scholarly journals Good Subjective Outcomes, Stable Knee and High Return to Sport after Tibial Eminence Avulsion Fracture in Children

Children ◽  
2020 ◽  
Vol 7 (10) ◽  
pp. 173
Author(s):  
Stefano Stallone ◽  
Filippo Selleri ◽  
Giovanni Trisolino ◽  
Alberto Grassi ◽  
Luca Macchiarola ◽  
...  
Keyword(s):  
Avulsion Fracture ◽  
Sport Activity ◽  
Return To Sport ◽  
Knee Laxity ◽  
International Knee Documentation Committee ◽  
High Rate ◽  
Special Focus ◽  
Early Return ◽  
Complete Restoration ◽  
Sport Activities

Avulsion fracture of the tibial spine (TSA) is uncommon in children, although its incidence is increasing with the earlier practice of competitive sport activities. This study aims to report mid to long term outcomes in children who sustained a TSA, with a special focus on a return to sport activities. Skeletally immature patients with a TSA, treated in two orthopedic hospitals, were evaluated for range of motion and knee laxity using KT1000, KiRA and Rolimeter. The pediatric International Knee Documentation Committee score (Pedi-IKDC) and the Hospital for Special Surgery pediatric Functional Activity Brief Scale (Pedi-FABS) questionnaires were recorded during the latest visit. Forty-two children were included. Twenty-six were treated nonoperatively and 16 underwent surgery. At a mean follow-up of 6.9 ± 3.6 years, 36 patients completed the questionnaires and 23 patients were tested with arthrometers. Among them, 96% had normal knee laxity. The Pedi-IKDC score averaged 96.4 ± 5.7 points, while the mean Pedi-FABS was 22.2 ± 5.9 points, without statistically significant differences between groups. Twenty-eight patients (78%) returned to their previous level of sport activity (eight amateur, 13 competitive, seven elite athletes). Eight patients (22%) quit sport, mostly because of re-injury fear. If properly treated, pediatric TSAs achieve a high rate of successful healing, with complete restoration of knee stability and an early return to sport activities.

scholarly journals Iliac Crest Avulsion Fracture in a Young Sprinter

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
L. Casabianca ◽  
R. Rousseau ◽  
P. Loriaut ◽  
A. Massein ◽  
G. Mirouse ◽  
...  
Keyword(s):  
Lower Limb ◽  
Iliac Crest ◽  
Avulsion Fracture ◽  
Return To Sport ◽  
Loss Of Function ◽  
Acceleration Phase ◽  
X Ray ◽  
Sport Activities ◽  
Phase Out ◽  
Rare Diagnosis

Avulsion fracture of the iliac crest is an uncommon pathology. It usually occurs in teenagers during sport activities, more common in boys. We report a case of 16-year-old male competitive sprinter, who had an avulsion of a part of the iliac crest and the anterior-superior iliac spine during a competition. The traumatism occurred during the period of acceleration phase out of the blocks which corresponds to the maximum traction phase on the tendons. Then a total loss of function of the lower limb appears forcing him to stop the run. X-ray and CT scan confirmed the rare diagnosis of avulsion of the quasitotality of the iliac crest apophysis, corresponding to Salter 2 fracture. We performed an open reduction and internal fixation with two screws, allowing a return to sport after 3 months and his personal best record in the 100 meters at the 6th postoperative month.

Repair of a Complete Radial Tear of the Lateral Meniscus

2021 ◽  
Vol 1 (4) ◽  
pp. 263502542110142
Author(s):  
Anthony J. Ignozzi ◽  
Greg Anderson ◽  
David R. Diduch
Keyword(s):  
Lateral Meniscus ◽  
Return To Sport ◽  
International Knee Documentation Committee ◽  
High Rate ◽  
Joint Effusion ◽  
Convex Shape ◽  
Axial Forces ◽  
Outer Capsule ◽  
Meniscus Healing ◽  
Radial Tear

Background: Recognizing and repairing a lateral meniscus complete radial tear is critical, as this tear pattern makes the meniscus nonfunctional for load sharing of axial forces, and the convex shape of the lateral tibial plateau increases contact pressure. Indications: The diagnosis of a lateral meniscus complete radial tear was supported by joint effusion, lateral joint line tenderness, positive McMurray test, and magnetic resonance imaging findings. Arthroscopy confirmed the complete radial tear. Technique Description: During the procedure, a self-capturing suture passer was used to pass a size 0 high-strength suture through the meniscus. To start the repair, the free ends of the suture were passed from top to bottom on both sides of the tear. These free ends were then crossed on the bottom of the meniscus to create an X configuration and passed from the bottom to top slightly further back from the first suture passes. A spinal needle and a chia were used from outside-in to create a side-to-side suture across the tear to reinforce the repair, and a knot was then tied on the outer capsule. The chia was used once again to shuttle the size 0 sutures to the exterior portion of the knee and the knots were tied on top of the capsule. Results: Postoperatively, patients are 25% weightbearing with a 0° to 90° range of motion restriction for 6 weeks, with no deep squatting for 3 months. With an isolated radial tear repair, the patient can expect to return to sport by 5 months. Radial tear repair outcomes demonstrate reduced lateral meniscus extrusion, complete meniscus healing in 86.4% of patients, and significantly improved International Knee Documentation Committee, Lysholm, and Tegner scores. Discussion/Conclusion: Repairing a complete radial tear of the lateral meniscus restores the function of the meniscus. This surgical technique provides a high rate of complete meniscus healing and excellent patient satisfaction.

scholarly journals Surgically Treated Nonunion following Ischial Tuberosity Avulsion Fracture of a 14-Year-Old Athlete

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Yuta Nakamatsu ◽  
Tomoaki Fukui ◽  
Keisuke Oe ◽  
Shinya Hayashi ◽  
Tomoyuki Matsumoto ◽  
...  
Keyword(s):  
Avulsion Fracture ◽  
Muscle Power ◽  
Return To Sport ◽  
Ischial Tuberosity ◽  
Return To Sports ◽  
Buttock Pain ◽  
Postoperative Rehabilitation ◽  
Avulsion Fractures ◽  
Early Return ◽  
Full Speed

A 14-year-old girl experienced acute left buttock pain during a sprint. At the local hospital, she was diagnosed with an avulsion fracture of the left ischial tuberosity. She was kept for observation for about 10 months; however, the buttock pain persisted, and the bone fragments did not unite. She was referred to our hospital approximately 11 months after the injury. Plain radiography revealed an increased transposition of the bone fragment, from 12 mm immediately after the injury to 23 mm. Twelve months after the injury, she underwent osteosynthesis using two cannulated cancellous screws and three suture anchors. Following postoperative rehabilitation, the power in her left hamstring recovered, and she was able to run at full speed and returned to athletics 9 months after the surgery. The operative indications for avulsion fractures of the ischial tuberosity are unclear. Careful follow-up is required as the rate of nonunion after conservative treatment tends to be high. This needs to be identified in order to provide timely treatment that allows for early return to sport. Although she had significant chronic pain and muscle weakness, the surgery successfully treated the fracture, and her muscle power recovered, leading to her return to sports.

Altered Knee Laxity and Stiffness in Response to a Soccer Match Simulation in Players Returning to Sport Within 12 Months After Anterior Cruciate Ligament Reconstruction

2021 ◽  
pp. 036354652110130
Author(s):  
Stefano Nuccio ◽  
Luciana Labanca ◽  
Jacopo Emanuele Rocchi ◽  
Pier Paolo Mariani ◽  
Paola Sbriccoli ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Return To Sport ◽  
Knee Laxity ◽  
Activity Level ◽  
Soccer Players ◽  
Control Group ◽  
Soccer Match ◽  
Anterior Cruciate ◽  
Anterior Knee

Background: The acute effects of exercise on anterior knee laxity (AKL) and anterior knee stiffness (AKS) have been documented in healthy participants, but only limited evidence has been provided for athletes cleared to return to sports after anterior cruciate ligament (ACL) reconstruction (ACLR). Purpose/Hypothesis: The purpose was to determine if 45 minutes of a soccer match simulation lead to acute changes in AKL and AKS in soccer players returning to sport within 12 months after ACLR. We hypothesized that the reconstructed knee of the ACLR group would exhibit an altered response to sport-specific exercise. Study Design: Controlled laboratory study. Methods: A total of 13 soccer players cleared to return to sport after ACLR and 13 healthy control soccer players matched for age, physical activity level, limb dominance, and anthropometric characteristics were recruited. To assess the effects of a standardized soccer match simulation (Soccer Aerobic Field Test [SAFT45]) on AKL and AKS, an arthrometric evaluation was carried out bilaterally before and immediately after SAFT45. To conduct a comprehensive examination of the force-displacement curve, the absolute and side-to-side difference (SSD) values of both AKL and AKS were extracted at 67, 134, and 200 N. Results: The ACLR and control groups showed similar AKL and AKS at baseline ( P > .05). In response to SAFT45, laxity increased bilaterally at all force levels by 14% to 17% only in the control group ( P < .025). Similarly, AKS at 134 and 200 N decreased in response to SAFT45 only in the control group (10.5% and 20.5%, respectively; P < .025). After SAFT45, the ACLR group had 1.9 and 2.5 times higher SSDs of AKS at 67 and 134 N compared with the control group, respectively ( P < .025), as well as a 1.9 times higher SSD of AKS at 134 N compared with baseline ( P = .014). Conclusion: Soccer players at the time of return to sport after ACLR showed an altered mechanical response to a sport-specific match simulation consisting of bilaterally unchanged AKL and AKS. Clinical Relevance: Soccer players showing altered AKL and AKS in response to exercise after ACLR may not be ready to sustain their preinjury levels of sport, thus potentially increasing the risk of second ACL injuries.

Comparative assessment of the dynamics of the incidence of pulmonary and etraulmonary tuberculosis in St. Petersburg for half a century of observation

MedAlliance ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 6-14
Keyword(s):  
Control System ◽  
Incidence Rate ◽  
Extrapulmonary Tuberculosis ◽  
High Rate ◽  
Tb Control ◽  
Complete Restoration ◽  
Third Stage ◽  
High Level ◽  
Clinical Awareness ◽  
Positive Effect

This article describes the results of comparative analysis of the dynamics of incidence of pulmonary tuberculo-sis (TBP), extrapulmonary extrarespiratory tuberculo-sis (TBER) and respiratory extrapulmonary tuberculosis (TBREP) in St. Petersburg (Leningrad) from 1970 to 2019. Throughout the 50 years of observation, epidemiological situation for TBP, especially for TBER, hasmuch improved, with incidence of the latter going down 30 times. Five stages (decades) were identified, within which the factors demonstrate practically the same impact, the growth rate of indicators was calculated for each stage (the value of indicators at the beginning of each stage taken as 100%).The first stage was a simultaneous reduction in the inci-dence rate in all categories of TB localization against the background of socio-economic factors positive effect and organization of effective and comprehensive an-ti-TB measures. In the second stage (1980ies, a period of growing socio-economic problems), the positive dynam-ics of TB incidence stopped and switched to stabilization at a low level. Indicators became more volatile, while TB dynamics by localization more and more desynchro-nized. Тhe third stage (1990iеs, a period of social and economic crisis) was char-acterised by a sharp increase of TB incidence, especially TBREP, with a switch to stabi-lization at a high level. The fourth stage (2000 through 2009, the beginning of TB control system restoration) demonstrated the indicators’ dynamics desynchroniza-tion: the incidence of TBP and TBREP has stabilized, and TBER continued to decline. The fifth stage (2009 through 2019, complete restoration of TB control system) showed a steady trend of incidence rate reduction and return of uniformity in incidence rate of various localizations.There is no increase in the proportion of extrapulmonary TB expected for the incidence decline. TBER incidence had been declining in most stages, with the exception of the 90ies, which could be explained by substandard work in identifying patients, and the rarity of TBER etiological verification. It is necessary to raise the clinical awareness of narrow specialists and general practitioners in the di-agnostic problems associated with TBER.The coincidence of the rate of TB incidence decrease in main localizations in the 1970ies and 2010s proves that a comprehensive state strategy to combat tuberculosis can provide a high rate of TB incidence decrease in various social layers with positive social and economic conditions of life of the population.

scholarly journals Return to Sport After Ankle Syndesmotic Injury: A Systematic Review

2018 ◽  
Vol 11 (2) ◽  
pp. 116-122 ◽  
Author(s):  
Seline Y. Vancolen ◽  
Ibrahim Nadeem ◽  
Nolan S. Horner ◽  
Herman Johal ◽  
Bashar Alolabi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Study Design ◽  
Return To Sport ◽  
Nonoperative Treatment ◽  
High Rate ◽  
Rate Of Return ◽  
Syndesmotic Injury ◽  
Level Of Evidence ◽  
Treatment Groups ◽  
Pertinent Data

Context: Ankle syndesmotic injuries present a significant challenge for athletes due to prolonged disability and recovery periods. The optimal management of these injuries and rates of return to sport in athletes remains unclear. Objective: The purpose of this study was to evaluate return to sport for athletes after ankle syndesmotic injuries. Data Source: The electronic databases MEDLINE, EMBASE, and PubMed were searched for relevant studies from database inception to January 15, 2017, and pertinent data were abstracted. Study Selection: Only studies reporting return-to-sport rates after ankle syndesmotic injuries were included. Study Design: Systematic review. Level of Evidence: Level 4. Data Extraction: Two reviewers extracted data from the included studies, which were stored in a standardized collection form (Microsoft Excel). Recorded data included demographics (eg, author, year of publication, study design), descriptive statistics (eg, patient age, percentage male, number of athletes, sample size), and outcomes (eg, time to return to sport, proportion of those who returned to sport, the self-reported questionnaire the Olerud-Molander Ankle Score). Results: A total of 10 studies and 312 patients with ankle syndesmotic injuries were included in this systematic review. The rate of return to preinjury or any injury level of sport after ankle syndesmotic injuries was 93.8% ± 1.2% and 97.6% ± 1.5%, respectively, for the corresponding 7 and 3 studies that reported this characteristic. The mean time to return to sport was 46.4 days (range, 15.4-70 days), with 55.2 ± 15.8 and 41.7 ± 9.8 days for operative and nonoperative management, respectively. Conclusion: This systematic review found a high rate of return to any as well as preinjury level of sport after ankle syndesmotic injury in both operative and nonoperative treatment groups. However, further high-level studies are required to compare operative and nonoperative treatment groups associated with return to sport after ankle syndesmotic injury.

scholarly journals Physical activity types and risk of dementia in community-dwelling older people: the Three-City cohort.

2020 ◽  
Author(s):  
Caroline Dupré ◽  
Bienvenue Bongue ◽  
Catherine Helmer ◽  
Jean François Dartigues ◽  
David Hupin ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older People ◽  
Sport Activity ◽  
Apoe Genotype ◽  
Community Dwelling ◽  
Activity Level ◽  
Activity Levels ◽  
Dementia Risk ◽  
Sport Activities ◽  
Activity Types

Abstract Background Physical activity may decrease the risk of dementia; however, previous cohort studies seldom investigated the different types of physical activity and household activities. Our objective was to analyze the links between two physical activity types and dementia in older people. Methods The study used data from the prospective observational Three-city cohort and included 1550 community-dwelling individuals aged 72 to 87 without dementia at baseline. Physical activity was assessed with the Voorrips questionnaire. Two sub-scores were calculated to assess household/transportation activities and leisure/sport activities. Restricted cubic spline and proportional hazard Cox models were used to estimate the non-linear exposure-response curve for the dementia risk and the appropriate activity level thresholds. Models were adjusted for possible confounders, including socio-demographic variables, comorbidities, depressive symptoms and APOE genotype. Results The median age was 80 years, and 63.6% of participants were women. After a median follow-up of 4.6 years, dementia was diagnosed in 117 participants (7.6%). An inverse J-shaped association was found between household/transportation physical activity sub-score and dementia risk, which means that the risk is lowest for the moderately high values and then re-increases slightly for the highest values. The results remained significant when this sub-score was categorized in three classes (low, moderate, and high), with hazard ratios (95% confidence interval) of 0.55 (0.35-0.87) and 0.62 (0.38-1.01) for moderate and high activity levels, respectively. No significant effect was found for leisure/sport activities. Conclusions The 5-year risk of dementia was significantly and negatively associated with the household/transportation activity level, but not with the leisure and sport activity sub-score. This highlights the importance of considering all physical activity types in 72 years or older people.

Measuring Physical Activity and Sports Participation After Autologous Cartilage Implantation: A Systematic Review

2014 ◽  
Vol 23 (3) ◽  
pp. 171-181 ◽  
Author(s):  
Andre Filipe Santos-Magalhaes ◽  
Karen Hambly
Keyword(s):  
Physical Activity ◽  
Sport Participation ◽  
Rating Scale ◽  
Evidence Synthesis ◽  
Return To Sport ◽  
Sports Participation ◽  
International Knee Documentation Committee ◽  
Primary Treatment ◽  
Functional Score ◽  
Sport And Exercise

Context:The assessment of physical activity and return to sport and exercise activities is an important component in the overall evaluation of outcome after autologous cartilage implantation (ACI).Objective:To identify the patient-report instruments that are commonly used in the evaluation of physical activity and return to sport after ACI and provide a critical analysis of these instruments from a rehabilitative perspective.Evidence Acquisition:A computerized search was performed in January 2013 and repeated in March 2013. Criteria for inclusion required that studies (1) be written in English and published between 1994 and 2013; (2) be clinical studies where knee ACI cartilage repair was the primary treatment, or comparison studies between ACI and other techniques or between different ACI generations; (3) report postoperative physical activity and sport participation outcomes results, and (4) have evidence level of I–III.Evidence Synthesis:Twenty-six studies fulfilled the inclusion criteria. Three physical activity scales were identified: the Tegner Activity Scale, Modified Baecke Questionnaire, and Activity Rating Scale. Five knee-specific instruments were identified: the Lysholm Knee Function Scale, International Knee Documentation Committee Score Subjective Form, Knee Injury and Osteoarthritis Outcome Score, Modified Cincinnati Knee Score, and Stanmore-Bentley Functional Score.Conclusions:Considerable heterogeneity exists in the reporting of physical activity and sports participation after ACI. Current instruments do not fulfill the rehabilitative needs in the evaluation of physical activity and sports participation. The validated instruments fail in the assessment of frequency, intensity, and duration of sports participation.

Sign in / Sign up

Export Citation Format

Share Document