Return to Competition After Surgery for Herniated Lumbar Disc in Professional Football Players.

OBJECTIVE: To investigate the prevalence and outcomes of surgery for lumbar disc herniation in professional football players. DESIGN: Retrospective case series. SETTING: Sports rehabilitation center. PARTICIPANTS: A period of 10 seasons of the Italian Football First League (Serie A) was retrospectively investigated. Thirty-three teams (for a total of 1960 players) took turns in the 10 seasons, and 42 team doctors were requested to provide information about the number of players who underwent surgery for lumbar disc herniation. INTERVENTION: Survey distributed to team doctors. MAIN OUTCOME MEASURES: Prevalence and match incidence of the lumbar discectomy, proportion of players returning to competition after surgery, recovery time and preintervention and postintervention number of appearances in official matches were analyzed. RESULTS: Eleven players underwent the surgical intervention during the considered period. The prevalence of the surgical treatment was 0.6%, whereas the match incidence was 0.09 cases/1000 match hours. All players returned to competitions 6.0 (3.5-7.7) months after surgery, with no significant difference between different roles. The number of appearances in official matches was comparable during the seasons before and after surgery. CONCLUSIONS: The lumbar discectomy must be considered a rare surgical procedure performed in professional football players. All players returned to competitions after surgery. The postintervention number of appearances in official matches was comparable with the preintervention one.

Web-based survey results: surgeon practice patterns in Italy regarding anterior cruciate ligament reconstruction and rehabilitation.

PURPOSE: The aim of this study was to report Italian orthopaedic surgeons' management of choice for ACL reconstruction and rehabilitation, and to compare surgical applications and rehabilitation approaches of Italian surgeons to the current approaches of "ACL Study Group". A secondary purpose was to compare the preferences of subgroup based on graft choice, surgical techniques and experience. METHODS: A web-based survey was developed to investigate the attitudes of members of a national association specialized in sports traumatology and knee surgery (SIGASCOT) regarding surgical techniques, routine post-operative applications, rehabilitation approaches and starting time of specific activities and exercises following ACL reconstruction. RESULTS: The response rate was 17 % (131 questionnaires). The most popular graft type was hamstring tendon (81 % in male patients, and 91 % in female patients). The rate of continuous passive motion use was 55 %. Half surgeons routinely used a brace (49 %), usually a hinged brace. In total, 33.0 % of surgeons allowed patients to load the operated knee as much as tolerated within the first 2 weeks. Fifty-nine per cent of surgeons did not limit full flexion within the first 2 weeks. Most surgeons advise to wait until 4 months or more (97 %) for return to sports not requiring contact, and 6 months or more for full-contact sport (86 %). CONCLUSIONS: This survey demonstrates clear trends in the practice of ACL reconstruction and rehabilitation in Italy. The data obtained from the SIGASCOT members revealed a more conservative approach when compared to the current approaches of "ACL Study Group". LEVEL OF EVIDENCE: Cross-sectional survey, Level III.

Return to sport after ACL reconstruction: a survey between the Italian Society of Knee, Arthroscopy, Sport, Cartilage and Orthopaedic Technologies (SIGASCOT) members.

BACKGROUND: A worldwide consensus for timing and criteria for return to sport after anterior cruciate ligament (ACL) reconstruction is lacking. The aim of the study was to survey among the Italian Society of Knee, Arthroscopy, Sport, Cartilage and Orthopaedic Technologies (SIGASCOT) members in order to evaluate their approaches to the return to sport after ACL reconstruction regarding timing and criteria. METHODS: A web survey among the SIGASCOT members was performed, including 14 questions regarding technical and graft preferences, timing for return to training and competitive activity for contact and non-contact sports and criteria to allow return to sport. RESULTS: Totally, 123 members completed the questionnaire. Return to training sports was allowed within 6 month by 87 % for non-contact sports and by 53 % for contact sports. Return to competitive activity was allowed within 6 months by 48 % for non-contact sports and by 13 % for contact sports. Full ROM (77 %), Lachman test (65 %) and Pivot-Shift test (65 %) were the most used criteria to allow return to sport. The 90 % used at least one clinical score. CONCLUSION: The SIGASCOT members showed various approaches in the return to sport after ACL reconstruction, with differences between return to training or competitive activity, and between contact and non-contact sports. Six months was generally considered adequate by most of the members for the most demanding activities. The most used criteria to allow return to sport were manual testing. A clear definition of sport activities and more objective criteria for the return to sport are needed. LEVEL OF EVIDENCE: Level V, expert opinion.

Sleep disordered breathing is associated with appropriate implantable cardioverter defibrillator therapy in congestive heart failure patients.

BACKGROUND: Implantable cardioverter defibrillators (ICDs) are increasingly employed in patients affected by congestive heart failure (CHF) and sleep disordered breathing (SDB) is frequent in this population. HYPOTHESIS: To investigate SDB prevalence and influence on appropriate ICD discharges in CHF patients. METHODS: A total of 22 consecutive ICD patients with systolic CHF (left ventricular ejection fraction [LVEF]< 45%) were studied by polysomnography. RESULTS: A total of 17 (77.2%) showed SDB (apnea-hypopnea index [AHI]_ 10 events/hour). After controlling for LVEF and New York Heart Association (NYHA) class, AHI and severity of hypoxia during sleep results correlated to appropriate ICD discharges (r = 0.718; P < .001, r = - 0.619; P = .003, respectively). CONCLUSIONS: Sleep disordered breathing is frequent in ICD recipients due to left systolic ventricular dysfunction and may increase the risk of ventricular arrhythmia and appropriate ICD discharges.

The Sforzesco brace and SPoRT concept (Symmetric, Patient-oriented, Rigid, Three-dimensional) versus the Lyon brace and 3-point systems for bracing idiopathic scoliosis.

UNLABELLED: We have developed a new rigid brace, the Sforzesco brace, according to a new concept SPoRT (Symmetric, Patient-oriented, Rigid, Three-dimensional, active). The aim of this study is to verify the first results of the SPoRT concept compared to a classical 3 point system. DESIGN: A pair-controlled retrospective study. POPULATION: 15 Patients (22 females), 14.0+/-1.7 years, 39.8+/-9.8 degrees Cobb ( degrees C). We examined for differences between the two groups, at the start with SPoRT worst than LY. All degrees C and degrees B parameters (maximal, average and single localizations) decreased significantly in both groups, apart from thoracic degrees C in LY. SPoRT had better results than LY (P<0.05) for maximal degrees C and average degrees C. Moreover, degrees C clinical results were better (P<0.05) in SPoRT than LY. SPoRT had better results than LY in aesthetic (P<0.05) of the shoulders and waists. Brace is effective in the short term also in high degree curves, and SPoRT obtained statistically significant 80% better degrees C results than LY in the worst scoliosis curve, and 40% in the average of all curves, as well as better aesthetic.