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Applied Sciences in Orthopaedics
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Applied Sciences in Orthopaedics

A special issue of Applied Sciences (ISSN 2076-3417). This special issue belongs to the section "Applied Biosciences and Bioengineering".

Deadline for manuscript submissions: closed (31 May 2022) | Viewed by 47285

Special Issue Editors

Prof. Dr. Cheng-Kung Cheng

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Guest Editor
School of Biomedical Engineering Director, Engineering Research Center of Digital Medicine and Clinical Translation of the Ministry of Education, Shanghai Jiao Tong University, Shanghai 200030, China
Interests: orthopedic biomechanics; implant retrieval analysis; knee implant; hip implant; spinal instrumentation
Special Issues, Collections and Topics in MDPI journals
Dr. Tsung-Yuan Tsai

E-Mail Website
Guest Editor
School of Biomedical Engineering and Med-X Research Institute, Shanghai Jiao Tong University, Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education, Shanghai 200030, China
Interests: biomedical engineering; orthopedic engineering; sports science; medical image processing; computational biomechanics
Dr. Liao Wang

E-Mail Website
Guest Editor
Shanghai Key Laboratory of Orthopedic Implants, Department of Orthopedic Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Interests: adult reconstruction; orthopaedic sports medicine; orthopaedic biomechanics; computer assisted orthopaedic surgery; 3D printing
Dr. Songtao Ai

E-Mail Website
Guest Editor
Department of Radiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Interests: imaging diagnosis of bone and joint; molecular imaging; sports science; medical image processing; artificial intelligence

Special Issue Information

Dear Colleagues,

It is our pleasure to announce a Special Issue of Applied Sciences on the topic of “Applied Sciences in Orthopedics”. This Special Issue will publish submissions from across all areas related to clinical and basic research on orthopedic surgery, especially involving orthopedic imaging and biomechanics. Many studies have focused on the aging of the musculoskeletal system, but recently there have been many sports injuries and functional deficits caused by abnormal or extreme movement. Many novel technologies and devices have been developed and applied in orthopedics to diagnose or treat these patients. However, there is a lack of long-term follow-up to prove their efficacy. This Special Issue intends to provide a platform to include all related research in order to explore the unsolved problems in future collaborations. Your contribution in the form of sharing your outstanding research outcomes will definitely make this Special Issue much more meaningful for this purpose.

We look forward to hearing from you and to your contribution to this Special Issue.

Prof. Dr. Cheng-Kung Cheng
Dr. Tsung-Yuan Tsai
Dr. Liao Wang
Dr. Songtao Ai
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Applied Sciences is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • musculoskeletal research
  • bone and joint diseases
  • medical imaging
  • biomechanics
  • biomaterials
  • functional evaluation
  • sports medicine
  • soft tissue repair
  • computer-assisted orthopedic surgery

Published Papers (16 papers)

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13 pages, 10191 KiB  
Article
Stereotactic Positioning System: Towards a Mechanism Used in Thermal Ablation Therapy
by Jose Mendez Maria, Gemima Lara Hernandez, Citlalli Jessica Trujillo-Romero, Albino Martinez Sibaja and Jose Jesus Agustín Flores Cuautle
Appl. Sci. 2022, 12(15), 7795; https://0-doi-org.brum.beds.ac.uk/10.3390/app12157795 - 03 Aug 2022
Viewed by 1292
Abstract
In microwave thermal ablation, placing the antenna on a specific coordinate is one of the most critical steps. Several stereotactic systems can place an instrument on a specific point with great accuracy. However, these systems are developed for neurosurgery; moreover, a stereotactic system [...] Read more.
In microwave thermal ablation, placing the antenna on a specific coordinate is one of the most critical steps. Several stereotactic systems can place an instrument on a specific point with great accuracy. However, these systems are developed for neurosurgery; moreover, a stereotactic system used in microwave thermal ablation must not disturb the electromagnetic (EM) pattern generated by the antenna. A stereotactic positioning system was designed, built, and tested. Different types of materials were proposed to manufacture the proposed stereotactic system to locate the microwave antennas. The stereotactic system can displace the microwave antenna around the Z-axis and Theta-axis. Displacements were generated by stepper motors and controlled by the user through a graphical interface. The system tests consist of programming displacements along the two axes in steps of 5 mm on the Z-axis and 5 degrees on the Theta-axis. Results showed that the system is capable of moving using cylindrical coordinates over a 70 mm displacement with an average error of ±0.85 mm for sensors on the Z-axis, while in the Theta-axis it reaches 180∘ displacement with an error of ±2.64∘. A stereotactic microwave antenna positioning system was developed and preliminarily tested. This first system can already be used to evaluate antenna performance either in phantoms or ex-vivo tissue. Moreover, this system can be extrapolated to different parts of the human body and be adapted to the required dimensions. Full article
(This article belongs to the Special Issue Applied Sciences in Orthopaedics)
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12 pages, 3722 KiB  
Article
Correlation between Scoliosis Flexibility Degree on Preoperative Imaging with Postoperative Curve Correction and Mechanical Complications
by Mauro Costa Morais Tavares Junior, Raphael Martus Marcon, Alexandre Fogaça Cristante and Olavo Biraghi Letaif
Appl. Sci. 2022, 12(14), 7305; https://0-doi-org.brum.beds.ac.uk/10.3390/app12147305 - 20 Jul 2022
Viewed by 1663
Abstract
(1) Background: In the preoperative planning stage of scoliosis surgery, it is routine to use radiographs obtained with and without traction to observe the curve flexibility in order to estimate curve correction, but its association with mechanical complications is not completely understood. (2) [...] Read more.
(1) Background: In the preoperative planning stage of scoliosis surgery, it is routine to use radiographs obtained with and without traction to observe the curve flexibility in order to estimate curve correction, but its association with mechanical complications is not completely understood. (2) Methods: Retrospective cohort study of all patients undergoing infantile, congenital, neuromuscular or idiopathic adolescent scoliosis correction surgery at a single institution between 2015 and 2019, with a minimum follow-up of 24 months. Associations between qualitative variables were tested with the chi-square test. The association between qualitative and quantitative variables were tested with the Mann–Whitney test, and correlations between quantitative variables was tested with Spearman’s correlation. (3) Results: A total of 330 patients, 88 males and 242 females, with a mean age of 16.98 years at surgery, were included. The mean value of preoperative main curves, its flexibility and postoperative value were 54.44 degrees, 21.73 degrees and 18.08 degrees, respectively. (4) Conclusions: Preoperative spinal X-ray examination with traction or bending films is a reasonable option for assessing scoliotic curve flexibility, and patients with neuromuscular scoliosis who are not ambulatory can be informed of the increased risks of late mechanical complications. Full article
(This article belongs to the Special Issue Applied Sciences in Orthopaedics)
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8 pages, 732 KiB  
Article
Is Caton–Deschamps Index Reliable and Reproducible in Preoperative Assessment of Patellar Height for Patellar Instability Surgery?
by Elisa Giacomina Pandini, Pierluigi Pironti, Davide Maria Maggioni, Lorenzo Impieri, Cristiana Balbino, Nicola Manta, Marco Viganò, Laura Mangiavini and Roberto D’Anchise
Appl. Sci. 2022, 12(10), 5251; https://0-doi-org.brum.beds.ac.uk/10.3390/app12105251 - 23 May 2022
Cited by 2 | Viewed by 3624
Abstract
The patellar height measurement is fundamental for surgical planning in patellar instability. The Caton–Deschamps index (CDI) is a widely employed method, but a gold standard is still lacking. The aim of this study was to evaluate the reliability and reproducibility of the CDI [...] Read more.
The patellar height measurement is fundamental for surgical planning in patellar instability. The Caton–Deschamps index (CDI) is a widely employed method, but a gold standard is still lacking. The aim of this study was to evaluate the reliability and reproducibility of the CDI in a patellar height assessment and to hypothesize its employment in the preoperative planning of patellar stabilization surgery. A total of 29 cases of recurrent patellar instability undergoing surgical treatment were analyzed. The preoperative and postoperative CDI were measured by six different raters (three seniors and three juniors). The interclass correlation coefficient (ICC) of the six raters was calculated to evaluate the interobserver agreement. The seniors’ and juniors’ measurements were compared to assess the CDI reproducibility. The Fleiss kappa was calculated among the six raters to estimate the agreement in favor of an anterior tibial apophysis (ATA) transposition surgery. This study shows excellent absolute agreement in terms of the ICC for the raters’ average and for single raters as units, both preoperatively (p < 0.001) and postoperatively (p < 0.001). The agreement of the surgical choice between the six observers corresponds to “substantial agreement”. This study demonstrates that the CDI is reliable and reproducible, and it could represent a valuable tool in the clinical assessment, treatment choice and pre-surgical planning of patellar instability surgery. Full article
(This article belongs to the Special Issue Applied Sciences in Orthopaedics)
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15 pages, 2289 KiB  
Article
Determining the Tightrope Tightening Force for Effective Fixation of the Tibiofibular Syndesmosis during Osteomeatal Synthesis of Fibula Injuries
by Oleg Bazaluk, Andriy Chuzhak, Vadym Sulyma, Andrii Velychkovych, Liubomyr Ropyak, Vasyl Vytvytskyi, Vasyl Mykhailiuk and Vasyl Lozynskyi
Appl. Sci. 2022, 12(10), 4903; https://0-doi-org.brum.beds.ac.uk/10.3390/app12104903 - 12 May 2022
Cited by 4 | Viewed by 1889
Abstract
The issue of choosing the method for optimal surgical treatment of a broken fibula has been debatable for many years. At the same time, concomitant repair of tibiofibular syndesmosis injuries does not have a unified approach. It has been determined that osteosynthesis of [...] Read more.
The issue of choosing the method for optimal surgical treatment of a broken fibula has been debatable for many years. At the same time, concomitant repair of tibiofibular syndesmosis injuries does not have a unified approach. It has been determined that osteosynthesis of broken shin bones with syndesmosis injury should combine stable fixation of the broken bone and should not limit the elastic properties of the syndesmosis. In case of a broken fibula, it is recommended to use a stable extracortical fixator and an elastic connection of the syndesmosis injury using a tightrope. An analytical model of the broken fibula, which is blocked with an extracortical fixator metal plate and elastically fixed with a tightrope, has been developed. The research object is the stress–strain state of the “broken fibula–extracortical titanium plate” composition under the action of tightrope tightening fixation. The main research result is an analytical dependence, which makes it possible to determine the permissible value of the tightrope tightening force for elastic fixation of the tibiofibular syndesmosis. The research results have been tested numerically, and the influence of the parameters of plate, bone and damage localization on the permissible value of the tightrope tightening force has been analyzed. By using the rational tightrope tightening force with stable–elastic fixation of the broken shin, it is possible to reduce the time before the start of loading on the injured extremity and accelerate the functional recovery of the patient. Full article
(This article belongs to the Special Issue Applied Sciences in Orthopaedics)
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10 pages, 1024 KiB  
Article
Ultra-Low Electromagnetic Fields Application on In Vitro Cartilage Regeneration: A Pilot Study to Improve Treatment of Osteoarticular Diseases
by Jessica Iorio, Giacomo Bagni, Valentina Devescovi, Roberto Duranti, Pietro De Biase, Annarosa Arcangeli and Claudia Duranti
Appl. Sci. 2022, 12(9), 4116; https://0-doi-org.brum.beds.ac.uk/10.3390/app12094116 - 19 Apr 2022
Viewed by 3502
Abstract
Extremely low-frequency and low-intensity electromagnetic fields show positive effects on the treatment of several osteoarticular diseases, such as osteoarthritis, and are currently applied in the clinical setting with promising results on tissue regeneration. However, the biological mechanisms underlying the beneficial effects triggered by [...] Read more.
Extremely low-frequency and low-intensity electromagnetic fields show positive effects on the treatment of several osteoarticular diseases, such as osteoarthritis, and are currently applied in the clinical setting with promising results on tissue regeneration. However, the biological mechanisms underlying the beneficial effects triggered by this type of physical stimulation still need to be deciphered. We tested the hypothesis that ultra-low complex electromagnetic fields stimulation using an innovative medical device could enhance chondrogenesis in human adipose-derived stem cells (ADSCs), and analyzed its biological effects. Chondrogenic lineage markers, like ACAN, SOX9, RUNX2, COL2A1, and COL10A1, were evaluated after 21 days of treatment. Thus far, we have provided preliminary evidence that a dedicated pattern of ultra-weak complex electromagnetic sequences emitted by a cutting-edge technology can promote cartilage regeneration, inducing the chondrogenic differentiation and maturity of ADSCs. Full article
(This article belongs to the Special Issue Applied Sciences in Orthopaedics)
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9 pages, 1963 KiB  
Article
Cutting Flute and Thread Design on Self-Tapping Pedicle Screws Influence the Insertion Torque and Pullout Strength
by Lien-Chen Wu, Yueh-Ying Hsieh, Fon-Yih Tsuang, Yi-Jie Kuo and Chang-Jung Chiang
Appl. Sci. 2022, 12(4), 1956; https://0-doi-org.brum.beds.ac.uk/10.3390/app12041956 - 13 Feb 2022
Cited by 3 | Viewed by 4723
Abstract
Self-tapping screws are commonly used in trauma and maxillofacial surgery and are increasingly used for pedicle screw insertions. In order to evaluate how the quantity and length of cutting flutes on self-tapping pedicle screws affect the insertion torque and pullout strength, eight different [...] Read more.
Self-tapping screws are commonly used in trauma and maxillofacial surgery and are increasingly used for pedicle screw insertions. In order to evaluate how the quantity and length of cutting flutes on self-tapping pedicle screws affect the insertion torque and pullout strength, eight different self-tapping pedicle screw designs were evaluated. All screws had a threaded length of 35 mm and featured variations in the number of leads, as well as the length and quantity of cutting flutes. Five samples of each design were inserted into pre-drilled, untapped holes (ø2.7 mm, length 35 mm) in sawbone blocks of density 20 PCF. The insertion torque and pullout strength were measured according to ASTM F543. The results showed that screws with a longer cutting flute of 9.5 mm had a lower mean maximum insertion torque than screws with shorter 2.9 mm cutting flutes. Pedicle screws with a double-lead thread design had a greater insertion torque than their single-lead counterparts, and the use of three cutting flutes produced a lower torque than two cutting flutes. The results demonstrated a greater pullout strength in screws with a single-lead thread rather than a double-lead, three cutting flutes instead of two, and a longer length for the cutting flute. In conclusion, to provide immediate stability and reduce the surgical insertion time, a single-lead, self-tapping pedicle screw incorporating three long cutting flutes is recommended because of the significantly greater pullout strength. This design could also reduce the risk of implant loosening in comparison to double-lead, self-tapping pedicle screw designs. Full article
(This article belongs to the Special Issue Applied Sciences in Orthopaedics)
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10 pages, 912 KiB  
Article
Validity and Absolute Reliability of Axial Vertebral Rotation Measurements in Thoracic and Lumbar Vertebrae
by José Hurtado-Avilés, Vicente J. León-Muñoz, Pilar Andújar-Ortuño, Fernando Santonja-Renedo, Mónica Collazo-Diéguez, Mercedes Cabañero-Castillo, Ana Belén Ponce-Garrido, Miriam González-Ballester, Francisco Javier Sánchez-Martínez, Pietro G. Fiorita, Nieves Aidé Ruiz-Cambra, Andrés Campuzano-Melgarejo, Victoria Eugenia Fuentes-Santos and Fernando Santonja-Medina
Appl. Sci. 2021, 11(23), 11084; https://0-doi-org.brum.beds.ac.uk/10.3390/app112311084 - 23 Nov 2021
Cited by 3 | Viewed by 1848
Abstract
Axial vertebral rotation (AVR) and Cobb angles are the essential parameters to analyse different types of scoliosis, including adolescent idiopathic scoliosis. The literature shows significant discrepancies in the validity and reliability of AVR measurements taken in radiographic examinations, according to the type of [...] Read more.
Axial vertebral rotation (AVR) and Cobb angles are the essential parameters to analyse different types of scoliosis, including adolescent idiopathic scoliosis. The literature shows significant discrepancies in the validity and reliability of AVR measurements taken in radiographic examinations, according to the type of vertebra. This study’s scope evaluated the validity and absolute reliability of thoracic and lumbar vertebrae AVR measurements, using a validated software based on Raimondi’s method in digital X-rays that allowed measurement with minor error when compared with other traditional, manual methods. Twelve independent evaluators measured AVR on the 74 most rotated vertebrae in 42 X-rays with the software on three separate occasions, with one-month intervals. We have obtained a gold standard for the AVR of vertebrae. The validity and reliability of the measurements of the thoracic and lumbar vertebrae were studied separately. Measurements that were performed on lumbar vertebrae were shown to be 3.6 times more valid than those performed on thoracic, and with almost an equal reliability (1.38° ± 1.88° compared to −0.38° ± 1.83°). We can conclude that AVR measurements of the thoracic vertebrae show a more significant Mean Bias Error and a very similar reliability than those of the lumbar vertebrae. Full article
(This article belongs to the Special Issue Applied Sciences in Orthopaedics)
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13 pages, 2407 KiB  
Article
Biomechanical Comparison of Fixation Stability among Various Pedicle Screw Geometries: Effects of Screw Outer/Inner Projection Shape and Thread Profile
by Ming-Kai Hsieh, Yun-Da Li, Mu-Yi Liu, Chen-Xue Lin, Tsung-Ting Tsai, Po-Liang Lai and Ching-Lung Tai
Appl. Sci. 2021, 11(21), 9901; https://0-doi-org.brum.beds.ac.uk/10.3390/app11219901 - 22 Oct 2021
Cited by 7 | Viewed by 1873
Abstract
The proper screw geometry and pilot-hole size remain controversial in current biomechanical studies. Variable results arise from differences in specimen anatomy and density, uncontrolled screw properties and mixed screw brands, in addition to the use of different tapping methods. The purpose of this [...] Read more.
The proper screw geometry and pilot-hole size remain controversial in current biomechanical studies. Variable results arise from differences in specimen anatomy and density, uncontrolled screw properties and mixed screw brands, in addition to the use of different tapping methods. The purpose of this study was to evaluate the effect of bone density and pilot-hole size on the biomechanical performance of various pedicle screw geometries. Six screw designs, involving three different outer/inner projections of screws (cylindrical/conical, conical/conical and cylindrical/cylindrical), together with two different thread profiles (square and V), were examined. The insertional torque and pullout strength of each screw were measured following insertion of the screw into test blocks, with densities of 20 and 30 pcf, predrilled with 2.7-mm/3.2-mm/3.7-mm pilot holes. The correlation between the bone volume embedded in the screw threads and the pullout strength was statistically analyzed. Our study demonstrates that V-shaped screw threads showed a higher pullout strength than S-shaped threads in materials of different densities and among different pilot-hole sizes. The configuration, consisting of an outer cylindrical shape, an inner conical shape and V-shaped screw threads, showed the highest insertional torque and pullout strength at a normal and higher-than-normal bone density. Even with increasing pilot-hole size, this configuration maintained superiority. Full article
(This article belongs to the Special Issue Applied Sciences in Orthopaedics)
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15 pages, 27560 KiB  
Article
Human Umbilical Cord Mesenchymal Stem Cells in Combination with Hyaluronic Acid Ameliorate the Progression of Knee Osteoarthritis
by Jia-Lin Wu, Pei-Chun Wong, Chung-Wei Ho, Chien-Han Chen, Kuan-Ya Liao, Ronald Lovel, Tang Bo-Chung Wu, Wen-Ying Chang, Yan-Zhang Lee and Willie Lin
Appl. Sci. 2021, 11(14), 6650; https://0-doi-org.brum.beds.ac.uk/10.3390/app11146650 - 20 Jul 2021
Cited by 2 | Viewed by 2576
Abstract
The aim of this study is to evaluate the feasibility and usefulness of the human umbilical cord mesenchymal stem cells (hUC-MSCs) and hyaluronan acid (HA) combination to attenuate osteoarthritis progression in the knee while simultaneously providing some insights on the mitigation mechanism. In [...] Read more.
The aim of this study is to evaluate the feasibility and usefulness of the human umbilical cord mesenchymal stem cells (hUC-MSCs) and hyaluronan acid (HA) combination to attenuate osteoarthritis progression in the knee while simultaneously providing some insights on the mitigation mechanism. In vitro, the effect of hUC-MSCs with HA treatment on chondrocyte cell viability and the cytokine profile were analyzed. Additionally, the antioxidation capability of hUC-MSCs-CM (conditioned medium) with HA towards H2O2-induced chondrocyte cell damage was evaluated. The HA addition increased the hUC-MSC antioxidation capability and cytokine secretion, such as Dickkopf-related protein 1 (DKK-1) and hepatocyte growth factor (HGF), while no adverse effect on the cell viability was observed. In vivo, the intra-articular injection of hUC-MSCs with HA to a mono-iodoacetate (MIA)-induced knee osteoarthritis (KOA) rat model was performed and investigated. Attenuation of the KOA progression in the MIA-damaged rat model was seen best in hUC-MSCs with a HA combination compared to the vehicle control or each individual element. Combining hUC-MSCs and HA resulted in a synergistic effect, such as increasing the cell therapeutic capability while incurring no observable adverse effects. Therefore, this combinatorial therapy is feasible and has promising potential to ameliorate KOA progression. Full article
(This article belongs to the Special Issue Applied Sciences in Orthopaedics)
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12 pages, 3421 KiB  
Article
Biomechanical Comparison of Vertebroplasty, Kyphoplasty, Vertebrae Stent for Osteoporotic Vertebral Compression Fractures—A Finite Element Analysis
by Jen-Chung Liao, Michael Jian-Wen Chen, Tung-Yi Lin and Weng-Pin Chen
Appl. Sci. 2021, 11(13), 5764; https://0-doi-org.brum.beds.ac.uk/10.3390/app11135764 - 22 Jun 2021
Cited by 3 | Viewed by 3596
Abstract
Vertebroplasty (VP), balloon kyphoplasty (BKP), and vertebral stent (VS) are usually used for treating osteoporotic compression fractures. However, these procedures may pose risks of secondary adjacent level fractures. This study simulates finite element models of osteoporotic compression fractures treated with VP, BKP, and [...] Read more.
Vertebroplasty (VP), balloon kyphoplasty (BKP), and vertebral stent (VS) are usually used for treating osteoporotic compression fractures. However, these procedures may pose risks of secondary adjacent level fractures. This study simulates finite element models of osteoporotic compression fractures treated with VP, BKP, and VS Vertebral resection method was used to simulate vertebra fracture with Young’s modulus set at 70 MPa to replicate osteoporosis. A follower load of (1175 N for flexion, and 500 N for all others) was applied in between vertebral bodies to simulate the muscle force. Moment loadings of 7.5 N-m in flexion, extension, lateral bending, axial rotation were applied respectively. The VS model had the highest von Mises stresses on the bone cement under all different loading conditions (flexion/5.91 MPa; extension/3.74 MPa; lateral bending/3.12 MPa; axial rotation/3.54 MPa). The stress distribution and maximum von Mises stresses of the adjacent segments, T11 inferior endplate and L1 superior endplate, showed no significant difference among three surgical models. The postoperative T12 stiffness for VP, BKP, and VS are 2898.48 N/mm, 4123.18 N/mm, and 4690.34 N/mm, respectively. The VS model led to superior surgical vertebra stiffness without significantly increasing the risks of adjacent fracture. Full article
(This article belongs to the Special Issue Applied Sciences in Orthopaedics)
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9 pages, 1168 KiB  
Article
Effects of Tendon Release Surgery on Inter-Limb Leg Stiffness Control in Children with Spastic Diplegic Cerebral Palsy during Gait
by Chien-Chung Kuo, Hsing-Po Huang, Hsuan-Yu Lu, Tsan-Yang Chen, Ting-Ming Wang and Tung-Wu Lu
Appl. Sci. 2021, 11(10), 4562; https://0-doi-org.brum.beds.ac.uk/10.3390/app11104562 - 17 May 2021
Cited by 3 | Viewed by 1955
Abstract
Impaired motor control and musculotendon tightness in the lower extremities are characteristic features of patients with diplegic cerebral palsy (CP). Tendon release surgery (TRS) helps improve joint and leg stiffness, but the effects of TRS on inter-limb coordination in terms of the total [...] Read more.
Impaired motor control and musculotendon tightness in the lower extremities are characteristic features of patients with diplegic cerebral palsy (CP). Tendon release surgery (TRS) helps improve joint and leg stiffness, but the effects of TRS on inter-limb coordination in terms of the total leg stiffness, and the bilateral symmetry in leg stiffness during gait, remain unknown. Ten children with spastic diplegic CP scheduled for TRS and ten healthy controls participated in this study. The inter-limb sharing of total leg stiffness during double-limb support phase and bilateral leg stiffness symmetry during stance phase of gait were calculated using the kinematic and ground reaction force data measured by a motion analysis system. Before TRS, the patients with diplegic CP walked with a decreased share of total leg stiffness during weight-acceptance (p < 0.05) and with increased bilateral leg stiffness asymmetry during single-limb support and weight-transfer during gait (p < 0.05) when compared to healthy controls. After TRS, the bilateral leg stiffness asymmetry was significantly reduced in the CP group, especially in the terminal stance phase, with inter-limb sharing of total leg stiffness becoming similar to that in controls (p > 0.05). The surgery seemed to improve the lower limb control and increased the bilateral limb symmetry during gait. Full article
(This article belongs to the Special Issue Applied Sciences in Orthopaedics)
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9 pages, 1928 KiB  
Article
Biomechanical Comparison of a Novel Implant and Commercial Fixation Devices for AO/OTA 43-C1 Type Distal Tibial Fracture
by Shun-Ping Wang, Kun-Jhih Lin, Cheng-En Hsu, Chao-Ping Chen, Cheng-Min Shih and Kang-Ping Lin
Appl. Sci. 2021, 11(10), 4395; https://0-doi-org.brum.beds.ac.uk/10.3390/app11104395 - 12 May 2021
Cited by 2 | Viewed by 3590
Abstract
This study compares the novel Asia Distal Lateral Tibial Locking Plate mechanical stability to that of the current anterolateral and medial tibial plates based on finite element analysis. Four-part fracture fragment model of the distal tibia was reconstructed using CAD software. A load [...] Read more.
This study compares the novel Asia Distal Lateral Tibial Locking Plate mechanical stability to that of the current anterolateral and medial tibial plates based on finite element analysis. Four-part fracture fragment model of the distal tibia was reconstructed using CAD software. A load was applied to simulate the swing phase of gait. The implant stress and the construct stiffness were compared. The results of the anterolateral plate and the medial plate were similar and the displacement values were determined lower than those in the medial plate. In the simulated distal tibia fracture, the Aplus Asia Distal Lateral Tibial Locking Plate and medial distal tibial plate tibia fixations will lead to a stiffer bone-implant construct compared to the anterolateral distal tibial plate. Moreover, the stress in the Aplus Asia Distal Lateral Tibial Locking Plate was lower than those for the medial distal tibial plate and anterolateral bone plates. The Aplus Asia Distal Lateral Tibial Locking Plate has better stabilization and is an anterolateral plate that avoids more soft tissue damage than other bone plates. The Aplus Asia Distal Lateral Tibial Locking Plate could be one of a suitable design in tibia distal fracture fixation. Full article
(This article belongs to the Special Issue Applied Sciences in Orthopaedics)
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9 pages, 1173 KiB  
Article
Association between Proximal Tibiofibular Joint Morphology and Knee Alignment in Osteoarthritis Patients
by Xin-Zheng Qi, Min Zhang, Mao-Dan Nie, Xiao-Ying Ma, Yi-Chao Luan, Cheng-Kung Cheng and Min Wang
Appl. Sci. 2021, 11(5), 2269; https://0-doi-org.brum.beds.ac.uk/10.3390/app11052269 - 04 Mar 2021
Cited by 1 | Viewed by 2004
Abstract
This study aimed to determine whether proximal tibiofibular joint (PTFJ) morphology was related to knee alignment in osteoarthritis (OA) patients. Methods: 67 OA patients were enrolled in this study. The morphology of the PTFJ including articular shape type, articular surface area, joint inclination, [...] Read more.
This study aimed to determine whether proximal tibiofibular joint (PTFJ) morphology was related to knee alignment in osteoarthritis (OA) patients. Methods: 67 OA patients were enrolled in this study. The morphology of the PTFJ including articular shape type, articular surface area, joint inclination, relative articular height, and joint declination were measured from 3D models. The knee alignment of each subject was characterized as varus, normal, or valgus according to the femorotibial angle (FTA). The FTA was measured on weight-bearing X-rays. Multinomial logistic regression analysis was used to evaluate the association between PTFJ morphology and knee alignment. Results: there were significant differences between varus, valgus, and normal FTA groups in terms of shape type (p = 0.021), inclination of the PTFJ (p = 0.025), relative articular height (p = 0.019), and PTFJ declination angle (p = 0.011). A higher relative articular height (OR: 0.608, 95% CI: 0.205–0.998, and p = 0.017) and lower declination angle (OR: 0.632, 95% CI: 0.601–0.887, and p =0.019) were found to be associated with an increased likelihood of having a valgus FTA rather than a varus FTA. Conclusion: our results indicate that PTFJ morphology is associated with knee alignment. Full article
(This article belongs to the Special Issue Applied Sciences in Orthopaedics)
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12 pages, 2421 KiB  
Technical Note
Fast-Track-Protocol for Optimization of Presurgical Planning in Acute Surgical Treatment of Acetabular Quadrilateral Plate Fractures Using 3D Printing Technology and Pre-Contoured Reconstruction Plates
by Krzysztof Andrzejewski, Marcin Elgalal, Piotr Komorowski, Jan Poszepczyński, Bożena Rokita and Marcin Domżalski
Appl. Sci. 2022, 12(7), 3492; https://0-doi-org.brum.beds.ac.uk/10.3390/app12073492 - 30 Mar 2022
Cited by 1 | Viewed by 1458
Abstract
Background. Preoperative planning and 3D printing can be used to treat pelvic bone fractures using pre-contoured surgical plates, in particular complex, comminuted fractures involving the acetabulum and quadrilateral plate. The aim of the study was to develop a Fast-Track-Protocol (fast track methodology) for [...] Read more.
Background. Preoperative planning and 3D printing can be used to treat pelvic bone fractures using pre-contoured surgical plates, in particular complex, comminuted fractures involving the acetabulum and quadrilateral plate. The aim of the study was to develop a Fast-Track-Protocol (fast track methodology) for creating 3D anatomical models, that could be used to shape surgical plates, using open-source software and budget 3D printers. Such a ‘low-budget’ approach would allow a hospital-based multidisciplinary team to carry out pre-surgical planning and treat complex pelvic fractures using 3D technology. Methods. The study included 5 patients with comminuted pelvic fractures. For each patient, CT (computed tomography) data were converted into two 3D models of the pelvis-injured side and mirrored model of the contralateral, uninjured hemipelvis. These models were 3D printed and used as templates to shape surgical plates. Results. A Fast-Track-Protocol was established and used to successfully treat 5 patients with complex, comminuted fractures of the pelvis. Conclusion. Using the Fast-Track-Protocol it was possible to prepare 3D printed models and patient-specific pre-contoured plates within 2 days of hospital admittance. Such an approach resulted in better surgical technique and shorter operative times, while incurring relatively low costs. Full article
(This article belongs to the Special Issue Applied Sciences in Orthopaedics)
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6 pages, 1748 KiB  
Case Report
Malignant Knee Joint Effusion—A New Dimension of Laboratory Diagnostics
by Eliska Vanaskova, Petr Kelbich, Martin Cegan and Tomas Novotny
Appl. Sci. 2022, 12(3), 994; https://0-doi-org.brum.beds.ac.uk/10.3390/app12030994 - 19 Jan 2022
Cited by 4 | Viewed by 6480
Abstract
Joint effusions are most frequently caused by osteoarthritis, trauma, an infection process or an autoimmune disease. The development of joint effusion due to a tumor process is rare but should be taken into consideration in the diagnostics. Joint effusions are examined mostly by [...] Read more.
Joint effusions are most frequently caused by osteoarthritis, trauma, an infection process or an autoimmune disease. The development of joint effusion due to a tumor process is rare but should be taken into consideration in the diagnostics. Joint effusions are examined mostly by means of microbiology to rule out or confirm pyogenic synovitis. These standard processes may take up to several days. The article presented here describes a unique case of a 74-year-old female diagnosed with a generalized malignant process according to a cytological-energy analysis and an immunocytochemical examination of a malignant joint effusion caused by femoral condyle metastasis. Other widely-used imaging methods such as X-ray, full-body CT scan and also laboratory examinations confirmed the malignancy and the origin. A cytological-energy analysis and an immunocytochemical examination can expedite the diagnostic process, can outline the processes happening in the joint and can indicate further examinations and subsequent therapy. The use of these laboratory methods appears to be a helpful diagnostic option to obtain additional information about a joint effusion, including the information about an ongoing malignant process. In our case report, they helped to confirm the typing of the tumor within three days, without the need for a metastasis biopsy. In appropriate cases, synovial fluid can play a role in tumor diagnostics. Full article
(This article belongs to the Special Issue Applied Sciences in Orthopaedics)
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12 pages, 695 KiB  
Study Protocol
Effects of Dog-Assisted Therapy on the Physical Function and Communication Skills of Adults with Autism: A Study Protocol for a Controlled Study
by Isabel Gómez-Calcerrada, Ana Myriam Lavín-Pérez, Santos Villafaina, Juan Carlos Rueda-Rubio, Beatriz Rivera-Martín, Israel González-García, Eugenio Merellano-Navarro, Marta Mateo-Garitagoitia, Carlota González-Plaza and Daniel Collado-Mateo
Appl. Sci. 2021, 11(22), 10650; https://0-doi-org.brum.beds.ac.uk/10.3390/app112210650 - 12 Nov 2021
Cited by 2 | Viewed by 2712
Abstract
Background and Objectives: Despite the scientific evidence of the positive effects of animal-assisted therapy (AAT) in adults with autism spectrum disorder (ASD), it is not still considered an evidence-based practice for this population. The proposed study will aim to evaluate the effects of [...] Read more.
Background and Objectives: Despite the scientific evidence of the positive effects of animal-assisted therapy (AAT) in adults with autism spectrum disorder (ASD), it is not still considered an evidence-based practice for this population. The proposed study will aim to evaluate the effects of a dog-assisted therapy program on gait, posture, and communication skills. Materials and Methods: A total of 24 adults with ASD will participate in this non-randomized controlled trial. The experimental group will involve 12 participants who will receive AAT for 10 weeks, at two sessions per week. The focus of these sessions will be conducting different activities and physical exercises, facilitated by dogs. The control group will receive treatment as usual. The outcome measures will be the ability to walk and climbing stairs, balance, risk of falls and communication skills. Conclusions: The role of dogs as facilitators of the movement may lead to relevant benefits in the gait, posture and communication skills of adults with ASD, improving their ability to perform activities of daily living. Full article
(This article belongs to the Special Issue Applied Sciences in Orthopaedics)
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