Validity of US measurements of cam-type femoroacetabular impingement parameters: a preliminary study in an asymptomatic adult population.

PURPOSE: To determine the accuracy of US for the quantitative parameters of cam-type femoroacetabular impingement (FAI) in an asymptomatic adult population, using MRI as the reference standard. MATERIALS AND METHODS: We prospectively evaluated 158 hips of 79 adult subjects (44 males, 35 females; age range 18-49 years) with a negative anterior impingement test. Two observers independently measured anterosuperior quadrant alpha angles and anterior femoral distances (AFDs) on both US and MRI. RESULTS: US measurements of alpha angle and AFD had a moderate-to-high positive correlation with MRI measurements and there was substantial and/or almost perfect agreement between observers on both imaging modalities. Anterior femoral distance measurements for both observers and alpha angles at MRI for Observer 1 showed no statistically significant difference between genders. CONCLUSION: Ultrasonography can be used for anterosuperior alpha angle and AFD measurements in asymptomatic adults. However, when used as the sole imaging method, its inherent limitations and possible discrepancies with MRI should be kept in mind.

Thirty Minutes of Running Exercise Decreases T2 Signal Intensity but Not Thickness of the Knee Joint Cartilage: A 3.0-T Magnetic Resonance Imaging Study.

OBJECTIVE: Recent studies showed a potential of magnetic resonance imaging (MRI), which can be used as an additional tool for diagnosing cartilage degeneration in the early stage. We designed a cross-sectional study in order to evaluate knee joint cartilage adaptation to running, using 3.0-T MRI equipped with the 3-dimensional turbo spin echo (VISTA = Volume ISotropic Turbo spin echo Acquisition) software. By this thickness (mm) and signal intensity (mean pixel value) can be quantified, which could be closely related to the fluid content of the knee joint cartilage, before and after running. METHODS: A total of 22 males, aged 18 to 35 years, dominant (right) and nondominant (left) knees were assessed before and after 30 minutes of running. Cartilage thickness and signal intensity of surfaces of the patella, medial and lateral femoral and tibial condyles were measured. RESULTS: Cartilage thickness of the lateral condyle decreased at the dominant knee, while it increased at the medial tibial plateau. Signal intensity decreased at all locations, except the lateral patella in both knees. The most obvious decrease in signal intensity (10.6%) was at the medial tibial plateau from 949.8 to 849.0 of the dominant knee. CONCLUSION: There was an increase in thickness measurements and decrease in signal intensity in medial tibial plateau of the dominant knee after 30 minutes of running. This outcome could be related to fluid outflow from the tissue. Greater reductions in the medial tibial plateau cartilage indicate greater load sharing by these areas of the joint during a 30-minute running.

Injuries Among Recreational Football Players: Results of a Prospective Cohort Study.

OBJECTIVES: To establish the incidence and patterns of football injuries and associated consequences in daily life and labor loss, among public employees. DESIGN: Prospective cohort study. SETTING: Football tournament between public employees in Turkey. PARTICIPANTS: A total of 1821 recreational players from 78 teams. MAIN OUTCOME MEASURES: Injury rates (injuries per 1000 hours of football exposure) during tournament by age group, as well as prevalence, severity, and injury types were recorded. The data regarding the occurrence (eg, location, type, circumstances) and consequences (eg, absenteeism, medical treatment, labor loss) of injuries were collected. RESULTS: Of the 1821 football players registered for participation, 57% (n = 1038) were included in the study with the returned questionnaire forms. In total, 257 matches were played with a total exposure time of 5654 hours. A total of 218 injuries were recorded in 192 players (10.5%), resulting in a mean of 0.85 time-loss injuries per match (38.6 per 1000 hours). Severe injuries constituted 42.6% of all injuries, and 28.9% of all injuries caused the participants to be absent at least 1 day for the next working day. The total labor loss was 1196 days for all injuries. The rate of missing subsequent working day was significantly less for muscle injuries (P < 0.05). CONCLUSIONS: The risk of injury in recreational football players is relatively high causing significant labor loss. The results suggest that prevention programs should consider specific injury characteristics, as there is a greater incidence of muscle and anterior cruciate ligament injuries in this population.

Double layer repair of tibialis anterior muscle hernia in a soccer player: a case report and review of the literature.

BACKGROUND: muscle herniations usually present in athletes especially in the lower legs; occurring through defects in the deep fascial layer of the muscles and typically seen following local blunt trauma or muscle hypertrophy after strenuous exercise. Management of muscle hernias varies from conservative therapy to surgical repair and usually needs multidisciplinary collaboration for differential diagnosis. METHODS: herein tibialis anterior muscle hernia in 17-year-old male soccer player was presented. The diagnosis was confirmed with dynamic ultrasonographic views changing with the different movements of the ankle. Since the symptoms were not relieved with conservative methods, surgical repair of the defect was offered. RESULTS: we preferred to repair fascial defect with double layer and Mesh graft that were placed over primary suture repair. No complications were reported such as wound or mesh infection postoperatively. The patient was clinically satisfied and returned his previous activity level after 3 months of surgery. After 2 years of follow-up the feature of the bulge was dissolved and player was satisfied with the operation. CONCLUSION: knowledge of the lower extremity muscle herniation is essential for both proper management and/or surgical referral. The importance of protective devices in prevention, dynamic ultrasonography in diagnosis and double layer repair of the fascial defect with Mesh graft in treatment of muscle herniations were highlighted.

Rehabilitation after endoscopically percutaneous intramuscular splintage for vastus medialis partial rupture - A case report and review of the literature.

Isolated rupture of the vastus medialis muscle is rare, and surgical repair is recommended. The results of rehabilitation programme after the percutaneous intramuscular splintage of a nearly total vastus medialis muscle tear in a 52-year professional-master degree weight-lifter is presented in this report.