The effect of Workers' Compensation on clinical outcomes of arthroscopic-assisted autogenous patellar tendon anterior cruciate ligament reconstruction in an acute population.

PURPOSE: To assess the effect of Workers' Compensation (WC) benefits on subjective outcomes of patients following anterior cruciate ligament (ACL) reconstruction. TYPE OF STUDY: Prospective study of ACL reconstruction with bone-patellar tendon-bone in an acute population. METHODS: From October 1991 through June 1997, 1,015 patients underwent ACL reconstruction, 769 with bone-patellar tendon-bone autografts; 235 met the criteria for this study. All chronic injuries, failed and/or bilateral reconstructions were excluded making the total population 139. The final populations included 115 patients in a non-WC group and 24 patients in a WC group. Average follow-up for was 34.5 months for the WC group and 33.6 months for the non-WC group. All patients had equal objective evaluations, which allowed the subjective criteria to be analyzed. RESULTS: The results revealed a significant difference in the subjective data of patients with WC benefits. Uniformly, WC patients rated subjective criteria as far worse than the non-WC group in postoperative stages. The average of the 15-item visual analog scale showed statistically significant (P <.01) differences between the WC and non-WC groups. Average postoperative Tegner scores were 3.05 for the WC group and 6.02 for the non-WC group, which was statistically significant. The WC group did not return to their preinjury Tegner score. CONCLUSIONS: The data show that the patients' perception of their knee function drastically differs from the objective findings on examination; therefore, it should be anticipated that the WC patient might have lower subjective outcomes from surgical treatment when compared with their non-WC counterparts.

Clinical comparison of intraarticular anterior cruciate ligament reconstruction using autogenous semitendinosus and gracilis tendons in men versus women.

Reconstruction of the anterior cruciate ligament using a hamstring tendon autograft has often been recommended for female athletes. We compared the results of acute, isolated, intraarticular anterior cruciate ligament reconstructions using quadruple-looped hamstring autografts in 39 female and 26 male patients. All reconstructions were performed by the same surgeon using a similar surgical technique and the same postoperative management. In each case, patients had Endobutton femoral fixation and either post or button fixation for the tibial side. The average follow-up was 40.9 months for women and 39.0 months for men. Objective analysis of results included examination for the presence of effusion and crepitus, Lachman and pivot shift testing, and KT-1000 arthrometer testing for side-to-side differences. Subjective analysis consisted of a 15-item visual analog scale completed by patients postoperatively, and pre- and postoperative Tegner and Lysholm scores. The clinical failure rate was 23% (9 of 39) for the female patients and 4% (1 of 26) for the male patients, which was statistically significant. There was also a trend toward increased laxity in female patients. Subjectively, the women also reported a higher frequency and intensity of pain. Based on Tegner activity levels, more of the men returned to their preinjury level of activity than did the women. When compared with the male patients, female patients had a significantly higher failure rate after reconstruction.

Detection of proteins which recognize and bind oriC sequences.

Extracts from E. coli capable of supporting in vitro oriC-dependent DNA replication have been examined with a protein blotting protocol to identify DNA-binding proteins. Four polypeptide chains with apparent affinity for oriC DNA were detected.

Characterization of transducin from bovine retinal rod outer segments. II. Evidence for distinct binding sites and conformational changes revealed by limited proteolysis with trypsin.

The first stage of amplification in the cyclic GMP cascade in bovine retinal rod is carried out by transducin, a guanine nucleotide regulatory protein consisting of two functional subunits, T alpha (Mr approximately 39,000) and T beta gamma (Mr approximately 36,000 and approximately 10,000). Limited trypsin digestion of the T beta gamma subunit converted the beta polypeptide to two stable fragments (Mr approximately 26,000 and approximately 14,000). The GTPase and Gpp(NH)p binding activities were not significantly affected by the cleavage. Trypsin digestion of the T alpha subunit initially removed a small segment from the polypeptide terminus and resulted in the formation of a single 38,000-Da fragment. When this fragment was recombined with the intact T beta gamma subunit in the presence of membranes containing photolyzed rhodopsin, the reconstituted transducin exhibited greatly reduced GTPase and Gpp(NH)p binding activities. The loss in activities was due to the inability of the cleaved T alpha to bind to the photolyzed rhodopsin. Prolonged digestion converted the 38,000-Da fragment to a transient 32,000-Da fragment and then to two stable 23,000-Da and 12,000-Da fragments. The cleavage of the 32,000-Da fragment, however, can be blocked by bound Gpp(NH)p. The 32,000-Da fragment contains the Gpp(NH)p binding site and retains the ability to activate phosphodiesterase. These results indicate that the guanine nucleotide binding and rhodopsin binding sites are located in topologically distinct regions of the T alpha subunit and proved evidence that a large conformational transition of the molecule occurs upon the conversion of the bound GDP to GTP.