Joint Osteoarthrosis Research Articles

Temporomandibular joint CBCT image segmentation via multi-view ensemble learning network.

Accurate segmentation of the temporomandibular joint (TMJ) from cone beam CT (CBCT) images holds significant clinical value for diagnosing temporomandibular joint osteoarthrosis (TMJOA) and related conditions. Convolutional neural network-based medical image segmentation methods have achieved state-of-the-art performance in various segmentation tasks. However, 3D medical images segmentation requires substantial global context and rich spatial semantic information, demanding much more GPU memory and computational resources. To address these challenges in 3D medical image segmentation, we propose a novel network- the MVEL-Net (Multi-view Ensemble Learning Network) for TMJ CBCT image segmentation. By resampling images along three dimensions, we generate multiple weak learners with different spatial semantic information. A subsequent strong learning network effectively integrates the outputs from these weak learners to achieve more accurate segmentation results. We evaluated our network model using a clinical dataset comprising 88 subjects with TMJ CBCT images. The average Dice similarity coefficient (DSC) was 0.9817 ± 0.0049, the average surface distance was 0.0540 ± 0.0179mm, and the 95% Hausdorff distance was 0.1743 ± 0.0550mm. Our proposed MVEL-Net demonstrates excellent segmentation performance on TMJ from CBCT images, while using fewer GPU memory resources compared to other 3D networks. The effectiveness of this method in capturing spatial context could be leveraged for tasks like organ segmentation from volumetric scans. This may facilitate wider adoption of AI-based solutions for automated analysis of 3D medical images.

Shoulder balloon spacer for massive irreparable rotator cuff tears results in significant improvements.

The aim of the present study was to assess the effectiveness of balloon implantation in patients with irreparable supraspinatus tears alone or in combination withother rotator cuff (RC) tendon tearsand the effect of several covariables, such as age, gender, status of the long head biceps, with or without tendon repair and regardless the number of tendon involved. Patients enrolled from 'San Carlo' Hospital of Potenza (Italy, IT), from January 2012 to September 2014, underwent arthroscopic implantation of shoulder balloon by a single surgeon, and followed for 3 years. The American Shoulder and Elbow Surgeons (ASES) and Constant score (CS) were administered pre-, post-operatively at 12 months, and then annually. Patients were classified on the basis of the number of tendons involved in the tears and treatment performed, considering the reparability of the tendons themselves. Gleno-humeral joint osteoarthrosis (OA) was evaluated through shoulder radiographs and classified according to the Samilson-Prieto classification, at the first examination and at the final follow-up. Statistical improvements were evaluated using a variance model (least-squares means)and a T distribution test for the evaluation between different treatment groups. A total of 61 procedures were performed, and eight patients were lost during follow-up. The mean baseline CS was 30.2 ± 15.4 with statistically significant improvement, respectively, at 1-, 2- and 3-year follow-up to 69.3 ± 4.2, 74.6 ± 3.6 and 69.7 ± 5.1 respectively. ASES score at baseline was 22.5 ± 10.9, with a statistically significant improvement to 69.7 ± 9.2, 68 ± 17.8 and 71.2 ± 16.6 at 1-, 2- and 3-year follow-up, respectively. Tenotomy or absence of long head biceps at presentation did not influence results (n.s.), with no difference according to gender and age. At final follow-up, 24 patients (43.9%) showed progression of glenohumeral OA. One patient required secondary surgery for shoulder replacement after 18 months for persistent pain and one patient required implant removal following post-operative laser treatment. Arthroscopic rotator cuff tears repair with subacromial spacer balloon implantation showed statistically significant clinical and functional improvement at 3-year follow-up. Patients treated with combined partial repair and subacromial spacer balloon implantation experienced good results independent of gender, age, type of tear and long-head biceps tendon status. The risks related to this procedure appear to be minimal. Level IV.

Characterization of the knee joint phenotype in the Portuguese population

Background: Neutral constitutional alignment and neutral joint line obliquity has been the standard alignment strategy for total knee arthroplasty. This one-for-all measure may negatively impact gait pattern and knee biomechanics. Novel alignment strategies surged, considering the variability in phenotypes found across the literature, as different populations may present different phenotype distributions. The Portuguese population has a distinct genetic origin, with no phenotype distribution data. Our objective was to characterise the population’s knee morphology, searching and analysing adjacent joint osteoarthrosis, and calculating the pre-disease coronal alignment. Methods: A retrospective cohort study was conducted. Full-length X-rays performed between 2016-2023 were analysed. Five alignment parameters were measured (LDFA, MPTA, JLCA, TJLA, HKA), and two parameters were calculated (aHKA, JLO). Knees were classified according to the CPAK classification. Results: For the arthritic cohort, CPAK-I (23%) II (20%) were most common, aHKA increases as KL increases (r=0.8352; p<0.001). For the healthy, Type-II (42%) and Type-I (15%) were most common. For paediatric, Type-II (43%) and Type-V (21%) were most common. CPAK Types-VII/VIII/IX were rare. Differences between genders for healthy and arthritic cohorts were statistically significant. The arthritic had higher prevalence of adjacent joint osteoarthritis. Conclusions: The Portuguese population presents a similar knee phenotype comparing with other populations, some differences have been found regarding the Asian continent. The most common phenotype was a neutral alignment if either healthy or paediatric, or a varus alignment if knee OA. Coronal alignment may not have a major impact in the prevalence of ankle and hip osteoarthritis; however, higher prevalence is observed in patients with knee OA.

Prevalence of orofacial and head pain: an umbrella review of systematic reviews

Head pain (HP) and orofacial pain (OFP) are the most prevalent types of pain worldwide, encompassing cranial, oral and facial pain. The aim of this umbrella review was to answer the following questions: “What is the overall prevalence of HP/OFP and the different prevalences of HP/OFP conditions in adults and children?”. We searched for studies investigating the prevalence of HP/OFP in four major databases and two databases from the grey literature, based on the following PECOS inclusion criteria:(P)opulation: Adults and children; (E)xposure: Orofacial or head pain conditions such as (1) dental, periodontal and gingival, (2) temporomandibular disorders (TMD), (3) neuropathic conditions, (4) headaches, and (5) idiopathic pain conditions; (C)omparison: None; (O)utcome: Prevalence; (S)tudies: Systematic reviews and/or meta-analyses. We identified 2275 studies and after selection through eligibility criteria, 24 systematic reviews were included. The prevalence of pain in adults for different subgroups ranged from 1.12% for Burning Mouth Syndrome to 80.80% for cancer therapy-related orofacial pain. In children, it ranged from 0.20% for temporomandibular joint osteoarthrosis to 83% for all types of headache. This umbrella review based on available evidence provides integrated data illustrating the highly variable prevalence of head pain and orofacial pain both in adults and children. Considering the high specificity of head pain/orofacial pain, specific public health programs should be developed to address such highly prevalent conditions.

Quantitative assessment of condylar bone resorption using fused CBCT images: differentiating and diagnosing three distinct groups based on volume and thickness decrease.

To investigate the accuracy of fused CBCT images in diagnosing three distinct groups of bone changes characterized by volume and thickness decrease in patients with temporomandibular joint osteoarthrosis (TMJ OA) during follow-up. In this retrospective study, 109 patients (176 TMJs) with TMJ OA were included. Two consecutive CBCT images for the same patient were registered and fused. Then, three image sets were established: without fusion, fused 2D image, and fused 3D image. Three residents randomly and independently evaluated whether there was condylar resorption with the three image sets respectively. The samples diagnosed as condylar resorption by the expert panel were divided into three subgroups according to the volume and thickness decrease calculated after segmentation. The inter- and intraobserver agreement, receiver operating characteristic (ROC), and area under the curve (AUC) evaluated the diagnostic capability for different subgroups. For the volume decrease more than 50 mm3 and thickness decrease more than 1 mm groups, the AUC values for fused image sets were higher than those without fusion (p < 0.01). For the volume decrease within 50 mm3 and thickness decrease within 1 mm groups, the AUC values for fused 2D image sets were higher than the image sets without fusion (p < 0.05), but there was no significant difference between the fused 3D image sets and the image sets without fusion (p = 0.48 for volume decrease, p = 0.37 for thickness decrease). The fused images can improve the diagnostic accuracy and repeatability for the samples with at least 50 mm3 volume decrease or 1 mm thickness decrease compared with the image groups without fusion.

Contribution of professor Elena V Karyakina to the progress of Russian rheumatology

The article follows all milestones of professor Elena V. Karyakina's scientific career. Her research of the connective tissue biochemistry and designing of medical technologies aimed at improving the efficacy of treatment and surgical management in patients with rheumatoid arthritis and osteoarthrosis of larger joints made a significant contribution to the development of Russian experimental and practical rheumatology.

Imaging study on the relationship between anterior and posterior occlusal planes and temporomandibular osteoarthrosis.

The aim of this study was to compare the anterior and posterior occlusal plane characteristics of patients with different temporomandibular joint osseous statuses. A total of 306 patients with initial cone beam CT (CBCT) and cephalograms were included. They were divided into three groups on the basis of their temporomandibular joint osseous status: bilateral normal (BN) group, indeterminate for osteoarthrosis (I) group, and osteoarthrosis (OA) group. The anterior and posterior occlusal planes (AOP and POP) of the different groups were compared. Then, the regression equation was established after adjusting for confounding factors, and a correlation analysis between the occlusion planes and other parameters was performed. SNA, SNB, FMA, SN-MP, Ar-Go, and S-Go were correlated with the occlusal planes. Relative to the BN and I groups, the FH-OP of the OA group increased by 1.67° on the average, FH-POP increased by 1.42° on the average, and FH-AOP increased by 2.05° on the average. The occlusal planes were steeper in the patients with temporomandibular osteoarthrosis than in the patients without it, and the mandible rotated downward and backward. The height of the mandibular ramus, the mandibular body length, and the posterior face height were small. In clinical practice, attention should be given to the potential risk of temporomandibular joint osteoarthrosis in such patients. In addition, SNB, FMA, SN-MP, Ar-Go, S-Go, and occlusal planes had moderate correlations.

Ginsenoside Rg1/ADSCs supplemented with hyaluronic acid as the matrix improves rabbit temporomandibular joint osteoarthrosis

ABSTRACT Objective: To investigate whether and how ginsenoside Rg1/ADSCs supplemented with hyaluronic acid as the matrix can improve rabbit temporomandibular joint osteoarthrosis. Method: Isolate and culture adipose stem cells, measure the activity of differentiated chondrocytes by MTT assay and expression of type II collagen in these cells by immunohistochemistry, in order to evaluate the effect of ginsenoside Rg1 on adipose stem cell proliferation and differentiation into chondrocytes.32 New Zealand white rabbits were randomly divided into four groups: blank group, model group, control group and experimental group, 8 in each group. Osteoarthritis model was established by intra-articular injection of papain. Two weeks after successful model building, medication was given for the rabbits in control group and experimental group. 0.6 mL ginsenoside Rg1/ ADSCs suspension was injected into superior joint space for the rabbits in control group, once a week; 0.6 mL ginsenoside Rg1/ ADSCs complex was injected for the rabbits in experimental group, once a week. Results: Ginsenoside Rg1 can promote ADSCs-derived chondrocytes’ activity and expression of type II collagen. Scanning electron microscopy histology images showed cartilage lesions of the experimental group was significantly improved in comparison with control group. Conclusion: Ginsenoside Rg1 can promote ADSCs differentiate into chondrocytes, and Ginsenoside Rg1/ADSCs supplemented with hyaluronic acid as the matrix can significantly improve rabbit temporomandibular joint osteoarthrosis.

Analysis of the Curative Effect of Temporomandibular Joint Disc Release and Fixation Combined with Chitosan Injection in the Treatment of Temporomandibular Joint Osteoarthrosis

Temporomandibular joint osteoarthritis (TMJ-OA) is common in clinic. The purpose of this study was to evaluate the efficacy of disc release, fixation and chitosan injection in the treatment of TMJ-OA. From March 2021 to March 2022, 32 patients who underwent the unilateral reduction and fixation of temporomandibular joint disc release were retrospectively studied. All patients were diagnosed with TMJ-OA and were treated with chitosan injection. This group of patients was analyzed by the visual analog scale (VAS) for pain and improvement of maximum comfortable mouth opening before treatment and 6 months after treatment. A paired t-test was used to evaluate the treatment effect, and p < 0.05 indicated that the difference was statistically significant. All 32 patients were successfully treated by surgery and chitosan injection in the second week after operation. The duration of disease in this group ranged from 1 to 10 months, with an average of 5.7 months. After 6 months of follow up, 30 patients were satisfied with the treatment and two were unsatisfied. The difference in the treatment effect was found to be statistically significant (p < 0.05). Temporomandibular joint disc release and fixation combined with chitosan injection is effective in the treatment of TMJ-OA.

Association of temporomandibular joint osteoarthrosis with dentoskeletal morphology in males: A cone-beam computed tomography and cephalometric analysis.

The objective of the study was to assess the differences in dentoskeletal morphology in males with and without temporomandibular joint osteoarthrosis (TMJOA). Three hundred seventy-one male participants seeking orthodontic treatment were enrolled in this cross-sectional study. Each participant's osseous status was evaluated using cone-beam computed tomography (CBCT) and classified into normal (N=104), indeterminate for TMJOA (N=110) and TMJOA (N=157) groups. The dentoskeletal characteristics were evaluated using cephalograms. Stratified analysis was performed based on age and skeletal pattern. Descriptive statistics and one-way analysis of variance were performed to investigate dentoskeletal differences among groups. P < .05 was considered statistically significant. The differences in posterior cranial base length, FMA, MP-OP, anterior facial height, articular angle, ramus height and L1-MP were statistically significant. After stratification by age, the differences in FMA, maxillomandibular angle, posterior facial height, facial height ratio, gonial angle and mandibular body length were statistically significant in adults. No statistical difference except for articular angle was observed in adolescents. After stratification by skeletal pattern, statistical differences were mainly apparent in skeletal Class II adults. Males with TMJOA showed a posteriorly positioned and backward-rotated mandible, especially in skeletal Class II adults. Compared with women, the craniofacial morphology of men is less affected by TMJOA. The association between TMJOA and craniofacial morphology also varied across different age groups and skeletal patterns. Prospective studies are required to clarify the cause-effect relationship between TMJOA and craniofacial morphology in males.

Imaging observation and analysis of condylar osteosclerosis in temporomandibular joint osteoarthrosis

Objective: To observe the different imaging manifestations of condylar sclerosis in temporomandibular joint osteoarthrosis and explore the imaging significance of condylar sclerosis. Methods: From January 2018 to December 2020, 50 patients with temporomandibular joint condylar sclerosis were examined by cone-beam CT (CBCT) and underwent spiral CT, MRI and radionuclide bone imaging at the Department of Oral and Maxillofacial Surgery in General Hospital of Chinese PLA. There were 15 males and 35 females aged from 16 to 65 years with age of (42.7±14.5) years. The imaging manifestations of CBCT, spiral CT, MRI and radionuclide bone imaging, joint disc displacement and abnormal bone metabolism of condylar sclerosis were analyzed. And the area of condylar sclerosis was graded according to the image of CBCT. Results: A total of 50 patients were included, including 38 unilateral condylar sclerosis, 12 patients with bilateral condylar sclerosis, the total condylar sclerosis were 66. There was no significant difference between the detection rate of further spiral CT (95.5%, 63/66) and CBCT (100.0%, 66/66) (corrected χ²=1.36,P=0.244). The area of condylar sclerosis was (35.5±4.5) mm2, ranged from 1 to 100 mm2. In addition, spiral CT showed more clearly condylar sclerosis than CBCT. Sclerosis can occur in all parts of condyle, mainly in the upper middle region (68.2%,45/66) in coronal position and in the upper front region (71.2%,47/66) in sagittal position. Fifty-seven condylar sclerosis were detected by MRI, including 4(4/19) condylar sclerosis less than 4 mm2. There was significant difference in the displacement of temporomandibular joint disc between the sclerotic side and the non sclerotic side (χ²=10.09, P=0.006). MRI display the condylar sclerosis showed low signal (56/62), followed by high signal (5/62) and medium signal (1/62). Radionuclide bone imaging showed that 4 of the 38 patients with unilateral condyle sclerosis had symmetrical bone metabolism, 34 had abnormal bone metabolism, and 21 patients had concentrated on the non-sclerotic side. Radionuclide bone imaging showed that 4 of the 38 patients with unilateral condyle sclerosis had symmetrical bone metabolism and 34 had abnormal bone metabolism. Conclusions: Spiral CT is more accurate than CBCT in terms of condyle sclerosis through different imaging analysis, and the detection rate of both is higher than MRI. Most of condylar sclerosis showed different degrees of low signal on MRI. The condylar sclerosis side is usually manifested by abnormal bone metabolism.

Diagnostic accuracy of fused CBCT images in the evaluation of temporomandibular joint condylar bone resorption.

To evaluate the diagnostic accuracy of fused CBCT images for patients with condylar bone resorption of temporomandibular joint (TMJ) osteoarthrosis. Forty-two TMJs from twenty-one patients were included. Bone resorption of condyles evaluated by three experts was used as the reference standard. Three oral and maxillofacial radiology residents evaluated the resorption of condyles with a five-point scale for the four sets of images (two consecutive CBCT images without fusion, fused 2D cross-sectional images, fused 3D images, andcombining fused 2D cross-sectional images and fused 3D images) randomly and independently. Each set of images was evaluated at least 1week apart, and a second evaluation was performed 4weeks later. Intraclass correlation coefficients were calculated to assess the intra- and inter-observer agreement. The areas under the ROC curves (AUCs) were compared among the four image sets using the Z test. Twenty-four TMJs were determined as condylar bone resorption, and eighteen were determined as no obvious change. The average AUC values from the three observers for the three fused image sets (0.94, 0.93, 0.93) were significantly higher than the image set without fusion (p < 0.01). The intra- and inter-observer agreement on the three fused image sets (0.70-0.89, 0.91-0.92) was higher than the image set without fusion (0.37-0.63, 0.75). Fused CBCT images of TMJ osteoarthrosis patients can intuitively display the condylar bone resorption and significantly improve the diagnostic accuracy. Fused CBCT images can help clinicians intuitively observe bone changes of the condyle in TMJ osteoarthrosis patients.

Ancient Egyptian paleopathology – The population of the tomb of IPI, necropolis of Dahshur-South

This study investigated the human remains of the tomb complex built by the ancient Egyptian high ranking official “Ipi” (4th Dynasty, ca. 2700-2600 BCE) in the Lower Egyptian necropolis of Dahshur-South. Beyond burials from the tomb owner and his family from the Old Kingdom, the complex was re-used until the Late Period. The excavated material presented the human remains of at least 73 individuals. Unfortunately, initial excavations had collected and mixed individual burials, so that individual identification in most skeletons was not possible. Later excavations presented complete individual burials. The custom typical of the New Kingdom until the Late Period of transnasal trephination offered, even with the mixed burials, a collection of 23 disturbed adults’ skulls (New Kingdom until Late Period) and 33 skulls of undisturbed adults (Old Kingdom). In these two groups sex ratios were fairly balanced. Most adult individuals died between 20 to 30 years. There were relatively few immature burials and a single skeleton was that of a 7th lunar month fetus, an obvious stillbirth; total number of immature was 10 (17.8%). Numerous paleopathological observations indicated the considerable impact of living conditions and health. There were 12 cases with healed traumatic sequelae including one with a healed ankylosed fracture of the knee and another with a fracture of the humerus, three cases of nonspecific osteomyelitis, three cases highly suggestive of spinal tuberculosis, one with evidence of metabolic bone disease from vitamin deficiency, and two cases with malignant bone tumours; one with multiple metastases of the vertebrae, and the other chondrosarcoma of the pelvis. Also, typical pathological changes were seen in teeth and jaws. Finally, the rate of osteoarthrosis of large joints and that of spondylosis suggest significant work load. These findings indicate various ailments either due to heavy work load (arthrosis and spondylosis, traumatic sequelae), or to the living conditions (tooth abrasion by sand ingestion; tuberculosis due to foundation of settlements and townships), metabolic osteopathies possibly due to parasitic diseases and/ or malnutrition. These skeletal remains therefore contribute to our understanding of ancient Egyptian life and diseases.

Natural course of severe temporomandibular joint osteoarthrosis evaluated by a novel condylar remodelling scoring system and quantitative volumetric analysis

Temporomandibular joint osteoarthrosis (TMJ-OA) frequently causes mild, moderate, or severe condylar morphological changes. A novel condylar remodelling scoring system (CRSS) based on three-dimensional cone beam computed tomography images is proposed, which is used to grade condylar morphological changes. In the CRSS, the condyle is divided into 10 regions by 11 reference points. For each increase in the number of regions involved in TMJ-OA, one point is subtracted from the full score of 10. The intra-class correlation coefficients for intra- and inter-observer agreement (range 0.656–0.898 and 0.841–0.906, respectively) indicated that the CRSS had good reliability. Cephalometric analysis showed that the condyles with severe morphological changes were prone to present with a retrognathic and clockwise rotating mandible, shorter ramus height, reduced mandibular length, larger mandibular angle, and maxillary retrusion. Qualitative CRSS evaluation and quantitative volumetric analysis were performed to evaluate the stability of severe TMJ-OA in its natural course (343 condyles). The continuous cortex group showed no remarkable changes with an average follow-up of 2 years. In the discontinuous cortex group, most (74.4%) converted into a continuous cortex during follow-up (mean 2 years).

Temporomandibular joint osteoarthritis: recognizing and challenging

Temporomandibular joint osteoarthritis is an ancient and challenging common disease in clinic. The challenge is clarifying the relationship among temporomandibular joint osteoarthritis, temporomandibular joint osteoarthrosis and temporomandibular disorders, understanding mutual influence among all bony structures' pathological lesions in the joint and exploring pathogenesis, making early diagnosis and accurate diagnosis, and giving effective and standard treatment.

Correlation between temporomandibular joint osteoarthrosis and coronoid process

Objective: To investigate the morphological characteristics of coracoid process in different stages of temporomandibular joint osteoarthrosis (TMJOA), and to provide theoretical data for clinical and anatomic study. Methods: A total of 290 patients who were diagnosed with TMJOA in the Department of Temporomandibular Joint, Kunming Medical University School and Hospital of Stomatology from January 2015 to February 2021 were collected, including 69 males and 221 females, with an average age of 35.1±13.7 years (16-69 years old), 64 cases of unilateral lesions (64 sides), and 226 cases of bilateral lesions (452 sides). According to the TMJOA X-ray staging standard put forward by Ma Xuchen in 2005, the affected joints were divided into stage I (227 sides), stage Ⅱ (38 sides), stage Ⅲ (164 sides) and stage Ⅳ (87 sides). Twenty-six patients without clinical and imaging manifestations of temporomandibular disorders in the Department of Radiology, Kunming Medical University School and Hospital of Stomatology from October 2020 to June 2021 were selected as the control group, including 8 males and 18 females. The average age was (34.3±13.9) years (17-60 years). The dicom data of each group were imported into SimplantPro11.04 software to measure the height of coracoid process, anteversion angle and the ratio of coracoid vertex to mandibular corner to condylar vertex to mandibular angle. R 3.6.1 was used to analyze the difference of the morphological characteristics of coracoid process between in the affected side of TMJOA and in the both sides of the control group, in the healthy side and the affected side of unilateral patients and in different stages of TMJOA. Results: The height of the coracoid process [(16.26±2.81 mm)], the ratio of the coracoid process vertex-mandibular angle point and the condyle vertex-mandibular angle point distance [0.96(0.92,1.01)] on the affected side of TMJOA were significantly higher than those in the control group [(15.31±3.03)mm;0.95(0.89、0.99)] (t=2.18, P=0.033; t=2.87, P=0.004). There was no significant difference between the ante-version angle and the control group (t=-1.37, P=0.176). The ratio of the distance between the apex of the coracoid process and the apex of the mandibular angle to the apex of the condyle and the angle of the mandible in the affected side of unilateral patients was significantly greater than that in the healthy side (t=-3.46, P=0.001). There was no significant difference in coracoid height, coracoid anteversion angle and the healthy side (t=-1.85, P=0.069; t=-0.06, P=0.955) in different periods. The intra-group analysis showed that there was no significant difference in the height of the coracoid process in different stages (F=0.37, P=0.774). There was no significant difference in the ante-version angle of the coracoid process: stage I, stage Ⅱ, and stage Ⅲ (P>0.008), but all were significantly smaller than stage Ⅳ (PⅠ-Ⅳ<0.001, PⅡ-Ⅳ=0.009, PⅢ-Ⅳ<0.001). The ratio of the distance between coracoid apex-mandibular angle and condyle apex-mandibular angle: there was no significant difference in stage I, stage Ⅱ, and stage Ⅲ (P>0.008), and stage I and stage Ⅲ were significantly smaller than stage Ⅳ (P<0.001). Conclusions: The coracoid height and the ratio of the coracoid apex-mandibular angle to the condyle apex-mandibular angle distance on the TMJOA side were significantly greater than those without temporomandibular joint disorders. The bone deposition was mainly concentrated in the upper and posterior part of the condyle. TMJOA had a certain correlation with the height of the coracoid process.

Morphometric Analysis of the Cervical Canal Using Computed Tomography Scan Among Patients With Neck Pain in North India.

IntroductionCervical spinal stenosis is a common disease that results in considerable morbidity and disability. To avoid long-term disability caused by irreversible spinal cord damage, quick diagnosis and treatment are required. To our knowledge, until recently, there has been no report or study evaluating the cervical canal stenosis and associated facet joint arthrosis as the major cause of neck pain, so the current study used computed tomography (CT) scans to determine the prevalence of cervical canal stenosis and facet joint osteoarthrosis in patients who presented with neck pain, including its relationship with age, sex, and cervical spinal levels (C3-C7).MethodsThe current clinical descriptive cross-sectional study was conducted in the Department of Anatomy and Radiodiagnosis at Santosh Medical College, Ghaziabad, for a period of 24 months among newly diagnosed outpatient department (OPD) cases of neck pain (18 years or older) with suspected cervical canal stenosis and facet joint arthrosis. Clinical history, patient-specific clinical examination, and relevant information were obtained in a structured data collection schedule through interviews during OPD hours. All of the participants underwent a CT scan of the cervical region. The independent factors (age, gender, height, and weight) were used in a multiple linear regression analysis of neck pain grading, Torg ratio (TR), and right and left facet joint degeneration, which were expressed as R-squared (R2) and adjusted R-squared (aR2). Statistical tests were executed at a 5% level of significance; an association was considered significant if the p-value was <0.05.ResultsA total of 83 subjects were enrolled in this study with equal representation from both sexes, i.e., males (49.4%) and females (50.6%). The transverse vertebral canal (T-VC) diameter was narrowest at the level of C3 (25.00 ± 1.13) and gradually increased at the level of C6 (25.18 ± 1.14) in this study. The mean TR of cervical vertebrae C3-C4 dropped gradually from C3 (0.78 ± 0.05) to C7 (0.76 ± 0.05) in this study. Severe left and right facet joint degeneration were observed in 13.3% and 10.5% of study subjects, respectively. In almost every subject, neck pain was a neurological symptom, so multiple linear regression analysis of neck pain grading was carried out with the independent variables (age, gender, height, and weight) and it was found to be not significant (R2 = 0.0617, aR2 = 0.0136, p = 0.2842).ConclusionThe articulations of the posterior arch of the vertebrae are known as facet joints. They are a vital component of the vertebral column's structural stability. The superior and inner articular facets of the vertebrae are joined by these joints, which are encased in a fibrous capsule.

PAIN MANAGEMENT IN DOGS WITH OSTEOARTHROSIS: A CASE REPORT

Degenerative joint disease (DAD) or osteoarthrosis (OA) is a common disease among dogs and is characterized by being progressive, minimally inflammatory and with non-neoplastic neoproliferative alterations, which causes considerable dysfunction in all joint structures with its subsequent failure. Affected animals present lameness, reluctance to move after rest and difficulty in performing certain activities, these being the earliest common signs. The outcome of these diseases can be aggravated by: obesity, genetic predisposition, age or trauma. Its diagnosis is based on anamnesis, patient history, physical and radiographic examination. OA treatments can be surgical or conservative depending on the case, and aim to relieve discomfort and delay the development of degenerative changes and it is impossible to revert to existing pathological changes.

Modern Aspects of Endoprosthetics in Hip Joint Osteoarthritis

The surgical procedure for an artificial joint – the endoprosthesis implantation significantly improves the patient’s quality of life and has a significant impact on his rehabilitation optimizing, necessary for a normal life in the future. Due to its anatomical characteristics and biomechanical ratio, the hip joint plays a critical role in maintaining body balance and proper gait. Endoprosthesis is used in a significant hip joint function disorder. Indications for the endoprosthesis may be degenerative changes, various injuries or some congenital disorders. A degenerative change, like coxarthrosis, leads to surgery due to its progression in almost all cases. Depending on an operator and a patient, this procedure can be performed in several ways depending on the chosen access to a thigh. Today, the direct access is most commonly used from the front, side, and rear. The difference is in a place of entry into the joint and the damage to the muscles caused by the procedure itself. Physiotherapy is required after the procedure. The process of physiotherapy begins immediately after the surgery, on the first day after the procedure. It is believed that, in the period of three to four months after rehabilitation, the patient can return to almost all the previous usual activities, of course, after examination and consultation with the doctor. Aim. To analyze the literature data on modern aspects of arthroplasty in the hip joint osteoarthrosis Results. Various arthroplasty complications in coxarthrosis can be associated with errors in the surgery techniques, as well as the lack of patients’ motivation. The number of studies concerning quality of life and therefore health is growing, and the research results can be used as relevant ones to represent the state of each individual group.

Neurophysiological parameters in patients with hallux valgus

We examined 38 patients (35 women and 3 men aged 30–40 years) with stage 2 and 3 hallux valgus in the department of traumatology and orthopedics of the Irkutsk Scientific Centre of Surgery and Traumatology to study the electroneuromyographic parameters during stimulation of the peripheral nerves of the lower extremities. All patients underwent electroneuromyographic study of peripheral nerves (n. tibialis and n. peroneus) to clarify the nature of their injuries. In 10 patients, the parameters of the monosynaptic H-reflex were additionally studied. Analysis of electroneuromyographic parameters in patients with hallux valgus demonstrated a deterioration in the peripheral nerves functioning, which was more pronounced for the tibial nerve (n. tibialis). At the same time, the parameters of the monosynaptic H-reflex obtained in patients with hallux valgus indicate the presence of a neurological deficit observed in the compression of the L5–S1 roots of the spinal cord in lumbar osteochondrosis. The results of the study suggest the presence of a single pathogenetic mechanism for the development of degenerative processes in the spinal joints (osteochondrosis) and limbs (deforming osteoarthrosis of large and small joints).