Evidence of weight loss in junior female judo athletes affects their development.

Purpose: The facile manipulation of body weight in junior athletes has the potential to pose significant risks to their lifelong health. In judo, which is a weight class sport, pre-competition weight loss is widespread even among juniors, but information on the current situation is scarce, especially for female athletes, for whom it is important to provide adequate nutrition and enhance bone mass during the growth period, and the details of the current situation are not clear. Therefore, the purpose of this study was to determine the actual weight loss during the growth period in junior female judo athletes and its subsequent impact on their health. Methods: The survey was a cross-sectional survey of junior female judo athletes in Japan using a questionnaire. Participants were asked to respond via an online questionnaire about their weight, height, weight loss experience, menstruation, competition results, and other lifestyle. Results: 51.8% of subjects experienced weight loss for competition during their junior high school years (ages 12-15). Those who experienced weight loss during secondary sexual characteristics were found to be significantly shorter in current height than those who did not (p < 0.05). Weight loss during secondary sexual characteristics did not affect current menstrual cycle. There was no significant difference in competition results due to the experience of weight loss during junior high school (χ 2 = 4.485, df = 3, n.s.). Conclusions: These findings suggest that weight loss during the growth spurt phase may adversely impact normal development. It also suggested that weight loss during the junior high school years may not be a strategy to bring about better competition results. These observations indicate the need for education on appropriate class selection and weight control for junior athletes in weight class competitions.

Anatomical variations in the tendon sheath of the first compartment.

Using Hiranuma's classification, we carefully examined anatomical variations in the first compartments of 246 human wrist joints from 124 cadavers. Morphological examinations were conducted to determine the number of accessory tendons and the existence of dissepiments for the extensor pollicis brevis (EPB) and abductor pollicis longus (APL) tendons. Anatomical variations of EPBs and APLs were grouped together by type, and appearance ratios were calculated based on Hiranuma's classification. Of the 246 wrist joints, 156 were categorized as normal type (63.4%), 57 as complete dissepiment type (23.2%), 22 as incomplete dissepiment type (8.9%), and 11 as EPB-lacking type (4.5%). Accessory tendons were identified in both the EPB and the APL tendons of most cadavers, and the incidence of dissepiment in tendon sheaths was approximately 33%. Sixty-six of the 193 wrist joints (34.2%) showed equal numbers of right and left accessory tendons. However, the number of EPB accessory tendons was higher than in previous studies, and in all cases some kind of dissepiment was observed in the APL and EPB. The number of EPB and APL accessory tendons showed no clear differences by gender, age, or right and left specificity.

Time-lapse observation of rat periodontal ligament during function and tooth movement, using microcomputed tomography.

The aim of this study was to observe the time-lapse changes in the rat periodontal ligament (PDL) during function and tooth movement. Under Nembutal anaesthesia, time-lapse changes in the thickness of the PDL of the first molars were investigated in five 12-week-old adolescent rats with microcomputed tomography. Three-dimensional (3D) images were reconstructed from the data. Histological observation was also performed, using undecalcified frozen sections of the maxillary first molar area. The PDL appeared as a radiolucent furrow on the 3D images. A slight change in the thickness of the PDL was observed 1 hour after initiation of orthodontic force loading, which became significant after 6 hours, with the appearance of pressure-tension zones during the tooth movement. These changes were more significant 3 days after orthodontic loading. Histological observation of the lingual cervical PDL (pressure zone) in nine 12- to 13-week-old rats demonstrated that the periodontal space had become narrow and the cellular elements appeared to be densely packed in the narrowed PDL 6 hours after orthodontic loading. Degeneration of tissues appeared 3 days after loading. Observation of the buccal cervical PDL (tension zone) demonstrated that the PDL was extended 6 hours after orthodontic force loading, and the extension continued for up to 3 days. Alkaline phosphatase activity was distributed in the PDL, except for the degenerating tissues in the pressure zone 3 days after loading. The results suggest that the periodontal reaction was initiated within 6 hours after orthodontic force loading, which was related to the structural changes of the PDL. The changes probably induced an early response in individual cells of the PDL.

Bone union of painful bipartite patella after treatment with low-intensity pulsed ultrasound: report of two cases.

We report two cases of painful bipartite patella in which bone union was achieved after treatment with low-intensity pulsed ultrasound. Both patients were 13-year-old males. Each received ultrasound (SAFHS, EXOGEN) for 20 min a day. The interval between the onset of pain and ultrasound treatment was between 2 and 4 months. The patellar pain disappeared within two months after treatment in both cases. Bone union was seen radiographically at 4 months. Low-intensity pulsed ultrasound is a non-invasive treatment that appeared to be helpful in the management of two patients with painful bipartite patella.

Relationship between osteochondritis dissecans of the lateral femoral condyle and lateral menisci types.

The purpose of this study was to examine the relationship between osteochondritis dissecans (OCD) of the lateral femoral condyle and lateral menisci. From 1993 to 2002, 38 knees (28 patients) were diagnosed with OCD of the lateral femoral condyle. OCD locations were graded by the Cahill and Berg classification. The types of lateral menisci were classified by Watanabe's classification. The relationship between OCD of the lateral femoral condyle and lateral menisci was examined. On the anterior-posterior view, 25 OCDs were located in zone 4 and 13 in zone 5. The types of lateral menisci were complete discoid in 19 knees, incomplete discoid in 15, and normal in 4. Ten of the 19 complete discoid menisci were damaged. Complete discoid menisci without tears were found in OCDs located in zone 4; incomplete discoid menisci were found in OCDs located in zone 5. The authors found a relationship between the type of OCD and the state of the lateral meniscus.

Effective repair of a fresh osteochondral defect in the rabbit knee joint by articulated joint distraction following subchondral drilling.

PURPOSE: Joint distraction has been used to treat osteoarthritis and was found to delay the need for arthrodesis or joint replacement. However, there has been little basic research on articulated joint distraction for the repair of osteochondral defects. We investigated the effects of joint distraction with motion after drilling on a fresh osteochondral defect in the weight bearing area of the rabbit knee joint. METHODS: A full thickness osteochondral defect was created in the weight bearing area of both medial femoral condyles of an adult Japanese white rabbit. After drilling of the defect, the experimental knee joint was distracted for 1.5 mm using a pair of external fixators to decrease compression force. The contralateral knee joint was used as a control with no apparatus. Gross findings and histological evaluation were assessed to study morphology of the repaired cartilage. RESULTS: A partial repair with cartilage-like tissue was observed in the joints of the experimental group at 4 weeks. While cartilage-like tissue stained with Safranin O was found in the experimental group at 8 and 12 weeks, destructive changes were observed in the control joints. Morphological changes were evaluated using the histological grading scale [Wakitani S, Goto T, Pineda SJ, et al. Mesenchymal cell-based repair of large, full-thickness defect of articular cartilage. J Bone Joint Surg Am 1994;76(4):579-92]. There was no significant difference between experimental and control groups at 4 weeks (mean 11.2 and 13.8 points, respectively). However, the mean scores of the experimental groups at 8 and 12 weeks (mean 6.8 and 7.5, respectively) were significantly better than those of the control groups at the same time points (mean 14 points each). Between the experimental groups, the scores at 8 and 12 weeks were both significantly better than those at 4 weeks. CONCLUSION: A combination of subchondral drilling, joint motion and distraction by an articulated external fixator promoted repair of a fresh osteochondral defect in the weight bearing area. Although distraction for 4 weeks was not a long enough period to repair the defect, distraction for 8 and 12 weeks resulted in a good outcome.

Osteochondritis dissecans of the talus treated by the transplantation of tissue-engineered cartilage.

Management of osteochondral lesions of the joint has been difficult, because articular cartilage has a poor healing capacity as a result of its lack of vessels, nerve supply, and its isolation of systemic regulation. Although a lot of basic research and surgical treatments for cartilage repair have focused on osteochondral lesions in the knee joint, orthopedic surgeons have recently diverted their attention to osteochondral lesions in the ankle joint, partly because of the widespread introduction of arthroscopy in ankle surgery. There have been many attempts to treat articular cartilage defects in the ankle joint as well as in the knee joint. However, no treatment has achieved efficient healing with hyaline cartilage. Recently, tissue engineering technique for cartilage repair has been gaining much attention in the orthopedic field. In this study, we reported on a patient with osteochondritis dissecans of the talar dome, successfully treated by transplantation of tissue-engineered cartilage made ex vivo using atelocollagen gel and low tibial osteotomy.

The complete type of suprapatellar plica in a professional baseball pitcher: consideration of a cause of anterior knee pain.

Abstract We report the case of a professional baseball pitcher who achieved complete relief of an anterior knee pain after resection of a complete type of suprapatellar plica under arthroscopy. The 27-year-old male professional baseball pitcher had complained of right anterior knee pain while pitching for more than 2 years. On physical examination, the mobility of his patella was limited and he complained of tenderness along the joint line of his lateral patellofemoral joint. The preoperative patellofemoral axial radiograph showed osteophyte formation on the lateral edge of the patella. On preoperative magnetic resonance imaging, a septum dividing the suprapatellar pouch was found. Arthroscopy revealed obvious cartilaginous damage on the lateral facet of the patella and facing trochlea of the femoral condyle. There was a complete type of suprapatellar plica. The suprapatellar plica seemed to be anchoring the patella, which reduced the mobility of the patella. After resecting the complete type of suprapatellar plica under arthroscopy, the mobility of the patella was improved. Because his anterior knee pain while pitching reduced rapidly postoperatively, he could return to regular baseball. We consider that the main cause of his anterior knee pain was cartilaginous damage on the patella and the trochlea, which might be accelerated by the existence of the suprapatellar plica that reduced the mobility of the patella.

Dental incremental lines in Sika deer (Cervus nippon); polarized light and fluorescence microscopy of ground sections.

Periodic growth incremental lines are found universally in dental hard tissues. This periodicity theoretically allows for estimation of age, even in days, which would be useful in studies of wild animals. In the present study, enamel and dentin increments of the sika deer (Cervus nippon) were observed in ground sections with a polarized light microscope, and their periodicity was examined by the use of a chronological labeling method with fluorochromes. Enamel increments occurred at a mean interval of 10.6 (SD=1.5) microm, and mean spacing of dentin increments was 17.3 (SD=1.8) microm. Fluorochromic marking revealed that incremental lines form each day in enamel and almost every second day in dentin. The fluorescence-labeled lines suggest that enamel formation of the first molar is complete by the age of 5 months. Due to its longer interval of incremental lines and longer term of formation, we conclude that dentin is more suitable than enamel for day-age estimation in sika deer. Experimental confirmation of incremental growth periodicity in various species can improve the reliability of use of tooth increments for age estimation and life history reconstruction.

Role of the periosteal flap in chondrocyte transplantation: an experimental study in rabbits.

To determine the role of the periosteal flap in chondrocyte transplantation for the treatment of articular cartilage defects, a cartilage defect was created on the patellar groove of the rabbit knee. The defect was filled with chondrocytes cultured in collagen gel, and was covered with a periosteal flap the cambial layer of which was facing the patella (P group), or facing down against the bone marrow (M group). The same defect was covered with a periosteal flap that was frozen and thawed three times (F group), and an artificial collagen film (C group). At 3 and 6 months, the defects were filled with reparative tissues that showed a smooth surface and resembled hyaline cartilage in the P, M, and F groups. There were no significant differences between the reparative tissues in the three groups histologically, immunohistochemically, biochemically, and biomechanically, although the collagen film fell down into the defect and the reparative tissue had a fibrous tissue-like appearance. These results showed that the periosteal flap does not have a beneficial humoral or cellular effect on the formation of reparative tissue, suggesting that the periosteal flap might act as a mechanical barrier to prevent leakage of grafted chondrocytes.

Phosphatidylinositol-dependent bond between alkaline phosphatase and collagen fibers in the periodontal ligament of rat molars.

Alkaline phosphatase (ALP) is anchored to the outer leaflet of the lipid bilayer via phosphatidylinositol (PI) and ALP activity has been localized in the plasma membrane of numerous tissues. In the periodontal ligament ALP activity is found in the collagen fibers in addition to the plasma membrane of the osteoblasts and fibroblasts. In this study, we examined the distribution of ALP activity in the periodontal ligament of rat molars and also examined whether the bond between ALP and collagen fibers is dependent on PI by using phosphatidylinositol-specific phospholipase C (PI-PLC). ALP activity was distributed in the periodontal ligament. The activity mirrored the distribution of collagen fibers in the periodontal ligament. Cytochemical analysis also demonstrated that ALP activity was located not only in the plasma membrane of fibroblasts, but also in the collagen fiber bundles and fibrils in the periodontal ligament. After treatment with PI-PLC, the loss of ALP activity in the periodontal ligament was observed histochemically, and the loss of ALP activity in the fibroblasts as well as in the collagen fiber bundles and fibrils was observed cytochemically. These results strongly indicate that the bond between ALP and the collagen fibers is also dependent on PI.

Drilling from the intercondylar area for treatment of osteochondritis dissecans of the knee joint.

We demonstrate a new method in which a drilling is made from the intercondylar space, and its efficacy in treating osteochondritis dissecans (OCD) of the knee in skeletally immature patients with relatively stable lesions with an intact articular surface, in cases where there was failure of initial non-operative management. The lesions of 16 knees of 12 patients with OCD of the femoral condyles failed to heal by conservative treatment for more than 3 months (average 5-6 months) and thereafter were arthroscopically treated with drilling from not the transarticular but the intercondylar bare area without damaging the articular surface. Eight lesions involved the medial femoral condyle, and eight involved the lateral femoral condyle. The average follow-up was 16 months. All lesions healed after drilling, and the average time of healing was 4 months by X-ray and 7 months by MRI. The average Lysholm score improved from an average of 70.4 points at preoperation to an average of 97.8 points after operation. The results of the Hughston Rating Scale were similar: 10 of the 12 patients showed excellent results and the remaining two patients good results. We advocate our new and less invasive procedure of drilling from the bare area of the intercondylar space for OCD in the knee joint of skeletally immature patients who have had failure of initial non-operative management.

Calcification of degenerating tissues in the periodontal ligament during tooth movement.

OBJECTIVE: Calcification of degenerating tissues in the periodontal ligament (PDL) during tooth movement was investigated longitudinally. MATERIALS AND METHODS: Upper first molars of male Wistar rats were moved lingually for 1, 7 and 21 d, following which unfixed undecalcified sections of the lingual PDL (in the pressure zone) were examined histologically, histochemically (autoradiography and electron probe microanalysis). RESULTS: On d 1 of tooth movement, degenerating tissues, together with some calcified particles, were visible in the pressure zone of the lingual PDL. On d 7, substantial calcified aggregations were seen in the degenerating tissues, predominantly situated between the bone and root. This was confirmed by the 45Ca autoradiography. On d 21 of tooth movement, large calcified aggregations were still clearly evident between the bone and root. CONCLUSIONS: This calcification of the degenerating tissues is a self-defense response of the living body to prevent direct contact between alveolar bone and the tooth root during compression of the PDL, so preventing friction between them and the development of ankylosis.

Determination of time of biologic fixation after anterior cruciate ligament reconstruction with hamstring tendons.

BACKGROUND: It has been unclear when a hamstring tendon graft becomes biologically fixed in the bone tunnel after anterior cruciate ligament reconstruction. HYPOTHESIS: Postoperative biomechanical testing and magnetic resonance images can indicate biologic fixation of the graft in the femoral bone tunnel. STUDY DESIGN: Prospective cohort study. METHODS: Sixty-four patients were evaluated by serial biomechanical testing, magnetic resonance imaging, and second-look arthroscopy 2 years after surgery. Biologic fixation of the graft was confirmed radiographically by injecting a contrast medium into the femoral bone tunnel. RESULTS: Forty-two stable knees with graft fixation maintained a high stiffness (120% of normal) and showed low signal intensity in an early postoperative magnetic resonance image (12 +/- 8 months). Fourteen stable knees without graft fixation had gradually increased anterior displacement with nearly normal stiffness and high signal intensity. Five unstable knees with graft fixation retained low stiffness (70%) and showed late low signal intensity at 20 +/- 9 months. Three unstable knees without biologic fixation had rapidly increased anterior displacement, with half the stiffness of a normal knee. CONCLUSION: Postoperative low stiffness and high signal intensity might indicate late biologic graft fixation, predicting a possibility of postoperative anterior knee instability.

Results of rasping of meniscal tears with and without anterior cruciate ligament injury as evaluated by second-look arthroscopy.

PURPOSE: Meniscal rasping without suturing has been experimentally shown to stimulate vascular induction in tears in the avascular zone of menisci, resulting in meniscal healing. The goals of this study were to arthroscopically assess the results of meniscal rasping and analyze the factors affecting meniscal healing. TYPE OF STUDY: Retrospective cohort study. METHODS: Forty-eight torn menisci in 47 patients (age range, 14-47 years; average, 24 years) treated arthroscopically with the meniscal rasping technique were evaluated by second-look arthroscopy. The interval between the injury and the time of surgery ranged from 3 weeks to 13 years. There were 35 lateral and 13 medial meniscal tears associated with 44 anterior cruciate ligament injuries; 28 of the menisci had a full-thickness longitudinal tear and the other 20 had a partial-thickness tear. The length of the tears ranged from 10 to 33 mm (mean, 14.4 mm). The distance from the capsule to the tear ranged from 1 to 9 mm (mean, 5.0 mm). RESULTS: Thirty-four menisci (71%) healed completely (without a marked visible unhealed area), 10 (21%) healed incompletely, and 4 (8%) showed no evidence of healing. There were no relationships between outcome and age, gender, injured side, or time from injury and rasping. Both the distance from the capsule to the tear and the length of the tear were longer in the unhealed menisci. Stable tears had a high healing rate after meniscal rasping. CONCLUSIONS: Meniscal rasping without suturing is an easy procedure to perform and seems to be a reliable way to repair longitudinal tears in the avascular region of the meniscus, although the healing potential of the procedure is affected by the distance from the capsule to the tear site and the length and the stability of the tear.

Optimum combination of monolayer and three-dimensional cultures for cartilage-like tissue engineering.

The autologous chondrocyte transplantation technique has been introduced for the repair of articular cartilage defects. The advantage of transplanting chondrocytes cultured in suspension includes the in vitro expansion of cell numbers. However, the disadvantages include the potential leakage of cells from defects, dedifferentiation of cellular phenotype, and uneven distribution of cells. Transplantation of chondrocytes cultured in collagen gel resolves those problems. However, the expansion of cells in three-dimensional culture is more difficult than in monolayer culture, and for practical reasons only limited numbers of chondrocytes can be obtained from an unloaded area of the knee. To develop a method for the production of high-quality cultured grafts, we investigated the combination of monolayer culture for cell expansion and three-dimensional culture for maintenance of cell phenotype. Articular chondrocytes from rabbits were divided into four groups, exposed to various combinations of culture conditions, and cultured for a total of 3 weeks. Each group was evaluated histologically, biochemically, and biomechanically. Our findings showed that the combination of 2 weeks of monolayer culture followed by 1 week of three-dimensional culture resulted in the highest chondroitin sulfate levels, sufficient cell numbers, and adequate stiffness of the chondrocyte-collagen composites, giving optimal graft preparation.

Effects of cell density on proliferation and matrix synthesis of chondrocytes embedded in atelocollagen gel.

The effects of cell density on the proliferation and chondroitin sulfate synthesis of chondrocytes embedded in Atelocollagen gel were examined. Chondrocytes of 21 10-week-old Japanese white rabbits isolated by collagenase digestion were embedded in Atelocollagen gel and cultured in Dulbecco's modified Eagles medium at cell densities of 2 x 105 cells/ml (105 group), 2 x 106 cells/ml (106 group), and 2 x 107 cells/ml (107 group) for 4 weeks. Chondrocytes in the 105 group gradually proliferated more than the other two groups. In contrast, most chondrocytes in the 107 group showed increased capability to produce chondroitin 6-sulfate. Cartilage-like tissue was produced from high-density cultures (107 cells/ml), although a decrease in cell number was seen. Even in three-dimensional cultures, the proliferation and chondroitin sulfate synthesis of chondrocytes were influenced by the cell density. These results are informative for the clinical application of chondrocyte transplantation in three-dimensional cultures for cartilage repair.

Compensatory bone formation in young and old rats during tooth movement.

The aim of this study was to investigate compensatory lingual alveolar bone formation during tooth movement in young and old rats, using the vital bone marker tetracycline. Wistar male rats were separated into the following groups: 13-week-old rats without appliances (13C: control, n = 5), 60-week-old rats without appliances (60C: control, n = 5), 13-week-old rats with appliances (13E: experimental, n = 10), and 60-week-old rats with appliances (60E: experimental, n = 10). The upper first molars of the 13E and 60E groups were moved lingually using fixed appliances. On the third day of tooth movement, tetracycline (TC) was intra-peritoneally injected in all animals including the controls. On the 21st day of tooth movement, the animals were killed and unfixed, and undecalcified, 5-microm frozen frontal sections of the rat first molar areas in both control and experimental groups were examined under light and fluorescent microscopes. In the 13C group without tooth movement, tetracycline labelling lines were obvious in the alveolar crest, apical areas, and interradicular septum, indicating vertical alveolar bone growth. However, in the 60C control group, tetracycline labelling was almost undetectable throughout the alveolar bone. Although the lingual alveolar crest was resorbed from the periodontal side after lingual tooth movement, the sharp, bright labelling lines were still present from the crest to the lingual periosteal alveolar bone in the 13E group. In the 60E group the lines appeared in the lingual periosteal alveolar bone containing the crest, indicating considerable new bone formation. The results indicate that compensatory bone formation occurs in the alveolar crest area and, consequently, alveolar bone height is maintained, even in aged rats.

Application of thermography in dentistry--visualization of temperature distribution on oral tissues.

The purpose of this study was to devise and propose appropriate conditions for the photographing of thermal images in the oral cavity and to evaluate which thermography techniques can be applied to dentistry by evaluating the differences in temperature among oral tissues. Thermal images of oral cavities of 20 volunteers in normal oral condition were taken according to the guidelines of the Japanese Society of Thermography, with five added items for oral observation. The use of a mirror made it possible to take thermal images of the posterior portion or palate. Teeth, free gingiva, attached gingiva and alveolar mucosa were identified on thermal images. There were differences in temperature between teeth, free gingiva, attached gingiva and alveolar mucosa. These were nearly in agreement with the anatomical view. Thermography need no longer be restricted to the anterior portion using a mirror, and can now be applied to the dental region.

A new surgical technique for treating bilateral Freiberg disease.

Freiberg disease is relatively rare and difficult to treat satisfactorily. We describe a new surgical technique of osteochondral plug transplantation for late-stage Freiberg disease that may restore normal function to the metatarsophalangeal joint. In the present series, we performed osteochondral plug transplantation to treat a stage IV lesion, according to Smillie's classification, by harvesting an osteochondral plug from the non-weight-bearing site on the upper lateral femoral condyle of the ipsilateral knee. We also treated a stage II lesion using retrograde drilling. One year after surgery, the patient had no pain when running and returned to full athletic activity. The clinical and morphologic results were excellent. Arthroscopic intervention produced good results in the early stages and osteochondral plug transplantation may be an excellent surgical procedure to restore normal function to the metatarsophalangeal joint in the later stages of Freiberg disease.