Introduction
Musculoskeletal (MSK) injuries in US trail sports are understudied as trail sport popularity grows. This study describes MSK injury patterns among hikers, trail runners, and mountain ...bikers from 2002 through 2021 and investigates MSK injury trends acquired during mountain sports.
Methods
The National Electronic Injury Surveillance System (NEISS) was used to identify US emergency department (ED) patients from 2002-2021 (inclusive) who endured MSK injuries during hiking, trail running, or mountain biking. Injury rates and national estimates were calculated across demographics.
Results
9835 injuries were included (48.4% male, 51.6% female). Injuries increased over time, with 1213 from 2002-2005 versus 2417 from 2018-2021. No sex differences existed before 2010, after which female injury rates exceeded those of males. The following findings were statistically significant, with P<0.05: females endured more fractures and strains/sprains; males endured more lacerations; concussions and head injuries were higher among those <18 y; dislocations and strains/sprains were higher for 18 to 65 y; fractures were higher for >65 y; <18 y had high mountain-biking and low running rates; 18 to 65 y had high running rates; and >65 y had low biking and running rates. Although all diagnoses increased in number over time, no significant differences existed in the proportion of any given diagnosis relative to total injuries.
Conclusions
MSK injuries during trail sports have increased since 2002. Males endured more injuries until 2009, after which females endured more. Significant sex and age differences were found regarding injury diagnosis and body parts. Further studies are needed to confirm these trends and their causes.
Risk factors for 30-day readmission following hip arthroscopy Hartwell, Matthew J.; Morgan, Allison M.; Johnson, Daniel J. ...
Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA,
04/2020, Letnik:
28, Številka:
4
Journal Article
Recenzirano
Purpose
Hip arthroscopy is known to be safe with low rates of postoperative complications. The purpose of this study is to evaluate hip arthroscopy cases in a national surgical database to identify ...risk factors associated with readmission.
Methods
The American College of Surgeons National Surgical Quality Improvement Program database was queried from 2012 to 2016 for current procedural terminology billing codes related to hip arthroscopy. International Classification of Diseases diagnostic codes were used to exclude cases involving infection, fracture, or open procedures. Univariate and multivariate analyses were performed to identify risk factors associated with 30-day readmission.
Results
1493 patients were identified who had undergone hip arthroscopy. The most common procedures were labral resection or chondroplasty (
n
= 589, 39.5%) and femoroplasty (
n
= 527, 35.3%). The 30-day complication rate was 1.7% and the most common complications following the procedure were bleeding (
n
= 12, 0.8%) superficial infections (
n
= 5, 0.3%), and returning to the operating room (
n
= 4, 0.3%). The 30-day readmission rate was 1.3%. On multivariate analysis, hypertension requiring anti-hypertensive medication (odds ratio OR, 3.5; 95% confidence interval CI, 1.4–8.7) and chronic corticosteroid or immunosuppressant use (OR 7.2; 95% CI 1.9–26.7) were identified as independent risk factors for readmission. There was no difference in complication rates when hip arthroscopy was performed with isolated femoroplasty (
n
= 340), isolated acetabuloplasty (
n
= 103), both (
n
= 187) or neither (
n
= 863).
Conclusion
These findings confirm that the 30-day readmission (1.3%) and complication rate (1.7%) are low for isolated hip arthroscopy procedures; however, hypertension and chronic steroid use are independent risk factors for readmission.
Level of evidence
Retrospective comparative study, Level III.
Purpose of Review
Arthroscopic hip surgery for femoroacetabular impingement syndrome has evolved over time and has resulted in significantly improved clinical outcomes. These outcomes can be measured ...by clinical and radiographic metrics. Return to sport is commonly used as an outcome measure, not only in terms of overall rate but also type of sport, level of competition, and timing of return, as its quantitative definition continues to develop. Qualitative research methods can highlight the patient-derived themes that affect an athlete’s individual return to sport pathway, and can augment the existing methods of outcome reporting. We will specifically review the qualitative research that has been performed on evaluating return to sport after arthroscopic hip surgery for femoroacetabular impingement syndrome.
Recent Findings
Current evidence finds a high overall rate of return to sport at 87–93% after arthroscopic hip surgery for femoroacetabular impingement syndrome. The available qualitative research in this body of literature, which is limited, has found three main overarching themes behind athletes’ decision and ability, or inability, to return to sport: self-efficacy, social support, and resetting expectations.
Summary
Athletes experience high rates of return to sport and athletic performance after arthroscopic hip surgery for femoroacetabular impingement syndrome. This review highlights the qualitative considerations for these athletes in their overall readiness to return to sport, and its utility for treating physicians as we interact with these athletes both pre- and post-operatively. Further research is required to elucidate any further overarching themes that may be prevalent in different levels of competition.
Background: Distal biceps rupture is a relatively uncommon injury that can significantly affect quality of life. Early complications following biceps tendon repair are not well described in the ...literature. This study utilizes a national surgical database to determine the incidence of and predictors for short-term complications following distal biceps tendon repair.
Methods: The American College of Surgeons’ National Surgical Quality Improvement Program database was used to identify patients undergoing distal biceps repair between January 1, 2011, and December 31, 2017. Patient demographic variables of sex, age, body mass index, American Society of Anesthesiologists class, functional status, and several comorbidities were collected for each patient, along with 30-day postoperative complications. Binary logistic regression was used to calculate risk ratios for these complications using patient predictor variables.
Results: Early postoperative surgical complications (0.5%)—which were mostly infections (0.4%)—and medical complications (0.3%) were rare. A readmission risk factor was diabetes (risk ratio RR, 4.238; 95% confidence interval CI, 1.180–15.218). Non-home discharge risk factors were smoking (RR, 3.006; 95% CI, 1.123–8.044) and ≥60 years of age (RR, 4.150; 95% CI, 1.611– 10.686). Maleness was protective for medical complications (RR, 0.024; 95% CI, 0.005–0.126). Surgical complication risk factors were obese class II (RR, 4.120; 95% CI, 1.123–15.120), chronic obstructive pulmonary disease (COPD; RR, 21.981; 95% CI, 3.719–129.924), and inpatient surgery (RR, 8.606; 95% CI, 2.266–32.689).
Conclusions: Complication rates after distal biceps repair are low. Various patient demographics, medical comorbidities, and surgical factors were all predictive of short-term complications. KCI Citation Count: 0
Performance prediction of induction machines (IMs) is highly dependent on the accuracy of the material characteristics and geometry of the machine during the modeling stage. To reduce the complexity ...of an IM model, normally the slotting effects are neglected. Likewise, the permeability of the stator and rotor cores are assumed to be infinite leading to an ideal set of partial differential equations (PDEs) for homogenous and isotropic materials. In this paper, the permeability of the stator and rotor cores are assumed not to be infinite and the slotting effects are taken into consideration to propose a more accurate and realistic model of an IM to reduce the discrepancies between the performance expectations and actual results. Fourier-based (FB) magnetic field approach is used to fulfill this aim via anisotropic layer theory (ALT) enabling the proposed model to include distortion of magnetic flux in the slotted regions. Air-gap flux density, core losses, efficiency and torque of an IM are predicted via the FB model and are validated through the finite element analysis (FEA) and experimental studies.
Ice hockey is a high-intensity contact sport that places athletes at an elevated risk for injury relative to other sports. The purpose of the current study was to analyze factors contributing to ...fatigue and decreased recovery time and their associations with injury incidence among professional athletes in the National Hockey League (NHL).
A retrospective review of all injuries suffered by NHL athletes during six consecutive seasons from 2013 to 2019 was performed. Team schedules were analyzed to assess (1) the number of instances with games on consecutive calendar days, (2) the number of overtime games, and (3) the number of overtime games within three calendar days of a previous overtime game. A Spearman's rank correlation coefficient was calculated from this data to assess the association between these factors and injury rates.
In total, 4886 injuries were suffered by NHL players during the period of study, with the 2013-2014 regular season highest injury rate per 1000 athletic exposures (15.8). The lower body was the most frequently injured body area (25.0% of all injuries), followed by injuries to the upper body (23.7%). In an analysis of the number of overtime games and games on consecutive days and their relationships to injury rate, only overtime games within three calendar days and total injuries were found to have a significant association (ρ = 0.19, p = 0.01).
The weak positive correlation between the number of overtime games within threedays of a previous overtime game and total injuries in professional ice hockey players suggests that overtime games played within a short period of time place athletes at increased risk for injury. Further studies are necessary to address this on an athlete-by-athlete level.
One of the unforeseen impacts of the COVID-19 pandemic has been a decrease in athletes' confidence to return to their sport after mandates were lifted. Both physical and psychological effects have ...been implicated. This study aimed to measure the severity of these changes among a group of National Collegiate Athletic Association (NCAA) athletes.
A novel
based on the validated ACL-RSI survey, was distributed to Division 1 collegiate athletes. The survey evaluated the psychological readiness of each player to return to sport in the context of the COVID-19 pandemic, utilizing a 1-10 scale (1 = least confident and 10 = most confident). Numerical responses to each survey were summed to create a primary outcome score-an athlete's
. Higher scores indicate higher levels of readiness to return to sport in the nearest coming season.
Responses came from 68 athletes representing a variety of sports. Of those with an injury, 14 (82.35%) attributed their injury to changes in their training schedule due to COVID-19 restrictions, and the remaining three (17.65%) did not. Among all athletes, the mean return to sport readiness (RTS) score was 44 (SD 24.76). Those playing a winter sport had the lowest mean RTS score, 35 ± 23, and those playing a fall season sport had the highest mean score, 48 ± 25.97. Overall, competitive athletes on leave from the sport due to collegiate and Division 1 COVID-19 guidelines had lower reported mean RTS scores as compared to athletes outlined in many other anterior cruciate ligament return to sport after injury survey (ACL-RSI) studies.
Overall, the athletes surveyed in our study reported much lower levels of readiness to return to sport in the context of COVID-19 than athletes surveyed in other studies, exhibiting COVID-19's unique impact on their confidence to return to their scheduled sport season. These differences may highlight the COVID-19 pandemic as a more severe detriment to returning to sport readiness among division-one athletes than recovering from injury alone. Given such an impact, more research is needed to elucidate the percentage of these athletes that returned to or abstained from their sport, as well as any motivating, facilitating, or detrimental factors in their choice.
Background:
Hip arthroscopy for femoroacetabular impingement (FAI) is known to produce excellent outcomes, yet some patients do not return to their preinjury level of sport participation. Much ...literature on return to sport has revolved around anterior cruciate ligament reconstruction and even shoulder instability, but none to date have used qualitative, semistructured patient interviews on patients with hip labral tears.
Purpose:
To understand the factors influencing the decision to return to sport after arthroscopic hip surgery for FAI.
Study Design:
Case series; Level of evidence, 4.
Methods:
An experienced interviewer conducted qualitative, semistructured interviews of patients aged 18 to 60 years who had arthroscopic hip surgery for FAI. All had preinjury participation in sport and a minimum 2-year follow-up with no revision surgery. Qualitative analysis was then performed to derive codes, categories, and themes. An assessment of preinjury and current sports participation by type, level of competition, and frequency along with patient-reported hip function was also obtained. In addition, current modified Harris Hip Score (mHHS), international Hip Outcome Tool (iHOT-12), Hip Outcome Score–sports-specific subscale (HOS-SSS), and a coping mechanism evaluation (Brief COPE) were also recorded.
Results:
A total of 23 patients were interviewed to reveal the overarching themes of internal motivation, external encouragement, and resetting expectations as the predominant factors influencing a patient’s decision to return to preinjury sport. Subjective outcome measurements (mHHS, iHOT-12, patient satisfaction) showed significant differences between patients who did and did not return to sport. Interestingly, the adaptive and maladaptive coping mechanisms matched and supported our themes in those patients who described fear and self-motivation as defining features influencing their cessation of or return to play, respectively.
Conclusion:
Self-motivation, aging, pain, encouragement from others, and adapting to physical limitations can largely affect a patient’s decision to return to sport after arthroscopic hip surgery for FAI. Innate coping mechanisms may also help to predict the course of and subsequently aid in a patient’s postoperative recovery.
Permanent cardiac pacing is the only effective treatment for symptomatic bradycardia, but complications associated with conventional transvenous pacing systems are commonly related to the pacing lead ...and pocket. We describe the early performance of a novel self-contained miniaturized pacemaker.
Patients having Class I or II indication for VVI pacing underwent implantation of a Micra transcatheter pacing system, from the femoral vein and fixated in the right ventricle using four protractible nitinol tines. Prespecified objectives were >85% freedom from unanticipated serious adverse device events (safety) and <2 V 3-month mean pacing capture threshold at 0.24 ms pulse width (efficacy). Patients were implanted (n = 140) from 23 centres in 11 countries (61% male, age 77.0 ± 10.2 years) for atrioventricular block (66%) or sinus node dysfunction (29%) indications. During mean follow-up of 1.9 ± 1.8 months, the safety endpoint was met with no unanticipated serious adverse device events. Thirty adverse events related to the system or procedure occurred, mostly due to transient dysrhythmias or femoral access complications. One pericardial effusion without tamponade occurred after 18 device deployments. In 60 patients followed to 3 months, mean pacing threshold was 0.51 ± 0.22 V, and no threshold was ≥2 V, meeting the efficacy endpoint (P < 0.001). Average R-wave was 16.1 ± 5.2 mV and impedance was 650.7 ± 130 ohms.
Early assessment shows the transcatheter pacemaker can safely and effectively be applied. Long-term safety and benefit of the pacemaker will further be evaluated in the trial.
ClinicalTrials.gov ID NCT02004873.
Background:
The coronavirus 2019 (COVID-19) pandemic led to frequent schedule changes, abbreviated seasons, and disrupted training at all levels of organized sports.
Purpose/Hypothesis:
The purpose ...of this study was to investigate the epidemiology of sports-related injuries at a single National Collegiate Athletic Association (NCAA) Division I institution during the 2020 COVID lockdown season when compared with pre-COVID seasons. It was hypothesized that there would be an increase in the overall injury rate and an increase in the number of days missed because of injury during the 2020 season when compared with the previous seasons.
Study Design:
Descriptive epidemiology study.
Methods:
The injury surveillance database at a single NCAA Division I institution was queried for injuries that resulted in time loss (missed game or practice) for a student-athlete or for injuries that persisted >3 days. Injuries were categorized by anatomic area. Days unavailable because of injury were recorded as total days that a student-athlete was listed as “out of activity.” Injury incidence and days unavailable, per 1000 athlete-exposures (AEs), were calculated for 3 pre-COVID seasons (2017-2019) and the 2020 season. The authors calculated the injury rate ratio (IRR) and its associated 95% CI of the 2020 season in comparison with those for the pre-COVID seasons.
Results:
Compared with the pre-COVID seasons, the total injury incidence increased by 10.5% in the 2020 season (68.45 vs 75.65 injuries/1000 AEs; IRR, 1.11 95% CI, 1.08-1.13). Total days unavailable decreased by 20.7% in the 2020 season (1374 vs 1089 days/1000 AEs; IRR, 0.79 95% CI, 0.77-2.26). Compared with women’s teams, men’s teams had a larger increase in total injury incidence (16.4% vs 6.5%) and larger decrease in days unavailable (23.7% vs 10.75%). There were no clear trends to changes in anatomic distribution of injuries, either by sport or between the sexes.
Conclusion:
Compared with the pre-COVID seasons, the injury incidence was higher and the number of days missed because of injury lower among collegiate student-athletes at a single NCAA Division I school in the season immediately after the COVID-19 lockdown.
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