Context: Individuals who sustain a knee surgery have been shown to have an increased likelihood to develop osteoarthritis (OA). Objective : Identify the consequences of knee surgery in a cohort of former college athletes. Design : Cross-sectional. Setting : Research laboratory. Participants: A group of 100 former Division I college athletes aged 40–65 years (60 males and 40 females) participated in the study. Interventions: All individuals self-reported whether they sustained a knee injury during college requiring surgery and if they have been diagnosed with knee OA by a medical physician post knee injury. Individuals were categorized into 3 groups: no history of knee injury requiring surgery (33 males and 24 females; 54.53 [5.95] y), history of knee surgery in college with no diagnosis of OA later in life (4 males and 6 females; 51.26 [7.29] y), and history of knee surgery in college with physician diagnosed OA later in life (23 males and 10 females; 54.21 [7.64] y). All individuals completed the knee injury and osteoarthritis outcome score (KOOS) and short form-36 version 2. Main Outcome Measures: Scores on the KOOS and short form-36 version 2. Results: A majority (76.7%) of individuals who had a knee surgery in college did develop OA. The largest mean differences were between the healthy knee and surgical knee/OA groups on the KOOS-quality of life scale (mean difference: 49.76; χ 2(3) = 44.65; P < .001) and KOOS-sports scale (mean difference: 43.69; χ 2(3) = 28.69; P < .001), with the surgical knee/OA group scoring worse. Conclusions: Later in life functional limitations were observed in individuals who sustained a knee injury requiring surgery and developed OA. These findings support increased efforts toward prevention of knee injuries and consideration of the long-term implication when making treatment and return to activity decisions.
Janet E. Simon, Dustin R. Grooms and Carrie L. Docherty
Nathan Millikan, Dustin R. Grooms, Brett Hoffman and Janet E. Simon
Context: Functional tests are limited primarily by measuring only physical performance. However, athletes often multitask, and deal with complex visual-spatial processing while being engaged in physical activity. Objective: To present the development and reliability of 4 new neurocognitive single-leg hop tests that provide more ecological validity to test sport activity demands than previous functional return to sport testing. Design: Cross-sectional. Setting: Gymnasium. Participants: Twenty-two healthy participants (9 males and 13 females; 20.9 [2.5] y, 171.2 [11.7] cm, 70.3 [11.0] kg) were recruited. Interventions: Maximum distance (physical performance) and reaction time (cognitive performance) were measured for 3 of the neurocognitive hop tests all testing a different aspect of neurocognition (single-leg central-reaction hop—reaction time to 1 central stimulus, single-leg peripheral-reaction crossover hop—reaction time between 2 peripheral stimuli, and single-leg memory triple hop—reaction to memorized stimulus with distractor stimuli). Fastest time (physical performance) and reaction time (cognitive performance) were measured for the fourth neurocognitive hop test (single-leg pursuit 6m hop—requiring visual field tracking [pursuit] and spatial navigation). Main Outcome Measures: Intraclass correlation coefficients were calculated to assess reliability of the 4 new hop tests. Additionally, Bland–Altman plots and 1-sample t tests were conducted for each single-leg neurocognitive hop to evaluate any systematic changes. Results: Intraclass correlation coefficients based on day 1 and day 2 scores ranged from .87 to .98 for both legs for physical and cognitive performance. The Bland–Altman plots and 1-sample t tests (P > .05) indicated that all 4 single-leg neurocognitive hop tests did not change systematically. Conclusions: These data provide evidence that a neurocognitive component can be added to the traditional single-leg hop tests to provide a more ecologically valid test that incorporates the integration of physical and cognitive function for return to sport. The test–retest reliability of the 4 new neurocognitive hop tests is highly reliable and does not change systematically.
Kelly Cornett, Katherine Bray-Simons, Heather M. Devlin, Sunil Iyengar, Patricia Moore Shaffer and Janet E. Fulton
Janet E. Simon, Matthew Donahue and Carrie L. Docherty
Taping and bracing are commonly used to protect the ankle joint and prevent ankle sprains. The purpose of this study was to: (1) determine ATs’ utilization of prophylactic support and (2) determine attitudes and behaviors toward the use of ankle taping and bracing. A survey was distributed electronically to 7,888 ATs. Over half of the responding ATs encouraged athletes to wear some form of ankle support. A majority of college ATs either encouraged or required athletes to use ankle taping, indicating the decision is derived from a complex integration of athlete preferences, the clinician’s internal evidence, and the best available external evidence.
Janet E. Simon and Carrie L. Docherty
It is theorized that ankle taping is effective in reducing the incidence of a recurrent ankle injury. The purpose of this study was to explore perceptions of ankle taping in Division III athletes. Of student-athletes in the population studied, 321 returned surveys, of which 132 (41.1%) individuals indicated they have had their ankle(s) taped. Of the 132 individuals, 99 (75.0%) have had an ankle sprain. There were similar responses between both groups, particularly regarding not being able to tape (anxious about injury). Results of this study revealed that regardless of history of ankle injury, a majority of individuals stated they taped their ankle to prevent injury.
Abbey C. Thomas, Janet E. Simon, Rachel Evans, Michael J. Turner, Luzita I. Vela and Phillip A. Gribble
Context: Knee osteoarthritis (OA) frequently develops following knee injury/surgery. It is accepted that knee injury/surgery precipitates OA with previous studies examining this link in terms of years after injury/surgery. However, postinjury OA prevalence has not been examined by decade of life; thereby, limiting our understanding of the age at which patients are diagnosed with posttraumatic knee OA. Objective: Evaluate the association between the knee injury and/or surgical history, present age, and history of receiving a diagnosis of knee OA. Design: Cross-sectional survey. Setting: Online survey. Participants: A total of 3660 adults were recruited through ResearchMatch©. Of these, 1723 (47.1%) were included for analysis due to history of (1) knee surgery (SURG: n = 276; age = 53.8 [15.3] y; and body mass index [BMI] = 29.9 [8.0] kg/m2), (2) nonsurgical knee injury (INJ: n = 449; age = 46.0 [15.6] y; and BMI = 27.5 [6.9] kg/m2), or (3) no knee injury (CTRL: n = 998; age = 44.0 [25.2] y; and BMI = 26.9 [6.6] kg/m2). Respondents were subdivided by decade of life (20–29 through 70+). Intervention: An electronic survey regarding knee injury history, treatment, and diagnosis of knee OA. Main Outcome Measures: Binary logistic regression determined the association between knee surgical status and OA by decade of life. Participants with no histories of OA or lower-extremity injury were the referent categories. BMI was a covariate in all analyses. Results: SURG respondents were more likely to report having knee OA than CTRL for all age groups (odds ratios: 11.43–53.03; P < .001). INJ respondents aged 30 years and older were more likely to have OA than CTRL (odds ratios: 2.99–14.22; P < .04). BMI influenced associations for respondents in their 50s (P = .001) and 60s (P < .001) only. Conclusions: INJ increased the odds of reporting a physician diagnosis of knee OA in adults as young as 30 to 39 years. Importantly, SURG yielded 3 to 4 times greater odds of being diagnosed with knee OA compared with INJ in adults as young as 20 to 29 years. Delaying disease onset in these young adults is imperative to optimize the quality of life long term after surgery.
Rachel R. Kleis, Janet E. Simon, Michael Turner, Luzita I. Vela, Abbey C. Thomas and Phillip A. Gribble
While knee injury-related pain and functional limitations are common in the physically active, the impact on general health is not well documented. Further, it is not known how much these outcomes differ among individuals that did or did not have surgery following the knee injury, as well as compared to those without knee injury history. We examined differences in health-related quality of life (HRQoL) and general health among patients after knee surgery, knee injury that did not require surgery, and healthy controls. Knee surgery participants reported higher body mass index and lower SF-8 physical component scores than knee nonsurgery and control (p < .001 all comparisons) groups. Knee nonsurgery participants had lower SF-8 physical component scores (p = .01) than control participants. Patients after knee surgery report more adverse health effects than those with nonsurgically treated knee injuries.