Return to play (RTP) decisions in football are currently based on expert opinion. No consensus gu... more Return to play (RTP) decisions in football are currently based on expert opinion. No consensus guideline has been published to demonstrate an evidence-based decision-making process in football (soccer). Our aim was to provide a framework for evidence-based decision-making in RTP following lower limb muscle injuries sustained in football. A 1-day consensus meeting was held in Milan, on 31 August 2018, involving 66 national and international experts from various academic backgrounds. A narrative review of the current evidence for RTP decision-making in football was provided to delegates. Assembled experts came to a consensus on the best practice for managing RTP following lower limb muscle injuries via the Delphi process. Consensus was reached on (1) the definitions of ‘return to training’ and ‘return to play’ in football. We agreed on ‘return to training’ and RTP in football, the appropriate use of clinical and imaging assessments, and laboratory and field tests for return to trainin...
Among all joints affected, knee osteoarthritis has a prevalence of about 10% in men and 13% in wo... more Among all joints affected, knee osteoarthritis has a prevalence of about 10% in men and 13% in women over 60 years old. Knee osteoarthritis has high economic and social costs and may have a devastating impact on patient quality of life. Treatment of symptomatic knee Osteoarthritis may involve oral or topical administration of non-steroidal anti-inflammatory drugs or intra-articular injection of corticosteroids. Recently, a novel injectable collagen formulation (ChondroGrid) consisting of bovine hydrolyzed <3 kDa type I collagen has been developed and is currently available on the market as an injectable medical device. The primary objective of this study was to investigate the in vitro and in vivo effects of ChondroGrid in treating knee osteoarthritis symptoms to assess its safety and performance. Viability and proliferation of ChondroGrid-exposed human chondrocytes derived from five donors were assessed through the Alamar Blue/CyQuant assays. Their expression of MMP1/MMP3 and TI...
groin pain affects all types of athletes, especially soccer players. Many diseases with different... more groin pain affects all types of athletes, especially soccer players. Many diseases with different etiologies may cause groin pain. offer a mini review of groin pain in soccer accompanied by the presentation of a case report highlighting the possible association of more clinical frameworks into the onset of groin pain syndrome, in order to recommend that clinical evaluations take into account possible associations between bone, muscle and tendon such as inguinal canal disease. the multifactorial etiology of groin pain syndrome needs to be examined with a comprehensive approach, with standardized clinical evaluation based on an imaging protocol in order to evaluate all possible diseases. Mini review- Case report (Level V).
Multiligamentous injury to the anterior cruciate ligament (ACL) and the posterior cruciate ligame... more Multiligamentous injury to the anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL) is an uncommon but debilitating event. Patients with combined ligament injuries typically complain of painful, debilitating knee instability that restricts their sports and daily activities. The purpose of this retrospective study was to evaluate functional and clinical outcomes of patients with chronic ACL and PCL deficiency who underwent simultaneous single-stage arthroscopic reconstruction of the central pivot. Medical records of 20 consecutive patients with chronic ACL and PCL deficiency who underwent simultaneous single-stage arthroscopic reconstruction of the central pivot were retrospectively reviewed. All patients had received either an allograft (group A) or a semitendinosus-gracilis graft for ACL repair and a bone-patellar tibial-bone graft for PCL repair (group B). Functional outcomes, after the initial follow-up period at 24-month FU, were assessed with concentric isokinetic knee extensor-flexor testing at 60 and 180°/s. The secondary aim was to compare long-term clinical recovery by the administration of the IKDC (International Knee Document Committee) Knee Ligament Evaluation Form, the Lysholm Knee Scoring Scale and the Cincinnati Knee Rating Scale. The mean per cent quadriceps strength deficit in the operated as compared to the healthy knee was 13.5 % in group A and 15 % in group B (angular velocity 60°/s) and 13.5 % in group A and 9.4 % in group B (angular velocity 180°/s). The mean per cent flexor strength deficit in the operated as compared to the healthy knee was 10.4 % in group A and 12.3 % in group B (angular velocity 60°/s) and 12.2 % in group A and 9 % in group B (angular velocity of 180°/s). The flexor-quadriceps ratio was 49.4 % in group A and 48.8 % in group B in the healthy knee and 53.2 % in group A and 53.8 % in group B in the operated knee (angular velocity 60°/s) and 63.9 % in group A and 60.7 % in group B in the healthy knee and 65 % in group A and 64.9 % in group B in the operated knee (angular velocity 180°/s). Lysholm outcome was 93.9 ± 3.9 in group A and 89.1 ± 7.6 in group B (n.s). Cincinnati score was 89.6 ± 7.3 in group A and 91.0 ± 6.9 in group B (p = 0.791). IKDC results were group A in six patients (60 %), group B in three patients (30 %) and group C in one patient (10 %) in the allograft group and group A in seven patients (70 %) and group B in three patients (30 %) for autologous group. The results of this study suggest that one-stage arthroscopic bicruciate ligament reconstruction can restore good knee joint function. Surgical treatment should be followed by a comprehensive rehabilitation programme with specific goals, objectives and strategies, including pain management and assessment of progress in recovery of joint function and perception of knee stability. Retrospective case series, Level IV.
ABSTRACT This article describes the technique of the single-incision arthroscopic method for post... more ABSTRACT This article describes the technique of the single-incision arthroscopic method for posterior cruciate ligament (PCL) reconstruction with doubled semitendinosus and gracilis autograft. This technique is indicated for chronic lesions with a posterior drawer of more than 10 mm compared with the contralateral knee. The steps are (1) diagnosis and treatment of associated lesions; (2) harvesting of tendon grafts; (3) removal of the PCL stump; (4) reconstruction of the PCL [(a) tibial tunnel with a guide at 55 degrees, (b) double femoral tunnels]; and (5) insertion and fixation of the grafts. The position of the posteromedial femoral tunnel is at 8 mm from the anterior femoral cartilage, and the anterolateral tunnel is at 13 mm. The salient feature of this technique is the fixation of the posteromedial and the anterolateral bundle in extension and flexion, respectively. A severe peripheral instability (usually posterolateral) requires the reconstruction of this portion before the intra-articular treatment. The postoperative management is slow, with the recovery of the full range of motion in 45 days.
... These include (especially when a player first joins a club): Orthopaedic assessment and traum... more ... These include (especially when a player first joins a club): Orthopaedic assessment and traumatological examination; -Instrumental examinations consisting of radiography, magnetic reso-nance imaging (MRI), ultrasound (US), and other instrumental examina-tions of areas ...
... Milan, Italy. Address correspondence and reprint request to Matteo Denti, MD, Istituto Ortope... more ... Milan, Italy. Address correspondence and reprint request to Matteo Denti, MD, Istituto Ortopedico Galeazzi, Via Galeazzi 4, 20161 Milano, Italy. ... Our recent preference is for that described by RogerLarson 3 using a ipsi-or contralateral semitendinosus tendon. ...
Return to play (RTP) decisions in football are currently based on expert opinion. No consensus gu... more Return to play (RTP) decisions in football are currently based on expert opinion. No consensus guideline has been published to demonstrate an evidence-based decision-making process in football (soccer). Our aim was to provide a framework for evidence-based decision-making in RTP following lower limb muscle injuries sustained in football. A 1-day consensus meeting was held in Milan, on 31 August 2018, involving 66 national and international experts from various academic backgrounds. A narrative review of the current evidence for RTP decision-making in football was provided to delegates. Assembled experts came to a consensus on the best practice for managing RTP following lower limb muscle injuries via the Delphi process. Consensus was reached on (1) the definitions of ‘return to training’ and ‘return to play’ in football. We agreed on ‘return to training’ and RTP in football, the appropriate use of clinical and imaging assessments, and laboratory and field tests for return to trainin...
Among all joints affected, knee osteoarthritis has a prevalence of about 10% in men and 13% in wo... more Among all joints affected, knee osteoarthritis has a prevalence of about 10% in men and 13% in women over 60 years old. Knee osteoarthritis has high economic and social costs and may have a devastating impact on patient quality of life. Treatment of symptomatic knee Osteoarthritis may involve oral or topical administration of non-steroidal anti-inflammatory drugs or intra-articular injection of corticosteroids. Recently, a novel injectable collagen formulation (ChondroGrid) consisting of bovine hydrolyzed <3 kDa type I collagen has been developed and is currently available on the market as an injectable medical device. The primary objective of this study was to investigate the in vitro and in vivo effects of ChondroGrid in treating knee osteoarthritis symptoms to assess its safety and performance. Viability and proliferation of ChondroGrid-exposed human chondrocytes derived from five donors were assessed through the Alamar Blue/CyQuant assays. Their expression of MMP1/MMP3 and TI...
groin pain affects all types of athletes, especially soccer players. Many diseases with different... more groin pain affects all types of athletes, especially soccer players. Many diseases with different etiologies may cause groin pain. offer a mini review of groin pain in soccer accompanied by the presentation of a case report highlighting the possible association of more clinical frameworks into the onset of groin pain syndrome, in order to recommend that clinical evaluations take into account possible associations between bone, muscle and tendon such as inguinal canal disease. the multifactorial etiology of groin pain syndrome needs to be examined with a comprehensive approach, with standardized clinical evaluation based on an imaging protocol in order to evaluate all possible diseases. Mini review- Case report (Level V).
Multiligamentous injury to the anterior cruciate ligament (ACL) and the posterior cruciate ligame... more Multiligamentous injury to the anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL) is an uncommon but debilitating event. Patients with combined ligament injuries typically complain of painful, debilitating knee instability that restricts their sports and daily activities. The purpose of this retrospective study was to evaluate functional and clinical outcomes of patients with chronic ACL and PCL deficiency who underwent simultaneous single-stage arthroscopic reconstruction of the central pivot. Medical records of 20 consecutive patients with chronic ACL and PCL deficiency who underwent simultaneous single-stage arthroscopic reconstruction of the central pivot were retrospectively reviewed. All patients had received either an allograft (group A) or a semitendinosus-gracilis graft for ACL repair and a bone-patellar tibial-bone graft for PCL repair (group B). Functional outcomes, after the initial follow-up period at 24-month FU, were assessed with concentric isokinetic knee extensor-flexor testing at 60 and 180°/s. The secondary aim was to compare long-term clinical recovery by the administration of the IKDC (International Knee Document Committee) Knee Ligament Evaluation Form, the Lysholm Knee Scoring Scale and the Cincinnati Knee Rating Scale. The mean per cent quadriceps strength deficit in the operated as compared to the healthy knee was 13.5 % in group A and 15 % in group B (angular velocity 60°/s) and 13.5 % in group A and 9.4 % in group B (angular velocity 180°/s). The mean per cent flexor strength deficit in the operated as compared to the healthy knee was 10.4 % in group A and 12.3 % in group B (angular velocity 60°/s) and 12.2 % in group A and 9 % in group B (angular velocity of 180°/s). The flexor-quadriceps ratio was 49.4 % in group A and 48.8 % in group B in the healthy knee and 53.2 % in group A and 53.8 % in group B in the operated knee (angular velocity 60°/s) and 63.9 % in group A and 60.7 % in group B in the healthy knee and 65 % in group A and 64.9 % in group B in the operated knee (angular velocity 180°/s). Lysholm outcome was 93.9 ± 3.9 in group A and 89.1 ± 7.6 in group B (n.s). Cincinnati score was 89.6 ± 7.3 in group A and 91.0 ± 6.9 in group B (p = 0.791). IKDC results were group A in six patients (60 %), group B in three patients (30 %) and group C in one patient (10 %) in the allograft group and group A in seven patients (70 %) and group B in three patients (30 %) for autologous group. The results of this study suggest that one-stage arthroscopic bicruciate ligament reconstruction can restore good knee joint function. Surgical treatment should be followed by a comprehensive rehabilitation programme with specific goals, objectives and strategies, including pain management and assessment of progress in recovery of joint function and perception of knee stability. Retrospective case series, Level IV.
ABSTRACT This article describes the technique of the single-incision arthroscopic method for post... more ABSTRACT This article describes the technique of the single-incision arthroscopic method for posterior cruciate ligament (PCL) reconstruction with doubled semitendinosus and gracilis autograft. This technique is indicated for chronic lesions with a posterior drawer of more than 10 mm compared with the contralateral knee. The steps are (1) diagnosis and treatment of associated lesions; (2) harvesting of tendon grafts; (3) removal of the PCL stump; (4) reconstruction of the PCL [(a) tibial tunnel with a guide at 55 degrees, (b) double femoral tunnels]; and (5) insertion and fixation of the grafts. The position of the posteromedial femoral tunnel is at 8 mm from the anterior femoral cartilage, and the anterolateral tunnel is at 13 mm. The salient feature of this technique is the fixation of the posteromedial and the anterolateral bundle in extension and flexion, respectively. A severe peripheral instability (usually posterolateral) requires the reconstruction of this portion before the intra-articular treatment. The postoperative management is slow, with the recovery of the full range of motion in 45 days.
... These include (especially when a player first joins a club): Orthopaedic assessment and traum... more ... These include (especially when a player first joins a club): Orthopaedic assessment and traumatological examination; -Instrumental examinations consisting of radiography, magnetic reso-nance imaging (MRI), ultrasound (US), and other instrumental examina-tions of areas ...
... Milan, Italy. Address correspondence and reprint request to Matteo Denti, MD, Istituto Ortope... more ... Milan, Italy. Address correspondence and reprint request to Matteo Denti, MD, Istituto Ortopedico Galeazzi, Via Galeazzi 4, 20161 Milano, Italy. ... Our recent preference is for that described by RogerLarson 3 using a ipsi-or contralateral semitendinosus tendon. ...
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