July 2019 Sports Medicine Journal Roundup
The American Journal of Sports Medicine (July 2019)
Kunze, K. N., Beck, E. C., Nwachukwu, B. U., Ahn, J., & Nho, S. J. (2019). Early Hip Arthroscopy for Femoroacetabular Impingement Syndrome Provides Superior Outcomes When Compared With Delaying Surgical Treatment Beyond 6 Months. The American Journal of Sports Medicine, 47(9), 2038–2044. https://doi.org/10.1177/0363546519837192
Among patients with FAIS, surgical intervention early after the onset of symptoms (3-6 months) was associated with superior postoperative outcomes when compared with patients who underwent surgical intervention beyond this time frame. This information may help guide preoperative decision making regarding delay of surgery. These findings should be confirmed in a prospective study.
Liu, J. N., Gowd, A. K., Garcia, G. H., Manderle, B. J., Beletsky, A., Nicholson, G. P., … Verma, N. N. (2019). Analysis of Return to Sport and Weight Training After Repair of the Pectoralis Major Tendon. The American Journal of Sports Medicine, 47(9), 2151–2157. https://doi.org/10.1177/0363546519851506
Patients undergoing pectoralis major tendon repair should expect significant functional improvements and a low complication rate. Yet, only 50% are able to return to preoperative intensity of sport, and they will also have significant reductions in their ability to weight lift.
Stares, J. J., Dawson, B., Peeling, P., Heasman, J., Rogalski, B., Fahey-Gilmour, J., … Toohey, L. (2019). Subsequent Injury Risk Is Elevated Above Baseline After Return to Play: A 5-Year Prospective Study in Elite Australian Football. The American Journal of Sports Medicine, 47(9), 2225–2231. https://doi.org/10.1177/0363546519852622
Subsequent injury risk was found to be highest in the week of RTP for both time loss injuries (9.4%) and non–time loss injuries (6.9%). Risk decreased with each week survived after RTP; however, it did not return to baseline risk of participation (3.6%).
Lynch, T. S., O’Connor, M., Minkara, A. A., Westermann, R. W., & Rosneck, J. T. (2019). Biomarkers for Femoroacetabular Impingement and Hip Osteoarthritis: A Systematic Review and Meta-analysis. The American Journal of Sports Medicine, 47(9), 2242–2250. https://doi.org/10.1177/0363546518803360
Cartilage oligomeric matrix protein (COMP) and fibronectin-aggrecan complex (FAC) are specific biomarkers with potential utility in the diagnosis and management of FAI and hip OA, given their ability to differentiate between controls and patients with hip lesions. Further research is necessary to identify their ability in determining disease severity, predicting the response to treatment, and establishing an association with the risk of long-term OA.
Sweegers MG, Altenburg TM, Brug J, et al. Effects and moderators of exercise on muscle strength, muscle function and aerobic fitness in patients with cancer: a meta-analysis of individual patient data. British Journal of Sports Medicine 2019;53:812.
Exercise interventions during and following cancer treatment had small effects on upper body muscle strength (UBMS) and lower body muscle strength (LBMS), lower body muscle function (LBMF) and aerobic fitness. Demographic, intervention-related and exercise-related characteristics including age, marital status, intervention timing, delivery mode and frequency and type and time of exercise sessions moderated the exercise effect on UBMS, LBMS and aerobic fitness.
Malhotra A, Dhutia H, Gati S, et al. Emergency response facilities including primary and secondary prevention strategies across 79 professional football clubs in England. British Journal of Sports Medicine 2019;53:813-817.
The majority of football clubs in England have satisfactory prevention strategies and emergency response planning in line with European recommendations. Additional improvements such as increasing awareness of European guidelines for emergency planning, AED training and mentorship with financial support to lower division clubs are necessary to further enhance cardiovascular safety of athletes and spectators and close the gap between the highest and lower divisions.
Naci H, Salcher-Konrad M, Dias S, et al. How does exercise treatment compare with antihypertensive medications? A network meta-analysis of 391 randomised controlled trials assessing exercise and medication effects on systolic blood pressure. British Journal of Sports Medicine 2019;53:859-869
Our findings confirm modest but consistent reductions in SBP in many studied exercise interventions across all populations but individuals receiving medications generally achieved greater reductions than those following structured exercise regimens. Assuming equally reliable estimates, the SBP-lowering effect of exercise among hypertensive populations appears similar to that of commonly used antihypertensive medications. Generalisability of these findings to real-world clinical settings should be further evaluated.
Sports Medicine (July 2019)
Tiller NB. Pulmonary and Respiratory Muscle Function in Response to Marathon and Ultra-Marathon Running: A Review. Sports Med. 2019 Jul;49(7):1031-1041. doi: 10.1007/s40279-019-01105-w. Review. Erratum in: Sports Med. 2019 Jun 17;:. PubMed PMID: 31030408; PubMed Central PMCID: PMC6548745.
Evidence of respiratory muscle fatigue was more prevalent following marathon compared to ultra-marathon, and might be a factor of work rate, and thus exercise ventilation, which is tempered during longer races.
Buckthorpe M. Optimising the Late-Stage Rehabilitation and Return-to-Sport Training and Testing Process After ACL Reconstruction. Sports Med. 2019 Jul;49(7):1043-1058. doi: 10.1007/s40279-019-01102-z. Review. PubMed PMID: 31004279
This narrative review discusses factors that may be highly relevant for RTS training and testing after ACL reconstruction,
(1) explosive neuromuscular performance
(2) movement quality deficits associated with re-injury risk, particularly the need to re-train optimal sport-specific movement patterns
(3) the influence of fatigue
(4) a lack of sport-specific re-training prior to RTS, with particular attention to an insufficient development of chronic training load
Sports Health Journal (July / August 2019)
The psychological readiness of the player is a major factor in successful safe return to sport (SRTS) decision making. Although strength, performance, and functional tests presently form the mainstay of SRTS criteria, there exists very little scientific evidence for their validity. More protection should be provided to athletes with known risk factors. Movement quality is important, if not more important than the quantifiable measures. As a result of the significantly high rerupture rate in young individuals, delayed SRTS should be considered preferably beyond 9 months postsurgery.
LESS analysis of both DVJ landings might improve neuromuscular control screening in female athletes and augment lower extremity and anterior cruciate ligament injury prevention programs.
Johal, H., Khan, M., Yung, S. P., Dhillon, M. S., Fu, F. H., Bedi, A., & Bhandari, M. (2019). Impact of Platelet-Rich Plasma Use on Pain in Orthopaedic Surgery: A Systematic Review and Meta-analysis. Sports Health, 11(4), 355–366. https://doi.org/10.1177/1941738119834972
PRP leads to a reduction in pain; however, evidence for clinically significant efficacy is limited. Available evidence supports the use of PRP in the management of lateral epicondylitis as well as knee osteoarthritis