Repair may be Just as Good as Reconstruction

Acute Anterior Cruciate Ligament Rupture: Repair or Reconstruction?

Hoogeslag RAG, Brouwer RW, Boer BC, de Vries AJ, and Huis in ‘t Veld H. Am J Sports Med. 2019. [Epub Ahead of Print].
https://journals.sagepub.com/doi/abs/10.1177/0363546519825878

Take Home Message: People who receive a dynamic augmented anterior cruciate ligament (ACL) repair have similar outcomes to those who receive an ACL reconstruction during the first 2 years after surgery

Many clinicians have discussed the pros and cons of a surgical reconstruction or conservative care for an anterior cruciate ligament (ACL) rupture. In recent years, there has also been a renewed interest in re-assessing suture repair of a ruptured ACL. Therefore, Hoogeslag and colleagues completed a randomized trial to examine patient-reported, clinical, and radiological outcomes among young adults receiving a dynamic augmented ACL repair or ACL reconstruction.

International consensus definitions of video signs of concussion in professional sports.

International consensus definitions of video signs of concussion in professional sports.

Davis GA, Makdissi M, Bloomfield P, Clifton P, Echemendia RJ, Falvey ÉC, Fuller GW, Green G, Harcourt P, Hill T, McGuirk N, Meeuwisse W, Orchard J, Raftery M, Sills AK, Solomon GS, Valadka A, McCrory P. Br J Sports Med. 2019 Apr 6. pii: bjsports-2019-100628. doi: 10.1136/bjsports-2019-100628. [Epub ahead of print]

Full Text is Not Freely Available

Representatives from seven sporting bodies (Australian Football League, Cricket Australia, Major League Baseball, NFL, NHL, National Rugby League, World Rugby) reached consensus on video signs considered most useful in identifying a possible concussion. The key signs were lying motionless, motor incoordination, impact seizure, tonic posturing, no protective action – floppy, and blank/vacant look. These signs are defined in the consensus statement.

View 191 other recent position statements, consensus statements, guidelines, and recommendations related to sports medicine.

SI Dysfunction? Manipulate it, Exercise it, or BOTH

Effectiveness of Exercise Therapy and Manipulation on Sacroiliac Joint Dysfunction: A Randomized Controlled Trial

Nejati P, Safarcherati A, & Karimi F.  Pain Physician. 2019; 22:53-61.

Full Text Freely Available

Take Home Message: Overall, exercise and manipulation may provide early improvements for patients with sacroiliac joint dysfunction. However, patients should be re-evaluated before 6 months to determine treatment plans moving forward since the combination of exercise and manipulation was not better than performing exercise or mobilizations alone after 6 months.

Sacroiliac joint dysfunction is a common cause of low back pain.  While exercise is considered to be effective for generalized low back pain, it remains unclear what is the best way to treat low back pain caused by sacroiliac joint dysfunction.  The authors of this study conducted a randomized controlled trial to evaluate the effectiveness of exercise therapy, manipulation therapy, and exercises + manipulation therapy among people with sacroiliac joint dysfunction.

International Association of Athletics Federations Consensus Statement 2019: Nutrition for Athletics

International Association of Athletics Federations Consensus Statement 2019: Nutrition for Athletics.

Burke LM, Castell LM, Casa DJ, Close GL, Costa RJS, Desbrow B, Halson SL, Lis DM, Melin AK, Peeling P, Saunders PU, Slater GJ, Sygo J, Witard OC, Bermon S, Stellingwerff T. Int J Sport Nutr Exerc Metab. 2019 Apr 5:1-12. doi: 10.1123/ijsnem.2019-0065. [Epub ahead of print]

Full Text is Not Freely Available

The International Association of Athletics Federations released a consensus statement on nutrition for athletics.

View 190 other recent position statements, consensus statements, guidelines, and recommendations related to sports medicine.

Rest Days are Unrelated with Concussion Rates

National Rugby League Match Scheduling and Rate of Concussion

Gardner AJ, Howell DR, Iverson GL. J Sci Med Sport. 2019 [Epub ahead of print]

https://www.ncbi.nlm.nih.gov/pubmed/30885613

Take Home Message: A rugby player was most likely to sustain a concussion during the first rugby match of the year compared with any other match. The number of rest days before a match was unrelated to concussions.

Rugby athletes are at high risk of suffering a concussion during a match. Over the past 12 years in Australia, the National Rugby League (NRL) added matches on Mondays (beginning of 2007 season) and Thursdays (beginning of 2012) rather than just on weekends. The scheduling changes resulted in fewer rest days during the 24-game season. Additionally, the NRL introduced the “concussion interchange rule” at the beginning of the 2014 season to allow for proper concussion medical care. This rule allows for a brief (up to 15 minutes) sideline concussion evaluation to decide if a player has a concussion and should be removed from play or if not then to return without costing the team one of its 12 player interchanges. No one has studied if the decreased rest time is associated with a higher rate of concussion or was more likely to activate the “concussion interchange rule”. Therefore, the authors sought to determine if there was a relationship between pre-match rest days, match location, time of the season, and match outcome with diagnosed concussion and use of the “concussion interchange rule”.

Parents are Open to Age Restrictions for Tackling in Football

Parents’ Perspectives Regarding Age Restriction for Tackling in Youth Football

Chrisman S, Whitlock KB, Kroshus E, Schwien C, Herring SA, Rivara FP. Pediatrics. 2019; 143(5) [Epub ahead of print]. https://pediatrics.aappublications.org/content/early/2019/03/28/peds.2018-2402?sso=1&sso_redirect_count=1&nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3a+No+local+token

Take Home Message: In the United States, the majority of parents (61%) support a minimum age for tackling in football. An additional 24% indicated that they would “maybe” support such an age limit.

In recent years, there have been increasing concerns about the acute and chronic effects of concussive and sub-concussive head impacts that occur during sports. Some sport organizations like US Soccer and USA Hockey have recently implemented age restrictions on heading and checking respectively with marked success with reducing injury in the latter. Despite football being the most popular youth sport for boys, no such age restriction exists for tackling. Furthermore, it is unclear if the public would support such restrictions if they were imposed. Therefore, Chrisman and colleagues surveyed a nationally representative sample of parents with school-aged children to determine the level of national support present for age restrictions on tackling.

Load, Overload, and Recovery in the Athlete: Select Issues for the Team Physician-A Consensus Statement

Load, Overload, and Recovery in the Athlete: Select Issues for the Team Physician-A Consensus Statement.

Med Sci Sports Exerc. 2019 Apr;51(4):821-828. doi: 10.1249/MSS.0000000000001910.

Full Text is Freely Available

The American Academy of Family Physicians, the American Academy of Orthopaedic Surgeons, the American College of Sports, Medicine, the American Medical Society for Sports Medicine, the American Orthopaedic Society for Sports Medicine, and the American Osteopathic Academy of Sports Medicine collaborated to develop a statement on load, overload, and recovery in the athlete. “This document provides an overview of the concepts of load, overload, and recovery, as well as the musculoskeletal and psychosocial issues related to overload injuries and illnesses that are important for the team physician to understand. In addition, understanding the role of wearable devices, technology, and other tools used to measure load, overload, and recovery is important.” The document also addresses intervention strategies.

View 189 other recent position statements, consensus statements, guidelines, and recommendations related to sports medicine.