Epidemiology of Non-Contact Muscle Injuries in the Italian Male Elite Under-19 Football (Soccer) Championship.

BACKGROUND: While extensive research exists on muscle injuries among adult football players, a notable gap persists in studies concerning younger footballers. The aim of the current study is to provide epidemiological data on the characteristics of time-loss muscle injuries in young football players participating in the Italian Under-19 male elite Championship ("Primavera 1"). RESULTS: Conducted as a multicentre, prospective, observational cohort study, this research gathered injury data from the 2022-23 season across 14 of the 18 Clubs in the first Italian Under-19 championship. The cohort comprised 391 players with a mean age (± standard deviation) of 18.0 ± 0.4 years. A total of 479 injuries were reported, resulting in 14,231 days of activity lost. Of these, muscle injuries were 209 (44%), accounting for 4,519 (32%) days lost. Overall muscle injuries incidence was 1.82/1000 hours, with a mean injury burden of 39.4 days lost/1000 hours. Almost all muscle injuries (206 out of 209: 98.5%) occurred in hamstrings, quadriceps, adductors, calf and iliopsoas. Hamstrings injuries were the most burdensome (18.8 days lost/1000 hours) accounting for nearly half of all days lost due to muscle injuries. Incidence and burden of adductors injuries (0.25 injuries and 4.1 days lost/1000 hours, respectively) were found to be comparable to calf injuries (0.24 injuries and 4.7 days lost/1000 hours, respectively). Iliopsoas injuries accounted for a noteworthy portion of the total, with an injury incidence of 0.16/1000 hours and a burden of 3.3 days lost/1000 hours. Injuries with myo-tendinous or myo-aponeurotic involvement demonstrated delayed return-to-football compared to those without such involvement (35.6 vs. 18.5 days, p < 0.0001). CONCLUSIONS: The study highlighted a peculiar distribution of non-contact muscle injuries among elite young football players. While hamstring injuries were confirmed as the most burdensome, incidence and burden of adductors and calf injuries were found to be similar. A significant incidence and burden of iliopsoas injuries were observed. These findings suggest potential implementations for targeted injury prevention strategies in the Italian male elite Under-19 football Championship.

Clinical and radiological results of a stemmed medial pivot revision implant in aseptic total knee revision arthroplasty.

BACKGROUND: Constraint choice in revision total knee arthroplasty depends on the stability of the collateral ligaments and on the severity of bone loss, but the least degree of constraint necessary is recommended. The purpose of this retrospective matched-paired study was to compare clinical results, radiographic outcome and the survival of a stemmed medial pivot revision implant in aseptic revision TKA vs. medial pivot implant in primary TKA. METHODS: Records were reviewed for 69 cases of aseptic revision TKA using Advance® Medial Pivot Stemmed Revision Knee system between 2002 and 2016. These patients were then matched in a 1:2 ratio control group of patients who received a primary TKA with Advance® Medial Pivot system. American Knee Society Score and Visual Analogue Scale pain score were recorded. Alignment, loosening, and incidence of radiolucent lines were evaluated on X-rays. Implant survival was assessed by Kaplan-Meier survival analysis. RESULTS: The primary TKA group had significant superior AKSS clinical and functional score at baseline (52.3 and 68.2 points, respectively) and at last follow up (84.6 and 68.6 points) compared with the revision TKA group (47.9 and 40.9 points; 78.4 and 59.9 points; P < 0.05). No significant difference was observed in the mean change from baseline to last follow up of AKSS score between the two groups (P > 0.05). Radiographical outcome and implant survival were similar in the two groups (P > 0.05). CONCLUSION: The authors support the use of this revision system in knees with collateral ligaments competence and mild-to-moderate bone defect.

Early experience with the ATTUNE Total Knee Replacement System.

BACKGROUND: Modern TKA implants promise to improve functional outcomes, stability, patient satisfaction and operating room efficiency. The purpose of this retrospective study is to evaluate our short-term clinical and radiological results and survival using the ATTUNE Total Knee Replacement System. METHODS: The authors reviewed 228 primary cemented TKAs using ATTUNE Total Knee Replacement System which were implanted between 2014 and 2018 concerning short-term clinical and radiographical outcomes and survival. Clinical evaluation was performed using the Knee injury Osteoarthritis Outcome Score (KOOS), the Oxford Score and a Numeric Rating Scale (NRS) for pain. Radiographic analysis was performed using the Modern Knee Society Score Evaluation System. RESULTS: The means of the clinical results as measured with KOOS score were Pain 82,7, Symptoms 79, ADL 78,3, Sport and recreation 51,8 and QOL 78,6. The mean Oxford score was 35 and NRS 2. The mean ROM was 113,4 (SD 9,4 range 90-130). Radiographically mean mechanical axis was 1,97° of Varus and radiolucent lines were detected in 43 knees (22,4%). The survival rate is 98.4% at 2 years and 97.4% at 5 years. CONCLUSION: At short-term follow-up the ATTUNE Knee Replacement System provide excellent clinical and radiographical outcomes and good results regarding revision rate. Due to high incidence of radiolucent lines, those patients should be closely monitored even though they show no clinical evidence for loosening.

Cementless metaphyseal reverse shoulder arthroplasty: our preliminary experience.

Reverse shoulder arthroplasty (rTSA) is a largely used procedure with a wide variety of indications. The incidence of this surgery is increased in recent years and the literature expects similar trend for them future. Metaphyseal stem rTSA seems to be a promising solution considering major objectives the preservation of humeral bone stock and ease of revision. In our study we analyzed 19 patients treated with cementless metaphyseal stem rTSA for osteoarthritis (group A) and acute fractures (group B). In group A (7 patients) the average Constant score improved from 21,57 (16-29) to 56,85 (38-72), the average SST improved from 2,29 (1-4) to 9,43 (8-12) and the mean VAS score improved from 14,29 to 4,86. In group B (12 patients) the mean Constant-Murlay score at last follow up was 42,17; the average SST was 7 and average pain score was 8,92. Overall active range-of-motion (ROM) improved significantly. Surgical considerations, clinical (analyzing Constant score and Simple Shoulder Test) and radiological short-term outcomes are encouraging, with low rate of complications. Long term follow-up studies are necessary to confirm our findings and the potential benefits related to these implants.

A clinical and radiological study of biodegradable subacromial spacer in the treatment of massive irreparable rotator cuff tears.

PURPOSE: The aim of this retrospective study was to report the clinical and radiographic results of the biodegradable subacromial spacer (InSpace Balloon®) implantation in patients with massive irreparable rotator cuff tears. MATERIALS AND METHODS: From February 2014 to October 2015, 30 patients affected by massive irreparable rotator cuff tears were treated with the implantation of InSpace Balloon®. Clinical evaluation (Constant Score and VAS), X-rays and MR imaging were performed preoperatively in all patients and 3, 6, 12 and 24 months after surgery, dividing patients in different groups according to the time elapsed from surgery. RESULTS: Constant Score increased from 39.89 to 62.33 points (p 0.0002) in the 6 months group and from 41.66 to 65.38 points (p< 0.0001) in the 12 months group. ROM (Range of Movement) and ADL (Activity of Daily Living) significantly improved with the contemporary reduction of VAS and pain at 12 months and, furthermore, an increase of functional performance with reduction of pain was registered at 24 months. CONCLUSIONS: Our results supported the surgical procedure of the arthroscopic implantation of biodegradable subacromial InSpace Balloon® for irreparable massive cuff tears in worker patients and with recreational activities' demands in order to recover the shoulder function with a reduction of the pain.