OBJECTIVE: To investigate the clinical effect the treatment of arthroscopy-assisted calcaneal spur resection combined with plantar fascia release and calcaneal decompression in the treatment of the patients with intractable calcaneal pain. METHODS: The clinical data of 50 patients with intractable heel pain from January 2016 to January 2019 were retrospectively analyzed, including 20 males and 30 females;aged from 40 to 68 years old with an average of (50.12±7.35)years old, the medical history ranged from 1 to 4 years. All patients underwent arthroscopy-assisted calcaneal spur resection combined with plantar fascia release and calcaneal decompression, and were followed up, the duration ranged from 24 to 60 months with an average of(42.00±3.28) months. All patients had obvious heel pain before surgery, and X-ray examinations often showed the presence of calcaneal spurs. In addition to the routine foot examination, the changes in the height and angle of the arch of the foot were also measured pre and post-operatively by X-ray, for the evaluation of clinical effect. The VAS system was used to evaluate the degree of foot pain;the AOFAS scoring system was used to comprehensively evaluate the foot pain, voluntary movement, gait and stability. RESULTS: The VAS decreased from (8.75±1.24) before surgery to (5.15±2.35) at 3 months after surgery, (4.07±2.53) at 6 months after surgery, and (3.95±2.44) at the last fllow-up(P<0.05). The AOFAS score increased from (53.46±4.17) before surgery to(92.46±2.53) at 3 months after surgery, (96.33±2.46) at 6 months after surgery, and (97.05±2.37) at the last follow-up(P<0.05). The arch height was (41.54±1.15) mm before operation and (41.49±1.09) mm after the operation, the difference was not statistically significant(P>0.05). The internal arch angle of the foot arch was (121±6)° before operation and (122±7)° after operation. The difference was not statistically significant(P>0.05). CONCLUSION Arthroscopy-assisted calcaneal bone spurs resection combined with plantar fascia release and calcaneal decompression exhibited great clinical effect for treating intractable heel.
Male ; Female ; Humans ; Adult ; Middle Aged ; Aged ; Heel/surgery* ; Heel Spur/surgery* ; Retrospective Studies ; Calcaneus/surgery* ; Foot Diseases ; Pain ; Endoscopes ; Treatment Outcome

The most reliable and convenient measurement method of tibial posterior slope(TPS) and its biomechanical relationship with posterior cruciate ligament (PCL) are still controversial. For X-ray measurement, it is recommended to use full-length lateral X-ray of the lower extremity in quatrous section, which has advantage of highly repeatable and common in the daily diagnosis and treatment process, but it is only applicable to patients with tibial rotation within 15°. When the rotation exceeds 30°, it is difficult to identify the inner contour of platform and is no applicable. If it is only used for daily diagnosis and treatment evaluation, when tibial rotation angle is less than 15°, lateral knee X-ray also has a certain reference significance, but the accuracy could not meet requirements of higher clinical research. For CT measurement method, it could correct tibial rotation, but using the fitting point to measure tibial posterior slope on three-dimensional CT reconstruction is only applicable to knee joint without degeneration, more osteophyte affects the way of using fitting point to determine the plane of tibia with real tibia platform conformity degree, have some limitations. For measurement of MRI, it could not only correct tibial rotation, but also minimize the effect of osteophytes by using tibial anatomical axis as the reference axis, which is a good measurement method. For the biomechanical relationship between tibial posterior slope and tibial posterior slope, increased tibial posterior slope indirectly alleviates tension of PCL through tibial anterior displacement or directly reduces load on posterior cruciate ligament in tibial osteotomies, suggesting a protective mechanism for tibial posterior slope;in total knee arthroplasty with cruciate ligament preserved, the size of tibial posterior slope will affect roll back mechanism of femur. When affected knee with PCL injury, it should be avoid to release then aggravate injury, and the stress could be alleviated by increasing tibial posterior slope appropriately. There has been no unified conclusion on the range of tibial posterior slope that is most beneficial to PCL. The natural tibial posterior slope is between 7 ° and 10°, which is considered to be the most beneficial to protection of PCL, but further studies are needed according to the differences in patients' bone status, surgical methods and so on.
Arthroplasty, Replacement, Knee/methods* ; Femur/surgery* ; Humans ; Knee Joint/surgery* ; Osteophyte/surgery* ; Posterior Cruciate Ligament/surgery* ; Tibia/surgery*

OBJECTIVE: To explore the genetic basis for a pedigree affected with hereditary multiple osteochondroma (HMO). METHODS: Peripheral blood samples were collected from the proband and members of his pedigree with informed consent. Following extraction of genomic DNA, all coding exons and flanking intronic sequences (-10 bp) of the EXT1 and EXT2 genes were subjected to targeted capture and next generation sequencing (NGS). Suspected variant was verified by Sanger sequencing. RESULTS: A heterozygous nonsense variant (c.1911C>A) was found in exon 10 of the EXT1 gene in the proband and his affected father but not in a healthy sister and normal controls. The variant was classified as a pathogenic based on the guidelines of the American College of Medical Genetics and Genomics (PVS1+PM2+PP1). Bioinformatic analysis predicted that the c.1911C>A variant may be disease-causing via nonsense-mediated mRNA decay and anomalous splicing. CONCLUSION The c.1911C>A variant probably underlay the disease in this pedigree. Discovery of this variant enriched the variant spectrum of HMO.
Codon, Nonsense ; Exons/genetics* ; Exostoses, Multiple Hereditary/genetics* ; Heterozygote ; Humans ; Pedigree

STUDY DESIGN: A cross-sectional study. OBJECTIVES: To provide reference data for the study and treatment of thoracic scoliosis. SUMMARY OF LITERATURE REVIEW: There have been no reports on the prevalence of thoracic scoliosis in Korea. MATERIALS AND METHODS: From August 2011 to October 2012, radiographs of patients under 80 years of age who underwent routine chest radiographs were retrospectively reviewed. Based on their age when the chest radiographs were obtained, the patients were divided into 8 groups. The prevalence and angle of the curve of thoracic scoliosis were investigated in each age group, and the prevalence of thoracic scoliosis according to sex, the direction of the curve, number of vertebrae in the major curve, the location and rotation of the apical vertebrae, and osteophyte location were examined. RESULTS: The prevalence of thoracic scoliosis was 2.4% (621 patients), and female patients (3.0%, 375 of 12471) showed a higher prevalence than male patients (1.8%, 246 of 13654) (p<0.001). Right curvature was present in 445 patients and left curvature in 176 patients. In each age group, the prevalence and degree of thoracic scoliosis were 1.1% (14.2°±3.2°), 2.3% (17.4°±7.7°), 2.5% (17.0°±8.9°), 1.9% (15.8°±5.9°), 1.3% (15.5°±6.6°), 2.1% (18.0°±13.6°), 2.9% (14.3°±3.6°), and 6.1% (16.2°±4.8°), respectively. The mean curvature in all scoliosis patients was 16.0°±7.0°. The angle of the curve was significantly different by sex (15.4°±7.1° for males, 16.8°±7.6° for females). The average curve angle of patients with thoracic scoliosis was 16.0°±7.0°, among whom it was 10°–20° in 533 patients, 20°–30° in 64, 30°–40° in 11, and over 40° in 13. CONCLUSIONS: This study could be used as a reference point for the study and treatment of thoracic scoliosis.
Cross-Sectional Studies ; Female ; Humans ; Korea ; Male ; Osteophyte ; Prevalence ; Radiography ; Radiography, Thoracic ; Retrospective Studies ; Scoliosis ; Spine ; Thoracic Vertebrae ; Thorax

An anterior cervical osteophyte is one of the causes of dysphagia. Surgical treatment is one of the treatment options available, and previous studies have suggested that it is an immediate and effective treatment. This paper reports a case of temporarily aggravated dysphagia after surgical treatment in a patient with anterior cervical osteophyte. A 75-year-old male complained of dysphagia for one year. A videofluoroscopic swallowing study (VFSS) revealed anterior cervical osteophytes at the C3 and C4 level, which resulted in decreased epiglottic folding and partial obstruction of the bolus passage. After he underwent osteophytectomy and anterior fixation, the post-operative VFSS showed an aggravation of dysphagia with prevertebral soft tissue edema. The major cause of dysphagia was attributed to the limitation of movement of the posterior pharyngeal wall and upper esophageal sphincter due to the increased prevertebral soft tissue thickness. In conclusion, surgery should be considered when a severe dysphagia is persistent after adequate conservative treatment in patients with dysphagia due to anterior cervical osteophytes, and patients at high risk of postoperative dysphagia might require swallowing rehabilitation.
Aged ; Cervical Vertebrae ; Deglutition ; Deglutition Disorders ; Edema ; Esophageal Sphincter, Upper ; Female ; Fluoroscopy ; Humans ; Male ; Osteophyte ; Rehabilitation

No abstract available.
Exostoses ; Fingers ; Korea

BACKGROUND AND OBJECTIVES: External auditory canal osteoma is an uncommon benign lesion and represents as unilateral solitary pedunculated mass. The aim of this study is to evaluate the clinical symptoms of osteoma and its treatment outcomes over a 10-year period in a tertiary hospital. SUBJECTS AND METHOD: Eight patients underwent operation to remove an external auditory canal osteoma at Chungbuk National University Hospital from 2008 to 2017. The medical records were retrospectively reviewed with regard to clinical characteristics, size and location of osteoma, method of surgery and treatment outcomes. RESULTS: The average age of patients was 41.8 years with the male predominance of 6:2. All of the lesions in the osteoma were unilateral and solitary (average size 5.0 mm). All of the eight cases were pedunculated: in four cases, the stalks of the osteoma were found on the tympanomastoid suture line and in three cases, it was found on the tympanosquamous suture line. Four patients were asymptomatic, where the lesions were found incidentally during unrelated evaluations. No patients were found with conductive hearing loss in the pure tone audiometry. Transcanal and endaural approach were used in five and three cases, respectively. Most of the cases were removed by curettage only, except for the two who needed additional drilling. The average surgery time was 15.6 minutes. There was no postoperative complication or recurrence. CONCLUSION: The external auditory canal osteoma was mostly unilateral and solitary. The removal of osteoma in the early stage was relatively easy with no recurrence or complication.
Audiometry ; Chungcheongbuk-do ; Curettage ; Ear Canal ; Exostoses ; Hearing Loss, Conductive ; Humans ; Male ; Medical Records ; Methods ; Osteoma ; Postoperative Complications ; Recurrence ; Retrospective Studies ; Sutures ; Tertiary Care Centers

Animal models of osteoarthritis (OA) have played a key role in understanding the etiology of OA and in the development of new therapeutic strategies. Although pigs have an advantage as an animal disease model due to their similarity to humans, there are few studies on the induction of OA in minipigs. Therefore, this study aimed to characterize disease progression of OA in total medial meniscectomy (TMM)-operated skeletally mature minipigs, up to day 180 postoperatively. There were no significant alterations in vital signs or hematological indices throughout the observation period. However, clinical manifestations of OA in the medial femoral condyles of TMM-operated minipigs were progressive, depending on postoperative duration, with respect to osteophytes formation and roughened surfaces on radiological observation, cartilage erosion under macroscopic examination, and severe cartilage defects including fibrillation, vertical fissures, and cartilage denuding on histopathological observation, with the highest score indicating late-stage OA on day 180 and without indicating apparent variation between subjects. In particular, the lateral femoral condyles were also degenerated, possibly due to localization of weight-bearing from both menisci to the lateral meniscus. Therefore, TMM in minipigs is suitable for reproducible induction of degenerative changes in the femorotibial joints that closely resemble late-stage OA, and is suitable for use in further research.
Cartilage ; Disease Models, Animal ; Disease Progression ; Humans ; Joints ; Menisci, Tibial ; Models, Animal ; Osteoarthritis ; Osteophyte ; Swine ; Swine, Miniature ; Vital Signs ; Weight-Bearing

Age estimation from skeletal remains is an important step in forensic biological identification. The main objective of this study is to develop an age estimation equation for the Thai population from vertebral osteophytes. Each vertebra in the cervical, thoracic and lumbar segments was scored for degree of osteophyte formation. Classification was carried out in accordance with the criteria established by Snodgrass and Watanabe, and used a new modified score of the length of vertebral osteophyte for age estimation. The sample included 400 individuals (262 males, 138 females) ranging in age from 22 to 97 years. A sample of Thai vertebral columns was used, the columns being divided into the following groups of vertebrae: cervical (C2–C7), thoracic (T1–T12), and lumbar (L1–L5). Each vertebra was scored for the degree of osteophyte formation and the accumulated data was analyzed statistically. Correlation coefficients and R-squared from mean in lumbar vertebrae for females of criteria established by the method of Snodgrass and Watanabe, the new modified score by length of vertebral osteophytes were 0.801 and 0.642 (P<0.01); 0.755 and 0.57 (P<0.01); 0.786 and 0.618 (P<0.01), respectively. This study presents all 23 subcategories (C2–L5) of the vertebrae to apply in real situations, showing all age estimation equations for males, females and combined sexes of unknown sex. One application of this study is age estimation when dealing with forensic cases in the Thai population.
Asian Continental Ancestry Group ; Classification ; Female ; Forensic Anthropology ; Forensic Sciences ; Humans ; Lumbar Vertebrae ; Male ; Methods ; Osteophyte ; Research Design ; Spine ; Thailand

Spinal stenosis most commonly occurs on lumbar vertebrae because of degenerative changes. This research studied the characteristics of osteophyte development in lumbar vertebrae foramina and association of osteophyte development with lumbar spinal stenosis. The total number of all levels of lumbar spines of subjects was 179 from 31 to 90 years of age. The vertebral foramen was divided into six zones. The prevalence and measurements of the length of osteophytes in the vertebral foramina were obtained. The prevalence and length of osteophytes in the posterior body zone were higher than the laminal zone, and higher than the pedicular zone, respectively. In each zone, the highest prevalence of osteophytes was at L5, except for the inferior posterior body zone that the highest prevalence is at L4. The length of osteophyte was also in same direction as the prevalence. The prevalence of osteophytes among six zones of each level were compared, and found, in L1 to L4, the inferior posterior body zone generally had the highest prevalence, except in L5, the superior posterior body zone had the highest prevalence. Moreover, prevalence, as well as length, of osteophytes in lumbar vertebral foramina, of all levels, was positively associated with age. Vertebral osteophytes can develop beginning at 31 years of age. In conclusion, posterior body of L4 and L5 had the highest prevalence of osteophyte formation, thus, these area had the highest probability to cause spinal stenosis.
Lumbar Vertebrae ; Osteophyte ; Prevalence ; Spinal Stenosis ; Spine