A Mesh Meta-Analysis of the Effectiveness of Different Warm-Up Exercises to Prevent Knee Injuries in Young Child Soccer Players

Objective: A mesh Meta-analysis was used to evaluate the effectiveness of four warm-up exercises to prevent knee injuries in juvenile soccer players. Method: They are a randomized controlled trial (RCT) on FIFA 11+ integrated warm-up, FIFA 11+ Kids integrated warm-up, and neuromuscular training (NMT) warm-up for the prevention of knee joint in juvenile soccer players by a computer search of CNKI, CBMdisc, WanFangdata, Pubmed, Web of science, and SPORTDicus database. The search period was from the establishment of each database to February 2022. Two investigators screened the literature, extracted data, and assessed risk bias for the included studies according to the pre-defined inclusion and exclusion criteria, and finally analyzed the data using Stata 14.0 software and OpenBUGS software. Results: A total of 10 RCT studies with 17,143 subjects, spanning the age range of 7 to 19 years, were included. The results of the reticulated Meta-analysis showed that all three warm-up modalities were effective in reducing the incidence of knee injuries in junior soccer players compared to conventional warm-up, with the optimality in descending order of FIFA 11+ Kids comprehensive warm-up (SUCRA = 85.3), neuromuscular training warm-up (SUCRA = 66.7), and FIFA 11+ combined warm-up (SUCRA = 44). Conclusion: The FIFA 11+ Kids comprehensive warm-up is the most effective warm-up exercise for the prevention of knee injuries in junior and child soccer players, but the above findings need further validation due to the quantity and quality of the literature and the quality of the evidence.

Effect of sodium hyaluronate combined with rehabilitation training on knee joint injury caused by golf

BACKGROUND In high-intensity sports like golf,knee joints are prone to injury,leading to pain,limited mobility,and decreased quality of life.Traditional treatment methods typically involve rehabilitation exercises,but their effectiveness may be limited.In recent years,sodium hyaluronate has emerged as a widely used biomedical material in the treatment of joint diseases.AIM To explore the effect of sodium hyaluronate combined with rehabilitation training on pain degree,flexion range of motion and motor function of knee joint injured by golf.METHODS Eighty patients with knee joint injury caused by golf were randomly divided into control(group B)and observation group(group A).The group B was treated with rehabilitation training,and the group A was treated with sodium hyaluronate combined with rehabilitation training.The clinical efficacy,range of motion and function of knee joint,quality of life and inflammatory factors were compared.RESULTS The excellent and good rate of rehabilitation in the group A was raised than group B.At 6 weeks and 3 months after treatment,the range of motion of the two groups was raised than that before treatment,and that of the group A was raised than group B.After treatment,the scores of Lysholm and International Knee Documentation Committee(IKDC)in the group A were raised,and those in the group A were raised than group B.The VAS score of the two groups was reduced than that of the group B,and the SF-36 score of the group A was reduced than group B.The interleukin(IL)-1β,IL-8 and tumor necrosis factor-αin the two groups were reduced,and those in the group A were reduced than group B.CONCLUSION Sodium hyaluronate combined with rehabilitation training has a good clinical effect in the treatment of patients with knee joint injury caused by golf,which relieve pain,maintain knee joint function and improve patients'life quality.

Chondroitin sulfate and glucosamine combination in patients with knee and hip osteoarthritis:A long-term observational study in Russia

BACKGROUND Oral treatment of glucosamine(GA) combined with chondroitin sulfate(CS) was reportedly effective for pain relief and function improvement in osteoarthritis patients with moderate to severe knee pain in clinical trials. While the effectiveness of GA and CS on both clinical and radiological findings has been demonstrated, only a few high-quality trials exist. Therefore, controversy regarding their effectiveness in real-world clinical practice remains.AIM To investigate the impact of GA + CS on clinical outcomes of patients with knee and hip osteoarthritis in routine clinical practice.METHODS A multicenter prospective observational cohort study included 1102 patients of both genders with knee or hip osteoarthritis(Kellgren & Lawrence grades Ⅰ-Ⅲ) in 51 clinical centers in the Russian Federation from November 20, 2017, to March 20,2020, who had started to receive oral capsules of glucosamine hydrochloride 500 mg and CS 400mg according to the approved patient information leaflet starting from 3 capsules daily for 3 wk,followed by a reduced dosage of 2 capsules daily before study inclusion(minimal recommended treatment duration is 3-6 mo). Changes in subscale scores [Pain, Symptoms, Function, and Quality of Life(QOL)] of the Knee Injury and Osteoarthritis Outcome Score(KOOS)/Hip Disability and Osteoarthritis Outcome Score(HOOS) questionnaires during the observational period(up to 54-64wk with a total of 4 visits). Patients’ treatment satisfaction, data on the combined oral use of glucosamine hydrochloride and CS, concomitant use of non-steroidal anti-inflammatory drugs(NSAIDs), and adverse events(AEs) were also evaluated.RESULTS A total of 1102 patients with knee and hip osteoarthritis were included in the study. The mean patient age was 60.4 years, most patients were women(87.8%), and their average body mass index was 29.49 kg/m2. All subscale scores(Pain, Symptoms, Function, and QOL) of the KOOS and HOOS demonstrated clinically and statistically significant improvements. In patients with knee osteoarthritis, the mean score increases from baseline to the end of Week 64 were 22.87, 20.78,16.60, and 24.87 on Pain, Symptoms, Physical Function(KOOS-PS), and QOL subscales(P < 0.001for all), respectively. In patients with hip osteoarthritis, the mean score increases were 22.81, 19.93,18.77, and 22.71 on Pain, Symptoms, Physical Function(HOOS-PS), and QOL subscales(P < 0.001for all), respectively. The number of patients using any NSAIDs decreased from 43.1% to 13.5%(P < 0.001) at the end of the observation period. Treatment-related AEs occurred in 2.8% of the patients and mainly included gastrointestinal disorders [25 AEs in 24(2.2%) patients]. Most patients(78.1%) were satisfied with the treatment.CONCLUSION Long-term oral GA + CS was associated with decreased pain, reduced concomitant NSAID therapy, improved joint function and QOL in patients with knee and hip osteoarthritis in routine clinical practice.

Lateral femoral tunnel preparation and graft fixation for anterior cruciate ligament reconstruction–A discussion

This article provides a discussion and commentary around the recent advances in arthroscopic anterior cruciate ligament reconstruction(ACLR),with a focus on the aspects of lateral femoral tunnel preparation and graft fixation techniques.The paper explores and comments on a recently published review by Dai et al,titled"Research progress on preparation of lateral femoral tunnel and graft fixation in ACLR",while providing insight into its relevance within the field of ACLR,and recommendations for future research.

Injuries Requiring Surgery in Folk Dancers： A Retrospective Cohort Study of 9 Years

Background： In this study, we examined professional folk dancer injuries which required surgery and if there are any associated factors like age, gender, dexterity, dance style and to evaluate the return to their full capacity. Materials and Methods： Seventy five members of the Fire of Anatolia dance group （mean age： 26.8 ± 5.2; 18-38 years） performers were evaluated. The dancers suffered 14 orthopedic injuries requiring surgery （3 meniscus tears, 2 anterior cruciate ligament tears one of which is with posterolateral corner tear, 1 posterior cruciate ligament tear, 1 patellar dislocation, 1 scaphoid fracture, 1 extensor tendon cut in hand, 1 infrapatellar bursitis, 2 Hoffa’s fat pad syndromes, 2 symptomatic medial plicaes） during a nine-year period. Follow-up time was 51 ± 41.9 （29.5-92） months. Results： Following surgeries, the dancers could restart rehearsals in 12.7 ± 9 （range： 4 to 36） weeks and perform live on the stage in 16.2 ± 12.2 （range： 5 to 52） weeks on average. Conclusion： Males were 8.64 times more likely to suffer an injury requiring surgery compared to the females （p = 0.003） and twelve （85.7%） of these injuries were lower extremity injuries and were all located in the knee in Anatolian folk dancers.

Treatment of Floating Knee Injury in Children

The necessity and superiority of the surgical operation on children with floating knee injury and the fracture union and complications were investigated. Twenty-eight children with floating knee injury were subjected to open reduction and internal fixation or external fixator. The patients were followed up for 18 months to 7 years. The curative effectiveness was scored by Karlstrom criteria. The results showed that no nonunion or deformity was found. The affected limb was 1.2 cm to 1.5 cm longer in 2 cases, 0.8 to 1.2 cm shorter in 3 cases than the contralateral. No severe dysfunction of knee joint occurred. The excellent-good rate was 92.8 % and the curative rate 71.4 respectively. So for children whose age is older than 5 years, it＇s a good way to treat the fractures of femur and tibia with open reduction and internal fixation or external fixator. The method can be advantageous for the nursing care, early function recovery, shortening of the hospital stay and avoidance of severe complications.

Creating Prep to Play PRO for women playing elite Australian football:A how-to guide for developing injury-prevention programs

Background:Developing context-specific,evidence-informed,and implementable injury-prevention programs is challenging.Women playing in the elite Australian Football League for Women are at high risk of serious knee injuries,and no specific injury-prevention program exists.The objective of the study was to describe the collaborative process used to create a context-specific injury-prevention program.Methods:A previously used intervention-development process was modified to incorporate a partnership with the sport’s governing organization and focus on engaging program implementers.The Reach Effectiveness Adoption Implementation and Maintenance(RE-AIM)Sports Setting Matrix guided program development and implementation strategies.Results:The 7-step process,aligned with the RE-AIM Sports Setting Matrix,was applied to develop the injury-prevention program and was titled Prep to Play PRO.The steps were:(Step 1)gaining organizational support and establishing a project partnership;(Step 2)using research evidence and clinical experience;(Step 3)consulting content and context experts;(Step 4)engaging the organization,experts,program implementers,and end-users to concreate the intervention and develop implementation strategies;(Step 5)testing the intervention acceptability and feasibility;(Step 6)evaluating the intervention and implementation strategies against theory;and(Step 7)obtaining feedback from early implementers and end-users.Conclusion:Engaging critical stakeholders at multiple ecological levels(organization,team,and athlete)throughout program development and implementation planning support real-world use.The processes and activities described can guide future sports injury-prevention program development and implementation.

A comparison of lower limb stiffness and mechanical muscle function in ACL-reconstructed,elite,and adolescent alpine ski racers/ski cross athletes

Purpose： The aim of this study was to compare mechanical muscle function in the eccentric/concentric phases of vertical bilateral jumping in anterior cruciate ligament-reconstructed （ACLR）, elite （ELITE）, and adolescent （ADOL） alpine ski racers and ski cross athletes. Methods： Alpine ski racers/ski crossers （ACLR： n = 12, age = 26.7 ± 3.8 years; ELITE： n = 12, age = 23.9 ± 3.0 years; ADOL： n = 12, age = 17.8 ± 0.7 years; females： n = 6 per group, males： n = 6 per group） performed 5 maximal countermovement jumps （CMJs） and 5 squat jumps. The ground reaction forces for each limb were analyzed using dual force plate recording to obtain body center of mass （BCM） velocity, displacement, and power. The eccentric deceleration （ECC） and concentric phases were determined from BCM velocity. CMJ net concentric and ECC impulses were calculated （body mass normalized） along with the peak and mean BCM power and maximal vertical jump height. CMJ lower limb stiffness （LLS） was determined by the slope of the ground reaction forces vs. the BCM displacement curve over the ECC phase. Concentric and ECC asymmetry indices were calculated for each leg, and the left vs. right LLS was compared. Outcome measures （reported as mean ± SD） calculated as a 5-jump mean were normalized to body mass and compared using an analysis of variance. Results： No between-group differences were found for peak and mean power or jump heights. There were no group differences for LLS or net concentric phase impulse, but the net ECC impulse was lower in the ADOL group compared with ELITE skiers （ADOL： 1.33 ± 0.32 Ns/kg; ELITE： 1.59 ± 0.16 Ns/kg; p 〈 0.05）. Although no group differences were found for ECC asymmetry indices, a group × limb interaction was found for LLS （p 〈 0.01）, which was systematically higher in the right vs. the left limb of ADOL skiers （right： 54.1 ± 17.9 N/m/kg; left： 48.7 ± 15.7 N/m/kg;p 〈 0.01）. Conclusion： ADOL skiers demonstrated decreased ECC impulse and systematic right limb dominance in LLS compared with ACLR and ELITE skiers. The implication of these findings for injury and performance are unknown, but further investigation into these potential relationships is warranted.2018 Published by Elsevier B.V. on behalf of Shanghai University of Sport. This is an open access article under the CC BY-NC-ND license. （http：//creativecommons.org/licenses/by-nc-nd/4.0/）.

“When you’re down, stay down”:A lesson for all competitive alpine skiers supported by an ACL rupture measured in vivo

Background:During an experiment,a ski racer equipped with various measurement devices suffered an anterior cruciate ligament(ACL)rupture in his right knee.The aim of this study was to describe the underlying injury mechanism from a functional perspective.Methods:Eight giant slalom turns(i.e.,4 left turns),followed by 1 left turn at which the ACL injury occurred,were recorded by 2 video cameras,electromyography of 4 relevant muscle groups,inertial measurement units to measure knee and hip angles,and pressure insoles to determine ground reaction forces.Results:Due to a loss of balance,the ski racer began to slide sideways at the apex of a left turn.During sliding,his right(outside)leg was actively abducted upward without touching the ground.The ski racer then attempted to stand up again by dropping his leg back towards the snow surface.The end of this dropping was accompanied by a decrease in electromyographic activity in the knee stabilizing muscles.Once the inside edge of the outer ski caught the snow surface,a rapidly increasing peak force,knee flexion,and an aggressive sudden activation of the vastus medialis muscle were observed,while biceps femoris and rectus femoris further decreased their activation levels.This likely resulted in excessive anterior translation of the tibia relative to the femur,causing damage to the ACL.Conclusion:Our example emphasizes that ski racers should not get up until they stop sliding.Remember:“When you’re down,stay down.”

Painful locking of the knee due to bucket handle tear of mediopatellar plica

A case of swelling and anterior painful knee due to tear of mediopateUar plica is reported. The patient also felt clunk of the patellofemoral joint and knee locking. Under arthroscopic examination, a thick and fibrous plica was found medial to patellar, and a bucket tear along the plica from medial patellar retinaculum to infrapatellar fat pad. Polarized microscopic examination showed collagen fiber fragment and loss of light reflecting property. Neuroimmunohistology suggested up-regulation of synovial plica innervation in the area around the crack. This may be related to the pain. The bucket tear of mediopatellar plicacaused pain and lock of knee are more common than previously reported.

Spiral CT arthrography of multiplanar reconstruction and virtual arthroscopy technique in diagnosis of knee with internal derangements

Objective:To evaluate the values of spiral CT arthrography with multiplanar reconstruction and virtual arthroscopy technique i n diagnosis of internal derangements of the knee. Methods:Ten bovine knees were used for experiment. The menisci , anterior and posterior cruciate ligaments and cartilage of these 10 bovine kne es were injured with a hook. Each of the joints was injected with 100 ml air, th en soon scanned with a PQ6000 spiral computed tomography scanner. The data obtai ned was input into the work station, and multiplanar reconstruction technique wa s used to illustrate lesions in the knees. The results of CT diagnosis were comp ared to those found by gross inspection of the specimens. Clinically, 10 knees o f 9 patients diagnosed as internal derangement were evaluated with the same meth od after 50-70 ml air was injected into each of the joints. Nine months later, the data of 2 patients were used for CT endoscopy reconstruction. The results we re compared with intraoperative findings. Results:Experimentally, the sensitivity and specificity were 88.9 % and 93.9 % by detection of meniscal abnormalities, 85.7 % and 10 0% by detection of cruciate ligament lesions, and 72.7 % and 100% by detectio n of cartilage damage, respectively. Clinically, the sensitivity and specificity were 90.0 % and 95.0 % by detection of meniscal lesion. As to ligament, t he figures were 85.7 % and 100% respectively. Images of virtual arthroscopy s imulated the images of real arthroscopy. Conclusions:Spiral CT arthrography of multiplanar reconstructi on technique offers fine images of internal structures of the knee, with clear b order and internal structure. It is an accurate method for detecting meniscal, cruciate and collateral ligament and cartilaginous lesions that cause internal d erangement of the knee. Virtual arthroscopy technique is a hopeful method for de tecting reasons of derangement of the knee.

Treatment of meniscal injury： a current concept review

Meniscal injury is one of the most common injuries to the knee. The menisci are important for normal knee function. And loss of a meniscus increases the risk of subsequent development of degenerative changes in the knee. Now there are different techniques available for meniscal injury. These techniques include expectant treatment, meniscectomy, meniscal repair, meniscal replacement, and meniscal tissue engineering. Expectant treatment is the appropriate treatment for minor tears of the menisci. Meniscectomy being favored at the beginning is now obsolete. Meniscus repair has become a standard procedure. Meniscal replacement and tissue engineering are used to deal with considerable meniscal injuries. The purpose of this paper is to provide current knowledge regarding the anatomy and function of the menisci, incidence,aetiology, symptoms, signs, investigations and treatments of meniscal injury.

Observation on Therapeutic Effect of Treating Traumatic Gonarthromeningitis by Combined Acupuncture and Chinese Herbs

Objective： To observe the therapeutic effects of treating traumatic gonarthromeningitis with acupuncture combined Chinese herbs. Methods： Seventy patients were randomly divided into two groups, with 35 cases in each group. The treatment group was treated with Chinese herbal medicine, acupuncture and cupping therapy. The control group was treated with Diclofenac Sodium Tablets, Corydalis Analgesic Tablets and Vitamin C Tablets. Results： The total effective rate of the treatment group was higher than that of the control group. There was a statistically significant difference between the two groups （P〈0.05）. Conclusion： The combined therapy with acupuncture and Chinese herbal medicine has a remarkable therapeutic effect on treating traumatic gonarthromeningitis.

Treatment of Infrapatellar Fat Pad Strain with Mountain-burning Fire Method

Strain of infrapatellar fat pad extensively occurs in people aged over 30 years, who often walk up hills or squat while working. The clinical manifestations are aching and weakness in the knee joints, aggravated when the knee joints are totally extended. Discomfort occurs in mild cases only when walking for long or going up and down the stairs. There is aching feeling in moderate cases when the patients are quiet. The pain is aggravated during exercises when the knee joints are half flexed and the patient can not stand up when squatting for prolonged periods of time. There are aching and weak feelings in the severe cases.

Observation on Therapeutic Effect of Warm Acupuncture in Treating Patellar Ligament Strain

The needles were inserted in the center of inferior margin and on the left and right sides of patella. Then moxibustion with warming needle and electroacupuncture were used respectively to treat 25 cases of patellar ligament strain. The effective rates were 96.0% and 69.6% respectively.