Prevalence of Musculoskeletal Injuries, Pain, and Illnesses in Elite Female Basketball Players.

Background and Objectives: The participation of women in sports, including basketball, is becoming increasingly common, and this increased involvement raises concerns about the potential risk of sports injuries, but there is a lack of epidemiological studies about the incidence of sports injuries in women's basketball, especially in Europe. The aim of this study was to determine the prevalence and localizations of sport related injuries and illnesses in elite female basketball players. Materials and Methods: This was a retrospective study. The sample consisted of 358 elite female basketball players, with a mean age of 23.4 ± 5.93 years, participated in the study. The players were interviewed using a pre-participation health questionnaire during the 2013-2016 sport seasons in the pre-season preparation phase. Results: 155 health problems were reported in 358 athletes during the screening period. The most frequently injured body parts were lower limbs: more than 60%, representing an injury rate of 0.14 per athletes and a 0.2 pain rate per athlete during the study period. Conclusions: The main findings showed the importance of monitoring lower extremity injuries and pain to pay attention to the players, which are at risk. The occurrence of injuries and pain among female basketball players was high. The lower extremities are the most frequently injured body area in the Lithuanian Women's Basketball League.

Comparison of Return to Pre-Injury Sport After 10 mm Size Bone-Patellar Tendon-Bone (BPTB) versus 8 mm Hamstring Anterior Cruciate Ligament Reconstruction: A Retrospective Study with a Two-Year Follow-Up.

BACKGROUND The aim of this study was to evaluate the reconstruction of a torn anterior cruciate ligament (ACL) with 10 mm diameter BPTB (bone-patellar tendon-bone) autograft versus 8 mm HT (hamstring tendon) autografts, to compare the ability to restore pre-injury sports activities and reduce revision risk after these procedures. MATERIAL AND METHODS A prospective clinical review was performed to compare results of patients who underwent primary anatomical ACLR with 10 mm BPTB autografts with patients who underwent 8 mm diameter HT autografts, between January 2011 and January 2014. RESULTS There were 183 patients evaluated: the 8 mm HT group showed statistically significant higher knee laxity values compared to the 10 mm BPTB group (p=0.042), and significant difference were detected in subjective International Knee Documentation Committee (IKDC) evaluation scores; the average subjective IKDC evaluations after two-year follow-up in the HT group was 88.45±2.8 versus 89.24±2.5 in BPTB group (p=0.047). In the evaluation of the IKDC objective protocol, results were excellent and good in 83 patients (94.3%) after BPTB and in 78 patients (82%) after HT ACLR (p<0.05). The average score on the Tegner activity scale in the HT group decreased from 6.5 at pre-injury to 5.8 at two-year follow-up (p<0.001) and from 6.7 at pre-injury to 6.5 at two-year follow-up in the BPTB group (p=0.4). The ability to restore pre-injury sports activities was higher in the BPTB group (6.5) versus the HT group (5.8) (p<0.001). Revision was required for two patients (2.2%) in the BPTB group compared with 14 patients (14.7%) in the HT group (p<0.05). CONCLUSIONS Smaller HT graft size was a predictor of higher knee laxity and greater revision risk at two-year post primary ACL reconstruction. Larger diameter BPTB ACL grafts had a better ability to restore knee stability and greater ability to restore pre-injury sports activities.

Influence of Graft Diameter on Functional Outcomes After Anterior Cruciate Ligament Reconstruction: A Prospective Study with a 1-Year Follow-Up.

BACKGROUND The aim of this study was to determine whether graft size is associated with recurrent instability and insufficient functional outcomes after ACL reconstruction. MATERIAL AND METHODS We analyzed 214 consecutive patients with a completed follow-up of 12 months: 55 (25.7%) women and 159 (74.3%) men. Patients were divided into 3 groups according to the diameter of the middle of the hamstring graft. Follow-up examinations were performed pre-surgery and 3, 6, and 12-months postoperatively, and laxity assessments were performed using GNRB®. Differential laxity measured at 134N (Δ134=heathy vs. operated side). A "residual laxity" of the ACLR was defined as Δ134N>3 mm. RESULTS The results of the General Linear Model (Repeated Measures) showed that there was a significant main effect of time factor (F=379.759, p<0.001, η²p=0.681) on differential laxity. We found statistically significant differences (p<0.001) in assessments of differential laxity pre-surgery and at 3, 6, and 12 months postoperatively (time factor). Tegner activity score at 12 months after reconstruction significantly differed when comparing patients with "residual laxity" (4.23±0.83) and others (4.85±1.17) (p=0.038). The study revealed a positive correlation between Tegner activity score at 12 months after surgery and pre-injury Tegner activity score (r=0.728, p<0.001) and negative correlation between age (r=-0.43, p<0.001) or BMI (r=-0.33, p<0.001). CONCLUSIONS Our study revealed that graft diameter is not associated with recurrent instability and does not affect laximetry results. The multiple regression model we developed made it possible to predict the Tegner activity score at 12 months after reconstruction based on pre-injury Tegner activity score, age (years), and BMI (kg/m²) of the patient.

The Patello-Femoral Joint Degeneration and the Shape of the Patella in the Population Needing an Arthroscopic Procedure.

Background: the main goal of the study was to investigate the prevalence of the articular cartilage defects (ACD) in the patellofemoral (PF) region of the knee joint based on the anatomical shapes of patella and its impact on the level of physical activity in the population needing arthroscopic procedures for all types of pathologies in the knee. Methods: The articular cartilage status of the PF region was obtained from 1098 arthroscopic procedures of the knee joint. The ACD were correlated to Wiberg's shape of the patella and classified according to the degree, size and depth of the ACD in the PF region using the ICRS (International Cartilage Repair Society) system: group I consisting of patients with Wiberg type I shape (W1), group II-patients with Wiberg type II shape (W2) and group III-patients with Wiberg type III shape (W3). The Tegner physical activity scale was used to evaluate the physical activity of the patients. Results: The mean of ACD size (PF region) in the W3 group was 3.10 ± 0.99 cm², which was a statistically significantly larger area in comparison with the W1 (1.90 ± 0.63 cm²; p < 0.0000) and W2 (1.95 ± 0.71 cm²; p < 0.0000). The patients from the W3 group (mean 3.10 ± 0.99) were less physically active (<4 Tegner) compared to the W2 group (mean of 4.48 ± 0.88; p = 0.004) and W1 group (mean of 4.55 ± 0.72; p = 0.002). Conclusions: The patients with the Wiberg type III patella shape had a higher incidence and larger size of ACD in the PF of the knee compared to the groups of Wiberg type I and II. Wiberg III patients with a lower level of physical activity had a larger size of ACD in the PF joint.

Characterization of tissue engineered cartilage products: Recent developments in advanced therapy.

Legislative requirements for the quality of pharmacological agents underwent certain evolution when new type of therapies emerged. This relates to cell based medicines, such as tissue engineered cartilage products (TECP) which are increasingly developed as new modalities for widely prevalent orthopaedic disorders. Although quality measures for TECP are subject to the same general regulatory quality requirements, combination of cellular and scaffold substances requires definition of specific characteristics in vitro that are highly relevant to potency and efficacy of the newly designed medicinal product. One of the specific issues in designing cell based medicines is the fact that the biological activity of active substance, or cells, usually is altered after seeding them on a three-dimensional scaffold. Newly acquired features of the TECP are influenced by chemical, physical and mechanical characteristics of the scaffolds. A vast array of analytical methods has been employed to measure efficacy and potency of TECP in cartilage regeneration studies in vitro. Designing specific physical characteristics of scaffolds may become essential part influencing pharmacological activity of cell based medicinal products, and discern TECP from typical pharmacological products. As an example, increasingly growing popularity of three-dimensional printing that utilizes direct laser writing technique provides an opportunity to improve efficacy of the final TECP. This review is intended to provide brief summary of current approaches used to characterize cells and scaffolds in vitro before and after combination into TECP. Validating TECP as pharmacological agents with unique biological and physical characteristics may broaden their clinical application.

Impact of storage conditions on electromechanical, histological and histochemical properties of osteochondral allografts.

BACKGROUND: Osteochondral allograft transplantation has a good clinical outcome, however, there is still debate on optimization of allograft storage protocol. Storage temperature and nutrient medium composition are the most critical factors for sustained biological activity of grafts before implantation. In this study, we performed a time-dependent in vitro experiment to investigate the effect of various storage conditions on electromechanical, histological and histochemical properties of articular cartilage. METHODS: Osteochondral grafts derived from goat femoral condyles were frozen at -70 °C or stored at 4 °C and 37 °C in the medium supplemented with or without insulin-like growth factor-1 (IGF-1). After 14 and 28 days the cartilage samples were quantitatively analysed for electromechanical properties, glycosaminoglycan distribution, histological structure, chondrocyte viability and apoptosis. The results were compared between the experimental groups and correlations among different evaluation methods were determined. RESULTS: Storage at -70 °C and 37 °C significantly deteriorated cartilage electromechanical, histological and histochemical properties. Storage at 4 °C maintained the electromechanical quantitative parameter (QP) and glycosaminoglycan expression near the normal levels for 14 days. Although hypothermic storage revealed reduced chondrocyte viability and increased apoptosis, these parameters were superior compared with the storage at -70 °C and 37 °C. IGF-1 supplementation improved the electromechanical QP, chondrocyte viability and histological properties at 37 °C, but the effect lasted only 14 days. Electromechanical properties correlated with the histological grading score (r = 0.673, p < 0.001), chondrocyte viability (r = -0.654, p < 0.001) and apoptosis (r = 0.416, p < 0.02). In addition, apoptosis correlated with glycosaminoglycan distribution (r = -0.644, p < 0.001) and the histological grading score (r = 0.493, p = 0.006). CONCLUSIONS: Our results indicate that quality of allografts is better preserved at currently established 4 °C storage temperature. Storage at -70 °C or at 37 °C is unable to maintain cartilage function and metabolic activity. IGF-1 supplementation at 37 °C can enhance chondrocyte viability and improve electromechanical and histological properties of the cartilage, but the impact persists only 14 days. The correlations between cartilage electromechanical quantitative parameter (QP) and metabolic activity were detected. Our findings indicate that non-destructive assessment of cartilage by Arthro-BST is a simple and reliable method to evaluate allograft quality, and could be routinely used before implantation.

Arthroscopic Implantation of a Cell-Free Bilayer Scaffold for the Treatment of Knee Chondral Lesions: A 2-Year Prospective Study.

OBJECTIVE: The main objective of this study is to assess the safety and clinical efficacy of a cell-free bilayer scaffold (MaioRegen Chondro+ by Fin-Ceramica) in patients affected by chondral knee lesions of different origin and localization. DESIGN: Thirty-one patients with focal chondral lesions of the knee were arthroscopically treated with MaioRegen Chondro+. All patients were prospectively evaluated for a minimum of 2 years using the International Knee Documentation Committee (IKDC) Questionnaire and the Tegner Activity Scale. Cartilage repair was assessed based on the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) 2.0 score at 12 months. Follow-up at 36 months was available for 25 out of 31 patients. RESULTS: From baseline to 6-, 12-, and 24-month follow-up, IKDC score significantly improved by 19.5 ± 7.27 (95% confidence interval [CI]: 16.9-22.2, P < 0.001), 30.8 ± 7.63 (95% CI: 28.0-33.6, P < 0.001), and 36.2 ± 8.00 points (95% CI: 33.3-39.2, P < 0.001), respectively. Tegner scores documented a substantial clinical improvement as early as 12 months after surgery (change of -0.6 ± 0.62; 95% CI: -0.8 to -0.4, P < 0.001), reaching the preinjury values. There was a statistically significant increase in the MOCART scores (P < 0.001). Comparable results were observed regardless of preintervention demographic characteristics, lesion site or etiology, or the number of treated sites. Notably, the significant clinical benefit was maintained in a subset of patients who reached 3-year follow-up. No adverse events were reported in the entire analyzed population. CONCLUSION: MaioRegen Chondro+ is a safe and effective device for the treatment of knee chondral lesions, enabling a significant clinical improvement for at least 2 years.

Comparison of osteochondral autologous transplantation, microfracture, or debridement techniques in articular cartilage lesions associated with anterior cruciate ligament injury: a prospective study with a 3-year follow-up.

PURPOSE: To compare the concomitant treatment of articular cartilage damage in the medial femoral condyle with osteochondral autologous transplantation (OAT), microfracture, or debridement procedures at the time of anterior cruciate ligament (ACL) reconstruction. METHODS: Between 2006 and 2009, 102 patients with a mean age of 34.1 years and with an ACL rupture and articular cartilage damage in the medial femoral condyle of the knee were randomized to undergo OAT, microfractures, or debridement at the time of ACL reconstruction. A matched control group was included, comprising 34 patients with intact articular cartilage at the time of ACL reconstruction. There were 34 patients in the OAT-ACL group, 34 in the microfracture (MF)-ACL group, 34 in the debridement (D)-ACL group, and 34 in the control group with intact articular cartilage (IAC-ACL group). The mean time from ACL injury to operation was 19.32 ± 3.43 months, and the mean follow-up was 36.1 months (range, 34 to 37 months). Patients were evaluated with the International Knee Documentation Committee (IKDC) score, Tegner activity score, and clinical assessment. RESULTS: Of 102 patients, 97 (95%) were available for the final follow-up. According to the subjective IKDC score, all 4 groups fared significantly better at the 3-year follow-up than preoperatively (P < .005). The OAT-ACL group's IKDC subjective knee evaluation was significantly better than that of the MF-ACL group (P = .024) and D-ACL group (P = .018). However, the IKDC subjective score of the IAC-ACL group was significantly better than the OAT-ACL group's IKDC evaluation (P = .043). There was no significant difference between the MF-ACL and D-ACL groups' IKDC subjective scores (P = .058). Evaluation of manual pivot-shift knee laxity according to the IKDC knee examination form showed similar findings for the 4 groups immediately postoperatively and at 3-year follow-up, and the findings were rated as normal or nearly normal (IKDC grade A or B) in 29 of 33 patients (88%) in the OAT-ACL group, 28 of 32 patients (88%) in the MF-ACL group, 27 of 32 patients (84%) in the D-ACL group, and 31 of 34 patients (91%) in the IAC-ACL group. CONCLUSIONS: Our study shows that intact articular cartilage during ACL reconstruction yields more favorable IKDC subjective scores compared with any other articular cartilage surgery type. However, if an articular defect is present, the subjective IKDC scores are significantly better for OAT versus microfracture or debridement after a mean period of 3 years. Anterior knee stability results were not significantly affected by the different articular cartilage treatment methods. LEVEL OF EVIDENCE: Level II, prospective comparative study.

Endoscopic removal of the osteochondroma of the fibular head.

We report the case of the osteochondroma of the fibular head in a 40-year-old female patient who underwent an endoscopic extirpation of a relapsed benign tumor. Initially, open surgery was performed, and the tumor was removed 3 years ago. Following the reoccurrence of the symptoms 3 years after the initial open extirpation, an x-ray and computed tomography of the calf were performed. The tumor was endoscopically removed, and the diagnosis of a relapsed osteochondroma measuring 1.5 × 1.5 × 2 cm was established. Endoscopic surgery can be applied for a successful extirpation of the osteochondroma of the fibular head.

Arthroscopic Electromechanical Assessment of Human Articular Cartilage Injury Correlates with ICRS Scores.

PURPOSE: This study aimed to conduct arthroscopic evaluation of cartilage electromechanical properties and establish their correlation with International Cartilage Repair Society (ICRS) grading scores. METHODS: In 18 patients, quantitative parameter (QP) measurements were taken on the weight-bearing surface of the medial femoral condyle. Adjacently, the same site was graded using ICRS scores (0-4). Electromechanical QPs for ICRS grades 0 to 3 were obtained during arthroscopy, while complete grade 4 injuries were assessed using femur cartilage-bone blocks from knee arthroplasty. The QP values for ICRS grades 0 to 2 were compared with grades 3 and 4 using Welch t test. The corresponding QP values were assigned to ICRS grades 0 to 4 and compared using Welch ANOVA (analysis of variance). Pearson's coefficient evaluated QP-ICRS grade relationship. RESULTS: Healthy grade 0 cartilage displayed a mean QP value of 10.5 (±2.8 SD, n = 4). The ICRS grade 1 and grade 2 injuries were associated with QP values of 12 (±0.7, n = 2) and 13.25 (±1.77, n = 2), respectively. The grade 3 defects had QP values of 20.43 (±4.84, n = 4), whereas complete grade 4 defects showed electromechanical values of 30.17 (±2.19, n = 6). Significant differences in QP values were observed between ICRS grades 0 to 2 (mean QP 11.56 ± 2.3, n = 8) and grades 3 and 4 (26.27 ± 6, n = 10; P < 0.0001). Pearson's correlation coefficient of 0.9 indicated a strong association between higher ICRS cartilage injury grades and elevated QP values (P < 0.0001). CONCLUSION: Arthroscopic electromechanical QP assessment robustly correlates with ICRS scores. The QP values for ICRS grades 0 to 2 are significantly lower, compared with grades 3 and 4.