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Musculoskeletal system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
Trauma – soft tissue injury will not normally require plain X-ray image examination except to look for an opaque foreign body. For superficial injury without large surface abrasion, ultrasound may determine the depth of injury, demonstrate retained foreign body (including non-radio-opaque bodies) and can demonstrate muscle and tendon tears and haematoma in localised injury. MRI offers a more comprehensive overview of the area and can detect subtle signal alterations indicating muscle injury with greater sensitivity than ultrasound. Tendon tears in areas amenable to ultrasound can often be diagnosed without recourse to MRI, and in the case of Achilles tendon rupture can indicate whether or not the tendon ends can be apposed by fixed flexion of the ankle (conservative management).
Gene variants previously associated with reduced soft tissue injury risk: Part 1 – independent associations with elite status in rugby
Published in European Journal of Sport Science, 2023
Jon Brazier, Mark R. Antrobus, Adam J. Herbert, Peter C. Callus, Georgina K. Stebbings, Stephen H. Day, Shane M. Heffernan, Liam P. Kilduff, Mark A. Bennett, Robert M. Erskine, Stuart. M. Raleigh, Malcolm Collins, Yannis. P. Pitsiladis, Alun G. Williams
The CC genotype of MIR608 rs4919510 was overrepresented and G-allele carriers underrepresented in elite rugby athletes across all groups (rugby athletes, RL athletes, RU athletes, RU forwards, RU front 5 and RU backs) compared to non-athletes, suggesting some inherited advantage to attaining elite rugby athlete status. MicroRNAs (miRNA) are a class of small non-coding RNAs that induce gene silencing and translational repression Matzke and Birchler (2005). Allele-specific polymorphisms within miRNA target sites influence the tissue-specific miRNA regulation of hundreds of genes, which implies that their genetic variation may be a prevalent cause of inter-individual phenotypic variability Kim and Bartel (2009). One of the miRNA family, MIR608 rs4919510, has been associated with altered risk of Achilles tendinopathy Brown et al. (2017), Kim et al. (2017), Abrahams, Laguette, Prince, and Collins (2013) However, the evidence is not consistent regarding which genotype is injury-protective. Abrahams et al. Abrahams et al. (2013) found the CC genotype overrepresented within a tendinopathy group versus uninjured, supported by moderate GWAS evidence (P < 5 × 10−8) when covariates were removed Kim et al. (2017). However, the only other study to date could not replicate these results, but found an association between the CG genotype and Achilles tendon rupture Brown et al. (2017). Indeed, our data demonstrate a likely benefit from carrying the CC genotype in achieving elite rugby athlete status. Notably, RL athletes were almost 3 times more likely to carry the CC genotype than non-athletes.
Implantable medical devices for tendon and ligament repair: a review of patents and commercial products
Published in Expert Review of Medical Devices, 2022
Marco Civera, Ester Devietti Goggia, Matteo De Ros, Vito Burgio, Federica Bergamin, Mariana Rodriguez Reinoso, Cecilia Surace
Several studies seem to suggest that this instrument may provide shorter surgery time [49], fewer complications and faster rehabilitation while avoiding sural nerve lesions, which might occur with percutaneous techniques [50] since the sutures are retrieved by the inner arm of the device [51]. In 2005 Calder et al [52] reported an analysis of 46 patients who had sustained a spontaneous rupture of the Achilles tendon and who underwent operative repair using the Achillon suture system: no re-ruptures and only one superficial wound infection were observed. A similar outlook is presented in a review by Yasser et al. [49]. Twenty-four patients, who had surgery with the device and a minimum 5 years follow-up, were interviewed. While 2 re-ruptures and 5 cases of sural nerve injury had occurred, the mean ATRSs (Achilles Tendon Rupture Scores) were 91.3/100 or higher; adding up the overall patient feedback, the Achillon suture system proved to be a safe and reliable option.
Validity, reliability, and normative data on calf muscle function in rugby union players from the Calf Raise application
Published in Sports Biomechanics, 2022
Kim Hébert-Losier, Te Manawa Ngawhika, Nicholas Gill, Carlos Balsalobre-Fernandez
The study with the most comparable calf raise endurance test method to ours (i.e., conducted on a step rather than on an incline or from the floor) assessed individuals 2 years post Achilles tendon rupture (Svensson et al., 2019). Their mean outcomes (20 repetitions and 2000 J) on the uninjured legs are comparable to our findings in rugby union players, which might be somewhat unexpected given the younger age of our cohort, their greater body mass, and their relatively high physical activity levels. Rugby union is a physical high-intensity sport (Nicholas, 1997) that emphasises strength, speed, and power abilities in testing and training (Argus et al., 2009; Smart et al., 2013). The muscular endurance abilities of players remain largely undocumented in this sport. The current data suggest that although rugby athletes may be more powerful than the general population, their calf muscle endurance are comparable to the general population. Without targeted calf muscle endurance training, male rugby athletes competing in Club to International level rugby on average should complete 20 calf raise repetitions and 2000 J of positive work when assessed on a step.