The International Skeletal Society: a look back at 50 years of multidisciplinary expertise, collaboration, and education in musculoskeletal health and disease.

Multidisciplinary collaboration and radiology-pathology correlation are key components to advancing our knowledge and understanding of musculoskeletal disease and improving clinical care. The International Skeletal Society was founded on this principle and in its 50-year history it has successfully cultivated a globally recognized and respected Annual Meeting and Refresher Course to foster interest and share expertise in musculoskeletal disorders. The Society's consistent efforts for outreach and intersociety connections with MSK societies around the world have further strengthened its heritage. This look back on the Society's first 50 years recounts how it all started, where it has been, and provides insights on its promising future, not only in its support for education and scientific discovery, but also in its enrichment of precision medicine.

Abulcasis (936-1013): his work and contribution to orthopaedics.

AIM OF THE STUDY: The purpose of this historic review is to summarize the life and work of Abulcasis (936-1013) and his contribution to surgery and orthopaedics. METHOD: We conducted an extensive search in libraries as well as online in PubMed and Google Scholar. RESULTS: Abulcasis in his work combines the knowledge of ancient Greek and Roman physicians and surgeons with the extensive knowledge of Arabic medicine and pharmacology. He also pioneered surgical technique with the invention of numerous surgical instruments and with several revolutionary surgical techniques. CONCLUSION: Abulcasis made an impact with his medical writings in which he summarized the works of ancient Greek and Roman physicians like Hippocrates and Galen with the influence of medieval authors and the knowledge of the Arabic medicine and pharmacology. His descriptions and innovations in his work remained a work of reference in the West and East for many centuries to come.

[Medical practice in Ancient Greece : The orthopaedic and trauma surgery case reports of the Hippocratic Corpus]. / Medizinische Praxis im alten Griechenland : Die orthopädischen und unfallchirurgischen Fallberichte des Corpus Hippocraticum.

OBJECTIVES: Which theoretical and practical competences do the orthopaedic and trauma surgery reports of the Hippocratic Corpus reveal? MATERIALS: The 431 Hippocratic case histories have been studied for reports and communication on diagnostics, therapy and prognosis of orthopaedic diseases and traumatic lesions. RESULTS: The seven books of the Hippocratic "Epidemics" describe a total of 26 patients with orthopaedic diseases and traumatic lesions. In the field of orthopaedic diseases, arthritis, myo- and tenopathia and gangrene play a prominent role, among the consequences of injury the fracture of the skull (n = 10) is in first place. Mainly individuals, but also groups of patients are reported. The clients' information on the course of the disease was often cautious. Diagnostics were limited to inspection and palpation. In addition to the measures of conservative treatment, four trepanations are described. The majority of traumatic brain lesions resulted in death. DISCUSSION: The Hippocratic doctor was faced with a variety of orthopaedic disases and traumatic lesions. Within the case reports, the subjective complaints, the objective findings and the course of the treatment are described in detail. Among the ailments of the musculoskeletal system, spinal disorders, especially hypercyphosis and scoliosis play an important role. The variety of reduction techniques reported suggests that most of the fractures detected were dislocated. Post-traumatic tetanus can be readily identified in several followup observations due to the development of opisthotonus. No other surgical intervention is discussed by Hippocrates as often and as variously as trepanation. It can be concluded with some certainty that perforating injuries of the skull were a common challenge in the life of a surgeon of classic antiquity.

The 'scientific artworks' of Doctor Paul Richer.

This article examines the little-known sculptures of pathology created by Doctor Paul Richer (1849-1933) in the 1890s for the so-called Musée Charcot at the Hôpital de la Salpêtrière in Paris. Under the direction of Doctor Jean-Martin Charcot (1825-1893), one of the founders of modern neurology, Richer was the head of the hospital's museum of pathological anatomy, as well as the Salpêtrière's resident artist. His 'series of figural representations of the principal types of nervous pathology' included busts of patients suffering from labio-glosso-laryngeal paralysis and myopathy, as well as sculptures depicting patients with Parkinson's disease and juvenile hypothyroidism. These patient portraits were seen as objective, while also paradoxically providing an alternative to mechanical media, such as the photograph and the cast, by permitting the doctor's intervention in not only controlling and animating the sitter, but also emphasising the patient's symptoms. This was a new kind of medical specimen: the 'scientific artwork', as they were called by a contemporary. This phrase, far from being an oxymoron, indicates the purposive collapse of the objective ('scientific') and subjective ('artistic') binary in Richer's sculptures of pathology. Through a detailed examination of three of Richer's works, this article problematises the categories traditionally used to describe, analyse and understand medical imagery and complicates our understanding of the relationship between science and art at the end of the nineteenth century.

Thomas L. DeLorme and the science of progressive resistance exercise.

In the latter years of the Second World War, the number of American servicemen who had sustained orthopedic injuries was overwhelming the nation's military hospitals. The backlog of patients was partly because of the sheer number of soldiers involved in the war effort, but it was exacerbated by rehabilitation protocols that required lengthy recovery times. In 1945, an army physician, Dr. Thomas L. DeLorme experimented with a new rehabilitation technique. DeLorme had used strength training to recover from a childhood illness and reasoned that such heavy training would prove beneficial for the injured servicemen. DeLorme's new protocol consisted of multiple sets of resistance exercises in which patients lifted their 10-repetition maximum. DeLorme refined the system by 1948 to include 3 progressively heavier sets of 10 repetitions, and he referred to the program as "Progressive Resistance Exercise." The high-intensity program was markedly more successful than older protocols and was quickly adopted as the standard in both military and civilian physical therapy programs. In 1951, DeLorme published the text Progressive Resistance Exercise: Technic and Medical Application, which was widely read by other physicians and medical professionals. The book, and DeLorme's academic publications on progressive resistance exercise, helped legitimize strength training and played a key role in laying the foundation for the science of resistance exercise.

Variation of musculoskeletal stress markers in the medieval population from Cedynia (Poland)--proposal of standardized scoring method application.

The objective of this paper is: (a) to present a rating scale for the evaluation of the musculoskeletal stress markers; (b) to analyze the medieval population from Cedynia in terms of the degree of expression and frequency of the musculoskeletal stress markers. The presented rating scale was developed based on the variability of the morphology of muscle attachment sites, observed in the skeletal material from Cedynia (102 males and 99 females). The scale encompasses 10 musculoskeletal stress markers located on the scapula, humerus, radius, femur and tibia. The system reflects three degrees (1, 2, 3) of complexity of the muscle attachment sites morphology. The analysis of asymmetry and sexual dimorphism of the musculoskeletal stress markers was made based on the chi2 (Pearson) statistics or chi2 statistics for 2 x 2 tables. Moderate degree (2) of muscle attachment site complexity is the most frequent degree of musculoskeletal stress markers development in the population from Cedynia. Low (1) and high (3) complexity of muscle attachment site are the most seldom observed categories. No statistically significant differences between the frequencies of the musculoskeletal stress markers on the bones of the right and left side of the skeleton were noted in females. Also in males the differences found were not statistically significant. Only in the case of deltoid tuberosity (H2) p = 0.052 oscillating around the threshold value may suggest existence of a statistically significant difference in the degree of expression of this stress marker on the bone of the right and left side of the skeleton. On the bones of the right side of the skeleton dimorphic differences were observed in the glenoid tuberosity (S2), bicipital groove (H1), pronator teres origin (R2), tibial tuberosity (T1), soleal crest (T2) and linea aspera (F2). On the bones of the left side of the skeleton dimorphic differences were noted for the bicipital groove (H1), pronator teres origin (R2) and glenoid tuberosity (S2).

Henry J. Mankin: A Trailblazer in Skeletal Pathology Research.

: Dr. Henry Mankin has made a profound impact in the fields of skeletal surgery and orthopedics. In a career spanning over 50 years, Dr. Mankin conducted extensive research on and provided treatment for numerous patients with Gaucher disease and spinal tumors such as sacral chordomas. Dr. Mankin's prolific career includes many leadership positions in the field of skeletal surgery, including Chief of Orthopaedics at the Hospital for Joint Diseases and at Massachusetts General Hospital. He has touched the lives of over 19,000 patients with bone and soft tissue tumors and undoubtedly shaped the future of skeletal surgery.

[L'image de la posture--l'image du mouvement: on the relationship between orthopaedic and neurological forms of representation in 19th century clinical photography]. / L'image de la posture--l'image du mouvement: Zum Verhältnis orthopädischer und neurologischer Repräsentationsformen in der klinischen Photographie des 19. Jahrhunderts.

The question of how medicine represents and documents malfunctions and deviances of human posture and movement is intrinsically linked to the problem of how those occurrences, which can be seen as the end result of medical treatment and manipulations, could be identified and classified. In fact, the relation of posture and movement is reciprocally interconnected: The "normality" of either state cannot be established or clinically reproduced without knowledge of the other. Both conditions of posture and movement serve as reference points for each other and help to distinguish between the dynamics of physiology and illness over the course of time. It is therefore understandable that orthopaedic surgeons and neurologists in particular, with a deeper interest in orthopaedic applications, were crucially involved in the collection of special cases of posture and movement disorders from their clinical experience. Not simply for didactic purposes, but likewise for the benefit of documenting their own treatment success, they strove to accurately depict severe cases of posture and movement disorders with the new visualization technique of photography. Clinical photography's allegedly "realistic capacity of representation" predestined the new method for capturing long-term processes of illness and therapy in collections of serial images. However, the very early clinical photographs of the 19th century had their origins rather in areas of psychiatric and neurological uses, and it was not until much later that clinical photography made its way into the surgical and orthopaedic fields of medicine. This article scrutinizes some of the intricate relations, which can be found in the neurological and orthopaedic representations of posture and movement as depicted in early clinical photography.

[History of orthopaedic surgery and "the gang of four"]. / Histoire de la chirurgie orthopédique "la bande des quatre".

Four practitioners, Victor Menard, François Calot, Jacques Calvé, Etienne Sorel were the prominent surgeons in the Hospital of Berck sur Mer. They tried to set a real resistance against the terrible disease : the articular tuberculosis. Each of them proposed a means either of diagnosis or classification or surgical treatment.

[François Calot, founder of the Orthopedic Institute of Berck]. / François Calot de la guérison des bossus à la création de l'Institut orthopédique.

François Calot (1861-1944) was an orthopaedist surgeon in Berck from 1890 to 1941. He acquired an international fame thanks to a paper read before the Academy of Medicine of Paris, on 22nd December 1896 about 37 cases of reduction of the angular curvature in Pott's disease. As he wrote many books on orthopaedic surgery he also founded the "Institut orthopédique de Berck" which is now named "Institut Calot".

[MUSCULOSKELETAL MARKERS, ARTHROPATY, TRAUMAS]. / INDICATORI SCHELETRICI DI LAVORO: MARCATORI MUSCOLO-SCHELETRICI, ARTROPATIE E TRAUMI.

The bone tissue remodeling due to strong physical/working activity is defined as ergonomic markers or MSM (Muscoloskeletal Stress Markers) (Capasso et al. 1999) and MOS (Markers of Occupational Stress). Among them we can find: enthesopaties, arthropaties, non metrical stress and traumas markers. In the present study, the analysis of these traits has been used to clarify habitual activity patterns of four imperial populations from Suburbium: Castel Malnome, Casal Bertone area Q, Via Padre Semeria e Quarto Cappello del Prete. The very high prevalence of activity-induced stress lesions occurred among the individuals of Castel Malnome and Casal Bertone area Q suggests that these groups were involved in strenuous occupations such as, respectively: the processing and storage of salt and the dyeing of textiles and hides discernible from the archaeological context. For the individuals of Via Padre Semeria and Quarto Cappello del Prete the alterations, instead, could be compatibles with agricultural work.

Work-related reproductive, musculoskeletal and mental disorders among working women--history, current issues and future research directions.

According to the recent changes of working environments and socio-economical conditions, the proportion of working women are increasing in Japan. Characteristics of occupational workload and stress of Japanese working women are consistent with those in many industrialized countries except man-dominant culture. In this review we describe the history, current issues, and future research directions on occupational health of working women, especially focused on reproductive health, work-related musculo-skeletal disorders (WMSDs), and mental disorders. In the reproductive health survey, traditionally main concern was about pregnancy outcomes, then fecundity studies, such as time to pregnancy, became topics recently. Future research will be shifted to outcomes not only during pregnancy but also disorders of hormonal balance and climacterium or health conditions after menopause. WMSDs are reviewed on mainly gender difference and its causative factors. Historically, mental health of working women in Japan has focused on the job stress of nurses. We compare results with a lot of recent researches in Europe and U.S.A., where interaction between occupational stress and family roles were studied. It is not easy to predict the prospective status of female workers in Japan, but social, workplace and familial supports will enhance their health promotion.

Bernardino Ramazzini's early observations of the link between musculoskeletal disorders and ergonomic factors.

Bernardino Ramazzini (1633-1714) systematically studied the relationship between work and diseases. He realized that it was not possible to ascribe all workers' diseases to chemicals or physical agents and foresaw that other factors were involved. He observed that common diseases could originate following the maintenance either of prolonged stationary postures or of unnatural postures (e.g. bakers, workers who stand, sedentary worker, scribes, weavers) or following activities requiring heavy muscular performance (e.g. porters and woodworkers). Furthermore, Ramazzini recognized the need to undertake measures to prevent disorders from repetitive motions and manual lifting and anticipated the now accepted advice of moderation and recommendations of reduction of work duration for a number of hard jobs requiring a standing position or severe muscular effort. From his early writings therefore it is evident that Ramazzini realized the importance of assessing the ergonomic factors associated with the occurrence of work-related musculoskeletal disorders.

[One hundred years of orthopedics in the Netherlands. VII. biomaterials]. / Honderd jaar orthopedie in Nederland. VII. Biomaterialen.

The use of biomaterials in orthopaedics is becoming increasingly important. They are widely used in artificial joints, as bone replacement material and as resorbable material. Also (recombinant) bone morphogenetic proteins are used. Classification of biomaterials is based on composition (animal or human tissue, metals, polymers, ceramics or composites) or on biological reactions after implantation (bio-inert, bio-tolerant or bio-active). Depending on location and function biomaterials have to meet requirements with respect to durability (artificial joints), fixation (total hip prosthesis), flexibility (artificial ligaments), solubility (suture wire) and stiffness (plates and screws). The development of biomaterials is in full swing, focussing on the decrease of wear and the increase of durable fixation of artificial joints, and the induction of cells to form bone and cartilage tissue.