The American journal of sports medicine
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The treatment of osteochondritis dissecans in the adult knee can be challenging. As part of our comprehensive treatment program, fresh osteochondral allografts have been used in the surgical management of osteochondritis dissecans of the femoral condyle. ⋯ With greater than 70% good or excellent results, fresh osteochondral allograft transplantation is a successful surgical treatment for osteochondritis dissecans of the femoral condyle.
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The International Knee Documentation Committee (IKDC) forms are commonly used to measure outcomes after anterior cruciate ligament (ACL) reconstruction. The knee examination portion of the IKDC forms includes a radiographic grading system to grade degenerative changes. The interrater and intrarater reliability of this radiographic grading system remain unknown. ⋯ While intrarater reliability was acceptable, interrater reliability was poor. These findings suggest that multiple raters may score the same radiographs differently using the IKDC radiographic grading system. The use of a single rater to grade all radiographs when using the IKDC radiographic grading system maximizes reliability.
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Randomized Controlled Trial
Continued sports activity, using a pain-monitoring model, during rehabilitation in patients with Achilles tendinopathy: a randomized controlled study.
Achilles tendinopathy is a common overuse injury, especially among athletes involved in activities that include running and jumping. Often an initial period of rest from the pain-provoking activity is recommended. ⋯ No negative effects could be demonstrated from continuing Achilles tendon-loading activity, such as running and jumping, with the use of a pain-monitoring model, during treatment. Our treatment protocol for patients with Achilles tendinopathy, which gradually increases the load on the Achilles tendon and calf muscle, demonstrated significant improvements. A training regimen of continued, pain-monitored, tendon-loading physical activity might therefore represent a valuable option for patients with Achilles tendinopathy.
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Multicenter Study
Treatment outcomes of autologous chondrocyte implantation for full-thickness articular cartilage defects of the trochlea.
The treatment of trochlear cartilage lesions is challenging given the likely presence of other patellofemoral joint pathologies, the topography of the area, and the limited available treatment options. Only 1 other study has examined the effectiveness of autologous chondrocyte implantation for lesions of the patellofemoral joint. ⋯ Autologous chondrocyte implantation appears to improve function and reduce symptoms in young to middle-aged patients with symptomatic, full-thickness articular cartilage lesions of the trochlea.
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Randomized Controlled Trial
Extracorporeal shockwave for chronic patellar tendinopathy.
Chronic patellar tendinopathy is an overuse syndrome with pathologic changes similar to tendinopathies of the shoulder, elbow, and heel. Extracorporeal shockwave was shown effective in many tendinopathies. ⋯ Extracorporeal shockwave therapy appeared to be more effective and safer than traditional conservative treatments in the management of patients with chronic patellar tendinopathy.