BACKGROUND: Individuals with transtibial amputation place more load on the contralateral lower extremity. A higher adduction moment at the knee joint has been shown to have an effect on the risk of osteoarthritis. OBJECTIVE: The aim of this study was to investigate the effect of weight-bearing of lower-limb prosthesis on the biomechanical parameters associated with the risk of contralateral knee osteoarthritis. STUDY DESIGN: Cross-sectional. METHODS: The experimental group of 14 subjects with unilateral transtibial amputation (13 males). The mean age was 52.7 ± 14.2 years, height 175.6 ± 6.3 cm, weight 82.3 ± 12.5 kg, and duration of prosthesis use 16.5 ± 9.1 years. The control group consisted of 14 healthy subjects with identical anthropometric parameters. Dual emission X-ray absorptiometry was used to determine the weight of the amputated limb. For gait analysis, 10 Qualisys infrared cameras and a motion sensing system on 3 Kistler force platforms were used. Gait was analyzed with the original, lighter, commonly used prosthesis, as well as the prosthesis loaded to the original limb weight. RESULTS: The gait cycle and kinetic parameters of the amputated and healthy limbs were more similar to those of the control group when using the weighted prosthesis. CONCLUSIONS: We recommend further research to more accurately specify the weight of the lower-limb prosthesis with respect to the prosthesis design and duration of use of the heavier prosthesis during the day.
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- artróza kolenních kloubů * chirurgie MeSH
- biomechanika MeSH
- chůze (způsob) MeSH
- dospělí MeSH
- kolenní kloub chirurgie MeSH
- lidé středního věku MeSH
- lidé MeSH
- průřezové studie MeSH
- senioři MeSH
- umělé končetiny * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- Publikační typ
- abstrakt z konference MeSH
Background. Most studies addressing the composition and volume of an amputated limb in lower extrem- ity amputations have focused on determining the amputation stump volume. Examination of the weight of the amputated part of the limb is important for guiding the application of a definitive prosthesis. Objectives. To assess the theoretical value of the weight of the amputated part of the lower limb in patients after transtibial amputation. Study design. Cross-sectional study. Methods. 14 patients with transtibial amputation were enrolled, along with 14 matching controls. We assessed limb weight using dual-emission X-ray absorptiometry (DXA) and compared these values to those derived using anthropometric models (per Zatsiorsky, Osterkamp, and Mozumdar). Results. The lowest average (± standard deviation) weight determined for the hypothetical distal part of the amputated limb by DXA was –3.11±1.13 kg. Compared to DXA, anthropometric models pro- vided significantly higher values. The highest value (4.85 ± 0.77 kg) resulted from using calculations according to Osterkamp, and the model proposed by Mosumdar gave the lowest value (3.43±0.45), which was closest to that derived using DXA. Conclusion. DXA is generally considered the gold standard for measuring body composition. Our comparison of data measured with DXA to that from anthropometric models shows that calculations of amputa- tion mass using selected anthropometric models can significantly overestimate the weight of an amputated limb.
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- abstrakt z konference MeSH
In acase of 64-year-old woman with osteoporosis, the authors demonstrate atextbook example of treatment failure of long-term bisphosphonate therapy which was the cause of atypical fracture of both femurs. The potential risk of long-term bisphosphonate therapy can be seen in their potent antiresorptive effect, which may be associated with deterioration of bone structure, atypical frac-tures or osteonecrosis of the jaws. Differentially diagnostic consideration should be given to similar radiological findings in congenital and acquired metabolic bone diseases where pseudofractures or fractures from fatigue can occur, e.g. hypophosphatemic rickets. The authors refer to the recom-mended approach for proper management of osteoporosis treatment in order to minimise the occurrence of atypical femoral fractures. The efficacy and safety of long-term administration of antiresorptive drugs and indication to intramedullary nailing of the femoral atypical fractures are discussed.
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BACKGROUND AND AIM: Osteogenesis imperfecta (OI), also called brittle bone disease, is a clinically and genetically heterogeneous disorder characterized by decreased bone density. Autosomal dominant forms result from mutations in either the COL1A1 (collagen type I alpha-1 chain) or COL1A2 (collagen type I alpha-2 chain) genes encoding the type I collagen. The aim of this study was to identify mutations and allelic variants of the COL1A1 gene in patients with osteogenesis imperfecta (OI). METHODS AND RESULTS: Molecular genetic analysis of the COL1A1 gene was performed in a cohort of 34 patients with OI. The DNA samples were analysed by PCR and Sanger sequencing. DNA changes in coding sequences of the gene were compared with Type 1 Collagen Mutation Database. Genetic variants resulting in either quantitatively or structurally defective protein production were found in 6 unrelated patients. Four identified mutations are connected to decreased protein production (Tyr47X, Arg131X, Arg415X, Gln1341X), 2 result in amino acid substitution (Cys61Phe, Pro1186Ala) and the last affects splicing (c.1057-1G>T). Further, one silent mutation (Gly794Gly) was detected. No protein analysis was performed. CONCLUSION: Of the 8 identified mutations, 5 were novel and have not been reported before. Only one causes substitution of glycine located within the Gly-X-Y triplets in the triple helical domain. Two mutations are located in major ligand binding regions (MLBR) which are important for bone strength and flexibility. Although the genotype-phenotype correlation is still unclear, our findings should contribute to elucidating this relationship in patients diagnosed with OI.
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- dítě MeSH
- dospělí MeSH
- fenotyp MeSH
- genotyp MeSH
- glycin genetika MeSH
- heterozygot MeSH
- kolagen typu I genetika MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mutace genetika MeSH
- osteogenesis imperfecta genetika MeSH
- substituce aminokyselin genetika MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Publikační typ
- abstrakt z konference MeSH
The case report documents the course of orthotic and orthopaedic surgical treatment of a girl with knee valgus deformity. The case shows the frequent treatment procedures used for the knock knee deformities in children at the Ambulant Centre for Defects of Locomotor Apparatus in Prague. Necessary part for indication of orthotic treatment (orhoses with bending prestressing) and mini-invasive surgery (hemi-epiphysiodesis) is the specific early anthropological examination and monitoring of tibio-femoral angle by both anthropometric and photographic methods.
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