Does the critical shoulder angle decrease after anterior acromioplasty?

INTRODUCTION: No clinical studies to date have analyzed the critical shoulder angle (CSA) following anterior acromioplasty. Our study's main objective was to measure the change in the CSA after acromioplasty. MATERIALS AND METHODS: Ninety patients were included in this retrospective series. The CSA and the type of acromion were evaluated before and after surgery. RESULTS: The average CSA for patients before surgery was 35.9° (± 3.7, 26.2, 44.2) and 33° after the acromioplasty (± 3.5, 24.8, 41.4). The decrease was significant and 2.9° on average (± 2.2, - 2.2, 11.9, p = 0.000). Preoperatively, 58% of patients had a CSA ≥ 35° (n = 52) and 24% postoperatively (n = 22, p = 0.000). CONCLUSIONS: Standardized anterior acromioplasty allows for a significant decrease in the CSA without lateral resection of the acromion. This study confirms the tight link between the CSA and the anterior acromion as well as the interest of this angle to quantify acromioplasty whether anterior or lateral. LEVEL OF EVIDENCE: Level IV, Case Series, Retrospective design.

Epidemiology of Time-Loss Injuries in Senior and under-18 Portuguese Male Rugby Players.

Rugby union has one of the highest injury incidence rates in team sports, however, most of the available data focus on the epidemiology of injuries in countries where rugby is popular. We aimed to report the incidence rate and relevant epidemiological aspects of injuries occurred in a group of Portuguese male rugby players. A prospective cohort study was conducted with a group of 45 senior and 32 under-18 male players (total of 77 players). Outcome measures included injury incidence, position, type, location and severity of injuries. The match injury incidence for all players was 55.84 per 1000 player match-hours (66.66 for seniors, 42.85 for under-18), while mean time-loss for injury was 20.79 days. No statistical differences were found between groups. Lower limb injuries accounted for 60.5% of all injuries, while joint/ligament injuries were the most prevalent type. Contact events were responsible for 65.1% of injuries. Despite the limitations, the obtained data are consistent with the literature. Time-loss injuries seem highly prevalent in rugby union and the incidence rates found in this Portuguese-based study were lower than the reported for international and senior men's professional rugby union, but higher than those occurring in community rugby in tier-1 countries. The authors believe these data reinforce the need to develop and implement effective injury surveillance and prevention programs.

Epidemiology of injuries in Portuguese senior male rugby union sevens: a cohort prospective study.

OBJECTIVES: To assess the incidence, type and location of injuries sustained during the Portuguese rugby union sevens circuit. To investigate the influence of players' training loads on injury risk. METHODS: A prospective cohort study recording time-loss injuries was conducted with all teams competing in the Portuguese national rugby sevens circuit (eight from the top-tier and seven from the second-tier). Main outcome measures included: incidence rate, anatomical location, type, injury incident and severity. Data were also collected regarding players' training loads. Fisher's exact test was used to estimate the relative risk of suffering an injury during the sevens season and training sevens during the fifteens season. RESULTS: A total of 27 injuries were recorded corresponding to an incidence rate of 133.9 injuries per 1000 player match-hours. The average severity was 22.22 days. Contact events preceded 81.5% of injuries. Most injuries occurred in the lower limb (66.7%) and were joint/ligament or muscle/tendon injuries (85.1%). The association between injuries and lower volume of training during the sevens season was identified for the second-tier (p = 0.021). For the same level, an inverse relation between training hours and injury severity was also found (p = 0.008). Top-tier players training sevens and fifteens simultaneously during the year presented a significant increase of injury risk (relative risk = 3.2; p = 0.011). CONCLUSIONS: Injury incidence in our study is similar to that reported for international sevens, although severity is lower. An association between training loads and the occurrence of injuries was found for both tiers, although with differential results, thus reinforcing the need to customize players' preparation. Further studies at non-elite competitions are needed to gather significant data to accurately formulate future injury prevention protocols or recommend modifications to game laws or competition formats, aiming at players' welfare.

Epidemiology of injuries in senior male rugby union sevens: a systematic review.

OBJECTIVES: In 2016 the Rugby Union variant of sevens will enter the official Olympic Programme. Until now, most of injury surveillance studies in Rugby Union focus on elite 15-a-side cohorts, with reported injury incidence rates reaching 96 per 1000 player-match-hours, and mean severity set at 20 days. Sparse data is available regarding rugby sevens. The aim of this study was to systematically review available data regarding the epidemiology of injuries in senior male rugby sevens. METHODS: Electronic databases (Pubmed, Google Scholar, SCOPUS, Scielo and IndexRMP) were searched in September 2015, complemented by manual searches of bibliographies and relevant "grey literature". RESULTS: Seven prospective cohort original articles addressing injuries in senior male rugby sevens players were included in this review. Overall injury incidence rates in elite rugby sevens tournaments ranged 101.5 to 119.8 per 1000 player-match-hours. Mean severity was greater than 34.1 days. Lower limb and joint/ligament injuries were the most frequent in elite players. The only study on amateur players revealed a lower injury incidence rate (74.7 per 1000 player-match-hours), and a higher proportion of muscle/tendon (37.5 %) injuries. CONCLUSION: Injury incidence rates in rugby sevens are higher than those reported for the 15-a-side variant, at the same level of competition. Injuries are also more severe, resulting in longer absence periods. This might result from the fact that rugby sevens is played with greater speed, leading to an increase in energy transfers during tackles, more running and turning manoeuvers, that can possibly cause more severe injuries.