scholarly journals MRI-based kinematics of the menisci through full knee range of motion

2021 ◽  
Vol 29 (2) ◽  
pp. 230949902110173
Author(s):  
Tadashi Yamamoto ◽  
Hiroshi Taneichi ◽  
Yoshiteru Seo ◽  
Katsuhisa Yoshikawa
Keyword(s):  
Range Of Motion ◽  
Femoral Condyle ◽  
Weight Bearing ◽  
Care Program ◽  
Superconducting Magnet ◽  
Posterior Horn ◽  
Motion Patterns ◽  
Medial Pivot ◽  
Full Flexion ◽  
The Right

Purpose: The meniscal kinematics in the full knee range of motion (ROM) have not been demonstrated by MRI, because the narrow bore of the superconducting magnet prevents full knee motion. The purpose of this study was to the investigate meniscal kinematics associated with femorotibial kinematics using an open-structure MRI unit that allows kinematic analysis of the menisci in full knee ROM. Methods: Non-weight-bearing MR images of the right knee of 10 subjects were acquired at six angles of knee flexion (0°, 30°, 60°, 90°, 120°, and full flexion) using a compact 0.2-T MRI system. The positions of the anterior and posterior horns of the medial and lateral menisci (MM/LM) and the medial and lateral femoral condyles (MFC/LFC) were measured at each angle of flexion. Results: Significant posterior LFC movement was observed in all sets of adjacent flexion angles of 60°–90° or more, indicating medial pivot motion of the femur. Significant differences in LM position were observed between adjacent flexion angles of 60°–90° or more. The positional relationship between the posterior horn of MM and the MFC was statistically significant in all but 60° flexion. The positional relationship between LM and LFC was significant at flexion angles of ≤90° in the anterior horn and at 60°, 90°, and full flexion in the posterior horn. Conclusion: Motion patterns of the menisci were analogous to those of the femoral condyle. Medial pivot motion of the femur caused the greatest posterior movement of the LM. Meniscal kinematics followed the femorotibial kinematics. Comprehension of meniscal kinematics in full knee ROM is important for understanding of injury mechanisms, planning meniscus transplant, and making postoperative care program for meniscus surgery.

Anterior Reach and Symmetry on the Y-Balance Test are Related to Dorsiflexion Range of Motion but not Single-Limb Balance in Physically Active Young Adults

2020 ◽  
pp. 1-5
Author(s):  
Matthew C. Hoch ◽  
Johanna M. Hoch ◽  
Cameron J. Powden ◽  
Emily H. Gabriel ◽  
Lauren A. Welsch
Keyword(s):  
Range Of Motion ◽  
Injury Risk ◽  
Weight Bearing ◽  
Collegiate Athletes ◽  
Balance Test ◽  
Convenience Sample ◽  
Physically Active ◽  
Left Limb ◽  
The Right ◽  
Club Sport

Background: The anterior reach distance and symmetry of the Y-Balance Test (YBT) has been associated with increased injury risk in collegiate athletes. Examining the influence of dorsiflexion range of motion (DROM) and single-limb balance (SLB) on YBT performance may identify underlying factors associated with injury risk. Objective: The purpose of this study is to determine if YBT anterior reach is related to DROM or SLB in collegiate varsity and club sport athletes. Methods: A convenience sample of 124 university varsity and club sport athletes (females: 99, age: 20.0 ± 1.6 years, height: 168.9 ± 12.5 kg, body mass: 68.8 ± 14.0 kg) completed the anterior direction of the YBT, weight-bearing DROM, and SLB components (firm and foam surface) of the Balance Error Scoring System on both limbs at one testing session. Relative symmetry was calculated by subtracting values of the left limb from the right limb. Results: For the left and right limb, normalized anterior reach distance was moderately correlated to DROM (R = .55, p < .001). Anterior reach distance and symmetry was weakly correlated to SLB and SLB symmetry (R = −.16 to −.03). Conclusion: There was a positive relationship between YBT anterior reach and weight-bearing DROM which was also observed in the between-limb symmetry. However, weak relationships were exhibited between YBT anterior reach and SLB. These findings may be useful for future injury prevention initiatives in athletic settings.

Medial femoral condyle fracture during an Oxford unicompartmental knee replacement surgery: case report

2020 ◽  
pp. jisakos-2019-000311
Author(s):  
Rafael Calvo ◽  
David Figueroa ◽  
Zoy Anastasiadis ◽  
Gonzalo Espinoza ◽  
Daniel Sarango
Keyword(s):  
Range Of Motion ◽  
Rare Complication ◽  
Femoral Condyle ◽  
Intraoperative Complications ◽  
Weight Bearing ◽  
Full Range ◽  
Unicompartmental Knee Replacement ◽  
Medial Condyle ◽  
Unicompartmental Knee ◽  
Condyle Fracture

Oxford unicompartmental knee arthroplasty has been used as a good alternative for medial unicompartmental osteoarthritis due to its association with early rehabilitation and a low rate of intraoperative complications. This case describes a rare complication during the procedure of an intraoperative fracture of the medial condyle that was treated with osteosynthesis with 6.5 mm cannulated screws and a compression technique. The patient followed a non-weight-bearing protocol for 6 weeks and reached full range of motion at 3 months. Complete radiological fusion and good functional outcome were observed. Intraoperative fractures can benefit from stable osteosynthesis that allows free range of motion and does not jeopardise the final surgical result.

scholarly journals Ankle Taping Effectiveness for the Decreasing Dorsiflexion Range of Motion in Elite Soccer and Basketball Players U18 in a Single Training Session: A Cross-Sectional Pilot Study

2020 ◽  
Vol 10 (11) ◽  
pp. 3759
Author(s):  
Carlos Romero-Morales ◽  
Carlos López-Nuevo ◽  
Carlos Fort-Novoa ◽  
Patricia Palomo-López ◽  
David Rodríguez-Sanz ◽  
...  
Keyword(s):  
Pilot Study ◽  
Range Of Motion ◽  
Elite Athletes ◽  
Weight Bearing ◽  
Training Session ◽  
Ankle Dorsiflexion ◽  
Ankle Sprains ◽  
Basketball Players ◽  
Cross Sectional ◽  
The Right

Ankle sprains have been defined as the most common injury in sports. The aim of the present study was to investigate the ankle taping for the reduction of ankle dorsiflexion range of motion (ROM) and inter-limb in elite soccer and basketball players U18 in a single training session. Methods: A cross-sectional pilot study was performed on 38 male healthy elite athletes divided into two groups: a soccer group and a basketball group. Ankle dorsiflexion ROM and inter-limb asymmetries in a weight-bearing lunge position were assessed in three points: with no-tape, before the practice and immediately after the practice. Results: For the soccer group, significant differences (p < 0.05) were observed for the right ankle, but no differences for the asymmetry variable. The basketball group reported significant differences (p < 0.05) for the right ankle and symmetry. Conclusions: Ankle taping decreased the ankle dorsiflexion ROM in youth elite soccer and basketball players U18. These results could be useful as a prophylactic approach for ankle sprain injury prevention. However, the ankle ROM restriction between individuals without taping and individuals immediately assessed when the tape was removed after the training was very low.

scholarly journals SAT-381 Adjunct Benefit of Aquatic Therapy in Juvenile Hypophosphatasia Initiated in an Adult

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Abdul Mannan Khan ◽  
James Lightell ◽  
Corey Majors
Keyword(s):  
Alkaline Phosphatase ◽  
Lumbar Spine ◽  
Physical Therapy ◽  
Range Of Motion ◽  
Weight Bearing ◽  
Standing Balance ◽  
Home Exercise ◽  
Aquatic Therapy ◽  
History Of ◽  
The Right

Abstract Background: This is a case of improvement in visual analog scale pain rating and objective functional capacity in juvenile hypophosphatasia (HPP) following treatment with asfotase alfa and adjunct physical therapy (PT) performed in an aquatic environment. Clinical Case: A 45-year-old female with a history of psoriatic arthritis and osteoarthritis was referred for low serum alkaline phosphatase (ALKP) (&lt;10 U/L). Her history of eight fractures over the preceding 25 years including bilateral femur nonunion repaired with rods eight years prior to presentation led to a diagnosis of juvenile HPP, and asfostase alfa was ordered. She is ambulatory only with a rolling walker from a deficit in dynamic standing balance and chronic pain. Referrals were made for both PT and pain management for these symptoms. The initial PT evaluation established reasonable goals to include the performance of in-home exercise, increase strength and range of motion, decrease pain, improve standing balance, and progress from walker to cane. Aquatic therapy was chosen in order to reduce patient’s effective weight. The right hip complex, lumbar spine, and left leg were chosen as areas of focus based on pain reports. A four-week follow-up evaluation by the therapist reported patient had been performing at home exercises. Pain scale reports of the lumbar spine, right hip, and left leg were within the moderate range and near or meeting the patient’s self-reported least pain experienced. Goniometric measurements of the right hip showed range of motion improvements averaging 9%. The lumbar spine’s range of motion increased an average of 18%. Discussion: HPP is capable of creating severe disability, and its rarity has led to a dearth of investigation into appropriate treatment. Recommendations have been made previously for PT in children and infants presenting with juvenile or infantile HPP; this case suggests these recommendations are applicable to adults as well. The mechanisms of these improvements remain unclear; however, evidence exists that weight-bearing exercise may result in increased levels of bone-specific isoforms of ALKP. This endogenous path to increased serum ALKP may play a role in potentiating the effects of asfostase alfa. 1. Shapiro JR, Lewiecki EM. Hypophosphatasia in Adults: Clinical Assessment and Treatment Considerations. Journal of Bone and Mineral Research 2017;32(10):1977–1980. 2. Phillips D, Case LE, Griffin D, Hamilton K, Lara SL, Leiro B, Monfreda J, Westlake E, Kishnani PS. Physical therapy management of infants and children with hypophosphatasia. Molecular Genetics and Metabolism 2016;119(1–2):14–19. 3. Rudberg A, Magnusson P, Larsson L, Joborn H. Serum Isoforms of Bone Alkaline Phosphatase Increase During Physical Exercise in Women. Calcified Tissue International 2000;66(5):342–347.

scholarly journals Hallux Motion

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0001
Author(s):  
Collin Barber ◽  
Alex McLaren ◽  
Paulo Castaneda ◽  
Dor Shoshan
Keyword(s):  
Range Of Motion ◽  
Stance Phase ◽  
Weight Bearing ◽  
Electromagnetic Sensors ◽  
Significant Difference ◽  
Angular Data ◽  
Restrict Movement ◽  
Immobilization Device ◽  
The Right ◽  
High Degree

Category: Bunion, Trauma, Other Introduction/Purpose: Immobilization is required for management of acute and chronic pathologic states of the hallux metatarsophalangeal (MTP) joint. Traditionally, this was performed using physician applied custom splint or cast and achieved a high degree of immobilization. Braces and orthotics are becoming less expensive and have several advantages, such as light weight and convenience in removal. However, this may come at the expense of ability to restrict movement. We hypothesize that generic braces will provide as much immobilization as custom applied plaster splints. Methods: Healthy volunteers were instrumented with electromagnetic sensors over bony prominences of the right foot. Range of motion exercises and activities of daily living were performed without an immobilization device. The same procedure was repeated with each of three immobilization devices: a post-operative shoe, a walking boot, and a custom applied plaster splint. Position and angular data were collected to determine range of motion primarily of the hallux MTP joint. This study was approved by the hospital IRB Results: Compared to baseline, all three immobilization devices significantly reduced range of motion at the MTP joint in non- weight bearing with the ankle in dorsiflexion and plantarflexion (p<0.05). There was no significant difference detected between the devices. There was no significant difference in hallux motion during the standing exercise in any of the immobilization devices compared to baseline. During stance phase of gait, all three devices reduced range of motion at the MTP joint compared to baseline (p<0.05), though there was no statistically significant difference between devices. Conclusion: Consistent with the hypothesis, data from this study show that all both generic devices and the physician applied splint reduced range of motion compared to baseline. Unfortunately, the study was not powered enough to detect significant differences between the devices, though there was a trend towards the walking boot providing more immobilization.

scholarly journals Reliability of the weight-bearing ankle dorsiflexion range of motion measurement using a smartphone goniometer application

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e11977
Author(s):  
Helena Zunko ◽  
Renata Vauhnik
Keyword(s):  
Range Of Motion ◽  
Weight Bearing ◽  
Intraclass Correlation ◽  
Ankle Dorsiflexion ◽  
Minimal Detectable Change ◽  
Rater Reliability ◽  
Motion Measurement ◽  
Left Ankle ◽  
The Right ◽  
Daily Physical Activities

Background Weight-bearing ankle dorsiflexion range of motion measurement (weight-bearing lunge test) is gaining in popularity because it mimics lower extremity function in daily physical activities. The purpose of the study is to assess the intra-rater and the inter-rater reliability of the weight-bearing ankle dorsiflexion range of motion measurement with a flexed knee using a smartphone application Spirit Level Plus installed on an Android smartphone. Methods Thirty-two young, healthy subjects participated in the study and were measured in four sessions by two examiners. One measurement was taken on each ankle in every session. Eight measurements were taken from each participant. A total of 256 were taken from all the participants. The measurements for the individual subject were repeated no sooner than 24 hours after the first session. In order to assess the reliability, intraclass correlation coefficients (ICC), standard error measurements (SEM) and minimal detectable change (MDC) at the 95% confidence interval were calculated. Results Statistical data analysis revealed moderate intra-rater reliability for the right ankle (ICC = 0.72, 95% CI [0.49–0.85]) and good intra-rater reliability for the left ankle (ICC = 0.82, 95% CI [0.66–0.91]). Inter-rater reliability is moderate for the right (ICC = 0.73, 95% CI [0.52–0.86]) and the left ankle (ICC = 0.65, 95% CI [0.39–0.81]). Conclusion The observed method is moderately reliable and appropriate when the main objective is to assess ankle dorsiflexion mobility in weight-bearing when weight-bearing is not contraindicated. The concurrent validity of the Spirit Level Plus application is excellent.

scholarly journals Unprecedented tibial bone lengthening of 33.5 cm by distraction osteogenesis for the reconstruction of a subtotal tibial bone defect. A case report and literature review

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Abdulnassir Ali ◽  
Ying Ren ◽  
Chun-Hao Zhou ◽  
Jia Fang ◽  
Cheng-He Qin
Keyword(s):  
Bone Defect ◽  
Distraction Osteogenesis ◽  
Chronic Osteomyelitis ◽  
Weight Bearing ◽  
Lower Leg ◽  
Bone Lengthening ◽  
Case Presentation ◽  
Tibial Length ◽  
Tibial Bone ◽  
The Right

Abstract Background We present a case of an immense unprecedented tibial bone lengthening of 33.5 cm. The management of chronic osteomyelitis of the right tibia with subtotal tibial bone defect, talus defect and equinus ankle deformity. We demonstrate limb reconstruction by distraction osteogenesis and correction of ankle deformity with the Ilizarov technique. Limb salvage was preferred as an alternative to amputation to restore basic limb function. Case presentation A 16-year-old male patient fell and injured his right lower leg. He attempted to treat the symptoms with traditional home remedies. During 15 months of self-treating, he developed osteomyelitis of the right tibia and had lost function in his foot. Radiology revealed immense bone defect of the right tibia, including talus bone defect and equinus deformity of the calcaneus. The patient’s right tibia was non weight-bearing, had drainage sinus just below his knee and a large scar anteriorly along the entire length of the tibia. Conclusion Upon completion of treatment, the patient was able to avoid amputation of his leg with partially restored function for weight-bearing. He carried himself without assistance after 3 years of lost function in his right leg. Tibial bone distraction osteogenesis of 33.5 cm was done after 90% of the tibial length was defected. To the best of our best knowledge, this case is one of a kind to achieve distraction of tibial bone to such length.

Osteoarthritis of the patella, lateral femoral condyle and posterior medial femoral condyle correlate with range of motion

2013 ◽  
Vol 21 (11) ◽  
pp. 2584-2589 ◽  
Author(s):  
Takashi Suzuki ◽  
Sayaka Motojima ◽  
Shu Saito ◽  
Takao Ishii ◽  
Keinosuke Ryu ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Femoral Condyle ◽  
Medial Femoral Condyle ◽  
Lateral Femoral Condyle

The Effect of 2 Forms of Talocrural Joint Traction on Dorsiflexion Range of Motion and Postural Control in Those With Chronic Ankle Instability

2017 ◽  
Vol 26 (3) ◽  
pp. 239-244 ◽  
Author(s):  
Cameron J. Powden ◽  
Kathleen K. Hogan ◽  
Erik A. Wikstrom ◽  
Matthew C. Hoch
Keyword(s):  
Postural Control ◽  
Range Of Motion ◽  
Outcome Measures ◽  
Ankle Instability ◽  
Weight Bearing ◽  
Chronic Ankle Instability ◽  
Physical Contact ◽  
Future Research ◽  
Talocrural Joint ◽  
Sham Condition

Context:Talocrural joint mobilizations are commonly used to address deficits associated with chronic ankle instability (CAI).Objective:Examine the immediate effects of talocrural joint traction in those with CAI.Design:Blinded, crossover.Setting:Laboratory.Participants:Twenty adults (14 females; age = 23.80 ± 4.02 y; height = 169.55 ± 12.38 cm; weight = 78.34 ± 16.32 kg) with self-reported CAI participated. Inclusion criteria consisted of a history of ≥1 ankle sprain, ≥2 episodes of giving way in the previous 3 mo, answering “yes” to ≥4 questions on the Ankle Instability Instrument, and ≤24 on the Cumberland Ankle Instability Tool.Intervention:Subjects participated in 3 sessions in which they received a single treatment session of sustained traction (ST), oscillatory traction (OT), or a sham condition in a randomized order. Interventions consisted of four 30-s sets of traction with 1 min of rest between sets. During ST and OT, the talus was distracted distally from the ankle mortise to the end-range of accessory motion. ST consisted of continuous distraction and OT involved 1-s oscillations between the mid and end-range of accessory motion. The sham condition consisted of physical contact without force application. Preintervention and postintervention measurements of weight-bearing dorsiflexion, dynamic balance, and static single-limb balance were collected.Main Outcome Measures:The independent variable was treatment (ST, OT, sham). The dependent variables included pre-to-posttreatment change scores for the WBLT (cm), normalized SEBTAR (%), and time-to-boundary (TTB) variables(s). Separate 1-way ANOVAs examined differences between treatments for each dependent variable. Alpha was set a priori at P < .05.Results:No significant treatment effects were identified for any variables.Conclusion:A single intervention of ST or OT did not produce significant changes in weight-bearing dorsiflexion range of motion or postural control in individuals with CAI. Future research should investigate the effects of repeated talocrural traction treatments and the effects of this technique when combined with other manual therapies.

scholarly journals Early Clinical and Radiographic Outcomes of Trabecular Metal Total Ankle Using Transfibular Approach

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0001 ◽  
Author(s):  
Alexej Barg ◽  
Charles Saltzman
Keyword(s):  
Range Of Motion ◽  
Weight Bearing ◽  
Total Ankle Replacement ◽  
Trabecular Metal ◽  
Non Union ◽  
Early Loosening ◽  
Early Results ◽  
Ankle Replacement ◽  
Patient Reported

Category: Ankle, Ankle Arthritis Introduction/Purpose: In the last two decades, total ankle replacement (TAR) has gained more acceptance as a treatment option in patients with end-stage ankle osteoarthritis. However, there is a lack of literature on TAR using a lateral transfibular approach. Therefore, we sought to report early clinical and radiographic results of a patient cohort treated with TAR using a lateral transfibular approach by a single surgeon. Methods: Fifty-five primary total ankle arthroplasties using the Zimmer trabecular metal implant were performed in 54 patients (29 men and 25 women; mean age, 67.0 years) from October 2012 to December 2014. Clinical assessment including pain evaluation and measurement of ankle range of motion was done preoperatively and at the latest follow-up. Weight-bearing radiographs were used to determine the angular alignment of the tibial and talar components and to analyze the bone-implant interface. Intraoperative and postoperative complications, revision surgeries, and failures were evaluated. Results: Implant survival was 93% at 36 months follow-up. There were 3 revisions of a tibial component due to aseptic loosening. In 10 of 55 procedures, a secondary procedure was performed during follow-up. Mean follow-up duration was 26.6 ± 4.2 months. No delayed union or non-union was observed for fibula healing. The average VAS pain score decreased significantly from 7.9 ± 1.3 to 0.8 ± 1.2. The average total range of motion increased significantly from 22.9° ± 11.8° to 40.2° ± 11.8°. Conclusion: Early results of Zimmer trabecular metal total ankle replacement demonstrated improved patient-reported outcomes and increased ankle motion at a minimum follow-up of one year. In the first 55 consecutive cases, the fibular osteotomy required for access to the ankle healed without complications. Painful early loosening requiring revision due to lack of bony ingrowth was seen in 3 of 55 cases.

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