The American journal of sports medicine
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A recent one-step arthroscopic technique based on bone marrow-derived cell transplantation has achieved good results in repairing osteochondral lesions of the talus (OLTs), overcoming some of the drawbacks of older techniques. ⋯ One-step repair of OLTs had good clinical results that were durable over time, even though there was a slight decrease in AOFAS score at the latest follow-up. The quality of the regenerated tissue detected by MRI T2 mapping directly correlated with the clinical results.
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Anterior cruciate ligament (ACL) injuries are a serious problem, with a high incidence and serious consequences. Published clinical screening tests are based on 2-legged and controlled drop jumps, but ACL injuries are known to occur in single-legged landings and sidestep cutting, where the load is predominantly distributed to a single leg. ⋯ Knee valgus angles during drop jumps do not predict knee abduction moments during sidestep cutting. The moderate correlation of knee valgus angles in drop jumps and sidestep cutting indicates that this measure may be more relevant for screening efforts.
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The utility of postconcussion neurocognitive testing versus symptom data has been debated. The sensitivity of the desktop version of the Immediate Post-concussion assessment and cognitive testing (ImPACT) tool has been documented, but psychometric properties of the recently released online version of ImPACT have yet to be fully established. ⋯ The online version of the ImPACT tool is a valid measure of neurocognitive performance at the acute stages of concussion, with high levels of sensitivity and specificity, even when athletes appear to be denying postconcussion symptoms.
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Plain films and computed tomography (CT)-based imaging were the first to establish measurements that evaluated patellar instability. Limited research has shown the efficacy of magnetic resonance imaging (MRI) in evaluating these established measurements. ⋯ The MRI-based patellar tilt measures proved to be an excellent group of measurements for delineating between controls and those with instability. Patella alta ratios, such as Insall-Salvati and Caton-Deschamps, demonstrated a statistically significant difference between normal and recurrent dislocators. Trochlear measurements proved significantly different at the proximal and distal trochlea. Our findings demonstrate that MRI is appropriate to help discern recognized pathologic abnormalities that characterize patellofemoral instability.
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Randomized Controlled Trial
Treatment with platelet-rich plasma is more effective than placebo for knee osteoarthritis: a prospective, double-blind, randomized trial.
Specific growth factors have been proposed as therapeutic proteins for cartilage repair. ⋯ A single dose of WBC-filtered PRP in concentrations of 10 times the normal amount is as effective as 2 injections to alleviate symptoms in early knee OA. The results, however, deteriorate after 6 months. Both groups treated with PRP had better results than did the group injected with saline only.