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Ferrandini M, Dao TT. On the estimation of hip joint centre location with incomplete bone ossification for foetus-specific neuromusculoskeletal modeling. Comput Methods Biomech Biomed Engin 2023:1-15. [PMID: 37837205 DOI: 10.1080/10255842.2023.2269285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 10/05/2023] [Indexed: 10/15/2023]
Abstract
Childbirth is a complex physiological process in which a foetal neuromusculoskeletal model is of great importance to develop realistic delivery simulations and associated complication analyses. However, the estimation of hip joint centre (HJC) in foetuses remains a challenging issue. Thus, this paper aims to propose and evaluate a new approach to locate the HJC in foetuses. Hip CT-scans from 25 children (F = 11, age = 5.5 ± 2.6 years, height = 117 ± 21 cm, mass = 26 kg ± 9.5 kg) were used to propose and evaluate the novel acetabulum sphere fitting process to locate the HJC. This new approach using the acetabulum surface was applied to a population of 57 post-mortem foetal CT scans to locate the HJC as well as to determine associated regression equations using multiple linear regression. As results, the average distance between the HJC located using acetabulum sphere fitting and femoral head sphere fitting in children was 1.5 ± 0.7 mm. The average prediction error using our developed foetal HJC regression equations was 3.0 ± 1.5 mm, even though the equation for the x coordinate had a poor value of R2 (R2 for the x coordinate = 0.488). The present study suggests that the use of the acetabulum sphere fitting approach is a valid and accurate method to locate the HJC in children, and then can be extrapolated to get an estimation of the HJC in foetuses with incomplete bone ossification. Therefore, the present paper can be used as a guideline for foetus specific neuromusculoskeletal modelling.
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Affiliation(s)
- Morgane Ferrandini
- Univ. Lille, CNRS, Centrale Lille, UMR 9013 - LaMcube - Laboratoire de Mécanique, Lille, France
| | - Tien-Tuan Dao
- Univ. Lille, CNRS, Centrale Lille, UMR 9013 - LaMcube - Laboratoire de Mécanique, Lille, France
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2
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Huang YY, Chen IJ, Wu CT, Chan YS, Chen DWC, Tang HC. The posterior capsule is distended in dysplastic hips, but the anterior capsule is not. Knee Surg Sports Traumatol Arthrosc 2023; 31:79-85. [PMID: 36315266 DOI: 10.1007/s00167-022-07207-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 10/21/2022] [Indexed: 01/21/2023]
Abstract
PURPOSE In the setting of acetabular dysplasia, the increased translational motion of the femur may damage the labrum and cartilage, as well as stretch the capsule. The purpose of the study was to investigate the relationship between the acetabular coverage and the capsular stiffness by assessing the distension of anterior and posterior joint recesses on the hip computed tomography arthrography. METHODS One hundred thirty-three patients (138 hips) with a median age of 36 years (range 18-50 years) who received the computed tomography arthrography for evaluation of nonarthritic hip pain in our institute between 2015 and 2017 were retrospectively reviewed. The maximal distance between the anterior/posterior capsule and the anterior femoral head-neck junction/posterior femoral head on the axial imaging of computed tomography arthrography was defined as the width of anterior/posterior joint recess. The width of anterior/posterior joint recess was adjusted with the diameter of the femoral head and was then compared between acetabular dysplasia (lateral center-edge angle < 25°), normal acetabulum (lateral center-edge angle between 25 and 39°), and deep acetabulum (lateral center-edge angle > 39°). In addition, the standard univariate linear regression analysis was used to investigate the relationship between the adjusted width of anterior/posterior joint recess and anterior/posterior coverage of the hip, determined by the anterior/posterior wall index. RESULTS The adjusted width of posterior joint recess was significantly greater in the acetabular dysplasia group than the normal acetabulum and deep acetabulum groups (p < 0.01 and p = 0.02, respectively). There was no significant difference of the adjusted width of anterior joint recess between the groups (n.s.). The adjusted width of posterior joint recess had a significant but weak negative correlation with the anterior wall index (r = - 0.25, p < 0.001), and no correlation with the posterior wall index (r = - 0.0004, n.s.). There was no significant correlation between the adjusted width of anterior joint recess and the anterior/posterior wall index (r = 0.05, n.s./r = 0.07, n.s.). CONCLUSIONS The distension of posterior capsule on the computed tomography arthrography was significantly greater in acetabular dysplasia. In addition, there was a significant but weak negative correlation between the distension of posterior capsule and the anterior coverage of the hip. It indicated a looser posterior capsule was observed in a dysplastic hip. The relevance of posterior capsular laxity to clinical outcomes warrants further investigation. Given the fact that the distension of anterior capsule was not significantly higher in acetabular dysplasia, the need of anterior capsular plication in a dysplastic hip should be carefully evaluated. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Yu-Yi Huang
- Department of Orthopedic Surgery, Chang Gung Memorial Hospital, No.222, Maijin Rd., Anle Dist, Keelung, 204, Taiwan
| | - I-Jung Chen
- College of Medicine, Chang Gung University, No.259, Wunhua 1st Rd., Guishan Dist, Taoyuan, 333,, Taiwan.,Department of Orthopedic Surgery, Chang Gung Memorial Hospital, No. 5, Fusing St., Gueishan, Taoyuan, 333, Taiwan
| | - Chen-Te Wu
- College of Medicine, Chang Gung University, No.259, Wunhua 1st Rd., Guishan Dist, Taoyuan, 333,, Taiwan.,Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, No. 5, Fusing St., Gueishan, Taoyuan, 333, Taiwan
| | - Yi-Sheng Chan
- Department of Orthopedic Surgery, Chang Gung Memorial Hospital, No.222, Maijin Rd., Anle Dist, Keelung, 204, Taiwan.,College of Medicine, Chang Gung University, No.259, Wunhua 1st Rd., Guishan Dist, Taoyuan, 333,, Taiwan
| | - Dave Wei-Chih Chen
- Department of Orthopedic Surgery, Chang Gung Memorial Hospital, No.222, Maijin Rd., Anle Dist, Keelung, 204, Taiwan.,College of Medicine, Chang Gung University, No.259, Wunhua 1st Rd., Guishan Dist, Taoyuan, 333,, Taiwan
| | - Hao-Che Tang
- Department of Orthopedic Surgery, Chang Gung Memorial Hospital, No.222, Maijin Rd., Anle Dist, Keelung, 204, Taiwan. .,College of Medicine, Chang Gung University, No.259, Wunhua 1st Rd., Guishan Dist, Taoyuan, 333,, Taiwan.
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3
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Ren B, Liu J, Chen J. Simulating human–machine coupled model for gait trajectory optimization of the lower limb exoskeleton system based on genetic algorithm. INT J ADV ROBOT SYST 2020. [DOI: 10.1177/1729881419893493] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The lower limb exoskeleton robot is capable of providing assisted walking and enhancing exercise ability of humans. The coupling human–machine model has attracted a lot of research efforts to solve the complex dynamics and nonlinearity within the system. This study focuses on an approach of gait trajectory optimization of lower limb exoskeleton coupled with human through genetic algorithm. The human–machine coupling system is studied in this article through multibody virtual simulation environment. Planning of the motion trajectory is carried out by the genetic algorithm, which is iteratively generated under optimization of a set of specially designed fitness functions. Human motion captured data are used to guide the evolution of gait trajectory generation method based on genetic algorithm. Experiments are carried out using the MATLAB/Simulink Multibody physical simulation engine and genetic algorithm-toolbox to generate a more natural gait trajectory, the results show that the proposed gait trajectory generation method can provide an anthropomorphic gait for lower limb exoskeleton device.
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Affiliation(s)
- Bin Ren
- School of Mechatronic Engineering and Automation, Shanghai Key Laboratory of Intelligent Manufacturing and Robotics, Shanghai University, Shanghai, China
| | - Jianwei Liu
- School of Mechatronic Engineering and Automation, Shanghai Key Laboratory of Intelligent Manufacturing and Robotics, Shanghai University, Shanghai, China
| | - Jiayu Chen
- Department of Architecture and Civil Engineering, City University of Hong Kong, Hong Kong
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4
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Neira A, Amenabar T, Cristi-Sánchez I, Rafols C, Monckeberg JE, Belemmi M, Neira M, Soldan M, Silvestre R. Evaluation of atraumatic hip instability measured by triaxial accelerometry during walking. J Hip Preserv Surg 2019; 6:134-139. [PMID: 31660198 PMCID: PMC6662898 DOI: 10.1093/jhps/hnz018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 02/22/2019] [Accepted: 05/05/2019] [Indexed: 11/12/2022] Open
Abstract
Hip joint instability has been targeted as an important issue that affects normal hip function. The diagnosis of hip instability could be very challenging and currently, there is no definitive diagnostic test. Hip instability results in an excessive amount of translation of femoroacetabular articulation, leading to changes on the dynamic loading of the hip. These changes in femoroacetabular translation could be evaluated by human movement analysis methods. The purpose of this study was to describe the triaxial and overall magnitude of acceleration in patients diagnosed with hip instability during gait cycle and compare those results with a control group. Our hypothesis was that acceleration values obtained from the instability group would be higher than asymptomatic controls. Ten patients with previously diagnosed hip instability were included and 10 healthy and asymptomatic subjects were enrolled as control group. Triaxial accelerometers attached bilaterally to the skin over the greater trochanter were used to record acceleration during walking on a treadmill. The overall magnitude of acceleration and the axial, anteroposterior and mediolateral accelerations (x/y/z) were obtained during gait. Mean overall magnitude of acceleration was higher in the hip instability group compared with the control group, 1.51 g (SD: 0.23) versus 1.07 g (SD: 0.16) (P = 0.022). The axial, anteroposterior and mediolateral accelerations significantly differed between the two groups. The axial and mediolateral accelerations showed to be higher for the hip instability group while the anteroposterior axis acceleration was lower.
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Affiliation(s)
- Alejandro Neira
- Laboratorio Ciencias del Ejercicio, Clínica MEDS, Santiago, Chile.,Escuela de Kinesiología, Facultad de Ciencias, Universidad Mayor, Chile
| | - Tomas Amenabar
- Traumatología y Ortopedia, Clínica MEDS, Santiago, Chile.,Instituto Trumatológico, Santiago, Chile
| | - Iver Cristi-Sánchez
- Laboratorio Ciencias del Ejercicio, Clínica MEDS, Santiago, Chile.,Escuela de Kinesiología, Facultad de Ciencias, Universidad Mayor, Chile
| | - Claudio Rafols
- Traumatología y Ortopedia, Clínica MEDS, Santiago, Chile
| | | | - Marcos Belemmi
- Traumatología y Ortopedia, Clínica MEDS, Santiago, Chile
| | - Mariano Neira
- Laboratorio Ciencias del Ejercicio, Clínica MEDS, Santiago, Chile
| | - Macarena Soldan
- Laboratorio Ciencias del Ejercicio, Clínica MEDS, Santiago, Chile
| | - Rony Silvestre
- Laboratorio Ciencias del Ejercicio, Clínica MEDS, Santiago, Chile
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5
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Domb BG, Chaharbakhshi EO, Perets I, Walsh JP, Yuen LC, Ashberg LJ. Patient-Reported Outcomes of Capsular Repair Versus Capsulotomy in Patients Undergoing Hip Arthroscopy: Minimum 5-Year Follow-up-A Matched Comparison Study. Arthroscopy 2018; 34:853-863.e1. [PMID: 29373289 DOI: 10.1016/j.arthro.2017.10.019] [Citation(s) in RCA: 93] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 09/29/2017] [Accepted: 10/06/2017] [Indexed: 02/02/2023]
Abstract
PURPOSE To elucidate whether capsular closure during hip arthroscopy affected patient outcomes over midterm follow-up. METHODS Between 2008 and 2011, data were prospectively collected and retrospectively reviewed on patients who underwent hip arthroscopy. Patients were then matched for age, gender, worker's compensation, body mass index, and acetabular coverage. The inclusion criteria were capsular repair or unrepaired capsulotomy, lateral-center edge angle ≥18°, and minimum 5-year follow-up. The exclusion criteria were previous hip surgery or conditions and Tönnis grade >1. Patient-reported outcome scores (PROs) included modified Harris hip score (mHHS), nonarthritic hip score, hip outcome score sport-specific subscale, and visual analog score for pain, which were collected preoperatively, at 3 months, and annually thereafter. Minimal clinical important difference (MCID) and patient acceptable symptomatic state (PASS) for both groups were analyzed. Patient satisfaction was noted as well as any complications, secondary surgery, and conversion to arthroplasty. RESULTS Minimum 5-year follow-up was available for 82.5% (287 of 348) hips that met the inclusion criteria and were eligible for matching. Ultimately, 65 patients who underwent capsular repair could be matched in a 1:1 ratio to 65 patients with release. Both groups had significant improvements in all mean PROs. The repair group had significant improvement of mean PROs, visual analog score, and patient satisfaction at both 2-year and minimum 5-year follow-up. The unrepaired group had a significant decrease in mHHS (P = .001) and patient satisfaction (P = .01) between 2- and 5-year follow-up. Despite decreasing mHHS in the repair group between 2- and 5-year follow-up, both groups met the MCID and PASS criteria with no significant difference between them. More patients in the release group required conversion to hip arthroplasty (18.5% vs 10.8%). Subgroup analysis considering various perioperative factors confirmed this trend. Rate of revision arthroscopy was the same in both groups (15.4%). Complication rate was low (4.6% vs 6.4%) in both groups. CONCLUSIONS Patients undergoing hip arthroscopy and who have minimal or no arthritis have significant short-term improvement, whether the capsule is closed or left unrepaired. However, at midterm follow-up, patients who had unrepaired capsules had deterioration in mHHS as well as a higher rate of conversion to arthroplasty, even when controlling for various perioperative variables. Despite this, patients in both groups met the MCID and PASS criteria. This study suggests that routine capsular closure may lead to more consistently durable outcome in patients undergoing hip arthroscopy, but also that individual patient pathology may dictate capsular management. LEVEL OF EVIDENCE Level III, retrospective comparative study.
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Affiliation(s)
- Benjamin G Domb
- Department of Orthopaedic Surgery, American Hip Institute, Westmont, Illinois, U.S.A.; Department of Orthopaedic Surgery, Hinsdale Orthopaedics, Westmont, Illinois, U.S.A..
| | - Edwin O Chaharbakhshi
- Department of Orthopaedic Surgery, American Hip Institute, Westmont, Illinois, U.S.A
| | - Itay Perets
- Department of Orthopaedic Surgery, American Hip Institute, Westmont, Illinois, U.S.A
| | - John P Walsh
- Department of Orthopaedic Surgery, American Hip Institute, Westmont, Illinois, U.S.A
| | - Leslie C Yuen
- Department of Orthopaedic Surgery, American Hip Institute, Westmont, Illinois, U.S.A
| | - Lyall J Ashberg
- Department of Orthopaedic Surgery, American Hip Institute, Westmont, Illinois, U.S.A
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6
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Domb BG, Chaharbakhshi EO, Perets I, Yuen LC, Walsh JP, Ashberg L. Hip Arthroscopic Surgery With Labral Preservation and Capsular Plication in Patients With Borderline Hip Dysplasia: Minimum 5-Year Patient-Reported Outcomes. Am J Sports Med 2018; 46:305-313. [PMID: 29268026 DOI: 10.1177/0363546517743720] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The arthroscopic management of hip dysplasia has been controversial and has historically demonstrated mixed results. Studies on patients with borderline dysplasia, emphasizing the importance of the labrum and capsule as secondary stabilizers, have shown improvement in patient-reported outcomes (PROs). Purpose/Hypothesis: The purpose was to assess whether the results of hip arthroscopic surgery with labral preservation and concurrent capsular plication in patients with borderline hip dysplasia have lasting, positive outcomes at a minimum 5-year follow-up. It was hypothesized that with careful patient selection, outcomes would be favorable. STUDY DESIGN Case series; Level of evidence, 4. METHODS Data were prospectively collected and retrospectively reviewed for patients aged <40 years who underwent hip arthroscopic surgery for intra-articular abnormalities. Inclusion criteria included lateral center-edge angle (LCEA) between 18° and 25°, concurrent capsular plication and labral preservation, and minimum 5-year follow-up. Exclusion criteria were severe dysplasia (LCEA ≤18°), Tönnis grade ≥2, pre-existing childhood hip conditions, or prior hip surgery. PRO scores including the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), and Hip Outcome Score Sport-Specific Subscale (HOS-SSS) and the visual analog scale (VAS) score for pain were collected preoperatively, at 3 months, and annually thereafter. Complications and revisions were recorded. RESULTS Twenty-five hips (24 patients) met the inclusion criteria. Twenty-one hips (19 patients, 84%) were available for follow-up. The mean age at surgery was 22.9 years. The mean preoperative LCEA and Tönnis angle were 21.7° (range, 18° to 24°) and 6.9° (range, -1° to 16°), respectively. The mean follow-up was 68.8 months. The mean mHHS increased from 70.3 to 85.9 ( P < .0001), the mean NAHS from 68.3 to 87.3 ( P < .0001), and the mean HOS-SSS from 52.1 to 70.8 ( P = .0002). The mean VAS score improved from 5.6 to 1.8 ( P < .0001). Four hips (19%) required secondary arthroscopic procedures, all of which resulted in improved PRO scores at latest follow-up. No patient required conversion to total hip arthroplasty. CONCLUSION While periacetabular osteotomy remains the standard for treating true acetabular dysplasia, hip arthroscopy may provide a safe and durable means of managing intra-articular abnormalities in the setting of borderline acetabular dysplasia at midterm follow-up. These procedures should be performed by surgeons with expertise in advanced arthroscopic techniques, using strict patient selection criteria, with emphasis on labral preservation and capsular plication.
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Affiliation(s)
- Benjamin G Domb
- American Hip Institute, Westmont, Illinois, USA.,Hinsdale Orthopaedics, Hinsdale, Illinois, USA
| | | | - Itay Perets
- American Hip Institute, Westmont, Illinois, USA
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7
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Benedetti MG, Beghi E, De Tanti A, Cappozzo A, Basaglia N, Cutti AG, Cereatti A, Stagni R, Verdini F, Manca M, Fantozzi S, Mazzà C, Camomilla V, Campanini I, Castagna A, Cavazzuti L, Del Maestro M, Croce UD, Gasperi M, Leo T, Marchi P, Petrarca M, Piccinini L, Rabuffetti M, Ravaschio A, Sawacha Z, Spolaor F, Tesio L, Vannozzi G, Visintin I, Ferrarin M. SIAMOC position paper on gait analysis in clinical practice: General requirements, methods and appropriateness. Results of an Italian consensus conference. Gait Posture 2017; 58:252-260. [PMID: 28825997 DOI: 10.1016/j.gaitpost.2017.08.003] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Revised: 07/31/2017] [Accepted: 08/02/2017] [Indexed: 02/06/2023]
Abstract
Gait analysis is recognized as a useful assessment tool in the field of human movement research. However, doubts remain on its real effectiveness as a clinical tool, i.e. on its capability to change the diagnostic-therapeutic practice. In particular, the conditions in which evidence of a favorable cost-benefit ratio is found and the methodology for properly conducting and interpreting the exam are not identified clearly. To provide guidelines for the use of Gait Analysis in the context of rehabilitation medicine, SIAMOC (the Italian Society of Clinical Movement Analysis) promoted a National Consensus Conference which was held in Bologna on September 14th, 2013. The resulting recommendations were the result of a three-stage process entailing i) the preparation of working documents on specific open issues, ii) the holding of the consensus meeting, and iii) the drafting of consensus statements by an external Jury. The statements were formulated based on scientific evidence or experts' opinion, when the quality/quantity of the relevant literature was deemed insufficient. The aim of this work is to disseminate the consensus statements. These are divided into 13 questions grouped in three areas of interest: 1) General requirements and management, 2) Methodological and instrumental issues, and 3) Scientific evidence and clinical appropriateness. SIAMOC hopes that this document will contribute to improve clinical practice and help promoting further research in the field.
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Affiliation(s)
| | - Ettore Beghi
- IRCCS Istituto di Ricerche Farmacologiche, Milano, Italy
| | | | - Aurelio Cappozzo
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Italy
| | | | | | - Andrea Cereatti
- POLCOMING Department, Bioengineering unit, University of Sassari, Italy
| | - Rita Stagni
- Department of Electric, Electronic and Information Engineering "Guglielmo Marconi" - DEI Università di Bologna, Italy
| | - Federica Verdini
- Department of Information Engineering, Università Politecnica delle Marche, Ancona, Italy
| | - Mario Manca
- Azienda Ospedaliero-Universitaria di Ferrara, Italy
| | - Silvia Fantozzi
- Department of Electric, Electronic and Information Engineering "Guglielmo Marconi" - DEI Università di Bologna, Italy
| | - Claudia Mazzà
- Department of Mechanical Engineering and Insigneo Institute for in silico Medicine, University of Sheffield, Sheffield, UK
| | - Valentina Camomilla
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Italy
| | - Isabella Campanini
- Motion Analysis Laboratory - Rehab. Dept, AUSL Reggio Emilia and Dept. of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Italy
| | | | | | | | - Ugo Della Croce
- POLCOMING Department, Bioengineering unit, University of Sassari, Italy
| | - Marco Gasperi
- Ospedale Riabilitativo Villa Rosa, Azienda Provinciale Servizi Sanitari di Trento, Italy
| | - Tommaso Leo
- Department of Information Engineering, Università Politecnica delle Marche, Ancona, Italy
| | - Pia Marchi
- Azienda Ospedaliero-Universitaria di Ferrara, Italy
| | | | | | | | | | - Zimi Sawacha
- Department of Information Engineering, University of Padova, Italy
| | - Fabiola Spolaor
- Department of Information Engineering, University of Padova, Italy
| | - Luigi Tesio
- Università degli Studi and Istituto Auxologico Italiano-IRCCS, Milano, Italy
| | - Giuseppe Vannozzi
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Italy
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8
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Camomilla V, Cereatti A, Cutti AG, Fantozzi S, Stagni R, Vannozzi G. Methodological factors affecting joint moments estimation in clinical gait analysis: a systematic review. Biomed Eng Online 2017; 16:106. [PMID: 28821242 PMCID: PMC5563001 DOI: 10.1186/s12938-017-0396-x] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 08/08/2017] [Indexed: 01/29/2023] Open
Abstract
Quantitative gait analysis can provide a description of joint kinematics and dynamics, and it is recognized as a clinically useful tool for functional assessment, diagnosis and intervention planning. Clinically interpretable parameters are estimated from quantitative measures (i.e. ground reaction forces, skin marker trajectories, etc.) through biomechanical modelling. In particular, the estimation of joint moments during motion is grounded on several modelling assumptions: (1) body segmental and joint kinematics is derived from the trajectories of markers and by modelling the human body as a kinematic chain; (2) joint resultant (net) loads are, usually, derived from force plate measurements through a model of segmental dynamics. Therefore, both measurement errors and modelling assumptions can affect the results, to an extent that also depends on the characteristics of the motor task analysed (i.e. gait speed). Errors affecting the trajectories of joint centres, the orientation of joint functional axes, the joint angular velocities, the accuracy of inertial parameters and force measurements (concurring to the definition of the dynamic model), can weigh differently in the estimation of clinically interpretable joint moments. Numerous studies addressed all these methodological aspects separately, but a critical analysis of how these aspects may affect the clinical interpretation of joint dynamics is still missing. This article aims at filling this gap through a systematic review of the literature, conducted on Web of Science, Scopus and PubMed. The final objective is hence to provide clear take-home messages to guide laboratories in the estimation of joint moments for the clinical practice.
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Affiliation(s)
- Valentina Camomilla
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza de Bosis 15, 00135 Rome, Italy
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, University of Rome “Foro Italico”, Piazza de Bosis 15, 00135 Rome, Italy
| | - Andrea Cereatti
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, University of Rome “Foro Italico”, Piazza de Bosis 15, 00135 Rome, Italy
- Information Engineering Unit, POLCOMING Department, University of Sassari, Viale Mancini, 5, 007100 Sassari, Italy
- Department of Electronics and Telecommunications, Politecnico di Torino, Corso Castelfidardo, 39, 10129 Turin, Italy
| | - Andrea Giovanni Cutti
- Centro Protesi INAIL, Production Directorate - Applied Research, Via Rabuina 14, 40054 Vigorso di Budrio (BO), Italy
| | - Silvia Fantozzi
- Department of Electrical, Electronic and Information Engineering “Guglielmo Marconi”, Alma Mater Studiorum University of Bologna, Via Risorgimento 2, 40136 Bologna, Italy
| | - Rita Stagni
- Department of Electrical, Electronic and Information Engineering “Guglielmo Marconi”, Alma Mater Studiorum University of Bologna, Via Risorgimento 2, 40136 Bologna, Italy
| | - Giuseppe Vannozzi
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza de Bosis 15, 00135 Rome, Italy
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, University of Rome “Foro Italico”, Piazza de Bosis 15, 00135 Rome, Italy
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9
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Zakani S, Rudan JF, Ellis RE. Translatory hip kinematics measured with optoelectronic surgical navigation. Int J Comput Assist Radiol Surg 2017. [PMID: 28624870 DOI: 10.1007/s11548-017-1629-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE An optoelectronic surgical navigation system was used to detect small but measurable translational motion of human hip cadavers in high-range passive motions. Kinematic data were also examined to demonstrate the role of soft tissues in constraining hip translation. METHODS Twelve cadaver hips were scanned using CT, instrumented for navigation, and passively taken through motion assessment. Center of the femoral head was tracked in the acetabular coordinates. Maximum non-impinging translation of the femoral head for each specimen hip was reported. This was repeated for 5 tissue states: whole, exposed to the capsule, partially or fully incised capsule, resection of the ligamentum teres and labrectomy. Femoral motions were compared to the reported value for ideal ball and socket model. RESULTS Whole and exposed hips underwent maximal translations of [Formula: see text] and [Formula: see text] mm, respectively. These translational motions were statistically significantly different from reported value for a purely spherical joint, [Formula: see text]. Further tissue removal almost always significantly increased maximum non-impingement translational motion with [Formula: see text]. CONCLUSION We found subtle but definite translations in every cadaver hip. There was no consistent pattern of translation. It is possible to use the surgical navigation systems for the assessment of human hip kinematics intra-operatively and improve the treatment of total hip arthroplasty patients by the knowledge of the fact that their hips translate. Better procedure selection and implantation optimization may arise from improved understanding of the motion of this critically important human joint.
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Affiliation(s)
- Sima Zakani
- Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada.
| | - John F Rudan
- Department of Surgery, Queen's University, Kingston, ON, Canada
| | - Randy E Ellis
- School of Computing, Department of Mechanical and Materials Engineering, Department of Surgery, Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada
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10
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Valentin S, Peham C, Zsoldos R, Licka T. A sphere fitting approach to determine the hip joint centre of the horse. COMPARATIVE EXERCISE PHYSIOLOGY 2017. [DOI: 10.3920/cep160039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Accurate identification of the hip joint centre (HJC) is crucial for the correct estimation of knee and hip joint loads and kinematics, which is particularly relevant in orthopaedic surgery and musculoskeletal modelling. Several methods have been described for calculation of the HJC in humans, however, no studies have used these methods in the horse despite a similar need for improved evaluation of hip joint biomechanics in rehabilitation and musculoskeletal modelling. This preliminary study uses the commonly used functional method (least-squares sphere fit) to determine the HJC in three equid cadavers. Bone pins with reflective markers attached were drilled into the tuber coxae (TC), tuber ischium (TI), tuber sacrale (TS), greater trochanter (GT), third trochanter (TT) and lateral femoral condyle (FC) of the uppermost limb of the cadavers positioned in lateral recumbency. Three repetitions of passive movements consisting of pro-and retraction, ab- and adduction and circumduction were performed. The HJC was calculated using a least-squares sphere fitting method and presented as a distance from the TC based on a percentage of the TC to TI vector magnitude. Mean (± standard deviation) of the HJC is located 52.4% (± 3.9) caudally, 0.2% (± 6.5) dorsally, and 19.8% (± 4.2) medially from the TC. This study is the first to quantify the HJC in horses ex vivo using a functional method. Further work (in vivo and imaging) is required to validate the findings of the present study.
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Affiliation(s)
- S. Valentin
- Institute for Clinical Exercise & Health Science, School of Science and Sport, University of the West of Scotland, Hamilton ML3 0JB, United Kingdom
| | - C. Peham
- Equine Clinic, University of Veterinary Medicine, Veterinärplatz 1, 1210 Vienna, Austria
| | - R.R. Zsoldos
- Working Group Animal Breeding, Department of Sustainable Agricultural Systems, University of Natural Resources and Life Sciences Vienna, Gregor-Mendel-Straße 33, 1180 Vienna, Austria
| | - T.F. Licka
- Equine Clinic, University of Veterinary Medicine, Veterinärplatz 1, 1210 Vienna, Austria
- Large Animal Hospital, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Roslin EH25 9RG, United Kingdom
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Watson PJ, Dostanpor A, Fagan MJ, Dobson CA. The effect of boundary constraints on finite element modelling of the human pelvis. Med Eng Phys 2017; 43:48-57. [DOI: 10.1016/j.medengphy.2017.02.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 01/19/2017] [Accepted: 02/05/2017] [Indexed: 11/27/2022]
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12
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Sholukha V, Panda J, Salvia P, Beyer B, Rooze M, Jan SVS. Prediction of the drilling path to surgically pin the femoral neck from the spatial location of pelvic and femoral anatomical landmarks: A cadaver validation study. Med Eng Phys 2016; 40:117-121. [PMID: 27956021 DOI: 10.1016/j.medengphy.2016.11.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 11/16/2016] [Accepted: 11/27/2016] [Indexed: 11/17/2022]
Abstract
Several clinical applications rely on accurate guiding information when drilling along the femoral neck (e.g., pin insertion in case of neck fracture). Currently, applications rely on real-time X-ray imaging, which results in irradiation issues for the surgeon conducting the operation. The goal of this paper was to develop an X-ray-free method that would allow for a pathway to be drilled between the lateral aspect of the femoral diaphysis (the so-called piercing point), the femoral neck and the head centres. The method is based on on-the-fly computational predictions relying on a biomechanical database that includes morphological data related to the femoral neck and head and various palpable anatomical landmarks located on the pelvis and the femoral bone. From the spatial location of the anatomical landmarks, scalable multiple regressions allow for the prediction of the most optimal drilling pathway. The method has been entirely validated using in vitro experiments that reproduce surgical conditions. Further, a surgical ancillary prototype that integrates the method of guiding the pin drilling has been developed and used during in vitro and in situ validation using nine hip joints. Pin insertion was controlled after drilling using medical imaging and show successful result for each of the nine trials. The mean accuracy of the estimated hip joint centre and neck orientation was 6.0 ± 2.8mm and 7.1 ± 3.8°, respectively.
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Affiliation(s)
- V Sholukha
- Laboratory of Anatomy, Biomechanics and Organogenesis (LABO), Faculty of Medicine, Université Libre de Bruxelles, 808 Lennik Street, 1070 Brussels, Belgium; Department of Applied Mathematics, Peter the Great St. Petersburg Polytechnic University (SPbPU), Russia.
| | - J Panda
- Department of Surgery, University of Lubumbashi, The Democratic Republic of the Congo
| | - P Salvia
- Laboratory of Anatomy, Biomechanics and Organogenesis (LABO), Faculty of Medicine, Université Libre de Bruxelles, 808 Lennik Street, 1070 Brussels, Belgium
| | - B Beyer
- Laboratory of Anatomy, Biomechanics and Organogenesis (LABO), Faculty of Medicine, Université Libre de Bruxelles, 808 Lennik Street, 1070 Brussels, Belgium
| | - M Rooze
- Laboratory of Anatomy, Biomechanics and Organogenesis (LABO), Faculty of Medicine, Université Libre de Bruxelles, 808 Lennik Street, 1070 Brussels, Belgium; Department of Orthopaedic, Erasme Hospital, Université Libre de Bruxelles, Belgium
| | - S Van Sint Jan
- Laboratory of Anatomy, Biomechanics and Organogenesis (LABO), Faculty of Medicine, Université Libre de Bruxelles, 808 Lennik Street, 1070 Brussels, Belgium
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Zelik KE, Takahashi KZ, Sawicki GS. Six degree-of-freedom analysis of hip, knee, ankle and foot provides updated understanding of biomechanical work during human walking. J Exp Biol 2015; 218:876-86. [DOI: 10.1242/jeb.115451] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
ABSTRACT
Measuring biomechanical work performed by humans and other animals is critical for understanding muscle–tendon function, joint-specific contributions and energy-saving mechanisms during locomotion. Inverse dynamics is often employed to estimate joint-level contributions, and deformable body estimates can be used to study work performed by the foot. We recently discovered that these commonly used experimental estimates fail to explain whole-body energy changes observed during human walking. By re-analyzing previously published data, we found that about 25% (8 J) of total positive energy changes of/about the body's center-of-mass and >30% of the energy changes during the Push-off phase of walking were not explained by conventional joint- and segment-level work estimates, exposing a gap in our fundamental understanding of work production during gait. Here, we present a novel Energy-Accounting analysis that integrates various empirical measures of work and energy to elucidate the source of unexplained biomechanical work. We discovered that by extending conventional 3 degree-of-freedom (DOF) inverse dynamics (estimating rotational work about joints) to 6DOF (rotational and translational) analysis of the hip, knee, ankle and foot, we could fully explain the missing positive work. This revealed that Push-off work performed about the hip may be >50% greater than conventionally estimated (9.3 versus 6.0 J, P=0.0002, at 1.4 m s−1). Our findings demonstrate that 6DOF analysis (of hip–knee–ankle–foot) better captures energy changes of the body than more conventional 3DOF estimates. These findings refine our fundamental understanding of how work is distributed within the body, which has implications for assistive technology, biomechanical simulations and potentially clinical treatment.
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Affiliation(s)
- Karl E. Zelik
- Department of Mechanical Engineering, Vanderbilt University, Nashville, TN 37212, USA
- Department of Physical Medicine and Rehabilitation, Vanderbilt University, Nashville, TN 37212, USA
- Laboratory of Neuromotor Physiology, Santa Lucia Foundation, Rome 00179, Italy
| | - Kota Z. Takahashi
- Joint Department of Biomedical Engineering, North Carolina State University and University of North Carolina at Chapel Hill, Raleigh, NC 27695, USA
| | - Gregory S. Sawicki
- Joint Department of Biomedical Engineering, North Carolina State University and University of North Carolina at Chapel Hill, Raleigh, NC 27695, USA
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Beretta E, De Momi E, Camomilla V, Cereatti A, Cappozzo A, Ferrigno G. Hip joint centre position estimation using a dual unscented Kalman filter for computer-assisted orthopaedic surgery. Proc Inst Mech Eng H 2014; 228:971-82. [PMID: 25313027 DOI: 10.1177/0954411914551854] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In computer-assisted knee surgery, the accuracy of the localization of the femur centre of rotation relative to the hip-bone (hip joint centre) is affected by the unavoidable and untracked pelvic movements because only the femoral pose is acquired during passive pivoting manoeuvres. We present a dual unscented Kalman filter algorithm that allows the estimation of the hip joint centre also using as input the position of a pelvic reference point that can be acquired with a skin marker placed on the hip, without increasing the invasiveness of the surgical procedure. A comparative assessment of the algorithm was carried out using data provided by in vitro experiments mimicking in vivo surgical conditions. Soft tissue artefacts were simulated and superimposed onto the position of a pelvic landmark. Femoral pivoting made of a sequence of star-like quasi-planar movements followed by a circumduction was performed. The dual unscented Kalman filter method proved to be less sensitive to pelvic displacements, which were shown to be larger during the manoeuvres in which the femur was more adducted. Comparable accuracy between all the analysed methods resulted for hip joint centre displacements smaller than 1 mm (error: 2.2 ± [0.2; 0.3] mm, median ± [inter-quartile range 25%; inter-quartile range 75%]) and between 1 and 6 mm (error: 4.8 ± [0.5; 0.8] mm) during planar movements. When the hip joint centre displacement exceeded 6 mm, the dual unscented Kalman filter proved to be more accurate than the other methods by 30% during multi-planar movements (error: 5.2 ± [1.2; 1] mm).
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Affiliation(s)
- Elisa Beretta
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Elena De Momi
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Valentina Camomilla
- Department of Movement, Human and Health Sciences, Università degli Studi di Roma Foro Italico, Rome, Italy
| | - Andrea Cereatti
- Department of Information Engineering, Political Sciences and Communication Sciences, Università degli Studi di Sassari, Sassari, Italy
| | - Aurelio Cappozzo
- Department of Movement, Human and Health Sciences, Università degli Studi di Roma Foro Italico, Rome, Italy
| | - Giancarlo Ferrigno
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
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A local reference frame for describing the proximal human femur: application in clinical settings. Skeletal Radiol 2014; 43:323-9. [PMID: 24346337 DOI: 10.1007/s00256-013-1782-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Revised: 10/01/2013] [Accepted: 11/10/2013] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The conventional reference frame for the femur has limited relevance for the planning of hip surgery as the femoral neck axis, a crucial reference for surgeons, has to be independently derived. The purpose of this study is to develop and validate a reliable frame of reference for the proximal femur that can be applied in clinical settings. MATERIALS AND METHODS Ten three-dimensional models of femurs were obtained. An iterative method was developed to find the femoral neck axis (X-axis). A second axis was also created from the lesser trochanter to the piriformis fossa (LTPF). The origin was defined as the femoral head centre. The cross product of the neck and LTPF axes provided the Z-axis and the third axis (Y-axis) was perpendicular to the other two. Intra-/inter-investigator reliability was assessed on the ten femur models; ten times by one investigator and twice by three investigators respectively. The results were then compared with the conventional reference frame using landmarks on the distal femur. RESULTS The femoral neck and LTPF axes had mean intra-/inter-investigator angle differences of 0.5° (SD 0.4°) and 0.7° (SD 0.5°), and 0.8° (SD 0.5°) and 0.9° (SD 0.6°) respectively while the variations of the X-, Y- and Z- axes were SD 0.6°, 0.7° and 0.5°. CONCLUSIONS A reliable method of obtaining the three-dimensional proximal femoral frame was developed, using the femoral neck axis, with greater relevance to clinical settings, preoperative planning and accurate assessment of procedures post-operatively.
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Momi ED, Beretta E, Ferrigno G. Hip joint centre localisation with an unscented Kalman filter. Comput Methods Biomech Biomed Engin 2013; 16:1319-29. [DOI: 10.1080/10255842.2012.670852] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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17
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De Rosario H, Page Á, Besa A, Valera Á. Propagation of soft tissue artifacts to the center of rotation: a model for the correction of functional calibration techniques. J Biomech 2013; 46:2619-25. [PMID: 24011673 DOI: 10.1016/j.jbiomech.2013.08.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 06/24/2013] [Accepted: 08/14/2013] [Indexed: 11/28/2022]
Abstract
This paper presents a mathematical model for the propagation of errors in body segment kinematics to the location of the center of rotation. Three functional calibration techniques, usually employed for the gleno-humeral joint, are studied: the methods based on the pivot of the instantaneous helical axis (PIHA) or the finite helical axis (PFHA), and the "symmetrical center of rotation estimation" (SCoRE). A procedure for correcting the effect of soft tissue artifacts is also proposed, based on the equations of those techniques and a model of the artifact, like the one that can be obtained by double calibration. An experiment with a mechanical analog was performed to validate the procedure and compare the performance of each technique. The raw error (between 57 and 68mm) was reduced by a proportion of between 1:6 and less than 1:15, depending on the artifact model and the mathematical method. The best corrections were obtained by the SCoRE method. Some recommendations about the experimental setup for functional calibration techniques and the choice of a mathematical method are derived from theoretical considerations about the formulas and the results of the experiment.
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Affiliation(s)
- Helios De Rosario
- Instituto de Biomecánica de Valencia, Valencia, Spain; CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Spain.
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18
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A hip joint kinematics driven model for the generation of realistic thigh soft tissue artefacts. J Biomech 2013; 46:625-30. [DOI: 10.1016/j.jbiomech.2012.09.018] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Revised: 09/14/2012] [Accepted: 09/20/2012] [Indexed: 11/22/2022]
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19
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Fabry C, Herrmann S, Kaehler M, Klinkenberg ED, Woernle C, Bader R. Generation of physiological parameter sets for hip joint motions and loads during daily life activities for application in wear simulators of the artificial hip joint. Med Eng Phys 2013; 35:131-9. [DOI: 10.1016/j.medengphy.2012.07.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2012] [Revised: 06/07/2012] [Accepted: 07/31/2012] [Indexed: 12/27/2022]
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20
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Masjedi M, Harris SJ, Davda K, Cobb JP. Mathematical representation of the normal proximal human femur: Application in planning of cam hip surgery. Proc Inst Mech Eng H 2012; 227:421-7. [DOI: 10.1177/0954411912466353] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Precise modelling of the proximal femur can be used for detecting and planning corrective surgery for subjects with deformed femurs using robotic technology or navigation systems. In this study, the proximal femoral geometry has been modelled mathematically. It is hypothesised that it is possible to fit a quadratic surface or combinations of them onto different bone surfaces with a relatively good fit. Forty-six computed tomography datasets of normal proximal femora were segmented. A least-squares fitting algorithm was used to fit a quadratic surface on the femoral head and neck such that the sum of distances between a set of points on the femoral neck and the quadratic surface was minimised. Furthermore, the position of the head–neck articular margin was also measured. The femoral neck was found to be represented as a good fit to a hyperboloid with an average root mean-squared error of 1.0 ± 0.13 mm while the shape of the femoral articular margin was a reproducible sinusoidal wave form with two peaks. The mathematical description in this study can be used for planning corrective surgery for subjects with cam-type femoroacetabular impingement.
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Affiliation(s)
- Milad Masjedi
- Department of Orthopaedics, MSK Laboratory, Imperial College London, Charing Cross Hospital, London, UK
| | - Simon J Harris
- Department of Orthopaedics, MSK Laboratory, Imperial College London, Charing Cross Hospital, London, UK
| | - Kinner Davda
- Department of Orthopaedics, MSK Laboratory, Imperial College London, Charing Cross Hospital, London, UK
| | - Justin P Cobb
- Department of Orthopaedics, MSK Laboratory, Imperial College London, Charing Cross Hospital, London, UK
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The accuracy of the use of functional hip motions on localization of the center of the hip. HSS J 2012; 8:192-7. [PMID: 24082860 PMCID: PMC3470661 DOI: 10.1007/s11420-012-9296-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Accepted: 06/22/2012] [Indexed: 02/07/2023]
Abstract
BACKGROUND The hip joint is generally considered a ball-and-socket joint, the center of which is used as an anatomic landmark in functional analyses and by surgical navigation systems. The location of the hip center has been estimated using functional techniques using various limb motions. However, it is not clear which specific motions best predicted the functional center. PURPOSE This study aims to compare the predicted functional center of the hip evaluated from multiplanar circumduction and star motions, and to compare this functional center with the geometric center. METHODS Eight hips in four fresh-frozen cadavers were used and verified as morphologically normal in CT scans. Three-dimensional motion of each lower limb was recorded using arrays of reflective markers rigidly attached to the femur and pelvis. Each hip was manipulated to produce circumduction or star motion, i.e., abduction-adduction and flexion extension. The hip was then dissected and the bearing surface traced with a probe, from which a best-fit sphere was calculated. The functional center was calculated from the motion data and compared to the geometric technique. RESULTS There was no difference between the functional hip center predicted by circumduction or star motions, although this was offset from the geometric hip center by up to 14 mm. For all except two hips, the functional center was less than 6 mm from the geometric hip in each anatomic direction. Test-retest differences were smaller for circumduction than for star motions. CONCLUSIONS Estimation of the hip center based on motion of the femur relative to the pelvis could localize the geometric center of the joint within 14 mm and circumduction motions were more repeatable. CLINICAL RELEVANCE Many surgical navigation systems make use of the functional hip center as a landmark for alignment or reconstruction. Errors associated with this would have a very minor influence in lower limb alignment, e.g., for knee reconstruction, but could affect proximal femoral geometry relevant to hip reconstruction.
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Cerveri P, Manzotti A, Baroni G. Patient-specific acetabular shape modelling: comparison among sphere, ellipsoid and conchoid parameterisations. Comput Methods Biomech Biomed Engin 2012; 17:560-7. [DOI: 10.1080/10255842.2012.702765] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Kratzenstein S, Kornaropoulos EI, Ehrig RM, Heller MO, Pöpplau BM, Taylor WR. Effective marker placement for functional identification of the centre of rotation at the hip. Gait Posture 2012; 36:482-6. [PMID: 22672896 DOI: 10.1016/j.gaitpost.2012.04.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2011] [Revised: 03/16/2012] [Accepted: 04/22/2012] [Indexed: 02/02/2023]
Abstract
The accuracy and precision of quantifying musculoskeletal kinematics, and particularly determining the centre of rotation (CoR) at the hip joint, using skin marker based motion analysis is limited by soft tissue artefact (STA). We posed the question of whether the contribution of individual markers towards improving the precision of the functional joint centre using marker based methods could be assessed, and then utilised to allow effective marker placement for determination of the CoR at the hip. Sixty-three retro-reflective skin markers were placed to encompass the thighs of seven healthy subjects, together with a set of sixteen markers on the pelvis. The weighted optimal common shape technique (wOCST) was then applied to determine the weighting, or importance, of each marker for identifying the centre of rotation at the hip. The markers with the highest weightings over all subjects and measurements were determined that identified the HJC with the highest precision. The use of six markers in selected regions (two anterior, two lateral and two posterior) allowed the HJC to be determined with a similar precision to the complete set of 63 markers, with the determined regions predominantly distant from the hip joint, excluding areas associated with the bellies of large muscles and therefore large motion artefact from muscle activity. The novel approach presented here allows an understanding of each marker's contribution towards a precise joint determination, and therefore enables the targeted placement of markers for reliable assessment of musculoskeletal kinematics.
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Affiliation(s)
- S Kratzenstein
- Julius Wolff Institute, Charité-Universitätsmedizin Berlin, Center for Sports Science and Sports Medicine Berlin, Philippstr. 13, Haus 11, 10115 Berlin, Germany
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Heller MO, Kratzenstein S, Ehrig RM, Wassilew G, Duda GN, Taylor WR. The weighted optimal common shape technique improves identification of the hip joint center of rotation in vivo. J Orthop Res 2011; 29:1470-5. [PMID: 21484858 DOI: 10.1002/jor.21426] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2010] [Accepted: 03/14/2011] [Indexed: 02/04/2023]
Abstract
Functional methods present a promising approach for the identification of skeletal kinematics, but their accuracy is limited by soft tissue artifacts (STAs). We hypothesized that consideration of the nonuniform distribution of STAs across the segment can lead to a significant improvement in the determination of the center of rotation at the hip. Twenty-four total hip arthroplasty (THA) patients performed repetitions of a star-arc movement. The location of the hip centers of rotation (CoRs) were estimated from the motion data using the Symmetrical Center of Rotation Estimation (SCoRE), both with and without procedures to minimize the effect of STAs. The precision of the CoR estimations was evaluated using the SCoRE residual, a measure of joint precision. Application of the newly developed weighted Optimal Common Shape Technique (wOCST) achieved the best CoR estimations with a precision of better than 3 mm, while the precision using raw data alone was up to seven times worse. Furthermore, consideration of the nonuniform distribution of STA across the surface of the skin using the wOCST produced an improvement of ∼24% over kinematics data processed using the standard OCST. Functional determination of the CoR at the hip using the newly developed wOCST can now identify the joint CoR with a precision of millimeters. Such approaches therefore offer improved precision in the assessment of skeletal kinematics and may aid in evaluating clinical treatment success and differentiating between therapy outcomes.
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Affiliation(s)
- Markus O Heller
- Julius Wolff Institute, Center for Sports Science and Sports Medicine Berlin, Charité-Universitätsmedizin Berlin, Philippstr 13, Haus 11, D-10115 Berlin, Germany
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Shu B, Safran MR. Hip Instability: Anatomic and Clinical Considerations of Traumatic and Atraumatic Instability. Clin Sports Med 2011; 30:349-67. [DOI: 10.1016/j.csm.2010.12.008] [Citation(s) in RCA: 162] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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