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      Musculoskeletal Screening Tests and Bony Hip Morphology Cannot Identify Male Professional Soccer Players at Risk of Groin Injuries: A 2-Year Prospective Cohort Study

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          Most cited references39

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          Why screening tests to predict injury do not work-and probably never will…: a critical review.

          Roald Bahr (2016)
          This paper addresses if and how a periodic health examination to screen for risk factors for injury can be used to mitigate injury risk. The key question asked is whether it is possible to use screening tests to identify who is at risk for a sports injury-in order to address the deficit through a targeted intervention programme. The paper demonstrates that to validate a screening test to predict and prevent sports injuries, at least 3 steps are needed. First, a strong relationship needs to be demonstrated in prospective studies between a marker from a screening test and injury risk (step 1). Second, the test properties need to be examined in relevant populations, using appropriate statistical tools (step 2). Unfortunately, there is currently no example of a screening test for sports injuries with adequate test properties. Given the nature of potential screening tests (where test performance is usually measured on a continuous scale from low to high), substantial overlap is to be expected between players with high and low risk of injury. Therefore, although there are a number of tests demonstrating a statistically significant association with injury risk, and therefore help the understanding of causative factors, such tests are unlikely to be able to predict injury with sufficient accuracy. The final step needed is to document that an intervention programme targeting athletes identified as being at high risk through a screening programme is more beneficial than the same intervention programme given to all athletes (step 3). To date, there is no intervention study providing support for screening for injury risk.
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            Methods for epidemiological study of injuries to professional football players: developing the UEFA model.

            A problem with epidemiological studies of football injuries is the inconsistent manner in which injury is defined and data are collected. Projects have been initiated to study the incidence and causes of injury in football, but there is no uniformly accepted reporting system. In this report, some common pitfalls encountered in the recording of injury are addressed, and practical guidelines for epidemiological studies are provided. An injury reporting system developed for the UEFA Football Safety Project for studies on professional footballers is used as a starting point for a general discussion on injury registration and compared with other existing reporting systems. The recording definition of injury may vary between studies depending on its purpose. A time loss injury definition is practical for all playing levels, and, as a minimum, results on time loss injuries should therefore always be reported separately to allow direct comparisons between studies. There is a need to agree on a uniform sports injury classification system with corresponding diagnostic criteria, as well as standardised return to play criteria after injury.
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              Cam impingement causes osteoarthritis of the hip: a nationwide prospective cohort study (CHECK).

              To determine the association between cam impingement, which is hip incongruity by a non-spherical femoral head and development of osteoarthritis. A nationwide prospective cohort study of 1002 early symptomatic osteoarthritis patients (CHECK), of which standardised anteroposterior pelvic radiographs were obtained at baseline and at 2 and 5 years follow-up. Asphericity of the femoral head was measured by the α angle. Clinically, decreased internal hip rotation (≤20°) is suggestive of cam impingement. The strength of association between those parameters at baseline and development of incident osteoarthritis (K&L grade  2) or end-stage osteoarthritis (K&L grades 3, 4, or total hip replacement) within 5 years was expressed in OR using generalised estimating equations. At baseline, 76% of the included hips had no radiographic signs of osteoarthritis and 24% doubtful osteoarthritis. Within 5 years, 2.76% developed end-stage osteoarthritis. A moderate (α angle>60°) and severe (α angle>83°) cam-type deformity resulted in adjusted OR of 3.67 (95% CI 1.68 to 8.01) and 9.66 (95% CI 4.72 to 19.78), respectively, for end-stage osteoarthritis. The combination of severe cam-type deformity and decreased internal rotation at baseline resulted in an even more pronounced adjusted OR, and in a positive predictive value of 52.6% for end-stage osteoarthritis. For incident osteoarthritis, only a moderate cam-type deformity was predictive OR=2.42 (95% CI 1.15 to 5.06). Individuals with both severe cam-type deformity and reduced internal rotation are strongly predisposed to fast progression to end-stage osteoarthritis. As cam impingement might be a modifiable risk factor, early recognition of this condition is important.
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                Author and article information

                Journal
                The American Journal of Sports Medicine
                Am J Sports Med
                SAGE Publications
                0363-5465
                1552-3365
                May 02 2018
                May 2018
                March 27 2018
                May 2018
                : 46
                : 6
                : 1294-1305
                Affiliations
                [1 ]Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
                [2 ]La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia
                [3 ]Center for Groin Injuries, Department of Orthopaedics, Erasmus University Medical Center, Rotterdam, the Netherlands
                [4 ]Department of Orthopaedics, Erasmus University Medical Center, Rotterdam, the Netherlands
                [5 ]Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway
                [6 ]Sports Orthopedic Research Center–Copenhagen, Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark
                Article
                10.1177/0363546518763373
                4a800788-35d8-4b16-8667-c2253d9e9c99
                © 2018

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