Objective: This study is a statistical analysis to establish whether a correlation exists between the level and degree of rectus femoris (RF) central tendon injury and the amount of time that an athlete is unable to participate subsequently, referred to as ''sports participation absence'' (SPA). Design: Causal-comparative study. Patients: 35 players from two high-level Spanish soccer teams with an injury to the central tendon of the RF based on clinical and ultrasound criteria. Main Outcome Measure: Ultrasound examination was performed with an 8-2 MHz linear multifrequency transducer. All studies included both longitudinal and transverse RF sections. Results: At the proximal level the SPA time is 45.1 days when the injury length is 4.0 cm. This value increases by 5.3 days with each 1 cm increase in the length of injury. In the case of distal level injury, SPA time is 32.9 days when the injury length is 3.9 cm. This value increases by 3.4 days with each 1 cm increase. In the total representative sample, SPA time when the injury length is 4.2 cm corresponds to 39.1 days. This value increases by 4.2 days per length unit. Conclusions: RF central tendon injury at the proximal level is associated with a greater SPA time than at the distal level. Patients with a grade II injury have an SPA time longer than those with a grade I injury whether the injury is located proximal or distal.The rectus femoris (RF) muscle is particularly vulnerable to injury because of the following characteristics: it spans two joints; the majority of its fibres are type II fast twitch; it performs eccentric-specific work during sporting activities.
Double-bundle (DB) anterior cruciate ligament (ACL) reconstruction is designed with the aim of reproducing the anatomy and the function of a healthy knee. This can be done by creating two femoral tunnels and one tibial tunnel (DB-3T), or two femoral and two tibial tunnels (DB-4T), There is very little comparative information regarding DB-3T, which is supposed to be more anatomical than DB-4T, and single bundle (SB). DB-3T reconstruction produces greater joint stability and clinical behavior than SB. Consecutive patients with a unilateral rupture of the ACL treated with the DB-3T technique, and a control group of 36 nonconcurrent patients, with similar conditions, treated with the SB technique were followed during 2 years. Anterior/posterior translation (APT), pivot-shift test, one-leg hop, and IKDC (International Knee Documentation Committee) subjective evaluations were performed. There were no significant differences in the reduction of APT. However, there was a significant improvement in the remaining parameters in the DB-3T group: greater reduction in rotational instability, greater one-leg hop capacity, and greater subjective evaluation. At the 2-year follow-up, patients having undergone ACL reconstruction using hamstring tendons by means of a DB technique with a single tibial tunnel showed greater rotational stability, greater one-legged hop capacity, and a greater subjective evaluation than those having undergone SB reconstruction.
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