Evaluation of the Knees of Asymptomatic Kangoo Jumpers with MR Imaging

Knowledge mapping and bibliometric analysis of medical knee magnetic resonance imaging for knee osteoarthritis (2004-2023)

Objectives

Magnetic resonance imaging (MRI) is increasingly used to detect knee osteoarthritis (KOA). In this study, we aimed to systematically examine the global research status on the application of medical knee MRI in the treatment of KOA, analyze research hotspots, explore future trends, and present results in the form of a knowledge graph.

Methods

The Web of Science core database was searched for studies on medical knee MRI scans in patients with KOA between 2004 and 2023. CiteSpace, SCImago Graphica, and VOSviewer were used for the country, institution, journal, author, reference, and keyword analyses.

Results

A total of 2,904 articles were included. The United States and Europe are leading countries. Boston University is the main institution. Osteoarthritis and cartilage is the main magazine. The most frequently cocited article was "Radiological assessment of osteoarthrosis". Guermazi A was the author with the highest number of publications and total references. The keywords most closely linked to MRI and KOA were "cartilage", "pain", and "injury".

Conclusions

The application of medical knee MRI in KOA can be divided into the following parts: (1). MRI was used to assess the relationship between the characteristics of local tissue damage and pathological changes and clinical symptoms. (2).The risk factors of KOA were analyzed by MRI to determine the early diagnosis of KOA. (3). MRI was used to evaluate the efficacy of multiple interventions for KOA tissue damage (e.g., cartilage defects, bone marrow edema, bone marrow microfracture, and subchondral bone remodeling). Artificial intelligence, particularly deep learning, has become the focus of research on MRI applications for KOA.

Overuse wrist injuries in adolescent platform and springboard divers

To investigate overuse wrist injuries in adolescent divers using magnetic resonance imaging (MRI). The bilateral wrists (76 wrists) of 38 professional divers were examined by MRI; 42 wrists with pain were placed in the symptomatic group, and 34 wrists without pain were placed in the asymptomatic group. Two experienced radiologists assessed the wrist injuries. Chi‑square test was used to compare the difference in injuries between the two groups. Subchondral osteosclerosis was observed in 47.62% of symptomatic wrists and 52.94% of asymptomatic wrists. Distal radial epiphyseal plate injury was detected in 42.86% of symptomatic wrists and 11.76% of asymptomatic wrists. Triangular fibrocartilage complex injury was observed in 19.04% of symptomatic wrists and 8.82% of asymptomatic wrists. Bursae around the wrist were observed in 21.42% of symptomatic wrists and 17.64% of asymptomatic wrists. The incidence of distal radial epiphyseal plate injury was higher in the symptomatic group than in the asymptomatic group (P = 0.007), however, other injuries were not statistically different between the two groups (P > 0.05). This study demonstrated that adolescent divers had various wrist injuries, and distal radial epiphyseal plate injury was more common in the symptomatic wrist; these injuries show no specific clinical symptoms and are easily overlooked.

Changes in ultrasound imaging of joints, entheses, bursae and tendons 24 and 48 h after adjusted weight training

Background:

Joint effusion and enthesitis are common ultrasound findings in rheumatic diseases such as rheumatoid arthritis or spondyloarthritis. However, changes of joints and entheses were not only observed in patients but also in physically active individuals and athletes.

Objectives:

The purpose of this study was to evaluate joint, entheseal, bursal and tendon musculoskeletal ultrasound (MSUS) findings in large and medium joints of young healthy individuals after completing a standardised weight training.

Design:

This is a prospective cohort study.

Methods:

MSUS examinations of large- and medium-sized joints, and related entheseal sites, bursae and tendons were performed on young healthy individuals (ages 18–30 years). Before, 24 and 48 h after completing 1 h of standardised weight exercise, the subjects were evaluated by MSUS. The development of the MSUS findings and associated effects were examined using generalised linear mixed effects models.

Results:

In total, 51 healthy individuals (52.9% female) with a mean age of 23.7 (±2.5) years were enrolled. The results showed an increase in the number of individuals with at least one joint effusion from 37 (72.5%) before the weight training to 48 (94.1%) after 48 h. Entheses with pathologies were observed in 14 participants (27.5%) at baseline, increasing to 29 participants (56.9%) 48 h after the weight training. Biceps tendon sheath effusion was detected in 9 individuals (17.6%) prior to training, rising to 22 individuals (43.1%) after 48 h. A significant increase in the number of joints with effusion and abnormal entheses within 48 h after the weight training was indicated by the generalised linear mixed effects models.

Conclusion:

Within 48 h after the weight training session, a significant increase in the prevalence of joint effusion in large and medium joints and the prevalence of abnormal entheses was observed. As a result, when performing and interpreting an MSUS examination, the patient’s physical activities should be taken into account.

Effects of a rebound shoe to reduce impact forces in jump-landing tasks

OBJECTIVES

Impact forces are risk factors for injuries during jump-landing tasks. Rebound shoes could reduce impact forces and show potential applications in training and rehabilitation programs. Here, we determine the capacity of a rebound shoe in attenuating impact forces during different motor tasks involving foot landing.

DESIGN

Crossover laboratory research design.

SETTINGS

Women not trained for jump-landing tasks performed different exercises while the vertical ground reaction force impact peak, time to peak, and asymmetries were determined. They were wearing a commercial rebound shoe and a control running shoe. Paired t-tests were used to compare the shoes and asymmetries.

PARTICIPANTS

Fifteen physically active women (average age of 23 years old, height of 1.64 m, and body mass of 63 kg).

MAIN OUTCOME MEASURES

Ground reaction forces.

RESULTS

The rebound shoe reduced the impact peak force and elicited slight asymmetries between the legs. The rebound shoe also showed a longer time to peak.

CONCLUSIONS

The rebound shoe tested reduced impact forces during jump-landing tasks, which is a potential application in training sessions and rehabilitation programs, requiring lower impact forces to the lower extremity. The effects of long-term use of these shoes still need to be investigated.

Physical Activity and Investigation With Magnetic Resonance Imaging Partly Explain Variability in the Prevalence of Patellar Tendon Abnormalities: A Systematic Review With Meta-analysis of Imaging Studies in Asymptomatic Individuals

OBJECTIVE

To estimate the pooled prevalence of, and factors associated with, the presence of patellar tendon abnormalities observed on imaging in people without symptoms.

DESIGN

Systematic review with stratified meta-analysis and meta-regression.

LITERATURE SEARCH

We searched Embase, Scopus, MEDLINE, CINAHL, SPORTDiscus, and Web of Science from 1980 to August 2020.

STUDY SELECTION CRITERIA

We included studies that reported the prevalence of asymptomatic patellar tendon abnormalities on imaging. We excluded studies of participants with current tendon pain, a history of tendon pain, or other systemic conditions.

DATA SYNTHESIS

Stratification and meta-regression of studies based on study-level descriptive statistics (mean age, body mass index, proportion of female participants, physical activity participation, imaging modality) were performed using a random-effects model to account for between-study heterogeneity. Risk of bias was assessed using the modified Newcastle-Ottawa scale.

RESULTS

Meta-analysis of 64 studies (7125 limbs from 4616 participants) found significant between-study heterogeneity (I²≥90%, P<.01), which precluded a summary prevalence estimate. Heterogeneity was partially explained by studies that included participants who were physically active and studies that assessed tendon abnormalities using magnetic resonance imaging compared to ultrasound (P<.05). Mean age, body mass index, proportion of female participants, and sample size did not explain the remaining heterogeneity.

CONCLUSION

There was substantial variability in the reported prevalence of asymptomatic patellar tendon abnormalities. A clear and valid method is needed to assess and report the presence of patellar tendon abnormalities to increase research capacity and establish the clinical value of imaging the patellar tendon. J Orthop Sports Phys Ther 2021;51(5):216-231. Epub 28 Mar 2021. doi:10.2519/jospt.2021.10054.

The Effect of Training Experience and Leg Dominance on the Prevalence of Asymptomatic Intraarticular Changes of the Knee Joints in Adult Professional Male Soccer Players

Background

Currently, no data is available regarding the association between professional experience or limb dominance and the prevalence of asymptomatic knee joint lesions in adult professional male soccer players.

Hypothesis

The prevalence of the accumulated changes increases with training experience. This is especially true for the dominant leg, which is involved in a large proportion of the athletes’ movements.

Study Design

Level 2 cross-sectional cohort study

Methods

MRI was used to assess the condition of 94 knee joints in 47 adult professional male soccer players (mean age 25.7 ± 4.6 years, BMI 22.8 ± 1.4). Previous surgery on joints was an exclusion criterion. No football player had knee injuries (including fresh bruises) for at least 3 months before the examination. All the scans were performed using a 1.5T MRI scanner and a slice thickness of 3 mm. The images were blindly analyzed by two experienced radiologists. We analyzed all the three compartments of the knee joint. We consider a chondral lesion already from grade I in modified Noyes and Stabler classification system. To assess the influence of soccer training experience, all players were divided into two groups: group 1 formed from players with less than 20 years of experience and group 2 with more than 20 years of experience.

Results

One hundred percent of the soccer players had at least one chondral and meniscal lesion.

In both legs, the posterior horn of the medial meniscus (95.6%) was the most frequent site of injury. Most of the injuries were classified as grade II injuries (73.3% for the dominant and 75.6% for the non-dominant leg).

Experience and age of the athletes significantly increased the probability of subcortical bone lesions. They were significantly positively correlated with the grades of patellar lesions and lesions of the patellar surface of the femur and significantly negatively correlated with the grades of lesions of posterior horn of lateral meniscus and anterior horn of medial meniscus.

No statistically significant differences in the prevalence and grades of cartilage and meniscal lesions in the dominant and non-dominant limb were observed.

Conclusion

Soccer practice is associated with the increased prevalence of asymptomatic chondral and meniscal lesions.

The probability of subcortical bone lesions significantly increases with training experience and age. These factors are also positively correlated with the grades of patellar lesions and lesions of the patellar surface of the femur.

The prevalence and grade of asymptomatic chondral and meniscal lesions is independent of leg dominance.

Prevalence of Asymptomatic Intra-articular Changes of the Knee in Adult Professional Soccer Players

Background:

Currently, there are few data on the association between participation in soccer and the condition of the knee joints in adult professional players.

Hypothesis:

A high percentage of professional soccer players will have asymptomatic intra-articular changes of the knee.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

The condition of the intra-articular structures (osteophytes, cartilage, and menisci) in 94 knee joints of 47 adult professional soccer players (mean ± SD age, 25.7 ± 4.6 years; body mass index, 22.8 ± 1.4 kg/m²) was analyzed. A 1.5-T magnetic resonance imaging scanner was used to perform the imaging, and the anonymized data were analyzed by 2 experienced radiologists.

Results:

Cartilage of both knee joints was affected in 97.9% of soccer players. Meniscal lesions were detected in 97.8% of joints, affecting both joints in 93.6% of athletes. Grade 2 cartilage lesions were the most prevalent (36%-60% depending on the lesion site), and grade 4 lesions were detected in 12.7% of joints. The medial femoral condyle and medial tibial plateau were most frequently affected by cartilage lesions (85.1%). Among meniscal lesions, grade 2 lesions were the most prevalent, being detected in 71% of the cases. Grade 3 lesions were detected in 13.8% of the joints. The posterior horn of the lateral meniscus was the most common site of meniscal lesions (affected in 95.7% of the joints). Osteophytes were detected in 4.2% of joints.

Conclusion:

The prevalence of asymptomatic cartilage and meniscal lesions in the knees of adult professional soccer players is extremely high and is not associated with the reduction of sports involvement. This research should promote the correct interpretation of magnetic resonance imaging data obtained from soccer players with acute trauma and the reduction of the number of unwarranted surgical procedures.