https://www.oarsijournal.com/article/S1063-4584(02)90801-0/pdf

Articular cartilage repair: basic science and clinical progress. A review of the current status and prospects.

Reports linking long-term use of bisphosphonates (BPs) with atypical fractures of the femur led the leadership of the American Society for Bone and Mineral Research (ASBMR) to appoint a task force to address key questions related to this problem. A multidisciplinary expert group reviewed pertinent published reports concerning atypical femur fractures, as well as preclinical studies that could provide insight into their pathogenesis. A case definition was developed so that subsequent studies report on the same condition. The task force defined major and minor features of complete and incomplete atypical femoral fractures and recommends that all major features, including their location in the subtrochanteric region and femoral shaft, transverse or short oblique orientation, minimal or no associated trauma, a medial spike when the fracture is complete, and absence of comminution, be present to designate a femoral fracture as atypical. Minor features include their association with cortical thickening, a periosteal reaction of the lateral cortex, prodromal pain, bilaterality, delayed healing, comorbid conditions, and concomitant drug exposures, including BPs, other antiresorptive agents, glucocorticoids, and proton pump inhibitors. Preclinical data evaluating the effects of BPs on collagen cross-linking and maturation, accumulation of microdamage and advanced glycation end products, mineralization, remodeling, vascularity, and angiogenesis lend biologic plausibility to a potential association with long-term BP use. Based on published and unpublished data and the widespread use of BPs, the incidence of atypical femoral fractures associated with BP therapy for osteoporosis appears to be very low, particularly compared with the number of vertebral, hip, and other fractures that are prevented by BPs. Moreover, a causal association between BPs and atypical fractures has not been established. However, recent observations suggest that the risk rises with increasing duration of exposure, and there is concern that lack of awareness and underreporting may mask the true incidence of the problem. Given the relative rarity of atypical femoral fractures, the task force recommends that specific diagnostic and procedural codes be created and that an international registry be established to facilitate studies of the clinical and genetic risk factors and optimal surgical and medical management of these fractures. Physicians and patients should be made aware of the possibility of atypical femoral fractures and of the potential for bilaterality through a change in labeling of BPs. Research directions should include development of animal models, increased surveillance, and additional epidemiologic and clinical data to establish the true incidence of and risk factors for this condition and to inform orthopedic and medical management. © 2010 American Society for Bone and Mineral Research.

https://asbmr.onlinelibrary.wiley.com/doi/pdf/10.1002/jbmr.416

Atypical subtrochanteric and diaphyseal femoral fractures: Report of a task force of the american society for bone and mineral Research

A critical review of recombinant human bone morphogenetic protein-2 trials in spinal surgery: emerging safety concerns and lessons learned

This article systematically reviews epidemiological studies on sports injury from 1977 to 2005 in which ankle injury was included. A total of 227 studies reporting injury pattern in 70 sports from 38 countries were included. A total of 201 600 patients were included, with 32 509 ankle injuries. Ankle injury information was available from 14 098 patients, with 11 847 ankle sprains. Results show that the ankle was the most common injured body site in 24 of 70 included sports, especially in aeroball, wall climbing, indoor volleyball, mountaineering, netball and field events in track and field. Ankle sprain was the major ankle injury in 33 of 43 sports, especially in Australian football, field hockey, handball, orienteering, scooter and squash. In sports injuries throughout the countries studied, the ankle was the second most common injured body site after the knee, and ankle sprain was the most common type of ankle injury. The incidence of ankle injury and ankle sprain was high in court games and team sports, such as rugby, soccer, volleyball, handball and basketball. This systematic review provides a summary of the epidemiology of ankle injury in sports.

/pdf/a-systematic-review-on-ankle-injury-and-ankle-sprain-in-4g9zbsl6fu.pdf

A systematic review on ankle injury and ankle sprain in sports.

Introduction: Reports linking long-term use of bisphosphonates (BPs) with atypical fractures of the femur led the leadership of the American Society for Bone and Mineral Research (ASBMR) to appoint a Task Force to address key questions related to this problem. Methods: A multi-disciplinary expert group reviewed pertinent published reports concerning atypical femur fractures, as well as pre-clinical studies that could provide insight into their pathogenesis. Results and Conclusions: A case definition was developed so that subsequent studies report on the same condition. The Task Force defined major and minor features of complete and incomplete atypical femoral fractures and recommends that all major features, including their location in the subtrochanteric region and femoral shaft, transverse or short oblique orientation, minimal or no associated trauma and absence of comminution, be present to designate a femoral fracture as atypical. Minor features include their associations with cortical thickening, a periosteal reaction of the lateral cortex, a medial spike when the fracture is complete, prodromal pain, bilaterality, comorbid conditions and concomitant drug exposures, including BPs, other antiresorptive agents, glucocorticoids and proton pump inhibitors. Preclinical data evaluating the effects of BPs on collagen cross-linking and maturation, accumulation of microdamage and advanced glycation end-products, mineralization, remodeling, vascularity and angiogenesis, lend biological plausibility to a potential association with long-term BP use. Based on published and unpublished data and the widespread use of BPs, the incidence of atypical femoral fractures associated with BP therapy for osteoporosis appears to be very low, particularly compared to the number of vertebral, hip and other fractures that are prevented by BPs. Moreover, a causal association between BPs and atypical fractures has not been established. However, recent observations suggest that the risk rises with increasing duration of exposure and there is concern that lack of awareness and under-reporting may mask the true incidence of the problem. Recommendations: Given the relative rarity of atypical femoral fractures, the Task Force recommends that specific diagnostic and procedural codes be created and that an international registry be established to facilitate studies of the clinical and genetic risk factors and optimal surgical and medical management of these fractures. Physicians and patients should be made aware of the possibility of atypical femoral fractures and of the potential for bilaterality through a change in labeling of BPs. Research directions should include development of animal models, increased surveillance and additional epidemiological and clinical data to establish the true incidence of and risk factors for this condition and to inform orthopaedic and medical management.

Atypical Subtrochanteric and Diaphyseal Femoral Fractures: Report of a Task Force of the American Society for Bone and Mineral Research Running Title: Atypical Femoral Fractures Task Force Report

The author investigated in 130 anatomical specimens the topographical relations of the sciatic nerve and the musculus piriformis in order to explain the clinical syndrome of the m. piriformis. The author found that in 6.15% of cases the nervus peroneus communis passes between the tendinous parts of the m. piriformis, and he considers this variation of practical significance for the development of the 'piriformis syndrome'. In unward rotation of the thigh, the m. piriformis is extended and the tendons of the divided muscle are tightly pressed together thus pinching the nerve between them. Pinching of the nerve causes the characteristic sciatic pain. In such a case, the patient can be relieved by cutting one of the tendons.

Contribution to the etiological explanation of the piriformis syndrome.

BackgroundThere has been rapid growth in the technical and physiologic demands made on skaters who perform more and more difficult jumps, spins, lifts, throws, and free skating movements.PurposeTo ...

https://usfigureskatingssmcblogdotcom.files.wordpress.com/2012/08/the-incidence-of-injuries-in-elite-junior-figure-skaters.pdf

The incidence of injuries in elite junior figure skaters

Placement of the acetabular cup during total hip arthroplasty is of great importance because usually every deviation from the ideal centre of rotation negatively influences endoprosthesis survival, polyethylene wear and hip load. Here we present hip load change in respect to various acetabular cup positions in female patients who underwent total hip replacement surgery due to hip dysplasia. The calculation suggests that, in the majority of cases, for every millimeter of lateral displacement of the acetabular cup (relative to the ideal centre of rotation) an increase of 0.7% in hip load should be expected and for every millimeter of proximal displacement an increase of 0.1% in hip load should be expected (or decreased if displacement is medial or distal). Also, for every millimeter of neck length increase, 1% decrease is expected and for every millimeter of lateral offset, 0.8% decrease is expected. Altogether, hip load decreases when the cup is placed more medially or distally and when the femoral neck is longer or lateral offset is used.

/pdf/influence-of-the-acetabular-cup-position-on-hip-load-during-3tu1uwrbqr.pdf

Influence of the acetabular cup position on hip load during arthroplasty in hip dysplasia

BackgroundJunior rowers have competed internationally for over 4 decades, and there are no epidemiological data available on traumatic and overuse injury in this population.ObjectiveTo define the types of musculoskeletal problems present in international elite-level junior rowers and to determine whether gender, physical stature, rowing discipline, and training programs affect the incidence of reported injuries.Study Design Descriptive epidemiology study.MethodsInjury data were obtained from a total of 398 rowers (42% female, 58% male) who completed a 4-page questionnaire on injury incidence while participating at the Junior World Rowing Championships in Beijing, People’s Republic of China, in August 2007.ResultsOverall, 290 (73.8%) reported injuries involved overuse, and 103 (26.2%) were related to a single traumatic event. Female rowers were injured more frequently than male rowers (110.2 vs 90.5 injuries per 100 rowers). In both genders, the most common injury site was the low back followed by the knee...

Traumatic and Overuse Injuries Among International Elite Junior Rowers

Purpose
The purpose of this study was to revise the clinical use of commercial BMP2 (Infuse) and BMP7 (Osigraft) based bone devices and explore the mechanism of action and efficacy of low BMP6 doses in a novel whole blood biocompatible device OSTEOGROW.

/pdf/the-clinical-use-of-bone-morphogenetic-proteins-revisited-a-1mbo60m8dt.pdf

Marko Pećina

Papers

Contribution to the etiological explanation of the piriformis syndrome.

The incidence of injuries in elite junior figure skaters

Influence of the acetabular cup position on hip load during arthroplasty in hip dysplasia

Traumatic and Overuse Injuries Among International Elite Junior Rowers

The clinical use of bone morphogenetic proteins revisited: a novel biocompatible carrier device OSTEOGROW for bone healing