Pub Date : 2023-01-19DOI: 10.3390/osteology3010003
High-quality academic publishing is built on rigorous peer review [...]
高质量的学术出版建立在严格的同行评审的基础上[…]
{"title":"Acknowledgment to the Reviewers of Osteology in 2022","authors":"","doi":"10.3390/osteology3010003","DOIUrl":"https://doi.org/10.3390/osteology3010003","url":null,"abstract":"High-quality academic publishing is built on rigorous peer review [...]","PeriodicalId":36674,"journal":{"name":"Clinical Osteology","volume":"53 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84023195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-06DOI: 10.3390/osteology3010002
A. Mamilos, C. Matzaroglou, G. Maier, Samer Zawy Alsofy, P. Drees, K. Kafchitsas
Vitamin D plays a pivotal role in calcium metabolism and bone mineralization. Sufficient vitamin D levels are important for the health and functionality of the musculoskeletal system. Hypovitaminosis D is a phenomenon affecting orthopedic patients worldwide. This study researched whether most orthopedic patients in two different cities of different countries had hypovitaminosis D, whether there was a correlation between sunshine hours and vitamin D serum levels, and whether hours of sunshine alone were enough to achieve vitamin D sufficiency among orthopedic patients regardless of their activities. The vitamin D serum levels of 500 orthopedic patients in Regensburg and 500 in Patras were assessed, in addition to their medical histories. The mean sunshine hours throughout the year were also calculated. Both the German and Greek groups showed hypovitaminosis D. Older patients were more affected. Although there were more hours of sunshine in Greece, Greek orthopedic patients also showed hypovitaminosis D. Hypovitaminosis D affects orthopedic patients independent of their latitude. Supplementation of vitamin D may be considered among orthopedic patients to achieve sufficient levels in serum. Sufficient vitamin D levels may be helpful for the treatment of orthopedic patients, reduce the negative effects of operations or postoperational settings.
{"title":"Vitamin D Deficiency in Orthopedic Patients in Different Latitudes—First Study Comparing German and Greek Populations","authors":"A. Mamilos, C. Matzaroglou, G. Maier, Samer Zawy Alsofy, P. Drees, K. Kafchitsas","doi":"10.3390/osteology3010002","DOIUrl":"https://doi.org/10.3390/osteology3010002","url":null,"abstract":"Vitamin D plays a pivotal role in calcium metabolism and bone mineralization. Sufficient vitamin D levels are important for the health and functionality of the musculoskeletal system. Hypovitaminosis D is a phenomenon affecting orthopedic patients worldwide. This study researched whether most orthopedic patients in two different cities of different countries had hypovitaminosis D, whether there was a correlation between sunshine hours and vitamin D serum levels, and whether hours of sunshine alone were enough to achieve vitamin D sufficiency among orthopedic patients regardless of their activities. The vitamin D serum levels of 500 orthopedic patients in Regensburg and 500 in Patras were assessed, in addition to their medical histories. The mean sunshine hours throughout the year were also calculated. Both the German and Greek groups showed hypovitaminosis D. Older patients were more affected. Although there were more hours of sunshine in Greece, Greek orthopedic patients also showed hypovitaminosis D. Hypovitaminosis D affects orthopedic patients independent of their latitude. Supplementation of vitamin D may be considered among orthopedic patients to achieve sufficient levels in serum. Sufficient vitamin D levels may be helpful for the treatment of orthopedic patients, reduce the negative effects of operations or postoperational settings.","PeriodicalId":36674,"journal":{"name":"Clinical Osteology","volume":"63 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83439512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-05DOI: 10.3390/osteology3010001
M. Akiyama
I previously reported that F-box/leucine-rich repeat protein 14 (FBXL14) expressed in periosteum-derived cells, and F-box and WD-40 domain-containing protein 2 (FBXW2) in the periosteum form a fiber-like structure. Here, two culture medium conditions, that is, media with and without ascorbic acid, were compared during explant culture. In the absence of ascorbic acid, the expression patterns of osteocalcin, FBXW2, and elastin were compared using fluorescent immunostaining during weeks 3–5. By observing the periosteum, cambium layer and bone, I demonstrated FBXL14 expression in micro-vessels and bone lacuna. Fluorescent immunostaining revealed that, without ascorbic acid, the FBXL14 layer was thin. Conversely, in the presence of ascorbic acid, FBXL14 formed a thick membrane-like structure inside the periosteum, and the multilayer of periosteum-derived cells (PDCs) was strong. The expression patterns of osteocalcin and FBXW2 were similar. Elastin retained its fiber structure for up to five weeks. Although osteocalcin and FBXW2 were expressed in regions similar to elastin, they could not retain their fiber structures. In conclusion, FBXL14 appears to play a role in preparing a native scaffold for forming a multilayered sheet of PDCs inside the periosteum. FBXW2 and osteocalcin appear to separate from elastic fibers during calcification.
我之前报道过F-box/leucine-rich repeat protein 14 (FBXL14)在骨膜源性细胞中表达，骨膜中的F-box和WD-40结构域蛋白2 (FBXW2)形成纤维样结构。在外植体培养过程中，比较了两种培养基条件，即含抗坏血酸培养基和不含抗坏血酸培养基。在缺乏抗坏血酸的情况下，采用荧光免疫染色法比较3-5周骨钙素、FBXW2和弹性蛋白的表达模式。通过观察骨膜、形成层和骨，我发现FBXL14在微血管和骨陷窝中表达。免疫荧光染色显示，未加抗坏血酸后，FBXL14层变薄。相反，当抗坏血酸存在时，FBXL14在骨膜内形成较厚的膜样结构，骨膜衍生细胞(PDCs)的多层性较强。骨钙素和FBXW2的表达模式相似。弹性蛋白保持其纤维结构长达五周。尽管骨钙素和FBXW2在与弹性蛋白相似的区域表达，但它们不能保留其纤维结构。综上所述，FBXL14似乎在制备天然支架以在骨膜内形成多层pdc片方面发挥作用。在钙化过程中，FBXW2和骨钙素与弹性纤维分离。
{"title":"Roles of Two F-Box Proteins: FBXL14 in the Periosteum and FBXW2 at Elastic Fibers","authors":"M. Akiyama","doi":"10.3390/osteology3010001","DOIUrl":"https://doi.org/10.3390/osteology3010001","url":null,"abstract":"I previously reported that F-box/leucine-rich repeat protein 14 (FBXL14) expressed in periosteum-derived cells, and F-box and WD-40 domain-containing protein 2 (FBXW2) in the periosteum form a fiber-like structure. Here, two culture medium conditions, that is, media with and without ascorbic acid, were compared during explant culture. In the absence of ascorbic acid, the expression patterns of osteocalcin, FBXW2, and elastin were compared using fluorescent immunostaining during weeks 3–5. By observing the periosteum, cambium layer and bone, I demonstrated FBXL14 expression in micro-vessels and bone lacuna. Fluorescent immunostaining revealed that, without ascorbic acid, the FBXL14 layer was thin. Conversely, in the presence of ascorbic acid, FBXL14 formed a thick membrane-like structure inside the periosteum, and the multilayer of periosteum-derived cells (PDCs) was strong. The expression patterns of osteocalcin and FBXW2 were similar. Elastin retained its fiber structure for up to five weeks. Although osteocalcin and FBXW2 were expressed in regions similar to elastin, they could not retain their fiber structures. In conclusion, FBXL14 appears to play a role in preparing a native scaffold for forming a multilayered sheet of PDCs inside the periosteum. FBXW2 and osteocalcin appear to separate from elastic fibers during calcification.","PeriodicalId":36674,"journal":{"name":"Clinical Osteology","volume":"214 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75393549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-14DOI: 10.3390/osteology2040020
S. Houtenbos, L. Kuehl, K. Wuertz-Kozak, P. Wippert
Depression constitutes a risk factor for osteoporosis (OP). Increasing physical activity might mitigate this risk, although intensive exercising may lead to opposing effects in depressed patients. The purpose of this scoping review was to summarize the evidence regarding the influence of exercise on bone health in depressed patients, divided into two sections: (1) Which bone markers are affected by depression? (2) How does exercise affect bone health in patients with depressive symptoms? A search of the literature was conducted in PubMed and Web of Science between August 2020–2022. Studies were included based on predetermined criteria for each sub-question. Regarding sub-question 1, eight studies revealed the following bone markers to be influenced by depression: P1NP, BAP, CTX, OC, RANKL, OPG, DPD, and PYD. Regarding sub-question 2, one study found a correlation between depression and bone health in an exercising population, and other studies detected improvements in bone health (n = 4) and depressive symptoms (n = 4) after exercise interventions. The current review shows the potential of exercise as a treatment form to improve bone health in depressed patients. Future trials are needed to assess the influence of exercise intervention on bone health in depressed patients.
抑郁症是骨质疏松症(OP)的危险因素。增加体力活动可能会减轻这种风险，尽管高强度运动可能会对抑郁症患者产生相反的效果。本综述的目的是总结有关运动对抑郁症患者骨骼健康影响的证据，分为两个部分:(1)哪些骨骼标志物受到抑郁症的影响?(2)运动如何影响抑郁症状患者的骨骼健康?在2020年8月至2022年8月期间，在PubMed和Web of Science上进行了文献检索。根据每个子问题的预定标准纳入研究。关于子问题1,8项研究揭示了以下骨标志物受抑郁影响:P1NP、BAP、CTX、OC、RANKL、OPG、DPD和PYD。关于子问题2，一项研究发现运动人群的抑郁与骨骼健康之间存在相关性，其他研究发现运动干预后骨骼健康(n = 4)和抑郁症状(n = 4)有所改善。目前的综述表明，运动作为一种治疗形式，有可能改善抑郁症患者的骨骼健康。未来的试验需要评估运动干预对抑郁症患者骨骼健康的影响。
{"title":"Depressive Symptoms as Potential Mediator between Physical Activity and Bone Health—A Scoping Review","authors":"S. Houtenbos, L. Kuehl, K. Wuertz-Kozak, P. Wippert","doi":"10.3390/osteology2040020","DOIUrl":"https://doi.org/10.3390/osteology2040020","url":null,"abstract":"Depression constitutes a risk factor for osteoporosis (OP). Increasing physical activity might mitigate this risk, although intensive exercising may lead to opposing effects in depressed patients. The purpose of this scoping review was to summarize the evidence regarding the influence of exercise on bone health in depressed patients, divided into two sections: (1) Which bone markers are affected by depression? (2) How does exercise affect bone health in patients with depressive symptoms? A search of the literature was conducted in PubMed and Web of Science between August 2020–2022. Studies were included based on predetermined criteria for each sub-question. Regarding sub-question 1, eight studies revealed the following bone markers to be influenced by depression: P1NP, BAP, CTX, OC, RANKL, OPG, DPD, and PYD. Regarding sub-question 2, one study found a correlation between depression and bone health in an exercising population, and other studies detected improvements in bone health (n = 4) and depressive symptoms (n = 4) after exercise interventions. The current review shows the potential of exercise as a treatment form to improve bone health in depressed patients. Future trials are needed to assess the influence of exercise intervention on bone health in depressed patients.","PeriodicalId":36674,"journal":{"name":"Clinical Osteology","volume":"209 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73223348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-07DOI: 10.3390/osteology2040019
M. Massaro, F. Mela, R. Espósito, Emanuele Maiorano, Guy Laskow
Background: Heterotopic Ossification (HO) of the knee is most commonly formed anteriorly to the distal femoral shaft in the quadriceps expansion. Although the incidence of severe HO with large dimensions affecting the knee and resulting in severe consequences is extremely rare, these cases are extremely difficult to prevent and have severe clinical limitations for the patient. Aim: The purpose of this study was to present and explore HO formation after Total Knee Arthroplasty (TKA). Conclusions: It is crucial to perform a stratification of patients for the risk of HO formation after TKA and to gain a better understanding of the fundamental role of post-operative treatments. In severe HO, surgery should be considered following appropriate investigations and should only be considered when the HO has fully matured. In comparison to Total Hip Arthroplasty (THA), HO formation after TKA is less frequent and underexplored. Therefore, further studies are required. This case report can represent a protocol for the treatment of clinically relevant HO in the knee after TKA.
{"title":"Severe Quadriceps Heterotopic Ossification after Knee Revision Arthroplasty in a 42-Year-Old Suffering from Rheumatoid Arthritis: A Case Report","authors":"M. Massaro, F. Mela, R. Espósito, Emanuele Maiorano, Guy Laskow","doi":"10.3390/osteology2040019","DOIUrl":"https://doi.org/10.3390/osteology2040019","url":null,"abstract":"Background: Heterotopic Ossification (HO) of the knee is most commonly formed anteriorly to the distal femoral shaft in the quadriceps expansion. Although the incidence of severe HO with large dimensions affecting the knee and resulting in severe consequences is extremely rare, these cases are extremely difficult to prevent and have severe clinical limitations for the patient. Aim: The purpose of this study was to present and explore HO formation after Total Knee Arthroplasty (TKA). Conclusions: It is crucial to perform a stratification of patients for the risk of HO formation after TKA and to gain a better understanding of the fundamental role of post-operative treatments. In severe HO, surgery should be considered following appropriate investigations and should only be considered when the HO has fully matured. In comparison to Total Hip Arthroplasty (THA), HO formation after TKA is less frequent and underexplored. Therefore, further studies are required. This case report can represent a protocol for the treatment of clinically relevant HO in the knee after TKA.","PeriodicalId":36674,"journal":{"name":"Clinical Osteology","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86820816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-17DOI: 10.3390/osteology2040018
M. Novi, S. Nicoletti
Anterior shoulder instability with Bankart lesion and associated posterior humeral head injury (Hill–Sachs) is common in athletes. Several treatments have been proposed for the management of the Hill–Sachs lesion, from bone grafts or rotation osteotomies to capsulotendinous interposition, such as remplissage. This procedure has been shown to be safe and effective in increasing glenohumeral stability. However, the correct indication concerning the bone defect and its effects in terms of range of motion and function, especially in highly demanding patients, is still debated. This narrative review aims to present the current state-of-the-art of the posterior capsulotenodesis in association with Bankart repair, for treating anterior shoulder instability in competitive athletes.
{"title":"The Remplissage Technique for Hill–Sachs Lesions in Competitive Athletes: A Narrative Review","authors":"M. Novi, S. Nicoletti","doi":"10.3390/osteology2040018","DOIUrl":"https://doi.org/10.3390/osteology2040018","url":null,"abstract":"Anterior shoulder instability with Bankart lesion and associated posterior humeral head injury (Hill–Sachs) is common in athletes. Several treatments have been proposed for the management of the Hill–Sachs lesion, from bone grafts or rotation osteotomies to capsulotendinous interposition, such as remplissage. This procedure has been shown to be safe and effective in increasing glenohumeral stability. However, the correct indication concerning the bone defect and its effects in terms of range of motion and function, especially in highly demanding patients, is still debated. This narrative review aims to present the current state-of-the-art of the posterior capsulotenodesis in association with Bankart repair, for treating anterior shoulder instability in competitive athletes.","PeriodicalId":36674,"journal":{"name":"Clinical Osteology","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89101745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-10DOI: 10.3390/osteology2040017
E. Faiella, G. Pacella, C. Altomare, C. Bernetti, M. Sarli, Laura Cea, F. Russo, G. Vadalà, B. Beomonte Zobel, R. Grasso
A vertebral compression fracture (VCF) is a pathological condition, which can be caused by osteoporotic degeneration or metastatic disease. It represents a socioeconomic burden on healthcare systems, due to increased pain, long-term morbidity, and disability. Vertebroplasty (VP) is an image-guided, minimally invasive, interventional procedure, in which bone cement is injected via a percutaneous approach into the vertebral soma, to provide structural support and to stabilize the weakened structure. The aim of this narrative review is to describe vertebral column biomechanics, as well as indications, contraindications, and techniques to successfully perform VP for the treatment of VCFs. Methods: We performed a narrative literature review on the main online databases regarding VP, and mainly focused on patient selection, preoperative imaging, procedural steps, complications, and outcomes. Results: The most recent evidence in the literature has shown that VP provides significant and sustained clinical benefits for patients with a VCF, and it is indicated in patients with comorbidities that make prolonged bed rest dangerous, patients with fractures that fail to heal, and as palliation in patients with a painful VCF due to metastatic disease. Conclusions: VP is considered to be a safe and effective treatment option for the treatment of osteoporotic and malignant VCFs that are resistant to adequate medical therapy. Patient selection, preprocedural evaluation, and proper technique execution are the key points to obtain the best outcomes and to minimize complications.
{"title":"Percutaneous Vertebroplasty: A Minimally Invasive Procedure for the Management of Vertebral Compression Fractures","authors":"E. Faiella, G. Pacella, C. Altomare, C. Bernetti, M. Sarli, Laura Cea, F. Russo, G. Vadalà, B. Beomonte Zobel, R. Grasso","doi":"10.3390/osteology2040017","DOIUrl":"https://doi.org/10.3390/osteology2040017","url":null,"abstract":"A vertebral compression fracture (VCF) is a pathological condition, which can be caused by osteoporotic degeneration or metastatic disease. It represents a socioeconomic burden on healthcare systems, due to increased pain, long-term morbidity, and disability. Vertebroplasty (VP) is an image-guided, minimally invasive, interventional procedure, in which bone cement is injected via a percutaneous approach into the vertebral soma, to provide structural support and to stabilize the weakened structure. The aim of this narrative review is to describe vertebral column biomechanics, as well as indications, contraindications, and techniques to successfully perform VP for the treatment of VCFs. Methods: We performed a narrative literature review on the main online databases regarding VP, and mainly focused on patient selection, preoperative imaging, procedural steps, complications, and outcomes. Results: The most recent evidence in the literature has shown that VP provides significant and sustained clinical benefits for patients with a VCF, and it is indicated in patients with comorbidities that make prolonged bed rest dangerous, patients with fractures that fail to heal, and as palliation in patients with a painful VCF due to metastatic disease. Conclusions: VP is considered to be a safe and effective treatment option for the treatment of osteoporotic and malignant VCFs that are resistant to adequate medical therapy. Patient selection, preprocedural evaluation, and proper technique execution are the key points to obtain the best outcomes and to minimize complications.","PeriodicalId":36674,"journal":{"name":"Clinical Osteology","volume":"120 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87730319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-30DOI: 10.3390/osteology2030016
S. Braga
About 400 million years ago, the first bone-like material, aspidin, was developed for external protection for the body of invertebrate marine creatures; this mineral shell is now believed to function as a reservoir for phosphorous and calcium [...]
{"title":"Osteology as a Forum for Research on the ‘Living Mineral’: Bone","authors":"S. Braga","doi":"10.3390/osteology2030016","DOIUrl":"https://doi.org/10.3390/osteology2030016","url":null,"abstract":"About 400 million years ago, the first bone-like material, aspidin, was developed for external protection for the body of invertebrate marine creatures; this mineral shell is now believed to function as a reservoir for phosphorous and calcium [...]","PeriodicalId":36674,"journal":{"name":"Clinical Osteology","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79782255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-19DOI: 10.3390/osteology2030015
Antonio Ventura, Claudia Smiraglio, A. Viscomi, S. De Salvatore, B. Bertucci
Shoulder instability is described as a functional deficiency caused by excessive mobility of the humeral head over the glenoid. Various Glenohumeral Instability (GI) types have been described, but the traumatic anteroinferior form is the most frequent. The differences between engaging and non-engaging Hill–Sachs lesions (HSLs) are linked to bone loss assessment. On the contrary, the novel difference between “on-track” and “off-track” lesions is strictly related to surgical techniques. The specific involvement of glenoid and humerus bone defects in recurrent GI was poorly assessed in the literature before the glenoid-track concept (GT). Magnetic Resonance Imaging (MRI) and Arthro-MRI have been widely used to identify and characterize lesions to the ligamentous structures. However, only new technologies (3 Tesla MRI) accurately detect HSLs. On the contrary, Computed Tomography (CT) has been adopted to quantify glenoid bone deficit. The GT concept is a valuable tool for evaluating anterior shoulder instability in patients. Shoulders out of alignment may require more than just an arthroscopic Bankart, and a remplissage or bone transfer may be necessary. Specifically, isolated Bankart repair should be considered in patients with recurrent instability and an on-track lesion with less than 25% glenoid bone loss. In off-track lesions and less than 25% glenoid bone loss, remplissage should be used. Bone transplant surgery is required for patients with a glenoid bone defect of more than 25%. This narrative review aims to report the most updated findings on “on-track” and “off-track” lesions in GI.
{"title":"The Glenoid Track Concept: On-Track and Off-Track—A Narrative Review","authors":"Antonio Ventura, Claudia Smiraglio, A. Viscomi, S. De Salvatore, B. Bertucci","doi":"10.3390/osteology2030015","DOIUrl":"https://doi.org/10.3390/osteology2030015","url":null,"abstract":"Shoulder instability is described as a functional deficiency caused by excessive mobility of the humeral head over the glenoid. Various Glenohumeral Instability (GI) types have been described, but the traumatic anteroinferior form is the most frequent. The differences between engaging and non-engaging Hill–Sachs lesions (HSLs) are linked to bone loss assessment. On the contrary, the novel difference between “on-track” and “off-track” lesions is strictly related to surgical techniques. The specific involvement of glenoid and humerus bone defects in recurrent GI was poorly assessed in the literature before the glenoid-track concept (GT). Magnetic Resonance Imaging (MRI) and Arthro-MRI have been widely used to identify and characterize lesions to the ligamentous structures. However, only new technologies (3 Tesla MRI) accurately detect HSLs. On the contrary, Computed Tomography (CT) has been adopted to quantify glenoid bone deficit. The GT concept is a valuable tool for evaluating anterior shoulder instability in patients. Shoulders out of alignment may require more than just an arthroscopic Bankart, and a remplissage or bone transfer may be necessary. Specifically, isolated Bankart repair should be considered in patients with recurrent instability and an on-track lesion with less than 25% glenoid bone loss. In off-track lesions and less than 25% glenoid bone loss, remplissage should be used. Bone transplant surgery is required for patients with a glenoid bone defect of more than 25%. This narrative review aims to report the most updated findings on “on-track” and “off-track” lesions in GI.","PeriodicalId":36674,"journal":{"name":"Clinical Osteology","volume":"68 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86454977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-27DOI: 10.3390/osteology2030013
S. Galletti, M. Miceli, S. M. Stella, F. Vita, D. Bigliardi, Danilo Donati, D. Creta, A. Frizziero
Calcific shoulder tendinopathy (CT) is a common condition involving the central part or insertion of the rotator cuff tendons (RC) or the subacromial-subdeltoid bursa (SASD). The calcific deposits consist of poorly crystallized calcium hydroxyapatite but the mechanism of their formation still remains unclear. CT can be divided into three distinct stages, as reported by Uthhoff et al. Clinically, this condition varies with the extent of the calcification and the phase of the condition. In particular, the disorder is asymptomatic or may cause mild discomfort during the deposition of calcium, while it becomes acutely painful during the resorptive phase. US-PICT (ultrasound-guided percutaneous irrigation of calcific tendinopathy) is indicated in the acute phase (resorptive phase) of CT with significant pain relief and a very low rate of minor complications. The aim of this manuscript is to define the rationale of the ultrasound-guided percutaneous irrigation of calcific tendinopathy, correlating it with the sequence of biochemical processes that lead to the hydrolysis of hydroxyapatite. Furthermore, we will explain the reasons why we prefer using the three-needle technique for the dissolution of calcifications.
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