Sagittal Research Articles

Radiological evaluation of facial nerve and facial canal in patients with Bell's palsy.

To evaluate the diameter of the facial nerve (FN) and facial canal (FC) at different segments in Bell's palsy (BP) patients and compare the facial nerve/facial canal width ratio (FN/FC) of the the affected and healthy sides to determine the entrapped sites. This retrospective study enrolled 47 patients with BP that were referred to a tertiary referral hospital. From patients' records, initial House-Brackmann grades, cranial computurized tomography (CT) and contrast enhanced temporal magnetic resonance imaging (MRI) scans were revieved. FC and FN diameter measurements were performed at the midpoint of labyrinthine segment, geniculate ganglion and tympanic segment in the axial plane, and mastoid segment in the sagittal plane. Contrast-enhanced segments on MRI were evaluated. There was no statistically significant difference between the FC diameters of the affected and the healthy sides on CT at any measured segments. FN diameter was increased significantly for all segments except mastoid segment on the affected side compared to the healthy side. FN/FC ratio was significantly greater on the affected side than the healthy side in all measured segments. Evident contrast enhancement was observed in all affected FNs, with geniculate ganglion and labyrinthine segment being the most common sites with contrast enhancement on MRI. Anatomical differences in FC may not be the main predisposing factor in BP. As the geniculate ganglion and labyrinthine segments had the highest FN/FC ratio and showed clear contrast enhancement on MRI, these findings may indicate a higher risk of inflammation and entrapment in these segments.

Ultra-distal tibial fractures: a retrospective comparison of distal plate versus nail fixation

BackgroundCurrent literature on ultra-distal tibial fractures (UDTF) is relatively limited, particularly regarding the outcomes and complications of different treatment strategies, with data being notably scarce. This study aimed to compare the clinical outcomes of intramedullary nailing (IMN) and distal tibial plate (DTP) fixation in the treatment of UDTF.MethodsA total of 48 eligible patients were retrospectively reviewed and divided into two matched groups based on age, gender, injury severity score, and fracture type. The IMN group comprised 21 patients, and the DTP group included 27 patients. All patients were followed up to assess both clinical and radiological outcomes.ResultsThe IMN group demonstrated significantly shorter surgery time (P = 0.043) and fracture healing time (P = 0.002) compared with the DTP group. However, no significant differences were found between the two groups in terms of time from fracture to admission (P = 0.740), preoperative hospital stay (P = 0.310), postoperative hospital stay (P = 0.379), infection rates (P = 1.000), or rates of nonunion (P = 0.822). Postoperative malalignment occurred in three patients in the IMN group and one patient in the DTP group (P = 0.430). The mean postoperative angulation in both groups was similar in the coronal plane (P = 0.101) and sagittal plane (P = 0.334). The mean Olerud–Molander Ankle Score (OMAS) was 88.62 ± 5.24 in the IMN group and 85.85 ± 8.39 in the DTP group (P = 0.169).ConclusionBoth implants are effective in treating UDTF. However, IMN offers advantages in reducing surgical time, accelerating fracture healing, and promoting early recovery. Therefore, IMN may represent a superior surgical option for managing UDTF.

Effects of Anticipation and Dual-Tasking on Lower Limb Biomechanics While Performing Change-of-Direction Tasks in Physically Active Individuals: A Systematic Review with Meta-Analysis.

Anterior cruciate ligament (ACL) injuries are highly prevalent in team sport athletes and often occur while performing change-of-direction (COD) tasks in combination with high cognitive demands, such as decision making or divided attention. Given the expanding body of research in this field, an updated literature review is warranted, as the most recent meta-analysis on this topic included original studies published up to November 2020. The aim of this systematic review was to examine the effects of anticipation and/or dual-tasking on lower limb biomechanics during COD tasks in healthy individuals. Systematic review with meta-analysis. A systematic literature search was conducted in the electronic databases PubMed, Web of Science, CINAHL and SPORTDiscus from inception until February 2024. The included studies examined the effects of anticipation and/or dual-tasking on knee kinetics and kinematics in the frontal and sagittal planes during COD tasks. A multilevel meta-analysis was performed to aggregate the results of studies comparing unanticipated versus anticipated CODs on lower limb biomechanics. Due to the limited available literature on dual-task versus single-task conditions, this aspect was analyzed qualitatively. The meta-analysis included 17 studies involving 355 individuals from different sports (e.g., soccer, American Football). No statistically significant differences were found between unanticipated and anticipated CODs for knee abduction and flexion moments as well as knee abduction angles (p > 0.05). Significantly higher knee flexion angles were found in unanticipated CODs (SMD = 0.74, 95% CI: 0.30-1.19; p < 0.01). Qualitative analyses of six studies including 171 individuals provided initial evidence for higher knee abduction moments and flexion angles during anticipated CODs while performing a secondary task concurrently. Findings from quantitative and qualitative analyses indicate that anticipation and dual-tasking during COD performance have an impact on injury-related aspects of lower limb biomechanics. Hence, cognitive challenges should be implemented in injury risk screening and preventive strategies. Further studies with high methodological quality are needed to improve the understanding of the biomechanical and cognitive interplay in injury-threatening situations. CRD42023433074. 13.10.2023.

What can we learn from scoliosis in children with the 22q11.2 deletion syndrome? Prognostic factors at pre-adolescent age for fast progressive, mild and self-resolving forms during adolescence.

Longitudinal data starting before adolescence and before curve onset, may elucidate prognostic factors for later scoliotic curve development. The aim is to predict the maximum curve acceleration (MCA; °/month) and the final curve progression in a cohort of 22q11.2DS subjects screened for scoliosis. Scoliosis screening starts immediately after 22q11.2DS diagnosis. A minimum of 2years follow-up, two assessments, Risser 0, open triradiate cartilage at start, were the inclusion criteria. Risser ≥ 3 corresponded to skeletally matured. Linear and logistic binary mixed effect models accounting for patients nested into multiple measurement occasions were created to predict MCA during adolescence and progressors (progression to ≥ 30) versus non-progressors (no scoliosis or < 30 at last follow-up). 161 subjects (59% females) with a mean baseline age 8.7 ± 2.4years, follow-up of 4.2 ± 2.4years and having reached skeletal maturity. Ultimately, 19 subjects became progressors and 142 became non-progressors. Curve magnitude at baseline was 8.8 ± 5.9° (range 0-50), at final follow-up 11.6 ± 12.4 (0-77). The mean curve acceleration was + 0.1 ± 0.5°, respectively + 0.2 ± 0.5°for non-progressors vs progressors during the acceleration phase. A linear mixed model showed that the triradiate cartilage closure accelerates MCA by 2.6 when adjusted for age and female gender. In a logistic mixed model, when the triradiate cartilage closes, the OR of reaching the MCA before the next follow-up is increased by 4.60 (CI95% 2.34-8.90 p < 0.001). No evidence for prognostic value of Risser in all derivated models. We found no evidence for the parameters in the coronal, sagittal nor transverse plane before curve onset acting as prognostic factors for curve behavior. In the prediction model on a longitudinal database that starts in many patients before scoliosis, no clear radiographic discriminant for later progressive scoliosis couldbeidentified. The closure of the triradiate cartilage resulted as the best sign of pubertal spurt onset and scoliosis acceleration.

Kinematic and muscle activity patterns of maximal ice hockey skating acceleration

ABSTRACT The ability to rapidly accelerate while skating is an essential quality for ice hockey players. Detailed neuromechanical characteristics of the performance should be known to inform strategies to improve skating acceleration capacity. In this study, we aimed to describe cycle-by-cycle lower limb kinematic and muscle activation patterns during a maximal effort 30 m ice hockey skating sprint. Twelve high-calibre players performed five maximal forward skating sprints. Muscle activities from eight lower limb muscles and sagittal plane joint kinematics from the hip and knee joints were measured throughout the sprint and reported cycle-by-cycle until the 7th cycle. The duration of the skating cycle and propulsion phase increased progressively from the 2nd until the 7th cycle. Qualitatively, the muscle activity patterns were quite similar between the cycles. However, some differences in the muscle activity levels during different cycle phases were identified in the accelerative cycles (cycles 1–6) compared to the maximal speed skating (7th cycle). The knee but not hip range of motion during the propulsion phase increased cycle-by-cycle, with the knee having a more flexed angle at the beginning of propulsion as the sprint progressed. The results can be used to inform training regimes to improve ice hockey skating acceleration.

OUTCOMES OF AN ANTERIOR BONE BLOCK TECHNIQUE WITH ILIAC CREST ALLOGRAFT FOR THE MANAGEMENT OF ANTEROINFERIOR SHOULDER INSTABILITY WITH SUBCRITICAL GLENOID DEFECTS.

OUTCOMES OF AN ANTERIOR BONE BLOCK TECHNIQUE WITH ILIAC CREST ALLOGRAFT FOR THE MANAGEMENT OF ANTEROINFERIOR SHOULDER INSTABILITY WITH SUBCRITICAL GLENOID DEFECTS.

Gait Assessment in the Transtibial Mercer Universal Prosthesis Designed with a “Neutral Alignment” Socket

Standardizing socket design and maintaining a default socket alignment in transtibial prostheses are innovations that aim to simplify fitting procedures and reduce prosthetic service costs, particularly in low-income countries. Objectives: This study evaluated the Mercer Universal Prosthesis (MUP) with a standardized “neutral alignment” against custom-made conventional prostheses (CVPs). Methods: Twenty transtibial amputees (n = 20) completed gait assessments using their CVP and immediately after fitting with an MUP. Temporal–spatial and sagittal plane kinematics (hip, knee, and ankle angles) were analyzed, along with a gait symmetry index. Results: the MUP group reported a significant difference between the prosthetic and the intact limb for both hip and knee kinematics (p &lt; 0.05), but there was no change in the CVP group. When compared with the sound limb in the MUP group, post hoc analysis showed that both hip flexion and the hip range of motion (ROM) in the MUP limb significantly increased by 5.7° and 7.3° (p = 0.002 and p &lt; 0.001, respectively). Spatial and temporal gait parameters were comparable between the MUP and CVP groups, and gait symmetry showed no significant differences. The CVP showed greater symmetry in terms of hip (19%, p = 0.012) and knee flexion (8%, p = 0.026) compared to the MUP, while the MUP had higher plantarflexion symmetry (24.4%, p = 0.013). Conclusions: Immediately post fitting, MUP improved joint mobility in the prosthetic limb, potentially enhancing kinematics. While short-term benefits are evident, further research is needed to assess long-term gait adaptation and quality of life impacts.

Short-segment Fixation for Thoracolumbar Kyphosis Caused by Osteoporotic Vertebral Compression Fractures: A Case Series.

Short-segment Fixation for Thoracolumbar Kyphosis Caused by Osteoporotic Vertebral Compression Fractures: A Case Series.

Modelling of a double-scattering proton therapy nozzle using the FLUKA Monte Carlo code and analysis of linear energy transfer in patients treated for prostate cancer.

The dose-averaged linear energy transfer (LETD) in proton therapy (PT) has in pre-clinical studies been linked to the relative biological effectiveness (RBE) of protons. Until recently, the most common PT delivery method in prostate cancer has been double-scattered PT, with LETD only available through dedicated Monte Carlo (MC) simulations. However, as most studies of the relationship between LETD and RBE in double scattered PT have been focused on the head and neck region, existing MC implementations have not been capable of calculating LETD for the longer field ranges used, for example, in the pelvic region. The initial aim of this study was to implement a MC code allowing for LETD calculations in double-scattered PT of prostate cancer. Additionally, we explored LETD profiles and LETD as a function of field configuration, by performing MC calculations for a large prostate cancer cohort treated with double-scattered PT. The components of a passive scattered clinical treatment nozzle used for delivery of extended field ranges, with two associated modulation wheels, were implemented into an existing FLUKA MC framework for LETD calculations. The code was validated to spread out Bragg peak (SOBP) measurements conducted using the treatment nozzle with 11 different range and modulation width configurations. After validation, LETD distributions were calculated on the planning computed tomographies of 582 prostate cancer patients treated with two-field double-scattered PT. All patients had symmetric field configurations with respect to the sagittal plane, with one pair of posterior oblique, lateral opposing, or anterior oblique fields. Dose and LETD volume parameters and the mean LETD ratio between the bladder and rectum were compared across the three groups. The range differences were below 1mm for all SOBP scenarios used for calibration. For 9 of 11 SOBP scenarios, the modulation width differences were below 2mm. For the patient simulations, the mean gamma pass rates (3mm/3%) were at least 98% in the PTV, bladder, and rectum. Comparing anterior to posterior field configurations, the mean LETD in the bladder increased within both the 10 and 70Gy iso-dose regions, and conversely, the mean LETD decreased for the rectum. There was a marked difference in the mean bladder-to-rectum LETD ratios between anterior oblique, lateral opposing and posterior oblique field configurations. A MC code allowing for accurate calculations of dose and LETD in double-scattered PT of prostate cancer was implemented and validated. The LETD distributions in the rectum and bladder showed a systematic dependence on the field configuration.

The Effect of Rotational Guided Growth With Flexible Tethers on the Distal Femoral Bone: An Experimental Study in a Porcine Model.

New and innovative surgical techniques, using a flexible tether to correct rotational deformities of the growing femur have recently emerged, but are lacking radiographic validation of desired rotation and adverse effects in the frontal and sagittal planes. We, therefore, investigated this new technique in an established large animal model. Eight skeletally immature pigs were included in the study in a paired (left vs. right leg) design. Mean (range) observation time was 83 days (77-90). CT-scans and X-rays were performed immediately after insertion of the tethers and again at euthanasia after 12 weeks. From the CT-scans, 3D-models of the left and right femora were generated and analyzed for intended external rotation and unintended effects in other planes and bone morphology. One pig was excluded due to surgical site infection. Average change in rotation between the operated and non-operated femora was 7.2° (CI: 5.9-8.6) external rotation. We also found unintended valgus deformity in the coronal plane (7.8° (CI: 3.9-12.0) and unintended extension in the sagittal plane (3.9° (CI: -1.8 to 8.7). Unintended changes to the joint morphology were also observed. Rotation by guided growth was achieved with this surgical technique, confirmed by radiological measurements. Clinical Significance. While this large animal study has shown that this new surgical technique reliably corrected rotational deformities by guided growth, it has also revealed adverse effects that need further investigation before clinical use.

Evaluation of dosimetric and spatial accuracy of a virtual cone technique for radiosurgery using linac-integrated CBCT-based polymer gel dosimetry.

This study evaluates the dosimetric and geometric precision of a virtual cone technique using CBCT-based polymer gel dosimetry, enabling radiation delivery, and imaging readout within an identical spatial coordinate system. We created a C# script for a virtual cone technique that generates a treatment plan with 10 gantry arcs at 0°, 36°, 72°, 288°, and 324° couch angles, with 2 arcs per couch angle using 45° and 135° collimator angles. Two verification plans using Eclipse v15.6 (AcurosXB) were created with 20Gy at the maximum dose for: (1) a cylindrical gel, with an additional calibration region; (2) a 3D printed anthropomorphic skull phantom with a gel insert. The 50% isodose (10Gy) width through the central axis of the axial and sagittal planes (SPs) were measured for the gel experiment. The distance between the centers-of-masses of the 10Gy isodose region of the plan and the gel (skull phantom) were calculated for an end-to-end spatial accuracy test. The maximum point dose measured with gel was within 1% of the plan, though the gel measured 50% isodose widths of 5.56 0.02mm, 5.65 0.04mm, 4.23 0.01mm for axial (anterior-posterior), axial (left-right), sagittal (superior-inferior) respectively, which were slightly narrower than Eclipse (1.29mm maximum difference in the SP due to CBCT slice thickness). The center-of-mass distance was 0.66mm for the gel experiment, and 0.94mm for complete end-to-end testing with the anthropomorphic phantom, including CBCT setup (kV-MV isocenter uncertainty). The 50% isodose width of the gel measurement was 5.15mm (mean), which was tighter than our Eclipse v15.6 beam model. The end-to-end spatial accuracy test, only achievable with gel dosimetry using CBCT readout, resulted in sub-millimeter accuracy. This study demonstrates the value of gel dosimetry in verifying the dosimetric and spatial accuracy of this high precision, stereotactic technique.

Anatomical Study of Lateral Compression II Screw Path and Entry Parameters Based on Three-Dimensional CT Image Reconstruction Techniques.

Lateral compression II (LC-II) fractures, a common type of pelvic injury, often require closed reduction and percutaneous screw fixation due to posterior pelvic ring instability. However, existing methods fail to adequately account for the internal structure of the screw path and lack precise anatomical guidance, increasing surgical risks. This study utilized digital medical software to analyze the LC-II screw path and entry parameters, providing the anatomical references. This retrospective study enrolled 43 adult patients (21 males and 22 females) who underwent a complete computed tomography (CT) scan examination from February 2017 to February 2019. The digital three-dimensional (3D) pelvic model was reconstructed, and the ideal LC-II screw path was designed by the cross-section method. The primary evaluation parameters included the screw path length (DAP), maximum diameter (Dmax), distances at narrow points (D1 and D2), bone thickness parameters (OW1 and IW1; OW2 and IW2), and screw entry angles (∠α, ∠β, ∠γ). Of 43 patients, 42 successfully completed LC-II screw path construction. Among 21 female patients, 5 (23.8%) could accommodate screws with a maximum diameter of < 6.5 mm. Compared with female patients, male patients exhibited significantly higher DAP, Dmax, D2, OW1, IW1, IW1/OW1, and IW2/OW2 (p < 0.05). The ∠γ was significantly lower in male patients. Furthermore, digital 3D pelvic model observations revealed that LC-II screws bone entry points in the anterior iliac region were all located posterior to the anterior inferior iliac spine (AIIS). The angles between the LC-II screw and coronal plane were 48.06° in males and 45.10° in females, while the angles between the LC-II screw and sagittal plane were 27.14° and 25.60°, respectively. This study utilized digital medical software to construct the LC-II screw path and analyze sex-based differences, highlighting the importance of individualized preoperative path planning and providing essential anatomical evidence for the precise and safe percutaneous insertion of LC-II screws.

Classification of Kinematic Coupling Patterns Between Lower Limb Joints During Running.

Abnormal foot alignment such flatfoot is involved in running injuries. The mechanism by which flatfoot is susceptible to running injuries has not yet been established. The purpose of this study was to classify kinematic coupling patterns by hierarchical clustering, adding individuals with flatfoot and motion in the transverse plane involved in running injuries, and to identify the factors that determine the clusters classified. Twenty-four young healthy adults were divided and classified into normal and flat foot groups of 12 participants each, using the foot posture index. The task involved treadmill running. Cross-correlation coefficients between the ankle and knee joints and between the knee and hip joint were used to evaluate kinematic coupling in the sagittal, frontal, and transverse planes during the stance phase. Hierarchical clustering was used to classify kinematic coupling patterns using the cross-correlation coefficient as an input variable. After cluster classification, joint angles during the stance phase and static standing were compared between clusters. Hierarchical clustering classified kinematic coupling patterns between lower limb joints into two clusters, mainly the kinematic coupling on the frontal plane. However, clusters were not classified by foot alignment. Significant differences in knee varus/valgus, hip adduction/abduction, and internal/external rotation angles during the stance phase were observed between clusters. Foot alignment was not involved in the cluster analysis in this study. Further detailed evaluation of foot alignment is required.

Effects of autoclave sterilization on the dimensional stability of implant surgical guides: A 3D in vitro analysis.

Surgical guides are medical devices used in static implant surgery to replicate the prosthetic and surgical implant position planned with computer-assisted software before surgery. Their use reduces invasiveness and improves safety and outcomes of implant surgery, provided that their accuracy is ensured from design to manufacturing and then to clinical usage. One of the factors that may potentially interfere with their accuracy is the sterilization procedure. The present study aimed to analyze how autoclave sterilization affects 3D-printed surgical guide stability. Ten 3D-printed surgical guides were scanned before (T0) and after (T1) autoclave sterilization. T0 and T1 scans were compared with the corresponding CAD model in a surface matching software program. Trueness of the intaglio surface, linear and axial deviations of sleeves' housings at T0 and T1 were measured and statistically analyzed by generalized estimated equation (GEE) models to evaluate the effects of the sterilization procedure. Surface variations, linear and axial deviations of sleeves' housings were found to be significantly (p<0.05) affected by the sterilization only in combination with the volume or the total surface area of the surgical guides. The magnitude of the T0-T1 differences was small (0.016mm and 0.035mm for mean absolute deviation (MAD) at the intaglio surface in contact with teeth or mucosa; 0.009mm for linear deviation of the central point of sleeves' housings; 0.084° and 0.180° for their axial deviation on the sagittal and frontal planes). The effects of autoclave sterilization on the stability of 3D-printed surgical guides remain limited and clinically insignificant.

Morphology, development and ecological implications of the dentition of Bajadasaurus pronuspinax

ABSTRACT The associated preservation between dentitions and dentigerous elements is crucial for understanding diverse biological features. Notwithstanding, their fossil record in Sauropoda is relatively seldom, compared to other skeletal elements. Here, the first partially complete dentition including upper and lower teeth in Dicraeosauridae is described, based on Bajadasaurus pronuspinax. This dentition lacks only one upper and two lower functional teeth. The dentigerous elements preserved replacement teeth, which reduce in length and number caudally. Tooth formation times and rates vary within the different elements, with a total mean replacement time of 40.7 days. The functional dentition shows three caudally directed patterns: reduction in size, reduction in curvature, and reduction in the occurrence of wear facets. The functional teeth number mirrors in the occlusal and sagittal planes. The replacement teeth count in Bajadasaurus is lower than the same for other diplodocoids. In this taxon, the tooth-replacement process fits the Zahnreihen with a Z-space-of-two model on the lower dentition, but this model results in a chaotic arrangement of the developmental pattern dorsally, probably due to a replacement mechanism of the whole upper dentition similar to Dicraeosaurus and Apatosaurus. Overall, the dental traits of Bajadasaurus suggest a plausible low-level specialist-feeding ecological niche for this taxon.

3D Sagittal Parameters Can Guide the Indications for Anterior Release in Thoracic AIS ≥70°.

Study DesignRetrospective, multicenter.ObjectivesThis study aims to evaluate the immediate postoperative effect of, and define indications for, an anterior release (discectomy) in large AIS curves utilizing 3D deformity analysis.MethodsA multicenter registry was queried for AIS patients with main thoracic curves ≥70° treated with either anterior/posterior (AP) or posterior-only surgery and biplanar stereoradiographic pre-operative and first-erect (FE) postoperative images. Standard 2D radiographic and 3D parameters were analyzed using custom MATLAB software. 3D thoracic kyphosis (3DTK) was calculated by removing the error induced by axial rotation and coronal deformity.Results109 patients were included, 21 AP and 88 posterior-only. The AP group had larger (89° vs 76°, P < .001), less flexible (9% vs 21%, P = .001) curves, though greater percent correction (79% vs 71%, P = .003), producing similar postoperative curve magnitude (19° vs 22°, P = 0.1). The AP group had less preoperative 3DTK (-15° vs -3°, P < .001), though similar postoperative 3DTK (24° vs 20°, P = .1), nearly double the improvement (39° vs 23°, P < .001). No cases with preoperative 3DTK < -18° achieved postoperative 3DTK >25° without anterior release. Segmental data of each motion segment demonstrated anterior release led to greater change in the coronal (P < .001) and sagittal (P = .003) planes, though not axial rotation of the apical vertebra (P = .157).ConclusionIn a cohort of AIS patients with thoracic curve magnitude >70°, 3D analysis comparing anterior/posterior vs posterior-only approach demonstrated improved correction in the coronal and sagittal, but not the axial plane. If 3DTK preop was <-18° only anterior release patients achieved postoperative 3DTK >25°.Level of EvidenceIII.

Evaluation of lumbar segmental motion using ultrasound imaging following common joint mobilization techniques

ABSTRACT Objectives Spinal mobility is clinically important in managing mechanical low back pain. Manual methods are commonly used for diagnosis and treatment in orthopedic practice. This study quantified changes in sagittal plane lumbar segmental motion using ultrasound imaging (USI) following common joint mobilization techniques in asymptomatic individuals. Additionally, tibial H-reflexes and sagittal plane trunk motion in standing were evaluated for association with lumbar segmental motion. Participants aged ≤ 30 or ≥ 50 years were recruited from among students, faculty, and affiliates of the Department of Physical Therapy at Winston-Salem State University and randomized to receive L4 central posterior-to-anterior (CPA) mobilization or left lumbar rotation mobilization interventions. Joint laxity was assessed using the Beighton score, and standing sagittal plane trunk motion was measured using the fingertip-to-floor method. Lumbar segmental motion was evaluated using USI in neutral, extension, and flexion positions at baseline, immediately following joint mobilization, and following 5 minutes of prone resting. Tibial H-reflexes were measured at baseline, immediately following joint mobilization, and in real-time during CPA mobilization. The primary outcome was lumbar segmental motion analyzed by position, mobilization group, sex, age category, and Beighton risk. Results Repeated measures ANOVA revealed significant increases in L4/5 flexion (p = .01, ƞ2=.21) and combined flexion and extension (p = .03, ƞ2=.15). These changes persisted following 5 minutes of prone resting, regardless of mobilization technique. Significant interactions between segmental motion, sex, and/or Beighton risk were observed. Discussion/Conclusion Significant increases were observed in L4/5 flexion immediately following joint mobilization regardless of mobilization group, with significant statistical interactions observed between segmental motion, sex, and/or Beighton risk. This is the first investigation to demonstrate the value of USI for quantifying lumbar segmental motion following joint mobilization. Quantifying lumbar segmental motion helps clarify the underlying mechanisms of manual therapy. Future studies should include patients with low back pain.

Anatomical landmarks allow for accurate tibial component positioning in kinematically aligned mobile bearing medial unicompartimental knee arthroplasty.

Anatomical landmarks allow for accurate tibial component positioning in kinematically aligned mobile bearing medial unicompartimental knee arthroplasty.

A novel preoperative prosthetic position planning algorithm for total hip arthroplasty based on the no-impingement principle: A case study.

Most preoperative planning calculations of impingement-free range of motion (IFROM) and impingement-free safe zone (IFSZ) rarely consider non-standard shaped prostheses and bony impingement (BI) for total hip arthroplasty (THA). This research developed a novel algorithm that considers BI, prosthetic impingement, pelvic tilt angle (PT) in the sagittal plane, and non-standard-shaped hip prostheses. This research aimed to investigate the effect of BI and PT on hip IFROM, IFSZ, and the BI rate. Using this algorithm to calculate a case, we found that when considering BI, (1) the upper limit of the hip IFROM was decreased, and the different PT affected the upper limit of the hip IFROM of various movements; (2) the BI rate of the flat-rim liner in standing and sitting postures were 54.6% and 67%; and (3) the maximum IFSZ size of the flat-rim liner was reduced by 12%, the reduction rate of the combined pelvic position with a non-zero IFSZ size was 83.2% for the flat-rim liner. Consideration of BI further reduces the IFROM, the IFSZ size, and the number of the combined position of the pelvis with a non-zero IFSZ size of the hip joint. Importantly, this algorithm provides a reliable tool for personalized prosthesis positioning for THA. This algorithm has excellent applications in personalized surgical planning and surgical robotics.

Correlation between cranial base morphology and skeletal malocclusion using cone beam computed tomography: a cross-sectional study

Correlation between cranial base morphology and skeletal malocclusion using cone beam computed tomography: a cross-sectional study