February 2021 Sports Medicine Journal Roundup
This month, we review all of February’s Sports Medicine Journals all in one place here on the sports medicine review.
THE AMERICAN JOURNAL OF SPORTS MEDICINE (Feb 2021)
- The incidence of posterior shoulder instability (1.84 per 1000 person-years) among US military personnel is higher than previously reported in the general US population, with a majority of cases due to subluxation.
- This increased incidence is likely reflective of a young and highly active population along with improvements in awareness and diagnosis of posterior instability in recent years.
- ACL reconstructive surgery in talented youth soccer players offers them the opportunity to become elite players as seniors and permits an activity level on a par with that of their uninjured peers.
- However, almost 1 in 4 requires further ACL surgery, so the players’ future knee health should be considered when deciding on a return to play.
- Osteochondral allograft (OCA) transplant was associated with significant clinical improvement and durability at mid- to long-term follow-up, with 5- and 10-year survival rates of 86.2% and 81.8%, respectively.
- Maintenance of clinically significant outcomes (CSOs) can be expected in the majority of patients at a mean of 7.7 years after OCA transplant.
- Although the reoperation rate was high (39.4%) and could have adversely affected chances of maintaining minimal clinically important difference (MCID), most patients did not have failure at long-term follow-up.
Park Y-B, Kim J-H, Ha C-W, Lee D-H. Clinical Efficacy of Platelet-Rich Plasma Injection and Its Association With Growth Factors in the Treatment of Mild to Moderate Knee Osteoarthritis: A Randomized Double-Blind Controlled Clinical Trial As Compared With Hyaluronic Acid. The American Journal of Sports Medicine. 2021;49(2):487-496.
- PRP had better clinical efficacy than HA.
- High concentrations of growth factors were observed in patients who scored above the MCID for clinical outcomes in the PRP group.
- These findings indicate that concentration of growth factors needs to be taken into consideration for future investigations of PRP in knee osteoarthritis.
- There has been statistically nonsignificant evidence to suggest that PRP injection ± PT reduced mean time to RTP or reinjury rates compared to no treatment or PT alone for hamstring injuries in a short-term follow-up.
- The complication profiles were favorable.
- Further studies of high quality and large cohorts are needed to better support or disprove the consensus of the systematic review and meta-analysis.
BRITISH JOURNAL OF SPORTS MEDICINE (Feb 2021)
- A single SRC had minimal associations with grey matter structure across a 6-month time frame.
- From 2008 to 2018, 180 injuries were reported in a total of 2102 gymnasts with injury incidence of 85.6 per 1000 gymnasts
- The most common injury site was at the ankle (16.7 per 1000 gymnasts, 95% CI 10.9 to 22.4), and muscle strain/rupture/tear was the most common type of injury (28.5 per 1000 gymnasts, 95% CI 21.2 to 35.9)
- The most common cause was contact with surface (56.1 per 1000 gymnasts, 95% CI 46.1 to 66.2), and the event where most injuries were sustained was the vault (21.9 per 1000 gymnasts, 95% CI 15.4 to 28.4)
SPORTS MEDICINE (Feb 2021)
- Only one meta-analysis showed good quality, in which HDL-C levels increased by 3.09 mg/dl in healthy adults and patients at high cardiovascular risk who practiced yoga.
- The rest had high RoB. Therefore, new systematic reviews with low RoB are needed to apply the results to clinical practice.
- Current evidence supports the use of no-nose saddles as a mean to reduce the negative impact of cycling on the perineum in healthy males at the cost of worse stability and increase of posterior seat pressure.
- Standing on the pedals every ten minutes might be an effective and potentially widely applicable strategy.
- The use of a recumbent bike appears to protect the perineum, but several concerns prevent its widespread use.
Runacres, Adam, Kelly A. Mackintosh, and Melitta A. McNarry. “Health Consequences of an Elite Sporting Career: Long-Term Detriment or Long-Term Gain? A Meta-Analysis of 165,000 Former Athletes.” Sports Medicine (2020): 1-13.
- Overall, athletes live longer and have a reduced incidence of both CVD and cancer mortality compared to the general population, refuting the ‘J’ shape hypothesis.
- However, different health risks may be apparent according to sports classification, and between sexes, warranting further investigation.
SPORTS HEALTH JOURNAL (JAN/FEB 2021)
- There was no statistical difference in nonoperative success rates between the braced and nonbraced athletes (P = 0.33). Braced athletes (n = 20) returned to play 80% of the time, while nonbraced athletes (n = 77) returned at a rate of 88%. Of the braced athletes, 85% were football players (n = 17). A football-only comparison demonstrated no difference between braced failures (26%) and nonbraced failures (16%) (P = 0.47).
- In adolescent athletes with shoulder instability treated nonoperatively, functional bracing did not result in increased success rates when compared with no bracing.
- The special test combination of the bear hug and belly press demonstrated the highest positive likelihood ratio (18.29). Overall, 3 special test combinations in series demonstrated a significant impact on posttest probabilities.
- With parallel testing, the combination of bear hug and belly press had the highest sensitivity (84%) and lowest calculated negative likelihood ratio (0.21).
- Running with RFS imposed higher biomechanical loads on overall ground impact and knee and patellofemoral joints, whereas FFS imposed higher biomechanical loads on the ankle joint and Achilles tendon.
- The modification of strike techniques may affect the specific biomechanical loads experienced on relevant structures or tissues during running.
- In patients with PFP who have inflexible hamstrings, dynamic hamstring stretching with strengthening exercises was superior for improving muscle activation time and clinical outcomes compared with static hamstring stretching with strengthening exercises.