Saturday, 28 August 2010

Heres a little bit of something for everyone on the list

1. Osteoarthritis Cartilage. 2010 Aug 3.
Autologous chondrocyte implantation for the treatment of cartilage lesions:

randomized control trials assessed in a systematic review.
Vasiliadis HS, Salanti G.

Orthopaedic Sports Medicine Center, Department of Orthopaedics, School of

Medicine, University of Ioannina, Greece; Molecular Cell Biology and Regenerative

Medicine, Sahlgrenska University Hospital, Gothenburg University, Sweden.

2. Dis Mon. 2010 Jul;56(7):436-42.

Blood-borne infections and the athlete.

Gutierrez RL, Decker CF.
Division of Infectious Diseases, Department of Internal Medicine, National Naval
Medical Center, Bethesda, Maryland, USA.
3. Phys Sportsmed. 2010 Jun;38(2):126-32.
Chronic exertional compartment syndrome of the leg in athletes: evaluation and management.
Gill CS, Halstead ME, Matava MJ.
Chronic exertional compartment syndrome (CECS) is a well-known cause of activity-related lower leg pain in both athletes and nonathletes. In contrast to acute compartment syndrome, CECS is generally not related to trauma, and is often suspected in the outpatient setting by primary care physicians, podiatrists, sports medicine clinicians, and orthopedic surgeons. The diagnosis of CECS is often overlooked because patients avoid or withdraw from exacerbating physical activities instead of seeking treatment for their symptoms from a health care professional. A thorough history and physical examination of an individual with activity-related lower leg pain is necessary for correct diagnosis to occur.
Appropriate diagnostic testing with measurement of intracompartmental pressures reliably confirms the diagnosis of CECS. Nonoperative treatments of CECS rarely leads to complete resolution of symptoms or an individual's ability to return to  previous levels of recreational or athletic activity. Fasciotomy of the involved compartments can reliably lead to resolution of pain and the ability to return to previous activities within 6 weeks.

4. Curr Probl Pediatr Adolesc Health Care. 2010 Aug;40(7):170-83.
Common lower extremity injuries in the skeletally immature athlete.
Grady MF, Goodman A.
Sports Medicine and Performance Center, Children's Hospital of Philadelphia, King of Prussia, PA, USA.

Lower extremity musculoskeletal pain is a common complaint in the adolescent athlete. During rapid growth, several common biomechanical changes occur that may predispose to overuse injury. Unlike fractures, most of these office-based sports medicine complaints are initially evaluated by the primary care provider. This review discusses several of the most common complaints and briefly discusses some clinically significant conditions that masquerade as common injuries. The article discusses only the injuries unique to the growing athlete. The article's goal is to help develop a framework for the pediatric clinician to evaluate common complaints and formulate a plan that includes simple stretches and physical therapy recommendations.

5. Curr Probl Pediatr Adolesc Health Care. 2010 Aug;40(7):154-69.
Concussion in the adolescent athlete.
Grady MF.
Sports Medicine and Performance Center, Children's Hospital of Philadelphia, King of Prussia, PA, USA.

Concussion in the adolescent athlete is a common sports and recreation injury.Traditional management of concussion in this age group has focused on sport return-to-play decisions. However, new research on mild traumatic brain injury has dramatically changed the management of concussion. During the acute healing phase, physical and cognitive rest are crucial for healing. In the school-aged athlete, new concepts, such as complete brain rest, have made school management decisions as important as sport return-to-play decisions. Despite tremendous improvements in the understanding of concussion, most of the research has been done in young adults. The lack of prospective studies in early adolescent student athletes limits definitive management recommendations. This article reviews the current understanding of the epidemiology, pathophysiology, and clinical presentation of concussion and discusses the unique factors involved in clinical  management of concussion in the adolescent student-athlete.

6. Phys Sportsmed. 2010 Jun;38(2):133-45.
Conservative treatment modalities and outcomes for osteoarthritis: the concomitant pyramid of treatment.
Langworthy MJ, Saad A, Langworthy NM. Michael J. Langworthy MD 1 Amira Saad MD 2 Nadia M. Langworthy MD 3 1Battle
Creek Orthopaedics and Sports Medicine Clinic Battle Creek MI 2Michigan State
University East Lansing MI 3University of Michigan Ann Arbor MI Correspondence:
Michael J. Langworthy MD Battle Creek Orthopaedics and Sports Medicine Clinic
6417 N. 39th St. Augusta MI 49012. Tel: 269-209-5066 Fax: 269-969-6283 E-mail:

This article reviews current treatment algorithms for the conservative treatment  of hip and knee osteoarthritis. The available treatment options for osteoarthritis (physical therapy, medical therapeutics, steroid injections, nutraceuticals, hyaluronic acid injections, acupuncture, pulsed electrical stimulation, and topical ointments) are compared to determine efficacy in the treatment of pain and return of function in the osteoarthritic joint. A literature review was conducted to determine combinations of appropriate concomitant therapy. Based on the available literature, we conclude that an early transition to multimodal and concomitant therapy is the most efficacious approach to decrease pain and improve joint function in the osteoarthritic hip and knee.
7. Knee Surg Sports Traumatol Arthrosc. 2010 Jul 22.
Evidence of accumulated stress in Achilles and anterior knee tendons in elite badminton players.
Boesen AP, Boesen MI, Koenig MJ, Bliddal H, Torp-Pedersen S, Langberg H.
Institute of Sports Medicine, Bispebjerg Hospital and Center for Healthy Aging,
Faculty of Health Sciences, University of Copenhagen, Bispebjerg Bakke 23, 2400,

Copenhagen NV, Denmark,

Tendon-related injuries are a major problem, but the aetiology of tendinopathies  is unknown. In tendinopathies as well as during unaccustomed loading, intra-tendinous flow can be detected indicating that extensive loading can provoke intra-tendinous flow. The aim of present study is to evaluate the vascular response as indicated by colour Doppler (CD) activity in both the Achilles and patella tendon after loading during high-level badminton matches.The Achilles tendon was subdivided into a mid-tendon, pre-insertional, and insertional region and the anterior knee tendons into a quadriceps-, patella- and tuberositas region. Intra-tendinous flow was measured using both a semi-quantitative grading system (CD grading) and a quantitative scoring system (CF) on colour Doppler. Intra-tendinous flow in the Achilles and anterior knee tendons was examined in fourteen single players before tournament and after 1st and 2nd match, respectively on both the dominant and non-dominant side. All players had abnormal intra-tendinous flow (Colour Doppler >/= grade 2) in at least one tendon in at least one scan during the tournament. At baseline, only two of the 14 players had normal flow in all the tendons examined. After 1st match, tendencies to higher intra-tendinous flow were observed in both the dominant patella tendon and non-dominant quadriceps tendon (P-values n.s.). After 2nd match, intra-tendinous flow was significant increased in the dominant patella tendon (P = 0.009). In all other locations, there was a trend towards a stepwise  increase in intra-tendinous flow. The preliminary results indicate that high amount of intra-tendinous flow was found in elite badminton players at baseline and was increased after repetitive loading, especially in the patella tendon (dominant leg). The colour Doppler measurement can be used to determine changes in intra-tendinous flow after repetitive loading.

8. Curr Sports Med Rep. 2010 Jul-Aug;9(4):195-201.
Exercise is medicine: a historical perspective.
Berryman JW.
Department of Bioethics and Humanities and Adjunct, Department of Orthopaedics and Sports Medicine, School of Medicine, University of Washington, Seattle, WA 98195, USA.

Much of the early information about exercise and medicine appeared in the ancient, medieval, and Renaissance medical literature in the context of the "six things nonnatural." These were the things that were under everyone's own control, directly influenced health, and became the central part of the new "physical
education" movement in the early 19 century in the United States. They were known then as the "Laws of Health." Until the early 1900s, "physical education" was dominated by physicians who specialized in health and exercise. However, physical education changed to a games and sports curriculum led by coaches who introduced competition and athletic achievement into the classroom. As that happened, physicians disappeared from the profession. Through the last half of the twentieth century, as exercise became more central to public health, the medical community began to view exercise as part of lifestyle, a concept embracing what was once called the "six things nonnatural."

9. Clin Sports Med. 2010 Jul;29(3):459-76.
Exertional collapse in the runner: evaluation and management in fieldside and office-based settings.
Childress MA, O'Connor FG, Levine BD.
Department of Family and Sports Medicine, DeWitt Army Community Hospital, Fort Belvoir, VA, USA.

Exertional collapse is a commonly encountered phenomenon among runners, particularly in the setting of long distances and extreme environments. Although exertional collapse is generally a benign event occurring in an exhausted finisher at race completion, the multifactorial nature of this disorder creates a broad differential diagnosis. The ability of the sports provider to appropriately recognize and treat these various potential concerns is critical, because collapse may represent several life-threatening conditions. It is especially challenging to determine the appropriate course of evaluation and management of collapse in the context of a mass participation event. This article presents a discussion of the etiology and pathophysiology of collapse as well as strategies for the effective assessment and treatment of collapsed runners, whether in the fieldside setting or in an outpatient office-based environment.

10. J Fam Pract. 2010 Aug;59(8):437-44.
Give your sports physicals a performance boost.
Womack J.
Family Medicine and Community Health, University of Medicine and Dentistry of New
Jersey - Robert Wood Johnson, New Brunswick, NJ, USA. E-mail:

Cover the 12 components of the preparticipation physical evaluation (PPE) recommended by the American Heart Association to screen young athletes for potentially life-threatening cardiovascular disease. Perform a genitourinary exam as part of the PPE for young men; assess young women for the criteria associated with the female athlete triad. Perform auscultation while the patient is squatting and while doing the Valsalva maneuver to determine whether any murmurs you detected on examination are associated with hypertrophic cardiomyopathy.

11. Dis Mon. 2010 Jul;56(7):404-6.
Infectious diseases in the athlete: an overview.
Decker CF.Uniformed Services University of the Health Sciences, Division of Infectious Diseases, Department of Internal Medicine, National Naval Medical Center, Bethesda, Maryland, USA.

12. Curr Sports Med Rep. 2010 Jul-Aug;9(4):191-3.
New innovations in sports medicine: good for the patient or good for the pocketbook?
Johnson RJ.
Department of Family Medicine and Community Health, University of Minnesota,
Minneapolis, MN, USA.
13. Sports Med. 2010 Sep 1;40(9):729-46.
A 'plane' explanation of anterior cruciate ligament injury mechanisms: a systematic review.
Quatman CE, Quatman-Yates CC, Hewett TE.
Cincinnati Children's Hospital Research Foundation, Sports Medicine Biodynamics
Center and Human Performance Laboratory, Cincinnati, Ohio, USA.

Although intrinsic and extrinsic risk factors for anterior cruciate ligament (ACL) injury have been explored extensively, the factors surrounding the inciting event and the biomechanical mechanisms underlying ACL injury remain elusive. This systematic review summarizes all the relevant data and clarifies the strengths
and weaknesses of the literature regarding ACL injury mechanisms. The hypothesis is that most ACL injuries do not occur via solely sagittal, frontal or transverse plane mechanisms. Electronic database literature searches of PubMed MEDLINE (1966-2008), CINAHL (1982-2008) and SportDiscus(R) (1985-2008) were used for the systematic review to identify any studies in the literature that examined ACL injury mechanisms. Methodological approaches that describe and evaluate ACL injury mechanisms included athlete interviews, arthroscopic studies, clinical imaging and physical exam tests, video analysis, cadaveric studies, laboratory tests (motion analysis, electromyography) and mathematical modelling studies. One hundred and ninety-eight studies associated with ACL injury mechanisms were identified and provided evidence regarding plane of injury, with evidence supporting sagittal, frontal and/or transverse plane mechanisms of injury. Collectively, the studies indicate that it is highly probable that ACL injuries are more likely to occur during multi-planar rather than single-planar mechanisms of injury.

14. Ann N Y Acad Sci. 2010 Jul;1201:121-8.
Redefining the role of mitochondria in exercise: a dynamic remodeling.
Bo H, Zhang Y, Ji LL.
Tianjin Key Laboratory of Exercise Physiology and Sports Medicine, Department of
Health and Exercise Science, Tianjin University of Sport, Tianjin, China.

Exercise induced adaptations in muscle are highly specific and dependent upon the type of exercise, as well as its frequency, intensity, and duration. Mitochondria are highly dynamic organelles. Fusion and fission reactions lead to a continuous  remodeling of the mitochondrial network, which range from reticulum of elongated and branched filaments to collections of individual organelles. Mitochondrial network dynamics are sensitive to various physiological and pathological stimuli,and mitochondrial morphological changes are no epiphenomena, but central to cell function and survival. There is a strong correlation between mitochondrial
network morphology, dynamic-related protein, and energy metabolism. It is expected that alteration in cellular energy status during exercise can also be achieved through mitochondrial network dynamics. In this review, we describe mitochondrial network remodeling response to acute and endurance exercise, which is accompanied by bioenergetics and redox regulation. In addition, potential mechanisms for metabolic and redox signaling involved in mitochondrial dynamic regulation are also reviewed.

15. Dis Mon. 2010 Jul;56(7):407-13.
Respiratory tract infections in athletes.
Lin L, Decker CF.
Infectious Diseases Service, Department of Internal Medicine, Walter Reed Medical Center, Washington, DC, USA.

16. J Bone Joint Surg Am. 2010 Aug 4;92(9):1842-50.
The rising incidence of acromioplasty.
Vitale MA, Arons RR, Hurwitz S, Ahmad CS, Levine WN.
Center for Shoulder, Elbow and Sports Medicine, Department of Orthopaedic Surgery, New York-Presbyterian Medical Center, Columbia University, 622 West 168th Street, PH-1117, New York, NY 10032, USA.

BACKGROUND: Acromioplasty is considered a technically simple procedure but has become controversial with regard to its indications and therapeutic value.
METHODS: Two complementary databases were used to ascertain the frequency of acromioplasty over a recent span of time. In Part A, the New York Statewide Planning and Research Cooperative System (SPARCS) ambulatory surgery database was searched from 1996 to 2006 to identify all ambulatory surgery acromioplasties as well as all orthopaedic ambulatory surgery procedures. In Part B, the American Board of Orthopaedic Surgery (ABOS) database was searched from 1999 to 2008 to identify all arthroscopic acromioplasties as well as all orthopaedic procedures.
RESULTS: Part A revealed that in 1996 there were 5571 acromioplasties in New York
State, representing a population incidence of 30.0 per 100,000. In 2006 there were 19,743 acromioplasties, representing a population incidence of 101.9 per 100,000. Over these eleven years, the volume of acromioplasties increased by 254.4%, compared with only a 78.3% increase in the volume of all orthopaedic
ambulatory surgery procedures. In 2006, as compared with 1996, patients were 2.4  times more likely to have an acromioplasty compared with all other orthopaedic ambulatory procedures (p < 0.0001). Part B revealed that, in 1999, a mean of 2.6  arthroscopic acromioplasties were reported per candidate for Board certification. In 2008 a mean of 6.3 arthroscopic acromioplasties per candidate were reported. Over these ten years, the mean number of arthroscopic acromioplasties reported increased by 142.3%, compared with only a 13.0% increase in the mean number of all orthopaedic surgery procedures. In 2008, as compared with 1999, candidates were 2.2 times more likely to report an arthroscopic acromioplasty compared with all other orthopaedic procedures (p < 0.0001). CONCLUSIONS: There has been a substantial increase in the overall volume and the population-based incidence of  acromioplasties in recent years on both the state and national levels in theUnited States. The reasons for this increase have yet to be determined and are likely multifactorial, with patient-based, surgeon-based, and systems-based factors all playing a role.

17. Scand J Med Sci Sports. 2010 Jul 29.
Sever's injury; treat it with a heel cup: a randomized, crossover study with two  insole alternatives.
Perhamre S, Lundin F, Norlin R, Klässbo M.
Centre of Sports Medicine in Värmland, Karlstad, Sweden.

Sever's injury (apophysitis calcanei) is considered to be the dominant cause of heel pain among children. Common advice is to reduce physical activity. However, our previous study showed that application of insoles reduced pain in Sever's injury without having to reduce physical activity. The purpose of this study was to test which of the two insoles, the heel wedge or the heel cup, provided best pain relief during sport activity in boys with Sever's injury (n=51). There was crossover design in the first randomized part of the study. In the second part,the boys, 9-14 years, chose which insole they preferred. There was a reduction in
odds score for pain to a fifth (a reduction of 80%) for the cup compared with the wedge (P<0.001). When an active choice was made, the heel cup was preferred by >75% of the boys. All boys maintained their high level of physical activity throughout. At 1-year follow-up, 22 boys still used an insole and 19 of them reported its effect on pain as excellent or good (n=41).

18. Phys Ther Sport. 2010 Aug;11(3):99-103. Epub 2010 Jul 24.
Short and mid-term results of a comprehensive treatment program for longstanding  adductor-related groin pain in athletes: a case series.
Weir A, Jansen J, van Keulen J, Mens J, Backx F, Stam H.
The Hague Medical Centre (MCH), Department of Sports Medicine, Burg Banninglaan
1, 2262 BA, Leidschendam, The Netherlands.

OBJECTIVE: To evaluate short and mid-term results of active physical therapy in athletes with longstanding groin pain. DESIGN: Case series. SETTING: Primary care physical therapy practice. PARTICIPANTS: A total of 44 athletes suffering longstanding adductor-related groin pain. INTERVENTION: A combination of passive (joint mobilization) and active (exercises) physical therapy interventions. MAIN  OUTCOME MEASUREMENTS: Return to (the same level of) sports, restriction in sports, and recurrence. RESULTS: Directly after treatment, return to the same level and type of sport was successful in 38 athletes (86%), and without symptoms in 34 athletes (77%). At 6.5-51 months follow up, 10/38 (26%) of those that returned to sports had experienced a relapse; 22 (50%) athletes were able to participate in sports without any restrictions at the mid-term follow-up.
CONCLUSIONS: For athletes with longstanding groin pain, short term results of physical therapy seem positive, whereas mid-term results are moderately positive. The risk for recurrence is high.

19. Dis Mon. 2010 Jul;56(7):414-21.
Skin and soft tissue infections in the athlete.
Decker CF.
Uniformed Services University of the Health Sciences, Division of Infectious
Diseases, Department of Internal Medicine, National Naval Medical Center, Bethesda, Maryland, USA.

20. Br Med Bull. 2010 Aug 14.
Sport injuries: a review of outcomes.
Maffulli N, Longo UG, Gougoulias N, Caine D, Denaro V.
Centre for Sports and Exercise Medicine, Barts and The London School of
Medicine and Dentistry, Mile End Hospital, 275 Bancroft Road, London E1 4DG, UK.

Injuries can counter the beneficial aspects related to sports activities if an athlete is unable to continue to participate because of residual effects of injury. We provide an updated synthesis of existing clinical evidence of long-term follow-up outcome of sports injuries. A systematic computerized literature search was conducted on following databases were accessed: PubMed, Medline, Cochrane, CINAHL and Embase databases. At a young age, injury to the physis can result in limb deformities and leg-length discrepancy. Weight-bearing joints including the hip, knee and ankle are at risk of developing osteoarthritis (OA) in former athletes, after injury or in the presence of malalignment, especially in association with high impact sport. Knee injury is a risk factor for OA. Ankle ligament injuries in athletes result in incomplete recovery (up to 40% at 6 months), and OA in the long term (latency period more than 25 years). Spine pathologies are associated more commonly with certain sports (e.g. wresting, heavy-weight lifting, gymnastics, tennis, soccer). Evolution in arthroscopy allows more accurate assessment of hip, ankle, shoulder, elbow and wrist intra-articular post-traumatic pathologies, and possibly more successful management. Few well-conducted studies are available to establish the long-term follow-up of former athletes. To assess whether benefits from sports participation outweigh the risks, future research should involve questionnaires regarding the health-related quality of life in former athletes, to be compared with the general population.

21. J Sci Med Sport. 2010 Sep;13(5):471-2. Epub 2010 Jul 31.
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