Investigation of the possible effectiveness of osteopathic correction in the complex treatment of children in the first year of life with hip dysplasia

Introduction. Congenital dysplasia of the hip joints is one of the main among congenital diseases of the musculoskeletal system in children and requires a long period of treatment, including in a hospital settings. Standard methods of treatment contain the orthopedic and rehabilitation measures: the use of abduction splints, a complex of physiotherapy exercises, general massage, the use of various physiotherapeutic procedures. Osteopathic correction is not included in the standards of care for this category of patients. At the same time, these standard treatment methods do not always give a desired result, and sometimes even lead to the development of complications. All this facts determines the need to search for additional therapeutic techniques.The aim of the study is to research the possible effectiveness of osteopathic correction as part of the complex treatment of children in the first year of life with hip dysplasia.Materials and methods. The study included 34 children with a diagnosis of hip dysplasia (ICD code-10 — Q65.8). The patients were randomly divided into 2 equivalent groups: study and control. Participants in both groups received standard treatment; the participants of the main group additionally underwent osteopathic correction of the revealed somatic dysfunctions. Before and after the course of treatment, the patients' osteopathic status, the disease clinical manifestations, and the X-ray data of the hip joints were assessed.Results. The inclusion of osteopathic correction in the complex with standard treatment procedures for children of the first year of life with hip dysplasia is accompanied by a statistically significant decrease in the detection frequency of the somatic dysfunctions at the regional and local levels. The median duration of standard orthopedic treatment also decreases (p<0,05).Conclusion. The obtained results demonstrate that the inclusion of osteopathic correction in the complex treatment of children in the first year of life with hip dysplasia shortens the treatment time for patients. It is recommended to continue research in this direction with a larger sample size.

Comparative Analysis of Healthy and Cam-Type Femoroacetabular Impingement (FAI) Human Hip Joints Using the Finite Element Method

In this study, a human hip joint with Cam-type Femoroacetabular Impingement (FAI) is studied by the Finite Element Method (FEM). This pathology consists of a malformation that causes a lack of sphericity of the head of the femur. In turn, this causes wear and tear of the cartilage, a cause of early osteoarthritis of the hip. The objective is to use the FEM to analyze and compare the increase in the von Mises stress and displacement of the cartilage in healthy and damaged (with Cam-type) human hip joints that this syndrome affects. The 3D models were reconstructed from two medical CT scans of a healthy and a damaged hip joint that were obtained, five years apart, for a male of 80 kg in weight. The 3D models were reconstructed using 3D Slicer software. The cortical and trabecular bone, as well as the cartilage, were segmented. The defects were corrected by MesMixer software that generated STL files. Both models were imported into the Marc Mentat® software for the Finite Element Analysis (FEA). It was noted that the thickness of the cartilage decreased enormously during the five years, which suggests imminent mechanical contact between the head of the femur and the acetabulum of the pelvis. The FEA results showed an excessive increase in the stress and displacement of the cartilage. This will certainly result in a condition of osteoarthritis for the patient in the future years.

On the hindlimb biomechanics of the avian take-off leap

Although extant land birds take to the air by leaping, generating the initial take-off velocity primarily from the hindlimbs, the detailed musculoskeletal mechanics remain largely unknown. We therefore simulated in silico the take-off leap of the zebra finch, Taeniopygia guttata, a model species of passerine, a class of bird which includes over half of all extant bird species. A 3D computational musculoskeletal model of the zebra finch hindlimb, comprising of 43 musculotendon units was developed and driven with previously published take-off ground reaction forces and kinematics. Using inverse dynamics, the external moments at the ankle, knee, and hip joints were calculated and contrasted to the cumulative muscle capability to balance these moments. Mean peak external flexion moments at the hip and ankle were 0.55 bodyweight times leg length (BWL) each whilst peak knee extension moments were about half that value (0.29 BWL). Muscles had the capacity to generate 146%, 230%, and 212 % of the mean peak external moments at the hip, knee, and ankle, respectively. Similarities in hindlimb morphology and external loading across passerine species suggest that the effective take-off strategy employed by the zebra finch may be shared across the passerine clade and therefore half of all birds.

The Perceived Demands of Ice Hockey Goaltending Movements on the Hip and Groin Region: An Elite Coach and Player Perspective

Background: Many ice hockey goaltending techniques force hip joints and groin muscles into extreme ranges of motion, which may increase the risk of hip and groin problems. Purpose: To explore how elite goaltenders and goaltending coaches perceive the demands of common goaltending techniques on the hip and groin region. We further explored differences in perception between goaltenders and their coaches as well as between junior (age <20 years) and senior (age ≥20 years) goaltenders. Study Design: Cross-sectional survey. Methods: We developed a model to categorize common ice hockey goaltending techniques into quantifiable units and invited elite goaltenders and coaches in Sweden to complete an online survey. Participants were asked to rate the perceived demands of each technique on the hip and groin using a Likert scale (not at all, slightly, somewhat, very, or extremely demanding). Using the chi-square test, the proportion of participants perceiving each technique as very or extremely demanding were compared between goaltenders and coaches as well as between senior and junior goaltenders. Results: We received responses from 132 goaltenders and 43 coaches. The stances most frequently perceived as very or extremely demanding were the reverse vertical horizontal post-play (40%) and the butterfly save (25%). Among transitions, movements into the post were most frequently rated as very or extremely demanding (11%–40%). Several techniques were perceived as demanding by a larger share of coaches than goaltenders (difference, 13%–46%; P < .001–.028) and a larger share of senior versus junior goaltenders (difference, 12%–20%; P = .13–.18). Conclusion: The post-play and the butterfly were the goaltending techniques most frequently perceived as demanding, and more coaches than goaltenders percieved these techniques demanding. The results of this study may inform injury prevention efforts for ice hockey goaltending.

THE AFFECTIONS OF JOINTS MORE HAPPENED IN IRAQI PURE BRED ARAB HORSES

This report was designed to study to affection of joints of the Iraqi Arabian horses limbs in vet. college clinic .The symmetrical in the size of joints and hooves in case of standing position . The clinical examination was done by palpation of fore and hind limbs from the sale of the hoof till the shoulder or hip joints. The results marked 68.35% of fetlock J.15.15% of coffin J.9.9%of hock J. and 6.6% of pastern joint. So it is means that the fetlock joint is more important than the other joints specially in fore limb e.i. one of the fore fetlock joints may lift the whole body weight .

“Unexpected” Infections in Revision Arthroplasty for Aseptic Loosening

Background. Data from the national registers of arthroplasty showed that about 12% of hip and knee arthroplasty undergo revision within 10 years after the primary surgery. The leading cause of hip revisions is aseptic loosening of components, knee joint periprosthetic infection (PPI). Some of the infectious complications, including those related to mechanical causes, remain out of sight. The aim of the study was to identify the frequency of unexpected infections during revision knee and hip arthroplasty performed for aseptic complications of any etiology. Materials and Methods. 839 cases of revision arthroplasty of knee and hip joints were analyzed, including 485 aseptic revisions in 450 patients. Clinical, X-ray, laboratory (complete blood count and comprehensive metabolic panel, coagulation panel) methods, synovial fluid analysis and microbiological examination of punctures, including intraoperative ones, were used. The ICM and EBJIS (European Bone and Joint Infections Society) consensus recommendations were used as criteria for assessing the presence of infection. Results. The average age of patients at the time of the revision was 61.7 years. The hip joint prevailed (59.4%), knee joint 40.6%. The growth of microorganisms in the intraoperative biomaterial was detected in 2.08% of observations: in 10 out of 287 patients after aseptic revision of the hip joints and in none of the 198 revisions of the knee joints. In 8 out of 10 cases, the causative agents were coagulase-negative staphylococci, including 6 MRSE; in two cases, anaerobic bacteria. All revisions were carried out by a one-stage method. Patients with detected PPI underwent systemic antibacterial therapy. At the stage of catamnesis, reinfection was assumed in one of the 10 identified cases of PPI, the patient did not show up for revision. In control 63% of the group of the other (aseptic) 470 patients, PPI developed in 4 cases, two-stage revisions were carried out. Conclusions. The frequency of infections accidentally detected during aseptic revisions of large joints was 2.08%. Three-time examination of joint punctures, including intraoperative, provides additional opportunities for the diagnosis of PPI during aseptic revision, and also allows you to choose the optimal stage of revision treatment. The experience gained makes it possible in certain cases to perform one-stage revision in the treatment of PPI.

Evaluation of CT-Guided Ultra-Low-Dose Protocol for Injection Guidance in Preparation of MR-Arthrography of the Shoulder and Hip Joints in Comparison to Conventional and Low-Dose Protocols

To evaluate patients’ radiation exposure undergoing CT-guided joint injection in preparation of MR-arthrography. We developed a novel ultra-low-dose protocol utilizing tin-filtration, performed it in 60 patients and compared the radiation exposure (DLP) and success rate to conventional protocol (26 cases) and low-dose protocol (37 cases). We evaluated 123 patients’ radiation exposure undergoing CT-guided joint injection from 16 January–21 March. A total of 55 patients received CT-guided joint injections with various other examination protocols and were excluded from further investigation. In total, 56 patients received shoulder injection and 67 received hip injection with consecutive MR arthrography. The ultra-low-dose protocol was performed in 60 patients, the low-dose protocol in 37 patients and the conventional protocol in 26 patients. We compared the dose of the interventional scans for each protocol (DLP) and then evaluated success rate with MR-arthrography images as gold standard of intraarticular or extracapsular contrast injection. There were significant differences when comparing the DLP of the ultra-low-dose protocol (DLP 1.1 ± 0.39; p < 0.01) to the low dose protocol (DLP 5.3 ± 3.24; p < 0.01) as well as against the conventional protocol (DLP 22.9 ± 8.66; p < 0.01). The ultra-low-dose protocol exposed the patients to an average effective dose of 0.016 millisievert and resulted in a successful joint injection in all 60 patients. The low dose protocol as well as the conventional protocol were also successful in all patients. The presented ultra-low-dose CT-guided joint injection protocol for the preparation of MR-arthrography demonstrated to reduce patients’ radiation dose in a way that it was less than the equivalent of the natural radiation exposure in Germany over 3 days—and thereby, negligible to the patient.

Risk factors for venous thrombosis in patients with endoprosthetics of hip joints

Background. Important part of orthopaedic surgery is endoprosthetics of hip joints, which eliminates pain syndrome, restores the amplitude of movements and the support ability of the lower limb. But there is a number of complications; venous thromboembolism among them occupies a leading place. Material and methods. 219 patients with a mean age of 64.7 ± 3.8 years were operated. In 137 (62.1%) observations, total cement hip replacement was performed for osteoarthritis. 82 (37.4%) patients received total and unipolar cement hip replacement for cervical femoral neck fractures. Results. Clinical manifestations of non-specific connective tissue dysplasia were detected in 83 (37.9%) patients, which were confirmed by the laboratory determination of the level of general, bound and free oxyproline. In the postoperative period, the thrombotic process in the venous system of the inferior vena cava was diagnosed in 23 (10.5%) observations. Operative intervention on the hip joint in patients with nonspecific dysplasia of connective tissue in 11 (13.3%) cases was complicated by the development of venous thrombosis. In patients without non-specific connective tissue dysplasia, postoperative thrombosis in the system of the inferior vena cava was diagnosed in 12 (8.8%) observations. Conclusions. Patients with osteoarthrosis of the hip joint and the femoral neck fracture accompanied by the non-specific dysplasia of the connective tissue are characterized by expressed levels of endothelial dysfunction and increased activity of the blood-coagulation system.

Joint Angle, Range of Motion, Force, and Moment Assessment: Responses of the Lower Limb to Ankle Plantarflexion and Dorsiflexion

There is limited research on the biomechanical assessment of the lower limb joints in relation to dynamic movements that occur at the hip, knee, and ankle joints when performing dorsiflexion (DF) and plantarflexion (PF) among males and females. This study investigated the differences in joint angles (including range of motion (ROM)) and forces (including moments) between the left and right limbs at the ankle, knee, and hip joints during dynamic DF and PF movements in both males and females. Using a general linear model employing multivariate analysis in relation to the joint angle, ROM, force, and moment datasets, the results revealed significant main effects for gender, sidedness, phases, and foot position with respect to joint angles. Weak correlations were observed between measured biomechanical variables. These results provide insightful information for clinicians and biomechanists that relate to lower limb exercise interventions and modelling efficacy standpoints.