August 2019 Sports Medicine Journal Roundup

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The American Journal of Sports Medicine (Aug 2019)

Pfaller, A. Y., Brooks, M. A., Hetzel, S., & McGuine, T. A. (2019). Effect of a New Rule Limiting Full Contact Practice on the Incidence of Sport-Related Concussion in High School Football Players. The American Journal of Sports Medicine, 47(10), 2294–2299.

  • The rate of SRC sustained in high school football practice decreased by 57% after a rule change limiting the amount and duration of full-contact activities, with no change in competition concussion rate. Limitations on contact during high school football practice may be one effective measure to reduce the incidence of SRC.

Chouhan, D. K., Dhillon, M. S., Patel, S., Bansal, T., Bhatia, A., & Kanwat, H. (2019). Multiple Platelet-Rich Plasma Injections Versus Single Platelet-Rich Plasma Injection in Early Osteoarthritis of the Knee: An Experimental Study in a Guinea Pig Model of Early Knee Osteoarthritis. The American Journal of Sports Medicine, 47(10), 2300–2307.

  • Both single and multiple injections of PRP exert similar anti-inflammatory effects on the synovium in the short term. However, this effect is sustained in the long term only for multiple injections. 

  • Multiple injections of PRP exert a chondroprotective effect, but only in the short term. This effect is not seen with a single injection of PRP.

Lizaur-Utrilla, A., Miralles-Muñoz, F. A., Gonzalez-Parreño, S., & Lopez-Prats, F. A. (2019). Outcomes and Patient Satisfaction With Arthroscopic Partial Meniscectomy for Degenerative and Traumatic Tears in Middle-Aged Patients With No or Mild Osteoarthritis. The American Journal of Sports Medicine, 47(10), 2412–2419.

  • There were no meaningful differences in patient satisfaction or clinical outcomes between patients with traumatic and degenerative tears and no or mild OA. Predictors of dissatisfaction with APM were female sex, obesity, and lateral meniscal tears. Our findings suggested that APM was an effective medium-term option to relieve pain and recover function in middle-aged patients with degenerative meniscal tears, without obvious OA, and with failed prior physical therapy.

British Journal of Sports Medicine (Aug Vol 15, Aug Vol 16)

Bricca A, Juhl CB, Steultjens M, et al Impact of exercise on articular cartilage in people at risk of, or with established, knee osteoarthritis: a systematic review of randomised controlled trials. British Journal of Sports Medicine 2019;53:940-947.

  • Knee joint loading exercise seems to not be harmful for articular cartilage in people at increased risk of, or with, knee OA. However, the quality of evidence was low, including some interventions studying activities considered outside the therapeutic loading spectrum to promote cartilage health.

Lubberts B, D’Hooghe P, Bengtsson H, et al. Epidemiology and return to play following isolated syndesmotic injuries of the ankle: a prospective cohort study of 3677 male professional footballers in the UEFA Elite Club Injury Study. British Journal of Sports Medicine 2019;53:959-964.

  • The incidence of isolated syndesmotic injuries in elite professional European football annually increased between 2001 and 2016. 

  • Isolated syndesmotic injury incidence was 0.05 injuries per 1000 hours of exposure (95% CI 0.04 to 0.06) or one injury per team every three seasons. 

  • The injury incidence during match play was 13 times higher compared with during training

Montalvo AM, Schneider DK, Yut L, et al. “What’s my risk of sustaining an ACL injury while playing sports?” A systematic review with meta-analysis. British Journal of Sports Medicine 2019;53:1003-1012.

  • One in 29 female athletes and 1 in 50 male athletes ruptured their ACL in a window that spanned from 1 season to 25 years. 

  • The incidence rate (IR) of ACL injury among female athletes in a season was 1.7 times higher than the IR of ACL injury among male athletes 

  • Incidence proportion (IP) of ACL injury among female athletes was 1.5 times higher than the IP of ACL injury among male athletes. 

Sports Medicine (Aug 2019)

Grandou C, Wallace L, Fullagar HHK. The Effects of Sleep Loss on Military Physical Performance. Sports Med. 2019 Aug;49(8):1159-1172. Doi: 10.1007/s40279-019-01123-8. Review. PubMed PMID: 31102110.

  • Sleep loss appears to have the greatest negative impact on aerobic capacity, muscular endurance and military-specific performance in military populations.

  • However, due to the limited evidence and inter-individual variability in results there is no clear consensus on the specific volume of sleep loss that induces significant or meaningful performance decrements.

Knapik JJ, Hoedebecke BL, Rogers GG. Effectiveness of Mouthguards for the Prevention of Orofacial Injuries and Concussions in Sports: Systematic Review and Meta-Analysis. Sports Med. 2019 Aug;49(8):1217-1232. Doi: 10.1007/s40279-019-01121-w. Review. PubMed PMID: 31148073.

  • The use of MGs reduced the overall risk of orofacial injuries in 12 cohort trials (summary RR [nonusers/users] = 2.33, 95% CI 1.59-3.44), and 11 trials involving self-report questionnaires (summary RR [nonusers/users] = 2.32, 95% CI 1.04-5.13). 

  • The influence of MGs on concussion incidence in five cohort studies was modest (summary RR [nonusers/users] = 1.25, 95% CI 0.90-1.74).

Andersen MP, Valeri L, Starkopf L. The Mediating Effect of Pupils' Physical Fitness on the Relationship Between Family Socioeconomic Status and Academic Achievement in a Danish School Cohort. Sports Med. 2019 Aug;49(8):1291-1301. doi: 10.1007/s40279-019-01117-6. PubMed PMID: 31111445.

  • Pupils' physical fitness partially mediated the pathway between family socioeconomic status and academic achievement.

Burn NL, Weston M, Maguire N. Effects of Workplace-Based Physical Activity Interventions on Cardiorespiratory Fitness: A Systematic Review and Meta-Analysis of Controlled Trials. Sports Med. 2019 Aug;49(8):1255-1274. doi: 10.1007/s40279-019-01125-6. Review. PubMed PMID: 31115827.

  • Workplace-based physical activity interventions consisting of at least moderate-intensity activity improve cardiorespiratory fitness. 

  • At the present time, we surmise that no single group of employees (e.g. older employees or less fit individuals) can be definitively identified as standing to benefit more from workplace physical activity interventions than others. 

Sports Health Journal (July / August 2019)

Kaplan, Y., & Witvrouw, E. (2019). When Is It Safe to Return to Sport After ACL Reconstruction? Reviewing the Criteria. Sports Health, 11(4), 301–305.

  • 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.

Scarborough, D. M., Linderman, S. E., Cohen, V. A., Berkson, E. M., Eckert, M. M., & Oh, L. S. (2019). Neuromuscular Control of Vertical Jumps in Female Adolescents. Sports Health, 11(4), 343–349. 

  • 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.

  • 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