Joint Function Research Articles

Longitudinal observational digital analysis of occlusion in Hall Technique.

To evaluate volumetric changes over time in teeth treated with the Hall Technique (HT) and their opposing teeth. Secondary aims included assessing occluso-vertical dimension (OVD), temporomandibular joint (TMJ) function, and children's treatment perceptions. Twenty-eight children (5-9 years-old) requiring HT treatment for one first primary molar were recruited. Dental impressions were taken. Mean volume differences were digitally calculated from scanned models (Rapidform2006) between HT-treated and opposing teeth over time. Canine overlap (to measure OVD) was assessed with digital calipers. TMJ function was evaluated using Helkimo Clinical Dysfunction Index and AAPD Temporomandibular Disorders guidance. Data were collected pre-treatment (T0), immediately post-treatment (T1), at one-month (T2), and three-months (T3) after. Children's perceptions were assessed at T3. The mean volume differences (mm³)±Standard error of the mean(SEM),(min-max) for HT teeth were:T0-T1:71.0 ± 3.2, (43.18 to 113.3mm³); T1-T2:10.1 ± 1.2 (0.02 to 23.52mm³); T2-T3:4.3 ± 1.0 (-4.11 to 15.43mm³) and for opposing teeth: T1-T2:6.8 ± 1.1 (-4.30 to 21.51mm³); T2-T3:0.5 ± 0.9 (-11.12 to 15.24mm³). Crowns and canine overlap measurements resolved within one month (p < 000.1), reflecting occlusion re-establishment. TMJ assessments showed mild-dysfunction in two children (8 %), resolved by T3, Children's perceptions: 26 children (93 %) "strongly agreed" or "agreed" they were happy with their crowned-tooth; one child preferred not to show it, and 26 (93 %) reported no discomfort or pain. The volumetric changes in HT-treated and opposing teeth, along with canine overlap, indicate gradual occlusion re-establishment, primarily within one month. OVD changes resolved, there was minimal TMJ dysfunction and high patient satisfaction. This study demonstrates that occlusal adjustments in Hall Technique-treated teeth mainly occur within one month of crown placement, with minimal effects on TMJ function and occlusion. Results support the Hall-Technique as a child-friendly option for managing carious primary molars with high acceptance and limited clinical adverse effects.

Biomechanical modeling of musculoskeletal function related to the terrestrial locomotion of Riojasuchus tenuisceps (Archosauria: Ornithosuchidae).

Riojasuchus tenuisceps was a pseudosuchian archosaur from the Late Triassic period in Argentina. Like other ornithosuchids, it had unusual morphology such as a unique "crocodile-reversed" ankle joint, a lesser trochanter as in dinosaurs and a few other archosaurs, robust vertebrae, and somewhat shortened, gracile forelimbs. Such traits have fuelled controversies about its locomotor function-were its limbs erect or "semi-erect"? Was it quadrupedal or bipedal, or a mixture thereof? These controversies seem to persist because analyses have been qualitative (functional morphology) or correlative (morphometrics) rather than explicitly, quantitatively testing mechanistic hypotheses about locomotor function. Here, we develop a 3D whole-body model of R. tenuisceps with the musculoskeletal apparatus of the hindlimbs represented in detail using a new muscle reconstruction. We use this model to quantify the body dimensions and hindlimb muscle leverages of this enigmatic taxon, and to estimate joint ranges of motion and qualitative joint functions. Our model supports prior arguments that R. tenuisceps used an erect posture, parasagittal gait and plantigrade pes. However, some of our inferences illuminate the rather contradictory nature of evidence from the musculoskeletal system of R. tenuisceps-different features support (or are ambiguous regarding) quadrupedalism or bipedalism. Deeper analyses of our biomechanical model could move toward a consensus regarding ornithosuchid locomotion. Answering these questions would not only help understand the palaeobiology and bizarre morphology of this clade, but also more broadly if (or how) locomotor abilities played a role in the survival versus extinction of various archosaur lineages during the end-Triassic mass extinction event.

Analgesic Effect of Acupuncture in Dogs Undergoing Tibial Tuberosity Advancement Surgery: A Double-blind, Randomized, Controlled Pilot Study

Tibial tuberosity advancement (TTA) surgery restores joint function in dogs with cruciate ligament failure. This study investigated the efficacy of reducing perioperative systemic opioid/non-opioid analgesics (i.e. fentanyl, ketamine), with acupuncture for TTA surgery. Twenty-one dogs admitted for surgery were divided into Controls (inhalation anesthesia, opioid/non-opioid analgesics), Electro-acupuncture (EAP) Group (inhalation anesthesia, EAP), or Dry-needle Acupuncture (DNAP) Group (inhalation anesthesia, DNAP). Intraoperative nociception, boluses of fentanyl, anesthetic recovery, post-extubation pain, duration until first postanesthetic actions, biomarker levels, and isoflurane end-tidal concentration, were recorded. Findings were analyzed for percent change from control/baseline values and statistical significance (p&lt;0.05). Results for percent change from control/baseline included: mean fentanyl boluses during surgery: Control: 3.6±2.0, EAP: 3.6±1.5, DNAP: 2.7±1.2 (25% lower than control); mean recovery score: Control: 2.1±1.2, EAP: 1.5±0.8 (30% better), DNAP: 1.0±0.0 (50% better); median post-extubation pain score: Control: 5.21±4.3, EAP: 4.38±2.1 (16% lower), DNAP: 3.75±1.6 (28% lower), and maximum pain score: Control: 10.83±7.0, EAP: 8.80±3.5 (19% lower), DNAP: 7.92±3.7 (27% lower). DNAP had the greatest increase of serotonin (twice controls) and smallest increase of substance P (half controls) during the 24-hour post-extubation period. Statistically significant findings included: DNAP had shortened duration to postanesthetic micturition; and higher isoflurane end-tidal concentration in acupuncture groups. Under the experimental conditions of this pilot study, perioperative acupuncture treatment may reduce the need for additional opioid/non-opioid analgesics during TTA surgery, along with providing better anesthetic recovery.

Comparative Evaluation of Functional Outcomes in High Condylar Fractures Treated with Closed Methods with and without Temporomandibular Joint Arthrocentesis: A Research Protocol for a Randomised Controlled Trial

Introduction: Temporomandibular Disorders (TMD) encompass a range of conditions affecting the joint and surrounding structures, often resulting in pain, restricted movement, and dysfunction. Arthrocentesis involves the insertion of a single needle into the joint space, allowing for irrigation, lavage, and aspiration of the joint. The present procedure aims to alleviate symptoms, improve joint function, and promote healing by removing inflammatory mediators, debris, and adhesions from the joint space. Need of the study: Arthrocentesis offers several advantages over traditional techniques, including reduced trauma, quicker recovery times, and a decreased risk of complications. It has emerged as a valuable tool in the multidisciplinary approach to managing TMDs, offering patients a minimally invasive option to relieve their symptoms and restore jaw function. Hence, the present study will present the utility of arthrocentesis as an adjunct procedure to closed reduction in high condylar fractures, improving the functionality of the condyle, providing pain relief, increasing mouth opening and bite force, stabilising bilateral occlusion, and normalising excursive movements. Aim: To compare and evaluate the efficacy of closed reduction with or without arthrocentesis in patients with high condylar fractures regarding functional outcomes. Materials and Methods: A randomised controlled trial will be conducted at Siddharth Gupta Memorial Cancer Hospital, Sawangi, Wardha, Maharashtra, India, from September 2024 to May 2026, involving 10 patients. The protocol includes examining patients with suspected high condylar fractures, taking detailed case histories, performing clinical examinations focusing on the Temporomandibular Joint (TMJ), and recording preoperative measurements of mouth opening and pain levels using a Visual Analogue Scale (VAS). Patients with suspected fractures will undergo radiographic examinations, and those meeting the inclusion criteria will be included in the study after providing informed consent. Arthrocentesis will be performed using a specialised needle with two lumens, inlet and outlet bevels, and a silicone stopper for maximal insertion depth. Statistical analysis will be conducted using descriptive and inferential statistics, specifically the Chi-square test and Student’s paired and Unpaired t-tests, with p-value&lt;0.05 considered significant.

Effectiveness and safety of radionuclide synovectomy with Yttrium-90 hydroxyapatite in patients with inflammatory arthritis: a longitudinal study.

Yttrium-90 plays a significant role in managing drug-resistant inflammatory arthritis through radionuclide synovectomy, where the radioisotope is injected into the affected joint to alleviate pain and inflammation by targeting the synovial tissue. This study aims to evaluate the effectiveness and safety of Yttrium-90 hydroxyapatite radionuclide synovectomy in improving joint functionality, as judged by physicians, in patients with inflammatory arthritis who had not responded to conventional treatments. Patients with inflammatory arthritis were recruited from the orthopedics department and referred to the nuclear medicine department for evaluation. A three-phase bone scan was conducted to identify eligible patients, who then received intra-articular injections of Yttrium-90 hydroxyapatite along with triamcinolone. After 48 h, patients underwent PET-CT imaging, followed by two follow-ups at 2 and 6 months to assess improvements in joint functionality and monitor for adverse reactions. Fifteen patients underwent radionuclide synovectomy. Significant improvements were observed between baseline and 2 months in joint restriction (P = 0.001), pain severity (P = 0.037), visual analog scale (VAS) (P = 0.004), and swelling (P = 0.002). At 6 months, further improvements were noted in joint restriction (P = 0.002), pain severity (P = 0.019), VAS (P = 0.013), and swelling (P = 0.023). However, no significant changes occurred between the 2- and 6-month follow-ups. One patient experienced radiation-induced skin necrosis, which resolved with conservative treatment, and another had self-limited skin rashes. Yttrium-90 hydroxyapatite radionuclide synovectomy proved to be an effective and safe treatment for improving joint functionality in patients with drug-resistant inflammatory arthritis of the knee for up to 6 months.

Arthroscopic-assisted total wrist arthrodesis: surgical design and clinical outcomes.

This study presents an innovative arthroscopy-assisted total wrist arthrodesis technique utilising three hollow screws, aimed at improving clinical outcomes for patients with severe wrist arthritis. The technique involved the placement of three hollow screws to facilitate wrist bone fusion. Between August 2019 and August 2023, four patients diagnosed with severe wrist arthritis underwent the arthroscopy-assisted procedure. Each patient was followed postoperatively for at least 1 year. Clinical evaluations included the Visual Analogue Scale (VAS), the Quick Disabilities of the Arm, Shoulder, and Hand (Quick DASH) questionnaire, and the Patient-Rated Wrist Evaluation (PRWE). Radiographic imaging was performed to confirm successful bone fusion. Postoperative complications and scar length were also recorded. At the final follow-up, all patients exhibited decreased scores on the VAS, Quick DASH, and PRWE assessments, indicating reduced pain and improved wrist function. Radiographic imaging confirmed successful wrist bone fusion. No major complications arose, with an average scar length of 2.8 cm. The novel arthroscopy-assisted total wrist arthrodesis technique offers a simple and minimally invasive method that effectively improves joint function and alleviates pain in patients with severe wrist arthritis, while reducing the risk of complications.

Chewing-Activated TRPV4/PIEZO1-HIF-1α-Zn Axes in a Rat Periodontal Complex.

The upstream mechanobiological pathways that regulate the downstream mineralization rates in periodontal tissues are limitedly understood. Herein, we spatially colocalized and correlated compression and tension strain profiles with the expressions of mechanosensory ion channels (MS-ion) TRPV4 and PIEZO1, biometal zinc, mitochondrial function marker (MFN2), cell senescence indicator (p16), and oxygen status marker hypoxia-inducible factor-1α (HIF-1α) in rats fed hard and soft foods. The observed zinc and related cellular homeostasis in vivo were ascertained by TRPV4 and PIEZO1 agonists and antagonists on human periodontal ligament fibroblasts ex vivo. Four-week-old male Sprague-Dawley rats were fed hard (n = 3) or soft (n = 3) foods for 4 wk (in vivo). Significant changes in alveolar socket and root shapes with decreased periodontal ligament space and increased cementum volume fraction were observed in maxillae on reduced loads (soft food). Reduced loads impaired distally localized compression-stimulated PIEZO1 and mesially localized tension-stimulated TRPV4, decreased mitochondrial function (MFN2), and increased cell senescence in mesial and distal periodontal regions. The switch in HIF-1α from hard food-distal to soft food-mesial indicated a plausible effect of shear-regulated blood and oxygen flows in the periodontal complex. Blunting or activating TRPV4 or PIEZO1 MS-ion channels by channel-specific antagonists or agonists in human periodontal ligament fibroblast cultures (in vitro) indicated a positive correlation between zinc levels and zinc transporters but not with MS-ion channel expressions. The effects of reduced chewing loads in vivo were analogous to TRPV4 and PIEZO1 antagonists in vitro. Study results collectively illustrated that tension-induced TRPV4 and compression-induced PIEZO1 activations are necessary for cell metabolism. An increased hypoxic state with reduced functional loads can be a conducive environment for cementum growth. From a practical standpoint, dose rate-controlled loads can modulate tension and compression-specific MS-ion channel activation, cellular zinc, and HIF-1α transcription. These mechanobiochemical events indicate the plausible catalytic role of biometal zinc in mineralization, periodontal maintenance, and dentoalveolar joint function.

Comparison of Single Knee Arthroplasty and Bilateral Knee Arthroplasty in Haemophiliacs During a Single Operation: A Systematic Review and Meta-Analysis.

Arthroplasty is the standard treatment for end-stage haemophilic knee arthritis; however, the choice between single knee arthroplasty (SKA) and bilateral knee arthroplasty (BKA) in a single operation remains controversial due to the risks specific to haemophiliacs. Two independent researchers conducted searches across CNKI, CBM, Wanfang, PubMed, Cochrane Library, Embase, and Web of Science, with the last search performed on 15 October 2024. Study results include joint function, complication and various cost. Literature quality was assessed using the Newcastle-Ottawa Scale (NOS). Outcomes were evaluated with fixed-effects or random-effects models, while heterogeneity and publication bias were also assessed. Nine studies involving 309 haemophilia patients were included, with 166 in SKA group and 143 in BKA group. No statistically significant differences were observed between the SKA and BKA groups in range of motion (95% CI: -0.22 [-3.57, 3.13], p = 0.90), Hospital for Special Surgery score (95% CI: -2.13 [-4.89, 0.64], p = 0.13), flexion degree (95% CI: -2.38 [-7.22, 2.46], p = 0.33), cost (95% CI: -0.24 [-0.94, 0.45], p = 0.49), complication rate (95% CI: 1.31 [-0.79, 2.17], p = 0.29), hospital stay (95% CI: 0.25 [-2.06, 2.57], p = 0.83), and coagulation factor usage (p = 0.49). However, The SKA group outperformed the BKA group in terms of operative time, postoperative drainage, and transfusion volume (p < 0.001). Our study indicates that, apart from differences in operative time, transfusion volume, and blood loss, SKA and BKA show no significant differences in postoperative joint function, complication rates, or costs.

Evaluating the Mechanical and Tribological Properties of 3D Printed PLA/n‐HA/PA66 Composite

ABSTRACTArtificial implants are necessary for orthopedic treatment and the recovery of bone and joint function in disabled individuals. However, existing materials present challenges in manufacturing complex structures and are limited in terms of mechanical and frictional properties. Current research is focused on the development of new environmentally friendly polymer composites for the manufacture of artificial implants, combined with 3D printing technology to improve design flexibility. In this study, nine kinds of PLA/n‐HA/PA66 composite scaffolds with different proportions were prepared using light‐curing 3D printing technology. The physical, mechanical, and tribological properties of the composite scaffolds were compared. The results showed that the PLA/n‐HA/PA66 composite scaffold was superior to traditional polymers, with compressive strength increased by 30–40 MPa and wear resistance increased by 27%–64%. This indicates that it has wide application potential in bone tissue engineering.

Cognitive representation of gait: differences in memory structures between individuals after total knee arthroplasty and total hip arthroplasty.

The objective was to examine differences in the gait-specific cognitive representation structures between individuals after total knee- (TKA) and after total hip-joint arthroplasty (THA). The cognitive representation structure was compared between three groups: 1. three months after TKA (n = 12), 2. three months after THA (n = 12), and 3. healthy control group (CG) (n = 12) using the structural dimensional analysis of mental representation (SDA-M). Additionally, perceived joint function was rated by either the KOOS, JR. or HOOS, JR. Mean distribution of perceived joint function was not significantly different between the TKA (60.35 ± 11.2) and THA group (68.01 ± 13.8) (t = - 1.425; p = .173). In the cognitive representation structure, the THA group exhibited functional differences from the TKA group and control group, both of which showed a functional structure. Three months after hip joint replacement the gait-specific cognitive representation structure seems to reflect joint function-specific deviations. Therefore, focussing on functional recovery of cognitive gait representation may facilitate gait rehabilitation in individuals after hip replacement.

A Study on the Effects of Gluteal Muscle Activation on the Electromyography of Lower Limb Muscles in Young Male Patients With Patellofemoral Pain Syndrome.

Patellofemoral pain syndrome (PFPS) is a common knee issue, and hip joint function significantly affects knee health. Gluteus activation exercises are a promising treatment for PFPS. This study aims to investigate the impact of gluteal muscle activation exercises on the muscle involvement and movement patterns of young male patients with PFPS. Our study was a randomized controlled clinical trial study from June 2020 to December 2021, included 18 young male patients with PFPS, randomly divided into two groups: the gluteus activation group (GAG) and control group (CON), with nine cases in each group. The GAG underwent gluteal muscle activation exercises for 40 min per session, three times per week, for 6 weeks; the CON received no intervention. At baseline and after 6 weeks, the integrated electromyography (IEMG), contribution rates (CRs), and activation times (ATs) of the gluteus maximus (GM), vastus medialis (VM), rectus femoris (RF), vastus lateralis (VL), biceps femoris (BF), and semitendinosus (ST) muscles of the affected lower limb during stair-climbing exercise were assessed. Additionally, the explosive power (EP) of the lower limbs and the visual analog scale (VAS) pain value of the knee joint were evaluated. Paired sample t-tests and independent sample t-tests were used to compare the differences within and between groups. After 6 weeks, the GAG showed a significant increase in the IEMG of GM by 118 ± 67.09 μVs compared to CON (p < 0.05), and an increase in the CR of the GM by 6.75% (p < 0.05). Additionally, the AT of the GM and BF was significantly reduced (p < 0.05), and the lower limb EP increased by 14.66% compared to the CON (p < 0.05). Concurrently, there was a very significant reduction in the knee VAS pain score (p < 0.01). The CON exhibited no significant changes in the EMG indices of the lower limbs, EP, and VAS before and after the 6 weeks (p > 0.05). A 6-week gluteal muscle activation training program for patients with PFPS can adjust and optimize the IEMG, CR, and firing order of the lower limb muscle groups, enhance EP, and alleviate pain.

Shear wave elastography reveals passive and active mechanics of triceps surae muscles in vivo: From shear modulus-ankle angle to stress-strain characteristics.

Characterizing individual muscle behavior is crucial for understanding joint function and adaptations to exercise, diseases, or aging. Shear wave elastography (SWE) is a promising tool for measuring the intrinsic material properties of muscle. This study assessed the passive and active shear modulus of the triceps surae muscle group in 14 volunteers (7 females, 25.9±2.5 years) using SWE. Ankle moment, surface electromyography, and SWE of the gastrocnemius medialis (GM), gastrocnemius lateralis (GL), and soleus (SOL) muscles were measured from 30° plantar flexion (PF) to 15° dorsiflexion (DF) ankle angles during passive and isometric contractions at 25%, 50%, and 75% of maximum voluntary contraction (MVC). Muscle length, passive and active ankle moment, and passive shear modulus increased from PF to DF (p<0.001 for all). At 15° DF, the passive shear modulus of the SOL was 76% lower than that of the GM (p<0.001), suggesting that the SOL operates within a lower strain range. The active shear modulus decreased from PF to DF (e.g., by 36.8% at 75% MVC, p=0.009) and was lowest in SOL. The decreasing active shear modulus suggests the muscles operate at shorter-than-optimal to optimal lengths. Contraction intensity also affected the shear modulus (p<0.001), indicating distinct force-sharing strategies, with GL possibly playing a crucial role at higher-intensity contractions and longer lengths. This study demonstrated SWE's potential to characterize muscle mechanics in vivo. If validated, predictions from SWE could facilitate studying muscle behavior and force-sharing strategies, serving as a diagnostic or monitoring tool for muscle function and performance.

Lateral pterygoid muscle enthesis reconstruction in alloplastic total temporomandibular joint replacement: An animal experiment with histological verification.

In current alloplastic total temporomandibular joint replacements (TMJRs) typically the lateral pterygoid muscle (LPM) insertion is sacrificed, affecting joint function. This study assesses a novel additively manufactured TMJR (CADskills BV, Gent, Belgium) designed to enable LPM reinsertion through a scaffold feature on the implant. Thirteen TMJRs were implanted in Swifter crossbreed sheep, with follow-up CT scans after 288 days to evaluate LPM reintegration. Five specimens showed a close approximation between the LPM enthesis and the scaffold. Histological analysis with Masson-Goldner staining and microscopy revealed close bony enthesis alignment with the scaffold, although true bony ingrowth was not observed. One specimen could not be fully evaluated due to preparation issues, limiting conclusions on osseointegration. Random samples from the ramal scaffold showed good integration with the native mandible, with osteogenic activity noted, but no bony ingrowth from the reattached enthesis into the bone grafted titanium scaffold. Despite this, all samples displayed a continuous fibrotic attachment, suggesting functional restoration of the LPM. Findings indicate that while the TMJR design supports fibrotic attachment, further optimization of reattachment techniques, scaffold properties, and post-operative care may improve osseointegration and functional outcomes in future human TMJRs.

Zero-incision treatment of supracondylar humeral fractures in extremely unstable Gartland type Ⅳ children by percutaneous prying combined with modified rotary reduction with Kirschner wire

To investigate the clinical efficacy of percutaneous prying combined with modified rotary reduction with needle in the treatment of supracondylar fracture of humerus in Gartland type Ⅳ children, and to evaluate the postoperative elbow joint function, the incidence of elbow varus deformity and the application prospect of this technique. A total of 98 children diagnosed with Gartland type Ⅳ supracondylar humeral fractures between June 2020 and January 2023 were included in this study, comprising of 57 males and 41 females. The age ranged from 2 to 14 years old with an average of (6.24±4.76) years old. There were 48 cases on the left side and 50 on the right side. The time interval from injury to surgery ranged from 2 hours to 2 days, and emergency operation was performed in 26 cases. During the operation, the Kirschner wire was inserted bluntly into the broken end of the fracture using the lever principle, and the reduction was performed by percutaneous prying. Then the modified rotary reduction method with kirschner wire was used to close and reset the Kirschner wire internal fixation, and zero incision was achieved in all cases. Flynn score was used to evaluatal the function and appearance of the elbow joint at 6 months after operation. The operation was successfully completed by all 98 children, and they were followed up for a duration from 6 to14 months with an average of (9.82±3.51) months. The fractures in all cases healed, the time ranged from 6 to 8 weeks with an average of (6.72±1.17) weeks. The Flynn function score of the elbow joint was rated as excellent in 95 cases and good in 3 cases at the 6-month postoperative evaluation. No related complications occurred, such as cubitus varus deformity, osteofascial compartment syndrome, Kirschner wire rupture or rejection, iatrogenic vascular and nerve injury, Volkmann's contracture or ossification myositis. Percutaneous pry extraction combined with modified rotary reduction with needle in the treatment of humeral supracondylar fracture in extremely instability Gartland type Ⅳ children has the advantages of zero incision, little trauma, safety and good efficacy, and minimization of surgical trauma and scar formation. The postoperative elbow joint function recovery is good.

Short-term clinical efficacy of unilateral external fixator combined with percutaneous Kirschner wire fixation in the treatment of type C1 distal radius fractures in elderly patients

To investigate the short-term clinical effect of closed reduction single arm external fixator combined with percutaneous needle fixation in the treatment of C1 distal radius fracture in elderly patients. Between December 2022 and December 2023, a total of 60 elderly patients diagnosed with type C1 distal radius fractures were treated, comprising 9 males and 51 females. The age ranged from 65 to 84 years old, with an average of (72.69±8.14) years old. Among them, there were 18 cases on the left side and 42 cases on the right side. There were 55 cases of falling injury and 5 cases of traffic accident injury. According to the different surgical methods, the patients were divided into observation group and control group, with 30 cases in each group. The control group underwent manual reduction and unilateral external fixator fixation, consisting of 4 males and 26 females. The mean age was (72.54±8.67) years old. The body mass index (BMI) was (20.61±2.17) kg·m-2. There were 10 cases on the left side and 20 cases on the right side. Among them, there were 27 cases of falling injury and 3 cases of traffic accident injury. The observation group was treated with manual reduction and unilateral external fixator combined with percutaneous Kirschner wire fixation, including 5 males and 25 females. The mean age was (72.76±7.23) years old. BMI (20.82±2.03) kg·m-2. The left side was involved in 8 cases and the right side in 22 cases. There were 28 cases of falling injury and 2 cases of traffic accident injury. The changes in radial height, ulnar declination, palmar inclination angle parameters and patient-rated wrist evaluation (PRWE) were assessed on X-ray films before surgery, 2 days after surgery, and 12 weeks after surgery between the two groups. All surgical procedures were successfully completed in both groups without any significant complications. All patients were followed up for a duration from 12 to 20 weeks with an average of(14.50±2.78) weeks. The two groups exhibited significant differences in radial height, palmar inclination angle, and ulnar deviation angle at 2 days and 12 weeks post-operation (P<0.05). However, there was no statistically significant difference observed in radial height, palmar inclination, and ulnar deviation between the two groups at 2 days after the operation (P>0.05). There were significant differences in radial height, palmar inclination angle, and ulnar deviation between the two groups at 12 weeks after operation (P<0.05). At 2 days and 12 weeks after the operation, there were significant differences in PRWE scores of the two groups compared with preoperative scores(P<0.05). At 2 days after the operation, there was no significant difference in PRWE score between the two groups (P>0.05). The PRWE score showed a significant difference between the two groups at 12 weeks post-operation(P<0.05). The combination of closed reduction and unilateral external fixator, along with percutaneous pin fixation provides move stable fixation for type C1 distal radius fractures. Gradual removal of external fixator further facilitatse the recovery of wrist joint function.

Meta-analysis of the efficacy of plate fixation and external fixator fixation in the treatment of AO-C type distal radius fractures

Meta-analysis of the clinical efficacy of plate and external fixator fixation in the treatment of AO-C type distal radius fractures. PubMed, Embase, Cochrane Medical Library, Web of Science, CNKI, Wanfang, VIP and SinoMed databases were searched for all literature on randomized controlled clinical trials of AO-C distal radius fractures. The search time limits were from each database. The database will be established until June 30, 2023. The included studies were extracted according to the Cochrane Handbook (Version 6.3, 2022) for information extraction and literature quality evaluation. RevMan 5.4 was used to evaluate the risk of Publication bias, test heterogeneity and Perform Meta-analysis. The outcome indicators were:imaging anatomy indicators (volar inclination angle, ulnar deviation angle, radial height), wrist joint mobility (flexion, extension, rotation, ulnar deviation), complication rate, and comparison of surgical treatments (operative blood loss, operation time, hospitalization time, fracture healing time) and wrist joint function scores and related scales. (1) A total of 28 studies were included, with a total of 2 192 patients, including 1 096 cases in the plate internal fixation group and 1 096 cases in the external fixation group.(2) Meta analysis results showed:the surgical treatment situation of the external fixation group:surgical blood loss MD=-37.93, 95%CI(-48.54, -27.31), P<0.000 01;operation time MD=-31.58, 95%CI(-48.96, -14.20), P<0.000 4;hospitalization time MD=-4.58, 95%CI(-5.44, -3.71), P<0.000 01;the fracture healing time MD=-0.88, 95%CI(-1.35, -0.41), P<0.000 2, which were significantly better than that of the plate internal fixation group(P<0.05).(3) The two groups:palmar inclination angle MD=-0.17, 95%CI(-0.95, 0.61), P=0.68;ulnar declination MD=0.22, 95%CI(-0.73, 1.17), P=0.65, radial height MD=-0.24, 95%CI(-1.15, 0.67), P=0.60;flexion and extension MD=-5.63, 95%CI(-11.85, 0.58), P=0.08;rotation MD=-5.80, 95%CI(-12.77, 1.17), P=0.10, radioulnar deviation MD=-2.86, 95%CI(-10.87, 5.15), P=0.48;complication rate RR=0.96, 95%CI(0.63, 1.46), P=0.83;Gartland-Werley clinical wrist score MD=0.13, 95%CI(-0.80, 1.06), P=0.78;excellent and good rate of Gartland-Werley wrist clinical score RR=0.93, 95%CI(0.87, 1.01), P=0.08;excellent and good rate of Cooney wrist score RR=0.99, 95%CI(0.62, 1.59), P=0.98;wrist DASH score MD=-4.67, 95%CI(-14.96, 5.62), P=0.37;the differences were not significant (P>0.05). Compared with internal fixation with plate, external fixation can significantly reduce the amount of surgical bleeding, shorten the operation time, hospitalization time and fracture healing time, and its imaging anatomical indicators, wrist mobility, and complications can be significantly reduced in treating AO-C distal radius fractures. Rates and wrist function scores were equivalent.

Multijoint Continuous Motion Estimation for Human Lower Limb Based on Surface Electromyography

The estimation of multijoint angles is of great significance in the fields of lower limb rehabilitation, motion control, and exoskeleton robotics. Accurate joint angle estimation helps assess joint function, assist in rehabilitation training, and optimize robotic control strategies. However, estimating multijoint angles in different movement patterns, such as walking, obstacle crossing, squatting, and knee flexion–extension, using surface electromyography (sEMG) signals remains a challenge. In this study, a model is proposed for the continuous motion estimation of multijoint angles in the lower limb (CB-TCN: temporal convolutional network + convolutional block attention module + temporal convolutional network). The model integrates temporal convolutional networks (TCNs) with convolutional block attention modules (CBAMs) to enhance feature extraction and improve prediction accuracy. The model effectively captures temporal features in lower limb movements, while enhancing attention to key features through the attention mechanism of CBAM. To enhance the model’s generalization ability, this study adopts a sliding window data augmentation method to expand the training samples and improve the model’s adaptability to different movement patterns. Through experimental validation on 8 subjects across four typical lower limb movements, walking, obstacle crossing, squatting, and knee flexion–extension, the results show that the CB-TCN model outperforms traditional models in terms of accuracy and robustness. Specifically, the model achieved R2 values of up to 0.9718, RMSE as low as 1.2648°, and NRMSE values as low as 0.05234 for knee angle prediction during walking. These findings indicate that the model combining TCN and CBAM has significant advantages in predicting lower limb joint angles. The proposed approach shows great promise for enhancing lower limb rehabilitation and motion analysis.

Equine temporomandibular joint diseases: A systematic review.

The temporomandibular joint (TMJ) is a unique joint that enables mandibular movement. Temporomandibular diseases (TMDs) impair joint function, leading to more or less specific clinical signs. To compile and disseminate clinical data and research findings from existing publications on equine TMD. Systematic review. Following PRISMA 2020 guidelines, literature searches were conducted in PUBMED, Scopus, and Web of Knowledge. The inclusion criteria covered case reports and research articles on equine TMDs. The selected records were grouped considering septic TMJ arthritis, primary TMJ osteoarthritis (OA), and non-arthritic TMDs. A risk of bias assessment was performed for the research articles. Equine TMD has been described in 51 publications to date, with septic TMJ arthritis accounting for 41.2% of TMD cases, fractures/luxations for 29.4%, and primary TMJ OA for 21.6%. Trauma was confirmed or suspected in 54.9% of TMD cases. The severity of clinical signs was mild to moderate in primary TMJ OA and mild to severe in septic TMJ arthritis and non-arthritic TMDs. Clinical signs were related to the underlying cause, particularly in terms of TMJ swelling, pain, and masticatory problems. Among diagnostic imaging modalities, CT was utilised in 92.2% of horses, radiography in 84.4%, and ultrasonography in 21.6%. The lack of clinical data in some reports. A risk of bias due to missing data. TMDs are infrequently described, with trauma being the most common TMD cause. TMDs are associated with TMJ dysfunction; however, the diagnostic protocol is varied. Regardless of the TMD type, a detailed diagnostic protocol should include a thorough history, detailed TMJ examination, and radiography as the first imaging choice in field practice, with CT as the 'gold standard' in clinical settings. For septic TMJ arthritis, a bacterial culture is recommended, while for primary TMJ OA, functional tests and local analgesia.

Feasibility of YOLOX computer model-based assessment of knee function compared with manual assessment for people with severe knee osteoarthritis

ObjectiveThis study aimed to assess the feasibility of computer model-based evaluation of knee joint functional capacity in comparison with manual assessment.MethodsThis study consisted of two phases: (1) developing an automatic knee joint action recognition and classification system on the basis of improved YOLOX and (2) analyzing the feasibility of assessment by the software system and doctors, identifying the knee joint function of patients, and determining the accuracy of the software system. We collected 40–50 samples for use in clinical experiments. The datasets used in this study were collected from patients admitted to the Joint Surgery Center. In this study, the knee joint assessment items included stair climbing, walking on uneven surfaces, and knee joint function. To assess the computer model’s automatic evaluation of knee joint function, MedCalc 20 statistical software was used to analyze the consistency of the Lequesne functional index between the computer model’s automated determinations and manual independent assessments.ResultsThe weighted kappa coefficients between the doctors’ assessments and the software system’s assessments were 0.76 (95% confidence intervals:0.59 ~ 0.92) for climbing up and down stairs, 0.64 (95% confidence intervals:0.45 ~ 0.82) for walking on uneven floors, and 0.68 (95% confidence intervals:0.53 ~ 0.84) for the Lequesne functional index, indicating good consistency between the assessments of the software system and doctors.ConclusionThis paper introduces an automatic knee joint action recognition and classification method based on improved YOLOX. By comparing the results obtained by orthopedic doctors and the software system, the feasibility of this software system was validated in the clinic.

Folic acid-modified ginger-derived extracellular vesicles for targeted treatment of rheumatoid arthritis by remodeling immune microenvironment via the PI3K-AKT pathway

Rheumatoid arthritis (RA), a form of autoimmune inflammation, is marked by enduring synovial inflammation and the subsequent impairment of joint function. Despite the availability of conventional treatments, they are often marred by significant side effects and the associated high costs. Plant-derived extracellular vesicles (PEVs) offer a compelling alternative, owing to their abundant availability, affordability, low immunogenicity, high biocompatibility, and feasibility for large-scale production. These vesicles enhance intercellular communication by transferring intrinsic bioactive molecules. In our research, we delve into the capacity of PEVs to treat RA, highlighting the role of ginger-derived extracellular vesicles (GDEVs). By conjugating GDEVs with folic acid (FA), we have developed FA-GDEVs that maintain their inherent immunomodulatory properties. FA-GDEVs are designed to selectively target M1 macrophages in inflamed joints via the folate receptors (FRs). Our in vitro findings indicate that FA-GDEVs promote the polarization towards a reparative M2 macrophage phenotype by modulating the PI3K-AKT pathway. Further corroboration comes from in vivo studies, which demonstrate that FA-GDEVs not only concentrate efficiently in the affected joints but also markedly reduce the manifestations of RA. Synthesizing these findings, it is evident that FA-GDEVs emerge as a hopeful candidate for RA treatment, offering benefits such as safety, affordability, and therapeutic efficacy.Graphical abstract