Pathophysiology behind Orthopaedics Disorders: From Mechanisms to Novel Therapeutic and Surgical Approaches

A special issue of Pathophysiology (ISSN 1873-149X).

Deadline for manuscript submissions: 1 July 2024 | Viewed by 9428

Special Issue Editors


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Guest Editor
LSU Health Sciences Center-Shreveport, Shreveport, LA, USA
Interests: biomechanics; hip; hand; spine; bone; gait; imaging
Special Issues, Collections and Topics in MDPI journals

E-Mail Website
Guest Editor
LSU Health Sciences Center-Shreveport, Shreveport, LA, USA
Interests: meniscus; knee; shoulder; elbow; foot; ankle

Special Issue Information

Dear Colleagues,

We are delighted to invite you to contribute to a Special Issue of Pathophysiology to improve our understanding of the etiology and development of orthopedic degenerative diseases and related therapeutic and surgical approaches. With the aging of the population and increased physical demands of older patients, the incidence of orthopedic-related disorders has increased. These musculoskeletal injuries and degenerative diseases have led to a large burden in terms of opioid usage and the monetary costs sustained by societies worldwide. Advancements in diagnostic tools and in conservative and surgical treatments allow prompt interventions that mitigate the negative impact of these diseases, improving the quality of life of patients. Therefore, this Special Issue is dedicated to presenting studies that target the understanding of the physiological processes underlying musculoskeletal diseases, the techniques of diagnosis, and intervention with novel treatments or surgeries. We welcome original studies that provide support for the discussion and debate of established concepts and also for research that shed new light on concepts in the field of orthopedic surgery and rehabilitation. We look forward to your contributions.

Dr. Giovanni F. Solitro
Dr. Patrick A. Massey
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. Pathophysiology is an international peer-reviewed open access quarterly 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 1400 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

  • hip
  • hand
  • knee
  • shoulder
  • spine
  • elbow
  • foot
  • bone
  • ankle
  • cartilage
  • biomechanics
  • imaging

Published Papers (4 papers)

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Research

13 pages, 278 KiB  
Article
Hormone Replacement Therapy Does Not Eliminate Risk Factors for Joint Complications following Total Joint Arthroplasty: A Matched Cohort Study
by Lacee K. Collins, Matthew W. Cole, Timothy L. Waters, Michael Iloanya, Patrick A. Massey and William F. Sherman
Pathophysiology 2023, 30(2), 123-135; https://doi.org/10.3390/pathophysiology30020011 - 4 Apr 2023
Cited by 1 | Viewed by 1742
Abstract
Aging causes a reduction in testosterone and estrogen, which is linked to diminished bone mineral density. Hormone replacement therapy and its effect on the outcome of joint arthroplasties is unclear. The purpose of this study was to analyze the impact of testosterone replacement [...] Read more.
Aging causes a reduction in testosterone and estrogen, which is linked to diminished bone mineral density. Hormone replacement therapy and its effect on the outcome of joint arthroplasties is unclear. The purpose of this study was to analyze the impact of testosterone replacement therapy (TRT) and estrogen replacement therapy (ERT) on the medical and joint outcomes of total hip (THA) and total knee arthroplasties (TKA). A retrospective cohort study was conducted using the PearlDiver database. Patients who received TRT or ERT perioperatively were matched to controls. Rates of 90-day medical complications and 2-year joint complications were queried. Patients who received TRT had an increased risk of revision, periprosthetic joint infection, and pooled joint complications within 2 years following a THA and increased rates of septic and aseptic revisions, and aseptic loosening after TKA compared to the control cohort. Patients receiving ERT had increased rates of aseptic loosening and pooled joint complications within 2 years following THA and increased rates of all-cause revisions and pooled joint complications after TKA. Patients who received TRT demonstrated significantly higher rates of revision rates and PJI. Patients who received perioperative ERT were significantly more likely to have increased risks of revision rates and joint infections. Full article
9 pages, 1214 KiB  
Article
Acetabular Wall Weakening in Total Hip Arthroplasty: A Pilot Study
by Madeline Gautreaux, Steven Kautz, Zashiana Martin, Edward Morgan, R. Shane Barton, Matthew Dubose, Hayden McBride and Giovanni F. Solitro
Pathophysiology 2023, 30(2), 83-91; https://doi.org/10.3390/pathophysiology30020008 - 23 Mar 2023
Cited by 1 | Viewed by 1664
Abstract
Total hip arthroplasty is a widely performed operation allowing disabled patients to improve their quality of life to a degree greater than any other elective procedure. Planning for a THA requires adequate patient assessment and preoperative characterizations of acetabular bone loss via radiographs [...] Read more.
Total hip arthroplasty is a widely performed operation allowing disabled patients to improve their quality of life to a degree greater than any other elective procedure. Planning for a THA requires adequate patient assessment and preoperative characterizations of acetabular bone loss via radiographs and specific classification schemes. Some surgeons may be inclined to ream at a larger diameter thinking it would lead to a more stable press-fit, but this could be detrimental to the acetabular wall, leading to intraoperative fracture. In the attempt to reduce the incidence of intraoperative fractures, the current study aims to identify how increased reaming diameter degrades and weakens the acetabular rim strength. We hypothesized that there is proportionality between the reaming diameter and the reduction in acetabular strength. To test this hypothesis, this study used bone surrogates, templated from CT scans, and reamed at different diameters. The obtained bone surrogate models were then tested using an Intron 8874 mechanical testing machine (Instron, Norwood, MA) equipped with a custom-made fixture. Analysis of variance (ANOVA) was used to identify differences among reamed diameters while linear regression was used to identify the relationship between reamed diameters and acetabular strength. We found a moderate correlation between increasing reaming diameter that induced thinning of the acetabular wall and radial load damage. For the simplified acetabular model used in this study, it supported our hypothesis and is a promising first attempt in providing quantitative data for acetabular weakening induced by reaming. Full article
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12 pages, 801 KiB  
Article
The Effect of Core Stabilization Training on Improving Gait and Self-Perceived Function in Patients with Knee Osteoarthritis: A Single-Arm Clinical Trial
by Daniel W. Flowers, Wayne Brewer, Katy Mitchell, Jennifer Ellison and Clifton Frilot
Pathophysiology 2022, 29(3), 495-506; https://doi.org/10.3390/pathophysiology29030040 - 1 Sep 2022
Viewed by 2374
Abstract
The treatment of patients with knee osteoarthritis is typically focused on the involved lower extremity. There is a gap in the literature concerning the effectiveness of core stabilization training on the treatment of patients with knee osteoarthritis. This investigation aimed to determine whether [...] Read more.
The treatment of patients with knee osteoarthritis is typically focused on the involved lower extremity. There is a gap in the literature concerning the effectiveness of core stabilization training on the treatment of patients with knee osteoarthritis. This investigation aimed to determine whether core stabilization improved the gait and functional ability of patients with knee osteoarthritis. Eighteen participants with knee osteoarthritis completed the six-week core stabilization intervention. Participants completed the gait motion analysis and the Knee Injury and Osteoarthritis Outcome Score to assess self-perceived function, pre- and post-intervention. Gait speed improved (p = 0.006, d = 0.59), while the external knee adduction moment decreased (p = 0.034, d = −0.90). Moreover, self-reported function improved (p < 0.001, d = 1.26). The gait speed and external knee adduction moment changes met minimal detectable change thresholds, while gait speed also met the minimal clinically important difference. A six-week core stabilization program can thus improve gait speed and reduce the external knee adduction moment, which is tied to disease progression. Increased functional scores post-intervention indicate an important clinical improvement. Core stabilization training is a safe and potentially effective treatment option for this population. Full article
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11 pages, 1907 KiB  
Article
Effects of Platelet-Rich Osteoconductive–Osteoinductive Allograft Compound on Tunnel Widening of ACL Reconstruction: A Randomized Blind Analysis Study
by Ruth Solomon, Jan Pieter Hommen and Francesco Travascio
Pathophysiology 2022, 29(3), 394-404; https://doi.org/10.3390/pathophysiology29030031 - 26 Jul 2022
Cited by 2 | Viewed by 2143
Abstract
The anterior cruciate ligament (ACL) is a commonly injured ligament in the knee. Bone tunnel widening is a known phenomenon after soft-tissue ACL reconstruction and etiology and the clinical relevance has not been fully elucidated. Osteoconductive compounds are biomaterials providing an appropriate scaffold [...] Read more.
The anterior cruciate ligament (ACL) is a commonly injured ligament in the knee. Bone tunnel widening is a known phenomenon after soft-tissue ACL reconstruction and etiology and the clinical relevance has not been fully elucidated. Osteoconductive compounds are biomaterials providing an appropriate scaffold for bone formation such as a demineralized bone matrix. Osteoinductive materials contain growth factors stimulating bone lineage cells and bone growth. A possible application of osteoinductive/osteoconductive (OIC) material is in ACL surgery. We hypothesized that OIC placed in ACL bone tunnels: (1) reduces tunnel widening, (2) improves graft maturation, and (3) reduces tunnel ganglion cyst formation. To test this hypothesis, this study evaluated the osteogenic effects of demineralized bone matrix (DBM) and platelet-rich plasma (PRP) on tunnel widening, graft maturation, and ganglion cyst formation. This was a randomized controlled clinical trial pilot study. A total of 26 patients that elected to have ACL reconstruction surgery were randomized between the OIC and control group. Measurements of tunnel expansion and graft-tunnel incorporation were conducted via the quantitative image analysis of MRI scans performed at six months after surgery for both groups. No patients had adverse post-operative reactions or infections. The use of OIC significantly reduced tunnel widening (p < 0.05) and improved graft maturation (p < 0.05). Patients treated with OIC had a significantly lower prevalence of ganglion cyst compared to the control group (p < 0.05). The use of OIC has measurable effects on the reduction of tunnel widening, improved graft maturation, and decreased size of ganglion cyst after ACL reconstruction. This study explored the utilization of biologics to minimize bone tunnel widening in ACL reconstruction surgery. Full article
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