Prevalence of knee injuries among male college students in Riyadh, Kingdom of Saudi Arabia

A cross-sectional study of musculoskeletal injuries related to exercise among gym members in Saudi Arabia in 2022: prevalence, common types, and predictor factors

BACKGROUND

Despite the importance of enhancing exercise, exercising can cause injuries that lead to disability and increase the load on the medical sector. This study aimed to estimate the prevalence of exercise-related injuries among gym members in the Kingdom of Saudi Arabia (KSA) and evaluate the more common types of such injuries. It also investigated the association between injury prevalence and the factors selected.

METHODS

A cross-sectional study with a self-reported survey was conducted targeting members of Fitness Time gyms across the KSA. The survey consisted of three parts: part one concerns participant demographic data and part two contains four questions regarding the participants' training experience. Part three contains ten questions targeting those with a history of injury. Descriptive statistical analysis was performed using frequencies and percentages for categorical variables. Crosstabs and chi-squared tests were used to assess the prevalence of exercise-related injuries when appropriate. Binary logistic regression was employed to investigate the association between injury prevalence and the potential associated factors. Odds ratios and their 95% confidence intervals were calculated and the threshold for statistical significance was set at p ≤ 0.05.

RESULTS

A total of 713 subjects participated in the study. The mean age was 36.5 ± 11.2 years and (n = 422, 59.2%) of the participants were female. The study found a prevalence of injury among gym members of about (n = 404, ~57%). The most commonly reported types of injuries were muscle strain (n = 126, 37%) and bruising (n = 45, 13%). The most prevalent anatomical location of injury was the knee (n = 287, 84.3%), followed by the shoulder (n = 283, 83.3%), and the least common was the head/neck (n = 7, 2.1%). The present study suggests some factors associated with exercise-related injury. A significant statistical association (p < 0.5) was found between injury prevalence and age, gender, educational level, period of training, and presence of a trainer. However, no association was detected between injury prevalence and Body Mass Index (BMI), place of residence, or source of advice.

CONCLUSION

Over half of the participants of this study reported at least one exercise-related injury. This study identifies factors associated with injury prevalence related to exercise among gym participants. Promoting safety and minimizing the incidence of injuries are crucial.

Current views on preoperative rehabilitation practice after anterior cruciate ligament injury among licensed physical therapists in Saudi Arabia: An online-based cross-sectional survey

Preoperative rehabilitation is an important stage to both physically and mentally prepare patients for anterior cruciate ligament reconstruction (ACLR) and postoperative rehabilitation. This study aimed to investigate the current preoperative rehabilitation practice after anterior cruciate ligament injury among licensed physical therapists in Saudi Arabia. This was an online-based cross-sectional survey. A total of 114 physical therapists completed the survey. The survey consisted of 16 mandatory questions about management strategies, prescribed exercises, patients' physical and psychological concerns, and discussions about nonoperative management. The majority of the respondents used the following preoperative interventions: education (89.5%), closed kinetic chain exercises (66.7%), stretches (63.2%), open kinetic chain exercises (61.4%), proprioceptive exercises (59.6%), cold (56.1%), and activity modification advice (52.6%). More than half of the respondents would recommend patients awaiting ACLR to complete the exercises 2 to 4 times weekly (56.1%) for up to 8 weeks (80.7%) before ACLR. The respondents (73.7%) reported that patients awaiting ACLR did not receive preoperative rehabilitation due to 2 primary factors: the orthopedic team did not refer patients to rehabilitation specialists, and there was a lack of awareness about preoperative rehabilitation. Most therapists (86%) would discuss conservative management if a patient returned to their preinjury level of function before surgery. The surveyed physical therapists reported using various interventions and preoperative rehabilitation lengths with patients awaiting ACLR. The majority of the therapists indicated that patients awaiting ACLR did not receive preoperative rehabilitation. Future studies are needed to establish a consensus on the optimal preoperative rehabilitation program.

Sagittal trunk excursion and lumbar repositioning error between female and male patients with patellofemoral pain syndrome

Background

Patellofemoral pain syndrome (PFPS) is a challenging clinical problem affecting adults, adolescents, and physically active populations. PFPS impacts the patient's trunk kinematics in the frontal plane. Previous studies have found gender-based biomechanical differences in patients with PFPS; however, sagittal trunk kinematics during mini-squats and lumbar proprioception in PFPS have not been studied previously.

Objectives

To investigate sagittal trunk excursion (It is defined as the sagittal trunk flexion angle from the start to the end of the mini squat) during mini-squats as well as lumbar repositioning error between individuals with and without PFPS, and determine gender differences in the outcome variables.

Methods

A sample of 56 participants aged 18-25 years was enrolled; 30 with PFPS (13 males, 17 females) and 26 asymptomatic controls (11 males, 15 females). The sagittal trunk excursion during mini-squats was examined by two-dimensional (2D) photographic analysis using Surgimap software. Active lumbar flexion repositioning error was assessed using an isokinetic dynamometer.

Results

For sagittal trunk excursion, no significant main effect of group was observed (p = 0 . 136 ). On the other hand, the main effect was significant for gender (p = 0 . 005 ), as was the interaction effect. Compared to the control group, the PFPS group showed significantly (p = 0 . 01 ) lower sagittal trunk excursion in females than in males during mini-squats. For active lumbar flexion repositioning error, no evidence was found for significant main or interaction effects (p > 0 . 05 ).

Conclusion

Females with PFPS exhibit a more erect sagittal trunk posture than males during mini-squats. Trunk posture should be considered during weight-bearing activities in PFPS, and gender-specific assessment protocols should be developed.

A Comprehensive Review on the Diagnosis of Knee Injury by Deep Learning-Based Magnetic Resonance Imaging

The continual improvement in the field of medical diagnosis has led to the monopoly of using deep learning (DL)-based magnetic resonance imaging (MRI) for the diagnosis of knee injury related to meniscal injury, ligament injury including the cruciate ligaments, collateral ligaments and medial patella-femoral ligament, and cartilage injury. The present systematic review was done by PubMed and Directory of Open Access Journals (DOAJ), wherein we finalised 24 studies conducted on the accuracy of DL MRI studies for knee injury identification. The studies showed an accuracy of 72.5% to 100% indicating that DL MRI holds an equivalent performance as humans in decision-making and management of knee injuries. This further opens up future exploration for improving MRI-based diagnosis keeping in mind the limitations of verification bias and data imbalance in ground truth subjectivity.

Knee positioning systems for X-ray environment: a literature review

The knee is one of the most stressed joints of the human body, being susceptible to ligament injuries and degenerative diseases. Due to the rising incidence of knee pathologies, the number of knee X-rays acquired is also increasing. Such X-rays are obtained for the diagnosis of knee injuries, the evaluation of the knee before and after surgery, and the monitoring of the knee joint's stability. These types of diagnosis and monitoring of the knee usually involve radiography under physical stress. This widely used medical tool provides a more objective analysis of the measurement of the knee laxity than a physical examination does, involving knee stress tests, such as valgus, varus, and Lachman. Despite being an improvement to physical examination regarding the physician's bias, stress radiography is still performed manually in a lot of healthcare facilities. To avoid exposing the physician to radiation and to decrease the number of X-ray images rejected due to inadequate positioning of the patient or the presence of artefacts, positioning systems for stress radiography of the knee have been developed. This review analyses knee positioning systems for X-ray environment, concluding that they have improved the objectivity and reproducibility during stress radiographs, but have failed to either be radiolucent or versatile with a simple ergonomic set-up.

Prevalence of Patellofemoral Pain and Knee Pain in the General Population of Saudi Arabia

Background

Patellofemoral pain (PFP) is a common cause of knee pain. This condition can restrict daily activities by trying to avoid activities that aggravate their pain. This study aimed to determine the prevalence of PFP and knee pain and its associated factors among Saudi young adults.

Methods

A descriptive cross-sectional study was conducted in Saudi Arabia. A validated translated Arabic questionnaire was used. Data was collected through an online self-administered questionnaire. Saudi young adults of both genders aged between (18 to 40 years) were included. The mean ±SD was described for continuous variables, whereas categorical variables were reported using frequencies and percentages. The chi-square test was used for descriptive analysis.

Results

A total of 1558 subjects were enrolled in the current study. About 663 (42.6%) were males and 895 (57.4%) were females. Of the total participants, 718 (46%) were within the age group of 18 to 25. The overall prevalence of PFP among the current study participant was found to be 30.3%. The prevalence of PFP among males was found to be 31.4% and the prevalence of PFP among females was found to be 29.5%. The overall prevalence of knee pain among study participants was found to be 13.2% as 205 of the participants reported knee pain. The prevalence of knee pain among males was found to be 14% and the prevalence of knee pain among females was found to be 12.3%. The multivariate analysis included the following variables: age, gender, and marital status. The following factors predicted higher rate of PFP: being 18 to 25 years old (p-value < 0.001, odds ratio = 1), being 26 to 35 years old (p-value = 0.001, odds ratio = 1.689).

Conclusion

The prevalence of PFP and knee pains was found to be relatively high in Saudi Arabia. Age less than 40 years old was found to be associated with a higher prevalence of PFP and knee pain when compared to other age groups.

Vertical Patella Fracture Fixed by Plate and Screws With Bone Graft: A Case Report

Fractures of the patella constitute approximately 1% of all skeletal injuries. The vertical pattern represents 12-17% and the open patella fracture represents 6-30%. We here represent a rare case constituting the presence of these two uncommon (vertical type patella fracture with depression of articular surface). A 22-year-old male had a close patella fracture after a road traffic accident. The fracture was classified as a vertical and comminuted pattern. A back slab above the knee was applied and then the patient was prepared for surgery. Open reduction and internal fixation of the patella by miniplate and bone graft restore the articular surface, which reduces the risk of post-traumatic osteoarthritis. At five months postoperatively, the patient had a satisfactory joint motion with full extension and 120° of joint flexion and returned to his daily life activities without restriction. Additionally, the patient was in good health and able to bear full weight. In conclusion, the treatment choice requires a thorough knowledge of the case to ensure good stability and avoid fracture displacement.

Wearable knee joint fatigue estimating system based on curvature and pressure sensing

BACKGROUND: The injury of the knee joint is found to be directly related to the fatigue caused by excessive exercise. Many previous studies used wearable devices to measure the angle of knee joint during activities, but did not pay enough attention to the load of knee joint related to the fatigue degree of it. OBJECTIVE: A wearable embedded system was designed to sense the motion state and load of knee joint and uses the sensoring data to estimate and predict the fatigue degree of knee joint during exercise in real time, so as to prevent it from being injured. METHODS: An economical wearable system is designed to measure the parameters of the knee joint during exercises. Then the warning message and recommended healthy lasting time are able to be sent to users to avoid excessive exercise. 24 healthy volunteers aged 20–25 years were involved in the experiments. Two famous evaluation scales for knee joint from Department of Orthopedics (Lysholm score and IKDC score) were adopted to evaluate the protective effect. RESULTS: After 14 days of the first stage testing, all the participants with wearable devices reported healthy knee joint state to verify the effectiveness of the system. For the second stage, the testing group equipped with wearable warning devices did not receive obvious change in the two scales. However, Lysholm score of control group dropped by at least 7.4 and IKDC score dropped by at least 11.1 which were significantly reduced. CONCLUSION: Only using human perception to prevent knee joint fatigue had a risk of failure while the designed wearable system could protect the knee successfully from injuries during exercises, such as running, badminton, table tennis and basketball. Moreover, female gender and a high BMI value may be two factors that increase the risk of knee injuries during sports.