Injuries among World Cup ski and snowboard athletes.

There is little information available on injuries to World Cup skiers and snowboarders. The aim of this study was to describe and compare the injury risk to World Cup athletes in alpine skiing, freestyle skiing, snowboarding, ski jumping, Nordic combined and cross country skiing. We performed retrospective interviews with the International Ski Federation (FIS) World Cup athletes from selected nations during the 2006-2007 and 2007-2008 winter seasons and recorded all acute injuries occurring during the seasons. We interviewed 2121 athletes and recorded 705 injuries. There were 520 (72%) time-loss injuries and 196 (28%) severe injuries (absence >28 days). In freestyle skiing, alpine skiing and snowboarding, there were 27.6, 29.8 and 37.8 time-loss and 14.4, 11.3 and 13.8 severe injuries per 100 athletes per season, respectively. In Nordic combined, ski jumping and cross country skiing, there were 15.8, 13.6 and 6.3 time-loss and 3.3, 5.6 and 0.7 severe injuries per 100 athletes per season, respectively. In conclusion about 1/3 of the World Cup alpine, freestyle and snowboard athletes sustain a time-loss injury each season, while the risk is low in the Nordic disciplines. A particular concern was the high proportion of severe injuries observed among alpine, freestyle and snowboard athletes, which is in contrast to most other sports.

Recording injuries among World Cup skiers and snowboarders: a methodological study.

No long-term injury surveillance programs exist for competitive skiing or snowboarding. The objective of this study was, therefore, to compare different methods to record injuries among World Cup athletes in alpine, freestyle, and cross-country skiing, snowboarding, ski jumping and Nordic combined. Information regarding injuries sustained during the 2006-2007 winter season was recorded through three separate and independent systems: prospective injury reports by technical delegates (TD) from the International Ski Federation, prospective medical team registration by selected teams, and retrospective athlete interviews at the end of the season. A total of 100 unique injuries to 602 World Cup athletes were identified from any of the three recording methods. Of these, 91% were registered through the athlete interviews, 47% by the medical team registration and 27% by the TD reports. Only 20 injuries (20%) were captured by all three methods. A total of 64 time-loss injuries were registered. The interviews captured 60 (94%), the medical team registration 39 (61%), and the TD reports 23 (36%) time-loss injuries, while 18 (28%) were registered by all three systems. Retrospective interviews with athletes/coaches regarding injuries during the last 6 months gave the most complete picture of injuries to World Cup skiers and snowboarders.

Injuries among male and female World Cup alpine skiers.

BACKGROUND: Limited knowledge exists on injuries among professional alpine skiers. OBJECTIVE: To describe the risk of injury and the injury pattern among competitive World Cup alpine skiers during the competitive season. METHODS: Retrospective interviews were performed with all World Cup athletes from 10 nations at the end of the 2006-7 and 2007-8 winter seasons, and all acute injuries occurring during the 4.5-month competitive season were recorded. If the athlete was not present, their coaches or medical personnel were interviewed. RESULTS: A total of 191 acute injuries were recorded among 521 World Cup alpine skiers. As many as 86 injuries (45%) occurred during World Cup/World Ski Championship competitions, corresponding to an injury rate of 9.8 injuries per 1000 runs (95% CI 7.8 to 11.9). The injury rate was found to increase with increasing speed (slalom 4.9 injuries per 1000 runs, 95% CI 2.5 to 7.4--giant slalom 9.2, 5.1 to 13.3--super-G 11.0, 5.2 to 16.8--downhill 17.2, 11.6 to 22.7). The most frequently injured body part was the knee, with 68 injuries (36%), and 37 of these were severe. The overall injury rate was higher in males than in females, but not for knee injuries. CONCLUSIONS: The risk of injury among World Cup athletes in alpine skiing is even higher than previously reported. The knee is the most commonly injured body part and with many severe injuries. Injury rate increased with a higher speed and was higher among males than in females.

No difference in time-dependent improvement in functional outcome following closing wedge versus opening wedge high tibial osteotomy: a randomised controlled trial with two-year follow-up.

AIMS: The aim of this prospective randomised study was to compare the time course of clinical improvement during the first two years following a closing or opening wedge high tibial osteotomy (HTO). It was hypothesised that there would be no differences in clinical outcome between the two techniques. PATIENTS AND METHODS: Between 2007 and 2013, 70 consecutive patients were randomly allocated to undergo either a closing or opening wedge HTO. All patients had medial compartment osteoarthritis (OA), and were aged between 30 years and 60 years. They were evaluated by independent investigators pre-operatively and at three and six months, and one and two years post-operatively using the Knee Injury and Osteoarthritis Outcome Score (KOOS), the Oxford Knee Score (OKS), the Lysholm score, the Tegner activity score, the University of California, Los Angeles (UCLA) activity scale and range of movement (ROM). RESULTS: There were no significant differences at any time between the two techniques for any clinical outcome score (p > 0.05). The mean scores for all the systems, except UCLA and Tegner, significantly improved until six months post-operatively (p < 0.001). For some scores, the improvement continued until one and two years. CONCLUSION: This prospective randomised study suggests that there are no differences in the time course of the clinical improvement between the closing and opening wedge techniques for HTO during the first two post-operative years. Patients can expect continued improvement in physical function for between six months and one year after HTO regardless of the technique used. Cite this article: Bone Joint J 2017;99-B:1157-66.

Bone marrow mesenchymal stem cells in a hyaluronan scaffold for treatment of an osteochondral defect in a rabbit model.

The purpose of this study was to evaluate the efficiency of using mesenchymal stem cells (MSC) in a hyaluronan scaffold for repair of an osteochondral defect in rabbit knee. Bone marrow was harvested from the posterior iliac crest in 11 New Zealand White rabbits. MSC were isolated and cultured in autologous serum for 28 days and transferred to a hyaluronan scaffold 24 h prior to implantation. A 4 mm diameter and 1.5 mm deep defect was created in the medial femoral condyle of both knees and the scaffold with MSC was implanted in one knee while an empty scaffold was implanted in the contra-lateral knee. After 24 weeks the rabbits were killed and histological sections were subjected to semiquantitative and quantitative evaluation by observers blinded regarding treatment modality. High degree of filling was obtained, but there was no statistically significant difference between the two treatments. However, there was a tendency for a better quality of repair in the MSC treated knees. No hypertrophy was observed by either method. MSC in a hyaluronan scaffold may be a promising treatment approach, but further studies are needed to determine the best combination of scaffold and cells.

Subcutaneous interstitial fluid colloid osmotic pressure in dehydrated rats.

We collected interstitial fluid for measurement of colloid osmotic pressure (COPi) of normally hydrated and dehydrated rats with two methods: (1) saline-soaked nylon-wicks implanted in vivo for 1 h; and (2) the crossover method, i.e. titration with wicks pre-loaded with serial dilutions of rat plasma implanted post mortem for 15-20 min. All wicks were implanted in subcutis on the back. Dehydration was induced by injection of 40 mg furosemide followed by 24 h water deprivation. The saline-soaked wick method gave an average control COPi of 10.8 mmHg, 2-3 mmHg lower than the corresponding pressure obtained with the crossover method. This discrepancy between the methods increased to 10-11 mmHg in dehydrated animals, indicating that the saline-soaked wick method underestimates COPi even more during dehydration than during control conditions. The mean COPi of 22.8 mmHg (SD = 3.7, n = 9) obtained in dehydrated rats using the crossover method corresponds well with what is to be expected from the reduction in interstitial fluid volume. The present study suggests that the frequently used implantation period for saline-soaked wicks of 60 min should be prolonged to 90-120 min. It further shows that the rise in COPi is about 3 times more important than the fall in interstitial fluid hydrostatic pressure in restricting mobilization of interstitial fluid during dehydration.

Colloid osmotic pressure of interstitial fluid in rat subcutis and skeletal muscle: comparison of various wick sampling techniques.

Interstitial fluid for measurement of colloid osmotic pressure (COPi) was collected from rat subcutis and skeletal muscle with three wick methods; saline-soaked wicks implanted in vivo, titration with wicks preloaded with serial dilutions of rat plasma implanted postmortem (crossover method) and dry wicks implanted in vivo and post-mortem. When compared in 12 rats, the mean subcutaneous COPi of 14.2 and 13.3 mmHg as estimated with the crossover method and dry wick method, respectively, both exceeded the 10.7 mmHg obtained in saline-soaked wicks implanted for 60 min. Colloid osmotic pressure (COP) in fluid from dry wicks implanted subcutaneously was slightly lower than in plasma 5 min after implantation in vivo, then fell gradually, but remained stable the last 30 min of the 60 min in vivo implantation period and the first 30 min post-mortem, when again starting to rise. COP in fluid isolated from dry wicks implanted in muscle post-mortem approached or even exceeded that of plasma, suggesting leakage of intracellular proteins to wick fluid. Electrophoresis of dry wick fluid from subcutis showed a pattern similar to that of plasma, while protein fractions not present in plasma were observed in muscle wick fluid. For measurement of COPi we recommend the use of dry wicks implanted post mortem for subcutis and saline-soaked or dry wicks implanted in vivo for 90-120 min for skeletal muscle.

Five-year outcome of 13 patients with an initially undiagnosed anterior cruciate ligament rupture.

We evaluated retrospectively the 5-year outcome of 13 patients with an initially undiagnosed and thus untreated anterior cruciate ligament rupture. At follow-up, these patients experienced decreased knee function and moderate to severe knee instability. They had attempted to reduce their discomfort by decreasing their activity level during the follow-up period. Immediately after the 5-year examination, 6 of the patients decided to have a late reconstruction of the ruptured anterior cruciate ligament. These results agree with previous reports of the natural course of anterior cruciate ligament ruptures.