Impact of Quadriceps/Hamstrings Torque Ratio on Three-Dimensional Pelvic Posture and Clinical Pubic Symphysis Pain-Preliminary Results in Healthy Young Male Athletes

Pain in the pubic symphysis is of significance, especially in high-performance sports. Pelvic torsion, possibly caused by muscular imbalances, is discussed as a pathogenic mechanism. This study examined a possible interrelationship between the maximum torques of quadriceps femoris and hamstrings and the spatial positioning of the hemi-pelvises, as well as the tenderness to palpation of the pubic symphysis. The three-dimensional pelvic contour of 26 pain free adolescents (age 16.0 ± 0.8 years, weight 66.3 ± 9.9 kg, height 176.2 ± 6.0 cm) was registered by means of an 3D optical system and the torsion of both hemi-pelvises against each other was calculated based on a simplified geometrical model. Tenderness on palpation of the pubic symphysis was assessed by means of a visual analogue scale, and isometric torques of knee extensors and flexors were measured for both legs. The torque ratio between knee extensors and flexors was calculated for both sides, as was the crossed torque ratio between the two legs. On the basis of a MANOVA, possible significant differences in torques and torque ratios between subgroups with lower and higher pelvic torsion were analyzed. The crossed torque ratio (F = 19.55, p < 0.001, partial η 2 = 0.453) and the tenderness to palpation of the pubic symphysis (F = 10.72, p = 0.003, partial η 2 = 0.309) were significantly higher in the subgroup with higher pelvic torsion. The results indicate the crossed torque ratio of knee flexors and extensors as a potential biomechanical-pathogenic mechanism to be considered in the primary prevention and diagnosis of symphyseal pain

Improvement of Groin Pain in a Football Player with Femoroacetabular Impingement via a Correction of the Pelvic Position—A Case Report

Background: Femoroacetabular impingement is one possible cause for groin pain and can lead to long periods of absence for football players. In cam impingement, the end-grade position of the leg at kicking makes the hip particularly prone to faulty contact between the acetabulum and the femoral head. Studies suggest that the resting position of the pelvis in the sagittal plane may have an important role in the biomechanics of movement in the presence of cam impingement. Methods: A 19-year-old male competitive footballer complained of sudden groin pain during a period of low athletic load. Biomechanical tests (3D posture and isometric strength analyses) showed that unbalanced individual strength training had resulted in an increased forward tilt of the pelvis. At the same time, cam impingement was confirmed radiologically, which obviously contributed to the sudden onset of the symptoms. The kicking technique of the athlete showed increased hip and trunk flexion, which also indicated a muscular imbalance. Targeted strength and stretching exercises three times a week improved the pelvic position in terms of reduced anteversion. At the same time, the patient performed strength exercises to improve his kicking technique. Results: After 8 weeks, improvements in his pelvic position and global posture and increased muscle strength could be verified. At the same time, the athlete was free of complaints again. Conclusions: When groin pain occurs in football players with cam impingement, special attention should be paid to the resting position of the pelvis in the sagittal plane. Correcting increased pelvic anteversion can prevent unfavourable end-grade collisions of the acetabulum and femoral head during kicking with strong hip flexion and adduction. Possible changes in the pelvic position due to adverse individual strength training performed by young athletes should always be kept in mind

Vacuum-assisted closure in the treatment of early hip joint infections

The aim of the present study was to evaluate the efficacy of the vacuum-assisted closure (V.A.C.) system in the treatment of early hip joint infections. 28 patients (11 m / 17 f; mean age 71 y. [43-84]) with early hip joint infections have been treated by means of the V.A.C.-therapy. At least one surgical revision [1-7] has been unsuccessfully performed for infection treatment prior to V.A.C. - application. Pathogen organisms could have been isolated in 22/28 wounds. During revision, cup inlay and prosthesis head have been exchanged and 1-3 polyvinylalcohol sponges inserted into the wound cavity/ periprosthetically at an initial continuous pressure of 200 mm Hg. Postoperatively, a systemic antibiosis was given according to antibiogram. 48-72 h after surgery an alteration from haemorrhagic to serous fluid was observed in the V.A.C.-canister. Afterwards, the pressure was decreased to 150 mm Hg and remained at this level till sponge removal. After a mean period of 9 [3-16] days the inflammation parameters have been retrogressive and the sponges were removed. An infection eradication could be achieved in 26/28 cases. In the two remaining cases the infected prosthesis had to be explanted and a gentamicin-vancomycin-loaded spacer has been implanted, respectively. At a total mean follow-up of 36 [12-87] months no reinfection or infection persistence was observed. The V.A.C.-system can be a valuable contribution in the treatment of early joint infections when properly used. Indications should be early infections with well-maintained soft-tissues for retention of the negative atmospheric pressure

Change of Muscle Activity as Well as Kinematic and Kinetic Parameters during Headers after Core Muscle Fatigue

In soccer, headers are a tactical measure and influenced by numerous factors. The goal of this study was to identify whether changes in kinematics and muscular activity, especially of the head-stabilizing muscles, occur during headers when the core musculature is fatigued. In two subgroups, muscular activity (12 amateur players, age 23.6 ± 4.2 years) and kinematics and dynamics (29 amateur players, age 23.7 ± 2.8 years) were examined during straight headers on a pendulum header. Data were collected before and after the core muscles were fatigued by an exercise program. Telemetric surface EMG, 3D acceleration sensor, force plate, and video recordings were used. Under fatigue, the activity of M. erector spinae and M. rectus abdominis was significantly reduced in the preparation phase of the header. The activity of M. sternocleidomastoideus was significantly increased during the jump phase, and the hip extension angle during maximum arched body tension was significantly reduced under fatigue. Jumping height, acceleration force impulse, and linear head acceleration were also significantly reduced. We conclude that fatigue of the core muscles affects the motion technique of the header and the activity of the muscle groups stabilizing the head. Therefore, the necessity of specific training in soccer should be emphasized from a medical-preventive point of view

tert-Butyl 1-hy­droxy­piperidine-2-carboxyl­ate

The title compound, C10H19NO3, is a disubstituted piperidine bearing substituents in two equatorial positions. One of the substituents is a hy­droxy group bound to nitro­gen and the second a tert-butyl ester group bound to the carbon next to the endocyclic nitro­gen. Enanti­omers of the title compound form hydrogen-bridged dimers across a center of inversion

Advanced modular self‐inactivating lentiviral expression vectors for multigene interventions in mammalian cells and in vivo transduction

In recent years, lentiviral expression systems have gained an unmatched reputation among the gene therapy community for their ability to deliver therapeutic transgenes into a wide variety of difficult‐to‐transfect/transduce target tissues (brain, hematopoietic system, liver, lung, retina) without eliciting significant humoral immune responses. We have cloned a construction kit‐like self‐inactivating lentiviral expression vector family which is compatible to state‐of‐the‐art packaging and pseudotyping technologies and contains, besides essential cis‐acting lentiviral sequences, (i) unparalleled polylinkers with up to 29 unique sites for restriction endonucleases, many of which recognize 8 bp motifs, (ii) strong promoters derived from the human cytomegalovirus immediate‐early promoter (PhCMV) or the human elongation factor 1α (PhEF1α), (iii) PhCMV- or PPGK- (phosphoglycerate kinase promoter) driven G418 resistance markers or fluorescent protein‐based expression tracers and (iv) tricistronic expression cassettes for coordinated expression of up to three transgenes. In addition, we have designed a size‐optimized series of highly modular lentiviral expression vectors (pLenti Module) which contain, besides the extensive central polylinker, unique restriction sites flanking any of the 5′U3, R‐U5‐ψ+‐SD, cPPT‐RRE‐SA and 3′LTRΔU3 modules or placed within the 5′U3 (-78 bp) and 3′LTRΔU3 (8666 bp). pLentiModule enables straightforward cassette‐type module swapping between lentiviral expression vector family members and facilitates the design of Tat‐independent (replacement of 5′LTR by heterologous promoter elements), regulated and self‐excisable proviruses (insertion of responsive operators or LoxP in the 3′LTRΔU3 element). We have validated our lentiviral expression vectors by transduction of a variety of insect, chicken, murine and human cell lines as well as adult rat cardiomyocytes, rat hippocampal slices and chicken embryos. The novel multi‐purpose construction kit‐like vector series described here is compatible with itself as well as many other (non‐viral) mammalian expression vectors for straightforward exchange of key components (e.g. promoters, LTRs, resistance genes) and will assist the gene therapy and tissue engineering communities in developing lentiviral expression vectors tailored for optimal treatment of prominent human disease