Gender differences in anterior cruciate ligament injury rates in wisconsin intercollegiate basketball.

OBJECTIVE: The incidence of anterior cruciate ligament (ACL) injuries in women basketball players has been shown to exceed that of male basketball players. The purpose of this study was to determine the ACL injury rate for both male and female intercollegiate basketball players in the state of Wisconsin and to determine if certain factors played a significant role in the number of ACL injuries incurred. DESIGN AND SETTING: The design was a 5-year retrospective survey study. The study took place in the state of Wisconsin at 22 colleges and universities. SUBJECTS: Certified athletic trainers were selected from the colleges and universities to answer the surveys. MEASUREMENTS: The survey consisted of close-ended questions about the incidence of ACL injuries and the circumstances surrounding these injuries. RESULTS: The injury rate was high in the female basketball players. The female athletes had a 2.3 times higher ACL injury rate than the male athletes. No other factors were found to be significant. CONCLUSIONS: ACL injuries were higher in the female athletes than the male athletes examined.

The acromion-splitting approach for large and massive rotator cuff tears.

A retrospective review of 42 patients in whom a rotator cuff injury was diagnosed and who subsequently underwent surgery with the superior acromion-spitting approach technique was conducted. The average size of the tear was 4.2 cm with an average tear retraction of 4.1 cm. Thirty-seven (38 shoulders) of the 42 patients underwent a physical examination, interview, and radiographs at an average followup of 33.4 months (range, 15 to 66). Using the University of California, Los Angeles Shoulder Rating Scale, 27 shoulders were graded as excellent or good, and 11 shoulders were graded as fair or poor. Radiographic examination demonstrated bony union in 29 shoulders. The remaining 9 shoulders had evidence of fibrous union that could be characterized as clinically asymptomatic. Twenty patients had computed tomography scans that demonstrated decompression where the bony or fibrous union had occurred. In addition, some increased decompression in several patients with fibrous union indicated that the anterior acromion sought its appropriate level. Based on the results of this study, the acromion-splitting approach, used as an extension of the miniapproach for rotator cuff tears, can be successfully used when a large or massive rotator cuff tear is identified.

Infrapatellar contracture syndrome. An unrecognized cause of knee stiffness with patella entrapment and patella infera.

Infrapatellar Contracture Syndrome (IPCS) is an infrequently recognized cause of posttraumatic knee morbidity. Unique to this group of patients is the combination of restricted knee extension and flexion associated with patella entrapment. IPCS can occur primarily as an exaggerated pathologic fibrous hyperplasia of the anterior soft tissues of the knee beyond that associated with normal healing. It can also occur secondarily to prolonged immobility and lack of extension associated with knee surgery, particularly intraarticular ACL reconstruction. IPCS follows a predictable natural history which is divided into three stages. Symptoms, diagnostic findings, and recommended treatment are determined by the stage at presentation. Once beyond its early presentation, IPCS is best treated by an anterior intraarticular and extraarticular capsular debridement and release, followed by extensive rehabilitation. The authors review 28 consecutive cases of IPCS. At followup 3 months to 4 years postoperation, the patients had averaged 2.3 additional surgical procedures following their index procedure or injury. The average increase in extension at followup was 12 degrees with the average increase flexion 35 degrees. Eighty percent of patients demonstrated signs and symptoms consistent with patellofemoral arthrosis; 16% of the patients demonstrated patella infera. The authors conclude that prevention or early detection and aggressive treatment are the only ways of avoiding complication in these problem cases.

Lateral Knee Braces in Football: Do They Prevent Injury?

In brief: Lateral knee braces are being used in increasing numbers by football teams attempting to decrease the number of valgum knee injuries. There has been little proof to date that these braces are effective. In this paper we review the results of three recently presented clinical studies as well as an in-depth biomechanical study, all of which raise serious doubts about the efficacy of preventive knee braces that are currently available.

Tarsal and carpal coalition and symphalangism of the Fuhrmann type. Report of a family.

We are reporting on fifteen members of a five-generation family (sixty-three members) who had an autosomal dominant osseous disorder that was characterized by tarsal and carpal coalition, symphalangism, short first metacarpals, and abnormalities of the elbow, including humeroradial fusion. This family is similar to the one reported by Fuhrmann et al.