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Sensors (Basel, Switzerland) Dec 2022Human motion analysis using inertial measurement units (IMUs) has recently been shown to provide accuracy similar to the gold standard, optical motion capture, but at...
Human motion analysis using inertial measurement units (IMUs) has recently been shown to provide accuracy similar to the gold standard, optical motion capture, but at lower costs and while being less restrictive and time-consuming. However, IMU-based motion analysis requires precise knowledge of the orientations in which the sensors are attached to the body segments. This knowledge is commonly obtained via time-consuming and error-prone anatomical calibration based on precisely defined poses or motions. In the present work, we propose a self-calibrating approach for magnetometer-free joint angle tracking that is suitable for joints with two degrees of freedom (DoF), such as the elbow, ankle, and metacarpophalangeal finger joints. The proposed methods exploit kinematic constraints in the angular rates and the relative orientations to simultaneously identify the joint axes and the heading offset. The experimental evaluation shows that the proposed methods are able to estimate plausible and consistent joint axes from just ten seconds of arbitrary elbow joint motion. Comparison with optical motion capture shows that the proposed methods yield joint angles with similar accuracy as a conventional IMU-based method while being much less restrictive. Therefore, the proposed methods improve the practical usability of IMU-based motion tracking in many clinical and biomedical applications.
Topics: Humans; Algorithms; Motion; Elbow; Elbow Joint; Finger Joint; Biomechanical Phenomena; Joints
PubMed: 36560219
DOI: 10.3390/s22249850 -
Hand (New York, N.Y.) Jul 2022Small joint reconstruction of the hand poses a significant challenge, especially in children where both functional motion and preservation of the epiphysis are desired....
BACKGROUND
Small joint reconstruction of the hand poses a significant challenge, especially in children where both functional motion and preservation of the epiphysis are desired. Auto-transplantation of whole joints is the only way to reconstruct a functional joint that maintains growth potential. Historically, nonvascularized toe-to-finger joint transfer has been criticized for high rates of avascular necrosis and joint dissolution, while vascularized transfers seemingly resulted in increased durability of the joint space and epiphysis. However, certain populations remain poor candidates for microvascular reconstruction, such as those with congenital deformities or sequelae from trauma or infection. In our case series, we demonstrate that a simplified nonvascularized surgical technique and careful patient selection can produce stable, functional joints.
METHODS
Nonvascularized toe-to-finger joint transfer was performed in 3 children between the ages of 4 and 6. Reconstructed joints included 2 proximal interphalangeal (PIP) joints and 1 metacarpophalangeal (MCP) joint. Donor grafts consisted of second toe PIP joints harvested en bloc to include the epiphysis of the middle phalanx, collateral ligaments, volar plate, and a diamond-shaped island of extensor tendon with its central slip attachment.
RESULTS
Follow-up ranged from 7 to 29 months. Each patient demonstrated functional improvements in joint motion and stability. Postoperative radiographs confirmed adequate joint alignment and persistence of the joint spaces. Epiphyseal closure was observed in 1 patient as early as 25 months postoperatively.
CONCLUSIONS
Nonvascularized joint transfer should remain a practical consideration for small joint reconstruction of the hand in certain pediatric patients.
Topics: Arthroplasty, Replacement; Child; Child, Preschool; Finger Joint; Hand; Humans; Metacarpophalangeal Joint; Toe Joint
PubMed: 32779490
DOI: 10.1177/1558944720948243 -
Osteoarthritis and Cartilage Jul 2020Preclinical imaging in osteoarthritis is a rapidly growing area with three principal objectives: to provide rapid, sensitive tools to monitor the course of experimental... (Review)
Review
Preclinical imaging in osteoarthritis is a rapidly growing area with three principal objectives: to provide rapid, sensitive tools to monitor the course of experimental OA longitudinally; to describe the temporal relationship between tissue-specific pathologies over the course of disease; and to use molecular probes to measure disease activity in vivo. Research in this area can be broadly divided into those techniques that monitor structural changes in tissues (microCT, microMRI, ultrasound) and those that detect molecular disease activity (positron emission tomography (PET), optical and optoacoustic imaging). The former techniques have largely evolved from experience in human joint imaging and have been refined for small animal use. Some of the latter tools, such as optical imaging, have been developed in preclinical models and may have translational benefit in the future for patient stratification and for monitoring disease progression and response to treatment. In this narrative review we describe these methodologies and discuss the benefits to animal research, understanding OA pathogenesis, and in the development of human biomarkers.
Topics: Animals; Bone and Bones; Cartilage, Articular; Disease Models, Animal; Joints; Magnetic Resonance Imaging; Mice; Molecular Imaging; Optical Imaging; Osteoarthritis; Osteophyte; Photoacoustic Techniques; Positron-Emission Tomography; Synovial Membrane; Ultrasonography; X-Ray Microtomography
PubMed: 32305526
DOI: 10.1016/j.joca.2020.03.016 -
Tissue Engineering and Regenerative... Aug 2019Articular cartilage lesions occur frequently but unfortunately damaged cartilage has a very limited intrinsic repair capacity. Therefore, there is a high need to develop... (Review)
Review
BACKGROUND
Articular cartilage lesions occur frequently but unfortunately damaged cartilage has a very limited intrinsic repair capacity. Therefore, there is a high need to develop technology that makes cartilage repair possible. Since joint damage will lead to (sterile) inflammation, development of this technology has to take into account the effects of inflammation on cartilage repair.
METHODS
A literature search has been performed including combinations of the following keywords; cartilage repair, fracture repair, chondrogenesis, (sterile) inflammation, inflammatory factors, macrophage, innate immunity, and a number of individual cytokines. Papers were selected that described how inflammation or inflammatory factors affect chondrogenesis and tissue repair. A narrative review is written based on these papers focusing on the role of inflammation in cartilage repair and what we can learn from findings in other organs, especially fracture repair.
RESULTS
The relationship between inflammation and tissue repair is not straightforward. Acute, local inflammation stimulates fracture repair but appears to be deleterious for chondrogenesis and cartilage repair. Systemic inflammation has a negative effect on all sorts of tissue repair.
CONCLUSION
Findings on the role of inflammation in fracture repair and cartilage repair are not in line. The currently widely used models of chondrogenesis, using high differentiation factor concentrations and corticosteroid levels, are not optimal. To make it possible to draw more valid conclusions about the role of inflammation and inflammatory factors on cartilage repair, model systems must be developed that better mimic the real conditions in a joint with damaged cartilage.
Topics: Animals; Arthritis; Cartilage, Articular; Fracture Healing; Humans; Inflammation; Joints
PubMed: 31413937
DOI: 10.1007/s13770-019-00204-z -
Journal of Foot and Ankle Research Jul 2023Kinematic coupling between the first metatarsophalangeal (MTP) and midtarsal joints is evident during gait and other movement tasks, however kinetic foot coupling during... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Kinematic coupling between the first metatarsophalangeal (MTP) and midtarsal joints is evident during gait and other movement tasks, however kinetic foot coupling during walking has not been examined. Furthermore, contributing factors to foot coupling are still unclear. Therefore, the purpose of this study was to investigate kinematic and kinetic coupling within the foot by restricting MTP motion during overground walking. We hypothesized that when the MTP joint was prevented from fully extending, the midtarsal joint would achieve less peak motion and generate less positive work compared to walking with normal MTP motion.
METHODS
Twenty-six individuals participated in this randomized cross-over study. Using motion capture to track motion, participants walked at 1.3 m/s while wearing a brace that restricted MTP motion in a neutral (BR_NT) or extended (BR_EX) position. Additionally, participants walked while wearing the brace in a freely moveable setting (BR_UN) and with no brace (CON). A pressure/shear sensing device was used to capture forces under each foot segment. During stance, peak joint motion and work were calculated for the MTP and midtarsal joints using inverse dynamics. A series of ANOVAs and Holm post hoc tests were performed for all metrics (alpha = 0.05).
RESULTS
The brace successfully decreased peak MTP motion by 19% compared to BR_UN and CON. This was coupled with 9.8% less midtarsal motion. Kinetically, the work absorbed by the MTP joint (26-51%) and generated by the midtarsal joint (30-38%) were both less in BR_EX and BR_NT compared to BR_UN.
CONCLUSION
Implications and sources of coupling between the MTP and midtarsal joints are discussed within the context of center of pressure shifts and changes to segmental foot forces. Our results suggest that interventions aimed at modulating MTP negative work (such as footwear or assistive device design) should not ignore the midtarsal joint.
Topics: Humans; Foot Joints; Walking; Foot; Gait; Metatarsophalangeal Joint; Biomechanical Phenomena; Range of Motion, Articular
PubMed: 37488576
DOI: 10.1186/s13047-023-00643-x -
International Journal of Environmental... Mar 2023Osteoarthritis (OA) is the most frequent degenerative progressive joint disease worldwide, with the hand, hip, and knee being the most-affected joints. Actually, no... (Review)
Review
Osteoarthritis (OA) is the most frequent degenerative progressive joint disease worldwide, with the hand, hip, and knee being the most-affected joints. Actually, no treatment can alter the course of OA, and therapy is directed at reducing pain and improving function. The exogenous administration of collagen has been investigated as a possible symptomatic adjuvant or stand-alone treatment for OA. The aim of this review is to assess if intra-articular collagen administration can be considered as a valid and safe therapeutic option for OA. A search in the main scientific electronic databases to identify the available scientific articles about the effects of intra-articular collagen as an OA treatment was performed. The results of the seven included studies showed that the intra-articular administration of collagen may stimulate chondrocytes to produce hyaline cartilage and hinder the normal inflammatory response leading to fibrous tissue formation, reducing symptoms, and improving functionality. The use of type-I collagen as an intra-articular treatment for knee OA was found not only to be effective, but also safe with negligible side effects. The reported findings are strongly promising, highlighting the need for further high-quality research to confirm the consistency of these findings.
Topics: Humans; Osteoarthritis, Knee; Knee Joint; Pain; Collagen Type I; Cartilage, Articular
PubMed: 36901400
DOI: 10.3390/ijerph20054390 -
International Journal of Molecular... Jul 2023Osteoarthritis (OA) is a multifactorial disease in which genetics, aging, obesity, and trauma are well-known risk factors. It is the most prevalent joint disease and the... (Review)
Review
Osteoarthritis (OA) is a multifactorial disease in which genetics, aging, obesity, and trauma are well-known risk factors. It is the most prevalent joint disease and the largest disability problem worldwide. Recent findings have described the role of damage-associated molecular patterns (DAMPs) in the course of the disease. In particular, alarmins such as HMGB1, IL-33, and S100B, appear implicated in enhancing articular inflammation and favouring a catabolic switch in OA chondrocytes. The aims of this review are to clarify the molecular signalling of these three molecules in OA pathogenesis, to identify their possible use as staging biomarkers, and, most importantly, to find out whether they could be possible therapeutic targets. Osteoarthritic cartilage expresses increased levels of all three alarmins. HMGB1, in particular, is the most studied alarmin with increased levels in cartilage, synovium, and synovial fluid of OA patients. High levels of HMGB1 in synovial fluid of OA joints are positively correlated with radiological and clinical severity. Counteracting HMGB1 strategies have revealed improving results in articular cells from OA patients and in OA animal models. Therefore, drugs against this alarmin, such as anti-HMGB1 antibodies, could be new treatment possibilities that can modify the disease course since available medications only alleviate symptoms.
Topics: Animals; Alarmins; Cartilage, Articular; Chondrocytes; HMGB1 Protein; Interleukin-33; Joints; Osteoarthritis; Synovial Membrane
PubMed: 37569519
DOI: 10.3390/ijms241512143 -
Frontiers in Immunology 2021Synovial joints are complex structures that enable normal locomotion. Following injury, they undergo a series of changes, including a prevalent inflammatory response.... (Review)
Review
Synovial joints are complex structures that enable normal locomotion. Following injury, they undergo a series of changes, including a prevalent inflammatory response. This increases the risk for development of osteoarthritis (OA), the most common joint disorder. In healthy joints, macrophages are the predominant immune cells. They regulate bone turnover, constantly scavenge debris from the joint cavity and, together with synovial fibroblasts, form a protective barrier. Macrophages thus work in concert with the non-hematopoietic stroma. In turn, the stroma provides a scaffold as well as molecular signals for macrophage survival and functional imprinting: "a macrophage niche". These intricate cellular interactions are susceptible to perturbations like those induced by joint injury. With this review, we explore how the concepts of local tissue niches apply to synovial joints. We introduce the joint micro-anatomy and cellular players, and discuss their potential interactions in healthy joints, with an emphasis on molecular cues underlying their crosstalk and relevance to joint functionality. We then consider how these interactions are perturbed by joint injury and how they may contribute to OA pathogenesis. We conclude by discussing how understanding these changes might help identify novel therapeutic avenues with the potential of restoring joint function and reducing post-traumatic OA risk.
Topics: Cell Movement; Humans; Knee Joint; Macrophages; Monocytes; Osteoarthritis; Synovial Membrane
PubMed: 34804052
DOI: 10.3389/fimmu.2021.763702 -
Journal of Orthopaedic Research :... Nov 2022As cancer survivorship increases, so does the number of patients that suffer from the late effects of radiation therapy. This includes arthrofibrosis, the development of...
As cancer survivorship increases, so does the number of patients that suffer from the late effects of radiation therapy. This includes arthrofibrosis, the development of stiff joints near the field of radiation. Previous reports have concentrated on skin fibrosis around the joint but largely ignored the deeper tissues of the joint. We hypothesized that fat, muscle, and the joint tissues themselves would play a more significant role in joint contracture after radiation than the skin surrounding the joint. To address this hypothesis, we irradiated the right hind flanks of mice with fractionated and unfractionated dose schedules, then monitored the mice for 3 months postradiotherapy. Mice were euthanized and physiological indications of arthrofibrosis including limb contracture and joint resting position were assessed. Stifle (knee) joints demonstrated significant arthrofibrosis, but none was observed in the hock (ankle) joints. During these studies, we were surprised to find that male and female mice showed a significantly different response to radiation injury. Female mice developed more injuries, had significantly worse contracture, and showed a greater difference in the expression of all markers studied. These results suggest that women undergoing radiation therapy might be at significantly greater risk for developing arthrofibrosis and may require specific adjustments to their care.
Topics: Animals; Ankle Joint; Contracture; Female; Fibrosis; Joint Diseases; Knee Joint; Male; Mice
PubMed: 35148568
DOI: 10.1002/jor.25297 -
Journal of Biomechanics May 2024Semi-recumbent cycling performed from a wheelchair is a popular rehabilitation exercise following spinal cord injury (SCI) and is often paired with functional electrical...
Semi-recumbent cycling performed from a wheelchair is a popular rehabilitation exercise following spinal cord injury (SCI) and is often paired with functional electrical stimulation. However, biomechanical assessment of this cycling modality is lacking, even in unimpaired populations, hindering the development of personalised and safe rehabilitation programs for those with SCI. This study developed a computational pipeline to determine lower limb kinematics, kinetics, and joint contact forces (JCF) in 11 unimpaired participants during voluntary semi-recumbent cycling using a rehabilitation ergometer. Two cadences (40 and 60 revolutions per minute) and three crank powers (15 W, 30 W, and 45 W) were assessed. A rigid body model of a rehabilitation ergometer was combined with a calibrated electromyogram-informed neuromusculoskeletal model to determine JCF at the hip, knee, and ankle. Joint excursions remained consistent across all cadence and powers, but joint moments and JCF differed between 40 and 60 revolutions per minute, with peak JCF force significantly greater at 40 compared to 60 revolutions per minute for all crank powers. Poor correlations were found between mean crank power and peak JCF across all joints. This study provides foundation data and computational methods to enable further evaluation and optimisation of semi-recumbent cycling for application in rehabilitation after SCI and other neurological disorders.
Topics: Humans; Male; Bicycling; Adult; Biomechanical Phenomena; Female; Hip Joint; Spinal Cord Injuries; Knee Joint; Ankle Joint; Models, Biological; Electromyography
PubMed: 38640830
DOI: 10.1016/j.jbiomech.2024.112094