La Valoración del Análisis de la Marcha en la Planificación de la Osteotomía Alta de Tibia

El objetivo de este trabajo ha sido el de valorar una nueva metódica clínica y biomecánica de los pacientes que presentan un genu varo y tratados quirúrgicamente mediante osteotomía tibial alta. De acuerdo a la metódica de Andriacchi e Insall y de nuestra pequeña experiencia hemos aplicado el estudio mediante "gait analysis" a estos pacientes preoperatoriamente. El cálculo preoperatorio del "momento adductor" parece ser discriminativo con respecto a los pacientes que tendrán un buen o mal resultado debido a la recidiva de la deformidad, dolor, etc. Tomando como referencia los resultados de estos estudios sugerimos algunas indicaciones pre y postoperatorias con referencia a la rehabilitación y la orientación quirúrgica más adecuada según el valor del momento adductor (alto o bajo) que presenten este tipo de pacientes.The purpose of this study has been to assess a new clinical and biomechanical approach of genu varum patients treated by high tibial osteotomy. According to Andriacchi, Insall, and their awn small experienc e the author s apply gait analysis to study the genu varum of patients pre-operatively. The assessment during preoperative gait of the adductor moment (high or low value s with respec t to the normal) seems to be discriminant in define patien that are goint to have good or bad results due to the recurrence of the pathology: pain, varus deformity, etc. Starting from the results the studies the authors suggest some indications in the pre and postoperative with reference to rehabilitation and surgical orientation taking in account the high or low level of preoperative the adductor moment

Tissue engineering for total meniscal substitution : Animal study in sheep model

Objective: The aim of the study was to investigate the use of a novel hyaluronic acid/polycaprolactone material for meniscal tissue engineering and to evaluate the tissue regeneration after the augmentation of the implant with expanded autologous chondrocytes. Two different surgical implantation techniques in a sheep model were evaluated. Methods: Twenty-four skeletally mature sheep were treated with total medial meniscus replacements, while two meniscectomies served as empty controls. The animals were divided into two groups: cell-free scaffold and scaffold seeded with autologous chondrocytes. Two different surgical techniques were compared: in 12 animals, the implant was sutured to the capsule and to the meniscal ligament; in the other 12 animals, also a transtibial fixation of the horns was used. The animals were euthanized after 4 months. The specimens were assessed by gross inspection and histology. Results: All implants showed excellent capsular ingrowth at the periphery. Macroscopically, no difference was observed between cell-seeded and cell-free groups. Better implant appearance and integrity was observed in the group without transosseous horns fixation. Using the latter implantation technique, lower joint degeneration was observed in the cell-seeded group with respect to cell-free implants. The histological analysis indicated cellular infiltration and vascularization throughout the implanted constructs. Cartilaginous tissue formation was significantly more frequent in the cell-seeded constructs. Conclusion: The current study supports the potential of a novel HYAFF/polycaprolactone scaffold for total meniscal substitution. Seeding of the scaffolds with autologous chondrocytes provides some benefit in the extent of fibrocartilaginous tissue repair

A NEW METHOD FOR EVALUATION OF THE CARRYING ANGLE IN-VIVO SET UP

The "carrying angle" is defined as the angle formed by the long axis of the humerus and the long axis of the ulna(1.2J. This angle was measured in-vitro by several methodsl1j but few authors accomplished this measurements in vivo [2J probably due to the difficulties related to the identification of repere points. The goal of this work was to define an easy, fast and accurate new method for evaluation of the carrying angle in an in-vivo set up usable in rehabilitation and sport fields. In this work we present the method, analyse its repeatability and we compare the results with measures performed using a goniometer

A PRELIMINARY STUDY TO MODEL CARRYING ANGLE VARIATIONS DURING FLEXION-EXTENSION OF THE ELBOW

The aim of this work was to identify an accurate method to evaluate the variability of the carrying angle during the flexion extension of the elbow and to define a mathematical description of this movement applicable in sport and rehabilitation field. In order to develop this objective, we marked the arm and the forearm by six reflective markers of six healthy subjects performing the flexion extension movement and acquired the coordinates using six infrared cameras (VICON Motion System). Five repeated measures were performed for each subject in order to verify the reliability of the measures. Our results demonstrated that this movement can be easily modelled as a linear variation of the carrying angle in function of the flexion angle. The reliability between repeated measures was high and adopting a linear fit the accuracy was more than 94% in all cases. This is the first study to compute the flexion-extension movement by a carrying angle evaluation

EQUATION REGRESSION MODEL FOR THE 50 M FREESTYLE PERFORMANCE IN ELITE MASTER SWIMMERS

This study was conducted during the 10th World Masters Championships, held in Riccione, Italy, June 3-11, 2004. The aim was to investigate, in male and female elite master swimmers, the relationships between performance time and age, anthropometric characteristics (weight, stature, arm and forearm lengths and forearm volume) and muscle strength (hand grip). Performance times were recorded during 50 m freestyle events. Anthropometric values and hand grip were collected the same day the competition in a field laboratory organised beside the swimming pool. For this study we considered twenty eight volunteers: 15 men aged 42-81 years and 13 women aged 4173 years. Firstly, the anthropometrical characteristics. the hand grip strength and the performance time were used for a simple correlation analysis. Subsequently a multiple regression analysis was carried out to create a swimming time prediction model for the 50 freestyle performances. It revealed that in 50 m freestyle women race, age, weight and strength explained about 97% of the variance in performance. This study provided novel information which could be useful in designing training programs, optimizing swimmer's resources or capabilities

INFLUENCE OF AGE AND HAND GRIP STRENGTH ON FREESTYLE PERFORMANCES IN MASTER SWIMMERS

The aim of our work was to examine whether age and hand grip strength are correlated with 50m, 100m, 200m, 400m, 800m swimming performance times in Master swimmers and how correlation varies considering short, middle or long distances. The main finding of this work was that hand grip strength and age correlated significantly at each distance. Hand grip strength showed a relevant influence on performance time and explained 52% of variance of performance time in 50m race freestyle and only 15% in 800m race. Increasing age was a disadvantageous factor for performance time, and explained 45% of variance of performance time in 800m race freestyle and only 20% in 50 m race

Satisfactory clinical results and low failure rate of medial collagen meniscus implant (CMI) at a minimum 20 years of follow-up

Purpose: The aim of the study was to evaluate the long-term clinical results, reoperations, surgical failure and complications at a minimum of 20 year of follow-up of the first 8 medial CMI scaffolds implanted by a single surgeon during a pilot European Prospective study. Methods: Seven (88%) out of 8 patients were contacted. The Cincinnati Score, VAS, and Lysholm score were collected. Moreover, magnetic resonance imaging (MRI) was performed on 4 patients at the last follow-up. Complications, reoperations and failures were also investigated. Results: The average follow-up was 21.5 ± 0.5 years. One patient underwent TKA after 13 years from CMI implantation; a second patient underwent valgus high tibial osteotomy 8 years after the index surgery and another patient underwent anterior cruciate ligament hardware removal at 21 years of follow-up. At the final follow-up, 3 patients were rated as “Excellent”, 1 as “Good” and 2 as “Fair” according to the Lysholm score. The Cincinnati score and the VAS were substantially stable over time. The MRI showed a mild osteoarthritis progression in 3 out of 4 patients according to the Yulish score, and the CMI signal was similar to the mid-term follow-up revealing 3 cases of myxoid degeneration and 1 case of normal signal with reduced scaffold size. Conclusion: The medial CMI is a safe procedure: satisfactory clinical results and a low failure rate could be expected even at a long-term follow-up. For this purpose, the correct indication as well as correcting axial malalignment and addressing knee instability at the time of the index surgery is mandatory. On the other hand, a mild osteoarthritis progression could be expected even after meniscus replacement. Level of evidence: IV

A computer simulation protocol to assess the accuracy of a Radio Stereometric Analysis (RSA) image processor according to the ISO-5725

Radio-Stereometric-Analysis and x-ray fluoroscopy are radiological techniques that require dedicated software to process data. The accurate calibration of these software is therefore critical. The aim of this work is to produce a protocol for evaluating the softwares' accuracy according to the ISO-5725. A series of computer simulations of the radiological setup and images were employed. The noise level of the images was also changed to evaluate the accuracy with different image qualities. The protocol was tested on a custom software developed by the authors. Radiological scene reconstruction accuracy was of (0.092 +- 0.14) mm for tube position, and (0.38 +- 0.31) mm / (2.09 +- 1.39) deg for detectors oriented in a direction other than the source-detector direction. In the source-detector direction the accuracy was of (2.68 +- 3.08) mm for tube position, and of (0.16 +- 0.27) mm / (0.075 +- 1.16) deg for the detectors. These disparate results are widely discussed in the literature. Model positioning and orientation was also highly accurate: (0.22 +- 0.46) mm / (0.26 +- 0.22) deg. Accuracy was not affected by the noise level. The protocol was able to assess the accuracy of the RSA system. It was also useful to detect and fix hidden bugs. It was also useful to detect and resolve hidden bugs in the software, and in optimizing the algorithms