Preventing Osteoarthritis After an Anterior Cruciate Ligament Injury: An Osteoarthritis Action Alliance Consensus Statement.

After an anterior cruciate ligament (ACL) injury, people need secondary prevention strategies to identify osteoarthritis at its earliest stages so that interventions can be implemented to halt or slow the progression toward its long-term burden. The Osteoarthritis Action Alliance formed an interdisciplinary Secondary Prevention Task Group to develop a consensus on recommendations to provide clinicians with secondary prevention strategies that are intended to reduce the risk of osteoarthritis after a person has an ACL injury. The group achieved consensus on 15 out of 16 recommendations that address patient education, exercise and rehabilitation, psychological skills training, graded-exposure therapy, cognitive-behavioral counseling (lacked consensus), outcomes to monitor, secondary injury prevention, system-level social support, leveraging technology, and coordinated care models. We hope this statement raises awareness among clinicians and researchers on the importance of taking steps to mitigate the risk of osteoarthritis after an ACL injury.

Evidence Review for Preventing Osteoarthritis After an Anterior Cruciate Ligament Injury: An Osteoarthritis Action Alliance Consensus Statement.

CONTEXT: The Osteoarthritis Action Alliance formed a secondary prevention task group to develop a consensus on secondary prevention recommendations to reduce the risk of osteoarthritis after a knee injury. OBJECTIVE: Our goal was to provide clinicians with secondary prevention recommendations that are intended to reduce the risk of osteoarthritis after a person has sustained an anterior cruciate ligament injury. Specifically, this manuscript describes our methods, literature reviews, and dissenting opinions to elaborate on the rationale for our recommendations and to identify critical gaps. DESIGN: Consensus process. SETTING: Virtual video conference calls and online voting. PATIENTS OR OTHER PARTICIPANTS: The Secondary Prevention Task Group consisted of 29 members from various clinical backgrounds. MAIN OUTCOME MEASURE(S): The group initially convened online in August 2020 to discuss the target population, goals, and key topics. After a second call, the task group divided into 9 subgroups to draft the recommendations and supportive text for crucial content areas. Twenty-one members completed 2 rounds of voting and revising the recommendations and supportive text between February and April 2021. A virtual meeting was held to review the wording of the recommendations and obtain final votes. We defined consensus as >80% of voting members supporting a proposed recommendation. RESULTS: The group achieved consensus on 15 of 16 recommendations. The recommendations address patient education, exercise and rehabilitation, psychological skills training, graded-exposure therapy, cognitive-behavioral counseling (lacked consensus), outcomes to monitor, secondary injury prevention, system-level social support, leveraging technology, and coordinated care models. CONCLUSIONS: This consensus statement reflects information synthesized from an interdisciplinary group of experts based on the best available evidence from the literature or personal experience. We hope this document raises awareness among clinicians and researchers to take steps to mitigate the risk of osteoarthritis after an anterior cruciate ligament injury.

The effect of acute pre-workout supplementation on power and strength performance.

BACKGROUND: Consumption of pre-workout dietary supplements by both recreational and competitive athletes has increased dramatically in recent years. The purpose of this study was to determine the acute effects of a caffeine-containing pre-workout dietary supplement on various measures of performance including anaerobic power, upper and lower body power, and upper body strength in recreationally trained males. METHODS: Thirteen males (mean ± SD age = 24 ± 6 yrs; height = 180.3 ± 5 cm; body mass = 83.4 ± 9 kg) participated in this investigation in which they reported to the laboratory on four separate occasions, each separated by one week. Each subject underwent an initial familiarization session on week one followed by baseline (BA) performance testing on week two. Performance testing included a medicine ball put (MBP) to determine upper body explosive power, vertical jump test (VJ) to determine lower body explosive power, one-rep maximum bench press (1-RM) for determining upper body strength, and a Wingate Anaerobic Power Test (WAnT) to determine measures of anaerobic power. On week three, subjects were randomly assigned to ingest either a pre-workout supplement (SUP) or a placebo (PL) and again complete the performance testing protocol. Subjects were provided with the crossover treatment on the fourth and final week. Performance testing commenced 20-minute following ingestion of both treatments, which was similar to previous investigations. RESULTS: Significant differences in anaerobic peak power relative to the WAnT were observed following ingestion of the SUP (782 ± 191 W) in comparison to the PL (722 ± 208 W; p = 0.003; effect size = 0.30) and BA (723 ± 205 W; p = 0.011; effect size = 0.28). Significant differences were also observed for anaerobic mean power following ingestion of the SUP (569 ± 133 W) in comparison to the PL (535 ± 149 W; p = 0.006; effect size = 0.24) and BA (538 ± 148 W; p = 0.020; effect size = 0.22). No significant differences between trials were observed for upper body power, lower body power, or upper body strength. CONCLUSIONS: Ingestion of the pre-workout dietary supplement led to significant improvements in anaerobic peak and mean power values in comparison to the placebo and baseline treatments. No improvements were observed in upper and lower body power or upper body strength. Taken prior to exercise, a caffeine-containing pre-workout dietary supplement may improve anaerobic power performance.