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A key requirement in both native knee joints and total knee arthroplasty is a stable capsular ligament complex. However, knee stability is highly individual and ranges from clinically loose to tight. So far, hardly any in vivo data on the intrinsic mechanical of the knee are available. This study investigated if stiffness of the native ligament complex may be determined in vivo using a standard knee balancer. Measurements were obtained with a commercially available knee balancer, which was initially calibrated in vitro. 5 patients underwent reconstruction of the force-displacement curves of the ligament complex. Stiffness of the medial and lateral compartments were calculated to measure the stability of the capsular ligament complex. All force-displacement curves consisted of a non-linear section at the beginning and of a linear section from about 80 N onwards. The medial compartment showed values of 28.4 ± 1.2 N/mm for minimum stiffness and of 39.9 ± 1.1 N/mm for maximum stiffness; the respective values for the lateral compartment were 19.9 ± 0.9 N/mm and 46.6 ± 0.8 N/mm. A commercially available knee balancer may be calibrated for measuring stiffness of knee ligament complex in vivo, which may contribute to a better understanding of the intrinsic mechanical behaviour of knee joints.
We have developed a novel, computer-assisted operation method for minimal-invasive total hip replacement (THR) following the concept of “femur first/combined anteversion,” which incorporates various aspects of performing a functional optimization of the prosthetic stem and cup position (CAS FF). The purpose of this study is to assess whether the hip joint reaction forces and patient’s gait parameters are being improved by CAS FF in relation to conventional THR (CON). We enrolled 60 patients (28 CAS FF/32 CON) and invited them for gait analysis at three time points (preoperatively, postop six months, and postop 12 months). Data retrieved from gait analysis was processed using patient-specific musculoskeletal models. The target parameters were hip reaction force magnitude (hrf), symmetries, and orientation with respect to the cup. Hrf in the CAS FF group were closer to a young healthy normal. Phase-shift symmetry showed an increase in the CAS FF group. Hrf orientation in the CAS FF group was closer to optimum, though no edge or rim-loading occurred in the CON group as well. The CAS FF group showed an improved hrf orientation in an early stage and a trend to an improved long-term outcome.
Soccer is one of the most popular sports all around the world. It is an injurious type of sport with a focus on lower extremities and high psychological pressure during matches. The stressor is linked with injuries and an increased musculoskeletal loading. This study investigates the influence of cognitive stress on the load profile of the knee joint. Twelve professional youth soccer players performed highly dynamic runs with and without additional cognitive stress. The runs were analysed with a musculoskeletal simulation software. The data analysis shows no difference in knee joint reaction loading under additional mental stress compared to the baseline. Yet running times are significantly lower in the baseline. While there is no increase in the joint loads, the running times indicate an altered movement behaviour when the subjects are exposed to additional mental demand.
Football players have a high risk of leg muscle injuries, especially when exposed to mental stress. Injuries to muscles of the thigh are common in amateur and professional football, representing almost a third of all injuries. These injuries occur primarily in non-contact situations and from overuse. They can lead to a range of costs, including financial costs associated with treatment as well as those associated with long-term recovery, and absence from training and/or competition. Further, there is a high risk of injury recurrence and subsequent injury.
Forschungsbericht 2012
(2012)