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PubMed1996

[Relationship between time of ossification center appearance and hip joint development stage using Graf's method].

The aim of this paper was to relate time of the ossification center appearance and development stage according to Graf. Retrospective analysis included 4546 sonograms in children from 1 to 6 months of age and 1252 sonograms in 313 healthy newborns. An earlier appearance of the ossification center was found in females (7 weeks against 10 weeks of life in males). Statistically significant relationship was found between the delay in the ossification center appearance time and hip dysplasia. The delay exceeding 6 months is suggestive of serious pathology and complications in later stages of hip development.

Female↗

PubMed1996

Ossification of the coracoacromial ligament: association with rotator cuff pathology of the shoulder.

The objective of this study was to assess the association of ossification of the coracoacromial ligament (CAL) observed on conventional radiographs with the presence of rotator cuff pathology as demonstrated by magnetic resonance imaging (MRI), arthrography, and/or surgery. Conventional radiographs (internal and external rotation and outlet and axillary views) on eight patients showed ossification of the coracoacromial ligament. Rotator cuff integrity was assessed by physical examination in all 8 patients, by arthrography in 3 patients, and by MRI in 2 patients. Surgery was performed on four of the patients. Physical examination showed impingement findings and decreased rotator cuff strength suggestive of rotator cuff disease in all eight patients. The arthrograms and MRI examinations showed the presence of full-thickness rotator cuff tears. Four of these patients underwent surgery and the rotator cuff defects were confirmed and repaired. Identification of ossification of the CAL on conventional radiographs should be recognized as strongly suggestive of associated significant rotator cuff pathology.

Aged↗

PubMedDate not supplied

Onset of ossification of the tarsal bones in congenital clubfoot.

Subjects of this study were 45 patients with 56 idiopathic congenital clubfeet (34 boys with 42 feet and 11 girls with 14 feet) who underwent successful conservative treatment. Radiologic examinations were performed at intervals of 3 months. In anteroposterior radiographs of bilateral feet, the period of appearance of the ossification center was observed for the first, second, and third cuneiform and the tarsal navicular. The ossification of the tarsal bones in the congenital clubfeet occurred later than that in the unaffected feet in boys. The difference between the clubfeet and the unaffected feet was particularly statistically significant for the tarsal navicular and the second cuneiform (p < 0.01). The tarsal naviculars, the first cuneiforms, and the second cuneiforms in clubfeet and in unaffected feet started to be ossified significantly earlier in girls than in boys. Ossification occurred out of order in three of 56 clubfeet and three of 34 unaffected feet.

Age of Onset↗

PubMed1997

[Order of appearance of the ossification centers in the foot during the period of intrauterine life in human material].

Forty seven skeletons belonging to human fetuses, whose age ranged from eight to thirty eight weeks, were studied in order to establish the beginning of ossification in the bones. Red alizarin was employed in order to stain bone calcifications. Our observations agree with other authors considered as references nonetheless, we also have found differences among the beginning and the sequence of development of some of the primary centers of ossification in the fetal foot. The appearance of the ossification centers was as follows: 1) the five metatarsals: 9th. week; 2) distal phalange first digit; 11th. week; 3) a) proximal phalange 1, 2, 3, 4, 5 digits: 12th. week, b) distal phalange 2, 3, 4, 5 digits: 12th. week; 4) middle phalange second digit: 17th. week; 5) a) middle phalange fourth digit: 18th. week, b) middle phalange third digit: 18th. week, y 6) middle phalange fifth digit: 21th. week.

Bone Development↗

PubMed1997

Ultrastructural investigation of calcification and ossification in experimental fracture healing with special reference to osteogenic role of fibroblasts.

OBJECTIVE: To investigate ultrastructurally the process of calcification and ossification in experimental fracture healing. METHODS: A standardized fracture of the radius was made in rabbits. Undecalcified callus tissues from different fracture regions were subjected to ultrastructural observation under transmission electron microscope. RESULTS: In the mitochondria and membrane-bound vesicles of the fibroblasts, osteoblasts and chondrocytes, high electron density calcium granules were seen. These granules provided raw materials for the deposition of calcium salt crystals. Around these cells, round, oval or irregularly shaped matrix vesicles could also be discerned, and they became calcified and formed flocculent calcospherules. Then in the Type I collagen fibrils around the fibroblasts and osteoblasts, and in the Type II collagen fibrils around the chondrocytes, calcium salt crystals also appeared. Innumerable flocculent calcospherules and calcified collagen fibrils coalesced together, expanded and finally turned into pieces of bone tissues. The fibroblasts also possessed the indispensable prerequisites for calcification and ossification in fracture healing. They either transformed into osteocytes or degenerated, perished and eventually were replaced by bone tissues. CONCLUSIONS: Sequence of events taking place in calcification and ossification in experimental fracture healing was depicted. Calcification of matrix vesicles and collagen fibrils triggered these processes. Evidence of osteogenic role played by fibroblasts was provided.

Animals↗

PubMed1976

Postoperative heterotopic ossification in patients with ankylosing hyperostosis on the spine (Forestier's disease).

Heterotopic ossification following hip surgery occurred in three patients with ankylosing hyperostosis of the spine. No technical difficulty during surgery was encountered in these individuals. The occurrence of this postoperative complication, coupled with the appearance of bony outgrowths at sites of ligament attachment throughout the axial and extra-axial skeleton in patients with ankylosing hyperostosis of the spine, suggests the presence of an underlying ossifying diathesis, diffuse idiopathic skeletal hyperostosis (DISH). A significant number of patients with DISH possess the second segregant series antigen, HLA-B27, a feature they share with individuals with other arthropathies characterized by abundant ossification; this gene may be closely related to one which influences bone formation. The possible association of postoperative heterotopic ossification and ankylosing hyperostosis of the spine indicates that a radiographic examination of the vertebral column in patients undergoing hip surgery may be a useful screening procedure.

Aged↗

PubMed2026

Ossification variants of the distal femoral condyle: longitudinal 3 T MRI evidence of progression to juvenile osteochondritis dissecans in asymptomatic siblings of patients with JOCD.

OBJECTIVE: Ossification variants (OVs) of the femoral condyles are traditionally regarded as benign developmental findings distinct from juvenile osteochondritis dissecans (JOCD). We aimed to characterize the longitudinal MRI behavior of OVs and JOCD lesions in asymptomatic siblings of JOCD patients. MATERIALS AND METHODS: In this HIPAA-compliant longitudinal pilot study, seven asymptomatic siblings of JOCD patients underwent serial 3 T bilateral knee MRI. Two fellowship-trained musculoskeletal radiologists independently assessed 56 studies for bone marrow edema, lesion location, and MRI-defined category (OV or JOCD). RESULTS: OV and MRI-defined JOCD lesions were identified in 21 of 28 condyles (75%, 95% CI: 56.6-87.3%), while 7 condyles (25%, 95% CI: 12.7-43.4%) remained normal throughout follow-up. Six condyles demonstrated MRI-defined JOCD lesions at one or more timepoints. Three OV lesions evolved over time: two progressed to MRI-defined JOCD but remained clinically silent, and one progressed from OV to MRI-defined JOCD and subsequently to clinically manifest JOCD requiring surgery. Using Generalized Linear Mixed model, a statistically significant association was found between bone marrow edema and MRI-defined category (F = 31.73, p < 0.001). OV lesions showed absent or trace edema, whereas JOCD showed definite edema. Inter-reader agreement using Cohen's Kappa was moderate to substantial between the radiologists (κ = 0.479-0.739, 95% CI: 0.314-0.633, 0.644-0.845, p < 0.001). CONCLUSIONS: In siblings of patients with JOCD, OV lesions are common and may represent dynamic MRI phenotypes along a continuum of epiphyseal ossification abnormalities, with occasional progression to MRI-defined JOCD and rare progression to clinically manifest JOCD.

Humans↗

PubMed1998

Surgical treatment for ossification of the posterior longitudinal ligament and the yellow ligament in the thoracic and cervico-thoracic spine.

This study analyzed the postoperative results of surgical treatment for thoracic and cervicothoracic myelopathy caused by ossification of the posterior longitudinal ligaments (OPLL) or ossification of the yellow ligaments (OYL) in 22 patients using magnetic resonance imaging (MRI), myelography and computed tomography (CT). Anterior procedures were performed in 11 patients for OPLL, while posterior approaches were adopted for the management of 11 patients for both OYL and OPLL combined with OYL lesions. Clinical symptoms were improved using both anterior and posterior techniques. MRI and myelo-CT studies, which show the direction of cord compression, the form and extent of the lesion, and the degree of thoracic kyphosis, are very useful when the surgical procedure for OPLL and OYL in the thoracic and cervico-thoracic spine is selected.

Adolescent↗

PubMed1998

Long-term follow-up results of laminectomy for cervical myelopathy caused by ossification of the posterior longitudinal ligament.

OBJECT: This retrospective study was performed to assess the long-term results of cervical laminectomy in treating ossification of the posterior longitudinal ligament (OPLL) of the cervical spine. METHODS: The authors reviewed medical records in 44 of 52 patients who underwent cervical laminectomy between 1970 and 1985 (mean follow up 14.1 years). The neurological recovery rate after laminectomy was 44.2% after 1 year and 42.9% after 5 years. The surgical outcome was maintained after 5 years but worsened between 5 and 10 years postsurgery: the recovery rate at the last follow-up review was 32.8%. Using multivariate stepwise analysis, the preoperative factors that affected clinical results were found to be the age at operation, the severity of preexisting myelopathy, and a history of trauma. Late neurological deterioration was observed in 10 (23%) of 44 patients. The earliest deterioration occurred at 1 year and the latest was at 17 years postsurgery (mean 9.5 years). The most frequent cause of deterioration was trauma due to a fall (six patients), followed by ossification of the ligamentum flavum (three patients). Postoperative spread of the OPLL was noted in 70% of the patients, but it was clearly the cause of neurological deterioration in only one of them. After laminectomy, postoperative progression of kyphotic deformity was observed in 47% of patients, but these changes did not cause neurological deterioration. CONCLUSION: The authors recommend early surgical decompression for OPLL because the outcome is better for younger patients and for those with a higher score as measured by the Japanese Orthopedic Association's system.

Accidental Falls↗

PubMed1978

Symptomatic ossification of the pterygomandibular raphe.

A case of symptomatic ossification of the pterygomandibular raphe, believed to be the first reported case of such an entity, was relieved by surgical removal of the ossified tissue. Ossification of the pterygomandibular raphe should, in the future, be considered in the differential diagnosis in cases of obscure lateral pharyngeal pain.

Humans↗

PubMed1997

BMPs induce endochondral ossification in rats when implanted ectopically within a carrier made of fibrous glass membrane.

BACKGROUND: Bone morphogenetic proteins (BMPs) replicate the process of embryonic bone formation when implanted in ectopic sites. Our previous studies have indicated that BMPs can induce intramembranous ossification, i.e., direct bone formation without preexisting cartilage when implanted in rats subcutaneously by using the fibrous collagen membrane (FCM) as a carrier for implanting BMPs (Sasano et al. 1993. Anat. Rec., 236:373-380). The present study was designed to investigate how the physicochemical property of the carrier material influences the process of bone formation induced by BMPs, using a carrier made of fibrous glass membrane (FGM). METHODS: BMPs, partially purified from bovine metatarsal bones, were added to an FGM carrier and implanted subcutaneously in rats. The implants were analyzed at weekly intervals, and the osteogenic process induced by BMPs was examined by histology and immunohistochemistry for cartilage and bone formation. RESULTS: Neither cartilage nor bone were observed after week 1. Cartilage formation occurred within the carrier after week 2, although no bone formation was seen. The cartilage matrix showed immunoreactivity for types II, X, and I collagen. Bone was induced on the previously formed cartilage after week 3. The bone matrix stained with anti-osteocalcin antibody and with anti-type I collagen antibody. The cartilage was replaced by bone and bone marrow after week 10. CONCLUSIONS: BMPs cause endochondral ossification when administered with an FGM carrier. The physicochemical property of the carrier may be involved in the BMP-induced phenotype expression of bone and cartilage.

Animals↗

PubMed2003

Apoptosis of terminal hypertrophic chondrocytes in an in vitro model of endochondral ossification.

It is widely accepted that growth plate chondrocytes undergo apoptosis when they reach the terminal hypertrophic stage of their differentiation during the process of endochondral ossification in vivo. In this report, an established chondrocyte cell culture model of mammalian endochondral ossification was utilized to investigate the fate of chondrocytes after they had entered hypertrophy in vitro. Fetal bovine epiphyseal chondrocytes were treated with the demethylating agent, 5-azacytidine, for 48 h and then cultured under azacytidine-depleted conditions. There was evidence for apoptosis in azacytidine-treated cells, as demonstrated by nuclear condensation and fragmentation (days 27 and 35) using transmission electron microscopy, and the detection of exposed phosphatidylserine on the plasma membrane surface of apoptotic chondrocytes (day 27) using fluorescence-labelled annexin V. Treated cultures on days 10 and 20 and untreated cultures at all corresponding time-points showed no morphological characteristics of apoptosis. In situ hybridization studies of treated cultures revealed that expression of the apoptotic suppressor, bcl-2, remained consistently high throughout the culture period, whilst the apoptotic inducer, bax, was not expressed until day 23. Quantification of these data showed a gradual shift in the ratio of the expression level of bcl-2 and bax in favour of bax with time in culture, particularly from day 23 onwards. Taken together, the results indicate that azacytidine-treated epiphyseal chondrocytes entered terminal hypertrophy from day 23 onwards in culture and died by apoptosis. This study confirms this culture system as a successful recapitulation of the entire mammalian chondrocyte differentiation pathway, including apoptosis. The culture model will prove valuable for studies of the apoptotic fate of terminally differentiated chondrocytes in the growth plate with a view to providing a better understanding of the underlying mechanisms of skeletal malformations and other pathological disorders such as osteoarthritis.

Animals↗

PubMed1992

Bilateral ankylosis of the hips following heterotopic ossification of the ilio-psoas in a child.

A case of bilateral ankylosis of the hip in a 3-year-old child due to heterotopic ossification of the iliopsoas following a long period of coma is presented. A review of the literature has failed to reveal a similar case with such extensive heterotopic ossification. The patient was treated successfully by surgical excision of the heterotopic bone which was extra-articular and extra-capsular and involved only the iliopsoas muscles.

Ankylosis↗

PubMed1990

[Effect of a calcium inhibitor, verapamil, on the development of heterotopic ossifications. An experimental study in rats].

After division of the tendo achilles in rats heterotopic bone forms in the muscle and in the tendon stumps. Tenotomy was performed in 26 male rats. Thirteen received Verapamil (36 mm/Kg) for six days per week for five months, and the remainder were not given this drug. The onset of heterotopic ossification was monitored by monthly x-rays. After five months the animals were killed and the sectioned tendons examined microscopically. The radiographs had shown that the amount of ossification was less in rats treated with Verapamil. This was confirmed at microscopy, but examination of the sections under polarised light showed that the ratio of lamellar to woven bone was the same in the two groups. Verapamil appeared to reduce the amount of heterotopic bone formation but did not influence the substitution of woven by lamellar bone.

Achilles Tendon↗

PubMed1995

Osteoplastic laminoplasty for cervical myeloradiculopathy secondary to ossification of the posterior longitudinal ligament.

Forty-seven patients with cervical myeloradiculopathy due to ossification of the posterior longitudinal ligament were treated by laminoplasty. The spinal canal from C3 to C7 was opened en bloc unilaterally and a spacer bone graft inserted to separate the floating laminae. The average follow up was 7.3 years (range 5 to 11 years). Favourable results were obtained in 35 patients and even though they had serious postoperative symptoms those with advanced neurological symptoms before operation showed considerable improvement. Late results were poor in patients who had greater than 50% compromise of the spinal canal by the ossified lesion. Laminoplasty is a safer method of obtaining favourable late results in patients with involvement of more than 3 vertebrae, but in those with a more severe compromise of the spinal canal by ossification, additional anterior decompression may be necessary later.

Adult↗

PubMed1994

Anterior decompression and fusion for cervical myeloradiculopathy secondary to ossification of the posterior ligament.

The authors reviewed 85 patients who had undergone anterior decompression and cervical fusion for myeloradiculopathy due to ossification of the posterior longitudinal ligament. There were 72 males and 13 females; the average follow up was for 8.3 years. Sixteen patients (group I) underwent one vertebra subtotal spondylectomy with fusion, 58 (group II) two vertebra subtotal spondylectomy, and 11 (group III) three vertebra subtotal spondylectomy. Neurological recovery was assessed on the grading system of the Japanese Orthopaedic Association. The patients in group I had an average improvement of 75%, in group II 72% and in group III 23%. The severity of compromise of the spinal cord did not affect the postoperative improvement. Duration of disease, previous injury and advanced neurological symptoms all affected neurological recovery. Spondylectomy of at most two vertebrae, with fusion, is recommended for ossification of the posterior longitudinal ligament. If there is more extensive involvement laminoplasty may be indicated.

Cervical Vertebrae↗

PubMed1994

Peculiar structures of the blood vessels forming the secondary ossification center in the rat femoral heads.

To investigate the development of the blood vessels forming the secondary ossification center in the femoral heads of growing rats, we observed the specimens of the proximal femurs having vascular casts using both an optical and a scanning electron microscopy (SEM). Histologically, the vascular invasion occurred from the lateral part of the cartilaginous epiphysis, prior to the appearance of the ossification center. The vascular casts were prominent within the cellular spaces consisting of a few hypertrophic chondrocytes. The SEM study suggested that the vascular buds had peculiar structures and invaded the cartilaginous epiphysis by breaking through the cellular spaces. The blood vessels budded out from the arch of the lateral epiphyseal vessels toward the femoral heads. The sizes of the large-caliber vascular buds of about 50 microns in diameter were similar to those of the cellular spaces, and they penetrated into the epiphysis by repeated merging and branching. Many deep impressions were noted on the surface of the vascular buds, and the tips showed the peculiar shape similar to a suction cup.

Animals↗

PubMed1982

Ossification of the posterior longitudinal ligament after cervical irradiation.

A case of ossification of the posterior longitudinal ligament (PLL) at the cervical level one year after cervical irradiation is reported. This condition is rare in Caucasian people. The cause is unknown. The particular circumstances of ossification occurrence in the case reported allow us to propose a new etiological hypothesis.

Adult↗