Biology of Sport
eISSN: 2083-1862
ISSN: 0860-021X
Biology of Sport
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2/2023
vol. 40
 
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abstract:
Review paper

Management of proximal rectus femoris injuries – do we know what we’re doing?: A systematic review

Lone Bogwasi
1
,
Louis Holtzhausen
1, 2, 3
,
Dina Christa Janse van Rensburg
1, 4
,
Audrey Jansen van Rensburg
1
,
Tanita Botha
5

  1. Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
  2. Aspetar Orthopedic and Sports Medicine Hospital, Weill-Cornell Medical College; Qatar
  3. Department of Exercise and Sports Sciences, University of the Free State, Bloemfontein, South Africa
  4. Medical Board Member, World Netball, Manchester, UK
  5. Department of Statistics, Faculty of Natural and Agricultural Sciences, University of Pretoria, Pretoria, South Africa
Biol Sport. 2023;40(2):497–512
Online publish date: 2022/07/21
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Rectus femoris (RF) injury is a concern in sports. The management RF strains/tears and avulsion injuries need to be clearly outlined. A systematic review of literature on current management strategies for RF injuries, and to ascertain the efficacy thereof by the return to sport (RTS) time and re-injury rates. Literature search using Medline via PubMed, WorldCat, EMBASE, SPORTDiscus. Eligible studies were reviewed. Thirty-eight studies involving hundred and fifty-two participants were included. Majority (n = 138; 91%) were males, 80% (n = 121) sustained RF injury from kicking and 20% (n = 31) during sprinting. The myotendinous (MT), (n = 27); free tendon (FT), (n = 34), and anterior-inferior iliac spine (AIIS), (n = 91) were involved. Treatment was conservative (n = 115) or surgical (n = 37) across the subgroups. 73% (n = 27) of surgical treatments followed failed conservative treatment. The mean RTS was shorter with successful conservative treatment (MT: 1, FT: 4, AIIS avulsion: 2.9 months). Surgical RTS ranged from 2–9 months and 18 months with labral involvement. With either group, there was no re-injury within 24 months follow-up. With low certainty of evidence RF injury occurs mostly from kicking, resulting in a tear or avulsion at the FT and AIIS regions with or without a labral tear. With low certainty, findings suggest that successful conservative treatment provides a shortened RTS. Surgical treatment remains an option for failed conservative treatment of RF injuries across all subgroups. High-level studies are recommended to improve the evidence base for the treatment of this significant injury
keywords:

rectus femoris, avulsions, return, treatment

 
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