Prevalence of early hip OA features on MRI in high-impact athletes. The femoroacetabular impingement and hip osteoarthritis cohort (FORCe) study

OBJECTIVE

To compare early hip osteoarthritis (OA) features on magnetic resonance imaging (MRI) in high-impact athletes with and without hip and/or groin pain, and to evaluate associations between early hip OA features, the International Hip Outcome Tool (iHOT33) and Copenhagen Hip and Groin Outcome Score (HAGOS).

DESIGN

This case-control study evaluated data of the femoroacetabular impingement and hip osteoarthritis cohort (FORCe). One hundred and eighty-two symptomatic (hip and/or groin pain >6 months and positive flexion-adduction-internal-rotation (FADIR) test) and 55 pain-free high-impact athletes (soccer or Australian football (AF)) without definite radiographic hip OA underwent hip MRI. The Scoring Hip Osteoarthritis with MRI (SHOMRI) method quantified and graded the severity of OA features. Each participant completed the iHOT33 and HAGOS.

RESULTS

Hip and/or groin pain was associated with higher total SHOMRI (0-96) (mean difference 1.4, 95% CI: 0.7-2.2), labral score (adjusted incidence rate ratio (aIRR) 1.33, 95% CI: 1.1-1.6). Differences in prevalence of cartilage defects, labral tears and paralabral cysts between symptomatic and pain-free participants were inconclusive. There was a lower prevalence of effusion-synovitis in symptomatic participants when compared to pain-free participants (adjusted odds ratio (aOR) 0.46 (95% CI: 0.3-0.8). Early hip OA features were not associated with iHOT33 or HAGOS.

CONCLUSIONS

A complex and poorly understood relationship exists between hip and/or groin pain and early hip OA features present on MRI in high-impact athletes without radiographic OA. Hip and/or groin pain was associated with higher SHOMRI and labral scores.

Getting more from standard rotator cuff strengthening exercises

BACKGROUND

A simple modification to standard rotator cuff exercises using an additional resistance band around the scapula has been recommended in the clinical setting, postulated to encourage activation of the posterior scapular stabilisers and increase rotator cuff activation. The aim of this clinical laboratory study was to compare scapular and rotator cuff muscle activation between standard and modified exercises.

METHODS

Electromyographic data were collected from 10 healthy adults via surface and intramuscular electrodes from the scapular and rotator cuff muscles. Internal and external rotation exercises of the shoulder with the arm abducted to 0°, 45° and 90° were performed using one handheld resistance band (standard) or two bands with the additional band applied to the scapula (modified).

RESULTS

Activation of the trapezii and rhomboid muscles during the modified exercises at 0° and 45° of abduction was significantly greater when compared to the standard exercises (P < 0.05). No significant differences were found in rotator cuff muscle activation.

DISCUSSION

Applying resistance to the posterior scapula increases activation of some scapular stabilising muscles particularly in lower ranges of abduction. This study provides preliminary evidence that this simple modification can elicit greater scapular muscle activity, potentially producing enhanced exercise outcomes with minimal additional effort.

Hip abductor muscle volume in hip osteoarthritis and matched controls

OBJECTIVE

Hip abductor muscle strength and function is negatively impacted by the presence of hip osteoarthritis (OA). This study aimed to quantify differences in hip abductor muscle volume, fatty infiltration and strength in a unilateral hip OA population when compared to a control group. Impact of radiographic severity of OA on these variables was also examined.

METHODS

Volumes of gluteus maximus (GMax), medius (GMed) minimus (GMin) and tensor fascia lata (TFL) was measured using MRI and muscle volume asymmetry between limbs was calculated. Fatty infiltrate within muscles was graded using the Goutallier classification system. Hip abduction and rotation strength was tested using a dynamometer. Differences between groups or limbs were analysed using t-tests and differences in fatty infiltration using non-parametric tests.

RESULTS

A statistically significant decrease in muscle volume was identified in GMax (P < 0.01), GMed (P < 0.02) and GMin (P < 0.01) on the affected side in the OA group compared to both the contralateral side and the control group and differences were related to severity of OA. Hip abduction and internal rotation strength was reduced in the OA group. Increased levels of fatty infiltration were identified in the affected limbs of the OA group for GMax (P = 0.01) and GMin (P = 0.04).

CONCLUSION

Gluteal muscle atrophy, increased gluteal fatty infiltration and hip strength deficits were evident in the affected hips of OA participants. Since severity of OA was related to the extent of atrophy and fatty deposits, rehabilitation programs targeting these muscles could reverse or halt the progression of these structural and functional deficits.

The effect of female sex hormone supplementation on tendon in pre and postmenopausal women: A systematic review

OBJECTIVES

Oestrogen deprivation has been shown to have a negative effect on connective tissue and its turnover. A link may exist between supplemental oestrogen, preservation of tendon collagen and less tendon abnormality. The aim was to determine the effects of female sex hormone supplementation (FSHS) on tendon.

METHODS

A systematic search of nine key health databases; Medline, CINAHL, EMBASE, SPORTDiscus, AUSPORT and AMI, Cochrane Library, SafetyLit and PEDro was completed (to Feb 24, 2016). The search yielded 6378 records using terms relating to hormone (oestrogen, estrogen, hormone replacement therapy, HRT, estrogen therapy, oestrogen therapy, oral contraceptive pill) and tendon. Quality assessment, data extraction and data synthesis of included papers was undertaken.

RESULTS

Low level of evidence for all outcomes; no positive or negative link between FSHS and molecular, mechanical and morphological tendon response outcomes, and the addition of exercise to FSHS, had minimal effects on tendon CSA.

CONCLUSIONS

The effect of oestrogen supplementation on tendon is contradictory and inconsistent. This review suggests there is a need for further studies to understand the effects of FSHS on tendon tissue at a mechanical, morphological and molecular level.

The acute effect of match play on hamstring strength and lower limb flexibility in elite youth football players

The aim of this study was to investigate the effect of competitive football match play on hamstring strength and lower limb flexibility. Fifteen male international youth football players were included. Hamstring strength and associated pain ratings, ankle dorsiflexion, hip extension, knee extension and flexion range of motion were evaluated immediately post-match and at intervals of 24, 48, and 72 h post-match. Strength significantly reduced post-match (P < 0.01), mean difference -0.43 (CI₉₅ : -0.56, -0.30) and 24 h post (P < 0.05) mean difference -0.12 Nm/kg (CI₉₅ : -0.20, -0.04). The associated pain scores significantly increased at the post-match (P < 0.01, ES = 0.61) and 24 h (P < 0.01, ES = 0.55) time intervals. At the 48 and 72 h post-match tests no significant difference was found for strength or pain ratings. No significant differences were detected for any of the range of motion measures. Competitive football match play has a significant acute and transient effect on isometric hamstring strength and associated pain levels during resisted knee flexion in male international youth players. Range of motion measures appear to remain relatively unaffected by match play. Isometric hamstring strength testing and associated pain levels might be considered for inclusion in-season to monitor player's post-match hamstring recovery characteristics.

Onset of sexual maturity in female chickens is genetically linked to loci associated with fecundity and a sexual ornament

Onset of sexual maturation is a trait of extreme importance both evolutionarily and economically. Unsurprisingly therefore, domestication has acted to reduce the time to sexual maturation in a variety of animals, including the chicken. In comparison with wild progenitor chickens [the Red Junglefowl (RJF)], domestic layer hens attain maturity approximately 20% earlier. In addition, domestic layers also possess larger combs (a sexual ornament), produce more eggs and have denser bones. A large quantitative trait loci (QTL) analysis (n=377) was performed using an F(2) intercross between a White Leghorn layer breed and a RJF population, with onset of sexual maturity measured and mapped to three separate loci. This cross has already been analysed for comb mass, egg production and bone allocation. Onset of sexual maturity significantly correlated with comb mass, whilst the genetic architecture for sexual maturity and comb mass overlapped at all three loci. For two of these loci, the QTL for sexual maturity and comb mass were statistically indistinguishable from pleiotropy, suggesting that the alleles that increase comb mass also decrease onset of sexual maturity.