An unusual case of early dislocation of a mobile bearing posterior stabilized total knee arthroplasty in a 48-year-old Caucasian woman is described. Dislocation occurred one day postoperatively, attributed to a gap mi...An unusual case of early dislocation of a mobile bearing posterior stabilized total knee arthroplasty in a 48-year-old Caucasian woman is described. Dislocation occurred one day postoperatively, attributed to a gap mismatch. Revision surgery reduced posterior dislocation, increased bearing plate thickness and rebalanced ligaments. A second dislocation occurred after revision surgery. The patient’s history was retaken and a hamstring spasm disease identified. A new revision utilized a more constrained design, without perioperative local nerve block. Two years following surgery, no further dislocation had occurred. A numerical musculoskeletal model of the case and implant configuration identified no trend to mobile bearing dislocation when regular muscle forces were applied. Muscle spasm is a risk factor for mobile bearing total knee arthroplasty dislocation, especially with femoral nerve block.展开更多
Aim:To evaluate the clinical usability of mechanomyography(MMG)in the evaluation of upper-limb spasticity states of hemiplegia patients with likelihood ratio analysis.Methods:The MMG signals from the 30 hemiplegia pat...Aim:To evaluate the clinical usability of mechanomyography(MMG)in the evaluation of upper-limb spasticity states of hemiplegia patients with likelihood ratio analysis.Methods:The MMG signals from the 30 hemiplegia patients'biceps and triceps were recorded with three-dimensional wireless accelerometer(Trigno Wireless System,Delsys Inc),when they extended or bent their elbow passively.At the same time,the physiotherapist assessed the MAS(Modified Ashworth Scale)of all the patients who participated in the study and would be divided them into four groups based on the MAS values(MAS0,MAS1,MAS1+and MAS2).The MMG sensors were built with triaxial accelerometers named as X,Y and Z that represent the muscle fibers lengthwise movement,the cross movement and the vertical the muscle moving direction,respectively.The root mean square(RMS)value of the MMG signal was calculated for analysis.Likelihood ratio analysis were used in the study.Results:All of the variables of the X,Y,Z axis of signals of MMG of BB and TB have related with muscle spasticity grading during passive elbow flexion in multinomial logistic regression(P=0.000,P<0.001).The regression coefficient of Y axis signal of MMG of BB is the largest.The 5 variables of the X,Y,Z axis of signals of MMG of BB and X,Y axis of TB have related with Muscle spasticity grading during passive elbow extension in multinomial logistic regression(P=0.000,P<0.001).The regression coefficient ofY axis signal of MMG of BB is the largest in equation and the Y axis signal of MMG of TB is second large.Conclusions:The effect of agonist is more than the antagonist during the MAS assessment,especially the muscle fibers cross movement and the vertical movement by the MMG assessment.展开更多
Objective Abnormal muscle response (AMR) to the electrical stimulation of a branch of facial nerve is a specific electrophysiological feature of primary hemifacial spasm (HFS) . Although the correlation between intrao...Objective Abnormal muscle response (AMR) to the electrical stimulation of a branch of facial nerve is a specific electrophysiological feature of primary hemifacial spasm (HFS) . Although the correlation between intraoperative AMR findings and postoperative results in patients with HFS were investigated before,展开更多
Surgical treatment and ESI （epidural steroid injection） are widely used forms of treatment for cervical radiculopathy but they are controversial and burdensome for patients. To relief pain fast without side effects,...Surgical treatment and ESI （epidural steroid injection） are widely used forms of treatment for cervical radiculopathy but they are controversial and burdensome for patients. To relief pain fast without side effects, we devised a new minimally invasive treatment method that widens the facet joints to decompress nerve roots and release the muscle spasm in cervical radiculopathy with acupuncture needles with blunt tip and mini-scalpel, and named it modified acupuncture procedure. MAP （Modified acupuncture procedure） was administered for 37 patients （mean age = 53.1 years, follow-up = 14.2 months） with cervical radiculopathy who did not recover from 4 weeks of nonsurgical treatment. We analyzed clinical outcomes of patients before and after the procedure through VAS （Visual Analogue Scale） and NDI （Neck Disability Index）. On average, patients received 1.4 MAP （modified acupuncture procedures）. The VAS score difference on the day after procedure and at 1 year follow-up was 36.8 ± 26.5 （from 60.1 ± 25.3 at the baseline to 25.3 ± 17.8 at the reading） （P 〈 0.01） and 31.0 ± 30.4 （29.0 ± 21.8 at the reading） respectively. The NDI value dropped by 19.9 ± 18.3 （from 37.2 ± 19.7 at the baseline to 17.2 ± 15.0 at the reading） （P〈 0.01） on 1 year follow up. MAP was found to have clinical efficacy for cervical radiculopathy.展开更多
文摘An unusual case of early dislocation of a mobile bearing posterior stabilized total knee arthroplasty in a 48-year-old Caucasian woman is described. Dislocation occurred one day postoperatively, attributed to a gap mismatch. Revision surgery reduced posterior dislocation, increased bearing plate thickness and rebalanced ligaments. A second dislocation occurred after revision surgery. The patient’s history was retaken and a hamstring spasm disease identified. A new revision utilized a more constrained design, without perioperative local nerve block. Two years following surgery, no further dislocation had occurred. A numerical musculoskeletal model of the case and implant configuration identified no trend to mobile bearing dislocation when regular muscle forces were applied. Muscle spasm is a risk factor for mobile bearing total knee arthroplasty dislocation, especially with femoral nerve block.
基金funded by the National Natural Science Foundation of China(#61135004,#51275101).
文摘Aim:To evaluate the clinical usability of mechanomyography(MMG)in the evaluation of upper-limb spasticity states of hemiplegia patients with likelihood ratio analysis.Methods:The MMG signals from the 30 hemiplegia patients'biceps and triceps were recorded with three-dimensional wireless accelerometer(Trigno Wireless System,Delsys Inc),when they extended or bent their elbow passively.At the same time,the physiotherapist assessed the MAS(Modified Ashworth Scale)of all the patients who participated in the study and would be divided them into four groups based on the MAS values(MAS0,MAS1,MAS1+and MAS2).The MMG sensors were built with triaxial accelerometers named as X,Y and Z that represent the muscle fibers lengthwise movement,the cross movement and the vertical the muscle moving direction,respectively.The root mean square(RMS)value of the MMG signal was calculated for analysis.Likelihood ratio analysis were used in the study.Results:All of the variables of the X,Y,Z axis of signals of MMG of BB and TB have related with muscle spasticity grading during passive elbow flexion in multinomial logistic regression(P=0.000,P<0.001).The regression coefficient of Y axis signal of MMG of BB is the largest.The 5 variables of the X,Y,Z axis of signals of MMG of BB and X,Y axis of TB have related with Muscle spasticity grading during passive elbow extension in multinomial logistic regression(P=0.000,P<0.001).The regression coefficient ofY axis signal of MMG of BB is the largest in equation and the Y axis signal of MMG of TB is second large.Conclusions:The effect of agonist is more than the antagonist during the MAS assessment,especially the muscle fibers cross movement and the vertical movement by the MMG assessment.
文摘Objective Abnormal muscle response (AMR) to the electrical stimulation of a branch of facial nerve is a specific electrophysiological feature of primary hemifacial spasm (HFS) . Although the correlation between intraoperative AMR findings and postoperative results in patients with HFS were investigated before,
文摘Surgical treatment and ESI （epidural steroid injection） are widely used forms of treatment for cervical radiculopathy but they are controversial and burdensome for patients. To relief pain fast without side effects, we devised a new minimally invasive treatment method that widens the facet joints to decompress nerve roots and release the muscle spasm in cervical radiculopathy with acupuncture needles with blunt tip and mini-scalpel, and named it modified acupuncture procedure. MAP （Modified acupuncture procedure） was administered for 37 patients （mean age = 53.1 years, follow-up = 14.2 months） with cervical radiculopathy who did not recover from 4 weeks of nonsurgical treatment. We analyzed clinical outcomes of patients before and after the procedure through VAS （Visual Analogue Scale） and NDI （Neck Disability Index）. On average, patients received 1.4 MAP （modified acupuncture procedures）. The VAS score difference on the day after procedure and at 1 year follow-up was 36.8 ± 26.5 （from 60.1 ± 25.3 at the baseline to 25.3 ± 17.8 at the reading） （P 〈 0.01） and 31.0 ± 30.4 （29.0 ± 21.8 at the reading） respectively. The NDI value dropped by 19.9 ± 18.3 （from 37.2 ± 19.7 at the baseline to 17.2 ± 15.0 at the reading） （P〈 0.01） on 1 year follow up. MAP was found to have clinical efficacy for cervical radiculopathy.
