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Auer S, Kubowitsch S, Dendorfer S. [Combined influence of psychological and biomechanical factors in muscular loads in soccer : A new approach for the prevention of muscle injuries]. ORTHOPADIE (HEIDELBERG, GERMANY) 2023; 52:876-881. [PMID: 37782318 PMCID: PMC10622364 DOI: 10.1007/s00132-023-04437-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/17/2023] [Indexed: 10/03/2023]
Abstract
When mental stress and musculoskeletal loading interact, the risk for injury increases due to altered body kinematics and increased muscle tension. These changes can be detected with musculoskeletal models, and mental loading and stress must be analyzed at emotional, cognitive, and behavioral levels. To investigate these kinematic and loading changes under stress, competitive athletes were subjected to mental stress during highly dynamic movements, and musculoskeletal models were used to analyze the biomechanical loading. It was shown that under mental stress, independent of the subjective perception, a strong change in muscle forces can occur. Accordingly, competitive athletes should undergo screenings to assess individual movement patterns and promote general stress resilience.
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Affiliation(s)
- Simon Auer
- Labor für Biomechanik, Ostbayerische Technische Hochschule Regensburg, Seybothstraße 2, 93053, Regensburg, Deutschland
| | - Simone Kubowitsch
- Abteilung Wirtschaftspsychologie, Technische Hochschule Augsburg, Augsburg, Deutschland
| | - Sebastian Dendorfer
- Labor für Biomechanik, Ostbayerische Technische Hochschule Regensburg, Seybothstraße 2, 93053, Regensburg, Deutschland.
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Kunze KN, Bovonratwet P, Polce EM, Paul K, Sculco PK. Comparison of Surgical Time, Short-term Adverse Events, and Implant Placement Accuracy Between Manual, Robotic-assisted, and Computer-navigated Total Hip Arthroplasty: A Network Meta-analysis of Randomized Controlled Trials. J Am Acad Orthop Surg Glob Res Rev 2022; 6:e21.00200. [PMID: 35472191 PMCID: PMC10566925 DOI: 10.5435/jaaosglobal-d-21-00200] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 02/12/2022] [Indexed: 01/13/2023]
Abstract
INTRODUCTION Recent years have observed the increasing utilization of robotic-assisted and computer navigation techniques in total hip arthroplasty (THA), given the proposed benefits of enhanced consistency and precision in implant placement. The purpose of this study was to conduct a systematic review of randomized controlled trials (RCTs) to determine whether differences in surgical times, adverse events, and implant positioning existed between manual, robotic-assisted, and computer navigation THA. METHODS PubMed, OVID/MEDLINE, and Cochrane databases were queried for RCTs comparing robotic-assisted versus manual THA and computer navigation versus manual THA at a minimum 1-year follow-up. Frequentist model network meta-analyses with P-scores were conducted to compare revisions, complications, and surgical times among the three treatment groups. A random-effects meta-analysis between computer navigation and manual THAs was conducted to analyze cup positioning because no robotic-assisted THA studies reported this outcome. RESULTS Five RCTs compared robotic-assisted and manual THAs, while seven compared computer navigation and manual THAs. manual THA was associated with significantly reduced surgical time in comparison with computer navigation (mean difference: 23.3 minutes) and robotic-assisted THAs (mean difference: 8.6 minutes; P < 0.001). No difference was observed in the incidence of all-cause complications (computer navigation: 1.7%, manual: 6.6%, and robotic-assisted: 16.2%) or revisions (computer navigation: 1.0%, manual: 1.7%, and robotic-assisted 4.8%) among the three treatment groups based on the network meta-analysis. In three studies that reported acetabular implant positioning, computer navigation had a significantly higher percentage of acetabular cups placed in the Lewinnek "safe zone" compared with manual THA (79% versus 52%; P = 0.02). CONCLUSIONS manual THA results in markedly shorter surgical times and a similar incidence of complications and revisions compared with robotic-assisted and computer navigation THAs, given the sample sizes available for study. However, computer navigation THA led to increased precision in the placement of acetabular implants.
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Affiliation(s)
- Kyle N. Kunze
- From the Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY (Dr. Kunze, Dr. Bovonratwet, and Dr. Sculco), University of Wisconsin School of Medicine and Public Health, Madison, WI (Mr. Polce), and the Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL (Ms. Paul)
| | - Patawut Bovonratwet
- From the Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY (Dr. Kunze, Dr. Bovonratwet, and Dr. Sculco), University of Wisconsin School of Medicine and Public Health, Madison, WI (Mr. Polce), and the Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL (Ms. Paul)
| | - Evan M. Polce
- From the Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY (Dr. Kunze, Dr. Bovonratwet, and Dr. Sculco), University of Wisconsin School of Medicine and Public Health, Madison, WI (Mr. Polce), and the Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL (Ms. Paul)
| | - Katlynn Paul
- From the Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY (Dr. Kunze, Dr. Bovonratwet, and Dr. Sculco), University of Wisconsin School of Medicine and Public Health, Madison, WI (Mr. Polce), and the Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL (Ms. Paul)
| | - Peter K. Sculco
- From the Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY (Dr. Kunze, Dr. Bovonratwet, and Dr. Sculco), University of Wisconsin School of Medicine and Public Health, Madison, WI (Mr. Polce), and the Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL (Ms. Paul)
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Palit A, Williams MA, Turley GA, Renkawitz T, Weber M. Femur First navigation can reduce impingement severity compared to traditional free hand total hip arthroplasty. Sci Rep 2017; 7:7238. [PMID: 28775337 PMCID: PMC5543156 DOI: 10.1038/s41598-017-07644-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 06/29/2017] [Indexed: 11/24/2022] Open
Abstract
Impingement is a major source of dislocation and aseptic loosening in total hip arthroplasty (THA). We compared impingement free range of motion (ROM) using a novel computer navigated femur first approach to conventional THA. In addition, impingement between genders was also explored. In a retrospective analysis of 121 THA patients, subject-specific post-operative ROM was simulated using post-operative 3D-CT data, and compared with the benchmark ROM, essential for activities of daily living. Three parameters were defined to express both implant-to-implant (ITI) and bone-to-bone (BTB) impingement - coverage percentage, third angle, and impingement severity. Although coverage percentage was similar between the navigated and conventional group for both ITI (p = 0.69) and BTB (p = 0.82) impingement, third angle was significantly reduced in the navigation group for both ITI (p = 0.02) and BTB (p = 0.05) impingement. Impingement severity for both ITI (p = 0.01) and BTB (p = 0.05) was significantly decreased in the navigation group compared to the conventional. Impingement severity in men was considerably higher compared to women for both ITI (p = 0.002) and BTB (p = 0.02). Navigation guided femur first THA is able to improve alignment of ROM axis, and consequently, to reduce impingement in THA. Men seem to be more prone to impingement than women.
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Affiliation(s)
- Arnab Palit
- WMG, University of Warwick, Coventry, CV4 7AL, UK
| | | | | | - Tobias Renkawitz
- Department of Orthopedic Surgery, Regensburg University, Medical Center, 93077, Bad Abbach, Germany
| | - Markus Weber
- Department of Orthopedic Surgery, Regensburg University, Medical Center, 93077, Bad Abbach, Germany.
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Renkawitz T, Weber T, Dullien S, Woerner M, Dendorfer S, Grifka J, Weber M. Leg length and offset differences above 5mm after total hip arthroplasty are associated with altered gait kinematics. Gait Posture 2016; 49:196-201. [PMID: 27450670 DOI: 10.1016/j.gaitpost.2016.07.011] [Citation(s) in RCA: 96] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 05/26/2016] [Accepted: 07/07/2016] [Indexed: 02/02/2023]
Abstract
We aimed to investigate the relationship between postoperative leg length/offset (LL/OS) reconstruction and gait performance after total hip arthroplasty (THA). In the course of a prospective randomized controlled trial, 60 patients with unilateral hip arthrosis received cementless THA through a minimally-invasive anterolateral surgical approach. One year post-operatively, LL and global OS restoration were analyzed and compared to the contralateral hip on AP pelvic radiographs. The combined postoperative limb length/OS reconstruction of the operated hip was categorized as restored (within 5mm) or non-restored (more than 5mm reduction or more than 5mm increment). The acetabular component inclination, anteversion and femoral component anteversion were evaluated using CT scans of the pelvis and the femur. 3D gait analysis of the lower extremity and patient related outcome measures (HHS, HOOS, EQ-5D) were obtained pre-operatively, six months and twelve months post-operatively by an observer blinded to radiographic results. Component position of cup and stem was comparable between the restored and non-restored group. Combined LL and OS restoration within 5mm resulted in higher Froude number (p<0.001), normalized walking speed (p<0.001) and hip range-of-motion (ROM) (p=0.004) during gait twelve months postoperatively, whereas gait symmetry was comparable regardless of LL and OS reconstruction at both examinations. Clinical scores did not show any relevant association between the accuracy of LL or OS reconstruction and gait six/twelve months after THA. In summary, postoperative LL/OS discrepancies larger than 5mm relate to unphysiological gait kinematics within the first year after THA. DRKS00000739, German Clinical Trials Register.
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Affiliation(s)
- Tobias Renkawitz
- Department of Orthopedic Surgery, Regensburg University, Medical Center, Bad Abbach, Germany
| | - Tim Weber
- Department of Orthopedic Surgery, Regensburg University, Medical Center, Bad Abbach, Germany; Faculty of Mechanical Engineering, Laboratory for Biomechanics, Ostbayerische Technische Hochschule Regensburg, 93053 Regensburg, Germany
| | - Silvia Dullien
- Department of Orthopedic Surgery, Regensburg University, Medical Center, Bad Abbach, Germany
| | - Michael Woerner
- Department of Orthopedic Surgery, Regensburg University, Medical Center, Bad Abbach, Germany
| | - Sebastian Dendorfer
- Faculty of Mechanical Engineering, Laboratory for Biomechanics, Ostbayerische Technische Hochschule Regensburg, 93053 Regensburg, Germany
| | - Joachim Grifka
- Department of Orthopedic Surgery, Regensburg University, Medical Center, Bad Abbach, Germany
| | - Markus Weber
- Department of Orthopedic Surgery, Regensburg University, Medical Center, Bad Abbach, Germany.
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