The effect of rehabilitation and return to activity on anterior-posterior knee displacements after anterior cruciate ligament reconstruction.

Anterior-posterior knee displacements were measured sequentially with the KT-1000 arthrometer on 84 patients after anterior cruciate ligament reconstruction for chronic deficiency. We determined the correlations between the initial onset of abnormal displacements (greater than 2.5 mm between limbs) and time from surgery or the phase of rehabilitation.

High tibial osteotomy and ligament reconstruction in varus angulated, anterior cruciate ligament-deficient knees. A two- to seven-year follow-up study.

We assessed short-term treatment results of younger patients with varus malalignment and chronic anterior cruciate ligament deficiency. Forty-one patients (mean, 32 years; range, 16 to 47) underwent a high tibial osteotomy. Because of giving way symptoms, 14 also had a lateral iliotibial band extraarticular procedure at the time of the osteotomy and 16 had an intraarticular anterior cruciate ligament allograft reconstruction after the osteotomy.

The early treatment of motion complications after reconstruction of the anterior cruciate ligament.

The use of active and passive knee motion in the immediate postoperative period and a treatment plan for early postoperative limitations in knee motion has proven highly effective in restoring motion after anterior cruciate ligament (ACL) reconstruction. Of 207 knees, 189 (91%) regained a full range of motion of 0 degrees-135 degrees. The remaining 18 knees (9%) did not regain motion as rapidly as the others and were placed in an early postoperative phased treatment program.

The early diagnosis and treatment of developmental patella infera syndrome.

Developmental patella infera and associated arthrofibrosis after knee surgery require prompt recognition and treatment. The condition develops because of contracture of peripatellar tissues, fatpad tissues, and quadriceps weakness, and may rapidly progress to permanent patella infera and disabling patellofemoral arthrosis. Case studies for five patients with acute developmental patella infera are described.

The assessment of work-related activities and limitations in knee disorders.

The success of knee treatment programs and surgery must be assessed, in part, by both the ability to return patients to work and the documentation of any work-related limitations. Existing occupational rating scales do not rate, in a valid manner, the effect of altered knee function on work activities. We performed a prospective randomized clinical trial in which two different occupational rating systems were tested on 50 patients.

Quantitative assessment of functional limitations in normal and anterior cruciate ligament-deficient knees.

The purpose of this study was to evaluate the effectiveness of five hopping, jumping, and cutting-type (shuttle run) tests in determining lower extremity functional limitations in anterior cruciate ligament- (ACL) deficient knees. Ninety-three normal subjects were tested. No statistical significance was found between right and left lower limb scores (limb symmetry index) as related to sports activity level, gender, or dominant side.

A rationale for assessing sports activity levels and limitations in knee disorders.

Existing published knee rating systems that assess sports participation, knee function, and subjective symptomatology following ligamentous surgical procedures were analyzed. Major errors in questionnaire design and data reduction have led to invalid conclusions. A questionnaire containing a minimum set of rating criteria was formulated to validly assess athletic participation before and after treatment or surgery.

A system for grading articular cartilage lesions at arthroscopy.

Although there are several different classification systems for the description of articular cartilage damage, each has certain limitations and deficiencies which can lead to confusion. We are proposing a new system which describes articular cartilage abnormalities in simple terms. It is based on four separate and distinct variables: the description of the articular surface, the extent (depth) of involvement, the diameter of the lesion, and the location of the lesion.

The medical aspects of soccer injury epidemiology.

In this article, the six major studies of soccer injury epidemiology are reviewed. Strengths and weaknesses of each epidemiologic design are critiqued and the crucial importance of the definition of injury is emphasized. The effect of age, sex, and intensity of play on injury rates is discussed.