J ISAKOS. 2025 Apr 25:100869. doi: 10.1016/j.jisako.2025.100869. Online ahead of print.

ABSTRACT

INTRODUCTION: Increased knee posterior tibial slope (PTS) angle elevates anterior cruciate ligament (ACL) strain and ACL injury risk. Adult biomechanical research indicates that decreasing the PTS may reduce ACL injuries. Younger patients have much higher risk of ACL injury than adults, with limited anatomic research on tibial slope. The purpose of this study is to evaluate the pediatric medial and lateral PTS in a larger cohort group than prior research.

METHODS: 83 CT scans of the knee from children aged <2 to 11 were evaluated using OsiriX imaging software. The PTS was evaluated at two distinct points on sagittal CT sections: (1) At the medial and 2) lateral tibial plateaus, both aligned with the central part of the coronal view of the femoral condyles.

RESULTS: The medial and lateral PTS demonstrated variability across ages <2 to 11, with mean values ranging from 3.6° ± 1.8° to 8.7° ± 5.3° for medial slopes and 5.1° ± 3.3° to 12.4° ± 3.6° for lateral slopes. The proportion of patients with at least one slope >10° peaked at age 8 (100%) and age 6 (67%). Simple linear regression revealed no statistically significant relationship between age and tibial slope for medial (coefficient of -0.07, p = 0.574, R2 = 0.004) or lateral slopes (coefficient of -0.08, p = 0.459, R2 = 0.007).

CONCLUSION: Corrective osteotomy of increased PTS to lower the risk of ACL injury may be performed in high injury risk adult patients. However, such invasive procedures are not recommended for the skeletal immature because osteotomy in the growth plates in the proximal tibia could induce growth disturbance. In a unique skeletally immature patient with high risk of recurrent ACL injury, guided growth might be an option in high risk for lowering PTS in a controlled manner. As younger patients have some of the higher risks of primary and recurrent ACL injury, future research in this area may offer another approach to lower the risk of these injuries.

LEVEL OF EVIDENCE: Level III.

PMID:40288755 | DOI:10.1016/j.jisako.2025.100869

Int J Legal Med. 2025 Apr 21. doi: 10.1007/s00414-025-03496-0. Online ahead of print.

ABSTRACT

The Suchey-Brooks (S-B) standard is one of the most frequently applied approaches for age-at-death estimation in modern forensic practice. However, classification accuracy is known to vary across different populations. At present, there is a paucity of research related to the assessment of biological attributes in Indonesia, particularly the estimation of age-at-death. The use of computed tomography (CT) in S-B phase assignments has been validated in the literature. In considering further validating the use of CT, transition analysis (TA), and Bayesian statistics in age-at-death estimation, this study evaluated the accuracy of the S-B standard on a sample obtained from Indonesia. TA and Bayesian statistics are incorporated to address methodological issues such as age mimicry. A total of 378 multi-slice CT scans were analysed in OsiriX®. TA and Bayesian statistics were used to derive age-at-death estimation models. Overall bias values were at - 6.0 years for females and - 13.1 years for males, while inaccuracy was at 9.6 years for females and 14.6 years for males. When applying the original S-B age ranges, 92.0% of females and 73.3% of males were correctly classified. Likewise, mean ages per S-B phase were higher in the Indonesian sample, except for females assigned to Phase VI. TA and Bayesian statistics derived age-at-death distribution models specific to the Indonesian population. The dissemination of an appropriate age-at-death estimation standard in the literature is of considerable benefit to casework conducted domestically in Indonesia, and also serves to further inform aspects of general forensic practice globally.

PMID:40254709 | DOI:10.1007/s00414-025-03496-0

J Orthop Surg Res. 2025 Apr 10;20(1):365. doi: 10.1186/s13018-025-05737-9.

ABSTRACT

BACKGROUND: Decreased size and mass of paraspinal muscles are associated with lower vertebral bone mineral density, more postoperative complications, increased mortality, and spinal sagittal imbalance. However, it is difficult to determine muscle loss in older adults with overweight and obesity. This study aimed to investigate the effects of body mass index (BMI) and central obesity on paraspinal muscle aging and to determine cutoff values for low paraspinal muscle mass/quality in Chinese community populations.

METHODS: In this nationwide cross-sectional study, abdominal CT scans and basic information were collected and analyzed from 4,305 community-dwelling adults from twelve representative cities in China between 2013 and 2017. Psoas and posterior paraspinal muscle index (PMI and PSMI) and density (PMD and PSMD) at the L3 level were measured using OsiriX software. Correlation analysis, multiple linear regression, and one-way ANOVA were performed for statistical analysis. Commonly used cutoff value calculations were applied to define low muscle index and density (Mean-2SD, 5th percentile in young people, and 20th percentile in older people) in the general population and individuals with different BMIs.

RESULTS: Correlation analysis showed that the paraspinal muscle index and density were primarily correlated with sex, BMI, and age. Multiple linear regression analysis indicated that the paraspinal muscle index (PSMI and PMI) was primarily influenced by sex (β=-0.391 and - 0.599, p < 0.001) and BMI (β = 0.442 and 0.371, p < 0.001), followed by age and waist circumference. In contrast, muscle density (PSMD and PMD) was mainly associated with sex (β=-0.405 and - 0.317, p < 0.001) and age (β=-0.409 and - 0.429, p < 0.001), with a slight influence from WC and BMI. Considering the significant effect of BMI on muscle mass, we calculated BMI-stratified cutoffs for PSMI (as 12.3/10.6, 15.0/11.7, and 15.2/11.9 cm2/m2 in normal, overweight, and obese men/women using M-2SD), PMI (as 3.8/2.9, 5.0/3.4, and 4.9/3.9 cm2/m2 in normal, overweight and obese men/women using M-2SD), and unstratified cutoffs for PSMD (as 36.3 and 31.1 HU in men and women) and PMD (as 40.1 and 36.9 HU in men and women).

CONCLUSIONS: This study found that sex and BMI were key determinants of paraspinal muscle mass, with BMI influencing paraspinal muscle number more than age. In contrast, muscle density was primarily influenced by sex and age. This study provided BMI-stratified and non-stratified cutoff values for low paraspinal muscle index and density, which aided in the identification of spinal sarcopenia in individuals with different BMIs.

PMID:40211378 | DOI:10.1186/s13018-025-05737-9

J Clin Med. 2025 Feb 8;14(4):1083. doi: 10.3390/jcm14041083.

ABSTRACT

Objective: The canalis sinuosus in the premaxillary region often has accessory canals palatal to the central and lateral incisors. These small anatomical structures are of increasing interest due to numerous case reports of postoperative complications following surgery in the upper anterior region. Methods: This study examined the number, position, and extent of the accessory foramina of the canalis sinuosus in 210 patients. Furthermore, this study examined the distances to neighboring teeth and to the buccal cortical bone in edentulous patients. Three-dimensional tomographic (CBCT) images were created with a resolution of 0.2 voxels and were evaluated using the Osirix MD 11.0 program. Results: The results showed a prevalence of 97% for accessory foramina, confirming them as a clear anatomical structure. Males had significantly more terminal openings of the canalis sinuosus than females, with clustering in the fourth to sixth decades of life. The foramina had a mean extension of 0.9 mm and a mean distance of 4.6 mm to adjacent teeth. Conclusions: This narrow position is particularly relevant for surgical procedures. Greater attention should be focused on larger foramina in implant planning, as postoperative complications are increasingly being described. Foramina and accessory canals should be detected in three-dimensional, navigated implant planning in order to minimize the risk of injury during oral surgery.

PMID:40004614 | DOI:10.3390/jcm14041083