A nterior cruciate ligament (ACL) rehabilitation programs have improved dramatically over the last decade. Whereas it once required 10 months to return patient5 to functional status (4,5,15), they can now begin an active lifestyle after only 24 weeks of rehabilitation (3,7).In light of the shortened rehabilitative process, the need to accurately and effectively assess lower extremity function in ACLreconstructed and -rehabilitated patients cannot be overstated. Yet advancements in these procedures have occurred at a far less aggressive pace. Currently, two forms of direct objective analysis exist: isokinetic dynamometry and dynamic functional testing.Isokinetic dynamometry has become a standard tool for lower extremity evaluation (10) because of its control over range of motion, accommodating resistance, movement velocity (21), and reliability (1,11,16,19, 23).Its validity and clinical relevance, on the other hand, have recently been questioned ( 1 1 ). Several studies, for instance, have reported discrepancies in torque output simply
Pneumomediastinum and subcutaneous emphysema during gynecologic laparoscopic surgery has rarely been documented. Several cases have been reported in the surgical literature after upper abdominal laparoscopic surgery. Many of these cases resolve without residual problems, but some cases may be associated with complications. The patient is a 26-yearold married female with a history of primary infertility of 4 years' duration. Previous evaluation revealed bilateral hydrosalpinx. During laparoscopic surgery for tuboplasty she developed increasing swelling of her upper chest, neck, and face with crepitus sensation. A chest radiograph revealed air in the mediastinum, a questionable small left apical pneumothorax, and subcutaneous emphysema. The condition resolved within 24 hours after surgery. Pneumomediastinum and subcutaneous emphysema in the chest wall, neck, and face may result during laparoscopic surgery for gynecologic procedures. This condition usually resolves spontaneously with oxygen inhalation. (J GYNECOL SURG 18:159)
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