bluuebunny/crossref_metadata_2025_split huggingface dataset:
Biomechanical Comparison of Tibial Inlay versus Transtibial Techniques for Posterior Cruciate Ligament Reconstruction
Authors: Margheritini Fabrizio , Mauro Craig S. , Rihn Jeffrey A. , Stabile Kathryne J. , Woo Savio L-Y. , Harner Christopher D. 
Published: March 2004

Background The tibial inlay technique for posterior cruciate ligament reconstruction has been proposed to provide a more anatomic reconstruction because it eliminates the sharp turn in the graft as it exits the proximal margin of the tibial tunnel in the transtibial technique. Hypothesis Reconstruction of the posterior cruciate ligament using the tibial inlay technique would more closely restore intact knee kinematics and in situ forces in the posterior cruciate ligament than would reconstruction using the transtibial technique. Methods Ten human cadaveric knees were tested in a controlled laboratory study. A robotic/universal force-moment sensor testing system was used to apply a 134-N posterior tibial load at 5 knee flexion angles: 0°, 30°, 60°, 90°, and 120°. Four knee conditions were tested: intact, posterior cruciate ligament–deficient, and the single-bundle tibial inlay reconstruction and transtibial posterior cruciate ligament reconstruction. Results Both reconstruction techniques restored posterior tibial translations to 1.7 to 2.1 mm of the intact knee, with no statistical differences between the techniques. In response to the posterior tibial load, in situ forces in both grafts were between 7 and 39 N less than those in the intact posterior cruciate ligament, with no significant differences between the grafts. Clinical Relevance The study suggests that either technique may be performed with similar biomechanical results at initial fixation under these loading conditions.
Relationship between Radiographic Abnormalities of Lumbar Spine and Incidence of Low Back Pain in High School and College Football Players
Authors: Iwamoto Jun , Abe Hitoshi , Tsukimura Yasunori , Wakano Koichi 
Published: March 2004

Background Low back pain is a common presenting symptom among players of American football. In Japan, however, skeletal disorders in football players, including low back problems, have been rarely studied, and management to prevent skeletal disorders has not been established. Study Design An epidemiological study with prospective observation. Methods The authors analyzed the relationship between lumbar spine abnormalities viewed through radiographs taken during the preparticipation physical examination, and the incidence of low back pain during a 1-year period in 171 high school and 742 college football players. Abnormalities assessed were spondylolysis, disc space narrowing, spinal instability, Schmorl's node, balloon disc, and spina bifida occulta. Results High school players with spondylolysis had a higher incidence of low back pain (79.8%) than those with no abnormal radiographic results (37.1%). College players with spondylolysis, disc space narrowing, and spinal instability had a higher incidence of low back pain (80.5%, 59.8%, and 53.5%, respectively) than those with no abnormal radiographs (32.1%), and college players with spondylolysis had a higher incidence of low back pain than those with disc space narrowing and spinal instability. Conclusions The results of the present study suggest that an abnormality such as spondylolysis is the most significant risk factor for low back pain in high school and college football players, and that disc space narrowing and spinal instability are also significant risk factors for low back pain in athletes with greater athletic activity such as college football players.
Relationships between Objective Assessment of Ligament Stability and Subjective Assessment of Symptoms and Function after Anterior Cruciate Ligament Reconstruction
Authors: Kocher Mininder S. , Steadman J. Richard , Briggs Karen K. , Sterett William I. , Hawkins Richard J. 
Published: March 2004

Background Relationships between objective assessment of ligament stability and subjective assessment of symptoms and function after anterior cruciate ligament reconstruction have not been established. Hypothesis Relationships exist between objective and subjective assessments after anterior cruciate ligament reconstruction. Study Design Case series. Methods Patients (N = 202) undergoing anterior cruciate ligament reconstruction with 2-year minimum follow-up were studied. Objective variables of ligament stability at follow-up included instrumented laxity, Lachman examination, and pivot-shift examination. Subjective variables of symptoms at follow-up included pain, swelling, giving way, locking, crepitus, stiffness, and limping. Subjective function at follow-up included walking, squatting, stair climbing, running, cutting, jumping, twisting, activity limitation, sports level, activities of daily living level, work level, knee function, sports participation, Lysholm score, and satisfaction withoutcome. Results Instrumented knee laxity and Lachman examination had no significant (P> .05) relationships with any subjective variables of symptoms and function. Pivot-shift examination had significant associations with satisfaction (P= .03), partial giving way (P= .01), full giving way (P= .01), difficulty cutting (P= .01), difficulty twisting (P= .01), activity limitation (P= .01), overall knee function (P= .03), sports participation (P= .02), and Lysholm score (P= .01). Conclusions The pivot-shift examination may be a better measure of “functional instability” than instrumented knee laxity or Lachman examination after anterior cruciate ligament reconstruction.
Diagnostic Value of Physical Tests for Isolated Chronic Acromioclavicular Lesions
Authors: Chronopoulos Efstathios , Kim Tae Kyun , Park Hyung Bin , Ashenbrenner Diane , McFarland Edward G. 
Published: March 2004

Purpose Chronic acromioclavicular joint lesions are a common source of pain and disability in the shoulder. The goal of this study was to evaluate diagnostic values of physical tests for isolated, chronic acromioclavicular joint lesions. Study Design A retrospective case-control study. Methods Between 1994 and 2002, 35 patients underwent a distal clavicle excision for isolated acromioclavicular joint lesions. The results of 3 commonly used examinations for acromioclavicular joint lesions were calculated for sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy. Results The cross body adduction stress test showed the greatest sensitivity (77%), followed by the acromioclavicular resisted extension test (72%) and active compression test (41%). The active compression test had the greatest specificity (95%). All tests had a negative predictive value of greater than 94%, but the positive predictive value was less than 30% for all tests. The active compression test had the highest overall accuracy (92%), followed by the acromioclavicular resisted extension test (84%) and the cross arm adduction stress test (79%). Combinations of the tests increased the diagnostic values for chronic acromioclavicular joint lesions. Conclusions These tests have utility in evaluating patients with acromioclavicular joint pathologic lesions, and a combination of these physical tests is more helpful than isolated tests.
A New Device to Detect Early Cartilage Degeneration
Authors: Duda Georg N. , Kleemann Ralf U. , Bluecher Uwe , Weiler Andreas 
Published: March 2004

Background Currently available arthroscopic techniques do not allow the quantification of cartilage stiffness without direct mechanical indentation or penetration of the tissue. Purpose A novel device, capable of quantifying cartilage stiffness during arthroscopy, is believed to detect degenerated cartilage. Study Design Controlled laboratory study. Methods The stiffness of biological materials was measured arthroscopically without contact between the instrument and the examined object. Object deformation was produced by a flow of sodium chloride and measured optically. Eight ovine femoral condyles and tibial plateaus were tested in a native and degenerated (0.1% trypsin solution) state. Cartilage stiffness was nondestructively determined by using the new device and by indentation methods. In addition, a standard probe was measured by 5 independent users. Results The trypsin caused cartilage degeneration and consequently stiffness reduction, measured at 30.8% by the new device and 33.0% by indentation. A good correlation (r = 0.69) between the new device and the standard indentation procedure was observed. Intraindividual and interindividual variability of the new device were low (<10%). Conclusions The developed device has demonstrated the ability to quantify the mechanical quality of cartilage by means of mechanical stiffness measurements. Clinical Relevance The findings suggest that this device has the capability to detect cartilage degeneration at an early stage.
Plantar Fascia Ruptures in Athletes
Authors: Saxena Amol , Fullem Brian 
Published: March 2004

Objective To educate sports medicine practitioners as to length of time for an athlete to return to activity after sustaining a rupture of the plantar fascia. Methods Athletic patients sustaining plantar fascia ruptures and subsequent treatment were reviewed. Diagnosis was based on clinical findings, although radiographic studies were done. Patients were treated for 2 to 3 weeks with a below-knee or high- top boot, nonweightbearing, with an additional 2 to 3 weeks of weightbearing in the boot. Patients used physical therapy. Results Eighteen athletes, including 6 elite athletes, were evaluated. Mean age was 40.9 ± 13.2 years. There were 12 males and 6 females. Mean postinjury follow-up was 42 months. Duration of prior plantar fascia symptoms ranged from 0 to 52 weeks. All but 2 ruptures were of the medial portion. Four patients had injections prior to rupture. Five patients wore orthoses preinjury; 14 wore orthoses postinjury. All patients returned to activity after 2 to 26 weeks (mean, 9.1 ± 6.0 weeks). Running athletes predominantly composed the cohort; others played tennis, volleyball, and basketball. Conclusion Using the treatment protocol, patients sustaining plantar fascia rupture can achieve favorable results with complete return to activity. None of the 18 patients sustained reinjury, had postinjury sequelae, or necessitated surgery, contrary to other studies.
Porcine Tibia is a Poor Substitute for Human Cadaver Tibia for Evaluating Interference Screw Fixation
Authors: Nurmi Janne T. , Sievänen Harri , Kannus Pekka , Järvinen Markku , Järvinen Teppo L. N. 
Published: March 2004

Background Animal tissues are commonly used in anterior cruciate ligament graft fixation studies. Hypothesis Porcine bones and tendons provide good surrogates for human cadaver tissues in the biomechanical evaluation of anterior cruciate ligament reconstruction. Study Design Randomized experimental study. Method Three different tissue models—pure porcine (porcine graft fixed in porcine tibia, group 1), combination (human hamstring graft and porcine tibia, group 2), and pure human (human graft and tibia, group 3)—were compared using both cyclicloading and subsequent single-cycle load-to-failure tests to assess the effect of graft and bone tissue source (porcine vs human) on the fixation strength of anterior cruciate ligament reconstruction. Results In the cyclic-loading test, the displacement (slippage) after 1500 cycles was 2.0 mm ± 0.7 mm, 1.6 mm ± 0.4 mm, and 4.4 mm ± 1.9 mm for groups 1, 2, and 3, respectively (P< .001 between 1 and 2 vs 3). In the subsequent single-cycle load-tofailure test, the corresponding average yield loads were 668 N ± 157 N, 962 N ± 238 N, and 448 N ± 98 N, all differences being statistically significant. Conclusions In comparison to young human cadaver tibia, porcine tibia underestimate graft slippage and overestimate the failure load of the soft tissue graft in anterior cruciate ligament reconstruction. Clinical Relevance Porcine tibia does not provide a reasonable surrogate for human cadaver tibia for evaluating ACL reconstructions.
Acute Quadriceps Muscle Strains
Authors: Cross Thomas M. , Gibbs Nathan , Houang Michael T. , Cameron Matthew 
Published: March 2004

Background There has been no research examining the magnetic resonance imaging findings, and in turn the prognosis, for a series of acute quadriceps muscle strains. Hypothesis The magnetic resonance imaging findings of acute quadriceps muscle strain injuries are helpful in predicting their prognosis. Study Design Causal-comparative study. Method Forty professional players of Australian Rules football were followed over 3 years. Magnetic resonance imaging examinations were performed within 24 to 72 hours of muscle-strain injury. Imaging features of muscle strain injury included the anatomical location, size (cross-sectional area and length), and site (proximal, middle, or distal). The time from injury to return to full training was termed the rehabilitation interval. Results 25 clinical quadriceps muscle strain injuries occurred, with 15 cases involving the rectus femoris. The rectus femoris injuries could be further categorized into cases with straining about the central tendon (n = 7, mean rehabilitation interval = 26.9 days) or cases with straining in the periphery (n = 8, mean rehabilitation interval = 9.2 days). Six cases involved one of the vastus muscles (mean rehabilitation interval = 4.4 days). Three players had normal magnetic resonance imaging examinations (mean rehabilitation interval = 5.7 days). Conclusions The rectus femoris–central tendon injury is the red flag diagnosis associated with a significantly longer rehabilitation interval. Clinical Relevance Magnetic resonance imaging is helpful in predicting the prognosis for acute quadriceps strains.
Mechanical Properties of Bioabsorbable Meniscal Arrows as a Function of Tear Location
Authors: Jani Mihir M. , Silva Matthew J. , Gregush Ron V. , Matava Matthew J. 
Published: March 2004

Background Ex vivo studies have established that arrow fixation of meniscal tears is inferior to vertical sutures and is dependent on arrow length, although the influence of tear location is not known. Hypothesis Arrow length and tear location influence the mechanical properties of meniscal arrows. Study Design Controlled laboratory study. Methods A longitudinal incision was created either 2 mm or 7 mm from the periphery in 70 bovine medial menisci. Each was repaired with a meniscal arrow (10, 13, or 16 mm) or a single vertical suture and subjected to load-to-failure testing and video- graphic analysis. Results Mode of failure (P < .0001), maximum force (P < .0001), stiffness (P < .01), 2-mm gap force (P < .03), and ultimate gap formation (P < .002) were all directly related to arrow length. Sixteen-mm arrows and suture exhibited similar, superior mechanical properties. Tear location significantly influenced properties of 10-mm and 16-mm but not 13-mm arrows. Ten-millimeter arrows displayed the worst performance. Conclusions Mechanical properties of meniscal arrows depend on tear location and arrow length. Clinical Relevance Sixteen-millimeter arrows are a possible alternative to suture for repair of central tears. Thirteen-millimeter arrows may be effective for central and peripheral tears. Ten-millimeter arrows should not be used.
Arthroscopic Microscopy of Articular Cartilage Using Optical Coherence Tomography
Authors: Chu Constance R. , Lin Diana , Geisler Jessica L. , Chu Charleen T. , Fu Freddie H. , Pan Yingtian 
Published: March 2004

Background Optical coherence tomography is an echograph of infrared light that can yield microscopic cross-sectional images of articular cartilage without removing or damaging the tissue. Hypothesis To determine whether optical coherence tomography images of human cartilage can be acquired arthroscopically and whether the resulting images have high correlation with histopathology. Methods Optical coherence tomography was configured into an arthroscope and used to image 2 human cadaver knees and 45 cores harvested from 9 osteoarthritic knees. The imaged cartilage was then processed for histological analysis. Optical coherence tomography images and histology were graded using a modified Mankin structural score. Agreement was determined using weighted kappa statistics. Morphometric analysis performed on optical coherence tomography images was correlated with histomorphometric analysis using linear regression. Results Imaging of the medial and lateral femoral condyles and trochlea was readily accomplished using the optical coherence tomography arthroscope. Modified Mankin surface scores for specimens with the earliest structural changes (grades 0-3) had high agreement with scores assigned to histology ([.kappa] = 0.87). Fibrillation indices calculated from optical coherence tomography had near-perfect correlation to that of histology (R = 0.98) Clinical Relevance Arthroscopic optical coherence tomography may be clinically useful for early detection of articular cartilage injury and nondestructive assessment of articular cartilage repair.
Arthroscopic Capsulolabroplasty for Posteroinferior Multidirectional Instability of the Shoulder
Authors: Kim Seung-Ho , Kim Hyo-Kon , Sun Jong-Il , Park Jun-Sic , Oh Irvin 
Published: March 2004

Background Arthroscopic treatment of posteroinferior multidirectional instability of the shoulder is not well documented. Purpose To evaluate pathologic lesions of posteroinferior multidirectional instability and the results of arthroscopic capsulolabroplasty. Study Design Prospective nonrandomized clinical trial. Methods Thirty-one patients with posteroinferior multidirectional instability were prospectively evaluated after arthroscopic capsulolabroplasty (mean follow-up, 51 months). Labral lesion and height were measured in the MRI arthrogram and arthroscopic examination. Results All patients had a labral lesion and variable capsular stretching in the posteroinferior aspect. There were 11 type I labral lesions (incomplete detachment), 12 type II (the Kim's lesion: incomplete and concealed avulsion), 6 type III (chondrolabral erosion), and 2 type IV (flap tear). All patients with type II and III lesions had chondrolabral retroversion, with lost labral height in the MRI arthrogram and arthroscopic examination. Twenty-one patients had an excellent Rowe score, nine had good scores, and one had a fair score. Thirty patients had stable shoulders, and one had recurrent instability. All patients had improved shoulder scores and function and pain scores. Conclusions Symptomatic patients with posteroinferior multidirectional instability had posteroinferior labral lesions, including retroversion of the posteroinferior labrum, which were previously unrecognized. Restoration of the labral buttress and capsular tension by arthroscopic capsulolabroplasty successfully stabilized shoulders with posteroinferior multidirectional instability.
Injuries in Intercollegiate Women's Lacrosse
Authors: Matz Samuel O. , Nibbelink Gregg 
Published: March 2004

Background Historically, the sport of women's lacrosse has required little or no protective equipment. Recently, there has been increasing concern over trauma to the face and head incurred during play. A rule change passed in spring 2003, during the course of this study, mandates goggles in 2005. Purpose To survey injuries in women's lacrosse over multiple seasons and institutions and to categorize injury rates and patterns. Study Design A prospective survey. Methods A standard report-of-injury form was sent to participating institutions. Injuries were defined by athletic training staff as any event resulting in the athlete missing one or more games or practices. Results The overall injury rate for women's lacrosse for the 2001-2002 and 2002-2003 seasons from participating schools was 3.8 per 1000 athlete exposures. The rate of head and face injuries was 1.4 per 1000 athlete exposures, representing 38.5% of all injuries incurred. The rate of eye injuries was 0.43 per 1000 athlete exposures, accounting for 11.5% of the total injuries. The practice injury rate was 2.7 per 1000 athlete exposures, and the competition injury rate was 8.8 per 1000 athlete exposures. Conclusion Data support the future requirements for protective eyewear. There is significant and increasing exposure for head and face trauma. Further investigation is needed to monitor injury patterns in women's lacrosse as rules for protective gear evolve.
Lyophilization Does Not Inactivate Infectious Retrovirus in Systemically Infected Bone and Tendon Allografts
Authors: Crawford Matthew J. , Swenson Cheryl L. , Arnoczky Steven P. , O'shea Jeremy , Ross Herbert 
Published: March 2004

Background A review of multiple transplantations of human immunodeficiency virus–infected musculoskeletal allografts found that recipients of lyophilized (freeze-dried) bone or tendon from an infected donor all tested negative for human immunodeficiency virus. The finding that 75% of the recipients of fresh-frozen bone from the same donor contracted human immunodeficiency virus has led to speculation that freeze-drying may render retroviral-infected musculoskeletal allografts noninfectious. Hypothesis Lyophilization does not inactivate retrovirus in systemically infected bone and tendon. Study Design Controlled laboratory study. Methods Tendons and cortical bone segments from cats systemically infected with feline leukemia virus were used in this study. Feline embryonic fibroblast cells were cultured in the presence of fresh-frozen or freeze-dried cortical bone or tendon segments. At each passage, feline leukemia virus p27 antigen was measured in media by enzyme-linked immunosorbent assay, and feline leukemia virus (pro)viral nucleic acids were quantified by real-time quantitative polymerase chain reaction in the DNA extracted from cells. Results Enzyme-linked immunosorbent assay results and quantitative polymerase chain reaction results demonstrated retroviral antigen and proviral DNA in all cultured cell replicates after exposure to fresh-frozen or freeze-dried bones or tendons. Conclusion Freeze-drying (lyophilization) of retroviral-infected cortical bone and tendon does not inactivate retrovirus. Clinical Relevance These results conclusively demonstrate that freeze-drying should not be relied on to inactivate infectious retrovirus in systemically infected musculoskeletal allografts.
Myogenic fusion of human bone marrow stromal cells, but not hematopoietic cells
Authors: Shi Daqing , Reinecke Hans , Murry Charles E. , Torok-Storb Beverly 
Published: March 2004

AbstractFollowing marrow transplantation in both patients and animals, cells containing donor nuclei have been detected in a variety of nonhematopoietic tissue. Whether this phenomenon represents transdifferentiation of marrow-derived cells, infiltration of blood cells, or cell fusion is still controversial. In muscle, where cell fusion occurs during normal myogenesis, fusion of marrow-derived cells with resident myotubes is a likely explanation. We tested 8 subpopulations of human bone marrow for their ability to fuse with mouse C2C12 myoblast cells. Relatively high fusion efficiency was observed with marrow stromal cells whereas hematopoietic cells, including populations enriched for stem cells, progenitor cells, and monocytes were refractory to fusion. Mouse myotubes containing human nuclei also contained transcripts for human muscle–specific genes. Injection in vivo of human stromal cells expressing green fluorescent protein (GFP) into the regenerating tibialis anterior muscle of nonobese diabetic–severe combined immunodeficient (NOD/SCID) β2m–/– mice resulted in regenerating mouse muscle fibers expressing GFP. These data suggest that marrow-derived cells contribute to myogenesis through fusion and that stromal cells are better fusion partners than hematopoietic cells.