Prospective Functional Performance Testing and Lower Extremity Injury Incidence in Adolescent Athletes

M.S. University of Hawaii at Manoa 2015.Includes bibliographical references.The purpose of this study was to prospectively investigate if a battery of functional performance tests could be used as a preseason screening tool to identify adolescent athletes at risk for sports-related lower extremity injury via comparison of injured and uninjured subjects. Ninety-five adolescent volleyball, basketball and soccer athletes (female, n=62; male, n=38; mean age = 14.4±1.6) participated. Each subject performed a battery of functional performance tests during the preseason, referred to in the present study as the “Lower Extremity Grading System” (LEGS). The LEGS assessment included: triple hop for distance, star excursion balance test, double leg lowering maneuver, drop jump video test, and multi-stage fitness test. Subjects were monitored throughout their designated sport season(s), which consisted of a six-month surveillance period. The schools certified athletic trainer recorded all injuries. Subjects were divided into groups according to gender and injury incidence (acute lower extremity injury vs. uninjured). Univariate general linear model (GLM) was used to assess differences between groups. Pearson product moment correlation coefficients were determined between variables of interest. The receiver-operator characteristic (ROC) analysis was used to determine the cut-off score. The prospective mean LEGS composite scores were significantly lower between the injured and uninjured groups in both genders (males: 19.06±3.59 vs. 21.90±2.44; females: 19.48±3.35 vs. 22.10±3.06 injured and uninjured, respectively)(p < .05). The ROC analysis determined the cut-off at ≤20 for both genders (sensitivity=.71, specificity=.81, for males; sensitivity=.67, specificity=.69, for females)(p<.05), suggesting moderate predictability for acute noncontact lower extremity injuries. Furthermore, significant positive correlations were found between the LEGS composite score and the multi-stage fitness test (r=.474, p=.003) in male subjects, suggesting a relationship between functional performance, aerobic capacity, and potential injury risk. Identifying individuals who are at greatest risk and prescribing corrective, neuromuscular, and cardiovascular exercise at the appropriate time during developmental stages for adolescent athletes may reduce sports-related injury risk

Meniscal ramp lesions: Anatomy, biomechanics, and clinical outcomes

Introduction: Anterior cruciate ligament (ACL) tears are the most common researched pathology in all of sports medicine. Researchers and clinicians have dedicated their careers to investigating the treatment of ACL tears and why ACL reconstructions fail. The medial meniscus is a known secondary stabilizer to the ACL and recent clinical studies have reported that meniscal deficiency is the most significant factor to predict ACL reconstruction graft failure. Meniscal ramp lesions, originally defined as peripheral tears of the posterior horn of the medial meniscus, have been reported to occur in roughly a quarter of all patients who suffer an ACL tear and have become increasingly recognized in the field of sports medicine over the past decade. However, controversy exists regarding identification and treatment of these lesions and a consensus has yet to be made on their exact biomechanical role in ACL deficient and ACL reconstructed knees

The future of meniscus science: international expert consensus

Purpose: The purpose of this study was to evaluate the main focus areas for research and development for furthering the state of meniscus science in 2021. Methods: An electronic survey including 10 questions was sent in a blind fashion to the faculty members of the 5th International Conference on Meniscus Science and Surgery. These faculty served as an expert consensus on the future of research and development areas of meniscus science. Survey responses were analyzed using descriptive statistics and ranking weighted averages were calculated to score survey questions. Results: Of the 82 faculty, 76 (93%) from 18 different countries completed the survey (84% male, 16% female). The highest ranked future research and development focus areas were meniscus repair, biologics, osteotomy procedures, addressing meniscus extrusion, and the development of new therapies for the prevention of posttraumatic osteoarthritis. Currently, the most ‘valuable’ type of biologic reported for meniscus treatment was platelet-rich plasma. The main reported global research limitation was a lack of long-term clinical outcomes data. The most promising emerging medical technologies for improving meniscus science were 3-D printing, personalized medicine, and artificial implants. Conclusions: This survey suggests that the future of meniscus science should be focused on meniscal preservation techniques through meniscus repair, addressing meniscal extrusion, and the use of orthobiologics. The lack of long-term clinical outcomes was the main reported research limitation globally for meniscus treatment. Future product development utilizing emerging medical technologies suggest the use of 3-D printing for meniscal transplants/scaffolds, personalized treatment, and bioengineering for artificial implants. Level of Evidence: Level V