The free synovial graft as a shield for collagen ingrowth in cruciate ligament repair.

The anterior cruciate ligament (ACL) was excised bilaterally in the knee joint of three dogs and was replaced in a conventional manner with a composite polyglycolic acid (PGA) and Dacron braided ligament prosthesis. In one knee of each dog, the ligaments were wrapped with a free synovial graft taken from the suprapatellar pouch in an attempt to keep the prosthesis extrasynovial, while the ligaments in the opposite three knees were left uncovered and thus directly exposed to synovial fluid. The dogs were killed at approximately one year postoperation, and microscopic sections of all ligaments were taken. The three knees with the synovial sheath showed a significantly greater bulk of fibrous tissue along the ligament scaffold grossly and a greater abundance of collagen producing cells microscopically, compared to the unwrapped ligaments. The gross and microscopic findings were identical in each of the three knees with the covered ligaments and were equally consistent in the three that had been left unprotected from the synovial fluid. These findings suggest that a free synovial graft may simulate the normal protective role of the synovial membrane and allow and/or induce collagen ingrowth in synthetic or autogeneic tissue stints for the repair of acute cruciate ligament tears.

Offensive Lineman's Thumb.

In brief: An unusual blocking technique caused dislocation of the metacarpophalangeal joints of the thumbs of both a college and a high school football offensive lineman. They were attempting to use their thumbs for additional leverage in obtaining a better mechanical advantage over their opponents. As the rule stands this may be a legal technique, but the authors advise a rule change or clarification to discourage its use.

The measured effect of taping on combined foot and ankle motion before and after exercise.

The Inman ankle machine was modified to determine plantarflexion, dorsiflexion, inversion neutral, eversion neutral, plantarflexion inversion, and plantarflexion eversion before taping, immediately after taping, and with tape after a 2.5- to 3-hour football practice. The previously uninjured feet and ankles of 16 college-age football players were used. All were tape by the same method. A single-tailed paired-sample t-test was done to determine the minimun amount of restriction that could be expected for each motion after the exercise period. Ninety percent confidence intervals between untaped versus taped preexercise, untaped versus taped postexercise for all motions were determined. Inversion neutral, plantarflexion inversion, and eversion neutral had an average residual restriction after exercise of 50%, or greater than the initial restriction prior to exercise. plantarflexion, dorsiflexion, and plantarflexion eversion loosened significantly greater than 50%.

Chondroma within the flexor hallucis longus tendon sheath. A case report and literature review.

Chondromas in tendon sheaths are a rare entity proviously reported in the flexor sheaths on the hand and possibly the foot. This is the first reported case of condroma of the flexor hallucis longus tendon sheath at the ankle region. A literature review with regard to pathogenesis, classification, and recurrence has been presented.