Faculty Bibliography

Ballet dancers may be at risk of eating disorders, and women with eating disorders are at increased risk for menstrual dysfunction. Caloric intakes of amenorrheic dancers have been reported to be less than those of eumenorrheic dancers, indicating a possible conservation of energy. We evaluated resting metabolic rate and the thermic effect of food following ingestion of a 500-kcal liquid supplement in 8 amenorrheic dancers and 10 eumenorrheic dancers. Body fat was higher for the eumenorrheic group (20%) than the amenorrheic group (15%). Resting metabolic rate did not differ between groups when corrected for body mass (24.2 +/- 1.1 kcal/kg/day for amennorheic dancers vs. 25.0 +/- 0.9 kca/kg/day for eumennorheic dancers), nor did resting metabolic rate differ when adjusted for lean mass. However, amennorheic dancers expended significantly less energy post-prandially once adjusted for lean mass (ANOVA, effect of group P = 0.035). Dancers were asked to complete the Eating Disorder Inventory, a self-report scale that measures symptoms of disordered eating; 9 of 10 eumennorheic but only 4 of 8 amennorheic women were willing to complete the questionnaire. Eumennorheic dancers had profiles similar to or less pathologic than those of non-eating-disordered populations. Greater dissatisfaction was expressed by eumennorheic women as body fat increased. Contrary to the findings in previous studies, amennorheic ballet dancers did not exhibit energy conservation via reductions in resting metabolic rate but did expend slightly less energy in thermic effect of food compared to normally menstruating women.

BACKGROUND: The purpose of this study was to evaluate the results of arthroscopic treatment of anterior bony and soft-tissue impingement of the ankle in elite dancers. METHODS: The study is a case series retrospectively reviewed. In the period between 1990 and 1999, 11 elite dancers (12 ankles) had ankle arthroscopy after a diagnosis of anterior ankle impingement that markedly interfered with their dancing. Initial nonoperative treatment failed in all subjects. Previous ankle trauma was noted in all subjects. There were seven women and four men (average age 28 years). Tibiotalar exostoses were radiographically noted in six ankles. Standard anteromedial and anterolateral arthroscopic portals and instrumentation were used for resection of bone spurs and debridement of impinging soft tissues. Patients were nonweightbearing for 5 days after surgery and had postoperative physiotherapy. RESULTS: Nine dancers returned to full dance activity at an average of 7 weeks after surgery. One patient did not return to dance performance because of concurrent unrelated orthopaedic problems, but he resumed work as a dance teacher; he developed a recurrent anterior tibial spur that was successfully resected at a second arthroscopy 9 years later. Another dancer developed postoperative scar-tissue impingement and stiffness; she had a repeat arthroscopy 4 months after the initial procedure and subsequently returned to dance performance. All patients eventually had marked postoperative improvement in pain relief and dance performance. CONCLUSIONS: Arthroscopic debridement is an effective method for the treatment of bony and soft-tissue anterior ankle impingement syndrome in dancers and has minimal morbidity

PURPOSE: To review the results of 34 patients who underwent radiofrequency thermal shrinkage (RFTS) for treatment of anterior cruciate ligament (ACL) laxity in the attenuated and partially torn ACL. TYPE OF STUDY: Retrospective cross-sectional survey performed at least 6 months after treatment. METHODS: Patients with recurrent instability after attenuation of ACL autografts and partially torn ACLs were treated with RFTS. Follow-up included subjective questionnaires (International Knee Documentation Committee [IKDC], Tegner, and Lysholm) and objective clinical tests (IKDC, KT-1000, pivot-shift, Lachman, single-leg hop). RESULTS: Mean follow-up was 21.4 months. Based on IKDC and subjective evaluation, 18 of 20 (90%) partially torn ACLs and 10 of 14 reconstructed ACLs (71%) treated with RTFS were judged to have good or excellent knee function (overall 82%). ACL laxity based on KT-1000 was less successful, with 15 of 20 (75%) partially torn ACLs and 8 of 12 (66%) reconstructed ACLs considered successful. CONCLUSIONS: With no major complications in this study, we conclude that RFTS for treatment of ACL laxity is a well-tolerated procedure with success rates around 71% to 90% in selected patients. RFTS may be offered as a less-extensive alternative to patients being considered for ACL reconstruction who have either attenuated or partially torn ligaments, especially in the athletically low-demand population. LEVEL OF EVIDENCE: Level IV, case series

The simultaneous diagnosis of ipsilateral patellar tendon rupture and anterior cruciate ligament tear is rare. Surgical repair is complicated by different rehabilitation regimens as well as anterior cruciate ligament graft choices. We present a case where at the same operative setting, the patellar tendon was repaired, and the anterior cruciate ligament reconstructed with autologous hamstring graft