Evaluation and treatment of acute and chronic injuries to the capsular ligaments of the knee.

Injury to the capsular ligaments of the knee commonly occurs in conjunction with cruciate ligament injury. An untreated grade III sprain can lead to recurrent meniscal injury, failure of cruciate ligament reconstruction, and arthrosis. Careful clinical examination is necessary to identify injuries to discrete ligaments and estimate the severity of injuries not discernable on imaging studies. A classification system of capsular injury is useful to link the diagnosis to a treatment algorithm. Anatomically based surgical procedures for acute and chronic sprains of the posteromedial, anterolateral, and posterolateral capsular structures have been proven in long-term outcome studies. The goal is to restore the anatomy by repair (for an acute sprain) or capsular shift (for a chronic sprain), rather than to substitute extra-articular tendon routing.

Outcome measurement in the treatment of extensor mechanism difficulties of the knee.

The authors' underlying philosophy is to use a standardized data package to collect information prospectively. This allows for the clinical evaluation and research of extensor mechanism disabilities. The use of a system of data management allows meaningful follow-up comparisons. Thus, one patient at a time, a surgeon's experience is documented.

Sudden Cardiac Arrest in Athletic Medicine.

OBJECTIVE: To emphasize the importance of decreasing the response time by a trained target responder to increase the survival rate among athletes experiencing sudden cardiac arrest at an athletic event. BACKGROUND: Death due to sudden cardiac arrest that is witnessed is preventable in many cases. However, most people who experience this condition die because of a prolonged response time from onset of the fatal arrhythmia to defibrillation by trained treatment providers. If athletic trainers or other members of the athletic care medical team are trained as target responders and equipped with automated electronic defibrillators, they can immediately treat an athlete who experiences a sudden, life-threatening tachyarrhythmia. This prompt response to the life-threatening emergency should result in a higher survival rate. DESCRIPTION: We review the causes of sudden cardiac arrest during athletic events, note some unusual clinical presentations, discuss improved methods of response and new equipment for treatment, and define the athletic trainer's role as a target responder trained to treat people experiencing sudden cardiac arrest at an athletic event. CLINICAL ADVANTAGES: An athletic care team willing to become part of an emergency response team can help improve the survival rate of athletes experiencing sudden cardiac arrest at an athletic event.