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Research Updates: Sports After Hip Resurfacing, ACL Injuries

July 19, 2007 11:37 AM
By Jim Brown, PhD, Editor, Sports Performance Journal, Author, Tennis: Steps to Success

Three studies on two different sports-related injuries recently appeared in The American Journal of Sports Medicine. One tells us what we can expect regarding participation in sports after hip resurfacing, the second reaffirms the importance of core stability, and the third contradicts previous findings on the relationship between ACL ruptures and the menstrual cycle in women.

Sports After Hip Resurfacing
Many middle-aged are older tennis players are faced with the possibility of hip replacement or resurfacing, and they want to know what they will be able to do after those kinds of surgical procedures.

A study in the May 7, 2007 issue of The American Journal of Sports Medicine provides at least a partial answer. Researchers in Zurich, Switzerland, surveyed 112 patients to determine their level of sports participation at an average of two years after hip resurfacing surgery. Approximately 25 percent participated in sports four or more times per week, and almost 60 percent of them engaged in exercise for an hour or more at a time. More than half had returned to sports training and competition within three months after surgery. Fifty-one percent were still involved in downhill skiing and in high-impact sports such as tennis (as in the impact of feet pounding a hard surface) or in contact sports. Seventy percent reported being pain-free during exercise. Those 60 and over participated in a greater variety of sports, more times per week, and in longer sessions than younger patients (average age, 46).

(Editor’s Note: Do not take these results as recommendations for your participation. Follow your doctor’s prescription for rehabilitation and his or her advice for returning to your favorite sport, which may or may not include impact and contact sports.)

ACL Injuries in Women
Two new studies add to the body of knowledge related to knee injuries — specifically, ACL ruptures in women. The first, conducted by scientists and physicians at Yale and at the University of Cincinnati, involved 277 collegiate athletes (140 men; 137 women). A three-year study found that deficits in control of the trunk (lack of core stability) predicted risk of knee, ligament, and ACL in women athletes, but not in men. Trunk displacement (again, lack of core stability), difficulty in proprioception (a sense of the body’s position in space), and a history of low back pain were also identified as predictors of knee ligament injury.

A second, smaller investigation was conducted at Ohio State with 12 men and 25 women, and looked again at potential causes for the high rate of ACL injuries in women athletes. Contrary to the findings of several previous studies, the new report says that women do not place any greater strain on their ACLs or related muscles during any one phase of the menstrual cycle or during contraception use. The lead author concluded that hormone cycling does not appear to affect either the hip or knee joints in terms of loading. However, it is still possible that hormones may be part of a more complex interaction between ligament structure, fatigue, and neuromuscular control.
(Editor’s Note: There are multiple and probably interactive causes of ACL injuries in women and men, and this piece of research adds to our understanding, but is not the final word on this type of injury.)



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