Current Issue : October - December Volume : 2019 Issue Number : 4 Articles : 6 Articles
Introduction. Cup position is critical to stability in total hip arthroplasty and is affected by pelvis motion during positions of daily\nlife.The purpose of this study was to explicitly define the relationship between sagittal pelvic motion and resultant cup functional\nanteversion and create a tool to guide the surgeon to a patient-specific intra-operative anteversion. Materials and Methods. 10,560\ncombinations of inclination, anteversion, and pelvic tilt were generated using a geometric model. Resultant functional anteversion\nwas calculated for each iteration and variableswere correlated.Anelectronicmobile toolwas created that compares inputted patientspecific\nvalues to population-based averages to determine pelvic positions and dynamics that may lead to instability. Results. A\nthird-degree polynomial equationwas used to describe the relationship between variables.Thefreely downloadablemobile tool uses\ninput from pre-operative plain radiographic measurements to provide the surgeon a quantitative correction to intra-operative cup\nanteversion based on differences in functional anteversion compared to population-based averages. Conclusion.This study provides\na geometric relationship between planned cup position, pelvic position and motion, and the resultant functional anteversion. This\nmathematical model was applied to an electronic tool that seeks to determine an individualized intra-operative cup anteversion\nbased on measured patient-specific pelvic dynamics....
According to our knowledge, there is no prior article that reports functional results of medial collateral ligament (MCL) primary\nrepair and insert change after MCL rupture and mobile-bearing dislocation as a late complication of unicompartmental knee\nreplacement (UKR). Firstly, 63-year-old woman was treated with UKR due to anteromedial knee osteoarthritis of the right knee\njoint. 1 year after UKR surgery, she suffered from MCL rupture and mobile-bearing dislocation because of falls while getting on\na public bus, and therefore, secondly, she was operated with MCL primary repair and mobile-bearing change and followed up\nfor 2 years. The patient was evaluated regarding functional capacity, pain intensity, range of motion (RoM), and quality of life.\nOur case showed an improvement in the functional level and the other outcomes (pain intensity and quality of life) at\npostoperative 2nd year when compared to the preoperative period. The wellbeing of our case in about the postop 2nd year\nfunctional capacity and also other outcomes after revision surgery prompted us to continue to this surgery approach in the\nsurgical management of similar cases that may arise thereafter....
Background. The purpose of this study is to review the current literature on knee joint biomechanical gait data analysis for knee\npathology classification. The review is prefaced by a presentation of the prerequisite knee joint biomechanics background and a\ndescription of biomechanical gait pattern recognition as a diagnostic tool. It is postfaced by discussions that highlight the\ncurrent research findings and future directions. Methods. The review is based on a literature search in PubMed, IEEE Xplore,\nScience Direct, and Google Scholar on April 2019. Inclusion criteria admitted articles, written in either English or French, on\nknee joint biomechanical gait data classification in general. We recorded the relevant information pertaining to the investigated\nknee joint pathologies, the participantsâ?? attributes, data acquisition, feature extraction, and selection used to represent the data,\nas well as the classification algorithms and validation of the results. Results. Thirty-one studies met the inclusion criteria for\nreview. Conclusions. The review reveals that the importance of medical applications of knee joint biomechanical gait data\nclassification and recent progress in data acquisition technology are fostering intense interest in the subject and giving a strong\nimpetus to research. The review also reveals that biomechanical data during locomotion carry essential information on knee\njoint conditions to infer an early diagnosis. This survey paper can serve as a useful informative reference for research on the subject....
We aimed to compare proximal femur geometry and biomechanics in postmenopausal\nwomen with osteoarthritis (OA) and/or osteoporosis (OP), using quantitative computed\ntomography (QCT). A retrospective analysis of QCT scans of the proximal femur of 175\npostmenopausal women was performed. Morphometric and densitometric data of the proximal\nfemur were used to evaluate its biomechanics. We found, 21 had a normal bone mineral density\n(BMD), 72 had osteopenia, and 81 were diagnosed with OP. Radiographic findings of hip OA were\nseen in 43.8%, 52.8%, and 39.5% of the normal BMD, osteopenic, and OP groups, respectively (p <\n0.05). OA was significantly correlated with total hip volume (r = 0.21), intertrochanteric cortical\nvolume (r = 0.25), and trochanteric trabecular volume (r = 0.20). In each densitometric group,\nsignificant differences in hip geometry and BMD were found between the OA and non-OA\nsubgroups. Hip OA and OP often coexist. In postmenopausal women, these diseases coexist in 40%\nof cases. Both OA and OP affect hip geometry and biomechanics. OA does so regardless of\ndensitometric status. Changes are mostly reflected in the cortical bone. OA leads to significant\nchanges in buckling ratio (BR) in both OP and non-OP women....
Background. Strengthening of hip and trunk muscles can modify pelvis and hip movements. However, the varus alignment of the\nfoot-ankle complex (FAC) may influence the effects of muscle strengthening, due to the relationship of FAC alignment with pelvic\nand hip kinematics. This study evaluated the effects of hip and trunk muscle strengthening on pelvis and hip kinematics during\nwalking, in subgroups with larger and smaller values of FAC varus alignment. In addition, this study evaluated the effects of hip\nand trunk muscle strengthening on hip passive and active properties, in the same subgroups. Methods. Fifty-three women, who\nwere divided into intervention and control groups, participated in this nonrandomized controlled trial. Each group was split\ninto two subgroups with larger and smaller values of FAC varus alignment. Hip and trunk muscle strengthening was performed\nthree times a week for two months, with a load of 70% to 80% of one repetition maximum. Before and after strengthening, we\nevaluated (1) pelvis and hip excursions in the frontal and transverse planes during walking, (2) isokinetic hip passive external\nrotator torque, and (3) isokinetic concentric and eccentric peak torques of the hip external rotator muscles. Mixed analyses of\nvariance (ANOVAs) were carried out for each dependent variable related to walking kinematics and isokinetic measurements\n(a= 0 05). Results. The subgroup with smaller varus alignment, of the intervention group, presented a reduction in pelvic drop\nafter strengthening (P = 0 03). The subgroup with larger varus alignment increased pelvic drop after strengthening, with a\nmarginal significance (P = 0 06). The other kinematic excursions did not change (pelvic anterior rotation P = 0 30, hip internal\nrotation P = 0 54, and hip adduction P = 0 43). The intervention group showed increases in passive torque (P = 0 002), peak\nconcentric torque (P < 0 001), and peak eccentric torque (P < 0 001), independently of FAC alignment. These results suggest\nthat FAC varus alignment influences the effects of strengthening and should be considered when hip and trunk muscle\nstrengthening is used to reduce pelvic drop during walking....
Two-stage exchange is most commonly used for treatment of prosthetic joint infections (PJI) but, this may fail to eradicate\ninfections. C-reactive protein/albumin ratio (CAR) has been used to predict survival and operative success in other surgical\nsubspecialties and so, we assess the association between CAR and reimplantation success during two-stage revision for PJI defined\nby the Musculoskeletal Infection Society following a primary total hip (THA) or knee (TKA) arthroplasty. From January, 2005 to\nDecember, 2015, two institutional databases were queried and patient demographics, antibiotic duration, C-reactive protein, and\nalbumin were collected prior to reimplantation. Two-stage revisions were considered successful if patients were off of antibiotics\nand did not require a repeat surgery. CAR was available for 79 patients (34 hips and 46 knees) with 61 successful two-stage\nrevisions and 18 failures.The average CAR for patients with successful reimplantation was 1.2 (0.2, 3.0) compared to 1.0 (0.4, 3.2)\nfor treatment failure. However, this was not statistically significant (p=0.766). Therefore, CAR is not applicable in predicting the\nprognosis of two-stage revisions for PJI in total arthroplasty but other preoperative inflammatory-based prognostic scores should be\nexplored....
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