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Evaluating The Biomechanical, Functional, And Clinical Outcomes Of Bicruciate Stabilized Total Knee Arthroplasty, Jordan S. Broberg

Electronic Thesis and Dissertation Repository

Total knee arthroplasty (TKA) is the only solution for treating arthritis of the knee joint. Although it is successful at reducing pain and returning function to affected joints, one in five patients still report dissatisfaction following their operation. Bicruciate stabilized (BCS) TKA was developed to improve outcomes by replicating normal knee structure and function. The biomechanical, functional, and clinical outcomes for the BCS design were investigated in this thesis through radiographic imaging techniques, wearable sensor systems, and questionnaires in a cohort of TKA patients.

A stereo x-ray technique, called radiostereometric analysis (RSA), assesses implant fixation by tracking micromotion of TKA …

Biomechanical Analysis Of Ligament Modelling Techniques And Femoral Component Malrotation Following Tka, Liam A. Montgomery

Electronic Thesis and Dissertation Repository

Previous studies have demonstrated that satisfaction and revision rates following total knee arthroplasty (TKA) are lower than those of comparable surgeries such as total hip replacements. A leading cause for these revisions is joint instability which may be due to improper ligament balancing or poorly aligned surgical implants. One of the methods used to investigate biomechanical forces and kinematics is computational modelling of the post-operative TKA knee.

A unique knee model was used to investigate the biomechanical and kinematic effects of ligament model complexity, as well as the effects of simulating ligament wrapping versus ignoring ligament wrapping. We then used …

4dct Analysis Of In-Vivo Carpal Kinematics During Fem, Manisha R. Mistry

Electronic Thesis and Dissertation Repository

A consensus, detailed understanding of carpal kinematics remains elusive. 4-dimensional CT (4DCT) is a validated modality capable of accurately studying in-vivokinematic motion. The objective of this work is to quantify normal, in-vivo kinematic motion of the carpus through a flexion-extension arc of motion using 4DCT. Ten healthy, un-injured volunteers underwent a 4DCT scanning protocol through a complete arc of flexion-extension motion. Kinematic changes in motion were quantified using helical axis motion data for each carpal bone. Helical axes were compared between bones and statistical analysis performed using repeated-measures ANOVA to identify difference in kinematic motion between bones (p<0.05). The carpus can be divided into four main kinematic blocks: the distal carpal block, the proximal carpal block and individual scaphoid and trapezial blocks. This work supports an additional segmentation of the trapezium from the distal carpal row, which suggests some modulation between the scaphoid and distal carpal row.

Kinematics In Total Knee Arthroplasty, Allan Roy Sekeitto

Electronic Thesis and Dissertation Repository

Total knee arthroplasty (TKA) continues to be a successful procedure for the past 50 years. We investigated the kinematics after under- and overstuffing the joint space with the polyethylene (PE) insert in both cruciate-retaining (CR) TKA and posterior-stabilized (PS) TKA. We compared CR and PS designs to evaluate their respective kinematic differences. This study employed a hybrid computational-experimental joint motion simulation on a 6 degrees of freedom joint motion simulator. Physical prototypes of a virtually performed TKA based on cadaveric CT scans and a virtual ligament model were utilized. We demonstrated understuffing decreases stability and the joint compressive forces, with …

In Vitro Analyses Of The Contributions Of The Hip Capsule To Joint Biomechanics, Emma Donnelly

Electronic Thesis and Dissertation Repository

Optimal management of the hip capsule during arthroscopic surgery has not been established. The impact of incisions made to the capsule during minimally invasive procedures on joint biomechanics, and whether repair provides any benefit, continue to be debated. The effectiveness of capsular repair to restore native kinematics may be insufficient. Therefore, a better understanding of joint behavior during various capsule conditions is needed. A new robotic system was used to analyze the effect of progressive capsulotomy incision and repairs on the behavior of a normal hip within range of motion (ROM) limits with respect to the intact joint. Complete repairs …

Lateral Subvastus Lateralis Versus Medial Parapatellar Approach For Total Knee Arthroplasty, Sahil Prabhnoor S. Sidhu

Electronic Thesis and Dissertation Repository

The current gold standard surgical approach for Total Knee Arthroplasty (TKA) is a medial parapatellar approach (MPA). We aimed to study a novel lateral subvastus lateralis approach (SLA) for TKA and compare patient outcomes and joint kinematics to the MPA.

Patients with neutral or varus alignment undergoing primary TKA were recruited to undergo the SLA. At one year postoperative, patient outcomes (WOMAC, SF-12, KSS) and joint kinematics (using radio stereometric analysis (RSA)) were analyzed. 7 LPA and 7 MPA patients were compared.

The SLA resulted in improved medial femoral rollback early in flexion, but less “regular” (external) rotation of the …

Biomechanical Analysis Of Total Knee Arthroplasty Performed On A 6 Degree Of Freedom Joint Motion Simulator Linked To A Virtual Ligament Model In Mechanical And Kinematic Alignments, Jance Mcgale

Electronic Thesis and Dissertation Repository

Total knee arthroplasty (TKA) is a very successful surgery providing many patients with increased quality of life. Despite this, some patients are dissatisfied. There are also complications with total knee arthroplasty that lead to the need for revision surgery. Improvements in stability, soft tissue balance, joint kinematics and overall patient satisfaction may lead to a decrease in TKA revisions. It is still unclear what the optimal soft tissue tension, balance or alignment is to provide superior patient outcomes. Computational models provide a means to effectively parameterize ligaments and simulate multiple scenarios of TKA. This work implemented a sophisticated 6-degree of …

Performance Impact Of Different Lower-Limb Setup Positions In The Backstroke Swimming Start, Gordon E. Barkwell

Electronic Thesis and Dissertation Repository

The performance impact of different knee extension angles in the setup position for a backstroke start was evaluated using an instrumented starting surface. Ten backstroke swimmers completed maximum-effort starts in each of two setup positions: one with the knees flexed, and one with the knees extended. The start handles and touchpad were instrumented with tri-axial force plates. Activity of major hip and knee extensors was measured using surface electromyography. Body position was recorded throughout the start using two high-speed cameras. There was no difference in time to 10 m between the two conditions, indicating there is likely no advantage in …

Characterization And Personalization Of Botulinum Toxin Type A Therapy For Upper Limb Tremor In Parkinson Disease And Essential Tremor Patients Using Multi-Sensor Kinematic Technology, Olivia Samotus

Electronic Thesis and Dissertation Repository

Tremor commonly affects the upper extremities in essential tremor (ET) and Parkinson disease (PD) patients where many experience functional disability and ultimately seek therapy. As ET and PD tremor features overlap and clinical assessment is challenging due to its highly complex nature, misdiagnosis is common resulting in unsuitable therapies and prognosis. Current treatment options for ET and PD tremor include pharmacotherapy, focal therapy with botulinum toxin type A (BoNT-A) injections, and surgical interventions which provide modest relief of tremor. However, such therapies are commonly associated with significant adverse events and lack long-term efficacy and tolerability. Hence lack of standardized, objective …

Markerless Radiostereogammetry Of The Shoulder Joint In Humans: Comparisons Of Scapulohumeral Kinematics Between Individuals With Healthy And Supraspinatus-Impaired Shoulders, Ashley N. Hannon

Electronic Thesis and Dissertation Repository

The purpose of this collection of studies was to further develop the knowledge of shoulder motion in order to better understand joint function through direct measurement of 3D scapulohumeral joint kinematics using a technique of high accuracy. Markerless, bi-planar fluoroscopic radiostereometric analysis using a generic shoulder model was developed in this thesis, reducing the amount of radiation exposure to subjects. The studies compared kinematic data of the scapulohumeral joint in six degrees of freedom with a precise, in-vivo measuring technique. Data were collected on young and older healthy individuals, individuals with a torn supraspinatus and post-surgical intervention.

Although this generic …

Effects Of Reduced Muscular Strength On Running Kinematics Relating To The Planus Foot, Adam D. Froats

Electronic Thesis and Dissertation Repository

The potential for injury is present in all forms of physical activity, particularly events involving repetitive motion. In attempt to identify kinematic changes following running induced reductions in muscular strength, 15 participants completed recorded treadmill runs before and after an outdoor run. Kinematics were recorded using a Vicon motion capture system and processed using 3D GAIT custom software. Using repeated measures ANCOVA with side (dominant and non-dominant) and time (pre-run and post-run) as within subject factors, and strength and arch height as covariates, no statistically significant differences were obtained. Using Pearson’s product-moment correlation coefficients to compare successive strides, post-run reductions …

The Effect Of Fixation Plate Length On Spinal Instability Following Anterior Cervical Plate Fixation For The Repair Of In Vitro Flexion-Distraction Injuries, Abdulaziz J. Al-Kuwari

Electronic Thesis and Dissertation Repository

Abstract:

The Effect of Fixation Plate Length on Spinal Instability Following Anterior Cervical Plate Fixation for the Repair of in Vitro Flexion-Distraction Injuries

Introduction: Anterior cervical decompression and fusion with a plate (ACDFP) is a commonly performed treatment following a traumatic injury to the subaxial cervical spine. The purpose of the presented work was to determine the biomechanical effect of plate length on cervical spine kinematic stability following ACDFP stabilization for a simulated traumatic injury.

Methods: Eleven fresh-frozen cadaveric C5-C6 and C6-C7 motion segments were examined in this study. To assess kinematics, flexibility testing was performed on each specimen …