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ObjectiveInvestigate sex/gender differences in self-reported activity and knee-related outcomes after anterior cruciate ligament (ACL) injury.DesignSystematic review with meta-analysis.Data sourcesSeven databases were searched in December 2021.Eligibility criteriaObservational or interventional studies with self-reported activity (including return to sport) or knee-related outcomes after ACL injury.ResultsWe included 242 studies (n=123 687, 43% females/women/girls, mean age 26 years at surgery). One hundred and six studies contributed to 1 of 35 meta-analyses (n=59 552). After ACL injury/reconstruction, very low-certainty evidence suggests females/women/girls had inferior self-reported activity (ie, return to sport, Tegner Activity Score, Marx Activity Scale) compared with males/men/boys on most (88%, 7/8) meta-analyses. Females/women/girls had 23%–25% reduced odds of returning to sport within 1-year post-ACL injury/reconstruction (12 studies, OR 0.76 95% CI 0.63 to 0.92), 1–5 years (45 studies, OR 0.75 95% CI 0.69 to 0.82) and 5–10 years (9 studies, OR 0.77 95% CI 0.57 to 1.04). Age-stratified analysis (20.0%). Very low-certainty evidence suggests females/women/girls experienced inferior knee-related outcomes (eg, function, quality of life) on many (70%, 19/27) meta-analyses: standardised mean difference ranging from −0.02 (Knee injury and Osteoarthritis Outcome Score, KOOS-activities of daily living, 9 studies, 95% CI −0.05 to 0.02) to −0.31 (KOOS-sport and recreation, 7 studies, 95% CI −0.36 to –0.26).ConclusionsVery low-certainty evidence suggests inferior self-reported activity and knee-related outcomes for females/women/girls compared with males/men/boys after an ACL injury. Future studies should explore factors and design targeted interventions to improve outcomes for females/women/girls.PROSPERO registration numberCRD42021205998.

ObjectiveTo investigate the prognostic capacity of individual hop tests, hop test batteries and other unilateral functional performance tests following anterior cruciate ligament (ACL) injury.DesignSystematic review with meta-analysis.Data sourcesSix databases searched up to June 2021.Eligibility criteriaStudies reporting associations between unilateral lower-limb function (eg, hop tests) following ACL injury and future (≥3 months) knee-related outcomes.ResultsOf 42 included studies (13 150 participants), all assessed the single-forward hop test and 32 assessed a repeated-forward hop test (crossover hop, triple hop, 6m-timed hop), mostly within a year after ACL injury/reconstruction. Results of meta-analyses indicated that higher single-forward and repeated-forward hop limb symmetry were associated with higher odds of return-to-sport 1–3 years post-ACL reconstruction (OR 2.15; 95% CI 1.30 to 3.54; OR 2.11; 95% CI 1.23 to 3.60, respectively). Higher single-forward and repeated-forward hop limb symmetry was associated with better self-reported symptoms and function 1–37 years after ACL injury (OR 2.51; 95% CI 1.62 to 3.88; OR 4.28; 95% CI 1.65 to 11.08, respectively). Higher limb symmetry on a repeated-forward hop does not appear to be associated with higher odds of successful rehabilitation without ACL reconstruction (OR 1.51; 95% CI 0.94 to 2.44). Achieving ≥90% limb symmetry on the single-forward hop was associated with reduced odds of knee osteoarthritis 5–37 years after ACL injury (OR 0.46; 95% CI 0.23 to 0.94).ConclusionVery low certainty evidence suggests single-forward and repeated-forward hop tests are prognostic indicators for important knee-related outcomes in individuals after ACL injury and may help stratify individuals at risk of poor outcomes to target rehabilitation interventions.PROSPERO registration numberCRD42018092197.

IntroductionAnterior cruciate ligament injury and reconstruction (ACLR) is often associated with pain, functional loss, poor quality of life and accelerated knee osteoarthritis development. The effectiveness of interventions to enhance outcomes for those at high risk of early-onset osteoarthritis is unknown. This study will investigate if SUpervised exercise-therapy and Patient Education Rehabilitation (SUPER) is superior to a minimal intervention control for improving pain, function and quality of life in young adults with ongoing symptoms following ACLR.Methods and analysisThe SUPER-Knee Study is a parallel-group, assessor-blinded, randomised controlled trial. Following baseline assessment, 184 participants aged 18–40 years and 9–36 months post-ACLR with ongoing symptoms will be randomly allocated to one of two treatment groups (1:1 ratio). Ongoing symptoms will be defined as a mean score of 4) subscales covering pain, symptoms, function in sports and recreational activities and knee-related quality of life. Participants randomised to SUPER will receive a 4-month individualised, physiotherapist-supervised strengthening and neuromuscular programme with education. Participants randomised to minimal intervention (ie, control group) will receive a printed best-practice guide for completing neuromuscular and strengthening exercises following ACLR. The primary outcome will be change in the KOOS4from baseline to 4 months with a secondary endpoint at 12 months. Secondary outcomes include change in individual KOOS subscale scores, patient-perceived improvement, health-related quality of life, kinesiophobia, physical activity, thigh muscle strength, knee function and knee cartilage morphology (ie, lesions, thickness) and composition (T2 mapping) on MRI. Blinded intention-to-treat analyses will be performed. Findings will also inform cost-effectiveness analyses.Ethics and disseminationThis study is approved by the La Trobe University and Alfred Hospital Ethics Committees. Results will be presented in peer-reviewed journals and at international conferences.Trial registration numberACTRN12620001164987.

Background: Knee magnetic resonance imaging (MRI) is increasingly used to inform clinical management. Features associated with osteoarthritis are often present in asymptomatic uninjured knees; however, the estimated prevalence varies substantially between studies. We performed a systematic review with meta-analysis to provide summary estimates of the prevalence of MRI features of osteoarthritis in asymptomatic uninjured knees. Methods: We searched six electronic databases for studies reporting MRI osteoarthritis feature prevalence (i.e., cartilage defects, meniscal tears, bone marrow lesions, osteophytes) in asymptomatic uninjured knees. Summary estimates were calculated using random-effects meta-analysis (and stratified by mean age

Department for Health, University of Bath, Bath, UK. Master of Science (MSc) in Sport and Exercise Medicine (SEM) and MSc in Sports Physiotherapy (both by distance/blended on-line learning). A Masters qualification in SEM or Sports Physiotherapy provides the foundation for specialisation. The Master’s graduate gains a considerable depth of academic knowledge, clinical skills and experience while also honing his or her understanding of professional practice and service development.1 Such expertise is increasingly demanded of clinicians who work with high-performance athletes, such as those competing in national and Olympic teams.2 Both MSc programmes (SEM and Sports Physiotherapy) are delivered in an integrated way under the stewardship of the current Director of Studies, Dr Polly McGuigan. She is supported by experienced Clinical Directors for SEM (Dr Julian Widdowson) and Sports Physiotherapy (Beenish Kamal) and approximately 15 other experienced academics and clinicians. The MSc in SEM is only open to medical doctors and the MSc to qualified physiotherapists. A strength of …

School of Public Health, Physiotherapy and Sports Science, University College Dublin (UCD), Dublin, Ireland Master of Science (MSc) in Sports Physiotherapy A Masters in Sports Physiotherapy provides physiotherapists with a recognised postgraduate qualification and mastery of foundation concepts and skills that are becoming increasingly important factors facilitating employability and mobility in sports and exercise medicine internationally. Such specialised knowledge and clinical skills enable the development of new and clearer frameworks for clinical, managerial and intellectual thinking and understanding, and is the definitive professional recognition of clinical expertise.1 The MSc in Sports Physiotherapy is aimed at Irish and international physiotherapists with at least 2 years of clinical experience wishing to develop a specialised career in sports and exercise-related physiotherapy (table 1). The programme is the longest running sports physiotherapy MSc in Ireland with a continuous student intake since 2003. The programme is directed by Dr Ulrik McCarthy Persson who has worked …

School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK. Master of Science (MSc) in Exercise and Sports Medicine (Football). Sports medicine within football in the UK and throughout the world remains a developing specialty. Although the medical team generally ranks poorly in the hierarchy of elite-level football teams, team success is highly influenced by injuries and player health.1 With a particular focus on football medicine, the MSc in Exercise and Sports Medicine at the University of Birmingham enables demonstration of advanced practice in football medicine and leadership within a multidisciplinary team providing clinical management in football, and enhancing employability in this, and the wider, sports medicine setting.2 Setting itself apart from other Sports and Exercise Medicine postgraduate programmes, the MSc in Exercise and Sports Medicine (Football) is delivered in partnership with the Football Association, English football’s governing body. The MSc programme has been developed for UK and international physiotherapists and medical doctors working within, or interested in moving into, football medicine. The MSc …

> Building a place where all physiotherapists can freely unite, collaborate, learn and contribute to improving global health — Rachael Lowe, Physiopedia Director Physiopedia is a free online resource of physiotherapy knowledge, collaboratively written and edited by physiotherapists (http://www.physio-pedia.com). Essentially Wikipedia for physiotherapists, Physiopedia uses an innovative Wiki platform enabling any qualified physiotherapist from anywhere around the globe to contribute and edit content. It is built around collaborative group authoring, with the aim of gathering the sum of all physiotherapy knowledge and making it freely available to all (including the general public). For the busy sports physiotherapist, Physiopedia offers an abundance of tissue-specific (eg, tendons, muscles) and joint-specific (eg, knee, shoulder) resources in one place at a click of a button, as well as lots of other physiotherapy-related material. Physiopedia receives ~1 million visits per month from over 200 countries, and the more than 2000 knowledge-based pages are updated by physiotherapists on average of 200 times per day. Free online content is made up largely …

International Olympic Committee (IOC). IOC Diploma in Sports Physical Therapies (online-learning). The success of individual athletes and sporting teams relies on players staying healthy, remaining injury free and recovering quickly from medical issues. One only has to look as far as last season's English Premier League, where Leicester City's unlikely success coincided with the league's lowest rate of injuries and least players used,1 to appreciate the importance of keeping athletes fit to compete. In recognition of the key role physical therapists (physiotherapists) and other similar health professionals (eg, athletic trainers) play in the successful prevention and management of sporting injuries,2 the Medical Commission of the IOC launched a new diploma in sports physical therapies in 2015. The programme provides an avenue to specialise in the area of sports physical therapies to ultimately optimise medical care for elite and recreational athletes.3 While its content is based on postgraduate sports physiotherapy courses offered by leading universities, …

FIFA Medical Assessment and Research Centre (F-MARC) in collaboration with FIFA Medical Centres of Excellence. Diploma in Football Medicine (online-learning). ‘Hey Doc, I'll be ok to take this supplement to help me recover quickly for the representative game tomorrow won't I?’ As the local football club medical attendant, the team's top midfielder throws you this question postclub match. How do you respond? Are you responsible for possibly encouraging the use of a banned substance? Where do you find the answer? Enter the Diploma in Football Medicine—a free online course dedicated to help health and medical practitioners to manage common football-related health and injury issues and enhance sports medicine knowledge in conjunction with FIFA's sport-related risk management framework.1 Each football player around the globe sustains an average …

If you want to be around in 10 years you’ve got to do something to differentiate yourself from the pack. Christopher Evans The number of physiotherapists around the world is increasing. Data from the UK show that the number of registered physiotherapists increased by 41% between 2000 and 2009.1 In Canada, a 7.5% increase in the number of registered physiotherapists occurred between 2007 and 2011.2 The increase in the number of undergraduate and graduate entry physiotherapy programmes in Australia has also created higher numbers of qualified physiotherapists.3 While this growth in the international physiotherapy profession is positive, particularly in regard to meeting current and future needs of an ageing global population, a higher number of physiotherapists may create professional and personal challenges. Such challenges likely include greater market competition to attract consumers (ie, patients) in the private sector, and a greater number of candidates applying for particular physiotherapy positions; good for organisations, more difficult for individual …

Institution Cardiff School of Sport, Cardiff Metropolitan University, Cardiff, UK. Course Master of Science (MSc) in Sport and Exercise Medicine. A Master of Sport and Exercise Medicine gives clinicians a deeper understanding of sports medicine, sports injuries and exercise medicine.1 Such specialised knowledge and advanced clinical skills are increasingly required to earn greater responsibility in managing the health of elite and recreational athletes and sporting teams,2 as well as for consulting with key sports governing bodies. The MSc in Sport and Exercise Medicine is a course for British and international medical doctors, chartered physiotherapists and osteopaths seeking a specialist qualification in Sport and Exercise Medicine. Applications from sports rehabilitators, nurses and podiatrists who have appropriate professional registration and sports experience are considered. The Royal College of General Practitioners-accredited programme is directed by Dr Craig Ranson, a Wales Rugby Team Sports Physiotherapist with vast experience working in national elite sports medicine teams and conducting sports injury research and education. An experienced team of sports medicine physicians, exercise and sports scientists, sports physiotherapists and orthopaedic surgeons provide …

The BMJ , in collaboration with the University of California San Francisco (UCSF). Research to Publication e-learning programme. ‘Congratulations, we are pleased to accept your manuscript for publication’—the e-mail notification that every researcher dreams of waking up to. Whether screening large numbers of athletes to identify risk factors for injury or diligently recording return to play outcomes, sports medicine researchers aim to publish, disseminate and implement to enhance outcomes for athletes1 and patients alike. However, as in other areas of health research, there is a problem with sports medicine research—up to 85% of it is going to waste.2 Researchers are not necessarily developing relevant research questions, studies are not always performed with the best methods, many important studies are not published and a lot of research that is published is not reported well.2 Key scientific and ethical requirements for successful publication are a mystery …