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Tischer T, Beaufilis P, Becker R, Ahmad SS, Bonomo M, Dejour D, Eriksson K, Filardo G, Feucht MJ, Grassi A, Wilson A, Menetrey J, Pujol N, Rathcke M, Seil R, Strauss MJ, Condello V. Management of anterior cruciate ligament revision in adults: the 2022 ESSKA consensus part I-diagnostics and preoperative planning. Knee Surg Sports Traumatol Arthrosc 2023; 31:4642-4651. [PMID: 36322180 DOI: 10.1007/s00167-022-07214-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 10/24/2022] [Indexed: 11/05/2022]
Abstract
PURPOSE The aim of this ESSKA consensus is to give recommendations based on evidence and expert opinion to improve diagnosis, preoperative planning, indication and surgical strategy in ACL revision. METHODS The European expert surgeons and scientists were divided into four groups to participate in this consensus. A "literature group" (four surgeons); "steering group" (14 surgeons and scientists); "rating group" (19 surgeons) and finally "peer review group" (51 representatives of the ESSKA-affiliated national societies from 27 countries). The steering group prepared eighteen question-answer sets. The quality of the answers received grades of recommendation ranging from A (high-level scientific support), to B (scientific presumption), C (low level scientific support) or D (expert opinion). These question-answer sets were then evaluated by the rating group. All answers were scored from 1 to 9. The comments of the rating group were incorporated by the steering group and the consensus was submitted to the rating group a second time. Once a general consensus was reached between the steering and rating groups, the question-answer sets were submitted to the peer review group. A final combined meeting of all the members of the consensus was held to ratify the document. RESULTS The literature review for the diagnosis and preoperative planning of ACL revision revealed a rather low scientific quality. None of the 18 questions was graded A and six received a grade B. The mean rating of all the questions by the rating group was 8.4 ± 0.3. The questions and recommendations are listed below. CONCLUSION ACL revision surgery is a widely debated subject with many different opinions and techniques. The literature reveals a poor level of standardisation. Therefore, this international consensus project is of great importance. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Thomas Tischer
- Klinik für Orthopädie und Unfallchirurgie, Malteser Waldkrankenhaus St. Marien, Rathsberger Straße 57, 91054, Erlangen, Germany.
- Department of Orthopaedic Surgery, University Medicine Rostock, Rostock, Germany.
| | | | - Roland Becker
- Centre of Orthopaedic and Traumatology, University of Brandenburg an Der Havel, Brandenburg, Germany
| | - Sufian S Ahmad
- Department of Orthopaedic Surgery of the Medical School of Hannover MHH, Annastift Hospital, Hannover, Germany
| | - Marco Bonomo
- Dipartimento di Ortopedia e Traumatologia, IRCCS Ospedale Sacro Cuore don Calabria, Negrar, VR, Italy
| | - David Dejour
- Lyon Ortho Clinic, Clinique de la sauvegarde Ramsay Santé, 29 avenue des sources, Lyon, France
| | - Karl Eriksson
- Department of Orthopaedics, Stockholm South Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Giuseppe Filardo
- Applied and Translational Research Center, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Matthias J Feucht
- Department of Orthopaedic Surgery Paulinenhilfe, Diakonie Klinikum, Stuttgart, Germany
- Department of Orthopaedics and Trauma Surgery, Medical Center, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
| | - Alberto Grassi
- II Clinica Ortopedica e Traumatologica, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Adrian Wilson
- Orthopaedic Specialist Group, Harley Street Specialist Hospital, Queen Anne St, London, UK
| | - Jacques Menetrey
- Center of Sports Medicine and Exercise, Hirslanden Clinique La Colline, Geneva, Switzerland
- Orthopaedic Surgery Service, University Hospital of Geneva, Geneva, Switzerland
| | - Nicolas Pujol
- Department of Orthopaedic and Trauma Surgery, Centre Hospitalier de Versailles, Le Chesnay-Rocquencourt, France
| | - Martin Rathcke
- Department of Orthopaedics and Sports traumatology, Bispebjerg-Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Romain Seil
- Department of Orthopaedic Surgery, Centre Hospitalier-Clinique d'Eich and Luxembourg Institute of Health, Luxembourg, Luxembourg
| | | | - Vincenzo Condello
- Joint Preservation and Reconstructive Surgery and Sports Medicine Unit, Humanitas Castelli Clinic, Bergamo, Italy
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Tischer T, Martens G, Cabri J, Thoreux P, Tscholl P, Edouard P, Leclerc S, Le Garrec S, Delvaux F, Croisier JL, Kaux JF, Hannouche D, Lutter C, Seil R. The awareness of injury prevention programmes is insufficient among French- and German-speaking sports medicine communities in Europe. Knee Surg Sports Traumatol Arthrosc 2023:10.1007/s00167-023-07416-w. [PMID: 37074402 DOI: 10.1007/s00167-023-07416-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 04/06/2023] [Indexed: 04/20/2023]
Abstract
PURPOSE Evaluate the current state of sports injury prevention perception, knowledge and practice among sports medicine professionals located in Western Europe and involved in injury prevention. METHODS Members of two different sports medicine organizations (GOTS and ReFORM) were invited to complete a web-based questionnaire (in German and in French, respectively) addressing perception, knowledge and implementation of sports injury prevention through 22 questions. RESULTS 766 participants from a dozen of countries completed the survey. Among them, 43% were surgeons, 23% sport physicians and 18% physiotherapists working mainly in France (38%), Germany (23%) and Belgium (10%). The sample rated the importance of injury prevention as "high" or "very high" in a majority of cases (91%), but only 54% reported to be aware of specific injury prevention programmes. The French-speaking world was characterized by lower levels of reported knowledge, unfamiliarity with existing prevention programmes and less weekly time spent on prevention as compared to their German-speaking counterparts. Injury prevention barriers reported by the respondents included mainly insufficient expertise, absence of staff support from sports organizations and lack of time. CONCLUSION There is a lack of awareness regarding injury prevention concepts among sports medicine professionals of the European French- and German-speaking world. This gap varied according to the professional occupation and working country. Relevant future paths for improvement include specific efforts to build awareness around sports injury prevention. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- Thomas Tischer
- Department of Orthopedics, University Medical Center, Rostock, Germany
| | - Géraldine Martens
- ReFORM IOC Research Centre for Prevention of Injury and Protection of Athlete Health, Liège, Belgium.
- Physical Medicine and Sport Traumatology Department, SportS2, University and University Hospital of Liege, Avenue de L'Hôpital, 1, 4000, Liège, Belgium.
| | - Jan Cabri
- ReFORM IOC Research Centre for Prevention of Injury and Protection of Athlete Health, Liège, Belgium
- Sports Medicine and Science, Luxembourg Institute of Research in Orthopedics, Luxembourg, Luxembourg
| | - Patricia Thoreux
- ReFORM IOC Research Centre for Prevention of Injury and Protection of Athlete Health, Liège, Belgium
- French National Institute of Sport (INSEP), Paris, France
- Centre d'Investigations en Médecine du Sport (CIMS) - Hôpital Hôtel Dieu-APHP, Paris, France
| | - Philippe Tscholl
- ReFORM IOC Research Centre for Prevention of Injury and Protection of Athlete Health, Liège, Belgium
- Department of Orthopaedic Surgery and Traumatology, Geneva University Hospitals, Geneva, Switzerland
| | - Pascal Edouard
- Department of Clinical and Exercise Physiology, Sports Medicine Unit, University Hospital of Saint-Etienne, Saint-Etienne, France
- Inter-University Laboratory of Human Movement Biology, EA 7424, Univ Lyon, UJM-Saint-Etienne, F-42023, Saint-Etienne, France
| | - Suzanne Leclerc
- ReFORM IOC Research Centre for Prevention of Injury and Protection of Athlete Health, Liège, Belgium
- Institut National du Sport du Québec (INS), Montréal, QC, Canada
| | - Sébastien Le Garrec
- ReFORM IOC Research Centre for Prevention of Injury and Protection of Athlete Health, Liège, Belgium
- French National Institute of Sport (INSEP), Paris, France
| | - François Delvaux
- ReFORM IOC Research Centre for Prevention of Injury and Protection of Athlete Health, Liège, Belgium
- Physical Medicine and Sport Traumatology Department, SportS2, University and University Hospital of Liege, Avenue de L'Hôpital, 1, 4000, Liège, Belgium
| | - Jean-Louis Croisier
- ReFORM IOC Research Centre for Prevention of Injury and Protection of Athlete Health, Liège, Belgium
- Physical Medicine and Sport Traumatology Department, SportS2, University and University Hospital of Liege, Avenue de L'Hôpital, 1, 4000, Liège, Belgium
| | - Jean-François Kaux
- ReFORM IOC Research Centre for Prevention of Injury and Protection of Athlete Health, Liège, Belgium
- Physical Medicine and Sport Traumatology Department, SportS2, University and University Hospital of Liege, Avenue de L'Hôpital, 1, 4000, Liège, Belgium
| | - Didier Hannouche
- ReFORM IOC Research Centre for Prevention of Injury and Protection of Athlete Health, Liège, Belgium
- Department of Orthopaedic Surgery and Traumatology, Geneva University Hospitals, Geneva, Switzerland
| | - Christoph Lutter
- Department of Orthopedics, University Medical Center, Rostock, Germany
| | - Romain Seil
- ReFORM IOC Research Centre for Prevention of Injury and Protection of Athlete Health, Liège, Belgium
- Sports Medicine and Science, Luxembourg Institute of Research in Orthopedics, Luxembourg, Luxembourg
- Department of Orthopaedic Surgery, Centre Hospitalier de Luxembourg-Clinique d'Eich, Luxembourg, Luxembourg
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Lutter C, Jacquet C, Verhagen E, Seil R, Tischer T. Does prevention pay off? Economic aspects of sports injury prevention: a systematic review. Br J Sports Med 2021; 56:470-476. [PMID: 34598936 DOI: 10.1136/bjsports-2021-104241] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To identify, summarise and critically assess economic evaluation studies on sports injury prevention strategies. DESIGN Systematic review. DATA SOURCES PubMed, SportDiscuss. ELIGIBILITY CRITERIA FOR SELECTING STUDIES The current literature was searched following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Economic analyses published since 2010 were checked for inclusion. The methodological quality of the studies was assessed using the Oxford Level of Evidence for economic and decision analysis; underlying randomised controlled trials (RCTs) were rated according to the Physiotherapy Evidence Database (PEDro) Scale, and risk of bias was assessed using the Revised Cochrane risk-of-bias tool. RESULTS Ten studies fulfilled the inclusion criteria. The quality assessment revealed limited data quality. For trial-based analysis, underlying RCTs were of good quality and had a low risk of bias. Prevention concepts for general injury reduction showed effectiveness and cost savings. Regarding specific injury types, the analysis of the studies showed that the best data are available for ankle, hamstring and anterior cruciate ligament injuries. Measures using specific training interventions were the predominant form of prevention concepts; studies investigating these concepts showed cost-effectiveness with total cost savings between €24.82 and €462 per athlete. CONCLUSION Injury prevention strategies that were studied are cost-effective. However, estimates and outcomes vary throughout the included studies, and precluded pooling of existing data. Knowledge about the cost-effectiveness of evaluated prevention measures will help improve the acceptance and application of prevention initiatives.
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Affiliation(s)
- Christoph Lutter
- Department of Orthopedics, University Medical Center Rostock, Rostock, Germany
| | - Christophe Jacquet
- Department of Orthopaedic Surgery, Centre Hospitalier de Luxembourg-Clinique d'Eich, Luxembourg, Luxembourg.,Luxembourg Institute of Health, Luxembourg, Luxembourg
| | - Evert Verhagen
- Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, University Medical Centers - Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Romain Seil
- Department of Orthopaedic Surgery, Centre Hospitalier de Luxembourg-Clinique d'Eich, Luxembourg, Luxembourg.,Luxembourg Institute of Health, Luxembourg, Luxembourg
| | - Thomas Tischer
- Department of Orthopedics, University Medical Center Rostock, Rostock, Germany
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