Sprain

This research aims to compare two surgical methods for treating hip labral tears, a condition affecting the cartilage around the hip joint. The study focuses on patients with femoroacetabular impingement and traumatic labral tears to evaluate which treatment may lead to better hip function and pain relief. The trial is a randomized, double-blind comparison conducted by Ain Shams University. Participants will undergo hip arthroscopy under general anesthesia, where surgeons will use two portals to access the hip joint under fluoroscopic guidance. Patients will be randomly assigned to receive either arthroscopic labral repair, which uses suture anchors to fix the tear, or arthroscopic labral debridement, which involves removing damaged tissue using electrocautery. Both procedures address any labral, cartilage, or bony issues present during surgery. Participants' hip function and pain levels will be assessed before surgery and at 1, 3, and 6 months, as well as at 1 year after the procedure, using the Hip Outcome Score, Harris Hip Score, and Visual Analog Scale. These evaluations will help measure changes in hip function and pain over time. The study follows patients for a total of one year after surgery to monitor recovery and outcomes.

Ankle sprains are a common injury, especially among children and adolescents, leading to prolonged pain and delayed return to normal activities. This trial investigates whether using a smartphone app for children and young adults with acute ankle inversion injuries improves functional outcomes such as pain, mobility, and return to activity compared to standard paper handouts. The study focuses on guidance tailored to pain management and recovery, aiming to overcome the limitations of current one-size-fits-all care approaches. Participants will be randomly assigned to one of two groups: one group will use a smartphone app that provides education, daily reminders on pain management including medication and exercises, and collects pain and functional scores at several timepoints up to 14 days. The other group will receive standard care through paper-based discharge instructions and will use a data collection app only for recording outcomes. The app-based group receives interactive support, while the standard care group receives the same information in printed form. During the study, participants will record pain levels and functional abilities using standardized scales on days 3, 5, 7, 10, 12, and 14 after discharge. Researchers will monitor pain management methods, range of motion exercises, and time to return to pre-injury function. The primary outcome is the Activities Scale for Kids-performance version score on day 7 post-discharge. The study includes children and young adults aged 12 to 30 years and involves assessments focused on recovery progress and safety over the two-week period.

Researchers are investigating a new approach to improve rehabilitation outcomes for patients with ankle instability, particularly among those who have experienced ankle sprains. This trial compares standard physical therapy alone to physical therapy combined with training on a rocky, uneven terrain treadmill, aiming to better prepare patients for real-world challenges and reduce the risk of future ankle injuries. The study will include adults aged 18 to 49 who have chronic ankle instability or recent ankle sprains. Participants will be randomly assigned to one of two groups: one receiving up to twelve sessions of progressive proprioceptive training on an uneven treadmill over about six weeks plus standard physical therapy, and the other receiving only standard physical therapy for the same period. The uneven treadmill activities may include varied walking speeds, inclines, head turning, vision challenges, multitasking, and load carrying, all adjusted by therapists based on individual tolerance and benefit. Both groups will be followed for 18 months to monitor progress and reinjury. Throughout the study, participants will undergo multiple assessments, including patient-reported outcome tools like the Cumberland Ankle Instability Tool and Foot and Ankle Ability Measure, as well as performance tests and biomechanical evaluations such as muscle activation and plantar pressure measurements. These evaluations will occur at baseline, during treatment, at discharge around six weeks, and at several follow-up points up to 18 months. Researchers will track ankle function, physical activity levels, pain, fear of movement, and reinjury rates to understand the effects of the interventions.

Musculoskeletal disorders and injuries cause significant disability worldwide, affecting people of all ages and leading to pain, limited mobility, and reduced quality of life. This ongoing open-label, single-arm phase I/IIa study is evaluating the safety of a human allogeneic bone marrow-derived mesenchymal stromal cell product called StromaForte in patients with musculoskeletal injuries and/or degeneration. The study aims to assess safety and changes in pain over one year after treatment with these stem cells. Participants receive 50 million StromaForte cells locally injected under ultrasound guidance at the injury or degeneration site, combined with or without 100 million cells given intravenously over about 30 minutes. If local injection is not possible, only the systemic intravenous treatment is given. Additional doses may be administered with specified minimum intervals between local and systemic doses. Four subgroups based on connective tissue injury or degeneration type are included. During the study, patients are monitored for adverse events up to one year after treatment. Researchers assess pain levels in each injured or degenerated area, quality of life measures using questionnaires, and changes in pain between treatment subgroups. Follow-up can be face-to-face or remote. This comprehensive evaluation will provide data on safety and patient-reported outcomes following StromaForte administration for musculoskeletal conditions.

Researchers are evaluating the feasibility of a randomized trial comparing perioperative single-shot adductor canal block (ACB) with standard general anesthesia without regional block in children and adolescents aged 10 to 18 undergoing arthroscopic anterior cruciate ligament (ACL) reconstruction. The study aims to determine if ACB improves quality of recovery as measured by the Quality of Recovery-15 questionnaire at several postoperative time points. Secondary questions include whether ACB reduces opioid use, shortens post-anesthetic care unit stay, improves pain scores, and increases patient satisfaction. Participants will be randomly assigned to receive either a single-shot ACB with ropivacaine and dexmedetomidine after induction of general anesthesia or no nerve block, with all other care standardized between groups. The nerve block is performed under ultrasound guidance. Patients in the non-block group will have a dressing placed to maintain blinding. Follow-up visits occur at postoperative days 2, 14, and 42. During the study, participants and caregivers will complete the Quality of Recovery-15 questionnaire and pain rating scales on the day of surgery and at follow-up calls or clinic visits. Satisfaction ratings will be collected at postoperative day 42 using a 5-item scale. Researchers will also monitor opioid consumption, post-anesthetic care unit time, and any hospital admissions until day 42. Enrollment feasibility will be assessed based on recruitment rates over a 12-month period.

Researchers are evaluating whether accelerated flap coverage within 72 hours of injury reduces infection-related complications compared to standard flap coverage timing in patients with severe open fractures and/or dislocations below the knee. This randomized controlled trial addresses an important uncertainty in care for these injuries, aiming to provide clear evidence to guide treatment timing and improve patient outcomes. The study includes adult patients 18 years and older who require acute flap coverage for their injury. Participants will be randomly assigned to receive either flap surgery within 72 hours of injury or flap surgery at the standard timing practiced at their medical center. The choice of flap type and management after surgery will be decided by the treating surgeons and recorded. Both groups will have their fracture or dislocation managed according to usual care. Follow-up visits are scheduled at 6 weeks, 3 months, 6 months, and 12 months after randomization to monitor progress. During the study, researchers will assess a combined primary outcome at 6 months that includes overall survival, limb amputation due to injury, re-operations for infection or flap issues, and days spent in acute hospital care. Secondary outcomes include these individual measures at 6 and 12 months, as well as patient-reported quality of life and satisfaction. Safety events will be reviewed regularly by a monitoring committee to ensure participant well-being throughout the trial.

Researchers are evaluating the immediate and short-term effects of the Graded Motor Imagery (GMI) method on people with chronic ankle instability (CAI). This study aims to understand how GMI influences pain levels, muscle stiffness, muscle strength, functional performance, and the feeling of ankle instability. The effects of this intervention will be compared with a control group of healthy individuals matched by age and sex. The GMI program involves six consecutive days of training with three progressive stages: Laterality Training, where participants perform ankle discrimination tasks using images; Motor Imagery, where they mentally rehearse ankle movements without actual motion; and Mirror Therapy, using a mirror to create a visual illusion of normal movement of the unaffected ankle. These stages are designed to improve motor control and proprioception. Participants will undergo assessments at the start and one week after the intervention to measure subjective instability using the Cumberland Ankle Instability Tool (CAIT), ground reaction force and static balance via ForceDecks, muscle stiffness with Myoton PRO, muscle strength using an isokinetic dynamometer, pain levels, and functional performance. The study includes safety monitoring and comparison between the ankle instability group and healthy controls, with the total participation duration covering the intervention and follow-up assessments.

Non-combat-related muscle, tendon, and bone injuries are common among military personnel, especially new recruits, affecting readiness and causing significant medical costs. This research investigates how hormonal changes, specifically sex hormones like testosterone and estrogen, influence muscle, tendon, and bone function as well as physical and psychological performance under stress. The study aims to improve military physical training and reduce injuries by understanding these hormonal effects. Participants will be assigned to different groups including a control group maintaining normal habits and a stress exposure group undergoing a 4-week military-style physical training program. Some men and women in the stress group will receive medications to suppress natural hormone production and then receive hormone replacement or a placebo. Treatments include a GnRH agonist injection and topical testosterone gels or estrogen/progesterone patches, with dosing varying by group and sex. Throughout the approximately 8-week study, participants will undergo measurements such as muscle and tendon imaging, body composition analysis, blood tests for hormone and biochemical markers, and physical and mental performance evaluations. Researchers will monitor changes in these outcomes over time to assess the effects of hormone suppression and replacement on musculoskeletal resilience and adaptation to stress.

Researchers are comparing a new sensorimotor ankle rehabilitation training (SMART) protocol with the standard of care (SOC) for people who have recently experienced lateral ankle sprains (LAS). The study aims to see if the SMART approach leads to better one-year outcomes, including fewer re-injuries and improved overall health. This research addresses the need for better rehabilitation strategies and understanding of patient recovery after neuromusculoskeletal injuries like LAS. The study includes two groups: one receiving the standard care focused on restoring ankle range of motion, strength, and balance, and the other receiving the SMART intervention, which builds on standard care by adding sensorimotor training to improve sensory inputs, motor outputs, and their integration. Participants will be randomly assigned to either group and will begin treatment shortly after their injury. Participants will be assessed when cleared to return to full activity and again at 6 and 12 months after return. Evaluations include clinical outcomes like ankle function, quality of life, physical activity, balance, range of motion, and rates of re-injury. The study also measures innovative markers of central nervous system function and ankle joint health. This follow-up helps researchers determine the success of the rehabilitation approaches over one year.

Chronic ankle instability (CAI) commonly develops after a lateral ankle sprain and causes symptoms like ankle "giving way," weakness, and instability that can limit daily activities and sports. Up to 40% of people who sprain their ankle may experience recurrence within a year, with around 30% developing persistent symptoms. This study investigates which of three muscle strengthening programs—ankle-focused, hip-focused, or combined ankle-hip—best improves function, strength, balance, and ankle mobility in people with CAI aged 18 to 35 years. Participants are randomly assigned to one of three groups after a baseline assessment. Each group completes a four-week program with three supervised sessions per week using isometric exercises measured by a handheld dynamometer. The ankle program targets plantarflexion, dorsiflexion, inversion, and eversion; the hip program targets hip abductors, external rotators, and extensors; and the combined program alternates these exercises. Each session includes a warm-up, familiarization, and high-intensity isometric contractions. Participants attend three assessment visits: before training, immediately after the four-week program, and at a follow-up time point. Assessments include functional questionnaires, sports participation reports, and tests of ankle and hip muscle strength, endurance (Heel Rise Test), balance (Modified Y-Balance Test), agility (Side Hop Test), and ankle dorsiflexion mobility (Weight-Bearing Lunge Test). Data are securely stored anonymized for 20 years, and participation is voluntary with the option to withdraw at any time.