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Articles by T. M DeBerardino
Total Records ( 3 ) for T. M DeBerardino
  D. C Taylor , T. M DeBerardino , B. J Nelson , M Duffey , J Tenuta , P. D Stoneman , R. X Sturdivant and S. Mountcastle
  Background

Controversy remains over the most appropriate graft for anterior cruciate ligament reconstruction.

Hypothesis

There is no significant difference in outcomes after 4-strand hamstring and patellar tendon autograft anterior cruciate ligament reconstructions using similar fixation techniques.

Study Design

Randomized controlled trial; Level of evidence, 1.

Methods

Between August 2000 and May 2003, 64 Keller Army Hospital patients with complete anterior cruciate ligament tears were randomized to hamstring (n = 32) or patellar tendon (n = 32) autograft anterior cruciate ligament reconstruction. Operative graft fixation and rehabilitative techniques were the same for both groups. Follow-up assessments included the Single Assessment Numeric Evaluation score, Lysholm score, International Knee Documentation Committee score, and Knee Injury and Osteoarthritis Outcome Score. Postoperative radiographs were analyzed for tunnel location and orientation.

Results

Eleven women and 53 men were randomized. Eighty-three percent of the patients (53 of 64) had follow-up of greater than 2 years, or to the point of graft rupture or removal (average follow-up, 36 months). Four hamstring grafts (12.5%) and three patellar tendon grafts (9.4%) (P = .71) ruptured. One deep infection in a hamstring graft patient necessitated graft removal. Forty-five of the 56 patients with intact grafts had greater than 2-year follow-up. Patients with patellar tendon grafts had greater Tegner activity scores (P = .04). Single Assessment Numeric Evaluation scores were 88.5 (95% confidence interval: 83.1, 93.8) and 90.1 (95% confidence interval: 85.2, 96.1) for the hamstring and patellar tendon groups, respectively (P = .53). Lysholm scores were 90.3 (95% confidence interval: 84.4, 96.1) and 90.4 (95% confidence interval: 84.5, 96.3) for the hamstring and patellar tendon groups, respectively (P = .97). There were no significant differences in knee laxity, kneeling pain, isokinetic peak torque, International Knee Documentation Committee score, or Knee Injury and Osteoarthritis Outcome Scores. Postoperative graft rupture correlated with more horizontal tibial tunnel orientation.

Conclusion

Hamstring and patellar tendon autografts provide similar objective, subjective, and functional outcomes when assessed at least 2 years after anterior cruciate ligament reconstruction.

  M. S Todd , S Lalliss , E Garcia , T. M DeBerardino and K. L. Cameron
  Background

Two previous studies have examined the association between an increased posterior tibial slope and anterior cruciate ligament (ACL) injuries as measured on plain radiographs. The study results were contradictory, with 1 reporting a statistical difference and the other showing no association.

Purpose

To determine if there is a difference in posterior tibial slope angle between patients with a history of noncontact ACL injury and a control group with no history of ACL injury. A secondary objective was to examine differences in tibial slope angle between male and female subjects within each group.

Study Design

Case-control study; Level of evidence, 3.

Methods

We identified all noncontact ACL injuries that were treated operatively at the United States Military Academy, West Point, New York, from 2004 to 2007. We digitally measured the posterior tibial slope from plain film radiographs of 140 noncontact ACL injuries, stratified them by sex, and compared them with a control cohort of 179 patients and radiographs.

Results

Subjects in the noncontact ACL group had significantly greater slope angles (9.39° ± 2.58°) than did control subjects (8.50° ± 2.67°) (P = .003). The trend toward greater tibial slope angles in the noncontact ACL group was also observed when each sex was examined independently; however, the difference was only statistically significant for the female subjects between the injury and control groups (9.8° ± 2.6° vs 8.20° ± 2.4°) (P = .002).

Conclusion

Despite the identification of an increased posterior tibial slope as a possible risk factor for women, more research that combines the multifactorial nature of an ACL injury must be performed.

  B. R Waterman , P. J Belmont , K. L Cameron , T. M DeBerardino and B. D. Owens
  Background

Ankle sprain is a common injury in athletic populations that results in significant time lost to injury.

Hypothesis

The incidence rates (IRs) of ankle ligament sprains are influenced by gender, height, weight, body mass index (BMI), physical conditioning, level of competition, type of sport, and athlete exposure to sport.

Study Design

Cohort study; Level of evidence, 2.

Methods

A longitudinal cohort study was performed to determine the effect of risk factors for ankle sprain at the United States Military Academy between 2005 and 2007.

Results

A total 614 cadets sustained new ankle sprains during 10 511 person-years at risk, resulting in an overall IR of 58.4 per 1000 person-years. Women (96.4), compared with men (52.7), had a significantly increased rate ratio (IRR) for ankle sprain of 1.83 (95% confidence interval [CI], 1.52–2.20). Men with ankle sprains had higher mean height, weight, and BMI than uninjured men (P <.001). Men with ankle sprains had higher average scores in push-ups, sit-ups, and run time than uninjured men (P <.001). Ankle sprain occurred most commonly during athletics (64.1%). Ankle sprain IR did not significantly differ between intercollegiate and intramural athletic competition after controlling for athlete-exposure (IRR, 1.05; 95% CI, 0.81–1.37). The ankle sprain IRR of female compared with male intercollegiate athletes was 0.93 (95% CI, 0.67–1.32) per 1000 person-years and 1.04 (95% CI, 0.74–1.47) per 1000 athlete-exposures. The intercollegiate sports of men’s rugby, women’s cheerleading, and men’s/women’s basketball, soccer, and lacrosse had the highest ankle sprain IR.

Conclusion

Higher mean height and weight in men, increased BMI in men, greater physical conditioning in men, and athlete exposure to selected sports were all risk factors for ankle sprain.

 
 
 
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