ABSTRACT
BACKGROUND: The optimal timing of surgical intervention for multiligament knee injuries remains controversial. PURPOSE: To review the clinical and functional outcomes after acute and delayed surgical intervention for multiligament knee injuries. STUDY DESIGN: Systematic review; Level of evidence, 4. METHODS: We performed a search of the PubMed, Embase, Cochrane Library, and Web of Science databases from inception to September 2020. Eligible studies reported on knee dislocations, multiligament knee injuries, or bicruciate ligament injuries in adult patients (age, ≥18 years). In addition to comparing outcomes between acute and delayed surgical intervention groups, we conducted 3 subgroup analyses for outcomes within isolated knee injuries, knee injuries with concomitant polytrauma/fractures, and high-level (level 2) studies. RESULTS: Included in the analysis were 31 studies, designated as evidence level 2 (n = 3), level 3 (n = 8), and level 4 (n = 20). These studies reported on 2594 multiligament knee injuries sustained by 2585 patients (mean age, 25.1-65.3 years; mean follow-up, 12-157.2 months). At the latest follow-up timepoint, the mean Lysholm (n = 375), International Knee Documentation Committee (IKDC) (n = 286), and Tegner (n = 129) scores for the acute surgical intervention group were 73.60, 67.61, and 5.06, respectively. For the delayed surgical intervention group, the mean Lysholm (n = 196), IKDC (n = 172), and Tegner (n = 74) scores were 85.23, 72.32, and 4.85, respectively. The mean Lysholm (n = 323), IKDC (n = 236), and Tegner (n = 143) scores for our isolated subgroup were 83.7, 74.8, and 5.0, respectively. By comparison, the mean Lysholm (n = 270), IKDC (n = 236), and Tegner (n = 206) scores for the polytrauma/fractures subgroup were 83.3, 64.5, and 5.0, respectively. CONCLUSION: The results of our systematic review did not elucidate whether acute or delayed surgical intervention produced superior clinical and functional outcomes. Although previous evidence has supported acute surgical intervention, future prospective randomized controlled trials and matched cohort studies must be completed to confirm these findings.
ABSTRACT
This study examined the incidence and trends of surfing-related and mild traumatic brain injuries that presented to United States emergency departments between 2001 and 2016. Subjects with surging-related head injuries were retrieved from the National Electronic Injury Surveillance System. A weighted total of 34,337 surfing-related head injuries were identified. The annual incidence of surfing-related head injuries insignificantly decreased from 2001 to 2016 (R2 = .119; p = .19). Most common injuries included lacerations (50.4%), blunt head injuries (25.7%), and mild traumatic brain injuries (16.1%). Mild traumatic brain injury incidence and annual percentage increased significantly during the study period (R2 = .251; p = .05 and R2 = .346; p = .02, respectively).
ABSTRACT
Despite potential health benefits of weightlifting and physical activity, individuals can suffer from a number of musculoskeletal injuries. This study aimed to: (i) compare incidence and annual trends of different weightlifting injury types presenting to emergency departments in the United States and (ii) identify frequency and annual trends of weightlifting-related sprains and strains to each body part. The National Electronic Injury Surveillance System was queried to identify all weightlifting-related injuries from 2010-2016. Incidence and annual trends of various types of weightlifting-related injuries were compared during the study period. Furthermore, frequency and annual trends of weightlifting-related sprains and strains to different body parts were assessed. The weighted estimated annual incidence of weightlifting-related injuries significantly increased from 86,910 in 2010 to 109,961 in 2016 (R2 = 3.382; p = 0.01). The most common weightlifting-related sprains and strains involved the lower trunk (29.4%), shoulder (22.6%), upper trunk (17.3%), neck (6.5%), upper arm (5.6%), wrist (4.8%), knee (3.4%), and elbow (2.6%). There was a significant increase in the frequency and trends of sprains and strains that involved the lower trunk (R2 = 0.631; p = 0.033). Weightlifting-related injuries have increased, of which sprains and strains were the most common. Additionally, the most commonly affected body part was the lower trunk. Further studies are needed to determine the etiologies of weightlifting-related lower trunk sprains/strains. This study may be beneficial to weightlifters, highlighting common injury types, thereby allowing them to take preventative measures.
