October 2020 Sports Medicine Journal Roundup
The American Journal of Sports Medicine (October 2020)
- Long-term outcomes of transtibial hamstring tendon graft ACL reconstruction with femoral cortical button fixation are generally good with a low failure rate, low awareness of the operated knee, and good clinical stability.
- Radiographic osteoarthritis was evident in approximately half of the patients at 20-year follow-up and was associated with meniscectomy at index surgery and decreased PROMs at follow-up.
- Meniscal repair in the revision ACL reconstruction setting does not have a high failure rate at 2-year follow-up.
- Failure rates for medial and lateral repairs were both <10% and consistent with success rates of primary ACL reconstruction meniscal repair.
- Medial tears underwent reoperation for failure at a significantly higher rate than lateral tears.
- Arthroscopic Matrix-assisted autologous chondrocyte transplantation (MACT) offered good and long-lasting results that were stable over time and resulted in a limited number of failures and reinterventions for up to 15 years of follow-up.
- Several factors were identified as having a prognostic value: a worse outcome could be expected in older patients, female patients, those affected by lesions with a degenerative cause, those having a longer duration of symptoms, and patients who underwent previous surgery.
- The percentage of players who received osteochondral autograft transplant (OAT) for capitellar osteochondritis dissecans (OCD) in junior high school and continued to play baseball in high school was favorable.
- However, satisfaction with elbow function during throwing was lower in pitchers than in nonpitchers.
- After surgical excision for hook of hamate fractures in professional baseball players, 84% were able to RTS, with 81% returning to the same or higher level.
- The median time for players to RTS after surgery was 48 days.
- Player usage increased after surgery, while hitting efficiency slightly declined.
- Normal saline (NS) injections yielded a statistically significant and clinically meaningful improvement in pain and functional outcomes in patients with lateral epicondylitis.
- New research should focus on better methods to diminish the potential confounders that could lead to this effect because NS injections could mask the real effect of an active therapeutic intervention in RCT.
British Journal of Sports Medicine (Oct 2020 54-19, Oct 2020 54-20)
- Diverse psychological, social and contextual factors are present and influence all stages of recovery following a traumatic sport-related knee injury.
- A better understanding of these factors at the time of injury and throughout rehabilitation could assist with optimising injury management, promoting RTS, and long-term health-related quality-of-life.
- In this cohort of professional football players, surgical stabilisation of isolated unstable syndesmosis injuries (West Point grade ≥IIB) allowed for relatively quick return to play.
- High grade injury (West Point grade III), concomitant cartilage injury and greater age were associated with longer return to play times.
- Interventions using activity trackers improve physical activity levels and mobility among older people compared with control.
- However, the impact of activity tracker interventions on quality of life, and mental health is unknown.
- A higher level of habitual physical activity is associated with a smaller decrease in the level of eGFR and a lower risk of developing chronic kidney disease.
- To date, strong uptake and use can be demonstrated for these studies, while a final contribution to impact requires further time to determine.
Sports Medicine (October 2020)
- OCP use might result in slightly inferior exercise performance on average when compared to naturally menstruating women, although any group-level effect is most likely to be trivial.
- Practically, as effects tended to be trivial and variable across studies, the current evidence does not warrant general guidance on OCP use compared with non-use.
- Therefore, when exercise performance is a priority, an individualised approach might be more appropriate.
- The analysis also indicated that exercise performance was consistent across the OCP cycle.
- The available literature provides evidence for the existence of at least five subtypes in SRC symptomatology, with clear relevance to clinical outcome.
- Systematically embedding the differentiation of SRC subtypes into prognosis, clinical management, and intervention strategies may optimize the recovery from SRC.
- Migraine cluster
- Cognitive–emotional cluster
- Sleep–emotional cluster
- Neurological cluster
- Undefined feelings cluster
Sports Health Journal (September/October 2020)
- Intrinsic factors, previous injury, range of motion (lack or excess), and rotator cuff weakness (isometric and isokinetic) highly increase the risk of future injuries.
- Years of athletic practice, body mass index, sex, age, and level of play seem to have modest influence.
- As for the effect of scapular dysfunction on shoulder injuries, it is still controversial, though these are typically linked.
- Extrinsic factors, field position, condition of practice (match/training), time of season, and training load also have influence on the occurrence of shoulder injuries.
- There was no significant difference in ER after throwing at underloaded weights. The overload condition showed a statistically significant increase of 3.3° in external rotation. The extreme overload condition showed a statistically significant increase in ER of 8.4°. There were no differences in internal rotation for any group.
- A significant increase in shoulder ER was observed immediately after throwing overload weighted balls. This effect increased as the weights of the balls increased.
- The handgrip test and vertical jump were associated with midshaft tibia speed of sound (T-SoS) in boys and girls independent of sport status. These results suggest that physical fitness is associated with bone health in adolescents, particularly boys, and that the relationship between physical fitness and bone may differ depending on sex and athletic status.
- Low intensity hand grip exercises (LI-IHE) seem to lower SBP, DBP, and MAP values in prehypertensive and hypertensive adults. It appears that LI-IHE reduces, in greater magnitude, blood pressure levels in hypertensive patients, specifically in patients aged <45 years, those who are overweight, and those on medications.
- Substantial heterogeneity in the main results and in the analyses by subgroups generated uncertainty about the real reduction magnitude that LI-IHE can produce on blood pressure.
