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Objective: While risk factors for osteoarthritis (OA) are well known, it is not well understood why certain individuals maintain high mobility and joint health throughout their life while others demonstrate OA at older ages. The purpose of this study was to assess which demographic, clinical and MRI quantitative and semi-quantitative factors are associated with preserving healthy knees in older individuals.
Methods: This study analyzed data from the OA Initiative (OAI) cohort of individuals at the age of 65 years or above. Participants without OA at baseline (BL) (Kellgren-Lawrence (KL) ≤ 1) were followed and classified as incident cases (KL ≥ 2 during follow-up; n = 115) and as non-incident (KL ≤ 1 over 96-month; n = 391). Associations between the predictor-variables sex, age, BMI, race, clinical scoring systems, T relaxation times and Whole-Organ Magnetic Resonance Imaging-Score (WORMS) readings at BL and the preservation of healthy knees (KL ≤ 1) during a 96-month follow-up period were assessed using logistic regression models.
Results: Obesity and presence of pain showed a significant inverse association with maintaining radiographically normal joints in patients aged 65 and above. T relaxation times of the lateral femur and tibia as well as the medial femur were also significantly associated with maintaining radiographically normal knee joints. Additionally, absence of lesions of the lateral meniscus and absence of cartilage lesions in the medial and patellofemoral compartments were significantly associated with maintaining healthy knee joints.
Conclusion: Overall, this study provides protective clinical parameters as well as quantitative and semi-quantitative MR-imaging parameters associated with maintaining radiographically normal knee joints in an older population over 8 years.
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http://dx.doi.org/10.1186/s12891-024-07590-z | DOI Listing |
Am J Case Rep
September 2025
Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan.
BACKGROUND Periprosthetic tibial fractures following total knee arthroplasty (TKA) are increasingly encountered in very elderly patients, where multiple comorbidities and osteoporosis compromise early mobilization and elevate the risk of complications. Maintaining pre-injury activities of daily living (ADL) while ensuring safe surgical management is challenging. We present a case of a 95-year-old woman with a periprosthetic tibial shaft fracture managed with open reduction, additional plate fixation, and Ilizarov external fixation, enabling immediate postoperative weight-bearing.
View Article and Find Full Text PDFJ Neurosurg Spine
September 2025
1Department of Spine and Orthopaedic Surgery, Japanese Red Cross Medical Center, Tokyo, Japan; and.
Objective: The objective of this study was to introduce and evaluate foraminoplastic inferior pedicle subtraction osteotomy (FiPSO), a novel technique that involves downward resection of the pedicle and vertebral body, aimed at addressing rigid lower lumbar kyphosis.
Methods: The clinical records were reviewed of the patients who underwent corrective surgery from January 2012 through December 2021 for adult spinal deformity using a combination of procedures: pedicle subtraction osteotomy (PSO) at the lumbar level and spinopelvic fixation. Inclusion criteria included patients older than 40 years with sagittal imbalance symptoms and significant radiographic findings: sagittal vertical axis (SVA) > 50 mm, pelvic tilt (PT) > 25°, or pelvic incidence (PI) minus lumbar lordosis (LL) > 10°.
PLoS Med
September 2025
Department of Orthopaedics, Tampere University Hospital, Tampere, Finland.
Background: The optimal management of distal radius fractures (DRFs) in older patients remains debatable. A knowledge gap exists concerning how to manage fractures with early malalignment during nonoperative treatment. We conducted a prospective, multicenter, and randomized controlled trial to compare nonoperative treatment to operative treatment with volar locking plating (VLP) in the management of primarily malaligned DRFs and DRFs that exhibit early malalignment during nonoperative treatment.
View Article and Find Full Text PDFKnee Surg Sports Traumatol Arthrosc
September 2025
Department of Orthopedic Surgery, APHM, CNRS, ISM, Institute of Movement Sciences, Sainte-Marguerite Hospital, Aix Marseille University, Marseille, France.
Purpose: Slope-reducing high tibial osteotomies (SR-HTOs) correct posterior tibial slope (PTS) abnormalities in patients with anterior knee instability, as in cases of anterior cruciate ligament (ACL) deficiency. The SR-HTO techniques, including infra-tubercle and retro-tubercle approaches, provide distinct benefits: retro-tubercle techniques help preserve patellofemoral joint mechanics, while infra-tubercle techniques are effective in mitigating iatrogenic varus. However, there is limited comparative literature available.
View Article and Find Full Text PDFJ Pediatr Orthop B
September 2025
Pediatric Orthopedic Department, 'Buzzi' Children's Hospital.
Flatfoot is a common condition in children; surgical treatment should be reserved for severe and symptomatic cases. Calcaneal lengthening osteotomy (CLO) has been associated with good results; the original technique considers the use of allografts or autografts. This study aimed to evaluate advantages of a titanium trapezoidal wedge (TTW) in a pediatric population, compared with traditional grafts.
View Article and Find Full Text PDF