Ankle fractures are frequent, and despite numerous publications on their treatment and outcome, there is a lack of precise data on the functional results in young, healthy and physically active ...patients. We hypothesized that patients who underwent open reduction and internal fixation (ORIF) for simple ankle fractures would have similar function compared to a healthy control group, whereas patients with complex fractures will have significant functional deficits. Furthermore, we postulate that there is a discrepancy between the radiological and the functional outcomes.
A set of specific provocation tests was developed to evaluate the postoperative possibility of weight bearing, stop-and-go activities and range of motion. In combination with three questionnaires and a radiographic evaluation, the true functional outcome and the possibility of participating in sporting activities were investigated and compared with those of an age- and sex-matched control group.
A significant impairment was found in unilateral and simple ankle fractures. This impairment increased in tests including stop-and-go activities in combination with load bearing and with the complexity of the fractures. Concerning the subjective outcome, there was a significant adverse effect for daily activities without any difference in preoperative or postoperative sporting activity between the groups. No difference was found in the radiological assessment.
Both simple and complex ankle fractures treated with ORIF have a significant and long-lasting impact on functional outcome in young and active patients. The radiological result is not associated with a good functional outcome.
BASEC-Nr. 2018 - 01124.
Colic surgery in horses impacts both short-term well-being of horses due to possible surgical and anesthetic complications and also long-term return to a sporting career. In this retrospective study, ...survival and complication rates, as well as functional outcome and behavioral problems in horses that underwent colic surgery were studied. Data from 283 horses that underwent colic surgery at a veterinary teaching hospital were analyzed. Furthermore, owners were contacted and requested to fill out a questionnaire concerning the first year of rehabilitation. Of 283 horses that underwent colic surgery, 167 (59%) were discharged home. After discharge from hospital, 34 horses (12%) were lost to follow-up. Of the remaining 133 horses, 128 were still alive after 1 year (96.2%), while 5 horses were euthanized due to recurrent colic. Of the horses that did not survive the hospitalization period 73 horses (25.8%) were euthanized intraoperatively and 36 horses (12.7%) during intensive care unit (ICU) stay. Survival of horses entering the ICU up to discharge from hospital was 79.5%. During rehabilitation, 49 horses (59.8%) that returned home experienced one or more recurrences of colic. Fifty-two horses (63.4%) that returned home reached at least preoperative level of performance. Altered behavior and gait-related problems during specific elements of riding (for instance during collecting, lateral bending, etc.) were reported in up to 46.2% of horses. Improving veterinary aftercare in collaboration with other disciplines (e.g., physiotherapy and saddle fitting) during rehabilitation could be a means to further improve athletic performance and welfare after recovery from colic surgery.
•Fifty nine percentage of horses that underwent a ventral midline celiotomy went home alive.•Ninety six percentage of horses that went home were still alive after 1 year.•Survival was significantly correlated to type of colic, complications during and total time spent in the ICU.•63.4% of horses that returned home reached at least the preoperative level of performance.
Background Patellar dislocation is common in young and active patients. The purpose of this study was to determine sporting activity following the medial reefing of patellar dislocation. Methods One ...hundred forty-four patients with objective patellar dislocation were treated between 2004 and 2013. Three groups were analyzed retrospectively with a minimum follow-up of 24 months: (1) primary dislocation that was treated with medial reefing without a recurrent dislocation until the day of follow-up (n = 74), (2) primary dislocation that was initially treated with medial reefing but with a recurrent dislocation until the day of follow-up (n = 44), and (3) medial reefing after failed conservative treatment (n = 26). Sporting activity was assessed using a widely-used sporting activity questionnaire and the Tegner score prior to the injury and at the follow-up (58.7 + or - 22.6 months after the injury). Clinical outcomes were assessed using IKDC and Kujala score. Results The Kujala score was 94.7 + or - 9.3 for Group 1, 84.1 + or - 16.6 for Group 2 and 93.4 + or - 9.7 for Group 3. IKDC at the time of follow-up was 97.2 + or - 9.3 for Group 1, 86.1 + or - 14.6 for Group 2 and 95.1 + or - 11.1 for Group 3. 91.9% of Group 1 and 92.3% of Group 3 were active in sports prior to their injuries and at the time of the follow-up. In Group 2, sporting activity reduced from 81.8 to 75.0%. In all groups, a shift from high performance to recreational sports was found. Conclusions Despite good clinical results, sporting activity was reduced following patellar dislocation treated with medial reefing. Also, a shift from engagement in high- to low-impact sports among the participants was noted. Keywords: Medial reefing, Sporting activity, Return to sports, Patellar dislocation
Background
There is increasing recognition that sport is important for individuals with haemophilia; however, there remains a paucity of data of the importance of this in adults, many of whom already ...have joint pathology related to childhood bleeds and treatment access. This multicentre, cross‐sectional study presents the impact of sport on health‐related quality of life (HRQoL), physical performance and clinical outcomes in adults with haemophilia.
Results
Fifty adults aged 35.12±14.7 with mild (n = 12), moderate (n = 10), or severe (n = 28) haemophilia A (70%) or B (30%) from four haemophilia centres across the United Kingdom participated in the study. A total of 64% were overweight/obese according to their BMI; median orthopaedic joint scores using the WFH Orthopaedic Joint Score (OJS) were 6 (range 0–48). On a VAS pain scale (range of 0–10), patients reported mean score of 5.66 ± 2.4. 36% of participants reported not doing any sport, mainly due to their physical condition. However, 64% of participants reported undertaking sporting activity including contact sports, mostly twice per week in average 4 h week−1. Participating in sport did not have a statistically significant impact on HRQoL; except in the domain ‘sport and leisure’ of the Haem‐A‐QoL. Patients doing more sport reported significantly better HRQoL than those doing less sport (P < 0.005). Those doing sport for more than 4 h week−1 had a significantly better physical performance than patients doing less sport (assessed with Hep‐Test‐Q). Encouraging physical activity and sport in older patients with haemophilia may have a direct impact on their HRQoL; thus, education about sport activity should be incorporated into routine haemophilia care.
To establish the reliability and responsiveness of a clinical test battery developed to determine readiness to return to sport after an upper extremity injury. A second objective was to examine the ...limb symmetry in single limb tests.
Methodological study.
Forty healthy participants (20 male) were tested weekly on three occasions.
Learning effect, inter-rater and intra-rater reliability was calculated for each test in the Shoulder Arm Return to Sports (SARTS) battery with repeated measures ANOVA and intraclass correlation coefficient (ICC). Measurement error and responsiveness were determined using Standard Error of Measure (SEM) and Minimal Detectable Change (MDC).
Drop Catches and Ball Taps showed a learning effect between Days 2–3. Intra-rater reliability for the remaining six tests between Days 2–3 ranged between 0.78 (95%CI 0.63–0.88) and 0.96 (95%CI 0.92–0.98) while inter-rater reliability on Day 2 ranged between ICC = 0.96 (95%CI 0.94–0.98) and ICC = 0.99 (95%CI 0.98–0.98). Two tests (BABER (91%) and Drop Catches (93%)) were significantly decreased on the non-dominant side (p = 0.05).
Six of the eight tests in the SARTS test battery demonstrate good psychometric properties to evaluate both open and closed chain upper extremity activities indicating their readiness for clinical use.
•6/8 tests in the SARTS test battery are reliable and can be used by clinicians to guide return to sport.•3 tests (BABER, Side Hold Rotations &Push-Up Claps) require a familiarization session before use.•2 tests (Drop Catches and Ball Taps) show a learning effect across the 3 testing sessions.
Childhood and adolescence are critical periods of bone development. Sporting activity is thought to impact peak bone mass acquisition, but most studies have used dual-energy X-ray absorptiometry ...(DXA) to assess bone health and reported associations between bone mass and elite sporting activity. The objective of this study was instead to assess the relationship between recreational sporting activity (RSA) and another bone assessment, calcaneal quantitative ultrasound (cQUS), in adolescents and young adults.
We related recreational sporting activity, assessed through a lifestyle questionnaire, to heel ultrasound bone parameters in a cohort of New Zealand students aged 16-35 years. Complete datasets with data on all relevant confounders (body mass index (BMI), pubertal timing, smoking status, and alcohol consumption) were available for 452 participants. cQUS was performed using a Lunar Achilles EX II machine to obtain bone parameters, broadband ultrasound attenuation (BUA), and speed of sound (SOS); stiffness index (SI) was derived from these measures. All descriptive statistics and statistical analyses were carried out using SPSS Statistics for Macintosh, Version 23.0 (IBM Corp., Armonk, NY, USA). Results are presented as p-values and 95% CI.
Reported lifetime sport participation declined after an individual's mid-teens. Bone cQUS parameters (SI and BUA and T-score) were all positively associated with BMI, and current physical activity (SI, SOS, BUA, T-score, and Z-score) with SI and SOS measures most strongly associated with current high impact and past recreational sporting activity (all p < 0.05).
Calcaneal heel ultrasound bone parameters were associated with physical activity, with SI and SOS rather than BUA more strongly related to current and past recreational sporting activity in young New Zealand adults.
Resumen: En las últimas décadas, debido a factores sociales diversos, asistimos al desarrollo y a la transformación de las prácticas deportivas. En el presente artículo llevamos a cabo un estudio ...longitudinal de la práctica deportiva entre los años 1995 y 2014, en España, entre la población de 18 años y más, de ambos sexos, atendiendo a las relaciones sociales que se dan en la práctica deportiva. El análisis, obtenido a partir de bases de datos nacionales, ha demostrado la hipótesis principal de estudio en base al análisis de tendencias de práctica del deporte, puesto que la práctica del deporte individual ha aumentado frente a formas de prácticas colectivas junto a amigos o familia. Mostramos, también, las variaciones de la práctica deportiva dependiendo del tipo de relación primaria que se establece en el deporte según sexo, edad, hábitat, ocupación, formación, forma de hacer deporte, grado de competición, frecuencia, instalaciones deportivas utilizadas, tipo de deporte practicado, horas de tiempo libre y sensación subjetiva de felicidad. Abstract: We have seen a transformation in the development of sporting activities over recent decades. There are a number of social factors behind this. In this article, we report a longitudinal study of sporting activities in Spain between 1995 and 2014 among the population aged 18 and over, including both sexes, examining the social relationships that arise in sporting activities. Our analysis is based on national databases and analysis of trends in sporting activities. It demonstrates the main hypothesis of the study, which is that individual sporting activities have increased compared to group activities with family and friends. We also examine changes in sporting activities depending on the primary relations established in the sport, by sex, age, habitat, occupation, educational level, the form in which the sport is practised, the degree of competition, frequency, the sports facilities used, the type of sport, hours of free time and the subjective sensation of happiness.
Retrospective cohort study.
This study aimed to investigate how participation in sporting activity affects patient-reported outcome (PRO), including Neck Disability Index (NDI), in males and females.
...Previously, our study reported that factors with a negative influence on the NDI in females were a lack of sporting activities. However, it was still unclear why it affected poor scores of NDI.
The subjects were 473 volunteers. They were divided into two groups (activity and non-activity) according to participation or non-participation in sporting activities using a self-filled questionnaire. The evaluation items were height, weight, grip strength, bone density, Hospital Anxiety and Depression Scale (HADS) score, standing radiographic parameters, PRO (evaluated by EuroQol-5 dimension EQ-5D, Oswestry Disability Index ODI), and NDI.
There were 101 males in the non-activity group and 69 in the activity group and 178 females in the non-activity group and 125 in the activity group. For the males, the evaluation items with significant influence were cervical lordosis (non-activity group:activity group, 17°:22°) and T1 slope minus cervical lordosis (10°:6°, p <0.05). For the females, the evaluation items with significant influence were sagittal vertical axis (28:14 mm), HADS (10.4:8.4), EQ-5D (0.79:0.86), ODI (17:12), and NDI (12:9, p <0.01). HADS and PRO in the females were significantly correlated with the EQ-5D (-0.40), ODI (0.43), and NDI (0.55).
Males who participated in sporting activities had better cervical spine alignment but no effect on PRO. Females with sporting activities had better spinal global alignment and less mental stress. It is suggested that sporting activity in females might be associated with PRO because HADS highly correlates with PRO.
Purpose
The aim of this article was to evaluate the resumption of physical activity and sports after valgus osteotomy for medial femorotibial osteoarthritis.
Methods
This series is composed of 83 ...patients, with 27 females and 56 males. The mean age was 50.4 ± 9.53 years (32–67) at the time of operation. Before the onset of symptoms of knee osteoarthritis, four (4.8 %) patients practiced a competitive sport, 44 (53 %) one (or more) recreational sport on a regular basis, 17 (20 %) occasionally and 18 (21.6 %) did not practice any sport but were active. Sixty-two opening wedge high tibial osteotomies were performed as well as 21 double level osteotomies for severe deformity. All the osteotomies were computer-assisted in order to reach the best overcorrection.
Results
At a mean follow up of 5.75 ± 1.3 years (five to nine years), 71 patients (85.5 %) resumed sporting activities and 66 (79.5 %) felt they had found a sporting level equal to the level prior surgery. The mean Lysholm score increased from 62.51 ± 15.53 points (30-100) pre-operatively to 90.49 ± 8.62 points (55–100) postoperatively (
p
< 0.001). The Tegner and UCLA scores didn’t decrease significantly after surgery (4.53 and 7.14 pre-operatively versus 4.1 and 6.55 postoperatively,
p
= 0.07 and 0.09). The mean postoperative KOO score was 73.52 ± 17.20. The frequency of sports sessions per week (2.36 ± 1.6) did not decrease significantly after surgery (2.13 sessions,
p
= 0.34). On the other hand, the duration of activities decreased significantly from 4.68 hours/week ± 4.25 to 3.48 hours/week (
p
= 0.04). Of the patients who practiced running before surgery 85 % (17 of 20) were able to resume this activity.
Conclusion
This study demonstrates that knee osteotomies for medial femorotibial osteoarthritis allow the resumption of sustained physical activity such as jogging or skiing downhill in a majority of patients.
Background: There are limited data regarding activity after osteochondral transplantation of the talus in orthopaedic publications.
Hypothesis: Osteochondral transplantation of the talus is a ...clinically successful treatment and enables patients to pursue regular and ongoing recreational sporting activities.
Study Design: Case series; Level of evidence, 4.
Methods: One hundred thirty-one patients were retrospectively analyzed to determine their sporting and recreational activities at an average of 60 ± 28.4 months postoperatively (range, 24-141 months). The clinical evaluation included the Tegner activity scale, the Activity Rating Scale (ARS), and a visual analog scale (VAS) for pain.
Results: The VAS illustrated significant preoperative to postoperative improvements (6.3 to 2.7; P < .001). Regarding sporting activity, 96.9% of the patients were engaged in sports during their lifetimes compared with 83.8% the year before surgery and 89.3% at the time of survey. The Tegner score dropped from 5.9 preoperatively to 5.0 after surgery (P = .001), and the ARS decreased from 8.9 preoperatively to 6.8 postoperatively (P = .003). The sports frequency and the duration of activities did not significantly change after surgery: 1.7 ± 2.0 (range, 0-8; P = .053) and 4.2 ± 3.8 hours (range, 0-30 hours; P = .052), respectively. The number of actual reported different sports disciplines was unchanged in comparison to the year before surgery (3.7 ± 2.9; range, 0-12). The top 10 cited sports activities did not change for the lifetime, preoperative, and postoperative periods but illustrated an altered order. Although the overall satisfaction with the surgery was good, 15% of our patients were only partially satisfied, and 14% were not satisfied with the procedure.
Conclusion: Patients engage in fewer, less frequent sporting activities when a symptomatic osteochondral lesion (OCL) at the talus is present. Talar osteochondral transplantation shows good clinical midterm results and allows patients to return to sporting activity. However, we found patients modify their postoperative sporting activities, and we noted a reduction of participation in high-impact and contact sports.
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