Sports Medicine Research Updates

In the NACOX prospective cohort of 272 patients (mean age 25.5 years) with acute ACL injury managed by shared decision-making, nonoperative (non-ACLR) and operative (ACLR) strategies produced similar patient-reported IKDC-SKF scores over 24 months and comparable overall return-to-sport (RTS) rates (72% non-ACLR vs 77% ACLR). Patients managed nonoperatively returned to sport earlier (mean 3.5 vs 8.1 months), and in those aged 26–40 years ACLR was associated with a higher risk of not returning to sport at 24 months (relative risk ~3.15).

Video and tracking analysis of 77 in‑game Achilles tendon ruptures in the NFL (2018–2024) found most ruptures were noncontact (64%) or indirect contact (35%) and occurred at relatively low translational speeds, with three scenarios (change of direction 40%, overload 30%, rock back 27%) accounting for 97% of injuries. Injuries commonly featured the injured leg extended behind the body with ankle dorsiflexion and hip/knee extension; defensive players and those with >3 years’ experience had higher injury rates, and the authors suggest targeting high‑risk movement patterns for prevention.

This systematic review and meta-analysis pooled 15 studies (4183 participants) comparing serum 25-hydroxyvitamin D in military personnel and athletes with stress fractures versus controls. Overall, cases had lower vitamin D (MD -5.82 nmol/L, 95% CI -10.35 to -1.29), with significant differences in military personnel (MD -7.33 nmol/L) and males (MD -9.14 nmol/L) but not in athletes or females. Meta-regression identified baseline vitamin D status as a major source of heterogeneity, and the association was present only in studies where control participants were vitamin D sufficient (MD -13.53 nmol/L).