Aims. The standard of surgical treatment for lower limb neoplasms had been characterized by highly interventional techniques, leading to severe kinetic impairment of the patients and incidences of phantom pain. Rotationplasty had arisen as a potent limb salvage treatment option for young cancer patients with lower limb bone tumours, but its impact on the gait through comparative studies still remains unclear several years after the introduction of the procedure. The aim of this study is to assess the effect of rotationplasty on gait parameters measured by
The Step Holter is a software and mobile application that can be used to easily study
Total knee replacement in a commonly performed procedure in the United Kingdom with more than 76000 primary procedures performed in 2010. With so many procedures performed there has to be a robust way of assessing the outcome of the procedure.
Introduction: It has been proposed that rotational gait abnormalities in the normal child are usually reflections of the anatomic deformity. A decreased acetabular and femoral anteversion have been recognized as a predisposing factor for osteoarthritis of the hip and the McKibbin instability index was introduced to quantify this relationship. Additionally, an increased femoral anteversion has been associated with osteoarthritis of the knee. However, it is well known that compensatory factors influence the dynamic rotational profile during gait. We compared rotational computed tomography data with
Patellofemoral osteoarthritis (PFOA) affects 32% men and 36% women over the age of 60years and is associated with anterior knee pain, stiffness, and poor mobility. Patellofemoral arthroplasty (PFA) is a bone-sparing treatment for isolated PFOA. This study set out to investigate the relationship between patient-related outcome measures (PROMs) and measurements obtained from
Total hip arthroplasty (THA) is one of the most successful surgery. However, patients' expectations have increased over the last two decades in regards to hip function after joint replacement, the patients assume to return their daily and sport activities without major limitations. This presentation will examine the effect of surgical approaches and implant designs as well as rehabilitation protocol on the clinical and biomechanical outcomes after THA. The new implant designs for THA aim to improve joint function whereas the surgical approaches intend to reduce muscle damage to regain muscle strength. One important determinant measured from
Total Knee Arthroplasty (TKA) has been widely performed and successful clinical outcomes have been achieved for the patients with knee osteoarthritis which is generally known to cause ADL problem. Clinical and radiographic evaluations are commonly used when evaluating postoperative outcomes, among which kinetic
Purpose. This study aimed to objectively define gait derangements and changes before and after Tibialis Anterior Tendon Transfer surgery in a group of patients treated using the Ponseti method. Methods. 21 feet in 13 patients with Ponseti treated clubfoot who showed supination in swing on clinical examination, underwent
Instrumented
Introduction. Total hip arthroplasty (THA) is the most effective treatment modality for severe arthritis of the hip. Patients report excellent clinical and functional outcomes following THA, including subjective improvement in gait mechanics. However, few studies in the literature have outlined the impact of THA, as well as surgical approach, on gait kinetics and kinematics. Purpose. The purpose of this study was to determine the impact of surgical approach for THA on quantitative
Total hip arthroplasty (THA) is the most effective treatment modality for severe arthritis of the hip. Patients report excellent clinical and functional outcomes following THA, including subjective improvement in gait mechanics. However, few studies in the literature have outlined the impact of surgical approach on gait kinetics and kinematics. The purpose of this study was to determine the impact of surgical approach for THA on quantitative
Background. The aim of this study is to analysis the ability of these patients, treated with MOMHR, to resume sport activities by
Introduction:. There is paucity of literature on
Introduction. Various rehabilitation shoes are prescribed to protect the forefoot following surgery. Patients often complain of discomfort in other areas as a result of the postoperative shoe, including the knee, hip and lower back. This has never been quantified. This study aims to establish the effect on other joints using
We studied the kinematic patterns of knee, performing
Background: Mobile-bearing knee replacements have some theoretical advantages over fixed-bearing devices. However, very few randomized controlled clinical trials have been published to date, and studies showed little clinical and subjective advantages for the mobile-bearing using traditional systems of scoring. The choice of the ideal outcome measure to assess total joint replacement remains a complex issue. However,
The Arthrotic knee is frequently associated with several-pain and loosening of joint function often so important to need a total knee arthroplasty (TKA). Obviously, the aims of a TKA is to obtain no pain and restore a good joint function so to contribute to a good health and a better quality life. To realize ends like these it’s necessary a good selection of the patients first, an adequate preparation for the surgery, correct surgery technique and a specific post-operative rehabilitation until achieving the normal daily activities. In this way clinical biomechanical evaluations can contribute to quantify the achievement of the ends and they can get influence to modulate the “ways” used. Actually the dynamic evaluation more useful and reproducible in the gonartrhosis is the
BACKGROUND. Many patients who underwent a THA, report a feeling of more “physiological” hip and of faster recovery when bigger heads are used. The aim of this study is to evaluate the walking recovery of patients after THA with different head diameters by the means of
Purpose of the study: How does a total knee arthroplasty (TKA) function? Do all prostheses provide the excellent results reported in the literature? This
Ankle arthrodesis for isolated ankle arthritis has a high patient satisfaction level; however,
Aim of study: To assess ankle dorsiflexion of operated pedes equinovari congenitales in both clinical examination and
Introduction: Mobile bearing total knee arthroplasty (TKA) has been developed to theoretically provide better, more physiological function of the knee and produce less PE wear. The theoretical superiority of mobile bearing TKAs over fixed bearing devices has not yet been proven in clinical studies. The objective of the present study was to prospectively analyze clinical and functional outcomes of randomized fixed and mobile bearing total knee arthroplasty patients by means of
Performing Total Knee Replacement (TKR) surgery using computer assisted navigation systems results in more reproducibly accurate component alignment. Navigation allows real time evaluation of passive knee behaviour throughout flexion. These kinematic measurements reflect tibial rotation about the femoral condyles, patellar tracking and soft tissue balance throughout surgery. In this study, we aim to study dynamic knee function in navigated and standard instrumentation TKR patients performing a range of everyday activities using
Background. There are limited previous findings detailed biomechanical properties following implantation with mechanical and kinematic alignment method in robotic total knee arthroplasty (TKA) during walking. The purpose of this study was to compare clinical and radiological outcomes between two groups and
Background. There are limited previous findings detailed biomechanical properties following implantation with mechanical and kinematic alignment method in robotic total knee arthroplasty (TKA) during walking. The purpose of this study was to compare clinical and radiological outcomes between two groups and
Background: Congenital absence of the cruciate ligaments is a commonly associated pathology of the knee joint in congenital longitudinal deformities. We performed a radiological analysis and investigated gait patterns in patients with congenital absence of one or both cruciate ligaments. Patients and Methods: Thirty-four knee joints in thirty-one patients with congenital longitudinal deficiency of the lower limb were evaluated. The cruciate ligaments and associated abnormalities of the bony configuration were evaluated on magnetic resonance imaging and tunnel view radiographs. A radiological classification is proposed.
Introduction. Surgical techniques for implant alignment in total knee arthroplasty (TKA) is a expanding field as manufacturers introduce patient-specific cutting blocks derived from 3D reconstructions of pre-operative imaging, commonly MRI or CT. The patient-specific OtisMed system uses a detailed MRI scan of the knee for 3D reconstruction to estimate the kinematic axis, dictating the cutting planes in the custom-fit cutting blocks machined for each patient. The resulting planned alignment can vary greatly from a neutral mechanical axis. The purpose of this study was to evaluate the early fixation of components in subjects randomized to receive shape match derived kinematic alignment or conventional alignment using computer navigation. A subset of subjects were evaluated with
In arthritis of the varus knee, a high tibial
osteotomy (HTO) redistributes load from the diseased medial compartment
to the unaffected lateral compartment. We report the outcome of 36 patients (33 men and three women)
with 42 varus, arthritic knees who underwent HTO and dynamic correction
using a Garches external fixator until they felt that normal alignment
had been restored. The mean age of the patients was 54.11 years
(34 to 68). Normal alignment was achieved at a mean 5.5 weeks (3
to 10) post-operatively. Radiographs,
Purpose of the study: The aim of this study was to analyze the mechanical function of the ankle after implantation of a total ankle arthroplasty.
Background: Mobile-bearing knee replacements have some theoretical advantages over fixed-bearing devices. However, very few randomized controlled clinical trials have been published to date, and studies showed little clinical and subjective advantages for the mobile-bearing using traditional systems of scoring. The choice of the ideal outcome measure to assess total joint replacement remains a complex issue. However,
Introduction: Fibular hemimelia (FH) is a congenital limb reduction deficiency characterised by partial or complete absence of the fibula and a spectrum of associated anomalies. For children with a major anticipated limb length discrepancy and severe foot deformity, management (amputation or limb reconstruction) is controversial. Materials and Methods: 8 children who are now adults (average age 28 years) underwent limb reconstruction as children in one of two UK centres for severe fibular hemimelia. All 8 participants were recalled to our institution for instrumented
This randomized clinical trial compares fixed- and mobile-bearing total knee prostheses in terms of the patients’ clinical outcome parameters (Knee Society Clinical Rating, WOMAC, SF-12), range of motion and performance during
The purpose of the study was to evaluate the functional outcome of different limb salvage procedures for osteosarcoma about the knee. A selection of patients who have undergone limb salvage procedures for osteosarcoma about the knee were invited to join the study. Medical and operation notes were reviewed along with recent radiographs of the involved limb. Patients completed the Musculoskeletal Tumour Society functional questionnaire and underwent a
Over a 4 year period 27 children with cerebral palsy underwent proximal femoral derotation osteotomy resulting in a total of 42 operations performed. Each of these children had pre operative
Conventional fixed-bearing (FB) knee prostheses have been proved clinically successful. Rotating platform, mobile-bearing (MB) total knee replacements (TKR) have been developed to improve knee kinematics, lower contact stresses on the polyethylene tibial component, minimize constraint, and allow implant self-alignment. The purpose of this study was to characterize and compare the functional outcome of FB- and MB- TKR during gait and deep knee bends, using a motion analysis system. Two groups of five patients with a unilateral FB TKR (PFC) or MB TKR (LCS) underwent a
Summary Statment. The dual-mobility cup seems to bring more stability without changing the gait pattern. Introduction. Dislocations and instability are among the worst complications after THA in elderly patient. Dual mobility cups seem to lower these risks. To our knowledge no study performed a
Aim We set out to see. whether ankle replacements were capable of maintaining a normal gait and. whether ankle replacements were superior to arthrodeses in maintaining a normal gait pattern. Method We performed
We studied 50 patients before and after unilateral total hip replacement, and compared them, using
Introduction: Numerous studies in the orthopaedic literature have reported changes in knee kinematics following rupture of the Anterior Cruciate Ligament (ACL).
Many studies describe the use of the Ilizarov ring fixator for lower limb lengthening and for the management of the 3-dimensional lower limb deformities in achondroplasia, and most confirm the efficacy of this technique. However, long term follow up of these achondroplastic patients is lacking. Most studies have focused on magnitude of lengthening, treatment time required and complications, but no study has analyzed the long term postoperative condition of these patients using an objective, functional method such as
Introduction. In prosthetic knee surgery, the axis of the lower limb is often determined only by static radiographic analysis. However, it is relevant to determine if this axis varies during walking, as this may alter the stresses on the implants. The aim of this study was to determine whether pre-operative measurement of the mechanical femorotibial axis (mFTA) varies between static and dynamic analysis in isolated medial femorotibial osteoarthritis. Methods. Twenty patients scheduled for robotic-assisted medial unicompartmental knee arthroplasty (UKA) were included in this prospective study. We compared three measurements of the coronal femorotibial axis: in a static and weightbearing position (on long leg radiographs), in a dynamic but non-weightbearing position (intra-operative acquisition during robotic-assisted UKA), and in a dynamic and weightbearing position (during walking by a gait analysis). Results. There was no significant difference in the mFTA between radiological (173.9 ± 3.3°), robotic (174.4 ± 3.4°), and
Introduction: Traditionally, the degree of correction for derotational femoral osteotomies in cerebral palsy has been based on clinical or radiographic measures. Recently, three dimensional
The purpose of this study is to assess the clinical outcome and
Introduction and Aims: The effects of injury to the posterior cruciate ligament (PCL) and posterior-lateral corner (PLC) on physical function are not as well documented compared to the more common injury to the anterior cruciate ligament. This study aimed at improving our understanding of PCL/PLC injury through
INTRODUCTION. Mobile-bearing knee prostheses have been designed in order to provide less constrained knee kinematics compared to fixed-bearing prosthesis. Currently, there is no evidence to confirm the superiority of either of the two implants with regard to walking performances. It has been shown that subjective outcome scores correlate poorly with real walking performance and it has been recommended to obtain an additional assessment of walking ability with objective
Aims. Conventional patient-reported surveys, used for patients undergoing total hip arthroplasty (THA), are limited by subjectivity and recall bias. Objective functional evaluation, such as
Aim: To quantify the gait characteristics of the children with a history of treated femoral shaft fracture, and compare the outcome of three different treatment methods (spica cast, plate fixation, and flexible intramedullary nailing) in terms of kinematic and kinetic characteristics of gait. Material and Methods: Fifteen children (9 boys, 8 girls), admitted to our hospital for unilateral (n=12) and bilateral (n=3) femoral fracture were evaluated in this study. The average age was 9.4 years (range 5–15 years). They were treated by three different methods: spica cast (n=5 ), plate fixation (n= 5), flexible intra-medullary nailing (n= 5). The cases were followed up with an average period of 23 months (6–48 months). At the end of the follow up period quantitative
Aims: Purpose of this retrospective study was to evaluate changes of pressure distribution during walking and joint movement after clubfootoperation. Methods: For this analysis the VICON 512 motion system including 12 cameras and 2 KISTLER force plates were used. Pressure distribution under both feet during gait was measured by a pressure sensitive plate (EMED NOVEL pressure plate). Muscle activity of the lateral and medial gastrocnemicus, anterior tibialis and longer peroneal muscles was registered by surface EMG using BIOVISION. The sampling rate of the motion analysis system was set at 120 Hz. Data acquisition of force and EMG signals were performed at 1080 Hz. The kinematic analysis of the human body was represented by a 7-segment model consisting of feet, lower legs, upper legs and pelvis. A set of 16 markers were used to identify the body segments. Results: 20 children with a mean age of 12 years underwent a quantitative 3-dimensional kinematic and kinetic
Purpose of the study: The effect of idiopathic scoliosis surgery on walking capacity has rare been studied. Results published in the literature have been discordant: reduced velocity, step rate and stride length for Lenke et al; no change for Engsber et al. We conducted a prospective study to analyze gait parameters after surgery for idiopathic scoliosis. Material and methods: This study was conducted in 46 patients who underwent surgery for idiopathic scoliosis. Mean age was 15 years (range 12–22). Mean angle was 56° (range 40–94°). A posterior approach was used for reduction and fusion in all patients. Mean postoperative angle was 20° (range 8–64°). There were no neurological, mechanical or infectious complications.