scholarly journals Retrograde Drilling for Osteochondral Lesion of the Talus in Juvenile Patients

2020 ◽  
Vol 5 (2) ◽  
pp. 247301142091613
Author(s):  
Yasunari Ikuta ◽  
Tomoyuki Nakasa ◽  
Yuki Ota ◽  
Munekazu Kanemitsu ◽  
Junichi Sumii ◽  
...  
Keyword(s):  
Physical Activity ◽  
Articular Surface ◽  
Healing Process ◽  
Osteochondral Lesion ◽  
Activity Level ◽  
Activity Score ◽  
Retrograde Drilling ◽  
Bone Sclerosis ◽  
Osteochondral Fragment

Background: Retrograde drilling (RD) is generally used for treating osteochondral lesion of the talus (OLT) with a stable osteochondral fragment and nearly normal articular cartilage surface. Previous studies that included participants of various ages have reported good clinical results. This study aimed to clarify the clinical outcomes of RD for OLT in juvenile patients whose bone-forming ability and physical activity might affect the healing process. Methods: This retrospective study included 8 juvenile patients who underwent RD for OLT (5 boys and 3 girls, mean age 14.9 years, mean follow-up 2 years, 7 medial and 1 central lesion). American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score and ankle activity score were evaluated, and arthroscopic findings were graded according to the International Cartilage Research Society (ICRS) classification system. The condition of the underlying bone was assessed on preoperative computed tomographic images. The stability, incorporation, and subsidence of the osteochondral fragment, articular surface congruity, and the area of the bone marrow lesion (BML) were evaluated using magnetic resonance imaging (MRI). Results: AOFAS ankle-hindfoot score and ankle activity score significantly improved postoperatively. Arthroscopically, the lesions were classified as ICRS grade 0 or 1. Bone sclerosis or multiple small cysts of the underlying bone were observed in all patients. MRI demonstrated no signs of osteochondral fragment instability or subsidence, good or fair fragment incorporation, good articular surface congruity, or slight irregularity. The postoperative BML was reduced; however, these BMLs were still detectable at 1 year after surgery. Conclusion: Our data suggested that RD is an option for treating juvenile patients with OLT refractory to nonoperative treatment at short-term follow-up. Although bone sclerosis or multiple small cysts were identified in the underlying bone preoperatively and the BML under the osteochondral fragment remained postoperatively, clinical status such as pain and physical activity level were improved by RD. Level of Evidence: Level IV, retrospective case series.

scholarly journals Retrograde Drilling for Osteochondral Lesion of the Talar Dome in Juvenile Patients

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0003
Author(s):  
Yasunari Ikuta ◽  
Tomoyuki Nakasa ◽  
Yusuke Tsuyuguchi ◽  
Yuki Ota ◽  
Munekazu Kanemitsu ◽  
...  
Keyword(s):  
Growth Plate ◽  
High Intensity ◽  
Articular Surface ◽  
Osteochondral Lesion ◽  
Early Period ◽  
Fat Suppression ◽  
Talar Dome ◽  
Retrograde Drilling ◽  
The Mean

Category: Ankle, Arthroscopy Introduction/Purpose: Osteochondral lesion of the talar dome (OLT) is common condition that causes pain of ankle joint in juvenile patients. Several surgical options have been available such as excision of detached cartilage fragment, microfracture, autologous cancellous bone graft and osteochondral autografting depending on the status of OLT. Arthroscopic drilling including transmalleolar or retrograde technique could be a good option for OLT patients with stable osteochondral fragment with normal articular surface. Retrograde drilling has an advantage in preventing the iatrogenic articular cartilage injury. This study aimed to clarify the clinical outcome of the retrograde drilling for OLT in juvenile patients. Methods: Our retrospective analysis included 8 patients who underwent retrograde drilling for OLT, in 5 boys and 3 girls, with a mean age of 14.9 years (range, 11-19). Range of motion (ROM) and American Orthopaedic Foot & Ankle Society (AOFAS) ankle- hindfoot score were evaluated as the clinical outcomes. OLTs were classified into 4 grades according to arthroscopic findings by international cartilage research society (ICRS) classification. Radiographic analysis was performed using preoperative and postoperative images. Growth plate was evaluated on plane radiographs, and the location and size of OLT were assessed on computed tomography. The high intensity area of the talus was also measured on T2 fat suppression images. Results: All 8 patients were followed with a mean follow-up period of 2 years, and they had no complication or revision surgery. The mean total ROM were 65.6° preoperatively and 67.1° postoperatively. AOFAS scale improved from 69.3 to 96.7 (p = 0.012). The ICRS 1 and 2 OLT lesions were identified arthroscopically in 5 and 3 patients, respectively. Growth plate remained open in 4 patients, and OLTs were located on the posteromedial in 7 patients, center in 1 patient. The mean size of OLT fragment was 9.8 mm, 6.8 mm and 3.5 mm in length, width and height. Coronal and sagittal T2 fat suppression images demonstrated that the high intensity area of 241.3 mm2, 554.5 mm2 at preoperative status and 190.9 mm2, 302.6 mm2 at final follow-up status. Conclusion: These findings revealed that the retrograde drilling remarkably improved clinical status in juvenile OLT patients. The high intensity area at the talus remained postoperatively, however, that did not affect clinical results. Retrograde drilling procedure should be considered for treating juvenile patients in the early period after detection of the OLT.

scholarly journals A case report of femoral head fracture with osteochondral lesion treated by osteosynthesis and biomimetic scaffold: 2-year clinical and radiological follow-up

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Alessandro Casiraghi ◽  
Claudio Galante ◽  
Marco Domenicucci ◽  
Stefano Cattaneo ◽  
Andrea Achille Spreafico ◽  
...  
Keyword(s):  
Case Report ◽  
Femoral Head ◽  
Articular Surface ◽  
Osteochondral Lesion ◽  
Hip Dislocation ◽  
Fracture Dislocation ◽  
Osteochondral Lesions ◽  
Femoral Head Fracture ◽  
Osteochondral Scaffold

AbstractThe aim of the present study was to present clinical and radiological outcome of a hip fracture-dislocation of the femoral head treated with biomimetic osteochondral scaffold.An 18-year-old male was admitted to the hospital after a motorcycle-accident. He presented with an obturator hip dislocation with a type IVA femoral head fracture according to Brumback classification system. The patient underwent surgery 5 days after accident. The largest osteochondral fragment was reduced and stabilized with 2 screws, and the small fragments were removed. The residual osteochondral area was replaced by a biomimetic nanostructured osteochondral scaffold. At 1-year follow-up the patient did not complain of hip pain and could walk without limp. At 2-year follow-up he was able to run with no pain and he returned to practice sports. Repeated radiographs and magnetic resonance imaging studies of the hip showed no signs of osteoarthritis or evidence of avascular necrosis. A hyaline-like signal on the surface of the scaffold was observed with restoration of the articular surface and progressive decrease of the subchondral edema.The results of the present study showed that the biomimetic nanostructured osteochondral scaffold could be a promising and safe option for the treatment of traumatic osteochondral lesions of the femoral head.Study Design: Case report.

scholarly journals The risk of venous thromboembolism and physical activity level, especially high level: a systematic review

2021 ◽  
Author(s):  
H. Danin-Mankowitz ◽  
A. Ugarph-Morawski ◽  
F. Braunschweig ◽  
P. Wändell
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Venous Thromboembolism ◽  
Activity Level ◽  
Case Control Studies ◽  
The Third ◽  
Area Of Interest ◽  
High Level ◽  
The Relationship

AbstractVenous thromboembolism (VTE) is the third most common cause of cardiovascular disease. Connection between high level of physical activity (PA) and the onset of VTE is unknown. We searched the literature on the possible association between PA level, especially high levels, and the risk of VTE. A systematic review was carried out to identify relevant articles on the relation between PA level and VTE. The initial search was conducted together with the Karolinska Institutet University Library in February 2018, with follow-up searches after that. In total, 4383 records were found and then screened for exclusion of duplicates and articles outside the area of interest. In total, 16 articles with data on 3 or more levels of PA were included. Of these, 12 were cohort and 4 were case-control studies. Totally 13 studies aimed at investigating VTE cases primarily, while three studies had other primary outcomes. Of the 16 studies, five found a U-shaped association between PA level and VTE risk, although non-significant in three of them. Two articles described an association between a more intense physical activity and a higher risk of VTE, which was significant in one. Nine studies found associations between increasing PA levels and a decreasing VTE risk. Available literature provides diverging results as to the association between high levels of PA and the risk of venous thromboembolism, but with several studies showing an association. Further research is warranted to clarify the relationship between high level PA and VTE.

The impact of supervised exercise intervention on short-term postprogram leisure time physical activity level in cancer patients undergoing chemotherapy: 1- and 3-month follow-up on the body & cancer project

2006 ◽  
Vol 4 (1) ◽  
pp. 25-35 ◽  
Author(s):  
JULIE MIDTGAARD ◽  
ANDERS TVETERÅS ◽  
MIKAEL RØRTH ◽  
REINHARD STELTER ◽  
LIS ADAMSEN
Keyword(s):  
Physical Activity ◽  
Cancer Patients ◽  
Physical Activity Level ◽  
Leisure Time Physical Activity ◽  
Exercise Adherence ◽  
The Body ◽  
Activity Level ◽  
Supervised Exercise ◽  
Cancer Project

Background:Exercise is becoming an important component of cancer rehabilitation programs. A consistent finding across studies is that patients experience improved physical fitness and reduced fatigue. However, sustained physical activity is essential if the benefits are to be preserved over the course of cancer survivorship.Objective:This study examined self-reported short-term exercise adherence following a 6-week, supervised exercise program (muscle strength, cardiovascular fitness, relaxation, body awareness, and massage) in a heterogeneous group of 61 cancer patients (mean age 42.9 years, 82% oncological and 18% haematological) from the Body & Cancer Project.Methods:Semistructured interviews were used to quantitatively assess leisure time physical activity level 1 and 3 months after completion of the program. The study furthermore included 3-month follow-up assessment of psychological distress (Hospital Anxiety and Depression Scale—HADS). Patient statements were selected that best illustrated trends found in the statistical material.Results:There was a significant postprogram reduction in physical activity from 6 to 10 weeks and from 6 to 18 weeks. However, the patients (half of whom were still undergoing treatment at the time of follow-up) reported a higher physical activity level postprogram compared to their baseline levels. The analyses showed a positive association between the 3-month postprogram physical activity level and pre-illness physical activity level, treatment, and postprogram changes in depression.Significance of research:Given the significant decrease in postprogram PA level, especially in subjects still undergoing cancer treatment, the study suggests that continuous supervised programs may be required in order to encourage and support exercise adherence in this population. However, randomized clinical controlled trials and more follow-up studies are needed to establish the optimal program length and content for sustained exercise adherence in cancer patients.

Abstract P281: All-cause and Cardiovascular Mortality in Men With High Levels of Physical Activity and Coronary Artery Calcification

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Laura F Defina ◽  
Nina B Radford ◽  
David Leonard ◽  
Stephen W Farrell ◽  
Andjelka Pavlovic ◽  
...  
Keyword(s):  
Physical Activity ◽  
Coronary Artery ◽  
Coronary Artery Calcification ◽  
Proportional Hazards ◽  
Subclinical Atherosclerosis ◽  
Activity Level ◽  
Mortality Hazard ◽  
Hazard Ratios ◽  
All Cause Mortality

Introduction: Recent studies have suggested that extreme levels of physical activity (endurance athletes) are associated with subclinical atherosclerosis as well as increased mortality. The safety of continuing high levels of physical activity is uncertain once coronary artery calcification (CAC) is discovered. Hypothesis: We hypothesized that men performing &ge3000 MET·minutes/week of physical activity would have greater all-cause and cardiovascular (CV) mortality compared to those with &lt1500 or 1500-&lt3000 MET·minutes/week of physical activity and that mortality risk would be greater in those with CAC&ge100 compared to &lt100 Agatston units. Methods: The cohort studied included 16,109 men without prevalent CV disease who reported physical activity levels and underwent EBT or MDCT scan. Physical activity was categorized into &ge3000 (n=1,266), 1500-3000 (n=3,027), and &lt1500 (n=11,816) MET·minutes/week. CAC scanning included EBT scans (1997-2007) or MDCT scans (2007-2013), and CAC score was categorized into &ge100 (n=3,547) and &lt100 (n=12,562) Agatston units. We fit separate proportional hazards regression models to follow-up times for all-cause and CV mortality. The models included all combinations of CAC and physical activity categories and were adjusted for baseline age, smoking, BMI, cholesterol, HDLc, and systolic blood pressure. Results: The average age of participants at baseline was 51.3±8.3 years. Men with the highest activity level had a lower BMI and higher HDLc. After an average follow-up of 8.9 years, there were 329 all-cause and 60 CV deaths, including 174 all-cause and 38 CV deaths in those with CAC&ge100. The sample had 80% power to detect all-cause mortality hazard ratios &ge 1.9 and 1.8 for physical activity &ge3000 versus &lt1500 in those with CAC&lt100 and &ge100, respectively. The corresponding minimum detectable CV mortality hazard ratios were 3.5 and 2.8. Comparing physical activity &ge3000 to &lt1500 in those with CAC&ge100, the hazard ratios (95% CI) were 0.9 (0.5, 1.5) for all-cause mortality and 0.9 (0.3, 3.1) for CV mortality. Hazard ratios were similar when comparing physical activity &ge3000 to 1500-&lt3000 in those with CAC &ge100. Finally, when comparing physical activity categories, there was no evidence that hazard ratios varied by CAC category, p&gt0.7. Conclusions: This sample offers no evidence that levels of activity &ge3000 MET·minutes/week are associated with increased all-cause or CV mortality compared to those with &lt1500 or 1500- &lt3000 MET·minutes/week, regardless of CAC level.

Changes in Leisure-Time Physical Activity and Subsequent Sickness Absence Due to Any Cause, Musculoskeletal, and Mental Causes

2016 ◽  
Vol 13 (8) ◽  
pp. 867-873 ◽  
Author(s):  
Ansku Holstila ◽  
Ossi Rahkonen ◽  
Eero Lahelma ◽  
Jouni Lahti
Keyword(s):  
Physical Activity ◽  
Sickness Absence ◽  
Social Insurance ◽  
Leisure Time ◽  
Negative Binomial ◽  
Response Rate ◽  
Leisure Time Physical Activity ◽  
Activity Level ◽  
Middle Aged

Background:The association between changes in physical activity and sickness absence is poorly understood. The aim of this study was to examine the association between changes in leisure-time physical activity and long-term sickness absence due to any cause and musculoskeletal and mental causes.Methods:We measured physical activity at baseline in 2000–2002 (response rate 67%) and at follow-up in 2007 (response rate 83%) among middle-aged employees of the City of Helsinki, Finland. The survey data were linked to the Finnish Social Insurance Institute’s register data on sickness benefit periods > 9 days, including diagnoses (ICD-10; International Statistical Classification of Diseases and Related Health Problems, 10th revision) (mean follow-up 2.3 years). We used a negative binomial model to calculate rate ratios. The analyses included 4010 respondents (81% women).Results:Those who were persistently vigorously active and those whose physical activity level changed from low to moderate or vigorous, from moderate to vigorous, or from vigorous to moderate were at lower risk for sickness absence than were the persistently low-activity group. For sickness absence due to musculoskeletal causes, vigorous activity showed stronger associations, whereas mental causes showed no such associations.Conclusions:To reduce sickness absence due to both musculoskeletal and mental causes, middle-aged and aging employees should be encouraged to engage in physical activity.

The Relationship among Television Watching, Physical Activity, and Body Composition of 5- or 6-Year-Old Children

1996 ◽  
Vol 8 (1) ◽  
pp. 15-26 ◽  
Author(s):  
Robert H. DuRant ◽  
William O. Thompson ◽  
Maribeth Johnson ◽  
Tom Baranowski
Keyword(s):  
Physical Activity ◽  
Body Mass Index ◽  
Body Composition ◽  
Rating Scale ◽  
The Body ◽  
Activity Level ◽  
Television Watching ◽  
Activity Rating ◽  
The Relationship

This follow-up investigation examined the relationship among observed time of television watching, physical activity, and body composition in 5- to 6-year-old children previously studied 2 years ago. Activity level on school and nonschool days was measured with the Children’s Activity Rating Scale. Television watching time was assessed by direct observation, and body composition was measured with the body mass index, skinfold thicknesses, and waist/hip ratio. Television watching behavior, which increased from the earlier study, was not associated with body composition. Physical activity was lower during television watching than nontelevision watching time.

Development and validation of a very brief questionnaire measure of physical activity in adults with coronary heart disease

2007 ◽  
Vol 14 (5) ◽  
pp. 615-623 ◽  
Author(s):  
Alison Orrell ◽  
Patrick Doherty ◽  
Jeremy Miles ◽  
Robert Lewin
Keyword(s):  
Physical Activity ◽  
Heart Disease ◽  
Confidence Intervals ◽  
Total Activity ◽  
Activity Level ◽  
Activity Score ◽  
Moderate Intensity ◽  
Accelerometer Data ◽  
Metabolic Equivalent ◽  
Activity Measure

Background The aim of this study was to validate the Total Activity Measure, a brief questionnaire, to measure physical activity in an older adult population with heart disease. Methods Two versions of the Total Activity Measure were administered twice, 7 days apart. The Total Activity Measure 1 asked respondents for the frequency and average duration of bouts of physical activity at three different intensity levels per week, whereas the Total Activity Measure 2 asked respondents for the total time spent in activity at each activity level per week. Questionnaire accuracy was studied in 62 men and 15 women aged 47-84 years, by repeatability and comparison of both administrations of the Total Activity Measure 1 and Total Activity Measure 2 with 7-day RT3 accelerometer data. Results Seventy-three adults (58 men, 15 women) were used for all statistical analyses. Intraclass correlation coefficients for the Total Activity Measure 1 and Total Activity Measure 2 total activity scores (metabolic equivalent per minute) were r = 0.73 (95% confidence intervals, 0.56-0.83) and r = 0.82 (95% confidence intervals, 0.71-0.88), respectively. Correlations between the Total Activity Measure 1 and RT3 accelerometer for total activity score (metabolic equivalent per minute) were significant, r = 0.26 at time 1 and r = 0.27 at time 2 for moderate intensity activities. Correlations between the Total Activity Measure 2 and RT3 accelerometer for total activity score (metabolic equivalent per minute) were also significant, r = 0.38 at time 1 and r = 0.36 at time 2, r = 0.31 at time 2 for strenuous intensity activities and r = 0.29 at time 1 and r = 0.25 at time 2 for moderate intensity activities. Participants overestimated the amount of physical activity on both questionnaires as compared with the RT3 accelerometer. Conclusions The Total Activity Measure 2 was reasonably accurate in assessing total and moderate intensity activity over a 7-day period and demonstrated good test-retest reliability. The Total Activity Measure 1 was less accurate. The Total Activity Measure 2 is a suitable measure of total or moderate intensity physical activity for surveys and audits in an adult cardiac population. Eur J Cardiovasc Prev Rehabil 14:615-623 © 2007 The European Society of Cardiology

scholarly journals Associations Between Data Driven Dietary Patterns at Age 71 and the Prevalence of Sarcopenia 16 Years Later: A Cohort Study

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 421-421
Author(s):  
Mikael Karlsson ◽  
Wulf Becker ◽  
Tommy Cederholm ◽  
Liisa Byberg
Keyword(s):  
Physical Activity ◽  
Dietary Patterns ◽  
Principal Component ◽  
Fermented Milk ◽  
Activity Level ◽  
Data Driven ◽  
Food Record ◽  
European Working ◽  
High Adherence

Abstract Objectives Unlike physical activity, the role of diet in sarcopenia is unclear, and studies have predominantly focused on effects of single nutrients. Therefore, we assessed the associations between adherences to data driven dietary patterns (DPs), and the prevalence of sarcopenia (and its constituents) 16 years later. Methods Four DPs were defined using principal component analysis based on information from a 7-day food record retrieved from 1133 men (average age 71 years) in the Uppsala Longitudinal Study of Adult Men. Associations of each DP with sarcopenia 16 years later (defined according to the European Working Group on Sarcopenia in Older People; EWGSOP2) were analyzed using multivariable logistic regression (n = 257). Associations of each DP with muscle strength, muscle mass and physical performance 16 years later were analyzed using multivariable linear regression. We applied two models when adjusting for potential confounders: one unadjusted for potential confounders and one adjusted for age at baseline, follow-up period, reported energy intake at baseline, education, physical activity level at baseline, smoking, morbidity at baseline and BMI at baseline. Results The prevalence of sarcopenia at follow-up was 19% (50/257). Associations were largely non-linear and DPs were categorized into low, medium and high adherence. Compared to low adherence, medium and high adherence to DP2 (i.e., vegetables, green salad, fruit, poultry, rice and pasta) was associated with lower odds ratio (OR) of sarcopenia; adjusted ORs: 0.41 (95% confidence interval [CI]: 0.17–0.98) and 0.40 (95% CI: 0.17–0.94), respectively. There was a tendency that a higher adherence to a DP mainly characterized by a consumption of potato, meat and egg, and low consumption of fermented milk (DP4) was associated with higher prevalence of sarcopenia (low vs high adherences; adjusted OR: 1.61, 95% CI: 0.67 - 3.87). The other DPs displayed no clear associations. The analyses of DPs in relation to the individual sarcopenia constituents indicated no clear associations. Conclusions Dietary patterns may be a contributing modifiable cause of sarcopenia. Funding Sources The Uppsala Geriatric Foundation and the Region Örebro County supported this work.

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