Condylar Osteophyte Research Articles

Prevalence of serum vitamin D and B12, Ca, P, Mg levels and rheumatoid factor status in the patients with bilateral TMJ-OA and their correlations with clinical and radiological findings

ABSTRACT Objective To evaluate the prevalence of serum vitamin D and B12, calcium, phosphorus, magnesium levels, and rheumatoid factor (RF) status in patients with bilateral temporomandibular joint osteoarthritis (TMJ-OA) and their correlations with clinical and radiological findings. Methods The clinical and radiologic findings and serum vitamin and mineral levels of 90 patients diagnosed with bilateral TMJ-OA were recorded. Descriptive statistics and the Spearman’s Rho correlation test were performed. Results Low serum vitamin D and B12 levels were detected in 82 (91.1%) and 74 (82.2%) patients. Calcium and phosphorus levels were seen at low rates. RF status was recorded as unfavorable in all patients. Correlations were found between age and the serum vitamin and mineral levels, except phosphorus. Low serum vitamin D levels correlated with pain complaints at rest and painless MIO. Serum B12 levels correlated with condylar erosion. Serum magnesium levels correlated with painful MIO and condylar osteophyte. Conclusion Patients with bilateral TMJ-OA showed a high prevalence of low serum vitamin D and B12 levels.

Effects of Posterior Femoral Condylar Osteophytes Removal on Range of Motion in Primary Total Knee Arthroplasty

Objective: To see the effects of posterior femoral condylar osteophytes removal on range of motion in primary total knee arthroplasty.Study Design: Quasi-experimental studyPlace and Duration of Study: Department of Orthopedics, Combined Military Hospital, Rawalpindi Pakistan, from Dec 2020 to Sep 2021.Methodology: We studied 78 patients [18 males (23.0%) and 60 females (76.9%)]. All of these patients were followed for threemonths. The primary outcome was knee range of motion at 03 months following treatment. Following total knee arthroplasty,the knee range of motion was measured using a goniometer. Results: The mean age of the patient was 63.05±4.98 years. The knee range of motion showed that the effect of posteriorosteophyte removal significantly improved at one-month, 2-months, and 3-months of follow-up. At the one-month follow-up,the average knee range of motion was 10.29±3.06 degrees to 95.69±2.87 degrees. At the three-months follow-up, the knee rangeof motion was 0±0.54 degrees to 110.47±3.12 degrees. Conclusion: Total knee arthroplasty aims to improve quality of life by reducing knee pain and improving function. Range ofmotion is an important part of knee function. This study showed that measurements improved at each follow-up. Removing osteophytes in primary knee arthroplasty positively influenced the range of motion.

Clinical Relevance of Posterior Osteophyte Formation in Ultra-congruent Total Knee Arthroplasty: Midterm Radiographic Rollback and Impingement Analysis.

Posterior femoral condylar osteophytes were frequently observed in patients with the ultra-congruent (UC) deep-dish design prosthesis. Therefore, the purpose of the present study was to verify the clinical relevance of osteophyte formation in the UC design. From March 2014 to February 2018, a comparative study was conducted on 96 knees using the UC design. They were divided into 2 groups (group 1: osteophyte +, group 2: osteophyte -). Intraoperative findings, indirect femoral rollback assessment using 30° flexion and active full flexion lateral radiographs, serial change of the osteophyte, and outcomes were compared. The mean follow-up period was 49.35 ± 3.47 months in group 1 and 47.52 ± 3.37 months in group 2. Posterior component coverage was significantly different between the groups: group 1 exhibited more underhang and group 2 exhibited more overhang (p = 0.022). On the indirect assessment of the femoral rollback, there was a statistically significant difference in deep flexion and change in distance (p < 0.001 and p < 0.001, respectively). There was no statistical difference between the 2 groups in the American Knee Society knee and function score, and group 2 showed significant improvement in pain compared to group 1 in Western Ontario and McMaster University Arthritis Index pain score (p = 0.029). Posterior condylar osteophyte formation was related to posterior impingement. It was more frequently observed in the underhang of the femoral component and insufficient femoral rollback. In addition, it changed with time and caused negative effects, including a gradual decrease in flexion and more pain.

Imaging signs of temporomandibular joint osteoarthritis in an urban population of 65-year-olds: a cone beam computed tomography study.

Symptoms of osteoarthritis (OA) in the temporomandibular joint (TMJ) may vary and possible causes should be further explored, such as prevalence and characteristics of imaging features. Investigate prevalence, gender differences and characteristics of imaging signs of TMJ-OA by cone beam computed tomography (CBCT) in a population-based sample of 65-year-old Oslo citizens. 159 (86 women, 73 men) individuals randomly recruited from a cohort of 460 Oslo citizens were examined with CBCT. The TMJs were categorized as with imaging signs of OA, no OA or indeterminate for OA. CBCT signs of TMJ-OA were found in 35 % of the 159 participants: 47% of the women and 22% of the men. CBCT signs of TMJ-OA were unilateral in two-thirds of the TMJs and characterized by articular surface flattening and condylar osteophytes. In almost all joints with bone erosive findings, bone productive findings were also found. Participants with and without CBCT signs of TMJ-OA showed no significant difference in TMD pain screener. Fourteen of the 159 participants (9%) had pain-related TMD and 12 (8%) had been in contact with health care services due to TMD. CBCT signs of TMJ-OA was common in this study group of 65-year-old Oslo citizens, found in every second woman and every fifth man. Articular surface flattening and bone productive changes, in particular condylar osteophytes, were the most frequent imaging features. Despite the high frequency of CBCT signs of TMJ-OA, few of the participants had pain-related TMD.

Is magnetic resonance imaging or cone beam computed tomography alone adequate for the radiological diagnosis of symptomatic temporomandibular joint osteoarthritis? A retrospective study

This study was performed to compare the diagnostic accuracy of cone beam computed tomography (CBCT) alone and magnetic resonance imaging (MRI) alone in patients with clinical symptoms of temporomandibular joint osteoarthritis (TMJ-OA). Fifty-two patients (83 joints) with clinical signs of TMJ-OA were included in the study. Two examiners evaluated CBCT and MRI images. McNemar and kappa tests and Spearman’s correlation analysis were applied. Radiological findings of TMJ-OA were detected in all 83 joints on CBCT or MRI . Seventy-four joints (89.2%) were positive for degenerative osseous changes on CBCT. MRI findings were positive in 50 joints (60.2%). Osseous changes were found in 22 joints, joint effusion in 30 joints, and disc perforation/degeneration in 11 joints on MRI. CBCT was more sensitive than MRI in detecting condylar erosion (P = 0.001), osteophyte (P = 0.001), and flattening (P = 0.002) and flattening of the articular eminence (P = 0.013) . Poor agreement (κ = −0.21) and weak correlations were found between CBCT and MRI. The study findings suggest that CBCT is superior to MRI in evaluating osseous changes of TMJ-OA, and that CBCT is more sensitive than MRI in detecting condylar erosion, condylar osteophyte, and flattening of the condyle and articular eminence.

Arthroscopic Osteophyte Resection for Osteophyte-Induced Popliteal Impingement

Popliteal tendinitis causes lateral knee pain. A cause is impingement of the popliteal tendon by lateral femoral condylar osteophytes. Conservative and surgical treatments have been reported; however, popliteal impingement is a relatively rare disease, and no treatment has been established. Reduction of mechanical stress is important in the treatment of impingement syndromes. The popliteal tendon is an important tissue that contributes to knee stability and, therefore, usually cannot be transected. On the other hand, osteophyte resection may allow the reduction of mechanical stress. Therefore, we describe an arthroscopic osteophyte resection technique for the treatment of osteophyte-induced popliteal impingement. In brief, this technique involves confirmation of popliteal impingement, osteophyte resection using an osteotome, smoothening of the resected area, and confirmation of the resolution of popliteal impingement.

Effect of sctence information regulator 3 on temporomandibular joint osteoarthritis

Temporomandibular joint osteoarthritis (TMJOA) is a common subclass of temporomandibular disorders, with complicated causes and limited treatment. In addition to inflammatory reaction, structural changes of temporomandibular joint (TMJ) as condylar osteophyte formation, sclerosis, erosion, and subchondral bone cysts will happen at the same time. At present, it is found that epigenetic regulation can affect the growth and development of TMJ and regulate the immune inflammatory reaction, so we can speculate that epigenetic modification is involved in the occurrence and development of TMJOA. This paper reviews the researches of silence information regulator 3 (SIRT3), which is a key factor in epigenetics, in the field of osteoarthritis and rheumatoid arthritis.In order to discuss the effect of SIRT3 on the growth and development of TMJ by mediating acetylation modification, such as bone, cartilage, synovium and blood vessels, as well as alleviating osteoarthritis and synovitis. By doing this, the understanding of TMJOA can be enriched, with the goal of finding a new possibility for the clinical treatment of TMJOA.

Treatment of condylar osteophyte in temporomandibular joint osteoarthritis with muscle balance occlusal splint and long-term follow-up: A case report

BACKGROUNDCondylar osteophytes, a remodeling form of temporomandibular joint osteoarthritis (TMJ OA), mainly manifest as marginal angular outgrowths of the condyle. Previous researchers have advocated surgical removal of condylar osteophytes. Reports on the effect of occlusal splint on TMJ OA patients’ joints have mostly focused on treatment with this splint, which can reduce the absorption of the affected condyle and promote repair and regeneration. However, the effect of the splint on the dissolution of condylar osteophytes has not yet been reported.CASE SUMMARYA 68-year-old female patient suffered from occlusal discomfort with left facial pain for 2 years. Cone beam computed tomography showed a rare osteophyte on top of her left condyle. She was finally diagnosed with TMJ OA. The patient refused surgical treatment and received conservative treatment with a muscle balance occlusal splint. The pain experienced by the patient on the left side of her face was relieved, and her chewing ability recovered after treatment. The osteophyte dissolved, and the condylar cortex remained stable during long-term follow-up observations.CONCLUSIONThe muscle balance occlusal splint could be a noninvasive means of treating condylar osteophytes in TMJ OA patients.

EVALUATION OF THE TEMPOROMANDIBULAR JOINT OSSEOUS CHANGES IN PATIENTS WITH ANTERIOR OPEN BITE: A RETROSPECTIVE STUDY

<h3>Background</h3> The temporomandibular joint (TMJ) has an important role in different human functions, including speech, mastication, and breathing. It has been found that osseous changes in the TMJ may stem from skeletal deformities of the head and neck. <h3>Objective(s)</h3> The aim of this study was to evaluate osseous changes in the TMJs of patients with an anterior open bite skeletal deformity using cone beam computed tomography (CBCT). <h3>Study Design</h3> Thirty-two female patients with skeletal anterior open bite and 32 age-matched normal females (skeletal class I) were included in this study. CBCT images were retrieved from the archives. In the CBCT scans, the presence of condylar deformities, including erosion, sclerosis, flattening, and condylar osteophytes, in addition to shape of condyle head in the sagittal and coronal view, were recorded. Moreover, inclination and height of the articular eminence were measured. Data were analyzed in SPSS version 24 software (SPSS Inc., Chicago, IL), with a confidence interval of 95%. <h3>Results</h3> The frequency of condylar head and articular eminence erosion was significantly higher in patients with open bite in comparison with the normal group (<i>P</i> < .05). A significant association was observed between the condylar head shape and the presence of open bite deformity in the coronal view, with the number of angular condylar shape being higher than that in the normal group (<i>P</i> < .05). In addition, inclination and height of the articular eminence was significantly higher in the normal group in comparison with the open bite group (<i>P</i> < .05). <h3>Discussion/Conclusions</h3> According to the present findings, osseous changes in the TMJ exist in patients with anterior open bite skeletal deformity. It was found that the shape of condyle was related to the presence of skeletal anterior open bite.

Effects of posterior condylar osteophytes on gap balancing in computer-assisted total knee arthroplasty with posterior cruciate ligament sacrifice

ObjectiveGap planning in navigated total knee arthroplasty (TKA) is a critical concern. Osteophytes are normally removed prior to gap planning, with the exception of posterior condylar osteophytes of the femur, which are removed after posterior condylar resection. This study investigated how posterior condylar osteophytes affect gap balancing during surgery.MethodsThis prospective study was conducted on 40 primary varus osteoarthritic knees with a posterior condylar osteophyte that underwent TKA navigation. For all knees, computed tomography (CT) was performed to evaluate osteophyte position. The extension gap and flexion gap were determined under navigation using a tension device with a distraction force of 44 lb. The extension gap and flexion gap were measured before and after osteophyte removal.ResultsThis study revealed that the average osteophyte thickness after removal was 7.75 ± 5.34 mm. The average extension gap change was 0.64 ± 0.80 mm, and the average flexion gap change was 0.85 ± 1.12 mm. With respect to increases in the medial extension gap, lateral extension gap, medial flexion gap and lateral flexion gap, the average effects of posterior condylar osteophyte removal were 0.74 ± 0.81 mm, 0.53 ± 0.96 mm, 0.71 ± 0.97 mm and 1.00 ± 1.41 mm, respectively. Posterior condylar osteophyte thickness was also significantly associated with increases in the lateral extension gap (R2 = 0.107, p = 0.03), medial flexion gap (R2 = 0.101, p = 0.04) and lateral flexion gap (R2 = 0.107, p = 0.04).ConclusionThese results indicated that posterior condylar osteophytes of the femur affect gap balancing during TKA navigation.

The stiff knee: Causes and cures

Gender, race, age, BMI, and pre-operative motion have been correlated with post-operative motion after TKA. Surgical techniques to achieve full motion include appropriate sizing and positioning of the implants, proper gap balancing and soft tissue release, removal of posterior condylar osteophytes, and adequate tibial slope. Patient education, pain management, and participation in post-operative rehabilitation are also important. If adequate motion is not achieved, then manipulation can be helpful particularly up to 3 months after surgery. Once scar tissue is more mature, 6 months to a year after surgery, arthroscopy to resect arthrofibrotic scar is an appropriate option. For stiffness beyond 1 year after surgery revision, TKA can be expected to result in modest improvement in motion, but pain relief may be quite variable.

Flexion-extension gap changes during total knee arthroplasty: effect of posterior cruciate ligament and posterior osteophytes removal.

Flexion and extension gap heights were measured in 50 consecutive primary posterior-stabilized total knee arthroplasties (TKAs) to determine whether posterior cruciate ligament (PCL) release or re-establishment of the posterior condylar recess increased gap width. After PCL release, a slight symmetrical increase was noted in both gaps. In extension, gap width increased on average 1.3 mm and 1 mm in the medial and lateral compartments, respectively. The same pattern was observed in flexion, averaging 1.3 mm medially and 1.3 mm laterally. Another increase in the two gaps was observed after the posterior condylar osteophytes were removed and the posterior recess was re-established. The gaps in extension increased, with respect to the base-line value, on average 1.8 mm medially and 1.8 mm laterally, whereas flexion increased an average 2 mm medially and 2.2 mm laterally. No statistical differences were noted between flexion and extension gaps. No independent differences between the flexion and extension gaps were found in any surgical phase. Posterior cruciate ligament removal and re-establishment of posterior condylar recess does not require additional consideration in gap balancing during posterior-stabilized TKA.

One-year clinical course following visually guided irrigation for chronic closed lock of the temporomandibular joint

This study aimed to explore the clinical course following visually guided irrigation (VGIR) for chronic closed lock (CCL) of the temporomandibular joint (TMJ) as well as the factors of importance for clinical outcome. Evaluation emphasis was placed on the period needed for the patients to reach the success criteria. Sixty-one patients with unilateral CCL comprised the study group. The cumulative success rate of VGIR and the additional surgical treatments following VGIR were studied. The 61 patients were divided into either the good outcome (g) group or poor outcome (p) group on the basis of whether they reached the success criteria within 3 months postoperatively, and clinical and arthroscopic factors were correlated with the clinical outcome of VGIR. The cumulative success rate of VGIR increased up to the 6-month follow-up (success rate of 72.1%) but did not change after that point in time. A repeated VGIR (success rate of 87.5%) was performed in 8 patients. Open TMJ surgery (success rate of 87.5%) was performed in 8 patients, 7 of whom had an interfering condylar osteophyte. A pronounced reduction of preoperative painless range of mandibular motion (P-ROM) and advanced osteoarthritis (OA) were more frequently found in the p-group than in the g-group. The multivariate adjusted odds ratio showed that a decreased preoperative P-ROM was significantly predictive for a poor outcome of VGIR. The efficacy of VGIR is clinically acceptable as an initial surgical treatment for TMJ CCL. A 6-month follow-up period ought to be sufficient for outcome assessment of VGIR. A pronounced reduction of preoperative P-ROM should be considered as a risk factor for delay of the postoperative improvement, and OA changes may sometimes affect the clinical outcome of VGIR.

Arthroscopic treatment of popliteus tendon dysfunction following total knee arthroplasty

Following total knee arthoplasty, the popliteus tendon may cause a “snap” when it rolls over a retained lateral femoral condylar osteophyte or when it subluxates over the posterior condyle of the femoral component. When this condition is painful and fails to respond to conservative treatment, arthroscopic release of the popliteus tendon has been beneficial

Popliteus tendon dysfunction following total knee arthroplasty

The popliteus tendon can be a potential source of internal derangement after total knee arthroplasty. It can subluxate anteriorly and posteriorly over a retained lateral femoral condylar osteophyte or over the overhanging edge of the metallic posterior femoral condyle. Surgical release of the tendon from its femoral insertion relieves the problem.