Sports Health-A Multidisciplinary Approach最新文献

{"title":"Change in Grip and Pinch Strength Over the Course of a Game in Professional Baseball Pitchers.","authors":"Brandon J Erickson, Paul Buchheit, Joseph Rauch, Michael G Ciccotti, Ryan Paul, Steven B Cohen","doi":"10.1177/19417381241305401","DOIUrl":"10.1177/19417381241305401","url":null,"abstract":"<p><strong>Background: </strong>Baseball pitching injuries can be related to fatigue. Changes in grip and pinch strength over the course of professional baseball games are unknown.</p><p><strong>Hypothesis: </strong>Grip and pinch strength will decrease as the number of innings pitched increases; injured pitchers will have a lower grip strength than uninjured pitchers.</p><p><strong>Study design: </strong>Prospective cohort study.</p><p><strong>Level of evidence: </strong>Level 3.</p><p><strong>Methods: </strong>Minor league pitchers for 1 affiliate of a single organization were included. Changes in dominant and nondominant grip, and middle and index finger pincer strength were recorded pregame and after each inning, and compared between players who sustained a shoulder/elbow injury and those who did not.</p><p><strong>Results: </strong>Of 41 pitchers included, 6 sustained a shoulder (n = 2) or elbow (n = 4) injury during the study period. Average grip strength for all pitchers was 124.5 ± 17 lb pregame and increased slightly after the first inning (125.2 ± 17 lb), then declined slowly after the second (120.7 ± 18.5 lb), third (119.2 ± 24 lb), and fourth (113.1 ± 19.6 lb) innings. There was a slight uptick in grip strength in the fifth (118.5 ± 23.6 lb) and sixth (121.3 ± 21.8 lb) innings, but pregame levels were not reached. Evaluating uninjured and injured pitchers, the grip strength of injured pitchers was lower at all timepoints. As a percentage of uninjured pitchers grip strength, injured pitcher grip strength was 94.8% pregame, and 97.9%, 95.4%, 81.8%, 87.7%, 82.3%, and 74.5% after the first to sixth innings, respectively.</p><p><strong>Conclusion: </strong>Dominant arm grip strength generally declined over the course of a game in professional baseball pitchers. Injured pitchers generally had weaker grip strength and a steeper decline in grip strength during games compared with uninjured pitchers.</p><p><strong>Clinical relevance: </strong>Incremental loss of grip strength may increase injury risk in professional baseball pitchers.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"19417381241305401"},"PeriodicalIF":2.7,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimal Detectable Change Scores and Factors Associated With Dynamic Exertion Test (EXiT) Performance After Sport-Related Concussion.","authors":"Dean Gomes, Aaron Sinnott, Aaron J Zynda, Victoria L Kochick, Sarah Ostop, Alicia M Trbovich, Abigail Feder, Michael W Collins, Anthony P Kontos","doi":"10.1177/19417381241298284","DOIUrl":"10.1177/19417381241298284","url":null,"abstract":"<p><strong>Background: </strong>Factors associated with performance outside of a normative range on dynamic exertion test (EXiT) after sport-related concussion (SRC) remain unknown. This study examined the role of demographic and medical history factors on performance using minimal detectable change (MDC) cutoff scores in athletes being cleared to return to sport (RTS) from SRC.</p><p><strong>Hypothesis: </strong>Older age, being female, and body mass index (BMI) ≥50th percentile would be associated with worse EXiT performance and with increased likelihood of falling outside the normative MDC score range.</p><p><strong>Study design: </strong>Cross-sectional.</p><p><strong>Level of evidence: </strong>Level 3.</p><p><strong>Methods: </strong>Demographic factors, physiological metrics, performance metrics, symptoms, and ratings of perceived exertion were collected from 55 participants (age, 16.5 ± 2.3 years, 31.5% female) initially evaluated within 14 days of SRC who completed EXiT at medical clearance for RTS. Chi-square analyses, logistic and ordinal regressions, and 1-way analyses of variance examined factors associated with EXiT performance.</p><p><strong>Results: </strong>Most participants fell within the MDC score range on aerobic (71.2-100%), dynamic (75.8-100%), and change-of-direction (36.5-98.0%) tasks, and symptoms (96.2-100%). Older age was associated with better performance on Box Drill Shuffle (<i>P</i> < 0.01) and lower heart rate (HR) outcomes after Ball Toss (<i>P</i> = 0.04), Box Drill Shuffle (<i>P</i> < 0.01), Box Drill Carioca (<i>P</i> = 0.04), and Pro Agility (<i>P</i> < 0.01). Greater BMI was associated with higher HR_%max after Ball Toss (<i>P</i> < 0.01) and worse posttreadmill aerobic performance (<i>P</i> < 0.01). Motion sickness history was associated with longer Zig Zag completion time (<i>P</i> = 0.036).</p><p><strong>Conclusion: </strong>Most athletes presenting for clearance from concussion performed within MDC score ranges on EXiT metrics.</p><p><strong>Clinical relevance: </strong>EXiT is accurate and effective in assessing response to dynamic exertion after SRC, and MDC scores can inform RTS decisions. Clinicians should consider age, BMI, and history of motion sickness when assessing EXiT performance.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"19417381241298284"},"PeriodicalIF":2.7,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11653372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Association Between Vastus Medialis Oblique Characteristics and Patellar Instability: A Comprehensive Case-Control Study.","authors":"Eran Beit Ner, Oded Rabau, Ahmad Essa, Ofir Vinograd, Roy Asaaf, Ron Gilat, Yoram Anekstein","doi":"10.1177/19417381241300159","DOIUrl":"10.1177/19417381241300159","url":null,"abstract":"<p><strong>Background: </strong>The contribution of vastus medialis oblique muscle (VMO) weakness or dysfunction to patellofemoral pain syndrome is well recognized, yet its role in lateral patellar instability and recurrent patellar dislocations remains unclear. This study investigates the association between VMO characteristics and patellar instability.</p><p><strong>Hypothesis: </strong>Altered VMO structure, characterized by differences in muscle elevation and cross-sectional area (CSA), is associated with patellar instability.</p><p><strong>Study design: </strong>A case-control study.</p><p><strong>Level of evidence: </strong>Level 3.</p><p><strong>Methods: </strong>The study included 204 participants, matched on a 1:1 ratio by age and sex, from a local hospital registry from 2005 to 2020. VMO measurements were taken via magnetic resonance imaging, and included muscle elevation, CSA, fiber angulation, and CSA-to-thigh circumference ratio. Univariate analysis, and multivariable regression model with adjustment for potential confounders were constructed. In addition, a secondary analysis was performed to evaluate the variations in VMO characteristics and mass across primary and recurrent patellar instability groups.</p><p><strong>Results: </strong>Patients with patellar instability demonstrated significant differences in VMO characteristics compared with controls, including increased muscle elevation (13 mm vs 5.9 mm; <i>P</i> < 0.01), increased muscle fiber angulation (42.5° vs 35.3°; <i>P</i> < 0.01), reduced CSA (716 mm² vs 902 mm²; <i>P</i> < 0.01), and a lower CSA-to-thigh circumference ratio (0.05 vs 0.07; <i>P</i> < 0.01). These findings remained significant in the multivariable adjusted model. Moreover, the secondary analysis revealed that both primary and recurrent instability patients had similar VMO characteristics alterations compared with controls, with slightly more pronounced reductions in VMO CSA in those sustaining recurrent instability episodes.</p><p><strong>Conclusion: </strong>This study confirms a statistically significant association between altered VMO characteristics and patellar instability, emphasizing the importance of considering VMO characteristics in the evaluation and management of patients with patellar instability.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"19417381241300159"},"PeriodicalIF":2.7,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11653378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative Physical Therapy Is Protective From Construct Failure in Anterior Cruciate Ligament Reconstruction.","authors":"Nicholas J Peterman, Brian K Hansen, Evan P Sandefur, Darren T Hackley, Garret Burks, Devon R Pekas, John R Tuttle","doi":"10.1177/19417381241298308","DOIUrl":"10.1177/19417381241298308","url":null,"abstract":"<p><strong>Background: </strong>Risk factors for anterior cruciate ligament reconstruction (ACLR) construct failure have been studied extensively. However, while some studies account for variables such as activity level, construct types, preoperative physical therapy, or patient demographics individually, comprehensive studies that control for all these factors simultaneously are scarce.</p><p><strong>Hypothesis: </strong>By utilizing a robust multivariable analysis, the factors associated with an increased risk of ACLR construct failure can be determined.</p><p><strong>Study design: </strong>A single-center, retrospective cohort study was conducted, encompassing patients who underwent primary ACLR between January 2015 and December 2021.</p><p><strong>Level of evidence: </strong>Level 3.</p><p><strong>Methods: </strong>Eligible patients were identified using the current procedural terminology code 29888. Datapoints collected included demographics, body mass index, injury setting, graft type, graft size, fixation type, concomitant ligamentous injuries, notchplasty, operating surgeon, preoperative physical therapy, and instances of construct failure. The prevalence of construct failure was analyzed using chi-square tests, comparing across all graft and fixation type combinations in ACLR procedures. A mixed-effects logistic regression model was utilized to account for the potential influence of all relevant variables on construct failure.</p><p><strong>Results: </strong>Out of 1245 patients, the construct failure rate was 5.62% (n = 70), with >95% of patients having >2 years of retrospective follow-up (95% CI [4.34-6.90]), with a median failure time of 502.5 days (interquartile range [265.5-1033.8]). The mixed-effect logistic model identified preoperative physical therapy (odds ratio, 0.404, 95% CI [0.193-0.844]) as the only significant factor in possibly preventing construct failure.</p><p><strong>Conclusion: </strong>Contrary to conventional focus on graft and fixation types, this study emphasizes the protective role of preoperative physical therapy in reducing ACLR construct failure.</p><p><strong>Clinical relevance: </strong>Our findings suggest the integration of preoperative physical therapy in clinical practices to mitigate ACLR construct failure risk, warranting further exploration in future studies.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"19417381241298308"},"PeriodicalIF":2.7,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11653376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fatal Exertional Heat Stroke Trends in Secondary School Sports From 1982 Through 2022.","authors":"Rebecca L Stearns, Kristen L Kucera, Yuri Hosokawa, Erica M Filep, Aleksis Grace, Randi DeLong, Robert Cantu, Douglas J Casa","doi":"10.1177/19417381241298293","DOIUrl":"10.1177/19417381241298293","url":null,"abstract":"<p><strong>Background: </strong>Exertional heat stroke (EHS) is a leading cause of secondary school sport-related death; however, a longitudinal analysis on observed trends is lacking. Our purpose was to describe EHS deaths in United States secondary school athletes since the 1982/1983 academic year.</p><p><strong>Hypothesis: </strong>EHS deaths will be primarily represented by football athletes and have a stable or increasing trend across a decade-by-decade analysis.</p><p><strong>Study design: </strong>Descriptive epidemiology study.</p><p><strong>Level of evidence: </strong>Level 4.</p><p><strong>Methods: </strong>EHS deaths in secondary school sports from July 1, 1982 through June 30, 2022 captured in the National Center for Catastrophic Sports Injury Research database were included (n = 67). Chi-square test of goodness of fit (alpha = 0.05), incidence rate ratios, and 95% CIs of differences in number of deaths between the 4 decades are reported.</p><p><strong>Results: </strong>Of 67 deaths, 66 (98.5%) were male. Ages ranged from 13 to 18 years. Football accounted for 63 (94%) of deaths, with basketball (n = 2), soccer (n = 1), and track and field (n = 1) accounting for the remainder. The southern region had the largest number of deaths, n = 50 (74.6%). Most deaths occurred in August (n = 38), followed by July (n = 15) and September (n = 9). Stratified into 4 separate 10-year periods, the proportion of EHS deaths differed significantly across time (<i>χ</i>²(3, n = 67) = 8.72; <i>P</i> = 0.03). The period 2002-2011 had the highest number of EHS deaths (n = 26), 1982-1991 had 9, while both 1992-2011 and 2012-2021 had 16 deaths.</p><p><strong>Conclusion: </strong>The most recent decade shows a 38% reduction from the peak decade (2002-2011, n = 26), but remains similar to 1982-1991.</p><p><strong>Clinical relevance: </strong>Continued efforts are required to prevent catastrophic sport-related death due to EHS. Secondary school EHS deaths are overwhelmingly represented by football, most commonly in August, and in the south. This emphasizes the need for secondary schools to be equipped with basic tools and policies to saves lives.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"19417381241298293"},"PeriodicalIF":2.7,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11635796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to \"Differences in Abdominal Muscle Thickness, Strength, and Endurance in Persons Who Are Runners, Active, and Inactive\".","authors":"","doi":"10.1177/19417381241303176","DOIUrl":"10.1177/19417381241303176","url":null,"abstract":"","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"19417381241303176"},"PeriodicalIF":2.7,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11577323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Society News.","authors":"","doi":"10.1177/19417381241300103","DOIUrl":"10.1177/19417381241300103","url":null,"abstract":"","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"19417381241300103"},"PeriodicalIF":2.7,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Secondary School Athletic Trainers' Perceptions of How Youth Sport Specialization Impacts Workload.","authors":"David R Bell, Madison N Renner, Mayrena I Hernandez, Kevin M Biese, Stephanie Adler, Emily Srygler","doi":"10.1177/19417381241231589","DOIUrl":"10.1177/19417381241231589","url":null,"abstract":"<p><strong>Background: </strong>Youth sport specialization is a growing trend in youth sports and is associated with an increased risk of injuries and burnout. However, it is unknown how sport specialization is perceived to be affecting the working environment of secondary school athletic trainers (ATs). The purpose of this paper is to describe how ATs perceive youth sport specialization impacting their workload and whether they perceive it to impact patient safety.</p><p><strong>Hypothesis: </strong>ATs will perceive that youth sport specialization impacts their workload and could impact patient safety.</p><p><strong>Study design: </strong>A sequential, explanatory mixed methods design with 2 phases: (1) cross-sectional surveys and (2) individual interviews.</p><p><strong>Level of evidence: </strong>Level 3.</p><p><strong>Methods: </strong>A total of 487 secondary school ATs completed the online survey (access rate, 8.4%; completion rate, 85.4%). The survey consisted of Likert questions and included sections about aspects of workload impacted by specialization, impacts on patient safety, demographics. Ten participants were selected to complete a semi-structured interview via video conference.</p><p><strong>Results: </strong>Approximately two-thirds of ATs perceive that sport specialization impacts their workload. (Somewhat, 38.6%; Quite a bit, 25.5%; A great deal, 5.5%) Attempts to reduce or modify patient activity and a patient's time for rehabilitation were the highest rated aspects of workload impacted by sport specialization. Approximately 30% ATs (29.9%) perceive that sport specialization impacts their workload to where it may influence patient safety (Somewhat, 21.6%; Quite a bit, 6.4%; A great deal, 1.9%). Three themes and subsequent subthemes were identified from the qualitative interviews: (1) current youth sport expectations, (2) conflict between school and club sports, and (3) AT job impacts.</p><p><strong>Conclusion: </strong>Secondary school ATs perceive their workload to be negatively impacted by youth sport specialization and some believe it may impact patient safety.</p><p><strong>Clinical relevance: </strong>Youth sport specialization is impacting youth sport stakeholders, including ATs, in a variety of ways.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"886-894"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139974588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability and Validity of the Star Excursion Balance Test for Evaluating Dynamic Balance of Upper Extremities.","authors":"Qi-Hao Yang, Yong-Hui Zhang, Shu-Hao Du, Yu-Chen Wang, Hao-Ran Xu, Ji-Wei Chen, Yuan Mao, Xue-Qiang Wang","doi":"10.1177/19417381231221716","DOIUrl":"10.1177/19417381231221716","url":null,"abstract":"<p><strong>Background: </strong>Upper extremity (UE) dynamic balance is a significant physical fitness ability, which includes high-level neuromuscular proprioception, joint mobility, force, and coordination. The evaluation methods of UE dynamic balance are insufficient and lack experimental support. The Star Excursion Balance Test (SEBT) is a reliable assessment of dynamic balance and injury risk of the lower extremity.</p><p><strong>Hypothesis: </strong>The UE-SEBT is a reliable and reproducible approach for evaluating dynamic balance of UEs.</p><p><strong>Study design: </strong>Observational study.</p><p><strong>Level of evidence: </strong>Level 4.</p><p><strong>Methods: </strong>This cross-sectional study recruited 65 healthy adults. All participants were required to complete UE-SEBT, UE Y-balance test (UE-YBT), maximal voluntary isometric contraction (MVIC) of UE, closed kinetic chain UE stability test (CKCUEST), trunk flexor endurance test (TFET), trunk extensor endurance test (TEET), and lateral trunk endurance test (LTET). Intra- and inter-rater reliability and the correlation of UE-SEBT with other outcomes were measured.</p><p><strong>Results: </strong>Among the participants, the intra- and interoperator reliability of UE-SEBT in all directions and composite score achieved a moderate-to-excellent (intraclass correlation coefficients [ICC], 0.729-0.946) reliability. For validity, the UE-SEBT had a moderate to very strong correlation with UE-YBT (<i>r</i> = 0.315-0.755, <i>P</i> < 0.01) and a strong correlation with CKCUEST (<i>r</i> = 0.4-0.67, <i>P</i> < 0.01). Furthermore, the UE-SEBT performance showed weak-to-strong correlations with MVIC (<i>r</i> = 0.26-0.43, <i>P</i> < 0.05). UE-SEBT was also correlated with LTET, TEET, and TFET to varying degrees.</p><p><strong>Conclusion: </strong>UE-SEBT has good reliability and validity to assess UE dynamic balance compared with other tests.</p><p><strong>Clinical relevance: </strong>UE-SEBT can be used as a clinical assessment method to evaluate UE dynamic balance and injury prevention.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"923-930"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139479175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Timing of Outcomes and Expectations After Knee Surgery in the US Military: A Systematic Review.","authors":"Benjamin G Adams, Daniel I Rhon, Kenneth L Cameron, Kristen L Zosel, Brittany R Hotaling, Richard B Westrick","doi":"10.1177/19417381231217449","DOIUrl":"10.1177/19417381231217449","url":null,"abstract":"<p><strong>Context: </strong>Knee injury and subsequent surgery are widespread in the military setting. Associations between knee surgery and expected outcomes over time have not been consolidated and characterized systematically by procedure type across the body of literature, and the temporal expectations of these outcomes remain unclear.</p><p><strong>Objective: </strong>To summarize common postoperative follow-up times and associated outcomes that determine clinical or surgical failure in US service members after elective knee surgery.</p><p><strong>Data sources: </strong>A systematic search was conducted with 3 bibliographic databases of published research reports from 2010 through 2021.</p><p><strong>Study selection: </strong>Studies in US military service members undergoing elective knee surgery, with a minimum of 1-year follow-up, and reporting on a functional/occupational outcome were included. Three reviewers screened all abstracts and full-text articles to determine eligibility.</p><p><strong>Study design: </strong>Systematic review of longitudinal cohort studies.</p><p><strong>Level of evidence: </strong>Level 2a.</p><p><strong>Data extraction: </strong>Extracted data included military demographics, surgical procedure variables, surveillance period, and outcome measures. The Newcastle-Ottawa Scale and the Grading of Recommendations Assessment, Development, and Evaluation approach were used to determine study quality and risk of bias.</p><p><strong>Results: </strong>A total of 22 studies (mean follow-up time of 40.7 months) met the inclusion criteria. For cruciate ligament repair, approximately one-third of patients required a second surgery or were medically separated from military service by 2 years from surgery; 100% were reinjured by 4 years, and 85% sustained a new injury within 5 years of surgery. For meniscal repair, nearly one-third of patients were medically separated, and half were placed on activity restrictions within 3 years of surgery. For articular cartilage repair, within 5 years, 39% of patients required a second surgery, 30% were placed on activity restrictions, and 36% were medically separated. For patellar repair, 37% of patients were medically separated and over half were placed on activity restrictions within 5 years.</p><p><strong>Conclusion: </strong>Common knee surgeries can have long-term implications for military careers that may not become apparent with shorter follow-up periods (<2 years). When longer surveillance periods are used (eg, up to 5 years), additional surgical procedures are more common and the likelihood of being injured or medically separated from military service is higher.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"1009-1020"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139040911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}