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1.
Cancer Sci ; 2021 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-34632664

RESUMO

From a mouse triple-negative breast cancer cell line, 4T1, we previously established 4T1.3 clone with a high capacity to metastasize to bone after its orthotopic injection into mammary fat pad of immunocompetent mice. Subsequent analysis demonstrated that the interaction between cancer cells and fibroblasts in a bone cavity was crucial for bone metastasis focus formation arising from orthotopic injection of 4T1.3 cells. Here, we demonstrated that a member of adhesion G-protein-coupled receptor (ADGR) family, G-protein-coupled receptor 56 (GPR56)/ adhesion G-protein coupled receptor G1 (ADGRG1), was expressed selectively in 4T1.3 grown in a bone cavity but not under in vitro conditions. Moreover, fibroblasts present in bone metastasis sites expressed type III collagen, a ligand for GPR56/ADGRG1. Consistently, GPR56/ADGRG1 proteins were detected in tumor cells in bone metastasis foci of human breast cancer patients. Deletion of GPR56/ADGRG1 from 4T1.3 cells reduced markedly intraosseous tumor formation upon their intraosseous injection. Conversely, intraosseous injection of GPR56/ADGRG1-transduced 4T1, TS/A (mouse breast cancer cell line), or MDA-MB-231 (human breast cancer cell line) exhibited enhanced intraosseous tumor formation. Furthermore, we proved that the cleavage at the extracellular region was indispensable for GPR56/ADGRG1-induced increase in breast cancer cell growth upon its intraosseous injection. Finally, inducible suppression of Gpr56/Adgrg1 gene expression in 4T1.3 cells attenuated bone metastasis formation with few effects on primary tumor formation in the spontaneous breast cancer bone metastasis model. Altogether, GPR56/ADGRG1 can be a novel target molecule to develop a strategy to prevent and/or treat breast cancer metastasis to bone.

2.
Sci Rep ; 11(1): 20091, 2021 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-34635735

RESUMO

This study aimed to evaluate the dynamics of the medial meniscus during knee flexion-extension by ultrasonography and compare them with MRI findings to confirm the usefulness of ultrasonography for evaluating early knee osteoarthritis (KOA). In total, 100 patients were diagnosed with early KOA using clinical and radiographical findings. Dynamic ultrasonographic evaluation and MRI were performed in all patients. Medial meniscal extrusion (MME) and medial meniscal tears were evaluated via ultrasonography and MRI. Abnormal MME was defined as MME > 2 mm on ultrasonography during knee extension. Patients with abnormal MME were divided into two groups: a decrease group (group D) and a non-decrease group (group N). Age, sex, absence or type of meniscus tear, and MME were compared between the two groups. Of the 100 patients, 75 demonstrated MME > 2 mm at knee extension. MME at all assessment positions using ultrasonography and MRI were significantly greater in group N (n = 34) than that in group D (n = 41). Medial meniscus posterior root tears or radial tears were observed in most cases in group N. A lack of decrease in MME from 0° to 90° of flexion on ultrasonography was a characteristic finding in patients with a loss of meniscal hoop function.

3.
Sci Rep ; 11(1): 19968, 2021 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-34620936

RESUMO

To compare the clinical results and ligamentization of anterior cruciate ligament reconstruction (ACLR) between skeletally immature and mature patients. Two-hundred-and-two patients who underwent primary ACLR were evaluated retrospectively. The clinical outcomes were compared between skeletally immature (immature group 1, n = 27) and mature (control group 1, n = 175) groups. Graft ligamentization of the reconstructed anterior cruciate ligament (ACL) using magnetic resonance imaging (MRI) signal intensity at 6 months postoperatively was compared between immature group 2 (n = 16), which included participants from immature group 1, and control group 2 (n = 32), created by recruiting data-matched controls from control group 1. Immature group 1 had significantly higher revision (14.8%) and pivot shift test positive (22.2%) rates than control group 1 (2.9% and 4.0%, respectively) (P = 0.020 and 0.003, respectively). The signal intensity in immature group 2 were significantly higher at the mid-substance and distal site of the reconstructed ACL than those in control group 2 (P = 0.003 and 0.034, respectively). Skeletally immature patients had higher graft revision and residual rotational laxity rates. Reconstructed ACL in skeletally immature patients showed higher signal intensity on MRI at 6 months postoperatively.

4.
Artigo em Inglês | MEDLINE | ID: mdl-34652514

RESUMO

PURPOSE: It remains to be established whether optical computed tomography (CT)-free and acceleration-based navigation systems differ in terms of implantation accuracy and clinical outcomes for total knee arthroplasty. This randomised prospective study compared the implantation accuracy of these two navigation systems in total knee arthroplasty. METHODS: Optical CT-free navigation (ExactechGPS) or acceleration-based navigation (KneeAlign2) was randomly assigned to the left or right knee of 45 patients who underwent a single-stage bilateral total knee arthroplasty: the ExactechGPS (n = 45) and KneeAlign2 groups (n = 45) were compared. Component alignments were evaluated using three-dimensional computed tomography and radiography at pre- and post-surgery. Implantation accuracy of the component alignment, proportion of outliers, postoperative range of motion, and Japanese Orthopaedic Association (JOA) score were compared between the systems. RESULTS: The implantation accuracies of the lower-extremity mechanical alignment, coronal femoral component angle, coronal tibial component angle, sagittal femoral component, axial femoral angle, and axial tibial angle had no significant difference between the groups. The implantation accuracy of the sagittal tibial component angle was superior in the ExactechGPS than the KneeAlign2 group (1.3° vs. 1.8°, P = 0.034). The proportions of outliers, range of motion, and JOA score had no significant difference between the groups. CONCLUSION: In the tibial sagittal plane, there was a significant difference in the implantation accuracy, but its difference did not affect the clinical outcomes. Both navigation systems have clinically acceptable implantation accuracy.

5.
JPRAS Open ; 30: 91-96, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34522755

RESUMO

Pacinian corpuscle hyperplasia is a pathological increase in the size (Pacinian hypertrophy) and/or density of mature Pacinian corpuscles. Although its aetiology and pathogenesis remain unclear, surgery is the main treatment. Here, we report a rare case of Pacinian hypertrophy at the fingertip treated with surgical excision and reconstruction using a reverse digital artery flap. A 47-year-old man presented with injuries to his right little finger, which was wedged in a door while unloading a truck. His fingertip was amputated and stump plasty was performed. However, severe pain persisted at the fingertip for 5 months after the surgery. Therefore, the painful part of his fingertip was resected, and reconstruction was performed using a reverse digital artery flap 6 months after the injury. Haematoxylin and eosin staining of the resected specimen revealed scar tissue with foreign body reaction and mild Pacinian hypertrophy. One year has passed since the injury, and the pain has completely disappeared. The patient regained complete range of motion in his little finger and was able to resume work without any limitations. Surgical excision with sufficient margin and reconstruction with a reverse digital artery flap is a reliable method to relieve pain due to Pacinian hypertrophy at the fingertip.

6.
Sci Rep ; 11(1): 18001, 2021 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-34504262

RESUMO

Autologous cancellous bone (ACB) grafting is the "gold standard" treatment for delayed bone union. However, small animal models for such grafts are lacking. Here, we developed an ACB graft rat model. Anatomical information regarding the iliac structure was recorded from five rat cadavers (10 ilia). Additionally, 5 and 25 rats were used as controls and ACB graft models, respectively. A defect was created in rat femurs and filled with ACB. Post-graft neo-osteogenic potential was assessed by radiographic evaluation and histological analysis. Iliac bone harvesting yielded the maximum amount of cancellous bone with minimal invasiveness, considering the position of parailiac nerves and vessels. The mean volume of cancellous bone per rat separated from the cortical bone was 73.8 ± 5.5 mm3. Bone union was evident in all ACB graft groups at 8 weeks, and new bone volume significantly increased every 2 weeks (P < 0.001). Histological analysis demonstrated the ability of ACB grafts to act as a scaffold and promote bone union in the defect. In conclusion, we established a stable rat model of ACB grafts by harvesting the iliac bone. This model can aid in investigating ACB grafts and development of novel therapies for bone injury.

7.
Cancers (Basel) ; 13(17)2021 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-34503240

RESUMO

After the lung, the skeleton is the second most common site of distant metastases in differentiated thyroid carcinoma (DTC). Patients with osteolytic bone metastases (BMs) from thyroid carcinoma often have significantly reduced performance status and quality of life. Recent advancements in cancer therapy have improved overall survival in multiple cancer subtypes, including thyroid cancer. Therefore, long-term local control of thyroid BMs is desired, especially in patients with a single metastasis or oligometastases. Here, we reviewed the current management options for DTC-BMs and especially focused on local treatments for long-term local tumor control from an orthopedic tumor surgeon's point of view. Metastasectomy and stereotactic radiosurgery can be performed either alone or in combination with radioiodine therapy and kinase inhibitors to cure skeletal lesions in selected patients. Percutaneous procedures have been developed in recent years, and they can also have a curative role in small BMs. Recent advancements in local therapies have the potential to provide not only long-term local tumor control but also a better prognosis.

8.
J Med Case Rep ; 15(1): 442, 2021 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-34470662

RESUMO

BACKGROUND: Patients with tethered cord syndrome often suffer severe spasticity. To the best of our knowledge, intrathecal baclofen (ITB) therapy in a patient with tethered cord syndrome has not been reported previously. We describe a case in which ITB therapy was useful for treating severe spasticity in an adult with tethered cord syndrome. CASE PRESENTATION: We present the case of a 50-year-old Japanese woman with tethered cord syndrome and related conditions suffering from severe spasticity and pain in the lower limbs. She was born with a lumbosacral myelomeningocele, which was closed in the neonatal period. For 4-5 years before this presentation, spasticity in the lower limbs had been exacerbated without any obvious cause. She received rehabilitation and pharmacotherapy from a local doctor, but symptoms were unimproved, and her previous doctor referred her to this department. A test with 50 µg of intrathecally delivered baclofen showed total relief of spasticity and pain, so a pump was implanted for continuous baclofen delivery. During 24 months of follow-up, spasticity has remained under excellent control with baclofen at 38.5-41.0 µg/day. CONCLUSIONS: ITB therapy proved extremely effective in this adult with severe spasticity from tethered code syndrome.


Assuntos
Relaxantes Musculares Centrais , Defeitos do Tubo Neural , Adulto , Baclofeno/uso terapêutico , Feminino , Humanos , Recém-Nascido , Bombas de Infusão Implantáveis , Injeções Espinhais , Pessoa de Meia-Idade , Relaxantes Musculares Centrais/uso terapêutico , Espasticidade Muscular/tratamento farmacológico , Espasticidade Muscular/etiologia , Defeitos do Tubo Neural/complicações , Defeitos do Tubo Neural/tratamento farmacológico
9.
BMC Musculoskelet Disord ; 22(1): 764, 2021 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-34488684

RESUMO

BACKGROUND: Finite element analysis (FEA) has been previously applied for the biomechanical analysis of acetabular dysplasia and osteotomy. However, until now, there have been little reports on the use of FEA to evaluate the effects of pelvic tilt on stress distribution in the acetabulum. METHODS: We used the Mechanical Finder Ver. 7.0 (RCCM, Inc., Japan) to construct finite element models based on 3D-CT data of patients, and designed dysplasia, borderline, and normal pelvic models. For analysis, body weight was placed on the sacrum and the load of the flexor muscles of the hip joint was placed on the ilium. The pelvic tilt was based on the anterior pelvic plane, and the pelvic tilt angles were -20°, 0°, and 20°. The load of the flexor muscle of the hip joint was calculated using the moment arm equation. RESULTS: All three models showed the highest values of von Mises stress in the -20° pelvic tilt angle, and the lowest in the 20° angle. Stress distribution concentrated in the load-bearing area. The maximum values of von Mises stress in the borderline at pelvic tilt angles of -20° was 3.5Mpa, and in the dysplasia at pelvic tilt angles of 0° was 3.1Mpa. CONCLUSIONS: The pelvic tilt angle of -20° of the borderline model showed equal maximum values of von Mises stress than the dysplasia model of pelvic tilt angle of 0°, indicating that pelvic retroversion of -20° in borderline is a risk factor for osteoarthritis of the hip joints, similar to dysplasia.


Assuntos
Luxação Congênita de Quadril , Luxação do Quadril , Acetábulo/diagnóstico por imagem , Análise de Elementos Finitos , Humanos , Tomografia Computadorizada por Raios X
10.
Cancer Genomics Proteomics ; 18(5): 637-643, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34479916

RESUMO

BACKGROUND/AIM: Osteosarcoma is a recalcitrant heterogenous malignancy. The aim of the present study was to compare a series of multikinase inhibitors (MKIs) for efficacy on two drug-resistant osteosarcoma patient-derived orthotopic xenograft (PDOX) models in order to identify a clinical candidate. MATERIALS AND METHODS: The two osteosarcoma PDOX models were tested for response to the following MKIs: pazopanib, sunitinib, sorafenib, crizotinib, and regorafenib, in comparison to first-line treatment with cisplatinum and an untreated control. RESULTS: Regorafenib led to regression of osteosarcoma in both PDOXs. Total necrosis was observed pathologically in the regorafenib-treated tumors. Sorafenib arrested growth, without inducing regression, in one osteosarcoma model but not the other, and the other MKIs only slowed tumor growth. CONCLUSION: The present study demonstrated that regorafenib is much more effective than the other MKIs tested and has clinical potential against recalcitrant osteosarcoma.

11.
Sci Rep ; 11(1): 17291, 2021 08 27.
Artigo em Inglês | MEDLINE | ID: mdl-34453061

RESUMO

Age affects the clinical outcomes of cancer treatment, including those for bone sarcoma. Successful reconstruction using frozen autograft after excision of bone sarcoma has been reported; however, little is known about the clinical outcomes of frozen autograft reconstruction according to age. The purpose was to evaluate the clinical outcomes of the frozen autograft reconstruction focusing on skeletally mature adolescents and young adults (AYAs) that was 15 to 39 years of age. A total of 37 AYA patients with primary bone sarcoma on the appendicular skeleton were enrolled in this study. The mean follow-up period was 89 months. The graft survival (GS), overall survival (OS), recurrence-free survival (RFS), complications and the function were retrospectively evaluated using medical records. The 10-year GS, OS, and RFS rates were 76%, 84%, and 79%, respectively. Bone union was achieved with a rate of 94% within 1 year after surgery, and nonunion (n = 1) and fracture (n = 2) were infrequently observed. Graft removal was performed in 7 cases, and the most common reason for the removal was infection (n = 5). The Musculoskeletal Tumor Society score was excellent in 23 cases of the available 29 cases. Frozen autograft reconstruction for AYAs showed excellent clinical outcomes, although the long-term follow-up is required.

12.
World Neurosurg ; 2021 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-34365045

RESUMO

BACKGROUND: The clinical outcomes of balloon kyphoplasty (BKP) for split-type osteoporotic vertebral fractures (OVF) are poor. These may be owing to the vertebral body bifurcating anteriorly and posteriorly when a load is applied and the filled cement being unstable. We report the usefulness of BKP combined with pediculoplasty using cannulated screws (vertebra-pediculoplasty) for OVF with a risk of cement dislodgement. METHODS: Between April 2020 and February 2021, this surgery was performed on 10 patients with split-type and delayed-union OVF. The diagnosis was made using imaging findings on preoperative computed tomography or intraoperative images during balloon inflation. Early postoperative ambulatory rehabilitation was performed, and clinical outcomes were evaluated. RESULTS: Early pain relief was obtained in all patients. The stability of the fractured vertebrae was demonstrated using both supine and seated radiographs from the early postoperative period, and good clinical results were obtained. The cement in this surgery was stabilized using a cannulated screw in the vertebral body, anteroposteriorly, and craniocaudally. The cement mass integrated with the cannulated screw was stabilized with the vertebral lamina and pedicle as a stopper. CONCLUSIONS: Vertebra-pediculoplasty could be an effective method for managing OVF with a high risk of cement dislodgement, which has been difficult to treat using conventional BKP.

13.
J Hand Surg Asian Pac Vol ; 26(3): 460-462, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34380391

RESUMO

Distal radius fractures often involve comminuted fragments of the dorsal cortex of the radius, but bone fragments rarely protrude into the radiocarpal joint. We report two cases of distal radius fracture with bone fragment protrusion into the radiocarpal joint. To the best of our knowledge, there are no English reports of distal radius fracture with bone fragment protrusion into the radiocarpal joint. Despite the rarity of these cases, clinicians should still be mindful of such injuries and not overlook the possibility of presence of bone fragments within the joint. Missed intra-articular fragments may cause pain, limited range of motion, and subsequent osteoarthritis.


Assuntos
Fraturas do Rádio , Fraturas Cominutivas/diagnóstico por imagem , Fraturas Cominutivas/cirurgia , Humanos , Rádio (Anatomia)/diagnóstico por imagem , Fraturas do Rádio/diagnóstico por imagem , Fraturas do Rádio/cirurgia , Articulação do Punho
14.
Oncologist ; 2021 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-34396627
15.
Artigo em Inglês | MEDLINE | ID: mdl-34397401

RESUMO

BACKGROUND: Abdominal bracing is effective in strengthening the trunk muscles; however, assessing performance can be challenging. We created a device for performing abdominal trunk muscle exercises. The effectiveness of this device has not yet been evaluated or comparedOBJECTIVE: We aimed to quantify muscle activity levels during exercise using our innovative device and to compare them with muscle activation during abdominal bracing maneuvers. METHODS: This study included 10 men who performed abdominal bracing exercises and exercises using our device. We measured surface electromyogram (EMG) activities of the rectus abdominis (RA), external oblique, internal oblique (IO), and erector spinae (ES) muscles in each of the exercises. The EMG data were normalized to those recorded during maximal voluntary contraction (%EMGmax). RESULTS: During the bracing exercise, the %EMGmax of IO was significantly higher than that of RA and ES (p< 0.05), whereas during the exercises using the device, the %EMGmax of IO was significantly higher than that of ES (p< 0.05). No significant difference was observed in the %EMGmax of any muscle between bracing exercises and the exercises using the device (p= 0.13-0.95). CONCLUSIONS: The use of our innovative device results in comparable activation to that observed during abdominal bracing.

16.
Sci Rep ; 11(1): 13750, 2021 07 02.
Artigo em Inglês | MEDLINE | ID: mdl-34215831

RESUMO

Understanding the morphology of the superior aspect of the proximal femur is critical for treating femoral fracture. We assessed the correlation among the ideal insertion point of the femoral nail, femur head-neck axis, and native anteversion. One hundred patients with normal femurs were included in this study. Computed tomography (CT) images of the proximal femur superior aspect and amount of native anteversion were acquired. Generalised Procrustes analysis showed the morphological characteristics of the superior proximal femur according to native anteversion amount. Morphological characteristics were represented by 4 parameters; the correlation between parameters and native anteversion was investigated using CT data. The passing point of the line from the proximal femoral canal parallel to the native anteversion at the greater trochanter was located more posteriorly (mean 35.6%); the passing point of native anteversion was posterior in the femoral neck and head, although the line of the head-neck centre passed more anteriorly at the greater trochanter (mean 67.5%). This posterior translation was significantly associated with native anteversion amount. Morphometric geometric analysis showed that the lag screw could not pass head-neck centre from the nail inserted into proximal femoral canal. Anterior insertion of the nail was needed for positioning the lag screw centre.

17.
Foot Ankle Surg ; 2021 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-34247920

RESUMO

BACKGROUND: The spring ligament complex (SLC) supports the medial longitudinal arch of the foot, particularly in standing. We evaluated posture-related changes in the thickness and length of the three SLC bundles and their histology. METHODS: The thickness and length of the supramedial calcaneonavicular ligament (smCNL), medioplantar oblique calcaneonavicular ligament (mpoCNL), and inferoplantar calcaneonavicular ligament (iplCNL) were measured in the supine and standing positions, using a multiposture magnetic resonance imaging system, in 72 healthy adult feet. Histological examination was performed for 10 feet from five cadavers. RESULTS: The smCNL thickness decreased and its length increased from the supine to the standing position (P < 0.001); no other posture-related effects were noted. Histologically, smCNL fibers overlapped along multiple directions while mpoCNL and iplCNL, fibers were oriented horizontally along the longitudinal axis and vertically along the short axis, respectively. CONCLUSION: The complex, multidirectional, orientation of the smCNL allows an adaptive response to changes in loading.

18.
Am J Transl Res ; 13(6): 5851-5865, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34306330

RESUMO

SRY (sex determining region Y)-box 2 (SOX2) plays a key role in the maintenance of stemness and resistance to drugs, whereas tumor necrosis factor (TNF)-α is essential for maintaining cancer cell proliferation and metastasis. Accumulation of muscle segment homeobox 2 (MSX2) leads to downregulation of SOX2 expression. Here, we explored the MSX2-SOX2-TNF-α signaling axis and its function in the tumor phenotypes of osteosarcoma cells. Colony formation assay, cell counting kit (CCK)-8 assay, and Flow cytometry were used to examine cell growth, viability, and death, respectively. Wound healing and Transwell invasive assay were employed to examine cell migratory and invasive activities, respectively. Western blotting and RT-qPCR were used to determine the protein and mRNA expressions of MSX2, SOX2, TNF-α, Bax, and matrix metalloproteinase-2 (MMP-2). Osteosarcoma clinical samples and cells showed lower levels of MSX2 than normal healthy control samples. Overexpression of MSX2 led to a reduced activity of SOX2 and TNF-α, whereas MSX2 depletion did not contribute to upregulated SOX2 levels. A gain-of-function experiment showed that osteosarcoma cell viability and growth were reduced, cell death was increased, and migration and invasion were inhibited in the MSX2 overexpression group compared with those in the non-transfected group. Furthermore, co-overexpression of MSX2 and SOX2 counteracted the inhibitory effects of MSX2 on the abovementioned tumor phenotypes of osteosarcoma cells. An in vivo tumor growth assay showed that MSX2 overexpression slowed the growth rate of osteosarcoma xenograft tumors. Thus, MSX2 loss plays a crucial role in the osteosarcoma phenotype by elevating SOX2 and TNF-α levels.

19.
Cancers (Basel) ; 13(14)2021 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-34298772

RESUMO

BACKGROUND: It is challenging to differentiate between enchondromas and atypical cartilaginous tumors (ACTs)/chondrosarcomas. In this study, correlations between radiological findings and final diagnosis were investigated in patients with central cartilaginous tumors. METHODS: To evaluate the diagnostic usefulness of radiological findings, correlations between various radiological findings and final diagnoses were investigated in a cohort of 81 patients. Furthermore, a new radiological scoring system was developed by combining radiological findings. RESULTS: Periosteal reaction on X-ray (p = 0.025), endosteal scalloping (p = 0.010) and cortical defect (p = 0.002) on CT, extraskeletal mass (p < 0.001), multilobular lesion (p < 0.001), abnormal signal in adjacent tissue (p = 0.004) on MRI, and increased uptake in bone scan (p = 0.002) and thallium scan (p = 0.027) was significantly correlated with final diagnoses. Based on the correlations between each radiological finding and postoperative histological diagnosis, a radiological scoring system combining these findings was developed. In another cohort of 17 patients, the sensitivity, specificity, and accuracy of the radiological score rates for differentiation between enchondromas and ACTs/chondrosarcomas were 88%, 89%, and 88%, respectively (p = 0.003). CONCLUSION: Radiological assessment with combined radiological findings is recommended to differentiate between enchondromas and ACT/chondrosarcomas.

20.
J Exp Orthop ; 8(1): 54, 2021 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-34296377

RESUMO

PURPOSE: This study aimed to evaluate the excessive anterior tibial translation (ATT) and muscle strength of patients with ramp lesions. We hypothesised that the higher ATT, lower hamstring-to-quadriceps (HQ) ratio, and higher flexion peak torque influenced by semimembranosus would be associated with ramp lesions. METHODS: One hundred and twenty-one patients who underwent anterior cruciate ligament (ACL) reconstruction were retrospectively evaluated. Clinical evaluation included ATT of the contralateral uninjured limb measured using a KT-1000 arthrometer, the knee flexor and extensor muscle strength of the contralateral uninjured limb at 60°/s and 180°/s of an angular velocity measured using an isokinetic dynamometer, and HQ ratio at 60°/s and 180°/s during the preoperative state. Binary stepwise logistic regression analysis was performed to evaluate the risk factors of ramp lesions. RESULTS: Ramp lesions were found in 27 cases of ACL injuries (27/121, 22.3%). Male sex (odds ratio [OR], 2.913; 95% confidence interval [CI], 1.090-7.787; P = 0.033), longer time between injury to surgery (OR, 2.225; 95% CI, 1.074-4.608; P = 0.031), and higher ATT in the contralateral uninjured limb (OR, 1.502; 95% CI, 1.046-2.159; P = 0.028) were indicated as the independent risk factors of the presence of ramp lesion associated with an ACL injury. CONCLUSIONS: Male sex, longer period from injury to surgery, and higher ATT in the contralateral uninjured limb were significantly associated with ramp lesion. These findings are advantageous for identifying patients with a greater risk of developing a ramp lesion with an ACL injury in the clinical setting. LEVEL OF EVIDENCE: Level IV.

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