4 Domain Sports PROM in Spanish: Cross-cultural adaptation in the Chilean population and reliability analysis

BACKGROUND

Patient-Reported Outcome Measures (PROMs) are tools of increasing interest in the sports population. The purpose of this study was to perform the cross-cultural adaptation and reliability analysis of the 4 Domain Sports Patient-Reported Outcome Measure (4DSP) into Spanish.

METHODS

A six-stage cross-cultural adaptation protocol was executed to obtain the Spanish version of the 4DSP (S-4DSP). Subsequently, the questionnaire was administered to a population of 108 postoperative athletes with ACL (Anterior Cruciate Ligament) injuries. The questionnaire was administered again after 30 days. Acceptability, floor and ceiling effects, internal consistency (Cronbach's alpha), and reproducibility (Intraclass Correlation) were evaluated.

RESULTS

The S-4DSP was fully completed by 108 participants (mean age 34 ± 10.75, 26% women), achieving 100% acceptability. No floor effect was detected. The statistical analysis yielded a global Cronbach's alpha for the questionnaire of 0.65, and domain-specific alphas of 0.88, 0.72, 0.27, and 0.68 for the first, second, third, and fourth domains, respectively. The Intraclass Correlation test reached a maximum of 0.94 and a minimum of 0.48 for the first and fifth questions, respectively.

CONCLUSIONS

The S-4DSP is a reliable and useful tool for evaluating Spanish-speaking athletes after ACL reconstruction.

Posterior cruciate ligament reconstruction using PCL inlay technique with the patient supine in bicruciate ligament injury reconstruction

BACKGROUND

Surgical reconstruction of the posterior cruciate ligament (PCL) can be technically challenging given the proximity of the popliteal artery to the PCL tibial insertion. This "no-safe zone" makes some knee surgeons less confident and willing to perform this surgical procedure.

SURGICAL TECHNIQUE

We present a PCL tibial inlay reconstruction technique using a set of instruments involving three tools (a slot cut, a bone plug positioner, and an impactor).

CONCLUSION

This set of instruments allows a more reproducible posteromedial approach and to produce a PCL tibial slot in a posterior cruciate ligament inlay reconstruction with the patient supine in bicruciate ligament injury reconstruction.

The management of concussion in sport is not standardized. A systematic review

INTRODUCTION

Concussion is traumatic brain injury with associated tissue damage commonly produced by an indirect or direct head or facial trauma that can negatively impact an athletes' career and personal life. In this context, the importance on how to deal with a concussion has received attention from worldwide literature and has become a topic of enormous interest in the sports medicine arena.

OBJECTIVE

This systematic review aimed to investigate how sports-related concussion is being managed regarding athletic injuries, athletes' age, clinical signs of concussion, adopted questionnaires, as well as decision making in sports medicine.

METHODS

A systematic review of the literature was performed searching 10 electronic databases with no limitations for year of publication up to December 2019. The search terms used were: Brain Concussion, Athletes, Sports Medicine, Athletic Injuries, Clinical Decision-Making, and Decision Making. The articles were considered eligible when the studies related to populations of regular sports practitioners, professional or recreational, of any age; sports injury; articles reporting concussion evaluation in at least 30 athletes; and articles published in English, French, Portuguese, Italian. We excluded systematic review articles, reviews, editorials, sport-unrelated concussion, no questionnaire application, approaching retired athletes, consensus statement letters, author's reply to editorials, synopsis, and abstracts.

RESULTS

The parameters adopted for decision-making and management were broadly variable and were based on a variety of clinical signs or scoring outcomes from a myriad of questionnaires with little consistency in protocol or management guidelines, which could guide the average clinician.

CONCLUSION

This systematic review provides current evidence that post-concussion management in sports medicine has yet to accomplish a standardized protocol that clinicians could use to optimally care for athletes. The extensive number of manuscripts and studies addressing the topic confirms that sports-related concussion in the pediatric and adolescent population has come to the forefront in the sports medicine field.

Estudo da perda da tensao do enxerto de tendão calcâneo bovino

A lesão do ligamento cruzado anterior do joelho (LCA) é um problema que afeta tanto os animais como os seres humanos, e pode evoluir com instabilidade articular, muitas vezes, sintomática e incapacitante para o paciente. Os enxertos de tendões autólogos são a principal opção como substitutos ligamentares. Durante a reconstrução cirúrgica do LCA, o enxerto é submetido a tensionamento com o objetivo de restabelecer a lassidão normal do joelho LCA-deficiente. Embora o tensionamento do enxerto exerça papel fundamental na evolução clínica pós-operatória, a literatura ainda não estabeleceu os níveis ideais de tensionamento a serem aplicados. Assim, o estiramento ou elongamento do enxerto que pode ocorrer com o passar do tempo permanece como uma das principais causas da falha da reconstrução ligamentar.Neste trabalho, dez tendões de calcâneo bovino foram submetidos a dois ensaios sucessivos de tensionamento fisiológico a deformação relativa máxima de 2.5% do comprimento inicial do tendão ensaiado, mantida durante 600s, sendo registrados os valores de força (N) no tempo zero (inicial), 300s e 600s. Ao término do primeiro ensaio, o tendão retornava ao seu comprimento inicial, sendo mantido em repouso durante 300s, seguido de novo ensaio de tensionamento repetindo-se os mesmos procedimentos anteriores. A análise estatística permitiu concluir que o elongamento do tendão é mais pronunciado nos 300s iniciais, refletindo uma queda mais acentuada nos valores da tensão do enxerto. Portanto, 300s após o tensionamento e fixação do enxerto, o cirurgião pode avaliar mais adequadamente se o nível de tensionamento foi suficiente.