Revision anterior cruciate ligament reconstruction with a reharvested ipsilateral patellar tendon.

The patellar tendon remains the most popular graft choice for anterior cruciate ligament reconstruction and has been proven to be the strongest substitute. Between 1991 and 1998, we performed revision anterior cruciate ligament reconstruction using the reharvested central third of the ipsilateral patellar tendon in 15 patients. Adequate follow-up was obtained in 13 of these 15 patients. The results in these 13 patients (mean age, 27.2 years) were reviewed. At an average postoperative follow-up of 39.4 months (range, 24 to 65), 11 patients had good or excellent results and 2 patients had fair results. Clinical examination revealed an average Tegner knee score of 5.8 (range, 3 to 9) and an average Lysholm knee score of 77.6 (range, 61 to 98). Postoperative KT-1000 arthrometer results showed an average side-to-side difference of 1.92 mm (range, -2.0 to 4.0). No patient demonstrated any loss of range of motion and only one reported patellofemoral problems, which were moderate. These favorable results demonstrate that, with appropriate patient selection, the use of a reharvested central third patellar tendon is a viable option for revision of a failed anterior cruciate ligament reconstruction.

Avoidance of soccer injuries with preseason conditioning.

The effect of a preseason conditioning program was studied to evaluate its influence on the occurrence and severity of soccer injuries. Three hundred female soccer players (ages 14 to 18 years) were studied over a 1-year period. Forty-two of these players participated in a 7-week training program before the start of the season. The type, mechanism, and severity of the injury, when the injury occurred, the number of games or practices missed, and type of shoe worn were recorded. All injuries occurred in the lower extremities, with 61.2% occurring at the knee and ankle. Student's t-test evaluations revealed that the trained group experienced a significantly lower incidence of injury than the untrained group (P = 0.0085). Although not statistically significant, the trained group also had a lower percentage (2.4%) of anterior cruciate ligament injuries compared with the untrained group (3.1%). These results suggest that this type of conditioning has a significant influence on lowering the incidence of injury in female adolescent soccer players.

Evaluation of physical activity measured via accelerometry in rural fourth-grade children.

Interest in the benefits of exercise has prompted increased research examining the relationship between physical activity and health status in adults. More recently, considerable research effort has been directed toward the role of physical activity in young children as a precursor to adult physical fitness. The purpose of this study was to estimate the relationship between physical activity measured via accelerometry and body mass index, body mass, body composition, and physical fitness in fourth-grade boys and girls during physical education lessons. 54 fourth-grade students in rural Pennsylvania (28 girls, M age 9.6, SD = .56; 26 boys, M age 9.5, SD = .51) were subjects. Girls were significantly less active during all lessons measured (p < .001). The results of linear regression analyses indicated that physical activity was negatively associated with body mass index, body mass, and body fat percentage (p < .05), and positively associated with physical fitness (VO2max) (p < .01). These data indicate the need for curricular intervention to motivate girls to increase their activity during structured physical education lessons and demonstrate the efficacy of the body mass index as a screening tool within the schools.