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Unicompartmental changes in the knee of a young athlete remains a difficult and controversial problem in orthopaedics. Excessive premature loading of articular cartilage, most often the result of a knee injury, has been shown to result in increased degenerative changes and pain in the younger patient. Instability may also contribute to the degeneration of cartilage and must therefore be considered in the treatment of osteoarthritis in the young adult. High tibial osteotomy has been described as a treatment option for malalignment in the older, less active adult and has shown promising results in a younger, more active population. Osteotomies for instability are more controversial and should be considered in more complex injury patterns. [ABSTRACT FROM AUTHOR]

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OBJECTIVE: Circulating leptin has recently been proposed as the peripheral signal indicating the adequacy of nutritional status for reproductive function. To test whether low plasma leptin concentration for a given degree of adiposity is associated with menstrual dysfunction, we measured plasma leptin concentration and body composition in young premenopausal women with normal or abnormal reproductive function. DESIGN: Fasting plasma leptin concentration (ELISA), body composition (dual energy X-ray absorptiometry) and menstrual status (menstrual history and hormonal profile) were assessed in 34 premenopausal women characterized by different levels of physical activity. RESULTS: Body fat content and plasma leptin concentration were both reduced in women with impaired reproductive function (amenorrheic < anovulatory < eumenorrheic women). However, after adjusting plasma leptin concentration for percentage body fat, there was no independent association between leptin and menstrual function. CONCLUSION: Menstrual abnormalities in young premenopausal women seem to occur as a consequence of the linear decline in adiposity and plasma leptin concentration observed in response to inadequate nutritional status. Levels of adiposity below 15% and plasma leptin concentration below 3 ng/ml are more likely to be associated with impaired reproductive function. [ABSTRACT FROM AUTHOR]