Sports Injuries and Prevention

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Sports Injuries and Prevention

Knee

NEWS:

High School Knee Injuries By Sport And Gender "The knee was the second most frequently injured body site overall, with boys' football and wrestling and girls' soccer and basketball recording the highest rates of knee injury. The most common knee injuries were incomplete ligament tears, contusions, complete ligament tears, torn cartilage, fractures/dislocations and muscle tears."

Knee Injuries Main Cause of HS Sports Surgeries “Knee injuries are the most common reason for high school sports-related surgeries, say researchers who analyzed data on nine high school sports at 100 U.S. high schools. The sports included were boys' football, soccer, basketball, baseball and wrestling, and girls' soccer, volleyball, basketball and softball. … Comstock and colleagues identified a number of differences between males and females. Boys had a higher overall rate of knee injury, but girls' knee injuries were more severe. Girls were more likely to miss more than three weeks of sports activity after a knee injury (compared to less than one week for boys) and were twice as likely to require surgery.“

ARTICLES:

Magnetic Resonance Imaging of Sports Injuries of the Knee

Patellar Injury and Dislocation

JOURNAL ARTICLES:

Anterior knee pain. (Eur J Radiol. 2007 )

Chronic multiple knee ligament injuries: epidemiological analysis of more than one hundred cases. (Clinics. 2008)

Common Lower Limb Sport-related Overuse Injuries in Young Athletes. (Ann Acad Med Singapore. 2008) "The knee joint was the commonest affected joint while the hip was the least affected joint. The mean age at diagnosis was younger in female compared to male for all conditions except in Sinding-Larson Johansson syndrome. Female was diagnosed at a mean age of 11.7 years while male at 10.8 years. Osgood-Schlatter disease was the commonest among the overuse injuries. There was no discernible racial predilection for these conditions except in the patients with anterior superior iliac spine avulsion. Conclusions: Overuse injuries are not uncommon in children and adolescent. An adequate understanding of the anatomy of the sports the children participated in as well as the anatomical differences between adult and children may assist the primary care providers better meet parents' and coaches' expectations."

Complications common after knee cartilage implant “More than one out of every six patients who have an implant of their own tissue to treat a knee cartilage defect will require repeat surgery, according to a new report on 309 patients treated with the procedure. The surgery, known as autologous chondrocyte implantation (ACI), involves an initial surgery to remove cartilage cells from the knee, which are grown in the lab and then, in a second procedure, are used to fill in the gap in the patient's cartilage.“

Does ACL reconstruction restore knee stability in combined lesions?: An in vivo study. (Clin Orthop Relat Res. 2007 )

Interventions for preventing venous thromboembolism in adults undergoing knee arthroscopy. (Cochrane Database Syst Rev. 2008)

Knee dislocations: a magnetic resonance imaging study correlated with clinical and operative findings. (Skeletal Radiol. 2008 ) “CONCLUSIONS: Knee dislocations occurred more commonly in low-velocity injuries than in high-velocity injuries, predominantly affecting amateur athletes. Biceps femoris tendon tears were the most common extra-articular injury requiring surgery. Neurovascular injury (5%) was uncommon. At imaging, femoral-tibial alignment was anatomic in the majority of patients.”

[Ligaments of the knee] (Orthopade. 2007)

MRI efficacy in diagnosing internal lesions of the knee: a retrospective analysis. (J Trauma Manag Outcomes. 2008 ) “CONCLUSION: MRI is very helpful in diagnosing meniscal and cruciate ligament injuries. But in a countable percentage reports with false results and in chondral defects its importance is still vague. The arthroscopy still remains the gold standard for definitive diagnosis.”

Multiple-ligament injured knee. (Chin J Traumatol. 2006 )

Natural history of bone bruises after acute knee injury: clinical outcome and histopathological findings. (Knee Surg Sports Traumatol Arthrosc. 2006) “These data are indicative of a significant injury to normal articular cartilage homeostasis, and support the suggestion that severe bone bruise is a precursor of early degenerative changes. We recommend delaying return to full weightbearing status when a severe bone bruise is detected to prevent further collapse of subchondral bone and further aggravation of articular cartilage injury.”

Patellar tendon ruptures in weight lifters after local steroid injections. (Arch Orthop Trauma Surg. 2008)

Prevention of overuse injuries by a concurrent exercise program in subjects exposed to an increase in training load: a randomized controlled trial of 1020 army recruits. (Am J Sports Med. 2008) "CONCLUSION: An exercise program with an emphasis on muscular strengthening, coordination, and flexibility based on intrinsic risk factors identified through a literature review did not influence the risk of developing overuse knee injuries or medial tibial stress syndrome in subjects undergoing an increase in physical activity. The program increased maximal running distance in a 12-minute test."

Relevant traumatic injury of the knee joint-MRI follow-up after 7-10 years. (Eur J Radiol. 2008)

The effect of anterior cruciate ligament deficiency on the in vivo elongation of the medial and lateral collateral ligaments. (Am J Sports Med. 2007 )

The long-term consequence of anterior cruciate ligament and meniscus injuries: osteoarthritis. (Am J Sports Med. 2007 ) “At 10 to 20 years after the diagnosis, on average, 50% of those with a diagnosed anterior cruciate ligament or meniscus tear have osteoarthritis with associated pain and functional impairment: the young patient with an old knee. These individuals make up a substantial proportion of the overall osteoarthritis population. There is a lack of evidence to support a protective role of repair or reconstructive surgery of the anterior cruciate ligament or meniscus against osteoarthritis development. A consistent finding in a review of the literature is the often poor reporting of critical study variables, precluding data pooling or a meta-analysis. Osteoarthritis development in the injured joints is caused by intra-articular pathogenic processes initiated at the time of injury, combined with long-term changes in dynamic joint loading. Variation in outcome is reinforced by additional variables associated with the individual such as age, sex, genetics, obesity, muscle strength, activity, and reinjury.”

The risk for a cruciate ligament injury of the knee in adolescents and young adults: a population-based cohort study of 46 500 people with a 9 year follow-up. (Br J Sports Med. 2008)

The value of magnetic resonance imaging in our current management of ACL and meniscal injuries. (Knee Surg Sports Traumatol Arthrosc. 2007 )

Traumatic patellar tendinopathy. (Disabil Rehabil. 2008)

TREATMENT:

Combined anterior cruciate ligament and medial collateral ligament injuries in adolescents. (J Pediatr Orthop. 2006)

Function, osteoarthritis and activity after ACL-rupture: 11 years follow-up results of conservative versus reconstructive treatment. (Knee Surg Sports Traumatol Arthrosc. 2008 ) “We observed significantly better knee-stability (P = 0.008) but more osteoarthritis (Grade II or higher) after ACL-reconstruction (42% vs. 25%). Physical activity levels were similar in both groups during the follow-up period (P = 0.16). Eleven years after ACL-rupture the physical activity levels are similar for both groups. After ACL-reconstruction, stability is higher as is osteoarthritis, whereby the result is not necessarily perceived as better subjectively. Specifically, this retrospective study yielded a 24% incidence of oseoarthrits 11 years after conservative management of ACL-rupture in patients not needing secondary surgery. The risk of secondary meniscal tears is reduced after ACL reconstruction, which reduces the negative effects of OA after surgery. The ultimate objective would be to achieve a good subjective outcome by conservative treatment followed by a rehabilitation program designed to keep secondary meniscus tears at a low level.”

Isolated repair of the medial patellofemoral ligament in primary dislocation of the patella: a prospective randomized study. (Arthroscopy. 2008)

Management of chronic knee pain: a survey of patient preferences and treatment received. (BMC Musculoskelet Disord. 2008)

Preventing blood clots after knee arthroscopy. (Ann Intern Med. 2008)

The effect of anterior cruciate ligament deficiency and reconstruction on the patellofemoral joint. (Am J Sports Med. 2008)