Treatment of anterior shoulder instability: a bibliometric analysis

Purpose The treatment of anterior shoulder instability is a focus in the field of sports medicine. While much research has been conducted, few bibliometric studies have been performed in this field. This study analyzed the main characteristics and identified emerging research trends and hotspots related to the treatment of anterior shoulder instability over the past four decades. Methods We searched for (anterior shoulder instability OR anterior shoulder dislocation) AND (treatment OR reconstruction) in ARTICLE (Mesh) in the Web of Science database from 1980 to 2020. We analyzed the keywords, author, institution, country, number of citations, average number of citations, publication year, and partnership of the identified articles. Information about annual publications was analyzed using Microsoft Excel 2019; the remaining data were analyzed using VOSviewer version 1.6.11 (Leiden University, Leiden, Netherlands) and CiteSpace version 5.7.R2 (Drexel University, Philadelphia, PA, USA). Results A total of 1964 articles were published between 1980 and 2020. The American Journal of Sports Medicine, the United States, the United States Department of Defense, and Arcieio were journals, countries, institutions, and authors with the highest numbers of publications. The topic hotspots were instability, shoulder, and dislocation, while the research frontiers were arthroscopic, Bankart repair, Latarjet procedure, risk factors, recurrence, and complications. Conclusion The treatment of anterior shoulder instability has shown an increasing number of publications each year and achieved great progress. The United States made the most outstanding contributions to this important field. Arthroscopic, Bankart repair, and Latarjet procedures were research hotspots and risk factors, recurrence, and complications were likely to research frontiers.

Platelet analogues in periodontal regeneration: A narrative review

Platelet analogues (PA; platelet rich plasma and platelet rich fibrin) are autologous bioactive compounds that have a wide range of medical and dental applications, including periodontal, maxillofacial, Plastic surgery and sports medicine. The aim of these technologies is to collect all the constituents of a patient's blood sample so that they can be used to promote tissue regeneration and improve healing. Since 1954, PA has come a long way. Periodontology and implant dentistry have both benefited from the use of PAs. However, the non-standard preparation technique, processing time, transfer of concentrates, centrifugation temperature, vibration, etc. are all variables that contribute to the various results described in the literature. This study will retrace the evolution of PAs, their preparation procedures, their clinical and technological characteristics and their uses.

Optimizing Health and Athletic Performance for Women

Purpose of Review The exponential growth of women participating in competitive sports throughout the years was made possible through several initiatives by the International Olympic Committee and the passage and implementation of Title IX as a federal law in the United States. However, this positive trend towards gender equity in sports has not transpired for women in medicine, especially in fields that care for elite athletes. This current review will discuss specific areas that can be tailored to help female athletes prevent injuries and optimize their athletic performance. We will also highlight how increased female team physician representation in sports may help optimize care for female athletes. Recent Findings Female athletes are considered high risk for certain conditions such as ACL tears, patellofemoral pain syndrome, bone stress injuries, sport-related concussions, and sexual violence in sport. Addressing factors specific to female athletes has been found to be valuable in preventing injuries. Strength and conditioning can optimize athletic performance but remains underutilized among female athletes. Although diversity in healthcare workforce has been found to be beneficial for multiple reasons, women remain underrepresented in sports medicine. Increasing female team physician representation may positively impact care for female athletes. Summary Team physicians must understand the physiologic, biomechanical, and anatomic factors that are unique to female athletes in order to tailor injury prevention programs and optimize their athletic performance. Advocating for gender equity in sports medicine to advance representation of women in the field will increase workforce diversity and promote excellence in sports medicine care.

Ultrasound findings in lateral elbow tendinopathy: A retrospective analysis of radiological tendon features

Background: Lateral elbow tendinopathy (LET) is prevalent in the upper extremity, with various therapeutic options. Understanding the types and the relations between the radiological tendon features would help to develop more specific treatments. This study reviewed ultrasound exams of LET to investigate the types of degenerative findings and the relationships between them in one of the most prominent sports medicine clinics in Latin America. Methods: A retrospective study was performed. We evaluated 4335 ultrasonographic exams with LET from 2017 and 2018. Five principal degenerative ultrasound criteria with subtypes were selected: hypoechogenicity, neovascularity, calcification, enthesopathy, and intrasubstance tear. A multiple linear regression model was conducted to explore the association between the findings, sex, and age. Results: Overall, 4324 ultrasound exams were analyzed; 2607 (60.29%) were males. Multiple degenerative tendon findings were found in adults (≥18 years) with LET. Hypoechogenicity (67.77%) and neovascularity (37.8%) were the most frequent. The mean length of a tendon tear in both sexes was 4.44 (± 2.81) millimeters. Mild hypoechogenicity (P < .001), and depth intrasubstance tear (P < .01) were statistically significant between them. Severe hypoechogenicity was associated with an increase in all tendon tear dimensions for length 1.37 ([95% Confidence interval (CI), 0.57, 2.17]; P < .001), for width 1.10 ([95% CI, 0.33, 1.87]; P < .01) and for depth 1.64 ([95% CI, 0.40, 2.88]; P < .01). Additional findings associated with an increase in the length dimension were 0.42 associated with focal neovascularity ([95% CI, 0.19, 0.65]; P < .001), and 0.71 associated with multiple neovascularity ([95% CI, 0.27, 1.15]; P < .01). Conclusions: Hypoechogenicity and neovascularity findings presented a positive association with the size of tendon tear in patients with LET. This study reaffirms the increased predominance of tendon tear during the 4th to 6th decades of life.

Development of a screening tool for pelvic floor dysfunction in female athletes: protocol of a Delphi consensus

Background/aim: Several epidemiological studies have found a high prevalence of Pelvic Floor Dysfunction (PFD) among female athletes. However, according to several authors, these data could even be underestimated, both in research and clinical practice. Screening for potential PFD is often delayed and risk factors are not often evaluated. As a consequence, withdrawal from sport, negative influence on performance, worsening symptoms and unrecognized diagnosis may occur. The aim of our research is to develop a screening tool for pelvic floor dysfunction in female athletes useful for clinicians (musculoskeletal/sport physiotherapists, sports medicine physicians, team physicians) to guide referral to a PFD expert (e.g. pelvic floor/women's health physiotherapist, gynecologist, uro-gynecologist, urologist). Methods: A 2-round modified Delphi study will be conducted to ascertain expert opinion on which combination of variables and risk factors should be included in the screening tool. Conclusion: The implementation of the present screening tool into clinical practice may facilitate the referral to a PFD expert for further assessment of the pelvic floor and therefore, to identify potential dysfunction and, eventually, the related treatment pathway.

Exercise medicine and physical activity promotion: core curricula for US medical schools, residencies and sports medicine fellowships: developed by the American Medical Society for Sports Medicine and endorsed by the Canadian Academy of Sport and Exercise Medicine

Regular physical activity provides a variety of health benefits and is proven to treat and prevent several non-communicable diseases. Specifically, physical activity enhances muscular and osseous strength, improves cardiorespiratory fitness, and reduces the risk of hypertension, coronary heart disease, stroke, type 2 diabetes, mental health disorders, cognitive decline and several cancers. Despite these well-known benefits, physical activity promotion in clinical practice is underused due to insufficient training during medical education. Medical trainees in the USA receive relatively few hours of instruction in sports and exercise medicine (SEM). One reason for this shortage of instruction is a lack of curricular resources at each level of medical education. To address this need, the American Medical Society for Sports Medicine (AMSSM) assembled a group of SEM experts to develop curricular guidance for exercise medicine and physical activity promotion at the medical school, residency and sports medicine fellowship levels of training. After an evidence review of existing curricular examples, we performed a modified Delphi process to create curricula for medical students, residents and sports medicine fellows. Three training level-specific curricula emerged, each containing Domains, General Learning Areas, and Specific Learning Areas; options for additional training and suggestions for assessment and evaluation were also provided. Review and comment on the initial curricula were conducted by three groups: a second set of experts in exercise medicine and physical activity promotion, sports medicine fellowship directors representing a variety of fellowship settings and the AMSSM Board of Directors. The final curricula for each training level were prepared based on input from the review groups. We believe enhanced medical education will enable clinicians to better integrate exercise medicine and physical activity promotion in their clinical practice and result in healthier, more physically active patients.

Wearable Sensors and Machine Learning for Hypovolemia Problems in Occupational, Military and Sports Medicine: Physiological Basis, Hardware and Algorithms

Hypovolemia is a physiological state of reduced blood volume that can exist as either (1) absolute hypovolemia because of a lower circulating blood (plasma) volume for a given vascular space (dehydration, hemorrhage) or (2) relative hypovolemia resulting from an expanded vascular space (vasodilation) for a given circulating blood volume (e.g., heat stress, hypoxia, sepsis). This paper examines the physiology of hypovolemia and its association with health and performance problems common to occupational, military and sports medicine. We discuss the maturation of individual-specific compensatory reserve or decompensation measures for future wearable sensor systems to effectively manage these hypovolemia problems. The paper then presents areas of future work to allow such technologies to translate from lab settings to use as decision aids for managing hypovolemia. We envision a future that incorporates elements of the compensatory reserve measure with advances in sensing technology and multiple modalities of cardiovascular sensing, additional contextual measures, and advanced noise reduction algorithms into a fully wearable system, creating a robust and physiologically sound approach to manage physical work, fatigue, safety and health issues associated with hypovolemia for workers, warfighters and athletes in austere conditions.