The American Orthopaedic Society of Sports Medicine 2010 Annual Meeting, AOSSM 2010, took place July 15 to 18 in Providence, R.I., and attracted approximately 1,500 participants. The conference focused on advances in the identification, prevention, treatment, and rehabilitation of sports-related injuries. Highlights included presentations focusing on the epidemiology of Major League Baseball players' injuries, cost savings associated with early anterior cruciate ligament (ACL) reconstruction surgery in pediatric patients, and the effectiveness of knee injury prevention programs in young athletes.
In one study, Matthew Posner, M.D., of the William Beaumont Army Medical Center in El Paso, Texas, and colleagues found that Major League Baseball pitchers had a significantly higher proportion of upper extremity injuries compared to field position players (67.0 versus 32.1 percent). However, field position players showed a significantly higher proportion of lower extremity injuries compared to pitchers (47.5 versus 16.9 percent). Overall, lower extremity injuries accounted for 30.6 percent of all injuries, and upper extremity injuries made up 51.4 percent of all injuries.
"Baseball injuries may not necessarily be attrition due to wear and tear over the season and may be due to preconditioning prior to the start of the season," Posner said. "Therefore, we are currently evaluating retooling what we recommend for spring training."
In another study, Adam Popchak, of the Center for Sports Medicine in Pittsburgh, and colleagues found that completion of a strength and conditioning program provided young baseball players with statistically significant gains in throwing velocity as well as rotator cuff and core strength. However, there were no statistically significant changes in hamstring flexibility or run time.
"There was no control group in this study, so we were unable to determine a cause and effect relationship. However, overall, with training these muscles we noted an increase in performance and decrease in discomfort in younger baseball players," Popchak said.
Kevin G. Shea, M.D., of Intermountain Orthopaedics in Idaho and the University of Utah School of Medicine in Salt Lake City, and colleagues found no level 1 evidence demonstrating that exercise/training programs can reduce the risk of ACL/knee injury in young female athletes. The researchers performed searches for ACL/knee injury prevention trials using MEDLINE, Cochrane, and CINAHL. Fifteen studies were identified, with 12 classified as level 2 studies and three as level 3 studies.
The researchers found that two of the three level 3 studies showed a significant reduction of knee and/or ACL injury. One of the three level 3 studies that reported ACL injury as an outcome measure showed a significant reduction in ACL injury. Of the level 2 studies, seven of 12 showed a significant reduction of knee and/or ACL injury. Four of 10 level 2 studies that reported ACL injury as an outcome measure showed a significant reduction of ACL injury. However, the researchers also discovered that many of these studies contained design flaws.
"At this time, the level of evidence in support of the effectiveness of prevention for knee and/or ACL injury is not of the highest level, and questions about the impact of these interventions still exist," the authors write. "Further well-designed research trials will be necessary to determine if these injuries can be prevented with specialized training programs."
In a study evaluating the costs associated with the timing of pediatric ACL rupture reconstruction surgery, Suneel B. Bhat, of the Caladrius Institute in Columbia, Md., and colleagues found that delaying ACL reconstruction significantly increased medial meniscal tears as well as lateral and medial compartment injury among pediatric patients and also resulted in increased surgical charges.
"The model developed by my co-author, Suneel Bhat, allows for a more elegant and generalizable analysis than standard statistical methods, by incorporating variability and simulating a prospective clinical trial," said study co-author, Theodore J. Ganley, M.D., of the Children's Hospital of Philadelphia. "We predict that early ACL reconstruction will save $30 million annually in the United States and prevent unnecessary meniscal and cartilage injuries to children."
AOSSM: Simple Tool Predicts ACL Injury Risk in Females
MONDAY, July 19 (HealthDay News) -- A novel, low-cost, in-office approach can accurately identify female athletes at increased risk of anterior cruciate ligament (ACL) injury, according to a study published online July 1 in the American Journal of Sports Medicine and presented at the annual meeting of the American Orthopaedic Society for Sports Medicine, held from July 15 to 18 in Providence, R.I.
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