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Skydiving have gained mainstream popularity over the past decades. However, limited data exist on the injury risk or type associated with skydiving. This systematic review evaluated the injuries and fatalities of civilian skydivers. A PRISMA-guided literature search was performed in MEDLINE, Web of Science, Cochrane Library, and Embase using the following MeSH terms: "skydiving" or "parachute" alone or in combination with "injury" or "trauma" was performed including all studies through June 2022 in both English and German. Additionally, injury reports from the German, American, and British Parachute Associations were reviewed. Of the 277 articles matching the selected search terms, 10 original articles and 34 non-scientific reports from various skydiving associations were included. More than 62 million jumps were evaluated, with an average of 3,200,000 jumps per year, which showed an average injury rate of 0.044% and an average fatality rate of 0.0011%. The most common injuries sustained by recreational skydivers involved the lumbar spine and lower extremities. Injuries were most commonly reported during the landing sequence. With modern equipment and training methods, fatalities occur in less than 1 per 100,000 cases, and serious injuries requiring hospitalization in less than 2 per 10,000 cases. This puts the assessment of skydiving as a high-risk sport into perspective.

Figure skating is associated with a high prevalence of sport-specific injuries and overuse symptoms. Impacts are of greater magnitude in jumps with more revolutions that are thus connected to a greater risk of injury. While figure skating programs seem to have recently increased in difficulty, performance trends have not yet been reported in the literature. We hypothesized increasing performance and decreasing age trends of the best athletes who competed at international level in recent years. Furthermore, we aimed to identify and analyse objective performance parameters and to assess a potential link between age and the risk of injury. The development of the number of double, triple and quadruple jumps in the singles figure skating events at the World and European Championships since the introduction of the new ISU Judging System in the 2004/2005 season was analysed using regression statistics and Student's T-Tests. In all groups, the numbers of jumps with fewer rotations significantly decreased in the favour of jumps with more rotations. Women only started to perform jumps with four rotations in 2019. In the men, the number of quadruple jumps increased from an average of less than one to more than three in recent years (European and World Championships, both p < 0.001). In the European, but not in the World Championships, the average age increased in the men and decreased in the women (European Championships, men and women p = 0.006). Our study was the first to assess performance trends in elite figure skating. The incidence of injuries and overuse syndromes in figure skating needs to be monitored cautiously, as increases can be expected following recent gains in performance and jump complexity., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2022 Rauer et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

In pair skating and ice dance, performance seems to have increased at international competitions, which is potentially associated with changes in athlete age. We hypothesized increasing age, numbers of total points and more complex jumps of the best elite couples at international championships in recent years. Corresponding data were assessed via the results databases of the European and World Championships, as well as the Winter Olympics since 2005. Linear regression statistics were conducted, and significance was assessed via one-way ANOVAs. There were no significant changes in age. Increases in total points were found in both disciplines (World and European Championships both p < 0.001 for both disciplines, Olympics pair skating p = 0.003, ice dance n/a). Significant increases were found in the number of double and triple twist jumps at the European Championships (Double p = 0.046, triple p = 0.041), but not at the World Championships or the Olympics. At the World Championships, single solo jumps decreased ( p = 0.031) in favor of triple jumps, which increased ( p = 0.020), without a similar effect at the European Championships or Olympics. In conclusion, increases in total points and more complex jumps were observed at international championships without associated changes in age. Attention should be given to possible changes in the incidence of acute and overuse injuries following this development.

Treatment strategies for anterior cruciate ligament (ACL) injuries continue to evolve. Evidence supporting best practice guidelines for the management of ACL injury is to a large extent based on studies with low-level evidence. An international consensus group of experts was convened to collaboratively advance towards consensus opinions regarding the best available evidence on operative versus non-operative treatment for ACL injury.The purpose of this study was to report the consensus statements on operative versus non-operative treatment of ACL injuries developed at the ACL Consensus Meeting Panther Symposium 2019. Sixty-six international experts on the management of ACL injuries, representing 18 countries, convened and participated in a process based on the Delphi method of achieving consensus. Proposed consensus statements were drafted by the Scientific Organising Committee and Session Chairs for the three working groups. Panel participants reviewed preliminary statements prior to the meeting and provided initial agreement and comments on the statement via online survey. During the meeting, discussion and debate occurred for each statement, after which a final vote was then held. Eighty per cent agreement was defined a priori as consensus. A total of 11 of 13 statements on operative veresus non-operative treatment of ACL injury reached consensus during the symposium. Nine statements achieved unanimous support; two reached strong consensus; one did not achieve consensus; and one was removed due to redundancy in the information provided.In highly active patients engaged in jumping, cutting and pivoting sports, early anatomical anterior cruciate ligament reconstruction (ACLR) is recommended due to the high risk of secondary meniscus and cartilage injuries with delayed surgery, although a period of progressive rehabilitation to resolve impairments and improve neuromuscular function is recommended. For patients who seek to return to straight plane activities, non-operative treatment with structured, progressive rehabilitation is an acceptable treatment option. However, with persistent functional instability or when episodes of giving way occur, anatomical ACLR is indicated. The consensus statements derived from international leaders in the field will assist clinicians in deciding between operative and non-operative treatment with patients after an ACL injury.Level of evidence: V., Competing Interests: Competing interests: TD, BBR, ADL,ES, EHS, TR, SJM, MVP and JK: none declared. LE: Smith and Nephew: fellowship grant. ORA: Conmed: Speakers Bureau. DJO: honoraria; JWX: Arthrex: consulting fees, non-consulting fees, royalties; Trice Medical: consulting fees; FHF: Smith & Nephew: educational support, hospitality payments. VM: Smith & Nephew: educational support, consulting fees, speaking fee; Arthrex: educational support., (© International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine 2021. Re-use permitted under CC BY-NC. No commercial re-use. Published by BMJ.)

Objectives: A precise and consistent definition of return to sport (RTS) after anterior cruciate ligament (ACL) injury is lacking, and there is controversy surrounding the process of returning patients to sports and their previous activity level. The aim of the Panther Symposium ACL Injury RTS Consensus Group was to provide a clear definition of RTS after ACL injury and description of the RTS continuum, as well as provide clinical guidance on RTS testing and decision-making., Methods: An international, multidisciplinary group of ACL experts convened as part of a consensus meeting. Consensus statements were developed using a modified Delphi method. Literature review was performed to report the supporting evidence., Results: Key points include that RTS is characterised by achievement of the preinjury level of sport and involves a criteria-based progression from return to participation to RTS, and ultimately return to performance. Purely time-based RTS decision-making should be abandoned. Progression occurs along an RTS continuum with decision-making by a multidisciplinary group that incorporates objective physical examination data and validated and peer-reviewed RTS tests, which should involve functional assessment as well as psychological readiness. Consideration should be given to biological healing, contextual factors and concomitant injuries., Conclusion: The resultant consensus statements and scientific rationale aim to inform the reader of the complex process of RTS after ACL injury that occurs along a dynamic continuum. Research is needed to determine the ideal RTS test battery, the best implementation of psychological readiness testing and methods for the biological assessment of healing and recovery., Competing Interests: Competing interests: CF–Karl Storz: IP royalties, paid consultant; Medacta: IP royalties, paid consultant, paid presenter or speaker; Zimmer: Research support. SLS–Arthrex: paid consultant; Smith & Nephew: paid consultant; CONMED: knee design team, paid consultant; Flexion Therapeutics: paid consultant; JRF Ortho: paid consultant; Olympus: paid consultant; Vericel: paid consultant; Zimmer: research support. BPL–Wolters Kluwer Health - Lippincott Williams & Wilkins: publishing royalties, financial or material support. Panther group authorship: Lars Engebretsen–Smith & Nephew grants, editor of JBJS and BJSM. Christopher C Kaeding–grant support from DJO, educational support from CDC medical, consulting fees from Zimmer Biomet, non-consulting fees from Arthrex. Jon Karlsson–Editor-in-Chief KSSTA. Ryosuke Kuroda–grants and personal fees from Smith & Nephew, grants and personal fees from Zimmer Biomet, grants from Stryker Japan KK, grants and personal fees from Johnson & Johnson KK, personal fees from Medacta International, personal fees from Arthrex, personal fees from Japan Tissue Engineering, personal fees from Hirosaki Life Science Innovation, personal fees from Arthrex Japan G.K.Volker Musahl–educational grants from Smith &Nephew and educational grants from Arthrex. Stephen J Rabuck–educational support from Mid-Atlantic Surgical, Siebold - Medacta International personal fees. Carola van Eck–eduational support from Arthrex, Mid-Atlantic Surgical and Smith & Nephew and grant support from DJO and Zimmer Biomet. Dharmesh Vyas–educational support from Mid-Atlantic Surgical, hospitality payments from Arthrex., (© International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine 2021. Re-use permitted under CC BY-NC. No commercial re-use. Published by BMJ.)