The American journal of sports medicine
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Anterolateral rotatory instability (ALRI) may result from combined anterior cruciate ligament (ACL) and lateral extra-articular lesions, but the roles of the anterolateral structures remain controversial. ⋯ The ITT showed large contributions in restraining anterior subluxation of the lateral tibial plateau and tibial internal rotation, which constitute pathological laxity in ALRI. In cases with ALRI, an ITT injury should be suspected and kept in mind if an extra-articular procedure is performed.
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It is not clear whether risk factors for revision anterior cruciate ligament reconstruction (ACLR) are the same throughout patients' lives. ⋯ Age at the time of ACLR surgery is a strong risk factor for revision ACLR. Other risk factors for revision ACLR, such as graft type, sex, race, and BMI, may vary in strength and significance over a patient's life. Understanding the age-related risk factors associated with revision ACLR may help with appropriate patient counseling and optimal graft choice when performing ACLR.
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Review Meta Analysis
Immobilization in External Rotation Versus Internal Rotation After Primary Anterior Shoulder Dislocation: A Meta-analysis of Randomized Controlled Trials.
The recurrence rate after primary anterior shoulder dislocation is high, especially in young, active individuals. Recent studies have suggested external rotation immobilization as a method to reduce the rate of recurrent shoulder dislocation in comparison to traditional sling immobilization. ⋯ Immobilization in external rotation is not significantly more effective in reducing the recurrence rate after primary anterior shoulder dislocation than immobilization in internal rotation. Additionally, this review suggests that there is minimal difference in patients' perceptions of their health-related quality of life after immobilization in internal versus external rotation.
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Randomized Controlled Trial Comparative Study
Corticosteroid Injections Accelerate Pain Relief and Recovery of Function Compared With Oral NSAIDs in Patients With Adhesive Capsulitis: A Randomized Controlled Trial.
Intra-articular corticosteroid injection is a common therapy for adhesive capsulitis, but there is a lack of prospective randomized controlled studies analyzing the efficacy of single injections applied blindly to accelerate improvement in pain and function. ⋯ In patients with adhesive capsulitis, a single corticosteroid injection applied without image control provides faster pain relief and earlier improvement of shoulder function and motion compared with oral NSAIDs.
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Patient-reported outcome instruments are frequently used for assessing clinical outcomes after injury and surgery. Previously reported normative data for the Knee injury and Osteoarthritis Outcome Score (KOOS) are limited to a narrow subset of ages and demographics or have not included patients who do not participate in sporting activities. ⋯ This study provides normative reference values for the KOOS in an 18- to 64-year-old metropolitan United States population. Study findings can aid surgeons in counseling patients and in developing expectations after the treatment of injuries.