No Effect of Generalized Joint Hypermobility on Injury Risk in Elite Female Soccer Players: A Prospective Cohort Study

2016 ◽  
Vol 45 (2) ◽  
pp. 286-293 ◽  
Author(s):  
Donna Blokland ◽  
Karin M. Thijs ◽  
Frank J.G. Backx ◽  
Edwin A. Goedhart ◽  
Bionka M.A. Huisstede
Keyword(s):  
Risk Factor ◽  
Cohort Study ◽  
Joint Hypermobility ◽  
Ankle Injuries ◽  
Soccer Players ◽  
Injury Incidence ◽  
Beighton Score ◽  
Generalized Joint Hypermobility ◽  
Significant Difference ◽  
Cutoff Points

Background: Although it has been suggested that generalized joint hypermobility (GJH) is a risk factor for injury in soccer players, it remains unclear whether this applies to elite female soccer players. Purpose: To investigate whether GJH is a risk factor for injury in elite female soccer players. Study Design: Cohort study; Level of evidence, 2. Methods: Elite female soccer players in the Netherlands were screened at the start of the 2014-2015 competitive season. GJH was assessed using the Beighton score. Soccer injuries and soccer exposure were registered throughout the entire season. Poisson regression was performed to calculate incidence risk ratios (IRRs) using different cutoff points of the Beighton score (≥3, ≥4, and ≥5) to indicate GJH. Results: Of the 114 players included in the study, 20 were classified as hypermobile (Beighton score ≥4). The mean (±SD) injury incidence per player was 8.40 ± 9.17 injuries/1000 hours of soccer, with no significant difference between hypermobile and nonhypermobile players. GJH was not a risk factor for injuries when using Beighton score cutoff points of ≥3 (IRR = 1.06 [95% CI, 0.74-1.50]; P = .762), ≥4 (IRR = 1.10 [95% CI, 0.72-1.68]; P = .662), or ≥5 (IRR = 1.15 [95% CI, 0.68-1.95]; P = .602). Similarly, GJH was not a significant risk factor for thigh, knee, or ankle injuries evaluated separately. Conclusion: This study indicates that GJH is not a risk factor for injuries in elite female soccer players, irrespective of Beighton score cutoff point. Hypermobile players at this elite level might have improved their active stability and/or used braces to compensate for joint laxity.

scholarly journals Generalized Joint Hypermobility and Injuries: A Prospective Cohort Study of 185 Pre-Professional Contemporary Dancers

2021 ◽  
Vol 10 (5) ◽  
pp. 1007
Author(s):  
Rogier M. van Rijn ◽  
Janine H. Stubbe
Keyword(s):  
Potential Risk ◽  
Injury Risk ◽  
Joint Hypermobility ◽  
Research Centre ◽  
Injury Incidence ◽  
Time Loss ◽  
Beighton Score ◽  
Generalized Joint Hypermobility ◽  
Professional Dancers ◽  
Academic Year

Generalized joint hypermobility (GJH) has been mentioned as one of the factors associated with dance injuries, but the findings are inconclusive. This study aims to investigate whether GJH, based on different Beighton score cut-off points, is a potential risk factor for injuries in pre-professional dancers. Four cohorts of first-year pre-professional dancers (N = 185), mean age 19.1 ± 1.3 years, were screened on musculoskeletal functioning at the start of their academic year. The Beighton score was used to measure GJH. During the academic year, the dancers completed monthly questionnaires about their physical and mental health. Based on the Oslo Sports Trauma Research Centre Questionnaire on Health Problems (OSTRC), three injury definitions were used (i.e., all complaints, substantial injury, and time-loss injury). To examine potential risk factors for injuries, univariate and multivariate regression models were applied. The response rate of monthly completed questionnaires was 90%. The overall mean (SD) Beighton score was 2.8. The 1-year injury incidence proportion was 67.6% (n = 125), 43.2% (n = 80), and 54.6% (n = 101) for all complaint injuries, substantial injuries, and time-loss injuries, respectively. The multivariate analyses showed a significant association between a previous long lasting injury in the past year and the three injury definitions (p < 0.05). Pre-professional contemporary dancers are at high risk for injuries and hypermobility. However, these two variables are not associated with each other. Health professionals should take injury history into account when assessing dance students, because this variable is associated with increased injury risk.

Outcome of Hip Impingement Surgery: Does Generalized Joint Hypermobility Matter?

2017 ◽  
Vol 45 (6) ◽  
pp. 1309-1314 ◽  
Author(s):  
Florian D. Naal ◽  
Aileen Müller ◽  
Viju D. Varghese ◽  
Vanessa Wellauer ◽  
Franco M. Impellizzeri ◽  
...  
Keyword(s):  
Risk Factors ◽  
Joint Hypermobility ◽  
Injury Incidence ◽  
Inverse Association ◽  
Failure Rates ◽  
Joint Degeneration ◽  
Beighton Score ◽  
Generalized Joint Hypermobility ◽  
Patient Reported

Background: Generalized joint hypermobility (JH) might negatively influence the results of surgical femoroacetabular impingement (FAI) treatment, as JH has been linked to musculoskeletal pain and injury incidence in athletes. JH may also be associated with worse outcomes of FAI surgery in thin females. Purpose: To (1) determine the results of FAI surgery at a minimum 2-year follow-up by means of patient-reported outcome measures (PROMs) and failure rates, (2) assess the prevalence of JH in FAI patients and its effect on outcomes, and (3) identify other risk factors associated with treatment failure. Study Design: Cohort study; Level of evidence, 3. Methods: We included 232 consecutive patients (118 females; mean age, 36 years) with 244 hips surgically treated for symptomatic FAI between 2010 and 2012. All patients completed different PROMs preoperatively and at a mean follow-up of 3.7 years. Satisfaction questions were used to define subjective failure (answering any of the 2 subjective questions with dissatisfied/ very dissatisfied and/or didn’t help/ made things worse). Conversion to total hip replacement (THR) was defined as objective failure. JH was assessed using the Beighton score. Results: All PROM values significantly ( P < .001) improved from preoperative measurement to follow-up (Oxford Hip Score: 33.8 to 42.4; University of California at Los Angeles Activity Scale: 6.3 to 7.3; EuroQol−5 Dimension Index: 0.58 to 0.80). Overall, 34% of patients scored ≥4 on the Beighton score, and 18% scored ≥6, indicating generalized JH. Eleven hips (4.7%) objectively failed and were converted to THR. Twenty-four patients (10.3%) were considered as subjective failures. No predictive risk factors were identified for subjective failure. Tönnis grade significantly ( P < .001) predicted objective failure (odds ratio, 13; 95% CI, 4-45). There was a weak inverse association ( r = −0.16 to −0.30) between Beighton scores and preoperative PROM values. There were no significant associations between Beighton scores and postoperative PROM values or subjective failure rates, but patients who objectively failed had lower Beighton scores than did nonfailures (1.6 vs 2.6; P = .049). Conclusion: FAI surgery yielded favorable outcomes at short- to midterm follow-up. JH as assessed by the Beighton score was not consistently associated with subjective and objective results. Joint degeneration was the most important risk factor for conversion to THR. Although statistical significance was not reached, female patients with no joint degeneration, only mild FAI deformity, and higher Oxford scores at the time of surgery seemed to be at increased risk for subjective dissatisfaction.

Nonunion Rates in Hind- and Midfoot Arthrodesis in Current, Ex-, and Nonsmokers

2020 ◽  
pp. 107110072097126
Author(s):  
Jack Allport ◽  
Jayasree Ramaskandhan ◽  
Malik S. Siddique
Keyword(s):  
Risk Factor ◽  
Cohort Study ◽  
Relative Risk ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Smoking Status ◽  
Time Frame ◽  
Modifiable Risk Factor ◽  
Level Of Evidence ◽  
Significant Difference

Background: Nonunion rates in hind or midfoot arthrodesis have been reported as high as 41%. The most notable and readily modifiable risk factor that has been identified is smoking. In 2018, 14.4% of the UK population were active smokers. We examined the effect of smoking status on union rates for a large cohort of patients undergoing hind- or midfoot arthrodesis. Methods: In total, 381 consecutive primary joint arthrodeses were identified from a single surgeon’s logbook (analysis performed on a per joint basis, with a triple fusion reported as 3 separate joints). Patients were divided based on self-reported smoking status. Primary outcome was clinical union. Delayed union, infection, and the need for ultrasound bone stimulation were secondary outcomes. Results: Smoking prevalence was 14.0%, and 32.2% were ex-smokers. Groups were comparable for sex, diabetes, and body mass index. Smokers were younger and had fewer comorbidities. Nonunion rates were higher in smokers (relative risk, 5.81; 95% CI, 2.54-13.29; P < .001) with no statistically significant difference between ex-smokers and nonsmokers. Smokers had higher rates of infection ( P = .05) and bone stimulator use ( P < .001). Among smokers, there was a trend toward slower union with heavier smoking ( P = .004). Conclusion: This large retrospective cohort study confirmed previous evidence that smoking has a considerable negative effect on union in arthrodesis. The 5.81 relative risk in a modifiable risk factor is extremely high. Arthrodesis surgery should be undertaken with extreme caution in smokers. Our study shows that after cessation of smoking, the risk returns to normal, but we were unable to quantify the time frame. Level of Evidence: Level III, retrospective cohort study.

scholarly journals The Effect Of Playing Surface On Anterior Cruciate Ligament Injury In NCAA Soccer

2020 ◽  
Vol 8 (3_suppl2) ◽  
pp. 2325967120S0012
Author(s):  
Mark Howard ◽  
Hyunwoo Paco Kang ◽  
Samantha Solaru ◽  
Alexander E. Weber ◽  
Mark F. Rick C
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Soccer Players ◽  
Injury Incidence ◽  
Artificial Turf ◽  
Acl Injuries ◽  
Natural Grass ◽  
Significant Difference ◽  
Anterior Cruciate

Objectives: Previous orthopaedic literature has examined the effect of synthetic playing surfaces on the risk of anterior cruciate ligament (ACL) injury in athletes and produced varying and inconclusive results. The objective of this study was to examine the role of playing surface on the incidence and risk of ACL injury in collegiate soccer athletes. Methods: The NCAA Injury Surveillance Program (ISP) database was queried for ACL injuries for male and female soccer players from the 2004-05 through the 2013-14 seasons at all levels of competition. The number of athlete exposures (AEs), defined as 1 athlete participating in 1 practice or competition in which they were exposed to the possibility of athletic injury, were recorded for grass and synthetic playing surfaces. Both the reported injuries and exposures provided were weighted in order to represent the entire NCAA collegiate soccer population. Normalized ACL incidence rates were calculated as well as 95% confidence intervals (95%CI). Rate ratios comparing competition type amongst both competition and practice were calculated. Results: ACL injuries were more common on grass surfaces (1.16 per 10,000 AEs, 95%CI 1.12-1.20) than artificial turf (0.92 per 10,000 AEs, 95%CI 0.84-1.04). This difference was statistically significant (IRR 1.26, p<0.0001), and driven primarily by the difference in injury incidence during practice. The injury incidence during practice on natural grass (1.18 per 10,000 AEs, 95% CI 1.11-1.26) was significantly greater than the injury incidence rate during practice on artificial turf (0.067 per 10,000 AEs, 95%CI 0.043-0.096). Players were 17.7 times more likely (95%CI 10.6678-27.2187, p<0.0001) to sustain an ACL injury during practice on natural grass when compared to practice on artificial turf. However, there was no significant difference in injury incidence during matches (IRR 0.96, p=0.44), with matches on natural grass (3.35 per 10,000 AEs, 95% CI 3.21-3.51) equivalent to matches on artificial surfaces (3.49 per 10,000 AEs, 95%CI 3.18-3.81). When comparing exposure type, the injury rate was significantly greater during matches (3.38 per 10,000 AEs, 95% CI 3.25-3.52) compared to practices (0.82 per 10,000 AEs, 95%CI 0.77-0.88), with a 4.10-fold increase in ACL injury incidence during matches compared to practice (p<0.0001). Conclusion: Between 2004 and 2014, NCAA soccer players experienced a greater number of ACL injuries on natural grass playing surfaces compared with artificial turf playing surfaces. This difference is driven by injuries during practice, where athletes were nearly 18 times more likely to suffer an ACL injury on grass versus artificial turf. While ACL injuries were more likely during matches compared to practices, no difference in incidence was noted between playing surfaces. Additional study is warranted investigating potential causes for this observed increased risk with soccer practice on grass fields.

scholarly journals Injuries in Professional Male Soccer Players in the Netherlands: A Prospective Cohort Study

2015 ◽  
Vol 50 (2) ◽  
pp. 211-216 ◽  
Author(s):  
Janine H. Stubbe ◽  
Anne-Marie M. C. van Beijsterveldt ◽  
Sissi van der Knaap ◽  
Jasper Stege ◽  
Evert A. Verhagen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Injury Risk ◽  
Knee Injuries ◽  
Lower Extremities ◽  
Body Part ◽  
Soccer Players ◽  
Injury Incidence ◽  
Time Loss ◽  
Professional Soccer ◽  
Common Diagnosis

Context: Injuries are a major adverse event in a soccer player's career. Reducing injury incidence requires a thorough knowledge of the epidemiology of soccer injuries. Objective: To investigate the incidence and characteristics of injuries in the Dutch premier soccer league. Design: Cohort study. Setting: The Dutch premier soccer league. Patients or Other Participants: During the 2009–2010 soccer season, a total of 217 professional soccer players from 8 teams were prospectively followed. Main Outcome Measure(s): The medical staff recorded time-loss injuries, including information on injuries (ie, type, body part, duration) and exposure data for training sessions and matches. Results: A total of 286 injuries were recorded, affecting 62.7% of the players. The overall injury incidence was 6.2 injuries per 1000 player-hours, 2.8 in training sessions and 32.8 in matches. Most of the recorded injuries were acute (68.5%). Eight percent of the injuries were classified as recurrent. Injuries were most likely to be located in the lower extremities (82.9%). Injury time loss ranged from 1 to 752 days, with a median of 8 days. Knee injuries had the greatest consequences in terms of days of absence from soccer play (on average, 45 days). The most common diagnosis was muscle/tendon injury of the lower extremities (32.9%). Conclusions: Injury risk in the Dutch premier soccer league is high, especially during matches. Preventive measures should focus on the most common diagnoses, namely, muscle/tendon injuries of the lower extremities.

scholarly journals Generalized Joint Hypermobility among School-going children in Majmaah region, Saudi Arabia

2019 ◽  
Author(s):  
Mohamed Sherif Sirajudeen ◽  
Mohamed Waly ◽  
Mazen Alqahtani ◽  
Msaad Alzhrani ◽  
Hariraja Muthusamy ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
School Children ◽  
Personal Characteristics ◽  
Joint Hypermobility ◽  
Primary School Children ◽  
Cutoff Score ◽  
Score Distribution ◽  
Beighton Score ◽  
Cross Sectional ◽  
Generalized Joint Hypermobility

Abstract Background Generalized Joint Hypermobility (GJH) is common among schoolchildren and usually benign. However, progressively may lead to joint pain and developmental delay. Identifying the GJH at the school-age would facilitate to monitor early changes and to plan for early rehabilitative intervention. Hence, we aimed to determine the prevalence, pattern, and factors associated with the GJH among school-going children in the Majmaah region, Saudi Arabia. Methods The school children of both genders aged 8 to 14 years from the Majmaah region of Saudi Arabia participated in this cross-sectional study. The Beighton’s score was used to assess the joint hypermobility. Personal characteristics like age, height, weight, Body mass index (BMI), and handedness was also collected. Descriptive statistics were produced for personal characteristics, the point prevalence of hypermobility, frequency of Beighton score distribution, and prevalence of GJH. The association between specific factors and the presence of GJH was analyzed using Chi-square tests and logistic regression measures. Results The occurrence of GJH as defined by Beighton cutoff score ≥ 4 in the 303 participated primary school children was 15.2%. The prevalence of GJH was high among females (16.8%) compared to males (13.4%), but this difference is not statistically significant. Younger male children (age 8 to 11 years) were 16.7 times more probable to develop hypermobility (adjusted OR 0.06 [95% CI 0.01 – 0.56]) compared to older male children (age 12 to 14 years). No associations were observed among female children. Conclusion The prevalence rate reported in this study among school-going children was in the lower range in comparison with the rates reported across the globe. Beighton score of ≥4 was adequate for use in identifying GJH among children in Saudi Arabia.

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