To explore the clinical relevance of joint space width (JSW) narrowing on standardized-flexion (SF) radiographs in the assessment of cartilage degeneration in specific subregions seen on MRI sequences in knee osteoarthritis (OA) with neutral, valgus, and varus alignments, and potential planning of partial knee arthroplasty. We retrospectively reviewed 639 subjects, aged 45 to 79 years, in the Osteoarthritis Initiative (OAI) study, who had symptomatic knees with Kellgren and Lawrence grade 2 to 4. Knees were categorized as neutral, valgus, and varus knees by measuring hip-knee-angles on hip-knee-ankle radiographs. Femorotibial JSW was measured on posteroanterior SF radiographs using a special software. The femorotibial compartment was divided into 16 subregions, and MR-tomographic measurements of cartilage volume, thickness, and subchondral bone area were documented. Linear regression with adjustment for age, sex, body mass index, and Kellgren and Lawrence grade was used.Aims
Methods
Aims. The preventive effects of bisphosphonates on articular cartilage in non-arthritic joints are unclear. This study aimed to investigate the effects of oral bisphosphonates on the rate of
Abstract. Objectives. A promising therapy for early osteoarthritis (OA) is the transplantation of human umbilical cord-derived mesenchymal stromal cells (hUC-MSCs). The synovial fluid (SF) from a pre-clinical ovine model treated with hUC-MSCs has been profiled using proteomics and bioinformatics to elucidate potential mechanisms of therapeutic effect. Methods. Four weeks after a medial meniscus transection surgery, sheep were injected with 10. 7. hUC-MSCs in Phosphate Buffered Saline (PBS) or PBS only (n=7) and sacrificed at 12 weeks. SF was normalised for protein abundance (ProteoMiner. TM. ) and analysed using label-free quantitation proteomics. Bioinformatics analyses (Ingenuity Pathway Analysis (IPA) and STRING) were used to assess differentially regulated functions from the proteomic data. Human orthologues were identified for the ovine proteins using UniProt and DAVID resources and proteins that were ≥±1.3 fold differentially abundant between treatment groups, were included in the bioinformatics analyses. Results. hUC-MSC treated animals demonstrated significantly less
Aims. Although there are various pelvic osteotomies for acetabular dysplasia of the hip, shelf operations offer effective and minimally invasive osteotomy. Our study aimed to assess outcomes following modified Spitzy shelf acetabuloplasty. Methods. Between November 2000 and December 2016, we retrospectively evaluated 144 consecutive hip procedures in 122 patients a minimum of five years after undergoing modified Spitzy shelf acetabuloplasty for acetabular dysplasia including osteoarthritis (OA). Our follow-up rate was 92%. The mean age at time of surgery was 37 years (13 to 58), with a mean follow-up of 11 years (5 to 21). Advanced OA (Tönnis grade ≥ 2) was present preoperatively in 16 hips (11%). The preoperative lateral centre-edge angle ranged from -28° to 25°. Survival was determined by Kaplan-Meier analysis, using conversions to total hip arthroplasty as the endpoint. Risk factors for
Aims. This study aimed to evaluate sagittal spinopelvic alignment (SSPA) in the early stage of rapidly destructive coxopathy (RDC) compared with hip osteoarthritis (HOA), and to identify risk factors of SSPA for destruction of the femoral head within 12 months after the disease onset. Methods. This study enrolled 34 RDC patients with
Introduction. Although surgical remedies tend to be the long-term solutions for patients with osteoarthritis (OA), many alternatives exist that offer the potential to slow progression, alleviate pain, and/or restore function. One such option is the unloader OA knee brace. The objective of this study was to assess the in vivo medial
Sequelae of Legg-Calve -Perthes disease (LCPD) and treatment of developmental dysplasia of the hip (DDH) can present a coxa breva or coxa magna deformity, sometimes associated with coxa vara. This unique deformity decreases the efficiency of the abductor mechanism, causing a Trendelenburg gait and hip pain, leg length discrepancy and leads to intra- and extra-articular impingement, and eventually osteoarthritis. Several surgical techniques have been advocated to treat this kind deformity, such as great trochanter transfer, relative femoral neck lengthening. We evaluated primary results of true femoral neck-lengthening osteotomy (TFNLO) in combination with periacetabular osteotomy (PAO) for treatment of Coxa Breva through surgical hip dislocation (SHD). Fourteen patients with Coxa Breva received true femoral neck lengthening osteotomy in combination of PAO through SHD between March 2020 and October 2023. Ten patients with minimum 1 year followed-up were retrospectively reviewed clinically and radiographically. Eight patients had Perthes disease, 2 had DDH received closed reduction and fixation during childhood. The mean age at surgery was 16 years (range, 12 to 31 years). Clinical findings, radiographic analyses including the change in horizontal femoral offset and the leg length discrepancy as well as complications were assessed. Horizontal femoral offset improved 19.5mm(6–28mm). Limb length increase 16.8mm(11–30mm). Mean HHS increased from 80.6(66–91) to 91.8(88–96). Complication: screw broken in 1(no need operation). Asymptomatic fibrous union of the great trochanter was found in 1. No infection and
We report on a minimum 5-year follow-up (mean 7 years) of 28 patients who underwent arthroscopically assisted ACL reconstruction using a patellar tendon graft. Knee function was assessed using Lysholm and Tegner scores and AP translation of the tibia was measured using a Stryker Laxity Tester, comparing the symptomatic with the normal knee. All measurements were made preoperatively and at the latest follow-up. In addition, all patients had standardised weight-bearing radiographs of the knee to assess
Scaphoid fractures are a common injury accounting for more than 58% of all carpal bone fractures(1,2). Biomechanical studies have suggested that scaphoid mal-union may lead to altered carpal contact mechanics causing decreased motion, pain and arthritis(1,2). The severity of mal-union required to cause deleterious effects has yet to be established. This limits the ability to define surgical indications or impacts on prevention of posttraumatic arthritis. Computed tomography has been shown to be a useful in determining the 3D implications of altered bony alignment on the joint contact mechanics of surrounding joints. The objective of this study was to report mid-term follow-up image-based outcomes of patients with scaphoid mal-unions to determine the extent to which arthritic changes and decreased joint space is present after a minimum of 4 years following fracture. Participants (n=14) who had previously presented with a mal-united scaphoid fracture (indicated by a Height:Length Ratio >0.6) between November 2005 and November 2013 were identified and contacted. A short-arm thumb spica case was used to treat X patients and X required surgical management. Baseline and follow-up CT images, were performed with the wrist in radial deviation and positioned such that the long axis of the scaphoid was perpendicular to the axis of the scanner. Three-dimensional inter-bone distance (joint space), a measure of joint congruency and 3D alignment, was quantified from reconstructed CT bone models of the distal radius, scaphoid, lunate, capitate, trapezium and trapezoid from both the baseline and follow-up scans(3). Repeated measures ANOVA was used to detect differences in contact area (mm2) between baseline and follow-up CT's for the radioscaphoid, scaphocapitate and scaphotrapezium-trapezoid joint. The average age of participants was 43.1 years (16–64 years old). There was significant loss of joint space, indicated by a greater joint contact area 3–4 years post fracture, between baseline and follow-up reconstruction models, at the scaphocapitate (mean difference: 21.5±146mm2, p=0.007) and scaphotrapezoid joints (mean difference: 18.4 ±28.6mm2, 0.042). Significant differences in the measured contact area was not found for the radioscaphoid (0.153) and scaphotrapezium joints (0.72). Additionally, the scaphoid, qualitatively, appears to track in the vorsal direction in the majority of patients following fracture. Increased joint contact area in the scaphocapitate and scaphotrapezoid joint 3–4 years following fracture results from decreased 3D joint space and overall
Knee joint distraction (KJD) has been associated with clinical and structural improvement and synovial fluid (SF) marker changes. However, structural changes have not yet been shown satisfactorily in regular care, since radiographic acquisition was not fully standardized. AI-based modules have shown great potential to reduce reading time, increase inter-reader agreement and therefore function as a tool for treatment outcome assessment. The objective was to analyse structural changes after KJD in patients using this AI-based measurement method, and relate these changes to clinical outcome and SF markers. 20 knee OA patients (<65 years old) were included in this study. KJD treatment was performed using an external fixation device, providing 5 mm distraction for 6 weeks. SF was aspirated before, during and immediately after treatment. Weight-bearing antero-posterior knee radiographs and WOMAC questionnaires were collected before and ~one year after treatment. Radiographs were analysed with the Knee Osteoarthritis Labelling Assistant (KOALA, IB Lab GmbH, Vienna, Austria), and 10 pre-defined biomarker levels in SF were measured by immunoassay. Radiographic one-year changes were analysed and linear regression was used to calculate associations between changes in standardized joint space width (JSW) and WOMAC, and changes in JSW and SF markers. After treatment, radiographs showed an improvement in Kellgren-Lawrence grade in 7 of 16 patients that could be evaluated; 3 showed a worsening.
There is some evidence to suggest that outcomes of THA in patients with minimal radiographic osteoarthritis may not be associated with predictable outcomes. The aim of this study was to:. Assess the outcome of patients with hip pain who underwent THA with no or minimal radiographic signs of osteoarthritis,. Identify patient comorbidities and multiplanar imaging findings which are predictive of outcome,. Compare the outcome in these patients to the expected outcome of THA in hip OA. A retrospective review of 107 hips (102 patients, 90F:12M, median age 40.6, IQR 35.1–45.8 years, range 18–73) were included for analysis. Plain radiographs were evaluated using the Tonnis grading scale of hip OA. Outcome measures were all-cause revision; iHOT12; EQ-5D; Oxford Hip Score; UCLA Activity Scale; and whether THA had resulted in the patient's hip pain and function being Better/Same/Worse. The median Oxford Hip Score was 33.3 (IQR 13.9, range 13–48), and 36/107 (33.6%) hips achieved an OHS≥42. There was no association between primary hip diagnosis and post-operative PROMs. A total of 91 of the 102 patients (89.2%, 93 hips) reported that their hip pain and function was Better than prior to THA and would have the surgery again, 7 patients (6.8%, 10 hips) felt the Same, and 4 patients (3.9%, 4 hips) felt Worse and would not have the surgery again. Younger patients undergoing total hip arthroplasty with no or minimal radiographic osteoarthritis had lower postoperative Oxford Hip Scores than the general population; though most felt symptomatically better and knowing what they know now, would have surgery again. Those with chronic pain syndrome or hypermobility were likely to benefit less. Those with subchondral cysts or
There is a surge of patients on the waiting-list for primary total hip replacement (THR), due to unprecedented reduction of elective activity caused by COVID-19. A higher incidence of femoral head collapse (FC) and acetabular erosion (AE) leading to increase in pain and instability as well as requirement of more complex surgery and potentially higher risk to patients was noted in this period. Rapidly progressive Arthritis (RPA) of the hip is a known entity often described as progression of
We retrospectively reviewed eight children with idiopathic chondrolysis (IC) of the hip and nine with atrophic tuberculosis (TB) of the hip treated over the 10 years 1990 to 1999. Both conditions present with a stiff hip and radiographic
Introduction. Hip Osteoarthritis (HOA) is a highly heterogeneous disease with potentially different genetic aetiologies. Thus far, few genetic variants have been robustly associated with broad definitions of HOA. We aimed to identify novel HOA susceptibility variants by examining a set of more homogeneous, radiographically-derived endophenotypes relating to anatomic pattern of joint involvement and bone remodelling response in HOA. Materials, Methods and Results. Individuals with HOA and AP-hip radiographs (n=2,109) were selected from the arcOGEN study, genotyped on 2 platforms. The most arthritic hip per patient was categorised using Bombelli's classification (atrophic/normotrophic/hypertrophic), and for pattern of
Purpose. The outcome of idiopathic chondrolysis in South Africa has been reported as a progressive downhill course resulting in a painful, stiff hip (Jones 1971, Sparks&Dall 1982). The cause of the disease remains unknown. Theories suggested are mechanical (decreased movement with loss of synovial nutrition; increased joint pressure) and an auto-immune response in genetically predisposed individuals. Our experience with continuous passive motion (CPM) and anti-inflammatory treatment has been disappointing. Method. In order to improve our understanding of the disease and our results, we prospectively studied 5 consecutive patients. All the patients had a subtotal capsulectomy (Roy&Crawford 1988) to relieve intra-articular pressure and correction of the flexion and abduction deformities. Post-operative treatment was with anti-inflammatories and CPM. Results. The patients were adolescent females between 10 and 12.5 years old. They presented with stiff, painful hips with flexion, abduction and external rotation deformities. They had normal auto-immune markers. Radiographs revealed osteopenia and
The long term outcome of open debridement for the treatment of anterior impingement in the ankle in 27 patients was assessed. Using pre-operative radiographs, patients were grouped according to both the McDermott and the van Dijk scoring systems for anterior impingement. The accuracy of these classifications in predicting outcome was assessed. Clinical outcome was evaluated using the Ogilvie-Harris scoring system, a visual analogue of patient satisfaction, time to return to full activities, and the ability to return to sports at the pre-morbid level. Follow-up radiographs were used to assess the recurrence of osteophytes. The incidence of talar osteochondral lesions at surgery was assessed. At a mean follow-up of 7.3 years, 23 of 25 (92%) patients without
Background. Unicompartmental knee arthroplasty (UKA) patients with knee partial thickness cartilage loss have inferior functional performance compared to those with full thickness loss. Therefore, the aim of the present study was to investigate on the association between postoperative patients' joint awareness and satisfaction and preoperative radiographic osteoarthritis (OA) Ahlbäck grade in subjects undergoing robotic arm-assisted UKA. Methods. This retrospective observational study includes 675 patients (681 knees) undergoing robotic arm-assisted UKA at two centres between January 2014 and May 2019. Pre-operatively, knee radiographs were performed, and Ahlbäck OA grade was measured by two independent observers. Post-operatively, patients were administered the Forgotten-Joint-Score-12 (FJS-12) and 5-Level-Likert-Scale to assess joint awareness and satisfaction. Postoperative complications and revisions were recorded. Correlations were described between FJS-12, satisfaction and OA grade by means of an adjusted multivariate statistical analysis. Results. A total of 574 patients (580 UKAs) were assessed at a mean follow-up of 3.6 years post-operatively (85.2% follow-up rate; min. 12, max. 75 months). Nine UKAs were revised. Primary or secondary medial knee OA was the preoperative diagnosis in 538 cases, osteonecrosis was present in 42 cases. Cases were divided based on their preoperative Ahlbäck grade in Group A (joint space narrowing, Ahlbäck 1, 279 cases), Group B (joint space obliteration or minor bone attrition, Ahlbäck 2 and 3, 197 cases) and Group C (moderate or severe bone attrition, Ahlbäck 4 and 5, 104 cases). Moderate to severe OA grades (Group B and C) were associated with higher probability of higher postoperative FJS-12 compared to
Aim: To investigate the functional and radiological outcome of shelf acetabuloplasty in adults with significantly symptomatic acetabular dysplasia, with a minimum of a 5 year follow-up. Material and Methods: 77 consecutive shelf procedures (68 patients) with an average follow-up of 10.9 years (range: 6–14) were reviewed. The Oxford hip score (OHS) was used for clinical assessment. Centre-edge angle (CEA) and acetabular angle (AA) were measured as indicators of joint containment. The severity of osteoarthiritis was based primarily on the extent of
Aim: To investigate the functional and radiological outcome of shelf acetabuloplasty in adults with significantly symptomatic acetabular dysplasia, with a minimum of a 5 year follow-up. Material and Methods: 77 consecutive shelf procedures (68 patients) with an average follow-up of 10.9 years (range: 6–17) were reviewed. The Oxford hip score (OHS) was used for clinical assessment. Centre-edge angle (CEA) and acetabular angle (AA) were measured as indicators of joint containment. The severity of osteoarthiritis was based primarily on the extent of
After tuberculosis of the spine, hip and knee, tuberculosis of the foot and ankle is the most common occurring area of skeletal tuberculosis seen in our unit. We retrospectively reviewed 14 patients (14 feet and/or ankles) seen over the 16-year period 1982 to 1997. The average age of the children was 5.2 years (range 1.5 to 11 years). The duration of symptoms ranged from 1 week to 1 year. The most common presentation was swelling and pain of the involved joint, but three patients each presented with a chronic discharging sinus after being drained elsewhere as an acute abscess. Radiographs revealed osteo-penia with or without lytic areas, joint margin destruction or