Surfing on the world stage: a narrative review of acute and overuse injuries and preventative measures for the competitive and recreational surfer.

Surfing has rapidly grown in popularity as the sport made its debut at the Tokyo 2020 Olympic Games. Surfing injuries are becoming more relevant with the globalisation and increasing risks of the sport, but despite this, little is known about surfing injuries or prevention strategies in either the competitive or recreational surfer. Prior research demonstrates that surfers are injured at a frequency of 0.74-1.79 injuries per 1000 hours of surfing. We reviewed the literature for the incidence, anatomical distribution, type and underlying mechanism of acute and overuse injuries, and discuss current preventative measures. This review finds that skin injuries represent the highest proportion of total injuries. Acute injuries most frequently affect the head, neck and face, followed by the lower limbs. Being struck by one's own board is the most common mechanism of injury. Non-contact acute ligament injuries have increased as surfing manoeuvres have become more acrobatic and overuse musculoskeletal injuries are highly correlated with paddling. However, there is a paucity of research for surfing injuries, and studies on overuse musculoskeletal injuries and prevention are disproportionally under-represented. Most of the prior studies are limited by small sample sizes, poor data collection methodology and geographical constraints. Further research is needed to establish preventative measures for both acute and overuse surfing injuries and to ensure the increasing popularity of surfing is met with an improved understanding of sport risks and safety. Specifically, we recommend research be prioritised regarding the efficacy of training programmes to prevent surfing-related overuse musculoskeletal injuries.

Meniscal tear - presentation, diagnosis and management.

BACKGROUND: Medial and lateral knee joint menisci serve to transfer load and absorb shock, aid joint stability and provide lubrication. The meniscus is the most commonly injured structure in the knee joint. Imaging techniques such as magnetic resonance imaging may be warranted but are no substitute for thorough clinical history and examination. OBJECTIVE: This article outlines the aetiology, presentation, diagnosis (both clinical and radiographic) and management of these important injuries. DISCUSSION: Magnetic resonance imaging can confirm clinical concern for meniscal tear, review intra- and extra-articular anatomical structures and exclude alternative diagnoses. Meniscal tears can be assessed arthroscopically for stability and vascularity. Even partial meniscectomy may lead to osteoarthritis. On the basis of the findings, treatment can be considered in terms of four Rs: Rest and Rehabilitate the patient (with physiotherapy), and if the patient is not improving on Review, Refer to an orthopaedic surgeon. New experimental surgical techniques seek to replace damaged tissue. These include meniscal allograft transplantation, biosynthetic scaffolds, growth factor and gene therapy, or a combination of these.

Surfinoma: a case report on a pseudotumor developing after a surfing sports injury.

We describe an unusual pseudotumor of the upper thorax, axillary, and shoulder girdle region with presentation 4 years after a surfing sports injury. We offer the coined term "Surfinoma" to describe a pseudotumor arising from a penetrating piece of fiberglass surf board, which induced a foreign body reaction.

Efficacy of a platelet-rich plasma injection for the treatment of proximal hamstring tendinopathy: A pilot study.

OBJECTIVES: To determine the efficacy of an ultrasound-guided platelet-rich plasma (PRP) injection in the treatment of patients with proximal hamstring tendinopathy (PHT). DESIGN: Pilot prospective cohort study METHODS: Administration of a single PRP injection under ultrasound guidance to 29 patients with PHT confirmed on magnetic resonance imaging (MRI). Pain, function and sporting activity were measured via the Victorian Institute of Sport Assessment-Proximal Hamstring Tendons (VISA-H) questionnaire, administered before injection and at 8-weeks follow-up. RESULTS: The study sample consisted of 22 females and 7 males with a mean age of 45.2 years (95% CI 40.8-49.5). When comparing pre-injection VISA-H scores (mean: 43.90; 95% CI 37.77-50.03) with 8-week post-injection VISA-H scores (mean: 51.14; 95% CI 43.39-58.88) in the total sample of patients, no statistically significant difference was found (p=0.14). When performing separate analyses for patients with mild (n=9), moderate (n=16) or marked (n=4) PHT, no statistically significant difference was found in pre-and post-injection VISA-H scores for any of the groups (p=0.86, p=0.13, p=0.28 respectively). 69% of patients reported no change in their ability to undertake sport or other physical activity at 8-weeks follow-up. CONCLUSIONS: Patients with PHT receiving a PRP injection did not improve on clinical outcomes at 8-weeks follow-up.

A review of current concepts in radiofrequency chondroplasty.

Radiofrequency (RF) chondroplasty is a promising treatment of chondral defects. The purpose of this study is to summarize current literature reporting the use of radiofrequency energy as an alternative treatment to mechanical shaving in chondroplasty. This review depicts the basic understanding of RF energy in ablating cartilage while exploring the basic science, laboratory evidence and clinical effectiveness of this form of chondroplasty. Laboratory studies have indicated that RF energy decreases inflammatory markers in the cartilage as well as providing optimal results with smoothing of chondral clefts. There have been concerns of chondrolysis due to heat damage of chondrocytes; however, this is unsubstantiated in clinical studies. These clinical trials have highlighted that RF energy is a safe and efficacious method of chondroplasty when compared to the mechanical shaving technique.

Dynamic hip screws versus proximal femoral nails for intertrochanteric fractures.

BACKGROUND: It is essential to determine the optimal treatment of intertrochanteric fractures due to their high incidence and related public health burden. Debate remains as to whether dynamic hip screws (DHS) or proximal femoral nails (PFNs) are best practice, and this pilot study seeks to collect information relevant to this query. METHODS: We undertook a retrospective audit of 144 patients who received a dynamic hip screw or a proximal femoral nail in order to compare age, sex, duration of surgery, duration of hospitalization, time of first mobilization, and rate anaemia, sepsis, avascular necrosis, prosthesis failure, revision, deep vein thrombosis, pulmonary embolus, non-ST elevation myocardial infarction, common peroneal nerve palsy and death between implantation of a DHS and a PFN. RESULTS: No differences were found between groups in age, duration of surgery, duration of hospitalization, time of first mobilization and rate of complications. Statistically significant differences were found in sex distributions, operation time and length of stay. However, analysis of median operation time and length of stay when adjusted for sex revealed no significant differences. CONCLUSION: This study demonstrated no statistically significant differences in peri- and post-operative measures between patients undergoing intertrochanteric fracture fixation via PFN or DHS. This is the only data from Australian hospitals, and further national research is needed.