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Take Home Message: While both the Y-graft and C-graft effectively stabilized the patellofemoral joint, the patients who received the Y-graft had significantly better subjective outcome scores than the patients who received the C-graft.
Patients who endure a patellofemoral dislocation are often plagued with patellofemoral instability and frequent re-injury. While multiple methods of patellar fixation exist, a gold-standard does not. Therefore, Kang and colleagues performed a randomized trial to compare the double-bundle anatomic medial patellofemoral ligament reconstruction with one of two fixation methods – Y-graft or C-graft.... Read more »
Kang, H., Cao, J., Yu, D., Zheng, Z., & Wang, F. (2013) Comparison of 2 Different Techniques for Anatomic Reconstruction of the Medial Patellofemoral Ligament: A Prospective Randomized Study. The American Journal of Sports Medicine, 41(5), 1013-1021. DOI: 10.1177/0363546513480468
Take Home Message: As the body fatigues there may be apparent compensatory strategies employed, however, lower extremity biomechanics deteriorate as fatigue becomes greater. This may have implications for injury prevention program implementation.
Lower extremity injuries (e.g., anterior cruciate ligament [ACL], ankle sprains) tend to occur later in games or practices when athletes may be fatigued; hence, fatigue may increase susceptibility to lower extremity injuries. However, there is only limited evidence that fatigue influences lower extremity biomechanics. Therefore, the purpose of this study was to evaluate lower extremity biomechanics among female soccer players at two different fatigue severities during a functional task.... Read more »
Cortes, N., Greska, E., Kollock, R., Ambegaonkar, J., & Onate, J. (2013) Changes in Lower Extremity Biomechanics Due to a Short-Term Fatigue Protocol. Journal of Athletic Training, 48(3), 306-313. DOI: 10.4085/1062-6050-48.2.03
Take Home Message: In the United States, traumatic brain injury laws reflect a uniform, but not scientifically proven consensus about return to play time, who makes the return to play decisions, and the best delivery method to distribute educational information. None of the laws target injury prevention.
Forty-four states and Washington DC passed legislation to reduce the overall impact of traumatic brain injuries. However, there are no studies comparing the content of the laws with the current scientific literature regarding symptoms, treatment, and the effect the laws have on youth traumatic brain injuries. Therefore, the purpose of this study was to describe the current statewide youth sports traumatic brain injury laws and their relationship to established scientific literature of youth traumatic brain injuries.... Read more »
Harvey HH. (2013) Reducing traumatic brain injuries in youth sports: youth sports traumatic brain injury state laws, january 2009-december 2012. American Journal of Public Health, 103(7), 1249-54. PMID: 23678903
Take Home Message: Among injury athletes, having a high level of support (emotional, esteem, informational, and tangible), particularly if the athlete perceives this support, is associated with less psychological stress.
It is widely accepted that strong social support can help alleviate psychological stress. This social support also shapes how athletes may cope with the psychological stresses that arise from injury, giving the athlete a social outlet so as to not feel isolated or alone. Mitchell and colleagues described 2 studies to determine the influence of social support on psychological responses to injury.... Read more »
Mitchell I, Evans L, Rees T, & Hardy L. (2013) Stressors, social support, and tests of the buffering hypothesis: Effects on psychological responses of injured athletes. British Journal of Health Psychology. PMID: 23621677
Take Home Message: Objective measurements may provide added perspective to the rehabilitation of femoroacetabular impingement not otherwise measured by self-report surveys and clinical passive range of motion.
Femoroacetabular impingement (FAI) is very common in some sports and can affect not only athletic activity but also activities of daily living. Despite functional impairments, we often evaluate the success of a treatment for FAI not with functional assessments but with just patient-reported pain levels and activity scales, post-surgical femoral head and acetabular rim shape, and clinical passive range-of-motion measurements. If we can develop new functional assessments to monitor FAI then this may improve our current treatment strategies. Rylander et. al. used 3-dimensional motion capture techniques to measure walking and stair climbing among 17 patients diagnosed with FAI prior to surgery and 1 year post-operatively. The authors also evaluated 17 age-, gender-, body mass index-matched volunteers, who reported no history of hip pain or lower extremity injury (assessed at one time point).... Read more »
Rylander, J., Shu, B., Favre, J., Safran, M., & Andriacchi, T. (2013) Functional Testing Provides Unique Insights Into the Pathomechanics of Femoroacetabular Impingement and an Objective Basis for Evaluating Treatment Outcome. Journal of Orthopaedic Research. DOI: 10.1002/jor.22375
Take Home Message: Following repair of massive rotator cuff tears, pre-operative fatty infiltration of the infraspinatus and post-operative reduced acromiohumeral distance negatively affects healing and functional outcomes, respectively. Each of these factors should be considered when determining prognosis and prescribing treatment strategies.
Massive rotator cuff tears are a common cause of shoulder pain and dysfunction. Unfortunately, surgical repair of massive cuff tears is often unsuccessful (failure rate up to 94%). Interestingly, many patients are able to achieve functional improvement even with an unhealed cuff after repair. However, the factors which affect function after massive cuff tear, particularly after failed repair, are unclear. Therefore, the purpose of this study was to evaluate outcomes after repair of massive cuff tears, to identify prognostic factors that affect cuff healing, and ultimately to determine the factors influencing functional outcome in failed rotator cuff healing.... Read more »
Chung SW, Kim JY, Kim MH, Kim SH, & Oh JH. (2013) Arthroscopic Repair of Massive Rotator Cuff Tears: Outcome and Analysis of Factors Associated With Healing Failure or Poor Postoperative Function. The American Journal of Sports Medicine. PMID: 23631883
Take Home Message: There is still no clear answer as to whether to use an autograft or allograft bone-patellar tendon-bone ACL reconstruction.
Patients and clinicians often need to consider what surgical options they prefer when undergoing anterior cruciate ligament (ACL) reconstruction. Many physicians and researchers have investigated the benefits of either an auto- or allo- bone-patellar tendon-bone graft, however, conclusive evidence as to which is the best option has yet to be determined. The purpose of this meta-analysis was to compare outcomes between these two specific surgical options in efforts to better answer this debate.... Read more »
Kraeutler, M., Bravman, J., & McCarty, E. (2013) Bone-Patellar Tendon-Bone Autograft Versus Allograft in Outcomes of Anterior Cruciate Ligament Reconstruction: A Meta-analysis of 5182 Patients. The American Journal of Sports Medicine. DOI: 10.1177/0363546513484127
Take Home Message: The predominate mechanisms of concussions in the NHL are player to opponent contact. This is usually directed to the lateral aspect of the head by the shoulder, elbow, or glove. Players that sustain a concussion typically do not have the puck and often a penalty was not called on the play.
Across all levels of play and age groups within ice hockey, concussions are one of the most common injuries that athletes suffer. Little is known about the exact mechanisms of how concussions occur in ice hockey. Establishing the most common mechanisms of how ice hockey players receive concussions will increase concussion awareness and education as well as assist medical professionals to detect potential concussive events. Therefore, the purposes of this study was to describe how concussions occur in the NHL as well as identify the association of concussion injuries with puck possession and penalties given at the time of concussive injury.... Read more »
Hutchison MG, Comper P, Meeuwisse WH, & Echemendia RJ. (2013) A systematic video analysis of National Hockey League (NHL) concussions, part II: how concussions occur in the NHL. British journal of sports medicine. PMID: 23637116
Take Home Message: Evidence of increased alpha angles has been shown in ice hockey players as compared to non-hockey playing matched controls. Even at young ages, signs of bony abnormality linked to femoroacetabular impingement are present.
Femoroacetabular impingement (FAI) is a common radiographic finding among athletes participating in sports requiring hip flexion, hip internal rotation, and repetitive cyclic motions. Cam-deformity FAI is marked by the aspherical shape of the femoral head, and is radiographically defined by an alpha angle 55˚. Hockey players employ a skating pattern that is suspected to cause cam-deformity but it remains unclear how common cam-deformities are among asymptomatic young ice hockey players. Therefore, Philippon and colleagues conducted a cohort study to determine how common a large alpha angle was among 61 youth hockey players and 27 youth skiers.... Read more »
Philippon, M., Ho, C., Briggs, K., Stull, J., & LaPrade, R. (2013) Prevalence of Increased Alpha Angles as a Measure of Cam-Type Femoroacetabular Impingement in Youth Ice Hockey Players. The American Journal of Sports Medicine. DOI: 10.1177/0363546513483448
Take Home Message: High adherence to a neuromuscular injury prevention program like the FIFA 11 decreases the risk of injury.
Injury prevention programs typically are multifaceted warm-up programs that focus on neuromuscular recruitment. Although various programs aim to improve performance and decrease injury risk no investigation has shown a link between improved physical performance and the quality and adherence of neuromuscular injury prevention training. Therefore, Steffen and colleagues completed a cluster-randomized trial to assess the influence of player adherence and delivery method of the FIFA 11 injury prevention program (approximately 20 minutes, 15 exercises) on injury risk among females.... Read more »
Steffen K, Emery CA, Romiti M, Kang J, Bizzini M, Dvorak J, Finch CF, & Meeuwisse WH. (2013) High adherence to a neuromuscular injury prevention programme (FIFA 11 ) improves functional balance and reduces injury risk in Canadian youth female football players: a cluster randomised trial. British Journal of Sports Medicine. PMID: 23559666
Take Home Message: Hyaluronic acid injections decrease factors related to collagen degradation. Some blood tests may differentiate responders and nonresponders to these injections.
Knee osteoarthritis, one of the leading causes of disability, has no cure and current treatments commonly involve medications to decrease inflammation and pain. Hyaluronic acid (HA) injections have become a popular form of treatment for knee osteoarthritis. However, the mechanism of action has yet to be determined. Therefore, the authors examined serum biomarkers of collagen breakdown (Coll2-1 and Coll2-1 NO2) in 45 patients with various stages of knee osteoarthritis before (-15 days), at the time of injection, and following treatment (30 and 90 days) with HA injections.... Read more »
Henrotin Y, Chevalier X, Deberg M, Balblanc JC, Richette P, Mulleman D, Maillet B, Rannou F, Piroth C, Mathieu P.... (2013) Early decrease of serum biomarkers of type II collagen degradation (Coll2-1) and joint inflammation (Coll2-1 NO2 ) by hyaluronic acid intra-articular injections in patients with knee osteoarthritis: A research study part of the Biovisco study. Journal of Orthopaedic Research, 31(6), 901-7. PMID: 23423846
Take Home Message: Fitness level may influence baseline concussion symptom reporting with fitter individuals reporting fewer concussion symptoms. Athletes also appear to report more concussion symptoms when reporting after exercise.
Baseline testing in concussion management, including graded symptom assessment, has become commonplace in multiple sports on almost every level of competition. Different assessment tools (e.g., Sideline Concussion Assessment Tool [SCAT3], Immediate Post-Concussion Assessment and Cognitive Testing [ImPACT]) establish a baseline for many nonspecific symptoms so that post-injury symptoms may be compared to baseline results. Previous research has shown that multiple factors, including physical-activity level, can result in reports of more neurological symptoms. Therefore, Mrazik, et al sought to evaluate if an individual’s fitness level correlated with report of concussion symptoms at baseline. They hypothesized that after exertion, athletes with higher fitness levels would report fewer symptoms at baseline.... Read more »
Mrazik, M., Naidu, D., Lebrun, C., Game, A., & Matthews-White, J. (2013) Does an Individual's Fitness Level Affect Baseline Concussion Symptoms?. Journal of Athletic Training, 2147483647. DOI: 10.4085/1062-6050-48.3.19
Take Home Message: Elite soccer athletes may be at an increased risk for knee and ankle osteoarthritis compared with the general population. This group should be identified as high risk and preventative measures should be taken.
While participation in elite-level sports is often viewed as a good thing, there is an established increased risk of short-term injuries (e.g., sprains, strains). This increased injury risk may leave athletes at an increased risk for long-term disability (e.g., osteoarthritis [OA]). The purpose of this systematic review was to investigate the prevalence of knee and ankle OA among former elite-level soccer players.... Read more »
Kuijt, M., Inklaar, H., Gouttebarge, V., & Frings-Dresen, M. (2012) Knee and ankle osteoarthritis in former elite soccer players: A systematic review of the recent literature. Journal of Science and Medicine in Sport, 15(6), 480-487. DOI: 10.1016/j.jsams.2012.02.008
Take Home Message: The balance error scoring system (BESS) test is more effective in assessing high school age students’ concussions compared to the Balance Accelerometer Measure (BAM) assessment. The tandem leg stances on firm and foam surface of the BESS test are the most sensitive and specific positions for the detection of a concussion.
Assessing balance after a concussion provides useful information not only for diagnosis and prognosis but also during the athlete’s return to play progression. Many clinicians evaluate balance with the balance error scoring system (BESS), which may be imprecise and susceptible to inter-rater error; however, it was specifically designed to assess concussion injuries. In contrast, the Balance Accelerometer Measure (BAM), which is assessed by the patient wearing small sensors, provides accurate balance assessments but was not designed to assess concussed athletes. Therefore, the purpose of this study was to compare the BAM test with the BESS test regarding the ability to detect differences in postural differences between 43 high school students with concussions compared to 27 age-matched controls.... Read more »
Furman GR, Lin CC, Bellanca JL, Marchetti GF, Collins MW, & Whitney SL. (2013) Comparison of the Balance Accelerometer Measure and Balance Error Scoring System in Adolescent Concussions in Sports. The American Journal of Sports Medicine. PMID: 23585486
Take Home Message: The Wii Balance Board is an acceptable substitute for measuring the center of pressure during single leg stance balance tests.
While a laboratory grade force plate is the gold standard for both testing and training balance, these force plates are limited to research laboratories. Due to the importance of balance testing and training during the rehabilitation process, a cost effective, widely available and portable force plate is desirable. Therefore, Huurnink and colleagues compared a laboratory grade, in-floor force plate to the Wii Balance Board (WBB).... Read more »
Huurnink A, Fransz DP, Kingma I, & van Dieën JH. (2013) Comparison of a laboratory grade force platform with a Nintendo Wii Balance Board on measurement of postural control in single-leg stance balance tasks. Journal of Biomechanics, 46(7), 1392-5. PMID: 23528845
Take Home Message: NSAIDs are a common treatment method for musculoskeletal injuries; however, over-the-counter availability, overuse, self-medication, and trends of initial use in high school may interfere with appropriate consumption among college athletes.
Nonsteroidal anti-inflammatory drugs (NSAIDs), a common treatment for athletic injuries, are generally safe medications when used short-term but can become problematic when used long-term and without oversight from a medical professional. There is a discrepancy between the amount of NSAIDs used in athletics and the number of studies that address their safety in athletics. In this cross-sectional study, Holmes et al. surveyed 211 collegiate football players at two institutions on two occasions (beginning of 2006 and 2009 seasons) regarding their NSAID use during the respective seasons.... Read more »
Holmes N, Cronholm PF, Duffy AJ 3rd, & Webner D. (2013) Nonsteroidal Anti-Inflammatory Drug Use in Collegiate Football Players. Clinical Journal of Sport Medicine. PMID: 23528841
Take Home Message: Achilles tendon pathology is associated with variation within a gene (TIMP2) responsible for inhibiting enzymes responsible for collagen degradation. Genetic pre-screening of at-risk individuals may help guide individualized treatment strategies.
Genetic risk factors have recently been identified for Achilles tendon pathology, which may allow for genetic screening and identification of at-risk patients and could help guide clinical management of this injury. Specifically, previous studies reviewed by SMR have shown that variants within genes that encode for structural and regulatory proteins (such as Col5a1 and TNC) are associated with risk of Achilles tendon pathology. However, additional genes encoding for enzymes that breakdown the extracellular matrix and their inhibitors (such as the ADAM, ADAMTS, and TIMP family of proteins) have not yet been evaluated. Therefore, the purpose of this study was to determine if variations within these genes are associated with Achilles tendon pathology. ... Read more »
El Khoury L, Posthumus M, Collins M, Handley CJ, Cook J, & Raleigh SM. (2013) Polymorphic variation within the ADAMTS2, ADAMTS14, ADAMTS5, ADAM12 and TIMP2 genes and the risk of Achilles tendon pathology: A genetic association study. Journal of Science and Medicine in Sport. PMID: 23491141
Take Home Message: Knees with a recent history of an anterior cruciate ligament injury have radiographic and biochemical differences from healthy knees.
An anterior cruciate ligament (ACL) injury predisposes a knee to osteoarthritis. Little is known about the causes and characteristics of the path from injury to osteoarthritis. Without these fundamental concepts it is challenging to determine who will develop knee osteoarthritis, optimal interventions, and how to measure if the treatments are effective at preventing early joint degeneration. Therefore, the purposes of these two studies were to investigate the early biochemical and structural changes among 39 knees after an ACL injury compared with 32 healthy knees.... Read more »
Tourville, T., Johnson, R., Slauterbeck, J., Naud, S., & Beynnon, B. (2013) Assessment of Early Tibiofemoral Joint Space Width Changes After Anterior Cruciate Ligament Injury and Reconstruction: A Matched Case-Control Study. The American Journal of Sports Medicine, 41(4), 769-778. DOI: 10.1177/0363546513477838
Tourville, T., Johnson, R., Slauterbeck, J., Naud, S., & Beynnon, B. (2013) Relationship Between Markers of Type II Collagen Metabolism and Tibiofemoral Joint Space Width Changes After ACL Injury and Reconstruction. The American Journal of Sports Medicine, 41(4), 779-787. DOI: 10.1177/0363546513476481
Take Home Message: Players sustained more head impacts and higher severity of impacts on days of diagnosed concussion compared to days with no diagnosed concussion. Also, peak linear acceleration was the best predictor of immediately diagnosed concussions.
Concussion prevention methods are difficult to develop because we lack an understanding of the relationship between head impact mechanics and subsequent concussions. We can improve our understanding by measuring impact forces during sporting events; however; most studies have only included a small number of athletes, which limited the ability to determine which biomechanical characteristics result in injury among football athletes. Therefore, the purpose of this study was to compare frequency and kinematic response of head impacts on days with and without a diagnosis of concussion and identify sensitivity and specificity of single-impact severity measures to diagnose concussive injuries.... Read more »
Beckwith JG, Greenwald RM, Chu JJ, Crisco JJ, Rowson S, Duma SM, Broglio SP, McAllister TW, Guskiewicz KM, Mihalik JP.... (2013) Head Impact Exposure Sustained by Football Players on Days of Diagnosed Concussion. Medicine and Science in Sports and Exercise, 45(4), 737-746. PMID: 23135363
Take Home Message: Coaches who are well trained to implement injury prevention, warm-up programs are as effective as the supervision of a physiotherapist at training sessions.
Injury prevention programs typically are multifaceted warm-up programs which focus on neuromuscular recruitment. While many programs exist it is difficult to assess their efficacy due to varying levels of adherence to the injury prevention program. Therefore, Steffen and colleagues completed a cluster-randomized trial to determine if implementation strategies of an effective injury prevention program influenced adherence and injury risk among female youth soccer teams. ... Read more »
Steffen K, Meeuwisse WH, Romiti M, Kang J, McKay C, Bizzini M, Dvorak J, Finch C, Myklebust G, & Emery CA. (2013) Evaluation of how different implementation strategies of an injury prevention programme (FIFA 11 ) impact team adherence and injury risk in Canadian female youth football players: a cluster-randomised trial. British Journal of Sports Medicine. PMID: 23486935
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