The American journal of sports medicine
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Comparative Study
Repair of large chondral defects of the knee with autologous chondrocyte implantation in patients 45 years or older.
Autologous chondrocyte implantation (ACI) has become an accepted option for the treatment of chondral defects in carefully selected patients. Current recommendations limit this procedure to younger patients, as insufficient data are available to conclusively evaluate outcomes in patients older than 45 years. ⋯ Our results showed a failure rate of ACI in older patients that is comparable with rates reported in younger patient groups. The procedure is associated with a substantial rate of reoperations, mostly for the arthroscopic treatment of graft hypertrophy, similar to that in younger patients.
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Muscle weakness, particularly of shoulder external rotation, is common after rotator cuff repair surgery. Neuromuscular electrical stimulation has been shown to be an effective adjunct in the enhancement of muscle recruitment. ⋯ Neuromuscular electrical stimulation may be used concomitantly with exercises to enhance the amount of force production and potentially minimize the inhibition of the rotator cuff after repair surgery.
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With more than a million high school athletes playing during the 2006-2007 academic year, basketball is one of the most popular sports in the United States. ⋯ High school basketball injury patterns vary by gender and type of exposure. This study suggests several areas of emphasis for targeted injury prevention interventions.
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Randomized Controlled Trial Multicenter Study
Radial extracorporeal shock wave therapy is safe and effective in the treatment of chronic recalcitrant plantar fasciitis: results of a confirmatory randomized placebo-controlled multicenter study.
Radial extracorporeal shock wave therapy is an effective treatment for chronic plantar fasciitis that can be administered to outpatients without anesthesia but has not yet been evaluated in controlled trials. ⋯ Radial extracorporeal shock wave therapy significantly improves pain, function, and quality of life compared with placebo in patients with recalcitrant plantar fasciitis.
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Although autologous chondrocyte implantation (ACI) is a well-established therapy for the treatment of isolated cartilage defects of the knee joint, little is known about typical complications and their treatment after ACI. ⋯ A major proportion of complications after ACI can be summarized by 4 major diagnoses (symptomatic hypertrophy, disturbed fusion, delamination, and graft failure). Among those, the overall complication rate and incidence of hypertrophy of the transplant were higher for periosteum-covered ACI. Furthermore, an increased rate of symptomatic hypertrophy was found for patellar defects. Therapeutic concepts need to be developed to treat these typical complications of ACI.