September 2019 Primary Care Sports Medicine Journal Roundup

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September 2019 Primary Care Sports Medicine Journal Roundup


The American Journal of Sports Medicine (August 2019, September 2019)

Note: I accidently reviewed August so we get some extra articles this month. Cheers, -John

Ramkumar, P. N., Navarro, S. M., Haeberle, H. S., et al. (2019). Concussion in American Versus European Professional Soccer: A Decade-Long Comparative Analysis of Incidence, Return to Play, Performance, and Longevity. The American Journal of Sports Medicine, 47(10), 2287–2293.

  • This study established the SRC incidence among elite soccer players in 2 international professional leagues and identified major RTP and performance differences between EPL and MLS players.

  • MLS players missed a mean 7.3 games after concussion (37.0 days missed); EPL players missed a mean 0.6 games after concussion!!

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.

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.

  • In animal models...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.

Kise, N. J., Aga, C., Engebretsen, L., et al. (2019). Complex Tears, Extrusion, and Larger Excision Are Prognostic Factors for Worse Outcomes 1 and 2 Years After Arthroscopic Partial Meniscectomy for Degenerative Meniscal Tears: A Secondary Explorative Study of the Surgically Treated Group From the Odense-Oslo Meniscectomy Versus Exercise (OMEX) Trial. The American Journal of Sports Medicine, 47(10), 2402–2411

  • Complex meniscal tears, larger extrusion, cartilage injuries, and larger meniscal excision were significant and clinically relevant prognostic factors for worse outcomes 1 and 2 years after arthroscopic partial meniscectomy. 

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.

Ishøi, L., Thorborg, K., Kraemer, O., et al. (2019). Demographic and Radiographic Factors Associated With Intra-articular Hip Cartilage Injury: A Cross-sectional Study of 1511 Hip Arthroscopy Procedures. The American Journal of Sports Medicine, 47(11), 2617–2625.

  • Several demographic and radiographic factors were associated with moderate to severe hip joint cartilage injury. Most notably, increased cam severity and borderline dysplasia substantially increased the risk of grade 3-4 acetabular and femoral head cartilage injury, respectively, indicating that specific deformity may drive specific cartilage injury patterns in the hip joint.

Jildeh, T. R., Okoroha, K. R., Taylor, K. A., et al. (2019). Effect of Concussions on the Performance of Running Backs and Wide Receivers in the National Football League. The American Journal of Sports Medicine, 47(11), 2717–2722.

  • A high rate of National Football League running backs and wide receivers are able to return to play after a concussion injury. These players were found to perform at a similar level in both the acute and long-term period after concussion.


British Journal of Sports Medicine (September Vol 17, September Vol 18)

Campbell RA, Bradshaw EJ, Ball NB, et alI. njury epidemiology and risk factors in competitive artistic gymnasts: a systematic review. British Journal of Sports Medicine 2019;53:1056-1069.

  • Male gymnasts sustained mostly upper limb injuries, while female gymnast reported lower limb injuries. 

  • Floor was associated with the greatest number of injuries for both male and female gymnasts. 

  • Higher competitive level and exposure to competition were risk factors for gymnastics injury: age, body mass, body size, training duration and life stress were significant associated factors.

Valtonen M, Waris M, Vuorinen T, et al. Common cold in Team Finland during 2018 Winter Olympic Games (PyeongChang): epidemiology, diagnosis including molecular point-of-care testing (POCT) and treatment. British Journal of Sports Medicine 2019;53:1093-1098.

  • The cold was indeed a common illness in Team Finland during the Winter Olympic Games. POCT proved to be clinically valuable, especially for influenza. The aetiology of the common cold was identified in most cases.

  • All subjects with influenza (n=6) and 32 close contacts were treated with oseltamivir

Ross R, Goodpaster BH, Koch LG, et al. Precision exercise medicine: understanding exercise response variability. British Journal of Sports Medicine 2019;53:1141-1153.

  • There are considerable interindividual differences in the response of cardiorespiratory fitness (CRF) and other cardiometabolic traits to a given exercise programme dose. 

  • The authors developed this consensus statement on exercise response variability following a symposium dedicated to this topic.

Burgi CR, Peters S, Ardern CL, et al. Which criteria are used to clear patients to return to sport after primary ACL reconstruction? A scoping review. British Journal of Sports Medicine 2019;53:1154-1161.

  • Time and impairment-based measures dominated RTS criteria, despite sport being a complex physical and biopsychosocial activity with demands across all aspects of function. 

  • Time was included as a criterion in 85% of studies, and over 80% of studies allowed RTS before 9 months. 

  • Whether RTS tests are valid—do they predict successful RTS?—is largely unknown.

Lie MM, Risberg MA, Storheim K, et al. What’s the rate of knee osteoarthritis 10 years after anterior cruciate ligament injury? An updated systematic review. British Journal of Sports Medicine 2019;53:1162-1167.

  • Highly variable- the reported radiographic OA prevalence varied between 0% and 100% >10 years after injury, regardless of follow-up time

Blond MB, Rosenkilde M, Gram AS, et al. How does 6 months of active bike commuting or leisure-time exercise affect insulin sensitivity, cardiorespiratory fitness and intra-abdominal fat? A randomised controlled trial in individuals with overweight and obesity. British Journal of Sports Medicine 2019;53:1183-1192.

  • Active bike commuting improved cardiometabolic health; as did leisure-time exercise. Leisure-time exercise of vigorous intensity conferred more rapid effects on peripheral insulin sensitivity as well as additional effects on cardiorespiratory fitness than did moderate intensity exercise.


Sports Medicine (September 2019)

Pairot-de-Fontenay B, Willy RW, Elias ARC, et al. Running Biomechanics in Individuals with Anterior Cruciate Ligament Reconstruction: A Systematic Review. Sports Med. 2019 Sep;49(9):1411-1424.

  • After ACL-R, knee flexion motion and internal knee extension moment are the most affected variables and are consistently smaller in the injured limb during running when pooling evidence. Clinicians should be aware that these deficits do not appear to resolve with time and, thus, specific clinical interventions may be needed to reduce long-term disability.

Rennerfelt K, Lindorsson S, Brisby H, et al. Effects of Exercise  Compression Stockings on Anterior Muscle Compartment Pressure and Oxygenation During Running: A Randomized Crossover Trial Conducted in Healthy Recreational Runners. Sports Med. 2019 Sep;49(9):1465-1473

  • Wearing exercise CS during and following a 10-km treadmill run elevated IMP and reduced muscle tissue oxygenation in the anterior compartment of healthy runners. Furthermore, the use of exercise CS did not prevent early exercise-induced muscle damage, as measured by serum biomarkers..


Sports Health Journal (September/ October 2019)

Sivakumar, G., Koziarz, A., & Farrokhyar, F. (2019). Vitamin D Supplementation in Military Personnel: A Systematic Review of Randomized Controlled Trials. Sports Health, 11(5), 425–431.

  • There was a positive trend in 25(OH)D concentrations from higher doses of supplementary vitamin D in military submariners and a possible benefit to bone health when vitamin D was combined with calcium.

Vajapey, S., Matic, G., Hartz, C., & Miller, T. L. (2019). Sacral Stress Fractures: A Rare but Curable Cause of Back Pain in Athletes. Sports Health, 11(5), 446–452

McElheny, K., Toresdahl, B., Ling, D., Mages, K., & Asif, I. (2019). Comparative Effectiveness of Alternative Dosing Regimens of Hyaluronic Acid Injections for Knee Osteoarthritis: A Systematic Review. Sports Health, 11(5), 461–466.

  • There are limited head-to-head trials comparing viscosupplementation formulations that differ based on number of injections, and in particular, there is a paucity of trials evaluating single-injection formulations. Based on the currently available data, there appears to be similar efficacy with the possibility for greater cost-effectiveness and less patient inconvenience with single-injection formulations.