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Hung YC, Chuang CA, Yao SY, Lin KY, Hung SF, Chen YJ, Chiu CH, Ho CS, Yang CP, Chan YS. Correlation between higher lateral tibial slope and inferior long term subjective outcomes following single bundle anterior cruciate ligament reconstruction. J Orthop Surg Res 2024; 19:315. [PMID: 38807173 PMCID: PMC11131331 DOI: 10.1186/s13018-024-04795-9] [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] [Received: 03/14/2024] [Accepted: 05/14/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND The impact of anatomical factors, such as the lateral tibial slope (LTS), on outcomes following anterior cruciate ligament (ACL) reconstruction is an area of growing interest. This study was led by the observation that patients with a higher LTS may have different recovery trajectories. HYPOTHESIS/PURPOSE The purpose of this study was to investigate the correlation between a higher LTS and long term subjective outcomes following single-bundle ACL reconstruction. STUDY DESIGN This study was designed as a retrospective cohort study. METHODS The study comprised 138 patients who underwent single-bundle ACL reconstruction. The LTS was measured on preoperative radiographs. Patient-reported outcome measures (PROMs) were collected, which included the Lysholm Knee Score, UCLA Activity Score, IKDC Score, and Tegner Activity Score, over a mean follow-up duration of 137 months. RESULTS A significant negative correlation was found between LTS and all measured PROMs (p < 0.001). The established cut-off value of LTS distinguishing between "Good" and "Fair" Lysholm scores was 8.35 degrees. Female patients have statistically significant higher LTS and lower PROMs scores than male. Patients with LTS greater than or equal to 8.35 had significantly lower PROMs, indicative of poorer functional and subjective outcomes. CONCLUSION Our findings suggest that a higher LTS is associated with inferior subjective outcomes following single-bundle ACL reconstruction in long term. The LTS cut-off value of 8.35 degrees could potentially be used as a reference in preoperative planning and patient counseling. CLINICAL RELEVANCE Understanding the relationship between LTS and ACL reconstruction outcomes could inform surgical planning and postoperative management. These findings highlight the need to consider anatomical variances, such as LTS, when assessing patient-specific risks and recovery expectations, contributing to the advancement of personalized care in sports medicine.
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Affiliation(s)
- Yu-Chieh Hung
- Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan City, 333, Taiwan
| | - Chieh-An Chuang
- Comprehensive Sports Medicine Center, Taoyuan Chang Gung Memorial Hospital, Taoyuan City, 333, Taiwan
- Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan City, 333, Taiwan
| | - Shang-Yu Yao
- Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan City, 333, Taiwan
| | - Keng-Yi Lin
- Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan City, 333, Taiwan
| | - Shih-Feng Hung
- Department of Orthopedic Surgery, Taoyuan Hospital, Ministry of Health and Welfare, Taoyuan City, 333, Taiwan
| | - Yi-Jou Chen
- Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan City, 333, Taiwan
| | - Chih-Hao Chiu
- Comprehensive Sports Medicine Center, Taoyuan Chang Gung Memorial Hospital, Taoyuan City, 333, Taiwan
- Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan City, 333, Taiwan
| | - Chin-Shan Ho
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan City, 333, Taiwan
| | - Cheng-Pang Yang
- Comprehensive Sports Medicine Center, Taoyuan Chang Gung Memorial Hospital, Taoyuan City, 333, Taiwan.
- Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan City, 333, Taiwan.
| | - Yi-Sheng Chan
- Department of Orthopedic Surgery, Keelung Chang Gung Memorial Hospital, Keelung City, 204, Taiwan.
- Comprehensive Sports Medicine Center, Taoyuan Chang Gung Memorial Hospital, Taoyuan City, 333, Taiwan.
- Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan City, 333, Taiwan.
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Gulati A, Desai V. Return to Play in the Professional Athlete. Semin Musculoskelet Radiol 2024; 28:107-118. [PMID: 38484763 DOI: 10.1055/s-0043-1778028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
The management of any injury in elite athletes poses unique challenges distinct from the general population because the goal is rapid recovery and return to play (RTP) while simultaneously managing residual symptoms and minimizing risk of reinjury. The time required for treatment, recovery, and return to peak performance can have consequences for both the athlete and his or her team: financial implications, psychological stressors, team dynamics, and future performance. RTP after an injury in the professional athlete requires a complex decision-making process with many stakeholders. Several factors influence this decision, not the least of which is the type and mechanism of injury. This article provides an overview of the RTP process including nonmedical factors that may influence this decision, common injuries seen in professional athletes, injury patterns particular to certain popular sports, and imaging guidelines for such injuries.
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Affiliation(s)
- Aishwarya Gulati
- Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Vishal Desai
- Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania
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Arashiro VK, Aguilar KC, Xu T, Rabelo NDDA, Netto ADS, Cury RDPL. Epidemiology of Knee Injuries in Baseball Players from the State of São Paulo. Rev Bras Ortop 2024; 59:e199-e205. [PMID: 38606125 PMCID: PMC11006523 DOI: 10.1055/s-0044-1785202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 11/06/2023] [Indexed: 04/13/2024] Open
Abstract
Objective This study aimed to identify the main knee complaints and injuries associated with baseball and their prevalence in the state of São Paulo, Brazil. Methods This epidemiological study analyzed data from an online questionnaire sent to baseball athletes from the state of São Paulo, Brazil, from 2019 to 2022. Results Ninety-eight athletes participated in the study. Their average age was 24.3 years, and 85.72% of the subjects were men. The most prevalent ethnicities were yellow (50%) and white (42.86%). Most athletes had incomplete or complete higher education (75.5%). Most (88.77%) have been training for over 1 year, and 40.82% played in more than 1 position. More than half also practiced another sport. Most (66.32%) athletes present knee complaints or symptoms, and 37.75% had suffered a knee injury playing baseball, with several mechanisms (contact with the ground, contact with another player, or no contact). More than half (59.45%) of the athletes required time away from baseball due to complaints, symptoms, or injuries. Conclusion Among the athletes interviewed, 66.32% had a knee complaint, and 37.75% had already had a knee injury, especially meniscal and ligament injuries. The injury rate was highest in the first year of practice.
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Affiliation(s)
- Victor Kenzo Arashiro
- Departamento de Ortopedia e Traumatologia, Faculdade de Ciências Médicas Santa Casa de Misericórdia de São Paulo (FCMSCSP), São Paulo, SP, Brasil
| | - Karin Coca Aguilar
- Departamento de Ortopedia e Traumatologia, Faculdade de Ciências Médicas Santa Casa de Misericórdia de São Paulo (FCMSCSP), São Paulo, SP, Brasil
| | - Tian Xu
- Departamento de Ortopedia e Traumatologia, Faculdade de Ciências Médicas Santa Casa de Misericórdia de São Paulo (FCMSCSP), São Paulo, SP, Brasil
| | - Nayra Deise dos Anjos Rabelo
- Núcleo de Apoio à Pesquisa em Análise do Movimento (NAPAM), Universidade Nove de Julho (Uninove), São Paulo, SP, Brasil
| | - Alfredo dos Santos Netto
- Departamento de Ortopedia e Traumatologia, Faculdade de Ciências Médicas Santa Casa de Misericórdia de São Paulo (FCMSCSP), São Paulo, SP, Brasil
| | - Ricardo de Paula Leite Cury
- Departamento de Ortopedia e Traumatologia, Faculdade de Ciências Médicas Santa Casa de Misericórdia de São Paulo (FCMSCSP), São Paulo, SP, Brasil
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Petrucci A, Guglielmino D, Pecci J, Pareja-Galeano H. The effects of isokinetic training in athletes after knee surgery: a systematic review. PHYSICIAN SPORTSMED 2023:1-8. [PMID: 38124233 DOI: 10.1080/00913847.2023.2297666] [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: 09/24/2023] [Accepted: 12/18/2023] [Indexed: 12/23/2023]
Abstract
PURPOSE To review the effectiveness of isokinetic training as an alternative method to traditional isotonic resistance training. MATERIALS AND METHODS Researchers examined data from PubMed, CENTRAL, MEDLINE COMPLETE, and Web of Science until February 2023. A total of 365 entries were obtained from databases, including studies that analyzed the effects of isokinetic vs. isotonic-based rehabilitation in athletes (16-50 years) after a surgical knee intervention. Return to sport (RTS), strength of the flex/extensor compartment of the thigh, muscle mass of the thigh, and knee function were screened as main outcomes. Two reviewers independently screened the studies for eligibility and assessed the risk of bias of the included ones. RESULTS Six studies involving 181 athletes were included. Isokinetic training demonstrated significant benefits in peak torque for knee flexor-extensor muscles in four studies. Two studies favored isokinetic training over isotonic for strength. Muscle mass findings were mixed, with one study favoring isokinetic significantly and two showing no significant differences. In terms of returning to sport, the isotonic group displayed slightly better limb symmetry index values, but without significance. Isokinetic training outperformed isotonic in two functionality questionnaire studies, while two others showed no significant differences. CONCLUSIONS Isokinetic training appears equally, if not more effective than isotonic, for restoring strength balance between hamstrings and quadriceps. This could lead to more favorable muscle mass changes. Isokinetic training also parallels isotonic rehabilitation for functional outcomes and meeting return-to-sport criteria. Therefore, isokinetic training should be included as one of the main strength restoration strategies after knee surgery, especially in early and middle rehabilitation stages. REGISTRATION NUMBER The present systematic review was registered on PROSPERO (registration number: CRD42022370398).
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Affiliation(s)
- Angelo Petrucci
- Faculty of Sports Sciences and Physiotherapy, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | - Dario Guglielmino
- Faculty of Sports Sciences and Physiotherapy, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | - Javier Pecci
- Department of Physical Education, Sport and Human Movement. Universidad Autónoma de Madrid, Ciudad Universitaria de Cantoblanco, Madrid, Spain
- Department of Physical Education and Sport, Universidad de Sevilla, Sevilla, Spain
| | - Helios Pareja-Galeano
- Faculty of Sports Sciences and Physiotherapy, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
- Department of Physical Education, Sport and Human Movement. Universidad Autónoma de Madrid, Ciudad Universitaria de Cantoblanco, Madrid, Spain
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Yousufy U, Chimera NJ. Is There an Association Between Injury History and Lower Extremity Joint Injury During Canada Games Competition? Int J Sports Phys Ther 2023; 18:1308-1319. [PMID: 38050547 PMCID: PMC10693481 DOI: 10.26603/001c.89273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 10/12/2023] [Indexed: 12/06/2023] Open
Abstract
Background Injuries during elite level competition like the Canada Games, occur frequently and injury history is one of the strongest predictors of future injury; however, this association is unknown in the Canada Games. Purpose To determine the association between injury history and incidence of lower extremity joint injury during Canada Games competition. Methods Data from the 2009 - 2019 Canada Games (8710 male and 8391 female athletes) competitions were de-identified by the Canada Games Council for analysis. Injury data were cleaned and categorized for previous injury and injury type and location. Injury history was self-reported and included concussion, major surgical procedure, neck and back, trauma to joint or bone, and trauma to ligament or tendon. Injury from the Canada Games competitions were categorized to include ankle, knee, hip, and patellofemoral joint injuries. Chi-Square (χ2 ) test of independence determined association between injury history and incidence of lower extremity joint injury during Canada Games competition. IBM SPSS (Version 26) was used for statistical analysis (p-value < 0.05). Results Four hundred and seventy-five ankle, 503 knee, 253 hip, and 106 patellofemoral joint injuries were reported during 10 years of Canada Games competitions. There were significant associations between history of neck and back injuries with ankle injuries and knee injuries, history of trauma and overuse of ligament or tendon with hip injuries and history of trauma or overuse of joint or bone with patellofemoral joint injuries. Conclusion These findings support previous literature suggesting that injury history is associated with future injury. Level of Evidence 3.
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Affiliation(s)
- Umar Yousufy
- Faculty of Applied Health Science Brock University
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Nusia J, Xu JC, Knälmann J, Sjöblom R, Kleiven S. Injury risk functions for the four primary knee ligaments. Front Bioeng Biotechnol 2023; 11:1228922. [PMID: 37860626 PMCID: PMC10582698 DOI: 10.3389/fbioe.2023.1228922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 09/11/2023] [Indexed: 10/21/2023] Open
Abstract
The purpose of this study was to develop injury risk functions (IRFs) for the anterior and posterior cruciate ligaments (ACL and PCL, respectively) and the medial and lateral collateral ligaments (MCL and LCL, respectively) in the knee joint. The IRFs were based on post-mortem human subjects (PMHSs). Available specimen-specific failure strains were supplemented with statistically generated failure strains (virtual values) to accommodate for unprovided detailed experimental data in the literature. The virtual values were derived from the reported mean and standard deviation in the experimental studies. All virtual and specimen-specific values were thereafter categorized into groups of static and dynamic rates, respectively, and tested for the best fitting theoretical distribution to derive a ligament-specific IRF. A total of 10 IRFs were derived (three for ACL, two for PCL, two for MCL, and three for LCL). ACL, MCL, and LCL received IRFs in both dynamic and static tensile rates, while a sufficient dataset was achieved only for dynamic rates of the PCL. The log-logistic and Weibull distributions had the best fit (p-values: >0.9, RMSE: 2.3%-4.7%) to the empirical datasets for all the ligaments. These IRFs are, to the best of the authors' knowledge, the first attempt to generate injury prediction tools based on PMHS data for the four knee ligaments. The study has summarized all the relevant literature on PHMS experimental tensile tests on the knee ligaments and utilized the available empirical data to create the IRFs. Future improvements require upcoming experiments to provide comparable testing and strain measurements. Furthermore, emphasis on a clear definition of failure and transparent reporting of each specimen-specific result is necessary.
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Affiliation(s)
- Jiota Nusia
- Department of Traffic Safety and Traffic Systems, The Swedish National Road and Transport Research Institute (VTI), Stockholm, Sweden
| | - Jia-Cheng Xu
- Department of Traffic Safety and Traffic Systems, The Swedish National Road and Transport Research Institute (VTI), Stockholm, Sweden
- Division of Neuronic Engineering, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Johan Knälmann
- Department of Strength and Crash Analysis, Scania CV AB, Södertälje, Sweden
| | - Reimert Sjöblom
- Department of Strength and Crash Analysis, Scania CV AB, Södertälje, Sweden
| | - Svein Kleiven
- Division of Neuronic Engineering, KTH Royal Institute of Technology, Stockholm, Sweden
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Houass E, Elgaliou M, Haouzi M, Mekkaoui M, Boufettal M, Bassir R, Kharmaz M, Berrada M. Triple Threat Ttrauma: A Rare Case Report of Avulsion Fracture of the Posterior Cruciate Ligament, Lateral Collateral Ligament, and diaphyseal Tibia Fracture. Trauma Case Rep 2023; 47:100910. [PMID: 37693746 PMCID: PMC10485158 DOI: 10.1016/j.tcr.2023.100910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2023] [Indexed: 09/12/2023] Open
Abstract
We present the case of a 24-year-old male who sustained a fall from a motorcycle resulting in a rare combination of injuries, including avulsion fractures of the posterior cruciate ligament (PCL) and femoral lateral collateral ligament (LCL), along with an ipsilateral diaphyseal tibia fracture. This case report aims to highlight the importance of early diagnosis, appropriate management, and comprehensive rehabilitation for such complex knee injuries. We discuss the patient's presentation, radiographic findings, surgical intervention, postoperative care and long-term outcomes. To our knowledge this kind of injury has never been documented in the literature.
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Affiliation(s)
- Elyazid Houass
- Department of Orthopedic Surgery and Trauma, Ibn Sina University Hospital Center Rabat Morocco, Faculty of Medicine and Pharmacy-University Mohamed V, Rabat, Morocco
| | - M.R. Elgaliou
- Department of Orthopedic Surgery and Trauma, Ibn Sina University Hospital Center Rabat Morocco, Faculty of Medicine and Pharmacy-University Mohamed V, Rabat, Morocco
| | - M.A. Haouzi
- Department of Orthopedic Surgery and Trauma, Ibn Sina University Hospital Center Rabat Morocco, Faculty of Medicine and Pharmacy-University Mohamed V, Rabat, Morocco
| | - M.J. Mekkaoui
- Department of Orthopedic Surgery and Trauma, Ibn Sina University Hospital Center Rabat Morocco, Faculty of Medicine and Pharmacy-University Mohamed V, Rabat, Morocco
| | - M. Boufettal
- Department of Orthopedic Surgery and Trauma, Ibn Sina University Hospital Center Rabat Morocco, Faculty of Medicine and Pharmacy-University Mohamed V, Rabat, Morocco
| | - R.A. Bassir
- Department of Orthopedic Surgery and Trauma, Ibn Sina University Hospital Center Rabat Morocco, Faculty of Medicine and Pharmacy-University Mohamed V, Rabat, Morocco
| | - M. Kharmaz
- Department of Orthopedic Surgery and Trauma, Ibn Sina University Hospital Center Rabat Morocco, Faculty of Medicine and Pharmacy-University Mohamed V, Rabat, Morocco
| | - M.S. Berrada
- Department of Orthopedic Surgery and Trauma, Ibn Sina University Hospital Center Rabat Morocco, Faculty of Medicine and Pharmacy-University Mohamed V, Rabat, Morocco
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Gurau TV, Gurau G, Voinescu DC, Anghel L, Onose G, Iordan DA, Munteanu C, Onu I, Musat CL. Epidemiology of Injuries in Men's Professional and Amateur Football (Part I). J Clin Med 2023; 12:5569. [PMID: 37685638 PMCID: PMC10488230 DOI: 10.3390/jcm12175569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/16/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023] Open
Abstract
Background (1): Football is the most popular sport among men, associated with a certain risk of injury, which leads to short- and long-term health consequences. While the injury profile of professional footballers is known, little is known about the injury profile of amateur footballers; amateur football is a major and diverse area, the development of which should be a priority for football associations around the world and UEFA. The aim of this study was to perform a systematic review of epidemiological literature data on injuries in professional and amateur football players belonging to certain leagues. Methods (2): A systematic review according to the PRISMA guidelines was performed until June 2023 in the databases PubMed, Web of Science, Google Academic, Google Scholar, and Diva portal. Forty-six studies reporting injury incidence in professional and amateur men's football were selected and analyzed. Two reviewers independently extracted data and assessed study quality using an adapted version of the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement and the Newcastle Ottawa Scale (NOS) to assess risk of bias for the quality of external validity. Results (3): The overall incidence of injuries in professional male football players was 7.75 ± 2.28, 95% confidence interval, injuries/1000 h of exposure and that of amateur football players was 7.98 ± 2.95, 95% confidence interval, injuries/1000 h of exposure. The incidence of match injuries (30.64 ± 10.28, 95% confidence interval, injuries/1000 exposure hours) was 7.71 times higher than the training injury incidence rate (3.97 ± 1.35, 95% confidence interval, injuries/1000 h) in professional football players and 5.45 times higher in amateurs (17.56 ± 6.15 vs. 3.22 ± 1.4, 95% confidence interval, injuries/1000 h). Aggregate lower extremity injuries had the highest prevalence in both categories of footballers, being 83.32 ± 4.85% in professional footballers and 80.4 ± 7.04% in amateur footballers: thigh, ankle, and knee injuries predominated. Conclusions (4): Professional and amateur football players are at substantial risk of injury, especially during matches that require the highest level of performance. Injury rates have implications for players, coaches, and sports medicine practitioners. Therefore, information on football injuries can help develop personalized injury risk mitigation strategies that could make football safer for both categories of football players. The current findings have implications for the management, monitoring, and design of training, competition, injury prevention, especially severe injury, and education programs for amateur football players.
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Affiliation(s)
- Tudor Vladimir Gurau
- Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University of Galati, 800008 Galati, Romania;
| | - Gabriela Gurau
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (G.G.); (C.L.M.)
| | - Doina Carina Voinescu
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galați, Romania; (D.C.V.); (L.A.)
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania
| | - Lucretia Anghel
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galați, Romania; (D.C.V.); (L.A.)
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania
| | - Gelu Onose
- Neuromuscular Rehabilitation Clinic Division, Teaching Emergency Hospital “Bagdasar-Ar-Seni”, 041915 Bucharest, Romania;
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 020022 Bucharest, Romania
| | - Daniel Andrei Iordan
- Department of Individual Sports and Kinetotherapy, Faculty of Physical Education and Sport, ‘Dunarea de Jos’ University of Galati, 800008 Galati, Romania
- Center of Physical Therapy and Rehabilitation, ‘Dunărea de Jos’ University of Galati, 800008 Galati, Romania
| | - Constantin Munteanu
- Department of Biomedical Sciences, Faculty of Medical Bioengineering, University of Medicine and Pharmacy “Grigore T. Popa” Iaşi, 700454 Iaşi, Romania;
| | - Ilie Onu
- Department of Biomedical Sciences, Faculty of Medical Bioengineering, University of Medicine and Pharmacy “Grigore T. Popa” Iaşi, 700454 Iaşi, Romania;
| | - Carmina Liana Musat
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (G.G.); (C.L.M.)
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galați, Romania; (D.C.V.); (L.A.)
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Moretti L, Bortone I, Delmedico M, Cassano DG, Caringella N, Bizzoca D, Moretti B. Clinical, Biomechanical, and Self-reported Health Status After ACL Reconstruction With Meniscal Repair in Soccer Players: Results at Minimum 1-Year Follow-up. Orthop J Sports Med 2023; 11:23259671231177309. [PMID: 37547078 PMCID: PMC10399262 DOI: 10.1177/23259671231177309] [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: 01/12/2023] [Accepted: 02/22/2023] [Indexed: 08/08/2023] Open
Abstract
Background Performing meniscal repair with anterior cruciate ligament reconstruction (ACLR) has been shown to contribute to the long-term preservation of knee health and gait biomechanics. Purpose To evaluate the role of meniscal repair in the performance of semiprofessional soccer players who returned to sport after ACLR. Study Design Case series; Level of evidence, 4. Methods This study included 51 male soccer players (mean ± SD age, 28.82 ± 5.33 years) who underwent ACLR at a single institution between July 2018 and July 2019. The players were divided into 3 groups according to surgery type: ACLR only (n = 30), ACLR with lateral meniscal repair (n = 9), and ACLR with medial meniscal repair (n = 12). Outcomes were evaluated through clinical examination, self-reported health questionnaires (Cincinnati Knee Rating System, Tegner activity score, Tegner Lysholm Knee Scoring Scale, Tampa Scale of Kinesiophobia, and ACL-Return to Sport After Injury), and biomechanical performance evaluations (balance, strength, coordination, and symmetry tests). Parametric and nonparametric tests were carried out for multiple comparisons. Results The mean ± SD follow-up time was 20.75 ± 9.38 months. Although no significant differences emerged in clinical and self-reported health status, almost all the physical parameters tested resulted in lower performance in players treated with ACLR and meniscal repair. Moreover, patients with ACLR with lateral meniscal repair reported higher pain and fear of reinjury, with lower outcomes in terms of strength, symmetry, and coordination as compared with the other 2 groups. Balance abilities were significantly affected in players who underwent meniscal repair as compared with those who underwent ACLR only. Conclusion The findings showed that biomechanical performance measures and fear of reinjury were significantly worse in soccer players with associated meniscal repair at a minimum 1-year follow-up, especially in those with a lateral meniscal tear.
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Affiliation(s)
- Lorenzo Moretti
- Orthopaedic and Trauma Unit, Department of Translational Biomedicine and Neuroscience “DiBraiN,” University of Bari “Aldo Moro,” Bari, Italy
| | - Ilaria Bortone
- Orthopaedic and Trauma Unit, Department of Translational Biomedicine and Neuroscience “DiBraiN,” University of Bari “Aldo Moro,” Bari, Italy
| | - Michelangelo Delmedico
- Orthopaedic and Trauma Unit, Department of Translational Biomedicine and Neuroscience “DiBraiN,” University of Bari “Aldo Moro,” Bari, Italy
| | - Danilo Giuseppe Cassano
- Orthopaedic and Trauma Unit, Department of Translational Biomedicine and Neuroscience “DiBraiN,” University of Bari “Aldo Moro,” Bari, Italy
| | - Nuccio Caringella
- Orthopaedic and Trauma Unit, Department of Translational Biomedicine and Neuroscience “DiBraiN,” University of Bari “Aldo Moro,” Bari, Italy
| | - Davide Bizzoca
- Orthopaedic and Trauma Unit, Department of Translational Biomedicine and Neuroscience “DiBraiN,” University of Bari “Aldo Moro,” Bari, Italy
| | - Biagio Moretti
- Orthopaedic and Trauma Unit, Department of Translational Biomedicine and Neuroscience “DiBraiN,” University of Bari “Aldo Moro,” Bari, Italy
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GUBLER C, PRICE T, WALDHELM A. The effect of adding a tuck to the drop vertical jump test in collegiate soccer players. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2022. [DOI: 10.23736/s0393-3660.21.04706-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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11
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Daggett MC, Witte KA, Cabarkapa D, Cabarkapa DV, Fry AC. Evidence-Based Data Models for Return-to-Play Criteria after Anterior Cruciate Ligament Reconstruction. Healthcare (Basel) 2022; 10:healthcare10050929. [PMID: 35628066 PMCID: PMC9141289 DOI: 10.3390/healthcare10050929] [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: 04/05/2022] [Revised: 05/11/2022] [Accepted: 05/17/2022] [Indexed: 02/04/2023] Open
Abstract
The anterior cruciate ligament (ACL) tear is one of the most common knee injuries in sports that require side-to-side pivoting movements. While the timeline and specific goals during rehabilitation protocols may vary, ACL reconstruction (ACLR) is the preferred procedure necessary to return these athletes to their respective field of play. However, there are no validated guidelines that define a specific timepoint when it is safe for an athlete to return-to-play, as functional movement deficit may be present much longer than six months post ACLR. A retrospective cross-sectional analysis was conducted on 33 subjects that underwent ACLR. As a part of standard of care, each subject completed a movement screening protocol at a singular timepoint during their rehabilitation process. An innovative three-dimensional markerless motion capture system was used to obtain three algorithm-derived biometric variables: mobility, alignment, and readiness. Significant gradual improvements in mobility and readiness were observed throughout a 3–6-month post ACLR procedure period. When examining the data trends, it was obvious that not all patients responded identically to treatment plans provided by clinical professionals. Therefore, the findings of the present study suggest that the decision regarding when it is safe to return to play needs to be determined on an individual basis.
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Affiliation(s)
| | - Kevin A. Witte
- Sano Orthopedics, Lee’s Summit, MO 64064, USA; (M.C.D.); (K.A.W.)
| | - Dimitrije Cabarkapa
- Jayhawk Athletic Performance Laboratory, Wu Tsai Human Performance Alliance, University of Kansas, Lawrence, KS 66045, USA; (D.V.C.); (A.C.F.)
- Correspondence:
| | - Damjana V. Cabarkapa
- Jayhawk Athletic Performance Laboratory, Wu Tsai Human Performance Alliance, University of Kansas, Lawrence, KS 66045, USA; (D.V.C.); (A.C.F.)
| | - Andrew C. Fry
- Jayhawk Athletic Performance Laboratory, Wu Tsai Human Performance Alliance, University of Kansas, Lawrence, KS 66045, USA; (D.V.C.); (A.C.F.)
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12
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Epidemiology and Risk Factors of Table-Tennis-Related Injuries: Findings from a Scoping Review of the Literature. Medicina (B Aires) 2022; 58:medicina58050572. [PMID: 35629989 PMCID: PMC9147389 DOI: 10.3390/medicina58050572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/13/2022] [Accepted: 04/19/2022] [Indexed: 11/16/2022] Open
Abstract
Background and Objectives: Table tennis represents one of the fastest ball games in the world and, as such, is characterized by unique physiological demands. Despite its popularity, there is a dearth of data related to table-tennis-related risk factors and injuries. Therefore, the present review was conducted to fill in this gap of knowledge. Material and Methods: The present review was designed as a scoping review. Eleven online databases were searched with no language/date limitations. Results: Forty-two investigations were retained in the present review. These studies indicated that tenosynovitis, benign muscle injuries, strains, and sprains were the most common injury types. In order, the most commonly affected anatomical regions were the lower limb, shoulder, spine, knee, upper limb, and trunk. When comparing the injury occurrence between training and competition, the results were contradictory. National/international athletes had higher indices of injury than regional players, even though other investigations failed to replicate such findings. According to some scholars, there was a difference between female and male athletes: in females, more injuries involved the upper limbs when compared to men who had more injuries to the lower limbs, while other studies did not find differences in terms of gender. Conclusions: Table tennis is generally considered at lower risk for injuries than other sports. However, the present scoping review showed that injuries can occur and affect a variety of anatomic regions. Sports scientists/physicians could utilize the information contained in the current review for devising ad hoc programs to adopt an effective/appropriate prevention strategy and to monitor table tennis players’ training load and to achieve maximal fitness, as these will reduce the risk of injuries. However, most of the studies included in our scoping review are methodologically weak or of low-to-moderate evidence, being anecdotal or clinical case reports/case series, warranting caution when interpreting our findings and, above all, further high-quality research in the field is urgently needed.
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13
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Isolated Femoral LCL Avulsion Fracture in the Adult Knee: Two Patient Cases and Literature Review. Case Rep Orthop 2022; 2022:6507577. [PMID: 35496950 PMCID: PMC9045978 DOI: 10.1155/2022/6507577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 04/04/2022] [Indexed: 11/17/2022] Open
Abstract
Avulsion injuries of the LCL most commonly occur at the fibular insertion. Femoral LCL avulsion injuries have only been previously described in pediatric patients or as multiligament knee injury components among adults. This case series with comprehensive literature review describes for the first time 2 cases of isolated LCL femoral avulsion fractures in adults including conservative treatment outcomes. Both patients sustained a strong varus stress mechanism to their right knee, following sport injury or road traffic accident. For both patients, a complete radiographic evaluation including X-rays, MRI, and CT scan confirmed no other associated knee lesions. The femoral LCL avulsion fractures that were observed were minimally displaced and noncomminuted. Furthermore, imagery suggested preserved integrity at the superior lateral genicular artery, adjacent articular capsule, and IT band. Based on clinical and imaging evaluations, the decision was made to follow conservative treatment. By 10 weeks postinjury, both patients were asymptomatic with early radiological fracture healing evidence. Comparative varus stress radiographs at 20° knee flexion revealed no side-to-side differences and clinical exam showed no posterolateral rotatory instability. The second patient case presented with mild femoral LCL attachment calcification on follow-up CT-scan. Following a detailed analysis of anatomic injury characteristics, we suggest that patients with isolated femoral LCL avulsion fractures have low secondary displacement risk provided SLGA, articular capsule, and IT band integrity are present. In contrast to high-grade ligamentous and distal avulsion LCL injuries, we recommend conservative treatment for patients who sustain these lesions.
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14
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Hammami N, Frih B, Rahali H, Mkacher W, Rezgui T, Čular D, Bouassida A. Effects of taekwondo style practice on cardiac remodeling and isokinetic thigh strength in elite women players. Sci Sports 2021. [DOI: 10.1016/j.scispo.2020.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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15
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Logerstedt DS, Ebert JR, MacLeod TD, Heiderscheit BC, Gabbett TJ, Eckenrode BJ. Effects of and Response to Mechanical Loading on the Knee. Sports Med 2021; 52:201-235. [PMID: 34669175 DOI: 10.1007/s40279-021-01579-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2021] [Indexed: 11/30/2022]
Abstract
Mechanical loading to the knee joint results in a differential response based on the local capacity of the tissues (ligament, tendon, meniscus, cartilage, and bone) and how those tissues subsequently adapt to that load at the molecular and cellular level. Participation in cutting, pivoting, and jumping sports predisposes the knee to the risk of injury. In this narrative review, we describe different mechanisms of loading that can result in excessive loads to the knee, leading to ligamentous, musculotendinous, meniscal, and chondral injuries or maladaptations. Following injury (or surgery) to structures around the knee, the primary goal of rehabilitation is to maximize the patient's response to exercise at the current level of function, while minimizing the risk of re-injury to the healing tissue. Clinicians should have a clear understanding of the specific injured tissue(s), and rehabilitation should be driven by knowledge of tissue-healing constraints, knee complex and lower extremity biomechanics, neuromuscular physiology, task-specific activities involving weight-bearing and non-weight-bearing conditions, and training principles. We provide a practical application for prescribing loading progressions of exercises, functional activities, and mobility tasks based on their mechanical load profile to knee-specific structures during the rehabilitation process. Various loading interventions can be used by clinicians to produce physical stress to address body function, physical impairments, activity limitations, and participation restrictions. By modifying the mechanical load elements, clinicians can alter the tissue adaptations, facilitate motor learning, and resolve corresponding physical impairments. Providing different loads that create variable tensile, compressive, and shear deformation on the tissue through mechanotransduction and specificity can promote the appropriate stress adaptations to increase tissue capacity and injury tolerance. Tools for monitoring rehabilitation training loads to the knee are proposed to assess the reactivity of the knee joint to mechanical loading to monitor excessive mechanical loads and facilitate optimal rehabilitation.
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Affiliation(s)
- David S Logerstedt
- Department of Physical Therapy, University of the Sciences in Philadelphia, Philadelphia, PA, USA.
| | - Jay R Ebert
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, WA, Australia.,Orthopaedic Research Foundation of Western Australia, Perth, WA, Australia.,Perth Orthopaedic and Sports Medicine Research Institute, Perth, WA, Australia
| | - Toran D MacLeod
- Department of Physical Therapy, Sacramento State University, Sacramento, CA, USA
| | - Bryan C Heiderscheit
- Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, WI, USA
| | - Tim J Gabbett
- Gabbett Performance Solutions, Brisbane, QLD, Australia.,Centre for Health Research, University of Southern Queensland, Ipswich, QLD, Australia
| | - Brian J Eckenrode
- Department of Physical Therapy, Arcadia University, Glenside, PA, USA
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16
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Iqbal A, Kalia S, Beale D, James SL, Botchu R. Isolated distal adductor magnus tendon avulsion as a rare cause of medial knee pain. A case report. Indian J Radiol Imaging 2021; 30:507-509. [PMID: 33737782 PMCID: PMC7954158 DOI: 10.4103/ijri.ijri_523_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 05/06/2020] [Accepted: 09/01/2020] [Indexed: 11/05/2022] Open
Abstract
Avulsion injuries of adductor frequently involve the proximal origin. We report the first case of avulsion fracture of adductor magnus at its insertion and discuss the relevant anatomy.
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Affiliation(s)
- Aamer Iqbal
- Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
| | | | | | - Steven L James
- Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
| | - Rajesh Botchu
- Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
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17
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Nicolini AP, Penna NA, Oliveira GTDE, Cohen M. EPIDEMIOLOGY OF ORTHOPEDIC INJURIES IN JIU-JITSU ATHLETES. ACTA ORTOPEDICA BRASILEIRA 2021; 29:49-53. [PMID: 33795970 PMCID: PMC7976864 DOI: 10.1590/1413-785220212901236466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 06/24/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVE This study aims to identify the epidemiology of orthopedic injuries in jiu-jitsu practitioners. METHODS Ninety-six jiu-jitsu practitioners aged between 18 and 45 years, male and female, answered a questionnaire addressing personal data and history of injuries related to the sport during the last 24 months. RESULTS In the period cover, 85% of the sample presented injuries related to the practice of jiu-jitsu, with an average of 60 days of absenteeism from sports practice. Fingers, shoulders, and knees were the joints most affected by orthopedic injuries. CONCLUSION Orthopedic injuries are quite prevalent among jiu-jitsu practitioners, often distancing athletes from the sport. Level of Evidence IV, case series / cross sectional study.
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Affiliation(s)
- Alexandre Pedro Nicolini
- Universidade Federal de São Paulo, Paulista School of Medicine, Sports Traumatology Center, São Paulo, SP, Brazil
| | - Nathália Abolis Penna
- Universidade Federal de São Paulo, Paulista School of Medicine, Sports Traumatology Center, São Paulo, SP, Brazil
| | - Gabriel Taniguti DE Oliveira
- Universidade Federal de São Paulo, Paulista School of Medicine, Sports Traumatology Center, São Paulo, SP, Brazil
| | - Moises Cohen
- Universidade Federal de São Paulo, Paulista School of Medicine, Sports Traumatology Center, São Paulo, SP, Brazil
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18
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Mishra P, Ajay, Goyal A, Mehta N, Lal H, kumar S. Comparison of semitendinosus tendon length and diameter in sports and non-sports group for ACL reconstruction. J Clin Orthop Trauma 2020; 11:S795-S798. [PMID: 32999558 PMCID: PMC7503151 DOI: 10.1016/j.jcot.2020.08.002] [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: 06/05/2020] [Revised: 08/05/2020] [Accepted: 08/07/2020] [Indexed: 11/25/2022] Open
Abstract
UNLABELLED Different anthropometric parameters such as weight, height, body mass index, thigh circumference, and thigh length have been extensively studied and their correlation assessed with hamstring graft length and diameter. This study is to analyse the difference of semitendinosus graft characteristics with sports activity of the patient. METHODS 110 patients undergoing any ligament reconstruction with semitendinosus were included, 55 in sports and 55 in non-sports group. Height, weight, BMI, sports activity were noted pre-operatively. Semitendinosus harvested and graft length and diameter measured. RESULTS 98 patients completed the study. The mean length of the harvested semitendinosus tendons was 28.45 ± 2.54 cm in non-sports group and 28.06 ± 4.18 cm in sports group. The mean diameter of semitendinosus was 6.29 ± 0.61 mm in non-sports group and 6.35 ± 0.6 mm in sports group. Positive correlation was found between height and graft length. No statistically significant difference between tendon length (p = 0.994) and diameter (p = 0.549) of sports and non-sports group was found. CONCLUSION Patient height should be considered for preoperative prediction of tendon length and thickness without any difference in sports or non-sports group. A taller patient has a longer and thicker graft.
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19
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Barcessat ARP, Bittencourt MN, Pereira JAC, Castagna A, Fontani V, Rinaldi S. REAC neurobiological treatments in acute post-traumatic knee medial collateral ligament lesion. Heliyon 2020; 6:e04539. [PMID: 32743108 PMCID: PMC7385461 DOI: 10.1016/j.heliyon.2020.e04539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/23/2020] [Accepted: 07/20/2020] [Indexed: 11/15/2022] Open
Abstract
Objective Physical traumas can lead to unconscious neuropsychical alterations, which can compromise rehabilitation result and functional recovery. Aim of this interventional study is to verify if neurobiological Radio Electric Asymmetric Conveyer (REAC) treatments Neuro Postural Optimization (NPO) and Tissue Optimization (TO) are able respectively to improve neuro psychomotor strategies and facilitate recovery process in medial collateral ligaments (MCL) lesions of the knee. Patients and methods 45 healthy subjects, 32 males and 13 females, with knee MCL lesion, diagnosed with MRI or ultrasound. Within 4 days after the trauma, subjects were clinically evaluated (T0), both through medical and subjective assessments. Clinical evaluation was repeated after the REAC NPO treatment (T1) and at the end of 18 REAC TO treatments (T2) and at the 30 days follow-up (T3). Results In comparison with the results commonly found in clinical practice, all REAC treated patients recovered much faster. They reported functional recovery, pain relief and joint stability, regardless of the severity of the lesion. Conclusion The combined use of REAC NPO and TO can envisage a new rehabilitative approach, which aims not only at recovering the outcomes of the physical trauma, but also at improving the neuropsychical state that can condition the rehabilitation result.
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Affiliation(s)
| | | | | | - Alessandro Castagna
- Department of Neuro Psycho Physio Pathology and Neuro Psycho Physical Optimization, Rinaldi Fontani Institute, Florence, Italy.,Department of Regenerative Medicine, Rinaldi Fontani Institute, Florence, Italy
| | - Vania Fontani
- Research Department, Rinaldi Fontani Foundation, Florence, Italy.,Department of Neuro Psycho Physio Pathology and Neuro Psycho Physical Optimization, Rinaldi Fontani Institute, Florence, Italy.,Department of Regenerative Medicine, Rinaldi Fontani Institute, Florence, Italy
| | - Salvatore Rinaldi
- Research Department, Rinaldi Fontani Foundation, Florence, Italy.,Department of Neuro Psycho Physio Pathology and Neuro Psycho Physical Optimization, Rinaldi Fontani Institute, Florence, Italy.,Department of Regenerative Medicine, Rinaldi Fontani Institute, Florence, Italy
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20
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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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Landing Kinematics, Sports Performance, and Isokinetic Strength in Adolescent Male Volleyball Athletes: Influence of Core Training. J Sport Rehabil 2020; 29:65-72. [PMID: 30526235 DOI: 10.1123/jsr.2018-0015] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 10/15/2018] [Accepted: 10/28/2018] [Indexed: 11/18/2022]
Abstract
CONTEXT Core control and strength are important for reducing the risk of lower-extremity injury. Current evidence on the effect of core training in male adolescent athletes is limited, and other investigations into the effects of core training often emphasized core strength only. OBJECTIVE To examine whether core training emphasizing both control and strength of the trunk and hip would improve joint kinematics during landing, sports performance, and lower-extremity muscle strength in adolescent male volleyball athletes. DESIGN Single group pretest and posttest design. SETTING University laboratory. PARTICIPANTS Sixteen male participants (age: 13.4 [1] y, height: 167.8 [8.6] cm, mass: 58.6 [13.9] kg, and volleyball experience: 3.8 [1.5] y) from a Division I volleyball team at a junior high school. MAIN OUTCOME MEASUREMENTS Kinematics of the trunk and lower-extremity during box landing and spike jump landing tasks, volleyball-related sports performance, and isokinetic strength of hip and knee muscles were assessed before and after a 6-week core training program. RESULTS After training, the participants demonstrated decreased trunk flexion angle (P = .01, Cohen's d = 0.78) during the box landing task and reduced the maximum knee internal rotation angle (P = .04, Cohen's d = 0.56) during the spike jump landing task. The average isokinetic strength of hip flexors and external rotators, and knee flexors and extensors also significantly increased (P = .001, Cohen's d = 0.98; P = .04, Cohen's d = 0.57; P = .02, Cohen's d = 0.66; P = .003, Cohen's d = 0.87, respectively); however, sports performance did not show significant changes. CONCLUSIONS A more erect landing posture following training suggests that the core training program may be beneficial for improving core stability. The long-term effect of core training for knee injury prevention needs further investigation.
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Bisciotti GN, Chamari K, Cena E, Bisciotti A, Bisciotti A, Corsini A, Volpi P. Anterior cruciate ligament injury risk factors in football. J Sports Med Phys Fitness 2019; 59:1724-1738. [PMID: 31062538 DOI: 10.23736/s0022-4707.19.09563-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
INTRODUCTION Anterior cruciate ligament (ACL) lesion represents one of the most dramatic injuries in a football (soccer) player's career. There are many injury risk factors related to intrinsic (non-modifiable) and/or extrinsic (modifiable) factors of ACL injury. EVIDENCE ACQUISITION Research of the studies was conducted until September 2018 without publication data limitation or language restriction on the following databases: PubMed/MEDLINE, Scopus, ISI, EXCERPTA. EVIDENCE SYNTHESIS To date, evidence from the literature suggests that the risk of ACL injury is multifactorial and involves biomechanical, anatomical, hormonal, and neuromuscular factors. Despite this relative complexity, the mechanisms of injury are well known and rationally classified into two categories: mechanisms of injury based on contact or on non-contact with another player, with the non-contact injury mechanisms clearly prevailing over the mechanisms of contact injury. One of the most frequent biomechanical risk factors, associated with ACL non-contact injury, is represented by the valgus knee in the pivoting and cutting movements and in the landing phase after jumping. Gender-related risk factors show female populations to have a higher predisposition to ACL injury than males However, there are still some theoretical and practical aspects that need further investigation such as; genetic risks together with the role of estrogen and progesterone receptors in female populations, and the in-vivo interaction shoe-playing surface. In particular, the genetic risk factors of ACL lesion seem to be an interesting and promising field of investigation, where considerable progress has still to be made. CONCLUSIONS This narrative review provides an insight into the risk factors of ACL injury that could be used by practitioners for preventing injury in football (soccer).
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Affiliation(s)
- Gian Nicola Bisciotti
- Qatar Orthopedic and Sport Medicine Hospital, FIFA Center of Excellence, Doha, Qatar -
| | - Karim Chamari
- Qatar Orthopedic and Sport Medicine Hospital, FIFA Center of Excellence, Doha, Qatar
| | - Emanuele Cena
- Qatar Orthopedic and Sport Medicine Hospital, FIFA Center of Excellence, Doha, Qatar
| | | | | | | | - Piero Volpi
- FC Internazionale Milano, Milan, Italy.,Unit of Traumatology, Department of Knee Orthopedic and Sports, Humanitas Research Hospital, Rozzano, Milan, Italy
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23
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Bone Bruises Associated with Anterior Cruciate Ligament Injury as Indicators of Injury Mechanism: A Systematic Review. Sports Med 2019; 49:453-462. [DOI: 10.1007/s40279-019-01060-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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MRI-Detected Sports-Related Knee Injuries and Abnormalities at the Rio de Janeiro 2016 Summer Olympic Games. AJR Am J Roentgenol 2018; 211:880-886. [PMID: 30063380 DOI: 10.2214/ajr.17.19334] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE The purpose of this article is to describe knee abnormalities and the occurrence of MRI-detected sports-related knee abnormalities by evaluating MRI examinations performed during the Rio de Janeiro Olympic Games held in August 2016. CONCLUSION There were 11,274 athletes at the Rio 2016 Olympic Games, and 113 of them underwent at least one knee MRI in the Olympic Village. Cartilage abnormalities, followed by meniscal tears and ligament sprains, were the most frequent abnormalities.
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Volpi P, Bisciotti GN, Chamari K, Cena E, Carimati G, Bragazzi NL. Risk factors of anterior cruciate ligament injury in football players: a systematic review of the literature. Muscles Ligaments Tendons J 2017; 6:480-485. [PMID: 28217570 DOI: 10.11138/mltj/2016.6.4.480] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The ACL lesion represents one of the most dramatic injuries in a sportsman's career. There are many injury risk factors related to intrinsic, or non-modifiable, and extrinsic, or modifiable, factors. In literature at today current evidence suggests that ACL injury risk is multifactorial and involves biomechanical, anatomical, hormonal and neuromuscular factors. PURPOSE To perform a systematic review of the literature concerning the ACL injury risk factors in soccer. CONCLUSION The injury risk factors show a low level of evidence, further studies in the field are needed. STUDY DESIGN Systematic review.
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Affiliation(s)
- Piero Volpi
- Department of Knee Orthopaedic and Sports Traumatology Unit, Humanitas Research Hospital, Rozzano, (MI), Italy; FC Internazionale Medical Staff, Milano, Italy
| | - Gian Nicola Bisciotti
- Qatar Orthopaedic and Sport Medicine Hospital, FIFA Center of Excellence, Doha, Qatar
| | - Karim Chamari
- Qatar Orthopaedic and Sport Medicine Hospital, FIFA Center of Excellence, Doha, Qatar
| | - Emanuela Cena
- Qatar Orthopaedic and Sport Medicine Hospital, FIFA Center of Excellence, Doha, Qatar
| | - Giulia Carimati
- Department of Knee Orthopaedic and Sports Traumatology Unit, Humanitas Research Hospital, Rozzano, (MI), Italy
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Sayampanathan AA, Howe BKT, Bin Abd Razak HR, Chi CH, Tan AHC. Epidemiology of surgically managed anterior cruciate ligament ruptures in a sports surgery practice. J Orthop Surg (Hong Kong) 2017; 25:2309499016684289. [PMID: 28142351 DOI: 10.1177/2309499016684289] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Anterior cruciate ligament (ACL) tears are common knee injuries, especially among sportsmen and sportswomen. The aim of this study is to better understand the epidemiology of surgically managed ACL tears sustained in our institution. METHODS All patients who underwent arthroscopic ACL reconstruction by the senior author of this article in Singapore from 2008 to 2013 were studied. Patients who were diagnosed clinically and/or radiologically to have a complete tear of the ACL and subsequently underwent arthroscopic ACL reconstruction were included. Patients who suffered from traumatic knee dislocation were excluded. Two hundred and ninety-two patients were available for analysis. All patients were operated on by the senior author. RESULTS 83.9% of patients were male. 60.5, 23.0, 8.46, and 8.11% were of Chinese, Malay, Indian and other origins, respectively. 69.6 and 28.7% were in white-collared and blue-collared jobs, respectively, while 1.69% were unemployed. Mean age at operation was 29.4 years. Mean body mass index was 25.3 kg/m2. 82.4 and 17.6% of ACL tears were sports (contact-27.5%; non-contact-72.5%) and non-sports injuries (activities of daily living-94.2%, road traffic accidents-5.77%), respectively. The top four sporting activities causing ACL tears were soccer, basketball, racquet games and volleyball. 56.2% of ACL tears presented with concomitant knee injuries (medial meniscus-63.4%; lateral meniscus-31.1%; posterior cruciate ligament-5.49%). 84.5% were primary tears. CONCLUSIONS In this epidemiological review of ACL injuries, we found that ACL injuries tend to cluster within certain population subgroups. Patterns of mechanisms of injuries have been observed. These findings may lead to better preventive and treatment strategies in the management of ACL tears.
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Affiliation(s)
| | | | | | - Chong Hwei Chi
- 2 Department of Orthopaedic Surgery, Singapore General Hospital, Singapore
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Simpson M, Rio E, Cook J. At What Age Do Children and Adolescents Develop Lower Limb Tendon Pathology or Tendinopathy? A Systematic Review and Meta-analysis. Sports Med 2016; 46:545-57. [PMID: 26626072 DOI: 10.1007/s40279-015-0438-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Tendon pathology and tendinopathy have been reported in children and adolescents; however, the age at onset and prevalence of the conditions have not been examined systematically. OBJECTIVE To examine the prevalence of lower limb tendon pathology and tendinopathy in children and adolescents, and the factors associated with these conditions in this population. METHODS Six databases were searched (MEDLINE, the Cochrane Central Register of Controlled Trials, Embase, Scopus, the Web of Science and the Allied and Complementary Medicine Database). Studies were included if the prevalence of lower limb tendon pathology and/or tendinopathy were reported in humans under the age of 18 years. Studies were divided according to the method of diagnosis (physical examination, ultrasound or a questionnaire) and further divided into studies that reported prevalence data by tendon [reported two data points (right and left) for each participant] and those that reported prevalence data for each participant [reporting one data point (right or left) per participant]. RESULTS Seventeen studies met the inclusion criteria. Lower limb tendinopathy prevalence (presence of pain and dysfunction) ranged between 8.2 and 33.3%, and increased in prevalence as age increased up to 18 years. The odds ratio for studies reporting tendinopathy by tendon was 0.37 (95% confidence interval 0.20-0.69) in favour of boys presenting with tendinopathy. Study aims and reporting methods were heterogeneous. CONCLUSIONS The age at onset of lower limb tendinopathy in children and adolescents has not been widely studied. This systematic review found that tendinopathy is present in children and adolescents, and increases in prevalence with age up to 18 years. Male sex is significantly associated with tendinopathy in studies that report tendinopathy by tendon.
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Affiliation(s)
- Mitchell Simpson
- Department of Physiotherapy, Monash University Peninsula, Building G, McMahons Road, Frankston, Melbourne, VIC, 3199, Australia.
| | - Ebonie Rio
- Department of Physiotherapy, Monash University Peninsula, Building G, McMahons Road, Frankston, Melbourne, VIC, 3199, Australia
| | - Jill Cook
- Department of Physiotherapy, Monash University Peninsula, Building G, McMahons Road, Frankston, Melbourne, VIC, 3199, Australia
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Evaluation of Knee Pain in Athletes: A Radiologist's Perspective. Can Assoc Radiol J 2016; 68:27-40. [PMID: 27681849 DOI: 10.1016/j.carj.2016.04.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Revised: 08/23/2015] [Accepted: 04/27/2016] [Indexed: 01/03/2023] Open
Abstract
Lower limb injuries account for most of all injuries suffered by athletes and the knee joint accounts for over half of these. The etiology of knee pain is multifactorial; a good history focusing on the mechanism of injury and the chronicity of pain is extremely useful in correlating with radiologic findings and establishing a clinically meaningful diagnosis. This review article will discuss several important and common causes of acute and chronic knee pain in athletes, focusing on their mechanism of injury and site of pain as well as their salient imaging findings.
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Cavalcante MLC, Teixeira PRL, Sousa TCS, Lima PODP, Oliveira RR. Índice de fadiga do músculo quadríceps femoral em atletas de futebol após reconstrução do ligamento cruzado anterior. Rev Bras Ortop 2016. [DOI: 10.1016/j.rbo.2015.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Cavalcante MLC, Teixeira PRL, Sousa TCS, Lima PODP, Oliveira RR. Index of fatigue quadriceps in soccer athletes after anterior cruciate ligament reconstruction. Rev Bras Ortop 2016; 51:535-540. [PMID: 27818974 PMCID: PMC5091019 DOI: 10.1016/j.rboe.2016.08.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 12/14/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The present study aimed to evaluate the muscle fatigue of the quadriceps muscle in high-performance soccer players undergoing (anterior cruciate ligament) ACL reconstruction. METHODS We evaluated 17 high-performance soccer players from three professional soccer teams of a state in Brazil from August 2011 to July 2012. All subjects were evaluated between 5.5 and 7 months after ACL reconstruction with a Biodex® isokinetic dynamometer (System 4 Pro) with test protocol CON/CON at 60°/s and 300°/s with 5 and 15 repetitions, respectively. In the calculation of local muscle fatigue, the fatigue index was used, which is calculated by dividing the labor done in the first one-third of the repetitions by that done at the final one-third of the repetitions, and multiplying by 100 to express a unit in percentage (i.e., as a discrete quantitative variable). RESULTS All subjects were male, with a mean age of 21.3 ± 4.4 years and mean BMI 23.4 ± 1.53 cm; left dominance was observed in 47% (n = 8) of athletes, and right dominance, in 53% (n = 9) of athletes; and the limb involved in the lesion was the dominant in 29% (n = 5) and the non-dominant in 71% (n = 12). Fatigue rates were 19.6% in the involved limb and 29.0% in the non-involved limb. CONCLUSION The results allow us to conclude that there was no significant difference between the limbs involved and not in ACL injuries regarding local muscle fatigue. No association was observed between the dominant side and the limb involved in the ACL injury.
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Affiliation(s)
| | - Paulo Renan Lima Teixeira
- Universidade Federal do Ceará (UFC), Hospital Universitário Walter Cantídio (HUWC), Fortaleza, CE, Brazil
| | | | - Pedro Olavo de Paula Lima
- Universidade Federal do Ceará (UFC), Hospital Universitário Walter Cantídio (HUWC), Fortaleza, CE, Brazil
| | - Rodrigo Ribeiro Oliveira
- Universidade Federal do Ceará (UFC), Hospital Universitário Walter Cantídio (HUWC), Fortaleza, CE, Brazil
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Haddad MA, Budich JM, Eckenrode BJ. CONSERVATIVE MANAGEMENT OF AN ISOLATED GRADE III LATERAL COLLATERAL LIGAMENT INJURY IN AN ADOLESCENT MULTI-SPORT ATHLETE: A CASE REPORT. Int J Sports Phys Ther 2016; 11:596-606. [PMID: 27525183 PMCID: PMC4970849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
STUDY DESIGN Case report. BACKGROUND Isolated, grade III lateral collateral ligament knee injuries are an uncommon traumatic injury with little guidance available in the literature for conservative management and prognosis for return to sport. The purpose of this case report is to describe the clinical decision-making in both differential diagnosis and physical therapy management of an isolated grade III lateral collateral ligament sprain in an adolescent multi-sport high school athlete. CASE DESCRIPTION A 16 year-old male, high school, multi-sport athlete (cross country, wrestling, track and field) sustained a traumatic knee injury during a wrestling match when his involved lower extremity was forcefully externally rotated by his opponent. Initial clinical presentation revealed pain and increased laxity with varus stress testing of the left knee, which was subsequently identified via MRI as a complete lateral collateral ligament rupture (grade III). A conservative physical therapy program was developed targeting the active and neuromuscular subsystems, theorized to compensate for the lack of an intact lateral collateral ligament. OUTCOMES The subject attended 18 visits of physical therapy over a period of 12 weeks. His rehabilitation program focused on functional strengthening of the posterolateral corner, enhancement of neuromuscular control, and graded progression to sports specific drills. Return to play decisions were based on a combination of lower extremity functional performance measures, condition specific outcome measures and subjective performance on sports specific tasks. At discharge from physical therapy, he reported 0/10 pain, scored a 76/80 on the Lower Extremity Functional Scale, and was able to return to competitive track and field events. DISCUSSION Few descriptions in the literature exist for the conservative management of isolated, grade III lateral collateral ligament injuries. A program of selective functional strengthening, proprioceptive training, and graded sport specific activities may allow these individuals to return to sport with conservative management. LEVELS OF EVIDENCE 4 (Single Case Report).
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Affiliation(s)
- M. Alex Haddad
- MossRehab, Outpatient Therapy Department, Philadelphia, PA, USA
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Sugawara K, Okada K, Saito I, Saito A, Wakasa M. Foot Pressure Pattern During Walking in Individuals with Anterior Cruciate Ligament Injury. J Am Podiatr Med Assoc 2016; 106:201-6. [PMID: 27269975 DOI: 10.7547/15-006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND We evaluated foot pressure distribution during walking in individuals with anterior cruciate ligament (ACL) injury. METHODS Our study included 24 ACL-deficient patients and 22 healthy young adults as controls. The former group was divided into the dominant-side ACL-deficient group (n = 17) and the nondominant-side ACL-deficient group (n = 7). The following parameters were calculated from the path of the center of pressure (COP) on a foot pressure distribution system: percentage of COP (%COP; the ratio of anteroposterior COP path length to foot length), percentage of COP locus area (%CLA; the ratio of the area encompassed by the COP path and a line between the start and end points of the COP path to foot area), and the value of maximum amplitude of COP (MACOP; the maximum perpendicular length from the COP path to a line between the start and end points of the COP). RESULTS In the nondominant-side ACL-deficient group, %COP (P = .026), %CLA (P = .001), and MACOP (P =.012) on the injured side were significantly lower than those in the nondominant leg side of the control group. No significant differences were found between the dominant-side ACL-deficient group and the control group. CONCLUSIONS Shortening of the COP trace in the nondominant-side ACL-deficient group may be associated with knee flexion during walking at heel contact. Because the parameters used herein can be obtained easily, repetitively, and quantitatively, they should be used in evaluating the gait of patients with ACL-deficient knees.
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Affiliation(s)
- Kaori Sugawara
- Department of Rehabilitation, Kure City Medical Association Hospital, Hiroshima, Japan
| | - Kyoji Okada
- Department of Physical Therapy, Akita University Graduate School of Health Sciences, Akita, Japan
| | - Isao Saito
- Department of Physical Therapy, Akita University Graduate School of Health Sciences, Akita, Japan
- Department of Rehabilitation, Ugo Town Hospital, Akita, Japan
| | - Akira Saito
- Department of Physical Therapy, Akita University Graduate School of Health Sciences, Akita, Japan
| | - Masahiko Wakasa
- Department of Physical Therapy, Akita University Graduate School of Health Sciences, Akita, Japan
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John R, Dhillon M, Syam K, Prabhakar S, Behera P, Singh H. Epidemiological profile of sports-related knee injuries in northern India: An observational study at a tertiary care centre. J Clin Orthop Trauma 2016; 7:207-11. [PMID: 27489418 PMCID: PMC4949405 DOI: 10.1016/j.jcot.2016.02.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2015] [Accepted: 02/03/2016] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Sports-related knee injuries occur commonly in athletes. However, there is no published epidemiological study from India till date. OBJECTIVES The purpose of this study was to identify common injuries sustained by Indian athletes participating in different sports and to study various associated demographic features. A secondary objective was to investigate different factors, which may affect return to sport by the athlete. STUDY DESIGN Cross-sectional study (observational study). STUDY CENTRE Sports injury clinic, PGIMER, Chandigarh. METHODS Out of 465 athletes who presented to us with sports-related knee injuries over a 5-year period, 363 athletes (from 24 different sports) with complete records were identified. Data were analysed for demographic features, type of sport, mechanism of injury, injury scenario, athlete's level of play, injury duration at presentation, injury patterns and type of management. Telephonic interviews were conducted with each athlete to enquire about return to sport and time lost in sport due to the knee injury. Factors associated with return to sport were investigated using statistical tests of association. RESULTS Soccer was found to be the most common sport associated with knee injuries accounting for 30.6% of the injuries followed by kabaddi (20.9%). The most common mechanism was non-contact injury (64.4%). Competitive injuries were found to be significantly more than practice/training injuries (p < 0.0001). The most common injuries noted were ACL tears (n = 314) followed by meniscus injuries (n = 284) and the most common combination of injuries were an ACL tear with medial meniscus tear (n = 163). Only 39.8% of the athletes returned to sport. Mean duration of time lost in sport among those who returned to sport was 8.84 months. Return to sport was significantly associated with body mass index, level of competitiveness of the athlete and type of management (p = 0.017, 0.045 and <0.0001, respectively). CONCLUSION Knee injuries take a huge toll on an athlete's career as observed in this study. Prevention of knee injuries is of paramount importance and more focussed epidemiological studies are needed for formulating policies to prevent sports injuries in both professional and amateur athletes. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- R. John
- Department of Orthopaedics, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India,Corresponding author. Tel.: +91 9781335111.
| | - M.S. Dhillon
- Department of Orthopaedics, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| | - K. Syam
- Department of Orthopaedics, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| | - S. Prabhakar
- Department of Orthopaedics, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| | - P. Behera
- Department of Orthopaedics, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| | - H. Singh
- Department of Immunopathology, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
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Papalia R, Torre G, Vasta S, Zampogna B, Pedersen DR, Denaro V, Amendola A. Bone bruises in anterior cruciate ligament injured knee and long-term outcomes. A review of the evidence. Open Access J Sports Med 2015; 6:37-48. [PMID: 25733936 PMCID: PMC4340462 DOI: 10.2147/oajsm.s75345] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background Bone bruises are frequently associated with anterior cruciate ligament (ACL) tears as a result of trauma or direct shear stress of the bone. Purpose To review the evidence regarding the characteristics of the bone bruise associated with ACL tears, its relevance on clinical outcomes, and its progression over time. In particular, the long-term effects of the bone bruise on the knee osteochondral architecture and joint function were evaluated. Study design Review; level of evidence: 4. Methods An electronic search was performed on PubMed. Combinations of keywords included: “bone bruise AND knee”; “bone bruise AND anterior cruciate ligament”; “bone bruise AND osteo-chondral defects”. Any level of evidence studies concerning bone bruises in patients with partial or complete ACL tears were retrieved. Results A total of 25 studies were included; three of them investigated biomechanical parameters, seven were concerned with clinical outcomes, and 15 were radiological studies. Evaluation of the bone bruise is best performed using a fat-saturated T2-weighted fast spin echo exam or a short tau inversion recovery sequence where fat saturation is challenging. The location of the injury has been demonstrated to be more frequent in the lateral compartment of the joint (lateral femoral condyle and lateral tibial plateau). It is associated with ACL tears in approximately 70% of cases, often with collateral ligament or meniscal tears. Mid- and long-term outcomes demonstrated a complete healing of the marrow lesions at magnetic resonance imaging, but chondral defects detected with T1ρ sequences are still present 1 year after the ACL injury. Functional examination of the knee, through clinical International Knee Documentation Committee scores, did not show any correlation with the bone bruise. Conclusion Although bone bruise presence yields to higher pain levels, no correlation with functional outcomes was reported. Most studies have a short-term follow-up (<2 years) compared to the length of time it takes to develop post-traumatic osteoarthritis, so it still remains unclear whether the initial joint injury and bone bruise have a direct relationship to long-term function.
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Affiliation(s)
- Rocco Papalia
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - Guglielmo Torre
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - Sebastiano Vasta
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - Biagio Zampogna
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - Douglas R Pedersen
- Department of Biomedical Engineering, University of Iowa, Iowa City, IA, USA ; Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, IA, USA
| | - Vincenzo Denaro
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - Annunziato Amendola
- Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, IA, USA
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