bluuebunny/crossref_metadata_2025_split huggingface dataset:
Triceps Tendon Ruptures in Professional Football Players
Authors: Mair Scott D. , Isbell William M. , Gill Thomas J. , Schlegel Theodore F. , Hawkins Richard J. 
Published: February 2004

Background Distal rupture of the triceps tendon is a rare injury, and treatment guidelines are not well established. Hypothesis Football players with triceps tendon ruptures will be able to return to their sport with minimal functional deficits. Study Design Uncontrolled retrospective review. Methods Twenty-one partial and complete ruptures of the triceps tendon were identified in 19 National Football League players over a period of 6 years. Team physicians retrospectively reviewed training room, clinical, and operative notes for each of these players. Results Most of the injured players were linemen. The most common mechanism of injury was an eccentric load to a contracting triceps. Seven players had prodromal symptoms prior to injury, and 5 had received a cortisone injection. Eleven elbows with complete tears underwent surgical repair. Of 10 players with partial tears, 6 healed without surgery. One player suffered a subsequent complete tear requiring surgery, and 3 with residual pain and weakness underwent surgical repair following the season. Two surgical complications occurred, both requiring a second operation. All of the players but 1 returned to play at least one season of professional football after their injury. Conclusions Partial triceps tendon ruptures can heal without functional deficit. Surgical repair for complete ruptures generally produces good functional results and allows return to play.
Effects of Increasing Tibial Slope on the Biomechanics of the Knee
Authors: Giffin J. Robert , Vogrin Tracy M. , Zantop Thore , Woo Savio L-Y. , Harner Christopher D. 
Published: February 2004

Purpose To determine the effects of increasing anterior-posterior (A-P) tibial slope on knee kinematics and in situ forces in the cruciate ligaments. Methods Ten cadaveric knees were studied using a robotic testing system using three loading conditions: (1) 200 N axial compression; (2) 134 N A-P tibial load; and (3) combined 200 N axial and 134 N A-P loads. Resulting knee kinematics were determined before and after a 5-mm anterior opening wedge osteotomy. Resulting in situ forces in each cruciate ligament were determined. Results Tibial slope was increased from 8.8 ± 1.8 ° to 13.2 ± 2.1 °, causing an anterior shift in the resting position of the tibia relative to the femur up to 3.6 ± 1.4 mm. Under axial compression, the osteotomy caused a significant anterior tibial translation up to 1.9 ± 2.5 mm (90 °). Under A-P and combined loads, no differences were detected in A-P translation or in situ forces in the cruciates (intact versus osteotomy). Conclusions Results suggest that small increases in tibial slope do not affect A-P translations or in situ forces in the cruciate ligaments. However, increasing slope causes an anterior shift in tibial resting position that is accentuated under axial loads. This suggests that increasing tibial slope may be beneficial in reducing tibial sag in a PCL-deficient knee, whereas decreasing slope may be protective in an ACL-deficient knee.
Relative Balance of Serratus Anterior and Upper Trapezius Muscle Activity during Push-Up Exercises
Authors: Ludewig Paula M. , Hoff Molly S. , Osowski Erin E. , Meschke Shane A. , Rundquist Peter J. 
Published: February 2004

Background Serratus anterior strengthening is used in prevention and treatment programs for poor scapular control. In certain clinical cases, exercises substantially activating the serratus with minimal upper trapezius activation are preferred. Hypothesis The standard push-up plus would show both the highest serratus anterior activation and lowest upper trapezius/ serratus ratios for both groups and all phases. Study Design Controlled laboratory study. Methods Thirty subjects, grouped as healthy or with mild shoulder dysfunction, were evaluated performing standard push-up plus exercises and modifications on elbows, knees, and against a wall. Surface electromyography of the serratus anterior and upper trapezius was compared between exercises. Results Both groups responded similarly across exercises. The standard push-up plus demonstrated the highest activation of the serratus (to 123%) and lowest trapezius/serratus ratios (< 0.2) during plus phases. The wall push-up plus and phases of other exercises demonstrated higher upper trapezius/serratus ratios (to 2.0). Conclusions In clinical cases where excess upper trapezius activation or imbalance of serratus and trapezius activation occurs, the push-up plus is an optimal exercise. Other cases may benefit from a progression of modified push-up exercises. Clinical Relevance Clinical selection of exercises for improving scapular control should consider both maximum serratus activation and upper trapezius/serratus anterior ratios.
Biomechanical and Histological Evaluation of Osteochondral Transplantation in a Rabbit Model
Authors: Nam Ellis K. , Makhsous Mohsen , Koh Jason , Bowen Mark , Nuber Gordon , Zhang Li-Qun 
Published: February 2004

Background Biomechanical and histological properties of osteochondral transplantation have not been extensively examined. Hypothesis Osteochondral grafts have properties similar to native articular cartilage. Study Design Controlled laboratory study. Methods A 2.7 mm (diameter) × 4.0 mm (depth) osteochondral defect was created in 17 New Zealand white rabbit knees. An osteochondral graft, harvested from the contralateral knee, was transplanted into the defect. Eight rabbits were sacrificed each at 6 and 8 weeks. Results The 12-week grafts (1213.6 ± 309.0 N/mm) had significantly higher stiffness than the 6-week grafts (483.1 ± 229.1 N/mm; P< .001) and of normal cartilage (774.8 ± 117.1 N/mm; P< .003). Stiffness of the 6-week grafts was significantly lower than normal cartilage (P< .036). At all time points, full-thickness defects had significantly lower stiffness than normal cartilage (P< .001). Histologically, transplanted grafts scored significantly higher than the full-thickness defects (P< .001). The defects showed inconsistent, fibrocartilage healing. The grafts demonstrated cartilage viability, yet with a persistent cleft between the graft and host. Conclusions Osteochondral transplants undergo increased stiffness in the short term, with evidence of structurally intact grafts. Clinical Relevance Osteochondral transplantation may be a viable treatment option; however, long-term investigation on graft function is necessary.
Interference Screw Fixation of Soft Tissue Grafts in Anterior Cruciate Ligament Reconstruction: Part 1
Authors: Nurmi Janne T. , Kannus Pekka , Sievänen Harri , Järvelä Timo , Järvinen Markku , Järvinen Teppo L. N. 
Published: February 2004

Background Compaction of the bone-tunnel walls by serial dilation is believed to enhance the interference screw fixation strength of the soft tissue grafts in anterior cruciate ligament (ACL) reconstruction. Hypothesis Serial dilation enhances the fixation strength of soft tissue grafts in ACL reconstruction over extraction drilling. Study Design Randomized experimental study. Methods Initial fixation strength of the doubled anterior tibialis tendon grafts (fixed with a bioabsorbable interference screw) was assessed in 21 pairs of human cadaver tibiae with either serially dilated or extraction-drilled bone tunnels. The specimens were subjected to a cyclic-loading test, and those surviving were then tested using the single-cycle load-to-failure test. Results During the cyclic-loading test, there were 3 fixation failures in the serially dilated and 6 failures in the extraction-drilled specimens but no significant stiffness or displacement differences between the groups. In the subsequent load-to-failure test, the average yield loads were 473 ± 110 N and 480 ± 115 N for the 2 groups respectively (P= .97) and no difference with regard to stiffness or mode of failure. Conclusions Serial dilation does not increase the strength of interference fixation of soft tissue grafts in ACL reconstruction over extraction drilling. Clinical Relevance The results of this experiment do not support the use of serial dilators in ACL reconstruction.
Arthroscopic Posterior Cruciate Ligament Reconstruction with Quadriceps Tendon Autograft
Authors: Chen Chih-Hwa , Chen Wen-Jer , Shih Chun-Hsiung , Chou Shih-Wei 
Published: February 2004

Background Various autografts or allografts have been used for posterior cruciate ligament (PCL) reconstruction. Quadriceps tendon-patellar bone autograft is considered a good graft choice. Hypothesis Quadriceps tendon-patellar bone graft for PCL reconstruction can achieve a satisfactory clinical outcome after 3 years postoperatively. Study Design Retrospective review of prospectively collected data. Methods From 1996, the graft has been used in 32 patients. Twenty-nine patients with a minimum of 3 years of follow-up were analyzed. Results Twenty-four (83%) patients achieved good or excellent results by Lysholm knee rating. Sixteen (55%) patients could return to moderate or strenuous activity. Twenty-five (86%) patients had ligament laxity of less than 5 mm. Twenty-four (83%) patients were rated as normal or nearly normal by International Knee Documentation Committee (IKDC) guidelines. Twenty-four (83%) and 26 (90%) patients could achieve recovery of extensor and flexor muscle strength to 80% or more of normal knee, respectively. A statistically significant difference exists in thigh girth difference, extensor strength, and flexor strength before and after reconstruction. Conclusion Our study revealed satisfactory clinical subjective and objective results at a minimum 3 years follow-up. Quadriceps tendon autograft has the advantage of being self-available, a relatively easier arthroscopic technique, and having a suitable size, making it an acceptable graft choice for PCL reconstruction.
Fractures in the Collegiate Athlete
Authors: Hame Sharon L. , LaFemina Jennifer M. , McAllister David R. , Schaadt Geoffrey W. , Dorey Frederick J. 
Published: February 2004

Purpose To determine the demographics and incidence of fractures in collegiate athletes. Study Design Retrospective review of prospectively collected data. Methods Division I collegiate athletes who sustained a fracture while enrolled at the university from 1986 to 2000 were identified through training room records. Type and location of fracture, sport, gender, age, position, height, and weight were recorded and analyzed. Team information was obtained from athletic department records and was used to calculate incidence. Results Between 1986 and 2000, 5900 Division I athletes at our institution sustained 349 primary fractures (5.9%). By gender, the incidence did not differ significantly between males and females (P = .236), except in water polo where the men sustained significantly more fractures. By type, females sustained significantly more stress fractures (P = .001) than males. Overall, by location, the hand contributed the greatest number of total fractures. By sport, the incidence rate was highest in basketball (0.081) for male athletes and in gymnastics (0.069) for female athletes. The incidence of a second fracture during the study period was twice the rate of the first fracture. Conclusions As expected, athletes participating in contact sports contributed the greatest number of fractures. Participation in basketball for men and in gymnastics for women posed the greatest risk. Female athletes sustained significantly more stress fractures.
The Surgical Treatment of External Coxa Saltans (the Snapping Hip) by Z-Plasty of the Iliotibial Band
Authors: Provencher Matthew T. , Hofmeister Eric P. , Muldoon Michael P. 
Published: February 2004

Purpose A snapping hip (coxa saltans) secondary to a tight iliotibial band rarely needs surgical intervention. The purpose of this study is to present the surgical results of refractory external-type snapping hip by Z-plasty of the iliotibial band. Materials and Methods Nine symptomatic snapping hips in 8 consecutive patients (1 bilateral) from August 1997 through March 2002 who underwent an iliotibial band Z-plasty were reviewed. Results Eight of the 9 hips were in active-duty military and 1 was a civilian, with an average age of 25.6 years (range, 21 to 38 years). Mean duration of symptoms prior to surgical intervention was 25.2 months (range, 16 to 39 months) with an average follow-up of 22.9 months (range, 7 to 38 months). All patients had complete resolution of the snapping hip, and all but 1 returned to full unrestricted activities. The 1 failure had persistent groin pain but no residual snapping. Conclusions Patients with snapping hip of the iliotibial band refractory to conservative treatment are rare. The surgical results of Z-plasty are excellent and predictable. Careful screening is necessary to preclude other confounding diagnoses. Z-plasty is recommended as an effective surgical treatment of the refractory snapping hip secondary to iliotibial band tightness.
A Prospective Cohort Study of Injury Incidence and Risk Factors in North Carolina High School Competitive Cheerleaders
Authors: Schulz Mark R. , Marshall Stephen W. , Yang Jingzhen , Mueller Frederick O. , Weaver Nancy L. , Bowling J. Michael 
Published: February 2004

Background Cheerleaders suffer nearly half of catastrophic injuries observed in female scholastic athletes in the United States. However, incidence of noncatastrophic injury in this population has not been described. Hypothesis Coach, athlete, and injury circumstance variables may predict the injury rate among cheerleaders. Study Design Prospective cohort. Methods The authors investigated injury incidence in a sample of North Carolina female cheerleaders who competed interscholastically from 1996 to 1999. Injury, exposure, and demographic data were collected from squads that participated in the North Carolina High School Athletic Injury Study. Results Cheerleaders suffered 133 injuries during 1701 athlete seasons. More than 21% of the injuries were ankle sprains. The injury rate was 8.7; the 95% confidence interval (CI) was 6.5 to 11.7 per 10,000 athlete exposures. In a multivariate Poisson regression model, cheerleaders supervised by coaches with the most education, qualifications, and training (coach EQT) had a nearly 50% reduction in injury risk (rate ratio [RR], 0.5; 95% CI, 0.3-0.9), and cheerleaders supervised by coaches with medium coach EQT had a nearly 40% reduction in injury risk (RR = 0.6; 95% CI, 0.3-1.2) compared to cheerleaders supervised by coaches with low coach EQT.
The Effect of Graft Height Mismatch on Contact Pressure following Osteochondral Grafting
Authors: Koh Jason Lee , Wirsing Kim , Lautenschlager Eugene , Zhang Li-Oun 
Published: February 2004

Hypothesis Incongruity of the articular cartilage following osteochondral transplantation affects surface contact pressure. Study Design An 80 N load was applied for 120 seconds to the femoral condyles of 10 swine knees. Contact pressures were measured using Fuji prescale film. Seven conditions were tested: (1) intact articular surface; (2) 4.5-mm diameter defect; (3) grafted with 4.5-mm diameter plug elevated 1 mm above adjacent cartilage; (4) plug elevated 0.5 mm; (5) plug flush; (6) plug sunk 0.5 mm below surface; and (7) sunk 1.0 mm. Conclusions Peak contact pressures were significantly (P< .001) elevated by ~20% after defect creation and were reduced to normal when plugs were flush. There were large and significant (P< .001) increases in pressure with plugs elevated 1 and 0.5 mm. Contact pressures with plugs sunk 0.5 and 1 mm were significantly (P< .01) higher than intact cartilage but were significantly (P < .01) lower than an empty defect. Clinical Relevance Normal contact pressures and patterns can be duplicated with flush articular surface grafts. However, small incongruities, particularly when the plug is elevated, can lead to significantly increased pressure. This reinforces the importance of articular surface congruity in the initial biomechanical state following osteochondral implantation.
The Effect of Creatine Supplementation on Strength Recovery after Anterior Cruciate Ligament (ACL) Reconstruction
Authors: Tyler Timothy F. , Nicholas Stephen J. , Hershman Elliott B. , Glace Beth W. , Mullaney Michael J. , McHugh Malachy P. 
Published: February 2004

Background Creatine supplementation has been shown to augment training-induced strength gains. The purpose of this study was to examine the effect of creatine supplementation on recovery of muscle strength after anterior cruciate ligament (ACL) reconstruction. Hypothesis Creatine supplementation will facilitate strength gains after ACL reconstruction. Study Design Double-blind, prospective, and randomized clinical trial. Methods Sixty patients were randomized into creatine or placebo groups. Quadriceps and hamstring strength and power were measured isokinetically. Hip flexor, abductor, and adductor strengths were measured with a handheld dynamometer prior to surgery and at 6 weeks, 12 weeks, or 6 months after surgery. Results From 6 weeks to 12 weeks after surgery, there were significant increases in strength on the involved side for knee extension (47%), knee flexion (27%), hip flexion (20%), hip abduction (9%), and hip adduction (17%). These strength improvements were unaffected by creatine supplementation with similar effects in the creatine and placebo groups. From 6 weeks to 12 weeks after surgery, there were significant increases in power on the involved side for knee extension (46%) and knee flexion (26%), but these effects were not affected by creatine supplementation. At 6 months, creatine supplementation did not affect outcome as measured by the single leg hop test for distance or the knee outcome score. Conclusions The results demonstrate that patients do not benefit from creatine supplementation during the first 12 weeks of rehabilitation after ACL reconstruction.
Shoulder Injuries to Quarterbacks in the National Football League
Authors: Kelly Bryan T. , Barnes Ronnie P. , Powell John W. , Warren Russell F. 
Published: February 2004

Background Quarterbacks are at risk for shoulder injury secondary to both the throwing motion as well as from contact injury. Objective To delineate the incidence and etiology of shoulder injuries to quarterbacks in the National Football League (NFL). Methods Using the NFL Injury Surveillance System (NFLISS), all reported injuries to quarterbacks between 1980 and 2001 were identified. Results A total of 1534 quarterback injuries were identified with a mean of 18.8 and a median of 6.0 days of playing time lost. The majority of these injuries occurred during a game (83.8%). Passing plays were responsible for 77.4% of all quarterbackrelated injuries. Shoulder injuries were the second most common injury reported (233 or 15.2%), following closely behind head injuries (15.4%). Direct trauma was responsible for 82.3% of the injuries, with acromioclavicular joint sprains being the most common injury overall (40%). Overuse injuries were responsible for 14% of the injuries, the most common being rotator cuff tendinitis (6.1%) followed by biceps tendinitis (3.5%). Conclusion In this review, the vast majority of shoulder injuries in quarterbacks occurred as a result of direct trauma (82.3%), and less than 15% were overuse injuries resulting from the actual throwing motion.
Economic evaluation of the use of PCR assay in diagnosing pulmonary TB in a low-incidence area
Authors: Rajalahti I. , Ruokonen E‐L. , Kotomäki T. , Sintonen H. , Nieminen M.M. 
Published: February 2004

To determine whether polymerase chain reaction (PCR) testing in the initial diagnosis of pulmonary tuberculosis (TB) is cost-effective in a low-prevalence population, an economic evaluation was carried out between the smear and culture (NOPCR) and smear, culture and PCR (+PCR) strategies.A decision tree model based on retrospective laboratory data was developed to assess the strategies of testing patients with suspicion of TB. Direct healthcare costs prior to confirmation of TB or nontuberculous mycobacteria by PCR or culture were included. Effectiveness was measured by the probability of correct treatment and isolation decisions.In the baseline situation NOPCR costs 29.50 less than the +PCR strategy per patient tested. According to sensitivity analyses, reducing PCR test price, shortening test performance time or increasing the proportion of smear-positive patients in the tested population would contribute to cost savings with the +PCR strategy.Routine polymerase chain reaction testing of all specimens from suspected tuberculosis patients in a low-prevalence population was not cost-saving. When the polymerase chain reaction assay was applied only to smear-positive sputum specimens, the smear and culture strategy was clearly dominated by it,i.e.the polymerase chain reaction smear-positive sputum strategy was less costly and more effective in producing correct treatment decisions and isolations.
The impact of smoking cessation on respiratory symptoms, lung function, airway hyperresponsiveness and inflammation
Authors: Willemse B.W.M. , Postma D.S. , Timens W. , ten Hacken N.H.T. 
Published: February 2004

Smoking is the main risk factor in the development of chronic obstructive pulmonary disease (COPD), and smoking cessation is the only effective treatment for avoiding or reducing the progression of this disease.Despite the fact that smoking cessation is a very important health issue, information about the underlying mechanisms of the effects of smoking cessation on the lungs is surprisingly scarce. It is likely that the reversibility of smoke-induced changes differs between smokers without chronic symptoms, smokers with nonobstructive chronic bronchitis and smokers with COPD. This review describes how these three groups differ regarding the effects of smoking cessation on respiratory symptoms, lung function (forced expiratory volume in one second), airway hyperresponsiveness, and pathological and inflammatory changes in the lung.Smoking cessation clearly improves respiratory symptoms and bronchial hyperresponsiveness, and prevents excessive decline in lung function in all three groups.Data from well-designed studies are lacking regarding the effects on inflammation and remodelling, and the few available studies show contradictory results. In chronic obstructive pulmonary disease, a few histopathological studies suggest that airway inflammation persists in exsmokers. Nevertheless, many studies have shown that smoking cessation improves the accelerated decline in forced expiratory volume in one second, which strongly indicates that important inflammatory and/or remodelling processes are positively affected.