Globalepolicy.org is a free to access global medical news service for the consumer, professional and researcher.
Our adviser: Drugs Infromation online


             
 

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


         

 

Background: The posterolateral corner of the knee consists of static and dynamic stabilizing structures. Knee injuries often include the posterolateral structures. The popliteus muscle-tendon unit is known as the major dynamic stabilizer of the posterolateral corner.

Hypothesis: The dynamic stabilization of the posterolateral structures of the knee via the popliteus muscle-tendon unit during a squatting exercise follows a constant activation pattern.

Study Design: Controlled laboratory study.

Methods: Within the pilot study, 6 volunteers performed 2 exercises to verify the electrode position scheme and to analyze cross-talk. In the main study 2 static exercises (standing and standing with knees flexed 90°) and 2 dynamic exercises (isolated popliteus muscle activation and squats) were recorded in 17 volunteers. Electromyograms were obtained of the popliteus, medial and lateral gastrocnemius, and quadriceps muscles. Knee angle-related muscle activity was recorded.

Results: In the pilot study it was assumed that the chosen electrode position allowed selective measurement of popliteus muscle activity. In the main study the mean popliteus onset angle was 43° ± 14° of flexion; activity lasted through the reversal point of the squat to 58° ± 21° of flexion during extension movement. Popliteus activity during all testing cycles revealed that the activity in the standing position is the smallest. The highest activity was recorded during the squat and the popliteus muscle-tendon unit exercise.

Conclusion: This study demonstrates an activation pattern of the popliteus muscle-tendon unit with high interindividual differences in the onset angles. A constant activation during the reversal phase of the squatting exercise could be observed.

Clinical Relevance: Reconstructive procedures of the posterolateral structures often include reconstruction of the popliteus muscle-tendon unit. Reconstructive procedures are usually done in a static manner, thus not addressing the dynamic stabilizing structure in a true functional way. The findings of the current study may be a useful contribution to the ongoing discussion of this topic.




May 2012
Mon Tue Wed Thu Fri Sat Sun
« Apr    
 123456
78910111213
14151617181920
21222324252627
28293031