The Role of Hyaluronic Acid in Sport-Related Tendinopathies: A Narrative Review.

Tendinopathy is a complex clinical condition with a rising incidence and prevalence, particularly during sports practice. For the return to play in affected patients, adequate functional and structural recovery of the tendon is the ultimate goal, avoiding the high risk of recurrence. In this perspective, local therapies alongside exercise are showing promising results. Despite evidence suggesting hyaluronic acid (HA) injections as effective in the treatment of tendinopathy, current recommendations about the management of this condition do not include this intervention. HA seems to be an effective therapeutic option for the management of sport-related tendinopathies, but further studies with a larger sample size are needed to confirm available findings. In this narrative review, we analyzed available literature about the rationale of the use of HA in the management of tendon injury and, particularly, in sport-related tendinopathies.

Intra-articular injections of HYADD4-G in male professional soccer players with traumatic or degenerative knee chondropathy. A pilot, prospective study.

BACKGROUND: Knee injuries are very common in some sports and particularly in soccer due to the highly repetitive loading of the mechanical stress involved in this practice. Knee-joint injuries account for 40% of all different kinds of lesions. Traumatic or degenerative patellofemoral or tibialfemoral chondropaties of knee cause disabling symptoms, joint pain and/or dysfunctions. The aim of the study was to evaluate the effects of HYADD4-G, a hydrogel based on a hyaluronic acid derivative, in professional soccer players affected by traumatic or degenerative knee chondropathy. METHODS: Thirty male professional soccer players participants in the Italian League 2014-2015, affected by traumatic or degenerative knee patellofemoral (N.=12) or tibiofemoral (N.=18) chondropathy assessed through MRI and/or arthroscopy of knee joints and the ICRS staging (International Cartilage Repair Society ≤3a), were enrolled in this pilot prospective study. Patients underwent 2 intra-articular (IA) injections of HYADD4-G (3 mL of 8 mg/mL) at one week interval. Patients were prospectively evaluated at baseline and then at 1, 3 and 6 months after the treatment by the Osteoarthritis Outcome Score (KOOS) Score (main outcome) and by the Visual Analog Scale (VAS) to evaluate pain. RESULTS: A significant improvement in all clinical endpoints from pretreatment to different times of evaluation was found in all patients. ANOVA with repeated measure using the SPSS has showed significantly better results in term of KOOS and VAS scores at 1, 3 and 6 months compared to the pre-injection value (P<0.05). CONCLUSIONS: IA HYADD4-G is highly effective to improve resting and walking pain in professional male soccer players with traumatic or degenerative knee chondropathy.

Flu vaccination in elite athletes: A survey among Serie A soccer teams.

Scant data is available on immunization policies and practices among professional athletes. Following up on a recent review on the topic, we conducted a survey among Italian Serie A soccer teams during the influenza season 2015-16, to explore vaccination practices and attitudes as well as influenza vaccine uptake. The survey covered a sample of over 600 professional athletes from 20 teams and was carried out in collaboration with the Italian Association of Physicians of Professional Football Teams (L.A.M.I.CA.). For each team, the head of the medical staff was interviewed (structured telephone interviews, 100% response rate). Seasonal influenza vaccine was actively offered in 75% of Serie A teams with a median coverage rate of 40% (range 0%-100%). Vaccines are often administered after matches or training sessions. We report vaccine hesitancy associated with fear of adverse events, poor communication and other selected determinants. Vaccination in elite athletes, if correctly managed, represents a powerful, cost-effective and long lasting preventive tool. In times where vaccines are losing public confidence, our findings are a useful basis to inform the planning, implementation and evaluation of interventions to promote prevention in sports medicine.