Lower Limb Length Research Articles

Assessing Leg Length Discrepancy Is Necessary Before Arthroplasty in Patients With Unilateral Crowe Type IV Hip Dislocation.

THA for high-riding developmental dysplasia of the hip (DDH) is challenging in terms of length equalization. Although previous studies suggested preoperative templating on AP pelvic radiographs is insufficient in patients with unilateral high-riding DDH because of hypoplasia of the hemipelvis on the affected side and unequal femoral and tibial length on scanograms, the results were controversial. The EOS™ (EOS™ Imaging) is a biplane X-ray imaging system using slot-scanning technology. Length and alignment measurements have been shown to be accurate. We used the EOS to compare the lower limb length and alignment in patients with unilateral high-riding DDH. (1) Is there an overall leg length difference in patients with unilateral Crowe Type IV hip dysplasia? (2) In patients with unilateral Crowe Type IV hip dysplasia with an overall leg length difference, is there a consistent pattern of abnormalities in the femur or tibia that account for observed differences? (3) What is the impact of unilateral high-riding Crowe Type IV dysplasia on femoral neck offset and knee coronal alignment? Between March 2018 and April 2021, we treated 61 patients with THA for Crowe Type IV DDH (high-riding dislocation). EOS imaging was performed preoperatively in all patients. Eighteen percent (11 of 61) of the patients were excluded because of involvement of the opposite hip, 3% (two of 61) were excluded for neuromuscular involvement, and 13% (eight of 61) had previous surgery or fracture, leaving 40 patients for analysis in this prospective, cross-sectional study. Each patient's demographic, clinical, and radiographic information was collected with a checklist using charts, Picture Archiving and Communication System, and an EOS database. EOS-related measurements that were related to the proximal femur, limb length, and knee-related angles were recorded for both sides by two examiners. The findings of the two sides were statistically compared. The overall limb length was not different between the dislocated and nondislocated sides (mean 725 ± 40 mm versus 722 ± 45 mm, mean difference 3 mm [95% CI -3 to 9 mm); p = 0.08). Apparent leg length was shorter on the dislocated side (mean 742 ± 44 mm versus 767 ± 52 mm, mean difference -25 mm [95% CI -32 to 3 mm]; p < 0.001). We observed that a longer tibia on the dislocated side was the only consistent pattern (mean 338 ± 19 mm versus 335 ± 20 mm, mean difference 4 [95% CI 2 to 6 mm]; p = 0.002), but there was no difference between the femur length (mean 346 ± 21 mm versus 343 ± 19 mm, mean difference 3 mm [95% CI -1 to 7]; p = 0.10). The femur of the dislocated side was longer by greater than 5 mm in 40% (16 of 40) of patients and shorter in 20% (eight of 40). The mean femoral neck offset of the involved side was shorter than that of the normal side (mean 28 ± 8 mm versus 39 ± 8 mm, mean difference -11 mm [95% CI -14 to -8 mm]; p < 0.001). There was a higher valgus alignment of the knee on the dislocated side with a decreased lateral distal femoral angle (mean 84° ± 3° versus 89° ± 3°, mean difference - 5° [95% CI -6° to -4°]; p < 0.001) and increased medial proximal tibia angle (mean 89° ± 3° versus 87° ± 3°, mean difference 1° [95% CI 0° to 2°]; p = 0.04). A consistent pattern of anatomic alteration on the contralateral side does not exist in Crowe Type IV hips except for the length of the tibia. All parameters of the limb length could be shorter, equal to, or longer on the dislocated side. Given this unpredictability, AP pelvis radiographs are not sufficient for preoperative planning, and individualized preoperative planning using full-length images of the lower limbs should be performed before arthroplasty in Crowe Type IV hips. Level I, prognostic study.

Follow-up of biological reconstruction of epiphysis preserving osteosarcoma around the knee in children: A retrospective cohort study.

Limb salvage treatment for malignant bone tumors in children includes prosthetic and biological reconstruction. Early function following prosthesis reconstruction is satisfactory; however, there are several complications. Biological reconstruction is another way to treat bone defects. We evaluated the effectiveness of reconstruction of bone defects by liquid nitrogen inactivation of autologous bone with preserving epiphysis in 5 cases of periarticular osteosarcoma of the knee. We retrospectively selected 5 patients with articular osteosarcoma of the knee who underwent epiphyseal-preserving biological reconstruction in our department between January 2019 and January 2020. Femur involvement occurred in 2 cases and tibia involvement occurred in 3 cases, with an average defect of 18 cm (12-30 cm). The 2 patients with femur involvement were treated with inactivated autologous bone by liquid nitrogen with vascularized fibula transplantation. Among the patients with tibia involvement, 2 were treated with inactivated autologous bone with ipsilateral vascularized fibula transplantation and 1 was treated with autologous inactivated bone with contralateral vascularized fibula transplantation. Bone healing was evaluated by regular X-ray examination. At the end of the follow-up, lower limb length, knee flexion, and extension function were evaluated. Patients were followed up for 24 to 36 months. Average bone-healing time was 5.2 months (3-8 months). All patients achieved bone healing with no tumor recurrence and no distant metastasis and all patients survived. The lengths of both lower limbs were equal in 2 cases, with shortening by ≤1 cm in 1 case and shortening by 2 cm in 1 case. Knee flexion was >90° in 4 cases and between 50 and 60° in 1 case. The Muscle and Skeletal Tumor Society score was 24.2 (range 20-26). Inactivation of autogenous bone with the epiphysis preserved by liquid nitrogen combined with vascularized fibula reconstruction for periarticular osteosarcoma of the knee in children is safe and effective. This technique supports bone healing. Postoperative limb length and function, and short-term effects were satisfactory.

The effectiveness and influencing factors of the "Y" line technique in reducing the leg length discrepancy after total hip arthroplasty.

To introduce a surgical technique (the "Y" line technique) that will control leg length discrepancy (LLD) after total hip arthroplasty and to observe its effectiveness and influencing factors. According to the inclusion and exclusion criteria, a total of 350 patients were selected in this study; 134 patients in whom used the "Y" line technique was used to control lower limb length were included in Group A and 166 patients treated with freehand methods to control lower limb length were included in Group B. A total of 50 patients in whom the standard anteroposterior x-ray of bilateral hips was taken preoperatively and in whom the "Y" line technique was used during the operation were included in Group C. The postoperative LLD of Group A was 4.74 mm (3.93), that of Group B was 5.85 mm (4.60), and that of Group C was 2 mm (1.00)-the difference was statistically significant (p < 0.001). There were significant statistical differences when comparisons were made between any two groups (p < 0.01). The distribution of postoperative LLD in Group A was better than that in Group B, and this factor was better in Group C than in Group A-the difference was statistically significant (p < 0.001). Severe unequal length rates of the lower extremities (LLD > 10 mm) were 5.97% (8/134) in Group A, 14.3% (24/166) in Group B, and 0% (0/50) in Group C-the difference was statistically significant (p < 0.001). There were significant differences between Group A and Group B and between Group B and Group C (p < 0.05), but there was no significant difference between Group A and Group C (p = 0.078). The "Y" line technique, which does not increase the operating time and patient cost, can effectively reduce postoperative LLD. Insufficient internal rotation of the healthy lower extremity and the low projection position in the preoperative anteroposterior x-ray of the bilateral hips were important factors affecting the accuracy of the "Y" line technique.

Influence of muscle volume on jumping performance in healthy male and female youth and young adults

BackgroundSex differences that appear throughout puberty have a substantial impact on the training process. It remains unclear what effect these sex differences should have on how training programs are planned and performed and what objectives should be established for boys and girls of different ages. This study aimed to investigate the relationship between vertical jump performance and muscle volume based on age and sex.MethodsOne hundred eighty healthy males (n = 90) and females (n = 90) performed three different types of vertical jumps (VJ): squat jump (SJ), counter movement jump (CMJ), and counter movement jump with arms (CMJ with arms). We used the anthropometric method to measure muscle volume.ResultsMuscle volume differed across age groups. There were significant effects of age, sex, and their interaction on the SJ, CMJ, and CMJ with arms heights. From the age of 14–15, males exhibited better performances than females, and large effect sizes became apparent in the SJ (d = 1.09, P = 0.04), CMJ (d = 2.18; P = 0.001) and CMJ with arms (d = 1.94; P = 0.004). For the 20–22-year-old age group, there was a significant difference in VJ performance between males and females. Extremely large effect sizes became apparent in the SJ (d = 4.44; P = 0.001), CMJ (d = 4.12; P = 0.001) and CMJ with arms (d = 5.16; P = 0.001). When performances were normalized to the lower limb length, these differences persisted. After normalization to muscle volume, males exhibited better performance when compared to females. This difference persisted only for the 20–22-year-old group on the SJ (p = 0.005), CMJ (p = 0.022) and CMJ with arms (p = 0.016). Among male participants, muscle volume was significantly correlated with SJ (r = 0.70; p < 0.01), CMJ (r = 0.70; p < 0.01) and CMJ with arms (r = 0.55; p < 0.01).ConclusionsThe results indicate that muscle volume may be one of the major determining factors in sex differences in vertical jumping performance.

Hybrid Lateral Closed-Wedge High Tibial Osteotomy Showed Similar Accuracy in Angular Correction and Reduction of Posterior Tibial Slope Compared to Opening-Wedge High Tibial Osteotomy: A Correction Angle Matched Cohort Study

BackgroundWe aimed to compare the accuracy of applied correction angle between hybrid lateral closed wedge high tibial osteotomy (hybrid HTO) and medial open wedge high tibial osteotomy (OWHTO), and verify previous reports on hybrid HTO by matching correction angle between groups. Change in various radiological parameters including union rate were also compared. MethodsA total of 50 OWHTO patients were selected for 2:1 propensity matching with 25 hybrid HTO patients. Rate of correction error was calculated by dividing the difference between the change in medial proximal tibial angle and preoperatively planned correction angle (PRD) by planned correction angle. Accuracy of angular correction was assessed using PRD and correction error rates. Hip-knee-ankle axis, mechanical lateral distal femoral angle, medial proximal tibial angle, joint line convergence angle, and length of the entire lower limb and tibia were measured. The Caton-Deschamps index (CDI) was used to assess change in patellar height. Serial postoperative radiographic analysis was performed to assess the union rate. ResultsThe discrepancy between planned correction angle and real correction angle was 0.8 ± 2.3° in hybrid HTO and 1.1 ± 3.4° in OWHTO (P > .05), and the rate of error in osteotomy was similar between the groups approximately 6%. Postoperatively, posterior tibial slope (PTS) (P < .001), tibia length, and CDI (P < .001) were significantly different between groups. The amount of change in PTS (P < .001), tibia length in hybrid HTO (P < .001), and CDI (P < .001) were significantly different between groups. Union rate of osteotomy site was significantly faster in hybrid HTO than in OWHTO (P < .001). ConclusionHybrid HTO showed similar accuracy in angular correction compared to correction angle-matched OWHTO. Reduction in PTS, tibial shortening, maintained patellar height relative to the proximal tibia, and faster osteotomy site union were also confirmed in hybrid HTO.

M-Mode Ultrasound Behavior of Rectus Femoris and Vastus Intermedius during Contraction with Anthropometric Correlations: Cross-Sectional Study

The quadriceps femoris muscle (QF) is of clinical importance since it has been correlated with pathologies at knee level, such as anterior cruciate ligament (ACL) injury, pain processes and complex clinical conditions. Among the variables that have been related to these clinical conditions are anthropometric measurements, architecture and muscular behavior of the QF. The aim of this study was to determine the relationship between the rectus femoris (RF) and vastus intermedius (VIM) muscles’ behavior measured by rehabilitative ultrasound imaging (RUSI) M-mode under maximal voluntary isometric contraction (MVIC) and anthropometric measurements. This was a cross-sectional, observational study. Sixty-two asymptomatic volunteers were included (20.42 ± 4.97 years, most women 59.7%). RUSI measurements were muscle contraction/rest thickness and contraction/relaxation velocity. Anthropometric measurements were, lower limb length, RF length, QF tendon length, distance between spines, proximal, middle and distal thigh perimeter. Statistically significant correlations (p &lt; 0.05) were found between VIM thickness at rest and contraction with thigh perimetry, RF length and dominant lower limb length. For the RF, a correlation was found between the thickness at rest and the length of this muscle (p = 0.003). There is a correlation between anthropometric variables and muscular behavior measured by RUSI M-mode.

A Combination of Ilizarov Frame, Externalized Locking Plate and Tibia Bridging for an Adult with Large Tibial Defect and Severe Varus Deformity Due to Chronic Osteomyelitis in Childhood: A Case Report

Background: Various techniques have been reported to treat large, segmental tibial defects, such as autogenous bone graft, vascularized free fibula transfer and bone transport. We present a case of a 24-year-old male with a 17-year history of chronic osteomyelitis with obvious lower limb length discrepancy and severe varus deformity of the tibia secondary to osteomyelitis in childhood. Aim: The aim of this work is to provide an alternative choice for treating patients in developing countries with severe lower limb deformity caused by chronic osteomyelitis. Case Presentations: Without surgical intervention for a prolonged period of time, the patient was admitted in our institute for corrective surgery. Corrective surgery consisted of three stages: lengthening with Ilizarov frame, removal of Ilizarov frame and fixation with externalized locking plate, and removal of externalized locking plate. Tibia bridging was achieved at the distal and proximal junction. The range of motion (ROM) of the knee joint was nearly normal, but the stiffness of the ankle joint was noticeable. The remaining leg discrepancy of 0.1 cm required no application of a shoe lift. Moreover, the patient could engage in daily activities without noted limping. Conclusions: Distraction-compression osteogenesis using the Ilizarov apparatus is a powerful tool to lengthen the shortened long bone and adjust the deformity of the lower limbs. Externalized locking plates provide an alternative to the traditional bulky external fixator, as its low profile makes it more acceptable to patients without compromising axial and torsional stiffness. In all, a combination of Ilizarov frame, externalized locking plate and tibia bridging is an alternative for patients in similar conditions.

Double-level knee osteotomy accurately corrects lower limb deformity and provides satisfactory functional outcomes in bifocal (femur and tibia) valgus malaligned knees.

Double-level knee osteotomy (DLO) is a challenging procedure that requires precision in preoperative planning and intraoperative execution to achieve the desired correction. It is indicated in cases of severe varus or valgus deformities where a single-level osteotomy would yield significantly tilted joint line obliquity (JLO). This study aimed to evaluate the effectiveness of DLO in achieving accurate correction without compromising JLO, using patient-specific cutting guides (PSCGs), in cases of bifocal valgus maligned knees. A single-centre, retrospective analysis of prospectively collected data for a total of 26 patients, who underwent DLO by PSCGs for valgus malaligned knees, between 2015 and 2020. Post-operative alignment was evaluated and the delta for different lower limb0.05, not statistically significant (ns)). All KOOS subs alignment parameters was calculated; the hip-knee-ankle angle (ΔHKA), medial proximal tibial angle (ΔMPTA), and lateral distal femoral angle (ΔLDFA). At the two-year follow-up, changes in the KOOS sub-scores, UCLA scores, lower limb discrepancy (LLD), and mean time to return to work and sport were recorded. All intraoperative and postoperative complications were recorded. The Mann-Whitney U test with a 95% confidence interval (95% CI) was used to evaluate the differences between two variables; one-way ANOVA between more than two variables and the paired Student's t-test was used to estimate the evolution of functional outcomes. The postoperative mean ΔHKA was 0.9 ± 0.9°, the mean ΔMPTA was 0.7 ± 0.7°, and the mean ΔLDFA was 0.7 ± 0.8° (all values with p > 0.05, not statistically significant (ns)). All KOOS subscore's mean values were improved to an extent two-fold superior to the reported minimal clinically important difference (MCID) (all with p < 0.0001). There was a significant increase in the UCLA score at the final follow-up (5.4 ± 1.5 preoperatively versus 7.7 ± 1.4, p < 0.01). The mean time to return to sport and work was 4.7 ± 1.1 and 4.3 ± 2.1months, respectively. There was an improvement in Lower-limb discrepancy preoperative (LLD = 1.3 ± 2cm) to postoperative measures (LLD = 0.3 ± 0.4cm), ns. Complications were 2 femoral hinge fractures, 2 deep vein thromboses, 1 delayed tibial healing, and 1 hardware removal for hamstring irritation syndrome. DLO is effective and safe in achieving accurate correction in bifocal valgus malaligned knees with maintained lower limb length and low complication rate with no compromise of JLO. III.

MORPHOMETRY OF EAGLE SPECIES (FAMILY ACCIPITRIDAE) AT BALI BIRD PARK

This study measured the morphometry of raptor species (Family Accipitridae) in Bali Bird Park (BBP) namely Nisaetus cirrhatus (Changeable Hawk Eagle), Elanus caeruleus (Black Winged Kite), Spilornis cheela (Crested Serpent Eagle) and Haliaeetus leucogaster (White Bellied Sea Eagle). Measurements were made with meter tape and caliper on birds that were in their resting period. Raptor at BBP generally rest for 6 months until experience molting before being retrained for 4-5 months, then the birds will be ready to perform bird show for the next 9-12 months. Our measurements obtained the largest bird was Haliaeetus leucogaster with a total body length of 75 cm, wings length 83.5-85 cm, tail length 26 cm, head size (8 cm length and 7 cm width), upper beak (8 cm length and 2.5 cm thick) and lower beak (3 cm length and 1 cm thick), lower limb length (femur 17 cm, tibia 9 cm, metatarsus 11 cm, middle toe 6.5 cm and grip 9 cm). The smallest bird was Elanus caeruleus with a total body length of 33 cm, wing length 39-45 cm, tail length 19 cm, head size (8 cm length, 5.5 cm width), upper beak (2.5 cm length and 0.5 cm thick) and lower beak (1 cm length and 0.3 cm thick), lower limb length (femur 8 cm, tibia 4 cm, metatarsus 5 cm, middle toe 3 cm and grip 5 cm) The morphometry of the species Nisaetus cirrhatus and Spilornis cheela were between the two other bird species.

The impact of coordination-based movement education model on balance development of 5-year-old children.

With this study, it was aimed to examine the effect of coordination-based movement education model on the development of balance in 5-year-old children. The research was designed with a control group pre-test post-test design, which is one of the quasi-experimental research models. The research group consists of a total of 42 (n = 20 experimental n = 22 control) 5-year-old children formed by using the convenient sampling method, which is one of the purposeful sampling methods. Each participant's age, body weight, body length and lower extremity limb lengths were measured. As a data collection tool and used the three-part Y Balance Test (YBT) platform, which was previously stated to have high reliability (ICC = 0.85-0.93). Reach distances of the participants were measured in three directions, anterior posteromedial and posterolateral. YBT scores were determined by calculating the average and normalized values for lower extremity limb length for each reach direction of the obtained scores, and composite YBT scores were determined by taking the averages of anterior, posteromedial and posterolateral reach distance scores. In order to determine whether the collected data are suitable for normal distribution, Levene test was applied first and it was determined that p > 0.05 for all parameters as a result of the test. Independent sample T-test from parametric tests was used to determine the differences between groups. Paired-group T-test was used to determine within-group differences. According to the results of the research, it was found that the balance motor capacity levels between the experimental and control groups did not differ significantly compared to the pre-test, but there was a significant difference in all reach directions scores in favor of the post-test and experimental group compared to the control group and the pre-test. When the results of the right and left lower extremity ANT, PM, PL and Composite reach distances were examined according to gender, although there was no statistically significant difference, when the averages were considered, it was seen that all parameters were in favor of girls (p > 0.05). As a result, it was concluded that coordination-based movement education model had a positive effect on the balance motor capacities of 5-year-old children.

Force-velocity profile in sprinting: sex effect.

The ability to produce muscle power during sprint acceleration is a major determinant of physical performance. The comparison of the force-velocity (F-v: theoretical maximal force, F0; velocity, v0 and maximal power output, Pmax) profile between men and women has attracted little attention. Most studies of sex differences have failed to apply a scaling ratio when reporting data. The present study investigated the sex effect on the F-v profile using an allometric model applied with body mass (BM), fat-free mass (FFM), fat-free mass of the lower limb (FFMLL), cross-sectional area (CSA) and leg length (LL) to mechanical parameters. Thirty students (15 men, 15 women) participated. Raw velocity-time data for three maximal 35m sprints were measured with a radar. Mechanical parameters of the F-v relationship were calculated from the modelling of the velocity-time curve. When F0 and Pmax were allometrically scaled with BM (p = 0.538; ES = 0.23) and FFM (p = 0.176; ES = 0.51), there were no significant differences between men and women. However, when the allometric model was applied to Pmax with FFMLL (p = 0.015; ES = 0.52), F0 with CSA (p = 0.016; ES = 0.93) and v0 with LL (p ≤ 0.001; ES = 1.98) differences between men and women persisted. FFM explained 83% of the sex differences in the F-v profile (p ≤ 0.001). After applying an allometric model, sex differences in the F-v profile are explained by other factors than body dimensions (i.e., physiological qualitative differences).

Pédiatrie - Internal lengthening nails: a novel method of lower limb reconstruction in children

Intramedullary lengthening nails for lower limb reconstruction in children are a rapidly growing field and represent an alternative to external fixators. Today, two types of intramedullary lengthening nails are used: motorized (FITBONE) and magnetically driven (PRECISE) bone lengthening nails. Indications for limb lengthening nails are: 1) Significant lower limb length discrepancy; 2) Short stature and deformities due to musculoskeletal or dysplastic syndromes; 3) Constitutional short stature. Intramedullary lengthening surgery is challenging and represents a safe and reliable mode of treatment in patients under 18 years of age with an excellent reported outcome.

Relationship between floating toes condition and lower limb muscle weight in 8-year-old children: the Yamanashi adjunct study of the Japan Environment and Children's Study (JECS-Y).

[Purpose] Floating toe is a condition in which the toes make insufficient contact with the ground. Weak muscle strength is reportedly one cause of floating toe. However, little evidence exists regarding the relationship between foot muscle strength and floating toe. Here we examined the relationship between foot muscle strength and floating toe by investigating the children' lower extremity muscle mass and floating toe conditions. [Participants and Methods] This cohort study enrolled 118 8-year-old children (62 females, 56 males) with recorded footprints and muscle mass evaluations using dual-energy X-ray absorptiometry. We calculated the floating toe score using the footprint. We measured the muscle weights and the muscle weights divided by the lengths of the lower limbs separately on the left and right sides using dual-energy X-ray absorptiometry. [Results] No significant correlations were observed between the floating toe score and muscle weights or muscle weights divided by lower-limb lengths for either gender or side. [Conclusion] In this study, no significant correlation was found between floating toe degree and lower limb muscle mass, suggesting that lower limb muscle strength is not the primary cause of floating toe, at least in children.

Application of human data to predict hamstring tendon autograft diameter in Zhuang population

To explore the value of human data from the Zhuang population via predicting the diameter of the hamstring tendon autograft in anterior cruciate ligament (ACL) reconstruction and determining the feasibility of preoperative ultrasound for prediction. In total, 24 Zhuang patients who underwent ACL reconstruction with a 4-strand semitendinosus and gracilis tendon autograft (4 S-STG) were enrolled in this study. Before the operation, the affected semitendinosus tendon (ST) was examined by ultrasonography, and its length, diameter, cross-sectional area, and circumference were measured. The patients' basic information and body data, ie, height, weight, body mass index, lower limb length injured, and thigh circumference injured, were recorded. Their ST and gracilis tendon lengths and diameters and 4 S-STG diameter were measured during the operation. A correlation analysis was conducted between the ultrasound measurement results and human data and intraoperative tendon measurements. The ST diameter measured by ultrasound was correlated with the ST length and ST diameter measured during operation, and the ST circumference measured by ultrasound was correlated with the ST diameter measured during operation. The patients' body weight can be used to distinguish a 4 S-STG diameter of ≥8 mm (P< .01, mean difference=11.59). The area under the receiver operating characteristic curve of body weight was 0.829. The final graft diameter ≥8 mm could be predicted with a body weight of 61.5kg as the cutoff point; the sensitivity and specificity were 72.2% and 83.3%, respectively. In Zhuang patients undergoing ACL reconstruction with 4 S-STG, body weight more accurately predicted graft diameter than preoperative semitendinosus diameter.

Age at Menarche, Growth Velocity, and Adiposity Indices in Italian Girls Aged 10 to 14.

Age at menarche (AAM) is an effective marker of puberty timing but its onset could be influenced by several intrinsic and extrinsic factors. This study aimed to assess the AAM in a sample of Italian adolescents and to investigate its association with anthropometric variables. Considering the rise in overweight/obesity worldwide, special attention was paid to a possible decrease in AAM as adiposity indices increase. A longitudinal study was carried out on 117 middle school girls in Northern Italy. Data concerning menarche and anthropometric traits (standing and sitting height, weight, waist circumference, and skinfold thicknesses) were directly collected. Lower limb length and indices of adiposity and growth were calculated. The median AAM was 11.66 (95% IC: 11.31-11.68). Age-adjusted ANCOVA between mature and non-mature girls showed significant differences in growth-related traits and WHtR. No preponderance of overweight/obesity among mature participants was found. AAM was not significantly associated with weight or the growth velocity of adiposity indices in a subsample of maturers. Moreover, the median AAM of our sample was similar to that found in women born about 60 years ago in the same region. In conclusion, in addition to a stabilization of AAM since the 1960s, our results suggest that there is no significant correlation between increased adiposity and early AAM.

To Study the Correlation between Acetabular Cup Size and Vertical Offset in Primary Total Hip Arthroplasty

Study design: Prospective Observational study. Objectives: To study whether the acetabular cup size and vertical offset in primary total hip arthroplasty are correlated or both are independent of each other. If correlated, whether the acetabular cup size and vertical offset in primary total hip arthroplasty are directly related to each other or inversely. Methods: A prospective study was conducted in Department of Orthopaedics, PGIMSR, New Delhi. 25 cases of ages 20 to 70 years were identified who had undergone primary total hip arthroplasty for various indications were included in the study. All the patients were assessed post operatively for acetabular cup size and vertical offset using plain X-ray pelvis with bilateral hip joints- AP view the very next day of surgery and Lower limb length discrepancy was assessed. Results: There is a significant positive correlation between acetabular cup size and vertical offset in patients undergoing primary THA with a correlation coefficient of 0.893 and p-value &lt; 0.001.Conclusion: Accurate size and correct positioning of implant is essential in THA for restoration of normal biomechanics of hip joint and correction of LLD thereby providing a good functional outcome to the patient and there is a significant positive correlation between acetabular cup size and vertical offset in patients undergoing THR.

Величина шеечно-диафизарного угла ножки эндопротеза тазобедренного сустава как биомеханическая предпосылка развития асептической нестабильности вертлужного компонента (экспериментальное исследование)

Introduction Causes of aseptic loosening of THA components and improvement of the implants remain the subject of scientific discussions. The objective was to perform comparative analysis of the results of biomechanical modeling of cementless total hip arthroplasty using implants with different stem neck-shaft angles as a prerequisite of aseptic loosening of the acetabular component. Material and methods A biomechanical model of the pelvis and an implant with different stem neck-shaft angles was constructed based on computed tomography findings. Stresses and strains that the patient typically experienced under full weight-bearing on the operated lower limb were explored. Results The use of a stem neck-shaft angle of 125° provided the most favorable localization of the contact patch at the border of the acetabular component – the pelvic bone and lower values of equivalent stresses and contact pressure in comparison with more "valgus" femoral components (135° and 145°). Discussion The data obtained were fully consistent with the results of biomechanical studies by L. Quagliarella et al. (2006) who reported the substantial significance of the neck-shaft angle for on the parameters of contact pressure, since wear and debris-associated osteolysis decrease with a decreased neck-shaft angle. The use of stem neckshaft angles equal to 125° can be indicated for young patients with good bone quality and equal lower limb length. Unstable femoral cup can be caused by eccentric position of the contact spot at the border of the bone and the acetabular component and distribution of contact pressure and equivalent stresses inside the spot that are typical for artificial joints with stem neck-shaft angle of 145°. Conclusion The findings suggested that the value of stem neck-shaft angle was likely be considered a prerequisite for aseptic loosening of the acetabular component.

Effect of different anthropometry-driven block settings on sprint start performance

Few studies have focused on the effect of individual anthropometrics when considering “set” position posture during the sprint start. This study aimed to measure the effect of different anthropometry-driven block settings on kinetic and kinematic parameters and performance during the start in well-trained and non-trained sprinters. Front block-starting line (FB/SL) distance was manipulated between 50% and 70% of each individual’s leg length at 5% intervals, whilst the inter-block distance was held constant at 45% of leg length. Thirty-six sprinters performed three maximal-effort 10 m sprints in each of the five conditions. Joint angles in the “set” position were quantified though 2D video analysis, the forces generated during block clearance phase were measured by dynamometric starting blocks, and times to 5 m and 10 m were measured with photocells. The effects of the five block setting conditions were largely consistent irrespective of ability level. Shorter FB/SL distances were associated with significantly more flexed hip and knee angles in the “set” position, a significantly more plantar flexed front ankle, and a significantly more dorsiflexed rear ankle. There were no significant effects of FB/SL distance on total block time, and thus the greater rear block peak forces and impulses produced from the shorter FB/SL distances combined with no effects on the resultant front block peak forces and impulses, led to higher levels of sprint start performance from the shorter FB/SL distances. Considering FB/SL distances closer to 50% of leg length may be beneficial for coaches and athletes to explore during sprint start training. Highlights The effects of different front-block starting line distances on “set” position kinematics, block clearance kinetics and sprint start performance are largely consistent irrespective of ability level. When using a medium inter-block distance (45% of leg length), shorter front block-starting line distances (down to 50% of the leg length) led to improved sprint start performance. From shorter front block-starting line distances, sprint start performance was primarily improved through greater force production against the rear block which led to greater impulses due to no change in push durations or resultant front foot forces. Lower-limb length is an important consideration when adjusting anteroposterior block distances.

Clinical effect of Corail femoral prosthesis with different offset in total hip arthroplasty

To explore the early clinical efficacy of primary total hip arthroplasty(THA) with Corail standard stems (KS type) and high offset stems (KHO type), by analyzing the postoperative radiographic parameters of different offset of femoral components with Corail stem which has a neck-shaft angle of 135 ° in unilateral primary THA, by comparing the measurement results on both sides and analyzing the reconstruction of the postoperative femoral offset and the hip joint function recovery. A retrospective analysis was made of 186 patients with unilateral hip joint lesions who underwent the first total hip arthroplasty with Johnson & Johnson Corail prostheses from January 2015 to June 2017. According to the use of femoral prostheses with different eccentricities during the operation, the patients were divided into high eccentricity group and standard eccentricity group. In the high eccentricity group, there were 52 cases of Corail high eccentricity prosthesis(KHO type), including 20 females and 32 males;aged 21 to 71 years old with an average of(50.6±13.2) years;body mass index(BMI) was (26.0±4.1) kg/m2. The standard eccentricity group included 134 Corail standard femoral stem prostheses(KS type), 57 females and 77 males;aged 18 to 77 years old with an average of (47.3±14.0) years;BMI was (25.3±3.5) kg/m2. The abduction arm, femoral eccentricity, acetabular eccentricity and the length difference of lower limbs were measured on the postoperatively positive X-ray film of the hip joint. Harris score and related complications were recorded before and after the operation, and the stability of the prosthesis was analyzed. There were significant differences in femoral eccentricity, joint eccentricity and abduction arm between the affected side and the healthy side in the high eccentricity group(P<0.05). There were significant differences in femoral eccentricity and acetabular eccentricity between the affected side and the healthy side in the standard eccentricity group(P<0.05). There were significant differences in combined eccentricity, abduction arm and length of lower limbs between two groups(P<0.05). In the high eccentricity group, the abduction arm of the affected hip joint was positively correlated with the femoral eccentricity, acetabular eccentricity and joint eccentricity(r=0.633, P<0.001;r=0.384, P=0.005;r=0.690, P<0.001). The same results were also obtained in the healthy side(r=0.688, P<0.001;r=0.574, P<0.001;r=0.765, P<0.001). In the standard eccentricity group, the abduction arm of the affected hip joint was positively correlated with the femoral eccentricity, acetabular eccentricity and combined eccentricity(r=0.734, P<0.001;r=0.418, P<0.001;r=0.749, P<0.001). The same results were also obtained in the healthy side(r=0.775, P<0.001;r=0.397, P<0.001;r=0.773, P<0.001). The difference of the length of both lower limbs was significantly correlated with the difference of bilateral joint eccentricity and bilateral abduction arm (r=0.376, P=0.006;r=-0.346, P=0.012). There was no significant correlation between the difference of the length of both lower limbs and the difference of bilateral joint eccentricity and bilateral abduction arm (r=-0.009, P=0.919;r=-0.036, P=0.682). There was no significant difference in Harris score between two groups at the last follow-up(P>0.05). At the last follow-up, Trendelenburg was negative in all patients in both groups, and the prostheses were stable. Both Corail standard stem and high offset stem may be effectively reconstruct the femoral offset, reconstruct the anatomical structure and biomechanics of the hip joint, and maintain the length of lower limbs and the stability of the hip joint in the unilateral primary total hip arthroplasty. Although the offset of the femur was not reconstructed normally in some cases, the stability of the components and postoperative function were not affected.

ANTHROPOMETRIC MODELING OF LOWER EXTREMITIES LENGTH OF STUDENTS OF HIGHER EDUCATION INSTITUTIONS DEPENDING ON THE SPORT TYPE

Taking into account the literature, further establishment of anthropometric parameters according to individual sports, followed by building a model to solve problems of selection and sports orientation is relevant and necessary in modern sports Creating the model based on anthropometric parameters will allow us to coduct sports selection among future athletes in order to achieve excellent results in professional sports. The objective of the study was to fi nd out the features of the length of the lower extremities depending on the sport type, followed by building a model for predicting their length.А comparative analysis of anthropometric parameters of the lengths of the lower extremities depending on the sport on 129 students of higher education, aged 16 to 18 years, who were divided into main – 89 (69%) and control group – 40 (31%), followed by model building predicting their length of the lower extremities. The length of the right lower extremities of the studied students of the main group is: volleyball – 91.72±3.0 cm; football – 90.02±3.0 cm; basketball – 89.42±3.0 cm; wrestling – 89.80±3.0 cm; tennis – 89.60±3.0 cm; wrestling – 89.80±3.0 cm; fi tness – 86.55±2.0 cm. Students in the control group, the average length of the right lower extremities is – 85.90±2.0 cm. The length of the left lower extremities of the studied students of the main group is: volleyball – 91.38±3.0 cm; football – 89.72±3.0 cm; basketball – 89.57±3.0 cm; wrestling – 89.40±3.0 cm; tennis – 89.20±3.0 cm; fi tness – 86.66±2.0 cm. Students in the control group, the average length of the left lower extremities is – 85.72±2.0 cm.Anthropometric study (length of the lower extremities) was performed according to the method of VV Bunak in the modifi cation of PP Shaparenko. Statistical analysis of the data was performed using a licensed program RStudio.Comparing the length of the right lower extremity depending on the sport found a signifi cant diff erence in the length of the right lower extremity in the pairs «football»-»fi tness», «volleyball»-»fi tness», «football»-»control group», «volleyball»-»control group», comparing the length of the left lower limb in pairs «volleyball»- »fi tness», «football»-»control group», «volleyball»-»control group». No signifi cant diff erence in the average length of the right and left upper extremities of both study groups was found (main group – 89.51±3.0 cm – right, 89.32±3.0 cm – left; control – 85.90±3.0 cm – right, 85.72±3.0 cm – left).It was found that a signifi cant factor for the length of both lower extremities is growth (based on regression analysis). Based on this, a model for predicting the length of the lower extremities is derived: L = 0.422 x h, (where L is the length of the upper extremity, h is the height).