Sex differences in the knee orthopaedic injury patterns among recreational alpine skiers

Background Although studies have reported the sex differences in injury patterns among recreational skiers, the findings are still conflicting. This study aims to analyse the sex differences of orthopaedic knee injuries that occurred during alpine skiing. Methods A total of 306 recreational alpine skiers (125 females and 181 males) who sustained knee surgeries between June 2016 and December 2018 participated in this study. Age, height, weight, and physical activity level of the patients were recorded. The orthopaedic knee injury patterns were analysed based on the diagnosis given by the physicians. Results Male skiers (17.13%) had a higher proportion of multiple knee ligament injuries than females (6.40%). The combined anterior cruciate ligament (ACL) and medial collateral ligament injury were the most common injury types in both females and males, with ACL injury being more prevalent for females (79.20%) than that in males (56.35%). The proportion of female skiers (17.6%) with vigorous-intensity activity level was significantly lower than that of males (30.9%). Female skiers had lower body height, body weight, and body mass index than male skiers (P < 0.001). Conclusions ACL injury is the most common orthopaedic injury among both female and male knee-injured recreational skiers. The proportion of females with an ACL injury is higher than that of males, but the proportion of multiple knee ligament injuries is lower than that of males. More male recreational skiers have vigorous-intensity activity level habits in daily life than females.

Chronic physical health conditions and associated factors among people with serious orthopaedic injuries: A systematic review

Introduction A clear understanding of the development of chronic physical health conditions following orthopaedic injury is essential to fully recognise the magnitude and burden of injury, improve treatment and predict certain outcomes. This review aimed at systematically identifying and evaluating current evidence of the incidence and prevalence of chronic physical health conditions and factors associated with chronic physical health conditions following serious orthopaedic injury. Materials and method Systematic literature search was performed using Ovid MEDLINE, Scopus, and Embase via Ovid, Cochrane Library and Ovid Emcare up to 30 December 2018. Observational studies relating to the incidence or prevalence of chronic physical health conditions and associated factors in people with serious orthopaedic injuries were included. Data extraction and methodological quality assessment were carried out independently by 2 reviewers. Result Of the 4835 references identified in the initial search, only five studies with sample sizes ranging from 83 to 3846 met the criteria for inclusion. The most prevalent conditions reported in people with serious orthopaedic injury included coronary artery disease, arrhythmias, myocardial infarction, hypertension, diabetes mellitus and chronic heart failure. Bronchial, rectal, prostate and breast cancers were also causes of late death in orthopaedic injury survivors. Most of the studies included in this review were unable to determine whether these conditions were related to injuries. Conclusions Chronic physical health conditions are prevalent among people with serious orthopaedic injury. Little is known about factors associated with chronic physical health conditions following serious orthopaedic injury or whether physical health conditions are associated with injury. Further work needs to be done to identify causal pathways and the longer-term effects of orthopaedic injury on the risk of developing chronic physical health conditions.

Agreement between the International Physical Activity Questionnaire and Accelerometry in Adults with Orthopaedic Injury

Orthopaedic injury can lead to decreased physical activity. Valid measures for assessing physical activity are therefore needed in this population. The aim of this study was to determine the agreement and concordance between the International Physical Activity Questionnaire–Short Form (IPAQ) and device-measured physical activity and sitting time in orthopaedic injury patients. Adults with isolated upper or lower limb fracture (n = 46; mean age of 40.5 years) wore two activity monitors (ActiGraph wGT3X-BT and activPAL) for 10 days, from 2 weeks post-discharge. The IPAQ was also completed for a concurrent 7-day period. Lin’s concordance correlation coefficients and Bland–Altman plots were calculated to compare walking/stepping time, total METmins, and sitting time. The IPAQ overestimated device-derived walking time (mean difference = 2.34 ± 7.33 h/week) and total METmins (mean difference = 767 ± 1659 METmins/week) and underestimated sitting time (mean difference = −2.26 ± 3.87 h/day). There was fair concordance between IPAQ-reported and device-measured walking (ρ = 0.34) and sitting time (ρ = 0.38) and moderate concordance between IPAQ-reported and device-measured METmins (ρ = 0.43). In patients with orthopaedic injury, the IPAQ overestimates physical activity and underestimates sitting time. Higher agreement was observed in the forms of activity (walking, total PA and sitting) commonly performed by this patient group.

Return to Sport after Injury: A Web-Based Survey of Owners and Handlers of Agility Dogs

Objective Internet-based surveys of canine agility injury rates have been performed, but unlike with equine and human competition, there is a paucity of data on return to sport of agility dogs after orthopaedic injury. This study aimed to gather initial information on canine return to competition. Methods Data were collected using an internet-based 18-question survey of 427 dogs from around the world (92.4% North America). Relationships between categorical variables and return to sport were assessed with descriptive statistics, a chi-squared or Fischer's exact test. Categorical variables included breed, sex, age, surgery, stifle versus shoulder surgery, stifle versus all other types of surgery and drop in competition class. Significance was set at p≤ 0.05. Results Of 427 completed surveys, age, sex and breed were not significantly associated with return to competition. Overall, 67.4% of dogs returned to competition post-orthopaedic injury, but jump height was lowered in 47% of cases. Dogs were returned to competition post-stifle surgery, but were the least likely of all injury types to return to competition (p = 0.044) and were more likely to compete at a lower class (p = 0.026). Clinical Significance While over half of all dogs returned to competition, just under half of that group decreased jump class. Dogs that have undergone stifle surgery have the worst prognosis for return to agility and if they return, they are more likely to drop class.