The American journal of sports medicine
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A retrospective review of anterior cruciate ligament injuries among professional alpine skiers was performed to compare sex-related differences in injury incidence. We screened 7155 ski patrollers or instructors (4537 men and 2618 women) for knee injuries before each ski season between 1991 and 1997. Screening involved a ski history questionnaire, a knee injury history questionnaire, and a knee physical examination. ⋯ Thirty-one skiing-related anterior cruciate ligament injuries were diagnosed, 21 in men and 10 in women. The incidence of ACL disruption was 4.2 injuries per 100,000 skier-days in men and 4.4 injuries per 100,000 skier-days in women. These data suggest that the incidences of anterior cruciate ligament injuries among male and female professional alpine skiers are similar.
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Using a cadaveric model, we evaluated the effect of knee and ankle position on the displacement of the severed ends of an Achilles tendon transected at three different points. In six cadaveric legs the Achilles tendon was severed transversely, then marked with radiopaque wire suture. The distance between the wire markers was measured on radiographs taken in different positions of ankle and knee flexion. ⋯ With the ankle fixed in 60 degrees of plantar flexion, knee position had no significant effect on the displacement of the severed ends of the Achilles tendon. Overall, the effect of knee flexion was neither statistically significant nor clinically significant, as the increase in displacement of the severed ends of the Achilles tendon was only 3 mm from 0 degrees to 120 degrees of knee flexion. These results suggest that the nonoperative treatment of Achilles tendon ruptures requires immobilization in maximal ankle plantar flexion, and that immobilization of the knee may not be necessary to achieve tendon-edge apposition.
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Comparative Study
The in vivo assessment of tibial motion in the transverse plane in anterior cruciate ligament-reconstructed knees.
Twenty-one knees with acutely injured anterior cruciate ligaments were reconstructed with patellar tendon autografts. Eight of the knees had concomitant medial ligament injuries that were not addressed surgically. Follow-up evaluation (average, 25 months) included computed tomography measurements to analyze transverse-plane laxity in both translation and rotation. ⋯ External rotation averaged 9.1 degrees in group I knees and 7.4 degrees in group II knees. The eight knees with concomitant medial ligament injuries were analyzed separately; external rotation without anterior load in group I was 9.5 degrees, compared with 5 degrees in group II. This difference was significant (P < 0.01).