June 2019 Primary Care Sports Medicine Journal Roundup
The American Journal of Sports Medicine (June 2019)
Ekås, G. R., Laane, M. M., Larmo, A., et al. (2019). Knee Pathology in Young Adults After Pediatric Anterior Cruciate Ligament Injury: A Prospective Case Series of 47 Patients With a Mean 9.5-Year Follow-up. The American Journal of Sports Medicine, 47(7), 1557–1566.
The incidence of new meniscal tears after pediatric ACL injury was 34% during a mean follow-up period of 9.5 years.
At final follow-up, 27 patients (57%) had normal menisci, and none had developed knee osteoarthritis.
Primary active rehabilitation, close follow-up, and delayed surgery if needed may be a viable and safe treatment option for some pediatric ACL injuries.
Perkins, C. A., Busch, M. T., Christino, M., et al. (2019). Allograft Augmentation of Hamstring Anterior Cruciate Ligament Autografts Is Associated With Increased Graft Failure in Children and Adolescents. The American Journal of Sports Medicine, 47(7), 1576–1582.
Supplementing allograft is bad mmmkayyyy
ACL reconstruction with hamstring tendon autografts augmented with allografts has a significantly increased risk of graft rupture compared with comparably sized hamstring tendon autografts. In situations where the surgeon harvests an inadequately sized 4-strand autograft, we recommend obtaining a larger graft diameter by tripling the semitendinosus rather than augmenting with an allograft.
Hagmeijer, M. H., Hevesi, M., Desai, V. S., et al. (2019). Secondary Meniscal Tears in Patients With Anterior Cruciate Ligament Injury: Relationship Among Operative Management, Osteoarthritis, and Arthroplasty at 18-Year Mean Follow-up. The American Journal of Sports Medicine, 47(7), 1583–1590.
This one hits too close to home
Secondary meniscal tears after ACL injury are most common among patients undergoing delayed surgical or nonoperative treatment of their primary ACL injuries. Secondary tears often present as complex tears of the medial meniscus and result in high rates of partial meniscectomy.
Scott, A., LaPrade, R. F., Harmon, K. G.,et al. (2019). Platelet-Rich Plasma for Patellar Tendinopathy: A Randomized Controlled Trial of Leukocyte-Rich PRP or Leukocyte-Poor PRP Versus Saline. The American Journal of Sports Medicine, 47(7), 1654–1661.
Not a good look for the regenerative medicine crowd
Combined with an exercise-based rehabilitation program, a single injection of LR-PRP or LP-PRP was no more effective than saline for the improvement of patellar tendinopathy symptoms.
Kim, Y.-S., Jin, H.-K., Lee, H.-J., et al. (2019). Is It Safe to Inject Corticosteroids Into the Glenohumeral Joint After Arthroscopic Rotator Cuff Repair? The American Journal of Sports Medicine, 47(7), 1694–1700.
Intra-articular injection of corticosteroids after rotator cuff repair does not increase the risk of retears and is thus an effective and safe treatment method for increasing ROM (forward flexion, external rotation) and improving clinical score (ASES) during the early postoperative period of patients undergoing rotator cuff repair.
McPherson, A. L., Nagai, T., Webster, K. E., & et al. (2019). Musculoskeletal Injury Risk After Sport-Related Concussion: A Systematic Review and Meta-analysis. The American Journal of Sports Medicine, 47(7), 1754–1762.
Based on the evidence of higher risk of MSK injuries after concussion, standard clinical assessments for athletes with concussion should include not only physical symptoms and cognitive function before return to sport but also neuromuscular risk factors associated with increased risk for MSK injuries.
Gouttebarge V, Castaldelli-Maia JM, Gorczynski P, et al. Occurrence of mental health symptoms and disorders in current and former elite athletes: a systematic review and meta-analysis. British Journal of Sports Medicine 2019;53:700-706.
Our meta-analyses showed that the prevalence of mental health symptoms and disorders ranged from 19% for alcohol misuse to 34% for anxiety/depression for current elite athletes, and from 16% for distress to 26% for anxiety/depression for former elite athletes.
Kroshus E, Wagner J, Wyrick D, et al. Wake up call for collegiate athlete sleep: narrative review and consensus recommendations from the NCAA Interassociation Task Force on Sleep and Wellness. British Journal of Sports Medicine 2019;53:731-736.
The authors provide a narrative review of four topics central to collegiate athlete sleep: (1) sleep patterns and disorders among collegiate athletes; (2) sleep and optimal functioning among athletes; (3) screening, tracking and assessment of athlete sleep; and (4) interventions to improve sleep.
McDuff D, Stull T, Castaldelli-Maia JM, et al. Recreational and ergogenic substance use and substance use disorders in elite athletes: a narrative review. British Journal of Sports Medicine 2019;53:754-760.
Substance use in elite athletes varies by country, ethnicity, gender, sport and competitive level. There are no studies on substance use disorder prevalence in elite male and female athletes and few studies with direct comparison groups.
Sports Medicine (June 2019)
Wilke J, Giesche F, Klier K, et al. Acute Effects of Resistance Exercise on Cognitive Function in Healthy Adults: A Systematic Review with Multilevel Meta-Analysis. Sports Med. 2019 Jun;49(6):905-916. Doi: 10.1007/s40279-019-01085-x. Review. PubMed PMID: 30838520.
Resistance exercise appears to be an appropriate method to immediately enhance cognitive function in healthy adults.
Further studies clearly elucidating the impact of effect modifiers such as age, training intensity, or training duration are warranted.
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.