bluuebunny/crossref_metadata_2025_split huggingface dataset:
A prospective, randomized study of three surgical techniques for treatment of acute ruptures of the anterior cruciate ligament
Authors: Engebretsen Lars , Benum Pal , Fasting Ove , Mølster Anders , Strand Torbjørn 
Published: June 2007

Treatment of ACL tears is controversial. Recent reports on nonoperative treatment have shown poor results. Results after primary repair have deteriorated with time, leading to augmentation procedures that seem to have improved the results. However, there have been few prospective, randomized studies in this field. Our goal was to compare primary repair with a bone-patellar tendon-bone augmentation method and with a new method using the Kennedy Ligament Augmentation Device. One hundred fifty patients aged 16 to 50, all of whom had acute ACL tears, were randomized with the closed envelope method to one of three groups treated with open surgical methods. Fifty patients were treated with primary repair, 50 patients with patellar tendon aug mentation, and 50 patients were augmented with the Kennedy Ligament Augmentation Device. All patients were operated on within 10 days of injury. The rehabil itation protocol was identical, consisting of a long leg cast for 2 weeks, followed by a brace with no weight bearing and limited motion for 6 weeks. The patients were followed prospectively by one surgeon (LE) using the Lysholm functional score, Tegner activity level score, clinical evaluation and KT-1000 arthrometer at 6 months, 1, and 2 years. Three patients were lost to followup. There was no age or activity level difference between the groups. Sport activities led to 85% of the injuries, with skiing, soccer, and European handball representing 80% of injuries. All three groups reduced their activity level the 1 st year. The repair group remained at the same level after 2 years. The Ligament Augmentation Device group had a small increase, while the patellar tendon group had a significant increase to almost the preinjury level. The patellar tendon group was judged to have results superior to the other groups, according to Lach man, pivot shift, and KT-1000 test results. The Liga ment Augmentation Device group fared better than the primary repair group, according to the Lysholm score, Lachman test, and pivot shift. In general, the results were as follows: the repair group deteriorated from 1 to the 2 years control, the Ligament Augmentation Device group did not change, and the patellar tendon group improved.
Injuries in the 1987 National Amateur Volleyball Tournament
Authors: Schafle Marie D. , Requa Ralph K. , Patton Wendy L. , Garrick James G. 
Published: June 2007

In a prospective study of injuries in the 1987 United States Volleyball Association's national tournament, we found 154 injuries in 1520 participants during 7812 hours of play. The injury rate in this study was 1.97/ 100 hours of play. Before the tournament, the participants' history was taken, and during the week of participation, records were kept of every player who presented with an injury. Players ranged in age from 17 to 60 and competed in five age/gender groups. Females had an injury rate of 2.3 and males had an injury rate of 1.7. The highest injury rate was seen in the men's open division, ages 17 to 35 (2.7), and the lowest rate was seen in the men's Golden Masters, ages 46 and up (1.5). Seventy- nine percent of the injuries occurred during the tour nament and 21 % were considered to be chronic injuries with an acute exacerbation. The upper extremities accounted for 20% of the injuries. The ankle (17.6%), low back (14.2%), and knee (11%) were the most common injury sites. Strains (36%) and sprains (28%) were the most frequent types of injury. Only eight (5.2%) injuries resulted in more than 5 days of time loss. Two of these injuries involved the knee and two others required surgery. It is likely that in studies relying upon retrospective methods, fewer of the less severe injuries are found, thereby leading to an overestimation of the percentages of knee and ankle injuries and the proportion of severe injuries. The clinician contemplating providing care for a high-level tournament should expect a preponderance of minor injuries occurring in a variety of anatomical locations. Major injuries were seen but were rare in our study.
A three-phase analysis of the prevention of recreational softball injuries
Authors: Janda David H. , Wojtys Edward M. , Hankin Fred M. , Benedict Milbry E. , Hensinger Robert N. 
Published: June 2007

Recreational sports injuries are expensive to society. Prevention of such injuries must be a major public health goal. In a previous retrospective study, base sliding was found to be responsible for 71 % of recreational softball injuries. Because most injuries occurred during rapid deceleration against stationary bases, quick-release (break-away) bases were evaluated as a means to modify this mechanism of injury. In a prospective study, 633 softball games were played on break-away base fields and 627 games were played on stationary base fields. Forty-five sliding injuries occurred on the station ary base diamonds (1 injury for every 13.9 games) and only two sliding injuries occurred on the break-away fields (1 injury for every 316.5 games). The medical costs for injuries on the stationary base fields was 79 times greater than that on the break-away fields. In a 1035 game follow-up study performed on all fields equipped with break-away bases, two sliding injuries occurred (1 injury for every 517.5 games). Installing break-away bases in fields used by recrea tional leagues would achieve a significant reduction of serious softball injuries (98%) and, therefore, should be mandatory. Based on our findings, the Centers for Disease Con trol has estimated 1.7 million injuries would be pre vented nationally per year, saving $2.0 billion per year nationally in acute medical care costs.
Axial loading injuries to the middle cervical spine segment
Authors: Torg Joseph S. , Sennett Brian , Vegso Joseph J. , Pavlov Helene 
Published: June 2007

Injuries to the cervical spine at the C3-C4 level involving the bony elements, intervertebral disks, and ligamen tous structures are rare. We present 25 cases of trau matic C3-C4 injuries sustained by young athletes and documented by the National Football Head and Neck Injury Registry. Review of the cases reveals that the response of energy inputs at the C3-C4 level differ from those involving the upper (C1-C2) and lower (C4-C5- C6-C7) cervical segments. Specifically, the C3-C4 le sions appear to be unique with regard to the infre quency of bony fracture, difficulty in effecting and main taining reduction, and a more favorable recovery follow ing early, aggressive treatment. In the majority of instances, injury at this level results from axial loading of the cervical spine. Lesions were distributed into specific categories: 1) acute intervertebral disc hernia tion (N = 4), 2) anterior subluxation of C3 on C4 (N = 4), 3) unilateral facet dislocation ( N = 6), 4) bilateral facet dislocation ( N = 7), and 5) fracture of vertebral body C4 (N = 4). Analysis of these 25 cases suggests that traumatic lesions of the cervical spine in general can be classified as involving the upper (C1-C2), middle (C3-C4), or lower (C4-C7) segments. This is based on our observations from this series that C3-C4 lesions 1) generally do not involve fracture of the bony elements; 2) acute inter vertebral disc herniations are frequently associated with transient quadriplegia; 3) reduction of anterior sublux ation of C3 on C4 is difficult to maintain; 4) reduction of unilateral facet dislocation is difficult to obtain by skeletal traction and is best managed by closed manip ulation and reduction under general anesthesia; and 5) reduction of bilateral facet dislocation is difficult to obtain by skeletal traction and is best managed by open methods. The more favorable results observed in this series of immediate reduction of both unilateral and bilateral facet dislocations deserves emphasis. In two cases of unilat eral facet dislocation reduced within 3 hours of injury and subsequently fused anteriorly, significant neuro logic recovery occurred. The other four patients, two who underwent an open reduction and laminectomy and two treated closed with skeletal traction, remained quadriplegic. In the four instances of bilateral facet dislocation where reduction was achieved by either closed or open methods, although there was no neurologic recovery, all four patients survived their injuries. However, the three patients who were not successfully reduced died.
Analysis of athletic performance with prophylactic ankle devices
Authors: Burks Robert T. , Bean Bill G. , Marcus Robin , Barker Howard B. 
Published: June 2007

We evaluated the effect of different ankle support de vices on athletic performance. Thirty varsity college athletes were tested with both ankles supported by taping, Swede-O brace, Kallassy brace or left unsup ported. The athletes performed four events: broad jump, vertical leap, 10 yard shuttle run, and 40 yard sprint. The events and appliances were randomized to prevent bias by fatigue. Compared to the results when no support was used, ankle taping resulted in a significant decreased perform ance in the vertical jump (4%), shuttle run (1.6%), and sprint (3.5%) (P < 0.05). Use of the Swede-O brace decreased performance in the vertical jump (4.6%), broad jump (3.6%), and time of the sprint (3.2%). Re sults using the Kallassy brace showed a decrease in the vertical jump (3.4%) when compared to no support. The test results of the shuttle run with taping were slower than the Kallassy brace (P < 0.05). Wearing the Swede-O brace caused the athletes' broad jump dis tance to decrease more than the Kallassy brace (P < 0.05). Subjective questionnaires supported the Kallassy brace as the most comfortable support and the one that decreased performance the least. Taping of the ankles is universally accepted for ankle prophylaxis. This study has shown a decrease in per formance when ankles are taped compared to ankles with no protection. Since the decreases in performance caused by ankle braces are minor, this should not be used as a criterion for selection of prophylactic support compared to taping.
The long-term followup of primary anterior cruciate ligament repair
Authors: Sherman Mark F. , Lieber Lawrence , Bonamo Joel R. , Podesta Luga , Reiter Ira 
Published: June 2007

Fifty primary ACL repairs using the Marshall multiple suture technique were analyzed. The average age at surgery was 23 years (range, 15 to 56), with 76% under the age of 30. The average followup was 61.3 months (range, 48 to 86). The average time from injury to surgery was 7 days (range, 1 to 18). Eighty percent of the injuries were sports-related with football and skiing predominating. Thirty-eight percent were "isolated" ACL tears, and 62% had associated injuries. There was a 46% incidence of meniscal tear with 59% of the meniscal tears being repaired. The postoperative evaluation included a multifactorial analysis correlating 43 variables including subjective, objective, radiographic, and KT-1000 data. The Hospi tal for Special Surgery Knee Diagnostic Score, a clinical objective score based on the postoperative Lachman and pivot shift examination, a KT-1000 arthrometer data score, and an overall combined assessment score were determined. The results showed 59% excellent, 18% good, 14% fair, and 8% poor. The Lachman test was diagnostic in all cases. The quality of ACL tissue at repair was rated excellent or good in 62% of the cases. Four patterns of ACL tears were distinguished by the location of the tear. Football injury, younger age, increased preoperative pivot shift, midsubstance Type IV tear, and return of full motion correlated with poor postoperative results. Increasing age, tight jointedness, Type I tears, and a 5° flexion contracture correlated with good postoperative results.
Anterior cruciate ligament reconstruction using bone-patellar tendon-bone allografts
Authors: Drez David J. , DeLee Jesse , Holden John P. , Arnoczky Steven , Noyes Frank R. , Roberts Thomas S. 
Published: June 2007

Twenty-eight goats underwent ACL reconstruction with freeze-dried bone-patellar tendon-bone allografts in one knee, the opposite knee serving as a control. One group of 16 knees was evaluated, in groups of four, at 6, 12, 26, and 52 weeks by histologic and vascular injection techniques. The other group of 12 knees was evaluated in two groups of six at 26 and 52 weeks by morpholog ical and biomechanical techniques of analysis. Within the first 12 weeks these allografts were revas cularized ; in the first 26 weeks they had matured to resemble normal connective tissue. Graft stiffness was 29% of the control value and maximum force to failure was 43% of the control value. The results of this study indicated that freeze-dried bone-patellar tendon-bone allografts are biomechani cally and biologically similar to patellar tendon auto- grafts.
Effectiveness of orthotic shoe inserts in the long-distance runner
Authors: Gross Michael L. , Davlin Lance B. , Evanski Philip M. 
Published: June 2007

Five hundred questionnaires were distributed to long- distance runners who had used, or who were using orthotic shoe inserts for symptomatic relief of lower extremity complaints. Three hundred forty-seven (69.4%) responded (males, 71%; females, 29%). The mean age of the respondents was 36 years (range, 15 to 61). The average distance run per week was 39.6 miles (range, 5 to 98). The mean duration for use of the orthotic inserts was 23 months (range, 1 to 96). The predominant (63%) type of orthotic device used was flexible. The presumed diagnoses in the population studied were excessive pronation (31.1 %), leg length discrepancy (13.5%), patellofemoral disorders (12.6%), plantar fasciitis (20.7%), Achilles tendinitis (18.5%), shin splints (7.2%), and miscellaneous (4.9%). Of the runners responding, 262 (75.5%) reported complete resolution or great improvement of their symptoms. Results of treatment with orthotic shoe inserts were independent of the diagnosis or the run ner's level of participation. A high degree of overall satisfaction was demonstrated by the finding that 90% of the runners continued to use the orthotic devices even after resolution of their symptoms. Orthotic shoe inserts were most effective in the treatment of symp toms arising from biomechanical abnormalities, such as excessive pronation or leg length discrepancy. Along with other conservative measures, orthotic shoe inserts may allow the athlete to continue participation in run ning and avoid other treatment modalities that are more costly and time consuming, and therefore less accept able to them.
Long-term study of anterior cruciate ligament reconstruction for chronic instability using the central one-third patellar tendon and a lateral extraarticular tenodesis
Authors: Aglietti Paolo , Buzzi Roberto , D'Andria Simone , Zaccherotti Giovanni 
Published: June 2007

Forty-four patients with symptomatic chronic anterior cruciate ligament instabilities that had been recon structed with the central one-third patellar tendon and a lateral extraarticular iliotibial band tenodesis were studied at an average followup of 7 years (range, 4 to 10). The cases with associated medial, lateral, or pos terior laxity were not included, nor were the cases with more than minimal preoperative degenerative changes. The average age at surgery was 21 years (range, 16 to 33). A postoperative cast was used for 4 weeks. Satisfactory objective stability, which was defined as a KT-1000 side-to-side difference of up to 5 mm at the manual maximum test, was obtained in 37 (84%) of the patients. In 25 patients (57%), stability was restored within normal limits (≤3 mm). No deterioration of the KT-1000 stability was noted at two follow-up visits performed by the same examiner (at an average of 4 and 7 years). A return to high-risk sports was possible in 27 (62%) of the patients. Difficulties in regaining a complete range of motion were recorded in 5 (11 %) of the patients. A flexion contracture of 5° to 7° was also found in 5 patients. Significant patellofemoral symptoms were present in 4 patients (9%). A 5% to 11% shortening of the patella tendon was observed in 14 (32%) of the knees, but did not correlate with patellar problems. Moderate radio graphic changes were noted in eight patients (18%) at followup and correlated with meniscectomy and pain. Overall satisfactory results were obtained in this initial experience in 29 (66%) of the patients. We believe that the operation gives reliable stability in the majority of the cases, but the results may be improved with more attention to isometry, earlier postoperative mobilization with complete extension, and a faster rehabilitation course.
The efficacy of continuous passive motion in the rehabilitation of anterior cruciate ligament reconstructions
Authors: Rosen Mark A. , Jackson Douglas W. , Atwell E. Allan 
Published: June 2007

Seventy-five patients undergoing arthroscopically-as sisted anterior cruciate ligament reconstruction by the same surgeon were divided into three random subgroups. All of the anterior cruciate ligament recon structions used the middle third of the ipsilateral patellar tendon autograft. Patients undergoing meniscal repair, extraarticular procedures, or repair of other ligaments were excluded. The 75 patients were divided into subgroups to assess the benefits or disadvantages of early active motion (25 patients), continuous passive motion (25 patients), and a combination of both (25 patients) during the first 30 days after surgery. All patients were evaluated at specific intervals for 6 months after surgery. Data recorded included drain output, medication usage, tourniquet time, leg involved, hospital stay length, KT-1000 testing (before surgery in the anesthetized patient, after the procedure was com pleted, and 2 and 6 months after surgery), and range of motion. Radiographs and the International Knee Evaluation Form were also used to evaluate the results. No statistically significant differences were found be tween the three groups. Side-to-side anterior-posterior differences, stability, and restoration of full range of motion were similar in each subgroup at each evaluated interval. In this prospective study of motion, started immediately after anterior cruciate ligament reconstruc tion, passive and active methods were shown to have identical results. A supervised active and passive mo tion program during the 1 st month had the same results as either one used individually.
Syndesmosis sprains of the ankle
Authors: Taylor Dean C. , Englehardt David L. , Bassett Frank H. 
Published: June 2007

A retrospective study of 50 syndesmosis sprains in 44 football players was performed. Five patients (6 ankles) were lost to followup, allowing review of 44 injuries. Average followup was 47 months. The patients were evaluated for recurrent injury, overall ankle function, and for persistent ankle symptoms, including stiffness, pain, limping, and swelling. Follow-up radiographs of the injured ankle were obtained in 22 patients. The average return time to full activity was 31 days. Pain with pushing-off was a major factor preventing return to activity. At final followup, 36% of the patients complained of persistent mild to moderate stiffness of the ankle. Twenty-three percent had mild to moderate pain, usu ally with activity. One patient had a mild limp with activity, and 18% of the ankles had persistent mild to moderate swelling. Ankle function was rated as good to excellent in 86%. All patients with fair results had recurrent ankle sprains. There were no poor results. Eleven of the 22 patients with follow-up radiographs developed heterotopic ossification within the interos seous membrane, but no patient developed a frank synostosis. The patients with heterotopic ossification required an average of 11 days more recovery time than those without ossification. There was no signifi cant difference between the 2 groups' ultimate ratings of ankle function or ankle symptoms, but the ankles with heterotopic ossification were associated with more recurrent lateral ankle sprains. We conclude that syndesmosis sprains require a longer recovery period than other types of ankle sprains. Most of these injuries showed good to excel lent ankle function after recovery, unless there was a recurrent ankle sprain. In the absence of frank synos tosis, the results were not affected by the formation of heterotopic ossification.
Long-term functional results of the modified Bristow procedure for recurrent dislocations of the shoulder
Authors: Wredmark Torsten , Törnkvist Hans , Johansson Christer , Brobert Birgitta 
Published: June 2007

Subjective shoulder function, range of motion, isoki netic muscular performance, and radiographs were analyzed in 44 patients at an average follow-up time of 6 years after a Bristow-Latarjet procedure for recurrent dislocations of the shoulder. The injured shoulder was compared with the healthy side in each patient. Ninety-five percent of the patients considered mobil ity, strength, and stability of the operated shoulder as good or excellent. Totally, 32 of 44 patients (72%) had no pain or discomfort at all, while the remaining 12 (28%) complained of moderate exertional pain. Range of motion in extension, flexion, abduction, and internal and external rotation did not differ significantly between the injured and healthy sides. Nor did isokinetic peak torque at 30 and 90 deg/sec differ in extension, flexion, or internal and external rotation. The rate of healing of the implant did not seem to influence the functional outcome of surgery. Two patients suffered from recur rent dislocations. The Bristow-Latarjet procedure provided a good or excellent long-term functional result in patients with recurrent shoulder dislocations.
Function of the quadriceps and hamstrings muscles in knees with chronic partial deficiency of the anterior cruciate ligament
Authors: Kannus Pekka , Jarvinen Markku , Johnson Robert , Renström Per , Pope Malcolm , Beynnon Bruce , Nichols Claude , Kaplan Michael 
Published: June 2007

We assessed the isokinetic and isometric strength and power profile of the knees of 37 patients who had a previous grade II sprain (partial tear) of the anterior cruciate ligament. Of the 37 knees, 11 had an isolated partial anterior cruciate ligament rupture and 26 had a partial anterior cruciate ligament rupture combined with a partial medial collateral ligament rupture. The Cybex II isokinetic dynamometer was used in the measure ments. Eight years after the injury, the mean strength deficit of the injured knees was minimal when compared with the uninjured side. In the hamstrings of both groups, the relative strength deficit increased significantly with a higher speed of isokinetic movement (P < 0.05). Compared with the strength parameters (peak torques), the other functional parameters (total work, average power, and peak angular impulse) of the in jured knees showed some, but not significantly greater, deficits (hamstrings, 7% to 10%; quadriceps, 4% to 10%). We found that the general thigh muscle function in knees with old grade II sprains of the anterior cruciate ligament appears adequate except in flexion where the strength deficits are significantly greater in higher speeds of isokinetic movement. Therefore, rehabilita tion using high-speed flexion (and extension) exercises is recommended.