Retorno al deporte recreativo luego de la reparación artroscópica del manguito rotador / Return to sports after arthroscopic rotator cuff repair in recreational athletes

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

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

Progress in evaluation of return to sports after anterior cruciate ligament reconstruction / 中国修复重建外科杂志

OBJECTIVE@#To summarize the evaluation methods of return to sports (RTS) after anterior cruciate ligament reconstruction (ACLR) in recent years, in order to provide reference for clinical practice.@*METHODS@#The literature related to the RTS after ACLR was searched from CNKI, Wanfang, PubMed, and Foreign Medical Information Resources Retrieval Platform (FMRS) databases. The retrieval range was from 2010 to 2023, and 66 papers were finally included for review. The relevant literature was summarized and analyzed from the aspects of RTS time, objective evaluation indicators, and psychological evaluation.@*RESULTS@#RTS is the common desire of patients with ACL injury and doctors, as well as the initial intention of selecting surgery. A reasonable and perfect evaluation method of RTS can not only help patients recover to preoperative exercise level, but also protect patients from re-injury. At present, the main criterion for clinical judgement of RTS is time. It is basically agreed that RTS after 9 months can reduce the re-injury. In addition to time, it is also necessary to test the lower limb muscle strength, jumping, balance, and other aspects of the patient, comprehensively assess the degree of functional recovery and determine the different time of RTS according to the type of exercise. Psychological assessment plays an important role in RTS and has a good clinical predictive effect.@*CONCLUSION@#RTS is one of the research hotspots after ACLR. At present, there are many related evaluation methods, which need to be further optimized by more research to build a comprehensive and standardized evaluation system.

Return to sports WeChat applet for evaluating the rehabilitation effects after anterior cruciate ligament reconstruction / 中国修复重建外科杂志

OBJECTIVE@#To clarify the intervention guidance of return to sports WeChat applet and evaluate the rehabilitation effectiveness after anterior cruciate ligament (ACL) reconstruction.@*METHODS@#Between September 2020 and September 2022, 80 patients who met the selection criteria and underwent ACL anatomical single bundle reconstruction were selected as the research objects. According to the double-blind random method, they were divided into the applet group and the regular group, with 40 cases in each group. Patients in the applet group were rehabilitated under the guidance of the return to sports WeChat applet, and the patients were asked to perform the test once a month after operation, including patients' subjective scores [Tegner score, knee injury and osteoarthritis outcome score (KOOS), International Knee Documentation Committee (IKDC) score, American Hospital for Special Surgery (HSS) score], psychological assessment [ACL recovery sports injury scale (ACL-RSI) score], jumping test, balance test, bending angle test. Patients in the regular group were followed up by doctors and nurses regularly by telephone every month. All the patients were reexamined at 3, 6, 9, and 12 months after operation, and the range of motion of the knee joint with 6 degrees of freedom (flexion and extension angle, varus and valgus angle, internal and external rotation angle, anteroposterior displacement, superior and inferior displacement, and internal and external displacement) recorded by Opti_Knee three-dimensional knee joint motion measurement gait analysis system was observed. The anterior tibial translation difference (ATTD) was measured by Ligs knee measuring instrument when a forward thrust of 120 N was applied to the posterior part of the proximal tibia. Tegner score, IKDC score, KOOS score (including KOOS-Pain score, KOOS-Symptoms score, KOOS-Activities of daily living score, KOOS-Sport score, and KOOS-Quality of life score), HSS score, ACL-RSI score, jumping ability, balance ability, patients' satisfaction with the rehabilitation process, and ACL healing grading according to ACL continuity and signal intensity shown by MRI.@*RESULTS@#There were significant differences in various indicators between different time points after operation in the two groups ( P<0.05). At 3 months after operation, except that the ACL-RSI score of the applet group was significantly higher than that of the regular group ( P<0.05), there was no significant difference in the other indicators between the two groups ( P>0.05). At 6 months after operation, the ACL-RSI score, IKDC score, Tegner score, KOOS scores of different items, HSS score, balance and jumping ability of the applet group were significantly higher than those of the regular group ( P<0.05), and there was no significant difference in the other indicators between the two groups ( P>0.05). At 9 months after operation, there was no significant difference in all indicators between the two groups ( P>0.05). At 12 months after operation, 27 cases (67.5%) in the applet group and 21 cases (52.5%) in the regular group returned to sport, with a significant difference of the return to sports incidence between the two groups [ RR(95% CI)=1.50 (1.00, 2.25), P=0.049]. In the applet group, 27 cases were very satisfied with the rehabilitation process, 10 cases were satisfied, 2 cases were basically satisfied, and 1 case was not satisfied, while 19, 13, 5, and 3 cases in the regular group, respectively. The satisfaction degree of the applet group was significantly better than that of the regular group ( P=0.049). MRI examination of the two groups showed that the ACL was continuous without secondary rupture or necrosis. The ACL healing grade of the applet group was 31 cases of grade 1 and 9 cases of grade 2, and that of the regular group was 28 cases of grade 1 and 12 cases of grade 2, there was no significant difference in ACL healing grade between the two groups ( P=0.449).@*CONCLUSION@#The application of return to sports WeChat applet in the rehabilitation of patients after ACL reconstruction can significantly reduce the fear of return to sports and improve the rate of return to sports. The return to sports WeChat applet is convenient to operate, with high utilization rate and high patient compliance, which significantly improves the satisfaction.

Processos de reflexividade dos psicólogos do esporte e coaches: um estudo fenomenológico / Reflexivity processes of sport psychologists and coaches: a phenomenological study / Procesos de reflexividad de psicólogos del deporte y coaches: un estudio fenomenológico

O objetivo desta pesquisa é identificar e compreender fenomenologicamente, por meio de relato de Psicólogos de Esporte (PE) e de Coaches, em sua vivência prática, como ocorrem os processos reflexivos em sua atuação, conforme apreendidos a partir de relatos de experiências. O método de investigação escolhido foi a fenomenologia, pois oferece os recursos necessários para tal mergulho junto à experiência reflexiva. A amostra intencional foi delineada por PE e Coaches (profissionais de Educação Física que recorrem ao Coaching) em atividade em esportes de alto rendimento, que tenham atuado ou estejam atuando em modalidades esportivas coletivas e/ou individuais. Realizaram-se nove entrevistas (cinco com PE, quatro com Coaches). O acesso ao objeto desse estudo se deu por meio de entrevistas em profundidade e semiestruturadas, orientadas pela escuta suspensiva. As questões disparadoras foram formuladas com base no Procedimento Estruturado de Reflexão adaptado. Para análise das entrevistas, realizou-se uma síntese de cada relato, seguindo-se de cruzamento intencional. Como resultados, percebeu-se que PE e Coaches trazem algumas similaridades no que se refere aos modos de refletir sobre sua prática. No entanto, as experiências que eles fazem desses processos reflexivos é que podem tomar rumos distintos. Os(as) PE amparam-se na regulamentação da profissão e resguardam-se em seus apontamentos, trazendo suas experiências e reflexões sobre os processos vividos. Os(as) Coaches trazem em suas explanações um trabalho coerente, organizado e compatível com o método do Coaching. Problematizar os processos reflexivos desses profissionais permite diferenciar qualitativa e eticamente suas atuações, possibilitando o fomento multiprofissional no esporte.(AU)

The aim of this study consists in phenomenologically identifying and understanding, by the report of Sport Psychologists (SP) and coaches, in their practical experience, how would be the reflexive processes that take place in their performance, as learned from reports of their experiences. The research method chosen was phenomenology, since it offers the necessary resources for such a dive along with the reflective experience. The intentional sample was outlined by SP and coaches (Physical Education professionals who use coaching) active in high performance sports, who have or are working in collective and/or individual sports. Nine interviews were conducted (five with SP, four with coaches). Access to the object of this study took place by in-depth and semi-structured interviews, guided by suspensive listening. The triggering questions were formulated based on the adapted Structured Reflection Procedure. For the analysis of the interviews, a synthesis of each report was carried out, followed by the intentional crossing. As results, it was noticed that SP and coaches bring some similarities regarding the ways of reflecting on their practice. However, their experiences of these reflective processes are that they can take different directions. The SP are based on the regulation of the profession and guard themselves in their notes, bringing their experiences and reflections on the processes experienced. Coaches bring in their explanations a coherent, organized, and compatible work with the coaching method. Problematizing the reflective processes of these professionals allows to differentiate their actuation qualitatively and ethically, making the multiprofessional phenomenon in sport possible.(AU)

El objetivo de este estudio consiste en identificar y comprender fenomenológicamente, a partir de la experiencia práctica de psicólogos del deporte (PD) y coaches, cómo serían los procesos reflexivos que se llevan a cabo en su rendimiento, tal y como se desprende de los informes de experiencias. El método de investigación elegido fue la fenomenología, ya que ofrece los recursos necesarios junto con la experiencia. La muestra intencional fue delineada por PD y coaches (profesionales de la educación física que utilizan el coaching) activos en deportes de alto rendimiento, que tienen o están trabajando en deportes colectivos e/o individuales. Se realizaron nueve entrevistas (cinco con PD, cuatro con coaches). El acceso al objeto de este estudio fue entrevistas en profundidad y semiestructuradas, guiadas por escuchas suspensivas. Las preguntas se formularon desde el procedimiento de reflexión estructurado adaptado. Para el análisis de las entrevistas, se hizo una síntesis de cada informe, seguida del cruce intencional. Como resultados, se notó que los PD y coaches tienen algunas similitudes con respecto a las formas de reflexionar sobre su práctica. Sin embargo, las experiencias que hacen de estos procesos pueden tomar diferentes direcciones. Los(las) PD se basan en la regulación de la profesión y se protegen en sus notas, aportando sus experiencias y reflexiones sobre los procesos vividos. Los(las) coaches plantean en sus explicaciones un trabajo coherente, organizado y compatible con el método de Coaching. Problematizar los procesos reflexivos de estos profesionales permite diferenciar sus acciones de manera cualitativa y ética, además de posibilitar la promoción multiprofesional en el deporte.(AU)

Sutura meniscal en deportistas: análisis de fallas y retorno al deporte / Meniscal suture in athletes: Failure analysis and return to Sport

Introducción: La sutura meniscal es una técnica cada vez más utilizada en pacientes con lesiones meniscales, con buenos resultados en la población general. Sin embargo, los estudios realizados en pacientes deportistas son escasos. Se analizaron las fallas de la sutura meniscal y el retorno al deporte en pacientes deportistas, y se identificaron posibles factores asociados. Materiales y Métodos: Se evaluaron retrospectivamente 61 suturas meniscales en deportistas (puntaje de Tegner ≥6) con un seguimiento mínimo de 12 meses. Cuarenta y nueve eran lesiones aisladas y 12 se asociaban con plástica del ligamento cruzado anterior. El seguimiento promedio fue de 61 meses y los pacientes fueron evaluados con los puntajes de Tegner y de Lysholm. Resultados: Se constató la falla de la sutura meniscal en 12 (19,67%) pacientes; la falla ocurrió, en promedio, 14 meses poscirugía. Nueve fallas se produjeron en suturas aisladas y 3 se asociaron con plástica del ligamento cruzado anterior (p <0,05). El menisco que más falló fue el interno. El 75% corresponde a pacientes que practicaban un deporte de contacto y pivote (p <0,05). Los pacientes que no sufrieron falla pudieron continuar con la misma actividad deportiva que antes de la lesión y el puntaje de Lysholm había mejorado significativamente (p <0,05). Conclusiones: Las fallas fueron significativamente más frecuentes en meniscos internos, suturas aisladas, lesiones en asa de balde, y deportes de contacto y pivote. Consideramos que la sutura meniscal es una excelente opción quirúrgica para pacientes deportistas, ya que un alto porcentaje de ellos retorna al deporte. Nivel de Evidencia: IV

Introduction: Meniscal suturing is a technique increasingly used in patients with meniscal lesions, with good outcomes in the general population. However, research on athletes is limited. Meniscal suture failures and return to sport in athletes were analy-zed, and possible contributing factors were identified. Materials and Methods: Sixty-one meniscal sutures in athletes (Tegner score ≥6) with a minimum follow-up of 12 months were retrospectively evaluated. Forty-nine were isolated lesions and 12 were associated with anterior cruciate ligament reconstruction. The average follow-up was 61 months and patients were evaluated with Tegner and Lysholm scores. Results: Meniscal suture failure was noted in 12 (19.67%) patients; failure occurred, on average, 14 months post-surgery. Nine failures occurred in isolated sutures and 3 were associated with anterior cruciate ligament recons-truction (p<0.05). The meniscus that failed the most was the internal meniscus. Seventy-five percent corresponded to patients who practiced pivot-contact sports (p<0.05). Patients who did not suffer failure were able to continue with the same sporting activity as before the injury and the Lysholm score had significantly improved (p<0.05). Conclusions: Failures were significantly more frequent in internal menisci, isolated sutures, bucket-handle injuries, and pivot-contact sports. We believe that meniscal suture is an excellent surgical option for athletic patients because a high percentage of them return to sports. Level of Evidence: IV

A disciplina psicologia do esporte nos cursos de psicologia e educação física / Sports psychology in psychology and physical education courses / La materia psicología del deporte en los cursos de psicología y educación física

Este discute a representatividade da disciplina Psicologia do Esporte nos cursos de Psicologia e Educação Física em instituições de ensino superior reconhecidas pelo MEC e situadas na região Sul do país. Foi realizado um estudo documental, com base nos currículos das Instituições. Os resultados revelaram que no Sul do Brasil 21,02% dos cursos de Psicologia, 41,96% dos cursos de bacharelado em Educação Física e apenas 14,83% dos cursos de licenciatura em Educação Física apresentam a disciplina Psicologia do Esporte em sua grade curricular. Observou-se que a disciplina é ofertada mais frequentemente em regime obrigatório nos cursos de bacharelado em Educação Física. Nos cursos de Psicologia, quando ofertada, costuma ser optativa. Os resultados evidenciam uma maior oferta da disciplina para os estudantes de Educação Física, em relação aos de Psicologia, o que pode estar relacionado ao próprio contexto de surgimento da disciplina e sua popularização no meio acadêmico. Para que esse panorama possa mudar e se possa oferecer uma formação adequada no curso de Psicologia para fomentar essa opção de carreira, há necessidade de se repensar o currículo e o próprio perfil do egresso, de forma a dar mais oportunidade aos estudantes para que conheçam as bases teóricas e os campos de aplicação da Psicologia do Esporte. Tal lacuna pode acarretar a fragilização da disseminação desse conhecimento aos estudantes de graduação e a consequente ocupação do mercado de trabalho.(AU)

This study discusses the representativeness of Sports Psychology in Psychology and Physical Education courses at higher education institutions from Southern Brazil. A documentary study was conducted based on the institutions' curricula. Results show that 21.02% of the Psychology major, 41.96% of the bachelor's in Physical Education, and only 14.83% of the license in Physical Education offer Sports Psychology in their curricula. Sports Psychology is most often offered as a compulsory subject in the bachelor's program in Physical Education, whereas Psychology courses offer it mainly as an elective. Physical Education students have greater contact with the discipline when compared with Psychology students, which may be explained by its context of development and popularization in the academic environment. To change this scenario and offer adequate education in the Psychology programs to foster this career option, institutions must rethink their curriculum and the graduate profile itself. This would give students better opportunity to get to know its theoretical bases and fields of application. Such a gap can hinder the dissemination of this knowledge to undergraduate students and the consequent labor market occupation.(AU)

El objetivo de este estudio es discutir la representatividad de la materia Psicología del Deporte en los cursos de Psicología y Educación Física en instituciones de educación superior de la región Sur de Brasil, reconocidas por el Ministerio de Educación (MEC). Se realizó un estudio documental, basado en los planes de estudio de las instituciones. Los resultados revelaron que, en el Sur de Brasil, el 21,02% de los cursos de Psicología, el 41,96% de los cursos de licenciatura en Educación Física y sólo el 14,83% de los cursos de profesorado en Educación tienen la materia Psicología del Deporte en sus planes de estudio. Se observó que la materia Psicología del Deporte se ofrece con mayor frecuencia como asignatura obligatoria en los cursos de licenciatura en Educación Física. Cuando se ofrece en los cursos de Psicología, es una materia optativa. Los resultados muestran una mayor oferta para los estudiantes de Educación Física en comparación con Psicología, lo que puede estar relacionado con el contexto del surgimiento de la Psicología del Deporte como materia y su popularización en el ámbito académico. Para que este escenario cambie y sea posible ofrecer una formación adecuada en el curso de Psicología con el fin de fomentar esta opción de carrera, es necesario repensar el plan de estudios y el perfil del egresado, así los estudiantes tendrán más oportunidades de conocer sus bases teóricas y sus campos de actuación. Tal brecha puede debilitar la difusión de este conocimiento a los estudiantes de grado y la consecuente ocupación en el mercado laboral.(AU)

Gordura corporal, índice de massa corporal e intensidade da atividade física de acordo com transporte ativo e a prática esportiva em escolares. Um estudo transversal / Body fat, body mass index and physical activity intensity according to active transport and sports practice in schoolchildren. A cross-sectional study

Contexto: A obesidade infantil ocasiona diversas doenças e uma das formas para combatê-la é a atividade física, que exerce um papel fundamental. Objetivo: Comparar as diferentes intensidades da atividade física mensurada objetivamente de acordo com o transporte ativo, a prática de esportes e as atividades físicas estruturadas e seu impacto na gordura corporal e índice de massa corporal (IMC) em escolares. Desenho e local: Estudo transversal de amostra por critério de conveniência, realizado em São Caetano do Sul pelo Centro de Estudos do Laboratório de Aptidão Física de São Caetano do Sul (CELAFISCS). Métodos: Foram avaliadas um total de 584 crianças (277 meninos) que atenderam aos critérios de inclusão. A amostra foi dividida em grupos segundo o transporte (ativo e passivo) e a prática esportiva (sim e não). Para análise estatística foi utilizado o teste t Student e o teste U de Mann-Whitney. Para o ajuste das variáveis foi utilizada a análise de covariância (ANCOVA). Resultados: Os meninos demonstraram que, independentemente do tempo de transporte, há efeito do tipo do transporte sobre a atividade física (AF) durante a semana, de intensidade moderada, moderada-vigorosa, AF durante o final de semana de intensidade moderada, moderada-vigorosa e vigorosa. As meninas demonstraram efeito do tipo de transporte sobre a AF durante a semana na AF de intensidade moderada e de intensidade moderada-vigorosa. A gordura corporal e o IMC não apresentaram diferenças entre os grupos. As práticas esportivas não tiveram diferenças significativas em nenhuma das variáveis. Conclusões: O transporte ativo atingiu os níveis de intensidade moderada, moderada-vigorosa durante a semana, tanto no masculino como no feminino. No final de semana, além dessas, a intensidade vigorosa foi encontrada nos meninos.

Retorno deportivo al mismo nivel en reconstrucciones del ligamento cruzado anterior. Utilidad de los criterios de alta con seguimiento de cinco años / Return-to-sport in ACL reconstruction

El tratamiento de las roturas de LCA debe considerar el retorno deportivo y la ausencia de complicaciones. El alta médica debe contemplar seis criterios: Desaparición de signos y síntomas, protocolo de rehabilitación completo, imágenes de RMN, evaluación isocinética, hop test y score psicológico ACL-RSI. Se analizó la relación entre el cumplimiento de las pruebas y el retorno deportivo al mismo nivel, complicaciones posoperatorias y score ACL-RSI a cinco años desde el alta. Se incluyeron pacientes que recibieron el alta entre julio y diciembre de 2017. Se otorgó el alta con tres de los seis criterios, registrando los resultados de los tres restantes. Se registró la incidencia de complicaciones, retorno deportivo a los 24 meses y al finalizar el seguimiento, score ACL RSI al finalizar el seguimiento. La muestra fue de 32 pacientes. El seguimiento fue de 53,2 meses. El retorno deportivo al mismo nivel fue del 65,7%. Considerando los seis criterios, el alta se hubiera otorgado al 53,1% de la muestra, y el retorno al mismo nivel hubiera sido del 94,1%. Un paciente sufrió re rotura y dos pacientes lesiones meniscales. Al finalizar el seguimiento el score ACL-RSI se encontró por debajo de 70 puntos en 43% de los pacientes, quienes mantuvieron su nivel deportivo en un 16,7%. La utilización de los seis criterios de alta predice aceptablemente el retorno y nivel deportivo de los pacientes. La confianza y nivel deportivo de los pacientes tienden a descender a lo largo del tiempo

Treatment of ACL injuries should consider return to play and absence of complications. Return to sports indication comprises 6 criteria: absence of signs and symptoms, complete rehabilitation protocol, MRI images, isokinetic testing, hop test and psychological ACL RSI score. The relationship between passing RTS tests and returning to play at same level was analyzed, as well as posop complications and ACL RSI score at 5 years follow up. Patients who were discharged between July and December 2017 were included. Discharge was granted with 3 of the 6 criteria, recording the results of the remaining 3. The incidence of complications, return to sport at 24 months and at the end of follow-up, ACL RSI score at end of follow-up were recorded. The sample was 32 patients. Follow-up was 53.2 months. The sports return at the same level was 65.7%. Considering the 6 criteria, discharge would have been granted to 53.1% of the sample, and return to the same level would have been 94.1%. One patient suffered re-rupture and two patients suffered meniscal injuries. At the end of the follow-up, the ACL-RSI score was below 70points in 43% of the patients, who maintained their sporting level in 16.7%. The use of the 6 discharge criterio acceptably predicts return and sports level of the patients. The confidence and sports level of patients tend to decrease over time

Luxación tibioperonea proximal. Tratamiento con fijación interna dinámica. Reporte de un caso y revisión bibliográfica / Proximal tibiofibular dislocation. Dynamic internal fixation. Case report and bibliographic revision

Presentamos el caso clínico de un paciente de cuarenta y un años que ingresa por guardia con dolor agudo de rodilla luego de un traumatismo deportivo (practicando fútbol). Se diagnosticó luxación de la articulación tibioperonea proximal. El tratamiento elegido fue quirúrgico mediante fijación dinámica de la articulación tibioperonea proximal con buena evolución y retorno a la actividad deportiva. Realizamos una búsqueda bibliográfica sobre las últimas publicaciones de dicha patología y sus tratamientos. La luxación de esta articulación proximal es una patología infrecuente y requiere de su sospecha para realizar el diagnóstico inicial. La fijación interna dinámica es una opción de tratamiento válida. Nivel de Evidencia: IV

We present the clinical case of a forty-one-year-old patient who was admitted with acute knee pain after a sports injury (playing football). A diagnosis of dislocation of the proximal tibiofibular joint was made. Surgical treatment was performed by means of dynamic fixation of the superior tibiofibular joint with good evolution and return to sports activity. We carry out a search on the latest publications presented on this pathology and its treatments. The dislocation of the proximal tibiofibular joint is an infrequent pathology and requires its suspicion to make the initial diagnosis. Dynamic internal fixation is a valid treatment option. Level of Evidence: IV

Ergometría en el entrenamiento de alto rendimiento cubano / Ergometry in cuban high performance training

Introducción: El Centro de Investigaciones del Deporte Cubano, en estrecha relación con el Instituto de Medicina Deportiva, ha realizado en el Área de control cardiorrespiratorio numerosas pruebas funcionales a los deportistas de alto rendimiento. Como parte del control médico a los deportistas, se han ejecutado pruebas ergométricas cardiopulmonares en el laboratorio, con la novedad de ajustarse los protocolos a las necesidades especiales del atleta en función de su modalidad deportiva. Objetivos: Fundamentar la importancia de la ergometría cardiovascular para el entrenamiento deportivo y rediseñar protocolos de ergometría deportiva acordes a las especificidades de la modalidad atlética. Métodos: Se realizó un estudio descriptivo, longitudinal, en el periodo entre noviembre de 2019 y febrero de 2020. Muestra selectiva intencional, todos los deportistas de los equipos nacionales en cada modalidad: judo, boxeo y luchas (libre y grecorromana). Resultados: Se rediseñaron los protocolos de ergometría sobre la base de los convencionales estandarizados en medicina deportiva, para judo, boxeo y lucha. Se obtuvieron parámetros óptimos (frecuencia cardíaca, volumen máximo de oxígeno y equivalente metabólico) para cada modalidad deportiva. Conclusiones: Las pruebas ergoespirométricas constituyen una herramienta científica útil en la medicina deportiva. Rediseñar protocolos ergométricos permite una mejor valoración funcional del atleta y proporciona un adecuado soporte científico al entrenamiento individual. La ergometría cardiopulmonar es un instrumento disponible para evaluar, recuperar y mejorar las capacidades funcionales y deportivas de los atletas de alto rendimiento, especialmente en la etapa pos-COVID-19(AU)

Introduction: The Cuban Sports Research Center, in close relationship with the Institute of Sports Medicine, has carried out numerous functional tests on high-performance athletes for cardiorespiratory monitoring. As part of the medical control of athletes, cardiopulmonary ergometric tests have been carried out in the laboratory, with the novelty of adjusting the protocols to the special needs of the athlete depending on their sports modality. Objectives: To demonstrate the importance of cardiovascular exercise testing for sports training and to redesign sports exercise testing protocols according to the specificities of the athletic modality. Methods: A descriptive, longitudinal study was carried out from November 2019 to February 2020. Intentional selective sample, all the athletes of the national teams in each modality such as judo, boxing and wrestling. Results: The ergometry protocols were redesigned based on the conventional standardized in sports medicine, for judo, boxing and wrestling. Optimal parameters, as heart rate, maximum oxygen volume and metabolic equivalent, were obtained for each sports modality. Conclusions: Ergospirometric tests are a useful scientific tool in sports medicine. Redesigning ergometric protocols allows better functional assessment of the athletes and provides adequate scientific support for individual training. Cardiopulmonary ergometry is an instrument available to evaluate, recover and improve the functional and sports capacities of high-performance athletes, especially in the post-COVID-19 stage(AU)

Return to Sports After High Tibial Osteotomy Using the Opening Wedge Technique / Retorno ao esporte após osteotomia tibial alta com método de cunha de abertura

Abstract Objective The present paper evaluates the resuming of physical activities by young, active patients who practiced some sport modality and underwent a high tibial osteotomy (HTO) using the opening wedge technique. Methods A total of 12 patients submitted to HTO using the opening wedge technique were prospectively analyzed. All patients were not playing sports at that time. Pre- and postoperative Lysholm and International Knee Documentation Committee (IKDC) scores, visual analog scale for pain and performance level were compared. The average follow-up time was of 12 months. Results One patient resumed sporting activities at a performance level significantly lower compared to the preoperative level, while eight patients returned at a slightly below level, two returned at the same level and one patient returned at a higher level in comparison with the preoperative period. Conclusion For isolated medial osteoarthrosis treatment, HTO using the opening wedge technique has favorable clinical and functional results, allowing patients to resume their sporting activities.

Resumo Objetivo Avaliar o retorno ao esporte em pacientes jovens e ativos praticantes de alguma modalidade esportiva submetidos a osteotomia tibial alta (OTA) com o método de cunha de abertura. Métodos Foram analisados prospectivamente 12 pacientes submetidos ao procedimento de OTA utilizando-se método de cunha de abertura. Todos os pacientes estavam afastados do esporte. Foram utilizados os escores Lysholm, questionário International Knee Documentation Committee (IKDC, na sigla em inglês), escala analógica de dor e nível de retorno em comparação ao período pré-operatório. O tempo médio de seguimento foi de 12 meses. Resultados Um paciente retornou ao esporte em nível muito abaixo do pré-operatório, oito pacientes retornaram em nível pouco abaixo, dois pacientes retornaram no mesmo nível e um paciente retornou em nível acima. Conclusão A OTA com uso do método de cunha de adição como forma de tratamento para osteoartrose medial isolada demonstra resultados clínicos e funcionais favoráveis e permite o retorno ao esporte.

Lesiones del ligamento cruzado anterior en esquiadores: conceptos actuales / Anterior cruciate ligament injuries in skiers: current concepts

El esquí es un deporte individual con una tasa de lesiones de 1,84 por 1.000 días esquiador en la población general. Las roturas del ligamento cruzado anterior (LCA) son algunas de las más comunes, llegando a una tasa de 5 por cada 100 esquiadores por temporada a nivel competitivo, debido a la gran exigencia a la que se encuentran sometidas las rodillas. Lo anterior presenta un desafío para el traumatólogo a la hora de plantear un manejo. Se realizó una revisión de la literatura respecto de los mecanismos de lesión, tratamiento, prevención, rehabilitación y uso de órtesis en el retorno deportivo. Se describen los mecanismos clásicos de lesión en esquiadores amateurs y competitivos. La mayoría de las lesiones de LCA son de resolución quirúrgica, en que la recomendación de reconstrucción debe ser con injerto autólogo de hueso-tendón patelar-hueso, salvo en los pacientes mayores o en pacientes con fisis abierta, en los que se recomienda el uso de injerto autólogo de semitendinoso-gracilis. La prevención y rehabilitación se basan en mejorar la fuerza y el control neuromuscular de los estabilizadores dinámicos de la rodilla implementándose programas específicos, evaluación del gesto deportivo, y pruebas de control neuromuscular. Se recomienda el uso de órtesis funcionales adecuadas en los pacientes sometidos a reconstrucción del LCA. Las lesiones de LCA en esquiadores de nivel competitivo son habituales, de manejo específico y multidisciplinario. La elección del injerto y del tipo de rehabilitación son fundamentales en el retorno deportivo del esquiador. NIVEL DE EVIDENCIA: V.

Skiing is an individual sport with an injury rate of 1.84 per 1,000 skier days among the general population. Anterior cruciate ligament (ACL) tears are among the most common injuries in skiers, with a rate of 5 per 100 skiers per season at a competitive level, because of the great demand placed on the knees. Their treatment is a challenge for orthopedic surgeons. A review of the literature was carried out regarding injury mechanisms, treatment, prevention, rehabilitation, and the use of bracing in the return to sports. The classic injury mechanisms in amateur and competitive skiers are described. Most ACL injuries require surgical resolution, with reconstruction using autologous bone-patellar tendon-bone graft, except in older patients or those with open physis, who must receive an autologous semitendinosusgracilis graft. Prevention and rehabilitation are based on improving strength and neuromuscular control of the dynamic knee stabilizers, implementing specific programs, evaluating the sport movements, and performing neuromuscular control tests. Suitable functional bracings are recommended in patients undergoing ACL reconstruction. ACL injuries in competitive-level skiers are common, and their management is specific and multidisciplinary. The choice of graft and rehabilitation type is critical to resume skiing. LEVEL OF EVIDENCE: V.

Artroscopia bilateral de rodilla en un solo tiempo quirúrgico, ¿es una opción segura? / Is single-stage bilateral knee arthroscopy a safe option?

Introducción: La artroscopia bilateral de rodilla en un solo tiempo quirúrgico permite cursar un solo posoperatorio y una única rehabilitación. El objetivo de este estudio fue evaluar los resultados clínico-funcionales y el tiempo hasta el retorno laboral y deportivo en una serie de pacientes sometidos a una artroscopia bilateral en un solo tiempo quirúrgico. materiales y métodos: Se evaluó a una serie retrospectiva de pacientes desde abril de 2016 hasta abril de 2019, que fueron sometidos a una artroscopia bi-lateral de rodilla en un solo tiempo quirúrgico. Se analizaron los resultados clínico-funcionales a corto y mediano plazo, y el tiempo para el retorno laboral y deportivo. Resultados: La edad promedio fue de 41 años (rango 18-63). El seguimiento promedio fue de 18 meses (rango 6-37). Los tiempos de anestesia y quirúrgico promedio fueron 105 min (rango 60-170) y 85 min (rango 50-150), respectivamente. El tiempo promedio para el retorno laboral fue de 2 meses (rango 1-5). Todos los pacientes recuperaron el rango completo de movilidad articular. Conclusiones: Si bien se han obtenido buenos resultados clínicos con la artroscopia bilateral de rodilla en un solo tiempo, en pacientes seleccionados, no se pueden establecer comparaciones ni conclusiones relevantes debido a la baja casuística y a la gran diversidad de las cirugías realizadas. La principal ventaja radicaría en evitar procedimientos en dos tiempos quirúrgicos, lo que implicaría dos operaciones, dos anestesias y dos programas de rehabilitación diferentes. Nivel de Evidencia: IV

Introduction: Single-stage bilateral arthroscopic surgery allows the patient to undergo a single postoperative and rehabilitation period. The aim of this article was to evaluate the functional-clinical outcomes and time to return to work and sports in a series of patients who had undergone single-stage bilateral arthroscopy. Materials and Methods: We evaluated a retrospective series of patients who had undergone single-stage bilateral knee arthroscopy from April 2016 to April 2019. Short- and medium-term clinical-functional outcomes, and time to return to work and sports were analyzed. Results: The average age of the patients was 41 years (range 18 - 63), with an average follow-up of 18 months (6-37). The average anesthesia time was 105 minutes (range 60 - 170) and the average surgical time was 85 minutes (50 to 150). The average time to return to work was 2 months (range 1-5). Joint range of motion was fully recovered in all patients. Conclusion: Although single-stage bilateral arthroscopy has shown good clinical outcomes in selected patients, no relevant comparisons or conclusions can be established due to the low casuistry and the great diversity of the surgeries performed. The main advantage would be in avoiding procedures in two surgical stages, which would imply two operations, twice the anesthesia and two different rehabilitation programs. Level of Evidence: IV

Retorno al deporte luego de una cirugía de Latarjet: revisión sistemática de la bibliografía / Return to sports after Latarjet surgery: Systematic literature review

Introducción: El objetivo de este estudio fue describir las tasas de retorno al deporte y el nivel alcanzado por los pacientes con inestabilidad de hombro luego del procedimiento abierto y artroscópico de Latarjet. materiales y métodos:Seguimos un protocolo prespecificado y registrado en PROSPERO. Evaluamos la calidad de los estudios y utilizamos el sistema GRADE para evaluar la calidad general de la evidencia obtenida en los resultados. Incluimos estudios que evalúan el retorno al deporte de los pacientes luego de una cirugía de Latarjet con un seguimiento mínimo de 2 años. Resultados: Se incluyeron 24 estudios, con 1436 atletas, todos con cirugía y un seguimiento promedio de 57 meses (rango 24-240). La tasa general de retorno al deporte varió del 65% al 100% de los pacientes, de ellos, el 23-100% retornó al mismo nivel. El tiempo promedio de retorno al deporte fue de 6 meses (rango 1-36). El nivel de evidencia fue bajo debido a las características de los estudios incluidos (nivel de evidencia IV), las limitaciones de los estudios y sus inconsistencias. Conclusiones: La mayoría de los atletas con luxación recidivante de hombro sometidos a una cirugía de Latarjet retoman la práctica deportiva; sin embargo, el nivel alcanzado varía sustancialmente. El tiempo promedio de retorno al deporte fue de 6 meses, y no hubo diferencias significativas entre los deportistas competitivos y recreacionales. Nivel de Evidencia: IV

background: The purpose of this study was to describe rates of return to sports and the level achieved by patients after a Latarjet procedure.methods: We followed a protocol registered in PROSPERO (registration number CRD42018107606). A literature search was performed in May 2019 in MEDLINE, EMBASE, CENTRAL and clinical trials records. We used the GRADE approach for the assessment of the overall quality of the evidence per outcome. We included studies (evidence level I to IV) evaluating return to sports following shoulder stabilization with the Latarjet procedure with a minimum of 2-year follow-up. Results: We included 24 studies, including 1436 athletes, all treated surgically after an average follow-up of 57 months (range 24 to 240). The overall rate of return to sport ranged from 65% to 100%, including 23% to 100% at an equivalent level of play. The average time for return to sport was 6 months (range, 1 - 36 months). Competitive athletes appeared to return to the same level of competition and this difference was not statistically significant (p = 0.32). The quality of the evidence was very low due to study design (evidence level IV), study limitations and inconsistency. Conclusion: Most athletes with glenohumeral instability returned to sport, however the level maintained after shoulder stabilization with the Latarjet procedure varied substantially. The average time to return to sports was 6 months and results were equally favorable in competitive and recreational athletes

Satisfacción y retorno deportivo luego de tratamiento artroscópico del síndrome de fricción femoroacetabular / Satisfaction and return-to-sport after arthroscopic treatment of femoroacetabular impingement syndrome

Introducción: El síndrome de fricción femoroacetabular (SFFA) es frecuentemente diagnosticado en atletas que participan en deportes con súbitos cambios de dirección como fútbol, básquet, tenis y en otras actividades con rangos suprafisiológicos de movimiento, como el ballet o yoga. El objetivo del presente estudio es evaluar el retorno al deporte de los pacientes a los que se les realizó una artroscopía de cadera como tratamiento del SFFA. Materiales y métodos: se incluyeron pacientes que realizaban deportes antes de la cirugía y que fueron tratados mediante una artroscopía de cadera por diagnóstico de SFFA, con un seguimiento mínimo de dos años. Todos fueron evaluados mediante una encuesta escrita acerca del deporte que realizaban, el tiempo de retorno a la práctica, en qué nivel competitivo la llevaban a cabo y la satisfacción con la cirugía. Se evaluaron los scores mediante Harris Hip Score modificado (mHHS) y la escala de Tegner antes y después de la cirugía. Resultados: se evaluaron ciento cuatro artroscopías de cadera, con seguimiento promedio de 29.4 meses (rango 24 ­ 46), en cuarenta y cinco (43.3%) mujeres y cincuenta y nueve (56.7%) hombres. Observamos que noventa y seis (92.3%) pacientes fueron capaces de retornar a su actividad deportiva con una media de 4.7 meses (rango 2-9). Ocho (7.7%) pacientes no pudieron retornar al deporte luego de la cirugía. Del total de la muestra, el 95.2% refirió estar conforme con la cirugía. Las puntuaciones del mHHS mostraron un incremento estadísticamente significativo (69.2 ± 4.8 versus 87.5 ± 4.4; p <0.05). No hubo diferencias estadísticamente significativas con los puntajes observados en la escala de actividad de Tegner (6.6 ± 0.9 versus 6.3 ± 1; p >0.05). Discusión: previamente se ha documentado en la literatura que la mayoría de los pacientes que realizan actividad deportiva recreacional, y que fueron sometidos a una artroscopía de cadera por presentar SFFA, pueden retornar a su actividad deportiva previa y presentan un alto índice de satisfacción postoperatoria. Nuestros resultados se condicen con la bibliografía.Conclusión: el tratamiento artroscópico del SFFA, en pacientes que realizan deportes de forma recreacional, brinda una tasa elevada (>90%) de satisfacción, de retorno a la práctica y a un nivel similar al que presentaban antes de la cirugía

Introduction: The aim of this study was to assess return to sport of patients after hip arthroscopy for treatment of femoroacetabular impingement syndrome (FAI). Materials and Methods: patients with sports activity prior to surgery and who underwent hip arthroscopy due to FAI syndrome, with minimum follow-up of two years were included. All patients had to complete a written survey about type of sports they performed, sports return, competition level and satisfaction with surgery. Modified Harris Hip Score (mHHS) was assessed, and level of sport activity was registered, according to Tegner's Activity Scale.Results: one hundred and four hip arthroscopies were available for full analysis with minimum follow-up of 29.4 (24 ­ 46) months. We observed ninety-six (92.3%) patients were able to return to same prior sports activity at a mean of 4.7 (range 2 ­ 9) months. Eight (7.7%) patients were unable to return to sports after surgery. 95.2% reported agreement with hip surgery. mHHS score showed an statistically significant increase after surgery (69.2 ± 4.8 versus 87.5 ± 4.4; p <0.05). There was no significant difference in Tegner's Activity Scale. Discussion: several authors sustain that patients with recreational sports activity who underwent hip arthroscopy for FAI syndrome, achieve excellent outcomes, and able to return to their prior level of competition with a high rate of satisfaction. Our results are similar, according with literature. Conclusion: FAI treatment with arthroscopy achieves high rates of satisfaction and sports return, with similar competition level before surgery

Revisión de ligamento cruzado anterior aislado o asociado a plástica extraarticular lateral. Estudio comparativo de treinta y seis casos / ACL revision with and without a lateral extra-articular reconstruction. Comparative study of thirty-six cases

Introducción: El objetivo primario de nuestro trabajo es analizar los resultados funcionales y retorno deportivo de una serie de pacientes operados de revisión de LCA aislado y aquellos en quien se asoció una plástica extraarticular lateral (PEAL). Como objetivo secundario analizamos la tasa de re-ruptura en ambos grupos. Materiales y métodos: cohorte retrospectiva con recolección de datos prospectivo. Se evaluaron pacientes consecutivos operados de revisión de LCA aislado entre 2014 y 2015 (Grupo 1), y en quienes se asoció una plástica extraarticular lateral (PEAL) entre 2015 y 2016 (Grupo 2). Fueron estudiados a través de un examen clínico, escalas subjetivas de Lysholm, IKDC, evaluación artrométrica con KT-1000, retorno deportivo y una resonancia magnética (RM) al año. Analizamos la tasa de re-ruptura.Resultados: treinta y seis pacientes, dieciocho en cada grupo con un seguimiento promedio de cincuenta y tres meses (rango 37-73). Para la PEAL se realizó una tenodesis extraarticular lateral con fascia lata en trece casos y una reconstrucción con aloinjerto en cinco casos. La mediana de edad fue de 30.5 (RIC 27-36 años) en el Grupo 1 y 26.5 (RIC 24-33 años) en el Grupo 2. La mediana de la escala de Lysholm pre y postoperatoria fue 65 (RIC 61-72) y 91 (RIC 87-98) en el Grupo 1, y 72 (RIC 53-75) y 90 (RIC 79-95) en el Grupo 2 (p 0.1). La mediana de la escala de IKDC pre y postoperatoria fue 55 (RIC 45-65) y 80 (RIC 75-94) en el Grupo 1, y 56 (RIC 48-67) y 76 (RIC 68-84) en el Grupo 2 (p 0.11). Dieciséis (89%) pacientes en cada grupo retornaron al deporte. La tasa de re-ruptura fue 17% (n = 3) para el Grupo 1 y 5.5% (n = 1) para el Grupo 2 (p >0.6) en un promedio de veinticuatro meses. Conclusión: los resultados clínicos y de retorno al deporte han demostrado ser satisfactorios ambos grupos. Si bien la tasa de re-ruptura fue tres veces menor en el Grupo 2, esta diferencia no fue significativa. Se requiere mayor número de pacientes y tiempo para establecer una conclusión.Tipo de estudio: Cohorte retrospectiva. Nivel de evidencia: III

Introduction: The aim of this study is to compare the clinical outcomes and return to sports of a consecutive series of patients treated for revision ACL with and without a lateral extra-articular reconstruction. The secondary objective was to analyze the failure rate in both groups.Materials and methods: we retrospectively evaluated a series of patients treated for isolated revision ACL between 2014 and 2015 (Group 1) and revision ACL associated with a lateral extra-articular plasty from 2015 to 2016 (Group 2). All patients were evaluated with clinical examination, subjective scales of Lysholm and IKDC, return to sports, arthrometric KT-1000 evaluation, magnetic resonance (MR) at one-year follow-up and failure rate.Results: thirty-six patients were evaluated, eighteen in each Group with a mean follow-up of fifty-three months (range 37-73). For the LEAP, in thirteen cases we performed a lateral tenodesis with ilio-tibial band and in five cases a reconstruction using allograft. The median age was 30.5 (IQR 27-36 years) for Group 1 and 26.5 (IQR 24-33 years) for Group 2. The median pre and postoperative Lysholm score was 65 (IQR 61-72) and 91 (IQR 87-98) in Group 1, and 72 (IQR 53-75) and 90 (IQR 79-95) in Group 2 (p 0.1). The median pre and postoperative IKDC score was 55 (IQR 45-65) and 80 (IQR 74-94) in Group 1, and 56 (IQR 48-67) and 76 (IQR 68-84) in Group 2 (p 0.11). Sixteen (89%) patients return to sports in each Group. The failure rate was 17% (n = 3) for Group 1 and 5.5% (n = 1) for Group 2 (p >0.6) at a mean of twenty-four months.Conclusion: clinical outcomes and return to sports were similar for both groups. Even though the failure rate was three times less in Group 2, this difference was not statistically significant. Greater number of patients and more follow-up is necessary to establish any conclusion.Type of study: Retrospective cohort . Level of evidence: III

Evaluación de la persistencia de síntomas luego de un episodio de infección por SARS-CoV-2 / Characterization of persistent symptoms after SARS-CoV-2 infection

Introducción: Es frecuente que, luego de un episodio de COVID-19, los pacientes persistan con síntomas, lo cual impacta negativamente en su calidad de vida. El objetivo primario de este estudio es determinar los síntomas prevalentes y su duración luego de un episodio de COVID-19 y la persistencia de estos al mes y a los tres meses del episodio. Los objetivos secundarios son describir el lapso entre el episodio de COVID-19, la reinserción laboral o académica y la reanudación de actividad física. Material y métodos: Estudio descriptivo, observacional, en adultos con antecedente de infección por SARS-CoV-2, realizado a través de una encuesta en línea. Se relacionaron variables demográficas y comorbilidades con síntomas durante la infección, al mes y al tercer mes del episodio.Resultados: Participaron 308 personas. Los síntomas más comunes en la fase aguda fueron dolor muscular y fiebre. Al mes, el 89% presentaba síntomas persistentes, siendo los más frecuentes: fatiga y mialgias. Luego de tres meses, 34,85% presentaba síntomas, siendo los más frecuentes: fatiga y anosmia. Solo el 45,7% de las personas logró la reinserción laboral/académica y el 17% de los individuos logró reiniciar actividad física al alta epidemiológica.Discusión: El porcentaje de personas con síntomas persistentes después de un episodio de COVID-19 es alto. La persistencia de los síntomas disminuye con el tiempo, lo cual es un dato alentador para todos aquellos pacientes que consultan por continuar sintomáticos.

Background: It is frequent that patients complain of persistent symptoms after an episode of COVID-19 infection, that worsened their quality of lifeAim: the aim of this study is to describe the main symptoms during a COVID-19 infection and persistent symptoms a month and three months after the episode. Our secondary objective is to describe the period between the COVID-19 episode and resuming work/ studies and exercise routine. Methods: this is a descriptive, observational study that included adults who underwent an episode of SARS-CoV-2 infection. Participants responded to an online survey. We include demographic and comorbidity data and symptoms during infection, and one and three months after infection. Results: 308 people responded to the survey, frequent symptoms during the episode included myalgia and fever. A month after the episode, 89% complained of persistent symptoms, most frequently myalgia and fatigue. Three months after the episode 38.85% complained of persistent symptoms , most frequently fatigue and anosmia. Only 45.7% could resume work/ studies 10 days after the diagnosis, and 17% could resume exercise routine 10 days after the diagnosis. Conclusions: there is a high percentage of people who persisted with symptoms after a COVID-19 infection. We noticed symptoms improved over time, this finding could be encouraged for patients who persist symptomatic after the episode.

Return to Sports after ACL Reconstruction with Resection or Remnant-Preserving Technique / Retorno ao esporte após reconstrução do LCA com ressecção ou preservação do remanescente

Abstract Objectives To analyze the results of anterior cruciate ligament (ACL) reconstruction with remnant-preserving versus remnant-resecting technique, concerning the return to pre-lesion activity level. Methods The present retrospective cohort study has assessed adults > 18 years old who underwent ACL anatomical reconstruction between 2010 and 2014. The main outcomes assessed were: level of physical activity (4-point scale), sports participation rate, ACL rerupture defined as documented lesion requiring revision surgery and the numeric pain scale rate (NPSR). Results A total of 83 individuals were included in the study, with a mean age of 31.8 years old and follow-up mean time of 4.2 years after the surgery. A total of 34 patients underwent ACL reconstruction with remnant-preserving technique, and 49 without remnant preservation. No statistically significant difference was found between groups in all outcomes assessed: level of physical activity before the lesion and after the surgery, ACL rerupture rates and postoperative pain level. Subgroup analysis has shown a statistically significant decrease in the activity level in both groups. The most practiced sport was football; 72% of patients in the remnant group have resumed football activity versus 52.6% of the control group. Conclusion Based in these findings, the comparison between ACL reconstruction with remnant preserving technique and remnant resecting technique has shown no differences concerning the return to prelesion activity level.

Resumo Objetivo Analisar os resultados da reconstrução do ligamento cruzado anterior (LCA) com preservação do remanescente, comparada à técnica convencional, no retorno do paciente ao nível de atividade física pré-lesão. Métodos Estudo transversal retrospectivo, que avaliou indivíduos adultos submetidos à reconstrução anatômica do LCA no período de 2010 a 2014. Os desfechos analisados foram: nível de atividade física, taxa retorno ao esporte, relesão do LCA definida como lesão documentada que necessite de nova reconstrução ligamentar, e dor pela escala numérica de dor (EVN). Resultados Foram incluídos 83 indivíduos com média de 31,8 anos de idade e seguimento médio de 4,2 anos após a cirurgia, 34 submetidos à reconstrução do LCA com preservação do remanescente, e 49 à convencional. Não houve diferença estatisticamente significativa entre os grupos na frequência de atividade física pré-lesão e pós-operatória, na taxa de relesão do LCA reconstruído e na intensidade da dor no pós-operatório. Na análise intragrupos, houve uma queda estatisticamente significativa na frequência da prática de atividade física pós-operatória para ambos os grupos em comparação ao nível pré-lesão. O tipo de esporte mais praticado foi o futebol, onde 72% pacientes do grupo remanescente retornaram ao esporte comparado a 52,6% do grupo controle; porém, essa diferença não foi estatisticamente significante. Conclusão Não foi possível observar diferenças entre os pacientes submetidos às técnicas cirúrgicas de reconstrução LCA com e sem a preservação do remanescente em relação ao retorno ao esporte, frequência de atividade física e intensidade da dor. Estudos futuros prospectivos são necessários.