Muscle Injuries: A Brief Guide to Classification and Management.

Muscle injuries are frequent in athletes. Despite their high incidence, advances in clinical diagnostic criteria and imaging, their optimal management and rehabilitation strategies are still debated in literature. Furthermore, reinjury rate is high after a muscle lesion, and an improper treatment or an early return to sports can increase the rate of reinjury and complications.

High-Volume Image-Guided Injection for Recalcitrant Patellar Tendinopathy in Athletes.

Objective: To assess the effectiveness of high-volume image-guided injection in the middle term in patients with recalcitrant patellar tendinopathy.

Design: Case series study; Level of evidence, 4.

Setting: All tertiary referrals, public, and private healthcare.

ISMuLT Guidelines for muscle injuries.

Muscle injuries are frequent in high demand sports. No guidelines are available in the scientific literature. ISMuLT, the "Italian Society of Muscles, Ligaments and Tendons", in line with its multidisciplinary mission, is proud to cover this gap.

Multiple percutaneous longitudinal tenotomies for chronic Achilles tendinopathy in runners: a long-term study.

Background: Multiple percutaneous longitudinal tenotomies have been successfully undertaken in runners with isolated midportion Achilles tendinopathy (nodular lesions <2.5 cm) without any sign of paratendinopathy.

Hypothesis: In the long term, minimally invasive multiple tenotomies allow the patient to remain involved in middle- and long-distance running.

Isolated anterior talofibular ligament Broström repair for chronic lateral ankle instability: 9-year follow-up.

Background: Lateral ankle sprains may result in pain and disability in the short term, decreased sport activity and early retirement from sports in the mid term, and secondary injuries and development of early osteoarthritis to the ankle in the long term.

Hypothesis: This combined approach to chronic lateral instability and intra-articular lesions of the ankle is safe and in the long term maintains mechanical stability, functional ability, and a good level of sport activity.

Study Design: Case series; Level of evidence, 4.

Free gracilis tendon graft for reconstruction of chronic tears of the Achilles tendon.

Background: Chronic tears of the Achilles tendon with a tendon gap exceeding 6 cm are a surgical challenge. The purpose of this study is to report the long-term results of reconstruction of such chronic Achilles tendon ruptures with use of a free autologous gracilis tendon graft.

Methods: Twenty-one patients underwent reconstruction of a chronic rupture of the Achilles tendon.

Peroneus brevis tendon transfer for reconstruction of chronic tears of the Achilles tendon: a long-term follow-up study.

Background: Chronic tears of the Achilles tendon can result in substantial loss of function. Those tears with a tendon gap of up to 6.5 cm can be treated surgically with use of an autologous peroneus brevis tendon graft.

Gracilis autograft for recurrent posttraumatic instability of the superior tibiofibular joint.

Background: Several reconstruction procedures have been proposed to manage recurrent dislocation of the superior tibiofibular joint.

Hypothesis: Reconstruction of the superior tibiofibular joint using a gracilis tendon autograft is effective in recurrent dislocation of the superior tibiofibular joint.

Study Design: Case series; Level of evidence, 4.

The 3-in-1 procedure for recurrent dislocation of the patella in skeletally immature children and adolescents.

Background: Recurrent patellar dislocations are common injuries in children and adolescents. The subjective and functional results of soft tissue surgical management in a population that was skeletally immature at the time of surgery have not been reported.

Hypothesis: The 3-in-1 procedure is an effective treatment for recurrent patellar dislocation in skeletally immature patients.

Isolated medial patellofemoral ligament reconstruction for recurrent patellar dislocation.

Background: Several medial patellofemoral ligament reconstruction procedures have been proposed to manage recurrent patellar dislocation.

Hypothesis: Reconstruction of the medial patellofemoral ligament using a hamstring graft with a 2 transverse patellar tunnels technique is an effective treatment for recurrent patellar dislocation in patients without any evident predisposing factors.

Study Design: Case series; Level of evidence, 4.

VISA-P score for patellar tendinopathy in males: adaptation to Italian.

Purpose: To translate and adapt the English VISA-P questionnaire to Italian and to perform reliability and validity evaluations of the Italian VISA-P version in patients with patellar tendinopathy.

Methods: The VISA-P English version was translated into Italian by a bilingual orthopaedic surgeon. The back translation of the Italian version into English was performed by another bilingual orthopaedic surgeon.

Italian translation of the VISA-A score for tendinopathy of the main body of the Achilles tendon.

Purpose. To translate and adapt the English VISA-A questionnaire to Italian, to perform reliability and validity evaluations of the Italian VISA-A version in patients with tendinopathy of the main body of the Achilles tendon. Methods.

Surgery for chronic Achilles tendinopathy produces worse results in women.

Purpose: To report the middle term outcome in male and female patients who underwent surgery for chronic recalcitrant Achilles tendinopathy.

Methods: We tried to match each of the 58 female patients with a diagnosis of tendinopathy of the main body of the Achilles tendon with a male patient with tendinopathy of the main body of the Achilles tendon who was within two years of age at the time of operation. A match accordingly was possible for 41 female subjects.

Surgery for chronic Achilles tendinopathy yields worse results in nonathletic patients.

Objective: To report the outcome of surgery for chronic recalcitrant Achilles tendinopathy in nonathletic and athletic subjects.

Design: Case-control study.

Setting: University teaching hospitals.

Recurrent subluxation of the peroneal tendons.

Background: Recurrent peroneal tendon subluxation is uncommon.

Hypothesis: The authors tested the null hypothesis that there are no differences between preoperative and postoperative status after anatomical repair of the superior peroneal retinaculum.

Study Design: Case series; Level of evidence, 4.

Similar histopathological picture in males with Achilles and patellar tendinopathy.

Purpose: To ascertain whether there are differences in the histopathological appearance of tendinopathic Achilles and patellar tendons.

Methods: In males, we studied biopsies from tendinopathic Achilles (N = 28; average age 34.1 yr) and patellar tendons (N = 28; average age 32.

Calcific insertional Achilles tendinopathy: reattachment with bone anchors.

Background: Recalcitrant calcific insertional Achilles tendinopathy is difficult to treat.

Hypothesis: Bursectomy, excision of the distal paratenon, disinsertion of the tendon, removal of the calcific deposit, and reinsertion of the Achilles tendon with bone anchors is safe and effective.

Study Design: Longitudinal study.

Clinical diagnosis of Achilles tendinopathy with tendinosis.

Objective: To evaluate sensitivity, specificity, reproducibility, and predictive value of palpation of the painful arc sign and of the Royal London Hospital test in 10 patients with Achilles tendinopathy and in 14 asymptomatic subjects.

Design: Test-retest study.

Setting: University teaching hospital.

Surgical release of de Quervain's stenosing tenosynovitis postpartum: can it wait?

We compared the efficacy of conservative management of de Quervain's disease in 30 women postpartum (group 1) and 30 nonpregnant women (group 2). All patients underwent conservative management consisting of 2 weeks of splinting of the affected wrist, followed by physiotherapy and antiinflammatory drugs (NSAIDs). Clinical evaluation was performed using a functional score and the visual analogue scale (VAS) of Scott-Huskinson at entry to the study, 1 month later, and at a follow-up of 6 months.

Management of Achilles tendinopathy by ultrasound-guided percutaneous tenotomy.

Purpose: To report the middle to long-term results of ultrasound-guided percutaneous longitudinal tenotomy of the Achilles tendon

Method: Seventy-five athletes with unilateral Achilles tendinopathy underwent ultrasound-guided percutaneous longitudinal tenotomy under local anesthetic infiltration after failure of conservative management. Sixty-three patients were reviewed at least 36 months after the operation (51 +/- 18.2 months).