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Advancing successful treatments for carpal instabilities of the wrist are hindered due, in part, to limited preclinical animal models. The purpose of this study was to evaluate the forelimb of the Yucatan minipig (YP) as a potential preclinical animal model for the human wrist by quantifying carpal biomechanics in vitro in the intact and after two ligament transection conditions. Porcine wrist biomechanics (n = 12, 5M, 7F) were determined in 28 range of motion (ROM) directions, in pronation-supination, and in volar-dorsal translation using a six-axis robotic musculoskeletal simulator. Testing was implemented in three conditions – intact, and after sequential transection of the radial intermediate ligament (RIL) and the dorsal intercarpal ligament (DIC). Mixed models were employed to examine differences in direction and conditions among male and female specimens. The intact ROM envelope was elliptical in shape and oriented toward ulnar flexion with the largest ROM about 15° from the flexion–extension axis. Transection of RIL and DIC did not alter the ROM envelope orientation, however, subtle increases in ROM were observed in extension and radial deviation following transection of both RIL and DIC. Pronation in neutral was greater than supination in all three test conditions. Volar translation increased subtly in the RIL and DIC condition. This novel study investigated the multidirectional biomechanics of the YP forelimb. ROM in the general directions of extension, radial and ulnar deviation were less than in humans, while flexion was substantially larger. These specific ligament transections had minor effects on the biomechanics of the YP forelimb.

Background The dromedary camel (Camelus dromedarius) carpal joint presents multiple joints and constitutes several bones and soft tissues. Radiography and/or ultrasonography of the carpus are challenging due to structural superimposition. High-field magnetic resonance imaging (MRI) technique precludes superimposed tissues and offers high soft tissue contrast in multiple sequences and planes. Hence, understanding the normal MRI anatomy is crucial during clinical investigations. Magnetic resonance imaging is highly sensitive for investigation of soft tissues and articular cartilage; therefore, it is extensively used for outlining joint anatomy and evaluation of a wide range of musculoskeletal conditions. MRI images of a specific anatomical region acquired by using multiple sequences in various planes are necessary for a complete MRI examination. Given the dearth of information on the MRI features of the dromedary camel carpus, the current study demonstrates the MRI appearance of the clinically significant structures in the camel carpus in various sequences and planes using a high-field 1.5 Tesla superconducting magnet. For this purpose, twelve cadaveric forelimbs, obtained from 6 clinically sound lameness free adult dromedary camels, were examined. Results The cortex and medulla of the radius, carpal bones and metacarpus were evaluated. Articular cartilage of the carpal joints was depicted and showed intermediate intensity. Carpal tendons expressed lower signal intensity in all pulse sequences. The collateral and inter-carpal ligaments showed mixed signal intensity. Conclusions The obtained data outlines the validation of MRI for investigation of the camel carpus and could set as a reference for interpretation in clinical patients.

BackgroundIn recent years, the high economic impact of biologic therapies (BT) on health care systems has promoted great interest in optimizing BT in Rheumatoid Arthritis (RA) patients in sustained clinical remission (CR). A relevant percentage of those optimized patients present clinical relapses. RA patients in CR have been shown to have active synovitis detectable by ultrasound (U). U can identify synovitis in patients about to present clinical relapse. U can be a useful tool in the optimization decision.ObjectivesThe main objective was to demonstrate that the optimization strategy using U is more useful than the strategy using clinical index. U used as an outcome measure, can further refine the choice of patients who are candidates for a reduction in treatment and therefore achieve lower relapse rates. To do this, we calculated the relapse rates in each of the groups and the time from the beginning in which it appears, and we compared them to assess whether they differ significantly and support our hypothesis. Secondary objective was evaluating the ultrasound remission in this group of patients.MethodsWe conducted a multicenter, randomize, prospective study in 5 tertiary centers in RA patients in sustained CR (>9 months). All signed the informed consent. Approval by the ethical committee was obtained (VDH-INF-2017-01). Two blinded and randomize arms, clinical (A) and U (B) were created to decide tapering (1/2, 1/3 or no reduction treatment) and compare flare rates (>1.2 DAS28 or >16 SDAI/CDAI increase) in 52 weeks (basal, 1, 6, 9 & 12 months). Demographic at baseline, US & clinic variables, and ESR & CRP at each visit, were registered. By using U with grayscale (GS) and power Doppler (PD) in a semiquantitative articular (A) and tendon (T) scale we studied: wrist, 1-5 MCP, 1-5 PIP, ankle, subtalar joint, 2nd, and 5th MTP, extensor tendons (Text) and flexors (Tflex) of the carpus, flexor tendons of the fingers, posterior tibial and peroneal tendons. DAS28 <2.6 was used as the clinical remission criteria, and the absence of synovitis was defined as U remission (EG and PD = 0). U activity was defined as GS≥1 and PD ≥1.Results78 patients were included, 48 completed 12 moths follow up and 28 were retired (5 screening failure, 16 flare, 5 lost follow up & 4 patient decision). 33 men and 45 women, 11.92 years of disease. Group A presented a significative more flare rates than group B (10 vs 6). Using SDAI or CDAI only 7 presented a clinical flare, and for SDAI (7 vs 0) & CDAI (7 vs 0) differences were significative (p<0.005), but not for DAS28 (10 vs 6) (Table 1). In U at baseline, the main involved joint was the wrist (28.6%), and of the tendons the Text (11.2%). In 53% a pathological U (A and T) was observed, 46.9% had pathological A and in 30% pathological T was observed. Considering as remission an ultrasound score of EG + PD = 0, only 46.9% were in remission.ConclusionUltrasound can improve tapering strategy when we used SDAI or CDAI score in patients in sustained clinical remission. Clinical and ultrasound remission are not equivalent. More than half of the patients do not fulfill UR and in one fifth of them a strict control should be carried out to avoid a relapse of the disease if it is decided to optimize.Table 1.baseline clinical characteristics of the subjects included in the sample, comparing according to the treatment group and outbreaks according to clinical indicesVariableGroupTotalpABTotal 1_41 (100%)37 (100%)NsESR (mm/hr) 24115.39 (10.07)3711.27 (8.92)7813.44 9.71NsCRP (mg/dl) 2400.58 (1.32)361.18 (2.59)760.87 2.03NsRF(UI/ml) 24096.60 (126.31)36164.85 (330.84)76128.93 246.08NsACPA (UA) 239264.29 (409.93)36230.48 (601.26)75248.06 507.51NsSJC 2410.00 (0.00)370.03 (0.16)780.01 0.11NsTJC 2410.17 (0.83)370.24 (0.60)780.21 0.73NsPtGA 2413.10 (8.28)373.43 (9.24)783.26 8.69NsPGA 2410.82 (3.12)371.71 (5.31)781.24 4.29NsDAS28 2411.85 (0.70)361.80 (0.62)771.82 0.66NsSDAI 2411.67 (2.23)372.32 (2.59)781.98 2.41NsCDAI 2411.59 (2.21)372.15 (2.56)781.86 2.38NsHAQ 2380.30 (0.46)330.32 (0.38)710.31 0.42NsDAS28 flare10616NsSDAI flare707<0.005CDAI flare707<0.005REFERENCES:NIL.Acknowledgements:NIL.Disclosure of InterestsNone Declared.

Background Despite advancements in pancarpal arthrodesis implants, the postoperative complication rate remains high, and implant removal is often required. This study assessed the implant removal rate following pancarpal arthrodesis and identified its associated factors. Case records of 52 pancarpal arthrodesis procedures performed on 42 dogs at three veterinary centres between 2017 and 2023 were reviewed. The collected data included signalment, medical history, surgical techniques, and postoperative follow-up, which were categorised into perioperative, short-term, mid-term, and long-term periods. Additionally, the timing and indications for implant removal were documented. Univariable logistic regression analysis was performed to analyse the data and identify factors associated with implant removal. Results The implant removal rate was 36.5%. The presence of orthopaedic injuries in the contralateral limb was not associated with implant removal. The interval between diagnosis and pancarpal arthrodesis was significantly associated with implant removal (mean delay: 368.5 and 47.5 days for explantation and non-explantation cases, respectively). Carpal arthrodesis angle showed a statistically significant association with explantation (median angle: 8.58° and 11.73° for explantation and non-explantation cases, respectively). Perioperative and short-term surgical site infections, perioperative and short-term cultures and sensitivities, and the need for additional perioperative antibiotic therapy showed a statistically significant association with explantation. Conclusions This study confirms the high implant removal rate following pancarpal arthrodesis. Although infection may contribute to this, prompt intervention and careful attention to the carpal arthrodesis angle intraoperatively may reduce this risk.

From early dinosaurs with as many as nine wrist bones, modern birds evolved to develop only four ossifications. Their identity is uncertain, with different labels used in palaeontology and developmental biology. We examined embryos of several species and studied chicken embryos in detail through a new technique allowing whole-mount immunofluorescence of the embryonic cartilaginous skeleton. Beyond previous controversy, we establish that the proximal-anterior ossification develops from a composite radiale+intermedium cartilage, consistent with fusion of radiale and intermedium observed in some theropod dinosaurs. Despite previous claims that the development of the distal-anterior ossification does not support the dinosaur-bird link, we found its embryonic precursor shows two distinct regions of both collagen type II and collagen type IX expression, resembling the composite semilunate bone of bird-like dinosaurs (distal carpal 1+distal carpal 2). The distal-posterior ossification develops from a cartilage referred to as \"element x,\" but its position corresponds to distal carpal 3. The proximal-posterior ossification is perhaps most controversial: It is labelled as the ulnare in palaeontology, but we confirm the embryonic ulnare is lost during development. Re-examination of the fossil evidence reveals the ulnare was actually absent in bird-like dinosaurs. We confirm the proximal-posterior bone is a pisiform in terms of embryonic position and its development as a sesamoid associated to a tendon. However, the pisiform is absent in bird-like dinosaurs, which are known from several articulated specimens. The combined data provide compelling evidence of a remarkable evolutionary reversal: A large, ossified pisiform re-evolved in the lineage leading to birds, after a period in which it was either absent, nonossified, or very small, consistently escaping fossil preservation. The bird wrist provides a modern example of how developmental and paleontological data illuminate each other. Based on all available data, we introduce a new nomenclature for bird wrist ossifications.

A novel form of recombinant human bone morphogenetic protein-2 (BMP-2) was explored for effective incorporation and long-term retention into fibrin ingrowth matrices. The solubility of native BMP-2 is greatly dependent on its glycosylation. To enhance retention of BMP-2 in fibrin matrices, a nonglycosylated form (nglBMP-2), which is less soluble than the native glycosylated protein, was produced recombinantly and evaluated in critical-size defects in the rat calvarium (group n=6). When 1 or 20 μg nglBMP-2 was incorporated by precipitation within the matrix, 74 ± 4% and 98 ± 2% healing was observed in the rat calvarium, respectively, as judged radiographically by closure of the defect at 3 weeks. More soluble forms of BMP-2, used as controls, induced less healing, demonstrating a positive correlation between low solubility, retention in vitro, and healing in vivo. Subsequently, the utility of nglBMP-2 was explored in a prospective veterinary clinical trial for inter-carpal fusion in dogs, replacing the standard-of-care, namely autologous cancellous autograft, with nglBMP-2 in fibrin. In a study of 10 sequential canine patients, fibrin with 600 μg/ml nglBMP-2 performed better than autograft in the first weeks of bone healing and comparably thereafter. Furthermore, a greater fraction of animals treated with nglBMP-2 in fibrin demonstrated bone bridging across each of the treated joints at both 12 and 17 weeks than in animals treated with autograft. These results suggest that evaluation in a human clinical setting of nonglycosylated BMP-2 in fibrin matrices might be fruitful.

Gammarus Fabricius, 1775 is the largest genus in the family Gammaridae and most species inhabit freshwater and exhibit high regional endemism. To date, 12 freshwater Gammarus species are known from South Korea. However, considering the complex topography of the Korean Peninsula, the species diversity of freshwater Gammarus may be underestimated. A new species of the genus Gammarus Fabricius, 1775 is described, originating from the Hantan River region, South Korea. Gammarus kyungsooki sp. nov. is morphologically characterised by the absence of calceoli on antenna 2, the presence of 6–7 clusters of long setae on the posterior margin of peduncular article 4 in antenna 2, long straight setae along the posterior margins of merus to carpus in pereopod 3, a 0–2–0 dorsal spine formula on urosomite 1, plumose setae on the outer margin of the outer ramus of uropod 3 and three or more clusters of setae on the outer margin of each telson lobe. Genetic distance analyses, based on mitochondrial cytochrome c oxidase subunit I (COI) and nuclear large-subunit ribosomal RNA (28S) gene sequences, support the distinctiveness of the new species, with interspecific divergences of 18.8%–25.2% (COI) and 1.7%–5.1% (28S).

Background The risk of carpal injury in racehorses may be related to the morphology, yet whether carpal morphologies are set from birth or change through growth remains unclear. Objective To quantify carpal bone changes through growth. Method Twenty privately owned Thoroughbred foals born between January 2022 and May 2023 were radiographed bimonthly from birth to 10 months of age. Imprint training was used to take radiographs safely without chemical restraints. Fifteen individual and 11 relative angular carpal parameters were measured using ImageJ on dorsopalmar radiographs of the carpus at zero degrees of vertical and horizontal rotation. Associations with age (growth), sex and the differences between left and right limbs were analysed separately using a linear mixed effects model. Results Six individual carpal parameters changed with age (radial carpal joint [RCJ], Prx.dor. radial carpal [Cr], Prx.Cu, Dis.dor. third carpal [C3], Dis.pal.C3 and Dis.pal. intermediate carpal), and one was influenced by side, that is higher in the left carpus (Dis.pal.Cr). Seven relative parameters changed with age, and one relative parameter was influenced by side, that is higher in the left (Ra.met‐RCJ). The proximo‐dorsal bone surface angle of Cr and disto‐dorsal bone surface angle of C3 became flatter over time, which may be associated with the re‐direction of the load towards the sagittal carpal plane. Sex did not influence any of the carpal parameters, nor did the combined effect of age, side of the limb and sex. Conclusion Specific individual and relative angular carpal parameters changed significantly over time and some differed between the left and right limb, whereas other parameters did not change. The steeper carpal bone angles achieved proximally with the parameters that did change may improve stability by redirecting the load more medially through the carpus and the proximal and distal bones. This report describes the change in specific radiographic carpal parameters in Thoroughbred foals through the first 10 months of growth. Several carpal parameters changed significantly over time, whereas variations in two parameters were explained by side (left or right). The steeper carpal bone angles achieved proximally together with the parameters that remained constant may act to improve stability by redirecting the load more medially through the carpus and to the proximal and distal bones.

There are no regulations for the flyball box angulation, which ranges from 45° to 89°. As such at present, the box turn is deemed to represent the greatest injury risk to competitors. The aim of this study was to understand the influence of box angle on kinematic variables during a flyball turn, by comparing dogs turning on three different angulations of flyball box (45°, 60° and 83°) to allow for recommendations to be made regarding the most appropriate box design in terms of limiting risk of injury across the sport, to increase both wellbeing and safety for competitors. Turning on a 45° box generates significantly more flexion in the forelimbs and carpus, whereas turning on an 83° box generates greater degrees of extension in the elbow, shoulder, hock and stifle. What our 3D analysis has shown is that the relationship between box angle and the physical demands placed on the dog are complex, and related mainly to asymmetrical nature of the sport, and as such no one angle may be more or less suitable for training and competition, but the 60° seems to be a mid-ground, whereas direction of turn may be fundamental in generating the potential for injury.

IntroductionOsteoid osteoma (OO) is a common benign bone tumor. OO is observed most frequently in the long bones, especially in the tibia and femur. When occurring in the bones of the hand, OO can be a diagnostic and therapeutic challenge. The aim of this study was to provide a systematic review of occurrence, symptoms, diagnosis and treatment options regarding OO in hand bones.Materials and methodsWe performed a systematic review of the literature. All studies from the online databases PubMed and SpringerLink, which reported cases of osteoid osteomas in the bones of the hand, were included. By summarizing the literature, we evaluated the localization within the hand as well as diagnostic and therapeutic options.ResultsWe included 133 studies reporting 401 cases. OO was mostly common in the phalanges. The diagnosis was mostly made by CT (computed tomography) scan. Most of the OO were treated surgically by open curettage or en bloc resection.ConclusionsOsteoid osteomas in the bones of the hand are rare and a delayed diagnosis is common. In cases of pain combined with particular symptoms such as nail hypertrophy and swelling OO should be considered. Of the most used imaging methods, CT scans have the highest sensitivity.