The American journal of sports medicine
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Female college basketball and soccer athletes have higher rates of anterior cruciate ligament injury than do their male counterparts. Rates of anterior cruciate ligament injuries for women and men in collegiate lacrosse have not been examined. Understanding anterior cruciate ligament injury patterns in lacrosse, a full-contact sport for men and noncontact sport for women, could further injury prevention efforts. ⋯ There was no discernable change in rate of anterior cruciate ligament injury in men or women during the study period. Men's lacrosse is a high-risk sport for anterior cruciate ligament injury. Unlike basketball and soccer, the rates of anterior cruciate ligament injury are essentially the same in men's and women's lacrosse. The level of allowed contact in pivoting sports may be a factor in determining sport-specific anterior cruciate ligament risk.
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Clinical and biomechanical studies have demonstrated the increase in contact pressure and progressive deterioration of the tibiofemoral compartments that occur after partial or complete meniscectomy. Meniscus transplantation has been indicated for the symptomatic postmeniscectomy patient to alleviate symptoms and potentially prevent the progression of articular degeneration. ⋯ Meniscus transplantation alone or in combination with other reconstructive procedures results in reliable improvements in knee pain and function at minimum 2-year follow-up. Longer term studies are necessary to determine if transplantation can prevent the articular degeneration associated with meniscectomy.
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Results of high-energy extracorporeal shock wave therapy for the treatment of insertional Achilles tendinopathy are not determined. It is unclear how local anesthesia alters the outcome of this procedure. ⋯ Extracorporeal shock wave therapy is an effective treatment for chronic insertional Achilles tendinopathy. Local field block anesthesia may decrease the effectiveness of this procedure.
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In gymnastics, the wrist joint is subjected to repetitive loading in a weightbearing fashion. In this setting, chronic wrist pain is quite common. ⋯ Recent studies provide more information on the relationships between these findings, as well as factors that may predispose some gymnasts to wrist pain. This article provides a comprehensive review of these issues and offers suggestions for management, preventive measures, and future research.
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Short-term results of anterior cruciate ligament reconstruction are well reported; however, there are no studies evaluating endoscopic reconstruction of the anterior cruciate ligament with a minimum 10-year follow-up. ⋯ Endoscopic anterior cruciate ligament reconstruction with patellar tendon autograft affords and maintains good self-reported assessments and clinical ligament evaluation up to 13 years. Radiographic degenerative changes were seen in three quarters of patients. Almost half developed loss of extension, suggesting onset of early osteoarthritis. Patients who had undergone meniscectomy at the time of reconstruction had increased clinical ligament laxity over time and greater odds of graft rupture, possibly reflecting the effect of prolonged increased strain on the graft. Continued follow-up is required to resolve concerns regarding integrity of the patellar tendon graft beyond 13 years, particularly in the absence of meniscal tissue.