Normal Joint Research Articles

A novel moisture damage detection method for asphalt pavement from GPR signal with CWT and CNN

To locate the moisture damage area in asphalt pavement, an automatic detection method by leveraging the state-of-the-art deep learning approach and continuous wavelet transform (CWT) method from high frequency GPR signal was presented. A numeric simulation and a laboratory experiment were employed to analyze the response of GPR signal in moisture damage area. GPR signals were transferred to time-frequency domain by using a CWT method, before comparing CWT results among normal pavement, moisture and bridge joints. Moisture damage datasets, including 8215 traces of moisture damages, 8215 traces of normal pavement and 7643 traces of bridge joints, were extracted from GPR field survey of bridge pavement with 2.3 GHz antenna. The maximum and mean values of CWT results were obtained from the dataset and used to normalize the CWT dataset. Typical classification models, including Resnet50, ResNet18, ShuffleNet, EfficientNet, NasNetmobile and DenseNet, were trained and compared on the CWT dataset. The result indicates that the CWT features among normal pavement, moisture damage and bridge joints have significant differences. Moreover, the energy distribution in the CWT image can represent the moisture damage depth and width information, proving that the CWT method is effective for extracting moisture damage features from GPR signal. The overall performance of ResNet50 model is best with high accuracy and high efficiency in moisture detection compared to other models. Experimental results proved the promising performance of our approach in detecting moisture damage in asphalt pavement, and this method could also be used for subsurface target detection in other GPR application.

Biomechanical Effects of Hindfoot Alignment in Supination External Rotation Malleolar Fractures: A Human Cadaveric Model.

Pressure distribution in the ankle joint is known to be dependent on various factors, including hindfoot alignment. We seek to evaluate how hindfoot alignment affects contact pressures in the ankle joint in the setting of supination external rotation (SER) type ankle fractures. SER fractures were created in 10 human cadaver lower extremity specimens, simulating progressive stages of injury: without fracture (step 0), SER fracture and intact deltoid ligament (step 1), superficial deltoid ligament disruption (step 2), and deep deltoid ligament disruption (step 3). At each step, varus and valgus alignment was simulated by displacing the calcaneal tuberosity 7 mm medial or lateral. Each limb was axially loaded following each osteotomy at a static load of 350 N. The center of force (COF), contact area (CA), and peak contact pressure (PP) under load were measured, and radiographs of the ankle mortise were taken to analyze the medial clear space (MCS) and talar tilt (TT). The COF (5.3 mm, P = .030) and the CA (-188.4 mm2, P = .015) changed in step 3 in the valgus hindfoot alignment compared to baseline parameters, indicating the importance of deep deltoid ligament integrity in maintaining normal ankle joint contact stress in the valgus hindfoot. These changes were not seen in the setting of varus alignment (COF: 2.3 mm, P = .059; CA -121 mm2, P = .133). PP were found to not change significantly in either varus or valgus (varus: -4.9 N, P = .132; valgus: -4 N, P = .464).The MCS demonstrated widening in step 3 compared to step 2 (0.7 mm, P = .020) in both varus and valgus hindfoot. The TT increased significantly in step 3 in the valgus hindfoot (2.8 degrees, P = .020) compared to step 0. SER-IV fractures with valgus hindfoot alignment showed significant changes in pressure distribution and radiographic parameters when compared to SER-IV fractures with varus hindfoot alignment. Based on this cadaver modeling study, patients with SERIV fracture with varus hindfoot alignment and complete deltoid ligament lesion may not need fracture fixation, whereas those with valgus hindfoot alignment likely need fracture fixation.

Congenital dislocation of the knee: A noninvasive treatment method

BACKGROUND: Congenital knee dislocation is a significant topic of interest in the possible application of new reduction techniques immediately after birth. This initiative aims to minimize the consequences of dislocation, ensuring the possibility of normal joint formation and functioning from the very first stages of life. This is not only a technical achievement but also an approach to providing optimal conditions for the health and development of children with congenital knee dislocation.
 AIM: This study aimed to evaluate the functional and long-term treatment outcomes of congenital knee dislocation using a new patented method.
 MATERIALS AND METHODS: A total of 120 patients (194 knees) with congenital knee dislocation were examined. The patients were divided into the main group (55 patients, 90 knee joints) and the control group (65 patients, 104 knee joints). The main group received the treatment developed by the authors using an Ergopower ER 7028 vibration massager. In the control group, the traditional method of orthopedic correction of congenital knee dislocation using a Von Rosen splint and circular plaster casts was employed. At the start of treatment, the age of the patients in the main group was Me 28 [Q1 28; Q3 30] hours and that of the control group was Me 30 [Q1 28; Q3 34.5] hours.
 RESULTS: A comparative analysis of the treatment outcomes of the main and control groups showed that the developed method for correcting congenital knee dislocation using a vibration massager and careful manipulations, in contrast to traditional technology, achieved the most accurate orthopedic correction in 95% of cases, ensured the restoration of the axial profile of the knee joint and its stability, and created conditions for the harmonious growth and development of the lower extremities in adulthood. In the main group, after conservative treatment of congenital knee dislocation using improved technology, indicators for assessing knee joint function (66.7%) and pain relief (98.2%) were excellent after 5 years of observation, which was confirmed by data from a clinical study and use of specialized questionnaires.
 CONCLUSIONS: The proposed innovative method of conservative orthopedic correction of congenital knee dislocation by vibrovascularization of the thigh muscles is a differentiated approach to conservative treatment, which improved the overall and long-term treatment outcomes.

De Quervain tendinitis after total trapeziometacarpal joint arthroplasty: Biomechanical evaluation of tendon excursion in the first extensor tendon compartment

De Quervain’s tenosynovitis is the most common complication after total trapeziometacarpal joint replacement. Etiology is unclear. Implantation of a ball-in-socket implant changes the biomechanics of the normal trapeziometacarpal saddle joint and increases its range of motion. The present study demonstrates that this procedure also significantly increases excursion of the abductor pollicis longus and extensor pollicis brevis tendons during thumb flexion-extension, and not during thumb abduction-adduction. Increased tendon gliding under the retinaculum of the first extensor tendon compartment could predispose to the development frictional tenosynovitis and play a role in the development of de Quervain’s syndrome after total trapeziometacarpal joint replacement. Level of evidenceNot applicable (laboratory study).

A Case of Baker’s Cyst with Synovial Chondromatosis of Knee

Synovial chondromatosis is a benign condition which arises from synovial membrane or bursae around the joints. Joint abnormalities in the form of arthritic or mechanical conditions such as detachment of osseocartilaginous fragments from the articular surface are its secondary associations. Rarely there maybe involvement of the Baker’s cyst. Here we report a case in which a 60-year-old female came with complaints of pain, swelling and restriction of movement of right knee joint for the past one year. After careful clinical and radiological examination, it was diagnosed as Baker’s cyst complicated by synovial chondromatosis. After the diagnosis the patient underwent the following procedures: open synovectomy, cyst removal and thorough joint debridement. Synovial chondromatosis was confirmed histopathologically. Secondary synovial chondromatosis has features of osteoarthritic changes, lack of extensive synovial proliferation and complicated Baker's cyst which is not seen in primary synovial chondromatosis.
 Synovial chondromatosis (SC) is caused by metaplasia of the synovium into chondrocytes and is a rare benign disorder.[1,2] Primary synovial chondromatosis (PSC) is a self-limited process that occurs in an otherwise normal joint.[3] When synovial chondromatosis develops in a joint previously affected with disease, often posttraumatic or degenerative osteoarthritis, it is called as secondary synovial chondromatosis.[4] SC may involve any joint, but the most common joint involved is knee joint followed by hip joint, and small joints of the hand and wrist. Least involvement is seen in elbow and shoulder joint. [5] The disease is categorised into three phases according to Milligram classification: active intrasynovial disease without any loose bodies observed in the early phase, active disease and loose bodies observed in the transitional phase, and multiple loose bodies without any intrasynovial disease observed in the late phase.
 In orthopaedic practice, popliteal cysts are common occurrence; many of them are associated with degenerative or rheumatoid arthritis. The differential diagnoses become more complex when loose bodies and calcifications are noted within the joint on a radiograph. Here in, we are presenting a case of Baker’s cyst with synovial chondromatosis of knee treated by surgical excision and confirmed by histopathology.

Dual-Channel/Localization Single-Molecule Fluorescence Probe for Monitoring ATP and HOCl in Early Diagnosis and Therapy of Rheumatoid Arthritis.

Rheumatoid arthritis (RA), a common chronic inflammatory illness, is still incurable, reducing the sufferers' quality of life significantly. Adenosine 5'-triphosphate (ATP) and hypochlorous acid (HOCl) are key indicators in RA, but their precise mechanisms in RA pathophysiology are unknown. As a result, in order to detect ATP and HOCl simultaneously, we created two new dual-channel/localization single-molecule fluorescence probes, RhTNMB and RhFNMB. Furthermore, RhFNMB outperformed RhTNMB in terms of detection performance. ATP and HOCl produce independent fluorescence responses in the light red channel (λex = 520 nm, λem = 586 nm) and deep red channel (λex = 620 nm, λem = 688 nm), respectively, without spectral crosstalk. It should be noted that the probe RhFNMB successfully imaged ATP in mitochondria and HOCl in cells. Surprisingly, the probe RhFNMB demonstrated remarkable detection ability in the diagnosis and treatment of Pseudomonas aeruginosa-induced abdominal inflammation in mice. We continued to apply the probe RhFNMB to track ATP and HOCl in RA and discovered that ATP and HOCl concentrations were considerably greater in RA joints than in normal joints. We also confirmed the therapeutic effect of methotrexate on RA. This study is the first to achieve dual-channel imaging of ATP and HOCl, which is of great value for the early diagnosis and therapy of RA.

Finite element analysis of sagittal angles of unicompartmental knee arthroplasty

BackgroundUnicompartmental knee arthroplasty is an effective treatment for knee osteoarthritis, but it has the risk of failure, and the installation position of the prosthesis is one of the factors affecting the failure. There are few biomechanical studies on the installation angle of unicompartmental knee prosthesis. MethodsConstructed a finite element model of a normal human knee joint, and the validity of the model was verified by stress and front anterior methods. The mobile-bearing unicompartmental knee arthroplasty femoral prosthesis was placed at 3° intervals from 0° sagittal plane to 15° flexion, and − 2° and 17°were established, and observing the biomechanical changes of components. FindingsMaximum peak stresses occurred at a sagittal mounting angle of −2° for the insert and the contralateral meniscus, with the tibia showing a maximum at 17° sagittal and the tibial prosthesis stress maximum occurring at 6° sagittal. As the sagittal plane angle of the femoral prosthesis increases and the osteotomy distance extends posteriorly, more bone is amputated during the osteotomy. The ratio of the distance from the tip of the anterior intramedullary nail to the anterior end of the osteotomy to the total anteroposterior length of the sagittal osteotomy ranged from 43.2% to 44.6%. InterpretationIn this paper, the more appropriate sagittal mounting position for the femoral prosthesis is between 9 and 12°, based on the amount of osteotomy and the peak stress of each component in a standing position.

Serial injections of 4% polyacrylamide hydrogel have no detrimental effects in equine joints following clinical, histologic, and synovial biomarker evaluation.

Polyacrylamide hydrogel (4% PAHG) is an inert viscoelastic supplement used to manage osteoarthritis in horses. Even with a prolonged clinical effect, horses may be administered multiple doses during their performance career. The effect of the serial 4% PAHG treatments is not known. The objectives of this study were to evaluate the clinical, histologic, and synovial fluid biomarker effects following serial administration of 4% PAHG in normal equine fetlock joints. 8 healthy horses. In a blinded, controlled in vivo study, horses received serial intra-articular injections of 4% PAHG (Noltrex Vet; Nucleus ProVets LLC) and contralateral 0.9% saline control on days 0, 45, 90, and 135. Treatment and control joints were randomly assigned. Synovial fluid was collected before administration of 4% PAHG or 0.9% saline on day 0 and at study completion for cellular and biomarker evaluation. Serial physical and lameness examinations were performed throughout the study. On day 240, gross examination and harvest of cartilage and synovial membrane for histology were completed. There were no histologic changes in articular cartilage or synovial fluid biomarkers. The 4% PAHG was seen on the surface of the synovium in 5 of 8 treated joints 105 days after the last treatment. There are minimal effects following serial injections of 4% PAHG on normal joints in horses following administration at 0, 45, 90, and 135 days, with final evaluation on day 240. Serial administration of intra-articular 4% PAHG in horses may provide long-term joint lubrication with no detrimental effects.

Eye morphometry, body size, and flexibility parameters in myopic adolescents

The aim of this study was to investigate the anatomical and physiological ocular parameters in adolescents with myopia and to examine the relations between refractive error (SER), ocular biometry, body size and flexibility parameters in myopic adolescents. A cross-sectional study of 184 myopic adolescents, aged 15 to 19 years was conducted. Refractive error and corneal curvature measures of the eye were evaluated using an autorefractometer under cycloplegia. Central corneal thickness was determined by contact pachymetry. The ocular axial length, anterior and vitreous chamber depth, and lens thickness were measured using A-scan biometry ultrasonography. Height and body weight were measured according to a standardized protocol. Body mass index (BMI) was subsequently calculated. Beighton scale was used to measure joint flexibility. Body stature was positively correlated with ocular axial length (r = 0.39, p < 0.001) and vitreous chamber depth (r = 0.37, p < 0.001). There was a negative correlation between height and SER (r = − 0.46; p < 0.001). Beighton score and body weight had weak positive correlations with axial length and vitreous chamber depth, and a weak negative correlation with SER. A significantly more negative SER was observed in the increased joint mobility group (p < 0.05; U = 5065.5) as compared to normal joint mobility group: mean − 4.37 ± 1.85 D (median − 4.25; IQR − 6.25 to − 3.25 D) and mean − 3.72 ± 1.66 D (median − 3.50; IQR − 4.75 to − 2.25 D) respectively. There was a strong association between height and axial length, as well as SER. Higher degree of myopia significantly correlated with greater Beighton score (increased joint mobility).

Formulation and In-vivo Characterization of 177Lu-tin-colloid as a Radiosynovectomy Agent.

Arthritis is an inflammatory disorder that affects one or more joints of the body for various reasons, including autoimmune disorders, trauma, or infection. In many cases, traditional long-term treatment with various drug combinations (NSAIDs, diseasemodifying antirheumatic drugs, systemic corticosteroids, etc.) can provide relief, but many joints require additional local treatment. Radiosynovectomy (RSV) is an alternative method to current treatment options. Both the global supply shortage of 90Y in recent years and the increasing use of 177Lu-labeled radiopharmaceuticals in the field of nuclear medicine have made it possible to develop 177Lu-labeled microparticles and test them in small groups as RSV agents. This study aimed to develop the 177Lu labeled tin colloid formulation and demonstrate its invivo characterization. Particle size, shape, and labelling efficiency of the four formulations developed were determined. The formula with the highest labelling efficiency was selected for further studies. The quality of the formulation was evaluated based on radionuclidic, radiochemical, and microbial purity. In-vitro stability was evaluated by determining the labelling efficiency. In-vitro stability was tested in PBS and synovial fluid. The biological characterization was assessed using SPECT/CT after injecting the formulation into the normal knee joints of the rabbits. Aggregated colloidal particles were spherical with a particle size of <5 μm. Labelling efficiency and radiochemical purity were >95 and 97.65% (Rf=0.2), respectively. The formulation was stable in vitro for up to 72 hours, both in PBS and synovial fluid. The formulation was homogeneously distributed in the joint at 0 and 1 hour after injection, and radioactivity- related involvement and inguinal lymph node involvement due to possible leakage were not detected in the late period. No pyrogenic/allergic side effects were observed during this period. 177Lu-tin-colloid was successfully prepared under optimized reaction conditions with high binding efficiency and radiochemical purity. The radiolabeled colloid was found to be stable in-vitro both in PBS and synovial fluid at room temperature. Serial PCET/CT images revealed that the activity was completely retained within the synovial cavity, with no activity leakage out of the joint until 48 hours after the injection. With the support of the results from further clinical studies, it may be possible for the formulation to enter clinical use.

The role of microbiota on rheumatoid arthritis onset.

Rheumatoid arthritis (RA) is a chronic autoimmune disease that causes inflammation and pain, which can lead to the loss of normal joint function. Although the exact cause of the disease is not yet fully understood, both environmental factors and genetics may play a role in its development. Moreover, research suggests microbiota contributes to the onset and progression of RA. People with RA show higher quantities of bacteria such as Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Prevotella copri, Proteus mirabilis, and Lactobacillus salivarius compared to healthy individuals. Conversely, studies propose that Lactobacillus casei, a probiotic bacterium with immunomodulatory properties, has beneficial effects for RA in murine and human models. Therefore, this work reviews the potential role of the gut microbiota in the development of RA and explores the feasibility of using probiotic bacteria as a supplementary treatment for this disease.

Histologic and cytologic changes in normal equine joints after injection with 2.5% injectable polyacrylamide hydrogel reveal low-level macrophage-driven foreign body response.

The data presented in this paper are derived from an in vivo study performed to characterize the nature of the synovial integration process of a 2.5% synthetic cross-linked injectable polyacrylamide hydrogel (2.5 iPAAG) injected IA in horses. 10 healthy horses not suffering from OA or signs of joint disease were administered 50 or 100 mg 2.5 iPAAG in a total of 13 metacarpophalangeal or middle carpal joints. Injected joints were examined at 0, 14, 42, and/or 90 days postinjection. Parameters investigated included clinical examination, synoviocentesis, gross pathology, histology, and scanning electron microscopy. All horses remained clinically normal, with no adverse events recorded throughout the study period. Gross postmortem did not reveal any significant findings. Arthrocentesis cytology parameters remained within clinically normal levels throughout the study. Synovial histology demonstrated that cellular infiltration of macrophages, villus hyperplasia, and vascularization were significantly higher in 2.5 iPAAG-injected joints compared to controls. Scanning electron microscopy confirmed that the 2.5 iPAAG demonstrated an extensive tissue integration as a 3-D scaffolding structure with intact cross-linked strands. Results confirm that an IA injection of 2.5 iPAAG induces a typical foreign body response that is predominately macrophage driven with no evidence of fibrosis or mineralization. Integration of the gel is evident by 14 days, with no free gel remaining in the joint cavity at this time.

MRI-based synthetic CT for assessment of the bony elements of the sacroiliac joints in children

ObjectivesThe purpose of this study is to assess the equivalency of MRI-based synthetic CT (sCT) to conventional CT for sacroiliac joint bony morphology assessment in children.MethodsA prospective study was performed. Children who had (PET-)CT-scan underwent additional MRI. sCT-CT image quality was analyzed by two readers subjectively overall, semi-quantitatively in terms of cortical delineation, joint facet defects, growth plate fusion, ossified nuclei, lumbosacral transitional anomaly, and bony bridges, and quantitatively for disc space height, spinal canal width, and sacral vertebrae width and height. Cohen’s kappa and equivalence analyses with Bland–Altman plots were calculated for categorical and continuous measures respectively.ResultsTen patients were included (6 boys; aged 9–16 years; mean age 14 years). Overall sCT image quality was rated good. Semi-quantitative assessment of cortical delineation of sacroiliac joints, bony bridges, and joint facet defects on the right iliac and sacral sides showed perfect agreement. Correlation was good to excellent (kappa 0.615–1) for the presence of lumbosacral transitional anomaly, fusion of sacral growth plates, joint facet defect, and presence of ossified nuclei. sCT-CT measurements were statistically equivalent and within the equivalence margins (–1–1 mm) for intervertebral disc space height and spinal canal width.Intra- and inter-reader reliability was excellent for quantitative assessment (0.806 < ICC < 0.998). For categorical scoring, kappa ranged from substantial to excellent (0.615–1).ConclusionsCT appears to be visually equivalent to CT for the assessment of pediatric sacroiliac joints. sCT may aid in visualizing sacroiliac joints compared to conventional MRI, with the benefit that no ionizing radiation is used, especially important in children.Critical relevance statementMRI-based synthetic CT, a new technique that generates CT-like images without ionizing radiation, appears to be visually equivalent to CT for assessment of normal pediatric sacroiliac joints and can potentially assess structural damage as it clearly depicts bony cortex.Key points• MRI-based sCT is a new image technique that can generate CT-like images.• We found that sCT performs similarly to CT in displaying bony structures of pediatric sacroiliac joints.• sCT has already been clinically validated in the sacroiliac joints in adults.• sCT can potentially assess structural damage from erosions or ankylosis as it clearly depicts bony cortex.Graphical

The Application of Sesamoid Position in Diagnosing Thumb Metacarpophalangeal Joint Dorsal Dislocation: A Retrospective Study.

The position of sesamoid of thumb metacarpophalangeal (MCP) joint changed clearly when the joint was dislocated dorsally. However, the significance of sesamoid location in diagnosing joint dislocation was unclear. The present study aimed to explore the positional relationship between sesamoid bone and thumb metacarpophalangeal joint in normal and dorsal dislocation joints. Between January 2018 and August 2023, we collected 60 isometric plain films from sixty outpatients and reviewed 56 anisometric plain films from twenty-eight emergency patients with dorsal dislocation of thumb MCP joint at Tianjin Hospital, then took measurements on the hand X-ray images. The sesamoid length on its longitudinal axis was defined as DP, the distance between the distal edge of sesamoid and thumb MCP joint was defined as DJ, and the ratio of DJ and DP was R. An independent-samples t-test and paired-samples t-test was utilized to analyze difference among data groups. The 60 isometric images were from 30 male and 30 female outpatients with normal bone structure in their hands, and the 56 anisometric images of the 28 emergency patients included both preoperative and postoperative materials. Among the outpatients, the actual distance between the distal edge of sesamoid and thumb MCP joint space (DJ) was 2.09 mm and 1.40 mm in males and females, respectively. The authentic average length of sesamoid (DP) was 4.46 mm in males and 4.22 mm in females. The average value of R (the ratio of DJ and DP) in males and females was 0.49 and 0.34, respectively. There were gender-related statistical differences in DJ (p < 0.01) and R (p=0.01), but no statistical difference in DP (p > 0.05). For the 28 emergency patients, the mean value of R was -0.47 before joint reduction and 0.58 after joint reduction, with statistical difference between them (p < 0.01). There was significant difference in the relative position between sesamoid and thumb MCP joint when joint dislocation and joint reduction. The distal edge of sesamoid beyond thumb MCP joint could be an evidence in diagnosing joint dorsal dislocation. The distal edge of sesamoid below thumb MCP joint could be an evidence of joint reduction.

Complete Morphometry of Normal and Dysplastic Hip Joint in Large Breeds of Dogs

Complete Morphometry of Normal and Dysplastic Hip Joint in Large Breeds of Dogs

Evaluation of the accuracy of a fully digital method of measuring sagittal condylar inclination.

This clinical study aimed to evaluate the accuracy of a fully digital technique for measuring sagittal condylar inclination (SCI), as well as validating whether differences existed between the left and right SCI values of the same participant, to provide a reference for clinical practice. Ten participants with good occlusal relationship and normal temporomandibular joint were recruited. Three methods were used to measure the SCI values of the participants, namely, A (mechanical facebow transferring and mechanical articulator-based measuring method with physical protrusive interocclusal registration), B (face scan-based virtual facebow and virtual articulator-based measuring method with digital protrusive interocclusal registration), and C (jaw motion tracking system-based measuring method). With the group subjected to methods A and C as the control, the SCI values obtained by the three methods were statistically analyzed. The left and right SCI values of the same participant were also compared. The left and right SCI values measured by method A were 41.70°±7.09° and 42.80°±8.62°, those by method B were 35.09°±12.49° and 37.63°±12.10°, and those by method C were 39.43°±8.72° and 38.45°±6.91°. No significant difference existed among the SCI values measured by the three methods (P>0.05). Meanwhile, no statistical difference existed between the SCI values on the left and right sides of the same participant (P>0.05). The accuracy of the virtual facebow and digital protrusive occlusal registration based SCI measuring method was the same as that of mechanical facebow based and jaw motion tracking system-based methods. The SCI values on the left and right sides of the same participant were similar. Clinically, an appropriate SCI measurement and setting strategy can be selected based on the actual situations.

Research on automatic recognition radiomics algorithm for early sacroiliac arthritis based on sacroiliac MRI imaging

ObjectiveTo create an automated machine learning model using sacroiliac joint MRI imaging for early sacroiliac arthritis detection, aiming to enhance diagnostic accuracy.MethodsWe conducted a retrospective analysis involving 71 patients with early sacroiliac arthritis and 85 patients with normal sacroiliac joint MRI scans. Transverse T1WI and T2WI sequences were collected and subjected to radiomics analysis by two physicians. Patients were randomly divided into training and test groups at a 7:3 ratio. Initially, we extracted the region of interest on the sacroiliac joint surface using ITK-SNAP 3.6.0 software and extracted radiomic features. We retained features with an Intraclass Correlation Coefficient > 0.80, followed by filtering using max-relevance and min-redundancy (mRMR) and LASSO algorithms to establish an automatic identification model for sacroiliac joint surface injury. Receiver operating characteristic (ROC) curves were plotted, and the area under the ROC curve (AUC) was calculated. Model performance was assessed by accuracy, sensitivity, and specificity.ResultsWe evaluated model performance, achieving an AUC of 0.943 for the SVM-T1WI training group, with accuracy, sensitivity, and specificity values of 0.878, 0.836, and 0.943, respectively. The SVM-T1WI test group exhibited an AUC of 0.875, with corresponding accuracy, sensitivity, and specificity values of 0.909, 0.929, and 0.875, respectively. For the SVM-T2WI training group, the AUC was 0.975, with accuracy, sensitivity, and specificity values of 0.933, 0.889, and 0.750. The SVM-T2WI test group produced an AUC of 0.902, with accuracy, sensitivity, and specificity values of 0.864, 0.889, and 0.800. In the SVM-bimodal training group, we achieved an AUC of 0.974, with accuracy, sensitivity, and specificity values of 0.921, 0.889, and 0.971, respectively. The SVM-bimodal test group exhibited an AUC of 0.964, with accuracy, sensitivity, and specificity values of 0.955, 1.000, and 0.875, respectively.ConclusionThe radiomics-based detection model demonstrates excellent automatic identification performance for early sacroiliitis.

Alteration in ACL loading after total and partial medial meniscectomy

Anterior cruciate ligament (ACL) injuries are often caused by high impact loadings during competitive sports but may also happen during regular daily activities due to tissue degeneration or altered mechanics after a previous knee injury or surgery such as meniscectomy. Most existing research on ACL injury has focused on impact loading scenarios or the consequence of ACL injury on meniscus. The objective of the present study was to investigate the effects of varying degrees of medial meniscectomy on the mechanics of intact ACL by performing a poromechanical finite element analysis under moderate creep loadings. Four clinical scenarios with 25%, 50%, 75% and total medial meniscectomy were compared with the intact knee finite element model. Our results suggested that different medial meniscal resections may increase, at different extents, the knee laxity and peak tensile stress in the ACL, potentially leading to collagen fiber fatigue tearing and altered mechanobiology under normal joint loadings. Interestingly, the ACL stress actually increased during early knee creep (~ 3 min) before it reached an equilibrium. In addition, meniscectomy accelerated ACL stress reduction during knee creep, transferred more loading to tibial cartilage, increased contact pressure, and shifted the contact center posteriorly. This study may contribute to a better understanding of the interaction of meniscectomy and ACL integrity during daily loadings.

Association between bilateral condylar resorption and reduced volumes of the craniofacial skeleton and masticatory muscles in adult patients: A retrospective study

ObjectivesThis retrospective cohort study aimed to analyze volumes of craniomaxillofacial bone and masticatory muscles of young adults with bilateral idiopathic condylar resorption. MethodsThis was a retrospective cohort study of 84 adults with bilateral idiopathic condylar resorption (BCR) and 48 adults with normal temporal-mandibular joint (TMJ) matched for age and sex (mean age, 23.2 ± 3.6 years). The volumes of craniomaxillofacial bone and masticatory muscles, as well as intercondylar angle were measured. Unpaired t-tests and Pearson correlation tests were applied to analyze the data. Multivariable linear regression models were used to estimate the association between bilateral condylar volume and volumes of craniomaxillofacial bone and masticatory muscles adjusted for age, sex, and disc status. ResultsCompared to the control group, the BCR group displayed significant decreased volumes of craniomaxillofacial bone (p < 0.001), craniomaxillofacial bone without mandible (p < 0.001), mandible (p < 0.001), mandible without mandibular condylar process (p < 0.001), bilateral masseter muscle (p < 0.001) and bilateral temporalis muscle (p < 0.001), as well as the intercondylar angle (p < 0.001). These variables were significantly correlated to the volume of mandibular condylar process (0.5< r < 0.8; p < 0.001). By linear regression analyses, significant associations were found for the bilateral condylar volume with craniomaxillofacial bone volume and mandible bone volume. ConclusionsYoung adults with BCR displayed smaller volumes of craniomaxillofacial skeleton and masticatory muscles, and smaller intercondylar angle than the normal patients. The craniofacial musculoskeletal volume and intercondylar angle are associated with mandibular condylar process volume.

Chondroitin sulfate and caseinophosphopeptides doped polyurethane-based highly porous 3D scaffolds for tendon-to-bone regeneration

Tendon disorders are common injuries, which can be greatly debilitating as they are often accompanied by great pain and inflammation. Moreover, several problems are also related to the laceration of the tendon-to-bone interface (TBI), a specific region subjected to great mechanical stresses. The techniques used nowadays for the treatment of tendon and TBI injuries often involve surgery. However, one critical aspect of this procedure involves the elevated risk of fail due to the tissues weakening and the postoperative alterations of the normal joint mechanics. Synthetic polymers, such as thermoplastic polyurethane, are of special interest in the tissue engineering field as they allow the production of scaffolds with tunable elastic and mechanical properties, that could guarantee an effective support during the new tissue formation. Based on these premises, the aim of this work was the design and the development of highly porous 3D scaffolds based on thermoplastic polyurethane, and doped with chondroitin sulfate and caseinophosphopeptides, able to mimic the structural, biomechanical, and biochemical functions of the TBI. The obtained scaffolds were characterized by a homogeneous microporous structure, and by a porosity optimal for cell nutrition and migration. They were also characterized by remarkable mechanical properties, reaching values comparable to the ones of the native tendons. The scaffolds promoted the tenocyte adhesion and proliferation when caseinophosphopetides and chondroitin sulfate are present in the 3D structure. In particular, caseinophosphopeptides’ optimal concentration for cell proliferation resulted 2.4 mg/mL. Finally, the systems evaluation in vivo demonstrated the scaffolds’ safety, since they did not cause any inflammatory effect nor foreign body response, representing interesting platforms for the regeneration of injured TBI.