scholarly journals Biomechanical Comparison of Capsular Repair, Capsular Shift, and Capsular Plication for Hip Capsular Closure: Is a Single Repair Technique Best for All?

2021 ◽  
Vol 9 (10) ◽  
pp. 232596712110400
Author(s):  
Anthony F. De Giacomo ◽  
Young Lu ◽  
Dong Hun Suh ◽  
Michelle H. McGarry ◽  
Michael Banffy ◽  
...  
Keyword(s):  
Repeated Measures ◽  
External Rotation ◽  
Capsular Shift ◽  
Maximum Extension ◽  
Capsular Repair ◽  
Capsular Plication ◽  
Hip Capsule ◽  
Hip Flexion ◽  
Biomechanical Comparison ◽  
Post Hoc

Background: In hip arthroscopy, the best capsular closure technique to prevent microinstability in some patients while preventing overconstraints in other patients has yet to be determined. Purpose: To evaluate the biomechanical effects of capsular repair, capsular shift, and combination capsular shift and capsular plication for closure of the hip capsule. Study Design: Controlled laboratory study. Methods: Eight cadaveric hips (4 male and 4 female hips; mean age, 55.7 years) were evaluated in 7 conditions: intact, vented, capsulotomy, side-to-side repair, side-to-side repair with capsular plication (interval closure between iliofemoral and ischiofemoral ligaments), capsular shift repair, and capsular shift repair with plication. Measurements, via a 360° goniometer, included internal and external rotation with 1.5 N·m of torque at 5° of extension and 0°, 30°, 60°, and 90° of flexion. In addition, the degree of maximum extension with 5 N·m of torque and the amount of femoral distraction with 40 N and 80 N of force were obtained. Repeated-measures analysis of variance and Tukey post hoc analyses were used to analyze differences between capsular conditions. Results: At lower hip positions (5° of extension, 0° and 30° of flexion), there was a significant increase in external rotation and total rotation after capsulotomy versus the intact state ( P < .05). At all hip flexion angles, there was a significant increase in external rotation, internal rotation, and total rotation as well as a significant increase in maximum extension after capsulotomy versus capsular shift with plication ( P < .05 for all). At all flexion angles, both capsular closure with side-to-side repair (with or without plication) and capsular shift without capsular plication were able to restore rotation, with no significant differences compared with the intact capsule ( P > .05). Among repair constructs, there were significant differences in range of motion between side-to-side repair and combined capsular shift with plication ( P < .05). Conclusion: At all positions, significantly increased rotational motion was seen after capsulotomy. Capsular closure was able to restore rotation similar to an intact capsule. Combined capsular shift and plication may provide more restrained rotation for conditions of hip microinstability but may overconstrain hips without laxity. Clinical Relevance: More advanced closure techniques or a combination of techniques may be needed for patients with hip laxity and microinstability. At the same time, simple repair may suffice for patients without these conditions.

Achieving the Split Position in a Saut de Chat Leap

2020 ◽  
Vol 35 (2) ◽  
pp. 68-72
Author(s):  
Danielle N Jarvis ◽  
Kornelia Kulig
Keyword(s):  
Repeated Measures ◽  
Center Of Mass ◽  
Peak Height ◽  
Knee Joints ◽  
Similar Time ◽  
Dance Training ◽  
Main Effect ◽  
Hip Flexion ◽  
Post Hoc ◽  
Coordination Patterns

OBJECTIVES: Dancers frequently perform complex jumping skills that involve achieving specific body positions while in the air. An examination of how skilled dancers achieve these aesthetic demands can provide information useful for dance training. The purpose of this study was to examine the temporal coordination of the hip and knee joints during the flight phase of a saut de chat leap, where dancers aim to achieve a split position in the air when the center of mass (COM) reaches peak height. METHODS: Thirty healthy, experienced dancers with 22.5±4.5 years of dance training performed 5 saut de chat leaps. The timing of peak hip and knee joint angles and velocities for the takeoff and leading legs were extracted and compared to the time when COM reached peak height in the leap using a repeated measures ANOVA, with post-hoc comparisons made using paired t-tests. RESULTS: Dancers demonstrated significant differences in timing associated with achieving the split position (main effect p<0.001), with only peak leading leg hip flexion occurring at a similar time to the COM reaching peak height (paired t-test p=0.074). CONCLUSIONS: The results of this study provide insight into coordination patterns used by trained dancers. Trained dancers demonstrate patterns in timing that may be important for successful performance. The hip and knee coordination patterns during flight demonstrate how dancers work to achieve the desired aesthetics of a saut de chat leap. However, it appears that dancers do not reach the full split position at the height of the leap, as would be aesthetically desirable.

Acute and Subacute Changes in Hip Strength and Range of Movement After Arthroscopy to Address Chondrolabral Pathology

2019 ◽  
Vol 47 (8) ◽  
pp. 1939-1948 ◽  
Author(s):  
Matthew D. Freke ◽  
Kay Crossley ◽  
Kevin Sims ◽  
Trevor Russell ◽  
Patrick Weinrauch ◽  
...  
Keyword(s):  
Hip Arthroscopy ◽  
Repeated Measures ◽  
External Rotation ◽  
Case Series ◽  
Hip Pain ◽  
Range Of Movement ◽  
Level Of Evidence ◽  
Hip Strength ◽  
Hip Flexion ◽  
And Function

Background:Hip pain is associated with reduced muscle strength, range of movement (ROM), and function. Hip arthroscopy is undertaken to address coexistent intra-articular pathologies with the aim of reducing pain and improving function.Purpose:To evaluate changes in strength and ROM in a cohort with chondrolabral pathology before surgery to 3 and 6 months after hip arthroscopy.Study Design:Case series; Level of evidence, 4.Methods:Sixty-seven individuals with hip pain who were scheduled for hip arthroscopy were matched with 67 healthy controls. Hip strength and ROM were collected preoperatively and at 3 and 6 months postoperatively. Repeated measures analysis of variance evaluated whether strength and ROM differed between limbs and among time points. Bonferroni post hoc tests determined differences in hip strength and ROM among testing times and between the hip pain group and matched controls.Results:Hip extension, internal rotation (IR), external rotation (ER), and adduction ( P < .040) strength were greater at 3 months after surgery; all directions, including flexion, abduction, and squeeze, were greater at 6 months ( P < .015). Hip flexion ROM was greater at 3 months after surgery ( P = .013). Flexion, IR, and ER ROM was greater at 6 months ( P < .041). At 6 months, IR ROM ( P = .003) and flexion, IR, and ER strength ( P < .005) remained less than matched controls.Conclusion:With the exception of squeeze and flexion, all directions of hip strength and hip flexion ROM are significantly improved 3 months after arthroscopy to address chondrolabral pathology. By 6 months after arthroscopy, strength in all directions and flexion and rotation ROM are significantly improved in both limbs, but hip flexion, IR, and ER strength and IR ROM remain significantly less than that of healthy matched controls in both limbs.

Legal Update: North Dakota Supreme Court: Third Edition of Guides is “Most Current”

1999 ◽  
Vol 4 (1) ◽  
pp. 6-7
Author(s):  
James J. Mangraviti
Keyword(s):  
Internal Rotation ◽  
External Rotation ◽  
Measurement Techniques ◽  
Fourth Edition ◽  
Hip Motion ◽  
The Difference ◽  
The Right ◽  
Hip Flexion ◽  
Hip Rotation ◽  
Hip Extension

Abstract The accurate measurement of hip motion is critical when one rates impairments of this joint, makes an initial diagnosis, assesses progression over time, and evaluates treatment outcome. The hip permits all motions typical of a ball-and-socket joint. The hip sacrifices some motion but gains stability and strength. Figures 52 to 54 in AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fourth Edition, illustrate techniques for measuring hip flexion, loss of extension, abduction, adduction, and external and internal rotation. Figure 53 in the AMA Guides, Fourth Edition, illustrates neutral, abducted, and adducted positions of the hip and proper alignment of the goniometer arms, and Figure 52 illustrates use of a goniometer to measure flexion of the right hip. In terms of impairment rating, hip extension (at least any beyond neutral) is irrelevant, and the AMA Guides contains no figures describing its measurement. Figure 54, Measuring Internal and External Hip Rotation, demonstrates proper positioning and measurement techniques for rotary movements of this joint. The difference between measured and actual hip rotation probably is minimal and is irrelevant for impairment rating. The normal internal rotation varies from 30° to 40°, and the external rotation ranges from 40° to 60°.

scholarly journals Gender Differences in Kinematic Analysis of the Lower Limbs during the Chasse Step in Table Tennis Athletes

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 703
Author(s):  
Xiaoyi Yang ◽  
Yuqi He ◽  
Shirui Shao ◽  
Julien S. Baker ◽  
Bíró István ◽  
...  
Keyword(s):  
Female Athletes ◽  
External Rotation ◽  
Rotational Velocity ◽  
Knee Extension ◽  
Lower Limbs ◽  
Table Tennis ◽  
Male Athletes ◽  
Analysis System ◽  
Hip Flexion ◽  
Hip Internal Rotation

The chasse step is one of the most important footwork maneuvers used in table tennis. The purpose of this study was to investigate the lower limb kinematic differences of table tennis athletes of different genders when using the chasse step. The 3D VICON motion analysis system was used to capture related kinematics data. The main finding of this study was that the step times for male athletes (MA) were shorter in the backward phase (BP) and significantly longer in the forward phase (FP) than for female athletes (FA) during the chasse step. Compared with FA, knee external rotation for MA was larger during the BP. MA showed a smaller knee flexion range of motion (ROM) in the BP and larger knee extension ROM in the FP. Moreover, hip flexion and adduction for MA were significantly greater than for FA. In the FP, the internal rotational velocity of the hip joint was significantly greater. MA showed larger hip internal rotation ROM in the FP but smaller hip external rotation ROM in the BP. The differences between genders can help coaches personalize their training programs and improve the performance of both male and female table tennis athletes.

scholarly journals Efficacy of galcanezumab in patients with migraine who did not benefit from commonly prescribed preventive treatments

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dulanji K. Kuruppu ◽  
Joshua Tobin ◽  
Yan Dong ◽  
Sheena K. Aurora ◽  
Laura Yunes-Medina ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Migraine Headache ◽  
Mixed Model ◽  
Preventive Treatment ◽  
Response Rates ◽  
Toxin A ◽  
Double Blind ◽  
Preventive Medication ◽  
Onabotulinum Toxin A ◽  
Post Hoc

Abstract Background Galcanezumab is a calcitonin gene-related peptide (CGRP) monoclonal antibody (mAb) indicated for the preventive treatment of migraine. While galcanezumab has demonstrated efficacy in patients who did not respond to prior preventive medications in general, its efficacy in patients who did not benefit from individual, commonly prescribed preventive treatments due to inadequate efficacy or safety/tolerability remains unknown. Methods CONQUER was a 3-month, randomized, double-blind, placebo-controlled, phase 3b study that enrolled patients with episodic or chronic migraine who had 2 to 4 migraine preventive medication category failures in the past 10 years. Patients were randomly assigned 1:1 to receive placebo (N = 230) or galcanezumab 120 mg/month (240 mg loading dose; N = 232). Post hoc analyses were conducted to determine the efficacy of galcanezumab in patients who had not benefited from six of the most commonly prescribed migraine preventive medications. The mean change from baseline in monthly migraine headache days and ≥ 50 % response rates were assessed over months 1–3. Improvement in Migraine-Specific Questionnaire Role Function-Restrictive (MSQ-RFR) scores were assessed at month 3. The endpoints were estimated via mixed model with repeated measures. Results The most common treatment failures due to inadequate efficacy or safety/tolerability, which at least 20 % of patients reported trying without benefit, included topiramate, amitriptyline, propranolol, valproate or divalproex, onabotulinum toxin A, and metoprolol. Patients who had not previously benefited from these treatments had a greater mean reduction in monthly migraine headache days across months 1–3 in the galcanezumab group compared to placebo (all p < 0.01). More patients treated with galcanezumab experienced a ≥ 50 % reduction from baseline in monthly migraine headache days across months 1–3 compared to placebo (all p < 0.05). Galcanezumab-treated patients had a greater improvement in mean MSQ-RFR scores at month 3 compared to placebo (all p < 0.01). Conclusions In this population, galcanezumab was effective in reducing monthly migraine headache days, improving response rates, and enhancing quality of life in patients who had not previously benefited from topiramate, amitriptyline, propranolol, valproate or divalproex, onabotulinum toxin A, and/or metoprolol due to inadequate efficacy or safety/tolerability. Trial registration ClinicalTrials.gov NCT03559257 (CONQUER).

scholarly journals Comparison of short-term outcomes of anterolateral supine approach and posterolateral approach for primary total hip arthroplasty: a retrospective study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Taku Ukai ◽  
Goro Ebihara ◽  
Masahiko Watanabe
Keyword(s):  
Total Hip Arthroplasty ◽  
Hospital Stay ◽  
Clinical Outcomes ◽  
Hip Arthroplasty ◽  
External Rotation ◽  
Posterolateral Approach ◽  
Level Of Evidence ◽  
Total Hip ◽  
Hip Flexion ◽  
Primary Total Hip Arthroplasty

Abstract Background This study aims to evaluate postoperative pain and functional and clinical outcomes of anterolateral supine (ALS) and posterolateral (PL) approaches for primary total hip arthroplasty. Materials and methods We retrospectively examined the joints of 110 patients who underwent primary total hip arthroplasty (THA). The ALS group was compared with the PL group using the pain visual analog scale (VAS) and narcotic consumption as pain outcomes. Functional outcomes included postoperative range of motion (ROM) of hip flexion, day on which patients could perform straight leg raising (SLR), day on which patients began using a walker or cane, duration of hospital stay, rate of transfer, and strength of hip muscles. Clinical outcomes included pre and postoperative Harris Hip Scores. Results No significant differences were found in the pain VAS scores or narcotic consumption between the two groups. The PL group could perform SLR earlier than the ALS group (P < 0.01). The ALS group started using a cane earlier (P < 0.01) and had a shorter hospital stay (P < 0.01) than the PL group. Degrees of active ROM of flexion at postoperative day (POD) 1 were significantly lower in the ALS group than in the PL group (P < 0.01). Regarding hip muscle strength, hip flexion was significantly weaker in the ALS group than in the PL group until 1-month POD (P < 0.01). External rotation from 2 weeks to 6 months postoperatively was significantly weaker in the PL group than in the ALS group (P < 0.01). Conclusion The ALS approach was more beneficial than the PL approach because ALS enabled better functional recovery of the strength of external rotation, improved rehabilitation, and involved a shorter hospital stay. Level of Evidence Level IV retrospective observational study.

Interfacial Nanoleakage and Bonding of Self-Adhesive Systems Cured with a Modified-Layering Technique to Dentin of Weakened Roots

2013 ◽  
Vol 38 (5) ◽  
pp. E154-E165 ◽  
Author(s):  
E Mobarak ◽  
R Seyam
Keyword(s):  
Bond Strength ◽  
Repeated Measures ◽  
Adhesive Systems ◽  
Root Canals ◽  
Root Region ◽  
Modes Of Failure ◽  
Group A ◽  
Post Hoc ◽  
Vertise Flow ◽  
Self Etch

SUMMARY Objective The purpose of the study was to evaluate the nanoleakage and bond strength of different self adhesive systems cured with a modified-layering technique (MLT) to dentin of weakened roots. Methods Twenty-one maxillary incisors were decoronated and then root canals were instrumented and obturated with the cold lateral compaction technique. Weakened roots were simulated by flaring root canals until only 1 mm dentin thickness remained. Teeth were distributed into three groups. The canals were backfilled with Vertise Flow (VF group), a self-adhering system, following a modified-layering technique using two light-transmitting posts, sizes 6 and 3. DT Light Post size 2 was cemented using the same material. Remaining roots were prepared and cured in the same way as the VF group. However, in the TS/MF group, Clearfil Tri-S Bond (TS) adhesive and Clearfil Majesty Flow (MF) composite were used, while in the ED/PF group, ED primer II (ED)/Panavia F2.0 (PF) were used. After one week of storage, each root was sectioned to obtain six slices (two slices from each root third: coronal, middle and apical) of 0.9 ± 0.1 mm thickness. Interfacial nanoleakage expression was analyzed using a field emission scanning electron microscope (FEG-SEM), and the micro push-out bond strength (μPOBS) was measured at different root regions. Modes of failure were also determined using SEM. Data were statistically analyzed using two-way analysis of variance with repeated measures and Tukey post hoc test (p≤0.05). Results With MLT, all adhesive systems showed nanoleakage. For μPOBS, there was a statistically significant effect for adhesive systems (p&lt;0.001) but not for root region (p&lt;0.64) or for their interaction (p=0.99). Tukey post hoc test revealed that the bond strength of the VF group was significantly higher than the TS/MF and ED/PF groups for all root regions. Conclusion All of the tested self-adhesive systems cured using MLT had slight nanoleakage and were not sensitive to root regional differences. Self-adhering systems had higher bond strength than self-etch adhesives.

Biomechanical comparison of the modified Bristow procedure with and without capsular repair

2015 ◽  
Vol 24 (2) ◽  
pp. 489-495 ◽  
Author(s):  
Michael H. Abdulian ◽  
Curtis J. Kephart ◽  
Michelle H. McGarry ◽  
James E. Tibone ◽  
Thay Q. Lee
Keyword(s):  
Capsular Repair ◽  
Biomechanical Comparison

scholarly journals Depth-Related Curing Potential of Ormocer- and Dimethacrylate-Based Bulk-Fill Composites

Materials ◽  
2021 ◽  
Vol 14 (22) ◽  
pp. 6753
Author(s):  
Ramona S. Oltramare ◽  
Reto Odermatt ◽  
Phoebe Burrer ◽  
Thomas Attin ◽  
Tobias T. Tauböck
Keyword(s):  
Double Bond ◽  
Repeated Measures ◽  
In Vitro Study ◽  
High Viscosity ◽  
Degree Of Conversion ◽  
Double Bond Conversion ◽  
Nanohybrid Composite ◽  
Post Hoc ◽  
One Way Anova

The aim of this in vitro study was to investigate the degree of C=C double bond conversion of high-viscosity dimethacrylate- or ormocer-based bulk-fill composites as a function of measurement depth. Four bulk-fill composites (Tetric EvoCeram Bulk Fill, x-tra fil, SonicFill, and Bulk Ormocer) and the conventional nanohybrid composite Tetric EvoCeram were applied in standardized Class II cavities (n = 6 per group) and photoactivated for 20 s at 1350 mW/cm2. The degree of conversion of the composites was assessed using Fourier-transform infrared spectroscopy at seven measurement depths (0.15, 1, 2, 3, 4, 5, 6 mm). Data were analyzed using repeated measures ANOVA and one-way ANOVA with Bonferroni post-hoc tests (α = 0.05). The investigated bulk-fill composites showed at least 80% of their maximum degree of conversion (80% DCmax) up to a measuring depth of at least 4 mm. Tetric EvoCeram Bulk Fill and Bulk Ormocer achieved more than 80% DCmax up to a measuring depth of 5 mm, x-tra fil up to 6 mm. The conventional nanohybrid composite Tetric EvoCeram achieved more than 80% DCmax up to 3 mm. In contrast to the conventional composite, the investigated ormocer- and dimethacrylate-based bulk-fill composites can be photo-polymerized in thick layers of up to at least 4 mm with regard to their degree of C=C double bond conversion.

scholarly journals Enhancement of Countermovement Jump Performance Using a Heavy Load with Velocity-Loss Repetition Control in Female Volleyball Players

2021 ◽  
Vol 18 (21) ◽  
pp. 11530
Author(s):  
Michal Krzysztofik ◽  
Rafal Kalinowski ◽  
Robert Trybulski ◽  
Aleksandra Filip-Stachnik ◽  
Petr Stastny
Keyword(s):  
Body Mass ◽  
Repeated Measures ◽  
Performance Enhancement ◽  
Countermovement Jump ◽  
Mean Power ◽  
Mean Velocity ◽  
Heavy Load ◽  
Jump Performance ◽  
Volleyball Players ◽  
Post Hoc

Although velocity control in resistance training is widely studied, its utilization in eliciting post-activation performance enhancement (PAPE) responses receives little attention. Therefore, this study aimed to evaluate the effectiveness of heavy-loaded barbell squats (BS) with velocity loss control conditioning activity (CA) on PAPE in subsequent countermovement jump (CMJ) performance. Sixteen resistance-trained female volleyball players participated in this study (age: 24 ± 5 yrs.; body mass: 63.5 ± 5.2 kg; height: 170 ± 6 cm; relative BS one-repetition maximum (1RM): 1.45 ± 0.19 kg/body mass). Each participant performed two different conditions: a set of the BS at 80% 1 RM with repetitions performed until a mean velocity loss of 10% as the CA or a control condition without CA (CNTRL). To assess changes in jump height (JH) and relative mean power output (MP), the CMJ was performed 5 min before and throughout the 10 min after the CA. The two-way analysis of variance with repeated measures showed a significant main effect of condition (p = 0.008; η2 = 0.387) and time (p < 0.0001; η2 = 0.257) for JH. The post hoc test showed a significant decrease in the 10th min in comparison to the value from baseline (p < 0.006) for the CNTRL condition. For the MP, a significant interaction (p = 0.045; η2 = 0.138) was found. The post hoc test showed a significant decrease in the 10th min in comparison to the values from baseline (p < 0.006) for the CNTRL condition. No significant differences were found between all of the time points and the baseline value for the CA condition. The CA used in the current study fails to enhance subsequent countermovement jump performance in female volleyball players. However, the individual analysis showed that 9 out of the 16 participants (56%) responded positively to the applied CA, suggesting that the PAPE effect may be individually dependent and should be carefully verified before implementation in a training program.

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