A prospective, randomized clinical investigation of the treatment of first-time ankle sprains.

Background: Acute ankle ligament sprains are treated with the use of controlled mobilization with protection provided by external support (eg, functional treatment); however, there is little information regarding the best type of external support to use.

Hypothesis: There is no difference between elastic wrapping, bracing, bracing combined with elastic wrapping, and casting for treatment of acute, first-time ankle ligament sprains in terms of the time a patient requires to return to normal function.

Study Design: Randomized controlled clinical trial; Level of evidence, 1.

Rehabilitation after anterior cruciate ligament reconstruction: a prospective, randomized, double-blind comparison of programs administered over 2 different time intervals.

Background: There are adverse effects associated with immobilization of the knee after anterior cruciate ligament reconstruction, yet very little is known about how much activity will promote adequate rehabilitation without permanently elongating the graft, producing graft failure, or creating damage to articular cartilage.

Hypothesis: Rehabilitation with either an accelerated or nonaccelerated program produces no difference in anterior-posterior knee laxity, clinical assessment, patient satisfaction, functional performance, and the synovial fluid biomarkers of articular cartilage metabolism.

Study Design: Randomized controlled clinical trial; Level of evidence, 1.

A new device to measure knee laxity during weightbearing and non-weightbearing conditions.

The Vermont knee laxity device (VKLD) was developed to evaluate anterior-posterior (A-P) displacement of the tibia relative to the femur (A-P laxity) during weightbearing and non-weightbearing conditions. The purposes of this study were to determine the repeatability and reliability of the VKLD measurements of A-P laxity and to compare them with two devices currently in clinical use: the KT-1000 knee arthrometer and planar stress radiography. Two independent examiners tested six subjects with no history of knee injury.

The elongation behavior of the anterior cruciate ligament graft in vivo. A long-term follow-up study.

The relationship between the elongation values of an autogenous bone-patellar tendon-bone graft immediately after fixation and the anterior-posterior laxity of the knee 5 years later was studied in vivo. Immediately after fixation, the change in the graft midsubstance length during passive knee flexion-extension was measured using a Hall-effect transducer, and anterior-posterior knee laxity was measured with the KT-1000 arthrometer. Subjects were divided into group 1 (N = 6), with graft elongation values bounded by the 95% confidence intervals of the normal anterior cruciate ligament elongation values, and group 2 (N = 7), subjects with values outside these intervals.

The benefit of a single-leg strength training program for the muscles around the untrained ankle.

Severe ankle injuries can require extended periods of immobilization that adversely affect the strength of the ankle muscles. We have investigated a single-leg strength training program of the muscles surrounding the ankle to determine if it produces a crossover benefit for the contralateral ankle muscles. Twenty subjects without any history of ankle injuries were randomly divided into a control and a training group.

Proprioception after anterior cruciate ligament reconstruction with and without bracing.

In this investigation we evaluated the effect of ACL reconstruction and functional knee bracing on knee proprioception. Twenty subjects who experienced acute ACL disruption and underwent reconstruction with a bone-patellar tendon-bone graft participated in a controlled rehabilitation program and were studied at a mean follow-up of 2 years. A control group of ten subjects were also studied.

The strain behavior of the anterior cruciate ligament during stair climbing: an in vivo study.

Stair climbing is a closed kinetic chain exercise that is thought to be useful for knee rehabilitation following anterior cruciate ligament (ACL) reconstruction while protecting the graft from excessive strain. The objectives of this study were to measure the strain produced in the anteromedial band (AMB) of the normal ACL during stair climbing in vivo. We have previously shown that the normal AMB strain pattern during knee passive flexion-extension motion is similar to that of an ACL graft immediately after graft fixation.