The American journal of sports medicine
-
Randomized Controlled Trial
Comparison of Anatomic Double- and Single-Bundle Techniques for Anterior Cruciate Ligament Reconstruction Using Hamstring Tendon Autografts: A Prospective Randomized Study With 5-Year Clinical and Radiographic Follow-up.
The aim of this prospective randomized study was to compare the outcomes of the anatomic double-bundle (DB) and anatomic single-bundle (SB) techniques 5 years after anterior cruciate ligament (ACL) reconstruction. Since more effective restoration of rotational laxity is considered the main advantage of the DB technique, the pivot-shift test was the primary outcome variable of the study. ⋯ At the 5-year follow-up of an unselected group of patients, anatomic DB reconstruction was not superior to anatomic SB reconstruction in terms of the pivot-shift test.
-
Patients with exercise-induced lower leg pain may suffer from deep posterior chronic exertional compartment syndrome (dp-CECS). Current evidence for the efficacy of surgery is based on retrospective studies. Effects of fasciotomy on symptoms associated with dp-CECS have not been systematically studied, and reasons for unsuccessful surgery are unknown. ⋯ Fasciotomy was beneficial in 71% of patients with dp-CECS in the lower leg; 47% of study patients experienced a good to excellent outcome. Outcomes were stable in the long term. Persistent complaints were often caused by other untreated conditions.
-
In ice hockey players, serious bone injuries in the foot and ankle, especially those attributed to impact from the moving puck, may be radiographically occult and underrecognized. ⋯ MRI can show severe bone injuries that are not visible radiographically in ice hockey players. Most fractures and high-grade contusions involve the medial ankle and midfoot bones, can be caused by direct blows from the puck, and are associated with prolonged recovery times.
-
The prevalence of adolescent knee pain is 33%, and patellofemoral pain (PFP) is the most common diagnosis with a nontraumatic onset. The 2-year prognosis of adolescent PFP compared with other types of knee pain is unknown. ⋯ Knee pain during adolescence, and PFP in particular, is in most cases present after 2 years and thus may not be self-limiting. A greater focus on early detection and prevention of knee pain during adolescence is needed.
-
Comparative Study
Effect of Medial Patellofemoral Ligament Reconstruction Method on Patellofemoral Contact Pressures and Kinematics.
There remains a lack of evidence regarding the optimal method when reconstructing the medial patellofemoral ligament (MPFL) and whether some graft constructs can be more forgiving to surgical errors, such as overtensioning or tunnel malpositioning, than others. ⋯ The correct femoral tunnel position and graft tension for restoring normal PFJ kinematics and articular cartilage contact stresses appear to be more important than graft selection during MPFL reconstruction. These findings emphasize the importance of the surgical technique when undertaking this procedure.