The American journal of sports medicine
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The Achilles tendon is one of the strongest tendons in the human body, and yet it frequently ruptures, which is a substantial clinical problem. However, the cause of ruptures remains elusive. ⋯ Earlier studies have demonstrated that specific training regimens to treat tendon injury can improve tendon composition and mechanical properties. This study supports the notion that treatment measures should aim to increase tendon collagen content and improve micromechanical quality of the tendon matrix.
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Patients with chronic exertional compartment syndrome who have failed nonoperative treatment are evaluated with pre-exertion and postexertion compartment pressure testing and may be treated with fasciotomy. Failure rates of up to 20% have been reported and may be related to factors such as age, sex, postexertion compartment pressures, compartment(s) released, and duration of symptoms. ⋯ High school and college patients (age <23 years) and isolated anterior compartment release (compared with anterior/lateral release) were factors associated with improved subjective function and satisfaction after fasciotomy. We recommend the avoidance of lateral release unless symptoms or postexertion compartment pressures are clearly indicative of lateral compartment involvement.
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Randomized Controlled Trial
Platelet-rich fibrin matrix in the management of arthroscopic repair of the rotator cuff: a prospective, randomized, double-blinded study.
Arthroscopic rotator cuff repair has a high rate of patient satisfaction. However, multiple studies have shown significant rates of anatomic failure. Biological augmentation would seem to be a reasonable technique to improve clinical outcomes and healing rates. ⋯ Platelet-rich fibrin matrix was not shown to significantly improve perioperative morbidity, clinical outcomes, or structural integrity. While longer term follow-up or different platelet-rich plasma formulations may show differences, early follow-up does not show significant improvement in perioperative morbidity, structural integrity, or clinical outcome.
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Plain films and computed tomography (CT)-based imaging were the first to establish measurements that evaluated patellar instability. Limited research has shown the efficacy of magnetic resonance imaging (MRI) in evaluating these established measurements. ⋯ The MRI-based patellar tilt measures proved to be an excellent group of measurements for delineating between controls and those with instability. Patella alta ratios, such as Insall-Salvati and Caton-Deschamps, demonstrated a statistically significant difference between normal and recurrent dislocators. Trochlear measurements proved significantly different at the proximal and distal trochlea. Our findings demonstrate that MRI is appropriate to help discern recognized pathologic abnormalities that characterize patellofemoral instability.