Search

Focuses on the accuracy of clinical knee examinations among patients with arthroscopically documented knee injuries. Patient characteristics; Experimental procedure; Missed observance for chondromalacia and loose bodies; Study limitations.

Background: Glenoid labral tears provide a diagnostic challenge. Hypothesis: Combinations of items in the patient history and physical examination will provide stronger diagnostic accuracy to suggest the presence or absence of glenoid labral tear than will individual items. Study Design: Cohort study (diagnosis); Level of evidence, 1. Methods: History and examination findings in patients with shoulder pain (N = 55) were compared with arthroscopic findings to determine diagnostic accuracy and intertester reliability. Results: The intertester reliability of the crank, anterior slide, and active compression tests was 0.20 to 0.24. A combined history of popping or catching and positive crank or anterior slide results yielded specificities of 0.91 and 1.00 and positive likelihood ratios of 3.0 and infinity, respectively. A positive anterior slide result combined with either a positive active compression or crank result yielded specificities of 0.91 and positive likelihood ratio of 2.75 and 3.75, respectively. Requiring only a single positive finding in the combination of popping or catching and the anterior slide or crank yielded sensitivities o 0.82 and 0.89 and negative likelihood ratios of 0.31 and 0.33, respectively. Conclusion: The diagnostic accuracy of individual tests in previous studies is quite variable, which may be explained in part by the modest reliability of these tests. The combination of popping or catching with a positive crank or anterior slide result or a positive anterior slide result with a positive active compression or crank test result suggests the presence of a labral tear. The combined absence of popping or catching and a negative anterior slide or crank result suggests the absence of a labral tear. [ABSTRACT FROM AUTHOR]

Background: Arthroscopic debridement is the standard of care for the treatment of acetabular labral tears. The Short Form-36 has not been used to measure hip arthroscopy outcomes, and the impact of disability status on hip arthroscopy outcomes has not been reported. Hypothesis: Short Form-36 subscale scores will demonstrate good correlation with the modified Harris hip score, but patients undergoing disability evaluation will have significantly worse outcome scores. Study Design: Case series; Level of evidence, 4. Methods: The records of active-duty soldiers who underwent hip arthroscopy at the authors' institution were retrospectively reviewed. Forty consecutive patients who underwent hip arthroscopy for the primary indication of labral tear formed the basis of the study group. Patients completed the modified Harris hip score, the Short Form-36 general health survey, and a subjec- tive overall satisfaction questionnaire. Results: Thirty-three patients, with a mean age of 34.6 years, were available for follow-up at a mean of 25.7 months postoper- atively. Fourteen (43%) patients were undergoing medical evaluation boards (military equivalent of workers' compensation or disability claim). Pearson correlation coefficients for comparing the Short Form-36 Bodily Pain, Physical Function, and Physical Component subscale scores to the modified Harris hip score were 0.73, 0.71, and 0.85, respectively (P < .001). The mean mod- ified Harris hip score was significantly lower in patients on disability status than in those who were not (92.4 vs 61.1; P < .0001). The Short Form-36 subscale scores were significantly lower in disability patients (P < .02). Patient-reported satisfaction rates (70% overall) were 50% for those undergoing disability evaluations and 84% for those who were not (P c .04). There was no sig- nificant difference in outcomes based on patient age, surgically proven chondromalacia, or gender for military evaluation board status. Conclusion: The Short Form-36 demonstrated good correlation with the modified Harris hip score for measuring outcomes after arthroscopic partial limbectomy. Arthroscopic debridement yielded a high percentage of good results when patients undergoing disability evaluations were excluded. Disability status may be a negative predictor of success after hip arthroscopy. [ABSTRACT FROM AUTHOR]

Presents a study which determined whether braiding hamstring tendons favorably increases graft strength and stiffness compared with unbraided four-strand hamstring tendon and bone-patellar tendon-bone grafts. Review of related studies; Materials and methods; Results and discussion.