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Neurology Hip

J F Alingh, V Weerdesteyn, B Nienhuis, E H F van Asseldonk, A C H Geurts, B E Groen
BACKGROUND: Recovery of walking is a primary rehabilitation goal of most stroke survivors. Control of pelvic movements is one of the essential determinants of gait, yet surprisingly, conventional robot-assisted gait trainers constrain pelvic movements. Novel robot-assisted gait trainers, such as LOPES II, are able to support pelvic movements during gait. The aim of this cross-over study was to investigate the immediate after-effects of pelvic support (PS) or pelvic constraint (PC) gait training with LOPES II on overground walking in healthy subjects...
March 15, 2019: Journal of Neuroengineering and Rehabilitation
Thomas J Sorenson, Giuseppe Lanzino, Leonardo Rangel Castilla
Herein, we demonstrate a case of a large, wide-necked, basilar apex aneurysm (BAA) that was treated with neck reconstruction-assisted coil embolization using the PulseRider device (PulsarVascular, Los Gatos, California), a novel neck-reconstruction device. A 68-yr-old man was found to have large BAA during work-up for sinusitis. Computed tomography angiogram revealed an 11 × 10-mm BAA. Patient has history of coronary artery disease, atrial fibrillation (currently taking Warfarin), recent left hip replacement and right femoral bypass...
March 12, 2019: Operative Neurosurgery (Hagerstown, Md.)
C Castagneri, V Agostini, S Rosati, G Balestra, M Knaflitz
Gait asymmetry is typically evaluated using spatio-temporal or joint kinematics parameters. Only a few studies addressed the problem of defining an asymmetry index directly based on muscle activity, extracting parameters from surface electromyography (sEMG) signals. Moreover, no studies used the extraction of the muscle principal activations (activations that are necessary for accomplishing a specific motor task) as the base to construct an asymmetry index, less affected by the variability of sEMG patterns...
March 7, 2019: IEEE Transactions on Neural Systems and Rehabilitation Engineering
Laura Marchal-Crespo, Panagiotis Tsangaridis, David Obwegeser, Serena Maggioni, Robert Riener
Robotic algorithms that augment movement errors have been proposed as promising training strategies to enhance motor learning and neurorehabilitation. However, most research effort has focused on rehabilitation of upper limbs, probably because large movement errors are especially dangerous during gait training, as they might result in stumbling and falling. Furthermore, systematic large movement errors might limit the participants' motivation during training. In this study, we investigated the effect of training with novel error modulating strategies, which guarantee a safe training environment, on motivation and learning of a modified asymmetric gait pattern...
2019: Frontiers in Neuroscience
Paul Lecoanet, Mathias Blangis, Matthieu Garcia, Yohan Legallois, Thierry Fabre
Introduction: Heavy metal intoxication after arthroplasty is extremely rare but could be lethal . Case Report . We report the case of a 69-year-old woman, who presented intense systemic symptoms of chromium-cobalt intoxication after revision of per-operative fractured ceramic components with metal-on-polyethylene. Systemic toxicity occurred a year after surgery and expressed brutally with mostly central neurological symptoms. Chelation associated with revision surgery allowed rapid regression of all symptoms...
2019: Case Reports in Orthopedics
R Houston, C Gagliardo, S Vassallo, P Wynne, C A Mazzola
BACKGROUND: Spinal epidural abscess (SEA) is a rare but serious infection that develops in the epidural space anywhere along the spinal cord. Early diagnosis is imperative to prevent permanent neurological sequelae. SEA should be considered in patients with backache, fever, neurological deficits and/ or spinal tenderness. Although these are non-specific symptoms, delayed diagnosis increases the risk of development of sepsis, which may be life threatening, or result in varying degrees of permanent neurological impairment...
February 21, 2019: World Neurosurgery
Sreeram Penna, Kerri L Bell, Feng-Chih Kuo, Robert Andrew Henderson, Carol Foltz, Antonia F Chen
BACKGROUND: The Comprehensive Care for Joint Replacement model is the newest iteration of the bundled payment methodology introduced by the Centers for Medicare and Medicaid Services. Comprehensive Care for Joint Replacement model, while incentivizing providers to deliver care at a lower cost, does not incorporate any patient-level risk stratification. Our study evaluated the impact of specific medical co-morbidities on the cost of care in total joint arthroplasty (TJA) patients. METHODS: A retrospective study was conducted on 1258 Medicare patients who underwent primary elective TJA between January 2015 and July 2016 at a single institution...
January 24, 2019: Journal of Arthroplasty
Caroline P Adrian, Kevin K Haussler, Christopher E Kawcak, Raoul F Reiser, Cheryl Riegger-Krugh, Ross H Palmer, C Wayne McIlwraith, Robert A Taylor
OBJECTIVE: Identify relevant electromyography (EMG), kinematic, and kinetic changes resulting from monopolar radiofrequency energy (MRFE)-induced cranial cruciate ligament (CCL) injury and eventual rupture in dogs. STUDY DESIGN: Experimental, repeated measures. ANIMALS: Five purpose-bred female dogs free of orthopedic and neurologic disease. METHODS: Surface EMG, joint kinematics, and ground reaction forces were assessed at a trot in the pelvic limbs at baseline, at 2 and 4 weeks after unilateral MRFE-induced CCL injury, and at 4, 8, and 16 weeks after CCL rupture (CCLR)...
February 13, 2019: Veterinary Surgery: VS
Markus T Berninger, Sven Hungerer, Jan Friederichs, Fabian M Stuby, Christian Fulghum, Rolf Schipp
BACKGROUND: Developmental hip dysplasia is the most common cause of secondary hip osteoarthritis. Due to severe acetabular bone deficiency, cup positioning in total hip arthroplasty (THA) of dysplastic hips remains a surgical challenge. The aim was to analyze the functional outcome of far proximal cup positions in primary THA. METHODS: Fifty patients (61 hips) with THA for severe dysplastic osteoarthritis and a far proximal cup position were included. Patients were divided according to the heights of the implanted cups with increasing vertical distance from the interteardrop line (group A: 55-65 mm, group B: 65-75 mm, group C: >75 mm)...
January 23, 2019: Journal of Arthroplasty
Michela Goffredo, Eleonora Guanziroli, Sanaz Pournajaf, Marina Gaffuri, Giulio Gasperini, Serena Filoni, Silvano Baratta, Carlo Damiani, Marco Franceschini, Franco Molteni
BACKGROUND: Wearable powered exoskeletons provide intensive overground gait training with patient's active participation: these features promote a successful active motor relearning of ambulation in stroke survivors. AIM: To investigate the feasibility and the clinical effects of an Overground Exoskeleton-Assisted Gait Training (OEAGT) in subacute stroke patients. DESIGN: Prospective, pilot pre-post, open label, non-randomized experimental study...
February 4, 2019: European Journal of Physical and Rehabilitation Medicine
Chia-Ter Chao, Rong-Sen Yang, Wei-Jia Huang, Keh-Sung Tsai, Ding-Cheng Derrick Chan
OBJECTIVE: A fracture liaison service (FLS) for patients with fractures is a promising approach for improving outcomes, but barriers to the successful implementation of an FLS remain. The factors influencing the outcomes of patients already receiving FLS care are unclear. DESIGN: A prospective multicenter cohort study. SETTINGS AND PARTICIPANTS: Patients with incident hip and clinical vertebral fractures treated at 2 institutions between January 2014 and June 2016 were prospectively enrolled...
February 2, 2019: Journal of the American Medical Directors Association
Stefano Giaretta, Andrea Silvestri, Alberto Momoli, Gian Mario Micheloni
Bilateral hip dislocation is a rare event, asymmetric dislocation is even rarer. Due to the intrinsic stability of the hip joint this lesions usually follow a high energy trauma. Because of the common associated lesions, the initial clinical assessment should be performed thoroughly. CT scan rather than x-rays offers a complete survey of these possible associated injuries such as thoracic or abdominal bleedings, neurologic lesions or fractures directly associated with the hips dislocations. The first goal should be reduction of the dislocation to prevent avascular necrosis (AVN) of the femoral head and arthritis...
January 10, 2019: Acta Bio-medica: Atenei Parmensis
Andrew J Riff, Kyle N Kunze, Kamran Movassaghi, Fady Hijji, Edward C Beck, Joshua D Harris, Shane J Nho
PURPOSE: To evaluate the safety and efficacy of hip arthroscopy for femoroacetabular impingement syndrome by assessing complications, comprehensive procedure survivorship, and the influence of labral and capsular management on procedure survivorship. METHODS: A systematic review of multiple medical databases was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and checklist. All clinical outcome studies that reported on the presence or absence of reoperation after hip arthroscopy for femoroacetabular impingement syndrome were eligible for inclusion...
February 2019: Arthroscopy: the Journal of Arthroscopic & related Surgery
James Rainville, James V Bono, Eric B Laxer, David H Kim, John M Lavelle, Aage Indahl, David G Borenstein, Andy J Haig, Jeffrey N Katz
BACKGROUND: Leg pain associated with walking is sometimes incorrectly attributed to hip osteoarthritis (OA) or lumbar spinal stenosis (LSS). PURPOSE: This study compared physicians' values of signs and symptoms for diagnosing and differentiating hip OA and LSS to their clinical utility. STUDY DESIGN/SETTING: Musculoskeletal physicians were surveyed with online questionnaires. Patients were recruited from hip and spine specialty practices. PATIENT SAMPLE: Seventy-seven hip OA and 79 LSS patients...
January 29, 2019: Spine Journal: Official Journal of the North American Spine Society
Roser Vives, Diana Fernandez-Galinski, Francisca Gordo, Alberto Izquierdo, Joan C Oliva, Carmen Colilles, Caridad Pontes
BACKGROUND: Bupivacaine and levobupivacaine have similar pharmacokinetic and pharmacodynamic characteristics, and are used regularly in spinal anesthesia. Whether potential differences in their hemodynamic and anesthetic profiles could determine a differential risk of complications in elderly subjects, is controversial. The main objective was to compare the effects of intrathecally administered levobupivacaine (LB) versus bupivacaine (B), on regional cerebral O2 saturation during spinal anesthesia, cognitive status and neurological complications in elderly patients undergoing surgery for hip fracture...
January 31, 2019: BMC Anesthesiology
X Y Peng, Y J Qu, F Song, X F Sun, X S Ge, H Jiao
Objective: To summarize the clinical manifestations and determine the molecular etiology for two collagen type Ⅵ-related myopathy pedigrees. Methods: Two spontaneous collagen type Ⅵ-related myopathy patients were admitted to Department of Neurology, Children's Hospital, Capital Institute of Pediatrics in October 2017. Clinical data of probands and their family members were collected and their genomic DNA was obtained for genetic testing. Next generation sequencing was performed and the variants were verified by the Sanger sequencing in the family members...
February 2, 2019: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Jae Lim Kim, Jong Geol Do, Young Cheol Yoon, Seung-Jae Lim, Duk Hyun Sung
This is a rare case of sciatic neuropathy in a 46-year-old man secondary to an intraneural ganglion cyst from the hip joint extending upward to the lumbar plexus and the L5 nerve root. Magnetic resonance neurography showed that the joint fluid passed through a labral tear and extended rostrally along the articular branch and the peroneal portion of the sciatic nerve to near the L5 nerve root. The condition was treated by arthroscopic disruption of the joint connection to the nerve with resolution of the intraneural cyst and partial neurological recovery...
January 28, 2019: PM & R: the Journal of Injury, Function, and Rehabilitation
Corey T Walker, S Harrison Farber, Tyler S Cole, David S Xu, Jakub Godzik, Alexander C Whiting, Cory Hartman, Randall W Porter, Jay D Turner, Juan Uribe
OBJECTIVEMinimally invasive anterolateral retroperitoneal approaches for lumbar interbody arthrodesis have distinct advantages attractive to spine surgeons. Prepsoas or transpsoas trajectories can be employed with differing complication profiles because of the inherent anatomical differences encountered in each approach. The evidence comparing them remains limited because of poor quality data. Here, the authors sought to systematically review the available literature and perform a meta-analysis comparing the two techniques...
January 25, 2019: Journal of Neurosurgery. Spine
Marius Henriksen, Tine Alkjær, Peter C Raffalt, Louse Jørgensen, Cecilie Bartholdy, Steen Honoré Hansen, Henning Bliddal
Objective: To investigate differences in gait variability induced by two different single-dose opioid formulations and an inert placebo in healthy volunteers and knee osteoarthritis patients. Design: Experimental, randomized, double-blinded, crossover study of inert placebo (calcium tablets), 50 mg of tapentadol, and 100 mg of tramadol. Setting: Laboratory setting. Subjects: Healthy volunteers and knee osteoarthritis patients...
January 12, 2019: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
A L Adams, B H Li, S Bhandari, S Kamat, S Sundar, H Krasa, C M Rhee, K Kalantar-Zadeh, S J Jacobsen, J J Sim
Chronic hyponatremia may contribute to decreased bone density. We studied 341,003 men and women who underwent DXA testing and observed that individuals with chronic hyponatremia (sodium < 135 mEq/L) had an 11% greater likelihood of having osteoporosis. There was a dose-dependent effect with lower sodium and stronger association with osteoporosis. INTRODUCTION: Chronic hyponatremia has been associated with both neurologic deficits and increased risk of gait abnormalities leading to falls and resultant bone fractures...
January 11, 2019: Osteoporosis International
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