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Biomedical subjects

W W Curl

Publications and source records attributed to W W Curl.

At least 19 recordsLinked to original sources
PubMed2001

Chondral and osteochondral injuries. Diagnosis and management.

Osteochondral lesions are relatively common and usually occur as a result of trauma. They often are unrecognized acutely and lead to osteochondral defects and eventually osteoarthritis. Detection of these lesions has been aided by bone scan, CT, and MR imaging. Acute osteochondral fragments can be replaced and internally fixed. Chronic osteochondral defects can be treated with several methods designed to stimulate healing by either fibrocartilage or healing by transplantation of bone and cartilage or cartilage alone. The goal of all treatment methods is to provide a stable, congruent joint surface, restore function, and prevent the evolution of osteoarthritis in the injured joint.

Algorithms↗
PubMed2000

Aging and exercise: are they compatible in women?

The benefits of physical exercise and fitness have long been understood. With the aging of society and longevity of women relative to men, interest finally is being given to the female population. There are many benefits to maintaining an active lifestyle as women age. These benefits include maintenance of bone mineral density and prevention of osteoporosis, decreased susceptibility to falls, and decreased susceptibility to breast cancer and other chronic diseases. There are great psychologic benefits to maintaining an active lifestyle, and the connection between cardiovascular fitness and lowering the incidence of cardiac disease is well established. Finally, physical activity and exercise can decrease the symptoms of arthritis. The Centers for Disease Control recommends at least 30 minutes of moderately intensive activity on most days of the week. In older women, the loss of lean body mass (sarcopenia) can be diminished through a strength training program. With these benefits of maintaining an active lifestyle, healthcare providers should become proactive in emphasizing the benefits of physical activity to the older female population.

Aged↗
PubMed1999

[Microcirculation of striated muscle in closed soft tissue injury: effect on tissue perfusion, inflammatory cellular response and mechanisms of cryotherapy. A study in rat by means of laser Doppler flow-measurements and intravital microscopy].

The authors investigated the effects of closed soft tissue injury (CSTI) and cryotherapy on microvascular perfusion by means of laser Doppler flowmetry. In a different protocol interactions between leukocytes and the microvascular endothelium of skeletal muscle, which are first steps in local inflammatory response were documented in an intravital microscopy model. Rats were chronically instrumented with dorsal skinfold chambers. Leukocyte rolling and adherence in postcapillary venules of striated muscle before and after standardized muscle contusion (group T: n = 6), cryotherapy following muscle contusion (TK: n = 6) or sham contusion (group N: n = 6) were quantitated prospectively and in random order using intravital microscopy. Tissue perfusion was assessed by laser Doppler flowmetry in the microvasculature of the flap over a period of 96 hours following CSTI (group T: n = 8), cryotherapy following CSTI (group TK: n = 8), sham trauma (group N: n = 8, control 1), or cryotherapy following sham trauma (group K: n = 8, control 2). 300 minutes after trauma the number of rolling and adherent leukocytes in striated muscle microvasculature was significantly reduced by cryotherapy. We found an acute effect of cryotherapy on perfusion of traumatized tissue (reduction of perfusion around 25 %). However, there was no long-term effect (96 hours evaluation) on microvascular perfusion of cryotherapy either in the presence or absence of CSTI. The effectiveness of ice application in reducing edema in striated muscle following contusion may be due in part to a reduction of the leukocyte/endothelial interactions accompanying CSTI.

Animals↗
PubMed1999

Etiologic factors associated with Achilles tendinitis in runners.

PURPOSE: The purpose of this study was to determine whether relationships exist between selected training, anthropometric, isokinetic muscular strength, and endurance, ground reaction force, and rearfoot movement variables in runners afflicted with Achilles tendinitis. METHODS: Specifically, we examined differences in selected measures between a noninjured cohort of runners (N = 58) and a cohort of injured runners with Achilles tendinitis (N = 31). Isokinetic, kinetic, and kinematic measures were collected using a Cybex II+ isokinetic dynamometer (Medway, MA), AMTI force plate (500 Hz), and Motion Analysis high-speed videography (200 Hz), respectively. Separate discriminant function analyses were performed on each of the five sets of variables to identify the factors that best discriminate between the injured and control groups. RESULTS: Years running, training pace, stretching habits (injured runners were less likely to incorporate stretching into their training routine), touchdown angle, plantar flexion peak torque at 180 degrees x s(-1) and arch index were found to be significant discriminators. CONCLUSION: A combined discriminant analysis using the above mentioned significant variables revealed that plantar flexion peak torque, touchdown angle, and years running were the strongest discriminators between runners afflicted with Achilles tendinitis and runners who had no history of overuse injury.

Achilles Tendon↗
PubMed1998

Contusion of skeletal muscle increases leukocyte-endothelial cell interactions: an intravital-microscopy study in rats.

OBJECTIVE: To investigate the relationship between secondary muscle damage after contusion and the interactions between leukocytes and endothelial cells, which are essential steps in secondary inflammatory response. METHODS: In a randomized animal study, rats were chronically instrumented with dorsal skinfold microvascular chambers and exposed to standardized contusion or sham contusion. Leukocyte rolling and adherence in postcapillary venules before and after muscle contusion or sham contusion were quantitated using in vivo microscopy. RESULTS: The number of rolling leukocytes in the postcapillary venules before contusion was low. At 300 minutes after contusion, the number of rolling and adherent leukocytes in the striated muscle microvasculature was increased significantly (p < or = 0.05) compared with either the baseline precontusion condition or the control group at the same time. CONCLUSION: In the mid-term to long-term stages of skeletal muscle injury associated with contusion, a significant portion of tissue damage is secondary to leukocyte-endothelial cell interactions.

Animals↗
PubMed1997

Cartilage injuries: a review of 31,516 knee arthroscopies.

Although articular cartilage injuries of the knee are common, injured cartilage has a limited ability to heal. Recent data suggest that articular cartilage grafting may provide treatment for these injuries. To define the patient population that might benefit from cartilage grafting, 31,516 knee arthroscopies were reviewed. Between June 1991 and October 1995, 53,569 hyaline cartilage lesions were documented in 19,827 patients. The majority were articular cartilage lesions; grade III lesions of the patella were the most common. Grade IV lesions were predominantly located on the medial femoral condyle. Patients under 40 years of age with grade IV lesions accounted for 5% of all arthroscopies; 74% of these patients had a single chondral lesions (4% of the arthroscopies). No associated ligamentous or meniscal pathology was found in 36.6% of these patients.

Adult↗
PubMed1997

The effect of contusion and cryotherapy on skeletal muscle microcirculation.

OBJECTIVE: The most common treatment of soft tissue contusions is ice application (cryotherapy). The physiological basis for this therapy is assumed to be cold-mediated vasoconstriction resulting in decreased edema formation and a reduction in overall morbidity. This proposed mechanism has not been tested. The present research examined the hypothesis that cryotherapy following contusion is effective because it reduces microvascular perfusion and subsequent edema formation. EXPERIMENTAL DESIGN: The microcirculatory responses to contusion were studied with and without cryotherapy in a chronically instrumented rat model. Initial studies evaluated the immediate effects of cryotherapy on arteriolar and venular diameters and microvascular perfusion (using laser Doppler floxmetry). Variables were measured before and immediately after 20 minutes of cryotherapy. Two additional studies monitored the same microvascular parameters longitudinally in four sets of chronically instrumented animals. Groups of rats studied had contusion or sham contusion with ice treatment or no ice treatment. Measurements were performed repeatedly before and after treatment for 24 hours or 96 hours after contusion/sham contusion. RESULTS: The acute microvascular effects of cryotherapy were vasoconstriction and decreased perfusion. However, when cryotherapy was used as a treatment following contusion/sham contusion, there were no long-lasting microvascular effects of cryotherapy either in the presence or absence of contusion. CONCLUSIONS: These results indicate that cryotherapy of striated muscle following contusion does not reduce microvascular diameters or decrease microvascular perfusion. Alternate mechanisms of action for cryotherapy treatment need to be investigated.

Animals↗
PubMed1995

Parents' knowledge of the purposes and content of preparticipation physical examinations.

OBJECTIVES: To determine whether parents of student athletes plan to use the preparticipation physical examination (PPE) as their student athlete's only annual health evaluation, to identify factors associated with this decision, and to assess their knowledge about the objectives of PPEs and more comprehensive examinations. DESIGN: Survey. SETTING: General community, school-sponsored PPEs. PARTICIPANTS: A convenience sample of parents or guardians of high school student athletes who obtained a school-sponsored, multiple-station format PPE were surveyed by using an anonymous paper-and-pencil questionnaire. Questionnaires were completed by the parents of 381 of 763 student athletes who obtained PPEs (participation rate, 49.9%). RESULTS: Thirty percent of the parents in this sample planned to use the PPE as their student athlete's only contact with a health care provider. Parents whose adolescent's health insurance provided for comprehensive health assessments were more likely than those without this benefit to plan a comprehensive care evaluation (75% vs 60%, respectively) (P = .01 by chi 2 analysis). In addition to addressing problems that might affect sports participation, parents thought that the PPE visit should evaluate medical problems that are unrelated to athletics (34%), perform health screening procedures (22%), assess social or behavioral issues (16%), and provide immunizations (7%). CONCLUSIONS: Many parents plan to use the PPE as their student athlete's only scheduled contact with a health care provider; this decision may be influenced by factors that are related to access to health care and misperceptions with regard to the mission of these specialized examinations. For these adolescents, important medical, social, and behavioral needs may not be met. Consideration should be given to including elements of the PPE in health assessments that are performed by individual clinicians or expanding the scope of large-group, multiple-station format PPEs.

Adolescent↗
PubMed1995

Etiology of iliotibial band friction syndrome in distance runners.

The objectives of our study were: 1) to examine differences between a noninjured cohort of runners (N = 70) and runners afflicted with iliotibial band friction syndrome (ITBFS) (N = 56) according to selected anthropometric, biomechanical, muscular strength, and training measures; 2) to explore multivariate relationships among these measures in both the well and injured groups; and 3) to develop specific hypotheses concerning risk factors for injury that will later be tested in a prospective observational study. High speed videography (200 fps), a force platform (500 Hz), and a Cybex II+ isokinetic dynamometer were used to assess rearfoot motion, ground reaction forces, and knee muscular strength and endurance, respectively. A linear discriminant function analysis of the training data revealed weekly mileage, training pace, number of months using current training protocol, % time spent swimming, and % time spent running on a track to be significant (P < 0.10). Height was a significant anthropometric discriminator, while seven isokinetic strength and endurance measures were found to discriminate significantly between the groups. Calcaneal to vertical touchdown angle, and maximum supination velocity were significant rearfoot movement discriminators. Maximum braking force was the only significant kinetic discriminator. A combined discriminant analysis using those variables found to be significant in the previous analyses revealed weekly mileage, and maximum normalized braking force to be the best discriminators (model P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

New skeletal muscle model for the longitudinal study of alterations in microcirculation following contusion and cryotherapy.

This preliminary report describes the use of a rat model developed to study in vivo the effect of anesthesia, contusion, and cryotherapy on skeletal muscle microcirculation by use of an implanted chamber. The diameters of arterioles and venules within the chamber were determined by photomicroscopy in the contusion study and by compound videomicroscopy in the anesthesia study; microvascular perfusion was determined by laser Doppler fluxmetry (LDF). Combined ketamine and xylazine anesthesia significantly reduced (P < 0.05) arteriolar and venular diameters by 32.4% and 37.8%, respectively, and average LDF measurements by 36.1%. Contusion significantly increased arteriolar diameters over baseline values (P < 0.05); cryotherapy did not alter arteriolar diameters but increased venular diameters (P < 0.05). It is hypothesized that this increase in venular diameter may, by increasing the surface area available for reabsorption, explain one mechanism by which cryotherapy decreases the edema of contusion. Use of this model should help to advance the understanding of microcirculatory dynamics following contusion and cryotherapy.

Anesthesia↗
PubMed1993

The fluoroscope in a traditional sports medicine setting.

Using a fluoroscope in a sports medicine setting is a new innovation. By using a hand-held portable fluoroscope, radiographic imaging can be done in the athletic training room or at an on-site athletic location. The fluoroscope produces a high-quality, realtime image. This is accomplished immediately, without the delay time and expense involved when the injured athlete is referred to an emergency facility. Through the use of the fluoroscope, a definite diagnosis can be made, and treatment can begin immediately. The fluoroscope has proven to be cost-effective, not only by decreasing radiographic expenses, but also by decreasing the time commitment of both the athlete and the athletic trainer.

Journal Article↗
PubMed1991

Etiologic factors associated with patellofemoral pain in runners.

The purpose of this study was to extend our knowledge of running related injuries by determining whether relationships exist between selected anthropometric, biomechanical, muscular strength and endurance, and training variables and runners afflicted with patellofemoral pain (PFP). Specifically, the objectives of this study were to examine differences in selected measures between a non-injured control group (C) of runners (N = 20) and a group of injured runners (INJ) diagnosed by an orthopedic surgeon as having PFP (N = 16). High speed photography, a force platform, and isokinetic dynamometry were used to determine rearfoot motion, ground reaction forces, and knee muscular strength and endurance. Stepwise discriminant function analyses were performed on the anthropometric, biomechanical, and muscular strength and endurance variables. Q angle was a significant discriminator (P less than 0.01) between the INJ and C groups. The muscular endurance data revealed several significant discriminators with the INJ subjects being weaker in knee extension endurance. Kinetic analysis revealed several significant discriminators whereas rearfoot movement variables were not good discriminators between the groups. The training data revealed that the INJ group ran significantly less (P less than 0.01) miles.wk-1 than the C group. Our results suggest that Q angle is a strong discriminator between runners afflicted with PFP and non-injured runners. In addition, several muscular endurance and kinetic variables may also be important components of the etiology of PFP.

Adolescent↗
PubMed1989

Arthroscopic treatment of chronic synovitis of the ankle.

Arthroscopic synovectomy is a valuable tool in treating synovitis of the knee joint. We have identified a group of patients who benefit from ankle synovectomy. To determine the indications and long-term results of arthroscopic synovectomy of the ankle, we evaluated the history, preoperative examination, roentgenograms, and operative data of patients who underwent this procedure and had a minimum of 2 years of follow-up. Sixteen patients who underwent arthroscopic ankle synovectomy were identified. Sprains and inversion-type injuries were common in this young patient group. All had failed conservative therapy. Operative findings revealed hypertrophic synovium in all cases. Good or excellent results were obtained in 75% of patients, using a subjective and functional evaluation scale. Complications were one deep infection, one superficial infection, and one temporary sensory paresthesia. Chronic synovitis, or anterior soft-tissue impingement, was responsive to arthroscopic treatment and results did not deteriorate over time.

Adult↗