Degree Of Joint Degeneration Research Articles

Thermal analysis of the biceps tendon samples obtained from patients underwent reversed shoulder arthroplasty for comminuted proximal humerus fractures

Most commonly occurring in elderly patients, the comminuted 4-part or Neer VI type proximal humerus fractures frequently necessitate complete shoulder replacement. Despite the recent advances in imaging technologies, there is still a need for more information about the degree of joint degeneration and changes of the collagen content of tendons to select the proper implant type. It is known that human long head biceps tendon subjected to synovial inflammation and mechanical wear could result in tear and structural damage. Differential scanning calorimetry has already been demonstrated to be a dependable in the assessment of collagen in degenerative tendon conditions. The purpose of the study was to determine whether variations in thermal parameters detected by DSC are related to the degenerative changes of LHBT samples. LHBT tendons were collected from patients who had reversed shoulder arthroplasty because of trauma. DSC was utilized to measure the thermodynamic changes. Macroscopical, radiological and histological assessment were also performed. Based on the thermal parameters and denaturation curves, LHBT samples collected of patients underwent reversed shoulder arthroplasty due to comminuted proximal humerus fracture have shown minimal or mild degenerative injuries. These data were supported by preoperative radiological examination and histological analysis. The authors suggest that DSC could be a useful investigative tool in the clinical evaluation of tendon injuries.

Arthroscopic Excision of Intra-Articular Osteoid Osteoma of the Hip: A Case Series

1) To identify the clinical features of intra-articular osteoid osteoma (OO) of hip, 2) to evaluate the clinical effect of arthroscopic excision for intra-articular OO.3) to summarize the characteristics of revision cases of hip OO and the revision surgery under arthroscopy on these cases. We retrospectively reviewed the data of 25 patients who underwent arthroscopic excision of hip OO. The case series included 10 patients who underwent revision surgery. Lesion location, presenting symptoms, and symptom duration were analyzed; postoperative improvement was assessed using the modified Harris Hip Score (mHHS) and international Hip Outcomes Tool (iHot-12) scores. We examined the reasons for need of revision surgery and the characteristics of OO progression after the first surgery. The most common presenting symptom was groin pain that was relieved by nonsteroidal anti-inflammatory drugs (NSAIDs). Varying degree of limitation of range of motion (ROM) was present in all patients. The osteosclerosis around the tumor nest in CT scan is a characteristic radiographic feature in this disease. However, the classic radiographic feature was only apparent on plain x-rays in 2 out of 25 patients. As a kind of efficient radiological method, MRI can help in distinguishing OO from femoroacetabular impingement (FAI), as the latter is characterized by a large effusion and bone marrow edema at the atypical site of impingement. For the patients who had only one arthroscopic resection, the mean mHHS and iHot-12 scores were 70.30 ± 9.06 (51-86) and 75.07 ± 7.69 (57-88), respectively. At last follow-up, the mean scores were 98.30 ± 2.15 (94-100) and 97.76 ± 2.04 (94-100). respectively (Table 3). For revision cases, the mean mHHS and iHot-12 scores were 68.55 ± 3.77 (60-72) and 67.88 ± 5.39 (56-76), respectively. At last follow-up, the mean scores were 97.11 ± 2.47 (94-100) and 95.22 ± 1.78 (94-100). respectively. In the present study, 24 of 25 patient (96%) reached the MCID of mHHS and 21 of 22 patients (95.2%) reached the MCID of iHot-12. Among the revision patients, the most common misdiagnosis at first surgery was FAI. Another feature is that a wrong diagnosis or incomplete intra-articular OO resection can stimulate the tumor and cause an inflammatory reaction and rapidly progressive OA, necessitating prompt revision surgery for complete removal. The degree of joint degeneration was related to the time since the first operation. OO of the hip joint typically presents with pain and limited joint activity. Misdiagnosis as FAI or synovitis is common and so that patient who has limit ROM, night pain and can be relieved by NASIDs should be suspected OO, and more advanced radiological evaluation, such as CT scan, should be performed. Arthroscopic excision appears to be an effective method for the treatment of OO of the hip joint. IV, case series.

Correlation between cold pain of knee joint and subchondral bone marrow edema in patients with knee osteoarthritis

To investigate relationship between cold pain of knee joint and subchondral bone marrow edema (BME). From May 2018 to August 2019, 92 patients with knee osteoarthritis (KOA) associated with cold pain of knee were admitted, all patients were underwent MRI examination. The patients were divided into observation group (47 patients with BME) and control group(45 patients without BME). In observation group, there were 6 males and 41 females aged from 36 to 87 years old with an average of (63.2±12.3) years old. In control group, there were 10 males and 35 females, aged from 48 to 84 years old with an average of (62.7±8.3) years old. All patientswere treated with drugs. The degree of joint degeneration was evaluated by Kellgren-Lawrence (K-L) grading. Degree of cold pain of knee was evaluated by knee cold pain score, and degree of BME was evaluated according to WORMS. The correlation between cold pain of knee and K-L grading and BME was analyzed. Score of cold pain in observation group (15.55±7.68) was higher than that of control group (9.42± 5.50), which had significant difference (t=4.383, P<0.001). There was no correlation between cold pain of knee and K-L grading(χ2=2.138, P=0.907). There was correlation between BME grading and degree of cold pain in observation group(χ2=19.709, P<0.001), and Spearman correlation coefficient was rs=0.509(P<0.001). The cold pain of KOA patients is not related to K-L grading, but corelate with BME grading. The Cold pain of knee was more pronounced in KOA patients with BME, and the severity of BME is often related to degree of cold pain. It seemed to be a tendency:the more serious BME, the heavier coldpain.

Periacetabular osteotomy for hip dysplasia treatment through a mini-invasive technique. Our results at mid-term in 131 cases

Background and objectivePeriacetabular osteotomy (PAO) is an accepted and worldwide technique recognised for residual dysplasia treatment and even in unstable hips with limited acetabular coverage. The aim of this study is to analyse the functional, radiological and complication results in patients treated with mini-invasive PAO. Material and methodsWe performed a retrospective study in which we analysed 131 cases undergoing mini-invasive PAO at our centre. The degree of joint degeneration was evaluated with Tönnis scale, Wiberg angle, acetabular index (AI), anterior coverage angle (AC), joint space, complications and functional outcome with the Non-Arthritic Hip Score (NAHS) were analysed preoperatively and at the end of follow-up. ResultsThe average age was 32.3±9.5 (SD) years, 102 (77.9%) were female and 29 (22.1%) were male. 7.7±2.8 (SD) years follow up. The radiological parameters improved between the pre-surgical phase and the end of follow-up, Wiberg angle +18.5° (18.3° versus 36.8°, 95% CI 17.3–19.7), AC angle +13.5° (26.2° versus 39.7°, 95% CI 11.6–15.4) and the AI −11.1° (19.5° versus 8.4°; 95% CI −12.1 to −10.1). In addition, the functional results, with the NAHS scale, improved +31.3 points (60.7 pre-surgical versus 92 at the end of follow-up, 95% CI 28.7–33.8). The most common complication was transient lateral femoral cutaneous nerve hypoaesthesia in 10 cases (7%). ConclusionThe mini-invasive PAO approach is a reproducible technique, it allows restoration of acetabular coverage and provides an improvement in functional scales as confirmed by our series.

Osteotomía periacetabular en el tratamiento de displasia de cadera mediante técnica mini-invasiva. Nuestros resultados a medio plazo en 131 casos

Background and objectivePeriacetabular osteotomy (PAO) is an accepted and worldwide technique recognized for residual dysplasia treatment and even in unstable hips with limited acetabular coverage. The aim of this study is to analyse the functional, radiological and complication results in patients treated with mini-invasive PAO. Material and methodsWe performed a retrospective study in which we analysed 131 cases undergoing mini-invasive PAO at our centre. The degree of joint degeneration was evaluated with Tönnis scale, Wiberg angle, acetabular index (AI), anterior coverage angle (AC), joint space, complications and functional outcome with the Non-Arthritic Hip Score (NAHS) were analysed preoperatively and at the end of follow-up. ResultsThe average age was 32.3±9.5 (SD) years, 102 (77.9%) were female and 29 (22.1%) were male. 7.7±2.8 (SD) years follow up. The radiological parameters improved between the pre-surgical phase and the end of follow-up, Wiberg angle+18.5° (18.3° versus 36.8°, 95% CI 17.3 to 19.7), AC angle+13.5° (26.2° versus 39.7°, 95%CI 11.6 to 15.4) and the AI -11.1° (19.5° versus 8.4°; 95%CI -12.1 to -10,1). In addition, the functional results, with the NAHS scale, improved+31.3 points (60.7 pre-surgical versus 92 at the end of follow-up, 95% CI 28.7 to 33.8). The most common complication was transient lateral femoral cutaneous nerve hypoaesthesia in 10 cases (7%). ConclusionThe mini-invasive PAO approach is a reproducible technique, it allows restoration of acetabular coverage and provides an improvement in functional scales as confirmed by our series.

Avaliação antropométrica e do ângulo quadricipital na osteoartrite de joelho em mulheres obesas

A osteoartrite (OA) é uma doença articular degenerativa, caracterizada por processo inflamatório, dor e deformidades; um de seus fatores preditivos é a obesidade. O objetivo deste estudo foi verificar possíveis correlações entre medidas antropométricas, o ângulo quadricipital (Q) e a osteoartrite de joelho. A amostra foi composta por 50 voluntárias obesas (30 com OA de joelho e 20 sem OA), com idade entre 40 e 60 anos. Foram mensurados, além do IMC (índice de massa corporal), circunferência abdominal (CA), perímetros de cintura e quadril para cálculo da relação cintura-quadril e o ângulo Q; a osteoartrite foi diagnosticada clinicamente e por meio de radiografia da articulação do joelho. Foram encontradas correlações positivas fracas entre IMC e ângulo Q e entre tempo de obesidade e grau de degeneração articular. A CA apresentou correlação positiva fraca com o grau de degeneração articular e o de gravidade da OA. O cálculo da razão de chance (OR) indica que as voluntárias com IMC&gt;34 kg/m² e CA&gt;110 cm tiveram 3,7 e 7 vezes, respectivamente, mais chance de apresentarem OA. A obesidade central, seu grau e duração possivelmente contribuem para a incidência da OA de joelhos em mulheres obesas. A circunferência abdominal foi a medida que melhor se correlacionou com a presença e grau de OA em obesas, o que aponta para a relevância de sua mensuração na avaliação clínica.

Wrist joint arthrodesis. Technique and outcome.

Arthrodesis of the wrist joint is indicated in degenerative joint desease, instability and restricted and painful range of motion. Further indications are: failed reconstruction, partial arthrodesis or arthroplasty/total joint replacement. The surgical technique depends mainly on the quality of bone substance and degree of joint degeneration. Differences can be made concerning the type of bone graft and osteosynthesis being used. The aim is to create, a stable joint in a good functional position. The position of arthrodesis depends on the patients needs. In patients with rheumatoid arthritis a straight position is generally accepted, where as in patients with degenerative joint desease, a slight wrist extension and ulnar deviation is preferred. A stable osteosynthesis with plates is reliable and allows early rehabilitation. We present 28 cases of arthrodesis with intramedullary rods and 61 cases of arthrodesis with plates. The complication rate was low, the functional results were good. We saw significant reduction of pain, increase of strength and handfunction. Arthrodesis of the wrist joint has proven to be a long term reliable and safe procedure. Loss of motion is accepted to obtain sufficient pain relief.

Mandibular Retrusion, Temporomandibular Joint Derangement, and Orthognathic Surgery Planning

One-hundred consecutive orthognathic surgery candidates with mandibular retrusion were selected for retrospective analysis. Patients had undergone imaging studies that included magnetic resonance imaging (MRI) of both temporomandibular joints to assess the presence or absence, stage, and activity of suspected internal derangement(s). Patients were divided into stable and unstable deformity groups based on the presence or absence of change in their facial contour and/or occlusal disturbances in the 24 months prior to evaluation. Each of the 58 unstable and 30 of 42 stable patients were found to have internal derangements of at least one temporomandibular joint. The degree of joint degeneration directly paralleled the severity of retrognathia in most cases. We concluded that temporomandibular joint internal derangement is common in cases of mandibular retrusion and leads to the facial morphology in a high percentage of patients. Preoperative temporomandibular joint imaging with MRI is recommended prior to orthognathic surgical correction of retrognathic deformities.