Background: Abnormal proximal femoral morphology in femoroacetabular impingement syndrome (FAIS) identifiable on the anteroposterior (AP) pelvic radiograph has been described as the “pistol grip” deformity. The effect of a superior cam deformity identified on this radiographic view remains unknown. Purposes: To assess the relationship between AP cam deformity (AP alpha angle [AP AA] >55°) and cartilage

Background: Ulnar collateral ligament reconstruction (UCLR) surgeries have increased significantly in amateur and professional baseball pitchers. Although showcase participation has been considered an injury risk factor, limited data are available to corroborate this association. Hypothesis: Elite pitchers achieving fastball velocities ≥90, ≥92, and ≥95 mph at younger ages would be more likely to undergo

Background: Impairments and dysfunction vary considerably after anterior cruciate ligament (ACL) injury, and distinct subgroups may exist. Purpose: (1) To identify subgroups of patients with ACL injury who share common trajectories of patient-reported knee function from initial presentation to 5 years after a treatment algorithm where they chose either ACL reconstruction (ACLR) plus rehabilitation

The authors regularly interact with professional team sport players in European and American leagues and their multidisciplinary support teams, and we are aware of players receiving regular intravenous nutrition (IVN) products. Furthermore, this is often evident in blood biomarker profiles where specific nutrients are beyond the upper-bound measurement limit of the clinical laboratory. The precise

The last few decades have seen a considerable increase in research attention to issues related to talent identification, skill acquisition, early sport specialisation and ‘safe’ athlete development.1 2 In parallel, those working in high-performance sport are regularly tasked with creating evidence-based policies to inform both injury prevention and sports performance programmes for developing athletes

Objective We synthesised and assessed credibility (ie, trustworthiness) of thresholds that define meaningful scores for patient-reported outcome measures (PROMs) following interventions for anterior cruciate ligament (ACL) tear or traumatic meniscus injury. Design Systematic review, narrative synthesis. Data sources We searched five databases, handsearched references of included studies and tracked

Background: The minimal clinically important difference (MCID), Patient Acceptable Symptom State (PASS), substantial clinical benefit (SCB), and maximum outcome improvement (MOI) satisfaction threshold for the Hip Outcome Score Sport-Specific Subscale (HOS-SSS) have not been established in athletes undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS). Purpose: To determine threshold

Background: The softball pitch is a full-body motion, where efficient proximal to distal energy flow through the kinetic chain is said to reduce stress at the upper extremity. Although altered trunk kinematic parameters are associated with upper extremity pain in softball pitchers, further research is needed to determine whether differences exist in proximal energy flow between softball pitchers with

Fibrosis is a common and debilitating pathological process that affects many organ systems and contributes to connective tissue disorders in orthopaedics. Tendons heal after acute and chronic injury through a process of fibrovascular scar tissue formation, and soft tissue joint capsules can be affected after traumatic joint injury, leading to arthrofibrosis. Although the precise underlying mechanisms

I have read the article by Lee et al.1 with great interest. This article reported favourable post-operative overall survival among obese patients with lung adenocarcinoma, a phenomenon known as the obesity paradox. Besides lung cancer, a better prognosis among overweight or obese patients has been repeatedly observed among patients with a broad range of diseases. For example, in 2021, this journal

Background: Anterior cruciate ligament (ACL) tears are associated with posttraumatic osteoarthritis, but the early biological changes that initiate joint degeneration after this injury are not well characterized. ACL tears typically result in effusion in the knee, which may provide insight into the initial response of the joint to injuries. Hypothesis: Patient- and injury-specific factors are associated

Statins are widely prescribed cholesterol-lowering drugs but have been shown to increase the risk of type 2 diabetes mellitus. However, the molecular mechanisms underlying the diabetogenic effect of statins are still not fully understood.

Sarcopenia is an age-related muscle disorder typically associated with a poor quality of life. Its definition has evolved over time, and several underlying causes of sarcopenia in the elderly have been proposed. However, the exact mechanisms involved in sarcopenia, as well as effective treatments for this condition, are not fully understood. The purpose of this article was to conduct a comprehensive

Objectives (1) To determine the prevalence of spine and upper limb osteoarthritis (OA) and pain in retired Olympians; (2) identify risk factors associated with their occurrence and (3) compare with a sample of the general population. Methods 3357 retired Olympians (44.7 years) and 1735 general population controls (40.5 years) completed a cross-sectional survey. The survey captured demographics, general

Objective The aim of this study was to test the extent to which physical activity performed during work and leisure is associated with systemic inflammation. Methods Data regarding job history and high-sensitivity C reactive protein (hs-CRP) levels, as well as potential confounders, came from the Copenhagen Aging and Midlife Biobank. The participants’ self-reported job history was combined with a job

One aspect of skeletal muscle memory is the ability of a previously trained muscle to hypertrophy more rapidly following a period of detraining. Although the molecular basis of muscle memory remains to be fully elucidated, one potential mechanism thought to mediate muscle memory is the permanent retention of myonuclei acquired during the initial phase of hypertrophic growth. However, myonuclear permanence

Ruan D, Tang C, Fei Y, et al. Early-stage primary anti-inflammatory therapy enhances the regenerative efficacy of platelet-rich plasma in a rabbit Achilles tendinopathy model. Am J Sports Med. 2021;49(12):3357-3371. (Original DOI:10.1177/03635465211037354)

Minkus M, Königshausen M, Maier D, et al. Immobilization in external rotation and abduction versus arthroscopic stabilization after first-time anterior shoulder dislocation: a multicenter randomized controlled trial. Am J Sports Med. 2021;49(4):857-865. doi:10.1177/0363546520987823

Objectives To investigate the dose–response association of aerobic physical activity (PA) and muscle-strengthening exercise (MSE) with all-cause mortality. Methods National Health Interview Survey data (1997–2014) were linked to the National Death Index through 2015, which produced a cohort of 416 420 US adults. Cox proportional-hazard models were used to estimate HRs and 95% CIs for the associations

Access to the liver transplant waitlist for patients with hepatocellular carcinoma (HCC) depends on tumour presentation, biology, and response to treatments. The Milan Criteria (MC) represent the benchmark for expanded criteria that incorporate additional prognostic factors. The purpose of this study was to determine the added value of skeletal muscle index (SMI) in HCC patients beyond the MC.

Objective Synthesise evidence for effectiveness of rehabilitation interventions following ACL and/or meniscal tear on symptomatic, functional, clinical, psychosocial, quality of life and reinjury outcomes. Design Overview of systematic reviews with Grading of Recommendations Assessment, Development and Evaluation certainty of evidence. Data sources MEDLINE, EMBASE, CINAHL, SPORTDiscus and Cochrane

PPGP is a specific category of pelvic girdle pain (PGP) impacting those in the perinatal period and differs in its aetiology as it is related to pregnancy and associated biopsychosocial influences. PGP in pregnancy and through the first postpartum year is common and combined with low back pain is estimated to occur in 56%–72% of antepartum people with 20% reporting severe symptoms during 20–30 weeks’

Sarcopenia is an increasingly recognized complication of cirrhosis that is associated with morbidity and mortality. Differences in the prevalence and prognosis of sarcopenia between men and women have been reported in other patient groups, but there is insufficient understanding of how sex impacts the prognostic value of sarcopenia in cirrhosis. A search of MEDLINE and Embase was conducted from earliest

Sport and Exercise Medicine (SEM) practitioners have, in recent years, taken a leading role in two immensely important areas of research and practice: safeguarding athletes1 and athlete mental health.2 We, as a field, recognise that these intertwined, pressing and growing concerns are becoming more visible thanks to the power of athlete voice. The International Olympic Committee (IOC) has also taken

What is the point of evidence if you cannot use it in the real world? This editorial is a call to action to reduce current knowledge-to-practice gaps and to emphasise the need for dissemination and implementation research in the field of sports injury and illness prevention. A challenging question exists for effective injury and illness prevention programmes: ‘Why is it that so many interventions in

The Sunnaas Foundation, a Norwegian non-profit foundation, has developed a Norwegian model of the Active Rehabilitation concept, in which peer mentorship is an essential element. Anecdotal evidence indicates that the participants’ experience increased independence in activities of daily living (ADL), including wheelchair skills, increased engagement in physical activities, social life and expanded

Objectives Knee injury and Osteoarthritis Outcome Score (KOOS)-Child is a modification of the adult KOOS aiming to evaluate knee injury, including ACL deficiency. However, the measurement properties of KOOS-Child have not been assessed in a cohort of children with ACL deficiency. We aimed to study the structure of KOOS-Child using modern test theory models (Rasch analysis and confirmatory factor analysis

Patients with multiple sclerosis (MS) experience reduced exercise tolerance that substantially reduces quality of life. The mechanisms underpinning exercise intolerance in MS are not fully clear. This study aimed to determine the contributions of the cardiopulmonary system and peripheral muscle in MS-induced exercise intolerance before and after exercise training.

Objectives This study aims (1) to determine the prevalence of lower limb osteoarthritis (OA) and pain in retired Olympians; (2) to identify factors associated with their occurrence and (3) to compare with a sample of the general population. Methods 3357 retired Olympians (median 44.7 years) and 1735 general population controls (40.5 years) completed a cross-sectional survey. The survey captured demographics

Improvements in hamstring injury risk management strategies are necessary, especially in sports requiring ‘sprinting’ (ie, maximal acceleration and/or velocity). Sprinting represents about two-thirds of hamstring injury mechanisms.1 Several sprinting-related parameters are associated with hamstring injuries.2–5 Thus, this editorial aims to (1) emphasise the importance of sprinting and (2) provide general

Objective To improve classification of movement behaviours in free-living accelerometer data using machine-learning methods, and to investigate the association between machine-learned movement behaviours and risk of incident cardiovascular disease (CVD) in adults. Methods Using free-living data from 152 participants, we developed a machine-learning model to classify movement behaviours (moderate-to-vigorous

Background: Collagen meniscal implant (CMI) is a biologic scaffold that can be used to replace meniscus host tissue after partial meniscectomy. The short-term results of this procedure have already been described; however, little is known about risk factors for failure. Purpose: To determine the factors that predict failure of meniscal scaffold implantation in a large series of patients treated at

My PhD addressed the aims and objectives in three published studies (studies 1, 3 and 4) and one unpublished study (study 2). Study 1 was a meta-analysis and systematic review. Study 2 investigated the association between cardiorespiratory fitness (CRF) measurements, cardiometabolic risk factors and inflammatory markers. Study 3 investigated the effect of the 90 s ‘Gear’ exercise programme repeated

Football (soccer) heading is an integral game-related skill which affects performance.1 The sport is under increasing pressure to minimise head to ball contact due to reported concerns of developing long-term neurodegenerative diseases (ND).2 The English Football Association (FA) recently responded with guidance limiting headers in training.3 However, current research presents no high-quality evidence

Low muscle strength is associated with adverse clinical outcomes in patients undergoing haemodialysis (HD). No studies have reported the association between dynapenia, defined by both low handgrip strength (HGS) and quadriceps isometric strength (QIS), and long-term clinical outcomes in patients on HD. We examined the associations between dynapenia, cardiovascular (CV) hospitalizations, and all-cause

Background: The rate of anterior cruciate ligament (ACL) reconstruction is increasing over time in pediatric/adolescent populations, but there is less evidence to support how concomitant meniscal procedures are changing over time. There are also less data to suggest which characteristics are associated with meniscectomy versus meniscal repair treatment. Hypothesis: Age, sex, race/ethnicity, income

Background: Autologous chondrocyte implantation (ACI) can be used to treat focal, full-thickness chondral defects of the knee. However, there is limited large-sample evidence available regarding the incidence, timing, and risk factors for revision surgery after ACI. Purpose: To assess the 5-year incidence, timing, and risk factors for revision surgery after ACI in a large national cohort. Study Design:

Background: The optimal graft choice between the bone–patellar tendon–bone (BPTB) and the quadriceps tendon remains controversial. Studies evaluating the microscopic anatomy of the quadriceps tendon–patellar bone (QTB) and BPTB grafts for anterior cruciate ligament (ACL) reconstruction are currently lacking. Hypothesis: The relationship between post–ACL reconstruction graft bending angle (GBA) and

Background: Individuals with anterior cruciate ligament (ACL) reconstruction (ACLR) are a population that has a higher risk for ACL injury compared with the general population. To reduce the reinjury rate and improve the rehabilitation outcome after ACLR, risk factors for ACL injury have to be addressed. Purpose: To compare the knee biomechanics during side-cutting and isokinetic strength of the thigh

Background: Autologous tendon grafts are used for meniscal reconstruction of surgically removed knee joint meniscus. However, as meniscal reconstruction cannot prevent the progression of cartilage degeneration, additional procedures that confer meniscus-like histological properties to the transplanted tendon are required for improved outcomes. Hypotheses: Parathyroid hormone (PTH)(1-34) induces cartilage

Background: Although biomechanical and clinical studies have reported adverse effects on the patellofemoral joint after medial open-wedge high tibial osteotomy (MOWHTO), there is a paucity of literature that describes outcomes longer than midterm follow-up. Purpose: We aimed to evaluate the mid- to long-term radiologic and clinical outcomes of the patellofemoral joint after MOWHTO and to assess whether

Background: There is a paucity of information in the literature on midterm outcomes of endoscopic gluteus medius and/or minimus repair with concomitant labral treatment using only modern surgical techniques. Purpose: To define the minimal clinically important difference (MCID) and Patient Acceptable Symptom State (PASS) at a minimum of 5 years postoperatively for patients undergoing endoscopic hip

The American Journal of Sports Medicine has been a natural destination for studies focused on epidemiology and statistics related to sports medicine over the past 50 years. The fields of epidemiology and statistics are surprisingly dynamic, and the publications in AJSM have paralleled this academic evolution.

The Sports and Exercise Medicine community and other sport stakeholders are becoming increasingly aware of the mental health symptoms (eg, depression, anxiety, substance misuse) reported by athletes. In 2019, this led to the publication of the first International Olympic Committee (IOC) consensus statement on mental health in this cohort and the establishment of the IOC Mental Health Working Group

Frailty and sarcopenia are age-associated syndromes that have been associated with the risk of several adverse events, mainly functional decline and death, that usually coexist. However, the potential role of one of them (sarcopenia) in modulating some of those adverse events associated to the other one (frailty) has not been explored. The aim of this work is to assess the role of sarcopenia within

Unexpected weight loss is a presenting feature of cancer in primary care. Data from primary care are lacking to quantify how much weight loss over what period should trigger further investigation for cancer. This research aimed to quantify cancer diagnosis rates associated with measured weight change in people attending primary care.

Chemotherapy induces a cachectic-like phenotype, accompanied by skeletal muscle wasting, weakness and mitochondrial dysfunction. Peroxisome proliferator-activated receptor-gamma coactivator-1 alpha (PGC1α), a regulator of mitochondrial biogenesis, is often reduced in cachectic skeletal muscle. Overexpression of PGC1α has yielded mixed beneficial results in cancer cachexia, yet investigations using

Cabozantinib, a standard of care metastatic renal cell carcinoma (mRCC), may be associated with weight and muscle loss. These effects of new generation VEGFR tyrosine kinase inhibitor on muscle mass loss are poorly described.

The adolescent athlete faces a number of developmental challenges that occur alongside pursuit of their sporting goals. These include the pressures to perform at a high level but also to develop emotionally and physically to the demands of training and competition. Medical professionals caring for adolescent athletes, must be aware of and help them to achieve a defining metabolic milestone early on

As we slowly emerge from the pandemic, the world is finding its new normal and we are beginning to quantify the ramifications of COVID-19 and what it means to physical activity, sport and health. With lockdowns, restrictions and fear of viral transmission, physical activity was arguably a big loser during the pandemic. As a sports medicine community, it is essential we continue to advocate for the

Chronic conditions, typically characterised as diseases of long duration, slow progression and that require long-term management, contribute significantly to the global burden of disease and are predicted to become more prevalent in the years to come.1 People with chronic conditions are less likely to be physically active than the general population, which has important health and economic consequences

Physical activity (PA) is one of the most important factors to determine health outcomes. It is well established that for many musculoskeletal problems, PA and exercise are the way to better health. PA offers a wide range of physical and psychological benefits which may vary based on intensity, frequency and activity type. Most of the international guidelines recommend that an adult takes part in at