Journal of Musculoskeletal Research

Recombinant human bone morphogenetic protein-2 (rhBMP-2) (0, 0.1, 1, or 5 μg) was injected into the autogeneous semitendinosus tendon, and the tendon was transplanted to the region of the medial meniscus defect in a rabbit model to repair the defect. Cartilaginous transformation of the tendon by rhBMP-2 was expected under the less-vascularized intra-articular environment. At four and eight weeks after surgery, the left knee joints were harvested, and the morphological changes of the graft were examined by radiological, histological, and immunohistochemical methods. Cartilaginous tissue within the graft was detected by Safranin O staining and immunostaining of Type-II collagen. At four weeks, fibrocartilagenous tissue, together with small ossicles, was consistently noted in tendon autografts that were injected with 1 or 5 μg of rhBMP-2. At eight weeks, the cartilage located at the basal part of the graft adjacent to the joint capsule was partially replaced with ectopic bone in the 1-μg or 5-μg groups. The ossicles might have been formed by vascular invasion into the rhBMP-2-induced cartilage, but the cartilageous structure remained at the peripheral part of the graft and filled the meniscus defect. The experimental results indicate the potential use of rhBMP-2 in regenerating the cartilaginous meniscus if additional methods to suppress vascular invasion into the rhBMP-2–induced cartilage also inhibit ossification.

This study aims to determine whether pre-employment medical, physical or psychological assessments can predict future back, neck and shoulder musculoskeletal injuries and claims in an Australian ambulance service.

This was a retrospective observational study based on linked datasets. Poisson regression analysis was undertaken to determine which pre-employment personality traits, using the Fifteen Factor Questionnaire and 36 medical and functional capacity evaluation variables, predicted the number of injuries and claims in ambulance officers.

Ambulance officers who at pre-employment assessment demonstrated more conceptual, intuitive and anxious personality traits, and those ambulance officers who had hypermobile joints, self-limited weights lifted, played less sport or exercised less, were more likely to sustain future back, neck or shoulder musculoskeletal injuries or submit workers compensation claims.

Individual pre-employment risk factors were found to predict musculoskeletal injuries and claims in a cohort of ambulance officers. Anxious as opposed to stable personality types and conceptual rather than practical personality types appear to be at greater risk of an injury or submitting a claim, as were recruits with hypermobile joints. Identification of individual risk factors at recruitment may assist in the selection of suitable applicants into the ambulance service as well as providing a focus for career counseling where relevant.

Purpose: Different assessment strategies for radiating low back pain (LBP) abound across and within primary-contact disciplines yet physical diagnosis of the involved faulty anatomical structures remain difficult. This study investigated pattern of pain distribution in patients with gluteal-related low back pain. Methods: The study involved forty (40) participants with radiating low back pain who were referred for physiotherapy from two major referral clinical settings in Ghana. They were recruited into the cross-sectional survey through consecutive sampling technique. Using marker and transparent tracing sheet, gluteal triangle was outlined from the lumbar region, the involved gluteal region and the posterior part of the involved thigh. Pattern of pain distribution was noted and physically correlated with stereotype patterns of pressure points as gold standard. Data analysis involved mean, frequency distribution, percentage distributions and z-score. Alpha value was considered significant at p < 0.05. Results: The mean ages, year (SD) were 52.0 years (12.0) and 48 years (15) for male and female, respectively. Myofascial and piriformis syndromes were the most predominant presentations among the patients recording 13 (32.5%) and 10 (25%), respectively. Male group recorded 9 (22.5%) of pain originating from myofascial syndrome compared to 4 (10%) assessed in their female counterparts. There was no gender difference in the proportion of pattern of pain distribution among the participants. Conclusion: This study demonstrated different patterns of pain distribution and was found to be consistent with gold standard pressure point in the assessment of patients with radiating LBP, thus it can be included as complimentary diagnostic tool in clinical practice.

Purpose: Back muscles' endurance assessment provides an objective indicator of the functional capacity of the back. This study sought to establish a gender and age referenced normative data for back muscles endurance for a Sub-Saharan African population. Methods: This cross sectional study involved 1253 (623 male, 630 female) consecutive participants between the ages of 11 and 69 years without a history of symptomatic LBP within one year to the time of the study. Participants were recruited from eight secondary schools, two universities and two teaching hospitals, respectively. All participants underwent assessment of the back extensor muscles' endurance using the modified Biering-Sorensen test of muscular endurance. The mean and percentile data for endurance time were determined for six gender/age groups classified on a range of 10 years. Results: The mean endurance time (ET) of all the participants was 119 ± 53.6 secs. Men exhibited a significantly (p = 0.001) higher ET than women (125.9 ± 53.3 versus 112.6 ± 53.1 secs). Using percentile values cut-points; poor endurance (less than 25th), moderate endurance (25–75th) and good endurance (> 75th percentile) were < 85.0 secs, 85–163 secs, and > 163 secs, respectively for male; and < 69.8 secs, 69.8–148 secs and > 148 secs, respectively for female. Conclusion: The normative values derived in this study would be useful in assessing impairment in back muscles' endurance in both healthy and patient populations. The results suggest that age, gender and anthropometric factors can significantly influence back muscles' endurance.

Background: Osteoarthritis of any joint may exert different effects on bone mineral density that may be the result of several mechanisms including change in the pattern of weight load distribution. In this cross-sectional study we tried to find correlations between unilateral knee osteoarthritis and bone mineral density of hips and lumbar vertebrae. Methods: Forty three patients with knee osteoarthritis (unilateral or more severe in one side) were recruited in this study. The American college of Rheumatology Criteria was followed for the diagnosis of osteoarthritis. Dual X-Ray absorptiometry was used to obtain the T score and the Z score of the hips and lumbar vertebrae. Results: The T score and Z score of the hip and T score of the femoral neck, at the side with ipsilateral knee osteoarthritis was lower than the other side (p < 0.05). The mean Z score and T score of the vertebrae was negative irrespective of the side of osteoarthritis. Conclusions: Bone mineral density of the hip with ipsilateral knee osteoarthritis was lower than the other side, which suggests that BMD may be sensitive to some extent in detecting osteoporosis in these patients; it has also been observed that osteoarthritis might not affect bone mineral density of the hips and lumbar vertebrae in the same manner or to the same extent.

Objective: To clarify the pathophysiology of knee arthropathy, articular sound in the knee joint was recorded using an accelerometer, vibroarthrography (VAG), during standing-up and sitting-down movements in patients with osteoarthropathy (OA) of the knees. Methods: VAG signals and angular changes of the knee joint during standing-up and sitting-down movements were recorded in patients with OA, including 17 knees with OA at Kellgren–Lawrence stage I and II, 16 knees with OA at III and IV stages, and 20 knees of age-matched control subjects. Results: The level of VAG signals was greater in knees with a higher stage of OA at 50–99 and 100–149 Hz among the groups (ANOVA with Tukey–Kramer multiple comparisons test, p < 0.01). The VAG signals did not correlate with WOMAC-pain or physical scores. Conclusions: We considered that the increase in VAG signals in these ranges of frequency corresponded with pathological changes of OA, but not self-reported clinical symptoms. This method of VAG can be used by clinicians during interventions to obtain pathological information regarding structural changes of the knee joint.

Fibrolipomatous hamartomas of nerve are rare slowly growing fibrofatty masses of peripheral nerves which surround and infiltrate the major nerves and their branches. It may cause symptoms of compression neuropathy. It most commonly affects the median nerve and very rarely involves the lower extremity. Here, we present a very uncommon case of an extensive fibrolipomatous hamartoma at an unusual location in the leg and foot of a young man arising from common peroneal nerve, extending inferiorly along the superficial peroneal nerve in the lateral aspect of leg and foot. We discuss the characteristic radiologic appearance of this entity that is often pathognomonic and allows a confident diagnosis, thus avoiding the need for biopsy.