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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


         

 

Clinical testing of a new, innovative method to treat Alzheimer’s disease began in March 2008 at Karolinska University Hospital, Stockholm. (See press release from April 7, 2008: http://www.karolinska.se/Pressmeddelanden). Six patients have now received brain implants of small capsules containing protein-producing cells.

 

The first family-based genome-wide association study in Alzheimer’s disease has identified the sites of four novel genes that may significantly influence risk for the most common late-onset form of the devastating neurological disorder.

 

Positron emission tomography (PET) scanning may allow non-invasive assessment of the formation of Alzheimer’s disease-related plaques in the brain, according to a study released early online on August 11, 2008 in the Archives of Neurology, one of the JAMA/Archives journals. Alzheimer’s disease is degenerative neurological disease characterized by dementia. It usually effects older people, though a small subset of early-onset victims exists.




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