Background/objective: The Magellan Society is composed of > 150 high-volume fellowship-trained sports surgeons from four continents. These surgeons represent their regional sports organisations in travelling fellowships and are considered to be opinion leaders in their respective organisations. Prior to the 2014 Magellan Meeting in Arima, Japan, a survey was conducted to understand how Magellan…
Ankle inversion ligamentous sprain is one of the most common sports injuries. The most direct way is to investigate real injury incidents, but it is unethical and impossible to replicate on test participants. Simulators including tilt platforms, trapdoors, and fulcrum devices were designed to mimic ankle inversion movements in laboratories. Inversion angle was the only element considered in ear…
Background: Injury to the medial collateral ligament (MCL) of the knee joint is the most common ligament injury of the knee. Ligament healing generally takes a long time. Micro-ribonucleic acid (miRNA) is one of the noncoding RNAs and plays a crucial role in physiological function;miRNA (miR)-210 is known as a potent factor of angiogenesis, which is an important initiator of ligament healing. T…
Ligament balancing is one of the most important surgical techniques for successful total knee arthroplasty. It has traditionally been recommended that medial and lateral as well as flexion and extension gaps are equal. This article reviews the relevant literature and discusses the clinical importance of the aforementioned gaps. Current evidence indicates that achieving medial stability througho…
Patellar tendinopathy is very common in patients complaining of anterior knee pain. Its aetiology is still unclear, but neovascularisation seems to play a role. Different treatments have been proposed overtime, from rehabilitation to platelet-rich-plasma injections, but there is no agreement on the best treatment protocol. The final stage of patellar tendinopathy is patellar tendon rupture. In …
Background/objective: Rotator cuff tears are common shoulder injuries. Various forms of rotator cuff tears are observed by arthroscopy. Inverted flap tears of the rotator cuff, however, also occur. The aim of the present study was to determine the preoperative characteristics of inverted torn cuffs and clinical outcomes after arthroscopic repair. Methods: Seventeen patients (10 men, 7 women; m…
Exercise-induced leg pain is a common condition in athletes and in people involved in recreational sports. The diagnosis is not always straightforward: many conditions may cause exercise-induced leg pain. The aim of the present review is to provide a complete discussion of the most common pathologies related to this condition. Particular attention is dedicated to the history and the physical ex…
Background/objective: The purpose of this study was to elucidate the biomechanical differences between anterior cruciate ligament (ACL) grafts reconstructed by isometric and anatomic reconstruction techniques, based on their length changes. Methods: One hundred and thirty-three knees with primary ACL reconstruction using the bone-patellar tendon-bone (BTB) graft were retrospectively identified…
Background: Mucoid degeneration of the anterior cruciate ligament (ACL) is mostly observed in middle-aged patients with knee pain and limited range of motion. Although arthroscopic resection of the degenerated ACL is the treatment of choice following the failure of conservative management, the extent of the excision and subsequent ACL reconstruction for postoperative knee instability remains co…
Background: This study was designed as an investigation in a local population to assess the relation between the knee joint and spinal alignment in a population-based study using the SpinalMouse. Methods: Medical check-ups were conducted for residents of a mountain village in Japan. The study population included 107 men and 157 women (528 knees) with a mean age of 71.1 ± 6.8 years (range, 60e…
The purpose of this study was to measure the change in hamstring muscle thickness between contracting and relaxing conditions following a return to sports after a hamstring muscle strain and thereby evaluate muscle function. Six male track and field sprinters participated in this study. All had experienced a prior hamstring strain injury that required a minimum of 2 weeks away from sport partic…
We developed the anatomic rectangular tunnel anterior cruciate ligament reconstruction (ART ACLR) with a boneepatellar tendonebone graft to mimic fibre arrangement inside the native ACL via tunnels with smaller apertures. With a 10-mm-wide graft, the cross-sectional area of the tunnels of 50 mm2 in ART ACLR is less than that of 79 mm2 in a 10-mm round tunnel one. Because tunnel encroachment wou…
Background: Rupture of the Achilles tendon may result in reduced functional activity and reduced plantar flexion strength. These changes may arise from elongation of the Achilles tendon. An observational study was performed to quantify the Achilles tendon resting angle (ATRA) in patients following Achilles tendon rupture, surgical repair, and rehabilitation, respectively. Methods: Between May …
The empty can (EC) and full can (FC) tests are used as diagnostic tools for patients with rotator cuff disease. However, recently concerns have been raised that these tests do not selectively activate the muscle. Therefore, the purpose of this study was to evaluate the rotator cuff muscle activation levels during the EC and FC tests in various positions using electromyography. Twelve healthy, r…
In this article, we describe the basic knowledge about shoulder biomechanics, which is thought to be useful for surgeons. Some clinical reports have described that the excellent outcome after cuff repair without acromioplasty and a limited acromioplasty might be enough for subacromial decompression. It was biomechanically demonstrated that a 10-mm medial shift of the tendon repair site has a mi…
Rotator cuff tear has been a known entity for orthopaedic surgeons for more than two hundred years. Although the exact pathogenesis is controversial, a combination of intrinsic factors proposed by Codman and extrinsic factors theorized by Neer is likely responsible for most rotator cuff tears. Magnetic resonance imaging remains the gold standard for the diagnosis of rotator cuff tears, but the …
The high retear rates after surgery for irreparable rotator cuff tears can be explained by the healing capacity potential of tendons and the native rotator cuff enthesis characterised by complex morphological structures, called direct insertion. Many experimental researches have focused on biologically augmenting the rotator cuff reconstruction and improving tendonebone healing of the rotator c…
The authors first reviewed the history of clinical application of artificial ligaments. Then, the status of clinical application of artificial ligaments was detailed. Some artificial ligaments possessed comparable efficacy to, and fewer postoperative complications than, allografts and autografts in ligament reconstruction, especially for the anterior cruciate ligament. At the end, the authors f…
We report a case of cuboid bone stress fracture in a 17-year-old rugby athlete. Cuboid bone stress fractures are rare in athletes. When an athlete with no history of trauma presents with pain on the lateral side of the foot and no abnormality on plain radiograph, cuboid bone stress fracture should be suspected and magnetic resonance imaging should be conducted. Keywords: athlete; cuboid; rug…
The aim of this study was to investigate the match and training injury incidence, injury patterns and severity, and their monthly variation in a Hong Kong male professional football league. The study design was a prospective cohort study. Seven teams in the Hong Kong Football Association first division league and 152 players from 10 professional teams participated in this study. On a weekly bas…
Rotational alignment is important for a good functional outcome and the longterm success of total knee arthroplasty (TKA). Malalignment can cause patellofemoral complications such as subluxation, dislocation, and wear. Furthermore, abnormal internal or external rotational alignment is reportedly a cause of instability, implant loosening, and unexplained painful total knee arthroplasty. To deter…
Background: In recent years, highly detailed evaluations have been performed using three-dimensional computed tomography (3D CT). Very small bony ridges, such as Resident's ridge and the lateral bifurcate ridge can be visualised by 3D CT. The purpose of this study was to ascertain whether Parsons' knob, which was recognised as the bony landmark of the anterior cruciate ligament insertion on the…
Meniscal root lesion is defined as an avulsion of the tibial insertion of the meniscus or a radial tear close to the meniscal insertion, which is commonly observed at the posterior region in the clinical practice. Although a number of biomechanical and clinical studies have shown the importance of the integrity of the posterior meniscal roots, the appropriate treatment is still controversial. T…
Purpose: The purpose of this study was to clarify the risk factors for graft rupture or contralateral anterior cruciate ligament (ACL) tear after anatomic ACL reconstruction. Methods: One hundred and eighty one patients with unilateral ACL injury underwent the anatomic double-bundle ACL reconstruction using autogenous semitendinosus tendon grafts. Of these, 149 patients were directly followed-…
To minimize damage to healthy tissues, we have been performing endoscopically assisted cubital tunnel syndrome surgery based on endoscopic nerve findings since 1995. This is the first study to focus on endoscopic surgery for cubital tunnel syndrome based on endoscopic ulnar nerve findings and the subsequent postoperative clinical results. We analysed 82 upper extremities of 74 cubital tunnel sy…
While performing total knee arthroplasty (TKA) using a standard midline skin incision, the transection of the infrapatellar branch of the saphenous nerve (ISN) or its terminal branches is relatively common. This usually causes an area of numbness in the distribution of the ISN, but rarely results in painful neuroma. Usually, the progress of neuromatous pain is relatively slow and the degree of …
Isolated chondral fractures without cancellous bone have limited healing potential. We reattached a chondral fragment without cancellous bone using bone pegs for chondral fracture of the femoral groove in a 13-year-old boy. Five months after the surgery, we performed a biopsy to evaluate the histological findings for the healed osteochondral junction. Biopsy results showed that osteoblasts had …
Successful anterior cruciate ligament (ACL) reconstruction with tendon graft requires extensive tendon-to-bone healing in the bone tunnels and progressive graft ligamentization for biological, structural, and functional recovery of the ACL. Improvement in graft-to-bone healing is crucial for facilitating early, aggressive rehabilitation after surgery to ensure an early return to pre-injury acti…
Displaced tibial intercondylar eminence fractures require early reduction and stable fixation to prevent nonunion, knee instability, and a lack of extension. Many types of surgical procedure are recommended including arthrotomy or an arthroscopic technique to stabilize the fracture segment using Kirschner wire, screws, staples, and suture fixation. However, contemporary arthroscopic techniques …
Although several risk factors for anterior cruciate ligament (ACL) injury have been evaluated in the literature, there are few reports on familial predisposition. This study investigated the familial predisposition to ACL injury. The study included 350 patients who underwent ACL reconstruction between January 2005 and September 2008. All patients were surveyed by telephone or a written question…
We report the case of a patient exhibiting the snapping phenomenon during flexion/extension motion caused by the gracilis tendon flipping over the posteromedial corner of the medial femoral condyle. A 30-year-old woman presented with a 2-year history of pain accompanied by snapping over the medial aspect of the left knee. Snapping was observed at the posteromedial corner of the medial femoral c…
Maintenance of the sporting activity of elite athletes in adapted sports can be difficult if a secondary disorder, such as a pressure ulcer, occurs. Pressure ulcers result from deep tissue injuries by external pressure. The purpose of this study was to use ultrasonography to investigate deep tissue injuries in male wheelchair basketball players of a Japanese national team, and to determine fact…
In our previous study, a fibroblast growth factor-2 (FGF-2)eapatite composite layer coated on titanium screws effectively prevented pin tract infection in rabbits because of enhanced wound healing; however, the FGF-2eapatite composite layers did not completely prevent pin tract infection. Thus, we recently developed a poly(ε-caprolactone) (PCL) sponge pad embedded with cefazolin sodium (þCEZ)…
Anterior cruciate ligament (ACL) reconstruction is one of the most commonly performed orthopaedic procedures. Recently, there has been a shift in interest towards reconstruction techniques that more closely restore the native anatomy of the ACL. This review paper discusses our approach to individualized anatomic ACL reconstruction, including the anatomy of the ACL, the physical exam, imaging mo…
enisci (DLM) surgeries, a minimum of 10 years of follow-up was performed after unilateral surgery for a torn DLM. Eligible patients had received arthroscopic meniscectomy between 1986 and 2001 for unilateral torn DLM. Patients with symptomatic contralateral knees at the time of initial surgery were excluded. Among these patients, only those aged no more than 20 years at the time of surgery were…
No standard surgical procedure for medial patellofemoral ligament (MPFL) reconstruction exists. The purpose of this study was to evaluate the clinical effectiveness and limitation of the reconstructions of the MPFL in single patellar and femoral bone tunnels. The methods used a hamstring tendon and titanium interference screws in patients with recurrent patellar dislocation. Nineteen knees in 1…
The purpose of this study was to examine tunnel length and incidence of posterior wall breakage during drilling of the femoral anteromedial (AM) tunnel in anatomic anterior cruciate ligament (ACL) reconstruction and compare those results between inside-out (transportal) and outside-in techniques. The study population comprised 68 patients (30 females and 38 males) with a mean age at surgery of …
Lateral elbow stability utilises a combination of bony and soft tissue constraints. Lateral elbow instability is usually associated with an episode of elbow dislocation. Isolated lateral ligament complex insufficiency results in posterolateral rotatory instability (PLRI), The most common presentation is lateral elbow discomfort and a sensation of instability, without recurrent dislocation. The …
Lateral extra-articular procedures were popular in the treatment of anterior cruciate ligament injury in the nineteen seventies and eighties, but fell from favor due to poor results, concerns regarding biomechanics, and concurrent advances in intra-articular reconstruction. Persistent problems with rotational control in modern reconstructive techniques have lead to a resurgence of interest in t…
Background: Though the mechanisms of skeletal muscle regeneration are deeply understood, those involved in muscle contusion, one of the most common muscle injuries in sports medicine clinics, are not. The objective of this study is to explore the mechanisms involved in muscle regeneration after contusion injury. Methods: In this study, a total of 72 mice were used. Eight of them were randomly …
Traditional biomechanical analyses of human movement are generally derived from linear mathematics. While these methods can be useful in many situations, they do not describe behaviors in human systems that are predominately nonlinear. For this reason, nonlinear analysis methods based on a dynamical systems approach have become more prevalent in recent literature. These analysis techniques have…
Background: Marginal changes in the execution of competitive sports movements can represent a significant change for performance success. However, such differences may emerge only at certain execution intensities and are not easily detectable through conventional biomechanical techniques. This study aimed to investigate if and how competition standard and progression speed affect race walking k…
Purpose: The purpose of this study was to compare the coordination between the trunk and the pelvis during a sustained asymmetric repetitive lifting task between a group with a history of low back pain (LBP; HBP) and a group with no history of LBP (NBP). Methods: Volunteers lifted a 11-kg box from ankle height in front to a shelf 45° off-center at waist height, and lowered it to the start pos…
Background: Athletes have been shown to exhibit better balance compared to non-athletes (NON). However, few studies have investigated how the surface on which athletes train affects the strategies adopted to maintain balance. Two distinct athlete groups who experience different types of sport-specific balance training are stable surface athletes (SSA) such as basketball players and those who tr…
Concussion, or mild traumatic brain injury, incidence rates have reached epidemic levels and impaired postural control is a cardinal symptom. The purpose of this review is to provide an overview of the linear and non-linear assessments of post-concussion postural control. The current acute evaluation for concussion utilizes the subjective balance error scoring system (BESS) to assess postural c…
Background: Many disease-specific factors such as muscular weakness, increased muscle stiffness, varying postural strategies, and changes in postural reflexes have been shown to lead to postural instability and fall risk in people with Parkinson’s disease (PD). Recently, analytical techniques, inspired by the dynamical systems perspective on movement control and coordination, have been used t…
In their comment, Krewer et al.1 argue that before selecting a specific method for assessing proprioception, it is essential to consider which component of proprioception is to be assessed. They also note that there is no single method for assessing all aspects of the various proprioceptive senses, because the neurophysiological processes underlying proprioceptive function are complex. We agree…
In recent years, the assessment of proprioceptive function has received increased attention in clinical and motor skill research. This is not surprising given the growing body of scientific evidence on the importance of proprioceptive information for controlling nearly all facets of human movement;from standing to performing highly skilled movement patterns in sports. In addition, the importan…
Background: In recent years, there has been a proliferation of technology and sport science utilized within an athlete’s training, especially at the elite level. However, the sport science is a broad field, encompassing disciplines such as biomechanics, motor control and learning, exercise physiology,sports medicine, sport psychology to name a few. Rarely are these disciplines applied in an i…
Purpose: This study aims to explore the effects of running on different surfaces on the characteristics of in-shoe plantar pressure and tibial acceleration. Methods: Thirteen male recreational runners were required to run at 12 km/h velocity on concrete, synthetic track, natural grass, a normal treadmill, and a treadmill equipped with an ethylene vinyl acetate (EVA) cushioning underlay (treadm…