Diagnostic Ultrasound can Shed Light on Knee Health After an Injury

Ultrasonographic Assessment of Femoral Cartilage in Individuals with Anterior Cruciate Ligament Reconstruction: A Case-Control Study

Harkey MS, Blackburn JT, Nissman D, Davis H, Durrington I, Rizk C, Kuismanen A, & Pietrosimone B.  J Athl Train. 2018; 53(11):2081-1088.  DOI: 10.4085/1062-6050-376-17

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Take Home Message: Diagnostic ultrasound can detect differences in cartilage thickness in a knee with an anterior cruciate ligament reconstruction compared with the uninjured knee and healthy people.

A patient after an anterior cruciate ligament reconstruction (ACLR) is at elevated risk of osteoarthritis.  Unfortunately, we have no treatment options to slow or reverse osteoarthritis progression. Therefore, our best option is to prevent osteoarthritis; but, to prevent osteoarthritis a clinician needs to have ways to detect who will likely develop osteoarthritis after an ACLR.  Diagnostic ultrasound is a clinically accessible method for sports medicine professionals to achieve this goal by observing changes in structures like articular cartilage. The researchers of this study used diagnostic ultrasound to compare anterior femoral cartilage thickness between knees of people with a history of ACLR and between knees with an ACLR or healthy controls.

American Medical Society for Sports Medicine Position Statement on Concussion in Sport

American Medical Society for Sports Medicine Position Statement on Concussion in Sport

Harmon KG, Clugston JR, Dec K, Hainline B, Herring SA, Kane S, Kontos AP, Leddy JJ, McCrea MA, Poddar SK, Putukian M, Wilson JC, Roberts WO. Clin J Sport Med. 2019 Feb 4. doi: 10.1097/JSM.0000000000000720. [Epub ahead of print]

Full Text Freely Available

The American Medical Society for Sports Medicine (AMSSM) has released an update to their 2013 statement on concussion in sport. The document covers who should evaluate and manage sports-related concussion, definition of concussion, pathophysiology, epidemiology, diagnosis of concussion, treatment of sport-related concussion, risks related to concussions, disqualification from sport, prevention, and future research directions.

View 184 other recent position statements, consensus statements, guidelines, and recommendations related to sports medicine.

What Patient-Reported Outcomes Tell Us About Adolescent Athletes

Changes in Patient-Reported Outcome Measures from the Time of Injury to Return to Play in Adolescent Athletes at Secondary Schools with an Athletic Trainer

Simon J, Valier ARS, Kerr ZY, Djoko A, Marshall SW, Dompier TP. J Athl Train. 2019. [Epub ahead of print]

Full Text Freely Available

Take Home Message: Many high school athletes had meaningful improvements on both generic and region-specific patient-reported outcome measures after a lower extremity injury; however, remained below normal scores at return to play.

Return to play is predominantly determined using clinical outcome measures (range of motion, strength, fitness). However, using only clinical outcome measures to determine readiness for return to activity poses a threat for a safe return to activity since these measures fail to assess a patient’s readiness to return from his/her point of view. A clinician can fill this gap by implementing the use of patient-reported outcome measures (generic health quality, injury/region specific). However, research to support the use of patient-reported outcome measures in a high school setting is lacking. Therefore, the authors collected data from 69 athletes from 24 different high schools that suffered a knee, lower leg, ankle, or foot injury.

Availability of Athletic Trainers Matters in the Detection and Management of Sports-Related Concussions

The influence of athletic trainers on the incidence and management of concussion in high school athletes.

McGuine TA, Pfaller AY, Post EG, Hetzel SJ, Brooks A, and Broglio SP. J Athl Training. 2018. 52 (11): 1017-1024.

Full Text Freely Available

Take Home Message: High school athletes with a sports-related concussion are more likely to report and receive post-concussion care in schools with higher availability of an athletic trainer.

Proper reporting and care of sports-related concussion are critical for athletes returning to activity safely. However, these critical steps in concussion management often rely on having access to healthcare professionals. The availability of athletic trainers varies among high schools in the United States and it remains unknown how athletic trainer availability relates to sports-related concussion reporting and management. McGuine and colleagues completed a prospective cohort study to better understand the relationship between the availability of an athletic trainer and the reporting and treatment of sports-related concussion in secondary schools.

Is Lifestyle a Factor for Adolescents with Bony Stress Injuries?

Identifying Factors That Contribute to Adolescent Bony Stress Injuries in Secondary School Athletes: A Comparative Analysis with a Healthy Control Group.

Nussbaum ED, Bjornaraa J, Gatt CJ. Sports Health. 2019 Jan. DOI 10.1177/1941738118824293. [Epub ahead of print]
Text Freely Available

Take Home Message: Adolescent athletes with bony stress injuries are younger, smaller, compete more, sleep less, and are more stressed than their healthy peers.

Almost half of all bony stress injuries occur in individuals under 20 years of age. Clinicians could develop targeted prevention strategies for bony stress injuries in young athletes if they had a better understanding of factors that contribute to these injuries. Therefore, the authors sought to identify factors related to bony stress injuries among adolescents competing in high school sports.

Nationwide Injury Prevention is On Our Side

A Nationwide Follow-Up Survey on the Effectiveness of an Implemented Neuromuscular Training Program to Reduce Acute Knee Injuries in Soccer Players

Aman M, Larsen K, Forssblad M, Nasmark A,Walden M, & Hagglund M.  Orthop J Sports Med. Published online December 2018; DOI: 10.1177/2325967118813841

https://journals.sagepub.com/doi/abs/10.1177/2325967118813841

Take Home Message: The implementation of an injury prevention program nationwide was related to a reduction in knee injuries among soccer players, especially females.

Knee injuries are relatively common in soccer players and can result in considerable time loss. There are many neuromuscular training injury prevention programs, including the Knee Control Program, which reduces the number of ACL injuries among female adolescent soccer players.  Sweden implemented the Knee Control Program nationwide in 2010, which created a great opportunity to study its effectiveness at a national level. Hence, the authors evaluated the effectiveness of this program to reduce acute knee injuries among soccer players at a national level. The authors also assessed the dissemination and implementation of this program. 

Don’t Forget About the Younger Athletes!

Concussion Incidence, Duration, and Return to School and Sport in 5- to 14-Year-Old American Football Athletes

Chrisman SPD, Lowry S, Herring SA, Kroshus E, Hoopes TR, Higgins SK, Rivara FP. J Pediatr. 2018. [Epub ahead of print]

https://www.sciencedirect.com/science/article/pii/S0022347618315865

Take Home Message: Over a 2-year period, 5 out of every 100 youth American football players sustain a concussion, and over half of the youth were still symptomatic 21 days post-concussion.

Over 45 million youth athletes (6 to 17 years of age) participate in organized sport. Brain injuries in this population, particularly at the elementary and middle school levels, can be alarming since there is little medical coverage during their games and practices. Additionally, we know little about whether brain injuries that occur in their developing brain have negative long-term problems. Therefore, researchers collected data on concussion incidence, risk factors, duration of symptoms, and return to school and sport during 2 10-week youth fall football seasons.