This study assessed the sensitivity of four different types of one-legged hop tests. The goal was to determine alterations in lower limb function in ACL deficient knees. Regression analyses were conducted between limb symmetry as measured by the hop tests and muscle strength, symptoms, and self-assessed function. In 67 patients, 50% had abnormal limb symmetry scores on a single hop test. When the results of two hop tests were calculated, the percent of abnormal scores increased to 62%. The percentage of normal scores indicated that these hop tests had a low sensitivity rate. However, the high specificity and low false-positive rates allow the tests to be used to confirm suspected defects in lower limb function. Statistical trends were noted between abnormal limb symmetry on the hop tests and low velocity quadriceps isokinetic test results.

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All injuries occurring over a 7-week period at a local indoor soccer arena were documented for analysis of incidence rates. All injury rates were calculated per 100 player-hours. The overall injury rates for male and female players were similar, 5.04 and 5.03, respectively. The lowest injury rate was found among the 19- to 24-year-old athletes and the highest injury rate was found among the oldest age group (> or = 25 years). Collision with another player was the most common activity at the time of injury, accounting for 31% of all injuries. The most common injury types were sprains and muscle contusions, both occurring at a rate of 1.1 injuries per 100 player-hours. Male players suffered a significantly higher rate of ankle ligament injuries compared with female players (1.24 versus 0.43, P < 0.05), while female players suffered a significantly higher rate of knee ligament injuries (0.87 versus 0.29, P < 0.01). Goalkeepers had injury rates (4.2) similar to players in nongoalkeeper positions (4.5).

The hypothesis proposed in this study was that the initiation of active and passive knee motion within 48 hours of major intraarticular knee ligament surgery would not have the deleterious effects of increasing knee effusion, hemarthrosis, periarticular soft tissue edema, and swelling. We conducted a prospective study with randomized assignment of 18 patients into two groups: 9 patients in the "motion" group began 10 hours of daily continuous passive motion (CPM) on the 2nd postoperative day, while the remaining 9 in the "delayed motion" group used a soft hinged knee brace with knee hinges locked at 10 degrees of flexion and entered into the motion program on the 7th postoperative day. All knees were allowed full 0 degrees to 90 degrees of motion except for a total of seven knees with concomitant mensicus repairs and extraarticular reconstructions where 20 degrees to 90 degrees of motion was allowed, limiting the last 20 degrees of knee extension for the first 4 postoperative weeks to protect the repair. In all other respects, the rehabilitation program after surgery was the same for the two groups, including postoperative compression dressings, exercises, and weight-bearing status. Ten of the eighteen patients had acute ACL disruptions and 8 had chronic ACL insufficiencies. There was an even distribution of acute and chronic knee cases and of open and arthroscopic ligament procedures in the early and delayed motion groups. Associated surgery included four meniscus repairs, three medial collateral ligament repairs, and one lateral collateral ligament repair. Special suturing and fixation techniques were used at surgery to maintain the integrity of ligament and meniscus structures, allowing the surgeon to feel safe in subjecting the joint to early postoperative motion. The objective parameters measured were KT-1000 arthrometer measurements, Cybex isokinetic testing, girth measurements at four lower limb locations, range of motion goniometer measurements, postoperative pain medications, and days of hospitalization. Starting intermittent passive motion on the 2nd postoperative day did not increase joint effusion, hemarthrosis, or soft tissue swelling. In both motion groups, postoperative joint effusions were absent after the 14th postoperative day. There was no statistically significant difference in knee extension or flexion limits, pain medication used, or hospital stay in comparing the two knee motion programs. An important finding of this study was the significant decreases in thigh circumference that occurred within the first few weeks of surgery, which progressed despite a closely supervised inpatient and outpatient rehabilitation program.(ABSTRACT TRUNCATED AT 400 WORDS)

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, PT, A T C~ atients with patellofemoral pain symptoms remain one of the most vexatious clinical challenges in rehabilitative medicine despite thc. recent advancements in the understanding and treatment of other knee conditions. Dve (21) has referred to this clinical conundrum as the "Black Hole of Orthopaedics," stating that no single explanation o r therapeutic approach has yet fully clarified this problem. This lack of understanding of patellofemoral pain and dysfunction is reflected in the vast number of different surgical procedures devised for the patellofemoral joint ( 2 2 ) .Patellofemoral disorders are prohablv the most common knee pathology encountered bv the orthopaedic and sports medicine clinician. Several studies (31,63,98,110,121,123, 124) have demonstrated that patellofemoral pain is one of the most common clinical conditions presenting to clinicians who treat musculoskeletal conditions. Unfortunately, there appears to be no consensus in the management of these conditions. There are certainly many reasons for this vacuousness of information, but perhaps one of the reasons is because of the manv subtle variations of "patellofemoral pain." Additionally, central to the development of a ratio- Patellofemoral disorders are among the most common clinical conditions managed in the orthopaedic and sports medicine setting. Nonoperative intervention is typicallv the initial form of treatment for patellofemoral disorders; however, there is no consensus on the most effective method of treatment. Although numerous treatment options exist for patellofemoral patients, the indications and contraindications of each approach have not been well established. Additionallv, there is no generallv accepted classification scheme for patellofemoral disorders. In this paper, we will discuss a classification svstem to be used as the foundation for developing treatment strategies and interventions in the nonsurgical

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Among 7,785 patients examined with knee problems, 370 were diagnosed with patellofemoral pain syndromes. Examination and treatment were performed using a systematic approach. The patients were placed on a conservative program consisting of a four-stage progression, with the goal of relieving symptoms and returning to full activity. The results of this approach showed that 77% recovered. to a satisfactory level and 23% were unsatisfactory and underwent surgical procedures. J Orthop Sports Phys Ther 1981;2(3):108-116.