Efficacy of a 3 month training program on the jump-landing technique in jump-landing sports. Design of a cluster randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>With the relatively high rate of injuries to the lower extremity due to jump-landing movement patterns and the accompanied high costs, there is need for determining potential preventive programs. A program on the intervention of jump-landing technique is possibly an important preventative measure since it appeared to reduce the incidence of lower extremity injuries. In real life situations, amateur sports lack the infrastructure and funds to have a sports physician or therapist permanently supervising such a program. Therefore the current prevention program is designed so that it could be implemented by coaches alone.</p> <p>Objective</p> <p>The objective of this randomized controlled trial is to evaluate the effect of a coach supervised intervention program targeting jump-landing technique on the incidence of lower extremity injuries.</p> <p>Methods</p> <p>Of the 110 Flemish teams of the elite division, 24 teams are included and equally randomized to two study groups. An equal selection of female and male teams with allocation to intervention and control group is obtained. The program is a modification of other prevention programs previously proven to be effective. All exercises in the current program are adjusted so that a more progressive development in the exercise is presented. Both the control and intervention group continue with their normal training routine, while the intervention group carries out the program on jump-landing technique. The full intervention program has a duration of three months and is performed 2 times a week during warm-up (5-10 min). Injuries are registered during the entire season.</p> <p>Discussion</p> <p>The results of this study can give valuable information on the effect of a coach supervised intervention program on jump-landing technique and injury occurrence. Results will become available in 2011.</p> <p>Trial registration</p> <p>Trial registration number: NTR2560</p

Primary Stability in Cementless Rotating Platform Total Knee Arthroplasty

Highly porous ingrowth surfaces have been introduced into tibial tray fixation to improve long-term survivorship in cementless total knee arthroplasty. This study was designed to evaluate the effect of porous ingrowth surface on primary stability in the implanted cementless tibial component. Three tibial tray designs possessing sintered bead or roughened porous coating ingrowth surfaces were implanted into a foam tibia model with primary stability assessed via digital image correlation during stair descent and condylar liftoff loading. Follow-up testing was conducted by implanting matched-pair cadaveric tibias with otherwise identical trays with two iterations of ingrowth surface design. Trays were loaded and micromotion evaluated in a condylar liftoff model. The sintered bead tibial tray exhibited slightly lower micromotion than the roughened porous coating in stair descent loading. However, no significant difference in primary stability was observed in condylar liftoff loading in either foam or cadaveric specimens. Cementless tibial trays featuring two different iterations of porous ingrowth surfaces demonstrated both good stability in cadaveric specimens with less than 80 microns of micromotion and 1 mm of subsidence under cyclic loading. While improved ingrowth surfaces may lead to improved biological fixation and long-term osteointegration, this study was unable to identify a difference in primary stability associated with subsequent ingrown surface design iteration.</jats:p

Total hip replacement in patients with history of illicit injecting drug use

BACKGROUND: A history of illicit injecting drug use makes indication of total hip arthroplasty (THA) in patients with end stage hip osteoarthritis difficult, as the risk of infection with colonized strains is multiplied if the patient continues to inject or inhale illicit drugs. METHODS: A retrospective survivorship analysis of a consecutive series of 27 THA in patients with a history of illicit drug use was performed. Follow-up evaluation consisted of (1) a WOMAC score, (2) a standardized interview including queries on drug habits and eventual additional medico-surgical treatments of the affected hip, (3) a clinical examination in order to complete a Harris Hip Score, (4) radiological examination and (5) blood tests (blood sedimentation rates and C-reactive protein). Defined endpoints were death, implant revised or awaiting revision for deep infection or any other reason and lost to follow-up or follow-up after at least 2 years. RESULTS: Overall, 5- and 10-year implant survival rates with failure for any reason were 61 % (CI: 41;81) and 52.3 % (CI: 29;76) and for septic reasons 70.6 % (CI: 52;89) and 60.5 % (CI: 36;85), respectively. Even if at the time of THA all patients and respective health care professionals confirmed abstinence of illicit injecting drug use, five patients reported occasional use. Declared abstinence of less than 1 year before THA was associated with higher recurrence rates (p = 0.001) and both with higher septic failure rates (p = 0.023, p = 0.061). Positive serology for human deficiency virus did not increase implant failure rates. CONCLUSION: We use this unacceptable high failure rate as evidence when counseling patients and their health care professionals about the appropriate treatment of osteoarthritis in patients with a history of illicit drug use. Furthermore, we support the request of hair analysis for drugs documenting abstinence of at least 1 year before indicating THA