Knee stability assessment on anterior cruciate ligament injury: Clinical and biomechanical approaches

Anterior cruciate ligament (ACL) injury is common in knee joint accounting for 40% of sports injury. ACL injury leads to knee instability, therefore, understanding knee stability assessments would be useful for diagnosis of ACL injury, comparison between operation treatments and establishing return-to-sport standard. This article firstly introduces a management model for ACL injury and the contribution of knee stability assessment to the corresponding stages of the model. Secondly, standard clinical examination, intra-operative stability measurement and motion analysis for functional assessment are reviewed. Orthopaedic surgeons and scientists with related background are encouraged to understand knee biomechanics and stability assessment for ACL injury patients

A systematic review of randomised controlled trials assessing effectiveness of prosthetic and orthotic interventions.

BACKGROUND: Assistive products are items which allow older people and people with disabilities to be able to live a healthy, productive and dignified life. It has been estimated that approximately 1.5% of the world's population need a prosthesis or orthosis. OBJECTIVE: The objective of this study was to systematically identify and review the evidence from randomized controlled trials assessing effectiveness and cost-effectiveness of prosthetic and orthotic interventions. METHODS: Literature searches, completed in September 2015, were carried out in fourteen databases between years 1995 and 2015. The search results were independently screened by two reviewers. For the purpose of this manuscript, only randomized controlled trials which examined interventions using orthotic or prosthetic devices were selected for data extraction and synthesis. RESULTS: A total of 342 randomised controlled trials were identified (319 English language and 23 non-English language). Only 4 of these randomised controlled trials examined prosthetic interventions and the rest examined orthotic interventions. These orthotic interventions were categorised based on the medical conditions/injuries of the participants. From these studies, this review focused on the medical condition/injuries with the highest number of randomised controlled trials (osteoarthritis, fracture, stroke, carpal tunnel syndrome, plantar fasciitis, anterior cruciate ligament, diabetic foot, rheumatoid and juvenile idiopathic arthritis, ankle sprain, cerebral palsy, lateral epicondylitis and low back pain). The included articles were assessed for risk of bias using the Cochrane Risk of Bias tool. Details of the clinical population examined, the type of orthotic/prosthetic intervention, the comparator/s and the outcome measures were extracted. Effect sizes and odds ratios were calculated for all outcome measures, where possible. CONCLUSIONS: At present, for prosthetic and orthotic interventions, the scientific literature does not provide sufficient high quality research to allow strong conclusions on their effectiveness and cost-effectiveness

Anterior cruciate ligament injury : factors affecting selection of treatment and intermediate outcome

Aim: The aim of this comprehensive study was to evaluate whether anterior cruciate ligament (ACL) injured patients choosing non-operative treatment differ from those choosing ACL reconstruction regarding age, gender, personality, activity level prior to injury, anterior-posterior knee joint laxity and outcome as evaluated using the Knee Osteoarthritis Outcome Score (KOOS) five weeks following the ACL injury. Furthermore the reasons for choosing reconstruction were studied to determine whether patients who choose reconstructive surgery early do so for the same reasons as patients who choose reconstruction later. The aim was also to identify factors, such as gender, personality and subsequent knee trauma, affecting the outcome six years after the injury as well as to study the effects of a functional knee brace on ACL-deficient patients early in the rehabilitation process. Material and methods: The subjects participating in this comprehensive study were between 18 and 50 years and had sustained a unilateral ACL tear within the past five weeks. At the time of inclusion the subjects completed the Swedish universities Scales of Personality (SSP). The subjects were continuously evaluated with the KOOS, the Cincinnati knee score, the Tegner score, the Visual Analogue Scale (VAS) 0-10, the KT-1 000 arthrometer and the Biodex System 3. Subjects who chose to undergo ACL reconstruction were asked to report the reasons relevant for their decision. At the six years follow-up the subjects completed the KOOS, the Tegner score and a questionnaire to determine ACL reconstruction and subsequent knee trauma. Medical records were reviewed. Results: The subjects who chose non-operative treatment had a lower pre-injury activity level and were older than those who chose to undergo ACL reconstruction. Further, they displayed less irritability and less aggression at the time of entry into the study than the subjects who later chose reconstructive surgery. Neither outcome, as evaluated using the KOOS within five weeks after the ACL injury, sagital knee joint laxity nor gender did correlate with treatment selection. The decision to undergo early reconstruction was in 15/20 (75 %) subjects based on concerns about future knee problems and not on their experience of knee dysfunction. Fourteen of the sixteen (88 %) subjects who chose delayed reconstructive surgery, based their decision on their experience of knee dysfunction. At the six years follow-up the subjects who had sustained additional knee trauma after their ACL injury had a significantly worse outcome according to the KOOS than the other subjects. There were no significant differences in the KOOS between the subjects who had undergone ACL reconstruction and those who were treated non-operatively. Furthermore neither age, gender, pre-injury activity level, personality nor history of meniscus and/or articular cartilage injury seemed to have an effect on the outcome at follow-up. When using the brace the subjects in the brace group reported significantly less knee instability as measured with the VAS than the control group. There was no difference between the groups with respect to pain, discomfort, ability to walk on even ground, stair climbing or ability to perform preinjury physical activities as measured with the VAS. Furthermore, bracing had no effect on any of the variables in the KOOS or the Cincinnati knee score and no effect on quadriceps or hamstring muscle peak torque. However, a vast majority of the subjects in the brace group noted that they experienced improved stability and a positive effect on rehabilitation when using the brace

Introducing Linux and open source

Ericsson is adapting its products and work processes to take advantage of opportunities afforded by open-source software. In particular, the Linux operating system (OS) has become an important component for Ericsson. The authors describe the use of Linux and open-source software in Ericsson products and how they benefit Ericsson’s customers. They also touch on the characteristics of open-source software and present a new Linux-based building block for Ericsson’s Integrated Site applications. Background The communications industry is moving toward systems that are based on modular and common, off-the-shelf hardware and software components. The underpinnings of this transition are open standards and architectures (Box A, Item I). Open architectures and the standardizatio