March 2021 SPORTS MEDICINE JOURNAL ROUNDUP
This month, we review all of March’s Sports Medicine Journals all in one place here on the sports medicine review.
Oudelaar BW, et al. Efficacy of Adjuvant Application of Platelet-Rich Plasma After Needle Aspiration of Calcific Deposits for the Treatment of Rotator Cuff Calcific Tendinitis: A Double-Blinded, Randomized Controlled Trial With 2-Year Follow-up. The American Journal of Sports Medicine. 2021;49(4):873-882.
- Needle aspiration of calcific deposits (NACD) +PRP resulted in worse clinical scores at the 6-week follow-up but better clinical scores at the 6-month follow-up compared with NACD +corticosteroids.
- At the 1- and 2-year follow-ups, the results were comparable between groups.
- Furthermore, PRP seemed to reduce the need for additional treatments but was associated with more complications.
- In conclusion, NACD +corticosteroids had a favorable early effect on pain and function combined with low comorbidity. Thus, it remains the treatment of choice for patients with RCCT.
- There was a statistically significant reduction in apprehension after patellofemoral stabilization in the majority of patients.
- Patients graded their apprehension symptoms significantly higher in both quantity and quality than the surgeon. Persistent patellar apprehension after stabilization was correlated with lower quality-of-life scores.
- No relationship could be found between persistent apprehension and patellofemoral risk factors.
- These results suggest that use of the apprehension tests as an outcome is inappropriate until further validation is performed.
Rugg CM, et al. Early Sport Specialization Among Former National Collegiate Athletic Association Athletes: Trends, Scholarship Attainment, Injury, and Attrition. The American Journal of Sports Medicine. 2021;49(4):1049-1058.
- Less than one-fifth of NCAA athletes surveyed specialized before age 15 years, and neither scholarship attainment nor time-loss injury rate was affected by early specialization.
- Early specialization is on the rise but is associated with increased burnout.
Milandri G, et al. A Randomized Controlled Trial of Eccentric Versus Concentric Cycling for Anterior Cruciate Ligament Reconstruction Rehabilitation. The American Journal of Sports Medicine. 2021;49(3):626-636.
- For rehabilitation after ACLR, progressive eccentric cycle training was not more clinically effective than concentric training at a matched perceived intensity dose in male patients.
- This can guide exercise prescription for reducing gait and strength deviations of these patients.
Maldonado DR, et al. Outcomes of Open and Endoscopic Repairs of Chronic Partial- and Full-Thickness Proximal Hamstring Tendon Tears: A Multicenter Study With Minimum 2-Year Follow-up. The American Journal of Sports Medicine. 2021;49(3):721-728.
- Patients who underwent open and endoscopic repairs for chronic partial- and full-thickness proximal hamstring tendon tears reported high PROs and satisfaction at a minimum 2-year follow-up with low rates of complications.
- Despite the frequent occurrence of radiographic changes, long-term functional outcome after Rockwood I and II acromioclavicular joint injuries is good, with only clinically nonrelevant functional differences between the injured and contralateral shoulders.
Figure 1. Return to play following the covid pandemic (courtesy of BJSM)
Figure 2. Exercise is Medicine: Staying active during the covid-19 pandemic (courtesy of BJSM)
Van Der Vlist, Arco C., et al. “Which treatment is most effective for patients with Achilles tendinopathy? A living systematic review with network meta-analysis of 29 randomised controlled trials.” British journal of sports medicine 55.5 (2021): 249-256.
- For midportion Achilles tendinopathy, wait-and-see is not recommended as all active treatments seemed superior at 3-month follow-up.
- There seems to be no clinically relevant difference in effectiveness between different active treatments at either 3-month or 12-month follow-up.
- As exercise therapy is easy to prescribe, can be of low cost and has few harms, clinicians could consider starting treatment with a calf-muscle exercise program.
Gazendam, Aaron, et al. “Intra-articular saline injection is as effective as corticosteroids, platelet-rich plasma and hyaluronic acid for hip osteoarthritis pain: a systematic review and network meta-analysis of randomised controlled trials.” British Journal of Sports Medicine 55.5 (2021): 256-261.
- Evidence suggests that IA hip saline injections performed as well as all other injectable options in the management of hip pain and functional outcomes.
Hutson, Mark J., et al. “Effects of low energy availability on bone health in endurance athletes and high-impact exercise as a potential countermeasure: a narrative review.” Sports Medicine (2020): 1-13.
Castellanos, Joel, et al. “Predicting risk of sport-related concussion in collegiate athletes and military cadets: a machine learning approach using baseline data from the CARE Consortium Study.” Sports medicine (2020): 1-13.
- This predictive model using only baseline data identified athletes and cadets who would go on to sustain sport-related concussion with comparable accuracy to many existing concussion assessment tools for identifying concussion.
- Furthermore, this study provides insight into potential concussion risk and protective factors.
Conley, Caitlin EW, et al. “A Comparison of Neuromuscular Electrical Stimulation Parameters for Postoperative Quadriceps Strength in Patients After Knee Surgery: A Systematic Review.” Sports Health 13.2 (2021): 116-127.
- Because of inconsistent evidence among studies, grade B evidence exists to support the use of NMES to aid in the recovery of quadriceps strength after knee surgery.
- Based on the parameters utilized by studies demonstrating optimal treatment effects, it is recommended to implement NMES treatment during the first 2 postoperative weeks at a frequency of ≥50 Hz, at maximum tolerable intensity, with a biphasic current, with large electrodes and a duty cycle ratio of 1:2 to 1:3 (2- to 3-second ramp).
- A 15-year-old male patient volunteered for an 8-week intervention where he performed 30 minutes of treadmill walking, 3 times per week, while wearing a custom-designed knee brace that provided resistance to the thigh muscles of his ACLR leg.
- A full 8 weeks of FRT that targeted both quadriceps and hamstring muscles lead to improvements in strength and gait, suggesting that FRT may constitute a promising and practical alternative to traditional methods of resistance training.
- Myocarditis is a known cause of sudden cardiac death in athletes.
- The currently reported rates of cardiac involvement of COVID-19 makes myocarditis a risk, and physicians who clear athletes for participation in sport as well as sideline personnel should be versed with the diagnosis, management, and clearance of athletes with suspected myocarditis.
- Given the potentially increased risk of arrhythmias, sideline personnel should practice their emergency action plans and be comfortable using an automated external defibrillator.
- Read More: https://wikism.org/Physical_Exam_Hip