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Mester B, Kröpil P, Ohmann T, Schleich C, Güthoff C, Praetorius A, Dudda M, Schoepp C. The influence of distribution, severity and volume of posttraumatic bone bruise on functional outcome after ACL reconstruction for isolated ACL injuries. Arch Orthop Trauma Surg 2023; 143:6261-6272. [PMID: 37269350 PMCID: PMC10491520 DOI: 10.1007/s00402-023-04907-w] [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: 09/21/2022] [Accepted: 05/06/2023] [Indexed: 06/05/2023]
Abstract
INTRODUCTION Posttraumatic MRI of ACL tears show a high prevalence of bone bruise (BB) without macroscopic proof of chondral damage. Controversial results are described concerning the association between BB and outcome after ACL tear. Aim of this study is to evaluate the influence of distribution, severity and volume of BB in isolated ACL injuries on function, quality of life and muscle strength following ACL reconstruction (ACLR). MATERIALS AND METHODS MRI of n = 122 patients treated by ACLR without concomitant pathologies were evaluated. BB was differentiated by four localizations: medial/lateral femoral condyle (MFC/LFC) and medial/lateral tibial plateau (MTP/LTP). Severity was graded according to Costa-Paz. BB volumes of n = 46 patients were quantified (software-assisted volumetry). Outcome was measured by Lysholm Score (LS), Tegner Activity Scale (TAS), IKDC, isokinetics and SF-36. Measurements were conducted preoperatively (t0), 6 weeks (t1), 26 weeks (t2) and 52 weeks (t3) after ACLR. RESULTS The prevalence of BB was 91.8%. LTP was present in 91.8%, LFC 64.8%, MTP 49.2% and MFC 28.7%. 18.9% were classified Costa-Paz I, 58.2% II and 14.8% III. Total BB volume was 21.84 ± 15.27 cm3, the highest value for LTP (14.31 ± 9.93 cm3). LS/TAS/IKDC/SF-36/isokinetics improved significantly between t0-t3 (p < 0.001). Distribution, severity and volume had no influence on LS/TAS/IKDC/SF-36/isokinetics (n.s.). CONCLUSIONS No impact of BB after ACLR on function, quality of life and objective muscle strength was shown, unaffected by concomitant pathologies. Previous data regarding prevalence and distribution is confirmed. These results help surgeons counselling patients regarding the interpretation of extensive BB findings. Long-time follow-up studies are mandatory to evaluate an impact of BB on knee function due to secondary arthritis.
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Affiliation(s)
- Bastian Mester
- Department for Trauma, Hand and Reconstructive Surgery, University Hospital Essen, Hufelandstraße 55, 45147, Essen, Germany.
| | - Patric Kröpil
- Department for Radiology, BG Klinikum Duisburg, Großenbaumer Allee 250, 47249, Duisburg, Germany
| | - Tobias Ohmann
- Research Department, BG Klinikum Duisburg, Großenbaumer Allee 250, 47249, Duisburg, Germany
| | - Christoph Schleich
- Department for Diagnostic and Interventional Radiology, University Hospital Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Claas Güthoff
- Centre for Clinical Research, BG Klinikum Unfallkrankenhaus Berlin, Warener Straße 7, 12683, Berlin, Germany
| | - Arthur Praetorius
- Department for Arthroscopic Surgery, Sports Traumatology and Sports Medicine, BG Klinikum Duisburg, Großenbaumer Allee 250, 47249, Duisburg, Germany
| | - Marcel Dudda
- Department for Trauma, Hand and Reconstructive Surgery, University Hospital Essen, Hufelandstraße 55, 45147, Essen, Germany
- Department for Orthopedics and Trauma Surgery, BG Klinikum Duisburg, Großenbaumer Allee 250, 47249, Duisburg, Germany
| | - Christian Schoepp
- Department for Arthroscopic Surgery, Sports Traumatology and Sports Medicine, BG Klinikum Duisburg, Großenbaumer Allee 250, 47249, Duisburg, Germany
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Li Z, Li M, Du Y, Zhang M, Jiang H, Zhang R, Ma Y, Zheng Q. Femur-tibia angle and patella-tibia angle: new indicators for diagnosing anterior cruciate ligament tears in magnetic resonance imaging. BMC Sports Sci Med Rehabil 2022; 14:66. [PMID: 35418093 PMCID: PMC9009057 DOI: 10.1186/s13102-022-00462-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 04/05/2022] [Indexed: 11/17/2022]
Abstract
Background Femur-tibia angle (FTA) and patella-tibia angle (PTA) are two MRI measurements that reflect the rotation of the knee joint. The purposes of this study were to assess whether FTA and PTA are associated with ACL tear and to explore their roles in ACL tear diagnosis. Methods FTA, PTA, ACL angle and anterior tibial subluxation were compared between the two matched groups: ACL tear group and control group (each n = 20). Diagnostic performance was evaluated in a consecutive 120-patient cohort who underwent MR imaging of the knee and subsequently had arthroscopy. Different measurements were assessed by area under the curve (AUC) of receiver operating characteristic (ROC) curve. Results FTA and PTA increased significantly in ACL tears group when compared to the control group (4.79 and 7.36 degrees, respectively, p < 0.05). In distinguishing complete ACL tear, ACL angle had the highest AUC of 0.906 while AUC of PTA and FTA were 0.849 and 0.809. The cutoff of FTA was 80 degrees with a sensitivity of 82% and specificity of 68%, while the cutoff of PTA was 91 degrees with a sensitivity of 82% and specificity of 74%. In distinguishing partial ACL tear, FTA and PTA had the highest AUCs of 0.847 and 0.813, respectively. The calculated cutoff of FTA was 84 degrees with a sensitivity of 90% and specificity of 81%, while the cutoff of PTA was 92 degrees with a sensitivity of 80% and specificity of 77%. Conclusion FTA and PTA increased when ACL tears and they might be valuable in diagnosing ACL tears, especially in distinguishing partial ACL tear from intact ACL.
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Affiliation(s)
- Zeng Li
- Department of Orthopedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China
| | - Mengyuan Li
- Department of Orthopedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China
| | - Yan Du
- Clinical Research Unit, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, 200011, China
| | - Mo Zhang
- Clinical Research Unit, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, 200011, China
| | - Hai Jiang
- Department of Orthopedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China
| | - Ruiying Zhang
- Department of Orthopedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China
| | - Yuanchen Ma
- Department of Orthopedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China.
| | - Qiujian Zheng
- Department of Orthopedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China.
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Strength Level of Professional Elite Soccer Players after the COVID-19 Lockdown Period: A Retrospective Double-Arm Cohort Study. JOURNAL OF SPORTS MEDICINE (HINDAWI PUBLISHING CORPORATION) 2022; 2022:8242210. [PMID: 35252459 PMCID: PMC8892033 DOI: 10.1155/2022/8242210] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/20/2021] [Accepted: 01/24/2022] [Indexed: 01/30/2023]
Abstract
Background It is well known that periods of inactivity generate a loss of muscle strength, a fundamental component of sports performance in soccer. However, little information is available on the decrease in strength levels in professional soccer players after the quarantine lockdown that occurred during the COVID-19 pandemic. Aim To compare the isokinetic peak torque profiles of professional soccer players from different teams before and after the quarantine period generated by COVID-19. Methods A retrospective observational study was performed using data collected from two different professional elite-level soccer teams just before and immediately after the COVID-19 quarantine period. One team gave individual instructions to its players for conditioning maintenance at home during the quarantine period, while the other team used regular video calls to maintain the player's conditioning status on home training. The main outcomes were the mean peak torque of knee extensors and flexors, from concentric and eccentric contractions of each playing position. Analysis. A two-way ANOVA analysis was used to compare peak torque before and after the quarantine period and between both teams' strategies, showing a statistically significant reduction in eccentric knee flexor peak torque from the team that did not have remote monitoring. Conclusions Remote monitoring programs are recommended so that athletes are less affected by the deleterious effects of confinement.
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Alves BMO, Scoz RD, Burigo RL, Ferreira IC, Ramos APS, Mendes JJB, Ferreira LMA, Amorim CF. Association between Concentric and Eccentric Isokinetic Torque and Unilateral Countermovement Jump Variables in Professional Soccer Players. J Funct Morphol Kinesiol 2022; 7:jfmk7010025. [PMID: 35323608 PMCID: PMC8953202 DOI: 10.3390/jfmk7010025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/15/2022] [Accepted: 02/23/2022] [Indexed: 11/16/2022] Open
Abstract
Isokinetic tests have been highly valuable to athletic analysis, but their cost and technical operation turn them inaccessible. The purpose of this study was to verify the correlation between unilateral countermovement jump variables and isokinetic data. Thirty-two male professional soccer players were subjected to the isokinetic testing of both knee extensors and flexors in concentric and eccentric muscle contractions. They also executed unilateral countermovement vertical jumps (UCMJ) to compare maximum height, ground reaction force, and impulse power with isokinetic peak torque. Data analysis was conducted through Pearson correlation and linear regression. A high correlation was found between dominant unilateral extensor concentric peak torque and the UCMJ maximum height of the dominant leg. The non-dominant leg jump showed a moderate correlation. No other variable showed statistical significance. Linear regression allowed the generation of two formulae to estimate the peak torque from UCMJ for dominant and non-dominant legs. Although few studies were found to compare our results, leading to more studies being needed, a better understanding of the unilateral countermovement jump may be used in the future as a substitute to the expensive and technically demanding isokinetic testing when it is unavailable, allowing the assessment of lower limb physical asymmetries in athletic or rehabilitation environments.
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Affiliation(s)
- Bruno Mazziotti Oliveira Alves
- Masters and Doctoral Program in Physiotherapy, University City of Sao Paulo (Unicid), Sao Paulo 03071-000, Brazil; (B.M.O.A.); (R.L.B.); (I.C.F.)
- Department of Physical Therapy and Biomechanics, Arsenal Football Club, London N7-7AJ, UK
| | - Robson Dias Scoz
- Masters and Doctoral Program in Physiotherapy, University City of Sao Paulo (Unicid), Sao Paulo 03071-000, Brazil; (B.M.O.A.); (R.L.B.); (I.C.F.)
- Correspondence: (R.D.S.); (C.F.A.)
| | - Ricardo Lima Burigo
- Masters and Doctoral Program in Physiotherapy, University City of Sao Paulo (Unicid), Sao Paulo 03071-000, Brazil; (B.M.O.A.); (R.L.B.); (I.C.F.)
| | - Isabella Christina Ferreira
- Masters and Doctoral Program in Physiotherapy, University City of Sao Paulo (Unicid), Sao Paulo 03071-000, Brazil; (B.M.O.A.); (R.L.B.); (I.C.F.)
| | - Ana Paula Silveira Ramos
- Physiotherapy Department, University of South of Santa Catarina (Unisul), Sao Jose 88137-270, Brazil;
| | - Jose Joao Baltazar Mendes
- Laboratory of Physical and Functional Assessment (LAFF), Interdisciplinary Center of Investigation Egas Monis (CiiEM), Caparica, 2829-511 Setubal, Portugal; (J.J.B.M.); (L.M.A.F.)
| | - Luciano Maia Alves Ferreira
- Laboratory of Physical and Functional Assessment (LAFF), Interdisciplinary Center of Investigation Egas Monis (CiiEM), Caparica, 2829-511 Setubal, Portugal; (J.J.B.M.); (L.M.A.F.)
| | - Cesar Ferreira Amorim
- Masters and Doctoral Program in Physiotherapy, University City of Sao Paulo (Unicid), Sao Paulo 03071-000, Brazil; (B.M.O.A.); (R.L.B.); (I.C.F.)
- Laboratory of Physical and Functional Assessment (LAFF), Interdisciplinary Center of Investigation Egas Monis (CiiEM), Caparica, 2829-511 Setubal, Portugal; (J.J.B.M.); (L.M.A.F.)
- Lab Corinthians R9, Sport Club Corinthians Paulista, Sao Paulo 03828-000, Brazil
- Laboratoire de Recherche BioNR, Université du Quebec, Saguenay, QC G7H-2B1, Canada
- Correspondence: (R.D.S.); (C.F.A.)
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Scoz RD, Alves BMO, Burigo RL, Vieira ER, Ferreira LMA, da Silva RA, Hirata RP, Amorim CF. Strength development according with age and position: a 10-year study of 570 soccer players. BMJ Open Sport Exerc Med 2021; 7:e000927. [PMID: 33754080 PMCID: PMC7938987 DOI: 10.1136/bmjsem-2020-000927] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2021] [Indexed: 11/25/2022] Open
Abstract
Background/aim The purpose of this study was to compare the isokinetic peak torque profiles from the quadriceps and hamstrings muscles during concentric and eccentric contractions in elite Brazilian soccer players across different field positions and age categories. Our hypothesis was that soccer players from different field positions are subjected to different ageing-related effects on their isokinetic peak torque. Methods This is a retrospective study based on professional elite-level soccer players between the years 2009 and 2019. It included 570 adult males who played for at least 5 years on first or second Brazilian divisions. Playing positions were divided as: goalkeepers, defenders, sidebacks, midfielders and forwards. Age categories were also divided as: G1 (17–20 years old), G2 (21–24 years old), G3 (25–28 years old), G4 (29–32 years old) and G5 (33 years old or more). Results The results indicate a moderate effect of age (F(4545)=8.197; p<0.001; η2=0.057) and a small effect of playing position (F(4545)=2.993; p<0.05; η2=0.021) on torque of concentric extensors; mainly from midfielders and goalkeepers with 29 years or more. Conclusions Soccer players from different field positions are subjected to different ageing related effects on their muscular performance during their career special attention should be given to these players to avoid reduction in physical performance.
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Affiliation(s)
| | - Bruno Mazziotti Oliveira Alves
- Universidade Cidade de Sao Paulo (UNICID), Sao Paulo, Brazil.,Physical Therapy Department, Arsenal Football Club, London, UK
| | | | - Edgar Ramos Vieira
- Physical Therapy Department, Florida International University (FIU), Miami, Florida, USA
| | | | | | | | - Cesar Ferreira Amorim
- Universidade Cidade de Sao Paulo (UNICID), Sao Paulo, Brazil.,Physical Therapy Department, Florida International University (FIU), Miami, Florida, USA.,KinesioLab, Instituto Piaget, Silves, Portugal.,Laboratoire de Recherche BioNR, Université du Quebec à Chicoutimi (UQAC), Saguenay, QC, Canada
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