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Articles by R. H Brophy
Total Records ( 3 ) for R. H Brophy
  R. H Brophy and A. D. Pearle

Conventional endoscopic single-bundle transtibial anterior cruciate ligament (ACL) reconstruction from the posterolateral tibial footprint to the anteromedial femoral footprint results in a vertical graft. A more oblique horizontal graft from the anteromedial tibial footprint to the posterolateral femoral footprint may offer a better alternative for all endoscopic ACL reconstruction.


When compared with a conventional ACL single-bundle position, the horizontal graft ACL position has more obliquity and so undergoes a greater change in length during anterior translation and internal rotation.

Study Design:

Controlled laboratory study.


A computer navigation system was used to acquire kinematic data during a flexion-extension cycle and outline the anteromedial and posterolateral aspects of the tibial and femoral footprints on 5 fresh-frozen cadaveric knees. Three virtual graft positions were defined: conventional (posterolateral tibia–anteromedial femur), central, and horizontal (anteromedial tibia– posterolateral femur). After transection of the ACL, the obliquity, anisometry, absolute length change, and apparent strain were computed for each graft position during the Lachman test, the anterior drawer test, and internal rotation at 0° and 30° of flexion.


The horizontal position was more oblique than the other positions (P < .05). There were no differences in anisometry. The horizontal position elongated more than the other positions during the Lachman test (P < .05) and more than the conventional position during the anterior drawer test (P = .009). During internal rotation at 30° flexion, the horizontal position elongated more than the other positions (P < .05). The central and horizontal positions had more apparent strain than that of the vertical position during the Lachman test and internal rotation (P < .05); no significant difference was found during the anterior drawer test.


In ACL-deficient cadaveric knees, the horizontal graft position has greater obliquity and so undergoes greater elongation without increased apparent strain when compared to the central graft position, in response to anterior translation and internal rotation maneuvers.

Clinical Relevance:

Horizontal graft placement of a single-bundle ACL may result in greater control of translation and rotation.

  S. C Gamradt , R. H Brophy , R Barnes , R. F Warren , J. W Thomas Byrd and B. T. Kelly

Avulsion of the rectus femoris origin is a rare injury. The only previous report of this injury in professional American football has been limited to the kicking athlete.


To describe the incidence and treatment of proximal rectus femoris avulsion in the National Football League (NFL).

Study Design:

Case series; Level of evidence, 4.


The NFL Injury Surveillance System (NFLISS) was reviewed for any proximal rectus femoris avulsion injuries from 1986 to 2006, including the type and mechanism of injury, player demographics, method of treatment, and time to return to play. The NFL team physicians and trainers were surveyed as to their experience with these injuries as well.


A total of 11 cases of proximal rectus femoris avulsion were identified starting in 1997. These injuries occurred in athletes in a variety of positions. All of these were treated nonoperatively, and the mean return to play was 69.2 days.


Rectus femoris avulsions are uncommon injuries in the NFL, occurring about once a year in the entire league (once magnetic resonance imaging facilitated correct diagnosis of these injuries). Conservative treatment of these injuries usually results in return to play after 6 to 12 weeks.

Clinical Relevance:

Proximal avulsions of the rectus femoris can be treated nonoperatively with a high degree of predictability for return to full, unrestricted participation in professional American football.

  R. H Brophy , C. S Gill , S Lyman , R. P Barnes , S. A Rodeo and R. F. Warren

Meniscal and anterior cruciate ligament (ACL) injuries are common in college football athletes. The effect of meniscectomy and/or ACL surgery on the length of an athlete’s career in the National Football League (NFL) has not been well examined.


Athletes with a history of meniscectomy or ACL surgery before the NFL combine have a shorter career than matched controls.

Study Design

Case-control study; Level of evidence, 3.


A database containing the injury history and career NFL statistics of athletes from 1987–2000 was used to match athletes with a history of meniscectomy and/or ACL surgery, and no other surgery or major injury, to controls without previous surgeries. Athletes were matched by position, year drafted, round drafted, and additional injury history.


Fifty-four athletes with a history of meniscectomy, 29 with a history of ACL reconstruction, and 11 with a history of both were identified and matched with controls. Isolated meniscectomy reduced the length of career in years (5.6 vs 7.0; P = .03) and games played (62 vs 85; P = .02). Isolated ACL surgery did not significantly reduce the length of career in years or games played. Comparing the athletes with meniscectomy or ACL reconstruction to athletes with combined ACL reconstruction and meniscectomy, a history of both surgeries, resulted in a shorter career in games started (7.9 vs 35.1; P <.01), games played (41 vs 63; P = .07), and years (4.0 vs 5.8; P = .08) than a history of either surgery alone.


A history of meniscectomy, but not ACL reconstruction, shortens the expected career of a professional football player. A combination of ACL reconstruction and meniscectomy may be more detrimental to an athlete’s durability than either surgery alone. Further research is warranted to better understand how these injuries and surgeries affect an athlete’s career and what can be done to improve the long-term outcome after treatment.

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