First metatarsophalangeal arthrodesis.

Arthrodesis of the first metatarsophalangeal joint is a highly successful treatment for patients with symptomatic hallux rigidus who have failed conservative management. Before arthrodesis, the importance of host factors, such as use of nicotine, local blood supply, medical comorbidites, and use of systemic immunosuppressive agents, must be considered. Arthrodesis is currently considered the gold standard treatment for end-stage arthritis of the metatarsophalangeal joint. Careful attention to surgical detail is critical to achieving optimal outcomes.

Performance and blood pressure characteristics of first-year national collegiate athletic association division I football players.

The authors were aware of no published studies in which the performance characteristics of first-year National Collegiate Athletic Association Division I collegiate football players were reported. From 2003 to 2006, 73 freshman and 12 transfer football recruits were tested before twice-a-day practices for bench press (BP), squat (SQ), power clean (PC), vertical jump (VJ), calculated jump power (CP), treadmill endurance capacity (Vo2peak), and maximal treadmill time (MTT). Individuals were grouped by player position for descriptive statistical analysis. As a group, offensive linemen (OL), defensive linemen (DL), linebackers (LB), tight ends (TE), and running backs (RB) averaged 152.8 kg for BP, 210.5 kg for SQ, 127.3 kg for PC, and 224.2 W for CP. These values were 22% to 30% higher than those for quarterbacks (QB), wide receivers (WR), defensive backs (DB), and kickers (K), who together averaged 120.2 kg for BP, 163.4 kg for SQ, 104.6 kg for PC, and 172.4 W for CP. Quarterbacks, WR, DB, and K as a group showed the highest MTT (13:13 m.s) and Vo2peak values (47.24 mL.kg.min), 15% to 20% higher than those for OL, DL, LB, RB, and TE, who averaged 11:27 m.s for MTT and 39.51 mL.kg.min for Vo2peak. Running backs, TE, LB, DB, and WR averaged 82.56 cm for VJ, which was 14% higher than that for DL, QB, K, and OL, who averaged 72.72 cm. On the basis of average resting blood pressure, 23.5% (20 players) were categorized as hypertensive (i.e., >/=140/90 mm Hg), 54% (46 players) as prehypertensive (i.e., 120-139/80-89 mm Hg), and 22.5% (19 players) as normal (i.e., <120/80 mm Hg). These data serve as a basis for comparisons among other Division I programs, benchmarking development and improvement through training, and creating position performance norms for incoming football athletes.

Long-term evaluation of interdigital neuroma treated by surgical excision.

BACKGROUND: We examined a large cohort of patients who had interdigital neurectomy and evaluated their clinical outcomes by using a previously developed scoring system as well as a visual analog scale (VAS). In addition, we wanted to identify risk factors that may lead to poorer outcomes. MATERIALS AND METHODS: A retrospective review identified 232 patients who had neuroma excision between 1994 and 2004, after failure of conservative treatment. Each patient was contacted via mail and given a Neuroma Clinical Evaluation Score survey as well as a visual analog score. Each patient received a unique identification number, allowing the evaluation process to be single-blinded. RESULTS: Of the 232 patients contacted, 120 (52%) returned their completed surveys. The average Giannini neuroma score was 53: 61 feet (51%) had good or excellent results, 12 (10%) had fair results, and 48 (40%) had poor results. The average VAS score was 2.5. The only significant (p = 0.027) difference in outcome was the location of the neuroma: second webspace had worse outcomes than third webspace neuromas on both the VAS and neuroma score. CONCLUSION: This retrospective review identified location in the second webspace as a possible prognostic indicator of poor outcome, but the more important finding may be that outcomes of neuroma excision do not appear to be as successful at long-term followup as previously reported.

Morphological profiles for first-year National Collegiate Athletic Association Division I football players.

We are aware of no published research in which the morphological profiles of first-year collegiate football players are characterized. In light of the known association between obesity and cardiovascular disease and recent data suggesting an increased frequency of obesity and early death in professional football players, we have compiled a morphological profile of 65 freshman and transfer recruits (age = 18.4 +/- 1.2 years) from a National Collegiate Athletic Association (NCAA) Division I football program. Measured variables included height (HT), body mass (BM), and body fat percentage (BF) (hydrostatic method). Body mass index (BMI) was calculated using HT and weight variables. Individuals were grouped by player position for descriptive statistical analysis. The means for all 65 players were as follows: HT = 189 +/- 7 cm, BM = 106.5 +/- 4.8 kg, BF = 15 +/- 7%, and BMI = 29.8 +/- 4.7. Mean data from these collegiate athletes were compared to recently published data from professional players. By comparison, the average HT, BM, BF, and BMI of the professional football athletes were 188 +/- 4 cm, 107 +/- 4.8 kg, 14 +/- 5%, and 30.1 +/- 1.9, respectively. While the average BMIs of the collegiate athletes in this study would be classified as overweight or obese, the BFs were found to be within an acceptable range for health status. These data provide important indicators of morphological characteristics and BM health risks of new football recruits at a Division I university. The data presented also provide an historical basis for (a) evaluating both the conditioning of first-year incoming athletes, (b) determining the physical development of the athletes as they progress through the training program, and (c) charting the morphological changes that occur in collegiate football throughout time that may contribute to increased health risks to the athletes.

Acute changes in blood lipids and enzymes in postmenopausal women after exercise.

The effectiveness of lifestyle intervention strategies to improve blood lipids in women may be dependent on preexisting cholesterol concentrations. We characterized the effects of cholesterol status on blood lipid, lipoprotein lipid, and lipid regulatory enzyme responses to a single session of aerobic exercise in physically active, postmenopausal women. In this study, blood samples were obtained from 12 women with high cholesterol (HC; > or =200 mg/dl) and 13 women with normal cholesterol (NC; <200 mg/dl), 24 h before (Pre), immediately after (IPE), and 24 and 48 h after an exercise session (treadmill walking at 70% peak oxygen consumption, 400 kcal). We found that repeated-measures analysis revealed the following: 1) preexercise cholesterol differences did not influence the lipid or lipoprotein lipid responses to exercise; 2) for both groups, triglyceride was significantly reduced (-8.5%) after exercise; 3) the concentration profile over time for high-density lipoprotein cholesterol was significant for both groups, first falling at IPE then rising back to Pre levels by 24 h after exercise; 4) the lecithin-cholesterol acyltransferase activity (LCATA) exercise response was group dependent, increasing modestly in the NC group at 24 and 48 h; 5) lipoprotein lipase activity (LPLA) increased at IPE (by 17%) in the HC group only and then fell at 24 and 48 h (by 21%) compared with Pre; and 6) cholesterol ester transfer protein activity was unchanged by exercise. From these findings, we conclude that in postmenopausal women, a single session of endurance exercise elicited a short-term, favorable decrease in triglycerides independent of initial blood cholesterol concentrations. However, LCATA and LPLA postexercise changes were influenced by preexercise cholesterol status.