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Sensors (Basel, Switzerland) Jun 2024(1) Background: Marker-based 3D motion capture systems (MBS) are considered the gold standard in gait analysis. However, they have limitations for which markerless... (Meta-Analysis)
Meta-Analysis Review
Accuracy, Validity, and Reliability of Markerless Camera-Based 3D Motion Capture Systems versus Marker-Based 3D Motion Capture Systems in Gait Analysis: A Systematic Review and Meta-Analysis.
(1) Background: Marker-based 3D motion capture systems (MBS) are considered the gold standard in gait analysis. However, they have limitations for which markerless camera-based 3D motion capture systems (MCBS) could provide a solution. The aim of this systematic review and meta-analysis is to compare the accuracy, validity, and reliability of MCBS and MBS. (2) Methods: A total of 2047 papers were systematically searched according to PRISMA guidelines on 7 February 2024, in two different databases: Pubmed (1339) and WoS (708). The COSMIN-tool and EBRO guidelines were used to assess risk of bias and level of evidence. (3) Results: After full text screening, 22 papers were included. Spatiotemporal parameters showed overall good to excellent accuracy, validity, and reliability. For kinematic variables, hip and knee showed moderate to excellent agreement between the systems, while for the ankle joint, poor concurrent validity and reliability were measured. The accuracy and concurrent validity of walking speed were considered excellent in all cases, with only a small bias. The meta-analysis of the inter-rater reliability and concurrent validity of walking speed, step time, and step length resulted in a good-to-excellent intraclass correlation coefficient (ICC) (0.81; 0.98). (4) Discussion and conclusions: MCBS are comparable in terms of accuracy, concurrent validity, and reliability to MBS in spatiotemporal parameters. Additionally, kinematic parameters for hip and knee in the sagittal plane are considered most valid and reliable but lack valid and accurate measurement outcomes in transverse and frontal planes. Customization and standardization of methodological procedures are necessary for future research to adequately compare protocols in clinical settings, with more attention to patient populations.
Topics: Humans; Gait Analysis; Gait; Imaging, Three-Dimensional; Biomechanical Phenomena; Reproducibility of Results; Motion Capture
PubMed: 38894476
DOI: 10.3390/s24113686 -
Sensors (Basel, Switzerland) Jun 2024The use of wearable sensors, such as inertial measurement units (IMUs), and machine learning for human intent recognition in health-related areas has grown considerably....
The use of wearable sensors, such as inertial measurement units (IMUs), and machine learning for human intent recognition in health-related areas has grown considerably. However, there is limited research exploring how IMU quantity and placement affect human movement intent prediction (HMIP) at the joint level. The objective of this study was to analyze various combinations of IMU input signals to maximize the machine learning prediction accuracy for multiple simple movements. We trained a Random Forest algorithm to predict future joint angles across these movements using various sensor features. We hypothesized that joint angle prediction accuracy would increase with the addition of IMUs attached to adjacent body segments and that non-adjacent IMUs would not increase the prediction accuracy. The results indicated that the addition of adjacent IMUs to current joint angle inputs did not significantly increase the prediction accuracy (RMSE of 1.92° vs. 3.32° at the ankle, 8.78° vs. 12.54° at the knee, and 5.48° vs. 9.67° at the hip). Additionally, including non-adjacent IMUs did not increase the prediction accuracy (RMSE of 5.35° vs. 5.55° at the ankle, 20.29° vs. 20.71° at the knee, and 14.86° vs. 13.55° at the hip). These results demonstrated how future joint angle prediction during simple movements did not improve with the addition of IMUs alongside current joint angle inputs.
Topics: Humans; Movement; Machine Learning; Male; Algorithms; Adult; Female; Wearable Electronic Devices; Young Adult; Range of Motion, Articular; Biomechanical Phenomena; Knee Joint; Joints; Ankle Joint; Hip Joint
PubMed: 38894447
DOI: 10.3390/s24113657 -
Diagnostics (Basel, Switzerland) May 2024Hybrid lateral closed-wedge high tibial osteotomy (HBHTO) carries certain advantages over medial open-wedge high tibial osteotomy (OWHTO). We investigated the potential...
Difference in Correction Power between Hybrid Lateral Closed-Wedge High Tibial Osteotomy and Medial Open-Wedge High Tibial Osteotomy was Associated with Severity of Varus Deformity and Different Hinge Distance from Center of Deformity.
Hybrid lateral closed-wedge high tibial osteotomy (HBHTO) carries certain advantages over medial open-wedge high tibial osteotomy (OWHTO). We investigated the potential difference in the required correction angle between HBHTO and OWHTO to achieve an equal amount of whole lower-extremity alignment correction, retrospectively analyzing the preoperative plain radiographic images of 100 patients. The medial proximal tibial angle (MPTA), joint line convergence angle (JLCA), mechanical lateral distal femoral angle (mLDFA), hip-knee-ankle axis (HKA), length of the tibia, width of the tibial plateau, length of the lower limb (leg length), and location of the center of deformity (CD) were measured. Differences in the required correction angle at the hinge point between the two techniques (CAD) were compared, and correlation analysis was performed to reveal the influential factors. The mean difference in CAD between HBHTO and OWHTO was 0.78 ± 0.22 (0.4~1.5)°, and mean WBL position change per correction angle was 3.9 ± 0.3 (3.0~4.6)% in HBHTO and 4.1 ± 0.3 (3.1~4.7)% in OWHTO. Correlation analysis revealed a strong positive correlation between CAD and HKA. mLDFA, JLCA, MPTA, leg length, OWCD, HBCD, and HCD were also significantly correlated with CAD. HBHTO required a 5.6% larger correction angle at the hinge point to achieve the same amount of alignment correction as OWHTO.
PubMed: 38893663
DOI: 10.3390/diagnostics14111137 -
International Journal of Molecular... May 2024Post-traumatic osteoarthritis of the ankle (PTOA) is frequently observed following a debilitating consequence of intra-articular ankle fractures. Numerous risk factors... (Review)
Review
Post-traumatic osteoarthritis of the ankle (PTOA) is frequently observed following a debilitating consequence of intra-articular ankle fractures. Numerous risk factors contribute to the pathogenesis of PTOA, including articular incongruity, joint malalignment, and concomitant soft tissue damage. Despite attempts to restore joint anatomy and manage soft tissues to avoid long-term complications after intra-articular ankle fractures, the incidence of PTOA remains markedly elevated. Inflammatory processes triggered by intra-articular ankle fractures have emerged as potential instigators that expedite the progression of PTOA. Injury to the articular cartilage and subchondral bone may lead to the release of inflammatory mediators, which can contribute to cartilage degradation and bone resorption. This study provides a narrative review on the current knowledge concerning the association between inflammation and the development of PTOA following intra-articular ankle fractures. We also discuss novel therapeutic agents that target inflammatory pathways to impede the progression of post-traumatic osteoarthritis after intra-articular ankle fractures. These medication and interventions were summarized within this review article.
Topics: Humans; Osteoarthritis; Inflammation; Animals; Cartilage, Articular; Ankle Joint; Ankle Fractures; Ankle Injuries
PubMed: 38892089
DOI: 10.3390/ijms25115903 -
Journal of Orthopaedic Surgery and... Jun 2024Near infrared brain functional imaging (FNIRS) has been used for the evaluation of brain functional areas, the imaging differences of central activation of...
BACKGROUND
Near infrared brain functional imaging (FNIRS) has been used for the evaluation of brain functional areas, the imaging differences of central activation of cognitive-motor dual tasks between patients with chronic lateral ankle instability (CLAI) and healthy population remain unclear. This study aimed to evaluated the role of central imaging based on FNIRS technology on the plan management in patients with CLAI, to provide insights to the clinical treatment of CLAI.
METHODS
CLAI patients treated in our hospital from January 1, 2021 to June 31, 2022 were selected. Both CLAI patients and health controls were intervened with simple task and cognitive-motor dual task under sitting and walking conditions, and the changes of oxygenated hemoglobin concentration in bilateral prefrontal cortex (PFC), premotor cortex (PMC) and auxiliary motor area (SMA) were collected and compared.
RESULTS
A total of 23 participants were enrolled. There were significant differences in the fNIRS ΔHbO of barefoot subtractive walking PFC-R and barefoot subtractive walking SMA-R between experimental and control group (all P < 0.05). There was no significant difference in ΔHbO between the experimental group and the control group in other states (P > 0.05). There was no significant difference in ΔHbO between the experimental group and the control group in each state of the brain PMC region.
CONCLUSION
Adaptive alterations may occur within the relevant brain functional regions of individuals with CLAI. The differential activation observed between the PFC and the SMA could represent a compensatory mechanism emerging from proprioceptive afferent disruptions following an initial ankle sprain.
Topics: Humans; Female; Joint Instability; Male; Adult; Chronic Disease; Young Adult; Spectroscopy, Near-Infrared; Ankle Joint; Walking; Prefrontal Cortex; Motor Cortex; Cognition
PubMed: 38890731
DOI: 10.1186/s13018-024-04790-0 -
PloS One 2024Significant alterations to subchondral trabecular bone microarchitecture are observed in late-stage osteoarthritis (OA). However, detailed investigation of these changes...
Significant alterations to subchondral trabecular bone microarchitecture are observed in late-stage osteoarthritis (OA). However, detailed investigation of these changes to bone in the ankle are under-reported. This study aimed to fully characterise the trabecular morphology in OA ankle bone specimens compared to non-diseased (ND) controls using both standard and individual-trabecular segmentation-based (ITS) analyses. Ten ND tibial bone specimens were extracted from three cadaveric ankles, as well as five OA bone specimens from patients undergoing total ankle arthroplasty surgery. Each specimen was scanned using microcomputed tomography from which a 4 mm cuboidal volume was extracted for analysis. Morphological parameters for the subchondral trabecular bone were measured using BoneJ (NIH ImageJ) and 3D ITS for whole volumes and at each depth level in 1 mm increments. The results show an overall increase in bone volume fraction (p<0.01) and trabecular thickness (p<0.001) with OA, with a decrease in anisotropy (p<0.05). ITS analysis showed OA bone was composed of more rod-like trabeculae and plate-like trabeculae compared to ND bone. Numerous properties were depth dependent, but the results demonstrated that towards the subchondral bone plate, both rod- and plate-like trabeculae were thicker, rods were longer and plates had increased surface area. Overall, this study has verified key microstructural alterations to ankle subchondral bone that are found in other OA lower-limb joints. Depth-based analysis has highlighted differences of interest for further evaluation into the remodelling mechanisms that occur with OA, which is critical to understanding the role of subchondral bone microarchitecture in the progression of the disease.
Topics: Humans; Osteoarthritis; Female; Aged; Male; X-Ray Microtomography; Ankle Joint; Middle Aged; Tibia; Cancellous Bone; Aged, 80 and over
PubMed: 38889162
DOI: 10.1371/journal.pone.0290914 -
Revista Espanola de Cirugia Ortopedica... Jun 2024Ankle fractures represent up to 9% of all fractures, with an increased incidence in the elderly population. Among these fractures, isolated fractures of the lateral... (Review)
Review
Ankle fractures represent up to 9% of all fractures, with an increased incidence in the elderly population. Among these fractures, isolated fractures of the lateral malleolus are the most common, representing 65-70% of all cases. The therapeutic decision-making primarily relies on the stability of the ankle ring, considering it stable if affected at one point and unstable if two or more points are affected. Surgical treatment focuses on restoring the length of the fibula, joint reconstruction, stabilizing the syndesmosis, and providing a stable fixation. It is crucial to rule out associated injuries that may influence therapeutic management. This article reviews the evaluation and management of lateral malleolus fractures, proposes a decision-making algorithm, and examines several fibular fixation options.
PubMed: 38885878
DOI: 10.1016/j.recot.2024.06.008 -
Tibiotalocalcaneal ankle arthrodesis with posterior approach arthroscopic-assisted hindfoot nailing.Journal of Orthopaedic Surgery (Hong... 2024End-stage ankle arthrosis causes severe pain and limited movement. Tibiotalocalcaneal arthrodesis with arthroscopy-assisted hindfoot nailing can be used to achieve a...
PURPOSE
End-stage ankle arthrosis causes severe pain and limited movement. Tibiotalocalcaneal arthrodesis with arthroscopy-assisted hindfoot nailing can be used to achieve a high union rate and low complication rate. We aimed to examine the early- and mid-term results of patients treated with this technique from various perspectives and to evaluate them by comparing them with the current literature.
METHODS
Data were collected from 25 patients who met the established criteria and underwent TTCA with arthroscopic-assisted hindfoot nailing. In addition to the demographic data of the patients, their clinical and pain scores were evaluated using the American Orthopedic Foot and Ankle Society (AOFAS) and visual analogue scale (VAS). Additionally, the union time and complication data during the follow-up period were examined.
RESULTS
When the AOFAS and VAS scores of the 25 patients were examined, a significant improvement was observed in the preoperative period and early postoperative period comparisons ( < .001). No significant change was observed between the comparison of the postoperative 12th month and last postoperative control clinical scores. While the union rate of the patients was observed to be 92%, the average union time was 13.1 ± 3.5 weeks. During follow-up, peri-implant fracture, deep infection, and non-union were observed in one patient each (12%).
CONCLUSION
The early- and mid-term postoperative results of patients treated with TTCA surgery with posterior approach arthroscopic-assisted hindfoot nailing show that this technique may be an option with low complication and high union rates for the appropriate group of patients planned for ankle arthrodesis.
Topics: Humans; Arthrodesis; Male; Female; Middle Aged; Ankle Joint; Arthroscopy; Bone Nails; Aged; Adult; Retrospective Studies; Osteoarthritis
PubMed: 38881517
DOI: 10.1177/10225536241264623 -
The Journal of Arthroplasty Jun 2024Mechanical alignment after total knee arthroplasty (TKA) is still widely used in the surgical community, but the alignment finally obtained by conventional techniques...
Restoring the Preoperative Phenotype According to the Coronal Plane Alignment of the Knee (CPAK) Classification After Total Knee Arthroplasty Leads to Better Functional Results.
PURPOSE
Mechanical alignment after total knee arthroplasty (TKA) is still widely used in the surgical community, but the alignment finally obtained by conventional techniques remains uncertain. The recent Coronal Plane Alignment of the Knee (CPAK) classification distinguishes nine knee phenotypes according to constitutional alignment and joint line obliquity (JLO). The aim of this study was to assess the phenotypes of osteoarthritic patients before and after TKA using mechanical alignment and to analyze the influence of CPAK restoration on functional outcomes.
METHODS
This retrospective multicenter study included 178 TKA with a minimum follow-up of two years. Patients were operated on using a conventional technique with the goal of neutral mechanical alignment. The CPAK grade (1 to 9), considering the arithmetic Hip Knee Ankle angle (HKA) and the joint line obliquity, was determined before and after TKA. Functional results were assessed using the following patient-reported outcome measures (PROMS): Knee Injury and Osteoarthritis Outcome Score (KOOS), the Simple Knee Value (SKV), and the Forgotten Joint Score (FJS).
RESULTS
A true neutral mechanical alignment was obtained in only 37.1%. Isolated restoration of Joint Line Obliquity (JLO) was found in 31.4%, and isolated restoration of the arithmetic HKA in 44.9%. Exact restoration of the CPAK phenotype was found in 14.6%. Restoration of the CPAK grade was associated with an improvement in the ''daily living'': 79.2 ± 5.3 versus 62.5 ± 2.3 (R = 0,05, P < 0.05) and ''Quality of life'' KOOS subscales: 73.8 ± 5.0 versus 62.9 ± 2.2 (R = 0.02, P < 0.05).
CONCLUSION
This study shows that few neutral mechanical alignments are finally obtained after total knee arthroplasty by conventional technique. A major number of patients present a postoperative modification of their constitutional phenotype. Functional results at two years' follow-up appear to be improved by the restoration of the CPAK phenotype, JLO, and aHKA.
PubMed: 38880407
DOI: 10.1016/j.arth.2024.06.012 -
BMC Musculoskeletal Disorders Jun 2024The aim of this study was to compare the clinical outcomes between patients with chronic ankle instability (CAI) undergoing arthroscopic anterior talofibular ligament... (Comparative Study)
Comparative Study
PURPOSE
The aim of this study was to compare the clinical outcomes between patients with chronic ankle instability (CAI) undergoing arthroscopic anterior talofibular ligament (ATFL) repair who received elastic bandage treatment and those who received lower-leg cast immobilization.
METHODS
CAI patients with isolated ATFL injury undergoing arthroscopic ATFL repair from January 2017 and August 2019 were included in the study. The visual analogue scale (VAS) at rest and during activities, American Orthopedic Foot and Ankle Society (AOFAS) score, Karlsson Ankle Functional Score (Karlsson score), and time of returning to walk, walk normally, work and sports were evaluated preoperatively, and at 6 months and 12 months follow-up.
RESULTS
A total of 41 patients were included in this study. Among them, 24 patients accepted lower-leg cast fixation, and the other 17 patients were immobilized with elastic bandage. Compared to patients with lower-leg immobilization, patients with elastic bandage fixation had significantly lower VAS during activities (P = 0.021) and higher AOFAS score (P = 0.015) at 12 months follow-up. The Karlsson score at 6 months follow-up were significantly higher in elastic bandage group than those in lower-leg group (P = 0.011). However, no significant difference was observed in time of returning to walk, work and sports between the two groups.
CONCLUSION
Elastic bandage treatment was better than lower-leg cast immobilization in terms of eliminating pain symptom at 12 months follow-up, and improving ankle functional outcome at 6 months follow-up. Moreover, the present study emphasized that lower-leg cast immobilization offered no advantages in arthroscopic ATFL repair postoperative immobilization.
STUDY DESIGN
Cohort study; Level of evidence, 3.
Topics: Humans; Female; Male; Casts, Surgical; Adult; Lateral Ligament, Ankle; Treatment Outcome; Joint Instability; Young Adult; Ankle Joint; Arthroscopy; Retrospective Studies; Ankle Injuries; Immobilization; Middle Aged; Recovery of Function; Follow-Up Studies
PubMed: 38879465
DOI: 10.1186/s12891-024-07584-x