The ankle joints of 14 healthy volunteers and 16 patients with unstable ankle joints were tested regarding their functional and proprioceptive capabilities. All of them were active athletes. Three tests were used of the study: single-leg stance test, single-leg jumping course test, angle-reproduction test. The influence of three stabilization devices (lace-on-brace/"Mikros", stirrup-brace/"Aircast", taping) on the proprioceptivity of stable and unstable ankle joints was evaluated. The scores of the single-leg jumping course without any stabilizing device (category "standard") ranged between 8.06 and 13.68 (10.65 +/- 1.29). In the categories "Mikros" (9.85 +/- 0.99), and "Aircast" (9.99 +/- 1.14) as well as with the tape bandage (10.27 +/- 0.81) better scores were achieved. The differences "standard vs. Mikros" and "standard vs. Aircast" revealed a significant reduction of the scores with orthoses (P < 0.01). The error rate in the single-leg stance test was within the range of 0-16 (5.12 +/- 2.85) for the category "standard". It was lower for the categories "Mikros" (3.65 +/- 2.65) and "Aircast" (4.17 +/- 2.59). The error rate was highest in the group with a tape bandage (5.79 +/- 3.53). The differences "standard vs Mikros" as well as "standard vs. Aircast" were significant (P < 0.01). There was also a significant difference between these categories regarding injured and not injured ankle joints (P < 0.01). The angle-reproduction-test showed higher values for the category "standard" (2.36 degrees +/- 0.97) in comparison to the categories "Mikros" (1.46 degrees +/- 0.72), "Aircast" (1.62 degrees +/- 0.91) and "taping" (1.84 degrees +/- 0.41).(ABSTRACT TRUNCATED AT 250 WORDS)
Athletic activity seems to load the anterior knee compartments, especially the lateral compartment. MRI shows meniscal lesions in a significant number of asymptomatic subjects, especially those older than 50 years.
In 55 patients with type I or type II impingement lesions we performed arthroscopic subacromial decompression. Fifty-two patients are followed up 1 year postoperatively. In all patients the condition of the affected shoulder before and after decompression was documented using a 100-point shoulder score (pain on activity, 15 points; pain without activity, 15 points; function, 20 points; weight lifting, 10 points; muscle strength, 15 points; range of motion, 25 points). At follow-up we also documented the extent of passive inferior shift of the humeral head by ultrasound. The mean score preoperatively was 60.9 (+/- 13.8). Postoperatively there was a significant increase to 84.7 (+/- 12.5). The average postoperative hospital stay was 8.8 days (+/- 2.1). In 12 patients (23%) the postoperative score was less than 85 points, and in these the treatment was considered to have failed. Comparison of these patients as a group with those in whom the treatment was successful revealed no difference in age, a small but not significant difference in the preoperative duration of shoulder complaints, and no difference in the postoperative length of stay in hospital. However, there was a significant difference in the extent of passive inferior shift of the humeral head: in the failure group the mean inferior shift was 4.6 +/- 1.9 mm, while in the other patients the shift was only 2.7 +/- 1.0 mm. This difference was statistically highly significant. There was a statistical highly significant negative Pearson correlation coefficient of -5.56 between postoperative score and inferior shift of the humeral head. We conclude that patients with subacromial pathology and hypermobile glenohumeral joints may not be good candidates for subacromial decompression.
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