Effect of screw angulation and multiple insertions on load-to-failure of polyaxial locking system.

PURPOSE: Polyaxial locking plates rely on the alignment between the thread-to-thread connections of the screw head and the plate hole. These implants have provided substantial support for surgeons. In particular, extended screw positioning have proven to be beneficial in the fixation of challenging fractures. This study aimed to investigate the mechanical properties of ChM 5.0 ChLP polyaxial screws inserted in off-axis trajectories, including multiple insertions and to correlate these parameters with the screw head and the plate hole thread-to-thread engagement. METHODS: Polyaxial locking screws were inserted into the plates at various angles (0°,10°,15°, -15° off-axis). Multiple time inserted screws were placed firstly at 15°, then 0° and finally -15° off-axis in the same plate hole. A microCT scan of the plate-hole and screw-head interface was conducted before destructive tests. Representative screws from each group were also examined by Scanning Electron Microscope. RESULTS: The standard insertion at 0° sustained the greatest maximum bending strength without relocation in the screw hole. Screws inserted at 10° and 15° (one time) showed a significant reduction in load-to-failure of up to 36% and 55%, (p = 0.001) (p = 0.001) respectively. Screws inserted at -15° after a maximum of three multiple insertions with angle shift, showed a total reduction in force of up to 70% (p = 0.001). A microCT analysis of thread engagement showed significant correlations. However, the results obtained for multiple insertions were highly variable. CONCLUSIONS: ChM 5.0 ChLP polyaxial locking system has valuable properties that foster fracture fixation, providing various surgical options. Nevertheless, the freedom of off-axis placement and multiple insertions of the screws comes at the price of reduced force. When possible surgeons should minimize the angles of insertions.

Effect of screw angulation on the bending performance of polyaxial locking interfaces: a micro-CT evaluation.

Polyaxial locking plates rely on a specific thread-to-thread interface of the screw head and the plate hole. The objective of this study was to evaluate the mechanical performance of single screw interfaces when inserted off-axis and to establish correlations between those parameters and the engagement of the screw head and the plate hole thread. Three polyaxial locking screw systems were inserted into the corresponding plates at various angles (0°, 5°, 10°, and 15° off-axis). The screws were tested until failure. A micro-CT was performed to examine the interface between the plate hole and the screw head. The standard insertion at 0° sustained the greatest maximum bending strength without relocation in the screw hole. Screws inserted at 15° showed a significant reduction in force of up to 44%, 55% and 57%, respectively. Micro-CT analysis of the interface showed a significant loss of thread engagement for off-axis insertion. Polyaxial plates offer additional advantages for off-axis placement of screws. However, this flexibility is related to a significant decrease in both thread engagement and bending strength compared to monoaxial insertion. Regardless the insertion angle, the loss of stability is comparable when screws are placed off-axis. Surgeons are advised to consider off-axis insertion as a salvage option, providing access to better bone stock.

Biomechanical evaluation of variable angle locking systems. A micro-CT analysis.

PURPOSE: Formerly poor bone stock and periprosthetic fractures used to jeopardize monaxial constructs. Polyaxial locking screws have substantially supported those particular fixation constructs. However, those systems rely on complex alignment between the screw head and the plate hole. This study aimed to investigate the mechanical properties of several polyaxial systems and to correlate these parameters with the screw head and the plate hole engagement. METHODS: Polyaxial locking systems were tested with screws inserted into the corresponding plates at various angles (0°, 5°, 10°, 15°). A micro-CT scan of the plate-hole and screw-head interface with the quantification of average thread engagement was performed before destructive tests. The screw-plate interface of each system was tested in a cantilever bending setup. Representative screws and plates were also examined by SEM. RESULTS: The standard insertion at 0° sustained the greatest maximum bending strength in all analyzed systems. Point-loading thread-in and cut-in screws inserted off-axis showed a significant reduction in bending strength (p<0.001) (p=0.041) (p<0.001). In contrast, locking cap screws maintained similar bending strength with disregard to the angle of insertion (p<0.4849). A micro-CT analysis confirmed that the average thread engagement of point-loading thread-in, cut-in and locking-cap screws was significantly reduced when placed off-axis (p=0.005) (p<0.001) (p=0.002) (p<0.001). The locking-cap mechanisms maintained the highest average thread engagement among all analyzed systems. CONCLUSIONS: The mechanical performance of polyaxial locking plates usually comes at the price of reduced bending strength. Surgeons should limit polyaxial insertions depending on the particular system's characteristics.

Internalization of the Western Standard of Beauty and Body Satisfaction: Evaluation Utilizing COPS and SATAQ-3 Questionnaires among Girls with Scoliosis.

Background and Objectives: Patients with adolescent idiopathic scoliosis (AIS) more frequently present significant back-related body image disturbances compared with healthy controls. The study aimed to adapt two screening questionnaires: Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ-3) and Cosmetic Procedure Screening Questionnaire (COPS), that could identify AIS patients, especially those threatened with body image disorders and might predict dissatisfaction with a desired-by-patients cosmetic result of treatment. Materials and Methods: In total, 34 AIS patients who undergo Cheneau brace treatment were asked to complete SATAQ-3 and COPS. Results: AIS patients presented a high level of internalization. Clinical and radiological factors that play a crucial role in the evaluation and decision process during brace treatment were not significantly associated with COPS and SATAQ-3 total scores. The SATAQ-3 total score and COPS results were also not related to sociodemographic parameters of the analyzed group. Conclusions: The presented study confirms the usefulness of the questionnaires, which aimed to isolate sociocultural risk factors of body image disorders in scoliosis patients as predictors of treatment dissatisfaction and worse compliance.

Temporomandibular Joint Disorders in Females with Adolescent Idiopathic Scoliosis: Long-Term Effects of Milwaukee Brace Treatment.

Patients with adolescent idiopathic scoliosis (AIS) more frequently suffer dysfunctions of dento-skeletal complex. To our knowledge, no study has ever evaluated the temporomandibular joint disorders (TMD) of AIS patients at least 23 years after the completion of Milwaukee brace treatment. We aimed to provide a complex assessment of TMD and AIS patients treated with a Milwaukee brace, in a minimum 23-year follow-up, using radiological, clinical, and socio-demographical data, and to adapt the TMD Disability Index Questionnaire (TMDQ) and Fonseca's questionnaire (FQ) to Polish conditions. In total, 42 healthy females and 30 AIS patients with a minimum of 23 years after a completed Milwaukee brace treatment were asked to complete the Polish version of (TMDQ-PL) and (FQ-PL). AIS patients present higher TMD levels than healthy controls. Significant differences exist between TMDQ-PL and FQ-PL (both in total scores and particular sub-sections), and AIS patients. Clinical and radiological factors affected the TMDQ-PL and FQ-PL results. Adult patients with scoliosis treated conservatively present limitations in everyday activities connected with the temporomandibular joint (TMJ). The variety of curve-related factors in a long-term follow-up of wearing the Milwaukee brace influence TMJ.

Mechanical and histomorphometrical evaluation of false and floating ribs of young adults with idiopathic scoliosis.

PURPOSE: The aim of this paper was to assess the histomorphometrical and mechanical properties of ribs in patients with idiopathic scoliosis who underwent corrective surgery of scoliosis combined with thoracoplasty. METHODS: The analyzed material encompasses 20 females between the ages of 12 and 18, whose pre-operative Cobb angle was 56.85 degrees, on average. The participants were divided into two age groups, up to the age of 15 and above 15 years old, taking into account the anatomical location of the assessed rib fragments with a division into floating and false ribs. The analysis of mechanical parameters was carried out by means of the quasi-static 3-point bending test, and the histomorphometric evaluation of the examined rib fragments was carried out using high-resolution computed tomography. RESULTS: The existence of explicit relationships between selected radiological parameters describing scoliosis and mechanical and histomorphometric parameters of the ribs has not been confirmed. Statistically significant correlations between age and rib stiffness as well as between Young's modulus and stiffness depending on the anatomical location of the examined rib fragment were confirmed. CONCLUSIONS: Mechanical and histomorphometric properties of bone tissue in patients with scoliosis are not explicitly associated with the radiological parameters characterizing scoliosis.

Adolescent idiopathic scoliosis and malocclusion - a cross sectional study of female patients without previous orthodontic treatment.

The purpose of the present study was to assess the prevalence of various types of malocclusions in a group of female patients with adolescent idiopathic scoliosis (AIS), as well as the association between occlusal anomalies and the side, location, and severity of the spine deformity. The study group was comprised of 60 females aged 12-16 years with AIS and 54 healthy controls. Apart from clinical examination, alginate impressions and wax bites were taken. Occlusal traits were assessed on the casts in maximum intercuspation. Data were statistically analyzed with a significance taken as p < 0.05. All patients with AIS showed at least one abnormal orthodontic trait, while 9 (16.7%) patients from the control group had dentition free from any orthodontic anomaly. The difference was statistically significant (p = 0.0032). In the sagittal dimension, patients with AIS had a higher frequency of bilateral distocclusion and unilateral mesiocclusion as compared to the control group (p = 0.0004 and p = 0.0034, respectively). They also showed crowding, increased overjet and overbite more often than healthy age- mates (p = 0.0417, p = 0.0121, and p = 0.0166, respectively). Regarding the association between site, side, or severity of scoliosis and the occurrence of the malocclusion, asymmetric molar occlusion was more frequently observed in patients with right convex (p = 0.0149), while unilateral mesiocclusion, appeared more often in patients with the thoracic apex of the curve (p = 0.0349). The results emphasize a need for collaboration between orthopedists and orthodontists in the complex medical care for scoliotic individuals. Orthodontic treatment can alleviate negative impact that a malocclusion has on the oral health, aesthetics, and psychological well-being of this vulnerable group of patients.

Factors affecting puberty gingivitis in Polish girls with adolescent idiopathic scoliosis.

OBJECTIVES: Age at menarche and hormonal disturbances have been linked to the occurrence and severity of adolescent idiopathic scoliosis (AIS). Concomitantly, an increase in the production of sex hormones during puberty may result in steroid hormones-related gingivitis. Thus, the study aimed to assess the prevalence and factors affecting puberty gingivitis, including menarcheal status, in female patients with AIS and control subjects. MATERIAL AND METHODS: The study group was comprised of 59 girls aged 12-16 years with AIS and 50 healthy controls. Dental examination included the assessment of oral hygiene, gingivitis, and dental caries intensity. Data were statistically analyzed with a significance taken as p < 0.05. RESULTS: There wasn't any statistically significant difference in the age at menarche and menarcheal status of both groups. During regression analysis, three predictors significantly affected gingival status of girls: oral hygiene, orthopedic condition, and laterality of the curve. Scoliosis and left convex of the curve significantly increased the index of gingival inflammation. CONCLUSIONS: The results indicate that gingivitis is frequent among female adolescents with AIS, due to poor oral hygiene and higher susceptibility to inflammation. It emphasizes a need for a development of preventive strategy for scoliotic patients, since incipient periodontal problems in children may turn into irreversible advanced periodontal diseases in adults.

Differences in beliefs about pain control after surgery due to lumbar or cervical discopathy and degenerative spine disease.

BACKGROUND: Clinical, psychological and demographic variables have been investigated to determine factors involved in quality of life of patients with chronic pain. It has been stressed that chronic pain is more associated with beliefs about pain, than with pain intensity. OBJECTIVE: The main aim of this retrospective cross-sectional study was to examine differences between postoperative beliefs about pain control, perception of pain and mood disturbances in patients treated operatively due to neck or lumbar discopathy and degenerative spine disease. METHODS: Forty-four patients treated operatively due to lumbar and forty-one patients treated surgically due to cervical discopathy filled in the Visual Analogue Scale (VAS), The Beck Depression Inventory (BDI-PL) and Beliefs about Pain Control Questionnaire (BPCQ-PL). Patients with lumbar and cervical discopathy additionally completed disease-specific outcome measures. RESULTS: The patient groups do not differ significantly in regards to BPCQ-PL, BDI-PL or VAS. Both study samples differ in regards to dependencies related to beliefs that pain is controlled by powerful others and about internal control of pain. CONCLUSIONS: Cognitive-behavioral interventions, concerning depression and beliefs about pain control, may be appropriate for both lumbar and cervical surgical populations, to improve post-surgical functioning.

Bilateral dentoalveolar asymmetries in female patients with adolescent idiopathic scoliosis.

PURPOSE: The aim of this cross-sectional research was to quantify left-right dentoalveolar fluctuating (FA) and directional asymmetries (DA) in patients with adolescent idiopathic scoliosis and to assess the relationship between these asymmetries and the side, location, and severity of scoliosis. MATERIALS AND METHODS: The study group comprised of 60 females aged 12-16 years, with idiopathic scoliosis, and 54 healthy controls. Measurements were made with the use of digital caliper on full-mouth dental casts. The following variables were measured from each subject: a shift of the incisor midline, left and right incisor overjet, deviation of canine and buccal segment relation as well as maxillary and mandibular arch chords. The data were statistically analyzed with significance taken as p < 0.05. RESULTS: Statistically significant differences in the mean shift of the incisor midline, buccal segment relation on the left and canine deviation on the left between the control group and the study group were detected ( p = 0.0419, p = 0.0.458 and p = 0.0204, respectively). FA of the midline deviation and canine deviation were statistically significantly higher for subjects with IS, compared to healthy controls ( p = 0.0315 and p = 0.0415, respectively). Neither direction of the curve nor apical vertebra's location or apical translation significantly affected the magnitude of dentoalveolar asymmetries. CONCLUSIONS: Our results confirmed that bilateral asymmetries are a common feature of the young females' occlusion. Individuals with IS show higher tendency to Angle Class II malocclusion, as well as higher FA of incisor midline discrepancy and canine deviation, compared to the controls.

Does rigid spinal orthosis carry more psychosocial implications than the flexible brace in AIS patients? A cross-sectional study.

BACKGROUND: A small body of data exists concerning psychosocial issues in adolescent idiopathic scoliosis (AIS) subjected to soft braces. No study was yet performed on the detailed psychosocial implications in AIS patients. OBJECTIVE: To compare the psychosocial implications of the flexible SpineCor with the Cheneau orthosis in AIS females. METHODS: Patients (aged 10-18 years) deliberately assigned to undergo SpineCor (SC group, 30 patients) or Cheneau brace (Ch group, 41 patients) intervention completed the Scoliosis Research Society-22 (SRS-22), the Spinal Appearance Questionnaire (SAQ), the Brace Questionnaire (BrQ) and the Pediatric Outcomes Data Collection Instrument (PODCI). RESULTS: Concerning the BrQ, study groups differ in regards to emotional functioning (p= 0.014), vitality (p= 0.022) and social functioning (p= 0.048), indicating better functioning in the Ch group. Considering the SAQ, the Ch group assesses body curve (p= 0.024) less critically. Regarding the PODCI, the Ch group scored higher in the Global Functioning Scale (p= 0.023), the Upper Extremity and Physical Function Scale (p= 0.000), the Transfer and Basic Mobility Scale (p= 0.088), the Pain/Comfort Scale (p= 0.009) and the Happiness Scale (p= 0.022). CONCLUSIONS: This study shows that patients treated with the rigid brace assess their vitality, physical function, emotional and social functioning better and are less critical towards body curve, in comparison to patients treated with the SpineCor.

Long-term effects of conservative treatment of Milwaukee brace on body image and mental health of patients with idiopathic scoliosis.

We aimed to provide a complex assessment of adult females with adolescent idiopathic scoliosis (AIS) after a minimum of 23 years after completed Milwaukee brace treatment. In the present study, a comparison between healthy female and AIS patients' perception of trunk disfigurement, self-image, mental health, pain level and everyday activity was made. Thirty AIS patients with a mean of 27.77 yrs (SD 3.30) after the treatment were included in the study. The control group consisted of 42 females, matching the age profile of the patient group. Study participants from both groups were examined using the same protocol, except for the radiological evaluation. Patients and healthy controls completed the Polish versions of the Scoliosis Research Society (SRS-22) and Spinal Appearance Questionnaire (SAQ). Patients additionally filled the Bad Sobberheim Stress Questionnaire-Deformity (BSSQ-Deformity) and Bad Sobberheim Stress Questionnaire-Brace (BSSQ-Brace). The study group's SAQ results differ significantly in regard to the total score and all individual domains, indicating better functioning among healthy controls. Except for the General domain (p = 0.002), among the remaining subscales the study group's results differed significantly at p<0.001. Considering SRS-22 results, it was revealed that the patient group scored higher, signaling better functioning with reference to pain level (p = 0.016), function/activity (p<0.001) and the total score (p<0.001). The findings add to the complexity of long-term effect evaluations of AIS, particularly amongst females treated with a Milwaukee brace. Long-term results were not conclusive in terms of nonverbal assessment of body image and emotional tension regarding the experiences of brace-wearing. Future patients can be reassured that scoliosis treated conservatively does not negatively affect everyday activity, pain level, childbearing and mental health. Subjects who declared to have psychological problems due to scoliosis had a bigger curve size after treatment and in this study than the other AIS patients.

Back and neck pain and function in females with adolescent idiopathic scoliosis: A follow-up at least 23 years after conservative treatment with a Milwaukee brace.

We aimed to explore the long-term outcomes of back and neck pain and functionality in adult females with adolescent idiopathic scoliosis (AIS), who had been treated with a Milwaukee brace, in a follow-up study a minimum of 23 years after the completion of the treatment, using radiological, clinical and socio-demographical data. Thirty AIS patients (scoliosis group-SG), were included in the study based on an extensive search of Pediatric Orthopedics and Traumatology Clinic charts. All treatments were successfully completed between 1974 and 1990. In all cases, scoliosis had not been detected before the age of 10 and was not combined with any major spinal deformities at the time when the brace treatment was implemented. In those patients, the Risser sign 4 and minimum two years post-menarche was defined as a maturity, after that time the brace treatment was completed. Patients were excluded from the study if they, at the time of the follow-up examinations, suffered from any other disease leading to trunk deformity. Forty patients met the criteria for inclusion, but due to change some personal details, not all of them were contacted. Finally, 30 women returned for a follow-up evaluation. Patients' follow-up period was mean 27.77 yrs. ± SD 3.30 (range 23-35). Curvature change from the end of the treatment until the present day was mean 9.1 degrees ± SD 7.64 (range 0-27). A control group of 42 healthy females (healthy controls group-HG) matching the age profile of the patient group was randomly selected for comparative purposes.Both SG and HG completed the Polish versions of the Revised Oswestry Lower Back Pain Disability Index (RODI), the Rolland-Morris Questionnaire (RMQ), the Quebec Back Pain Disability Scale (QDS), the Neck Disability Index (NDI) and the Copenhagen Neck Functional Disability Scale (CNFDS). Descriptive statistics were calculated for demographics and baseline questionnaire scores. To determine if the investigated sample sizes are equivalent, the chi-square test was used. The chi-square test was used to compare qualitative features between persons with scoliosis and healthy controls. In addition, a Mann-Whitney test was utilized to compare differences between both groups in regard to quantitative characteristics. To establish relations between quantitative data such as e.g. age, duration of brace application, apical translation, Cobb angle, and questionnaire results, we used Spearman's rank correlation (marked as rS). To determine dependency between quantitative and qualitative characteristics, e.g. between questionnaire numerical data and marital status, place of residence or curve type, ANOVA Kruskal-Wallis test was used. A p<0.05 indicates statistical significance. Statistical calculations were performed by Statistica software. In regards to RODI, RMQ, QDS, NDI and CNFDS (both for total scores and particular sub-sections), statistically significant differences (p <0.001) between both samples were found, indicating higher levels of pain and neck and lower back pain-related disability among persons with scoliosis. Associations exist between RODI and RMQ (rS = 0.76) QDS (rS = 0.70), NDI (rS = 0.69) and CNFDS (rS = 0.60). RMQ was associated with QDS (rS = 0.71) and NDI (rS = 0.69), whereas QDS correlated with NDI (rS = 0.80) and CNFDS (rS = 0.60). NDI was also associated with CNFDS (rS = 0.81). Persons with scoliosis treated in adolescence with a Milwaukee brace display significant restrictions in everyday activities, due to lower back pain (LBP) and neck-related disabilities, compared to healthy controls. In addition, back pain is associated with curve progression in long-term follow-up after conservative treatment. Moreover, LBP-related disability coexists with restrictions experienced due to neck pain.

Mental health and adjustment to juvenile idiopathic arthritis: Level of agreement between parent and adolescent reports according to Strengths and Difficulties Questionnaire and Adolescent Outcomes Questionnaire.

The aims of this study were threefold. Firstly, to analyze the psychometric properties of the Polish-language Pediatric Outcomes Data Collection Instrument (PODCI) questionnaire in the self-report Adolescent Outcomes Questionnaire (adolescents, 11-18 years of age) and in the parent-report Adolescent Outcomes Questionnaire (completed by a parent or guardian of an adolescent aged 11-18 years). Secondly, to determine the level of agreement between parents and adolescents in rating dysfunction in juvenile idiopathic arthritis (JIA) and thirdly, to examine associations between psychological adjustments of patients to JIA and disease as well as their socio-demographic characteristics. The study sample consisted of 52 participants. 26 adolescents between the ages of 11 and 18 years with a diagnosis of JIA and 26 parents were considered for inclusion. Disease course was classified as pauciarticular (n = 12, 46.2%) and polyarticular (n = 14, 53.8%). Participants completed the PODCI (self- and parent- report) twice and the Strengths and Difficulties Questionnaire-25 (SDQ-25). Considering the distribution of results regarding PODCI normative scores, 73.1% of parents and 69.2% of patients scored below 50 on the Global Functioning Scale; that is lower than the average for the general healthy population. Regarding the parent report, the total score of the SDQ-25 equaled 11.86 (SD 2.66), whereas the patient report equaled 11.23 (SD 2.78). The study groups do not differ significantly in regards to either the PODCI or the SDQ-25 results. Parents and adolescents with JIA appear to hold very similar perceptions of patients' health. Greater differences emerge as disease severity and age of patients increase. Excellent internal consistency, intrarater and test-retest reliability of the Global Functioning Scale have been confirmed in the Polish version of the PODCI, the questionnaire may therefore aid identification of patients reporting significant problems in this group.

The Pediatric Outcomes Data Collection Instrument for a Polish sample with juvenile idiopathic arthritis: psychometric properties of proxy version.

AIM: The aims of the study were to investigate the psychometric properties of the Pediatric Outcomes Data Collection Instrument (PODCI) for parents of children aged 2-10 years, in a Polish sample of juvenile idiopathic arthritis and to compare the results from children with chronic arthritis to the results from a normative sample. METHODS: The sample consisted of the parents of 29 (72.5%) girls and 11 (27.5%) boys. The ages of the children ranged from 2 to 10 years (mean 6.50, standard deviation [SD] 2.63). Disease course was classified as oligoarticular (n = 26, 65%) and polyarticular (n = 14, 35%). Parents who took part in the intrarater reliability study completed the Polish version of PODCI twice. The PODCI consists of the following subscales: Upper Extremity and Physical Function, Transfer and Mobility Tasks, Sports/Physical Functioning, Pain/Comfort, and Happiness. A Global Functioning Scale consists of the mean of the 'mean of items' values for the first four scales. RESULTS: The mean standarized Global Functioning Scale was 81.79 (SD 13.45), whereas the mean normative Global Functioning Scale score equaled 33.65 (SD 18.19). Cronbach's alpha value of the Global Functioning Scale was excellent and equaled 0.81. The effect size concerning the Global Functioning Scale equaled 0.123. Test-retest reliability equaled 0.98, whereas intrarater reliability (intraclass correlation coefficient) equaled 0.99. CONCLUSIONS: The translation and cross-cultural adaptation of the PODCI questionnaire provides a Polish equivalent to assess physical function in children with chronic arthritis.

Quantification of the asymmetric migration of the lipophilic dyes, DiO and DiD, in homotypic co-cultures of chondrosarcoma SW-1353 cells.

DiO and DiD are lipophilic cell labelling dyes used in the staining of cells in vivo and in vitro. The aim of the present study was to quantify the asymmetrical distribution of dyes in co­cultured cells and to measure the intercellular transfer of DiO and DiD. DiO and DiD were applied separately to stain two identical populations of SW­1353 human chondrosarcoma cells that were subsequently co­cultured (homotypic co­culture). The intercellular migration of dyes in the co­cultured cells was measured by flow cytometry and recorded under a fluorescent microscope. DiD and DiO caused no effect on the proliferation of cells, the degradation rate of the two dyes was comparable and crossover effects between dyes were negligible. The results of the present study suggested that asymmetrical intercellular migration of DiD and DiO was responsible for the asymmetrical distribution of these dyes in co­cultured cells. To take advantage of the lipophilic dyes migration in the double-stained co-cultured cells we suggest to apply mixed-dyes controls prior to the flow cytometric analysis. These controls are performed by staining cells with a 1:1 mix of the two dyes and would enable the estimation of the intensity of intercellular contact in co­culture systems. A 1:1 premix of DiO and DiD was applied to estimate cellular effect on intercellular exchange of lipid dyes in co­cultures incubated with cycloheximide and cytochalasin B. The cellular effect contributed 6­7% of intercellular migration of the lipophilic dyes, DiO and DiD. The majority of the observed intercellular transfer of these dyes was due to non­cellular, passive transfer.

Kinesiophobia in pre-operative patients with cervical discopathy and coexisting degenerative changes in relation to pain-related variables, psychological state and sports activity.

BACKGROUND: No research group has ever investigated the level of kinesiophobia in a well defined group of preoperative patients treated due to cervical discopathy and degenerative spine disease, confirmed by X-ray and magnetic resonance imaging (MRI) examinations. We aimed to investigate the degree of kinesiophobia and the differences in pain-related and psychosocial characteristics between patients with high and low levels of kinesiophobia, in relation to factors commonly associated with neck pain. MATERIAL/METHODS: Sixty-five consecutive patients with cervical discopathy and coexisting degenerative changes were assessed pre-surgically. The mean pain duration was 31.7 SD 34.0 months. Patients completed the Polish versions of the Tampa Scale for Kinesiophobia (TSK-PL) on 2 occasions, and the following once: Neck Disability Index (NDI-PL), State-Trait Anxiety Inventory (STAI-PL), Coping Strategies Questionnaire (CSQ-PL), and the Visual Analogue Scale (VAS-PL). RESULTS: A high level of kinesiophobia was indicated in 81.5% and 87.7% of patients in first and second completion, respectively. Patients with high and low kinesiophobia differ in regards to the recreation section of NDI-PL (p=0.012), gender (p=0.043), and sports activity (p=0.024). Correlations were identified between TSK-PL and marital status (p=0.023) and sports activity (p=0.024). CONCLUSIONS: Kinesiophobia levels are higher in patients with chronic cervical pain before surgical treatment. Fear of movement tends to be higher in women and among patients avoiding sports recreation before surgical treatment. Although sports activity and socio-demographic data are predictors of kinesiophobia, psychological, pain-related, and clinical data are not. These findings should be considered when planning rehabilitation after surgical treatment of cervical discopathy and coexisting degenerative changes.

Isokinetic evaluation of knee joint flexor and extensor muscles after tibial eminence fractures.

The aim of the study was to evaluate the knee joint function in adolescent patients following operative treatment - fixation via arthroscopic or open surgery (arthrotomy), due to tibial eminence fractures. 28 patients, aged from 7 to 16 years, treated operatively between 1994-2009 in four orthopeadic centres underwent evaluation. Evaluation was performed 12-180 months following surgery. Patients were divided into two groups depending on the operative treatment received. Group A consisted of 14 patients who underwent arthroscopic reduction and stabilization. Group B consisted of 14 patients who were treated by open reduction (artrothomy) and stabilization. The results of clinical and radiological examinations and isokinetic tests used in the evaluation declared that operative treatment due to tibial eminence fracture, regardless of surgical method used, does not significantly disrupt knee joint function resulting in a slight weakening of knee joint extensor muscle strength.

A longitudinal study of alexithymia in relation to physical activity in adolescent females with scoliosis subjected to cheneau brace treatment: preliminary report.

STUDY DESIGN: A longitudinal pilot study of changes in levels of alexithymia among females with adolescent idiopathic scoliosis (AIS) under brace treatment. OBJECTIVE: To investigate the prevalence of alexithymia and to evaluate changes in alexithymia levels among female patients with AIS treated with a Cheneau brace, in comparison with healthy female adolescents. SUMMARY OF BACKGROUND DATA: Alexithymia is a personality trait incorporating the following core characteristics: difficulty in identifying and describing feelings, difficulty in distinguishing between feelings and the physical sensation of emotional arousal, limited imaginal processes, and an externally oriented cognitive style. Alexithymia can be common among adolescents and young adults with severe idiopathic scoliosis. METHODS: Thirty-six female patients with AIS, aged 13.4 years (standard deviation [SD], 1.7) at the beginning of the study, completed the Polish version of the Toronto Alexithymia Scale-26 (TAS-26). The second and third evaluations took place at 6 and 12 months, respectively, after the beginning of the study. Thirty-six healthy female controls were also included. RESULTS: The mean TAS-26 total score was 63.4 (SD, 9.3), 59.5 (SD, 12.1), and 59.6 (SD, 12.5) during the first, second, and last patient evaluation, whereas in healthy females 60.0 (SD, 10.9). With regard to the TAS-26 total score, results differed significantly between the first and the second (P = 0.007) and between the first and the third patient evaluation (P = 0.007). Regression analysis revealed that during the second and third patient evaluation, duration of recreational sports activity had a statistically significant (P = 0.029 and P = 0.005, respectively) influence on the probability of females reporting no alexithymia. CONCLUSION: The prevalence of alexithymia in healthy female controls is the same as in patients with scoliosis subjected to underarm brace treatment. Statistically significant changes with regard to TAS-26 total score and externally oriented thinking domain were found in patient sample. Physical activity in females with AIS treated nonoperatively coexists with lower scores in the TAS-26. LEVEL OF EVIDENCE: 2.

Anti­tuberculosis drugs decrease viability and stimulate the expression of chondrocyte marker genes in human nucleus pulposus cells.

Isoniazid (INH), rifampicin (RIF), ethambutol (ETH) and pyrazinamide (PYR) are first­line drugs used in anti­tuberculosis (TB) therapy. However, no studies have been conducted concerning the effect of anti­TB drugs on the cells of the intervertebral discs (IVDs), the predominant location of the osteoarticular form of TB (OATB). Cells from the nucleus pulposus (NP), which are located in the center of the IVDs, were obtained from 12 adolescent patients who underwent surgery due to idiopathic scoliosis. The NP cells were incubated for 24 h with transforming growth factor ß1 (TGF­ß1) and each anti­TB drug (INH, RIF, ETH and PYR), separately. Incubation with 2.5 ng/ml TGF­ß1 resulted in an 80% decrease in ACAN mRNA levels; while 5 µg/ml INH led to a 2.3­fold increase in COL2A1 and a 2.9­fold increase in ACAN mRNA levels. Treatment with 10 µg/ml RIF initiated a 2.2­fold increase in COL1A1 mRNA levels and 5 µg/ml PYR resulted in an 8­fold increase in SOX9 mRNA levels. Following 192 h of treatment with INH and RIF, NP cell viability was diminished; however, no drugs modified the concentrations of glycosaminoglycans (GAGs). This study aimed to determine the effect of anti­TB drugs on the expression of chondrocyte marker genes in human IVD cells. Anti­TB drugs increased the expression of chondrocyte marker genes and diminished the viability of IVD cells. This study demonstrated that in addition to the common side effects of anti­TB drugs, these drugs also have an effect on IVD cells.