Document:

<PAGE>
                                                                    EXHIBIT 10.1

                       FOURTH LOAN MODIFICATION AGREEMENT

        THIS FOURTH LOAN MODIFICATION AGREEMENT ("Modification Agreement") is
made as of September 26, 2002, between ADVANCED MARKETING SERVICES, INC., a
Delaware corporation ("Borrower"), and CALIFORNIA BANK & TRUST, a California
banking corporation ("Bank"), with reference to the following:

                                 R E C I T A L S

        A. Bank and Borrower are parties to that certain Revolving Credit
Agreement dated as of January 11, 2002 ("Loan Agreement"), pursuant to which
Borrower delivered to Bank a promissory note dated the same as the Loan
Agreement made by Borrower as maker to Bank, in the original principal amount of
$13,000,000 ("Note"), and a Security Agreement also dated the same as the Loan
Agreement made by Borrower in favor of Bank ("Security Agreement"), through
which Bank obtained a security interest in Borrower's accounts receivable and
other related collateral as described in Paragraph 2 thereof ("Collateral"). The
Security Agreement provides in Paragraph 3 that it secures not only the Loan,
but other obligations of Borrower to Bank which recite that they are secured
thereby. The Loan Agreement, Note, Security Agreement and related documents are
referred to collectively as the "Loan Documents". The Loan Documents were
previously modified by those certain Loan Modification Agreements dated as of
January 31, 2002 ("First Modification Agreement"), as of March 6, 2002 ("Second
Modification Agreement"), and as of July 10, 2002 ("Third Modification
Agreement"). Initially capitalized terms not otherwise defined herein have the
same meanings as in the Loan Agreement, as previously modified.

        B. Bank and Borrower are also parties to that certain Amended and
Restated Loan Agreement entered into effective July 27, 2000, which was amended
as of January 11 and July 10, 2002, relating to a $12,000,000 revolving credit
facility ("Junior Revolving Facility"). The Junior Revolving Facility is not
currently secured by the Security Agreement, although Bank and Borrower have
previously agreed, by the July 10, 2002 modification of the Junior Revolving
Facility, that in the event of a reduction of Borrower's Current Ratio below
1.0:1 as of the end of any fiscal quarter, all obligations of Borrower relating
to the Junior Revolving Facility would automatically and without further action
of the parties be secured by the Security Agreement.

        C. The parties wish to revise the Loan Documents again, to provide for
(i) a temporary increase in the Loan amount from $23,000,000 to $33,000,000
through December 1, 2002, (ii) the reduction of the Loan amount back to
$23,000,000 as of December 1, 2002, and (iii) the Junior Revolving Facility to
be secured by the Security Agreement during the period of the temporary increase
in the Loan amount, notwithstanding that Borrower's Current Ratio has not fallen
below 1.0:1.

        THE PARTIES AGREE AS FOLLOWS:

        1. MODIFICATION OF LOAN DOCUMENTS. Subject to the conditions precedent
of Paragraph 2 below, the Loan Documents are modified in the following respects:

               (a) The Loan amount is increased as of the date hereof from
Twenty-Three Million Dollars ($23,000,000) to Thirty-Three Million Dollars
($33,000,000) ("Temporary Increased Loan Amount"). Effective as of December 1,
2002, the Loan amount will be reduced to, and Borrower shall thereafter have no
right to any Advances in excess of, $23,000,000.

               (b) For good and valuable consideration, Borrower promises to pay
to Bank, or order, the Temporary Increased Loan Amount, or so much thereof as
may be advanced under the Note as modified hereby, with interest from the date
of each Advance at the interest rate specified in the Note, until paid in full
in accordance with the terms of the Note.

                                       1
<PAGE>

               (c) No later than December 1, 2002, Borrower shall pay to Bank
the amount, if any, by which the principal balance outstanding on the Note
exceeds $23,000,000.

               (d) Effective immediately, and continuing until the later of
December 1, 2002 or the date by which Borrower has made any principal reduction
payment required by Paragraph 1(c) above, all obligations of Borrower relating
to the Junior Revolving Facility shall be secured by the Security Agreement.
Following the later of December 1, 2002 or the date by which Borrower has made
any payment required by Paragraph 1(c) above, Borrower's obligations relating to
the Junior Revolving Facility will be secured by the Security Agreement only to
the extent required by the July 10, 2002 modification of the Junior Revolving
Facility (i.e., if Borrower's Current Ratio should fall below 1.10:1 at the end
of any fiscal quarter).

        2. CONDITIONS PRECEDENT. This Modification Agreement, and the temporary
increase of the Loan amount as set forth herein, shall be effective only upon
the date on which by which all of the following conditions precedent set forth
below have been satisfied or waived: (i) Borrower shall have paid Bank an
additional funding fee in the amount of Two Thousand Five Hundred Dollars
($2,500); and (ii) Borrower shall have paid Bank all costs and expenses
reasonably incurred by Bank in connection with this Modification Agreement,
including without limitation Bank's legal fees. The foregoing conditions
precedent are solely for the benefit of Bank, and may be waived in writing
unilaterally by Bank.

                      (a) REPRESENTATIONS AND WARRANTIES. As a material
inducement to Bank to enter into this Modification Agreement, Borrower hereby
unconditionally represents and warrants to Bank each of the matters set forth in
this Paragraph.

               (i) Borrower: (i) is solvent (i.e., the aggregate fair value of
Borrower's assets exceeds the sum of its liabilities); (ii) has adequate working
capital; and (iii) is able to pay its obligations as they mature. Borrower has
not filed and has no present intent to file any voluntary petition in bankruptcy
or to seek relief, protection, reorganization, liquidation, dissolution or
similar relief for debtors under any law or in equity, or to take any action
which would directly or indirectly cause any property of Borrower to become the
property of any bankruptcy estate or the subject of any bankruptcy, dissolution,
litigation or insolvency proceedings.

               (ii) All financial statements delivered by Borrower to Bank prior
to the date of this Modification Agreement have been prepared in accordance with
GAAP unless otherwise noted therein, are true and correct in all material
respects, fairly present the financial condition of Borrower as of and for the
periods presented therein, and as of the date of this Modification Agreement,
there are no obligations, liabilities or indebtedness (including contingent
liabilities) which are material to Borrower which are not reflected in such
financial statements other than those incurred in the ordinary course of
Borrower's business. No material adverse change has occurred in the financial
condition or business of Borrower since the date of the most recent financial
statements which Borrower has delivered to Bank.

               (iii) Except as disclosed to Bank in writing prior to or
concurrently with delivery of this Modification Agreement, there is no
litigation, investigation or governmental proceeding is pending or, to the
knowledge of Borrower, threatened against Borrower, and no judgments have been
rendered against Borrower.

               (iv) No representation or warranty made by Borrower in the Loan
Documents or this Modification Agreement contains any untrue statement of a
material fact or omits to state any material fact necessary to make the
statements therein not misleading, in light of the circumstances under which t
hey were made. Except as previously disclosed to Bank in writing, there is no
fact known to Borrower which has or might reasonably be anticipated to have a
material adverse effect on the business, assets, financial condition or
operations of Borrower.

               (v) Borrower is the sole owner of all the Collateral, and no
person except for Bank has (or, in the case of after-acquired Collateral, at the
time Borrower acquires rights therein, will have) any right, title, claim or
interest (by way of security interest or other lien or charge) in, against or to
the Collateral.

                                       2
<PAGE>
        3. OTHER MATTERS OF AGREEMENT.

               (a) Except as expressly set forth herein, this Modification
Agreement shall not affect or impair any other covenants or conditions set forth
in the Loan Documents.

               (b) This document may be executed in two or more counterparts,
each of which will be considered an original but all of which together shall
constitute one agreement.

               (c) Except as modified hereby, all provisions of the Loan
Documents as previously modified shall remain in full force and effect.

BANK:                                  CALIFORNIA BANK &
                                       TRUST, a California banking corporation

                                       By /s/ Steve DeLong
                                          --------------------------------------
                                       Name Steve DeLong
                                            ------------------------------------
                                       Title V.P.
                                             -----------------------------------

                                       By
                                          --------------------------------------
                                       Name
                                            ------------------------------------
                                       Title
                                             -----------------------------------

BORROWER:                              ADVANCED MARKETING
                                       SERVICES, INC., a Delaware corporation

                                       By /s/ Michael M. Nicita
                                          --------------------------------------
                                          Michael M. Nicita, President and CEO

                                       By /s/ Edward J. Leonard
                                          --------------------------------------
                                          Edward J. Leonard, Exec. Vice Pres.
                                          and CFO

                                       3<PAGE>

                                                                   EXHIBIT 10.65

                                                      AMENDMENT NO. 2 TO CREDIT
                                            AGREEMENT (this "Amendment"), dated
                                            as of October 29, 2002, among DJ
                                            ORTHOPEDICS, INC., a Delaware
                                            corporation ("Holdings"), DJ
                                            ORTHOPEDICS, LLC, a Delaware limited
                                            liability company (the "Borrower"),
                                            the financial institutions listed on
                                            the signature pages hereto (the
                                            "Lenders"), WACHOVIA BANK, NATIONAL
                                            ASSOCIATION, as administrative agent
                                            (in such capacity, the
                                            "Administrative Agent"), and
                                            JPMORGAN CHASE BANK, as syndication
                                            agent (in such capacity, the
                                            "Syndication Agent").

                WHEREAS, pursuant to the Credit Agreement, dated as of June 30,
1999, among Holdings, the Borrower, the Lenders, the Administrative Agent and
the Syndication Agent (as amended by Amendment No. 1 dated as of May 25, 2000
and Agreement dated as of July 13, 2000, as such may be amended, supplemented or
otherwise modified from time to time, the "Credit Agreement"), the Lenders have
extended credit to the Borrower, and have agreed to extend credit to the
Borrower, pursuant to the terms and subject to the conditions set forth therein;

                WHEREAS, the Borrower anticipates incurring certain cash and
non-cash charges attributable to the third and fourth fiscal quarters of fiscal
year 2002 and the first fiscal quarter of fiscal year 2003 in connection with
its performance improvement program; and

                WHEREAS, the anticipated charges, together with the good faith
estimate of the Borrower's management as to the amounts thereof, are described
on Schedule A hereto; and

                WHEREAS, the Borrower has requested that the Required Lenders
agree to amend certain provisions of the Credit Agreement in order to permit the
addback of such charges in the calculation of Consolidated EBITDA and in order
to avoid anticipated financial covenant violations during the fourth fiscal
quarter of fiscal year 2002 and the first fiscal quarter of fiscal year 2003;
and

                WHEREAS, the Required Lenders are willing to amend the Credit
Agreement, pursuant to the terms and subject to the conditions set forth herein.

                ACCORDINGLY, in consideration of the premises and the mutual
agreements contained herein and for other good and valuable consideration, the
receipt and sufficiency of which are hereby acknowledged, the parties hereto
hereby agree as follows:

        Section 1.Defined Terms. Capitalized terms used and not otherwise
defined in this Amendment shall have the meanings given to them in the Credit
Agreement.

<PAGE>

        Section 2.Amendments.

                (a) The following defined term is hereby added to Section 1.01
of the Credit Agreement in proper alphabetical order:

                1. " `Second Amendment' shall mean Amendment No. 2 to Credit
        Agreement, dated as of October 29, 2002, among Holdings, the Borrower,
        the Lenders party thereto, the Administrative Agent and the Syndication
        Agent."

                (a) The definition of "Consolidated EBITDA" set forth in Section
1.01 of the Credit Agreement is hereby amended by adding the following proviso
at the end of the first sentence thereof immediately before the period:

        "; provided that, in determining Consolidated EBITDA, the Borrower may
        add back cash and non-cash charges and expenses of the types described
        on Schedule A to the Second Amendment (collectively, `Permitted
        Addbacks') that are recorded during the period consisting of the third
        and fourth fiscal quarters of the Borrower's 2002 fiscal year and the
        first quarter of the Borrower's 2003 fiscal year (such period, the
        `Permitted Addback Period'), in each case to the extent originally
        deducted from revenues in determining Consolidated Net Income for any
        applicable period; but provided further that (I) no cash or non-cash
        charges or expenses of any kind (other than Permitted Addbacks and items
        of the types described in clauses (a), (b), (c), (d) (but as to clause
        (d), only depreciation an amortization), (e), (g), and (h) above)
        recorded during the Permitted Addback Period may be added back to
        Consolidated Net Income in calculating Consolidated EBITDA for any
        period and (II) the aggregate of all Permitted Addbacks recorded during
        the Permitted Addback Period and added back to Consolidated Net Income
        pursuant to this definition shall not exceed $17,000,000"

                (b) The definition of "Permitted Acquisition" set forth in
Section 1.01 of the Credit Agreement is hereby amended by adding the following
proviso at the end of the last sentence thereof immediately before the period:

        "and provided further that the aggregate amount of cash consideration
        paid with respect to Permitted Acquisitions consummated during the
        period consisting of the fourth fiscal quarter of the Borrower's 2002
        fiscal year and the first fiscal quarter of the Borrower's 2003 fiscal
        year shall not exceed $3,000,000"

                (c) Section 6.13 of the Credit Agreement is hereby amended and
restated in its entirety as follows:

                                       2
<PAGE>

                "SECTION 6.13. Leverage Ratio. The Borrower will not permit the
        Leverage Ratio as of any date during any period set forth below to be in
        excess of the ratio set forth below opposite such period:

<TABLE>
<CAPTION>
                      Period                                            Ratio
                      ------                                            -----
            <S>                                                         <C>
            December 31, 2001 through September 28, 2002                4.50

            September 29, 2002 through February 15, 2003                5.75

            February 16, 2003 through December 30, 2003                 4.00

            December 31, 2003 and thereafter                            3.50"
</TABLE>

                (d) Section 6.14 of the Credit Agreement is hereby amended and
restated in its entirety as follows:

                "SECTION 6.14. Consolidated Interest Coverage Ratio. The
        Borrower will not permit the Consolidated Interest Coverage Ratio for
        any four-fiscal-quarter period ending during any period set forth below
        to be less than the ratio set forth below opposite such period:

<TABLE>
<CAPTION>
                      Period                                            Ratio
                      ------                                            -----
            <S>                                                         <C>
            December 31, 2001 through December 30, 2002                 1.80

            December 31, 2002 through March 28, 2003                    1.70

            March 29, 2003 through December 30, 2003                    2.10

            December 31, 2003 and thereafter                            2.50"
</TABLE>

        Section 2.Representations and Warranties. In order to induce the Lenders
to enter into this Amendment, each of Holdings and the Borrower hereby
represents and warrants to the Lenders as of the Effective Date, as follows:

                (a) This Amendment has been duly executed and delivered by it
and constitutes its legal, valid and binding obligation enforceable against it
in accordance with its terms except as such enforceability may be limited by
bankruptcy, insolvency, moratorium, reorganization or other similar laws
affecting creditors' rights generally and except as such enforceability may be
limited by general principles of equity (regardless of whether such
enforceability is considered in a proceeding in equity or at law).

                (b) No Default or Event or Default has occurred and is
continuing.

                (c) Each of the representations and warranties set forth in
Article III of the Credit Agreement is true and correct in all material respects
with the same effect as if made on the

                                       3
<PAGE>

Effective Date, except to the extent such representations and warranties
expressly relate to an earlier date (in which case such representations and
warranties shall be true and correct in all material respects as to such earlier
date).

        Section 3.Effectiveness. This Amendment shall be deemed effective as of
the date (the "Effective Date") when each of the following conditions precedent
has been satisfied or waived:

                (a) The Administrative Agent shall have received duly executed
counterparts of this Amendment bearing the authorized signatures of the Required
Lenders, Holdings and the Borrower.

                (b) In consideration of this Amendment and the amendments made
herein, the Borrower shall have paid to the Administrative Agent, for the
account of each Lender executing this Amendment by 5:00 p.m. (New York time) on
the Effective Date, a fee in the amount of 25 basis points (0.25%) on the
aggregate principal amount of such Lender's Revolving Commitment and outstanding
Term Loans.

        Section 4.Applicable Law. THIS AMENDMENT SHALL BE GOVERNED BY, AND
CONSTRUED IN ACCORDANCE WITH, THE LAWS OF THE STATE OF NEW YORK.

        Section 5.Effect of Amendment. Except as expressly set forth herein,
this Amendment shall not, by implication or otherwise, limit, impair, constitute
a waiver of, or otherwise affect the rights and remedies of the Lenders, the
Administrative Agent, the Syndication Agent, the Borrower or Holdings under the
Credit Agreement or any other Loan Document, and shall not alter, modify, amend
or in any way affect any of the terms, conditions, obligations, covenants or
agreements contained in the Credit Agreement or any other Loan Document, all of
which are ratified and affirmed in all respects and shall continue in full force
and effect. Nothing herein shall be deemed to entitle the Borrower or Holdings
to a consent to, or a waiver, amendment, modification or other change of, any of
the terms, conditions, obligations, covenants or agreements contained in the
Credit Agreement or any other Loan Document in similar or different
circumstances. After the date hereof, any reference to the Credit Agreement
shall mean the Credit Agreement as modified hereby. This Amendment shall
constitute a "Loan Document" for all purposes of the Credit Agreement and the
other Loan Documents. This Amendment may not be amended nor may any provision
hereof be waived except pursuant to a writing signed by each of the parties
hereto.

        Section 6.Notices. All notices hereunder shall be given in accordance
with the provisions of Section 9.01 of the Credit Agreement.

        Section 7.Counterparts. This Amendment may be executed by one or more of
the parties to this Amendment on any number of separate counterparts (including
by facsimile transmission), and all of said counterparts taken together shall be
deemed to constitute one and the same instrument, and shall become effective as
provided in Section 4 hereof.

                                       4
<PAGE>

        Section 8.Headings. The headings used herein are for convenience of
reference only, are not part of this Amendment and are not to be taken into
consideration in interpreting this Amendment.

                                       5
<PAGE>

                IN WITNESS WHEREOF, this Amendment has been duly executed as of
the day and year first above written.

                                            DJ ORTHOPEDICS, LLC

                                            By:  /s/ Vickie L. Capps
                                                 -------------------------------
                                                 Name:  Vickie L. Capps
                                                 Title: Sr. V.P. & CFO

                                            DJ ORTHOPEDICS, INC.

                                            By:  /s/ Vickie L. Capps
                                                 -------------------------------
                                                 Name:  Vickie L. Capps
                                                 Title: Sr. V.P. & CFO

                                            WACHOVIA BANK, NATIONAL ASSOCIATION,
                                            individually and as Administrative
                                            Agent and Collateral Agent

                                            By:  /s/ Harry E. Ellis
                                                 -------------------------------
                                                 Name:  Harry E. Ellis
                                                 Title: Managing Director,
                                                        Senior Vice President

                                            JPMORGAN CHASE BANK, individually
                                            and as Syndication Agent, Issuing
                                            bank and Swingline Lender

                                            By:  /s/ Robert Bottamedi
                                                 -------------------------------
                                                 Name:  Robert Bottamedi
                                                 Title: Vice President

<PAGE>

                                            AMSOUTH BANK

                                            By:
                                                 -------------------------------
                                                 Name:
                                                 Title:

<PAGE>

                                            BAYERISCHE HYPO-UND VEREINSBANK AG,
                                            NEW YORK BRANCH

                                            By:  /s/ Ajay Nanda
                                                 -------------------------------
                                                 Name:  Ajay Nanda
                                                 Title: Associate Director

                                            By:  /s/ Elizabeth Tallmadge
                                                 -------------------------------
                                                 Name:  Elizabeth Tallmadge
                                                 Title: Chief Investment Officer

<PAGE>

                                            BANK LEUMI USA

                                            By:  /s/ Gloria Bucher
                                                 -------------------------------
                                                 Name:  Gloria Bucher
                                                 Title: Senior Vice President,
                                                        Managing Director

<PAGE>

                                            FLEET NATIONAL BANK

                                            By:  /s/ Christopher J. Wickles
                                                 -------------------------------
                                                 Name:  Christopher J. Wickles
                                                 Title: Vice President

<PAGE>

                                            WELLS FARGO BANK, N.A.

                                            By:  /s/ Martin Roblee
                                                 -------------------------------
                                                 Name:  Martin Roblee
                                                 Title: Vice President

<PAGE>

                                            THE PROVIDENT BANK

                                            By:  /s/ Thomas W. Doe
                                                 -------------------------------
                                                 Name:  Thomas W. Doe
                                                 Title: Vice President

<PAGE>

                                            PROVIDENT BANK OF MARYLAND

                                            By:  /s/ Samuel B. Bayne, Jr.
                                                 -------------------------------
                                                 Name:  Samuel B. Bayne, Jr.
                                                 Title: Vice President

<PAGE>

                                   Schedule A

                      Performance Improvement Program Costs

<TABLE>
<CAPTION>
                  Type of Cost                                   Estimated Amount
                  ------------                                   ----------------
<S>                                                              <C>
Severance                                                          $4.1 million

AlixPartners--Consulting Expenses                                  $3.5 million

Non-cash reserves for inventory and intangibles                    $3.3 million
related to refocus of product strategy

Vacated facilities rent accrual                                    $2.5 million

IT Consulting                                                      $1.0 million

Moving costs and other                                             $1.1 million
</TABLE>

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