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Physical Medicine and Rehabilitation... Nov 2021Detailed understanding of the course and location of articular nerves supplying the shoulder joint is paramount to the successful utilization of image-guided... (Review)
Review
Detailed understanding of the course and location of articular nerves supplying the shoulder joint is paramount to the successful utilization of image-guided radiofrequency ablation to manage chronic shoulder pain. In this article, the origin, course, and relationship to anatomic landmarks of articular nerves supplying the shoulder and acromioclavicular joints are discussed. The shoulder joint capsule was consistently reported to receive innervation from multiple sources including the suprascapular, axillary, subscapular, and lateral pectoral nerves. The acromioclavicular joint received innervation from suprascapular and lateral pectoral nerves. The consistent relationship of articular branches to anatomic landmarks provides the basis for specific image-guided targeting.
Topics: Acromioclavicular Joint; Cadaver; Humans; Joint Capsule; Shoulder; Shoulder Joint
PubMed: 34593135
DOI: 10.1016/j.pmr.2021.05.005 -
ACS Biomaterials Science & Engineering Nov 2020Osteoarthritis (OA) is the fourth leading cause of disability in adults. Yet, few viable pharmaceutical options exist for pain abatement and joint restoration, aside... (Review)
Review
Osteoarthritis (OA) is the fourth leading cause of disability in adults. Yet, few viable pharmaceutical options exist for pain abatement and joint restoration, aside from joint replacement at late and irreversible stages of the disease. From the first onset of OA, as joint pain increases, individuals with arthritis increasingly reach for drug delivery solutions, from taking oral glycosaminoglycans (GAGs) bought over the counter from retail stores (e.g., Costco) to getting injections of viscous, GAG-containing synovial fluid supplement in the doctor's office. Little is known regarding the efficacy of delivery mode and/or treatment by such disease-modulating agents. This Review addresses the interplay of mechanics and biology on drug delivery to affected joints, which has profound implications for molecular transport in joint health and (patho)physiology. Multiscale systems biology approaches lend themselves to understand the relationship between the cell and joint health in OA and other joint (patho)physiologies. This Review first describes OA-related structural and functional changes in the context of the multilength scale anatomy of articular joints. It then summarizes and categorizes, by size and charge, published molecular transport studies, considering changes in permeability induced through inflammatory pathways. Finally, pharmacological interventions for OA are outlined in the context of molecular weights and modes of drug delivery. Taken together, the current state-of-the-art points to a need for new drug delivery strategies that harness systems-based interactions underpinning molecular transport and maintenance of joint structure and function at multiple length scales from molecular agents to cells, tissues, and tissue compartments which together make up articular joints. Cutting edge and cross-length and -time scale imaging represents a key discovery enabling technology in this process.
Topics: Humans; Injections, Intra-Articular; Joints; Osteoarthritis; Pharmaceutical Preparations; Synovial Fluid
PubMed: 33449636
DOI: 10.1021/acsbiomaterials.0c01081 -
Hand Clinics May 2022Isolated dislocations of thumb CMC joints are rare injuries with serious functional implications. Patients suffering these injuries will have decreased pinch and grip... (Review)
Review
Isolated dislocations of thumb CMC joints are rare injuries with serious functional implications. Patients suffering these injuries will have decreased pinch and grip strength. A high-energy, axially directed force on a flexed thumb typically causes dislocation. Chronically dislocated thumb CMC joints may be due to untreated remote trauma, hypermobility, or connective tissue disorders. Roberts and CMC stress view radiographs help identify joint dislocations. Treatment of these injuries includes closed reduction and immobilization, percutaneous pinning, open reduction with direct repair, and ligament reconstruction. Timely identification, timely treatment, and proper hand therapy often lead to adequate joint stability with minimal residual pain.
Topics: Carpometacarpal Joints; Hand Joints; Humans; Joint Dislocations; Range of Motion, Articular; Thumb
PubMed: 35465944
DOI: 10.1016/j.hcl.2022.01.003 -
Nature Reviews. Rheumatology Sep 2021Osteoarthritis (OA) is a whole-joint disease characterized by subchondral bone perfusion abnormalities and neovascular invasion into the synovium and articular... (Review)
Review
Osteoarthritis (OA) is a whole-joint disease characterized by subchondral bone perfusion abnormalities and neovascular invasion into the synovium and articular cartilage. In addition to local vascular disturbance, mounting evidence suggests a pivotal role for systemic vascular pathology in the aetiology of OA. This Review outlines the current understanding of the close relationship between high blood pressure (hypertension) and OA at the crossroads of epidemiology and molecular biology. As one of the most common comorbidities in patients with OA, hypertension can disrupt joint homeostasis both biophysically and biochemically. High blood pressure can increase intraosseous pressure and cause hypoxia, which in turn triggers subchondral bone and osteochondral junction remodelling. Furthermore, systemic activation of the renin-angiotensin and endothelin systems can affect the Wnt-β-catenin signalling pathway locally to govern joint disease. The intimate relationship between hypertension and OA indicates that endothelium-targeted strategies, including re-purposed FDA-approved antihypertensive drugs, could be useful in the treatment of OA.
Topics: Animals; Bone and Bones; Humans; Hypertension; Joints; Models, Biological; Osteoarthritis; Synovial Membrane
PubMed: 34316066
DOI: 10.1038/s41584-021-00650-x -
Sports Biomechanics Dec 2019Ballerinas use their ankle joints more extremely and sustain injuries on the ankle joint more frequently than non-dancers. Therefore, the ankle movement of dancers is... (Comparative Study)
Comparative Study
Ballerinas use their ankle joints more extremely and sustain injuries on the ankle joint more frequently than non-dancers. Therefore, the ankle movement of dancers is important and should be studied to prevent injuries. Measuring ankle joint range of motion (ROM) using radiographs could demonstrate the contribution to motion of each joint. The aim of this study was to analyse and compare ankle joint movements and the ratio of each joint's contribution during movement between dancers and non-dancers, using radiographic images. Dancers have lower dorsiflexion (26.7 ± 6.2°), higher plantarflexion (74.3 ± 7.1°) and higher total (101.1 ± 10.8°) ROMs than non-dancers (33.9 ± 7.0°, 57.2 ± 6.8° and 91.1 ± 9.3°, respectively) ( < 0.05). Although the ROMs were different between the two groups, the ratios of each joint movement were similar between these two groups, in all movements. Regarding total movement, the movement ratio of the talocrural joint was almost 70% and other joints accounted for almost 30% of the movement role in both dancers and non-dancers. Therefore, the differences in ROM between dancers and non-dancers were not a result of a specific joint movement but of all the relevant joints' collaborative movement.
Topics: Ankle Joint; Biomechanical Phenomena; Dancing; Female; Foot; Humans; Metatarsal Bones; Movement; Radiographic Image Interpretation, Computer-Assisted; Radiography; Range of Motion, Articular; Tarsal Bones; Young Adult
PubMed: 29768088
DOI: 10.1080/14763141.2018.1452967 -
Der Radiologe Mar 2020Magnetic resonance (MR) arthrography is a sensitive examination technique. In this institute the majority of MR arthrography examinations are carried out on the... (Review)
Review
Magnetic resonance (MR) arthrography is a sensitive examination technique. In this institute the majority of MR arthrography examinations are carried out on the shoulder (57 %), followed by hand (24 %) and hip joints (16 %). The use of MR arthrography is superior to native MR imaging (MRI) particularly for detection of partial thickness tendon tears of the shoulder joint. Nevertheless, this technique is invasive, time-consuming and may be uncomfortable for patients. This article summarizes the indications, risks and contraindications of MR arthrography, highlights the puncture technique and illustrates possible pitfalls.
Topics: Arthrography; Humans; Joints; Magnetic Resonance Imaging; Shoulder Joint
PubMed: 32067106
DOI: 10.1007/s00117-020-00648-8 -
The Journal of Hand Surgery, European... Jan 2022The technical simplicity of the Darrach procedure may explain why it has been so popular. Excising the distal ulna, however, may have potentially undesired consequences...
The technical simplicity of the Darrach procedure may explain why it has been so popular. Excising the distal ulna, however, may have potentially undesired consequences to the biomechanics in two areas: the distal radioulnar and the ulno-carpal joints. These conjointly define the radio-ulno-carpal joint (RUCJ). The RUCJ is not a small and irrelevant articulation that can be removed without possibly paying a functional penalty. It is an important link of the antebrachial frame that provides stability to the distal forearm and the carpus. This article revisits the mechanisms by which some ligaments and muscles ensure that all forces about and within the RUCJ are dealt with efficiently.
Topics: Biomechanical Phenomena; Humans; Ligaments; Ligaments, Articular; Muscles; Radius; Ulna; Wrist Joint
PubMed: 34472392
DOI: 10.1177/17531934211042316 -
Journal of Orthopaedic Surgery (Hong... 2022The compensation mechanism of subtalar joint in ankle with varus or valgus deformity is controversial and not well established. This biomechanical study aims to...
The compensation mechanism of subtalar joint in ankle with varus or valgus deformity is controversial and not well established. This biomechanical study aims to investigate how subtalar joint arthrodesis will affect the ankle joint pressure in varus and valgus malalignment of the tibia. Eight fresh-frozen human cadaver legs were tested in this study. A custom-made fixture was utilized and a total of 600N was applied to simulate weight-bearing. Intra-articular sensors (TeckScan) were inserted in the ankle joint to demonstrate the ankle joint pressure. Conditions include: Neutral, 5°, 10°, 15° and 20° varus, 5°, 10°, 15° and 20° valgus. After the fusion of the subtalar joint, when the tibia is gradually inverted, the inside pressure of the ankle joint gradually increases, and the pressure on the outside of the ankle joint gradually decreases. When the tibia is gradually eversion, the pressure on the outside of the ankle joint gradually increases, and the inside of the ankle joint gradually decreases. After the subtalar joint is fused, the compensatory activity of the subtalar joint disappears, and the regulation of the pressure in the ankle joint will be lost. We hypothesized that the inversion compensation of the subtalar joint is more likely to occur than the eversion compensation.
Topics: Ankle Joint; Arthrodesis; Humans; Subtalar Joint; Tibia; Weight-Bearing
PubMed: 35467445
DOI: 10.1177/10225536221098478 -
Journal of Applied Biomechanics Apr 2021This study determined changes in lower limb joint stiffness when running with body-borne load, and whether they differ with stride or sex. Twenty males and 16 females...
This study determined changes in lower limb joint stiffness when running with body-borne load, and whether they differ with stride or sex. Twenty males and 16 females had joint stiffness quantified when running (4.0 m/s) with body-borne load (20, 25, 30, and 35 kg) and 3 stride lengths (preferred or 15% longer and shorter). Lower limb joint stiffness, flexion range of motion (RoM), and peak flexion moment were submitted to a mixed-model analysis of variance. Knee and ankle stiffness increased 19% and 6% with load (P < .001, P = .049), but decreased 8% and 6% as stride lengthened (P = .004, P < .001). Decreased knee RoM (P < .001, 0.9°-2.7°) and increased knee (P = .007, up to 0.12 N.m/kg.m) and ankle (P = .013, up to 0.03 N.m/kg.m) flexion moment may stiffen joints with load. Greater knee (P < .001, 4.7°-5.4°) and ankle (P < .001, 2.6°-7.2°) flexion RoM may increase joint compliance with longer strides. Females exhibited 15% stiffer knee (P = .025) from larger reductions in knee RoM (4.3°-5.4°) with load than males (P < .004). Stiffer lower limb joints may elevate injury risk while running with load, especially for females.
Topics: Ankle Joint; Biomechanical Phenomena; Female; Gait; Hip Joint; Humans; Knee Joint; Male; Range of Motion, Articular; Running; Sex Factors; Weight-Bearing; Young Adult
PubMed: 33361491
DOI: 10.1123/jab.2020-0135 -
Journal of Hand Therapy : Official... 2024Recent research interest has grown in exploring the role of muscles, isometric contraction, proprioception, and neuromuscular control in addressing dynamic scapholunate... (Review)
Review
BACKGROUND
Recent research interest has grown in exploring the role of muscles, isometric contraction, proprioception, and neuromuscular control in addressing dynamic scapholunate and lunotriquetral joint instability, marking a shift in the understanding of wrist stability.
PURPOSE
To present a comprehensive review of the carpal ligaments anatomy and wrist biomechanics, with a particular focus on the role of proprioception in dynamic carpal stability and their role in managing scapholunate (SL) and lunotriquetral (LTq) dynamic instabilities.
STUDY DESIGN
We conducted a systematic search of the literature and review of the most relevant papers published and indexed in pubmed, related to wrist biomechanics, proprioception and its contribution to carpal dynamic stability.
METHODS
The study involved a comprehensive review of neuromuscular mechanisms in dynamic stabilization of the carpus, based on cadaver studies. The 3D position of the scaphoid, triquetrum, and capitate was monitored before and after tendon loading.
RESULTS
The extensor carpi ulnaris (ECU) and the flexor carpi radialis (FCR) are identified as the primary pronators of the midcarpal joint. The ECU's pronation effect can potentially strain the scapholunate ligament, while the supinator muscles, the abductor pollicis longus (APL), the extensor carpi radialis longus (ECRL), and the flexor carpi ulnaris (FCU), have a protective role, particularly in cases of scapholunate ligament dysfunctions. The FCR, despite being a pronator of the distal row, has a beneficial effect as it provokes supination of the scaphoid.
CONCLUSIONS
Comprehending carpal dysfunctions and instabilities hinges on understanding carpal anatomy and normal biomechanics. Proprioception, encompassing joint position sensation and neuromuscular control, is pivotal for stability. Biomechanical research informs tailored muscle strengthening for specific carpal issues. Supinator muscles should be strengthened for SL injuries, and ECU-focused strengthening and proprioceptive training are key for dynamic LTq instabilities. Ongoing research should delve into the intricate relationship between carpal ligaments, muscles, and proprioception to enhance wrist stability.
Topics: Humans; Proprioception; Joint Instability; Wrist Joint; Ligaments, Articular; Biomechanical Phenomena; Carpal Joints; Muscle, Skeletal
PubMed: 37852909
DOI: 10.1016/j.jht.2023.09.011