Reference intervals and sources of variation of pressure pain threshold for quantitative sensory testing in a Japanese population.

Quantitative sensory testing (QST) is useful when analysing musculoskeletal pain disorders. A handheld algometer is most commonly used for pressure pain threshold (PPT) tests. However, reference intervals for PPTs are not elucidated.

Neutrophil-, Monocyte- and Platelet-to-Lymphocyte Ratios, and Absolute Lymphocyte Count for Diagnosis of Malignant Soft-tissue Tumors.

Background/aim: Soft-tissue tumors are difficult to differentiate as benign or malignant. Immune markers, such as the neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), platelet-lymphocyte ratio (PLR), and absolute lymphocyte count (ALC) in serum, have been reported to be useful in the diagnosis and predicting prognosis of several malignancies. We investigated the diagnostic value of these immune markers in differentiating soft-tissue tumors.

Resurfacing Egg-shell Patellar Defect in a Single-staged Primary total Knee Arthroplasty - A Case Report.

Introduction: Patellofemoral biomechanics are a very critical factor for patient satisfaction after total knee arthroplasty. Patellar defects in a primary total knee arthroplasty are rare. We present a rare case of valgus deformed knee with an eroded egg-shell like patella managed with primary knee arthroplasty.

Chondromodulin is necessary for cartilage callus distraction in mice.

Chondromodulin (Cnmd) is a glycoprotein known to stimulate chondrocyte growth. We examined in this study the expression and functional role of Cnmd during distraction osteogenesis that is modulated by mechanical forces. The right tibiae of the mice were separated by osteotomy and subjected to slow progressive distraction using an external fixator.

Novel nano-hydroxyapatite coating of additively manufactured three-dimensional porous implants improves bone ingrowth and initial fixation.

Electron beam melting (EBM) has been used to fabricate three-dimensional (3D) porous Ti-6Al-4V surfaces for acetabular cups in total hip arthroplasty. However, there are radiographic concerns regarding poor implant fixation and bone ingrowth around electron beam melted (EBMed) 3D porous cups. We hypothesize that nano-hydroxyapatite (nHA) coating can promote bone ingrowth and thus decrease the occurrence of radiolucent lines around EBMed 3D porous cups.

Optimal intraoperative medial joint gap in extension to prevent flexion contracture following total knee arthroplasty using modified gap balancing technique.

Background: Primary aim to identify the ideal medial joint gap in extension needed to prevent post-operative flexion contracture following total knee arthroplasty (TKA) in varus osteoarthritic knees by the modified gap balancing technique. A secondary aim was to analyze multiple factors that influence knee extension in TKA by modified gap balancing.

Methods: This is a prospective cohort study of 150 patients diagnosed with osteoarthritic varus knee who underwent TKA using the modified gap balancing technique.

Current Concept of Quantitative Sensory Testing and Pressure Pain Threshold in Neck/Shoulder and Low Back Pain.

In recent years, several published articles have shown that quantitative sensory testing (QST) and pressure pain threshold (PPT) are useful in the analysis of neck/shoulder and low back pain. A valid reference for normal PPT values might be helpful for the clinical diagnosis of abnormal tenderness or muscle pain. However, there have been no reliable references for PPT values of neck/shoulder and back pain because the data vary depending on the devices used, the measurement units, and the area examined.

Greater Trochanteric Fracture with Lesser Trochanter Extension: A Report of 2 Cases and CT-Based Finite Element Analysis.

Case: Two patients (aged 71 and 82 years) presented with a greater trochanteric fracture with lesser trochanter extension. These cases were successfully treated by prophylactic osteosynthesis to prevent secondary intertrochanteric/cervical fracture and to facilitate an early return to daily life. We also clarified the mechanical strength of the area that escaped bone fracture using the patient-specific computed tomography-based finite element method (CT/FEM).

Significant reduction of patellar height affected lower clinical outcomes and knee flexion over five-year follow-up after total knee arthroplasty.

Aims: This study aimed to investigate the relationship between changes in patellar height and clinical outcomes at a mean follow-up of 7.7 years (5 to 10) after fixed-bearing posterior-stabilized total knee arthroplasty (PS-TKA).

Methods: We retrospectively evaluated knee radiographs of 165 knees, which underwent fixed-bearing PS-TKA with patella resurfacing.

Effects of sclerostin antibody on bone healing.

Promoting bone healing after a fracture has been a frequent subject of research. Recently, sclerostin antibody (Scl-Ab) has been introduced as a new anabolic agent for the treatment of osteoporosis. Scl-Ab activates the canonical Wnt (cWnt)-β-catenin pathway, leading to an increase in bone formation and decrease in bone resorption.

Bisphosphonate-related atypical insufficiency fracture of the tibial plateau : A case report.

Objective : Only a few cases of insufficiency fractures of the tibial plateau following bisphosphonate use have been reported. The authors report a case with bisphosphonate (BP) -related atypical insufficiency fracture of tibial plateau, which developed delayed union. Patient : A 65-year-old Japanese woman presented with left knee pain without any trauma.

Shrug radiographs for the diagnosis of long thoracic nerve palsy in traumatic brachial plexus injury.

Background: Preoperative diagnosis of long thoracic nerve (LTN) palsy is important for shoulder reconstruction after a traumatic brachial plexus injury (BPI). In the present study, we developed an objective diagnostic method for LTN palsy for patients with traumatic BPI.

Methods: This is a retrospective review of 56 patients with traumatic BPI who had been receiving treatment at a single institution for over 8 years.

Calcification of the Anterior Acromial Insertion of the Deltoid Muscle.

A 45-year-old man presented with severe left shoulder pain that was not associated with trauma. Plain radiography with the arm in an elevated position and ultrasonography demonstrated calcium deposits at the anterior acromial insertion site of left deltoid muscle. Conservative management could successfully relieve pain.

The AO trauma CPP bone infection registry: Epidemiology and outcomes of Staphylococcus aureus bone infection.

Bone infection represents a serious complication of orthopedic surgery and Staphylococcus aureus is the most common pathogen. To improve the understanding of host-pathogen interaction, we developed a biospecimen registry (AO Trauma CPP Bone Infection Registry) to collect clinical data, bacterial isolates, and serum from patients with S. aureus bone infection.

Continuous infusion of PTH delayed fracture healing in mice.

Hyperparathyroidism, which is increased parathyroid hormone (PTH) levels in the blood, could cause delayed or non-union of bone fractures. But, no study has yet demonstrated the effects of excess continuous PTH exposure, such as that seen in hyperparathyroidism, for fracture healing. Continuous human PTH (teriparatide) infusion using an osmotic pump was performed for stabilized tibial fractures in eight-week-old male mice to determine the relative bone healing process compared with saline treatment.

Ulnar nerve palsy caused by synovial protrusion in synovial chondromatosis of the elbow: a case report and literature review.

We describe an unusual case of ulnar nerve compression (cubital tunnel syndrome) caused by synovial protrusion in primary synovial chondromatosis of the elbow in a 59-year-old man. Magnetic resonance imaging is a useful tool for diagnosing this rare condition. Surgical excision of the intra-articular multiple loose bodies and ulnar nerve decompression were performed.

Isolated Salter-Harris Type III Physeal Fracture of the Distal Ulna.

We describe a case of isolated physeal fracture of ulna distal end in a 13-year-old boy. This fracture type is uncommon, especially Salter-Harris type III of this injury has not been reported. Plain radiographs showed a small vertical fracture line at the ulnar distal end and an enlargement of epiphyseal plate at the base of ulnar styloid process.

Teriparatide (human PTH) compensates for impaired fracture healing in COX-2 deficient mice.

Genetic ablation of cyclooxygenase-2 (COX-2) in mice is known to impair fracture healing. To determine if teriparatide (human PTH) can promote healing of Cox-2-deficient fractures, we performed detailed in vivo analyses using a murine stabilized tibia fracture model. Periosteal progenitor cell proliferation as well as bony callus formation was markedly reduced in Cox-2 mice at day 10 post-fracture.

The use of dynamic radiographs in trapeziometacarpal joint arthrodesis for accurate range of motion evaluation.

Background: Increased motion at the scaphotrapeziotrapezoidal (STT) joint and compensatory hypermobility of metacarpophalangeal (MP) joint contribute to the total abduction and adduction motion of the thumb after trapeziometacarpal (TM) joint arthrodesis. However, there were no detailed studies to evaluate the contribution of motion of each joint towards total thumb mobility.

Methods: We conducted a comparative study on thumb joint motion in 56 hands who underwent TM joint arthrodesis against that of 56 hands in normal subjects.

Analysis of shoulder abduction by dynamic shoulder radiograph following suprascapular nerve repair in brachial plexus injury.

Background: Suprascapular nerve repair is a widely-prioritized procedure for shoulder reconstruction following brachial plexus injury. Although this procedure only reconstructs glenohumeral joint motion, the standard clinical assessment of shoulder function also includes the scapulothoracic joint contribution. The purpose of this preliminary study was to develop an objective method to accurately analyze shoulder abduction following suprascapular nerve repair in brachial plexus injury patients.