The Intra-articular Tendinous Graft Diameter of 10-mm Bone-Patellar Tendon-Bone Autografts in Adolescent Patients: An MRI Analysis of 100 Patients.

Background: Bone-patellar tendon-bone (BPTB) autograft size may be one modifiable predictor of anterior cruciate ligament (ACL) reconstruction postoperative success, as smaller graft diameter has been associated with higher rates of rupture requiring revision. However, measuring the true intra-articular tendinous graft diameter of the soft tissue portion of a BPTB graft with standard intraoperative methods is difficult while keeping the graft intact. Purpose/Hypothesis: The purpose of the study was to use 3-dimensional magnetic resonance imaging (MRI) measurements to determine the cross-sectional area of the soft tissue, tendinous portion of a standard BPTB autograft with 10-mm diameter bone plugs, and, by calculation, the collagen graft size (ie, graft diameter), as would typically be reported in ACL reconstruction studies that consider soft tissue graft size. It was hypothesized that the calculated collagen graft diameter of 10-mm BPTB autografts would be significantly smaller than 10 mm. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 100 patients (10 girls and 10 boys at each age from 13 to 17 years) who underwent a knee MRI at a single academic orthopaedic center without documented extensor mechanism pathology were identified. The central 10-mm width of the patellar tendon that would be harvested for BPTB autograft was measured. The region of interest area tool was then used to measure the cross-sectional area of a 10-mm BPTB graft with subsequent soft tissue autograft diameter calculation. Results: The mean calculated tendinous graft diameter of a 10 mm-wide BPTB graft was 6.3 ± 0.5 mm and was significantly smaller than a 10-mm reference (P≤ .001). There was no significant association between age and cross-sectional area or graft diameter. Conclusion: Modern 3-dimensional imaging-based measurement techniques demonstrated that the true intra-articular tendinous soft tissue portion of 10-mm BPTB autografts shows substantial variation and is significantly smaller in diameter than the tunnels typically reamed to accommodate the bone plug portions of these grafts. Moreover, as graft size is a predictor of rupture rate, preoperative MRI-based evaluation may be an important tool when considering BPTB autograft for ACL reconstruction. Future comparative clinical research utilizing graft size as a study variable should consider quantifying and utilizing the diameter of the soft tissue component of BPTB autografts.

The 25 Most Cited Articles in Pediatric Orthopaedic Sports Medicine.

Background: Citation analysis reflects the influence a work has on a field of research and can be used to identify "classic" works and their qualities in medical specialties. By analyzing the characteristics of these works, we intended to determine what qualities make for a highly cited work in pediatric orthopaedic sports medicine. Purpose: To identify the top 25 most cited articles in the field of pediatric orthopaedic sports medicine. Study Design: Cross-sectional study. Methods: The Science Citation Index Expanded feature within the Web of Science database was searched using a Boolean string, generating 2008 pediatric orthopaedic sports medicine articles arranged by number of citations. The top 25 most cited articles were reviewed for authors, year of publication, source journal, country of origin, region of origin, diagnosis or condition of focus, and level of evidence (LOE). Results: Most of the articles were published in the 2000s (range, 1992-2016). The mean number of citations was 166 (range, 119-329), and the mean citation density was 13.25 (range, 4.25-29.57). There were 18 of 25 studies performed in the United States. A plurality of the articles were published in the American Journal of Sports Medicine. The LOE ranged from 2 to 4, with the most common being level 2 (11/25). Anterior cruciate ligament (ACL) injury management (14/25) and epidemiological studies on the incidence of various sports injuries (6/25) were the most represented topics of study. Since the 1990s, the mean citation density for articles related to ACL injuries in young athletes and the epidemiology of sports injuries has been increasing. Conclusion: This evaluation demonstrated that ACL injuries and the epidemiology of sports injuries had the highest citation density of the most influential studies in pediatric orthopaedic sports medicine. We identified attributes such as country of publication, journal of publication, and LOE that make for a highly cited pediatric orthopaedic sports medicine article. Overall, citation density in pediatric sports medicine is increasing. Nonetheless, the most represented LOE in the most cited works is level 2, with no level 1 studies being represented in the top 25. In terms of both topics and LOE, this study allows surgeons to identify deficiencies in the existing literature and meaningfully design future studies to improve on these.

[Return to activity and return to sports after total knee replacement]. / "Return-to-activity" und "return-to-sport" nach endoprothetischer Versorgung des Kniegelenks.

BACKGROUND: Total knee arthroplasty (TKA) is one of the most common and successful operations in the field of orthopaedics, with a steadily increasing number of patients. However, as the patient population becomes younger, expectations regarding the outcome of the surgery are also changing. In addition to pain reduction and improved mobility, the longevity of the implant and the recovery of (everyday) activity in general (return-to-activity, RtA) and sporting activity in particular (return-to-sports, RtS) are becoming increasingly important. STATE OF THE STUDY: RtS with a tendency towards low-impact sports seems generally possible but is highly dependent on the individual characteristics of the patient. Despite comprehensive studies on treatment with TKA, there are no systematic studies and reliable conclusions on the key factors that enable patients to return to sports after TKA. Any recommendation by the responsible surgeons remains dependent on their subjective experience due to the lack of standardized implementation of an RtA/RtS assessment and the necessary long-term follow-up observation under control of patient-related confounding factors.

Pediatric Concussions in Contact Sports: A 10-Year Retrospective Analysis of Mechanisms and Associated Symptoms.

Background: Concussions make up a significant proportion of sports injuries. This study aimed to describe the mechanisms of injury and associated symptoms of pediatric patients diagnosed with concussions (age range, 4-17 years) from contact sports. Hypothesis: Mechanisms of injury would differ based on sex and age, with female athletes and younger athletes aged 4 to 11 years sustaining fewer concussions from player-to-player contact. Study Design: Descriptive epidemiology study. Methods: The National Electronic Injury Surveillance System was queried for all contact sport concussions presented to United States emergency departments. The sports analyzed included basketball, football, soccer, hockey, rugby, and lacrosse. Descriptive data, mechanisms of injury, and associated symptoms were analyzed for each sport. Differences in the number of concussions sustained by year and sport, the severity of the injury, and associated symptoms were compared using chi-square test, and differences in proportion were calculated for mechanisms of injury stratified by sex and age. Results: A total of 12,602 youth athletes sustained concussions between 2012 and 2021. Most patients were male (78.5%), with a mean age of 13.48 years. Football concussions were the most common, with 45.32% of the concussions. The mechanism of injury was largely sport-specific, with player-to-player contact the most common overall. Older male athletes were more likely to have concussions from player-to-player contact, whereas younger athletes were more impacted by head-to-ground mechanisms. Symptom presentation was not sport-specific, and headache and dizziness were the most common presentation at 41.2% and 26.2%, respectively. Conclusion: The most important overall mechanism of injury was player-to-player contact, especially in older male youth athletes, whereas younger athletes were more likely to be concussed due to head-to-ground injuries.

Open Capsular Repair with Dermal allograft and tarsal tunnel release in the treatment of Tarsal Tunnel Syndrome in a Young Collegiate Athlete: A Case Report.

Tarsal tunnel syndrome is an entrapment neuropathy of the posterior tibial nerve beneath the flexor retinaculum that can be precipitated by either intrinsic or extrinsic factors. We report a unique case of a posterior medial ankle joint capsular defect with localized fluid extravasation between the flexor digitorum longus and flexor hallucis longus leading to symptoms consistent with tarsal tunnel syndrome in a collegiate tennis player. This patient is a 19-year-old female with no past medical history who presented with symptoms consistent with tarsal tunnel syndrome. After confirmation with magnetic resonance imaging, the patient underwent capsular reconstruction with dermal allograft in combination with a tarsal tunnel release. The patient had improvement in pain and recovery of paresthesia 3 months postoperatively. At the latest follow-up of 1 year postoperatively, the patient has not had a recurrence of symptoms and has returned to the same level of competitive play. Many different causes of tarsal tunnel syndrome are described in the literature, but to our knowledge, there is no current literature that describes a defect in the tibiotalar joint capsule as a cause of tarsal tunnel syndrome.

Ankle, knee and concussion concerns: Unveiling injury patterns in highly trained South African netball players.

OBJECTIVES: To describe the rate and type of netball injuries sustained during women's university-level tournament matches in South Africa. DESIGN: Descriptive epidemiological study. SETTING: Three editions of the women's Varsity Netball tournament (2021-23). PARTICIPANTS: Student-athletes representing nine university women's teams. MAIN OUTCOME MEASURES: Medical attention match injuries prospectively recorded by team medical staff. Injuries were classified according to the 2020 consensus statement, with the addition of "concussion" as a separate pathology type. The main outcomes are reported as incidence (injuries per 1000h; 95% confidence intervals - CIs), burden (days lost per 1000h; 95%CIs), and frequency (% of all injuries). RESULTS: Sixty-three injuries were recorded from 48 different players (58.8 per 1000h; 45.2-75.3) and the overall injury burden was 401 days per 1000h (364-440). Injury incidence by pathology type was highest for joint sprains (28.9 per 1000h), tendinopathies (7.5 per 1000h), and concussions (4.7 per 1000h). Joint sprains to the ankle accounted for 49% of the overall estimated days lost. CONCLUSIONS: Ankle joint sprains should be the primary target of injury risk reduction programmes in highly trained netball players. Concussions were reported and efforts should be made to increase awareness among players, coaches and medical staff.

Sport PRactice and its Effects on aortic size and valve function in bicuspid Aortic valve Disease: a cross-sectional report from the SPREAD study.

OBJECTIVE: Concerns exist about the possible detrimental effects of exercise training on aortic size and valve function in individuals with bicuspid aortic valve (BAV). This multicentre international study aimed to determine the characteristics of aortic size and valve function in athletes versus non-athletes with BAV and athletes with tricuspid aortic valve (TAV). METHODS: We enrolled competitive athletes with BAV and age- and sex-matched athletes with TAV and non-athletes with BAV. We assessed valve function, aortic size and biventricular measures using echocardiography. Individuals with established moderate-severe AV stenosis, regurgitation or significant aortic dilation were excluded from the study. RESULTS: The study population comprised 504 participants: 186 competitive athletes with BAV (84% males; age 30±11 years), 193 competitive athletes with TAV and 125 non-athletes with BAV. The aortic annulus was greater in athletes with BAV than athletes with TAV and non-athletes with BAV (p<0.001). Both athletic and non-athletic individuals with BAV had greater sinuses of Valsalva, sino-tubular junction and ascending aorta diameters than athletes with TAV (p<0.001). However, no significant differences were found between athletes and non-athletes with BAV. Left ventricular index volumes and mass were greater in athletes with BAV than in the other two groups (p<0.001). Individuals with BAV (athletes and non-athletes) had greater mean gradients than TAV athletes. CONCLUSION: This multicentre international study demonstrates no differences between athletes with BAV and non-athletes with BAV regarding aortic valve function or aortic dimensions. However, athletes with BAV have larger aortic diameters and a relatively worse valvular function than athletes with TAV.

Surface electromyography of the vastus lateralis and gluteus medius muscles in post-operative T3-L3 hemilaminectomy dogs: a prospective controlled observational study.

Objective: The objective of this study was to determine if surface electromyography (sEMG) demonstrates differences in muscle activation between normal and dogs recovering from spinal cord injury due to intervertebral disk extrusion. Animals: Two groups of client-owned small-breed chondrodysplastic-type dogs were tested. Group 1 consisted of seven ambulatory paraparetic dogs that had undergone a hemilaminectomy procedure in the T3-L3 region for intervertebral disk extrusion 1 month prior. Group 2 was made up of seven normal dogs that had no history of intervertebral disk disease or spinal surgery. Procedures: Each subject walked 10 feet on a nonslip surface for at least five gait cycles for the sEMG to capture muscle activation of the vastus lateralis and gluteus medius, bilaterally. Muscle activation was quantified as the total myoelectric output area under the curve, averaged across all gait cycles. Results: Muscle activation was significantly greater in the post-operative hemilaminectomy group (p = 0.012). There was a significant difference in muscle activation between each hindlimb in the post-operative hemilaminectomy group, but not in the normal group. The muscle activation was significantly lower on the side that underwent surgery compared to the opposite limb (p = 0.0034). Conclusion and clinical importance: Post-operative hemilaminectomy dogs have greater hindlimb muscle activation compared to normal dogs, which likely represents a lack of descending inhibition secondary to upper motor neuron syndrome. The side of surgery is correlated with decreased muscle activation. Surface EMG can be used to evaluate muscle activity in dogs recovering from spinal decompression surgery.

Evaluation of Tibial Slope on Radiographs in Pediatric Patients With Tibial Spine Fractures: An Age- and Sex-Matched Study.

Background: A recent study has reported that the radiographic measurement of posterior tibial slope (PTS) is larger in male pediatric patients with tibial spine fractures (TSF) than in controls. However, they found no difference in PTS between female patients and controls. Purpose: (1) To identify whether PTS is larger in female pediatric patients with TSF than in female controls and (2) to validate the relationship between PTS and pediatric TSF in male patients. Study Design: Cross-sectional study; Level of evidence, 3. Methods: After an a priori power analysis, 84 pediatric patients with TSF (50 female patients and 34 male patients) and 84 age- and sex-matched controls were enrolled in this study. Demographic information, including sex, age, and race, was recorded. Skeletal maturity was determined based on the stage of epiphyseal union on knee radiographs. PTS was defined as the angle between a line perpendicular to the longitudinal axis of the tibia and the posterior inclination of the medial tibial plateau on standard knee lateral radiographs. Results: The mean age when the TSF occurred was 11.2 ± 2.7 years for female patients and 12.9 ± 2.5 years for male patients. There was no significant difference in skeletal maturity between female patients and female controls or between male patients and male controls. The mean PTS was not significantly different between female patients (8.8°± 2.8°) and female controls (8.3°± 3.1°) (P = .366) or between male patients (9.0°± 2.8°) and male controls (9.3°± 2.6°) (P = .675). Those with a PTS >1 SD (2.9°) above the mean (8.8°) had no greater odds (1.0 [95% CI, 0.4-2.5]; P≥ .999) of having a TSF than others. Conclusion: PTS was not found to be a risk factor for pediatric TSF in female or male patients in this study.

Publications and ranking in orthopaedics and sports medicine of European countries during the last three decades: A bibliometric analysis.

Introduction: The present investigation examined the trend of publications and ranking in Orthopaedics and Sports Medicine of European countries during the years 1996 to 2022 and compared these with all the regions globally. Methods: In September 2023, the SCOPUS data of publications in Orthopaedics and Sports Medicine from the SCImago Journal & Country Rank website were retrieved. All the data from Western and Eastern Europe were extracted from the overall data of the global countries and merged into Excel files, for each of the years 1996-2022 and 2022. Results: Western European countries contributed significantly to the global share of publications in Orthopaedics and Sports Medicine with nearly 1/3rd of the total publications. Eastern European countries' contribution was minimal to the global publications and was almost 10 times less than the Western European countries. The total number of publications in the area of Orthopaedics and Sports Medicine from 1996 to 2022 at the European scale was led by the United Kingdom (N = 51510) and has maintained its supremacy until recently, in 2022. Amongst Western European countries, during the cumulative period of 1996-2022, the maximum contributions were made by the United Kingdom (N = 51510), and also in 2022, the United Kingdom contributed maximally (N = 3339). In the cumulative period of 1996-2022, Poland contributed maximally (N = 4049) among the Eastern European countries. In 2022, the maximum contribution from the Eastern European countries came from the Russian Federation (N = 462). Conclusion: The European continent is the major contributor to Orthopaedics and Sports Medicine research and publications, with almost 1/3rd of the global share of publications. Western European countries are far ahead in their contributions than Eastern European countries.

Effectiveness of a physiotherapy self-management programme for adult patients with chronic non-specific low back pain in low- and middle-income countries: protocol for a systematic review and meta-analysis.

INTRODUCTION: Chronic non-specific low back pain (CNLBP) is among the most common musculoskeletal system conditions reported worldwide; however, few studies are available from low- and middle-income countries (LMICs). Self-management is a set of tasks performed by the patient aiming at managing their symptoms and interference in activities, mood and relationships due to pain. A physiotherapy-guided self-management programme (SMP) following a biopsychosocial approach has been reported as effective and affordable in the management of CNLBP in high-income countries. The objective of this systematic review is to determine the overall effectiveness of SMPs for adults with CNLBP in LMICs. METHODS AND ANALYSIS: In this systematic review, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Protocol (PRISMA-P) guidelines will be followed. A three-step search strategy will be used to search the electronic databases (PubMed, MEDLINE, SPORTDiscus, Scopus and CINAHL, Academic Search Complete and PEDro) for randomised controlled trials assessing the effectiveness of physiotherapy-guided self-management for CNLBP among adult participants in LMICs. The processes of screening search results for eligible studies, extracting data from included studies and appraising will be done independently by at least two review authors. Random effects meta-analysis will be used to synthesise results and heterogeneity will be assessed using the I2 test statistic and χ2 test. ETHICS AND DISSEMINATION: Ethics clearance was obtained for the broader PhD study on the development of a physiotherapy-guided SMP for adult people with CNLBP in Limpopo Province, South Africa. The results of the manuscript for this protocol will be published in peer-reviewed journals and also presented at conferences, symposia, and congresses. PROSPERO REGISTRATION NUMBER: CRD42023399572.

Profile of Sport and Exercise Physician trainee's clinical practice within Australasia in 2019: a cross-sectional study.

Objective: To identify the patient population profile and the spectrum of training activities and influencing factors of Australasian College of Sport and Exercise Physician (ACSEP) trainees. Design: Retrospective cross-sectional design. Setting: Training settings for ACSEP trainees. Participants: Twenty ACSEP trainees undertaking full-time training in training period 2 of the 2019 training year (1 August 2019-31 January 2020). Exclusion criteria were trainees undertaking part time study and new fellows who completed their fellowship exams in 2019. Independent variables: Patient and practitioner demographics. Method: Retrospective cross-sectional design. Main outcome measurements: Patient data recorded in ACSEP trainees' logbook. Short questionnaire capturing pertinent trainee demographics. Results: Most ACSEP trainee patients are adults aged 18-65 years of age (78.2%), presenting with knee (18.7%), ankle (17%) and spinal complaints (13.1%) in clinical practice or sporting team environments. Youths 10-17 make up 13.1% of presentations and older adults 66 years and older make up 8%. Only Australian trainees are engaging in additional training activities, such as surgical assisting outside of the clinic or sporting team environment. Conclusion: Australasian Sport and Exercise Physician trainees appear to consult primarily musculoskeletal complaints, including providing broader care to paediatric and older populations, and work with sporting teams. There are differences between Australia and New Zealand trainee employment conditions, which appear to be affecting training experiences. These differences warrant consideration to ensure equitable training experiences and financial stability for trainees.

Qualitative and quantitative return-to-sport test battery and second anterior cruciate ligament injury risk factors.

Objective: To determine risk factors for second anterior cruciate ligament (ACL) injury following primary ACL reconstruction (ACLR) using return-to-sport (RTS) tests consisting of qualitative and quantitative measures in young athletes. Methods: A case-control study design was used, and a retrospective review of adolescent athletes after primary ACLR was performed. All athletes completed an RTS test consisting of qualitative and quantitative assessments and psychological assessments with the Tampa Scale of Kinesiophobia. Athlete demographics, surgical characteristics and sports participation were also examined. A binary logistic regression was performed to verify an independent association between risk factors and second ACL injury using adjusted OR (aORs), 95% CI and p<0.05. Results: In 72 eligible athletes, 12 (16.7%) suffered a second ACL injury. The mean Tegner activity level was 8.4+1.1, and the mean time from ACLR to RTS test completion was 10.4+2.9 months. One variable that showed the lowest p-value in the preliminary analysis was entered into the binary logistic regression model, which resulted in that qualitative assessment of knee valgus during the sidestep cut was associated with second ACL injury (aOR=4.64, 95% CI: 1.18 to 18.23, p=0.03). Conclusion: Athletes who demonstrated excessive dynamic knee valgus on the involved limb during the sidestep cut were approximately 4.6 times more likely to suffer a second ACL injury.

Youth Sport Specialization: Current Concepts and Clinical Guides.

The concept of youth sport specialization has evolved over the past decade, from a focus on the risk of overuse injury to a broader awareness of its effects on mental health, social well-being, quality of life, growth and maturation, sport performance, and long-term athletic success. This review article considers a recently revised definition of youth sport specialization, as well as guidelines and consensus statements from various sports medicine organizations, with practical applications for young athletes.

Patellofemoral Instability in Pediatric and Adolescent Athletes: A Review of Risk Factors and Treatments.

Pediatric patellar instability can impair function and restrict activity participation. If left untreated, it can lead to a degenerative knee. The incidence of patellar dislocations is highest in adolescents between 10 and 17 years of age; more than half of all first-time patellar dislocations occur during sports. This article reviews the evidence of risk factors for traumatic patellar instability, surgical interventions, and return-to-sport (RTS) considerations for pediatric and adolescent athletes. Anatomic risk factors for patellar instability in pediatric and adolescent patients include trochlear dysplasia, elevated tibial tuberosity-trochlear groove (TT-TG) distance, patella alta, genu valgum, femoral anteversion and tibial torsion, and hyperlaxity.

Understanding multicentric haemangioendothelioma: diagnostic dilemmas and treatment strategies.

Epithelioid haemangioendothelioma (EH) is a rare malignant vascular tumour occurring mainly in the liver and lungs, with bones being a rare site and primarily seen in the adult population. This case presents a male patient in his 40s who presented to the outpatient department with a chief issue of a painless swelling over the inguinal region for 4 months, gradually increasing in size, along with a history of a gradually enlarging, painless mass on his left knee over the past 5 years. Despite occasional discomfort during physical activities, the mass exhibited no associated trauma, fever, weight loss or systemic symptoms. Physical examination revealed a firm mass on the left knee and a matted lymph nodal swelling in the left inguinal region. Subsequent imaging studies identified multiple soft tissue lesions, osseous involvement and pulmonary metastases, suggestive of multicentric haemangioendothelioma. The patient underwent surgical excision of the inguinal mass and fixation of a pathological fracture in the left femur. He is currently undergoing chemotherapy and is scheduled for regular follow-up appointments. This case underscores the importance of thorough diagnostic evaluation and multidisciplinary management in complex oncological conditions like multicentric haemangioendothelioma.

An Explorative Anatomical Study on Inter-Individual Variation of the Tibial Nerve and Landmarks for Perineural Anesthesia in Horses.

Perineural anesthesia of the tibial nerve can be performed ultrasound-guided or blindly, with the latter still being commonly used in equine practice due to practical constraints, despite its lower accuracy and hence, common failure to achieve desensitization. This may be associated with anatomical variations or inadequate landmarks for injection. To examine the course of the tibial nerve, document potential anatomical variations, and determine optimal landmarks for perineural injection, dissection was conducted along the medial aspect of the tibia in 10 paired cadaver hindlimbs. No anatomical variations of the tibial nerve were observed. Mean tibial nerve thickness was 6 ± 1 mm. The junction with the plantar nerves was located at a maximum of 85 mm and the junction with the medial cutaneous branch was at a maximum of 150 mm proximal to the proximal aspect of the calcaneal tubercle. The mean distance of the tibial nerve to the cranial border of the superficial digital flexor was 11 ± 6 mm. In conclusion, problems with perineural anesthesia of the tibial nerve cannot simply be attributed to anatomical variations. The thickness of the nerve and the amount of perineural tissue may present specific challenges for achieving adequate desensitization. Our results support the generally recommended site for tibial nerve perineural injection at 100 mm proximal to the calcaneal tubercle and 11 mm cranial to the superficial digital flexor.

Does lower extremity stiffness influence change of direction speed in badminton athletes after dynamic loaded warm-up?

This study investigated whether lower extremity stiffness plays a role in the enhancement of change of direction speed (CODS) and the duration of this enhancement after dynamic loaded warm-up (DLWU). Fifteen badminton athletes underwent DLWU, and CODS, individual muscle and tendon stiffness, and vertical stiffness were measured before DLWU and 6, 12, and 18 min after DLWU. The data were analyzed using ANOVA and covariance analysis. Significant improvements in CODS were found at 6, 12, and 18 min post-DLWU compared to pre-DLWU (p < 0.05). The Achilles tendon stiffness of the dominant leg increased at 6 min (p = 0.039) and 18 min (p = 0.024) post-DLWU compared to pre-DLWU. Achilles tendon stiffness of the dominant leg had a significant effect on improving CODS (p > 0.05). CODS improvement lasted up to 18 min after DLWU in badminton athletes, potentially related to increased Achilles tendon stiffness of the dominant leg.

Twenty-first century knowledge mapping on oral diseases and physical activity/exercise, trends, gaps, and future perspectives: a bibliometric review.

Maintenance and improvement of an individual's overall well-being require a multidisciplinary approach that encompasses everything from oral health care to regular physical exercise. The notion that poor oral health can influence general health and athletic performance has sparked an interest in this relationship. This study offers an overview of relevant research and a knowledge map,and discusses publication metrics and key topics concerning the relationship between physical activity or exercise and oral diseases. We searched the Web of Science database for articles published in the 21st century that addressed the relationship between physical activity and oral diseases. Under the stipulated inclusion criteria, a rigorous selection process yielded 276 from 3,883 retrieved articles. The articles were classified by what was assessed as follows: occurrence of oral diseases in athletes or sports enthusiasts (n = 174); impact of physical activity or exercise on the oral cavity (n = 59); effects of oral changes on sports performance and physical fitness (n = 31); and the connection between oral health status, physical activity or exercise, and systemic conditions (n = 12). Orofacial trauma has received the most attention among all investigated oral diseases. However, there is a need for greater attention of dysfunctional habits that can contribute to premature tooth wear, as well as oral inflammatory diseases that can have systemic implications. This mapping can encourage the development of new primary research.