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In vivo selective inhibition of mitogen-activated protein kinase kinase 1/2 in rabbit experimental osteoarthritis is associated with a reduction in the development of structural changes.

OBJECTIVE: The primary aim of this study was to investigate, using an experimental rabbit model of osteoarthritis (OA), the effect of a selective mitogen-activated protein kinase kinase 1/2 (MEK-1/2) inhibitor, PD 198306, on the development of structural changes. Additional aims were to assess the effects of the inhibitor on levels of phosphorylated extracellular signal-regulated kinase 1/2 (phospho-ERK-1/2) and matrix metalloproteinase 1 (MMP-1; collagenase 1) in OA chondrocytes. METHODS: After surgical sectioning of the anterior cruciate ligament of the right knee joint, rabbits with OA wer

What is the probability of recovery of C5 palsy after cervical spine surgery over time? A systematic review and meta-analysis.

BACKGROUND CONTEXT: As recovery from brachial neuropathy after C5 or more extensive palsies after cervical spine surgery is generally favorable and may occur even beyond 2 years, early surgical interventions (eg, nerve transfers) may risk overtreatment. Estimates of recovery probability over time may help guide decisions about the timing and potential benefits of additional surgery. Bayesian analysis is helpful in estimating this probability, as it estimates the probability of recovery and updates it when new information becomes available, such as when nerve recovery does not occur over time.

Successful Medial Meniscal Repair Reduces Knee Pain 10 Years After Anterior Cruciate Ligament Reconstruction: Exploring the Consequences of Subsequent Surgery With Causal Mediation Analysis in the MOON Cohort.

BACKGROUND: Medial meniscal repair performed at the time of primary anterior cruciate ligament reconstruction (ACLR) has been shown to be significantly associated with subsequent surgery, and subsequent surgery has been associated with increased Knee injury and Osteoarthritis Outcome Score (KOOS) pain score and decreased patient satisfaction. HYPOTHESIS/PURPOSE: The purpose was to determine if medial meniscal repair decreases KOOS pain 10 years after ACLR and to assess the consequences of subsequent surgery on the development of KOOS pain. The authors hypothesized that medial meniscal repair

Posterior 'superior mesenteric artery first' approach for resection of locally advanced pancreatic cancer.

BACKGROUND: En bloc resection of the superior mesenteric vein (SMV), portal vein (PV), and/or splenic vein (SV) with concomitant venous reconstruction is required in 11-65 % of cases of locally advanced pancreatic cancer.1 Early retropancreatic dissection of the superior mesenteric artery (SMA) from behind the pancreatic head utilizing an 'artery first' approach has been reported to be an efficient and safe approach to pancreaticoduodenectomy when SMA involvement is suspected.2 Additionally, this technique has been shown to reduce blood loss and result in shorter PV clamp times.3 While there a

[Dynamic neutralization using the Dynesys system for treatment of degenerative disc disease of the lumbar spine].

PURPOSE OF THE STUDY: Degenerative disc disease (DDD) is a spinal condition resulting from degeneration of the intervertebral discs. It is associated with symptoms of sciatica, back pain and leg weakness and also with degenerative instability of the spine. To arrest the degenerative cascade of disc disease, and taking into consideration stress placed on the adjacent discs managed by decompression and stabilisation by instrumented fusion, the lumbar spine was treated by dynamic posterior stabilisation of the segments affected. Based on the classification described by Dubois et al., the Dynesys

Differences in Injury Profiles Between Female and Male Athletes Across the Participant Classification Framework: A Systematic Review and Meta-Analysis.

BACKGROUND: Female sex is a significant determinant of anterior cruciate ligament (ACL) injury. It is not understood if sex is a key determinant of other sports-related injuries. OBJECTIVE: The aim of this systematic review was to identify where differences in injury profiles are most apparent between the sexes in all sports across the six-tiered participant classification framework. METHODS: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and the 'implementing PRISMA in Exercise, Rehabilitation

The impact of early vs. delayed surgery on outcomes in cervical spinal cord injury without fracture or dislocation.

OBJECTIVE: This study aims to retrospectively analyze 104 patients diagnosed with cervical spinal cord injury without fracture or dislocation (CSCIwoFD) who underwent surgical treatment, in order to compare the effects of early vs. delayed surgical intervention on neurological functional recovery. METHODS: Patients diagnosed with CSCIwoFD and treated surgically at our institution between August 2020 and January 2023 were retrospectively reviewed. Based on the time interval from injury to surgery, patients were categorized into two groups: early surgery group (Group A) and delayed surgery grou

Open Excision of Dorsal Wrist Ganglion.

BACKGROUND: Ganglion cysts are benign soft-tissue tumors that are most commonly found in the wrist. Within the wrist, 60% to 70% of ganglion cysts occur on the dorsal side and 20% to 30% occur on the volar side1. Although ganglia arise from multiple sites over the dorsal wrist, dorsal ganglia most commonly originate at the scapholunate joint2,3. Open excision is the standard surgical treatment for dorsal wrist ganglia. This procedure is considered when symptoms such as pain and range-of-motion deficits begin to impact activities of daily living. DESCRIPTION: Open excision of a dorsal wrist ga

Laparoscopic Transduodenal Ampullectomy: How We Have Standardized the Technique (with Video).

BACKGROUND: The procedure of choice for the resection of ampullary tumors comprises transduodenal ampullectomy (TDA), endoscopic papillectomy (EP), and pancreaticoduodenectomy (PD).1 For neoplasms with low-grade dysplasia, TDA and EP have equivalent efficacies and lower morbidities than PD1. Compared with EP, also as an organ-preserving procedure, TDA could be applicable for tumors involving the pancreatic ducts or common bile ducts.2 Because TDA has a lower incidence of postoperative gastrointestinal bleeding and a higher R0 resection rate, its use could avoid the need to use multiple endosco

Quantitative Assessment of In Vivo Human Anterior Cruciate Ligament Autograft Remodeling: A 3-Dimensional UTE-T2* Imaging Study.

BACKGROUND: The timing of return to play after anterior cruciate ligament (ACL) reconstruction is still controversial due to uncertainty of true ACL graft state at the time of RTP. Recent work utilizing ultra-short echo T2* (UTE-T2*) magnetic resonance imaging (MRI) as a scanner-independent method to objectively and non-invasively assess the status of in vivo ACL graft remodeling has produced promising results. PURPOSE/HYPOTHESIS: The purpose of this study was to prospectively and noninvasively investigate longitudinal changes in T2* within ACL autografts at incremental time points up to 12 m

Craniovertebral Junction Instability after Oncological Resection: A Narrative Review.

The craniovertebral junction (CVJ) is a complex transition area between the skull and cervical spine. Pathologies such as chordoma, chondrosarcoma and aneurysmal bone cysts may be encountered in this anatomical area and may predispose individuals to joint instability. An adequate clinical and radiological assessment is mandatory to predict any postoperative instability and the need for fixation. There is no common consensus on the need for, timing and setting of craniovertebral fixation techniques after a craniovertebral oncological surgery. The aim of the present review is to summarize the an

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… The anterior arch of the atlas represents 1/6 of the circumference of the inner ring and ventrally presents the anterior tubercle, whereby the anterior longitudinal ligament is inserted, and it posteriorly presents a concave facet that houses the odontoid process of the axis. … The anterior longitudinal and posterior longitudinal ligaments connect the anterior tubercle of the atlas to the anterior surface of the axis and the posterior tubercle of the atlas to the spinous process of the axis, respectively. 2.5. …

Seropositive Neuromyelitis Optica in a Case of Undiagnosed Ankylosing Spondylitis: A Neuro-Rheumatological Conundrum.

Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune astrocytopathy against foot processes of aquaporin-4 (AQP4) water channels. … sult from bony (vertebral) ankylosis, subluxation of joints, ossification of anterior and posterior longitudinal ligaments, secondary spinal canal stenosis, bony (vertebral) fractures, and subsequent compressions over nerve radicles/roots/cauda equina, and inflammation-related (entrapment) peripheral neuropathies.12,16,17 Acute transverse myelitis can occur as a subset …

Radiological Diagnosis and Advances in Imaging of Vertebral Compression Fractures.

Vertebral compression fractures (VCFs) affect 1.4 million patients every year, especially among the globally aging population, leading to increased morbidity and mortality. Often characterized with symptoms of sudden onset back pain, decreased vertebral height, progressive kyphosis, and limited mobility, VCFs can significantly impact a patient's quality of life and are a significant public health concern. Imaging modalities in radiology, including radiographs, computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) studies and bone scans, play crucial

Risk factors for the development of medication-related osteonecrosis of the jaw and effects of tooth extraction with local infection.

BACKGROUND/PURPOSE: Tooth extraction has been avoided in patients receiving antiresorptive agent (ARA) therapy. This study aimed to investigate dental findings associated with medication-related osteonecrosis of the jaw (MRONJ) development in patients. MATERIALS AND METHODS: First, in patients treated with high-dose ARAs, the relationship between dental findings and MRONJ development was examined. Next, in patients with MRONJ undergoing surgery, the relationship between dental findings and MRONJ occurring at a site distant from the initial site was examined. RESULTS: MRONJ occurred in 13 of

Long-term follow-up of thalidomide embryopathy: malformations and development of osteoarthritis in the lower extremities and evaluation of upper extremity function.

BackgroundBetween 1959 and 1962, several children with multiple malformations were born after maternal intake of thalidomide during pregnancy, known as thalidomide embryopathy (TE).ObjectivesThe aim of this study was to evaluate the malformations, their long-term effect on the function of the extremities and the development of degenerative osteoarthritis (OA) in the lower extremities.MethodsAll living persons with TE in Sweden were invited to participate in the study. Thirty-one patients were examined clinically as a part of a multi-disciplinary follow-up programme. Evaluation of upper and low

Elbow hemiarthroplasty with a 3D-printed prosthesis for distal humeral bone defects after tumor excision: a case report.

INTRODUCTION: The distal humerus is a rare site for primary and metastatic bone tumors. Due to the scarcity of cases and lack of standardized surgical strategies, it is often difficult for surgeons to choose the right choice. The application of a 3D-printed prosthesis with hemiarthroplasty for the treatment of the distal humerus after tumor resection can be a very effective option. CASE PRESENTATION: We present a clinical case of a 3D-printed distal humeral prosthesis for the treatment of bone defects caused by metastatic bone tumors. The preoperative evaluation was aggressively performed, an

A practical approach to joint pain in primary care.

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Amyloidosis and Carpal Tunnel Syndrome: Surgical Technique for Extended Carpal Tunnel Release with Tenosynovium and Transverse Carpal Ligament Biopsies.

UNLABELLED: Carpal tunnel syndrome (CTS) is common in patients with transthyretin amyloidosis (ATTR), and many experience residual symptoms and/or develop recurrent disease following routine carpal tunnel release (CTR). An extended CTR with median nerve neurolysis is recommended for thorough nerve decompression. Tissue confirmation of amyloidosis can be performed at the time of CTR with biopsies of the transverse carpal ligament and/or tenosynovium. METHODS: We describe a retrospective, single-center experience performing an extended CTR technique including unilateral and bilateral cases for

Skeletal organoids.

The skeletal system, composed of bones, muscles, joints, ligaments, and tendons, serves as the foundation for maintaining human posture, mobility, and overall biomechanical functionality. However, with ageing, chronic overuse, and acute injuries, conditions such as osteoarthritis, intervertebral disc degeneration, muscle atrophy, and ligament or tendon tears have become increasingly prevalent and pose serious clinical challenges. These disorders not only result in pain, functional loss, and a marked reduction in patients' quality of life but also impose substantial social and economic burdens.

Discordance in diagnosis of osteoporosis by quantitative computed tomography and dual-energy X-ray absorptiometry in Chinese elderly men.

ObjectiveThe objective of this study was to investigate the diagnostic discordance of osteoporosis by quantitative computed tomography (QCT) and dual-energy X-ray absorptiometry (DXA) in Chinese elderly men.MethodsA total of 313 males older than 60 years, who underwent both spinal QCT and lumbar spine and hip DXA in our department, were included. The diagnostic criteria established by the World Health Organisation in 1994 were used for DXA to diagnose osteoporosis, and the criteria recommended by the International Society of Clinical Densitometry were used for QCT. The osteoporosis detection r