scholarly journals Restoring range of motion in reduced acetabular version by increasing femoral antetorsion – What about joint load?

2021 ◽  
pp. 105409
Author(s):  
Tabitha Roth ◽  
Stefan Rahm ◽  
Anna Jungwirth-Weinberger ◽  
Janine Süess ◽  
Reto Sutter ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Acetabular Version ◽  
Femoral Antetorsion ◽  
Joint Load

scholarly journals The effect of humeral polyethylene insert constraint on reverse shoulder arthroplasty biomechanics

2017 ◽  
Vol 10 (1) ◽  
pp. 25-31 ◽  
Author(s):  
Irfan Abdulla ◽  
Daniel G Langohr ◽  
Joshua W. Giles ◽  
James A. Johnson ◽  
George S. Athwal
Keyword(s):  
Range Of Motion ◽  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
Biomechanical Study ◽  
Polyethylene Insert ◽  
Muscle Forces ◽  
Joint Load ◽  
Joint Loads ◽  
Load Angle ◽  
Active Abduction

Background There is little information on the effects of altering reverse shoulder arthroplasty (RSA) polyethylene constraint on joint load, load angle and deltoid force. The present biomechanical study aimed to investigate the effects of changing RSA polyethylene constraint on joint load, load angle, deltoid force and range of motion. Methods A custom RSA implant capable of measuring forces across the joint with varying polyethylene constraint was tested in six cadaveric shoulders. Standard-, low- and high-constraint (retentive) polyethylene liners were tested, and joint kinematics, loads and muscle forces were recorded. Results When polyethylene constraint was altered, joint load and load angle during active abduction were not affected significantly ( p > 0.19). Additionally, the force required by the deltoid for active abduction was not affected significantly by cup constraint ( p = 0.144). Interestingly, active abduction range of motion was also not affected significantly by changes in cup constraint ( p > 0.45). Conclusions Altering polyethylene cup constraint in RSA to enhance stability does not significantly alter resultant joint loads and deltoid forces. Surprisingly, terminal abduction range of motion was also not significantly different with varying cup constraint, indicating that terminal impingement may be tuberosity related rather than polyethylene.

scholarly journals THE RELATIONSHIP OF ACETABULAR AND FEMORAL VERSION IN PATIENTS UNDERGOING PERIACETABULAR OSTEOTOMY

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0016
Author(s):  
Andrea M. Spiker ◽  
Kara G. Fields ◽  
Alexandra Wong ◽  
Ernest L. Sink
Keyword(s):  
Range Of Motion ◽  
Patient Reported Outcomes ◽  
Periacetabular Osteotomy ◽  
Patient Reported Outcome Measures ◽  
Harris Hip Score ◽  
Weak Correlation ◽  
Acetabular Version ◽  
Femoral Version ◽  
Patient Reported ◽  
The Relationship

Background: Hip dysplasia is a complex, three dimensional diagnosis. Little is known about version (acetabular, femoral and the relationship between the two) in dysplastic patients. We sought to 1) compare femoral and acetabular version between hips that underwent a primary periacetabular osteotomy (PAO) versus nondysplastic hips (CEA >25degrees); 2) estimate the correlation between femoral and acetabular version in dysplastic hips; 3) estimate the correlation of femoral and acetabular version with preoperative range of motion in dysplastic hips; 4) estimate the association of femoral and acetabular version with patient-reported outcome measures 11-23 months postoperatively in patients that underwent PAO. We hypothesized an association between acetabular and femoral version, and an association between version and patient reported outcomes. Methods: We retrospectively reviewed our institution’s hip registry to identify all PAO patients from March 2010 and June 2016. We included patients who had pre-operative computed tomography (CT) imaging and a minimum of 1 year follow-up. We created a comparison group of non-dysplastic patients (CEA > 25degrees). We calculated the association between acetabular version, femoral version and hip range of motion (ROM), as well as between femoral version, acetabular version, age, sex, and preoperative and 1 year postoperative modified Harris Hip Score (mHHS), Hip Outcome Score (HOS), and International Hip Outcome Tool 33 (iHOT33) score. Results: 75 PAO patients met inclusion criteria (93% female, mean age 24) and 1332 non-dysplastic patients (45% female, mean age 25). Pre-operative CT measurements (95% CI) demonstrated mean CEA for our PAO patients was 24, and for the non-dysplastic group 37. We found a very weak correlation between acetabular version and femoral version. Dysplastic patients had significantly greater acetabular and femoral version than nondysplastic patients (8 vs 1 at 1 o’clock; 15 vs 10 at 2 o’clock; 21 vs 16 at 3 o’clock, FV 21 vs 14, all p<0.001). We found only a weak correlation of hip ROM to acetabular version, but there was a moderate correlation of hip ROM and femoral version. We found no evidence of an association between mHHS, HOS-activities of daily living (ADL), HOS-sport specific (SS), or iHOT-33 scores and pre-operative femoral version, acetabular version, age, or sex. Conclusions/Significance: Our current investigation confirmed a statistically higher acetabular and femoral version in dysplastic hips than nondysplastic hips. However, while acetabular version measurements correlated strongly, there was only a very weak correlation between acetabular version and femoral version. Pre-operative ROM was correlated only moderately with femoral version, but not correlated with acetabular version. Additionally there was no association with acetabular or femoral version and patient reported outcomes after PAO, suggesting that femoral version does not need to be addressed at the time of PAO surgery.

scholarly journals Multi-Dimensional Range-of-Motion-Based Safe Zone for Patient-Specific Total Hip Arthroplasty

10.29007/vk8v ◽  
2018 ◽  
Author(s):  
Juliana Hsu ◽  
Matias de La Fuente ◽  
Klaus Radermacher
Keyword(s):  
Total Hip Arthroplasty ◽  
Range Of Motion ◽  
Hip Arthroplasty ◽  
Spherical Surface ◽  
Safe Zone ◽  
Patient Specific ◽  
Femoral Antetorsion ◽  
Total Hip ◽  
Mathematical Formulas ◽  
Safe Zones

Proper component alignment is crucial for a successful total hip arthroplasty (THA). Some studies found safe cup orientations and corresponding stem antetorsions based on a defined desired range of motion (ROM) suitable for activities of daily living. These studies either used complex and time consuming 3D simulations or more simple mathematical formulas which cannot be extended to combined motions.With the method introduced in this work, any arbitrary motion can be applied. The ROM specified as the ROM of the femur relative to the pelvis is transformed into the ROM of the prosthesis neck relative to the cup for each cup orientation. For this transformation, the orientation and design of the stem are considered. The comparison of the neck and cup orientations is done using a 2D mapping of a 3D spherical surface which reduces the complexity of the calculation.We found that the femoral antetorsion as well as the neutral stem flexion and adduction have an influence on the resulting safe zone. The result is not just a combined anteversion but a combined orientation. For validating the plausibility of the algorithm, the resulting safe zones are compared to literature. Same results can be achieved using the same input data. Using this technique, a patient-specific safe zone based on the ROM can be derived and adjusted to the stem orientation.

scholarly journals The effect of different decline angles on the biomechanics of double limb squats and the implications to clinical and training practice

2016 ◽  
Vol 52 (1) ◽  
pp. 125-138 ◽  
Author(s):  
Jim Richards ◽  
James Selfe ◽  
Jonathan Sinclair ◽  
Karen May ◽  
Gavin Thomas
Keyword(s):  
Range Of Motion ◽  
Patellar Tendon ◽  
Tibialis Anterior ◽  
Patellofemoral Joint ◽  
Rectus Femoris ◽  
Biceps Femoris ◽  
Ankle Joints ◽  
Additional Stability ◽  
Integrated Emg ◽  
Joint Load

Abstract Bilateral decline squatting has been well documented as a rehabilitation exercise, however, little information exists on the optimum angle of decline. The aim of this study was to determine the ankle and knee angle, moments, the patellofemoral joint load, patellar tendon load and associated muscle activity while performing a double limb squat at different decline angles and the implications to rehabilitation. Eighteen healthy subjects performed double limb squats at 6 angles of declination: 0, 5, 10, 15, 20 and 25 degrees. The range of motion of the knee and ankle joints, external moments, the patellofemoral/patellar tendon load and integrated EMG of gastrocnemius, tibialis anterior, rectus femoris and biceps femoris were evaluated. As the decline angle increased up to 20 degrees, the range of motion possible at the ankle and knee increased. The joint moments showed a decrease at the ankle up to 15 degrees and an increase at the knee up to 25 degrees, indicating a progressive reduction in loading around the ankle with a corresponding increase of the load in the patellar tendon and patellofemoral joint. These trends were supported by a decrease in tibialis anterior activity and an increase in the rectus femoris activity up to 15 degrees declination. However, gastrocnemius and biceps femoris activity increased as the decline angle increased above 15 degrees. The action of gastrocnemius and biceps femoris stabilises the knee against an anterior displacement of the femur on the tibia. These findings would suggest that there is little benefit in using a decline angle greater than 15-20 degrees unless the purpose is to offer an additional stability challenge to the knee joint.

Passive Hip Range of Motion Predicts Femoral Torsion and Acetabular Version

2016 ◽  
Vol 98 (2) ◽  
pp. 127-134 ◽  
Author(s):  
Vivek Chadayammuri ◽  
Tigran Garabekyan ◽  
Asheesh Bedi ◽  
Cecilia Pascual-Garrido ◽  
Jason Rhodes ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Acetabular Version ◽  
Femoral Torsion ◽  
Hip Range Of Motion

Impairment Tutorial: Recurrent Radioculpathy: Recurrent Radioculpathy and Apportionment

2002 ◽  
Vol 7 (4) ◽  
pp. 8-10
Author(s):  
Christopher R. Brigham ◽  
Leon H. Ensalada
Keyword(s):  
Lumbar Spine ◽  
Range Of Motion ◽  
Disk Herniation ◽  
Fourth Edition ◽  
Recurrent Injury ◽  
Injury Model ◽  
Whole Person ◽  
Spinal Region

Abstract Recurrent radiculopathy is evaluated by a different approach in the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, compared to that in the Fourth Edition. The AMA Guides, Fifth Edition, specifies several occasions on which the range-of-motion (ROM), not the Diagnosis-related estimates (DRE) method, is used to rate spinal impairments. For example, the AMA Guides, Fifth Edition, clarifies that ROM is used only for radiculopathy caused by a recurrent injury, including when there is new (recurrent) disk herniation or a recurrent injury in the same spinal region. In the AMA Guides, Fourth Edition, radiculopathy was rated using the Injury Model, which is termed the DRE method in the Fifth Edition. Also, in the Fourth Edition, for the lumbar spine all radiculopathies resulted in the same impairment (10% whole person permanent impairment), based on that edition's philosophy that radiculopathy is not quantifiable and, once present, is permanent. A rating of recurrent radiculopathy suggests the presence of a previous impairment rating and may require apportionment, which is the process of allocating causation among two or more factors that caused or significantly contributed to an injury and resulting impairment. A case example shows the divergent results following evaluation using the Injury Model (Fourth Edition) and the ROM Method (Fifth Edition) and concludes that revisions to the latter for rating permanent impairments of the spine often will lead to different results compared to using the Fourth Edition.

Spinal Impairment Evaluation: Fifth Edition Changes

2001 ◽  
Vol 6 (1) ◽  
pp. 1-3
Author(s):  
Robert H. Haralson
Keyword(s):  
Spinal Cord ◽  
Lower Extremity ◽  
Range Of Motion ◽  
Upper Extremity ◽  
Spinal Cord Injuries ◽  
Clinical Findings ◽  
Fourth Edition ◽  
Treatment Results ◽  
Standard Terminology ◽  
Made In

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, was published in November 2000 and contains major changes from its predecessor. In the Fourth Edition, all musculoskeletal evaluation and rating was described in a single chapter. In the Fifth Edition, this information has been divided into three separate chapters: Upper Extremity (13), Lower Extremity (14), and Spine (15). This article discusses changes in the spine chapter. The Models for rating spinal impairment now are called Methods. The AMA Guides, Fifth Edition, has reverted to standard terminology for spinal regions in the Diagnosis-related estimates (DRE) Method, and both it and the Range of Motion (ROM) Method now reference cervical, thoracic, and lumbar. Also, the language requiring the use of the DRE, rather than the ROM Method has been strengthened. The biggest change in the DRE Method is that evaluation should include the treatment results. Unfortunately, the Fourth Edition's philosophy regarding when and how to rate impairment using the DRE Model led to a number of problems, including the same rating of all patients with radiculopathy despite some true differences in outcomes. The term differentiator was abandoned and replaced with clinical findings. Significant changes were made in evaluation of patients with spinal cord injuries, and evaluators should become familiar with these and other changes in the Fifth Edition.

Osteosynthesis of Combined Injuries of the Capitellum humeri and the Radial Head

Swiss Surgery ◽  
2003 ◽  
Vol 9 (6) ◽  
pp. 275-282
Author(s):  
Ott ◽  
Rikli ◽  
Babst
Keyword(s):  
Range Of Motion ◽  
Radial Head ◽  
Performance Score ◽  
Anatomische Rekonstruktion ◽  
Mayo Elbow Performance Score ◽  
Capitulum Humeri ◽  
Combined Injuries

Einleitung: Kombinierte Verletzungen des Capitulum humeri und des Radiusköpfchens sind selten. Meist sind neben den osteocartilaginären Schäden am Gelenk auch Verletzungen der Kollateralbänder assoziiert. Behandlungsempfehlungen für diese seltenen schwerwiegenden Ellenbogenverletzungen fehlen. Studientyp: In einer retrospektiven Analyse werden fünf Fälle untersucht, bei denen die osteocartilaginären Verletzungen des Capitulum humeri durch den gleichen Zugang, der zur Versorgung des Radiusköpfchens verwendet wurde, versorgt wurden. Die Osteosynthese erfolgte mit Mini-Titanimplantaten z.T. kombiniert mit resorbierbaren Pins. Patienten und Methode: Zwischen 1996-1999 wurden fünf Patienten (vier Männer, eine Frau) mit einer Kombinationsverletzung von Radiuskopf und Capitulum humeri operativ stabilisiert. Das Durchschnittsalter beträgt 34 Jahre (31-40 Jahre). Alle Frakturen wurden über einen direkten radialen Zugang mittels 1.5mm oder 2.0mm Zugschrauben, zum Teil mit resorbierbaren Pins stabilisiert. Anschliessend wurden die Patienten radiologisch und klinisch gemäss dem Mayo-elbow-performance Score beurteilt. Resultate: Alle Patienten konnten persönlich durch einen nicht in die Initialtherapie involvierten Untersucher nach durchschnittlich 12.8 Monaten (8-24 Monate) nachuntersucht werden. 4/5 Patienten konnten bezüglich ihrer subjektiven Einschätzung befragt werden. Radiologische Zeichen einer Nekrose des Capitulum humeri oder Arthrosezeichen fanden sich nicht. Bei drei Patienten fanden sich periartikuläre Verkalkungen. Der range of motion beträgt durchschnittlich 124 Grad (Extension 5-30 Grad, Flexion 110-145 Grad) in drei von fünf Fällen waren Sekundäreingriffe zu Mobilitätsverbesserung nötig. Der Mayo-elbow-performance Score beträgt im Mittel 85 Punkte (range 70-100 Punkte). Schlussfolgerung: Die direkte Verschraubung mit Miniimplantaten zum Teil in Kombination mit resorbierbaren Pins ermöglicht eine stabile anatomische Rekonstruktion des Capitulum humeri durch den gleichen Zugang wie er für die Stabilisierung des Radiusköpfchens notwendig ist. Die transartikuläre Fixation der kleinen Schalenfragmente des Capitulum humeri erlaubt eine sichere interfragmentäre Kompression und damit eine frühfunktionelle Rehabilitation. Sekundäreingriffe zur Verbesserung der Gelenkbeweglichkeit waren in drei von fünf Fällen nötig.

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