Abstract: ABSTRACT: BACKGROUND: Anterior cruciate ligament (ACL) injury or reconstruction can cause knee impairments and disability. Knee impairments are related to quadriceps performance - accelerated reaction time (ART) - and disability to performance of daily living activities which is assessed by questionnaires such as the Lysholm knee score. The purposes of this study were to investigate the effect of cross exercise, as supplementary rehabilitation to the early phase of ACL reconstruction: a) on quadriceps ART at the angles 45 degrees , 60 degrees and 90 degrees of knee flexion and, b) on the subjective scores of disability in ACL reconstructed patients. METHODS: 42 patients who underwent ACL reconstruction were randomly divided into 3 groups, two experimental and one control. All groups followed the same rehabilitation program. The experimental groups followed 8 weeks of cross eccentric exercise (CEE) on the uninjured knee; 3 d/w, and 5 d/w respectively.Quadriceps ART was measured at 45 degrees , 60 degrees and 90 degrees of knee flexion pre and nine weeks post-operatively using an isokinetic dynamometer. Patients also completed pre and post operatively the Lysholm questionnaire whereby subjective scores were recorded. RESULTS: Two factor ANOVA showed significant differences in ART at 90 degrees among the groups (F = 4.29, p = 0.02, p < 0.05). Post hoc Tukey HSD analysis determined that the significant results arose from the first experimental group in comparison to the control (D = -0.83, p = 0.01). No significant differences were revealed at 45 degrees and 60 degrees .Significant differences were also found in the Lysholm score among the groups (F = 4.75, p = 0.01, p < 0.05). Post hoc analysis determined that the above significant results arose from the first experimental group in comparison with the control (D = 7.5, p < 0.01) and from the second experimental in comparison with the control (D = 3.78, p = 0.03). CONCLUSION: CEE showed improvements on quadriceps ART at 90 degrees at a sequence of 3 d/w and in the Lysholm score at a sequence of 3 d/w and 5 d/w respectively on ACL reconstructed patients.
Abstract: OBJECTIVE: To investigate both prophylactic and therapeutic roles of salmon calcitonin on the articular cartilage of rabbit's knees. METHODS: Right knee instability was produced in 30 New Zealand white rabbits by sectioning the cranial cruciate ligament (CCL). Animals were separated into four groups: placebo prophylactic-stage group (n=6), killed 8 weeks post surgery, calcitonin prophylactic-stage group (n=6), treated immediately after surgery with salmon calcitonin and killed at 8 weeks, placebo therapeutic-stage group (n=9) killed at 16 weeks post surgery and calcitonin therapeutic-stage group (n=9), treated with salmon calcitonin from 8th to 16th week and killed at 16 weeks post surgery. A histomorphometric study was based on the morphological changes of the articular cartilage and subchondral bone (degeneration indexes), as well as the articular cartilage thickness, chondrocytes' arrangement and their metabolic activity (regeneration indexes). RESULTS: Calcitonin groups showed smoother articular surface, no or minimal signs of ulceration, smaller osteophytes, and less subchondral cystic formation than placebo groups. Normal distribution of chondrocytes or hypercellularity was noticed in areas of mild osteoarthritic (OA) changes in the calcitonin groups indicating regeneration activity. Periodic Acid Schiff's and Alcian blue staining were negative in the placebo groups while increased absorption in the calcitonin groups revealed high anabolic activity. CONCLUSIONS: In prophylactic stages salmon calcitonin seemed to inhibit the progression of osteoarthritis by increasing the layers of hyaline cartilage, restoring the cellular metabolism, and decreasing the volume of osteophytes. In therapeutic stages, the hormone had a healing effect by decreasing the subchondral cysts, regenerating the hyaline cartilage and restoring cellular metabolism. Both macroscopic and histological findings of this study supported the biochemical results of previous studies showing the therapeutic effect of calcitonin on osteoarthritis.
Abstract: Complete dislocation of the talus is an extremely rare injury. We report on a case that was treated according to a surgical technique described by Günal et al. According to this technique, a pseudarthrosis is created between the tibia and the calcaneus by transposing and fixing the medial malleolus laterally and displacing the entire foot anteriorly. The result was considered to be initially unsatisfactory. At the 2-year follow-up examination, the outcome was considered to be satisfactory. This was attributed to preservation of motion and stability in the new mortise.
