Biomechanical investigation of ambulatory training in patients with acetabular dysplasia

2008 ◽  
Vol 28 (1) ◽  
pp. 52-57 ◽  
Author(s):  
Akira Kanai ◽  
Takahiro Kiyama ◽  
Eiichi Genda ◽  
Yasuo Suzuki
Keyword(s):  
Acetabular Dysplasia ◽  
Ambulatory Training ◽  
Biomechanical Investigation

5. A needs assessment for a CanMEDS-based curriculum in ambulatory care for internal medicine residents in Canada

2007 ◽  
Vol 30 (4) ◽  
pp. 29
Author(s):  
R. Wong ◽  
S. Roff
Keyword(s):  
Internal Medicine ◽  
Ambulatory Care ◽  
Learning Outcomes ◽  
Delphi Technique ◽  
Training Programs ◽  
Internal Medicine Training ◽  
Modified Delphi ◽  
Ambulatory Training ◽  
Ambulatory Medicine ◽  
Care Training

In Canada, graduates of internal medicine training programs should be proficient in ambulatory medicine and practice. Before determining how to improve education in ambulatory care, a list of desired learning outcomes must be identified and used as the foundation for the design, implementation and evaluation of instructional events. The Delphi technique is a qualitative-research method that uses a series of questionnaires sent to a group of experts with controlled feedback provided by the researchers after each round of questions. A modified Delphi technique was used to determine the competencies required for an ambulatory care curriculum based on the CanMEDS roles. Four groups deemed to be critical stakeholders in residency education were invited to take part in this study: 1. Medical educators and planners, 2. Members of the Canadian Society of Internal Medicine (CSIM), 3. Recent Royal College certificants in internal medicine, 4. Residents currently in core internal medicine residency programs. Panelists were sent questionnaires asking them to rate learning outcomes based on their importance to residency training in ambulatory care. Four hundred and nineteen participants completed the round 1 questionnaire that was comprised of 75 topics identified through a literature search. Using predefined criteria for degree of importance and consensus, 19 items were included in the compendium and 9 were excluded after one round. Forty-two items for which the panel that did not reach consensus, as well as 3 new items suggested by the panel were included in the questionnaire for round 2. Two hundred and forty participants completed the round 2 questionnaire; consensus was reached for each of the 45 items. After two rounds, 21 items were included in the final compendium as very high priority topics (“must be able to”). An additional 26 items were identified as high priority topics (“should be able to”). The overall ratings by each of the four groups were similar and there were no differences between groups that affected the selection of items for the final compendium. To our knowledge this is the first time a Delphi-process has been used to determine the content of an ambulatory care curriculum in internal medicine in Canada. The compendium could potentially be used as the basis to structure training programs in ambulatory care. Barker LR. Curriculum for Ambulatory Care Training in Medical residency: rationale, attitudes and generic proficiencies. J Gen Intern Med 1990; 5(supp.):S3-S14. Levinsky NG. A survey of changes in the proportions of ambulatory training in internal medicine clerkships and residencies from 1986-87 to 1996-97. Acad Med 1998; 73:1114-1115. Linn LS, Brook RH, Clarke VA, Fink A, Kosecoff J. Evaluation of ambulatory care training by graduates of internal medicine residencies. J Med Educ 1986; 61:293-302.

scholarly journals Genetic determinants of mild acetabular dysplasia

2016 ◽  
Vol 24 ◽  
pp. S227-S228
Author(s):  
M. Versteeg ◽  
F. Saberi-Hosnije ◽  
M.E. Zuiderwijk ◽  
J.H. Waarsing ◽  
R. Agricola ◽  
...  
Keyword(s):  
Acetabular Dysplasia ◽  
Genetic Determinants

scholarly journals A physiological and biomechanical investigation of three passive upper-extremity exoskeletons during simulated overhead work

Ergonomics ◽  
2021 ◽  
pp. 1-33
Author(s):  
Eric B. Weston ◽  
Mina Alizadeh ◽  
Hamed Hani ◽  
Gregory G. Knapik ◽  
Reid A. Souchereau ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Biomechanical Investigation

scholarly journals BORDERLINE ACETABULAR DYSPLASIA: THREE-DIMENSIONAL DEFORMITY PREDICTORS OF THE DIAGNOSIS OF SYMPTOMATIC INSTABILITY TREATED WITH PERIACETABULAR OSTEOTOMY

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0016
Author(s):  
Elizabeth Graesser ◽  
Maria Schwabe ◽  
Cecilia Pascual Garrido ◽  
John C. Clohisy ◽  
Jeffrey J. Nepple
Keyword(s):  
Low Dose ◽  
Acetabular Dysplasia ◽  
Periacetabular Osteotomy ◽  
Alpha Angle ◽  
Three Dimensional ◽  
Acetabular Coverage ◽  
Low Dose Ct ◽  
Femoral Version ◽  
Center Edge ◽  
Hip Morphology

Introduction: Borderline acetabular dysplasia is classically defined as a lateral center edge angle (LCEA) of 20-25 degrees. The optimal treatment strategy in this patient group remains controversial, with some patients having primarily hip instability-based symptoms, while others have primarily impingement-based symptoms (non-instability). The purpose of the current study was to define the 3D characteristics on low-dose CT that differentiate patients with instability symptoms from those without instability in the setting of borderline acetabular dysplasia. Methods: Seventy consecutive hips with borderline acetabular dysplasia undergoing surgical treatment were included in the current study. All patients underwent low-dose pelvic CT with femoral version assessment for preoperative planning. CT measurements included alpha angle and radial acetabular coverage (RAC) at standardized clockface positions (9:00-posterior to 3:00-anterior), central and cranial acetabular version. RAC was assessed in three sectors (anterior, superior, and posterior) and defined (relative to published normative data) as normal (-1 SD, +1 SD), undercoverage (<-1 SD), or overcoverage (>+1 SD). Statistical analysis was performed to compare the CT characteristics of the symptomatic instability and non-instability groups. Results: Of the 70 hips, 62.9% had the diagnosis of symptomatic instability, while 37.1% had no instability symptoms. Hips with instability (compared to non-instability) had significantly lower alpha angle (maximal difference at 1:00 - 47.0° vs. 59.4°), increased femoral version (22.3° vs. 15.3°), and decreased radial acetabular coverage (maximal difference at 1:00 – 59.9% vs. 62.2%) (all p<0.001). Multivariate analysis identified femoral version (OR 1.1, p=0.02), alpha angle at 1:00 (OR 0.91, p=0.02), and RAC at 1:00 (OR 0.46, p=0.003) as independent predictors of the presence of instability. The model combining these three factors had excellent predictive probability with a c-statistic 0.92. Conclusion: We found significant differences in the 3D hip morphology of the symptomatic instability and non-instability subgroups within the borderline dysplasia cohort. In the setting of borderline dysplasia, three-dimensional deformity characterization with low-dose CT allowed for differentiation of patients diagnosed with underlying instability vs. non-instability. Femoral version, alpha angle at 1:00, and radial acetabular coverage at 1:00 were identified as independent predictors of diagnosis in borderline acetabular dysplasia. Summary: This study attempts to define 3D CT characteristics to help distinguish between patients with impingement-based vs instability-based symptoms of borderline acetabular dysplasia.

Morphometric Analysis of Acetabular Dysplasia in Cerebral Palsy: Three-dimensional CT Study

2009 ◽  
Vol 29 (8) ◽  
pp. 896-902 ◽  
Author(s):  
Shinichi Gose ◽  
Takashi Sakai ◽  
Toru Shibata ◽  
Tsuyoshi Murase ◽  
Hideki Yoshikawa ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Morphometric Analysis ◽  
Acetabular Dysplasia ◽  
Three Dimensional

Optimisation of the drill-in behaviour of the EcoFit® SC threaded cup

2020 ◽  
Vol 65 (4) ◽  
pp. 477-484
Author(s):  
Christoph Thorwächter ◽  
Matthias Woiczinski ◽  
Inês Santos ◽  
Florian Schmidutz ◽  
Alexander Paulus ◽  
...  
Keyword(s):  
Three Dimensional ◽  
Primary Stability ◽  
Clinical Results ◽  
Clinical Applications ◽  
Testing System ◽  
Clinical Use ◽  
Maximum Torque ◽  
3D Images ◽  
Universal Testing ◽  
Biomechanical Investigation

AbstractThreaded cups show good clinical results when implanted correctly. In clinical use, multiple cases with an incomplete placement of the EcoFit threaded cup (implantcast) were observed. This behaviour could not be explained intra- and postoperatively. The aim of this study was to compare and optimise the drill-in-behaviour of the EcoFit cup in a biomechanical investigation. EcoFit cup sizes 46, 50 and 54 mm were compared with the SC cup (Aesculap) size 50 mm. Foam blocks (Sawbones) of density 0.16 g/ml (pcf 10), 0.32 g/ml (pcf 20) and 0.48 g/ml (pcf 30) were used. After standardised placement using a universal testing system (n = 8 per group), the primary stability, the overhang of the cups and the drill-in behaviour were measured. Overreamings of 1 and 2 mm were performed (pcf 20, n = 8) for the EcoFit cup size 50 and the primary stability as well as the overhang measurements were examined. Measurements of the cup diameter, thread depth and thread pitch were performed on three-dimensional (3D) images of the cup size 50 mm. The drill-in behaviour was different between the EcoFit and the SC cups. Even with maximum torque, the EcoFit cup could not be positioned as deep as the SC cup in standard reaming conditions (overhang of 1.1 ± 0.4 mm for the EcoFit size 50 in pcf 20 and of −0.01 ± 0.2 mm for the SC cup). The primary stability was lower for the EcoFit cup in comparison to the SC cup (128.8 ± 3.2 Nm vs. 138.6 ± 9.1 Nm, p = 0.0291). With overreaming to 51 mm, a deeper positioning of the EcoFit was possible (overlap of −0.3 ± 0.1, comparable to the SC cup). The overreaming of the cavity also led to a significantly higher primary stability of 143.4 ± 3.7 Nm (p < 0.001) comparable to the unaltered condition (128.8 ± 3.2 Nm). Overreaming to 52 mm had no further advantage in terms of primary stability or overhang. The geometric measurements showed significant differences as well. The previously clinically observed difficulties in inserting the cup were confirmed by this study. By overreaming to 51 mm, the drill-in behaviour, the primary stability and the measured overhang were comparable to the reference cup. The obtained results suggest that the extension of the acetabulum cavity to 51 mm while using the implantcast EcoFit size 50 should be implemented in clinical applications.

Untreated Acetabular Dysplasia of the Hip in the Navajo

1999 ◽  
Vol 364 ◽  
pp. 108-116 ◽  
Author(s):  
Richard M. Schwend ◽  
William B. Pratt ◽  
Jeffrey Fultz
Keyword(s):  
Acetabular Dysplasia ◽  
Dysplasia Of The Hip
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