Search Results (98)

Background: The pelvic girdle is an important component of the human stabilization system, both during the maintenance of an upright standing position and during motor activities. Frequent functional and structural asymmetries within it can affect the structure and function of many organs and systems of the human body. The mechanism of their occurrence is not fully explained. The objective of the present study was to verify the hypothesis regarding the relationship between the value of pelvic asymmetry and the functional state of muscles that stabilize the lumbo–pelvic–hip complex, as measured by changes in their stiffness. Methods: The study group consisted of 40 young women aged from 19 to 29 years. The observational cross-sectional study incorporated the following elements: an interview, an anthropometric test, an inclinometric assessment of the magnitude of hip girdle rotation utilizing a duometer and tensiomyography. Results: Analysis of the variables examined in subjects with symmetric or rotated pelvises did not show significant differences between the studied sides in the two groups. Evaluation of associations between the magnitude of pelvic rotation and tensiomyography findings showed that with increased pelvic rotation, the stiffness of the back extensor muscles and the rectus thigh muscles increased only slightly bilaterally, and the contraction rate of the rectus abdominis and biceps thigh muscles decreased. Conclusions: The results of the tensiomyography study did not unequivocally demonstrate that changes in pelvic symmetry in the transverse plane are associated with dysfunction of the muscles that stabilize the pelvic girdle. Full article

Patient-tailored hip implants are a major area of development in orthopedic surgery. Thanks to the recent developments in titanium printing, the medical industry now places special demands on implants. The lattice design enhances osseointegration and brings the stiffness of the implant closer to that of the bone, so this is an important direction in the development of hip implant design processes. In our previous research, several lattice structures were compared from a strength perspective, considering surgical specifications regarding cell size. The so-called 3D lattice infill type built into ANSYS with a predefined size has proven to be suitable for medical practice and can be easily manufactured with additive manufacturing techniques. A major step in the implant design process is numerical strength analysis, which elucidates implant material response. Due to the complex geometry of the lattice structure, finite element calculations are extremely time-consuming and require high computation capacity; therefore, the focus of our current research was to develop a surrogate numerical model that provides sufficiently fast and accurate information about the behavior of the designed structure. The developed surrogate model reduces the simulation time by more than one hundred times, and the accuracy of the calculation is more than satisfactory for engineering practice. The deviation from the original model is, on average, below 5%, taking deformation into account. This makes the design phase much more manageable and competitive. Full article

In this study, we propose a solution for automatically measuring body circumferences by utilizing the built-in LiDAR sensor in mobile devices. Traditional body measurement methods mainly rely on 2D images or manual measurements. This research, however, utilizes 3D depth information to enhance both accuracy and efficiency. By employing HRNet-based keypoint detection and transfer learning through deep learning, the precise locations of body parts are identified and combined with depth maps to automatically calculate body circumferences. Experimental results demonstrate that the proposed method exhibits a relative error of up to 8% for major body parts such as waist, chest, hip, and buttock circumferences, with waist and buttock measurements recording low error rates below 4%. Although some models showed error rates of 7.8% and 7.4% in hip circumference measurements, this was attributed to the complexity of 3D structures and the challenges in selecting keypoint locations. Additionally, the use of depth map-based keypoint correction and regression analysis significantly improved accuracy compared to conventional 2D-based measurement methods. The real-time processing speed was also excellent, ensuring stable performance across various body types. Full article

Background/Objectives: Recurrent hip dislocations are a rare occurrence in pediatric patients. As there are few cases of voluntary habitual dislocation documented in the literature, there is a paucity of information available regarding its pathogenesis, risk factors, and classification. The prognosis for these patients is generally good. A long-term follow-up duration of two years was conducted to evaluate outcomes. Statistical analysis was performed to assess the impact of family structure and treatment approaches on outcomes. Methods: From January 2010 to December 2022, patients with voluntary habitual hip dislocation were retrospectively identified through the hospital information system. Data regarding demographic characteristics, clinical findings, and treatment outcomes were analyzed. A total of 13 patients (14 hips) met the inclusion criteria. Conservative treatment methods, including orthosis and family therapy, were applied. Statistical analysis was performed to assess the impact of family structure and treatment approaches on outcomes. Results: The mean age at diagnosis was 48.7 months, with 77% of cases being female. Posterior dislocation was observed in all cases, and no underlying bone pathology was detected on imaging. The prognosis for these patients is generally good. At the one-year follow-up, 85% of patients achieved a complete resolution of dislocations, increasing to 100% by the two-year follow-up. Patients from larger families demonstrated significantly slower recovery rates at the first- and sixth-month evaluations (p = 0.033 and p = 0.048, respectively), but outcomes were comparable by one year. A unique aspect of this study is the emphasis on family dynamics, which significantly influenced treatment adherence and recovery. Statistical analysis was performed to assess the impact of family structure and treatment approaches on outcomes. Conclusions: Voluntary habitual hip dislocation is a rare condition with good long-term outcomes under conservative management. This study highlights the importance of addressing family dynamics in the treatment plan, especially in larger families, where attention and psychological factors may play a significant role in delayed recovery. Full article

Background: Clinical guidelines for physiotherapy following total hip and knee arthroplasty (THA/TKA) recommend using Patient-Reported Outcome Measures (PROMs) like the Hip disability and Knee injury Osteoarthritis Outcome Score (HOOS/KOOS). However, it remains unclear how physiotherapists use these PROMs in daily clinical practice. Objective: To explore primary care physiotherapists’ experiences with the HOOS/KOOS in daily clinical practice following THA and TKA. Methods: Thirteen physiotherapists in the Netherlands were recruited via convenience sampling. Data were collected through semi-structured interviews, which explored HOOS/KOOS use in clinical practice, administrative regulations, and applications beyond patient care, as well as think-aloud interviews to capture perceptions of the content of these PROMs and interpretations of hypothetical patient scores. Interviews were analysed using reflexive thematic analysis. Results: The physiotherapists’ ages ranged from 25 to 54y, with annual THA/TKA volumes from 5 to 50 patients. Three themes emerged, as follows: (1) “Physiotherapists use the HOOS/KOOS for various purposes in daily clinical practice”, including complementing history taking and monitoring patient progress; (2) “Perceptions of the relevance of the HOOS/KOOS for daily clinical practice vary per item, domain, and version,” with items related to daily life activities and psychosocial factors being perceived as more valuable; and (3) “Practical aspects of HOOS/KOOS administration influence their use in daily clinical practice,” with electronic health records (EHRs) that facilitate PROM administration enhancing their use, while administrative regulations limit this. Conclusions: Physiotherapists experience HOOS/KOOS items related to daily life activities and psychosocial factors useful for history-taking and monitoring patient progress, particularly when embedded in EHRs that facilitate PROM administration. Full article

This study analyzes the results of a displacement measurement of the Sungnyemun Gate’s structural members, such as column, girder, and hip rafter, carried out by the National Institute of Cultural Heritage for about 10 years from December 2013 to October 2022. Through this, we attempt to examine the behavior of wooden architectural heritage sites according to seasonal changes and infer the factors influencing structural deformation. As a result of the analysis, it was confirmed that the structural members of the Sungnyemun Gate, including the columns, girders, and hip rafters, continued to move and that the displacement of members was accumulated, and the structure was deformed. It was also confirmed that member displacements accumulated in a specific direction. In the case of the Sungnyemun Gate, the column leaning south, the hip rafters’ endpoint sagging, and the girders’ center deflecting were continuously observed. Furthermore, the behavior of wooden architectural heritage sites, where displacement accumulates as it undergoes repeated deformation and recovery according to seasonal changes, was also revealed in detail. The deformation of the Sungnyemun Gate’s members shows a pattern that reflects the mechanical properties of wood, which repeatedly increases and decreases displacement depending on the season. However, seasonal deformation did not appear the same in all the members. Even the same member has an uneven drying speed due to differences in the amount of sunlight it receives depending on its location, which leads to uneven distribution of deformation. The significance of this study is that it examined the behavior of a wooden architectural heritage site in detail based on the quantitative results of long-term measurements and prepared primary data for the future management of wooden architectural heritage sites. Full article

The increasing demand for rehabilitation and walking assistive devices driven by aging populations has promoted the development of a novel hip joint structure. This design aims to enhance the functionality of lower limb exoskeletons by eliminating the kinematic mismatch with the human’s biological hip. The design utilizes three 1-DOF (Degree of Freedom) rotational joints to replicate natural hip movement. By integrating IMU data, motor compensation is dynamically made to facilitate a more natural gait. Experimental results indicate improved hip joint angles and enhanced user comfort, presenting a promising solution for better walking assistance for elderly individuals. Full article

Background: Acetabular fractures continue to pose a major challenge in clinical practice, not least because of the growing geriatric population. While the influence of the force vectors on fracture formation is well established, the impact of anatomical factors on fracture morphology remains poorly understood. The aim of this study was to investigate patient-specific hip joint geometry, identify structural risk factors and correlate these with the resulting fracture patterns. Methods: This retrospective cohort analysis included 226 patients (Mdn age = 58 yrs.) with acetabular fracture categorized by Judet/Letournel and the AO/OTA classification. Computed tomography (CT) datasets of the injured and contralateral sides were analyzed using multiplanar reconstruction. Parameters included modified center-edge (CE) angle (Wiberg), rotation angles (Ullmann and Anda), acetabular sector angle (Anda), true caput-collum-diaphyseal (CCD) angle, femoral head diameter and volume, as well as femoral neck length, circumference, and diameter. In addition, intrarater reliability within a subcohort was assessed for the metric measurements and inter-rater analysis for the classification of the entire sample. Results: The primary analysis showed direct effects of femoral head diameter, femoral neck length and femoral head size on the fracture type according to AO/OTA (type A/B/C), whereby this effect was particularly seen between type A and type C fractures (p = 0.001). Ordinal regression identified femoral head diameter as the only significant predictor (p = 0.02), with a 25% increased likelihood of complex fractures per unit of change. Low-energy trauma doubled the risk of severe fractures. Specific findings include a higher acetabular anteversion in anterior column fractures. Age correlated positively with the cause of injury and fracture type. The inter-rater reliability for fracture classification was excellent, as was the intrarater reliability of the measurements. Conclusions: This study suggests that anatomical factors, particularly proximal femoral geometry, have an impact on acetabular fracture morphology—in addition to factors such as trauma type and patient demographics. Full article

Stress shielding and aseptic loosening have been identified as adverse effects of short-stem total hip arthroplasty resulting in hardware failure. However, there is a gap in research regarding the impact of stress shielding in customized porous coatings. The purpose of this study was to optimize the distribution of the coefficients of friction in the porous coating of a metaphyseal femoral stem to minimize stress shielding. Static structural analysis of an implanted short, tapered-wedge stem with a titanium porous coating was performed with the use of Analysis System Mechanical Software under axial loading. To limit computational time, we randomly sampled only 500 of the possible combinations of coefficients of friction. Results indicate that the coefficient of friction in the distal lateral porous coating significantly affected the mid-distal medial femoral surface and lateral femoral surface. The resultant increased proximal strains resulted from an increased coefficient of friction in lateral porous coating and a reduction in the coefficient of friction in medial mid-distal coating. These findings suggest that a customized porous coating distribution may produce strain patterns that are biomechanically closer to intact bone, thereby reducing stress shielding in short femoral stems. Full article

Background/Objectives: Evidence-based guidelines and care standards recommend offering oral nutrition supplements to all older adults with hip fracture, not just those already malnourished. This study aimed to identify the proportion of inpatients in a sample of hospitals in two countries that were provided with oral nutritional supplementation (ONS) following a hip fracture and to identify factors associated with ONS provision. Methods: An analysis of prospectively collected data from a bi-national Hip Fracture Registry nutrition sprint and registry audit data limited to older adults (≥65 years) undergoing surgical intervention for a fractured hip from 1 to 31 August 2021. Multivariable logistic regression was used to identify factors associated with providing ONS. Results: Patient-level data was available for 385 older adults (median 85 years; 60.5% female) admitted to twenty-nine hospitals. Less than half (n = 47.3%) of the audited inpatients were provided ONS. After adjusting for covariates, ONS was more likely to be provided to older adults who were identified as malnourished on formal testing (OR 11.92; 95%CI 6.57, 21.69). Other factors associated with prescription of ONS included those who did not have a preoperative medical assessment (OR 2.26; 95%CI 1.19, 4.27) or were cognitively impaired (OR 1.83; 95%CI 1.01, 3.32), severely frail, or terminally ill (OR 3.17; 95%CI 1.10, 9.17). Conclusions: ONS was provided in line with evidence-based recommendations for less than half of the older adults with a hip fracture in 29 hospitals in two countries. A structured approach to implementation may be required to reduce complications and improve outcomes for all older adults after a hip fracture, not just those assessed as cognitively impaired, frail, and/or malnourished. Full article

This research investigates the tensile strength and microstructural properties of stainless steel 316L, comparing samples fabricated using additive manufacturing (AM) to those produced via conventional manufacturing techniques such as forging and casting using stainless steel 316L for its mechanical performance and corrosion resistance. Tensile tests revealed that AM samples had an ultimate tensile strength (UTS) of 650 MPa, a yield strength of 550 MPa and an elongation at break of 20%, and conventionally manufactured samples achieved a UTS of 580 MPa, a yield strength of 450 MPa and a higher elongation at break of 35%. The reduced ductility of AM samples is offset by their higher strength. Scanning electron microscopy (SEM) analysis showed that AM samples had a refined grain structure, with grain sizes ranging from 1 to 5 µm, whereas conventionally produced samples exhibited larger grain sizes of 10 to 20 µm, contributing to their increased ductility. This shows that while AM processes can give a rather high strength, the ductility property is simpler to attain with casting. Further work is needed to investigate post-processing techniques like hot isotropic pressing (HIP) and heat treatments for enhancing the ductility of AM parts as well as mechanical properties. Full article

Hip Disability and Osteoarthritis Outcome Survey (HOOS) was developed as a region- and disease-specific outcome to assess hip disability. Despite the use of the HOOS in clinical practice and research, psychometric analyses of the scale in a large dataset of patients have not been performed. As such, the purposes of this study were to assess the structural validity of the HOOS in patients who underwent a total hip arthroplasty. Data were obtained from the Surgical Outcome System (SOS) global registry. Confirmatory factor analysis (CFA) was conducted to assess the scale structure of the 40-item HOOS and exploratory factor analysis (EFA) was conducted to identify a parsimonious scale structure. The parsimonious model identified was subjected to multi-group and longitudinal invariance testing and LGC modeling. The original five-factor, 40-item HOOS did not meet recommended model fit indices values (CFI = 0.822, TLI = 0.809, IFI = 0.822, RMSEA = 0.085). Alternate model generation identified an alternative model (i.e., HOOS-9). Sound model fit was identified for the HOOS-9 (CFI = 0.974, TLI = 0.961, RMSEA = 0.046). Invariance testing criteria were also met between groups (i.e., age and sex) and across time. Lastly, a nonlinear growth trajectory was identified in responses pertaining to hip disability. The original scale structure of the 40-item HOOS was not supported. The HOOS-9 met contemporary model fit recommendations, along with multi-group and longitudinal invariance testing. Our findings support the preliminary use of the HOOS-9 to assess hip function and disability in research and clinical practice. Full article

Background/Objectives: Obesity can be associated with impaired growth hormone (GH) secretion, with possible negative repercussions on bone health. We aimed to investigate the relationships between GH secretory capacity, evaluated with GHRH + arginine stimulation test, and bone parameters, assessed with a dual-energy X-ray absorptiometer, in a population of adult female patients affected by overweight and obesity. Methods: We assessed 276 women affected by overweight or obesity referred to the High-Specialization Center for the Care of Obesity, Umberto I Polyclinic, between 2014 and 2019 with signs or symptoms of growth hormone deficiency (GHD). Results: A total of 97 patients were diagnosed with GHD, and 179 patients with normal GH secretion were considered our control group. GHD patients showed a significantly reduced trabecular bone score (TBS) (p = 0.01). Bone quality parameters corrected for body mass index (BMI) had a positive and significant linear correlation with stimulated GH secretory capacity. Conclusions: In conclusion, bone quality, evaluated by TBS and hip structural analysis, correlates with GH-stimulated secretory capacity. GHD may act as an additive factor in the alteration of bone microarchitecture in patients affected by obesity, who are already at a higher risk of fractures. Full article

The scientific literature suggests that, if periprosthetic osteolysis (PPO) is not treated, it may have a negative impact on the results of a total hip replacement and possibly result in failure. This systematic review aimed to determine the efficacy of using bisphosphonates preventatively to limit PPO after a total hip arthroplasty (THA). Methods: A systematic review and meta-analysis were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A PICOS template was developed to ensure a structured approach. A search for relevant studies was performed across four databases, including Pubmed, Scopus, Embase, and Cochrane. They were all last searched on March 1st and were assessed using the Cochrane risk of bias tool for randomised studies. Results: The final analysis included seven studies with a total of 126 study group participants and 144 control group participants. The studies looked at Bony Mass Density in terms of bone loss on Gruen’s femoral zones after THA in a bisphosphonate (treatment) and control group (placebo/no treatment). The analysis revealed a statistically significant difference (p < 0.05) in favour of the bisphosphonate group in many of the included studies at 6, 12, and 24 postoperative months. Conclusions: This systematic review and meta-analysis, using the most recent applicable studies, showed the efficacy of bisphosphonates in limiting periprosthetic osteolysis after THA in a period between 6 and 24 postoperative months. Future studies should focus increasing group sizes and collecting results beyond the 2-year mark. Full article

The paper describes the type of changes in the structure and mechanical properties of 3D printed shapes under the influence of mineral oil. The effects of a room (23 °C) and elevated temperature (70 °C) on 3D prints manufactured by the FDM method and stored in oil for 15, 30, and 60 days on the change of properties and structure were investigated. The samples were produced from ABS (poly(acrylonitrile-co-butadiene-co-styrene)), ASA (poly(acrylonitrile-co-styrene-co-acrylate), PLA (poly(lactic acid)), and HIPS (high-impact polystyrene). Tests related to the strength of the materials, such as the static tensile test and Charpy impact test, were carried out. The structure was evaluated using a scanning electron microscope, and changes in chemical structure were determined by conducting FTIR (Fourier transform infrared spectroscopy) and TGA (thermogravimetric analysis) tests. The analysis of the results provided important information about the impact of mineral oil on specific materials. This is critical for designing and manufacturing components that can withstand mineral oil exposure in real-world environments. The materials underwent varying changes. Strength increased for PLA by about 28%, remained unchanged for ABS and HIPS during exposure for 30 days, and decreased for ASA with extended exposure up to 14%. Full article