Joint Injury Research Articles

Occupational Therapy Program for young men who Specialize in wrestling sports after treatment of knee joint injuries

Today, Martial Arts are an effective means of forming a reliable reserve of defenders of Ukraine. During systematic training in a chosen type of Martial Art, an individual develops basic Physical Qualities, develops leadership Qualities, as well as psychological resistance to adverse environmental factors. The Analysis of the latest Research and publications in the chosen field of Scientific Research shows that insufficient number of Scientific works are devoted to the topical issue of the organization of the Occupational Therapy System of young men who Specialize in Martial Arts after treatment of knee joint injuries. This emphasizes the relevance, timeliness and Practical component of the chosen direction of Scientific Research. The Research was carried out according to the Plan of the initiative Scientific Project "Ergo Therapy of knee joints". Research methods: idealization, formalization, axiomatic, historical and logical, descent from concrete. As a Result of Theoretical Research, we have developed an Experimental Program of occupational Therapy for young men who Specialize in wrestling Sports after treatment of knee joint injuries. The Results of the study are implemented in the Occupational Therapy System of wrestlers, members of National teams of Higher Education Institutions of Ukraine. The Occupational Therapy Program involves the use of the following tools (components): kinesiological taping, elements of TRX, elements of basic Sambo etc. Prospects for further Research in the chosen field of Scientific Research include the organization of a Pedagogical Experiment to test the effectiveness of the Occupational Therapy Program for young men who Specialize in Sambo Wrestling after treatment of knee joint injuries.

Approbation of the Program of Occupational Therapy of young men who specialize in Wrestling, after treatment of knee joint injuries

It is known that during the educational and training process and during participation in competitions, sportsmen and women who specialize in wrestling often receive injuries of various kinds, which negatively affects the indicators of their sportsmanship. This, in turn, requires qualified medical assistance and the subsequent organization of an effective and balanced System of Occupational Therapy. What in the future will ensure a quick and safe introduction of wrestlers to systematic training in the chosen sport and increase the indicators of Competitive Activity. The main goal of the study is to adjust and approve an Experimental Program of Occupational therapy for young men aged 17-19 who specialize in Sambo wrestling after treatment of knee joint injuries. The study was carried out in accordance with the Plan of the Initiative Scientific Project "Ergo Therapy of knee joints". In the process of Research and Analytical work, the following Research Methods were used: abstraction, analysis and synthesis, induction and deduction, modeling, mathematical and statistical analysis. As a Result of an Empirical Study, the members of the Research Group developed and tested an Experimental Program of Occupational Therapy for young men aged 17-19 who specialize in Sambo wrestling after treatment of knee joint injuries. The Experimental Program developed by us was implemented during three stages: Theoretical-Adaptive, Corrective and Engaging. Prospects for Further Research in the chosen field of Scientific Research include the development of an Occupational Therapy Program for women who specialize in Combat Sports after treatment of knee joint injuries.

Hsa_circ_0007482 Promotes Proliferation and Differentiation of Chondrocytes in Knee Osteoarthritis.

Knee osteoarthritis (KOA) is a complex degenerative joint disease and a major cause of joint dysfunction. This study aimed to explore the function of hsa_circ_0007482 on inflammation, proliferation, differentiation, and apoptosis in KOA. Real-time quantitative polymerase chain reaction (PCR) was performed to detect the expression of circ_0007482, inflammatory factors, and differentiation-related molecules in KOA chondrocytes and interleukin (IL)-1β-stimulated chondrocytes. The correlation between the circ_0007482 expression and inflammatory factors was analyzed by the Pearson method. KOA cell model was established using IL-1β for 24 hours. The proliferation activity of chondrocytes was evaluated by CCK-8 assay, and cell apoptosis rate was assessed by flow cytometry. The downstream miRNA of circ_0007482 was validated using dual-luciferase reporter assay. The circ_0007482 expression was elevated in both KOA cartilage tissues and IL-1β-treated chondrocytes and positively correlated with inflammatory factors expression. In comparison to the control group, IL-1β treatment diminished chondrocyte proliferation abilities and increased cell apoptosis and inflammatory factors IL-6, IL-8, and tumor necrosis factor (TNF)-α mRNA expression. Inhibition of circ_0007482 partially improved IL-1β-induced inflammatory reaction. Circ_0007482 could negatively regulate the expression of miR-558. Interfering of circ_0007482 might partially promote cell proliferation and differentiation, while inhibit cell apoptosis to improve joint injury by regulating miR-558 in IL-1β-treated chondrocyte cell model.

Role of MRI in Evaluation of Post-Traumatic Knee Injuries: A Prospective Study

INTRODUCTIONThe knee joint is the largest and most complex joint in the human body. Therefore it is often affected by trauma. Magnetic Resonance Imaging (MRI) is a non-invasive imaging modality that provides detailed images of the soft tissue structures of the knee joint. The objective of this study was to evaluate MRI findings in patients with post-traumatic knee joint injuries. MATERIAL AND METHODSThis prospective study was carried out using a 3.0 Tesla MRI (Magnetom Lumina) scanner in the Department of Radiodiagno- sis and Medical Imaging at Universal College of Medical Sciences & Teaching Hospital, Bhairahawa, Nepal, involving 128 patients with knee injuries, from September 2023 to February 2024. Data were analyzed using SPSS version 20. RESULTSIn this study of 128 participants, 57.81% were male and 42.19% were female, with a mean age of 38.60±13.05 years. The majority of MRI findings were medial meniscus tear (51.56%), followed by anterior cruciate ligament tear (46.09%), medial collateral ligament sprain (44.53%), lateral meniscus tear (39.84%), lateral collateral ligament sprain (33.59%), and posterior cruciate ligament tear (17.97%). Our study also revealed various grades of collateral ligament injuries, including the medial and lateral ligaments. There were 59.65% of cases with a grade I medial collateral ligament sprain, followed by grade II at 33.33% and grade III at 7.02%. The grade I and grade II lateral collateral ligament sprains were 62.79% and 37.21%, respectively. CONCLUSIONMRI is a non-invasive and valuable diagnostic modality that can provide an accurate diagnosis. It is often preferred over arthroscopy.

Biofusion design and parameter optimization for a novel passive assisted knee exoskeleton robot based on eight-bar mechanism

Abstract In an effort to alleviate the issue of knee joint fatigue and injury during lower limb ambulation, a novel passive assisted exoskeleton robot with human–machine interaction is investigated to assist the movement of the human knee joint. The design of the exoskeleton configuration takes into consideration the physiological structure and gait function of the knee joint, ensuring that it satisfies the requirements for motion, force, and gait function of the knee joint. To explore the interaction between the wearer and the exoskeleton, a human–machine kinematic model after wearing exoskeleton is established, which is instrumental in analyzing the integration motion of the wearer and exoskeleton. In addition, the dynamic and static models of the knee joint after wearing the exoskeleton are established, utilizing the Newton–Euler method and force polygon method, respectively, to evaluate the effectiveness of the exoskeleton. Moreover, the size parameters and spring stiffness of the exoskeleton are optimized, using both human body kinematic model and mechanic model. Furthermore, the effectiveness of the exoskeleton in proving assistance is evaluated through human body simulation, using OpenSim. The results indicate that the exoskeleton significantly reduces the knee joint torque by 48.42%.

Incidence of Intraoperative Cardiothoracic Intervention During Open Surgery Following Acute Posterior Sternoclavicular Joint Injury: A Case Series and Review of the Literature.

Acute posterior sternoclavicular joint injuries are rare but potentially lethal injuries-signs of mediastinal compression range from nonspecific to neurovascular compromise. Currently, orthopaedic experts recommend a cardiothoracic surgeon be placed on standby during open surgery for potential intraoperative complications. However, few studies have reported on how often cardiothoracic intervention is required. First, we identified patients in our institution by CPT codes 23530, 23525, and 23532 from January 1, 2002 to May 1, 2023. Demographic variables and intraoperative cardiothoracic intervention rates were collected. Second, we systematically reviewed the literature to identify articles on acute posterior sternoclavicular injury using PubMed, Embase, and CINAHL databases (through August 20, 2023). Exclusion criteria included conservative treatment, successful closed reduction, chronic injury (>6wk) cadaver studies, reviews, and nonavailable text. Thirteen local patients underwent open surgery for an acute posterior sternoclavicular joint injury, 11 males and 2 females with an average age of 18.2 years old (range: 15 to 32.4). The most common mechanism of injury was sports (n=9; 69.2%). Four (30.8%) patients had physical or radiographic evidence of mediastinal compression. No patients required intraoperative cardiothoracic intervention in our institution. The literature search yielded 132 articles and 512 open surgeries for acute posterior sternoclavicular joint injuries. Four patients required intraoperative cardiothoracic intervention, all of whom presented with polytrauma and/or clinical or radiographic signs of neurovascular compromise, giving a combined overall rate of 0.76%. Expert opinion commonly recommends cardiothoracic backup during open surgery for acute posterior sternoclavicular joint injuries. On the basis of our local data and systematic literature review, we found an overall cardiothoracic intervention rate of 0.76%. In the presence of polytrauma and/or findings of neurovascular compromise, we suggest having cardiothoracic surgery on close standby during the procedure. However, a patient with an isolated acute posterior sternoclavicular joint injury and no clinical or radiographic findings of neurovascular compromise does not appear to require a cardiothoracic surgeon on standby. Ultimately, the decision to involve cardiothoracic backup during open surgery for an acute posterior sternoclavicular injury should be made on a case-by-case basis after a thorough physical and radiographic evaluation of the patient. Level III.

Single Nuclear Analyses Reveal Compromised Integrity of Neuromuscular Junction Myonuclei Following Joint Injury

The neuromuscular junction is an essential structure that links electrical signals from the nervous system to contraction of skeletal muscle. The post synaptic region of a muscle cell is maintained by a subset of specialized myonuclei responsible for clustering of post synaptic structural proteins and acetylcholine receptors. Disruptions in the transcriptional program of these myonuclei may result in ineffective myofiber recruitment, slowed force generation, and muscle weakness. We have shown that traumatic joint injury results in protracted deficits in muscle strength and power, but the peripheral mechanistic underpinnings remain unclear. Phenotypically, muscle pathology occurring after traumatic joint injury resembles that of neuromuscular destabilization, yet molecularly, this remains uninvestigated. Therefore, we hypothesize that disruption of neuromuscular regulatory gene programs and destabilization of the neuromuscular junction following joint injury will result in rapid muscle functional deficits. Human muscle biopsies were obtained from the vastus lateralis of anterior cruciate ligament (ACL) injured and healthy limbs of 26 participants. Injured biopsies were taken before and 7 days following reconstruction surgery. Bulk tissue RNA-seq analysis was performed on all participants and single-nucleus RNAseq (snRNAseq) was performed on a subset of participants. Briefly, for snRNAseq, muscle was dounce homogenized, filtered, and nuclei isolated via fluorescent activated cell sorting. Following sequencing, CellRanger output files containing count matrices were filtered, and analyzed using Partek Flow and Seurat. Biopsy sections were processed for histochemistry to analyze fiber size and motor end plate innervation. All participants underwent strength testing on a biodex to assess isometric quadriceps torque and rate of torque development. RNA sequencing displayed >3 fold upregulation of CHRNA1 (P< 0.001) after injury alone and >18 fold upregulation 7 days following reconstruction surgery (P< 0.001). This was accompanied by a host of other neuromuscular regulatory genes including HDAC4 (P< 0.001), GDNF (P< 0.001), and RUNX1 (P< 0.001). Single nucleus sequencing revealed a complete disappearance of neuromuscular junction regulatory myonuclei following reconstruction surgery coupled with delocalization of acetylcholine receptor expression. These findings were confirmed with fluorescent in situ hybridization of CHRNA1 RNA on biopsy sections. Functionally, CHRNA1 RNA expression strongly correlates with deficits in rate of torque development following injury (R^2 = 0.85, P< 0.001). Our results display rapid remodeling of the postsynaptic neuromuscular junction following joint injury that underscores sustained deficits in strength and power. Interventions targeting the preservation of peripheral innervation may be warranted to enhance outcomes following joint injury. R01AR072061. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

HDAC4 Genomic Methylation and Subsequent DNA Binding Following Joint Injury Confers a Sustained Epigenetic Memory of Disrupted Muscle Plasticity

Joint injury is associated with protracted atrophy and weakness that poorly recovers; our objective was to define molecular effectors of lost muscle size, strength, and plasticity following joint injury. We hypothesized that epigenetic imprinting of joint injury in muscle impairs muscle plasticity and contributes to poor functional recovery following surgical repair. We recruited a total of sixteen ACL-injured participants from whom we obtained vastus lateralis muscle biopsies Pre-, 7-days post-, and 4-months post- reconstruction surgery (Sx) and strength measures up to 6-months post-Sx. We performed immunohistochemistry, RNA-seq, reduced representation bisulfite sequencing (RRBS), and HDAC4 chromatin immunoprecipitation sequencing (HDAC4 ChIP-seq) to determine the impact of epigenetics and gene expression on histological profiles, muscle size and muscle strength following injury. Binding and Expression Target Analysis (BETA) of DNA methylation revealed a conserved 985bp regulatory genomic region that was differentially methylated upstream of the HDAC4 promoter. We observed 108 (Pre-Sx), 111 (7d post-Sx), and 110 (4-months post-Sx) differentially methylated promoter sites of which 95 sites were common across all timepoints in the injured limb. Additionally, we observed 1293 differentially methylated intragenic sites within the HDAC4 locus that were also common across all timepoints following injury. Altered HDAC4 methylation was associated with a 2.2 and 4.3 fold change in HDAC4 transcript abundance Pre-Sx and 7d post-Sx, respectively (FDR < 0.05). Notably, HDAC4 binding to critical contractile genes coincided with their downregulation 7d post-Sx (Log2 fold change: ACTA1: -2.02; CKM: -0.97; ATP2A1: -2.34; HOMER2: -1.09; all FDR<0.05). Altered transcript abundance of these genes coincided with lower mean muscle fiber cross-sectional area in the injured limb compared to Healthy (Healthy: 4845 ± 213.4μm2; pre-Sx: 4313 ± 190.6μm2, p<0.05; 7d post-Sx: 3685 ± 228.1μm2, p<0.05; 4-months post-Sx: 3422 ± 142.8μm2, p<0.05) and lower peak torque compared to Healthy (Healthy: 174.8 ± 10.72nm; pre-Sx: 135.2 ± 10.19nm, p<0.05; 4-months post-Sx: 82.64 ± 6.80nm, p<0.05; 6-months post-Sx: 105.9 ± 8.26nm, p<0.05) that was sustained throughout follow-up. Our results suggest that joint injury confers HDAC4 promoter-proximal and intragenic epigenetic imprinting by DNA methylation that increases HDAC4 transcript abundance and HDAC4-DNA binding to represses expression of genes regulating muscle contractile function. This HDAC4 gene regulatory program likely contributes to prolonged deficits in muscle size and strength following joint injury. This work was supported by NIH-NIAMS R01 AR072061. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Open Acromioclavicular Joint Reconstruction via Cerclage With Semitendinosus Allograft

Background: Acromioclavicular (AC) joint separations occur most often in young male patients, commonly in athletes. Initially described by Jones et al. in 2001, reconstruction with semitendinosus allograft via cerclage has been increasingly adopted in recent times, though this not been as well described in video journals. Indications: Operative management of AC joint separation is classically indicated in Rockwood grade IV or higher AC joint injuries and controversial for grade III separations. One such treatment is AC joint reconstruction with semitendinosus allograft as described in this 37-year-old male patient, with a grade IIIB AC joint separation. Technique Description: A 6-cm incision was created overlying the clavicle. No distal clavicle excision was performed, but coracoclavicular (CC) scar tissue was elevated with medial and lateral windows about the coracoid. A passing suture was placed around the coracoid, and holes were drilled in the clavicle at 17% and 31% of the total clavicle length, consistent with ratios described by Rios et al; 5-mm tunnels were created corresponding to the trapezial and conoid limbs of the CC ligaments and tapped to 5.5 mm. A semitendinosus allograft was passed and fixed with two 5.5 × 15 mm polyetheretherketone (PEEK) screws after primary fixation with a FiberTape cerclage looped around the coracoid and clavicle independently with use of a tensiometer for maximal tightening. A FiberTak was used to fix the additional graft limb at the acromion to stabilize the AC joint and reinforced on itself with 0 vicryl. The patient was placed in a sling and assigned physical therapy (PT) focusing on limiting shoulder abduction and forward flexion for the first 6 weeks. Results: At 6 months postoperation, the patient continues to progress from PT, with low pain and near full range of motion. Although PT protocols vary widely, a full recovery is expected by 6 months, with the patient able to return to work, lifting no greater than 50 pounds. Discussion/Conclusion: This study describes the treatment of an acute grade IV AC joint separation in a 37-year-old male patient. Further adoption of AC joint reconstruction utilizing a semitendinosus allograft via cerclage continues to be a viable option for patients requiring operative management. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.

Acute Effect of Static and Dynamic Stretching on Activating Scapular Stabilizer Muscles During Pull-Up Movement in Gymnasts

Background and Aims Today, there is an argument about the effect of various stretching movements on the performance of athletes. Therefore, this study investigated the acute effect of static and dynamic stretching on muscle activity and co-contraction of scapular stabilizer muscles during pull-ups in gymnasts. Methods According to the inclusion and exclusion criteria, 15 professional gymnasts with a mean age of 23.25±2.57 years, height of 170.93±5.88 cm, and weight of 64.54±5.06 kg were selected as research samples and divided into three subgroups (each with 5 athletes). In the pre-test, subjects performed pull-up activity, and muscle activities of the serratus anterior, upper trapezius, middle trapezius, and lower trapezius muscles were measured using a biometric electromyography device. Then, each subgroup performed a different stretching protocol in each session, and a post-test was conducted like the pre-test. Repeated measures analysis of variance, the Bonferroni post hoc test, and the paired t test were used to test the study hypotheses. Results The results showed that static and dynamic stretching caused a significant decrease and increase in muscle activity in both concentric and eccentric phases, respectively. Also, the results showed that dynamic stretch caused a reduction in co-contraction of the serratus anterior and middle trapezius muscles in both concentric and eccentric phases. In addition, there is a significant difference between the effect of static and dynamic stretch and between dynamic stretch and control on the co-contraction of the serratus anterior and middle trapezius muscles in the concentric and eccentric phases. Conclusion The results showed that the co-contraction of the serratus anterior and middle trapezius muscles decreased after using dynamic stretching. Therefore, considering the importance of muscle co-contraction in the occurrence of shoulder joint injuries and preventing injuries in the shoulder joint of gymnasts, it is suggested that coaches and gymnasts use dynamic stretching exercises more carefully.

Surgical restabilization reduces the progression of post-traumatic osteoarthritis initiated by ACL rupture in mice

ObjectivePeople who sustain joint injuries such as anterior cruciate ligament (ACL) rupture often develop post-traumatic osteoarthritis (PTOA). In human patients, ACL injuries are often treated with ACL reconstruction. However, it is still unclear how effective joint restabilization is for reducing the progression of PTOA. The goal of this study was to determine how surgical restabilization of a mouse knee joint following non-invasive ACL injury affects PTOA progression. DesignIn this study, 187 mice were subjected to non-invasive ACL injury or no injury. After injury, mice underwent restabilization surgery, sham surgery, or no surgery. Mice were then euthanized on day 14 or day 49 after injury/surgery. Functional analyses were performed at multiple time points to assess voluntary movement, gait, and pain. Knees were analyzed ex vivo with micro-computed tomography, RT-PCR, and whole-joint histology to assess articular cartilage degeneration, synovitis, and osteophyte formation. ResultsBoth ACL injury and surgery resulted in loss of epiphyseal trabecular bone (-27-32%) and reduced voluntary movement at early time points. Joint restabilization successfully lowered OA score (-78% relative to injured at day 14, p<0.0001), and synovitis scores (-37% relative to injured at day 14, p=0.042), and diminished the formation of chondrophytes/osteophytes (-97% relative to injured at day 14, p<0.001, -78% at day 49, p<0.001). ConclusionsThis study confirmed that surgical knee restabilization was effective at reducing articular cartilage degeneration and diminishing chondrophyte/osteophyte formation after ACL injury in mice, suggesting that these processes are largely driven by joint instability in this mouse model. However, restabilization was not able to mitigate the early inflammatory response and the loss of epiphyseal trabecular bone, indicating that these processes are independent of joint instability.

Rare complication of rheumatoid arthritis: Charcot Neuro-osteoarthropathy

BackgroundRheumatoid arthritis (RA) is an autoimmune disease.However, there are few cases of Charcot Neuro-osteoarthropathy (CN) caused by rheumatoid diseases in clinical reports. It is not easy to pay attention to the diagnosis of CN in the complications of rheumatoid disease, which greatly increases the probability of misdiagnosis and missed diagnosis. This case reported a rare complication of rheumatoid arthritis, Charcot arthritis, and the molecular mechanism and diagnosis and treatment of CN caused by RA were systematically discussed.Case presentationThe patient, a 79-year-old woman, was hospitalized due to bilateral shoulder pain, limited activity for half a year, aggravated for 4 months to the hospital. During this period, the symptoms did not improve after treatment with acupuncture and Chinese medicine. The patient was previously diagnosed with rheumatoid arthritis for more than 3 years and intermittent irregular use of methylprednisolone and methotrexate for 2 years. She had a history of osteoporosis. Physical examination: symmetrical malformed swelling of the finger joints of both hands; Bilateral supraspinatus and deltoid muscle atrophy, tenderness at the acromion, and attachment of the long head tendon of the biceps brachii were observed. The left Dugas test and the right Dugas test were positive.Blood test: anti-cyclic citrullinated peptide antibody (A-CCP) 33.10U/ml (normal range: 0-5RU/ml); antinuclear antibody quantification (ANA) 47.40AU/ml (normal range: Negative or < 32); anti-double stranded DNA IgG antibody quantification (dsDNA) 31.00 IU/ml (normal range: 0-100 IU/ml); D-Dimer 6.43 µg/ml (normal range: 0–0.5 mg/L); erythrocyte sedimentation rate (ESR) was 27 mm/h (normal range: < 20 mm/60 min). C-reactive protein (CRP) 39.06 mg/L(0.068-8 mg/L).MRI 3.0 T enhancement of bilateral shoulder joints, cervical spine and thoracic spine showed: 1.Large bone destruction, cartilage injury, multiple effusion, synovitis, obvious on the right side. 2.Intervertebral disc degeneration, cervical 3/4, 4/5, 5/6, 6/7 disc herniation, with cervical 3/4 obvious, posterior central herniation;ConclusionsRheumatoid arthritis complicated with Charcot's joint is rare. Clinically, patients with rheumatoid diseases should not ignore Charcot's joint complications because of rareness. Early blood inflammatory markers, neuro electrophysiology, and imaging MRI of rheumatoid CN are of great significance for the diagnosis of this mild or early neurovascular inflammation. Early diagnosis and treatment are helpful to prevent further joint injury. The clinical diagnosis, treatment, and molecular mechanism of osteolysis in RA and peripheral sensory nerve injury remain to be further revealed.

Development of a smart lumbar posture correction vest

Lack of proper lumbar posture is responsible for the occurrence of neck and shoulder pain, low back pain, and muscle and joint injuries in the abdominal region in more than 75% of individuals. This scenario is influenced by the excessive use of computers in the workplace, prolonged periods of incorrect sitting posture, inadequate posture during daily activities, and repetitive and localized movements, among other factors. Consequently, numerous studies are being carried out with the aim of reducing or eliminating the frequency of the problem. The most common solution proposed by researchers is the use of lumbar posture correction waistcoats. This article has automated a posture correction waistcoat that protects the wearer but also monitors their posture. When incorrect posture is identified, the waistcoat generates a warning signal. To do this, gyro sensors, accelerometer sensors, and vibration motors were installed and supervised by an Arduino microcontroller. A communication system based on Bluetooth technology was used, integrated into an Android app that interacts with the user, displaying monitoring data and providing graphical representations of inappropriate postures. In addition, a health and well-being module was implemented, which suggests a physical exercise routine to prevent back pain. In addition, a therapeutic massage module was included for relaxation and an interface for storing music that can be played while wearing the waistcoat. The results demonstrated that the implemented system generated a smart vest capable of monitoring and alerting the user when an incorrect posture was identified. Furthermore, the results indicated that the health and well-being module provided a positive user experience.

Load carriage changes tibiofemoral arthrokinematics during ambulatory tasks in recruit-aged women

The introduction of women into U.S. military ground close combat roles requires research into sex-specific effects of military training and operational activities. Knee osteoarthritis is prevalent among military service members; its progression has been linked to occupational tasks such as load carriage. Analyzing tibiofemoral arthrokinematics during load carriage is important to understand potentially injurious motion and osteoarthritis progression. The study purpose was to identify effects of load carriage on knee arthrokinematics during walking and running in recruit-aged women. Twelve healthy recruit-aged women walked and ran while unloaded (bodyweight [BW]) and carrying additional + 25%BW and + 45%BW. Using dynamic biplane radiography and subject-specific bone models, tibiofemoral arthrokinematics, subchondral joint space and center of closest contact location between subchondral bone surfaces were analyzed over 0–30% stance (separate one-way repeated measures analysis of variance, load by locomotion). While walking, medial compartment contact location was 5% (~ 1.6 mm) more medial for BW than + 45%BW at foot strike (p = 0.03). While running, medial compartment contact location was 4% (~ 1.3 mm) more lateral during BW than + 25%BW at 30% stance (p = 0.04). Internal rotation was greater at + 45%BW compared to + 25%BW (p < 0.01) at 30% stance. Carried load affects tibiofemoral arthrokinematics in recruit-aged women. Prolonged load carriage could increase the risk of degenerative joint injury in physically active women.

Lateral Ankle Joint Injuries in Indoor and Court Sports: A Systematic Video Analysis of 445 Nonconsecutive Case Series

Background: Lateral ankle sprains are one of the most common injuries in indoor and court sports. Self-reports and case studies have indicated that these injuries occur via both contact and noncontact injury mechanisms typically because of excessive inversion in combination with plantarflexion and adduction of the foot. Video-based documentation of the injury mechanism exists, but the number of cases reported in the literature is limited. Purpose: To retrieve and systematically analyze a large number of video-recorded lateral ankle injuries from indoor and court sports, as well as describe the injury mechanism, injury motion, and injury pattern across different sports. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 445 unique video-recorded lateral ankle sprain injuries were retrieved from indoor and court sports of broadcasted levels of competition. The videos were independently analyzed by 2 different reviewers. Outcomes included classification of the injury mechanism according to the International Olympic Committee consensus guidelines, primary and secondary motions of ankle joint distortion, and documentation of the fixation point (fulcrum) around which the foot rotates. Results: Overall, 298 (67%) injuries were direct contact, 113 (25%) were noncontact, and 32 (7%) were indirect contact incidents. Direct contact injuries were especially prevalent in basketball (76%), handball (80%), and volleyball (85%), while noncontact injuries dominated in tennis and badminton (96% vs 95% across both). Inversion (65%) and internal rotation (33%) were the primary distortion motions, with the lateral forefoot (53%) and lateral midfoot (40%) serving as the main fulcrums. Landing on another player's foot was the leading cause of injury (n = 246; 55%), primarily characterized by inversion (79%) around a midfoot fulcrum (54%). The noncontact and indirect landings on floor (n = 144; 33%) were primarily characterized by a distortion around a forefoot fulcrum (69%). Conclusion: Two of 3 ankle sprains from online video platforms were direct contact injuries, with most involving landing on another player's foot. The distortion motion seems to be related to the injury mechanism and the fixation point between the foot and the floor. The injury mechanisms varied greatly between sports, and future studies should clearly differentiate and investigate the specific injury mechanisms.

Complex Axial Carpal Dislocation with Scapholunate Ligament Injury

Abstract Background Axial carpal dislocations (ACDs) are high-impact injuries, involving both proximal and distal carpal rows, adding complexity to the diagnostic and treatment challenges. This article explores a distinctive case of axial radial carpal dislocation, highlighting an irreducible second carpometacarpal joint (CMCJ) and concomitant scapholunate (SL) ligament injury. Understanding the background of axial carpal injuries is crucial for recognizing and addressing these complex cases effectively. Description A 27-year-old man presented with a left wrist injury following a motorcycle accident, revealing an irreducible second CMCJ with a unique ligamentous injury pattern. Despite unsuccessful closed reduction attempts, the surgical intervention involved a dorsal midline incision, fixation of the second CMCJ and SL interval, and ligament repair. Postoperative assessment demonstrated proper alignment with a mild gap in the SL interval, revealing the intricate nature of the injury. Literature Review Existing studies describe a type of axial dislocation starting at the third webspace, traveling through capitate–hamate intervals leading to scaphoid dislocation. However, in the article, we describe a variant of ACD through second CMCJ causing an SL interval instability. Clinical Relevance Recognizing and comprehensively addressing axial radial carpal dislocations are crucial for optimal patient outcomes. The case report contributes valuable insights into the rare pattern of ACD involving SL instability that was missed on initial radiographs but detected through computed tomography scan and thereby managed appropriately. Any CMCJ dislocation should raise a suspicion of axial dislocation unless proved otherwise.

Assessing the efficacy of the Stop OsteoARthritis (SOAR) program: A randomized delayed-controlled trial in persons at increased risk of early onset post-traumatic knee osteoarthritis

ObjectiveAssess the efficacy of an 8-week virtual, physiotherapist (PT)-guided knee health program (SOAR) to improve knee extensor strength in individuals at risk of post-traumatic knee osteoarthritis (PTOA). MethodIn this superiority, randomized delayed-control trial, persons aged 16-35 years, 1-4 years after a self-reported knee joint injury were randomly assigned (1:1) to receive the SOAR program immediately (experimental group) or after a 9-week delay (control group). SOAR includes 1) one-time Knee Camp (virtual PT-guided group education, knee assessment, 1:1 exercise and physical activity goal-setting); 2) Weekly personalized home-based exercise and physical activity program with tracking; 3) Weekly 1:1 PT counseling (virtual). The primary outcome was change in isokinetic knee extensor strength (baseline to 9-weeks). Additional outcomes included change in self-reported knee-related quality-of-life (QOL), self-efficacy, self-management and kinesiophobia, and physical activity (accelerometer) at 9 and 18-weeks. Linear regression models estimated the effect of the 8-week intervention at the primary endpoint (9-week). Results49 of 54 randomized participants completed the study (91%). Participants were a mean±SD age of 27±5.0 years, and 2.4±0.9 years post-injury. No mean between group differences for the primary (0.05; 95%CI: -0.10,0.19) or other outcomes were seen at 9 weeks except for greater improvements in perceived self-management (Partner in Health Scale; 11.3/96, 95%CI: 5.5,17.1) and kinesiophobia (Tampa Scale of Kinesiophobia; -4.4/33, 95%CI: -7.0,-1.8). ConclusionFor active persons with elevated risk of PTOA, an 8-week SOAR program did not change knee-related strength, QOL, self-efficacy, or physical activity, on average, but may benefit the ability to self-manage knee health and kinesiophobia.

Archery injuries: A literature review

BACKGROUND: Archery is one of the oldest human skills that survived to the present day. At first, it was used for hunting and war and later became a sport. The interest in archery has grown annually. Each type of sport has specific injuries. Information about archery-related injuries will allow us to develop preventive measures and help make this sport safer. The article will be useful for coaches, sports doctors, physiotherapists, and orthopedic surgeons.&#x0D; AIM: To present modern information about frequency, types of archery-related injuries, and preventive methods.&#x0D; MATERIALS AND METHODS: The publication search was performed in the PubMed/MEDLINE databases from 1978 to 2023 using combinations of OR, AND operators, and keywords: archery, archery injuries, rotator cuff injuries, arrow injuries, and overuse. Consequently, we extracted 49 foreign and domestic scientific sources.&#x0D; RESULTS: Archery injuries occur in 4.4 per 10,000 people involved in this sport. Acute injuries in archers are rare, mainly due to shooting errors and most often lead to soft tissue damage because of a fracture of a bow, arrow, or bowstring during a shot (83.3%) or as a result of touching the bowstring with a bow. Chronic injuries occur in 83.9% of archery athletes. The main risk factors for their occurrence include overuse, high repetitions during training, lack of strength of the athlete, and incorrect technique. Overuse (67.9%) is the most common cause of chronic tendon, ligament, and joint injuries. Injuries occurred in 30%–53% of cases in the shoulders (rotator cuff tear, scapular dyskinesia, and shoulder impingement syndrome), 12.8% in the elbow (medial and lateral epicondylitis and traumatic bursitis), 8.9%–19.9% in the spine and forearm (chronic tendovaginitis and tunnel syndromes).&#x0D; CONCLUSIONS: Proper training and safety measures help prevent acute injuries. Practicing archery techniques and strength training are the main measures of preventing muscle overuse and reducing the incidence of chronic injuries.

Exploring biomechanical variations in ankle joint injuries among Latin dancers with different stance patterns: utilizing OpenSim musculoskeletal models.

Background: Dancers represent the primary demographic affected by ankle joint injuries. In certain movements, some Latin dancers prefer landing on the Forefoot (FT), while others prefer landing on the Entire foot (ET). Different stance patterns can have varying impacts on dancers' risk of ankle joint injuries. The purpose of this study is to investigate the differences in lower limb biomechanics between Forefoot (FT) dancers and Entire foot (ET) dancers. Method: A group of 21 FT dancers (mean age 23.50 (S.D. 1.12) years) was compared to a group of 21ET dancers (mean age 23.33 (S.D. 0.94) years), performing the kicking movements of the Jive in response to the corresponding music. We import data collected from Vicon and force plates into OpenSim to establish musculoskeletal models for computing kinematics, dynamics, muscle forces, and muscle co-activation. Result: In the sagittal plane: ankle angle (0%-100%, p < 0.001), In the coronal plane: ankle angle (0%-9.83%, p = 0.001) (44.34%-79.52%, p = 0.003), (88.56%-100%, p = 0.037), ankle velocity (3.73%-11.65%, p = 0.017) (94.72-100%, p = 0.031); SPM analysis revealed that FT dancers exhibited significantly smaller muscle force than ET dancers around the ankle joint during the stance phase. Furthermore, FT dancers displayed reduced co-activation compared to ET dancers around the ankle joint during the descending phase, while demonstrating higher co-activation around the knee joint than ET dancers. Conclusion: This study biomechanically demonstrates that in various stance patterns within Latin dance, a reduction in lower limb stance area leads to weakened muscle strength and reduced co-activation around the ankle joint, and results in increased ankle inversion angles and velocities, thereby heightening the risk of ankle sprains. Nevertheless, the increased co-activation around the knee joint in FT dancers may be a compensatory response for reducing the lower limb stance area in order to maintain stability.

Influence of Walking Over Unexpected Uneven Terrain on Joint Loading for Individuals With Transtibial Amputation.

Individuals with transtibial amputation (TTA) experience asymmetric lower-limb loading which can lead to joint pain and injuries. However, it is unclear how walking over unexpected uneven terrain affects their loading patterns. This study sought to use modeling and simulation to determine how peak joint contact forces and impulses change for individuals with unilateral TTA during an uneven step and subsequent recovery step and how those patterns compare to able-bodied individuals. We expected residual limb loading during the uneven step and intact limb loading during the recovery step would increase relative to flush walking. Further, individuals with TTA would experience larger loading increases compared to able-bodied individuals. Simulations of individuals with TTA showed during the uneven step, changes in joint loading occurred at all joints except the prosthetic ankle relative to flush walking. During the recovery step, intact limb joint loading increased in early stance relative to flush walking. Simulations of able-bodied individuals showed large increases in ankle joint loading for both surface conditions. Overall, increases in early stance knee joint loading were larger for those with TTA compared to able-bodied individuals during both steps. These results suggest that individuals with TTA experience altered joint loading patterns when stepping on uneven terrain. Future work should investigate whether an adapting ankle-foot prosthesis can mitigate these changes to reduce injury risk.