Background:Shoulders of throwing and swimming athletes are highly stressed joints that often show structural abnormalities on magnetic resonance imaging (MRI). However, while water polo players exhibit a combination of throwing and swimming movements, a specific pattern of pathological findings has not been described.Purpose:To assess specific MRI abnormalities in shoulders of elite water polo players and to compare these findings with a healthy control group.Study Design:Cross-sectional study; Level of evidence, 3.Methods:After performing a power analysis, volunteers were recruited for this study. Both shoulders of 28 semiprofessional water polo players and 15 healthy volunteers were assessed clinically (based on the Constant score) and had bilateral shoulder MRIs. The shoulders were clustered into 3 groups: 28 throwing and 28 nonthrowing shoulders of water polo athletes and 30 shoulders of healthy control subjects.Results:Twenty-eight male water polo players with an average age of 24 years and 15 healthy subjects (30 shoulders) with an average age of 31 years were examined. Compared with controls, significantly more MRI abnormalities in the water polo players' throwing shoulders could be found in the subscapularis, infraspinatus, and posterior labrum (P = .001, P = .024, and P = .041, respectively). Other structures showed no statistical differences between the 3 groups, including the supraspinatus tendon, which had abnormalities in 36% of throwing versus 32% of nonthrowing shoulders and 33% of control shoulders. All throwing shoulders showed abnormal findings in the MRI, but only 8 (29%) were symptomatic.Conclusion:The shoulders of semiprofessional water polo players demonstrated abnormalities in subscapularis and infraspinatus tendons that were not typical abnormalities for swimmers or throwing athletes.Clinical Relevance:The throwing shoulders of water polo players have specific MRI changes. Clinical symptoms do not correlate with the MRI findings.

Zusammenfassung OperationszielKorrektur einer Valgusdeformität im Metatarsophalangealgelenk zur Verbesserung der Gehfähigkeit und des Aussehens des Fußes sowie zur Erleichterung der Schuhversorgung. IndikationenHallux-valgus-Fehlstellungen bis 40° mit Sesambeinluxation. Hallux rigidus. KontraindikationenDurchblutungsstörungen des Vorfußes. Entzündliche Veränderungen im Operationsgebiet. OperationstechnikResektion des proximalen Drittels der Großzehengrund-phalanx. "Einpfropfen" des gelenktragenden Resektats in die Markhöhle der Grundphalanx. Die Sesambeine werden reponiert. Die Plantaraponeurose wird transossär an die Grundphalanx fixiert. Korrektur der Valgusdeformität durch Raffung der medialen Gelenkkapsel. WeiterbehandlungMobilisation mit halbsteifer Sohle unter Vollbelastung. Tägli-che passive und nach Abklingen der Schmerzen aktive Bewegungsübungen der Großzehe. Übergang auf normales Schuhwerk mit Vollbelastung ab der 6. postoperativen Woche. ErgebnisseIm Zeitraum von 1983 bis 1998 (durchschnittliche Nachbeobachtungszeit 7,4 Jahre) wurden 93 Füße (91%) mit 102 operierten Großzehen nachkontrolliert. Komplikationen: zwei Nekrosen des Metakarpalköpfchens, sieben Rezidive im Sinne eines Korrekturverlusts. Die präoperative Sesambeinluxationrate lag bei 77% (n = 72), in der Langzeitnachkontrolle bei 21% (n = 21). Außerdem zeigten sich ein Korrekturverlust des Hallux-valgus-Winkels von 8° und ein Verlust der Korrektur des Intermetatarsalwinkels von 2°. 56% der Patienten beurteilten das Ergebnis mit sehr gut, 29% mit gut, 14% mit zufrieden stellend und 1% mit schlecht. Abstract ObjectiveCorrection of valgus deformity of the first metatarsophalangeal joint to improve gait and appearance and to facilitate wearing of shoes.

Introduction Handball is a contact sport which involves throwing and jumping, exposing players to serious physical stress. There is a high risk of injuries leading to possible long-term sequelae. The aim of this study was to assess the incidence of musculoskeletal injuries in elite male handball players compared with an age-matched control group. Patients and methods Former elite handball players, who had played on the Swiss national team between 1980 and 1985, answered a questionnaire about injuries, surgical interventions and their current health status. A total of 34 athletes were compared with 58 age-matched volunteers, who only engaged in recreational sports or no sports at all. Results The mean age of the athletes was 58.4 years (range 52–68 years) and did not differ significantly from the mean age of the control group of 58.7 years (range 53–69 years). In the control group, 70 % engaged in recreational sports. There was no statistical difference regarding the life-long incidence of shoulder injuries and surgical interventions, sequelae or persistent shoulder pain. Athletes had more interventions after elbow injuries (0.09 vs. 0, p = 0.047), but the difference with respect to chronic pain or late sequelae was not statistically significant. For knee injuries, there were no significant differences regarding the incidence of injuries or interventions, the prevalence of secondary consequences or persistent pain. Concerning the foot and ankle, there was a significantly higher incidence of injuries (0.5 vs. 0.03, p < 0.001) and interventions (0.5 vs. 0.09, p < 0.001) in athletes, but no statistical difference regarding sequelae or persistent pain. Overall quality of life had identical ratings in both groups (athletes mean 85.9 %, controls mean 85.8 %). Discussion Top handball players did not sustain more shoulder or knee injuries than the age-matched control group. The elbow was more at risk in these top athletes, but long-term consequences appeared to be less severe. The most distinctive difference was seen in foot and ankle injuries. Conclusions A career as an elite handball player had no adverse effect on the overall quality of life of elite handball players 25 to 30 years after retiring from professional sports.

The editorial team greatly appreciates the reviewers who have dedicated their considerable time and expertise to the journal's rigorous editorial process over the past 12 months, regardless of whether the papers are finally published or not. In 2019, a total of 317 papers were published in the journal, with a median time to first decision of 22 days and a median time from submission to publication of 55 days. The editors would like to express their sincere gratitude to the following reviewers for their generous contribution in 2019:Abbas, Azhar

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