Percutaneous iliosacral screw fixation is a widely accepted method of stabilizing the posterior pelvic ring. Recently developed tools such as 3D-navigated fluoroscopy and computed navigation seem to prevent a surgeon from conducting screw misplacement. The study aimed to comparatively assess the introduction of sacroiliac screw placement using 2D and 3D fluoroscopy in terms of accuracy and radiation exposure. Iliosacral screws were introduced in 37 patients using 2D (group N1) and in 36 patients using 3D fluoroscopy (group N2) techniques. Overall, 61 and 56 screws were introduced in groups N1 and N2, respectively. Screw placement accuracy was assessed using postoperative computed tomography and Smith’s scale. Intraoperative radiation exposure was also assessed. No differences were noted between groups in terms of screw positioning accuracy and radiation dose. Both 2D and 3D fluoroscopy provide good visualization for safely placing percutaneous iliosacral joint screws. Using 3D fluoroscopy-based navigation in comparison with 2D fluoroscopy is not advantageous.

Background and Objectives: The negative effects of smoking on the musculoskeletal system were presented by many authors, although the relationship between smoking and osteoarthritis remains unclear. The aim of this paper was to investigate the negative effects of smoking on meniscal tissue in osteoarthritic knees by microscopic examination, by adapting the Bonar scoring system and its modifications. Materials and Methods: The study involved 34 patients with varus knees, from whom 65 samples of knee menisci were obtained. The mean age in the studied group was 65.385 years. The smoking status of the patients concluded that there were 13 smokers and 21 nonsmokers. Results: Among smokers, the mean classical Bonar score was 8.42 and the mean modified Bonar score was 6.65, while nonsmokers were characterized by scores of 8.51 and 7.35, respectively. There was a statistically significant negative correlation between the number of cigarettes and the collagen in the medial meniscus (p = 0.0197). Moreover, in the medial meniscus, the modified Bonar score correlated negatively with the number of cigarettes (p = 0.0180). Similarly, such a correlation was observed between the number of cigarettes and the modified Bonar score in the lateral meniscus (p = 0.04571). Furthermore, no correlation was identified between the number of cigarettes and the classical Bonar score in the lateral meniscus. There was a statistically significant difference in the collagen variable value between the smokers and nonsmokers groups (p = 0.04525). Conclusions: The microscopic investigation showed no differences in the menisci of smokers and nonsmokers, except for the collagen, which was more organized in smokers. Moreover, the modified Bonar score was correlated negatively with the number of cigarettes, which supports the role of neovascularization in meniscus pathology under the influence of tobacco smoking.

Background: Operative treatment of fragility fractures of the pelvis has become a gold standard. Preoperative planning, including the assessment of the pathway for iliosacral screws, is crucial. The anchorage of the screw depends on the bone quality. Some recent studies have concentrated on assessing bone mineral density (BMD) with the use of Hounsfield unit (HU) values obtained from CT scans. The aim of the present study is to determine the best sacral levels of S1–S3 on the pathway of iliosacral screws for sacroiliac joint fixation. Methods: Patients admitted to the Independent Public Healthcare Center in Rypin between 1 of September and 1 of December in 2023, who had CT scans of the pelvis performed on them for different reasons, were included in this study. In total, 103 patients—56 men and 47 women—were enrolled in the study and consecutively separated into two groups of different ages: 18–60 years old (group A) and above 60 years old (group B). The volumetric bone density expressed in HU values was measured with sacral levels of S1, S2 and S3. Apart from the bodies of sacral vertebrae S1–S3, our measurements involved the ala of the ilium in the vicinity of the sacroiliac joint and the wing of the sacrum. All the measurements were performed on the pathway of presumptive iliosacral screws to stabilize the sacroiliac joint. Results: In group A (58 patients) the highest bone density in sacral bodies was found in S1 that gradually decreased to S3, while the opposite tendency was demonstrated in the ala of ilium. The HU values in the wing of the sacrum did not display statistical significance. In group B (45 patients), the highest bone density was also found in the sacral body S1 that decreased toward S3 but in the ala of ilium, the highest bone density was found with level S1 and lowest with level S2. In both groups, the highest bone density referred to the wing of the sacrum. Conclusion: While the perfect construct for posterior pelvic ring fixation remains unclear, our findings may imply that sacroiliac joint screws inserted into the wing of the sacrum of greater bone density could provide much more successful fixation in comparison to those anchored in the body of sacral vertebra of lesser bone density.

This study aimed to investigate the degeneration of the meniscal tissue in osteoarthritic knees and to adapt the Bonar score and its modifications to develop a microscopic examination. This study included consecutive patients who underwent total knee arthroplasty for symptomatic end-stage gonarthrosis. During the surgery, the menisci were completely dissected to preserve their original shapes. The samples were prepared using the hematoxylin and eosin (H&E) staining method and the Alcian blue protocol and were examined under light microscopy. The extent of histopathological changes was assessed based on the classical Bonar score assumptions. Additionally, in the second step of the examination, menisci remnants were evaluated using the modified Bonar score developed by Zabrzyński et al. The study involved 44 patients, from whom 83 samples of knee menisci were obtained. Histological examination of the meniscal specimens under a light microscope revealed tissue degeneration in all cases, in both the medial and lateral menisci. The mean classical Bonar score was 8.3571 and the mean modified Bonar score was 6.9398. There were no statistically significant differences in classical Bonar score assessment between medial and lateral menisci (p = 0.3014). There were no statistically significant differences in the modified-Bonar score assessment between medial and lateral menisci (p = 0.3620). We show that both menisci are implicated in the degenerative process, with high scores in the Bonar system, regardless of knee axial deformity. The Bonar score, along with its modifications, can be readily employed in the microscopic assessment of meniscus pathology.

Objectives: The present study aimed to analyze the growth dynamics of the ossification centers of the seventh cervical (C7) vertebra in the human fetus, focusing on linear, planar, and volumetric parameters of both the vertebral body and neural processes. Methods: The study was conducted on 55 human fetuses of both sexes (27 males and 28 females), aged 17–30 weeks’ gestation. High-resolution computed tomography, three-dimensional reconstruction, digital image analysis, and appropriate statistical modeling were used to obtain detailed morphometric measurements of the C7 ossification centers. Results: All morphometric parameters—length, cross-sectional area, and volume—of the vertebral body ossification center increased linearly with gestational age, except for the sagittal diameter, which followed a logarithmic growth pattern. Linear growth was likewise observed in all diameters of the neural process ossification centers, including length, width, cross-sectional area, and volume. No statistically significant sex-related or side-related differences were detected. Conclusions: The CT-based morphometric data and growth models for the ossification centers of C7 presented in this study offer preliminary reference values for the vertebra prominens during fetal development. Although limited by sample size, these results establish a baseline that may assist anatomists, radiologists, obstetricians, pediatricians, and spinal surgeons in assessing cervical-spine maturation and in detecting congenital anomalies prenatally. Further studies involving larger and more diverse fetal cohorts are warranted to validate and extend these observations.

Objectives: The present study aimed to determine the growth dynamics of the ossification centers of the twelfth thoracic vertebra in the human fetus, focusing on detailed linear, surface, and volumetric parameters of both the vertebral body and neural processes. Methods: The investigation was based on 55 human fetuses (27 males, 28 females) aged 17–30 weeks of gestation. High-resolution low-dose computed tomography, three-dimensional reconstruction, digital image analysis and appropriate statistical modeling were used to obtain detailed morphometric measurements. Results: All measured morphometric parameters of the Th12 vertebral body ossification center—transverse and sagittal diameters, cross-sectional area, and volume—increased linearly with gestational age (R² = 0.94–0.97). A similar linear growth pattern was demonstrated for the length, width, cross-sectional area, and volume of the right and left neural process ossification centers (R² = 0.97–0.98). No statistically significant sex-related or side-related differences were found, allowing the establishment of single normative growth curves for each parameter. Conclusions: This study provides the first comprehensive CT-based normative data for the ossification centers of the fetal Th12 vertebra in the second and early third trimesters. The presented linear growth models and reference values may assist anatomists, radiologists, obstetricians, and pediatric spine surgeons in estimating fetal age, and in the prenatal and postnatal assessment of congenital spinal anomalies, especially at the thoracolumbar junction. Further research on larger and broader gestational cohorts is warranted to validate and extend these findings.