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Validation of a noninvasive technique to precisely measure in vivo three-dimensional cervical spine movement. Spine (Phila Pa 1976) 2011; 36:E393-400. [PMID: 21372650 PMCID: PMC3077907 DOI: 10.1097/brs.0b013e31820b7e2f] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN In vivo validation during functional loading. OBJECTIVE To determine the accuracy and repeatability of a model-based tracking technique that combines subject-specific computed tomographic (CT) models and high-speed biplane x-ray images to measure three-dimensional (3D) in vivo cervical spine motion. SUMMARY OF BACKGROUND DATA Accurate 3D spine motion is difficult to obtain in vivo during physiological loading because of the inability to directly attach measurement equipment to individual vertebrae. Previous measurement systems were limited by two-dimensional (2D) results and/or their need for manual identification of anatomical landmarks, precipitating unreliable and inaccurate results. All previous techniques lack the ability to capture true 3D motion during dynamic functional loading. METHODS Three subjects had 1.0-mm-diameter tantalum beads implanted into their fused and adjacent vertebrae during anterior cervical discectomy and fusion surgery. High-resolution CT scans were obtained after surgery and used to create subject-specific 3D models of each cervical vertebra. Biplane x-ray images were collected at 30 frames per second while the subjects performed flexion/extension and axial rotation movements 6 months after surgery. Individual bone motion, intervertebral kinematics, and arthrokinematics derived from dynamic radiostereophotogrammetric analysis served as a gold standard to evaluate the accuracy of the model-based tracking technique. RESULTS Individual bones were tracked with an average precision of 0.19 and 0.33 mm in nonfused and fused bones, respectively. Precision in measuring 3D joint kinematics in fused and adjacent segments averaged 0.4 mm for translations and 1.1° for rotations, while anterior and posterior disc height above and below the fusion were measured with a precision ranging between 0.2 and 0.4 mm. The variability in 3D joint kinematics associated with tracking the same trial repeatedly was 0.02 mm in translation and 0.06° in rotation. CONCLUSION The 3D cervical spine motion can be precisely measured in vivo with submillimeter accuracy during functional loading without the need for bead implantation. Fusion instrumentation did not diminish the accuracy of kinematic and arthrokinematic results. The semiautomated model-based tracking technique has excellent repeatability.
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152
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Massimini DF, Warner JJ, Li G. Non-invasive determination of coupled motion of the scapula and humerus—An in-vitro validation. J Biomech 2011; 44:408-12. [DOI: 10.1016/j.jbiomech.2010.10.003] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2010] [Revised: 09/10/2010] [Accepted: 10/07/2010] [Indexed: 11/26/2022]
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153
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Martin DE, Greco NJ, Klatt BA, Wright VJ, Anderst WJ, Tashman S. Model-based tracking of the hip: implications for novel analyses of hip pathology. J Arthroplasty 2011; 26:88-97. [PMID: 20347253 DOI: 10.1016/j.arth.2009.12.004] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2009] [Accepted: 12/03/2009] [Indexed: 02/01/2023] Open
Abstract
This study investigated the efficacy of a combined high-speed, biplane radiography and model-based tracking technique to study hip joint kinematics and arthrokinematics. Comparing model-based tracking to the gold standard of radiostereometric analysis using implanted metal beads, joint translation was measured with a bias of 0.2 mm and a precision of 0.3 mm, whereas joint rotation was measured with a bias of 0.2° and a precision of 0.8°. A novel measure of hip arthrokinematics characterizing the region of closest contact in the anterosuperior acetabulum was measured with a bias of 0.9% and a precision of 2.5%. Model-based tracking of the hip thus provides the opportunity to noninvasively study hip pathologic conditions such as osteoarthritis and femoroacetabular impingement with great accuracy.
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Affiliation(s)
- Daniel E Martin
- University of Pittsburgh Medical Center Department of Orthopedic Surgery, Pittsburgh, Pennsylvania, USA
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154
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Deneweth JM, Bey MJ, McLean SG, Lock TR, Kolowich PA, Tashman S. Tibiofemoral joint kinematics of the anterior cruciate ligament-reconstructed knee during a single-legged hop landing. Am J Sports Med 2010; 38:1820-8. [PMID: 20472756 DOI: 10.1177/0363546510365531] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Abnormal 3-dimensional tibiofemoral joint kinematics have been identified in anterior cruciate ligament-reconstructed knees during functional gait tasks, which is suggested to directly affect risk of knee osteoarthritis. However, the extent to which similar high-risk abnormalities are present during more demanding maneuvers, such as single-legged hopping, is largely unknown. HYPOTHESIS When performing a single-legged forward hop landing, the reconstructed knee will demonstrate altered sagittal, frontal, and transverse plane kinematics compared with the contralateral limb. STUDY DESIGN Controlled laboratory study. METHODS High-speed biplane radiography was used to quantify bilateral 3-dimensional tibiofemoral joint kinematics in 9 subjects with unilaterally reconstructed anterior cruciate ligaments (mean time after surgery, 4 months) during 3 single-legged, forward hop landing trials. Mean subject-based initial foot contact and maximum stance (0-250 ms) values were calculated for each kinematic variable. Two-tailed paired t tests were subsequently applied to examine for the main effect of limb (reconstructed vs contralateral). RESULTS The reconstructed knees exhibited significantly greater extension (P = .04), external tibial rotation (P = .006), and medial tibial translation (P = .02) than the contralateral knees at initial contact. Reconstructed knees underwent significantly greater maximum flexion (P = .05), maximum external tibial rotation (P = .01), and maximum anterior tibial translation (P = .02). No significant differences existed between limbs for initial contact (P = .65) or maximum adduction-abduction (P = .55). CONCLUSION Tibiofemoral joint kinematics of the anterior cruciate ligament-reconstructed knee are significantly different from those of the uninjured contralateral limb during a single-legged hop landing. This altered kinematic profile, in conjunction with the large impact loads associated with hopping, may further contribute to the risk of posttraumatic knee osteoarthritis. CLINICAL RELEVANCE Returning to sports involving dynamic single-legged landings at 4 months after anterior cruciate ligament reconstruction surgery may contribute to accelerated knee joint degeneration.
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155
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Brainerd EL, Baier DB, Gatesy SM, Hedrick TL, Metzger KA, Gilbert SL, Crisco JJ. X-ray reconstruction of moving morphology (XROMM): precision, accuracy and applications in comparative biomechanics research. ACTA ACUST UNITED AC 2010; 313:262-79. [PMID: 20095029 DOI: 10.1002/jez.589] [Citation(s) in RCA: 210] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
X-Ray Reconstruction of Moving Morphology (XROMM) comprises a set of 3D X-ray motion analysis techniques that merge motion data from in vivo X-ray videos with skeletal morphology data from bone scans into precise and accurate animations of 3D bones moving in 3D space. XROMM methods include: (1) manual alignment (registration) of bone models to video sequences, i.e., Scientific Rotoscoping; (2) computer vision-based autoregistration of bone models to biplanar X-ray videos; and (3) marker-based registration of bone models to biplanar X-ray videos. Here, we describe a novel set of X-ray hardware, software, and workflows for marker-based XROMM. Refurbished C-arm fluoroscopes retrofitted with high-speed video cameras offer a relatively inexpensive X-ray hardware solution for comparative biomechanics research. Precision for our biplanar C-arm hardware and analysis software, measured as the standard deviation of pairwise distances between 1 mm tantalum markers embedded in rigid objects, was found to be +/-0.046 mm under optimal conditions and +/-0.084 mm under actual in vivo recording conditions. Mean error in measurement of a known distance between two beads was within the 0.01 mm fabrication tolerance of the test object, and mean absolute error was 0.037 mm. Animating 3D bone models from sets of marker positions (XROMM animation) makes it possible to study skeletal kinematics in the context of detailed bone morphology. The biplanar fluoroscopy hardware and computational methods described here should make XROMM an accessible and useful addition to the available technologies for studying the form, function, and evolution of vertebrate animals.
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Affiliation(s)
- Elizabeth L Brainerd
- Department of Ecology and Evolutionary Biology, Brown University, Providence, Rhode Island 02912, USA.
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156
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Affiliation(s)
- Marcus G. Pandy
- Department of Mechanical Engineering, University of Melbourne, Parkville, Victoria 3010, Australia;
| | - Thomas P. Andriacchi
- Department of Mechanical Engineering, Stanford University, Stanford, California 94305
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157
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McDonald CP, Bachison CC, Chang V, Bartol SW, Bey MJ. Three-dimensional dynamic in vivo motion of the cervical spine: assessment of measurement accuracy and preliminary findings. Spine J 2010; 10:497-504. [PMID: 20359957 DOI: 10.1016/j.spinee.2010.02.024] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2009] [Revised: 01/18/2010] [Accepted: 02/18/2010] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Previous research has quantified cervical spine motion with conventional measurement techniques (eg, cadaveric studies, motion capture systems, and fluoroscopy), but these techniques were not designed to accurately measure three-dimensional (3D) dynamic cervical spine motion under in vivo conditions. PURPOSE The purposes of this study were to characterize the accuracy of model-based tracking for measuring 3D dynamic cervical spine kinematics and to demonstrate its in vivo application. STUDY DESIGN Through accuracy assessment and application of technique, in vivo cervical spine motion was measured. METHODS The accuracy of model-based tracking for measuring cervical spine motion was determined in an in vitro experiment. Tantalum beads were implanted into the vertebrae of an ovine specimen, and biplane X-ray images were acquired as the specimen's neck was manually moved through neck extension and axial neck rotation. The 3D position and orientation of each cervical vertebra were determined from the biplane X-ray images using model-based tracking. For comparison, the position and orientation of each vertebra were also determined by tracking the position of the implanted beads with dynamic radiostereometric analysis. To demonstrate in vivo application of this technique, biplane X-ray images were acquired as a human subject performed two motion tasks: neck extension and axial neck rotation. The positions and orientations of each cervical vertebra were determined with model-based tracking. Cervical spine motion was reported with standard kinematic descriptions of translation and rotation. RESULTS The in vitro validation demonstrated that model-based tracking is accurate to within +/-0.6 mm and +/-0.6 degrees for measuring cervical spine motion. For the in vivo application, there were significant rotations about all three anatomical axes for both the neck extension and axial neck rotation motion tasks. CONCLUSIONS Model-based tracking is an accurate technique for measuring in vivo, 3D, dynamic cervical spine motion. Preliminary data acquired using this technique are in agreement with previous studies. It is anticipated that this experimental approach will enhance our understanding of cervical spine motion under normal and pathologic conditions.
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Affiliation(s)
- Colin P McDonald
- Bone and Joint Center, Henry Ford Hospital, Detroit, MI 48202, USA.
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158
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Akbarshahi M, Schache AG, Fernandez JW, Baker R, Banks S, Pandy MG. Non-invasive assessment of soft-tissue artifact and its effect on knee joint kinematics during functional activity. J Biomech 2010; 43:1292-301. [DOI: 10.1016/j.jbiomech.2010.01.002] [Citation(s) in RCA: 129] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2009] [Revised: 01/27/2010] [Accepted: 01/27/2010] [Indexed: 10/19/2022]
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159
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Assessment of Internal and External Prosthesis Kinematics during Strenuous Activities Using Dynamic Roentgen Stereophotogrammetric Analysis. ACTA ACUST UNITED AC 2010. [DOI: 10.1097/jpo.0b013e3181cca7bb] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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160
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Prins A, Kaptein B, Stoel B, Reiber J, Valstar E. Detecting femur–insert collisions to improve precision of fluoroscopic knee arthroplasty analysis. J Biomech 2010; 43:694-700. [DOI: 10.1016/j.jbiomech.2009.10.023] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2008] [Revised: 10/01/2009] [Accepted: 10/07/2009] [Indexed: 11/27/2022]
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161
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Tsai TY, Lu TW, Chen CM, Kuo MY, Hsu HC. A volumetric model-based 2D to 3D registration method for measuring kinematics of natural knees with single-plane fluoroscopy. Med Phys 2010; 37:1273-84. [DOI: 10.1118/1.3301596] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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162
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Abstract
Osteoarthritis is widely believed to result from local mechanical factors acting within the context of systemic susceptibility. This narrative review delineates current understanding of the etiopathogenesis of osteoarthritis and more specifically examines the critical role of biomechanics in disease pathogenesis. There are several ways the mechanical forces across the joint can be measured, including some that rely heavily on imaging methods. These are described and methods to advance the field are proposed.
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163
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Bauman JM, Chang YH. High-speed X-ray video demonstrates significant skin movement errors with standard optical kinematics during rat locomotion. J Neurosci Methods 2010; 186:18-24. [PMID: 19900476 PMCID: PMC2814909 DOI: 10.1016/j.jneumeth.2009.10.017] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2009] [Revised: 10/13/2009] [Accepted: 10/22/2009] [Indexed: 11/22/2022]
Abstract
The sophistication of current rodent injury and disease models outpaces that of the most commonly used behavioral assays. The first objective of this study was to measure rat locomotion using high-speed X-ray video to establish an accurate baseline for rat hindlimb kinematics. The second objective was to quantify the kinematics errors due to skin movement artefacts by simultaneously recording and comparing hindlimb kinematics derived from skin markers and from direct visualization of skeletal landmarks. Joint angle calculations from skin-derived kinematics yielded errors as high as 39 degrees in the knee and 31 degrees in the hip around paw contact with respect to the X-ray data. Triangulation of knee position from the ankle and hip skin markers provided closer, albeit still inaccurate, approximations of bone-derived, X-ray kinematics. We found that soft tissue movement errors are the result of multiple factors, the most impressive of which is overall limb posture. Treadmill speed had surprisingly little effect on kinematics errors. These findings illustrate the significance and context of skin movement error in rodent kinematics.
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Affiliation(s)
- Jay M Bauman
- School of Applied Physiology, Georgia Institute of Technology, Atlanta, GA 30332-0356, USA
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164
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Bey MJ, Kline SK, Zauel R, Kolowich PA, Lock TR. In Vivo Measurement of Glenohumeral Joint Contact Patterns. EURASIP JOURNAL ON ADVANCES IN SIGNAL PROCESSING 2010; 2010:162136. [PMID: 21546990 PMCID: PMC3086287 DOI: 10.1155/2010/162136] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The objectives of this study were to describe a technique for measuring in-vivo glenohumeral joint contact patterns during dynamic activities and to demonstrate application of this technique. The experimental technique calculated joint contact patterns by combining CT-based 3D bone models with joint motion data that were accurately measured from biplane x-ray images. Joint contact patterns were calculated for the repaired and contralateral shoulders of 20 patients who had undergone rotator cuff repair. Significant differences in joint contact patterns were detected due to abduction angle and shoulder condition (i.e., repaired versus contralateral). Abduction angle had a significant effect on the superior/inferior contact center position, with the average joint contact center of the repaired shoulder 12.1% higher on the glenoid than the contralateral shoulder. This technique provides clinically relevant information by calculating in-vivo joint contact patterns during dynamic conditions and overcomes many limitations associated with conventional techniques for quantifying joint mechanics.
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Affiliation(s)
- Michael J Bey
- Department of Orthopaedic Surgery, Bone and Joint Center, Henry Ford Hospital, 2799 W. Grand Blvd., E&R 2015, Detroit, MI 48202, USA
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165
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Anderst WJ, Tashman S. Using relative velocity vectors to reveal axial rotation about the medial and lateral compartment of the knee. J Biomech 2009; 43:994-7. [PMID: 20006336 DOI: 10.1016/j.jbiomech.2009.11.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2009] [Revised: 11/11/2009] [Accepted: 11/11/2009] [Indexed: 11/28/2022]
Abstract
A new technique is presented that utilizes relative velocity vectors between articulating surfaces to characterize internal/external rotation of the tibio-femoral joint during dynamic loading. Precise tibio-femoral motion was determined by tracking the movement of implanted tantalum beads in high-speed biplane X-rays. Three-dimensional, subject-specific CT reconstructions of the femur and tibia, consisting of triangular mesh elements, were positioned in each analyzed frame. The minimum distance between subchondral bone surfaces was recorded for each mesh element comprising each bone surface, and the relative velocity between these opposing closest surface elements was determined in each frame. Internal/external rotation was visualized by superimposing tangential relative velocity vectors onto bone surfaces at each instant. Rotation about medial and lateral compartments was quantified by calculating the angle between these tangential relative vectors within each compartment. Results acquired from 68 test sessions involving 23 dogs indicated a consistent pattern of sequential rotation about the lateral condyle (approximately 60 ms after paw strike) followed by rotation about the medial condyle (approximately 100 ms after paw strike). These results imply that axial knee rotation follows a repeatable pattern within and among subjects. This pattern involves rotation about both the lateral and medial compartments. The technique described can be easily applied to study human knee internal/external rotation during a variety of activities. This information may be useful to define normal and pathologic conditions, to confirm post-surgical restoration of knee mechanics, and to design more realistic prosthetic devices. Furthermore, analysis of joint arthrokinematics, such as those described, may identify changes in joint mechanics associated with joint degeneration.
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Affiliation(s)
- William J Anderst
- Department of Orthopaedics, Orthopaedic Research Laboratories, University of Pittsburgh, Rivertech Office Works, 3820 South Water Street, Pittsburgh, PA 15203, USA.
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166
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Role of Alignment and Biomechanics in Osteoarthritis and Implications for Imaging. Radiol Clin North Am 2009; 47:553-66. [DOI: 10.1016/j.rcl.2009.04.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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167
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Kedgley AE, Birmingham T, Jenkyn TR. Comparative accuracy of radiostereometric and optical tracking systems. J Biomech 2009; 42:1350-4. [DOI: 10.1016/j.jbiomech.2009.03.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2008] [Revised: 03/06/2009] [Accepted: 03/12/2009] [Indexed: 11/25/2022]
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168
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Wang J, Ye M, Liu Z, Wang C. Precision of cortical bone reconstruction based on 3D CT scans. Comput Med Imaging Graph 2009; 33:235-41. [DOI: 10.1016/j.compmedimag.2009.01.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2008] [Revised: 12/22/2008] [Accepted: 01/06/2009] [Indexed: 10/21/2022]
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169
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Wilson DR, McWalter EJ, Johnston JD. The measurement of joint mechanics and their role in osteoarthritis genesis and progression. Med Clin North Am 2009; 93:67-82, x. [PMID: 19059022 DOI: 10.1016/j.mcna.2008.08.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Mechanics play a role in the initiation, progression, and successful treatment of osteoarthritis. However, we don't yet know enough about which specific mechanical parameters are most important and what their impact is on the disease process to make comprehensive statements about how mechanics should be modified to prevent, slow, or arrest the disease process. The objectives of this review are (1) to summarize methods for assessing joint mechanics and their relative merits and limitations, (2) to describe current evidence for the role of mechanics in osteoarthritis initiation and progression, and (3) to describe some current treatment approaches that focus on modifying joint mechanics.
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Affiliation(s)
- David R Wilson
- Department of Orthopaedics, University of British Columbia, UBC Orthopaedics, Room 3114, 910 West 10th Avenue, Vancouver, BC, V5Z 4E3 Canada.
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170
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Measuring three-dimensional knee kinematics under torsional loading. J Biomech 2009; 42:183-6. [DOI: 10.1016/j.jbiomech.2008.10.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2008] [Revised: 10/01/2008] [Accepted: 10/14/2008] [Indexed: 11/21/2022]
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171
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Glenoid inclination: in vivo measures in rotator cuff tear patients and associations with superior glenohumeral joint translation. J Shoulder Elbow Surg 2009; 18:231-6. [PMID: 19062313 PMCID: PMC2669899 DOI: 10.1016/j.jse.2008.08.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2008] [Revised: 07/31/2008] [Accepted: 08/04/2008] [Indexed: 02/01/2023]
Abstract
Glenoid inclination has been associated with rotator cuff tears and superior humeral translation, but the relationship between glenoid inclination and superior humeral translation has not been assessed in vivo. This study compared glenoid inclination between repaired and contralateral shoulders in 21 unilateral rotator cuff repair patients. As a secondary analysis, we assessed the relationship between glenoid inclination and in vivo superior humeral translation. Glenoid inclination was measured from patient-specific, computed tomography-based bone models. Glenohumeral joint motion was measured from biplane radiographs collected during coronal-plane abductions. Glenoid inclination was significantly lower for the rotator cuff tear shoulders (90.7 degrees ) than the asymptomatic, contralateral shoulders (92.3 degrees , P = .04). No significant correlation existed between increased glenoid inclination and superior-inferior translation of the uninjured shoulder (P > .30). This study failed to support the theory that glenoid inclination is responsible for superior humeral translation and the development of subacromial impingement.
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172
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Anderst WJ, Tashman S. The association between velocity of the center of closest proximity on subchondral bones and osteoarthritis progression. J Orthop Res 2009; 27:71-7. [PMID: 18634007 PMCID: PMC2605192 DOI: 10.1002/jor.20702] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Altered surface interactions following joint instability may apply novel, damaging loads to articular cartilage. This study measured the velocity of the centers of closest proximity on subchondral bone surfaces on the femur and tibia during running in normal and unstable canine stifle (knee) joints. The purpose was to explore the relationship between the velocity of the centers of closest proximity on subchondral bones and the severity of cartilage damage. Dynamic biplane radiography was used to acquire serial knee kinematics [5 control, 18 cranial cruciate ligament (CCL) deficient] during treadmill running over 2 years. Custom software calculated the difference between the rate at which the center of closest proximity on the femur translated relative to the femur bone surface and the rate at which the center of closest proximity on the tibia translated relative to the tibia bone surface. Comparisons were made between dogs that developed minor versus major medial compartment cartilage damage over 2 years. Major damage dogs showed a significantly greater increase in the difference between femur and tibia medial compartment closest proximity point velocity from the instant of paw strike to peak velocity difference at 2, 4, and 6 months after CCL transaction. This implies increased tangential forces associated with the velocity of the compressed cartilage region during joint movement (plowing) may be a mechanism that initiates osteoarthritis (OA) development and drives OA progression. In the future, articulating surface velocity measurements may be useful to identify patients at risk for long-term OA due to joint instability.
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Affiliation(s)
- William J Anderst
- Department of Orthopedics, Biodynamics Lab, University of Pittsburgh, Pittsburgh, Pennsylvania 15203, USA.
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173
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Chan KM, Fong DTP, Hong Y, Yung PSH, Lui PPY. Orthopaedic sport biomechanics - a new paradigm. Clin Biomech (Bristol, Avon) 2008; 23 Suppl 1:S21-30. [PMID: 18054416 DOI: 10.1016/j.clinbiomech.2007.10.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2007] [Revised: 10/11/2007] [Accepted: 10/12/2007] [Indexed: 02/07/2023]
Abstract
This article proposes a new paradigm, "Orthopaedic sport biomechanics", for the understanding of the role of biomechanics in preventing and managing sports injury. Biomechanics has three main roles in this paradigm: (1) injury prevention, (2) immediate evaluation of treatment, and (3) long-term outcome evaluation. Related previous studies showing the approach in preventing and managing anterior cruciate ligament rupture and anterior talofibular ligament tear are highlighted. Orthopaedics and biomechanics specialists are encouraged to understand what they could contribute to the current and future practice of sports medicine.
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Affiliation(s)
- Kai-Ming Chan
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
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174
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Draper CE, Santos JM, Kourtis LC, Besier TF, Fredericson M, Beaupre GS, Gold GE, Delp SL. Feasibility of using real-time MRI to measure joint kinematics in 1.5T and open-bore 0.5T systems. J Magn Reson Imaging 2008; 28:158-66. [PMID: 18581329 DOI: 10.1002/jmri.21413] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE To test the feasibility and accuracy of measuring joint motion with real-time MRI in a 1.5T scanner and in a 0.5T open-bore scanner and to assess the dependence of measurement accuracy on movement speed. MATERIALS AND METHODS We developed an MRI-compatible motion phantom to evaluate the accuracy of tracking bone positions with real-time MRI for varying movement speeds. The measurement error was determined by comparing phantom positions estimated from real-time MRI to those measured using optical motion capture techniques. To assess the feasibility of measuring in vivo joint motion, we calculated 2D knee joint kinematics during knee extension in six subjects and compared them to previously reported measurements. RESULTS Measurement accuracy decreased as the phantom's movement speed increased. The measurement accuracy was within 2 mm for velocities up to 217 mm/s in the 1.5T scanner and 38 mm/s in the 0.5T scanner. We measured knee joint kinematics with small intraobserver variation (variance of 0.8 degrees for rotation and 3.6% of patellar width for translation). CONCLUSION Our results suggest that real-time MRI can be used to measure joint kinematics when 2 mm accuracy is sufficient. They can also be used to prescribe the speed of joint motion necessary to achieve certain measurement accuracy.
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Affiliation(s)
- Christine E Draper
- Department of Mechanical Engineering, Stanford University, 318 Campus Drive, Stanford, CA 94305, USA
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175
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Anderst WJ, Vaidya R, Tashman S. A technique to measure three-dimensional in vivo rotation of fused and adjacent lumbar vertebrae. Spine J 2008; 8:991-7. [PMID: 17919983 DOI: 10.1016/j.spinee.2007.07.390] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2007] [Revised: 05/03/2007] [Accepted: 07/23/2007] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Previous attempts to measure vertebral motion in vivo have been either static measure, imprecise, two-dimensional, or overly invasive to be applied to serial studies. PURPOSE This study evaluated the efficacy of a unique high-speed biplane X-ray system for tracking lumbar vertebrae in vivo during dynamic motion. Additional goals were to determine parameters for future studies using this tool and to obtain preliminary data on the effects of lumbar fusion on vertebral kinematics. STUDY DESIGN/SETTING A high-speed biplane radiographic X-ray system was used to measure the three-dimensional (3D) relative rotation between fused and adjacent vertebrae in vivo during muscle driven movement. Subjects were tested 2, 3, and 6 months after fusion procedures to assess vertebral motion of fused and adjacent vertebrae. PATIENT SAMPLE Five subjects received lumbar fusion surgery. OUTCOME MEASURES Physiologic measures included 3D vertebral rotation of fused and adjacent vertebrae. METHODS Tantalum beads were implanted into lumbar vertebrae during fusion operations. Radiographic data was collected continuously at 50 frames per second during flexion-extension, lateral bending, and axial twist movements serially, at 2, 3, and 6 months after fusion surgery. RESULTS Implanted beads were tracked with an accuracy of 0.18 mm during dynamic motion. Vertebral rotation was not necessarily linearly related to trunk rotation, supporting the use of continuous data collection during movement; collecting only movement start and end points may not be sufficient. Some movements indicated fusion was complete, whereas others indicated incomplete fusion. This suggests patients be tested performing a variety of movements to test for complete fusion. The fusion site often acted as a pivot point for vertebral rotation, with vertebrae superior to the fusion rotating in the direction of the trunk and vertebrae inferior rotating opposite trunk rotation. CONCLUSIONS This technique is sufficiently accurate for in vivo serial studies of vertebral motion during muscle driven movements. A variety of movements should be performed to assess surgical results, and the data should be collected continuously through the entire range of motion, not just at the movement endpoints. However, care must be exercised in subject selection, in camera location, and in the placement of tracking beads in relation to implanted instrumentation.
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Affiliation(s)
- William J Anderst
- Department of Orthopaedics, University of Pittsburgh, Biodynamics Lab, 3820 South Water Street, Pittsburgh, PA 15203, USA.
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176
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Craig M, Bir C, Viano D, Tashman S. Biomechanical response of the human mandible to impacts of the chin. J Biomech 2008; 41:2972-80. [DOI: 10.1016/j.jbiomech.2008.07.020] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2007] [Revised: 07/02/2008] [Accepted: 07/24/2008] [Indexed: 11/24/2022]
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177
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Bey MJ, Kline SK, Tashman S, Zauel R. Accuracy of biplane x-ray imaging combined with model-based tracking for measuring in-vivo patellofemoral joint motion. J Orthop Surg Res 2008; 3:38. [PMID: 18771582 PMCID: PMC2538511 DOI: 10.1186/1749-799x-3-38] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2008] [Accepted: 09/04/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Accurately measuring in-vivo motion of the knee's patellofemoral (PF) joint is challenging. Conventional measurement techniques have largely been unable to accurately measure three-dimensional, in-vivo motion of the patella during dynamic activities. The purpose of this study was to assess the accuracy of a new model-based technique for measuring PF joint motion. METHODS To assess the accuracy of this technique, we implanted tantalum beads into the femur and patella of three cadaveric knee specimens and then recorded dynamic biplane radiographic images while manually flexing and extending the specimen. The position of the femur and patella were measured from the biplane images using both the model-based tracking system and a validated dynamic radiostereometric analysis (RSA) technique. Model-based tracking was compared to dynamic RSA by computing measures of bias, precision, and overall dynamic accuracy of four clinically-relevant kinematic parameters (patellar shift, flexion, tilt, and rotation). RESULTS The model-based tracking technique results were in excellent agreement with the RSA technique. Overall dynamic accuracy indicated errors of less than 0.395 mm for patellar shift, 0.875 degrees for flexion, 0.863 degrees for tilt, and 0.877 degrees for rotation. CONCLUSION This model-based tracking technique is a non-invasive method for accurately measuring dynamic PF joint motion under in-vivo conditions. The technique is sufficiently accurate in measuring clinically relevant changes in PF joint motion following conservative or surgical treatment.
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Affiliation(s)
- Michael J Bey
- Henry Ford Health Systems, Department of Orthopaedics, Bone and Joint Center, E&R 2015, 2799 W Grand Blvd, Detroit, MI 48202, USA.
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178
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Patient-specific knee joint finite element model validation with high-accuracy kinematics from biplane dynamic Roentgen stereogrammetric analysis. J Biomech 2008; 41:2633-8. [DOI: 10.1016/j.jbiomech.2008.06.027] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2008] [Revised: 06/12/2008] [Accepted: 06/16/2008] [Indexed: 11/18/2022]
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179
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Wilson DR, McWalter EJ, Johnston JD. The Measurement of Joint Mechanics and their Role in Osteoarthritis Genesis and Progression. Rheum Dis Clin North Am 2008; 34:605-22. [DOI: 10.1016/j.rdc.2008.05.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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180
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Anderst W, Zauel R, Bishop J, Demps E, Tashman S. Validation of three-dimensional model-based tibio-femoral tracking during running. Med Eng Phys 2008; 31:10-6. [PMID: 18434230 DOI: 10.1016/j.medengphy.2008.03.003] [Citation(s) in RCA: 198] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2007] [Revised: 03/07/2008] [Accepted: 03/12/2008] [Indexed: 12/28/2022]
Abstract
The purpose of this study was to determine the accuracy of a radiographic model-based tracking technique that measures the three-dimensional in vivo motion of the tibio-femoral joint during running. Tantalum beads were implanted into the femur and tibia of three subjects and computed tomography (CT) scans were acquired after bead implantation. The subjects ran 2.5m/s on a treadmill positioned within a biplane radiographic system while images were acquired at 250 frames per second. Three-dimensional implanted bead locations were determined and used as a "gold standard" to measure the accuracy of the model-based tracking. The model-based tracking technique optimized the correlation between the radiographs acquired via the biplane X-ray system and digitally reconstructed radiographs created from the volume-rendered CT model. Accuracy was defined in terms of measurement system bias, precision and root-mean-squared (rms) error. Results were reported in terms of individual bone tracking and in terms of clinically relevant tibio-femoral joint translations and rotations (joint kinematics). Accuracy for joint kinematics was as follows: model-based tracking measured static joint orientation with a precision of 0.2 degrees or better, and static joint position with a precision of 0.2mm or better. Model-based tracking precision for dynamic joint rotation was 0.9+/-0.3 degrees , 0.6+/-0.3 degrees , and 0.3+/-0.1 degrees for flexion-extension, external-internal rotation, and ab-adduction, respectively. Model-based tracking precision when measuring dynamic joint translation was 0.3+/-0.1mm, 0.4+/-0.2mm, and 0.7+/-0.2mm in the medial-lateral, proximal-distal, and anterior-posterior direction, respectively. The combination of high-speed biplane radiography and volumetric model-based tracking achieves excellent accuracy during in vivo, dynamic knee motion without the necessity for invasive bead implantation.
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Affiliation(s)
- William Anderst
- University of Pittsburgh, Department of Orthopaedic Surgery, Orthopaedic Research Laboratories, 3820 South Water Street, Pittsburgh, PA 15203, USA.
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181
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Gillette RL, Angle TC. Recent developments in canine locomotor analysis: a review. Vet J 2008; 178:165-76. [PMID: 18406641 DOI: 10.1016/j.tvjl.2008.01.009] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2006] [Revised: 01/14/2008] [Accepted: 01/15/2008] [Indexed: 10/22/2022]
Abstract
Subjective evaluation of canine gait has been used for many years. However, our ability to perceive minute details during the gait cycle can be difficult and in some respects impossible even for the most talented gait specialist. The evolution of computer technology in computer assisted gait analysis over the past 20 years has improved the ability to quantitatively define temporospatial gait characteristics. These technological advances and new developments in methodological approaches have assisted researchers and clinicians in gaining a better understanding of canine locomotion. The use of kinematic and kinetic analysis has been validated as a useful tool in veterinary medicine. This paper is an overview of the kinematic and kinetic analytical techniques of the last decade.
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Affiliation(s)
- Robert L Gillette
- Auburn University Veterinary Sports Medicine Program, Department of Clinical Sciences, College of Veterinary Medicine, 100 McAdory Hall, Auburn University, AL 36832, USA.
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182
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Barber FA, Dockery WD. Long-term absorption of beta-tricalcium phosphate poly-L-lactic acid interference screws. Arthroscopy 2008; 24:441-7. [PMID: 18375277 DOI: 10.1016/j.arthro.2007.10.004] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2007] [Revised: 09/24/2007] [Accepted: 10/07/2007] [Indexed: 02/02/2023]
Abstract
PURPOSE The purpose of this study was to evaluate the long-term in vivo degradation of biodegradable interference screws made of poly-L-lactic acid (PLLA) and beta-tricalcium phosphate (beta-TCP). METHODS Twenty patients undergoing patellar tendon autograft anterior cruciate ligament reconstruction fixed at both the femur and tibia with beta-TCP-PLLA screws at least 44 months earlier were evaluated by physical, radiographic, and computed tomography (CT) evaluations. This study was approved by the institutional review board. Lysholm, Tegner, Cincinnati, and International Knee Documentation Committee scores were also obtained. CT data were measured in Hounsfield units. RESULTS We evaluated 13 male and 7 female patients at a mean of 50 months after surgery (range, 44 to 56 months). CT scans and radiographs showed the bone plug fused to the tunnel wall with no beta-TCP-PLLA screw remaining. The screws were replaced with clearly calcified non-trabecular material, denser than soft tissue. Osteoconductivity was present in 75% of the tunnels and complete in 10%. No positive pivot-shift tests were found. Lysholm, Tegner, and Cincinnati scores improved from 60.4, 3.7, and 53.3, respectively, preoperatively to 90.8, 5.8, and 86.4, respectively, at follow-up. The mean side-to-side difference determined by use of the KT arthrometer (MEDmetric, San Diego, CA) was 0.4 mm. CONCLUSIONS The beta-TCP-PLLA interference screw (Bilok; ArthroCare, Sunnyvale, CA) completely degraded, and no remnant was present 4 years after insertion. Osteoconductivity was confirmed by CT scans at 75% of the screw sites and completely filled the site in 10%. The addition of beta-TCP to PLLA results in a biocomposite interference screw that is osteoconductive. LEVEL OF EVIDENCE Level IV, therapeutic case series.
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Affiliation(s)
- F Alan Barber
- Plano Orthopedic and Sports Medicine Center, Plano, Texas 75093, USA
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183
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Fernandez JW, Akbarshahi M, Kim HJ, Pandy MG. Integrating modelling, motion capture and x-ray fluoroscopy to investigate patellofemoral function during dynamic activity. Comput Methods Biomech Biomed Engin 2008; 11:41-53. [DOI: 10.1080/10255840701551046] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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184
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de Bruin PW, Kaptein BL, Stoel BC, Reiber JHC, Rozing PM, Valstar ER. Image-based RSA: Roentgen stereophotogrammetric analysis based on 2D–3D image registration. J Biomech 2008; 41:155-64. [PMID: 17706656 DOI: 10.1016/j.jbiomech.2007.07.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2007] [Revised: 07/01/2007] [Accepted: 07/02/2007] [Indexed: 10/22/2022]
Abstract
Image-based Roentgen stereophotogrammetric analysis (IBRSA) integrates 2D-3D image registration and conventional RSA. Instead of radiopaque RSA bone markers, IBRSA uses 3D CT data, from which digitally reconstructed radiographs (DRRs) are generated. Using 2D-3D image registration, the 3D pose of the CT is iteratively adjusted such that the generated DRRs resemble the 2D RSA images as closely as possible, according to an image matching metric. Effectively, by registering all 2D follow-up moments to the same 3D CT, the CT volume functions as common ground. In two experiments, using RSA and using a micromanipulator as gold standard, IBRSA has been validated on cadaveric and sawbone scapula radiographs, and good matching results have been achieved. The accuracy was: |mu |< 0.083 mm for translations and |mu| < 0.023 degrees for rotations. The precision sigma in x-, y-, and z-direction was 0.090, 0.077, and 0.220 mm for translations and 0.155 degrees , 0.243 degrees , and 0.074 degrees for rotations. Our results show that the accuracy and precision of in vitro IBRSA, performed under ideal laboratory conditions, are lower than in vitro standard RSA but higher than in vivo standard RSA. Because IBRSA does not require radiopaque markers, it adds functionality to the RSA method by opening new directions and possibilities for research, such as dynamic analyses using fluoroscopy on subjects without markers and computer navigation applications.
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Affiliation(s)
- P W de Bruin
- Orthopaedics Department, Leiden University Medical Center, Leiden, The Netherlands
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185
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Bey MJ, Kline SK, Zauel R, Lock TR, Kolowich PA. Measuring dynamic in-vivo glenohumeral joint kinematics: technique and preliminary results. J Biomech 2007; 41:711-4. [PMID: 17996874 DOI: 10.1016/j.jbiomech.2007.09.029] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2007] [Revised: 09/24/2007] [Accepted: 09/25/2007] [Indexed: 11/16/2022]
Abstract
Rotator cuff tears are a common injury that affect a significant percentage of the population over age 60. Although it is widely believed that the rotator cuff's primary function is to stabilize the humerus against the glenoid during shoulder motion, accurately measuring the three-dimensional (3D) motion of the shoulder's glenohumeral joint under in-vivo conditions has been a challenging endeavor. In particular, conventional motion measurement techniques have frequently been limited to static or two-dimensional (2D) analyses, and have suffered from limited or unknown in-vivo accuracy. We have recently developed and validated a new model-based tracking technique that is capable of accurately measuring the 3D position and orientation of the scapula and humerus from biplane X-ray images. Herein we demonstrate the in-vivo application of this technique for accurately measuring glenohumeral joint translations during shoulder motion in the repaired and contralateral shoulders of patients following rotator cuff repair. Five male subjects were tested at 3-4 months following arthroscopic rotator cuff repair. Superior-inferior humeral translation was measured during elevation, and anterior-posterior humeral translation was measured during external rotation in both the repaired and contralateral shoulders. The data failed to detect statistically significant differences between the repaired and contralateral shoulders in superior-inferior translation (p=0.74) or anterior-posterior translation (p=0.77). The measurement technique overcomes the limitations of conventional motion measurement techniques by providing accurate, 3D, in-vivo measures of glenohumeral joint motion during dynamic activities. On-going research is using this technique to assess the effects of conservative and surgical treatment of rotator cuff tears.
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Affiliation(s)
- Michael J Bey
- Henry Ford Hospital, Department of Orthopaedics, Bone and Joint Center; E&R 2015, 2799 W. Grand Blvd., Detroit, MI 48202, USA.
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186
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Hardy WN, Mason MJ, Foster CD, Shah CS, Kopacz JM, Yang KH, King AI, Bishop J, Bey M, Anderst W, Tashman S. A study of the response of the human cadaver head to impact. STAPP CAR CRASH JOURNAL 2007; 51:17-80. [PMID: 18278591 PMCID: PMC2474809 DOI: 10.4271/2007-22-0002] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
High-speed biplane x-ray and neutral density targets were used to examine brain displacement and deformation during impact. Relative motion, maximum principal strain, maximum shear strain, and intracranial pressure were measured in thirty-five impacts using eight human cadaver head and neck specimens. The effect of a helmet was evaluated. During impact, local brain tissue tends to keep its position and shape with respect to the inertial frame, resulting in relative motion between the brain and skull and deformation of the brain. The local brain motions tend to follow looping patterns. Similar patterns are observed for impact in different planes, with some degree of posterior-anterior and right-left symmetry. Peak coup pressure and pressure rate increase with increasing linear acceleration, but coup pressure pulse duration decreases. Peak average maximum principal strain and maximum shear are on the order of 0.09 for CFC 60 Hz data for these tests. Peak average maximum principal strain and maximum shear decrease with increasing linear acceleration, coup pressure, and coup pressure rate. Linear and angular acceleration of the head are reduced with use of a helmet, but strain increases. These results can be used for the validation of finite element models of the human head.
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Affiliation(s)
- Warren N Hardy
- Wayne State University, Bioengineering Center, 818 W. Hancock, Detroit, MI 48201, USA.
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187
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Bey MJ, Brock SK, Beierwaltes WN, Zauel R, Kolowich PA, Lock TR. In vivo measurement of subacromial space width during shoulder elevation: technique and preliminary results in patients following unilateral rotator cuff repair. Clin Biomech (Bristol, Avon) 2007; 22:767-73. [PMID: 17560699 PMCID: PMC2033432 DOI: 10.1016/j.clinbiomech.2007.04.006] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2007] [Revised: 04/10/2007] [Accepted: 04/11/2007] [Indexed: 02/07/2023]
Abstract
BACKGROUND The shoulder's subacromial space is of significant clinical interest due to its association with rotator cuff disease. Previous studies have estimated the subacromial space width to be 2-17 mm, but no study has measured in vivo subacromial space width during shoulder motion. The purpose of this study was to measure the in vivo subacromial space width during shoulder elevation in patients following rotator cuff repair. METHODS Biplane X-ray images were collected during shoulder elevation of 11 patients who had undergone rotator cuff repair. Glenohumeral joint motion was measured from the biplane X-ray images for each subject's repaired and asymptomatic, contralateral shoulders. The joint motion data were combined with subject-specific CT models to measure the subacromial space width during shoulder motion. FINDINGS Subacromial space width decreased with shoulder elevation, ranging from 2.3 to 7.4 mm in the repaired shoulder and 1.2-7.1 mm in the contralateral shoulder. Subacromial space width in the repaired shoulder was only 0.5 mm less than the contralateral shoulder when averaged over 10-60 degrees of glenohumeral elevation. INTERPRETATION The results indicate that the humerus in the repaired shoulder is positioned more cranially on the glenoid than in the contralateral shoulder. It is unclear if these subtle differences in subacromial space width are due to the surgical procedure or post-operative stiffness, or if subacromial impingement contributed to the development of the rotator cuff tear. Future research will ascertain if these results represent a transient response to the surgery or a more fundamental difference in rotator cuff function between repaired and contralateral shoulders.
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Affiliation(s)
- Michael J Bey
- Henry Ford Hospital, Department of Orthopaedic Surgery, Bone and Joint Center, 2799 W. Grand Blvd., E&R 2015 Detroit, MI 48202, United States.
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188
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Seisler AR, Sheehan FT. Normative three-dimensional patellofemoral and tibiofemoral kinematics: a dynamic, in vivo study. IEEE Trans Biomed Eng 2007; 54:1333-41. [PMID: 17605365 DOI: 10.1109/tbme.2007.890735] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
In order to advance biomechanical modeling, knee joint implant design and clinical treatment of knee joint pathology, accurate in vivo kinematic data of the combined patellofemoral and tibiofemoral joint during volitional activity are critical. For example, one cause of the increased prevalence of anterior knee pain in the female population is hypothesized to be altered tibiofemoral kinematics, resulting in pathological patellofemoral kinematics. Thus, the objectives of this paper were to test the hypothesis that knee joint kinematics vary based on gender and to explore the correlation between the 3-D kinematics of the patellofemoral and tibiofemoral joints. In order to accomplish these goals, a large (n = 34) normative database of combined six degree of freedom patellofemoral and tibiofemoral kinematics, acquired noninvasively during volitional knee extension-flexion using fast-PC (dynamic) magnetic resonance imaging, was established. In this normative database, few correlations between tibiofemoral and patellofemoral kinematics were found. Specifically, tibial external rotation did not predict lateral patellar tilt, as has been stated in previous studies. In general, significant differences could not be found based on gender. Further investigation into these relationships in the presence of pathology is warranted.
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Affiliation(s)
- Andrea R Seisler
- National Institutes of Health, Physical Disabilities Branch, National Institute of Child Health and Human Development and the Clinical Center, NIH, Bethesda, MD 20892, USA
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189
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Beillas P, Lee SW, Tashman S, Yang KH. Sensitivity of the tibio-femoral response to finite element modeling parameters. Comput Methods Biomech Biomed Engin 2007; 10:209-21. [PMID: 17558649 DOI: 10.1080/10255840701283988] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
A generic finite element (FE) model of the lower limb was used to study the knee response in-vivo during a one-legged hop. The approach uses an explicit FE code and a combination of estimated muscle forces and measured three-dimensional tibio-femoral kinematics and ground reaction force as input to the FE model. The sensitivity of the simulated tibio-femoral response to variations of key geometric and material parameters was investigated by performing a total of 38 different simulations. The amplitudes of both kinematic and kinetic responses were affected by the change of these parameters. For the current approach, the results suggest that while cartilage mechanical and geometric properties are very important for the estimation of tibio-femoral cartilage pressure, they have limited effects on the overall kinematic response. The study may help to better define the relative importance of modeling parameters for the development of subject-specific models.
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Affiliation(s)
- P Beillas
- LBMC, French National Institute for Transport and Safety Research, INRETS UCBLI UMR-T 9406, Bron, France.
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190
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Howard RA, Rosvold JM, Darcy SP, Corr DT, Shrive NG, Tapper JE, Ronsky JL, Beveridge JE, Marchuk LL, Frank CB. Reproduction of In Vivo Motion Using a Parallel Robot. J Biomech Eng 2007; 129:743-9. [PMID: 17887900 DOI: 10.1115/1.2768983] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Although alterations in knee joint loading resulting from injury have been shown to influence the development of osteoarthritis, actual in vivo loading conditions of the joint remain unknown. A method for determining in vivo ligament loads by reproducing joint specific in vivo kinematics using a robotic testing apparatus is described. The in vivo kinematics of the ovine stifle joint during walking were measured with 3D optical motion analysis using markers rigidly affixed to the tibia and femur. An additional independent single degree of freedom measuring device was also used to record a measure of motion. Following sacrifice, the joint was mounted in a robotic/universal force sensor test apparatus and referenced using a coordinate measuring machine. A parallel robot configuration was chosen over the conventional serial manipulator because of its greater accuracy and stiffness. Median normal gait kinematics were applied to the joint and the resulting accuracy compared. The mean error in reproduction as determined by the motion analysis system varied between 0.06mm and 0.67mm and 0.07deg and 0.74deg for the two individual tests. The mean error measured by the independent device was found to be 0.07mm and 0.83mm for the two experiments, respectively. This study demonstrates the ability of this system to reproduce in vivo kinematics of the ovine stifle joint in vitro. The importance of system stiffness is discussed to ensure accurate reproduction of joint motion.
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Affiliation(s)
- Ryan A Howard
- Department of Civil Engineering, Schulich School of Engineering, University of Calgary, c/o Joint Injury and Arthritis Research Group, 3330 Hospital Drive, Calgary, Alberta, Canada T2N 4N1.
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191
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Feeney LC, Lin CF, Marcellin-Little DJ, Tate AR, Queen RM, Yu B. Validation of two-dimensional kinematic analysis of walk and sit-to-stand motions in dogs. Am J Vet Res 2007; 68:277-82. [PMID: 17331017 DOI: 10.2460/ajvr.68.3.277] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To assess the intra- and interobserver repeatability of 2-dimensional (2-D) kinematic analysis of walk and sit-to-stand motions in dogs. ANIMALS 10 healthy adult Labrador Retrievers. PROCEDURES 10 dogs were filmed during walk and sit-to-stand motions. Five trials were recorded for each dog, 3 of which were digitized. Two observers manually marked 15 landmarks on each frame during the motions of interest for these 3 trials. Each observer repeated the procedure approximately 1 week later. The 2-D joint angles were calculated. Intra- and interobserver coefficients of multiple correlations (CMCs) were calculated for each joint angle-time history. RESULTS Intraobserver repeatability, assessed as the mean CMCs of 12 joint angle measurements made for 10 dogs by 2 observers, was good or excellent in 23 of 24 (96%) mean CMCs of the joints measured. Interobserver variation, assessed by comparing CMCs of measurements made by 2 observers on 10 dogs on 2 days, was good or excellent in 161 of 240 (67%) CMCs of joints measured. CONCLUSIONS AND CLINICAL RELEVANCE Intraobserver repeatability of 2-D kinematic measurements made on digitized videotapes was excellent. Interobserver repeatability of these measurements was acceptable.
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Affiliation(s)
- Lauren C Feeney
- Comparative Orthopedics Laboratory, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606
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192
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Beardsley CL, Paller DJ, Peura GD, Brattbakk B, Beynnon BD. The effect of coordinate system choice and segment reference on RSA-based knee translation measures. J Biomech 2007; 40:1417-22. [PMID: 16797021 DOI: 10.1016/j.jbiomech.2006.05.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2005] [Accepted: 05/07/2006] [Indexed: 11/26/2022]
Abstract
Roentgen stereophotogrammetric analysis (RSA) can be utilized to accurately describe joint kinematics, but even when measuring small displacements within radiographically discernible structures, standardized reference frames are imperative for useful comparison across patients and across studies. In the current paper, accurately controlled laboratory models demonstrated the considerable influence that a mere 1.9-cm offset of the origin of the coordinate system from the rotation axes could exert on translation measures when rotations were occurring. In addition, the use of two different coordinate systems to gauge translation on a radiographic anterior-posterior (A-P) knee laxity exam resulted in a significant correlation (R(2)=0.562) between the two systems; however, differences of up 9.28 mm were found between corresponding measurements. This implies that clinical conclusions can potentially be upheld or refuted, based on the same data set, subject to coordinate system definition. Although the data analyzed presently involved the knee joint, similar issues surround the RSA motion analysis of other joints as well.
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Affiliation(s)
- Christina L Beardsley
- McClure Musculoskeletal Research Center, University of Vermont, Stafford Hall, Burlington, VT 05405, USA.
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193
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Moore DC, Crisco JJ, Trafton TG, Leventhal EL. A digital database of wrist bone anatomy and carpal kinematics. J Biomech 2007; 40:2537-42. [PMID: 17276439 DOI: 10.1016/j.jbiomech.2006.10.041] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2006] [Accepted: 10/31/2006] [Indexed: 11/23/2022]
Abstract
The skeletal wrist consists of eight small, intricately shaped carpal bones. The motion of these bones is complex, occurs in three dimensions, and remains incompletely defined. Our previous efforts have been focused on determining the in vivo three-dimensional (3-D) kinematics of the normal and abnormal carpus. In so doing we have developed an extensive database of carpal bone anatomy and kinematics from a large number of healthy subjects. The purpose of this paper is to describe that database and to make it available to other researchers. CT volume images of both wrists from 30 healthy volunteers (15 males and 15 females) were acquired in multiple wrist positions throughout the normal range of wrist motion. The outer cortical surfaces of the carpal bones, radius and ulna, and proximal metacarpals were segmented and the 3-D motion of each bone was calculated for each wrist position. The database was constructed to include high-resolution surface models, measures of bone volume and shape, and the 3-D kinematics of each segmented bone. The database does not include soft tissues of the wrist. While there are numerous digital anatomical databases, this one is unique in that it includes a large number of subjects and it contains in vivo kinematic data as well as the bony anatomy.
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Affiliation(s)
- Douglas C Moore
- Bioengineering Laboratory, Department of Orthopaedics, Brown Medical School/Rhode Island Hospital, CORO West, Suite 404, 1 Hoppin Street, Providence, RI 02903, USA
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194
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Stergiou N, Ristanis S, Moraiti C, Georgoulis AD. Tibial Rotation in Anterior Cruciate Ligament (ACL)-Deficient and ACL-Reconstructed Knees. Sports Med 2007; 37:601-13. [PMID: 17595155 DOI: 10.2165/00007256-200737070-00004] [Citation(s) in RCA: 124] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Excessive tibial rotation has been documented in anterior cruciate ligament (ACL) deficiency during walking. ACL reconstruction has been unable to correct this abnormality in activities that are more demanding than walking and involve both anterior and rotational loading of the knee. These findings persist regardless of graft selection for the ACL reconstruction (bone-patellar tendon-bone or semitendinosus gracilis). Based on this research work, we propose a theoretical perspective for the development of osteoarthritis in both the ACL-deficient and the ACL-reconstructed knee. We propose that excessive tibial rotation will lead to abnormal loading of the cartilage areas that are not commonly loaded in the healthy knee. Over time, this abnormal loading will lead to osteoarthritis. We hypothesise that the development of new surgical procedures and grafts, such as a more horizontally oriented femoral tunnel or a double-bundle ACL reconstruction, could possibly restore tibial rotation to normal levels and prevent future knee pathology. However, in vivo gait analysis studies are needed to examine the effects of these surgical procedures on tibial rotation. Prospective in vivo and in vitro studies are also necessary to verify or refute our theoretical proposition for the development of osteoarthritis.
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Affiliation(s)
- Nicholas Stergiou
- Health, Physical Education and Recreation Biomechanics Laboratory, University of Nebraska at Omaha, Omaha, Nebraska, USA
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195
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Tashman S, Kolowich P, Collon D, Anderson K, Anderst W. Dynamic function of the ACL-reconstructed knee during running. Clin Orthop Relat Res 2007; 454:66-73. [PMID: 17091011 DOI: 10.1097/blo.0b013e31802bab3e] [Citation(s) in RCA: 237] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Little is known about the three-dimensional behavior of the anterior cruciate ligament (ACL) reconstructed knee during dynamic, functional loading, or how dynamic knee function changes over time in the reconstructed knee. We hypothesized dynamic, in vivo function of the ACL-reconstructed knee is different from the contralateral, uninjured knee and changes over time. We measured knee kinematics for 16 subjects during downhill running 5 and 12 months after ACL reconstruction (bone-patellar tendon-bone or quadrupled hamstring tendon with interference screw fixation) using a 250 frame per second stereoradiographic system. We used repeated-measures ANOVA to ascertain whether there were differences between the uninjured and reconstructed limbs and over time. We found no differences in anterior tibial translation between limbs, but reconstructed knees were more externally rotated and in more adduction (varus) during the stance phase of running. Anterior tibial translation increased from 5 to 12 months after surgery in the reconstructed knees. Anterior cruciate ligament reconstruction failed to restore normal rotational knee kinematics during dynamic, functional loading and some degradation of graft function occurred over time. These abnormal motions may contribute to long-term joint degeneration associated with ACL injury and reconstruction.
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Affiliation(s)
- Scott Tashman
- Department of Orthopaedics, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
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196
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Sheehan FT. The finite helical axis of the knee joint (a non-invasive in vivo study using fast-PC MRI). J Biomech 2007; 40:1038-47. [PMID: 17141789 DOI: 10.1016/j.jbiomech.2006.04.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2005] [Accepted: 04/05/2006] [Indexed: 10/23/2022]
Abstract
An understanding of the in vivo knee joint kinematics is critical for the further improvement and validation of knee joint models and for the development of better surgical and rehabilitative protocols. Unfortunately, most studies exploring the finite helical axis (FHA) tend to produce excellent qualitative results, but quantitative results are often lacking. Thus, the purpose of this study was to non-invasively and in vivo quantify the tibiofemoral FHA in a relatively large normal population during volitional knee extension using fast-PC MRI, to report the data relative to consistent coordinate systems (making it available for modeling input, experimental comparison and for device design), to determine the variability of the FHA, to investigate the screw home mechanism and to test the hypothesis that knee joint kinematics are independent of gender. Intra- and inter-subject repeatability was excellent. The intra- (inter-) subject repeatability of the FHA orientation in the frontal and axial planes was 1.8% (3.3%) and 3.7% (6.0%) of the average value, respectively. At the beginning of extension, the FHA was directed laterally and slightly superiorly and at the end of extension, it was directed in the lateral-inferior direction, indicative of the screw-home mechanism. The FHA location was not fixed during extension. There was small, but significant differences in all FHA parameters between genders and normalizing positional data relative to epicondylar width helped to reduce this difference. The data obtained in the current study forms an excellent base for future knee joint modeling and clinical studies.
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Affiliation(s)
- Frances T Sheehan
- Physical Disabilities Branch(1), National Institutes of Health, Bethesda, MD, USA.
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197
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Steckel H, Starman JS, Baums MH, Klinger HM, Schultz W, Fu FH. The double-bundle technique for anterior cruciate ligament reconstruction: a systematic overview. Scand J Med Sci Sports 2006; 17:99-108. [PMID: 17076829 DOI: 10.1111/j.1600-0838.2006.00600.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In traditional anterior cruciate ligament reconstruction, there is a subset of patients complaining of knee instability, especially rotational instability, and athletes not able to return to their preinjury level of sports activity. Currently, controversy exists over the usefulness of the double bundle technique (DBT) in addressing these problems. In order to evaluate the DBT, we completed a literature review from 1969 to February 2006 focusing on anatomy, magnetic resonance imaging, graft incorporation, biomechanics, kinematics, surgical techniques, complications and outcome. The DBT is not a standardized technique, which makes it difficult to compare results. Cadaver studies have proven biomechanical advantages with respect to ap-stability, but assessing the rotational stability remains difficult. There is a lack of available outcome studies with sufficient follow-up to demonstrate the potential advantages of DBT. The theoretical advantages of DBT require careful evaluation with outcome, biomechanical and kinematic studies. In addition, studies are needed to address issues such as graft incorporation and complications. An advantage offered by DBT is the possibility to identify rupture patterns that can lead to surgical preservation of an intact and augmentation of an injured bundle. The approach of augmentating a single bundle technique reconstruction with adequate anterior-posterior but poor rotational stability is promising.
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Affiliation(s)
- H Steckel
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
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198
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Bey MJ, Zauel R, Brock SK, Tashman S. Validation of a new model-based tracking technique for measuring three-dimensional, in vivo glenohumeral joint kinematics. J Biomech Eng 2006; 128:604-9. [PMID: 16813452 PMCID: PMC3072582 DOI: 10.1115/1.2206199] [Citation(s) in RCA: 209] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Shoulder motion is complex and significant research efforts have focused on measuring glenohumeral joint motion. Unfortunately, conventional motion measurement techniques are unable to measure glenohumeral joint kinematics during dynamic shoulder motion to clinically significant levels of accuracy. The purpose of this study was to validate the accuracy of a new model-based tracking technique for measuring three-dimensional, in vivo glenohumeral joint kinematics. We have developed a model-based tracking technique for accurately measuring in vivo joint motion from biplane radiographic images that tracks the position of bones based on their three-dimensional shape and texture. To validate this technique, we implanted tantalum beads into the humerus and scapula of both shoulders from three cadaver specimens and then recorded biplane radiographic images of the shoulder while manually moving each specimen's arm. The position of the humerus and scapula were measured using the model-based tracking system and with a previously validated dynamic radiostereometric analysis (RSA) technique. Accuracy was reported in terms of measurement bias, measurement precision, and overall dynamic accuracy by comparing the model-based tracking results to the dynamic RSA results. The model-based tracking technique produced results that were in excellent agreement with the RSA technique. Measurement bias ranged from -0.126 to 0.199 mm for the scapula and ranged from -0.022 to 0.079 mm for the humerus. Dynamic measurement precision was better than 0.130 mm for the scapula and 0.095 mm for the humerus. Overall dynamic accuracy indicated that rms errors in any one direction were less than 0.385 mm for the scapula and less than 0.374 mm for the humerus. These errors correspond to rotational inaccuracies of approximately 0.25 deg for the scapula and 0.47 deg for the humerus. This new model-based tracking approach represents a non-invasive technique for accurately measuring dynamic glenohumeral joint motion under in vivo conditions. The model-based technique achieves accuracy levels that far surpass all previously reported non-invasive techniques for measuring in vivo glenohumeral joint motion. This technique is supported by a rigorous validation study that provides a realistic simulation of in vivo conditions and we fully expect to achieve these levels of accuracy with in vivo human testing. Future research will use this technique to analyze shoulder motion under a variety of testing conditions and to investigate the effects of conservative and surgical treatment of rotator cuff tears on dynamic joint stability.
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Affiliation(s)
- Michael J Bey
- Henry Ford Health Systems, Department of Orthopaedics and Rehabilitation, Bone and Joint Center, E&R 2015, 2799 W. Grand Blvd., Detroit, MI 48202, USA.
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199
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Barber FA, Dockery WD. Long-term absorption of poly-L-lactic Acid interference screws. Arthroscopy 2006; 22:820-6. [PMID: 16904577 DOI: 10.1016/j.arthro.2006.04.096] [Citation(s) in RCA: 92] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2005] [Revised: 04/14/2006] [Accepted: 04/17/2006] [Indexed: 02/08/2023]
Abstract
PURPOSE To evaluate the long term in vivo degradation of poly-L-lactic acid (PLLA) interference screws with computed tomography (CT) and radiography as used in patellar tendon autograft anterior cruciate ligament (ACL) reconstruction. METHODS A total of 20 patients who had undergone patellar tendon autograft ACL reconstruction fixed with PLLA screws at least 7 years earlier were evaluated by physical examination, radiography, and CT to determine whether PLLA screw reabsorption and bone ingrowth had occurred. This study was granted Institutional Review Board approval. Lysholm, Tegner, Cincinnati, and International Knee Documentation Committee (IKDC) scores were obtained. CT data were measured in Hounsfield units. RESULTS In all, 15 men and 5 women were evaluated 104 months after surgery (range, 89 to 124 months). CT and radiography demonstrated that the bone plug had fused to the tunnel wall, and that no intact interference screw was left. A parallel, threaded, and corticated screw tract was visible adjacent to the bone plug. No bone ingrowth had occurred at the screw site, although, occasionally, minimal calcification was seen. This was never as dense as cancellous bone, and no trabeculae were ever present. No positive pivot-shift test results were obtained. Lysholm, Tegner, and Cincinnati scores were 83, 5.6, and 75, respectively, at follow-up. Average KT difference was 0.7 mm. DISCUSSION PLLA interference screws completely degraded, and the resulting area demonstrated a low Hounsfield count, consistent with soft tissue 7 years after insertion. No significant bone ingrowth occurred at the screw site. Femoral and tibial ACL tunnels were absent of anything but fibrous tissue and usually had a sclerotic cortical lining. CONCLUSION PLLA biodegradable ACL screws eventually disappear completely. PLLA material is not replaced by bone. ACL graft tunnels are filled with nonossified material. This study provides a baseline for comparison with other biodegradable interference screws that may encourage bone ingrowth as they degrade. LEVEL OF EVIDENCE Level IV (no or historical control).
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Affiliation(s)
- F Alan Barber
- Plano Orthopedic and Sports Medicine Center, Plano, Texas 75093, USA.
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200
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Tapper JE, Fukushima S, Azuma H, Thornton GM, Ronsky JL, Shrive NG, Frank CB. Dynamic in vivo kinematics of the intact ovine stifle joint. J Orthop Res 2006; 24:782-92. [PMID: 16514638 DOI: 10.1002/jor.20051] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The ovine stifle joint is a promising model for the investigation of joint mechanobiology in both normal and pathological states. The objectives of this study were to characterize three-dimensional (3D) joint motion in the intact ovine stifle joint during walking, incline walking, and trotting; to determine the range of variability in normal joint motion (intrasubject and intersubject); and to characterize the 3D ground reaction forces in the ovine hind limb during walking. 3D in vivo kinematics were measured in the right hind limb of eight sheep during walking, incline walking, and trotting on a treadmill (accuracy: 0.4 +/- 0.4 mm, 0.4 +/- 0.4 degrees). 3D ground reaction forces were measured in the hind limbs of the same subjects during walking. Joint flexion ranged from 43.1 to 77.0 degrees, and was coupled with abduction (0.0-4.1 degrees ), internal rotation (5.9-17.6 degrees), and translations in the medial (5.1-7.3 mm), anterior (21.9-23.8 mm), and superior (6.0-11.4 mm) directions. Kinematics were similar during walking, incline walking, and trotting. Intrasubject variability was small, ranging from 0.4-2.0 degrees for rotations, and 0.4-0.5 mm for translations. The active range of joint motion was offset between subjects leading to intersubject variability of 4.1-7.4 degrees for rotations and 2.5-4.2 mm for translations. Peak vertical ground reaction forces in the hind limbs ranged from 34.5(+/-1.6) to 50.0(+/-5.6)% body weight. This study establishes the bounds of normal motion in the intact ovine stifle joint and provides baseline data for further studies of joint mechanobiology in this model.
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Affiliation(s)
- Janet E Tapper
- Department of Mechanical and Manufacturing Engineering, University of Calgary, c/o Joint Injury and Arthritis Research Group, 3330 Hospital Dr, Calgary, Alberta, Canada T2N 4N1.
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