Objectives: The development of effective fall prevention programs requires understanding of underlying causes of falls. Measurement tools are needed that predict the risk of falling and give objective
Introduction. Partial knee arthroplasty (PKA) has demonstrated the potential to improve patient satisfaction over total knee arthroplasty. It is however perceived as a more challenging procedure that requires precise adaptation to the complex mechanics of the knee. A recently developed PKA system aims to address these challenges by anatomical, compartment specific shapes and fine-tuned mechanical instrumentation. We investigated how closely this PKA system replicates the balance and kinematics of the intact knee. Materials and Methods. Eight post-mortem human knee specimens (age: 55±11 years, BMI: 23±5, 4 male, 4 female) underwent full leg CT scanning and comprehensive robotic (KUKA KR140 comp) assessments of tibiofemoral and patellofemoral kinematics. Specimens were tested in the intact state and after fixed bearing medial PKA. Implantations were performed by two experienced surgeons. Assessments included laxity testing (anterior-posterior: ±100 N, medial-lateral: ±100 N, internal-external: ±3 Nm, varus- valgus: ±12 Nm) under 2 compressive loads (44 N, 500 N) at 7 flexion angles and simulations of level walking, lunge and stair descent based on in-vivo loading profiles. Kinematics were tracked robotically and optically (OptiTrack) and represented by the femoral flexion facet center (FFC) motions. Similarity between intact and operated curves was expressed by the root mean square of deviations (RMSD) along the curves. Group data were summarized by average and standard deviation and compared using the paired Student's T-test (α = 0.05). Results. During the varus-valgus
Backgrounds. In order to permit soft tissue balancing under more physiological conditions during total knee arthroplasties (TKAs), we developed an offset type tensor to obtain soft tissue balancing throughout the range of motion with reduced patella-femoral (PF) and aligned tibiofemoral joints and reported the intra-operative soft tissue
There are some reports that the invasive surgery of knee joint replacement repair static and dynamic balance. We investigated the changes in static and dynamic balance and muscle strength in pre- and postoperative of TKA and UKA for the purpose of assessing time dependent improvement. A total of 168 patients (137 TKA; mean age 75.3, 31 UKA; mean age 78.1) were recruited to the study. These patients underwent static and dynamic
Dislocation remains a common complication following total hip arthroplasty, second only to aseptic loosening as a cause of revision. Factors thought to play a role in dislocation include cup and stem alignment, soft tissue tension, surgical approach, patient factors, and design features of the prosthesis, including femoral head size. We analysed all consecutive total hip replacements at one institution over a 17 year period. Criteria for study inclusion were hips replaced due to primary osteoarthritis with no previous surgery, femoral head sizes of 28mm and 32mm only, and at least one year from date of surgery. 3682 hips fulfilled these criteria. All procedures were carried out using a posterolateral approach with enhanced posterior repair, and a standard method of intraoperative soft tissue
Dislocation remains a common complication following total hip arthroplasty, second only to aseptic loosening as a cause of revision. Factors thought to play a role in dislocation include cup and stem alignment, soft tissue tension, surgical approach, patient factors, and design features of the prosthesis, including femoral head size. We analysed all consecutive total hip replacements at one institution over a 17 year period. Criteria for study inclusion were hips replaced due to primary osteoarthritis with no previous surgery, femoral head sizes of 28mm and 32mm only, and at least one year from date of surgery. 3682 hips fulfilled these criteria. All procedures were carried out using a posterolateral approach with enhanced posterior repair, and a standard method of intraoperative soft tissue
ProFaNE, Prevention of Falls Network Europe, is a four year project, funded by the European Community Framework 5. It is a thematic network, coordinated by the University of Manchester, UK, with 25 partners across Europe. There are also Network Associates from a number of EU and non-EU countries who give their advice and experience at meetings, seminarsand conferences. The aim is to bring together workers from around Europe to focus on a series of tasks aimed at developing multi-factorial prevention programmes to reduce the incidence of falls and fractures amongst elderly people. The work of ProFaNE is practical, both in terms of developing the evidence base for implementation of effective interventions and encouraging best practice across Europe. The task of each work package is to convene workshops, undertake personnel exchanges and set up collaborative studies, data sharing in order to develop evidence based protocols and publications which can be used to implement change. Work Package 1 - Fall prevention trials - Taxonomy of interventions and agreed set of outcomes. An agreed and standardised set of outcome definitions and measures is important to improve the robustness of data from intervention studies, will enable comparison across studies, good quality measurement in multi-centre trials, and facilitate meta-analysis of trial results. A taxonomy of interventions will facilitate comparisons between studies, help to determine the most effective components or sub-components of interventions, and aid the decision making process of policy makers and health insurance plans. A Consensus taxonomy and outcome measures statement, Trial design statement, Meta - analysis protocol and Self help materials will be produced. Work Package 2 - Clinical Assessment and Outcomes. Aims to gain an understanding of the current issues surrounding falls prevention across Europe and to embrace at national and international level, the different political and health service agendas in each country such that recommendations can ultimately be translated into working models of practice. They will establish a robust network of key members across Europe to facilitate the effective and efficient promulgation of evidence likely to influence service developments at national and local level and derive a consensus approach to assessment and management of older people at risk of falling in a variety of clinical settings using the existing evidence base as well as inviting expert opinions in the field. Work Package 3 -