Measurement properties of the German version of the IKDC subjective knee form (IKDC-SKF).

PURPOSE: To examine the measurement properties of the German International Knee Documentation Committee Subjective Knee Form (IKDC-SKF) in knee disorder patients. METHODS: Three hundred twelve consecutive patients undergoing surgery for anterior cruciate ligament, meniscus and/or cartilage injuries completed the IKDC-SKF, Lysholm Score, Tegner Activity Scale, and Short Form-12 Health Survey before and 6 months post-surgery. IKDC-SKF measurement properties were calculated and patients were also asked to rate the relevance/comprehensibility of the questionnaire items. RESULTS: Reliability was good with high Cronbach's alpha and intraclass correlation coefficients, and standard error of measurement values of 4.4 to 6.0. The smallest detectable change (SDC) ranged from 12.3 to 16.7 points. Validity was good with 90% of all hypotheses confirmed. Confirmatory factor analysis did not show adequate fitting indices within the model. Over half of the items were rated as essential, and all were well comprehended. The majority of hypotheses for responsiveness were confirmed. No floor and ceiling effects were observed. The area under the curve ranged from 0.82 to 0.89 and the minimal important difference was smaller than the SDC. CONCLUSIONS: The German IKDC-SKF is a reliable outcome measure with good hypotheses testing and responsiveness, but its MIC and structural/content validity need further analysis.

Osteoarthritis in Football.

Football is currently the most popular sporting activity in the world. Multiple reports have shown that a high incidence of osteoarthritis is found in football players. Evidence clearly shows that traumatic injury significantly predisposes players for such pathophysiology. Injuries are frequent in amateur as well as professional football players, with knee and ankle accounting for the most severe injuries. Many professional athletes lose playing time due to injuries and many are forced into early retirement. Posttraumatic osteoarthritis is a common finding among ex-football players with numbers well above the normal population. Today's surgical techniques are advanced and capable of restoring the joint to a certain extent. However, a restitution ad integrum is reached only in very rare cases. Professional football players that return to play after serious injuries perform their extremely strenuous activity on morphologically compromised joints. Incomplete rehabilitation and pressure to return to play after an injurious event clearly put the athlete at an even higher risk for joint degeneration. Prevention strategies, improved surgical management, strict rehabilitation, as well as future aspects such as early suppression of inflammation, personalized medicine, and predictive genomics DNA profiling are needed to reduce incidence and improve the health perspectives of football players.

Frontal Tendon Lengthening Plasty for Treatment of Structural Patella Baja.

Patella baja is a severe complication seen after trauma, prolonged immobilization and surgery. Several surgical methods have been described to proximalize the patella without a change in the patella tendon length. Yet, patella tendon shortening and thickening can be regarded as the hallmark pathology. As such, we describe a technique for the lengthening of the patellar tendon to pathoconformly address underlying patella baja. The technique is reproducible and gives the possibility of an early postoperative mobilization to prevent re-baja-a typical complication after patella baja surgery.

Inside-Out Trans-Arthroscopic Drain Application During Knee Joint Arthroscopy.

Although knee joint arthroscopy is one of the most frequently performed surgical procedures worldwide, there is no consensus on how to apply a drain in the joint if it is decided to use one. Therefore we describe a simple technique to safely apply a drain intra-articularly under full arthroscopic control, avoiding placement of the drain through the arthroscopic portal.