Search results for: knee joint

Authors: Muhammad Yasir Tarar

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Background: Intraarticular steroid injections are an effective option in alleviating the symptoms of conditions like osteoarthritis, rheumatoid arthritis, crystal arthropathy, and rotator cuff tendinopathy. Most of these injections are conducted in the elderly who are on polypharmacy, including anticoagulants at times. Up to 6% of patients aged 80-84 years have been reported to be taking Warfarin. The literature availability on safety quotient for patients undergoing intraarticular injections on Warfarin is scarce. It has remained debatable over the years which approach is safe for these patients. Continuing warfarin has a theoretical bleeding risk, and stopping it can lead to even severe life-threatening thromboembolic events in high-risk patients. Objectives: To evaluate the risk of bleeding complications in patients on warfarin undergoing intraarticular injections or arthrocentesis. Study Design & Methods: A literature search of MEDLINE (1946 to present), EMBASE (1974 to present), and Cochrane CENTRAL (1988 to present) databases were conducted using any combination of the keywords, Injection, Knee, Shoulder, Joint, Intraarticular, arthrocentesis, Warfarin, and Anticoagulation in November 2020 for articles published in any language with no publication year limit. The study inclusion criteria included reporting on the rate of bleeding complications following injection of the knee or shoulder in patients on warfarin treatment. Randomized control trials and prospective and retrospective study designs were included. An electronic standardized Performa for data extraction was made. The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) the methodology was used. The articles were appraised using the methodological index for nonrandomized studies. The Cochrane Risk of Bias Tool used to assess the risk of bias in included RCTs and the MINORS tool for assessment of bias in observational studies. Results: The search of databases resulted in a total of 852 articles. Relevant articles as per the inclusion criteria were shortlisted, 7 articles deemed suitable to be include. A total of 1033 joints sample size was undertaken with specified knee and shoulder joints of a total of 820. Only 6 joints had bleeding complications, 5 early bleeding at the time of injection or aspiration, and one late bleeding complication with INR of 5, additionally, 2 patients complained of bruising, 3 of pain, and 1 managed for infection. Conclusions: The results of the metanalysis show that it is relatively safe to perform intraarticular injections in patients on Warfarin regardless of the INR range.

Keywords: arthrocentesis, warfarin, bleeding, injection

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Authors: Reza Aghayan

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This paper illustrates that numerically invariant joint signatures suffer biases in the resulting signatures. Next, we classify the arising biases as Bias Type 1 and Bias Type 2 and show how they can be removed.

Keywords: Euclidean and affine geometries, differential invariant signature curves, numerically invariant joint signatures, numerical analysis, numerical bias, curve analysis

Procedia PDF Downloads 598

Authors: Reza Kalantari, Ghazanfarah Hafeez

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The paper presents outcomes of the numerical research performed on standard and dovetail corner joints under lateral loads. An overview of the past research on log shear walls is also presented. To the authors’ best knowledge, currently, there are no specific design guidelines available in the code for the design of log shear walls, implying the need to investigate the performance of log shear walls. This research explores the performance of the log shear wall corner joint system of standard joint and dovetail types using numerical methods based on research available in the literature. A parametric study is performed to study the effect of gap size provided between two orthogonal logs and the presence of wood and steel dowels provided as joinery between log courses on the performance of such a structural system. The research outcomes are the force-displacement curves. 8% variability is seen in the reaction forces with the change of gap size for the case of the standard joint, while a variation of 10% is observed in the reaction forces for the dovetail joint system.

Keywords: dovetail joint, finite element modelling, log shear walls, standard joint

Procedia PDF Downloads 218

Authors: Young-Su Ryu, Su-Hyun Jung, Myoung-Jin Kim, Hyoung-Kyu Song

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In this paper, improved performance scheme for joint transmission is proposed in downlink (DL) coordinated multi-point(CoMP) in case of constraint transmission power. This scheme is that serving transmission point (TP) request a joint transmission to inter-TP and selects one pre-coding technique according to channel state information(CSI) from user equipment(UE). The simulation results show that the bit error rate(BER) and throughput performances of the proposed scheme provide high spectral efficiency and reliable data at the cell edge.

Keywords: CoMP, joint transmission, minimum mean square error, zero-forcing, zero-forcing dirty paper coding

Procedia PDF Downloads 553

Authors: Nabeel Abdulkadhim Athab

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The purpose of this research is to conduct a comparative study according analysis of programmed to some of physical and mechanical variables for joint wrist injury. As it can be through this research to distinguish between the amount of variation in the work of the joint after sample underwent rehabilitation program to improve the effectiveness of the joint and naturally restore its effectiveness. Supposed researcher that there is statistically significant differences between the results of the tests pre and post the members research sample, as a result of submission the sample to the program of rehabilitation, which led to the development of muscle activity that are working on wrist joint and this is what led to note the differences between the results of the tests pre and post. The researcher used the descriptive method. The research sample included (6) of injured players in the wrist joint, as the average age (21.68) and standard deviation (1.13) either length average (178cm) and standard deviation (2.08). And the sample as evidenced homogeneous among themselves. And where the data were collected, introduced in program for statistical processing to get to the most important conclusions and recommendations and that the most important: 1-The commitment of the sample program the qualifying process variables studied in the search for the heterogeneity of study activity and effectiveness of wrist joint for injured players. 2-The analysis programmed a high accuracy in the measurement of the research variables, and which led to the possibility of discrimination into account differences in motor ability camel and injured in the wrist joint. To search recommendations including: 1-The use of computer systems in the scientific research for the possibility of obtaining accurate research results. 2-Programming exercises rehabilitation according to an expert system for possible use by patients without reference to the person processor.

Keywords: analysis of joint wrist injury, physical and mechanical variables, wrist joint, wrist injury

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Authors: Aizreena Azaman, Mai Ishibashi, Masanori Ishizawa, Shin-Ichiroh Yamamoto

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Sensory input plays an important role to human posture control system to initiate strategy in order to counterpart any unbalance condition and thus, prevent fall. In previous study, joint stiffness was observed able to describe certain issues regarding to movement performance. But, correlation between balance ability and joint stiffness is still remains unknown. In this study, joint stiffening strategy at ankle and hip were observed under different sensory manipulations and its correlation with conventional clinical test (Functional Reach Test) for balance ability was investigated. In order to create unstable condition, two different surface perturbations (tilt up-tilt (TT) down and forward-backward (FB)) at four different frequencies (0.2, 0.4, 0.6 and 0.8 Hz) were introduced. Furthermore, four different sensory manipulation conditions (include vision and vestibular system) were applied to the subject and they were asked to maintain their position as possible. The results suggested that joint stiffness were high during difficult balance situation. Less balance people generated high average joint stiffness compared to balance people. Besides, adaptation of posture control system under repetitive external perturbation also suggested less during sensory limited condition. Overall, analysis of joint stiffening response possible to predict unbalance situation faced by human.

Keywords: balance ability, joint stiffness, sensory, adaptation, dynamic

Procedia PDF Downloads 462

Authors: Meltem Ramoglu, Ertugrul Safran, Hikmet Ucgun, Busra Kepenek Varol, Hulya Nilgun Gurses

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Down’s syndrome (DS) is a human genetic disorder caused by the presence of all or part of an extra chromosome 21. Many patients with DS have musculoskeletal problems that affect weak muscle tone (hypotonia) and ligament laxity. This leads to excessive joint hypermobility and decreased position sense (proprioception). Lack of proprioception may cause balance problems. The aim of our study was to investigate how does joint hypermobility affect balance in patients with DS. Our study conducted with 13 DS patients age between 18 to 40 years. Demographic data were recorded. Beighton Hypermobility Score (BHS) was used to evaluate joint hypermobility. Balance score of participants was evaluated with Berg Balance Scale (BBS). Mean age of our participants was 29,8±3,57 year. Average score of body mass index and BHS were; 33,23 ±3,78 kg/m2 and 7,61±1,04, respectively. Out of a maximum possible score of 56 on the Berg Balance Scale, scores of participants with DS ranged from 36–51, with a mean of 43±4,45. Significant correlation was found between BHS and BBS (r: -,966, p=0.00). All of our participants have 6/9 or higher grade from BHS. As a conclusion of our study; joint hypermobility may affect balance score in patients with DS. The results suggest that people with DS have worse balance scores which affected by hypermobility. Further studies need larger population for more reliable results.

Keywords: adults, balance, Down's syndrome, joint hypermobility

Procedia PDF Downloads 330

Authors: Nawaf Al Khashram, Graham Arnold, Weijie Wang

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Background—Gait classifying allows clinicians to differentiate gait patterns into clinically important categories that help in clinical decision making. Reliable comparison of gait data between normal and patients requires knowledge of the gait parameters of normal children's specific age group. However, there is still a lack of the gait database for normal children of different ages. Objectives—The aim of this study is to investigate the kinematics of the lower limb joints during gait for normal children in different age groups. Methods—Fifty-three normal children (34 boys, 19 girls) were recruited in this study. All the children were aged between 5 to 16 years old. Age groups were defined as three types: young child aged (5-7), child (8-11), and adolescent (12-16). When a participant agreed to take part in the project, their parents signed a consent form. Vicon® motion capture system was used to collect gait data. Participants were asked to walk at their comfortable speed along a 10-meter walkway. Each participant walked up to 20 trials. Three good trials were analyzed using the Vicon Plug-in-Gait model to obtain parameters of the gait, e.g., walking speed, cadence, stride length, and joint parameters, e.g. joint angle, force, moments, etc. Moreover, each gait cycle was divided into 8 phases. The range of motion (ROM) angle of pelvis, hip, knee, and ankle joints in three planes of both limbs were calculated using an in-house program. Results—The temporal-spatial variables of three age groups of normal children were compared between each other; it was found that there was a significant difference (p < 0.05) between the groups. The step length and walking speed were gradually increasing from young child to adolescent, while cadence was gradually decreasing from young child to adolescent group. The mean and standard deviation (SD) of the step length of young child, child and adolescent groups were 0.502 ± 0.067 m, 0.566 ± 0.061 m and 0.672 ± 0.053 m, respectively. The mean and SD of the cadence of the young child, child and adolescent groups were 140.11±15.79 step/min, 129±11.84 step/min, and a 115.96±6.47 step/min, respectively. Moreover, it was observed that there were significant differences in kinematic parameters, either whole gait cycle or each phase. For example, RoM of knee angle in the sagittal plane in whole cycle of young child group is (65.03±0.52 deg) larger than child group (63.47±0.47 deg). Conclusion—Our result showed that there are significant differences between each age group in the gait phases and thus children walking performance changes with ages. Therefore, it is important for the clinician to consider age group when analyzing the patients with lower limb disorders before any clinical treatment.

Keywords: age group, gait analysis, kinematics, normal children

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Authors: Bing Chen, Xiang Ni, Eric Li

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With the population ageing, the number of patients suffering from chronic diseases is increasing, among which stroke is a high incidence for the elderly. In addition, there is a gradual increase in the number of patients with orthopedic or neurological conditions such as spinal cord injuries, nerve injuries, and other knee injuries. These diseases are chronic, with high recurrence and complications, and normal walking is difficult for such patients. Nowadays, robotic knee exoskeletons have been developed for individuals with knee impairments. However, the currently available robotic knee exoskeletons are generally developed with heavyweight, which makes the patients uncomfortable to wear, prone to wearing fatigue, shortening the wearing time, and reducing the efficiency of exoskeletons. Some lightweight materials, such as carbon fiber and titanium alloy, have been used for the development of robotic knee exoskeletons. However, this increases the cost of the exoskeletons. This paper illustrates the design of a new ultra-light and ultra-stiff truss type of lattice structure. The lattice structures are arranged in a fan shape, which can fit well with circular arc surfaces such as circular holes, and it can be utilized in the design of rods, brackets, and other parts of a robotic knee exoskeleton to reduce the weight. The metamaterial is formed by continuous arrangement and combination of small truss structure unit cells, which changes the diameter of the pillar section, geometrical size, and relative density of each unit cell. It can be made quickly through additive manufacturing techniques such as metal 3D printing. The unit cell of the truss structure is small, and the machined parts of the robotic knee exoskeleton, such as connectors, rods, and bearing brackets, can be filled and replaced by gradient arrangement and non-uniform distribution. Under the condition of satisfying the mechanical properties of the robotic knee exoskeleton, the weight of the exoskeleton is reduced, and hence, the patient’s wearing fatigue is relaxed, and the wearing time of the exoskeleton is increased. Thus, the efficiency and wearing comfort, and safety of the exoskeleton can be improved. In this paper, a brief description of the hardware design of the prototype of the robotic knee exoskeleton is first presented. Next, the design of the ultra-light and ultra-stiff truss type of lattice structures is proposed, and the mechanical analysis of the single-cell unit is performed by establishing the theoretical model. Additionally, simulations are performed to evaluate the maximum stress-bearing capacity and compressive performance of the uniform arrangement and gradient arrangement of the cells. Finally, the static analysis is performed for the cell-filled rod and the unmodified rod, respectively, and the simulation results demonstrate the effectiveness and feasibility of the designed ultra-light and ultra-stiff truss type of lattice structures. In future studies, experiments will be conducted to further evaluate the performance of the designed lattice structures.

Keywords: additive manufacturing, lattice structures, metamaterial, robotic knee exoskeleton

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Authors: H. Noureddine, P. Rao, R. Guru, A. Chandratreya

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The nice guidance for elective total knee replacements states that patients should be given mechanical thrombo-prophylaxis, and if no contraindications chemical thromboprophylaxis in the form of Dabigatran etexilate, Rivaroxiban, UFH, LMWH, or Fondaparinux sodium (CG92, 1.5.14, January 2010). In Practice administering oral agents has been the dominant practice as it reduces the nursing needs, and shortens hospital stay and is generally received better by patients. However, there are well documented associated bleeding risks, and their effects are difficult to reverse in case of major bleeding. Our experience with oral factor 10 inhibitors used for thromboprophylaxis was marked with several patients developing complications necessitating return to the theatre for wound washouts. This has led us to try a different protocol for thromboprophylaxis that we applied on our patients undergoing total and unicondylar knee replacements. We applied mechanical thromboprophylaxis in the form of intermittent pneumatic pressure devices, and chemical thromboprophylaxis in the form of a dose of prophylactic LMWH pre-op, then 150 mg of Aspirin to start 24 hours after the surgery and to continue for 6 weeks, alongside GI cover with PPIs or antihistamines. We also administered local anaesthetics intra-operatively in line with the ERAS protocol thus encouraging early mobilization. We have identified a cohort of 133 patients who underwent one of the aforementioned procedures in the same trust, and by the same surgeon, where this protocol was applied and examined their medical notes retrospectively with a mean follow-up period of 14 months, to identify the rate and percentage of patients who had thrombo-embolic events in the post-operative period.

Keywords: aspirin, heparin, knee arthroplasty, thromboprophylaxis

Procedia PDF Downloads 370

Authors: Elham Azimzadeh, Saeedeh Sepehri, Hamidollah Hassanlouei

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Obesity is associated with postural instability, might influence the quality of daily life, and could be considered a potential factor for falling in obese people. The fat body mass especially in the abdominal area may increase body sway. Furthermore, loss of visual feedback may induce a larger postural sway in obese people. Moreover, Muscle fatigue may impair the work capacity of the skeletal muscle and may alter joint proprioception. So, the purpose of this study was to investigate the effect of physical fatigue and visual feedback on body sway and strength of lower extremities in obese people. 12 obese (4 female, 8 male; BMI >30 kg/m2), and 12 normal weight (4 female, 8 male; BMI: 20-25 kg/m2) subjects aged 37- 47 years participated in this study. The postural stability test on the Biodex balance system was used to characterize postural control along the anterior-posterior (AP) and mediolateral (ML) directions in eyes open and eyes closed conditions and maximal voluntary contraction (MVC) of knee extensors and flexors were measured before and after the high-intensity exhausting exercise protocol on the ergometer bike to confirm the presence of fatigue. Results indicated that the obese group demonstrated significantly greater body sway, in all indices (ML, AP, overall) compared with the normal weight group (eyes open). However, when visual feedback was eliminated, fatigue impaired the balance in the overall and AP indicators in both groups; ML sway was higher only in the obese group after exerting the fatigue in the eyes closed condition. Also, maximal voluntary contraction of knee extensors was impaired in the fatigued normal group but, there was no significant impairment in knee flexors MVC in both group. According to the findings, peripheral fatigue was associated with altered postural control in upright standing when eyes were closed, and that mechanoreceptors of the feet may be less able to estimate the position of the body COM over the base of support in the loss of visual feedback. This suggests that the overall capability of the postural control system during upright standing especially in the ML direction could be lower due to fatigue in obese individuals and could be a predictor of future falls.

Keywords: maximal voluntary contraction, obesity, peripheral fatigue, postural control, visual feedback

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Authors: Woo Young Jung, Min Ho Kwon, Bu Seog Ju

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A failure of the non-structural component can cause significant damages in critical facilities such as nuclear power plants and hospitals. Historically, it was reported that the damage from the leakage of sprinkler systems, resulted in the shutdown of hospitals for several weeks by the 1971 San Fernando and 1994 North Ridge earthquakes. In most cases, water leakages were observed at the cross joints, sprinkler heads, and T-joint connections in piping systems during and after the seismic events. Hence, the primary objective of this study was to understand the seismic performance of T-joint connections and to develop an analytical Finite Element (FE) model for the T-joint systems of 2-inch fire protection piping system in hospitals subjected to seismic ground motions. In order to evaluate the FE models of the piping systems using OpenSees, two types of materials were used: 1) Steel 02 materials and 2) Pinching 4 materials. Results of the current study revealed that the nonlinear moment-rotation FE models for the threaded T-joint reconciled well with the experimental results in both FE material models. However, the system-level fragility determined from multiple nonlinear time history analyses at the threaded T-joint was slightly different. The system-level fragility at the T-joint, determined by Pinching 4 material was more conservative than that of using Steel 02 material in the piping system.

Keywords: fragility, t-joint, piping, leakage, sprinkler

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Authors: Bongsik Park, Jae Hyun Park, Jae-Yeol Cho

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Mixed structure, which is a kind of hybrid system, is incorporating steel beam and prestressed concrete beam. Hybrid bridge adopting mixed structure have some merits. Main span length can be made longer by using steel as main span material. In case of cable-stayed bridge having asymmetric span length, negative reaction at side span can be restrained without extra restraining devices by using weight difference between main span material and side span material. However angle of refraction might happen because of rigidity difference between materials and stress concentration also might happen because of abnormal loading transmission at joint in the hybrid bridge. Therefore the joint might be a weak point of the structural system and it needs to pay attention to design of the joint. However, design codes and standards about the joint in the hybrid-bridge have not been established so the joint designs in most of construction cases have been very conservative or followed previous design without extra verification. In this study parametric study using finite element analysis for optimal design of hybrid bridge joint is conducted. Before parametric study, finite element analysis was conducted based on previous experimental data and it is verified that analysis result approximated experimental data. Based on the finite element analysis results, parametric study was conducted. The parameters were selected as those have influences on joint behavior. Based on the parametric study results, optimal design of hybrid bridge joint has been determined.

Keywords: parametric study, optimal design, hybrid bridge, finite element analysis

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Authors: Chih-I. Tsai, Yu-Chien. Lin

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Through experiences of clinical practices, it is discovered that locations on the body at a level of four fingerbreadth above and below the joints are the points at which muscles connect to tendons, and since the muscles and tendons possess opposite characteristics, muscles are full of blood but lack qi, while tendons are full of qi but lack blood, these points on our body become easily blocked. It is proposed that through doing acupuncture or creating localized pressure to the areas four fingerbreadths above and below our joints, with an elastic bandage, we could help the energy, also known as qi, to flow smoothly in our body and further improve our health. Based on the Four Fingers Theory, we understand that human height is 22 four fingerbreadths. In addition, qi and blood travel through 24 meridians, 50 times each day, and they flow through 6 cun with every human breath. We can also understand the average number of human heartbeats is 75 times per minute. And the function of qi-blood circulation system in Traditional Chinese Medicine is the same as the blood circulation in Western Medical Science. Informed by Four Fingers Theory, this study further examined its applications in acupuncture practices. The research question is how Four Fingers Theory proves what has been mentioned in Nei Jing that there are 66 acupoints under a human’s elbow and knee. In responding to the research question, there are 66 acupoints under a human’s elbow and knee. Four Fingers Theory facilitated the creation of the acupuncture naming and teaching system. It is expected to serve as an approachable and effective way to deliver knowledge of acupuncture to the public worldwide.

Keywords: four fingers theory, meridians circulation, 66 acupoints under human elbow and knee, acupuncture

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Authors: Soonwon Kang, Jinwoong Choi, Sungnam Hong, Seung-Kyung Kye, Sun-Kyu Park

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The modular bridge is to be constructed by assembling standardized precast segments. This bridge is classified as a slab type and T-girder type. The T-girder bridge has transverse joint. However, it did not perform the verification on the transverse joint, but the slab type was done on the analytic study on the joint. Therefore, it is necessary for precast modular T-girder bridge that has a transverse joint to propose an appropriated model. In this study, specimens and analysis models compared integrated type with segmented type. Results of the integrated and segmented specimens, each of the deflection was 98.40mm and 74.66mm when the maximum load was 269.71kN and 248.29kN, in case of the modeling the specimens, each of the deflection was 84.04mm, 69.39mm when the maximum load was 269.71kN, 248.29kN, therefore, the precast T-girder modular bridges form the analytic model proposed appropriate.

Keywords: precast, T-girder modular bridge, finite element analysis, joint

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Authors: Shaher Bano, Samia Fida, Asif Israr

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The continuous development and exploitation of materials and designs have diverted the attention of the world towards the use of robust composite materials known as fiber-metal laminates in many high-performance applications. The hybrid structure of fiber metal laminates makes them a material of choice for various applications such as aircraft skin panels, fuselage floorings, door panels and other load bearing applications. The synergistic effect of properties of metals and fibers reinforced laminates are responsible for their high damage tolerance as the metal element provides better fatigue and impact properties, while high stiffness and better corrosion properties are inherited from the fiber reinforced matrix systems. They are mostly used as a layered structure in different joint configurations such as lap and but joints. The FML layers are usually bonded with each other using either mechanical fasteners or adhesive bonds. This research work is also focused on modification of an adhesive bonded joint as a single lap joint of carbon fibers based CARALL FML has been modified to increase interlaminar shear strength and avoid delamination. For this purpose different joint modification techniques such as the introduction of spews and shoulder to modify the bond shape and use of nanofillers such as carbon nano-tubes as a reinforcement in the adhesive materials, have been utilized to improve shear strength of lap joint of the adhesively bonded FML layers. Both the simulation and experimental results showed that lap joint with spews and shoulders configuration have better properties due to stress distribution over a large area at the corner of the joint. The introduction of carbon nanotubes has also shown a positive effect on shear stress and joint strength as they act as reinforcement in the adhesive bond material.

Keywords: adhesive joint, Carbon Reinforced Aluminium Laminate (CARALL), fiber metal laminates, spews

Procedia PDF Downloads 300

Authors: Azadeh Jafari, Mohammad Taghi Karimi, Azadeh Nadi

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Background: Scoliosis is the lateral curvature of the spine which may influence the abilities of the subjects during standing and walking. Most of the scoliotic subjects use orthosis to reduce the curve and to decrease the risk of curve progression. There was lack of information regarding the effects of orthosis on kinematic and joint contact force. Therefore, this research was done to highlight the effects of orthosis on the aforementioned parameters. Method: 5 scoliotic subjects were recruited in this study, with single curve less than 40 (females with age 13.2 ± 1.7). They were asked to walk with and without orthosis. The kinematic of the joints, force applied on the legs, moments transmitted through the joints and joint contact forces were evaluated in this study. Moreover, the lengths of muscles were determined by use of computer muscle control approach in OpenSim. Results: There was a significant difference between the second peak of vertical ground reaction force while walking with and without orthosis (p-value < 0.05). There was no difference between spatiotemporal gait parameters while walking with and without orthosis (P-value > 0.05). The mean values of joint contact forces (vertical component) increased by the use of orthosis, but the difference was not significant (p-value > 0.05). Conclusion: Although the kinematic of most of the body joints was not influenced by the use of orthosis, the joint contact force may be increased by orthosis. The increase in joint contact force may be due to the performance of orthosis which restricts the motions of pelvic and increases compensatory mechanism used by the subjects to decrease the side effects of the orthosis.

Keywords: scoliosis, joint contact force, kinetic, kinematic

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Authors: Ezzeddin Anawa, Abdol-Ghane Olabi

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The dissimilar joint between aluminum /titanium alloys (Al 6082 and Ti G2) alloys were successfully achieved by CO2 laser welding with a single pass and without filler material using the overlap joint design. Laser welding parameters ranges combinations were experimentally determined using Taguchi approach with the objective of producing welded joint with acceptable welding profile and high quality of mechanical properties. In this study a joining of dissimilar Al 6082 / Ti G2 was result in three distinct regions fusion area (FA), heat-affected zone (HAZ), and the unaffected base metal (BM) in the weldment. These regions are studied in terms of its microstructural characteristics and microhardness which are directly affecting the welding quality. The weld metal was mainly composed of martensite alpha prime. In two different metals in the two different sides of joint HAZ, grain growth was detected. The microhardness of the joint distribution also has shown microhardness increasing in the HAZ of two base metals and a varying microhardness in fusion zone.

Keywords: microharness , microstructure, laser welding and dissimilar jointed materials.

Procedia PDF Downloads 375

Authors: Vladyslav Povoroznyuk, Anna Musiienko, Nataliia Zaverukha, Roksolana Povoroznyuk

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Along with the global aging of population, the number of people with somatic diseases is increasing, including such interrelated pathologies as obesity, osteoarthritis (OA) and osteoporosis (OP). The objective of the study is to examine the connection between body mass index (BMI), OA and bone mineral density (BMD) of lumbar spine, femoral neck and trabecular bone score (TBS) in postmenopausal women with OA. We have observed 359 postmenopausal women (50-89 years old) and divided them into four groups by age: 50-59 yrs, 60-69 yrs, 70-79 yrs and over 80 years old. In addition, according to the American College of Rheumatology (ACR) Clinical classification criteria for knee and hip OA, we divided them into 2 groups: group I – 117 females with symptomatic OA (including 89 patients with knee OA, 28 patients with hip OA) and group II –242 women with a normal functional activity of large joints. Analysis of data was performed taking into account their BMI, classified by World Health Organization (WHO). Diagnosis of obesity was established when BMI was above 30 kg/m². In woman with obesity, a symptomatic OA was detected in 44 postmenopausal women (41.1%), a normal functional activity of large joints - in 63 women (58.9%). However, in women with normal BMI – 73 women, who account for 29.0% of cases, a symptomatic OA was detected. According to a chi-squared (χ2) test, a significantly higher level of BMI was detected in postmenopausal women with OA (χ2 = 5.05, p = 0.02). Women with a symptomatic OA had a significantly higher BMD of lumbar spine compared with women who had a normal functional activity of large joints. No significant differences of BMD of femoral necks or TBS were detected in either the group with OA or with a normal functional activity of large joints.

Keywords: bone mineral density, body mass index, obesity, overweight, postmenopausal women, osteoarthritis

Procedia PDF Downloads 125

Authors: Osk Dagsdottir

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Background—Gait classifying allows clinicians to differentiate gait patterns into clinically important categories that help in clinical decision making. Reliable comparison of gait data between normal and patients requires knowledge of the gait parameters of normal children's specific age group. However, there is still a lack of the gait database for normal children of different ages. Objectives—This study aims to investigate the kinematics of the lower limb joints during gait for normal children in different age groups. Methods—Fifty-three normal children (34 boys, 19 girls) were recruited in this study. All the children were aged between 5 to 16 years old. Age groups were defined as three types: young child aged (5-7), child (8-11), and adolescent (12-16). When a participant agreed to take part in the project, their parents signed a consent form. Vicon® motion capture system was used to collect gait data. Participants were asked to walk at their comfortable speed along a 10-meter walkway. Each participant walked up to 20 trials. Three good trials were analyzed using the Vicon Plug-in-Gait model to obtain parameters of the gait, e.g., walking speed, cadence, stride length, and joint parameters, e.g., joint angle, force, moments, etc. Moreover, each gait cycle was divided into 8 phases. The range of motion (ROM) angle of pelvis, hip, knee, and ankle joints in three planes of both limbs were calculated using an in-house program. Results—The temporal-spatial variables of three age groups of normal children were compared between each other; it was found that there was a significant difference (p < 0.05) between the groups. The step length and walking speed were gradually increasing from young child to adolescent, while cadence was gradually decreasing from young child to adolescent group. The mean and standard deviation (SD) of the step length of young child, child and adolescent groups were 0.502 ± 0.067 m, 0.566 ± 0.061 m and 0.672 ± 0.053 m, respectively. The mean and SD of the cadence of the young child, child and adolescent groups were 140.11±15.79 step/min, 129±11.84 step/min, and a 115.96±6.47 step/min, respectively. Moreover, it was observed that there were significant differences in kinematic parameters, either whole gait cycle or each phase. For example, RoM of knee angle in the sagittal plane in the whole cycle of young child group is (65.03±0.52 deg) larger than child group (63.47±0.47 deg). Conclusion—Our result showed that there are significant differences between each age group in the gait phases and thus children walking performance changes with ages. Therefore, it is important for the clinician to consider the age group when analyzing the patients with lower limb disorders before any clinical treatment.

Keywords: action research, creative learning, mathematics education, professional development

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Authors: Ibrahim Abdel Gadir Malik, Dafalla Siddig Dafalla, Osama Abdelgadir El-Bushra

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Geological and engineering characteristics of intact rock and the discontinuity surfaces was used to describe and classify rock mass into zones based on mechanical and physical properties. Many conditions terms that affect the rock mas; such as Rock strength, Rock Quality Designation (RQD) value, joint spacing, and condition of joint, water condition with block size, joint roughness, separation, joint hardness, friction angle and weathering were used to classify the rock mass into: Good quality (class II) (RMR values range between 75% and 56%), Good to fair quality (class II to III) (RMR values range between 70% and 55%), Fair quality (class III) (RMR values range between 60% and 50%) and Fair to poor quality (Class III to IV) (RMR values, range between (50% and 35%).

Keywords: rock strength, RQD, joints, weathering

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Authors: Sagar Pandit

Abstract:

The present work focuses on the effect of various process parameters on the mechanical properties and microstructure of joints produced by continuous drive friction welding and linear friction welding. An attempt is made to investigate the feasibility of obtaining an acceptable weld joint between similar as well as dissimilar components and the microstructural changes have also been assessed once the good weld joints were considered (using Optical Microscopy and Scanning Electron Microscopy techniques). The impact of forging pressure in the microstructure of the weld joint has been studied and the variation in joint strength with varying forge pressure is analyzed. The weld joints were obtained two pair of dissimilar materials and one pair of similar materials, which are listed respectively as: Al-AA5083 & Cu-C101 (dissimilar), Aluminium alloy-3000 series & Mild Steel (dissimilar) and High Nitrogen Austenitic Stainless Steel pair (similar). Intermetallic phase formation was observed at the weld joints in the Al-Cu joint, which consequently harmed the properties of the joint (less tensile strength). It was also concluded that the increase in forging pressure led to both increment and decrement in the tensile strength of the joint depending on the similarity or dissimilarity of the components. The hardness was also observed to possess maximum as well as minimum values at the weld joint depending on the similarity or dissimilarity of workpieces. It was also suggested that a higher forging pressure is needed to obtain complete joining for the formation of the weld joint.

Keywords: forging pressure, friction welding, mechanical properties, microstructure

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Authors: Ayman Hegab

Abstract:

Increasing evidence supports the use of platelet-rich plasma (PRP) combined with hyaluronic acid (HA) for the treatment of knee osteoarthritis, which effectively promotes cartilage repair. This study aimed to determine whether injection of PRP+HA following arthrocentesis reduces pain and improves maximum incisal opening. This was a single-blind, prospective, randomized control study. The patients were selected based on the Hegab classification: Group I: patients treated with arthrocentesis followed by a single PRP injection; Group II (Control): patients treated with arthrocentesis followed by a single HA injection; and Group III: patients treated with arthrocentesis followed by a single PRP+HA combination injection. The primary predictor variable was the medication used for injection. The primary outcome variables were the maximum voluntary mouth opening and pain index scores. The secondary outcome variable was joint sounds. All outcome variables were assessed and compared among the three groups at baseline and at 1-, 3-, 6-, and 12-month intervals. Other variables, including patients’ age and sex, were evaluated in relation to the patient outcomes. Injecting PRP+HA showed statistically significant improvement in the primary and secondary treatment outcomes over PRP or HA injection throughout the study period (P<0.005). Injection of PRP+HA following arthrocentesis had significant long-term clinical efficacy regarding pain relief that was considered the main concern of both the patient and clinician.

Keywords: TMJ, HA, PRP, osteoarthritis

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Authors: Bong-Su Sin, Jong-Kyu Kim, Se-Il Song, Kwon-Hee Lee

Abstract:

An automobile ball joint is a pivoting element used to allow rotational motion between the parts of the steering and suspension system. And it plays a role in smooth transmission of steering movement, also reduction in impact from the road surface. A ball joint is under various repeated loadings that may cause cracks and abrasion. This damages lead to safety problems of a car, as well as reducing the comfort of the driver's ride, and raise questions about the ball joint procedure and the whole durability of the suspension system. Accordingly, it is necessary to ensure the high durability and reliability of a ball joint. The structural responses of stiffness and pull-out strength were then calculated to check if the design satisfies the related requirements. The analysis was sequentially performed, following the caulking process. In this process, the deformation and stress results obtained from the analysis were saved. Sequential analysis has a strong advantage, in that it can be analyzed by considering the deformed shape and residual stress. The pull-out strength means the required force to pull the ball stud out from the ball joint assembly. The low pull-out strength can deteriorate the structural stability and safety performances. In this study, two design variables and two noise factors were set up. Two design variables were the diameter of a stud and the angle of a socket. And two noise factors were defined as the uncertainties of Young's modulus and yield stress of a seat. The DOE comprises 81 cases using these conditions. Robust design of a ball joint was performed using the DOE. The pull-out strength was generated from the uncertainties in the design variables and the design parameters. The purpose of robust design is to find the design with target response and smallest variation.

Keywords: ball joint, pull-out strength, robust design, design of experiments

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Authors: Radwa E. Sweif, Amira A. A. Abdallah

Abstract:

Background: Evaluation of gait efficiency is used to examine energy consumption especially in patients with movement disorders. Hypothesis/Purpose: This study compared the physiological and mechanical measures of gait efficiency between patients with ACL reconstruction (ACLR) and healthy controls and correlated among these measures. Methods: Seventeen patients with ACLR and sixteen healthy controls with mean ± SD age 23.06±4.76 vs 24.85±6.47 years, height 173.93±6.54 vs 175.64±7.37cm, and weight 74.25±12.1 vs 76.52±10.14 kg, respectively, participated in the study. The patients were operated on six months prior to testing. They should have completed their accelerated rehabilitation program during this period. A 3D motion analysis system was used for collecting the mechanical measures (Biomechanical Efficiency Quotient (BEQ), the maximum degree of knee internal rotation during stance phase and speed of walking). The physiological measures (Physiological Cost Index (PCI) and Rate of Perceived Exertion (RPE)) were collected after performing the 6- minute walking test. Results: MANOVA showed that the maximum degree of knee internal rotation, PCI, and RPE increased and the speed decreased significantly (p<0.05) in the patients compared with the controls with no significant difference for the BEQ. Finally, there were significant (p<0.05) positive correlations between each of the PCI & RPE and each of the BEQ, speed of walking and the maximum degree of knee internal rotation in each group. Conclusion: It was concluded that there are alterations in both mechanical and physiological measures of gait efficiency in patients with ACLR after being rehabilitated, clarifying the need for performing additional endurance as well as knee stability training programs. Moreover, the positive correlations indicate that using either of the mechanical or physiological measures for evaluating gait efficiency is acceptable.

Keywords: ACL reconstruction, mechanical, physiological, gait efficiency

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Authors: Mariam A. Abu-Alim

Abstract:

The purpose of this study was to validate muscle activation amplitudes of two field base dynamic balance tests that are used as strengthen and motor control exercises too in the activation of selected hip and knee stabilizer muscles. Methods: Eighteen college-age females students (21±2 years; 65.6± 8.7 kg; 169.7±8.1 cm) who participated at least for 30 minutes in physical activity most days of the week volunteered. The wireless BIOPAC (MP150, BIOPAC System. Inc, California, USA) surface electromyography system was used to validate the activation of the Gluteus Medius and the Adductor Magnus of hip stabilizer muscles; and the Hamstrings, Quadriceps, and the Gastrocnemius of the knee stabilizer muscles. Surface electrodes (EL 503, BIOPAC, System. Inc) connected to dual wireless EMG BioNormadix Transmitters were place on selected muscles of participants dominate side. Manual muscle testing was performed to obtain the maximal voluntary isometric contraction (MVIC) in which all collected muscle activity data during the three reaching direction: anterior, posteromedial, posterolateral of the Star Excursion Balance Test (SEBT) and the Y-balance Test (YBT) data could be normalized. All participants performed three trials for each reaching direction of the SEBT and the YBT. The domanial leg trial for each participant was selected for analysis which was also the standing leg. Results: the selected hip stabilizer muscles (Gluteus Medius, Adductor Magnus) were both greater than 100%MVIC during the performance of the SEBT and in all three directions. Whereas, selected knee stabilizer muscles had greater activation 0f 100% MVIC and were significantly more activated during the performance of the YBT test in all three reaching directions. The results showed that the posterolateral and the postmedial reaching directions for both dynamic balance tests had greater activation levels and greater than 200%MVIC for all tested muscles expect of the hamstrings. Conclusion: the results of this study showed that the SEBT and the YBT had validated high levels of muscular activity for the hip and the knee stabilizer muscles; which can be used to represent the improvement, strength, control and the decreasing in the injury levels. Since these selected hip and knee stabilizer muscles, represent 35% of all athletic injuries depending on the type of sport.

Keywords: dynamic balance tests, electromyography, hip stabilizer muscles, nee stabilizer muscles

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Authors: Yuri Seu, Seong-Kyu Choi, Hyun Jin Park, Jin Seo Park, HongtaeKim, Mi-Sun Hur

Abstract:

The aim of this study was to clarify the attachments of the distal oblique membrane (DOM) and distal oblique bundle (DOB) of the interosseous membrane of the forearm. The distal oblique membrane was investigated in the 21 specimens of 11 Korean cadavers. The muscles in the forearms were removed to observe the DOB. The DOB was found in 13 of 21 specimens (61.9 %). The DOB was attached to the distal radioulnar joint capsule and the septum between the tendons of the extensor digiti minimi (EDM) and extensor carpi ulnaris (ECU) as well as the radius and ulna. In the cases that the DOB was absent, a part of the DOM extended to the distal radioulnar joint capsule and the septum between the tendons of the EDM and ECU, as well as the radius and ulna in all specimens (100%). The DOM, including the DOB, was arranged obliquely in the anteroposterior direction, whereas the intermediate part of the interosseous membrane was arranged in the same plane between the radius and ulna. The extension of the DOM and DOB to the wrist region may stabilize the distal radioulnar joint during supination and pronation. These data will be useful when performing reconstructive surgeries.

Keywords: distal oblique membrane, distal oblique bundle, distal radioulnar joint capsule, interosseous membrane

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Authors: John Scanlon, Antony Raymond, Randeep Aujla, Peter D’Alessandro, Satyen Gohil

Abstract:

Background: The incidence of significant acute chondral injuries with patella dislocation is around 10-15%. It is accepted that chondral procedures should only be performed in the presence of joint stability Methods:Patients were identified from surgeon/hospital logs. Patient demographics, lesion size and location, surgical procedure, patient reported outcome measures, post-operative MR imaging, and complications were recorded. PROMs and patient satisfaction was obtained. Results:20 knees (18 patients) were included. Mean age was 18.6 years (range; 11-39), and the mean follow-up was 16.6 months (range; 2-70). The defect locations were the lateral femoral condyle (9/20; 45%), patella (9/20; 45%), medial femoral condyle (1/20; 5%) and the trochlea (1/20; 5%). The mean defect size was 2.6cm2. Twelve knees were treated with cartilage fixation, 5 with microfracture, and 3 with OATS. At follow up, the overall mean Lysholm score was 77.4 (± 17.1), with no chondral regenerative procedure being statistically superior. There was no difference in Lysholm scores between those patients having acute medial patellofemoral ligament reconstruction versus medial soft tissue plication (p=0.59). Five (25%) knees required re-operation (one arthroscopic arthrolysis; one patella chondroplasty; two removal of loose bodies; one implant adjustment). Overall, 90% responded as being satisfied with surgery. Conclusion: Our aggressive pathway to identify and treat acute cartilage defects with early operative intervention and patella stabilisation has shown high rates of satisfaction and Lysholm scores. The full range of chondral restoration options should be considered by surgeons managing these patients.

Keywords: patella dislocation, chondral restoration, knee, patella stabilisation

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Authors: Ayoade Adeyemi, Leo Nherera, Paul Trueman, Antje Emmermann

Abstract:

Background and objectives: Radiofrequency (RF) generated plasma chondroplasty is considered a promising treatment alternative to mechanical debridement (MD) with a shaver. The aim of the study was to perform a cost-effectiveness analysis comparing costs and outcomes following COBLATION chondroplasty versus mechanical debridement in patients with knee pain associated with a medial meniscus tear and idiopathic ICRS grade III focal lesion of the medial femoral condyle from a payer perspective. Methods: A decision-analytic model was developed comparing economic and clinical outcomes between the two treatment options in German patients following knee chondroplasty. Revision rates based on the frequency of repeat arthroscopy, osteotomy and conversion to total knee replacement, reimbursement costs and outcomes data over a 4-year time horizon were extracted from published literature. One-way sensitivity analyses were conducted to assess uncertainties around model parameters. Threshold analysis determined the revision rate at which model results change. All costs were reported in 2016 euros, future costs were discounted at a 3% annual rate. Results: Over a 4 year period, COBLATION chondroplasty resulted in an overall net saving cost of €461 due to a lower revision rate of 14% compared to 48% with MD. Threshold analysis showed that both options were associated with comparable costs if COBLATION revision rate was assumed to increase up to 23%. The initial procedure costs for COBLATION were higher compared to MD and outcome scores were significantly improved at 1 and 4 years post-operation versus MD. Conclusion: The analysis shows that COBLATION chondroplasty is a cost-effective option compared to mechanical debridement in the treatment of patients with a medial meniscus tear and idiopathic ICRS grade III defect of the medial femoral condyle.

Keywords: COBLATION, cost-effectiveness, knee chondroplasty, mechanical debridement

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Authors: Jeron Maheswaran, Sudath C. Siriwardane

Abstract:

In fatigue analysis, the structural detail of tubular joint has taken great attention among engineers. The DNV-RP-C203 is covering this topic quite well for simple and clear joint cases. For complex joint and geometry, where joint classification isn’t available and limitation on validity range of non-dimensional geometric parameters, the challenges become a fact among engineers. The classification of joint is important to carry out through the fatigue analysis. These joint configurations are identified by the connectivity and the load distribution of tubular joints. To overcome these problems to some extent, this paper compare the fatigue life of tubular joints in offshore jacket according to the stress concentration factors (SCF) in DNV-RP-C203 and finite element method employed Abaqus/CAE. The paper presents the geometric details, material properties and considered load history of the jacket structure. Describe the global structural analysis and identification of critical tubular joints for fatigue life estimation. Hence fatigue life is determined based on the guidelines provided by design codes. Fatigue analysis of tubular joints is conducted using finite element employed Abaqus/CAE [4] as next major step. Finally, obtained SCFs and fatigue lives are compared and their significances are discussed.

Keywords: fatigue life, stress-concentration factor, finite element analysis, offshore jacket structure

Procedia PDF Downloads 453