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Temporin K, Miyoshi Y, Miyamura S, Shimada K. Bone deformity in sports-related elbow osteoarthritis: influence of osteochondritis dissecans of the capitellum-a cross-sectional study. Arch Orthop Trauma Surg 2024; 144:1685-1691. [PMID: 38386060 DOI: 10.1007/s00402-024-05214-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 01/26/2024] [Indexed: 02/23/2024]
Abstract
INTRODUCTION Sports activity can cause elbow osteoarthritis, which subsequently induces bone deformity. Osteochondritis dissecans (OCD) of the capitellum develops defects of articular surfaces and can exacerbate bone deformity. This study aimed to investigate whether OCD exacerbates deformities in sports-related elbow osteoarthritis. MATERIALS AND METHODS Twenty-one patients who underwent bilateral computed tomography preoperatively followed by surgery for sports-related elbow osteoarthritis were included. Patients were divided into two groups according to the presence or absence of an OCD history: OCD + (n = 6) and OCD- (n = 15). Bilateral three-dimensional bone models of the humerus, ulna, and radius were created using computed tomography data, and bone deformities were extracted by subtracting healthy mirror models from the affected models using a Boolean operation. Bone deformities were divided into 22 regions in the 3 bones. The volume of the deformity was estimated by correlating the anteroposterior and lateral diameters of the OCD and by comparing the two groups. RESULTS The anteroposterior diameter of the OCD correlated with the articular surface of the medial trochlear notch, whereas the lateral diameter correlated with the whole ulna, medial gutter of the ulna, whole radius, and lateral side of the radial head. The deformities were 2.2 times larger in the whole humerus, 1.9 times larger in the whole ulna, and 3.0 times larger in the whole radius in the OCD + group than in the OCD- group. The deformities were significantly larger in the OCD + group than in the OCD- group in the radial fossa, posterior capitellum, medial gutter, and lateral gutter in the humerus, medial gutter in the ulna, and lateral, anterior, and posterior sides of the radial head. CONCLUSION Larger OCD exacerbated deformity in elbow OA, and the presence of OCD exacerbated deformities in sports-related elbow OA. These results demonstrate the highlight of preventing OCD progression.
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Affiliation(s)
- Ko Temporin
- Center of Hand and Trauma Surgery, Japan Community Healthcare Organization Osaka Hospital, 4-2-78 Fukushima, Fukushima-Ku, Osaka-Shi, Japan.
- Department of Orthopaedic Surgery, Japan Community Healthcare Organization Osaka Hospital, Osaka, Japan.
| | - Yuji Miyoshi
- Department of Orthopaedic Surgery, Japan Community Healthcare Organization Osaka Hospital, Osaka, Japan
| | - Satoshi Miyamura
- Department of Orthopaedic Surgery, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Kozo Shimada
- Department of Orthopaedic Surgery, Japan Community Healthcare Organization Osaka Hospital, Osaka, Japan
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Remily EA, Bains SS, Dubin JA, Hameed D, Chen Z, Livesey MG, Ingari JV, Gilotra MN, Hasan SA. Open versus arthroscopic elbow arthrolysis for primary osteoarthritis: A comparison of demographics and complications at two years. J Orthop 2023; 42:30-33. [PMID: 37449025 PMCID: PMC10338139 DOI: 10.1016/j.jor.2023.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 06/26/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction Open techniques have traditionally been utilized in the surgical management of elbow osteoarthritis (OA). However, advances in elbow arthroscopy, in conjunction with the movement towards minimally invasive surgery, have led to an increase in the utilization of an arthroscopic approach. The primary aim of this investigation was to compare demographics and complication rates between patients undergoing open or arthroscopic arthrolysis for elbow OA with a secondary objective of identifying risk factors for infection with each treatment. Methods A retrospective review of a private, all-payer database was performed to identify patients undergoing either open (n = 1482) or arthroscopic (n = 2341) arthrolysis for elbow osteoarthritis. The primary outcome was 2-year complications, which included infection, wound complications, and nerve injuries. Categorical variables were compared utilizing chi-square analyses, while continuous variables were compared using independent sample t-tests. Odd ratios (OR) were ascertained to quantify the risk attributed to open arthrolysis compared to arthroscopic. Multivariable logistic regression was performed to assess risk factors for infection following open or arthroscopic arthrolysis of an elbow with OA. Results Age was significantly higher in the open cohort (55 ± 13.4 years) compared to the arthroscopic cohort (52 ± 13.1 years) (p < 0.001). The open cohort was more likely to be female (32.0 vs. 22.9%, p < 0.001) and have a Charlson Comorbidity Index (CCI) greater than three (9.2 vs. 7.1%, p < 0.001). Open procedures were associated with an increased risk of nerve injury (OR: 1.50) and wound complications (OR: 7.70) compared to arthroscopic arthrolysis. Multivariable logistic regression identified open procedures as a risk factor for infection (OR: 11.15). Moreover, diabetes (OR: 1.48), chronic kidney disease (OR: 1.89) and tobacco use (OR: 2.29) were found as risk factors for infection among the open cohort. Conclusions This study found patients undergoing open arthrolysis of OA to be older and have a greater number of medical comorbidities compared to those undergoing arthroscopic arthrolysis. Open arthrolysis was associated with an increased rate of infection, nerve injury and wound complications compared to arthroscopic arthrolysis. After controlling for age and comorbidities with multivariable logistic regression, open arthrolysis remained a risk factor for infection. Arthroscopic elbow arthrolysis is associated with a lower risk of complications, including infection and may be favored for the management of OA of the elbow. Level of Evidence III (retrospective cohort study).
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Affiliation(s)
- Ethan A. Remily
- LifeBridge Health, Sinai Hospital of Baltimore, Rubin Institute for Advanced Orthopaedics, Baltimore, MD, USA
| | - Sandeep S. Bains
- LifeBridge Health, Sinai Hospital of Baltimore, Rubin Institute for Advanced Orthopaedics, Baltimore, MD, USA
| | - Jeremy A. Dubin
- LifeBridge Health, Sinai Hospital of Baltimore, Rubin Institute for Advanced Orthopaedics, Baltimore, MD, USA
| | - Daniel Hameed
- LifeBridge Health, Sinai Hospital of Baltimore, Rubin Institute for Advanced Orthopaedics, Baltimore, MD, USA
| | - Zhongming Chen
- LifeBridge Health, Sinai Hospital of Baltimore, Rubin Institute for Advanced Orthopaedics, Baltimore, MD, USA
| | - Michael G. Livesey
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD, USA
| | - John V. Ingari
- LifeBridge Health, Sinai Hospital of Baltimore, Rubin Institute for Advanced Orthopaedics, Baltimore, MD, USA
| | - Mohit N. Gilotra
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD, USA
| | - S. Ashfaq Hasan
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD, USA
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Meena JS, Choi SB, Jung SB, Kim JW. Electronic textiles: New age of wearable technology for healthcare and fitness solutions. Mater Today Bio 2023; 19:100565. [PMID: 36816602 PMCID: PMC9932217 DOI: 10.1016/j.mtbio.2023.100565] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 01/25/2023] [Accepted: 01/25/2023] [Indexed: 01/30/2023] Open
Abstract
Sedentary lifestyles and evolving work environments have created challenges for global health and cause huge burdens on healthcare and fitness systems. Physical immobility and functional losses due to aging are two main reasons for noncommunicable disease mortality. Smart electronic textiles (e-textiles) have attracted considerable attention because of their potential uses in health monitoring, rehabilitation, and training assessment applications. Interactive textiles integrated with electronic devices and algorithms can be used to gather, process, and digitize data on human body motion in real time for purposes such as electrotherapy, improving blood circulation, and promoting wound healing. This review summarizes research advances on e-textiles designed for wearable healthcare and fitness systems. The significance of e-textiles, key applications, and future demand expectations are addressed in this review. Various health conditions and fitness problems and possible solutions involving the use of multifunctional interactive garments are discussed. A brief discussion of essential materials and basic procedures used to fabricate wearable e-textiles are included. Finally, the current challenges, possible solutions, opportunities, and future perspectives in the area of smart textiles are discussed.
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Affiliation(s)
- Jagan Singh Meena
- Research Center for Advanced Materials Technology, Core Research Institute, Sungkyunkwan University, Suwon, Republic of Korea
| | - Su Bin Choi
- Department of Smart Fab Technology, Sungkyunkwan University, Suwon, Republic of Korea
| | - Seung-Boo Jung
- School of Advanced Materials Science and Engineering, Sungkyunkwan University, Suwon, Republic of Korea
| | - Jong-Woong Kim
- Department of Smart Fab Technology, Sungkyunkwan University, Suwon, Republic of Korea
- School of Mechanical Engineering, Sungkyunkwan University, Suwon, Republic of Korea
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Karateev AE, Chernikova AA, Makarov MA. Post-traumatic osteoarthritis: epidemiology, pathogenesis, clinical picture, approaches to pharmacotherapy. MODERN RHEUMATOLOGY JOURNAL 2023. [DOI: 10.14412/1996-7012-2023-1-108-116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Post-traumatic osteoarthritis (PTOA) is an inflammatory and degenerative disease that occurs as a result of the joint structures injury. It is a common pathology, accounting for approximately 12% of all cases of osteoarthritis (OA). PTOA often occurs in people of young productive age, progresses rapidly, causing chronic pain and increasing dysfunction. Individuals undergoing joint replacement for PTOA are, on average, 10 years younger than those with primary OA. The time interval from the moment of injury to the onset of typical PTOA radiological signs varies widely – from 1 year to 15–20 years.The main injuries that cause PTOA are intra-articular fractures, anterior cruciate ligament injuries, meniscus rupture and dislocation of the patella of the knee joint, joint dislocations with damage to the ligamentous apparatus of the ankle and shoulder joints.The pathogenesis of PTOA is determined by chronic inflammation accompanied by macrophage activation, hyperproduction of cytokines, primarily interleukin (IL) 1â, chemokines and growth factors, progressive destruction of joint tissue and degenerative changes (fibrosis, neoangiogenesis, osteophytosis).Pathogenetic treatment of PTOA, which would stop the progression of the disease, has not been developed. The possibility of using inhibitors of IL1â, IL6, inhibitors of tumor necrosis factor á, glucocorticoids, hyaluronic acid, autologous cell based therapy is under study. The control of pain and inflammation in PTOA requires the prescription of traditional drugs that are widely used in the practice of managing patients with primary OA. In particular, the use of symptomatic delayed-acting agents, such as the injectable form of chondroitin sulfate, seems to be appropriate.
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Momtaz D, Ahmad F, Cushing T, Gonuguntla R, Ghali A, Jabin M, Miggins J, Khalafallah Y, Mitchell S. Radiocapitellar Arthroplasty: Systematic Review. J Shoulder Elb Arthroplast 2023; 7:24715492231152735. [PMID: 36727141 PMCID: PMC9884944 DOI: 10.1177/24715492231152735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 11/21/2022] [Accepted: 01/05/2023] [Indexed: 01/28/2023] Open
Abstract
Introduction Primary elbow osteoarthritis affects approximately 2% of the population, and has been treated with arthroplasty. However, total elbow arthroplasty (TEA) implants currently have severe weight limitations and issues with longevity. In patients with unicompartmental arthritis, unicompartmental arthroplasty may be used instead of TEA. We describe the use of Uni-Elbow Radio-Capitellum and Lateral Resurfacing Elbow for radiocapitellar arthroplasty (RCA) in this article. Methods Reviewers independently searched databases for keywords, such as radiocapitellar arthroplasty, RCA, uni-elbow radiocapitellum, UNI-E, and lateral resurfacing elbow, LRE. The measured outcomes of interest were the change in motion arc and patient-reported outcome scores. Studies that were not of appropriate quality determined by the Cochrane risk of bias summary tool and review studies were excluded. Results RCA resulted in a postoperative 38.3° ± 28.5° increase in elbow flexion-extension (P < .001), and 35.2° ± 28.6° increase in elbow pronation-supination (P < .001). Mayo Elbow Performance Score was significantly increased by 44.8 ± 12.6. DASH Score saw a significant reduction by 45.0 ± 14.6 points (P < .001), while the American Shoulder and Elbow Surgeons Score increased by 47.0 ± 10.6 points (P < .001). Of the 105 adult patients 16.2% experienced complications such as minor stiffness, ulnar neuropathy, component loosening, or radial head UNI-E stem failure. Reported complications were higher in the UNI-E group than in the LRE group. Conclusion RCA has shown promise as an option to treat radiocapitellar arthritis, particularly when excising the radial head causes lateral column instability.
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Affiliation(s)
- David Momtaz
- Long School of Medicine, UT Health Science Center at San Antonio,
San Antonio, TX, USA
| | - Farhan Ahmad
- Department of Orthopedics, Rush University Medical
Center, Chicago, IL, USA
| | - Tucker Cushing
- Department of Orthopedics, Baylor College of Medicine, Houston, TX, USA
| | - Rishi Gonuguntla
- Long School of Medicine, UT Health Science Center at San Antonio,
San Antonio, TX, USA
| | - Abdullah Ghali
- Department of Orthopedics, Baylor College of Medicine, Houston, TX, USA,Abdullah Ghali, Baylor College of Medicine,
Department of Orthopedics, Houston, TX, USA.
| | | | - John Miggins
- Department of Orthopedics, Baylor College of Medicine, Houston, TX, USA
| | | | - Scott Mitchell
- Department of Orthopedics, Baylor College of Medicine, Houston, TX, USA
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Karateev AE, Nesterenko VA, Makarov MA, Lila AM. Chronic post-traumatic pain: rheumatological and orthopedic aspects. RHEUMATOLOGY SCIENCE AND PRACTICE 2022. [DOI: 10.47360/1995-4484-2022-526-537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Trauma causes a complex local and systemic reaction of the macroorganism, the consequences of which can be various functional, neurological and psychoemotional disorders. One of the most painful complications of injuries of the musculoskeletal system is chronic post-traumatic pain (CPTP), which occurs, depending on the severity of the damage, in 10–50% of cases. The pathogenesis of this syndrome is multifactorial and includes the development of chronic inflammation, degenerative changes (fibrosis, angiogenesis, heterotopic ossification), pathology of the muscular and nervous systems, neuroplastic changes leading to the development of central sensitization, as well as depression, anxiety and catastrophization. Risk factors for CPTP should be considered the severity of injury, comorbid diseases and conditions (in particular, obesity), stress and serious trauma-related experiences (within the framework of post-traumatic stress disorder), the development of post-traumatic osteoarthritis and chronic tendopathy, genetic predisposition, deficiencies in treatment and rehabilitation in the early period after injury. To date, there is no clear system of prevention and treatment of CPTP. Considering the pathogenesis of this suffering, adequate anesthesia after injury, active anti–inflammatory therapy (including local injections of glucocorticoids), the use of hyaluronic acid, slow-acting symptomatic agents and autologous cellular preparations – platelet-riched plasma, mesenchymal stem cells, etc. are of fundamental importance. However, therapeutic and surgical methods of CPTP control require further study
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Affiliation(s)
| | | | | | - A. M. Lila
- V.A. Nasonova Research Institute of Rheumatology; Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian Federation
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Misir A, Gunay AE, Oguzkaya S, Uzun E, Kizkapan TB, Yildiz KI, Ozcamdalli M. A Comprehensive Coronal and Axial Bone Dimension and Cartilage Thickness Evaluation of the Distal Humerus: Age and Sex Differences. Cartilage 2021; 13:464S-472S. [PMID: 32037860 PMCID: PMC8808949 DOI: 10.1177/1947603520903780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE There are limited data on bone dimension and cartilage thickness of the distal humeral articular surface. This study aimed to evaluate sex- and age-related bone dimension and cartilage thickness differences and assess the effect of cartilage thickness on distal humeral shape. DESIGN Elbow magnetic resonance images of 180 healthy participants were evaluated. Cartilage thicknesses of the trochlea and capitellum were measured at 19 points using coronal and axial images. In addition, bone diameters were measured from the flexion-extension axis to the 19 points on the coronal and axial magnetic resonance images. Sex differences were evaluated, and the correlation between age and measurement parameters was assessed. RESULTS Significant sex differences regarding the diameters of the axial trochlear bone, coronal lateral trochlear bone, and medial capitellar bone, cartilage thickness at the apex of the lateral trochlear ridge in the axial and coronal plane and at the most lateral point of the capitellar articular surface in the axial plane were observed. A negative correlation was observed between age and axial plane trochlear bone dimensions and between age and coronal plane lateral trochlear and medial capitellar bone dimensions. No significant correlation was found between cartilage thickness and bone dimensions. CONCLUSIONS Bone dimension and cartilage thickness at the distal humerus vary according to sex and age. The data could be used in the donor site selection and graft preparation while osteochondral autograft transfer and allograft transplantation, and in the development of gender-compatible hemiarthroplasty implants.
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Affiliation(s)
- Abdulhamit Misir
- Department of Orthopedics and
Traumatology, Health Sciences University Gaziosmanpasa Taksim Training and Research
Hospital, Istanbul, Turkey,Abdulhamit Misir, Health Sciences
University, Gaziosmanpasa Taksim Training and Research Hospital, Karayollari
Mah. Osmanbey Cad. 621. Sk. 34255 Gaziosmanpasa, Istanbul, Turkey.
| | - Ali Eray Gunay
- Department of Orthopedics and
Traumatology, Kayseri City Hospital, Kayseri, Talas, Turkey
| | - Sinan Oguzkaya
- Department of Orthopedics and
Traumatology, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Erdal Uzun
- Department of Orthopedics and
Traumatology, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Turan Bilge Kizkapan
- Department of Orthopedics and
Traumatology, Bursa Cekirge State Hospital, Bursa, Turkey
| | - Kadir Ilker Yildiz
- Department of Orthopedics and
Traumatology, Health Sciences University Baltalimani Bone and Joint Diseases
Training and Research Hospital, Istanbul, Turkey
| | - Mustafa Ozcamdalli
- Department of Orthopedics and
Traumatology, Ahi Evran University Training and Research Hospital, Kirsehir,
Turkey
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Seah RB, Mak WK, Bryant K, Korlaet M, Dwyer A, Bain GI. Four-dimensional computed tomography scan for dynamic elbow disorders: recommendations for clinical utility. JSES Int 2021; 6:182-186. [PMID: 35141694 PMCID: PMC8811401 DOI: 10.1016/j.jseint.2021.09.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background Four-dimensional computed tomography (4D CT) is rapidly emerging as a diagnostic tool for the investigation of dynamic upper limb disorders. Dynamic elbow pathologies are challenging to diagnose, and at present, limitations exist in current imaging modalities Objective We aimed to assess the clinical utility of 4D CT in detecting potential dynamic elbow disorders. Methods Twenty-eight elbow joints from 26 patients with symptoms of dynamic elbow pathology were included in this study. They were first assessed by a senior orthopedic surgeon with subsequent qualitative data obtained via a Siemens Force Dual Source CT scanner (Erlangen, Germany), producing two- and three-dimensional “static” images and 4D dynamic “movie” images for assessment in each clinical scenario. Clinical assessment before and after scan was compared. Results Use of 4D CT scan resulted in a change of diagnosis in 16 cases (57.14%). This included a change in primary diagnosis in 2 cases (7.14%) and secondary diagnosis in 14 cases (50%). In 25 cases (89.29%), the 4D CT scan allowed us to understand the pathological anatomy in greater detail which led to a change in the management plan of 15 cases (53.57%). Conclusion 4D CT is a promising diagnostic tool in the management of dynamic elbow disorders and may be considered in clinical practice. Future studies need to compare it with other diagnostic modalities such as three-dimensional CT.
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Affiliation(s)
| | - Wai-Keong Mak
- Department of Orthopaedic Surgery, Sengkang General Hospital, Singapore
- Corresponding author: Wai-Keong Mak, MRCS, MBBS, 110 Sengkang E Way, Singapore 544886.
| | - Kimberley Bryant
- Clinical and Research Imaging Centre, SAHMRI, Adelaide, SA, Australia
| | - Mishelle Korlaet
- Department of Orthopaedic Surgery and Trauma, Flinders University, Bedford Park, SA, Australia
| | - Andrew Dwyer
- Department of Orthopaedic Surgery and Trauma, Flinders University, Bedford Park, SA, Australia
| | - Gregory I. Bain
- Department of Orthopaedic Surgery and Trauma, Flinders University, Bedford Park, SA, Australia
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Guglielmino C, Musumeci G. Early elbow osteoarthritis in competitive enduro motorcyclist. Scand J Med Sci Sports 2020; 30:1287-1290. [PMID: 32246791 DOI: 10.1111/sms.13664] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 03/11/2020] [Accepted: 03/23/2020] [Indexed: 12/30/2022]
Abstract
This case report speculates that prolonged vibration from enduro off-road sport is deleterious for the elbow joint. This contribution could also aid sports physicians in better understanding this complex unknown phenomenon. No published data are present in the current literature that demonstrates the correlation between early elbow osteoarthritis in enduro motorcyclist overuse.
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Affiliation(s)
- Claudia Guglielmino
- Orthopedics Traumatology and Rehabilitation Unit, Polyclinic "G.B. Morgagni" Mediterranean Foundation, Catania, Italy
| | - Giuseppe Musumeci
- Human, Histology and Movement Science Section, Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy.,Research Center on Motor Activities (CRAM), University of Catania, Catania, Italy.,Department of Biology, College of Science and Technology, Sbarro Institute for Cancer Research and Molecular Medicine, Temple University, Philadelphia, PA, USA
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