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: Successful meniscus transplantation depends on an accurate sizing of the meniscal allograft. Although accurate sizing of the meniscal allograft is crucial during meniscus transplantation, the accuracy of meniscal measurement methods is still in debate.

Purpose: This study was undertaken to evaluate the relationship between the width and length of the lateral meniscus. These anatomic dimensions were also evaluated in the context of the patient’s height, weight, gender, and body mass index (BMI).

Study Design: Descriptive laboratory study.

Methods: Ninety-one samples of fresh lateral meniscus were obtained during total knee arthroplasty. The samples were obtained carefully without injuring the meniscus itself and the bony attachment sites. For each lateral meniscus, the anatomic dimensions (width [LMW] and length [LML]) were recorded. The height, weight, gender, and BMI of the patients were also recorded. The Pearson correlation and multivariate and linear regression analysis were applied for each variable. The accuracy was defined as those measures that fell within 10% of the original size. A P value ≤ .05 was considered significant.

Results: The mean LMW was 30.7 mm (standard deviation [SD] = 3.5) and 27.0 mm (SD = 2.6) for men and women, respectively. The mean LML was 33.7 mm (SD = 4.3) and 30.8 mm (SD = 2.6) for men and women, respectively. Thirty-nine samples (42.5%) showed LMW measurements within a 10% difference of LML, whereas 50 samples (55%) showed an LMW greater than a 10% difference of LML. Although there were correlations between LML with LMW in men and correlations between weight and LMW with LML in women, the accuracy for the derived linear regression formulas was 3%, 9%, and 12%, respectively.

Conclusion: The length cannot be predicted accurately from the width of the lateral meniscus. The height, weight, gender, and BMI failed to estimate the dimensions of the lateral meniscus. Therefore, it is essential to measure the width and length separately and match it with the allograft with other size measuring methods.

Clinical Relevance: This study emphasizes the importance of measuring the width and length of the lateral meniscus independently during preoperative sizing for a meniscal allograft transplantation procedure. The height, weight, gender, and body mass index may not be reliable parameters for estimating the size of the meniscus.




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