Estimation of the forces exerted on the limb long bones of a white rhinoceros (Ceratotherium simum) using musculoskeletal modelling and simulation.

Heavy animals incur large forces on their limb bones, due to the transmission of body weight and ground reaction forces, and the contractions of the various muscles of the limbs. This is particularly true for rhinoceroses, the heaviest extant animals capable of galloping. Several studies have examined their musculoskeletal system and the forces their bones incur, but no detailed quantification has ever been attempted. Such quantification could help understand better the link between form and function in giant land animals. Here we constructed three-dimensional musculoskeletal models of the forelimb and hindlimb of Ceratotherium simum, the heaviest extant rhino species, and used static optimisation (inverse) simulations to estimate the forces applied on the bones when standing at rest, including magnitudes and directions. Overall, unsurprisingly, the most active muscles were antigravity muscles, which generate moments opposing body weight (thereby incurring the ground reaction force), and thus keep the joints extended, avoiding joint collapse via flexion. Some muscles have an antigravity action around several joints, and thus were found to be highly active, likely specialised in body weight support (ulnaris lateralis; digital flexors). The humerus was subjected to the greatest amount of forces in terms of total magnitude; forces on the humerus furthermore came from a great variety of directions. The radius was mainly subject to high-magnitude compressive joint reaction forces, but to little muscular tension, whereas the opposite pattern was observed for the ulna. The femur had a pattern similar to that of the humerus, and the tibia's pattern was intermediate, being subject to great compression in its caudal side but to great tension in its cranial side (i.e. bending). The fibula was subject to by far the lowest force magnitude. Overall, the forces estimated were consistent with the documented morphofunctional adaptations of C. simum's long bones, which have larger insertion areas for several muscles and a greater robusticity overall than those of lighter rhinos, likely reflecting the intense forces we estimated here. Our estimates of muscle and bone (joint) loading regimes for this giant tetrapod improve the understanding of the links between form and function in supportive tissues and could be extended to other aspects of bone morphology, such as microanatomy.

Desmoid Fibromatosis Fused With a Lipoma in the Upper Arm.

Lipoma, the most common mesenchymal tumor, often appears as a slow-growing mass in the musculoskeletal system (MSK). While generally non-invasive, their location can cause symptoms. Desmoid fibromatosis (DF), a rare and locally aggressive neoplasm, poses challenges in MSK system diagnosis and management due to its infiltrative nature. Despite lacking metastatic potential, DF has a high recurrence rate, classifying it as "intermediate, locally aggressive" in the WHO classification. Collaborative efforts among orthopedic surgeons, radiologists, and pathologists are crucial for accurate diagnosis and treatment planning for all tumors of the MSK system. This case report presents the first documented example of a DF within a lipoma, highlighting the challenges of diagnosing and treating musculoskeletal tumors.

Determining a musculoskeletal system's pre-stretched state using continuum-mechanical forward modelling and joint range optimization.

The subject-specific range of motion (RoM) of a musculoskeletal joint system is balanced by pre-tension levels of individual muscles, which affects their contraction capability. Such an inherent pre-tension or pre-stretch of muscles is not measureable with in vivo experiments. Using a 3D continuum mechanical forward simulation approach for motion analysis of the musculoskeletal system of the forearm with 3 flexor and 2 extensor muscles, we developed an optimization process to determine the muscle fibre pre-stretches for an initial arm position, which is given human dataset. We used RoM values of a healthy person to balance the motion in extension and flexion. The performed sensitivity study shows that the fibre pre-stretches of the m. brachialis, m. biceps brachii and m. triceps brachii with 91 % dominate the objective flexion ratio, while m. brachiradialis and m. anconeus amount 7.8 % and 1.2 % . Within the multi-dimensional space of the surrogate model, 3D sub-spaces of primary variables, namely the dominant muscles and the global objective, flexion ratio, exhibit a path of optimal solutions. Within this optimal path, the muscle fibre pre-stretch of two flexors demonstrate a negative correlation, while, in contrast, the primary extensor, m. triceps brachii correlates positively to each of the flexors. Comparing the global optimum with four other designs along the optimal path, we saw large deviations, e.g., up to 15 ∘ in motion and up to 40% in muscle force. This underlines the importance of accurate determination of fibre pre-stretch in muscles, especially, their role in pathological muscular disorders and surgical applications such as free muscle or tendon transfer.

Outcomes of ultrasound-guided injections of Bennett lesions of the shoulder.

PURPOSE: To describe our technique and short term follow up of ultrasound-guided injections of symptomatic Bennett lesions. METHODS: We performed 13 ultrasound-guided injections in 10 baseball players from August 2014 to August 2021. The cohort was comprised of 10 males, with a mean age of 25 years and 1 month (age range: 17 years, 10 months-33 years, 1 month). Of the 10 patients, 6 were major league baseball players (including 5 pitchers and a second baseman), 3 were minor league baseball pitchers; and 1 pitched in high school. Symptoms in our patients included posterior shoulder pain at rest, pain with pitching (including in the acceleration phase and with follow-through), glenoid internal reduction deficit, and decreased pitching velocity. The procedure was performed in a similar fashion as a standard posterior approach glenohumeral injection, though with the linear transducer positioned slightly more medially. The needle was inserted from a lateral to medial approach, in plane with the transducer and aimed to the superficial surface of the Bennett lesion, onto which anesthetic and steroid was injected, avoiding injection into the glenohumeral joint. RESULTS: All patients had MRIs that showed Bennett lesions and all but one of the sonograms demonstrated the Bennett lesion. In 8/12 (67%) injections, the patient reported varying degrees of immediate symptom relief. In 4/12 injections, patients were unable to assess for immediate postprocedural change in symptomatology and for one patient post-procedural symptomatology was not documented. No complications occurred. Analytics of the average 4-seam fastball velocity was available for 2 of the major league players who had in-season injections, with minimal change in postprocedural velocity in the year after their ultrasound procedure; for one of the pitchers, his fastball velocity slightly increased in the month after the procedure while the other pitcher had his injection towards the end of the season and he threw no fastballs in his final games of the season. Two of the other professional pitchers went on to surgical intervention and neither returned to pitch professionally. CONCLUSION: Injection of symptomatic Bennett lesions is a safe procedure and can provide symptomatic relief that may be temporary, though equivocally useful clinically.

Ergonomic interventions and endodontic treatment outcomes: An analysis of dentist working posture and error rates.

Purpose: Dentists spend a long time the day in the position. It is possible that this leads to discomfort that may translate to procedural errors during treatment, such as root canal treatment. This study aims to investigate the relationship of working posture and procedural errors in endodontic manipulations. Materials and Methods: 32 dentists (17 men, 53.13%, and 15 women, 46.88%) from the University Dental Polyclinic of Uzhhorod National University (Uzhhorod, Ukraine) were included in the study. REBA, RULA, frequency of procedural errors were analysed using regression. Results: This study revealed a surprising trend where a decrease in errors during endodontic treatment was associated with higher RULA and REBA scores, contrary to the expected increase in errors with higher ergonomic stress. Additionally, the research highlighted the significant impact of a dentist's handedness and tooth position in the dental arch on treatment ergonomics and efficiency, as observed and analyzed through ergonomic assessments and statistical methods. Conclusions: The study conclusively demonstrated that optimal positioning and alignment during dental procedures significantly contribute to a reduction in procedural errors, underscoring the importance of ergonomics in clinical dentistry.

INJURY EPIDEMIOLOGY IN BEACH TENNIS: INCIDENCE AND RISK FACTORS.

Introduction: Due to the growing increase in beach tennis practice in Brazil and the lack of studies on the injuries that occur in this sport, it has become necessary to develop more research on the subject. Objective: to identify risk and protection factors for injuries in beach tennis, in order to generate prevention strategies for musculoskeletal injuries. Method: A cross-sectional epidemiological study, level 3 of evidence, was carried out through an electronic form with 698 Beach Tennis players, who answered questions about their relationship with the practice of the sport and occurrences of injuries. We researched the prevalence of injuries, their types, and their relation with personal physical characteristics and the practice of other sports. Results: We found a positive relationship between injuries when associated with longer exposure time and the presence of a previous injury. We did not find differences regarding BMI, gender, and stretching and muscle strengthening performance. Conclusion: the most frequent non-traumatic injuries were to the elbow and shoulder (tendonitis) and traumatic (sprain) injuries to the knee and ankle. Level of Evidence II; Cohort Study.

Introdução: Devido ao crescente aumento da prática de Beach Tennis no Brasil e a carência de estudos sobre as lesões que ocorrem nesse esporte se faz necessário o desenvolvimento de mais pesquisas sobre o tema. Objetivo: identificar fatores de risco e de proteção para lesões no Beach Tennis, afim de gerar estratégias de prevenção às injurias musculoesqueléticas. Método: realizado estudo epidemiológico transversal nível 3 de evidência através de um formulário eletrônico com 698 praticantes de Beach Tennis, que responderam questionamentos sobre sua relação com a prática do esporte e ocorrências de lesões. Pesquisamos a prevalência das lesões e seus tipos, assim como sua relação com as características físicas pessoais e prática de outros esportes. Resultados: encontramos relação de positividade para lesões quando associadas a maior tempo de exposição e presença de lesão prévia. Não encontramos diferença quanto ao IMC, sexo e a realização de alongamento e fortalecimento muscular. Conclusão: as lesões mais frequentes não traumáticas foram no cotovelo e ombro (tendinite) e traumáticas (entorse) de joelho e tornozelo. Nível de Evidência II; Estudo de Coorte.

The reciprocity of skeletal muscle and bone: an evolving view from mechanical coupling, secretory crosstalk to stem cell exchange.

Introduction: Muscle and bone constitute the two main parts of the musculoskeletal system and generate an intricately coordinated motion system. The crosstalk between muscle and bone has been under investigation, leading to revolutionary perspectives in recent years. Method and results: In this review, the evolving concept of muscle-bone interaction from mechanical coupling, secretory crosstalk to stem cell exchange was explained in sequence. The theory of mechanical coupling stems from the observation that the development and maintenance of bone mass are largely dependent on muscle-derived mechanical loads, which was later proved by Wolff's law, Utah paradigm and Mechanostat hypothesis. Then bone and muscle are gradually recognized as endocrine organs, which can secrete various cytokines to modulate the tissue homeostasis and remodeling to each other. The latest view presented muscle-bone interaction in a more direct way: the resident mesenchymal stromal cell in the skeletal muscle, i.e., fibro-adipogenic progenitors (FAPs), could migrate to the bone injury site and contribute to bone regeneration. Emerging evidence even reveals the ectopic source of FAPs from tissue outside the musculoskeletal system, highlighting its dynamic property. Conclusion: FAPs have been established as the critical cell connecting muscle and bone, which provides a new modality to study inter-tissue communication. A comprehensive and integrated perspective of muscle and bone will facilitate in-depth research in the musculoskeletal system and promote novel therapeutic avenues in treating musculoskeletal disorders.

Explorative study using ultrasound time-harmonic elastography for stiffness-based quantification of skeletal muscle function.

Time-harmonic elastography (THE) is an emerging ultrasound imaging technique that allows full-field mapping of the stiffness of deep biological tissues. THE's unique ability to rapidly capture stiffness in multiple tissues has never been applied for imaging skeletal muscle. Therefore, we addressed the lack of data on temporal changes in skeletal muscle stiffness while simultaneously covering stiffness of different muscles. Acquiring repeated THE scans every five seconds we quantified shear-wave speed (SWS) as a marker of stiffness of the long head (LHB) and short head (SHB) of biceps brachii and of the brachialis muscle (B) in ten healthy volunteers. SWS was continuously acquired during a 3-min isometric preloading phase, a 3-min loading phase with different weights (4, 8, and 12 kg), and a 9-min postloading phase. In addition, we analyzed temporal SWS standard deviation (SD) as a marker of muscle contraction regulation. Our results (median [min, max]) showed both SWS at preloading (LHB: 1.04 [0.94, 1.12] m/s, SHB: 0.86 [0.78, 0.94] m/s, B: 0.96 [0.87, 1.09] m/s, p < 0.001) and the increase in SWS with loading weight to be muscle-specific (LHB: 0.010 [0.002, 0.019] m/s/kg, SHB: 0.022 [0.017, 0.042] m/s/kg, B: 0.039 [0.019, 0.062] m/s/kg, p < 0.001). Additionally, SWS during loading increased continuously over time by 0.022 [0.004, 0.051] m/s/min (p < 0.01). Using an exponential decay model, we found an average relaxation time of 27 seconds during postloading. Analogously, SWS SD at preloading was also muscle-specific (LHB: 0.018 [0.011, 0.029] m/s, SHB: 0.021 [0.015, 0.027] m/s, B: 0.024 [0.018, 0.037] m/s, p < 0.05) and increased by 0.005 [0.003, 0.008] m/s/kg (p < 0.01) with loading. SWS SD did not change over loading time and decreased immediately in the postloading phase. Taken together, THE of skeletal muscle is a promising imaging technique for in vivo quantification of stiffness and stiffness changes in multiple muscle groups within seconds. Both the magnitude of stiffness changes and their temporal variation during isometric exercise may reflect the functional status of skeletal muscle and provide additional information to the morphological measures obtained by conventional imaging modalities.

[Analysis of symptoms and influencing factors of low back work-related musculoskeletal disorders among workers in a container manufacturing factory].

Objective: To investigate the occurrence of low back work-related musculoskeletal disorders (WMSDs) among workers in a container manufacturing factory, and to explore the influencing factors. Methods: In June 2022, 952 workers from a container factory were selected as the research objects by cluster random sampling. Through questionnaire survey, the incidence of low back WMSDs symptoms among workers in the past one year was collected, and the influencing factors of low back WMSDs were analyzed by logistic regression. Results: The incidence rate of low back WMSDs was 46.7% (445/952). The factors with higher exposure at work were frequent slight bending (77.0%, 733/952), frequent overtime (74.1%, 705/952), and the need to turn around while working (62.3%, 593/952). Multivariate logistic regression analysis showed that age over 40 years old, smoking, drinking, often bending over slightly, sitting for a long time, maintaining a large bending posture for a long time, often working overtime, limited operating space, and there was always a need to complete conflicting things in the container manufacturing factory workers were the risks of increasing the low back WMSDs (OR=1.68, 1.96, 2.47, 1.49, 1.84, 2.11, 1.90, 1.82, 2.00, P<0.05). Standing at work, always friendly colleagues, and always supportive and helpful leaders were protective factors for low back WMSDs (OR=0.60, 0.32, 0.40, P<0.05) . Conclusion: The incidence of low back WMSDs symptoms in container manufacturing workers is high, and work-related factors such as frequent slight bending, long time holding large bending posture and limited operating space are the focus of ergonomic intervention in container manufacturing enterprises.

Pictorial review: challenges in distinguishing bilateral metaphyseal marrow abnormalities on magnetic resonance imaging.

The paediatric metaphysis is afflicted by a wide range of pathological processes as it is the most metabolically active and well-vascularised part of the developing skeleton. This review focuses on metaphyseal marrow signal change detected with magnetic resonance imaging, which is most often occult on radiographs. When bilateral, these imaging appearances frequently present a diagnostic quandary. This review assists the radiologist to confidently dismiss physiological signal change and confidently work through the differential diagnosis. This is achieved by illustrating a practical method of classifying signal change into four categories: physiological red marrow, red marrow reconversion, marrow infiltration, and oedema-like marrow signal intensity. In doing so, various pathological entities are reviewed along with imaging pearls and next-step investigations.

Impacts of ß-1, 3-N-acetylglucosaminyltransferases (B3GNTs) in human diseases.

Glycosylation modification of proteins is a common post-translational modification that exists in various organisms and has rich biological functions. It is usually catalyzed by multiple glycosyltransferases located in the Golgi apparatus. ß-1,3-N-acetylglucosaminyltransferases (B3GNTs) are members of the glycosyltransferases and have been found to be involved in the occurrence and development of a variety of diseases including autoimmunity diseases, cancers, neurodevelopment, musculoskeletal system, and metabolic diseases. The functions of B3GNTs represent the glycosylation of proteins is a crucial and frequently life-threatening step in progression of most diseases. In this review, we give an overview about the roles of B3GNTs in tumor, nervous system, musculoskeletal and metabolic diseases, describing the recent results about B3GNTs, in order to provide a research direction and exploration value for the prevention, diagnosis and treatment of these diseases.

Dynamics of disability and pain indicators under the influence of physical therapy for adhesives capsulitis and myofascial pain syndrome.

OBJECTIVE: Aim: To compare the effectiveness of end-range mobilization and therapeutic exercises, used in combination with ischemic compression, on disability and pain indicators among patients with adhesive capsulitis of the shoulder joint and thoracic myofascial pain syndrome. PATIENTS AND METHODS: Materials and Methods: The study involved 68 patients. Goniometry of the shoulder joint, assessment of pain in myofascial trigger points, and the Shoulder Pain and Disability Index questionnaire were used before and after physical therapy. The duration of physical therapy comprised 3 weeks. Physical therapy of the first group of patients consisted of end-range mobilization and ischemic compression. Patients of the second group performed therapeutic exercises and ischemic compression. RESULTS: Results: Both groups demonstrated positive dynamics of shoulder joint mobility, Shoulder Pain and Disability Index and pain in trigger points. However, the final results of the studied indicators were better in the first group of patients. CONCLUSION: Conclusions: Physical therapy based on the combination of end-range mobilization and ischemic compression had a more positive impact on disability and pain indicators for adhesive capsulitis of the shoulder joint and myofascial pain syndrome as compared to the combination of therapeutic exercises and ischemic compression.

Quantitative and qualitative evaluation of three MSCT for high resolution bone imaging.

INTRODUCTION: Strategies for achieving high resolution varies between manufacturers. In CT, the helical mode with narrow collimation has long been considered as the gold standard for high-resolution imaging. More recently, incremental modes with small dexels and focal spot, have been developed but have not been compared with helical acquisitions under optimal conditions. The aim of this work is to compare the high-resolution acquisition strategies currently proposed by recent MSCT. METHODS: Three CT systems were compared. A phantom was used to evaluate geometric accuracy, uniformity, scan slice geometry, and spatial resolution. Human dry bones were used to test different protocols on real bone architecture. A blind visual analysis was conducted by trained CT users for classifying the different acquisitions (p-values). RESULTS: All systems give satisfactory results in terms of geometric accuracy and uniformity. The in-plane MTF at 5% were respectively 13.4, 15.9 and 18.1 lp/cm. Dry-bones evaluation confirms that acquisition#3 is considered as the best. CONCLUSIONS: The incremental acquisition coupled with à small focal spot, and a high-sampling detector, overpasses the reference of low-pitch helical acquisitions for high-resolution imaging. Cortical bone, bony vessels, and tumoral matrix analysis are the very next challenges that will have to be managed to improve normal and pathologic bone imaging thanks to the availability UHR-CT systems.

Ergonomic risks and problems of the musculoskeletal system for physiotherapists: comparison of employees in the fields of pediatric and adult care.

Objectives. The aim of this study is to compare the ergonomic risk levels, musculoskeletal complaints and quality of life of physiotherapists (PTs) according to their field of work. Methods. A total of 107 volunteer PTs participated in the study, whose information was recorded. Ergonomic risk levels were determined using rapid entire body assessment (REBA). Complaints about the musculoskeletal system of PTs were evaluated with the Cornell musculoskeletal discomfort questionnaire (CMDQ) and quality of life was evaluated by the Nottingham health profile. Results. PTs who worked with pediatric patients (Grouppediatric; n = 47) were younger (p<0.001). PTs who worked with adult patients (Groupadult; n = 60) had a higher daily number of patients (p<0.001). The REBA score did not make a difference between the groups (p = 0.379). The difference was found in the upper back region of the CMDQ (p<0.05). There was no difference between groups for quality of life (p>0.05). Conclusions. Grouppediatric may be working in ergonomically demanding positions, although there is no statistical difference. The injury sites of the musculoskeletal system can differ. However, the reflection of musculoskeletal system problems on quality of life does not show any difference between the groups of PTs.

[Role of NLRP3 inflammasomes in musculoskeletal disorders].

Inflammasomes are innate immune sensors and receptors that play key pathological roles in the development and progression of numerous diseases. Recent studies have shown that NLRP3 inflammasomes are critical in the pathology of diseases with a high impact on public health, such as musculoskeletal disorders. Musculoskeletal disorders, mainly caused or aggravated by work and the surrounding environment, are locomotor system disorders such as muscles, joints, bones, as well as diseases associated with neurological and circulatory system injuries. Activation of NLRP3 inflammasomes can induce inflammation and pyroptosis, leading to further bodily harm. Therefore, investigating the mechanism and function of NLRP3 inflammasomes, holds great significance and importance for the prevention and treatment of musculoskeletal disorders. This review provides a summary of the activation pathway and mechanism of NLRP3 inflammasomes, and analyzes the role in musculoskeletal disorders such as sarcopenia, osteoporosis and arthritis, with the aim to facilitate the treatment of musculoskeletal disorders.

Autonomic Recalibration: A Promising Approach for Alleviating Myofascial Pain Explored in a Retrospective Case Series.

This retrospective case series introduces autonomic recalibration (AR) as a novel approach for alleviating chronic myofascial pain. The manuscript explores the rationale, theory, and practice of AR, which targets the autonomic nervous system (ANS) to restore homeostasis and reduce pain. The involvement of the ANS in pain modulation and the role of autonomic imbalance in chronic pain are discussed, emphasizing the potential benefits of addressing autonomic dysregulation through AR. The technique combines manual interventions and patient education, relying on neuroplastic adaptations. Three diverse case reports are presented to illustrate the effectiveness of AR in patients with different sources of pain. Each case presents a unique clinical scenario, including a nine-year-old male diagnosed with spondylolisthesis, a 68-year-old male with a history of abdominal surgeries, and a 56-year-old male with chronic low back pain following lumbar fusion surgery. In all cases, AR resulted in pain relief, improved sleep, and restoration of functional abilities. These findings support the potential of AR as an effective alternative approach for myofascial pain. Further research is warranted to validate these outcomes and investigate the underlying mechanisms of AR.

Current Concepts in Early Mobilization of Critically Ill Patients Within the Context of Neurologic Pathology.

Neurocritical patients (NCPs) in the intensive care unit (ICU) rapidly progress to respiratory and peripheral muscle dysfunctions, which significantly impact morbidity and death. Early mobilization in NCPs to decrease the incidence of ICU-acquired weakness has been showing rapid growth, although pertinent literature is still scarce. With this review, we summarize and discuss current concepts in early mobilization of critically ill patients within the context of neurologic pathology in NCPs. A narrative synthesis of literature was undertaken trying to answer the following questions: How do the respiratory and musculoskeletal systems in NCPs behave? Which metabolic biomarkers influence physiological responses in NCPs? Which considerations should be taken when prescribing exercises in neurocritically ill patients? The present review detected safety, feasibility, and beneficial response for early mobilization in NCPs, given successes in other critically ill populations and many smaller intervention trials in neurocritical care. However, precautions should be taken to elect the patient for early care, as well as monitoring signs that indicate interruption for intervention, as worse outcomes were associated with very early mobilization in acute stroke trials.

Scalable musculoskeletal model for dynamic simulations of lower body movement.

A musculoskeletal (MSK) model is an important tool for analysing human motions, calculating joint torques during movement, enhancing sports activity, and developing exoskeletons and prostheses. To enable biomechanical investigation of human motion, this work presents an open-source lower body MSK model. The MSK model of the lower body consists of 7 body segments (pelvis, left/right thigh, left/right leg, and left/right foot). The model has 20 degrees of freedom (DoFs) and 28 muscle torque generators (MTGs), which are developed from experimental data. The model can be modified for different anthropometric measurements and subject body characteristics, including sex, age, body mass, height, physical activity, and skin temperature. The model is validated by simulating the torque within the range of motion (ROM) of isolated movements; all simulation findings exhibit a good level of agreement with the literature.

Secreted ADAMTS-like proteins as regulators of connective tissue function.

The extracellular matrix (ECM) determines functional properties of connective tissues through structural components, such as collagens, elastic fibers, or proteoglycans. The ECM also instructs cell behavior through regulatory proteins, including proteases, growth factors, and matricellular proteins, which can be soluble or tethered to ECM scaffolds. The secreted a disintegrin and metalloproteinase with thrombospondin type 1 repeats/motifs-like (ADAMTSL) proteins constitute a family of regulatory ECM proteins that are related to ADAMTS proteases but lack their protease domains. In mammals, the ADAMTSL protein family comprises seven members, ADAMTSL1-6 and papilin. ADAMTSL orthologs are also present in the worm, Caenorhabditis elegans, and the fruit fly, Drosophila melanogaster. Like other matricellular proteins, ADAMTSL expression is characterized by tight spatiotemporal regulation during embryonic development and early postnatal growth and by cell type- and tissue-specific functional pleiotropy. Although largely quiescent during adult tissue homeostasis, reexpression of ADAMTSL proteins is frequently observed in the context of physiological and pathological tissue remodeling and during regeneration and repair after injury. The diverse functions of ADAMTSL proteins are further evident from disorders caused by mutations in individual ADAMTSL proteins, which can affect multiple organ systems. In addition, genome-wide association studies (GWAS) have linked single nucleotide polymorphisms (SNPs) in ADAMTSL genes to complex traits, such as lung function, asthma, height, body mass, fibrosis, or schizophrenia. In this review, we summarize the current knowledge about individual members of the ADAMTSL protein family and highlight recent mechanistic studies that began to elucidate their diverse functions.