Ultrasonography and MRI are used for imaging evaluation of patellar tendinopathy, and “thickening of the tendon” is known as one of the characteristic findings. However, there are no evidence-based quantitative criteria to help evaluate this phenomenon. The purpose of this study was to investigate an objective measure of patellar tendon thickness. Patellar tendon thickness was evaluated in 65 elite university athletes using both ultrasonography and MRI. The relationship between tendon thickness and clinical patellar tendinopathy was investigated, and the cutoff value of the tendon thickness was calculated. Of the 129 knees included in the analysis, clinical patellar tendinopathy was found in 16 knees (12.4%). The proximal patellar tendon was significantly thicker in athletes with clinical patellar tendinopathy on both ultrasonography (8.3 mm vs. 5.1 mm; p < 0.001) and MRI (9.9 mm vs. 5.5 mm; p < 0.001). Setting the cutoff value to a thickness of >7.0 mm was an accurate predictor of clinical patellar tendinopathy (ultrasonography: sensitivity 81.3%, specificity 95.6%; MRI: sensitivity 100%, specificity 89.4%). Both ultrasonography and MRI measurement of the proximal patellar tendon thickness reflected the presence of clinical patellar tendinopathy. Defining “thickening of the patellar tendon” as thicker than 7.0 mm on both ultrasonography and MRI therefore has clinical significance.
The aim of this study was to examine the injury profile of Japanese university handball players. In this cross-sectional study, a total of 1017 participants who played in the 2018 Japanese National University Handball Championship were followed. The incidence within the previous year was 0.59 [95% CI, confidence interval: 0.56-0.62] per player per year. The ankle (33.3%), knee (23.6%), and shoulder/clavicle (12.6%) were the body regions most affected by traumatic mechanisms, while the lumbar spine/lower back (26.0%), knee (15.7%), and shoulder (15.0%) were the body regions most affected by overuse mechanisms. Sprain (30.7%), ligamentous rupture (23.2%), and fracture (11.8%) were the main types of traumatic injuries, and stress fracture (25.0%) and lesion of meniscus or cartilage (25.0%) were the main types of overuse injuries. Female players were 1.5 times more likely (OR, odds ratio: 1.55 [95% CI: 1.20-2.01]) to experience an injury than their male counterparts, and line players were also 1.5 times more likely (OR: 1.49 [95% CI: 1.00-2.21]) to experience an injury than their wing counterparts. This study showed that there is a need for increased injury prevention efforts in Japanese handball, especially among female players.
The reduction of local recurrence of metastatic spinal tuomors after intratumoral excision improves the quality of life. We have developed a novel photodynamic therapy (PDT) comprising an indocyanine green (ICG)-labeld nanocarrier (ICG-lactosome) and near-infrared light for use as an intraoperative adjuvant therapy. ICG-lactosomes accumulated in bone metastases from breast cancer because of enhanced permeability and retention effect. The cytotoxic effects of this novel PDT on human breast cancer cells were confirmed. In conclusion, ICG-lactosomes enable selective tumor imaging and represent a potential new PDT photosensitizer for adjuvant therapy during surgery for bone metastases from human breast cancer.
(1) Background: Postoperative recovery of external rotation after reverse shoulder arthroplasty (RSA) has been reported despite nonfunctional external rotator muscles. Thus, this study aimed to clinically determine the ideal prosthetic design allowing external rotation recovery in such a cohort. (2) Methods: A monocentric comparative study was retrospectively performed on patients who had primary RSA between June 2013 and February 2018 with a significant preoperative fatty infiltration of the infraspinatus and teres minor. Two groups were formed with patients with a lateral humerus/lateral glenoid 145° onlay RSA—the onlay group (OG), and a medial humerus/lateral glenoid 155° inlay RSA—the inlay group (IG). Patients were matched 1:1 by age, gender, indication, preoperative range of motion (ROM), and Constant score. The ROM and Constant scores were assessed preoperatively and at a minimum follow-up of two years. (3) Results: Forty-seven patients have been included (23 in OG and 24 in IG). Postoperative external rotation increased significantly in the OG only (p = 0.049), and its postoperative value was significantly greater than that of the IG by 11.1° (p = 0.028). (4) Conclusion: The use of a lateralized humeral stem with a low neck-shaft angle resulted in significantly improved external rotation compared to a medialized humeral 155° stem, even in cases of severe fatty infiltration of the infraspinatus and teres minor. Humeral lateralization and a low neck-shaft angle should be favored when planning an RSA in a patient without a functional posterior rotator cuff.
NIR fluorescence imaging of ICG-lactosomes detects arthritic joints in a mouse model of RA. ICG-lactosomes may preferentially localize to inflamed joints via enhanced permeability and retention.
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