The Shared Contributions Of The Capsule, Labrum, And Bone On The Suction Seal Of The Hip, Alexander J. Hoffer

Electronic Thesis and Dissertation Repository

The hip capsule, labrum, and bone contribute to hip stability. Abnormalities in these structures are associated with pain and microinstability. Previous studies have quantified the individual stabilizing roles of the capsule and labrum and have associated cam over-resection with decreased hip stability.

The first objective of this thesis was to identify the relative biomechanical contributions of the capsule, labrum, and bone to the hip suction seal, as a representation of hip stability. The second objective was to assess the effectiveness of a labral reconstruction in restoring the suction seal after a cam over-resection.

Ten human cadaveric hips were tested in …

Evaluation Of Conservative And Operative Treatments In Active Patients With Acromioclavicular (Ac) And Rotator Cuff (Rc) Injuries, Jesse Singh

Electronic Thesis and Dissertation Repository

Abstract

Introduction: Shoulder pain and disability, particularly acromioclavicular joint (ACJ) and rotator cuff (RC) injuries, are common in a physically active population. Determining operative or rehabilitative treatment plans involve multiple treatment choices influenced by the injury grade and treatment goals, such as return to sport. This thesis investigates the management of treatment for AC and RC injuries

Method: The first study is a scoping review that uses the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) to synthesize 32 studies involving athletes who have undergone conservative or operative treatment for their Rockwood grade III …

Pannexin3 In Exercise, Obesity, And Osteoarthritis, Brent Wakefield

Electronic Thesis and Dissertation Repository

Pannexin 3 (PANX3), is a glycoprotein that oligomerizes to form mechano-sensitive channels expressed in musculoskeletal tissues, and has been identified as a potential target for the treatment of obesity and osteoarthritis (OA). Obesity and OA are two of the most prevalent diseases worldwide, leading to disability and even death. These conditions are thought to originate from a complex interaction between genetics, aging, sex, and modifiable lifestyle factors, such as exercise. Investigating the interactions between genetic and exercise may provide a more comprehensive, context-specific understanding of gene function. This thesis aimed to understand the interactions between PANX3 and exercise interventions on …

Plantar Flexor Dynamic Contractile Rates Are Not Dependent On Calcaneal Tendon Stiffness, Sohum Kulkarni

Electronic Thesis and Dissertation Repository

The ability to rapidly generate muscular torque and velocity is important in specialized activities and daily tasks of living. Tendon stiffness is one factor in the neuromuscular system that influences musculoskeletal torque transmission. Previous studies have reported weak-to-moderate correlations between tendon stiffness and rate of torque development (RTD). However, these correlations have been reported only for isometric contractions which may not be relevant to contractions involving joint rotation (i.e., dynamic). The purpose was to investigate the effect of calcaneal tendon stiffness on the dynamic rates of torque (RTD) and velocity (RVD) development in plantar flexor muscles. Young adult males (n=13) …

The Design And Evaluation Of A Subacromial Implant In Restoring Normal Glenohumeral Joint Stability In The Presence Of A Massive Irreparable Rotator Cuff Tear, Cole T. Fleet

Electronic Thesis and Dissertation Repository

Massive irreparable rotator cuff tears are a common cause of pain and disability. Several different treatment options are available for this pathology; however, these treatments have been associated with poor clinical outcomes when used to treat younger (<65 years), more active patients. The purpose of this thesis was to design and evaluate a subacromial implant in its ability to restore normal glenohumeral stability and range of motion. The implant was created as a modular device, which captured different implant thicknesses (5mm and 8mm) and constraints (high and low) within its design. In-vitro testing compared the ability of these implants to restore normal shoulder biomechanics. The results indicated the 5mm high constraint implant to be the most effective in restoring normal joint position. Furthermore, range of motion increased when the implant was paired with a tuberoplasty procedure. These results suggest this implant may be advantageous in treating younger patients.

Rna Isolation In Duchenne Muscular Dystrophy (Dmd) Mice Models, Salem Abu Al-Burak

Undergraduate Student Research Internships Conference

Fibrosis is a progressive and typically irreversible disease process characterized by the excessive deposition of collagen in organs and in tissues of the musculoskeletal (MSK) system^1,2. This process, which causes loss of organ and tissue function, can be initiated by micro-traumas³, an excessive and/or prolonged immune response¹, the activation and proliferation of fibrosis-inducing progenitor cells⁴, and a pro-fibrotic extra-cellular microenvironment⁵. In parallel with the events that initiate fibrosis, genetic or environmental influences may cause cells and tissues to become predisposed to fibrosis development prior to initiation. This suggests that these …

Connexin 43 Contributes To Phenotypic Variability Of The Mouse Skull, Elizabeth Jewlal

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The purpose of this study was to determine whether connexin 43 (Cx43) contributes to craniofacial phenotypic variability. Skull shape and variation were compared within and among two heterozygous mutant mouse models (G60S/+ and I130T/+) that exhibit different levels of Cx43 channel function when compared to their wildtype counterparts (~80% and ~50% reduction in function, respectively). Results indicated mutants have significant differences in skull shape compared to wildtype littermates. Similar patterns of shape difference were found in both mutants. Increased skull shape variation and a disruption in the covariation of skull structures were observed in G60S/+ mutants only. These results show …

Femoroacetabular Impingement Syndrome: Evaluating Postoperative Rehabilitation Progress And Return To Sport Readiness, Trevor A. Day

Electronic Thesis and Dissertation Repository

Femoroacetabular impingement syndrome (FAIS) is a common cause of non-arthritic hip pain and reduced physical activity in active young adults. It is defined as a motion-related disorder of the hip with a triad of symptoms, clinical signs, and imaging findings that represents symptomatic premature contact between the proximal femur and the acetabulum. There are two anatomical morphologies that can cause FAIS, cam, and pincer, and is a challenging clinical pathology. Patients typically undergo hip arthroscopy to repair damage to the joint and recess the bone causing the impingement. These procedures can result in positive outcomes for the patient, like reduced …

The Role Of Pannexin 3 In Forced Exercise Bone Remodelling And Its Potential Implications For Osteoarthritis, Justin Tang

Undergraduate Student Research Internships Conference

Exercise such as running has been hypothesized to be a factor of osteoarthritis development. However, the relationship is unclear as differences in genetic backgrounds may influence the risk of osteoarthritis (OA). The gene Panx3 codes for the Pannexin 3 protein (PANX3), a mechanically sensitive channel that allows for the passage of various signalling molecules in both chondrocytes and osteoblasts (Boassa et al., 2007; Penuela et al., 2013; Zhang et al., 2021). We have previously shown PANX3 to be protective in traumatic osteoarthritis, however beneficial in age-induced osteoarthritis (Moon et al., 2021), suggesting that PANX3’s role in osteoarthritis development …

Towards Standardized Assessment Of Paraspinal Muscle Using Mri, Hamza Mirza

Undergraduate Student Research Internships Conference

• Common methodological variations in paraspinal muscle (PSM) measurement

significantly affect cross-sectional area and fat percentage measurements.

• The lack of standardization of PSM measurements complicates

comparisons of findings between studies and prevents pooling of

data for meta-analyses.

• Standardization in PSM measurements is needed to move the field forward

The Role Of Gsk3 Alpha And Beta In Embryonic Craniofacial Development, Harman Jassar

Electronic Thesis and Dissertation Repository

Background: The GSK-3 genes (Gsk3a and Gsk3b) have been known to affect many cellular processes and signaling pathways some of which are implicated in the growth and development of the craniofacial skeleton.

Aim: The purpose of this study was to assess the effect of chondrocyte-specific deletion of Gsk3a and Gsk3b on the size of the mandible and craniofacial skeleton in embryonic mice.

Materials & Methods: Mice were bred to generate cartilage-specific Gsk3a and Gsk3b KO mice. On embryonic day 18.5 (E18.5) the offspring were gathered by caesarian section. Whole mount skeletal staining was completed on the specimens using …

Assessment Of Landing Biomechanics And Rehabilitation After Anterior Cruciate Ligament Reconstruction, Sheila S. Gagnon

Electronic Thesis and Dissertation Repository

Aberrant landing biomechanics increase the risk of anterior cruciate ligament (ACL) injury and are a focus of rehabilitation after ACL reconstruction. The purpose of the present thesis was to develop and evaluate methods of assessing landing mechanics and investigate the effects of different rehabilitation strategies after ACL reconstruction. Three studies were conducted. The first study used a Delphi process to develop the content of a Clinician-Rated Drop Vertical Jump Scale to evaluate jump landing mechanics during rehabilitation after ACL reconstruction. Twenty experts participated in four rounds of questioning, resulting in 92% agreement for knee valgus collapse, lateral trunk lean, insufficient …

An Investigation On The Influences Of Radial Head Hemiarthroplasty Stem Fixation Techniques On Articular Mechanics, Jakub Szmit

Electronic Thesis and Dissertation Repository

Radial head hemiarthroplasty design has been extensively studied with a focus on utilizing the geometrical characteristics of the native radial dish as a guide of implant placement and design. Although implant design has been studied, optimal radial head implant fixation technique remains unknown. This thesis focused on the effect of stem fit on radiocapitellar contact mechanics, using both finite element and experimental bench-top approaches. Additionally, investigation into the impact of varus/valgus malalignment of the radial head in both the native state and following hemiarthroplasty was conducted. It was found that loose fitting a smooth stem axisymmetric radial head implant through …

Implementing A Multi-Segment Foot Model In A Clinical Setting To Measure Inter-Segmental Joint Motions, Tahereh Amiri

Electronic Thesis and Dissertation Repository

It has been illustrated that measuring inter-segmental joint motions of the foot using a dynamic method is required to evaluate the function and level of impairment of the foot joints. Optical motion tracking using the multi-segment foot model (MSFM) developed by Jenkyn and Nicole (2007), has been demonstrated to be a valid tool for measuring the motion of the joints within the foot. However, in current practice, inter-segmental joint motions of this model are measured using a custom-written software (MATLAB) and it limits the clinical usefulness of this model. Hence, this study implemented the MSFM introduced by Jenkyn and Nicole …

Quadriceps Muscle Layer Thickness In Kidney Transplant Recipients: A Potential Measure Of Frailty And Sarcopenia, Max A. Levine

Electronic Thesis and Dissertation Repository

Introduction: Frailty and sarcopenia are related concepts that can impact outcomes after kidney transplantation. Measures of these two entities and new/emerging metrics of sarcopenia remain to be validated.

Methods: In a prospective cohort study, kidney and kidney-pancreas transplant recipients were assessed at the time of transplant with the Physical Frailty Phenotype, bioimpedance analysis, quadriceps muscle layer thickness (QMLT), and CT. The impact on length of stay (LOS), prediction of frailty/sarcopenia, and relative concordance of metrics were analyzed.

Results: Low QMLT, a putative surrogate of sarcopenia/frailty, was more frequently associated with longer LOS (>14 days) after transplant. Additionally, QMLT was …

The Of Application Of 3d-Printing To Lumbar Spine Surgery, Andrew J. Kanawati

Electronic Thesis and Dissertation Repository

Rapid prototyping refers to the manufacturing process in which a three-dimensional (3D) digital model can be transformed into a physical model by layering material in the shape of successive cross sections atop of previously layers. Rapid prototyping has been increasing in popularity in the field of medicine and surgery due to the ability to personalize various aspects of patient care. The thesis will explore the use of rapid prototyping in lumbar spine surgery, aim to quantify the accuracy of medical imaging when relating to imaged structures and their corresponding models produced by rapid prototyping, and determine if complex patient-specific guides …

Investigating The Role Of Nuclear Receptor Peroxisome Proliferator-Activated Receptor Δ In Obesity-Associated Osteoarthritis, Bethia C. To

Electronic Thesis and Dissertation Repository

Osteoarthritis (OA) is a heterogeneous disease, differentiated based by risk factors that drive joint damage. Peroxisome proliferator-activated receptor delta (PPARd) is a nuclear receptor previously implicated in cartilage damage in OA. Given its deleterious role in post-traumatic OA and in regulating metabolism, we hypothesized that PPARd inhibition will protect against obesity-associated OA. Diet-induced obesity was used to induce OA in mice. Mice fed the western diet for 40 weeks exhibited mild OA, with subchondral bone remodelling occurring alongside cartilage damage. Cartilage-specific Ppard knockout (KO) mice were generated to study its role in metabolic OA. Both wildtype and PPARd KO mice …

Does An Acute Achilles Tendon Rupture Become A Patient's Achilles Heel In The Long-Term?, Michaela Cm Khan

Electronic Thesis and Dissertation Repository

It is unknown if deficits in the involved limb following acute Achilles tendon rupture (AATR) persist in the long-term, or differ between patients treated operatively or non-operatively. This study investigated 43 patients 15±1 years post-AATR from a previous randomized controlled trial (RCT) that compared operative and non-operative treatment. Structural characteristics in the Achilles tendon and surrounding musculature were assessed using magnetic resonance imaging. We also performed physical examinations and evaluated performance-based and patient-reported outcomes. Overall, there were substantial differences between the involved and uninvolved limbs in most outcomes. Some outcomes improved over time from the initial RCT to the final …

Acromial Insufficiency Fractures In Reverse Total Shoulder Arthroplasty: A Biomechanical Study, Alicia Kerrigan

Electronic Thesis and Dissertation Repository

Reverse total shoulder arthroplasty (RTSA) is increasingly utilized in the aging population, with a growing list of surgical indications including rotator cuff tear arthropathy, proximal humerus fractures, and revision arthroplasty. Acromial insufficiency fractures following RTSA are poorly understood, difficult to diagnose, and associated with inferior clinical outcomes. There is limited knowledge in the literature regarding the etiology of post-operative acromial fractures. The purpose of this study is to evaluate the role of implant parameters on acromial strain following RTSA.

Using a cadaveric model, a custom designed modular RTSA system was implanted that allowed for evaluation of modifiable parameters including glenoid …

Tibiotalar Arthrodesis: Development Of A Novel Jig And Alignment Guide, Adam Mathew Ropchan

Electronic Thesis and Dissertation Repository

Tibiotalar arthrodesis is a surgical procedure, used for the treatment of end-stage ankle arthrosis and instability. There are dozens of described procedures in the literature, all with varying rates of success. Two of the most common reasons for reoperation in tibiotalar arthrodesis are nonunion and infection; few studies have established any associations between patient/surgical factors and reoperation for nonunion and infection.

The first part of this thesis focuses on determining the rate of reoperation to the ipsilateral lower limb and if any patient/surgical factors are associated with reoperation for nonunion and infection. The second part of this thesis turns attention …

Examining The Tissue-Level And Gross Phenotypic Effects Of The Connexin43i130t/+ Mutation On The Developing Mouse Skull, Sommer G.E. Jarvis

Electronic Thesis and Dissertation Repository

The purpose of this study was to investigate the effects of reduced Connexin43 function on the developing skull phenotype, osteoblast and chondrocyte proliferation and differentiation, and to determine if a correlation exists between cell processes and gross morphology. Using the Cx43^I130T/+mouse model, skull shape was analyzed using geometric morphometrics and cell proliferation and differentiation were assessed using immunohistochemistry at late embryonic and early post-natal stages. The largest shape changes between Cx43^I130T/+ and wildtype mice were observed in the cranial base and facial skeleton. Changes infacial morphology correspond to reduced osteoblast differentiation. However, no changes in chondrocyte proliferation …

The Effects Of Tracheal Occlusion On Wnt Signaling In A Rabbit Model Of Congenital Diaphragmatic Hernia, Martina M. Mudri

Electronic Thesis and Dissertation Repository

Purpose: Tracheal occlusion (TO) reverses pulmonary hypoplasia (PH) in congenital diaphragmatic hernia (CDH), but its effect on epithelial-mesenchymal transition (EMT) in lung development remains poorly understood. The purpose of this study was to a) confirm the CDH rabbit model produced PH which was reversed by TO and b) determine the effects of CDH +/- TO on EMT pathways.

Methods: CDH was created at 23 days, TO at 28 days and lung collection at 31 days gestation in fetal rabbits. Lung body weight ratio (LBWR), mean terminal bronchiole density (MTBD), and expression of mRNA and micro-RNA was determined.

Results: Fifteen CDH, …

Functional Anatomy Of Palmar Musculature, Colin W. Moore

Electronic Thesis and Dissertation Repository

The palmaris longus (PL) and palmaris brevis (PB) are upper limb muscles considered atavistic remnants of those found in animal species. Despite their use in surgical grafting and tendon transfer procedures, the functional role of the PL and PB have not been investigated comprehensively in vivo. Using a multi-modal experimental approach consisting of indwelling fine wire electromyography (EMG), ultrasonography and immunohistochemical muscle staining techniques, the function of the PL and PB in the hand was evaluated both in in vivo and in situ.

The purpose of Study 1 was to determine whether the PL provides synergistic contributions to …

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 …

Degrees Of Damage: Quantifying Male Vs. Female Exercise-Induced Muscle Damage Through Magnetization Transfer Ratios, Nicholai Michael Clausius Crawford

Electronic Thesis and Dissertation Repository

No direct, quantitative, and non-invasive markers presently exist to assess exercise-induced muscle damage (EIMD). However, magnetization transfer ratios (MTR), an emerging measurement quantified via magnetic resonance imagery, provide more direct indication of muscle integrity following EIMD. This study compares and correlates the temporal pattern of the MTR to alternative indirect markers of EIMD in male vs. female populations, and subsequently establishes whether there are sex differences in biochemical activity during recovery. The antioxidant properties of estrogen hypothetically minimize muscle trauma, maintain membrane stability, and limit swelling resulting in heightened tissue integrity and resilience to EIMD. Six males and three females …

The Ctcf Chromatin Organizer Is Required For Hindlimb Development, Katherine L. Rabicki

Electronic Thesis and Dissertation Repository

Mutations in chromatin organizer CTCF were identified in patients with intellectual disability and skeletal defects. Previous studies demonstrated that depletion of CTCF in murine limb mesenchyme results in apoptosis in the forelimb. The role of CTCF in the hindlimb, however, is unknown. My objective was to investigate effects of CTCF deletion on chondrogenesis and skeletal development in the hindlimb. In vitro wild-type micromass cultures demonstrate that chondrocyte gene expression is delayed in the hindlimb when compared to forelimbs. Embryonic Ctcf^Fl/Fl;Prx1Cre mice were investigated, and qRT-PCR and histology were performed on limb buds and long bones. Results show that …

Surgical Approach In Total Hip Arthroplasty: Patient Outcomes And Impact On Costs, Stephen M. Petis

Electronic Thesis and Dissertation Repository

Total hip arthroplasty is often renowned as one of the most important surgical advances of the past century. Orthopaedic surgeons must choose a surgical approach to gain access to the hip joint in order to perform the reconstruction. There is debate in the literature as to which surgical approach optimizes patient outcomes, minimizes complications, and reduces costs to hospitals as a high volume procedure.

In the current studies, patient reported outcomes were compared at short-term follow-up using a prospective study design across the anterior, posterior, and lateral approach. A micro-costing method was used to acquire costs related to each procedure, …

Development And Assessment Of An Impact Apparatus And High-Speed Camera Motion Tracking System To Quantify The Effect Of Static Muscle Loads On Fracture Threshold Measures In The Distal Radius, Jacob M. Reeves

Electronic Thesis and Dissertation Repository

Distal radius fractures are prevalent, debilitating, and costly. This thesis conducts an in vitro investigation of these injuries, examining the role of static muscle loading on fracture threshold measures (i.e., force, impulse, energy). Initially, an impact apparatus and custom LabVIEW colour-thresholding program were designed and assessed for repeatability and accuracy in quantifying fracture measures and impact kinematics. These tools were then used to test six pairs of cadaveric forearms, with static muscle loads simulated in one specimen from each pair. Distal radius fractures were achieved in 5 pairs, with perilunate dislocations in the remaining pair. None of the …

Hearts And Minds: Examining The Evolution Of The Egyptian Excerebration And Evisceration Traditions Through The Impact Mummy Database, Andrew D. Wade

Electronic Thesis and Dissertation Repository

Egyptian mummification and funerary rituals were a transformative process, making the deceased a pure being; free of disease, injury, and disfigurements, as well as ethical and moral impurities. Consequently, the features of mummification available to specific categories of individuals hold social and ideological significance. This study refutes long-held classical stereotypes, particularly dogmatic class associations; demonstrates the apocryphal nature of universal heart retention; and expands on the purposes of excerebration and evisceration implied by synthetic and radiological analyses.

Features of the embalming traditions, specifically the variable excerebration and evisceration traditions, represented the Egyptian view of death. Fine-grain analyses, through primary imaging …