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Igor Setuain, Mikel Izquierdo, Fernando Idoate, Eder Bikandi, Esteban M. Gorostiaga, Per Aagaard, Eduardo L. Cadore and Jesús Alfaro-Adrián

Context:

The muscular function restoration related to the type of physical rehabilitation followed after anterior cruciate ligament reconstruction (ACLR) using autologous hamstring tendon graft in terms of strength and cross-sectional area (CSA) remain controversial.

Objective:

To analyze the CSA and force output of quadriceps and hamstring muscles in subjects following either an Objective Criteria-Based Rehabilitation (OCBR) algorithm or the usual care (UCR) for ACL rehabilitation in Spain, before and 1 year after undergoing an ACLR.

Design:

Longitudinal clinical double-blinded randomized controlled trial.

Setting:

Sports-medicine research center.

Patients:

40 recreational athletes (30 male, 10 female [24 ± 6.9 y, 176.55 ± 6.6 cm, 73.58 ± 12.3 kg]).

Intervention:

Both groups conducted differentiated rehabilitation procedures after ACLR. Those belonging to OCBR group were guided in their recovery according to the current evidence-based principles. UCR group followed the national conventional approach for ACL rehabilitation.

Main Outcome Measures:

Concentric isokinetic knee joint flexor-extension torque assessments at 180°/s and Magnetic Resonance Imaging (MRI) evaluations were performed before and 12 months after ACLR. Anatomical muscle CSA (mm2) was assessed, in Quadriceps, Biceps femoris, Semitendinous, Semimembranosus, and Gracilis muscles at 50% and 70% femur length.

Results:

Reduced muscle CSA was observed in both treatment groups for Semitendinosus and Gracilis 1 year after ACLR. At 1-year follow-up, subjects allocated to the OCBR demonstrated greater knee flexor and extensor peak torque values in their reconstructed limbs in comparison with patients treated by UCR.

Conclusions:

Objective atrophy of Semitendinosus and Gracilis muscles related to surgical ACLR was found to persist in both rehabilitation groups. However, OCBR after ACLR lead to substantial gains on maximal knee flexor strength and ensured more symmetrical anterior-posterior laxity levels at the knee joint.

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Zong-Ming Li, Shouchen Dun, Daniel A. Harkness and Teresa L. Brininger

The purpose of the current study was to examine motion enslaving characteristics of multiple fingers during isolated flexion of the distal interphalangeal joints. Because the distal interphalangeal joints are flexed by multiple tendons of the single flexor digitorum profundus, the current experimental design provided a unique advantage to understand inter-finger enslaving effects due to the flexor digitorum profundus. Eight subjects were instructed to flex the distal inter-phalangeal joint of each individual finger from the fully extended position to the fully flexed position as quickly as possible. Maximal angular displacements, velocities, or accelerations of individual fingers were used to calculate the enslaving effects. An independence index, defined as the ratio of the maximal displacement of a master finger to the sum of the maximal displacements of the master and slave fingers, was used to quantify relative independence of each finger. The angular displacements of the index, middle, ring, and little fingers were 68.6° (±7.7), 68.1° (±10.1), 68.1° (±9.7), and 74.7° (±13.3), respectively. The motion of a master finger was invariably accompanied by motion of 1 or 2 slave fingers. Angular displacements of master and slave fingers increased to maximum values with time monotonically. Velocity curves demonstrated bell-shaped profile, and the acceleration curves were sinusoidal. Enslaving effects were generated mainly on the neighboring fingers. The amount of enslaving on the middle and ring fingers exceeded more than 60% of their own maximum angular displacements when a single adjacent finger moved. The index finger had the highest level of independence as indicated by the lowest enslaving effects on other fingers or by other fingers. The independence indices of the index, middle, ring, and little fingers were 0.812 (±0.070), 0.530 (±0.051), 0.479 (±0.099), and 0.606 (±0.148), respectively. In all tasks, motion of slave fingers always lagged with respect to the master finger. Time delays, on average, ranged from 7.8 (±5.0) to 35.9 (±22.1) ms. Our results suggest that there exist relatively large enslaving effects among the compartments of the flexor digitorum profundus, and functional independence of fingers in daily activities is likely enhanced through synergistic activities of multiple muscles, including flexors and extensors.

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. previous knee surgery 10. In this case, the three patients were treated with PRT at these two sites: a. patella tendon and psoas muscle b. patella tendon and quadriceps muscle c. patella tendon and quadriceps tendon d. psoas muscle and quadriceps tendon 11. Discharge criteria for these patients included

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Lucas C. Bianco, James M. May, Smokey L. Fermin, Robert Oates and Scott W. Cheatham

patient outcomes related to function and pain. Persistent pain in the anterior aspect of the knee is commonly associated with patella tendinopathy. 1 – 3 Patella tendinopathy includes conditions involving the patella tendon on the inferior pole of the patella and is commonly associated with inflammation

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Jan Wilke, Kristin Kalo, Daniel Niederer, Lutz Vogt and Winfried Banzer

Kim et al 8 , 9 observed that the plantar aponeurosis and the Achilles tendon merge strongly in younger persons, while the degree of morphological continuity ceases or even completely disappears in older persons. If, thus, a mechanical force transmission represents the decisive factor of nonlocal

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Paula Chaves, Daniela Simões, Maria Paço, Sandra Silva, Francisco Pinho, José Alberto Duarte and Fernando Ribeiro

Patellar tendinopathy, also known as jumper’s knee, is a condition associated with load demands and excessive use of the patellar tendon, which results in a pathologic cascade of events including neovascularization, nerve ingrowth, tendon degeneration, and, ultimately, a painful tendon. 1 – 3

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Yuya Ueda, Takehiko Matsushita, Yohei Shibata, Kohei Takiguchi, Akihiro Kida, Daisuke Araki, Noriyuki Kanzaki, Yuichi Hoshino, Rei Ono, Yoshitada Sakai and Ryosuke Kuroda

remain unclear. Eitzen et al 15 found that at least 80% preoperative quadriceps strength was necessary to achieve a good postoperative quadriceps strength recovery and self-reported function at 2 years after ACL reconstruction with bone–patellar tendon–bone (BPTB) autograft. Ueda et al 16 have reported

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Gulcan Harput, Volga B. Tunay and Matthew P. Ithurburn

and physical therapy at our clinic. Inclusion criteria for the study included (1) unilateral arthroscopic ACLR with hamstring tendon or bone–patellar–tendon–bone grafts, (2) age between 16 and 35 years, (3) noncontact injury mechanism, (4) preinjury Tegner score ≥5, and (5) regularly continued the

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Hio Teng Leong and Siu Ngor Fu

partial or complete tears that is related to RC tendons and associated tissues such as long head of the biceps tendinopathy, subacromial bursitis, and shoulder impingement syndrome. 2 Clinical symptoms include pain, weakness, and disability during arm elevation, and affects health and quality of life by

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Niranjan Chakrabhavi and Varadhan SKM

effect of finger interdependence is primarily associated with mechanical and neural mechanisms related to the extrinsic muscles that are responsible for movement of finger phalanges: (1) mechanical coupling—the tendons connecting extrinsic muscle to neighboring fingers of the hand, mechanically shear