Level III, prospective case-control study.

The purpose of this study was to examine the reliability, usefulness, and validity of the 30-15 Intermittent Ice Test (30-15(IIT)) in 17 young elite ice hockey players. For the reliability and usefulness study, players performed the 30-15(IIT) 7 days apart. For the validity study, data derived from the first 30-15(IIT) were compared with those obtained from the 30-15 Intermittent Fitness Test (30-15(IFT), the running version of this test used as a reference marker for its ability to assess cardiovascular fitness in the field, that is, VO₂peak). Maximal speed, heart rate at exhaustion (HR(peak)) and postexercise blood-lactate levels ([La](b)) were collected for all tests, whereas submaximal HR was taken at stages 4 and 8 (HR(stage4) and HR(stage8)) during the 30-15(IIT). All intra-class correlation coefficients were >0.94. Coefficients of variation were 1.6% (90% CI, 1.3-2.3), 1.7% (1.3-2.8), 1.4% (1.0-2.2), and 0.7% (0.5-1.1) for maximal skating speed, HR(stage4), HR(stage8), and HR(peak), respectively. Correlations between maximal velocities and HR(peak) obtained for the 30-15(IIT) vs. 30-15(IFT) were very large (r = 0.72) and large (r = 0.61), respectively. Maximal skating speed was also largely correlated to estimated VO₂peak (r = 0.71). There was however no correlation for [La](b) values between both tests (r = 0.42). These results highlight the specificity of the on-ice 30-15(IIT) and show it to be a reliable and valid test for assessing cardiorespiratory fitness in young elite players. Coaches could interpret a change in performance of at least 2 stages, or a change in submaximal HR of more than 8% (≈8 b·min⁻¹) during the eighth stage to be a meaningful change in skating fitness.

Increasing the number of outer glove renewals, notably during certain surgical stages at risk for contamination (prosthesis reduction) or perforation (surgical incision/femoral cementing) can reduce the risk of contamination and perforation. The bacteria isolated suggest a cutaneous origin. Regularly changing gloves has resulted in a sterile state in 80% of cases. LEVEL OF EVIDENCE AND TYPE OF STUDY: Level III prospective diagnostic study.

Several flaps have been described to treat severe soft tissue defects of the finger dorsal side. Many authors studied vascular organization of the hand on its dorsal side; most of them insisted on deep vascularization into the intermetacarpal spaces, which is formed by the dorsal metacarpal arteries. Those dorsal metacarpal arteries are the anatomical support of many flaps, which do not preserve the dorsal interosseous muscles fascias. Only few authors described dorsal vascular organization at the level of the proximal phalanx; however, using a rotation point of a flap distally to the metacarpal head with a donor site on the dorsal aspect of the hand could cover all distal soft tissue defect of long finger. In order to determine the technical limitations of dorsal digito-metacarpal flap procedures, we studied number and location of arterial anastomoses between the reticular subcutaneous dorsal network and the rest of the vascularization at this level, which was formed by the deeper dorsal metacarpal arteries, common palmar digital arteries and proper palmar digital arteries, and between the dorsal digital arteries. Twenty-four long fingers from embalmed cadavers were studied after a reverse flow injection of colored latex and dissected layer-by-layer preserving the digital-metacarpal arterial network. At the level of the hand, the dorsal metacarpal arteries of the third and fourth intermetacarpal spaces were inconstant. When present, two or three arteries anastomosed in star shape with the reticular network. No such arterial anastomosis was observed proximally to the level of the intertendinous connections (junctura tendinorum) that bridge the extensor digitorum communis tendons. When no dorsal metacarpal artery was present, some communicant arteries arose from the common palmar digital arteries. Moreover, all the nutrient branches were more numerous distally to the intertendinous connections (junctura tendinorum). At the level of the metacarpophalangeal joints, the hand cutaneous network was always anastomosed with the dorsal cutaneous network. At the level of fingers, the dorsal cutaneous network was always supplied by four branches arising from the proper digital artery. Our study supported the reliability of dorsal digitometacarpal flaps, supplied by numerous palmodorsal digital anastomoses and by a rich plexiforme network joining the hand skin supply and that of the dorsal finger skin. During the procedure, we recommend limiting the surgical dissection of the flap at the level of the middle phalanx.

This prospective study compares the outcome of 157 hydroxyapatite (HA)-coated tibial components with 164 cemented components in the ROCC Rotating Platform total knee replacement in 291 patients. The mean follow-up was 7.6 years (5.2 to 11). There were two revisions for loosening: one for an HA-coated and one for a cemented tibial component. Radiological evaluation demonstrated no radiolucent lines with the HA-coated femoral components. A total of three HA-coated tibial components exhibited radiolucent lines at three months post-operatively and these disappeared after three further months of protected weight-bearing. With HA-coated components the operating time was shorter (p < 0.006) and the radiological assessment of the tibial interface was more stable (p < 0.01). Using revision for aseptic loosening of the tibial component as the end point, the survival rates at nine years was identical for both groups at 99.1%. Our results suggest that HA-coated components perform at least as well as the same design with cemented components and compare favourably with those of series describing cemented or porous-coated knee replacements, suggesting that fixation of both components with hydroxyapatite is a reliable option in primary total knee replacement.