Diagnosis and management of Achilles tendon ailments: the Scottish mist.

The diagnosis and management of Achilles tendon ailments continue to be widely discussed by the scientific community. Also, the nomenclature used to describe the tendinopathic lesion in patients changed over the last decades together with the evolution in the knowledge of the physiopathology of Achilles tendinopathy, and unfortunately, through ignorance and possibly laziness, confusion still abounds. To emerge from these foggy paths, some clarifications are still necessary.

The Royal London Hospital Test for the clinical diagnosis of patellar tendinopathy.

Purpose: To ascertain whether the Royal London Hospital test is reproducible, sensitive, and specific for diagnosis of patellar tendinopathy.

Methods: Fifteen consecutive athletes with patellar tendinopathy were prospectively enrolled and compared with a control group of 15 non consecutive athletes with Achilles tendinopathy. Two testers examined separately each patient, using manual palpation and the Royal London Hospital test for diagnosis of patellar tendinopathy.

Surgery for unilateral and bilateral patellar tendinopathy: a seven year comparative study.

Purpose: Open surgery for patellar tendinopathy allows patients with unilateral and bilateral tendinopathy to return to high levels of physical activity.

Materials: Two groups of 23 athletes each underwent open surgical exploration for management of patellar tendinopathy. One group suffered from unilateral patellar tendinopathy (unilateral group), and the other group had bilateral (bilateral group) patellar tendinopathy.

Development and validation of a questionnaire to measure the severity of functional limitations and reduction of sports ability in German-speaking patients with exercise-induced leg pain.

Background: Currently, there is no generally agreed measure available to quantify a subject's perceived severity of exercise-induced leg pain symptoms. The aim of this study was to develop and validate a questionnaire that measures the severity of symptoms that impact on function and sports ability in patients with exercise-induced leg pain.

Methods: The exercise-induced leg pain questionnaire for German-speaking patients (EILP-G) was developed in five steps: (1) initial item generation, (2) item reduction, (3) pretesting, (4) expert meeting and (5) validation.

Figure-of-four pivot shift test--a technical note.

The pivot shift test is a cornerstone in the clinical diagnosis of anterior cruciate ligament (ACL) deficiency. It can be difficult to perform in overweight patients or in those with long or bulky legs. We present an alternative method to perform the pivot shift test that recalls the judo technique of figure-of-four knee lock and eases the examination of the patient with anterior cruciate ligament deficiency.

Chronic exertional compartment syndrome of the foot.

Chronic exertional compartment syndrome (CECS) usually refers to myoneural ischemia from a reversible increase in tissue pressure within a myofascial compartment. CECS of the leg is well documented, as its first description by Mavor in 1956. CECS of the foot remains underdiagnosed, and has been reported in the literature only on an anecdotal basis.

Is knee laxity change after ACL injury and surgery related to open kinetic chain knee extensor training load?

Objective: The purpose of this study was to evaluate whether knee anterior laxity changes after anterior cruciate ligament injury and surgery are related to aspects of thigh muscle resistance training during rehabilitation.

Design: Forty-nine subjects (13 females) diagnosed with an anterior cruciate ligament-deficient knee or who had undergone anterior cruciate ligament reconstructive surgery participated in this study. The subjects trained their knee extensors in the open kinetic chain during a 6-wk program, and the relationship of aspects of training (for example, absolute resistance load) and other factors to anterior laxity change during this period were analyzed using linear regression analysis.

[The effect of ankle position on intracompartmental pressures of the leg].

Objectives: We investigated differences in the intracompartmental pressures (ICP) of the leg in relation to various positions of the ankle joint in patients with chronic exertional compartment syndrome (CECS).

Methods: The study included 16 patients (10 males, 6 females; mean age 30+/-9 years, range 16 to 48 years) actively involved in various sports. Intracompartmental pressures were monitored with the use of slit catheters connected to a pressure transducer in 28 anterior and 14 deep posterior compartments before and after exercise during the following positions of the ankle joint: relaxed-resting, passive plantar flexion, neutral, and passive dorsiflexion.

Factors related to early recovery rate after partial knee meniscectomy.

A main role of clinicians treating patients after orthopedic surgery is to inform patients about their anticipated recovery rate and recovery endpoint. In estimating recovery rate, clinicians consider a series of potentially influencing factors, including the type and severity of injury and the characteristics of the patient. Unfortunately, this is done largely without evidence to support factors believed to be important in recovery rate.

Surgery for chronic Achilles tendinopathy produces worse results in women.

Purpose: To report the middle term outcome in male and female patients who underwent surgery for chronic recalcitrant Achilles tendinopathy.

Methods: We tried to match each of the 58 female patients with a diagnosis of tendinopathy of the main body of the Achilles tendon with a male patient with tendinopathy of the main body of the Achilles tendon who was within two years of age at the time of operation. A match accordingly was possible for 41 female subjects.

Surgery for chronic Achilles tendinopathy yields worse results in nonathletic patients.

Objective: To report the outcome of surgery for chronic recalcitrant Achilles tendinopathy in nonathletic and athletic subjects.

Design: Case-control study.

Setting: University teaching hospitals.

Knee extensors kinetic chain training in anterior cruciate ligament deficiency.

Open kinetic chain (OKC) knee extensor resistance training has lost favour in rehabilitation of patients with knee ACLD due to concerns that this exercise is harmful to the remaining portion of the ACL and its secondary stabilizers, and will be less effective in improving function. In this randomized, single-blind clinical trial, closed and OKC knee extensor training were compared for their effects on knee laxity and function in patients with ACLD knees. Sixty-four patients with a diagnosis of knee ACLD (49 M, 15 F; mean age=30 years) were measured for knee laxity, using a ligament arthrometer, and function with the Hughston Clinic knee self-assessment questionnaire and maximal effort single leg jump testing.

Effects of closed versus open kinetic chain knee extensor resistance training on knee laxity and leg function in patients during the 8- to 14-week post-operative period after anterior cruciate ligament reconstruction.

Open kinetic chain (OKC) knee extensor resistance training has lost favour in ACLR rehabilitation due to concerns that this exercise is harmful to the graft and will be less effective in improving function. In this randomized, single-blind clinical trial OKC and closed kinetic chain (CKC) knee extensor training were compared for their effects on knee laxity and function in the middle period of ACLR rehabilitation. The study subjects were 49 patients recovering from ACLR surgery (37 M, 12 F; mean age=33 years).

Similar histopathological picture in males with Achilles and patellar tendinopathy.

Purpose: To ascertain whether there are differences in the histopathological appearance of tendinopathic Achilles and patellar tendons.

Methods: In males, we studied biopsies from tendinopathic Achilles (N = 28; average age 34.1 yr) and patellar tendons (N = 28; average age 32.

Articular cartilage lesions in the symptomatic anterior cruciate ligament-deficient knee.

Purpose: The goal of the study was to report the prevalence of the lesions of the articular cartilage of the femoral condyles and tibial plateau in patients with a symptomatic anterior cruciate ligament (ACL)-deficient knee undergoing day-case arthroscopy.

Type Of Study: Case series study.

Methods: We studied 378 skeletally mature patients (average age, 27.

Clinical diagnosis of Achilles tendinopathy with tendinosis.

Objective: To evaluate sensitivity, specificity, reproducibility, and predictive value of palpation of the painful arc sign and of the Royal London Hospital test in 10 patients with Achilles tendinopathy and in 14 asymptomatic subjects.

Design: Test-retest study.

Setting: University teaching hospital.