Accuracy of unguided and ultrasound guided Coracohumeral ligament infiltrations – a feasibility cadaveric case series

Coracohumeral ligament (CHL) thickening, contracture, and fibroplasia have been identified in glenohumeral idiopathic adhesive capsulitis (GHIAC). The CHL is the main structure responsible for the range of motion limitations. Favorable outcomes have been reported with CHL surgical release. Intra-articular glenohumeral joint corticosteroid infiltrations are utilized to disrupt the inflammatory process and reduce pain in GHIAC. The aim of this study was to investigate whether the CHL could be accurately targeted with a periligamentous infiltration

Use of embedded strain gages for the in-vitro study of proximal tibial cancellous bone deformation during knee flexion-extension movement: development, reproducibility and preliminary results of feasibility after frontal low femoral osteotomy

<p>Abstract</p> <p>Background</p> <p>This paper reports the development of an in-vitro technique allowing quantification of relative (not absolute) deformations measured at the level of the cancellous bone of the tibial proximal epiphysis (CB_TPE) during knee flexion-extension. This method has been developed to allow a future study of the effects of low femoral osteotomies consequence on the CB_TPE.</p> <p>Methods</p> <p>Six strain gages were encapsulated in an epoxy resin solution to form, after resin polymerisation, six measurement elements (ME). The latter were inserted into the CB_TPEof six unembalmed specimens, just below the tibial plateau. Knee motion data were collected by three-dimensional (3D) electrogoniometry during several cycles of knee flexion-extension. Intra- and inter-observer reproducibility was estimated on one specimen for all MEs. Intra-specimen repeatability was calculated to determine specimen's variability and the error of measurement. A varum and valgum chirurgical procedure was realised on another specimen to observed CB_TPEdeformation after these kind of procedure.</p> <p>Results</p> <p>Average intra-observer variation of the deformation ranged from 8% to 9% (mean coefficient of variation, MCV) respectively for extension and flexion movement. The coefficient of multiple correlations (CMC) ranged from 0.93 to 0.96 for flexion and extension. No phase shift of maximum strain peaks was observed. Inter-observer MCV averaged 23% and 28% for flexion and extension. The CMC were 0.82 and 0.87 respectively for extension and flexion. For the intra-specimen repeatability, the average of mean RMS difference and the mean ICC were calculated only for flexion movement. The mean RMS variability ranged from 7 to 10% and the mean ICC was 0.98 (0.95 - 0.99). A Pearson's correlation coefficient was calculated showing that RMS was independent of signal intensity. For the chirurgical procedure, valgum and varum deviation seems be in agree with the frontal misalignment theory.</p> <p>Conclusions</p> <p>Results show that the methodology is reproducible within a range of 10%. This method has been developed to allow analysis the indirect reflect of deformation variations in CB_TPEbefore and after distal femoral osteotomies. The first results of the valgum and varum deformation show that our methodology allows this kind of measurement and are encourageant for latter studies. It will therefore allow quantification and enhance the understanding of the effects of this kind of surgery on the CB_TPEloading.</p

Glenohumeral joint capsular tissue tension loading correlates moderately with shear wave elastography: a cadaveric investigation

Purpose The purpose of this study was to investigate changes in the mechanical properties of capsular tissue using shear wave elastography (SWE) and a durometer under various tensile loads, and to explore the reliability and correlation of SWE and durometer measurements to evaluate whether SWE technology could be used to assess tissue changes during capsule tensile loading. Methods The inferior glenohumeral joint capsule was harvested from 10 fresh human cadaveric specimens. Tensile loading was applied to the capsular tissue using 1-, 3-, 5-, and 8-kg weights. Blinded investigators measured tissue stiffness and hardness during loading using SWE and a durometer, respectively. Intraobserver reliability was established for SWE and durometer measurements using intraclass correlation coefficients (ICCs). The Pearson product-moment correlation was used to assess the associations between SWE and durometer measurements. Results The ICC3,5 for durometer measurements was 0.90 (95% confidence interval [CI], 0.79 to 0.96; P<0.001) and 0.95 (95% CI, 0.88 to 0.98; P<0.001) for SWE measurements. The Pearson correlation coefficient values for 1-, 3-, and 5-kg weights were 0.56 (P=0.095), 0.36 (P=0.313), and -0.56 (P=0.089), respectively. When the 1- and 3-kg weights were combined, the ICC3,5 was 0.72 (P<0.001), and it was 0.62 (P<0.001) when the 1-, 3-, and 5-kg weights were combined. The 8-kg measurements were severely limited due to SWE measurement saturation of the tissue samples. Conclusion This study suggests that SWE is reliable for measuring capsular tissue stiffness changes in vitro at lower loads (1 and 3 kg) and provides a baseline for the non-invasive evaluation of effects of joint loading and mobilization on capsular tissues in vivo

ARanatomy, an Augmented Reality Application Dedicated to Anatomy and Histology Teaching. an Educational Innovation with High Potential in Different Educational Strategies

peer reviewedAnatomy and histology are cornerstones of preclinical education for health professionals. However, students may not fully perceive the importance of these disciplines and therefore may not develop a sufficient level of competence. To facilitate learning and increase efficiency, 3D environments using augmented reality (AR) recently emerge as educational strategies. They seem to improve knowledge and create an environment conducive to learning. Therefore, we have developed an AR application that integrate anatomy and histology, based on anatomical reality, able to scalable and usable in hybrid teaching. Reference patient DICOM data were transformed into .obj formats using the 3D slicer software and imported into the blender, while zbrush, autodesk maya and substance software were used to optimize the skeleton, urinary cavities, and vascular structures. Bone images obtained by photogrammetry were superimposed on this reconstruction. To this basic structure, relevant anatomical and histological structures with a high degree of scientific fidelity have been integrated. A feasibility study was carried out to assess the technical aspects, the ways to introduce the app to the students and the potential for its implementation in educational strategies. First, a technical test was performed with 500 first-year medical students. From 202 respondents, 31% of them encountered technical difficulties mostly related to functionalities. We are nevertheless optimistic about the tool potential because almost half of the students (47% of respondents) have found it very useful to better visualize the 3D aspects and the relationships between organs. A second feasibility study investigated the tool handling. 41 second-year medical students were randomly assigned to three protocols: one totally autonomous, one autonomous after watching an explanatory video and another supervised by a teacher. The handling was evaluated by questions requiring the use of all the app functionalities. The most successful group is the one that used the explanatory video, followed by the accompanied group and then the working independently group. The survey showed that the students experienced technical difficulties to display the model (20%) and the observation levels (11%), to perform rotations (40%) and zooms (17%). The tool potential was underlined as 91% find the app useful. Aspects relating to anatomy and histology integration (34%), 3D visualization (28%) and topography (17%) are mentioned in the free answers. Several anatomical visualizations in the same tool, displaying areas of interest and superimposing histological images are estimated useful by all of the involved students (100%). Finally, 97% of students have a general positive opinion qualifying the app as promising, useful, fun, integrative, congruent with morphology courses. This view is tempered by difficulties related to technical stability. In conclusion, the difficulties encountered are explained by the fact that the tool is still in the optimization phase. The app potential was undeniably highlighted. The integration of anatomy and histology in the same learning tool is a real opportunity. Indeed, while most students approach anatomy as a compartmentalized memorization task, those who combine it with understanding, integration with other disciplines and visualization at different levels seems to have a better acquisition of knowledge. This aspect will be investigated in the future.4. Quality educatio

Méthodologie de la Thérapie Manuelle. 1

info:eu-repo/semantics/published

l'articulation sous astragalienne, cinématique, méthodes d'évaluations et résultats -- DES en Kinésithérapie Ostéopathique

info:eu-repo/semantics/nonPublishe

Utilisation de la jauge d'extensiométrie à l'étude des contraintes articulaires tibio-fémorales: Mise au point et premiers résultats -- DEA préparatoire au Doctorat en Sciences Biomédicale

info:eu-repo/semantics/nonPublishe

Study of the effects of 3D planar femoral bone deviation on the knee joint biomecanics: experimental contribution

Le but de ce travail était de déterminer l’effet de déviations planaires tridimensionnelles in vitro du fémur sur l’évolution des variables biomécaniques de l’articulation du genou lors d’un mouvement de flexion de celle-ci. La cinématique du compartiment fémoro-tibial, les bras de levier de certains muscles de la cuisse ainsi que l’évolution du régime de contrainte de l’os sous-glénoïdien ont été étudiés. Du point de vue de l’étude du régime de contrainte de l’os sous-glénoïdien, une méthodologie originale utilisant la jauge de contrainte enrobée d’une résine époxyde a été développée. Un électrogoniomètre à 6 DDL ainsi que 6 LVDT ont permis de mesurer respectivement la cinématique fémoro-tibiale et la course tendineuse des principaux muscles de la cuisse.Trois designs expérimentaux ont été entrepris sur un total de 15 spécimens. Ces différents designs ont permis de réaliser des déviations de l’extrémité distale du fémur selon les plans transversal, frontal et sagittal suite à une ostéotomie fémorale localisée 10 cm au dessus de l’interligne articulaire fémoro-tibiale. Les variables biomécaniques ont été enregistrées avant section osseuse et suite à l’application de déviations par step de 6° compris entre des angulations de -18° à 18° selon les différents plans anatomiques. Les données des variables biomécaniques ont été obtenues lors du mouvement de flexion du genou.Même si nous sommes conscients des limitations de nos travaux expérimentaux, les résultats de ceux-ci nous permettent d’apporter une réflexion nouvelle par rapport aux conséquences sur l’articulation du genou d’un désalignement du membre inférieur en intégrant la notion des tissus péri-articulaires (capsulaire, ligamentaire et musculaire) généralement absents des modèles théoriques employés.Doctorat en Sciences biomédicales et pharmaceutiquesinfo:eu-repo/semantics/nonPublishe