Aleksey V. Sankov

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: to summarize all clinically significant factors determining the Achilles tendon predisposition to rupture.Materials and methods: the basis of this scientific-analytical review was the analysis of data from the electronic portals PubMed-NCBI, Google Academy, and “Scientific electronic e-Library.ru”.Results: the presented literature review indicates that injuries and ruptures of the Achilles tendon can be provoked by numerous factors, among which genetic predisposition, individual anatomico-morphological features of the tendon complex structure, initial connective tissue failure, pathological changes in the Achilles tendon structure itself, foot and ankle deformities are of great importance. Men are more susceptible to this injury. Tendon injuries are most common either in 30–40 years, or in the period from 60 to 80 years. Professional athletes and people who lead sedentary lifestyles and do not exercise properly are at risk of Achilles tendon ruptures. Concomitant metabolic disorders and use of some medications also play an important role in the predisposition to this injury. Local corticosteroid injections pose a particular tendon rupture risk. The combination of several established factors significantly increases the likelihood of this emergency.Conclusions: early detection of predisposition to Achilles tendon rupture will allow timely development of effective measures for its prevention in physical training and sports.