RESUMEN

INTRODUCTION: a common concern in presurgical medical appointment of total knee replacement medical appointment is return to exercise. The purpose of this study was to analyze functional results and return to sport in patients under 60 years of age after this surgery. MATERIAL AND METHODS: we retrospectively analyzed 41 total knee replacements in 36 athletic patients (average age: 53 years [46-60]). Average follow-up of two years (6 months-5 years). Diagnoses: 37 osteoarthritis, three sequelae of Rheumatoid Arthritis, 1 extra-articular deformity. Functional and radiographic outcomes assessed using modified Knee Society and High Activity Arthroplasty Scores. RESULTS: average improvement from 31.95 to 91.61 in KSS and average from 7.95 to 13.73 in HAAS. Return to sport in 3.5 months average (range 2-6 months). Three patients did not return to sport. CONCLUSIONS: we consider that delaying surgery in these patients will cause progression in their osteoarthritis pathology and cessation of their sports activities. This makes the surgical technique difficult in addition to reducing the patient's physical performance. Analyzing the survival rate of implants in young patients, more than 80% is reported in a 25-year follow-up.

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INTRODUCCIÓN: una inquietud frecuente en consultas prequirúrgicas de reemplazo total de rodilla es el regreso al ejercicio. El propósito de este estudio fue analizar resultados funcionales y retorno al deporte en pacientes menores de 60 años posterior a esta cirugía. MATERIAL Y MÉTODOS: analizamos retrospectivamente 41 reemplazos totales de rodilla en 36 pacientes deportistas (edad promedio: 53 años [46-60]). Seguimiento promedio de dos años (6 meses-5 años). Diagnósticos: 37 gonartrosis, tres secuelas de artritis reumatoidea, una deformidad extraarticular. Resultados funcionales y radiográficos evaluados mediante Knee Society modificado y High Activity Arthroplasty Score. RESULTADOS: mejoría promedio de 31.95 a 91.61 en KSS y promedio de 7.95 a 13.73 en HAAS. Retorno al deporte en 3.5 meses promedio (rango: 2-6 meses). Tres pacientes no retornaron al deporte. CONCLUSIONES: consideramos que el retraso de la cirugía en estos pacientes producirá progresión en su patología artrósica y cese de sus actividades deportivas. Esto dificulta la técnica quirúrgica además de disminuir el rendimiento físico del paciente. Analizando la tasa de supervivencia de implantes en pacientes jóvenes, se reporta más de 80% en seguimientos de 25 años.

Asunto(s)

Artroplastia de Reemplazo de Rodilla , Volver al Deporte , Humanos , Estudios Retrospectivos , Artroplastia de Reemplazo de Rodilla/métodos , Artroplastia de Reemplazo de Rodilla/estadística & datos numéricos , Persona de Mediana Edad , Masculino , Femenino , Volver al Deporte/estadística & datos numéricos , Estudios de Seguimiento , Factores de Tiempo , Osteoartritis de la Rodilla/cirugía , Resultado del Tratamiento , Recuperación de la Función , Factores de Edad

RESUMEN

PURPOSE: The aim of this study was to compare the functional outcomes, recurrence rate, range of motion (ROM) and return to sports activities between arthroscopic Bankart repair (ABR) versus arthroscopic Bankart/SLAP repair (ABR/S) in limited contact-athletes with a type V SLAP lesion in the scenario of recurrent anterior shoulder instability (RASI). Our hypothesis was that there is no difference between the two treatments. METHODS: Two groups of 45 limited-contact athletes with type V SLAP lesion were created. Group 1 underwent an arthroscopic Bankart repair, while group 2 had an arthroscopic Bankart/SLAP repair. The minimum follow-up period was 2 years. The WOSI and ASES scores were used to assess primary functional outcomes. Recurrence rate, ROM and return to sport were also evaluated. RESULTS: Significant differences were reported in the WOSI and ASES scores pre- and post-operatively in each group. There were no significant differences between the two groups (P = 0.78 and 0.43). We reported 4 recurrences (8.8 %) in group 1 and 5 (11.1 %) in group 2, with no difference between them (P = 0.62). There were no significant differences between the range of motion of each of the groups as well as between them. More than 90% of the athletes in both groups returned to their previous sporting activities. CONCLUSIONS: Limited-contact athletes with RASI who have a type V SLAP lesion as their primary diagnosis can be treated using either ABR or ABR/S with equal efficacy. Both treatment alternatives preserve athlete's function, stability, ROM and return to sport.

Asunto(s)

Artroscopía , Inestabilidad de la Articulación , Rango del Movimiento Articular , Recurrencia , Volver al Deporte , Humanos , Artroscopía/métodos , Masculino , Volver al Deporte/estadística & datos numéricos , Estudios Prospectivos , Inestabilidad de la Articulación/cirugía , Inestabilidad de la Articulación/fisiopatología , Femenino , Adulto , Adulto Joven , Lesiones del Hombro/cirugía , Articulación del Hombro/cirugía , Articulación del Hombro/fisiopatología , Traumatismos en Atletas/cirugía , Traumatismos en Atletas/fisiopatología , Resultado del Tratamiento , Adolescente , Luxación del Hombro/cirugía , Luxación del Hombro/fisiopatología , Lesiones de Bankart/cirugía , Recuperación de la Función

RESUMEN

INTRODUCTION: Open Bankart repair plus inferior capsular shift has not yet been tested under the concept of glenoid track as a predictor of failure. The aim of this study was to compare the subjective and objective outcomes in collision athletes with subcritical glenoid bone loss and on-track Hill Sachs lesions versus those with off-track Hill Sachs lesions, all treated with open Bankart repair. METHODS: Two study groups were created: 50 patients had on-track Hill Sachs lesions, while 38 had off-track lesions. The subcritical glenoid bone loss was ≤ 10%. A minimum follow-up period of 3 years was established. Preoperative and postoperative evaluation of each group and between them was performed. The Western Ontario Shoulder Instability Index score and the American Shoulder and Elbow Surgeons scale were used to assess subjective outcomes. Recurrence rate, range of motion and return to sport were evaluated as objective outcomes. RESULTS: Significant differences were reported in the WOSI and ASES scores between preoperative and postoperative values in each group. There were no significant differences between the two groups (p-value = 0.36 and 0.71). Three dislocations (6%) in the on-track group and 3 (7.8%) in the off-track group were recorded, showing no differences between the two groups (p-value = 0.83). There were no differences in ROM between pre- and post-operatively in each group or when comparing the two groups. CONCLUSIONS: We found no differences between the outcomes of the two groups. According to the surgeon's preference, we recommend performing open Bankart repair plus inferior capsular shift as a treatment alternative in collision athletes with SGBL ≤ 10% independently of the type of Hill Sachs lesion.

Asunto(s)

Lesiones de Bankart , Humanos , Masculino , Lesiones de Bankart/cirugía , Femenino , Adulto , Adolescente , Adulto Joven , Traumatismos en Atletas/cirugía , Articulación del Hombro/cirugía , Articulación del Hombro/fisiopatología , Resultado del Tratamiento , Volver al Deporte , Luxación del Hombro/cirugía , Rango del Movimiento Articular , Estudios Retrospectivos

RESUMEN

OBJECTIVES: To investigate the current clinical practice regarding pre- and post-surgical rehabilitation and return to sport (RTS) criteria following anterior cruciate ligament reconstruction (ACLR). DESIGN: Cross-sectional design. Online survey. SETTING: Survey platform. PARTICIPANTS: Argentinian physical therapists (PTs). OUTCOME MEASURES: The survey consisted of a combination of 39 open- and closed-ended questions, divided across 3 sections: (1) demographic and professional information, (2) clinical practice and rehabilitation strategies, and (3) return-to-running (RTR) and RTS. RESULTS: A total of 619 PTs completed the survey. Considerable variability was observed in preoperative rehabilitation, criteria used for rehabilitation progression and RTS decision-making criteria used by PTs. From the total surveyed, 336 (54.3%) carried out RTS assessment in their clinical practice. Most of PTs (53.3%) use visual estimation to assess knee range of motion. Only 20% of the PTs reported incorporating patient-reported outcome measures in their decision-making. From PTs who use strength assessment as a criterion of RTS (68.8%), 16.6% extrapolate this from jump tests and 15.3% use manual muscle testing. Less than the 50% of the PTs recommended nine months or more to allow patients to RTS. CONCLUSIONS: Current rehabilitation practices of Argentinian PTs following ACLR are largely variable and not aligned with current evidence and scientific guidelines. To achieve better rehabilitation and RTS practices better knowledge dissemination and implementation are required.

Asunto(s)

Lesiones del Ligamento Cruzado Anterior , Reconstrucción del Ligamento Cruzado Anterior , Fisioterapeutas , Volver al Deporte , Humanos , Reconstrucción del Ligamento Cruzado Anterior/rehabilitación , Argentina , Estudios Transversales , Lesiones del Ligamento Cruzado Anterior/cirugía , Lesiones del Ligamento Cruzado Anterior/rehabilitación , Encuestas y Cuestionarios , Femenino , Masculino , Adulto , Rango del Movimiento Articular , Medición de Resultados Informados por el Paciente , Traumatismos en Atletas/rehabilitación , Traumatismos en Atletas/cirugía

RESUMEN

Anterior cruciate ligament (ACL) injury is one of the main injuries in professional and amateur athletes of different sports. Hundreds of thousands of ACL ruptures occurs annually, and only 55% of the athletes return to competitive level, with a 15 times higher chance of suffering a second injury. 60% of these injuries occur without physical contact and since they occur in the acute process, they can cause joint effusion, muscle weakness and functional incapacity. In the long term, they can contribute to a premature process of osteoarthritis. This narrative review is of particular interest for clinicians, practitioners, coaches and athletes to understand the main factors that contribute to an injury and/or re-injury and thus, to optimize their training to reduce and/or prevent the risk of injury and/or reinjury of ACL. Therefore, we aimed reports a narrative overview of the literature surrounding communication and explore through a theoretical review, the main risk factors for an ACL injury and/or re-injury, as well as bringing practical and correct methods of training applications. The lack of theoretical/practical knowledge on the part of rehabilitation and/or training professionals may impair the treatment of an athlete and/or student. High-quality research that can testing different training methods approaches in randomized controlled trials is needed.

Asunto(s)

Lesiones del Ligamento Cruzado Anterior , Traumatismos en Atletas , Lesiones de Repetición , Humanos , Factores de Riesgo , Volver al Deporte

RESUMEN

OBJECTIVES: To describe the perceptions of physiotherapists and the injury prevention practices implemented within elite women's football clubs in Brazil. DESIGN: Cross-sectional study. SETTING: Online survey. PARTICIPANTS: Head physiotherapists from 32 Brazilian elite clubs. MAIN OUTCOME MEASURES: Structured questionnaire. RESULTS: Physiotherapists identified ACL rupture as the primary target for prevention. The top-five perceived injury risk factors included 'early return to sport after injury', 'workload too high', 'previous injury', 'poor sleep/rest', and 'muscle strength/power deficit'. 'Adoption of return to sport criteria' was almost unanimously recognized as a very important preventive strategy. 'Poor infrastructure' was elected as the main barrier to implementing prevention programs. From a practical standpoint, at least two-third of clubs implemented multi-component exercise interventions for injury prevention. These interventions typically encompassed flexibility/mobility, balance/proprioception, lumbo-pelvic stability, and agility exercises, alongside exposure to sprinting. Strength training routines typically included traditional, functional, and eccentric exercises. Most teams also employed other prevention strategies, including adoption of return to sport criteria, internal workload monitoring, post-exercise recovery modalities, preseason risk factor screening, and application of rigid strapping tapes. CONCLUSIONS: This study provided unprecedented insights into the physiotherapists' perceptions and injury prevention practices implemented within elite women's football clubs.

Asunto(s)

Traumatismos en Atletas , Fisioterapeutas , Fútbol , Humanos , Femenino , Estudios Transversales , Brasil , Fútbol/lesiones , Traumatismos en Atletas/prevención & control , Encuestas y Cuestionarios , Adulto , Volver al Deporte , Factores de Riesgo , Lesiones del Ligamento Cruzado Anterior/prevención & control , Percepción

RESUMEN

INTRODUCTION: After an ankle sprain, up to 20% of patients may develop chronic lateral ankle instability (CLAI) requiring surgical treatment. The objective of this study was to investigate the functional outcomes and rates of return to sport activities in a cohort of non-athlete patients with chronic lateral ankle instability (CLAI) who underwent the opened Brostrom-Gould technique (BGT). MATERIALS AND METHODS: Seventy-nine patients (seventy-nine feet) from three different centers undergoing BGT were reviewed. For clinical and functional analysis, the AOFAS ankle-hindfoot scale was applied and rates of return to sport activities were assessed. Correlation of Δ-AOFAS and rates of return to sport activities with all variables analyzed was performed. RESULTS: Mean AOFAS score improved from 64.6 to 97.2 (p < 0.001). Sixty-one (77.2%) returned to preinjury activities and 18 (22.8%) changed to a lower-level modality. Symptoms of instability were related to Δ-AOFAS (p = 0.020). Change in the sport activity was related to pain and symptoms of instability (p = 0.41 and p < 0.001). CONCLUSION: Recreational athlete patients who underwent the BGT demonstrated excellent functional outcomes after a mean follow-up of 7 years. Residual pain and symptoms of instability after surgery were the main complaints associated with limitations in physical activities.

Asunto(s)

Traumatismos del Tobillo , Inestabilidad de la Articulación , Volver al Deporte , Humanos , Volver al Deporte/estadística & datos numéricos , Masculino , Femenino , Adulto , Inestabilidad de la Articulación/cirugía , Inestabilidad de la Articulación/fisiopatología , Inestabilidad de la Articulación/etiología , Estudios de Seguimiento , Traumatismos del Tobillo/cirugía , Traumatismos del Tobillo/fisiopatología , Adulto Joven , Resultado del Tratamiento , Recuperación de la Función , Persona de Mediana Edad , Estudios Retrospectivos , Adolescente , Articulación del Tobillo/cirugía , Articulación del Tobillo/fisiopatología , Procedimientos Ortopédicos/métodos

RESUMEN

PURPOSE: The purpose of this study is to compare the patient-reported outcomes and return to sports of the conservative and surgical treatment of distal hamstring tendon injuries. METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, two reviewers searched PubMed, Scopus and Virtual Health Library databases in January 2023. Clinical studies evaluating conservative or surgical management outcomes of distal hamstring tendon injuries were considered eligible for this systematic review if predefined criteria were fulfilled: (1) published in English or Spanish; (2) evaluated any of the following: patient-reported outcomes, return-to-sports rate (RTS-R) or return-to-sports time (RTS-T). Data were presented in tables using absolute values from individual studies and derived pooled percentages. RESULTS: Eighteen studies were included for 67 patients and 68 distal hamstring tendon injuries. Initially, 39 patients (58.2%) underwent surgical treatment, whereas 28 (41.8%) were treated conservatively. Among conservative treatment patients, 15 failed and had to be operated on (53.6%), all with distal semitendinosus tendon injuries. Anchor fixation was the technique of choice in 20 lesions (36.4%), tenodesis in 16 (29.1%), tenectomy in 14 (25.5%) and sutures were preferred in five (9%). Thirteen out of 28 patients (46.4%) undergoing initial conservative treatment returned to sports at a mean of 3.6 months (range 1 week to 12 months), in contrast to surgical treatment, in which 36 out of 39 patients (92.3%) returned at a mean of 4.2 months (range 6 weeks to 12 months). Additionally, 14 of 15 patients (93.3%) converted to surgical treatment after failed conservative treatment returned to sports at a mean of 7.6 months after injury. CONCLUSION: Initial surgical treatment of distal hamstring tendon injuries yields a high RTS-R (92.3%) at a mean of 4.2 months. Furthermore, 15 out of 28 patients (53.6%) initially treated conservatively had to be operated on, delaying the RTS-T (mean 7.6 months after injury) without affecting their RTS-R. LEVEL OF EVIDENCE: IV.

Asunto(s)

Tendones Isquiotibiales , Volver al Deporte , Traumatismos de los Tendones , Humanos , Traumatismos en Atletas/cirugía , Tratamiento Conservador , Tendones Isquiotibiales/lesiones , Tendones Isquiotibiales/cirugía , Medición de Resultados Informados por el Paciente , Traumatismos de los Tendones/cirugía

RESUMEN

IMPORTANCE: Return to sport (RTS) is considered an indicator of successful recovery after anterior cruciate ligament reconstruction (ACLR). In recent years, there has been major interest in documenting RTS following anterior cruciate ligament (ACL) injury. Despite women being at increased risk for ACL injuries and a global increase in women's participation in sports, research has not adequately focused on female athletes. OBJECTIVE: The purpose of this study is to conduct a systematic review and meta-analysis evaluating the RTS rate in female athletes after ACLR. We hypothesize that most of the female athletes can RTS. EVIDENCE REVIEW: A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Electronic databases (PubMed, Embase, and Epistemonikos) were searched for articles reporting RTS rates and contextual data in female athletes. The following search terms were used: "anterior cruciate ligament reconstruction" OR "ACL reconstruction" AND "female" OR "women" AND "return to sports" OR "return to play" to retrieve all relevant articles published between 2003 and 2023. A quality assessment of the included studies was conducted. FINDINGS: Fifteen articles were included, reporting on 1456 female athletes participating in pivoting sports. The included studies comprised 9 cohorts, 1 case-control study, 2 case series, 2 descriptive epidemiology studies, and 1 observational study. Eight out of fifteen studies focused solely on elite-level athletes. The participants had a mean age of 23.13 years. Soccer was the most prevalent sport among the participants, accounting for 49.7% of all athletes included. All 15 studies reported an RTS rate, yielding a meta-proportion of 69% [95% CI, 58-80%] for RTS. Nine articles reported the average time to RTS, which was 10.8 months [95% CI, 8.7-12.8 months]. CONCLUSIONS: This systematic review demonstrates that a majority of female athletes (69 â€‹%) can RTS participation at an average of 10.8 months, however, the available information is insufficient, and quantitative data and reasons for not returning to play are lacking. Future studies should establish return-to-play criteria in this population and determine reasons for not returning to play. LEVEL OF EVIDENCE: III.

Asunto(s)

Lesiones del Ligamento Cruzado Anterior , Reconstrucción del Ligamento Cruzado Anterior , Atletas , Volver al Deporte , Humanos , Reconstrucción del Ligamento Cruzado Anterior/métodos , Femenino , Volver al Deporte/estadística & datos numéricos , Lesiones del Ligamento Cruzado Anterior/cirugía , Atletas/estadística & datos numéricos , Traumatismos en Atletas/cirugía

RESUMEN

OBJECTIVES: Football is a globally played sport that poses potential risks for musculoskeletal injuries. Upper-limb injuries have a lower incidence rate than lower-limb injuries but can still cause absenteeism and performance impairment in football players. This descriptive epidemiological study aimed to evaluate and compare the epidemiological data on shoulder injuries among professional football players in two major Brazilian football championships. METHODS: Data were collected throughout the championships, and club physicians medically evaluated each player during official games using two online forms. The collected information included the player's age and position, injury diagnosis, laterality, location on the field where the injury occurred, playing time, imaging examinations performed, need for surgical treatment, time to return to play (TRP), and recurrence of the injury. The incidence of injuries was evaluated using the Federation Internationale de Football Association (FIFA) incidence formula. RESULTS: A total of 107 shoulder injuries were recorded (4.3% of all injuries), with a FIFA incidence of 0.847. Glenohumeral dislocations (GHDs) and acromioclavicular dislocations (ACDs) accounted for 37.38% and 35.51% of all shoulder injuries, respectively. Goalkeepers and defenders presented, respectively, a 2.15 and 1.57 times increased risk of suffering shoulder injuries, while attackers presented a 0.63 times decreased risk. Injury recurrence was observed in 14.95% of cases, with GHDs and ACDs showing recurrence rates of 35.00% and 5.26%, respectively. Surgery was performed in 9.35% of cases, with GHDs representing 50% of all surgeries. The average TRP was 22.37 days, with severe and major injuries accounting for 11.21% and 10.28% of all injuries, respectively. Goalkeepers had the highest average TRP of 36.15 days. Recurring injuries had a higher average TRP of 33.44 days compared to nonrecurring injuries, which had an average TRP of 20.43 days. Surgically treated injuries had the highest average TRP of 112.5 days. CONCLUSION: Shoulder injuries in the professional football scenario are of great concern due to the high recurrence rate and need for surgical treatment, which will lead to a long TRP. These findings emphasize the need to implement prevention protocols and effective treatments to reduce the consequences of such injuries, which are usually underestimated in this sport. LEVEL OF EVIDENCE: III.

Asunto(s)

Traumatismos en Atletas , Lesiones del Hombro , Fútbol , Humanos , Brasil/epidemiología , Fútbol/lesiones , Masculino , Incidencia , Lesiones del Hombro/epidemiología , Adulto , Traumatismos en Atletas/epidemiología , Adulto Joven , Luxación del Hombro/epidemiología , Volver al Deporte/estadística & datos numéricos , Articulación Acromioclavicular/lesiones , Recurrencia

RESUMEN

INTRODUCTION: Return to sport is an important measure of treatment success for athletes undergoing rotator cuff repair, which can be challenging in older athletes. The purpose of the present study was to systematically review and summarize the literature regarding the return to sport in athletes older than 35 years undergoing rotator cuff repair. MATERIALS AND METHODS: A systematic review of the literature was performed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The electronic databases of PubMed, MEDLINE, and Cochrane were used for the literature search. Studies in English evaluating return to sport after repair of partial- or full-thickness rotator cuff tears among athletes older than 35 years of all levels and sports were included. RESULTS: Four studies of level III and IV were included in this review, with a total of 140 athletes. Both full- and partial-thickness rotator cuff tears were described and managed via acromioplasty combined with open or arthroscopic repair using single or double-row suture. Of the 140 athletes, 122 returned to sports, with 102 returning to equal or higher level pre-injury. The lower mean time to return to sport among the studies included was 6.3 months. CONCLUSIONS: Although the evidence is limited, rotator cuff tear should not be seen as a mandatory reason for the retirement of older athletes. Of the 140 athletes included in this review, 122 returned to sport, with 102 returning to equal or higher level pre-injury.

Asunto(s)

Lesiones del Manguito de los Rotadores , Humanos , Anciano , Lesiones del Manguito de los Rotadores/cirugía , Manguito de los Rotadores/cirugía , Volver al Deporte , Artroscopía , Atletas , Resultado del Tratamiento

Asunto(s)

Lesiones del Ligamento Cruzado Anterior , Deportes , Humanos , Volver al Deporte , Lesiones del Ligamento Cruzado Anterior/cirugía , Rotura , Factores de Riesgo

RESUMEN

OBJECTIVES: Core muscle injury is a debilitating condition that causes chronic groin pain in athletes, particularly common in soccer players. The condition is characterised by pain in the inguinal region and can lead to a significant number of absences from high-intensity physical activity. It is caused by repetitive overload without proper counterbalance from the abdominal muscles, hip flexors, and adductors in susceptible athletes. Surgical indications for core muscle injury consider cases where non-surgical treatments have not provided sufficient relief. The aim of this study was to assess the results of surgical intervention for core muscle injury using the technique employed by the Sports Medicine Group of (Institute of Orthopedics and Traumatology of Hospital das Clínicas - Universidade de São Paulo). The procedure involves releasing the anterior portion of the tendon of the rectus abdominis muscle near the pubic symphysis, along with proximal tenotomy of the adductor longus muscle tendon. METHODS: This study utilised a consecutive historical cohort analysis of the medical records of 45 male athletes, of which, 75.6% were professional soccer players, who underwent surgical treatment between January 1, 2002, and December 31, 2021. The participants included active athletes aged between 18 and 40 years, with a mean age of 23.9 years, and were diagnosed with myotendinous core muscle injury. These athletes experienced pain in the pubic symphysis and adductor tendon region and had previously undergone medical treatment and physical therapy for a duration of three to six months without significant improvement. RESULTS: The average time for athletes to return to sport after surgery was 135 days, with a majority of participants being soccer and futsal players. The surgical intervention yielded promising results, with a positive correlation between unilateral injuries and the time taken to return to sport. The complication rate was low, at 6.7%. Notably, the rate of symptom resolution was high, at 93.3%. Furthermore, the analysis indicated that the player's position on the field significantly influenced the discharge period, suggesting that the game position plays a role in the recovery process. CONCLUSION: The combined surgical procedure involving the release of the rectus abdominis tendon and adductor longus muscle tenotomy demonstrates favourable outcomes for athletes with core muscle injury. This study provides strong support for the effectiveness of this surgical approach in managing the condition and offers a potential path to recovery and return to sports activities. STUDY DESIGN: Cross-sectional study.

Asunto(s)

Traumatismos en Atletas , Dolor Crónico , Humanos , Masculino , Adolescente , Adulto Joven , Adulto , Tenotomía/métodos , Recto del Abdomen/cirugía , Recto del Abdomen/lesiones , Volver al Deporte , Estudios Transversales , Traumatismos en Atletas/cirugía , Brasil , Tendones/cirugía , Dolor Crónico/cirugía

RESUMEN

Objetivo: Evaluar el retorno al deporte recreativo luego de una reparación artroscópica del manguito rotador. materiales y métodos: Se realizó un análisis retrospectivo de atletas recreativos sometidos a una reparación artroscópica del manguito rotador entre agosto de 2019 y diciembre de 2020 (seguimiento mínimo 1 año). Se los dividió en dos grupos: alta y baja demanda del hombro. El resultado principal evaluado fue el retorno al deporte y los resultados secundarios fueron: tiempo de retorno, nivel alcanzado, escala analógica visual pre y posoperatoria para dolor; escalas ASES y Constant. Se calcularon la diferencia mínima clínicamente importante y el beneficio clínico sustancial. Se registraron las complicaciones. Resultados: Se incluyó a 102 pacientes (media de edad 58.7 años). Setenta practicaban un deporte de alta demanda para el hombro. La media de seguimiento fue de 18 meses. El 82,3% volvió al deporte; 63, al mismo nivel. La mediana hasta el regreso fue de 6 meses. El 91% de los deportistas con baja demanda para el hombro y el 79% con alta demanda retornaron al deporte. Los puntajes de las escalas mejoraron a los 6 y 12 meses. El 98% y el 100% alcanzaron la diferencia mínima clínicamente importante y el beneficio clínico sustancial para las escalas ASES y Constant, respectivamente. Ocho tenían dolor persistente. Cinco fueron sometidos a una cirugía de revisión. Conclusión: La reparación artroscópica del manguito rotador en deportistas recreativos logró muy buenos resultados funcionales con una alta tasa de retorno deportivo al mismo nivel y un 7,8% de complicaciones. Nivel de Evidencia: IV

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Objective: To assess return to sports in recreational athletes after arthroscopic rotator cuff repair (ARCR). Materials and methods: Retrospective single-site study of recreational athletes who were operated onbetween August 2019 and December 2020 for ARCR, with a minimum follow-up of one year. Patients were divided into 2 groups based on their shoulder demand: high or low. The primary endpoint was return to sports. Secondary criteria included time to return, level achieved, pre and postoperative VAS for pain, and ASES and Constant scores. The minimal clinically important difference (MCID) and substantial clinical benefit (SCB) were calculated. Complications were recorded.Results:A total of 102 patients (mean age: 58.7 years) were included. Seventy patients practiced a sport with high shoulder involvement. The mean follow-up was 18 months. 82.3% of patients returned to recreational sports, with 63 participating at the same level. The median time to return was six months. Return to sports was 91% in the low-shoulder demand group versus 79% in the high-shoulder demand group. VAS, Constant and ASES scores improved after six and twelve months. For the ASES and Constant scores, 98 and 100% of patients met the MCID and SCB, respectively. A total of eight patients reported persistent pain. Five patients required revision surgery. Conclusion: Most recreational athletes who undergo ARCR are able to resume their previous level of activity. Most athletes achieved significant clinical improvement with a low rate of complications (7.8%). Level of Evidence: IV

Asunto(s)

Adulto , Persona de Mediana Edad , Artroscopía/métodos , Articulación del Hombro , Volver al Deporte , Lesiones del Manguito de los Rotadores

RESUMEN

PURPOSE: This systematic review and meta-analysis aimed to (1) determine the proportion of patients who underwent anterior shoulder instability surgery and did not return to sports for psychological reasons and (2) estimate differences in psychological readiness scores between patients who did and did not return to sports. METHODS: The EBSCOhost/SPORTDiscus, PubMed/Medline, Scopus, EMBASE and Cochrane Library databases were searched for relevant studies. The data synthesis included the proportion of patients who did not return to sports for psychological reasons and the mean differences in the psychological readiness of athletes who returned and those who did not return to sports. Non-binomial data were analysed using the inverse-variance approach and expressed as the mean difference with 95% confidence intervals. RESULTS: The search yielded 700 records, of which 13 (1093 patients) were included. Fourteen psychological factors were identified as potential causes for not returning to sports. The rates of return to sports at any level or to the preinjury level were 79.3% and 61.9%, respectively. A total of 55.9% of the patients cited psychological factors as the primary reason for not returning to sports. The pooled estimate showed that patients who returned to sports had a significantly higher Shoulder Instability-Return to Sport After Injury score (P < 0.00001) than those who did not, with a mean difference of 30.24 (95% CI 24.95-35.53; I2 = 0%; n.s.). CONCLUSIONS: Psychological factors have a substantial impact on the rate of return to sports after anterior shoulder instability surgery. Patients who returned to sports had significantly higher psychological readiness than those who did not return to sports. Based on these results, healthcare professionals should include psychological and functional measurements when assessing athletes' readiness to return to sports. LEVEL OF EVIDENCE: Level IV.

Asunto(s)

Inestabilidad de la Articulación , Articulación del Hombro , Deportes , Humanos , Volver al Deporte/psicología , Inestabilidad de la Articulación/cirugía , Hombro , Articulación del Hombro/cirugía , Deportes/psicología

RESUMEN

ABSTRACT: The shoulder is commonly injured in overhead sports. This is associated with a high degree of mobility at the expense of stability, sports specific demands, high volume or intensity of practice and competition, biomechanical deficits, and poor technique. Following injury, the return to competition process includes nonsurgical or surgical treatment, comprehensive rehabilitation, and a structured return to sports program. The return to sports continuum is divided into phases which include return to practice of the sport, return to competition at a lower level or with reduced performance, and return to expected performance. Components of the return to sports decision include clinical evaluation of physical and psychological readiness, measurement of muscle strength using isokinetic tests, evaluation of overhead functional tasks, and progression in a supervised interval throwing program. The evidence for the effectiveness of return to sports programs following shoulder injury is limited but evolving and is an area that will merit continued investigation.

Asunto(s)

Lesiones del Hombro , Deportes , Humanos , Volver al Deporte , Lesiones del Hombro/diagnóstico , Lesiones del Hombro/terapia , Terapia por Ejercicio

RESUMEN

BACKGROUND: The objective was to compare the performance in field tests, dynamic knee valgus, knee function, and kinesiophobia of soccer players who were psychologically ready and not ready to return to unrestricted training or competitions after ACL reconstruction. METHODS: Thirty-five male soccer players who had undergone primary ACL reconstruction at least 6 months were divided based on the Anterior Cruciate Ligament Return to Sport after Injury (ACL-RSI) questionnaire score into ready (≥60) and not-ready (<60) groups. The modified Illinois change of direction test (MICODT) and reactive agility test (RAT) were used to impose the demand for directional change and reactive decision-making. We assessed the frontal plane knee projection angle (FPKPA) during a single-leg squat and distance in crossover hop test (CHD). In addition, we assessed kinesiophobia through the shortened version of the Tampa Scale of Kinesiophobia (TSK-11) and knee function using the International Knee Documentation Committee Subjective Knee Form (IKDC). Independent t-tests were used to compare the groups. RESULTS: The not-ready group had lower performance on the MICODT (effect size (ES) = -1.2; p < 0.001) and RAT (ES = -1.1; p = 0.004) tests and higher FPKPA (ES = 1.5; p < 0.001). In addition, they presented lower IKDC (ES = 3.1; p < 0.001) and higher TSK-11 (ES = -3.3; p < 0.001) scores. CONCLUSIONS: Physical and psychological deficits may persist in some individuals after rehabilitation. On-field tests and dynamic knee alignment evaluation should be included in the athlete evaluation before the decision-making about clearance to sports participation, especially in athletes who perceive themselves as psychologically not ready.

Asunto(s)

Lesiones del Ligamento Cruzado Anterior , Fútbol , Humanos , Masculino , Volver al Deporte/psicología , Lesiones del Ligamento Cruzado Anterior/cirugía , Recuperación de la Función , Articulación de la Rodilla/cirugía

RESUMEN

AIMS: Our objective is to compare the functional results in patients that underwent surgery for recurrent anterior shoulder instability (RAGHI) during the COVID-19 pandemic with remotely-based rehabilitation, to those who had surgery before the pandemic and had in-person rehabilitation therapy. METHODS: A retrospective case series of 68 patients were included and divided into two groups: In person-group and Home-based group. Western Ontario Shoulder Instability Index (WOSI) and Subjective Shoulder Value (SSV) scores were used to evaluate objective and subjective clinical parameters. Time and level of return to sports was studied by the Subjective Patient Outcome for Return to Sports (SPORTS) score. RESULTS: The mean SSV score was 82% (40-100) on the In-Person group compared with 87% (65-100) for the Home-Based group. Results for WOSI score were similar, with an average of 210.42 (90%) for In-Person and 261.45 (88%) for the Home-Based group (p 0.12). Return to sports was carried out in an average of 6.6 (4-16) months for In-Person group, compared to 6.5 (5-8) months for Home-Based. CONCLUSION: Follow-up and rehabilitation methods for patients who underwent surgery for RAGHI, during COVID-19 lockdown, were not significantly (p 0.12) affected on functional and athletic return in comparison to traditional methods according to WOSI scale. LEVEL OF EVIDENCE: IV Retrospective series of cases.

Asunto(s)

COVID-19 , Inestabilidad de la Articulación , Articulación del Hombro , Deportes , Humanos , Control de Enfermedades Transmisibles , Inestabilidad de la Articulación/cirugía , Pandemias , Estudios Retrospectivos , Volver al Deporte , Articulación del Hombro/cirugía

RESUMEN

Pain is modulated by multiple factors. A relevant psychological process peculiar to athletes and which could be associated with pain is Psychological Readiness to Return to Sport (PRRS). The analysis of this association in competition context is particularly important. OBJECTIVE: To determine the correlation between the PRRS and pain intensity in elite volleyball players during their participation in a continental sporting event. METHODS: A cross-sectional study was conducted. Data from 107 male volleyball players (23.50 ± 4.08 years of age) participating in the South American Volleyball Championship were used. The athletes answered a self-report questionnaire on the day the championship began regarding their history of injuries in the previous six months. The athletes who declared injuries were asked about the current pain intensity using the Pain Numeric Rating Scale (NRS) and Psychological Readiness to Return to Sport using the Injury-Psychological Readiness to Return to Sport scale (I-PRRS). RESULTS: 43.93% (n = 47) of the athletes (23.70 ± 3.54 years) reported an injury in the six months prior to the championship. They presented a median on the NRS of three (interquartile range (IQR), 2-5), and 54 (IQR, 46-58) on the I-PRRS. The Spearman's Rho correlation test showed an inversely and moderate correlation (rs = -0.36; p = 0.011; CI: -0.64--0.08) between pain intensity and PRRS. CONCLUSIONS: In male elite volleyball players who participate in a Continental Championship in South America, higher levels of PRRS was correlated to lower pain intensity.

Asunto(s)

Voleibol , Humanos , Masculino , Estudios Transversales , Volver al Deporte/psicología , Atletas/psicología , Dolor

RESUMEN

PURPOSE: To reduce the length of the Shoulder Instability-Return to Sport After Injury (SIRSI) scale and determine the predictive validity of the short version compared with the original form. METHODS: This study included patients who underwent an arthroscopic Bankart repair or open Latarjet procedure between 2017 and 2019. One group was used for the SIRSI scale-reduction process, and a second group was used to test the predictive validity of the proposed short SIRSI scale. The Cronbach α value was used to evaluate internal consistency. Validity was determined by calculating the Pearson correlation coefficient with the Western Ontario Shoulder Instability Index scale. Predictive validity was assessed using receiver operating characteristic (ROC) curve statistics. RESULTS: A total of 158 patients participated in the scale-reduction process, and 137 patients participated in the predictive-validation process. The SIRSI scale was successfully reduced to a 5-item scale constructed by 1 underlying factor accounting for 60% of the variance. The short version showed good internal consistency (Cronbach α = 0.82) and was highly correlated with the Western Ontario Shoulder Instability Index scale and the long version. The short SIRSI scores were significantly different between patients who returned to sports and those who did not. The SIRSI scale had excellent predictive ability for return-to-sport outcomes (area under ROC curve of 0.84 for short version [95% confidence interval, 0.7-0.9] and 0.83 for long version [95% confidence interval, 0.7-0.9]). CONCLUSIONS: A valid 5-item, short version of the SIRSI scale was successfully developed in our patient population. The short version was found to be as robust as the long scale for discriminating and predicting return-to-sport outcomes. LEVEL OF EVIDENCE: Level II, prospective cohort study.

Asunto(s)

Inestabilidad de la Articulación , Luxación del Hombro , Articulación del Hombro , Humanos , Volver al Deporte/psicología , Inestabilidad de la Articulación/cirugía , Articulación del Hombro/cirugía , Hombro , Estudios Prospectivos , Luxación del Hombro/cirugía , Recurrencia