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A ten year follow up study carried out by researchers in Spain and Turkey on patients who had laser surgery to treat high myopia (short or near sightedness) found the treatment was safe and effective in the long term, with a retreatment rate of under 30 per cent.

Recent improvements in anterior cruciate ligament (ACL) reconstruction have been notable for strategies to improve ACL healing and to improve graft placements. The controversial choice of 1-bundle or 2-bundle grafts requires an advanced knowledge of native ACL insertional anatomy and an appreciation for the kinematic effects of graft placements. Understanding the limitations of surgical techniques to place tunnels is important. Once grafts are placed, new biologic strategies to promote intra-articular and intraosseous healing are evolving. Although these biologic engineering strategies are currently experimental, they are projected for clinical application in the near future.

Background: Glenoid labral tears provide a diagnostic challenge.

Hypothesis: Combinations of items in the patient history and physical examination will provide stronger diagnostic accuracy to suggest the presence or absence of glenoid labral tear than will individual items.

Study Design: Cohort study (diagnosis); Level of evidence, 1.

Methods: History and examination findings in patients with shoulder pain (N = 55) were compared with arthroscopic findings to determine diagnostic accuracy and intertester reliability.

Results: The intertester reliability of the crank, anterior slide, and active compression tests was 0.20 to 0.24. A combined history of popping or catching and positive crank or anterior slide results yielded specificities of 0.91 and 1.00 and positive likelihood ratios of 3.0 and infinity, respectively. A positive anterior slide result combined with either a positive active compression or crank result yielded specificities of 0.91 and positive likelihood ratio of 2.75 and 3.75, respectively. Requiring only a single positive finding in the combination of popping or catching and the anterior slide or crank yielded sensitivities of 0.82 and 0.89 and negative likelihood ratios of 0.31 and 0.33, respectively.

Conclusion: The diagnostic accuracy of individual tests in previous studies is quite variable, which may be explained in part by the modest reliability of these tests. The combination of popping or catching with a positive crank or anterior slide result or a positive anterior slide result with a positive active compression or crank test result suggests the presence of a labral tear. The combined absence of popping or catching and a negative anterior slide or crank result suggests the absence of a labral tear.

Background: Sports-related open lateral collateral ligament injury of the interphalangeal joint of the great toe has not been previously described in the English literature.

Hypothesis: This injury can occur in adolescents while performing barefooted high-kicking or fast-running exercises involving rapid, 180° turns on a dry, rough, wooden floor in a Taekwondo gymnasium. Injury occurs when the whole body turns quickly while supported only by the plantar aspect of the distal phalanx of the great toe.

Study Design: Case series; Level of evidence, 4.

Methods: The 7 study subjects consisted of 6 boys and 1 girl between 10 and 16 years old. Causes, pattern, mechanism of injury, treatment, and outcomes were investigated.

Results: All patients showed the same injury pattern and mechanism. They all had an open wound on the dorsolateral aspect of the interphalangeal joint. It was postulated that rapid whole body turning supported only by the distal phalanx of the great toe produces nonphysiologic varus stress at the interphalangeal joint, which results in open detachment of the lateral collateral ligament and adjoining periosteum from the proximal phalanx and interphalangeal joint subluxation. All 7 patients regained full great toe function after surgical repair.

Conclusion: This unique sports-related open interphalangeal joint injury should be recognized. Participants, trainers, and health providers engaged in Taekwondo or similar sports should understand the pathomechanism of this injury and develop preventive measures.

Background: Women with anterior cruciate ligament reconstruction have different neuromuscular strategies than noninjured women during functional tasks after ligament reconstruction and rehabilitation.

Hypothesis: Landing from a jump creates high loads on the knee creating dynamic instability in women with anterior cruciate ligament reconstruction, whereas noninjured women have stable knee landing mechanics.

Study Design: Controlled laboratory study.

Methods: Fifteen noninjured women and 13 women with anterior cruciate ligament reconstruction performed 5 trials of a single-legged 40-cm drop jump and 2 trials of a 20-cm up-down hop task. Multivariate analyses of variance were used to compare hip and knee joint kinematics, knee joint moments, ground-reaction forces, and electromyographic findings between the dominant leg in noninjured women and reconstructed leg in women with anterior cruciate ligament reconstruction.

Results: No statistically significant differences between groups were found for peak hip and knee joint angles for the drop jump task. Statistically significant differences in neuromuscular activity (P = .001) and anterior-posterior knee shear forces (P < .001) were seen in women with anterior cruciate ligament reconstruction compared with noninjured women in the drop jump task. However, no statistically significant differences (P > .05) between groups were found for either peak hip and knee joint angles, peak joint kinetics, or electromyographic findings during the up-down hop task.

Conclusion: Women with anterior cruciate ligament reconstruction have neuromuscular strategies that allow them to land from a jump similar to healthy women, but they exhibit joint moments that could predispose them to future injury if they participate in sports that require jumping and landing.