Aleksey D. Repetyuk

Background: Joint dislocations/subluxations are an extremely common serious problem confronting athletes. Repeated joint injuries lead to the development of chronic musculoskeletal diseases and early disability. An important factor in preventing joint re-dislocations/subluxations is the early identification of an underlying predisposition to joint injuries. Therefore, it seemed relevant to identify diagnostically significant morpho-functional musculoskeletal dysplastic signs associated with repeated joint dislocations/subluxations and to assess their diagnostic value in identifying individuals with joint re-injury. Methods: Comprehensive clinic-phenotypic examination was conducted on 538 young adults (aged 18–35 years) involved in mass sports. The study was reported in accordance with the STROBE and STARD 2015 guidelines. Results: The repeated sports-related joint dislocations/subluxations were observed in 10.4% (95% CI: 8.0–13.3). All 56 participants with recurrent joint dislocations/subluxations had connective tissue dysplasia syndrome, compared with 71.2% of those without them (p < 0.001). The dysplastic severity discriminated participants with and without joint re-dislocations/subluxations (AUC = 0.839; 95% CI: 0.773–0.906, p < 0.001). A total connective tissue dysplasia score of 35.91 or higher raised the probability of a joint re-dislocation/subluxation history from 10.4% to 28.9% (sensitivity 78.6%, specificity 77.6%, positive likelihood ratio 3.5), whereas a lower score made it unlikely (negative predictive value 96.9%). The dysplastic phenotype associated with a predisposition to joint dislocations/subluxations has characteristic dysplastic signs, which, when considered together, could form the basis for the developing screening method to identify individuals prone to such recurrent joint instability. Conclusions: The obtained results provide a practical tool for sports practitioners to identify athletes who need closer assessment and, after prospective validation, to implement preventive measures in a targeted manner supporting personalized strategies to preserve musculoskeletal health in young athletes.

Objective. The purpose of this study is to evaluate the effectiveness of using the EMW MED deep electromagnetic tissue stimulation system in the comprehensive rehabilitation of patients in the early postoperative period after TEKS. Material and methods. A prospective, randomized, controlled study was conducted involving 30 patients (15 in each group) hospitalized after TKA surgery. The main group received a comprehensive rehabilitation program, including therapeutic exercise classes and a course of electromagnetic stimulation procedures on the deep «EMW MED» device (low-intensity mode: 150 Hz, 40–60 mT, 10 minutes, a course of 10 daily procedures). In addition to therapeutic gymnastics, patients in the control group received magnetic therapy using the Almag+ device (50 Hz, 20–30 mT, 15 minutes, a course of 10 daily procedures). The dynamics of the patients’ condition were assessed at three time points (the 1st, 5th, and 10th days) using the following parameters: pain syndrome — using the visual analog scale (VAS), range of motion in the knee joint using goniometry, swelling severity — measuring the limb circumference at four levels, and the safety and tolerability of the procedures were also taken into account. Statistical analysis was performed using the Mann-Whitney U-test (intergroup comparisons) and the Wilcoxon test (intragroup dynamics) with Bonferroni correction. Data are presented as medians and interquartile ranges. Results. The groups were comparable by age, gender, and comorbid status (p>0.05 for all comparisons). In the main group, the median VAS decreased from 3.6 [3.2; 3.7] points to 0.2 [0.0; 0.5] points (on the 10th day), in the control group — from 3.5 [3.3; 3.7] points to 2.3 [2.0; 2.5] points; the differences between the groups on the 5th and 10th days were statistically significant (p 0.05 for all levels and terms). Adverse events were not recorded in any of the groups. Conclusion. The use of the EMW MED system in early rehabilitation after TKA provides a more pronounced analgesic effect and faster restoration of range of motion compared to low-intensity pulsed magnetic therapy using the Almag+ device. The method is safe and well tolerated by patients. The obtained results require confirmation with a larger sample of patients.

Late-stage gonarthrosis (Kellgren-Lawrence grades III-IV, Kosinskaya grade III) is a common cause of persistent pain and dysfunction in the lower extremities. Total knee arthroplasty (TKR) is an effective surgical procedure; however, rehabilitation outcomes in the early postoperative period are not always predictable. Existing prognostic models rely primarily on questionnaires and scales, while objective biomechanical parameters—gait characteristics and postural stability—remain understudied in their relationship with psychosocial status. The aim of this study was to determine the prognostic significance of the initial psychosocial status of female patients after TKR in relation to the dynamics of clinical, functional, podometric, and stabilometric parameters in the early postoperative period. Material and methods. A prospective cohort study included 29 female patients (median age 65.5 years) undergoing primary TKA for stage III–IV gonarthrosis. Entry testing was performed on the third postoperative day, and final testing was conducted after 7–12 days of inpatient rehabilitation. Quality of life (SF 36), clinical and functional status (KSS, WOMAC), spatiotemporal gait parameters on the C-Mill treadmill, and postural stability on the D-Wall platform were assessed. Statistical analysis included nonparametric tests, calculation of the summary psychosocial index (mean Z scores for subscales) and summary motor index, the Wilcoxon signed-rank test for assessing the dynamics of indicators, and partial rank correlation with control for the baseline motor level. Results. During the rehabilitation period, significant improvement was recorded in the WOMAC scale (from 39.5 to 26.5 points; p <0.001), KSS (clinical from 79.0 to 88.5 points; p <0.001), decreased stance phase asymmetry (p=0.041) and double support (p=0.024), improved postural stability with eyes open (decreased rate of shift of the center of pressure, p=0.016–0.042). The summary psychosocial index positively correlated with the final motor index (ρ=0.748; p=0.005); the relationship remained after statistically accounting for the initial motor level (partial rank correlation ρ=0.734; p=0.0065). Patients with a higher initial psychosocial index achieved significantly better motor results (p=0.009). Conclusion. The obtained results demonstrate that initial psychosocial status is an independent predictor of final motor recovery early after TKA. The identified relationships substantiate the need for preoperative psychological screening and targeted optimization of psychosocial functioning to improve the effectiveness of rehabilitation programs.

In recent years, there has been an increase in the number of people with transplanted organs in Russia leading an active lifestyle; however, issues related to their participation in organized sports, including football, remain insufficiently studied and systematized. The lack of unified approaches to medical support, the training process, and psychological assistance hinders the development of inclusive sports programs for this category of athletes, which determines the relevance of the present search-and-analytical study. The article presents an analysis of the current state and prospects for the development of football for individuals with transplanted organs in the Russian Federation. Particular attention is paid to the problems of medical and biological support and psychological assistance, as well as to the issues of developing specialized sports training programs, financing, and infrastructure development. Possible ways to address these problems are considered, including the development of adapted training programs, the organization of specialized tournaments, the implementation of psychological support, and the enhancement of public awareness regarding organ donation. In conclusion, the importance of developing inclusive sports programs is emphasized, and practical recommendations are presented for creating safe conditions for playing football, improving infrastructure, and training specialized professionals, which makes it possible to expand opportunities for the social integration of people with transplanted organs into active sports life.

BACKGROUND: Knee osteoarthritis is a chronic disease that can eventually lead to surgical arthroplasty. Overuse, inflammation, metabolic disorders, and hormonal changes play important roles in the pathogenetic development of osteoarthritis of the knee. Recent studies have shown that collagen hydrolysate slows down the degenerative processes in cartilage tissue and has analgesic and anti-inflammatory effects. AIMS: To examine the effect of a dietary supplement of collagen hydrolysate (COLLA GEN) on the treatment and rehabilitation of patients with symptomatic knee osteoarthritis. MATERIALS AND METHODS: This prospective, blinded, placebo-controlled study included 99 patients diagnosed with radiographic knee osteoarthritis. All patients were randomly divided into two groups. Both groups were prescribed a course of therapeutic exercises. Group I was also prescribed a food supplement of collagen hydrolysate (COLLA GEN), whereas group II received placebo. The effectiveness of collagen hydrolysate in symptomatic osteoarthritis was evaluated based on the comparison of the WOMAC and VAS scores before the treatment and rehabilitation process and after 1, 3, and 6 months. RESULTS: Daily intake of 40 g of collagen hydrolysate dietary supplement of collagen hydrolysate («COLLA GEN») for 3 months, in combination with exercise therapy, in patients with symptomatic osteoarthritis, allowed statistically significant (p 0.05), compared with the placebo group, to improve such indicators on the WOMAC scale as «pain» (3.9±1.5 in group I and 5.4±1.8 in group II), «physical function» (8.7±3.2 in group I and 13.7±2.9 in group II), and «total score» (14.5±5.2 in group I and 21.5±4.9 in group II) by 6 months of observation. When analyzing the indicators on the VAS scale at the end of the 3rd and 6th month of treatment, a statistically significant difference (p 0.05) was observed between the indicators of regression of pain symptoms, which were 2.17 and 3.72 points in group I and 0.83 and 2.03 points in group II, respectively. CONCLUSION: The use of a novel hydrolysate collagen formulation in the complex treatment and rehabilitation of patients with symptomatic knee osteoarthritis has potential therapeutic effects.

The study reflects the results of comprehensive rehabilitation of professional athletes with fibular tendinopathy. The effectiveness was evaluated based on the indicators of goniometry of the ankle joint at different stages of the rehabilitation process.Objective. To evaluate the effectiveness of the developed comprehensive program of physical rehabilitation with tendinopathy of the fibular tendons.Materials and methods. The study involved 60 professional male athletes with the diagnosis of “fibular tendinopathy” established by ultrasound examination. All patients were randomly divided into two equal groups of 30 people. Group I patients, in addition to the main ones, were assigned specially designed exercises for balance, balance and proprioceptive sensitivity on the Biodex Balance System (BBS) biofeedback system (Biodex Medical Systems, Inc. New York, USA), as well as balancing disksResults. The percentage of reduction in the total amplitude of movement in the ankle joint, that is, its deficiency, statistically significantly differed between the groups. Thus, at the time of examination before the start of treatment, the total amplitude deficit in group I patients was 13.2°, and in group II – 14.0°. At week 6 after the start of treatment, this indicator improved in group I patients and amounted to 3.8°, and in group II – 12.2°.

Background The present-day conservative treatment algorithms of Osgood-Shlatter Disease (OSD) are often inadequate for young athletes because they require extremity immobilization and avoidance of sports, and hence the longer duration of rehabilitation. Therefore, the development of safe and efficacious treatment protocols for young athletes is of great practical importance. The aim of the study The aim of the study was to assess the efficacy and safety of the conservative treatment of Osgood-Schlatter disease in young professional soccer players. Materials and methods Medical records of young soccer players from two different Russian soccer-academies from the period January 2016–July 2019 were analyzed in a retrospective cohort study. Trauma records of young soccer players aged 11–15 years were included in the analysis. Statistical analysis was performed using IBM SPSS Statistics software, 23.0. Descriptive statistics tools were applied for the analysis. Results A total of 280 soccer players were included in the study. The aged ranged between 11 and 15 years. Ten percent of players (n = 28, mean age 12.9 ± 1.3) were diagnosed with OSD during the observation period. The mean OSD treatment duration was 27.3 ± 13.9 days. Bilateral symptoms were observed in 42.9% of cases, and unilateral symptoms in 57.1%. In 53.6% of players, the first manifestation of OSD symptoms was observed during wintertime. All players were training on artificial turf playing fields. Conservative treatment without immobilization was applied to all patients. It included kinesiotherapy for quadriceps muscle lengthening and physiotherapy as well as gradual increase of physical activity. A total of 35.7% of players reported having discomfort upon resuming regular training, which caused some restrictions in exercise. However, the symptoms resolved spontaneously with time. Surgical treatment or complete avoidance of exercise was not used in any of the patients. Conclusion High incidence of OSD was revealed among young soccer players of the leading Russian soccer academies. The OSD most commonly occurred during wintertime. Conservative treatment of OSD—i.e., physiotherapy and kinesiotherapy—enabled disease-free resuming of sports activity for the majority of patients.