Literature on the comparative effectiveness of nonoperative treatments for patellofemoral pathologies has been limited. The purpose of this investigation was to study the effectiveness of selected static and isokinetic physical therapy rehabilitation programs for subjects with a clinical diagnosis of chondromalacia patella. Criteria employed to assess the effects of these therapeutic programs included measures of knee functional capacity as measured by the Cincinnati Rating System and traditional measures of leg strength and flexibility. Twenty-nine subjects were screened by an orthopaedic physician and assigned to a control (N = 9), static (N = 11), or isokinetic (N = 9) exercise group. Noncontrol subjects were administered a program of 12 treatments, three times a week, for four weeks by a registered physical therapist. Results of the ANCOVA for 17 pretest and posttest measures indicated that the static and isokinetic groups demonstrated significant (P < 0.05) functional improvements over the control group in walking, stair activity, running, jumping/twisting, and overall activity level as well as increased quadriceps strength and hamstring range of motion. No significant differences, however, were determined to exist between the static and isokinetic groups. The major implication of this investigation is that static and isokinetic treatment programs provide positive and comparable rehabilitation effects on the functional capacity of the knee joint for subjects with chondromalacia patella. Static therapy, however, appears to be most cost-effective.

J Orthop Sports Phys Ther 1990;12(6):256-266.

Index by subject of all manuscripts published by the Journal from July through December 1990.

The opinions and assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense.

This paper was presented and discussed at the Annual Meeting of the American Orthopaedic Society of Sports Medicine, New Orleans, Louisiana, July 23. 1975.

Reprint requests may be addressed to the Technical Publications Editor, Letterman Army Medial Center, Presidio of San Francisco, California 94129.

Reprinted from The American Journal of Sports Medicine 4:95-100. 1976.

During the period 1967 to 1971, 64 cadets at the United States Military Academy, West Point, New York, had surgical repair for isolated tear of the anterior cruciate ligament. In a five-year follow-up study to determine the functional impairment, present disability, and reinjury to the knee, 32 of the 64 patients were located and evaluated by radiographic examination and either by interview or by questionnaire. Twenty-two were commissioned to full duty, 23 had attended ranger or airborne school, and 16 had been in combat. Impairment of ordinary activities was noted by 12 and impairment of athletic endeavors by 24; pain by 71%; swelling by 66%; stiffness by 71%; and instability by 94%. Seventeen of the 32 had experienced a significant reinjury after the repair of the anterior cruciate ligament. Clinically, the isolated tear of the anterior cruciate ligament can be diagnosed by four essential ingredients-a pop at time of injury, inability to continue participation, gross swelling of knee, and maximal swelling within 12 hr. The mechanism of injury is usually deceleration and change of direction, not contact with another player. The follow-up study on this small series indicates that the patients have progressive deterioration of the knee.

J Orthop Sports Phys Ther 1990;12(6):232-236.

The purpose of this study was to examine the relationships between hip extension range of motion (ROM) and three determinants of postural alignment: standing pelvic tilt, standing lumbar lordosis, and abdominal muscle performance. The subjects were 25 healthy adults ranging in age from 21 to 49 years. The Pearson product-moment correlation of hip extension ROM with pelvic tilt was -0.04, with lumbar lordosis -0.09, and with abdominal muscle performance 0.09. These results indicate that these variables are not related. This study demonstrates that the hypothetical correlation among these clinical parameters needs to be reassessed.

J Orthop Sports Phys Ther 1990;12(6):243-247.