Knee osteoarthritis, joint laxity and PROMs following conservative management versus surgical reconstruction for ACL rupture: a meta-analysis

AbstractIntroductionPatients whose rupture of the anterior cruciate ligament (ACL) can be managed conservatively or undergo reconstruction surgery.Source of dataCurrent scientific literature published in Web of Science, PubMed and Scopus.Areas of agreementSeveral studies published by July 2022 compare surgical and conservative management following ACL rupture. The latest evidence suggests that surgical management may expose patients to an increased risk of early-onset knee osteoarthritis (OA).Areas of controversyThe state of art does not recommend a systematic ACL reconstruction to all patients who tore their ACL. After the initial trauma, surgical reconstruction may produce even greater damage to the intra-articular structures compared to conservative management.Growing pointsThe state of art does not recommend systematic surgical reconstruction to all patients who tore their ACL. The present study compared surgical reconstruction versus conservative management for primary ACL ruptures in terms of joint laxity, patient reported outcome measures (PROMs) and rate of osteoarthritis.Areas timely for developing researchACL reconstruction provides significant improvement in joint laxity compared to conservative management, but is associated with a significantly greater rate of knee osteoarthritis, despite similar results at PROM assessment

Dynamic spinal posture and pelvic position analysis using a rasterstereographic device

Background Until recently, rasterstereographic analysis of the spine was limited to static measurements. However, understanding and evaluating the motion of the spine under dynamic conditions is an important factor in the diagnosis and treatment of spinal pathologies. The aim of this study was to study the spinal posture and pelvic position under dynamic conditions and compare it to static measurements using a dynamic rasterstereographic system. Methods A total of 121 healthy volunteers (56 females; 65 males) were included in this observational study. The parameters trunk inclination, trunk imbalance, pelvic obliquity, kyphotic angle, lordotic angle, surface rotation, and lateral deviation were studied and compared under static and dynamic (1, 2, 4, 5 km/h) conditions using the system Formetric 4D Motion (R) (DIERS International GmbH, Germany). Results Female volunteers had a higher lordotic angle than males under static conditions (p< 0.001). Trunk inclination (5.31 degrees vs. 6.74 degrees), vertebral kyphotic angle (42.53 degrees vs. 39, 59 degrees), and surface rotation (3.35 degrees vs. 3.81 degrees) increase under dynamic conditions (p< 0.001). Trunk inclination and lordotic angle both show significant changes during walking compared to static conditions (p< 0.001). Conclusion The spinal posture differs between females and males during standing and during walking. Rasterstereography is a valuable tool for the dynamic evaluation of spinal posture and pelvic position, which can also be used to quantify motion in the spine and therefore it has the potential to improve the understanding and treatment of spinal pathologies

Arthroscopic versus mini-open rotator cuff repair: A meta-analysis

BackgroundAn all-arthroscopic rotator cuff repair (ASR) may result in less postoperative pain and better functional outcomes than the mini-open (MOR) approach. This meta-analysis provides an updated assessment of the current literature which compares the clinical outcomes of mini-open versus all arthroscopic rotator cuff repair techniques.Material and methodsThe main online databases were accessed in October 2021. All the trials directly comparing primary ASR versus MOR for rotator cuff rupture were accessed. Studies concerning revision settings were not eligible, nor where those combining the surgical procedures with other adjuvants.ResultsA total of 21 articles were retrieved. Data from 1644 procedures (ASR = 995, MOR = 649) were collected. The mean follow-up was 26.7 (6.0–56.4) months. Comparability was found between ASR and MOR groups at baseline with regards to age (P = 0.3), gender (P = 0.7) and mean duration of the follow-up (P = 0.7). No difference was found between ASR and MOR with regard to surgical duration (P = 0.05), Constant score (P = 0.2), University of California at Los Angeles Shoulder (P = 0.3), American Shoulder and Elbow Surgeons Shoulder (P = 0.5), VAS (P = 0.2), forward flexion (P = 0.3), abduction (P = 0.3), external rotation (P = 0.2), internal rotation (P = 0.7), re-tear (P = 0.9), adhesive capsulitis (P = 0.5).ConclusionArthroscopic and mini-open rotator cuff repair result in similar clinical outcomes. Male gender and older age lead to greater rates of rotator cuff re-tears, while longer surgical duration was associated with a greater rate of adhesive capsulitis

The Biomechanics of Cartilage—An Overview

Articular cartilage (AC) sheathes joint surfaces and minimizes friction in diarthrosis. The resident cell population, chondrocytes, are surrounded by an extracellular matrix and a multitude of proteins, which bestow their unique characteristics. AC is characterized by a zonal composition (superficial (tangential) zone, middle (transitional) zone, deep zone, calcified zone) with different mechanical properties. An overview is given about different testing (load tests) methods as well as different modeling approaches. The widely accepted biomechanical test methods, e.g., the indentation analysis, are summarized and discussed. A description of the biphasic theory is also shown. This is required to understand how interstitial water contributes toward the viscoelastic behavior of AC. Furthermore, a short introduction to a more complex model is given

CT-based navigation for total hip arthroplasty: a meta-analysis

Introduction: Computer tomography (CT) based navigation is considered by some authors as an advance in total hip arthroplasty (THA). A meta-analysis was conducted to compare CT based versus conventional THA in terms of surgical duration of the procedure, leg length difference, acetabular cup position, and rate of dislocation. Material and methods: The present study was conducted according to the PRISMA 2020. In December 2022, the following databases were accessed: PubMed, Web of Science, Google Scholar, Embase with no time constrain. All the clinical studies comparing CT based navigation versus the conventional THA were accessed. Results: Data from 1801 procedures were collected. The mean age of the patients was 61.6 ± 5.3 years, and the mean BMI was 26.9 ± 2.3 kg/m2. There was between studies comparability at baseline in terms of age, BMI, pain score, Harris hip score, leg length discrepancy (P > 0.1). The navigated group demonstrated lower leg length discrepancy (P = 0.02), and lower degrees of cup anteversion (P = 0.002). Similarity was found in cup inclination (P = 0.98), surgical duration (P = 0.3), and the rate of dislocation (P = 0.6). Conclusion: CT guided THA may have the potential to increase the accuracy of acetabular positioning and reduce the leg length discrepancy. Current evidence is very limited and heterogeneous, and no recommendations can be inferred. Further investigations are required to definitely clarify the role of CT based THA in current practice

Osteoarthritis Risks and Sports: An Evidence-based Systematic Review

Purpose: Regular sports activities are associated with multiple physical and psychological health benefits. However, sports also may lead to injuries and the development of osteoarthritis (OA). This systematic review investigated the association between sports activity, sports type, and the risk of developing OA. Methods: A systematic review was performed by assessing studies that have investigated the risk of OA development in sports. Data extracted included general information, study design, number of participants, related body mass index, sports type, and assessment of OA. The methodological quality of the studies was assessed using the Newcastle-Ottawa Scale. Results: A total of 63 studies were included in this systematic review. The overall Newcastle-Ottawa Scale score was 6.46±1.44 demonstrating a good methodological quality of the articles included in the present study. A total of 628,036 participants were included, with a mean follow-up of 8.0±8.4 years. The mean age of the included athletes was 45.6±15.8, with a mean body mass index of 24.9±2.3 kg/m2. Conclusion: Football and soccer players seem to be at higher risk for the development of OA, although the injury status of the joint should be considered when assessing the risk of OA. High equipment weight and increased injury risk also put military personnel at a higher risk of OA, although elite dancing leads to more hip labral tears. Femoroacetabular impingement was also often diagnosed in ice-hockey players and ballet dancers

Long-range angular correlations of π, K and p in p–Pb collisions at sNN\sqrt{s_{NN}} = 5.02 TeV

Angular correlations between unidentified charged trigger particles and various species of charged associated particles (unidentified particles, pions, kaons, protons and antiprotons) are measured by the ALICE detector in p-Pb collisions at a nucleon--nucleon centre-of-mass energy of 5.02 TeV in the transverse-momentum range 0.3 < $p_T$ < 4 GeV/c. The correlations expressed as associated yield per trigger particle are obtained in the pseudorapidity range |$\eta_{lab}$| < 0.8. Fourier coefficients are extracted from the long-range correlations projected onto the azimuthal angle difference and studied as a function of $p_T$ and in intervals of event multiplicity. In high-multiplicity events, the second-order coefficient for protons, $v_2^p$, is observed to be smaller than that for pions, $v_2^\pi$, up to about $p_T$ = 2 GeV/c. To reduce correlations due to jets, the per-trigger yield measured in low-multiplicity events is subtracted from that in high-multiplicity events. A two-ridge structure is obtained for all particle species. The Fourier decomposition of this structure shows that the second-order coefficients for pions and kaons are similar. The $v_2^p$ is found to be smaller at low $p_T$ and larger at higher $p_T$ than $v_2^\pi$, with a crossing occurring at about 2 GeV. This is qualitatively similar to the elliptic-flow pattern observed in heavy-ion collisions. A mass ordering effect at low transverse momenta is consistent with expectations from hydrodynamic model calculations assuming a collectively expanding system.Angular correlations between unidentified charged trigger particles and various species of charged associated particles (unidentified particles, pions, kaons, protons and antiprotons) are measured by the ALICE detector in p-Pb collisions at a nucleon-nucleon centre-of-mass energy of 5.02 TeV in the transverse-momentum range $0.3 < p_{\rm T} < 4$ GeV/$c$. The correlations expressed as associated yield per trigger particle are obtained in the pseudorapidity range $|\eta_{\rm lab}|<0.8$. Fourier coefficients are extracted from the long-range correlations projected onto the azimuthal angle difference and studied as a function of $p_{\rm T}$ and in intervals of event multiplicity. In high-multiplicity events, the second-order coefficient for protons, $v_2^p$, is observed to be smaller than that for pions, $v_2^\pi$, up to about $p_{\rm T} = 2$ GeV/$c$. To reduce correlations due to jets, the per-trigger yield measured in low-multiplicity events is subtracted from that in high-multiplicity events. A two-ridge structure is obtained for all particle species. The Fourier decomposition of this structure shows that the second-order coefficients for pions and kaons are similar. The $v_2^p$ is found to be smaller at low $p_{\rm T}$ and larger at higher $p_{\rm T}$ than $v_2^pi$, with a crossing occurring at about 2 GeV. This is qualitatively similar to the elliptic-flow pattern observed in heavy-ion collisions. A mass ordering effect at low transverse momenta is consistent with expectations from hydrodynamic model calculations assuming a collectively expanding system.Angular correlations between unidentified charged trigger particles and various species of charged associated particles (unidentified particles, pions, kaons, protons and antiprotons) are measured by the ALICE detector in p–Pb collisions at a nucleon–nucleon centre-of-mass energy of 5.02 TeV in the transverse-momentum range 0.3<pT<4 GeV/c . The correlations expressed as associated yield per trigger particle are obtained in the pseudorapidity range |ηlab|<0.8 . Fourier coefficients are extracted from the long-range correlations projected onto the azimuthal angle difference and studied as a function of pT and in intervals of event multiplicity. In high-multiplicity events, the second-order coefficient for protons, v2p , is observed to be smaller than that for pions, v2π , up to about pT=2 GeV/c . To reduce correlations due to jets, the per-trigger yield measured in low-multiplicity events is subtracted from that in high-multiplicity events. A two-ridge structure is obtained for all particle species. The Fourier decomposition of this structure shows that the second-order coefficients for pions and kaons are similar. The v2p is found to be smaller at low pT and larger at higher pT than v2π , with a crossing occurring at about 2 GeV/c . This is qualitatively similar to the elliptic-flow pattern observed in heavy-ion collisions. A mass ordering effect at low transverse momenta is consistent with expectations from hydrodynamic model calculations assuming a collectively expanding system

J/ψJ/\psi production and nuclear effects in p-Pb collisions at SNN\sqrt{S_{NN}} = 5.02 TeV

Inclusive J/$\psi$ production has been studied with the ALICE detector in p-Pb collisions at $\sqrt{s_{NN}}$ = 5.02 TeV at the CERN LHC, in the rapidity domains 2.03 < y$_{cms}$ < 3.53 and −4.46 < y$_{cms}$ < −2.96, down to zero transverse momentum. The J/$\psi$ measurement is performed in the Muon Spectrometer through the $\mu^+\mu^−$ decay mode. In this Letter, the J/$\psi$ production cross section and the nuclear modification factor R$_{pPb}$ for the rapidities under study are presented. While at forward rapidity a suppression of the J/$\psi$ yield with respect to binary-scaled pp collisions is observed, in the backward region no suppression is present. The ratio of the forward and backward yields is also shown differentially in rapidity and transverse momentum. Theoretical predictions based on nuclear shadowing, as well as on models including, in addition, a contribution from partonic energy loss, are in fair agreement with the experimental results.Inclusive J/$\psi$ production has been studied with the ALICE detector in p-Pb collisions at the nucleon-nucleon center of mass energy $\sqrt{s_{\rm NN}}$ = 5.02 TeV at the CERN LHC. The measurement is performed in the center of mass rapidity domains $2.03<y_{\rm cms}<3.53$ and $-4.46<y_{\rm cms}<-2.96$, down to zero transverse momentum, studying the $\mu^+\mu^-$ decay mode. In this paper, the J/$\psi$ production cross section and the nuclear modification factor $R_{\rm pPb}$ for the rapidities under study are presented. While at forward rapidity, corresponding to the proton direction, a suppression of the J/$\psi$ yield with respect to binary-scaled pp collisions is observed, in the backward region no suppression is present. The ratio of the forward and backward yields is also measured differentially in rapidity and transverse momentum. Theoretical predictions based on nuclear shadowing, as well as on models including, in addition, a contribution from partonic energy loss, are in fair agreement with the experimental results

Energy Dependence of the Transverse Momentum Distributions of Charged Particles in pp Collisions Measured by ALICE

Differential cross sections of charged particles in inelastic pp collisions as a function of p_T have been measured at $\sqrt{s}$ = 0.9, 2.76 and 7 TeV at the LHC. The $p_T$ spectra are compared to NLO-pQCD calculations. Though the differential cross section for an individual $\sqrt{s}$ cannot be described by NLO-pQCD, the relative increase of cross section with sqrt(s) is in agreement with NLO-pQCD. Based on these measurements and observations, procedures are discussed to construct pp reference spectra at $\sqrt{s}$ = 2.76 and 5.02 TeV up to $p_T$ = 50 GeV/c as required for the calculation of the nuclear modification factor in nucleus-nucleus and proton-nucleus collisions