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Abstract Background Hamstring tendons are a popular choice for autografts in anterior cruciate ligament (ACL) reconstruction. However, there is increasing evidence that hamstring tendon autografts carry a high risk of revision and residual instability in young patients. To elucidate the reasons for the inferior outcome of the reconstructed ACL with hamstring tendon autografts in young patients, we investigated the Young’s modulus and the extent of cyclic loading-induced slackening of the semitendinosus tendon used for ACL reconstruction across a broad range of ages. Methods Twenty-six male patients (aged 17–53 years), who were scheduled for ACL reconstruction surgery using the semitendinosus tendon autograft, participated in this study. The distal portion of the harvested semitendinosus tendon, which was not used to construct the autograft, was used for cyclic tensile testing to calculate the Young’s modulus and the extent of slackening (i.e., increase in slack length). Results Spearman correlation analysis revealed that the Young’s modulus of the semitendinosus tendon was positively correlated with the patient’s age (ρ = 0.559, P = 0.003). In contrast, the extent of tendon slackening did not correlate with the patient’s age. Conclusions We demonstrated that the Young’s modulus of the semitendinosus tendon increases with age, indicating that the semitendinosus tendon used for ACL reconstruction is compliant in young patients.

Objective: Anterior cruciate ligament (ACL) injury is one of the causes for post-traumatic knee osteoarthritis (OA), and ACL reconstruction surgery is reportedly unable to prevent OA development. In early-stage knee OA, medial meniscus extrusion (MME) is closely correlated with tibial medial osteophyte width, which consists of bone and cartilage -parts. However, the relationship between MME and osteophyte in ACL-injured patients remains elusive. We examined MME and osteophyte and their relationship in ACL-injured patients before and after surgery. Design: Thirty ACL-injured patients who underwent surgery (30.7 years old, on average) were enrolled. Correlations between magnetic resonance imaging (MRI)-detected OA changes and MME before and after surgery (7.6 months interval) were analyzed. Results: MME (>3 ​mm) was present in 16.7% and 26.7% of the patients before and after surgery, respectively, and MME was significantly increased after surgery (2.4 ​± ​1.3 ​mm) than before surgery (1.9 ​± ​1.2 ​mm) (p ​

Objective: Knee osteoarthritis (OA) is one of the most common causes for reduction in gait speed. Research into the mechanism of underlying knee OA pain and other symptoms such as the reduction in the gait speed is essential to development of disease-modifying treatments for knee OA. We examined the magnetic resonance imaging (MRI)-detected structural alterations in knee joints those were associated with gait speed in knee OA patients. Design: In this cross-sectional study, structural alterations in knee joints of 74 knee OA patients (51 females; mean 72.2 years old) were evaluated by MRI, and subjects’ gait speed was measured. Results: The mean self-selected gait speed of the subjects was 0.73 ​± ​0.21 ​m/s. A simple linear regression analysis revealed that MME was only correlated with the gait speed of the subjects with knee OA, while cartilage lesion, bone marrow lesion, subchondral bone cyst, subchondral cyst, osteophytes and meniscal pathology were not. A multiple regression analysis revealed that only MME was associated with gait speed (R2 ​= ​0.484, p ​

Abstract Background Medial meniscal extrusion (MME) is associated with progression of medial knee osteoarthritis (OA), but no or little information is available for relationships between MME and osteophytes, which are found in cartilage and bone parts. Because of the limitation in detectability of the cartilage part of osteophytes by radiography or conventional magnetic resonance imaging (MRI), the rate of development and size of osteophytes appear to have been underestimated. Because T2 mapping MRI may enable us to evaluate the cartilage part of osteophytes, we aimed to examine the association between MME and OA-related changes, including osteophytes, by using conventional and T2 mapping MRI. Methods Patients with early-stage knee OA (n = 50) were examined. MRI-detected OA-related changes, in addition to MME, were evaluated according to the Whole-Organ Magnetic Resonance Imaging Score. T2 values of the medial meniscus and osteophytes were measured on T2 mapping images. Osteophytes surgically removed from patients with end-stage knee OA were histologically analyzed and compared with findings derived by radiography and MRI. Results Medial side osteophytes were detected by T2 mapping MRI in 98% of patients with early-stage knee OA, although the detection rate was 48% by conventional MRI and 40% by radiography. Among the OA-related changes, medial tibial osteophyte distance was most closely associated with MME, as determined by multiple logistic regression analysis, in the patients with early-stage knee OA (β = 0.711, p

In this study, we performed osteosynthesis for a distal radius fracture using a minimally invasive approach for a patient with skin disorder of the forearm and obtained favorable results. This case report may provide new findings confirming the usefulness of this surgical approach for distal radius fractures. Blister formation on the right forearm was observed in a 53-year-old female who was diagnosed with a distal fracture of the right radius and underwent splinting in a local hospital, and she was referred to our hospital 2 days after the injury. Minimally invasive locking plate osteosynthesis was performed, and there was no skin lesion at this incision site. Postoperatively, there were no complications in soft tissues and the operative scar was almost unrecognizable. We reported volar locking plate osteosynthesis using the minimally invasive approach in a patient with skin disorder of the forearm. Such patients are rarely encountered. However, this minimally invasive approach is extremely useful for utilizing the advantages of volar locking plate fixation without being affected by the soft tissue environment.

Background Treatment of volar-displaced distal radius fractures (DRF) accompanied by marginal rim fragment has recently been actively discussed. It is difficult to obtain a sufficient buttress effect on this fragment. Therefore, we actively apply a distal volar locking plate (DVLP) to fractures with this fragment. Here, we report the treatment outcomes and caveats of surgery of fractures with this fragment. Materials and Methods The subjects were 32 patients (male: 11, female: 21, and mean age: 59.4 years) with volar dislocated DRF accompanied by the marginal rim fragment treated using DVLP. The fracture type of AO classification was B3 in 6 patients, C1 in 12, C2 in 6, and C3 in 8. Results The mean duration of follow-up was 13.8 (12-30) months. The plate could be covered with the pronator quadratus muscle in surgery in all patients. On the final follow-up, visual analog scale score was 1.4/10, quick disabilities of the arm, shoulder, and hand score was 9.2/100, and the Mayo wrist score was 93.7/100. No complication was observed in the soft tissue, such as the nerves and flexor tendons. Conclusion The factor determining retention of the reduction position of the marginal rim fragment is a sufficient buttress effect, and DVLP is a useful implant in terms of this point. [ABSTRACT FROM AUTHOR]

Objectives: To examine the factors associated with increase in lumbar spine bone mineral density (LSBMD) by bisphosphonates (BPs) with active vitamin D analog (aVD). Methods: Two independent postmenopausal osteoporotic patients treated by BPs with aVD for 24 months (Study 1: n=93, Study 2: n=99) were retrospectively analyzed. Results: In Study 1, LS-BMD of the patients significantly increased for 24 m (5.4%, p<.001). A multiple regression analysis among baseline characteristics revealed that serum calcium (sCa: 8.5-10.5 mg/dL) was associated with an increased LS-BMD by treatment (r2: 0.088, p=.02). While average sCa of the patients was 9.2 mg/dL before treatment, it increased time-dependently to 9.6mg/dL for 24 m by treatment. As each patient had their LS-BMD five times during the study, there were four instances of %LSBMD in each patient, resulting in 372 instances of %LS-BMD in Study 1. The smallest Akaike's information criterion value for the most appropriate cut-off levels of sCa for %LS-BMD by treatment every 6 m was 9.3 mg/dL. The %LS-BMD by treatment for 6 m during 24 m period in patients with sCa -9.3mg/dL (1.5%) was significantly higher than that in patients with sCa <9.3 mg/dL (0.8%, p=.038). The results of Study 2 were similar to those of Study 1, confirming the phenomena observed. Conclusion: sCa was associated with an increased LS-BMD by BPs with aVD. [ABSTRACT FROM AUTHOR]

In the present study, the thenar muscles were evaluated using magnetic resonance imaging (MRI), in addition, the correlations between thenar muscle changes, clinical findings and electrodiagnostic results from patients with carpal tunnel syndrome were investigated. The subjects were 13 patients (17 wrists) who were clinically diagnosed with carpal tunnel syndrome. In all patients, a medical history was obtained and physical examination was performed, in addition to assessment using the Kapandji scoring system, visual analogue scale (VAS), quick-disabilities of the arm, shoulder and hand (Q-DASH) score, electrodiagnostic results of the median nerve, and MRI of the thenar muscles. Thenar muscle volume was not significantly correlated with clinical data or the electrodiagnostic results. The thenar muscle major axis was significantly correlated with grasp power (P<0.05) and the Kapandji score (P<0.05), while the thenar muscle minor axis was significantly correlated with abductor pollicis brevis distal motor latency (APB DML) (P<0.01). In addition, the thenar muscle minor axis/thenar muscle major axis ratio was significantly correlated with APB DML and Kanatani's stage. Notably, thenar muscle thinness was significantly correlated with the severity of electrodiagnostic changes, while the grasp power and Kapandji score were correlated with thenar muscle thickness. Furthermore, it was demonstrated that thenar muscle thinness was significantly correlated with the severity of electrodiagnostic changes; in addition, there was a significant correlation between the thenar muscle major axis and the grasp power or Kapandji score. Taken together, these results revealed that thenar muscle atrophy did not affect patient-based assessments, including VAS and Q-DASH, but reflected electrodiagnostic results, particularly DML and severity. The results of the present study suggest that thenar muscle atrophy can be used to estimate the severity of carpal tunnel syndrome. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this prospective cohort study was to examine whether MRI-detected osteoarthritis (OA)-structural changes at baseline could predict knee OA patients who would undergo total knee arthroplasty (TKA). Methods: In total, 128 end-stage medial-type knee OA patients were enrolled and followed up for 6 months. MRI using the whole-organ MRI scoring (WORMS) method, radiographic findings, visual analog scale (VAS) for pain and a patient-oriented outcome measure, and the Japanese Knee Osteoarthritis Measure (JKOM) were recorded at baseline. The area under the curve (AUC) was estimated to determine the discriminative value of the prediction models. Results: While 74 patients (57.8%) did not undergo TKA, the remaining 54 patients (42.2%) underwent TKA during this period. The AUCs of the receiver operating characteristic (ROC) curve for the activities of daily living (ADL) score evaluated by the JKOM ADL score [0.70 (95% CI: 0.60-0.79)] and osteophyte score [0.72 (0.64-0.81)] were 0.70 or greater. The JKOM ADL score (17/40) and the osteophyte score (30/98) showed relative risks (RR) of 2.61 (1.32-5.15) and 3.01 (1.39-6.52) for undergoing TKA, respectively. Conclusion: The osteophyte score detected by MRI, in addition to ADL score, was found to be an important factor in determining whether the patient should undergo TKA. [ABSTRACT FROM AUTHOR]