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Fulltext The assessment of immediate post-operative scoliosis correction using pedicle screw system by utilising the fulcrum bending technique

Chan CY, Kwan MK, Saravanan S, Saw LB, Deepak AS

Med J Malaysia, 2007 Mar;62(1):33-5.
PMID: 17682567 MyJurnal

Assessment of the curve flexibility is a crucial step in a surgeon's pre-operative planning for scoliosis surgery. Many techniques have been described. These include traction films, supine side bending films, push prone techniques, traction under general anaesthesia as well as fulcrum bending film. In this study, we studied the pre- and immediate post-operative radiographs of twenty eight adolescent idiopathic scoliosis (AIS) patients who were corrected using pedicle screw systems between January 2004 and August 2006. There were twenty two females and six male patients. The mean age of the patients were 17.5 years with a range of 12 to 38 years. Skeletal maturity of the patients was assessed by Risser's score. The majority was Risser 4 (15 cases, 53.6%). Based on King and Moe's classification, the most common curve was type 3 curve (15 cases, 53.6%). Among the twenty eight patients, twenty three patients underwent only posterior correction, while 5 patients underwent additional anterior release surgery. The mean pre-operative Cobb's angle for the posterior surgery group was 65.5 +/- 13.9 degrees and the mean post-operative Cobb's angle was 32.9 +/- 12.6 degrees. There was no difference between the mean correction estimated by fulcrum bending films (Fulcrum Flexibility) and the post- operative Correction Rate figures (44.2% vs. 49.9%). The mean Fulcrum Bending Correction Index (FBCI) in this group of patients is 112.8%. In the group of patients who underwent additional anterior release, their curves were noted to be larger and less flexible with the mean pre-operative Cobb's angle and Fulcrum Flexibility of 90.4 degrees +/- 9.3 degrees and 23.4% respectively. The Fulcrum Bending Correction Index (FBCI) for this group of patients was significantly higher than the posterior surgery group: i.e. 164.0% vs 112.8%. Thus, anterior release does help to improve the correction significantly. The fulcrum bending films give good pre-operative estimation of the amount of correction to be expected post-operatively. The fulcrum bending films can help to identify the curve types which might require anterior release in order to improve the scoliosis correction. Using the Fulcrum Bending Correction Index (FBCI) will also enable surgeons to quantify more accurately the amount of correction achieved by taking into account the inherent flexibility of the spine.

Matched MeSH terms: Range of Motion, Articular/physiology*
Late presentation of supracondylar fracture of the humerus in children

Devnani AS

Clin Orthop Relat Res, 2005 Feb.
PMID: 15685053

In children with delayed presentation of displaced supracondylar fractures, closed or open reduction with K-wire fixation risks complications. Gradually reducing the fracture with traction potentially reduces these risks. An unacceptable deformity can be corrected later by an osteotomy. This concept was used for 28 children, with an average age of 7 years 6 months, who presented after an average delay of 5.6 days. Their stay in the hospital was 14 days on average. At followup (average, 24 months), five children (18%) who had cubitus varus greater than 10 degrees had corrective osteotomy. There were no additional neurovascular injuries after treatment. The results are comparable with other methods of treatment.

Matched MeSH terms: Range of Motion, Articular
Fulltext Outcome of longstanding dislocated elbows treated by open reduction and excision of collateral ligaments

Devnani AS

Singapore Med J, 2004 Jan;45(1):14-9.
PMID: 14976577

To study the long term result of open reduction of longstanding dislocated elbows with regard to stability, avascular necrosis of the distal humerus and degenerative changes of the joint.

Matched MeSH terms: Range of Motion, Articular/physiology
Fulltext Gradual reduction of supracondylar fracture of the humerus in children reporting late with a swollen elbow

Devnani AS

Singapore Med J, 2000 Sep;41(9):436-40.
PMID: 11193116

AIM: To study the outcome of gradual reduction by skin traction of supracondylar fracture of the humerus in children with swollen elbow, who seek treatment two days or longer after the injury.
METHOD: Fifteen children aged between 4 and 11 years (average 7 years 11 months), who had initially consulted a traditional practitioner, reported between 2 and 21 days (average 7.5) after the injury were treated by skin traction with the elbow kept straight and the forearm in position of comfort.
RESULTS: The average duration of stay in hospital was 14 days. All fractures healed; there was no incidence of myositis ossificans or neurovascular deficit. All patients had functional range of movements at the elbow within 6 months. Five patients developed cubitus varus deformity greater than 5 degrees, they were classified as poor result. Four out of these 5 patients had sought treatment after a delay of 7 days or longer. There were 9 good (60%), 1 fair (7%) and 5 poor (33%) results.
CONCLUSION: Gradual reduction by skin traction is safe. It is possible to achieve satisfactory reduction if the delay is up to 7 days. The results with regards to deformity and function were comparable with those obtained following open or closed Kirschner wire fixation.

Matched MeSH terms: Range of Motion, Articular
Fulltext The orthotic management of the congenitally short lower limb--a new appliance

Devnani AS

Singapore Med J, 2000 Nov;41(11):534-7.
PMID: 11284611

To describe an appliance used for equalisation of severe congenital lower limb length discrepancy for patients who refuse to undergo any operative correction but wish to walk and look better.

Matched MeSH terms: Range of Motion, Articular
Fulltext Reconstruction of severe patellar infera syndrome with free vascularised composite tensor fascia lata flap

Sulaiman AR, Halim AS, Azman WS, Eskandar H

Singapore Med J, 2008 Aug;49(8):e205-7.
PMID: 18756334

Post-traumatic severe patella infera and intra-articular adhesion may lead to a severe knee stiffness. We report a 29-year-old man, a muslim prayer leader, who had a previous knee injury. He presented with knee movement from ten degrees to 30 degrees, patellar infera with a length of patella to length of patellar tendon ratio of 2:5, and severe knee arthrofibrosis. He underwent incision of the patella ligament and open arthrofibrosis release, leaving a tendon gap and skin defect of 5 cm. Reconstruction was successfully done using a free vascularised composite tensor fascia lata flap. He regained full range of knee motion with normal strength quadriceps mechanism at five months after surgery, and remained in full function at 18 months follow-up.

Matched MeSH terms: Range of Motion, Articular
Development of generalized feed forward network for predicting annual flood (depth) of a Tropical River

Mohsen Salarpour, Milad Jajarmizadeh, Zulkifli Yusop, Fadhilah Yusof

Sains Malaysiana, 2014;43:1865-1871.

The modeling of rainfall-runoff relationship in a watershed is very important in designing hydraulic structures, controlling flood and managing storm water. Artificial Neural Networks (ANNs) are known as having the ability to model nonlinear mechanisms. This study aimed at developing a Generalized Feed Forward (GFF) network model for predicting annual flood (depth) of Johor River in Peninsular Malaysia. In order to avoid over training, cross-validation technique was performed for optimizing the model. In addition, predictive uncertainty index was used to protect of over parameterization. The governing training algorithm was back propagation with momentum term and tangent hyperbolic types was used as transfer function for hidden and output layers. The results showed that the optimum architecture was derived by linear tangent hyperbolic transfer function for both hidden and output layers. The values of Nash and Sutcliffe (NS) and root mean square error (RMSE) obtained 0.98 and 5.92 for the test period. Cross validation evaluation showed 9 process elements is adequate in hidden layer for optimum generalization by considering the predictive uncertainty index obtained (0.14) for test period which is acceptable.

Matched MeSH terms: Motion
Fulltext Measurement properties of cervical joint position error in people with and without chronic neck pain

AlDahas A, Devecchi V, Deane JA, Falla D

PLoS One, 2023;18(10):e0292798.
PMID: 37824590 DOI: 10.1371/journal.pone.0292798

BACKGROUND: People with chronic neck pain (CNP) often present with impaired neck proprioception. The most widely used clinical test for assessing neck proprioception is cervical joint position sense which measures joint position error (JPE). This clinical test is typically performed using a laser pointer to examine the accuracy of returning to a neutral head position (NHP) or target head position (THP) following active neck movements. The aim of this study was to determine the measurement properties of JPE using a laser pointer when tested in people with and without CNP under a variety of different testing conditions (i.e., different movement directions, sitting versus standing, NHP versus THP).
METHODS: Forty-three participants (23 asymptomatic and 20 with CNP) underwent neck proprioception testing, returning to a NHP and THP in both sitting and standing positions (six trials for each test). A laser pointer was secured on the participant's forehead and inertial measurement unit (IMU) sensors were placed beneath the laser pointer and at the level of the spinous process of the seventh cervical vertebra. Both the absolute and the constant JPE were assessed.
FINDINGS: For the asymptomatic participants, good reliability (ICC: 0.79) was found only for right rotation of the THP task in sitting. In standing, good reliability (ICC: 0.77) was only found in flexion for the THP task. In standing, good reliability (ICC: 0.77) was only found for right rotation of the THP for the absolute JPE and left rotation (ICC: 0.85) for the constant error of the NHP task. In those with CNP, when tested in sitting, good reliability was found for flexion (ICC: 0.8) for the absolute JPE and good reliability (ICC range: 0.8-0.84) was found for flexion, extension, and right rotation for the constant JPE. In standing, good reliability (ICC range: 0.81-0.88) was found for flexion, and rotation for the absolute JPE. The constant JPE showed good reliability (ICC: 0.85) for right rotation and excellent reliability (ICC: 0.93) for flexion. Validity was weak to strong (r range: 0.26-0.83) and moderate to very strong (r range: 0.47-0.93) for absolute and constant error respectively, when tested in sitting. In standing, the validity was weak to very strong (0.38-0.96) for the absolute JPE and moderate to very strong (r range: 0.54-0.92) for the constant JPE.
CONCLUSION: The reliability of the measure of JPE when tested in sitting and standing in both groups showed good reliability, but not for all movements. The results of the current study also showed that the laser pointer correlated well with the Noraxon IMUs, but not for all movements. The results of the current study support the use of the JPE using a laser pointer in clinical and research settings.

Matched MeSH terms: Range of Motion, Articular
Fulltext Slip flow through a non-uniform channel under the influence of transverse magnetic field

Farooq J, Mushtaq M, Munir S, Ramzan M, Chung JD, Farooq U

Sci Rep, 2018 Sep 03;8(1):13137.
PMID: 30177724 DOI: 10.1038/s41598-018-31538-8

This study deals with the steady laminar slip flow of an incompressible Newtonian fluid in a non-uniform permeable channel under the influence of transverse magnetic field. The reabsorption through the wall is accounted for by considering flux as a function of downstream distance. The non-linear coupled partial differential equations of motion are first transformed into a single fourth order partial differential equation and then solved analytically using Adomain decomposition method. Effects of pertinent parameters on different flow properties are discussed by plotting graphs. Results reveal that magnetic field considerably influences the behavior of flow.

Matched MeSH terms: Motion
Fulltext On solution existence of MHD Casson nanofluid transportation across an extending cylinder through porous media and evaluation of priori bounds

Abdal S, Hussain S, Siddique I, Ahmadian A, Ferrara M

Sci Rep, 2021 Apr 08;11(1):7799.
PMID: 33833251 DOI: 10.1038/s41598-021-86953-1

It is a theoretical exportation for mass transpiration and thermal transportation of Casson nanofluid over an extending cylindrical surface. The Stagnation point flow through porous matrix is influenced by magnetic field of uniform strength. Appropriate similarity functions are availed to yield the transmuted system of leading differential equations. Existence for the solution of momentum equation is proved for various values of Casson parameter [Formula: see text], magnetic parameter M, porosity parameter [Formula: see text] and Reynolds number Re in two situations of mass transpiration (suction/injuction). The core interest for this study aroused to address some analytical aspects. Therefore, existence of solution is proved and uniqueness of this results is discussed with evaluation of bounds for existence of solution. Results for skin friction factor are established to attain accuracy for large injection values. Thermal and concentration profiles are delineated numerically by applying Runge-Kutta method and shooting technique. The flow speed retards against M, [Formula: see text] and [Formula: see text] for both situations of mass injection and suction. The thermal boundary layer improves with Brownian and thermopherotic diffusions.

Matched MeSH terms: Motion
Dynamic Modeling of Fiber-Reinforced Soft Manipulator: A Visco-Hyperelastic Material-Based Continuum Mechanics Approach

Mustaza SM, Elsayed Y, Lekakou C, Saaj C, Fras J

Soft Robot, 2019 06;6(3):305-317.
PMID: 30917093 DOI: 10.1089/soro.2018.0032

Robot-assisted surgery is gaining popularity worldwide and there is increasing scientific interest to explore the potential of soft continuum robots for minimally invasive surgery. However, the remote control of soft robots is much more challenging compared with their rigid counterparts. Accurate modeling of manipulator dynamics is vital to remotely control the diverse movement configurations and is particularly important for safe interaction with the operating environment. However, current dynamic models applied to soft manipulator systems are simplistic and empirical, which restricts the full potential of the new soft robots technology. Therefore, this article provides a new insight into the development of a nonlinear dynamic model for a soft continuum manipulator based on a material model. The continuum manipulator used in this study is treated as a composite material and a modified nonlinear Kelvin-Voigt material model is utilized to embody the visco-hyperelastic dynamics of soft silicone. The Lagrangian approach is applied to derive the equation of motion of the manipulator. Simulation and experimental results prove that this material modeling approach sufficiently captures the nonlinear time- and rate-dependent behavior of a soft manipulator. Material model-based closed-loop trajectory control was implemented to further validate the feasibility of the derived model and increase the performance of the overall system.

Matched MeSH terms: Motion
Measurement of range of motions of L3-L4 healthy spine through offsetting reflective markers and in silico analysis of meshed model

Kosalishkwaran G, Parasuraman S, Singh DKJ, Natarajan E, Elamvazuthi I, George J

Med Biol Eng Comput, 2019 Oct;57(10):2305-2318.
PMID: 31444622 DOI: 10.1007/s11517-019-02026-6

Degenerative disc disease (DDD) is a common condition in elderly population that can be painful and can significantly affect individual's quality of life. Diagnosis of DDD allows prompt corrective actions but it is challenging due to the absence of any symptoms at early stages. In studying disc degeneration, measurement of the range of motion (RoM) and loads acting on the spine are crucial factors. However, direct measurement of RoM involves increased instrumentation and risk. In this paper, an innovative method is proposed for calculating RoM, emphasizing repeatability and reliability by considering the posterior thickness of the spine. This is achieved by offsetting the position of markers in relation to the actual vertebral loci. Three geometrically identical finite element models of L3-L4 are developed from a CT scan with different types of elements, and thereafter, mesh element-related metrics are provided for the assessment of the quality of models. The model with the best mesh quality is used for further analysis, where RoM are within ranges as reported in literature and in vivo experiment results. Various kinds of stresses acting on individual components including facet joints are analysed for normal and abnormal loading conditions. The results showed that the stresses in abnormal load conditions for all components including cortical (76.67 MPa), cancellous (69.18 MPa), annulus (6.30 MPa) and nucleus (0.343 MPa) are significantly greater as compared to normal loads (49.96 MPa, 44.2 MPa, 4.28 MPa and 0.23 MPa respectively). However, stress levels for both conditions are within safe limits (167-215 MPa for cortical, 46 MPa for the annulus and 3 MPa for facets). The results obtained could be used as a baseline motion and stresses of healthy subjects based on their respective lifestyles, which could benefit clinicians to suggest corrective actions for those affected by DDD.

Matched MeSH terms: Motion; Range of Motion, Articular
Fulltext Platelet-rich plasma (PRP): an adjuvant to hasten hamstring muscle recovery. A randomized controlled trial protocol (ISCRTN66528592)

A Hamid MS, Mohamed Ali MR, Yusof A, George J

BMC Musculoskelet Disord, 2012 Aug 06;13:138.
PMID: 22866670 DOI: 10.1186/1471-2474-13-138

BACKGROUND: Muscle injuries are one of the commonest injuries affecting athletes. It often leads to significant pain and disability causing loss of training and competition time. With current treatment, the duration to return-to-play ranges form six weeks to never, depending on injury severity. Recent researches have suggested that autologous platelet-rich plasma (PRP) injection into the injured site may hasten soft tissues healing. To-date, there has been no randomised clinical trials to evaluate the effects of PRP on muscle healing. The aim of this study is to examine the effects of autologous PRP on duration to return-to-play after muscle injury.
METHODS AND DESIGN: A randomised, single blind controlled trial will be conducted. Twenty-eight patients aged 18 years and above with a recent grade-2 hamstring injury will be invited to take part. Participants will be randomised to receive either autologous PRP injection with rehabilitation programme, or rehabilitation programme only. Participants will be followed up at day three of study and then weekly for 16 weeks. At each follow up visit, participants will be assessed on readiness to return-to-play using a set of criteria. The primary end-point is when participants have fulfilled the return-to-play criteria or end of 16 weeks.The main outcome measure of this study is the duration to return-to-play after injury.
CONCLUSION: This study protocol proposes a rigorous and potential significant evaluation of PRP use for grade-2 hamstring injury. If proven effective such findings could be of great benefit for patients with similar injuries.
TRIAL REGISTRATION: Current Controlled Trials ISCRTN66528592.

Matched MeSH terms: Range of Motion, Articular
Verification of equations for incipient motion studies for a rigid rectangular channel

Bong CH, Lau TL, Ghani AA

Water Sci Technol, 2013;67(2):395-403.
PMID: 23168641 DOI: 10.2166/wst.2012.580

The current study aims to verify the existing equations for incipient motion for a rigid rectangular channel. Data from experimental work on incipient motion from a rectangular flume with two different widths, namely 0.3 and 0.6 m, were compared with the critical velocity value predicted by the equations of Novak & Nalluri and El-Zaemey. The equation by El-Zaemey performed better with an average discrepancy ratio value of 1.06 compared with the equation by Novak & Nalluri with an average discrepancy ratio value of 0.87. However, as the sediment deposit thickness increased, the equation by El-Zaemey became less accurate. A plot on the Shields Diagram using the experimental data had shown the significant effect of the sediment deposit thickness where, as the deposit becomes thicker, the dimensionless shear stress θ value also increased. A new equation had been proposed by incorporating the sediment deposit thickness. The new equation gave improved prediction with an average discrepancy ratio value of 1.02.

Matched MeSH terms: Motion*
Satisfaction and problems experienced with wrist movements: comparison between a common body-powered prosthesis and a new biomechatronics prosthesis

Abd Razak NA, Abu Osman NA, Kamyab M, Wan Abas WA, Gholizadeh H

Am J Phys Med Rehabil, 2014 May;93(5):437-44.
PMID: 24429510 DOI: 10.1097/PHM.0b013e3182a51fc2

This report compares wrist supination and pronation and flexion and extension movements with the common body-powered prosthesis and a new biomechatronics prosthesis with regard to patient satisfaction and problems experienced with the prosthesis. Fifteen subjects with traumatic transradial amputation who used both prosthetic systems participated in this study. Each subject completed two questionnaires to evaluate their satisfaction and problems experienced with the two prosthetic systems. Satisfaction and problems with the prosthetic's wrist movements were analyzed in terms of the following: supination and pronation; flexion and extension; appearance; sweating; wounds; pain; irritation; pistoning; smell; sound; durability; and the abilities to open a door, hold a cup, and pick up or place objects. This study revealed that the respondents were more satisfied with the biomechatronics wrist prosthesis with regard to supination and pronation, flexion and extension, pain, and the ability to open a door. However, satisfaction with the prosthesis showed no significant differences in terms of sweating, wounds, irritation, pistoning, smell, sound, and durability. The abilities to hold a cup and pick up or place an object were significantly better with the body-powered prosthesis. The results of the survey suggest that satisfaction and problems with wrist movements in persons with transradial amputation can be improved with a biomechatronics wrist prosthesis compared with the common body-powered prosthesis.

Matched MeSH terms: Range of Motion, Articular/physiology*
Fulltext Anteromedial Surface Plating for Midshaft Fracture Humerus Through an Anterolateral Approach - A Better Option than Anterolateral Plating

Rai SK, Sud AD, Kashid M, Gogoi B

Malays Orthop J, 2020 Nov;14(3):66-72.
PMID: 33403064 DOI: 10.5704/MOJ.2011.011

Introduction: Osteosynthesis by plate fixation of humeral shaft fractures as a gold standard for fracture fixation has been proven beyond doubt. However, during conventional anterolateral plating Radial nerve injury may occur which can be avoided by applying plate on the medial flat surface. The aim of this study was to evaluate the results of application of plate on the flat medial surface of humerus rather than the conventional anterolateral surface.
Materials and Methods: This study was conducted between Oct 2010 to Dec 2015. One-hundred-fifty fracture shafts of the humerus were treated with the anteromedial plating through the anterolateral approach.
Results: One-hundred-fifty patients with a fracture shaft of the humerus were treated with anteromedial plating. Twenty were female (mean ±SD,28 years±4.5) and 130 were male (mean ± SD, 38 years±5.6). One hundred and forty-eight out of 150 (98.6%) patients achieved union at 12 months. Two of three patients developed a superficial infection, both of which were treated successfully by antibiotics and one developed a deep infection, which was treated by wound debridement, prolonged antibiotics with the removal of the plate and subsequently by delayed plating and bone grafting.
Conclusion: In the present study, we applied plate on the anteromedial flat surface of humerus using the anterolateral approach. It is an easier and quicker fixation as compared to anterolateral plating because later involved much more dissection than a medial application of the plate and this application of plate on a medial flat surface, does not required Radial nerve exposure and palsy post-operatively. The significant improvement in elbow flexion without brachialis dissection is also a potential benefit of this approach. Based on our results, we recommend the application of an anteromedial plate for treatment of midshaft fractures humerus.

Matched MeSH terms: Range of Motion, Articular
Fulltext Self-Adaptive Filtering Approach for Improved Indoor Localization of a Mobile Node with Zigbee-Based RSSI and Odometry

Loganathan A, Ahmad NS, Goh P

Sensors (Basel), 2019 Nov 01;19(21).
PMID: 31683837 DOI: 10.3390/s19214748

This study presents a new technique to improve the indoor localization of a mobile node by utilizing a Zigbee-based received-signal-strength indicator (RSSI) and odometry. As both methods suffer from their own limitations, this work contributes to a novel methodological framework in which coordinates of the mobile node can more accurately be predicted by improving the path-loss propagation model and optimizing the weighting parameter for each localization technique via a convex search. A self-adaptive filtering approach is also proposed which autonomously optimizes the weighting parameter during the target node's translational and rotational motions, thus resulting in an efficient localization scheme with less computational effort. Several real-time experiments consisting of four different trajectories with different number of straight paths and curves were carried out to validate the proposed methods. Both temporal and spatial analyses demonstrate that when odometry data and RSSI values are available, the proposed methods provide significant improvements on localization performance over existing approaches.

Matched MeSH terms: Motion
Fulltext Seismic response of a base isolated cable-stayed bridge under near-fault ground motion excitations

Ahad Javanmardi, Zainab Ibrahim, Khaled Gheadi, Mohammed Jameel, Usman Hanif, Gordan, Meisam

Scientific Research Journal, 2018;15(1):1-14.
MyJurnal

Nowadays, development of cable-stayed bridges is increasing around the world. The mitigation of seismic forces to these bridges are obligatory to prevent damages or failure of its structural members. Herein, this paper aimed to determine the near-fault ground motion effect on an existing cablestayed bridge equipped with lead-rubber bearing. In this context, Shipshaw cable-stayed bridge is selected as the case study. The selected bridge has a span of 183.2 m composite deck and 43 m height of steel tower. 2D finite element models of the non-isolated and base isolated bridges are modelled by using SAP2000. Three different near-fault ground motions which are Tabas 1978, Cape Mendocino 1992 and Kobe 1995 were subjected to the 2D FEM models in order to determine the seismic behaviour of the bridge. The near-fault ground motions were applied to the bridge in the longitudinal direction. Nonlinear dynamic analysis was performed to determine the dynamic responses of the bridge. Comparison of dynamic response of nonisolated and base isolated bridge under three different near-fault ground motions were conducted. The results obtained from numerical analyses of the bridge showed that the isolation system lengthened the period of bridge and minimised deck displacement, base shear and base moment of the bridge. It is concluded that the isolation system significantly reduced the destructive effects of near-fault ground motions on the bridge.

Matched MeSH terms: Motion
Fulltext Short-Term Effects of Strengthening Exercises of the Lower Limb Rehabilitation Protocol on Pain, Stiffness, Physical Function, and Body Mass Index among Knee Osteoarthritis Participants Who Were Overweight or Obese: A Clinical Trial

Rafiq MT, Hamid MSA, Hafiz E

ScientificWorldJournal, 2021;2021:6672274.
PMID: 34975349 DOI: 10.1155/2021/6672274

BACKGROUND: Osteoarthritis (OA) of the knee is defined as a progressive disease of the synovial joints and is characterized by wear and tear of the cartilage and underlying bone. This study aimed to determine the short-term effects of the lower limb rehabilitation protocol (LLRP) on pain, stiffness, physical function, and body mass index (BMI) among knee OA participants who were overweight or obese. Methodology. A single-blinded randomized controlled trial of one-month duration was conducted at Rehmatul-Lil-Alameen Postgraduate Institute, Lahore, Pakistan. Fifty overweight or obese participants with knee OA were randomly divided into two groups by a computer-generated number. Participants in the rehabilitation protocol group (RPG) were provided with leaflets explaining the strengthening exercises of the LLRP and instruction of daily care (IDC), while the participants in the control group (CG) were provided with leaflets explaining the IDC only for a duration of four weeks. The primary outcome measures were the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores for pain, stiffness, and physical function. The secondary outcome measures were BMI, exercise adherence, and patients' satisfaction assessed by using the numeric rating scale ranging from 0 to 10. The paired-sample t-test was used to analyze the differences within groups from baseline to posttest evaluations. The analysis of variance 2 × 2 factor was used to analyze the differences in BMI, knee pain, stiffness, and physical function between the groups.
RESULTS: Participants in the RPG and CG reported a statistically significant reduction in knee pain and stiffness (p ≤ 0.05) within the group. The reduction in the scores of knee pain was higher in participants in the RPG than that in participants in the CG (p=0.001). Additionally, participants in the RPG reported greater satisfaction (p=0.001) and higher self-reported exercise adherence (p=0.010) and coordinator-reported exercise adherence (p=0.046) than the participants in the CG.
CONCLUSION: Short-term effects of the LLRP appear to reduce knee pain and stiffness only, but not physical function and BMI.

Matched MeSH terms: Range of Motion, Articular
Breakage of an intramedullary rod after bone union in congenital pseudoarthrosis of the tibia: a report of two cases

Sulaiman AR, Simbak N, Wan Ismail WF, Wan Z, Halim AS

J Orthop Surg (Hong Kong), 2011 Aug;19(2):250-3.
PMID: 21857057

We report 2 patients with congenital pseudoarthrosis of the tibia who underwent intramedullary Rush rod transfixation through the ankle joint following refracture and nonunion of vascularised fibular grafting 6 and 8 months earlier. After 9 and 5 years, both Rush rods were broken at the level of the ankle joints, while the reconstructed area was solidly united. The growth of the distal tibia increased the distance of the tips of the broken rod and hence the ankle joint motion. The broken tips may damage the articular cartilage and result in valgus deformity of the ankle and limb length discrepancy.

Matched MeSH terms: Range of Motion, Articular

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