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Dünkel J, Scheider TO, Tamborrini G. [Muscle injuries: the importance of high-resolution dynamic sonography in diagnostics, treatment and monitoring]. ORTHOPADIE (HEIDELBERG, GERMANY) 2024; 53:404-414. [PMID: 38739271 PMCID: PMC11142968 DOI: 10.1007/s00132-024-04505-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/15/2024] [Indexed: 05/14/2024]
Abstract
BACKGROUND Muscle injuries are common in football. Imaging diagnostics have a major role in establishing a diagnosis. The main diagnostic procedures are MRI and ultrasound. Both diagnostics have advantages and disadvantages, which should be balanced against each other. NEW ULTRASONIC TECHNIQUES The role of MRI as the gold standard is increasingly being replaced by high-resolution ultrasound techniques, and MRI imaging is not always useful. To detect complications in the early stages it is advised to perform regular ultrasound-imaging check-ups. The healing process can be monitored, and it offers additional options for ultrasound-guided interventions such as hematoma punctures and targeted infiltrations. ADVANTAGES AND DISADVANTAGES However, ultrasound imaging is highly user dependent. Experienced operators can eliminate this disadvantage, which makes ultrasound a superior imaging system in many areas, especially for dynamic examinations. Nevertheless, MRI imaging remains a necessary imaging method in certain areas.
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Affiliation(s)
- Jörg Dünkel
- Sportklinik Bern, Bümplizstrasse 83, 3018, Bern, Schweiz.
| | | | - Giorgio Tamborrini
- UZR - Schweizer Ultraschallzentrum und Institut für Rheumatologie, Basel, Schweiz
- Klinik für Rheumatologie, Universitätsspital Basel, Basel, Schweiz
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2
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Partenheimer A, Warnhoff M, Lill H. [Management of muscle trauma in popular sports]. UNFALLCHIRURGIE (HEIDELBERG, GERMANY) 2023; 126:895-903. [PMID: 37870560 DOI: 10.1007/s00113-023-01377-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/15/2023] [Indexed: 10/24/2023]
Abstract
Muscle injuries make up the majority of injuries in popular sports. The causes for the development are multifactorial and can be divided into functional disorders and a lack of knowledge regarding training control. Insufficient warm-up and overtraining both increase the danger of the occurrence of the injury. Knowledge of the different types of muscle injuries and their incorporation into an exact classification enable the establishment of a correct treatment plan and can have a positive influence on the healing process. In addition to acute treatment the knowledge and application of preventive programs are necessary as these can significantly reduce the prevalence of muscle injuries in sports.
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Affiliation(s)
- Axel Partenheimer
- Spine & Sport, Herrenhäuser Kirchweg 38, 30167, Hannover, Deutschland.
- Klinik für Orthopädie und Unfallchirurgie, DIAKOVERE Friederikenstift, Hannover, Deutschland.
| | | | - Helmut Lill
- Klinik für Orthopädie und Unfallchirurgie, DIAKOVERE Friederikenstift, Hannover, Deutschland
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3
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Trsan J, Nottle BF, Pusterla N. Effect of Procaine Penicillin G and Flunixin Meglumine on Serum Amyloid A Response in Healthy Adult Horses. J Equine Vet Sci 2023; 129:104876. [PMID: 37451522 DOI: 10.1016/j.jevs.2023.104876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/29/2023] [Accepted: 06/27/2023] [Indexed: 07/18/2023]
Abstract
This study was designed to determine the effect of PPG and/or flunixin meglumine on SAA response when used at clinical dosing regimens in healthy adult horses. Six healthy adult horses were enrolled in a crossover study design including one control and three treatment groups: no treatment (control); PPG alone (intramuscularly q12h for 72h); flunixin meglumine alone (intravenously q24h for 72h); and PPG (intramuscularly q12h for 72h) and flunixin meglumine (intravenously q24h for 72h). Whole blood was collected at 0, 24, 48, 72, 96 and 120 hours post-initial drug administration to measure SAA using a commercial lateral-flow immunoassay. The washout period was 30 days. Individual SAA values were within the reference range (≤ 20 µg/mL) for almost all horses in the control group. One control horse displayed a SAA value of 28 µg/mL at 72 hours. All horses from the PPG group showed normal SAA values throughout the study. Apart from one horse (SAA of 24 µg/mL at 96 hours) from the flunixin meglumine group, all horses showed normal SAA values. For the PPG and flunixin meglumine group, 5 horses had SAA values within reference range. One horse displayed increased SAA values (32-45 µg/mL) between 48 to 96 hours post-drug administration. There was no difference in area under the SAA time curve amongst control and treatment groups (P > 0.05). The administration of intramuscular PPG and/or intravenous flunixin meglumine does not trigger an inflammatory response that induces a SAA value above reference range in most adult healthy horses.
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Affiliation(s)
- Jurica Trsan
- Equine Internal Medicine, William R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, CA.
| | - Bridget F Nottle
- Equine Internal Medicine, William R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, CA; Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO
| | - Nicola Pusterla
- Equine Internal Medicine, William R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, CA
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4
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Orthobiologic Interventions for Muscle Injuries. Phys Med Rehabil Clin N Am 2023; 34:181-198. [DOI: 10.1016/j.pmr.2022.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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5
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Carneiro de Castro IF, Schmidt V, Silvanose CD, Binoy A, Azmanis PN. Safety of an Intravenous Formulation of Voriconazole as an Intramuscular Injection in Pigeons (Columba livia f. domestica). J Avian Med Surg 2022; 36:262-271. [DOI: 10.1647/20-00006] [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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6
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Garcia AG, Andrade R, Afonso J, Runco JL, Maestro A, Espregueira-Mendes J. Hamstrings injuries in football. J Orthop 2022; 31:72-77. [PMID: 35464813 PMCID: PMC9026901 DOI: 10.1016/j.jor.2022.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/08/2022] [Accepted: 04/09/2022] [Indexed: 11/15/2022] Open
Abstract
Background Hamstrings injuries are a major concern in football (soccer), affecting both recreational players and professional athletes. Although being a recognized issue within the football community, its incidence has been increasing over the last years and still poses a challenge to all practitioners involved. Study objectives and rationale The goal of this narrative review is to outline hamstrings injuries epidemiology and mechanisms of injury, identify and discuss its risk factors, provide an approach to a proper early diagnosis, evaluate the efficacy of current treatment options and return to sports, and present the best strategies for hamstrings injury prevention. These guidelines will help the sports medicine staff team on how to better manage their players with or at risk of hamstrings injuries. Conclusion Despite several breakthroughs in research of hamstrings injuries, there is still heterogeneity across studies and lack of consensus in regards to classification, diagnosis, treatment and prevention. Hamstrings injuries compromise the athlete's performance with time loss due to injury, shortens their highest-level career longevity with higher risk of reinjury rates, and is a defying problem for clubs to balance financial losses due to having their players off the pitch. Further research is warranted to keep moving forward with evidence on treating and preventing hamstrings injuries to mitigate its high incidence and keep the players safe.
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Affiliation(s)
- André Gismonti Garcia
- Casa de Saúde São José, Rio de Janeiro, Brazil
- Clínica Espregueira – FIFA Medical Centre of Excellence, Porto, Portugal
| | - Renato Andrade
- Clínica Espregueira – FIFA Medical Centre of Excellence, Porto, Portugal
- Dom Henrique Research Centre, Porto, Portugal
- Porto Biomechanics Laboratory (LABIOMEP), University of Porto, Porto, Portugal
| | - José Afonso
- Centre of Research, Education Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, Portugal
| | | | - Antonio Maestro
- Instituto Asturiano de Traumatologia Real Sporting de Gijon, Gijon, Spain
- Corresponding author.
| | - João Espregueira-Mendes
- Clínica Espregueira – FIFA Medical Centre of Excellence, Porto, Portugal
- Dom Henrique Research Centre, Porto, Portugal
- School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's–PT Government Associate Laboratory, Braga/Guimarães, Portugal
- 3B's Research Group – Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Barco, Guimarães, Portugal
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7
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Potts G, Reid D, Larmer P. The effectiveness of preoperative exercise programmes on quadriceps strength prior to and following anterior cruciate ligament (ACL) reconstruction: A systematic review. Phys Ther Sport 2021; 54:16-28. [PMID: 34933208 DOI: 10.1016/j.ptsp.2021.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 12/09/2021] [Accepted: 12/11/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVES to evaluate the effectiveness of preoperative exercise programmes on quadriceps strength prior to and following anterior cruciate ligament (ACL) reconstruction. DESIGN Systematic review. METHODS a systematic review was undertaken, included studies were evaluated using the Modified Downs and Black checklist which is appropriate for determining the quality of randomised and non-randomised studies. Scientific databases searched included PubMED, EBSCO Health, CINAHL, Medline, and Cochrane Library databases from inception to March 2021. RESULTS Ten studies met the inclusion criteria. There were six randomised studies and four prospective studies. The level of evidence is categorised as 'limited' due to heterogenicity and only six studies reported quadriceps strength increases. Five studies demonstrated preoperative exercise of 4-16 weeks duration can significantly increase preoperative quadriceps strength. One study demonstrated preoperative OKC exercise produced significantly stronger preoperative quadriceps compared to CKC exercise. One study showed no between group (intervention vs control) quadriceps strength difference pre or 12 weeks postoperatively. CONCLUSIONS 4-16 weeks of preoperative exercise could increase quadriceps strength preoperatively but any persistent postoperative strength benefit from undertaking a standardised preoperative intervention is unclear. There is considerable variation and methodological limitations across the included studies and the composition of optimal preoperative ACLR exercise is currently unknown.
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Affiliation(s)
- Geoff Potts
- Faculty of Health and Environmental Sciences, School of Clinical Sciences, Auckland University of Technology, Private Bag 92006, Auckland, 1142, New Zealand; KneeCare, 5 Akoranga Drive, Northcote, 0627, Auckland, New Zealand.
| | - Duncan Reid
- Faculty of Health and Environmental Sciences, School of Clinical Sciences, Auckland University of Technology, Private Bag 92006, Auckland, 1142, New Zealand.
| | - Peter Larmer
- Faculty of Health and Environmental Sciences, School of Clinical Sciences, Auckland University of Technology, Private Bag 92006, Auckland, 1142, New Zealand.
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Ling X, Ma X, Kuang X, Zou Y, Zhang H, Tang H, Du H, Zhu B, Huang H, Xia Q, Chen M, Mao D, Chen D, Shen H, Yan J. Lidocaine Inhibits Myoblast Cell Migration and Myogenic Differentiation Through Activation of the Notch Pathway. DRUG DESIGN DEVELOPMENT AND THERAPY 2021; 15:927-936. [PMID: 33688167 PMCID: PMC7936691 DOI: 10.2147/dddt.s290002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 12/31/2020] [Indexed: 11/23/2022]
Abstract
Purpose To assess the cellular and molecular effects of lidocaine on muscles/myoblasts. Methods Cultured myogenic precursor (C2C12) cells were treated with varying concentrations of lidocaine. Results Cell viability of C2C12 cells was inhibited by lidocaine in a concentration-dependent manner, with concentrations ≥0.08%, producing a dramatic reduction in cell viability. These ≥0.08% concentrations of lidocaine arrested cell cycles of C2C12 cells in the G0/G1 phase. Moreover, lidocaine inhibited cell migration and myogenic processes in C2C12 cells at low concentrations. Results from QRT-PCR assays revealed that following treatment with lidocaine, Notch1, Notch2, Hes1, Csl and Dll4 all showed higher levels of expression, while no changes were observed in Mmal1, Hey1, Dll1 and Jag1. Conclusion This work provides the first description of the effects of lidocaine upon the regeneration of muscles and maintenance of satellite cells at the cellular and molecular levels. In specific, we found that the Dll4-Notch-Csl-Hes1 axis was up-regulated suggesting that the Notch signaling pathway was involved in producing these effects of lidocaine. These findings provide a new and important foundation for future investigations into the effects of drug therapies in muscle diseases.
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Affiliation(s)
- Xiangtian Ling
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510060, People's Republic of China
| | - Xinqi Ma
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510060, People's Republic of China
| | - Xielan Kuang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510060, People's Republic of China
| | - Yuxiu Zou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510060, People's Republic of China
| | - Han Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510060, People's Republic of China
| | - Han Tang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510060, People's Republic of China
| | - Han Du
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510060, People's Republic of China
| | - Binbin Zhu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510060, People's Republic of China
| | - Hao Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510060, People's Republic of China
| | - Qing Xia
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510060, People's Republic of China
| | - Minghao Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510060, People's Republic of China
| | - Danyi Mao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510060, People's Republic of China
| | - Dongli Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510060, People's Republic of China
| | - Huangxuan Shen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510060, People's Republic of China.,Biobank of Eye, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510060, People's Republic of China
| | - Jianhua Yan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510060, People's Republic of China
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9
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Silvers-Granelli HJ, Cohen M, Espregueira-Mendes J, Mandelbaum B. Hamstring muscle injury in the athlete: state of the art. J ISAKOS 2020; 6:170-181. [PMID: 34006581 DOI: 10.1136/jisakos-2017-000145] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 08/16/2020] [Accepted: 09/26/2020] [Indexed: 11/03/2022]
Abstract
Hamstring injuries (HSI) are the source of significant impairment and disability for both professional and recreational athletes. The incidence and prevalence of HSIs has been well documented in the literature, as they are among the most common soft tissue injuries reported. The significant time loss due to injury and the inherent risk of reinjury pose a significant issue to the athlete, their career longevity and the success of their respective team. This review will deal predominantly with describing the prevalence and incidence of HSI in athletes, discuss risk factors and the mechanisms of injury for HSI, how to properly diagnose, image and prognosticate appropriate return to sport (RTS) for individuals who have sustained an HSI, prescribe treatment and prevention strategies and to discuss relevant options to decrease overall risk of primary and secondary recurrence of HSI.Current treatments of acute HSI necessitate a thorough understanding of the mechanism of injury, identifying muscle imbalances and/or weakness, inclusion of eccentric and concentric hamstring (HS) and hip extension (HE) exercises, evaluation of pathokinematic movement patterns and use non-surgical methods to promote healing and RTS. This methodology can be used prospectively to mitigate the overall risk of HSI. Injection therapies for HSI, including ultrasound-guided platelet-rich plasma and corticosteroids, may impart some short-term benefit, but the existing literature is largely inconclusive with respect to long-term functional outcomes. Future directions should prioritise injury prevention, early diagnosis and targeted interventions that combine both non-surgical and minimally invasive orthobiological approaches and identifying biomechanical risk factors prospectively to mitigate risk.
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Affiliation(s)
- Holly J Silvers-Granelli
- Musculoskeletal Research Center, Velocity Physical Therapy, Santa Monica, California, USA .,Medical Assessment Research Committee, Major League Soccer, New York, New York, USA
| | - Moises Cohen
- Orthopedic Department, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
| | - João Espregueira-Mendes
- Dom Research Center, Clinica Espregueira Mendes, FIFA Medical Centre of Excellence, Porto, Portugal
| | - Bert Mandelbaum
- Medical Assessment Research Committee, Major League Soccer, New York, New York, USA.,Sports Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
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10
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Fang J, Wang X, Jiang W, Zhu Y, Hu Y, Zhao Y, Song X, Zhao J, Zhang W, Peng J, Wang Y. Platelet-Rich Plasma Therapy in the Treatment of Diseases Associated with Orthopedic Injuries. TISSUE ENGINEERING PART B-REVIEWS 2020; 26:571-585. [PMID: 32380937 DOI: 10.1089/ten.teb.2019.0292] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Platelet-rich plasma (PRP) is an autologous platelet concentrate prepared from the whole blood that is activated to release growth factors (GFs) and cytokines and has been shown to have the potential capacity to reduce inflammation and improve tissue anabolism for regeneration. The use of PRP provides a potential for repair due to its abundant GFs and cytokines, which are key in initiating and modulating regenerative microenvironments for soft and hard tissues. Among outpatients, orthopedic injuries are common and include bone defects, ligament injury, enthesopathy, musculoskeletal injury, peripheral nerve injury, chronic nonhealing wounds, articular cartilage lesions, and osteoarthritis, which are caused by trauma, sport-related or other types of trauma, or tumor resection. Surgical intervention is often required to treat these injuries. However, for numerous reasons regarding limited regeneration capacity and insufficient blood supply of the defect region, these treatments commonly result in unsatisfactory outcomes, and follow-up treatment is challenging. The aim of the present review is to explore future research in the field of PRP therapy in the treatment of diseases associated with orthopedic injuries. Impact statement In recent years, platelet-rich plasma (PRP) has become widely used in the treatment of diseases associated with orthopedic injuries, and the results of numerous studies are encouraging. Due to diseases associated with orthopedic injuries being common in clinics, as a conservative treatment, more and more doctors and patients are more likely to accept PRP. Importantly, PRP is a biological product of autologous blood that is obtained by a centrifugation procedure to enrich platelets from whole blood, resulting in few complications, such as negligible immunogenicity from an autologous source, and it is also simple to produce through an efficient and cost-effective method in a sterile environment. However, the applicability, advantages, and disadvantages of PRP therapy have not yet been fully elucidated. The aim of the present review is to explore future research in the field of PRP therapy in the treatment of diseases associated with orthopedic injuries, as well as to provide references for clinics.
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Affiliation(s)
- Jie Fang
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Lab of Musculoskeletal Trauma & War Injuries, PLA, Beijing, P.R. China.,Graduate School of The North China University of Science and Technology, Hebei, P.R. China.,Department of Hand and Foot Surgery, Tianjin Union Medical Center, Tianjin, P.R. China
| | - Xin Wang
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Lab of Musculoskeletal Trauma & War Injuries, PLA, Beijing, P.R. China
| | - Wen Jiang
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Lab of Musculoskeletal Trauma & War Injuries, PLA, Beijing, P.R. China
| | - Yaqiong Zhu
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Lab of Musculoskeletal Trauma & War Injuries, PLA, Beijing, P.R. China
| | - Yongqiang Hu
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Lab of Musculoskeletal Trauma & War Injuries, PLA, Beijing, P.R. China
| | - Yanxu Zhao
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Lab of Musculoskeletal Trauma & War Injuries, PLA, Beijing, P.R. China
| | - Xueli Song
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Lab of Musculoskeletal Trauma & War Injuries, PLA, Beijing, P.R. China
| | - Jinjuan Zhao
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Lab of Musculoskeletal Trauma & War Injuries, PLA, Beijing, P.R. China
| | - Wenlong Zhang
- Department of Hand and Foot Surgery, Tianjin Union Medical Center, Tianjin, P.R. China
| | - Jiang Peng
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Lab of Musculoskeletal Trauma & War Injuries, PLA, Beijing, P.R. China.,Co-innovation Center of Neuroregeneration Nantong University, Nantong, Jiangsu Province, P.R. China
| | - Yu Wang
- Institute of Orthopedics, Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Lab of Musculoskeletal Trauma & War Injuries, PLA, Beijing, P.R. China.,Co-innovation Center of Neuroregeneration Nantong University, Nantong, Jiangsu Province, P.R. China
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11
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Beggs I. Biological Basis of Treatments of Acute Muscle Injuries: A Short Review. Semin Musculoskelet Radiol 2020; 24:256-261. [PMID: 32987424 DOI: 10.1055/s-0040-1708087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Muscle strains occur frequently in recreational and professional sports. This article considers various treatment options in a biological context and reviews evidence of their efficacy. Treatments reviewed include the PRICE principle (P: rotection, R: est, I: ce, C: ompression, E: levation), early mobilization, physical therapy, hematoma aspiration, platelet-rich plasma injections, use of nonsteroidal anti-inflammatory drugs, corticosteroids, and local anesthetics, cellular therapies, and surgery.
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Affiliation(s)
- Ian Beggs
- Analytic Imaging, Edinburgh, United Kingdom
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12
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The conservative treatment of longstanding adductor-related groin pain syndrome: a critical and systematic review. Biol Sport 2020; 38:45-63. [PMID: 33795914 PMCID: PMC7996386 DOI: 10.5114/biolsport.2020.97669] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 06/12/2020] [Accepted: 07/15/2020] [Indexed: 02/07/2023] Open
Abstract
Longstanding (chronic) adductor-related groin pain syndrome is a widely common problem for athletes in many sports activities which often drastically reduces player activity and performance. The first choice in therapeutic treatment is conservative therapy. The objective of this study is to provide a systematic review regarding conservative treatment for longstanding adductor-related groin pain syndrome present in literature today. Furthermore, this study aims to give a critical vision of the current state of the art of the considered topic. After screening 234 articles, 19 studies following the inclusion criteria were included and summarized in this current systematic review and seven different types of therapeutic interventions were described. Compression clothing therapy, manual therapy together with strengthening exercise and prolotherapy were the therapeutic interventions which showed both the greatest level of strength of evidence (Moderate) and grade of recommendation (D). The remaining four types of therapeutic interventions i.e.: corticoid injection, platelet rich plasma therapy, intra-tissue percutaneous electrolysis and pulse-dose radiofrequency, showed both lower levels of strength of evidence (Conflicting) and grade of recommendation (C). In conclusion the literature available on the conservative treatment for longstanding adductor-related groin pain syndrome is limited and characterized by a low level of evidence. Therefore, our recommendation is to refer only to the few studies with higher level of evidence and at the same time to encourage further research in this area. The intervention showing the greater level of strength of evidence, and the greater grade of recommendation are compression clothing therapy, manual therapy and strengthening exercise, and prolotherapy. Other therapeutic interventions such as intra-tissue percutaneous electrolysis and pulse-dose radiofrequency seem promising but require further studies to confirm their efficacy.
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13
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Reichl FX, Högg C, Liu F, Schwarz M, Teupser D, Hickel R, Bloch W, Schweikl H, Thomas P, Summer B. Actovegin® reduces PMA-induced inflammation on human cells. Eur J Appl Physiol 2020; 120:1671-1680. [PMID: 32447451 PMCID: PMC8497287 DOI: 10.1007/s00421-020-04398-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 05/16/2020] [Indexed: 01/06/2023]
Abstract
Purpose The effect of Actovegin® was investigated on PMA- and LPS-induced human peripheral blood mononuclear cells (PBMCs). Methods PBMCs (1 × 106 cells/ml) from five blood donors (2 f, 3 m; 45–55 years) were grown in medium and exposed to Actovegin® in the presence or absence of PMA or LPS. Supernatants were collected to assess the concentration of cytokines (TNF-α, IL-1beta, IL-6 and IL-10). The reactive oxygen species (ROS) were assessed by a ROS-GloTM H2O2 assay. Results Stimulation of cells by PMA or LPS (without Actovegin®) significantly increased the secretion of IL-1beta, IL-6, IL-10 and TNF-α from PBMCs, compared to controls. Pre-treatment of cells with Actovegin® (1, 5, 25, 125 µg/ml) plus PMA significantly decreased the secretion of IL-1beta from PBMCs, compared to controls (PMA without Actovegin®). In contrast, addition of Actovegin® (1, 5, 25, 125 and 250 µg/ml) plus LPS did not alter the IL-1beta production, compared to controls (LPS without Actovegin®). TNF-α, IL-6 and IL-10 do not contribute to the reduction of inflammatory reactions with Actovegin®. Conclusions Actovegin® can reduce the PMA-induced IL-1beta release and the ROS production from PBMCs. These findings may help to explain the clinically known positive effects of Actovegin® on athletic injuries with inflammatory responses (e.g., muscle injuries, tendinopathies).
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Affiliation(s)
- Franz-Xaver Reichl
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Goethestr. 70, 80336, Munich, Germany.
| | - Christof Högg
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Goethestr. 70, 80336, Munich, Germany
| | - Fangfang Liu
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Goethestr. 70, 80336, Munich, Germany
| | - Markus Schwarz
- Institute for Laboratory Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Daniel Teupser
- Institute for Laboratory Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Reinhard Hickel
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Goethestr. 70, 80336, Munich, Germany
| | - Wilhelm Bloch
- Molecular and Cellular Sport Medicine, German Sport University, Cologne, Germany
| | - Helmut Schweikl
- Department of Conservative Dentistry and Periodontology, University Hospital, Regensburg, Germany
| | - Peter Thomas
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - Burkhard Summer
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
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14
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Bedi A, Trinh TQ, Olszewski AM, Maerz T, Ramme AJ. Nonbiologic Injections in Sports Medicine. JBJS Rev 2020; 8:e0052. [PMID: 32224626 DOI: 10.2106/jbjs.rvw.19.00052] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Nonbiologic medications (local anesthetics, corticosteroids, and nonsteroidal anti-inflammatory drugs) are commonly administered to athletes for analgesia after injury. However, the risks of nonbiologic injections often are overlooked simply because of their long-term market availability.
A thorough understanding of the mechanism of action, the reported benefits, and the potential risks of nonbiologic medications is crucial prior to their use, especially in the treatment of young athletes. Sports medicine physicians and surgeons must be aware of the systemic and local effects of these medications to ensure an appropriate drug choice that minimizes side effects and avoids recently reported toxicity to myocytes, tenocytes, and chondrocytes.
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Affiliation(s)
- Asheesh Bedi
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan
| | - Thai Q Trinh
- Department of Orthopaedic Surgery, Genesis Healthcare, Zanesville, Ohio
| | - Adam M Olszewski
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan
| | - Tristan Maerz
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan
| | - Austin J Ramme
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan.,Steindler Orthopedic Clinic, Iowa City, Iowa
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15
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Intramuscular Injection of Combined Calf Blood Compound (CFC) and Homeopathic Drug Tr14 Accelerates Muscle Regeneration In Vivo. Int J Mol Sci 2020; 21:ijms21062112. [PMID: 32204424 PMCID: PMC7139694 DOI: 10.3390/ijms21062112] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 03/16/2020] [Accepted: 03/17/2020] [Indexed: 12/12/2022] Open
Abstract
Skeletal muscle injuries in competitive sports cause lengthy absences of athletes from tournaments. This is of tremendous competitive and economic relevance for both the athletes and their respective clubs. Therapy for structural muscle lesions aims to promote regeneration and fast-track return-to-play. A common clinical treatment strategy for muscle injuries is the intramuscular injection of calf blood compound and the homeopathic drug, Tr14. Although the combination of these two agents was reported to reduce recovery time, the regulatory mechanism whereby this occurs remains unknown. In this in vivo study, we selected a rat model of mechanical muscle injury to investigate the effect of this combination therapy on muscle regeneration. Gene expression analysis and histological images revealed that this combined intramuscular injection for muscle lesions can enhance the expression of pro-myogenic genes and proteins and accelerate muscle regeneration. These findings are novel and depict the positive effects of calf blood compound and the homeopathic drug, Tr14, which are utilized in the field of Sports medicine.
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Abstract
BACKGROUND Actovegin is a biological drug with a controversial history of use in the treatment of sports injuries during the past 60 years. Particular concerns have been raised about its ergogenic potential to enhance performance, but some of these have been based on little more than anecdote. OBJECTIVES In this article, we review the most recent scientific evidence to determine the clinical efficacy, safety profile, and legal status of Actovegin. METHODS We considered all studies directly commenting on experience with Actovegin use as the primary intervention within the past 10 years. Outcomes included mechanisms of action, clinical efficacy in enhancing muscle repair, any report of safety issues, and any evidence for ergogenic effect. RESULTS Our database search returned 212 articles, abstracts were screened, and after inclusion/exclusion criteria were applied, 25 articles were considered: Publications included 11 primary research articles (7 in vitro studies and 4 clinical trials), 8 review articles, 5 editorials, and a single case report. CONCLUSIONS Current literature is still yet to define the active compound(s) of Actovegin, but suggests that it shows antioxidant and antiapoptotic properties, and may also upregulate macrophage responses central to muscle repair. Clinical efficacy was supported by one new original research article, and the use of Actovegin to treat muscle injuries remains safe and supported. Two articles argued the ergogenic effect of Actovegin, but in vitro findings did not to translate to the outcomes of a clinical trial. An adequate and meaningful scientific approach remains difficult in a field where there is immense pressure to deliver cutting-edge therapies.
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Injury prevention strategies specific to pre-elite athletes competing in Olympic and professional sports — A systematic review. J Sci Med Sport 2019; 22:887-901. [DOI: 10.1016/j.jsams.2019.03.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 12/17/2018] [Accepted: 03/06/2019] [Indexed: 10/27/2022]
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18
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Schobersberger W, Blank C, Budgett R, Pipe A, Stuart MC. Compliance with needle-use declarations at two Olympic Winter Games: Sochi (2014) and PyeongChang (2018). Br J Sports Med 2019; 54:27-32. [DOI: 10.1136/bjsports-2018-100342] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2019] [Indexed: 11/04/2022]
Abstract
ObjectivesWe describe compliance with the ‘IOC Needle Policy’ at two Winter Olympic Games (Sochi and PyeongChang) and compare these findings to those of the Summer Olympic Games of Rio de Janeiro.MethodAll needle-use declaration(s) (NUD) received during the course of the 2014 and 2018 Olympic Games were reviewed. We recorded socio-demographic data, the nature and purpose of needle use, product(s) injected, and route of administration. Data were analysed descriptively.ResultsIn total, doctors from 22 National Olympic Committees (NOCs) submitted 122 NUD involving 82 athletes in Sochi; in PyeongChang, doctors from 19 NOCs submitted 82 NUD involving 61 athletes. This represented approximately 2% of all athletes at both Games, and 25% and 20% of all NOCs participating in Sochi and PyeongChang, respectively. No marked differences in the NUD distribution patterns were apparent when comparing the two Winter Olympic Games. The most commonly administered substances were as follows: local anaesthetics, non-steroidal anti-inflammatory drug and glucocorticoids. Physicians submitted multiple NUD for 24% of all athletes who required a NUD.ConclusionA limited number of NOCs submitted NUD suggesting a low incidence of needle use or limited compliance (approximately 2%). A key challenge for the future is to increase the rate of compliance in submitting NUD. More effective education of NOCs, team physicians and athletes regarding the NUD policy, its purpose, and the necessity for NUD submissions, in association with the enforcement of the appropriate sanctions following non-compliance are needed.
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19
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Ko EY, Cho J, Cho JH, Jo K, Lee SH, Chung YJ, Jung S. Reduction in Lesion Incidence in Pork Carcass Using Transdermal Needle-free Injection of Foot-and-Mouth Disease Vaccine. Korean J Food Sci Anim Resour 2018; 38:1155-1159. [PMID: 30675107 PMCID: PMC6335128 DOI: 10.5851/kosfa.2018.e46] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 10/08/2018] [Accepted: 10/10/2018] [Indexed: 11/07/2022] Open
Abstract
Foot-and-mouth disease (FMD) is an infectious disease affecting pigs. The control of FMD in
swine husbandry is very important because its outbreak results in a vast economic loss. FMD
vaccination has effectively controlled FMD; however, it results in economic loss associated
with the incidence of lesions in the pork meat at the injection site. The objective of this
study was to investigate the effects of transdermal needle-free injection (NFI) of the FMD
vaccine on the incidence of lesions at the injection site. Pigs (n=493) in the control group
were vaccinated with the FMD vaccine using a commercial syringe needle, while 492 pigs in the
transdermal NFI group received the FMD vaccine using a needle-free gas-powered jet injector.
After the slaughter of the pigs, the incidence of lesions at the injection site of all pigs was
checked by plant workers. The result of this study showed that the incidence of lesions in the
pork ham from pigs vaccinated with NFI was 14.82% lower than that in control pigs
(p<0.01). In addition, lesions generated in the NFI group were found just in the
subcutaneous tissue. Therefore, the incidence of lesions at the injection site in pork from
pigs vaccinated with the FMD vaccine can be effectively reduced by using transdermal NFI rather
than a conventional syringe needle.
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Affiliation(s)
- Eun Young Ko
- Dodram Pig Farmers' Cooperative, Icheon 17405, Korea.,Division of Animal and Dairy Science, Chungnam National University, Daejeon 34134, Korea
| | - Jaesung Cho
- Division of Animal and Dairy Science, Chungnam National University, Daejeon 34134, Korea
| | - Jin Ho Cho
- Department of Animal Science, Chungbuk National University, Cheongju 28644, Korea
| | - Kyung Jo
- Division of Animal and Dairy Science, Chungnam National University, Daejeon 34134, Korea
| | - Seung Hwan Lee
- Division of Animal and Dairy Science, Chungnam National University, Daejeon 34134, Korea
| | - Yoon Ji Chung
- Division of Animal and Dairy Science, Chungnam National University, Daejeon 34134, Korea
| | - Samooel Jung
- Division of Animal and Dairy Science, Chungnam National University, Daejeon 34134, Korea
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20
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Exercise Interventions for the Prevention and Treatment of Groin Pain and Injury in Athletes: A Critical and Systematic Review. Sports Med 2018; 47:2011-2026. [PMID: 28497284 DOI: 10.1007/s40279-017-0742-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Groin injury is a common musculoskeletal complaint for athletes competing in a variety of sports. The extent to which exercise interventions incorporating external load are an appropriate option for the treatment and prevention of groin injury in athletes is not yet clear. OBJECTIVES The aim of this review was to describe and evaluate exercise therapy interventions and outcomes for the treatment and prevention of groin injury with specific attention to application of external load. DATA SOURCES The databases Medline, PubMed, SPORTDiscus, Web of Science, and Cochrane were searched on 18 April 2016. STUDY ELIGIBILITY CRITERIA This review was registered as PROSPERO CRD42016037752 and a systematic search was conducted with the following inclusion criteria: any study design evaluating exercise interventions for the prevention or treatment of groin pain in athletes. DATA ANALYSIS Two independent authors screened search results, performed data extraction, assessed risk of bias using the modified Downs and Black appraisal tool and determined strength and level of evidence. Reporting standards for exercise interventions were assessed using the Consensus for Exercise Reporting Template (CERT). RESULTS A total of 1320 titles were identified with 14 studies satisfying the inclusion criteria, four (29%) of which demonstrated low risk of bias. Ten (71%) studies utilised external load as a component of the exercise intervention. Reporting standards for exercise intervention scores ranged from 0 to 63%. CONCLUSION There is limited evidence from level 2 and 3 studies indicating exercise therapy may reduce the incidence and hazard risk of sustaining a groin injury in athletes. There is strong evidence from level 4 studies indicating exercise therapy is beneficial as a treatment for groin injury in athletes in terms of symptom remission, return to sport and recurrence outcomes. However, there are limited studies with low risk of bias, and exercise interventions for the treatment of groin injury are poorly described.
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Abstract
OBJECTIVE To review the literature guiding all aspects of the use of injectable corticosteroids for painful musculoskeletal conditions, with a focus on the treatment of athletes. DATA SOURCES An extensive search of the literature was completed including search terms of corticosteroid, steroid, athlete, and injection, among others. Additional articles were used after being identified from previously reviewed articles. MAIN RESULTS Injections of corticosteroids for a variety of painful conditions of the extremities and the axial spine have been described. Numerous minor and major complications have been reported, including those with a high degree of morbidity. There is a dearth of published research on the use of corticosteroid injections in athletes, with most of the research on this topic focused on older, nonathlete populations. Generally, these injections are well tolerated and can provide short-term pain improvement with little or no long-term benefits. CONCLUSIONS Corticosteroid injections should be used cautiously in athletes and only after a full consideration of the pharmacology, pathogenesis of disease, potential benefits, complications, factors specific to the athlete, and rules of athletic governing bodies. Corticosteroid injections are just one component of a comprehensive rehabilitation plan available to the physician providing care to athletes.
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22
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Hotfiel T, Seil R, Bily W, Bloch W, Gokeler A, Krifter RM, Mayer F, Ueblacker P, Weisskopf L, Engelhardt M. Nonoperative treatment of muscle injuries - recommendations from the GOTS expert meeting. J Exp Orthop 2018; 5:24. [PMID: 29931565 PMCID: PMC6013414 DOI: 10.1186/s40634-018-0139-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 06/11/2018] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Muscle injuries are some of the most common injuries in sports; they have a high recurrence rate and can result in the loss of ability to participate in training or competition. In clinical practice, a wide variety of treatment strategies are commonly applied. However, a limited amount of evidence-based data exists, and most therapeutic approaches are solely based on "best practice". Thus, there is a need for consensus to provide strategies and recommendations for the treatment of muscle injuries. METHODS The 2016 GOTS Expert Meeting, initiated by the German-Austrian-Swiss Society for Orthopaedic Traumatologic Sports Medicine (GOTS), focused on the topic of muscle and tendon injuries and was held in Spreewald/Berlin, Germany. The committee was composed of twenty-two medical specialists. Nine of them were delegated to a subcommittee focusing on the nonoperative treatment of muscle injuries. The recommendations and statements that were developed were reviewed by the entire consensus committee and voted on by the members. RESULTS The committee reached a consensus on the utility and effectiveness of the management of muscle injuries. MAIN RESULTS the "PRICE" principle to target the first inflammatory response is one of the most relevant steps in the treatment of muscle injuries. Haematoma aspiration may be considered in the early stages after injury. There is presently no clear evidence that intramuscular injections are of use in the treatment of muscle injuries. The ingestion of non-steroidal anti-inflammatory drugs (NSAIDs) should be regarded critically because there is currently no hard evidence to support their use, although they are appropriate in exceptional cases. CONCLUSIONS The present work provides a structured overview of the various nonoperative treatment strategies of muscle injuries and evaluates their effectiveness with respect to the existing scientific evidence and clinical expertise in the context of basic science on the healing process of muscle injuries. The committee agreed that there is a compelling need for further studies, including high-quality randomized investigations to completely evaluate the effectiveness of the existing therapeutic approaches. The given recommendations may be updated and adjusted as further evidence will be generated.
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Affiliation(s)
- T Hotfiel
- Department of Orthopaedic Surgery, Friedrich-Alexander-University Erlangen-Nuremberg, Rathsbergerstraße 57, D-91054, Erlangen, Germany.
| | - R Seil
- Department of Orthopaedic Surgery, Clinique d'Eich - Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
- Sports Medicine Research Laboratory, Luxembourg Institute of Health, Luxembourg, Luxembourg
| | - W Bily
- Department of Physical Medicine and Rehabilitation, Wilhelminenspital, Vienna, Austria
| | - W Bloch
- Department of Molecular and Cellular Sports Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - A Gokeler
- Luxembourg Institute of Research in Orthopedics, Sports Medicine and Science, Luxembourg City, Luxembourg
- Exercise Science and Neuroscience, Department Exercise & Health Faculty of Science, Paderborn University, Paderborn, Germany
| | - R M Krifter
- ORTHOFOCUS-Orthopedic Competence Center, Graz-Salzburg, Austria
| | - F Mayer
- Outpatient Clinic Potsdam, Sports Medicine & Sports Orthopaedics, University of Potsdam, Potsdam, Germany
| | - P Ueblacker
- MW Center of Orthopedics and Sports Medicine, Munich, Germany
| | - L Weisskopf
- Altius Swiss Sportmed Center, Rheinfelden, Switzerland
| | - M Engelhardt
- Department of Trauma and Orthopedic Surgery, Klinikum Osnabrück, Osnabrück, Germany
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23
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Mattyasovszky SG, Langendorf EK, Ritz U, Schmitz C, Schmidtmann I, Nowak TE, Wagner D, Hofmann A, Rommens PM, Drees P. Exposure to radial extracorporeal shock waves modulates viability and gene expression of human skeletal muscle cells: a controlled in vitro study. J Orthop Surg Res 2018; 13:75. [PMID: 29625618 PMCID: PMC5889540 DOI: 10.1186/s13018-018-0779-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Accepted: 03/23/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Recent clinical and animal studies have shown that extracorporeal shock wave therapy has a promoting influence on the healing process of musculoskeletal disorders. However, the underlying biological effects of extracorporeal shock wave therapy on human skeletal muscle cells have not yet been investigated. METHODS In this study, we investigated human skeletal muscle cells after exposure to radial extracorporeal shock waves in a standardized in vitro setup. Cells were isolated from muscle specimens taken from adult patients undergoing spine surgery. Primary muscle cells were exposed once or twice to radial extracorporeal shock waves in vitro with different energy flux densities. Cell viability and gene expression of the paired box protein 7 (Pax7), neural cell adhesion molecule (NCAM), and myogenic factor 5 (Myf5) and MyoD as muscle cell markers were compared to non-treated muscle cells that served as controls. RESULTS Isolated muscle cells were positive for the hallmark protein of satellite cells, Pax7, as well as for the muscle cell markers NCAM, MyoD, and Myf5. Exposure to radial extracorporeal shock waves at low energy flux densities enhanced cell viability, whereas higher energy flux densities had no further significant impact. Gene expression analyses of muscle specific genes (Pax7, NCAM, Myf5, and MyoD) demonstrated a significant increase after single exposure to the highest EFD (4 bar, 0.19 mJ/mm2) and after double exposure with the medium EFDs (2 and 3 bar; 0.09 and 0.14 mJ/mm2, respectively). Double exposure of the highest EFD, however, results in a significant down-regulation when compared to single exposure with this EFD. CONCLUSIONS This is the first study demonstrating that radial extracorporal shock wave therapy has the potential to modulate the biological function of human skeletal muscle cells. Based on our experimental findings, we hypothesize that radial extracorporal shock wave therapy could be a promising therapeutic modality to improve the healing process of sports-related structural muscle injuries.
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Affiliation(s)
- Stefan G Mattyasovszky
- Department of Orthopedics and Traumatology, University Medical Centre of the Johannes Gutenberg-University of Mainz, Langenbeckstraße 1, 55131, Mainz, Germany.
| | - Eva K Langendorf
- Department of Orthopedics and Traumatology, University Medical Centre of the Johannes Gutenberg-University of Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
| | - Ulrike Ritz
- Department of Orthopedics and Traumatology, University Medical Centre of the Johannes Gutenberg-University of Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
| | - Christoph Schmitz
- Extracorporeal Shock Wave Research Unit, Department of Anatomy II, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Irene Schmidtmann
- Institue for Medical Biometry, Epidemiology and Computer Science, University Medical Centre of the Johannes Gutenberg-University of Mainz, Mainz, Germany
| | - Tobias E Nowak
- Department of Orthopedics and Traumatology, University Medical Centre of the Johannes Gutenberg-University of Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
| | - Daniel Wagner
- Department of Orthopedics and Traumatology, University Medical Centre of the Johannes Gutenberg-University of Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
| | - Alexander Hofmann
- Department of Orthopedics and Traumatology, University Medical Centre of the Johannes Gutenberg-University of Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
| | - Pol M Rommens
- Department of Orthopedics and Traumatology, University Medical Centre of the Johannes Gutenberg-University of Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
| | - Philipp Drees
- Department of Orthopedics and Traumatology, University Medical Centre of the Johannes Gutenberg-University of Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
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24
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Drew MK, Raysmith BP, Charlton PC. Injuries impair the chance of successful performance by sportspeople: a systematic review. Br J Sports Med 2017; 51:1209-1214. [DOI: 10.1136/bjsports-2016-096731] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2017] [Indexed: 01/08/2023]
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25
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Alessi Pissulin CN, Henrique Fernandes AA, Sanchez Orellana AM, Rossi E Silva RC, Michelin Matheus SM. Low-level laser therapy (LLLT) accelerates the sternomastoid muscle regeneration process after myonecrosis due to bupivacaine. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2017; 168:30-39. [PMID: 28161653 DOI: 10.1016/j.jphotobiol.2017.01.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 01/19/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Because of its long-lasting analgesic action, bupivacaine is an anesthetic used for peripheral nerve block and relief of postoperative pain. Muscle degeneration and neurotoxicity are its main limitations. There is strong evidence that low-level laser therapy (LLLT) assists in muscle and nerve repair. The authors evaluated the effects of a Gallium Arsenide laser (GaAs), on the regeneration of muscle fibers of the sternomastoid muscle and accessory nerve after injection of bupivacaine. METHODS In total, 30 Wistar adult rats were divided into 2 groups: control group (C: n=15) and laser group (L: n=15). The groups were subdivided by antimere, with 0.5% bupivacaine injected on the right and 0.9% sodium chloride on the left. LLLT (GaAs 904nm, 0,05W, 2.8J per point) was administered for 5 consecutive days, starting 24h after injection of the solutions. Seven days after the trial period, blood samples were collected for determination of creatine kinase (CK). The sternomastoid nerve was removed for morphological and morphometric analyses; the surface portion of the sternomastoid muscle was used for histopathological and ultrastructural analyses. Muscle CK and TNFα protein levels were measured. RESULTS The anesthetic promoted myonecrosis and increased muscle CK without neurotoxic effects. The LLLT reduced myonecrosis, characterized by a decrease in muscle CK levels, inflammation, necrosis, and atrophy, as well as the number of central nuclei in the muscle fibers and the percentage of collagen. TNFα values remained constant. CONCLUSIONS LLLT, at the dose used, reduced fibrosis and myonecrosis in the sternomastoid muscle triggered by bupivacaine, accelerating the muscle regeneration process.
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Affiliation(s)
- Cristiane Neves Alessi Pissulin
- Department of Anatomy, Universidade do Oeste Paulista (UNOESTE), Presidente Prudente, SP, Brazil; General Bases of Surgery, Botucatu Medical School, Unesp, Botucatu, SP, Brazil.
| | | | | | | | - Selma Maria Michelin Matheus
- Department of Anatomy, Institute of Bioscience, General Bases of Surgery, Botucatu Medical School, Unesp, Botucatu, SP, Brazil.
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Punduk Z, Oral O, Ozkayin N, Rahman K, Varol R. Single dose of intra-muscular platelet rich plasma reverses the increase in plasma iron levels in exercise-induced muscle damage: A pilot study. JOURNAL OF SPORT AND HEALTH SCIENCE 2016; 5:109-114. [PMID: 30356475 PMCID: PMC6188580 DOI: 10.1016/j.jshs.2014.11.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2014] [Revised: 10/02/2014] [Accepted: 11/17/2014] [Indexed: 06/08/2023]
Abstract
BACKGROUND Platelet rich plasma (PRP) therapy is widely used in enhancing the recovery of skeletal muscle from injury. However, the impact of intramuscular delivery of PRP on hematologic and biochemical responses has not been fully elucidated in exercise-induced muscle damage. The purpose of this investigation the effects of intramuscular delivery of PRP on hematologic and biochemical responses and recovery strategy muscle damage induced by high intensity muscle exercise (exercise-induced muscle damage, EIMD). METHODS Moderately active male volunteers participated in this study and were assigned to a control group (control, n = 6) and PRP administration group (PRP, n = 6). The subjects performed exercise with a load of 80% one repetition maximum (1RM) maximal voluntary contraction of the elbow flexors until point of exhaustion of the non-dominant arm was reached. The arms were treated with saline or autologous PRP post-24 h EIMD. Venous blood samples were obtained in the morning to establish a baseline value and 1-4 days post-exercise and were analyzed for serum ferritin, iron, iron binding capacity (IBC), creatinine kinase (CK), lactate dehydrogenase (LDH), aspartate aminotransferase (AST), and alanine aminotransferase (ALT). RESULTS The baseline levels of plasma iron, ferritin, IBC, CK, LDH, AST, and ALT were similar in both the control and PRP groups. However, 24-h following exercise a significant increase in these parameters was observed in both groups between 1 and 4 days during the recovery period. Interestingly, PRP administration decreased plasma iron levels compared to the control on the second day post-exercise. Plasma IBC increased in PRP group from Days 2 to 4 post-exercise compared to the control group whilst PRP administration had no effect on plasma ferritin, CK, AST, ALT, or LDH. CONCLUSION Acute exhaustive exercise increased muscle damage markers, including plasma iron, IBC, and ferritin levels, indicating muscle damage induced by exercise. PRP administration improves inflammation by reversing the increase in the iron levels post-exercise without displaying any myotoxicity and may have a role to play in the recovery of exercise-induced muscle damage.
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Affiliation(s)
- Zekine Punduk
- Department of Physical Education and Sports, University of Balikesir, Balikesir 10100, Turkey
| | - Onur Oral
- Department of Physical Education and Sports, University of Ege, Izmir 35040, Turkey
| | - Nadir Ozkayin
- Medical Faculty, Department of Orthopaedics and Traumatology, University of Ege, Izmir 35100, Turkey
| | - Khalid Rahman
- Faculty of Science, School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, L3 3AF, UK
| | - Rana Varol
- Department of Physical Education and Sports, University of Ege, Izmir 35040, Turkey
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27
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Saw AE, Main LC, Gastin PB. Monitoring the athlete training response: subjective self-reported measures trump commonly used objective measures: a systematic review. Br J Sports Med 2015; 50:281-91. [PMID: 26423706 PMCID: PMC4789708 DOI: 10.1136/bjsports-2015-094758] [Citation(s) in RCA: 422] [Impact Index Per Article: 46.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2015] [Indexed: 12/02/2022]
Abstract
Background Monitoring athlete well-being is essential to guide training and to detect any progression towards negative health outcomes and associated poor performance. Objective (performance, physiological, biochemical) and subjective measures are all options for athlete monitoring. Objective We systematically reviewed objective and subjective measures of athlete well-being. Objective measures, including those taken at rest (eg, blood markers, heart rate) and during exercise (eg, oxygen consumption, heart rate response), were compared against subjective measures (eg, mood, perceived stress). All measures were also evaluated for their response to acute and chronic training load. Methods The databases Academic search complete, MEDLINE, PsycINFO, SPORTDiscus and PubMed were searched in May 2014. Fifty-six original studies reported concurrent subjective and objective measures of athlete well-being. The quality and strength of findings of each study were evaluated to determine overall levels of evidence. Results Subjective and objective measures of athlete well-being generally did not correlate. Subjective measures reflected acute and chronic training loads with superior sensitivity and consistency than objective measures. Subjective well-being was typically impaired with an acute increase in training load, and also with chronic training, while an acute decrease in training load improved subjective well-being. Summary This review provides further support for practitioners to use subjective measures to monitor changes in athlete well-being in response to training. Subjective measures may stand alone, or be incorporated into a mixed methods approach to athlete monitoring, as is current practice in many sport settings.
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Affiliation(s)
- Anna E Saw
- Centre for Exercise and Sport Science, Deakin University, School of Exercise and Nutrition Sciences, Burwood, Victoria, Australia
| | - Luana C Main
- Centre for Physical Activity and Nutrition Research, Deakin University, School of Exercise and Nutrition Sciences, Burwood, Victoria, Australia
| | - Paul B Gastin
- Centre for Exercise and Sport Science, Deakin University, School of Exercise and Nutrition Sciences, Burwood, Victoria, Australia
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Pas HIMFL, Reurink G, Tol JL, Weir A, Winters M, Moen MH. Efficacy of rehabilitation (lengthening) exercises, platelet-rich plasma injections, and other conservative interventions in acute hamstring injuries: an updated systematic review and meta-analysis. Br J Sports Med 2015. [DOI: 10.1136/bjsports-2015-094879] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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