Does Patient-Specific Instrumentation Improve Femoral and Tibial Component Alignment in Total Knee Arthroplasty? A Prospective Randomized Study.

Alignment of the prosthesis is one of the most significant factors that affect the long-term clinical outcome following total knee arthroplasty (TKA). There is conflicting evidence whether patient-specific instrumentation (PSI) for TKA improves the component position compared to standard instrumentation. This study aimed to compare the rotational alignment of the femoral and tibial components in TKA patients when performed with either conventional or PSI. Sixty patients with primary knee osteoarthritis were randomly divided into two groups treated surgically with TKA: one with conventional instrumentation and the other with the Visionaire PSI system (Smith and Nephew, Memphis, TN). Computerized tomography (CT) and X-ray imaging were performed preoperatively and 12 weeks after surgery. The rotational alignment of the femoral and tibial component in all patients was assessed postsurgically using CT imaging according to the Berger protocol. Both groups were clinically assessed in a blinded fashion using the Knee Society Score (KSS) and a visual analog scale (VAS). Fifty-eight patients were prospectively assessed. The mean postsurgical follow-up was 3.0 ± 0.4 months. CT images did not reveal any significant improvement in the rotational alignment of the implant components between the groups. X-rays revealed a significant improvement in the deviation from the optimal alignment range of the femoral component in the coronal plane in both groups. Patients operated with Visionaire PSI assistance had poorer functional outcomes. We conclude that there were no improvements in clinical outcomes or knee component alignment in patients treated with PSI compared with those treated with standard instruments. In addition, clinical and functional assessment showed inferior results in terms of KSS and VAS scores at the midterm follow-up in patients treated with PSI.

Use of cervical collar after whiplash injuries.

Whiplash injuries, also known as neck sprains and strains, are currently some of the most common injuries of the cervical spine. Mechanism of injury is still controversial and current treatment methods do not provide satisfactory results. In this article we present QTF classification of related disorders, epidemiological data and treatment methods. We described basic principles of using a soft collar, goals and effects of collar use and potential complications ensuing from immobilization. Authors reviewed publications comparing the effects of collar use with other methods of treatment and physiotherapy following whiplash injury.

Relationship between Countermovement Jump and Sprint Performance in Professional Football Players.

Objectives: The aim of this study was to assess the relationship between the countermovement jump (CMJ) and sprint performance of professional football players, and to determine which strength and speed elements assessed by the CMJ translate into effective running. Methods: The research sample comprised 87 male professional football players (age 23.7 ± 4.20 years; body mass 82.33 ± 6.56 kg; body height 1.86 ± 0.05 m) who performed the CMJ on a dual-force platform, as well as the 30 m sprint test. The time and velocity of the run were recorded by photocells at 0, 5, 10, and 30 m of the distance. Results: No significant differences were noted in the time or velocity of the sprint over the initial 5 m between the groups of football players with a higher and lower braking rate of force development (RFD) in the CMJ (p > 0.05). However, at subsequent intervals (5-10 m and 10-30 m), players with a higher braking RFD achieved significantly better time and velocity than those with a lower RFD. Significant correlations in the group with a lower braking RFD between the CMJ and sprint variables occurred in the propulsion phase of the CMJ and most of them were in the first interval (0-5 m). In the group with a higher braking RFD, significant relationships were visible in both the propulsion (concentric) and braking (eccentric) phases of the CMJ, mainly during the second and third intervals of the sprint test. Conclusions: The noted observations may suggest that the relationship between strength and running performance is more complex than previously indicated, and that higher strength in the CMJ does not fully correlate with better sprinting. Therefore, it has been hypothesized that training aimed at generally increasing strength may not always be fully beneficial for running performance in football players and hence specific training guidelines are suggested for targeted strengthening of the required muscle performance characteristics. This may possibly contribute to reducing the unnecessary muscle overload during both training and matches, thereby preventing sports-related injuries.

Current Uses of Ultrasound Imaging in Musculoskeletal Rehabilitation.

The term Rehabilitative Ultrasound Imaging (RUSI) refers to the use of ultrasound imaging by physiothera-pists. Ultrasound is used by physiotherapists to evaluate the morphology of muscles and other associated soft tissues not only at rest but also for a dynamic assessment of those structures during physical activities and tasks. RUSI is most commonly utilized as part of a biofeedback mechanism, which shows good efficacy in lower back pain treatment. Several possibilities have been also described for clinically adapting this method in the rehabilitation of the shoulder and knee and postoperative improvement of tendons. RUSI is a novel method with a high clinical potential to support physiotherapeutic therapies.