A commentary on soccer match-play simulations for applied research and practice.

Soccer is a fast-growing area of research, demonstrated by a 10-fold increase in the number of PubMed articles derived from the search term 'soccer' between 2001 and 2021. The scope of contemporary soccer-related articles ranges from match-play observations to laboratory evaluations of performance. The activity profile of soccer match-play is variable and techniques to collect data within matches are limited. Soccer-specific simulations have been developed to simulate the evolving demands of match-play. The evolutionary designs of novel simulations provide a reproducible exercise stimulus for varying researcher and practitioner objectives. The applied researcher can utilise simulations to investigate the efficacy of nutritional interventions and environmental stress on performance, while assessing the physiological and biomechanical responses to representations of match-play. Practitioners can adopt simulations for rehabilitation to progressively facilitate return-to-play processes, while implementing extra top-up conditioning sessions for unused and partial-match players. However, there are complexities involved with the selection of varying simulations which are dependent on the research question or practical application. There also remains a paucity of published information to support researchers and practitioners in selecting from differing simulation models. To assist with researcher and practitioner interpretations, we present a commentary of the current simulations to inform decision-making processes for research and training purposes and enhance the application of future research. An objective scoring system was adopted for rating the research and practical applications of each simulation design. Overall scores of 22, 16 and 18 out of 36 were revealed for free-running (n = 7), non-motorised- (n = 4) and motorised-treadmill-based simulations (n = 4), respectively.

Transcapsular Decompression of Shoulder Ganglion Cysts.

Paralabral cysts are an increasingly recognized cause of suprascapular nerve (SSN) impingement, often causing insidious weakness in the rotator cuff. Compression at the suprascapular notch is often due to the presence of a SLAP tear and leads to pain, weakness, and atrophy of both the supraspinatus and infraspinatus muscles. Compression of the SSN at the spinoglenoid notch leads to weakness and atrophy of the infraspinatus only. Arthroscopic decompression of cysts with repair of labral pathology is typically performed in a sublabral fashion, which may make visualization of the extent of the cyst difficult and places the SSN at increased risk. With any approach, an intimate knowledge of the anatomy of the SSN is vital to safe decompression. We present a surgical technique for decompression of paralabral cysts using an intra-articular transcapsular approach. This approach maximizes visualization and efficiency and reduces possible damage to the SSN.

Arthroscopic Anterior Elbow Capsular Release Initiated Using Metal Trocar.

Elbow stiffness occurs as a consequence of multifactorial etiologies and can be broadly classified into either extra-articular or intra-articular contracture. Although nonoperative treatment regimens may prove successful, recalcitrant cases may require operative management. Both open and arthroscopic procedures to address these contractures have been described. Open techniques have historically been the mainstay of surgical management prior to the advent and advancement of arthroscopy. Although often successful, open elbow contracture release introduces added iatrogenic insult to the soft tissue envelope and has the potential to compromise the intraoperatively obtained gains in motion. Arthroscopic contracture release, although not without its own inherent risks, has been shown to be an effective intervention for the release of elbow capsular contractures. Arthroscopic release of the elbow capsule can be challenging, however, because of its thickness and proximity to vital neurovascular structures. The authors describe an adjunctive technique for effectively and efficiently releasing the anterior and posterior capsule under arthroscopic visualization using a 4.5-mm large metal trocar.

Handheld Osteotomes Facilitate Arthroscopic Elbow Osteophyte Removal.

Arthroscopic elbow surgery is a challenging procedure in part because of the limited intra-articular volume of the joint, the congruence of the elbow articulation, and the close proximity of the neurovascular structures. Arthritic conditions that result in the development of bony prominences and osteophytes are usually amenable to arthroscopic management and include diagnoses such as osteoarthritis, rheumatoid arthritis, and valgus extension overload syndrome. Safe and efficient removal of these osteophytes can be problematic, however, because of technical difficulties often encountered while using arthroscopic burrs and shavers as well as the risks of inadvertent, iatrogenic injury to adjacent articular cartilage and other structures. A valuable and effective technique using small handheld osteotomes to facilitate the arthroscopic removal of intra-articular osteophytes and other bony prominences is described and shown.

Arthroscopic Management of Locked Posterior Shoulder Dislocations.

Locked posterior shoulder dislocations occur relatively uncommonly but pose aunique array of challenges for the treating surgeon. Posterior labral detachments and capsular damage along with reverse Hill-Sachs lesions are commonly present in these patients and must often be addressed at the time of surgical intervention. Multiple open and arthroscopic procedures that address these pathologic lesions have been described. Arthroscopic shoulder stabilization for patients with locked posterior shoulder dislocations for whom significant posterior instability and subluxation persist following closed reduction is described. A specific patient who underwent both arthroscopic posterior stabilization and supplemental advancement of the subscapularis into the reverse Hill-Sachs defect serves as a case example of this technique.

Arthroscopic 360° Shoulder Labral Reconstruction: A Stepwise Approach.

Combined lesions of the glenoid labrum are a relatively common finding in shoulder instability patients. Even so, relatively few studies have been published evaluating outcomes after repair of these complex labral detachments. To achieve a successful outcome, accurate identification of all pathologic lesions in the shoulder combined with an organized, stepwise approach to sometimes circumferential labral fixation is required. Repair of 360° labral tears can be effectively and efficiently achieved by implementing the reproducible steps and sequence described to reconstruct these circumferential labral tears.

Tylosin resistance in Arcanobacterium pyogenes is encoded by an erm X determinant.

Arcanobacterium pyogenes, a commensal on the mucous membranes of many economically important animal species, is also a pathogen, causing abscesses of the skin, joints, and visceral organs as well as mastitis and abortion. In food animals, A. pyogenes is exposed to antimicrobial agents used for growth promotion, prophylaxis, and therapy, notably tylosin, a macrolide antibiotic used extensively for the prevention of liver abscessation in feedlot cattle in the United States. Of 48 A. pyogenes isolates, 11 (22.9%) exhibited inducible or constitutive resistance to tylosin (MIC of > or = 128 microg/ml). These isolates also exhibited resistance to other macrolide and lincosamide antibiotics, suggesting a macrolide-lincosamide resistance phenotype. Of the 11 resistant isolates, genomic DNA from nine hybridized to an erm(X)-specific probe. Cloning and nucleotide sequencing of the A. pyogenes erm(X) gene indicated that it was >95% similar to erm(X) genes from Corynebacterium and Propionibacterium spp. Eight of the erm(X)-containing A. pyogenes isolates exhibited inducible tylosin resistance, which was consistent with the presence of a putative leader peptide upstream of the erm(X) open reading frame. For at least one A. pyogenes isolate, 98-4277-2, erm(X) was present on a plasmid, pAP2, and was associated with the insertion sequence IS6100. pAP2 also carried genes encoding the repressor-regulated tetracycline efflux system determinant Tet 33. The repA gene from pAP2 was nonfunctional in Escherichia coli and at least one A. pyogenes isolate, suggesting that there may be host-encoded factors required for replication of this plasmid.

Susceptibility of Arcanobacterium pyogenes from different sources to tetracycline, macrolide and lincosamide antimicrobial agents.

Chlortetracycline, oxytetracycline, and the macrolide, tylosin, are extensively used for growth promotion and disease prophylaxis in the cattle and swine industries in the US. Arcanobacterium pyogenes, a common inhabitant of the mucosal surfaces of cattle and swine, is also a pathogen associated with a variety of infections in these animals. A broth microdilution technique was used to determine the antimicrobial susceptibility of 48 A. pyogenes isolates to macrolides, lincosamides and tetracyclines. The MIC50 and MIC90 for chlortetracycline were 0.12 and 8 mg/l, respectively. Similarly, the MIC50 and MIC90 for oxytetracycline were 0.25 and 8 mg/l, while the MIC50 and MIC90 for tetracycline were 0.25 and 16 mg/l, respectively. The MIC50 and the MIC90 were < or = 0.06 and >64 mg/l, respectively, for erythromycin, tylosin and clindamycin. This resistance pattern indicated that some of these A. pyogenes isolates may carry an MLS(B) resistance determinant. A. pyogenes isolates (12.5%) were resistant to erythromycin, and this percentage doubled when MICs were performed following induction with erythromycin. Of the 48 A. pyogenes isolates, 25 and 41.7% were resistant to MLS(B) antimicrobial agents and the tetracycline derivatives, respectively. MLS(B) resistance was present in 22.2 and 35.3% of A. pyogenes isolates of bovine (n=27) or porcine (n=17) origin. In contrast, 70.6% of porcine isolates were resistant to the tetracyclines, compared with 25.9% of bovine isolates. These data suggest that a large proportion of A. pyogenes field isolates may be resistant to these commonly used antimicrobial agents.