1/17. Osteochondral mosaicplasty for the treatment of focal chondral and osteochondral lesions of the knee and talus in the athlete. Rationale, indications, techniques, and results.New techniques for articular cartilage transplantation have become available recently for traumatic chondral injuries. Applications to the athlete have generated considerable interest in the sports medicine community. The autogenous osteochondral grafting mosaicplasty has been used to treat these injuries in the athlete population for the past six years. The rationale, indications, operative technique, results, and limitations of mosaicplasty in the athlete are presented and discussed.- - - - - - - - - - ranking = 1keywords = medicine (Clic here for more details about this article) |
2/17. sports medicine and sailing.Although there is little epidemiologic data in the sport of sailing, the identification of important trends can assist the clinician in successful evaluation, treatment, and rehabilitation of the individual. It appears that like other sports, the majority of injuries encountered are of the microtraumatic or overuse type. An understanding of biomechanics, the overload injury, and the sport of sailing will allow the development of a comprehensive rehabilitation program to ensure the optimal performance and safety of the sailor.- - - - - - - - - - ranking = 4keywords = medicine (Clic here for more details about this article) |
3/17. Traumatic arthritis in sport.After the introduction of ultrasonography in sports medicine, traumatic arthritis is recognized relatively frequently among athletes. In this case study, the ultrasonographic findings and the prompt effect of ultrasonographically guided intra-articular injection of long-acting steroid are demonstrated in two patients.- - - - - - - - - - ranking = 1keywords = medicine (Clic here for more details about this article) |
4/17. Casebook: chronic knee pain.It is beyond the scope of this article to fully explore the many and varied causes of chronic knee pain, but we hope to have reminded the reader of some of the essential principles involved. The importance of a full history cannot be over-emphasised and particular attention should be paid to issues surrounding the mechanism of injury and the role of a patient's chosen sport in their life. The cases highlight the value of the involvement of a multi-disciplinary team including physiotherapists, podiatrists and dieticians. It is also usual to involve sports psychologists and team coaches/trainers at the higher levels of sport. An appreciation of normal biomechanics is necessary. There are several specialised tests used in the evaluation of knee pain and it is worthwhile spending some time with a physiotherapist or colleague with an interest in musculoskeletal medicine to learn and practice them.- - - - - - - - - - ranking = 1keywords = medicine (Clic here for more details about this article) |
5/17. Statistical procedures for determining the extent of cognitive change following concussion.Neuropsychological (NP) testing is now often used to help to determine if the cognitive function of a concussed athlete has declined. The NP test score after concussion is compared with the baseline test score. Many clinicians simply subtract one from the other and make a clinical decision about the significance or otherwise of the resulting "difference score". Such techniques are inadequate, as they fail to account for the many factors that may confound interpretation of serially acquired cognitive test scores. This is a review of a number of alternative approaches used in other areas of medicine for differentiating "true" changes from changes caused by these confounding factors. A case example is used to illustrate the effect that the statistical approach may have on clinical decision making.- - - - - - - - - - ranking = 1keywords = medicine (Clic here for more details about this article) |
6/17. Endartery stenosis of the popliteal artery mimicking gastrocnemius strain: a case report.This report presents a case of leg pain in a recreational athlete that was caused by a stenotic lesion of an endartery branch of the popliteal artery. Isolated areas of arterial stenosis are rarely reported in the sports medicine literature as the primary cause of leg pain. This may be due in part to the difficulty of obtaining the diagnosis. This study includes a review of the relevant anatomic, pathophysiologic, diagnostic, and therapeutic considerations and concludes with a discussion of the potentially underrecognized significance of arterial stenosis in the sports population.- - - - - - - - - - ranking = 1keywords = medicine (Clic here for more details about this article) |
7/17. The use of diagnostic imaging in sports medicine.Imaging should only be undertaken if it is likely to influence patient management. The dose of ionising radiation to the patient should be considered. Requesting the appropriate imaging method requires an understanding of the pathological process. Plain x-ray should still generally be the first imaging technique; exceptions include some forms of superficial tendinopathy, in which ultrasound may be more appropriate, and situations where radiation exposure is contraindicated, such as in a pregnant patient. The cost of the examination to the patient and the community should also be considered (eg, ultrasound v magnetic resonance imaging).- - - - - - - - - - ranking = 4keywords = medicine (Clic here for more details about this article) |
8/17. 6. Doctor on the sidelines.Effectively managing on-field emergencies is the most important role of the doctor on the sidelines. Pre-event preparation is essential and should include a formulated plan for dealing with emergencies and access to emergency equipment such as a stretcher and a bag and mask. Game day injuries should be assessed by adhering as closely as possible to a normal clinical consultation, with a proper history and examination being performed for all injuries. The athlete with an on-field head injury should be treated as having a concomitant cervical spine injury until proven otherwise. athletes with any symptoms after head injury should be comprehensively and continuously assessed. Return-to-play decisions are made by balancing the risk of injury recurrence, the potential severity of injury recurrence and the benefits of returning to the field (which are higher at elite than amateur level). There is currently a shortage of doctors willing to cover sports events in australia, which is partially explained by inadequate remuneration, inadequate facilities provided at venues, inadequate training opportunities in sports medicine, and fear of the medicolegal consequences in taking on the role as a team doctor.- - - - - - - - - - ranking = 1keywords = medicine (Clic here for more details about this article) |
9/17. Abdominal musculature abnormalities as a cause of groin pain in athletes. Inguinal hernias and pubalgia.There has been increasing interest within the European sports medicine community regarding the etiology and treatment of groin pain in the athlete. groin pain is most commonly caused by musculotendinous strains of the adductors and other muscles crossing the hip joint, but may also be related to abdominal wall abnormalities. Cases may be termed "pubalgia" if physical examination does not reveal inguinal hernia and there is an absence of other etiology for groin pain. We present nine cases of patients who underwent herniorrhaphies for groin pain. Two patients had groin pain without evidence of a hernia preoperatively (pubalgia). In the remaining seven patients we determined the presence of a hernia by physical examination. At operation, eight patients were found to have inguinal hernias. One patient had no hernia but had partial avulsion of the internal oblique fibers from their insertion at the public tubercle. The average interval from operation to return to full activity was 11 weeks. All patients returned to full activity within 3 months of surgery. One patient had persistent symptoms of mild incisional tenderness, but otherwise there were no recurrences, complications, or persistence of symptoms. Abnormalities of the abdominal wall, including inguinal hernias and microscopic tears or avulsions of the internal oblique muscle, can be an overlooked source of groin pain in the athlete. Operative treatment of this condition with herniorrhaphy can return the athlete to his sport within 3 months.- - - - - - - - - - ranking = 1keywords = medicine (Clic here for more details about this article) |
10/17. Clinical aspects of muscle injury.Muscle injuries are a common part of the clinical practice of sports medicine. Due to variations in muscle injury, the clinical presentation may vary from the subclinical to the catastrophic. Muscle injuries may present in four broad categories: acute, chronic, acute exacerbation of a chronic problem, or subclinical alteration. Each muscle injury can be further broken down into five areas: tissue injury, clinical symptoms, functional biomechanical deficit, functional adaptations, and tissue overload. Case studies are presented to illustrate the presentation of each type and analysis of the component parts of the injury. It is only through such analysis that an accurate and complete diagnosis, followed by a functional rehabilitation plan, may be constructed.- - - - - - - - - - ranking = 1keywords = medicine (Clic here for more details about this article) |
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