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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: Ankle injuries account for the highest percentage of injuries among female collegiate volleyball players. Since 1998, all female volleyball players at the authors’ institution have worn bilateral double-upright padded ankle braces at all times.

Purpose: To review the authors’ experience with this brace in preventing ankle injuries that result in a loss of play.

Study Design: Case series; Level of evidence, 4.

Methods: Injury data, preparticipation medical histories, and total exposure data were collected prospectively on all female volleyball players at the authors’ institution from 1998 to 2005. Injuries and exposures were defined based on established National Collegiate Athletic Association Injury Surveillance System criteria. Injury rate was calculated as the number of injuries per 1000 exposures. The National Collegiate Athletic Association female volleyball injury data from 1998 to 2005 were used for comparison.

Results: During the study period, there were a total of 13 500 exposures and 1 injury in our group yielding an injury rate of 0.07 per 1000 exposures. Nearly half of our athletes had a preparticipation history of ankle sprains, yet only 1 ankle injury occurred during all of our braced exposures.

Conclusion: There were 811 710 exposures and 797 injuries in the National Collegiate Athletic Association comparison group with an increased injury rate of 0.98 per 1000 exposures (P = .001). Prophylactic use of a double-upright ankle brace significantly reduced the ankle injury rate compared with that reported by the National Collegiate Athletic Association. From these data, it appears that the use of such a brace is an effective way to decrease the incidence of ankle injuries in this active but vulnerable group of athletes.




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