Temporal feature estimation during walking using miniature accelerometers: an analysis of gait improvement after hip arthroplasty

A new method for the detection of gait cycle phases using only two miniature accelerometers together with a light, portable digital recorder is proposed. Each subject is asked to walk on a walkway at his/her own preferred speed. Gait analysis was performed using an original method of computing the values of temporal parameters from accelerometer signals. First, to validate the accelerometric method, measurements are taken on a group of healthy subjects. No significant differences are observed between the results thus obtained and those from pressure sensors attached under the foot Then, measurements using only accelerometers are performed on a group of 12 patients with unilateral hip osteo-arthritis. The gait analysis is carried out just before hip arthroplasty and again, three, six and nine months afterwards. A mean decrease of 88% of asymmetry of stance time and especially a mean decrease of 250% of asymmetry of double support time are observed, nine months after the operation. These results confirm the validity of the proposed method for healthy subjects and its efficiency for functional evaluation of gait improvement after arthroplasty

Clinical relevance of heparin-PF4 complex antibody in DVT after total joint replacement

<p>Abstract</p> <p>Background</p> <p>Antibodies to the heparin-platelet factor-4 (HPF-4) complex (HIT antibodies) have been observed in patients with heparin-induced thrombocytopenia (HIT). These antibodies are thought to be involved in thrombosis through activation of platelet/endothelial cells. This prospective study was conducted to determine the incidence of post-operative HIT antibodies to assess the associated risk of deep vein thrombosis (DVT) in patients undergoing total knee arthroplasty (TKA) or total hip arthroplasty (THA).</p> <p>Methods</p> <p>We studied 104 patients who underwent unilateral primary TKA (n = 44) and primary THA (n = 60) with short-duration prophylaxis (1–2 days of a fixed dose of unfractionated heparin). HIT antibodies were assayed using a sandwich-type ELISA before the operation and after heparin treatment (post-operative day 7).</p> <p>Results</p> <p>In the clinical outcome, the incidence of symptomatic DVT was 15.4% (16/104, TKA; 10, THA 6) and pulmonary embolism (PE) was not observed. The total seroconversion rate of HIT antibodies at post-operative day 7 was 34.6% (36/104). Among 36 seroconverted patients, 11 (30.6%) developed symptomatic DVT and 5 out of 68 of the non-seroconverted patients (7.4%) developed symptomatic DVT. The incidence for DVT was significantly higher in the seroconverted patients compared with that of the non-seroconverted patients (odds ratio 5.5, 95%CI: 1.7–17.6 <it>p </it>= 0.0028). Furthermore, in the patients with symptomatic DVT, the titer of HIT antibodies at post-operative day 7 was significantly higher compared with those without symptomatic DVT.</p> <p>Conclusion</p> <p>Our data therefore suggest that seroconversion for HIT antibodies generated by heparin is associated with a risk of DVT in patients undergoing total joint replacement.</p