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A prospective study was designed to provide 5-year fol lowup of the treatment of isolated grade I I I sprains of the medial collateral ligament with early functional rehabili tation in 35 athletes. After injury, patients were placed in lateral hinged braces to provide valgus support with out restricting flexion or extension of the knee. Treat ment was initiated with range of motion exercises per formed in a whirlpool or swimming pool. Patients were then started on quadriceps setting and leg raises. When 90° of flexion was present, resistive exercises were added. Upon recovery, patients were allowed to return to unrestricted sports. Followup consisted of both ques tionnaires and physical examination and was graded on the 50-point Hospital for Special Surgery scale. Mean followup was 5.3 years (range, 2.5 to 8); mean Hospital for Special Surgery knee rating score was 45.9 points (range, 41 to 50). These results are comparable with those achieved with surgery or immobilization by earlier investigators. Thus, early functional rehabilitation treat ment of complete medial collateral ligament sprains pro duces results comparable with those achieved with sur gery or immobilization while minimizing treatment- related morbidity and allowing more rapid return to sports participation.

We compared the reproducibility of measurements made with the Genucom knee analysis system using two methods of restraint. The first method was that sug gested by the manufacturer and consisted of clamping the thigh to the examination chair with 70 N of vertical force and 110 N of mediolateral force and used a single elastic strap to secure the electrogoniometer cuff to the leg. In the second, or enhanced, method, the vertical and mediolateral clamping forces were each increased to 156 N, and an additional strap was used to secure the cuff to the leg. Tests performed were the anteroposte rior stress tests at 20° and 90° of knee flexion, and the varus-valgus stress test, the internal-external rotation stress test, and the medial and lateral pivot shift tests at 20°. Five normal subjects were installed and tested on 6 different days with the manufacturer's suggested se curing method and on 12 different days with the en hanced securing method. The enhanced method of re straint resulted in significantly reduced day-to-day variance for all tests performed except the varus-valgus stress test.