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PubMed2005

Effects of relaxin in a model of rat adjuvant-induced arthritis.

A reduction in the incidence and severity of rheumatoid arthritis is seen in pregnant women. Relaxin, a hormone of pregnancy, has been implicated in decreased immune responsiveness. Consequently, the effects of relaxin and estradiol valerate, alone or in combination, were assessed in the development of adjuvant-induced arthritis in the rat. Combination hormone therapy reduced adjuvant-induced paw inflammation. Radiographic analysis of the tarsal joints showed that estradiol valerate plus relaxin treatment minimized soft tissue damage and bone changes when compared to vehicle-treated arthritic controls. These results indicate that relaxin may be a factor in reducing inflammation during pregnancy.

Animals↗
PubMed2001

Drosophila transcription factor AP-2 in proboscis, leg and brain central complex development.

We report loss- and gain-of-function analyses that identify essential roles in development for Drosophila transcription factor AP-2. A mutagenesis screen yielded 16 lethal point mutant alleles of dAP-2. Null mutants die as adults or late pupae with a reduced proboscis, severely shortened legs (approximately 30% of normal length) lacking tarsal joints, and disruptions in the protocerebral central complex, a brain region critical for locomotion. Seven hypomorphic alleles constitute a phenotypic series yielding hemizygous adults with legs ranging from 40-95% of normal length. Hypomorphic alleles show additive effects with respect to leg length and viability; and several heteroallelic lines were established. Heteroallelic adults have moderately penetrant defects that include necrotic leg joints and ectopic growths (sometimes supernumerary antennae) invading medial eye territory. Several dAP-2 alleles with DNA binding domain missense mutations are null in hemizygotes but have dominant negative effects when paired with hypomorphic alleles. In wild-type leg primordia, dAP-2 is restricted to presumptive joints. Ectopic dAP-2 in leg discs can inhibit but not enhance leg elongation indicating that functions of dAP-2 in leg outgrowth are region restricted. In wing discs, ectopic dAP-2 cell autonomously transforms presumptive wing vein epithelium to ectopic sensory bristles, consistent with an instructive role in sensory organ development. These findings reveal multiple functions for dAP-2 during morphogenesis of feeding and locomotor appendages and their neural circuitry, and provide a new paradigm for understanding AP-2 family transcription factors.

Alleles↗
PubMed2006

Ankle arthrodesis and its relationship to ipsilateral arthritis of the hind- and mid-foot.

It has been suggested that arthrodesis of the ankle leads to osteoarthritis of the joints of the ipsilateral hind- and midfoot. We believe these studies overlooked the presence of osteoarthritic changes in these joints before the arthrodesis. We reviewed the pre-operative radiographs of 70 patients with osteoarthritis of the ankle who underwent 71 ankle arthrodeses (one was bilateral). The talonavicular, calcaneocuboid, subtalar and naviculocuneiform joints were given an osteoarthritis score according to Kellgren and Lawrence. The mean age at operation was 54.9 years and the most common indication was for post-traumatic osteoarthritis (52 cases). A total of 68 patients showed pre-existing arthritis in either the hind- or mid-foot, with the subtalar joint the most commonly affected. Ipsilateral hind- and mid-foot arthritis is almost universally present in patients with arthritis of the ankle requiring arthrodesis. The presence of such changes may not be a consequence of this arthrodesis.

Adult↗
PubMed2002

Harlequin ichthyosis in two greater kudu (Tragelaphus strepsiceros).

Two greater kudu calves (Tragelaphus strepsiceros) born 7 years apart were found with fissures and thickened, scaly, cutaneous plates covering over 80% of their bodies. One was dead at presentation, and the other was euthanized shortly after birth. Both animals shared a common sire. On necropsy, chemosis, ectropion, eclabium, and bilateral valgus deformities of the tarsal joints were observed in one calf, presumed to be secondary to the plates restricting normal fetal development. The principal microscopic lesion was severe lamellar orthokeratosis, with focal mild parakeratosis. Ultrastructural epidermal lesions included the absence of normal lamellar granules, large dilated endoplasmic reticulum, and abnormal retention of organelles and vesicles. Gross, histopathologic, and electron microscopic findings in both kudu calves were consistent with those of harlequin ichthyosis, a rare dermatosis of humans believed to have an autosomal recessive inheritance pattern. The underlying genetic and molecular abnormality and heritability of this condition in this greater kudu herd were not determined.

Animals↗
PubMed1997

Pathological evaluation of effect of anti-rheumatic drugs on type II collagen-induced arthritis in Lewis rats.

The effects of anti-rheumatic drugs (dexamethasone 0.1 mg/kg and naproxen 5 mg/kg) were evaluated immunologically and histopathologically on type II collagen-induced arthritis in Lewis rats. Increased paw volume in the hind limbs was significantly suppressed in the groups treated with dexamethasone or naproxen, but noticeable retardation of body weight gain was observed in the group treated with dexamethasone. Serum anti-type II collagen IgG was significantly suppressed in the group treated with dexamethasone but not naproxen. Histopathological evaluation by our grading system, classification of the stages in arthritic lesion development, revealed suppression of the inflammatory changes in the tarsal joints of the animals treated with dexamethasone or naproxen. From our results, histopathological evaluation is considered to be more suitable for assessment of the efficacy of anti-rheumatic drugs on type II collagen-induced arthritis, an animal model for human rheumatoid arthritis.

Animals↗
PubMed1997

Motion of the hindfoot after simulated arthrodesis.

Arthrodesis of the subtalar joint, triple arthrodesis (involving the subtalar, talonavicular, and calcaneocuboid joints), double arthrodesis (involving the talonavicular and calcaneocuboid joints), arthrodesis of the talonavicular joint, and arthrodesis of the calcaneocuboid joint were simulated in a cadaver model, and the range of motion of each joint not involved in the simulated arthrodesis was measured with a three-dimensional magnetic space tracking system. The excursion of the posterior tibial tendon was also measured under all of these conditions. We found that any combination of simulated arthrodeses that included the talonavicular joint severely limited the motion of the remaining joints to about 2 degrees and limited the excursion of the posterior tibial tendon to 25 per cent of the preoperative value. Simulated arthrodesis of the calcaneocuboid joint had little effect on the range of motion of the subtalar joint, and it reduced the range of motion of the talonavicular joint to a mean of 67 per cent of the preoperative value; a mean of 73 per cent of the excursion of the posterior tibial tendon was retained. After simulated arthrodesis of the subtalar joint, a mean of 26 per cent of the motion of the talonavicular joint, 56 per cent of the motion of the calcaneocuboid joint, and 46 per cent of the excursion of the posterior tibial tendon was retained. The talonavicular joint is the key joint of the triple joint complex. The talonavicular joint had the greatest range of motion, and simulated arthrodesis of this joint essentially eliminated motion of the other joints of the complex.

Arthrodesis↗
PubMed2004

Animal models of HLA-B27-associated diseases.

The HLA-B27 molecule is strongly associated with the spondyloarthropathies (SpA), a group of inflammatory conditions affecting the skeleton, the skin and several mucosae. The mechanism of this association remains unknown, largely because the HLA-B27 molecule displays normal function. A disease that closely mimicks SpA arises spontaneously in HLA-B27 transgenic rats. This disease is dependent on the presence of a normal bacterial flora and implicates the immune system. The presence of both CD4+ T cells and antigen presenting cells (APCs) expressing high levels of HLA-B27, seems of critical importance in its pathogenesis, whereas CD8+ T cells are dispensable. The T cell stimulatory function of APCs is disturbed by the HLA-B27 molecule. This disease could result from a failure of tolerance, related in part to high level of B27 expression in professional APCs and to the immune response to gut bacteria. In contrast, HLA-B27 transgenic mice have usually remained healthy. However, two types of inflammatory conditions affecting the skeleton, which arise in mice of susceptible background after exposure to a conventional bacterial flora, are increased by an HLA-B27 transgene. The first is ANKENT, a spontaneous ankylosing enthesitis that affects ankle and/or tarsal joints of ageing mice; the second is a spontaneous arthritis of hindpaws developing in mice lacking endogenous mbeta2m. As in rats, the absence of CD8+ T cells in the latter model, argues against the "arthritogenic peptide" hypothesis. In these mbeta2m0 mice, B27 free heavy chain could be implicated in the pathogenesis of arthritis by presenting extracellular peptides to CD4+ T cells.

Alleles↗
PubMed2004

Evaluation of serum concentrations of biomarkers of skeletal metabolism and results of radiography as indicators of severity of osteochondrosis in foals.

OBJECTIVE: To determine whether serum concentrations of biomarkers of skeletal metabolism can, in conjunction with radiographic evaluation, indicate severity of osteochondrosis in developing horses. ANIMALS: 43 Dutch Warmblood foals with varying severity of osteochondrosis. PROCEDURE: 24 foals were monitored for 5 months and 19 foals were monitored for 11 months. Monthly radiographs of femoropatellar-femorotibial and tibio-tarsal joints were graded for osteochondral abnormalities. Serial blood samples were assayed for 8 cartilage and bone biomarkers. At the end of the monitoring period, foals were examined for macroscopic osteochondrosis lesions. RESULTS: Temporal relationships were evident between certain serum biomarkers and osteochondrosis severity in foals during their first year. Biomarkers of collagen degradation (collagenase-generated neoepitopes of type-II collagen fragments, type-I and -II collagen fragments [COL2-3/4C(short)], and cross-linked telopeptide fragments of type-I collagen) and bone mineralization (osteocalcin) were positive indicators of osteochondrosis severity at 5 months of age. In foals with lesions at 11 months of age, osteochondrosis severity correlated negatively with COL2-3/4C(short) and osteocalcin and positively with C-propeptide of type-II procollagen (CPII), a collagen synthesis marker. Radiographic grading of osteochondrosis lesions significantly correlated with macroscopic osteochondrosis severity score at both ages and was strongest when combined with osteocalcin at 5 months and CPII at 11 months. CONCLUSIONS AND CLINICAL RELEVANCE: The ability of serum biomarkers to indicate osteochondrosis severity appears to depend on stage of disease and is strengthened with radiography. In older foals with more permanent lesions, osteochondrosis severity is significantly related to biomarker concentrations of decreased bone formation and increased cartilage synthesis.

Animals↗
PubMed2001

A study of ten cases of focal peritarsal infection as a cause of severe lameness in the thoroughbred racehorse: clinical signs, differential diagnosis, treatment and outcome.

The differential diagnoses of tarsal joint infection, fracture and peritarsal focal infection are of particular importance in practice. The objective of the present report is to provide additional clinical data to assist in the understanding of one of these conditions. The haematological parameters, clinical signs, treatment and outcome of 10 cases of severe lameness associated with peritarsal infection are reviewed. All horses had a significant rise in rectal temperature. The majority of cases (6/10) had haematological changes consistent with acute bacterial infection on the day of first examination. In the remaining cases these changes were not apparent on a blood sample taken on the first examination, but became so after 24 h. Nine out of 10 cases made a complete recovery on a regimen of i.v. antibiotic therapy, in conjunction with administration of nonsteroidal anti-inflammatory drugs and repeated forced exercise. One case developed osteomyelitis of the third and fourth metatarsal bones, but made a full recovery in due course. It is concluded that, in the majority of cases, prompt treatment with antibiotic therapy, analgesics and forced exercise results in complete resolution of the condition.

Animals↗
PubMedDate not supplied

Talus fractures: evaluation and treatment.

Fractures of the talus are uncommon. The relative infrequency of these injuries in part accounts for the lack of useful and objective data to guide treatment. The integrity of the talus is critical to normal function of the ankle, subtalar, and transverse tarsal joints. Injuries to the head, neck, or body of the talus can interfere with normal coupled motion of these joints and result in permanent pain, loss of motion, and deformity. Outcomes vary widely and are related to the degree of initial fracture displacement. Nondisplaced fractures have a favorable outcome in most cases. Failure to recognize fracture displacement (even when minimal) can lead to undertreatment and poor outcomes. The accuracy of closed reduction of displaced talar neck fractures can be very difficult to assess. Operative treatment should, therefore, be considered for all displaced fractures. Osteonecrosis and malunion are common complications, and prompt and accurate reduction minimizes their incidence and severity. The use of titanium screws for fixation permits magnetic resonance imaging, which may allow earlier assessment of osteonecrosis; however, further investigation is necessary to determine the clinical utility of this information. Unrecognized medial talar neck comminution can lead to varus malunion and a supination deformity with decreased range of motion of the subtalar joint. Combined anteromedial and anterolateral exposure of talar neck fractures can help ensure anatomic reduction. Posttraumatic hindfoot arthrosis has been reported to occur in more than 90% of patients with displaced talus fractures. Salvage can be difficult and often necessitates extended arthrodesis procedures.

Ankle Injuries↗
PubMed1996

Functional significance of torsion of the tendon of tibialis posterior.

The authors describe the anatomical necessity and functional significance of torsion of the tendon of tibialis posterior. A wooden model of the right lower extremity has been constructed which includes representations of the ankle, subtalar, and oblique midtarsal joints. The model is used to show that the presence of torsion within the tendon of tibialis posterior eliminates the need for any longitudinal slippage between individual tendon fibers during triplane movement of the joints of the lower extremity.

Ankle Joint↗
PubMed1995

The morphology and pathology of Besnoitia sp. in reindeer (Rangifer tarandus tarandus).

Four of five reindeer (Rangifer tarandus tarandus) obtained from a Besnoitia sp.- infected herd at the Assiniboine Park Zoo in Winnipeg, Manitoba, Canada, in October 1989, had evidence of mild dermatitis over the articular surfaces of carpal and tarsal joints. Cysts of Besnoitia sp., either surrounded by inflammatory reactions or without evident host response, were present within the dermis, submucosa of the nasal turbinates, periosteum, tendons, testes and hooves. The light microscopic and histochemical features of Besnoitia sp. from reindeer were indistinguishable from those of other Besnoitia spp. described in cattle, rodents and horses. The Besnoitia sp. cysts and organisms from reindeer were unique in that bradyzoite membrane micropores and cytoplasmic enigmatic bodies were not observed. Two cats were fed cysts of Besnoitia sp. but no oocysts were detected in feces for 90 days post-infection.

Animals↗
PubMed1999

Triple arthrodesis and subtalar joint arthrodesis. For the treatment of end-stage posterior tibial tendon dysfunction.

The current literature clearly supports the use of subtalar and triple arthrodeses for the treatment of end-stage PTTD. There is debate, however, regarding whether or not an isolated fusion is preferable to the triple arthrodesis. Complete evaluation of the patient's deformity and symptoms is imperative before choosing to perform a rearfoot fusion. If the deformity can be isolated to the STJ, then perhaps a limited fusion is appropriate. With the close interrelationship of the subtalar and midtarsal joints, however, it is the authors' opinion that chronic dysfunction of the posterior tibial tendon infrequently causes isolated STJ pathology. Perhaps earlier intervention in the process of tendon degeneration, before multiple joint adaptations, would warrant an isolated fusion. We anticipate further research into the advantages of STJ and double arthrodeses over the triple arthrodesis. Clearer identification of the patients in whom these limited fusions are warranted is necessary, especially with respect to adult flatfoot secondary to PTTD. Currently, isolated and combined hindfoot fusions continue to be valuable salvage procedures in the treatment of end-stage arthritic deformities.

Adolescent↗
PubMed1999

Triple arthrodesis: twenty-five and forty-four-year average follow-up of the same patients.

BACKGROUND: Triple arthrodesis is used to treat major deformities of the hindfoot and is often performed in young patients. The purpose of this study was to assess the long-term outcomes of triple arthrodesis in young patients. METHODS: Sixty-seven feet of fifty-seven patients were evaluated at an average of twenty-five and forty-four years after triple arthrodesis. The most common indication for the operation was neuromuscular imbalance of the hindfoot, which was secondary to poliomyelitis in thirty-seven feet (55 percent), Charcot-Marie-Tooth disease in six (9 percent), spinal cord abnormalities in four (6 percent), cerebral palsy in three (4 percent), and Guillain-Barré syndrome in one (1 percent). RESULTS: Fifty-two feet (78 percent) had some residual deformity after the arthrodesis. However, these deformities appeared to be nonprogressive between 1973 and 1994. Pseudarthrosis occurred in thirteen feet. Thirty feet or ankles (45 percent) were painful at the first follow-up evaluation, and thirty-seven feet or ankles (55 percent) were painful at the second follow-up evaluation. Of the thirty feet or ankles that were painful at the first follow-up evaluation, twenty-three were painful at the second follow-up evaluation. Of the thirty-seven feet or ankles that were not painful at the first follow-up evaluation, fourteen were painful at the second follow-up evaluation. Eighteen patients (32 percent) needed walking support at the time of the first follow-up, and thirty-nine patients (68 percent) needed it at the time of the second follow-up. Two of the patients who needed support at the first follow-up evaluation did not need it at the second follow-up evaluation. At the first follow-up evaluation, twenty-one ankles (31 percent) had no radiographic evidence of degenerative changes. However, by the second follow-up evaluation, all of the ankles had some degenerative changes. Similar progressive arthritic findings were noted at the naviculocuneiform and tarsometatarsal joints. According to the system of Angus and Cowell, the overall result at the time of the first follow-up was rated as good in fifty feet (75 percent) and as fair in seventeen feet (25 percent). At the time of the second follow-up, nineteen feet (28 percent) were rated as good, forty-six (69 percent) were rated as fair, and two (3 percent) were rated as poor. CONCLUSIONS: Despite progressive symptoms and radiographic degeneration in the joints of the ankle and midfoot, fifty-four patients (95 percent) were satisfied with the result of the operation. The triple arthrodesis was a satisfactory solution for imbalance of the hindfoot in this group of patients.

Adolescent↗
PubMed2000

Isolated fusions of the hindfoot.

Increasingly, isolated arthrodeses are being used to successfully manage disorders of the hindfoot. Their relative simplicity makes these procedures an attractive alternative to the triple arthrodesis. Each joint fusion is not without certain pitfalls, and issues such as the location of the pain, origin, planal dominance, and multiple joint involvement must be taken into consideration when choosing a specific procedure. With proper patient selection and careful technique, the surgeon will find these procedures provide a valuable addition to his/her armamentarium.

Arthrodesis↗
PubMed1975

Multiple cartilaginous exostoses in the dog.

The clinicopathologic aspects of multiple cartilaginous exostoses (MCE) in 2 dogs were compared with those in 9 previously reported cases of MCE in dogs. Although a familial tendency is probable, there is apparently no sex or breed predilection. Only bones that developed by endochondral ossification were affected. The vertebrae, ribs, and long bones were the most frequent location of exostoses. Bones of the carpal and tarsal joints and the skull were not affected in the cases evaluated. Physical examination and radiography may provide strong supportive evidence for a diagnosis of MCE, but a definitive diagnosis must be based on microscopic evaluation of osseous lesions. Treatment is unnecessary unless growth of exostoses results in clinical sequelae. Surgical extirpation of lesions should be considered if dysfunction of the skeletal, muscular, or neurologic systems develops. The prognosis is variable, being dependent on the location and number of lesions, the age of the patient at the time of diagnosis, and the presence or absence of clinical complications.

Animals↗
PubMed2000

[Surgical treatment of chronic Achilles tendiopathies. Report of 52 cases].

PURPOSE OF THE STUDY: We reviewed a series of 52 cases of chronic Achilles tendinopathy treated surgically by release of the fascia cruris, resection of peritendon, longitudinal incision of the tendon and occasional excision of intratendinous lesions. MATERIALS AND METHODS: The mean course prior to surgery was about 18 months. Twenty-six patients practiced sports. Complaints were bilateral in 12 cases. Pain was always present. Ultrasound exploration evidenced paratendinitis (n=21), tendinosis (n=22) and paratendinitis with tendinosis (n=9) (Puddu classification). Patients were reviewed after a minimal 2-year follow-up. Results were assessed on the basis of clinical findings. RESULTS: Mean follow-up was 5 years 6 months. Twenty-nine patients were free of pain. The range of motion was normal in 48 cases and 29 patients resumed sports activities at the same level as prior to surgery. Outcome was very good in 29 patients, good in 14 average in 6 and poor in 3. DISCUSSION: Stiffness of the tibio-tarsal joint can be avoided by proper mobilization. Outcome appears to be better in middle-aged patients. Poor outcome is closely related to amyotrophy. The presence of a foot deformity does not appear to have an unfavorable influence on outcome. The Achilles tendon must not be infiltrated. Ultrasound is highly contributive, but MRI provides a more accurate analysis. CONCLUSION: Surgical treatment of chronic Achilles tendinopathies can be proposed when conservative treatment has been unsuccessful. Outcome is better in young active patients and in cases where paratendinitis predominates.

Achilles Tendon↗