Compared to conventional road-cycling, little is known about overuse injuries in mountainbiking. The adjustment of the mountainbike seems to be crucial avoiding these syndromes. No other study has prospectively put overuse injuries into correlation with the mountainbike’s adjustment in a competition setting until now.

Methods: This prospective field study consisted of two phases using preformed questionnaires to interview volunteering athletes in a race. In phase one overused body regions were identified in mountainbikers. In phase two riders were examined before and after the race for overused body regions which were put into correlation with the bike’s adjustments. The statistical analysis comprised a multivariance analysis.

Results: 169 competitors were analyzed of which 87 had after the race. Most injuries inflicted the lower back, the buttocks and the knee. There was a significant correlation between inadequate saddle pedal distance and the incidence of knee pain (p< 0.038), and paraesthetic sensations in the hand (p< 0.023). The inclination of the saddle has also significant impact on the occurrence of pain in the buttocks (p< 0.014)). Symptoms occurred highly statistically in downhill (p< 0.0001) and uphill (p< 0.0007) passages.

Conclusion: Overuse injuries are frequently observed in competitive mountain bikers. More than half of the investigated athletes had pain at any body region immediately after the race. The bike’s adjustment has a significant impact in the occurrence of overuse injuries.

We describe a new method of reconstruction of the extensor apparatus after extensive resection of malignant tumours around the knee joint with a polyester ligament. Twenty- two patients after a mean follow up of eighteen months (six to thirty-six months) were treated. Six patients had excellent knee function with a lag of extension less than five degrees, four of less than twenty, three had less than forty degrees and six patients could not lift their limb extended against gravity, although no patient required any kind of walking aid. The mean Enneking Score was 81.5 the mean TESS Score was eighty-three.

Limb salvage surgery in primary malignant bone tumours is widely accepted as the surgical treatment of choice around the knee joint. Extraarticular resection for oncological radicality usually results in additional resection of at least part of the extensor mechanism

Since January 2000 we used a Polyester Band (LARS®) for either augmentation of a transposed muscle or as a complete soft tissue bridging after tumour resection in twenty-two patients (fourteen men, eight women) with a mean age of thirty-two (8–75). The HMRS tumour endoprosthesis was used for the reconstruction of the knee joint.

The location of the tumour was in the distal femur in ten cases and the proximal tibia in eleven. One synovial sarcoma arose at the lateral meniscus. The mean follow up was eighteen months (6–36) after implantation of the Lars® ligament. Patient’s functional outcome and satisfaction was eighty-three (65–92) at the TESS Score and 81,5 (43–92) at the Enneking Score, respectively. Six patients had excellent knee function with an extension deficit of less than five degrees. In four cases the extension deficit was less than twenty, in three cases it was less than forty. In six patients the active extension lag was more than forty degrees. However, their remaining quadriceps strength was sufficient for stabilisation of the knee joint during gait without any aids. At last follow up all implants were in situ without any signs of loosening. No patient had to be amputated because of septic complication.