March 2019 Primary Care Sports Medicine Journal Roundup
The American Journal of Sports Medicine (March 2019)
Webster, K. E., & Feller, J. A. (2019). Expectations for Return to Preinjury Sport Before and After Anterior Cruciate Ligament Reconstruction. The American Journal of Sports Medicine, 47(3), 578–583. https://doi.org/10.1177/0363546518819454
84% of patients expected to be able to return to their preinjury level of sport.
At 12 months after surgery, 24% of patients who expected to return to their preinjury level of sport had actually returned, and 15% of all patients had already decided to give up sport
MacFarlane, L. A., Yang, H., et al. (2019). Influence of Baseline Magnetic Resonance Imaging Features on Outcome of Arthroscopic Meniscectomy and Physical Therapy Treatment of Meniscal Tears in Osteoarthritis. The American Journal of Sports Medicine, 47(3), 612–619. https://doi.org/10.1177/0363546518819444
Arthroscopy in patients with OA remains controversial
This small study suggests those with less intra-articular damage on MRI may have greater improvement in pain with arthroscopic partial meniscectomy and PT than with PT alone
Porter, M., Shadbolt, B., et al. (2019). Ankle Lateral Ligament Augmentation Versus the Modified Broström-Gould Procedure: A 5-Year Randomized Controlled Trial. The American Journal of Sports Medicine, 47(3), 659–666. https://doi.org/10.1177/0363546518820529
Among physically active patients with chronic lateral ligament instability, primary repair combined with ligament augmentation reconstruction system (LARS) results in better total FAOS at 5-year follow-up and higher Tegner activity scores as compared with the modified Broström-Gould (MBG) procedure.
Zhang, Y., Yu, J., Zhang, J., & Hua, Y. (2019). Simvastatin With PRP Promotes Chondrogenesis of Bone Marrow Stem Cells In Vitro and Wounded Rat Achilles Tendon–Bone Interface Healing In Vivo. The American Journal of Sports Medicine, 47(3), 729–739. https://doi.org/10.1177/0363546518819108
Some simvastatin with your PRP?
The combination of simvastatin with PRP may be a good clinical treatment for wounded tendon/ligament junction healing, especially for acute sports-related tendon/ligament injuries
Hurley, E. T., Lim Fat, D., et al (2019). The Efficacy of Platelet-Rich Plasma and Platelet-Rich Fibrin in Arthroscopic Rotator Cuff Repair: A Meta-analysis of Randomized Controlled Trials. The American Journal of Sports Medicine, 47(3), 753–761. https://doi.org/10.1177/0363546517751397
The current evidence indicates that the use of PRP in rotator cuff repair results in improved healing rates, pain levels, and functional outcomes.
In contrast, PRF has been shown to have no benefit in improving tendon healing rates or functional outcomes.
Strong to moderate evidence indicated that age, height, weight, body mass index (BMI), body fat and Q angle were not risk factors for future PFP
Quadriceps weakness in military recruits and higher hip strength in adolescents were risk factors for PFP
Brunner R, Friesenbichler B, Casartelli NC, et al Effectiveness of multicomponent lower extremity injury prevention programmes in team-sport athletes: an umbrella review. Br J Sports Med 2019;53:282-288.
Lower extremity injury prevention programmes in team sports are effective in preventing lower extremity, knee, ACL and ankle injuries.
Tryfonos A, Green DJ, Dawson EA. Effects of Catheterization on Artery Function and Health: When Should Patients Start Exercising Following Their Coronary Intervention? Sports Med. 2019 Mar;49(3):397-416.
Patients following coronary interventions can start an exercise training programme between 2 and 4 weeks post-percutaneous transluminal coronary angiography (PTCA) and/or percutaneous coronary intervention (PCI; angioplasty)
Bone bruise location patterns indicate that tibial anterior translation relative to the femur was a primary injury mechanism in the majority of ACL injuries selected in this review
Recommendations provided by institutional guidelines appear to be insufficient to support adequate resistance training prescription in the context of cardiovascular disease.
Need more research
Sports Health Journal (March/ April 2019)
Vancolen, S. Y., Nadeem, I., Horner, N. S., Johal, H., Alolabi, B., & Khan, M. (2019). Return to Sport After Ankle Syndesmotic Injury: A Systematic Review. Sports Health, 11(2), 116–122. https://doi.org/10.1177/1941738118816282
This systematic review found a high rate of return to any as well as preinjury level of sport after ankle syndesmotic injury in both operative and nonoperative treatment groups.
Grassi, A., Bailey, J. R., et al. (2019). Return to Sport Activity After Meniscal Allograft Transplantation: At What Level and at What Cost? A Systematic Review and Meta-analysis. Sports Health, 11(2), 123–133. https://doi.org/10.1177/1941738118819723
Physical activity after MAT appears possible, especially for low-impact sports.
However, because of the limited number of studies, their low quality, and the short-term follow-up, the participation recommendation for high-impact and strenuous activities should be considered with caution until high-quality evidence of long-term safety becomes available
Pectoralis major tendon repair is an effective treatment that results in a high rate of return to sport and work, pain relief, and improved cosmetic appearance, albeit with a significant rate of complication
Bowman, E. N., Elshaar, R., et al. (2019). Proximal, Distal, and Contralateral Effects of Blood Flow Restriction Training on the Lower Extremities: A Randomized Controlled Trial. Sports Health, 11(2), 149–156.
Low-load BFR training led to a greater increase in muscle strength and limb circumference. BFR training had similar strengthening effects on both proximal and distal muscle groups.