Epidemiology of injury in a non professional basketball club during a regular season: a prospective study / Epidemiología lesional en club de baloncesto no profesional durante una temporada regular: estudio prospectivo

Introduction: The knowledge about patterns of injury in non professional and adolescent basketball players is the base for prevention programs. While large series about injuries in professional basketball players have been published previously, little is known in non professional and young-in-training athletes. This study aims to describe the epidemiology of injuries, relate it with gender and type of activity in a non-professional basketball club over one season. Material and method: Two hundred and thirty players (Mean age: 17.3, SD 5.7 years, 73.9% males) were enrolled in a one season prospective study. An injury report form was used to systematically collect all data and was filled weekly by each player. Characteristics of injuries were described and its distribution by gender and type of activity. Incidence of injury is shown as number of injuries /1000 hours exposure. Results: Overall incidence was 3.86 injuries /1000h. The ankle (32.3%) was the most common location of injury and sprain (35.5%) the most frequent diagnosis, which was also seen in subgroups analysis. Mean time loss was 7.52 sessions (SD 11.28) Wrist injuries meant largest time loss (14.5 sessions, SD 13.43). Males showed higher incidence than females (4.16/1000h vs 3.04/1000h), who were more prone to fractures and upper extremity injuries. During competition, incidence of injury was 11.7 times higher than practices, and patterns of injury differed in each setting. Conclusion: Ankle sprain was the most common injury in our study. Wrist injuries meant the longest time loss. Males got injured more often than females. Injuries during competition were notably more frequent than during practice with different patterns of injuries

Introducción: Conocer los patrones de lesión en baloncesto es la base para desarrollar programas preventivos. Aunque se han publicado grandes series en jugadores profesionales, poco se conoce sobre jugadores en formación y no profesionales. El objetivo de este estudio es describir la epidemiología de las lesiones en un club de baloncesto no profesional durante una temporada, y relacionarla con el género y el tipo de actividad competitiva. Material y método: Doscientos treinta jugadores (edad media: 17,3, DS 5,7 años, 73,9% varones) se incluyeron en un estudio prospectivo a lo largo de una temporada. Un cuestionario sobre aparición de lesiones se utilizó para registrar los datos y se rellenó semanalmente por cada jugador. Se describieron las características de las lesiones y su distribución por género y tipo de actividad. La incidencia lesional se muestra como número de lesiones/1000 horas de exposición. Resultados: La incidencia global fue de 3,86 lesiones /1.000 h. El tobillo (32,3%) fue la localización más común y el esguince (35,5%) el diagnóstico más frecuente. Esto también se observó en los análisis de subgrupos. El tiempo medio de baja fue de 7,52 sesiones (DS 11,28). Las lesiones de la muñeca conllevaron tiempos de baja más prolongados (14,5 sesiones, DS 13,43). Los varones presentaron una incidencia mayor que las mujeres (4,16/1000h vs 3,04/1000h), las cuales mostraron mayor tendencia a sufrir fracturas y lesiones del miembro superior. La incidencia de lesión durante la competición fue 11,7 veces mayor que durante el entrenamiento, y los patrones de lesión diferían. Conclusión: El esguince de tobillo fue la lesión más frecuente en nuestro estudio. Las lesiones de muñeca supusieron mayores tiempos de baja. Los varones se lesionaron con más frecuencia que las mujeres. Las lesiones durante la competición fueron notablemente más frecuentes que durante el entrenamiento y presentaron diferente espectro

Strength recovery after anterior cruciate ligament reconstruction with quadriceps tendon versus hamstring tendon autografts in soccer players: A randomized controlled trial.

BACKGROUND: The comparison between HT and QT grafts in strength recovery and function after an ACLR is scarce in the literature. METHODS: A total of 56 participants were enrolled in this randomized controlled trial and placed into two groups: HT or QT. The hamstring/quadriceps (H/Q) ratio was the primary end-point measured with a Genu-3 dynamometer. Peak torque, functional assessment (Lysholm knee scoring scale and Cincinnati Knee Rating System), and anteroposterior laxity (KT-2000™ arthrometer) were also assessed. An intention-to-treat analysis was performed. RESULTS: The results of the H/Q ratio analysis of the participants over time revealed significant differences at 60, 180, and 300°/s at three, six, and 12months of follow-up (60°/s: F=5.3, p=0.005; 180°/s: F=5.5, p=0.004; 300°/s: F=5.1, p=0.005). Furthermore, they revealed significant differences at 60°/s, 180°/s, and 300°/s in the participants over time for peak torque in the extensor muscle strength at three and six months of follow-up, with higher values in the hamstring tendon group but not at 12months of follow-up. There were no significant differences in functional endpoints or arthrometer assessments at 24months of follow-up. CONCLUSION: An ACLR with a QT graft showed similar functional results with a better isokinetic H/Q ratio compared to an ACLR with the HT at 12months of follow-up in soccer players. This higher H/Q ratio observed with the QT could be an advantage of this graft over the HT for an ACLR.

Rotura del ligamento cruzado anterior en la mujer deportista: factores de riesgo y programas de prevención / Anterior cruciate ligament injury in the female athlete: risk and prevention

Objetivo: La lesión del ligamento cruzado anterior de la rodilla (LCA) es la segunda lesión deportiva más frecuente tras el esguince de tobillo. Provoca inestabilidad de la rodilla y afecta al rendimiento deportivo, por lo que es importante saber qué lo favorece y cómo lo podemos evitar. En este trabajo se expone la epidemiología de la lesión del LCA haciendo referencia a los factores de riesgo predisponentes y a los programas preventivos de la misma. El objetivo de este trabajo ha sido mostrar los factores de riesgo que predisponen a una mayor incidencia de lesión del ligamento cruzado anterior, así como presentar la efectividad de los programas de prevención de la misma. Método: Se ha realizado una revisión de la literatura a través de PubMEd, Cochrane y UpToDate incluyendo los metanálisis o ensayos clínicos publicados en los últimos 10 años. Resultados: La incidencia de lesión es mayor en la mujer que en el hombre con una relación 3:1, y sobre todo se produce en deportes como el fútbol y el baloncesto, donde se realizan ejercicios como pivotar, cambio brusco de dirección en la carrera o frenar de forma brusca. Los factores de riesgo son multifactoriales, entre ellos los únicos modificables son los factores de riesgo biomecánicos y es en ellos donde se centran los programas de prevención. Conclusiones: Las mujeres tienen una mayor incidencia de lesión de LCA. Los programas de prevención se centran en factores de riesgo modificable, principalmente en el entrenamiento neuromuscular y disminuyen de forma estadísticamente significativa tanto en el fútbol como en el balonmano, pero no en el baloncesto. Estos programas se centran en ejercicios de fortalecimiento, control proximal y ejercicios pliométricos

Background: The anterior cruciate ligament (ACL) injury of the knee is the second most common sports injury after the ankle sprain. It causes knee instability and impacts sport performance. Knowing what predisposes this injury is important to prevent it, specially in women, where the rate is higher. This paper presents the ACL injury epidemiology, making reference to the underlying risk factors and its preventive programmes. The aim of this study was to show the risk factors that predispose to a higher incidence of anterior cruciate ligament injury, as well as to present the effectiveness of the prevention programs. Methods: A literature review through PubMEd, Cochrane and UpToDate has been performed including the meta-analysis or clinical trials published over the past 10 years. Results: The injury incidence rate is three times higher in women than in men. It specially develops in sports like football and basketball, i.e., sports where pivoting, sharp running direction changes or abruptly stopping exercises are more common. The risk factors are multifactorial; and the only adjustable ones are the biomechanical risk factors. Prevention programmes are focused in these factors, trying to enhance strength and biomechanical propioception. Conclusions: After the review we can conclude that ACL injuries are more frequent in women. Prevention programmes focus on neuromuscular training (strengthening exercises, proximal control and plyometric exercises) and they reduces significantly the injury for football and handball players, but not for basketball ones. The programmes focus on strengthening exercises, proximal control and plyometric exercise

A Comparison of Genicular Nerve Treatment Using Either Radiofrequency or Analgesic Block with Corticosteroid for Pain after a Total Knee Arthroplasty: A Double-Blind, Randomized Clinical Study.

BACKGROUND: Knee osteoarthritis is a disease that affects a third of the population over 65 years of age, and it is increasingly becoming a motive for consultation and a source of pain and disability. The gold standard surgical treatment is a total knee arthroplasty; however, 15% to 30% of patients who have undergone surgery continue to experience pain and functional limitation. METHODS: A double-blind, randomized clinical study compared neurolysis using traditional radiofrequency (RF) to local anesthetic and corticosteroid block of the superolateral, superomedial, and inferomedial branches of the knee genicular nerves in patients who had total knee arthroplasty but still experience pain. RESULTS: Twenty-eight patients, 14 on each treatment arm, were followed for over a 1-year period. A reduction in pain and significant joint function improvement during the first 3 to 6 months was shown, with similar results using both techniques. No adverse effects were noted. An improvement in both disability and quality of life was observed, as well as a reduction in the need for analgesics in both treatment groups. CONCLUSIONS: Further clinical trials need to be undertaken, with a larger sample size, in order to demonstrate the efficacy of this technique and to detect the possible appearance of any long-term adverse effects.

Liberación endoscópica del túnel cubital. Técnica quirúrgica y resultados preliminares / Endoscopic cubital tunnel release. Surgical technique and preliminary results

Introducción: Estudios recientes sugieren que la descompresión simple del túnel cubital es tan efectiva como otras técnicas quirúrgicas. La liberación endoscópica se ha aplicado satisfactoriamente en el tratamiento quirúrgico del síndrome del túnel cubital. Presentamos la técnica quirúrgica y los resultados obtenidos con la descompresión endoscópica del nervio cubital en el codo. Material y método: Entre el año 2011 y 2012, 7 pacientes (edad media, 50 años, rango 43-61 años), 5 hombres y 2 mujeres, fueron sometidos a la descompresión endoscópica del nervio cubital en el codo. Todos los pacientes presentaron signos clínicos típicos de síndrome del túnel cubital y estudios neurofisiológicos positivos (5 moderada y grave 2). Los pacientes fueron clasificados según la clasificación de McGowan: 6 codos (86,7%) fueron clasificados como grado II y 1 (14,3%) como grado III. La puntuación media en la clasificación Gabel y Amadio fue de 4,7 puntos. Resultados: El seguimiento medio fue de 9 meses (rango 4-12). Después de la operación, 3 casos (42,8%) fueron clasificados como grado I en la clasificación McGowan y 3 estaban asintomáticos. Un paciente no cambió su graduación (grado III) tras la cirugía. La puntuación media en la clasificación de Gabel y Amadio aumentó hasta 8,14 puntos: los resultados fueron excelentes o buenos en 6 de los 7 casos. Todos los pacientes mejoraron después de la cirugía, se mostraron satisfechos con el procedimiento y regresaron a sus actividades previas en una media de 26 días. Un paciente mostró disestesias alrededor del área de la cicatriz. No hubo otras complicaciones. Conclusiones: La liberación endoscópica del nervio cubital, en pacientes seleccionados, presenta buenos resultados a corto plazo, especialmente para el alivio de la sintomatología sensitiva y en términos de satisfacción del paciente. Además, la tasa de complicaciones es muy baja, consiguiendo una recuperación precoz de los pacientes. No obstante, esta técnica debe ser comparada con el resto en estudios aleatorizados a largo plazo. Nivel de evidencia: Serie de casos, nivel IV de evidencia (AU)

Purpose: Recently, several studies suggested that simple decompression is as effective as other surgical techniques in cubital tunnel syndrome. A technique of endoscopic release of the cubital tunnel has been successfully applied to surgical treatment of this disease. We present our technique and results with endoscopic decompression in cubital tunnel syndrome. Materials and methods: Between 2011 and 2012, 7 patients (mean age, 50 years; range, 43-61 years), 5 males and 2 females, underwent endoscopic decompression of the ulnar nerve at the elbow. All patients presented with typical clinical signs and neurophysiologic studies (5 moderate and 2 severe). Patients were categorized by stage of cubital tunnel syndrome according to McGowan classification: 6 (86,7%) were classified as grade II and 1 (14,3%) grade III. The average score in Gabeland Amadio classification was 4,7 points. Results: The mean postoperative follow-up examination was 9 months (range 4–12). Postoperatively, 3 cases (42,8%) were classified as grade I in McGowan classification and 3 asymptomatic. One patient did not change its classification stage (grade III). The average score in Gabel and Amadio classification improve to 8,14 points: outcomes were excellent or good in 6 of7 cases. All patients improved after surgery, were satisfied with the procedure and returned to full activities within 26 days. One patient showed burning sensation around scar area. There were no other complications. Conclusions: Endoscopic release of the ulnar nerve at elbow, in selected patients, has good short-term outcomes, especially for the relief of sensory symptoms and patient satisfaction. Also, the complication rate is very low, achieving early recovery of patients. However, randomized prospective studies with long-term follow-up should be performed to compare this technique in the treatment of cubital tunnel syndrome. Level of evidence: Case series, level IV (AU)