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Background: Surgeons have limited knowledge of the lumbar intervertebral foramina. This study aimed to classify osteophytes in the lumbar intervertebral foramen and to determine their pathoanatomical characteristics, discuss their potential biomechanical effects, and contribute to developing surgical methods. Methods: We conducted a retrospective, non-randomized, single-center study involving 1224 patients. The gender, age, and anatomical location of the osteophytes in the lumbar intervertebral foramina of the patients were recorded. Results: Two hundred and forty-nine (20.34%) patients had one or more osteophytes in their lumbar 4 and 5 foramina. Of the 4896 foramina, 337 (6.88%) contained different types of osteophytes. Moreover, four anatomical types of osteophytes were found: mixed osteophytes in 181 (3.69%) foramina, osteophytes from the lower endplate of the superior vertebrae in 91 (1.85%) foramina, osteophytes from the junction of the pedicle and lamina of the upper vertebrae in 39 foramina (0.79%), and osteophytes from the upper endplate of the lower vertebrae in 26 (0.53%) foramina. The L4 foramen contained a significantly higher number of osteophytes than the L5 foramen. Osteophyte development increased significantly with age, with no difference between males and females. Conclusions: The findings show that osteophytic extrusions, which alter the natural anatomical structure of the lumbar intervertebral foramina, are common and can narrow the foramen. [ABSTRACT FROM AUTHOR]

It is unclear whether osteochondral lesions of the talus (OLTs) without chronic lateral ankle instability (CLAI) progress to osteoarthritis, which affects the therapeutic strategy. Especially, the efficacy of conservative treatment for OLT remains controversial. Since various anatomical abnormalities have been reported, there may be abnormal movement of the talus in the mortise, causing ankle instability. We hypothesized that OLTs have frequent osteoarthritic changes even without CLAI. This study aimed to evaluate the incidence of osteoarthritic changes and stress distribution on the talus in OLT. Fifty-eight ankles with medial OLT without CLAI were retrospectively reviewed. Osteophytes and joint space narrowing on radiographs were scored using Kraus's classification and compared to ankles without OLTs. OA scores were compared between over 18 years and less than 17 years in OLTs. On computed tomography images, the area of OLTs was measured. Besides, Hounsfield Units (HU) of the talus in patients with and without OLTs were measured and compared. Osteoarthritic changes were observed in 54 of the 58 ankles (94.8%) in the OLT patients. Osteophytes were frequently observed at the medial gutter and anterior tibial plafond. The OA score in patients aged over 18 years was significantly higher than that in patients aged less than 17 years (P < 0.05). HU values in the talus were significantly higher than those in non-OLT patients. OLTs more than 100 mm2 had a significantly higher osteoarthritic score than those less than 100 mm2. Medial OLT without CLAI has frequently osteoarthritic changes, especially large lesions. Osteoarthritic changes in OLTs will progress over time, which needs to be considered when deciding whether to perform the surgical or non-surgical treatment. [ABSTRACT FROM AUTHOR]

Purpose: Ankle impingement is generally characterised by limited range of motion and pain due to pathological contact between structures. Anterior ankle impingement is usually diagnosed by clinical examination and radiographic evidence of tibiotalar osteophytes. In addition to osteophytes, radiographs may show a correlation between the tibia and talus, which may further aid in the diagnosis of anterior ankle impingement. The purpose of this study is to investigate the relationship between the tibia and talus in anterior ankle impingement. Methods: In this retrospective cohort study, the tibial coverage of 22 patients with anterior ankle impingement was compared with that of 67 healthy subjects. Results: The percentage of tibial coverage was 0.674 ± 0.043 in the anterior ankle impingement group and 0.580 ± 0.032 in the control group. The difference between groups was statistically significant (P < 0.05). Conclusions: In addition to existing criteria, the percentage of tibial coverage may provide valuable information for the diagnosis of anterior ankle impingement. [ABSTRACT FROM AUTHOR]

Objective: Diffuse idiopathic skeletal hyperostosis (DISH) is characterized by osteophytes in the anterior vertebrae, and the presence of aorta may have an impact on their formation. However, the anatomical positional relationship between the aorta and osteophytes in patients with DISH remains controversial. This study aimed to evaluate the position of osteophytes in relation to aorta in DISH, and the influence of aortic pulsation on the formation of osteophytes from the perspective of morphology. Methods: We conducted a retrospective review of 101 patients diagnosed with DISH and symptomatic lumbar spinal stenosis between June 2018 and December 2021. A total of 637 segments with heterotopic ossification in DISH were used for quantitative measurements on CT scans. The Cartesian coordinate system was built up on the axial CT scans to reflect the relative position between aorta and osteophytes. Osteophytes were divided into adjacent aorta group (AD group) and non‐adjacent aorta group (N‐AD group). In terms of the morphology, osteophytes in the AD group were further divided into convex, flat, and concave types. The relative position between aorta and osteophytes, and the aorta‐osteophyte distance and morphology of osteophytes were compared. Univariate analysis of variance was performed for multiple groups, and two independent‐samples t‐tests were used for two groups. Results: From T5 to L4, aorta gradually descended from left side to middle of vertebrae, and osteophytes gradually shifted from right side of vertebrae (T5‐T10) to bilateral sides (T11‐L4). Of 637 osteophytes in DISH, 60.1% (383/637) were in AD group, including convex type 0.6% (4/637), flat type 34.7% (221/637), and concave type 24.8% (158/637). The N‐AD group accounted for 39.9% (254/637). Flat osteophytes were concentrated in T5‐T12, while concave osteophytes in T11‐L4. Overall, the aorta‐osteophyte distance of concave type was significantly smaller than that of flat type. Conclusion: Osteophytes are not always located on the right side of vertebrae, but move with the position of the descending aorta. Furthermore, the morphology of osteophytes varies by vertebral segment in DISH, which is related to aorta descending anteriorly in the spine. [ABSTRACT FROM AUTHOR]

Olecranon spurs are enthesophytes, observed in the posterior part of the proximal olecranon surface. They can be symptomatic in isolation but are frequently mentioned with inflammatory conditions such as triceps tendonitis or olecranon bursitis and gout. Its surgical management entails anatomical information. Olecranon spur has rarely been reported in anatomical studies. We present a case of bilateral olecranon spur in the ulnae of a 62-year-old male skeleton. To the best of our knowledge, this report is the first anatomical report on biletral olecranon spur. The size of the spur was noticed carefully. Thorough anatomical knowledge of the olecranon spur can provide clinicians, radiologists, and forensic experts with better clinical judgment and may add insight to the surgical planning by orthopedic surgeons. Olecranon spur should also be considered in the differential diagnosis of pain at the posterior elbow, which may develop spontaneously, after a traumatic event, or in association with different sports. [ABSTRACT FROM AUTHOR]

Objectives: Our study aimed to determine how often the osteophyte located underneath the anterior intermeniscal ligament is observed in patients who underwent arthroscopic surgery due to degenerative meniscal tears, how often this osteophyte can be diagnosed by magnetic resonance imaging, and whether this osteophyte could be an indication for the surgery to be performed for degenerative meniscopathy. Methods: Our retrospective study included 47 patients operated for degenerative meniscus tears between 2017 and 2018, with a minimum follow-up of 2 years. Visual analog scale (VAS), Lysholm knee, and Western Ontario Meniscal Evaluation Tool (WOMET) scores were applied to all patients included in the study preoperatively and at the postoperative 3rd, 6th, 12th, and 24th months. The operated patients were grouped into two groups with and without osteophytes beneath the anterior intermeniscal ligament in magnetic resonance imaging (Group A and B). Preoperative and postoperative values of the patients were compared among themselves. Results: The average age of the patients included in our study was 57 (range: 42 to 72) years. Forty (85%) participants were female. Osteophyte was detected in 36.1% (n = 17) of the patients in preoperative magnetic resonance imagings (Group-A). There was a statistically significant difference between preoperative VAS, Lysholm, and WOMET scores and postoperative 3rd, 6th, 12th, and 24th months (p < 0.05). Mean follow-up time was 32 (range: 24 to 60) months. Conclusions: We believe that arthroscopic control of the inferior intermeniscal ligament for the presence of any osteophytes in patients treated surgically for degenerative meniscal tears is one of the main steps of this surgery. [ABSTRACT FROM AUTHOR]

Objective: Diffuse idiopathic skeletal hyperostosis (DISH), Forestier’s disease, is a systemic disease characterized by the abnormal ossification and calcification of the paravertebral ligaments and muscles in front of the vertebral bodies. It rarely causes clinical symptoms but sometimes produces dysphagia. This study will evaluate the effectiveness of the anterior cervical approach in patients with Forestier’s disease who suffer from dysphagia. Material and Method: In this series, a retrospective analysis was performed on five patients referred to our clinic with dysphagia. Clinical, demographic, and surgical features were evaluated. Result: All of the cases were male. Their mean age was 63.6 (range 56-69). The involved regions were C3-4; C2-3; C6-7; C3-7; C3-D3. All the patients who have dysphagia were treated via the anterolateral cervical approach. There were no neurological deficits or complaints postoperatively. All the patients stated that they benefited from surgery. Conclusion: Osteophyte resection by an anterolateral cervical approach is a safe and effective treatment option for dysphagia in Forestier’s disease. [ABSTRACT FROM AUTHOR]

Posterior cervical foraminotomy against anterior osteophyte is an indirect decompression procedure but less invasive compared to anterior cervical discectomy and fusion. Residual compression to the nerve root may lead to poor surgical outcomes. Although clinical results of posterior cervical foraminotomy for osteophytes are not considered better than those of disk herniation, osteophyte size and the association of the decompression area with poor surgical outcomes remain unclear. This study aimed to identify the limitations of minimally invasive posterior cervical foraminotomy for cervical radiculopathy and discuss the methods to improve surgical outcomes. We analyzed 55 consecutive patients with degenerative cervical radiculopathy who underwent minimally invasive posterior cervical foraminotomy. Minimum postoperative follow-up duration was 1 year. We divided the patients into nonimproved and improved groups. The cutoff value between preoperative and postoperative Neck Disability Index scores was 30% improvement. Preoperative imaging data comprised disk height, local kyphosis, spinal cord compression, anterior osteophytes in the foramen, and anterior osteophytes of >50% of the intervertebral foramen diameter. Postoperative imaging data comprised craniocaudal length and lateral width of decompressed lamina, preserved superior facet width, and area of decompressed lamina. Fifty-five patients were divided into two groups: nonimproved (n = 19) and improved (n = 36). The presence of osteophytes itself was not significant; however, the presence of osteophytes of >50% of the foramen diameter increased in the nonimproved group (P = 0.004). Mean lateral width and mean area of decompressed lamina after surgery significantly increased in the improved group (P = 0.001, P = 0.03). The presence of anterior osteophytes >50% of the diameter of the foramen led to poor improvement of clinical outcomes in minimally invasive posterior cervical foraminotomy. However, the larger the lateral width and area of the decompressed lamina, the better the surgical outcome. [ABSTRACT FROM AUTHOR]

Background: Osteophyte formation is an important radiographic sign of osteoarthritis (OA) and limited joint motion in knee osteoarthritis patients. Some studies revealed relationships of osteophyte formation with a high bone mineral density and a high muscle mass, while others showed no correlations. The aim of this study was to identify relationships of osteophyte formation with bone mineral density and muscle mass. Methods: A cross sectional study of knee osteoarthritis was conducted. Cases were classified as patients with osteophyte formation, while controls were those without osteophytes. All subjects underwent a knee x-ray and bone mineral density and body composition evaluation. General patient characteristics, covariates, and the results of biochemical analyses were also recorded. Statistical analysis was conducted using SPSS Version 22.0. Logistic regression and the chi-square test were utilized to analyze the relationships between the presence of knee osteophytes and the study variables. Results: A total of 228 patients were enrolled, including 78 with osteophytes in the knee joint and 150 without. A total of 162/228 are females; knee OA is commonly explained among females. (p = 0.001). The mean age was 73.23 ± 11.10 years in the osteophyte group and 71.86 ± 12.23 in the no osteophyte group (p = 0.409). The mean body mass index was 24.15 ± 3.27 kg/m2 in the osteophyte group and 23.37 ± 3.48 kg/m2 in the no osteophyte group (p = 0.433). More patients in the osteophyte group had hypertension (p = 0.002), so the age group 73 years expected to have OA and hypertension along other metabolic diseases, and the femoral neck T score was higher in the osteophyte group (p = 0.044). Logistic regression analysis showed that the male gender was associated with less osteophyte formation (p = 0.001, odds ratio (OR) 0.11 (0.03–0.37)), and hypertension was associated with increased muscle loss (p = 0.005). Femoral neck T score was associated with the presence of osteophyte formation (p = 0.011, OR 1.98 (1.17–3.36)). Conclusions: The results demonstrated an association of knee osteophyte formation with the femoral neck T score and hypertension, but no association with muscle mass. We speculated that in patients with osteophytosis and increased bone mass, metabolic factors such as hypertension should be considered. Further study of the molecular mechanisms regulating these processes is needed in the future. Key Points • Associations of knee osteophyte formation with the femoral neck T score, but not with muscle mass. • Those with osteophytosis and an increased bone mass and metabolic factors such as hypertension need to be assessed. [ABSTRACT FROM AUTHOR]

Bone spurs are projections that are seen along the borders of bone. These pathologies are usually located within joints and are referred to as osteophytes. Due to the increased frequency or incidence within the joints, osteophytes are named after the location of occurrence, such as extraspinal osteophytes. Due to the lack of a definition or classification of bone spurs in scientific literature and the paucity of cases reported in the jaws, the the current article reports a case of the bone spur along the inferior border of the mandible. [ABSTRACT FROM AUTHOR]

Diffuse idiopathic skeletal hyperostosis (DISH) is an ossifying and ankylosing skeletal condition that can be associated with DISH-related dysphagia in the case of cervical involvement. In contrast to most cases of dysphagia, which are managed conservatively, DISH-related dysphagia can be discouraging due to the progressive nature of DISH. We report two cases of DISH-related dysphagia that were treated with the surgical removal of osteophytes via an anterolateral approach. We were able to remove osteophytes using the bottleneck point as an anatomical landmark between the vertebral body and the bony excrescence. Patients' symptoms improved following osteophyte removal, without recurrence. In cases of DISH-related dysphagia, osteophyte removal using an osteotome could improve dysphagia safely and quickly. [ABSTRACT FROM AUTHOR]

Background: Bow hunter’s syndrome (BHS) is a rare condition induced by occlusion or compression of the vertebral artery (VA) during head movement or rotation. Here, we report a patient with BHS effectively treated with an anterior cervical discectomy and fusion (ACDF). Case Description: A 75-year-old male experienced recurrent embolic strokes to the posterior circulation. This was attributed angiographically to transient stenosis of the right VA due to a right-sided C5-C6 osteophyte when the head was rotated to the right; the stenosis was improved when the patient rotated his head to the left. The patient successfully underwent a C5-C6 ACDF for removal of the right-sided lateral osteophyte which resulted in no further transient right-sided VA occlusion. Conclusion: Following a C5-C6 ACDF for removal of a right lateral osteophyte, a 75-year-old male’s intermittent right-sided VA occlusion responsible for multiple posterior circulation emboli was relieved. [ABSTRACT FROM AUTHOR]

Background: The efficacy of the powered rasp, a new reciprocating motion device for arthroscopic resection of osteophytes, has not been verified. The aim of this study was to compare the intraoperative efficacy of the powered rasp in arthroscopic resection of anterior ankle osteophytes to that of the conventional burr.Methods: A total of 49 consecutive patients who underwent arthroscopic resection of anterior ankle osteophytes (26 patients with the conventional burr and 23 patients with the powered rasp) were retrospectively reviewed. The preoperative volume of each osteophyte was measured using computerized tomography scan and three-dimensional software. The resection time was measured by review of the individual arthroscopy video, and the estimated resection rate was calculated as the volume of osteophytes/resection time.Results: The preoperative volume of osteophytes was not different between the two groups (847.8 ± 685.3 mm3 in the conventional burr and 913.3 ± 605.8 mm3 in the powered rasp, p = 0.726). The resection time was 442.4 ± 216.6 s (seconds) in the conventional burr and 386.4 ± 186.3 s in the powered rasp, and the estimated resection rate was 1.8 ± 1.0 mm3/s with the conventional burr and 2.4 ± 1.3 mm3/s with the powered rasp. These measurements were not significantly different between the two groups (p = 0.340 and 0.083, respectively).Conclusion: The intraoperative efficacy of the powered rasp did not show superiority to that of the conventional burr in arthroscopic resection of anterior ankle osteophytes.Level Of Evidence: Level III, retrospective comparative study. [ABSTRACT FROM AUTHOR]

We describe a case report of a 62-year-old male who presented with complaints of dysphagia, difficulty in breathing, and pain in the neck for 1 year. He underwent a computed tomography scan and flexible videolaryngoscopy and was diagnosed to have enlarged cervical osteophyte at the C3–C5 level. The patient was successfully managed by transoral endoscopic approach using potassium titanyl phosphate (KTP) laser. The postsurgery patient was completely relieved from airway obstruction. Thus, we conclude that transoral endoscopic KTP laser-assisted reduction is a minimally invasive surgery to treat airway obstruction due to enlarged cervical osteophyte. [ABSTRACT FROM AUTHOR]

Objectives: To assess the clinical outcomes of using a bipedicle advancement flap to cover the skin defects after digital mucous cyst (DMC) excision. Methods: Data for 15 patients (18 fingers) with DMC, admitted to the Department of Orthopaedics and Surgery of the Affiliated Zhongshan Hospital of Dalian University from January 2016 to January 2018, were analyzed retrospectively. This study included 4 men and 11 women, with a mean age of 64 ± 7.8 years (range, 47–77 years). A total of 5 cases involved the thumb, 4 involved the index finger, 5 involved ithe middle finger, and 4 involved the ring finger. Among a total of 18 digital mucous cysts, 7 cases were in the left hand and 11 were in the right hand. Approximately 77.8% of cases had osteophytes. The cysts ranged in size from 0.5–1.0 cm to 0.7–1.2 cm. All patients underwent cyst and osteophyte excision and a bipedicle advancement flap to cover the resultant defect. The same surgical procedure was applied to all patients. Postoperative flap survival, healing, and infection were evaluated. The preoperative and postoperative ranges of motion (ROM) of the distal interphalangeal (DIP) and thumb interphalangeal joints (TIPJ) were recorded. Postoperative patient satisfaction was assessed by the visual analog scale (VAS, 0–10) during follow‐up visits. The Shapiro–Wilk test was used to determine whether the data for the difference between the preoperative and postoperative ROM of the DIP/TIPJ were normally distributed or not. The homogeneity of variance was expressed as mean ± standard deviation. A paired t‐test was used to compare the preoperative and postoperative ROM of the DIP/TIPJ. Results: The patients were followed up for 20 ± 6.0 months (range, 12–36 months). All the flaps survived after surgery, and the incisions healed well. The sutures were removed 2 weeks postoperatively. No infections occurred and there was no cyst recurrence at follow up. After systemic physical therapy and functional exercises, the ROM of all the fingers was restored to the preoperative ROM by 1 month after surgery. The scores for patient satisfaction with surgery by means of the VAS were 8.5 ± 1.0 points, 2.8 ± 1.4 points, 2.0 ± 1.6 points, 1.5 ± 1.2 points, and 1.1 ± 1.3 points preoperatively, and 1, 3, 6, and 12 months postoperatively, respectively. The data for the difference between preoperative and postoperative VAS scores were normally distributed. There were significant differences between the preoperative and postoperative VAS scores. The preoperative DIP/TIPJ ROM was 71.7° ± 14.0°, and the postoperative ROM at 1, 3, 6, and 12 months were 69.3° ± 15.3°, 70.4° ± 12.7°, 71.5° ± 15.6°, and 71.8° ± 15.6°, respectively. The data for the difference between preoperative and postoperative ROM of the DIP/TIPJ were normally distributed. No difference was found between the preoperative and postoperative ROM. Conclusion: The bipedicle advancement flap provides a simple and effective technique for covering skin defects following DMC excision. [ABSTRACT FROM AUTHOR]

The severity of osteoarthritis (OA) has been related to osteophyte size. However, the effects on osteophyte size of repeated and increased loading associated with joint laxity and varus misalignment remain unclear. We investigated these relationships in patients with medial knee OA and compared the performances of computed tomography (CT) and radiography for assessing osteophyte parameters. We examined knee joint alignment on radiographs and knee laxity using arthrometry in 191 patients with medial knee OA who were undergoing total knee arthroplasty. We also measured femur and tibia osteophyte distance (largest perpendicular distance from the cortical line to outer margin of the osteophyte) using radiography and CT, osteophyte areas (largest area surrounded by the outer margin of an osteophyte) by CT and determined the locations of the osteophytes in the femur and tibia by CT. We then analyzed the correlations between the variables using Spearman's rank correlation tests. Osteophyte sizes in the femur and tibia as determined by radiography (distance) or CT (distance and area) were positively correlated with the degree of varus alignment but not with medial or lateral laxity. There was also a significant correlation between maximum osteophyte distances measured by radiography and CT. The greatest number and the largest osteophytes were located in the posterior third of the femur and middle third of the tibia, respectively. Osteophyte size was correlated with preoperative knee alignment but not with knee laxity in patients with medial knee OA. Osteophyte size can be evaluated using conventional radiography, without the need for CT. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:639–644, 2020 [ABSTRACT FROM AUTHOR]

We aimed to investigate whether post‐traumatic osteoarthritis (PTOA) progression is appropriately represented by a PTOA mouse model using a unique climbing cage to add mechanical loading after anterior cruciate ligament (ACL) transection and to determine how Hedgehog signaling inhibition prevents PTOA progression by observing time‐dependent morphological changes. This controlled laboratory study histologically compared mice with surgically‐induced ACL transection (ACLT) and those with voluntary increased activity in a climbing cage from 1 week postoperatively (ACLT + climbing). We generated conditional knockout (cKO) mice with a deleted Smoothened (Smo) gene. Time‐dependent histopathological, immunohistochemical, and gene expression analyses were performed. The ACLT + climbing group showed more severe cartilage defects and massive osteophyte formation than the ACLT group. Smo deletion significantly suppressed PTOA progression. The time‐dependent assessment revealed cartilaginous processes of equivalent size at the posterior tibial margin in the Smo cKO and control mice at 4 weeks postoperatively. However, at 8 weeks postoperatively, mature ossifying lesions were detected in the controls but not in Smo cKO mice. In the articular cartilage, ADAMTS5 and RUNX2 expression were observed in hypertrophic chondrocytes near the defective cartilage in controls but not in Smo cKO mice. Climbing exercise after ACLT accelerated PTOA progression more severely not only through increasing joint instability induced by ACLT but also through mechanical loading force induced by climbing exercise. Hedgehog signaling inhibition attenuated PTOA progression by suppressing chondrocyte hypertrophy induced by mechanical loads, to which ACL‐deficient athletes are usually exposed. Thus, Hedgehog signaling inhibition may be a therapeutic option to prevent arthritic changes in athletes. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:609–619, 2020 [ABSTRACT FROM AUTHOR]

Spinal stenosis most commonly occurs on lumbar vertebrae because of degenerative changes. This research studied the characteristics of osteophyte development in lumbar vertebrae foramina and association of osteophyte development with lumbar spinal stenosis. The total number of all levels of lumbar spines of subjects was 179 from 31 to 90 years of age. The vertebral foramen was divided into six zones. The prevalence and measurements of the length of osteophytes in the vertebral foramina were obtained. The prevalence and length of osteophytes in the posterior body zone were higher than the laminal zone, and higher than the pedicular zone, respectively. In each zone, the highest prevalence of osteophytes was at L5, except for the inferior posterior body zone that the highest prevalence is at L4. The length of osteophyte was also in same direction as the prevalence. The prevalence of osteophytes among six zones of each level were compared, and found, in L1 to L4, the inferior posterior body zone generally had the highest prevalence, except in L5, the superior posterior body zone had the highest prevalence. Moreover, prevalence, as well as length, of osteophytes in lumbar vertebral foramina, of all levels, was positively associated with age. Vertebral osteophytes can develop beginning at 31 years of age. In conclusion, posterior body of L4 and L5 had the highest prevalence of osteophyte formation, thus, these area had the highest probability to cause spinal stenosis. [ABSTRACT FROM AUTHOR]

Introduction: The present study aimed to review the condylar changes in the patients with osteoarthritis using cone beam computed tomography (CBCT) images. Methods: In this study, 80 CBCT images of the temporomandibular joint (TMJ) pertaining 20 patients with osteoarthritis and 20 healthy individuals were evaluated, as well as the CBCT images that were obtained for other reasons. The images were reviewed in the coronal and sagittal sections. Considering the higher prevalence of osteoarthritis in women and after eliminating gender-based interventions, all the female patients were enrolled in the study. Chi-square was used to evaluate the correlations between the changes in the condylar head by the grouping of the patients, and the significance level was considered at 0.05. Results: The correlation of condylar head flattening (P=0.051) and Ely's cysts (P=0.544) was assessed in the control group and osteoarthritis patients, and no significant difference was observed between the two variables and patient classification. In addition, the association between erosion (P<0.001) and osteophyte (P=0.002) of the condylar head was evaluated in the control group and osteoarthritis patients, and the presence or absence of these conditions had a significant correlation with disease grouping. Conclusion: According to the results, the presence of osteophyte and erosion was more significant in the osteoarthritis group compared to the healthy subjects. The most prevalent bony changes in the condylar head were due to flattening, and the less prevalent changes were associated with Ely's cysts. Moreover, osteophyte and erosion were more prevalent in the patients with osteoarthritis. [ABSTRACT FROM AUTHOR]

Objective To investigate swallowing characteristics of patients with dysphagia caused by anterior cervical osteophytes (ACOs) and compare clinical courses according to treatment options. Methods A retrospective analysis of 1,866 videofluoroscopic swallowing studies (VFSS) of patients with ACOs from electronic medical records was performed. Patients with other diseases that could explain the dysphagia were excluded. Dysphagia characteristics and severity and clinical and radiological characteristics of subjects with ACOs were evaluated. Dysphagia characteristics and clinical course were compared among three treatment groups: surgical treatment, swallowing rehabilitation, and conservative treatment. Results Subjects were 22 men and 1 woman with a mean age of 78.69±8.01 years. The mean osteophyte thickness was 9.07±3.84 mm. It was significantly thicker in the surgical group than that in other groups (p=0.01). ACOs were most frequently found at C5 level. This level also had the thickest osteophytes. However, videofluoroscopic dysphagia scales (VDS) were not significantly different among the three treatment groups. The pharyngeal phase score of the VDS was significantly higher in the surgical group (p=0.041). Dysphagia severity was decreased significantly in the surgical group at 3 months after the initial VFSS (p=0.004). Conclusion The main swallowing characteristics in patients with ACOs were dysphagia features of the pharyngeal phase, including inappropriate airway protection, decreased laryngeal elevation, and reduced epiglottis inversion. When determining treatment options, it may be helpful to consider dysphagia severity at pharyngeal phase and osteophyte thickness. [ABSTRACT FROM AUTHOR]

Objective We assessed the efficacy of "only fixation" as treatment for cervical radiculopathy. Methods From 2012 to December 2017, 21 patients who had presented with primary symptoms related to cervical radiculopathy, including radiating pain, tingling paresthesia, numbness, weakness, and wasting were treated by facetal stabilization surgery aimed at achieving segmental arthrodesis. No decompression by removal of bone, disc material, or osteophyte was performed. The age of the patients ranged from 27 to 59 years. Of the 21 patients, 19 were men and 2 were women. The imaging findings showed a herniated disc in 4, a disc bulge in 12, and osteophyte-related foraminal stenosis in 5 patients. Transarticular screw fixation was deployed for surgery. The levels of cervical fixation were guided by the clinical and radiological information and determined by direct observation of the facet morphology and stability by manual manipulation of the bones in the region. Results All the patients experienced "remarkable" relief of the presenting radicular symptoms in the "immediate" postoperative period. The visual analog scale and neck disability index scores were used to assess the patients before and after surgical treatment. During the follow-up period, which ranged from 6 to 64 months, all the patients continued to experience satisfactory symptomatic relief. Conclusions Instability of the spinal segment is the nodal point of pathogenesis and the primary cause of symptoms related to degenerative spondylotic radiculopathy. The treatment is spinal stabilization. No direct bone or soft tissue decompression is necessary. Highlights • Cervical radiculopathy can be treated surgically using only fixation. • Thus, decompression involving resection of bone, soft tissues, osteophytes, or disc is not required. • After stabilization of the spinal segment, disc herniation and osteophytes could regress. [ABSTRACT FROM AUTHOR]

Osteophytes have been suggested to influence the bone mechanical properties. The aim of this study was to compare the microcrack density in osteophytes with that in the other parts of the osteoarthritic femoral neck (FN). The presence of microcracks was investigated in the ultra-distal FN and in the osteophytes in samples obtained during hip arthroplasty in 24 postmenopausal women aged 67 ± 10 years. Furthermore, the 3D microarchitecture and the collagen crosslinks contents were assessed by high-resolution peripheral quantitative computed tomography and high-performance liquid chromatography, respectively. Osteophytes were present in the 24 FN, mainly at the level of the inferior quadrant. Microcracks were present in all FN with an average of 2.8 per sample. All observed microcracks were linear. The microcrack density (Cr.N/BV; #/mm2) was significantly higher in cancellous than in cortical bone (p = 0.004), whereas the microcrack length (Cr.Le, µm) was significantly greater in cortical bone (p = 0.04). The collagen crosslinks ratio pyridinoline/deoxypyridinoline was significantly and negatively correlated with Cr.N/BV in the posterior (r' = - 0.68, p = 0.01) and inferior (r' = - 0.53, p = 0.05) quadrants. Microcracks were observed in seven osteophytes in seven patients. When microcracks were present in the osteophyte area, Cr.N/BV was also significantly higher in the whole FN and in the quadrant of the osteophyte compared to the cases without microcrack in the osteophyte (p < 0.03). In conclusion, in FN from hip osteoarthritis microcracks are present in all FNs but in only 23% of the osteophytes. The microcrack formation was greater and their progression was smaller in the cancellous bone than in the cortex. The spatial distribution of microcracks varied according to the proximity of the osteophyte, and suggests that osteophyte may influence microcrack formation related to changes in local bone quality. [ABSTRACT FROM AUTHOR]

Background Context: Anterior vertebral body osteophytes are common with degeneration but their biomechanical influence on the whole lumbar spine remains unclear.Purpose: To investigate the biomechanical influence of anterior vertebral body osteophytes on the whole lumbar spine.Study Design/setting: This is a study using finite element analysis.Outcome Measures: Intersegmental rotation, maximum Mises stress, and intradiscal pressure on the intervertebral discs of different lumbar levels were calculated.Methods: A finite element model of an intact lumbar spine was constructed and validated against in vitro studies. The modified models, which had different degrees of anterior vertebral body osteophyte formation (OF) in combination with disc space narrowing, were applied with physiological loadings.Results: The lumbar levels with various degrees of OF altered the kinematics of these levels, which also affected the whole lumbar spine. In flexion and lateral bending, the segment that was one level inferior to the vertebra with OF showed a trend towards increased range of motion. On the intervertebral discs that were one level inferior to the OF level, a trend towards increase in the maximum von Mises stress was found on the annulus.Conclusions: Segments adjacent to levels with anterior vertebral body osteophytes showed increased intersegmental rotation and maximum stress. Further clinical observation should be performed to verify the results in vivo. [ABSTRACT FROM AUTHOR]

Diffuse idiopathic skeletal hyperostosis (DISH) is a common disease in which ossification lesions occur in the bones including the vertebrae. Dysphagia may occur in advanced cases, but there are few cases that require treatment. A 68-year-old man was diagnosed with hypopharyngeal cancer of the left pyriform sinus and asymptomatic DISH on the anterior cervical vertebrae. Due to prior history of radiation, partial laryngopharyngectomy was performed. After surgery, severe dysphagia and aspiration pneumonia occurred, and the patient needed to undergo total laryngectomy. It was determined that dysphagia was due to multiple factors, including insufficient laryngeal elevation and esophageal compression by osteophytes of DISH. Asymptomatic DISH can cause severe dysphagia after partial laryngopharyngectomy. We suggest that evaluation of the swallowing function and surgical options, including laryngeal suspension and cricopharyngeal myotomy should be considered when performing partial laryngopharyngectomy in patients with DISH, even if they demonstrated no difficulties in swallowing before treatment. [ABSTRACT FROM AUTHOR]

Knee osteoarthritis (OA) is one of the most common musculoskeletal diseases and osteophytes area frequent radiographic feature of knee OA. The osteophyte structure in knee OA, however, is not well elucidated. This study aimed to clarify the three-dimensional microstructural characteristics of osteophytes in the medial compartment of the knee in knee OA patients using micro-computed tomography (micro-CT). We hypothesized that the morphology of osteophytes would differ from that of the neighboring normal cancellous bones. Ten medial compartment knee OA patients with Kellgren-Lawrence grade 4 severity were enrolled in the study, and all patients underwent total knee arthroplasty. Osteophytes and cancellous bones were obtained from the medial femoral condyle. The three-dimensional trabecular bone microstructure was analyzed by quantitative micro-CT using image analysis software. The trabecular bone volume fraction and trabecular number were significantly lower in osteophytes than in cancellous bones. Consistently, trabecular separation was significantly higher in osteophytes. Osteophytes exhibited disorganized trabecular orientation, trabecular perforation, disruption, and complete disconnection. These findings suggest that osteophytes are functionally fragile. [ABSTRACT FROM AUTHOR]

We report our experience with 6 patients who had total knee replacements with lateral‐sided knee pain, referred for ultrasound (US) assessment and US‐guided injection. All cases showed an osteophyte within the popliteus sulcus of the lateral femoral condyle impinging on the adjacent tendon. Five of 6 patients reported improvement of symptoms immediately after US‐guided injection of an anesthetic and a steroid. Ultrasound has a unique role in the imaging of knee replacements because of its real‐time capabilities and absence of artifacts at the popliteus tendon origin. [ABSTRACT FROM AUTHOR]

Background. The age estimation of bone is essential for identification of the unknown-identity persons in both forensic and anthropological sciences. The lumbar vertebrae carry the most weight; hence, they have more biomechanical stress than any other vertebrae. As a result, the degenerative changes commonly occur in them. However, the estimation from visual assessment in lumbar vertebrae has not been reported in a Thai population. Objective. To evaluate the age estimation from the degree of osteophyte formation, the macroporosity, and the cortical surface to develop equations of lumbar vertebrae. Material and methods. A total of 250 lumbar columns (125 males and 125 females) in age range of 22 to 89 years were collected from the Forensic Osteology Research Center (FORC), Faculty of Medicine, Chiang Mai University. Results. The most appropriate linear regression equation was used to estimate age by the inferior surface of L1 vertebra (R2= 0.408) with the standard error of 11.686 years. Conclusion. It was clear to recognize that three morphological aspects will be useful methods for forensic situations. [ABSTRACT FROM AUTHOR]

Backgrounds: Impingement is a risk factor for instability and prosthetic failure following total hip arthroplasty (THA). If the periacetabular osteophytes are not removed at surgery, impingement could occur between the osteophytes and the femoral stem following THA. However, excessive removal of the osteophytes could lead to bleeding from the bone. The aim of our study, therefore, was to locate the site of the impingement and to determine the width of tolerable osteophytes, which does not induce impingement during activities of daily living (ADL), using a three-dimensional simulation.Methods: On 35 hip models, virtual THA was performed. The acetabular cups were positioned at 45° abduction and 20° anteversion, and the anteversion of femoral stems was 15°. Circular osteophytes with a 30-mm rim were built around the acetabular cup. Fourteen ADL motions were simulated, and the osteophytes were removed until there was no impingement. A clock face was used to map the location and the width of tolerable osteophytes.Results: The impingement mainly occurred in antero-superior and posterior portions around the acetabular cup. Only 4.2-6.2-mm osteophytes were tolerable at the antero-superior portion (12-3 o'clock) and 6.3-7.2-mm osteophytes at the posterior portion (8-10 o'clock) following a total hip arthroplasty. In antero-inferior and postero-superior portions, over-20-mm osteophytes did not induce any impingement.Conclusion: Osteophytes in the antero-superior and posterior portion of the acetabulum should be excised during a THA to avoid impingement of the femur-stem construct on the acetabular osteophytes during ADLs. [ABSTRACT FROM AUTHOR]

The objective of the present study is to demonstrate that a newly developed selective c-Fos/activator protein (AP)-1 inhibitor, T-5224, inhibits the expression of matrix metalloproteinases (MMPs) in human articular chondrocytes, and prevents cartilage destruction in an osteoarthritis (OA)-induced mouse model. First, we examined the effect of T-5224 on MMP and inflammatory cytokine expression by real-time polymerase chain reaction in human articular chondrocytes. We created an OA model by destabilization of the medial meniscus (DMM) in mice. T-5224 was orally administered once a day and the OA pathology was assessed by histological, immunohistochemical, and micro-computed tomography (CT) analyses. T-5224 inhibited the mRNA expression levels of MMP-1, 3, and 13, and interleukin (IL)-1β, tumor necrosis factor (TNF)-α and IL-6 in IL-1-stimulated human chondrocytes. Oral administration of T-5224 to OA-induced mice prevented cartilage destruction. The histological scores for OA were significantly better in the T-5224-treated group than the vehicle-treated group. Type X collagen and MMP-13 were not increased in the T-5224-treated group by immunohistochemical staining. Micro-CT analysis showed mild but apparent osteophyte development in the femoral condyle and antero-medial aspect of the tibia in the vehicle-treated group but not in the T-5224-treated group. Taken together, specific inhibition of c-Fos/AP-1 and the resulting inhibition of the transactivation of a broad spectrum of downstream MMPs, along with inflammatory cytokines, effectively prevented cartilage destruction and osteophyte formation. [ABSTRACT FROM AUTHOR]

This study aimed to compare the diagnostic value of ultrasonography to conventional radiography in detecting osteophytes and erosions in the midfoot joints in patients suffering from inflammatory and non-inflammatory joint disease. Patients with current foot radiographs were included and stratified in two cohorts: inflammatory and non-inflammatory joint disease. The ten midfoot joints of each foot were evaluated by conventional radiography assessing the presence of osteophytes and erosions and by ultrasonography determining the presence of osteophytes, erosions, and joint effusion. Power Doppler activity was scored semi-quantitatively from 0 to 3. A total of 2445 joints in 124 patients (90 with inflammatory joint disease, 34 with non-inflammatory joint disease) were assessed. Ultrasonography detected significantly more osteophytes than conventional radiography (344; 14.1% vs. 13; 0.5%), as well as more erosions (60; 2.5% vs. 3; 0.1%). There was weak agreement between the two modalities (κ-statistic 0.029-0.035). Power Doppler ultrasonography demonstrated no significant difference in hyperperfusion comparing patients with inflammatory joint disease and non-inflammatory joint disease. Ultrasonography of the midfoot is more sensitive than conventional radiography in the detection of osteophytes and erosions in patients suffering from inflammatory and non-inflammatory joint disease. Thus, midfoot ultrasonography may be a useful tool in the diagnosis of joint diseases as rheumatoid arthritis and osteoarthritis. [ABSTRACT FROM AUTHOR]

Objective To determine the prevalence of osteophyte induced lung fibrosis (OIF) and its relationship to osteophyte size, location, and surrounding fat. Methods 94 CT scans of the chest were reviewed, size of the largest osteophyte and the presence of fibrosis were recorded. Results Presence of fibrosis was higher among patient with large (> 10 mm) osteophytes compared to those with small (1–10 mm) osteophytes. Age and presence of periosteophyte fat were significantly associated with presence of fibrosis. Conclusions As the size of an osteophyte increases, there is a greater likelihood of lung fibrosis. Subpleural fat protects the lung from OIF. [ABSTRACT FROM AUTHOR]

Purpose: Erosions and osteophytes are radiographic characteristics that are found in different stages of temporomandibular joint (TMJ) osteoarthritis. This study assessed the effectiveness of digital subtraction radiography (DSR) in diagnosing simulated osteophytes and erosions in the TMJ. Materials and Methods: Five intact, dry human skulls were used to assess the effectiveness of DSR in detecting osteophytes. Four cortical bone chips of varying thicknesses (0.5 mm, 1.0 mm, 1.5 mm, and 2.0 mm) were placed at the medial, central, and lateral aspects of the condyle anterior surface. Two defects of varying depth (1.0 mm and 1.5 mm) were created on the lateral, central, and medial poles of the condyles of 2 skulls to simulate erosions. Panoramic images of the condyles were acquired before and after artificially creating the changes. Digital subtraction was performed with Emago dental image archiving software. Five observers familiar with the interpretation of TMJ radiographs evaluated the images. Receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic accuracy of the imaging methods. Results: The area under the ROC curve (Az) value for the overall diagnostic accuracy of DSR in detecting osteophytic changes was 0.931. The Az value for the overall diagnostic accuracy of panoramic imaging was 0.695. The accuracy of DSR in detecting erosive changes was 0.854 and 0.696 for panoramic imaging. DSR was remarkably more accurate than panoramic imaging in detecting simulated osteophytic and erosive changes. Conclusion: The accuracy of panoramic imaging in detecting degenerative changes was significantly lower than the accuracy of DSR (P<.05). DSR improved the accuracy of detection using panoramic images. [ABSTRACT FROM AUTHOR]

ABSTRACT We previously reported that perlecan, a heparan-sulfate proteoglycan (Hspg2), expressed in the synovium at the cartilage-synovial junction, is required for osteophyte formation in knee osteoarthritis. To examine the mechanism underlying this process, we examined the role of perlecan in the proliferation and differentiation of synovial mesenchymal cells (SMCs), using a recently established mouse synovial cell culture method. Primary SMCs isolated from Hspg2−/−-Tg (Hspg2−/−;Col2a1-Hspg2Tg/−) mice, in which the perlecan-knockout was rescued from perinatal lethality, lack perlecan. The chondrogenic-, osteogenic-, and adipogenic-potentials were examined in the Hspg2−/−-Tg SMCs compared to the control SMCs prepared from wild-type Hspg2+/+-Tg (Hspg2+/+;Col2a1-Hspg2Tg/−) littermates. In a culture condition permitting proliferation, both control and Hspg2−/−-Tg SMCs showed similar rates of proliferation and expression of cell surface markers. However, in micromass cultures, the cartilage matrix production and Sox9 and Col2a1 mRNA levels were significantly reduced in Hspg2−/−-Tg SMCs, compared with control SMCs. The reduced level of Sox9 mRNA was restored by the supplementation with exogenous perlecan protein. There was no difference in osteogenic differentiation between the control and Hspg2−/−-Tg SMCs, as measured by the levels of Runx2 and Col1a1 mRNA. The adipogenic induction and PPARγ mRNA levels were significantly reduced in Hspg2−/−-Tg SMCs compared to control SMCs. The reduction of PPARγ mRNA levels in Hspg2−/−-Tg SMCs was restored by supplementation of perlecan. Perlecan is required for the chondrogenic and adipogenic differentiation from SMCs via its regulation of the Sox9 and PPARγ gene expression, but not for osteogenic differentiation via Runx2. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:837-846, 2017. [ABSTRACT FROM AUTHOR]

Objectives High Bone Mass (HBM) is associated with (a) radiographic knee osteoarthritis (OA), partly mediated by increased BMI, and (b) pelvic enthesophytes and hip osteophytes, suggestive of a bone-forming phenotype. We aimed to establish whether HBM is associated with radiographic features of OA in non-weight-bearing (hand) joints, and whether such OA demonstrates a bone-forming phenotype. Methods HBM cases (BMD Z-scores ≥ + 3.2) were compared with family controls. A blinded assessor graded all PA hand radiographs for: osteophytes (0–3), joint space narrowing (JSN) (0–3), subchondral sclerosis (0–1), at the index Distal Interphalangeal Joint (DIPJ) and 1st Carpometacarpal Joint (CMCJ), using an established atlas. Analyses used a random effects logistic regression model, adjusting a priori for age and gender. Mediating roles of BMI and bone turnover markers (BTMs) were explored by further adjustment. Results 314 HBM cases (mean age 61.1 years, 74% female) and 183 controls (54.3 years, 46% female) were included. Osteophytes (grade ≥ 1) were more common in HBM (DIPJ: 67% vs. 45%, CMCJ: 69% vs. 50%), with adjusted OR [95% CI] 1.82 [1.11, 2.97], p = 0.017 and 1.89 [1.19, 3.01], p = 0.007 respectively; no differences were seen in JSN. Further adjustment for BMI failed to attenuate ORs for osteophytes in HBM cases vs. controls; DIPJ 1.72 [1.05, 2.83], p = 0.032, CMCJ 1.76 [1.00, 3.06], p = 0.049. Adjustment for BTMs (concentrations lower amongst HBM cases) did not attenuate ORs. Conclusions HBM is positively associated with OA in non-weight-bearing joints, independent of BMI. HBM-associated OA is characterised by osteophytes, consistent with a bone-forming phenotype, rather than JSN reflecting cartilage loss. Systemic factors ( e.g. genetic architecture) which govern HBM may also increase bone-forming OA risk. [ABSTRACT FROM AUTHOR]

Background: The factors associated with lateral curve flexibility in degenerative scoliosis have not been well documented. Disc degeneration could result in significant change in stiffness and range of motion in lateral bending films. The osteophytes could be commonly observed in degenerative spine but the relationship between osteophyte formation and curve flexibility remains controversial. The aim of the current study is to clarify if the disc degeneration and osteophyte formation were both associated with curve flexibility of degenerative scoliosis.Methods: A total of 85 patients were retrospectively analyzed. The inclusion criteria were as follow: age greater than 45 years, diagnosed as degenerative scoliosis and coronal Cobb angle greater than 20°. Curve flexibility was calculated based on Cobb angle, and range of motion (ROM) was based on disc angle evaluation. Regional disc degeneration score (RDS) was obtained according to Pfirrmann classification and osteophyte formation score (OFS) was based on Nanthan classification. Spearman correlation was performed to analyze the relationship between curve flexibility and RDS as well as OFS.Results: Moderate correlation was found between RDS and curve flexibility with a Spearman coefficient of -0.487 (P = 0.009). Similarly, moderate correlation was observed between curve flexibility and OFS with a Spearman coefficient of -0.429 (P = 0.012). Strong correlation was found between apical ROM and OFS compared to the relationship between curve flexibility and OFS with a Spearman coefficient of -0.627 (P < 0.001).Conclusions: Both disc degeneration and osteophytes formation correlated with curve rigidity. The pre-operative evaluation of both features may aid in the surgical decision-making in degenerative scoliosis patients. [ABSTRACT FROM AUTHOR]

Study Design: Prospective clinical study. Purpose: To observe the usefulness of anterior cervical osteophytes as intrinsic markers for spinal level localization (SLL) during sub-axial cervical spinal surgery via the anterior approach. Overview of Literature: Various landmarks, such as the mandibular angle, hyoid bone, thyroid cartilage, first cricoid ring, and C6 carotid tubercle, are used for gross cervical SLL; however, none are used during cervical spinal surgery via the anterior approach. We present our preliminary assessment of SLL over anterior vertebral surfaces (i.e., intrinsic markers) in 48 consecutive cases of anterior cervical spinal surgeries for the disc-osteophyte complex (DOC) in degenerative diseases and granulation or tumor tissue associated with infectious or neoplastic diseases, respectively, at an ill-equipped center. Methods: This prospective study on patients undergoing anterior cervical surgery for various sub-axial cervical spinal pathologies aimed to evaluate the feasibility and accuracy of SLL via intraoperative palpation of disease-related morphological changes on anterior vertebral surfaces visible on preoperative midline sagittal T1/2-weighted magnetic resonance images. Results: During a 3-year period, 48 patients (38 males,10 females; average age, 43.58 years) who underwent surgery via the anterior approach for various sub-axial cervical spinal pathologies, including degenerative disease (n= 42), tubercular infection (Pott's disease; n=3), traumatic prolapsed disc (n=2), and a metastatic lesion from thyroid carcinoma (n=1), comprised the study group. Intrinsic marker palpation yielded accurate SLL in 79% of patients (n=38). Among those with degenerative diseases (n=42), intrinsic marker palpation yielded accurate SLL in 76% of patients (n=32). Conclusions: Intrinsic marker palpation is an attractive potential adjunct for SLL during cervical spinal surgeries via the anterior approach in well-selected patients at ill-equipped centers (e.g., those found in developing countries). This technique may prove helpful when radiographic visualization is occasionally inadequate. [ABSTRACT FROM AUTHOR]

We present the palaeopathological study of a left patella (ATD6-56) belonging to the Early Pleistocene species Homo antecessor (Atapuerca-Gran Dolina, Spain). The abnormal morphology observed in the inferior margin of the patella is an osseous overgrowth (osteophyte). Macroscopic and microscopic techniques, including microtomography and zoom stereomicroscope, were used to describe the lesion. Externally, the osteophyte has a smooth and porous texture; the boundary between the more radiolucent osteophyte and the normal bone can be identified in X-ray images. We suggest that the observed signs could be secondary to a local trauma. The lesion would have involved either the bone or related soft tissues of the left limb, possibly affecting the stability of the joint. Consequently, the individual's knee would have suffered an abnormal mechanical load that could have eventually triggered osteoarthritic changes. This is also supported by the lack of changes observed in the associated right patella (ATD6-22). [ABSTRACT FROM AUTHOR]

Acute locked knee is usually caused by mechanical blockage. We report an unusual case of a locked knee due to tibial osteophyte in a young man following a sport injury. To the best of our knowledge, there has been no previous report describing the same etiology. This case report emphasizes the need for thorough history taking and careful assessment to aid us in the diagnosis. The findings made by arthroscopy confirmed our diagnosis. [ABSTRACT FROM AUTHOR]