Search results for: knee joint injury

Authors: Pagadaplly Girish, P. V. Manohar

Abstract:

Introduction: Management of distal femur fractures is challenging. Recently, treatment has evolved towards indirect reduction and minimally invasive techniques. Objectives: To assess the fracture union and functional outcome following open reduction and internal fixation of distal femur fractures with locking compression plate and to achieve restoration of the anatomical alignment of fracture fragments and stable internal fixation. Methodology: Patients with distal femur fracture treated by locking compression during Oct 2011 to April 2013 were assessed prospectively. Patients below 18 years and those with neuro-vascular deficits were excluded. Age, sex of the patient, type of fracture, mechanism of injury, type of implant used, operative time and postoperative complications were analysed. The Neer’s scale was used to assess the outcome of the patients. Results: The total number of patients was 30; 28 males and 2 females; mean age was 41.53 years. Road traffic accidents were the major causes of injury followed by falls. The average duration of hospital stay was 21.3 days. The overall complication rate note was 23.33%. The mean range of movement around the knee joint after 6 months of follow-up was 114.330. The average time for the radiological union was 14 weeks. Excellent to good results were noted in 26 patients (86.6%) and average to poor results were observed in 4 (13.33%) patients. Conclusions: The locking compression plate gives a rigid fixation for the fracture. It also provides a good purchase in osteoporotic bones. LCP is simple and a reliable implant appropriate for fixation of femoral fractures with promising results.

Keywords: distal femur fractures, locking compression plate, Neer’s criteria, neuro-vascular deficits

Procedia PDF Downloads 219

Authors: Nayeli Camacho, Fernanda Lara-Perez, Carolina Ortega-Portilla, Diego G. Espinosa-Arbelaez, Juan M. Alvarado-Orozco, Guillermo C. Mondragon-Rodriguez

Abstract:

Ultra-high molecular weight polyethylene (UHMWPE) has been the gold standard material for total knee replacements for almost five decades. Wear damage to UHMWPE articulating surface is inevitable due to the natural sliding and rolling movements of the knee. This generates a considerable amount of wear debris, which results in mechanical instability of the joint, reduces joint mobility, increases pain with detrimental biologic responses, and causes component loosening. The presence of wear particles has been closely related to adverse reactions in the knee joint surrounding tissue, especially for particles in the range of 0.3 to 2 μm. Carbon-based materials possess excellent mechanical properties and have shown great promise in tribological applications. In this study, diamond-like carbon coatings (DLC) and carbon nanotubes (CNTs) were used to decrease the wear rate of ultra-high molecular weight polyethylene. A titanium doped DLC (Ti-DLC) was deposited by magnetron sputtering on stainless steel precision spheres while CNTs were used as a second phase reinforcement in UHMWPE at a concentration of 1.25 wt.%. A comparative tribological analysis of the wear of UHMWPE and UHMWPE-CNTs with a stainless steel counterpart with and without Ti-DLC coating is presented. The experimental wear testing was performed on a pin-on-disc tribometer under dry conditions, using a reciprocating movement with a load of 1 N at a frequency of 2 Hz for 100,000 and 200,000 cycles. The wear tracks were analyzed with high-resolution scanning electron microscopy to determine wear modes and observe the size and shape of the wear debris. Furthermore, profilometry was used to study the depth of the wear tracks and to map the wear of the articulating surface. The wear tracks at 100,000 and 200,000 cycles on all samples were relatively shallow, and they were in the range of average roughness. It was observed that the Ti-DLC coating decreases the mass loss in the UHMWPE and the depth of the wear track. The combination of both carbon-based materials decreased the material loss compared to the system of stainless steel and UHMWPE. Burnishing of the surface was the predominant wear mode observed with all the systems, more subtle for the systems with Ti-DLC coatings. Meanwhile, in the system composed of stainless steel-UHMWPE, the intrinsic surface roughness of the material was completely replaced by the wear tracks.

Keywords: CNT reinforcement, self-lubricating materials, Ti-DLC, UHMWPE tribological performance

Procedia PDF Downloads 89

Authors: Chungyu Chen, Hui-Ju Chang, Pei-Shan Guo, Huei-Ling Jhan, Yi-Ping Lin

Abstract:

The purpose of this study was to investigate the effect of the amount of acutely static stretching on muscular strength and power. There were 15 males, and 7 females recruited voluntarily as the participants in the study. The mean age, body height, and weight of participants were 23.4 ± 2.8 years old, 171.0 ± 7.2 cm, and 65.7 ± 8.7 kg, respectively. Participants were repeated to stretch hamstring muscles 2 or 6 30-s bouts randomly on a separate day spaced 5-7 days apart in a passive, static, sit-and-reach stretching exercise. Before and after acutely static stretching, the Biodex System 4 Pro was used to acquire the peak torque, power, total work, and range of motion for right knee under the loading of 180 deg/s. The 2 (test-retest) × 2 (number of stretches) repeated measures two-way analysis of variance were used to compare the parameters of muscular strength/power (α = .05). The results showed that the peak torque, power, and total work increased significantly after acutely passive static stretching (ps < .05) in flexor and extensor of knee. But there were no significant differences found between the 2 and 6 30-s bouts hamstring muscles stretching (ps > .05). It indicated that the performance of muscular strength and power in knee flexion and extension do not inhibit following the increase of amount of stretching.

Keywords: knee, power, flexibility, strength

Procedia PDF Downloads 252

Authors: A. L. I. Prasanna, E. Liyanage, S. A. Rajaratne, K. P. A. P. Kariyawasam, A. A. J. Rajaratne

Abstract:

Maintaining or improving the muscle strength of the injured body part is essential to optimize performance among disabled athletes. General conditioning and strengthening exercises might be ineffective if not sufficiently intense enough or targeted for each participant’s specific impairment. Specific strengthening programme, targeted to the affected body part, are essential to improve the strength of impaired muscles and increase in strength will help reducing the impact of disability. Methods: The muscle strength of hip, knee and ankle joints was assessed in a group of randomly selected disabled athletes, using the Medical Research Council (MRC) grading. Those having muscle strength of grade 4 or less were selected for this study (24 in number) and were given and a custom made exercise program designed to strengthen their hip, knee or ankle joint musculature, according to the muscle or group of muscles affected. Effectiveness of the strengthening program was assessed after a period of 3 months. Results: Statistical analysis was done using the Minitab 16 statistical software. A Mann-Whitney U test was used to compare the strength of muscle group before and after exercise programme. A significant difference was observed after the three month strengthening program for knee flexors (Left and Right) (P =0.0889, 0.0312) hip flexors (left and right) (P=0.0312, 0.0466), hip extensors (Left and Right) (P=0.0478, 0.0513), ankle plantar flexors (Left and Right) (P=0.0466, 0.0423) and right ankle dorsiflexors (P= 0.0337). No significant difference of strength was observed after the strengthening program in the knee extensors (left and right), hip abductors (left and right) and left ankle dorsiflexors. Conclusion: Impairment specific exercise programme appear to be beneficial for disabled athletes to significantly improve the muscle strength of the affected joints.

Keywords: muscle strengthening programme, disabled athletes, physiotherapy, rehabilitation sciences

Procedia PDF Downloads 325

Authors: Kebret Kebede, Anthony Scinta

Abstract:

Obesity is the most prevalent global problem that continues to rise at alarming rates both in the industrialized and developing countries. Adipose tissue is an endocrine tissue that secretes numerous chemical signals, hormones, lipids, cytokines and coagulation factors as well as prompting insulin resistance which is a primary contributor to Type II Diabetes- one of its most common adverse effects on health. Other hormones whose levels are linked to obesity and nutritional state are leptin, IGF-1, and adiponectin. Several studies indicate that obesity is the leading cause of high levels of cholesterol that leads to fatty liver disease, gallstones, hypertension, increased risk for cancer and degenerative joint disease that primarily affects the weight bearing joints of the lower extremities. The activation of inflammatory pathways promotes synovial pathology that results in accelerated degeneration of the joints. The study examines the prevalence of obesity in the US female population in comparison to that of the developing world and its emergence as a significant and potentially modifiable risk factor in degenerative disease of the hip and knee joints that has resulted in staggering healthcare cost. Studies have shown that as the prevalence of obesity rises, we continue to see a rise in degenerative joint disease. The percentage of arthritis cases linked directly to obesity has risen from 3 percent in 1971 to 18 percent in 2002. A person with obesity is around 60 percent more likely to develop arthritis than someone of normal body weight. In women, obesity is associated with increased mortality from breast, cervical, endometrial and ovarian cancer that may accompany debilitating joint diseases and restricted mobility.

Keywords: obesity, endocrine, degenerative, mortality, joint diseases, cancer, debilitating, mobility

Procedia PDF Downloads 410

Authors: Vignesh Ratnaraj, Daniel Marascia, Kelly Ruecker

Abstract:

Purpose: Pulmonary embolism (PE) is a major cause of morbidity and mortality in trauma patients. Data suggests PE is occurring earlier in trauma patients, with attention being turned to possible de novo events. Here, we examine the incidence of early PE at a level 1 trauma center and examine the relationship with a chest injury. Method: A retrospective analysis was performed from a prospective trauma registry at a level 1 trauma center. All patients admitted from 1 January 2010 to 30 June 2019 diagnosed with PE following trauma were included. Early PE was considered a diagnosis within 72 hours of admission. The severity of the chest injury was determined by the Abbreviated Injury Score (AIS). Analysis of severe chest injury and incidence of early PE was performed using chi-square analysis. Sub-analysis on the timing of PE and PE location was also performed using chi-square analysis. Results: Chest injury was present in 125 of 184 patients diagnosed with PE. Early PE occurred in 28% (n=35) of patients with a chest injury, including 24.39% (n=10) with a severe chest injury. Neither chest injury nor severe chest injury determined the presence of early PE (p= > 0.05). Sub-analysis showed a trend toward central clots in early PE (37.14%, n=13) compared to late (27.78%, n=25); however, this was not found to be significant (p= > 0.05). Conclusion: PE occurs early in trauma patients, with almost one-third being diagnosed before 72 hours. This analysis does not support the paradigm that chest injury, nor severe chest injury, results in statistically significant higher rates of early PE. Interestingly, a trend toward early central PE was noted in those suffering chest trauma.

Keywords: trauma, PE, chest injury, anticoagulation

Procedia PDF Downloads 74

Authors: Fadi Al Khatib, Raouf Mbarki, Malek Adouni

Abstract:

In various sport and recreational activities, the patellofemoral joint undergoes large forces and moments while accommodating the significant knee joint movement. In doing so, this joint is commonly the source of anterior knee pain related to instability in normal patellar tracking and excessive pressure syndrome. One well-observed explanation of the instability of the normal patellar tracking is the patellofemoral ligaments and patellar tendon damage. Improved knowledge of the damage mechanism mediating ligaments and tendon injuries can be a great help not only in rehabilitation and prevention procedures but also in the design of better reconstruction systems in the management of knee joint disorders. This damage mechanism, specifically due to excessive mechanical loading, has been linked to the micro level of the fibred structure precisely to the tropocollagen molecules and their connection density. We argue defining a clear frame starting from the bottom (micro level) to up (macro level) in the hierarchies of the soft tissue may elucidate the essential underpinning on the state of the ligaments damage. To do so, in this study a multiscale fibril reinforced hyper elastoplastic Finite Element model that accounts for the synergy between molecular and continuum syntheses was developed to determine the short-term stresses/strains patellofemoral ligaments and tendon response. The plasticity of the proposed model is associated only with the uniaxial deformation of the collagen fibril. The yield strength of the fibril is a function of the cross-link density between tropocollagen molecules, defined here by a density function. This function obtained through a Coarse-graining procedure linking nanoscale collagen features and the tissue level materials properties using molecular dynamics simulations. The hierarchies of the soft tissues were implemented using the rule of mixtures. Thereafter, the model was calibrated using a statistical calibration procedure. The model then implemented into a real structure of patellofemoral ligaments and patellar tendon (OpenKnee) and simulated under realistic loading conditions. With the calibrated material parameters the calculated axial stress lies well with the experimental measurement with a coefficient of determination (R2) equal to 0.91 and 0.92 for the patellofemoral ligaments and the patellar tendon respectively. The ‘best’ prediction of the yielding strength and strain as compared with the reported experimental data yielded when the cross-link density between the tropocollagen molecule of the fibril equal to 5.5 ± 0.5 (patellofemoral ligaments) and 12 (patellar tendon). Damage initiation of the patellofemoral ligaments was located at the femoral insertions while the damage of the patellar tendon happened in the middle of the structure. These predicted finding showed a meaningful correlation between the cross-link density of the tropocollagen molecules and the stiffness of the connective tissues of the extensor mechanism. Also, damage initiation and propagation were documented with this model, which were in satisfactory agreement with earlier observation. To the best of our knowledge, this is the first attempt to model ligaments from the bottom up, predicted depending to the tropocollagen cross-link density. This approach appears more meaningful towards a realistic simulation of a damaging process or repair attempt compared with certain published studies.

Keywords: tropocollagen, multiscale model, fibrils, knee ligaments

Procedia PDF Downloads 102

Authors: Kai Way Li, Lang Gan

Abstract:

Slip &Fall are common in Taiwan. They could result in injuries and even fatalities. Official statistics indicate that more than 15% of all occupational incidences were slip/fall related. All the workers in Taiwan are required by the law to join the worker’s insurance program administered by the Bureau of Labor Insurance (BLI). The BLI is a government agency under the supervision of the Ministry of Labor. Workers claim with the BLI for insurance compensations when they suffer fatalities or injuries at work. Injuries statistics based on worker’s compensation claims were rarely studied. The objective of this study was to quantify the injury statistics and financial cost due to slip-fall incidences based on the BLI compensation records. Compensation records in the BLI during 2007 to 2013 were retrieved. All the original application forms, approval opinions, results for worker’s compensations were in hardcopy and were stored in the BLI warehouses. Xerox copies of the claims, excluding the personal information of the applicants (or the victim if passed away), were obtained. The content in the filing forms were coded in an Excel worksheet for further analyses. Descriptive statistics were performed to analyze the data. There were a total of 35,024 claims including 82 deaths, 878 disabilities, and 34,064 injuries/illnesses which were slip/fall related. It was found that the average losses for the death cases were 40 months. The total dollar amount for these cases paid was 86,913,195 NTD. For the disability cases, the average losses were 367.36 days. The total dollar amount for these cases paid was almost 2.6 times of those for the death cases (233,324,004 NTD). For the injury/illness cases, the average losses for the illness cases were 58.78 days. The total dollar amount for these cases paid was approximately 13 times of those of the death cases (1134,850,821 NTD). For the applicants/victims, 52.3% were males. There were more males than females for the deaths, disability, and injury/illness cases. Most (57.8%) of the female victims were between 45 to 59 years old. Most of the male victims (62.6%) were, on the other hand, between 25 to 39 years old. Most of the victims were in manufacturing industry (26.41%), next the construction industry (22.20%), and next the retail industry (13.69%). For the fatality cases, head injury was the main problem for immediate or eventual death (74.4%). For the disability case, foot (17.46%) and knee (9.05%) injuries were the leading problems. The compensation claims other than fatality and disability were mainly associated with injuries of the foot (18%), hand (12.87%), knee (10.42%), back (8.83%), and shoulder (6.77%). The slip/fall cases studied indicate that the ratios among the death, disability, and injury/illness counts were 1:10:415. The ratios of dollar amount paid by the BLI for the three categories were 1:2.6:13. Such results indicate the significance of slip-fall incidences resulting in different severity. Such information should be incorporated in to slip-fall prevention program in industry.

Keywords: epidemiology, slip and fall, social burden, workers’ compensation

Procedia PDF Downloads 302

Authors: Amiel Satvedi, Richard Pyne

Abstract:

Injuries in professional sports occur on a regular basis. Some may be minor, while others can cause huge impact on a player's career and earning potential. In soccer, there is a high risk of players picking up injuries during game time. This research work seeks to help soccer players reduce the risk of getting injured by predicting the likelihood of injury while playing in the near future and then providing recommendations for intervention. The injury prediction tool will use a soccer player's number of minutes played on the field, number of appearances, distance covered and performance data for the current and previous seasons as variables to conduct statistical analysis and provide injury predictive results using a machine learning linear regression model.

Keywords: injury predictor, soccer injury prevention, machine learning in soccer, big data in soccer

Procedia PDF Downloads 146

Authors: Li Xu, Yang Hong, T. Zhao Wen

Abstract:

Experimental results of many RC beam-column subassemblage indicate that slippage of longitudinal beam rebar within the joint and the shear deformation of joint core have significant influence on seismic behavior of the subassemblage. However, rigid joint assumption has been generally used in the seismic response analysis of RC frames, in which two kinds of inelastic deformation of joint have been ignored. Based on OpenSees platform, ‘Super Joint Element Model’ with more detailed inelastic mechanism is used to simulate the inelastic response of joints. Two finite element models of typical RC plane frame, namely considering or ignoring the inelastic deformation of joint respectively, were established and analyzed under seven strong earthquake waves. The simulated global and local inelastic deformations of the RC plane frame is shown and discussed. The analyses also confirm the security of the earthquake-resistant frame designed according to Chinese codes.

Keywords: frame structure, beam-column joint, longitudinal bar slippage, shear deformation, nonlinear analysis

Procedia PDF Downloads 383

Authors: Binnur Sagbas

Abstract:

Artificial joint replacements such as total knee and total hip prosthesis have been applied to the patients who affected by osteoarthritis. Although different material combinations are used for these joints, biopolymers are most commonly preferred materials especially for acetabular cup and tibial component of hip and knee joints respectively. The main limitation that shortens the service life of these prostheses is wear. Wear is complicated phenomena and it must be considered with friction and lubrication. In this study, micro wave (MW) induced argon+oxygen plasma surface modification were applied on ultra-high molecular weight polyethylene (UHMWPE) and vitamin E blended UHMWPE (VE-UHMWPE) biopolymer surfaces to improve surface wettability and wear resistance of the surfaces. Contact angel measurement method was used for determination of wettability. Ball-on-disc wear test was applied under 25% bovine serum lubrication conditions. The results show that surface wettability and wear resistance of both material samples were increased by plasma surface modification.

Keywords: artificial joints, plasma surface modification, UHMWPE, vitamin E, wear

Procedia PDF Downloads 275

Authors: Sangbaek Park, Seungju Lee, Soo-Won Chae

Abstract:

Unstable shoes are known to strengthen lower extremity muscles and improve gait ability and to change the user’s gait pattern. The change in gait pattern affects human body enormously because the walking is repetitive and steady locomotion in daily life. It is possible to estimate the joint motion including joint moment, force and inertia effect using kinematic and kinetic analysis. However, the change of internal stress at the articular cartilage has not been possible to estimate. The purpose of this research is to evaluate the internal stress of human body during gait with unstable shoes. In this study, FE analysis was combined with motion capture experiment to obtain the boundary condition and loading condition during walking. Motion capture experiments were performed with a participant during walking with normal shoes and with unstable shoes. Inverse kinematics and inverse kinetic analysis was performed with OpenSim. The joint angle and muscle forces were estimated as results of inverse kinematics and kinetics analysis. A detailed finite element (FE) lower extremity model was constructed. The joint coordinate system was added to the FE model and the joint coordinate system was coincided with OpenSim model’s coordinate system. Finally, the joint angles at each phase of gait were used to transform the FE model’s posture according to actual posture from motion capture. The FE model was transformed into the postures of three major phases (1st peak of ground reaction force, mid stance and 2nd peak of ground reaction force). The direction and magnitude of muscle force were estimated by OpenSim and were applied to the FE model’s attachment point of each muscle. Then FE analysis was performed to compare the stress at knee cartilage during gait with normal shoes and unstable shoes.

Keywords: finite element analysis, gait analysis, human model, motion capture

Procedia PDF Downloads 296

Authors: N. Ahmadi, H. Yousefnia, A. Bahrami-Samani

Abstract:

Chitosan is a natural and biodegradable polysaccharide with special characteristic for application in intracavital therapy. 166Ho-chitosan has been reported for the treatment of hepatocellular carcinoma and RSV with promising results. The aim of this study was to prepare 186/188Re-chitosan for radiosynovectomy purposes and investigate the probability of its leakage from the knee joint. 186/188Re was produced by neutron irradiation of the natural rhenium in a research reactor. Chemical processing was performed to obtain (186/188Re)-NaReO4- according to the IAEA manual. A stock solution of chitosan was prepared by dissolving in 1 % acetic acid aqueous solution (10 mg/mL). 1.5 mL of this stock solution was added to the vial containing the activity and the mixture was stirred for 5 min in the room temperature. The radiochemical purity of the complex was checked by the ITLC method, showing the purity of higher than 98%. Distribution of the radiolabeled complex was determined after intra-articular injection into the knees of rats. Excellent retention was observed in the joint with approximately no activity in the other organs.

Keywords: chitosan, leakage, radiosynovectomy, rhenium

Procedia PDF Downloads 311

Authors: Duvert A. Puentes T., Javier A. Maldonado E., Ivan Quintero., Diego F. Villegas

Abstract:

Mechanical Computation is a great tool to study the performance of complex models. An example of it is the study of the human body structure. This paper took advantage of different types of software to make a 3D model of the glenohumeral joint and apply a finite element analysis. The main objective was to study the change in the biomechanical properties of the joint when it presents an injury. Specifically, a BANKART lesion, which consists in the detachment of the anteroinferior labrum from the glenoid. Stress and strain distribution of the soft tissues were the focus of this study. First, a 3D model was made of a joint without any pathology, as a control sample, using segmentation software for the bones with the support of medical imagery and a cadaveric model to represent the soft tissue. The joint was built to simulate a compression and external rotation test using CAD to prepare the model in the adequate position. When the healthy model was finished, it was submitted to a finite element analysis and the results were validated with experimental model data. With the validated model, it was sensitized to obtain the best mesh measurement. Finally, the geometry of the 3D model was changed to imitate a BANKART lesion. Then, the contact zone of the glenoid with the labrum was slightly separated simulating a tissue detachment. With this new geometry, the finite element analysis was applied again, and the results were compared with the control sample created initially. With the data gathered, this study can be used to improve understanding of the labrum tears. Nevertheless, it is important to remember that the computational analysis are approximations and the initial data was taken from an in vitro assay.

Keywords: biomechanics, computational model, finite elements, glenohumeral joint, bankart lesion, labrum

Procedia PDF Downloads 129

Authors: Mawuli M. Sedegah, Emmanuel O. Sarpong, Ernest Y. Acheampong

Abstract:

Sports injuries among student-athletes in high schools have become prevalent in most developing countries. The study explores the risk factors influencing sports injuries and identify those sustained among high schools’ competitions in the Akuapem Municipality. Drawing on literature from sports injuries, 610 student-athletes were used to understand how they sustained various injuries during schools’ sports and games. Using a cross-sectional survey, the study reveals how wounds, knee injury, muscle cramps, and thigh injury are common injuries in the municipality. The physiological factor was rampant, resulting from the number of games played by student-athletes, which significantly influenced sprain, strain, dislocation, and nose bleeding injuries among them. Results recorded a low correlation accounting for 9% occurrence of sports injuries in the Akuapem Municipality. Further study can be done in the other districts to have a general approach to remedy some of these sports injuries.

Keywords: common injuries, physiological factors, sports injuries, student-athletes

Procedia PDF Downloads 131

Authors: Didem Venus Yildiz, Murat Hocaoglu, Murat Dursun, Taner Akkan

Abstract:

The shoulder joint is a more complex structure than the hip or knee joints. In addition to the overall complexity of the shoulder joint, two different factors influence the insufficient outcome of shoulder replacement: the shoulder prosthesis design is far from fully developed and it is difficult to place these shoulder prosthesis due to shoulder anatomy. The glenohumeral joint is the most complex joint of the human shoulder. There are various treatments for shoulder failures such as total shoulder arthroplasty, reverse total shoulder arthroplasty. Due to its reverse design than normal shoulder anatomy, reverse total shoulder arthroplasty has different physiological and biomechanical properties. Post-operative achievement of this arthroplasty is depend on improved design of reverse total shoulder prosthesis. Designation achievement can be increased by several biomechanical and computational analysis. In this study, data of human both shoulders with right side fracture was collected by 3D Computer Tomography (CT) machine in dicom format. This data transferred to 3D medical image processing software (Mimics Materilise, Leuven, Belgium) to reconstruct patient’s left and right shoulders’ bones geometry. Provided 3D geometry model of the fractured shoulder was used to constitute of reverse total shoulder prosthesis by 3-matic software. Finite element (FE) analysis was conducted for comparison of intact shoulder and prosthetic shoulder in terms of stress distribution and displacements. Body weight physiological reaction force of 800 N loads was applied. Resultant values of FE analysis was compared for both shoulders. The analysis of the performance of the reverse shoulder prosthesis could enhance the knowledge of the prosthetic design.

Keywords: reverse shoulder prosthesis, biomechanics, finite element analysis, 3D printing

Procedia PDF Downloads 131

Authors: Pedro Ferraz-Gameiro

Abstract:

Introduction: The Pellegrini-Stieda lesion is the result of post-traumatic calcification and/or ossification on the medial collateral ligament (MCL) of the knee. When this calcification is accompanied by gonalgia and limitation of knee flexion, it is called Pellegrini-Stieda syndrome. The pathogenesis is probably the calcification of a post-traumatic hematoma at least three weeks after the initial trauma or secondary to repetitive microtrauma. On anteroposterior radiographs, a Pellegrini-Stieda lesion is a linear vertical ossification or calcification of the proximal portion of the MCL and usually near the medial femoral condyle. Patients with Pellegrini-Stieda syndrome present knee pain associated with loss of range of motion. The treatment is usually conservative with analgesic and anti-inflammatory drugs, either systemic or intra-articular. Physical medicine and rehabilitation techniques associated with shock wave therapy can be a way of reduction of pain/inflammation. Patients who maintain instability with significant limitation of knee mobility may require surgical excision. Methods: Research was done using PubMed central using the terms Pellegrini-Stieda syndrome. Discussion/conclusion: Medical treatment is the rule, with initial rest, anti-inflammatory, and physiotherapy. If left untreated, this ossification can potentially form a significant bone mass, which can compromise the range of motion of the knee. Physical medicine and rehabilitation techniques associated with shock wave therapy are a way of reduction of pain/inflammation.

Keywords: knee, Pellegrini-Stieda syndrome, rehabilitation, shock waves therapy

Procedia PDF Downloads 105

Authors: Vu Hoang Thu Huong

Abstract:

Background and Purpose: The effects of Extracorporeal Shockwave Therapy (ESWT) in the participants with knee osteoarthritis (KOA) were unclear on physical performance although its effects on pain had been investiagted. This study aims to explore the effects of ESWT on pain relief and physical performance on KOA. Methods: The studies with the randomized controlled design to investigate the effects of ESWT on KOA were systematically searched using inclusion and exclusion criteria through seven electronic databases including Pubmed etc. between 1990 and Dec 2022. To summarize those data, visual analog scale (VAS) or pain scores were determined for measure of pain intensity. Range of knee motion, or the scores of physical activities including Lequesne index (LI), Knee Injury and Osteoarthritis Outcome Score (KOOS), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were determined for measure of physical performances. The first evaluate after treatment period was define as the effect of post-treatment period or immediately effect; and the last evaluate was defined as the effect of following period or the end effect in our study. Data analysis was performed using RevMan 5.4.1 software. A significant level was set at p<0.05. Results: Eight studies (number of participant= 499) reporting the ESWT effects on mild-to-moderate severity (Grades I to III Kellgren–Lawrence) of KOA were qualified for meta-analysis. Compared with sham or placebo group, the ESWT group had a significant decrease of VAS rest score (0.90[0.12~1.67] as mean difference [95% confidence interval]) and pain score WOMAC (2.49[1.22~3.76]), and a significant improvement of physical performance with a decrease of the scores of WOMAC activities (8.18[3.97~12.39]), LI (3.47[1.68~5.26]), and KOOS (5.87[1.73~ 10.00]) in the post-treatment period. There were also a significant decrease of WOMAC pain score (2.83[2.12~3.53]) and a significant decrease of the scores of WOMAC activities (9.47[7.65~11.28]) and LI (4.12[2.34 to 5.89]) in the following period. Besides, compared with other treatment groups, ESWT also displayed the improvement in pain and physical performance, but it is not significant. Conclusions: The ESWT was effective and valuable method in pain relief as well as in improving physical activities in the participants with mild-to-moderate KOA. Clinical Relevance: There are the effects of ESWT on pain relief and the improvement of physical performance in the with KOA.

Keywords: knee osteoarthritis, extracorporeal shockwave therapy, pain relief, physical performance, shockwave

Procedia PDF Downloads 52

Authors: Katarzyna Kamińska

Abstract:

Joint physical custody means that both parents after divorce or separation have the right and responsibility to take care of the child on the daily basis. In a joint physical custody arrangement, the child spends substantial, but not necessarily equal, time with both parents. Joint physical custody can be symmetric care arrangement or not. However, it is accepted in the jurisprudence that the best interests of the child is served when the child spends at least 35% of the time during a two-week period with each parent. Joint physical custody, also known as joint, dual, or shared residence, is a challenge in contemporary family law. It has its supporters and opponents. On the one hand, joint physical custody is beneficial because it provides children with frequent and continuous contact with a mother and father after their divorce or separation. On the other hand, it isn’t good for children to be shuttled back and forth between two residences. Children need a home base. The conclusion is therefore that joint physical custody can’t be seen as a panacea for all post-divorce or post-separation parenting cases and the court shouldn’t automatically make such a determination. The possibility to award this arrangement requires the court to carefully weigh the pros and cons of each individual case. It is difficult to say that joint physical custody is better than single physical custody in any case. It depends on the circumstances and needs of each family. It appears that an individual approach is going to be much better as opposed to a one-size-fits-all idea.

Keywords: joint physical custody, shared residence, dual residence, the best interests of the child

Procedia PDF Downloads 57

Authors: Luna Sequier, Florian Forelli, Maude Traulle, Amaury Vandebrouck, Pascal Duffiet, Louis Ratte, Jean Mazeas

Abstract:

The study's objective is to compare the muscular activity of the flexor knee muscle in patients who underwent an anterior cruciate ligament reconstruction with hamstring autograft and the individuals who have not undergone surgery. Methods: The participants were divided into two groups: a healthy group and an experimental group who had undergone an anterior cruciate ligament reconstruction with a hamstring graft. All participants had to perform a knee flexion strength test on an isokinetic dynamometer. The medial Gastrocnemius, lateral Gastrocnemius, Biceps femoris, and medial Hamstring muscle activity were measured during this test. Each group’s mean muscle activity was tested with statistical analysis, and a muscle activity ratio of gastrocnemius and hamstring muscles was calculated Results: The results showed a significant difference in activity of the medial gastrocnemius (p = 0,004901), the biceps femoris (p = 5,394.10-6), and the semitendinosus muscles (p = 1,822.10-6), with a higher Biceps femoris and Semitendinosus activity for the experimental group. It is however noticeable that inter-subject differences were important. Conclusion: This study has shown a difference in the gastrocnemius and hamstring muscle activity between patients who underwent an anterior cruciate ligament reconstruction surgery and healthy participants. With further results, this could show a modification of muscle activity patterns after surgery which could lead to compensatory behaviors at a return to sport and eventually explain a higher injury risk for our patients.

Keywords: anterior cruciate ligament, electromyography, muscle activity, physiotherapy

Procedia PDF Downloads 213

Authors: Arash Sharafat Vaziri, Leila Aghaghazvini, Soodeh Jahangiri, Mohammad Tahami, Roham Borazjani, Mohammad Naghi Tahmasebi, Hamid Rabie, Hesan Jelodari Mamaghani, Fardis Vosoughi, Maryam Salimi

Abstract:

Aims: It is essential to know the normal extrusion measures in order to detect pathological ones. In this study, we aimed to define some normal reference values for meniscal extrusion in the normal knees during different ranges of motion. Methods: The amount of anterior and posterior portion of meniscal extrusion among twenty-one asymptomatic volunteers (42 knees) were tracked at 0, 45, and 90 degrees of knee flexion using an ultrasound machine. The repeated measures analysis of variance (ANOVA) was used to show the interaction between the amounts of meniscal extrusion and the different degrees of knee flexion. Result: The anterior portion of the lateral menisci at full knee extension (0.59±1.40) and the posterior portion of the medial menisci during 90° flexion (3.06±2.36) showed the smallest and the highest mean amount of extrusion, respectively. The normal average amounts of anterior extrusion were 1.12± 1.17 mm and 0.99± 1.34 mm for medial and lateral menisci, respectively. The posterior meniscal normal extrusions were significantly increasing in both medial and lateral menisci during the survey (F= 20.250 and 11.298; both P-values< 0.001) as they were measured at 2.37± 2.16 mm and 1.53± 2.18 mm in order. Conclusion: The medial meniscus can extrude 1.74± 1.84 mm normally, while this amount was 1.26± 1.82 mm for the lateral meniscus. These measures commonly increased with the rising of knee flexion motion. Likewise, the posterior portion showed more extrusion than the anterior portion on both sides. These measures commonly increased with higher knee flexion.

Keywords: meniscal extrusion, ultrasonography, knee

Procedia PDF Downloads 68

Authors: Liuyu Zhang, Di Mo, Qiang Yan, Min Liu

Abstract:

As the important equipment in the construction field, cuplock scaffold plays an important role in the construction process. As a scaffold connecting member, cuplock joint is of great importance. In order to explore the rotational stiffness nonlinear characteristics changing features of different structural forms of cuplock joint in different tightening torque condition under different conditions of load, ANSYS is used to establish four kinds of cuplock joint models with different forces to simulate the real force situation. By setting the different load conditions which means the cuplock is loaded at a certain distance from the cuplock joint in a certain direction until the cuplock is damaged and considering the gap between the cross bar joint and the vertical bar, the differences in the influence of the structural form and tightening torque on the rotation stiffness of the cuplock under different load conditions are compared. It is significantly important to improve the accuracy of calculating bearing capacity and stability of the cuplock steel pipe scaffold.

Keywords: cuplock joint, highway tunnel, non-linear characteristics, rotational stiffness, scaffold stability, theoretical analysis

Procedia PDF Downloads 93

Authors: R. Gwynn, P. Panwalkar, K. Veravalli , M. Tofighi, R. Clement, A. Mofidi

Abstract:

The aim of this study was to access the impact of Covid-19 and lockdown on the incidence, injury pattern, and treatment of tibial plateau fractures in a combined rural and urban population in wales. Methods: Retrospective study was performed to identify tibial plateau fractures in 15-month period of Covid-19 lockdown 15-month period immediately before lockdown. Patient demographics, injury mechanism, injury severity (based on Schatzker classification), and associated injuries, treatment methods, and outcome of fractures in the Covid-19 period was studied. Results: The incidence oftibial plateau fracture was 9 per 100000 during Covid-19, and 8.5 per 100000, and both were similar to previous studies. The average age was 52, and female to male ratio was 1:1 in both control and study group. High energy injury was seen in only 20% of the patients and 35% in the control groups (2=12, p<0025). 14% of the covid-19 population sustained other injuries as opposed 16% in the control group(2=0.09, p>0.95). Lower severity isolated lateral condyle fracturesinjury (Schatzker 1-3) were seen in 40% of fractures this was 60% in the control populations. Higher bicondylar and shaft fractures (Schatzker 5-6) were seen in 60% of the Covid-19 group and 35% in the control groups(2=7.8, p<0.02). Treatment mode was not impacted by Covid-19. The complication rate was low in spite of higher number of complex fractures and the impact of covid-19 pandemic. Conclusion: The associated injuries were similar in spite of a significantly lower mechanism of injury. There were unexpectedly worst tibial plateau fracture based Schatzker classification in the Covid-19 period as compared to the control groups. This was especially relevant for medial condyle and shaft fractures. This was postulated to be caused by reduction in bone density caused by lack of vitamin D and reduction in activity. The treatment mode and outcome was not impacted by the impact of Covid-19 on care for tibial plateau fractures.

Keywords: Covid-19, knee, tibial plateau fracture, trauma

Procedia PDF Downloads 95

Authors: Katarzyna Kamińska

Abstract:

The main purpose of the work is to present the results of the studies regarding joint physical custody in the Polish legal system. The issues addressed fit into the ongoing process of modernising family law regulations and their adaptation to changing social reality in Poland. The Polish legislator now faces a dilemma: whether to introduce into Polish law a developed substantive or procedural regulation of joint physical custody and then whether it should be considered a legal presumption. Joint physical custody after divorce or separation is theoretically possible in Poland. It can either follow from the court’s independent proposal based on the assessment of the circumstances or from the parenting plan submitted by parents wishing to jointly retain full parental authority. However, joint physical custody does not result directly from the Polish Family and Guardianship Code. Therefore, there is real legal uncertainty in this matter, which leads to different treatment of citizens by the public authorities and courts. Another problem is that joint physical custody is misunderstood by the Polish courts. The main thesis of the work is that joint physical custody does not only mean the system of symmetrical child care (50/50), and the possibility to award joint physical custody will require the courts to carefully weigh the pros and cons of such an arrangement in each individual case.

Keywords: joint physical custody, shared parenting, divorce, separation, parental authority

Procedia PDF Downloads 42

Authors: Masoumeh Shojaei, Natalie Gedayloo, Amir Sarshin

Abstract:

The purpose of the present study was to investigate the effect of Isokinetic fatigue of muscles around the ankle, knee, and hip on the indicators of dynamic postural stability. Therefore, 15 female university students (age 19.7± 0.6 years old, weight 54.6± 9.4 kg, and height 163.9± 5.6 cm) participated in within-subjects design for 5 different days. In the first session, the postural stability indices (time to stabilization after jump-landing) without fatigue were assessed by force plate and in each next sessions, one of muscle groups of the lower limb including the muscles around ankles, knees, and hip was randomly exhausted by Biodex Isokinetic dynamometer and the indices were assessed immediately after the fatigue of each muscle group. The method involved landing on a force plate from a dynamic state, and transitioning balance into a static state. Results of ANOVA with repeated measures indicated that there was no significant difference between the time to stabilization (TTS) before and after Isokinetic fatigue of the muscles around the ankle, knee and hip in medial – lateral direction (p > 0.05), but in the anterior – posterior (AP) direction, the difference was statistically significant (p < 0.05). Least Significant Difference (LSD) post hoc test results also showed that there was significant difference between TTS in knee and hip muscles before and after isokinetic fatigue in AP direction. In the other hand knee and hip muscles group were affected by isokinetic fatigue only in AP surface (p < 0.05).

Keywords: dynamic balance, fatigue, lower limb muscles, postural control

Procedia PDF Downloads 208

Authors: E. Botchway, C. Godfrey, V. Anderson, C. Catroppa

Abstract:

Introduction: Sleep disturbances are common after childhood traumatic brain injury (TBI). This systematic review aimed to assess the prevalence, types, and predictors of sleep disturbances in childhood TBI. Methods: Medline, Pubmed, PsychInfo, Web of Science, and EMBASE databases were searched. Out of the 547 articles assessed, 15 met selection criteria for this review. Results: Sleep disturbances were common in children and adolescents with TBI, irrespective of injury severity. Excessive daytime sleepiness and insomnia were the most common sleep disturbances reported. Sleep disturbance was predicted by sex, injury severity, pre-existing sleep disturbances, younger age, pain, and high body mass index. Conclusions: Sleep disturbances are highly prevalent in childhood TBI, regardless of the injury severity. Routine assessment of sleep in survivors of childhood TBI is recommended.

Keywords: traumatic brain injury, sleep diatiurbances, childhood, systematic review

Procedia PDF Downloads 365

Authors: Xiao-Jing Zhu, Liang Zhou, Shi-Zhong Zheng

Abstract:

Various studies have shown that diallyl trisulfide (DATS) can protect the liver injury, and DATS has a strong antioxidant property. The aim of this study is to evaluate the in vivo role of DATS in protecting the liver against injury and fibrogenesis and further explores the underlying mechanisms. Our results demonstrated that DATS protected the liver from CCl4-caused injury by suppressing the elevation of ALT and AST activities, and by improving the histological architecture of the liver. Treatment with DATS or colchicine improved the liver fibrosis by sirius red staining and immunofluorescence. In addition, immunohistochemistry, western blot, and RT-PCR analyses indicated that DATS inhibited HSC activation. Furthermore, DATS attenuated oxidative stress by increasing glutathione and reducing lipid peroxides and malondialdehyde. These findings suggest that the protective effect of DATS on CCl4-caused liver injury and liver fibrogenesis was, at least partially, attributed to its antioxidant activity.

Keywords: liver fibrogenesis, liver injury, oxidative stress, DATS

Procedia PDF Downloads 399

Authors: B. A. Alwahaby

Abstract:

Background: The number of Total Knee Replacement (TKR) and Anterior Cruciate Ligament Reconstruction (ACLR) performed every year is increasing. The main aim of physiotherapy early recovery rehabilitation after these surgeries is to control pain and edema and regain Range of Motion (ROM) and physical activity. All of these outcomes need to be managed by safe and effective modalities. Kinesiotaping (KT) is an elastic non-invasive therapeutic tape that has become recognised in different physiotherapy situation as injury prevention, rehabilitation, and performance enhancement and been used with different conditions. However, there is still clinical doubt regarding the effectiveness of KT due to inconclusive supporting evidence. The aim of this systematic review is to collate all the available evidence on the effectiveness of KT in the early rehabilitation of ACLR and TKR patients and analyse whether the use of KT combined with standard rehabilitation would facilitate recovery of postoperative outcome than standard rehabilitation alone. Methodology: A systematic review was conducted. Medline, EMBASE, Scopus, AMED PEDro, CINAHL, and Web of Science databases were searched. Each study was assessed for inclusion and methodological quality appraisal was undertaken by two reviewers using the JBI critical appraisal tools. The studies were then synthesised qualitatively due to heterogeneity between studies. Results: Five moderate to low quality RCTs were located. All five studies demonstrated statistically significant improvements in pain, swelling, ROM, and functional outcomes (p < 0.05). Between group comparison, KT combined with standardised rehabilitation were shown to be significantly more effective than standardised rehabilitation alone for pain and swelling (p < 0.05). However, there were inconstant findings for ROM, and no statistically significant differences reported between groups for functional outcomes (p > 0.05). Conclusion: Research in the area is generally low quality; however, there is consistent evidence to support the use of KT combined with standardised post-operative rehabilitation for reducing pain and swelling. There is also some evidence that KT may be effective in combination with standardised rehabilitation to regain knee extension ROM faster than standardised rehabilitation alone, but further primary research is required to confirm this.

Keywords: anterior cruciate ligament reconstruction, ACLR, kinesio taping, KT, postoperative, total knee replacement, TKR

Procedia PDF Downloads 90

Authors: Taraneh Ashrafi Motlagh, Abdolrasoul Daneshjoo

Abstract:

Background and Aim: Increased fatigue causes injuries; the purpose of this article was to investigate the angular displacement of the hip and knee joints in girls with patellofemoral syndrome. Materials and Methods: Thirty girls with an average age (age 28.73±1.83, height 168.49±5.59, weight 63.73±12.73) participated in this study in two groups of 15, experimental and control. The jet evaluation test was taken from the subjects' knee and thigh angle, and then these tests were repeated with the application of different inclines of the treadmill; the tests were examined in a neutral position and in a positive and negative slope of 5 degrees. The mean and standard deviation were used to describe the data, and the Shapirovik test was used for the normalization of the data to compare and examine the variables in the two research groups using an independent t-test and repeated analysis of variance at a significance level of 0.05. Conclusion: In general, according to the current studies of people with patellofemoral syndrome, running on steep inclines, as well as running on a treadmill and making the incline angle of the treadmill within the limit of minus 5% to plus 5%, does not affect the improvement of this condition, and it is not recommended. And according to the research, girls with patellofemoral syndrome should be placed on the treadmill at an inclined angle to run.

Keywords: patellofemoral syndrome, angular displacement of the knee, angular displacement of the thigh

Procedia PDF Downloads 32

Authors: Farah Al-Shatti, Elsayed El-Khamisi, Nabel Suleiman

Abstract:

The study aimed at identifying the relationship between self-injury behavior and social skills among children with mild intellectual disability (ID) in the state of Kuwait. The sample of the study consisted of 65 males and females with ID; their ages ranged between 8 to 12 years. The study used a measure for rating self-injury behavior designed by the researcher; and a measure for rating social skills was designed. The results of the study showed that there was an increase in the percentages of the two dimensions of the self-injury behavior for children with ID; the self-injury behavior by child’s own body was higher than the self-injury behavior by environmental tools, additionally the results showed that there were statistically significant differences between males and females on the dimensions and total scorer of self-injury scale favor the males, and there were statistically significant differences between them on the dimensions of the social skills and total score favor the females, It also indicated that there was statistically significant negative relationship between the dimensions of the self-injury and the dimensions of the social skills for children with intellectual disability.

Keywords: mild intellectual disability, self injury behavior, social skills, state of Kuwait

Procedia PDF Downloads 324