The American journal of sports medicine
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Allografts from many tissue banks are carefully processed and stored with the goal of preserving chondrocyte viability. However, the importance of living chondrocytes for graft stability is unclear, in part because actual viabilities of individual allografts at the time of placement are seldom known. ⋯ Conventional staining methods that overestimate chondrocyte viability in osteoarticular allografts may mislead investigators attempting to assess the effects of chondrocyte viability on graft stability following implantation. A more reliable means to measure chondrocyte viability will be required to accurately assess these effects.
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Proximal or distal realignment procedures have long been selected as treatment for recurrent patellar dislocation, but associated knee osteoarthritis has been a substantial problem that leads to poor results. A new approach, medial patellofemoral ligament reconstruction, has recently started, but there have been no reports on the long-term follow-up. ⋯ The association of definite knee osteoarthritis in medial patellofemoral ligament reconstruction with or without lateral release was small in the long-term follow-up. The conclusion is that medial patellofemoral ligament reconstruction not only prevents further patellar dislocation but also shows no or only slight progression of knee osteoarthritis.
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Grade III syndesmosis sprains are usually treated with internal fixation. Limited information is available on early weightbearing and early return to activity after operative treatment for grade III syndesmosis sprains. ⋯ In selective cases, athletes can return to full activity as early as 6 weeks after internal fixation of grade III syndesmosis sprains.
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Nonoperative treatment of posterolateral knee injuries tends to yield poor results. In patients with chronic posterolateral knee injuries, failure to correct genu varus alignment will often result in failure of the posterolateral knee repair or reconstruction. ⋯ Proximal tibial opening wedge osteotomy can be an effective first method of treatment for patients with chronic combined posterolateral knee injuries and genu varus alignment. Patients with low-velocity knee injuries and isolated chronic posterolateral knee injuries may not require a second-stage soft tissue ligament reconstruction after healing the osteotomy and undergoing a program of rehabilitation.
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Many patients with chronic tendinosis have experienced early pain relief after application of bipolar radiofrequency treatment. It is hypothesized that the mechanism of action may be the acute degeneration and/or ablation of sensory nerve fibers. ⋯ Early degeneration followed by later regeneration of nerve fibers after bipolar radiofrequency treatment may explain long-term postoperative pain relief after microtenotomy for tendinosis.