The American journal of sports medicine
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In posterolateral corner (PLC) injuries in which the lateral collateral ligament (LCL) is intact, there is controversy about whether reconstructing the popliteus tendon (POP), the popliteofibular ligament (PFL), or both structures (POP + PFL) is required to restore normal external tibial rotation. ⋯ In an LCL-intact PLC injury model, the POP and PFL function as a unit in resisting external rotation. All surgical procedures described and tested were able to reduce the increased external rotational laxity found in the sectioned state. The PFL reconstruction technique was able to restore external rotation to near normal. However, the techniques involving POP reconstruction overconstrained external rotation during laxity testing.
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Case Reports
Operative and nonoperative treatment of cervical disc herniation in National Football League athletes.
Limited evidence exists to guide clinical decision making regarding cervical disc herniations in professional athletes playing for the National Football League (NFL) in the United States. ⋯ Data regarding the treatment of this unique population are limited but suggest that NFL athletes can safely return to sport after the treatment of cervical disc herniations. In the treatment algorithm for this study, cord compression with signal change in the cord on MRI was a consistent operative indication. Discs abutting the cord can be treated nonoperatively but do not allow for return to sport until symptoms have improved and repeat imaging demonstrates no cord compression. Isolated nerve root compression has a more favorable prognosis. It can be treated symptomatically and return to sport allowed when symptoms permit.
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Clinical Trial
Improving the rapid and reliable diagnosis of complete distal biceps tendon rupture: a nuanced approach to the clinical examination.
Diagnosis of complete distal biceps tendon rupture (DBTR) is frequently missed or delayed on clinical examination. No single clinical test, including MRI, has demonstrated 100% efficacy in assessing the integrity of the distal biceps tendon. ⋯ Application in sequence of the hook test, the PFP test, and the BCI test results in 100% sensitivity and specificity when the outcomes on all 3 special tests are in agreement.
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Comparative Study Clinical Trial
Psychometric properties of patient-reported outcome measures for hip arthroscopic surgery.
Patient-reported outcomes (PROs) are considered the gold standard when evaluating outcomes in a surgical population. While the psychometric properties of some PROs have been tested, the properties of newer PROs in patients undergoing hip arthroscopic surgery remain somewhat unknown. ⋯ The PROs of the HOOS and iHOT-33 demonstrate psychometric properties that may enable researchers and clinicians to use them with confidence in a population undergoing hip arthroscopic surgery. The psychometric properties of the MHHS, HOS, and some subscales of the HAGOS are reduced, and these PROs may be less valuable in this group.
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Randomized Controlled Trial
Effect of prehabilitation on the outcome of anterior cruciate ligament reconstruction.
Prehabilitation is defined as preparing an individual to withstand a stressful event through enhancement of functional capacity. ⋯ The 6-week progressive prehabilitation program for subjects undergoing ACLR led to improved knee function based on the single-legged hop test and self-reported assessment using the modified Cincinnati score. These effects were sustained at 12 weeks postoperatively. This study supports prehabilitation as a consideration for patients awaiting ACLR; however, further studies are warranted.