Medial collateral ligament injuries of the knee: current treatment concepts

The medial collateral ligament is one of the most commonly injured ligaments of the knee. Most injuries result from a valgus force on the knee. The increased participation in football, ice hockey, and skiing has all contributed to the increased frequency of MCL injuries. Prophylactic knee bracing in contact sports may prevent injury; however, performance may suffer. The majority of patients who sustain an MCL injury will achieve their pre-injury activity level with non-operative treatment alone; however, those with combined ligamentous injuries may require acute operative care. Accurate characterization of each aspect of the injury will help to determine the optimum treatment plan

Larval parasitoids and pathogens of the groundnut leaf miner, Aproaerema modicella (Lep.: Gelechiidae), in India

Natural enemies of the groundnut leaf miner,Aproaerema modicella (Deventer), were studied at the International Crops Research Institute for the Semi-Arid Tropics (ICRISAT) located near Hyderabad in peninsular India. Hymenopterous parasitoids attacking leaf miner larvae were the most important group of natural enemies. Nine primary and eight secondary parasitoids emerged from host larvae, and killed up to 50% of the leaf miner larvae sampled. The trophic relationships between primary and secondary parasitoids are incompletely understood. The influence of pathogens of this species is reported for the first time. These pathogens killed up to 30% of the leaf miner larvae. The combined effects of all mortality agents killed up to 95% of the leaf miner larvae per sample period. However, use of insecticides in sprayed plots reduced the efficacy of parasitoids. The impact of predators on larval populations was not studied and may explain underestimates of leaf miner mortality rate

Bone contusion progression from traumatic knee injury: association of rate of contusion resolution with injury severity

Douglas R Pedersen,1 Georges Y El-Khoury,2 Dan R Thedens,3 Mothana Saad-Eldine,1 Phinit Phisitkul,1 Annunziato Amendola4 1Department of Orthopaedics and Rehabilitation, 2Department of Radiology, University of Iowa Hospitals and Clinics, 3Department of Electrical and Computer Engineering, University of Iowa, Iowa City, IA, 4Department of Orthopaedics and Sports Medicine, Duke University Medical School, Durham, NC, USA Background: Bone contusions are frequently encountered in magnetic resonance imaging (MRI) evaluation of knee anterior cruciate ligament (ACL) injuries. Their role as indicators of injury severity remains unclear, primarily due to indeterminate levels of joint injury forces and to a lack of preinjury imaging.Purpose: The purpose of this study was to 1) quantify bone contusion pathogenesis following traumatic joint injuries using fixed imaging follow-ups, and 2) assess the feasibility of using longitudinal bone contusion volumes as an indicator of knee injury severity.Study design: Prospective sequential MRI follow-ups of a goat cohort exposed to controlled stifle trauma in vivo were compared to parallel clinical MRI follow-ups of a human ACL tear patient series.Methods: Reproducible cartilage impact damage of various energy magnitudes was applied in a survival goat model, coupled with partial resection of anterior portions of medial menisci. Both emulate injury patterns to the knee osteochondral structures commonly encountered in human ACL injury imaging as well as instability from resultant ligament laxity. Longitudinal clinical MRI sequences portrayed stifle bone contusion evolution through 6 months after the inciting event.Results: In the first 2 weeks, biological response variability dominated the whole-joint response with no apparent correlation to trauma severity. Control goats subjected to partial meniscectomy alone exhibited minimal bone response. Thereafter, 0.6 J impact bone contusions portrayed a faster rate of resolution than those induced by 1.2 J cartilage impacts.Conclusion: Bone contusion sizes combined with time of persistence are likely better measures of joint injury severity than isolated bone contusion volume. Keywords: bone contusion, contusion pathogenesis, anterior cruciate ligament, magnetic resonance imaging, knee, knee injury severit