Eine neue In-vivo-Technik zur dreidimensionalen Analyse der Translation der Femurkondylen und der Menisken unter dem Einfluß antagonistischer Muskelkräfte

The aim of our study was to develop a 3-D MR-based technique for the analysis of meniscal and femoral translations during flexion of the knee, and under the influence of antagonistic muscle forces in healthy subjects. In an open MR system, 5 knees were examined at 30 degrees and 90 degrees flexion using a T1-weighted 3-D gradient echo sequence. A force of 30 Newtons, first in the extending and then in the flexing direction, was applied to the distal lower leg. After three-dimensional reconstruction, the minimal distances between the centre of the tibial plateau and the posterior edge of the menisci and femoral condyles were determined. At 30 degrees flexion, the minimum distance for the meniscus was larger medially than laterally (23.2 +/- 1.8 mm vs. 16.2 +/- 3.3 mm), and this also applied to the condyles (25.1 +/- 1.5 vs. 19.0 +/- 3.0 mm). During flexion to 90 degrees, a posterior translation of 0.5 +/- 0.2 mm was observed for the lateral, and of 3.4 +/- 1.2 mm for the medial, meniscus. The condyles demonstrated a different posterior translation (lateral 2.2 +/- 0.56 mm; medial 1.8 +/- 1.9 mm). No obvious differences were found between extension and flexion muscle activity for the different positions of the knee. In the present study, a new 3-D technique is presented for the analysis of the femoral and meniscal translation at various positions of the knee, and under muscle activity. The results suggest different translation for the menisci and condyles

AI may enable robots to make a clinical impact in total knee arthroplasty, where navigation has not!

Total knee arthroplasty (TKA) is on the verge of being revolutionized by artificial intelligence (AI), which will make it possible for robots to have a clinical influence in areas where navigation systems have been rendered ineffective. Navigation has been shown to increase surgical accuracy; never- theless, it has not been shown to provide major gains in terms of clinical outcome for the patient. On the other hand, robotic systems that are powered by artificial intelligence have the potential to improve functional outcomes, boost precision, and tailor procedures to the specific anatomy of each unique patient. Through the utilization of real‐time data and prediction algorithms, artificial intelligence‐guided robots have the potential to overcome the limits of conventional approaches, thereby establishing a new benchmark for TKA

Theoretical Directional and Modulated Rates for Direct SUSY Dark Matter Detection

Exotic dark matter together with the vacuum energy (cosmological constant) seem to dominate in the flat Universe. Thus direct dark matter detection is central to particle physics and cosmology. Supersymmetry provides a natural dark matter candidate, the lightest supersymmetric particle (LSP). Furthermore from the knowledge of the density and velocity distribution of the LSP, the quark substructure of the nucleon and the nuclear structure (form factor and/or spin response function), one is able to evaluate the event rate for LSP-nucleus elastic scattering. The thus obtained event rates are, however, very low. So it is imperative to exploit the two signatures of the reaction, namely the modulation effect, i.e. the dependence of the event rate on the Earth's motion, and the directional asymmetry, i.e. the dependence of the rate on the the relative angle between the direction of the recoiling nucleus and the sun's velocity. These two signatures are studied in this paper employing various velocity distributions and a supersymmetric model with universal boundary conditions at large tan(beta).Comment: 11 LATEX pages, 1 table and 4 ps figures included. Paper presented in DARK2002, Fourth Heidelberg International Conference on Dark Matter in Astro- and Particle Physics, Cape Town, South Africa, 4-9 February, 2002, to appear in the proceedings (to be published by Springer Verlag

Same same but different—Image-based versus imageless robotic-assisted total knee arthroplasty!

Robotic‐assisted total knee arthroplasty (RTKA) has gained widespread acceptance due to its demon- strated ability to improve surgical accuracy com- pared to conventional total knee arthroplasty (CTKA). While the precise impact of RTKA on postoperative patient‐reported outcome measures (PROMs) remains inconclusive, the increased accuracy in alignment and joint kinematics suggests potential improvements in patient satisfaction and functional outcomes. Two primary RTKA systems exist: image‐based, which uses preoperative CT scans for detailed 3D modeling, and image‐less, which relies on intra‐operative digitization of ana- tomical landmarks. Both systems aim to achieve accurate implant placement and soft‐tissue bal- ancing, yet they differ in methodology and reliance on preoperative data. Despite RTKA's theoretical advantages, there is ongoing debate about whether accuracy alone is sufficient to achieve optimal postoperative out- comes, particularly concerning joint kinematics and alignment strategies. Literature reveals no significant difference in coronal plane alignment between image‐based and image‐less systems, though image‐less systems may be more prone to varus errors due to the reliance on intra‐articular landmarks. Additionally, image‐free systems may face challenges in replicating native knee anat- omy, especially in the sagittal plane, leading to potential limitations in achieving ideal tibial slope reconstruction. The future of RTKA may lie in refining implant po- sitioning strategies that minimize postoperative al- terations to pre‐arthritic knee kinematics, particu- larly with standardized off‐the‐shelf implants. As robotic technology evolves, there is potential to enhance surgical outcomes by combining accurac

The cross on rings performed by an Olympic champion

The cross is a key skill in Male Artistic Gymnastics rings routines. However, few researches were found about this skill. There is knowledge about the forces needed to perform the cross, or about muscles activation, separately. The aim of this paper was to accomplish a comprehensive research about the biomechanics of cross on rings, in order to obtain a descriptive model about this skill. Therefore, the currently Olympic champion on rings event volunteered in this research. He performed three crosses with the usual apparatus in his training gym. The measurement methods were combined: One digital video camera, one strain gauge in each cable and surface electromyography of nine right shoulder muscles were used. Statistical analyses were performed by parametric and non parametric tests and descriptive statistics. Symmetry values were calculated for shoulder angles and cables of right and left side. Coefficient of variation of muscle activation and co contraction were verified. Within gymnast variability was calculated using biological coefficient of variation (BCV), discretely for kinematic measures. Low variability values of shoulder angles and cable forces were verified and low values of asymmetry as well. Muscle activation varied according to muscle function, while co-contraction values were different among trials. These results pointed out the characteristics of the cross performed by an elite gymnast. Knowledge about the characteristics of cross can inform coaches, practitioners and clinicians how a successful skill should be presented

Shoulder rhythm in patients with impingement and in controls: Dynamic RSA during active and passive abduction

Background and purpose Impingement syndrome is probably the most common cause of shoulder pain. Abnormal abduction and proximal humeral translation are associated with this condition. We evaluated whether the relative distribution between glenohumeral and scapular-trunk motions (the scapulohumeral rhythm) and the speed of motion of the arm differed between patients with impingement and a control group without shoulder symptoms

Comparison of Two Methods for In Vivo Estimation of the Glenohumeral Joint Rotation Center (GH-JRC) of the Patients with Shoulder Hemiarthroplasty

Determination of an accurate glenohumeral-joint rotation center (GH-JRC) from marker data is essential for kinematic and dynamic analysis of shoulder motions. Previous studies have focused on the evaluation of the different functional methods for the estimation of the GH-JRC for healthy subjects. The goal of this paper is to compare two widely used functional methods, namely the instantaneous helical axis (IHA) and symmetrical center of rotation (SCoRE) methods, for estimating the GH-JRC in vivo for patients with implanted shoulder hemiarthroplasty. The motion data of five patients were recorded while performing three different dynamic motions (circumduction, abduction, and forward flexion). The GH-JRC was determined using the CT-images of the subjects (geometric GH-JRC) and was also estimated using the two IHA and SCoRE methods. The rotation centers determined using the IHA and SCoRE methods were on average 1.47±0.62 cm and 2.07±0.55 cm away from geometric GH-JRC, respectively. The two methods differed significantly (two-tailed p-value from paired t-Test ∼0.02, post-hoc power ∼0.30). The SCoRE method showed a significant lower (two-tailed p-value from paired t-Test ∼0.03, post-hoc power ∼0.68) repeatability error calculated between the different trials of each motion and each subject and averaged across all measured subjects (0.62±0.10 cm for IHA vs. 0.43±0.12 cm for SCoRE). It is concluded that the SCoRE appeared to be a more repeatable method whereas the IHA method resulted in a more accurate estimation of the GH-JRC for patients with endoprostheses

Impact of movement training on upper limb motor strategies in persons with shoulder impingement syndrome

<p>Abstract</p> <p>Background</p> <p>Movement deficits, such as changes in the magnitude of scapulohumeral and scapulathoracic muscle activations or perturbations in the kinematics of the glenohumeral, sternoclavicular and scapulothoracic joints, have been observed in people with shoulder impingement syndrome. Movement training has been suggested as a mean to contribute to the improvement of the motor performance in persons with musculoskeletal impairments. However, the impact of movement training on the movement deficits of persons with shoulder impingement syndrome is still unknown. The aim of this study was to evaluate the short-term effects of supervised movement training with feedback on the motor strategies of persons with shoulder impingement syndrome.</p> <p>Methods</p> <p>Thirty-three subjects with shoulder impingement were recruited. They were involved in two visits, one day apart. During the first visit, supervised movement training with feedback was performed. The upper limb motor strategies were evaluated before, during, immediately after and 24 hours after movement training. They were characterized during reaching movements in the frontal plane by EMG activity of seven shoulder muscles and total excursion and final position of the wrist, elbow, shoulder, clavicle and trunk. Movement training consisted of reaching movements performed under the supervision of a physiotherapist who gave feedback aimed at restoring shoulder movements. One-way repeated measures ANOVAs were run to analyze the effect of movement training.</p> <p>Results</p> <p>During, immediately after and 24 hours after movement training with feedback, the EMG activity was significantly decreased compared to the baseline level. For the kinematics, total joint excursion of the trunk and final joint position of the trunk, shoulder and clavicle were significantly improved during and immediately after training compared to baseline. Twenty-four hours after supervised movement training, the kinematics of trunk, shoulder and clavicle were back to the baseline level.</p> <p>Conclusion</p> <p>Movement training with feedback brought changes in motor strategies and improved temporarily some aspects of the kinematics. However, one training session was not enough to bring permanent improvement in the kinematic patterns. These results demonstrate the potential of movement training in the rehabilitation of movement deficits associated with shoulder impingement syndrome.</p