The American journal of sports medicine
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We reviewed 13 patients with end stage jumper's knee, 10 with patellar tendon ruptures, and 3 with ruptures of the quadriceps tendon to evaluate our long-term results in treating these tendon ruptures in an athletic population. The focus was on the natural history, the time until return, and the level of return, to athletic activity. Jumper's knee affected all patients to a varying degree prior to rupture. ⋯ Patellar and quadriceps tendon ruptures from indirect injury in athletes represent the end stage of jumper's knee and result from repetitive microtrauma. Excellent function usually follows repair of patellar tendon ruptures when surgery is performed early and care is taken to restore normal patellar tendon length. Results of quadriceps ruptures are less satisfactory since these ruptures are usually incomplete and all degenerative tissue may not be involved in the healing response.
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Assessment is made of the effectiveness of femoral nerve block, administered either before or after surgery, in supplementing postoperative analgesia for knee joint (anterior cruciate) reconstruction surgery. Femoral nerve block, performed before surgery, with Bupivacaine 0.5%, reduced intramuscular opiate administration by 80% in the recovery room and 40% in the first 24 postoperative hours. An effective and rapidly performed technique for femoral nerve block is described.
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Over a period of 10 years we have studied 14,952 cases of skiing injuries. Of these, 660 cases (4.5%) were injuries to the shoulder with 291 cases (44.1%) being anterior dislocations of the shoulder. One hundred forty-three cases revealed an initial dislocation (49.1%), and 148 cases were recurrent dislocations (50.9%). ⋯ Of these initial dislocations, one-half of the capsular detachment type were redislocated, but no redislocation had occurred in the capsular tear type. In addition, almost all of the recurrent cases were of the capsular detachment type. Thus, through arthrography of the anterior dislocated shoulder, we have been able to discover the mechanism of the dislocation and decide upon the necessary duration and method of fixation of the shoulder after reduction.