Foot pain and related problems are quite common in the community. It is reported that 24% of individuals older than 45 experienced foot pain. Also, it is stated that at least two thirds of individuals experiences moderate physical disability due to foot problems. In the absence of evaluation of risk factors such as limited ankle dorsiflexion in the early period of the diseases (Plantar fasciitis, Achilles Tendinopathy e.g.) and the lack of mobile systems with portable remote access, foot pain becomes refractory/chronic foot pain, secondary pathologies and ends with workload of 1., 2. and 3rd level healthcare services. In the literature, manuel and dijital methods have been used to analyze the ankle
Abstract. Objectives. Impingement in total hip replacements (THRs), including bone-on-bone impingement, can lead to complications such as dislocation and loosening. The aim of this study was to investigate how the location of the anterior inferior iliac spine (AIIS) affected the
Purpose. This study was to investigate the effect of posterior tibial slope (PTS) on the kinematics in the cruciate-retaining total knee arthroplasty (CR-TKA) using 2- to 3- dimensional registration technique. Material & Methods. A total of 75 knees in 58 patients were recruited and categorized into the following two groups according to PTS. Group A was categorized PTS under 7degrees (n = 33) and group B was categorized PTS over 7 degrees (n = 42). The average age of group A and group B at the time of fluoroscopic surveillance date was 73.5 ± 7.4 years and 74.3 ± 4.5 years, respectively and the average follow-up period from operation date to fluoroscopic surveillance date was 13.8 ± 9.3 months and 16.7 ± 8.6 months, respectively. In vivo kinematics during sequential deep knee bending under weight-bearing condition were evaluated using fluoroscopic image analysis and 2- to 3- dimensional registration technique.
Recently, several smartphone applications (apps) have been developed and validated for ankle ROM measurement tools like the universal goniometer. This is the first innovative study introduces a new smartphone application to measure ankle joint ROM as a remote solution. This study aimed to assess the correlation between smartphone ROM and universal goniometer measurements, and also report the evaluation of the DijiA app by users. The study included 22 healthy university students (14F/8M; 20.68±1.72 years) admitted to Yeditepe University. Fourty four feet was measured by both the universal goniometer (UG) and DijiA app. The datas were analyzed through using the intraclass correlation coefficient (ICC). The DijiA app was evaluated by usability testing with representative users. Pearson correlation coefficient test showed moderate correlation between the DijiA and UG for dorsiflexion (DF) and plantar flexion (PF) measurements (Pearson correlation coefficient: r=0.323, for DF; r=0.435 for PF 95% confidence interval). The application usability was found as high with 76.5 average score and users liked it. The DijiA app may be a more convenient and easy way to measure ankle DF and PF-ROM than UG. It can be used to evaluate ROM in clinical practice or home using as a personal smartphone.
Total Knee Arthroplasty (TKA) improves the quality of life of osteoarthritic and rheumatoid arthritis patients, however, is associated with moderate to severe postoperative pain. There are multiple methods of managing postoperative pain that include epidural anesthesia but it prevents early mobilization and results in postoperative hypotension and spinal infection. Controlling local pain pathways through intra-articular administration of analgesics is a novel method and is inexpensive and simple. Hence, we assess the effects of postoperative epidural bupivacaine injection along with intra-articular injection in total knee replacement patients. The methodology included 100 patients undergoing TKA randomly divided into two groups, one administered with only epidural bupivacaine injection and the other with intra-articular cocktail injection. The results were measured based on a 10-point pain assessment scale, knee's
Abstract. Objectives. The objective of this study was to determine the kinematic factor(s) underlying the reduction in walking velocity displayed by total hip arthroplasty (THA) patients in comparison to healthy controls during walking gait. Methods. Eleven patients with well-functioning THA (71 ± 8 years, Oxford Hip Score = 46 ± 3) and ten healthy controls (61 ± 5 years) participated within this study. Sagittal plane lower limb kinematics were captured using a 10 camera Qualisys motion capture system, sampling at 200Hz, as participants walked overground at a self-selected pace. Bivariate linear regression was used to explore the relationship between walking velocity and a number of kinematic variables in a deterministic manner. Kinematic variables significantly associated with walking velocity were compared between THA and healthy groups utilising independent samples t-tests. Results. Peak hip extension was a significant (r2 = .36; p =.004) predictor of hip
Abstract. Objectives. Dual mobility (DM) hip implants whereby the polyethylene liner is “free-floating” are being used increasingly clinically. The motion of the liner is not well understood and this may provide insight into failure mechanisms; however, there are no published methods on tracking liner motion while testing under clinically relevant conditions. The aim was to develop and evaluate a bespoke inertial tracking system for DM implants that could operate submerged in lubricant without line-of-sight and provide 3D orientation information. Methods. Trackers (n=5) adhered to DM liners were evaluated using a robotic arm and a six-degree of freedom anatomical hip simulator. Before each set of testing the onboard sensor suites were calibrated to account for steady-state and non-linearity errors. The trackers were subjected to
Introduction and Objective. Kinesiophobia, the fear of physical movement and activity related to injury vulnerability, has been linked to sub-optimal outcomes following total knee replacement (TKR). This systematic review has two aims: to define the relationship between kinesiophobia and functional outcomes, pain and
Introduction and Objective. TKA have shown both excellent long-term survival rate and symptoms and knee function improvement. Despite the good results, the literature reports dissatisfaction rates around 20%. This rate of dissatisfaction could be due to the overstuff that mechanically aligned prostheses could produce during the
Tendinopathy is a disease associated with pain and tendon degeneration, leading to a decreased
Adult Spine Deformity (ASD) is a degenerative condition of the adult spine leading to altered spine curvatures and mechanical balance. Computational approaches, like Finite Element (FE) Models have been proposed to explore the etiology or the treatment of ASD, through biomechanical simulations. However, while the personalization of the models is a cornerstone, personalized FE models are cumbersome to generate. To cover this need, we share a virtual cohort of 16807 thoracolumbar spine FE models with different spine morphologies, presented in an online user-interface platform (SpineView). To generate these models, EOS images are used, and 3D surface spine models are reconstructed. Then, a Statistical Shape Model (SSM), is built, to further adapt a FE structured mesh template for both the bone and the soft tissues of the spine, through mesh morphing. Eventually, the SSM deformation fields allow the personalization of the mean structured FE model, leading to generate FE meshes of thoracolumbar spines with different morphologies. Models can be selectively viewed and downloaded through SpineView, according to personalized user requests of specific morphologies characterized by the geometrical parameters: Pelvic Incidence; Pelvic Tilt; Sacral Slope; Lumbar Lordosis; Global Tilt; Cobb Angle; and GAP score. Data quality is assessed using visual aids, correlation analyses, heatmaps, network graphs, Anova and t-tests, and kernel density plots to compare spinopelvic parameter distributions and identify similarities and differences. Mesh quality and
Hop tests are used to determine return to sports after ACL reconstruction. They mostly measure distance and symmetry but do not assess kinematics and kinetics. Recently, biomechanical evaluations have been incorporated into these functional jump tests for the better assessment of return to sport. We assessed the sagittal plane
Radial head fractures are among the most common fractures around the elbow. Radial head arthroplasty is one of the surgical treatment options after complex radial head fractures. This surgery is usually done under general anaesthesia. However, there is a recent anaesthetic technique - wide awake local anaesthesia no tourniquet (WALANT) - that has proven useful in different surgical settings, such as in distal radius or olecranon fractures. It allows a good haemostatic control without the use of a tourniquet and allows the patient to actively collaborate during the surgical procedure. Furthermore, there are no side effects or complications caused by the general anaesthesia and there's an earlier patient discharge. The authors present the case of a seventy-six-year-old woman who presented to the emergency department after a fall from standing height with direct trauma to the left elbow. The radiological examination revealed a complete intra-articular comminuted fracture of the radial head (Mason III). Clinical management: The patient was submitted to surgery with radial head arthroplasty, using WALANT. The surgery was successfully completed without pain. There were no intra or immediate post-operative complications and the patient was discharged on the same day. Six weeks after surgery, the patient had almost full
The aim of this study was to report the restauration of the normal vertebral morphology and the absence of curve progression after removal the instrumentation in AIS patients that underwent posterior correction of the deformity by common all screws construct whitout fusion. A series of 36 AIS immature patients (Risser 3 or less) were include in the study. Instrumentation was removed once the maturity stage was complete (Risser 5). Curve correction was assessed at pre and postoperative, before instrumentation removal, just post removal, and more than two years after instrumentation removal. Epiphyseal vertebral growth modulation was assessed by a coronal wedging ratio (WR) at the apical level of the main curve (MC). The mean preoperative coronal Cobb was corrected from 53.7°±7.5 to 5.5º±7.5º (89.7%) at the immediate postop. After implants removal (31.0±5.8 months) the MC was 13.1º. T5–T12 kyphosis showed a significant improvement from 19.0º before curve correction to 27.1º after implants removal (p<0.05). Before surgery, WR was 0.71±0.06, and after removal WR was 0.98±0.08 (p<0.001). At the end of follow-up, the mean sagittal
The principal of “function priority, early rehabilitation, and return to sports” is now the goal for sports injury rehabilitation. Neuromuscular electrical stimulation for anterior cruciate ligament (ACL) reconstruction is a rising procedure for early rehabilitation. This paper systematically assessed the effects of neuromuscular electrical stimulation on postoperative ACL reconstruction to provide guidance for physiotherapist and patient when designing a suitable rehabilitation protocol. To evaluate the interventional outcomes of neuromuscular electrical stimulation following ACL reconstruction, we searched PubMed, EMbase, the Cochrane Library, Web of Science and CNKI to collect all randomized controlled trials (RCTs) comparing the effects with neuromuscular electrical stimulation and without intervention on rehabilitation after ACL reconstruction up to January 30, 2022. Two investigators independently performed literature screening, data extraction, bias assessment of risk, and used RevMan 5.3 software to conduct a meta-analysis. A total of six RCTs were included, and the results showed that the use of neuromuscular electrical stimulation after anterior cruciate ligament reconstruction significantly improved the International Knee Documentation Committee (IKDC) scores (MD 6.33, 95% CI [-0.43, 12.22]; I2 = 66%; p = 0.040), the Lysholm score (MD 7.94, 95% CI [6.49, 9.39]; I2 = 89%; p < 0.001), and the
In healthy subjects, respiratory maximal volumes are highly dependent on the sagittal
One-fourth of all ankle trauma involve injury to the syndesmotic ankle complex, which may lead to syndesmotic instability and/or posttraumatic ankle osteoarthritis in the long term if left untreated. The diagnosis of these injuries still poses a deceitful challenge, as MRI scans lack physiologic weightbearing and plain weightbearing radiographs are subject to beam rotation and lack 3D information. Weightbearing cone-beam CT (WBCT) overcomes these challenges by imaging both ankles during bipedal stance, but ongoingdebate remains whether these should be taken under weightbearing conditions and/or during application of external rotation stress. The aim of this study is study therefore to compare both conditions in the assessment of syndesmotic ankle injuries using WBCT imaging combined with 3D measurement techniques. In this retrospective study, 21 patients with an acute ankle injury were analyzed using a WBCT. Patients with confirmed syndesmotic ligament injury on MRI were included, while fracture associated syndesmotic injuries were excluded. WBCT imaging was performed in weightbearing and combined weightbearing-external rotation. In the latter, the patient was asked to internally rotate the shin until pain (VAS>8/10) or a maximal
Conventional proximal tibial osteotomy is a widely successful joint-preserving treatment for osteoarthritis; however, conventional procedures do not adequately control the posterior tibial slope (PTS). Alterations to PTS can affect knee instability, ligament tensioning, knee kinematics, muscle and joint contact forces as well as
Postoperative knee stability is critical in determining the success after reconstruction; however, only posterior and anterior stability is assessed. Therefore, this study investigates medial and lateral rotational knee laxity changes after partial and complete PCL tear and after PCL allograft reconstruction. The extending Lachman test assessed knee instability in six fresh-frozen human cadaveric knees. Tibia rotation was measured for the native knee, after partial PCLT (pPCLT), after full PCLT (fPCLT), and then after PCLR tensioned at 30° and 90°. In addition, tests were performed for the medial and lateral sides. The tibia was pulled with 130N using a digital force gauge. A compression load of 50N was applied to the joint on the universal testing machine (MTS Systems) to induce contact. Three-dimensional tibial rotation was measured using a motion capture system (Optotrak). On average, the tibia rotation increased by 33%-42% after partial PCL tear, and by 62%-75% after full PCL tear when compared to the intact case. After PCL reconstruction, the medial tibia rotation decreased by 33% and 37% compared to the fPCL tear in the case that the allograft was tensioned at 30° and 90° of flexion, respectively. Similarly, lateral tibial rotation decreased by 15% and 2% for allograft tensioned at 30° and 90° of flexion respectively, compared to the full tear. Rotational decreases were statistically significant (p<0.005) at the lateral pulling after tensioning the allograft at 90°. PCLR with the graft tensioned at 30° and 90° both reduced medial knee laxity after PCLT. These results suggest that while both tensioning angles restored medial knee stability, tensioning the Achilles graft at 30° of knee flexion was more effective in restoring lateral knee stability throughout the