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Parry GN, Williams S, McKay CD, Johnson DJ, Bergeron MF, Cumming SP. Associations between growth, maturation and injury in youth athletes engaged in elite pathways: a scoping review. Br J Sports Med 2024; 58:1001-1010. [PMID: 39209526 PMCID: PMC11420720 DOI: 10.1136/bjsports-2024-108233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2024] [Indexed: 09/04/2024]
Abstract
OBJECTIVE To describe the evidence pertaining to associations between growth, maturation and injury in elite youth athletes. DESIGN Scoping review. DATA SOURCES Electronic databases (SPORTDiscus, Embase, PubMed, MEDLINE and Web of Science) searched on 30 May 2023. ELIGIBILITY CRITERIA Original studies published since 2000 using quantitative or qualitative designs investigating associations between growth, maturation and injury in elite youth athletes. RESULTS From an initial 518 titles, 36 full-text articles were evaluated, of which 30 were eligible for final inclusion. Most studies were quantitative and employed prospective designs. Significant heterogeneity was evident across samples and in the operationalisation and measurement of growth, maturation and injury. Injury incidence and burden generally increased with maturity status, although growth-related injuries peaked during the adolescent growth spurt. More rapid growth in stature and of the lower limbs was associated with greater injury incidence and burden. While maturity timing did not show a clear or consistent association with injury, it may contribute to risk and burden due to variations in maturity status. CONCLUSION Evidence suggests that the processes of growth and maturation contribute to injury risk and burden in elite youth athletes, although the nature of the association varies with injury type. More research investigating the main and interactive effects on growth and maturation on injury is warranted, especially in female athletes and across a greater diversity of sports.
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Affiliation(s)
- Gemma N Parry
- Department of Health, University of Bath-Claverton Down Campus, Bath, UK
| | - Sean Williams
- Department of Health, University of Bath-Claverton Down Campus, Bath, UK
| | - Carly D McKay
- Department of Health, University of Bath-Claverton Down Campus, Bath, UK
| | - David J Johnson
- Department of Health, University of Bath-Claverton Down Campus, Bath, UK
- West Ham United Football Club, London, UK
| | - Michael F Bergeron
- Performance Health, WTA Women's Tennis Association, St. Petersburg, Florida, USA
| | - Sean P Cumming
- Department of Health, University of Bath-Claverton Down Campus, Bath, UK
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Cerezal A, Roriz D, Canga A, Cerezal L. Imaging of sports injuries in adolescents. Pediatr Radiol 2024:10.1007/s00247-024-05991-9. [PMID: 38995428 DOI: 10.1007/s00247-024-05991-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Revised: 06/25/2024] [Accepted: 06/26/2024] [Indexed: 07/13/2024]
Abstract
Musculoskeletal injuries in adolescents tend to occur in particular locations and have distinct characteristics, as they affect an immature skeleton. Increased engagement in sports, extended training and competition periods, and early specialization in specific sports, among other factors, have contributed significantly to the rise in musculoskeletal sports injuries in adolescents. Furthermore, females show a particularly pronounced increase in sports participation, where anatomical and hormonal factors play crucial roles in the development and increased frequency of sports-related injuries. Consequently, there is a growing demand for diagnostic imaging techniques. Musculoskeletal and pediatric radiologists require a comprehensive understanding of intrinsic and extrinsic risk factors and the successive stages of skeletal development that can influence the specific characteristics of sports injuries in adolescents. These aspects are crucial for the diagnostic, prognostic, and therapeutic management of these injuries and for mitigating chronic conditions that could compromise future sports participation. This review analyzes the primary musculoskeletal injuries in adolescent athletes and highlights the pivotal role of different imaging methods in their diagnosis and management.
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Affiliation(s)
- Alvaro Cerezal
- Department of Orthopaedic Surgery and Traumatology, Hospital Universitario La Paz, Madrid, Spain
| | - Diogo Roriz
- Department of Radiology, ULSAM, Viana Do Castelo, Portugal
| | - Ana Canga
- Department of Radiology, Valdecilla University Hospital, Santander, Spain
| | - Luis Cerezal
- Department of Radiology, Diagnóstico Médico Cantabria (DMC), Calle Castilla 6, 39002, Santander, Spain.
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3
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Martinkėnienė VB, Austys D, Šaikus A, Brazaitis A, Bernotavičius G, Makulavičius A, Verkauskas G. The Significance of Selecting an Appropriate Patient-Reported Outcome Measure (PROM): A Cross-Cultural Adaptation of the Specific Paediatric International Documentation Committee Subjective (Pedi-IKDC) Knee Form. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1930. [PMID: 38136132 PMCID: PMC10742502 DOI: 10.3390/children10121930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 12/03/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023]
Abstract
INTRODUCTION The selection of an appropriate PROM is a crucial aspect in assessing outcomes. Questionnaires that have not been designed or validated for a paediatric population are routinely used. Using a questionnaire requires translation, cultural adaptation, and testing the psychometric properties of the translated questionnaire. There is no applicable questionnaire in our country for children with knee-specific conditions in sports orthopaedics. Therefore, this study aims to translate, culturally adapt, and assess the psychometric properties of the Paediatric IKDC (Pedi-IKDC) questionnaire within the Lithuanian paediatric population. METHODS The translation was conducted in accordance with international standards. Patients aged 11-17 years with various knee disorders participated in three surveys and completed the Pedi-IKDC, Lysholm, and PedsQL questionnaires. Interviews with patients following the translation process, in addition to floor and ceiling effects, were used to assess content validity. Cronbach alpha (α) statistics and the intraclass correlation coefficient (ICC) were applied to measure internal consistency and reproducibility, respectively. The standard error of measurement (SEM) and smallest detectable change (SDC) were calculated to assess reliability. Pearson correlations were calculated between Pedi-IKDC and Lysholm PedsQL scores to determine criteria validity. The effect size (ES) and standardised response mean (SRM) were calculated to assess the responsiveness to change. RESULTS Cronbach's alpha (α) was 0.91 for the total score, 0.75 for symptoms, and 0.92 for the sport/function component. The ICC for overall scores was 0.98, with each question ranging from 0.87 to 0.98. The SEM was 2.97, and the SDC was 8.23. Lysholm and PedsQL physical functioning domain scores had moderate correlations (0.8 > r > 0.5), and the overall PedsQL score had a weak correlation (0.5 > r > 0.2) to the Pedi-IKDC score. The floor and ceiling effects were 3.3% and 1.6%, respectively. The SRM was 1.72 and the ES was 1.98. CONCLUSIONS The Lithuanian Pedi-IKDC version is an appropriate evaluation instrument for assessing outcomes in children with knee disorders. All of the psychometric features produced acceptable results.
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Affiliation(s)
- Viktorija Brogaitė Martinkėnienė
- Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania
- Department of Children’s Orthopedics and Traumatology, Vilnius University Hospital Santaros Klinikos, LT-08406 Vilnius, Lithuania (G.B.)
| | - Donatas Austys
- Department of Public Health, Institute of Health Sciences, Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania;
| | - Andrius Šaikus
- Department of Children’s Orthopedics and Traumatology, Vilnius University Hospital Santaros Klinikos, LT-08406 Vilnius, Lithuania (G.B.)
| | - Andrius Brazaitis
- Centre for Radiology and Nuclear Medicine, Vilnius University Hospital Santaros Klinikos, LT-08661 Vilnius, Lithuania
| | - Giedrius Bernotavičius
- Department of Children’s Orthopedics and Traumatology, Vilnius University Hospital Santaros Klinikos, LT-08406 Vilnius, Lithuania (G.B.)
- Clinic of Gastroenterology, Nefrourology and Surgery, Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania
| | - Aleksas Makulavičius
- Clinic of Rheumatology, Orthopaedics Traumatology and Reconstructive Surgery, Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania
| | - Gilvydas Verkauskas
- Clinic of Gastroenterology, Nefrourology and Surgery, Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania
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Little CC, Howell DR, Armento AM, Sweeney EA, Walker GA. Training volume recommendations and psychosocial outcomes in adolescent athletes. PHYSICIAN SPORTSMED 2023; 51:420-426. [PMID: 36000411 DOI: 10.1080/00913847.2022.2113987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 08/12/2022] [Indexed: 10/15/2022]
Abstract
OBJECTIVES Researchers have recommended that youth athletes limit their practice volume to the number of hours/week that they are old in years. We examined sport perceptions, burnout, anxiety, and depressive symptoms among youth athletes who did and did not report playing more hours/week of organized sports than their age. METHODS Uninjured athletes aged 13-18 years old completed questionnaires documenting demographics, sport participation volume, health and injury history, depressive symptoms, anxiety, burnout, and sport perceptions during a pre-participation physical examination. We grouped participants as those who reported more hours/week in organized sports than their age (exceeds age/volume recommendation) vs. those who reported equal/less hours/week in organized sports than their age (meets age/volume recommendation). RESULTS Of 161 participants, 21% (n = 33) were in the 'exceeds age/volume recommendation' group (age = 15.2 ± 1.3 years; 55% female; 18.7 ± 4.0 hours/week) and 79% (n = 128) were in the 'meets age/volume recommendation' group (age = 15.6 ± 1.2 years; 50% female; 10.2 ± 3.4 hours/week). A higher proportion of the 'exceeds age/volume recommendation' group agreed with the statement 'youth in my sport play too many games before college' than the 'meets age/volume recommendation' group (33% vs. 16%; p = 0.03). After adjusting for the effect of age, sport specialization level, and weight, exceeding age/volume recommendations was associated with the perception that youth in sports play too many games before college (aOR = 3.24; 95% CI = 1.26, 8.29; p = 0.01), while burnout (aOR = 0.99; 95% CI = 0.94, 1.06; p = 0.93), anxiety (aOR = 0.97; 95% CI = 0.84, 1.11; p = 0.65), and depressive symptoms (aOR = 0.90; 95% CI = 0.74, 1.10; p = 0.30) were not significantly related. CONCLUSION Athletes who spend more hours in sport than their age appear to perceive their competition load during youth sports to be excessive. Coaches and providers should monitor athlete's training hours and perceptions of competition load to offer support and potentially prevent burnout development.
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Affiliation(s)
- Casey C Little
- Sports Medicine Center, Children's Hospital, Colorado, CO, USA
| | - David R Howell
- Sports Medicine Center, Children's Hospital, Colorado, CO, USA
- Department of Orthopedics, University of Colorado School of Medicine, CO, USA
| | - Aubrey M Armento
- Sports Medicine Center, Children's Hospital, Colorado, CO, USA
- Department of Orthopedics, University of Colorado School of Medicine, CO, USA
| | - Emily A Sweeney
- Sports Medicine Center, Children's Hospital, Colorado, CO, USA
- Department of Orthopedics, University of Colorado School of Medicine, CO, USA
| | - Gregory A Walker
- Sports Medicine Center, Children's Hospital, Colorado, CO, USA
- Department of Orthopedics, University of Colorado School of Medicine, CO, USA
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5
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Farana R, Williams G, Fujihara T, Wyatt HE, Naundorf F, Irwin G. Current issues and future directions in gymnastics research: biomechanics, motor control and coaching interface. Sports Biomech 2023; 22:161-185. [PMID: 34962219 DOI: 10.1080/14763141.2021.2016928] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The sport of gymnastics is undergoing a global examination of its culture and the relationship between the gymnast, coach and environment is a central focus. The aim of this review is to explore biomechanics and motor control research in skill development and technique selection in artistic gymnastics with a focus on the underlying concepts and scientific principles that allow performance enhancement, skill development and injury risk reduction. The current review examines peer reviewed papers from 2000 onwards, with a focus on contemporary approaches in the field of gymnastics research, and highlights several key directions for future gymnastics research. Based on our review and the integration of the models of Newell (1986) and Irwin et al. (2005), we recommend that future gymnastics research should embrace at the very least a multidisciplinary approach and aim for an interdisciplinary paradigm.
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Affiliation(s)
- R Farana
- University of Ostrava, Ostrava, Czech Republic
| | | | - T Fujihara
- Osaka University of Health and Sport Sciences, Osaka, Japan
| | - H E Wyatt
- Sports Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand
| | - F Naundorf
- Institute for Applied Training Science Leipzig, Leipzig, Germany
| | - G Irwin
- University of Ostrava, Ostrava, Czech Republic.,Cardiff Metropolitan University, Cardiff, UK
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6
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Wu Z, Tu X, Tu Z. Hyperosmolar dextrose injection for Osgood-Schlatter disease: a double-blind, randomized controlled trial. Arch Orthop Trauma Surg 2022; 142:2279-2285. [PMID: 34673998 DOI: 10.1007/s00402-021-04223-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 10/11/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Osgood-Schlatter disease (OSD) is one of the common causes of long-term knee pain, leading to functional limitations, long-term deformity of the tubercle interfering with kneeling, and impaired peer-important sport participation. Nonetheless, patient management continues to rely on the usual conservative methods. This study examined the use of hyperosmolar dextrose injection in patients with OSD. METHODS We conducted a randomized, double-blind clinical trial involving 70 patients with OSD. One group received a hyperosmolar dextrose injection (12.5%), while the other received a saline injection. The injections were conducted under ultrasound guidance. The Victorian Institute of Sport Assessment (VISA) score was used to assess each patient's pain and sport level. RESULTS The dextrose group outperformed the saline group in improvement in the VISA-Patella (VISA-P) score from baseline to 3 months (27.1 ± 6.5 vs. 1.4 ± 2.6; mean difference 25.4 (22.4 to 28.3); p < .0001), 6 months (31.7 ± 7.9 vs. 25.2 ± 7.8; mean difference 6.2 (3.2 to 9.4); p < .0001), and 12 months (34 ± 9.0 vs. 28.2 ± 7.5; mean difference 5.5 (1.9 to 9.1); p = .0026). The changes in both groups were clinically important, suggesting that both therapies were active treatments. The dextrose group improved too rapidly for spontaneous improvement to explain much of this change. CONCLUSION After three injections, at the 6-month and 12-month follow-up visits, the VISA-P scores of the two groups were significantly improved; the dextrose group score was better than the saline group score, and there were significant differences between the two groups.
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Affiliation(s)
- Zhe Wu
- Department of Orthopedics, Fujian Provincial Corps Hospital of Chinese People's Armed Police Force, Fuzhou, China.
| | - Xiaoxian Tu
- Department of Medical Records Management Room, Fujian Medical University Union Hospital, Fuzhou, China
| | - Zhiyuan Tu
- Department of Orthopedics, Fujian Provincial Corps Hospital of Chinese People's Armed Police Force, No. 159 North Second Ring West Road, Fuzhou, China
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Ozone K, Kokubun T, Takahata K, Takahashi H, Yoneno M, Oka Y, Minegishi Y, Arakawa K, Kano T, Murata K, Kanemura N. Structural and pathological changes in the enthesis are influenced by the muscle contraction type during exercise. J Orthop Res 2022; 40:2076-2088. [PMID: 34862672 DOI: 10.1002/jor.25233] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 08/10/2021] [Accepted: 11/20/2021] [Indexed: 02/04/2023]
Abstract
Mechanical stress is involved in the onset of sports-related enthesopathy. Although the amount of exercise undertaken is a recognized problem during disease onset, changes in muscle contraction type are also involved in the increase in mechanical stress during exercise. This study aimed to clarify the effects of increased mechanical stress associated with muscle contraction type and amount of exercise on enthesis. Twenty mice underwent treadmill exercise, and the muscle contraction type and overall load during exercise were adjusted by varying the angle and speed conditions. Histological analysis was used to the cross-sectional area of the muscle; area of the enthesis fibrocartilage (FC), and expression of inflammation-, degeneration-, and calcification-related factors in the FC area. In addition, the volume and structure of the bone and FC area were examined using microcomputer imaging. Molecular biological analysis was conducted to compare relative expression levels of inflammation and cytokine-related factors in tendons. The Overuse group, which increased the amount of exercise, showed no significant differences in parameters compared to the sedentary mice (Control group). The mice subjected to slow-speed downhill running (Misuse group) showed pathological changes compared to the Control and Overuse groups, despite the small amount of exercise. Thus, the enthesis FC area may be altered by local mechanical stress that would be increased by eccentric muscle contraction rather than by mechanical stress that increases with the overall amount of exercise. Clinical Significance: The muscle contraction type might be more involved in the onset of sports-related enthesopathy rather than the amount of exercise.
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Affiliation(s)
- Kaichi Ozone
- Department of Health and Social Services, Health and Social Services, Graduate School of Saitama Prefectural University, Koshigaya, Saitama, Japan.,Japan Society for the Promotion of Science, Tokyo, Japan
| | - Takanori Kokubun
- Department of Physical Therapy, Health and Social Services, Saitama Prefectural University, Koshigaya, Saitama, Japan
| | - Kei Takahata
- Department of Health and Social Services, Health and Social Services, Graduate School of Saitama Prefectural University, Koshigaya, Saitama, Japan
| | - Haruna Takahashi
- Department of Health and Social Services, Health and Social Services, Graduate School of Saitama Prefectural University, Koshigaya, Saitama, Japan
| | - Moe Yoneno
- Department of Health and Social Services, Health and Social Services, Graduate School of Saitama Prefectural University, Koshigaya, Saitama, Japan
| | - Yuichiro Oka
- Department of Health and Social Services, Health and Social Services, Graduate School of Saitama Prefectural University, Koshigaya, Saitama, Japan
| | - Yuki Minegishi
- Department of Health and Social Services, Health and Social Services, Graduate School of Saitama Prefectural University, Koshigaya, Saitama, Japan.,Japan Society for the Promotion of Science, Tokyo, Japan
| | - Kohei Arakawa
- Department of Health and Social Services, Health and Social Services, Graduate School of Saitama Prefectural University, Koshigaya, Saitama, Japan
| | - Takuma Kano
- Department of Health and Social Services, Health and Social Services, Graduate School of Saitama Prefectural University, Koshigaya, Saitama, Japan
| | - Kenji Murata
- Department of Physical Therapy, Health and Social Services, Saitama Prefectural University, Koshigaya, Saitama, Japan
| | - Naohiko Kanemura
- Department of Physical Therapy, Health and Social Services, Saitama Prefectural University, Koshigaya, Saitama, Japan
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Emmet D, Roberts J, Yao KV. Update on Preventing Overuse Injuries in Youth Athletes. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2022. [DOI: 10.1007/s40141-022-00362-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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9
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Vij N, Naron I, Tolson H, Rezayev A, Kaye AD, Viswanath O, Urits I. Back pain in adolescent athletes: a narrative review. Orthop Rev (Pavia) 2022; 14:37097. [PMID: 35936806 PMCID: PMC9353696 DOI: 10.52965/001c.37097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 01/25/2022] [Indexed: 04/28/2024] Open
Abstract
Background Back pain in young athletes is common. Adolescents are at an increased risk for back pain related to several factors including rapid growth. Traditionally, the conversation around back pain in the adolescent age group has been centered around diagnosis and treatment; however, there are emerging studies regarding prevention. Objective The purpose of the present investigation is to summarize sport-specific risk factors, to describe the growing emphasis on prevention/screening, and report results on minimally invasive and surgical options. Methods The literature search was performed in Mendeley. Search fields were varied until redundant. All articles were screened by title and abstract and a preliminary decision to include an article was made. The full-text screening was performed on the selected articles. Any question regarding the inclusion of an article was discussed by at least 3 authors until an agreement was reached. Results Adolescent athletes have a higher risk of developing spondylolysis and spondylolisthesis than their non-athletic counterparts. Participation in athletic activity alone, increased body mass index, varsity status, and nationally/internationally competitive status are identified are demographic risk factors. Weightlifters, gymnasts, football players, and combat athletes may be at higher risks. Increased lumbar lordosis, abdominal muscle weakness, hip flexor tightness, hamstring tightness, thoracolumbar fascia tightness, femoral anteversion, genu recurvatum, and thoracic kyphosis also predispose. Recent cadaveric and kinematic studies have furthered our understanding of pathoanatomic. There is some evidence to suggest that isokinetic testing and electromyographic data may be able to identify at-risk individuals. Perturbation-based exercise interventions can reduce the incidence of adolescent athletic back pain. There is a large body of evidence to support the efficacy of physical therapy. There is some data to support minimally invasive treatments including external bone growth simulators, steroid injections, and chemonucleolysis for specific pathologies. Endoscopic surgery results for a limited subset of patients with certain disease processes are good. Conclusions Back pain in adolescent athletes is common and may not lead to appropriate alterations in athletes' level of participation. Athletes with a higher body mass index should be counseled regarding the benefits of losing weight. Isokinetic testing and electromyographic data have the potential as diagnostic and screening tools. Strength deficits and postural control could be used to identify patients requiring early intervention and thus reduce the incidence. External bone growth simulators, steroid injections, and chemonucleolysis could potentially become conservative options in the future. When surgery is indicated, the endoscopic intervention has the potential to decrease operative time, decrease cost, and promote healing.
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Affiliation(s)
- Neeraj Vij
- University of Arizona College of Medicine - Phoenix
| | - Ian Naron
- Louisiana State University Health Shreveport School of Medicine
| | | | - Arthur Rezayev
- Louisiana State University Health Shreveport School of Medicine
| | - Alan D Kaye
- Department of Anesthesiology, Louisiana State University Health Shreveport
| | - Omar Viswanath
- Department of Anesthesiology, Louisiana State University Health Shreveport
| | - Ivan Urits
- Department of Anesthesiology, Louisiana State University Health Shreveport
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Tajika T, Shinozaki T, Takata M, Hatori Y, Suzuki J, Kuboi T, Chikuda H. Epiphyseal injury of the lateral condyle related to throwing in a young baseball player: A report of a rare case. JSES Int 2022; 6:535-538. [PMID: 35572449 PMCID: PMC9091790 DOI: 10.1016/j.jseint.2022.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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11
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Heath MR, Janosky JJ, Pegno A, Schachne JM, Fabricant PD. Age Is More Predictive of Safe Movement Patterns Than Are Physical Activity or Sports Specialization: A Prospective Motion Analysis Study of Young Athletes. Am J Sports Med 2021; 49:1904-1911. [PMID: 33914649 DOI: 10.1177/03635465211008562] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Movement quality and neuromuscular balance are noted predictors of acute injury. Early sports specialization and extremely high activity levels have been linked to elevated risk of injury. PURPOSE To investigate for any relationships among quality of physical movement, quantity of physical activity, and degree of sports specialization in a healthy cohort of active children and adolescents. STUDY DESIGN Cross-sectional study with prospectively collected data. METHODS Healthy children between the ages of 10 and 18 years were recruited and completed the Hospital for Special Surgery Pediatric Functional Activity Brief Scale to assess quantity of physical activity and the Jayanthi scale to assess degree of sports specialization (high, score of 2 or 3; low, score of 0 or 1). Movement quality was assessed using motion analysis sensors during 5 repetitions of 4 different jumping and squatting motions, with a maximum score of 100 per participant. Independent-samples t tests were used to compare participants with high versus low specialization on physical activity and movement quality. A Spearman correlation was used to determine the relationship between quantity of physical activity and movement quality, and linear regression was used to assess for the effect of participant age on relevant covariables. RESULTS Final analyses included 147 participants (72% male) with a mean ± SD age of 13.4 ± 2.2 years. Participants who were highly specialized displayed better movement quality than did participants with low sports specialization (27.6 ± 14.0 vs 19.8 ± 10.1; P < .01). Participants who were highly specialized had significantly higher activity levels (24.6 ± 5.9 vs 18.1 ± 6.9; P < .001). Movement quality was moderately correlated with physical activity level (r = 0.335; P < .001). Physical activity; hours of organized sports activity; hours of free, unorganized physical activity; and specialization level were not significant predictors of movement quality when controlling for age. Age alone predicted 24.2% of the variance in the overall movement quality score (R2 = 0.242; B = 3.0; P < .001). CONCLUSION This study found that sports specialization and physical activity levels were not associated with movement quality when controlling for age, which was the most important variable predicting athletic movement quality. Although all participants displayed movement patterns that were associated with high risk for injury, overall movement quality improved with advancing chronological age. CLINICAL RELEVANCE All young athletes should ensure that neuromuscular training accompanies sport-specific training to reduce risk of injury.
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Affiliation(s)
| | | | - Angelo Pegno
- Hospital for Special Surgery, New York, New York, USA
| | - Jonathan M Schachne
- Hospital for Special Surgery, New York, New York, USA.,Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
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12
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"Greek KOOS-Child: a valid, disease specific, diagnostically accurate and responsive PROM in children with knee-related pathology". Knee Surg Sports Traumatol Arthrosc 2021; 29:1841-1849. [PMID: 32809119 DOI: 10.1007/s00167-020-06237-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 08/10/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE The Knee Injury Osteoarthritis Outcome Score (KOOS)-Child questionnaire is one of the frequently child-friendly measures used in pediatric studies. The aim of this study was to transculturally adapt the Greek version of KOOS-Child and evaluate its clinimetric properties in children with knee disorders. METHODS Children visiting the Outpatients Orthopaedic Clinic of a Greek Paediatric General Hospital were considered eligible if they were aged 8-14 years, had a knee soft tissue injury and associated physical limitations. The transcultural adaptation was based on a multistage backward translation approach. Participants completed the KOOS-Child at their first visit to the orthopedic specialist (baseline), 2 weeks and 3 months after baseline. Content validity of the KOOS-Child was evaluated using general QoL measures (KIDSCREEN and Kid-KINDL) and construct validity was explored by correlating relevant items. Responsiveness was evaluated according to the children's response on the given orthopeadic treatment. RESULTS Sample consisted of 59 children (30 males), aged: 11 ± 1.8 years. The KOOS-Child showed high internal consistency (Cronbach's a: 0.80-0.96). Adequate convergent validity with > 75% relevant a priori hypotheses was confirmed. Construct validity was moderate to strong (Pearson's r correlations between related KOOS and Kid-KINDL subdimensions: 0.54-0.62). KOOS and KIDSCREEN subdimensions correlations were fair (Pearson's r correlations: 0.32-0.65). KOOS-Child's diagnostic accuracy was high. Factor analysis extracted height factors accounting for 76.15% of the total variance, confirmed by the scree plot. Responsiveness was moderate to high with Cohen's d from 0.6 to 1.4. CONCLUSION The Greek version of the KOOS-Child demonstrated excellent internal consistency, good construct validity, diagnostic accuracy and interpretability as well as good responsiveness. The measure could be used across Greek children with orthopaedic knee problems. Generalisability of findings is limited due to the relatively limited cohort. LEVEL OF EVIDENCE II.
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Iwame T, Matsuura T, Suzue N, Iwase J, Uemura H, Sairyo K. Factors Associated With Knee Pain and Heel Pain in Youth Soccer Players Aged 8 to 12 Years. Orthop J Sports Med 2019; 7:2325967119883370. [PMID: 31799330 PMCID: PMC6868579 DOI: 10.1177/2325967119883370] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Soccer is played by many children younger than 12 years. Despite its health benefits, soccer has also been linked to a high number of sport-related injuries. Purpose: To investigate the relationship between clinical factors and knee or heel pain in youth soccer players. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Study participants included 602 soccer players aged 8 to 12 years who were asked whether they had experienced episodes of knee or heel pain. Data were collected on age, body mass index, years of playing soccer, playing position, and training hours per week. Associations of clinical factors with the prevalence of knee or heel pain were examined by univariate and multivariate logistic regression analyses. Results: Episodes of knee and heel pain were reported by 29.4% and 31.1% of players, respectively. Multivariate analyses revealed that older age and more years of playing soccer were significantly and positively associated with the prevalence of knee pain (P = .037 and P = .015 for trend, respectively) but did not identify any significant associations for heel pain. Conclusion: In this study of youth soccer players, knee pain was associated with older age and more years of play, but heel pain was not significantly associated with any factor.
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Affiliation(s)
- Toshiyuki Iwame
- Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Tetsuya Matsuura
- Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Naoto Suzue
- Department of Orthopaedic Surgery, Tokushima Red Cross Hospital, Komatsushima, Japan
| | - Joji Iwase
- Department of Orthopaedic Surgery, Tokushima Prefectural Central Hospital, Tokushima, Japan
| | - Hirokazu Uemura
- Department of Preventive Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Koichi Sairyo
- Department of Orthopaedic Surgery, Tokushima Red Cross Hospital, Komatsushima, Japan
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14
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Conservative management of an acute avulsion of the iliac apophysis in an adolescent football player: a case report. CURRENT ORTHOPAEDIC PRACTICE 2019. [DOI: 10.1097/bco.0000000000000807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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15
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van der Velden CA, van der Steen MC, Leenders J, van Douveren FQMP, Janssen RPA, Reijman M. Pedi-IKDC or KOOS-child: which questionnaire should be used in children with knee disorders? BMC Musculoskelet Disord 2019; 20:240. [PMID: 31113406 PMCID: PMC6530098 DOI: 10.1186/s12891-019-2600-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Accepted: 04/30/2019] [Indexed: 11/25/2022] Open
Abstract
Background The Pedi International Knee Documentation Committee (IKDC) and Knee Injury and Osteoarthritis Outcome Score (KOOS) child are validated questionnaires for children with knee disorders. The aim of this study was to translate these questionnaires in Dutch and to recommend which questionnaires should – based on their psychometric properties – be used in clinical practice. Methods The English Pedi-IKDC and KOOS-Child were translated by the forward-backward procedure. Subsequently, content validity of the Pedi-IKDC and KOOS-Child was evaluated by both patients (n = 18) and experts (n = 18). To evaluate construct validity and interpretability participants with knee disorders (n = 100) completed the Numeric Rating Scale Pain, Lysholm Knee Scoring Scale, EuroQol-5 Dimension, Pedi-IKDC and KOOS-Child at baseline. Participants completed the anchor question, Pedi-IKDC and KOOS-child two weeks (n = 54) and one year (n = 71) after baseline, for evaluating the test-retest reliability and responsiveness. Psychometric properties were interpreted following the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) criteria. Results The Pedi-IKDC showed adequate test-retest reliability (intraclass correlation coefficient (ICC) 0.9; standard error of measurement (SEM) 8.6; smallest detectable change (SDC) 23.8), adequate content validity (> 75% relevant), adequate construct validity (75% confirmed hypotheses), low floor or ceiling effects (scores between 5 and 95) and adequate responsiveness (> 75% confirmed hypotheses). The KOOS-Child showed an adequate test-retest reliability (ICC 0.8–0.9; SEM 8.9–16.9; SDC 24.7–46.9), adequate content validity (> 75% relevant, except KOOS-Child subscale ADL), adequate construct validity (75% confirmed hypotheses), low floor and ceiling effects (scores between 5 and 95, except KOOS-Child subscale activities of daily living and Sport/play) and moderate responsiveness (40% confirmed hypotheses). Conclusions The Pedi IKDC showed better psychometric properties than the KOOS-Child and should therefore be used in children with knee disorders.
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Affiliation(s)
| | - M C van der Steen
- Orthopaedic Center Máxima, Máxima Medical Center, Postbus 90052, 5600, PD, Eindhoven, The Netherlands. .,Department of Orthopaedic Surgery, Catharina Hospital Eindhoven, Postbus 1350, 5602, ZA, Eindhoven, The Netherlands.
| | - Jens Leenders
- Orthopaedic Center Máxima, Máxima Medical Center, Postbus 90052, 5600, PD, Eindhoven, The Netherlands
| | | | - Rob P A Janssen
- Orthopaedic Center Máxima, Máxima Medical Center, Postbus 90052, 5600, PD, Eindhoven, The Netherlands
| | - Max Reijman
- Orthopaedic Center Máxima, Máxima Medical Center, Postbus 90052, 5600, PD, Eindhoven, The Netherlands
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17
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Aguado-Henche S, Slocker de Arce A, Carrascosa-Sánchez J, Bosch-Martín A, Cristóbal-Aguado S. Isokinetic assessment of shoulder complex strength in adolescent elite synchronized swimmers. J Bodyw Mov Ther 2018; 22:968-971. [PMID: 30368343 DOI: 10.1016/j.jbmt.2018.01.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 01/23/2018] [Accepted: 01/30/2018] [Indexed: 01/14/2023]
Abstract
Children and adolescent participation in sport has increased in recent years. Synchronized swimming requires correct muscle balance in the shoulder complex. The purpose of this study was to establish isokinetic strength profiles and peak torque ratios of shoulder internal and external rotator muscles in a female high-level synchronized swimming team. Twenty-six adolescent female high-level synchronized swimmers, aged 12-14, participated in this study. Maximal bilateral shoulder concentric external and internal rotation force was measured at 60°/s (5 repetitions) and 180°/s (15 repetitions). The isokinetic concentric strength generated by the internal rotator muscles was significantly higher (p < 0.05) than by the external rotators in both limbs and at both velocities. Significant bilateral differences in the external rotation (ER):internal rotation (IR) strength ratio were noted at 60°/s. Isokinetic assessment is essential in sports medicine, since it is the only test capable of diagnosing any shoulder strength deficit.
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Affiliation(s)
- Soledad Aguado-Henche
- Teaching Unit of Human Anatomy and Embryology, Faculty of Medicine and Health Sciences, University of Alcalá, Spain.
| | - Ana Slocker de Arce
- Teaching Unit of Human Anatomy and Embryology, Faculty of Medicine and Health Sciences, University of Alcalá, Spain
| | - Josefa Carrascosa-Sánchez
- Teaching Unit of Human Anatomy and Embryology, Faculty of Medicine and Health Sciences, University of Alcalá, Spain
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18
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Watanabe H, Fujii M, Yoshimoto M, Abe H, Toda N, Higashiyama R, Takahira N. Pathogenic Factors Associated With Osgood-Schlatter Disease in Adolescent Male Soccer Players: A Prospective Cohort Study. Orthop J Sports Med 2018; 6:2325967118792192. [PMID: 30182029 PMCID: PMC6113738 DOI: 10.1177/2325967118792192] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Background: A previous cross-sectional study reported that pathogenic factors associated with Osgood-Schlatter disease (OSD) in adolescent athletes include increased quadriceps muscle tightness, lower leg malalignment, and development of apophysitis in the tibial tuberosity. Purpose: To confirm these pathogenic factors associated with OSD in a longitudinal study with regard to physical function and performance. Study Design: Cohort study; Level of evidence, 2. Methods: In this study, 37 boys (mean age, 10.2 ± 0.4 years) were recruited from 2 soccer teams at an elementary school. This cohort study was conducted over an observation period of 1 year, with measurements recorded at baseline, followed by screening for OSD every 6 months. Variables evaluated at baseline included physical function (morphometry, joint flexibility, and lower extremity alignment), presence of Sever disease, and kicking motion. Results: Pathogenic factors associated with OSD in the support leg of adolescent male soccer players included height, weight, body mass index, quadriceps femoris muscle tightness in the kicking and support legs, and gastrocnemius muscle tightness, soleus muscle tightness, and medial longitudinal arch in the support leg. Additional factors included a diagnosis of Sever disease and distance from the lateral malleolus of the support leg’s fibula to the center of gravity during kicking. Conclusion: The onset of OSD was found to be affected by many factors, including developmental stage, physical attributes, and pre-existing apophysitis. In particular, a diagnosis of Sever disease and backward shifting of the center of gravity during kicking increased the risk of the subsequent onset of OSD, suggesting that these factors are very important as a possible focus for interventions.
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Affiliation(s)
- Hiroyuki Watanabe
- Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara, Japan
| | - Meguru Fujii
- Nishifuna Clinic, Funabashi Orthopedic Hospital, Funabashi, Japan
| | - Masumi Yoshimoto
- Department of Physical Therapy, Faculty of Health and Medical Science, Teikyo Heisei University, Tokyo, Japan
| | - Hiroshi Abe
- Department of Rehabilitation, Kitasato Institute Hospital, Kitasato University, Tokyo, Japan
| | - Naruaki Toda
- Department of Rehabilitation, Kitasato Institute Hospital, Kitasato University, Tokyo, Japan
| | - Reiji Higashiyama
- Department of Orthopedic Surgery, School of Medicine, Kitasato University, Sagamihara, Japan
| | - Naonobu Takahira
- Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara, Japan
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19
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Chambers G, Kraft J, Kingston K. The role of ultrasound as a problem-solving tool in the assessment of paediatric musculoskeletal injuries. ULTRASOUND : JOURNAL OF THE BRITISH MEDICAL ULTRASOUND SOCIETY 2018; 27:6-19. [PMID: 30774694 DOI: 10.1177/1742271x18759807] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 12/28/2017] [Indexed: 11/15/2022]
Abstract
Musculoskeletal trauma in the paediatric population covers a wide range of injuries; although many overlap with their adult counterparts, others are exclusive to the immature skeletal system. Ultrasound is a versatile tool particularly suited to both the imaging of children and the dynamic assessment of musculoskeletal injuries. This pictorial review aims to discuss a range of injuries, focusing on those commonly encountered in children. We shall describe the muscle-tendon-bone complex and changes that occur with increasing skeletal maturity and how this affects the type of injury encountered.
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Affiliation(s)
- Greg Chambers
- Department of Radiology, Leeds General Infirmary, Leeds Teaching Hospital Trust, UK
| | - Jeannette Kraft
- Department of Radiology, Leeds General Infirmary, Leeds Teaching Hospital Trust, UK
| | - Kate Kingston
- Department of Radiology, York Hospital, York Teaching Hospital NHS Foundation Trust, UK
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20
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Nguyen JC, Sheehan SE, Davis KW, Gill KG. Sports and the Growing Musculoskeletal System: Sports Imaging Series. Radiology 2017. [DOI: 10.1148/radiol.2017161175] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Jie C. Nguyen
- From the Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, E1/313, Madison, WI 53792-3252
| | - Scott E. Sheehan
- From the Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, E1/313, Madison, WI 53792-3252
| | - Kirkland W. Davis
- From the Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, E1/313, Madison, WI 53792-3252
| | - Kara G. Gill
- From the Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, E1/313, Madison, WI 53792-3252
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21
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Raissaki M, Demetriou S, Spanakis K, Skiadas C, Katzilakis N, Velivassakis EG, Stiakaki E, Karantanas AH. Multifocal bone and bone marrow lesions in children - MRI findings. Pediatr Radiol 2017; 47:342-360. [PMID: 28004130 DOI: 10.1007/s00247-016-3737-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 09/13/2016] [Accepted: 10/18/2016] [Indexed: 12/20/2022]
Abstract
Polyostotic bone and bone marrow lesions in children may be due to various disorders. Radiographically, lytic lesions may become apparent after loss of more than 50% of the bone mineral content. Scintigraphy requires osteoblastic activity and is not specific. MRI may significantly contribute to the correct diagnosis and management. Accurate interpretation of MRI examinations requires understanding of the normal conversion pattern of bone marrow in childhood and of the appearances of red marrow rests and hyperplasia. Differential diagnosis is wide: Malignancies include metastases, multifocal primary sarcomas and hematological diseases. Benign entities include benign tumors and tumor-like lesions, histiocytosis, infectious and inflammatory diseases, multiple stress fractures/reactions and bone infarcts/ischemia.
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Affiliation(s)
- Maria Raissaki
- Department of Radiology, University Hospital of Heraklion, University of Crete, Faculty of Medicine, Heraklion, Crete, Greece.
| | - Stelios Demetriou
- Department of Radiology, University Hospital of Heraklion, University of Crete, Faculty of Medicine, Heraklion, Crete, Greece
| | - Konstantinos Spanakis
- Department of Radiology, University Hospital of Heraklion, University of Crete, Faculty of Medicine, Heraklion, Crete, Greece
| | - Christos Skiadas
- Department of Radiology, University Hospital of Heraklion, University of Crete, Faculty of Medicine, Heraklion, Crete, Greece
| | - Nikolaos Katzilakis
- Department of Pediatric Hematology-Oncology, University Hospital of Heraklion, University of Crete, Faculty of Medicine, Heraklion, Crete, Greece
| | | | - Eftichia Stiakaki
- Department of Pediatric Hematology-Oncology, University Hospital of Heraklion, University of Crete, Faculty of Medicine, Heraklion, Crete, Greece
| | - Apostolos H Karantanas
- Department of Radiology, University Hospital of Heraklion, University of Crete, Faculty of Medicine, Heraklion, Crete, Greece
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22
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Arnold A, Thigpen CA, Beattie PF, Kissenberth MJ, Shanley E. Overuse Physeal Injuries in Youth Athletes. Sports Health 2017; 9:139-147. [PMID: 28165873 PMCID: PMC5349397 DOI: 10.1177/1941738117690847] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Context: Despite rising awareness of the risks associated with sports participation, overuse injuries continue to increase in youth athlete populations. Physeal injuries are one type of overuse injury exclusive to pediatric populations that are often sustained during athletic practice or competition. Overuse physeal injuries are, in theory, preventable; however, little consensus has been reached surrounding the risk factors, prevention, and treatment strategies. Objective: This systematic review summarizes the best available evidence concerning overuse physeal injuries in youth and adolescent athletes. It can be used to develop prevention and treatment programs specific to this population. Data Sources: PubMed and Academic Search Complete (EBSCOhost) were explored using the keyword physeal injuries from January 1950 through May 2015 to identify 24 studies. Study Selection: Original research studies of athletic populations with mechanisms of injury related to sport were chosen. Study Design: Systematic review. Level of Evidence: Level 3. Data Extraction: Data were extracted as available from 24 eligible studies. Study quality was rated using the Oxford Centre for Evidence-based Medicine (OCEBM) guidelines. Results: Risk factors for injury include periods of accelerated growth, chronological age, body size, training volume, and previous injury. Injury prevention strategies currently emphasize participation limitations and sport-specific training programs in skeletally immature athletes. The most effective treatment after an overuse physeal injury was an extended period of active rest and joint immobilization when necessary. Conclusion: Overuse physeal injuries are multifactorial in nature. Muscular imbalances after accelerated growth periods predispose young athletes to overuse injuries. Modifiable risk factors such as flexibility, strength, and training volume should be regularly monitored to prevent these injuries.
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Affiliation(s)
- Amanda Arnold
- University of South Carolina, Greenville, South Carolina
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23
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Lloyd RS, Cronin JB, Faigenbaum AD, Haff GG, Howard R, Kraemer WJ, Micheli LJ, Myer GD, Oliver JL. National Strength and Conditioning Association Position Statement on Long-Term Athletic Development. J Strength Cond Res 2016; 30:1491-509. [PMID: 26933920 DOI: 10.1519/jsc.0000000000001387] [Citation(s) in RCA: 204] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
There has recently been a growing interest in long-term athletic development for youth. Because of their unique physical, psychological, and social differences, children and adolescents should engage in appropriately prescribed exercise programs that promote physical development to prevent injury and enhance fitness behaviors that can be retained later in life. Irrespective of whether a child is involved in organized sport or engages in recreational physical activity, there remains a need to adopt a structured, logical, and evidence-based approach to the long-term development of athleticism. This is of particular importance considering the alarmingly high number of youth who fail to meet global physical activity recommendations and consequently present with negative health profiles. However, appropriate exercise prescription is also crucial for those young athletes who are physically underprepared and at risk of overuse injury because of high volumes of competition and an absence of preparatory conditioning. Whether the child accumulates insufficient or excessive amounts of exercise, or falls somewhere between these opposing ends of the spectrum, it is generally accepted that the young bodies of modern day youth are often ill-prepared to tolerate the rigors of sports or physical activity. All youth should engage in regular physical activity and thus should be viewed as "athletes" and afforded the opportunity to enhance athleticism in an individualized, holistic, and child-centered manner. Because of emerging interest in long-term athletic development, an authorship team was tasked on behalf of the National Strength and Conditioning Association (NSCA) to critically synthesize existing literature and current practices within the field and to compose a relevant position statement. This document was subsequently reviewed and formally ratified by the NSCA Board of Directors. A list of 10 pillars of successful long-term athletic development are presented, which summarize the key recommendations detailed within the position statement. With these pillars in place, it is believed that the NSCA can (a) help foster a more unified and holistic approach to long-term athletic development, (b) promote the benefits of a lifetime of healthy physical activity, and
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Affiliation(s)
- Rhodri S Lloyd
- 1Youth Physical Development Unit, School of Sport, Cardiff Metropolitan University, Cardiff, United Kingdom; 2Sports Performance Research Institute New Zealand, AUT University, Auckland, New Zealand; 3Center for Exercise and Sport Science Research, Edith Cowan University, Joondalup, Australia; 4Department of Health and Exercise Science, The College of New Jersey, Ewing, New Jersey; 5Department of Kinesiology, West Chester University, West Chester, Pennsylvania; 6Department of Human Sciences, The Ohio State University, Columbus, Ohio; 7Department of Orthopaedics, Division of Sports Medicine, Boston Children's Hospital, Boston, Massachusetts; 8Harvard Medical School, Boston, Massachusetts; 9The Micheli Center for Sports Injury Prevention, Boston, Massachusetts; 10Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; 11Department of Pediatrics and Orthopaedic Surgery, College of Medicine, University of Cincinnati, Cincinnati, Ohio; and 12Department of Orthopaedics, University of Pennsylvania, Philadelphia, Pennsylvania
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24
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Delgado J, Jaramillo D, Chauvin NA. Imaging the Injured Pediatric Athlete: Upper Extremity. Radiographics 2016; 36:1672-1687. [DOI: 10.1148/rg.2016160036] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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25
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Rössler R, Junge A, Chomiak J, Dvorak J, Faude O. Soccer Injuries in Players Aged 7 to 12 Years: A Descriptive Epidemiological Study Over 2 Seasons. Am J Sports Med 2016; 44:309-17. [PMID: 26646513 DOI: 10.1177/0363546515614816] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND As part of a risk-management approach, sound epidemiological data are needed to develop prevention programs. A recent review on soccer injuries of players younger than 19 years concluded that prospective data concerning children are lacking. PURPOSE To analyze the incidence and characteristics of soccer injuries in children aged 7 to 12 years. STUDY DESIGN Descriptive epidemiological study. METHODS The present survey was a prospective descriptive epidemiological study on soccer injuries over 2 seasons in the Czech Republic and Switzerland. Exposure of players during training and match play (in hours) and injury data were reported by coaches via an Internet-based registration system. Location, type, and severity of injuries were classified according to an established consensus. Injury characteristics are presented as absolute numbers and injury incidence rates (injuries per 1000 hours of soccer exposure). An injury was defined as any physical complaint sustained during a scheduled training session or match play resulting in at least 1 of the following: (1) inability to complete the current match or training session, (2) absence from subsequent training sessions or matches, and (3) injury requiring medical attention. RESULTS In total, 6038 player-seasons with 395,295 hours of soccer exposure were recorded. The mean (±SD) age of the players was 9.5 ± 2.0 years, and 3.9% of the participants were girls. A total of 417 injuries were reported. Most (76.3%) injuries were located in the lower limbs, with 15.6% located in the upper limbs. Joint and ligament injuries comprised 30.5%, contusions 22.5%, muscle and tendon injuries 18.5%, and fractures and bone injuries 15.4% of all injuries; 23.7% of injuries led to more than 28 days of absence from sport participation. The overall injury incidence was 0.61 (95% CI, 0.53-0.69) injuries per 1000 hours of soccer exposure during training sessions and 4.57 (95% CI, 4.00-5.23) during match play. Injury incidence rates increased with increasing age. CONCLUSION The observed injury incidences were lower compared with studies in youth players. Children showed a relatively high proportion of fractures and bone stress and of injuries to the upper limbs. CLINICAL RELEVANCE The study provides an evidence base for injury incidence rates and injury characteristics in children's soccer. These data are the basis to develop an age-specific injury-prevention program.
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Affiliation(s)
- Roland Rössler
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Astrid Junge
- FIFA-Medical Assessment and Research Centre (F-MARC) Schulthess Clinic, Zurich, Switzerland Medical School Hamburg, Germany
| | - Jiri Chomiak
- Department of Orthopaedics, 1st Faculty of Medicine, Charles University and Hospital, Prague, Czech Republic
| | - Jiri Dvorak
- FIFA-Medical Assessment and Research Centre (F-MARC) Schulthess Clinic, Zurich, Switzerland Fédération Internationale de Football Association (FIFA), Zurich, Switzerland
| | - Oliver Faude
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
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26
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Abstract
We report a typical case of acute avulsion of the anterior iliac crest apophysis diagnosed in an indoor football player. The injury occurred as a result of a sudden twist of the trunk while kicking. Plain radiographs made the diagnosis. Complementary CT with 3D reconstructions was preferred to ultrasound because of the very strong habitus - 110 kilograms for 1,73 meter - of the 15-year old adolescent. CT confirmed that occult chronic mechanical stress on the iliac apophysis had preceded the acute avulsion and also emphasized the crucial role of the tensor fascia lata in the mechanism of the injury. The patient was successfully treated conservatively. The case is presented with a short review of the literature.
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Abstract
There has been a substantial increase in the number of children participating in organized competitive sports, which has led to a surge in the number of both acute and overuse injuries. To prevent further complications such as limb deformity and disability, radiologists must be familiar with typical overuse injury patterns in children. Traction apophysitis, chronic physeal injury, and stress fractures are the principal overuse injuries. This article reviews overuse injuries in children with an emphasis on the role of magnetic resonance imaging in diagnosis, prognosis, and treatment.
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28
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Boström A, Thulin K, Fredriksson M, Reese D, Rockborn P, Hammar ML. Risk factors for acute and overuse sport injuries in Swedish children 11 to 15 years old: What about resistance training with weights? Scand J Med Sci Sports 2015; 26:317-23. [PMID: 25727791 DOI: 10.1111/sms.12432] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2015] [Indexed: 11/30/2022]
Abstract
To determine the 1-year self-reported incidence of overuse and traumatic sport injuries and risk factors for injuries in children participating in a summer sports camp representing seven different sports. 4363 children, 11 to 15 years old participating in a summer camp in seven different sports answered a questionnaire. Injury in this cross-sectional study was defined as a sport-related trauma or overload leading to pain and dysfunction preventing the person from participation in training or competition for at least 1 week. A number of risk factors for injury were investigated such as sex, age, number of hours spent on training in general, and on resistance training with weights. Nearly half [49%, 95% confidence interval (CI) 48-51%] of the participants had been injured as a result of participation in a sport during the preceding year, significantly more boys than girls (53%, 95% CI 50-55% vs 46%, 95% CI 43-48%; P < 0.001). Three factors contributed to increased incidence of sport injuries: age, sex, and resistance training with weights. Time spent on resistance training with weights was significantly associated with sport injuries in a logistic regression analysis. In children age 11 to 15 years, the risk of having a sport-related injury increased with age and occurred more often in boys than in girls. Weight training was the only modifiable risk factor that contributed to a significant increase in the incidence of sport injuries.
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Affiliation(s)
- A Boström
- Division of Obstetrics and Gynaecology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - K Thulin
- Clinical Department of Orthopedic Surgery, County Council of Östergötland, Norrköping, Sweden.,Division of Orthopedics, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - M Fredriksson
- Divison of Occupational and Environmental Medicine, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - D Reese
- IFK Norrköping, Norrköping, Sweden
| | - P Rockborn
- Clinical Department of Orthopedic Surgery, County Council of Östergötland, Norrköping, Sweden.,Division of Orthopedics, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - M L Hammar
- Division of Obstetrics and Gynaecology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
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29
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Tony G, Charran A, Tins B, Lalam R, Tyrrell PNM, Singh J, Cool P, Kiely N, Cassar-Pullicino VN. Intra-epiphyseal stress injury of the proximal tibial epiphysis: preliminary experience of magnetic resonance imaging findings. Eur J Radiol 2014; 83:2051-7. [PMID: 25183557 DOI: 10.1016/j.ejrad.2014.08.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Revised: 07/31/2014] [Accepted: 08/08/2014] [Indexed: 10/24/2022]
Abstract
Stress induced injuries affecting the physeal plate or cortical bone in children and adolescents, especially young athletes, have been well described. However, there are no reports in the current English language literature of stress injury affecting the incompletely ossified epiphyseal cartilage. We present four cases of stress related change to the proximal tibial epiphysis (PTE) along with their respective magnetic resonance imaging (MRI) appearances ranging from subtle oedema signal to a pseudo-tumour like appearance within the epiphyseal cartilage. The site and pattern of intra-epiphyseal injury is determined by the type of tissue that is affected, the maturity of the skeleton and the type of forces that are transmitted through the tissue. We demonstrate how an awareness of the morphological spectrum of MRI appearances in intra-epiphyseal stress injury and the ability to identify concomitant signs of stress in other nearby structures can help reduce misdiagnosis, avoid invasive diagnostic procedures like bone biopsy and reassure patients and their families.
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Affiliation(s)
- G Tony
- Stafford General Hospital, Weston Road, Stafford, Staffordshire ST16 3SA, UK.
| | - A Charran
- Hillingdon Hospital, Pield Heath Rd, Uxbridge, Middlesex UB8 3NN, UK.
| | - B Tins
- Department of Diagnostic Imaging, Robert Jones and Agnes Hunt, Orthopaedic Hospital, Oswestry, Shropshire SY10 7 AG, UK.
| | - R Lalam
- Department of Diagnostic Imaging, Robert Jones and Agnes Hunt, Orthopaedic Hospital, Oswestry, Shropshire SY10 7 AG, UK.
| | - P N M Tyrrell
- Department of Diagnostic Imaging, Robert Jones and Agnes Hunt, Orthopaedic Hospital, Oswestry, Shropshire SY10 7 AG, UK.
| | - J Singh
- Department of Diagnostic Imaging, Robert Jones and Agnes Hunt, Orthopaedic Hospital, Oswestry, Shropshire SY10 7 AG, UK.
| | - P Cool
- Orthopaedic Oncology, Robert Jones and Agnes Hunt, Orthopaedic Hospital, Oswestry, Shropshire SY10 7 AG, UK.
| | - N Kiely
- Paediatric Orthopaedics, Robert Jones and Agnes Hunt, Orthopaedic Hospital, Oswestry, Shropshire SY10 7 AG, UK.
| | - V N Cassar-Pullicino
- Department of Diagnostic Imaging, Robert Jones and Agnes Hunt, Orthopaedic Hospital, Oswestry, Shropshire SY10 7 AG, UK.
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Paxinos O, Karavasili A, Manolarakis M, Paxinos T, Papavasiliou A. Neglected lesser tuberosity avulsion in an adolescent elite gymnast. Shoulder Elbow 2014; 6:178-81. [PMID: 27582934 PMCID: PMC4935056 DOI: 10.1177/1758573214531413] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2013] [Accepted: 03/03/2014] [Indexed: 11/17/2022]
Abstract
We report the case of a 16-year-old elite gymnast who presented with recurring pain in the left shoulder after training. The athlete recalled an injury to the shoulder 2 years ago. Clinically a localized tenderness to the anterior shoulder and loss of strength and range of motion was noted. Imaging investigation suggested a neglected lesser tuberosity avulsion. The athlete was treated with open excision of the deformed tuberosity and direct repair of the subscapularis to the humeral head. Following a careful postoperative rehabilitation protocol the athlete was able to return to unrestricted gymnastics after 6 months. After surgery the athlete followed a intense rehabilitation program that allowed him to return to sports at 6 months. At 5-years follow-up, the athlete was asymptomatic and competing at an international level. Avulsion fractures of the lesser tuberosity are extremely rare injuries with significant shoulder disability if left untreated. Anatomic repair can yield excellent results, even in neglected cases.
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Affiliation(s)
- Odysseas Paxinos
- Orthopedic Department, 251 Hellenic Air Force
Hospital, Athens, Greece,Hellenic Gymnastics Federation Medical Team,
Athens, Greece,Odysseas Paxinos, 251 Hellenic Air Force Hospital,
Athens, Greece 3 P. Kanellopoulou Street, Athens, 11525, Greece. E-mail:
Tel: +30-210-7464903; Fax: +30-210-7781104
| | | | | | - Thrasivoulos Paxinos
- Hellenic Army Academy, Faculty of Physical and
Cultural Education, Vari, Attiki, Greece
| | - Athanasios Papavasiliou
- Department of Physical Education and Sport
Science, Aristotle University of Thessaloniki, Greece
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Yanagisawa S, Osawa T, Saito K, Kobayashi T, Tajika T, Yamamoto A, Iizuka H, Takagishi K. Assessment of Osgood-Schlatter Disease and the Skeletal Maturation of the Distal Attachment of the Patellar Tendon in Preadolescent Males. Orthop J Sports Med 2014; 2:2325967114542084. [PMID: 26535345 PMCID: PMC4588527 DOI: 10.1177/2325967114542084] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Osgood-Schlatter disease (OSD) is a traction apophysitis of the tibial tuberosity. Ultrasonography (US) is able to detect pathologic changes, such as cartilage swelling and fragmentation of the tibial tubercle ossification center. PURPOSE To compare the US stages of tibial tuberosity development and the physical features and prevalence of OSD in this patient cohort. STUDY DESIGN Cross-sectional study; Level of evidence, 3. METHODS Subjects included 238 males (n = 476 joints) with a mean age of 11.4 ± 1.6 years (range, 7-14 years). The tibial tuberosity development on US was divided into 3 stages: the cartilaginous stage (stage C), apophyseal stage (stage A), and epiphyseal stage (stage E). It was then investigated whether the subjects had pain in the tibial tuberosity on application of pressure. Age, height, body weight, body mass index (BMI), heel-buttock distance (HBD, cm), and straight-leg raise angle (SLRA) were evaluated. To confirm the diagnosis of OSD, the participant had to fulfill the following clinical criteria: pain with direct pressure on the tibial apophysis, fragmentation of the bone, and irregularity of the ossification center detected by US. RESULTS The tibial tuberosity was stage C in 195 knees, stage A in 105 knees, and stage E in 176 knees. The subjects' heights, weights, and BMIs significantly increased with advancing development of the tibial tuberosity. The HBD increased in stage E (P < .01). The SLRA was not significantly different among groups. There was fragmentation of the bone and irregularity of the ossification center in 32 knees (6.8%): 0 in stage C, 21 (4.3%) in stage A, and 11 (2.3%) in stage E. Fragmentation of the bone and irregularity were observed significantly more often in stage A (P < .01). On the other hand, there were 10 joints with OSD (2.1%): 0 in stage C, 3 (0.6%) in stage A, and 7 (1.5%) in stage E. OSD was observed significantly more often in stage E than in the other stages (P < .05). CONCLUSION The present study showed that the HBD increased from stage A to stage E. The prevalence of OSD was highest in stage E.
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Affiliation(s)
- Shinya Yanagisawa
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Takashi Osawa
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Kenichi Saito
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Tsutomu Kobayashi
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Tsuyoshi Tajika
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Atsushi Yamamoto
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Haku Iizuka
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Kenji Takagishi
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Gunma, Japan
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Andrew N, Gabbe BJ, Cook J, Lloyd DG, Donnelly CJ, Nash C, Finch CF. Could targeted exercise programmes prevent lower limb injury in community Australian football? Sports Med 2014; 43:751-63. [PMID: 23681448 DOI: 10.1007/s40279-013-0056-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Australian football is a popular sport in Australia, at both the community and elite levels. It is a high-speed contact sport with a higher incidence of medically treated injuries when compared with most other organized sports. Hamstring injuries, ligament injuries to the knee or ankle, hip/groin injuries and tendinopathies are particularly common and often result in considerable time lost from sport. Consequently, the prevention of lower limb injuries is a priority for both community and elite Australian football organizations. There is considerable literature available on exercise programmes aimed at reducing lower limb injuries in Australian football and other running-related sports. The quality and outcomes of these studies have varied considerably, but indicate that exercise protocols may be an effective means of preventing lower limb injuries. Despite this, there has been limited high-quality and systematic evaluation of these data. OBJECTIVE The aim of this literature review is to systematically evaluate the evidence about the benefits of lower limb injury prevention exercise protocols aimed at reducing the most common severe lower limb injuries in Australian football. METHODS The Cochrane Central Register of Controlled Trials, the Cochrane Bone Joint and Muscle Trauma Group Specialized Register, MEDLINE and other electronic databases were searched, from January 1990 to December 2010. Papers reporting the results of randomized controlled trials (RCTs), quasi-RCTs, cohort and case-control studies were extracted. Primary outcomes were injury reduction or risk factor identification and/or modification. Secondary outcomes were adherence to any trialled interventions, injury severity and adverse effects such as secondary injuries and muscle soreness. The methodological quality of extracted manuscripts was assessed and results were collated. RESULTS Forty-seven papers were identified and reviewed of which 18 related to hamstring injury, eight related to knee or ankle ligament injury, five related to tendon injury and four were hip or groin injury related. Another 12 papers targeted general lower limb injuries. Most (n = 27 [57%]) were observational studies, investigating injury risk factors. Twenty reported the results of intervention trials. Of these, 15 were efficacy trials reporting the effects of an intervention in reducing injury rates, four were biomechanical interventions in which the impact of the intervention on a known injury risk factor was assessed and one reported changes in injury risk factors as well as injury rates. The strength of the evidence base for exercise programmes for lower limb injury prevention was found to be limited, primarily due to the research methods employed, low adherence to interventions by the study participants and a lack of statistical power. Limited evidence obtained from a small number of RCTs suggests that balance and control exercises might be efficacious in preventing ankle ligament injuries and a programme involving a combination of balance and control exercises, eccentric hamstring, plyometrics and strength exercises could be efficacious in preventing all lower limb injuries. CONCLUSIONS Overall, the evidence for exercise programmes as an efficacious lower limb injury prevention strategy is predominantly restricted to studies addressing injury aetiology and mechanisms. The findings of this review highlight the need to develop and test interventions in well designed population-based trials with an emphasis on promoting intervention uptake and adherence and, hence, intervention effectiveness. The results of this review can inform the development of the components of a future lower limb injury prevention exercise protocol for community-level Australian football.
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Affiliation(s)
- Nadine Andrew
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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Skiadas V, Perdikakis E, Plotas A, Lahanis S. MR imaging of anterior knee pain: a pictorial essay. Knee Surg Sports Traumatol Arthrosc 2013; 21:294-304. [PMID: 22488011 DOI: 10.1007/s00167-012-1976-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2011] [Accepted: 03/15/2012] [Indexed: 01/11/2023]
Abstract
Anterior knee pathology is a frequent cause of joint pain and limitation of function and mobility among patients presenting to an orthopaedic department. Proper recognition and treatment of pathologic conditions depend on the knowledge of normal anatomy and of the various abnormalities, which affect this area of the knee and may present with anterior knee pain. A broad array of benign and malignant processes may be manifested as anterior knee discomfort, and this common clinical entity is among the most frequent indications for MR imaging of the lower extremities. Clinical history and physical examination are also of paramount importance. The disorders can be categorized and differentiated primarily according to their location. Traumatic or non-traumatic disorders of the patella, patellar retinacula, quadriceps and patellar tendons and supra or infrapatellar fat pad can be the source of symptoms. This article includes a comprehensive pictorial essay of the characteristic MR features of common and uncommon disorders causing anterior knee pain. For accurate assessment of the aforementioned clinical problem, a radiologist should be able to identify typical MR imaging patterns that contribute in establishing the correct diagnosis and thus tailoring the appropriate therapy. Level of evidence IV.
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Schneider S, Yamamoto S, Weidmann C, Brühmann B. Sports injuries among adolescents: incidence, causes and consequences. J Paediatr Child Health 2012; 48:E183-9. [PMID: 23009049 DOI: 10.1111/j.1440-1754.2012.02578.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM The purpose of this study was to evaluate the 1-year incidence, location, type, mechanism and severity of sports injuries for adolescents in Germany. METHODS Data were from the 'German Health Interview and Examination Survey for Children and Adolescents', a nationwide study of n = 17 641 children and adolescents. Analyses were based on a weighted total sample size of n(w) = 7451 adolescents between 11 and 17 years of age, 51% of them boys. RESULTS A total of 577 adolescents (8%) reported having experienced a sports injury during the past year. Collisions and falls were reported as being the most important causes. The most frequent diagnoses were contusions, dislocations, strains and sprains (60%), followed by fractures (26%). Most injuries (88%) were treated on an outpatient basis with only 12% resulting in hospitalisation. Gender-specific analyses showed that 9% of the boys and 7% of the girls suffered from a sports injury during the past year. After adjusting for the level of physical activity, these gender differences disappeared (OR(girls) 0.94; 95% confidence intervals: 0.74-1.18). Excluding injuries incurred from falls while horse riding, there were no gender differences in the mechanism of injury. Among boys, 30% of all injuries were fractures, among girls 20% (P < 0.05). Apart from fractures, no further differences between the sexes in the range of diagnoses were identified. CONCLUSIONS Although these results suggest that the risk of sports injuries does not differ significantly based on adolescents' gender, the incidence rate of adolescent sports injuries within Germany is relatively high.
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Affiliation(s)
- Sven Schneider
- Mannheim Institute of Public Health, Social and Preventive Medicine, Mannheim Medical Faculty, Heidelberg University, Mannheim, Germany.
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Nusman C, van Rijn R, Lim L, Maas M. An 11-year-old high-level competitive gymnast with back pain. Br J Sports Med 2012; 47:929-32. [DOI: 10.1136/bjsports-2011-090647] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Brühmann B, Schneider S. Risk groups for sports injuries among adolescents--representative German national data. Child Care Health Dev 2011; 37:597-605. [PMID: 21392052 DOI: 10.1111/j.1365-2214.2011.01209.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Physical activity during childhood and adolescence is of major importance with regard to an individual's engagement with sports in later life. Apart from the physical trauma, sports injuries often have negative effects on the motivation to remain physically active. This study evaluates data to gain detailed knowledge on 1-year incidence and risk groups with the aim of providing information for the development of preventive measures. METHODS Our data analysis is based on a net sample from a national study in Germany including 7697 children and adolescents aged 11 to 17 years. Within the statistical analyses, we developed weighting factors and calculated group differences as well as regression models for sports injury incidence. RESULTS A total of 7.7% of the children and adolescents reported a sport injury during the last 12 months. Bivariate analyses showed significant associations between sports injuries and several social and lifestyle-related covariates. After adjustment for participation in leisure time physical activity, age, non-migrant status and residence in a large city remained positively associated with the incidence of sports injuries. CONCLUSIONS In comparison with other results for developed countries, the incidence seems rather high. It remains to be clarified whether this is because of our use of more accurate population-based data. The results suggest that while developing preventive measures, the interaction between preferences for high-risk sports and physical as well as psychological development has to be considered.
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Affiliation(s)
- B Brühmann
- Faculty of Health and Society, Malmö University, Malmö, Sweden.
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Foot, Ankle, and Lower Leg Injuries in Young Male Track and Field Athletes. INTERNATIONAL JOURNAL OF ATHLETIC THERAPY & TRAINING 2011. [DOI: 10.1123/ijatt.16.3.19] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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de Lucena GL, dos Santos Gomes C, Guerra RO. Prevalence and associated factors of Osgood-Schlatter syndrome in a population-based sample of Brazilian adolescents. Am J Sports Med 2011; 39:415-20. [PMID: 21076014 DOI: 10.1177/0363546510383835] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Osgood-Schlatter (OS) syndrome is a disease of the musculoskeletal system often observed during the bone growth phase in adolescents. HYPOTHESIS/ PURPOSE: Demographic and anthropometric factors and those linked to the practice of sports may be related to the prevalence of OS. The aim of the present study was to describe the epidemiologic profile and associated factors of individuals with OS syndrome in a population-based sample of Brazilian adolescents. STUDY DESIGN Cross-sectional study; Level of evidence, 3. METHODS A cross-sectional study was conducted with 956 adolescent students (474 boys, 482 girls) from 2008 to 2009 enrolled in the school system of Natal, Brazil. The age ranged between 12 and 15 years (13.7 ± 1.04 years). Tests were performed to assess the anthropometric and clinical aspects related to OS. To confirm the diagnosis of OS syndrome, the participant had to fulfill all the following clinical criteria: pain with direct pressure on the tibial apophysis; aforementioned pain before, during, and after physical activities; enlargement or prominence of the tibial apophysis; pain with resisted knee extension; and pain from jumping. RESULTS The prevalence of OS in the sample was 9.8% (11.0% of boys and 8.3% of girls; boys, 13.5 ± 1.07 years; girls, 13.6 ± 1.01 years). The results showed that 74.6% of the students suffered from muscle shortening. Multivariate analysis using logistic regression showed that the factors associated with the presence of OS were the regular practice of sport activity (odds ratio, 1.94; 95% confidence interval, 1.22-3.10) and the shortening of the rectus femoris muscle (odds ratio, 7.15; 95% confidence interval, 2.86-17.86). CONCLUSIONS The regular practice of sports in the pubertal phase and the shortening of the rectus femoris muscle were the main factors associated to the presence of OS syndrome in the students.
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Affiliation(s)
- Gildásio Lucas de Lucena
- Department of Physiotherapy, Federal University of Rio Grande do Norte, Campus Universitário Lagoa Nova, CEP, Natal-RN 59072-970 Brazil.
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