Effect Of Internal Rotation Research Articles

Immobilization in External Rotation Versus Internal Rotation After Primary Anterior Shoulder Dislocation

Background: The recurrence rate after primary anterior shoulder dislocation is high, especially in young, active individuals. Recent studies have suggested external rotation immobilization as a method to reduce the rate of recurrent shoulder dislocation in comparison to traditional sling immobilization. Purpose: To assess and summarize evidence from randomized controlled trials on the effect of internal rotation versus external rotation immobilization on the rate of recurrence after primary anterior shoulder dislocation. Study Design: Meta-analysis. Methods: PubMed, MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, and abstracts from recent proceedings were searched for eligible studies. Two reviewers selected studies for inclusion, assessed methodological quality, and extracted data. Results: Six randomized controlled trials (632 patients) were included in this review. Demographic and prognostic variables measured at baseline were similar in the pooled groups. The average age was 30.1 years in the pooled external rotation group and 30.3 years in the pooled internal rotation group. Two studies found that external rotation immobilization reduced the rate of recurrence after initial anterior shoulder dislocation compared with conventional internal rotation immobilization, whereas 4 studies failed to find a significant difference between the 2 groups. This meta-analysis suggested no overall significant difference in the rate of recurrence among patients treated with internal rotation versus external rotation immobilization (risk ratio, 0.69; 95% CI, 0.42-1.14; P = .15). There was no significant difference in the rate of compliance between internal and external rotation immobilization (P = .43). The Western Ontario Shoulder Instability Index scores were pooled across 3 studies, and there was no significant difference between the 2 groups (P = .54). Conclusion: Immobilization in external rotation is not significantly more effective in reducing the recurrence rate after primary anterior shoulder dislocation than immobilization in internal rotation. Additionally, this review suggests that there is minimal difference in patients’ perceptions of their health-related quality of life after immobilization in internal versus external rotation.

Uni-directional coupling between tibiofemoral frontal and axial plane rotation supports valgus collapse mechanism of ACL injury

Despite general agreement on the effects of knee valgus and internal tibial rotation on anterior cruciate ligament (ACL) loading, compelling debate persists on the interrelationship between these rotations and how they contribute to the multi-planar ACL injury mechanism. This study investigates coupling between knee valgus and internal tibial rotation and their effects on ACL strain as a quantifiable measure of injury risk. Nineteen instrumented cadaveric legs were imaged and tested under a range of knee valgus and internal tibial torques. Posterior tibial slope and the medial tibial depth, along with changes in tibiofemoral kinematics and ACL strain, were quantified. Valgus torque significantly increased knee valgus rotation and ACL strain (p<0.020), yet generated minimal coupled internal tibial rotation (p=0.537). Applied internal tibial torque significantly increased internal tibial rotation and ACL strain and generated significant coupled knee valgus rotation (p<0.001 for all comparisons). Similar knee valgus rotations (7.3° vs 7.4°) and ACL strain levels (4.4% vs 4.9%) were observed under 50Nm of valgus and 20Nm of internal tibial torques, respectively. Coupled knee valgus rotation under 20Nm of internal tibial torque was significantly correlated with internal tibial rotation, lateral and medial tibial slopes, and medial tibial depth (R2>0.30; p<0.020). These findings demonstrate uni-directional coupling between knee valgus and internal tibial rotation in a cadaveric model. Although both knee valgus and internal tibial torques contribute to increased ACL strain, knee valgus rotation has the ultimate impact on ACL strain regardless of loading mode.

High Axial Loads While Walking Increase Anterior Tibial Translation in Intact and Anterior Cruciate Ligament–Deficient Knees

To evaluate the effect of high axial loading (AL) on anterior tibial translation (ATT) according to the increase in knee flexion and the effect of valgus stress (VS) and internal rotation (IR) combined with high AL in intact and anterior cruciate ligament (ACL)-deficient knees according to the increase in knee flexion. We used 10 fresh-frozen, human cadaveric knees. Different loading conditions (134-N anterior drawer, 1,000-N AL, 10-Nm VS, and 5-Nm IR) were sequentially combined, and ATT was measured at 0°, 15°, 30°, 45°, and 60° of flexion in the intact and ACL-deficient knees. ATT increased significantly by adding high AL in intact knees (P= .001) and ACL-deficient knees (P< .0001) according to the change in flexion angle (P < .0001). Under high AL, ATT in the ACL-deficient knees was significantly larger than that in the intact knees for all loading conditions, and it also increased gradually according to the increase in knee flexion (P= .0001). ATT increased significantly after adding IR or VS with high AL in intact knees (VS, P= .002; VS/IR, P= .03) and ACL-deficient knees (VS, P= .0004) at some of the flexion angles. The added high AL increased ATT in intact and ACL-deficient knees from 0° to 60° of flexion. The effect of high AL on ATT became greater in ACL-deficient knees than in intact knees, and ATT also gradually increased according to the increase in knee flexion from 0° to 60°. In both the intact and ACL-deficient knees, ATT increased significantly after valgus stress or IR from 0° to 60°. ATT during weight bearing increases stress to the ACL, which worsens with valgus stress and/or IR forces. This finding should be considered when one is studying ACL injury mechanisms, as well as prescribing rehabilitation after ACL surgery.

Causes and calculated predictors of a Duchenne gait in adolescents and young adults with cerebral palsy

Adolescents with cerebral palsy often complain about a Duchenne gait, which increases the load on the spine, the energy consumption and therefore decreases gait efficiency. However the underlying causes of a Duchenne gait in patients with CP are not clearly researched yet. Nevertheless there is an assumption that excessive trunk lean might assist foot clearance to compensate for muscle weakness or contractures of the legs. In particular weakness, secondary to surgical soft tissue muscle tendon lengthening in childhood, might predispose patients to greater compensatory movements of the trunk. Therefore the aim of this study was to estimate the prevalence, underlying causes and calculated predictors for a Duchenne gait on CP patients with and without previous muscle tendon lengthening. 50 CP patients between 12 and 22 years with diplegia and GMFCS II (GMFCS: Gross Motor Function Classification System) participated in this study. 25 patients had no previous surgeries (CP-0). 25 patients had previous calf, hamstrings and/or adductor muscle tendon lengthening surgeries (CP-1). Data of 20 typically developed adolescents served as controls (TD). Gait was analysed using an instrumented gait analysis system (Vicon, Oxford, UK) The parameter "thorax obliquity range" (TOR) investigated the dimension of Duchenne gait. CP-0 showed a prevalence of 72 %, CP-1 of 66 % for Duchenne gait. TOR was 5 ± 2°, 16 ± 8° and 16 ± 8°, for TD, CP-0 and CP-1, respectively. CP-0 and CP-1 showed significant differences in TOR between TD (both p < 0.001), but not between CP-0 and CP-1 (p = 1.0). Passive hip abduction range of motion (ROM) showed no significant correlation to TOR in both groups, whereas hip abduction muscle strength revealed significant correlation (rs = - 0.37) in CP-0. Best gait predictors in CP-0 patients were increased hip generation work (stance = st) and ankle dorsi flexion (swing = sw), together explaining 47 % of the variance in TOR. In CP-1 best gait predictors were increased hip generation work (st) as well as reduced knee flexion (sw) and ankle generation work (st), explaining 31 % of the variance in TOR. With a prevalence of 66 % or higher Duchenne gait is a serious gait pathology in CP. Neither the hypothesis that previous muscle tendon lengthening nor that hip adductor contractures increase Duchenne gait could be confirmed in this study. Weak hip abductor muscle strength only showed a small correlation in CP-0. Best predictor in both groups was hip generation work (st). Certain hip abductors (M.gluteus medius ventral; M.gluteus minimus; M.tensor fasciae latae) function also as hip flexors and internal rotators. This leads to the hypothesis that during stance the Duchenne gait unloads the hip abductor muscles and therefore decreases the effect of internal rotation and hip flexion which leads to improved dynamic power of the hip for propulsion. In consequence the resultant hip extension moment increases by reducing the hip flexion moment. Presumably this is due to the fact that patients with CP show a reduced selective muscle control. For CP patients the negative effects of the common pelvis drop and internal rotation of the hip during gait decrease.

The effects of methyl internal rotation and (14)N quadrupole coupling in the microwave spectra of two conformers of N,N-diethylacetamide.

The gas phase structures and internal dynamics of N,N-diethylacetamide were determined with very high accuracy using a combination of molecular beam Fourier-transform microwave spectroscopy and quantum chemical calculations at high levels. Conformational studies yielded five stable conformers with C1 symmetry. The two most energetically favorable conformers, conformer I and II, could be found in the experimental spectrum. For both conformers, quadrupole hyperfine splittings of the (14)N nucleus and torsional fine splittings due to the internal rotation of the acetyl methyl group occurred in the same order of magnitude and were fully assigned. The rotational constants, centrifugal distortion constants as well as the quadrupole coupling constants of the (14)N nucleus were determined and fitted to experimental accuracy. The V3 potentials were found to be 517.04(13) cm(-1) and 619.48(91) cm(-1) for conformer I and II, respectively, and compared to the V3 potentials found in other acetamides. Highly accurate CCSD(T) and DMC calculations were carried out for calculating the barriers to internal rotation in comparison with the experimentally deduced V3 values.

The effect of hip rotation on shear elastic modulus of the medial and lateral hamstrings during stretching

Regarding hamstring stretching methods, many studies have investigated the effect of stretching duration or frequency on muscle stiffness. However, the most effective stretching positions for hamstrings are unclear because it is impossible to quantify muscle elongation directly and noninvasively in vivo. Recently, a new ultrasound technology, ultrasonic shear wave elastography, has permitted noninvasive and reliable measurement of muscle shear elastic modulus, which has a strong linear relationship to the amount of muscle elongation. This study aimed to investigate the effect of hip internal and external rotation on shear elastic modulus of the lateral and medial hamstrings, respectively, during stretching in vivo using ultrasonic shear wave elastography. Twenty-three healthy men (age, 23.0 ± 2.1 years) were recruited for this study. To investigate the effect of hip rotation on the elongation of the medial and lateral hamstrings, shear elastic modulus of the biceps femoris (BF) and semitendinosus (ST) was measured at rest (a supine position with 90° knee flexion, 90° hip flexion, and hip neutral rotation) and in seven stretching positions (with 45° knee flexion and hip internal, external, and neutral rotation) using ultrasonic shear wave elastography. In both BF and ST, the shear elastic modulus in the rest position was significantly lower than that in all stretching positions. However, no significant differences were seen among stretching positions. Our results suggest that adding hip rotation at a stretching position for the hamstrings may not have a significant effect on muscle elongation of the medial and lateral hamstrings.

Determination of thermodynamic parameters of C2–C3 nitroalkanes using anharmonic oscillator approximation and explicit treatment of internal rotation

Harmonic oscillator approximation is usually used to calculate the partition function for low frequency modes that represent hindered internal rotation. Nevertheless, employing of harmonic oscillator approximation may lead to significant errors when internal rotation of functional groups in molecules corresponds to hindered or free rotation. From the other hand anharmonic oscillator approximation should be used for the proper reproduction of the energies of excited vibrational states especially at high temperatures. Therefore, we carried out present theoretical study to reveal the effect of internal rotation and anharmonic oscillator approximation on thermodynamic parameters of nitroethane, 1- and 2-nitropropane.

THE INFLUENCE OF HIP JOINT CONTROL ON KNEE JOINT VALGUS MOMENT IN YOUNG FEMALE ELITE ATHLETES

BackgroundBiomechanical investigations of sports-specific movements may yield information on which measures could be most efficient for prevention of Anterior Cruciate Ligament (ACL) injuries. High knee valgus moments have been related...

Toward Accurate and Efficient Predictions of Entropy and Gibbs Free Energy of Adsorption of High Nitrogen Compounds on Carbonaceous Materials

The adsorption of high nitrogen compounds (HNCs) on the selected adsorption sites of carbonaceous materials from the gas phase has been investigated by ab initio quantum chemical methods at the density functional level applying both periodic and cluster approaches with M06-2X and BLYP functionals including dispersion forces (BLYP-D2). Among the possible structures of the adsorption complexes, the most stable systems possess nitrogen-containing heterocycles in a parallel orientation toward the modeled carbon surface. The adsorption enthalpies, calculated using the rigid rotor-harmonic oscillator approach (RRHO), were in good agreement with available experimental data. This approach was shown to provide sufficiently accurate adsorption enthalpies from the gas phase for the HNC–carbon systems. The vibrational, rotational, and translation contributions to the adsorption entropy were also analyzed by the approach extended beyond the RRHO scheme. The effects of anharmonic vibrations and internal rotations of th...

Fluorescence Properties of (E,E,E)-1,6-Di(n-naphthyl)-1,3,5-hexatriene (n= 1, 2): Effects of Internal Rotation

The fluorescence spectroscopic properties of (E,E,E)-1,6-di(n-naphthyl)-1,3,5-hexatrienes (1, n = 1; 2, n = 2) have been investigated in solution and in the solid state. In solution, the absorption maxima (λ(a)) of the lowest-energy band (1, 374 nm; 2, 376 nm in methylcyclohexane) were similar for 1 and 2, whereas the fluorescence maxima (λ(f)) (1, 545 nm; 2, 453 nm) and quantum yields (φ(f)) (1, 0.046; 2, 0.68) were very different regardless of the solvent polarity. The fluorescence spectrum of 1 was independent of the excitation wavelength (λ(ex)), whereas the spectrum of 2 was weakly λ(ex)-dependent. In the solid state, the spectroscopic properties of 1 and 2 were similar (λ(a) = 437-438 nm, λ(f) = 496-505 nm, φ(f) = 0.04-0.07). The origins of emission are both considered to be mainly monomeric. With the help of single-crystal X-ray structure analysis and ab initio quantum chemical calculation, we conclude that the red-shifted and weak emission of 1 in solution originates from a planar excited state having small charge transfer character, reached from a twisted Franck-Condon state by the excited-state geometrical relaxation accompanied by the internal rotation around the naphthalene (Ar)-CH single bond. The similar fluorescence properties of 1 and 2 in the solid state can be attributed to the restriction of the geometrical relaxation. The effects of the Ar-CH rotational isomerism on the fluorescence properties in solution, for 2 in particular, are also discussed.

The Effect of Isometric Shoulder Internal and External Rotation on the Acromiohumeral Distance

This study aimed to determine the effect of isometric internal and external rotation at various degrees of shoulder abduction on the acromiohumeral distance (AHD). This was a prospective study that used a within-subject repeated-measures design and randomization of independent variables. Data from 29 of 58 (40 women, 18 men) prospectively enrolled healthy subjects were used for analysis. A still ultrasound image of the right subacromial space was taken to measure the AHD for each of three contraction conditions (rest, isometric internal, and external rotation) at three shoulder positions (neutral and 30 and 45 degrees of abduction). Intrarater reliability ranged from 0.86 to 0.99. At 45 degrees of shoulder abduction, the AHD was significantly smaller with isometric external rotation when compared with no contraction (P = 0.0015) and with isometric internal rotation (P = 0.0002). The AHD was not affected by resistive isometric internal rotation of the shoulder, although it decreased with resistive isometric external rotation at 45 degrees of shoulder abduction. Resistive isometric shoulder external rotation in a position of abduction should be used with caution when the goal is to maintain the AHD. Further research is required to determine the effects of isometric contraction in patients with subacromial impingement syndrome.

Patellofemoral pain during step descents with and without fatigue-induced hip internal rotation

Abstract Weakness of hip external rotator muscles may cause excessive hip internal rotation during functional activity and it is associated with the development of patellofemoral pain (PFP). The aetiology of PFP is multifactorial in nature. Therefore, routine enrolment of patients into a hip-strengthening programme may not be effective and cost-effective. The present study examined the effect of fatigue-induced hip internal rotation during functional activity. Twenty subjects with PFP were asked to descend a step in barefoot before and after an isokinetic exercise protocol to induce muscle fatigue of hip external rotators. The hip motion was captured by eight high-speed cameras and analysed by a three-dimensional motion analysis system. The level of PFP during step descent and their usual PFP level were measured by validated instruments. Patients with PFP presented with more pronounced hip pathomechanics ( p p = 0.001) after muscle fatigue. The pain score after muscle fatigue during step descent better reflects the usual functional disturbance associated with PFP (r s = −0.655, p = 0.002). Physical examination with induced muscle fatigue may be helpful in clinical decisions on the management programme for patients with PFP, which are related to altered hip mechanics.

A code for analysis of the fine structure in near-rigid weakly-bonded open-shell complexes that consist of a diatomic radical in a [formula omitted] state and a closed-shell molecule

A code for analysis of the fine structure in near-rigid weakly-bonded open-shell complexes that consist of a diatomic radical in a [formula omitted] state and a closed-shell molecule

Unexpected structural and electronic effects of internal rotation in diruthenium paddlewheel complexes containing bulky carboxylate ligands

A series of Ru 2 II,III complexes containing the bulky carboxylate ligand 2,4,6-triisopropylbenzoate (TiPB) of type trans-[Ru 2(TiPB) 2(O 2CCH 3) 2X] [X = Cl ( 1), PF 6 ( 2)] and [Ru 2(TiPB) 4X] [X = Cl ( 3), PF 6 ( 4)] have been synthesised. The corresponding Ru 2 II,II complexes trans-[Ru 2(TiPB) 2(O 2CCH 3) 2] ( 5) and [Ru 2(TiPB) 4] ( 6) were also isolated. Magnetic susceptibility measurements indicate that the diruthenium cores have the expected three ( 1– 4) or two ( 5 and 6) unpaired electrons consistent with σ 2π 4δ 2(δ ∗π ∗) 3 and σ 2π 4δ 2δ ∗2π ∗2 electronic configurations. Compounds 1– 4 and 6 were structurally characterised by X-ray crystallography, and show the expected paddlewheel arrangement of carboxylate ligands around the diruthenium core. The diruthenium cores of complexes 3, 4 and 6 are all distorted to minimise steric interactions between the bulky carboxylate ligands. The Ru–Ru bond length in the Ru 2 II,II complex 6 [2.2425(6) Å] is the shortest observed for a diruthenium tetracarboxylate and, surprisingly, is 0.014 Å shorter than in the analogous Ru 2 II,III complex 4, despite an increase in the formal Ru–Ru bond order from 2.0 ( 6) to 2.5 ( 4). This is rationalised in terms of the extent of internal rotation, or distortion, about the diruthenium core. This was supported by density functional theory calculations on the model complexes [Ru 2(O 2CH) 4] and [Ru 2(O 2CH) 4] +, that demonstrate the relationship between Ru–Ru bond length and internal rotation. Electrochemical and electronic absorption data were recorded for all complexes in solution. Comparison of the data for the ‘ bis– bis’ ( 1, 2 and 5) and tetra-substituted ( 3, 4 and 6) complexes indicates that the shortening of the Ru–Ru bond length results in a small increase in energy of the near-degenerate δ ∗ and π ∗ orbitals.

Intramolecular Dynamics of RS−SR′ Systems (R, R′ = H, F, Cl, CH3, C2 H5): Torsional Potentials, Energy Levels, Partition Functions

The equilibrium and cis and trans geometric structures of a series of disulfides RS-SR' (HSSH, HSSF, HSSCl, HSSCH3, HSSC2H5, FSSF, ClSSCl, ClSSF, CH3SSCH3, C2H5SSC2H5) have been studied using both density functional theory (B3LYP/6-311++G(3df, 3pd)) and second-order Møller-Plesset perturbation theory (MP2(FU)/aug-cc-pVTZ). The effects of internal rotation on the structural parameters have been analyzed and the torsional potentials around the S-S bond have been compared with experimental and theoretical information, when available, as well as with the analogues of the peroxydic family. Torsional levels were calculated, and their distribution as a function of temperature was determined, obtaining partition functions. This information is of interest for statistical approaches to equilibrium properties and to rates of processes in which torsional anharmonicity is relevant. It is also required for recent atmospheric modeling studies and also for prototypical chiral separation experiments, in view of a possible dynamic mechanism for chirality exchange by molecular collisions. In general, barriers for such processes are higher than for the corresponding peroxides, and accordingly, rates for chirality change are estimated to be consistently smaller.

Gravitational field of a spinning sigma-model cosmic string

We study the effect of internal space rotation on the gravitational properties of infinite straight and stationary cosmic strings. From the approximate solution of Einstein equations for the spinning $Q$-lump string, we obtain long-range gravitational acceleration resembling that of a rotating massive cylindrical shell. We also compute the angular velocity of the inertial frame dragging and the angle of light deflection by the $Q$-lump string. Matter accretion onto spinning strings can play a role in galaxy formation when the angular velocity times the string width is comparable to the speed of light.

H ∕ D isotope effect of methyl internal rotation for acetaldehyde in ground state as calculated from a multicomponent molecular orbital method

We have analyzed the differences in the methyl internal rotation induced by the HD isotope effect for acetaldehyde (CH(3)CHO) and deuterated acetaldehyde (CD(3)CDO) in ground state by means of the multicomponent molecular orbital (MC_MO) method, which directly accounts for the quantum effects of protons and deuterons. The rotational constant of CH(3)CHO was in reasonable agreement with experimental one due to the adequate treatment of the protonic quantum effect by the MC_MO method. The C-D bond distances were about 0.007 A shorter than the C-H distances because of the effect of anharmonicity of the potential. The Mulliken population for CD(3) in CD(3)CDO is larger than that for CH(3) in CH(3)CHO because the distribution of wavefunctions for the deuterons was more localized than that for the protons. The barrier height obtained by the MC_MO method for CH(3)CHO was estimated as 401.4 cm(-1), which was in excellent agreement with the experimentally determined barrier height. We predicted the barrier height of CD(3)CDO as 392.5 cm(-1). We suggest that the internal rotation of the CD(3) group was more facile than that of the CH(3) group because the C-D bond distance was observed to be shorter than the C-H distance. Additionally the localized electrons surrounding the CD(3) group in CD(3)CDO caused the extent of hyperconjugation between the CD(3) and CDO groups to be smaller than that in the case of CH(3)CHO, which may have also contributed to the observed differences in methyl internal rotation. The differences in bond distances and electronic populations induced by the H/D isotope effect were controlled by the difference in the distribution of wavefunctions between the protons and deuterons.

Internal rotation effects in the pulsed jet rotational spectrum of the trifluoromethane–carbon dioxide dimer

The rotational spectrum of the normal isotopic species of the HCF 3–CO 2 weakly bound complex has been measured by Fourier-transform microwave (FTMW) spectroscopy. All transitions are split into A and E states by internal rotation of the trifluoromethane subunit. A global fit of these states gives rotational constants that are consistent with a structure predicted by an MP2/6-311++G(2d,2p) ab initio calculation in which the axes of the monomers are coplanar, with the hydrogen atom of the trifluoromethane angled toward one of the oxygen atoms of the CO 2. Measured dipole moment components ( μ a = 0.431(6) D, μ b = 0, μ c = 1.436(6) D, μ total = 1.499(6) D) confirm the ab initio prediction of an ac plane of symmetry; however, the very near-prolate nature of the complex ( κ = −0.997), combined with the relatively high barrier to internal rotation (∼30 cm −1) leads to asymmetry splittings and internal rotation splittings of similar magnitude, resulting in the observation of dipole forbidden b-type E-state transitions in addition to the expected a- and c-type lines. Although this effect has been observed previously in several monomer spectra, this appears to be one of few examples for a weakly bound complex.

An In Vivo Biomechanical Study on the Tension–Versus–Knee Flexion Angle Curves of 2 Grafts in Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction: Effects of Initial Tension and Internal Tibial Rotation

The purposes of this study were to determine the relation between the graft tension and the knee flexion angle in the anteromedial (AM) and posterolateral (PL) bundles of a clinically simulated anatomic double-bundle anterior cruciate ligament (ACL) reconstruction procedure and to clarify the effect of initial tension on the tension-versus-flexion curve of each graft, as well as the effect of internal rotation of the tibia on the tension of the 2 grafts. During ACL reconstruction in 30 patients, 2 suture anchors with a No. 1 polyester suture were firmly screwed into the center of the anatomic attachment of the AM and PL bundles on the femur, respectively, and each graft tension was measured with a strain gauge-type tensiometer attached at the end of the suture under 2 conditions of initial tension. The averaged tension-versus-flexion curves were significantly different between the AM and PL grafts under each initial tension condition (P < .0001). The initial tension applied at 30 degrees of knee flexion significantly affected the absolute values of each graft tension at each knee flexion angle (P < .0001) but did not significantly affect the tension-versus-flexion curve pattern of each graft. The maximal internal rotation of the tibia significantly increased the tension on both the AM and PL grafts at knee flexion angles of less than 60 degrees under each initial tension condition (P < .0001). The tension-versus-flexion curves of the 2 sutures, which mimicked the AM and PL grafts reconstructed clinically with the anatomic double-bundle ACL reconstruction procedure, were significantly different in the tension values. Differences in initial tension applied to the 2 grafts significantly affected the absolute values of each graft tension at each knee flexion angle but did not significantly affect the tension-versus-flexion curve pattern. The maximal internal rotation of the tibia significantly increased the tension on both the AM and PL suture grafts at knee flexion angles of less than 60 degrees . Level I, testing of previously developed diagnostic criteria in series of consecutive patients with universally applied gold standard.

The effect of internal and external foot rotation on the adduction moment and lateral–medial shear force at the knee during gait

It has been hypothesised that those with medial compartment knee osteoarthritis tend to externally rotate their foot during gait in order to unload the diseased compartment. This has been found to decrease the adduction moment at the knee during late stance, although the effects of foot rotation on shear forces at the knee have not yet been determined. Also, the effects of internal foot rotation on the knee during gait are not clear. This study performed a gait analysis on 11 healthy participants (M: 6; mean age 22.9+/-1.8 years) in three conditions: (1) natural foot rotation position; (2) internal foot rotation and (3) external foot rotation. Three-dimensional gait analysis calculated the knee adduction moment and lateral-medial shear force for all three foot rotation conditions. Internal rotation of the foot increased the knee adduction moment and lateral-medial shear force magnitude during late stance, while external rotation of the foot decreased the magnitude of both these measures. This implies that walking with an externally and internally rotated foot may unload the diseased compartment for those with medial and lateral compartment knee OA, respectively. Also, the relationship of foot rotation angle to the adduction moment and lateral-medial shear force was strengthened when data were corrected for the subject's normal walking condition. Knee OA subject data revealed that they were able to reduce the knee adduction moment more than normal subjects during late stance, indicating that other factors besides the rotation of the foot need to be investigated.