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Cleveland T Barnett, Natalie Vanicek, David F Rusaw
OBJECTIVE: To assess whether variables from a postural control test relate to and predict falls efficacy in prosthesis users. DESIGN: Twelve-month within and between subjects repeated measures design. Participants performed the Limits of Stability (LOS) test protocol at study baseline and at 6-month follow-up. Participants also completed the Falls Efficacy Scale-International (FES-I) questionnaire, reflecting the fear of falling, and reported the number of falls monthly between study baseline and 6-month follow-up, and additionally at 9- and 12-month follow-ups...
June 16, 2018: Archives of Physical Medicine and Rehabilitation
Mustafa Özer, Hamza Özer, Hakan Selek, Gül Baltacı, Gülcan Harput, Anıl Taşkesen, Mehmet Çetinkaya
Background/aim: This study aimed to compare radiological and functional outcomes of patients who had single-bundle anterior cruciate ligament (ACL) reconstruction with autologous hamstring tendon grafts using transtibial (TT) versus anteromedial (AM) femoral tunnel drilling techniques. Materials and methods: Sixty patients who had been operated on between 2010 and 2013 were enrolled in this study. Tunnel positions and widenings in the femur and tibia were evaluated with radiographs, arthrometric measurements with a Rolimeter arthrometer (Aircast, Summit, NJ, USA), stability assessment with Lachman and reverse pivot shift tests, and functional assessment with the International Knee Documentation Committee and Tegner and Lysholm scoring systems...
June 14, 2018: Turkish Journal of Medical Sciences
Gabrielle Thibault, Hossein Gholizadeh, Emily Sinitski, Natalie Baddour, Edward D Lemaire
Walking on various surfaces encountered in everyday life requires lower limb prosthesis users to continually adapt their movement patterns. Elevated vacuum suspension systems could improve transtibial amputee gait on non-level surfaces; however, research is lacking to guide clinical practice. Twelve transtibial amputees were fitted with the Össur sleeveless vacuum suspension system (Unity). After a one month accommodation period, the CAREN-Extended system was used to evaluate gait on a self-paced treadmill when walking with continuous perturbations (medial-lateral translations, rolling hills, simulated uneven ground) with an active or inactive vacuum suspension system...
2018: PloS One
Abdulkadir Aydın, Sibel Çağlar Okur
BACKGROUND The aim of this retrospective study was to investigate the frequency of admissions, reason for admissions, and test socket satisfaction in patients who received a lower-limb prosthesis with or without a test socket in our unit. MATERIAL AND METHODS A total of 88 patients (54 men, 34 women) were included in the study. Patients were divided into 2 groups: the group with test socket (Group I, 44 patients) and the group without test socket (Group II, 44 patients). Variables related to the functional status, frequency of complaints, and test socket satisfaction were investigated in the 2 groups...
June 13, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Joshua P Herzog, Edward D Arrington, Creighton C Tubb, Gautham Prabhakar, Nicholas J Zarkadis, Nicholas A Kusnezov
Objective: To evaluate the accuracy of radiographs in determining integrity of the posterior femoral cortex following ACL reconstruction. Methods: Fifty adult volunteers undergoing primary arthroscopic transtibial ACL reconstructions were prospectively enrolled into this study. Plain radiographs and fine-cut CT of the operative knee were obtained post-operatively. Three blinded orthopaedic surgeons were asked to measure the distance from the femoral tunnel to the posterior cortex on lateral radiographs...
June 2018: Journal of Orthopaedics
David R Tribble, Louis R Lewandowski, Benjamin K Potter, Joseph L Petfield, Daniel J Stinner, Anuradha Ganesan, Margot Krauss, Clinton K Murray
OBJECTIVES: We assessed osteomyelitis risk factors in U.S. military personnel with combat-related open tibia fractures (2003-2009). METHODS: Patients with open tibia fractures who met diagnostic criteria of osteomyelitis were identified as cases using Military Health System data and verified through medical record review. Controls were patients with open tibia fractures who did not meet osteomyelitis criteria. Gustilo-Andersen (GA) fracture classification scheme was modified to include transtibial amputations (TTAs) as the most severe level...
May 24, 2018: Journal of Orthopaedic Trauma
Maurice Balke, Ralph Akoto, Christoph Offerhaus, Juergen Hoeher
The biomechanical consequences of a tear of the posterior root of the medial meniscus are comparable to that of a complete meniscectomy. The integrity of the meniscal roots is crucial to enable the important function of load sharing and shock absorption. An untreated root tear leads to extrusion and loss of function of the meniscus causing early degenerative arthritis of the respective knee compartment. Meniscal root repair can be achieved by 2 main techniques: indirect fixation using pullout sutures through a transtibial tunnel with extracortical fixation and direct fixation using suture anchors...
May 2018: Arthroscopy Techniques
Sachin Ramchandra Tapasvi, Anshu Shekhar, Shantanu Sudhakar Patil
Medial meniscus posterior root tears are common injuries, especially in the Asian world. This injury must be repaired where indicated to restore knee biomechanics and prevent arthritis. Suturing the meniscus using suture tapes provides good hold of the tissue. The use of a 70° arthroscope and creation of a transseptal portal improve visualization of the posterior compartment. Creation of a high posteromedial portal achieves the correct trajectory for the suture anchor insertion. A knotless suture anchor can be used to fix the posterior root at its anatomic attachment site...
May 2018: Arthroscopy Techniques
Ezio Adriani, Berardino Di Paola, Andrea Alfieri, Edoardo De Fenu
Posterior cruciate ligament (PCL) ruptures account for 1% to 44% of all acute ligament injuries of the knee. In this paper we wanted to try out a system for femural fixation. Hamstring tendons are harvested and standard tibial tunnel is prepared using the transtibial PCL guide; by identifying the PCL footprint, the femoral half tunnel 27 to 30 mm with in-out technique is performed. The femoral rod of a curve cross-pin system is inserted into the anterolateral access within the femoral half tunnel. The guide block is placed 2...
April 2018: Arthroscopy Techniques
Joshua R Jarrell, Brad J Farrell, Robert S Kistenberg, John F Dalton, Mark Pitkin, Boris I Prilutsky
Ongoing animal preclinical studies on transcutaneous bone-anchored prostheses have aimed to improve biomechanics of prosthetic locomotion in people with limb loss. It is much less common to translate successful developments in human biomechanics and prosthetic research to veterinary medicine to treat animals with limb loss. Current standard of care in veterinary medicine is amputation of the whole limb if a distal segment cannot be salvaged. Bone-anchored transcutaneous prostheses, developed for people with limb loss, could be beneficial for veterinary practice...
May 23, 2018: Journal of Biomechanics
Tyler R Clites, Matthew J Carty, Jessica B Ullauri, Matthew E Carney, Luke M Mooney, Jean-François Duval, Shriya S Srinivasan, Hugh M Herr
Humans can precisely sense the position, speed, and torque of their body parts. This sense is known as proprioception and is essential to human motor control. Although there have been many attempts to create human-mechatronic interactions, there is still no robust, repeatable methodology to reflect proprioceptive information from a synthetic device onto the nervous system. To address this shortcoming, we present an agonist-antagonist myoneural interface (AMI). The AMI is composed of (i) a surgical construct made up of two muscle-tendons-an agonist and an antagonist-surgically connected in series so that contraction of one muscle stretches the other and (ii) a bidirectional efferent-afferent neural control architecture...
May 30, 2018: Science Translational Medicine
Gerasimos Bastas, Joshua J Fleck, Richard A Peters, Karl E Zelik
BACKGROUND: Inertial Measurement Unit (IMU)-based gait analysis algorithms have previously been validated in healthy controls. However, little is known about the efficacy, performance, and applicability of these algorithms in clinical populations with gait deviations such as lower limb prosthesis users (LLPUs). RESEARCH QUESTION: To compare the performance of 3 different IMU-based algorithms to demarcate steps from LLPUs. METHODS: We used a single IMU sensor affixed to the midline lumbopelvic region of 17 transtibial (TTA), 16 transfemoral (TFA) LLPUs, and 14 healthy controls (HC)...
May 22, 2018: Gait & Posture
Zoe A Schafer, John L Perry, Natalie Vanicek
BACKGROUND: Lower limb amputees (LLAs) are at increased risk of falling due to the inherent asymmetry resulting from their limb loss, muscle weakness and other neuro-musculoskeletal limitations. RESEARCH QUESTION: The aim of this study was to evaluate the effects of a personalised exercise programme on falls prevention and gait parameters in LLAs. METHODS: Fifteen LLAs, recruited from their local prosthetic services centre, were block randomised, by age and level of amputation, into two groups: exercise group (transfemoral, n = 5; transtibial, n = 2) and control group (transfemoral, n = 5; transtibial, n = 3)...
April 30, 2018: Gait & Posture
Sheila M Clemens, Glenn K Klute, Neva J Kirk-Sanchez, Michele A Raya, Kyoung Jae Kim, Ignacio A Gaunaurd, Robert S Gailey
BACKGROUND: Daily ambulation with a prosthesis often involves turning to negotiate within the home and community environments, however how people with lower limb loss perform turns is infrequently studied. Administering a common clinical outcome measure to capture turn performance data provides a convenient means of assessing this ubiquitous activity. RESEARCH QUESTION: What temporal-spatial parameters are exhibited by people with unilateral lower limb amputation while performing a 180˚ turn task? METHODS: Forty community-ambulating subjects with unilateral lower limb amputation (20 transtibial amputees, 20 transfemoral amputees) performed the Component Timed-Up-and-Go (cTUG) test turning once in each direction, both toward the intact and toward the prosthetic limb...
May 12, 2018: Gait & Posture
Amy L Lenz, Katie A Johnson, Bush Tamara Reid
Many people with amputation utilize a prosthetic device to maintain function and ambulation. During the use of the prosthetic device, their residual limbs can develop wounds called pressure ulcers. The formation of these wounds has been linked to deformation and loading conditions of the skin and deeper tissues. Our research objective was to develop a complete profile of displacements on the gel liner at the interface with the socket during walking in transtibial amputees. Displacements for seven regions along the limb were quantified in addition to six calculations of displacement and three rotations relative to the prosthetic socket...
September 1, 2018: Journal of Biomechanical Engineering
Elizabeth G Halsne, Cody L McDonald, Sara J Morgan, Sarah M Cheever, Brian J Hafner
BACKGROUND: Crossover feet incorporate features of energy-storing feet and running-specific feet. As such, crossover feet may be suitable for both daily ambulation and participation in physically demanding activities. OBJECTIVES: To compare crossover feet and energy-storing feet on performance-based tests including a range of low-level (e.g. sit-to-stand) and high-level (e.g. jogging) activities. STUDY DESIGN: Cross-sectional, repeated measures...
May 1, 2018: Prosthetics and Orthotics International
Vera Jaecker, Tabea Zapf, Jan-Hendrik Naendrup, Ajay C Kanakamedala, Thomas Pfeiffer, Sven Shafizadeh
PURPOSE: The purpose of this study was to evaluate and classify causes for anterior cruciate ligament (ACL) reconstruction failure. It was hypothesized that specific technical and biological reconstruction aspects would differ when comparing traumatic and non-traumatic ACL reconstruction failures. MATERIALS AND METHODS: One hundred and forty-seven consecutive patients who experienced ACL reconstruction failure and underwent revision between 2009 and 2014 were analyzed...
May 19, 2018: Archives of Orthopaedic and Trauma Surgery
Jaclyn Megan Sions, Elisa Sarah Arch, John Robert Horne
BACKGROUND: Adults postamputation are not meeting physical activity recommendations. Physical activity is an important consideration in prosthetic prescription. The objective of this study was to determine if functional mobility, balance confidence, and prosthetic use are associated with physical activity among adults with a lower-limb amputation. METHODS: This study recruited patients aged 18-85 years with unilateral transtibial amputations. The Cumulative Illness Rating Scale was used to determine comorbidity burden...
June 1, 2018: Journal of Physical Activity & Health
Steven Culver, Harrison Bartlett, Amanda Shultz, Michael Goldfarb
This paper presents a control system for a powered transtibial prosthesis that provides stair ascent and descent capability, as well as ability for user-controlled transitions between walking, standing, stair ascent, and stair descent. The control system was implemented on a powered prosthesis and evaluated on a single unilateral transtibial amputee subject. The ability of the prosthesis to provide appropriate functionality during stair ascent and descent was assessed by comparing gait kinematics and kinetics of the prosthesis to those of a passive dynamic elastic response prosthesis and those of a set of non-amputee subjects...
May 2018: IEEE Transactions on Neural Systems and Rehabilitation Engineering
Yong Seuk Lee, Seung Hoon Lee, O-Sung Lee
INTRODUCTION: Despite numerous published reports on posterior cruciate ligament (PCL) reconstruction in the past 30 years, the ideal graft source remains unclear, and few objective scientific data have been published that thoroughly evaluate the long-term outcomes according to the graft source. We, therefore, conducted a systematic review of available high-quality comparative studies that evaluated clinical and objective stability testing to compare the different graft sources for PCL reconstruction...
May 4, 2018: Archives of Orthopaedic and Trauma Surgery
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