Pub Date : 2024-01-01Epub Date: 2024-05-10DOI: 10.26502/josm.511500146
Merlin Rajesh Lal, Devendra K Agrawal
The biomechanical properties of the tendon are affected due to the changes in composition of the tendon extracellular matrix (ECM). Age, overuse, trauma and metabolic disorders are a few associated conditions that contribute to tendon abnormalities. Hyperlipidemia is one of the leading factors that contribute to the compromised biomechanical. Injury was made on infraspinatus tendon of hyperlipidemic swines. After 8 weeks (i) infraspinatus tendon from the injury site, (ii) infraspinatus tendon from the contralateral side and (iii) Achilles tendon, were collected and analyzed for ECM components that form the major part in biomechanical properties. Immunostaining of infraspinatus tendon on the injury site had higher staining collagen type-1 (COL1A1), biglycan, prolyl 4-hydroxylase and mohawk but lower staining for decorin than the control group. The Achilles tendon of the swines that had injury on infraspinatus tendon showed a chronic adaptation towards load which was evident from a more organized ECM with increased decorin, mohawk and decreased biglycan, scleraxis. The mechanism behind the collagen turnover and chronic adaptation to load need to be studied in detail with the biomechanical properties.
{"title":"Chronic Adaptation of Achilles Tendon Tissues upon Injury to Rotator Cuff Tendon in Hyperlipidemic Swine.","authors":"Merlin Rajesh Lal, Devendra K Agrawal","doi":"10.26502/josm.511500146","DOIUrl":"https://doi.org/10.26502/josm.511500146","url":null,"abstract":"<p><p>The biomechanical properties of the tendon are affected due to the changes in composition of the tendon extracellular matrix (ECM). Age, overuse, trauma and metabolic disorders are a few associated conditions that contribute to tendon abnormalities. Hyperlipidemia is one of the leading factors that contribute to the compromised biomechanical. Injury was made on infraspinatus tendon of hyperlipidemic swines. After 8 weeks (i) infraspinatus tendon from the injury site, (ii) infraspinatus tendon from the contralateral side and (iii) Achilles tendon, were collected and analyzed for ECM components that form the major part in biomechanical properties. Immunostaining of infraspinatus tendon on the injury site had higher staining collagen type-1 (COL1A1), biglycan, prolyl 4-hydroxylase and mohawk but lower staining for decorin than the control group. The Achilles tendon of the swines that had injury on infraspinatus tendon showed a chronic adaptation towards load which was evident from a more organized ECM with increased decorin, mohawk and decreased biglycan, scleraxis. The mechanism behind the collagen turnover and chronic adaptation to load need to be studied in detail with the biomechanical properties.</p>","PeriodicalId":73881,"journal":{"name":"Journal of orthopaedics and sports medicine","volume":"6 2","pages":"80-88"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11210446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141473249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01Epub Date: 2024-04-22DOI: 10.26502/josm.511500144
Merlin Rajesh Lal L P, Devendra K Agrawal
Hyperlipidemia is linked to atherosclerosis and various diseases. Its strong association with Achilles tendinopathies and xanthomas affects tendon properties through lipid deposition in tendon tissue. We examined the impact of hyperlipidemia on the biomechanical properties of the swine Achilles tendons. Swines were fed a high-cholesterol-high-fat diet to induce hyperlipidemia, and their Achilles tendons were collected and examined for biomechanical properties. The ultimate tensile strength, modulus of elasticity and viscoelastic properties did not exhibit significant differences between hyperlipidemic and control swines. H&E and pentachrome staining revealed extracellular matrix (ECM) disorganization and cellular infiltration in the hyperlipidemic swines, highlighting a marked difference between the control and hyperlipidemic groups. These results suggest hyperlipidemia in young swines alters the tendon composition and may contribute to weak biomechanical properties with time.
{"title":"Hyperlipidemia Induced Pathological Changes with no Effect in Biomechanical Properties in the Achilles Tendon of Young Swine.","authors":"Merlin Rajesh Lal L P, Devendra K Agrawal","doi":"10.26502/josm.511500144","DOIUrl":"10.26502/josm.511500144","url":null,"abstract":"<p><p>Hyperlipidemia is linked to atherosclerosis and various diseases. Its strong association with Achilles tendinopathies and xanthomas affects tendon properties through lipid deposition in tendon tissue. We examined the impact of hyperlipidemia on the biomechanical properties of the swine Achilles tendons. Swines were fed a high-cholesterol-high-fat diet to induce hyperlipidemia, and their Achilles tendons were collected and examined for biomechanical properties. The ultimate tensile strength, modulus of elasticity and viscoelastic properties did not exhibit significant differences between hyperlipidemic and control swines. H&E and pentachrome staining revealed extracellular matrix (ECM) disorganization and cellular infiltration in the hyperlipidemic swines, highlighting a marked difference between the control and hyperlipidemic groups. These results suggest hyperlipidemia in young swines alters the tendon composition and may contribute to weak biomechanical properties with time.</p>","PeriodicalId":73881,"journal":{"name":"Journal of orthopaedics and sports medicine","volume":"6 2","pages":"67-72"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11113011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141089536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Paolo Mario Sarais, G. Alvarez Rey, G. Boni, D. Dıraçoğlu, J. Laíns, Raimondo Leone, F. Migliore, A. Perrotta, A. Migliore
Cold therapy application is commonly used to relieve pain symptoms, to reduce inflammation in chronic diseases and damage in injuries at the musculoskeletal level. Two types of technologies, Partial Body Cryotherapy (PBC) or Whole Body Cryotherapy (WBC), are available in the market. This narrative review reports data from trials exploring WBC in Sport and in physical activity with the aim to show limitations and effectiveness in healthy subjects performing sport activity. The systematic search was conducted on the past ten years. The search keywords were "Whole Body Cryotherapy" OR "Cryogenic chamber therapy" OR "Cryostimulation" AND "Sport" OR "Exercise" OR "Athlete" OR "Physical Activity." The sample size, subject’s age and gender, year of publication, duration and temperature of exposition, physical activity and outcomes were extracted. 15 articles met the inclusion criteria. Data on 265 subjects aged between 20 to 56 years were reported. The WBC protocols covered temperatures from -20 to -120 degrees Celsius. Exposure times ranged from 1 minute to 3 minutes. The cryostimulation sessions were coupled to normal daily recreational activities or, in the case of athletes, competitive activities during the competition season. WBC is a safe procedure and no major adverse events neither alteration of vital parameters were reported. The benefits have been found especially in post-exercise DOMS. Since many aspects need to be clarified a research agenda has been produced to answer crucial questions. In conclusion WBC seems to be a useful tool in Sport Medicine. However, further studies are necessary to establish standardized protocols.
{"title":"Whole Body Cryotherapy in Sport and Physical Activity: A Narrative Review","authors":"Paolo Mario Sarais, G. Alvarez Rey, G. Boni, D. Dıraçoğlu, J. Laíns, Raimondo Leone, F. Migliore, A. Perrotta, A. Migliore","doi":"10.26502/josm.511500102","DOIUrl":"https://doi.org/10.26502/josm.511500102","url":null,"abstract":"Cold therapy application is commonly used to relieve pain symptoms, to reduce inflammation in chronic diseases and damage in injuries at the musculoskeletal level. Two types of technologies, Partial Body Cryotherapy (PBC) or Whole Body Cryotherapy (WBC), are available in the market. This narrative review reports data from trials exploring WBC in Sport and in physical activity with the aim to show limitations and effectiveness in healthy subjects performing sport activity. The systematic search was conducted on the past ten years. The search keywords were \"Whole Body Cryotherapy\" OR \"Cryogenic chamber therapy\" OR \"Cryostimulation\" AND \"Sport\" OR \"Exercise\" OR \"Athlete\" OR \"Physical Activity.\" The sample size, subject’s age and gender, year of publication, duration and temperature of exposition, physical activity and outcomes were extracted. 15 articles met the inclusion criteria. Data on 265 subjects aged between 20 to 56 years were reported. The WBC protocols covered temperatures from -20 to -120 degrees Celsius. Exposure times ranged from 1 minute to 3 minutes. The cryostimulation sessions were coupled to normal daily recreational activities or, in the case of athletes, competitive activities during the competition season. WBC is a safe procedure and no major adverse events neither alteration of vital parameters were reported. The benefits have been found especially in post-exercise DOMS. Since many aspects need to be clarified a research agenda has been produced to answer crucial questions. In conclusion WBC seems to be a useful tool in Sport Medicine. However, further studies are necessary to establish standardized protocols.","PeriodicalId":73881,"journal":{"name":"Journal of orthopaedics and sports medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69349457","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}
{"title":"Sensitivity of Diagnostic Methods for Detecting S. stercoralis Infection and Comparison of the Total Global Number of Strongyloidiasis Cases with Other Recognized NTDs: A Systematic Review","authors":"Heron Gezahegn","doi":"10.26502/josm.511500098","DOIUrl":"https://doi.org/10.26502/josm.511500098","url":null,"abstract":",","PeriodicalId":73881,"journal":{"name":"Journal of orthopaedics and sports medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69349340","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}
{"title":"Creating an Inexpensive PVC Knee Model for the Training of Ultrasound-Guided Medial Intra-Articular Knee Injections","authors":"Ryland McDermott, Joshua Melanson, Skylar Davidson, Nora Doyle","doi":"10.26502/josm.511500104","DOIUrl":"https://doi.org/10.26502/josm.511500104","url":null,"abstract":",","PeriodicalId":73881,"journal":{"name":"Journal of orthopaedics and sports medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69349513","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: Noma is a gangrenous disease that primarily affects young children in extremely poor regions of Africa, Asia, and Latin America. Noma has one of the highest mortality rates, estimated at 90%. Noma begins in the oral cavity and it spreads rapidly and destroys bone, muscle, and skin in the orofacial anatomy. The full onset of Noma is preventable and inexpensive to treat at its early stage. However, a significant number of Noma cases do not receive treatment until it is either too late to save their face or, more commonly, their life. With the recommendation to further investigate the beliefs and perceptions of Noma patients to understand their behavior in seeking medical care, the focus in this situation should remain on understanding the underlying causes. This study examined the main reasons Noma survivors initially had for delaying medical care and that eventually motivated them to seek it. Methods: To achieve the objective of the study, a structured and scheduled qualitative interview was used. A total of 46 Noma cases from different geographic areas in Ethiopia were interviewed in March 2023 to describe the main factors that prevent them from seeking timely medical care and ultimately lead them to seek it. The study participants were asked to indicate their main reason for not seeking medical care soon enough. Then they were asked why they finally decided to pursue medical care.
{"title":"Impact of Erroneous Belief on Timely Health Care-Seeking Practices Among Noma (Facial Gangrene) Survivors in Ethiopia","authors":"Heron Gezahegn Gebretsadik","doi":"10.26502/josm.511500105","DOIUrl":"https://doi.org/10.26502/josm.511500105","url":null,"abstract":"Background: Noma is a gangrenous disease that primarily affects young children in extremely poor regions of Africa, Asia, and Latin America. Noma has one of the highest mortality rates, estimated at 90%. Noma begins in the oral cavity and it spreads rapidly and destroys bone, muscle, and skin in the orofacial anatomy. The full onset of Noma is preventable and inexpensive to treat at its early stage. However, a significant number of Noma cases do not receive treatment until it is either too late to save their face or, more commonly, their life. With the recommendation to further investigate the beliefs and perceptions of Noma patients to understand their behavior in seeking medical care, the focus in this situation should remain on understanding the underlying causes. This study examined the main reasons Noma survivors initially had for delaying medical care and that eventually motivated them to seek it. Methods: To achieve the objective of the study, a structured and scheduled qualitative interview was used. A total of 46 Noma cases from different geographic areas in Ethiopia were interviewed in March 2023 to describe the main factors that prevent them from seeking timely medical care and ultimately lead them to seek it. The study participants were asked to indicate their main reason for not seeking medical care soon enough. Then they were asked why they finally decided to pursue medical care.","PeriodicalId":73881,"journal":{"name":"Journal of orthopaedics and sports medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69349522","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}
T. Tsuji, Chiaki Wada, M. Kawanishi, Yasuhisa Fujita, Y. Kamijo, Y. Umemoto, K. Kouda, Kazunari Nishiyama, F. Tajima, Yukihide Nishimura
The present study aimed to assess whether surface electromyogram (sEMG) signal from the vastus medialis could be a candidate method to quantify physical activities during combined activities in ambulatory persons (ergometer exercise, treadmill walking, and squatting). In the first trial, twelve healthy men performed a graded cycle ergometer exercise at 0%, 30%, 60%, and 80% of peak oxygen consumption rate (VO 2peak ), followed by treadmill walking at 0, 2, 4, and 6 km/h for 3 min of each, and each exercise was intermitted by 3 min of rest. sEMG from the Vastus Medialis Oblique Longus (VML) was collected, and the integrated amplitude of spikes (sEMGAMP) were calculated every minute. Positive correlations were observed between ∆VO 2 and ΣsEMG AMP ; data at sampling frequency of 250Hz in both exercise types were plotted (r=0.888; P<0.0001; y=339.04x+4.0267). In the second trial, thirteen healthy participants (three women) performed the combined exercise comprising 3 min each for optimal walking (3 km/h), fast walking (5 km/h and 6 km/h for women and men, respectively), squatting, second optimal walking, and ergometer exercise at 30% VO 2peak , which were intermitted by 30 sec. Finally, they performed ergometer exercise at 100% VO 2peak for 1 min followed by 3-min cool-down (0W). Changes (∆) in VO 2 from the resting value and sEMG AMP during exercise were summed throughout the exercise period (Σ∆VO 2 and ΣsEMG AMP ). ΣΔsEMG AMP was positively correlated with ΣΔVO 2 (r=0.68, p=0.011, @250Hz). Monitoring sEMG from VML may be a candidate method for the evaluation of physical activities for exercise therapy in ambulatory persons.
本研究旨在评估来自股内侧肌的表面肌电图(sEMG)信号是否可以作为一种候选方法来量化活动者在联合活动(测力仪运动、跑步机行走和下蹲)期间的身体活动。在第一项试验中，12名健康男性在0%、30%、60%和80%的峰值耗氧率(vo2peak)下进行了渐进式循环力计运动，然后在跑步机上以0、2、4和6公里/小时的速度步行3分钟，每次运动中间休息3分钟。收集股内侧斜长肌(VML)的肌电信号，每分钟计算一次综合峰幅(sEMGAMP)。∆VO 2与ΣsEMG AMP呈正相关;绘制采样频率为250Hz时两种运动类型的数据(r=0.888;P < 0.0001;339.04 x + y = 4.0267)。在第二项试验中，13名健康参与者(3名女性)进行了3分钟的组合运动，分别为最佳步行(3公里/小时)、快速步行(女性和男性分别为5公里/小时和6公里/小时)、深蹲、第二最佳步行和30% VO 2峰值的测力仪运动，这些运动间隔30秒。最后，他们以100% VO 2峰值进行了1分钟的测力仪运动，然后进行了3分钟的冷却(0W)。计算运动期间VO 2与静息值和sEMG AMP的变化(∆)(Σ∆VO 2和ΣsEMG AMP)。ΣΔsEMG AMP与ΣΔVO 2呈正相关(r=0.68, p=0.011， @250Hz)。监测VML的肌电图可能是评估运动治疗中运动活动的候选方法。
{"title":"Quantification of Physical Activities Simulated Exercise Therapy in Ambulatory Inpatients Using Surface Electromyogram from the Vastus Medialis","authors":"T. Tsuji, Chiaki Wada, M. Kawanishi, Yasuhisa Fujita, Y. Kamijo, Y. Umemoto, K. Kouda, Kazunari Nishiyama, F. Tajima, Yukihide Nishimura","doi":"10.26502/josm.511500085","DOIUrl":"https://doi.org/10.26502/josm.511500085","url":null,"abstract":"The present study aimed to assess whether surface electromyogram (sEMG) signal from the vastus medialis could be a candidate method to quantify physical activities during combined activities in ambulatory persons (ergometer exercise, treadmill walking, and squatting). In the first trial, twelve healthy men performed a graded cycle ergometer exercise at 0%, 30%, 60%, and 80% of peak oxygen consumption rate (VO 2peak ), followed by treadmill walking at 0, 2, 4, and 6 km/h for 3 min of each, and each exercise was intermitted by 3 min of rest. sEMG from the Vastus Medialis Oblique Longus (VML) was collected, and the integrated amplitude of spikes (sEMGAMP) were calculated every minute. Positive correlations were observed between ∆VO 2 and ΣsEMG AMP ; data at sampling frequency of 250Hz in both exercise types were plotted (r=0.888; P<0.0001; y=339.04x+4.0267). In the second trial, thirteen healthy participants (three women) performed the combined exercise comprising 3 min each for optimal walking (3 km/h), fast walking (5 km/h and 6 km/h for women and men, respectively), squatting, second optimal walking, and ergometer exercise at 30% VO 2peak , which were intermitted by 30 sec. Finally, they performed ergometer exercise at 100% VO 2peak for 1 min followed by 3-min cool-down (0W). Changes (∆) in VO 2 from the resting value and sEMG AMP during exercise were summed throughout the exercise period (Σ∆VO 2 and ΣsEMG AMP ). ΣΔsEMG AMP was positively correlated with ΣΔVO 2 (r=0.68, p=0.011, @250Hz). Monitoring sEMG from VML may be a candidate method for the evaluation of physical activities for exercise therapy in ambulatory persons.","PeriodicalId":73881,"journal":{"name":"Journal of orthopaedics and sports medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69349681","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: The effective gait restoration due to antigravity treadmill exercise has been demonstrated in patients with locomotor or nervous system disorders. The element of unweighting, its effect on the parameters of the gait cycle and possible deviation from overground walking, despite all the clinical evidence, remains questionable.
{"title":"The Relationship between Antigravity Treadmill Therapy Settings and Gait Cycle Parameters","authors":"Miloslav Kubicek and, Tomas Brozek","doi":"10.26502/josm.511500128","DOIUrl":"https://doi.org/10.26502/josm.511500128","url":null,"abstract":"Background: The effective gait restoration due to antigravity treadmill exercise has been demonstrated in patients with locomotor or nervous system disorders. The element of unweighting, its effect on the parameters of the gait cycle and possible deviation from overground walking, despite all the clinical evidence, remains questionable.","PeriodicalId":73881,"journal":{"name":"Journal of orthopaedics and sports medicine","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135506553","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}
Scott C Everett, Andrew L Alejo, Blake Boggess, E. Reinke, Cindy L. Green, E. Poehlein, Benjamin Boswell
Exposing children to numerous radiographs in order to diagnose various musculoskeletal injuries is not ideal due to the deleterious side effects of ionizing radiation on growth plates. In particular, Little Leaguer’s Shoulder is a common pediatric and adolescent injury that relies mainly on radiographs in order to recognize and treat. Thus, if other imaging modalities without ionizing radiation, such as ultrasound, can be shown to be reliable and accurate in measuring humeral physeal width, it may serve as a better means of identifying these injuries. The purpose of this study was to assess the consistency of two separate physician measures of proximal humeral epiphysis widening in children ages 12-16. Inter-rater and intra-rater reliability of ultrasound measurements of the proximal humeral epiphysis was calculated among twelve patients with open physes. Longitudinal measurements of the epiphyseal plate were obtained in three locations: just distal to the most lateral aspect of the acromion, 2 cm anterior to that line, and 2 cm posterior to that line with the same measurements repeated on the opposite arm. Measurements were then averaged for an overall width. Overall, no statistically significant variation was found when comparing epiphyseal plate width on dominant versus non-dominant arms. Ultrasonographic measurement of proximal humeral epiphyseal width shows narrow variability when used and interpreted by a sports medicine physician.
{"title":"Accuracy of Ultrasound in Determining Proximal Humeral Epiphyseal Widening in Youth Athletes: A Case Series","authors":"Scott C Everett, Andrew L Alejo, Blake Boggess, E. Reinke, Cindy L. Green, E. Poehlein, Benjamin Boswell","doi":"10.26502/josm.511500109","DOIUrl":"https://doi.org/10.26502/josm.511500109","url":null,"abstract":"Exposing children to numerous radiographs in order to diagnose various musculoskeletal injuries is not ideal due to the deleterious side effects of ionizing radiation on growth plates. In particular, Little Leaguer’s Shoulder is a common pediatric and adolescent injury that relies mainly on radiographs in order to recognize and treat. Thus, if other imaging modalities without ionizing radiation, such as ultrasound, can be shown to be reliable and accurate in measuring humeral physeal width, it may serve as a better means of identifying these injuries. The purpose of this study was to assess the consistency of two separate physician measures of proximal humeral epiphysis widening in children ages 12-16. Inter-rater and intra-rater reliability of ultrasound measurements of the proximal humeral epiphysis was calculated among twelve patients with open physes. Longitudinal measurements of the epiphyseal plate were obtained in three locations: just distal to the most lateral aspect of the acromion, 2 cm anterior to that line, and 2 cm posterior to that line with the same measurements repeated on the opposite arm. Measurements were then averaged for an overall width. Overall, no statistically significant variation was found when comparing epiphyseal plate width on dominant versus non-dominant arms. Ultrasonographic measurement of proximal humeral epiphyseal width shows narrow variability when used and interpreted by a sports medicine physician.","PeriodicalId":73881,"journal":{"name":"Journal of orthopaedics and sports medicine","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69349577","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: Fluoride is a beneficial trace element. It is contained in the calcified tissues. Fluoride has a prophylactic effect against dental caries when absorbed in doses of less than 1.5 mg/day on the surface of the tooth enamel. It is also used as a therapeutic agent in adults for the treatment of postmenopausal osteoporosis at doses of 15 to 25 mg/day. However, fluoride in high doses can cause skeletal fluorosis, which can lead to bone fractures. The effects of fluoridated water on the skeleton are poorly understood, but there is some evidence that prolonged consumption of highly fluoridated water increases the risk of bone fractures. This case-control study examined the association between skeletal fluorosis and bone fractures among adults living in Ethiopia's Rift Valley (fluoride endemic) region. Method: A case-control study was conducted among adult Ethiopians in February 2023 to investigate the association between skeletal fluorosis and bone fractures. The study aimed to determine whether skeletal fluorosis poses a risk for bone fractures. Three matched controls were chosen for every case, considering a 1:3 ratio. Spine radiographic investigations were conducted to determine possible skeletal fluorosis-associated morphologic changes among the study participants. Chi-square tests and odds ratios (ORs) were computed. The P-value was also calculated considering a degree of freedom (df) of 1. Results: Given the 1:3 ratio between cases and controls, the study included 9 cases (6 females and three males) and 27 controls. The cases were diagnosed with femoral neck fractures (n=2), callus fractures (n=2), distal tibial fracture (n=1), lumbar vertebra fractures (n=3), and calcaneal fractures (n=1). The age range of cases and controls was 38 to 69 years. Analysis revealed a statistically (p-value = 0.01) significant association between skeletal fluorosis and bone fractures. Five subjects (4 cases and one control) had a constellation of abnormal bony changes in the spine. The odd ratio (OD) and chi-square (χ2) were calculated as 20.80 and 6.27, respectively, while the 95% CI was determined as [1.904, 227.274]. Conclusion: This study revealed that skeletal fluorosis is a risk factor for multiple types of bone fractures among adults living in a highly fluoridated area in Ethiopia. However, more thorough studies need to be conducted with a broader study population to further determine the association between skeletal fluorosis and bone fractures.
{"title":"Skeletal Fluorosis: A Risk Factor of Bone Fractures Among Adults in Ethiopia: A Case-Control Study","authors":"Heron Gezahegn Gebretsadik","doi":"10.26502/josm.511500111","DOIUrl":"https://doi.org/10.26502/josm.511500111","url":null,"abstract":"Background: Fluoride is a beneficial trace element. It is contained in the calcified tissues. Fluoride has a prophylactic effect against dental caries when absorbed in doses of less than 1.5 mg/day on the surface of the tooth enamel. It is also used as a therapeutic agent in adults for the treatment of postmenopausal osteoporosis at doses of 15 to 25 mg/day. However, fluoride in high doses can cause skeletal fluorosis, which can lead to bone fractures. The effects of fluoridated water on the skeleton are poorly understood, but there is some evidence that prolonged consumption of highly fluoridated water increases the risk of bone fractures. This case-control study examined the association between skeletal fluorosis and bone fractures among adults living in Ethiopia's Rift Valley (fluoride endemic) region. Method: A case-control study was conducted among adult Ethiopians in February 2023 to investigate the association between skeletal fluorosis and bone fractures. The study aimed to determine whether skeletal fluorosis poses a risk for bone fractures. Three matched controls were chosen for every case, considering a 1:3 ratio. Spine radiographic investigations were conducted to determine possible skeletal fluorosis-associated morphologic changes among the study participants. Chi-square tests and odds ratios (ORs) were computed. The P-value was also calculated considering a degree of freedom (df) of 1. Results: Given the 1:3 ratio between cases and controls, the study included 9 cases (6 females and three males) and 27 controls. The cases were diagnosed with femoral neck fractures (n=2), callus fractures (n=2), distal tibial fracture (n=1), lumbar vertebra fractures (n=3), and calcaneal fractures (n=1). The age range of cases and controls was 38 to 69 years. Analysis revealed a statistically (p-value = 0.01) significant association between skeletal fluorosis and bone fractures. Five subjects (4 cases and one control) had a constellation of abnormal bony changes in the spine. The odd ratio (OD) and chi-square (χ2) were calculated as 20.80 and 6.27, respectively, while the 95% CI was determined as [1.904, 227.274]. Conclusion: This study revealed that skeletal fluorosis is a risk factor for multiple types of bone fractures among adults living in a highly fluoridated area in Ethiopia. However, more thorough studies need to be conducted with a broader study population to further determine the association between skeletal fluorosis and bone fractures.","PeriodicalId":73881,"journal":{"name":"Journal of orthopaedics and sports medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69349587","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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