Kinematic alignment matches functional alignment for the extension gap: a consecutive analysis of 749 primary varus osteoarthritic knees with stress radiographs

2022 ◽  
Author(s):  
E. Sappey-Marinier ◽  
P. Meynard ◽  
J. Shatrov ◽  
A. Schmidt ◽  
L. Cheze ◽  
...  
Keyword(s):  
Kinematic Alignment ◽  
Stress Radiographs ◽  
Extension Gap

scholarly journals Consistency and Reliability of Ankle Stress Radiography in Patients With Chronic Lateral Ankle Instability

2021 ◽  
Vol 9 (5) ◽  
pp. 232596712110040
Author(s):  
Ji Hye Choi ◽  
Kug Jin Choi ◽  
Chin Youb Chung ◽  
Moon Seok Park ◽  
Ki Hyuk Sung ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Tilt Angle ◽  
Ankle Instability ◽  
Interobserver Reliability ◽  
Initial Presentation ◽  
Lateral Ankle ◽  
Chronic Lateral Ankle Instability ◽  
Stress Radiographs ◽  
Lateral Ankle Instability

Background: Ankle stress radiographs are important tools for evaluating chronic lateral ankle instability. The consistency of a patient’s ankle condition as it affects the reliability of ankle stress radiographs has never been evaluated. Purpose: To investigate the consistency and reliability of ankle stress radiographs in patients with chronic lateral ankle instability without an ankle injury during the study period. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: Included were patients with chronic lateral ankle instability who underwent 2 repeated ankle stress radiographs between January 2014 and July 2019; those with an ankle injury during the study period were excluded. The tibiotalar tilt angle on varus stress radiographs and anterior translation of the talus on anterior drawer stress radiographs were measured at initial presentation and final follow-up examination. Interobserver reliability and consistency of ankle stress radiographs were analyzed using the intraclass correlation coefficient (ICC). Results: A total of 45 patients (mean ± standard deviation age, 36.4 ± 13.4 years; 18 men and 27 women; follow-up duration, 9.1 ± 3.2 months) were included. The mean ± standard deviation tibiotalar tilt angle and anterior talar translation at initial presentation were 10.8° ± 5.2° and 6.9 ± 2.7 mm, respectively. The interobserver reliabilities of the tibiotalar tilt angle and anterior talar translation were excellent (ICC = 0.926 [95% CI, 0.874-0.959] and 0.911 [95% CI, 0.766-0.961], respectively). The consistency between the initial and final radiographs was good for tibiotalar tilt angle (ICC = 0.763 [95% CI, 0.607-0.862]) and poor for anterior talar translation (ICC = 0.456 [95% CI, 0.187-0.660]). Conclusion: Although the interobserver reliability of the radiographic measurements was excellent, the consistency of the ankle stress radiographs was not as acceptable. Surgeons need to be cautious when deciding whether to operate on a patient with chronic lateral ankle instability based on a single ankle stress radiograph.

scholarly journals True Kinematic Alignment Is Applicable in 44% of Patients Applying Restrictive Indication Criteria—A Retrospective Analysis of 111 TKA Using Robotic Assistance

2021 ◽  
Vol 11 (7) ◽  
pp. 662
Author(s):  
Kim Huber ◽  
Bernhard Christen ◽  
Sarah Calliess ◽  
Tilman Calliess
Keyword(s):  
Soft Tissue ◽  
Retrospective Analysis ◽  
Patient Specific ◽  
Kinematic Alignment ◽  
Postoperative Phase ◽  
Robotic Assistance ◽  
Component Position ◽  
Joint Stability ◽  
Robotic Assisted ◽  
Primary Tkas

Introduction: Image-based robotic assistance appears to be a promising tool for individualizing alignment in total knee arthroplasty (TKA). The patient-specific model of the knee enables a preoperative 3D planning of component position. Adjustments to the individual soft-tissue situation can be done intraoperatively. Based on this, we have established a standardized workflow to implement the idea of kinematic alignment (KA) for robotic-assisted TKA. In addition, we have defined limits for its use. If these limits are reached, we switch to a restricted KA (rKA). The aim of the study was to evaluate (1) in what percentage of patients a true KA or an rKA is applicable, (2) whether there were differences regarding knee phenotypes, and (3) what the differences of philosophies in terms of component position, joint stability, and early patient outcome were. Methods: The study included a retrospective analysis of 111 robotic-assisted primary TKAs. Based on preoperative long leg standing radiographs, the patients were categorized into a varus, valgus, or neutral subgroup. Initially, all patients were planned for KA TKA. When the defined safe zone had been exceeded, adjustments to an rKA were made. Intraoperatively, the alignment of the components and joint gaps were recorded by robotic software. Results and conclusion: With our indication for TKA and the defined boundaries, “only” 44% of the patients were suitable for a true KA with no adjustments or soft tissue releases. In the varus group, it was about 70%, whereas it was 0% in the valgus group and 25% in the neutral alignment group. Thus, significant differences with regard to knee morphotypes were evident. In the KA group, a more physiological knee balance reconstructing the trapezoidal flexion gap (+2 mm on average laterally) was seen as well as a closer reconstruction of the surface anatomy and joint line in all dimensions compared to rKA. This resulted in a higher improvement in the collected outcome scores in favor of KA in the very early postoperative phase.

Impact Assessment of Front Line Demonstrations on Summer Mung Productivity under Irrigated Agro-ecosystem of Haryana

2021 ◽  
Author(s):  
Jogender Singh ◽  
Kuldeep Singh ◽  
Hemender . ◽  
Premdeep .
Keyword(s):  
Soil Health ◽  
Wheat Crop ◽  
Economic Returns ◽  
Front Line ◽  
Nutritional Security ◽  
Northern India ◽  
Yield Gaps ◽  
Production Technologies ◽  
Extension Gap ◽  
Additional Income

Background: Summer mung proved to be an effective crop in improving soil health, providing additional income to the farmers, works as catch crop and fits in paddy-wheat crop rotation in Northern India. Its cultivation leads to increase in house hold income of the farmers and contributed to nutritional security in rural India. The present study was carried out by Krishi Vigyan Kendra (KVK), Sonepat in its adopted villages. Methods: A total number of 159 front line demonstrations (FLDs) were conducted on summer mung in 75.2 hectare area using improved variety MH-421 during summer 2017 and 2018 after harvesting of wheat and prior to paddy transplanting to show case improved production technologies on farmers’ field specifically under paddy-wheat rotation. The production, productivity and economic returns of summer mung in demonstrations and farmers’ practice were compared and different yield gaps were analyzed. Result: Average yield of demonstration plots was recorded significantly higher by 20.0 per cent and 21.3 per cent in summer 2017 and 2018, respectively. The extension gap was 1.75 q/ha and 1.90 q/ha while technology gap was 1.5 q/ha and 1.2 q/ha in 2017 and 2018, respectively. The additional economic returns for farmers ranged from Rs. 2907/ha to Rs. 3200/ha as a results of these FLDs. Hence, adoption of improved summer mung cultivation practices contributed to better yield and higher economic returns under paddy-wheat rotation after harvesting of wheat crop.

​Impact of Cluster Front Line Demonstrations on the Yield and Economics of Chickpea under National Food Security Mission in Bharatpur District of Rajasthan, India

2021 ◽  
Author(s):  
Krishna Avatar Meena ◽  
J.K. Gupta ◽  
R.K. Dular ◽  
B.K. Bhinchhar ◽  
R.K. Meena ◽  
...  
Keyword(s):  
Average Yield ◽  
Front Line ◽  
Nutritional Security ◽  
Legume Crop ◽  
Farming Community ◽  
Leguminous Crop ◽  
Food And Nutritional Security ◽  
Improved Technology ◽  
Extension Gap ◽  
National Food Security

Background: Chickpea is an important legume crop that plays an important role in the food and nutritional security of people in the developing countries and contributing to protein intake. It is a soil building crop and being a leguminous crop, it fixes atmospheric nitrogen through symbiotic fixation, there by helps in N cycling within the ecosystem. Methods: Cluster front line demonstrations of chickpea were conducted by Krishi Vigyan Kendra, Kumher, Bharatpur (Rajasthan) during Rabi season from 2016-17 to 2019-20. A total 350 front line demonstrations were conducted on chickpea in 140 ha area by the active participation of the farmers with the objective of improved technologies of chickpea production potentials. Result: The results of the demonstrations observed that on an average yield of chickpea under improved technology ranged from 11.83 to 17.52 q/ha with a mean of 14.47 q/ha; which was 20.95 per cent more yield as compared to farmer’s practices (11.97 q/ha). Moreover, average yield was also recorded higher under demonstration (14.47 q/ha) over district (8.17 q/ha) and State (10.74 q/ha) average. The study exhibited mean extension gap of 250.75 Kg/ha, mean technology gap of 627.75 kg/ha with mean technology index of 29.71 per cent. Higher mean net return of Rs. 46618/ha with mean B: C ratio of 3.10 was obtained with improved technologies in comparison to farmers’ practices (Rs. 36737/ha). The present study resulted to convincing the farming community for higher productivity and returns.

Adjusting Insert Thickness and Tibial Slope Do Not Correct Internal Tibial Rotation Loss Caused by PCL Resection: In Vitro Study of a Medial Constraint TKA Implanted with Unrestricted Calipered Kinematic Alignment

2021 ◽  
Author(s):  
Alexander J. Nedopil ◽  
Peter J. Thadani ◽  
Thomas H. McCoy ◽  
Stephen M. Howell ◽  
Maury L. Hull
Keyword(s):  
Internal Rotation ◽  
Cruciate Ligament ◽  
Tibial Slope ◽  
Kinematic Alignment ◽  
Tibial Rotation ◽  
Medial Condyle ◽  
Maximum Extension ◽  
Posterior Tibial ◽  
Internal Tibial Rotation ◽  
Lift Off

AbstractMost medial stabilized (MS) total knee arthroplasty (TKA) implants recommend excision of the posterior cruciate ligament (PCL), which eliminates the ligament's tension effect on the tibia that drives tibial rotation and compromises passive internal tibial rotation in flexion. Whether increasing the insert thickness and reducing the posterior tibial slope corrects the loss of rotation without extension loss and undesirable anterior lift-off of the insert is unknown. In 10 fresh-frozen cadaveric knees, an MS design with a medial ball-in-socket (i.e., spherical joint) and lateral flat insert was implanted with unrestricted calipered kinematic alignment (KA) and PCL retention. Trial inserts with goniometric markings measured the internal–external orientation relative to the femoral component's medial condyle at maximum extension and 90 degrees of flexion. After PCL excision, these measurements were repeated with the same insert, a 1 mm thicker insert, and a 2- and 4-mm shim under the posterior tibial baseplate to reduce the tibial slope. Internal tibial rotation from maximum extension and 90 degrees of flexion was 15 degrees with PCL retention and 7 degrees with PCL excision (p < 0.000). With a 1 mm thicker insert, internal rotation was 8 degrees (p < 0.000), and four TKAs lost extension. With a 2 mm shim, internal rotation was 9 degrees (p = 0.001) and two TKAs lost extension. With a 4 mm shim, internal rotation was 10 degrees (p = 0.002) and five TKAs lost extension and three had anterior lift-off. The methods of inserting a 1 mm thicker insert and reducing the posterior slope did not correct the loss of internal tibial rotation after PCL excision and caused extension loss and anterior lift-off in several knees. PCL retention should be considered when using unrestricted calipered KA and implanting a medial ball-in-socket and lateral flat insert TKA design, so the progression of internal tibial rotation and coupled reduction in Q-angle throughout flexion matches the native knee, optimizing the retinacular ligaments' tension and patellofemoral tracking.

scholarly journals Performance assessment of Bhendi hybrid Co 4 cultivation over local check variety under Front Line Demonstration

2020 ◽  
Vol 13 (1) ◽  
pp. 189-196
Author(s):  
V. Sivakumar ◽  
S. Praneetha ◽  
R. Balakumbahan ◽  
B. Meena ◽  
G. Thiyagarajan ◽  
...  
Keyword(s):  
Tamil Nadu ◽  
Growth Yield ◽  
Field Investigation ◽  
Average Yield ◽  
Front Line ◽  
Recorded Data ◽  
Check Variety ◽  
Gap Technology ◽  
Benefit Cost ◽  
Extension Gap

A field investigation on productivity augmentation of bhendi [Abelmoschus esculentus L. Moench] was carried out at Melanagai village, Mannargudi block of Thrivarurur district. The study was conducted by ICAR-Krishi Vigyan Kendra, Needamangalam [Tamil Nadu], during 2016-17 to assess the bhendi/okra hybrid Co 4 performance along with local check variety.The per cent yield improvement, technology gap, extension gap, technology index were calculated based on the observation recorded on growth, yield and economical attributes of both demonstration and local adopted check variety. The recorded data showed that the average yield of demonstration plots was 20.35 tha–1whereas the local check recorded an average yield of 12.80 tha–1 and there is an amplified average yield by 37.21 per cent. The gross returns and benefit cost ratios from the demonstration plot were higher [Rs. 121020/ha and 2.80 respectively] as compared to farmer’s practices [Rs. 76800/ha and 1.90]. The demonstrated improved variety i.e. okra hybrid Co 4 recorded superior growth, yield and economical parameters of the local adopted check variety. The enhancement in growth, yield and economic parameters under okra hybrid Co4 than the farmers’ practice [local check] signifying the technical and economic viability of improved variety / hybrid over farmers practices.

(iv) Flexion—extension gap theory

2001 ◽  
Vol 15 (6) ◽  
pp. 423-427 ◽  
Author(s):  
D. Macdonald
Keyword(s):  
Flexion Extension ◽  
Extension Gap

Impact on Cluster Frontline Demonstrations on the Productivity of Mustard (Brassica juncea)

2021 ◽  
Vol 12 (5) ◽  
pp. 295-302
Author(s):  
Laxman Prasad Balai ◽  
◽  
Navab Singh ◽  
D. R. Sharma ◽  
◽  
...  
Keyword(s):  
New Technology ◽  
Educational Activity ◽  
Rabi Season ◽  
White Rust ◽  
Logical Method ◽  
Cultivation Technology ◽  
Gap Technology ◽  
Extension Gap ◽  
National Food Security

Cluster frontline demonstrations (CFLDs) are the long-term educational activity conducted in a logical method on partner farmer’s field to show the worth of new technology under micro farming. The present investigation was carried out during the Rabi season (October to March) of respective year 2016-17 to 2019-20 under the National Food Security Mission, Government of India. Four hundred thirteen CFLDs were conducted in 165.2 ha area with the farmers and scientists of KVK. The CFLDs were conducted at adopted fifteen villages of Dholpur district. Cultivation technology was applied under CFLDs included scientific intervention. The highest yield was obtained in demonstrated practices (DP) with an average of 2272.00 kg ha-1 as compared to farmer practice (FP) with an average of 1829.00 kg ha-1. Further, an average additional return (` 16,063.6), effective gain (` 14,335.8), net return (` 64,512.1 ha-1) and benefit-cos ratio (3.49) were found in the DP as compared to farmer practice. An average occurrence of Alternaria blight, white rust, stem rot, aphid were recorded 27.44, 5.93 and 14.85 and 25.05, respectively showed in DP as compared to farmer practice. An average extension gap, technology gap and technology index between and was noted 443.0 kg ha-1, 234.75 kg ha-1 and 10.39%, respectively. The results indicate that the use of scientific intervention under CFLDs to increase the production and profitability of Mustard.

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