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Scientific Reports Jul 2022The knowledge gap regarding the topography and anatomy of the dromedary's carpal joint must be bridged to improve diagnostic and treatment procedures such as...
The knowledge gap regarding the topography and anatomy of the dromedary's carpal joint must be bridged to improve diagnostic and treatment procedures such as ultrasonography, arthrocentesis, and arthroscopy. Thirty-five distal forelimbs were harvested from 21 dromedaries and studied through gross dissection, casting, ultrasonography, and computerized tomography. Representative three-dimensional models of the joint cavities, recesses, and pouches were obtained using various casting agents. The safety and feasibility of different arthrocentesis approaches were evaluated. This study provides a detailed description of dorsally located joint recesses and palmarly located joint pouches. The dorsomedial and dorsolateral approach is recommended for arthroscopy and arthrocentesis of the radiocarpal and intercarpal joint when the carpus is flexed. However, caution must be exercised during these approaches to prevent needle injury to the articulating cartilage. Caution is necessary to prevent the formation of inadvertent communication between the dorsally located tendon sheaths and joint cavities. Arthrocentesis via the lateral approach to the lateropalmar pouch is the most favourable approach for the radiocarpal joint. A subtendinous synovial bursa was found between the lateropalmar pouch of the radiocarpal joint and the extensor carpi ulnaris muscle. The subtendinous synovial bursa must be considered during the lateral arthrocentesis approach. The palmar approach is not recommended for arthrocentesis due to the high risk of injury to nerves, veins, and arteries located palmarly.
Topics: Animals; Arthrocentesis; Camelus; Carpal Joints; Forelimb; Wrist Joint
PubMed: 35896772
DOI: 10.1038/s41598-022-16801-3 -
Scientific Reports Oct 2023Irrespective of the exceptional adaptation of dromedaries to harsh environmental conditions, they remain highly susceptible to joint lameness resulting from a range of...
Irrespective of the exceptional adaptation of dromedaries to harsh environmental conditions, they remain highly susceptible to joint lameness resulting from a range of diverse factors and conditions. The joints most often affected by traumatic osteoarthritis in dromedaries are the metacarpophalangeal and metatarsophalangeal joints. A comprehensive understanding of joint anatomy and topography of the dromedary is required to perform arthrocentesis correctly on affected joints. Forty-two distal limbs were taken from 28 camels and studied by gross dissection, casting, ultrasonography, and computed tomography (CT). Representative three-dimensional models of the joint cavities, recesses, and pouches were obtained using different casting agents. This study provides a detailed description of dorsally, axially, and abaxially positioned joint recesses, as well as palmar/plantar positioned joint pouches. The safety and feasibility of the different arthrocentesis approaches were evaluated. The traditional dorsal arthrocentesis approach of the metacarpophalangeal, metatarsophalangeal, proximal interphalangeal, and distal interphalangeal joints, has limitations due to the risk of damaging the tendon structures and articular cartilage, which can lead to joint degeneration. A lateral arthrocentesis approach via the proximal palmar/plantar pouches of the metacarpophalangeal/metatarsophalangeal and proximal interphalangeal joints is recommended. This approach eliminates the potential needle injury to the articulating joint cartilage and other surrounding joint structures, such as tendons, blood vessels, and nerves.
Topics: Animals; Camelus; Arthrocentesis; Forelimb; Joints; Cartilage, Articular; Metatarsophalangeal Joint
PubMed: 37833397
DOI: 10.1038/s41598-023-44391-1 -
Journal of Biomechanics Aug 2017Work performance and individual joint contribution to total work are important information for creating training protocols, but were not assessed so far for sloped...
Work performance and individual joint contribution to total work are important information for creating training protocols, but were not assessed so far for sloped walking. Therefore, the purpose of this study was to analyze lower limb joint work and joint contribution of the hip, knee and ankle to total lower limb work during sloped walking in a healthy population. Eighteen male participants (27.0±4.7yrs, 1.80±0.05m, 74.5±8.2kg) walked on an instrumented ramp at inclination angles of 0°, ±6°, ±12° and ±18° at 1.1m/s. Kinematic and kinetic data were captured using a motion-capture system (Vicon) and two force plates (AMTI). Joint power curves, joint work (positive, negative, absolute) and each joint's contribution to total lower limb work were analyzed throughout the stance phase using an ANOVA with repeated measures. With increasing inclination positive joint work increased for the ankle and hip joint and in total during uphill walking. Negative joint work increased for each joint and in total work during downhill walking. Absolute work was increased during both uphill (all joints) and downhill (ankle & knee) walking. Knee joint contribution to total negative and absolute work increased during downhill walking while hip and ankle contributions decreased. This study identified, that, when switching from level to a 6° and from 6° to a 12° inclination the gain of individual joint work is more pronounced compared to switching from 12° to an 18° inclination. The results might be used for training recommendations and specific training intervention with respect to sloped walking.
Topics: Adult; Biomechanical Phenomena; Gait; Humans; Joints; Kinetics; Lower Extremity; Male; Walking
PubMed: 28734544
DOI: 10.1016/j.jbiomech.2017.07.001 -
Muscle & Nerve May 2024Hemiparetic gait disorders are common in stroke survivors. A circumductory gait is often considered the typical hemiparetic gait. In clinical practice, a wide spectrum...
Hemiparetic gait disorders are common in stroke survivors. A circumductory gait is often considered the typical hemiparetic gait. In clinical practice, a wide spectrum of abnormal gait patterns is observed, depending on the severity of weakness and spasticity, and the anatomical distribution of spasticity. Muscle strength is the key determinant of gait disorders in hemiparetic stroke survivors. Spasticity and its associated involuntary activation of synergistic spastic muscles often alter posture of involved joint(s) and subsequently the alignment of hip, knee, and ankle joints, resulting in abnormal gait patterns. Due to combinations of various levels of muscle weakness and spasticity and their interactions with ground reaction force, presentations of gait disorders are variable. From a neuromechanical perspective, a stepwise visual gait analysis approach is proposed to identify primary underlying causes. In this approach, the pelvic and hip joint movement is examined first. The pelvic girdle constitutes three kinematic determinants. Its abnormality determines the body vector and compensatory kinetic chain reactions in the knee and ankle joints. The second step is to assess the ankle and foot complex abnormality. The last step is to examine abnormality of the knee joint. Assessment of muscle strength and spasticity of hip, knee, and ankle/foot joints needs to be performed before these steps. Lidocaine nerve blocks can be a useful diagnostic tool. Recognizing different patterns and identifying the primary causes are critical to developing clinical interventions to improve gait functions.
Topics: Humans; Muscle Spasticity; Gait; Knee Joint; Stroke; Ankle Joint; Gait Disorders, Neurologic; Movement Disorders; Biomechanical Phenomena
PubMed: 38372396
DOI: 10.1002/mus.28052 -
Radiographics : a Review Publication of... Jan 2023The distal radioulnar joint (DRUJ) is the distal articulation between the radius and ulna, acting as a major weight-bearing joint at the wrist and distributing forces...
The distal radioulnar joint (DRUJ) is the distal articulation between the radius and ulna, acting as a major weight-bearing joint at the wrist and distributing forces across the forearm bones. The articulating surfaces are the radial sigmoid notch and ulnar head, while the ulnar fovea serves as a critical attachment site for multiple capsuloligamentous structures. The DRUJ is an inherently unstable joint, relying heavily on intrinsic and extrinsic soft-tissue stabilizers. The triangular fibrocartilage complex (TFCC) is the chief stabilizer, composed of the central disk, distal radioulnar ligaments, ulnocarpal ligaments, extensor carpi ulnaris tendon subsheath, and ulnomeniscal homologue. TFCC lesions are traditionally classified into traumatic or degenerative on the basis of the Palmer classification. The novel Atzei classification is promising, correlating clinical, radiologic, and arthroscopic findings while providing a therapeutic algorithm. The interosseous membrane and pronator quadratus are extrinsic stabilizers that offer a minor contribution to the joint's stability in conjunction with the joints of the wrist and elbow. Traumatic and overuse or degenerative disorders are the most common causes of DRUJ dysfunction, although inflammatory and developmental abnormalities also occur. Radiography and CT are used to evaluate the integrity of the osseous constituents and joint alignment. US is a useful screening tool for synovitis in the setting of TFCC tears and offers dynamic capabilities for detecting tendon instability. MRI allows simultaneous osseous and soft-tissue evaluation and is not operator dependent. Arthrographic CT or MRI provides a more detailed assessment of the TFCC, which aids in treatment and surgical decision making. The authors review the pertinent anatomy and imaging considerations and illustrate common disorders affecting the DRUJ. RSNA, 2022.
Topics: Humans; Wrist Joint; Triangular Fibrocartilage; Ulna; Radius; Joint Instability
PubMed: 36399415
DOI: 10.1148/rg.220109 -
The Journal of Hand Surgery Jun 2024Painful arthritis of the small joints of the hand is a common condition affecting older adults, with distal interphalangeal joint and thumb carpometacarpal joint being... (Review)
Review
Painful arthritis of the small joints of the hand is a common condition affecting older adults, with distal interphalangeal joint and thumb carpometacarpal joint being the two most common locations. Younger adults may also develop painful arthritis after trauma and with inflammatory arthropathy. Traditional surgical approaches address the structure of the joints with either arthrodesis or arthroplasty with or without an implant. In recent decades, denervation has been reported as an alternative treatment for painful small joints that are mobile and stable. Publications on denervation often report faster surgery and recovery times than traditional surgeries that manipulate the small joint bony structures. This article reviews the history, anatomy, surgical techniques, and outcomes of denervation of the small joints of the hand.
Topics: Humans; Denervation; Thumb; Finger Joint; Carpometacarpal Joints; Arthritis; Treatment Outcome; Hand Joints; Arthralgia
PubMed: 38323946
DOI: 10.1016/j.jhsa.2023.12.015 -
Annals of Physical and Rehabilitation... Jun 2016Osteoarthritis (OA) is the most common form of joint disease. This review aimed to consolidate the current evidence that implicates the inflammatory process in the... (Review)
Review
Osteoarthritis (OA) is the most common form of joint disease. This review aimed to consolidate the current evidence that implicates the inflammatory process in the attenuation of synovial lubrication and joint tissue homeostasis in OA. Moreover, with these findings, we propose some evidence for novel therapeutic strategies for preventing and/or treating this complex disorder. The studies reviewed support that inflammatory mediators participate in the onset and progression of OA after joint injury. The flow of pro-inflammatory cytokines following an acute injury seems to be directly associated with altered lubricating ability in the joint tissue. The latter is associated with reduced level of lubricin, one of the major joint lubricants. Future research should focus on the development of new therapies that attenuate the inflammatory process and restore lubricin synthesis and function. This approach could support joint tribology and synovial lubrication leading to improved joint function and pain relief.
Topics: Biomechanical Phenomena; Disease Progression; Glycoproteins; Humans; Inflammation Mediators; Joints; Osteoarthritis; Synovial Fluid
PubMed: 27118399
DOI: 10.1016/j.rehab.2016.03.005 -
Experimental Gerontology Sep 2017Age-related gait changes may play a critical role in functional limitations of older adults. Despite sizable interest in determining how age alters walking mechanics,... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Age-related gait changes may play a critical role in functional limitations of older adults. Despite sizable interest in determining how age alters walking mechanics, small sample sizes and varied outcome measures have precluded a comprehensive understanding of the impact of age on lower extremity joint kinematics and kinetics.
OBJECTIVE
The aim of this study was to perform a systematic review and meta-analysis of the aging gait mechanics literature.
METHODS
The overall standardized effect of age on walking mechanics was computed for 29 studies (200 standardized effects). To account for variation in reported outcome variables, analyses were carried out for comparisons between young and older adult results using all discrete kinematic or kinetic variables reported for the ankle, knee, or hip. Different variables reported for a given joint were then analyzed as separate categorical moderators.
RESULTS
The overall standardized effect of age was large for ground reaction forces, moderate for ankle and small for knee and hip kinematics and ankle and hip kinetics. When the analysis was restricted to studies with similar or matched walking speed, the standardized effects of age remained similar except for hip power generation and knee kinematic variables.
CONCLUSIONS
The results of this meta-analysis provide evidence to support moderate standardized effects, with and without consideration of walking speeds, for changes in lower extremity kinematics, joint moments and powers at the ankle, and ground reaction forces. The standardized effects of age for knee mechanics are less conclusive and would benefit from further research.
Topics: Adult; Age Factors; Aged; Aging; Ankle Joint; Biomechanical Phenomena; Gait; Hip Joint; Humans; Joints; Knee Joint; Muscle Strength; Muscle, Skeletal; Range of Motion, Articular; Walking
PubMed: 28499954
DOI: 10.1016/j.exger.2017.05.005 -
Rheumatology (Oxford, England) May 2019
Topics: Carpometacarpal Joints; Humans; Inflammation; Knee Joint; Osteoarthritis; Synovial Fluid
PubMed: 30304502
DOI: 10.1093/rheumatology/key300 -
Scientific Reports Jun 2024This study aimed to elucidate the relationship between joint structures of the first tarsometatarsal and articular facet degeneration. A total of 100 feet from 50...
This study aimed to elucidate the relationship between joint structures of the first tarsometatarsal and articular facet degeneration. A total of 100 feet from 50 cadavers were examined. The articular facets of the first metatarsal and medial cuneiform were categorized into four types based on the superior and inferior facets' separation, and the formation of the inferior lateral facet on the lateral plantar prominence: Type I, a single facet with no separation or inferior lateral facet; Type II-a, two facets with separation but no inferior lateral facet; Type II-b, two facets, no separation, but with an inferior lateral facet; Type III, three facets with separation and an inferior lateral facet. When both bone types matched, they were defined as Type I, Type II-a, Type II-b, and Type III joints, respectively; unmatched types were classified as Unpair joints. The severity of articular cartilage degeneration on both bones was assessed using a 5-point scale. The degeneration grade was compared among joint types. Type III joints exhibited significantly milder articular cartilage degeneration in medial cuneiform compared to Type II-a, II-b, Unpair joints. The formation of inferior lateral facet and separation of the superior and inferior facets might be crucial for the joint's stability.
Topics: Humans; Female; Male; Aged; Middle Aged; Aged, 80 and over; Cadaver; Cartilage, Articular; Metatarsal Bones; Tarsal Joints; Foot Joints
PubMed: 38866886
DOI: 10.1038/s41598-024-64064-x