scholarly journals Knee position at the moment of bone bruise could reflect the late phase of non-contact anterior cruciate ligament injury rather than the mechanisms leading to ligament failure

2021 ◽  
Author(s):  
Alberto Grassi ◽  
Piero Agostinone ◽  
Stefano Di Paolo ◽  
Gian Andrea Lucidi ◽  
Luca Macchiarola ◽  
...  
Keyword(s):  
External Rotation ◽  
Late Phase ◽  
Ligament Injury ◽  
Bone Bruise ◽  
Knee Position ◽  
Flexion Extension ◽  
Ligament Failure ◽  
The Moment ◽  
Tibial Translation

Abstract Purpose The aim of the present study was to trace knee position at the time of bone bruise (BB) and investigate how much this position departed from the knee biomechanics of an in vivo flexion–extension. Methods From an original cohort of 62 patients, seven (11%) presented bicompartmental edemas and were included in the study. 3D models of bones and BB were obtained from MRI. Matching bone edemas, a reconstruction of the knee at the moment of BB was obtained. For the same patients, knee kinematics of a squat was calculated using dynamic Roentgen sterephotogrammetric analysis (RSA). Data describing knee position at the moment of BB were compared to kinematics of the same knee extrapolated from RSA system. Results Knee positions at the moment of BB was significantly different from the kinematics of the squat. In particular, all the patients’ positions were out of squat range for both anterior and proximal tibial translation, varus–valgus rotation (five in valgus and two in varus), tibial internal–external rotation (all but one, five externally and one internally). A direct comparison at same flexion angle between knee at the moment of BB (average 46.1° ± 3.8°) and knee during squat confirmed that tibia in the former was significantly more anterior (p < 0.0001), more externally rotated (6.1 ± 3.7°, p = 0.04), and valgus (4.1 ± 2.4°, p = 0.03). Conclusion Knee position at the moment of Bone bruise position was out of physiological in-vivo knee range of motion and could reflect a locked anterior subluxation occurring in the late phase of ACL injury rather than the mechanism leading to ligament failure. Level of evidence Level IV

scholarly journals Patient-specific resurfacing implant knee surgery in subjects with early osteoarthritis results in medial pivot and lateral femoral rollback during flexion: a retrospective pilot study

2021 ◽  
Author(s):  
Philippe Moewis ◽  
René Kaiser ◽  
Adam Trepczynski ◽  
Christoph von Tycowicz ◽  
Leonie Krahl ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
External Rotation ◽  
Knee Kinematics ◽  
Axial Rotation ◽  
Patient Specific ◽  
Post Surgery ◽  
Flexion Extension ◽  
Medial Pivot ◽  
Femoral Rollback

Abstract Purpose Metallic resurfacing implants have been developed for the treatment of early, small, condylar and trochlear osteoarthritis (OA) lesions. They represent an option for patients who do not fulfill the criteria for unicompartmental knee arthroplasty (UKA) or total knee arthroplasty (TKA) or are too old for biological treatment. Although clinical evidence has been collected for different resurfacing types, the in vivo post-operative knee kinematics remain unknown. The present study aims to analyze the knee kinematics in subjects with patient-specific episealer implants. This study hypothesized that patient-specific resurfacing implants would lead to knee kinematics close to healthy knees, resulting in medial pivot and a high degree of femoral rollback during flexion. Methods Retrospective study design. Fluoroscopic analysis during unloaded flexion–extension and loaded lunge was conducted at > 12 months post-surgery in ten episealer knees, and compared to ten healthy knees. Pre- and post-operative clinical data of the episealer knees were collected using a visual analog scale (VAS), the EQ 5d Health, and the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaires. Results A consistent medial pivot was observed in both episealer and healthy knees. Non-significant differences were found in the unloaded (p = 0.15) and loaded (p = 0.51) activities. Although lateral rollback was observed in both groups, it was significantly higher for the episealer knees in both the unloaded (p = 0.02) and loaded (p = 0.01) activities. Coupled axial rotation was significantly higher in the unloaded (p = 0.001) but not in the loaded (p = 0.06) activity in the episealer knees. Improved scores were observed at 1-year post-surgery in the episealer subjects for the VAS (p = 0.001), KOOS (p = 0.001) and EQ Health (p = 0.004). Conclusion At 12 month follow-up, a clear physiological knee kinematics pattern of medial pivot, lateral femoral rollback and coupled axial external femoral rotation during flexion was observed in patients treated with an episealer resurfacing procedure. However, higher femoral rollback and axial external rotation in comparison to healthy knees was observed, suggesting possible post-operative muscle weakness and consequent insufficient stabilization at high flexion.

Wearable Motion Capture System Evaluation for Biomechanical Studies for Hip Joints

2020 ◽  
Author(s):  
Senay Mihcin ◽  
Samet Ciklacandir ◽  
Mertcan Kocak ◽  
Aliye Tosun
Keyword(s):  
Motion Capture ◽  
Hip Joint ◽  
External Rotation ◽  
Human Motion ◽  
Simulation Software ◽  
Wearable System ◽  
Single Plane ◽  
Flexion Extension

Abstract Human motion capture (MOCAP) systems are vital, while determining the loads occurring at the joints. Most of the clinical MOCAP systems are very costly, requiring investment and infrastructure. Therefore, alternative technologies are in demand. In this study, a novel marker-less wearable MOCAP system, was assessed for its compatibility with a biomechanical modelling software. To collect evidence, experiments were designed in two stages for quantifying the range of motion of the hip joint; in vitro and in vivo. Three constrained-single-plane motions; abduction/adduction, flexion/extension, and internal/external rotation movements of the active leg were analysed. The data were collected from 14 healthy volunteers, using the wearable system and a medical grade optoelectronic MOCAP system simultaneously and compared against. For the in vitro study, the Root Mean Square Error (RMSE) for the abduction/adduction motion of the hip joint was calculated as 0.11°/0.30° and 0.11°/0.09° respectively for the wearable and the opto-electronic system. The in vivo Bland-Altman plots showed that the two system data are comparable. The simulation software is found compatible to run the simulations in offline mode. The wearable system could be utilized in the field of biomechanics software for running the kinetic simulations. The results demonstrated that the wearable system could be an alternative in the field of biomechanics based on the evidence collected.

scholarly journals The Spinebot—A Robotic Device to Intraoperatively Quantify Spinal Stiffness

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Philippe Büchler ◽  
Jonas Räber ◽  
Benjamin Voumard ◽  
Steve Berger ◽  
Brett Bell ◽  
...  
Keyword(s):  
Ex Vivo ◽  
Three Dimensional ◽  
Axial Rotation ◽  
Flexion Extension ◽  
Torque Load ◽  
The Moment ◽  
Reference Measurements ◽  
Spine Function ◽  
And Function

Abstract Degenerative spine problems and spinal deformities have high socio-economic impacts. Current surgical treatment is based on bony fusion that can reduce mobility and function. Precise descriptions of the biomechanics of normal, deformed, and degenerated spinal segments under in vivo conditions are needed to develop new approaches that preserve spine function. This study developed a system that intraoperatively measures the three-dimensional segmental stiffness of patient's spine. SpineBot, a parallel kinematic robot, was developed to transmit loads to adjacent vertebrae. A force/torque load cell mounted on the SpineBot measured the moment applied to the spinal segment and calculated segmental stiffnesses. The accuracy of SpineBot was characterized ex vivo by comparing its stiffness measurement of five ovine specimens to measurements obtained with a reference spinal testing system. The SpineBot can apply torques up to 10 N·m along all anatomical axes with a total range of motion of about 11.5 deg ± 0.5 deg in lateral bending, 4.5 deg ± 0.3 deg in flexion/extension, and 2.6 deg ± 0.5 deg in axial rotation. SpineBot's measurements are noisier than the reference system, but the correlation between SpineBot and reference measurements was high (R2 &gt; 0.8). In conclusion, SpineBot's accuracy is comparable to that of current reference systems but can take intraoperative measurements. SpineBot can improve our understanding of spinal biomechanics in patients who have the pathology of interest, and take these measurements in the natural physiological environment, giving us information essential to developing new “nonfusion” products.

scholarly journals Effect of Fatigue on Functional Stability of the Knee: Particularities of Female Handball Players

2019 ◽  
Vol 40 (07) ◽  
pp. 468-476 ◽  
Author(s):  
Timothée Gillot ◽  
Maxime L'Hermette ◽  
Typhanie Garnier ◽  
Claire Tourny-Chollet
Keyword(s):  
Cruciate Ligament ◽  
Joint Laxity ◽  
Ligament Injury ◽  
Anterior Tibial Translation ◽  
Knee Stability ◽  
Load Curve ◽  
Fatigue Protocol ◽  
Flexion Extension ◽  
Anterior Tibial ◽  
Tibial Translation

AbstractThe risk of anterior cruciate ligament injury in female handball players is high. Fatigue of active stabilizers and increases in joint laxity are often mentioned in the literature as causal factors. However, no studies have been carried out on this population. Our objective is to determine the effect of muscle fatigue on active and passive knee stability in female handball players. This prospective study assessed tibiofemoral joint laxity, as well as hamstring and quadriceps strength, before (Tinitial), during and 3 min after (Tfinal) an isokinetic fatigue protocol (25 repetitions of knee flexion / extension at 180°.s−1). Laxity values (slope of the displacement-load curve and anterior tibial translation) were measured using a GNRB-Rotab® arthrometer; torque values were measured at specific joint angles and peak muscle torque using an isokinetic dynamometer. Nineteen women (20.9±2.4 years, 62.0±4.9 kg, 166±5 cm) were included. Normalized peak torque decreased significantly between the first three and last three repetitions of the fatigue protocol (p<0.0001, ES=3.2 and 3.2). Slope of the displacement-load curve and anterior tibial translation, functional and conventional ratios did not change significantly between Tinitial and Tfinal. Active and passive markers of knee stability were not altered by a fatigue protocol in female handball players, suggesting these players have a large capacity for recovery. These results suggest that muscle strengthening to prevent ACL injury in female handball players may be inappropriate.Level of evidence: Level 2b, Prospective Cohort.

EFEITOS DO DEEP RUNNING SOBRE A AMPLITUDE DE MOVIMENTO E A CAPACIDADE FUNCIONAL DOS MEMBROS SUPERIORES DE MULHERES MASTECTOMIZADAS: RELATO DE CASOS

2019 ◽  
pp. 121-131
Keyword(s):  
Range Of Motion ◽  
Upper Limb ◽  
Functional Capacity ◽  
External Rotation ◽  
Treatment Protocol ◽  
Range Of Movement ◽  
Flexion Extension ◽  
Before And After ◽  
In The Beginning ◽  
And Function

Introduction: Breast cancer is the most common type of cancer among women in Brazil and in the worl. The surgical treatment procedure may cause severe morbidity in the upper limb homolateral to surgery, including the reduction of the range of motion, with consequent impairment of function. A physiotherapeutic approach has an important role in the recover range of motion and the functionality of these women, guaranteeing the occupational, domestestic, familiar and conjugated activities, and, in this way, also improving the quality of life. Objectives: To analyse chances in the shoulder's range of motion and the functional capacity of the upper limbs, promoted by the deep running procedure in women with late postoperative mastectomy. Methods: All the patients were submitted to an evaluation in the beginning and end of the treatment, including: goniometry of flexion, extension, abduction, adduction, internal and external rotation of the shoulder joint; and function capacity analysis in activities that involve the upper members by DASH questionnaire. The treatment protocol includes twelve sessions of deep running, realized twice a week, in deep pool, for 20-minute during six weeks. Results: Were submitted to treatment a total of 4 patients. Despite the improvement in the numerical values, statistically significant differences were not found on the range of movements and in the functional capacity of upper members before and after the deep running sessions in post-mastectomy women. Conclusion: Deep running had effects on the numerical values of range of movement and upper limb functionality in women in the late postoperative period of the mastectomy procedure, but without statistically significant differences.

scholarly journals Reliability of a New Portable Dynamometer for Assessing Hip and Lower Limb Strength

2021 ◽  
Vol 11 (8) ◽  
pp. 3391
Author(s):  
Jan Marušič ◽  
Goran Marković ◽  
Nejc Šarabon
Keyword(s):  
Lower Limb ◽  
External Rotation ◽  
Peak Torque ◽  
Knee Extension ◽  
Lower Limb Muscles ◽  
Lower Limb Strength ◽  
Flexion Extension ◽  
Strength Tests ◽  
Hip Abduction ◽  
Maximal Peak

The purpose of this study was to evaluate intra- and inter-session reliability of the new, portable, and externally fixated dynamometer called MuscleBoard® for assessing the strength of hip and lower limb muscles. Hip abduction, adduction, flexion, extension, internal and external rotation, knee extension, ankle plantarflexion, and Nordic hamstring exercise strength were measured in three sessions (three sets of three repetitions for each test) on 24 healthy and recreationally active participants. Average and maximal value of normalized peak torque (Nm/kg) from three repetitions in each set and agonist:antagonist ratios (%) were statistically analyzed; the coefficient of variation and intra-class correlation coefficient (ICC2,k) were calculated to assess absolute and relative reliability, respectively. Overall, the results display high to excellent intra- and inter-session reliability with low to acceptable within-individual variation for average and maximal peak torques in all bilateral strength tests, while the reliability of unilateral strength tests was moderate to good. Our findings indicate that using the MuscleBoard® dynamometer can be a reliable device for assessing and monitoring bilateral and certain unilateral hip and lower limb muscle strength, while some unilateral strength tests require some refinement and more extensive familiarization.

scholarly journals Decoding the temporal nature of brain GR activity in the NFκB signal transition leading to depressive-like behavior

2021 ◽  
Author(s):  
Young-Min Han ◽  
Min Sun Kim ◽  
Juyeong Jo ◽  
Daiha Shin ◽  
Seung-Hae Kwon ◽  
...  
Keyword(s):  
Inhibitory Action ◽  
Time Course ◽  
Molecular Mechanisms ◽  
Late Phase ◽  
Fine Tuning ◽  
Dependent Manner ◽  
Middle Phase ◽  
Temporal Shift

AbstractThe fine-tuning of neuroinflammation is crucial for brain homeostasis as well as its immune response. The transcription factor, nuclear factor-κ-B (NFκB) is a key inflammatory player that is antagonized via anti-inflammatory actions exerted by the glucocorticoid receptor (GR). However, technical limitations have restricted our understanding of how GR is involved in the dynamics of NFκB in vivo. In this study, we used an improved lentiviral-based reporter to elucidate the time course of NFκB and GR activities during behavioral changes from sickness to depression induced by a systemic lipopolysaccharide challenge. The trajectory of NFκB activity established a behavioral basis for the NFκB signal transition involved in three phases, sickness-early-phase, normal-middle-phase, and depressive-like-late-phase. The temporal shift in brain GR activity was differentially involved in the transition of NFκB signals during the normal and depressive-like phases. The middle-phase GR effectively inhibited NFκB in a glucocorticoid-dependent manner, but the late-phase GR had no inhibitory action. Furthermore, we revealed the cryptic role of basal GR activity in the early NFκB signal transition, as evidenced by the fact that blocking GR activity with RU486 led to early depressive-like episodes through the emergence of the brain NFκB activity. These results highlight the inhibitory action of GR on NFκB by the basal and activated hypothalamic-pituitary-adrenal (HPA)-axis during body-to-brain inflammatory spread, providing clues about molecular mechanisms underlying systemic inflammation caused by such as COVID-19 infection, leading to depression.

Hip and ankle strength and range of motion in female soccer players with dynamic knee valgus

2021 ◽  
pp. 1-6
Author(s):  
Young Jin Jo ◽  
Young Kyun Kim
Keyword(s):  
Range Of Motion ◽  
Female Athletes ◽  
External Rotation ◽  
Preventive Measure ◽  
Control Group ◽  
Knee Valgus ◽  
Strength Ratio ◽  
Flexion Extension ◽  
Hip Abduction ◽  
Single Leg Squat

BACKGROUND: Dynamic knee valgus (DKV) is a known risk factor for acute and chronic knee injuries and is more frequently diagnosed in females. A real-time single-leg squat test (SLST) could screen for DKV to prevent injuries. OBJECTIVE: To compare the differences in lower extremity strength and range of motion (ROM) in female soccer athletes with and without DKV during an SLST. METHODS: Eighteen subjects with DKV (DKV group) and 18 subjects without DKV (control group) during a single-leg squat were included. Hip strength (flexion, extension, abduction, adduction, internal rotation, and external rotation) was measured with a hand-held dynamometer. Hip ROM (internal and external rotation), and ankle ROM (dorsiflexion with the knee flexed and extended) were measured. Independent t-test was used to compare the averages of the groups. RESULTS: There were significant differences in hip abduction to adduction strength ratio (DKV: 1.48 ± 0.3, control: 1.22 ± 0.26, p< 0.01) and ankle dorsiflexion with knee flexed (DKV: 17.22 ± 6.82, control: 21.22 ± 4.55, p< 0.05) and extended (DKV: 10.14 ± 4.23, control: 14.75 ± 3.40, p< 0.001) between the groups. CONCLUSION: The hip abduction to adduction strength ratio and gastrocnemius and soleus flexibility may be associated factors in dynamic knee valgus and therefore should be assessed and treated, if indicated, as a possible preventive measure in female athletes with this variation.

scholarly journals Accuracy and repeatability of wrist joint angles in boxing using an electromagnetic tracking system

2019 ◽  
Vol 23 (1) ◽  
Author(s):  
Ian T. Gatt ◽  
Tom Allen ◽  
Jon Wheat
Keyword(s):  
Wrist Joint ◽  
Tracking System ◽  
Testing Procedure ◽  
Electromagnetic Tracking ◽  
Good Reliability ◽  
Flexion Extension ◽  
In Vivo Testing ◽  
Accuracy And Repeatability ◽  
Electromagnetic Tracking System

AbstractThe hand-wrist region is reported as the most common injury site in boxing. Boxers are at risk due to the amount of wrist motions when impacting training equipment or their opponents, yet we know relatively little about these motions. This paper describes a new method for quantifying wrist motion in boxing using an electromagnetic tracking system. Surrogate testing procedure utilising a polyamide hand and forearm shape, and in vivo testing procedure utilising 29 elite boxers, were used to assess the accuracy and repeatability of the system. 2D kinematic analysis was used to calculate wrist angles using photogrammetry, whilst the data from the electromagnetic tracking system was processed with visual 3D software. The electromagnetic tracking system agreed with the video-based system (paired t tests) in both the surrogate (< 0.2°) and quasi-static testing (< 6°). Both systems showed a good intraclass coefficient of reliability (ICCs > 0.9). In the punch testing, for both repeated jab and hook shots, the electromagnetic tracking system showed good reliability (ICCs > 0.8) and substantial reliability (ICCs > 0.6) for flexion–extension and radial-ulnar deviation angles, respectively. The results indicate that wrist kinematics during punching activities can be measured using an electromagnetic tracking system.

scholarly journals High Natural Permissivity of Primary Rabbit Cells for HIV-1, with a Virion Infectivity Defect in Macrophages as the Final Replication Barrier

2010 ◽  
Vol 84 (23) ◽  
pp. 12300-12314 ◽  
Author(s):  
Hanna-Mari Tervo ◽  
Oliver T. Keppler
Keyword(s):  
T Cells ◽  
Late Phase ◽  
Small Animal ◽  
Receptor Complex ◽  
Restriction Factors ◽  
Cyclin T1 ◽  
Primary Rabbit ◽  
Species Specific ◽  
Hiv 1

ABSTRACT An immunocompetent, permissive, small-animal model would be valuable for the study of human immunodeficiency virus type 1 (HIV-1) pathogenesis and for the testing of drug and vaccine candidates. However, the development of such a model has been hampered by the inability of primary rodent cells to efficiently support several steps of the HIV-1 replication cycle. Although transgenesis of the HIV receptor complex and human cyclin T1 have been beneficial, additional late-phase blocks prevent robust replication of HIV-1 in rodents and limit the range of in vivo applications. In this study, we explored the HIV-1 susceptibility of rabbit primary T cells and macrophages. Envelope-specific and coreceptor-dependent entry of HIV-1 was achieved by expressing human CD4 and CCR5. A block of HIV-1 DNA synthesis, likely mediated by TRIM5, was overcome by limited changes to the HIV-1 gag gene. Unlike with mice and rats, primary cells from rabbits supported the functions of the regulatory viral proteins Tat and Rev, Gag processing, and the release of HIV-1 particles at levels comparable to those in human cells. While HIV-1 produced by rabbit T cells was highly infectious, a macrophage-specific infectivity defect became manifest by a complex pattern of mutations in the viral genome, only part of which were deamination dependent. These results demonstrate a considerable natural HIV-1 permissivity of the rabbit species and suggest that receptor complex transgenesis combined with modifications in gag and possibly vif of HIV-1 to evade species-specific restriction factors might render lagomorphs fully permissive to infection by this pathogenic human lentivirus.

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