The American journal of sports medicine
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Despite persistent continuity of the attenuated posterior cruciate ligament (PCL) in most PCL insufficient knees, few reconstruction techniques that preserve the PCL remnant have been presented. Furthermore, data regarding the clinical outcomes of these approaches are even more limited, and the clinical validity of remnant preservation has not yet been established. ⋯ Techniques combining remnant-preserving transtibial single-bundle PCL reconstruction with posterolateral corner reconstruction resulted in somewhat better activity-related outcomes compared with those of approaches without remnant preservation. However, incorporation of remnant preservation does not appear to provide increased posterior stability or result in clinically superior outcomes versus those of techniques without remnant preservation.
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There is a lack of prospective studies comparing the long-term outcome of endoscopic anterior cruciate ligament (ACL) reconstruction with either a patellar tendon or hamstring tendon autograft. ⋯ Anterior cruciate ligament reconstruction using ipsilateral autograft continues to show excellent results in terms of patient satisfaction, symptoms, function, activity level, and stability. The use of HT autograft does, however, show better outcomes than the PT autograft in all of these outcome measures. Additionally, at 15 years, the HT graft-reconstructed ACLs have shown a lower rate of radiological osteoarthritis.
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Reconstructions of the coracoclavicular (CC) ligament in an open or arthroscopically assisted procedure are often combined with a resection of the distal clavicle to prevent or treat osteoarthritic degenerations of the acromioclavicular (AC) joint. However, increased horizontal translation leading to symptomatic instability may be associated with resection of the distal clavicle. ⋯ These results suggest that resection of the distal clavicle leads to increased horizontal translation despite an intact superior and posterior AC capsule. Only sparing resection of the distal clavicle should be performed and only if strictly indicated. Violation of the AC capsule further increases horizontal translation and should therefore be avoided, or if indicated in AC joint dislocations, a reconstruction of the AC capsule should be considered.
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Clinical Trial
Effectiveness of the women's lacrosse protective eyewear mandate in the reduction of eye injuries.
In an effort to minimize the risk of catastrophic eye injury, US Lacrosse initiated mandatory use of protective eyewear in women's lacrosse in the 2004-2005 season. ⋯ The use of protective eyewear in women's lacrosse was associated with a reduction in the number of eye injuries. The number of head/face injuries decreased in this study group after introduction of protective eyewear, and there was no change in overall injury rates. The reason for the increase in concussion rate cannot be determined conclusively based on this study, but the authors speculate that this increase resulted largely from increased recognition and diagnosis because overall injury rates do not indicate rougher play with introduction of protective equipment.
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Intense exercise has been reported as one risk factor for hip and knee osteoarthritis (OA). ⋯ Hip and knee OA and hip and knee arthroplasty are more commonly found in former male elite athletes than expected. A previous knee injury is associated with knee OA in former impact athletes but not in nonimpact athletes.