Patellofemoral pain syndrome (PFPS): a systematic review of anatomy and potential risk factors

Patellofemoral Pain Syndrome (PFPS), a common cause of anterior knee pain, is successfully treated in over 2/3 of patients through rehabilitation protocols designed to reduce pain and return function to the individual. Applying preventive medicine strategies, the majority of cases of PFPS may be avoided if a pre-diagnosis can be made by clinician or certified athletic trainer testing the current researched potential risk factors during a Preparticipation Screening Evaluation (PPSE). We provide a detailed and comprehensive review of the soft tissue, arterial system, and innervation to the patellofemoral joint in order to supply the clinician with the knowledge required to assess the anatomy and make recommendations to patients identified as potentially at risk. The purpose of this article is to review knee anatomy and the literature regarding potential risk factors associated with patellofemoral pain syndrome and prehabilitation strategies. A comprehensive review of knee anatomy will present the relationships of arterial collateralization, innervations, and soft tissue alignment to the possible multifactoral mechanism involved in PFPS, while attempting to advocate future use of different treatments aimed at non-soft tissue causes of PFPS

Patellofemoral pain syndrome (PFPS): a systematic review of anatomy and potential risk factors-1

Medial femoral condyle.<p><b>Copyright information:</b></p><p>Taken from "Patellofemoral pain syndrome (PFPS): a systematic review of anatomy and potential risk factors"</p><p>http://www.dynamic-med.com/content/7/1/9</p><p>Dynamic Medicine : DM 2008;7():9-9.</p><p>Published online 26 Jun 2008</p><p>PMCID:PMC2443365.</p><p></p

Patellofemoral pain syndrome (PFPS): a systematic review of anatomy and potential risk factors-0

Medial femoral condyle.<p><b>Copyright information:</b></p><p>Taken from "Patellofemoral pain syndrome (PFPS): a systematic review of anatomy and potential risk factors"</p><p>http://www.dynamic-med.com/content/7/1/9</p><p>Dynamic Medicine : DM 2008;7():9-9.</p><p>Published online 26 Jun 2008</p><p>PMCID:PMC2443365.</p><p></p

Personal trainer demographics, current practice trends and common trainee injuries

Increasing emphasis on maintaining a healthy lifestyle has led many individuals to seek advice on exercise from personal trainers. There are few studies to date that evaluate personal trainer education, practice trends, and injuries they have seen while training clients. A survey was distributed to personal trainers using Survey Monkey® (Palo Alto, CA, USA) with 605 personal trainers accessing the survey. An exercise related bachelor’s degree was held by 64.2% of survey participants and a certification in personal training by 89.0%. The most common personal trainer certifications were from American College of Sports Medicine (59.2%) and National Strength and Conditioning Association (28.9%). Only 2.9% of all personal trainers surveyed had no exercise-related bachelor’s degree and no personal trainer certification. The most common injuries seen by personal trainers during sessions were lumbar muscle strain (10.7%), rotator cuff tear/tendonitis (8.9%), shin splints (8.1%), ankle sprain (7.5%), and cervical muscle strain (7.4%). There is variability in the practices between different personal trainers when analyzing differences in collegiate education, personal trainer certifications, and strength and conditioning certifications. The clinical implication of the differences in practices is unknown as to the impact on injuries or exercise prescription effectiveness

AAFD: Is the gastroc just pulling some strings?

Whether ankle equinus predominantly contributes to or ensues from an adult-acquired flatfoot deformity (AAFD) remains unknown. Regardless of the exact nature of this relationship, current evidence supports a distinct role for concomitant gastrocnemius recession or Achilles tendon lengthening during surgical correction of significant AAFD deformity. Achieving the appropriate degree of surgical correction for components of ankle equinus, hindfoot valgus, and/or Chopart collapse that may contribute to AAFD requires proper clinical evaluation and an appreciation of contributory pathophysiology. Review of recent literature describing gastrocnemius contracture and its potential role in AAFD provides a platform from which to approach this challenging problem.Level of Evidence: Diagnostic Level V. See Instructions for Authors for a complete description of levels of evidence

CrossFit® instructor demographics and practice trends

CrossFit® is an increasingly popular exercise modality that uses high intensity power training. The literature to date regarding CrossFit® has focused on its benefits to VO2 Max, body composition and the motivational variables of participants of CrossFit®. A computerized survey was distributed to CrossFit® instructors using Survey Monkey® (Palo Alto, CA, USA). One hundred and ninety-three CrossFit® instructors responded to the survey. Of these 86.6% (155/179) reported being a certified CrossFit® instructor with 26.7% (48/180) having a bachelor’s degree in an exercise-related field. Instructors with a CrossFit® certification have less bachelor’s (P=0.04) or master’s (P=0.0001) degrees compared to those without a CrossFit® certification, more utilization of Olympic weightlifting (P=0.03), one-on-one teaching (P=0.0001), 1-RM max on snatch (P=0.004), 1- RM on clean and jerk or hang clean (P=0.0003), kettlebell use (P=0.0001) and one-on-one training (P=0.0001). Instructors report differences in their education and differences in use of weightlifting platforms and various types of footwear. Non-certified instructors differ from CrossFit® certified instructors in regards to teaching of Olympic weightlifting and exercise programming

Adolescent differences in knee stability following computer-assisted anterior cruciate ligament reconstruction

<div class="page" title="Page 1"><div class="section"><div class="layoutArea"><div class="column"><p><span>Anterior cruciate ligament (ACL) surgery is being increasingly performed in the adolescent population. Computer navigation offers a reliable way to quantitatively measure knee stability during ACL reconstruction. A retrospective review of all adolescent patients (&lt;18 years old) who underwent computer-assisted primary single bundle ACL reconstruction by a single surgeon from 2007 to 2012 was performed. The average age was 15.8 years (SD 3.3). Female adolescents were found to have higher internal rotation than male adolescents both pre- (25.6° </span><em>vs </em><span>21.7°, P=0.026) and post-reconstruction (20.1° </span><em>vs </em><span>15.1°, P=0.005). Compared to adults, adolescents demonstrated significantly higher internal rotation both pre- (23.3° </span><em>vs </em><span>21.5°, P=0.047) and post-reconstruction (17.1° </span><em>vs </em><span>14.4°, P=0.003). They also had higher total rotation both pre- (40.9° </span><em>vs </em><span>38.4°, P=0.02) and post-reconstruction when compared to adults (31.56° </span><em>vs </em><span>28.67°, P=0.005). In adolescent patients, anterior translation was corrected more than rotation. Females had higher pre- and residual post-reconstruction internal rotation compared to males. When compared to adults, adolescents had increased internal rotation and total rotation both pre- and post-reconstruction. </span></p></div></div></div></div

Hypersensitivity to Orthopedic Implants: A Review of the Literature

<p><b>Article full text</b></p> <p><br></p> <p>The full text of this article can be found here<b>. </b><a href="https://link.springer.com/article/10.1007/s40744-017-0062-6">https://link.springer.com/article/10.1007/s40744-017-0062-6</a></p> <p><br></p> <p><b>Provide enhanced content for this article</b></p> <p><br></p> <p>If you are an author of this publication and would like to provide additional enhanced content for your article then please contact <a href="http://www.medengine.com/Redeem/”mailto:[email protected]”"><b>[email protected]</b></a>.</p> <p><br></p> <p>The journal offers a range of additional features designed to increase visibility and readership. All features will be thoroughly peer reviewed to ensure the content is of the highest scientific standard and all features are marked as ‘peer reviewed’ to ensure readers are aware that the content has been reviewed to the same level as the articles they are being presented alongside. Moreover, all sponsorship and disclosure information is included to provide complete transparency and adherence to good publication practices. This ensures that however the content is reached the reader has a full understanding of its origin. No fees are charged for hosting additional open access content.</p> <p><br></p> <p>Other enhanced features include, but are not limited to:</p> <p><br></p> <p>• Slide decks</p> <p>• Videos and animations</p> <p>• Audio abstracts</p> <p>• Audio slides</p

Volume Measurements on Weightbearing Computed Tomography Can Detect Subtle Syndesmotic Instability

While weightbearing computed tomography (WBCT) allows three-dimensional (3D) visualization of the distal syndesmosis, image interpretation has largely relied on one-dimensional (1D) distance and, more recently, two-dimensional (2D) area measurements. This study aimed to (1) determine the sensitivity and specificity of 2D area and 3D volume WBCT measurements towards detecting subtle syndesmotic instability, (2) evaluate whether the patterns of changes in the 3D shape of the syndesmosis can be attributed to the type of ligament injury. A total of 24 patients with unilateral subtle syndesmotic instability and 24 individuals with uninjured ankles (controls) with bilateral ankle WBCT were assessed retrospectively. First, 2D areas at 0, 1, 3, 5, and 10 cm, and 3D volumes at 1, 3, 5, and 10 cm above the tibial plafond were measured bilaterally. Secondly, the 3D model of the distal tibiofibular space was created based on WBCT in a subset of 8 out of 24 patients in whom the type of ligament injury was recognized via magnetic resonance imaging. The 3D model of the injured side was superimposed on the uninjured contralateral side to visualize the pattern of changes in different planes. Volume measurement up to 5 cm above the tibial plafond showed the lowest p-value (<0.001 vs. other methods), higher sensitivity (95.8%, 95% confidence interval [CI]: 87.8–100), and specificity (83.3%, 95% CI: 68.4–98.2) for detection of syndesmotic instability. No specific pattern of changes in the 3D shape could be attributed to a type of ligament rupture. We suggest 3D volume measurements, best measured up to 5 cm proximal to the plafond, as a promising means of diagnosing syndesmotic instability, particularly for subtle cases that are hard to detect. Clinical significance: The ability to compare the ankle joints bilaterally in a 3D manner under physiologic weight provided by weightbearing CT has led to a more accurate diagnostic method. Using volumetric measurement up to 5 cm above the tibial plafond showed higher sensitivity and specificity for recognizing an unstable syndesmosis, especially in subtle cases. However, our preliminary investigations showed that the pattern of 3D alterations in the distal tibiofibular joint space based on WBCT images does not indicate the type of syndesmotic ligamentous injury. Our results can also help image viewing programs to improve their measurement tools to facilitate 3D measurement for the syndesmosis as well as other conditions that may benefit from 3D evaluation of the clinical images