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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: The purpose of this study was to compare the injury patterns and incidence of snowboarding and ski boarding injuries with that of alpine skiing in 2000 to 2005, as there are few previous studies comparing these 3 sports, especially in Asia.

Hypothesis: The injury patterns are different among the 3 snow sports.

Study Design: Descriptive epidemiology study.

Methods: The subjects were alpine skiers (1240 cases), snowboarders (2220 cases), and ski boarders (132 cases) who were injured in 2 ski resorts located in Niigata prefecture in Japan and visited the authors’ clinics in these ski resorts between 2000 and 2005. On visiting the clinics, patients completed a questionnaire reviewing the circumstances surrounding the injury event, and physicians documented the diagnosis.

Results: The injury rate, which was based on all purchased lift tickets, in snowboarding decreased gradually, although it was still 2 times higher than that of alpine skiing. Snowboarding and ski boarding had a higher fracture and dislocation rate. Both sports also had a 4 times higher rate of injuries because of jumping. The characteristics of ski boarding were a lower head and neck injury rate and collision injury rate than those of the other 2 snow sports, as well as a 2 times higher rate of fractures compared with alpine skiing injuries and a 1.4 times higher incidence than that of snowboarding injuries. Of the fractures caused by ski boarding accidents, 39.6% affected the lower leg bones.

Conclusion: Injury prevention strategies should focus on jumps for snowboarders and ski boarders.




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