LONG-TERM OUTCOME AFTER ARTHROSCOPIC MENISCAL REPAIR VERSUS ARTHROSCOPIC PARTIAL MENISCECTOMY FOR TRAUMATIC MENISCAL TEARS. Stien T, Mehling AP et al. American Journal of Sports Medicine 2010;38:1542-1548 (published online before print June 15, 2010)

Eighty-one patients with an arthroscopic meniscus shape– preserving surgery after isolated traumatic medial meniscal tear (repair: n = 42; meniscectomy: n = 39) were examined clinically (Lysholm score, Tegner score) and radiologically (Fairbank score, compared with the uninjured knee). The follow-up was

divided into midterm (3.4 years; n = 35) and long term (8.8 years; n = 46). Additionally, the influences of the preoperative sports activity level and age at surgery were evaluated. In the long-term follow-up, no osteoarthritic progress was detectable in 80.8% after repair compared with 40.0% after meniscectomy with significant benefit for the “young” subgroup.

TREATMENT OF BICEPS TENDON LESIONS IN THE SETTING OF ROTATOR CUFF TEARS PROSPECTIVE COHORT STUDY OF TENOTOMY VERSUS TENODESIS. Koh KH, Ahn JH et al. American Journal of Sports Medicine 2010;38:1584-1590 (published online before print June 15, 2010)

Ninety patients (age, >55

years) with a rotator cuff tear and biceps tendon lesion (tear more than 30%, subluxation or dislocation, or degenerative superior labrum anterior to posterior lesion type II) were evaluated prospectively. The first 45 patients treated consecutively underwent biceps tenodesis, and the next 45 underwent biceps tenotomy. Postoperatively, patient evaluations were conducted with a focus on (1) “Popeye” deformity, (2) arm cramping pain, and (3) elbow flexion powers (measured with a hand dynamometer). Overall shoulder function was assessed with the American Shoulder and Elbow Surgeons (ASES) score and the Constant score. At final follow-up, 43 in the tenodesis and 41 in the tenotomy groups were available for evaluation. There was no difference between

groups in demographic data such as age, sex, dominant arm, and the time from symptom to surgery and in preoperative ASES score, Constant score, and rotator cuff tear size. A Popeye deformity occurred in 4 (9%) in the tenodesis group and in 11 (27%) in the tenotomy group. Mild cramping pain was observed in 2 in the tenodesis group and 4 in the tenotomy group. Mean elbow flexor power ratio (vs the contralateral side) showed no difference between the 2 groups, The ASES and Constant scores were improved in both groups.

sportEX comment Another obvious one really. If you tether the end of the tendon to the bone there is more likelihood of it regaining function and appearance.

The preinjury activity level was obtained in 96.2% after repair compared with 50% after meniscectomy. The function score revealed no significant difference between these strategies. The athletes showed a significantly reduced loss of sports activity after repair compared with the athletes after meniscectomy.

sportEX comment This should be obvious really. Fix it or chop bits out. The result here is that the fix approach is better especially in the all important category of return-to-sport.

IMMEDIATE EFFECT AND PREDICTORS OF EFFECTIVENESS OF TAPING FOR PATELLOFEMORAL PAIN SYNDROME: A PROSPECTIVE COHORT

STUDY. Lan TY, Lin WP, et al.

American Journal of Sports Medicine 2010;38:1626-1630 (published online before print May 26)

LONG-TERM FOLLOW-UP OF 24.5 YEARS AFTER INTRA-ARTICULAR ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION WITH LATERAL EXTRA-ARTICULAR AUGMENTATION Pernin J,Verdonk P, et al. American Journal of Sports Medicine 2010;38:1094-1102 (published online before print March 19, 2010)

One hundred of 148 patients reviewed at 11.5 years of follow-up could be reviewed at

24.5 years. Complete clinical and radiographic evaluation (International Knee Documentation Committee scale and Knee Injury and Osteoarthritis Outcome Score) was performed. The radiographic International Knee Documentation Committee rating was as follows: grade A, 39%; grade B, 7%; grade C, 27%; and grade D, 27%. Onset of osteoarthritis was correlated with medial meniscal status and femoral chondral defects at time of surgery.

sportEX comment The overall conclusion was that total medial meniscectomy and articular cartilage

damage were risk factors for osteoarthritis. Like much of the research quoted in this edition this seems obvious but it is nice to have proof. The athletes we are getting back to sport now will eventually pay a medical price.

A total of 118 consecutive patients with patellofemoral pain syndrome were recruited; 100 of them completed this study. Patient sex, age, body mass index, Q angle, lateral patellar displacement, and lateral patellofemoral angle were recorded/measured. One therapist applied adhesive tape to each patient using the McConnell method. Patients scored their pain level on a 100 mm visual analog scale during stepping down from an 8 inch platform, before and after taping. Patients with a visual analog scale score decrease of 20 mm or more after taping were considered responsive, and the others were considered nonresponsive. The overall mean visual analog scale score decreased significantly after taping. There were 66 patients in the responsive group and 34 in nonresponsive group. Among the factors, body mass index, lateral patellofemoral angle, and Q angle were significant predictors of effectiveness. The responsive group had significantly smaller mean lateral patellofemoral angle, larger mean Q angle, and larger mean pre-taping visual analog scale score than the nonresponsive group.

sportEX comment Taping was an effective treatment

for patellofemoral pain syndrome, but you need to select the patients. It was less effective in those with higher body mass index, larger lateral patellofemoral angle, and smaller Q angle.

4 sportEX medicine 2010:46(Oct):3-5