Smith machine squats pose high risk to ACL graft integrity after the ACL reconstruction and conventional squats are a safer alternative.

PURPOSE: The purpose of this study was to evaluate the impact of squats after the anterior cruciate ligament (ACL) reconstruction on the ACL graft, considering new data on biomechanics, posterior tibial slope (PTS) and anterolateral ligament (ALL). METHODS: Utilising finite element analysis on the new 14-component knee joint model, we have evaluated stresses on the knee elements separately for the knee with a native double-bundle ACL and with a single-bundle ACL graft for the 5° and 14° PTS variants during both conventional and Smith machine horizontal squats. RESULTS: Replacing a native ACL with a single-bundle graft causes an overstrain on the graft compared to the intact ACL under all conditions. Stresses on the ACL, ACL graft and ALL are much higher during the Smith machine squats compared to the conventional ones. The stress on the menisci is 3.6-4.9 times higher with conventional squats. PTS at the squats' lowest point minimally affects ACL stress but impacts menisci. CONCLUSIONS: The single-bundle ACL reconstruction (ACLR) does not reproduce the biomechanics of the native ACL and increases stresses in most knee joint elements, according to the current study. Conventional squats are relatively safe for the ACL graft at their lowest point. Passing the half-squat position is the most dangerous point. Smith machine horizontal squats produce stress on the ACL graft several times higher than its estimated breaking load and dangerous stress levels on the ALL. During the rehabilitation following ACLR, it is advisable to prioritise the conventional squats over Smith machine squats until ligamentisation is complete. LEVEL OF EVIDENCE: Level III.

The impact of mirror therapy on body schema perception in patients with complex regional pain syndrome after distal radius fractures.

INTRODUCTION: Mirror therapy requires a minimum of equipment, is relatively simple to perform and effective for various pathological conditions. The effect of mirror therapy on body schema disturbances registered in complex regional pain syndrome type I (CRPS I) patients has not yet been determined. METHODS: The study is based on the analysis of the treatment results of 30 patients with CRPS I, developed as a result of the distal radius fractures, with help of mirror therapy together with exercise therapy and medications. The control group consisted of 20 patients with CRPS I developed as a result of the distal radius fractures treated only with exercise therapy and medications. We evaluated the results before the treatment, after 3 days and after 6 weeks of treatment according to The Bath CRPS Body Perception Disturbance Scale. RESULTS: A total of 83.33% patients experienced the positive effect of mirror therapy on the perception of the 'body schema' after 6 weeks of treatment, and 35% underwent standard treatment without mirror therapy. The positive effect was statistically significant for the first five points of the Bath scale after 6 weeks of treatment compared to the control group. Improvements observed in some patients after 3 days of treatment were less pronounced and statistically insignificant. CONCLUSION: Mirror therapy can improve the perception of the body schema as an element of integrated treatment of CRPS I developed after fractures of the distal radius less than 3 years duration.

Three- to six-year results of metacarpophalangeal joints arthroplasty in psoriatic arthritis.

BACKGROUND: Patients with psoriatic arthritis often need the replacement of the hand joints owing to the high prevalence of hand joints involvement and their often severe destruction and/or function loss. The long-term results of silicone arthroplasty of metacarpophalangeal joints in psoriatic patients are almost unreported in the scientific literature. MATERIALS AND METHODS: We analyzed 3- to 6-year results of 14 metacarpophalangeal joint replacements with silicone implants that we performed in nine psoriatic patients. RESULTS: The metacarpophalangeal joints arthroplasty in all the patients led to the significant short-term and long-term increase of range of motions and decrease of pain. However, two complications occurred. The choice of the implant, the possibility, causes, and significance of the complications are justified. CONCLUSIONS: Metacarpophalangeal joints silicone arthroplasty in psoriatic arthritis during skin manifestations remission period is an effective and relatively safe method of finger joints contractures and deformities treatment.

Proportions of hand segments / Proporciones de los segmentos de la mano

The analysis of proportions of hand segments has been carried out on the basis of X-ray films of 66 adult patients without developmental abnormalities. There were hand joint topographies determined proceeding from the data obtained. There were suggested methods of practical utilization of the obtained data in the field of medicine.

Se analizaron en radiografías de 66 pacientes sin anomalías del desarrollo las proporciones de los diferentes segmentos de la mano. De acuerdo a los datos obtenidos se determinó una topografía de las articulaciones. Se proponen modos de empleo en la medicina de los datos obtenidos en este estudio.