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Background: A treatment algorithm and screening examination have been developed to guide patient management and prospectively determine potential for highly active individuals to succeed with nonoperative care after anterior cruciate ligament rupture.

Objective: To prospectively characterize and classify the entire population of highly active individuals over a 10-year period and provide final outcomes for individuals who elected nonoperative care.

Methods: Inclusion criteria included presentation within 7 months of the index injury and an International Knee Documentation Committee level I or II activity level before injury. Concomitant injury, unresolved impairments, and a screening examination were used as criteria to guide management and classify individuals as noncopers (poor potential) or potential copers (good potential) for nonoperative care.

Results: A total of 832 highly active patients with subacute anterior cruciate ligament tears were seen over the 10-year period; 315 had concomitant injuries, 87 had unresolved impairments, and 85 did not participate in the classification algorithm. The remaining 345 patients (216 men, 129 women) participated in the screening examination a mean of 6 weeks after the index injury. There were 199 subjects classified as noncopers and 146 as potential copers. Sixty-three of 88 potential copers successfully returned to preinjury activities without surgery, with 25 of these patients not undergoing anterior cruciate ligament reconstruction at the time of follow-up.

Conclusion: The classification algorithm is an effective tool for prospectively identifying individuals early after anterior cruciate ligament injury who want to pursue nonoperative care or must delay surgical intervention and have good potential to do so.



NAVIGATION


         

 

Background: Few prospective epidemiological studies on soccer match injuries have collected continuous data using subjects from the same group.

Purpose: To investigate long-term injury-induced changes during official matches in the professional Japanese soccer league.

Study Design: Descriptive epidemiological study.

Methods: Acute injuries during official matches among top-division Japanese professional soccer leaguers were prospectively collected from 1993 to 2007. Injuries preventing player participation for 7 days or more were defined as a reportable injury. Interseasonal variations of injury rate (IR: injuries/1000/player hours) and injury pattern (type, location, circumstances, severity, injury time, positional role, and relationship to weather) were analyzed.

Results: Throughout the study period, 2947 injuries from 3984 matches occurred. Mean annual IR was 21.77/1000 player hours, and annual variance showed gradual decrement throughout the study period. The proportion of injury type and location were not significantly changed. Sprain and contusion as injury type and thigh and ankle joint as location were the most common in every season. Contact-related injuries comprised 73.3% on average and were observed to occur more frequently during the last 15 minutes and extra time of match play. The proportion of foul play–related injuries showed a clear declining trend. The proportion of severe injury showed a sporadic increase from 2001 to 2004. The second, fifth, and sixth 15-minute match segments showed a higher IR. Goalkeepers had a lower IR versus other field players. Matches on rainy days resulted in a lower IR than did those held under other weather conditions.

Conclusion: Long-term surveillance and statistical feedback of injury characteristics to organization members were considered effective in improving safer play awareness among players and for referees to reduce injury incidence, particularly foul play–related injuries.

 

Background: Few descriptive epidemiologic studies of injury in soccer are of community-level players. Although many sports injury surveillance systems have been described in the scientific literature, only 1 has been implemented in community-level soccer and that was restricted to adolescent players in a single club.

Purpose: The objective of this study was to develop a method for undertaking routine surveillance of injury in community-level soccer.

Study Design: Cohort study; Level of evidence, 2.

Methods: A cohort of 880 community-level players aged 13 years and over was followed over 1 winter competitive season. Each week, each player was contacted by telephone and an interview conducted to collect data on participation in matches and training sessions, injuries, and adherence to injury prevention measures.

Results: Seventy-five percent (n = 510) of the cohort was male and the median age was 16 years. Data were collected on 11 268 player-matches totaling 13 483 player-match hours and 11 540 player-training sessions totaling 16 031 player-training hours. A total of 677 match injury events were reported, giving overall incidence rates of 50.2 injury events per 1000 player-match hours and 6.0 injury events per 100 player-matches. The incidence rate for match injury events was significantly higher for females than for males (63.9 vs 46.9). A total of 145 training injury events were reported, giving overall incidence rates of 9.0 injury events per 1000 player-training hours and 1.3 injury events per 100 player-training sessions. The most common injuries were sprains and strains of the lower limb, and tackling was the most common cause of injury.

Conclusion: This study has shown that routine injury surveillance, using a cohort design with exposure measurement, can be successfully implemented in community-level soccer.




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