Journal of Musculoskeletal Research

Purpose: Formetric 4D dynamic system (F4D) is a radiation-free imaging system that can be used to detect static and dynamic back contour in children with adolescent idiopathic scoliosis (AIS). The aim of this paper is (1) to compare the F4D to other systems; (2) to review the correlation of spinal measurements taken by F4D with those taken by radiographs as well as the reproducibility of the F4D; (3) to present future clinical uses and suggest potential research studies utilizing F4D. Methods: MEDLINE (PubMed), ScienceDIRECT, SCOPUS, Cochrane, and Web of Science were queried for studies on AIS using surface topography. Papers were evaluated using PRISMA criteria. Results: Correlations between scoliosis angle as measured by F4D and Cobb angle by radiographs are from 0.7 to 0.872 in the thoracic spine and from 0.5 to 0.758 in the lumbar spine. The intraday reliability of F4D measurements by the same observer ranged from 0.65 to 0.996 across two studies. The study that evaluated reproducibility of F4D when segmented by patients with BMI below and above 24.99 kg/m² found that the reproducibility was 0.990 and 0.995, respectively. There is potential for using F4D as a screening tool for scoliosis using an algorithm with 92% sensitivity and 74% specificity. Conclusions: F4D as a surface topography machine has great potential in screening and monitoring progression of the curvatures of AIS.

Purpose: A remedy for ankle osteoarthritis is artificial joint replacement surgery. By estimating the relative positional difference (alignment) between the bone before and after deformation, precise artificial joint replacement surgery can be performed. By using the estimated alignment, an artificial ankle joint can ensure high satisfaction with less pain and can perform necessary functions. Although bone alignment is currently estimated from X-rays and computed tomography (CT) images, it is difficult to measure three-dimensional (3D) data from two-dimensional (2D) images. Although 3D data can be estimated using a 2D–3D registration method, it requires capturing the bone images multiple times and imposing considerable burden on the patient. In this paper, we propose a method to estimate the 3D bone alignment based on the size of the bone using principal component analysis (PCA), which requires scanning only one data. Method: In the proposed method, PCA is used to create a 3D bone model based on the bone thickness, and the bone alignment is estimated by the Go-ICP algorithm. In this study, the images of the foot were captured using a CT device, and the 3D bone model was created by stacking CT images. For improving the accuracy of the alignment, a reference model based on the bone thickness was created using PCA. Subsequently, the bone was overlapped and the alignment was estimated. Result: For the evaluation of the accuracy of alignment in the proposed method, three types of methods were used to create a bone model. The proposed method was found to be the most accurate with respect to the true value in five of the six evaluation criteria. In addition, the alignment of the tibiofibular joint was evaluated using the proposed method. Regarding the displacement in the $Z$-axis direction, there were significant differences in both Stage 3B and Stage 4 compared with the healthy subjects. In addition, the magnitude of rotation in the $Z$-axis direction showed a significant difference in stage 3B as compared with a healthy subject. Conclusion: Using the proposed method, we have shown that bone alignment can be estimated three-dimensionally by scanning the bone data once only. In addition, by comparing with the reference model using PCA based on the thickness of the bone, the accuracy of alignment is improved as compared with the reference model, which is not based on the bone thickness.

Purpose: This study was conducted to histopathologically compare the results of the administration of intra-articular PDRN and HA injections in experimentally induced OA in rats. Methods: Osteoarthritis of the knee joints was induced in a total of 30 rats. Rats were randomly divided into three groups; polydeoxyribonucleic (PDRN) acid group, hyaluronic acid (HA) group, and saline group. The PDRN group was injected with 12 mg/0.05 ccPDRN acid. The HA group was injected with 12 mg/0.05 ccHA, whereas the saline group was injected with 50 $\mu$l (0.05 cc) of 0.9% sodium chloride solution. All rats were sacrificed on postinjection day 29, and the right knee joints were prepared and evaluated histologically using the Mankin scoring system. Results: Total Mankin scores showed a significant difference among all groups ($p$ = 0.001). According to bilateral comparisons performed to identify the group that showed a difference, the total Mankin scores of the PDRN acid and HA groups were found to be significantly lower than those of the saline group. In PDRN acid group, tidemark continuity wasobserved in all specimen. Conclusion: Intra-articular injections of PDRN acid resulted in greater chondroprotective effects and less degeneration than those of HA and saline in experimentally induced OA of the knee joints in rats.

Purpose: Our study aimed to find the location and pattern of musculoskeletal injuries in participants enrolled in Zumba-based training and to analyze the contributing risk factors for injuries through a self-administered questionnaire. Methods: A total of 50 participants were recruited in an offline and online-based study using a self-administered questionnaire based on seven demographic-based questions, eight injury-related questions and five questions based on the risk factors related to Zumba-based training. Binomial logistic regression analysis was used to predict the odds-ratio and factors contributing to the risk of injuries. Results: Twenty-nine out of 50 participants (58%) had single or multiple musculoskeletal injuries with the most common sites of injury being in the order of: leg (23%), knee (18%) and ankle, foot and the lower back (15%). Amongst the injured subjects, 10 (34.4%) had sought medical help and 11 (37.9%) had resorted to self-management. The binomial regression analysis showed the presence of recurrent injuries and the flooring of the class to be significantly associated with the risk of injuries. Conclusion: There was a 58% prevalence of musculoskeletal injuries in the subjects enrolled in Zumba-based training. The factors which are found to be an increased risk for musculoskeletal injuries were recurrent injuries and flooring of the class.

Background: Oxford Elbow Score, abbreviated OES, is a tool used for measurement of a patient’s experience post elbow surgery. The tool is formulated as a questionnaire. OES has three subscales: pain, elbow function and social-psychological effects. The patient may complete the questionnaire and the results used as an outcome measure post elbow surgery. Objectives: The study aims to develop and evaluate the Arabic version of the OES for reliability, validity concerning patients after elbow trauma and surgery. Material and Methods: Fifty two patients participated in this survey at the baseline (14 days after the operation) and follow-up (after 60 days). We calculated internal consistency using Cronbach’s alpha. Also, Pearson’s correlation was calculated for construct validity verification. Results: The values for Cronbach’s alpha for psychological, function and pain subscales were 0.701, 0.704 and 0.779, respectively. Cronbach’s alpha for the questionnaire had a value of 0.743. We confirmed construct validity using correlation coefficients of values $-0.820$, $-0.750$ and $-0.800$ as compared to DASH. Conclusion: The Arabic OES is an internal consistent tool with good construct validity, which can be used to estimate the patient’s condition after the elbow surgery.

Purpose: Evaluate the reliability of the early functional recovery and postoperative pain control using adductor canal block (ACB) compared with that using femoral nerve block (FNB) in patients undergoing total knee replacement (TKR). Patients and Methods: A total of 80 patients scheduled for TKR were randomly and blindly distributed into two groups (40 patients each). Group A received ACB and group F received FNB. The early quadriceps strength, range of motion and pain control were assessed after surgery during the first 48h. Results: Patients in group F had significantly less quadriceps power postoperatively than those in group A. There were no significant differences between the two studied groups as regard ambulation, range of motion and pain estimation. Conclusion: Since both blocks have comparable analgesic effect and opioid consumption rates, the increased quadriceps muscle strength and ability to ambulate on the first postoperative day is the driving factor in selecting the ACB. With the findings discussed in our study and in literature, an ACB is a viable option in place of a FNB in patients undergoing a total knee arthroplasty. Additional large participant randomized controlled studies should be conducted to further discover the benefits of an ACB in patients undergoing a total knee arthroplasty.