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Background: A treatment algorithm and screening examination have been developed to guide patient management and prospectively determine potential for highly active individuals to succeed with nonoperative care after anterior cruciate ligament rupture.
Objective: To prospectively characterize and classify the entire population of highly active individuals over a 10-year period and provide final outcomes for individuals who elected nonoperative care.
Methods: Inclusion criteria included presentation within 7 months of the index injury and an International Knee Documentation Committee level I or II activity level before injury. Concomitant injury, unresolved impairments, and a screening examination were used as criteria to guide management and classify individuals as noncopers (poor potential) or potential copers (good potential) for nonoperative care.
Results: A total of 832 highly active patients with subacute anterior cruciate ligament tears were seen over the 10-year period; 315 had concomitant injuries, 87 had unresolved impairments, and 85 did not participate in the classification algorithm. The remaining 345 patients (216 men, 129 women) participated in the screening examination a mean of 6 weeks after the index injury. There were 199 subjects classified as noncopers and 146 as potential copers. Sixty-three of 88 potential copers successfully returned to preinjury activities without surgery, with 25 of these patients not undergoing anterior cruciate ligament reconstruction at the time of follow-up.
Conclusion: The classification algorithm is an effective tool for prospectively identifying individuals early after anterior cruciate ligament injury who want to pursue nonoperative care or must delay surgical intervention and have good potential to do so.
NAVIGATION
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Symptom-Based Screening May Improve Detection Of HIV In High-Risk MenCategory: HIV / AIDS | Leave a Comment |
Testing for HIV when flu-like symptoms develop may offer a cost-effective alternative for early detection of HIV infection in men who have sex with men (MSM), reports a study in the journal AIDS. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health…
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Safe Alternative To Conventional Follow Up Is Remote ICD MonitoringCategory: Cardiovascular / Cardiology | Leave a Comment |
Device management using a home monitoring system with daily telemetry in patients with ICDs (implantable cardioverter defibrilators) is a safe alternative to conventional monitoring and could decrease the number of inappropriate shocks, according to results of the ECOST study, a multicentre randomised trial performed in France…
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Remote Follow-Up Of ICD PatientsCategory: Cardiovascular / Cardiology | Leave a Comment |
Results from the EVATEL (EVAluation of TELe follow-up) trial are the first in Europe to demonstrate potential safety and efficacy benefits from the remote follow-up of ICD patients. The trial was conducted in France, with the financial support of the French Ministry for Health and independent of any manufacturer grants…
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PCI Patients Given Sirolimus-Eluting And Everolimus-Eluting Stents: Clinical OutcomesCategory: Cardiovascular / Cardiology | Leave a Comment |
The second generation drug-eluting stent, everolimus-eluting stent (EES), has consistently demonstrated superior clinical outcomes in randomised controlled trials over the first generation drug-eluting stent, paclitaxel-eluting stent…
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Potential To See Beneath Skin In 4-D With New MicroscopeCategory: Medical Devices / Diagnostics | Leave a Comment |
A new type of laser scanning confocal microscope (LSCM) holds the promise of diagnosing skin cancer in a single snapshot. Typical LSCMs take 3-D images of thick tissue samples by visualizing thin slices within that tissue one layer at a time…
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New Technologies Improve Understanding Of Bacterial InfectionsCategory: Infectious Diseases / Bacteria / Viruses | Leave a Comment |
Understanding how bacteria infect cells is crucial to preventing countless human diseases. In a recent breakthrough, scientists from the University of Bristol have discovered a new approach for studying molecules within their natural environment, opening the door to understanding the complexity of how bacteria infect people…
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Heart Failure Patients Benefit From MitraClip TherapyCategory: Cardiovascular / Cardiology | Leave a Comment |
Results of an observational study presented at the European Society of Cardiology (ESC) meeting in Paris demonstrate that the percutaneous catheter-based MitraClip treatment improves symptoms and promotes reverse left ventricular (LV) remodeling in patients with mitral regurgitation (MR), who do not respond to cardiac resynchronization therapy (CRT)…
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Sniffing Out Heart FailureCategory: Cardiovascular / Cardiology | Leave a Comment |
A German team has developed a completely new non-invasive method to identify heart failure. It consists of an “electronic nose” which could make the “smelling” of heart failure possible. The projet was presented at the ESC Congress 2011…
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Temperature Response Differences Within Living Cells Revealed By Nano-ThermometersCategory: Medical Devices / Diagnostics | Leave a Comment |
Using a modern version of open-wide-and-keep-this-under-your-tongue, scientists reported that taking the temperature of individual cells in the human body, and finding for the first time that temperatures inside do not adhere to the familiar 98.6 degree Fahrenheit norm…
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Implanted Sensor Chip For Monitoring TumorsCategory: IT / Internet / E-mail | Leave a Comment |
A chip implant may soon be capable of monitoring tumors that are difficult to operate on or growing slowly. Medical engineers at Technische Universitaet Muenchen (TUM) have developed an electronic sensor chip that can determine the oxygen content in a patient’s tissue fluid. This data can then be wirelessly transmitted to the patient’s doctor to support the choice of therapy…