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The two major aims of the present study were: (i) quantify localised cortical bone adaptation at the surface level using contralateral endpoint imaging data and image analysis techniques, and (ii) investigate whether cortical bone adaptation responses are universal or region specific and dependent on the respective peak load. For this purpose, we re-analyse previously published μ CT data of the mouse tibia loading model that investigated bone adaptation in response to sciatic neurectomy and various peak load magnitudes (F = 0, 2, 4, 6, 8, 10, 12 N). A beam theory-based approach was developed to simulate cortical bone adaptation in different sections of the tibia, using longitudinal strains as the adaptive stimuli. We developed four mechanostat models: universal, surface-based, strain directional-based, and combined surface and strain direction-based. Rates of bone adaptation in these mechanostat models were computed using an optimisation procedure (131,606 total simulations), performed on a single load case (F = 10 N). Subsequently, the models were validated against the remaining six peak loads. Our findings indicate that local bone adaptation responses are quasi-linear and bone region specific. The mechanostat model which accounted for differences in endosteal and periosteal regions and strain directions (i.e. tensile versus compressive) produced the lowest root mean squared error between simulated and experimental data for all loads, with a combined prediction accuracy of 76.6, 55.0 and 80.7% for periosteal, endosteal, and cortical thickness measurements (in the midshaft of the tibia). The largest root mean squared errors were observed in the transitional loads, i.e. F = 2 to 6 N, where inter-animal variability was highest. Finally, while endpoint imaging studies provide great insights into organ level bone adaptation responses, the between animal and loaded versus control limb variability make simulations of local surface-based adaptation responses challenging.

Objective: To assess the effect of topically applied hyaluronic acid (HA) on the stability of immediately loaded implants in the posterior maxilla. Materials and Methods: For the clinical study, a total of 20 implants were placed in 14 patients seeking the replacement of missing single or multiple posterior maxillary teeth. The patients were randomly divided into two groups. In the clinical control group (CC group), 10 implants were placed and immediately loaded, while in the clinical study group (CS group), 10 implants were coated with HA immediately before placement and immediately loaded. All patients had implant stability clinically evaluated at implant placement time (T0) and 1 (T1), 3 (T3), and 6 (T6) months after loading. Peri-implant pocket depth and modified sulcus bleeding index were evaluated clinically at 6 months in all patients. Bone density was evaluated radiographically after 3 months. All the clinical and radiographic data were subjected to statistical analysis. For the animal study, a total of 12 implants were placed in the tibiae of six rabbits. For each rabbit, 1 implant without any applied HA was placed in the left tibia (AC group), and 1 implant coated with HA was placed in the right tibia (AS group). The rabbits were euthanized at 21 and 45 days after implant insertion. Results: There were no significant statistical differences between the two groups regarding implant stability, peri-implant pocket depth, modified sulcus bleeding index, or bone density from the palatal and apical aspects. However, there was a significant statistical difference in the bone density from the buccal aspect in favor of the study group. The animal study showed that the newly formed bone in the right tibiae showed improved quantity and quality of bone, as it had denser bone trabeculae and smaller marrow spaces compared to the left tibiae. Conclusion: In the clinical study, the application of hyaluronic acid had a superior effect on the buccal bone density around immediately loaded implants. In the animal study, hyaluronic acid had a synergistic effect on the quality and quantity of bone formation around dental implants. [ABSTRACT FROM AUTHOR]

Purpose: To assess the literature comparing histologic levels of osseointegration for titanium vs zirconia dental implants. Materials and Methods: This systematic review was conducted following the PRISMA guidelines and was registered in PROSPERO (CRD42021236781). Electronic and manual searches were carried out through the PubMed/MEDLINE, PubMed Central, and Embase databases with a platform-specific search strategy combining controlled terms (MeSH and Emtree) and text words. The articles were selected by two independent investigators who evaluated the articles based on the criteria for eligibility. Results: A total of 17 articles were included. All were preclinical studies. The populations included dogs (27.55%), minipigs (14.28%), rats (14.28%), and rabbits (43.89%); and the implantation site varied among the mandible (36.82%), maxilla (9.04%), tibia (17.64%), skull (10.70%), and femur (25.80%). A total of 370 titanium (Ti) implants and 537 zirconia (Zr) implants were evaluated. The average osseointegration (% bone-to-implant contact) for Zr was 55.51% (17.6% to 89.09%), and for Ti was 58.50% (23.2% to 87.85%). There was no statistical difference between studies at the 2-month follow-up (P = .672), but this difference was significant at 1 and 3 months (P < .001). Conclusions: Within the limitations of this review, Zr implants had a similar level of osseointegration compared to Ti implants. Nonetheless, because these findings are based on preclinical research, all data must be carefully examined. [ABSTRACT FROM AUTHOR]

Introduction Approximately 89% of all service members with amputations do not return to duty. Restoring intuitive neural control with somatosensory sensation is a key to improving the safety and efficacy of prosthetic locomotion. However, natural somatosensory feedback from lower-limb prostheses has not yet been incorporated into any commercial prostheses Materials and Methods We developed a neuroprosthesis with intuitive bidirectional control and somatosensation and evoking phase-dependent locomotor reflexes, we aspire to significantly improve the prosthetic rehabilitation and long-term functional outcomes of U.S. amputees. We implanted the skin and bone integrated pylon with peripheral neural interface pylon into the cat distal tibia, electromyographic electrodes into the residual gastrocnemius muscle, and nerve cuff electrodes on the distal tibial and sciatic nerves. Results. The bidirectional neural interface that was developed was integrated into the existing passive Free-Flow Foot and Ankle prosthesis, WillowWood, Mount Sterling, OH. The Free-Flow Foot was chosen because it had the highest Index of Anthropomorphicity among lower-limb prostheses and was the first anthropomorphic prosthesis brought to market. Conclusion. The cats walked on a treadmill with no cutaneous feedback from the foot in the control condition and with their residual distal tibial nerve stimulated during the stance phase of walking [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to investigate whether double‐level (femur + tibia) derotational osteotomy is superior to single‐level femoral derotational osteotomy for recurrent patellar dislocation with severe femoral and tibial rotational deformities (femoral anteversion >30° and external tibial torsion >30°). Methods: Between January 2015 and June 2020, a total of 115 knees with recurrent patellar dislocation treated with combined medial patellofemoral ligament reconstruction (MPFL‐R) and derotational osteotomies were evaluated after a minimum follow‐up of 2 years. Among these cases, 15 knees that underwent double‐level derotational osteotomy were included in the double‐level group, which was propensity‐matched in a 1:2 ratio to a single‐level group of patients who underwent single‐level femoral derotational osteotomy (30 knees). The clinical and radiological outcomes were evaluated and compared between the groups. Furthermore, the foot progression angle was measured preoperatively and 2 years after surgery. Results: The patient‐specific variables did not differ significantly between the double‐ and the single‐level groups after propensity score matching. The postoperative mean foot progression angle was significantly lower in the double‐level group than in the single‐level group (9° ± 8° vs. 15° ± 11°; p = 0.014); however, there were no statistically significant differences between the groups in terms of any other clinical and radiological assessments. Conclusion: For patients with severe femoral and tibial torsional deformities (femoral anteversion >30° and external tibial torsion >30°), the double‐level derotational osteotomy is superior to single‐level osteotomy in maintaining normal foot progression angle, but it does not show an advantage in terms of patient‐reported outcomes, radiological results and redislocation rate at minimum 2 years of follow‐up. Furthermore, concomitant excessive external tibial torsion (>30°) did not have an adverse effect on clinical outcomes in patients who underwent derotational distal femoral osteotomy with MPFL‐R due to excessive femoral anteversion. Level of Evidence: Level III. [ABSTRACT FROM AUTHOR]

Objective: This study was conducted to evaluate the effect of dietary supplementation of vitamin A (VA) on the tibial growth, calcium (Ca) and phosphorus (P) metabolism, VA, and vitamin D (VD) deposition, and associated gene expression in goslings. Methods: A total of 180 healthy, 1-day-old male goslings were randomly divided into 3 treatment groups (0, 9,000, and 15,000 IU VA/kg), with 6 replicates containing 10 goslings each. They were weighed and sampled on days 14, 28, 42, 56, and 70. Results: No addition of VA reduced VA content in the serum and liver of goslings, and supplementation of 15,000 IU/kg VA increased VA content from day 14 (p<0.05). The trend of VA concentration in the serum and liver was in line with the relative mRNA expression of retinoic acid receptor β in the jejunal mucosa. In both no addition of VA and supplementation of 15,000 IU/kg VA reduced 25-hydroxycholecalciferol (25-OH-VD3) content in the serum and VD content in the liver (p<0.05). From day 28, no addition of VA or supplementation of 15,000 IU/kg VA had a negative effect on tibia length, strength, and Ca, P, and ash content in goslings (p<0.05). Tibia P content was lower in the supplementation of 15,000 IU/kg VA group than in the no addition of VA group (p<0.05). No addition of VA or supplementation of 15,000 IU/kg VA had the most effect on early serum parathyroid hormone (PTH) levels in goslings (p<0.05). The effect of no addition of VA on the bone Gla protein (BGP) content of goslings started from day 14 (p<0.05). The relative mRNA expression of bone Gla-protein (BGLAP) and bone morphogenetic protein 4 (BMP4) in the liver and jejunal mucosa was decreased by either no addition of VA or supplementation of 15,000 IU/kg VA (p<0.05). Conclusion: Both no addition of VA and supplementation of 15,000 IU/kg VA affected the mineralization process of the bone, and ultimately reduced tibial quality. [ABSTRACT FROM AUTHOR]

Changes in bone microarchitecture resulting from chronic physical stress such as that experienced during U.S. Army Basic Combat Training (BCT) underscore its adaptive potential. There is a need for noninvasive biomarkers of adaptive bone formation that can be obtained at scale in real-world settings. Differential mass spectrometry (dMS), a label-free quantitative proteomics technique, may provide useful information about bone adaptation based on the proteomic features of urine. Purpose: The purpose of this study is to optimize a dMS-based urinary proteomic technique and evaluate the relationship between urinary proteome content and adaptive changes in bone microarchitecture during BCT. Methods: Urinary proteomes were analyzed with an optimized dMS technique in two groups of 13 recruits (N = 26) at the beginning (Pre) and end (Post) of BCT. Matched by age (21 ± 4 yr), sex (16 W), and baseline tibial trabecular bone volume fractions (Tb.BV/TV), these groups were distinguished by themost substantial (High) and minimal (Low) improvements in Tb.BV/TV. Differential protein expression was analyzed with mixed permutation ANOVA and false discovery proportion-based adjustment for multiple comparisons. Results: Tibial Tb.BV/TV increased from pre- to post-BCT in High (3.30 ± 1.64%, P < 0.0001) but not Low (-0.35 ± 1.25%, P = 0.4707). The optimized dMS technique identified 10,431 peptides from 1368 protein groups that represented 165 integrative biological processes. Seventy-four urinary proteins changed from pre- to post-BCT (P = 0.0019), and neutrophil-mediated immunity was the most prominent ontology. Two proteins (immunoglobulin heavy constant gamma 4 and C-type lectin domain family 4 member G) differed from pre- to post-BCT in High and Low (P = 0.0006). Conclusions: The dMS technique can identify more than 1000 urinary proteins. At least 74 proteins are responsive to BCT, and other principally immune system--related proteins show differential expression patterns that coincide with adaptive bone formation. [ABSTRACT FROM AUTHOR]

Introduction Military transport can induce whole-body vibrations, and combat almost always involves high impact between lower extremities and the ground. Therefore, robust splinting technology is necessary for lower extremity fractures in these settings. Our team compared a novel one-step spray-on foam splint (FastCast) to the current military standard structured aluminum malleable (SAM) splint. Materials and Methods Ten cadaveric specimens were subjected to complete tibia/fibula osteotomy. Specimens were fitted with custom accelerometer and gyroscope sensors superior and inferior to the fracture line. Each specimen underwent fracture and splinting from a standard of care SAM splint and an experimental FastCast spray foam splint in a randomized order. Each specimen was manually transported to an ambulance and then released from a 1 meter height to simulate impact. The custom sensors recorded accelerations and rotations throughout each event. Repeated-measures Friedman tests were used to assess differences between splint method within each event and between sensors within each splint method. Results During splinting, overall summation of change and difference of change between sensors for accelerations and rotations were greater for SAM splints than FastCast across all axes (P  ≤ 0.03). During transport, the range of acceleration along the linear superior/inferior axis was greater for SAM splint than FastCast (P  = 0.02), as was the range of rotation along the transverse plane (P  < 0.01). On impact, the summation of change observed was greater for SAM splint than FastCast with respect to acceleration and rotation on the posterior/anterior and superior/inferior axes (P  ≤ 0.03), and the cumulative difference between superior and inferior sensors was greater for SAM than FastCast with respect to anterior-axis rotation (P  < 0.05). Conclusion FastCast maintains stabilization of fractured lower extremities during transport and impacts to a significantly greater extent than SAM splints. Therefore, FastCast can potentially reduce the risk of fracture complications following physical stressors associated with combat and extraction. [ABSTRACT FROM AUTHOR]

Introduction: The current study, which delves into proximal tibia morphometric parameters in a Greek sample, not only analyzes whether specific linear distance ratios are consistent but also paves the way for a potential novel metric system for knee arthroplasty imaging studies using constant ratios. These findings could have significant implications for future enlarged research and clinical practice. Methods: A total of 38 dried tibiae were evaluated by two independent investigators. The following distances were measured with a digital Vernier sliding caliper: (1) the mediolateral distance of the proximal surface (A), (2) the anteroposterior distance of the proximal surface (B), (3) The longitudinal length of the bone (C), (4) the line connecting the anterior margin of the proximal surface with the highest peak of the tibia tuberosity (D), (5) the depth of the proximal margin of the medial articular facet (AF) (medial plateau) (E) and (6) the depth of the proximal margin of the lateral AF (lateral plateau) (F). Results: The A, B, C, D, E, and F mean distances were 71.3 mm, 47.4 mm, 340.2 mm, 37.1 mm, 42 mm, and 35.9 mm. Reliability analysis for each observer on all measurements revealed an interclass correlation (ICC) score of 0.975 (observer 1) and 0.971 (observer 2). The ratio A/B was 1.5, A/C was a constant 0.2, and D/C was 0.1. The ratio E/F was 1.2. The six measurements (A-F) showed excellent inter-observer reliability (all ICC values > 0.990). Conclusions: The study established constant ratios of the studied linear distances around the proximal tibia. Considering these ratios, asymmetrical tibial components in knee arthroplasty seem to replicate the native anatomy more closely. Furthermore, the distance from the anterior margin of the proximal surface to the tibial tuberosity peak, constituting one-tenth of the longitudinal length of the tibia, shows promise as a metric system for imaging studies, especially in assessing lesions around tibial components. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study is to reveal the morphometry of the distal tibia and posterior malleolus and to generate morphometric reference data for the tibial component of total ankle prosthesis. Methods: This study was performed on 121 human dry tibiae (47 right, 74 left). The morphometric measurements of distal tibial structures, tibial length and the distance between the medial and posterior malleolus were measured in this study. Measurements on 44 tibiae were repeated three times and averaged for minimizing intra-observer error. Results: The tibial length was found 34.19 ± 2.31 cm. Mean values of width of fibular notch at tibial plafond and 10 mm proximal to the tibial plafond were 25.71 ± 2.44 mm and 17.81 ± 2.46 mm, respectively. Mean depth of fibular notch at tibial plafond and 10 mm proximal to the tibial plafond were 3.60 ± 1.04 mm and 3.37 ± 1.24 mm, respectively. Mean height of fibular notch was found 48.21 ± 10.51 mm. Mean width and height of medial malleolus were 25.08 ± 2.13 mm and 14.73 ± 1.85 mm, respectively. Mean width and length of tibial plafond were 27.71 ± 2.74 mm and 26.96 ± 2.62 mm, respectively. Mean values of width and height of posterior malleolus were measured 21.41 ± 3.26 mm and 6.74 ± 1.56 mm, respectively. Mean distance between medial and posterior malleolus was found 37.17 ± 3.53 mm. Mean width and depth of malleolar groove were 10.26 ± 1.84 mm and 1.73 ± 0.75 mm, respectively. The mean intra-class correlation values were found between the 0.959 and 0.999. Conclusions: Knowing the distal tibial morphometry is crucial for designing convenient ankle replacement implants for Turkish population. To our knowledge, this study is the first in the literature that identifies posterior malleolar morphometry on dry tibiae. We believe that this study will make a significant contribution to the literature about distal tibial morphometry and especially the posterior malleolus and the data of our study can be used for designing total ankle prosthesis in Turkish population. [ABSTRACT FROM AUTHOR]

The All-Inside PCL Reconstruction is a surgical technique which overcomes some of the key challenges faced with traditional PCL Reconstruction, and is becoming more relevant as the rate of PCL reconstruction increases. The purpose of this study is to review the technical practices of the all-inside PCL reconstruction since it was first introduced, with respect to the various key components involved in the surgical technique, to provide more information to the surgeon of the various surgical options available in practice. A systematic review was performed by the authors in January 2023 as per Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines to identify all studies outlining the all-inside surgical technique in the past decade. The predetermined eligibility criteria were applied in the screening of the literature in Pubmed, Cochrane and Google Scholar databases. A total of 14 studies were included in the final review, 9 technical studies, 2 case series, 2 book chapters and 1 review. An allograft was the preferred choice in 9 of the 14 studies. The semitendinosus was preferred when an autograft was chosen. Quadruple folding of the graft was the preferred configuration in 11 studies with the graft diameters from 8 to 12 mm and length ranging from 60 to 150 mm. The femur socket length ranged from 15 to 35 mm and the tibia socket length ranged from 20 to 70 mm. All the studies reported the use of at least 3 portals and up to 6 portals was also reported. 13 studies reported the graft docking first into tibia socket followed by the femoral socket. 7 studies reported the graft entry via the AM portal and 6 studies used a lateral portal. 9 studies used augmentation such as suture anchors (6 studies) and suture tape (3 studies). The 30° and 70° arthroscopic lenses were used alternatingly in 8 studies and fluoroscopy was utilized in 10 studies. The current literature review of all-inside PCL reconstruction consisted mainly technical studies and more clinical outcomes studies are needed to determine its efficacy. It observed a trend to use an allograft, at least 3 portals and docking the graft in the tibia socket first. There is no obvious preference of portal for graft entry. [ABSTRACT FROM AUTHOR]

The ability to meet high exercise intensities is limited by the increased risk of injury in some clinical populations. Previous studies have linked large tibia peak positive accelerations resulting from running to increased risk of developing lower-extremity injury. The purpose of this study is to determine the feasibility of using a hip flexion feedback system (HFFS) to meet and maintain different exercise intensities while maintaining low tibia axial accelerations. Ten healthy participants were tested on a HFFS test and an independent walking/running test to meet exercise intensities of 40% and 60% of heart rate reserve (HRR). During the HFFS test, the HFFS controlled in real time the exercise intensity by directing individuals to specific maximum hip flexion targets during walking and providing visual information that assists them in maintaining low tibia peak positive accelerations during the initial contact phase. Maximum hip flexion targets during walking are calculated based on real-time readings of the participant's heart rate. During the independent test, exercise intensity was controlled independently by the participant using treadmill speed. Compared to the independent test, using the HFFS at 60% HRR resulted in similar heart-rate error but lower tibia peak positive accelerations. No differences were observed for the 40% HRR intensity. This paper describes a novel exercise approach that uses the individual's heart rate to calculate maximal hip flexion targets that an individual should meet during treadmill walking. The HFFS also provides tibia peak positive peak acceleration cues. Therefore, the HFFS can increase and control exercise intensities while maintaining low tibia accelerations. In particular, the HFFS might be an alternative strategy to meet moderate to vigorous exercise intensities in populations at risk of developing lower-extremity injuries. [ABSTRACT FROM AUTHOR]

Objectives Methods Results Conclusion To introduce our modified technique for calcanization of the tibia in managing massive bony loss of hindfoot and preliminary outcomes.From January 2015 to December 2021, modified calcanization of the tibia were performed in 10 patients with unilateral loss of the calcaneus. Clinical outcomes were assessed based on the American Orthopaedic Foot & Ankle Society score and Symptom Checklist‐90‐Revised questionnaire. Paired two‐group t‐test was applied to compare the parameters.The mean lengthened length of the tibia was 77.3 ± 3.0 mm (range, 74–83 mm). The mean external fixation time was 123.7 ± 52.1 days (range, 117–134 days) and the mean external fixation index was 1.601 ± 0.046 days/mm. All patients stuck to the postoperative follow‐up plan with an average follow‐up time of 29.7 ± 3.4 months (range, 24–35 months). Deformities of the injured limbs were well corrected. Based on American Orthopaedic Foot & Ankle Society score, eight good and two fair results were achieved. The mental status of all patients was within the normal range, and several indices of the Symptom Checklist‐90‐Revised questionnaire of each patient were improved after the whole procedure.We demonstrate that the modified calcanization of the tibia is qualified for total loss of calcaneus with limited complications. Early rehabilitation is attainable since external fixation time is shortened due to a simplified procedure. [ABSTRACT FROM AUTHOR]

Objective Methods Results Conclusion The clinical evidence on the management for congenital pseudoarthrosis of the tibia (CPT) in adults is limited. The aim of this study is to assess the functional and radiological outcomes of Ilizarov distraction for treating CPT in adults.A retrospective analysis was conducted. Between 2013 and 2022, an Ilizarov distraction technique was performed on 14 adults (14 limbs) with CPT in our limb deformity center. There were seven females and seven males with a mean age of 33.7 (range, 18 ~ 53) years. The diagnosis of NF‐1 was confirmed in seven (50.0%) patients. Eight patients had a history of previous surgical failure. The pseudoarthrosis occurred in the middle and lower tibia in all limbs (six left and eight right). The CPT was classified by Crawford classification and Paley classification. The surgical procedures, external fixation time (EFT), and all outcomes and complications were recorded. The Kolmogorov–Smirnov test was performed to test the normality of the data. The American Orthopedic Foot and Ankle Society (AOFAS) ankle‐hindfoot score at the preoperative and final follow‐up was compared by using the Wilcoxon's signed‐rank test. The limb‐length discrepancy (LLD) and a self‐made exercise capacity score at the preoperative and final follow‐up were compared by using the student's t‐test. The clinical and radiological outcomes were assessed by the Inan scale.The mean EFT of Ilizarov fixator was 19.5 months (range, 7.3 ~ 39.1). At a median follow‐up of 26.8 months (IQR, 20.2 ~ 34.3), bone union of the pseudarthrosis and consolidation of the distraction zone were achieved in all patients. The mean LLD was decreased from 11.3 cm (range, 3.4 ~ 17.3) preoperatively to 1.1 cm (range, 0.3 ~ 3.7) (p < 0.05). The mean or median AOFAS ankle‐hindfoot score was improved from 53.5 (IQR, 26.5 ~ 60.5) preoperatively to 63.9 (range, 53 to 73) at final follow‐up (p < 0.05). The mean score for exercise capacity were improved from 4.9 (range, 1 to 8) preoperatively to 9.6 (range, 7 ~ 12) at final follow‐up (p < 0.05). According to the criteria described by Inan et al., the clinical results were classified as good in 10 and fair in 4, while the radiological results were classified as excellent in three, good in 8, and fair in 2. The success rate was 92.9%, as refracture was defined as treatment failure and occurred in one patient.Ilizarov distraction provided a suitable treatment option for the CPT in adults, as it could achieve a high rate of bone union, a good correction of secondary deformity, a low risk of refracture, and consequently restore a relatively functional limb. [ABSTRACT FROM AUTHOR]

The current study examines the growth pattern and lifestyle habits of the freshwater snapping turtles Chelydra and Macrochelys based on limb bone histology. Femora, humeri, and tibiae of 25 individuals selected from a range of ontogenetic stages were assessed to determine inter‐element and intraskeletal histological variation. Osteohistological assessment of multiple elements is consistent with overall moderate growth rates as revealed by the dominance of parallel‐fibered bone. However, the growth was cyclical as shown by deposition of multiple lines of arrested growths in the compacta. It appears that the bone tissue of C. serpentina is more variable through ontogeny with intermittent higher growth rates. M. temminckii appears to grow more slowly than C. serpentina possessing compact and thick cortices in accordance with their larger size. Overall, vascularization decreases through ontogeny with humeri and femora being well‐vascularized in both species. Contrarily, epipodials are poorly vascularized, though simple longitudinal and radial canals are present, suggesting differences in growth patterns when compared with associated diaphyseal sections. The tibiae were found to be the least remodeled of the limb bones and therefore better suited for skeletochronology for snapping turtles. Intra‐elementally, femora and humeri preserved higher cortical vascularity ventrally, suggestive of faster relative growth. We hypothesize that the differential growth pattern in limb bones of snapping turtles may relate to differential functional constraints, where forelimbs are operational in swimming while the hindlimbs provide stability. [ABSTRACT FROM AUTHOR]

Background: Biologic graft infection (BGI) is one of the main complications in graft reconstructions. However, very little evidence exists regarding the epidemiology of BGI, as most of the data come from sparse reports. Moreover, most of the series did not detail the treatment and outcome of graft infections. The aim of this systematic review of the literature is to provide a comprehensive data collection on BGI after oncologic resections. Methods: Three different databases (PubMed, Scopus, and Web of Science) were searched for relevant articles, and further references were obtained by cross-referencing. Results: 139 studies met the inclusion criteria. A total of 9824 grafts were retrieved. Among these, 684 (6.9%) were in the humerus, 365 (3.7%) in the pelvis, 2041 (20.7%) in the femur and 1660 (16.8%) in the tibia. Most grafts were osteoarticular (2481, 26.7%) and intercalary 2112 (22.7%) allografts. In 461 (5.0%), vascularized fibula grafts (VFGs) were used in combination with recycled autografts. Recycled grafts were reported in 1573 (16.9%) of the cases, and allograft-prosthetic composites in 1673 (18.0%). The pelvis and the tibia had the highest incidence of BGI (20.4% and 11.0%, respectively). The most reported first treatment was debridement and implant retention (DAIR) in 187 (42.8%) cases and two-stage revision with graft removal in 152 (34.8%). Very little data are reported on the final outcome specified by site or type of graft. Conclusions: This systematic review of the literature confirms a high incidence of infections in biologic reconstructions after resections of primary bone tumors. Despite DAIR being a viable attempt, in most cases, a two-stage approach with graft removal and reconstruction with endoprosthesis presented the highest chance to overcome infection, guaranteeing a reconstruction. We emphasize the need for future multicentric studies to focus on the management of infections after biological reconstructions in bone sarcomas. [ABSTRACT FROM AUTHOR]

The aim of the present study was to determine the morphometric characteristics of the fibular notch (FN). This study was carried out with 76 dry adult tibial bone specimens (right 38, left 38) with unknown age and sex collected from the Department of Anatomy, Cukurova University, Adana. The mean width of the FN was 23.04 ± 2.02 mm; the mean depth of the FN 3.63 ± 0.83 mm; the mean height of the FN was 41.76 ± 4.01 mm. The mean anterior facet length and posterior facet length was found to be 10.44 ± 1.94 mm and 13.93 ±1.63 mm, respectively. The mean value of the angle between the anterior and posterior facets was found to be 140.56° ± 11.72. The mean value of the angle between the anterior surface of the tibia and the intertubercular line was 75.5° ± 5.47. No statistically significant differences were detected between the right and left sides for all measurements. It is considered that knowing the morphometric and anatomical characteristics of the fibular notch in detail will help radiologists evaluate the talocrural region. It is also considered that these data will guide surgeons and help determine the appropriate size for ankle reconstruction operations. [ABSTRACT FROM AUTHOR]

Objective Methods Results Conclusion A robotic system was recently introduced to improve prosthetic alignment during total knee arthroplasty (TKA). The purpose of this multicenter, prospective, randomized controlled trial (RCT) was to determine whether robotic‐arm‐assisted TKA improves clinical and radiological outcomes when compared to conventional TKA.One hundred and thirty patients who underwent primary TKA were enrolled in this prospective, randomized controlled trial, which was conducted at three hospitals. Five patients were lost to follow‐up 6 weeks after surgery. Therefore, 125 participants (63 in the intervention group and 62 in the control group) remained in the final analysis. The primary outcome was the rate at which the mechanical axis of the femur deviated by less than 3° from the mechanical axis of the tibia. This was evaluated by full‐length weight‐bearing X‐rays of the lower limb 6 weeks postoperatively. Secondary outcomes included operation times, 6‐week postoperative functional outcomes evaluated by the American Knee Society score (KSS) and the Western Ontario and McMaster Universities osteoarthritis index (WOMAC), short form‐36 (SF‐36) health survey results, and the occurrence of adverse events (AEs) and serious adverse events (SAEs).At 6 weeks postoperatively, we found that the rate of radiographic inliers was significantly higher in the intervention group (78.7% vs 51.6%; p = 0.00; 95% confidence interval, 10.9% to 43.2%). The operation was significantly longer in the intervention group than in the control group (119.5 vs 85.0 min; p = 0.00). There were no significant differences in the 6‐week postoperative functional outcomes, SF‐36, AEs, and SAEs between the two groups. There were no AEs or SAEs that were determined to be “positively related” to the robotic system.Robotic‐arm‐assisted TKA is safe and effective, as demonstrated in this trial. [ABSTRACT FROM AUTHOR]

Background: The use of a tibial stem for large deformities (> 10°) would reduce the incidence of pain. The aim of this study was to compare the effect of tibial stem on postoperative pain and aseptic loosening at the tibia in patients with a preoperative deformity > 10° in the frontal plane at 2 years follow-up. Methods: This was a retrospective single-center case–control study. Ninety-eight patients with deformities greater than 10° in the frontal plane and a BMI > 30 kg/m2 who had undergone posterior-stabilized (PS) total knee arthroplasty (TKA) with a tibial stem were matched using a propensity score to 98 patients who had undergone PS TKA without a tibial stem. The primary endpoint was the pain rate at 2 years. The secondary endpoints were the rate of aseptic loosening of the tibia at 2 years post-operatively. Results: A significant difference was found in the rate of postoperative pain at 2 years. It was higher in the group without tibial stem compared with the group with tibial stem (41.8% vs 17.3%, p = 0.0003). In the group without tibial stem, 24.4% of pain was mild, 61% moderate and no severe pain. In the tibial stem group, 47.1% of pain was mild, 41.2% moderate and no severe pain. A radiolucent line (RLL) was present at 2 years in 26.5% of prostheses in the without tibial stem group and in 9.2% of prostheses in the tibial stem group (p = 0.002). There was no difference between the two groups in terms of aseptic loosening. Conclusion: The use of a tibial stem in primary TKA in patients with frontal deformities greater than 10° reduces postoperative pain and the presence of radiolucent lines. [ABSTRACT FROM AUTHOR]

We present the distinctive morphological characteristics of Tramea limbata from other species of the Tramea family. While the adult species is well documented, the nymph of Tramea limbata is not described in the literature. The nymphs of Tramea limbata are robust, greenish-yellow and translucent aquatic insects while alive, and their exuviae are straw-brown. The exuvial characteristics match well with the final instar and are sufficient to identify the species. Notably, in T. limbata, compared to T. binotata and other species, the appendages exhibit distinct patterns; the tibia and tarsus are adorned with comb-like tufts of setae, and the femur bears stout spines. Also, the lack of spiniform setae on the dorsal region of the tergum of abdominal segments, particularly segments 6 to 9, gives them a smooth appearance. Another characteristic of T. limbata is that the epiproct and paraproct are half the length of the cerci. The labium is spoon-shaped with a pair of labial palps with ten short inner palpal setae, 12 long outer palpal setae, and a pair of movable palpal hooks at the distal margin. Premental setae are 16 in number on either side. The anterior margin of the head of T. limbata is characterised by ten crenulations ending in short, stout spiny setae, extending up to the width of the lower jaw. These features help to distinguish Tramea limbata nymphs from strikingly similar nymphs of other Tramea species, and their exuvia provides a noninvasive approach to conservation studies. [ABSTRACT FROM AUTHOR]

Objective: This study aims to enhance the precision of implant cavity preparation, addressing a notable challenge in the current state of the field by utilizing femtosecond lasers. Background: The application of femtosecond lasers in implant cavity preparation heralds a noninvasive and efficient technique, characterized by diminished thermal damage and high biocompatibility. Despite these promising attributes, the realization of precise cavity preparation remains a significant challenge in the contemporary domain. Materials and Methods: Our research group devised a specialized femtosecond laser microsurgery robotic system tailored for sophisticated implant cavity preparation. This system facilitated the meticulous analysis of sheep shank bone samples, enabling precise three-dimensional cutting. The analysis included an extensive examination of ablation effects, using a laser scanning microscope and VK Analyzer software. This investigation spanned the phases of laser flux calibration and experimental validation, offering a critical evaluation of the automated preparation process. Results: The study delineated that at the focus position of our custom-made oral clinical femtosecond laser microsurgery robotic system, the laser spot diameter is 75.69 lm, and ascertained the ablation threshold for sheep shank cortical bone to be 1.47 J/cm². Utilizing low laser flux with minimal ablation craters overlap compromised the sidewall precision of the implant cavity, whereas employing high laser flux with extensive ablation craters overlap resulted in an enlarged ablation angle. At a laser energy setting of 2.2362 J/cm² and a 50% ablation crater overlap, an implant cavity was successfully crafted featuring a top diameter of 4.41 mm, a bottom diameter of 3.98 mm, and a depth of 3mm, devoid of any adverse thermal effects such as cracking or carbonization. Conclusions: The oral clinical femtosecond laser microsurgery robotic system can achieve automated and precise implant cavity preparation. This advancement promotes the broader application of femtosecond lasers in the field of orthopedics. [ABSTRACT FROM AUTHOR]

Purpose: Acute compartment syndrome (ACS) remains a devastating complication of orthopaedic trauma. The tibial diaphysis is especially implicated in the development of ACS, both at the time of injury and after operative management. Identification of risk factors for ACS for these distinct scenarios has been investigated in a large cohort of patients. Methods: This is a retrospective cohort study of all adults (age 18 years and older) presenting to a level 1 trauma centre with a diaphyseal tibia fracture. ACS was determined by a combination of clinical signs and symptoms and compartmental pressure monitoring. Potential risk factors were subject to univariate analysis with significant variables undergoing binary logistic regression analysis. Results: 1147 tibial diaphyseal fractures over a twelve year period were studied. Age, multifragmented fracture pattern, male gender, high energy mechanism and intra- articular extension all showed a statistically significant association for ACS. Increasing body mass index (BMI) and treatment with an intramedullary nail favoured development of ACS post-operatively. Conclusion: Risk factors for the development of ACS specifically in tibial diaphyseal fractures have been highlighted. Patients managed with IMN or high BMI may warrant particular observation following operative intervention. [ABSTRACT FROM AUTHOR]

Purpose: Management of fibular hemimelia includes either prosthetic care with or without a suitable amputation or tibial lengthening. Many studies have documented the success of both procedures. Most parents of these children refuse an amputation or have no access to good prosthetic care. The author presents a limb-salvage procedure with tibial lengthening and ankle stabilization. Methods: Twelve children of fibular hemimelia with 14 extremities had been subjected to limb lengthening after lateral leg release. To correct the valgus procurvatum, double oblique diaphyseal osteotomy (DODO) of the tibia was performed in 11 extremities. The age of the patients ranged from two to 15 years with the median of five years. All were male. The proposed procedure included three stages of loosening, lengthening, and stabilization with ankle arthrodesis at a later stage. Results: All patients returned for follow-up for the first four years and had been walking on their sensate feet. With DODO followed by fixator/traction could straighten and lengthen the tibia simultaneously and correct the valgus procurvatum. Ankle stabilization provided stability and a plantigrade foot. A follow-up of six to 30 years with a median of ten years has been reported. Conclusion: A new procedure of loosening, lengthening, and stabilization of the leg with ankle arthrodesis has been proposed. A follow-up of 30 years with a median of ten years of the said procedure has been reported. The procedure provides a long-lasting plantigrade and painless foot that has sensation and proprioception. An amputation at any level has not been recommended. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the efficacy of Bacillus-based probiotics supplemented at two different levels to modulate the productive performance, egg quality, tibia traits, and specific cecal bacteria counts of Hy-Line Brown layers from 25 to 37 weeks of age. Methods: A total of 216 twenty-five-week-old hens were randomly distributed into 3 experimental diets with 12 replicates of 6 birds per cage. Diets included basal diet supplemented with 0 (CON), 3x108 (PRO1), or 3x109 (PRO2) colony-forming unit (CFU) of the test probiotic containing Bacillus subtilis PB6, Bacillus subtilis FXA, and Bacillus licheniformis G3 per kilogram of feed. Results: Improved egg weights and mass at 29 weeks; and feed intake at 31 weeks (p<0.10) were noticed with the probiotic-supplemented PRO1 and PRO2 diets. Considering egg quality, the shell thickness, Haugh units, and yolk color were improved; but yolk cholesterol was lowered (p<0.05) with PRO1 and PRO2 diets at 29 weeks. At both 33 and 37 weeks, the egg-breaking strength, shell color and thickness, albumen height, Haugh units, and yolk color were improved; but yolk cholesterol was similarly lowered (p<0.05) with the PRO1 and PRO2 diets. Improved tibia Ca, ash, weights, and density; and raised cecal counts of Bifidobacteria and Lactobacilli (p<0.05) were noticed with PRO1 and PRO2 diets. Improved tibia P but reduced Clostridia counts (p<0.10) were also observed with the PRO1 and PRO2 diets. Conclusion: Probiotic supplementation of Bacillus subtilis PB6, Bacillus subtilis FXA, and Bacillus licheniformis G3 at 3x108 CFU/kg of feed is adequate to significantly improve egg quality, lower yolk cholesterol, enhance several tibia traits, and raise the populations of beneficial cecal bacteria. Modest improvements in several productive parameters and tibia P but reduced Clostridia were also observed; and could warrant further investigation of probiotic effects beyond the current test period. [ABSTRACT FROM AUTHOR]

In this research, an experimental biomechanics construct was developed to reveal the mechanics of distal tibial fracture by submitting synthetic tibiae to cyclic loading, resulting in a combined stress state due to axial compression and bending loads. The synthetic tibia was fixed at the knee but allowed to rotate in the coronal and sagittal planes at the ankle. The first three loading regimes lasted for 4000 cycles/each, and the final until ultimate failure. After 12k±80 cycles, the observed failure patterns closely resembled distal tibial fractures. The collected data during cyclic loading were fitted into a phenomenological model to deduce the time-dependent response of the synthetic tibiae. Images were also collected and analyzed using digital image correlation to deduce the full-field state of strain. The latter revealed that longitudinal strain contours extended in the proximal–distal direction. The transverse strain contours exemplified a medial-to-lateral distribution, attributed to the combined contributions of the Poisson's effect and the flexural deformation from axial and bending components of the applied load, respectively. The experimental construct, full-field characterization, and data analysis approaches can be extended to elucidate the effect of different fixation devices on the overall mechanical behavior of the bone and validate computational models in future research. [ABSTRACT FROM AUTHOR]

Measuring the healing status of a bone fracture is important to determine the clinical care a patient receives. Implantable devices can directly and continuously assess the healing status of fracture fixation constructs, while subject‐specific virtual biomechanical tests can noninvasively determine callus structural integrity at single time points. Despite their potential for objectification, both methods are not yet integrated into clinical practice with further evidence of their benefits required. This study correlated continuous data from an implantable sensor assessing healing status through implant load monitoring with computer tomography (CT) based longitudinal finite element (FE) simulations in a large animal model. Eight sheep were part of a previous preclinical study utilizing a tibial osteotomy model and equipped with such a sensor. Sensor signal was collected over several months, and CT scans were acquired at six interim time points. For each scan, two FE analyses were performed: a virtual torsional rigidity test of the bone and a model of the bone‐implant construct with the sensor. The longitudinal simulation results were compared to the sensor data at corresponding time points and a cohort‐specific empirical healing rule was employed. Healing status predicted by both in silico simulations correlated significantly with the sensor data at corresponding time points and correctly identified a delayed and a nonunion in the cohort. The methodology is readily translatable with the potential to be applied to further preclinical or clinical cohorts to find generalizable healing criteria. Virtual mechanical tests can objectively measure fracture healing progressing using longitudinal CT scans. [ABSTRACT FROM AUTHOR]

The need for additional fibular osteotomy (FO) when performing supramalleolar osteotomy (SMO) in the varus ankle arthritis (VAA) is controversial. Some cadaveric studies have been performed to prove this; however, it is difficult to implement deformities including talar tilting and translation in cadavers. In this study, we created a model of VAA with the tilting and translation using three‐dimensional (3‐D) finite element (FE) analysis and analyzed the results of SMO with or without FO depending on the types of VAA. The validated normal foot and ankle 3‐D FE model was constructed including the ankle cartilages of the talar dome and tibia plafond. The VAA models were determined and reconstructed by following the classification of VAA, VAA with medial translation for stage 3a, VAA with varus tilting (7.5°) for stage 3b. The postoperative SMO models (SMO with and without FO) were reconstructed by corresponding to each VAA models. The FE analysis conditions were commonly applied. The boundary condition of ankle joint was defined as "sliding condition" and applied 0.002 friction coefficient to realize lubricative property. Loading condition was assumed as a two‐leg standing position and half of the subject body weight (325 N) was loaded on center of ground to vertical direction. Contact pressure changes were predicted at the medial ankle cartilage. As a result, in VAA with medial translation, isolated SMO may provide sufficient pressure reduction at the medial ankle joint. However, in VAA with varus tilting, SMO combined with FO could appropriately relieve concentrated pressure at the medial ankle joint. [ABSTRACT FROM AUTHOR]

Image-based robotic-assisted total knee arthroplasty (RA-TKA) allows three-dimensional surgical planning informed by osseous anatomy, with intraoperative adjustment based on a dynamic assessment of ligament laxity and gap balance. The aim of this study was to identify ranges of implant alignment and bone resections with RA-TKA. We retrospectively reviewed 484 primary RA-TKA cases, stratified by preoperative coronal alignment. Demographics and intraoperative data were collected and compared using Chi-square and ANOVA tests. Planned limb, femoral, and tibial alignment became increasingly varus in a progressive order from valgus to neutral to the highest in varus knees (p < 0.001). Planned external transverse rotation relative to the TEA was lowest in the valgus cohort; relative to the PCA, whereas the varus cohort was highest (p < 0.001, both). Planned resections of the lateral distal femur and of the medial posterior femur were greater in the varus group compared to neutral and valgus (p < 0.001). There were significant differences between cohorts in planned tibia resections, laterally and medially. Varus knees demonstrated higher variability, while valgus and neutral had more metrics with low variability. This study demonstrated trends in intraoperative planned alignment and resection metrics across various preoperative coronal knee alignments. These findings contribute to the understanding of RA-TKA and may inform surgical decision-making. [ABSTRACT FROM AUTHOR]

Background: This study aimed to evaluate the biological behavior of a novel implant design incorporating decompressive cervical blades. Hence, the aim of the present study was to evaluate the healing outcomes in cortical regions where decompressive protocols were implemented using implants equipped with blades and installed applying a bicortical anchorage. Materials and Methods: Blades with varying diameters were integrated into the coronal portion of the implant to prepare the cortical region of rabbit tibiae. The blade diameters differed from the implant collar by the following amounts: control group (0 µm), +50 µm, and +200 µm. Results: No marginal bone loss was detected. Instead, all implants exhibited new bone formation in the coronal region. Complete closure was observed in the CG-0 group, as well as in the TG-50 and TG-200 groups, despite the presence of marginal gaps without primary bone contact at installation. In the apical region, most implants breached the cortical layer. Nevertheless, new bone formation in this region completely closed the osteotomy, effectively isolating the internal environment of the tibia from the external. Conclusions: The use of a blade incorporated into the implant body enabled precise preparation of the cortical layer, allowing for controlled decompression in the targeted area. This technique resulted in optimal osseointegration with no loss of marginal bone, and complete restoration of marginal gaps ranging from 0 µm to 200 µm. [ABSTRACT FROM AUTHOR]

It is not clear as to whether weight bearing and ambulation may affect bone growth. Our goal was to study the role of mechanical loading (one of the components of ambulation) on endochondral ossification and longitudinal bone growth. Thus, we applied cyclical, biologically relevant strains for a prolonged time period (4 weeks) to one tibia of juvenile mice, while using the contralateral one as an internal control. By the end of the 4‐week loading period, the mean tibial growth of the loaded tibiae was significantly greater than that of the unloaded tibiae. The mean height and the mean area of the loaded tibial growth plates were greater than those of the unloaded tibiae. In addition, in female mice we found a greater expression of PTHrP in the loaded tibial growth plates than in the unloaded ones. Lastly, microCT analysis revealed no difference between loaded and unloaded tibiae with respect to the fraction of bone volume relative to the total volume of the region of interest or the tibial trabecular bone volume. Thus, our findings suggest that intermittent compressive forces applied on tibiae at mild–moderate strain magnitude induce a significant and persistent longitudinal bone growth. PTHrP expressed in the growth plate appears to be one growth factor responsible for stimulating endochondral ossification and bone growth in female mice. [ABSTRACT FROM AUTHOR]

Simple Summary: Simple Summary: T-2 toxin is widely present in grain and animal feed, posing a threat to cause growth retardation and tissue damage in poultry. Goose is a sensitive waterfowl to T-2 toxin. Tibia is a representative of long bones, which is the target organ of T-2 toxin. However, tibial damage caused by T-2 toxin in geese has not been fully demonstrated. Here, Yangzhou goslings were daily gavaged with T-2 toxin at concentrations of 0, 0.5, 1.0, and 2.0 mg/kg body weight for 21 days, and the changes in bone development, bone quality, chondrocyte differentiation, and bone metabolism in the tibia were investigated. The results showed that T-2 toxin significantly inhibited tibial growth and development, accompanied by decreased bone geometry parameters and properties, hindered chondrocyte differentiation, and imbalanced bone metabolism. These findings reveal tibial damage caused by T-2 toxin in goslings, providing scientific information for understanding and alleviating the osteotoxicity of T-2 toxin in poultry production. T-2 toxin, the most toxic type A trichothecene, is widely present in grain and animal feed, causing growth retardation and tissue damage in poultry. Geese are more sensitive to T-2 toxin than chickens and ducks. Although T-2 toxin has been reported to cause tibial growth plate (TGP) chondrodysplasia in chickens, tibial damage caused by T-2 toxin in geese has not been fully demonstrated. This study aims to investigate the adverse effects of T-2 toxin on tibial bone development, bone quality, chondrocyte differentiation, and bone metabolism. Here, forty-eight one-day-old male Yangzhou goslings were randomly divided into four groups and daily gavaged with T-2 toxin at concentrations of 0, 0.5, 1.0, and 2.0 mg/kg body weight for 21 days, respectively. The development of gosling body weight and size was determined by weighing and taking body measurements after exposure to different concentrations of T-2 toxin. Changes in tibial development and bone characteristics were determined by radiographic examination, phenotypic measurements, and bone quality and composition analyses. Chondrocyte differentiation in TGP and bone metabolism was characterized by cell morphology, tissue gene-specific expression, and serum marker levels. Results showed that T-2 toxin treatment resulted in a lower weight, volume, length, middle width, and middle circumference of the tibia in a dose-dependent manner (p < 0.05). Moreover, decreased bone-breaking strength, bone mineral density, and contents of ash, Ca, and P in the tibia were observed in T-2 toxin-challenged goslings (p < 0.05). In addition, T-2 toxin not only reduced TGP height (p < 0.05) but also induced TGP chondrocytes to be disorganized with reduced numbers and indistinct borders. As expected, the apoptosis-related genes (CASP9 and CASP3) were significantly up-regulated in chondrocytes challenged by T-2 toxin with a dose dependence, while cell differentiation and maturation-related genes (BMP6, BMP7, SOX9, and RUNX2) were down-regulated (p < 0.05). Considering bone metabolism, T-2 toxin dose-dependently and significantly induced a decreased number of osteoblasts and an increased number of osteoclasts in the tibia, with inhibited patterns of osteogenesis-related genes and enzymes and increased patterns of osteoclast-related genes and enzymes (p < 0.05). Similarly, the serum Ca and P concentrations and parathyroid hormone, calcitonin, and 1, 25-dihydroxycholecalciferol levels decreased under T-2 toxin exposure (p < 0.05). In summary, 2.0 mg/kg T-2 toxin significantly inhibited tibia weight, length, width, and circumference, as well as decreased bone-breaking strength, density, and composition (ash, calcium, and phosphorus) in 21-day-old goslings compared to the control and lower dose groups. Chondrocyte differentiation in TGP was delayed by 2.0 mg/kg T-2 toxin owing to cell apoptosis. In addition, 2.0 mg/kg T-2 toxin promoted bone resorption and inhibited osteogenesis in cellular morphology, gene expression, and hormonal modulation patterns. Thus, T-2 toxin significantly inhibited tibial growth and development with a dose dependence, accompanied by decreased bone geometry parameters and properties, hindered chondrocyte differentiation, and imbalanced bone metabolism. [ABSTRACT FROM AUTHOR]

Introduction: Launched in 2018 for revision total ankle arthroplasty (rTAA), the INVISION talar component addresses subsidence when poor talar bone stock is present. Due to the recency of the market-availability of the INVISION, studies evaluating its efficacy are lacking. This study presents the first analysis of early-term outcomes of patients undergoing rTAA with the INVISION talar component. Methods: This was a single-center, retrospective review of 28 patients undergoing rTAA with the INVISION talar component and INBONE II tibial component performed between 2018 and 2022. Data on preoperative characteristics, postoperative complications, secondary procedures, and survivorship were collected. The primary outcome measures were rates of major complications, re-operation, and implant failure. Secondary outcomes included post-operative changes in varus and valgus alignment of the tibia and talus. Results: The most common secondary procedures performed with rTAA were medial malleolus fixation (n = 22, 78.6%) and gastrocnemius recession (n = 14, 50%). Overall, 10.7% (n = 3) of patients underwent reoperation and 14.3% (n = 4) suffered major complications. Incidence of implant failure was 10.7% (n = 3). All reoperations were caused by infection. Mean varus alignment of the tibia and talus improved from 4.07 degrees and 4.83 degrees to 1.67 degrees and 1.23 degrees, respectively. Mean valgus alignment of the tibia and talus improved from 3.67 degrees and 4.22 degrees to 2.00 degrees and 2.32 degrees, respectively. Conclusions: In a series of 28 patients undergoing rTAA with the INVISION talar component, we discovered comparatively low rates of reoperation, major complication, and implant failure (10.7%, 14.3%, and 10.7%). The INVISION system appears to have a reasonable safety profile, but further studies evaluating long-term outcomes are required to assess the efficacy of the INVISION system. [ABSTRACT FROM AUTHOR]

Pseudoscorpions can be found in different microhabitats, one of which is moss. In this paper, we report the first records of pseudoscorpions associated with mosses in Mexico. We found three species: Albiorix edentatus, Paratemnoides nidificator and a new species of the genus Cocinachernes which is described below as C. akalchesis sp. nov. The specimens were collected from moss of the genus Bryum. This new species has globose spermathecae with four tubes: two short and two long, with ocular spots in the carapace; trichobothrium distance between t and st is less than the distance of t from the fingertip, Femur L/B ranges from 2.4 to 2.9, tibia from 1.68 to 1.9, chela is 2.9 (without pedicel), and hand (without pedicel) ranges from 2.53 to 2.88; galea short and slightly robust, without divisions in males; anterior operculum with 36 setae long and acuminated, posterior operculum with 20 acuminated setae. This new species represents the second known species of Cocinacheres from Mexico. [ABSTRACT FROM AUTHOR]

Total knee arthroplasty (TKA) is a common surgical procedure for end-stage knee osteoarthritis. However, conventional alignment techniques may lead to postoperative dissatisfaction in up to 20% of cases. Kinematic alignment (KA) has emerged as a new philosophy to restore the native joint line and achieve more natural kinematics. Preserving the posterior tibial slope (PTS) and posterior cruciate ligament (PCL) is crucial to maintaining the pre-arthritic joint line and improving knee kinematics. This study aimed to assess the prevalence of postoperative PTS changes and their impact on functional outcomes and range of motion. A retrospective single-center study was conducted on patients who underwent KA-TKA with PCL preservation. The preoperative and postoperative PTS were measured on lateral knee radiographs using the tibial proximal anatomic axis method. Patient-reported outcome measures (PROMs) were collected pre- and postoperatively up to a two-year follow-up. Of the 95 included patients, 62.1% achieved an anatomically similar PTS (within 3° from the preoperative value), while 37.9% experienced noticeable PTS changes. However, no significant associations existed between PTS changes and compromised PROMs (WOMAC, 22.2 and 23.1; FJS, 66.6 and 67.3), ROM (118.5° and 119.4°), or patient satisfaction. No postoperative complications requiring reoperation or component revisions were observed. Preserving or modifying the native PTS during KA-TKA could be confidently undertaken without compromising functional outcomes or patient satisfaction. [ABSTRACT FROM AUTHOR]

(1) Background: OD burs are used in two different modes: (i) CW and (ii) CCW. The purpose of the study was to evaluate the ΔT during the preparation of implant osteotomies in a four-way interaction. (2) Methods: Three hundred and sixty osteotomies were prepared at 12 mm depth in human cadaver tibiae. The ΔT values were calculated similarly to the method used in two previous studies carried out by our group. Four different variables were evaluated for their effect on ΔT. (3) Results: A four-way interaction was observed in the CCW mode, allowing for 1000 RPM to have the least effect in both modes. However, in the CCW mode the use of 3.0 and 4.0 burs after 23 osteotomies showed a statistically significant increase in ΔT, and significant chatter, compared to the CW mode. In the CCW mode, the ΔT was increased significantly as the diameter of the burs increased in 800 and 1200 RPM. (4) Conclusions: The synergistic effect of drills' diameter, CCW mode, 800 and 1200 RPM, and bur usage (over 23 times) had a significant effect on ΔT, which exceeded 47 °C. One thousand (1000) RPM had the least effect in both modes. The 3.0 and 4.0 burs in the CCW mode drastically increased the temperature and produced significant chatter. [ABSTRACT FROM AUTHOR]

Changes in lower limb alignment after open‐wedge high tibial osteotomy (owHTO) influence joint kinematics. The aim of this study was to investigate the morphological and kinematic changes of the knee joint, in particular the patellofemoral joint, using a multibody simulation model. OwHTO with an open tibial wedge of 6–12 mm (1 mm intervals) was virtually performed on each of 13 three‐dimensional (3D) computer‐aided design models (CAD models) derived from computer tomography scans of full‐leg cadaver specimens. For each owHTO, an individual biomechanical simulation model was built and knee flexion from 5° to 100° was simulated using a multibody simulation model of the native knee. Morphologic and alignment parameters as well as tibiofemoral and patellofemoral kinematic parameters were evaluated. Almost linear changes in tibial tuberosity trochlea groove (TT‐TG) (0.42 mm/1 mm wedge height) were observed which led to pathological values (TT‐TG > 20 mm) in 3 out of 13 knees. Furthermore, a 6 mm increase in osteotomy wedge height increased lateral patellofemoral rotation by 0.8° (range: 0.39° to 1.11°) and led to a lateral patellar translation of 0.8 mm (range: 0.37–3.11 mm) on average. Additionally, valgisation led to a medial translation of the tibia and a decrease in the degree of tibial internal rotation during knee flexion of approximately 0.3°/1 mm increase in osteotomy wedge height. The increase in TT‐TG and the biomechanical effects observed influence patellofemoral tracking, which may increase retropatellar pressure and are potential risk factors for the development of anterior knee pain. [ABSTRACT FROM AUTHOR]

Background: In revision total knee arthroplasty, addressing significant bone loss often involves the use of cemented or press-fit stems to ensure implant stability and long-term fixation. A possible alternative to stem was recently introduced utilizing custom-made porous metaphyseal cones, designed to reconstruct the missing tibial and femoral geometries. Early clinical and radiological assessments have shown promising results. The objective of this research was to biomechanically evaluate the performances of these custom-made cones. Methods: The biomechanical study was conducted using a validated finite element model. The bone geometries of a patient (selected for their history of four knee revisions due to infection and periprosthetic fractures, followed by a successful treatment with custom-made 3D-printed metaphyseal cones) were employed for the study. On these bone models, different revision scenarios were simulated and examined biomechanically: (A) custom-made cementless metaphyseal cones; (B) cemented stems; (C) press-fit stems; (D) distal femoral reconstruction with press-fit stem. All the models were analyzed at 0 °and 90 °of flexion, under physiological load conditions simulating daily activities; stress distribution, average Von-Mises stresses and risk of fracture were then analyzed and compared among configurations. Results: The use of custom-made 3D-printed cones exhibited the most favorable stress distribution in both femoral and tibial bones. Tibial bone stress was evenly distributed in custom-made cone configurations, while stress concentration was observed in distal regions for the other scenarios. Additionally, custom-made cones displayed overall homogeneity and lower stress levels, potentially contributing to limit pain. Symmetrical stress distribution was observed between the lateral and medial proximal tibia in custom-made cone models, whereas other scenarios exhibited uneven stress, particularly in the anterior tibial bone. Conclusions: The biomechanical analysis of porous custom-made metaphyseal cones in re-revision arthroplasties is in agreement with the positive clinical and radiological outcomes. These findings provide valuable insights into the potential benefits of using custom-made cones, which offer more uniform stress distribution and may contribute to improve patient outcomes in revision TKA procedures. Further studies in this direction are warranted to validate these biomechanical findings. [ABSTRACT FROM AUTHOR]

Bone morphometry varies among dogs of different sizes and breeds. Studying these differences may help understand the predisposition of certain breeds for specific orthopedic pathologies. This study aimed to develop a statistical shape model (SSM) of the femur, patella, and tibia of dogs without any clinical orthopeadic abnormalities to analyze and compare morphological variations based on body weight and breed. A total of 97 CT scans were collected from different facilities and divided based on breed and body weight. The 3D models of the bones were obtained and aligned to a coordinate system. The SSM was created using principal component analysis (PCA) to analyze shape variations. The study found that the first few modes of variation accounted for a significant percentage of the total variation, with size/scale being the most prominent factor. The results provide valuable insights into normal anatomical variations and can be used for future research in understanding pathological bone morphologies and developing 3D imaging algorithms in veterinary medicine. [ABSTRACT FROM AUTHOR]

Background: This study aimed to demonstrate the occurrence of lower extremity deformities and their risk factors in patients with solitary osteochondromas. Methods: We retrospectively reviewed consecutive patients with solitary osteochondromas around the knee. The laterality (left or right), involved bone (femur or tibia), tumor type (pedunculated or sessile), and direction (medial or lateral) were examined. The whole limb length (WLL), mechanical lateral distal femoral angle (mLDFA), and medial proximal tibial angle (MPTA) were measured using teleroentgenogram. Lower limb deformity was defined as a difference of more than 5° in mLDFA or MPTA in both lower extremities or a difference in WLL of more than 1 cm. Patients were divided into two groups, with deformity and without deformity. Results: Lower extremity deformities were observed in 8 of 83 patients. Significant difference in the type of osteochondroma (p = 0.004) between the groups was observed. Differences in sex, age, laterality, involved bone, direction, and distance from the physis to the osteochondroma between groups were not statistically significant. The sessile type of osteochondroma was a risk factor for lower limb deformity with an odds ratio of 24.0 according to Firth's logistic regression analysis. Conclusion: In our cohort with solitary osteochondroma, lower limb deformities were observed in 8 (9.6%) out of the 83 patients and these were significantly associated with sessile-type tumors. Therefore, patients with sessile-type solitary osteochondroma around the knee require careful surveillance of lower limb alignment with whole leg teleroentgenogram. [ABSTRACT FROM AUTHOR]

Background: Infantile tibia vara (ITV) is a rare proximal tibia deformity in infancy, leading to progressive knee varus. High tibial osteotomy is commonly practiced but has high recurrence rates. This study analyzed factors affecting treatment failure and recurrence in children undergoing opening-wedge high tibial osteotomy (OWHTO) for ITV. Methods: We retrospectively studied children with ITV who had OWHTO with a press-fit cancellous bone allograft between 2000 and 2020, with ≥2-year follow-up. Outcomes included recurrence (knee varus with tibiofemoral angle > 10°), complications, and reintervention. Results: We analyzed 39 knees in 29 patients (mean age: 4.8 ± 1.9 years; median follow-up: 7.4 years). Recurrence occurred in 22 cases (56%). Age at surgery significantly influenced recurrence, with rates of 16% before age 5 versus 95% later (hazard ratio: 12.0, p = 0.001). Langenskiöld stage also affected recurrence (β-coefficient: 2.7, 95% C.I. 1.0–4.5, p = 0.002; pseudo-R-squared: 0.50, p = 0.001), with recurrence in all stage IV or higher cases. Conclusions: Early diagnosis and treatment before age 5, ideally with Langenskiöld stage III or lower, are crucial for stable correction with OWHTO alone. Late, high-grade ITV may require combined, acute or gradual, and/or staged correction. Further evidence is needed for optimal management. [ABSTRACT FROM AUTHOR]

The 3.5 mm diameter or thicker Steinmann pins were commonly used in skeletal traction, which are so highly invasive that may result in severe complications such as pin tract infection and iatrogenic calcaneus fractures. Accordingly, Xirui Wu designed a new type of tension traction bow that can be assembled with 2.0 mm diameter Kirschner wires, but its effectiveness is unclear. We aim to evaluate the effectiveness of 2.0 mm diameter Kirschner wires assembled with Wu's Tension Traction Bows in calcaneal skeletal traction. Data of 65 patients who were admitted to our department with tibia fractures from January 2021 to June 2022 and underwent preoperative calcaneal skeletal traction were collected retrospectively. 36 patients treated with 2.0 mm diameter Kirschner wires assembled with Wu's Tension Traction Bows were assigned into Group 1, and 29 patients treated with 3.5 mm diameter Steinmann pins assembled with Bohler's traction bows were assigned into Group 2. Pins loosening, breakage, and calcaneus fractures occurred in neither group. No statistical differences were observed in traction weight, swelling reduction efficacy, and traction duration (P > 0.05). Statistically significant differences were found between the two groups in term of post-traction bleeding incidence, average bleeding duration, and mean size and healing time of traction wounds (P < 0.05). Though VAS pain score before traction and on the first two days after traction in Group 1 didn't differ from Group 2 (P > 0.05), it was significantly lower in Group 1 compared to Group 2 on the third day after traction (P = 0.030). This study demonstrates that 2.0 mm diameter Kirschner wires assembled with Wu's Tension Traction Bows produce satisfied traction outcomes with less invasion and are recommended in calcaneal skeletal traction. [ABSTRACT FROM AUTHOR]

Background: High tibial osteotomy (HTO) aims to realign the varus knee to alleviate stress in the medial compartment. However, detailed information on the impact of HTO on stress distribution across the tibiofemoral joint surface still needs to be completely elucidated. Purpose/Hypothesis: The present study aimed to analyze the subchondral bone density distribution to validate the alignment threshold causing paradoxical changes. We hypothesized that there would be a paradoxical stress change in the medial compartment beyond a specific threshold for lower limb realignment after HTO. Study Design: Case series; Level of evidence, 4. Methods: A retrospective clinical study of 32 knees from 30 patients who underwent medial opening-wedge HTO between 2015 and 2019 was conducted at Hokkaido University Hospital. The subchondral bone density across the tibiofemoral joint was analyzed using computed tomography–osteoabsorptiometry before and after HTO. The high-density area (HDA) within the medial and lateral compartments and their subregions, which were quartered in the coronal plane, was specifically examined. Results: The hip-knee-ankle angle, medial proximal tibial angle (MPTA), joint line obliquity (JLO), and joint line convergence angle significantly changed after HTO (P <.01). The HDA of the medial compartment to the total HDA ratio decreased from 83% to 77%. Paradoxically, the HDA in the most central subregion of the medial compartment increased from 24% to 30%. There were significant differences between MPTA and JLO in patients with and without paradoxical changes in the HDA. MPTA and JLO cutoff values causing paradoxical changes in the HDA were 94° and 4°, respectively. Conclusion: There was a paradoxical stress increase in the M4 region at the medial compartment associated with the MPTA and JLO beyond specific thresholds. Therefore, surgical planning should be cautiously performed to prevent overcorrection, which can lead to adverse stress distribution changes. [ABSTRACT FROM AUTHOR]

Simple Summary: The non-phytate phosphorous (NPP) requirements of laying hens vary significantly at different stages of growth and development due to their differing physiological characteristics. Non-linear models and factorial methods are often used to estimate the nutritional requirements of animals at different stages of growth. In this study, the NPP requirement of Chinese Jing Tint 6 layer chicks from hatch to d 42 was evaluated using both a non-linear model and factorial method. The non-linear models were fitted based on the criterion of growth performance, serum biochemical parameters, bone characteristics, and phosphorus utilization. The factorial methods were used to classify the requirements of the layer chicks into growth requirements and maintenance requirements. Based on the current results, it was recommended that dietary 0.367% and 0.439% NPP benefit from the best P utilization of 1–14 and 15–42 d birds, respectively. By predicting the nutritional needs of poultry at different stages as accurately as possible, the model can help formulate more scientific and reasonable feed formulation. We aimed to estimate the non-phytate phosphorus (NPP) requirements of Chinese Jing Tint 6 layer chicks. We randomly allocated 720 birds to five treatments with six cages of 24 birds each, feeding them a corn–soybean diet containing 0.36%, 0.41%, 0.46%, 0.51%, and 0.56% NNP. The results showed that the body weight gain (BWG), tibial length, and apparent total tract digestibility coefficients (ATTDC) of P were affected (p < 0.05) by dietary NPP level. A quadratic broken-line analysis (p < 0.05) of BWG indicated that the optimal NPP for birds aged 1–14 d was 0.411%. Similarly, 0.409% of NPP met tibial growth needs. However, 0.394% of NPP was optimal for P utilization according to the ATTDC criterion. For 15–42 d birds, 0.466% NPP, as estimated by the BWG criterion, was sufficient for optimal growth without decreasing P utilization. Using the factorial method, NPP requirements were calculated as 0.367% and 0.439%, based on the maintenance factors and BWG for 1–14 and 15–42 d birds, respectively, to maintain normal growth. Combining the non-linear model with the factorial method, this study recommends dietary NPP levels of 0.367% and 0.439% for 1–14 and 15–42 d birds, respectively, to optimize P utilization without affecting performance. [ABSTRACT FROM AUTHOR]

Background: Both kinematically-aligned (KA) total knee arthroplasty (TKA) and bicruciate stabilized (BCS) TKA aim to reproduce the physiological knee kinematics. In this study, we compared the femoro-tibial component rotational mismatch between patients who underwent modified KA-TKA and those who received guided-motion BCS-TKA, and its influence on the clinical outcomes. Methods: In this retrospective study, 77 consecutive patients were included and divided into two groups: subjects who underwent modified KA-TKA with Persona (KA Group; n = 42) and those who received BCS-TKA with JOURNEY II (BCS group; n = 35). Range of motion, the 2011 Knee Society Score (KSS), the rotational alignment of the femoral and tibial components, and the correlations between the rotational mismatch and the 2011 KSS subscales were examined. Results: The postoperative objective knee indicators (P = 0.0157), patient satisfaction (P = 0.0039) and functional activity scores (P = 0.0013) in the KA group were significantly superior to those in the BCS group 1 year postoperatively. There was no significant difference between the two groups observed in the rotational mismatch. In the BCS group, significant negative correlations were identified between the rotational mismatch and objective indicators, patient satisfaction, and functional activity scores but not in the KA group. Conclusions: The short-term clinical results following KA-TKA showed superior objective knee indicators, patient satisfaction and functional activity scores. A negative correlation was observed between component rotational mismatch and the 2011 KSS subscales in the BCS group, compared to no relationship found between the two in the KA group. These findings suggested that KA-TKA has a relatively higher tolerance for rotational mismatch than BCS-TKA. [ABSTRACT FROM AUTHOR]

The incidence of paediatric fractures among winter sport athletes is not adequately studied. Our objective was to categorize fractures that occurred in paediatric skiers and snowboarders at a single ski resort. X-rays of 756 skiers/snowboarders aged 3–17 diagnosed with a fracture were categorized using the Salter-Harris (SH) classification. SH fractures were seen in 158 (21%) patients, with 123 (77%) being Type II. There were no significant differences between patients with a SH fracture and patients with a non-SH fracture for age, sex, snowboarding or skiing, mechanism of injury, terrain or the resort conditions on the day of injury. The most common mechanism of injury was falling onto snow while collisions resulted in more severe injuries. Compared to fractures without growth plate involvement, a higher proportion of SH fractures were seen in the humerus, radius, fibula and thumb; a lower proportion of SH fractures were observed at the tibia and clavicle. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the clinical outcomes of the use of tibiotalocalcaneal nail for the treatment of complex distal tibia and ankle fractures in elderly people, in a major trauma centre. Methods: Elderly patients (age > 65) with distal tibia or ankle fractures that underwent stabilization with a tibiotalocalcaneal nail were eligible to participate. Exclusion criteria were patients that died or were lost to follow-up and cases in which the nail was used in a chronic setting, such as malunion and non-union. Main parameters evaluated were fracture union, complications and functional outcomes. The functional outcome was assessed using the Olerud–Molander Ankle Score (OMAS). The minimum follow-up was 12 months. Results: Thirty-two consecutive patients (12 males) with a mean age of 80.2 years (range 66–98) met the inclusion criteria and formed the basis of this study. Fracture union was achieved in 93.8% of the cases at a mean time of 3.9 months (range 2–8). Two patients developed surgical site infections and underwent reoperation before union. The overall complication rate was 25.1%, while the respective reintervention rate was 18.8%. In terms of functional outcomes, the mean OMAS score was 45, ranging from 20 to 70. Conclusion: Tibiotalocalcaneal nailing can be considered as an acceptable less invasive option with good functional outcomes for the treatment of complex distal tibia and ankle fractures in frail patients with problematic local soft tissues. [ABSTRACT FROM AUTHOR]

Purpose: To compare clinical outcomes of high tibial osteotomy (HTO) and unicompartmental knee arthroplasty (UKA) for anterior medial osteoarthritis (AMOA) as well as offer surgical recommendations through age stratification. Methods: Between May 2019 and May 2021, 68 cross-indicated AMOA patients were analyzed. The patients were divided into HTO and UKA groups and further into two age groups of 55–60 and 60–65 years. Additionally, general data, visual analog scale (VAS) score, and Hospital for Special Surgery knee score (HSS) were analyzed. Results: All the patients were followed up for 18 months. Knee joint HSS significantly improved, and VAS score decreased in both groups (P < 0.05). In the 55–60 age group, HTO showed superior knee HSS at 1 and 3 months (P < 0.05), with no significant difference at 6, 12, and 18 months. HTO had a significantly lower VAS score at one month, and the VAS scores of the two groups decreased gradually with no significant difference. In the 60–65 age group, the UKA group showed superior knee joint HSS at one month, with no significant difference at 3, 6, 12, and 18 months. The UKA group had a significantly lower VAS score at one month, and both groups' VAS scores decreased gradually with no significant difference. Conclusion: Both methods yield satisfactory results for AMOA cross-indications, improving knee joint function. The observed recovery trends have implications for personalized surgical recommendations, guiding interventions based on age-specific considerations for optimal outcomes in anterior medial osteoarthritis cases. [ABSTRACT FROM AUTHOR]

Purpose: Lateral hinge fractures are the main complications in the high tibial osteotomy to treat varus deformities. The aim of present study is to answer the question whether the lateral hinge length (H) has an effect on the type of fracture and required force during the opening in high tibia osteotomy. It was hypothesized in this comparative research that extending the hinge length increased opening force and probability of a type II and type III fractures. Methods: A monoplanar medial open wedge osteotomy with different intact hinge lengths varying from 9 to 32 mm was performed in 20 ostrich bones. A biomechanical experiment using unidirectional tensile testing apparatus was performed to open the wedge, and the required force was increased until a 10 mm opening was reached; then, the presence of fracture in the lateral cortex and its direction were evaluated. Lateral hinge fracture type based on direction was classified as suggested by Takeuchi et al. Results: Fracture that grows along the osteotomy line (type I) was observed in 4 samples with the mean hinge length (H) of 11 ± 1.54 mm. For seven bones with Takeuchi fracture type II, with downward crack propagation, the mean H was 16 ± 3.36 mm. For the mean H of 25 ± 6.53 mm, the crack propagated upward to the cutting path, displaying a Takeuchi type III fracture in seven samples. The statistical analysis showed that the fracture type significantly depends on the hinge length (P value < 0.05). Also, the mean opening force significantly increased with hinge lengthening (P value < 0.05). The peak forces at crack initiation were 41.8 ± 21.9, 115.2 ± 41.5, and 167 ± 135.3 N, respectively, for the fracture types I, II, and III samples. Conclusion: The lateral cortical hinge length was significantly associated with hinge fracture type. The experimental tests indicated that the hinge lengthening increases the risk of type II and III fractures, as classified by Takeuchi. [ABSTRACT FROM AUTHOR]

The use of custom-made foot orthoses has been associated with numerous benefits, such as decreased impact accelerations. However, it is not known whether this effect could be due to better customisation. The present study analysed the effects of the first generation of a microwavable prefabricated self-customised foot orthosis vs. a prefabricated standard one on impact accelerations throughout a prolonged run. Thirty runners performed two tests of 30-min running on a treadmill, each one with an orthosis condition. Impact acceleration variables of tibia and head were recorded every 5 min. Microwavable self-customised foot orthosis increased the following variables in the first instants compared to the prefabricated standard one: tibial peak (min1: 6.5 (1.8) vs. 6.0 (1.7) g, P =.009, min5: 6.6 (1.7) vs. 6.2 (1.7) g, P =.035), tibial magnitude (min1: 8.3 (2.6) vs. 7.7 (2.4) g, P =.030, min5: 8.5 (2.6) vs. 7.9 (2.5) g, P =.026) and shock attenuation (min1: 61.4 (16.8) vs. 56.3 (16.3)%, P =.014, min5: 62.0 (15.5) vs. 57.2 (15.3)%, P =.040), and tibial rate throughout the entire run (504.3 (229.7) vs. 422.7 (212.9) g/s, P =.006). However, it was more stable throughout 30-min running (P <.05). These results show that the shape customisation entailed by the thermoformable material does not provide impact acceleration improvements. [ABSTRACT FROM AUTHOR]

Objectives: Comparisons between Indigenous peoples over time and within a particular geographic region can shed light on the impact of environmental transitions on the skeleton, including relative bone strength, sexual dimorphism, and age‐related changes. Here we compare long bone structural properties of the inhabitants of the late prehistoric‐early historic Pecos Pueblo with those of present‐day Indigenous individuals from New Mexico. Materials and Methods: Femora and tibiae of 126 adults from Pecos Pueblo and 226 present‐day adults were included in the study. Cross‐sectional diaphyseal properties—areas and second moments of area—were obtained from past studies of the Pecos Pueblo skeletal sample, and from computed tomography scans of recently deceased individuals in the present‐day sample. Results: Femora and tibiae from Pecos individuals are stronger relative to body size than those of present‐day Indigenous individuals. Present‐day individuals are taller but not wider, and this body shape difference affects cross‐sectional shape, more strongly proximally. The tibia shows anteroposterior strengthening among Pecos individuals, especially among males. Sexual dimorphism in midshaft bone shape is stronger within the Pecos Pueblo sample. With aging, Pecos individuals show more medullary expansion but also more subperiosteal expansion than present‐day individuals, maintaining bone strength despite cortical thinning. Discussion: Higher activity levels, carried out over rough terrain and throughout adult life, likely explain the relatively stronger lower limb bones of the Pecos individuals, as well as their greater subperiosteal expansion with aging. Greater sexual dimorphism in bone structure among Pecos individuals potentially reflects greater gender‐based differences in behavioral patterns. [ABSTRACT FROM AUTHOR]