Gait analysis of patients with continuous proximal sciatic nerve blockade in flexion contractures after primary total knee arthroplasty

A functional calibration protocol for ankle plantar-dorsiflexion estimate using magnetic and inertial measurement units: Repeatability and reliability assessment

The ankle joint complex presents a tangled functional anatomy, which understanding is fundamental to effectively estimate its kinematics on the sagittal plane. Protocols based on the use of magnetic and inertial measurement units (MIMUs) currently do not take in due account this factor. To this aim, a joint coordinate system for the ankle joint complex is proposed, along with a protocol to perform its anatomical calibration using MIMUs, consisting in a combination of anatomical functional calibrations of the tibiotalar axis and static acquisitions. Protocol repeatability and reliability were tested according to the metrics proposed in Schwartz et al. (2004) involving three different operators performing the protocol three times on ten participants, undergoing instrumented gait analysis through both stereophotogrammetry and MIMUs. Instrumental reliability was evaluated comparing the MIMU-derived kinematic traces with the stereophotogrammetric ones, obtained with the same protocol, through the linear fit method. A total of 270 gait cycles were considered. Results showed that the protocol was repeatable and reliable for what concerned the operators (0.4 ± 0.4 deg and 0.8 ± 0.5 deg, respectively). Instrumental reliability analysis showed a mean RMSD of 3.0 ± 1.3 deg, a mean offset of 9.4 ± 8.4 deg and a mean linear relationship strength of R² = 0.88 ± 0.08. With due caution, the protocol can be considered both repeatable and reliable. Further studies should pay attention to the other ankle degrees of freedom as well as on the angular convention to compute them.

Micro- and nano-tomography analysis of mouse soleus muscle using radiation

In this study, we analyze radiation images of muscle structure of mice soleus muscles using radiation source-based microtomography and nanotomography. Soleus muscle samples were collected for analysis from 8-week-old male Institute of Cancer Research mice. First, phase-contrast X-ray microtomography was employed in these experiments. Then to obtain images with excellent contrast, imaging was performed using monochromatic light with excellent transmission power. To analyze additional muscle structures in higher magnification images than these images, nanotomography was performed, which facilitated obtaining high-magnification and high-resolution images. Muscle tissue microstructures were confirmed through three-dimensional images obtained from phase-contrast X-ray microtomography. Thus, the muscle tissue's overall shape at microscopic level can be captured. Additionally, a single muscle fiber was examined using hard X-ray nano-imaging, through which we could observe the alignment of countless myofibrils, that is, actin and myosin filaments in the muscle fibers. Thus, the methodology adopted here proved to be advantageous in analyzing the muscle tissue's overall structure with microtomography and in observing the myofibrils in detail using nanotomography.

Gait Analysis after Total Knee Arthroplasty Assisted by 3D-Printed Personalized Guide

Background

With the development of three-dimensional printing (3DP) technology, the patient-specific instrumentation (PSI) has been widely applied in total knee arthroplasty (TKA). The purpose of this study was to compare the gait parameters of patients with 3DP personalized guide-assisted and standard TKA.

Methods

Retrospective analysis of the advanced knee OA cases in our hospital between June 2017 and June 2018 was conducted. 30 cases received 3DP personalized guide-assisted TKA (group A), and 60 patients who underwent standard TKA during the same period were in group B and group C according to the computed tomography (CT) measurement results, each with 30 cases. Hip–knee–ankle angle (HKA), patella transverse axis-femoral transepicondylar axis angle (PFA), and gait parameters were statistically analyzed. The function was assessed by Hospital for Specific Surgery (HSS) and Knee Society Score (KSS).

Results

The mean follow-up period was 12.3 months in the three groups. The knee max flexion angle at the swing phase of group A was larger than group B and group C (P < 0.05), there was no statistically significant difference in other gait parameters. The mean PFA of group A was smaller than that of group B and group C (P < 0.05). While, the HKA, HSS, and KSS scores of three groups showed no significant difference.

Conclusion

3DP personalized guide technology could improve the gait parameters after surgery, specifically reflected in the knee max flexion angle at the swing phase. It could also assist in the reconstruction of more accurate patellar tracking and rotational alignment in TKA, avoiding the occurrence of insufficient or excessive extorsion.

Sensor-to-Segment Calibration Methodologies for Lower-Body Kinematic Analysis with Inertial Sensors: A Systematic Review

Kinematic analysis is indispensable to understanding and characterizing human locomotion. Thanks to the development of inertial sensors based on microelectronics systems, human kinematic analysis in an ecological environment is made possible. An important issue in human kinematic analyses with inertial sensors is the necessity of defining the orientation of the inertial sensor coordinate system relative to its underlying segment coordinate system, which is referred to sensor-to-segment calibration. Over the last decade, we have seen an increase of proposals for this purpose. The aim of this review is to highlight the different proposals made for lower-body segments. Three different databases were screened: PubMed, Science Direct and IEEE Xplore. One reviewer performed the selection of the different studies and data extraction. Fifty-five studies were included. Four different types of calibration method could be identified in the articles: the manual, static, functional, and anatomical methods. The mathematical approach to obtain the segment axis and the calibration evaluation were extracted from the selected articles. Given the number of propositions and the diversity of references used to evaluate the methods, it is difficult today to form a conclusion about the most suitable. To conclude, comparative studies are required to validate calibration methods in different circumstances.