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Innsbruck, Austria

Herbst E.,Innsbruck Medical University | Herbst E.,TU Munich | Hoser C.,Sportsclinic Austria | Hildebrandt C.,University of Innsbruck | And 5 more authors.
Knee Surgery, Sports Traumatology, Arthroscopy | Year: 2015

Purpose: The purpose of this study was to utilize a novel functional test system to facilitate determining the time of return to sports following ACL reconstruction.Methods: Sixty-nine patients with unilateral ACL reconstruction were included in this pilot study. All the patients performed a standardized test battery consisting of one- and two-legged stability tests, counter movement jumps, speedy jumps, plyometric jumps and a quick feed test. The first test was administered on average 170.7 ± 75.1 days post-operatively, and the retest was administered on average 239.1 ± 79.7 days post-operatively. The values of the subtests were compared with the normative data of healthy gender- and age-matched controls to determine the functional capacities of patients following ACL reconstruction.Results: After the first and second test, 15.9 and 17.4 % of the patients met the criteria for a “return to non-competitive sports”. One patient fulfilled the criteria for a “return to competitive sports” after the second test battery. The most limiting factor was a poor LSI value of <90 % if the dominant leg was involved and <80 % if the non-dominant leg was involved.Conclusion: This test battery demonstrates that, in terms of neuromuscular abilities, most patients, compared to healthy controls, are most likely not ready for a safe return to sports, even 8 months post-operatively. This should be considered in the future to determine when it is safe to return to sports and should avoid a premature return to competitive sports.Level of evidence: III. © 2015, The Author(s).

Liebensteiner M.C.,Innsbruck Medical University | Krismer M.,Innsbruck Medical University | Koller A.,Institute for Sports Medicine | Semenitz B.,Innsbruck Medical University | Mayr E.,Innsbruck Medical University
Clinical Orthopaedics and Related Research | Year: 2012

Background Less invasive dissection of the extensor apparatus, one of the aspects of minimally invasive surgical (MIS) TKA, might result in less reduction of postoperative quadriceps strength. However, it is unclear whether MIS is associated with less strength reduction. Questions/purposes We asked whether knee strength (extensor or flexor torque) would be greater in patients having a MIS TKA compared with patients having a standard TKA and whether knee scores, alignment, ROM, tourniquet and operating times, and hospital length of stay were improved. Methods We prospectively recruited 52 patients awaiting MIS or standard TKA, matched for age, weight, height, BMI, sex, and surgically treated side, but not randomized. Isokinetic tests were performed preoperatively and postoperatively to obtain peak values of extensor and flexor torque. Postoperative-to-preoperative ratios and the extensor- flexor torque ratio also were calculated. Results Mean baseline extensor torques were 57 Nm and 53 Nm for MIS and standard TKAs, respectively. At 8 weeks postoperatively, absolute values of the mean postoperative knee extensor torque also were similar: 47 and 45 Nm for patients with MIS and standard TKAs, respectively. The postoperative-to-preoperative ratios were 0.8 for extensor and flexor torque in both groups. The extensor-flexor torque ratios were similar between groups. Conclusions Our data suggest a less invasive dissection of the extensor apparatus involved in MIS TKA does not enhance postoperative quadriceps strength. © The Association of Bone and Joint Surgeons® 2012.

Reule C.A.,University of Stuttgart | Alt W.W.,University of Stuttgart | Lohrer H.,Institute for Sports Medicine | Hochwald H.,University of Stuttgart
British Journal of Sports Medicine | Year: 2011

Background There are many possible predisposing factors for Achilles tendon disorders suggested in the literature but their pathogenetic relevance is not proven in most cases. The asymmetric mechanical load distribution within the Achilles tendon during locomotion is frequently addressed as a major risk factor for Achilles tendon disorders. The spatial orientation of the subtalar joint axis (STA) may infl uence the Achilles tendon loading possibly leading to overload injuries. Hypothesis There is a signifi cant difference between the orientation of the STA in subjects with and without Achilles tendon pathologies. Materials and methods 614 subtalar joint axes determined in 307 long-distance runners with and without Achilles tendon disorders were included. Achilles tendon disorders were defi ned as any Achilles tendon-related pain during or following running, existing for more than 2 weeks in the past. Motion analysis of the foot was performed using an ultrasonic pulse-echo-based measurement system. The orientation of the STA was expressed by two angles. Results The mean inclination angle was 42±16° and the mean deviation angle was 11±23°. There was a signifi cant difference (p=0.002) between the mean deviation angle measured in subjects with Achilles tendon pathologies (18±23°) and those without (10±23°). Conclusions The results demonstrate a wide interindividual variability of the spatial orientation of the STA. In addition, the mean deviation angle in people with Achilles tendon pathologies is signifi cantly more oblique than in people without. This fi nding indicates that the spatial orientation of the STA is related to the incidence of overuse injuries of the Achilles tendon in the investigated sample.

Jayanthi N.A.,Loyola University Chicago | Labella C.R.,Institute for Sports Medicine | Labella C.R.,Northwestern University | Fischer D.,Loyola University Chicago | And 2 more authors.
American Journal of Sports Medicine | Year: 2015

Background: Data are lacking regarding the independent risk of injury related to intense single-sport training or growth rate in young athletes. Purpose: To determine whether sports specialization, weekly training volumes, and growth rates are associated with increased risk for injury and serious overuse injury in young athletes. Study Design: Case-control study; Level of evidence, 3. Methods: Injured athletes aged 7 to 18 years were recruited from 2 hospital-based sports medicine clinics and compared with healthy controls from affiliated primary care clinics undergoing sports physicals (2010-2013). Participants completed surveys reporting hours per week spent in organized sports, physical education class, and free play, as well as degree of sports specialization and Tanner stage. Heights and weights were measured. Injury details were obtained from athlete surveys and electronic medical records. Results: Of 1214 athletes enrolled, 1190 (50.7% male) had data satisfactory for analysis. There were 822 injured participants (49.5% male; unique injuries, n = 846) and 368 uninjured participants (55% male). Injured athletes were older than uninjured athletes (14.1 ± 2.1 vs 12.9 ± 2.6 years; P<.001) and reported more total hours of physical activity (19.6 ± 9.2 vs 17.6 ± 8.9 h/wk; P <.001) and organized sports activity (11.2 ± 2.6 vs 9.1 ± 6.3 h/wk; P<.01). After accounting for age and hours in sports activity spent per week, sports-specialized training was an independent risk for injury (odds ratio [OR], 1.27; 95% CI, 1.07-1.52; P<.01) and serious overuse injury (OR, 1.36; 95% CI, 1.08-1.72; P<.01). Young athletes participating in more hours of sports per week than number of age in years (OR, 2.07; 95% CI, 1.40-3.05; P<.001) or whose ratio of organized sports to free play time was >2:1 hours/week had increased odds of having a serious overuse injury (OR, 1.87; 95% CI, 1.26-2.76; P <.01). Growth rates were similar between injured and uninjured athletes (4.8 cm/y for both groups; P = .96). Conclusion: Injured young athletes were older and spent more hours per week in organized sports. There is an independent risk of injury and serious overuse injury in young athletes who specialize in a single sport. Growth rate was not related to injury risk. The study data provide guidance for clinicians counseling young athletes and their parents regarding injury risks associated with sports specialization. © 2015 The Author(s).

Nauck T.,Institute for Sports Medicine | Lohrer H.,Institute for Sports Medicine | Padhiar N.,John King Center for Leg Pain | King J.B.,John King Center for Leg Pain
British Journal of Sports Medicine | Year: 2015

Background: Currently, there is no generally agreed measure available to quantify a subject's perceived severity of exercise-induced leg pain symptoms. The aim of this study was to develop and validate a questionnaire that measures the severity of symptoms that impact on function and sports ability in patients with exercise-induced leg pain. Methods: The exercise-induced leg pain questionnaire for German-speaking patients (EILP-G) was developed in five steps: (1) initial item generation, (2) item reduction, (3) pretesting, (4) expert meeting and (5) validation. The resulting EILP-G was tested for reliability, validity and internal consistency in 20 patients with exercise-induced leg pain, 20 asymptomatic track and field athletes serving as a population at risk and 33 asymptomatic sport students. Results: The patient group scored the EILP-G questionnaire significantly lower than both control groups (each p<0.001). Test-retest demonstrates an excellent reliability in all tested groups (Intraclass Correlation Coefficient, ICC=0.861-0.987). Concurrent validity of the EILP-G questionnaire showed a substantial agreement when correlated with the chronic exertional compartment syndrome classification system of Schepsis (r=-0.743; p<0.001). Internal consistency for the EILP-G questionnaire was 0.924. Conclusions: EILP-G questionnaire is a valid and reliable self-administered and disease-related outcome tool to measure the severity of symptoms that impact on function and sports ability in patients with exerciseinduced leg pain. It can be recommended as a robust tool for measuring the subjectively perceived severity in German-speaking patients with exercise-induced leg pain.

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