The American journal of sports medicine
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Mild traumatic brain injury (mTBI) is an emerging public health issue in high-contact sports. Understanding the incidence along with the risk and protective factors of mTBI in high-contact sports such as rugby is paramount if appropriate preventive strategies are to be developed. ⋯ Nonprofessional rugby has a high incidence of mTBI, with the absence of headgear and a recent history of mTBI associated with an increased risk of subsequent mTBI. These findings highlight that both use of headgear and the management of prior concussion would likely be beneficial in reducing the likelihood of mTBI among nonprofessional rugby players, who compose more than 99% of rugby union players in Australia.
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Fibrous connections and fibrofatty tissue between the layers of the medial retinaculum have prevented accurate definition of the true anatomy of the medial patellofemoral ligament. This has led to confusion about the origin, form, course, and insertion of this structure. ⋯ This study provides essential new information that could help surgeons safely locate the medial patellofemoral ligament and repair or reconstruct it anatomically.
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The roles of each ligament supporting the subtalar joint have not been clarified despite several biomechanical studies. The effects of ankle braces on subtalar instability have not been shown. ⋯ In cases of severe ankle sprains involving the calcaneofibular ligament, cervical ligament, and interosseous talocalcaneal ligament injuries, application of an ankle brace might be less effective in limiting internal-external rotational instabilities than in cases of inversion instabilities in the subtalar joint. An improvement in the design of the brace is needed to restore better rotational stability in the subtalar joint.
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Humeral head defects have been associated with failed anterior shoulder instability repairs. Quantitative data are required to determine (1) the critical defect size for consideration of surgical repair and (2) the ability of proposed repair techniques to restore normal joint function. ⋯ Defects as small as 12.5% of the humeral head have biomechanical consequences that may affect joint stability. In addition, shoulders with large osteoarticular defects (37.5% or 50.0%) may benefit from osteoarticular allograft transplantation to restore shoulder stability.
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Although arthroscopic glenoid labrum repair using the BioKnotless anchor is common, the benefits and efficacy have not been fully evaluated. ⋯ Clinically and radiologically, the BioKnotless anchor appears to be an acceptable alternative for arthroscopic labrum repair, and a suitable material allowing the avoidance of certain troublesome drawbacks of the conventional knot-tying suture anchor.