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Foot and Ankle Clinics Jun 2017Reoperation rates are higher in total ankle arthroplasties (TAAs) compared with ankle arthrodesis. Infection rates for primary TAAs are 1.4% to 2.4%. The survival rate... (Review)
Review
Reoperation rates are higher in total ankle arthroplasties (TAAs) compared with ankle arthrodesis. Infection rates for primary TAAs are 1.4% to 2.4%. The survival rate of TAA is approximately 75% to 90% at 10 years. Arc of motion is maintained with TAAs compared with ankle arthrodesis. Ankle arthrodesis increases arc of motion through the talonavicular joint. Several factors are strong reasons to favor ankle fusion rather than TAA. TAA and ankle arthrodesis are effective treatments of end-stage ankle arthritis but the choice must be tailored to individual patients.
Topics: Ankle Joint; Arthritis; Arthrodesis; Arthroplasty, Replacement, Ankle; Humans; Tarsal Joints
PubMed: 28502347
DOI: 10.1016/j.fcl.2017.01.013 -
Drug Design, Development and Therapy 2022Indeed, the body articulation units, commonly referred to as body joints, play significant roles in the musculoskeletal system, enabling body flexibility. Nevertheless,... (Review)
Review
Indeed, the body articulation units, commonly referred to as body joints, play significant roles in the musculoskeletal system, enabling body flexibility. Nevertheless, these articulation units suffer from several pathological conditions, such as osteoarthritis (OA), rheumatoid arthritis (RA), ankylosing spondylitis, gout, and psoriatic arthritis. There exist several treatment modalities based on the utilization of anti-inflammatory and analgesic drugs, which can reduce or control the pathophysiological symptoms. Despite the success, these treatment modalities suffer from major shortcomings of enormous cost and poor recovery, limiting their applicability and requiring promising strategies. To address these limitations, several engineering strategies have been emerged as promising solutions in fabricating the body articulation as unit models towards local articulation repair for tissue regeneration and high-throughput screening for drug development. In this article, we present challenges related to the selection of biomaterials (natural and synthetic sources), construction of 3D articulation models (scaffold-free, scaffold-based, and organ-on-a-chip), architectural designs (microfluidics, bioprinting, electrospinning, and biomineralization), and the type of culture conditions (growth factors and active peptides). Then, we emphasize the applicability of these articulation units for emerging biomedical applications of drug screening and tissue repair/regeneration. In conclusion, we put forward the challenges and difficulties for the further clinical application of the in vitro 3D articulation unit models in terms of the long-term high activity of the models.
Topics: Biocompatible Materials; Bioprinting; Drug Evaluation, Preclinical; Humans; Joint Diseases; Joints; Printing, Three-Dimensional; Regenerative Medicine
PubMed: 35087267
DOI: 10.2147/DDDT.S344036 -
Journal of Strength and Conditioning... Feb 2021Suchomel, TJ, Giordanelli, MD, Geiser, CF, and Kipp, K. Comparison of joint work during load absorption between weightlifting derivatives. J Strength Cond Res 35(2S):...
Suchomel, TJ, Giordanelli, MD, Geiser, CF, and Kipp, K. Comparison of joint work during load absorption between weightlifting derivatives. J Strength Cond Res 35(2S): S127-S135, 2021-This study examined the lower-extremity joint-level load absorption characteristics of the hang power clean (HPC) and jump shrug (JS). Eleven Division I male lacrosse players were fitted with 3-dimensional reflective markers and performed 3 repetitions each of the HPC and JS at 30, 50, and 70% of their 1 repetition maximum (1RM) HPC while standing on force plates. Load absorption joint work and duration at the hip, knee, and ankle joints were compared using 3-way repeated-measures mixed analyses of variance. Cohen's d effect sizes were used to provide a measure of practical significance. The JS was characterized by greater load absorption joint work compared with the HPC performed at the hip (p < 0.001, d = 0.84), knee (p < 0.001, d = 1.85), and ankle joints (p < 0.001, d = 1.49). In addition, greater joint work was performed during the JS compared with the HPC performed at 30% (p < 0.001, d = 0.89), 50% (p < 0.001, d = 0.74), and 70% 1RM HPC (p < 0.001, d = 0.66). The JS had a longer loading duration compared with the HPC at the hip (p < 0.001, d = 0.94), knee (p = 0.001, d = 0.89), and ankle joints (p < 0.001, d = 0.99). In addition, the JS had a longer loading duration compared with the HPC performed at 30% (p < 0.001, d = 0.83), 50% (p < 0.001, d = 0.79), and 70% 1RM HPC (p < 0.001, d = 0.85). The JS required greater hip, knee, and ankle joint work on landing compared with the load absorption phase of the HPC, regardless of load. The HPC and JS possess unique load absorption characteristics; however, both exercises should be implemented based on the goals of each training phase.
Topics: Ankle Joint; Biomechanical Phenomena; Exercise; Hip Joint; Humans; Knee Joint; Male; Muscle Strength; Weight Lifting
PubMed: 33666596
DOI: 10.1519/JSC.0000000000002927 -
Cartilage Dec 2021Pathology of the facet and sacroiliac (SI) joints contributes to 15% to 45% and 10% to 27% of lower back pain cases, respectively. Although tissue engineering may offer...
OBJECTIVE
Pathology of the facet and sacroiliac (SI) joints contributes to 15% to 45% and 10% to 27% of lower back pain cases, respectively. Although tissue engineering may offer novel treatment options to patients suffering from cartilage degeneration in these joints, the tribological characteristics of the facet and SI joints have not been studied in either the human or relevant large animal models, which hinders the development of joint-specific cartilage implants.
DESIGN
Cartilage was isolated from the knee, cervical facet, thoracic facet, lumbar facet, and SI joints of 6 skeletally mature Yucatan minipigs (). Tribological characteristics were assessed via coefficient of friction testing, interferometry, and immunohistochemistry for lubricin organization.
RESULTS
Compared with the knee, the coefficient of friction was higher by 43% in the cervical facet, 77% in the thoracic facet, 37% in the lumbar facet, and 28% in the SI joint. Likewise, topographical features of the facet and SI joints varied significantly, ranging from a 114% to 384% increase and a 48% to 107% increase in global and local surface roughness measures, respectively, compared with the knee. Additionally, the amount of lubricin in the SI joint was substantially greater than in the knee. Statistical correlations among the various tribological parameters revealed that there was a significant correlation between local roughness and coefficient of friction, but not global roughness or the presence of lubricin.
CONCLUSION
These location-specific tribological characteristics of the articular cartilages of the spine will need to be taken into consideration during the development of physiologically relevant, functional, and durable tissue-engineered replacements for these joints.
Topics: Animals; Cartilage, Articular; Humans; Knee Joint; Sacroiliac Joint; Swine; Swine, Miniature; Zygapophyseal Joint
PubMed: 34105385
DOI: 10.1177/19476035211021906 -
Journal of Clinical Rheumatology :... Aug 2023Symmetrical involvement of the hand joints is described as characteristic of rheumatoid arthritis (RA). Quantitative data on specific patterns of involvement are lacking.
BACKGROUND
Symmetrical involvement of the hand joints is described as characteristic of rheumatoid arthritis (RA). Quantitative data on specific patterns of involvement are lacking.
OBJECTIVE
The Brigham Rheumatoid Arthritis Sequential Study was created for observational studies of patients with RA and afforded a unique opportunity to answer these questions.
METHODS
Of 1598 subjects in the Brigham Rheumatoid Arthritis Sequential Study cohort, 535 met the following criteria: (1) disease duration of 7 years or greater, (2) seropositive, and (3) hand radiographs available. Patterns in specific hand joints based on physical examination and radiographic findings obtained at entry were identified. The level of symmetry of involvement of the metacarpophalangeal (MCP) and wrist joints was determined, as was the correlation between findings on physical examination and radiographic changes in the hand joints.
RESULTS
The prevalence of joint space narrowing and/or erosions in each proximal interphalangeal (PIP) joints ranged between 11% and 18%. Joint space narrowing and/or erosions in the MCPs increased radially from the fifth to the second finger. Swelling and tenderness on physical examination of both the PIPs and MCPs also increased radially although the positive predictive value of physical examination as an indicator of joint damage decreased radially. The wrist was the most common joint involved both by physical examination (67%) and radiographically (70%). The right side was more involved radiographically. Analysis of radiographic changes in individual patients revealed that symmetrical findings in the wrists and MCPs occurred in only 67% of patients.
CONCLUSIONS
The study describes the pattern of involvement of the hand joints in patients with long standing RA. Findings of interest include symmetrical involvement in only 67% of patients and a discordancy between physical findings and radiographic changes most marked in the more radial PIP joints.
Topics: Humans; Finger Joint; Arthritis, Rheumatoid; Hand Joints; Wrist Joint; Radiography
PubMed: 37158761
DOI: 10.1097/RHU.0000000000001971 -
BioMed Research International 2023Biomechanics researchers often experimentally measure static or fluctuating dynamic contact forces, areas, and stresses at the interface of natural and artificial... (Review)
Review
Biomechanics researchers often experimentally measure static or fluctuating dynamic contact forces, areas, and stresses at the interface of natural and artificial joints, including the shoulders, elbows, hips, and knees. This information helps explain joint contact mechanics, as well as mechanisms that may contribute to disease, damage, and degradation. Currently, the most common in vitro experimental technique involves a thin pressure-sensitive film inserted into the joint space; but, the film's finite thickness disturbs the joint's ordinary articulation. Similarly, the most common in vivo experimental technique uses video recording of 3D limb motion combined with dynamic analysis of a 3D link-segment model to calculate joint contact force, but this does not provide joint contact area or stress distribution. Moreover, many researchers may be unaware of older or newer alternative techniques that may be more suitable for their particular research application. Thus, this article surveys over 50 years of English-language scientific literature in order to (a) describe the basic working principles, advantages, and disadvantages of each technique, (b) examine the trends among the studies and methods, and (c) make recommendations for future directions. This article will hopefully inform biomechanics investigators about various in vitro and in vivo experimental methods for studying the contact mechanics of joints.
Topics: Motion; Research Design; Joints; Cartilage, Articular; Biomechanical Phenomena; Stress, Mechanical
PubMed: 37780487
DOI: 10.1155/2023/4914082 -
Physical and Engineering Sciences in... Mar 2023The knee is one of the most stressed joints of the human body, being susceptible to ligament injuries and degenerative diseases. Due to the rising incidence of knee... (Review)
Review
The knee is one of the most stressed joints of the human body, being susceptible to ligament injuries and degenerative diseases. Due to the rising incidence of knee pathologies, the number of knee X-rays acquired is also increasing. Such X-rays are obtained for the diagnosis of knee injuries, the evaluation of the knee before and after surgery, and the monitoring of the knee joint's stability. These types of diagnosis and monitoring of the knee usually involve radiography under physical stress. This widely used medical tool provides a more objective analysis of the measurement of the knee laxity than a physical examination does, involving knee stress tests, such as valgus, varus, and Lachman. Despite being an improvement to physical examination regarding the physician's bias, stress radiography is still performed manually in a lot of healthcare facilities. To avoid exposing the physician to radiation and to decrease the number of X-ray images rejected due to inadequate positioning of the patient or the presence of artefacts, positioning systems for stress radiography of the knee have been developed. This review analyses knee positioning systems for X-ray environment, concluding that they have improved the objectivity and reproducibility during stress radiographs, but have failed to either be radiolucent or versatile with a simple ergonomic set-up.
Topics: Humans; X-Rays; Reproducibility of Results; Knee Joint; Knee; Radiography
PubMed: 36692683
DOI: 10.1007/s13246-023-01221-y -
Arthroscopy : the Journal of... May 2019Over the past decade, the interest in acromioclavicular (AC) joint research has experienced a revolutionary increase. Biomechanical and anatomic studies have been...
Over the past decade, the interest in acromioclavicular (AC) joint research has experienced a revolutionary increase. Biomechanical and anatomic studies have been carried out to investigate and obtain a better understanding of the function of this joint. The reason for this huge investigational effort is the fact that we do not have any gold standard for the treatment, diagnosis, or follow-up of patients with acute or chronic AC joint injuries. This is reflected by the huge number of over 160 different surgical techniques described in the literature. So far, we have a variety of anatomic procedures, nonanatomic procedures, and nonanatomic procedures with open reduction and internal fixation, with a significantly better clinical outcome for anatomic techniques. Because of this wide variety, it is hard and nearly impossible to compare clinical data. Within the past 5 years, we have focused not only on the vertical instability but also, more and more, on the horizontal instability and tried to understand the rotational component of this joint with the importance of scapulothoracic motion. The evolutionary advantage of bipedalism with the support of the clavicle compared with quadrupedalism allows us to lift our arms for overhead activities. Therefore, we need an intact sternoclavicular and AC force transfer, described as the "strut function," to give a resistance against the thorax when abducting the arm over 90°. Once we have an interruption in this force transfer, we believe that it is the most important aspect in AC joint surgery to try to anatomically restore this joint's anatomy. For this reason, we have changed our practice in the past few years in line with the newly derived data, by addressing the coracoclavicular ligaments as well as the AC capsule to restore horizontal and vertical stability but also allow for physiological rotation and movement.
Topics: Acromioclavicular Joint; Clavicle; Humans; Ligaments, Articular; Respect; Shoulder
PubMed: 31054713
DOI: 10.1016/j.arthro.2019.01.038 -
Journal of Ultrasound in Medicine :... Sep 2018Injuries to the collateral ligaments of the metacarpophalangeal (MCP) and interphalangeal (IP) joints are commonly encountered in both athletes and nonathletes. They... (Review)
Review
Injuries to the collateral ligaments of the metacarpophalangeal (MCP) and interphalangeal (IP) joints are commonly encountered in both athletes and nonathletes. They require prompt evaluation to ensure proper management and prevent loss of joint motion and permanent disability. Imaging is often required to confirm the diagnosis and assess injury severity. This review article aims to provide physicians with guidelines for sonographic assessment of the collateral ligaments of the MCP and IP and related injuries. Sonographic features of ligament injuries ranging from sprains and partial-thickness tears to full-thickness tears are described. Specific lesions of the ulnar collateral ligament of the thumb MCP joint, such as gamekeeper's thumb, skier's thumb, and Stener lesions, are also included. In conclusion, sonography is effective in evaluating the collateral ligaments of the MCP and IP joints and related injuries and represents a valuable tool for diagnosis.
Topics: Collateral Ligaments; Humans; Joint Diseases; Metacarpophalangeal Joint; Ultrasonography
PubMed: 29480577
DOI: 10.1002/jum.14575 -
Cells, Tissues, Organs 2024The impact of mild synovitis on the chondrogenic environment in the joint pertaining to cartilage repair is often neglected. In this study, 21 synovial samples were...
The impact of mild synovitis on the chondrogenic environment in the joint pertaining to cartilage repair is often neglected. In this study, 21 synovial samples were collected from foot surgeries for histology and isolation of fibroblast-like synoviocytes (FLSs). Of the 21 samples, 13 were normal and eight were mild synovitis, according to their synovitis scores. In mild synovitis, CD3+ lymphocytes were increased in the sublining layer. When chondrocytes were cultured and treated with the conditioned medium produced by FLSs, their glycosaminoglycan production was negatively correlated with the synovitis scores of the synovium, from which FLSs were isolated. In conclusion, mild synovitis in common joint conditions compromises the process of chondrogenesis, via inhibiting chondrocyte matrix production by FLSs. The results suggest that the concomitant synovitis, even being mild, could significantly alter the joint environment for chondrogenesis and impair the outcome of cartilage repair.
Topics: Humans; Synovitis; Chondrogenesis; Chondrocytes; Middle Aged; Male; Female; Synoviocytes; Adult; Aged; Glycosaminoglycans; Cells, Cultured; Joints; Culture Media, Conditioned; Synovial Membrane
PubMed: 37524055
DOI: 10.1159/000532008