ArticleJournal of bone and mineral metabolism2019
Microcrack-associated bone remodeling is rarely observed in biopsies from athletes with medial tibial stress syndrome.
Article in Journal of bone and mineral metabolism, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 38 citations in OpenAlex.
- Unraveling stress fractures: from cellular and molecular mechanisms to therapeutic approaches.Journal of orthopaedic translation · 2026Review
- Medial tibial stress syndrome.Musculoskeletal surgery · 2026Review
- Effects of running distance on per-step and cumulative lower-extremity loading during a simulated treadmill half marathon.Frontiers in public health · 2026Article
- Differences in bone turnover markers and injury risks between local and international horses: A Victorian Spring Racing Carnival study.Equine veterinary journal · 2025Article
- Medial Tibial Stress Syndrome: A Scoping Review of Epidemiology, Biomechanics, and Risk Factors.Cureus · 2025Review
- Assessment of subchondral bone microdamage quantification using contrast-enhanced imaging techniques.Journal of anatomy · 2024Article
- Medial Tibial Stress Syndrome (Shin Splint): Prevalence, Causes, Prevention, and Management in Saudi Arabia.Cureus · 2024Article
- Femoral neck stress fracture and medial tibial stress syndrome following high intensity interval training: A case report and review of literature.World journal of clinical cases · 2022Article
- Bone stress injuries.Nature reviews. Disease primers · 2022Review
- Mechanical stimuli-mediated modulation of bone cell function-implications for bone remodeling and angiogenesis.Cell and tissue research · 2021Review
- Bilateral Looser zones or pseudofractures in the anteromedial tibia as a component of medial tibial stress syndrome in athletes.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2021Article
- The effectiveness of PROLOTHERAPY for recalcitrant Medial TIBIAL Stress Syndrome: a prospective consecutive CASE series.Journal of foot and ankle research · 2021Article
- The Effect of Inflammation on Bone.Frontiers in physiology · 2020Review
- The diagnosis and management of medial tibial stress syndrome : An evidence update.Der Unfallchirurg · 2020Review
- [The diagnosis and management of medial tibial stress syndrome : An evidence update-German version].Der Unfallchirurg · 2019Review
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The pathology of medial tibial stress syndrome (MTSS) is unknown. Studies suggest that MTSS is a bony overload injury, but histological evidence is sparse. The presence of microdamage, and its potential association with targeted remodeling, could provide evidence for the pathogenesis of MTSS. Understanding the pathology underlying MTSS could contribute to effective preventative and therapeutic interventions for MTSS. Our aim was to retrospectively evaluate biopsies, previously taken from the painful area in athletes with MTSS, for the presence of linear microcracks, diffuse microdamage and remodeling. Biopsies, previously taken from athletes with MTSS, were evaluated at the Department of Anatomy and Cell Biology at the Indiana University. After preparing the specimens by en bloc staining, one investigator evaluated the presence of linear microcracks, diffuse microdamage and remodeling in the specimens. A total of six biopsies were evaluated for the presence of microdamage and remodeling. Linear microcracks were found in 4 out of 6 biopsies. Cracking in one of these specimens was artefactual due to the biopsy procedure. No diffuse microdamage was seen in any of the specimens, and only one potential remodeling front in association with the microcracks. We found only linear microcracks in vivo in biopsies taken from the painful area in 50% of the athletes with MTSS, consistent with the relationship between linear cracks and fatigue-associated overloading of bone. The nearly universal absence of a repair reaction was notable. This suggests that unrepaired microdamage accumulation may underlie the pathophysiological basis for MTSS in athletes.
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