The purpose of this study was two-fold:

to examine perioperative prospective changes in pain, disability and psychosocial variables in ACL reconstructed recreational athletes over the pre-op to eight week post-op period.

All participants were recreational athletes at the time of their injuries who had patella-autograft procedure at the the Queen Elizabeth II Health Sciences Centre. Fifty-four patients (twenty-nine males; mean age = 25.4 years, SD = 8.08). Mean education was fourteen years (SD = 2.08), 32%(17) were married, 67%(36) single, and 1% was divorced. 94%(51) of the sample was Caucasian, 3%(2) Black, and 1% Asian. One quarter reported their ACL injury was due to sport-based contact, with non-contact sporting activity reported at 76%(41). All participants completed measures of pain, depression, pain catastrophizing, state anxiety pre-op, on days one and two following surgery and again at eight weeks post-op. Disability was assessed pre-op and eight weeks post-op.

Pain was varied across comparisons with preoperative pain increased twenty-four and forty-eight-hour post-op. Pain at forty-eight-hours postoperative was significantly higher than pain reported at eight-weeks post-op. Catastrophizing did not differ from the pre-op to twenty-four-hour post-op but did drop from twenty-four to forty-eight-hours and forty-eight-hours to eight-weeks post-op. Pre-op depression increased twenty-four-hour post-op, but not from twenty-four to forty-eight-hours and declined at eight-weeks. Anxiety increase pre-op to twenty-four-hours but not from twenty-four to forty-eight-hours but did drop from forty-eight-hours to eight-weeks.Disability did not change over time. Regression showed age or gender did not predict disability but forty-eight hour pain and catastrophizing did.

These data indicate that pain and psychological variables change over time of ACL recovery. Results suggest that pain and distress peek during acute post-op period. As well, post-op catastrophizing predicts disability at eight weeks post-op which may indicate that catastrophizing may be related to behaviours related to slower recovery following ACL reconstructive surgery.

Proximal tibial osteotomy is commonly performed for osteoarthritis of the knee with deformity. The results of 105 dome osteotomies have been reviewed at a minimum follow-up of one year and an average of 4.8 years. Before operation all the knees were painful, 50.5% severely; a further 45.7% disturbed sleep at night. At review 15.2% of knees were free of pain and 60% had only slight pain which did not restrict activity. The preoperative range of movement was maintained and there was only a slight tendency for radiological changes to progress, with actual improvement in some cases. No correlation was found between the correction of deformity to physiological valgus and the result. We cannot explain why tibial osteotomy produces such useful and sustained pain relief.

Seventy-eight patients who had been operated on for bony entrapment of lumbar nerve roots were studied in an attempt to define the clinical syndrome, and to assess the results of a new technique of decompression which preserves spinal stability. The mean age of the patients was 45 years and 28 of them had previously undergone spinal operations. Pain in the leg was the predominant symptom, with evidence of motor involvement in half of the patients. Signs of nerve root tension were found in only one-third of the patients. The principal factor in the aetiology was degenerative change in the posterior facet joints. Decompression was achieved by a partial undercutting facetectomy. Fifty-nine per cent of the patients obtained a "good" result and 85 per cent were satisfied with the result of their operation. Successful partial facetectomy for bony entrapment of lumbar nerve roots produced rapid and lasting relief of pain.