Objective: Quadriceps dysfunction has been suggested as a complication after medial patellofemoral ligament (MPFL) reconstruction. The purpose of this study was to investigate changes in knee extensor strength before and after MPFL reconstruction.
Methods: Twenty patients who underwent MPFL reconstruction for unilateral recurrent patellar dislocation (18 females and 2 males; mean age 20.8 ± 7.6 years) were examined. The peak isometric torque at 60° and 90° of knee flexion and isokinetic knee extensor strength at speeds of 60°/s and 90°/s in operated and non-operated legs were measured using a dynamometer preoperatively and 6 months, 1 year, and 2 years postoperatively. The following parameters were evaluated: (1) body weight-adjusted muscle strength, (2) improvement index (post-/preoperative value × 100) (%), and (3) extensor strength ratio (operated/non-operated value × 100) (%).
Results: The mean knee extensor strength in both operated and non-operated legs significantly increased 2 years after surgery compared with that before surgery. At 2 years postoperatively, the improvement indexes of the isometric knee extensor strength at 60° and 90° and of the isokinetic knee extensor strength at 60°/s and 90°/s were 237%, 192%, 318%, and 186%, respectively, in the operated legs and 144%, 124%, 140%, and 140%, respectively, in the non-operated legs. At 2 years postoperatively, the mean isometric knee extensor strength ratios at 60° and 90° and the isokinetic knee extensor strength ratios at 60°/s and 180°/s were 81%, 84%, 81%, and 82%, respectively.
Conclusions: Knee extensor strength was improved in most patients after MPFL reconstruction, at least compared with that before surgery, although an approximately 20% deficit against the non-operated legs remained even 2 years after surgery. 相似文献
BackgroundFollowing rehabilitation for total knee arthroplasty, “quadriceps avoidance gait”, defined by limited knee flexion angle excursion during walking, persists and contributes to poor long-term outcomes. Given the presence of several post-surgical impairments, identifying the contribution of multiple factors to knee flexion angle excursion is important to developing targeted interventions to improve recovery after total knee arthroplasty.Research questionsWhich outcomes continue to improve following rehabilitation for total knee arthroplasty? What are the primary contributors to impaired knee flexion angle excursion during walking following total knee arthroplasty?MethodsPeak muscle strength and rate of torque development of the quadriceps, hip abductors, and hip external rotators, five-time sit-to-stand test, Knee Injury & Osteoarthritis Outcome Score, and gait mechanics were assessed in 24 participants at three and six months post-surgery. Paired sample t-tests or Wilcoxon Signed-Rank tests were used to compare outcomes between assessments. Stepwise multiple linear regression were used to assess the contribution of each measure to knee flexion angle excursion.ResultsSignificant improvements were noted in all outcomes except hip external rotation rate of torque development, gait speed, and knee flexion angle excursion. Quadriceps rate of torque development and knee pain significantly contributed to knee flexion angle excursion at three months (Adjusted R2 = 0.342), while quadriceps rate of torque development and peak hip external rotation strength significantly contributed at six months (Adjusted R2 = 0.436).SignificanceWhile higher pain levels at three months and greater peak hip external rotation muscle strength at six months contribute to impaired knee flexion angle excursion, quadriceps rate of torque development was the primary contributor to knee flexion angle excursion at both three and six months after surgery. Implementing strategies to maximize quadriceps rate of torque development during rehabilitation may help to reduce quadriceps avoidance gait after total knee arthroplasty. 相似文献
Mechanical peak power output (PPO) is a determinant of performance in sprint cycling. The purpose of this study was to examine the relationship between PPO and putative physiological determinants of PPO in elite cyclists, and to compare sprint performance between elite sprint and endurance cyclists. Thirty-five elite cyclists (18 endurance; 17 sprint) performed duplicate sprint cycling laboratory tests to establish PPO and its mechanical components. Quadriceps femoris (QVOL) and hamstring muscle volume (HAMVOL) were assessed with MRI, vastus lateralis pennation angle (PθVL) and fascicle length (FLVL) were determined with ultrasound imaging, and neuromuscular activation of three muscles was assessed using EMG at PPO during sprint cycling. For the whole cohort, there was a wide variability in PPO (range 775-2025 W) with very large, positive, bivariate relationships between PPO and QVOL (r = .87), HAMVOL (r = .71), and PθVL (r = .81). Step-wise multiple regression analysis revealed that 87% of the variability in PPO between cyclists was explained by two variables QVOL (76%) and PθVL (11%). The sprint cyclists had greater PPO (+61%; P < .001 vs endurance), larger QVOL (P < .001), and BFVOL (P < .001) as well as more pennate vastus lateralis muscles (P < .001). These findings emphasize the importance of quadriceps muscle morphology for sprint cycling events. 相似文献
The implant surface must withstand high insertion torque during implant insertion. The aim of this study was to investigate the damage to implant surfaces caused by two different insertion protocols in vitro. Fifteen titanium implants per group were inserted in standardized polyurethane foam models, group 1 according to a non-threaded surgical protocol and group 2 according to a threaded surgical protocol. Before and after insertion, the surfaces were visualized by scanning electron microscopy (SEM) and non-contact laser profilometry. Different surface area parameters were evaluated and maximum torque during insertion was determined. SEM detected topographical changes such as deposition of the test block and smoothening of the surface in the region of the thread crests in both groups. The laser profilometry analysis revealed significant changes in the surface topography of the implants in both groups, but no differences between the groups. Insertion torque was significantly decreased in the threaded group. Both types of surgical intervention resulted in surface damage. Less damage was detected to the thread crests with the use of a thread cutter, and most of the surface was not visibly affected by the surgical protocol at the microscopic level. The surgical protocol seems to have a minor influence on preservation of the implant surface. 相似文献
Backgrounds: Joint kinetic calculations are sensitive to joint centre locations. Although geometric hip and knee joint centre/axis are generally developed, the ankle joint centre (AJC) is conventionally defined as the midpoint between the malleolus lateralis and medialis (AJCMID) in most gait analyses.Research question: We examined the positional difference of the AJCMID from the geometric centre of rotation (AJCFUN) and its effect on the ankle joint kinetics in representative human gaits.Methods: In the first experiment, we calculated the AJCFUN and indicated its location on the ankle MRI in 14 (seven male and seven female) participants. In the second experiment, we compared ankle kinematics/kinetics based on AJCFUN and AJCMID during walking and hopping at 2.6 Hz in 17 (nine male and eight female) participants.Results: In both experiments, AJCFUN was located at positions significantly medial (-9.2 ± 5.4 mm and -10.1 ± 4.4 mm) and anterior (17.0 ± 7.4 mm and 15.3 ± 5.2 mm) from the AJCMID. Furthermore, the AJCMID underestimated peak dorsiflexion (AJCMID/AJCFUN: 52.6 ± 17.1%) and inversion (AJCMID/AJCFUN: 62.2 ± 11.5%) torques and their durations in walking. Additionally, AJCMID overestimated the plantar flexion torque in both gait modes [AJCMID/AJCFUN: 111.3 ± 4.8% (walking) and 112.7 ± 6.3% (hopping)].Significance: We therefore concluded that the positional difference between the geometric and landmark-based AJC definitions significantly affected ankle kinetics, thereby indicating that the functional method should be used for defining AJC for gait analysis. 相似文献
Objective: The objective of this study was to explore effects of implant macrodesign and diameter on initial intraosseous stability and interface mechanical properties of immediately placed implants. Material and method: Mandibular premolars of four fresh‐frozen human cadavers were extracted. Ø 4.1/4.8 mm ITI® TE®, Ø 4.1 and 4.8 mm solid screw synOcta® ITI® implants were placed into freshly prepared extraction sockets. Resonance frequency analysis was conducted to quantify primary implant stability quotient (ISQ). Installation torque value (ITV) and removal torque value (RTV) of the implants were measured using a custom‐made strain‐gauged torque wrench connected to a data acquisition system at a sample rate of 10,000 Hz. The vertical defect depth around the collar of each implant was measured directly by an endodontic spreader. The bone–implant contact was determined in digitalized images of periapical radiographs and expressed as percentage bone contact. Results: The ISQ values of the TE® implant was higher than the Ø 4.1 mm implant (P<0.01), and comparable with the Ø 4.8 mm implants (P>0.05). ITVs and RTVs of TE® and Ø 4.8 mm implants were higher than the Ø 4.1 mm implant, although the differences between groups were statistically insignificant (P>0.05). The vertical defect depths around all types of implants were similar. In the radiographic analyses, percentage bone–implant contact of the TE® and Ø 4.8 mm implants were comparable at the marginal bone region and both were higher than that of the Ø 4.1 mm ITI® implant. Nonparametric correlations between groups revealed a significant correlation between ITV and RTV (r=0.838; P<0.001), but not between ISQ values and ITVs and RTVs (P>0.05). Conclusion: Immediately placed ITI® TE® implant leads to initial intraosseous stability and interface mechanical properties comparable with a wide diameter implant. 相似文献
summary The aim of this study was to determine the bone density in the designated implant sites using computerized tomography (CT), the fastening torque values of dental implants, and the implant stability values using resonance frequency analysis. Further aim was to evaluate a possible correlation between bone density, fastening torque and implant stability. Eighty‐five patients were treated with 158 Brånemark System implants. CT machine was used for preoperative evaluation of the jawbone for each patient, and bone densities were recorded in Hounsfield units (HU). The fastening torque values of all implants were recorded with the OsseoCare equipment. Implant stability measurements were performed with the Osstell machine. The average bone density and fastening torque values were 751·4 ± 256 HU and 39·7 ± 7 Ncm for 158 implants. The average primary implant stability was 73·2 ± 6 ISQ for seventy implants. Strong correlations were observed between the bone density, fastening torque and implant stability values of Brånemark System TiUnite MKIII implants at implant placement (P < 0·001). These results strengthen the hypothesis that it may be possible to predict and quantify initial implant stability and bone quality from pre‐surgical CT diagnosis. 相似文献
Background: The primary stability of dental implants associated with resistance to micromotion during healing is affected by surgical technique and implant design, which are important especially in the soft bone, where implant failures are more likely. Purposes: This study was designed to compare the parameters associated with implant insertion using two different methods of enhancing implant primary stability and to identify any relationship between these parameters at implant insertion. Materials and Methods: A total of 60 implants were placed in the maxillary posterior regions of 22 patients. The bone densities at the implant sites were recorded using a computerized tomography machine in Hounsfield unit (HU). The maximum insertion torque data were recorded with the Osseocare™ (Nobel Biocare AB, Göteborg, Sweden) equipment, while resonance frequency analysis (RFA) measurements were taken using an Osstell™ (Integration Diagnostics AB, Göteborg, Sweden) machine at implant surgery. Comparisons including HU, Ncm, and implant stability quotient were made between two control groups (C1 and C2), and corresponding four test groups (T1–T4) using thinner drills to enhance primary implant stability. Results: Two implants were lost, meaning an overall implant survival rate of 96.6% after 3 ± 1 years. When compared to control groups, significantly higher mean maximum insertion torque and RFA values were found for corresponding test groups. In addition, strong correlations were observed between the bone density and insertion torque, and implant stability values at implant placement. Conclusion: The results of this study suggest that using thinner drills for implant placement in the maxillary posterior region where bone quality is poor may improve the primary implant stability, which helps clinicians to obtain higher implant survival rates. 相似文献
This clinical study aimed to determine the bone density in dental implant recipient sites using computerized tomography (CT) and to establish a lower threshold value of bone density for early loading protocols. The study group was composed of 100 early loaded implants in 42 patients. A total of four groups were established according to the loading time and implant sites. The bone density of each recipient site for implant placement was determined using CT. The maximum insertion torque values were recorded with torque controlling machine. Implant stability measurements were performed with resonance frequency analyser. The bone density values varied from 528 to 1231 HU. It was found that mean bone density, insertion torque and resonance frequency analysis values were 887 +/- 180 HU, 41.2 +/- 6 Ncm, and 73.7 +/- 4 ISQ, respectively. Strong correlations were found between these three parameters. CT may be a useful tool for assessing the bone density of recipient areas before implant placement, and the early loading of dental implants may be possible in the implant sites where bone density is over 528 HU. 相似文献