April 2019 Primary Care Sports Medicine Journal Roundup

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The American Journal of Sports Medicine (April 2019)

Gil, J. A., Gunaseelan, V., et al. (2019). Risk of Prolonged Opioid Use Among Opioid-Naïve Patients After Common Shoulder Arthroscopy Procedures. The American Journal of Sports Medicine, 47(5), 1043–1050.

  • The risk of prolonged opioid use after arthroscopic shoulder procedures is 8.3%, and it is higher among women and among those with greater opioid use in the early postoperative period, mental health conditions, substance dependence and abuse, and preexisting pain disorders

Shanley, E., Thigpen, C., et al (2019). Return to Sport as an Outcome Measure for Shoulder Instability: Surprising Findings in Nonoperative Management in a High School Athlete Population. The American Journal of Sports Medicine, 47(5), 1062–1067.

  • Nonoperatively treated (85%) and operatively treated (72%) athletes successfully returned to the same sport without injury for at least 1 full season (P = .11).

  • Players sustaining a dislocation were significantly more likely to fail to return when compared with those sustaining a subluxation (26% vs 89%, P = .013).

Fitzpatrick, J., Bulsara, M. K., et al. (2019). Leucocyte-Rich Platelet-Rich Plasma Treatment of Gluteus Medius and Minimus Tendinopathy: A Double-Blind Randomized Controlled Trial With 2-Year Follow-up. The American Journal of Sports Medicine, 47(5), 1130–1137

  • Among patients with chronic gluteal tendinopathy and a length of symptoms >15 months, a single intratendinous LR-PRP injection performed under ultrasound guidance results in greater improvement in pain and function than a single CSI.

  • The improvement after LR-PRP injection is sustained at 2 years, whereas the improvement from a CSI is maximal at 6 weeks and not maintained beyond 24 weeks.

British Journal of Sports Medicine (April Volume 7, April Volume 8)

Junge A, Prinz B. Depression and anxiety symptoms in 17 teams of female football players including 10 German first league teams. Br J Sports Med 2019;53:471-477.

  • The CES-D score indicated mild to moderate symptoms of depression in 48 (16.6%) and severe symptoms in 41 (14.1%) players.

  • The GAD-7 score indicated an at least moderate generalised anxiety disorder in 24 (8.3%) players

  • Only a third of the 45 (15.7%) players who stated that they currently wanted or needed psychotherapeutic support received it!!

Corder K, Winpenny E, Love R, et al. Change in physical activity from adolescence to early adulthood: a systematic review and meta-analysis of longitudinal cohort studies. Br J Sports Med 2019;53:496-503.

  • Physical activity declines modestly between adolescence and young adulthood

Roberts SSH, Teo W, Warmington SA. Effects of training and competition on the sleep of elite athletes: a systematic review and meta-analysis. Br J Sports Med 2019;53:513-522.

  • Athletes were often unable to achieve sleep recommendations during training or competition periods.

  • Sleep was impaired the night of competition compared with previous nights.

  • Early morning training, increases in training load, travel departure times, jet lag and altitude can impair athletes’ sleep

Buckthorpe M, Wright S, Bruce-Low S, et al. Recommendations for hamstring injury prevention in elite football: translating research into practice. Br J Sports Med 2019;53:449-456.

Sports Medicine (April 2019)

Heuberger JAAC, Cohen AF. Review of WADA Prohibited Substances: Limited Evidence for Performance-Enhancing Effects. Sports Med. 2019 Apr;49(4):525-539.

  • Only 5 of 23 substance classes show evidence of having the ability to enhance actual sports performance, i.e. anabolic agents, β2-agonists, stimulants, glucocorticoids and β-blockers.

  • One additional class, growth hormone, has similar evidence but only in untrained subjects.

  • The observed effects all relate to strength or sprint performance (and accuracy for β-blockers); there are no studies showing positive effects on reliable markers of endurance performance.

  • For 11 classes, no well-designed studies are available, and, for the remaining six classes, there is evidence of an absence of a positive effect.

Saw AE, McIntosh AS, Kountouris A, Newman P, Gaida JE. Vertebral Artery Dissection in Sport: A Systematic Review. Sports Med. 2019 Apr;49(4):553-564.

  • VAD attributed to sports participation is uncommonly reported and the mechanisms are varied.

  • Impact to the mastoid region is consistently implicated in fatal cases and should be the focus of injury prevention strategies in sport

Tassignon B, Verschueren J, Delahunt E, Smith M, Vicenzino B, Verhagen E, Meeusen R. Criteria-Based Return to Sport Decision-Making Following Lateral Ankle Sprain Injury: a Systematic Review and Narrative Synthesis. Sports Med. 2019 Apr;49(4):601-619.

  • There are currently no published evidence-based criteria to inform RTS decisions for patients with an LAS injury

Sports Health Journal