Sports medicine

BACKGROUND: The rerupture or need for revision after anterior cruciate ligament reconstruction (ACLR) is a serious complication. Preventive strategies that target the early identification of risk factors are important to reduce the incidence of additional surgery. PURPOSE: To perform a systematic review and meta-analysis to investigate risk factors for revision or rerupture after ACLR. STUDY DESIGN: Systematic review and meta-analysis; Level of evidence, 4...

BACKGROUND: The Nordic hamstring exercise (NHE) is commonly implemented to selectively improve eccentric knee-flexor strength. However, the standard version of the exercise (leveled shanks, extended hip joint) is too strenuous for most individuals, whose muscle activity rapidly decreases at extended knee angles. Hitherto, a gradual approach to the exercise has been missing. In this exploratory case study, we investigated elite performance to introduce a stepwise progression to the NHE...

Anterior knee pain (AKP) is one of the most common conditions to bring active young patients to a sports injury clinic. It is a heterogeneous condition related to multiple causative factors. Compared to the general population, there appears to be a higher risk of development of patellofemoral osteoarthritis in patients with AKP. AKP can be detrimental to the patient's quality of life and, in the larger context, significantly burdens the economy with high healthcare costs. This study aims to present a comprehensive evaluation of AKP to improve clinical daily practice...

UNLABELLED: Blood flow restriction (BFR) is an expanding rehabilitation modality that uses a tourniquet to reduce arterial inflow and occlude venous outflow in the setting of resistance training or exercise. Initially, this technique was seen as a way to stimulate muscular development, but improved understanding of its physiologic benefits and mechanism of action has allowed for innovative clinical applications. BFR represents a way to decrease stress placed on the joints without compromising improvements in strength, whereas for postoperative, injured, or load-compromised individuals BFR represents a way to accelerate recovery and prevent atrophy...

UNLABELLED: Anterior cruciate ligament (ACL) injuries and surgical intervention in the pediatric population have increased in the recent years. Although surgical techniques have advanced, evidence-based rehabilitation guidelines that consider all aspects of the youth athlete are currently lacking. The purpose of this commentary is to review the current evidence on unique considerations for the pediatric and adolescent population during rehabilitation and return to sport after ACL reconstruction (ACLR), with a focus on children under 18 years of age...

CONTEXT: Rehabilitation after anterior cruciate ligament reconstruction (ACLR) is challenging for adolescent patients concurrently experiencing growth and development, changes in attitudes and social interactions, and a gradual shift toward independence. OBJECTIVE: Therefore, the purpose of this study was to examine the perceptions of information sharing and interpersonal communication among adolescent patients going through ACLR, their parents, and physical therapist (PT) treating adolescent patients with ACLR...

Clinical evaluation and management of anterior cruciate ligament (ACL) injury is one of the most widely researched topics in orthopedic sports medicine, giving providers ample data on which to base their practices. The ACL is also the most commonly treated knee ligament. This study reports on current topics and research in clinical management of ACL injury, starting with evaluation, operative versus nonoperative management, and considerations in unique populations. Discussion of graft selection and associated procedures follows...

BACKGROUND: Bone marrow contusions are common after an acute anterior cruciate ligament (ACL) injury. It is unknown whether the severity of this initial bruise can predict the potential of developing chondral changes even after ACL reconstructive surgery (ACLR). PURPOSE: To investigate whether the initial bone bruise area could be predictive of progressive chondral defects. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: A retrospective chart review was performed to capture patients with an acute ACL injury with pre- and post-ACLR magnetic resonance imaging (MRI) between January 2000 and December 2017...

PURPOSE: Recent advances in diagnostic imaging techniques and soft tissue endoscopy now allow for precise diagnosis and management of extra-articular hip pathology. The aim of this scoping review is to present an evidence-based update of the relevant literature focussing only on the pathoanatomy, clinical assessment and the diagnosis of pathology in the peritrochanteric space. METHODS: A literature search was performed on PubMed to include articles which reported on the anatomy and diagnosis of greater trochanteric pain syndrome, trochanteric bursitis, gluteus medius tears and external snapping hip syndrome...

PURPOSE: The purposes of our study were to evaluate Achilles tendon loading profiles of various exercises and to develop guidelines to incrementally increase the rate and magnitude of Achilles tendon loading during rehabilitation. METHODS: Eight healthy young adults completed a battery of rehabilitation exercises. During each exercise, we collected three-dimensional motion capture and ground reaction force data to estimate Achilles tendon loading biomechanics. Using these loading estimates, we developed an exercise progression that incrementally increases Achilles tendon loading based on the magnitude, duration, and rate of tendon loading...

No abstract text is available yet for this article.

STUDY DESIGN: Comprehensive review and meta-analysis. BACKGROUND: The recovery in rapid force production measured as the rate of force development (RFD) is not clear after anterior cruciate ligament reconstruction (ACLR). OBJECTIVES: To evaluate (a) time-course change of between-limb asymmetries in isometric knee extension/flexion RFD in individuals post-ACLR and (b) differences in RFD between individuals post-ACLR and healthy controls. METHODS: A literature search of Web of Science, SPORTDiscus, PubMed-MEDLINE, and ScienceDirect identified 10 eligible studies (n = 246) assessing RFD after ACLR...

OBJECTIVES: To: (1) analyze the results of 5 years of preparticipation cardiac screening including 12-lead electrocardiogram (ECG) of National Collegiate Athletic Association (NCAA) Division I athletes; and (2) assess the rates of ECG screening abnormalities and false-positive rates among 3 ECG screening criteria. DESIGN: Retrospective chart review. SETTING: National Collegiate Athletic Association Division I University. PARTICIPANTS: One thousand six hundred eighty-six first-year athletes presenting for their preparticipation examination including 12-lead resting ECG...

No abstract text is available yet for this article.

OBJECTIVE: To compare the effects of conventional (constant load) eccentric training and isokinetic eccentric training on quadriceps muscle mass, strength and functional performance in recreational athletes following anterior cruciate ligament (ACL) reconstruction. METHODS: Thirty recreational male athletes (25 years old) undergoing ACL reconstruction received a standard rehabilitation program. Volunteers were randomized to conventional group (CG; n = 15) or isokinetic group (IG; n = 15) to be engaged in a 6-week (2 sessions/week) quadriceps eccentric training program at the extensor chair or at the isokinetic dynamometer, respectively...

BACKGROUND: Many studies have investigated factors that predict a return to sport participation after anterior cruciate ligament (ACL) reconstruction, but it is unclear whether the same factors are associated with a return to preinjury level of sport performance. PURPOSE: To identify factors that contribute to an athlete's return to preinjury level of performance after ACL reconstruction. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: A cohort of 222 patients (132 male, 90 female) who had ACL reconstruction surgery and completed a 12-month postoperative assessment were followed out to a mean 3 years (range, 2-4 years) to determine whether they had returned to their self-reported preinjury levels of sport performance...

BACKGROUND: The incidence of meniscocapsular junction tears of the medial meniscus posterior horn, known as ramp lesions , is reported to be 9.3% to 23.9%. However, these lesions are not consistently diagnosed with routine arthroscopic exploration and magnetic resonance imaging (MRI). PURPOSE: To determine risk factors associated with ramp lesions in anterior cruciate ligament-injured knees. STUDY DESIGN: Cross-sectional study; Level of evidence, 3...

OBJECTIVE: Examine the comfort and pain experienced with blow flow restriction resistance training (BFR-RT) compared to standard care heavy load resistance training (HL-RT) during anterior cruciate ligament reconstruction (ACLR) patient rehabilitation. DESIGN: Randomised controlled trial. SETTING: United Kingdom National Health Service. PARTICIPANTS: Twenty eight patients undergoing unilateral ACLR surgery with hamstring autograft were recruited...

BACKGROUND: We implemented a blood flow restriction resistance training (BFR-RT) intervention during an 8-week rehabilitation programme in anterior cruciate ligament reconstruction (ACLR) patients within a National Health Service setting. OBJECTIVE: To compare the effectiveness of BFR-RT and standard-care traditional heavy-load resistance training (HL-RT) at improving skeletal muscle hypertrophy and strength, physical function, pain and effusion in ACLR patients following surgery...

Muscle coordination plays an important role in glenohumeral stability. The rotator cuff and the long head of the biceps are considered the primary dynamic stabilizers muscles. However, the fact that a subgroup of patients with a massive tear in the rotator cuff were able to keep a normal function, should make us question this traditional view. We hypothesize that the teres major which is also a monoarticular scapulohumeral muscle, although it is not part of the conjoined tendon of the rotator cuff, can play a role in glenohumeral stability by a direct support of the humeral head generated by the particular posteroanterior location of this muscle under the humeral head and which, as far as we know, has not been written up previously...