Leg Growth Research Articles

Prevalence of Vitamin D Deficiency in Children Aged Between 1 to 16 Years: An Observational Study

Introduction: Vitamin D is crucial for bone growth, mineralization, and various metabolic processes in the body. Consequently, a deficiency or insufficiency of this vitamin can lead to long-term consequences, especially in children. Therefore, this study aimed to assess the prevalence of vitamin D deficiency vitamin D deficiency in children aged between 1 to 16 years. Methods: This was an observational study conducted in the Department of Paediatrics, Dr. Sirajul Islam Medical College & Hospital, Dhaka & Ad-Din Akij Medical College Hospital, Khulna, Bangladesh during the period from July 2023 to July 2024. The study enrolled children aged 1 to 16 years from the pediatric department, excluding those with specific health issues. Data analysis was conducted with SPSS 23, and ethical approval was obtained from Dr. Sirajul Islam Medical College & Hospital and Ad-Din Akij Medical College Hospital. Results: In our study, we included 100 children with vitamin D deficiency symptoms who attended the paediatrics department of our study institutions. Participants were categorized into four age groups: 1-3 years (30%), 4-6 years (15%), 7-10 years (21%), and 11-16 years (34%). The sample comprised 59% females and 41% males, with an average age of 12.84 years. Most were from middle-class families (39%), and 48% were in primary school. Common health issues included leg pain (58%), growth retardation (47%) and muscle pain/bone pain (39%). Vitamin D deficiency was prevalent, with rates of 50.00% in 1-3 years, 53.33% in 4-6 years, 47.62% in 7-10 years, and 61.76% in 11-16 years, indicating increased insufficiency with age. Conclusion: This study shows that vitamin D deficiency is high among our study children. A comprehensive action plan, including supplementation and food fortification, is crucial to prevent this deficiency in Bangladesh.

Cumulative and interannual effects of reproduction in eastern grey kangaroos.

Reproduction can reduce energy allocation to other life-history traits such as survival and growth. Resource constraints give rise to (co)variation in life-history traits and to heterogeneity in energy acquisition and allocation. At each reproductive opportunity, females face a choice between allocation to current reproduction or to maintenance. Many studies compare reproductive trade-offs between two consecutive years, but few account for the cumulative effects of reproduction over multiple years, a crucial factor in understanding life-history evolution in long-lived iteroparous species. We compared short- (interannual) and long-term (cumulative) reproductive trade-offs with a 14-year capture-mark-recapture study of eastern grey kangaroos, where females can have substantial skeletal growth for several years after maturation. We used a multivariate approach to compare how interannual and multi-annual cumulative reproduction affected growth (n = 378 measurements), mass change (n = 376 measurements) and subsequent reproduction (n = 388 measurements), and to quantify (co)variation between these traits among individuals (n = 107) and years (n = 14). Interannually, young females that reproduced experienced decreased skeletal growth compared to young females that did not reproduce. Reproductive females of all ages experienced reduced mass gain and weaning probability in the following year. The cumulative effects of multiple reproductions included decreased skeletal growth, mass gain and weaning probability in the following year. These effects increased with age and reproductive rate. We found positive trait correlations between mass change, leg growth and subsequent reproduction among individuals and years, though weaker at the cumulative than interannual level. Females experience dynamic interannual and cumulative trade-offs. Our analyses of cumulative costs of reproduction revealed long-term trade-offs as well as cumulative costs that were not apparent when estimating interannual costs. Trait correlations suggested heterogeneity in growth and reproduction among females. Years of increased growth were followed by years of increased reproduction, and years of poor growth were followed by years of poor reproduction. Our exploration of both interannual and cumulative costs of reproduction underscores the need to account for long-term reproductive histories to better understand reproductive trade-offs in long-lived iteroparous species.

Age-related anthropometric changes in physical development among aboriginal schoolchildren in Russia’s North-East

BACKGROUND: Schoolchildren from an educational institution of Severo-Evensk District Magadan Region, participated in an anthropometric survey. AIM: To assess anthropometric characteristics of indigenous schoolchildren in the Magadan Region across different age-groups. MATERIAL AND METHODS: Two hundred and eight boys and one hundred and ninety girls from the Evens, Koryaks and Itelmen ethnic groups participated in the 2021–2023 Anthropometric Survey. They accounted for 67.2% of all schoolchildren surveyed. Body height (BH), body mass (BM), chest circumference (CC), sitting height (HSit), right- and left-hand grip strength were measured. We also calculated annual increase in weight and height, as well as proportionality of physical development of the children. RESULTS: A natural increase in the absolute body indicators of BH, BM, HSit, CC, and right and left hand strength have been observed parallel to increase in age from 8 to 17 years. The rate of annual growth indicated different timing of the periods of accelerated increase in the anthropometric characteristics. Girls exhibited a CC maximum increase at 10–11 years old with simultaneous increase in BH, BM, HSit, and hand grip strength at 11–12 years old. During the same age-periods, boys showed a pronounced BH growth with BM and CC increase at 12–13 years of age. After a slight attenuation in the growth rate, we observed a substantial increase in BH at the age of 14–15, associated with gender-related aspects in older children groups. Sex-related characteristics of BH increase were primarily associated with differences in the leg growth rates during the puberty, and tend to be greater in boys. Most of the studied boys had an asthenic somatotype. At the same time, most girls had a proportional body type with high percentage of those with relatively short legs. CONCLUSION: We observed that girls were ahead of boys in their physical development. Boys demonstrated a continuous development in their main anthropometric characteristics with more pronounced dynamics in adolescence. Our findings suggest that indigenous schoolgirls have better physical development and adaptive adjustments compared to boys.

Effects of the putative probiotics Bacillus licheniformis, Bacillus pumilus, and Bacillus subtilis on white leg shrimp, Litopenaeus vannamei, immune response, gut histology, water quality, and growth performance.

A commercially significant species in the aquaculture sector globally, particularly in Egypt, is Litopenaeus vannamei. The experiment's objective was to ascertain how Sanolife PRO-F impacted the growth, water quality, immunological response, and intestinal morphometry of L. vannamei. In the current investigation, which lasted 12 weeks, Sanolife PRO-F was administered to shrimp post-larvae at diet doses of 0 (control), 1 (group one), 2 (group two), and 3 (group three) g/kg diet, respectively. Each experimental group had three repetitions. In the current study, shrimp fed on probiotic-treated diets showed a considerable improvement in growth performance measures and survival rate, and the nonspecific immune response was also enhanced. Shrimp fed probiotic diets had longer and more intestinal villi overall. Shrimp fed on the G2 and G3 diets showed no appreciable differences in growth or intestinal morphology. With the G2 and G3 diet, the water had lower concentrations of nitrite and ammonia. The study's findings indicate that Sanolife PRO-F treatment at 2-3 g/kg feed promotes the growth of shrimp, immunological response, gut health and function, and water quality.

Leg health and growth performance of broiler chickens supplemented with grape seed extract

Background: Active bone remodeling processes can be altered by the presence of reactive oxygen species and, therefore, cause leg problems in broiler chickens. The antioxidant activity present in grape seed extract (GSE) could be a viable alternative to high inclusion levels of vitamin E (VE) as a nutritional strategy to improve the antioxidant capacity of birds and, thus, prevent leg abnormalities. Objective: To evaluate the effect of partial substitution of VE with grape GSE on leg health and performance of broiler chickens. Methods: Four hundred and twenty newly-hatched Ross 308 male broiler chickens were distributed into three treatments: 1) Control-AL, a diet containing 40 IU/kg of VE and fed ad libitum (CAL); 2) Control-FR, the CAL diet but offered through a feed restriction program (CFR); and 3) grape seed extract-AL, a diet containing 10 mg/kg of GSE + 10 IU/kg of VE fed ad libitum (GSE-AL). The trial was conducted for 47 days. Feed intake and body weight of the chickens were recorded weekly to evaluate performance. At day 43, gait score (GS), valgus/varus angulation (AngV), foot burn (FB), and hock burn (HB) lesions were evaluated. At day 47, tibia-breaking strength (TBS) and gastrocnemius tendon-breaking strength (GTBS) were evaluated. Results: Birds in the GSE-AL treatment showed reduced (p≤0.05) GS compared to the other treatments. No statistical differences (p>0.05) were found in AngV, HB, FB, TBS, TGBS, and growth performance among treatments. Conclusions: These results suggest that GSE may partially replace VE in broiler diets without negative effects on growth performance or leg health. Further research is required to evaluate the potential of grape seed extract to replace VE or other ingredients with antioxidant activity under different rearing conditions and feeding programs.

Generality of Evaporative Crystal Liftoff on Heated Hydrophobic Substrates

Scaling or mineral fouling occurs due to the presence of dissolved minerals in water. Scaling is problematic in numerous industrial and household plumbing applications where water is used. The current methods of scale removal often utilize harsh chemicals that are not environmentally friendly. The evaporation of a saline droplet provides a platform to study the role of the substrate in the dynamics of crystallization during scaling. In the present work, we show out-of-plane growth of crystal deposits during the evaporation of saline droplets of aqueous potassium chloride on a heated smooth and microtextured hydrophobic substrate. These out-of-plane deposits, termed as "crystal legs", are in minimal contact with the substrate and can be easily removed from the substrate. The out-of-plane evaporative crystallization of saline droplets of different initial volumes and concentrations is observed irrespective of the chemistry of the hydrophobic coating and the crystal habits investigated. We attribute this general behavior of crystal legs to the growth and stacking of smaller crystals (size ∼10 μm) between the primary crystals toward the end of evaporation. We show that the rate at which the crystal legs grow increases with an increase in the substrate temperature. A mass conservation model is applied to predict the leg growth rate, which agrees well with the experiments.

25-year Follow-up of Primary Tibial Periosteal Graft for Hard Palate Repair in Cleft Lip and Palate: Outcomes, Concerns and Controversies.

This study evaluates long-term outcomes in adults with Unilateral and Bilateral Cleft Lip and Palate (UCLP/BCLP) treated during the period 1992 to 1995 with tibial periosteal graft in primary repair. Retrospective study. Department of Plastic and Maxillofacial Surgery, Children's Hospital Bambino Gesù (Italy). The study included 52 patients with non-syndromic BCLP/UCLP who met the inclusion criteria. All patients underwent a standardized surgical protocol using a tibial periosteal graft as primary repair of the hard palate. Long-term outcomes on maxillary growth, residual oronasal fistula, and leg length discrepancy. About <2% of patients showed oral-nasal communication. Mean value of maxillary depth was 86° ± 4.5°. The lower value for maxillary retrusion was 76.8° in relation to the Frankfurt plane. At the x-ray control, 12.2% of patients showed leg discrepancy with a difference of always <2 cm. The rate of maxillary retrusion obtained was the same if compared to other techniques. Tibial periosteal graft reduces the risk of fistula and the need for reintervention after secondary bone graft. The study did not observe negative impacts on leg growth after 25 years.

Genome-wide association study identifies SNPs for growth performance and serum indicators in Valgus-varus deformity broilers (Gallus gallus) using ddGBS sequencing

BackgroundValgus-varus deformity (VVD) is a lateral or middle deviation of the tibiotarsus or tarsometatarsus, which is associated with compromised growth, worse bone quality and abnormal changes in serum indicators in broilers. To investigate the genetic basis of VVD, a genome wide association study (GWAS) was performed to identify candidate genes and pathways that are responsible for VVD leg disease, serum indicators and growth performance in broilers.ResultsIn total, VVD phenotype, seven serum indicators and three growth traits were measured for 126 VVD broilers (case group) and 122 sound broilers (control group) based on a high throughput genome wide genotyping-by-sequencing (GBS) method. After quality control 233 samples (113 sound broilers and 120 VVD birds) and 256,599 single nucleotide polymorphisms (SNPs) markers were used for further analysis. As a result, a total of 5 SNPs were detected suggestively significantly associated with VVD and 70 candidate genes were identified that included or adjacent to these significant SNPs. In addition, 43 SNPs located on Chr24 (0.22 Mb - 1.79 Mb) were genome-wide significantly associated with serum alkaline phosphatase (ALP) and 38 candidate genes were identified. Functional enrichment analysis showed that these genes are involved in two Gene Ontology (GO) terms related to bone development (cartilage development and cartilage condensation) and two pathways related to skeletal development (Toll−like receptor signaling pathway and p53 signaling pathway). BARX2 (BARX homeobox 2) and Panx3 (Pannexin 3) related to skeleton diseases and bone quality were obtained according to functional analysis. According to the integration of GWAS with transcriptome analysis, HYLS1 (HYLS1 centriolar and ciliogenesis associated) was an important susceptibility gene.ConclusionsThe results provide some reference for understanding the relationship between metabolic mechanism of ALP and pathogenesis of VVD, which will provide a theoretical basis for disease-resistant breeding of chicken leg soundness.

Anthropometrics of Estonian children in relation to family disruption: Thrifty phenotype and Trivers-Willard effects.

Background and objectivesThe thrifty phenotype hypothesis proposes that at resource limitation, the growth of some organs/tissues is selectively spared to preserve more critical ones, such as the brain or lungs. The Trivers–Willard hypothesis (TWH) predicts that boys are more vulnerable in the case of resource limitation than girls. Both hypotheses were tested in children from disrupted families, differing in the extent of deprivation/adversities imposed on them.MethodologyIn a retrospective cohort study in the mid-20th century Estonia (Juhan Aul’s database), different types of orphans and children of divorced parents (treatment groups; n = 106–1401) were compared with children from bi-parental families (control groups; n = 2548–8648) so that children from treatment groups were matched with control children on the basis of sex, age, year of birth, urban versus rural origin and socioeconomic position.ResultsChildren in orphanages suffered strong growth suppression, best explained by psychosocial deprivation. Their feet were on average 0.5 SD shorter than the feet of the controls, followed by height, leg/torso ratio and cranial volume that differed from controls by ca 0.4 SD. Weight difference was 0.2 SD units, while body mass index did not differ from controls. The growth of boys and girls in orphanages was suppressed to the same extent. Boys whose mothers were dead were relatively smaller and less masculine than girls from such families. Fathers’ absence was unrelated to growth suppression. Sons of divorced parents had broader shoulders than boys whose fathers were dead.Conclusions and implicationsPrediction of TWH about the greater vulnerability of male growth may hold under some conditions but not universally. Predictions of the thrifty phenotype hypothesis were partly supported: trunk growth was spared at the expense of leg growth; however, no evidence for brain sparing was found. Comparison of children of divorced versus dead fathers may appear useful for indirect assessment of sexual selection on offspring quality. Lay Summary: Boys and girls in orphanages suffered similarly strong growth suppression, best explained by psychosocial deprivation. Boys whose mothers were dead were relatively smaller and less masculine than girls from such families. The occurrence of sex-specific associations between family structure and children’s growth depends on the type of family disruption.

Determinants of growth after kidney transplantation in prepubertal children

BackgroundShort stature is a frequent complication after pediatric kidney transplantation (KT). Whether the type of transplantation and prior treatment with recombinant human growth hormone (GH) affects post-transplant growth, is unclear.MethodsBody height, leg length, sitting height, and sitting height index (as a measure of body proportions) were prospectively investigated in 148 prepubertal patients enrolled in the CKD Growth and Development study with a median follow-up of 5.0 years. We used linear mixed-effects models to identify predictors for body dimensions.ResultsPre-transplant Z scores for height (− 2.18), sitting height (− 1.37), and leg length (− 2.30) were reduced, and sitting height index (1.59) was increased compared to healthy children, indicating disproportionate short stature. Catch-up growth in children aged less than 4 years was mainly due to stimulated trunk length, and in older children to improved leg length, resulting in normalization of body height and proportions before puberty in the majority of patients. Use of GH in the pre-transplant period, congenital CKD, birth parameters, parental height, time after KT, steroid exposure, and transplant function were significantly associated with growth outcome. Although, unadjusted growth data suggested superior post-transplant growth after (pre-emptive) living donor KT, this was no longer true after adjusting for the abovementioned confounders.ConclusionsCatch-up growth after KT is mainly due to stimulated trunk growth in young children (< 4 years) and improved leg growth in older children. Beside transplant function, steroid exposure and use of GH in the pre-transplant period are the main potentially modifiable factors associated with better growth outcome.

T-box transcription factors Dorsocross and optomotor-blind control Drosophila leg patterning in a functionally redundant manner

The T-box genes are essential transcription factors during limb development. In Drosophila, Dorsocross (Doc) and optomotor-blind (omb), members of the Tbx2 and Tbx6 families, are best studied in the Drosophila wing development. Despite prominently expressed in leg discs, the specific function of these genes in leg growth is still not revealed. Here we demonstrated that Doc and omb regulated the morphogenesis of leg intermediate regions in a functionally redundant manner. Loss of Doc or omb individually did not result in any developmental defects of the legs, but loss of both genes induced significant defects in femur and proximal tibia of the adult legs. These genes located in the dorsal domain, where the Doc region expanded and cross-overlapped with the omb region corresponding to the presumptive leg intermediate region. We detected that the normal epithelial folds in the leg discs were disrupted along with dorsal repression of cell proliferation and activation of cell apoptosis when Doc and omb were both reduced. Furthermore, the dorsal expression of dachshund (dac), a canonical leg developmental gene specifying the leg intermediate region, was maintained by Doc and omb. Meanwhile, the Notch pathway was compromised in the dorsal domain when these genes were reduced, which might contribute to the joint defect of the adult leg intermediate regions. Our study provides cytological and genetic evidence for understanding the redundant function of Doc and omb in leg morphogenesis.

Hedgehog signaling regulates regenerative patterning and growth in Harmonia axyridis leg.

Appendage regeneration has been widely studied in many species. Compared to other animal models, Harmonia axyridis has the advantage of a short life cycle, is easily reared, has strong regeneration capacity and contains systemic RNAi, making it a model organism for research on appendage regeneration. Here, we performed transcriptome analysis, followed by gene functional assays to reveal the molecular mechanism of H. axyridis leg regenerative growth process. Signaling pathways including Decapentaplegic (Dpp), Wingless (Wg), Ds/Ft/Hippo, Notch, Egfr, and Hedgehog (Hh) were all upregulated during the leg regenerative patterning and growth. Among these, Hh and its auxiliary receptor Lrp2 were required for the proper patterning and growth of the regenerative leg. The targets of canonical Hh signaling were required for the regenerative growth which contributes to the leg length, but were not essential for the pattern formation of the regenerative leg. dpp, wg and leg developmental-related genes including rn, dac and Dll were all regulated by hh and lrp2 and may play an essential role in the regenerative patterning of the leg.

Peak Torque Explains More Unique Variability in Growth Measurements than Rate of Torque Development in Young Boys and Girls.

Gillen, ZM, Shoemaker, ME, McKay, BD, Bohannon, NA, Gibson, SM, and Cramer, JT. Peak torque explains more unique variability in growth measurements than rate of torque development in young boys and girls. J Strength Cond Res 34(9): 2507-2514, 2020-This study reported test-retest reliability and evaluated collinearity for isometric leg extension and flexion peak torque (PT) and rate of torque development (RTD) in young boys and girls. Measurements of growth included height, body mass, fat-free mass, maturity offset, and leg extensor and flexor muscle cross-sectional area. Maximal isometric contractions quantified PT and RTD. Intraclass correlation coefficients (ICCs), SEM, coefficients of variation, and minimum detectable changes quantified test-retest reliability. Zero-order correlations and first-order partial correlations evaluated collinearity. Peak torque from leg extension and flexion exhibited ICCs ≥ 0.90, RTD from leg extension and flexion exhibited ICCs ≥ 0.38. Partialing out leg flexion PT reduced the relationships between leg extension PT and growth (rPText, growth.PTflex = 0.392-0.605). Partialing out leg extension PT eliminated the relationships between leg flexion PT and growth (rPTflex, growth.PText = 0.098-0.263). Partialing out leg extension RTD reduced the relationships between PT and growth (rPText, growth.RTDext = 0.516-0.775). Partialing out leg extension PT eliminated the relationships between RTD and growth (|rRTDext, growth.PText| = 0.001-0.148). Leg extension PT was more reliable and explained the most unique variability in growth among young boys and girls. In contrast, RTD was less reliable and was fully accounted for by PT, indicating that RTD may be an unnecessary measurement in studies of young boys and girls.

Leg Extension Strength, Explosive Strength, Muscle Activation, and Growth as Predictors of Vertical Jump Performance in Youth Athletes

The purpose of this study was to examine the relationships among leg extension strength, explosive strength, muscle activation, and measurements of growth to predictions of vertical jump performance in youth athletes. Height, body mass, skinfolds, and quadriceps femoris muscle cross-sectional area were measured in 39 sports active children (20 females, 19 males, age = 12.52 ± 0.62 years old). Peak torque (PT), rate of torque development (RTD), rate of velocity development (RVD), and rate of electromyographic amplitude rise (RER) were measured during isometric and isokinetic leg extensions. PT, RTD, and RVD were expressed in absolute terms and normalized to body mass. Estimated jump height (JH) and peak power (PP) were assessed during static (SJ), counter-movement (CMJ), and drop (DJ) jumps. JH exhibited greater correlations with PT normalized to body mass (r = 0.387–0.758) than absolute PT (r = 0.338–0.417), whereas PP exhibited greater correlations with absolute PT (r = 0.368–0.837). Only negligible to moderate relationships existed between JH and PP across all jumps (r = 0.053–0.605). Over 50% of the variability in PP was predicted in 24 of 30 regression models with absolute muscle strength, muscle activation, and measurements of growth, while only 6 of 30 models predicted more than 50% of the variability in JH. Overall, absolute static and dynamic muscle strength, muscle activation, and growth better explained PP measured during vertical jumps than estimated JH.

Ameliorative effect of naringin against thiram-induced tibial dyschondroplasia in broiler chicken.

Tetramethyl thiuram disulfide (thiram) is widely used in agricultural production as an insecticide and fungicide, which can also lead to tibial dyschondroplasia (TD) in poultry. TD is characterized by leg disorders and growth performance retardation, and no targeted drugs have been found to treat TD until now. Therefore, the objective of the present study was to explore the ameliorative effect of traditional Chinese medicine naringin on thiram-induced TD chickens. A total of 180 one-day-old Arbor Acres (AA) broiler chickens were randomly divided into three equal groups (n = 60): control group (standard diet), thiram-induced group (thiram 50mg/kg from day 3 to day 7), and naringin-treated group (naringin 30mg/kg from day 8 to day 18). During the 18-day experiment, the growth performance, tibial bone parameters, antioxidant property of liver, serum biochemical changes and clinical symptoms were recorded to evaluate the protective effect of naringin in thiram-induced TD broiler chickens. Additionally, mRNA expressions and protein levels of Ihh and PTHrP genes were determined via quantitative real-time polymerase chain reaction and western blot. Administration of naringin showed significant results by alleviating lameness, increased growth performance, recuperated growth plate (GP) width, and improved functions and antioxidant enzyme level of liver in broilers affected by TD. Moreover, naringin treatment restored the development of damaged tibia bone via downregulating Ihh and upregulating PTHrP mRNA and protein expressions. In conclusion, our study determines naringin could be used as an effective medicine to treat TD.

Plasticity in the growth of body segments in relation to height‐for‐age and maternal education in Guatemala

ObjectivesPlasticity in the growth of body segments between populations has been researched in relation to migration, temporal change and high‐altitude studies. We study the within population variation in body segments, thus controlling for some of the environmental and genetic differences that could be at play in between populations studies. We test a version of the thrifty phenotype hypothesis, where the growth of head‐trunk and hand are prioritized due to their functional significance over height and leg growth.Materials and methodsA total of 3913 Guatemalan, rural, semi‐urban and urban, Maya and Ladino children 6 to 15 years old were studied. Height, sitting height, leg length, and metacarpal length were studied in relation to three proxies for living conditions: height‐ and leg length‐for‐age, and maternal education. Estimation statistics and null hypothesis significance testing were used to analyze the data.ResultsMetatarsal length and sitting height values were higher than height and leg length respectively. Relative metacarpal length was conserved across height‐for‐age groups. Females were less affected than males for metacarpal length and sitting height, but more affected for leg length.ConclusionOur results agree with the thrifty phenotype hypothesis, where metacarpal and sitting height growth would be prioritized over height and leg length due to greater functional significance.

Combined Transphyseal and Lateral Extra-articular Pediatric Anterior Cruciate Ligament Reconstruction: A Novel Technique to Reduce ACL Reinjury While Allowing for Growth

Background: Treatment of anterior cruciate ligament (ACL) injuries in the adolescent population continues to be complicated by an unacceptably high rate of secondary ACL injury. Purpose: To describe the failure rate and outcomes after a hybrid pediatric ACL reconstruction (ACLR) employing transphyseal hamstring (TPH) autograft combined with an extra-articular technique using an iliotibial band (ITB) autograft. Study Design: Case series; Level of evidence, 4. Methods: Consecutive patients undergoing combined TPH-ITB ACLR between January 2012 and April 2017 with a minimum 2-year follow-up were reviewed. With the goal of decreasing ACL graft injury in this high-risk group, this technique employed anteromedial portal drilling for TPH with an extraosseous femoral ITB technique and intra-articular TPH-ITB grafts fixed within the tibial bone tunnel. Demographics, bone age, standing alignment radiograph for growth and mechanical axis grade, return to sport, graft failure, and patient-reported outcome measures were analyzed. Results: A total of 61 knees in 60 adolescents underwent the combined TPH-ITB ACLR, with 57 knees (93.4%) meeting inclusion criteria with a mean follow-up of 38.5 months (range, 24-78 months). Only 3 of 57 knees (5.3%) sustained ACL reinjury. The mean age was 13.0 years (range, 11-16 years) with 36 male patients (mean bone age, 14.2 years) and 21 female patients (mean bone age, 13.3 years), and 91% of patients (52 of 57) returned to sport. Participants demonstrated a high functional level at final follow-up, with a mean score of 91.2 (range, 46.7-100) on the Pediatric International Knee Documentation Committee (Pedi-IKDC) Subjective Knee Evaluation Form and mean score of 22.4 (range, 4-30) on the Pediatric Functional Activity Brief Scale (Pedi-FABS). To critically assess growth, a cohort with ≥18 months of growth remaining at surgery was evaluated at maturity. No difference was seen in mean operative and nonoperative leg growth (49.7 mm and 49.8 mm). Although no family reported cosmetic or functional alignment or length concerns, 1 of 18 (5.5%) had a final limb length discrepancy >10 mm (12 mm) and a perioperative alignment difference (0-Grade II valgus). Conclusion: Combined TPH-ITB ACLR in adolescents resulted in high activity levels (Pedi-FABS, 22.4; median, 25) and a low (5.3%) graft failure rate at a mean 38.5 months.

Correction to: Leg health, growth and carcass characteristics in growing-finishing pigs of two different genotypes reared on Swedish organic farms

Correction to: Leg health, growth and carcass characteristics in growing-finishing pigs of two different genotypes reared on Swedish organic farms

Leg health, growth and carcass characteristics in growing-finishing pigs of two different genotypes reared on Swedish organic farms

Increased prevalence of joint abnormalities at slaughter among pigs from organically certified herds in Sweden has been reported. Most of these abnormalities are caused by osteochondrosis, which has a genetic background. Thus, we investigated whether changing the sire breed from the commonly used Hampshire to the commercially available sire breed Duroc affected joint health and growth rate. We studied 766 commercially reared growing-finishing pigs from insemination of the mother sow until slaughter. The pigs were raised at four commercial organic farms (integrated or externally integrated, and had 40–160 sows in production) and slaughtered at one slaughter plant. We found no significant difference between the offspring of the two sire breeds regarding back conformation, leg conformation, swollen joints, locomotion or lameness at 13 or 24 weeks of age, or regarding joint abnormalities at slaughter. This indicates that clinical leg health will not be improved by changing sire breed. However, the Hampshire-sired pigs had higher daily growth rate (P < 0.008), allowing earlier slaughter.

Can Combined Trans-physeal and Lateral Extra-Articular Pediatric ACL Reconstruction Techniques Be Employed to Reduce ACL Re-Injury While Allowing for Growth?

Objectives: To describe outcomes, including failure rates, following a pediatric ACL reconstruction (ACLR) employing combined trans-physeal technique with hamstring autograft (TPH) and a hybrid extra-articular technique using iliotibial band autograft (ITB). Methods: Consecutive skeletally immature patients undergoing combined TPH/ITB ACLR from 1/2012 to 4/2017 were reviewed. With the goal of decreasing ACL graft re-injury in this high-risk group; this technique employed anterior-medial portal drilling for TPH, with an extra-osseous femoral ITB technique and intra-articular combined TPH/ITB grafts fixed within the tibial bone tunnel (Figure 1). Inclusion required a minimum 12 months follow up; exclusions were prior knee surgery and multi-ligamentous injury. Demographics, bone-age (hand), standing alignment XR for growth and mechanical axis grade, and PROs were documented. T-tests, Mann-Whitney tests, and Spearman’s correlation coefficients were employed. Results: 60 knees in 59 adolescents underwent the combined TPH/ITB ACLR, with 49 knees meeting inclusion criteria with a mean follow up = 23 months (r = 12-48 m). Only 1/49 knees (2%) sustained ACL re-injury. Mean age was 12.9y (11-16y) with 29 males (mean bone-age = 14.1) and 19 females (mean bone-age =13.3). There was a high level return to pre-operative sport. No families reported cosmetic, functional alignment or length concerns, and no clinical deformity was diagnosed. Outcome measures at final follow up indicated a high functional level with a mean Pedi-IKDC = 90.39 and mean Pedi-Fabs = 22.66. To critically assess growth, a cohort of 22 knees (mean age = 12.8y) with &gt; 18 months of growth remaining at surgery were evaluated at maturity. No difference was seen in mean operative and non-operative leg growth (54.1 mm and 53.0 mm). One patient, 1/22 (4.5%), had a final LLD &gt; 10 mm (12 mm), and peri-operative alignment difference [0-GII (central compartment) valgus]. Growth and alignment were not significantly associated with age, bone age, height, weight, demonstrated growth, or pre-operative alignment. Conclusion: Combined TPH/ITB ACLR in adolescent patients resulted in return to high activity levels (Pedi-Fabs = 22.66), and a low (2%) re-injury rate at an average of 23 months. A novel pediatric ACLR employing combined trans-physeal hamstring and extra-osseous iliotibial band grafts merits further study as a technique for reducing re-injury in high-risk, growing adolescents by maximizing articular graft size while adding anterior-lateral rotational knee control. [Figure: see text]