic (Dow Corning Wright, Arling ton, TN) casts for competitive athletes. A retrospective review of 14 scaphoid fractures oc curring in athletes competing in contact sports was completed to determine if effective immobilization could be maintained with this technique. The study covered a 10 year period with an average followup of 3.9 years (range 2 to 9 years). Ten of 11 middle third scaphoid fractures healed uneventfully. One nonunion occurred following a 7 week delay in diagnosis. Two of three proximal third scaphoid fractures went on to nonunion, while the third healed after a prolonged period of treat ment. Our data indicate that nondisplaced middle third scaphoid fractures can be effectively immobilized for competition in contact sports with the custom-made Silastic cast described.
Rehabilitation of the pitching shoulder
Authors: Pappas Arthur M. , Zawacki Richard M. , Mccarthy Claire F. 
Published: June 2007

Shoulder pain is a common complaint among baseball pitchers. Frequently, the nature of shoulder pathology can be traced to lack of flexibility and muscular imbal ance. This paper describes: (1) the normal biomechanics of a properly functioning shoulder during a baseball pitch, (2) pathomechanics of shoulder problems, (3) flexibility requirements of the throwing shoulder, and (4) the muscular balance necessary for an effective throwing shoulder. Appropriate examination procedures are de scribed along with remedial exercises which ensure normal glenohumeral motion and integrated muscle action.
Shock absorption characteristics of running shoes
Authors: Cook Stephen D. , Kester Marcus A. , Brunet Michael E. 
Published: June 2007

The change in shock absorption properties of running shoes was evaluated as a function of miles run. Differ ent models of running shoes encompassing a wide range in retail price were obtained and mechanically tested to simulate the repeated heel strikes of running. The energy absorbed by the shoes was determined from the area under the load deformation curve at the equivalent of 0, 5, 10, 25, 50, 75, 100, 125, 150, 200, 250, 300, and 500 miles of running. Shoes were also tested at similar intervals after having been worn by volunteers during normal training. An approximate 33% difference in the initial shock absorption was observed in the different shoe models. In general, the shoes retained approximately 75% of their initial shock absorption capability after 50 miles of simulated running, and approximately 67% after 100 to 150 miles. Between 250 and 500 miles the shoes retained less than 60% of their initial shock absorption capacity. No differences in shock absorption character istics were apparent based upon either shoe price or the manufacturer model. The results of shoes tested by the volunteer runners also showed a marked reduc tion in shock absorption with mileage. The loss, how ever, was not as great as in the machine-simulated running, with approximately 70% of initial shock ab sorption retained at 500 miles.
Polypropylene braid augmented and nonaugmented intraarticular anterior cruciate ligament reconstruction
Authors: Roth James H. , Kennedy John C. , Lockstadt Harry , Mccallum Catherine L. , Cunning Leonard A. 
Published: June 2007

The purpose of this clinical retrospective study is to determine whether a polypropylene braid (PB) used to augment an intraarticular autograft to reconstruct the anterior cruciate ligament (ACL) is safe and to deter mine whether the PB improves the efficacy of the procedure. A simultaneous review was performed of patients who had undergone an intraarticular ACL reconstruc tion using an autograft composed of the central quad riceps tendon, prepatellar periosteum, and patellar ten don left attached distally to the tibial tubercle and of patients who had undergone the same procedure with PB augmentation of the autograft. Preoperatively, all patients had chronic ACL insufficiency and were expe riencing symptomatic giving way. A subjective questionnaire and a physician exami nation (JHR) were completed on each patient. Objective laxity and functional testing, including KT 1000 arthro meter measurement, Cybex isokinetic strength analy sis, and one leg horizontal hop for distance, were performed. Six radiographs of each operated knee were obtained. Results were statistically analyzed. Thirty-eight of 43 (88%) nonaugmented procedures performed were reviewed, with a mean followup of 64 months. Forty-five of 48 (94%) PB augmented recon structions with a minimum followup of 42 months (max imum 57 months, mean 50 months), were reviewed. On objective laxity and function testing, the PB aug mented patients had better results than the nonaug mented patients. On subjective questioning, physician's examination, and radiographic analysis, the PB aug mented results were significantly better. There were 12 (32%) knees with recurrent symptomatic giving way in the nonaugmented group and 5 (11 %) in the PB aug mented group. Chrondromalacia patellae and arthrofi brosis were seen in both groups. No adverse reaction to the PB was seen. We conclude that the PB is safe and that PB aug mentation improves the efficacy of the intraarticular autograft to reconstruct the ACL.
The functional relationship of the posterior oblique ligament to the medial collateral ligament of the human knee
Authors: Fischer Richard A. , Arms Steven W. , Johnson Robert J. , Pope Malcolm H. 
Published: June 2007

Strain in the human knee medial collateral ligament (MCL) was measured in cadavers with a Hall effect strain transducer during normal passive knee flexion, as well as knee flexion accompanied by applied external tibial rotation and valgus torques. In an attempt to determine the contribution of the posterior oblique lig ament (POL) to the strain behavior of the MCL, the POL was systematically separated from the MCL and changes in strain in the MCL were observed. These changes in strain were mild and variable, except in the one knee which was later found to be lacking an anterior cruciate ligament. In that particular knee, strain in the MCL increased up to 9.97% under the influence of a valgus torque once the POL fibers had been separated from the MCL. Anatomical dissection and transillumi nation techniques of the MCL/POL complex demon strated definite ligament fibers connecting the MCL to the POL. The results demonstrate an intimate anatomical re lationship between the POL and MCL. However, the POL and MCL appear to work independently from each other according to our test method.
The lon g -term followup of soldiers with stress fractures
Authors: Milgrom C. , Giladi M. , Chisin R. , Dizian R. 
Published: June 2007

A group of 295 Israeli infantry recruits was evaluated in a prospective study of stress fractures which began in basic training. On the basis of scintigraphy, 91 of the recruits (31 %) were found to have sustained stress fractures during basic training. Sixty-six of the 91 recruits with stress fractures (72%) were followed for a minimum of 1 year after basic training to determine the natural history of a soldier who sustains a stress fracture and resumes training after a period of rest. Five clinical patterns were ob served : (1) uneventful recovery (47%); (2) protracted recovery (13.6%); (3) symptoms consistent with recur rent stress fractures in new sites (19.6%); (4) intermit tent nonstress fracture bone pain (16.7%); and (5) chronic stress fractures (3%). The incidence of recur rent stress fractures was 10.6%. A control group of 60 recruits who sustained no stress fractures in basic training had a 1.7% incidence of stress fractures after basic training. Recruits who sustained stress fractures in basic training continued to be a higher risk for stress fractures during subsequent training.
Reconstruction of the anterior cruciate ligament with freeze dried fascia lata allografts in dogs
Authors: Curtis Ralph J. , Delee Jesse C. , Drez David J. 
Published: June 2007

In 16 adult dogs the anterior cruciate ligament (ACL) was transected and then reconstructed using freeze dried fascia lata allografts. Eight of the dogs had the intraarticular graft passed through drill holes in the tibia and femur, while in the other eight dogs the graft was passed through a drill hole in the tibia and routed "over- the-top" of the lateral femoral condyle. In all dogs the grafts were then passed deep to the lateral collateral ligament and secondarily secured to the tibia as an extraarticular reconstruction. Specimens from each group underwent histologic study and biomechanical testing on a mechanical testing system at 3, 6, 12, and 24 week intervals. All grafts were found to be intact at sacrifice with no overt evidence of biologic incompatibility. The knees displayed only mild instability to clinical testing without evidence of arthrosis. Histologically, the grafts ap peared to function as a collagenous scaffolding for revascularization and fibrovascular creeping substitu tion. The mean maximum load at failure in the 24 week specimens reached 536.44 N, compared to values of 801.85 N in contralateral knees with an intact ACL.
Fine wire electromyography analysis of muscles of the shoulder during swimming
Authors: Nuber Gordon W. , Jobe Frank W. , Perry Jacquelin , Moynes Diane R. , Antonelli Daniel 
Published: June 2007

Fine wire EMG of the shoulder was performed on 11 swimmers; 5 performed during dry land studies and 7 during aquatic studies. One individual underwent both studies. A cinematographic analysis was synchronized with the EMG data to determine what muscles were firing at each phase of the swim stroke. Eight muscles were studied: biceps, subscapularis, latissimus dorsi, pectoralis major, supraspinatus, infraspinatus, serratus anterior, and deltoid. Three stokes were analyzed: freestyle, breaststroke, and butterfly. The freestyle and butterfly are frequently associated with impingement type syndromes in swimmers. It was determined that the supraspinatus, infraspi natus, middle deltoid, and serratus anterior were pre dominately recovery phase muscles. The latissimus dorsi and pectoralis major were predominately pull- through phase muscles. The biceps had mixed incon sistent activity during both phases. From dry land quan tifications of the EMG signal it was determined that the serratus anterior functions near maximal muscle test during each stroke, and theoretically may fatigue with repetition. It is hoped that a training program aimed to strengthen the scapular rotators may help alleviate impingement syndrome in swimmers.
The effect of exercise on anterior-posterior knee laxity
Authors: Steiner M.E. , Grana W.A. , Chillag K. , Schelberg-Karnes E. 
Published: June 2007

A commercial knee laxity testing device was used to quantitate anterior and posterior laxity before and after exercise. Measurements were made at 20° of knee flexion and with a displacement force of 133 N (30 pounds). In sedentary controls no significant change in laxity was noted over 2 hours. Squat power lifters sustained no significant change in laxity after a series of squats (0.4 to 0.7 cm) using 1.6 times body weight. However, 18% to 20% increases in mean anterior and posterior laxity were noted in college basketball players after 90 minutes of practice and in recreational runners after a 10 km race. The role of muscle relaxation in such tests was also evaluated by measuring laxity in normal knees before and during general anesthesia. Negligible laxity change was noted. Thus, functionally "complete" muscle relax ation can be obtained during testing in the cooperative individual. In conclusion, basketball players and distance run ners experienced a transient increase in anterior and posterior laxity during exercise. Power lifters doing squats did not demonstrate a significant change in laxity. It appears that repetitive physiologic stresses at a high strain rate produce significant ligamentous laxity, while a relatively few large stresses at a low strain rate do not.
Exercise-related knee joint laxity
Authors: Skinner H.B. , Wyatt M.P. , Stone M.L. , Hodgdon J.A. , Barrack R.L. 
Published: June 2007

Knee injuries are the topic of increasingly sophisticated research because of the importance in professional athletics as well as increasing participation in recrea tional sports. The role of conditioning and fatigue in these injuries remains controversial. Ligaments have high collagen content, and a viscoelastic response to stress would be expected. Because of the postulated relationship between laxity and knee ligament injuries, an experiment was designed using highly motivated athletes to test the hypothesis that exercise to the point of muscular fatigue may cause laxity of the knee and thereby place athletes at risk for ligamentous injury to the knee when fatigued. An exercise protocol was designed to produce mus cle fatigue in the hamstring and quadriceps muscle groups. Knee ligament laxity was tested prior to and subsequent to the exercise protocol. To document muscle fatigue, isokinetic testing of right knee flexion and extension power was used several times during the exercise protocol. A knee arthrometer (KT-1000) was used to quantitatively document ligamentous laxity before and after exercise. The results indicated a sig nificant lengthening in knee joint laxity between preex ercise and postexercise in the left knee as measured at 15 and 20 pounds of passive displacement force ( P < 0.05). Maximum manual displacement also demon strated a significant increase in joint laxity (P = 0.02). The right knee, which had undergone isokinetic testing, demonstrated a similar tendency but without a statisti cally significant difference before and after exercise. There was no significant preexercise side to side differ ence, but postexercise measurements demonstrated a left-right difference at 15 pounds, 20 pounds, and max imum manual displacement of statistical significance (P < 0.01). These previously unreported findings document an in vivo increase in the anterior laxity of the knee joint due to exercise. The clinical implications to be drawn from this study are that more accurate clinical examination of the knee may be obtained after a short cool-down period in the knee with suspected ligamentous injury, and, in addition, athletes should be encouraged to perform vigorous warm-up exercises when entering organized sports activities after cool-down periods of greater than 15 minutes.
Long-term results of nonoperative treatment of isolated posterior cruciate ligament injuries in the athlete
Authors: Parolie James M. , Bergfeld John A. 
Published: June 2007

The long-term results of 25 patients treated nonopera tively with isolated posterior cruciate ligament (PCL) injuries were evaluated. Mean followup was 6.2 years (range, 2.2 to 16 years). All patients were evaluated both subjectively (questionnaire) and objectively (clinical examination, x-ray films, Cybex II dynamometer, and KT-1000 Knee Arthrometer). At followup, 80% of the patients were satisfied with their knees and 84% had returned to their previous sport (68% at the same level of performance, 16% at a decreased level of performance). Mean torque Cybex II quadriceps values for three velocities of testing (45, 90, and 180 deg/sec) in patients fully returned to sport and satisfied with their knees was greater than 100% of uninvolved quadricep; conversely, those not satisfied with their knees all had values less than 100% of uninvolved knee. The amount of knee instability as determined by the KT-1000 Arthrometer was not re lated to the patient's return to sport nor to knee satis faction. We concluded that the majority of athletes with isolated PCL injuries who maintain strength in muscu lature return to sports without functional disability.
The anatomy of the iliopatellar band and iliotibial tract
Authors: Terry Glenn C. , Hughston Jack C. , Norwood Lyle A. 
Published: June 2007

Based on an extensive review of the literature and dissections of 17 fresh-frozen knee specimens, the authors divide the lateral fascia lata of the knee into two functional components: the iliopatellar band and the iliotibial tract. Aponeurotic, superficial, middle, deep, and capsulo-osseous layers contribute to these two functional components. The superficial layer of the iliotibial tract, combined with the deep, and capsulo-osseous layers, is hypoth esized to function as an anterolateral ligament of the knee. The iliopatellar band provides stabilization of the patella against a medially directed force and is dynam ically influenced by the vastus lateralis. The relationship of the iliotibial tract to extraarticular reconstructions of the knee with anterolateral rotatory instability is discussed.
Lateral retinacular release in patellofemoral subluxation
Authors: Henry J.H. , Goletz T.H. , Williamson B. 
Published: June 2007

A consecutive series of patients who have undergone arthroscopy and lateral retinacular release for patello femoral subluxation was evaluated so that the results could be compared to an earlier series of open patel lofemoral reconstructions. Of 96 patients, 4 had bilat eral releases; therefore, 100 knees were evaluated. The average age was 28 years. Specific symptoms and signs were reviewed. All patients were initially treated conservatively with specific exercises. Failure of the exercise program to improve symptoms significantly, the patient's inability to perform normal daily activities, or expected associ ated pathology were indications for surgery. The surgical technique consisted of arthroscopy with treatment of associated pathology and lateral reti nacular release using the Smillie meniscotome through the inferior lateral portal. The patella could be tilted approximately 90° medially when the release was ac complished. Pain, function, and patellar instability were evaluated preoperatively and postoperatively by signs of tender ness on the retinaculum or bone, patellar mobility, effusion, muscle atrophy, and tone. Range of motion was also evaluated. Average followup was 36 months. When evaluated subjectively by the patients, pain improved from a mean preoperative grade of 3.4 to 1.7 postoperatively, function improved from 3.4 to 1.7, and instability from 3.4 to 1.6. Objective evaluation found that tenderness on the patella improved from a mean preoperative grade of 3.3 to 1.7 postoperatively. Tenderness on the retinac ulum improved from 3.2 to 1.7. Patellar mobility im proved from 3.3 to 1.7. Effusion dropped from 3.2 preoperatively to 1.5 postoperatively; quadriceps atro phy from a mean preoperative grade of 3.2 to 1.5, and quadriceps tone from 3.2 to 1.6. Lateral retinacular release compared favorably to a similar series of patellofemoral reconstructions. The average mean difference in preoperative and postop erative ratings improved 1.6 in lateral retinacular release compared to 1.9 in open patellofemoral reconstruc tions. The authors believe that a lateral retinacular release involves less surgery than a formal patellofemoral re construction. The patients do improve significantly from lateral retinacular release, and the degree of improve ment parallels that of patellofemoral reconstruction. If the lateral retinacular release patient does not improve, then patellofemoral reconstruction should be consid ered.