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PubMedDate not supplied

The increasing recognition of medullary lysis, cortical osteophytic proliferation, and fragmentation of implanted silicone polymer implants.

During the past 20 years in the United States more than 2 million hinged, spacing implants, intended to replace degenerated bone and to allow improved motion in cases of hallux rigidus, hallux limitus, rheumatoid arthritis, trauma, and hallux valgus have been implanted in first and lesser metatarsophalangeal joints. In addition, implants made of similar material have been implanted in the fingers, hands, wrists, and elsewhere. Most of these materials have been constructed of silicone rubber or SILASTIC. Adverse effects such as implant fracture, implant particulization, and loss of cortical and intramedullary bone are now being seen with increasing frequency. Salvage surgical procedures are now being developed.

Adult↗
PubMed1993

Surgical treatment of osteophytes and calcified discs of the cervical spine.

There are many options available for the surgical treatment of cervical spondylotic radiculopathy and cervical spondylotic myelopathy, with advantages and disadvantages to each. We have presented our approach to this clinical syndrome and the surgical techniques we prefer for each of its variants. Good, objective scientific data based on randomized, prospective clinical studies comparing the various surgical alternatives are lacking. The information that exists does not clearly favor any one single approach or operative option. It is critical to remember that each surgeon's experience and skill with a given technique have a profound impact on outcome. Contemporary spine surgeons should be well-versed in multiple operative techniques and should choose an appropriate approach for each individual patient based on that patient's clinical presentation and higher unique anatomy and pathologic condition, modified by the surgeon's personal experience.

Calcinosis↗
PubMedDate not supplied

[Arthrotic sciatica caused by radicular compression of osteophytic origin in the lateral recess. Apropos of 18 cases].

The authors report 18 cases of arthrosic sciatica due to toot compression in the lateral recess by posterior corporeal and/or posterior apophyseal osteophytosis. The authors study the clinical and radiological characteristics that may indicate the diagnosis and discuss the different mechanisms by which vertebral arthrosis can lead to radicular compression. When surgery is necessary because of the persistent nature of the sciatica, a broader approach should be undertaken than that required for excision of the disc, in order to explore fully the roots, the multiplicity of possible compression sites being one of the essential characteristics of these cases of arthrosic radiculopathy. Study of the literature and of the series of sciatica patients operated upon by the authors shows that although discal hernia is far from being the most frequent cause of common sciatica, arthrosic compression is a cause that cannot be ignored, especially in aged subjects.

Female↗
PubMed1997

Effect of osteoarthritis in the lumbar spine and hip on bone mineral density and diagnosis of osteoporosis in elderly men and women.

To determine in the elderly the effect of osteoarthritis on bone mineral density (BMD) and on diagnosis of osteoporosis, lumbar spine and hip were radiographed and BMD measured by dual-energy X-ray absorptiometry (DXA) in 120 men and 314 women, aged 60-99 years. Prevalence and severity of osteoarthritis were scored on osteophytes, joint space narrowing and bone sclerosis. Ultrasound measurements were also made at the heel to examine whether osteoarthritis at hip or lumbar spine influence bone at this remote site. Osteophytes were the commonest feature, with men having a higher prevalence than women, and lumbar spine having more disease than hip. Lumbar spine osteophytes affected 75% of men and 61.1% of women, and hip osteophytes affected 31.7% of men and 27.4% of women. Stepwise multiple regression analysis using age, weight, height, osteophytes, sclerosis and joint space narrowing indicated that lumbar osteophytes explained 16.6% of variation in lumbar spine BMD in women, and 22.4% in men. Hip osteophytes had a minimal effect on hip BMD, accounting for only 2.2% of variation in women, and none in men. Sclerosis and joint narrowing had little effect on BMD at lumbar spine or hip. Indirect effects of osteoarthritis on BMD were small and inconsistent across genders. Lumbar spine osteophytes in men explained 3.1% of hip BMD variation and 6% of variation in speed of sound at the heel, whereas hip osteophytes in women explained 2.2% of lumbar spine BMD variation. Osteoporosis at the hip, defined as BMD < 2.5 SD of the young normal mean, was present in 33.1% of women and 25.8% of men, whereas, at the lumbar spine it was present in only 24.2% of women and 4.2% of men. However, in women and men free of spinal osteoarthritis, 37.7% of women and 10% of men had osteoporosis. We conclude that lumbar spine osteophytes affect most subjects over the age of 60 years, and contribute substantially to lumbar spine BMD measured in the anteroposterior position by DXA. The effect is largely direct by virtue of osteophytes being included in the BMD measurement. However, a small indirect effect on remote skeletal sites is also present. Diagnosis of osteoporosis and assessment of osteoporotic fracture risk in the elderly should be based on hip BMD and not on anteroposterior lumbar spine, unless spinal osteoarthritis has been excluded.

Aged↗
PubMed1999

The distribution, determinants, and clinical correlates of vertebral osteophytosis: a population based survey.

OBJECTIVE: Vertebral osteophytes are a characteristic feature of intervertebral disc degeneration. There are, however, few population data concerning the occurrence of and clinico-biological correlates of vertebral osteophytes in both the dorsal and lumbar spine. Our purpose was to determine the frequency and distribution of anterior osteophytes in the thoracic and lumbar spine, and their relationship with both various putative risk factors, including physical activity and obesity, and self-reported back pain. METHODS: Men and women aged 50 years and over were recruited from primary care based registers in 5 UK centers. They were invited to attend for an interviewer administered lifestyle questionnaire, assessment of height and weight, and lateral spinal radiographs. Lateral spinal radiographs were evaluated by a single observer for the presence of osteophytes from T4 to L5 using a semiquantitative score (grade): 0 = none, 1 = doubtful, 2 = mild, 3 = moderate, 4 = severe. Based on these data 2 summary statistics were derived: the maximum osteophyte grade at any vertebral level (MAX), and the sum of the osteophyte grades at the individual vertebral levels (TOT). RESULTS: In total, 681 women, mean age 63.3 years, and 499 men, mean age 63.7 years, were studied; 84% of men and 74% of women had at least one vertebral level with a grade 1 or higher osteophyte. Both the sum of the individual grades (TOT) and the proportion of subjects with MAX > or =2 were greater in men than in women in both the dorsal and lumbar spine, and both increased with age. The pattern of spinal involvement was similar in the sexes, with osteophytes occurring most frequently at T9-10 and L3. Increasing body mass index was associated with more frequent osteophytes at both dorsal and lumbar spine, although the relationship was stronger at the dorsal spine. Heavy physical activity, particularly in young adult life, was associated with osteophytosis in men. Self-reported back pain, both ever and in the past year, was linked with lumbar osteophytes in men. CONCLUSION: The distribution within the spine in our study and the relationship with heavy physical activity points to mechanical factors being important in pathogenesis of vertebral osteophytosis. Prospective studies are needed to explore the types of physical activity that increase susceptibility to vertebral osteophytosis. In men, osteophytes affecting the lumbar spine are associated with back pain.

Aged↗
PubMed2004

The anterior ankle impingement syndrome: diagnostic value of oblique radiographs.

BACKGROUND: The diagnostic value of an oblique radiograph, in addition to a lateral radiograph, for detecting osteophytes in the anterior ankle impingement syndrome was evaluated in a prospective study. The hypothesis was that the application of a lateral radiograph is insufficient to detect osteophytes that are located in the anteromedial aspect of the ankle joint. Oblique anteromedial impingement (AMI) radiographs were hypothesized to be a relevant adjunct, because of their utility to detect these anteromedially located osteophytes. METHODS: Presence or absence of tibial and talar osteophytes on both radiographs was compared with the combined findings of CT, MRI scan, and arthroscopic surgery. Estimates of test characteristics were obtained for 60 consecutive patients with an anterior ankle impingement syndrome. RESULTS: It was shown that the sensitivity of lateral radiographs for detecting anterior tibial and talar osteophytes was 40% and 32%, respectively (specificity, 70% and 82%). When the lateral radiograph was combined with an oblique AMI radiograph, these figures increased to 85% and 73%, respectively (specificity decreased to 45% and 68%). This increase was due to the high sensitivity of the oblique AMI radiographs for detecting anteromedial osteophytes (93% for tibial and 67% for talar osteophytes). CONCLUSION: A lateral radiograph is insufficient to detect all anteriorly located osteophytes. An oblique AMI radiograph is a useful adjunct to routine radiographs and is recommended to detect anteromedial tibial and talar osteophytes.

Adolescent↗
PubMed1995

[The MRT of osteophytosis in experimental gonarthrosis].

PURPOSE: The value of MRI for the detection of knee osteophytosis was determined in an animal osteoarthritis model. METHODS: 10 dogs with experimentally induced unilateral osteoarthritis of the knee were investigated with MRI including 2-D-spin echo (SE) and 3-D-gradient echo (GE) imaging. The results were correlated with gross and histopathologic findings and with radiography. RESULTS: Osteophyte formation appeared early in the osteoarthritic process. Pathological analysis yielded 65 osteophytes. With 3-D-GE imaging, 91% of the osteophytes were detected, while 68% were visible on 2-D-SE images. With two-level radiography, 43% of the osteophytes were diagnosed. Additional use of tunnel view and conventional tomography increased the detection rate to 65%. Independent of the imaging technique, MRI revealed three different signal patterns of the osteophyte bone structure. Compared with the histologically evident fat marrow content and the grade of bone sclerosis, best agreement was achieved with 2-D-SE sequences. However, a discrepancy remained in 22%. A fibrocartilaginous layer at the osteophyte surface could be delineated especially on 3-D-GE images. CONCLUSIONS: MRI provides the highest standard in non-invasive diagnosis of osteophytes in the knee. 3-D-GE imaging in particular can demonstrate early and small osteophyte formation.

Animals↗
PubMed2004

Radiographic features of lumbar disc degeneration and self-reported back pain.

OBJECTIVE: To characterize the occurrence of radiographic features of lumbar disc degeneration including the presence of osteophytes, endplate sclerosis, and disc space narrowing and to determine their relationship with self-reported back pain. METHODS: Subjects aged 50 years and over were recruited from a primary care based community health index in Aberdeen, UK. Subjects were invited to complete an interviewer administered questionnaire and to have lateral spinal radiographs performed. The questionnaire included questions concerning the occurrence of back pain, both ever and in the past year. The inter-vertebral disc spaces (L1/2 to L4/5) were evaluated for the presence and severity of anterior osteophytes, endplate sclerosis, and disc space narrowing using a semi-quantitative score (grade 0-3). Logistic regression was used to determine the association between these individual radiographic features of lumbar disc degeneration (using for each feature, the most severely affected vertebra) and back pain, with adjustments made for age and gender. RESULTS: There were 286 men (mean age 65.3 years), and 299 women (mean age 65.2 years) with spinal radiographs. Osteophytes were the most frequent radiographic feature. Osteophytes and endplate sclerosis were more frequent in men than women, but there was no gender difference in the frequency of disc space narrowing. All radiographic features increased in frequency with age; for osteophytes this was true only after excluding mild (grade 1) osteophytes. Compared to those without, those with disc space narrowing were more likely to report back pain both ever, [odds ratio (OR) = 2.1; 95% confidence interval (CI): 1.5 to 3.0] and in the past year (OR = 1.7) with the strength of the association increasing with increasing severity of narrowing. Endplate sclerosis was not linked with back pain although moderate (grade 2) sclerosis was associated with back pain, both ever and in the past year. Compared to those without, or those with mild osteophytes, those with more severe osteophytes (grade > 1) were more likely to report back pain ever (OR = 1.7; 95% CI: 1.2 to 2.5). CONCLUSION: These data highlight the frequent occurrence, and the increase in frequency with age, of the individual radiographic features of lumbar disc degeneration in population samples of men and women. Disc space narrowing appeared more strongly associated with back pain than the other radiographic features.

Aged↗
PubMed2002

Oblique radiograph for the detection of bone spurs in anterior ankle impingement.

OBJECTIVE: The aim of this study was to develop a radiographic view to detect anteromedial talotibial osteophytes that remain undetected on standard radiographs. DESIGN AND PATIENTS: In 10 cadaver specimens the maximal size was measured of anteromedial tibial osteophytes that remain undetected on a standard lateral radiograph projection, due to the presence of the anteromedial tibial rim. The average projection of the most prominent anterolateral tibial rim over the anteromedial rim was found to be 7.3 mm. A 7 mm barium-clay osteophyte was attached to this anteromedial rim of the distal tibia. Anteromedial osteophytes become most prominent on an oblique view, in which the radiographic beam is tilted into a 45 degrees craniocaudal direction with the leg in 30 degrees external rotation. This oblique view was compared with the findings of arthroscopic surgery in 25 consecutive patients with anterior ankle impingement syndrome. RESULTS: Medially located tibial and talar osteophytes remained undetected on a standard lateral projection and became visible on the oblique anteromedial impingement (AMI) radiograph. Anterolateral tibial and talar osteophytes were well detected on a standard lateral radiograph projection but were invisible on the AMI view. There was a high correlation between the location of the osteophyte and the location of symptoms and the findings at arthroscopy. CONCLUSION: A combination of lateral and oblique radiographs can be used to differentiate between anteromedial and anterolateral bony ankle impingement.

Adult↗
PubMed1985

Clinical evaluation of dogs after surgical and nonsurgical management of osteochondritis dissecans of the talus.

Osteochondritis dissecans of the medial aspect of the talus was diagnosed in 17 joints in 11 dogs. In 10 of the 11 dogs, intermittent lameness had persisted after initial diagnosis and therapy. Radiographs made during the initial examination showed a widening of the medial tarsocrural joint space, with osteophyte formation involving the medial and caudal tarsocrural joint. The follow-up radiographs showed greatest change in the increase in reactive bone formation, especially involving the medial and caudal aspects of the tarsocrural joint and the medial aspect of the talus. Arthrotomy for flap removal and curettage was performed on 11 joints; 6 joints did not receive surgery. After a mean period of 34 months following diagnosis, the dogs were examined clinically and the affected joints were radiographed. The degree of lameness, range of motion, and stability of the tarsocrural joint were graded for each limb. Radiographic determinants that were assessed included: width of the medial tarsocrural joint space, medial tarsocrural osteophyte formation, lateral tarsocrural osteophyte formation, caudal tarsocrural osteophyte formation, medial talus osteophyte formation, lateral talus osteophyte formation, intertarsal osteophyte formation, subchondral sclerosis of the distal end of the tibia, presence of joint bodies, and periarticular soft-tissue thickness. On the basis of clinical and radiographic evaluations, the surgical procedures described in this report did not modify progression of osteoarthritic changes.

Animals↗