Articles - Lectures

Acute Lateral Ankle Sprains In Track & Field Athletes: A Proposal Of An Expanded Classification

We present a longitudinal observational study on classification of acute lateral ankle ligament injuries in track & field athletes, based on objective criteria. These very common and sometimes troublesome sports injuries are treated functionally but there is a lack in international literature in predicting the time needed for full recovery.

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Ten year follow-up study comparing conservative versus operative treatment of anterior cruciate ligament ruptures. A matched-pair analysis of high level athletes

Objective: To compare long term outcome of highly active patients with anterior cruciate ligament ruptures treated operatively versus non-operatively.

Design: We reviewed high level athletes with an anterior cruciate ligament rupture on either MRI or arthroscopic evaluation more than 10 years previously, who were treated conservatively. They were pair-matched with patients who had had an anterior cruciate ligament reconstruction with bone-patella-tendon-bone, with respect to age, gender and Tegner activity score before injury.Participants: In total 50 patients were pair-matched.

Results: We found no statistical difference between the patients treated conservatively or operatively with respect to osteoarthritis or meniscal lesions of the knee, as well as activity level, objective and subjective functional outcome. The patients who were treated operatively had a significantly better stability of the knee at examination.

Conclusion: We conclude that the instability repair using

a bone-patella-tendon-bone anterior cruciate ligament reconstruction is a good knee stabilising operation. Both treatment options however show similar patient outcome at 10 year follow up.

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ACL injuries. Diagnosis, treatment and rehabilitation

The ability to recognize the ACL deficient knee is lacking, even among orthopaedic surgeons. The history of an acute ACL tear is remarkably constant, because the injury is often non contact, and patients usually report a twist on the flexed knee, turning to the same side as the injured knee, although hyperextension or direct injury is the cause in some sports. Patients often remember a loud pop, but, because there are no nociceptors in the ACL, pain is not an immediate feature in the isolated lesion. Players may attempt to continue to play, but they usually stop because the knee feels insecure. Pain ensues in association with a hemarthrosis: 70% of acute hemarthroses of the knee are associated with a tear of the ACL. The diagnosis must be confirmed before treatment is offered.

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