The American journal of sports medicine
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The occurrence of osteoarthritis (OA), associated meniscal injuries, meniscectomy, and patient-related measures for patients treated nonoperatively after anterior cruciate ligament (ACL) injuries have not been well described in the literature in terms of natural history. ⋯ The study had a favorable long-term outcome regarding incidence of radiographic knee OA, knee function and symptoms, and need for ACL reconstruction. Although risk factors for posttraumatic OA are multifactorial, the primary risk factor that stood out in this study was if a meniscectomy had been performed. Early activity modification and neuromuscular knee rehabilitation might also have been related to the low prevalence of radiographic knee OA. In patients with ACL injury willing to moderate activity level to avoid reinjury, initial treatment without ACL reconstruction should be considered.
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Comparative Study
IKDC or KOOS? Which measures symptoms and disabilities most important to postoperative articular cartilage repair patients?
The relevance of knee-specific subjective measures of outcome to patients has not been evaluated for cartilage repair procedures. ⋯ The International Knee Documentation Committee Subjective Knee Form provided the best overall measure of symptoms and disabilities that are most important to this population of postoperative articular cartilage repair patients. This brings into question the validity of using the Knee injury Osteoarthritis Outcome Score in shorter-term--less than 10 years--studies. Issues related to sports activity appear to be highly valued and very pertinent to evaluation of outcomes for this patient group.
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Recent studies have revealed structural changes with neovessels in patients with jumper's knee and Achilles tendinopathy, and treatment with sclerosing injections has shown promising clinical results. ⋯ About two thirds of patients with jumper's knee can be expected to have structural tendon changes with neovascularization. There was no relationship between changes in ultrasound characteristic and knee function after sclerosing treatment.
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Because chondrocytes are responsible for articular cartilage matrix synthesis and maintenance, reduced chondrocyte viability could compromise graft survival, healing, and clinical outcome. ⋯ Any theoretical benefits of cancellous bone compaction that may occur in grafts that are recessed or are longer than the recipient holes must be balanced against the potential reduction in chondrocyte viability.
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Football is one of the leading causes of athletic-related injuries. Injury rates and patterns of the training camp period of the National Football League are unknown. ⋯ Muscle strains are the most common injury type in practices. Contact type injuries are most common during pre-season games, and the number of significant injuries that occur during preseason games is high.