Background: Femoroacetabular impingement syndrome (FAI) is a complex, often post-traumatically developing impairment of the hip joint. It is characterized by ambiguous symptomatology, which makes early diagnosis difficult. Aim: The study was conducted to evaluate the applicability of a triaxial gyroscopic sensor in routine practice as an additional indication criterion for operative versus conservative treatment procedures. Methods: Ninety-two patients were included in the experimental retrospective study and 62 completed the examination. All patients signed informed consent. A gyroscopic sensor was placed on the right side of the pelvis above the hip joint and patients walked approximately 15 steps. Data were also evaluated while the patients climbed stairs. A complete clinical examination of the dynamics and physiological movements in the joint was performed. The data measured by the gyroscopic sensor were processed using differential geometry methods and subsequently evaluated using spectral analysis and neural networks. Results: FAI diagnosis using gyroscopic measurement is fast and easy to implement. Our approach to processing the gyroscopic signals used to detect the stage of osteoarthritis and post-traumatic FAI could lead to more accurate detection and capture early in FAI development. Conclusions: The obtained data are easily evaluated, interpretable, and beneficial in the diagnosis of the early stages of FAI. The results of the study show that this approach can lead to more accurate and early detection of osteoarthritis and post-traumatic FAI.
- MeSH
- analýza chůze metody MeSH
- biomechanika * MeSH
- femoroacetabulární impingement * chirurgie diagnóza patofyziologie MeSH
- kyčelní kloub patofyziologie MeSH
- lidé MeSH
- nositelná elektronika * MeSH
- osteoartróza diagnóza patofyziologie MeSH
- retrospektivní studie MeSH
- telemedicína metody MeSH
- umělá inteligence MeSH
- Check Tag
- lidé MeSH
Understanding the intricacies of human movement coordination and variability during running is crucial to unraveling the dynamics of locomotion, identifying potential injury mechanisms and understanding skill development. Identification of minimum number of cycles for calculation of reliable coordination and its variability could help with better test organization and efficient assessment time. By adopting a cross-sectional study design, this study investigated the minimum required cycles for calculating hip-knee, hip-ankle and knee-ankle coordination and their variability using a continuous relative phase (CRP) method. Twenty-nine healthy adults ran on a treadmill at speeds of 9, 12.5, and 16 km.h-1 while 3D kinematic data of their lower limbs were recorded using 6 optoelectronic cameras. Using Intraclass Correlation Coefficient (ICC) analysis, reliability between CRP and its variability (CRPv) in different gait cycles (3, 5, 10, 20, 30) was assessed for each speed. A minimum of 10 cycles was required for CRP calculation across all speeds, whereas CRPv necessitated a minimum of 30 cycles for moderate to good reliability. While increasing the number of cycles improved ICC values for inter-joint CRP, the same trend was not consistently observed for CRPv, emphasizing the importance of separately assessing CRP and its variability metrics.
- MeSH
- běh * fyziologie MeSH
- biomechanika MeSH
- chůze (způsob) * fyziologie MeSH
- dospělí MeSH
- hlezenní kloub * fyziologie MeSH
- kolenní kloub * fyziologie MeSH
- kyčelní kloub fyziologie MeSH
- lidé MeSH
- mladý dospělý MeSH
- průřezové studie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Precise positioning of the acetabular component during total hip replacement is the key to achieving optimal implant function and ensuring long-term patient comfort. However, different anatomical variations, degenerative changes, dysplasia, and other diseases make it difficult. In this study, we discuss a method based on the three-dimensional direction of the transverse ligament, predicting native acetabular anteversion with higher accuracy. METHODS: Angular positions of the acetabulum and direction of the transverse ligament were automatically calculated from routine computed tomography data of 270 patients using a registration algorithm. The relationship between acetabular angles and ligament direction and their relationship with sex, age, and pelvic tilt were sought. These relationships were then modelled using multilinear regression. RESULTS: Including the direction of the transverse ligament in the sagittal and transverse planes as a regressor in the multilinear model explained the variation in acetabular anteversion (R2 = 0.76 for men, R2 = 0.63 for women; standard deviation in prediction: men, 3.92° and women, 4.00°). CONCLUSIONS: The results indicate that the ligament was suitable as a guidance structure almost insensitive to the ligament in the sagittal and transverse planes must be considered. Estimation based on the direction in only 1 plane was not sufficiently accurate. The operative acetabular inclination was not correlated with the direction of the ligament. The correlations were higher in men than in women.
- MeSH
- acetabulum * diagnostické zobrazování chirurgie MeSH
- anteverze kosti diagnostické zobrazování MeSH
- dospělí MeSH
- kloubní ligamenta * diagnostické zobrazování anatomie a histologie MeSH
- kyčelní kloub diagnostické zobrazování anatomie a histologie chirurgie MeSH
- lidé středního věku MeSH
- lidé MeSH
- náhrada kyčelního kloubu * metody MeSH
- počítačová rentgenová tomografie * MeSH
- retrospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- zobrazování trojrozměrné MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
This study was aimed to compare the variability of inter-joint coordination in the lower-extremities during gait between active individuals with transtibial amputation (TTAs) and healthy individuals (HIs). Fifteen active male TTAs (age: 40.6 ± 16.24 years, height: 1.74 ± 0.09 m, and mass: 71.2 ± 8.87 kg) and HIs (age: 37.25 ± 13.11 years, height: 1.75 ± 0.06 m, and mass: 74 ± 8.75 kg) without gait disabilities voluntarily participated in the study. Participants walked along a level walkway covered with Vicon motion capture system, and their lower-extremity kinematics data were recorded during gait. The spatiotemporal gait parameters, lower-extremity joint range of motion (ROM), and their coordination and variability were calculated and averaged to report a single value for each parameter based on biomechanical symmetry assumption in the lower limbs of HIs. Additionally, these parameters were separately calculated and reported for the intact limb (IL) and the prosthesis limb (PL) in TTAs individuals. Finally, a comparison was made between the averaged values in HIs and those in the IL and PL of TTAs subjects. The results showed that the IL had a significantly lower stride length than that of the PL and averaged value in HIs, and the IL had a significantly lower knee ROM and greater stance-phase duration than that of HIs. Moreover, TTAs showed different coordination patterns in pelvis-to-hip, hip-to-knee, and hip-to-ankle couplings in some parts of the gait cycle. It concludes that the active TTAs with PLs walked with more flexion of the knee and hip, which may indicate a progressive walking strategy and the differences in coordination patterns suggest active TTA individuals used different neuromuscular control strategies to adapt to their amputation. Researchers can extend this work by investigating variations in these parameters across diverse patient populations, including different amputation etiologies and prosthetic designs. Moreover, Clinicians can use the findings to tailor rehabilitation programs for TTAs, emphasizing joint flexibility and coordination.
- MeSH
- amputace * MeSH
- amputovaní MeSH
- biomechanika MeSH
- chůze (způsob) * fyziologie MeSH
- chůze fyziologie MeSH
- dolní končetina MeSH
- dospělí MeSH
- hlezenní kloub patofyziologie MeSH
- kolenní kloub patofyziologie chirurgie MeSH
- kyčelní kloub chirurgie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- rozsah kloubních pohybů * MeSH
- tibie chirurgie patofyziologie MeSH
- umělé končetiny * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Variations observed in biomechanical studies might be attributed to errors made by operators during the construction of musculoskeletal models, rather than being solely attributed to patient-specific geometry. RESEARCH QUESTION: What is the impact of operator errors on the construction of musculoskeletal models, and how does it affect the estimation of muscle moment arms and hip joint reaction forces? METHODS: Thirteen independent operators participated in defining the muscle model, while a single operator performed 13 repetitions to define the muscle model based on 3D bone geometry. For each model, the muscle moment arms relative to the hip joint center of rotation was evaluated. Additionally, the hip joint reaction force during one-legged stance was assessed using static inverse optimization. RESULTS: The results indicated high levels of consistency, as evidenced by the intra- rater and inter-rater agreement measured by the Intraclass Correlation Coefficient (ICC), which yielded values of 0.95 and 0.99, respectively. However, the estimated muscle moment arms exhibited an error of up to 16 mm compared to the reference musculoskeletal model. It was found that muscles attached to prominent anatomical landmarks were specified with greater accuracy than those attached over larger areas. Furthermore, the variability in estimated moment arms contributed to variations of up to 12% in the hip joint reaction forces. SIGNIFICANCE: Both moment arm and muscle force demonstrated significantly lower variability when assessed by a single operator, suggesting the preference for employing a single operator in the creation of musculoskeletal models for clinical biomechanical studies.
- MeSH
- biologické modely MeSH
- biomechanika MeSH
- kosterní svaly * fyziologie MeSH
- kyčelní kloub * fyziologie MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
PURPOSE OF THE STUDY Femoroacetabular impingement syndrome is a complex, often post-traumatically developing impairment of the hip joint, characterized by ambiguous symptomatology, which makes early diagnosis diffi cult, especially in the early stages. Experimental retrospective study was carried out to evaluate the usability of a triaxial gyroscopic sensor in routine practice as an additional indication criterion for operative versus conservative treatment procedures. MATERIAL AND METHODS 92 patients were included in the retrospective study, and 62 completed the investigation. All patients signed informed consent. A gyroscopic sensor was placed on the right side of the pelvis above the hip joint, and the patients walked approximately 15 steps. Furthermore, an evaluation of the data during stair climbing and a complete clinical examination of the dynamics and physiological movements in the joint was carried out. Data measured with a gyroscopic sensor were processed using differential geometry methods and then evaluated using spectral analysis and neural networks. The proposed technique of diagnosing FAI using gyroscope measurement is a fast, easy-to-perform method. RESULTS Our approach in processing gyroscopic signals used to detect the stage of arthrosis and post-traumatically developing FAI could lead to more accurate early detection and capture in the early stages. CONCLUSIONS The obtained data are easily evaluated, interpretable and benefi cial in diagnosing the early stages of FAI. The results of the conducted research showed this approach to more accurate early detection of arthrosis and post-traumatically developing FAI. Key words: wearable sensors; osteoarthritis; mathematical biophysics; telemedicine.
- MeSH
- dítě MeSH
- konzervativní terapie MeSH
- kyčelní kloub * diagnostické zobrazování patologie MeSH
- lidé MeSH
- nekróza hlavice femuru MeSH
- Perthesova nemoc diagnóza etiologie patofyziologie terapie MeSH
- skluz proximální femorální epifýzy chirurgie diagnóza etiologie patofyziologie MeSH
- synovitida diagnóza etiologie patofyziologie terapie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Publikační typ
- přehledy MeSH
PURPOSE OF THE STUDY Hip dislocation is one of the major causes of disability in children with cerebral palsy (CP). Surgical treatment can be achieved using different techniques including proximal femoral varus derotation osteotomy (FVDRO), pelvic osteotomies, and open hip reduction (OHR). However, we claim that pathologies originating from extraarticular structures in the dislocated hip in CP can be reconstructed by extraarticular methods and OHR may not always be necessary. Therefore, this study aims to discuss the results of hip reconstruction with extraarticular intervention in patients with CP. MATERIAL AND METHODS In total, 141 hips (95 patients) were included in the study. All patients underwent FVDRO, either with or without a Dega osteotomy. Changes in the Acetabular Index (AI), Migration Index (MI), neck-shaft angle (NSA), and center-edge angle (CEA) were assessed on the preoperative, postoperative, and final follow-up anterior-posterior radiographs of the pelvis. RESULTS Median age was 8 years (range between 4-18 years). The average follow-up duration was 5 years (range between 2-9 years). Changes in AI, MI, NSA and CEA values were statistically significant for postop and follow-up periods when compared to preoperative values. Of the 141 operated hips, 8 (5.6%) hips required revision surgery due to redislocation/resubluxation detected at the follow-ups, and unilateral operation can be accepted as a risk factor for redislocation. CONCLUSIONS Our results demonstrate that reconstructive treatment consisting of FVDRO, medial capsulotomy (in the case of reduction difficulty) and transiliac osteotomy (in the case of acetabular dysplasia) provides satisfactory outcomes in hip dislocation in CP. Key words: hip displacement, cerebral palsy, hip reduction.
- MeSH
- acetabulum MeSH
- dítě MeSH
- kyčelní kloub chirurgie MeSH
- lidé MeSH
- luxace kyčle * diagnostické zobrazování etiologie chirurgie MeSH
- mladiství MeSH
- mozková obrna * komplikace chirurgie MeSH
- následné studie MeSH
- pánev MeSH
- předškolní dítě MeSH
- retrospektivní studie MeSH
- výsledek terapie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- předškolní dítě MeSH
- Publikační typ
- časopisecké články MeSH
PURPOSE: The study evaluates long-term results in patients treated by valgus intertrochanteric osteotomy (VITO) for partial avascular necrosis of the femoral head (ANFH) after fracture of the femoral neck in adolescent age. Although this method is mentioned in literature frequently, there are only few studies in the literature dealing with it in detail. METHODS: Authors evaluated five patients at the interval of 15 to 20 years following VITO. The mean age of the patients at the time of injury was 13.6 years and at the time of VITO 16.7 years. The studied parameters included resorption of necrotic segment of femoral head, development of posttraumatic osteoarthritis and leg shortening. RESULTS: Comparison of radiographs and MRI scans before and after VITO showed resorption of the necrotic segment of the femoral head and its remodeling in all five patients. However, two patients gradually developed slight osteoarthritic changes. In one patient, remodeling of the femoral head occurred during the first 6 years postoperatively. Subsequently, the patient developed severe osteoarthritis with marked clinical symptoms. CONCLUSION: VITO can improve the long-term function of the hip joint in adolescents with ANFH after a femoral neck fracture, but cannot restore completely the original shape and structure of the femoral head.
- MeSH
- fraktury krčku femuru * diagnostické zobrazování etiologie chirurgie MeSH
- kyčelní kloub chirurgie MeSH
- lidé MeSH
- mladiství MeSH
- nekróza hlavice femuru * diagnostické zobrazování etiologie chirurgie MeSH
- osteoartróza * MeSH
- osteotomie škodlivé účinky metody MeSH
- Check Tag
- lidé MeSH
- mladiství MeSH
- Publikační typ
- časopisecké články MeSH
