-
Journal of Medicine and Life Aug 2023Inflammation and hypertrophy of the ankle joint's synovial lining can occur due to various causes. Chronic pain and degenerative changes may be due to synovitis causing...
Inflammation and hypertrophy of the ankle joint's synovial lining can occur due to various causes. Chronic pain and degenerative changes may be due to synovitis causing clinical manifestations through traction on the joint capsule. The failure of conservative treatment for at least six months indicates arthroscopic debridement, which can provide significant pain relief without the morbidity of extensive surgical exposures. This study was therefore conducted to establish the functional results of arthroscopic debridement of the ankle joint in synovitis. Fifteen patients with chronic ankle pain who had not responded to conservative treatment for approximately six months were included in the study. Arthroscopic debridement was performed using a shaver blade, followed by a postoperative ankle physiotherapy regimen. Patients were assessed preoperatively and postoperatively using the AOFAS, FADI, and VAS scores, with a mean follow-up period of 26 months. There was a significant improvement in the final clinical outcomes of the patients. The post-operative VAS score improved to 2.20±0.56 (2-4) (p-value=0.001), the AOFAS score was 86±8.25 (65-98) (p-value-0.001), and the FADI Score was 86.93±7.35(70-96) (p-value=0.001). Thirteen patients (86.67%) achieved outstanding or good results, while two had fair results, according to Meislin's criterion. One patient reported a superficial wound infection, which subsided with antibiotic therapy. The study findings indicate that arthroscopic ankle debridement is an efficient method to treat persistent ankle discomfort induced by synovitis, and it has a low postsurgical complications rate, quicker recovery, and less joint stiffness.
Topics: Humans; Ankle; Ankle Joint; Debridement; Synovitis; Pain; Retrospective Studies; Treatment Outcome
PubMed: 38024814
DOI: 10.25122/jml-2023-0117 -
International Journal of Environmental... Sep 2021Acupuncture can improve explosive force production and affect joint stiffness by affecting muscle activation levels. This study aims to explore the effects of true... (Randomized Controlled Trial)
Randomized Controlled Trial
Acupuncture can improve explosive force production and affect joint stiffness by affecting muscle activation levels. This study aims to explore the effects of true acupuncture (TA) compared with sham acupuncture (SA) on the explosive force production and stiffness of the knee joint in healthy male subjects. Twenty subjects were randomly divided into the TA group ( = 10) and SA group ( = 10) to complete isokinetic movement of the right knee joint at a speed of 240°/s before and after acupuncture. Futu (ST32), Liangqiu (ST34), Zusanli (ST36), Xuehai (SP10), and Chengshan (BL57) were selected for acupuncture. The intervention of SA is that needles with a blunt tip were pushed against the skin, giving an illusion of insertion. The results showed that acupuncture and the intervention time had a significant interaction effect on knee joint explosive force and joint stiffness ( < 0.05). The average maximum (max) torque, average work, average power, average peak power and total work of the TA group increased significantly after acupuncture ( < 0.05), while the SA group did not ( > 0.05). Therefore, true acupuncture can immediately improve the explosive force and joint stiffness of the male knee joint by inducing post-activation potentiation (PAP) and/or De-Qi.
Topics: Acupuncture Therapy; Humans; Knee Joint; Male; Osteoarthritis, Knee
PubMed: 34574441
DOI: 10.3390/ijerph18189518 -
Knee Surgery, Sports Traumatology,... Jul 2020Tunnel enlargement and graft rupture are common complications associated with ACL reconstruction (ACLR). This study aims to explore how variations in graft stiffness and...
PURPOSE
Tunnel enlargement and graft rupture are common complications associated with ACL reconstruction (ACLR). This study aims to explore how variations in graft stiffness and shape affect the strain energy density (SED) around bone tunnel entrances and stress on the graft and subsequently influencing the level of tunnel enlargement and graft wear.
METHODS
Finite element ACLR models were developed using different graft stiffnesses (323 N/mm, 545 N/mm and 776 N/mm) and shapes (circular and elliptical). The models were subjected to a combined loading of 103 N anterior tibial load, 7.5 Nm internal tibial moment, and 6.9 Nm valgus tibial moment at joint flexion of 30°. SED at tunnel entrances and stresses on the graft was recorded and compared among the different models.
RESULTS
Increasing the graft stiffness resulted in greater stress on the graft (17.2, 24.4 and 31.7 MPa for graft stiffnesses of 323 N/mm, 545 N/mm and 776 N/mm), but had little effect on the SED reduction around the tunnel entrances. Changing the cross section of the graft from circular to elliptical caused an additional reduction in SED (56.8 vs 2.8 kJ/m) at the posterior zone of the femoral tunnel entrance and increased the stress on the graft (31.7 MPa vs 38.9 MPa).
CONCLUSIONS
This study recommends using ACL grafts with lower stiffness and a circular cross section to reduce tunnel enlargement and graft wear following ACLR.
Topics: Anterior Cruciate Ligament; Anterior Cruciate Ligament Injuries; Anterior Cruciate Ligament Reconstruction; Biomechanical Phenomena; Cadaver; Elasticity; Femur; Finite Element Analysis; Humans; Male; Middle Aged; Models, Biological; Range of Motion, Articular; Rupture; Tibia; Transplants
PubMed: 31690994
DOI: 10.1007/s00167-019-05772-0 -
Journal of Shoulder and Elbow Surgery Dec 2021To evaluate the effects of diabetes and corticosteroid injected in the joints on the shoulder motion, gait, and joint capsular properties in a rat stiffness model.
PURPOSE
To evaluate the effects of diabetes and corticosteroid injected in the joints on the shoulder motion, gait, and joint capsular properties in a rat stiffness model.
METHODS
A total of 27 rats were randomly distributed into 3 groups-nondiabetes group (group A), diabetes group (group B), and diabetes plus steroid injection group (group C). The diabetes model was developed by inducing hyperglycemia with a submaximal dose of streptozotocin and the stiffness model by completely immobilizing the right shoulder of each animal in all groups with sutures passed between the scapula and humeral shaft. The left shoulder was used as an untreated control in all groups. Three weeks after immobilization, the sutures were removed in all groups, and a single dose of triamcinolone acetonide (0.5 mg/kg) was injected into the glenohumeral joint in group C. After 3 weeks of free activity, range of motion (ROM) evaluation, gait analysis by stride length, and capsular area measurement were performed in all rats.
RESULTS
Hyperglycemia was successfully induced with a mean blood glucose level of 448.9±55.9 mg/dL in group B and 431.6±17.8 mg/dL in group C, which were significantly higher than 136.5±13.4 mg/dL in group A (P < .001). A significantly smaller ROM and stride length were found in the right (stiffness-induced) shoulder than that in the left (control) shoulder only in group B, and significantly larger capsular area in the right shoulder than that in the left shoulder in groups A and B (all P < .05). However, in group C, there were no differences between the right and left shoulders in all measurements (all P > .05). In case of the right shoulders in each group, group C showed significantly larger ROM (68° ± 11° vs. 42° ± 7°) and smaller capsular area (3934.4 ± 537.1 pixels vs. 7402.3 ± 1840.3 pixels) than group B (all P < .0167).
CONCLUSIONS
The diabetic model had a detrimental effect on the development of stiffness by thickening the joint capsule, and an intra-articular steroid injection resolved the thickened joint capsule and restored shoulder motion.
Topics: Adrenal Cortex Hormones; Animals; Diabetes Mellitus; Joint Capsule; Range of Motion, Articular; Rats; Shoulder Joint
PubMed: 34273535
DOI: 10.1016/j.jse.2021.06.003 -
PloS One 2021Biomechanical deviations at individual joints are often identified by gait analysis of patients with cerebral palsy (CP). Analysis of the control of joint and leg... (Clinical Trial)
Clinical Trial
Biomechanical deviations at individual joints are often identified by gait analysis of patients with cerebral palsy (CP). Analysis of the control of joint and leg stiffness of the locomotor system during gait in children with spastic diplegic CP has been used to reveal their control strategy, but the differences between before and after surgery remain unknown. The current study aimed to bridge the gap by comparing the leg stiffness-both skeletal and muscular components-and associated joint stiffness during gait in 12 healthy controls and 12 children with spastic diplegic CP before and after tendon release surgery (TRS). Each subject walked at a self-selected pace on a 10-meter walkway while their kinematic and forceplate data were measured to calculate the stiffness-related variables during loading response, mid-stance, terminal stance, and pre-swing. The CP group altered the stiffness of the lower limb joints and decreased the demand on the muscular components while maintaining an unaltered leg stiffness during stance phase after the TRS. The TRS surgery improved the joint and leg stiffness control during gait, although residual deficits and associated deviations still remained. It is suggested that the stiffness-related variables be included in future clinical gait analysis for a more complete assessment of gait in children with CP.
Topics: Adolescent; Cerebral Palsy; Child; Female; Gait; Humans; Joints; Lower Extremity; Male; Tendons; Tenotomy; Walking
PubMed: 33449939
DOI: 10.1371/journal.pone.0245616 -
Current Drug Targets 2021Rheumatoid Arthritis (RA) is a systemic, chronic, autoimmune, inflammatory disorder that affects both large and small synovial joints in a symmetric pattern. RA... (Review)
Review
Rheumatoid Arthritis (RA) is a systemic, chronic, autoimmune, inflammatory disorder that affects both large and small synovial joints in a symmetric pattern. RA initiates as painful inflammation of the joints leading to stiffness of joint, joint destruction and further worsens the condition causing permanent irreversible damage to the joints, making them physically disabled. Across the globe, there are around 1.2 million cases of RA reported. Inspite of various available therapeutic and pharmacological agents against RA, none of the treatments assure complete cure. Understanding the in depth-role of cytokines and interleukins in the disease pathogenesis of RA could help in exploiting them for developing novel therapeutic strategies against RA. This review provides insights into the pathogenesis of RA and gives a brief overview of cytokines, which play an important role in the progression of the disease. We have also discussed the possible role of interleukins in the context of RA, which could help future researchers to explore them for identifying new therapeutic agents.
Topics: Arthritis, Rheumatoid; Cytokines; Humans; Inflammation; Interleukins; Joints
PubMed: 33109042
DOI: 10.2174/1389450121666201027124625 -
Technology and Health Care : Official... 2022Children with Down syndrome (DS) have critical biomechanical impairments such as increased ligamentous laxity, muscle hypotonia, and dysfunctional motor coordination,...
BACKGROUND
Children with Down syndrome (DS) have critical biomechanical impairments such as increased ligamentous laxity, muscle hypotonia, and dysfunctional motor coordination, which makes performing everyday tasks challenging.
OBJECTIVE
The purpose of the study was to explore the differences in the vertical joint stiffness, plantar force, and range of motion during drop landing for DS and age-matched typically developing children.
METHODS
Six young male children with DS and age-matched seven healthy typically developing children (TD) assessed joint strength using an isokinetic dynamometer and performed five trials of single-leg drop jump using force platform and motion capture system.
RESULTS
The peak vertical ground reaction force (VGRF), Range of motion (ROM), joint stiffness, and joint strength of lower limb were calculated and compared across DS and TD groups. The results revealed a significantly larger peak VGRF [z=-2.857, p< 0.001] values for the DS group compared to the TD groups. The results of Spearman's correlation analysis showed a negative correlation between hip joint stiffness and knee joint ROM [r=-0.886, p< 0.05] and ankle joint stiffness and knee joint ROM [r=-0.829, p< 0.05] for DS.
CONCLUSIONS
The abnormal movements observed among DS was not due to the difference in stiffness of the lower extremity but due to the utilization of different landing mechanisms with changes in ROM.
Topics: Ankle Joint; Biomechanical Phenomena; Child; Down Syndrome; Humans; Knee Joint; Male; Range of Motion, Articular
PubMed: 35124613
DOI: 10.3233/THC-THC228035 -
IEEE Transactions on Bio-medical... Dec 2022Regulating the impedance of our joints is essential for the effective control of posture and movement. The impedance of a joint is governed mainly by the mechanical...
OBJECTIVE
Regulating the impedance of our joints is essential for the effective control of posture and movement. The impedance of a joint is governed mainly by the mechanical properties of the muscle-tendon units spanning it. Many studies have quantified the net impedance of joints but not the specific contributions from the muscles and tendons. The inability to quantify both muscle and tendon impedance limits the ability to determine the causes underlying altered movement control associated with aging, neuromuscular injury, and other conditions that have different effects on muscle and tendon properties. Therefore, we developed a technique to quantify joint, muscle, and tendon impedance simultaneously and evaluated this technique at the human ankle.
METHODS
We used a single degree of freedom actuator to deliver pseudorandom rotations to the ankle while measuring the corresponding torques. We simultaneously measured the displacement of the medial gastrocnemius muscle-tendon junction with B-mode ultrasound. From these experimental measurements, we were able to estimate ankle, muscle, and tendon impedance using non-parametric system identification.
RESULTS
We validated our estimates by comparing them to previously reported measurements of muscle and tendon stiffness, the position-dependent component of impedance, to demonstrate that our technique generates reliable estimates of these properties.
CONCLUSION
Our approach can be used to clarify the respective contributions from the muscle and tendon to the net mechanics of a joint.
SIGNIFICANCE
This is a critical step forward in the ultimate goal of understanding how muscles and tendons govern ankle impedance during posture and movement.
Topics: Humans; Ankle; Electric Impedance; Ankle Joint; Tendons; Muscle, Skeletal; Biomechanical Phenomena
PubMed: 35594215
DOI: 10.1109/TBME.2022.3175646 -
Unfallchirurgie (Heidelberg, Germany) Sep 2023The term Monteggia-like lesions or Monteggia equivalent injuries includes fractures of the proximal ulna with dislocation and dislocation fractures of the radial head... (Review)
Review
The term Monteggia-like lesions or Monteggia equivalent injuries includes fractures of the proximal ulna with dislocation and dislocation fractures of the radial head from the proximal radio-ulnar joint. The complexity of the injury requires a dedicated understanding of the anatomical structures and their biomechanical properties. Particularly due to the rarity, the complication and revision rates are high. A conservative treatment is not usually effective. Three-dimensional imaging by computed tomography is part of the surgical preparation. The goal of surgical treatment is osteosynthetic reconstruction of the fractures and restoration of joint congruency. In cases of nonreconstructable radial head fractures, radial head arthroplasty may be necessary. In addition to reconstruction of the bony stabilizers, refixation of the ligamentous structures is essential for treatment success. The combination of complex fracture patterns and possible dislocation positions in the ulnohumeral, radiohumeral and proximal radio-ulnar joints poses a great challenge to the surgeon. The most frequent complications are peri-implant infections, implant failure, loss of reduction, stiffness or instability. Especially the anatomical configuration of the proximal ulna is complex and requires accurate reconstruction. Therefore, reconstruction of the proximal ulna in length and rotation, including the coronoid process, is considered to be a key factor in the surgical treatment of Monteggia-like injuries.
Topics: Humans; Elbow Injuries; Joint Dislocations; Elbow Joint; Radius Fractures; Radius
PubMed: 37278731
DOI: 10.1007/s00113-023-01328-7 -
Hand Clinics May 2022This article reviews the key components of a complete history and physical examination for a patient presenting with thumb pain. The history should include the location... (Review)
Review
This article reviews the key components of a complete history and physical examination for a patient presenting with thumb pain. The history should include the location and severity of pain, alleviating and exacerbating factors, and impact of disability. Physical examination consists of joint palpation; assessment for laxity or stiffness; inspection for swelling, subluxation, or deformity; and provocative maneuvers. Further workup includes plain radiographs with possible dedicated thumb views. Last, we review the Eaton-Littler classification system, a commonly used radiographic grading system, and some of its limitations.
Topics: Carpometacarpal Joints; Humans; Osteoarthritis; Pain; Physical Examination; Thumb
PubMed: 35465932
DOI: 10.1016/j.hcl.2021.12.001