Factors influencing the association between depressive symptoms and cardiovascular disease in US population.

Cardiovascular disease (CVD) and depression are common diseases that lead to adverse health outcomes. Depressive Symptoms may be a risk factor for CVD. But few studies focused on the impact of socioeconomic factors, common medical history and dietary intake about this association. This study analyzed National Health and Nutrition Examination Survey (NHANES) 2007-2016. Complex sampling-weighted logistic regression models were used to compare the odds ratios (ORs) of CVD in participants with different depressive symptoms. 11,516 NHANES participants aged ≥ 40 years were included in the final analysis, of whom 1842 had CVD. Compared with participants with no/minimal depression, participants with mild, moderate, and moderately severe/severe depression had OR values of 1.25 (95%  CI 1.01-1.54), 1.98 (95% CI 1.32-2.96), and 2.41 (95% CI 1.63-3.57). The association of depressive symptoms with CVD follow a dose-dependent pattern. The interactions of depressive symptoms with gender (Interaction P = 0.009), diabetes (Interaction P = 0.010), household income level (Interaction P = 0.002), dietary cholesterol intake (Interaction P = 0.017) on CVD were observed. More severe depressive symptoms are associated with increased risk of CVD in US population. The association may be more pronounced in the female population, population with diabetes, low family income level, or high dietary cholesterol intake.

Association of Graft Maturity on MRI With Return to Sports at 9 Months After Primary Single-Bundle ACL Reconstruction With Autologous Hamstring Graft.

Background: The relationship between graft maturity on magnetic resonance imaging (MRI) and return to sports (RTS) after anterior cruciate ligament (ACL) reconstruction is unclear. Purpose: To compare signal-to-noise quotient (SNQ) values and ACL graft T2* (gradient echo) values between patients who did RTS and those who did not RTS (NRTS) after ACL reconstruction and to evaluate the predictive value of T2* mapping for RTS after ACL reconstruction. Study Design: Case-control study; Level of evidence, 3. Methods: At a minimum of 9 months after arthroscopic single-bundle ACL reconstruction with autologous hamstring tendon graft, 82 patients underwent RTS assessment as well as MRI evaluation. The patients were classified into RTS (n = 53) and NRTS (n = 29) groups based on the results of the assessment. The SNQ values in the proximal, middle, and distal regions of the graft and the T2* values of the graft were measured on MRI. The correlation between T2* values and RTS was assessed using Spearman correlation analysis. Receiver operating characteristic curves were constructed to compare the diagnostic performance, and the optimal T2* cutoff value for detecting RTS was determined based on the maximum Youden index. Results: At 9 months after ACL reconstruction, the proximal, middle, and mean SNQ values in the RTS group were significantly lower than those in the NRTS group (proximal: 17.15 ± 4.85 vs 19.55 ± 5.05, P = .038; middle: 13.45 ± 5.15 vs. 17.75 ± 5.75, P = .001; mean: 12.37 ± 2.74 vs 15.07 ± 3.32, P < .001). The T2* values were lower in the RTS group (14.92 ± 2.28 vs 17.69 ± 2.48; P < .001) and were correlated with RTS (r = -0.41; P = .02). The area under the curve of T2* was 0.79 (95% CI, 0.75-0.83), and the optimal cutoff value for T2* was 16.65, with a sensitivity and specificity for predicting failure to RTS of 67.9% and 88.2%, respectively. Conclusion: Study findings indicated that the SNQs (mean, proximal, and middle) and the T2* values of the graft in the RTS group were significantly lower than those in NRTS group. A T2* value of 16.65 was calculated to predict patients who failed RTS tests with a sensitivity of 67.9% and specificity of 88.2%.

Global research status of anterior cruciate ligament reconstruction: a bibliometric analysis.

Purpose: The aim of this study is to comprehensively analyze the publications of anterior cruciate ligament reconstruction (ACLR) research and display the current research status in this field. Methods: Articles regarding ACLR research published before October 7, 2021, were downloaded from the Web of Science Core Collection. Excel 2016 and Bibliometric website were used to analyze the annual article trends and international cooperation network. CiteSpace V and VOSviewer were used to perform co-occurrence and citation analyses for journals, institutions, authors, cocitation authors and keywords. Burst keyword detection was also performed with CiteSpace V. Results: A total of 12 223 ACLR articles were identified. The American Journal of Sports Medicine (1636 publications, 92,310 citations), the Pennsylvania Commonwealth System of Higher Education (624 publications, 25,304 citations) and Freddie H. Fu (321 publications, 15,245 citations) were journals, institutions and authors with the most publications and citations, respectively. Patellar tendon was the keyword with the most occurrences (1618 times) and return to sport was the keyword with the most burst strength (burst strength: 46.99). Conclusion: ACLR-related publications showed a rapid increasing trend since 1990. A large number of articles have been published by authors from different institutions and countries, some of which have gained great academic influence. Based on keyword analysis, patellar tendon is identified as the research hotspot and return to sport is identified as the current research frontier.

Multi-planar instability, laxity and reduced knee flexion during the support phase of walking are determinants of return to sports.

Background: After anterior cruciate ligament reconstruction, some patients are not recommended to return to high-level physical activity because they fail to pass return-to-sports tests. The kinematic difference between these patients and those who pass the return-to-sports tests is unclear. Methods: Eighty-two patients who received anatomic single-bundle anterior cruciate ligament (ACL) reconstruction for unilateral ACL injury underwent return-to-sport tests during a hospital visit at a minimum of 9 months (9-11 months) of follow-up. Fifteen patients who passed the return-to-sports tests (RTS group) and fifteen patients who did not (NRTS group) were randomly selected to perform a treadmill walk under dual-fluoroscopic imaging system surveillance for a 6 degrees of freedom kinematic evaluation. Results: Of the 82 patients, 53 passed the return-to-sports tests 9 months after surgery, with a return-to-sports rate of 64.6%. In the stance phase, the NRTS group had a larger anterior tibial translation (1.00 ± 0.03 mm vs. 0.76 ± 0.03 mm, p = 0.001), a larger lateral tibial movement (1.61 ± 0.05 mm vs. 0.77 ± 0.05 mm, p < 0.001), a larger distal tibial displacement (-3.09 ± 0.05 mm vs. -2.69 ± 0.05 mm, p < 0.001), a smaller knee flexion angle (6.72 ± 0.07° vs. 8.34 ± 0.07°, p < 0.001), a larger varus angle (-0.40 ± 0.03°VS. -0.01 ± 0.03°, p < 0.001) and a larger external rotation angle (1.80 ± 0.05° vs. 1.77 ± 0.05°, p < 0.001) than the RTS group. The maximum anterior tibial translation of the NRTS group is also larger than that of the RTS group (3.64 ± 0.42 mm vs. 3.03 ± 0.59 mm, p = 0.003). Conclusion: Compared with patients passing RTS tests, those who fail to pass show significant anterior, lateral, and rotational instability; knee laxity; and reduced flexion angle of the knee in the support phase during walking, which may be the possible factors hindering a return to sports.

Multiplanar knee kinematics-based test battery helpfully guide return-to-sports decision-making after anterior cruciate ligament reconstruction.

Background: There are currently no well-established criteria to guide return to sports (RTS) after anterior cruciate ligament reconstruction (ACLR). In this study, a new test battery consisting of subjective and objective tests, especially multiplanar knee kinematics assessment, was developed to aid RTS decision making after ACLR. Methods: This study was conducted with 30 patients who were assessed a mean of 9.2 ± 0.5 months after ACLR. All patients underwent complete evaluations of both lower limbs with four objective assessments [isokinetic, hop, knee laxity, and 6-degree of freedom (6DOF, angle: flexion-extension, varus-valgus, internal-external rotation; translation: anteroposterior, proximodistal, mediolateral) knee kinematics tests] and two subjective assessments [International Knee Documentation Committee (IKDC) and Anterior Cruciate Ligament Return to Sport after Injury (ACL-RSI) questionnaires]. Limb symmetry indices (LSIs) of knee strength, hop distance, and range of motion (ROM) of knee kinematics were calculated. LSI ≥90%, IKDC scale score within the 15th percentile for healthy adults, and ACL-RSI score >56 were defined as RTS criteria. Results: Significant differences between affected and contralateral knees were observed in the quadriceps strength (p < 0.001), hamstring strength (p = 0.001), single hop distance (p < 0.001), triple hop distance (p < 0.001), and rotational ROM (p = 0.01). Only four patients fulfilled the overall RTS criteria. The percentages of patients fulfilling individual criteria were: quadriceps strength, 40%; hamstring strength, 40%; single hop distance, 30%; triple hop distance, 36.7%; knee ligament laxity, 80%; flexion-extension, 23.3%; varus-valgus rotation, 20%; internal-external rotation, 66.7%; anteroposterior translation, 20%; proximodistal translation, 33.3%; mediolateral translation, 26.7%; IKDC scale score, 53.3%; and ACL-RSI score, 33.3%. Conclusion: At an average of 9 months after ACLR, objectively and subjectively measured knee functional performance was generally unsatisfactory especially the recovery of knee kinematics, which is an important prerequisite for RTS.

Emerging research trends and foci of studies on the meniscus: A bibliometric analysis.

INTRODUCTION: Meniscus has always been the focus of sport medicine with thousands of articles published annually. Few study has tried to analyze these papers with bibliometric methods. The purpose of this study is to statistically analyze the output of meniscus research and determine emerging research trends and hot spots. METHODS: Papers related to the meniscus published from 2010 to 2019 were downloaded from the Web of Science Core Collection. Information about annual publications and journal distribution was analyzed by Excel 2016. Co-occurrence analysis of the countries/regions, institutions, authors, and keywords were performed with CiteSpace V, which was also used to perform a co-cited analysis of the references and generate corresponding knowledge maps as well as detect burst keywords. RESULTS: A total of 10,066 articles regarding meniscus were published between 2010 and 2019. The number of articles annual about meniscus increased from 786 to 1300. Knee Surgery Sports Traumatology Arthroscopy, the United States, University of Pittsburgh, and LaPrade RF were journal, country, institution, and author with the most publications, respectively. Makris EA et al. in 2011 was the most cited articles, with a citation of 198. Osteoarthritis, tear repair, anterior cruciate ligament, and articular cartilage were keywords with occurrence of more than 500. Meniscal extrusion, scaffold, and tissue engineering were terms with most burst strength. CONCLUSIONS: Meniscus-related publications showed a gradual rising trend from 2010 to 2019. Osteoarthritis, tear repairs, and the anterior cruciate ligament are the current research hot spots. Extrusion and scaffolds may be the frontiers of meniscus research in the next few years. LEVEL OF EVIDENCE: IV.