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Knee Flexion

Nipun Sodhi, Anton Khlopas, Joseph O Ehiorobo, Caitlin Condrey, Kevin Marchand, Robert C Marchand, Matthew S Hepinstall, Michael A Mont
INTRODUCTION: Tibial or femoral extra-articular deformities complicate the goal achieving optimal mechanical axis alignment for successful total knee arthroplasty (TKA) outcomes. In the presence of these extra-articular deformities, standard operative techniques and instruments may not be reliable. Robotic-arm assisted technology was developed to help achieve a well-aligned and balanced knee in a variety of clinical scenarios. Although prior case series have reported on the use of robotic-arm assisted devices for cases with severe angular deformity, there is a lack of data concerning the use of the robotic device for patients with other potentially complex surgical factors...
March 18, 2019: Surgical Technology International
A Keihanian, H Arazi, M Kargarfard
The aim of this study was to compare the effects of 8 weeks of aerobic versus resistance training programs on serum fetuin-A, fetuin-B, and fibroblast growth factor-21 (FGF-21) levels in males with type 2 diabetes mellitus. Participants (n = 34) were randomly assigned to a resistance training group (RTG; n = 12), an aerobic training group (ATG; n = 11), or a control group (n = 11). The ATG completed 30-45 min of aerobic running training at 65%-75% of the maximum heart rate. The RTG completed three sets of 10 repetitions maximum of leg press, bench press, knee extension, seated cable row, knee flexion, military press, and calf rise...
March 19, 2019: Physiology International
Julia R Dahlqvist, Sofie T Oestergaard, Nanna S Poulsen, Kirsten Lykke Knak, Carsten Thomsen, John Vissing
Spinobulbar muscular atrophy (SBMA) is caused by a trinucleotide repeat expansion in the androgen receptor gene on the X chromosome. There is a toxic effect of the mutant receptor on muscle and neurons resulting in muscle weakness and atrophy. The weakness can be explained by wasting due to loss of muscle cells, but it is unknown whether weakness also relates to poor muscle contractility of the remaining musculature. In this study, we investigated the muscle contractility in SBMA. We used stationary dynamometry and quantitative MRI to assess muscle strength and absolute and fat-free, cross-sectional areas...
March 18, 2019: Scientific Reports
Michael J McAuliffe, Gautam Garg, Thomas Orschulok, John Roe, Sarah L Whitehouse, Ross Crawford
Balanced soft tissues are important to total knee arthroplasty (TKA) outcomes. Surgical algorithms for balancing are potentially varied in varus and valgus osteoarthritic (OA) knees. While coronal plane varus knee laxity has been documented, no study has objectively defined the medial and lateral laxity of the valgus OA knee. The lower limb was manipulated at the time of TKA using computer navigation, prior to surgical releases, to allow the limb weight-bearing axis to pass through the knee center in maximum extension, 20° and 90° of flexion...
January 2019: Journal of Orthopaedic Surgery
Yong-Gon Koh, Ji-Hoon Nam, Hyun-Seok Chung, Hwa-Yong Lee, Ho-Joong Kim, Hyo-Jeoung Kim, Kyoung-Tak Kang
PURPOSE: This study aimed to elucidate the primary differences in trochlear morphology between men and women utilizing three-dimensional magnetic resonance image reconstruction of the femoral trochlea. METHODS: Differences in anthropometric femoral trochlea data of 975 patients (825 women, 150 men) were evaluated. The following morphological parameters were measured at three flexion angles (15°, 30°, and 45°) of the femoral trochlea: the sulcus angle, condylar height, and the trochlear groove orientation and mediolateral groove position...
March 16, 2019: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Katia Turcot, Bianca Lachance
BACKGROUND: Toe-out foot positioning is increasingly analyzed as a compensatory body-mechanical strategy to reduce pain and joint constraints in people with degenerative joint disease during gait. However, its influence during functional tasks, such as sit-to-stand, has not been reported. RESEARCH QUESTION: How uni- and bilateral toe-out foot positioning influence body-dynamics during a STS task? METHODS: The study was conducted on 15 healthy participants...
March 8, 2019: Gait & Posture
Moiyad Aljehani, Kathleen Madara, Lynn Snyder-Mackler, Cory Christiansen, Joseph A Zeni
BACKGROUND: Although unilateral symptoms and unilateral total knee arthroplasty (TKA) are common, many patients have bilateral radiographic osteoarthritis (OA). Because the contralateral (non-operated) limb is often used as a comparison for clinical and biomechanical outcomes, it is important to know if the presence of OA influences movement patterns in either limb. RESEARCH QUESTION: The purpose of this study was to compare bilateral sagittal plane biomechanics between subjects with and without contralateral knee OA after unilateral TKA...
March 8, 2019: Gait & Posture
Tunc Akbas, Sunil Prajapati, David Ziemnicki, Poornima Tamma, Sarah Gross, James Sulzer
It has long been held that hip abduction compensates for reduced swing-phase knee flexion angle, especially in those after stroke. However, there are other compensatory motions such as pelvic obliquity (hip hiking) that could also be used to facilitate foot clearance with greater energy efficiency. Our previous work suggested that hip abduction may not be a compensation for reduced knee flexion after stroke. Previous study applied robotic knee flexion assistance in people with post-stroke Stiff-Knee Gait (SKG) during pre-swing, finding increased abduction despite improved knee flexion and toe clearance...
March 8, 2019: Journal of Biomechanics
Min Up Kim, Jae Won Kim, Man Soo Kim, Seok Ju Kim, Oui Sik Yoo, Yong In
PURPOSE: To compare variations in femoral graft bending angle during range of motion (ROM) of the knee between inside-out (IO) and retro-socket outside-in (OI) techniques in posterior cruciate ligament (PCL) reconstruction using in vivo 3-dimensional (3D) computed tomography analysis. METHODS: Ten patients underwent PCL reconstruction by the IO technique (5 patients) or the retro-socket OI technique (5 patients) for suspensory femoral fixation. After PCL reconstruction, 3D computed tomography was performed in 0° extension and 90° flexion to reconstruct 3D femur and tibia bone models using Mimics software...
March 11, 2019: Arthroscopy: the Journal of Arthroscopic & related Surgery
Xiao-Hong Wang, Xiang Dong, Bao-Zhang Zhu, Lei Jiang, Zhong-Min Jin, Toru Suguro, Cheng-Kung Cheng
The primary intent of anatomical knee implants is to replicate the motions of a normal knee joint. In developing such designs, a preclinical evaluation of kinematic behavior is needed. This study introduces an in vitro testing method for recording movements of the knee joint. A novel testing jig was developed and incorporated into a knee simulator setup alongside a motion capture system to directly track the medial and lateral movements of a knee prosthesis. The test system developed in this study required a number of factors to be validated; (i) gait inputs to the knee simulator (result: 0...
March 11, 2019: Medical Engineering & Physics
Katherine A Boyer, Jocelyn F Hafer
BACKGROUND: Exercise-induced pain flares represent a significant barrier for individuals with knee osteoarthritis to meet physical activity recommendations. There is a need to understand factors that contribute to pain flares and the potential for the motor system to adapt and reduce joint loading should a flare occur. The study aim was to examine the impact of a bout of exercise on self-reported pain, walking mechanics and muscle co-contraction for participants with knee osteoarthritis...
March 14, 2019: BMC Musculoskeletal Disorders
Eddie H M Sze
BACKGROUND: Candy cane stirrups are widely used for vaginal surgery because they provide sufficient operating space. When placed in the standard perpendicular alignment, however, these stirrups cause excessive flexion, abduction, and external rotation of the thigh, which may injure the femoral, lateral femoral cutaneous, sciatic, and common peroneal nerves. TECHNIQUE: We corrected this deficiency by positioning the stirrups parallel to the operating table, just above and tilting slightly toward its lower break...
March 11, 2019: Obstetrics and Gynecology
Christoph Kittl, Deborah K Becker, Michael J Raschke, Marcus Müller, Guido Wierer, Christoph Domnick, Johannes Glasbrenner, Philipp Michel, Mirco Herbort
BACKGROUND: Little is known about the dynamic restraints of the semimembranosus muscle (SM). PURPOSE AND HYPOTHESIS: The goal of the present study was to elucidate the role of (1) passive and (2) active restraints to medial-side instability and to analyze (3) the corresponding tightening of the posteromedial structures by loading the SM. It was hypothesized that points 1 to 3 will significantly restrain medial knee instability. This will aid in understanding the synergistic effect of the semimembranosus corner...
March 2019: American Journal of Sports Medicine
Ben Langley, Mary Cramp, Stewart C Morrison
To-date there is a paucity of information about how different types of conventional running shoes influence lower limb kinematics. The aim of the study was to determine the influence of motion control, neutral and cushioned running shoes upon lower limb kinematics. Twenty-eight active males completed one test session running in standardised motion control, neutral and cushioned running shoes, on a treadmill at a self-selected pace (2.9 ± 0.6 m.s-1 ). Kinematic data were collected using a VICON motion analysis system with hip, knee and ankle joint angles calculated...
March 12, 2019: Journal of Applied Biomechanics
Jae-Kwang Lee, Jong-Ha Hwang, Chan-Myeong Kim, Jong Kyung Lee, Ji-Won Park
[Purpose] There have been many study ipsilateral erector spinae in regard of prone hip extension (PHE). However, mediating methods have been focusing on the reinforcement of gluteus. Hereupon, this study is intended to identify how an increase of gluteus maximus influences on posterior oblique sling (POS) and suggest a mediating method to effectively reinforce them. This study shows the seclective POS strength exercise. [Participants and Methods] This study has been conducted on normal male (13) and female (13), and participants were asked to proceed PHE exercise and prone hip extension with hip abduction with knee flexion (PHEAKF)...
February 2019: Journal of Physical Therapy Science
Marine Alhammoud, Baptiste Morel, Clint Hansen, Mathew Wilson, Regis Mecca, Erick Nael, Christophe Hautier
Standard outcomes of traditional isokinetic testing do not detect differences between various muscle mechanical properties. This study i) explored a novel analysis throughout the range of motion based on statistical parametric mapping and ii) examined the impact of sex and discipline on hamstrings/quadriceps torque in elite alpine skiers. Twenty-eight national team skiers (14 females, 14 males; 14 technical, 14 speed) undertook an isokinetic evaluation of the knee flexors/extensors (range 30-90°, 0° representing full extension)...
March 11, 2019: International Journal of Sports Medicine
Derek F Amanatullah, Paul M Lichstein, William G Lundergan, Wendy W Wong, William J Maloney, Stuart B Goodman, James I Huddleston
BACKGROUND: Suboptimal implant rotation has consequences with respect to knee kinematics and clinical outcomes. We evaluated the functional outcomes of revision total knee arthroplasty (TKA) for poor axial implant rotation. METHODS: We retrospectively reviewed 42 TKAs undergoing aseptic revision for poor axial implant rotation. We assessed improvements in Knee Society Score (KSS) and final range of motion (ROM). Subgroup analyses were performed for preoperative instability and stiffness, as well as the number of components revised and level of implant constraint used...
February 14, 2019: Journal of Arthroplasty
Adam S Lepley, Dustin R Grooms, Julie P Burland, Steven M Davi, Jeffrey M Kinsella-Shaw, Lindsey K Lepley
Quadriceps muscle dysfunction is common following anterior cruciate ligament reconstruction (ACLR). Data considering the diversity of neural changes, in-concert with morphological adaptations of the quadriceps muscle, are lacking. We investigated bilateral differences in neural and morphological characteristics of the quadriceps muscle in ACLR participants (n = 11, month post-surgery: 69.4 ± 22.4) compared to controls matched by sex, age, height, weight, limb dominance, and activity level. Spinal reflex excitability was assessed using Hoffmann reflexes (H:M); corticospinal excitability was quantified via active motor thresholds (AMT) and motor-evoked potentials (MEP) using transcranial magnetic stimulation...
March 9, 2019: Experimental Brain Research. Experimentelle Hirnforschung. Expérimentation Cérébrale
Mutsumi Watanabe, Shinichi Kuriyama, Shinichiro Nakamura, Kohei Nishitani, Yoshihisa Tanaka, Kazuya Sekiguchi, Hiromu Ito, Shuichi Matsuda
BACKGROUND: In general, the flexion gap is larger than the extension gap with posterior cruciate ligament-sacrificing total knee arthroplasty. Several methods compensate for an excessive flexion gap, but their effects are unknown. The purpose of this study was to compare three methods to compensate for an increased flexion gap. METHODS: In this study, squatting in knees with excessive (4 mm) and moderate (2 mm) flexion gaps was simulated in a computer model...
February 27, 2019: Clinical Biomechanics
Andrew R Cuff, Monica A Daley, Krijn B Michel, Vivian R Allen, Luis Pardon Lamas, Chiara Adami, Paolo Monticelli, Ludo Pelligand, John R Hutchinson
Electromyography (EMG) is used to understand muscle activity patterns in animals. Understanding how much variation exists in muscle activity patterns in homologous muscles across animal clades during similar behaviours is important for evaluating the evolution of muscle functions and neuromuscular control. We compared muscle activity across a range of archosaurian species and appendicular muscles, including how these EMG patterns varied across ontogeny and phylogeny, to reconstruct the evolutionary history of archosaurian muscle activation during locomotion...
March 8, 2019: Journal of Morphology
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