Hip Range Of Motion Research Articles

Long-term follow-up result of short metaphyseal femoral stem in primary total hip arthroplasty: A retrospective study

BACKGROUND Total hip arthroplasty (THA) has increased along with an increasing demand for improved quality of life. Combined with prolonged life expectancy, the number of revision surgeries is expected to increase. Stress shielding is a significant issue with traditional femoral stems used in THA, making revision surgeries particularly challenging in younger patients. This has sparked renewed interest in studying safety and functional outcomes of short metaphyseal femoral stems, which have the potential to alleviate these challenges and simplify revision surgeries. AIM To evaluate the long-term outcomes of short-stem THA. METHODS A total of 124 hips that underwent THA using the short femoral stem (TRILOCK® Depuy) between May 2006 and November 2008 were included in this study. Patients were followed for a period of 15 years. Outcomes were assessed in terms of pain relief, hip joint range of motion, improvement in mobility, and functional outcomes using the modified Harris Hip Score, Oxford hip score, and Western Ontario and McMaster Universities Osteoarthritis index score. RESULTS A total of 124 hips in 98 patients were evaluated. Significant improvements in functional outcomes were observed over the 15-year follow-up period, with no cases of subsidence, implant loosening, or complications necessitating revision surgery. The only complication reported was heterotopic ossification in 1 patient. CONCLUSION Short metaphyseal stems provide better functional outcomes with early mobilization, and its long-term follow-up without subsidence, implant loosening, or proximal femoral bone loss simplifies revision surgery in younger patients.

Exploring the Potential of AI-Assisted Technology in Joint Range-of-Motion Measurements: A Reliability Study

Background and Objectives: Measuring joint range of motion (ROM) is essential for diagnosing and treating musculoskeletal diseases. However, most clinical measurements are conducted using conventional devices, and their reliability may significantly depend on the tester. This study implemented an RGB-D (red/green/blue-depth) sensor-based artificial intelligence (AI) device to measure joint ROM and compared its reliability with that of a universal goniometer (UG). Materials and Methods: A single-center study was conducted from January 2022 to December 2022 on participants visiting the Chung-nam National University Hospital to compare the reliability of the RGB-D sensor-based AI device with that of the UG for measuring ROM. The ROM of the shoulder, hip, and lumbar spine joints was measured in 35 healthy participants in our hospital. The ROM was measured during active motion by the participants in the standing position. The ROM was measured twice consecutively using the RGB-D sensor-based AI device, and the mean values were obtained along with other values. A clinician also measured the ROM twice using a UG. Bland–Altman analysis was performed to evaluate the reliability of the measurements, which was assessed using intra-class correlation coefficient (ICC). An ICC value greater than 0.90 indicates excellent reliability. Results: Both methods achieved good-to-excellent intra-test reliability results (ICC > 0.75) for all the joints, with the reliability being slightly higher for the RGB-D sensor-based AI method than for the UG measurements. Moreover, for both methods, the inter-test reliability was higher than good (ICC > 0.75) for shoulder and lumbar joint ROM measurements but lower than good (ICC < 0.75) for hip ROM measurements. Conclusions: This study compared the efficacies of the RGB-D sensor-based AI method and UG in measuring ROM. In the future, this RGB-D sensor-based AI method should be technologically improved, and the measurement methods and protocols should be standardized.

Poor knee strength is associated with higher incidence of knee injury in adolescent female football players: The Karolinska football injury cohort

AbstractPurposeTo investigate the association between common measures of trunk and lower extremity range of motion (ROM), strength, the results of one‐leg jump tests at baseline and the incidence of subsequent substantial knee injuries in adolescent female football players.MethodsPlayers were assessed at baseline regarding (1) ROM of trunk, hip, and ankle; (2) trunk, hip, and knee strength; and (3) one‐leg jump tests. Players were prospectively monitored weekly for 1 year regarding knee injuries and the volume of matches and training. Hazard rate ratios (HRRs) and 95% confidence intervals (CIs) were calculated with Cox regression for the association between the baseline tests and the incidence of substantial knee injury (moderate/severe reduction in training volume or performance, or complete inability to participate in football). Exposures were categorized in tertiles (high, medium and low values). The highest tertile was used as reference.Results376 players were included without substantial knee injury at baseline (mean age, 13.9 ± 1.1 years), and 71 (19%) reported at least one substantial knee injury during the follow‐up. Several associations were found; the strongest was that players in the lowest tertile of knee extension strength had a higher incidence of knee injuries than players in the highest tertile (HRR, 2.28; 95% CI, 1.20−4.38). Players in the lowest tertile of trunk rotation ROM in lunge position half‐kneeling (HRR, 0.50; 95% CI, 0.27−0.94) had lower incidence of knee injuries than players in the highest tertile.ConclusionsPoor knee strength and high trunk ROM were associated with an increased incidence of substantial knee injury in adolescent female football players. Therefore, knee‐strengthening exercises during season may be recommended.Level of EvidenceLevel II.

Retrospective Analysis of the Clinical and Radiological Outcomes Following Modified Dunn Osteotomy in Patients with Stable, Moderate-to-severe Chronic Slipped Capital Femoral Epiphysis.

Objective The management of slipped capital femoral epiphysis (SCFE) has been completely transformed by modified Dunn osteotomy, a subcapital realignment osteotomy achieved through a safe surgical dislocation technique originally described by Ganz. The purpose of this study was to evaluate the clinical and radiological outcomes of patients with moderate to severe SCFE after modified Dunn osteotomy. Methods A total of 15 patients (16 hips, with one bilateral case; 12 males, 3 females) aged from 10.2 to 17-years-old (mean: 14.3) with stable, moderate to severe, chronic SCFE (moderate: = 6; severe = 10) underwent modified Dunn osteotomy as treatment. The hip joint range of motion (ROM), Harris (HHS), and Merle d'Aubigné (MdA) hip scores were used for clinical assessments. They were assessed radiographically using the Southwick and Alpha angles. Results At the most recent follow-up (mean 8.6 years; 3.1-14), the mean hip joint ROM, the mean HHS (preoperative: 69.20 ± 5.94; postoperative: 86 ± 7.37; p < 0.00001), and the mean MdA score (preoperative: 12.47 ± 1.13; postoperative: 14.27 ± 1.83; p < 0.00001) all showed statistically significant clinical improvements The radiological results demonstrated improvements in the mean Southwick angle (preoperative: 56.60 ± 12.89°; postoperative: 16.40 ± 4.69°; p < 0.00001) and Alpha angle (preoperative: 101.87 ± 12.88°; postoperative: 29.33 ± 7.29°; p < 0.00001). There were two significant postoperative complications identified: femoral head avascular necrosis (AVN) and deep infection. Conclusion According to the study's findings, the modified Dunn osteotomy is a safe, efficient treatment option for stable moderate-to-severe chronic SCFE with a manageable risk of complications.

Rambam Hospital Protocol for Treatment of Early Stages of Legg-Calve-Perthes Disease

Introduction: The treatment of Leg-Calve-Perthes Disease (LCPD) is an orthopedic enigma without consensus in the literature. Despite all efforts, coxa breva with overgrowth of the greater trochanter (GT) is commonly present in many patients. In 2013, we introduced a protocol that included transepiphyseal drilling of the femoral head, closure of the GT, adductor tenotomy, and 4 months of non–weight-bearing on the affected leg. The purpose of this study was to evaluate midterm results in patients treated by our protocol. Methods: Over 11 years, we treated 31 patients with LCPD. Average age was 7.1 (range 5 to 10) years. We divided all patients into 2 groups: group A included 18 patients in early fragmentation stage, group B contained 12 patients in late fragmentation and one in reossification stage. All patients underwent the same treatment protocol as described. Results: Mean follow-up was 52 months. All patients had a limp before surgery. At the latest follow-up, 22 had no limp, and 23 had substantial improvement in hip range of motion. In group A, 12 patients had Stulberg type 1, 5 Stulberg 2, and 1 Stulberg type 3. In group B, 1 patient had Stulberg type 2, 9 patients had Stulberg type 4, and 3 patients had Stulberg type 5. Conclusions: On the basis of our experience, the proposed protocol can be effective in the treatment of the early fragmentation stage of LCPD.

Endoscopic Iliopsoas Fractional Lengthening as a Treatment for Refractory Iliopsoas Impingement After Total Hip Arthroplasty Shows Favorable Functional Outcomes With No Impact In Range of Motion

To report the minimum 2-year clinical outcomes of endoscopic iliopsoas fractional lengthening (IFL) in patients with recalcitrant iliopsoas tendinitis after total hip arthroplasty (THA). Data were prospectively collected from 2014 to 2020 for patients who underwent IFL after primary THA as part of our institutional hip outcomes registry. Patients were included if they had completed the following patient-reported outcomes preoperatively and at minimum 2-year follow-up: modified Harris Hip Score and visual analog scale score. Preoperative and postoperative data were available for the International Hip Outcome Tool 12 score, and patient satisfaction was analyzed. Patients included in the study reported irritation of the iliopsoas tendon after cementless THA, refractory to conservative treatment methods. IFL was recommended after a workup that included ruling out infection and aseptic loosening, as well as a positive response to an iliopsoas guided diagnostic injection. Seventeen patients were included in the study. The mean age at IFL was 56.42 years (range, 30.17-81.29 years). The mean interval between THA and IFL was 2.72 years (range, 0.25-8.34 years). There was a significant improvement in all evaluated patient-reported outcomes, and a high percentage of patients met the minimal clinically important difference for the modified Harris Hip Score (14, 82.35%), International Hip Outcome Tool 12 score (11, 91.66.00%), and visual analog scale score (16, 94.12%) (P < .05). Furthermore, 15 patients (88.2%) reported a positive response to the patient acceptable symptom state anchor question. No impact on preoperative versus postoperative active range of motion was observed, and no patient reported weakness at the latest follow-up (P > .05). Preoperative flexion was 106.33° (range, 85.0°-120.0°), and postoperative flexion was 106° (range, 90°-120°). Endoscopic IFL yielded significant improvements in functional outcomes with high patient satisfaction at minimum 2-year follow-up, with no reported complications. This procedure did not have a significant negative impact on hip range of motion. Level IV, retrospective case series.

Double plating and iliac crest bone graft can safely fix femoral shaft nonunion

Introduction Femoral shaft nonunion can be extremely vexing and result in significant morbidity. We aimed to evaluate the outcomes of patients with nonunion of the femoral shaft fracture undergoing double plating and bone grafts from the iliac crest and femoral canal. Methods This retrospective study included 44 patients with femoral shaft nonunion between March 2020 to March 2022. Patients underwent dual plating, bone grafting from the iliac crest, and the utilization of the femoral canal. Age, sex, body mass index (BMI), the two surgical interventions interval, union time after the second surgery, hip range of motion (ROM), limb length discrepancy (LLD), infections, and deep vein thrombosis (DVT) were evaluated. Results Patients comprised 21 males (47.7%) and 23 females (52.3%), with a mean age of 42.3 ± 15.2 years. The mean BMI was 26.7 ± 3.77 kg/m2. The mean duration between the two surgical interventions for the patients was 17.07 ± 6.6 months. The patients were followed for ≥ 12 months. All patients achieved successful union and fracture healing, with an average time of 5 months. The mean hip flexion and extension were 112.84 ± 7.7˚ and 14.8 ± 5.2˚ degrees, respectively. Thirteen patients showed LLD after the first surgery, with a mean LLD of 7.15 ± 5.04 millimeters. LLDs were successfully rectified in all patients following the surgical intervention. No patients experienced postoperative infections or DVT. Conclusion According to our findings, the utilization of double-plate fixation in combination with iliac crest and femoral canal bone graft has proven to be a secure, productive, and straightforward surgical alternative for the management of femoral nonunion.

Effects of using exposure footwear for firemen and fitness training shoes on lower limb biomechanics during walking

Exposure footwear for firemen (EFF) is a crucial component of firefighters’ personal protective equipment, designed to protect against hazards, such as heat, punctures, impact, and electrocution. However, its effect on gait biomechanics remains unclear. This study was aimed to investigate the influence of EFF on firefighters’ lower limb biomechanical performance and the underlying mechanisms. Twenty healthy male firefighters (mean height: 175.41 ± 4.39 cm, mean weight: 65.74 ± 5.81 kg, mean BMI: 21.37 ± 2.17 kg/m2) were randomly assigned to wear EFF and fitness training shoes for comparison during walking tasks. Lower limb biomechanics were analyzed, focusing on joint range of motion (ROM), moments, work and muscle activity. The results indicated that wearing EFF led to increased hip and knee joint ROM in the sagittal plane, reduced ankle and metatarsophalangeal (MTP) joint ROM in the sagittal plane, increased peak hip flexion/extension and ankle dorsiflexion moments, and decreased MTP joint dorsiflexion peak moments. EFF use also resulted in increased positive work done by the hips, increased negative work done by the ankles, reduced positive work done by the ankle joints, and increased negative work by the MTP joint, The activation levels of the rectus femoris and tibialis anterior muscles were higher when wearing EFF compared to fitness training shoes. In conclusion, EFF significantly alters the biomechanical characteristics of firefighters’ lower limbs during walking, leading to elevated muscle activation in the rectus femoris and tibialis anterior. This increased demand on the lower limb muscle groups for mechanical energy generation heightens the risk of fatigue, musculoskeletal injuries, and osteoarthritis. Therefore, it is recommended that EFF boots be designed using lightweight and flexible materials. Additionally, training programs should prioritize strengthening the hip flexor/extensor, ankle dorsiflexor muscle groups, and especially the rectus femoris and tibialis anterior muscles.

Cross-sectional analysis of speed-up mechanism in normal gait among healthy older adults with and without falls – Results from the Baltimore Longitudinal Study of Aging

BackgroundFalls in older adults increase the risk of mobility loss. Proper understanding of gait mechanisms related to falls may provide novel solutions for maintaining mobility in older adults. Research questionIdentify fall-related gait patterns through analyzing alterations in gait parameters to walk faster than usual pace in older adults. MethodsA Total of 519 participants (mean age = 73.12 years; 51.05 % female), including non-fallers (n = 396) and fallers (n = 123), aged 60–96 years were assessed in the Baltimore Longitudinal Study of Aging. Participants completed gait assessments at both usual and fast paces. Range of motions (ROM) for the hip, knee, and ankle joint in the sagittal plane and hip abductor ROM during normal and fast pace gait were measured by 3D motion capture system (Vicon 612). For all gait variables, percentage-changes (PC; (((fast-walking_parameter – usual-walking_parameter) /usual-walking_parameter)*100)) was calculated. Associations of PC for gait speed and PC for other gait parameters were compared between fallers and non-fallers. ResultsCompared to non-fallers, fallers walked with shorter stride, elongated double support time and shorter knee ROM in the faster pace walk (p = 0.044, p = 0.019, and p = 0.036, respectively). PCs of all gait related variables were significantly associated with PC of gait speed in non-fallers (ps < 0.005), while in the fallers, only PC for stride length, cadence, and hip ROM were associated with PC for gait speed (ps < 0.001). SignificanceAmong non-fallers related PC for gait speed was associated with PC across gait parameters suggesting the use of similar biomechanical approaches in usual and fast gait. Compared to non-fallers, fallers demonstrated different mechanisms of transition from usual to fast gait. Evaluating speed-up strategies could provide insight into subtle yet important gait modifications in apparently well-functioning older adults that would help identify individuals at high risk of falling.

The effects of free dance versus hatha yoga on quality of life and motor and non-motor symptoms in people with Parkinson's disease: protocol study for a randomized clinical trial

Objective: To describe a protocol comparing the effects of free dance, hatha yoga, and a control group on quality of life, motor and non-motor symptoms in people with Parkinson's disease (PwP). Methods: This is a randomized three-arm study. Inclusion criteria will be people with clinically diagnosed Parkinson's disease (PD), ≥ 45 years old, and in stages I to IV of the Hoehn and Yahr Disability Scale (HY). Who do not reach the cut-off point of the Montreal Cognitive Assessment (MoCA) and classified in stage V of the HY will be excluded. The interventions will last 60 minutes, twice a week, progressing from light to vigorous intensity. The primary outcome will be quality of life assessed by the Parkinson's Disease Questionnaire (PDQ39). Secondary outcomes will include the Unified Parkinson's Disease Rating Scale (UPDRS), the evaluation of motor and physical function such as shoulder and hip range of motion (goniometer), cardiorespiratory fitness (six-minute walk test), balance (MiniBESTest), as well as non-motor aspects such as anxiety (Beck Anxiety Inventory), self-esteem (Rosenberg Self-Esteem Scale), cognition (MoCA), hope (Herth Hope Scale), fecal incontinence (Fecal Incontinence Quality of life), urinary incontinence (International Consultation on Incontinence Questionnaire - Short Form), and depressive symptoms (Beck Depression Inventory). Data will be collected at baseline and post-intervention. Discussion: If study interventions are deemed effective compared to standard of care (i.e. control group), the present study will advance current knowledge on non-pharmacological therapeutic strategies for People with Parkinson. Study registered RBR-54s92mh on 02/29/24.

Is limb asymmetry an intrinsic risk factor for time-loss groin injury in professional male soccer players?

To provide normative values for between-limb asymmetry of hip strength and range of motion (ROM) in professional male soccer players and evaluate the relationship between these asymmetries and groin injury. Secondary analysis of a prospective cohort study. A total of 438 professional male soccer players underwent musculoskeletal screening, injury and exposure surveillance over two consecutive seasons. Between-limb asymmetry for two hip strength (eccentric adduction and abduction) and six ROM measures were calculated, and normal asymmetry considered within 1 standard deviation (SD) of the mean. Cox proportional hazard regression analysis estimated the association between asymmetry and time-loss groin injury. Normal asymmetry ranged between 0.3% and 27.3% across strength and ROM variables. No association was found between groin injuries and asymmetry in eccentric hip adduction (HR=0.99, 95%CI=0.98-1.00; p=0.167) or abduction strength (HR=1.00, 95%CI=0.99-1.01; p=0.745). For five of the six ROM measures, no association with groin injuries were determined. A statistically significant, though likely clinically irrelevant, association was found between groin injury and dominant leg total hip rotation ROM (HR=1.03, 95% CI=1.00-1.05; p=0.040). Normal hip strength and ROM asymmetry ranged between -27 and +20%. No clinically relevant associations were found between asymmetry in hip strength or ROM and time-loss groin injuries.

Investigating the Influence of Modifiable Physical Measures on the Elbow Varus Torque - Ball Velocity Relationship in Collegiate Baseball Pitchers.

The mechanism of ulnar collateral ligament (UCL) injury during pitching is excessive elbow varus torque (EVT). The EVT-ball velocity (T-V) relationship allows concurrent assessment of player performance and UCL injury risk. Modifiable physical capacities may underlie individual variation seen in the T-V relationship. To identify physical performance characteristics that impact the T-V relationship during pitching. Descriptive laboratory study. A total of 87 National Collegiate Athletic Association Division I pitchers participated. Pitching collection involved measurement of EVT and ball velocity during 5 maximal effort fastballs thrown to a catcher. Physical measures collected were the following: shoulder and hip passive range of motion (ROM) and strength, shoulder rate of torque development (RTD), grip strength, and lumbopelvic stability. Physical measures were entered into univariate linear mixed models with ball velocity as a covariate to predict EVT. Variable reduction for multivariate models involved selection of physical measures based on random forest-derived variable importance and univariate relationship significance, rendering a 27-variable pool. Multivariate linear mixed models predicting EVT, adjusting for physical measures and other physical characteristics, were then created using backward elimination. In univariate analysis, for every 1 m/s (2.2 mph) increase in ball velocity, the mean EVT increased by 1.51 Nċm (95% CI, 0.66-2.37 Nċm; P = .001). In univariate analysis, hip abduction strength symmetry and bilateral lumbopelvic stability significantly increased EVT, while dominant-shoulder ROM, scaption RTD symmetry, and hip ROM significantly decreased EVT. Variables that increased EVT while controlling for ball velocity in the final model include grip strength symmetry, lead-leg lumbopelvic stability, and bodyweight. Increased dominant-shoulder internal rotation (IR) strength, dominant-shoulder flexion ROM, and scaption strength asymmetry decreased EVT as ball velocity increased. Several modifiable physical measures affected EVT in the univariate analysis. In our final model, when controlling for ball velocity, EVT increased with increased grip strength symmetry, lead-leg lumbopelvic stability, and bodyweight and decreased with increased dominant-shoulder IR strength, dominant-shoulder flexion ROM, and scaption strength asymmetry. Defining the individual and multivariate effects of these physical capacities on EVT contextualizes their role in the T-V relationship and helps identify access points through which coaches and clinicians can optimize a pitcher's T-V relationship.

The Influence of Pelvic Tilt and Femoral Torsion on Hip Biomechanics: Implications for Clinical Assessment and Treatment

Background: Hip biomechanics are crucial in understanding movement disorders and joint pathologies. Pelvic tilt and femoral torsion are key factors influencing hip function and stability. This review aims to elucidate their effects on acetabular orientation, hip range of motion (ROM), and associated compensatory mechanisms. Methods: A comprehensive search of databases, including PubMed, Scopus, and Pedro, was conducted. Studies were selected based on Population, Concept, and Context (PCC) criteria, focusing on those examining the relationship between pelvic tilt, femoral torsion, and hip biomechanics. Eight studies were included, utilizing methodologies such as CT imaging, musculoskeletal modeling, and gait analysis, covering populations ranging from asymptomatic adults to elderly women with pelvic retroversion. Results: The review identified significant effects of pelvic retroversion on acetabular anteversion and hip extension. Some studies found no correlation between pelvic index (PI) and acetabular orientation, while others reported a linear increase in acetabular anteversion with pelvic retroversion. Subjects with pelvic retroversion showed greater hip extension. Additionally, femoral anteversion was linked to increased internal rotation and altered hip joint contact forces during gait, with changes in hip ROM and force distribution. No relationship was found between femoral and acetabular anteversion in patients with hip osteoarthritis. Conclusions: Pelvic tilt and femoral torsion significantly affect hip biomechanics, influencing acetabular orientation, ROM, and compensatory mechanisms. Future studies should include symptomatic populations to explore these relationships further. These findings emphasize the critical need for individualized clinical assessments and further research on symptomatic populations to enhance our understanding of pelvic tilt and femoral torsion’s impact on hip biomechanics.

Relationship Between Hip and Groin Pain and Hip Range of Motion in Amateur Soccer and Australian Rules Football Players

Background: The relationship between hip/groin pain and hip range of motion (ROM) is unclear. Purpose: To explore the relationship between hip/groin pain and hip joint ROM and examine the influence of sex and cam morphology on this relationship. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Included were 184 amateur soccer and Australian Rules football players (276 hips; 20% women; median age, 26 years; interquartile range, 24-30 years) with hip/groin pain &gt;6 months and a positive flexion-adduction-internal-rotation (FADIR) test, and 50 matched asymptomatic control players (98 hips; 28% women, median age, 26 years; interquartile range, 23-31 years). Hip ROM measures were flexion, internal and external rotation at 90° of hip flexion, total rotation (internal and external), and bent-knee fall out (BKFO). Cam morphology was determined from anteroposterior pelvis or 45° Dunn radiographs, defined by an alpha angle ≥60°. Linear regression models with generalized estimating equations were used to examine the relationship between group (symptomatic and asymptomatic) and each ROM measure. Interaction terms (group × cam morphology or group × sex) were included to examine if relationships between group and hip ROM were influenced by cam morphology or sex. Where appropriate, models were adjusted for sex, age, and cam morphology. Results: An interaction between the relationship between group × cam and internal rotation ROM was found. Symptomatic players with cam morphology had lower internal rotation ROM than controls with cam morphology (adjusted mean difference [AMD] = −4.5°; 95% CI, −7.4° to −1.6°). Hip/groin pain was not associated with internal rotation ROM if cam morphology was absent. A significant interaction was also found for group × sex and BKFO and total rotation ROM. Symptomatic women had lower total rotation ROM than control women (AMD = −8.2°; 95% CI, −14.1° to −2.2°), but no difference was seen in men. BKFO range was lower in men with hip/groin pain compared with control men (AMD = 1.6 cm; 95% CI, 0.3-3.0 cm), but no difference was seen in women. Flexion and external rotation ROM did not differ between symptomatic and control hips. Conclusion: Cam morphology was an effect modifier of the relationship between hip/groin pain and internal rotation ROM. Sex-related differences were also observed in the relationship between hip/groin pain and hip ROM.

Transforming Steps: A Glimpse into the Future of Gait Analysis with Deep Learning and Markerless Motion Capture

Category: Basic Sciences/Biologics; Other Introduction/Purpose: Gait analysis is essential for diagnosing foot and ankle disorders. However, conventional gait analysis methods are costly and complex, especially when evaluating large populations or requiring swift diagnostics. Our study focuses on an innovative application of deep learning (DL) technique to simplify gait analysis. We propose a markerless motion capture system utilizing a single-camera setup, bypassing infrared markers and multi-camera. This novel method aims to be cost-effective and adaptable, enhancing diagnostic efficiency. It is designed to accurately capture gait patterns, offering a comprehensive view of patient-specific conditions when combined with other diagnostic tools such as weight-bearing radiographs and computed tomography. This study evaluates the reliability of the DL-assisted markerless motion capture technique for clinical gait analysis, potentially revolutionizing the evaluation of foot and ankle pathologies. Methods: From March 2023 to February 2024, 18 patients who underwent ankle arthrodesis or subtalar arthrodesis for degenerative arthritis were analyzed using the Remobody-S device (Remo Inc., South Korea) integrated with the HuMoR deep learning architecture. This equipment interprets 3D skeletal coordinates, joint range of motion (ROM), and gait metrics from 2D video input. We focused on the hip, knee, and ankle ROMs during the gait cycle. Patients walked 4 meters preoperatively and six months postoperatively, with their movements captured by an attached 2D camera. Differences in gait metrics and joint ROMs between the affected and unaffected sides were compared using the intraclass correlation coefficient (ICC). Clinical outcomes were evaluated using the visual analogue scale (VAS) and Lower extremity function score (LEFS). Results: Results indicated that the significant preoperative differences in joint ROMs became comparable postoperatively (Figure 1). The ICCs for hip, knee, and ankle ROMs approached 1 postoperatively, denoting reduced discrepancies between both sides (Table 1). The mean VAS improved from 6.67 ± 1.23 preoperatively to 3.67 ± 0.55 postoperatively (p = 0.003). The mean LEFS improved from 36.3 ± 12.9 preoperatively to 53.0 ± 17.4 postoperatively (p = 0.251). Conclusion: The DL-assisted markerless motion capture technique for gait analysis reliably depicted postoperative gait improvement, consistent with clinical outcomes. Its potential clinical application warrants further research.

More is not always better: Association between hip range of motion and symptom severity in patients with femoroacetabular impingement syndrome.

More is not always better: Association between hip range of motion and symptom severity in patients with femoroacetabular impingement syndrome.

Efficacy of Outside-In Hip Arthroscopy without Traction in the Treatment of Hip Synovial Osteochondromatosis.

Arthroscopic treatments of hip synovial osteochondromatosis are mostly performed under traction, resulting in neurovascular injury or iatrogenic damage to the labrum or cartilage. This study aimed to assess the effectiveness of outside-in hip arthroscopy without traction in treating hip synovial osteochondromatosis. This retrospective study was conducted on a series of patients with hip synovial osteochondromatosis treated using outside-in hip arthroscopy without traction in our hospital between 2018 and 2020. Plain radiography and magnetic resonance imaging (MRI) scans were obtained. The Harris hip score (HHS), hip range of motion (ROM), and visual analog scale (VAS) scores were analyzed. The preoperative scores and last follow-up scores were compared with a paired-sample t test. The complications and recurrence postsurgery were recorded. This study included five patients (three male and two female) with an average age of 41 years (range 28-54 years). The mean follow-up time was 25.2 months (range 18-36 months). All patients experienced groin pain relief and improved ROM. The mean VAS score was significantly lower postoperatively (0.4 ± 0.5) than preoperatively (3.2 ± 0.8) (p < 0.001). The mean HHS improved from 58.6 ± 12.7 (range 43-73) to 89.8 ± 5.26 (range 81-95) (p < 0.001). No major complications, including infection, perineal numbness and swelling, neurotrosis, thromboembolism, or severe persistent pain, were reported. Synovial osteochondromatosis recurred in one patient after 2 years of follow-up without any obvious symptoms such as hip pain or joint locking. Therefore, no further treatment was necessary. This study showed that outside-in hip arthroscopy without traction might be a viable option for treating hip synovial osteochondromatosis, effectively and safely relieving symptoms with minimal complications, especially in patients without lesions in the central compartment.

The relationship between hip joint morphology and hip range of motion in circus performers with hip-related pain

The relationship between hip joint morphology and hip range of motion in circus performers with hip-related pain

Heel Riser Height Influence on Kinematics and Muscle Activity of Ski Mountaineering: A FieldBased Study

Introduction: The ski binding plays an important role in ski mountaineering. When traveling uphill, the binding has an adjustable heel height known as the riser. Previous laboratory research reported joint kinematics and kinetics are influenced by riser height, however little is known about changes to muscle activity associated with differing joint motion. The purpose of this work was to assess riser height influence on kinematics and muscle activity at different slopes during on-snow skiing. Methods: Three female and nine male recreational ski mountaineers (19-26 y) were tested on 5o and 16o gradients using no riser (0 cm) and riser (5.3 cm) at a submaximal 80% HRmax. Each subject used Backland 85 UL skis and Backland Bindings (Atomic Skis, Altenmarkt, Austria). Subjects skied for 6 min at each binding setting with the last 10 gait-cycles evaluating lower limb joint motion gathered from 2D-sagittal plane motion capture. Electromyography (EMG) collected unilaterally on the rectus femoris, biceps femoris, medial gastrocnemius and triceps brachii also. Results: 5o slope: hip range of motion [ROM] decreased (p = .003), ankle ROM decreased (p =.005), stride length decreased (p = .004), RPE increased (p = .02) for riser compared to no riser. At 16o slope: hip ROM decreased (p = .001), and Rating of perceived exertion [RPE] decreased (p =.004) for riser compared to no riser. HR, glide distance, velocity, EMG, and net mechanical efficiency were not different between riser heights on either slope. Conclusion: Lower body joint kinematics, step length and RPE varied significantly with riser height. Kinematic differences did not impact velocity or muscle activity when controlling pace. These results agree with previous findings showing minimal differences in EMG and HR while lower body kinematics and RPE changed with riser height.

Use of the Modified Thomas Test for Hip Flexor Stretching: What Are the Acute and Prolonged Effects?

Background/Objectives: The flexibility deficits of hip flexors have been identified as potential biomechanical risk factors for the lumbo–pelvic–hip complex, with postural repercussions on the trunk and lower limbs. The purpose of this study was to conduct a single gravity stretching experiment and to monitor its acute and prolonged effects. Methods: The sample comprised 14 healthy participants (8 females and 6 males). Data were collected during two-day measurement sessions. These analyzed via Kinovea software. The single intervention (i.e., gravity stretching) was performed on the first day. A modified Thomas test was used at the same time in two ways, both as a measurement and as an intervention tool. Stretching was achieved by relaxing in a position to perform the modified Thomas test where, each participant lies completely relaxed for 3 min, allowing gravity to stretch the hip flexors of the examined limb. Results: After intervention, a significant acute increase in hip extension range of motion and a decrease in knee extension range of motion were found. We did not find any significant prolonged effects; moreover, after 48 h, the hip range of motion almost returned to the initial value. Conclusions: A single 3 min stretch is very effective in terms of achieving immediate changes in the range of motion, but insufficient for long-term improvements in flexibility.