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Journal of Orthopaedic Research :... Mar 2022Anterior cruciate ligament (ACL) ruptures significantly impact athletes in terms of return to play and loss of long-term quality of life. Before the onset of this study,... (Review)
Review
Anterior cruciate ligament (ACL) ruptures significantly impact athletes in terms of return to play and loss of long-term quality of life. Before the onset of this study, understanding the mechanism of ACL injury was limited. Thus, the primary focus of this manuscript is to describe our multi-faceted approach to uncovering the mechanism of noncontact ACL injury (NC-ACLI) with the goal of developing preventive strategies. The initial qualitative analysis of ACL injury events revealed most (70%) injuries involve minimal to no contact and occurr during landing or deceleration maneuvers in team sports with a minor perturbation before the injury that may disrupt the neuromuscular system leading to poor body dynamics. A series of quantitative videotape studies demonstrated differences in leg and trunk positions at the time of NC-ACLI in comparison to control subjects. Analysis of the faulty dynamics provoking NC-ACLI, especially the flat-footed landing component, supports the theory that an axial compressive force is the critical factor responsible for NC-ACLI. Our magnetic resonance imaging study demonstrated the NC-ACLI position was associated with a higher tibial slope, and joint contact occurring on the flat, anterior portion of the lateral femoral condyle versus the round, posterior aspect. Both anatomic conditions favor sliding (pivot shift) over rolling in the presence of an axial compressive force. Subsequent cadaveric studies supported axial compressive forces as the primary component of NC-ACLI. Both a strong eccentric quadriceps contraction and knee abduction moments may increase the compressive force at the joint thereby lowering the axial threshold to injury. This manuscript summarizes the NC-ACLI mechanism portion of the 2021 OREF Clinical Research Award.
Topics: Anterior Cruciate Ligament; Anterior Cruciate Ligament Injuries; Awards and Prizes; Humans; Knee Joint; Quality of Life; Tibia
PubMed: 34951064
DOI: 10.1002/jor.25257 -
International Journal of Environmental... Dec 2022The objectives of this study were to analyze the injuries suffered during the previous year by amateur padel players according to the characteristics of the racket,...
The objectives of this study were to analyze the injuries suffered during the previous year by amateur padel players according to the characteristics of the racket, their usual volume of practice and their experience in padel. A total of 950 amateur players ( age: 31.68 years; weight: 70.84 kg; height: 170.9 cm) participated voluntarily, completing an ad-hoc questionnaire. The results indicated that the appearance of the injuries and their location was different according to the sex of the amateur padel players. Men had a higher incidence of muscle and ligament injuries in the shoulder, and tendon injuries in the elbow. On the other hand, women had a greater probability of having muscle injuries in the shoulder and arm, ligament injuries in the elbow and bone injuries in the wrist and elbow. In general, tendon injuries were the most common injury in padel and the shoulder and elbow were the most affected areas. Moreover, men tend to use heavy (CSR = 6.0), fiberglass or carbon (CSR = 2.1), diamond-shaped rackets (CSR = 3.2), with a hard core (CSR = 4.4) and with two or more over grips (CSR = 2.7). Women usually use less heavy (CSR = 6.0), round-shaped rackets (CSR = 4.9), with a soft core (CSR = 4.4) and with one or no over grips (CSR = 2.7). In addition, men tend to play padel more often and have been practicing for longer. In conclusion, although the risk of injury depends on many factors, we identified that the characteristics of the racket, the volume of weekly practice, the experience of the player and the gender of the player are fundamental aspects to take into account for the prevention of injuries in amateur padel players.
Topics: Male; Humans; Female; Adult; Incidence; Athletes; Shoulder; Elbow; Tendon Injuries; Athletic Injuries
PubMed: 36554736
DOI: 10.3390/ijerph192416858 -
Turkish Journal of Obstetrics and... Dec 2016Angular pregnancy is a rare condition in which the embryo is implanted in the lateral angle of the uterine cavity, medial to the uterotubal junction and round ligament,...
Angular pregnancy is a rare condition in which the embryo is implanted in the lateral angle of the uterine cavity, medial to the uterotubal junction and round ligament, and causes life-threatening obstetric complications. It is important to differentiate this condition from interstitial and cornual pregnancy because they all result in emergency conditions. Although angular pregnancy can progress to term pregnancy, it may be associated with major obstetric complications such as uterine rupture, placental retention, postpartum hemorrhage, or may need further surgery and hysterectomy. This report describes a case of angular pregnancy from the 6 gestational week and continued until delivery in the 32 gestational week. Sonographic findings, follow-up, and delivery concerns are described in this manuscript.
PubMed: 28913126
DOI: 10.4274/tjod.42402 -
Taiwanese Journal of Obstetrics &... Jan 2022Inguinal endometriosis is a very rare entity with uncertain pathophysiology, that poses several diagnostic and therapeutic challenges. This study aimed to summarize... (Review)
Review
Inguinal endometriosis is a very rare entity with uncertain pathophysiology, that poses several diagnostic and therapeutic challenges. This study aimed to summarize published literature on the diagnosis and treatment of this condition. Thus, a systematic literature search was conducted in PubMed/MEDLINE, Scopus and the Cochrane Library. An effort was made to numerically analyze all parameters included in case reports and retrospective analyses, as well. The typical and atypical features of this condition, investigations used, type of treatment and histopathology were recorded. More specifications about the surgical treatment, such as operations previously performed, type of surgery and treatment after surgery have been acknowledged. Other sites of endometriosis, the presence of pelvic endometriosis and the follow-up and recurrence have been also documented. Overall, the search yielded 61 eligible studies including 133 cases of inguinal endometriosis. The typical clinical presentation includes a unilateral inguinal mass, with or without catamenial pain. Transabdominal or transvaginal ultrasound was typically used as the first line method of diagnosis. Groin incision and exploratory surgery was the treatment indicated by the majority of the authors, while excision of part of the round ligament was reported in about half of the cases. Chemotherapy and radiotherapy were initiated in cases of coexisting endometriosis-related neoplasia. Inguinal recurrence or malignant transformation was rarely reported. The treatment of inguinal endometriosis is surgical and a long-term follow-up is needed. More research is needed on the effectiveness of suppressive hormonal therapy, recurrence rate and its relationship with endometriosis-associated malignancies.
Topics: Endometriosis; Female; Groin; Humans; Inguinal Canal; Round Ligament of Uterus; Treatment Outcome; Ultrasonography
PubMed: 35181041
DOI: 10.1016/j.tjog.2021.11.007