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The Journal of Hand Surgery, European... Mar 2023The proximal interphalangeal joint is critical for good hand function. Its anatomical complexities often predispose it to stiffness, involving damage to one or more... (Review)
Review
The proximal interphalangeal joint is critical for good hand function. Its anatomical complexities often predispose it to stiffness, involving damage to one or more structures. Improving or resolving the stiffness and increasing the range of motion require an accurate assessment and understanding of the pathogenesis. The surgical strategy can then be tailored accordingly. In some cases, restoration to pre-injury level may not be possible and this condition still represents an unsolved problem in hand surgery. V.
Topics: Humans; Finger Joint; Finger Injuries; Orthopedic Procedures; Range of Motion, Articular; Fasciotomy
PubMed: 36638137
DOI: 10.1177/17531934221143690 -
Medicine and Science in Sports and... Dec 2020The purpose of this study was to compare leg, sagittal plane knee and ankle, and frontal plane ankle stiffness over the course of a prolonged treadmill run in neutral...
INTRODUCTION
The purpose of this study was to compare leg, sagittal plane knee and ankle, and frontal plane ankle stiffness over the course of a prolonged treadmill run in neutral and stability footwear.
METHODS
Thirteen male habitual rearfoot runners completed two biomechanical testing sessions in which they ran for 21 min at their preferred running speed in a neutral shoe, then changed either into the same neutral shoe or a stability shoe and ran a further 21 min on a force-instrumented treadmill. Three-dimensional kinematics and kinetics were recorded at the beginning and end of each 21-min interval.
RESULTS
No differences were observed in leg stiffness between footwear conditions throughout the run (P > 0.05). Knee stiffness increased during the first 21 min (P = 0.009), whereas ankle stiffness reduced at minute 21 (P = 0.004) and minute 44 (P = 0.006). These changes were modulated by an increase in ankle joint compliance and knee joint moments. No differences were observed between footwear conditions for leg and sagittal plane lower extremity joint stiffness (P > 0.05). During the second half of the run, frontal plane ankle stiffness increased in the stability shoe but decreased in the neutral shoe (P = 0.019), attributed to reduced eversion range of motion caused by the added medial post.
CONCLUSIONS
These results suggest that over the course of a prolonged treadmill run, shock attenuation strategies change, which may affect the knee joint.
Topics: Adult; Analysis of Variance; Ankle Joint; Biomechanical Phenomena; Equipment Design; Heart Rate; Humans; Knee Injuries; Knee Joint; Lower Extremity; Male; Running; Shoes; Time Factors; Young Adult
PubMed: 32496368
DOI: 10.1249/MSS.0000000000002416 -
Orthopaedics & Traumatology, Surgery &... Feb 2022Trochlear dysplasia consists in deficient trochlear concavity, giving rise to a flat or convex trochlea, and is the main risk factor for patellar dislocation. Surgical... (Review)
Review
Trochlear dysplasia consists in deficient trochlear concavity, giving rise to a flat or convex trochlea, and is the main risk factor for patellar dislocation. Surgical indications depend on familiarity with trochlear dysplasias, and especially those of high grade, identified on clinical examination and standard and cross-sectional imaging, and on quantification of associated instability factors. Treatment strategy is accordingly determined "à la carte" to correct these factors one by one. Sulcus deepening trochleoplasty corrects the morphology and is the appropriate etiological treatment. It gives good results in terms of recurrence of dislocation, but tends to cause knee stiffness and patellofemoral osteoarthritis. Indications are based on objective patellar instability associated to high-grade B or D dysplasia. Medial patellofemoral ligament reconstruction should be systematically associated. The lateral retinaculum is systematically sectioned, as patellar tilt is never reducible in such high-grade dysplasia. Trochleoplasty corrects the sulcus defect, resolves protrusion and enables proximal realignment. The main complications are stiffness and pain due to persistence or onset of cartilage lesions. Trochleoplasty is indicated: 1) in first line for objective patellar instability associated with high-grade dysplasia; or 2) for recurrence in high-grade dysplasia previously managed by other surgery. The aim of the present study was to review the literature on trochleoplasty and address the following questions: how to define high-grade dysplasia? What are the key clinical and radiologic points? What are the risk factors for patellar dislocation? What trochleoplasty techniques are available? What results can be expected? Level of evidence: V; expert opinion.
Topics: Femur; Humans; Joint Instability; Ligaments, Articular; Patellar Dislocation; Patellofemoral Joint
PubMed: 34863959
DOI: 10.1016/j.otsr.2021.103160 -
Research in Veterinary Science Oct 2022Knowledge of the micromechanical characteristics of the menisci is required to better understand their role within the stifle joint, improve early diagnosis of meniscal...
AIMS
Knowledge of the micromechanical characteristics of the menisci is required to better understand their role within the stifle joint, improve early diagnosis of meniscal lesions, and develop new treatment and/or replacement strategies. The aim of the study was to determine the mechanical properties of the healthy medial canine meniscus and to evaluate the effect of regional (caudal, central, and cranial) and circumference (axial and abaxial) locations on these properties.
METHODS
To study the micromechanical properties of the medial menisci in healthy (Beagle) dogs, the influence of regional (caudal, central, and cranial) and circumference (axial and abaxial) locations were evaluated. Nanoindentation-relaxation tests were performed to characterize the local stiffness and the viscoelastic properties at each region and specific circumference. Linear interpolation onto the indentation points was performed to establish a map of the micromechanical property heterogeneities.
RESULTS
The results indicate that the cranial region was significantly stiffer and less viscous than the central and caudal regions. Within the central region the inner part (axial) was significantly stiffer than the periphery (abaxial). Within the caudal region the inner part was significantly less viscous than the periphery.
CONCLUSION
Significant regional and radial variations were observed for both the stiffness and the viscoelastic properties. Moreover, a viscous behavior of the entire medial meniscus was observed (elastic fraction <0.5). These results deter the use of average elastic modulus to study the regional mechanical properties of healthy meniscus.
Topics: Animals; Biomechanical Phenomena; Dogs; Menisci, Tibial; Stifle; Viscosity
PubMed: 35405630
DOI: 10.1016/j.rvsc.2022.03.018 -
American Journal of Medical Genetics.... Sep 2019Arthrogryposis multiplex congenita (AMC) is characterized by congenital joint contractures present in two or more body areas. Lack of fetal movement is the underlying... (Review)
Review
Arthrogryposis multiplex congenita (AMC) is characterized by congenital joint contractures present in two or more body areas. Lack of fetal movement is the underlying cause of AMC, which can lead to abnormal connective tissue surrounding the joint resulting in stiffness and muscle atrophy. Treatment aims at improving function and mobility through surgical and/or conservative interventions. A scoping review was conducted to explore the existing knowledge of the evaluation and treatment of muscle and joint function in children with AMC. Three search engines were included and identified 1,271 articles. Eighty-seven studies met the selection criteria and were included in this review. All included studies focused on joints, 30 of which also assessed the muscle. Assessment most often included the position of the contractures (n = 72), as well as range of motion (n = 66). Interventions to improve muscle and joint function were reported in 82 of the 87 papers and included surgery (n = 70) and conservative interventions (n = 74) with bony surgery (i.e., osteotomy) the most common surgery and rehabilitation the most common conservative intervention. Recurrences of contractures were mentioned in 46 of the 68 studies providing a follow-up. Future studies should use validated measures to assess muscle and joint function, and conservative interventions should be described in greater detail and to include a longer follow-up.
Topics: Arthrogryposis; Child; Humans; Joints; Muscles; Range of Motion, Articular
PubMed: 31350946
DOI: 10.1002/ajmg.c.31726 -
Journal of Orthopaedic Research :... Sep 2020Deviations are often identified at individual joints in the gait analysis of patients with cerebral palsy. Previous gait studies on hemiplegic cerebral palsy (HCP) have... (Comparative Study)
Comparative Study
Deviations are often identified at individual joints in the gait analysis of patients with cerebral palsy. Previous gait studies on hemiplegic cerebral palsy (HCP) have focused mainly on deviations of the affected side. The current study aimed to quantify and compare the joint and leg stiffness, the contributions of skeletal and muscular components, and the associated joint angles and moments of the affected and nonaffected lower limbs during level walking in children with spastic HCP. A total of 12 children with spastic HCP and 12 healthy controls walked at a self-selected speed in a gait laboratory while their kinematic and forceplate data were measured and analyzed during loading response, midstance, terminal stance, and preswing. The altered joint kinematics and kinetics in the nonaffected limb in the HCP group appeared to be mainly a compensatory strategy to minimize the bilateral asymmetry in leg stiffness during the double-limb support phase and joint stiffness during the entire stance phase. The current results suggest that therapeutic planning and decision-making for children with HCP should consider not only the mechanics of the affected side but also the control of the nonaffected side.
Topics: Adolescent; Case-Control Studies; Cerebral Palsy; Child; Gait; Hemiplegia; Humans; Joints; Leg
PubMed: 32086827
DOI: 10.1002/jor.24635 -
PloS One 2022Even though running enjoys growing popularity, the effects of fatigue on the running kinematics of novices have rarely been studied. This is surprising, given the risk...
Even though running enjoys growing popularity, the effects of fatigue on the running kinematics of novices have rarely been studied. This is surprising, given the risk of running-related injuries when detrimental movement patterns are adopted. Therefore, the goal of the present study was to characterize the effects of fatigue induced by a high-intensity running protocol on spatiotemporal and stiffness parameters as well as on joint kinematics and center of mass (CoM) motion in novice runners. 14 participants performed a standardized treadmill familiarization and ran at 13 km/h until voluntary exhaustion. Kinematics were captured using a 3D motion capture system. Spatiotemporal and stiffness parameters as well as the range of motion (RoM) of the joints and CoM were compared by use of paired t-tests. Time series of the joint angles and CoM motion were analyzed by the statistical parametric mapping method. The results revealed that novice runners did not change spatiotemporal or stiffness parameters, but showed adaptations in joint kinematics, e.g. decreased dorsiflexion and increased pronation in the ankle joint during the swing phase. The findings of this study underline the importance of strengthening the ankle joint to prevent excessive pronation and increase its stability in novice runners.
Topics: Ankle Joint; Biomechanical Phenomena; Humans; Leg; Pronation; Range of Motion, Articular
PubMed: 35363776
DOI: 10.1371/journal.pone.0265550 -
Acta Biochimica Et Biophysica Sinica Jan 2022The pericellular matrix stiffness is strongly associated with its biochemical and structural changes during the aging and osteoarthritis progress of articular cartilage....
The pericellular matrix stiffness is strongly associated with its biochemical and structural changes during the aging and osteoarthritis progress of articular cartilage. However, how substrate stiffness modulates the chondrocyte regulatory volume decrease (RVD) and calcium signaling in chondrocytes remains unknown. This study aims to investigate the effects of substrate stiffness on the chondrocyte RVD and calcium signaling by recapitulating the physiologically relevant substrate stiffness. Our results showed that substrate stiffness induces completely different dynamical deformations between the cell swelling and recovering progresses. Chondrocytes swell faster on the soft substrate but recovers slower than the stiff substrate during the RVD response induced by the hypo-osmotic challenge. We found that stiff substrate enhances the cytosolic Ca oscillation of chondrocytes in the iso-osmotic medium. Furthermore, chondrocytes exhibit a distinctive cytosolic Ca oscillation during the RVD response. Soft substrate significantly improves the Ca oscillation in the cell swelling process whereas stiff substrate enhances the cytosolic Ca oscillation in the cell recovering process. Our work also suggests that the TRPV4 channel is involved in the chondrocyte sensing substrate stiffness by mediating Ca signaling in a stiffness-dependent manner. This helps to understand a previously unidentified relationship between substrate stiffness and RVD response under the hypo-osmotic challenge. A better understanding of substrate stiffness regulating chondrocyte volume and calcium signaling will aid the development of novel cell-instructive biomaterial to restore cellular functions.
Topics: Calcium; Calcium Signaling; Cartilage, Articular; Chondrocytes; Humans; Osmosis; Osteoarthritis
PubMed: 35130619
DOI: 10.3724/abbs.2021008 -
Sports Medicine (Auckland, N.Z.) May 2021In the wake of the quest to break the 2-h marathon barrier, carbon-fiber plates have become commonplace in marathon racing shoes. Despite the controversy surrounding... (Review)
Review
In the wake of the quest to break the 2-h marathon barrier, carbon-fiber plates have become commonplace in marathon racing shoes. Despite the controversy surrounding this shoe technology, studies on the effects of increased longitudinal bending stiffness on running economy report mixed results. Here, we provide a comprehensive review of the current literature on midsole bending stiffness and carbon-fiber plates in distance running shoes, focusing on how longitudinal bending stiffness affects running energetics and lower limb mechanics. The current literature reports changes in running economy with increased longitudinal bending stiffness ranging from ~ 3% deterioration to ~ 3% improvement. In some studies, larger improvements have been observed, but often those shoes varied in many aspects, not just longitudinal bending stiffness. Biomechanically, increased longitudinal bending stiffness has the largest impact on metatarsal-phalangeal (MTP) and ankle joint mechanics. Plate location [top loaded (an insole), embedded (in between midsole foam), and bottom loaded (along the bottom of the shoe)] and geometry (flat/curved) affect joint moments and angular velocities at the MTP and ankle joint differently, which partly explains the mixed running economy results. Further research investigating how carbon-fiber plates interact with other footwear features (such as foam and midsole geometry), scaling of those with shoe size, body mass, and strike pattern, and comparing various plate placements is needed to better understand how longitudinal bending stiffness affects running economy.
Topics: Ankle Joint; Biomechanical Phenomena; Humans; Lower Extremity; Running; Shoes
PubMed: 33830444
DOI: 10.1007/s40279-020-01406-5 -
The Journal of Arthroplasty Jan 2021The functional anatomy of the osteoarthritic hip joint in the sagittal plane has not been defined. The purpose of this study was to define the functional anatomy of the...
BACKGROUND
The functional anatomy of the osteoarthritic hip joint in the sagittal plane has not been defined. The purpose of this study was to define the functional anatomy of the hip using clinical and radiographic analyses.
METHODS
320 hips had preoperative standing and sitting lateral spine-pelvis-hip X-rays. Radiographic pelvic measurements were pelvic incidence (PI) and sacral slope (SS), and hip measurements were anteinclination (AI) and pelvic femoral angle (PFA). Pelvic tilt (PT) was calculated as PI-SS. A triangle model was created from the clinical data that illustrates the functional motion of the hip during postural changes from standing to sitting.
RESULTS
Pelvic motion was coordinated with hip motion, even with spinopelvic imbalance and stiffness. Pelvic motion (ΔSS) varied for all 5 types of imbalance, but pelvic motion (ΔSS) and acetabular motion (ΔAI) changed with a 1:1 ratio and inversely with femoral motion (ΔPFA) with a 1:1 ratio. The triangle model showed similar results with ΔSS, ΔPT, and ΔAI changing in a 1:1:1 ratio, and femur motion inversely changing with a 1:1 ratio.
CONCLUSION
The functional anatomy of the hip joint can be visually illustrated using a triangle model. Pelvic angles SS, PT, and AI change in unison, whereas femoral motion (ΔPFA) changes inversely with pelvic motion (ΔSS) in a 1:1 ratio. This coordinated mobility explains the limitations of the Lewinnek safe zone, which include only the acetabulum.
Topics: Acetabulum; Arthroplasty, Replacement, Hip; Hip Joint; Humans; Pelvis; Range of Motion, Articular
PubMed: 32839062
DOI: 10.1016/j.arth.2020.07.065