The majority of previous studies on partial ruptures of the anterior cruciate ligament (ACL) include a relatively large proportion of knees with associated intra-articular injury or collateral ligament tear that contributes to an increase in the symptoms of instability and further deterioration of knee function. In the present study only patients with isolated, partial ruptures of the ACL were evaluated. Fifty-six patients with one injured knee were examined after a median of 5.3 (range 2.0-12.7) years using the IKDC evaluation form, Lysholm knee function score and Tegner activity score. Of the 56 knees, 6 underwent autologous reconstruction due to early progression to complete rupture. Of 34 knees evaluated for laxity, 25 had a negative Lachman test and 7 a positive (+) Lachman. In 2 knees a Lachman ++ result and a positive pivot shift were found. With instrumented laxity testing 24 knees had 2 mm or less difference in laxity compared with the contralateral uninjured knee. The largest side-to-side difference in knee laxity was 4.5 mm. Lysholm score was median 86 (range 52-100) points, and 62% had good or excellent knee function. A significant decline in activity was seen. Only 10 patients (30%) resumed their preinjury activities. We find that the majority of patients with an isolated, partial rupture of the ACL have an acceptable knee function and a stable knee after a median 5 years follow-up. There is, however, a marked reduction in activity.
One hundred and thirty-two consecutive soccer players (117 males and 15 females, median age 23, range 16-39 years) underwent primary reconstruction of the anterior cruciate ligament (ACL) with an iliotibial band (ITB) autograft. All patients were followed prospectively for a minimum of 2 years. One hundred and eighteen patients (89%) attended an independent observer follow-up after a median of 47 (24-92) months. The time before participating in soccer was a median of 7 (5-24) months. At a median of 4 years, 80 (68%) were still active soccer players, while 38 had changed activity to a lower level. Twenty-five gave up soccer playing for reasons unrelated to the knee, and 13 (11%) gave up due to problems from the reconstructed knee. The Lysholm score improved from a median of 82 (range 42-99, mean [SD] 80.5 [+/-11.9]) points prior to the operation to a median of 99 (range 57-100, mean [SD] 94.6 [+/-8.5]) at follow-up. The Tegner score improved from a median of 3.5 (0-7) preoperatively to 9 (1-10). Four patients (3%) sustained a rupture of the graft: three ruptures occurred among the 15 females (20%), and one was seen among the 117 males (0.8%) (P=0.01). Eight per cent had predominantly minor cosmetic complaints from the donor-site hernia, while 51% had temporary discomfort from the staples used for graft fixation. Using the ITB autograft for ACL reconstruction, we found excellent and good results in soccer players with ACL deficiency and high demands for optimal knee function. The failure rate in general was comparable with other methods, and the majority was still active in soccer sports at a median of 4 years after surgery. An unacceptably high rerupture rate was registered in female players.
This study was designed to evaluate the injuries in indoor and in beach volleyball, and to compare the injury pattern in the two different types of volleyball. Injuries in 295 volleyball players were recorded during the beach volleyball season 1993 and during the following indoor volleyball season 1993 to 1994. The method of enquiry was two identical questionnaires. Equal numbers of men and women, elite and recreational players were represented. In beach volleyball 24 injuries were reported and 286 in indoor volleyball, representing an incidence of 4.9 injuries per 1000 volleyball hours in beach volleyball and 4.2 in indoor volleyball. The most frequent injuries were acute injuries located in the ankle and finger and overuse injuries in the knee and shoulder. The injury pattern was different in indoor and in beach volleyball. In beach volleyball most injuries occurred in field defence and in spiking, with overuse injuries in the shoulder as the major site. In indoor volleyball most injuries occurred during blocking and spiking, resulting most frequently in acute finger and ankle injuries, respectively.
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