Sports Medicine Research: In the Lab & In the Field (Sports Med Res)
Wednesday, March 25, 2015

Bisphosphonate May Protect Against Joint Degeneration in the Short-Term After a Knee Injury

Effects of alendronate on post-traumatic osteoarthritis induced by anterior cruciate ligament rupture in mice.

Khorasani MS, Diko S, Hsia AW, Anderson MJ, Genetos DC, Haudenschild DR and Christiansen BA. Arthritis Res and Therapy. 2015. [Epub Ahead of Print].

Take Home Message: In a mouse model, high-dose injections of alendronate delayed joint damage compared with a low-dose or placebo.

Post-traumatic osteoarthritis (PTOA) is a common, long-term consequence of anterior cruciate ligament (ACL) injury. Unfortunately, there is no approved therapy to prevent or slow the onset of PTOA. Bisphosphonates, like alendronate, are typically used to treat osteoporosis but may also be beneficial in delaying PTOA; however, this is not proven. Therefore, Khorasani and colleagues completed a study to better understand the effectiveness of alendronate in mice with or without an ACL rupture.
Wednesday, March 18, 2015

Altered Joint Health 1 Year Post ACL Reconstruction

Early knee osteoarthritis is evident one year following anterior cruciate ligament reconstruction: A magnetic resonance imaging evaluation

Culvenor AG, Collins NJ, Guermazi A, Cook JL, Vicenzino B, Khan KM, Beck N, van Leeuwen J, & Crossley KM. Arthritis & Rheumatology. Online ahead of print, December 16, 2014.

Take Home Message: There are osteoarthritic changes in knee as early as one year post anterior cruciate ligament reconstruction in both the tibiofemoral and patellofemoral joints.

Over the past few years, Sports Med Res has had multiple posts (see below) regarding anterior cruciate ligament (ACL) injury as a risk factor for early-onset knee osteoarthritis (OA).  Approximately 50% of knees develop radiographic evidence of OA within 10 years after ACL injury. Unfortunately, by the time we see radiographic evidence of OA there’s extensive joint damage. Magnetic resonance imaging (MRI) may be a more sensitive measure to detect earlier OA changes after an ACL injury, which may help us recognize patients to target treatment strategies to slow the onset of more joint damage.  Therefore, the authors of this study wanted to determine knee OA prevalence using MRI among 111 participants 1 year after ACL reconstruction and 20 healthy matched controls.
Monday, March 16, 2015

Don’t Blink. The King-Devick Test: A Rapid, Sideline Visual Assessment Tool to Assist in Detection of Concussion

The King-Devick test for sideline concussion screening in collegiate football

Leong DF, Balcer LJ, Galetta SL, Evans G, Gimre M, Watt D. Journal of Optometry. 2015. doi: 10.1016/j.optom.2014.12.005. [Epub]

Take Home Message: The King-Devick test is a quick and reliable method to assess vision, eye movements, language function, and attention. An athlete with a concussion tends to complete the test slower than his/her preseason assessment while other athletes improve over time. 

With recent attention on the potential consequences associated with concussions there has been an emphasis on rapid and accurate diagnosis of concussions.  This will aid in removal from activity to assist recovery and hopefully prevent athletes from sustaining further head trauma.  The purpose of this article was to assess the validity of the King-Devick test as a sideline concussion assessment among collegiate athletes.
Wednesday, March 11, 2015

Bone Marrow Oedema May Signify Poor Long-Term Outcomes Following an ACL Injury

Anterior cruciate ligament injury: post-traumatic bone marrow oedema correlates with long-term prognosis.

Filardo G, Kon E, Tentoni F, Andriolo L, Di Martino A, Busacca M, Di Matteo B, and Marcacci M. Int Orthop. 2015. [Epub Ahead of Print]

Take Home Message: Knees with bone marrow oedema 3 or more months after an anterior cruciate ligament injury are less likely to return to activity when compared with knees without oedema.

Bone marrow oedema (BME) is commonly seen on magnetic resonance (MR) images among knees with an anterior cruciate ligament (ACL) rupture. In these cases, BME is often referred to as a bone bruise or bone contusion. BME patterns may relate to the mechanism and severity of injury. It remains unclear if BME may be predictive of patient outcomes years after an injury.  Understanding this would help clinicians better communicate the long-term expectations to their patients following an ACL injury. Therefore, Filardo and colleagues completed a retrospective cohort study to assess the relationship between BME shortly after an ACL injury and return to play as well as clinical outcomes at least 5 years after an injury.
Monday, March 9, 2015

Interassociation Recommendations for Developing a Plan to Recognize and Refer Student-Athletes With Psychological Concerns at the Secondary School Level: A Consensus Statement

Interassociation Recommendations for Developing a Plan to Recognize and Refer Student-Athletes With Psychological Concerns at the Secondary School Level: A Consensus Statement

Neal TL, Diamond AB, Goldman S, Liedtka K, Mathis K, Morse ED, Putukian M, Quandt E, Ritter SJ, Sullivan JP, Welzant V. J Athl Train. 2015 Mar 2. [Epub ahead of print]

An international work group that was composed of representative from 8 national organizations and an attorney experienced in sports medicine and health-related litigations have drafted a consensus statement regarding developing a plan to recognize and refer to student athletes with psychological concerns at the secondary school level. “The purpose of this consensus statement is for the reader to take the information provided and develop an appropriate plan for his or her institution to address the psychological concerns of student-athletes as part of a comprehensive sports medicine health care program.” The document includes a concise executive summary, background information and sections related to the recognition of psychological concerns in student-athletes, special considerations that may affect the psychological health of the student-athlete, and referral of the student-athlete for psychological evaluation and care.

Wednesday, March 4, 2015

“Shock”ingly No Improvements in Ankle Sprain Outcomes

Electrical stimulation as a treatment intervention to improve function, edema or pain following acute lateral ankle sprains: A systematic review

Feger MA, Goetschius J, Love H, Saliba SA, & Hertel J. Physical Therapy in Sport. Online ahead of print, January 16 2015.

Take Home Message: There is no evidence to support the use of electrical stimulation after an acute lateral ankle sprain to reduce edema, decrease pain, or improve functional limitations.

Acute lateral ankle sprain treatment commonly includes rest, ice, compression, and elevation, but an earlier Sports Med Res post reported on an article that questioned the evidence behind this common clinical practice.  Electrical stimulation is also sometimes applied in an effort to expedite recovery and help reduce pain and edema; however, little evidence exists to support the use of electrical stimulation for these purposes.  The authors of this systematic review aimed to investigate whether or not there is evidence to support the use of electrical stimulation to facilitate recovery after an acute lateral ankle sprain.
Monday, March 2, 2015

Tau-A Could be a Grade A Concussion Tool for Safe Return To Play

Serum tau fragments predict return to play in concussed professional ice hockey players

Shahim P., Linemann T., Inekci D., Karsdal MA., Blennow K.,Tegner Y., Zetterberg H., Henriksen K. Journal of Neurotrauma. Epub ahead of print.

Take Home Message: The Tau-A biomarker is a potential biomarker to distinguish those at risk for prolonged recovery following a concussion.

Diagnosis and return to play following a concussion rely heavily on subjective information from athletes. Thus, there is a great need to develop an objective tool, such as a blood test, to diagnose and monitor a concussion. Therefore, the authors evaluated professional Swedish ice hockey players to determine the utility of 2 fragments of tau, an intracellular protein in the central nervous system, (tau-A & tau-C) for diagnosis and prognosis of sports-related concussions.