Current Issue : April - June Volume : 2013 Issue Number : 2 Articles : 6 Articles
Steroid-induced osteonecrosis of the femoral condyle is a relatively uncommon condition and is often difficult to\r\nselect appropriate treatment especially in young patients. Three young men (aged 25, 18, and 24) presented with\r\nsevere pain and dysfunction of the knee diagnosed as steroid-induced osteonecrosis of the femoral condyle by\r\nmagnetic resonance imaging (MRIs). Full-thickness cartilage defects sized 20 Ã?â?? 10, 15 Ã?â?? 10, and 30 Ã?â?? 20 mm\r\nrespectively were classified as International Cartilage Repair Society Grade IV lesions and treated with osteochondral\r\nautograft transplantation. They were treated successfully with osteochondral autograft transplantation certificated by\r\npost-operative MRI and second look arthroscopy....
Purpose: To evaluate the relative involvement of tibial stress injuries using high-resolution axial MR imaging and\r\nthe correlation with MR and radiographic images.\r\nMethods: A total of 33 patients with exercise-induced tibial pain were evaluated. All patients underwent\r\nradiograph and high-resolution axial MR imaging. Radiographs were taken at initial presentation and 4 weeks later.\r\nHigh-resolution MR axial images were obtained using a microscopy surface coil with 60 Ã?â?? 60 mm field of view on a\r\n1.5T MR unit. All images were evaluated for abnormal signals of the periosteum, cortex and bone marrow.\r\nResults: Nineteen patients showed no periosteal reaction at initial and follow-up radiographs. MR imaging showed\r\nabnormal signals in the periosteal tissue and partially abnormal signals in the bone marrow. In 7 patients, periosteal\r\nreaction was not seen at initial radiograph, but was detected at follow-up radiograph. MR imaging showed\r\nabnormal signals in the periosteal tissue and entire bone marrow. Abnormal signals in the cortex were found in 6\r\npatients. The remaining 7 showed periosteal reactions at initial radiograph. MR imaging showed abnormal signals in\r\nthe periosteal tissue in 6 patients. Abnormal signals were seen in the partial and entire bone marrow in 4 and 3\r\npatients, respectively.\r\nConclusions: Bone marrow abnormalities in high-resolution axial MR imaging were related to periosteal reactions\r\nat follow-up radiograph. Bone marrow abnormalities might predict later periosteal reactions, suggesting shin splints\r\nor stress fractures. High-resolution axial MR imaging is useful in early discrimination of tibial stress injuries....
Background: Basketball is the second most popular sport in Nigeria after football and is commonly played by\r\nadolescents. Prospective studies on adolescent basketball players in Nigeria are lacking. Such studies will help to\r\ndevelop injury counter-measures. Hence, this study aimed at determining the incidence and pattern of injuries\r\namong adolescent basketball players in Nigeria.\r\nMethods: A prospective observational study involving 141 adolescent basketball players (75 boys and 66 girls; with\r\nage range 15 ââ?¬â?? 18 years) who participated in the 2010 National Finals of the Nigeria NestlÃ?© Milo Basketball\r\nCompetition. Basketball-related injury data were collected by an assessor during the competition using a\r\nstandardized basketball injury report form. Data were analyzed using descriptive and inferential statistics.\r\nResults: A total of 32 injuries were recorded with an incidence of 22.7 injuries per 100 participants same for boys\r\nand girls. This is equivalent to 1.1 injury per match for boys and 0.9 injuries per match for girls. Jumping/landing\r\nwas the most common cause of injury (28.1%, N = 9). Most of the injuries were at the lower extremities (75%,\r\nN = 24); with majority at the knee joint (40.6%, N = 13). Ligament sprain was the most common types of injury. The\r\npattern of injuries among boys did not significantly differ from that of girls (P > 0.05). Most injuries (N = 13, 41%)\r\noccurred in the offensive half of the court and cryotherapy was the most frequently used treatment modality.\r\nConclusion: The overall incidence of match injury among adolescent amateur basketball players during a national\r\ncompetition in Nigeria was 22.7 injuries per 100 participants; equivalence of 1.0 injury per match. The pattern of\r\ninjuries was similar in both genders and consistent with what has been previously reported in literature for\r\nadolescent basketball players. Exercise-based injury prevention programmes aimed at improving core strength and\r\nneuromuscular control at the lower limbs may help reduce the incidence of injuries....
Purpose: To investigate the usefulness of the ââ?¬Å?inducer graftingââ?¬Â technique for regeneration of the semitendinosus\r\n(ST) tendon after its harvest for anterior cruciate ligament (ACL) reconstruction.\r\nMethods: Twenty knees of 20 patients (mean age at the time of surgery, 23.1 years) underwent ACL reconstruction\r\nwith a double bundle autograft using the ST tendon (7 patients) and the ST + the gracilis (G) tendons (13 patients).\r\nââ?¬Å?Inducer graftingââ?¬Â technique\r\nAfter harvesting the ST tendon, a passing pin with a loop thread is inserted along with the tendon stripper. The\r\npassing pin is pulled out from the medial thigh and the loop thread retained. As an inducer graft, the ST tendon\r\nbranch is used. After the ACL graft has been secured, the inducer graft is sutured to the pes anserinus and the\r\nproximal end passed through by pulling the thread out. Then the inducer graft is placed within the tendon canal.\r\nThe mean follow-up period was 15 months. The presence and morphology of the regenerated ST tendon were\r\nexamined by MRI. And the isometric hamstring strength was examined at 45Ã?°, 90Ã?° and 120Ã?° of knee flexion.\r\nResults: One month after the operation in all the patients, MRI demonstrated a low-intensity structure at the\r\nanatomical location of the ST, at the level of the superior pole of the patella and the joint line, apparently\r\nrepresenting the regenerated ST tendon. Four months after the operation, the distal portion of the regenerated ST\r\ntendon had reached the pes anserinus in all patients. Twelve months after the operation, the regenerated ST\r\ntendon was hypertrophic in 19 of the 20 patients (95%). The isometric knee flexion torque of the ACL-reconstructed\r\nlimb was significantly lower at 90Ã?° and 120Ã?° compared with the contralateral limb.\r\nConclusion: These results suggest that the ââ?¬Å?inducer graftingââ?¬Â technique is able to improve the regeneration rate of\r\nthe harvested ST tendon and promote hypertrophy of the regenerated ST tendon, extending all the way to the pes\r\nanserinus. However, this technique couldnââ?¬â?¢t improve the deficits in knee flexion torque after ACL reconstruction...
Background: The incidences of tendon injuries in certain sections of human or animal populations such as athletes\r\nare high, but every human or animal, regardless of age or level of activity experiences some degree of tendon\r\ninjury. In spite of the various investigations of injuries and treatment, comprehensive studies dealing with the\r\nhistological, ultrastructural and biomechanical aspects of healing of load-bearing tendons are rare. This study was\r\ndesigned to compare the outcome of healing of the transverse sectioned superficial digital flexor tendon (SDFT)\r\nafter 28 and 84 days post injury (DPI) in rabbits.\r\nMethods: Forty white New Zealand mature female rabbits were randomly divided into two equal groups of 28 and\r\n84 DPI After tenotomy and surgical repair of the left SDFT, the injured legs were casted for 14 days. The weight of\r\nthe animals, tendon diameter, and clinical, radiographic and ultrasonographic evaluations were conducted at weekly\r\nintervals. The animals were euthanized on 28 and 84 DPI and the tendons were evaluated for histopathological,\r\nultrastructural, biomechanical and percentage dry weight parameters.\r\nResults: Although the clinical, ultrastructural, morphological and biomechanical properties of the injured tendons\r\non day 84 showed a significant improvement compared to those of the 28 DPI, these parameters were still\r\nsignificantly inferior to their normal contra-lateral tendons.\r\nConclusions: This study showed that tendon healing is very slow and at 84 days post-injury the morphological and\r\nbiomechanical parameters were still inferior to the normal tendons and many collagen fibrils still had the same\r\ndiameter as those seen at 28 DPI....
Background: The only three randomized trials on the treatment of MTSS were all performed in military\r\npopulations. The treatment options investigated in this study were not previously examined in athletes. This study\r\ninvestigated if functional outcome of three common treatment options for medial tibial stress syndrome (MTSS) in\r\nathletes in a non-military setting was the same.\r\nMethods: The study design was randomized and multi-centered. Physical therapists and sports physicians referred\r\nathletes with MTSS to the hospital for inclusion. 81 athletes were assessed for eligibility of which 74 athletes were\r\nincluded and randomized to three treatment groups. Group one performed a graded running program, group two\r\nperformed a graded running program with additional stretching and strengthening exercises for the calves, while\r\ngroup three performed a graded running program with an additional sports compression stocking. The primary\r\noutcome measure was: time to complete a running program (able to run 18 minutes with high intensity) and\r\nsecondary outcome was: general satisfaction with treatment.\r\nResults: 74 Athletes were randomized and included of which 14 did not complete the study due a lack of\r\nprogress (18.9%). The data was analyzed on an intention-to-treat basis. Time to complete a running program and\r\ngeneral satisfaction with the treatment were not significantly different between the three treatment groups.\r\nConclusion: This was the first randomized trial on the treatment of MTSS in athletes in a non-military setting. No\r\ndifferences were found between the groups for the time to complete a running program....
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