Histological evidence of successful internal fixation for traumatic chondral fracture of the femoral groove

AbstractIsolated chondral fractures without cancellous bone have limited healing potential. We reattached a chondral fragment without cancellous bone using bone pegs for chondral fracture of the femoral groove in a 13-year-old boy. Five months after the surgery, we performed a biopsy to evaluate the histological findings for the healed osteochondral junction. Biopsy results showed that osteoblasts had proliferated in the subchondral layer, and some osteoblasts had invaded the calcified cartilage, suggesting active new bone formation. A tidemark was observed between the radial cartilage layer and the calcified cartilage, and it was evident that the osteochondral junction had been completely restored. Four years and 3 months after the surgery, magnetic resonance imaging revealed that the cartilage on the femoral groove was maintained and the patient can play basketball asymptomatically. This report shows that surgeons can attempt the reattachment of chondral fragments without cancellous bone in adolescent patients

Solid variant of aneurysmal bone cyst in the tibia treated with simple curettage without bone graft: a case report

The solid variant of aneurysmal bone cyst (solid ABC) is rarely encountered in long bones and appropriate treatment for this disease remains unclear. We experienced a 13-year-old boy suffering from pain in his left knee caused by solid ABC. Simple curettage of the bone lesion without any adjuvant therapy and a bone graft gave immediate pain relief. Histological examination of the surgical specimen showed typical features of solid ABC, and cycloxygenase-2 (COX-2) expression was confirmed in giant cells with a background of spindle cells by immunohistochemistry. Magnetic resonance imaging showed that soft tissue edema surrounding the lesion was improved two months after surgery and there was no indication of recurrence two years after surgery

Prevalence of Chronic Nonspecific Low Back Pain and Its Associated Factors among Middle-Aged and Elderly People: An Analysis Based on Data from a Musculoskeletal Examination in Japan

Study DesignA cross-sectional study.PurposeTo clarify the prevalence of chronic nonspecific low back pain (CNSLBP) and its associated factors among middle-aged and elderly Japanese individuals using data from a musculoskeletal examination conducted in general Japanese populations.Overview of LiteratureMost studies evaluating low back pain-associated factors have been conducted in Western countries, but they have not always evaluated CNSLBP.MethodsWe obtained data on 213 subjects aged >50 years who responded to a survey regarding age, gender, body mass index, lifestyle-related diseases (diabetes mellitus, hypertension, and hyperlipidemia), glucocorticoid use, smoking and alcohol-drinking habits, labor intensity, and chronic low back pain (CLBP) and underwent screening for lumbar spinal stenosis, evaluation for quality of life (QOL), and evaluation for specific spinal pathology via thoracolumbar spine X-rays. We investigated the prevalence of CNSLBP and association between CNSLBP and measured variables.ResultsThe prevalence of CNSLBP and chronic specific low back pain (CSLBP) was 15.4% and 9.3%, respectively. Among the subjects with CLBP, 62.2% had CNSLBP. In age-adjusted logistic models, smoking habits (p=0.049, odds ratio [OR]=2.594), low back pain (p<0.001, OR=0.974), lumbar function (p=0.001, OR=0.967), and social function (p=0.023, OR=0.976) in the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) were significantly associated with CNSLBP, whereas EQ-5D utility score (p=0.024, OR=0.068), low back pain (p=0.007, OR=0.981), lumbar function (p=0.001, OR=0.963), walking ability (p=0.001, OR=0.968), and social function (p=0.002, OR=0.966) in JOABPEQ were significantly associated with CSLBP.ConclusionsCNSLBP among middle-aged and elderly individuals was associated with smoking habits and decreased QOL; however, CSLBP was considered to be more multilaterally associated decreased QOL

Assessment of the Relationship between Pelvic Tilt and the Sacro-Femoral-Pubic Angle in Middle-Aged and Elderly Asian Individuals

Study DesignCross-sectional study.PurposeThe purpose of this study was to evaluate the correlation between pelvic tilt (PT) and the sacro-femoral-pubic (SFP) angle, which is easier to identify than PT, in middle-aged and elderly Asian subjects from the general population.Overview of LiteratureMeasuring PT is important in the diagnosis and treatment of adult spinal deformity. However, identifying femoral heads, which are necessary to determine PT, using sagittal radiographs is often difficult.MethodsStanding coronal and sagittal pelvic radiographs of individuals aged more than 50 years were taken during a local medical examination. The subjects were divided into female, male, and total groups at the time of evaluation. Linear regression analysis was performed to investigate the relationship between PT and the SFP angle, which were obtained from the X-rays.ResultsThe present study included 291 subjects. There were no statistically significant differences between the left and right SFP angles, and there was gender difference regarding the SFP angle. However, a gender difference was observed regarding PT. The correlation between PT and the SFP angle was substantiated in each group. Pearson's correlation coefficients between PT and the SFP angle in the total, female, and male groups were 0.696, 0.853, and 0.619, respectively. In the linear regression analysis, PT was calculated as follows: PT=60.1−0.77×(SFP angle) in the total group, PT=62.8−0.80×(SFP angle) in the female group, and PT=51.5−0.64×(SFP angle) in the male group.ConclusionsA significant correlation between PT and the SFP angle was observed in middle-aged and elderly Asian subjects from the general population

Shoulder and elbow pain in elementary school baseball players : The results from a nation-wide survey in Japan

Background: Despite recommendations on how to prevent baseball injuries in youths by the Japanese Society of Clinical Sports Medicine, shoulder and elbow pain still frequently occurs in young baseball players. We conducted a questionnaire survey among baseball players at elementary schools across the country to understand the practice conditions of players, examining the risk factors of shoulder and elbow pain in baseball players. Methods: The questionnaire survey was conducted among elementary school baseball players as members of the Baseball Federation of Japan in September 2015. Results: A total of 8354 players belonging to 412 teams (average age: 8.9) responded to the survey. Among 7894 players who did not have any shoulder and/or elbow pain in September 2014, elbow pain was experienced in 12.3% of them, shoulder pain in 8.0% and shoulder and/or elbow pain in 17.4% during the previous one year. A total of 2835 (39.9% of the total) practiced four days or more per week and 97.6% practiced 3 h or more per day on Saturdays and Sundays. The risk factors associated shoulder and elbow pain included a male sex, older age, pitchers and catchers, and players throwing more than 50 balls per day. Conclusions: It has been revealed that Japanese elementary school baseball players train too much. Coaches should pay attention to older players, male players, pitchers and catchers in order to prevent shoulder and elbow pain. Furthermore, elementary school baseball players should not be allowed to throw more than 50 balls per day. Study design: Retrospective cohort study

Curettage of benign bone tumors without grafts gives sufficient bone strength: A case-series of 78 patients

Background and purpose The defect that results after curettage of a bone tumor is usually filled in the same way. We report the outcome in patients with benign bone tumors that were treated with curettage but no filling