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Osteology, Volume 3, Issue 1 (March 2023) – 5 articles

Cover Story (view full-size image): Protrusio acetabuli is a condition known to increase the complexity and risk of complications in THA. Although grading systems for native hip protrusio have been described, there is no widely adopted classification system that categorizes the condition into distinct classes to guide management. We propose a novel classification to simplify and standardize the management of protrusio acetabuli in modern THA. This classification describes protrusio based on the relationship of the femoral head to the ilioischial and iliopectineal lines, allowing for reproducible and consistent categorization of pathology. We also discuss recommendations and technical pearls for THA in the protrusio patient population, including soft tissue releases, fluoroscopy, navigation, bone graft, and augments. View this paper
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14 pages, 3137 KiB  
Article
Managing Native Hip Protrusio: Simplified Classification and Surgical Recommendations
by Lidia Ani, Zachary Radford and Lee E. Rubin
Osteology 2023, 3(1), 33-46; https://doi.org/10.3390/osteology3010005 - 13 Mar 2023
Cited by 1 | Viewed by 6961
Abstract
Protrusio acetabuli is a unique osteological condition that has been long described in the literature and is known to potentially increase both the surgical complexity and the risk of complications when performing total hip arthroplasty. Although grading systems for native hip protrusio have [...] Read more.
Protrusio acetabuli is a unique osteological condition that has been long described in the literature and is known to potentially increase both the surgical complexity and the risk of complications when performing total hip arthroplasty. Although grading systems for native hip protrusio have been described in the past, there has not yet been a widely adopted classification system that categorizes the condition into separate classes in order to guide management. We propose a novel classification system with the goal of simplifying and standardizing the management of protrusio acetabuli in the context of modern total hip arthroplasty. This classification system describes protrusio based on the relationship of the femoral head to the ilioischial and iliopectineal lines, allowing for a more reproducible and consistent categorization of pathology. We also discuss general recommendations and technical pearls for total hip arthroplasty in the protrusio patient population, including the use of strategic soft tissue releases, fluoroscopy, navigation, bone graft, and augments. Full article
(This article belongs to the Special Issue New Trends in Arthroplasty)
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11 pages, 2046 KiB  
Review
Disease-Modifying Adjunctive Therapy of Osteopenia and Osteoporosis with a Multimineral Marine Extract, LithoLexal® Bone
by Denise M. O’Gorman, Zahra Naderi, Ali Yeganeh, Ramin Malboosbaf and Erik Fink Eriksen
Osteology 2023, 3(1), 22-32; https://doi.org/10.3390/osteology3010004 - 20 Feb 2023
Cited by 1 | Viewed by 2191
Abstract
There is evidence to suggest that restoration of major/rare biominerals by supplementation can produce osteogenic and anti-resorptive effects in humans. LithoLexal® is a natural extract harvested from a marine alga, Lithothamnion sp., with a porous microstructure and multimolecular composition rich in calcium [...] Read more.
There is evidence to suggest that restoration of major/rare biominerals by supplementation can produce osteogenic and anti-resorptive effects in humans. LithoLexal® is a natural extract harvested from a marine alga, Lithothamnion sp., with a porous microstructure and multimolecular composition rich in calcium (32% w/w) and magnesium (2.2% w/w) together with ~72 trace bioelements. In vitro, LithoLexal® demonstrated cellular-level osteogenic efficacy through enhancing the maturation and activity of pre-osteoblasts. This extract also expressed the ability to suppress osteoclastogenesis by downregulating the pro-resorptive cytokines TNF-α and IL-1β and the master regulator of inflammation NF-κB. Parathyroid hormone inhibition of parathyroid hormone secretion is another bioactivity of LithoLexal® Bone reported with both short- and long-term administration at a longer duration and higher magnitude than what calcium carbonate could induce. Due to these bioactivities that affect pathogenetic factors of osteoporosis, LithoLexal® Bone is referred to as a disease-modifying adjunctive therapy (DMAT). In postmenopausal animal models, LithoLexal® monotherapy preserved bone mineral density, microarchitecture, and biomechanical properties, while calcium carbonate failed to produce significant outcomes. The pro-resorptive effect of a high-fat diet was also efficiently counteracted in vivo by supplementary LithoLexal®. A large clinical trial on postmenopausal women verified the mitigating effects of LithoLexal® Bone on bone resorption and turnover rate. The characteristic composition of LithoLexal® together with its lattice microstructure are suggested to underlie its in vivo bioactivities. In conclusion, adjunctive therapy with LithoLexal® Bone is an attractive option for clinical prevention and treatment of osteopenia/osteoporosis. Full article
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1 pages, 148 KiB  
Editorial
Acknowledgment to the Reviewers of Osteology in 2022
by Osteology Editorial Office
Osteology 2023, 3(1), 21; https://doi.org/10.3390/osteology3010003 - 19 Jan 2023
Viewed by 866
Abstract
High-quality academic publishing is built on rigorous peer review [...] Full article
10 pages, 706 KiB  
Article
Vitamin D Deficiency in Orthopedic Patients in Different Latitudes—First Study Comparing German and Greek Populations
by Andreas Mamilos, Charalambos Matzaroglou, Gerrit S. Maier, Samer Zawy Alsofy, Philipp Drees and Konstantinos Kafchitsas
Osteology 2023, 3(1), 11-20; https://doi.org/10.3390/osteology3010002 - 6 Jan 2023
Cited by 1 | Viewed by 2467
Abstract
Vitamin D plays a pivotal role in calcium metabolism and bone mineralization. Sufficient vitamin D levels are important for the health and functionality of the musculoskeletal system. Hypovitaminosis D is a phenomenon affecting orthopedic patients worldwide. This study researched whether most orthopedic patients [...] Read more.
Vitamin D plays a pivotal role in calcium metabolism and bone mineralization. Sufficient vitamin D levels are important for the health and functionality of the musculoskeletal system. Hypovitaminosis D is a phenomenon affecting orthopedic patients worldwide. This study researched whether most orthopedic patients in two different cities of different countries had hypovitaminosis D, whether there was a correlation between sunshine hours and vitamin D serum levels, and whether hours of sunshine alone were enough to achieve vitamin D sufficiency among orthopedic patients regardless of their activities. The vitamin D serum levels of 500 orthopedic patients in Regensburg and 500 in Patras were assessed, in addition to their medical histories. The mean sunshine hours throughout the year were also calculated. Both the German and Greek groups showed hypovitaminosis D. Older patients were more affected. Although there were more hours of sunshine in Greece, Greek orthopedic patients also showed hypovitaminosis D. Hypovitaminosis D affects orthopedic patients independent of their latitude. Supplementation of vitamin D may be considered among orthopedic patients to achieve sufficient levels in serum. Sufficient vitamin D levels may be helpful for the treatment of orthopedic patients, reduce the negative effects of operations or postoperational settings. Full article
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10 pages, 1904 KiB  
Article
Roles of Two F-Box Proteins: FBXL14 in the Periosteum and FBXW2 at Elastic Fibers
by Mari Akiyama
Osteology 2023, 3(1), 1-10; https://doi.org/10.3390/osteology3010001 - 5 Jan 2023
Viewed by 1413
Abstract
I previously reported that F-box/leucine-rich repeat protein 14 (FBXL14) expressed in periosteum-derived cells, and F-box and WD-40 domain-containing protein 2 (FBXW2) in the periosteum form a fiber-like structure. Here, two culture medium conditions, that is, media with and without ascorbic acid, were compared [...] Read more.
I previously reported that F-box/leucine-rich repeat protein 14 (FBXL14) expressed in periosteum-derived cells, and F-box and WD-40 domain-containing protein 2 (FBXW2) in the periosteum form a fiber-like structure. Here, two culture medium conditions, that is, media with and without ascorbic acid, were compared during explant culture. In the absence of ascorbic acid, the expression patterns of osteocalcin, FBXW2, and elastin were compared using fluorescent immunostaining during weeks 3–5. By observing the periosteum, cambium layer and bone, I demonstrated FBXL14 expression in micro-vessels and bone lacuna. Fluorescent immunostaining revealed that, without ascorbic acid, the FBXL14 layer was thin. Conversely, in the presence of ascorbic acid, FBXL14 formed a thick membrane-like structure inside the periosteum, and the multilayer of periosteum-derived cells (PDCs) was strong. The expression patterns of osteocalcin and FBXW2 were similar. Elastin retained its fiber structure for up to five weeks. Although osteocalcin and FBXW2 were expressed in regions similar to elastin, they could not retain their fiber structures. In conclusion, FBXL14 appears to play a role in preparing a native scaffold for forming a multilayered sheet of PDCs inside the periosteum. FBXW2 and osteocalcin appear to separate from elastic fibers during calcification. Full article
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