The American journal of sports medicine
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Treatment choices for skeletally immature patients sustaining anterior cruciate ligament (ACL) injuries have been controversial. The main dilemma is whether surgical treatment should be provided before patients reach skeletal maturity or whether nonoperative treatment should be provided until the physis has closed. Surgical reconstruction risks physeal damage, while delaying surgery may increase menisci and cartilage damage. ⋯ This is the first study to measure the incidence of ACL injuries in a skeletally immature population. For patients undergoing ACL reconstruction, an increased number of significant encounters was statistically significantly associated with combined meniscal and cartilage injuries, while increased time from injury to surgery was not significantly associated with additional injuries. In addition, one-third of the patients continued nonoperative treatment without symptoms that warranted surgical interventions during the follow-up period.
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Increasing attention has been paid to concussions and especially sports-related concussions in youth. To prevent an inappropriate return to play while symptomatic, nearly all states have now passed legislation on youth sports-related concussions. ⋯ More objective and accurate methods are needed to identify concussions. Changes in athlete attitudes on reporting concussive symptoms will likely not be accomplished through legislation alone.
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Osteochondral fractures are often seen on magnetic resonance imaging (MRI) of acutely injured knees, but their existence has gained little interest because of a lack of knowledge of their relation to treatment options and outcome. It is not clear whether acute phase synovial fluid (SF) concentrations of cartilage and bone markers and proinflammatory cytokines are different between traumatically injured knees with or without osteochondral fracture. ⋯ In acutely injured knees with hemarthrosis, a concomitant osteochondral fracture with disrupted cortical bone is associated with a higher degree of joint inflammation.
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A medial collateral ligament (MCL) knee sprain is a prevalent injury in athletic populations that may result in significant time lost to injury. Remarkably little is known of the epidemiology of this injury. ⋯ Medial collateral ligament injuries are relatively common in athletic cohorts. The most injurious sports are contact sports such as wrestling, hockey, judo, and rugby. Male athletes are at a greater risk than female athletes. Intercollegiate athletes are at a greater risk than intramural athletes. The average amount of time lost per injury was 23.2 days, with greater time lost with higher grade sprains than grade 1 sprains.
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Most states in the United States have passed laws regarding concussions, but little is known regarding the implementation of these laws. Hypothesis/ ⋯ Clinicians should be aware that athletes and parents may not be receiving significant concussion education.