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Dalos D, Marshall PR, Lissy M, Maas KJ, Henes FO, Kaul MG, Kleinertz H, Frings J, Krause M, Frosch KH, Welsch GH. Influence of leg axis alignment on MRI T2* mapping of the knee in young professional soccer players. BMC Musculoskelet Disord 2024; 25:144. [PMID: 38360606 PMCID: PMC10868071 DOI: 10.1186/s12891-024-07233-3] [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: 08/29/2023] [Accepted: 01/26/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Investigation of the association between leg axis alignment and biochemical MRI in young professional soccer players in order to identify a potential influence of the leg axis on cartilage regions at risk. METHODS Sixteen professional soccer players (21 ± 3 years) underwent static and dynamic leg axis analysis via radiation free DIERS formetric 4 D as well as 3-T MRI examination of both knees. Quantitative T2* mapping of the knee cartilage was performed and T2* values were evaluated as 144 regions of interest. Subgroup analysis was performed in players with severe varus alignment (> 6°). RESULTS Analysis of the leg axis geometry revealed a mean static alignment of 6.6° ± 2.5 varus and a mean dynamic alignment of 5.1° ± 2.6 varus. Quantitative T2* mapping showed significantly increased T2* values in the superficial cartilage layer compared to the deeper region (p < 0.001) as well as a significant increase in relaxation times in the femoral cartilage from anterior to intermediate to posterior (p < 0.001). Combination of both methods revealed a significant correlation for the degree of varus alignment and the femoral, posterior, deep region of the medial knee compartment (r = 0.4; p = 0.03). If severe varus alignment was present this region showed a significant increase in relaxation time compared to players with a less pronounced leg axis deviation (p = 0.003). CONCLUSION This study demonstrates that varus alignment in young soccer players is associated with elevated T2* relaxation times in the deep cartilage layer of the medial, posterior, femoral compartment and might therefore be a contributing factor in the early pathogenesis of manifest cartilage lesions. Therefore, these findings should be considered in the development of preventive training programs.
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Affiliation(s)
- D Dalos
- Center for Athletic Medicine, UKE Athleticum, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany.
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - P R Marshall
- RasenBallsport Leipzig GmbH, Leipzig, Germany
- Department of Orthopaedic and Trauma Surgery, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - M Lissy
- Center for Athletic Medicine, UKE Athleticum, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - K J Maas
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - F O Henes
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Diagnostic and Interventional Radiology, BG Hospital Hamburg, Hamburg, Germany
| | - M G Kaul
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - H Kleinertz
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - J Frings
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M Krause
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - K H Frosch
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Trauma Surgery, Orthopaedics and Sports Traumatology, BG Hospital Hamburg, Hamburg, Germany
| | - G H Welsch
- Center for Athletic Medicine, UKE Athleticum, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Pillay L, Janse van Rensburg DC, Ramkilawon G, Maas M, Orhant E, Rantanen J, Salo J, Kerkhoffs G, Gouttebarge V. Determination of the Prevalence of Knee and Hip Clinical Osteoarthritis in the Active Professional Male Footballer and Its Association with Pain, Function, Injury and Surgery. Sports (Basel) 2023; 11:136. [PMID: 37505623 PMCID: PMC10385669 DOI: 10.3390/sports11070136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 07/09/2023] [Accepted: 07/13/2023] [Indexed: 07/29/2023] Open
Abstract
OBJECTIVE To comment on and explore (1) the prevalence of clinical knee and hip osteoarthritis (OA); (2) the association between pain or function and clinical knee or hip OA; (3) the association between injury or surgery and clinical knee or hip OA. METHODS Participants were recruited from FIFPRO members. A total of 101 footballers consented to answer (1) a developed questionnaire, (2) patient-reported outcome measures, and (3) be evaluated by their team physician for clinical knee or hip OA. RESULTS Of the 53% evaluated for clinical knee and hip OA, a prevalence of 9.43% and 7.55% of knee and hip OA, respectively, was found. There was a significant and strong association between knee (p = 0.033; Cramers v Value = 0.523) and hip pain (p = 0.005; Cramers v Value = 0.602) and clinical OA. A significant association existed between Hip dysfunction and Osteoarthritis Outcome short form Scores and clinical OA of the hip (p = 0.036). The odds of clinical knee OA were 1.5 and 4.5 times more after one or more injuries or surgeries, respectively. There was no association between playing position and clinical OA. CONCLUSION There is a low prevalence of a clinical knee or hip OA in the active professional male footballer. Pain may be a valid symptom to predict or monitor knee or hip OA. Validated assessment tools should be utilised to identify a negative effect on function. The odds of developing clinical OA in the knee with the number of injuries or surgeries. The hip presents with earlier clinical signs of OA compared to the knee.
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Affiliation(s)
- Lervasen Pillay
- Amsterdam UMC location University of Amsterdam, Department of Orthopedic Surgery and Sports Medicine, Meibergdreef 9, 1105 Amsterdam, The Netherlands; (L.P.)
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria 0028, South Africa
| | - Dina C. Janse van Rensburg
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria 0028, South Africa
| | - Gopika Ramkilawon
- Department of Statistics, University of Pretoria, Pretoria 0028, South Africa
| | - Mario Maas
- Amsterdam UMC location University of Amsterdam, Department of Radiology and Nuclear Medicine, Meibergdreef 9, 1105 Amsterdam, The Netherlands
- Academic Center for Evidence-Based Sports Medicine (ACES), 1105 Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Aging & Vitality, Musculoskeletal Health, Sports, 1105 Amsterdam, The Netherlands
- Amsterdam Collaboration on Health & Safety in Sports (ACHSS), IOC Research Center of Excellence, 1105 Amsterdam, The Netherlands
| | - Emmanuel Orhant
- French Football Federation (FFF), Clairefontaine Medical Centre, FIFA Medical Center of Excellence, 93216 Clairefontaine, France
| | - Jussi Rantanen
- Orthopaedics and Sports Clinic, Mehilainen NEO Hospital, 20520 Turku, Finland
| | - Jari Salo
- Sports Hospital Mehilainen, 41400 Helsinki, Finland
| | - Gino Kerkhoffs
- Amsterdam UMC location University of Amsterdam, Department of Orthopedic Surgery and Sports Medicine, Meibergdreef 9, 1105 Amsterdam, The Netherlands; (L.P.)
- Academic Center for Evidence-Based Sports Medicine (ACES), 1105 Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Aging & Vitality, Musculoskeletal Health, Sports, 1105 Amsterdam, The Netherlands
- Amsterdam Collaboration on Health & Safety in Sports (ACHSS), IOC Research Center of Excellence, 1105 Amsterdam, The Netherlands
| | - Vincent Gouttebarge
- Amsterdam UMC location University of Amsterdam, Department of Orthopedic Surgery and Sports Medicine, Meibergdreef 9, 1105 Amsterdam, The Netherlands; (L.P.)
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria 0028, South Africa
- Academic Center for Evidence-Based Sports Medicine (ACES), 1105 Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Aging & Vitality, Musculoskeletal Health, Sports, 1105 Amsterdam, The Netherlands
- Amsterdam Collaboration on Health & Safety in Sports (ACHSS), IOC Research Center of Excellence, 1105 Amsterdam, The Netherlands
- Football Players Worldwide (FIFPRO), 2132 Hoofddorp, The Netherlands
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3
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Weaver KJ, Relph N. Lower Limb Anthropometric Profiling in Professional Female Soccer Players: A Proof of Concept for Asymmetry Assessment Using Video Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6124. [PMID: 37372711 DOI: 10.3390/ijerph20126124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 03/16/2023] [Accepted: 03/23/2023] [Indexed: 06/29/2023]
Abstract
The objective was to evaluate the clinical joint and limb measures in professional female soccer players. The study was a cross-sectional observational design. It was a preseason clinical setting. The inclusion criteria were outfield professional female soccer players, based in the UK, competing in the highest English league. The exclusion criteria included players who had had surgery in the last six months or had missed a single training session or match due to injury in the previous three months. In terms of the outcome measures, the dependent variables were the true limb length, ankle dorsiflexion, knee flexion and extension, hip flexion, extension, internal rotation and external rotation, and straight leg raise measured using video analysis software. Additionally, passive clinical knee and ankle stability tests were conducted. The independent variables were leg dominance and playing position (defender, midfielder, and attacker). For the results, all the ROM measurements demonstrated limb symmetry (p = 0.621). However, there were significant main effects of the playing position on the ankle dorsiflexion and hip internal rotation, with defenders demonstrating a significantly reduced range of motion in comparison to midfielders and attackers. A notable finding from the bilateral passive stability measures was that 38.3% of players exhibited ankle talar inversion instability when using a talar tilt. In conclusion, bilateral differences do not appear to be apparent in this population; however, positional differences may occur in the ankle and hip range of motion measures. A high proportion of this population may present with passive ankle inversion instability. Future research should consider whether this leads to a higher risk of injury in this population.
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Affiliation(s)
- Kristian J Weaver
- Sports Injuries Research Group, Edge Hill University, St. Helens Road, Ormskirk, Lancashire L39 4QP, UK
| | - Nicola Relph
- Faculty of Health, Social Care and Medicine, Edge Hill University, St. Helens Road, Ormskirk, Lancashire L39 4QP, UK
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Toyooka S, Moatshe G, Persson A, Engebretsen L. Return to Pivoting Sports after Cartilage Repair Surgery of the Knee: A Scoping Review. Cartilage 2023; 14:17-25. [PMID: 36661094 PMCID: PMC10076897 DOI: 10.1177/19476035221141416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE To perform a scoping literature review evaluating and reporting on outcomes and return to pivoting sports after cartilage procedures. For this review, the following cartilage procedures were evaluated: microfracture, osteochondral autograft transplantation (OAT), osteochondral allograft transplantation (OCA), and autologous chondrocyte implantation (ACI). DESIGN The scoping review incorporated articles identified using PubMed (MEDLINE), CINAHL, and Cochrane Central Register of Controlled Trials. Screening of reference lists of included studies and forward citation tracking were performed to identify additional studies. Reported on return to pivoting sports after cartilage surgery written in English language. RESULTS Sixteen studies fulfilled the inclusion criteria. The return to sports (RTS) rates after microfracture ranged from 44% to 83%, and to preinjury level from 25% to 75%. The RTS rates after OAT ranged from 87% to 100%, and to preinjury level from 67% to 93%. The RTS rates after OCA ranged from 77% to 80%, and to preinjury level 64%. The RTS rates after ACI ranged from 33% to 96%, and to preinjury level from 26% to 67%. CONCLUSIONS There was a high heterogeneity and range in rates of RTS in athletes participating in pivoting sports. Most studies reported high rates of RTS; however, return to preinjury level was lower. These data may be important to clinicians in shared decision making on the type of procedure to be performed and counseling pivoting sports athletes on prognosis and expected RTS rates.
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Affiliation(s)
- Seikai Toyooka
- Department of Orthopaedic Surgery, Oslo Sports Trauma Research Center, Oslo University Hospital, Oslo, Norway
- Department of Orthopaedic Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Gilbert Moatshe
- Department of Orthopaedic Surgery, Oslo Sports Trauma Research Center, Oslo University Hospital, Oslo, Norway
| | - Andreas Persson
- Department of Orthopaedic Surgery, Oslo Sports Trauma Research Center, Oslo University Hospital, Oslo, Norway
| | - Lars Engebretsen
- Department of Orthopaedic Surgery, Oslo Sports Trauma Research Center, Oslo University Hospital, Oslo, Norway
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5
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Xu L, Xu Z. Application of Image Processing Technology in the Diagnosis of Football Injury. Appl Bionics Biomech 2022; 2022:5926098. [PMID: 36032047 PMCID: PMC9410979 DOI: 10.1155/2022/5926098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/09/2022] [Accepted: 07/14/2022] [Indexed: 11/22/2022] Open
Abstract
With the hot development of football, sports injuries caused by football have also received special attention. In football games, although there are medical staff on and off the field always on call to protect the safety of players, because of the complexity of diagnosis work, medical staff can easily lead to diagnostic errors due to factors such as fatigue, which seriously affects the condition of athletes. Image processing is a technology that uses computer to process images, which can greatly overcome the uncertain factors brought by manual diagnosis. Based on this, this paper uses image processing technology and pattern recognition as technical means to explore the specific application of image processing in football injury diagnosis. This paper firstly takes football clubs as the main research object and analyzes and explores the specific utility of image segmentation and feature recognition in sports injury image processing. Then, starting from the relevant image features, the paper analyzes and compares the sensitivity of support vector machine pattern recognition and neural network pattern recognition in football injury diagnosis. This article comprehensively summarizes the application of image processing technology in the diagnosis of football injuries and puts forward constructive suggestions for its subsequent development. Experiments show that the effect of pattern recognition is often different for different injury parts of football. Among them, the sensitivity of pattern recognition based on image processing can reach 68.9%, and the detection rate of football injuries can also be maintained at about 81.2%. This fully shows that image processing technology can play an active role in the actual football injury diagnosis, and provide very valuable information for clinical diagnosis.
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Affiliation(s)
- Liyun Xu
- Physical Education Department, Anhui University of Finance and Economics, Bengbu, 233041 Anhui, China
| | - Zhubo Xu
- Physical Education Department, Anhui University of Finance and Economics, Bengbu, 233041 Anhui, China
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6
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Salucci S, Falcieri E, Battistelli M. Chondrocyte death involvement in osteoarthritis. Cell Tissue Res 2022; 389:159-170. [PMID: 35614364 PMCID: PMC9287242 DOI: 10.1007/s00441-022-03639-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 05/09/2022] [Indexed: 12/22/2022]
Abstract
Chondrocyte apoptosis is known to contribute to articular cartilage damage in osteoarthritis and is correlated to a number of cartilage disorders. Micromass cultures represent a convenient means for studying chondrocyte biology, and, in particular, their death. In this review, we focused the different kinds of chondrocyte death through a comparison between data reported in the literature. Chondrocytes show necrotic features and, occasionally, also apoptotic features, but usually undergo a new form of cell death called Chondroptosis, which occurs in a non-classical manner. Chondroptosis has some features in common with classical apoptosis, such as cell shrinkage, chromatin condensation, and involvement, not always, of caspases. The most crucial peculiarity of chondroptosis relates to the ultimate elimination of cellular remnants. Independent of phagocytosis, chondroptosis may serve to eliminate cells without inflammation in situations in which phagocytosis would be difficult. This particular death mechanism is probably due to the unusual condition chondrocytes both in vivo and in micromass culture. This review highlights on the morpho-fuctional alterations of articular cartilage and focus attention on various types of chondrocyte death involved in this degeneration. The death features have been detailed and discussed through in vitro studies based on tridimensional chondrocyte culture (micromasses culture). The study of this particular mechanism of cartilage death and the characterization of different biological and biochemical underlying mechanisms can lead to the identification of new potentially therapeutic targets in various joint diseases.
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Affiliation(s)
- S Salucci
- Department of Biomolecular Sciences (DiSB), Urbino University Carlo Bo, Via Cà le Suore, 2, Campus Scientifico Enrico Mattei, 61029, Urbino (PU), Italy.,Cellular Signalling Laboratory, Department of Biomedical and NeuroMotor Sciences (DIBINEM), University of Bologna, 40126, Bologna, Italy
| | - E Falcieri
- Department of Biomolecular Sciences (DiSB), Urbino University Carlo Bo, Via Cà le Suore, 2, Campus Scientifico Enrico Mattei, 61029, Urbino (PU), Italy
| | - M Battistelli
- Department of Biomolecular Sciences (DiSB), Urbino University Carlo Bo, Via Cà le Suore, 2, Campus Scientifico Enrico Mattei, 61029, Urbino (PU), Italy.
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Hartnett DA, Milner JD, Bodendorfer BM, DeFroda SF. Lower extremity injuries in the baseball athlete. SAGE Open Med 2022; 10:20503121221076369. [PMID: 35154741 PMCID: PMC8832566 DOI: 10.1177/20503121221076369] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 01/10/2022] [Indexed: 01/02/2023] Open
Abstract
Baseball is unique in its multiple facets: pitching, hitting, base rounding, and fielding are distinct activities that require different athletic skills to perform at a high level. Likewise, these different aspects of the game can contribute to a multitude of varying injuries. While high-velocity overhead throwing, along with batting, can produce a plethora of upper extremity injuries that often garner attention, injuries to the lower extremity can severely impact a player’s performance and ability to compete. The rigors of the short, explosive sprinting required for base running, as well as the dynamic movement required for fielding, create ample opportunity for lower limb injury, and even subtle pathology can affect a pitcher’s ability to perform or increase their long-term risk of injury. Chronic injury from conditions such as femoroacetabular impingement and hip labral tears can also occur. The purpose of the present review is to summarize the relevant epidemiology, pathophysiology, and treatment of lower extremity injuries in baseball athletes, with reference to current research into the prevention and management of such injuries.
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Affiliation(s)
- Davis A Hartnett
- Department of Orthopaedic Surgery, The Warren Alpert School of Medicine, Brown University, Providence, RI, USA
| | - John D Milner
- Department of Orthopaedic Surgery, The Warren Alpert School of Medicine, Brown University, Providence, RI, USA
| | - Blake M Bodendorfer
- Miller Orthopedic Specialists, Council Bluffs, IA, USA
- Miller Orthopedic Specialists, Omaha, NE, USA
| | - Steven F DeFroda
- Department of Orthopaedic Surgery, Missouri Orthopaedic Institute, University of Missouri, Columbia, MO, USA
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8
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Semi-quantitative magnetic resonance imaging scoring of the knee detects previous injuries in professional soccer players. Knee Surg Sports Traumatol Arthrosc 2022; 30:1161-1168. [PMID: 35182170 PMCID: PMC9007775 DOI: 10.1007/s00167-022-06897-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 01/20/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE The medical examination ("medical") is an important procedure in professional soccer since it has high economic relevance. In addition to clinical tests, magnetic resonance imaging (MRI) is used to assess joint health. In the present study, the reliability of semiquantitative knee MRI during the "medical" in professional soccer was tested, and its relationship with clinical data and days missed due to knee injury was observed. METHODS In this cross-sectional study, between 2012 and 2019, 69 newly assigned players (age 18-35 years) from a professional soccer club underwent MRI (3.0 T) of both knee joints during their "medical". Reported knee injuries and previously missed days due to injury were obtained from player anamnesis and the "transfermarkt.com" database. Based on the established "Whole-Organ Magnetic Resonance Imaging Score" (WORMS), two independent radiologists graded the MRI results. Further evaluation was based on the mean score of both knees. RESULTS The mean WORMS for all subjects was 13.9 (median 10.5, range 0-61). Players with previous injuries had significantly higher scores than players without reported injuries (22.1 ± 17.7 vs. 8.9 ± 4.4, p < 0.002). Three outliers (previously undetected injuries) in the group of players without reported injuries were observed (6.7%). The WORMS was significantly correlated with a prior knee injury (r: 0.424, p < 0.0001) and days missed due to injury (r: 0.489, p < 0.001). Age was correlated with the WORMS (r: 0.386, p < 0.001). In a linear regression model, prior injury was the only significant predictor of a high WORMS (p = 0.001). The WORMS was a significant predictor of days missed due to injury (p < 0.0002) and prior injury (sensitivity: 78%, specificity: 91%, p = 0.006). The intraclass correlation coefficient was excellent (0.89). CONCLUSION Semiquantitative knee MRI for WORMS determination during the soccer "medical" is a robust and reliable method. Prior injury, even in players without documented trauma, was detected by the WORMS, and previously missed days due to injury were correlated with the semiquantitative MR knee score. LEVEL OF EVIDENCE Level III.
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9
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Goderecci R, De Dominicis S, Necozione S, Ciriello V, Angelozzi M, Calvisi V, Logroscino G. Knee function after a mean of 19 years Post-retirement in 65 Italian semi-professional rugby veterans. ACTA BIO-MEDICA : ATENEI PARMENSIS 2022; 93:e2022139. [PMID: 35775769 PMCID: PMC9335446 DOI: 10.23750/abm.v93i3.12562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 12/05/2021] [Indexed: 11/30/2022]
Abstract
Background and aim sport activity has been largely correlated to the development of knee osteoarthritis, but only few papers have investigated the long-term impact of a rugby career on the knee joint. The aim of this retrospective study was to evaluate the incidence and epidemiology of knee osteoarthritis and general health in a population of 65 retired semi-professional rugby players. Methods demographic and anamnestic analysis was recorded and Oxford Knee score, SF-12 and VAS were submitted to all veterans in order to assess current knee function, general health condition and level of pain. Parametric analysis of Spearman was used to evaluate the statistical significance on these results and the Kruskal-Wallis test was used to assess the significant differences between the questionnaire results and the demographic and anamnestic records. Results we found that players who sustained a knee injury during their career have a current reduction of the knee function compared to veterans who did not suffer any injury and who showed values comparable with those of the health population. In terms of general and mental health, athletes who retired later have now a better condition than those who retired from the sport earlier. Conclusions: we concluded that knee injury prevention should be an unequivocal priority because although rugby is a high energy sport, it does not increase the risk of knee osteoarthritis in absence of serious knee injuries.
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Affiliation(s)
- Remo Goderecci
- Unit of Orthopaedics and Traumatology”, G. Mazzini Civil Hospital, Asl 4 Teramo, Teramo, Italy
| | - Simone De Dominicis
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, Sports Science Area, L’Aquila, Italy
| | - Stefano Necozione
- Department of Life Health & Environmental sciences, University of L’Aquila, General and Applied Hygiene Unit, L’Aquila, Italy
| | - Vincenzo Ciriello
- Department of Surgery, Orthopaedic and Trauma Unit, S. Croce e Carle Hospital, Cuneo, Italy
| | - Massimo Angelozzi
- Department of Life Health & Environmental sciences, University of L’Aquila, Unit of Orthopaedics and Traumatology, L’Aquila, Italy
| | - Vittorio Calvisi
- Department of Life Health & Environmental sciences, University of L’Aquila, Unit of Orthopaedics and Traumatology, L’Aquila, Italy
| | - Giandomenico Logroscino
- Department of Life Health & Environmental sciences, University of L’Aquila, Unit of Orthopaedics and Traumatology, L’Aquila, Italy
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Schenk H, Simon D, Waldenmeier L, Evers C, Janka R, Welsch GH, Pachowsky ML. Regions at Risk in the Knee Joint of Young Professional Soccer Players: Longitudinal Evaluation of Early Cartilage Degeneration by Quantitative T2 Mapping in 3 T MRI. Cartilage 2021; 13:595S-603S. [PMID: 32449383 PMCID: PMC8808898 DOI: 10.1177/1947603520924773] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
PURPOSE The study aims to detect regions at risk for (pre-)osteoarthritis in the tibiofemoral joint of young professional soccer players by evaluating cartilage composition by T2 mapping in a 3 T magnetic resonance imaging setting. METHODS In this longitudinal study, 20 professional adolescent soccer players were included. Tibiofemoral cartilage was assessed by quantitative T2 mapping and T2 values were evaluated by regions of interest analysis. Statistical evaluation, using Wilcoxon signed-rank tests, was performed to compare global T2 values and subregional T2 values between a baseline and a follow-up investigation 4.3 years later. Based on the average of playing time (15 years) we divided the cohort in 2 groups and differences were evaluated. RESULTS When comparing baseline and follow-up, our findings showed statistically significant increases of the global medial tibial and femoral T2 values. The most noticeable results of the subregional T2 analysis were statistically significant increases in the medial posterior zones (deep femoral 36.1 vs. 39.5, P = 0.001; superficial femoral 57.0 vs. 62.4, P = 0.034; deep tibial 28.3 vs. 34.1, P = 0.009; superficial tibial 43.2 vs. 55.3, P = 0.002). CONCLUSION The elevation of T2 values in the medial, especially medial posterior, compartment of the knee joint indicates that these regions are at risk for early cartilage degeneration already at the time of adolescence. The findings can help individualize and optimize training concepts and to be aware of the chronic stress on these vulnerable areas. Prevention programs should be established in young players to avoid further cartilage damage.
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Affiliation(s)
- Hanna Schenk
- Friedrich-Alexander University
Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - David Simon
- Friedrich-Alexander University
Erlangen-Nürnberg (FAU), Erlangen, Germany,Department of Internal Medicine
3–Rheumatology and Immunology, University Hospital of Erlangen, Erlangen,
Germany
| | - Leonie Waldenmeier
- Department of Internal Medicine,
University Hospital of Basel, Basel, Switzerland
| | - Christoph Evers
- Department of Radiooncology, University
Hospital of Halle/Saale, Halle, Germany
| | - Rolf Janka
- Friedrich-Alexander University
Erlangen-Nürnberg (FAU), Erlangen, Germany,Department of Radiology, University
Hospital of Erlangen, Erlangen, Germany
| | - Goetz H. Welsch
- UKE Athleticum, University Hospital
Hamburg-Eppendorf, Hamburg, Germany
| | - Milena L. Pachowsky
- Friedrich-Alexander University
Erlangen-Nürnberg (FAU), Erlangen, Germany,Department of Internal Medicine
3–Rheumatology and Immunology, University Hospital of Erlangen, Erlangen,
Germany,Department of Trauma and Orthopedic
Surgery, University Hospital of Erlangen, Erlangen, Germany,Milena L. Pachowsky, Department of Trauma
and Orthopedic Surgery, University Hospital of Erlangen, Maximiliansplatz 1,
Erlangen 91054, Germany.
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11
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Younas A, Gu H, Zhao Y, Zhang N. Novel approaches of the nanotechnology-based drug delivery systems for knee joint injuries: A review. Int J Pharm 2021; 608:121051. [PMID: 34454029 DOI: 10.1016/j.ijpharm.2021.121051] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 08/14/2021] [Accepted: 08/23/2021] [Indexed: 12/13/2022]
Abstract
The knee joint is one of the largest, most complex, and frequently utilized organs in the body. It is very vulnerable to injuries due to activities, diseases, or accidents, which lead to or cause knee joint injuries in people of all ages. There are several types of knee joint injuries such as contusions, sprains, and strains to the ligament, tendon injuries, cartilage injuries, meniscus injuries, and inflammation of synovial membrane. To date, many drug delivery systems, e.g. nanoparticles, dendrimers, liposomes, micelles, and exosomes, have been used for the treatment of knee joint injuries. They aim to alleviate or reverse the symptoms with an improvement of the function of the knee joint by restoring or curing it. The nanosized structures show good biodegradability, biocompatibility, precise site-specific delivery, prolonged drug release, and enhanced efficacy. They regulate cell proliferation and differentiation, ECM synthesis, proinflammatory factor secretion, etc. to promote repair of injuries. The goal of this review is to outline the finding and studies of the novel strategies of nanotechnology-based drug delivery systems and provide future perspectives to combat the challenges of knee joint injuries by using nanotechnology.
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Affiliation(s)
- Ayesha Younas
- Department of Pharmaceutics, School of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou 450001, Henan, PR China; Key Laboratory of Targeting Therapy and Diagnosis for Critical Diseases, Henan Province, Zhengzhou 450001, Henan, PR China; Key Laboratory of Advanced Pharmaceutical Technology, Ministry of Education of China, Henan, Zhengzhou 450001, Henan, PR China
| | - Hongzhou Gu
- Fudan University Shanghai Cancer Center, and the Shanghai Key Laboratory of Medical Epigenetics, Institutes of Biomedical Sciences, Shanghai Stomatological Hospital, Fudan University, Shanghai 200032, PR China
| | - Yongxing Zhao
- Department of Pharmaceutics, School of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou 450001, Henan, PR China; Key Laboratory of Targeting Therapy and Diagnosis for Critical Diseases, Henan Province, Zhengzhou 450001, Henan, PR China; Key Laboratory of Advanced Pharmaceutical Technology, Ministry of Education of China, Henan, Zhengzhou 450001, Henan, PR China.
| | - Nan Zhang
- Department of Pharmaceutics, School of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou 450001, Henan, PR China; Key Laboratory of Targeting Therapy and Diagnosis for Critical Diseases, Henan Province, Zhengzhou 450001, Henan, PR China; Key Laboratory of Advanced Pharmaceutical Technology, Ministry of Education of China, Henan, Zhengzhou 450001, Henan, PR China.
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12
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Freiberg A, Bolm-Audorff U, Seidler A. The Risk of Knee Osteoarthritis in Professional Soccer Players—a Systematic Review With Meta-Analyses. DEUTSCHES ARZTEBLATT INTERNATIONAL 2021; 118:49-55. [PMID: 33759745 PMCID: PMC8182778 DOI: 10.3238/arztebl.m2021.0007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 02/26/2020] [Accepted: 08/24/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND We address the question whether professional soccer players with and without macroinjury of the knee joint are at an elevated risk for knee osteoarthritis. METHODS A systematic review with meta-analyses was conducted. The study protocol was prospectively registered (registration number CRD42019137139). The MEDLINE, EMBASE, and Web of Science databases were searched for relevant publications; in addition, forward searching was performed, and the listed references were considered. All steps of the process were undertaken independently by two reviewers, and any discordances were resolved by consensus. For all publications whose full text was included, the methods used were critically evaluated. The quality of the evidence was judged using the GRADE criteria. RESULTS The pooled odds ratio for objectively ascertained osteoarthrosis of the knee was 2.25 (95% confidence interval [1.41-3.61], I2 = 71%). When only radiologically ascertained knee osteoarthrosis was considered, the odds ratio was 3.98 [1.34; 11.83], I2 = 58%). The pooled risk estimator in studies in which knee joint macroinjury was excluded was 2.81 ([1.25; 6.32], I2 = 71%). CONCLUSION A marked association was found between soccer playing and knee osteoarthritis in male professional soccer players. For female professional soccer players, the risk of knee osteoarthritis could not be assessed because of the lack of data. Knee injuries seem to play an important role in the development of knee osteoarthritis in professional soccer players.
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Affiliation(s)
- Alice Freiberg
- Institute and Policlinic of Occupational and Social Medicine, Medical Faculty Carl Gustav Carus, Technische Universität Dresden; Division of Occupational Health, Department of Occupational Safety and Environment, Regional Government of South Hesse, Wiesbaden; Extraordinary Chair of Occupational Medicine, University of Gießen
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Koch M, Klügl M, Frankewycz B, Lang S, Worlicek M, Popp D, Alt V, Krutsch W. Football-related injuries are the major reason for the career end of professional male football players. Knee Surg Sports Traumatol Arthrosc 2021; 29:3560-3568. [PMID: 34370085 PMCID: PMC8514381 DOI: 10.1007/s00167-021-06684-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 07/29/2021] [Indexed: 11/17/2022]
Abstract
PURPOSE Little is known about the consequences of injuries on professional male football players' career and retirement period. The aim of this study is to investigate the impact of injuries that male professional football players endure during their career, reasons for the end of their career and the post-career phase of retirement. METHODS In a retrospective cross-sectional cohort study, retired male professional football players of the German Bundesliga were investigated by a standardised questionnaire to analyse the history of injuries sustained during their professional football career, the reasons for ending their career, their current health status and their suggestions for future prevention strategies. RESULTS Most of the 116 analysed players (n = 73 (62.9%)) stated an injury as the reason for ending their professional career. Relevant injuries were mainly located in the lower extremities (n = 587 (61.3%)) with a focus on the knee (p < 0.001) and ankle (p < 0.001). A significant majority of the participants who had retired due to injury described degenerative symptoms, such as pain or instability, and were diagnosed with osteoarthritis after retirement (p < 0.001). These players had also often been affected by symptoms of depression during their career, which had decreased significantly after retirement. Moreover, players who had not retired due to injury had significantly better overall health status and quality of life after retirement. CONCLUSION Football-related injuries have a significant impact on the career end of professional male football players and their health status after retirement. Future prevention strategies need to particularly address injuries to the knees and ankles and to implement measures for preventing osteoarthritis after retirement. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Matthias Koch
- Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany.
| | - Martin Klügl
- herz:bewegt - Praxis für Kardiologie und Sportmedizin, Bahnhofstraße 19, 94315 Straubing, Germany
| | - Borys Frankewycz
- grid.411941.80000 0000 9194 7179Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany
| | - Siegmund Lang
- grid.411941.80000 0000 9194 7179Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany
| | - Michael Worlicek
- grid.411941.80000 0000 9194 7179Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany
| | - Daniel Popp
- grid.411941.80000 0000 9194 7179Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany
| | - Volker Alt
- grid.411941.80000 0000 9194 7179Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany
| | - Werner Krutsch
- grid.411941.80000 0000 9194 7179Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany ,SportDocsFranken, Nuernberg, Germany
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Vincent HK, Bruner M, Obermayer C, Griffin B, Vincent KR. Musculoskeletal pain in lacrosse officials impacts function on the field. Res Sports Med 2020; 29:486-497. [PMID: 33350867 DOI: 10.1080/15438627.2020.1860046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study determined the prevalence of joint pain among lacrosse officials and described the impact of pain thereof on current officiating duties on the field. Members of the US Lacrosse Officials Development Programme were provided with an electronic survey (a 15.7% response rate resulted in N = 1,441 of completed surveys). Pain sites and severity, previous injuries and current impact of musculoskeletal pain on officiating duties were captured. Pain was present in 18.1-40.1% of respondents at the foot, shoulder, back and knee. A total of 437 officials reported diagnoses of osteoarthritis ([OA]; knee 48.7%, hip 10.5%, spine 10.1%, shoulder 8.0%) and 247 reported OA in more than one joint (p < .05). Officials with OA or previous lacrosse-related injuries reported frequent difficulty with running the entire field distance (p < 0.0001), starting and stopping on the field (p < 0.0001), keeping pace (p < 0.0001), focusing on multiple actions of players at once (p < 0.0001), and enjoyment (all p < 0.0001). Musculoskeletal pain is a common, unrecognized issue in this population that interferes with sport officiating functions. Additional study is needed to objectively determine the impact of OA pain and musculoskeletal injuries on measurable performance outcomes on the field and subjective measures of focus, attention and enjoyment.
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Affiliation(s)
- Heather K Vincent
- Department of Orthopaedics and Rehabilitation, UF Health Sports Performance Center, University of Florida, Gainesville, FL, USA
| | - Michelle Bruner
- Department of Orthopaedics and Rehabilitation, UF Health Sports Performance Center, University of Florida, Gainesville, FL, USA
| | | | - Bruce Griffin
- Management Advisory & Compliance Services, Towson University, Sparks Glencoe, MD, USA
| | - Kevin R Vincent
- Department of Orthopaedics and Rehabilitation, UF Health Sports Performance Center, University of Florida, Gainesville, FL, USA
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Feigenbaum LA, Gaunaurd IA, Kim KJ, Raya MA, Ruiz JT, Rapicavoli J, Best TM, Kaplan L, Gailey RS. Accuracy of the Region of Limb Stability in Predicting Risk for Lower Limb Injury. Med Sci Sports Exerc 2020; 52:2483-2488. [PMID: 33064416 DOI: 10.1249/mss.0000000000002384] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE This study aimed to determine whether a measure of lower limb segment stability derived from body-worn inertial measurement units can predict risk for lower limb musculoskeletal injury in Division I Collegiate Football Players (D1CFP). METHODS The region of limb stability (ROLS) values were collected in a cohort of D1CFP during preseason. ROLS is a measure of knee joint stability, defined by thigh and shank excursion (cm) in the anterior-posterior and medial-lateral direction during single limb stance. The ROLS symmetry index (SI) (%) is the ratio between lower limb ROLS values where 100% suggests absolute symmetry. RESULTS One-hundred and four D1CFP participated in this study and were divided into two groups: 1) no previous lower limb injury or no in-season injury (n = 70, "noninjured group") and 2) no previous lower limb injury, but in-season injury requiring surgery (n = 34, "injured group" group). The mean ± SD ROLS SI was 82.86% ± 14.75% and 65.58% ± 16.46% for the noninjured and injured group, respectively. Significant differences in ROLS SI were found between groups (P < 0.001). The ROLS SI demonstrated an area under the curve of 0.8 (P < 0.001; 95% confidence interval = 0.71-0.88) with an SE of 0.04, indicating that the ROLS SI has good predictive accuracy in detecting those healthy D1CFP at risk for lower limb injury resulting in surgery. CONCLUSION The ROLS SI was found to have good predictive accuracy in detecting individuals at risk for injury that were healthy and asymptomatic during preseason testing. Increase in thigh and shank excursions and/or decrease in SI between lower limbs may be a predictor of risk for future injury.
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Affiliation(s)
| | | | - Kyoung Jae Kim
- Department of Physical Therapy, University of Miami, Miller School of Medicine, Coral Gables, FL
| | - Michele A Raya
- Department of Physical Therapy, University of Miami, Miller School of Medicine, Coral Gables, FL
| | | | | | | | | | - Robert S Gailey
- Department of Physical Therapy, University of Miami, Miller School of Medicine, Coral Gables, FL
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Abstract
INTRODUCTION Elite and Olympian athletes are often stretching the upper limits of normal physiology and biomechanics of the musculoskeletal system in their efforts to excel in their sport. For them to get back to their sport at the same level after injury, the management, repair techniques, and rehabilitation protocols should be robust to permit healing of tissues to allow supra-normal loading and performance. The knee and the meniscus are commonly injured in these sports. Yet, the incidence, mechanisms, types of injuries to the meniscus, and their management are not known across different sports in the Olympics. METHODS We set out to look into the incidence and the trends of publications on meniscal injuries of the knee in Olympic games. A search of the PubMed and Scopus for these injuries using a search strategy gave 79 and 116 articles, respectively. RESULTS There were very few publications giving the incidence of meniscal injuries in the Olympics. Football is the sport with the highest rate of meniscal injuries. Different sports are popular in different countries, and depending on the popularity and the country reporting these injuries, incidences differed. There was data available from India and Brazil for Elite athlete from diverse sports, whereas most data from other countries were for football and soccer. Knee was found to be the second most commonly injured part of the body in both Winter and Summer Olympics as well as the Youth Winter Olympics. Data were not available from the Youth Summer Olympics to make any conclusions. The number of publications on this topic is low. We presented the timeline of publications and citations of articles on this topic. The top country, language, journal, university, and author were USA, English, American Journal of Sports Medicine, Hospital of Special Surgery in New York and Brophy RH, respectively. The data on the risk factors for meniscal injuries were analyzed, discussed, and presented for football, as this was the most extensively studied sport. CONCLUSIONS Even though the knee is one of the commonly injured anatomical locations in elite athletes, there is a lack of literature on meniscal injuries in this subset of population. We looked at possible reasons and made recommendations to improve data collection on these injuries.
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Krutsch W, Lehmann J, Jansen P, Angele P, Fellner B, Achenbach L, Krutsch V, Nerlich M, Alt V, Loose O. Prevention of severe knee injuries in men's elite football by implementing specific training modules. Knee Surg Sports Traumatol Arthrosc 2020; 28:519-527. [PMID: 31541292 DOI: 10.1007/s00167-019-05706-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Accepted: 09/11/2019] [Indexed: 11/24/2022]
Abstract
PURPOSE Injury prevention of knee injuries by means of training and warm-up exercises has been investigated in several studies in amateur football. However, the number of investigations in elite football is limited despite the currently higher injury incidence of severe knee injuries. Therefore, the purpose of this study was to investigate whether specifically adapted preventive training modules may reduce severe knee injuries in elite football. METHODS In a prospective controlled cohort study of elite football players in Germany, an injury prevention programme with 5 modules was implemented in the season of 2015-2016. The training modules were specifically adapted to this skill level and based on scientific evidence, team coach preferences, and the specific environment of this playing level. Of the 62 teams taking part in this study, 26 used the new trainings modules and 36 continued their standard programme as a control group. Success of the programme was documented by means of an injury report over one season. The primary outcome was reduction in severe knee injuries. RESULTS A pre-seasonal investigation had identified five modules to be implemented in the training routine. Postural stability, mobilisation of lower extremity joints, leg and trunk stabilisation, jumping, and landing exercises as well as agility movements were incorporated into the programme to prevent severe knee injuries in elite football. Over the season, the study group (529 players) with the adapted training modules had sustained 52 severe knee injuries (incidence: 0.38 per 1000 h football exposure; prevalence: 9.8%) compared to 108 severe knee injuries in the control group (601 players) using the standard programme (incidence: 0.68 per 1000 h football exposure; prevalence: 18.0%; p < 0.05). The overall injury incidence for any other type of injury was comparable between the two groups (3.3 vs. 3.4 in h 1000 football, n.s.). CONCLUSION Appropriate preventive training modules reduce severe knee injuries in elite football significantly. The key for the sustainability of preventive training measures are programmes specifically adapted to the demands of the playing level and to the preferences of the coaches LEVEL OF EVIDENCE: II.
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Affiliation(s)
- Werner Krutsch
- Department of Trauma Surgery, University Medical Centre Regensburg, Franz-Josef-Straus-Allee 11, 93053, Regensburg, Germany.
| | - Jennifer Lehmann
- Institute of Sport Science, University of Regensburg, Regensburg, Germany
| | - Petra Jansen
- Institute of Sport Science, University of Regensburg, Regensburg, Germany
| | - Peter Angele
- Department of Trauma Surgery, University Medical Centre Regensburg, Franz-Josef-Straus-Allee 11, 93053, Regensburg, Germany
| | - Birgit Fellner
- Institute of Sport Science, University of Regensburg, Regensburg, Germany
| | - Leonard Achenbach
- Department of Trauma Surgery, University Medical Centre Regensburg, Franz-Josef-Straus-Allee 11, 93053, Regensburg, Germany
| | - Volker Krutsch
- Department of Otorhinolaryngology, Paracelsus Medical University Nuremberg, Nuremberg, Germany
| | - Michael Nerlich
- Department of Trauma Surgery, University Medical Centre Regensburg, Franz-Josef-Straus-Allee 11, 93053, Regensburg, Germany
| | - Volker Alt
- Department of Trauma Surgery, University Medical Centre Regensburg, Franz-Josef-Straus-Allee 11, 93053, Regensburg, Germany
| | - Oliver Loose
- Clinic of Orthopedic Surgery, Olga Hospital, Stuttgart, Germany
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Volpi P, Quaglia A, Carimati G, Petrillo S, Bisciotti GN. High incidence of hip and knee arthroplasty in former professional, male football players. J Sports Med Phys Fitness 2019; 59:1558-1563. [DOI: 10.23736/s0022-4707.18.08962-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Falotico GG, Arliani GG, Yamada AF, Fernandes ADRC, Ejnisman B, Cohen M. Professional soccer is associated with radiographic cam and pincer hip morphology. Knee Surg Sports Traumatol Arthrosc 2019; 27:3142-3148. [PMID: 29876863 DOI: 10.1007/s00167-018-5008-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Accepted: 06/01/2018] [Indexed: 01/22/2023]
Abstract
PURPOSE Femoroacetabular impingement (FAI) syndrome is characterized by a triad: symptoms, clinical signs and imaging findings. Some individuals, especially athletes, have only imaging alterations. The objective of this study was to evaluate the prevalence of cam and pincer morphology in professional soccer players compared with a control group of non-athletes and to investigate the association between the age at which players start playing competitive soccer more than three times per week and duration of the soccer career with the prevalence of these radiographic findings. METHODS The prevalence of cam and pincer morphology in sixty professional adult male soccer players and thirty-two male controls was determined using pelvic anteroposterior radiography. Data were recorded for all hips and correlated with the age at which the players started competitive soccer practice and with the duration of their soccer career. RESULTS The prevalence of morphological FAI in the soccer players was 92.5% versus 28.1% in the controls (p < 0.001). The duration of the soccer career was positively correlated with the alpha angle (p = 0.033) and negatively correlated with the retroversion index (p = 0.009). The age at which competitive play began was inversely correlated with the alpha angle (p < 0.001). CONCLUSION The study showed a high prevalence of cam and pincer morphology in Brazilian professional soccer players compared with controls. The duration of the soccer career was associated with an increased alpha angle and a decreased retroversion index, and the age at which competitive soccer participation began was negatively associated with alpha angle values. Finally, this manuscript provides data about the association between greater exposure to soccer and cam and pincer morphological changes in the hip; specifically, cam morphology was more common in patients who began participating in sports at earlier ages. This information serves as an alert for coaches of youth teams to manage the training load in youth athletes. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Guilherme Guadagnini Falotico
- Departamento de Ortopedia e Traumatologia, Universidade Federal de São Paulo, Borges Lagoa, 783-5° floor, São Paulo, SP, Brazil.
| | - Gustavo Gonçalves Arliani
- Departamento de Ortopedia e Traumatologia, Universidade Federal de São Paulo, Borges Lagoa, 783-5° floor, São Paulo, SP, Brazil
| | - André Fukunishi Yamada
- Departamento de Diagnóstico por Imagem, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | | | - Benno Ejnisman
- Departamento de Ortopedia e Traumatologia, Universidade Federal de São Paulo, Borges Lagoa, 783-5° floor, São Paulo, SP, Brazil
| | - Moises Cohen
- Departamento de Ortopedia e Traumatologia, Universidade Federal de São Paulo, Borges Lagoa, 783-5° floor, São Paulo, SP, Brazil
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Gouttebarge V, Aoki H, Kerkhoffs GMMJ. Lower extremity osteoarthritis is associated with lower health-related quality of life among retired professional footballers. PHYSICIAN SPORTSMED 2018. [PMID: 29527975 DOI: 10.1080/00913847.2018.1451718] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The objective of the current study was to explore whether retired professional footballers suffering from lower extremity OA have a lower health-related quality of life than those without OA or current professional footballers. METHODS An observational study based on a cross-sectional design by means of questionnaires was conducted. Participants were retired and current professional footballers recruited by the World Players' Union (FIFPro). Information about lower extremity OA (clinically diagnosed by a medical professional) was gathered, while health-related quality of life (Global Physical Health and Global Mental Health scores) was assessed through a validated scale. RESULTS A total of 396 retired and 361 current professional footballers were included in the analyses (response rate of 54%). The group of retired professional footballers was on average 36 years old, and they had competed in professional football for 11 years (retired for 5 years). The group of current professional footballers was on average 25 years old, and they had been active in professional football for 7 years. Within the group of retired professional footballers, prevalence of lower extremity OA was 33%. Both Global Physical Health and Global Mental Health scores among retired professional footballers with lower extremity OA were significantly lower than among retired players without OA and current players, but these scores were nearly similar to the norm for the general population (regardless the presence of OA or not). CONCLUSIONS Health-related quality of life among retired professional footballers with lower extremity OA was significantly lower than among retired players without OA and current players but nearly similar to the norm for the general population (regardless the presence of OA or not). A rational recommendation is that a support measure such as the After Career Consultation should be introduced among retired professional footballers in order to empower their sustainable health and quality of life, focussing especially on the prevention of the occurrence or worsening of lower extremity OA.
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Affiliation(s)
- Vincent Gouttebarge
- a World Players' Union (FIFPro) , Hoofddorp , The Netherlands.,b Department of Orthopaedic Surgery, Academic Medical Center , University of Amsterdam, Amsterdam Movement Sciences , Amsterdam , The Netherlands.,c Academic Center for Evidence based Sports medicine (ACES) , Academic Medical Center , Amsterdam , The Netherlands.,d Amsterdam Collaboration on Health & Safety in Sports (ACHSS) , AMC/VUmc IOC Research Center , Amsterdam , The Netherlands.,e Division of Exercise Science and Sports Medicine , University of Cape Town , Cape Town , South Africa
| | - Haruhito Aoki
- f St. Marianna University School of Medicine , Kawasaki , Japan.,g Yokohama City Sports Medical Center , Yokohama , Japan
| | - Gino M M J Kerkhoffs
- b Department of Orthopaedic Surgery, Academic Medical Center , University of Amsterdam, Amsterdam Movement Sciences , Amsterdam , The Netherlands.,c Academic Center for Evidence based Sports medicine (ACES) , Academic Medical Center , Amsterdam , The Netherlands.,d Amsterdam Collaboration on Health & Safety in Sports (ACHSS) , AMC/VUmc IOC Research Center , Amsterdam , The Netherlands
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Ali Khan MM, Siddiqui AA, Yaqoob U, Yaqub MD, Khan OJ, -Ul-Haq F. Post-football Gonathrosis: Injuries and Surgeries are A Risk. Cureus 2018; 10:e2953. [PMID: 30214841 PMCID: PMC6132680 DOI: 10.7759/cureus.2953] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Football is one of the most popular sports in the world. Many studies have shown there is a high incidence of gonarthrosis in football players. The reason for this increase is said to be injuries to the meniscus, the anterior cruciate ligament (ACL) and the resulting surgeries. The incidence is significantly increased in players with knee injuries. The knee is also the most commonly injured site in football and the most common cause of surgery in football players. Together these injuries, particularly of the ACL or meniscus and the resulting surgeries, increase the risk of developing gonarthrosis in post-football years.
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Affiliation(s)
| | - Adeel A Siddiqui
- Orthopedic Surgery, Dow University of Health Sciences, Karachi, PAK
| | - Uzair Yaqoob
- Surgery, Jinnah Postgraduate Medical Centre, Karachi, PAK
| | | | - Osama J Khan
- Sindh Medical College, Dow University of Health Sciences, Karachi, PAK
| | - Faizan -Ul-Haq
- Sindh Medical College, Dow University of Health Sciences, Karachi, PAK
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Beach handball is safer than indoor team handball: injury rates during the 2017 European Beach Handball Championships. Knee Surg Sports Traumatol Arthrosc 2018; 26:1909-1915. [PMID: 29594323 DOI: 10.1007/s00167-018-4907-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 03/20/2018] [Indexed: 10/17/2022]
Abstract
PURPOSE Beach handball is a relatively new type of sports, which was derived from team handball. Medical issues such as frequency and severity of injury are yet unknown. The purpose of this study was to investigate the injury pattern and injury rates of this new type of sports. METHODS This study investigated the injury incidence of 30 national teams (10 senior and 20 u-17 teams, 16 men's and 14 women's teams) participating in the 2017 European Beach Handball Championships. Reports on injuries sustained during the senior and u-17 youth tournaments were provided by the medical staff of each team. Injury incidence was differentiated between age and sex, and between the five field positions (goalkeeper, wing, central defender, pivot, and specialist). RESULTS During the tournaments, 87 injuries were recorded yielding an overall injury incidence of 286.1 per 1000 match hours. Time-loss due to injury was 49.3 per 1000 match hours. Senior players had a higher overall injury incidence with 395.3 injuries than u-17 players with 205.7 injuries per 1000 h match hours (p < 0.01). Comparison of the injury incidence between the two sexes showed 330.23 injuries per 1000 h handball exposure for male players and 234.9 injuries for female players (n.s.). The most frequent injury type was sprains (21 injuries, 24.1%) followed by contusions (19 injuries, 21.8%) and skin abrasions with (15 injuries, 17.2%). Central defenders and specialists had the highest injury incidence. Thighs, ankles, as well as foot and toes (altogether 12 injuries, all 13.8%) were the three most frequently injured anatomic sites. CONCLUSIONS Beach handball seems to have a lower incidence of time-loss injuries than that reported for indoor team handball. This study is an important basis for developing injury prevention strategies in this sports that should focus on thighs, ankles, feet and toes. Further research into this new type of sports is essential to identify risk factors and to develop adequate injury prevention measures. LEVEL OF EVIDENCE II.
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Gouttebarge V, Aoki H, Kerkhoffs GMMJ. Knee osteoarthritis in professional football is related to severe knee injury and knee surgery. Inj Epidemiol 2018; 5:26. [PMID: 29911282 PMCID: PMC6004342 DOI: 10.1186/s40621-018-0157-8] [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: 02/27/2018] [Accepted: 05/07/2018] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND As a consequence of severe knee injuries, knee osteoarthritis (OA) seems prevalent in retired professional footballers. However, some epidemiological data remain missing, for instance whether knee OA is also prevalent in current professional footballers, whether knee OA is associated with knee injuries and surgeries, and whether knee OA leads to a lower level of functioning. Therefore, three research questions were answered: (i) what is the prevalence of knee osteoarthritis (OA) among current and retired professional footballers? (ii) is severe knee injury or knee surgery associated with knee OA among current and retired professional footballers? (iii) what are the consequences of knee OA on physical knee function among current and retired professional footballers? METHODS An observational study based on a cross-sectional design by means of questionnaires was conducted. Participants were current and retired professional footballers recruited by the World Players' Union (FIFPro). Information about severe knee injury and knee OA was gathered (medical record or team doctor), while physical knee function was assessed through a validated scale. RESULTS A total of 1360 participants (964 current and 396 retired professional footballers) were enrolled in the study (response rate of 54%). Prevalence of knee OA was 13% among current players and 28% among retired players (p < 0.01), being higher among older players. Current and retired professional footballers were nearly twice as likely to suffer from knee OA by every additional severe knee injury and by every additional knee surgery (risk ratio: 1.72-1.96; p < 0.01). Current and retired professional footballers with knee OA reported a lower level of physical knee function than current and retired players without OA (p < 0.01), their physical knee function being also lower than reference values (adult population, young athletic population and amateur footballers). CONCLUSION The prevalence of knee OA was higher among retired than among current professional footballers and reached up to 40%, leading to negative consequences for their physical knee function. Current and retired professional footballers were nearly twice as likely to suffer from knee OA by every additional severe knee injury and by every additional knee surgery incurred during their career. Management of knee OA should be prioritized among professional footballers, especially to prevent the worsening of the condition during their retirement years.
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Affiliation(s)
- Vincent Gouttebarge
- World Players' Union (FIFPro), Scorpius 161, 2132 LR, Hoofddorp, The Netherlands. .,Department of Orthopaedic Surgery, Academic Medical Center, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands. .,Academic Center for Evidence based Sports medicine (ACES), Academic Medical Center, Amsterdam, The Netherlands. .,Amsterdam Collaboration on Health & Safety in Sports (ACHSS), AMC/VUmc IOC Research Center, Amsterdam, The Netherlands. .,Division of Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa.
| | - Haruhito Aoki
- St. Marianna University School of Medicine, Kawasaki, Japan.,Yokohama City Sports Medical Center, Yokohama, Japan
| | - Gino M M J Kerkhoffs
- Department of Orthopaedic Surgery, Academic Medical Center, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands.,Academic Center for Evidence based Sports medicine (ACES), Academic Medical Center, Amsterdam, The Netherlands.,Amsterdam Collaboration on Health & Safety in Sports (ACHSS), AMC/VUmc IOC Research Center, Amsterdam, The Netherlands.,Division of Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa
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DuPont WH, Meuris BJ, Hardesty VH, Barnhart EC, Tompkins LH, Golden MJP, Usher CJ, Spence PA, Caldwell LK, Post EM, Beeler MK, Kraemer WJ. The Effects Combining Cryocompression Therapy following an Acute Bout of Resistance Exercise on Performance and Recovery. J Sports Sci Med 2017; 16:333-342. [PMID: 28912650 PMCID: PMC5592284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Accepted: 06/20/2017] [Indexed: 06/07/2023]
Abstract
Compression and cold therapy used separately have shown to reduce negative effects of tissue damage. The combining compression and cold therapy (cryocompression) as a single recovery modality has yet to be fully examined. To examine the effects of cryocompression on recovery following a bout of heavy resistance exercise, recreationally resistance trained men (n =16) were recruited, matched, and randomly assigned to either a cryocompression group (CRC) or control group (CON). Testing was performed before and then immediately after exercise, 60 minutes, 24 hours, and 48 hours after a heavy resistance exercise workout (barbell back squats for 4 sets of 6 reps at 80% 1RM, 90 sec rest between sets, stiff legged deadlifts for 4 sets of 8 reps at 1.0 X body mass with 60 sec rest between sets, 4 sets of 10 eccentric Nordic hamstring curls, 45 sec rest between sets). The CRC group used the CRC system for 20-mins of cryocompression treatment immediately after exercise, 24 hours, and 48 hours after exercise. CON sat quietly for 20-mins at the same time points. Muscle damage [creatine kinase], soreness (visual analog scale, 0-100), pain (McGill Pain Q, 0-5), fatigue, sleep quality, and jump power were significantly (p < 0.05) improved for CRC compared to CON at 24 and 48 hours after exercise. Pain was also significantly lower for CRC compared to CON at 60-mins post exercise. These findings show that cryocompression can enhance recovery and performance following a heavy resistance exercise workout.
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Affiliation(s)
- William H DuPont
- Department of Human Sciences, The Ohio State University, Columbus OH, USA
| | | | - Vincent H Hardesty
- Department of Human Sciences, The Ohio State University, Columbus OH, USA
| | - Emily C Barnhart
- Department of Human Sciences, The Ohio State University, Columbus OH, USA
| | | | | | | | | | - Lydia K Caldwell
- Department of Human Sciences, The Ohio State University, Columbus OH, USA
| | - Emily M Post
- Department of Human Sciences, The Ohio State University, Columbus OH, USA
| | - Matthew K Beeler
- Department of Human Sciences, The Ohio State University, Columbus OH, USA
| | - William J Kraemer
- Department of Human Sciences, The Ohio State University, Columbus OH, USA
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