Narrow Joint Research Articles

The Effect of TENS and Ultrasound Diathermy on Osteoarthritis Patients in Physical Medicine and Rehabilitation Unit of Patut Patuh Patju Hospital, West Nusa Tenggara

Osteoarthritis is generally recognized as a common musculoskeletal condition in Indonesia, characterized by the degeneration of joint cartilage and narrowing of the joint space. The form of therapy that can be given to knee OA patients is a combination of TENS therapy and ultrasound diathermy (USD). WOMAC is an index used to measure osteoarthritis patiens based on pain, stiffness, and physical function. Patut Patuh Patju General Hospital is the only hospital in West Lombok district where physical medicine and medical rehabilitation have recently been introduced. This research aims to determine the effects of administering TENS and ultra sound diathermy on OA patients in the physical medicine and rehabilitation unit of Patut Patuh Patju Hospital, a newly established district hospital in NTB, which has been operational for the past year. This type of research uses a pre-experimental design with a one group pretest-posttest method. Sampling was taken using a purposive sampling technique with a total sample of 30. The research population was knee osteoartritis patients undergoing physiotherapy treatment at the Medical Rehabilitation Unit of Patut Patuh Patju General Hospital. Data was collected using the WOMAC questionnaire before and after 6 until 8 times therapy. The distribution of research data was analyzed using the Shapiro-Wilk test. If the data distribution is normal, it is analyzed using the paired t-test, whereas if it is not normal, it is analyzed using the Wilcoxon test. The combination of TENS therapy and ultra sound diathermy results in improvement of WOMAC scores in knee osteoarthritis patients with p-value = 0.000 (p < 0.05).

Prediction of the Upwarp Buckling Critical Temperature Rise for Longitudinally Connected Slab Track Under Joint Damage State

The joint of longitudinally connected slab track is vulnerable to damage from environmental impacts and repeated train loads. Under high temperature environments, the joint becomes a high risk area for track slab upwarp, which significantly affects the upwarp stability of the track slab and the safe operation of trains. This study employs the arc length approach and a finite element model to investigate the upwarp equilibrium development path of the track slab, the upwarp evolution process of the track slab under the joint damage is further analyzed. Then, the influence of different initial defects on the vertical stability of the track slab is studied. Utilizing dimensional analysis, a general formula for calculating the critical temperature rise of the track slab is proposed. The results are as follows: (1) The entire upwarp process of track slab under joint damage can be divided into three stages: stability, upwarping development, and instability. (2) A nonlinear correlation exists between the upwarp critical temperature rise of the track slab and three types of initial defects. Height defects in narrow joints exert the most significant impact on the critical temperature rise, followed by initial Out-of-straight (initial OOS), with the initial bending shape having the least effect. The complete defect of the narrow joint reduces the upwarp critical temperature rise of the track slab by 53.26°C, a 48.4% reduction. (3) A unified expression, derived from the characteristic parameters of initial defects and dimensional analysis, can more accurately predict the upwarp critical temperature rise of the track slab.

Changes of bone and articular cartilage in broilers with femoral head necrosis

Femoral head necrosis (FHN) in broilers is a common leg disorder in intensive poultry farming, giving rise to poor animal health and welfare. Abnormal mechanical stress in the hip joint is a risk factor for FHN, and articular cartilage is attracting increasing attention as a cushion and lubrication structure for the joint. In the present study, broilers aged 3 to 4 wk with FHN were divided into femoral head separation (FHS) and femoral head separation with growth plate lacerations (FHSL) groups, with normal broilers as control. The features of the hip joint, bone, and cartilage were assessed in FHN progression using devices including computed tomography (CT), atomic force microscope (AFM), and transmission electron microscopy (TEM). Broilers with FHN demonstrated decreased bone mechanical properties, narrow joint space, and thickened femoral head stellate structures. Notably, abnormal cartilage morphology was observed in FHN-affected broilers, characterized by increased cartilage thickness and rough cartilage surfaces. In addition, as FHN developed, cartilage surface friction and friction coefficient dramatically increased, while cartilage modulus and stiffness decreased. The ultramicro-damage occurred in chondrocytes and the extracellular matrix (ECM) of cartilage. Cell disintegration, abnormal mitochondrial accumulation, and oxidative stress damage were observed in chondrocytes. A notable decline in cartilage collagen content was observed in ECM during the initial stages of FHN, accompanied by a pronounced reduction in collagen fiber diameter and proteoglycan content as FHN progressed. Furthermore, the noticeable loosening of the collagen fiber structure and the appearance of type I collagen were noted in cartilage. In conclusion, there was a progressive decrease in bone quality and multifaceted damage of cartilage in the femoral head, which was closely linked to the severity of FHN in broilers.

Pterostilbene Protects against Osteoarthritis through NLRP3 Inflammasome Inactivation and Improves Gut Microbiota as Evidenced by In Vivo and In Vitro Studies.

Osteoarthritis (OA) is a persistent inflammatory disease, and long-term clinical treatment often leads to side effects. In this study, we evaluated pterostilbene (PT), a natural anti-inflammatory substance, for its protective effects and safety during prolonged use on OA. Results showed that PT alleviated the loss of chondrocytes and widened the narrow joint space in an octacalcium phosphate (OCP)-induced OA mouse model (n = 3). In vitro experiments demonstrate that PT reduced NLRP3 inflammation activation (relative protein expression: C: 1 ± 0.09, lipopolysaccharide (LPS): 1.14 ± 0.07, PT: 0.91 ± 0.07, LPS + PT: 0.68 ± 0.04) and the release of inflammatory cytokines through NF-κB signaling inactivation (relative protein expression: C: 1 ± 0.03, LPS: 3.49 ± 0.02, PT: 0.66 ± 0.08, LPS + PT: 2.78 ± 0.05), ultimately preventing cartilage catabolism. Interestingly, PT also altered gut microbiota by reducing inflammation-associated flora and increasing the abundance of healthy bacteria in OA groups. Collectively, these results suggest that the PT can be considered as a protective strategy for OA.

Flexural performance of UHPC-filled narrow joints between precast concrete bridge slabs

The deck slabs narrow joints in concrete bridges filled with Ultra-high performance concrete (UHPC) have the potential for wide application and high-efficiency promotion, but there is limited research available on this topic. This paper conducted flexural tests on the new joints. Ten precast concrete deck panels were designed and manufactured for concrete bridges. These panels were connected using UHPC-filled narrow joints. Combined with stress analysis, this study investigates the influence and mechanism of various factors on the mechanical performance of UHPC joints. These factors include the geometric shape of the joint, the roughness of the joint interface, the filling material used in the joint, the width of the joint, and the configuration of joint reinforcement (including the shape and length of lap reinforcement). The test results show that the panel with the UHPC joint filled with steel fibers has excellent flexural and bonding capacity. The jointed panel with a lap length of 140 mm and 120 mm has better flexural performance than the one with a lap length of 90 mm. The straight-jointed panel has a higher flexural capacity compared to the complex triangular-jointed panel. Additionally, reducing the joint width can achieve similar mechanical properties as before. A method has been proposed for calculating the flexural capacity of a jointed panel, utilizing the strut-and-tie model (STM). This method can accurately predict experimental results.

Experimental study on direct-shear behaviour of narrow joints in socket connections for precast pier-to-pile footing systems

The application of precast concrete segmental piers in modern construction, being economic and environmental, is an inevitable global trend. With the ease of construction and high performance, socket connections have a broad prospect for substructures, which can connect precast piers to footings with preformed sockets through narrow joints grouted by high-performance cement-based materials. However, these joints are different in direct-shear behaviour than those in precast concrete segmental beams. In this study, the direct-shear behaviour of narrow joints in socket connections for precast pier-to-pile footing systems is investigated through experimental analysis. The joint specimens were designed as full-scale local models for push-out tests. The results reveal that improving the tensile strength of the grouting material by applying steel-fiber reinforced concrete or self-compacting concrete, decreasing the width of the joints and increasing the number of shear keys are all beneficial to improve the direct-shear performance, while the use of corrugated steel pipes as a stay-in-place formwork without additional reinforcements in footings reduces this characteristic.

Radiographic Incidence of Knee Osteoarthritis After Isolated ACL Reconstruction Versus Combined ACL and ALL Reconstruction: A Prospective Matched Study from the SANTI Study Group

Objectives: The aim of this study was to evaluate the incidence of OA with isolated ACLR in comparison with ACLR with ALLR at medium-term follow-up. We hypothesized that there would be no differences between the groups. Methods: Patients who underwent ACLR 1 ALLR with hamstring tendon autograft between January 2011 and March 2012 were propensity matched to patients who underwent isolated ACLR with bone–patellar tendon–bone (BPTB) or hamstring tendon autograft in the same period. Medium-term radiographic evaluation was performed using the International Knee Documentation Committee (IKDC) radiographic OA grading scale, modified Kellgren-Lawrence grade, and the surface fit method to assess percentage of joint space narrowing. Clinical outcomes were assessed with the following measures: IKDC, Knee injury and Osteoarthritis Outcome Score (KOOS), Lysholm, Tegner, and ACL Return to Sport after Injury. Results: A total of 80 patients (42 ACLR 1 ALLR and 38 isolated ACLR) were analyzed with a mean follow-up of 104 months. There was no significant difference between groups for joint space narrowing in the medial or lateral tibiofemoral or lateral patellofemoral (PF) compartment. However, 36.8% in the isolated ACLR group versus 11.9% in the ACLR 1 ALLR group had narrowing of the medial PF compartment (P = .0118). A lateral meniscal tear increased the risk of lateral tibiofemoral narrowing by nearly 5 times (odds ratio, 4.9; 95% CI, 1.547-19.367; P = .0123). The risk of medial PF narrowing was .4-fold with an isolated ACLR (odds ratio, 4.8; 95% CI, 1.44-19.05; P = .0179). Between the isolated ACLR group and the ACLR 1 ALLR group, the secondary meniscectomy rate was 13.2% versus 11.9% (not significantly different). There was no difference between groups in KOOS, Tegner, or IKDC scores. There was also no difference between groups for grades of osteoarthritic change for any classification system. Patients who received a BPTB graft had medial PF joint narrowing in 66.7% of cases as compared with 11.9% in those who received ACLR 1 ALLR (P = 0.118). Conclusions: ACLR 1 ALLR did not increase the risk of OA in the lateral tibiofemoral compartment when compared with an isolated] ACLR at medium-term follow-up. Isolated ACLR using BPTB was associated with a significantly increased risk of medial PF joint space narrowing.

Functional Assessment of Human Articular Cartilage Using Second Harmonic Generation (SHG) Imaging: A Feasibility Study.

Many arthroscopic tools developed for knee joint assessment are contact-based, which is challenging for in vivo application in narrow joint spaces. Second harmonic generation (SHG) laser imaging is a non-invasive and non-contact method, thus presenting an attractive alternative. However, the association between SHG-based measures and cartilage quality has not been established systematically. Here, we investigated the feasibility of using image-based measures derived from SHG microscopy for objective evaluation of cartilage quality as assessed by mechanical testing. Human tibial plateaus harvested from nine patients were used. Cartilage mechanical properties were determined using indentation stiffness (Einst) and streaming potential-based quantitative parameters (QP). The correspondence of the cartilage electromechanical properties (Einst and QP) and the image-based measures derived from SHG imaging, tissue thickness and cell viability were evaluated using correlation and logistic regression analyses. The SHG-related parameters included the newly developed volumetric fraction of organised collagenous network (Φcol) and the coefficient of variation of the SHG intensity (CVSHG). We found that Φcol correlated strongly with Einst and QP (ρ = 0.97 and - 0.89, respectively). CVSHG also correlated, albeit weakly, with QP and Einst, (|ρ| = 0.52-0.58). Einst and Φcol were the most sensitive predictors of cartilage quality whereas CVSHG only showed moderate sensitivity. Cell viability and tissue thickness, often used as measures of cartilage health, predicted the cartilage quality poorly. We present a simple, objective, yet effective image-based approach for assessment of cartilage quality. Φcol correlated strongly with electromechanical properties of cartilage and could fuel the continuous development of SHG-based arthroscopy.

Real-time detection and localization method for weld seam of narrow butt joint based on semantic segmentation

Structured light measurement is widely used in welding seam tracking because of its high precision and robustness. For the narrow butt joint, the positioning method by reconstructing the weld contour is not suitable for the welding of the narrow butt joint because it is difficult for the laser stripe to produce obvious deformation when projected to the weld. In this study, high-quality images with laser stripes and narrow butt joints are captured by the improved structured light vision sensor, which is equipped with an auxiliary light source. A two-step processing framework, including semantic segmentation and groove positioning, is raised to locate the feature point of the narrow butt joint. Firstly, we design the strip pooling ENet (SP-ENet), a real-time network specifically designed to accurately segment narrow weld images. Our proposed network outperforms other classical segmentation networks in terms of segmentation accuracy and proves to be highly suitable for the detection of narrow butt joint welds. Secondly, a combining method of random sample consensus (RANSAC) and iterative fitting to calculate the sub-pixel coordinates of weld feature points accurately. Finally, a trajectory smoothing model based on the Kalman filter is proposed to reduce the trajectory jitter. The above methods were tested on a self-built robotic welding experimental platform. Experimental results show that the proposed method can be used for real-time detection and positioning of narrow butt joints. The positioning trajectory is smooth, with most positioning errors less than 2 pixels. The mean tracking error reaches 0.207 mm, which can meet the practical welding requirements.

Humeral head size predicts baseplate lateralization in reverse shoulder arthroplasty: a comparative computer model study

BackgroundIn reverse shoulder arthroplasty (RSA), the ideal combination of baseplate lateralization (BL), glenosphere size (GS) and overhang (GOH) with a commonly used 145° neck shaft angle (NSA) is unclear. This is the first study evaluating correlations of body height (BH), humeral head size (HS), glenoid height (GH) and association of gender with best glenoid configurations for range of motion (ROM) maintaining anatomic lateralization (aLAT) for optimized muscle length in 145° and less distalized 135° RSA. MethodsIn this computer model study, 22 CTs without joint narrowing were analyzed (11 male/female). A standardized semi-inlay 145° platform stem was combined with 20 glenoid configurations (baseplate (B) 25, 25+3/+6 lateralized (l), 29, 29+3/6l combined with glenosphere36, 36+2eccentric (e), 36+3l, 39, 39+3e, 39+3l , 42, 42+4e). Abduction-adduction, flexion-extension, external rotation-internal rotation, total ROM (TROM) and total notching relevant (TNR) ROM were computed, best TROM models respecting aLAT (-1mm to +1mm) and HS/GH recorded. Secondly, the 145° models (Ascend Flex stem; Stryker, Kalamazoo, MI, USA) were converted and compared to a 135° inlay RSA (New Perform stem; Stryker, Kalamazoo, MI, USA) maintaining GOH (6.5-7mm) and aLAT. ResultsBest 145° models had eccentric glenospheres (mean BL: 3.5mm, GOH 8.8mm, GS 38.1mm, distalization (DIS) 23mm). The 135° models had concentric glenospheres, mean BL 3.8mm, GOH 6.9mm, GS 39.7mm, DIS 14.1mm. Head size showed the strongest positive correlation with BL in 145° and 135° models (0.65/0.79). Despite reduced GOH in smaller females with a 135° NSA, adduction, external rotation, extension, TNR ROM and TROM were significantly increased (p=0.02, p=0.005, p=0.005, p=0.004, p=0.003), abduction however reduced (p=0.02). The same trends were seen for males. ConclusionsHead size is a practical measure in surgery or preoperatively, and the strong positive correlation with BL is a useful planning aid. Despite reduction of GOH, conversion to a less distalized 135° NSA is powerful to maintain and even significantly increase all components of TNR ROM (extension/external rotation/adduction) in small females with the drawback of reduced abduction which may however be compensated by scapula motion. Lateralization with a less distalized 135° RSA optimizes muscle length, may facilitate subscapularis repair and maintains highest rigid body motion.

Bond behavior between Fe-SMA strips and mortar in masonry joint after resistive heating

In recent years, iron-based shape memory alloys (Fe-SMA) have attracted much interest as an innovative prestressing material with the ability to eliminate the need for on-site tensioning and complex anchoring. This unique property offers application potential for using Fe-SMA to effectively strengthen masonry structures, especially in narrow space joint strengthening applications. Here, based on the premise that the Fe-SMA needs heating to generate prestress, the bond characteristics between the Fe-SMA strips and mortar in the masonry joint after resistive heating were investigated. The effects of various factors, such as heating time, strips surface condition, and bond length, on the bond behaviors were analyzed. The results show that under reasonable resistance heating conditions, Fe-SMA did not significantly damage the bonding interface during masonry joint strengthening. After resistive heating at a heating temperature of 200 °C and a heating time of 30 s, the bond strength of the specimens remained high, and it only decreased by 9.38 %∼10.36 % of the bond strength of the unheated specimen. Following the rough surface treatment of Fe-SMA strips, the bonding properties of the Fe-SMA strips were obviously improved before and after resistive heating, and bond energy dissipation was the clearest performance increase to over 5 times the original value. In addition, a prediction model for the bond strength between the Fe-SMA strip and mortar in masonry joint strengthening after resistive heating was proposed and could provide references for subsequent studies.

Conventional Radiography of Grade III Knee Osteoarthritis: A Case Report

Introduction: Osteoarthritis (OA) is the most common form of inflammatory joint disease. It occurs most frequently in the knees, hips, the spine (vertebrae), and ankles. Radiological prevalence of knee OA in Indonesia reaches 15.5% in men and 12.7% in women aged between 40-60 years. X-ray imaging is routinely used in clinical practice to confirm knee OA diagnosis and in clinical research to monitor the progression of knee OA. Case report: A 62-year-old female patient presented with knee pain in both knees that had been ongoing for the past 6 months. The pain was described as throbbing and stabbing, the right knee worse affected than the left. Palpation elicited tenderness, crepitus in both joints and did not reveal any deformities. Radiological AP/Lateral X-ray of the right knee revealed evidence of osteophytes, sclerosis and narrowing joint space, leading to the impression of Grade III osteoarthritis in the right knee. Discussion: Joint pain is the chief complaint that leads patients with knee osteoarthritis to seek medical attention. Pain typically worsens with movement and decreases with rest. In diagnosing OA, an AP/Lateral radiographic examination of the right knee is conducted, revealing the presence of osteophytes, subchondral bone sclerosis and accompanied by slight joint narrowing. This impression aligns with the Grade III OA criteria according to the Kellgren-Lawrence grading system. Conclusion: Diagnosis of osteoarthritis involves a comprehensive approach combining medical history, physical examination, and diagnostic tests. Radiographic examinations including conventional radiography play a significant role in diagnosing OA. In the early stages of the disease, joint radiographs may still appear normal. The severity of knee OA can be evaluated using the Kellgren-Lawrence (KL) grading scheme which ranges from grade 0 to grade 4. Keywords: Knee Osteoarthritis, Conventional Radiography, The Kellgren-Lawrence Grading

Experimental evaluation of poly methyl methacrylate-acrylonitrile butadiene styrene transmission welding using mold-integrated simultaneous laser welding technology

Automotive lamps have not only functional roles but also highly esthetic purposes in the design of a car. As such, they use complex three-dimensional shapes to implement various designs. The main manufacturing challenge comes from the plastic bonding process of the complex components, which currently is done by thermal bonding, ultrasonic bonding, and laser welding. Laser welding processes with a narrow joint area are preferred since they require minimal joint area and produce no burr. In this study, an optimization study for simultaneous bonding of lamps is carried out using multiple light sources generated by connecting specially manufactured bundle optical fibers with a diode laser source. The diode laser beams with a wavelength of 915 nm and a power of 80 W, each, were simultaneously delivered through a 30-optical fibers bundle. The fibers were integrated within the mold that holds the lamp achieving transmission welding through the overlapped upper transparent polymer PMMA (IF850) and the lower nontransparent polymer ABS (HL121H). The process parameters investigated were the laser power, duration time, waveguide gap, and clamping pressure. We present optimized process parameters that achieved no pores and relatively uniform melting. In the shear test, the average load was approximately 1300 N, and the base sheet fractures along the welding joints were observed.

Radiographic joint space width in individuals with hand osteoarthritis: Are their “healthy” joints really healthy?

We aimed to investigate the systemic nature of hand osteoarthritis (OA). We hypothesized that people who suffer from hand OA will display narrower radiographic joint space width (JSW) - not only in joints with apparent radiographic OA but also in their unaffected "healthy" joints. We examined 3394 participants from the Osteoarthritis Initiative (OAI) with available dominant hand radiographs at baseline. Cases were defined as having interphalangeal OA (IPOA) based on a Kellgren and Lawrence (KL) score of ≥2 in two or more finger joints, whereas controls did not have IPOA. We used custom software to make JSW measurements of the metacarpophalangeal (MCP), proximal interphalangeal (PIP), and distal interphalangeal (DIP) joints in fingers 2-5 per hand. In joint-level analyses, we included only KL score = 0, allowing us to compare all joints without IPOA in cases and controls. We used generalized estimating equation (GEE) models to compare JSW between both groups, adjusted for age, gender, metacarpal length, and joint type. Finger joints without radiographic OA had significantly narrower JSW in the IPOA group compared to finger joints in the control group (p<0.001). The differences were significant across all joint types and for both total JSW measurements as well as for central and lateral sub-regions within each joint group (p<0.001). Unaffected finger joints in people with IPOA had narrower joint space than joints of healthy controls. This implies a systemic nature of hand OA, in which people may have a predisposition for general cartilage deterioration.

Angelica sinensis polysaccharide improves mitochondrial metabolism of osteoarthritis chondrocytes through PPARγ/SOD2/ROS pathways.

Osteoarthritis (OA) is a common degenerative joint disease, which is characterized by wear of articular cartilage and narrow joint space, resulting in joint movement disorder. At present, accurate molecular mechanisms and effective interventions are still being explored. Here, we propose that angelica sinensis polysaccharide (ASP) alleviates OA progression by activating peroxisome proliferator-activated receptor gamma (PPARγ). Therapeutic effect of ASP improving mitochondrial metabolism of OA chondrocytes was evaluated in vitro and in vivo, respectively. During cell experiments, the concentration and time response of tert butyl hydroperoxide (TBHP) and ASP were determined by cell viability. Apoptosis was detected by flow cytometry. Mitochondrial metabolism was detected by reactive oxygen species (ROS), mitochondrial membrane potential (MMP), release of cytochrome C, adenosine triphosphate (ATP) production, and superoxide dismutase 2 (SOD2) activity. Expressions of Aggrecan, collagen type II (Col2a1), PPARγ, and SOD2 were detected by qRT-PCR and western blot. In animal experiments, we detected cell apoptosis and target protein expression separately through terminal deoxynucleotidyl transferase dUTP nick end-labeling (TUNEL) staining and immunohistochemistry. Pretreatment of ASP significantly activated PPARγ and SOD2 in rat chondrocytes incubated with TBHP, cleared ROS, improved mitochondrial metabolism, increased chondrocytes viability, and alleviated chondrocytes apoptosis. In vivo, the administration of ASP could effectively ameliorate cartilage degeneration in OA rats, promote extracellular matrix synthesis, and decelerate the progress of OA. Our research identifies the role of ASP in mitochondrial metabolism of OA chondrocytes through PPARγ/SOD2/ROS pathways, which provides a new idea for the treatment of OA.

Time-variant reliability of interlayer damage of CRTS-II slab track by combining the second-order fourth-moment and outcrossing method

This study proposes the combining second-order fourth-moment and outcrossing method for evaluating the time-variant reliability of slab tracks’ interlayer damage. The merit of the method is to improve significantly the computing efficiency and accuracy for the implicit and strong nonlinear limit state function. Furthermore, the effects of narrow joints damage and temperature load on the time-variant reliability of slab tracks’ interlayer damage are investigated. Narrow joints damage is an inducement for the decrease of time-variant reliability index of slab tracks’ interlayer damage, and the index decreases more violently with the increase of temperature rise than that of positive temperature gradient.

Role of Ultrasonography in The Diagnosis of Knee Joint Lesions

Introduction: Ultrasound can provide clinically useful information on a wide range of pathologic conditions affecting components of the knee joint, including the tendons, ligaments, muscles, synovial space, articular cartilage, nerves and surrounding soft tissues. The advantages of ultrasound include low cost, portability, real-time assessment, and facilitated side-by-side comparisons. The aim of the study was to study the various pathological conditions of painful knee joint by using ultrasound for early diagnosis and prompt therapeutic approach and to evaluate the osteoarthritic changes in the painful knee joint by ultrasound. Materials and Methods: This is a prospective observational study conducted in the Department of Radiology and Orthopedics&amp; trauma surgery, National Medical College &amp; teaching hospital, Birgunj, Parsa, Nepal for the 6 months duration, patients presented with knee joint pathology including swelling, and pain.Patients included in this study was above 20 years with unilateral (single) knee joint pain. With ethical clearance from the Institutional Review Committee of National Medical College and after obtaining the informed consent of the patient, prospective observational study was conducted. All ultrasound assessments were performed using the same machine with a 9 MHz linear transducer of GE Logiq P7 USG machine. A30–45-degree flexion of the knees was standardized by using the same wedge for all ultrasound assessments. Results: This study included 40 symptomatic patients with knee joints pain included in this study. In 40 patients 19 were females (47.5%) and 21 males (52.5%), with ages ranged from 20 to 70 years. Ultrasound findings showed joint effusions in 25 (62.5 %) as most common finding in painful knees,synovial thickening in 17 (42.5 %) knees, Synovitis in 14 (35.0%) and tendinopathy seen in only 1 (2.5%) knee joint pain. Osteoarthritis such as narrow joint space in 4 (10%) knees, marginal osteophytes in 4 (10%) knees, loose bodies in 3 (7.5%) knees, Baker’s cyst in 1 (2.5%) knee. Most common involved age group is 51-60 years with 17 cases followed by 41-50 years in 11 cases. Conclusion: Ultrasound is a simple and reproducible technique for the assessment of knee joint effusion, synovial changes and osteoarthritis related changes.

Patellar malalignment correlates with increased pain and increased synovial stress hormone levels-A cross-sectional study.

Risk factors for the development of pain in the context of knee osteoarthritis (KOA) remain unclear. Radiological findings often do not correlate with clinical findings, so other pathomechanisms in the development and perception of pain must play a role. The purpose of this study is to investigate the correlation of increased sympathetic nervous system (SNS) activity (measured by subjective and objective chronic stress parameters) with KOA severity, patellofemoral malalignment, and pain. 47 patients with KOA were assessed. Radiological measurements of tibiofemoral and patellofemoral parameters (Kellgren-Lawrence-score, patellar tilt (PT), Caton-Deschamps-Index and Hepp´s classification) were performed and correlated with knee-specific questionnaires (WOMAC®, KSS©) and chronic stress questionnaires (PSQ-20). Additionally, parameters associated with chronic stress were quantified in synovial fluid and serum samples from patients. PT correlated significantly with Caton-Deschamps-Index (r = 0.394,p = 0.006) and with medial patellofemoral joint space (r = 0.516,p<0.001). In addition, asymmetric trochlear groove (Hepp's classification > II) was associated with significantly higher PT values (p = 0.014). A negative correlation between PT and KSS©-symptoms subgroup was found (r = -0.340,p = 0.024). Patients with PT<5° had significantly higher scores in the Knee Society Score©-symptoms subgroup (p = 0.038). A positive and significant correlation between synovial aldosterone levels and PT was observed (r = 0.548,p = 0.042). The results of this study indicate that patellar malalignment might correlate with increased pain. The previous specification of standard PT values must be reconsidered as even low PT values seem to play a role in the occurrence of patellofemoral osteoarthritis symptoms. Lower PT values might lead to aggravated symptoms in patients with KOA due to a narrow medial patellofemoral joint space. In addition, PT might induce the release of synovial stress biomarkers and thus contribute to the progression of KOA.

Effect of joint width on shear behaviour of wet joints using reactive powder concrete with confining stress

The filling concrete in a wet joint without steel reinforcements of precast segmental bridges is one of the weakest part of the bridges under shear. The joint width tends to be narrowed in construction, but structural shear behaviour might be different when the joint geometry varies. Therefore, it is crucial to study the shear behaviour of wet joints with various joint widths. In this study, the shear behaviour of wet joints with confining stress induced by the effect of joint width was investigated via experimental research and numerical simulation. A calculation model was proposed to evaluate the shear capacity of wet joints considering the effect of joint width. The experimental results revealed different failure modes of wide and narrow joints with a change in the force transmitting path. The wide joint exhibited brittle failure with one diagonal crack, whereas two symmetrical cracks were observed in the narrow joint before its failure. The load–displacement curve of the narrow joint exhibited two fluctuations, whereas that of the wide joint exhibited only one. These fluctuations represented the number of the cracks occurring in the joints. The numerical results demonstrated that the rotation effect, which was induced by different joint widths, caused a longer crack in the wide joints. Additional concrete was involved in the shear load transfer because the vertical area of shear component along the crack expanded. The average ratio of the calculations from the proposed formula to the results of this study and previous researches was 1.14, which showed to be accurate to predict the shear capacity of the wet joints.

Indications of musculoskeletal health in deceased male individuals with lower-limb amputations: comparison to non-amputee and diabetic controls

Individuals with lower-limb amputations, many of whom have type 2 diabetes, experience impaired musculoskeletal health. This study: (1) compared residual and intact limbs of diabetic and non-diabetic post-mortem individuals with amputation to identify structures vulnerable to injury, and (2) compared findings to diabetic and healthy control groups to differentiate influences of amputation and diabetes on musculoskeletal health. Postmortem CT scans of three groups, ten individuals each, were included: (1) individuals with transtibial or transfemoral amputations, half with diabetes (2) diabetic controls, and (3) healthy controls. Hip and knee joint spaces, cross-sectional thigh muscle and fat areas, and cross-sectional bone properties (e.g. area, thickness, geometry) were measured. Wilcoxon Signed-Rank and Kruskal–Wallis tests assessed statistical significance. Asymmetry percentages between limbs assessed clinical significance. Residual limbs of individuals with amputation, particularly those with diabetes, had significantly less thigh muscle area and thinner distal femoral cortical bone compared to intact limbs. Compared to control groups, individuals with amputation had significantly narrower joint spaces, less thigh muscle area bilaterally, and thinner proximal femoral cortical bone in the residual limb. Diabetic individuals with amputation had the most clinically significant asymmetry. Findings tended to align with those of living individuals. However, lack of available medical information and small sample sizes reduced the anticipated clinical utility. Larger sample sizes of living individuals are needed to assess generalizability of findings. Quantifying musculoskeletal properties and differentiating influences of amputation and diabetes could eventually help direct rehabilitation techniques.