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1.
Rev. bras. med. esporte ; 29: e2022_0161, 2023. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1394835

RESUMO

ABSTRACT Introduction: With the 2022 Winter Olympic Games launch, ice and snow sports have come into the spotlight, receiving government incentives to encourage their practice. Objective: Examine the causes of knee injury in skiers, proposing preventive measures for joint injury. Methods: The current situation of joint injury in skiers' knees, joint movement in skiing, the cause of joint injury, and the prevention of joint injury were analyzed, and scientific prevention and corresponding treatment plan were developed according to the results of the analysis. Results: The injury rate among skiers is high. Ligament injury, tendon injury, and muscle strain are the three main types of injury. There are 57 mild injuries of various types to the knee joint - 53.27% of all injuries; 41 moderate injuries, representing 38.32% of all injuries; 9 serious injuries, representing 8.41% of all injuries, with minor injuries. Conclusion: This article examines knee motion and the causes of knee injury in skiers and proposes preventive measures for joint injury. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.


RESUMO Introdução: Com o lançamento dos Jogos Olímpicos de Inverno de 2022, os esportes de gelo e neve entraram em evidência, recebendo incentivos governamentais para encorajamento de sua prática. Objetivo: Examinar as causas da lesão no joelho em esquiadores, propondo medidas preventivas para a lesão articular. Métodos: Foram analisadas a situação atual de lesão articular nos joelhos dos esquiadores, o movimento articular no esqui, a causa das lesões articulares e a prevenção de lesões articulares, além de um plano de prevenção científica e tratamento correspondente, de acordo com os resultados da análise. Resultados: A taxa de lesões em esquiadores é alta. Lesão ligamentar, lesão tendinosa e tensão muscular são os três principais tipos de lesão. Há 57 lesões leves de vários tipos na articulação do joelho - 53,27% de todas as lesões; 41 lesões moderadas, representando 38,32% de todas as lesões; 9 lesões graves, representando 8,41% de todos os ferimentos, com ferimentos menores. Conclusão: Este artigo examina o movimento do joelho e as causas da lesão no joelho em esquiadores, e propõe medidas preventivas para lesão articular. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.


RESUMEN Introducción: Con la puesta en marcha de los Juegos Olímpicos de Invierno de 2022, los deportes de hielo y nieve han pasado a ser el centro de atención, recibiendo incentivos gubernamentales para fomentar su práctica. Objetivo: Examinar las causas de las lesiones de rodilla en los esquiadores, proponiendo medidas preventivas de las lesiones articulares. Métodos: Se analizó la situación actual de las lesiones articulares en las rodillas de los esquiadores, el movimiento articular en el esquí, la causa de las lesiones articulares y la prevención de las mismas, y se elaboró un plan científico de prevención y tratamiento correspondiente según los resultados del análisis. Resultados: El índice de lesiones en los esquiadores es alto. Las lesiones de ligamentos, las lesiones de tendones y las distensiones musculares son los tres tipos principales de lesiones. Hay 57 lesiones leves de diversos tipos en la articulación de la rodilla, el 53,27% de todas las lesiones; 41 lesiones moderadas, que representan el 38,32% de todas las lesiones; 9 lesiones graves, que representan el 8,41% de todas las lesiones, con lesiones leves. Conclusión: Este artículo examina el movimiento de la rodilla y las causas de las lesiones de rodilla en los esquiadores, y propone medidas preventivas para las lesiones articulares. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.


Assuntos
Humanos , Masculino , Feminino , Traumatismos em Atletas/prevenção & controle , Esqui/lesões , Traumatismos do Joelho/etiologia , Traumatismos do Joelho/prevenção & controle , Traumatismos em Atletas/epidemiologia , China/epidemiologia , Traumatismos do Joelho/epidemiologia
2.
Rev. bras. med. esporte ; 28(6): 763-766, Nov.-Dec. 2022. tab
Artigo em Inglês | LILACS | ID: biblio-1376773

RESUMO

ABSTRACT Introduction Basketball is a popular sport globally, and as the development of college basketball develops, basketball injuries also tend to increase. The knee has the highest injuries and problems incidence, reducing the athlete's ability and shortening their professional career. Objective Explore the causes and characteristics of knee joint injuries in basketball players, comparing their different levels, performances, and positions. Methods 600 college basketball players were studied. Current and past injuries were collected. A questionnaire on lifestyle, behavior, and habits was also applied, and their levels of physical ability and knowledge were also evaluated. Statistical methods were employed to investigate the characteristics and causes of knee joint injuries in young athletes. Results Among knee joint injuries of adolescent basketball players, there were more medial collateral ligament injuries and meniscal injuries. The probabilities are 34.1% and 24.3%, respectively. Patellar strain and cruciate ligament injury accounted for 12.1% and 19.5%, respectively, and the probability of fracture injury was 2.4%. Conclusion The knee joint is one of the most vulnerable joints in basketball. The consequences of its injury can bring an athletic career down and have a considerable impact on athletes' physical and mental health. Evidence Level II; Therapeutic Studies - Investigating the results.


RESUMO Introdução O basquete é um esporte popular em todo o mundo e com o desenvolvimento do basquetebol universitário, as lesões causadas pelo basquetebol também tendem a aumentar. O joelho possui o maior índice de lesões e problemas nessa articulação também reduzem a capacidade do atleta, encurtando a sua carreira profissional. Objetivo Explorar as causas e características das lesões na articulação do joelho em jogadores de basquetebol comparando seus diferentes níveis, desempenhos e posições. Métodos 600 universitários jogadores de basquete foram estudados. Foram arquivadas as lesões atuais e pregressas. Um questionário sobre estilo de vida, comportamento e hábitos também foi aplicado; seus níveis de habilidade física e conhecimento foram avaliados. Métodos estatísticos investigaram as características e causas das lesões na articulação do joelho nos jovens atletas. Resultados Entre as lesões articulares de joelho nos jogadores adolescentes de basquete, houve mais lesões ligamentares colaterais mediais e lesões meniscais. As probabilidades são de 34,1% e 24,3%, respectivamente. A tensão patelar e a lesão do ligamento cruzado representaram 12,1% e 19,5%, respectivamente, e a probabilidade de lesão por fratura foi de 2,4%. Conclusão A articulação do joelho é uma das partes mais vulneráveis do basquetebol. As consequências de sua lesão podem acarretar o fim da carreira esportiva, tendo um impacto considerável sobre a saúde física e mental dos atletas. Nível de evidência II; Estudos Terapêuticos - Investigação de Resultados.


RESUMEN Introducción El baloncesto es un deporte popular en todo el mundo y con el desarrollo del baloncesto universitario, las lesiones causadas por el baloncesto también tienden a aumentar. La rodilla tiene el mayor índice de lesiones y los problemas en esta articulación también reducen la capacidad del deportista, acortando su carrera profesional. Objetivo Explorar las causas y características de las lesiones de la articulación de la rodilla en jugadores de baloncesto comparando sus diferentes niveles, rendimientos y posiciones. Métodos Se estudiaron 600 jugadores de baloncesto universitario. Se presentaron las lesiones actuales y pasadas. También se aplicó un cuestionario sobre el estilo de vida, el comportamiento y los hábitos; y también se evaluaron sus niveles de capacidad física y conocimientos. Se emplearon métodos estadísticos para investigar las características y las causas de las lesiones de la articulación de la rodilla en atletas jóvenes. Resultados Entre las lesiones de la articulación de la rodilla de los jugadores de baloncesto adolescentes, hubo más lesiones del ligamento colateral medial y de menisco. Las probabilidades son del 34,1% y del 24,3%, respectivamente. La distensión rotuliana y la lesión del ligamento cruzado representaron el 12,1% y el 19,5%, respectivamente, y la probabilidad de lesión por fractura fue del 2,4%. Conclusión La articulación de la rodilla es una de las partes más vulnerables del baloncesto. Las consecuencias de su lesión pueden llevar al fin de una carrera deportiva, teniendo un impacto considerable en la salud física y mental de los atletas. Nivel de evidencia II; Estudios terapéuticos - Investigación de resultados.


Assuntos
Humanos , Traumatismos em Atletas/epidemiologia , Basquetebol , Traumatismos do Joelho/epidemiologia , Inquéritos e Questionários , Estilo de Vida
3.
Rheum Dis Clin North Am ; 48(4): 907-930, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36333003

RESUMO

Osteoarthritis is a debilitating chronic condition involving joint degeneration, impacting over 300 million people worldwide. This places a high social and economic burden on society. The knee is the most common joint impacted by osteoarthritis. A common cause of osteoarthritis is traumatic joint injury, specifically injury to the anterior cruciate ligament. The purpose of this review is to detail the non-modifiable and modifiable risk factors for osteoarthritis with particular focus on individuals after anterior cruciate ligament injury. After reading this, health care providers will better comprehend the wide variety of factors linked to osteoarthritis.


Assuntos
Lesões do Ligamento Cruzado Anterior , Traumatismos do Joelho , Osteoartrite do Joelho , Humanos , Osteoartrite do Joelho/epidemiologia , Osteoartrite do Joelho/etiologia , Articulação do Joelho , Traumatismos do Joelho/complicações , Traumatismos do Joelho/epidemiologia , Lesões do Ligamento Cruzado Anterior/complicações , Lesões do Ligamento Cruzado Anterior/epidemiologia , Fatores de Risco
4.
Clin Sports Med ; 41(4): 769-787, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36210170

RESUMO

The participation of females in sports has increased significantly since the passage of Title IX. Sports participation may place young athletes at risk for knee injuries, including patellofemoral pain syndrome (PFPS), osteochondritis dissecans (OCD), and anterior cruciate ligament (ACL) rupture. Differences in anatomy, hormone production, and neuromuscular patterns between female and male athletes can contribute to disparities in knee injury rates with female athletes more vulnerable to PFPS and ACL injury. Biological differences between sexes alone cannot fully explain worldwide differences in musculoskeletal health outcomes. Social, cultural and societal attitudes toward gender and the participation of girls and women in sports may result in a lack of accessible training for both injury prevention and performance optimization; one must recognize the effects of gender disparities on injury risk. More nuanced approaches to assess the complex interplay among biological, physiologic, and social influences are needed to inform best practices for intervention and sports injury prevention.


Assuntos
Lesões do Ligamento Cruzado Anterior , Traumatismos em Atletas , Traumatismos do Joelho , Lesões do Ligamento Cruzado Anterior/epidemiologia , Atletas , Traumatismos em Atletas/epidemiologia , Traumatismos em Atletas/prevenção & controle , Criança , Feminino , Hormônios , Humanos , Traumatismos do Joelho/epidemiologia , Masculino , Fatores Sexuais
5.
Acta Orthop ; 93: 783-793, 2022 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-36173141

RESUMO

BACKGROUND AND PURPOSE: A doubling of arthroscopic meniscal procedures was observed in Denmark from 2000 to 2011, but arthroscopic meniscal procedures for degenerative meniscal tears are no longer recommended. We performed an updated investigation of Danish meniscal procedure trends in the private and public healthcare sectors in Denmark from 2006 to 2018, including trends for other arthroscopic knee procedures. PATIENTS AND METHODS: We extracted data on the 5 most commonly registered arthroscopic knee procedures (diagnostic arthroscopy, meniscal surgery, anterior cruciate ligament reconstruction, synovectomy, and cartilage resection) from the Danish National Patient Register from January 1, 2006 to December 31, 2018, linked with the Danish Population Statistic Register, to obtain data on age and sex. RESULTS: 414,253 arthroscopic knee procedures were registered during 315,290 surgeries on 244,113 individual patients in the study period. For meniscal procedures, the highest incidence was observed in 2010 (319 per 105 persons/year, 95% CI 314-323) and the lowest in 2018 (173 per 105 persons/year, CI 169-176), corresponding to relative decrease of 46% from 2010 to 2018. Remaining arthroscopic procedures also showed declining trends, with lowest incidence for all procedures in 2018. INTERPRETATION: A large decrease in the incidence for arthroscopic meniscal procedures was observed from 2010 to 2018, possibly in response to mounting evidence of limited benefit of this procedure for degenerative knee disease. All other investigated arthroscopic knee procedures also declined in the same period.


Assuntos
Lesões do Ligamento Cruzado Anterior , Traumatismos do Joelho , Menisco , Lesões do Menisco Tibial , Lesões do Ligamento Cruzado Anterior/epidemiologia , Lesões do Ligamento Cruzado Anterior/cirurgia , Artroscopia/métodos , Dinamarca/epidemiologia , Humanos , Traumatismos do Joelho/epidemiologia , Traumatismos do Joelho/cirurgia , Meniscos Tibiais/cirurgia , Menisco/cirurgia , Lesões do Menisco Tibial/diagnóstico , Lesões do Menisco Tibial/epidemiologia , Lesões do Menisco Tibial/cirurgia
6.
J Sci Med Sport ; 25(10): 834-844, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36109306

RESUMO

OBJECTIVES: To systematically evaluate the literature and estimate the prevalence, incidence, and burden of gradual-onset knee injuries in team ball-sports. DESIGN: Systematic review with meta-analysis. METHODS: Six databases (MEDLINE, EMBASE, Web of Science, CINAHL, SPORTDiscus, SCOPUS) were searched from inception to June 2021. Cohort studies of team ball-sports reporting the number of gradual-onset knee injuries were included. Study quality was assessed using a modified Newcastle-Ottawa scale. Studies were pooled using a Freeman-Tukey Double arcsine transformation (prevalence) and a Poisson random effects regression model (incidence, burden). RESULTS: Forty-nine studies that captured gradual-onset knee injuries (unclassified, patellofemoral pain, tendinopathies, and iliotibial band friction syndrome) across 15 team ball-sports were included. For unclassified gradual-onset knee injuries, prevalence was 4 % (95 % Confidence Interval (CI) 2 % to 7 %, I2 = 96 %), incidence was 0.32 per 1000 player-hours (95 % CI 0.25 to 0.43, I2 = 88 %), and burden was 3.24 days lost per 1000 player-hours (95 % CI 1.95 to 5.37, I2 = 99 %). For patellofemoral pain, prevalence was 6 % (95 % CI 1 % to 13 %, I2 = 93 %), and incidence was 0.07 per 1000 player-hours (95 % CI 0.04 to 0.12, I2 = 67 %). For tendinopathies, prevalence was 1 % (95 % CI 0 % to 2 %, I2 = 68 %), incidence was 0.07 per 1000 player-hours (95 % CI 0.04 to 0.11, I2 = 76 %), and burden was 2.14 days lost per 1000 player-hours (95 % CI 1.23 to 3.71, I2 = 92 %). CONCLUSIONS: Estimates of prevalence, incidence and burden generated from this systematic review quantify the extent of gradual-onset knee injuries in team ball-sports. Further research is required to assess whether age, sport, and participation level are predictors of gradual-onset knee injuries.


Assuntos
Traumatismos em Atletas , Traumatismos do Joelho , Síndrome da Dor Patelofemoral , Tendinopatia , Traumatismos em Atletas/epidemiologia , Humanos , Incidência , Traumatismos do Joelho/epidemiologia , Síndrome da Dor Patelofemoral/epidemiologia , Prevalência , Tendinopatia/epidemiologia
7.
Am J Sports Med ; 50(12): 3218-3227, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36177758

RESUMO

BACKGROUND: Anterior cruciate ligament (ACL) injuries are among the most common knee injuries sustained in elite sport, and athletes generally undergo ACL reconstruction (ACLR) to facilitate their return to sport. ACL graft rupture is a career-threatening event for elite athletes. PURPOSE/HYPOTHESIS: The purpose of this study was to determine the risk factors for graft failure in professional athletes undergoing ACLR. It was hypothesized that athletes who underwent combined ACLR with a lateral extra-articular procedure (LEAP) would experience significantly lower rates of graft rupture in comparison with those who underwent isolated ACLR. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Professional athletes who underwent primary ACLR with a minimum follow-up of 2 years were identified from the Santy database. Patients were excluded if they underwent major concomitant procedures, including multiligament reconstruction surgery or osteotomy. Further ipsilateral knee injury, contralateral knee injury, and any other reoperations or complications after the index procedure were identified by interrogation of the database and review of the medical notes. RESULTS: A total of 342 athletes with a mean follow-up of 100.2 ± 51.9 months (range, 24-215 months) were analyzed. Graft failures totaling 31 (9.1%) were reported, requiring revision surgery because of symptomatic instability. The rate of graft failure was significantly higher when ACLR was not combined with a LEAP (15.5% vs 6.0%; P = .0105) and in athletes aged 21 years or younger (13.8% vs 6.6%; P = .0290). A multivariate analysis was performed using the Cox model and demonstrated that athletes undergoing an isolated ACLR were at >2-fold risk of ACL graft rupture (hazard ratio [HR], 2.678 [1.173; 4.837], P = .0164) when compared with those undergoing a combined ACLR with a LEAP. Additionally, athletes aged ≤21 years were also at >2-fold risk of graft failure (HR, 2.381 [1.313; 5.463]; P = .0068) than those aged >21 years. Sex, sport, and graft type were not found to be significant risk factors for graft failure. CONCLUSION: Professional athletes undergoing isolated ACLR and aged ≤21 years are at >2-fold greater risk of graft failure. Orthopaedic surgeons treating elite athletes should combine an ACLR with a LEAP to improve ACL graft survivorship.


Assuntos
Lesões do Ligamento Cruzado Anterior , Traumatismos do Joelho , Ligamento Cruzado Anterior/cirurgia , Lesões do Ligamento Cruzado Anterior/epidemiologia , Lesões do Ligamento Cruzado Anterior/cirurgia , Atletas , Estudos de Coortes , Seguimentos , Humanos , Traumatismos do Joelho/epidemiologia , Traumatismos do Joelho/cirurgia , Articulação do Joelho/cirurgia , Fatores de Risco
8.
Rev. bras. ortop ; 57(4): 675-681, Jul.-Aug. 2022. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1394877

RESUMO

Abstract Objective The present paper aims to describe multiligament knee injuries and to associate their features with the profile of the patients and trauma mechanisms. Methods This is a cross-sectional study evaluating 82 patients with multiligament knee injuries from September 2016 to September 2018. Evaluated parameters included age, gender, mechanical axis, affected side, range of motion, trauma mechanism, associated injuries, affected ligaments, and absence from work. Results The sample included patients aged between 16 and 58 years old, with an average age of 29.7 years old; most subjects were males, with 92.7% of cases. The most common trauma mechanism was motorcycle accident (45.1%). The most injured ligament was the anterior cruciate ligament (80.5%), followed by the posterior cruciate ligament (77.1%), the posterolateral corner (61.0%), and the tibial collateral ligament (26.8%). The most frequent type of dislocation was KD IIIL (30.4%). Only 1 patient had a vascular injury, and 13 (15.9%) presented with neurological injuries. Most subjects took medical leave from work (52.4%). Conclusion There is a big difference between patients with multiligament lesions in Brazil compared with international studies. Thus, it is advisable to carry out more specific studies on the topic with our population to improve the treatment of these patients.


Resumo Objetivo Descrever e associar as características das lesões multiligamentares de joelho com o perfil do paciente e mecanismo de trauma. Métodos Trata-se de um estudo transversal que avaliou 82 pacientes com lesões multiligamentares do joelho de setembro de 2016 até setembro de 2018. As variáveis coletadas foram idade, gênero, eixo mecânico, lateralidade, arco de movimento, mecanismo do trauma, lesões associadas, ligamentos afetados e afastamento do trabalho. Resultados A amostra incluiu pacientes de 16 a 58 anos, com média de 29,7 anos, e os homens foram os mais afetados, correspondendo a 92,7% dos casos. O mecanismo de trauma mais comum foi acidente motociclístico (45,1%). O ligamento mais lesado foi o ligamento cruzado anterior (80,5%), seguido do ligamento cruzado posterior (77,1%), do canto posterolateral (61,0%) e do ligamento colateral tibial (26,8%). O tipo de luxação mais frequente era o KD IIIL (30,4%). Apenas 1 paciente apresentou lesão vascular, e 13 (15,9%) apresentaram lesões neurológicas. A maioria das vítimas foi afastada do trabalho (52,4%). Conclusão Há grande diferença entre os pacientes que apresentam lesão multiligamentar no Brasil em relação ao encontrado nos estudos internacionais. Desta forma, convém realizar mais estudos específicos sobre o tema com a nossa população, de modo a aperfeiçoar o tratamento destes pacientes.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Estudos Epidemiológicos , Luxação do Joelho , Instabilidade Articular , Traumatismos do Joelho/epidemiologia
9.
Acta Biomed ; 93(3): e2022139, 2022 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-35775769

RESUMO

Background and aim sport activity has been largely correlated to the development of knee osteoarthritis, but only few papers have investigated the long-term impact of a rugby career on the knee joint. The aim of this retrospective study was to evaluate the incidence and epidemiology of knee osteoarthritis and general health in a population of 65 retired semi-professional rugby players. Methods demographic and anamnestic analysis was recorded and Oxford Knee score, SF-12 and VAS were submitted to all veterans in order to assess current knee function, general health condition and level of pain. Parametric analysis of Spearman was used to evaluate the statistical significance on these results and the Kruskal-Wallis test was used to assess the significant differences between the questionnaire results and the demographic and anamnestic records. Results we found that players who sustained a knee injury during their career have a current reduction of the knee function compared to veterans who did not suffer any injury and who showed values comparable with those of the health population. In terms of general and mental health, athletes who retired later have now a better condition than those who retired from the sport  earlier. Conclusions: we concluded that knee injury prevention should be an unequivocal priority because although rugby is a high energy sport, it does not increase the risk of knee osteoarthritis in absence of serious knee injuries.


Assuntos
Futebol Americano , Traumatismos do Joelho , Osteoartrite do Joelho , Veteranos , Futebol Americano/lesões , Humanos , Traumatismos do Joelho/epidemiologia , Articulação do Joelho , Osteoartrite do Joelho/epidemiologia , Aposentadoria , Estudos Retrospectivos , Rugby
10.
Traffic Inj Prev ; 23(7): 452-457, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35793173

RESUMO

OBJECTIVE: Projectile legform tests are used to evaluate pedestrian lower extremity injury risk, including risk of injury to the cruciate and collateral ligaments. However, it has been suggested that cruciate ligament injuries rarely occur without collateral ligament injuries, making a cruciate ligament injury requirement unnecessary in pedestrian test procedures. Therefore, the current study examines cruciate ligament injuries among U.S. pedestrians with and without other injuries that are evaluated in pedestrian test procedures. METHODS: Injury data for pedestrians treated in U.S. trauma centers from 2007 to 2017 were drawn from the National Trauma Data Bank (NTDB) Research Data Set (RDS) and from its successor, the Trauma Quality Program (TQP) Participant User Files (PUF). Crash and demographic details for individual cases with documented knee ligament injuries were obtained from the Pedestrian Crash Data Study (PCDS). RESULTS: Among pedestrians aged 16 and older with knee ligament injuries, 38% had only collateral injuries, 31% had only cruciate injuries and 31% were documented with injuries to both. Younger pedestrians also sustained cruciate injuries without collateral injuries, with 36% of the 0-15 year-old pedestrians diagnosed with knee ligament injuries having isolated cruciate injuries. Given that injuries to the left and right knee could not be distinguished in NTDB cases, these estimates of isolated ligament injuries are likely conservative, so that at least 31% of pedestrians aged 16 and older and at least 36% of younger pedestrians sustained cruciate ligament injuries without collateral ligament injuries in the same knee. A PCDS case study illustrated how cruciate injury can occur without collateral injury in a lateral bumper impact below the knee. CONCLUSIONS: Cruciate ligament injuries can occur in pedestrian crashes, with or without other injuries that are evaluated in pedestrian test procedures. Isolated cruciate injuries may be more likely in impacts above or below the knee and in impacts with a component of anterior-posterior loading. The frequency of cruciate injury in the absence of collateral injury in lateral and non-lateral impact supports inclusion of injury measures correlating to cruciate injury risk in pedestrian legform test procedures.


Assuntos
Traumatismos do Joelho , Pedestres , Acidentes de Trânsito , Adolescente , Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Traumatismos do Joelho/epidemiologia , Articulação do Joelho , Ligamentos Articulares
11.
Injury ; 53(10): 3494-3501, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35853790

RESUMO

PURPOSE: The aim of the study was to analyze the incidence of proximal avulsion of the five main ligaments and to revise the diagonal tension/compression concept in tibial plateau fractures. METHODS: Computed tomographic images of 1263 cases of tibial plateau fractures were retrospectively analyzed by the OTA/AO classification and four-column nine-segment classification. The correlation between proximal avulsion of five ligaments and the injury mechanism was analyzed. RESULTS: In total, 1263 tibial plateau fractures in 1253 patients were included. A total of 92 cases (7.3%) associated with proximal avulsions were identified among the 1263 tibial plateau fracture cases obtained from our institution's database. The 92 avulsions occurred in 82 patients, among whom 10 patients had two different avulsions in a single knee. The incidence of proximal avulsion fracture of the medial and lateral collateral ligament was 3.6% (45/1263) and 2.1% (26/1263), respectively. The incidence of avulsion of the anterior cruciate ligament and avulsion of the posterior cruciate ligament was much lower at 0.2% (2/1263) and 0.1% (1/1263), respectively. Proximal avulsion of the patellar ligament occurred in 18 cases (incidence rate = 1.4%). Several combinations of injuries, composed of distal tibial plateau fractures and proximal avulsion of ligaments, were identified. CONCLUSIONS: Among the patients with tibial plateau fracture, the incidence of proximal avulsion of the five ligaments was 7.3% (92/1263). The four-column and nine-segment classification is an exhaustive method for recording injuries in these ligaments. The revised diagonal injury concept is useful for understanding the injury mechanism and choosing the appropriate surgical strategy.


Assuntos
Lesões do Ligamento Cruzado Anterior , Traumatismos do Joelho , Fraturas da Tíbia , Ligamento Cruzado Anterior , Lesões do Ligamento Cruzado Anterior/diagnóstico por imagem , Humanos , Traumatismos do Joelho/complicações , Traumatismos do Joelho/diagnóstico por imagem , Traumatismos do Joelho/epidemiologia , Estudos Retrospectivos , Fraturas da Tíbia/complicações , Fraturas da Tíbia/diagnóstico por imagem , Fraturas da Tíbia/epidemiologia
12.
J Sci Med Sport ; 25(9): 743-749, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35811264

RESUMO

OBJECTIVES: To determine the direct and indirect costs of injuries in sub-elite footballers in New South Wales (NSW), Australia, stratified by injury location, type, sex and age groups. DESIGN: Descriptive epidemiological study. METHODS: A de-identified insurance database containing three seasons (2018-2020) of football injuries in NSW was used to determine injury costs. Injuries were coded using the Orchard Sports Injury and Illness Classification System. Claim costs are presented by age group (Junior = 7-17 years, Senior = 18-34 years, and Veteran = 35+ years), sex and injury location and type. Cost data are reported as means ±â€¯standard deviation (SD) with 95 % Confidence Intervals (CI). RESULTS: There were 4145 total injury claims, totalling AU$13,716,173, at a mean cost of $3309 (95 % CI 3042-3577) per injury. Joint sprains accrued the largest costs ($6,665,938) with knee injuries accounting for just under half of the total costs of all injuries over the three-season period (49.1 %). ACL injuries accounted for 26.2 % of total costs with a high mean cost per injury ($4564 SD ±â€¯346) alongside lower limb fractures ($4787 SD ±â€¯425) and tendon ruptures ($4659 SD ±â€¯1053). Despite only 22.5 % of injuries accruing indirect costs, these costs accounted for 70.2 % of the total cost ($9,623,665) with the mean indirect cost per injury being ten-times higher than the mean direct cost per injury ($10,337 vs. $987, respectively). CONCLUSIONS: Knee injuries (mainly ACL ruptures), joint sprains, fractures and tendon ruptures are the costliest injuries in sub-elite football in NSW. With effective preventative measures available, there is potential to reduce injury rates and subsequent costs.


Assuntos
Traumatismos em Atletas , Futebol Americano , Fraturas Ósseas , Seguro , Traumatismos do Joelho , Lesões dos Tecidos Moles , Entorses e Distensões , Traumatismos dos Tendões , Adolescente , Traumatismos em Atletas/epidemiologia , Austrália/epidemiologia , Criança , Futebol Americano/lesões , Humanos , Incidência , Traumatismos do Joelho/epidemiologia , Traumatismos dos Tendões/epidemiologia
13.
Rev. bras. ortop ; 57(3): 422-428, May-June 2022. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1388025

RESUMO

Abstract Objective To evaluate the incidence and epidemiological profile of meniscal ramp lesions in patients undergoing anterior cruciate ligament (ACL) reconstruction surgery, and to determine the related risk factors. Methods In total, 824 patients undergoing ACL reconstruction surgery were retrospectively analyzed. Patients who presented medial meniscal instability were submitted to evaluation of the posteromedial compartment of the knee. In case of injury, surgical repair was performed. Potential risk factors associated with the lesions were analyzed. Results The overall incidence of ramp lesions in the population studied was of 10.6% (87 lesions in 824 patients). The multivariate analysis through the Chi-squared test showed that the presence of meniscal ramp lesions was significantly associated with the following risk factors: right laterality and chronic lesions. Gender, age and sports activity were not statistically significant. Soccer was the most frequent cause of ramp injuries related to sport, with 78.2% of the cases. However, it was not shown to be a risk factor. The annual incidence from 2014 to 2019 ranged from 4.0% to 20.6%. Conclusion The incidence of meniscal ramp lesions was of 10.6% in ACL reconstruction surgeries, being more frequent among patients with chronic lesions. The increasing annual incidence ranged from 4.0% in 2014 to 20.6% in 2019.


Resumo Objetivo Avaliar a incidência e o perfil epidemiológico das lesões da rampa meniscal nos pacientes submetidos a cirurgia de reconstrução do ligamento cruzado anterior (LCA), e determinar os fatores de risco relacionados. Métodos Foram analisados retrospectivamente 824 pacientes submetidos a cirurgia de reconstrução do LCA. Os pacientes que apresentaram instabilidade meniscal medial foram submetidos a avaliação do compartimento posteromedial do joelho. Em caso de lesão, o reparo cirúrgico foi realizado. Potenciais fatores de risco associados às lesões foram analisados. Resultados A incidência geral de lesões da rampa na população estudada foi de 10,6% (87 lesões em 824 pacientes). A análise multivariada pelo teste do Qui-quadrado demonstrou que a presença de lesões da rampa meniscal foi significativamente associada aos seguintes fatores de risco: lateralidade direita e lesões crônicas. Sexo, idade e atividade esportiva não foram estatisticamente significantes. O futebol foi a causa mais frequente de lesões da rampa relacionadas ao esporte, com 78,2% dos casos. No entanto, não se mostrou ser um fator de risco. De 2014 a 2019, a incidência anual variou de 4,0% a 20,6%. Conclusão A incidência das lesões da rampa meniscal foi de 10,6% nas cirurgias de reconstrução do LCA, sendo mais frequente em pacientes com lesões crônicas. A incidência anual foi crescente, e variou de 4,0%, em 2014, a 20,6%, em 2019.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Artroscopia , Perfil de Saúde , Fatores de Risco , Reconstrução do Ligamento Cruzado Anterior , Traumatismos do Joelho/epidemiologia
14.
Sports Med ; 52(10): 2447-2467, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35622227

RESUMO

BACKGROUND: Not all anterior cruciate ligament (ACL) injuries are preventable. While some ACL injuries are unavoidable such as those resulting from a tackle, others that occur in non-contact situations like twisting and turning in the absence of external contact might be more preventable. Because ACL injuries commonly occur in team ball-sports that involve jumping, landing and cutting manoeuvres, accurate information about the epidemiology of non-contact ACL injuries in these sports is needed to quantify their extent and burden to guide resource allocation for risk-reduction efforts. OBJECTIVE: To synthesize the evidence on the incidence and proportion of non-contact to total ACL injuries by sex, age, sport, participation level and exposure type in team ball-sports. METHODS: Six databases (MEDLINE, EMBASE, Web of Science, CINAHL, Scopus and SPORTDiscus) were searched from inception to July 2021. Cohort studies of team ball-sports reporting number of knee injuries as a function of exposure and injury mechanism were included. RESULTS: Forty-five studies covering 13 team ball-sports were included. The overall proportion of non-contact to total ACL injuries was 55% (95% CI 48-62, I2 = 82%; females: 63%, 95% CI 53-71, I2 = 84%; males: 50%, 95% CI 42-58, I2 = 86%). The overall incidence of non-contact ACL injuries was 0.07 per 1000 player-hours (95% CI 0.05-0.10, I2 = 77%), and 0.05 per 1000 player-exposures (95% CI 0.03-0.07, I2 = 97%). Injury incidence was higher in female athletes (0.14 per 1000 player-hours, 95% CI 0.10-0.19, I2 = 40%) than male athletes (0.05 per 1000 player-hours, 95% CI 0.03-0.07, I2 = 48%), and this difference was significant. Injury incidence during competition was higher (0.48 per 1000 player-hours, 95% CI 0.32-0.72, I2 = 77%; 0.32 per 1000 player-exposures, 95% CI 0.15-0.70, I2 = 96%) than during training (0.04 per 1000 player-hours, 95% CI 0.02-0.07, I2 = 63%; 0.02 per 1000 player-exposures, 95% CI 0.01-0.05, I2 = 86%) and these differences were significant. Heterogeneity across studies was generally high. CONCLUSION: This study quantifies several key epidemiological findings for ACL injuries in team ball-sports. Non-contact ACL injuries represented over half of all ACL injuries sustained. The proportion of non-contact to total ACL injuries and injury incidence were higher in female than in male athletes. Injuries mostly occurred in competition settings.


Assuntos
Lesões do Ligamento Cruzado Anterior , Traumatismos em Atletas , Traumatismos do Joelho , Esportes , Lesões do Ligamento Cruzado Anterior/epidemiologia , Atletas , Traumatismos em Atletas/epidemiologia , Feminino , Humanos , Traumatismos do Joelho/epidemiologia , Masculino
15.
Artigo em Inglês | MEDLINE | ID: mdl-35457516

RESUMO

Anterior cruciate ligament (ACL) injuries account for a large percentage of knee injuries, disproportionately affecting female athletes. To help health professionals stay current, we performed an umbrella review to evaluate the effectiveness of ACL injury prevention programs in reducing non-contact ACL injury rates, determine the effective components within interventions, and provide clinical recommendations. Twelve databases (Medline, Embase, Cochrane Database of Systematic Reviews, SPORTDiscus, Cumulative Index to Nursing and Allied Health Literature, PEDro, Web of Science Core Collection, Epistemonikos, TRIP, BC Guidelines and Protocols, CPG Infobase, ProQuest Dissertations and Theses Global) were searched in May 2021 to identify relevant systematic reviews and meta-analyses. Four databases were searched again in September 2021 to identify recent primary literature. Non-contact ACL injury data were extracted to calculate incidence rate ratios (IRRs) and these were combined using an inverse variance random-effects model. A qualitative assessment of included reviews was performed. The methodological quality of the studies was assessed using a Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) or Cochrane Risk-of-Bias Tool for Randomized Trials (RoB 2). Sixteen reviews and two primary studies met the inclusion criteria. Across 11 primary studies, prevention programs were effective in reducing non-contact ACL injuries by 64% (IRR = 0.36 (95% CI: 0.18-0.70)). A multi-faceted exercise program, beginning in the pre-season and containing at least three exercise types, may be beneficial in reducing ACL injury risk.


Assuntos
Lesões do Ligamento Cruzado Anterior , Traumatismos em Atletas , Traumatismos do Joelho , Adolescente , Lesões do Ligamento Cruzado Anterior/epidemiologia , Lesões do Ligamento Cruzado Anterior/prevenção & controle , Atletas , Traumatismos em Atletas/epidemiologia , Traumatismos em Atletas/prevenção & controle , Feminino , Humanos , Traumatismos do Joelho/epidemiologia , Revisões Sistemáticas como Assunto
16.
BMC Musculoskelet Disord ; 23(1): 188, 2022 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-35232412

RESUMO

BACKGROUND: Fabella is a sesamoid bone of knee that has potential biomechanical function. We aimed to examine the fabellar prevalence and parameters in Chinese population and test the hypothesis that fabellar presence and morphology were associated with meniscus tear or ligament injury. METHODS: A total of 1011 knee magnetic resonance imaging scans from 979 patients with knee pain were analyzed retrospectively. The exclusion criteria are postsurgical scans, difficulty in fabella discrimination, conditions not suitable for measurement, and unsatisfied image. The fabellar presence and its parameters (length, width and thickness) were documented. The association between fabellar presence and meniscus tear or ligament injury were assessed by chi-square test, in all knees and subgroups (age, gender, side, lesion part). The correlation of fabellar presence and parameters with advancing age was assessed by Spearman correlation analysis. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to investigate whether factors related with meniscus tear or ligament injury. Diagnostic performance of risk factors was assessed by receiver operating characteristic (ROC) analysis. RESULTS: The overall prevalence of fabellae was 39.8% (402/1011 knees) and increased with the increasing age (r = 0.237, P < 0.001). The size of the fabellae differed according to genders, age, and presence of articulating grooves. Fabella presented more often in knees with medial meniscus (MM) tears (66.7% vs 33.8%; P < 0.001) with a multivariate OR of 2.960 (95% CI, 1.853-3.903). The association remained in all tear parts (anterior, middle, and posterior), and in younger (age < 50 years) and older patients (age ≥ 50 years). Age, fabellar length, width, length/thickness ratio and width/thickness ratio yielded an area under the ROC curve (AUC) of 0.604-0.766 to predict an MM tear. In combination with age, fabellar width and length/thickness ratio, the AUC was improved 0.791 (95% CI, 0.744-0.837), with a sensitivity of 73.0% and a specificity of 74.6%. CONCLUSION: The presence of fabellae, increased fabellar length and width as well as flatter fabellar morphology, are significantly associated with an increased risk for MM tear. These findings might aid clinicians in identifying patients at risk for a MM tear and informing them.


Assuntos
Lesões do Ligamento Cruzado Anterior , Traumatismos do Joelho , Ossos Sesamoides , Lesões do Menisco Tibial , Lesões do Ligamento Cruzado Anterior/cirurgia , Feminino , Humanos , Traumatismos do Joelho/complicações , Traumatismos do Joelho/diagnóstico por imagem , Traumatismos do Joelho/epidemiologia , Imageamento por Ressonância Magnética , Masculino , Meniscos Tibiais/diagnóstico por imagem , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Lesões do Menisco Tibial/complicações , Lesões do Menisco Tibial/diagnóstico por imagem , Lesões do Menisco Tibial/epidemiologia
17.
Clin J Sport Med ; 32(5): 476-479, 2022 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-35350039

RESUMO

OBJECTIVE: The aim of this study was to identify the accuracy of the McMurray test in the adolescent and pediatric population. DESIGN: Retrospective case series. SETTING: Tertiary care, institutional. PATIENTS: Inclusion criteria included patients who presented with unilateral knee pain and were seen by pediatric sports medicine physicians. Patients were excluded if their knee pain was related to any underlying conditions. Three hundred patient charts were reviewed, and 183 patients (age range: 8-18 years, mean: 14 years; 74 male) met the inclusion criteria. INTERVENTIONS: Symptoms at initial visit (knee pain). MAIN OUTCOME MEASURES: Presence of a meniscal tear using the McMurray test. RESULTS: Eighty-four percent (160/191) of patients had a McMurray test documented as performed by the physician, and 17% (27/160) elucidated a positive response. Of 26 patients who had a positive McMurray and underwent magnetic resonance imaging (MRI), 16 (62%) showed a meniscal tear on their MRI. However, of the 87 patients who had a negative McMurray and still underwent MRI, 25 (29%) had a positive meniscal tear. The sensitivity, specificity, positive predictive value, and negative predictive value were 39%, 86%, 62%, and 71%, respectively. CONCLUSION: In a pediatric and adolescent population, the McMurray test was negative for 61% (23/38) of meniscal tears identified on MRI. CLINICAL RELEVANCE: Although the test can be a useful tool as a part of a thorough evaluation, combining it with mechanical symptoms, patient history and imaging may be more helpful to diagnose a meniscus tear.


Assuntos
Traumatismos do Joelho , Lesões do Menisco Tibial , Adolescente , Artroscopia/métodos , Criança , Humanos , Traumatismos do Joelho/diagnóstico , Traumatismos do Joelho/epidemiologia , Imageamento por Ressonância Magnética , Masculino , Dor , Estudos Retrospectivos , Sensibilidade e Especificidade , Lesões do Menisco Tibial/diagnóstico por imagem
18.
J Dance Med Sci ; 26(1): 41-49, 2022 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-34865681

RESUMO

Some studies suggested that adolescent scoliotic dancers were more likely to sustain dance injuries than non-scoliotic dancers. This study aimed to investigate the association between scoliosis and dance injury among children and adolescent recreational dancers. Identical web-based and paper-based questionnaires were distributed to children and adolescent recreational dancers to collect demographic information, dance experiences, history and location of dance injuries, as well as the frequency of dance injury in the last 12 months. The prevalence rates of the top three dance injury sites (lower back, knee, and ankles) were estimated. Associations between the presence of scoliosis and various dance injuries in the last 12 months were evaluated by multivariate logistic regression. Data from 704 respondents (644 females, 13.3 ± 2.4 years) was analyzed. Ninety-one respondents (12.9%) reported scoliosis and 11 respondents (1.6%) were wearing scoliosis braces. The 12-month prevalence rates of lumbar, knee, and ankle injuries in scoliotic dancers (24.2%, 22.2%, and 28.5%, respectively) were significantly higher than those of non-scoliotic dancers (10.4%, 14.9%, and 14.8%, respectively). Scoliosis was an independent risk factor for lumbar spine injury (Odds ratio, OR = 2.7), knee injury (OR = 2.6), and multi-site dance-related injury (OR = 1.9). Given the observed strong associations between scoliosis and lumbar or knee dance injuries in the current study, future studies are warranted to investigate the underlying causes.


Assuntos
Dança , Traumatismos do Joelho , Escoliose , Adolescente , Articulação do Tornozelo , Criança , Estudos Transversais , Dança/lesões , Feminino , Humanos , Traumatismos do Joelho/epidemiologia , Escoliose/epidemiologia
19.
Knee Surg Sports Traumatol Arthrosc ; 30(4): 1380-1387, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33987689

RESUMO

PURPOSE: To identify football-specific factors associated with ACL injuries that can be targeted for sport-specific injury prevention. METHODS: A study-specific questionnaire was developed to study the characteristics of ACL injuries in football including intrinsic, extrinsic, and injury specific factors. The questionnaire was available at the Swedish national knee ligament registry's website for the football players to voluntarily fill out. Data are presented on group level for all football players in total and for females and males separate to examine gender-specific differences. The results are based on answers collected over a 3-year period from 2875 football players, 1762 (61%) males and 1113 (39%) females. RESULTS: ACL were more frequently sustained during games 66% than during practices 25%. The injury mechanism was non-contact in 59% and contact in 41%. For the contact injuries during games, no action was taken by the referee in 63% of the situation and a red card was shown in 0.5%. The risk of ACL injury was highest early in the football game with 47% sustained during the first 30 min and 24% in the first 15 min. Players changing to a higher level of play 15% had a higher rate of ACL injuries than players changing to a lower level 8%. This difference was especially seen in female football players with 20% of ACL injuries being sustained by players going to a higher division compared to 7% for those going to a lower division. 15% of the male and 21% of the female ACL injuries occurred in teams with a coach change during the season. Knee control exercises to warm up was used by 31% of the female players and 16% of the males. 40% of the players reported that they did not plan on returning to football. CONCLUSION: Neuromuscular training programs have proven to reduce ACL injuries, but greater adherence to these remains a challenge as only 1 in 5 of the ACL-injured football players report using them. Teams changing coach and players going to a higher division appear to have an increased risk of ACL injury warranting attention and further investigations. LEVEL OF EVIDENCE: IV.


Assuntos
Lesões do Ligamento Cruzado Anterior , Traumatismos em Atletas , Futebol Americano , Traumatismos do Joelho , Futebol , Exercício de Aquecimento , Lesões do Ligamento Cruzado Anterior/epidemiologia , Lesões do Ligamento Cruzado Anterior/etiologia , Lesões do Ligamento Cruzado Anterior/prevenção & controle , Traumatismos em Atletas/epidemiologia , Traumatismos em Atletas/etiologia , Traumatismos em Atletas/prevenção & controle , Feminino , Futebol Americano/lesões , Humanos , Traumatismos do Joelho/epidemiologia , Traumatismos do Joelho/etiologia , Traumatismos do Joelho/prevenção & controle , Masculino , Futebol/lesões
20.
Knee Surg Sports Traumatol Arthrosc ; 30(5): 1776-1785, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-34524500

RESUMO

PURPOSE: Anterior cruciate ligament (ACL) injuries are a common severe type of football injury at all levels of play. A football-specific ACL registry providing both prospective ACL injury data according to the skill level and risk factors for ACL injury is lacking in the literature. METHODS: This study is based on the prospective 'ACL registry in German Football' implemented in the 2014-15 season. Professional (1st-3rd league), semi-professional (4th-6th league) and amateur leagues (7th league) were analysed regarding the incidence and risk factors for ACL injuries. Injuries were registered according to the direct reports of the injured players to the study office and double-checked via media analysis. After injury registration, the players received a standardised questionnaire. Data were analysed from the 2014-15 to the 2018-19 football season. RESULTS: Overall, 958 ACL injuries were registered during the 5-year study period. The incidence of ACL injuries was highest in amateur football (0.074/1000 h football exposure) compared to professional (0.058/1000 h; p < 0.0001) and semi-professional football (0.043/1000 h; p < 0.0001). At all skill levels, match incidence (professional: 0.343; semi-professional: 0.249; amateur: 0.319) was significantly higher than training incidence (professional: 0.015; semi-professional: 0.004; amateur: 0.005). Major risk factors were previous ACL injury (mean: 23.3%), other knee injuries (mean: 19.3%) and move to a higher league (mean: 24.2%). CONCLUSION: This sports-specific ACL registry provides detailed information on the incidence and risk factors for ACL injuries in football over five years. Risk factors are skill level, match exposure, move to a higher league and previous knee injury. These factors offer potential starting points for screening at-risk players and applying targeted prevention. LEVEL OF EVIDENCE: II.


Assuntos
Lesões do Ligamento Cruzado Anterior , Traumatismos em Atletas , Futebol Americano , Traumatismos do Joelho , Futebol , Ligamento Cruzado Anterior , Lesões do Ligamento Cruzado Anterior/epidemiologia , Lesões do Ligamento Cruzado Anterior/etiologia , Traumatismos em Atletas/epidemiologia , Traumatismos em Atletas/etiologia , Futebol Americano/lesões , Humanos , Traumatismos do Joelho/epidemiologia , Traumatismos do Joelho/etiologia , Estudos Prospectivos , Sistema de Registros , Futebol/lesões
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