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Biomedicines
Special Issues
Musculoskeletal Injuries: Clinical, Radiological, and Biochemical Evaluation in Orthopedics
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Musculoskeletal Injuries: Clinical, Radiological, and Biochemical Evaluation in Orthopedics

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Molecular and Translational Medicine".

Deadline for manuscript submissions: 31 July 2025 | Viewed by 5246

Special Issue Editors

Prof. Dr. Carlo Biz

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Guest Editor
Orthopedics and Orthopedic Oncology, Department of Surgery, Oncology and Gastroenterology (DiSCOG), University of Padova, 35128 Padova, Italy
Interests: foot and ankle surgery; arthroscopic surgery; diabetic foot; anatomy of the foot and ankles; trauma surgery; fracture; muscle precursor cells of human skeletal muscle
Special Issues, Collections and Topics in MDPI journals
Dr. Elisa Belluzzi

E-Mail Website
Guest Editor
1. Musculoskeletal Pathology and Oncology Laboratory, Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padova, 35129 Padova, Italy
2. Orthopedics and Orthopedic Oncology, Department of Surgery, Oncology and Gastroenterology (DiSCOG), University of Padova, 35129 Padova, Italy
Interests: inflammation; molecular biology; cell biology; osteoarthritis; cartilage; musculoskeletal diseases; bone cancer; synovium; infrapatellar fat pad; chodrosarcoma
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Pietro Ruggieri

E-Mail Website
Guest Editor
Orthopedics and Orthopedic Oncology, Department of Surgery, Oncology and Gastroenterology DiSCOG, University of Padua, Padova, Italy
Interests: bone tumors
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue is focused on clinical, radiological, and biochemical evaluation in the orthopedic field, the protagonist of important changes in recent years. From robotics-assisted surgeries to 3D-printed implants, smart and wearable technology, regenerative medicine, and tissue engineering, various cutting-edge devices are revolutionizing orthopedic surgery.

Considering these new directions and the importance of improving of minimally invasive, percutaneous, and nano-surgical procedures, it is vital that we evaluate clinical and radiological outcomes in treated patients. Additionally, studies focused on biochemical evaluation are welcome, as different biomarkers could be useful in diagnosing and managing an orthopedic pathology or could serve as disease predictors and prognostic factors. From this perspective, we intend for this Special Issue to collect original articles and reviews around these topics.

Dr. Carlo Biz
Dr. Elisa Belluzzi
Prof. Dr. Pietro Ruggieri
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Biomedicines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • orthopedic surgery
  • sports injuries
  • bone cancer
  • diabetic foot
  • clinical evaluation
  • radiological evaluation
  • biomarkers
  • prognostic markers

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Published Papers (5 papers)

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14 pages, 3602 KiB  
Article
Quantitative Spatial Analysis on Radiographic Features of Rotator Cuff Calcifications: An Exploratory Study
by Ju-Hyeon Kim, Dahae Yang and Jae-Hyun Lee
Biomedicines 2025, 13(3), 551; https://doi.org/10.3390/biomedicines13030551 - 21 Feb 2025
Viewed by 401
Abstract
Background/Objectives: Plain radiography is the primary diagnostic tool for calcific tendinitis of the shoulder. Several qualitative grading methods have been proposed to represent the pathophysiologic phase and guide treatment decisions. However, these methods have demonstrated low reliability, complicating their effectiveness for such [...] Read more.
Background/Objectives: Plain radiography is the primary diagnostic tool for calcific tendinitis of the shoulder. Several qualitative grading methods have been proposed to represent the pathophysiologic phase and guide treatment decisions. However, these methods have demonstrated low reliability, complicating their effectiveness for such purposes. This study aims to perform the first quantitative analysis of calcific lesions using radiographic imaging and explore their correlation with ultrasonographic parameters to enhance their diagnostic utility. Methods: A total of 57 shoulders presenting with painful calcific tendinitis in either the supraspinatus or subscapularis tendon were reviewed. The calcific deposits and tendon regions of interest were meticulously identified and annotated. Image brightness was reduced to 256 grayscale levels, and descriptive and heterogeneity parameters, including skewness, kurtosis, complexity, and entropy, were quantified and analyzed. Results: In the region of calcification, the average grayscale values were 21.69 units higher than those of tendon tissue. All spatial heterogeneity parameters, except for skewness, demonstrated statistically significant differences when compared with the adjacent tendon. Notably, entropy and complexity were the most distinctive features, with an area under the curve of 0.93 and cut-off values of 4.62 and 4.18, respectively. Significant correlations were observed between the heterogeneity parameters and ultrasonographic findings, such as bursal contact and peri-calcific hypoattenuation. Conclusions: Calcific deposits demonstrated not only increased brightness in grayscale levels but also distinct spatial heterogeneity. The correlation with ultrasonographic findings indicates that these heterogeneity parameters may reflect underlying pathophysiological characteristics. Future prospective research could explore the whole temporal changes of calcifications more thoroughly. Full article
(This article belongs to the Special Issue Musculoskeletal Injuries: Clinical, Radiological, and Biochemical Evaluation in Orthopedics)
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14 pages, 2857 KiB  
Article
Pain Reduction in Patellofemoral Knee Patients During 3-Month Intervention with Biomechanical and Sensorimotor Foot Orthoses: A Randomized Controlled Clinical Study
by Steven Simon, Andreas Heine, Jonas Dully, Carlo Dindorf, Oliver Ludwig, Michael Fröhlich and Stephan Becker
Biomedicines 2025, 13(1), 38; https://doi.org/10.3390/biomedicines13010038 - 27 Dec 2024
Viewed by 1008
Abstract
Background: Patellofemoral pain (PFP) significantly affects patients’ daily activities and consequently reduces their quality of life. Custom-made foot orthoses (FOs) are a common method of medical treatment that positively influences biomechanical factors such as the kinematics of the lower extremity and reduces pain [...] Read more.
Background: Patellofemoral pain (PFP) significantly affects patients’ daily activities and consequently reduces their quality of life. Custom-made foot orthoses (FOs) are a common method of medical treatment that positively influences biomechanical factors such as the kinematics of the lower extremity and reduces pain perception in patients. However, there is a gap in research regarding the influence of different FO treatments on knee pain. Therefore, this study addresses the impact of biomechanical foot orthoses (BMFOs) and sensorimotor foot orthoses (SMFOs) on patients with foot deformity and PFP. Methods: A total of 26 participants (9 men, 17 women; 27.7 ± 10.7 years; 175.0 ± 0.1 cm; 75.7 ± 18.8 kg; BMI: 24.7 ± 5.6) took part in this randomized controlled clinical trial. In the pre-test, knee pain was evaluated using the Kujala Anterior Knee Pain Scale after the physician’s anamnesis and plantar pressure measurement. A 3-month intervention with SMFO and BMFO was performed, and weekly development was evaluated using 11-item visual analog scales (VASs). Repeated measures analyses of variance were used to assess differences between time of measurements (ToMs) and the interaction effect between ToMs and treatment groups (SMFO, BMFO). Results: Statistical analysis revealed no statistically significant interaction between ToMs and treatment groups but a significant main effect on Kujala anterior knee pain scores (MDiff = 10.189; p = 0.014) and 12-week VAS (p = 0.001). Conclusions: The findings indicate that both treatment approaches effectively alleviated perceived knee pain in the PFP sample with foot deformity, with neither approach demonstrating superior efficacy. This trial was registered in the WHO International Clinical Trials Registry Platform (ICTRP) and German Clinical Trials Register (DRKS00035082). Full article
(This article belongs to the Special Issue Musculoskeletal Injuries: Clinical, Radiological, and Biochemical Evaluation in Orthopedics)
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11 pages, 2381 KiB  
Article
Bone Marrow Stem Cell Population in Single- and Multiple-Level Aspiration
by Xiangguo Che, Hee-June Kim, Xian Jin, Joon-Woo Kim, Kyeong-Hyeon Park, Jeong-Ok Lim, Hee-Soo Kyung, Chang-Wug Oh and Je-Yong Choi
Biomedicines 2024, 12(12), 2731; https://doi.org/10.3390/biomedicines12122731 - 28 Nov 2024
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Abstract
Background: Bone marrow aspiration concentrate (BMAC) has garnered increasing interest due to its potential for healing musculoskeletal injuries. While the iliac crest remains a common harvest site, the aspiration technique’s efficacy in offering the highest yield and prevalence of mesenchymal stem cells (MSCs) [...] Read more.
Background: Bone marrow aspiration concentrate (BMAC) has garnered increasing interest due to its potential for healing musculoskeletal injuries. While the iliac crest remains a common harvest site, the aspiration technique’s efficacy in offering the highest yield and prevalence of mesenchymal stem cells (MSCs) is controversial. This study aimed to compare two different techniques of bone marrow aspiration over the anterior iliac crest from a single level versus multiple levels. Methods: Anterior iliac crests were selected in seven adult patients (aged between 31 and 59 years old). Aspiration was achieved using an 11-gauge needle (length: 100 mm; diameter: 2.3 mm) specifically manufactured for bone marrow collection (BD, Becton, Franklin Lakes, NJ, USA) connected to a 10 mL syringe. On one side, 4cc of bone marrow was aspirated at a single level to a depth of 7 cm without changing the needle direction. On the other side, over the same portion of the iliac crest, 1 cc of bone marrow was obtained from multiple levels of different depths during needle retrieval, maintaining a distance of 1 cm and changing the tip direction. The samples were blindly sent to the laboratory without indicating whether they came from an single level or multiple levels. Fluorescence-activated cell sorting (FACS) and osteoblast differentiation were analyzed and compared. Results: In the FACS analysis, the single level resulted in a higher population of MSCs that were positive for CD105, CD73, and CD90 and negative for CD34, compared to the multiple-level method. In the process of osteoblast differentiation, it was observed that MSCs exhibited more advanced features of enhanced osteoblastic abilities in the single-level method rather than the multiple-level method. Conclusions: A single-level aspiration technique at the anterior iliac crest may produce a high-quality bone marrow aspirate. This technique may help obtain specific populations of MSCs with the desired characteristics for use in regenerative therapies for musculoskeletal injuries. Full article
(This article belongs to the Special Issue Musculoskeletal Injuries: Clinical, Radiological, and Biochemical Evaluation in Orthopedics)
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10 pages, 4362 KiB  
Article
The HuRaA Trial—The Radiocapitellar Line Shows Significant Posterior Translation in Healthy Elbows: A Prospective Analysis of 53 Healthy Individuals
by Christian T. Schamberger, Tobias Grossner, Christoph Rehnitz, Sebastian Findeisen, Thomas Ferbert, Arnold J. Suda, Gerhard Schmidmaier and Stephan Stein
Biomedicines 2024, 12(12), 2660; https://doi.org/10.3390/biomedicines12122660 - 21 Nov 2024
Viewed by 910
Abstract
Background: The elbow joint is stabilized by complex interactions between bony structures and soft tissues, notably the lateral and medial collateral ligaments. Posterolateral rotatory instability (PLRI), a form of elbow instability, is challenging to diagnose due to overlapping symptoms with other conditions. [...] Read more.
Background: The elbow joint is stabilized by complex interactions between bony structures and soft tissues, notably the lateral and medial collateral ligaments. Posterolateral rotatory instability (PLRI), a form of elbow instability, is challenging to diagnose due to overlapping symptoms with other conditions. The radiocapitellar line (RCL) is a radiographic tool for assessing humeroradial alignment and elbow stability, but its diagnostic accuracy remains debated. This study aims to provide normative data on RCL deviations in healthy individuals to improve diagnostic criteria for PLRI. Methods: A prospective study was conducted with 53 healthy individuals (27 males, 26 females) aged 18–45 years. MRI scans of the participants’ elbows were performed in maximum extension and supination to assess radiocapitellar deviations (RCDs). Two orthopedic surgeons independently analyzed the images to evaluate RCDs and assess interobserver reliability. Statistical analyses, including independent t-tests and Pearson correlations, were used to explore the relationship between RCDs, demographic factors, and elbow stability. Results: The average RCD in the cohort was 1.77 mm (SD 1.06 mm). Notably, 62.9% of participants had deviations greater than 1.2 mm, while 12.9% exceeded 3.4 mm, thresholds traditionally used to diagnose PLRI. Gender and age did not significantly influence RCD values. The interobserver reliability was almost good (ICC = 0.87), supporting the consistency of the RCL measurements. Conclusions: Significant RCDs occur even in asymptomatic individuals, challenging the current diagnostic thresholds for PLRI based solely on RCL measurements. A comprehensive assessment that includes clinical, anatomical, and functional evaluations is essential for accurate diagnosis. These findings highlight the need for refined diagnostic criteria and further research into elbow stability. Full article
(This article belongs to the Special Issue Musculoskeletal Injuries: Clinical, Radiological, and Biochemical Evaluation in Orthopedics)
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16 pages, 9545 KiB  
Case Report
Post-Traumatic Left Subclavian Artery Pseudoaneurysm Secondary to Clavicular Fracture: A Case Report and Literature Review
by Małgorzata Edyta Wojtyś, Patryk Skórka, Dawid Kordykiewicz, Aleksander Falkowski, Joanna Jakubowska-Grzeszyk, Janusz Wójcik and Edward Michael Wojtys
Biomedicines 2025, 13(1), 187; https://doi.org/10.3390/biomedicines13010187 - 14 Jan 2025
Viewed by 808
Abstract
Subclavian artery pseudoaneurysms are rare but potentially life-threatening vascular injuries frequently associated with trauma such as clavicle fractures. In this paper we describe the case of a 49-year-old male who developed a post-traumatic pseudoaneurysm of the subclavian artery after a bicycle accident. The [...] Read more.
Subclavian artery pseudoaneurysms are rare but potentially life-threatening vascular injuries frequently associated with trauma such as clavicle fractures. In this paper we describe the case of a 49-year-old male who developed a post-traumatic pseudoaneurysm of the subclavian artery after a bicycle accident. The diagnosis was delayed due to non-specific symptoms and an initially missed aneurysm on computed tomography imaging. Persistent pain, swelling, and erythema in the subclavian region prompted further detailed diagnostics, which ultimately revealed the pseudoaneurysm. The patient was successfully treated with endovascular stent–graft implantation. We screened the PubMed database to identify similar cases managed exclusively through endovascular intervention. Reports of iatrogenic pseudoaneurysms and those treated with open surgery were excluded. Variables such as time to diagnosis, clinical presentation, features of pseudoaneurysms, and complications were analyzed to highlight the role of endovascular techniques as a minimally invasive and effective treatment option. These cases pose both a diagnostic and a therapeutic challenge, as early recognition of symptoms is crucial to prevent serious complications including thrombosis, neurological deficits, and even limb loss. Full article
(This article belongs to the Special Issue Musculoskeletal Injuries: Clinical, Radiological, and Biochemical Evaluation in Orthopedics)
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