Field hockey, a physically demanding Olympic sport, carries a high risk of lower limb injuries, yet data on injury risk in elite field hockey are limited. Functional knee stability is important for injury prevention and a safe return to sport. This study is the first to investigate functional knee stability in elite field hockey, considering gender and playing class, and establishes reference data for functional knee stability by using a standardized test battery that assesses one- and two-legged stability, jumping tests, speed, and agility. Seventy-two elite field hockey players, 30 males and 42 females (age 19.82±3.74 years) were divided into High Playing Class (HPC) and Moderate Playing Class (MPC). HPC players showed significantly better performance in all functional tests except balance tests ( p <0.01-0.024). Females showed significantly better one- and two-leg stability ( p <0.01) with lower injury rates, indicating the relevance of gender considerations. The study emphasizes the importance of balance and stability in the prevention of lower limb injuries in Olympic field hockey and also highlights the importance of considering pre-existing deficits in functional knee capability when assessing athletes for return to sport. These results can help improve athletic performance, identify individual strengths and weaknesses, prevent injury or re-injury, and facilitate return to sport after injury.

To assess the accessibility and content of query Interventional Radiology (IR) fellowship program websites and determine the impact of these websites on applicants.All IR fellowship programs were individually evaluated, and all IR fellowship applicants to our institution were surveyed.In 2015, 44.3% of programs had an appropriate functional link to the fellowship website. Most provided a program description and application information. In our survey, applicants reported that website quality was moderately important to their overall impression of a fellowship. The most important aspects were didactics and facilities information.Fellowship website content and quality are important to applicants.

Inline skater hockey is a sport originating from ice hockey, which is practised in Germany by about 6000 athletes. There are some differences to ice hockey, which lead to a special risk profile of the athletes.All 315 active players of the First German Inline Skater Hockey League in the years 2018 and 2019 were contacted to participate in an online survey. The subjects of the study completed an anonymised 83-item multiple-choice questionnaire about injuries, training frequency, training content, and sports equipment. 178 athletes responded and 116 questionnaires could be analysed (100 men, 8 women, 8 without information/16 goalies, 55 forwards, 44 defenders).The overall injury incidence was 36.98 per 1000 hours. Minor injuries (wounds, bruises, and blunt muscle injuries) most frequently comprised leg injuries (9.4/1000 hours) and arm injuries (7.2/1000 hours). Relevant injuries (fractures, dislocations, and ligamentous injuries) were most common to the foot (2.4/1000 hours) (n=147) and to the head (1.9/1000 hours) (n=140) and knee (1.7/1000 hours) (n=126). Of 76 fractures, 48 (63.2%) resulted from direct or indirect body contact. Goalkeepers suffered more knee injuries compared with field players, while field players sustained more shoulder injuries. Head injuries (fractures, dental injuries, traumatic brain injuries) were significantly more frequent in players without face protection (3.0/1000h vs. 1.8/1000h). Players who did not perform additional fitness training had significantly more relevant injuries. In this group, knee injuries occurred more frequently as well (4.2/1000h vs. 1.3/1000h). The duration of stretching exercises showed a negative correlation with overall injury incidence (0 minutes: 53.5/1000 hours, 1-4 minutes: 55.8/1000 hours, 5-9 minutes: 23.5/1000 hours, & GE;10 minutes: 21.5/1000 hours, p < 0.05).In particular, mild injuries occurred with a highly significant reduction in frequency if the subjects performed stretching exercises. Inline skater hockey in the First German League is characterised by a high risk of injury, which can be compared with professional ice hockey. Serious injuries are mainly caused by physical contact. Relevant injuries are most common to the head and lower extremity. The implementation of fitness training had a positive influence on the frequency of injuries. In the context of further professionalisation of this sport, these findings can contribute to the prevention of injuries in inline skater hockey.

Bone-tendon junctions are prone for acute trauma due to its structural weakness, especially in premature males. For the lower limb, the most eminent area is the tibial tubercle apophysis. Osgood Schlatter disease (OSD) due to repetitive trauma or epiphyseal fractures due to one trauma is well described in literature and known in pediatric practice. Traumatic distal patella tendon ruptures on the other hand are a typical injury of the knee extensor mechanism of mature patients in the fourth decade. Here, the very rare condition of fracture of the tibial tubercle apophysis with simultaneous rupture of the distal patellar tendon of a 15 year old soccer player with previous history of OSD is presented including a review of the recent literature.

Purpose Orthopaedic scores are essential for the clinical assessment of movement disorders but require an experienced clinician for the manual scoring. Wearable systems are taking root in the medical field and offer a possibility for the convenient collection of motion tracking data. The purpose of this work is to demonstrate the feasibility of automated orthopaedic scorings based on motion tracking data using the Harris Hip Score and the Knee Society Score as examples. Methods Seventy-eight patients received a clinical examination and an instrumental gait analysis after hip or knee arthroplasty. Seven hundred forty-four gait features were extracted from each patient’s representative gait cycle. For each score, a hierarchical multiple regression analysis was conducted with a subsequent tenfold cross-validation. A data split of 70%/30% was applied for training/testing. Results Both scores can be reproduced with excellent coefficients of determination R 2 for training, testing and cross-validation by applying regression models based on four to six features from instrumental gait analysis as well as the patient-reported parameter ‘pain’ as an offset factor. Conclusion Computing established orthopaedic scores based on motion tracking data yields an automated evaluation of a joint function at the hip and knee which is suitable for direct clinical interpretation. In combination with novel technologies for wearable data collection, these computations can support healthcare staff with objective and telemedical applicable scorings for a large number of patients without the need for trained clinicians.

Background:Return to sport testing is an established routine, especially for athletes who have ruptured their anterior cruciate ligament (ACL). Various tests are performed, often combined in test batteries, such as the Back-in-action (BIA) test battery. Unfortunately, pre-injury performance is often unknown, and only few athletes pass the high demands of these test batteries. Purpose:The aim of the study was to determine the performance of under 18 American football players on the BIA to establish pre-injury sport specific benchmarks for future RTS testing and to compare these values to data from an age-matched reference group. Methods:Fifty-three healthy male American football players underwent a functional assessment using the "Back-in-action" test battery evaluating agility, speed (Parkour-Jumps and Quick-Feet test), balance (using a PC based balance board), and power (Counter-Movement-Jump [CMJ]) as objective measures. Their results were compared with a previously tested reference group (RP) and within the american football players (AF) through three subgroups according to field playing position. Results:Overall, the American football (AF) athletes showed lower balance scores for both legs (AF: 3.71/3.57/3.61; RP: 3.4/3.2/3.2; p<0.002) compared to the reference population (RP). CMJ height and Quick-Feet results were not statistically different (p>0.05), Parkour-Jump times (AF: 8.18/ 8.13 sec.; RP: 5.9/5.9sec.; p<0.001) were significantly slower. Power output in all CMJ's (AF: 46.86/36.94/37.36 W/kg; RP: 43.2/29.5/29 W/kg; p<0.001) was significantly higher than the RP. Passing and running game involved players (G2 & G3) showed significantly better balance scores (G2+G3: 3.36/3.27/3.33; G1: 4.22/4.06/4.10; p<0.001), higher jump height (G2&G3: 38.87/24.02/24.96 cm; G1: 32.03/19.50/18.96 cm; p<0.001) and more watts/kg (G2&G3: 48.83/37.21/37.64 W/kg; G1: 43.95/36.88/36.53 W/kg; p<0.001) compared to blocking players like Linemen (G1) and to the age matched reference population (RP). Conclusion:Only 53% of the healthy athletes would have been cleared for sport using the BIA test criteria, which highlights the challenging passing criteria. Despite significantly greater power measurements, scores of balance and agility were poorer compared to the reference group, especially for linemen. These data may serve as sport and position specific reference for high school American football players, instead of using the non-specific reference group data. Study design:cross-sectional study. Level of evidence:IIb.

ZusammenfassungInline-Skaterhockey ist eine aus dem Eishockey entstandene Sportart, die in Deutschland von ca. 6000 Sportlern ausgeübt wird. Es gibt allerdings einige Unterschiede zum Eishockey, die zu einem besonderen Risikoprofil der Athleten führen.Alle 315 aktiven Spieler der deutschen Inline-Skaterhockey-Bundesliga 2018 und 2019 wurden online mittels eines anonymisierten Fragebogens über Verletzungen, Trainingshäufigkeit, Trainingsinhalte und Sportausrüstung angeschrieben. 178 Athleten antworteten und 116 Fragebögen konnten ausgewertet werden (100 Männer, 8 Frauen, 8 keine Angabe/16 Goalie, 55 Stürmer, 44 Verteidiger).Die Gesamtverletzungsinzidenz lag bei 36,98 pro 1000h. Unter den leichten Verletzungen (Wunden, Prellungen und stumpfe Muskelverletzungen) waren Beinverletzungen (9,4/1000h) und Armverletzungen (7,2/1000h) am häufigsten. Relevante Verletzungen (Frakturen, Luxationen und Bandverletzungen) waren am häufigsten am Fuß (2,4/1000h) (n=147) sowie am Kopf (1,9/1000h) (n=140) und am Knie (1,7/1000h) (n=126). Von 76 Frakturen entstanden 48 (63,2%) durch direkten oder indirekten Körperkontakt. Torhüter haben im Vergleich zu Feldspielern mehr Knieverletzungen, allerdings haben Feldspieler mehr Schulterverletzungen. Kopfverletzungen (Frakturen, Zahnverletzungen, Schädelhirntraumata) zeigten sich bei Spielern ohne Gesichtsschutz signifikant häufiger (3,0/1000h vs. 1,8/1000h). Spieler, welche kein zusätzliches Fitnesstraining durchführten, zeigten signifikant mehr relevante Verletzungen. Auch Knieverletzungen waren in dieser Gruppe häufiger(4,2/1000h vs. 1,3/1000h). Die Dauer der Dehnübungen zeigt eine negative Korrelation mit der Gesamtverletzungsinzidenz (0min: 53,5/1000h, 1–4min: 55,8/1000h, 5–9min: 23,5/1000h, ≥10min: 21,5/1000h, p<0,05). Insbesondere leichte Verletzungen werden durch Dehnübungen hochsignifikant seltener. Inline-Skaterhockey in der 1. Bundesliga zeichnet sich durch ein hohes Verletzungsrisiko aus, welches mit dem professionellen Eishockey verglichen werden kann. Schwerwiegende Verletzungen entstehen im Inline-Skaterhockey am häufigsten durch Körperkontakt. Relevante Verletzungen kommen am häufigsten am Kopf und an der unteren Extremität vor. Die Durchführung von Fitnesstraining zeigte einen positiven Einfluss auf die Verletzungshäufigkeit. Im Rahmen der weiterführenden Professionalisierung des Sportes können diese Erkenntnisse zur Prävention von Verletzungen im Inline-Skaterhockey beitragen.

This paper presents a wearable harmonic radar system for biomechanical joint angle estimation to be used in medical rehab applications. Active frequency doubling reflector tags are placed on a patient's limbs and get detected by a dual receive channel harmonic radar front end. Target-tracking is realized by use of a motion-model based estimator with minimal quadratic error association. Range and angle estimation is performed by bilateration of individual channel target tracks. The resulting positional data is to be used as input for a model-based physiological joint angle estimation, which is not part of this paper. The system is tested on a healthy subject performing gait with multiple strides at a comfortable pace. The positional tracking is compared to equivalent data captured by a marker-based optical motion capturing system, which is the gold standard for gait analysis.

Abstract The return to sport after knee injury is challenging. This is burdensome for sports with a high incidence of injuries, such as team handball. Various tests guide decision making, but often the athlete’s preinjury performance of these measures remains unknown. Moreover, objective return-to-sport criteria of a matching population are missing. The purpose of this study was to evaluate objective measures of knee capability in handball depending on players’ age. Two hundred sixty-one handball players performed a functional test battery designed to evaluate knee capability after an anterior cruciate ligament injury: two- and one-legged stability analysis, jumps, speed tests, and agility assessments. For age-specific evaluation, athletes were divided into three age groups (16–19; 20–29;≥30 years). Male players showed differences in two and one-legged jumping height (p<0.02) as well as power per body weight (p<0.01) between age groups. Young female players reached better results in two-and one-legged stability. Besides the quick feet test, results of females did not differ between age groups. Functional knee stability in healthy handball players is partly influenced by age, and females show better results in stability and male athletes in power measurements. This aspect should be considered for return to sports testing and underlines the importance of performance measures in athletic testing.

Bone substitutes have been applied to treat osseous defects for a long time. To prevent implant related infection (IRI) and enhance bone healing functionalized biomaterials, antibiotics and osteoinductive substances have been introduced. This study gives an overview of the current available surface-coated bone substitutes and provides an outlook for future perspectives.

AbstractHandball is one of the most traumatic sports. The knee is the most commonly injured joint. To prevent knee injuries, optimal functional knee stability is of great importance. Nevertheless, there is still no consensus about objective criteria for knee function. Depending on playing class, injury rates seem to differ. The purpose of this study was to evaluate knee function in handball depending on playing class and to establish reference data for functional knee stability. 261 handball players (25.1±5.8 years) performed a functional test including two- and one-legged stability assessments, jump tests, speed and agility analysis. Except for balance, differences between playing classes were detected in all tests with superior performance of high-class players (Germany’s 1st (“Oberliga”) and 2nd (“Verbandsliga”) non-elite playing class). High-class players achieved significant better results in jumping height (p≤0.011–0.029), relative power per body weight in the two-legged counter movement jump (p≤0.023) and speed and agility tests (p≤0.001). This study illustrates the relevance of playing class specific screening. Sports and playing class-specific databases will help to identify individual deficits and strengths in order to prevent injury and increase performance. Moreover, objective criteria for return to sports can be established.

ZusammenfassungVerschiedene Untersuchungen in den vergangenen Jahren haben gezeigt, dass innerhalb der Ballsportarten Handballspieler einem besonders hohen Verletzungsrisiko ausgesetzt sind. Dabei ist das Kniegelenk die am häufigsten verletzte Körperregion und ein Riss des vorderen Kreuzbandes die häufigste Verletzung am Knie. Um Folgeschädigungen oder erneuten Verletzungen vorzubeugen, ist eine gute situative Kniestabilität entscheidend. Diese kann nicht nur Verletzungen vorbeugen, sondern ist auch ausschlaggebend für die Optimierung handballspezifischer Bewegungsabläufe und eine verletzungsfreie Ausübung des Sports. Obwohl es zahlreiche Studien zu Verletzungen im Handball gibt (meist an Profisportlern durchgeführt), ist das Forschungsfeld in Bezug auf die situative Kniestabilität defizitär. Dieser Beitrag gibt einen Überblick über den aktuellen Forschungsstand. Zudem werden aktuelle Präventionsansätze aufgegriffen und diskutiert.

Handball zählt nicht nur zu den beliebtesten Sportarten, sondern auch zu den verletzungsreichsten. In den deutschen Profiligen ist die Anzahl der Verletzungen pro Spieler höher als im Fußball. Zudem ist das Kniegelenk, neben Verletzungen der Finger, bei Handballern das am häufigsten verletzte Gelenk. Um Knieverletzungen vorzubeugen, ist daher eine optimale funktionelle Kniestabilität von großer Bedeutung. Referenzwerte im Handball zur Beurteilung dieser fehlen jedoch bisher. Ziel der Studie ist die Erhebung erster handballspezifischer Referenzwerte mittels einer etablierten funktionellen Testbatterie. Aufgrund variierender geschlechterspezifischer Verletzungsraten im Handballsport wird zudem hypothesiert, dass sich die funktionelle Kniestabilität von weiblichen und männlichen Athleten unterscheidet. Insgesamt nahmen 261 Handballspieler (w:130; m:131) im Alter von 25,1 ± 5,8 Jahren an der Studie teil. Diese absolvierten eine funktionelle Testbatterie, bestehend aus sieben Sporttauglichkeitsübungen: beid- und einbeinige Stabilitätsübungen, beid- und einbeinige Sprunganalysen, einbeinige Agilitäts- und beidbeinige Schnelligkeitstests. Die Ergebnisse zeigen Unterschiede bezüglich der funktionellen Kniestabilität zwischen weiblichen und männlichen Athleten. Während Frauen im Bereich der beid- und einbeinigen Stabilisationsübungen bessere Score-Werte erreichen (p ≤ 0,001), erzielen männliche Spieler bessere Ergebnisse bei Messung der Sprungkraft, Agilität und Schnelligkeit (p ≤ 0,002–0,001). Die aktuelle Arbeit verdeutlicht die Relevanz von interindividuellen Unterschieden bei der Verwendung von Referenzwerten zur kniebezogenen Leistungsfähigkeit im Handballsport. Diese Referenzwerte sollten dazu dienen, mögliche individuelle Leistungsdefizite zu erkennen und Verletzungen vorzubeugen. Sport- und geschlechterspezifische Datenbanken sollen zukünftig dazu beitragen, objektivierbare und damit reliablere Kriterien zur Sport- und Wettkampftauglichkeit zu entwickeln.

Despite the great evolvement of sports medicine, there is still a lack of consensus among sports physicians regarding the decision of return to sports after knee injury, especially in non-elite sports. Currently, no sport-specific reference data for an objective reliable evaluation of functional knee stability exist. The purpose of this study was to assess objective measures on knee joint stability from an established test battery in non-elite handball. It was assumed that players’ knee stability differs depending on their field position. One-hundred and sixty-five non-elite handball players with a mean age of 24.3 ± 5.5 years underwent a test battery including two-legged and one-legged stability tests, two-legged and one-legged counter movement jumps, two-legged plyometric jumps, one-legged speedy jumps, and a quick feed test. Athletes’ physical performance differs in terms of field position. Significant differences between handball players of different positions were found in regard to two-legged stability (p < 0.036) and one-legged stability in the dominant leg (p < 0.009). Players of different positions differed in ground contact time of the plyometric jumps (p < 0.017), whereas the other functional tests did not show significant differences. This study is first to report differences in functional knee stability of non-elite handball players on the basis of objective data. Significant differences of functional performance were noted, which were in congruence with position-specific demands. These findings demonstrate the importance of position-specific screening and training to prevent injuries. II.

Osteoarthritis (OA) is the most frequently diagnosed joint disorder worldwide with increasing prevalence and crucial impact on the quality of life of affected patients through chronic pain, decreasing mobility and invalidity. Although some risk factors, such as age, obesity and previous joint injury are well established, the exact pathogenesis of OA on a cellular and molecular level remains less understood. Today, the role of nitrosative and oxidative stress has not been investigated conclusively in the pathogenesis of OA yet. Therefore, the objective of this study was to identify biological substances for oxidative and nitrosative stress, which mirror the degenerative processes in an osteoarthritic joint. 69 patients suffering from a diagnosed knee pain participated in this study. Based on the orthopedic diagnosis, patients were classified into an osteoarthritis group (OAG, n=24) or in one of two control groups (meniscopathy, CG1, n=11; anterior cruciate ligament rupture, CG2, n=34). Independently from the study protocol, all patients underwent an invasive surgical intervention which was used to collect samples from the synovial membrane, synovial fluid and human serum. Synovial biopsies were analyzed histopathologically for synovitis (Krenn-Score) and immunohistochemically for detection of end products of oxidative (8-isoprostane F2α) and nitrosative (3-nitrotyrosine) stress. Additionally, the fluid samples were analyzed for 8-isoprostane F2α and 3-nitrotyrosine by competitive ELISA method. The analyzation of inflammation in synovial biopsies revealed a slight synovitis in all three investigated groups. Detectable concentrations of 3-nitrotyrosine were reported in all three investigated groups without showing any significant differences between the synovial biopsies, fluid or human serum. In contrast, significant increased concentrations of 8-isoprostane F2α were detected in OAG compared to both control groups. Furthermore, our data showed a significant correlation between the histopathological synovitis and oxidative stress in OAG (r=0.728, P<0.01). There were no significant differences between the concentrations of 8-isoprostane F2α in synovial fluid and human serum. The findings of the current study support the hypothesis that oxidative and nitrosative stress are components of the multi-factory pathophysiological formation of OA. It seems reasonable that an inflammatory process in the synovial membrane triggers the generation of oxidative and nitrosative acting substances which can lead to a further degradation of the articular cartilage. Based on correlations between the observed degree of inflammation and investigated biomarkers, especially 8-isoprostane F2α seems to be a novel candidate biomarker for OA. However, due to the finding that also both control groups showed increased concentrations of selected biomarkers, future studies have to validate the diagnostic potential of these biomarkers in OA and in related conditions of the knee joint.

BACKGROUND:Wear debris is a major factor in aseptic loosening of total hip arthroplasty. Ultra high molecular weight polyethylene inlays are known for significant wear, and the following generation, highly cross-linked polyethylene (HCLPE), has shown promising in vitro and short-term in vivo results. This study aimed to investigate wear debris of HCLPE liners with ceramic heads after 9 years to reveal the in vivo wear kinetics of this common bearing combination. METHODS:Fifty-seven patients (72 hips; 46.5 ± 15.5 years; range 16-76 years) who underwent hip arthroplasty with an HCLPE liner (28- or 32-mm Biolox forte ceramic head) were followed up (mean 9.1 ± 2.4 years; range 3.9-13.8 years). Conventional anteroposterior X-rays were analyzed using Hip Analysis Suite software. RESULTS:Volumetric wear had a mean of 38.67 ± 22.09 mm3/year, 333.08 ± 183.93 mm3 overall, and linear wear was 0.063 ± 0.03 mm/year and 0.546 ± 0.27 mm overall. Male patients had a significantly higher wear rate (46.42 ± 27.68 mm3/year) and total wear (400.71 ± 235.21 mm3). Larger femoral heads had a significantly higher wear rate (43.10 ± 23.93 mm3/year) and total wear (364.23 ± 203.68 mm3). Regression analysis showed a significant cubic relationship (R2 = 0.307) with increasing yearly wear after approximately 108 months postoperatively. CONCLUSIONS:HCLPE liners show significant in vivo wear after 9 years. While the total wear compared to ultra high molecular weight polyethylene liners was decreased, the wear kinetics show a comparable course. The increase in wear rate after only 108 months postoperatively is especially alarming. Longer term follow-up is needed to distinguish the long-term superiority of HCLPE liners in polyethylene-ceramic paired hip arthroplasty.

PURPOSE:Ischemic preconditioning (IPC) is known to reduce muscle damage induced by ischemia and reperfusion injury during surgery. Because of similarities between the pathophysiological formation of ischemia and reperfusion injury and eccentric exercise-induced muscle damage (EIMD), as characterized by an intracellular accumulation of Ca, an increased production of reactive oxygen species, and increased proinflammatory signaling, the purpose of the present study was to investigate whether IPC performed before eccentric exercise may also protect against EIMD. METHODS:Nineteen healthy men were matched to an eccentric-only (ECC; n = 9) or eccentric proceeded by IPC group (IPC + ECC; n = 10). The exercise protocol consisted of bilateral biceps curls (3 × 10 repetitions at 80% of the concentric one-repetition maximum). In IPC + ECC, IPC was applied bilaterally at the upper arms by a tourniquet (200 mm Hg) immediately before the exercise (3 × 5 min of occlusion, separated by 5 min of reperfusion). Creatine kinase (CK), arm circumference, subjective pain (visual analog scale score), and radial displacement (tensiomyography, maximal radial displacement) were assessed before IPC, preexercise, postexercise, and 20 min, 2 h, 24 h, 48 h, and 72 h postexercise. RESULTS:CK differed from baseline only in ECC at 48 h (P < 0.001) and 72 h (P < 0.001) postexercise. After 24, 48, and 72 h, CK was increased in ECC compared with IPC + ECC (between groups: 24 h, P = 0.004; 48 h, P < 0.001; 72 h, P < 0.001). The visual analog scale score was significantly higher in ECC at 24-72 h postexercise when compared with IPC + ECC (between groups: all P values < 0.001). The maximal radial displacement was decreased on all postexercise days in ECC (all P values < 0.001) but remained statistically unchanged in IPC + ECC (between groups: P < 0.01). CONCLUSIONS:These findings indicate that IPC performed before a bout of eccentric exercise of the elbow flexors blunts EIMD and exercise-induced pain while maintaining the contractile properties of the muscle.

The tensiomyography (TMG) technique is increasingly used to determine muscle contractile properties in exercise and injury management. The present study investigated the informative value of TMG parameters in correlation with commonly used (creatine kinase, CK; myoglobin, Mb) and novel candidate biomarkers of muscle damage (heart-type fatty acid-binding protein, h-FABP; high-mobility group box 1, HMGB1).

Objective: Mixed martial arts (MMA) is a combination of multiple combat sports. Acute injuries in MMA are well known and have been broadly described. However, there is little knowledge about degenerative changes in the musculoskeletal system. The aim of this study was to investigate the impact of techniques used in MMA on the occurrence of degenerative changes in the hand and wrist in comparison to classical boxing. Methods: 11 MMA fighters and 10 boxers with chronic wrist pain were clinically examined. Age, weight, years of training, number of fights, level of competition and weekly hours of training were recorded. To determine degenerative changes, an MRI of the symptomatic hand was assessed. Results: Years of training, level of competition and number of fights did not show a significant difference between MMA and boxing fighters (p > 0.05), but MMA fighters showed significantly more hours of training per week (p < 0.001). The MMA fighters had more often and more severe degenerative changes of all examined structures (bone, fibrocartilage, ligaments and tendons), with the category "bone" reaching significance (p = 0.002). Conclusion: MMA athletes show significantly greater incidence and degree of degeneration in hand and wrist joints. The exact reasons are still unknown and further research is needed to determine the influence of MMA techniques on the severity of degenerative changes in the hand and wrist.