Sports Med Research Articles

Mental health impacts of interpersonal violence in sports

Mental health impacts of interpersonal violence in sports

Research trends of platelet-rich plasma therapy on knee osteoarthritis from 2011 to 2021: A review.

Platelet-rich plasma (PRP) has been widely used to alleviate osteoarthritis of the knee, and research results are abundant. However, there are no bibliometric reports in publications in this field. Therefore, the current status of PRP for the treatment of osteoarthritis of the knee from 2011 to 2021 was analyzed using Citespace 6.1.R2 software. Publications regarding PRP treating Knee Osteoarthritis between 2011 and 2021 were extracted from the Web of Science database. CiteSpace was used to analyze the number of publications, countries, institutions, journals, authors, cited references, and keywords by using standard bibliometric indicators. A total of 988 publications were searched from 2011 to 2021. In the last decade, the number of publications has increased in the field. Brian J. Cole was the author with the most output, with 31 relevant articles, and Giuseppe Filardo ranked first in cited authors. Am J Sport Med was the most cited journal. In this field, the most prolific country is the United States and the most prolific institution is Rush University. An article published by Sandeep Patel ranked first in cited references with 118 citations. "Randomized controlled trial" was the most bursting keyword and other more popular keywords about PRP for knee osteoarthritis: "hyaluronic acid," "double-blind," and "mesenchymal stem cell." This bibliometric study provides a decade of current clinical research on PRP for the treatment of osteoarthritis of the knee, which can help researchers understand the hot spots in the field and provide a new direction for their research.

Adhesive capsulitis after COVID-19 vaccine injection: a peculiar case treated with combined bursa distention and glenohumeral capsular hydrodilatation

Frozen shoulder is a common and self-limiting condition affecting the soft tissues of the shoulders, characterized by severe pain, impaired range of motion (ROM) and limitation of daily activities. Its prevalence is 5% and it occurs most commonly in the fifth and sixth decades of life; women are more affected [DePalma in Clin Orthop Relat Res 466:552–560, 2008]. It can be idiopathic or associated with other conditions such as metabolic disorders, diabetes, thyroid diseases, prolonged immobilization, trauma [DePalma in Clin Orthop Relat Res 466:552–560, 2008], or complications after vaccine administration known as SIRVA (Shoulder injury related to vaccine administration). SIRVA is not caused by the vaccine itself but by inappropriate vaccination techniques [Martín Arias et al. in Vaccine 35:4870–4876, 2017]. The natural history of the frozen shoulder is a progression through three stages based on clinical and arthroscopic presentations: freezing, frozen and thawing [DePalma in Clin Orthop Relat Res 466:552–560, 2008; Do et al. in Orthop J Sport Med 9:232596712110036, 2021]. The onset is characterized by disabling pain, that worsens at night; it is induced by inflammation and hypervascularity and lasts from 10 to 36 weeks [Do et al. in Orthop J Sport Med 9:232596712110036, 2021]. The second stage is predominated by stiffness and severe reduction of ROM. This phase typically lasts from 9 to 12 months [Do et al. in Orthop J Sport Med 9:232596712110036, 2021]. Eventually, a recovery phase occurs, with a gradual recovery of the ROM that can last between 12 and 42 months. Ultrasound is an emerging diagnostic tool that contributes to differential diagnosis and treatment [Zappia et al. in Insights Imaging 7:365–371, 2016; Ricci et al. in J Ultrasound Med 39:633–635, 2020]: signs of adhesive capsulitis consist of thickening of the inferior recess of the glenohumeral joint capsule, thickening of the coracohumeral ligament and soft tissue structures in the rotator cuff interval, with hypervascularity. An unspecific sign is increased fluid in the tendon sheath of the long head of the biceps [Martín Arias et al. in Vaccine 35:4870–4876, 2017; Tandon et al. in J Ultrasound 20:227–236, 2017].

Single-cell RNA sequencing reveals different signatures of mesenchymal stromal cell pluripotent-like and multipotent populations

Somatic stem cells are advantageous research targets for understanding the properties required to maintain stemness. Human bone marrow-mesenchymal stromal cells (BM-MSCs) were separated into pluripotent-like SSEA-3(+) Muse cells (Muse-MSCs) and multipotent SSEA-3(-) MSCs (MSCs) and were subjected to single-cell RNA sequencing analysis. Compared with MSCs, Muse-MSCs exhibited higher expression levels of the p53 repressor MDM2; signal acceptance-related genes EGF, VEGF, PDGF, WNT, TGFB, INHB, and CSF; ribosomal protein; and glycolysis and oxidative phosphorylation. Conversely, MSCs had higher expression levels of FGF and ANGPT; Rho family and caveola-related genes; amino acid and cofactor metabolism; MHC class I/II, and lysosomal enzyme genes than Muse-MSCs. Unsupervised clustering further divided Muse-MSCs into two clusters stratified by the expression of cell cycle-related genes, and MSCs into three clusters stratified by the expression of cell cycle-, cytoskeleton-, and extracellular matrix-related genes. This study evaluating the differentiation ability of BM-MSC subpopulations provides intriguing insights for understanding stemness.

Stimulant use by athletes

Stimulant use by athletes

Effect of caffeine on mitochondrial biogenesis in the skeletal muscle - A narrative review.

Caffeine is one of the most widely used substances as recreational drug for performance-enhancement in sport, underpinned by a strong evidence base. Although the effects of caffeine are widely investigated within the scope of performance physiology, the molecular effects of caffeine within skeletal muscle remain unclear. Evidence from invitro and invivo models suggest that caffeine regulates the glucose metabolism in the skeletal muscle. Moreover, caffeine seems to stimulate CaMKII, PPARδ/β, AMPK and PGC1α, classical markers of exercise-adaptations, including mitochondrial biogenesis and mitochondrial content. This review summarizes evidence to suggest caffeine-effects within skeletal muscle fibers, focusing on the putative role of caffeine on mitochondrial biogenesis to explore whether caffeine supplementation might be a strategy to enhance mitochondrial biogenesis.

Post-COVID-19 condition: current evidence and unanswered questions

Post-COVID-19 condition: current evidence and unanswered questions

Middle Aged, Everlasting Athletes, and Osteoarthritis: The Present and Future.

One issue was definitely not enough! We are prompted to be active, and we are told that exercise is medicine. Indeed, exercise is great medicine: it keeps at bay metabolic conditions associated with sedentarism, and exerts a favorable effect on our mental health. Some of us are born exercisers, some become so, some drift from being great athletes in youth to a life in an armchair, and some discover exercise later in life. Many of us are competitive, and we often compete against ourselves, never to win. For all of us, however, middle-age looms, and osteoarthritis (OA) may become a major issue: in the West, up to 20% of individuals close to retirement age suffer from it, and their life can be ruined. It is not surprising, therefore, that so much interest is placed on how to prevent, diagnose, manage, “cure” OA: a never-ending battle, with no end in sight. As physicians, we would like to know why some of our patients have developed OA, and others are spared. Why some present little evidence of joint degeneration, and are crippled with pain. Above all, we want to make our patients better. The first part of this series produced a great set of evidence-based systematic reviews of the literature on several epidemiological aspects of OA and middle age sports practice. In a natural evolution, this second issue of Sports Medicine and Arthroscopic Review continues along those lines, and dwells in some aspects of biology and regenerative medicine, examining, for example, how drugs can be delivered in a novel fashion, and whether allogeneic tissues can be used to regenerate our battered articular cartilage. In this field, imagination has to be married with high-level science to progress our clinical knowledge. Eventually, exercise is medicine, and, as with all medications, too much is never too good. The spectre of overdosing must be corrected by our regenerative capabilities. Hopefully, this issue will help pave the way. On the Cover: Role of cytokines in mediating the communication between immune cells. In color, the molecules upregulated in platelet-rich plasma compared with platelet-poor plasma. Sports Med Arthrosc Rev. 2022;30:141–146.

Prevention and treatment of psychiatric disorders through physical activity, exercise, and sport

Prevention and treatment of psychiatric disorders through physical activity, exercise, and sport

Author Correction: Japanese physical fitness surveillance: a greater need for international publications that utilize the world’s best physical fitness database [J Phys Fitness Sports Med, 11 (3): 161-167 (2022)

Author Correction: Japanese physical fitness surveillance: a greater need for international publications that utilize the world’s best physical fitness database [J Phys Fitness Sports Med, 11 (3): 161-167 (2022)

Supporting physical activity in an ageing world: a call for action

Supporting physical activity in an ageing world: a call for action

Poster 254: Mechanical Response of ACL to Submaximal Fatigue Loading

Poster 254: Mechanical Response of ACL to Submaximal Fatigue Loading

Poster 223: Evidence-Based Opioid Prescribing Guidelines Following Anterior Cruciate Ligament Reconstruction (ACLR)

Objectives:Opioid prescriptions following anterior cruciate ligament reconstruction (ACLR) vary substantially.1-3 Expert panel guidelines recommend up to 50 pills for ACLR with many surgeons refilling 40 or more tablets.1,3 The CDC warns that a five-day supply is sufficient to develop opiate dependence.4 Current recommendations are based on consensus rather than evidence and place a vulnerable population at risk for opiate misuse.2,3 Orthopaedic surgeons do not possess evidence driven regimens for opioid prescriptions following ACLR.5,6 The purpose of this study was to develop evidence-based prescription guidelines for ACLR. We hypothesized that patients would require fewer opioids than traditional guidelines suggest with a high rate of patient satisfaction.1. Beck, J.J., et al., Prospective Study of Acute Opioid Use After Adolescent Anterior Cruciate Ligament Reconstruction Shows No Effect From Patient- or Surgical-Related Factors. J Am Acad Orthop Surg, 2020. 28(7): p. 293-300.2. Wyles, C.C., et al., Implementation of Procedure-Specific Opioid Guidelines: A Readily Employable Strategy to Improve Consistency and Decrease Excessive Prescribing Following Orthopaedic Surgery. JB JS Open Access, 2020. 5(1): p. e0050.3. Stepan, J.G., et al., Development of an Institutional Opioid Prescriber Education Program and Opioid-Prescribing Guidelines: Impact on Prescribing Practices. J Bone Joint Surg Am, 2019. 101(1): p. 5-13.4. Shah A HC, Martin BC. Characteristics of Initial Prescription Episodes and Likelihood of Long-Term Opioid Use — United States, 2006–2015. MMWR Morb Mortal Wkly Rep 2017:265-269.5. Reider, B. Opioid Epidemic. Am J Sports Med, 2019. 44(5): p. 1039-1042.6. Morris BJ, Mir HR. The opioid epidemic: Impact on orthopaedic surgery. J Am Acad Orthop Surg 2015;23: 267-271.Methods:This multicenter prospective study enrolled 46 patients undergoing ACLR. Subject demographics and opioid prescriptions were recorded at the time of enrollment. All patients were given instructions and education on opiate use. All patients followed the same perioperative, multimodal analgesic regimen (Table 1). Following surgery, patients were given postoperative “Pain Journals” to document visual analog scale (VAS) pain scores and to track their daily opioid consumption for the first 7 postoperative days (PODs) and on postoperative visit (POV) at 14 days. No changes were made to existing prescribing habits, postoperative physical rehabilitation, or surgical methodology.Results:35 patients were included in this analysis. Mean subject age was 39 years old. 46% of patients were male; 54% of patients were female. Patients were prescribed a median of 15 oxycodone 5 mg pills and consumed a median of 2 pills postoperatively. Mean postoperative opioid consumption was 5 pills (range 0 to 31 pills). 42% of patients consumed 0 opioid pills; 77% of patients consumed ≤ 5 opioid pills; 73% of patients discontinued opioid use after POD 2 (Figure 1). Patients reported a mean daily VAS value of 2.5 of 10; mean satisfaction with pain management was high at 4.16/5 on a Likert satisfaction score. Overall, patients consumed a mean 28% of their opioid prescriptions, leaving 230 opioid pills not consumed.Conclusions:This study suggests that current expert panels may be recommending an unrequired volume of opioids. As the third largest prescriber of opiate medication, orthopedic surgeons are charged with reducing the risk of opiate dependence, particularly in the ACLR vulnerable population.6 Based on our findings, patients only require 15 Oxycodone 5mg tablets following ACLR. Despite this lower volume prescription, mean pain scores remained below 3/10, patient satisfaction with pain control remained high, and 72% of opiate medication prescribed was not used.

Last Word on Viewpoint: Using V̇o2max as a marker of training status in athletes-can we do better?

Last Word on Viewpoint: Using V̇o2max as a marker of training status in athletes-can we do better?

An immunometabolic signature of athletes susceptible to respiratory tract illness? Comment on: Evidence of immunometabolic dysregulation and airway dysbiosis in athletes susceptible to respiratory illness.

An immunometabolic signature of athletes susceptible to respiratory tract illness? Comment on: Evidence of immunometabolic dysregulation and airway dysbiosis in athletes susceptible to respiratory illness.

Osteochondral lesions of the talar dome in the athlete: what evidence leads to which treatment

Osteochondral lesions of the talar dome in the athlete: what evidence leads to which treatment

Web-based exercise therapy for the treatment of depression

Web-based exercise therapy for the treatment of depression

Biomechanical Analysis of Tibial Motion and ACL Graft Forces After ACLR with and without let at Varying Tibial Slopes

Background:Lateral extra-articular tenodesis (LET) is being performed with increasing frequency in the setting of anterior cruciate ligament reconstruction (ACLR) as a way to decrease rotational instability and graft failure rates, especially in young, active patients. The degree of posterior tibial slope has been shown to affect ACL graft failure rates.1 The effect of LET plus ACLRs on tibial motion and graft forces in the setting of varying tibial slopes has not been elucidated.Hypothesis/Purpose:LET will decrease tibial translation, tibial rotation, and ACL graft forces compared to ACLR alone with increasing tibial slope throughout knee range of motion.Methods:Twelve cadaveric knees (40.5 mean age, all female) were tested in 4 conditions (1: intact; 2: ACLR; 3: ACLR + LET; and 4: ACL cut) with varying posterior tibial slopes (5°, 10°, 15°, and 20°) at three flexion angles (0°, 30, ° and 60°). Specimens were mounted to a load frame which applied a 500-N axial load with 1 N-M of internal rotation torque (Figure 1). The amount of tibial translation was measured using a laser sensor and rotation was measured along the axis of the load frame. ACL graft forces were measured via a force transducer.Results:No clinically relevant difference was found in graft force (all differences <6.8 N, except the 5° posterior tibial slope at 30° of flexion showing a 12.1 N reduction with LET), anterior tibial translation (all differences <2.4 mm), or internal rotation (all differences < 1.59°). Compared to the intact state, the cut ACL state had higher anterior tibial translation (maximum increase +9.1 mm at slope 20°, Flexion 60°) and internal rotation (maximum increase +4.3° at slope 5°, flexion 30°). Higher ACL graft forces were observed with increasing posterior tibial slope (ACLR graft force at 0° of flexion was 81.6 N at 5°, 97.8 N at 10°, 107.0 N at 15°, 113.9 N at 20° of slope). Figure 2 shows ACL graft forces in N, Figure 3 shows anterior tibial translation in mm and Figure 4 shows internal rotation in degrees. All figures present data at 30°of flexion.Conclusion:No clinically relevant difference was shown with the addition of LET in the setting of ACLR for patients with posterior tibial slopes from 5° to 20° at flexion angles of 0°, 30°, and 60° in regards to graft force, anterior tibial translation, and internal tibial rotation under a 500 N compressive load.Figure 1.AP and Posteromedial views of the testing specimen mounted on load frameFigure 2.ACL Graft Force at 500N compression at Flexion 30° for ACLR (Red) vs ACLR+LET (Blue) states at varying posterior tibial slopes (5°, 10°, 15°, and 20°)Figure 3.Anterior Tibial Translation at Flexion 30° for all states (Intact (blue), ACLR+LET (red), ACLR (green), ACL cut (orange)) at varying posterior tibial slopes (5°, 10°, 15°, and 20°)Figure 4.Internal Tibial Rotation at Flexion 30° for all states (Intact (blue), ACLR+LET (red), ACLR (green), ACL cut (orange)) at varying posterior tibial slopes (5°, 10°, 15°, and 20°)Reference:1. Bernhardson AS, Aman ZS, Dornan GJ, et al. Tibial Slope and Its Effect on Force in Anterior Cruciate Ligament Grafts: Anterior Cruciate Ligament Force Increases Linearly as Posterior Tibial Slope Increases. Am J Sports Med. 2019;47(2):296-302. doi:10.1177/0363546518820302

Long COVID: systemic inflammation and obesity as therapeutic targets

Long COVID: systemic inflammation and obesity as therapeutic targets

Author Correction: Post-training urinary titin fragment concentration increases in athletes with previous muscle strain injury: a pilot study in soccer players [J Phys Fitness Sports Med, 10 (5): 263-268 (2021)

Author Correction: Post-training urinary titin fragment concentration increases in athletes with previous muscle strain injury: a pilot study in soccer players [J Phys Fitness Sports Med, 10 (5): 263-268 (2021)