Journal Description

Osteology

Osteology is an international, peer-reviewed open access journal devoted to the basic and clinical research of bone science, published quarterly online by MDPI.

Open Access—free to download, share, and reuse content. Authors receive recognition for their contribution when the paper is reused.
Rapid Publication: First decisions in 15 days; acceptance to publication in 3 days (median values for MDPI journals in the second half of 2020).
Recognition of Reviewers: APC discount vouchers, optional signed peer review, and reviewer names published annually in the journal.
Osteology is a companion journal of Applied Sciences.

Imprint Information Journal Flyer Open Access ISSN: 2673-4036

Latest Articles

Open AccessArticle

Influence of Gender on Occurrence of Aseptic Loosening and Recurrent PJI after Revision Total Knee Arthroplasty

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Osteology 2021, 1(2), 92-104; https://doi.org/10.3390/osteology1020010 - 17 May 2021

Abstract

Background: Periprosthetic joint infection (PJI) is a common yet severe complication after total knee arthroplasty (TKA). Surgical intervention and antibiotic therapy are obligatory to achieve successful, infection-free outcome. Compared to the outcomes after primary TKA, prosthesis failure rates are drastically increased after PJI-dependent revision surgery. Recurrent PJI and aseptic loosening are the most common reasons for prosthesis failure after revision TKA. An open question is the influence of the patients’ gender on long-term prosthesis survival after revision surgery. Additionally, it is unknown whether gender-related parameters and risk factors or differences in treatment are responsible for potential differences in outcome after revision arthroplasty. Patients and Methods: In this report, 109 patients that received TKA revision surgery due to PJI were retrospectively analyzed. We used clinical, paraclinical and radiological examinations to study the influence of gender on the long-term complications aseptic loosening and recurrent PJI after PJI-dependent revision arthroplasty. Results: While overall prosthesis failure rates and risk of recurrent PJI did not differ between genders, the long-term risk of aseptic loosening was significantly elevated in female patients. Postoperative coronal alignment was significantly more varus for women later diagnosed with aseptic loosening. Besides coronal alignment, no gender-dependent differences in clinical presentation or treatment were observed. Conclusions: Female patients displayed a significantly increased risk for aseptic loosening after PJI-dependent revision TKA. The observed gender-dependent differences in long-term outcome in our study support theories surrounding the role of bone metabolism in the development of aseptic loosening. Our data suggest that further research on a female design for PJI-dependent revision prostheses is warranted. Full article

(This article belongs to the Special Issue Bone Biomechanics: Diseases, Treatment and Rehabilitation)

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Open AccessFeature PaperArticle

Normative Values for Femoral Length, Tibial Length, and the Femorotibial Ratio in Adults Using Standing Full-Length Radiography

Stuart A Aitken

Osteology 2021, 1(2), 86-91; https://doi.org/10.3390/osteology1020009 - 13 May 2021

Abstract

Knowledge of the normal length and skeletal proportions of the lower limb is required as part of the evaluation of limb length discrepancy. When measuring limb length, modern standing full-length digital radiographs confer a level of clinical accuracy interchangeable with that of CT imaging. This study reports a set of normative values for lower limb length using the standing full-length radiographs of 753 patients (61% male). Lower limb length, femoral length, tibial length, and the femorotibial ratio were measured in 1077 limbs. The reliability of the measurement method was tested using the intra-class correlation (ICC) of agreement between three observers. The mean length of 1077 lower limbs was 89.0 cm (range 70.2 to 103.9 cm). Mean femoral length was 50.0 cm (39.3 to 58.4 cm) and tibial length was 39.0 cm (30.8 to 46.5 cm). The median side-to-side difference was 0.4 cm (0.2 to 0.7, max 1.8 cm) between 324 paired limbs. The mean ratio of femoral length to tibial length for the study population was 1.28:1 (range 1.16 to 1.39). A moderately strong inverse linear relationship (r = −0.35, p < 0.001, Pearson’s) was identified between tibial length and the corresponding femorotibial ratio. The PACS-based length measurement method used in this study displayed excellent inter-observer reliability (ICC of 0.99). This study presents a normal range of values for lower limb length in adults and is the first to identify a linear relationship between tibial length and the femorotibial ratio. Full article

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Open AccessBrief Report

Bone and Joint Infections in Children and Adolescents in Luanda, Angola

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Osteology 2021, 1(2), 80-85; https://doi.org/10.3390/osteology1020008 - 19 Apr 2021

Abstract

We reviewed the characteristics of children hospitalized for bone and joint infections in Luanda, Angola. In a retrospective chart review of 45 patients with childhood osteomyelitis or septic arthritis, 51% of the patients had sickle cell disease, and these patients presented with lower hemoglobin and needed blood transfusion more frequently (p < 0.05). Out of all patients, 64% underwent surgical procedures; a pathological fracture occurred in 31% of the patients. Full article

(This article belongs to the Special Issue Bone Biomechanics: Diseases, Treatment and Rehabilitation)

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Open AccessConcept Paper

The Products of Bone Resorption and Their Roles in Metabolism: Lessons from the Study of Burns

Gordon L. Klein

Osteology 2021, 1(2), 73-79; https://doi.org/10.3390/osteology1020007 - 01 Apr 2021

Abstract

Surprisingly little is known about the factors released from bone during resorption and the metabolic roles they play. This paper describes what we have learned about factors released from bone, mainly through the study of burn injuries, and what roles they play in post-burn metabolism. From these studies, we know that calcium, phosphorus, and magnesium, along with transforming growth factor (TGF)-β, are released from bone following resorption. Additionally, studies in mice from Karsenty’s laboratory have indicated that undercarboxylated osteocalcin is also released from bone during resorption. Questions arising from these observations are discussed as well as a variety of potential conditions in which release of these factors could play a significant role in the pathophysiology of the conditions. Therapeutic implications of understanding the metabolic roles of these and as yet other unidentified factors are also raised. While much remains unknown, that which has been observed provides a glimpse of the potential importance of this area of study. Full article

(This article belongs to the Special Issue Feature Papers in Osteology)

Open AccessArticle

Comparative Evaluation of Primary Stability between Different Diameters Multi-Scale Roughness Dental Implant by Solid Rigid Polyurethane Simulation

Margherita Tumedei

Morena Petrini

Alessandro Cipollina

Mariastella Di Carmine

Adriano Piattelli

Antonio Cucurullo

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Giovanna Iezzi

Osteology 2021, 1(1), 62-72; https://doi.org/10.3390/osteology1010006 - 12 Mar 2021

Cited by 1

Abstract

Background: Implant primary stability is determined by screw characteristics and surgical procedure. The aim of the present study was to evaluate, on a polyurethane model, the insertion torque (IT), removal torque (RT), and resonance frequency analysis (RFA) of multi-scale roughness dental implants of different diameters. Methods: Two implant sizes were tested on two polyurethane blocks (20 pounds per cubic foot (PCF) and 30 PCF): 3.0 diameter and 13 mm length and 5.0 diameter and 13 mm length. The IT, RT, and RFA were assessed. Results: A significant difference of IT and RT was present in favor of wider implants at both polyurethane densities. No statistical difference was present between the 5.0 diameter and 3.0 diameter implants at both polyurethane densities. A statistically increased RFA was reported for 5.0 implant 30 PCF polyurethane blocks. Conclusions: Multi-scale roughness dental implants of both diameters showed high insertion torque and primary stability on polyurethane blocks, which is valuable for implant loading protocols. Full article

(This article belongs to the Special Issue Feature Papers in Osteology)

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Open AccessSystematic Review

Isolated Medial Subtalar Joint Dislocation during Sports Activities: A Systematic Review of the Literature with Individual Participant Data Analysis

Carlo Biz

Giovanni Baldin

Claudia Cappelletto

Nicola Luigi Bragazzi

Pietro Nicoletti

Alberto Crimì

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Pietro Ruggieri

Osteology 2021, 1(1), 48-61; https://doi.org/10.3390/osteology1010005 - 05 Mar 2021

Abstract

In athletes, one of the most common injuries is a sprained ankle. If the energy of the trauma is particularly high, this type of injury can lead to an isolated medial dislocation of the subtalar joint (STJ), a rare condition poorly described in the literature. The aim of this study was to verify if a reliable conservative treatment and a specific physiotherapy rehabilitation protocol in isolated medial dislocation of the STJ in athletes is described in the literature. A systematic review of the published literature of the last 11 years was performed by applying the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using three databases: Pubmed, Scopus, and Web of Science. The keywords used were “(subtalar OR talocalcaneal) AND dislocation”. We considered only studies that included professional or amateur athletes (athletic patients). We used the American Orthopedic Foot and Ankle Society (AOFAS) scale, range of motion (ROM) of the subtalar and ankle joint, subtalar and talonavicular joint osteoarthritis, and patient feedback to evaluate their outcomes. A total of 12 studies were included in our review, with a total of 26 athletic patients. Sixteen of them had good results with the correlation between the duration of immobilisation and the outcomes. Nevertheless, due to the small number of patients included in the analysed studies on this subject in the literature, there is not yet a univocal clinical protocol to treat the isolated medial subtalar joint dislocation (STJD) warranting further research in the field. Full article

(This article belongs to the Special Issue Feature Papers in Osteology)

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Open AccessArticle

Complex Regional Pain Syndrome: Current Practice Management and Referral Trends in a Closed Healthcare System

Connor Zale

Joshua Hansen

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Paul Ryan

Osteology 2021, 1(1), 39-47; https://doi.org/10.3390/osteology1010004 - 31 Dec 2020

Abstract

Background: Complex regional pain syndrome (CRPS) is a neurologic condition that can present with severe pain and dysfunction. Delay in treatment adversely affects outcomes. The purpose of this study is to evaluate patient outcomes as they relate to the time from diagnosis to pain management referral once the diagnosis of CRPS has been made in a closed healthcare system. Methods: A retrospective record review from a closed healthcare system was utilized for CRPS cases from 2010–2019. Demographics, injury pattern, surgeries, pain score, treatment modalities, occupational outcomes, and time to pain management referral were recorded. Results: There were 26 cases of CRPS that met inclusion criteria. The mean time from diagnosis to treatment was 55 days. 16/26 (61.5%) were medically discharged from the military. 23/26 (88.5%) were unable to return to full duty due to CRPS. There was no significant difference in the reported pain scores over time regardless of treatment (p = 0.76). A linear regression demonstrated a significantly higher Visual Analog Scale Pain Score (VAS) over time in patients that were medically discharged (p = 0.022). Conclusions: The mean delay in referral to the pain service was 55 days. The majority of patients (88.5%) did not return to full duty secondary to the diagnosis of CRPS, and 61.5% of patients required medical separation from active duty. Due to the negative impact that the diagnosis of CRPS has on occupational outcomes with a mean delay in referral of 55 days, clinics and providers should set up referral criteria and establish early pain pathways for patients diagnosed with CRPS. Full article

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Open AccessArticle

Delayed Rehabilitation Protocol after Rotator Cuff Repair

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Osteology 2021, 1(1), 29-38; https://doi.org/10.3390/osteology1010003 - 26 Dec 2020

Cited by 1

Abstract

Rotator cuff tears are a frequent cause of shoulder pain that often require arthroscopic repair. After surgery an intense and well-studied rehabilitation protocol is needed to obtain the complete recovery of shoulder function. Fifty patients, who sustained arthroscopic rotator cuff repair for symptomatic, atraumatic and full-thickness supraspinatus tendon tear, were involved. According to our rehabilitation protocol, during the first four postoperative weeks, the arm was supported with an abduction sling pillow, and pendulum exercises, table slide and active elbow extension and flexion were conceded. Outcome measures (Oxford shoulder score (OSS), simple shoulder test (SST), patient-reported satisfaction), shoulder function (range of motion (ROM) and muscle strength), and MRI examination were evaluated. The mean OSS score and SST score increased from 16 to 30.2 and from 5.3 to 11.4, respectively. Patient-reported satisfaction was 96%. At 12 months, patients improved ROM and muscle strength. Postoperative passive anterior elevation was 176; external rotation averaged 47; internal rotation was 90. Postoperative muscle strength during anterior elevation was 8.3 ± 2.2 kg, internal rotation 6.8 ± 3 kg, external rotation 5.5 ± 2.3 kg. Five out of seven patients with recurrent tears evaluated their results as satisfactory. They reported improvements in terms of OSS and SST mean scores despite recurrent tears; therefore, they did not undergo revision surgery. The delayed postoperative physical therapy protocol was associated with improvements in the outcome measures and shoulder function compared to the preoperatory state and rotator cuff healing demonstrated by MRI. Full article

(This article belongs to the Special Issue Feature Papers in Osteology)

Open AccessReview

The Role of Cathepsins in the Growth of Primary and Secondary Neoplasia in the Bone

Henrietta O. Fasanya

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Dietmar W. Siemann

Osteology 2021, 1(1), 3-28; https://doi.org/10.3390/osteology1010002 - 09 Oct 2020

Cited by 1

Abstract

The upregulation of proteolytic enzymes has been demonstrated to promote primary tumor development and metastatic bone cancer. The secreted proteases increase tumor growth and angiogenesis, and potentiate neoplastic cell dissemination. This article reviews the role and mechanisms of cathepsins in normal physiology, cancer, bone remodeling, and the tumor–bone interface, with a specific focus on cathepsins B, D, H, G, L, and K. In this review, we highlight the role of cathepsins in primary bone cancer (i.e., osteosarcoma (OS)), as well as metastatic breast (BCa) and prostate (PCa) cancer. In addition, we discuss the clinical utility and therapeutic potential of cathepsin-targeted treatments in primary and secondary bone cancers. Full article

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