scholarly journals APKASS Consensus Statement on Chronic Syndesmosis Injury, Part 1: Clinical Manifestation, Radiologic Examination, Diagnosis Criteria, Classification, and Nonoperative Treatment

2021 ◽  
Vol 9 (6) ◽  
pp. 232596712110210
Author(s):  
Chen Jiao ◽  
Jianchao Gui ◽  
Hiroaki Kurokawa ◽  
Yasuhito Tanaka ◽  
Patrick Yung ◽  
...  
Keyword(s):  
Diagnostic Criteria ◽  
Clinical Manifestation ◽  
Sports Medicine ◽  
Consensus Statement ◽  
Treatment Strategies ◽  
Nonoperative Treatment ◽  
Radiologic Examination ◽  
Syndesmosis Injury ◽  
Strong Consensus ◽  
International Experts

Background: Clinical manifestation, radiologic examination, diagnostic criteria, classification, and nonoperative treatment strategies regarding chronic syndesmosis injury remain unclear. Purpose: An international group of experts representing the fields of sports injuries in the foot and ankle area were invited to collaboratively advance toward consensus opinions based on the best available evidence regarding chronic syndesmosis injuries. All were members of the Asia-Pacific Knee, Arthroscopy and Sports Medicine Society (APKASS). Study Design: Consensus statement. Methods: From November to December 2020, a total of 111 international experts on sports medicine or ankle surgery participated in a 2-stage Delphi process that included an anonymous online survey and an online meeting. A total of 13 items with 38 statements were drafted by 13 core authors. Of these, 4 items with 15 clinical questions and statements were related to the clinical manifestation, radiologic examination, diagnostic criteria, classification, and nonoperative treatment strategies for chronic syndesmosis injury and are presented here. Each statement was individually presented and discussed, followed by a general vote. The strength of consensus was characterized as follows: consensus, 51% to 74%; strong consensus, 75% to 99%; unanimous, 100%. Results: Of the 15 questions and statements, 5 reached unanimous support and 10 achieved strong consensus. Conclusion: This APKASS consensus statement, developed by international experts in the field, will assist surgeons and physical therapists with diagnosis, classification, and nonoperative treatment strategies for chronic syndesmosis injury.

scholarly journals APKASS Consensus Statement on Chronic Syndesmosis Injury, Part 2: Indications for Surgical Treatment, Arthroscopic or Open Debridement, and Reconstruction Techniques of Suture Button and Screw Fixation

2021 ◽  
Vol 9 (6) ◽  
pp. 232596712110210
Author(s):  
Hiroaki Kurokawa ◽  
Hongyun Li ◽  
Chayanin Angthong ◽  
Yasuhito Tanaka ◽  
Yujie Song ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Sports Medicine ◽  
Consensus Statement ◽  
Screw Fixation ◽  
Asia Pacific ◽  
Suture Button ◽  
Syndesmosis Injury ◽  
Strong Consensus ◽  
International Experts ◽  
Open Debridement

Background: The indications for surgical treatment of chronic syndesmosis injury are challenging for many orthopaedic clinicians, as there is no international consensus on the optimal management of these injuries. Purpose: An international group of experts representing the field of sports injuries in the foot and ankle area was invited to collaboratively advance toward consensus opinions based on the best available evidence regarding chronic syndesmosis injury. All were members of the Asia-Pacific Knee, Arthroscopy and Sports Medicine Society (APKASS). Study Design: Consensus statement. Methods: From November to December 2020, a total of 111 international experts on sports medicine or ankle surgery participated in a 2-stage Delphi process that included an anonymous online survey and an online meeting. A total of 13 items with 38 statements were drafted by 13 core authors. Of these, 9 items with 17 clinical questions and statements were related to indications for surgical treatment, arthroscopic versus open debridement, and suture button versus screw fixation reconstruction techniques and are presented here. Each statement was individually presented and discussed, followed by a general vote. The strength of consensus was characterized as follows: consensus, 51% to 74%; strong consensus, 75% to 99%; and unanimous, 100%. Results: Of the 17 questions and statements, 4 achieved unanimous support, 11 reached strong consensus, and 2 reached consensus. Conclusion: This APKASS consensus statement, developed by international experts in the field, will assist surgeons and physical therapists with surgical indications and techniques for chronic syndesmosis injury.

scholarly journals APKASS Consensus Statement on Chronic Syndesmosis Injury, Part 3: Fusion Techniques, Comorbidity Treatments, Postoperative Rehabilitation, and Return-to-Sport Indications

2021 ◽  
Vol 9 (6) ◽  
pp. 232596712110210
Author(s):  
Yujie Song ◽  
Zhongmin Shi ◽  
Hiroaki Kurokawa ◽  
Yasuhito Tanaka ◽  
Samuel K.K. Ling ◽  
...  
Keyword(s):  
Sports Medicine ◽  
Consensus Statement ◽  
Return To Sport ◽  
Postoperative Treatment ◽  
Return To Sports ◽  
Postoperative Rehabilitation ◽  
Surgical Fusion ◽  
Syndesmosis Injury ◽  
Strong Consensus ◽  
International Experts

Background: Questions regarding surgical fusion techniques, postoperative treatment, and indications for return to sport after chronic syndesmosis injury or its comorbidities remain unanswered. Purpose: An international group of experts representing the field of injuries in the foot and ankle area was invited to collaboratively advance toward consensus opinions based on the best available evidence regarding chronic syndesmosis injury. All were members of the Asia-Pacific Knee, Arthroscopy and Sports Medicine Society (APKASS). Study Design: Consensus statement. Methods: From November to December 2020, a total of 111 international experts on sports medicine or ankle surgery participated in a 2-stage Delphi process that included an anonymous online survey and an online meeting. A total of 13 items with 38 statements were drafted by 13 core authors. Of these, 4 items with 6 clinical questions and statements were related to surgical fusion techniques, comorbidity treatments, postoperative rehabilitation, and return-to-sports indications and are presented here. Each statement was individually presented and discussed, followed by a general vote. The strength of consensus was characterized as follows: consensus, 51% to 74%; strong consensus, 75% to 99%; and unanimous, 100%. Results: Of the 6 questions and statements, 5 achieved unanimous support and 1 reached strong consensus. Conclusion: This APKASS consensus statement, developed by international experts in the field, will assist surgeons and physical therapists with surgical and postoperative treatment strategies for chronic syndesmosis injury.

scholarly journals Chinese Consensus on Insertional Achilles Tendinopathy

2019 ◽  
Vol 7 (10) ◽  
pp. 232596711987905
Author(s):  
◽  
Hanlin Xu ◽  
Hongyun Li ◽  
Yinghui Hua ◽  
Lu Bai ◽  
...  
Keyword(s):  
Clinical Diagnosis ◽  
Sports Medicine ◽  
Consensus Statement ◽  
Achilles Tendinopathy ◽  
Pathological Process ◽  
Expert Consensus ◽  
Diagnosis And Treatment ◽  
Chinese Society ◽  
Strong Consensus ◽  
Insertional Achilles Tendinopathy

Background: Insertional Achilles tendinopathy (IAT) is a common finding in the clinic. However, consensus on its mechanism, pathological process, diagnosis, treatment, and rehabilitation is lacking. Thus, the Chinese Society of Sports Medicine organized and invited experts representing the fields of ankle disease and tendinopathy to jointly develop an expert consensus on IAT. Study Design: A consensus statement of the Chinese Society of Sports Medicine. Methods: A total of 34 experts in the field of sports medicine and orthopaedics were invited to participate in the compilation of a consensus statement regarding IAT. Consensus was achieved according to the Delphi method. First, 10 working groups composed of 34 experts were established to compile draft statements about clinical problems related to IAT by reviewing and analyzing the available literature. An expert consensus meeting to discuss drafts was then arranged. Each statement was individually presented and discussed, followed by a secret vote. Consensus was reached when more than 50% of the experts voted in its favor. The strength of the proposed recommendation was classified based on the proportion of favorable votes: consensus, 51% to 74%; strong consensus, 75% to 99%; unanimity, 100%. Results: Of the 10 expert consensus statements on the clinical diagnosis and treatment of IAT, there was strong consensus for 8 statements and unanimity for 2 statements. Conclusion: This expert consensus focused on the concepts, causes, pathological process, clinical diagnosis, and treatment of IAT. Accepted recommendations in these areas which will assist clinicians in carrying out standardized management of related diseases.

scholarly journals DETECTION OF OVERREACHING AND OVERTRAINING DUE TO PHYSICAL ACTIVITY IN HIGH LEVEL ATHLETES WITH USE OF CONTEMPORARY DIAGNOSTIC CRITERIA (GEORGIA)

2019 ◽  
Author(s):  
Tamar Kajaia ◽  
Kakhaber Chelidze ◽  
Valeri Akhalkatsi ◽  
Zurab Kakhabrishvili ◽  
Lela Maskhulia
Keyword(s):  
Diagnostic Criteria ◽  
Sports Medicine ◽  
Consensus Statement ◽  
Medical Monitoring ◽  
Improve Performance ◽  
Flexible Tool ◽  
Sports Science ◽  
Competitive Athletes ◽  
High Level ◽  
European College

The goal of training competitive athletes is to provide training loads that will improve performance. When prolonged, excessive training occurs concurrent with other stressors and insufficient recovery, performance decrement can result first in functional overreaching (FO), then extreme overreaching or non-functional overreaching (NFO) and overtraining. Chronic maladaptations may lead then to the overtraining syndrome (OTS). As it is possible to recover from functional overreaching within a period of 2 weeks, the recovery from NFO needs several weeks or even months. Athletes who suffer from OTS may need months or even years to completely recover (1). Early diagnostic of overreaching is of high importance for prevention of overtraining as well as for interruption of progression of NFO/OTS. The purpose of the study was detection of nonfunctional overreaching and overtraining with use of contemporary diagnostic criteria. Diagnosis of OTS was based on the checklist provided by the consensus statement of the European College of Sports Science (ECSS) and the American College of Sports Medicine (ACSM) (3). Examination of 348 high level athletes revealed 43 subjects with NFO/OTS, among them 37 with NFO and 6 athletes with OTS. Prevalence of NFO and OTS was seen in sporting disciplines with mixed high intensity workload-27(62,8%) NFO and 4 (9,3%) OTS, particularly, majority of NFO/OTS was revealed in wrestling: NFO – 19 (44,2%) and OTS – 4 (9,3%). Checklist criteria elaborated by ECSS and ACSM is efficient and flexible tool for diagnosing overreaching and overtraining in athletes. Most frequently NFO/OTS is seen in wrestling, which needs further investigation and regular medical monitoring.

scholarly journals Neuro-oncology management during the COVID-19 pandemic with a focus on WHO grades III and IV gliomas

2020 ◽  
Vol 22 (7) ◽  
pp. 928-935 ◽  
Author(s):  
Denise Bernhardt ◽  
Wolfgang Wick ◽  
Stephanie E Weiss ◽  
Arjun Sahgal ◽  
Simon S Lo ◽  
...  
Keyword(s):  
Consensus Statement ◽  
Negative Impact ◽  
Scale Up ◽  
Treatment Strategies ◽  
Mitigation Strategies ◽  
Interdisciplinary Treatment ◽  
Oncological Patients ◽  
Increased Risk ◽  
Practice Recommendation ◽  
International Experts

Abstract Background Because of the increased risk in cancer patients of developing complications caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), physicians have to balance the competing risks of the negative impact of the pandemic and the primary tumor disease. In this consensus statement, an international group of experts present mitigation strategies and treatment guidance for patients suffering from high grade gliomas (HGGs) during the coronavirus disease 2019 (COVID-19) pandemic. Methods Sixteen international experts in the treatment of HGG contributed to this consensus-based practice recommendation, including neuro-oncologists, neurosurgeons, radiation oncologists, and a medical physicist. Generally, treatment of neuro-oncological patients cannot be significantly delayed and initiating therapy should not be outweighed by COVID-19. We present detailed interdisciplinary treatment strategies for molecular subgroups in 2 pandemic scenarios, a scale-up phase and a crisis phase. Conclusion This practice recommendation presents a pragmatic framework and consensus-based mitigation strategies for the treatment of HGG patients during the SARS-CoV-2 pandemic.

Conservative Management and Biological Treatment Strategies: Proceedings of the International Consensus Meeting on Cartilage Repair of the Ankle

2018 ◽  
Vol 39 (1_suppl) ◽  
pp. 9S-15S ◽  
Author(s):  
Malcolm E. Dombrowski ◽  
Youichi Yasui ◽  
Christopher D. Murawski ◽  
Lisa A. Fortier ◽  
Eric Giza ◽  
...  
Keyword(s):  
Cartilage Repair ◽  
Conservative Management ◽  
Biological Treatment ◽  
Treatment Strategies ◽  
Consensus Meeting ◽  
Osteochondral Lesions ◽  
International Consensus ◽  
Consensus Statements ◽  
Working Groups ◽  
Strong Consensus

Background: The evidence supporting best practice guidelines in the field of cartilage repair of the ankle are based on both low quality and low levels of evidence. Therefore, an international consensus group of experts was convened to collaboratively advance toward consensus opinions based on the best available evidence on key topics within cartilage repair of the ankle. The purpose of this article is to report the consensus statements on “Conservative Management and Biological Treatment Strategies” developed at the 2017 International Consensus Meeting on Cartilage Repair of the Ankle. Methods: Seventy-five international experts in cartilage repair of the ankle representing 25 countries and 1 territory were convened and participated in a process based on the Delphi method of achieving consensus. Questions and statements were drafted within 11 working groups focusing on specific topics within cartilage repair of the ankle, after which a comprehensive literature review was performed and the available evidence for each statement was graded. Discussion and debate occurred in cases where statements were not agreed upon in unanimous fashion within the working groups. A final vote was then held, and the strength of consensus was characterized as follows: consensus, 51% to 74%; strong consensus, 75% to 99%; unanimous, 100%. Results: A total of 12 statements on Conservative Management and Biological Treatment Strategies reached consensus during the 2017 International Consensus Meeting on Cartilage Repair of the Ankle. Ten statements reached strong consensus (greater than 75% agreement), and 2 achieved consensus. Conclusions: This international consensus derived from leaders in the field will assist clinicians with conservative management and biological treatment strategies for osteochondral lesions of the talus.

scholarly journals Current Trends Among US Surgeons in the Identification, Treatment, and Time of Repair for Medial Meniscal Ramp Lesions at the Time of ACL Surgery

2019 ◽  
Vol 7 (2) ◽  
pp. 232596711982726 ◽  
Author(s):  
Nicholas N. DePhillipo ◽  
Lars Engebretsen ◽  
Robert F. LaPrade
Keyword(s):  
United States ◽  
Acl Reconstruction ◽  
Sports Medicine ◽  
Orthopaedic Surgery ◽  
Cruciate Ligament ◽  
Treatment Strategies ◽  
The United States ◽  
Cross Sectional ◽  
Current Trends ◽  
Acl Surgery

Background: Given the potential hidden nature of medial meniscal ramp lesions and the controversy regarding treatment, it is important to understand the current trends regarding the identification and treatment strategies of meniscal ramp lesions by the leading surgeons and educators in the field of sports medicine. Purpose: To better understand the current trends in orthopaedic surgery regarding arthroscopic identification and treatment of medial meniscal ramp lesions at the time of anterior cruciate ligament (ACL) surgery. Study Design: Cross-sectional study. Methods: An electronic questionnaire was sent in a blinded fashion to 91 directors of orthopaedic sports medicine fellowship training programs in the United States. Participants’ email addresses were obtained through the American Orthopaedic Society for Sports Medicine directory of current fellowship program directors. Inclusion criteria were only those surgeons who currently performed ACL reconstruction surgery. Exclusion criteria were those surgeons who did not perform ACL reconstruction or who chose to opt out of the survey. Results: Overall, 19 surgeons opted out of the survey; 36 responded from the remaining 72 surveys (50%). The majority (n = 31, 86%) reported routinely checking for a medial meniscal ramp lesion via inspection of the posteromedial meniscocapsular junction during an ACL reconstruction. The most common repair technique cited was all-inside (n = 24, 66.7%), followed by inside-out (n = 8, 22.2%). Three (8%) surgeons indicated that they did not repair meniscal ramp lesions. Regarding surgical treatment (repair vs no treatment), the majority reported using the extent of the tear (89%; partial vs full thickness) and the stability of the tear upon probing (81%) as the main criteria for intraoperative decision making. Nineteen (52.8%) surgeons required a mean time of <15 minutes for meniscal ramp repair; 16 surgeons (44.4%), 15 to 30 minutes; and 1 surgeon (2.8%), 30 to 45 minutes. Conclusion: This study provides insight regarding meniscal ramp tear identification, treatment, and repair strategies from the fellowship directors of sports medicine orthopaedic surgery in the United States. Such information may be useful for current orthopaedic surgeons to advance their practice according to the current trends surrounding ACL reconstruction and medial meniscal ramp repair.

scholarly journals The European Association for Sports Dentistry, Academy for Sports Dentistry, European College of Sports and Exercise Physicians consensus statement on sports dentistry integration in sports medicine

2020 ◽  
Vol 36 (6) ◽  
pp. 680-684
Author(s):  
Athanasios Stamos ◽  
Steve Mills ◽  
Nikos Malliaropoulos ◽  
Sophie Cantamessa ◽  
Jean‐Luc Dartevelle ◽  
...  
Keyword(s):  
Sports Medicine ◽  
European Association ◽  
Consensus Statement ◽  
Sports And Exercise ◽  
European College

Pharmacologic Treatment of Agitation in Dementia: A Comprehensive Review

1996 ◽  
Vol 9 (3) ◽  
pp. 107-119 ◽  
Author(s):  
Melinda S. Lantz ◽  
Deborah Marin
Keyword(s):  
Sample Size ◽  
Diagnostic Criteria ◽  
Disruptive Behavior ◽  
Small Sample Size ◽  
Treatment Strategies ◽  
Small Sample ◽  
Pharmacologic Treatment ◽  
Comprehensive Review ◽  
Pharmacologic Treatments ◽  
Growing Population

Agitated behaviors are a common and nearly universal occurrence among patients suffering from dementing illnesses. The pharmacologic treatments available for this troubling syndrome are varied, but treatment studies are limited. Clinicians are frequently faced with the challenging management of patients with disruptive behavior who fail to respond to trials with multiple agents. This review summarizes available treatment studies of agitation in dementia and offers a guide to therapy and management. Reports of therapies for agitation in dementia are limited by lack of controlled studies, variability of diagnostic criteria and outcome measures, and small sample size. The need for carefully designed, well-controlled studies of outcome in this growing population is formidable. It is imperative to identify effective and well-tolerated treatment strategies to reduce the morbidity of these distressing and burdensome symptoms.

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