0utcomes following injury of ligaments or menisci of the knee have usually been evaluated in terms of laxity, clinical examination, or radie logic findings (8,12,14,24). Patients, however, are usually more concerned with symptoms and function. Although symptoms and function have been assessed for these patients, the measures to do so have not always been proven reliable, valid for the subjects at interest, or responsive to clinical change. Furthermore, instruments used for assessing patient-relevant outcomes have often been administered by the surgeon who performed the operation, creating the opportunity for observer bias.In a critical analysis of knee ligament rating systems, Sgaglione et a1 (27) pointed out that three commonly used instruments-the Hospital for Special Surgery (36), the Lysholm (32), and the Cincinnati Knee Ligament ( 1 ) rating systems-yield different results and may reflect different underlying constructs. The Hospital for Special Surgery rating scale aggregates findings from a clinical examination and information regarding symptoms and function into one score, whereas the Lysholm scaring scale assesses symptoms and func-

Meniscectomy is associated with long-term symptoms and functional limitations, especially in women. Patients who had developed severe radiographic OA experienced more symptoms and functional limitations. Age did not influence self-reported outcomes, however older age was associated with worse muscular performance.

Standing balance measured as sway and standing time both on one and two legs, was studied by use of a stable force platform (Kistler) in 36 patients aged 48–87 years with trans-tibial amputation and 27 healthy subjects matched for age. The aim of the study was to compare postural function in standing in two groups with unilateral trans-tibial amputations, separating vascular disease from trauma. Results revealed that the vascular group had a significantly increased sway in the lateral direction compared with the healthy group, when standing on both feet close together for 30 seconds, looking straight ahead or blindfolded (p values ranging from 0.003 to 0.02). In the sagittal direction the trauma amputees had a significantly decreased sway when looking straight ahead, compared to the vascular and healthy groups (p values = 0.03). No significant differences in the lateral or sagittal direction were seen among the three groups when comparing standing on one leg. There was a significant difference, however, in the standing time in the one-leg standing test of the vascular group when compared with the trauma and healthy groups (p values ranging from 0.0009 to 0.02). In contrast to the vascular group, all subjects in the trauma and healthy groups from 48 to 59 years could stand on the healthy leg for 30 seconds when looking straight ahead, and from 60 to 79 years they could stand for 5 seconds. None in the vascular or trauma group older than 80 years could stand on the healthy leg for 5 seconds. The standing balance of the vascular amputees was found to be inferior to that of the trauma amputees. In conclusion, vascular and trauma trans-tibial amputees should not be considered as an entity in test situations or rehabilitation programmes.

Sixty-seven patients with classical or definite rheumatoid arthritis (RA) were studied concerning the effects of standardized physical training on muscle function in the lower extremities. The patients were randomly assigned to four different training groups and were given 6 weeks of training supervised by a physiotherapist at a health care centre. The groups differed according to type (dynamic or static) and extent (12 or 4 times) of training. During this training period as well as for an additional 3 months, the patients carried out programs of exercise at home (either dynamic or static). A significantly greater increase in function during the 6-week period as regards muscle strength, endurance, aerobic capacity, and functional ability was found for the dynamic as compared with the static groups. The findings at follow-up 3 months later were similar. The effectiveness of the programs did not vary with the extent of training. In conclusion, in RA patients, dynamic training gives a greater increase in physical capacity than does static training.