Longitudinal changes in bone quantitative ultrasound measurements in healthy pre-school children: Maternal and child determinants.

A total number of 300 breeder Japanese quails at 40 weeks of age were used to investigate the single and interactive impacts of vitamins D3 (0 and 6300 IU), A (0 and 23100 IU) and K3 (0, 17 and 34 mg) on tibia mineralization in a 2 × 2 × 3 factorial arrangement in a complete randomized block experiment design. Vitamin preparations were injected subcutaneously (SC) in the back of the neck of birds weekly. Proximal epiphysis and diaphysis diameter of the right tibia bone and its ash percentage were significantly superior in the vitamin D3 injected birds by 4.3, 4.9 and 9.3 percent, respectively (P < 0.05). Parenteral administration of 6300 IU vitamin D3 increased serum level of the same vitamin by 38.5 percent and decreased serum P level (by 12.7 Percent; P < 0.05) but not that of calcium (Ca) and albumin (ALB) levels as well as ALP and PTH activity (P > 0.05). Robustness index (RI) was significantly greater in the vitamin D3 treated birds compared with the corresponding control group (P < 0.05). Tibia ash content showed a moderate positive correlation with tibia length (r = 0.43; P < 0.01) and a negative moderate relation with Robustness index (P < 0.01). Serum PTH and ALK activity showed a weak and a moderate correlation coefficient with tibia ash percentage, respectively. No significant interaction was noticed among vitamins concerned in all features assessed (P > 0.05). It was concluded that extra nutritional administration of vitamin D3 via weekly SC injection, may impose promising effects on bone strength and mineralization in aged laying quails, evidenced by greater tibia ash percentage as well as superior proximal epiphyses and diaphysis diameter.

Age-dependent mechanical heterogeneity in immature murine bone: A nanoindentation mapping study.

Exploring age-related changes in bone and muscle: Insights from radiomics and MRI.

A 32-year-old man is involved in motorcycle accident and sustained a Gustilo-Anderson type 3b open tibia shaft fracture. He underwent a debridement, nailing, and free flap by the plastic surgery team. After the debridement, there is a 6 cm mid-diaphyseal bone defect. Please debate whether the induced membrane technique or bone transport should be used to reconstruct the bone defect.

Sex-Specific Associations of Radiographic Knee Osteoarthritis and Pain with Distal Tibia Bone Microarchitecture: the Study of Muscle, Mobility and Aging (SOMMA).

Introduction: In the osteochondral autograft transfer system (OATS) procedure, a wide accessible area is required to introduce the femoral plug at varying angles. This may not always be achievable through standard anteromedial or anterolateral arthrotomy approaches. The aim of this case report was to describe the use of an anterior chevron-type tibial osteotomy as a technical approach for treating a centrolateral osteochondral lesion of the talus (OLT) with the OATS technique. Methods: A 48-year-old female patient with chronic ankle pain following an ankle sprain 32 years ago. The anterior osteotomy was performed with dimensions of 3 cm in width, 2 cm in depth, and 4 cm in height. After removing the anterior tibial bone block, we identified and debrided the OLT. The lesion site was prepared, and a bone plug obtained from the lateral femoral trochlea was inserted, congruent with the surrounding articular cartilage. The temporarily removed anterior tibial bone block was reattached and secured with three cannulated screws. Results: By 44 months postoperatively, the patient demonstrated significant clinical improvement and had returned to full activity. Preoperatively, she reported a VAS score of 7 for pain, which improved to 1 postoperatively. Her American Orthopaedic Foot and Ankle Society ankle-hindfoot score increased from 41 to 90. Ankle range of motion improved, from a preoperative total of 90 degrees to 100 degrees postoperatively. No complications were observed following the tibial osteotomy or the OATS procedure. Conclusion: The anterior chevron-type tibial osteotomy provided an adequate exposure of a centrolateral OLT, enabling precise graft positioning during the OATS procedure. It allowed safe insertion of the plug at the desired angle while preserving joint congruity. This technique may represent a surgical option for treating centrally and laterally located OLT when conventional approaches do not provide sufficient access.

The aims were to assess the influence of tibial bone mineral density (BMD) and cement viscosity on cement mantle thickness in total knee arthroplasty (TKA), and to determine whether BMD is a more dominant factor than cement viscosity in achieving optimal cement penetration. A prospective, randomized controlled trial involving 117 knees from 130 patients undergoing primary TKA was conducted. Patients were allocated to receive either medium-viscosity cement (Group M) or high-viscosity cement (Group H). Cement mantle thickness was measured radiologically at predefined tibial zones using the Modern Knee Society Radiographic Evaluation System. Preoperative tibial BMD was assessed via CT-based quantification. Correlations between tibial BMD and mantle thickness were analyzed, and a cutoff tibial BMD value for achieving ≥ 2.1 mm mantle thickness was determined. This threshold was based on previous findings suggesting that a cement mantle thickness of at least 2.1 mm may help reduce the incidence of radiolucent lines around the tibial component. No significant differences in mantle thickness were observed between groups at peripheral zones. However, Group H showed significantly greater thickness at central zones (Zone 3 medial (M) (p = 0.001); Zone 3 lateral (L) (p = 0.001); Zone 3 anterior (A) (p=0.001); and Zone 3 posterior (P) ( p = 0.001). Strong negative correlations were found between tibial BMD and mantle thickness in both groups (r = -0.64 to -0.70). The cutoff tibial BMD value to achieve ≥ 2.1 mm mantle thickness was 78.4 HA/cm³. The intra- and inter-rater reliability of the radiological measurements were acceptable (interclass correlation coefficient 0.77 and 0.68, respectively). Cement penetration beneath the tibial tray is more closely associated with tibial BMD than with cement viscosity. In patients with extremely dense bone, alternative fixation strategies such as cementless fixation or enhanced drilling should be considered.

Primates display a wide range of locomotor behaviours, each resulting in distinct mechanical demands on the ankle joint. This study examines how variation in distal tibial shape and internal bone structure captures these locomotor adaptations. We examined the morphology of distal tibiae from eight extant catarrhine genera using canonical holistic morphometric analysis. Relative trabecular bone volume fraction was quantified across homologous three-dimensional volumes, and shape was assessed via a new geometric morphometric-based approach. Our analyses reveal taxonomic and locomotor differences in both distal tibial trabecular distribution and shape. Humans exhibit a squared tibial plafond with trabecular reinforcement at its center, reflecting vertical axial loading. African apes show a trapezoidal plafond with trabecular reinforcement linked to ankle flexion during climbing and quadrupedalism. Orangutans and hylobatids exhibit diverse trabecular distribution and morphology, consistent with multidirectional loading. Cercopithecoids display posterior trabecular reinforcement and narrower joint morphology, consistent with plantarflexed postures during quadrupedalism. Substantial covariation between tibial shape and trabecular distribution was identified across taxa, with functional gradients aligning with ankle loading regimes, showing that analyzing trabecular structure and external shape enhances our understanding of joint mechanics, offering critical insight for interpretation of primate locomotor diversity and evolution.

Background: In type 2 diabetes mellitus (T2DM), bone and microvascular complications may be linked. Methods: The University of California Davis (UCD) polygenic T2DM and Sprague Dawley healthy control (CTL) rats (N = 48) were divided equally into diabetic and age-matched groups: (1) pre-diabetes, (2) diabetes onset, (3) early-stage T2DM, and (4) late-stage T2DM. Body mass, HbA1c, fasted blood glucose and femoral and tibial lengths were measured. Bones were scanned (μCT; 15 µm) to assess trabecular microarchitecture and density and mid-shaft cortical thickness (Ct.Th, µm), density and porosity. Ossified vessel volume (OsVV, %) and thickness (OsV.Th, µm) were also analyzed. A GLM determined significance at p &lt; 0.05. Body mass and HbA1c were higher (p &lt; 0.05) in all T2DM groups and blood glucose became elevated (p &lt; 0.05) in early-stage T2DM and late-stage T2DM. Results: Tibiae and femora were longer (p &lt; 0.05) with diabetes. Tibial bone volume was lower (p &lt; 0.05) in pre-diabetes (4 ± 1% vs. CTL, 9 ± 2%) and late-stage T2DM (5 ± 2% vs. CTL, 8 ± 2%), and femoral bone volume was lower (p &lt; 0.05) in pre-diabetes (7 ± 1% vs. 12 ± 4%). Cortical density (tibia) was lower (p &lt; 0.05) in pre-diabetes and early-stage T2DM. Trabecular density in the femur was lower (p &lt; 0.05) in all T2DM groups and cortical density was reduced (p &lt; 0.05) in pre-diabetes, diabetes onset, and late-stage T2DM. OsVV in both bones were lower (p &lt; 0.05) during early-stage T2DM. Tibial OsV.Th was higher (p &lt; 0.05) in pre-diabetes (69 ± 14 µm vs. CTL, 56 ± 13 µm) and late-stage T2DM (80 ± 10 µm vs. CTL, 59 ± 13 µm) and higher (p &lt; 0.05) in the femur at diabetes onset (58 ± 14 µm vs. CTL, 40 ± 10 µm). Conclusions: Trabecular and cortical bone varied as diabetes progressed, and the thicker ossified vessels may represent microangiopathy.

Arthroscopic Medial Meniscus Substitution Using Autologous Semitendinosus Tendon with Suture Tape Augmentation as an Alternative to Meniscal Allograft Transplantation: A Modified Technique.

Distraction osteogenesis using the Ilizarov technique is a cornerstone in managing bone defects and limb length discrepancies. The choice of corticotomy method - multiple drill-hole or percutaneous Gigli saw osteotomy - affects regenerate quality, though no clear consensus exists on the superior technique. This prospective observational study compared Gigli saw (n = 14) and multiple drill-hole (n = 20) corticotomy techniques in 34 skeletally mature patients undergoing Ilizarov-based tibial lengthening or bone transport. All surgeries were performed by a single surgeon, with a minimum 1-year follow-up. The Modified Healing Index (MHI) was the primary outcome, while consolidation time and postoperative pain (VAS score) were secondary measures. The mean patient age was 36.97 ± 8.6 years, with road traffic accidents as the most common indication. Radiographs confirmed cortical formation in all cases. The mean consolidation time was 8.85 ± 2.9 months, and the overall MHI averaged 1.32 ± 0.17 months/cm. The drill-hole group showed a significantly lower MHI than the Gigli saw group (t = -2.733, P = 0.010), indicating superior bone regeneration. Both techniques are effective, but the multiple drill-hole method demonstrated better healing and consolidation. Further multicentric randomized studies are needed to confirm these findings.

Accumulating evidence shows that bacteria influence cancer homeostasis, yet the effects of tumor‑associated microbes and their products remain largely unexplored. We previously reported that P. aeruginosa-cancer crosstalk suppresses tumors via the bacterial cupredoxin azurin, and we developed an azurin‑derived peptide that was tested in clinical trials. Building on our previous studies, we studied tumor-resident bacteria for novel therapeutics and targets. Photosynthetic bacteria from the phylum Chloroflexota, including a member of the class Chloroflexia, identified in tumors, carry the cupredoxin auracyanin gene. Based on the structural and chemical characteristics of auracyanin, we designed a novel cell-penetrating peptide, aurB. Plant chloroplasts are thought to have evolved from a bacterial endosymbiont, and both chloroplasts and mitochondria possess shared proteins essential for ATP-dependent energy production, indicating that these bacterial-derived proteins may influence mitochondrial function. Consistent with this model, we demonstrated that aurB, a peptide from cupredoxin auracyanin B, localized at mitochondria, blocked energy production by targeting ATP synthase in prostate cancer cells, thereby significantly inhibiting tumor growth. More strikingly, combination treatment with aurB and radiation therapy significantly inhibited tumor growth in a tibial bone metastasis model. Moreover, the number of metastatic lesions in the lungs was also significantly lower upon aurB treatment. Multiplex RNA-expression profiling revealed that the inhibition of ATP production by aurB increased the efficacy of radiation therapy by modulating multiple pathways involving HIF-1α. Our findings indicate that electron transfer proteins could represent an important source of promising novel peptide-based agents that target the aberrantly activated mitochondrial energy system in cancer.

Comparison of the Effect of Osteotomy Type, Screw Type, and Configuration on Stability in Medial Malleolus Osteotomy: Biomechanical Analysis.

T o stu d y t he effe ct o f a newly developed adaptogenic complex on the chemical composition of muscle and bone tissues, as well as on the quality and process characteristics of the broiler chickens breast and thigh muscles, an experiment was conducted on 3 groups of the broiler chickens in the physiological ward of the Federal Research Center for Animal Husbandry named after Academy Member L. K. Ernst (n = 40, N = 120) (1 control group and 2 experimental groups) under conditions of increased stocking density. The poultry from the experimental groups received the DHQEC complex with their diet (the 2 nd experimental group started receiving it from the 22 nd da y o f lif e, i.e., fr om t he da y o f t he o ns e t o f si m ul a t ed o vercr o w ded envir o n m ent a l c o n d iti o ns; t he 3 r d experi m ent a l gr o up st a rt ed r e c ei ving it fr om t he 7 th da y o f t hei r lif e). On the day 34 th (n = 10, N = 20) and 52 nd (n = 10, N = 20) of age, the samples of the breast and thigh muscles and the tibia bones were collected. The chemical composition, as well as several quality and process properties of the meat were determined. The administration of DHQEC for 34 days of the poultry life contributed to an increase in fat content in the breast muscle from 0.74 % in the control group up to 1.03 % and 1.17 % in the experimental groups, respectively; an increase in the pH of muscle tissue; an increase in the water-holding capacity (WHC) of the breast (p &lt; 0.01) and thigh (p &lt; 0.01) tissues; and elevated levels of reduced glutathione (at p &lt; 0.05 and p &lt; 0.01) and superoxide dismutase (at p &lt; 0.01) compared to the control group values. In the liver of the poultry that received DHQEC, an increase in the level of water-soluble antioxidants was observed, whereas in the cardiac muscle, conversely, a decrease was noted. At the 52 nd day of age, the trend of differences between the groups persisted. A significant difference was found in phosphorus content (it was lower in the control group) (p &lt; 0.05) and magnesium content (it was lower in the 3 rd experi m ent a l gr o up) (p &lt; 0.05), which may be associated with the impact of stress and its mitigation by the DHQEC complex. The most pronounced effect of the complex was observed when it was introduced into the diet from the 7 th da y o f t he p o ultry lif e. Th e ob t a in ed da t a o p en b r oad pr o sp e cts f o r t he inclusi o n o f t he DHQEC c om plex int o b r o iler c h ic k en die ts, p a rticul a rly d uring p eriod s o f str e ss exp o sur e fr om t he first da ys o f lif e.

Standard clinical imaging metrics perform poorly in predicting skeletal fragility in chronic kidney disease (CKD), particularly due to the complex and heterogeneous cortical deterioration that characterizes advanced disease. Here, this study aimed to identify radiomic features derived from high-resolution peripheral quantitative computed tomography (HR-pQCT) in tibial cortical bone that distinguish CKD-related differences and may serve as markers of subtle cortical alterations undetected by conventional imaging. HR-pQCT image stacks were obtained from 72 participants (38 non-CKD and 34 with CKD stage 5D) at 7.3% (distal) and 30% (diaphyseal) proximally from the tibial endplate, resulting in a total of 24 192 slices. In non-CKD cases, features were largely derived from first-order statistics, while complex features from higher-order statistics were more prominent in CKD cases. Although conventional HR-pQCT outcomes, such as volumetric bone mineral density, showed limited ability to differentiate CKD from non-CKD cortical bone in our population of stage 5D patients, the top features, such as Minimum and Strength, provided a significant distinction between the two groups (P < 0.001, Effect size r = from 0.813 to 0.856). Our findings demonstrate that radiomic analysis identifies cortical bone differences associated with CKD that were not distinguished by conventional HR-pQCT metrics, highlighting its potential to improve bone quality assessment in this high-risk population.

Bone defect size and healing outcomes in femoral and tibial fracture-related bone defects treated with the Masquelet technique.

Severe tibial and/or femoral bone defects pose a significant challenge in both complex primary and revision total knee arthroplasty (TKA). Various techniques of reconstruction have been reported to address these defects, including adjustable augments, porous metal cones or sleeves, and the cement-and-screw technique. This technical note described the technique of impaction bone grafting (IBG), which involves using fresh-frozen femoral head allograft, that is structured or morselized and compacted into the femoral or tibial cavitary defect, followed by cementation of stemmed TKA implant. Although IBG is poorly documented in the literature and has been predominantly utilized in revision TKA, we presented its application in three cases: one complex primary TKA and two revision TKA (one involving tibial reconstruction and the other femoral reconstruction). Our report highlighted the effectiveness of IBG for both tibial and femoral reconstruction, with clinical and radiographic evidence confirming successful osseointegration at the 5-year follow-up. Therefore, IBG may be a viable technique for managing severe bone defects in both complex primary and revision TKA. LEVEL OF EVIDENCE: IV.

Concurrent joint contact in anterior cruciate ligament injury induces cartilage micro-injury and subchondral bone sclerosis, resulting in knee osteoarthritis.

Clear Cell Chondrosarcoma (CCC) accounts for about 2% of all chondrosarcoma subtypes and typically presents in individuals during their third to fourth decades of life. This type of tumour most commonly arises in the proximal epiphyseal region of the femur, followed by the humerus, tibia, and small bones. It is frequently observed in males and often manifests as a painful lesion that reduces mobility, leading to misdiagnosis as a benign condition. Histopathologically, the tumour is characterised by round to polygonal cells having clear to vacuolated cytoplasm, arranged in diffuse sheets and lobules, accompanied by reactive woven bone formation and rare mitotic activity. Due to high recurrence rates associated with conservative treatments such as curettage, wide excision of the affected bone followed by reconstruction is recommended. We report a rare case of CCC involving the proximal end of the femur in a 30-year-old male patient who presented with right hip pain for five months. Radiological investigations revealed a well-defined osteolytic lesion confirmed by MRI. Biopsy showed clear cells, reactive woven bone and a few multinucleated giant cells. Herein, we discuss the several differentials possible and discuss the challenges encountered during final diagnosis.