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001 THE FIST SEPARATION SIGN: AN ADJUNCT TO SELECTION OF THE ANTERIOR CRUCIATE LIGAMENT DEFICIENT KNEE REQUIRING RECONSTRUCTION
R.T. Roach1, I. Dos Remedios, D. Griffiths, D. Rees, N. Maffulli.
North Staffs Royal Infirmary, University of Keele, Stoke on Trent, Staffordshire, UK; 1Robert Jones and Agnes Hunt Hospital, Oswestry, Shropshire, UK
We designed a retrospective and prospective study to analyse the presence of perceived linear separation in the anterior cruciate ligament (ACL) injured knee. This information is easily elicited by mimicking the knee joint as two fists articulating with each other.
Retrospective recall is poor before reconstruction, but the sign remains absent after successful surgery. It is also absent in any patient selecting conservative treatment and control normal knees. However, the sign is present in arthroscopically proven completely deficient ACL knees warranting reconstruction on the basis of pivotal instability, but is not so convincing with the partial tear or ACL on posterior cruciate ligament subgroups. In the prospectively followed patients, the perceived separation clearly resolves with surgery.
The fist separation sign is easy to elicit and should be included as an adjunct in the initial consultation. It can be used as a quick screening question to aid diagnosis and facilitate fast track referral. Patients can also be confidently informed that this perceived feeling will improve with reconstruction.
003 ROLE OF EXERCISE IN MULTIPLE SCLEROSIS
E. Curry, A.J. Maile.
Dept of Physical Education, Sport and Leisure Studies, University of Edinburgh, Edinburgh, Scotland, UK
Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system where it produces widespread demyelination1 causing symptoms such as fatigue and muscle weakness,2 which can be seen to have effects on a patient’s capability to exercise. This project aimed to investigate whether exercise could have a positive effect on disease symptoms as evidence for this is emerging.3
Twenty patients (six men and 14 women, mean age 44.2 years), of moderate disability3 were split into …