The regenerative therapies of the ankle degeneration; A focus on multipotential mesenchymal stromal cell application

The ankle degeneration ranging from focal osteochondral lesions to osteoarthritis (OA) can cause a total joint function loss. With rising life-expectancy and activity of the patients, various regenerative therapies were introduced aiming to preserve the joint function via the induction of cartilage and bone repair. Here, biological events and mechanical changes of the ankle degeneration were discussed. The regenerative therapies were reviewed versus the standard surgical treatment. We especially focused on the use of multipotential mesenchymal stromal cells (MSCs) highlighting their dual functions of regeneration and cell modulation with the focus on the emerging MSC-based clinical studies. Being at an early step, more basic and clinical research is needed to optimize the applications of all ankle regenerative therapies including MSC-based method

Systematic Review of Acute Isolated Distal Radioulnar Joint Dislocation: Treatment Options

Background/Objectives: Acute isolated distal radioulnar joint (DRUJ) dislocations are rare and often misdiagnosed during initial evaluation due to subtle clinical presentation, low index of suspicion, and imaging barriers. Prompt diagnosis and treatment are critical to avoid chronic instability, limited wrist mobility, and osteoarthritis. This systematic review evaluates the functional outcomes of conservative and surgical treatment protocols for acute isolated DRUJ dislocations. Methods: A systematic search of PubMed, Scopus, and Mendeley databases (2000–2024) was conducted following PRISMA guidelines. Inclusion criteria involved adult patients with isolated DRUJ dislocations diagnosed and managed within one week of injury. Studies reporting on underage patients, associated fractures, delayed management, and open injuries were excluded. Data on demographics, injury mechanism, diagnostic methods, treatment protocols, and functional outcomes were extracted and analyzed. Results: In total, 22 cases across 20 studies were included. The majority (90.9%) were males, with a mean age of 37.9 years (range: 20–70 years). Falls and sports injuries were the major causes, with volar dislocations predominating (18/22). The misdiagnosis rate was equal to 18%. Most cases were treated conservatively with closed reduction and immobilization for an average of 4.9 weeks. Operative treatment was performed in 6 cases, mainly following failed closed reductions. Functional outcomes were generally favorable, although the same parameters were not consistently studied in all patients. Overall, 82% (14 of 17 patients) achieved a full range of motion; 88% (14 of 16 patients) reported no pain, and all assessed cases had stable DRUJs at follow-up. Conclusions: This review highlights the rarity and diagnostic challenges of this injury. The functional outcomes of both conservative and operative treatment are generally satisfactory. Conservative treatment should be the first-line approach, with surgery reserved for irreducible or unstable cases. Future research using standardized outcome measures is needed to provide guidance for clinicians

The Effect of a Balance Training Program on the Balance and Technical Skills of Adolescent Soccer Players

Soccer is a complex sport, and balance appears to play a crucial role in the quality execution of technical skills, which are mostly performed while standing on one foot. Nevertheless, in younger ages, when learning still affects soccer performance, the effect of a balance-training program on the player’s balance and technical skills remains unexplored. This research examined the effect of a balance-training program (BTP) on balance and technical skills of adolescent soccer players. Τhe participating volunteers were thirty-two soccer players (12 13 years old with 3.84 ± 0.95 years of practice), randomly separated into two groups: an experimental (EXP, n1 = 17) and a control group (CON, n2 = 15). Both groups were evaluated in static and dynamic balance and in technical skills (dribbling, passing, juggling, and shooting with dominant and non-dominant legs) before (Pre-condition) and after the intervention (Post-condition) which was an eight-week BTP for the EXP group and a placebo-training program for the CON group. Α 2 by 2 (groups×condition) mixed analysis of variance (ANOVA) with repeated measures on the condition factor was used to assess possible differences between groups. A significant groups × condition interaction effect was found in dynamic balance (p = 0.008), static (p = 0.042), and shooting (p = 0.022) with dominant leg performance. The EXP group improved (p = 0.007) its static balance by 37.82% and also significantly improved its dynamic balance and shooting accuracy with dominant leg in Post condition by 24.98% (p = 0.006) and 83.84% (p = 0.006) respectively. No significant improvement of other variables was detected in the EXP group Post condition. Dynamic and static balance, and shooting with dominant leg skills can be improved in adolescent soccer players through a specialized 8-week BTP. Balance-training program may contribute to technical skill improvement in soccer training. © Journal of Sports Science and Medicine

Mechanical characterisation of the lateral collateral ligament complex of the ankle at realistic sprain-like strain rates

Background Synthetic interventions continue to evolve with the progression made in materials science, surgical technologies and surgical methods. To facilitate the evolution of synthetic devices for lateral ankle repair a better understanding of the mechanical properties and failure mechanisms of the lateral collateral ligament (LCL) complex is required. This study aimed to improve understanding of the mechanical properties and failure modes of the LCL complex at strain rates representative of sprain. Method The LCLs were dissected from six human cadavers to produce individual bone-ligament-bone specimens. A mechanical testing device uni-axially loaded the ligaments in tension. Initially, preconditioning between 2 N and a load value corresponding to 3.5% strain was conducted for 15 cycles, before extension to failure at strain rate of 100%.s−1. The results were stratified by age, weight and body mass index (BMI) to explore potential correlations with ligament ultimate failure load or ligament stiffness. Results The mean ultimate failure loads and the 95% confidence intervals for the ATFL, calcaneofibular (CFL) and posterior talofibular (PTFL) ligaments were 263.6 ± 164.3 N, 367.8 ± 79.8 N and 351.4 ± 110.8 N, respectively. A strong positive Pearson correlation was found between BMI and ultimate failure load of the CFL (r = 0.919; P = .01). A non-significant relationship was found between the mechanical properties and both age and weight. The ATFL avulsed from the fibula four times, the CFL avulsed from the fibula twice, the PTFL avulsed from the talus twice and all remaining failures were mid-substance. Conclusion The results identify the forces required to induce failure of the individual ligaments of the LCL complex and the related failure modes of individual ligaments. A correlation may exist between BMI and the ultimate failure load of the CFL and PTFL, although a greater sample size is required for confirmation

Comparative Analysis of 2-Point Jump Shot and Free Throw Kinematics in High- and Low-Level U18 Male Basketball Players

Background/Objectives: This study examined the influence of competition level and player position on shooting accuracy and kinematic parameters in U18 male basketball players, focusing on two-point jump shots and free throws. Methods: Thirty-eight higher-level (HL-group) and forty-one lower-level (LL-group) participants, categorized into guard, forward, and center subgroups, completed a two-point basketball shooting test, followed by a free-throw shooting test after a 30 min interval. These tests were administered using a crossover, counterbalanced approach with the Latin square method to ensure effective randomization. Results: The results indicated that the HL group displayed significantly faster (12.5%) shot release times (RTs) and closer-to-optimal 45° (8.1%) ball entry angles (EAs) into the hoop for free throws, as well as superior (24.2%) shot success rates (SSRs) for two-point jump shots compared with the LL group. Across all groups and subgroups, a higher EA was achieved in two-point shots than in free throws, though free throws showed higher SSR. This study found no positional differences in shooting mechanics or performance, suggesting that modern training practices may foster consistency across player roles. Conclusions: These findings emphasize the potential for targeted drills to improve RTs, EAs, and SSRs, especially in LL players. Coaches can apply these insights to enhance shooting mechanics and consistency, thereby elevating performance in young basketball athletes. Future research should investigate the impact of fatigue and defensive pressure on shooting parameters across varied competitive contexts. © 2024 by the authors

Comparative Analysis of 2-Point Jump Shot and Free Throw Kinematics in High- and Low-Level U18 Male Basketball Players

Background/Objectives: This study examined the influence of competition level and player position on shooting accuracy and kinematic parameters in U18 male basketball players, focusing on two-point jump shots and free throws. Methods: Thirty-eight higher-level (HL-group) and forty-one lower-level (LL-group) participants, categorized into guard, forward, and center subgroups, completed a two-point basketball shooting test, followed by a free-throw shooting test after a 30 min interval. These tests were administered using a crossover, counterbalanced approach with the Latin square method to ensure effective randomization. Results: The results indicated that the HL group displayed significantly faster (12.5%) shot release times (RTs) and closer-to-optimal 45° (8.1%) ball entry angles (EAs) into the hoop for free throws, as well as superior (24.2%) shot success rates (SSRs) for two-point jump shots compared with the LL group. Across all groups and subgroups, a higher EA was achieved in two-point shots than in free throws, though free throws showed higher SSR. This study found no positional differences in shooting mechanics or performance, suggesting that modern training practices may foster consistency across player roles. Conclusions: These findings emphasize the potential for targeted drills to improve RTs, EAs, and SSRs, especially in LL players. Coaches can apply these insights to enhance shooting mechanics and consistency, thereby elevating performance in young basketball athletes. Future research should investigate the impact of fatigue and defensive pressure on shooting parameters across varied competitive contexts