Sleep habits, exercise, and a positive depression screen were associated with burnout risk within the medical student population.

Although some technical corrections, such as testing manoeuvre and recording procedure, are needed to improve the image data sampling using the iPad application, the potential of the iPad application to classify the pivot shift was demonstrated.

The primary purpose of this investigation was to evaluate the influence of a whole body compression garment on recovery from a typical heavy resistance training workout in resistance-trained men and women. Eleven men (mean +/- SD: age, 23.0 +/- 2.9 years) and 9 women (mean +/- SD: age 23.1 +/- 2.2 years) who were highly resistance trained gave informed consent to participate in the study. A within-group (each subject acted as their own control), balanced, and randomized treatment design was used. Nutritional intakes, activity, and behavioral patterns (e.g., no pain medications, ice, or long showers over the 24 hours) were replicated 2 days before each test separated by 72 hours. An 8-exercise whole body heavy resistance exercise protocol using barbells (3 sets of 8-10 repetition maximum, 2.0- to 2.5-minute rest) was performed after which the subject showered and put on a specific whole body compression garment one designed for women and one for men (CG) or just wore his/her normal noncompression clothing (CON). Subjects were then tested after 24 hours. Dependent measures included sleep quality, vitality rating, resting fatigue rating, muscle soreness, muscle swelling via ultrasound, reaction movement times, bench throw power, countermovement vertical jump power, and serum concentrations of creatine kinase (CK) measured from a blood sample obtained via venipuncture of an arm vein. We observed significant (p < or = 0.05) differences between CG and CON conditions in both men and women for vitality (CG > CON), resting fatigue ratings (CG < CON), muscle soreness (CG < CON), ultrasound measure swelling (CG < CON), bench press throw (CG > CON), and CK (CG < CON). A whole body compression garment worn during the 24-hour recovery period after an intense heavy resistance training workout enhances various psychological, physiological, and a few performance markers of recovery compared with noncompressive control garment conditions. The use of compression appears to help in the recovery process after an intense heavy resistance training workout in men and women.

Tendon-to-bone healing is vital to the ultimate success of the various surgical procedures performed to repair injured tendons. Achieving tendon-to-bone healing that is functionally and biologically similar to native anatomy can be challenging because of the limited regeneration capacity of the tendon-bone interface. Orthopaedic basic-science research strategies aiming to augment tendon-to-bone healing include the use of osteoinductive growth factors, platelet-rich plasma, gene therapy, enveloping the grafts with periosteum, osteoconductive materials, cell-based therapies, biodegradable scaffolds, and biomimetic patches. Low-intensity pulsed ultrasound and extracorporeal shockwave treatment may affect tendon-to-bone healing by means of mechanical forces that stimulate biological cascades at the insertion site. Application of various loading methods and immobilization times influence the stress forces acting on the recently repaired tendon-to-bone attachment, which eventually may change the biological dynamics of the interface. Other approaches, such as the use of coated sutures and interference screws, aim to deliver biological factors while achieving mechanical stability by means of various fixators. Controlled Level-I human trials are required to confirm the promising results from in vitro or animal research studies elucidating the mechanisms underlying tendon-to-bone healing and to translate these results into clinical practice.

The pivot shift test is a commonly used clinical examination by orthopedic surgeons to evaluate knee function following injury. However, the test can only be graded subjectively by the examiner. Therefore, the purpose of this study is to develop software for a computer tablet to quantify anterior translation of the lateral knee compartment during the pivot shift test. Based on the simple image analysis method, software for a computer tablet was developed with the following primary design constraint - the software should be easy to use in a clinical setting and it should not slow down an outpatient visit. Translation of the lateral compartment of the intact knee was 2.0 ± 0.2 mm and for the anterior cruciate ligament-deficient knee was 8.9 ± 0.9 mm (p < 0.001). Intra-tester (ICC range = 0.913 to 0.999) and inter-tester (ICC = 0.949) reliability were excellent for the repeatability assessments. Overall, the average percent error of measuring simulated translation of the lateral knee compartment with the tablet parallel to the monitor increased from 2.8% at 50 cm distance to 7.7% at 200 cm. Deviation from the parallel position of the tablet did not have a significant effect until a tablet angle of 45°. Average percent error during anterior translation of the lateral knee compartment of 6mm was 2.2% compared to 6.2% for 2 mm of translation. The software provides reliable, objective, and quantitative data on translation of the lateral knee compartment during the pivot shift test and meets the design constraints posed by the clinical setting.

Case-Control study, Level III.

No abstract

Background:The Segond fracture is an avulsion-type fracture located on the anterolateral aspect of the tibia associated with a ligament recently termed the anterolateral ligament. This injury has been described as pathognomonic for an anterior cruciate ligament (ACL) tear and is associated with a higher grade pivot shift.Purpose:To present and report 2-year clinical outcomes of a surgical technique for acute ACL reconstruction with fixation of a concomitant Segond fracture.Study Design:Case series; Level of evidence, 4.Methods:A retrospective chart review was performed of patients who underwent acute reconstruction for a complete ACL tear with concomitant Segond fracture fixation between January 2010 and December 2014; surgery was performed by a single surgeon. Patients underwent direct Segond fracture repair by either suture alone, suture anchor, or cannulated screw fixation based on the size of the lesion, followed by a 2-incision hamstring autograft intra-articular reconstruction. Pre- and postoperative KT-1000 arthrometer assessment, Lachman test, and pivot-shift test were performed, and patients were administered validated subjective outcome surveys.Results:Twelve patients met inclusion criteria for this review. The measured pre- and postoperative objective and subjective scores were significantly improved in all patients. Side-to-side anterior laxity was significantly improved in all patients based on Lachman and KT-1000 arthrometer testing. A significant pivot shift demonstrated preoperatively (3+, n = 11 [92%]; 2+, n = 1 [8%]) was corrected after fixation, except in 1 patient (8%), who maintained a 1+ pivot shift. Lysholm, Tegner, and International Knee Documentation Committee subjective and objective scores were significantly improved. At a minimum 2-year follow-up, no patients reported rerupture, and only 1 patient (8%) underwent a subsequent procedure (a meniscectomy). No major or minor complications were reported, and all patients returned to their previous activity levels at a mean of 6 months postoperatively.Conclusion:Direct repair of the Segond fracture and plication of the anterolateral capsule in patients with an ACL rupture and a high-grade pivot shift demonstrate good clinical outcomes, restoration of rotational stability, and maintenance of knee range of motion at 2 years postoperatively, with no major complications.