Sportverletzung-Sportschaden最新文献

Intramuscular tendon injuries of the thigh muscles are a relatively common and significant problem in sports medicine, particularly in high-speed sports. MRI is a valuable tool for diagnosing and evaluating the severity of these injuries. Depending on the severity and chronicity of the injury, treatment options include conservative or surgical treatment. We present the typical MRI criteria for acute and chronic injuries to the intramuscular thigh tendons and provide a detailed description of the surgical treatment and technique. Both acute and chronic lesions can be successfully treated with surgery. In rehabilitation, MRI remains a valuable tool for monitoring, but functional tests such as EMG, force plate measurements and isokinetic testing should also be included. A return to competitive sport is typically possible within approximately four months.

Returning to sport after anterior cruciate ligament reconstruction (ACLR) can be a challenging and complex process for the athlete, with the rate of return to the pre-injury level of sport observed to be less than athlete expectations. Of the athletes that do return to sport (RTS), knee re-injury rates remain high, and multiple studies have observed impaired athletic performance upon RTS after ACLR as well as reduced playing time, productivity, and career lengths. To mitigate re-injury and improve RTS outcomes, multiple RTS after ACLR consensus statements/clinical practice guidelines have recommended objective RTS testing criteria to be met prior to medical clearance for unrestricted sports participation. While the achievement of RTS testing criteria can improve RTS rates after ACLR, current criteria do not appear valid for predicting safe RTS. Therefore, there is a need to review the various factors related to the successful return to the pre-injury level of sport after ACLR, clarify the utility of objective performance testing and RTS criteria, further discuss safe RTS decision-making as well as present strategies to reduce the risk of ACL injury/re-injury upon RTS. This article provides a practical review of the current RTS after ACLR literature, as well as makes medical recommendations for rehabilitation and RTS decision-making after ACLR.

This biomechanical study of 38 male and female recreational runners demonstrates the relationship between the four most frequently used footwear technologies and the biomechanical load on the lower extremities during running. Running with the four midsole technologies ((1) neutral, cushioning running shoes (N_LS), (2) supportive, motion control running shoes (S_LS), (3) maximalist, carbon-fibre plate running shoes (M_LS), and (4) running shoes with a U-shaped midsole construction and highly cushioning foam (U_LS)) indicates a strong impact of the midsole technology on the kinetics of the lower extremities. Midsole construction and material of the four running shoe categories systematically influence joint moments at the foot, ankle joint, and knee joint, thereby modulating the mechanical load on the biological structures of the lower extremities with each running step. The data demonstrate no significant differences in running kinetics between N_LS and S_LS, while M_LS increases and U_LS decreases ankle joint and knee joint load during the stance phase.A 12-month standardized and randomized intervention trial surveyed 1697 recreational runners who used one of the four dedicated running shoe categories in more than 75% of their runs. The results demonstrate a strong relation between the development of running-associated injuries in general, and knee and Achilles tendon problems in particular, and the footwear categories. While neutral and supportive running shoes show no significant differences in the development of running-related injuries, M_LS increases and U_LS decreases this risk, especially the occurrence of knee pain. Other risk factors, such as age, gender, BMI, running distance, average speed, surface as well as foot morphology and leg axis, only had a minor effect on the development of running-related injuries in the 12-month survey. Running shoe midsole technologies offer a sophisticated causal explanation for overload injuries of biological structures in the lower extremity during running and the resulting running-related injuries.

The trend sports kitesurfing and wakeboarding are increasingly gaining popularity. Tricks and high jumps - both in the air and over obstacles - are performed with increasing difficulty. Repeated high loads on the body, particularly when landing after a jump, can lead to overuse and acute injuries directly related to peak forces, particularly in the lower extremities.There is a lack of detailed analyses of these forces resulting from wakeboarding or kitesurfing, although such data would be relevant for the analysis of injury mechanisms and the subsequent development of prevention strategies. This study is the first of its kind in which the loads on the lower extremity during wakeboarding and kitesurfing were subjected to in-vivo measurements during various maneuvers.Six wakeboarders and 12 kitesurfers (6 with loop bindings and 6 with fixed bindings) were investigated (mean age 33.1 ± 9.9 years). Jump height, hang time, acceleration, and the maximum vertical ground reaction force of both feet during takeoff and landing were recorded by means of sensor insoles (Moticon, Germany) on the feet of the athletes and simultaneously by a height and acceleration sensor (PIQ Sport Intelligence) on the board. A statistical analysis was performed.The data showed that wakeboarders were exposed to higher loads than kitesurfers, with significant differences occurring only between wakeboarders and kitesurfers with loop bindings and between kitesurfers with loop bindings and fixed bindings. High mean forces occurred during the landing of wakeboarders (rear foot 24.24 N/kg ± 8.82; front foot 20.33 N/kg ± 5.05) compared to kitesurfers with loop bindings (rear foot 12.09 N/kg ± 5.6; front foot 12.23 N/kg ± 4.92) as well as partially in kitesurfers with fixed shoe bindings (front foot 13.61 N/kg ± 5.92). Forces during lift-off were comparable in the rear foot (wakeboarders, kitesurfers with fixed bindings, kitesurfers with loop bindings 14.17 ± 6.37 vs. 16.39 ± 4.99 vs. 14.72 ± 5.13 N/kg). Similarly, despite the higher average acceleration force of the wakeboarders (4.16 g ± 1.02), there was no statistically significant difference (p = 0.166) compared to the kitesurfers.The in-vivo forces acting on the lower extremities during wakeboarding and kitesurfing are high (highest absolute values of 3012 N and relative values of 31.71 N/Kg). In addition, fixed boot bindings allow for the generation of higher forces than strap bindings. The results of our study have important implications on load control and preventive approaches in these two sports.

To systematically compare the clinical efficacy of conservative treatment and arthroscopic one-stage repair for patients with first-time anterior dislocation of the shoulder. A retrieval and systematic review of randomized controlled studies of primary anterior shoulder dislocation with conservative versus arthroscopic repair was conducted and further pooled analysis was performed to compare the overall difference in clinical outcomes, including redislocation and revision surgery rates, shoulder function scores and related complications. Preliminary meta-analysis showed that the risk of anterior shoulder redislocation was 4.73-fold higher in patients treated conservatively than those undergoing arthroscopic repair (RR:4.73 [2.95-7.58], p < 0.000; I² = 0 %, p = 0.920),and that the revision surgery rate was 5.91 times higher in the conservative group than in the arthroscopic repair group (RR:5.91 [2.82-12.39], p < 0.000; I² = 0 %, p = 0.560).Early arthroscopic repair can significantly reduce the redislocation and revision surgery rates and also improve the shoulder joint function score, without serious complications. However, it is necessary to recognize the subset of patients with a higher risk of redislocation in young patients through a high quality, blinded, prospective cohort study when early arthroscopic repair intervention in this subset of high-risk patients will be of significant clinical value.

ACL rupture is a common injury in recreational and professional athletes. Most ACL tears occur in combination with an ALL lesion. Combined reconstruction of the ACL and ALL reduces re-rupture rates by up to 3.1 times compared to isolated ACL reconstruction using hamstring tendons; however, it has not yet been established as the surgical standard. The purpose of this study was to investigate if patients benefit from ACL+ALL reconstruction in terms of translation and rotation stability, return to activity and return to sport, as well as to assess any potential negative effects of this technique.This is a multicentric study of retrospectively collected patients who were followed up 12.7 months postoperatively. The patient sample consisted of 55 patients (group 1: n=29, Munich/Germany, ACL+ALL, femoral ALL fixation with interference screw, and group 2: n=26, Bolzano/Italy, ACL+ALL, femoral ALL-fixation with SwiveLock). Clinical outcomes were evaluated through instrumental measurements with two different devices to assess translational anteroposterior and rotational stability and through patient-reported outcome measures (Lysholm Score, Activity Rating Scale, Tegner Score, VAS (PROMs)).A total of 55 patients (mean (± SD) age: 24.7 ± 7.8 years) with a mean follow-up of 12.7 ± 1.5 months were included. The mean anterior translation of all operated (ACL+ALL) knees was 3.2 ± 1.1 mm and was not significantly different from the values of the non-operated knees (2.6 ± 1.0 mm). The results of the anterior drawer test in internal rotation were 3.3 ± 1.1 mm for the operated knee vs. 2.7 ± 1.0 mm for the non-operated knee (p=0.0014). There were no further significant differences between the operated and non-operated knee regarding translation or internal and external rotation. The mean value for pain on the lateral side of the knee was 1.1 ± 1.3 on the VAS 0-10 pain scale. All other PROMs showed no relevant differences between pre-injury and post-operative.ALL reconstruction restores the function of the anterolateral ligament of the knee. In this study, knee joint stability regarding anteroposterior translation and rotation showed values almost identical to those of the healthy non-operated contralateral knee. It leads to excellent patient outcomes with near pre-injury levels regarding the relevant PROMs. In particular, combined reconstruction did not result in any clinically significant negative side-effects such as pain on the ALL incision site or signs of overstrain in the lateral knee.

Adolescent elite athletes in Olympic sports often specialise at an early age, which increases the risk of overuse and traumatic injuries. The knowledge of injury patterns is a key aspect for prevention strategies. However, little is known about adolescent athlete's injury patterns in most Olympic sports. This study aimed to analyse the incidence and pattern of traumatic and overuse injuries in adolescent elite athletes from three Olympic sports with various physical demands.A retrospective data analysis was performed, including 348 initial orthopaedic consultations of adolescent elite athletes (m/f: 267/81, 15.9±1.7 years, 179±9 cm, 71±11 kg, 648±107 training hours/year). Athletes from handball (n=185), canoe sprint (n=112) and triathlon (n=51) presented at the local sports medicine centre. All consultations included a medical history obtained by a physician, an orthopaedic examination, and a documentation of anthropometric and training-related data. Injury patterns were classified for traumatic and overuse ratio, type, area, structure, and cause of injury. Incidence per 1000 hours (h) of exposure and injury ratio were analysed in the entire cohort and compared between sports.The mean injury incidence was 3.3/1000 h, while overuse injuries occurred approximately twice as often as traumatic injuries (2.0 versus 1.2/1000 h). Sport-specific total injury incidence was lowest in canoe sprint (1.6/1000 h) and highest in handball (4.7/1000 h). The traumatic versus overuse injury ratio was lowest in canoe sprint (0.13) and highest in handball (0.54). Injury incidence increased with age and training hours from 1.0/1000 h in young athletes (12-13 years) to 5.1/1000 h in older athletes (16-17 years). Type, area, structure and cause of injuries differed significantly between athletes of the three sports. Handball players presented with various traumatic and overuse pathologies, mostly located in the lower extremity. Canoeists and triathletes mainly suffered from tendon overload and muscle injuries of the extremities and the lower back.Both the total incidence and the ratio of traumatic versus overuse injuries differ between athletes participating in handball, canoe sprint, and triathlon. Overuse injuries occurred approximately twice as often as traumatic injuries in the present cohort. Further investigation is required to evaluate whether the variety of injuries seen in individual and team sports is to be taken into consideration in the development of prevention strategies.

We present the case of a preventive tibial plateau flexion osteotomy in an adolescent patient who had a reduced posterior slope of the tibial plateau. The patient was asymptomatic and without instability at the time. However, magnetic resonance imaging (MRI) showed a dysmorphic posterior cruciate ligament, which was interpreted as an indication for osteotomy. This article demonstrates the surgical technique and postoperative outcome. The postoperative MRI shows a reorganization of the posterior cruciate ligament into a physiological ligament appearance.

Achieving anatomic reduction, securing fixation, and ensuring adequate compression are crucial steps in the internal fixation process for traumatic osteochondral defects. A variety of fixation methodologies have been in use, e.g., metal pins, bioabsorbable screws, and glue tissue adhesives, each of them yielding different outcomes. This study presents the outcomes of utilising the concept of suture bridge fixation for traumatic femoral osteochondral injury in a 34-year-old patient. Following a three-year follow-up, the patient demonstrated a return to normal activities with complete and pain-free knee mobility. In conclusion, it can be stated that suture bridges offer an alternative approach for the fixation of osteochondral fragments in the knee attributable to traumatic injuries.

Injury burden is a composite measure of injury incidence and mean severity; this parameter has been reported as an output measure from injury surveillance studies in rugby for over 20 years. The benefits of reporting injury burden results have, more recently, been recognised in other sports. This wider use of injury burden as an output measure from injury surveillance studies has, however, highlighted misunderstandings about how to calculate, present and interpret injury burden data. The aim of this critical review is to explain why median severity and ordinal severity scales should not be used to calculate and report injury burden results in injury surveillance studies. Equations are presented to show how injury burden results should be calculated, and graphs and tables are presented to explain the errors that are introduced when median severity and ordinal scales of severity are used instead of mean severity. This critical review is intended to highlight the correct procedures for calculating, reporting and interpreting injury burden results in order to avoid incorrect results, conclusions and injury prevention recommendations being published.