Chronic and Recurrent Rectus Femoris Central Tendon Ruptures in Athletes: Clinical Picture, MRI Findings, and Results of Surgical Treatment.

BACKGROUND: Severe rectus femoris central tendon rupture is an uncommon sports-related injury. Most rectus femoris central tendon injuries can be treated by nonoperative means, but some tend to reinjure, resulting in chronic symptoms. Physicians treating athletes with rectus femoris injuries should be aware of this clinical condition and know that surgical treatment could be beneficial to the athlete if the rectus femoris central tendon rupture becomes chronic. PURPOSE: To describe the clinical picture, magnetic resonance imaging (MRI) findings, and surgical treatment results of rectus femoris central tendon injuries. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: This study included 12 patients who underwent successful repair of recurrent rectus femoris central tendon rupture. Presurgical MRI scans were obtained and compared with the surgical findings. The time of return to play was recorded, and the outcome of surgical treatment was evaluated with validated Subjective Patient Outcome for Return to Sports (SPORTS) criteria: good = full return to preinjury level of sports without any symptoms; moderate = return to preinjury level of sports with some residual symptoms (mild discomfort during sports); and poor = did not return to preinjury level of sports. RESULTS: Overall, 10 patients had a good outcome (83%), and 2 had a moderate outcome (17%). All athletes included in the study were able to return to sport at their preinjury levels 2.5 to 4 months postoperatively. Presurgical MRI scans correlated well with the surgical findings. CONCLUSION: The surgical treatment of rectus femoris central tendon rupture seems to be a good option in chronic and recurrent cases. After surgery and successful rehabilitation, the athlete is expected to continue sports at the preinjury level.

Effectiveness of a Dietary Supplement Containing Hydrolyzed Collagen, Chondroitin Sulfate, and Glucosamine in Pain Reduction and Functional Capacity in Osteoarthritis Patients.

This observational, open, multicenter clinical trial with a single treatment group aimed to evaluate the effectiveness of a dietary supplement whose main ingredients are hydrolyzed gelatin, chondroitin sulfate, glucosamine sulfate, and devil's claw and bamboo extracts for pain reduction and improvement of functional capacities in patients with osteoarthritis (OA) of the knee and/or hip (REDART study). In all, 130 patients with OA recruited from Spanish hospitals received the dietary supplement for 6 months. The primary outcome was the patients' global assessment of pain in the affected joint as measured with a visual analogue scale (VAS). Other outcome measurements included the Lequesne Functional Index (subindexes for pain/discomfort, distance walked, and daily living) and the Western Ontario and McMaster Universities Arthritis Index (WOMAC; subindexes for pain, stiffness, and physical function). Scores were taken at months 3 and 6 of the treatment. Patients (N = 78) showed a reduction of pain of 3.77 ± 1.77 points after 6 months (p < .0001) in the VAS. The total reduction in the Lequesne Functional Index was 6.30 ± 4.08 points after 6 months (p < .0001), with significant reductions in all subindexes of the scale. A similar pattern was found for the WOMAC index, with an overall reduction of 22.49 ± 14.03 points after 6 months (p < .0001) and significant reductions in all subindexes. No major adverse events were noted during the treatment. This exploratory study shows that treatment with the dietary supplement significantly reduces pain and improves locomotor function in patients with OA of the knee and/or hip.

Operative Treatment of Proximal Rectus Femoris Injuries in Professional Soccer Players: A Series of 19 Cases.

BACKGROUND: Proximal rectus femoris (PRF) tears are relatively rare injuries among top-level athletes. PRF injuries can be avulsions of both tendon heads (direct and reflected heads) or of a single head, and some have a tendency to progress to recurrent injuries. PURPOSE: To describe a series of operatively treated PRF ruptures in professional soccer players. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Nineteen cases of PRF injuries (18 patients, 1 bilateral) in professional soccer players who were treated surgically were retrospectively reviewed. Perioperative findings with return-to-play data were recorded. RESULTS: Of the PRF injuries, 10 total avulsions (both heads) and 9 single-head tears were seen on magnetic resonance imaging and were later confirmed during surgery. All 18 patients returned to their preinjury level of play (mean follow-up, 2.8 years [range, 1-11 years]). CONCLUSION: The repair of PRF tears in professional soccer players yielded good results and allowed all patients to return to their preinjury level of play.

Central Tendon Injuries of Hamstring Muscles: Case Series of Operative Treatment.

BACKGROUND: As compared with injuries involving muscle only, those involving the central hamstring tendon have a worse prognosis. Limited information is available regarding the surgical treatment of central tendon injuries of the hamstrings. PURPOSE: To describe the operative treatment and outcomes of central tendon injuries of the hamstrings among athletes. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Eight athletes (6 top level, 2 recreational) with central hamstring tendon injuries underwent magnetic resonance imaging and surgical treatment. The indication for surgery was recurrent (n = 6) or acute (n = 2) central hamstring tendon injury. All patients followed the same postoperative rehabilitation protocol, and return to play was monitored. RESULTS: Magnetic resonance imaging found a central tendon injury in all 3 hamstring muscles (long head of the biceps femoris, semimembranosus, and semitendinosus) with disrupted tendon ends. In acute and recurrent central tendon injuries, full return to play was achieved at 2.5 to 4 months. There were no adverse events during follow-up. CONCLUSION: Central tendon injuries of the hamstrings can be successfully repaired surgically after acute and recurrent ruptures.

Aspectos clínicos y de imagen en el diagnóstico y seguimiento de lesiones proximales de la porción larga del bíceps femoral (lesión del tendón libre y de la unión miotendinosa). A propósito de dos casos / Clinical and imaging aspects of assessment and management of proximal long head biceps femoris injury (free-tendon and miotendinosus junction injuries). A report of two cases

Las lesiones agudas de los isquiotibiales son las más frecuentes en el fútbol profesional y la porción larga del bíceps (PLBF) es el músculo más afectado, siendo las localizaciones proximales las más habituales con importantes características clínicas, como el tiempo de baja y el riesgo de relesión. Se presentan dos casos clínicos de lesiones proximales de PLBF: una lesión miotendinosa típica y una menos frecuente que afecta al tendón libre de PLBF. Las lesiones de la unión miotendinosa localizadas en los isquiotibiales pueden tratarse de manera conservadora, aunque las lesiones de los futbolistas profesionales, cuando la cantidad de tejido conectivo afectado es grande (tendón libre), deben ser tratadas quirúrgicamente (AU)

Acute hamstring injury is the most common muscle damage in professional footballers and long head biceps femoris (LHBF) is the most commonly affected muscle with proximal locations being most prevalent with important clinical features such as time of recovery and risk of re-injury. Two clinical reports of proximal LHBF injuries are presented: a typical miotendinosus junction (MTJ) injury and a less common injury affecting the free-tendon of LHBF. MTJ injuries located in hamstrings can be treated conservatively but in professional football players, when the amount of connective tissue involved is great (free-tendon) injuries have to be treated surgically (AU)

Enfermedad de Müller-Weiss: a propósito de un caso en un futbolista en etapa formativa / Müller-Weiss disease: Presentation of a case in a football player in the training stage

Aunque muchos autores la consideran una osteonecrosis, la enfermedad de Müller-Weiss es una displasia del escafoides tarsiano producida en la infancia, pero que se mantiene asintomática hasta la edad adulta. La fisiopatología es debida a un retraso en la osificación, asociado a una compresión de la porción lateral del escafoides tarsiano por el astrágalo lateralizado y en varo. El compromiso suele ser bilateral y simétrico

Although many authors consider Müller- Weiss syndrome as a osteonecrosis, it is a navicular dysplasia occurring in childhood that remains asymptomatic until adulthood. It is caused by a delay in the ossification of the navicular associated with the compression of the lateral portion of the tarsal navicular by the talus that is shifting laterally and in varus. There is usually bilateral and symmetrical involvement

Lesión de “tennis leg” asociada a rotura parcial del tendón de Aquiles / ‘‘Tennis leg’’ injury associated with a partial rupture of the Achilles tendon

La rotura de la porción distal del músculo gemelo interno también es conocida como la lesión de “tennis leg”. Es frecuente que esta patología esté asociada a la rotura del músculo sóleo o la del músculo plantar delgado, así como la trombosis venosa profunda. Presentamos el caso de un jugador profesional de baloncesto con antecedentes de tendinopatía aquílea y bursitis retrocalcánea que presenta un “tennis-leg” asociado a una rotura parcial del tendón de Aquiles(AU)

A tear in the distal part of the internal calf muscle is also known as ‘‘tennis leg’’. This injury is often associated with the rupture of the soleus muscle or the plantaris muscle, as well as deep vein thrombosis. We present the case of a professional basketball player with a history of Achilles tendonitis and retrocalcaneal bursitis, who had a ‘‘tennis leg’’ associated to a partial rupture of the Achilles tendon(AU)