Dilution Effect of Intra-articular Injection Administered After Knee Arthroscopy.

The hypothesis was that agents delivered intra-articularly after knee arthroscopy will be diluted by residual arthroscopic fluid. Diagnostic arthroscopy was performed on six cadaver knees. Each procedure was followed by an intra-articular injection of a dye solution.

The role of mitochondrial reactive oxygen species in cartilage matrix destruction.

Upregulation of matrix metalloproteinases (MMPs) is a hallmark of osteoarthritis progression; along with the role reactive oxygen species (ROS) may play in this process. Moreover, mitochondrial DNA damage and dysfunction are also present in osteoarthritic chondrocytes. However, there are no studies published investigating the direct relationship between mitochondrial ROS, mitochondrial DNA damage, and MMP expression.

Joint stability characteristics of the ankle complex after lateral ligamentous injury, part I: a laboratory comparison using arthrometric measurement.

Context: The mechanical property of stiffness may be important to investigating how lateral ankle ligament injury affects the behavior of the viscoelastic properties of the ankle complex. A better understanding of injury effects on tissue elastic characteristics in relation to joint laxity could be obtained from cadaveric study.

Objective: To biomechanically determine the laxity and stiffness characteristics of the cadaver ankle complex before and after simulated injury to the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) during anterior drawer and inversion loading.

Joint stability characteristics of the ankle complex in female athletes with histories of lateral ankle sprain, part II: clinical experience using arthrometric measurement.

Context: This is part II of a 2-part series discussing stability characteristics of the ankle complex. In part I, we used a cadaver model to examine the effects of sectioning the lateral ankle ligaments on anterior and inversion motion and stiffness of the ankle complex. In part II, we wanted to build on and apply these findings to the clinical assessment of ankle-complex motion and stiffness in a group of athletes with a history of unilateral ankle sprain.

Return to Play After Open Bankart Repair: A Systematic Review.

Background: Results of open Bankart repair have been well reported. However, less information is available outlining the timetable for return to play (RTP) in athletes after this procedure.

Purpose: To review the current literature regarding (1) the timetable recommended for athletes to RTP after an open Bankart repair and (2) the objective criteria on which the decision to allow an athlete to RTP is based.

Modified technique for unipolar allograft ankle replacement: midterm follow-up. A case report.

The management of tibiotalar arthritis remains a clinical challenge. Conventional treatment relies primarily upon arthrodesis or prosthetic arthroplasty. Fresh osteochondral total ankle allograft transplantation has been reported in limited cases.

Apoptosis and mitochondrial dysfunction in human chondrocytes following exposure to lidocaine, bupivacaine, and ropivacaine.

Background: Several mechanisms have been proposed to explain toxicity of local anesthetics to chondrocytes, including the blockade of potassium channels and mitochondrial injury. The purposes of this investigation were to study the effects of lidocaine, bupivacaine, and ropivacaine on human chondrocyte viability and mitochondrial function in vitro and to characterize the type of cell death elicited following exposure.

Methods: Primary chondrocyte cultures from patients with osteoarthritis undergoing knee replacement were treated with saline solution and the following concentrations of local anesthetics: 2%, 1%, and 0.

Effects of hyaluronic acid on mitochondrial function and mitochondria-driven apoptosis following oxidative stress in human chondrocytes.

Hyaluronic acid is widely used in the treatment of osteoarthritis and exerts significant chondroprotective effects. The exact mechanisms of its chondroprotective action are not yet fully elucidated. Human articular chondrocytes actively produce reactive oxygen and nitrogen species capable of causing cellular dysfunction and death.

Survey of short-term oral corticosteroid administration by orthopaedic physicians in college and high school athletes.

The use of oral corticosteroid (OCS) drugs is advocated because of their potent anti-inflammatory effects. They also possess many potential adverse effects. No study has assessed physician prescribing practices of OCS therapy in high school (HS) or college (COL) athletes.

Knee and ankle position, anterior drawer laxity, and stiffness of the ankle complex.

Context: Anterior drawer testing of the ankle is commonly used to diagnose lateral ligamentous instability. Our hypothesis was that changing knee and ankle positions would change the stability of the ankle complex during anterior drawer testing.

Objectives: To assess the effects of knee and ankle position on anterior drawer laxity and stiffness of the ankle complex.

Osteoarticular autograft and allograft transplantation of the knee: 3 year follow-up.

Between 1998 and 2001, a total of 48 patients underwent autologous or allograft osteoarticular transplantation with a minimum follow-up of 24 months. Nineteen patients underwent concomitant procedures. Average patient age was 46 years.

The results of arthroscopic versus mini-open repair for rotator cuff tears at mid-term follow-up.

Background: To prospectively evaluate patients who underwent a "mini-open" repair versus a completely arthroscopic technique for small to large size rotator cuff tears.

Methods: Fifty-two patients underwent "mini-open" or all arthroscopic repair of a full thickness tear of the rotator cuff. Patients who complained of shoulder pain and/or weakness and who had failed a minimum of 6 weeks of physical therapy and had at least one sub-acromial injection were surgical candidates.

Transfer of the latissimus dorsi as a salvage procedure for failed debridement and attempted repair of massive rotator cuff tears.

Seven patients who had a previously failed attempt at debridement and repair of a massive rotator cuff tear were managed with latissimus dorsi transfer. Patient age averaged 63 years and average follow-up was 31 months. All patients were evaluated with shoulder radiographs, Constant and Murley Scores, UCLA Shoulder Score, visual analog pain score, range of motion, and the Short Shoulder Form.

Medicolegal issues affecting sports medicine practitioners.

The practice of sports medicine represents a unique subspecialty within the discipline of medicine. Practitioners provide care for athletes who engage in activities that may put the athletes at risk for serious injury. Physicians may be held legally liable for not doing a standardized pre-participation evaluation, for not administering adequate on-site or after injury care, or for violating an individual's civil rights by refusing to allow continued participation because of medical risk.

A salvage procedure for refractory shoulder instability.

We present the case of a patient with symptomatic refractory multidirectional shoulder instability who was treated with staged bilateral anterior and posterior glenoid bone augmentation after previous failed arthroscopic and open procedures. The patient was pain free postoperatively and has not had symptoms of instability in either shoulder. At her most recent followup, 24 months after surgery, she had nearly full symmetric shoulder range of motion without anterior or posterior apprehension signs.

The effect of posterior cruciate ligament injury and reconstruction on meniscal strain.

Background: The relationship between posterior cruciate ligament insufficiency and meniscal injury is unclear.

Hypothesis: Posterior cruciate ligament insufficiency results in increased medial and lateral meniscal strain.

Study Design: Descriptive anatomic study.

Chondrocyte viability in refrigerated osteochondral allografts used for transplantation within the knee.

Purpose: To evaluate cell viability and matrix characteristics of refrigerated osteochondral allografts implanted up to 44 days after harvest.

Methods: Sixteen refrigerated allografts underwent histologic and ultrastructural examination and fluorescence excitation analysis prior to implantation. The average size of the graft implanted was 6.

A biomechanical comparison of three lower extremity tendons for ligamentous reconstruction about the knee.

Purpose: The purpose of this investigation was to evaluate 3 previously unreported allograft tendons for use in knee surgery. These are the doubled tibialis anterior (TA), doubled tibialis posterior (TP), and doubled peroneus longus (PL) tendons.

Type Of Study: A biomechanical evaluation of the properties of the TA, TP, and PL.

Assessment of Ankle-Subtalar-Joint-Complex Laxity Using an Instrumented Ankle Arthrometer: An Experimental Cadaveric Investigation.

OBJECTIVE: To show the relationship between direct measurements of tibial-calcaneal bone motion and instrumented measurements of ankle-subtalar-joint-complex laxity using a portable ankle arthrometer; to assess within and between-tester measurement reliability; and to determine if the ankle arthrometer can detect increased mechanical laxity of the ankle-subtalar-joint-complex after simulated injury of the lateral ankle ligaments. DESIGN AND SETTING: We used linear regression analysis to examine the relationship between direct measurements of tibial-calcaneal bone motion and instrumented measurements of ankle-subtalar-joint-complex laxity. An intraclass correlation coefficient (2,1) was calculated to determine intratester and intertester reliability for instrumented measurements of ankle-subtalar-joint-complex laxity.

Fresh osteochondral grafting in the treatment of osteochondritis dissecans of the talus.

We present a review of the literature on classification and treatment of osteochondral defects of the talus. We report the case of an isolated Berndt and Harty grade II lesion treated with a fresh osteochondral allograft. We believe that fresh allograft osteochondral grafting of the talus is an excellent technique for symptomatic Berndt and Harty grade II or higher lesion of the talus without significant tibiotalar arthritis.

Biomechanical comparison of reconstruction techniques for disruption of the acromioclavicular and coracoclavicular ligaments.

Injuries to the acromioclavicular joint are common. For selected injuries, operative reconstruction is recommended. The purpose of the current study was to compare three reconstruction procedures: (1) nine strands of woven polydioxanonsulphate (PDS II) suture passed through the clavicle and around the coracoid; (2) procedure No.

Radiographic findings associated with symptomatic rotator cuff tears.

This study compared shoulder radiographs of patients with a documented rotator cuff tear with those of asymptomatic age-matched controls. Radiographs of 40 subjects with documented rotator cuff tears were evaluated along with similar films of 84 asymptomatic age-matched controls. Three radiographs were taken of each shoulder: (1) acromioclavicular joint view, (2) anterior-posterior view with 30 degrees of external rotation, and (3) supraspinatus outlet view.