May 2019 Primary Care Sports Medicine Journal Roundup
The American Journal of Sports Medicine (May 2019)
Loughran, G. J., Vulpis, C. T., Murphy, et al (2019). Incidence of Knee Injuries on Artificial Turf Versus Natural Grass in National Collegiate Athletic Association American Football: 2004-2005 Through 2013-2014 Seasons. The American Journal of Sports Medicine, 47(6), 1294–1301. https://doi.org/10.1177/0363546519833925
Artificial turf is an important risk factor for specific knee ligament injuries in NCAA football.
Injury rates for PCL tears were significantly increased during competitions played on artificial turf as compared with natural grass.
Lower NCAA divisions (II and III) also showed higher rates of ACL injuries during competitions on artificial turf versus natural grass.
Hott, A., Brox, J. I., Pripp, A. H., Jet al (2019). Effectiveness of Isolated Hip Exercise, Knee Exercise, or Free Physical Activity for Patellofemoral Pain: A Randomized Controlled Trial. The American Journal of Sports Medicine, 47(6), 1312–1322. https://doi.org/10.1177/0363546519830644
The authors found no difference in short-term effectiveness in combining patient education with knee-focused exercise, hip-focused exercise, or free training for patients with PFP
Trinh, T. Q., Naimark, M. B., Bedi, A., et al (2019). Clinical Outcomes After Anterior Shoulder Stabilization in Overhead Athletes: An Analysis of the MOON Shoulder Instability Consortium. The American Journal of Sports Medicine, 47(6), 1404–1410. https://doi.org/10.1177/0363546519837666
Primary arthroscopic anterior shoulder stabilization in overhead athletes is associated with a low rate of recurrent stabilization surgery.
Return to overhead athletics at short-term follow-up is lower than that previously reported for the general athletic population.
Chen, A. W., Craig, M. J., Yuen, L. C., et al (2019). Five-Year Outcomes and Return to Sport of Runners Undergoing Hip Arthroscopy for Labral Tears With or Without Femoroacetabular Impingement. The American Journal of Sports Medicine, 47(6), 1459–1466. https://doi.org/10.1177/0363546519836429
Hip arthroscopy for all levels of runners is associated with a significant increase in PROs and a low risk of complications.
The rate of return to running is moderately high after hip arthroscopy at midterm follow-up.
Hip arthroscopy may be considered for runners presenting with symptoms of femoroacetabular impingement that fail nonoperative treatments.
Abdul-Rassoul, H., Galvin, J. W., Curry, E. J., et al (2019). Return to Sport After Surgical Treatment for Anterior Shoulder Instability: A Systematic Review. The American Journal of Sports Medicine, 47(6), 1507–1515. https://doi.org/10.1177/0363546518780934
Of the pooled data, patients who underwent arthroscopic Bankart showed the highest rate of RTS, while patients who underwent open Latarjet showed the shortest time to RTS.
Return to preinjury level was highest in the arthroscopic Bankart group and lowest in the arthroscopic Latarjet group.
Physicians can utilize these data to set expectations for their patient-athletes regarding RTS after anterior shoulder stabilization procedures.
Ackerman KE, Holtzman B, Cooper KM, et alLow energy availability surrogates correlate with health and performance consequences of Relative Energy Deficiency in Sport. British Journal of Sports Medicine 2019;53:628-633.
low energy availability measured using self-report questionnaires is strongly associated with many health and performance consequences proposed by the relative energy deficiency in sport
Viana RB, Naves JPA, Coswig VS, et alIs interval training the magic bullet for fat loss? A systematic review and meta-analysis comparing moderate-intensity continuous training with high-intensity interval training (HIIT). British Journal of Sports Medicine 2019;53:655-664.
High intensity interval training and moderate intensity continuous training both resulted in reduced body fat percentage.
Interval training provided 28.5% greater reductions in total absolutely fat mass (kg)
Rhon DI, Greenlee TA, Marchant BG, et al. Comorbidities in the first 2 years after arthroscopic hip surgery: substantial increases in mental health disorders, chronic pain, substance abuse and cardiometabolic conditions. British Journal of Sports Medicine 2019;53:547-553.
Major (potentially ‘hidden’) clinical comorbidities increased substantially after elective arthroscopic hip surgery when compared with preoperative status.
Cases of mental health disorders rose 84%, chronic pain diagnoses increased 166%, substance abuse disorders rose 57%, cardiovascular disorders rose by 71%, metabolic syndrome cases rose 85.9%, systemic arthropathy rose 132% and sleep disorders rose 111%
These comorbidities appear to have been overlooked in major studies evaluating the benefits and risks of arthroscopic hip surgery.
Sports Medicine (May 2019)
Trexler ET, Persky AM, Ryan ED, et al. Acute Effects of Citrulline Supplementation on High-Intensity Strength and Power Performance: A Systematic Review and Meta-Analysis. Sports Med. 2019 May;49(5):707-718. doi: 10.1007/s40279-019-01091-z. Review. PubMed
The effect size was small (0.20), and confidence intervals for each individual study crossed the line of null effect
The results may be relevant to high-level athletes, in which competitive outcomes are decided by small margins
Goh SL, Persson MSM, Stocks J, et al. Relative Efficacy of Different Exercises for Pain, Function, Performance and Quality of Life in Knee and Hip Osteoarthritis: Systematic Review and Network Meta-Analysis. Sports Med. 2019 May;49(5):743-761. Doi: 10.1007/s40279-019-01082-0.
Aerobic or mind–body exercise may be the best for pain and function improvements.
Strengthening and flexibility/skill exercises may be used for multiple outcomes.
Mixed exercise is the least effective and the reason for this merits further investigation.
Sports Health Journal (May/ June 2019)
Gohal, C., Shamshoon, S., Memon, M., et al. (2019). Health-Related Quality of Life After Hip Arthroscopy for Femoroacetabular Impingement: A Systematic Review and Meta-analysis. Sports Health, 11(3), 209–217. https://doi.org/10.1177/1941738119838799
Hip arthroscopy can lead to significant improvement in generic and hip-specific health-related quality of life outcomes at 12 to 24 months postoperatively in patients with FAI who do not have advanced hip osteoarthritis.
Emamvirdi, M., Letafatkar, A., & Khaleghi Tazji, M. (2019). The Effect of Valgus Control Instruction Exercises on Pain, Strength, and Functionality in Active Females With Patellofemoral Pain Syndrome. Sports Health, 11(3), 223–237. https://doi.org/10.1177/1941738119837622
There was a significant difference before and after implementation of the valgus control instruction program with regard to pain (49.18% ↓, P = 0.000), single-leg hop test (24.62% ↑, P = 0.000), triple-hop test (23.75% ↑, P = 0.000), crossover hop test (12.88% ↑, P = 0.000), single-leg 6-m timed hop test (7.43% ↓, P = 0.000), knee dynamic valgus angle (59.48% ↓, P = 0.000), peak abductor to adductor eccentric torque ratio (14.60% ↑, P = 0.000), peak external (59.73% ↑, P = 0.023) and internal rotator (15.45% ↑, P = 0.028) eccentric torques, and the ratio of peak external to internal rotator eccentric torque (40.90% ↑, P = 0.000) (P < 0.05).
Patellofemoral pain syndrome rehabilitation and prevention programs should consider valgus control instruction exercises to decrease pain, improve strength, and increase athletes’ functional performance.
Geldenhuys, A. G., Swart, J., & Bosch, A. (2019). Investigation of the Impact of Below-Knee Compression Garments on Markers of Exercise-Induced Muscle Damage and Performance in Endurance Runners: A Prospective Randomized Controlled Trial. Sports Health, 11(3), 254–264. https://doi.org/10.1177/1941738119837644
There are limited indications of a beneficial impact of compression garments with improvements in ankle circumference measurements.
No ergogenic impact was detected.