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Mizoguchi Y, Suzuki K, Shimada N, Naka H, Hall T, Akasaka K. Prevalence and associated factors of non-traumatic knee pain in high school volleyball players: a cross-sectional study. PHYSICIAN SPORTSMED 2024:1-7. [PMID: 38669135 DOI: 10.1080/00913847.2024.2348439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Accepted: 04/24/2024] [Indexed: 04/28/2024]
Abstract
OBJECTIVES This study aimed to determine the prevalence of knee pain among high school volleyball attackers, identify associated factors, and explore the relationship between knee pain and lower back pain (LBP). METHODS A cross-sectional study involving 82 high school volleyball attackers (15-17 years) used questionnaires, interviews, and field-based assessments to collect data on demographics, volleyball-specific factors, flexibility, and jumping ability. Logistic regression analysis was used to identify factors associated with knee pain. RESULTS The prevalence of knee pain was 19.5%. Factors significantly associated with knee pain were a history of LBP (OR, 4.64; 95% CI, 1.28 to 16.8; p = 0.019) and flexibility determined by the absolute difference in heel-buttock distance (OR, 1.37; 95% CI, 1.02 to 1.83; p = 0.037). Participants with knee pain had more volleyball experience and a higher proportion of players who competed as starters in the previous year. Both groups reported approximately 18 hours of practice per week during the school year and around 27 hours during school holidays, with no significant difference observed. CONCLUSION Factors associated with knee pain include a history of LBP and reduced flexibility on the heel-buttock distance test. The study highlights the need for a comprehensive approach, considering the coexistence of LBP and focusing on improving anterior thigh flexibility.
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Affiliation(s)
- Yasuaki Mizoguchi
- Graduate School of Medicine, Saitama Medical University, Saitama, Japan
- Department of Rehabilitation, Kimura Orthopaedic Clinic, Saitama, Japan
| | - Kenta Suzuki
- Department of Rehabilitation, Kimura Orthopaedic Clinic, Saitama, Japan
| | - Naoki Shimada
- Department of Rehabilitation, Kurando Orthopaedic Clinic, Saitama, Japan
| | - Hiroyuki Naka
- Department of Rehabilitation, Saitama Medical University Hospital, Saitama, Japan
| | - Toby Hall
- Curtin School of Allied Health, Curtin University, Perth, Australia
| | - Kiyokazu Akasaka
- Graduate School of Medicine, Saitama Medical University, Saitama, Japan
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Davis J, Doyle B, Ishii H, Jayanthi N. S.P.O.R.R.T.-A Comprehensive Approach to the Assessment and Non-Operative Management of Overuse Knee Conditions in Youth Athletes. Curr Rev Musculoskelet Med 2023; 16:627-638. [PMID: 37999828 PMCID: PMC10733244 DOI: 10.1007/s12178-023-09874-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/30/2023] [Indexed: 11/25/2023]
Abstract
PURPOSE OF REVIEW The evaluation of a young athlete with an overuse injury to the knee involves a comprehensive approach. There are a number of elements to consider including assessments of skeletal maturity (biologic maturation), workload (training load + competition load), sport specialization status, and biomechanics. The type of injury and treatment, as well as future prognosis, may be influenced by these and other factors. RECENT FINDINGS Calculating the percentage of predicted adult height (PPAH) is a valuable tool in assessing overuse injury patterns and diagnoses in youth athletes. Modifiable and non-modifiable overuse injury risk factors require monitoring from clinicians as young athletes mature and develop over time. Training and rehabilitation programs should be adapted to account for these. In this manuscript, we seek to introduce a novel, comprehensive approach: S.P.O.R.R.T. (Skeletal Maturity, Prior Injury Risk, One Sport Specialization, Rehabilitation, Return to Play, Training Recommendations) (Fig. 1). Overuse, non-traumatic injuries to the knee in youth athletes will be presented in a case-based and evidence-based model to provide a framework for a comprehensive approach to the assessment and treatment of youth athletes with overuse injuries.
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Affiliation(s)
- Jacob Davis
- Emory Sports Medicine Center, 6335 Hospital Parkway, Suite 302, Johns Creek, GA, 30097, USA
- Georgia Institute of Technology, Sports Medicine, Atlanta, GA, USA
| | - Bridget Doyle
- Emory Sports Medicine Center, 6335 Hospital Parkway, Suite 302, Johns Creek, GA, 30097, USA
| | - Haruki Ishii
- Emory Sports Medicine Center, 6335 Hospital Parkway, Suite 302, Johns Creek, GA, 30097, USA
| | - Neeru Jayanthi
- Emory Sports Medicine Center, 6335 Hospital Parkway, Suite 302, Johns Creek, GA, 30097, USA.
- Emory Sports Performance & Research Center (SPARC), 4450 Falcon Pkwy, Flowery Branch, GA, USA.
- Emory University School of Medicine, Department of Orthopedics and Family Medicine, Atlanta, GA, USA.
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Morphometric Parameters and MRI Morphological Changes of the Knee and Patella in Physically Active Adolescents. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59020213. [PMID: 36837415 PMCID: PMC9965593 DOI: 10.3390/medicina59020213] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 01/16/2023] [Accepted: 01/19/2023] [Indexed: 01/25/2023]
Abstract
Background and Objectives: The immature skeleton in a pediatric population exposed to frequent physical activity might be extremely prone to injuries, with possible consequences later in adulthood. The main aim of this study is to present specific morphometric parameters and magnetic resonance imaging (MRI) morphological changes of the knee and patella in a physically active pediatric population. Additionally, we wanted to investigate the morphological risk factors for patellar instability. Materials and Methods: The study included the MRI findings of 193 physically active pediatric patients with knee pain. The participants underwent sports activities for 5 to 8 h per week. Two divisions were performed: by age and by patellar type. We evaluated three age groups: group 1 (age 11-14), group 2 (age 15-17), and group 3 (age 18-21 years). In addition, participants were divided by the patellar type (according to Wiberg) into three groups. The following morphometric parameters were calculated: lateral trochlear inclination (LTI), the tibial tubercle-trochlear groove distance (TT-TG), trochlear facet asymmetry (TFA), Insall-Salvati index, modified Insall-Salvati index, Caton-Deschamps index, articular overlap, morphology ratio and contact surface ratio. Results: We found a statistically significant association between patellar type groups in LTI (p < 0.001), TFA (p < 0.001), Insal-Salvati (p = 0.001) index, and Caton-Deschamps index (p = 0.018). According to age groups, we found statistical significance in the Caton-Deschamps index (p = 0.039). The most frequent knee injury parameter, according to Wiberg, in physically active pediatric patients was patella type 2 in boys and type 3 in girls. Conclusions: The MRI morphometric parameters observed in our study might be factors of prediction of knee injury in physically active children. In addition, it might be very useful in sports programs to improve the biomechanics of the knee in order to reduce the injury rate in sports-active children.
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Molony JT, Greenberg EM, Weaver AP, Racicot M, Merkel D, Zwolski C. Rehabilitation After Pediatric and Adolescent Knee Injuries. Clin Sports Med 2022; 41:687-705. [DOI: 10.1016/j.csm.2022.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Kraus E, Rizzone K, Walker M, Brown N, Kaur J, Magrini D, Glover J, Nussbaum E. Stress Injuries of the Knee. Clin Sports Med 2022; 41:707-727. [DOI: 10.1016/j.csm.2022.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Djuricic G, Milojkovic D, Mijucic J, Ducic S, Bukva B, Radulovic M, Rajovic N, Milcanovic P, Milic N. The Magnetic Resonance Imaging Pattern of the Lesions Caused by Knee Overuse in the Pediatric Population. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58081107. [PMID: 36013574 PMCID: PMC9416774 DOI: 10.3390/medicina58081107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 08/05/2022] [Accepted: 08/11/2022] [Indexed: 11/16/2022]
Abstract
Background and Objectives: Excessive use of the knee in patients with immature locomotor systems leads to a whole spectrum of morphological changes with possible consequences in adulthood. This study aimed to examine the morphological pattern in magnetic resonance imaging (MRI) that is associated with recurrent pain due to increased physical activity in children. Materials and Methods: This was a retrospective study conducted among pediatric patients treated at the University Children’s Hospital in Belgrade in 2018 and 2019. MRI findings of patients who reported recurrent pain in the knee joint during physical activity and who were without any pathological findings on both clinical examination and knee radiographs were included in the study. Results: MRI findings of 168 patients (73 boys and 95 girls, mean age 14.07 ± 3.34 years) were assessed. Meniscus and cartilage lesions were the most commonly detected morphological findings: meniscus lesions in 49.4%, cartilage ruptures in 44.6%, and cartilage edema in 26.2% of patients. The medial meniscus was more often injured in girls (p = 0.030), while boys were more prone to other joint injuries (p = 0.016), re-injury of the same joint (p = 0.036), bone bruises (p < 0.001), and ligament injuries (p = 0.001). In children older than 15 years, tibial plateau cartilage edema (p = 0.016), chondromalacia patellae (p = 0.005), and retropatellar effusion (p = 0.011) were detected more frequently compared to younger children. Conclusions: Children reporting recurrent knee pain due to increased physical activity, without any detected pathological findings on clinical examination and knee radiography, may have morphological changes that can be detected on MRI. Timely diagnosis of joint lesions should play a significant role in preventing permanent joint dysfunction in the pediatric population as well as in preventing the development of musculoskeletal diseases in adulthood.
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Affiliation(s)
- Goran Djuricic
- University Children’s Hospital, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | | | - Jovana Mijucic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Sinisa Ducic
- University Children’s Hospital, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Bojan Bukva
- University Children’s Hospital, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Marko Radulovic
- Institute of Oncology and Radiology of Serbia, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Nina Rajovic
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Petar Milcanovic
- Laboratory for Sports Institute of Medical Physiology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Natasa Milic
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
- Department of Internal Medicine, Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN 55901, USA
- Correspondence:
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A Clinical Study to Evaluate the Safety and Efficacy of Oral Administration of Microscopic Dose Gold Nanoparticle (AuNP) on Knee Joint Health and Function in Arthritis Patients. J Funct Morphol Kinesiol 2022; 7:jfmk7030052. [PMID: 35893326 PMCID: PMC9326595 DOI: 10.3390/jfmk7030052] [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: 05/06/2022] [Revised: 06/10/2022] [Accepted: 06/14/2022] [Indexed: 11/20/2022] Open
Abstract
The purpose of this clinical study was to determine whether gold nanoparticle (AuNP) supplementation at a dosage of 0.34 mg elemental gold per day can improve knee joint health, function, and quality of life for arthritis patients. A total of 51 participants (24 male and 27 female, age 62.1 ± 13.1) were followed for 20 weeks through a three-phase longitudinal study. Both subjective and objective parameters were used to measure changes in joint health and function, as well as quality of life. The study found patients' Knee injury and Osteoarthritis Outcome Score (KOOS) improved with statistical significance. It was reported that 71.42% of the cohort experienced improvements in their perceived knee pain and 61.22% with improvements in knee stiffness. Majority of objective measurements such as pain with range of motion and specific exercises requiring proper knee health and function did not show statistically significant improvement but did show a positive improving trend in support of AuNP supplement. Study cohort showed statistically significant improvements in two specific exercises: sit-to-stand and single-leg squat. By the end of the study, 70% of the study cohort indicated that they would continue to take the supplement even after the study concluded. Though the study has limitations and is not definitely conclusive, it was the first clinical study to show that oral micro-dosage of AuNP as low as 0.34 mg daily is safe and effective for both rheumatoid arthritis and osteoarthritis patients. This study opened way for the use of AuNP in both clinical and daily settings to improve joint health and function for both average and athletic users.
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Cabral MD, Patel DR, Greydanus DE, Deleon J, Hudson E, Darweesh S. Medical perspectives on pediatric sports medicine–Selective topics. Dis Mon 2022; 68:101327. [DOI: 10.1016/j.disamonth.2022.101327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Kuwabara A, Kraus E, Fredericson M. Narrative Review - Knee Pain in the Pediatric Athlete. Curr Rev Musculoskelet Med 2021; 14:239-245. [PMID: 33818701 PMCID: PMC8137791 DOI: 10.1007/s12178-021-09708-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/24/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE OF REVIEW This review article seeks to highlight common youth athlete knee conditions due to overuse or trauma and elucidate differences from the adult populations. RECENT FINDINGS Overuse conditions presented include apophysitis, osteochondritis dissecans plica syndrome, and discoid meniscus. Traumatic conditions presented include patellar instability, patellar sleeve fracture, and patellofemoral osteochondral fractures. Knee injuries affect a significant proportion of youth athletes. These injuries place athletes at higher risk of chronic pain and potentially osteoarthritis. We have reviewed common overuse and traumatic knee injuries and differentiating factors between the adult population to improve and expedite the diagnosis, treatment, and prognosis for youth athletes with knee injuries.
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Affiliation(s)
- Anne Kuwabara
- Department of Physical Medicine and Rehabilitation, Stanford University, 500 Jefferson Avenue #823, Redwood City, CA 94063 USA
| | - Emily Kraus
- Department of Physical Medicine and Rehabilitation, Stanford University, 500 Jefferson Avenue #823, Redwood City, CA 94063 USA
| | - Michael Fredericson
- Department of Physical Medicine and Rehabilitation, Stanford University, 500 Jefferson Avenue #823, Redwood City, CA 94063 USA
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