Osseous Reaction Research Articles

Sports Injuries in Young Athletes: Long-Term Outcome and Prevention Strategies

Physical activity plays a significant role in the physical and emotional well-being of a child. In the past 15 to 20 years, there has been a dramatic increase in sports participation at a young age, which has offered numerous health benefits, including self-esteem, confidence, team play, fitness, agility, and strength. Children are playing sports at younger ages. This article assesses the long-term outcome of sports injuries in young athletes, with suggestions on how to prevent such injuries. There are no definitive epidemiological data on withdraw from sports activities due to injury in young athletes. Disturbed physeal growth as a result of injury can result in length discrepancy, angular deformity, or altered joint mechanics, and may cause significant long-term disability. Sequelae of Osgood-Schlatter lesion include painful ossicle in the distal patellar tendon. Fragmentation or separation of the apophysis appears to be the result of adaptive changes to the increased stress that occurs in overuse activities. The presence of these changes undeniably demonstrates an osseous reaction, although they are not disabling. Promotion of a physically active lifestyle is encouraged worldwide, particularly with regard to the many health benefits. Reduction of only a moderate proportion of all sports injuries is of significance for the young athletes' health and could have a long-term economic impact on health care costs. It is therefore important to convince medical doctors, physical therapists, athletic trainers and coaches, as well as athletes of the necessity to implement active prevention measures in their therapy and training programs, thus decreasing the injury and re-injury rate and enhancing athletic performance.

MR Imaging Findings of Parosteal Lipoma: Case Report

Parosteal lipoma is a rare benign tumor containing mature adipose tissue having an intimate relationship to the periosteum. Characteristically, this tumor presents as a lipomatous mass adjacent to bone, eliciting variable reactive changes in the underlying cortex. We report a case of parosteal lipoma of the foot. The MR findings consisted of juxtacortical lipomatous mass abutting to bony protuberance, with internal fibrous striations, and osseous reaction in the adjacent bone. By the aid of multiplanar imaging capability, high spatial and contrast resolution of MRI, characteristic features of parosteal lipoma can lead to diagnosis on imaging.

Akuter, traumatischer versus chronischer Knorpelschaden unter gutachterlichen Gesichtspunkten

Have chondral lesions been found in the course of an articular injury? Are these lesions of traumatic or degenerative origin? Is it possible to differentiate traumatic from pre-existing pathology with the help of history, clinical findings and imaging features? The answers to these questions are of paramount importance in the setting of legal expert assessment. The diagnosis of an acute traumatic chondral injury is based on arthroscopic and/or MRI findings. MRI is the diagnostic method of choice in a suspected isolated chondral injury. The method yields high accuracy in detecting chondral and osteochondral lesions. The MRI finding of a concomitant subchondral bone contusion ("bone bruise") adjacent to a cartilage lesion helps in the diagnosis of acute chondral lesions. Traumatic bone marrow alterations regress in most cases over the course of 6 months. For this reason the initial MRI should be performed within 1 to 6 weeks after trauma. A follow-up study should be undertaken not prior to 3 months after injury. Osteoarthritic cartilage lesions show a distinct regional pattern on MRI usually affecting the weight-bearing regions. In advanced stages, regularly concomitant osseous reactions such as osteophytes, subchondral sclerosis and bone attrition are observed. Subchondral bone marrow lesions in osteoarthritis show a tendency to progress. The direct inspection and probing of the joint during arthroscopy allows for a detailed assessment of the chondral surface and the diagnosis of possible cartilage softening. An arthroscopic differentiation between acute traumatic chondral lesions and chronic cartilage alterations is possible in most cases within the first 6 to 12 weeks after injury.

Perkutane lumbale interkorporelle Spondylodese mit autogenen Osteoblasten in vivo

In the present study we have investigated the potential of autogenous osteoblasts for osteoinduction in a spinal arthrodesis model. After posterolateral instrumentation of 3 segments of a sheep spine the intervertebral space was filled with cancellous bone, osteoblasts or left empty after nucleotomy and elimination of cartilage. Radiological and histological analyses proved a significant osseous reaction in segments treated with cancellous bone or osteoblasts in contrast to the control segment. This outcome provides evidence of spondylodeses by spinal instrumentation in combination with osteoblasts in a sheep model. The results suggest a possible application of autologous osteoblasts as an osteoinductor after percutaneous nucleotomy in spinal fusion. The possible application in a human model should be examined.

PRECONCEIVED NOTIONS AND HYPOTHESIS TESTING: HOLES IN THE BLUE HOLE

Reconciling reported frequencies of periosteal reaction has been compromised by variable criteria for its recognition. One of the most important aspects of paleopathologic diagnosis is logical consideration of data, while avoiding biases introduced by preconceived notions. Documentation that skeletal manifestations of the treponemal diseases (as a population phenomena) are sufficiently (and reproducibly) distinct would allow meaningful assessment of the course of invasion and spread of treponemal disease in the Western Hemisphere. Quantitative assessment of the nature of osseous impact of specific treponemal diseases has resulted in identification of reproducible discriminating characteristics. The osseous reaction to treponemal infection, although reproducible for each variety, is not uniform among them. Examination of population frequency, demographics, character, and skeletal distribution of osseous treponemal impact provides clear, reproducible clues to the identity of the underlying treponematosis and help to distinguish them from other periosteal/cortical disorders. Application of the standard for distinguishing among the treponematoses has revealed only four patterns of disease: Those categorized as syphilis, yaws, bejel and a null pattern. The apparently inviolate categorization allows confidence in distinguishing among them.

Molecular evidence for different stages of tuberculosis in ancient bone samples from Hungary.

This paleomicrobiologic study was conducted on osseous tissue specimens from ancient Hungarian skeletal samples from the 7-8th and the 17th centuries AD with typical macromorphologic evidence of osseous tuberculosis (n = 3), morphologic alterations probably due to tuberculosis (n = 6), or with nontypical osseous changes of vertebral bodies suggestive of inflammatory reaction (n = 5). From these bone samples, DNA was extracted and amplified by polymerase chain reaction (PCR) by using various primer pairs recognizing DNA segments of different mycobacterial species. To confirm specificity of the analysis, the amplification products of several samples were subjected to restriction enzyme digestion and/or direct sequencing. Of the analyzed 14 cases, 8 were unambiguously positive for mycobacterial DNA of the Mycobacterium tuberculosis complex, as shown by the amplification of the IS6110 sequence. In 13 cases we found a PCR product with primers specific for the 65-kDa antigen gene, including 2 cases without genomic DNA. We conclude that the application of other mycobacterial DNA primers may reveal contamination of bones with atypical saprophytic mycobacteria. A positive result for typical mycobacteria was seen in 2 of 3 cases with typical morphologic signs of tuberculosis and amplifiable DNA, in 3 of 6 probable cases, but also in 3 of 6 cases with nontypical bone changes. This indicates that minor osseous reactions of the surface of vertebral bodies may be due-at least in several cases-to infections with bacteria of the M. tuberculosis complex. In these cases the disease may have proceeded rapidly, and the morphologic osseous changes may represent "early" stages of tuberculous infection of the vertebrae.

Late Results After Subtrochanteric Angulation Osteotomy in Young Patients

Young patients with painful congenital dislocation of the hips need surgery if conservative treatment is unsuccessful. A total of 24 patients after 28 subtrochanteric angulation osteotomies without resection of the femoral head were followed up (mean, 17 years) to evaluate long-term results. Most patients maintain improved function: 20 hips showed persistent gain of abduction, 14 patients showed improvement of gait, and 18 patients described less pain. The degree of angulation must equal the inclination of the pelvic wall to influence hip stability as well as hip range of motion. Osseous reactions of support-seen in 10 hips-are not proof of operative success. Angulation osteotomy does not exclude later surgical procedures such as total hip replacement.

Treponemal Disease Revisited: Skeletal Discriminators for Yaws, Bejel, and Venereal Syphilis

Assigning responsibility for the origins of treponemal disease has been complicated because of the (diagnostic) impreciseness of the historical written record and the inability to microbiologically distinguish among the treponematoses. Bedouin skeletal remains of individuals from the Negev area of Israel who had bejel, skeletons from the Todd human skeleton collection of individuals in whom syphilis was diagnosed, and skeletal remains from Guam of individuals who had yaws were analyzed to quantitatively assess their skeletal damage. The osseous reactions, although reproducible for each variety of treponemal disease, are not uniform among these skeletons. Examination of population frequency, demographics, character, and skeletal distribution of osseous treponemal damage in these skeletal sites provides clear, reproducible clues to the identity of the underlying treponematosis: bejel and yaws are common (> 20% according to skeletal findings) in the population. Syphilis and bejel usually spare the hands and feet. Yaws tends to be more polyostotic. Analysis of these parameters as population phenomena in pre-Columbian archeological sites should afford the opportunity to define the origins of the various treponemal disorders.

Osseous reaction to implanted ZOE retrograde filling materials in the tibia of rats

The osseous reaction of IRM and EBA cement were studied utilizing an intraosseous implant technique in rats. Samples of IRM, EBA cement, and amalgam were placed into polyethylene tubes and subsequently introduced surgically into rat tibias. Specimens of each were evaluated histologically after 7, 14, 21, 56, and 100 days. The IRM and amalgam samples demonstrated essentially complete healing at 56 days. The EBA cement samples displayed a slightly greater inflammatory response up to the 56-day interval; however, they also showed complete healing by 100 days. A favorable osseous reaction was seen with both of these zinc oxide-eugenol materials.

Parosteal lipoma: MR imaging characteristics.

The purpose of this study was to determine the characteristics of parosteal lipomas on MR imaging. We retrospectively reviewed the images and medical records of eight patients with surgically and pathologically confirmed parosteal lipomas. Radiologic studies performed included conventional radiography and MR imaging (n = 8), CT (n = 7), conventional tomography (n = 2), and scintigraphy (n = 5). Osseous reaction was present in all cases, manifesting as either mild cortical thickening best seen on magnification radiographs or larger osseous excrescences seen on all radiologic images. These osseous reactions were surrounded by the lipomatous component of the neoplasm and created a firm attachment of the neoplasm to the underlying bone. The lipomatous component showed typical features of adipose tissue on all images and was usually seen on radiographs (n = 7). However, CT or MR imaging was needed to determine the anatomic location and relationship to surrounding structures before surgery. MR imaging was considered superior to CT for preoperative assessment, primarily because of its multiplanar imaging capability. In addition, cartilage and fibrous tissue (n = 3) were identified adjacent to larger osseous excrescences. Associated muscle atrophy in three cases was caused by nerve impingement. These manifestations of parosteal lipoma were also better assessed with MR images because of improved contrast resolution. The distribution of muscle atrophy could be used to determine the site of nerve involvement preoperatively. We conclude that MR imaging is the most useful adjunct to conventional radiography in the presurgical evaluation of parosteal lipomas because of its multiplanar imaging capabilities and improved contrast resolution for detecting muscle atrophy and site of nerve involvement when present. These factors are important for preoperative assessment to help guide surgical intervention.

Bone formation in coralline hydroxyapatite. Effects of pore size studied in rabbits.

We analyzed osseous reactions in the rabbit femoral condyle to coralline hydroxyapatite bone substitutes of various pore sizes by radiology and histology. The results were compared to bone repair of empty cavities and to integration of allografts. Spontaneous bone repair of the empty cavities took approximately 12 weeks, while integration of the cryopreserved allografts occurred after 9 weeks. However, no signs of new bone formation were found with the 200 microns pore size hydroxyapatite. In contrast, there was substantial production of bone within the 500 microns pore size implants at 12 and 26 weeks. Our results indicate that the pore size of the coralline hydroxyapatite influenced the development of bone in the implants in the cancellous bone bed of the rabbit femoral condyle. The results also show that spontaneous bone repair should be taken into consideration when the integration of implants is evaluated.

Distal Tibial Articular Fractures in Racing Greyhounds: A Review of Six Cases

SummarySix spontaneously occurring distal tibial fractures extending into the posterior articular margin of young racing greyhounds were reviewed. Concomitant fractures of both malleoli occurred in three cases. Fracture patterns, methods of treatment and functional results were determined. Open anatomical reduction and rigid internal fixation promoted healing with minimal osseous reaction and showed better results than conservative treatment. Complications adversely affecting the outcome were periarticular deformity and osteoarthritis, these were observed as early as five to seven weeks following the operations.Six spontaneously occurring distal tibial fractures extending into the posterior articular margin of young racing greyhounds were reviewed. Fracture patterns, methods of treatment and functional results were determined.

The Effect of Silicon Nitride Ceramic on Rabbit Skeletal Cells and Tissue

This article presents a morphologic assessment of the effect of silicon nitride ceramic (Si3N4) on rabbit marrow stromal cells and their differentiation when grown in vitro and in vivo. In vitro marrow stromal cells (MSC) attached initially to upper portions of ceramic discs. However, at four weeks, cells only attached to disc edges. Fresh marrow or first passage MSC, inoculated into diffusion chambers with and without Si3N4, formed cartilage, bone, and fibrous tissue after being implanted intraperitoneally for five weeks. Tissue differentiated adjacent to Si3N4 but not within the pores. In contrast, Si3N4 implants inserted into femoral marrow cavities were surrounded initially by woven bone and within three months by mature bone that had permeated implants with a pore size of 255 +/- 64 microns. Plugs having a pore diameter of 170 +/- 45 microns mainly contained vascularized fibrous tissue with occasional foci of osteoid or bone in the peripheral pores. In a pilot experiment, three femoral segmental Si3N4 endoprostheses were implanted in three adult rabbits, and the osseous reactions were monitored during their natural life. Each implant was enclosed by a stable cuff of bone within four months of implantation and remained unchanged during the rest of the animal's life. Autopsies confirmed these roentgenographic observations, and tissue appositional to each prosthesis was morphologically normal. Si3N4 has the potential of an important ceramic for use in osseous reconstruction.

Conventional Radiography in Transient Synovitis of the Hip in Children

Conventional radiography was performed at diagnosis and at follow-up 5 to 9 months later in 70 children with transient synovitis of the hip. Twenty-four of the patients also had CT examination at diagnosis. The cartilaginous and osseous reaction in the conventional antero-posterior radiographs was studied as was the relation between the radiographic and CT findings concerning fat planes, joint effusion, and position of the hip joint. At diagnosis there was significant increase in the medial joint space and at follow-up examination there was significant increase in medial and cranial joint space, metaphyseal width and acetabular roof width. There was a correlation of a bulging lateral 'capsular fat plane' to the position of abduction in the affected hip which explains the asymmetry in the lateral fat plane observed in these patients.

Osseous reactions to three hemostatic agents

The effects of bone wax, Surgicel, and Gelfoam on bone healing were evaluated microscopically using two different intraosseous implantation techniques. Experimental defects were made in both tibias of rats. Test materials were placed in defects in right tibias and were left in situ for the duration of the experiment. Likewise, materials were placed in left tibial defects and then were removed as completely as possible after 10 min. All three hemostatic agents affected healing when left in situ. Bone wax inhibited osteogenesis. Surgicel markedly slowed the rate of repair and caused inflammation. Gelfoam was usually completely resorbed and healing was complete 120 days after surgery. Residues of test materials were observed in most left tibial defects and they elicited reactions that were qualitatively similar but quantitatively less involved than those observed in the right tibias. These results indicate that careful removal of hemostatic agents during periapical surgery aids healing.

Osseous reactions to bimetallic couples composed of amalgam and gold implanted in rat tibias

Small, bimetallic couples were manufactured by condensing dental amalgam against a gold post which had been placed in polyethylene tubing. These devices were placed in rat tibias and osseous reactions were evaluated microscopically up to 112 days after surgery. The low current levels generated by the bimetallic couples used in this study did not affect the healing rate of the surgical osseous defect. Statistical analysis demonstrated that there were equal amounts of bone deposited at the anodes and cathodes of the experimental implants at all time intervals studied. The small currents produced by experimental implants did not interfere with the normal healing process, and the implications of this study in clinical situations are discussed.

Experimental production of osseous reactions on metal implants. Influencing of the priosteal bone formation through mechanical tensions

Experimental production of osseous reactions on metal implants. Influencing of the priosteal bone formation through mechanical tensions

Bone Lesions in Children

THE bones of the child differ from those of the adult skeleton in structure and composition, and, as a result of these variations, the osseous reaction to pathologic processes varies at different age periods. The bone of the child being more vascular is subject more frequently to infection of hematogenous origin and being less compact is more quickly destroyed by infection; also, being less compact than adult bone it will yield more readily under pressure or strain. On the other hand, the greater vascularity and the inherent power of growth and repair of young tissues result in rapid bone proliferation and, at times, complete restoration after injury or disease. Affections peculiar to the epiphyses may occur only during the period of growth; certain diseases of infancy and childhood affect the epiphyses primarily, retarding growth and producing deformities. Trauma is common in childhood and may be a predisposing or direct etiologic factor in many bone affections. Neoplasms of bone, both benign and maligna...