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Objective This project is designed to examine the prevalence of skeletal pathology in two archaeological avian bone assemblages. Materials Archaeological avian bone assemblages with Number of Identified Specimens of 14,909 (UNL-055) and 36,866 (UNL-048). Methods Visual examination of humeri, coracoids, tarsometatarsi, and cranial elements for pathology during taxonomic identification. Results 83 instances of skeletal pathology were observed in these assemblages and were most prevalent in the UNL-048 assemblage. Marginal osteophytes around the articular surfaces of the coracoid were the primary bone pathology in the UNL-048 avian assemblage. Conclusions The prevalence of osteoarthritis in surface diving birds at the UNL-048 site could be due to changing climate. Significance Considering the environmental factors that contribute to instances of animal pathology allows for a more contextual interpretation of the cultural processes that occurred at archaeological sites. Limitations Time and budgetary constraints did not allow for examination of the entire avian assemblage. Suggestions for future research Further intensive review of archaeological avian assemblages alongside consideration of environmental and cultural processes occurring during the site occupation is advised.

Few studies have been reported about kinematic comparison between bicruciate stabilized and cruciate retaining total knee arthroplasty with the same anatomical surface geometry. The aim of this study was to demonstrate the in vivo kinematics and postoperative patient-reported outcomes of these two surgeries with the same anatomical surface geometry. We analyzed 17 bicruciate stabilized and 18 cruciate retaining total knee arthroplasties using single-plane fluoroscopic surveillance with two- to three-dimensional registration techniques during squatting from minimum to maximum flexion. Flexion angle, femoral external rotation, anteroposterior position of the medial and lateral sides, and postoperative 2011 Knee Society Scores were analyzed. Maximum flexion angles were larger for bicruciate stabilized than for cruciate retaining total knee arthroplasties. There was no significant difference in femoral external rotation between the two types. The medial and lateral femoral condyles in bicruciate stabilized type translated more posteriorly during deeper flexion and at maximum flexion angle, respectively, than those in cruciate retaining total knee arthroplasty. Both groups revealed medial pivots in early flexion, but during deep flexion, bicruciate stabilized total knee arthroplasty revealed bicondylar roll-back and cruciate retaining total knee arthroplasty revealed paradoxical anterior motion. Both groups exhibited similar results in postoperative 2011 Knee Society Scores. Bicruciate stabilized and cruciate retaining total knee arthroplasties with the same anatomical articular surfaces demonstrated different kinematics patterns during squatting. However, there were no significant differences in postoperative 2011 Knee Society Scores between the two types of surgery.

Introduction: Radiocarpal fracture-dislocations consist of the total loss of contact between the articular surfaces of the first row of the carpus and the radius. They are caused by high-energy trauma. The purpose of the work is to retrospectively evaluate a series of cases to compare the incidence of these lesions, their therapeutic management and functional outcomes with the literature published by reference centers in this pathology. Materials and Methods: Between February 2018 and June 2020 we retrospectively evaluated patients with radiocarpal fracture-dislocations, which were classified into groups I and II according to Dumontier.Inclusion criteria: males and females over 18 years of age with closed or open radiocarpal fracture-dislocations with a minimum follow-up of 3 months. A clinical/imaging follow-up was carried out using radiographs, the DASH questionnaire (Disabilities of the Arm, Shoulder and Hand), Modified Mayo Wrist Score, visual analog scale (VAS) and Patient Satisfaction Questionnaire Short Form (PSQ-18). Results: Eight patients with nine lesions with an average follow-up of 8 months were evaluated. Lesions weregrouped into type 1 (4) and type II (5). All were surgically treated. According to the final values, outcomes were excellent in two cases, good/acceptable in six, and poor in one. Conclusion: We believe that the best method for definitive treatment is surgical. The correct classification and study of the pathology will play a fundamental role in making therapeutic decisions.

Summary Objective The objectives of this study were: first, to compare solute uptake driven by sliding to cyclic uniaxial compression. And secondly, to evaluate the role of the superficial region on passive diffusion to determine if mechanical action is merely overcoming the low permeability of the superficial region or exceeding equilibrium capacity of the tissue. Design Tests were performed on osteochondral plugs under two types of conditions: cyclic loading (sliding vs axial compression) and unloaded passive diffusion (intact vs superficial zone removed). The articular surfaces were exposed to a fluorescent bath and uptake was quantified from the surface to the subchondral bone using fluorescent microscopy. Primary outcome measures were total mass transfer, mass transfer rate, and surface partition factor. Results Mass transfer was 2.1-fold higher at 0.5 h for sliding compared to uniaxial compression (p = 0.004). This increased to 4.4-fold at 2 h (p = 0.002). Solute transport for both loading conditions at 2 h had reached or exceeded intact passive diffusion at 12 h. Total mass transport and mass transport per hour was higher in samples without the superficial region compared to intact samples at equilibrium. Rate of mass transfer was not declining for samples subject to sliding indicating solute uptake induced by sliding would exceed passive tissue capacity. Conclusions These results are the first to quantify solute uptake between two components of joint articulation. The study demonstrates that sliding is a larger driver of solute transport compared to cyclic uniaxial compression. This has implications for cell nutrition, tissue engineering and biochemical signaling.

Objective We report a probable case of multiple skeletal dysplasia observed in a Late Iron Age young adult male. Materials The individual studied belongs to a Late Iron Age necropolis from Switzerland. The skeletal elements are well preserved Methods Macroscopic and radiographic assessment. Results The individual shows evidence of both craniofacial and mandibular deformation. Developmental defects are also visible with effects on the general shape and articular surfaces of both humeri, as well as the left femur and tibia. Conclusion We propose that the lesions observed are manifestations of skeletal dysplasia, such as pseudo-achondroplasia or multiple epiphyseal dysplasia. Significance This is the first recorded case of multiple skeletal dysplasia in an Iron Age necropolis in Switzerland, questioning the integration of physically compromised individuals in La Tene society. Limitations Examination of other skeletal dysplasias from archaeological contexts provides support for this diagnosis. Suggestions for future research The integration of individuals with disabilities in La Tene societies is still poorly understood and further research is needed to better characterize these communities.

Background: Bipolar or “kissing” cartilage lesions formed on 2 opposite articular surfaces of the knee joint are commonly listed as exclusion criteria for advanced cartilage therapies. Purpose: To test, in a pilot large-animal study, whether autologous nasal chondrocyte (NC)–based tissue engineering, recently introduced for the treatment of focal cartilage injuries, could provide a solution for challenging kissing lesions. Study Design: Controlled laboratory study. Methods: Osteochondral kissing lesions were freshly introduced into the knee joints of 26 sheep and covered with NC-based grafts with a low or high hyaline-like extracellular matrix; a control group was treated with a cell-free scaffold collagen membrane (SCA). The cartilage repair site was assessed at 6 weeks and 6 months after implantation by histology, immunohistochemistry, and magnetic resonance imaging evaluation. Results: NC-based grafts, independently of their composition, induced partial hyaline cartilage repair with stable integrity in surrounding healthy tissue at 6 months after treatment. The SCA repaired cartilage to a similar degree to that of NC-based grafts. Conclusion: Kissing lesion repair, as evidenced in this sheep study, demonstrated the feasibility of the treatment of complex cartilage injuries with advanced biological methods. However, the potential advantages of an NC-based approach over a cell-free approach warrant further investigations in a more relevant preclinical model. Clinical Relevance: NC-based grafts currently undergoing phase II clinical trials have a high potential to replace existing cartilage therapies that show significant limitations in the quality and reproducibility of the repair method. We have brought this innovative concept to the next level by addressing a new clinical indication.

Objectives The competing functional demands of diarthrodial joints, permitting mobility while retaining enough stability to transmit forces across the joint, have been linked with the shape and size of the joint's articular surfaces. A clear understanding of the relationship between joint morphology and joint movement potential is important for reconstructing locomotor behaviors in fossil taxa. Methods In a sample of matched tali and calcanei of lorisids (n = 28) and cheirogaleids (n = 38), we quantify the surface areas of the talar and calcaneal ectal (=posterior talocalcaneal) articular surfaces and model the principal curvatures of these surfaces with quadric formulas. These two taxonomic groups have similar body masses, but differ substantially in positional behavior, so that differences in joint surface morphology should reflect adaptive demands of their locomotor behavior. Results Compared with cheirogaleids, lorisids exhibit: (a) a significantly greater area difference between their paired joint surfaces; and (b) a more pronounced saddle shape for the talar ectal facet. Conclusion The increased subtalar joint mobility observed in lorisids may be achieved by increasing the amount of sliding and rolling that can occur at the subtalar joint. The subtalar joint morphology observed in two fossil euarchontans, the plesiadapiforms Purgatorius sp. and Plesiadapis cookei, compares favorably with the morphology observed among lorisids, potentially suggesting antipronograde postures within these extinct taxa.

As applied to bone, ���determinate growth��� identifies an upper limit to size and the point when normal endochondral ossification ceases. This contrasts with ���indeterminate growth���, which proceeds through the entire life of the animal. In this study, a non-destructive method, epi-illumination surface microscopy of the articular surfaces of long bones, is applied for the first time in 40 taxa of non-avian dinosaurs to determine cessation of endochondral growth. Thereby, the presence or absence of articular vascular channels between the endochondral bone and the cartilage is assessed. As articular vascular channels are the major source of nutrients for continued longitudinal growth, atrophy or loss of those channels would preclude continued growth of bone. We correlated our findings with published histological data and bone length measurements. We found articular vascular channels in all assessed dinosaur groups, but some individuals showed a loss of detectable articular vascular channels ��� what we interpret as evidence of longitudinal skeletal growth cessation. This observation contrasts with the hypothesis of continuous indeterminate growth in dinosaurs, at least for the taxa identified here, in which channels have been documented as closed or closing over. The new method introduced here provides a phylogenetic tool for definitively distinguishing new ���dwarf��� species from juveniles of known species. Furthermore, this study confirms the rarity of skeletally mature dinosaurs discovered to date and indicates that we have only begun to witness the full extent of dinosaur growth. Bruce M. Rothschild [spondylair@gmail.com], Carnegie Museum, 4400 Forbes Ave, Pittsburgh, PA 15213, USA; Florian Witzmann* [florian.witzmann@mfn.berlin], Museum f��r Naturkunde, Leibniz Institute for Evolution and Biodiversity Science, Invalidenstra��e 43, 10115 Berlin, Germany.

Introduction Although arthroscopic acromioclavicular (AC) joint resection is a frequently performed procedure, the pathophysiology of non-traumatic AC joint degeneration is still unclear. The purpose of this study was to investigate whether non-traumatic AC joint degeneration shows a typical pattern and whether it starts at the posterior part of the joint with malalignment of the articular surfaces. Materials and methods In a retrospective monocentric diagnostic study, healthy and affected subjects were investigated using T2 magnet resonance imaging (MRI) scans in the transverse plane. Group 1 included 30 healthy asymptomatic adults with no history of trauma (mean age, 38.6 years). In group 2, 90 patients with symptomatic AC joints who underwent arthroscopic AC joint resection were included (mean age, 60.0 years). All patients with relevant pathologies that affect the AC joint were excluded. Malalignment was defined as posterior joint space smaller than 2 mm in conjunction with an AC angle lower than 12°. Results The measured values were (mean group 1 in mm; mean group 2 in mm; p-value): anterior joint space (6.07; 5.63; 0.50), central joint space (2.97; 2.09; 0.001), and posterior joint space (3.97; 2.38; 0,001), AC angle (7.63; 19.2; 0.001). In group 1, n = 24 (80%) of subjects showed aligned AC joints, whereas in group 2, only n = 11 (12.2%) of joints were aligned (p p = 0.021). Conclusions Patients with symptomatic degenerative changes of the AC joint show a typical pattern of anterior opening of the joint with early contact of the posterior joint surfaces in contrast to healthy subjects. Increasing age influences this effect.

Relevance. Koenigs disease, or osteochondritis dissecans of the knee joint, has been known since the end of the 16th century. The incidence is high (18-30 cases per 100 thousand of the population), while there is no common opinion on the management tactics and the treatment method for this pathology. Incorrect treatment choice as well as the lack of active management tactics provokes inevitably the transformation of primary pathology in early deforming arthrosis, followed by a pronounced decrease in joint function and the working capacity of an adult patient. Material and methods: electronic scientific library PubMed, SciVerse (Science Direct), and Scopus were the open Internet tools we searched for literature sources. For data search we used following keywords: dissecting osteochondritis, Koenigs disease, osteochondritis dissecans. The article presents the main results in the publications of domestic and foreign experts with an emphasis on the diagnosis and treatment of dissecting osteochondritis. In some cases, their own comments about the diagnosis and treatment are made. Conclusion. In our opinion, the surgical objectives are to restore the congruency of the articular surfaces by improving vascularization of the affected area, tight fixation of the unstable fragment and protecting the supporting part of the loaded condyle section in the postoperative period. Due to the rarity of such a pathology and the lack of research with a high level of evidence base, further development of treatment methods is actual.

Bilateral condylar fractures are common but are frequently undertreated. In most of the cases, only one side is surgically addressed and the other side is managed conservatively. Bilateral condylar fractures lead to loss of ramal height bilaterally, accentuated anterior open bite, disruption of articular surfaces, and disc and muscle attachments. In a mandibular bilateral condylar fracture, even though open reduction and internal fixation (ORIF) is done on one side, a patient still needs Inter Maxillary Fixation (IMF) for 2-4 weeks postoperatively to correct occlusion and deviation. The possibility of doing ORIF on the other is never explored. Here, we present two cases of bilateral condylar fracture treated both sides by ORIF. The article discusses the advantages and new approach to consider treating both sides.

Background The high prevalence of foot pathologies in women and the elderly is suggested to be linked to sex- and age-related differences in the calcaneal morphology. Given that, it is expected that there also exists sex- and age-related differences of the articular morphology in the keystone of the foot, the talus. The present study investigated the orientation and curvature of the three articular surfaces of the talus in relation to sex and age based on computer tomography (CT). Methods The CT images of 56 feet were used in this study. The orientations of the talocrural, subtalar, and talonavicular joints were quantified three-dimensionally by calculating normal and principal axes of the articular surfaces defined by planar approximation. The curvature radii of the articular surfaces were also quantified by cylindrical and spherical approximations. Results The talonavicular surface was significantly more twisted and less internally rotated in females than in males. With aging, the subtalar articular surface was significantly facing more posteriorly. Moreover, it was found that the curvature radii of the trochlea and navicular articular surfaces significantly increased with aging, indicating the flattening of the articular surfaces. Conclusion The sex- and age-related differences in talar articular morphology were observed. The substantial degeneration pattern of the talar morphology with aging could potentially lead to a higher prevalence of foot disorders in the elderly.

Objective. To prove the dependence of a fracture or dislocation of the acromial end of the clavicle on the features of the shape of the arrangement of the articular surfaces of the clavicle and acromion. Materials and methods. We conducted anatomical studies on 50 unfixed and unopened corpses of people of both sexes and aged 20 to 60 years. Among them, there were 35 men and 15 women. At the same time, we observed three forms of variability in the arrangement of the articular surfaces of the acromion and clavicle. Results. We studied the radiological forms of the location of the articular surfaces of the clavicle and acromion in 50 patients with a collarbone fracture and in 50 patients with dislocation of the acromial end of the clavicle from 20 to 55 years old, among them 30 were men, 20 women. In all cases, the trauma mechanism was indirect. A certain relationship was revealed between the frequency of a fracture or dislocation and the form of arrangement of the articular surfaces of the acromion and clavicle. Clavicle fracture more often (78.0%) occurred with a vertical arrangement of the articular surfaces of aroma and clavicle. Conclusion. Anatomical and clinical-radiological studies have shown the dependence of the fracture or dislocation of the acromial end of the clavicle on the peculiarities of the arrangement of the articular surfaces of the clavicle and acromion.

Osteoarthritis (OA) is one of the most common causes of disability throughout the world. Current therapeutic strategies are aimed at preventing the development and delaying the progression of OA, as well as repairing or replacing worn articular surfaces, because the regeneration of lost hyaline articular cartilage is not currently a clinically feasible option. Imaging is useful in formulating treatment strategies in patients at risk for OA, allowing assessment of risk factors, the degree of preexisting tissue damage, and posttreatment monitoring. Magnetic resonance imaging (MRI), in particular, provides in-depth evaluation of these patients, with optimal clinical sequencing allowing sensitive assessment of chondral signal and morphology, and the addition of advanced MRI techniques facilitating comprehensive evaluation of joint health, with increased sensitivity for changes in articular cartilage and surrounding joint tissues.

Background: Fractures of proximal humerus are very common. Many options are available for its management including non-operative management. Reconstruction of the articular surfaces including restoration of the anatomy and a stable fixation with minimal soft tissue damage is the main principle of this procedure. Percutaneous pinning is the less invasive, less time consuming and reliable procedure and avoids complications such as avascular necrosis, infections and heavy weight bearing implants. Aims and Objectives: 1. To study the clinical profile of adult patients with proximal humeral fractures. 2. To study the functional outcome of closed reduction and percutaneous pinning of proximal humeral fractures. 3. To study the factors affecting functional outcome of proximal humeral fractures. Materials and Methods: This is a prospective study among 32 patients on whom percutaneous pinning was done after closed reduction for the fractures of proximal humerus. This study was conducted from August 2014 to December 2016. Results: According to Neer's functional assessment score the functional outcome was excellent in 18 (56.3%) patients, satisfactory in 6 (18.8%) patients, unsatisfactory in 7 (21.9%) patients and failure in 1 (3.1%) patient. Conclusion: Percutaneous pinning is simple, less invasive, reliable and effective procedure. It reduces risk of heavy implant bearing, infection and avascular necrosis.

IntroductionAnatomic cruciate ligament reconstruction is known to be correlated with better clinical results. The aim of the study was to provide a simple method to enable anatomic results in the setting of PCL reconstruction. We, therefore, assessed the tibial and femoral insertion site of the posterior cruciate ligament (PCL) by the use of an objective coordinate system in an anatomical study. We also sought to show reproducibility of these measurements using intra- and inter-observer coefficients.Materials and methodsWe studied 64 knees, previously preserved according to Thiel’s technique. After proper preparation of the articular surfaces of both the tibiae and femora, photographs were taken according to a standardized protocol. PCL footprints were measured by the use of a coordinate system twice by two examiners. We evaluated these measurements by use of the Cohen’s kappa inter- and intra-observer coefficient for two observers.ResultsTibial and femoral measurements of PCL footprints were generated with highly comparable inter- (k = 0.970) and intra-observer (k = 0.992) coefficients and may, therefore, be considered as highly reproducible.ConclusionOur findings confirmed the reproducibility of defining PCL footprints using a coordinate system and may contribute to planning intraoperative graft-placement to ensure optimal conditions in the upcoming techniques for PCL reconstruction.

The sheep middle ear has been used in training to prepare physicians to perform surgeries and to test new ways of surgical access. This study aimed to (1) collect anatomical data and inertial properties of the sheep middle-ear ossicles and (2) explore effects of these features on sound transmission, in comparison to those of the human. Characteristic dimensions and inertial properties of the middle-ear ossicles of White-Alpine sheep (n = 11) were measured from high-resolution micro-CT data, and were assessed in comparison with the corresponding values of the human middle ear. The sheep middle-ear ossicles differed from those of human in several ways: anteroinferior orientation of the malleus handle, relatively small size of the incus with a relatively short distance to the lenticular process, a large area of the articular surfaces at the incudostapedial joint, and a relatively small moment of inertia along the anterior–posterior axis. Analysis in this study suggests that structure and orientation of the middle-ear ossicles in the sheep are conducive to an increase in the hinge-like ossicular-lever-action around the anterior–posterior axis. Considering the substantial anatomical differences, outcomes of middle-ear surgeries would presumably be difficult to assess from experiments using the sheep middle ear.

Background: Appropriate component sizing plays an important role in determining the functional outcome following total knee arthroplasty. Comparative studies of different populations have shown significant differences in the anthropometric parameters of knees in different race groups which negates the possibility of using a single sized implant system across different ethnic groups. This study evaluates the dimensions of femoral and tibial articular surfaces of Indian patients and compares the parameters with other ethnic groups and correlates the dimensions with five different commercially available knee systems. Material & Methods: Computerized tomography (CT) scans of contralateral normal knees of patients who underwent the scan for various ailments of the knee were retrieved retrospectively from the hospital database and 3D reconstruction of the images was done. Mediolateral dimensions (fML,tML), Anteroposterior dimensions (fAP, tAP) and aspect ratio (fML/fAP, tML/tAP) of the femur and tibia respectively were calculated and compared with the dimensions of different ethnic groups as well as the femoral and tibial components of five different knee prosthesis systems. Results The average fML in the study group was less than that of Caucasian knees but was marginally larger than other ethnic groups. The fAP, tML and tAP was found to be smaller than all other ethnic groups but a larger femoral aspect ratio was reported than other ethnic groups. Among the implant systems, only NexGen LPS and Scorpio NRG implant femoral components closely matched the femoral dimensions in the study group whereas all implant systems showed significant mismatch with tibial component dimensions when compared to the study populations. Conclusion This study concludes that the dimensions of Indian knees are different from other ethnic groups and the use of commercially available knee Implants designed based on measurements in Caucasian populations can lead to significant mismatch between implant and resected bone surfaces.

The Kinematic Alignment (KA) technique for total knee arthroplasty (TKA) is an alternative surgical technique aiming to resurface knee articular surfaces. The restricted KA (rKA) technique for TKA applies boundaries to the KA technique in order to avoid reproducing extreme constitutional limb/knee anatomies. The vast majority of TKA cases are straightforward and can be performed with KA in a standard (unrestricted) fashion. There are some specific situations where performing KA TKA may be more challenging (complex KA TKA cases) and surgical technique adaptations should be included. To secure good clinical outcomes, complex KA TKA cases must be preoperatively recognized, and planned accordingly. The proposed classification system describes six specific issues that must be considered when aiming for a KA TKA implantation. Specific recommendations for each situation type should improve the reliability of the prosthetic implantation to the benefit of the patient. The proposed classification system could contribute to the adoption of a common language within our orthopaedic community that would ease inter-surgeon communication and could benefit the teaching of the KA technique. This proposed classification system is not exhaustive and will certainly be improved over time. Cite this article: EFORT Open Rev 2021;6:881-891. DOI: 10.1302/2058-5241.6.210042

The management of Kienbock’s Disease presents a challenge to the treating surgeon. Arthroscopy should be used in conjunction with a thorough clinical review and appropriate investigations. Diagnostic arthroscopy is the most effective way to assess the articular surfaces and soft tissues within the wrist. Arthroscopic treatment confers a number of benefits, allowing for a minimally invasive directed approach to the patient with KD. It should be used with an algorithm-based approach, respecting the status of the patient, the lunate, and the wrist.

This study aimed to analyze the possibility of using spherical contact pairs to model the articular surfaces of the joints of the wrist. To do so, a three-dimensional surface model of the bones in the wrist was created based on medical scans from computer tomography. Twenty-two pairs of surfaces, which represented the contact areas, were selected and cut out of the model. After that, these pairs were imported into custom software in Python, which allowed for numerical sphere fitting using optimization. The obtained results were then analyzed in terms of the validity of the obtained contact pairs, whether they formed actual ball-and-socket joints and based on fit quality. To verify the results obtained from the first model, a second set of meshes was obtained. The obtained results showed that for most of the joints in the wrist, the spherical approximation might be a viable choice. In some of the cases, the returned radii of the spheres were unusually large, which could mean that different contact pairs, such as the sphere-plane type might be more accurate.

The menisci are fibroelastic structures interposed between the articular surfaces of the femur and tibia. They absorb impact and transmit load. Meniscal injury may compromise function and cause rapid joint degeneration, leading to the development of secondary osteoarthritis. Surgical treatment of meniscal injury is usually performed by arthroscopy, and meniscectomy or meniscal suture may be associated with such treatment. Meniscal repair should be considered when the injury compromises the proper functioning of the meniscus to recover its anatomy and function. Different meniscal suture techniques exist; the most widely used are the inside-out, outside-in, and all-inside techniques. The gold-standard repair technique is the inside-out technique. A drawback of this technique is the need to alternate between intra- and extra-articular structures for every stitch, which makes it even more laborious. We describe the continuous meniscal suture technique, also called “meniscal stitching,” for a medial meniscal bucket-handle injury. This technique is performed from the inside out and allows the surgeon to perform multiple stitches with the same thread quickly and effectively. This surgical technique is performed using a single meniscal suture device, called the “Meniscus 4 A-II” device (Síntegra Surgical, Pompéia,SP, Brazil).

Although joints with synovial cavities and articular surfaces are very variable, they all have one common peculiarity. In most cases, one of the articular surfaces is concave, whereas the other one is convex. During the formation of a joint, the epiphysis, which has less kinetic energy during the movements in the joint, forms a convex surface, whereas large kinetic energy forms the epiphysis with a concave surface. Basing on this concept, the analysis of the structure of the joints, allows to determine forces involved into their formation, and to identify the general patterns of the formation of the skeleton.

To use T2 relaxation time distribution profiles to assess inter-group regional differences along articular surfaces and to evaluate the feasibility of this analysis for comparison of cartilage insufficiency. Twelve pairs matched according to age and gender (12 healthy volunteers and 12 patients after anterior cruciate ligament reconstruction (ACLR)) underwent 3-T MRI. T2 maps were calculated from six time echo images of the mid-sagittal slice in the lateral and medial compartment. The femoral and tibial cartilage was analyzed by measuring T2 distribution profiles along the articular surfaces. T2 distribution profiles were generated along the length of the articular surface in the femorotibial compartments. Differences in the T2 distribution profiles between the tibial and femoral cartilage as well as between the cartilage of the femoral condyles were identified in healthy individuals. T2 distribution profiles clearly demonstrated cartilage insufficiency in the weight-bearing areas for subjects in the ACLR group. T2 distribution profiles can identify regional differences in femoral and tibial cartilage. The T2 distribution profile pattern is preserved with cartilage insufficiency, however, with important differences in T2 values for the ACLR group in weight-bearing areas.

SummaryNonlinear articular geometries of biological joints have contributed to highly agile and adaptable human-body motions. However, human–machine interaction could potentially distort natural human motions if the artificial mechanisms overload the articular surfaces and constrain biological joint kinematics. It is desired to better understand the deformable articular geometries of biological joints in vivo during movements for design and control of wearable robotics. An articular geometry reconstruction method is proposed to measure the effective articular profile with a wearable compliant device and illustrated with its application to knee-joint kinematic analysis. Regarding the joint articulation as boundary constraints for the compliant mechanism, the equivalent articular geometry is constructed from the beam deformations driven by knee motions, where the continuous deformations are estimated with strain data from the embedded sensors. Both simulated analysis and experimental validation are presented to justify the proposed method.

Objective The aim of this study was to determine if articulated joint distraction in the canine elbow can effectively maintain a distraction gap between the articular surfaces of the canine elbow under a weight-bearing load. Study Design An articulated external skeletal fixator with turnbuckles was applied to seven canine cadaveric elbow specimens. Specimens were potted and mechanically tested at 135° of flexion, while joint contact pressure was recorded at three locations within the elbow. Joint distraction was sequentially increased, and loads of 5 N, 90 N and 180 N were incrementally applied. This process was repeated until no pressure was recorded at each of the three locations within the elbow under 180 N of applied load. Results To achieve 0 N of joint contact force with 180 N of axial load, the average amount of distraction needed was 2.3 ± 0.71 mm (range, 1.8–3.6 mm) at the distal turnbuckles and 1.67 ± 1.10 mm (range, 1.8–2.7 mm) at the proximal turnbuckles. Conclusion Results suggest that joint distraction can effectively decrease articular pressure within the canine elbow joint. A maximum of 3.6 mm of distraction between the fixator turnbuckles was necessary to eliminate joint contact for the construct tested. Clinical investigation is necessary to establish if articulated elbow joint distraction is a safe and effective for the treatment of canine elbow osteoarthritis.

Purpose of the study — to justify the algorithm for evaluation of bipolar defects in anterior shoulder instrability using the most accurate, statistically significant and reproducible methods which would make the algorithm applicable in practical surgery.Materials and methods. The authors established 4 groups with 6 patients in each with shoulder instability, group distribution was based on glenoid defect size: small (15%), moderate (15-19%), large (20-25%) and massive (25%). All 24 patients underwent 3D-CT, 3D VIBE MRI and shoulder arthroscopy. Measurements were taken by 7 specialists 5 of whom measured defect during arthroscopy. Glenoid defect was measured by linear and sectional relation methods. Pico method on 3D-CT was taken as the “golden standard”. Accuracy was verified by analysis of variance with post-hoc comparison. Reproducibility was evaluated by intraclass correlation coefficient.Results. All groups excluding the one with massive glenoid defects demonstrated significant differences from the model (p≤0,05) for measurements during arthroscopy and examinations by 3D-CT and 3D VIBE MRI. Restrospective analysis confirmed the least accuracy and the worst reproducibility of visual evaluation of glenoid defects less than 25%. Sectional relation method on 3D-CT had the maximum accuracy and reproducibility in all groups (PE = 1,29%±2,39%, ICC = 0,756-0,856), excluding the group with massive defects, where researched measurement methods had close accuracy when applied on 3D-CT, 3D VIBE MRI and during arthroscopy. Linear relation method on 3D-CT overestimated the defect volume at 2,1-7,9% and demonstrated less reliable reproducibility (PE = 3,22%±5,31%, ICC = 0,612-0,621). The highest error (up to 7,9%) was demonstrated by linear method in case of borderline defects in the III group of 20-25%. Insufficient conformity of results for linear (ICC = 0,42) method and moderate conformity for sectional (ICC = 0,62) method were observed during comparison of 3D VIBE MRI with 3D-CT. MRI underestimated the value of small defects and overestimated large defects. Reproducibility of measurements on 3D-CT by different operators was moderate for visual (ICC=0,594) and linear methods (ICC = 0,621) and good for sectional method (ICC = 0,756). Reproducibility of measurements by each operator also was moderate for visual and linear methods (ICC = 0,553 и ICC = 0,612) and good for sectional method (ICC = 0,856). The authors suggested an algorithm for selection of examination method and measurements for defects of articular surfaces which also considers the main factors of prognosis and risk of recurrent instability.Conclusion. Sectional relation method on 3D-CT is the most precise and reproducible method of glenoid defect measurements used in the clinical practice. MRI use without CT is inadmissible for bipolar defects of borderline size. Suggested algorithm allows not to make CT examination at extreme ISIS values and increases the share of osteoplastic surgeries due to identification of off-track injuries with glenoid defects of borderline size (15-25%).

To develop a method for T2 mapping of the entire tibiotalar/hindfoot articular surfaces and to examine regional T2 variation in asymptomatic volunteers, establishing necessary methods for future T2 mapping work in patients with ankle/hindfoot injury.Twenty-six asymptomatic volunteers (11 female/13 male, aged 23-64 years in final analysis) underwent sagittal T2 mapping. Tibiotalar and hindfoot cartilage surfaces were segmented by two raters. The tibiotalar joint cartilage was divided into subregions to assess T2 variation across the joint. The articular surface and subregion mean T2 values were compared using Tukey post hoc pairwise comparisons to test for statistical significance.Mean ankle/hindfoot cartilage T2 ranged from 37 ± 3 to 47 ± 7 ms. Tibial plafond mean T2 was significantly different from the middle and posterior subtalar cartilage T2 (both articular surface comparisons resulted in P .05). Talar dome mean T2 was significantly different from the posterior calcaneal-side and talar-side subtalar cartilage, and middle calcaneal-side subtalar cartilage (P .05 for all comparisons). Tibial plafond middle versus lateral, anterior versus middle, middle versus posterior, and anterior versus posterior subregion T2 values were significantly different (P .05 for all comparisons). Talar dome medial versus middle, middle versus lateral, anterior versus middle, and middle versus posterior subregion T2 values were significantly different (P .05 for all comparisons). Ankle/hindfoot joint cartilage T2 mapping and segmentation was found to be feasible for all cartilage surfaces except the anterior subtalar joint facet. Mean T2 differed significantly between ankle/hindfoot joint and subregion cartilage in asymptomatic volunteers.

One biomechanical goal of kinematically aligned total knee arthroplasty (KA TKA) is to achieve knee laxities and neutral positions that are not different from those of the native knee without soft tissue release. However, replacing the articular surfaces and menisci with implants of discrete sizes and average shapes and resecting the anterior cruciate ligament (ACL) might prevent KA TKA from achieving this goal in the tibiofemoral joint. Accordingly, the objective was to determine whether either or both surgically induced changes cause differences in laxities and/or neutral positions from native using a cruciate retaining implant. Eight laxities and four neutral positions were measured from 0° to 120° flexion in 30° increments in 13 human cadaveric knees in three knee conditions: native, ACL-deficient, and KA TKA. After KA TKA, 5 of the 40 laxity measures (8 laxities × 5 flexion angles) and 6 of the 20 neutral position measures (4 neutral positions × 5 flexion angles) were statistically different from those of the native knee. The greatest differences in laxities from native after KA TKA occurred at 30° flexion in anterior translation (1.6 ± 2.1 mm increase, p < 0.0001); this difference was 1.7 ± 2.1 mm less than that in the ACL-d knee (p < 0.0001). The greatest difference in neutral positions from native after KA TKA occurred in anterior-posterior translation at 0° flexion (3.8 ± 1.9 mm anterior, p < 0.0001); this difference was 2.6 ± 1.9 mm greater than that in the ACL-d knee (p = 0.0002). Clinical Significance: These results indicate that the biomechanical goal of KA TKA is largely realized despite the two surgically induced changes. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:358-369, 2019.

Background Knee movements performed in open (OKC) and closed (CKC) kinetic chains generate various patterns of muscle activities and especially distinct contact stresses in the patellofemoral joint (PFJ). In contrast to these features, the arthrokinematic motion quality (AMQ) of the PFJ has not been compared between mentioned conditions. In this study we performed vibroarthrographic analysis of AMQ in movements performed in OKC and CKC, in healthy subjects and individuals with chondromalacia patellae, to assess which of the test conditions is more efficient in differentiation between healthy and deteriorated joints. Moreover, our analysis will broaden the knowledge related to behavior of normal and pathological synovial joints during motion with and without weight bearing. It is an essential issue, due to the recently observed significant interest in comparing potential benefits and limitations of CKC and OKC exercises as they relate to lower extremity rehabilitation. Methods 100 subjects (62 healthy controls and 38 subjects with PFJ chondromalacia) were enrolled. During repeated knee flexion/extension motions performed in OKC (in a sitting position) and CKC (sit-to-stand movements), the vibroarthrographic signals were collected using an accelerometer and described by variability (VMS), amplitude (R4), and spectral power in 50–250 Hz (P1) and 250–450 Hz (P2) bands. Results Significant differences in VMS [V], R4 [V], P1 [V2/Hz] and P2 [V2/Hz] between OKC and CKC were found (0.0001, 0.969. 0.800 0.041 vs 0.013, 3.973, 6.790, 0.768, respectively, P

Hnatiuk Mykhailo, Rubas Lesia. Morphometric evaluation of features of remodeling of chondrocites of joint surfaces of temporomandibular joint of experimental animals in hyperglycemia. Journal of Education, Health and Sport. 2021;11(06): 137-142. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2021.11.06.014 https://apcz.umk.pl/czasopisma/index.php/JEHS/article/view/JEHS.2021.11.06.014 https://zenodo.org/record/5035110 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2021; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 21.05.2021. Revised: 03.06.2021. Accepted: 25.06.2021. MORPHOMETRIC EVALUATION OF FEATURES OF REMODELING OF CHONDROCITES OF JOINT SURFACES OF TEMPOROMANDIBULAR JOINT OF EXPERIMENTAL ANIMALS IN HYPERGLYCEMIA Mykhailo Stepanovych Hnatiuk, Lesia Vasylivna Rubas I.Ya. Horbachevsky Ternopil National Medical University 46001, 1 Maidan Voli, Ternopil, Ukraine Corespondent e-mail: rebukhal@gmail.com Hnatiuk Mykhailo Stepanovych1, https://orcid.org/0000-0002-4110-5568 Rubas Lesia Vasylivna2, https://orcid.org/0000-0003-4306-0313 Abstract Aim: to study morphometrically the peculiarities of remodeling of chondrocytes of the articular surfaces of the temporomandibular joint in hyperglycemia. Materials and methods: Quantitative morphological methods were used to study diameters of chondrocytes and their nuclei, nuclear-cytoplasmic relationship in these cells, relative volume of damaged chondrocytes, intercellular-chondrocytic relationship in mature chondrocytes of the articular surfaces of the temporomandibular joint of 45 laboratory mature white male rats with simulated diabetes. Results: A comprehensive analysis of the morphometric parameters presented in the article showed that they did not differ in the articular surfaces of the temporal fossa and mandibular head of the intact temporomandibular joint. The expressed structural changes of chondrocytes were revealed at a monthly and a two-month diabetic arthropathy of this joint. Conclusions: Proceeded studies and obtained results suggest that prolonged hyperglycemia leads to diabetic arthropathy of the TMJ, which is characterized by atrophy of chondrocytes, violation of nuclear-cytoplasmic relationships, an increase in the relative volume of damaged chondrocytes and volume of intercellular substance. The detected changes in quantitative morphological parameters depended on the duration of hyperglycemia and dominated in the cartilaginous tissue of the articular surface of the mandibular head. Key words: chondrocytes; temporomandibular joint; hyperglycemia; cartilaginous tissue.

SUMMARY Imaging of the distal radius is of paramount importance in diagnosing injuries, indicating patients for operative or nonoperative treatment, and appropriately following patients for associated injuries and complications. Plain radiographs and fluoroscopy are the dominant imaging modalities in all settings because they are readily available and provide valuable information about the osseous structures and any instrumentation. Computed tomography can offer more information about implant placement and the level of comminution of the articular surfaces but is more expensive and exposes patients to higher doses of radiation. Magnetic resonance imaging is less commonly used but is useful for occult fractures and other associated injuries. Ultrasonography is gaining popularity in evaluating implant placement, especially regarding tendon impingement and subsequent tendon injury.

BACKGROUND: The screw-home mechanism (SHM) plays an important role in the stability of the knee. Accordingly, the analysis of tibial rotation patterns can be used to elucidate the effect of SHM-related factors. OBJECTIVE: The purpose of this study was to compare the magnitude of the angle and the pattern of SHM between passive and active movements. METHODS: We studied twenty healthy males, of which the angle of knee flexion-extension and tibial longitudinal rotation (TLR) during active and passive movements were measured using the inertial measurement unit. Student’s t-tests were used to compare the magnitude of TLR. The waveform similarity was quantified using a coefficient of multiple correlation (CMC). RESULTS: Significant differences were found in the TLR between the active and passive movements (p< 0.05). The knee flexion-extension waveform similarity was excellent (CMC = 0.956). However, the waveform similarity of TLR was weak (CMC = 0.629). CONCLUSION: The SHM increased abruptly during the last 20∘ of the active (extension) movement compared with passive extension. The SHM occurred mainly owing to the geometry and shape of the articular surfaces of the knee joint. In addition, muscle contraction was considered to be an important factor in the articulation movement.

International audience; Estimating the motion between two bones is crucial for understanding their biomechanical function. The vertebral column is particularly challenging because the vertebrae articulate at more than one surface. This paper proposes a method to estimate 3D motion between two avian vertebrae, by bones surface reconstruction and contact modeling. The neck of birds was selected as a case study because it is a functionally highly versatile structure combining dexterity and strength. As such, it has great potential to serve as a source for bioinspired design, for robotic manipulators for instance. First, 3D models of the vertebrae are obtained by computed tomography (CT). Next, joint surfaces of contact are approximated with polynomial surfaces, and a system of equations derived from contact modeling between surfaces is established. A constrained optimization problem is defined in order to find the best position of the vertebrae for a set of given orientations in space. As a result, the possible intervertebral range of motion is estimated

CASE We report a case of asymmetric medial ankle arthritis that was treated by medial malleolar osteotomy and oblique fibular osteotomy to expose and resurface both the medial talar dome and medial tibial plafond articular surfaces. CONCLUSION This technique permitted a unique application of mosaicplasty in which osteochondral plugs were placed in a "kissing" orientation. The outcome seen here suggests the possibility of mosaicplasty as a viable option for treatment of localized ankle arthritis. In addition, this exposure technique is also applicable to treating isolated lesions of the medial tibial plateau.

A chondral lesion can occur due to various reasons like trauma, degeneration, pathologies like osteochondritis dissecans (OCD) or a vascular insult. While most of the traumatic lesions are due to the impact of an acute abnormal biomechanical force on the chondral or the osteochondral surface, chronic degenerative lesions occur due to a gradual alteration of the biomechanics over the years. It is the type, force, direction and the repetitions of the load that determine whether the abnormal biomechanics will cause chondral injury or not. While it is not true that there will be abnormal biomechanics behind every cartilage lesion, every abnormal biomechanics will indeed put abnormal loads on the articular surface. Pathologies like OCD and vascular causes may not have abnormal biomechanics all the time. The purpose of this chapter is to discuss some of the abnormal biomechanics that imparts abnormal loads on the articular surfaces of the knee, resulting in a chondral damage. The chapter should open up a thought process in a cartilage surgeon’s mind to understand the importance of the abnormal biomechanics vis-a-vis a chondral lesion.