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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


         

 

Background

High rotational traction between football shoes and the playing surface may be a potential mechanism of injury for The abstract goes here and covers two columns. the lower extremity.


Hypothesis

Rotational traction at the shoe-surface interface depends on shoe design and surface type.


Study Design

Controlled laboratory study.


Methods

A mobile testing apparatus with a compliant ankle was used to apply rotations and measure the torque at the shoe-surface interface. The mechanical surrogate was used to compare 5 football cleat patterns (total of 10 shoe models) and 4 football surfaces (FieldTurf, AstroPlay, and 2 natural grass systems) on site at actual surface installations.


Results

Both artificial surfaces yielded significantly higher peak torque and rotational stiffness than the natural grass surfaces. The only cleat pattern that produced a peak torque significantly different than all others was the turf-style cleat, and it yielded the lowest torque. The model of shoe had a significant effect on rotational stiffness.


Conclusion

The infill artificial surfaces in this study exhibited greater rotational traction characteristics than natural grass. The cleat pattern did not predetermine a shoe’s peak torque or rotational stiffness. A potential shoe design factor that may influence rotational stiffness is the material(s) used to construct the shoe’s upper.


Clinical Relevance

The study provides data on the rotational traction of shoe-surface interfaces currently employed in football. As football shoe and surface designs continue to be updated, new evaluations of their performance must be assessed under simulated loading conditions to ensure that player performance needs are met while minimizing injury risk.




March 2010
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