Acute complex instability of the elbow treated with internal joint stabilizer IJS-E System

Objective: To assess the level of depression, severity of pain and pain in single/multiple sites in patients with different severity of bruxing behavior and Temporomandibular Disorders (TMDs). Methods: We evaluated 131 patients with bruxism and TMDs: 20 patients with mild bruxism, 42 patients with moderate bruxism, 45 patients with severe bruxism and 24 patients with extreme bruxism. We used the Beck Depression Inventory (BDI), clinical examination, a questionnaire of clinical epidemiological data, criteria for TMDs and bruxism, palpation of muscles and joints, the Visual Analogue Scale for pain, classification of the occlusion and biomechanical tests to assess for internal joint derangements. Results: The level of depression increased from the mild, to the moderate, severe and extreme bruxing behavior groups, but the difference was significant only from the mild to the extreme group (p<0.001). Pain levels increased from the mild and moderate to the severe and extreme subgroups, but were not statistically significant. Mean number of pain sites increased from the mild, to the moderate, severe and extreme subgroup and the difference was extremely significant (p<0.0001). Conclusion: Levels of depression, severity of pain and pain sites increased with severity of bruxing behavior. A higher number of pain sites with more severe bruxism indicates somatization in bruxers, but a further study using the same protocol and a psychological test for somatization would be indicated to further substantiate these findings.

Download Full-text

Method for instrumentation of orthotic joints for measurement of internal joint loads

Current Directions in Biomedical Engineering ◽

10.1515/cdbme-2017-0008 ◽

2017 ◽

Vol 3 (1) ◽

pp. 35-38

Author(s):

David Hochmann ◽

Lucien Opitz

Keyword(s):

Gait Analysis ◽

Cross Talk ◽

Inertial Sensors ◽

Small Sample Size ◽

Fem Simulation ◽

Small Sample ◽

Safety Testing ◽

Internal Joint ◽

Custom Made ◽

Joint Loads

Abstract:Introduction:The lack of knowledge of mechanical loads in orthotic joints can lead to oversized or breaking components. Previous studies suffer from small sample size and technical limitations. The goal of this study was to develop and validate a method that allows the direct measurement of moments in sagittal, frontal and transverse planes in knee and ankle joints of existing custom made orthoses.Methods:We developed a modular measurement system based on standard joint components, which were instrumented with strain gauges. To ensure sufficient signals and reduce cross talk an iterative approach based on FEM simulation was utilized. The system also contains inertial sensors for mobile gait analysis.Results:Instrumented joints show good results regarding linearity, hysteresis and cross talk. First pilot trials with post-polio and ICP patients demonstrated that joint loads depend on several factors and not solely on body weight. If combined with conventional gait analysis, measurement results can characterize the individual muscle situation of the patient.Conclusion:A novel method for obtaining data on loads in orthotic components was developed and validated. It provides the basis to develop safety testing standards and clinical guidelines, as well as allowing individual optimization of orthotic devices.

Download Full-text

Computational Modeling: Human Dynamic Model

Frontiers in Neurorobotics ◽

10.3389/fnbot.2021.723428 ◽

2021 ◽

Vol 15 ◽

Author(s):

Lijia Liu ◽

Joseph L. Cooper ◽

Dana H. Ballard

Keyword(s):

Dynamic Model ◽

Degrees Of Freedom ◽

Dynamic Models ◽

Movement Analysis ◽

Human Movement ◽

Uncontrolled Manifold ◽

Human In The Loop ◽

Joint Forces ◽

Internal Joint ◽

Movement Function

Improvements in quantitative measurements of human physical activity are proving extraordinarily useful for studying the underlying musculoskeletal system. Dynamic models of human movement support clinical efforts to analyze, rehabilitate injuries. They are also used in biomechanics to understand and diagnose motor pathologies, find new motor strategies that decrease the risk of injury, and predict potential problems from a particular procedure. In addition, they provide valuable constraints for understanding neural circuits. This paper describes a physics-based movement analysis method for analyzing and simulating bipedal humanoid movements. The model includes the major body segments and joints to report human movements' energetic components. Its 48 degrees of freedom strike a balance between very detailed models that include muscle models and straightforward two-dimensional models. It has sufficient accuracy to analyze and synthesize movements captured in real-time interactive applications, such as psychophysics experiments using virtual reality or human-in-the-loop teleoperation of a simulated robotic system. The dynamic model is fast and robust while still providing results sufficiently accurate to be used to animate a humanoid character. It can also estimate internal joint forces used during a movement to create effort-contingent stimuli and support controlled experiments to measure the dynamics generating human behaviors systematically. The paper describes the innovative features that allow the model to integrate its dynamic equations accurately and illustrates its performance and accuracy with demonstrations. The model has a two-foot stance ability, capable of generating results comparable with an experiment done with subjects, and illustrates the uncontrolled manifold concept. Additionally, the model's facility to capture large energetic databases opens new possibilities for theorizing as to human movement function. The model is freely available.

Download Full-text

Sesamoid malalignment in hallux valgus: Radiographic and MRI measurements and their correlation with internal derangement findings of the first metatarsophalangeal joint

British Journal of Radiology ◽

10.1259/bjr.20190038 ◽

2019 ◽

Vol 92 (1100) ◽

pp. 20190038

Author(s):

Justin Skweres ◽

Avneesh Chhabra ◽

Jed Hummel ◽

Nathan Heineman ◽

Riham Dessouky ◽

...

Keyword(s):

Hallux Valgus ◽

Rotation Angle ◽

Metatarsophalangeal Joint ◽

Preoperative Assessment ◽

X Rays ◽

First Metatarsophalangeal Joint ◽

Valgus Angle ◽

Internal Joint ◽

Reader Reliability ◽

Mri Measurements

Objective: Sesamoid displacement (SD) and rotation are important components in the preoperative assessment of hallux valgus (HV). To date, Inter reader reliability (IRR) of SD on X-rays and MRI, correlations with hallux valgus angle (HVA), and qualitative changes of the hallux-sesamoid complex (HSC) on MRI have not been studied. The aim of this study was to correlate sesamoid malalignment with HV severity and findings of internal joint derangement. Methods: Two readers analyzed a series of 56 consecutive patients who had X-rays and MRI performed on the same foot within 3 months of each other. Multiple measures of SD on X-rays and MRI and the sesamoid rotation angle (SRA) on MRI were assessed and correlated with HVA and various qualitative features at the HSC including cartilage, plantar plate, and collateral ligament abnormalities. Results: We found excellent IRR (ICC = 0.79 – 0.99) for SRA on MR, but poor IRR for lateral sesamoid displacement (LDS) and tibial sesamoid position (TSP) scales on both modalities. Good IRR was also seen for morphologic abnormalities of HSC. The absolute value of the SRA on MR positively correlated with HVA ( p < 0.0001). LDS and TSP on both modalities lacked a significant correlation with HVA ( p > 0.05). No correlation was found between any measure of SD or rotation with HSC morphologic changes ( p > 0.05). Conclusion: Among different measures of sesamoid malalignment, sesamoid rotation angle measured on MRI can be used to judge the severity of HV; however, it does not correlate with qualitative morphologic abnormalities of the HSC. Advances in knowledge: The MRI measurement of SRA is a better indicator of sesamoid displacement relative to the HSC than standard AP radiographic measures of non-rotational sesamoid displacement; however, it should not be used to predict qualitative morphologic abnormalities of the HSC.

Download Full-text

A Systematic Review of the Associations Between Inverse Dynamics and Musculoskeletal Modeling to Investigate Joint Loading in a Clinical Environment

Frontiers in Bioengineering and Biotechnology ◽

10.3389/fbioe.2020.603907 ◽

2020 ◽

Vol 8 ◽

Author(s):

Jana Holder ◽

Ursula Trinler ◽

Andrea Meurer ◽

Felix Stief

Keyword(s):

Knee Joint ◽

Clinical Decision Making ◽

Inverse Dynamics ◽

Clinical Decision ◽

Contact Forces ◽

Musculoskeletal Modeling ◽

Joint Loading ◽

Joint Moments ◽

Internal Joint ◽

Joint Contact

The assessment of knee or hip joint loading by external joint moments is mainly used to draw conclusions on clinical decision making. However, the correlation between internal and external loads has not been systematically analyzed. This systematic review aims, therefore, to clarify the relationship between external and internal joint loading measures during gait. A systematic database search was performed to identify appropriate studies for inclusion. In total, 4,554 articles were identified, while 17 articles were finally included in data extraction. External joint loading parameters were calculated using the inverse dynamics approach and internal joint loading parameters by musculoskeletal modeling or instrumented prosthesis. It was found that the medial and total knee joint contact forces as well as hip joint contact forces in the first half of stance can be well predicted using external joint moments in the frontal plane, which is further improved by including the sagittal joint moment. Worse correlations were found for the peak in the second half of stance as well as for internal lateral knee joint contact forces. The estimation of external joint moments is useful for a general statement about the peak in the first half of stance or for the maximal loading. Nevertheless, when investigating diseases as valgus malalignment, the estimation of lateral knee joint contact forces is necessary for clinical decision making because external joint moments could not predict the lateral knee joint loading sufficient enough. Dependent on the clinical question, either estimating the external joint moments by inverse dynamics or internal joint contact forces by musculoskeletal modeling should be used.

Download Full-text

A Clinical Comparison of Internal Joint Disorders in Patients Presenting Disk-Attachment Pain: Prevalence, Characterization, and Severity of Bruxing Behavior

CRANIO® ◽

10.1080/08869634.2003.11746227 ◽

2003 ◽

Vol 21 (1) ◽

pp. 17-23 ◽

Cited By ~ 3

Author(s):

Omar Franklin Molina ◽

José dos Santos ◽

Stanley Nelson ◽

Thomas Nowlin ◽

Marcelo Mazzetto

Keyword(s):

Clinical Comparison ◽

Internal Joint ◽

Pain Prevalence

Download Full-text

Multicenter trial of an internal joint stabilizer for the elbow

Journal of Shoulder and Elbow Surgery ◽

10.1016/j.jse.2016.09.023 ◽

2017 ◽

Vol 26 (1) ◽

pp. 125-132 ◽

Cited By ~ 9

Author(s):

Jorge L. Orbay ◽

David Ring ◽

Amir R. Kachooei ◽

Jose Santiago-Figueroa ◽

Luis Bolano ◽

...

Keyword(s):

Multicenter Trial ◽

Internal Joint

Download Full-text

How the External Impact Energy Affects the Internal Kinetics of Knee Joint: The Comparison of Porcine and Human Knee Joint

Advances in Bioengineering ◽

10.1115/imece2003-42913 ◽

2003 ◽

Author(s):

Jaw-Lin Wang ◽

Cheng-Hsien Chung ◽

Chung-Kai Chiang

Keyword(s):

Knee Joint ◽

Impact Energy ◽

Impact Loading ◽

Bending Moment ◽

Knee Joints ◽

External Energy ◽

Human Knee ◽

Human Knee Joint ◽

Internal Joint ◽

Porcine Knee

Degenerative osteoarthritis is recognized as the consequences of mechanical injuries. The abnormal impact force applied to articular cartilage would result in bone fracture or surface fissuring, and would cause the osteoarthritis [1,2]. The relation among the injury and impact energy was well studied. However, how the external energy attenuated to the internal joint is not carefully studied yet. The porcine knee joint was used as a biomechanical model for the simulation of human knee joint during impact loading. The objective of current study was to find the variation of kinetic characteristics between human and porcine knee joint during axial impact loading. Eight fresh-frozen knee joints from 10 month-old swine and seven cadaver human knee joints were used in the experiment. The mechanical responses such as forces and bending moment of knee joint, and the accelerations of femur was quantitatively analyzed. The results showed that the axial force response between human and porcine joints was similar, however, the anteroposterior shear, flexion bening moment and accelerations of these two joints were different.

Download Full-text