Background: Knee joint osteoarthritis, a widespread disabling disease with no known cause continues to produce considerable bouts of intractable pain and disability as a result of multiple disease associated health problems despite years of research.Aim: This paper examines if there is sufficient reason to believe one or more neural based abnormalities in the knee neural network may be involved or implicated in inducing and perpetuating at least some forms of knee joint osteoarthritis, but is often unrecognized and thus untreated or ignored.Methods: Peer reviewed data retrieved from several sources were examined to highlight and discuss the structural and functional nature of the knee joint nerves and their ramifications in various knee joint tissues, the spinal cord and central nervous system and motor control pathways.Results: Knee joint nerve pathways that are damaged or functioning abnormally can affect normal joint biomechanics, plus joint stability and thereby can influence the onset or perpetuation of knee joint pathology and exaggerated activation of pain fibers and cognitions.Conclusion: To improve the effectiveness of strategies designed to avert knee joint osteoarthritis pain and disability, attention to its possible ongoing neuropathology as well as possible declines in joint protective, perceptual and stability mechanisms in older vulnerable adults are indicated.
{"title":"Knee Joint Neural Sources and Pathways and Their Osteoarthritis Pathogenic Linkages and Pain Control Implications","authors":"Ray Marks","doi":"10.46889/josr.2024.5205","DOIUrl":"https://doi.org/10.46889/josr.2024.5205","url":null,"abstract":"Background: Knee joint osteoarthritis, a widespread disabling disease with no known cause continues to produce considerable bouts of intractable pain and disability as a result of multiple disease associated health problems despite years of research.\u0000\u0000Aim: This paper examines if there is sufficient reason to believe one or more neural based abnormalities in the knee neural network may be involved or implicated in inducing and perpetuating at least some forms of knee joint osteoarthritis, but is often unrecognized and thus untreated or ignored.\u0000\u0000Methods: Peer reviewed data retrieved from several sources were examined to highlight and discuss the structural and functional nature of the knee joint nerves and their ramifications in various knee joint tissues, the spinal cord and central nervous system and motor control pathways.\u0000\u0000Results: Knee joint nerve pathways that are damaged or functioning abnormally can affect normal joint biomechanics, plus joint stability and thereby can influence the onset or perpetuation of knee joint pathology and exaggerated activation of pain fibers and cognitions.\u0000\u0000Conclusion: To improve the effectiveness of strategies designed to avert knee joint osteoarthritis pain and disability, attention to its possible ongoing neuropathology as well as possible declines in joint protective, perceptual and stability mechanisms in older vulnerable adults are indicated.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"66 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141817908","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}
Background: Surgical treatment of Early Onset Scoliosis (EOS) involves operations with repetitive maneuvers that may put a surgeon at risk for a work-related Musculoskeletal Disorder (MSD). The purpose of this study was to evaluate the prevalence of MSDs that surgeons self-attributed to EOS operations.Methods: Surgeons in an international study group were invited to participate in a 41-question survey and data was analyzed from surgeons with 5 or more years of experience post training. This included demographics, occurrence of an MSD directly attributed to repetitive EOS surgery, MSD anatomic location and treatment type.Results: A total of 60 respondents qualified. Most respondents were male (51/60, 85%), with a mean age of 53 (range 36-78) and a mean of 20 years in practice (range 5-47). They reported a mean of 102 spine surgeries per year (range 12-300). A total of 117 MSDs were reported; the most common being cervical spine (30), lumbar spine (28) and wrist/hand (27). Of the 60 respondents, 49 (82%) reported at least one; 17 (30%) sustained 2 separate MSDs and 18 (30%) sustained 3 or more MSDs. Of those who reported at least one MSD, 29 respondents (59%) underwent treatment; the most common being injection (12/49, 25%), physical or occupational therapy (6/49, 12%) and surgery (6/49, 12%). There was a significant relationship between age and the prevalence of MSDs in the shoulder or rotator cuff region (r=0.38; p=0.002).Conclusion: In a cohort of 60 EOS surgeons, more than 80% have sustained at least 1 MSD they self-attributed to EOS surgery, with the most frequent conditions affecting the cervical and lumbar spine and 58% reported >1 condition. Six participants (10%) underwent surgical treatment for an MSD they directly attributed to EOS surgery.
{"title":"https://athenaeumpub.com/wp-content/uploads/Prevalence-of-Work-related-Musculoskeletal-Disorders-in-Early-Onset-Scoliosis-Surgeons.pdf","authors":"R. F. Murphy","doi":"10.46889/josr.2024.5204","DOIUrl":"https://doi.org/10.46889/josr.2024.5204","url":null,"abstract":"Background: Surgical treatment of Early Onset Scoliosis (EOS) involves operations with repetitive maneuvers that may put a surgeon at risk for a work-related Musculoskeletal Disorder (MSD). The purpose of this study was to evaluate the prevalence of MSDs that surgeons self-attributed to EOS operations.\u0000\u0000Methods: Surgeons in an international study group were invited to participate in a 41-question survey and data was analyzed from surgeons with 5 or more years of experience post training. This included demographics, occurrence of an MSD directly attributed to repetitive EOS surgery, MSD anatomic location and treatment type.\u0000\u0000Results: A total of 60 respondents qualified. Most respondents were male (51/60, 85%), with a mean age of 53 (range 36-78) and a mean of 20 years in practice (range 5-47). They reported a mean of 102 spine surgeries per year (range 12-300). A total of 117 MSDs were reported; the most common being cervical spine (30), lumbar spine (28) and wrist/hand (27). Of the 60 respondents, 49 (82%) reported at least one; 17 (30%) sustained 2 separate MSDs and 18 (30%) sustained 3 or more MSDs. Of those who reported at least one MSD, 29 respondents (59%) underwent treatment; the most common being injection (12/49, 25%), physical or occupational therapy (6/49, 12%) and surgery (6/49, 12%). There was a significant relationship between age and the prevalence of MSDs in the shoulder or rotator cuff region (r=0.38; p=0.002).\u0000\u0000Conclusion: In a cohort of 60 EOS surgeons, more than 80% have sustained at least 1 MSD they self-attributed to EOS surgery, with the most frequent conditions affecting the cervical and lumbar spine and 58% reported >1 condition. Six participants (10%) underwent surgical treatment for an MSD they directly attributed to EOS surgery.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"361 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141686354","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}
Introduction: Idiopathic scoliosis is a complex three-dimensional deformity of the spinal column. Adolescent Idiopathic Scoliosis (AIS) is the most common type affecting healthy young individuals. Psychological well-being of these young group of patients has been area of concern when managing these patients. Aim of this study was to assess quality of life in patient undergoing corrective surgery for AIS using the SRS-30 questionnaire.Methodology: A cross sectional study of all patients that underwent deformity correction surgery for AIS from January 2016 till December 2019 was done. Patient had to be followed up for over 1 year. Only patient with idiopathic adolescent scoliosis were included. Radiographic measurements of the Cobb angle preoperative and postoperatively were obtained from medical records of the patient. Patients were then given the SRS-30 questionnaire.Results: 24 patients were recruited in this study based on the inclusion and exclusion criteria. The median preoperative Cobb angle was 63.0 (19.90), while post operatively it was 18.0 (11.25) with a percentage of correction of 68.0 (17.5). The average total SRS score is 4.20 (0.38). Using the Spearman’s Rho correlation analysis there was a significance and moderately positive correlation between the satisfaction with management domain scores and the percentage of Cobb’s Angle correction.Conclusion: In this study, the average total SRS score was 4.2 (0.38) indicating a favorable outcome in terms of quality of life in patient undergoing scoliosis surgery.
{"title":"Improvement of Life After Scoliosis Surgery: Assessment Using the SRS-30 Questionnaire","authors":"Abdul Nawfar Sadagatullah","doi":"10.46889/josr.2024.5202","DOIUrl":"https://doi.org/10.46889/josr.2024.5202","url":null,"abstract":"Introduction: Idiopathic scoliosis is a complex three-dimensional deformity of the spinal column. Adolescent Idiopathic Scoliosis (AIS) is the most common type affecting healthy young individuals. Psychological well-being of these young group of patients has been area of concern when managing these patients. Aim of this study was to assess quality of life in patient undergoing corrective surgery for AIS using the SRS-30 questionnaire.\u0000\u0000Methodology: A cross sectional study of all patients that underwent deformity correction surgery for AIS from January 2016 till December 2019 was done. Patient had to be followed up for over 1 year. Only patient with idiopathic adolescent scoliosis were included. Radiographic measurements of the Cobb angle preoperative and postoperatively were obtained from medical records of the patient. Patients were then given the SRS-30 questionnaire.\u0000\u0000Results: 24 patients were recruited in this study based on the inclusion and exclusion criteria. The median preoperative Cobb angle was 63.0 (19.90), while post operatively it was 18.0 (11.25) with a percentage of correction of 68.0 (17.5). The average total SRS score is 4.20 (0.38). Using the Spearman’s Rho correlation analysis there was a significance and moderately positive correlation between the satisfaction with management domain scores and the percentage of Cobb’s Angle correction.\u0000\u0000Conclusion: In this study, the average total SRS score was 4.2 (0.38) indicating a favorable outcome in terms of quality of life in patient undergoing scoliosis surgery.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"7 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141265587","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}
Recurrent shoulder instability is known to be a challenge in terms of the success rate of surgical stabilization of the shoulder joint. According to the latest literature the choice of the glenohumeral stabilization surgical treatment is guided by the degree of bone loss. Among the techniques dedicated to significant glenoid bone loss, one will find many already reported, but each has its drawbacks. As we observe currently popular techniques, we conclude that we should continue to look for techniques or some modifications to those already available that are laden with as few complications as possible. In 2019, a new technique called bone block cerclage has been described. It is a new approach, using when metal implants are not used while providing benefits such as maintenance and integrity and function of structures like coracobrachialis, short head of biceps, pectoralis minor and preservation of subscapularis tendon. Currently, there are not many reported cases in the literature after BBC with a longer follow-up time. In this paper, we present the case of our patient operated on 24 months ago with this technique with good results. The patient is still under our observation. Due to the relatively new technique and the small number of described follow- ups, we feel it is relevant to describe our case.
{"title":"Case Report of Arthroscopic Anatomical Bone Glenoid Augmentation with Subscapularis Tendon Protection with A 24 Months Follow-Up and Literature Review of The Current Concepts of Glenoid Bone Augmentation","authors":"Aleksandra Sibilska","doi":"10.46889/josr.2024.5201","DOIUrl":"https://doi.org/10.46889/josr.2024.5201","url":null,"abstract":"Recurrent shoulder instability is known to be a challenge in terms of the success rate of surgical stabilization of the shoulder joint. According to the latest literature the choice of the glenohumeral stabilization surgical treatment is guided by the degree of bone loss. Among the techniques dedicated to significant glenoid bone loss, one will find many already reported, but each has its drawbacks. As we observe currently popular techniques, we conclude that we should continue to look for techniques or some modifications to those already available that are laden with as few complications as possible. In 2019, a new technique called bone block cerclage has been described. It is a new approach, using when metal implants are not used while providing benefits such as maintenance and integrity and function of structures like coracobrachialis, short head of biceps, pectoralis minor and preservation of subscapularis tendon. Currently, there are not many reported cases in the literature after BBC with a longer follow-up time. In this paper, we present the case of our patient operated on 24 months ago with this technique with good results. The patient is still under our observation. Due to the relatively new technique and the small number of described follow- ups, we feel it is relevant to describe our case.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"60 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140985082","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}
Background: Osteoarthritis, a painful oftentimes disabling joint disorder affects many older adults and others globally. Involving progressive and distinctive biologic as well as structural alterations of the articular cartilage tissue lining freely moving joints such as the knee joint and often the underlying bone the condition is presently considered incurable.Objective: In seeking to advance therapies for this condition, this report was designed to examine the rationale for and potential efficacy of, applying pulsed electromagnetic fields clinically for purposes of reducing osteoarthritis pain and other related symptoms disease features, especially through its impact on cartilage, the tissue most consistently implicated in this disease.Methods: Available English language literature published largely on PUBMED between 1974 and 2024 were reviewed a) in general; b) to specifically examine whether favourable changes in pain as well as the disease itself might be expected from the application of pulsed electromagnetic fields in some form to an osteoarthritic joint and c) why this occurs, if observed. Key search terms used were: Pulsed Electromagnetic Fields, Cartilage, Chondrocyte, Disability and Osteoarthritis.Results: The data search revealed a large body of basic and clinical research in this field has persisted over time with no definitive conclusion, but with tentative support for its possible potential use for mitigating pain and improving cartilage homeostasis and joint function via several biologic pathways.Conclusion: Further basic and carefully controlled short and long term clinical research alongside comparable lab studies appear strongly indicated and may help to better validate and support the possible more mainstream and/or targeted clinical use of one or more forms of pulsed electromagnetic fields in facilitating function and possible joint reparative processes in adults with osteoarthritis, while reducing pain, inflammation, stiffness and the magnitude of joint derangement and dysfunction.
{"title":"Are New Approaches Needed to Solidify Pulsed Electromagnetic Fields and Osteoarthritis Associations: A 50-year Retrospective Showing Promise but No Definitive Lab or Clinical Research Conclusions (1974-2024)","authors":"Ray Marks","doi":"10.46889/josr.2024.5111","DOIUrl":"https://doi.org/10.46889/josr.2024.5111","url":null,"abstract":"Background: Osteoarthritis, a painful oftentimes disabling joint disorder affects many older adults and others globally. Involving progressive and distinctive biologic as well as structural alterations of the articular cartilage tissue lining freely moving joints such as the knee joint and often the underlying bone the condition is presently considered incurable.\u0000\u0000Objective: In seeking to advance therapies for this condition, this report was designed to examine the rationale for and potential efficacy of, applying pulsed electromagnetic fields clinically for purposes of reducing osteoarthritis pain and other related symptoms disease features, especially through its impact on cartilage, the tissue most consistently implicated in this disease.\u0000\u0000Methods: Available English language literature published largely on PUBMED between 1974 and 2024 were reviewed a) in general; b) to specifically examine whether favourable changes in pain as well as the disease itself might be expected from the application of pulsed electromagnetic fields in some form to an osteoarthritic joint and c) why this occurs, if observed. Key search terms used were: Pulsed Electromagnetic Fields, Cartilage, Chondrocyte, Disability and Osteoarthritis.\u0000\u0000Results: The data search revealed a large body of basic and clinical research in this field has persisted over time with no definitive conclusion, but with tentative support for its possible potential use for mitigating pain and improving cartilage homeostasis and joint function via several biologic pathways.\u0000\u0000Conclusion: Further basic and carefully controlled short and long term clinical research alongside comparable lab studies appear strongly indicated and may help to better validate and support the possible more mainstream and/or targeted clinical use of one or more forms of pulsed electromagnetic fields in facilitating function and possible joint reparative processes in adults with osteoarthritis, while reducing pain, inflammation, stiffness and the magnitude of joint derangement and dysfunction.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"30 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140672418","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}
Ramadan, the ninth month of the Islamic lunar calendar, involves fasting from dawn until sunset as a spiritual practice. For individuals engaged in bodybuilding and fitness pursuits, Ramadan presents unique challenges and opportunities. This article reviews the scientific literature on the effects of Ramadan fasting on muscle physiology and performance, as well as strategies for optimizing bodybuilding goals during this period. It examines nutritional and training considerations to help individuals maintain muscle mass, strength and performance while observing Ramadan.
{"title":"Exploring the Intersection of Bodybuilding and Ramadan: Strategies for Maintaining Muscle Mass and Performance During Fasting","authors":"Khaled Hamlaoui","doi":"10.46889/josr.2024.5110","DOIUrl":"https://doi.org/10.46889/josr.2024.5110","url":null,"abstract":"Ramadan, the ninth month of the Islamic lunar calendar, involves fasting from dawn until sunset as a spiritual practice. For individuals engaged in bodybuilding and fitness pursuits, Ramadan presents unique challenges and opportunities. This article reviews the scientific literature on the effects of Ramadan fasting on muscle physiology and performance, as well as strategies for optimizing bodybuilding goals during this period. It examines nutritional and training considerations to help individuals maintain muscle mass, strength and performance while observing Ramadan.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"17 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140700646","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}
Introduction: Intramedullary nailing has revolutionized the treatment of long bone fractures and non-unions. However, there is rightly concern about the use of nails when there is established infection or when the risk of subsequent infection is high. Recently, this concern has been partly addressed by the introduction of intramedullary nails combined with an antibacterial coating. Various methods have been reported with some success but also with some drawbacks.Methods: This paper reports a simple technique for coating an intramedullary nail with an absorbable antibiotic carrier. The carrier is injected directly into the reamed medullary canal, coating the nail during nail passage and delivering high levels of antibiotics at the nail-bone interface.Results: This technique was found to be easy to apply. It allowed use of standard fracture implants without the need for downsizing of the nail diameter. There is no need for nail removal or exchange after initial treatment of the infection.Conclusion: This simple technique combines the benefits of a bioabsorbable antibiotic carrier with standard fracture nails to prevent or treat long bone infections. It avoids the problems of PMMA coated nails or the need for specialist implants.
{"title":"Intramedullary Nailing with an Absorbable Antibiotic Carrier (INaac): A Simple Technique Using Standard Implants","authors":"Martin McNally","doi":"10.46889/josr.2024.5109","DOIUrl":"https://doi.org/10.46889/josr.2024.5109","url":null,"abstract":"Introduction: Intramedullary nailing has revolutionized the treatment of long bone fractures and non-unions. However, there is rightly concern about the use of nails when there is established infection or when the risk of subsequent infection is high. Recently, this concern has been partly addressed by the introduction of intramedullary nails combined with an antibacterial coating. Various methods have been reported with some success but also with some drawbacks.\u0000\u0000Methods: This paper reports a simple technique for coating an intramedullary nail with an absorbable antibiotic carrier. The carrier is injected directly into the reamed medullary canal, coating the nail during nail passage and delivering high levels of antibiotics at the nail-bone interface.\u0000\u0000Results: This technique was found to be easy to apply. It allowed use of standard fracture implants without the need for downsizing of the nail diameter. There is no need for nail removal or exchange after initial treatment of the infection.\u0000\u0000Conclusion: This simple technique combines the benefits of a bioabsorbable antibiotic carrier with standard fracture nails to prevent or treat long bone infections. It avoids the problems of PMMA coated nails or the need for specialist implants.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"30 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140739999","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}
Background: To assess long-term clinical and radiological data of porous titanium cervical interbody cages.Methods: We recruited 34 out of 49 patients previously enrolled in the EFFECT trial on 3D printed titanium cages, for 5 years follow-up. Objectives were the evaluation of Neck Disability Index, Visual Analog Scale of arm pain and neck pain, Likert self-reported perceived recovery, EQ-5D, fusion status and subsidence. Fusion was defined as rotation ≤ 4° and ≤ 1.25 mm translation at the index level, using flexion-extension radiograph.Results: All patients had good outcomes in terms of NDI (12.5±15.4), VAS neck pain (23.5±24.1), VAS arm pain (18.7±20.2) and EuroQol (0.77±0.24). 88.6% of the patients experienced complete or nearly complete recovery. NDI improved significantly at 5 years compared to 1 year, all other outcome measures did not significantly differ from the 12 months results. The fusion rate at the index level increased from 91.5% at 12 months to 100% at 5 years.Conclusion: 3D printed stand-alone porous titanium cervical implants are effective in terms of clinical and radiological outcome with 88.6% complete or nearly complete recovery and fusion rate of 100% at 5 years follow-up. Moreover, solid single level anterior cervical fusion can be achieved without additional plating.Trial Registration: The study has been registered in The Netherlands Trial Register (NTR 1289) and approved by the Medical Ethical Committee (NL76079.058.20).
{"title":"Interbody Fusion Device in the Treatment of Cervicobrachial Syndrome: A Prospective 5-Year Follow-Up Extension Study of Porous Titanium Cervical Cages","authors":"MP Arts","doi":"10.46889/josr.2024.5108","DOIUrl":"https://doi.org/10.46889/josr.2024.5108","url":null,"abstract":"Background: To assess long-term clinical and radiological data of porous titanium cervical interbody cages.\u0000\u0000Methods: We recruited 34 out of 49 patients previously enrolled in the EFFECT trial on 3D printed titanium cages, for 5 years follow-up. Objectives were the evaluation of Neck Disability Index, Visual Analog Scale of arm pain and neck pain, Likert self-reported perceived recovery, EQ-5D, fusion status and subsidence. Fusion was defined as rotation ≤ 4° and ≤ 1.25 mm translation at the index level, using flexion-extension radiograph.\u0000\u0000Results: All patients had good outcomes in terms of NDI (12.5±15.4), VAS neck pain (23.5±24.1), VAS arm pain (18.7±20.2) and EuroQol (0.77±0.24). 88.6% of the patients experienced complete or nearly complete recovery. NDI improved significantly at 5 years compared to 1 year, all other outcome measures did not significantly differ from the 12 months results. The fusion rate at the index level increased from 91.5% at 12 months to 100% at 5 years.\u0000\u0000Conclusion: 3D printed stand-alone porous titanium cervical implants are effective in terms of clinical and radiological outcome with 88.6% complete or nearly complete recovery and fusion rate of 100% at 5 years follow-up. Moreover, solid single level anterior cervical fusion can be achieved without additional plating.\u0000\u0000Trial Registration: The study has been registered in The Netherlands Trial Register (NTR 1289) and approved by the Medical Ethical Committee (NL76079.058.20).","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":" 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140210269","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}
Objective: This study aims to examine potential gender-based publication disparities among 2023 orthopaedic surgery matched-applicants, investigate variations in research emphasis based on program affiliation and assess publication differences across different geographic regions.Methods: Orthopaedic surgery residency programs participating in the 2023 NRMP with a publicly available incoming resident class were identified using the NRMP database. Each resident was searched using PubMed and ORCID identifiers for publications. Each program was designated as “university-based”, “community-based”, “community-based/university affiliated” or “other” using the American Medical Association’s FRIEDA database.Results: In total, 763 residents were identified with a mean and median number of publications of 6.1 (SD=10.0) and 3.0 (IQR=1.0-7.0) respectively. There was no significant difference in the median number of publications between males (2.0) and females (3.0, p=0.2315). Those who matched to “community-based/university affiliated” (median=2.0) programs had a lower median number of publications than those who matched to “university-based” (median=3.0, p<0.0001) or “other” (median=6.0, p=0.0006). Geographically, applicants in the West-South Central region (median=1.0) had the lowest publication median compared to those in the New England (median=4.0, p=0.0010) or Pacific (median=4.0, p=0.0015) regions.Conclusion: There lies a perceived increase in significance of research publications for competitiveness in the orthopaedic surgery match. This largely follows the elimination of objective Step-1 scoring to help stratify potential applicants. Research remains an objective manner to stratify applicants; however, new data lacks on recent analysis of the 2023 match pool. There was not a significant difference in the number of publications between male vs female matched-applicants. The program category “other” and the New England and Pacific regions had the highest median number of publications.Keywords: Orthopaedics; Medical Residency; Graduate Medical Education; Medical School; Residency Match; Orthopaedic Education; Orthopaedic Residency
{"title":"Discrepancies in Publication Volume Per Matched-Applicant Between Sex, Geographic Regions and Program Affiliation in the 2023 Orthopaedic Surgery Residency Match","authors":"Chloe Farnham","doi":"10.46889/josr.2024.5106","DOIUrl":"https://doi.org/10.46889/josr.2024.5106","url":null,"abstract":"Objective: This study aims to examine potential gender-based publication disparities among 2023 orthopaedic surgery matched-applicants, investigate variations in research emphasis based on program affiliation and assess publication differences across different geographic regions.\u0000\u0000Methods: Orthopaedic surgery residency programs participating in the 2023 NRMP with a publicly available incoming resident class were identified using the NRMP database. Each resident was searched using PubMed and ORCID identifiers for publications. Each program was designated as “university-based”, “community-based”, “community-based/university affiliated” or “other” using the American Medical Association’s FRIEDA database.\u0000\u0000Results: In total, 763 residents were identified with a mean and median number of publications of 6.1 (SD=10.0) and 3.0 (IQR=1.0-7.0) respectively. There was no significant difference in the median number of publications between males (2.0) and females (3.0, p=0.2315). Those who matched to “community-based/university affiliated” (median=2.0) programs had a lower median number of publications than those who matched to “university-based” (median=3.0, p<0.0001) or “other” (median=6.0, p=0.0006). Geographically, applicants in the West-South Central region (median=1.0) had the lowest publication median compared to those in the New England (median=4.0, p=0.0010) or Pacific (median=4.0, p=0.0015) regions.\u0000\u0000Conclusion: There lies a perceived increase in significance of research publications for competitiveness in the orthopaedic surgery match. This largely follows the elimination of objective Step-1 scoring to help stratify potential applicants. Research remains an objective manner to stratify applicants; however, new data lacks on recent analysis of the 2023 match pool. There was not a significant difference in the number of publications between male vs female matched-applicants. The program category “other” and the New England and Pacific regions had the highest median number of publications.\u0000\u0000Keywords: Orthopaedics; Medical Residency; Graduate Medical Education; Medical School; Residency Match; Orthopaedic Education; Orthopaedic Residency","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"125 29","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140078883","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}
Introduction: Despite efforts to use scaffolds to treat meniscus tears, minimal progress has been made in facilitating meniscus regeneration and return of function. Our research objective was to develop a meniscus repair and regeneration implant by applying a resorbable scaffold in combination with cells and growth factors. We report here the results of using Platelet-Rich Plasma (PRP) as a source of growth factors to induce fibrochondrogenic differentiation of human Adipose- Derived Mesenchymal Stem Cells (hADSC) in a three-dimensional (3D) Type I collagen-based scaffold in-vitro. Methods: Scaffold Preparation: Type I collagen scaffolds were prepared following a protocol previously published. Two different densities of scaffolds, High Density (HD) and Low Density (LD), were produced for in-vitro study. hADSC and PRP Preparation. hADSCs were cultured to the fifth passage to reach the desired number for experimentation. PRP was collected from human blood and activated. Cell Culture Procedure: Effects of PRP on hADSC proliferation and differentiation into fibrochondrogenic cells were examined in four scaffold groups: LD, HD, LD+PRP and HD+PRP. hADSCs were seeded onto scaffolds (n=5) at a concentration of 2 × 106 cells/scaffold. 1% of PRP was added to the experimental media. Cellular proliferation was assessed at 1, 7, 14 and 21 days. Differentiation was measured using qRT-PCR on Days 14 and 21. qRT- PCR analysis of gene expression was completed with primers for COLLAGEN 1 and AGGRECAN. Data Analysis: ANOVAs were conducted (two-tailed tests) at the .05 significance level.Results: Cellular proliferation of hADSCs seeded on each scaffold increased over time. Similar trend was observed for cells seeded on HD scaffolds with and without PRP. hADSC showed significant increase in cellular proliferation on the LD scaffolds at Days 1 and 7. At Day 21, PRP treatment and LD scaffold had a synergistic positive effect on Type I collagen gene expression. PRP did not elevate type I collagen gene in the HD group, the HD scaffold alone had the same level of type I collagen gene expression as LD+PRP. Aggrecan expression was elevated in the presence of PRP in both the HD and LD scaffold groups, indicating enhanced fibrochondrogenic differentiation of hADSCs. Effective cell infiltration was observed across both HD and LD scaffolds with and without PRP treatment. HD scaffolds displayed larger cell clusters and more extensive cell migration over time compared to LD scaffolds. However, LD scaffolds resulted a more uniform cellular distribution than HD scaffolds.Conclusion: Our study demonstrates that PRP can play an important role in directing hADSCs towards fibrochondrogenic differentiation in Type I collagen-based scaffolds in-vitro. Additionally, our study shows that collagen scaffold density can influence the spatial distribution and cellular behavior of infiltrated cells.
简介：尽管人们努力使用支架治疗半月板撕裂，但在促进半月板再生和恢复功能方面进展甚微。我们的研究目标是开发一种半月板修复和再生植入物，将可吸收支架与细胞和生长因子结合使用。我们在此报告使用富血小板血浆（PRP）作为生长因子来源，诱导人脂肪间充质干细胞（hADSC）在基于 I 型胶原的三维（3D）支架中进行体外纤维软骨分化的结果。方法：支架制备支架制备：I型胶原支架按照之前发表的方案制备。高密度（HD）和低密度（LD）两种不同密度的支架用于体外研究。从人体血液中采集并活化 PRP。细胞培养过程：在四个支架组中考察 PRP 对 hADSC 增殖和分化为纤维软骨细胞的影响：将 hADSCs 以 2 × 106 cells/scaffold 的浓度播种到支架上（n=5）。在实验培养基中加入 1%的 PRP。细胞增殖在 1、7、14 和 21 天时进行评估。使用 COLLAGEN 1 和 AGGRECAN 引物完成了基因表达的 qRT- PCR 分析。数据分析：进行方差分析（双尾检验），显著性水平为 0.05：结果：每种支架上播种的 hADSCs 的细胞增殖均随时间推移而增加。第 1 天和第 7 天，hADSC 在 LD 支架上的细胞增殖显著增加。在第 21 天，PRP 处理和 LD 支架对 I 型胶原基因表达有协同的积极影响。在 HD 组中，PRP 并未提高 I 型胶原基因的表达，而单独使用 HD 支架的 I 型胶原基因表达水平与 LD+PRP 相同。在有 PRP 存在的情况下，HD 和 LD 支架组的 Aggrecan 表达均升高，这表明 hADSCs 的纤维软骨分化增强。无论是否经过 PRP 处理，在 HD 和 LD 支架上都能观察到有效的细胞浸润。与 LD 支架相比，HD 支架随着时间的推移显示出更大的细胞簇和更广泛的细胞迁移。然而，与 HD 支架相比，LD 支架的细胞分布更均匀：我们的研究表明，PRP 在引导 hADSCs 在 I 型胶原支架中进行体外纤维软骨分化方面发挥着重要作用。此外，我们的研究还表明，胶原支架密度可影响浸润细胞的空间分布和细胞行为。
{"title":"Fibrochondrogenic Differentiation Potential of Human Adiposederived Mesenchymal Stem Cells in a Type I Collagen-based Meniscus Scaffold with Activated Platelet-Rich Plasma Stimulation In-vitro","authors":"Andrew C Muran","doi":"10.46889/josr.2024.5105","DOIUrl":"https://doi.org/10.46889/josr.2024.5105","url":null,"abstract":"Introduction: Despite efforts to use scaffolds to treat meniscus tears, minimal progress has been made in facilitating meniscus regeneration and return of function. Our research objective was to develop a meniscus repair and regeneration implant by applying a resorbable scaffold in combination with cells and growth factors. We report here the results of using Platelet-Rich Plasma (PRP) as a source of growth factors to induce fibrochondrogenic differentiation of human Adipose- Derived Mesenchymal Stem Cells (hADSC) in a three-dimensional (3D) Type I collagen-based scaffold in-vitro. \u0000\u0000Methods: Scaffold Preparation: Type I collagen scaffolds were prepared following a protocol previously published. Two different densities of scaffolds, High Density (HD) and Low Density (LD), were produced for in-vitro study. hADSC and PRP Preparation. hADSCs were cultured to the fifth passage to reach the desired number for experimentation. PRP was collected from human blood and activated. Cell Culture Procedure: Effects of PRP on hADSC proliferation and differentiation into fibrochondrogenic cells were examined in four scaffold groups: LD, HD, LD+PRP and HD+PRP. hADSCs were seeded onto scaffolds (n=5) at a concentration of 2 × 106 cells/scaffold. 1% of PRP was added to the experimental media. Cellular proliferation was assessed at 1, 7, 14 and 21 days. Differentiation was measured using qRT-PCR on Days 14 and 21. qRT- PCR analysis of gene expression was completed with primers for COLLAGEN 1 and AGGRECAN. Data Analysis: ANOVAs were conducted (two-tailed tests) at the .05 significance level.\u0000\u0000Results: Cellular proliferation of hADSCs seeded on each scaffold increased over time. Similar trend was observed for cells seeded on HD scaffolds with and without PRP. hADSC showed significant increase in cellular proliferation on the LD scaffolds at Days 1 and 7. At Day 21, PRP treatment and LD scaffold had a synergistic positive effect on Type I collagen gene expression. PRP did not elevate type I collagen gene in the HD group, the HD scaffold alone had the same level of type I collagen gene expression as LD+PRP. Aggrecan expression was elevated in the presence of PRP in both the HD and LD scaffold groups, indicating enhanced fibrochondrogenic differentiation of hADSCs. Effective cell infiltration was observed across both HD and LD scaffolds with and without PRP treatment. HD scaffolds displayed larger cell clusters and more extensive cell migration over time compared to LD scaffolds. However, LD scaffolds resulted a more uniform cellular distribution than HD scaffolds.\u0000\u0000Conclusion: Our study demonstrates that PRP can play an important role in directing hADSCs towards fibrochondrogenic differentiation in Type I collagen-based scaffolds in-vitro. Additionally, our study shows that collagen scaffold density can influence the spatial distribution and cellular behavior of infiltrated cells.","PeriodicalId":382112,"journal":{"name":"Journal of Orthopaedic Science and Research","volume":"131 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140428911","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}
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