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Clin Orthop Relat Res 2021 May 11. Epub 2021 May 11.

M. J. Hartwell, R. E. Harold, P. T. Sweeney, A. L. Seitz, G. Marra, M. D. Saltzman, Department of Orthopaedic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.

Background: Fatty infiltration of the rotator cuff evaluated with CT has been associated with asymmetric glenoid wear and humeral head subluxation in patients with glenohumeral arthritis. The relationship between rotator cuff pathologic findings and abnormal glenoid wear plays an important role in determining the optimal surgical management of advanced glenohumeral osteoarthritis. Compared with CT, MRI has increased sensitivity for identifying rotator cuff conditions; therefore, prior studies using CT may have underestimated the association between fatty infiltration of the rotator cuff and abnormal glenoid wear. Read More

J Bone Joint Surg Am 2021 May 11. Epub 2021 May 11.

Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.

Background: Most North American surgeons predominantly use uncemented stems in primary total hip arthroplasties (THAs) and reserve cemented stems for selected older patients and those with poor bone quality. However, data on this "selective use" strategy for cemented stems in the population at risk for periprosthetic fracture and implant loosening are limited. The purpose of this study was to describe implant survivorship, complications, and radiographic results of a specific collarless, polished, tapered cemented stem (Exeter; Stryker) used selectively in a predominantly elderly population undergoing primary THA. Read More

Arthritis Care Res (Hoboken) 2021 May 10. Epub 2021 May 10.

Department of Imaging and Functional Musculoskeletal Research, Institute of Anatomy and Cell Biology, Paracelsus Medical University Salzburg and Nuremberg, Salzburg, Austria.

Objective: To study whether layer-specific cartilage transverse relaxation time (T2), and/or longitudinal change is associated with clinically relevant knee osteoarthritis (OA) disease progression.

Methods: The FNIH biomarker consortium was a nested case-control study on 600 knees from 600 Osteoarthritis Initiative participants. Progressor knees had both medial tibiofemoral radiographic joint space width (JSW) loss (≥0. Read More

Arthritis Care Res (Hoboken) 2021 May 10. Epub 2021 May 10.

Pfizer Inc, Groton, Connecticut, USA.

Objective: This pooled analysis of 3 randomized, placebo-controlled trials (16─24 week treatment; 8─24 week follow-up) assessed safety of subcutaneous tanezumab (2.5─10 mg every 8 weeks) in 1840 patients with hip or knee osteoarthritis.

Methods: Overall treatment-emergent adverse events (TEAEs) and TEAEs of abnormal peripheral sensation (APS) were prospectively assessed in 3 trials. Read More

BMC Health Serv Res 2021 May 10;21(1):444. Epub 2021 May 10.

Department of Rheumatology, Sint Maartenskliniek, Nijmegen, the Netherlands.

Background: Self-management is of paramount importance in the non-surgical treatment of knee/hip osteoarthritis (OA). Modern technologies offer the possibility of 24/7 self-management support. We developed an e-self-management application (dr. Read More

Arch Orthop Trauma Surg 2021 May 10. Epub 2021 May 10.

Department of Orthopaedic, Trauma and Plastic Surgery, Leipzig University, Liebigstr. 20, 04103, Leipzig, Germany.

Introduction: Atraumatic necrosis of the femoral head (AFHN) is a common disease with an incidence of 5000-7000 middle-aged adults in Germany. There is no uniform consensus in the literature regarding the configuration of the bone in AFHN. The clinical picture of our patients varies from very hard bone, especially in idiopathic findings, and rather soft bone in cortisone-induced necrosis. Read More

Ann Rheum Dis 2021 May 7. Epub 2021 May 7.

Rheumatology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.

Objective: The FORWARD (FGF-18 Osteoarthritis Randomized Trial with Administration of Repeated Doses) trial assessed efficacy and safety of the potential disease-modifying osteoarthritis drug (DMOAD) sprifermin in patients with knee osteoarthritis. Here, we report 5-year efficacy and safety results.

Methods: Patients were randomised to intra-articular sprifermin 100 µg or 30 µg every 6 months (q6mo) or 12 months, or placebo, for 18 months. Read More

J Arthroplasty 2021 Apr 18. Epub 2021 Apr 18.

Department of Orthopaedics, Fuyang Hospital of Anhui Medical University, Fuyang, Anhui Province, China.

Background: To evaluate the influence of patellar morphology on knee joint function and patellofemoral tracking in patients with primary osteoarthritis after total knee arthroplasty (TKA) without patellar resurfacing.

Methods: We performed a retrospective study of 156 patients with primary osteoarthritis who underwent TKA without patellar resurfacing from April 2018 to July 2019. As per Wiberg classification, patients were divided into Wiberg type I (group A, n = 38), II (group B, n = 88), and III (group C, n = 30) groups. Read More

BMJ Case Rep 2021 May 6;14(5). Epub 2021 May 6.

Plastic Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

A 59-year-old woman was referred with weakness, paraesthesia, numbness and clawing of the little and ring fingers for the last 2 years. MRI of the cervical spine was normal and nerve conduction velocity revealed abnormality of the ulnar nerve. Ultrasound and MRI showed medial osteophytes and effusion of the elbow joint with stretched and thinned ulnar nerve in the cubital tunnel. Read More

J Orthop Case Rep 2020 May-Jun;10(3):90-94

Department of Orthopaedic Surgery, University of Michigan Medical School, MedSport Domino's Farms, 24 Frank Lloyd Wright Drive, Lobby A, Suite 1000, Ann Arbor, MI 48106 USA.

Introduction: Degeneration of the fibrocartilaginous acromioclavicular (AC) joint disk can become significant in later life and lead to primary osteoarthritis and shoulder pain. Younger, non-arthritic individuals may develop residual shoulder symptoms due to tearing of the disk itself.

Case Report: Six patients (seven shoulders) were included in this case series. Read More

Orthop Rev (Pavia) 2021 Mar 31;13(1):9059. Epub 2021 Mar 31.

Department of Clinical Science and Education, Södersjukhuset, Karolinska Institute, Sweden.

The aim of this retrospective cohort study was to investigate the effect of BMI on 1-year functional outcome, quality of life (QoL) and rate of postoperative complications after shoulder arthroplasty. We included 121 patients (59 men and 62 women) with primary osteoarthritis (OA) who underwent anatomical or reverse total shoulder arthroplasty (TSA or rTSA) between 2011 and 2016. Age, sex, preoperative BMI, preoperative medical status using American score of anesthesiologists (ASA) class, type of prosthesis, preoperative and 1-year postoperative functional outcome using the Constant score and quality of life (QoL) using the EQ-5D as well as postoperative complication rate were documented. Read More

Cell Death Dis 2021 May 5;12(5):448. Epub 2021 May 5.

Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical University, 210029, Nanjing, China.

Osteoarthritis (OA) is the most common chronic joint disease in the elderly population. Growing evidence indicates that a balance between autophagy and apoptosis in chondrocytes plays a key role in OA's cartilage degradation. Thus, drugs targeting the balance between apoptosis and autophagy are potential therapeutic approaches for OA treatment. Read More

JMIR Mhealth Uhealth 2021 May 5;9(5):e20966. Epub 2021 May 5.

Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac-Thoracic-Vascular Sciences and Public Health, University of Padova, Padova, Italy.

Background: Regular physical activity (PA) contributes to the primary and secondary prevention of several chronic diseases and reduces the risk of premature death. Physical inactivity is a modifiable risk factor for cardiovascular disease and a variety of chronic disorders such as diabetes, obesity, hypertension, bone and joint diseases (eg, osteoporosis and osteoarthritis), depression, and colon and breast cancer. Population aging and the related increase in chronic diseases have a major impact on the health care systems of most Western countries and will produce an even more significant effect in the future. Read More

Pain Med 2021 May 3. Epub 2021 May 3.

Pain Research, Informatics, Multimorbidities, and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, CT.

Objective: We describe the most frequently used musculoskeletal diagnoses in Veterans Health Administration (VHA) care. We report the number of visits and patients associated with common musculoskeletal ICD-10 codes and compare trends across primary and specialty care settings.

Design: Secondary analysis of a longitudinal cohort study. Read More

J Arthroplasty 2021 Apr 22. Epub 2021 Apr 22.

Department of Orthopaedics, Medical University of South Carolina, Charleston, SC.

Background: Higher body mass index (BMI) is a well-known risk factor for the development of hip and knee osteoarthritis and predicts total hip arthroplasty (THA) and total knee arthroplasty (TKA) at an earlier age. The purpose of this study is to document the nationwide trends in age and obesity in primary THA and TKA throughout the obesity epidemic.

Methods: A retrospective analysis of the National Inpatient Sample database was conducted on patients undergoing primary THA and TKA for primary OA between 2002 and 2017. Read More

J Arthroplasty 2021 Apr 20. Epub 2021 Apr 20.

Traumaplasty.Melbourne, East Melbourne, Victoria, Australia; Department of Orthopaedics, Royal Melbourne Hospital, Parkville, Victoria, Australia.

Background: Hip hemiarthroplasty is the most common arthroplasty option for fractured neck of femur (FNOF). Revision to total hip arthroplasty (THA) is occasionally required. This study aimed to assess the outcome of hemiarthroplasty revised to THA and to assess the impact of femoral head size, dual mobility (DM), and constrained liners. Read More

Bone Jt Open 2021 May;2(5):278-292

Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.

Aims: The main aims were to identify risk factors predictive of a radiolucent line (RLL) around the acetabular component with an interface bioactive bone cement (IBBC) technique in the first year after THA, and evaluate whether these risk factors influence the development of RLLs at five and ten years after THA.

Methods: A retrospective review was undertaken of 980 primary cemented THAs in 876 patients using cemented acetabular components with the IBBC technique. The outcome variable was any RLLs that could be observed around the acetabular component at the first year after THA. Read More

Arch Orthop Trauma Surg 2021 May 3. Epub 2021 May 3.

ARCUS Sportklinik, Rastatterstr. 17-19, 75179, Pforzheim, Germany.

Introduction: This retrospective study aimed to compare activity levels before and at mid-term follow-up after primary cementless total hip arthroplasty (THA) in patients older than 75 years.

Materials And Methods: A cohort of 79 patients with a mean age at surgery of 78 years (range 76-84 years) was evaluated 6.3 years (range 4-8 years) after cementless THA due to osteoarthritis and was followed up with a questionnaire to determine their activity level. Read More

Cureus 2021 Mar 28;13(3):e14155. Epub 2021 Mar 28.

Centre of Orthopedics and Traumatology, Republican Vilnius University Hospital, Vilnius, LTU.

Introduction: Despite relatively low incidence, dislocation remains one of the main reasons for total hip arthroplasty (THA) revision. It is a devastating complication for a patient and a surgeon, and has high burden on the healthcare system. The aim of the present study was to assess and compare the risk factors for revision after early and delayed THA dislocations. Read More

Front Genet 2021 15;12:618803. Epub 2021 Apr 15.

Department of Orthopedic Surgery, Renmin Hospital of Wuhan University, Wuhan, China.

Objectives Transcriptional changes in cartilage can impact function by causing degradation such as that which occurs during the development of osteoarthritis (OA). Epigenetic regulation may be a key factor leading to transcriptional changes in OA. In this study, we performed a combined analysis of DNA methylation and gene expression microarray datasets and identified key transcription factors (TFs) central to the regulation of gene expression in OA. Read More

Bone Joint J 2021 May;103-B(5):864-871

Musculoskeletal Research Unit, Bristol Medical School, University of Bristol, Bristol, UK.

Aims: Debate remains whether the patella should be resurfaced during total knee replacement (TKR). For non-resurfaced TKRs, we estimated what the revision rate would have been if the patella had been resurfaced, and examined the risk of re-revision following secondary patellar resurfacing.

Methods: A retrospective observational study of the National Joint Registry (NJR) was performed. Read More

J Orthop Res 2021 May 2. Epub 2021 May 2.

McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA.

Post-traumatic osteoarthritis is a disabling condition impacting the mostly young and active population. In the present study, we investigated the impact of intra-articular sprifermin, a recombinant truncated fibroblast growth factor 18, on the outcome of microfracture treatment, a widely used surgical technique to enhance cartilage healing at the site of injury. For this study, we created a cartilage defect and performed microfracture treatment in fetlock joints of 18 horses, treated joints with one of three doses of sprifermin (10, 30, or 100 μg) or with saline, hyaluronan (HA), and evaluated animals functional and structural outcomes over 24 weeks. Read More

Knee Surg Sports Traumatol Arthrosc 2021 May 1. Epub 2021 May 1.

Department of Orthopaedics and Traumatology, Medical University of Innsbruck, Anichstrase 35, 6020, Innsbruck, Austria.

Purpose: To determine whether preoperative radiologic joint space width (JSW) is related to the outcome of medial unicondylar knee arthroplasty (UKA) (primary hypothesis).

Methods: A retrospective comparative analysis was performed. One group was comprised of UKA patients with preoperative JSW 0-1 mm. Read More

Gait Posture 2021 Apr 28;87:163-169. Epub 2021 Apr 28.

Department of Rehabilitation Medicine, Seoqwipo Medical Center, 47, Jangsu-ro, Jeju, 63585, Republic of Korea. Electronic address:

Background: After total knee arthroplasty (TKA), walking speed and distance are main concerns of patients.

Research Question: Which physical functions affect walking speed and distance after TKA?

Methods: Cross-sectional data from 149 patients who underwent unilateral primary TKA and completed performance-based physical function tests. Instrumental gait evaluation for spatiotemporal parameters, isometric knee extensor and flexor strength of both knees, 6-minute walk test (6MWT), timed up-and-go (TUG) test, timed stair climbing test (SCT), and knee flexion and extension range of motion (ROM) of surgical knee were examined. Read More

Osteoarthritis Cartilage 2021 Apr 29. Epub 2021 Apr 29.

Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Staffordshire, ST5 5BG, UK. Electronic address:

Objective: To identify proximate causes ('triggers') of flares in adults with, or at risk of, knee osteoarthritis (OA), estimate their course and consequences, and determine higher risk individuals.

Methods: In this 13-week web-based case-crossover study adults aged ≥40 years, with or without a recorded diagnosis of knee OA, and no inflammatory arthropathy who self-reported a knee flare completed a questionnaire capturing information on exposure to 21 putative activity-related, psychosocial and environmental triggers (hazard period, ≤72 hours prior). Comparisons were made with identical exposure measurements at four 4-weekly scheduled time points (non-flare control period) using conditional logistic regression. Read More

Trials 2021 May 1;22(1):316. Epub 2021 May 1.

Department of Plastic, Reconstructive and Hand Surgery, University Medical Center Utrecht, Heidelberglaan 100, 3508 GA, Utrecht, The Netherlands.

Background: To our knowledge, to date, 52 patients with thumb carpometacarpal osteoarthritis (CMC1 OA) were treated with joint distraction. So far, most patients experienced improved physical function and less pain. After 2 years, only 1 patient proceeded to trapeziectomy. Read More

Ultrasound Med Biol 2021 Apr 27. Epub 2021 Apr 27.

Department of Orthopaedics, Tufts Medical Center, Boston, Massachusetts, USA.

We assessed whether pre-operative femoral cartilage thickness and echo intensity on ultrasound are different between individuals who are symptomatic (n = 6) and asymptomatic (n = 7) at 1 year after a primary unilateral anterior cruciate ligament (ACL) reconstruction (age, 23 ± 4 y; 31% women, 69% men; body mass index, 24.9 ± 3.7 kg/m). Read More

BMC Musculoskelet Disord 2021 Apr 30;22(1):399. Epub 2021 Apr 30.

Department of Orthopaedic Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.

Background: For active patients with a tear of the anterior cruciate ligament (ACL) who would like to return to active level of sports, the current surgical gold standard is reconstruction of the ACL. Recently, there has been renewed interest in repairing the ACL in selected patients with a proximally torn ligament. Repair of the ligament has (potential) advantages over reconstruction of the ligament such as decreased surgical morbidity, faster return of range of motion, and potentially decreased awareness of the knee. Read More

Arch Phys Med Rehabil 2021 Apr 27. Epub 2021 Apr 27.

Doctor of Physical Therapy Program, Department of Public Health & Community Medicine, Tufts University School of Medicine.

Objective: To investigate the diagnostic accuracy of patient history associated with hip pain.

Data Sources: A systematic, computerized search of electronic databases (PubMed, MEDLINE, CINAHL, and Web of Science), a search of the grey literature, and review of the primary authors personal library was performed. Hip specific search terms were combined with diagnostic accuracy and subjective/self-report history-based search terms using the Boolean operator AND. Read More