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Computer Methods in Biomechanics and... Jun 2024The meniscus plays a crucial role in the proper functioning of the knee joint, and when it becomes damaged, partial removal or replacement is necessary to restore proper...
The meniscus plays a crucial role in the proper functioning of the knee joint, and when it becomes damaged, partial removal or replacement is necessary to restore proper function. Understanding the stress and deformation of the meniscus during various movements is essential for developing effective materials for meniscus repair. However, accurately estimating the contact mechanics of the knee joint can be challenging due to its complex shape and the dynamic changes it undergoes during movement. To address this issue, the open-source software SCONE can be used to establish a kinematics model that monitors the different states of the knee joint during human motion and obtains relevant gait kinematics data. To evaluate the stress and deformation of the meniscus during normal human movement, values of different states in the movement gait can be selected for finite element analysis (FEA) of the knee joint. This analysis enables researchers to assess changes in the meniscus. To evaluate meniscus damage, it is necessary to obtain changes in its mechanical behavior during abnormal movements. This information can serve as a reference for designing and optimizing the mechanical performance of materials used in meniscus repair and replacement.
PubMed: 38899984
DOI: 10.1080/10255842.2024.2368656 -
Revista Espanola de Salud Publica Jun 2024Childhood flatfoot and overweight can affect children's quality of life and influence their development, increasing the risk of musculoskeletal problems in adulthood....
OBJECTIVE
Childhood flatfoot and overweight can affect children's quality of life and influence their development, increasing the risk of musculoskeletal problems in adulthood. There is evidence linking overweight to the development of childhood flatfoot. The aim of the study was to assess the relationship between the weight status of school children and their foot posture and to determine whether there are differences between both sexes.
METHODS
A cross-sectional study (2021) in a sample of schoolchildren (n=296, 153 boys and 143 girls, mean age 8.5±2.7) from Colegio San Agustín in Zaragoza was carried out. Foot posture was assessed according to the foot postural index, and weight status was obtained using the body mass index according to the criteria of the International Obesity Task Force. The correlation between weight status and foot posture was analyzed using Spearman's coefficient. The Chi-square test was used to determine the differences between the variables according to sex.
RESULTS
Weight status showed no correlation with foot posture in boys (right foot p=0.095; left foot p=0.067) and girls (right foot p=-0.04; left foot p=0.008). Boys had a higher prevalence of flat feet than girls (boys foot posture index=8; girls foot posture index=7; right foot p<0.036; left foot p<0.009). Boys had higher prevalence of overweight than girls (28.75; 18.18, p<0.027).
CONCLUSIONS
Weight status has no effect on foot posture. The male gender could predispose to the development of flat feet and overweight in childhood.
Topics: Humans; Male; Cross-Sectional Studies; Female; Child; Flatfoot; Posture; Overweight; Body Mass Index; Prevalence; Foot; Sex Factors; Pediatric Obesity; Spain
PubMed: 38899629
DOI: No ID Found -
Journal of Foot and Ankle Research Jun 2024Posterior Tibial Tendon Dysfunction (PTTD) is commonly seen within musculoskeletal care. The condition's prevalence and management is poorly understood. This study aims...
BACKGROUND
Posterior Tibial Tendon Dysfunction (PTTD) is commonly seen within musculoskeletal care. The condition's prevalence and management is poorly understood. This study aims to demonstrate current practice by multi-professional clinicians across the United Kingdom within the National Health Service.
METHODS
A national (UK) cross-sectional online survey was conducted among multi-professionals who treat PTTD within their NHS practice. The survey covered assessment, management and evaluation. This was shared via social media and professional groups.
RESULTS
Two hundred thirteen surveys were completed, with 153 matching the eligibility criteria. The main respondents were Physiotherapists (48%) and Podiatrists (38%). Ultrasound scanning was used most frequently when considering initial imaging (67%). Many different treatment modalities were used, but a core set of education/advice, foot orthoses, and foot specific as well as general exercise were most commonly chosen. Outcome measures routinely used were pain scale (96/269) and single leg heel raise (84/269), but patient reported outcome measures were not routinely used. The most frequent reason to escalate care was failure to manage symptoms with conservative management (106/123; 86.2%), followed by fixed deformity (10/123; 8.2%).
CONCLUSIONS
This survey provides evidence on current non-surgical management for PTTD from UK NHS practice. It provides a valuable marker for clinicians to use to compare their own practice and can be used in further research as a comparator.
Topics: Humans; United Kingdom; Posterior Tibial Tendon Dysfunction; Cross-Sectional Studies; Conservative Treatment; Female; Male; Podiatry; Practice Patterns, Physicians'; Physical Therapists; Foot Orthoses; Ultrasonography; Adult; Surveys and Questionnaires; Middle Aged; Physical Therapy Modalities; Health Care Surveys; State Medicine; Exercise Therapy
PubMed: 38898672
DOI: 10.1002/jfa2.12033 -
Journal of Clinical Medicine May 2024: Due to their high frequency, common risk factors, and similar pathogenic mechanisms, musculoskeletal disorders (MSDs) are more likely to occur with other chronic...
: Due to their high frequency, common risk factors, and similar pathogenic mechanisms, musculoskeletal disorders (MSDs) are more likely to occur with other chronic illnesses, making them a "component disorder" of multimorbidity. Our objective was to assess the prevalence of multimorbidity and to identify the most common clusters of diagnosis within multimorbidity states, with the primary hypothesis that the most common clusters of multimorbidity are MSDs. : The current study employed data from a population-based 2019 European Health Interview Survey (EHIS). Multimorbidity was defined as a ≥2 diagnosis from the list of 17 chronic non-communicable diseases, and to define clusters, the statistical method of hierarchical cluster analysis (HCA) was performed. : Out of 13,178 respondents, multimorbidity was present among 4398 (33.4%). The HCA method yielded six multimorbidity clusters representing the most common diagnoses. The primary multimorbidity cluster, which was prevalent among both genders, age groups, incomes per capita, and statistical regions, consisted of three diagnoses: (1) lower spine deformity or other chronic back problem (back pain), (2) cervical deformity or other chronic problem with the cervical spine, and (3) osteoarthritis. : Given the influence of musculoskeletal disorders on multimorbidity, it is imperative to implement appropriate measures to assist patients in relieving the physical discomfort and pain they endure. Public health information, programs, and campaigns should be utilized to promote a healthy lifestyle. Policymakers should prioritize the prevention of MSDs by encouraging increased physical activity and a healthy diet, as well as focusing on improving functional abilities.
PubMed: 38892800
DOI: 10.3390/jcm13113089 -
Skeletal Radiology Jun 2024Nodular fasciitis is a benign soft tissue pseudotumour typically occurring in the upper extremities, head and neck, thigh and trunk. It is most commonly seen in...
Nodular fasciitis is a benign soft tissue pseudotumour typically occurring in the upper extremities, head and neck, thigh and trunk. It is most commonly seen in subcutaneous locations but also can be present in intramuscular and intermuscular (fascial) locations. Its occurrence in the hand is rare, and while it can occur in close proximity to tendons, its presentation as an intra-tendinous mass has not been previously described. We present a unique and rare case of nodular fasciitis arising within the flexor digitorum profundus (FDP) tendon of the hand in a 16-year-old female. The patient presented with a painful swelling in the volar aspect of the base of her left middle finger, with progressive flexion deformity of the finger. Ultrasound and magnetic resonance imaging revealed a mass within the FDP tendon of the middle finger. An ultrasound-guided biopsy revealed a diagnosis of nodular fasciitis. Given the self-limiting nature of the condition, she was managed conservatively with close clinical and imaging follow-up. This case highlights the importance of considering nodular fasciitis in the differential diagnosis of an intra-tendinous lesion in the hand, even though it is a rare occurrence in this location. The clinical presentation, diagnostic workup, and management of this unique case are discussed, emphasising the potential for its misdiagnosis as a malignancy which can have important implications in management.
PubMed: 38888624
DOI: 10.1007/s00256-024-04728-x -
International Journal of Spine Surgery Jun 2024We sought to determine which aspect of the upper instrumented vertebrae (UIV)-tilt angle or screw angle-was more strongly associated with: (1) proximal junctional...
Comparing the Upper Instrumented Vertebrae Tilt Angle vs Screw Angle in the Development of Proximal Junction Kyphosis After Adult Spinal Deformity Surgery: Which Matters More?
BACKGROUND
We sought to determine which aspect of the upper instrumented vertebrae (UIV)-tilt angle or screw angle-was more strongly associated with: (1) proximal junctional kyphosis/failure (PJK/F), (2) other mechanical complications and reoperations, and (3) patient-reported outcome measures (PROMs).
METHODS
A single-institution, retrospective cohort study was undertaken for patients undergoing adult spinal deformity (ASD) surgery from 2011 to 2017. Only patients with UIV at T7 or below were included. The primary exposure variables were UIV tilt angle (the angle of the UIV inferior endplate and the horizontal) and UIV screw angle (the angle of the UIV screws and superior endplate). Multivariable logistic regression included age, body mass index, osteopenia/osteoporosis, postoperative sagittal vertical axis, postoperative pelvic-incidence lumbar lordosis mismatch, UIV tilt angle and UIV screw angle.
RESULTS
One hundred and seventeen patients underwent adult spinal deformity surgery with a minimum of 2-year follow-up. A total of 41 patients (35.0%) had PJK and 26 (22.2%) had PJF. (1) UIV tilt angle: 96 (82.1%) had lordotic UIV tilt angles, 6 (5.1%) were neutral, and 15 (12.8%) were kyphotic. (2) UIV screw angle: 38 (32.5%) had cranially directed screws, 4 (3.4%) were neutral, and 75 (64.1%) were caudally directed. Both lordotic-angled UIV endplate (OR = 1.06, 95% CI = 1.01-1.12, and = 0.020) and cranially directed screws (OR = 1.19, 95% CI = 1.07-1.33, and < 0.001) were associated with higher odds of PJK, with a more pronounced effect of UIV screw angle compared with UIV tilt angle (Wald test, 9.40 vs 4.42). Similar results were found for PJF. Neither parameter was associated with other mechanical complications, reoperations, or patient-reported outcome measures.
CONCLUSIONS
UIV screw angle was more strongly associated with development of PJK/F compared with tilt angle. Overall, these modifiable parameters are directly under the surgeon's control and can mitigate the development of PJK/F.
CLINICAL RELEVANCE
Surgeons may consider selecting a UIV with a neutral or kyphotically directed UIV tilt angle when performing ASD surgery with a UIV in the lower thoracic or lumbar region, as well as use UIV screw angles that are caudally directed, for the purprose of decreasing the risk of developing PJK/F.
PubMed: 38886012
DOI: 10.14444/8607 -
PloS One 2024Non-traumatic orthopedic conditions are pathological conditions involving musculoskeletal system that includes muscles, tendons, bone and joints and associated with...
Non-traumatic orthopedic conditions are pathological conditions involving musculoskeletal system that includes muscles, tendons, bone and joints and associated with frequent medical and surgical care and high treatment costs. There is paucity of information on the pattern of non-traumatic orthopedic conditions in low and middle income countries. The purpose of this study was to determine the epidemiology of non-traumatic orthopedic conditions among inpatients at the Kenyatta National Hospital in Kenya. This was a cross-sectional study with a sample of 175 charts reviewed. Approximately, 70.3% of the inpatients were aged between 25 to 64 years of age with the mean age of 39.97 years (STD 18.78). Ever married tended to be older 53.5 (95% CI: 46.8-60.2) years than other marital statuses. Approximately, 60.6% were males, 38.9% had comorbidities and 49.1% were casuals or unemployed. All inpatients were Kenyans with Nairobi County comprising 52.6% of all inpatients. Approximately, 77.7% were self-referrals. The commonest non-trauma orthopaedic conditions were infection and non-union (35.4%) and spinal degenerative diseases (20.60%) and the least was limb deformities (1.70%). Compared to females, males were 3.703 (p<0.001) times more likely to have infection and non-union. Patients with primary, secondary and tertiary education were 88.2% (p<0.001), 75.6% (p<0.001) and 68.1% (p = 0.016) less likely to have infection and non-union compared to those with no or preschool education. Widows were 8.500 (p = 0.028) times more likely to have spinal degenerative disease than married. Males were 70.8% (p = 0.031) less likely to have osteoarthritis than females. Inpatients with secondary education were 5.250 (p = 0.040) times more likely to have osteoarthritis than those with no or preschool education. In conclusion, majority of inpatients were young and middle aged adults. Infection and non-union and spinal degenerative diseases were the most common non-trauma orthopedic conditions. While males and those with low education were more likely to have infection and non-union, married were more likely to have spinal degenerative disease. Osteoarthritis was more likely among female admissions.
Topics: Humans; Kenya; Male; Female; Adult; Middle Aged; Cross-Sectional Studies; Inpatients; Tertiary Care Centers; Young Adult; Hospitals, Teaching; Adolescent; Aged; Musculoskeletal Diseases; Referral and Consultation
PubMed: 38885257
DOI: 10.1371/journal.pone.0303898 -
Orphanet Journal of Rare Diseases Jun 2024Arthrogryposis multiplex congenita (AMC) is a group of rare musculoskeletal conditions that is associated with complex healthcare needs and long-term follow up. The...
BACKGROUND
Arthrogryposis multiplex congenita (AMC) is a group of rare musculoskeletal conditions that is associated with complex healthcare needs and long-term follow up. The literature reports significant direct, indirect, and psychosocial costs for caregivers of children with neuromuscular conditions. Due to mobility limitations and frequent hospital visits, caring for a child with AMC is complex. Other challenges experienced by caregivers include financial strain, job changes, changes in interpersonal relationships and abandonment. This study was aimed at exploring the lived experience of caregivers of children with AMC.
METHODS
The present study is part of a larger global mixed methods study. In the initial quantitative aspect of the study, caregivers (n = 158) of children and youths with AMC (aged 0-21 years) responded to a cost of care survey on an electronic platform. Of the 158 participants, 13 caregivers then further consented to participate in the qualitative aspect of the study in which a 60-min semi-structured, individual interview was conducted remotely. Open-ended questions were developed to gain a deeper understanding of the direct and indirect costs of care, their impact on the caregivers' lives and the quality of the care-giving experience. Interviews were transcribed, and a coding scheme was developed drawing from both the existing literature and the content of the interviews. A deductive and inductive thematic analysis was used to analyze the qualitative data using the NVivo® qualitative data analysis software.
RESULTS AND CONCLUSION
Five themes describing the experiences of caregivers of children with AMC emerged from the analysis of the qualitative data: 1. Impact of the caregiving experience; 2. Cost of childcare; 3. Support system for care; 4. Managing and navigating care; 5. Supporting the child's growth and development. In addition to the results of the thematic analysis, specific recommendations shared by the caregivers included the need for support groups and provision of support to youths to prepare them for adolescence. These findings will inform resource allocation, policymaking, and support services for children with rare conditions, their caregivers and families.
Topics: Humans; Arthrogryposis; Caregivers; Child; Adolescent; Female; Male; Child, Preschool; Infant; Young Adult; Adult; Rare Diseases; Qualitative Research; Infant, Newborn; Musculoskeletal Diseases
PubMed: 38877508
DOI: 10.1186/s13023-024-03224-8 -
Frontiers in Pediatrics 2024Congenital contractures of the limbs and face, hypotonia, and developmental delay (CLIFAHDD) syndrome (OMIM #616266) is an autosomal dominant hereditary disease that can...
BACKGROUND
Congenital contractures of the limbs and face, hypotonia, and developmental delay (CLIFAHDD) syndrome (OMIM #616266) is an autosomal dominant hereditary disease that can lead to the congenital contracture of the limbs and face, hypotonia, and developmental delay. In addition, it may result in growth retardation and present various clinical symptoms, such as brain atrophy, a small pituitary gland, musculoskeletal abnormalities, abnormal breathing, abdominal hernia, and abnormal facial features. Herein, we describe a novel missense genetic variant in the sodium leak channel, non-selective (NALCN) gene that is associated with CLIFAHDD syndrome.
CASE DESCRIPTION
This study describes a patient with varus deformities in both feet, deviation of the ulnar side of the fingers, and severe hypotonia. This patient was subsequently confirmed to have CLIFAHDD syndrome through genetic testing, which also revealed a novel missense genetic variant in the NALCN gene (c.3553G > A, p.Ala1185Thr).
CONCLUSIONS
Our findings further enrich the known variant spectrum of the NALCN gene and may expand the range of clinical options for treating NALCN-related disorders.
PubMed: 38873579
DOI: 10.3389/fped.2024.1370790 -
International Journal of Therapeutic... Jun 2024Lumbar hyperlordosis is the most prevalent musculoskeletal postural deformity. Maintenance of normal limits of lumbar lordosis is necessary for obtaining an ideal...
BACKGROUND
Lumbar hyperlordosis is the most prevalent musculoskeletal postural deformity. Maintenance of normal limits of lumbar lordosis is necessary for obtaining an ideal posture. Literature suggests that poor posture results in fascial restriction in which the fascia reorganizes in response to tension. Gross myofascial release (MFR) combined with posterior pelvic tilting exercises proved to be beneficial in improving the lumbar range of motion. Three-dimensional (3D) MFR is a novel approach toward reducing fascial restrictions. However, the literature determining the effects of 3D MFR is still emerging.
AIM
To determine the effect of 3D MFR on a lumbar lordosis angle and lumbar range of motion, in individuals with asymptomatic hyperlordosis.
METHOD
Participants (n = 30) with hyperlordosis were randomly assigned to either the experimental group receiving 3D MFR (n = 15) or the control group (n = 15) that received sham 3D MFR for six sessions (3 alternate days for 2 weeks). The outcomes were assessed at day 1 and day 6. Lumbar range of motion was assessed using modified-modified Schober's test and the lumbar lordosis angle was measured using x-ray and flexicurve.
RESULTS
There was significant decrease (p = 0.0001) in the lumbar lordosis angle, increase in the lumbar flexion (p = 0.0001), and decrease in the extension (p = 0.0011) range of motion in the experimental group when compared to the control group.
CONCLUSION
Lumbar lordosis decreased and the lumbar range of motion increased in the experimental group only with 3D MFR and not with sham 3D MFR. Hence, 3D MFR is an effective method in the correction of lumbar hyperlordosis and improving the lumbar range.Clinical Trial Registry of India (CTRI) trial number
PubMed: 38873188
DOI: 10.3822/ijtmb.v17i2.957