The American journal of sports medicine
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Despite relatively high reinjury rates after acute hamstring injuries, there is a lack of detailed knowledge about where and when hamstring reinjuries occur, and studies including imaging-confirmed reinjuries are scarce. ⋯ The majority of the hamstring reinjuries occurred in the same location as the index injury, early after RTS and with a radiologically greater extent, suggesting incomplete biological and/or functional healing of the index injury. Specific exercise programs focusing on reinjury prevention initiated after RTS from the index injury are highly recommended.
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A special type of meniscal lesion involving the peripheral attachment of the posterior horn of the medial meniscus (PHMM), termed ramp lesion, is commonly associated with anterior cruciate ligament (ACL) injury. However, no study has investigated its anatomic risk factors. Recently, increased meniscal slope has been identified as an independent anatomic risk factor for noncontact ACL injury. ⋯ Increased MMS was identified to be an independent anatomic risk factor of concomitant ramp lesions in noncontact ACL injuries, particularly for those with a TFI ≥6 months. This may provide additional information for counseling patients who have increased MMS on the greater risk of secondary PHMM lesions if their ACL-deficient knee joints are not well stabilized initially.
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A hamstring strain injury (HSI) has become the most common noncontact injury in soccer. Isokinetic muscle strength deficits are considered a risk factor for HSIs. However, underpowered studies with small sample sizes unable to determine small associations have led to inconclusive results regarding the role of isokinetic strength and strength testing in HSIs. ⋯ This study identified small absolute strength differences and a wide overlap of the absolute strength measurements at the group level. The small associations between lower hamstring eccentric strength and lower quadriceps concentric strength with HSIs can only be considered as weak risk factors. The identification of these risk factors still does not allow the identification of individual players at risk. The use of isokinetic testing to determine the association between strength differences and HSIs is not supported.
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Review Meta Analysis
Cartilage Restoration of the Knee: A Systematic Review and Meta-analysis of Level 1 Studies.
Focal cartilage defects of the knee are a substantial cause of pain and disability in active patients. There has been an emergence of randomized controlled trials evaluating surgical techniques to manage such injuries, including marrow stimulation (MS), autologous chondrocyte implantation (ACI), and osteochondral autograft transfer (OAT). ⋯ There is no significant difference between MS, ACI, and OAT in improving function and pain at intermediate-term follow-up. Further randomized trials with long-term outcomes are warranted.
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Randomized Controlled Trial
Liposomal Bupivacaine for Pain Control After Anterior Cruciate Ligament Reconstruction: A Prospective, Double-Blinded, Randomized, Positive-Controlled Trial.
Local anesthetics are commonly administered into surgical sites as a part of multimodal pain control regimens. Liposomal bupivacaine is a novel formulation of bupivacaine designed for slow diffusion of a single dose of local anesthetic over a 72-hour period. While early results are promising in various settings, no studies have compared pain management regimens containing liposomal bupivacaine to traditional regimens in patients undergoing anterior cruciate ligament (ACL) reconstruction. ⋯ ClinicalTrials.gov NCT02189317.