Correlation between rotational moments of the knee and other joints during gait, including the free moment of patients with a medial meniscus tear.

PURPOSE: Rotation of the knee puts stress on the medial meniscus and can be a factor in the progression of knee osteoarthritis. This study aimed to investigate the rotational moment (internal rotation and external rotation) of the knee during gait and relationship between the rotational moments of the knee and other joints, including the free moment during gait. METHODS: We included 18 patients with medial meniscus tears (MM group) and 10 asymptomatic participants in this study. We performed 3D gait analysis. The internal ankle, knee, and hip rotational moments as well as free moment were compared between the groups. Additionally, we investigated correlations between rotational moments of the knee and other joints during gait. RESULTS: The maximal knee external rotation moment in the MM group was smaller than that in the asymptomatic group ( p = 0.04, g = 0.76); however, there were no significant differences in the maximal internal rotation moment between the groups ( p = 0.97, g = 0.02). The internal rotation (external knee external rotation) moment positively correlated with the hip internal rotation moment ( p 〈 0.01, r = 0.69) in the MM group. CONCLUSIONS: The internal rotation (passive knee external rotation moment) did not decrease sufficiently, and correlation was observed between moments of the knee and hip in the MM group, especially during the late stance phase of gait. Reducing these abnormal moments during gait through rehabilitation may be important in patients with medial meniscus tears to prevent rapid progression of knee osteoarthritis.

Hip Sway in Patients With Hip Osteoarthritis During One-Leg Standing With a Focus on Time Series Data.

This study aimed to investigate the hip sway and the relationship between the center of pressure (CoP) and kinematic parameters regarding the time series scaling component α in patients with hip osteoarthritis (OA) during a one-leg standing task. The scaling exponent α, SD, hip sway maximal acceleration change, and balance performance, which was measured using CoP parameters, were compared between hip OA and control groups during a one-leg standing task. The relationships between balance performance with CoP parameters and kinematic parameters were investigated with the regression analysis. In the hip OA group, the scaling exponent α was smaller in the medial-lateral direction, and the SD and maximal amount of change in hip sway acceleration were larger in the anterior-posterior direction in the hip OA group. In this group, the CoP parameters were significantly associated with α in the medial-lateral direction (negatively) and in the anterior-posterior direction (positively). In the hip OA group, hip sway adaptability in the medial-lateral direction was limited, while the anterior-posterior direction showed greater movement.

Coordination Pattern of the Thigh, Pelvic, and Lumbar Movements during the Gait of Patients with Hip Osteoarthritis.

There are limited reports on segment movement and their coordination pattern during gait in patients with hip osteoarthritis. To avoid the excessive stress toward the hip and relevant joints, it is important to investigate the coordination pattern between these segment movements, focusing on the time series data. This study aimed to quantify the coordination pattern of lumbar, pelvic, and thigh movements during gait in patients with hip osteoarthritis and in a control group. An inertial measurement unit was used to measure the lumbar, pelvic, and thigh angular velocities during gait of 11 patients with hip osteoarthritis and 11 controls. The vector coding technique was applied, and the coupling angle and the appearance rate of coordination pattern in each direction were calculated and compared with the control group. Compared with the control group, with respect to the lumbar/pelvic segment movements, the patients with hip osteoarthritis spent more rates in anti-phase and lower rates in in-phase lateral tilt movement. With respect to the pelvic/thigh segment movements, the patients with hip osteoarthritis spent more rates within the proximal- and in-phases for lateral tilt movement. Furthermore, patients with osteoarthritis spent lower rates in the distal-phase for anterior/posterior tilt and rotational movement. Patients with hip osteoarthritis could not move their pelvic and thigh segments separately, which indicates the stiffness of the hip joint. The rotational movement and lateral tilt movements, especially, were limited, which is known as Duchenne limp. To maintain the gait ability, it seems important to pay attention to these directional movements.

[Bone disease with pain. Osteomyelitis in the long bone].

In the present time various antibiotics have been developed. But suppurative osteomyelitis has been very difficult to cure still up to now. If it fails to treat at the initial treatment, it recurs often. Many patients are annoyed by the recurrence. Moreover, increase of multiple resistance bacteria, opportunistic infection and traumatic osteomyelitis make them complex to treat. We have treated 256 osteomyelitis patients by debriding the infected area with closed irrigation before 1981. Then we have been treated 553 patients with Hyperbaric Oxygen Therapy (HBOT) . Include closed irrigation therapy, 95% of cases a good result occurred. The case that has fistula, sequestrum, foreign material or vast range of osteonecrosis is difficult to calm completely by only HBOT. In such cases, they should be taken curettage and closed irrigation.

Irreducible open dorsal dislocation of the proximal interphalangeal joint: a case report.

We report a rare case of open dorsal dislocation of the proximal interphalangeal joint which needed operative reduction. A 39-year-old man injured his right middle finger while playing baseball. There was a laceration on the proximal interphalangeal crease, and the condyles of the proximal phalanx protruded through the wound. The flexor tendons had slipped behind the radial condyle, and made reduction impossible. After the flexor tendons and volar plate were replaced back into their normal position, the reduction was successful. Finally, the patient had full and painless motion of the digit. We review the reported cases of this injury in the relevant literature.