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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


         

 

Identifying diseases at an early, presymptomatic stage may offer the best chance for establishing proper treatment and improving patient outcomes. A new technique known as immunosignaturing harnesses the human immune system as an early warning sentry - one acutely sensitive to changes in the body that may be harbingers of illness…

 

A new method for quickly identifying individual viruses and recognising how they bind to host cells may become a vital tool in the early control of winter vomiting disease and other virus-based diseases. In the west, this means saving money and reducing stress on health-care systems. In developing countries, this means saving lives…

 

Using the only microscope of its kind in Australia, medical scientists have been able for the first time to see the inner workings of T-cells, the front-line troops that alert our immune system to go on the defensive against germs and other invaders in our bloodstream…

 

A new genomics study, led by the Center for Applied Genomics at The Children’s Hospital of Philadelphia, sets the stage for the first predictive diagnostic test in a serious immunodeficiency disease in children. If the disorder, common variable immunodeficiency disease (CVID), can be diagnosed early, children may receive life-saving treatments before the disease can progress…

 

A new genomics study, led by the Center for Applied Genomics at The Children’s Hospital of Philadelphia, sets the stage for the first predictive diagnostic test in a serious immunodeficiency disease in children. If the disorder, common variable immunodeficiency disease (CVID), can be diagnosed early, children may receive life-saving treatments before the disease can progress…

 

A coalition of 30 leading global health organizations that work on vaccines, drugs, and other tools and technologies that save lives today released a list of recommendations for US policymakers and regulators, calling for acceleration of scientific innovations and streamlining the approval of safe and affordable inventions in order to save more lives around the world…

 

Inovio Pharmaceuticals, Inc. (NYSE Amex: INO), a leader in the development of novel therapeutic and preventive vaccines against cancers and infectious diseases, announced the presentation of recent preclinical data using its next generation of minimally invasive intradermal (skin) electroporation delivery devices at the Phacilitate Vaccine Forum 2011 in Washington, DC…

 

New research from Georgetown University Medical Center (GUMC) suggests that up to 40 percent of scleroderma patients will not be correctly diagnosed with the disorder using a new automated commercial screening test. The findings of the study will be presented Wednesday, November 10th at the Annual Scientific Meeting of the American College of Rheumatology in Atlanta, Georgia…

 

Researchers at the University of Calgary Faculty of Medicine are using an innovative new imaging technique to study how white blood cells (called neutrophils) respond to inflammation, and have revealed new targets to inhibit the response…

 

Scientists in the US who developed a skin patch that uses hundreds of microscopic dissolvable needles to deliver vaccine into the body have shown it works on animals, perhaps even better than the traditional injection method; they envisage that one day this approach could reduce the cost and administration of mass vaccination, for instance during flu epidemics, because …




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