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Knee - Science topic

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What types of physiotherapy techniques or therapeutic exercises are the best for a grade I or grade II injury of the medial collateral ligament of the knee?
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In addition it is recommended to address any valgus knee pattern due to hip weakness and habitual patterning. Femoral internal rotation and tibial external rotation should be addressed while individual is recovering.
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It is evident that males are more fatigable during submaximal knee extensions. Has there been any studies that used a repeated knee extension protocol that showed similar fatigability between the sexes? Perhaps, there is a certain contraction speed or relative workload level that elicits comparable fatigability?
I am looking for dynamic knee extensions, but perhaps I can get some insights from isometric ones as well.
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The following studies have compared sex differences in fatigue in the knee extension:
Gabriel DA. Fatigue Patterns for Accommodating Hydraulic Resistance Exercise. The Journal of Strength & Conditioning Research. 1991;5(1):6-10.
Pullinen T, Mero A, Huttunen P, Pakarinen A, Komi PV. Resistance exercise-induced hormonal responses in men, women, and pubescent boys. Medicine and Science in Sports and Exercise. 2002;34(5):806-13.
Latella C, Hendy A, Vanderwesthuizen D, Teo W-P. The modulation of corticospinal excitability and inhibition following acute resistance exercise in males and females. European Journal of Sport Science. 2018;18(7):984-93.
Metcalf E, Hagstrom AD, Marshall PW. Trained females exhibit less fatigability than trained males after a heavy knee extensor resistance exercise session. European Journal of Applied Physiology. 2019;119(1):181-90.
Lewis MH, Siedler MR, Lamadrid P, Ford S, Smith T, SanFilippo G, et al. Sex Differences May Exist for Performance Fatigue but Not Recovery After Single-Joint Upper-Body and Lower-Body Resistance Exercise. Journal of Strength and Conditioning Research. 2022;36(6):1498-505.
Most of these observe minimal sex differences, but it depends on how it is measured.
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He presented with severe Varus and Posterior instability of left knee following previous ORIF 10 years ago.
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it depends on the ligament status that shows it in the MRI. first MRI should be done according to the examination and MRI finding the soft tissues and boney procedure will be done.
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Linguistic or conceptual body-part metaphors relate not only to Heads, Shoulders, Knees, and Toes, Knees, but also to Eyes, Ears, Mouth and Nose and other human body parts. Here are a few English metaphors related to “head”: head of lettuce, head of a company, head over heels in love, head Start, headers & footers, and headlights. Check out the attached PowerPoint about Body Part Metaphors, and then discuss body-part metaphors in English and other languages.
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Peter: Excellent response. I especially like your German, Spanish, and Chinese examples.
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I am trying to simulate the knee joint and I have a concentrated force applied on the femoral part of the model, the model also has a kinematic constraint that allows for the femur to flex and extend ie displacement boundary condition and the tibia part is fixed. the aim is to include the anterior-posterior motion of the tibia as well
The load is time based as well as the displacements. when I run the simulation, with the required load the stress generated is the same as when 4x the initial load is applied. How can I fix this?
Please find attached the cae file for this model
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As mentioned by Nils Wagner, you'd better share .inp file, because your .cae file can only be used in ABAQUS/CAE 2021.
Btw, are the stresses any meaningful? Applying concentrated force sometimes results in local stress rise around the loading node, while the other nodes does not affect by.
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For VAS score, WOMAC overall and individual component scores, KOOS and individual component scores, Lysholm score, and MOCART score
Give your inputs with references
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At leat 50% improvement in pain or function
MCID for the WOMAC was 4.2 points for the pain subscale, 1.9 points for the stiffness subscale, 10.1 points for the function subscale, and 16.1 points for the total
adjusted MCIDs for improvement ranged from 2.89 to 16.24 score points
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In view of standardizing the preparation and therapeutic protocols utilized in BM-MSC therapy for OA Knee, I am looking forward to the variables to be considered.
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Some process variables are discussed in this study
Is the list sufficiently exhaustive to standardize the treatment?
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Share your experience of dealing any of such cases of the hip
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pm sent Raju Vaishya
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We can use type 3 polyethylene instead of type 1 in the treatment of knee replacement؟
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The high cross linked polyéthylène is commonly used in total knee prosthesis.
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In my last research, I investigate whether patients with musculoskeletal disorders had increased susceptibility to SARS-CoV2 infection or developed more severe forms of COVID-19; as well as whether COVID-19 affected the underlying disease.
Results showed that the frequency of COVID-19 was low and statistically nonsignificant, but that led to a worsening of the underlying disease.
What are your clinical impressions, ie do you have similar research results?
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COVID-19 and Its impact on the musculoskeletal system
Not only the people with musculoskeletal disorders are more susceptible to the COVID-19 pandemic (1), but musculoskeletal symptoms are one of the manifestations of COVID-19 illness (2). Furthermore, these disorders are also more common in people as long-term effects of COVID-19 (or long-COVID) (3-4).
Please have a look at these articles for evidence:
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Hello,
I am working on machine learning algorithms using EMG and IMU (Inputs) to map joint angles (outputs). I have used RMSE to evaluate model performance because RMSE penalizes outliers more heavily compared to MAE.
However, I am also curious if there are metrics to determine the performance of the predicted slopes (flexion vs. extension). For example, if a user is performing knee flexion, then the predicted slope should follow the same direction as knee flexion. Conversely, if the predicted slope was in the opposite direction of knee flexion by incorrectly predicting knee extension, how would we 'penalize' this prediction? In this case, should I use a binary classifier (flexion/extension) and plot a Receiver Operator Characteristic (ROC) Curve?
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Radiologically more severe knee osteoarthritis of the same patient is showing nearly noraml range of motion than with the less severe one
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Thank you very much
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Hello,
I am conducting a research and for that I am looking for an answer of how many mitochondria per cell and how many cell per tissue in a different type of human body parts (e.g. Knee, Shoulder, Head etc). I would really appreciate If anybody can refer me the right experimental or computational research article.
Thank you in advance.
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Please suggest..
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X-rays are enough for identification of arthritis. MRI would help to identify early arthritis and more importantly soft tissue problems.
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Hello everyone
Please help me to find the normal values for knee extension in kg, I want to analyze the values of my study sample. For that purpose, I want the normal values as a reference
Thanks in advance
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I have developed ideas and concepts by which we can change the paradigm of OA to Cartilage attrition arthropathy, to facilitate a change in thinking, so that arthritis in the knee can be regarded as a condition that can and should be halted rather than being an inexorably progressive condition awaiting knee replacement.
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it looks you are a medical doctor and you have made observations in the patients? is this correct
May be you should write your research paper and ask someone to read and get suggestions. Initially send that paper to your local conference for presentation so that your idea gets scruitinized that you are in the right direction and than publish a paper if you get good feedback. Good luck.
I can read the paper if you send it to me. I will not have anything to collaborate. But I can just help you only.
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Hello, I am a student, and I am trying to perform a fatigue analysis on Ansys. This is for a knee replacement joint. Usually joint spacers are made of UHMWPE. This is my first time doing this analysis. Every time I try to run the simulation, there is an error that asks me to define the S-N curve. However, no matter how hard I research, I am not able to find a curve that compares the alternating stress vs the cycles. I don't have a background with materials so I am not really sure where I could find this curve.
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I suggest that you set up the FEM analysis only to compute stress and strain values (e.g. steady-stste structural analysis), then extract the calculated values to estimate fatigue life outside the program based on SN curve data, if available. The finite element method should not be intended to be used for fatigue calculations directly, this is only a tool offered by modern software for inexperienced users
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Is there any way to classify Knee OA into mild, moderate, and severe on the basis of just clinical examination? I have no record of radiological investigation of patients. Actually, patients were referred from the ortho department. I have the WOMAC score of all patients. How to classify the patients into the mild, moderate, and severe categories depending on WOMAC score? are there any cut-off values for the WOMAC score for each category?
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In knee and shoulder surgery minimal invasive procerures have alreday proven their advantages for patients. Mainly the quick recovery. What about minimal invasive lumbar spine fixation? I hear for many surgeons that the treated patients suffer more pain than the ones treated in open way....
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Recent literature has demonstrated positive outcomes for patients undergoing MIS-TLIF, including minimized operative times, reduced postoperative analgesic use, decreased lengths of stay, and less overall soft tissue damage.
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Hello All
I want to evaluate the usability of new AFO for patients with knee osteoarthritis. There are several questionnaire for "usability evaluation of orthoses" but unfortunately there is no exclusively one for AFO as well as in Persian version.
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Thanks for your response
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How can I classify knee osteoarthritis into mild, moderate, and severe on the basis of WOMAC score?
Please guide me
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This article looks at Kellgren and Lawrence scores of 3 and 4 and also uses the WOMAC scale with a cut off score of 30 and above to be referred for arthroplasty. Maybe this article will help you?
Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index as an Assessment Tool to Indicate Total Knee Arthroplasty in Patients with Primary Knee Osteoarthritis IMJM Volume 19 No.3, Oct 2020
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What makes periprosthetic ankle infections different than the knee or are they? Size of joint? Vascularity in the ankle joint? Talus perfusion being much less than the femur or tibia? Really looking forward to your opinions and experiences.
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1. The limited volume of total ankle arthroplasty in comparison to knee and hip arthroplasty.
2.Currently, there is a lack of well-defined, uniform definition of prosthetic joint infection in total ankle arthroplasty, literature describing the diagnosis and treatment of prosthetic joint infection in total ankle arthroplasty is entirely reliant on the literature surrounding knee and hip arthroplasty. Large multicenter clinical trials are required.
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The problem is this: there is model of robot, created in Simscape. And knee of this robot is made of "pin-slot-joint", which allows one transnational and one rotational degree of freedom. In transnational motion, it is imposed the stiffness and damping factor, which gives influence also to rotational torque. My aim is to write optimization or control algorithm in such a way that this algorithm should provide such stiffness(in linear direction), which will reduce the rotational torque. By the way, rotational reference motion of knee is provided in advance(as input), and appropriate torque is computed inside of the joint by inverse dynamics. But to create such algorithm, I have no deep information about block dynamics, because block is provided by simscape, and the source code and other information is hidden. By having signals of input stiffness, input motion, and output torque, I need to optimize the torque.  I will be truly grateful if you suggest me something. (I tried to obtain equation, by using my knowledge in mechanics, but there are lots of details are needed such as the mass of the joint actuator, it's radius, the length of the spring and etc. AND I HAVE NO THIS INFORMATION.) If you suggest me something, I will be truly grateful.
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very interesting
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I am currently planning to construct a meta-analysis on a supplement for knee osteoarthritis. The primary outcomes include parameters from the WOMAC scale.
However, from the trials that I gathered, some use Likert scale 0-4 for each question, some used visual analog scale (VAS).
How do I transform it to the same format/presentation so that meta analysis is possible?
Is there any formula?
Please help me.
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Hi Nor, I also have the same question as you. I have data from the 100 mm VAS version of WOMAC (pain and function) that I like to transfer to five-point Likert scale. Did you find out? Thank you. Regards, Magnus Ringberg
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Clinically it has been observed that some patients present with severe knee pain on one side and mild or no pain in other knee, on xrays Grade IV is not that painful as Grade III. So what are the possible reasons?
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Inappropriate postural/kinesthetic awareness leading to overloading plus poor conditioning of muscles on painful side.
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I am designing a knee simulation focusing on the meniscus. I want to add different material layers to the meniscus. I have tried to add composite layup to the menisci in a uniform way but the shape is complex and I don't know how to do this.
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Be sure you’re working with material(s) that are compatible with our body.
Also, be sure that what ever shape you have can be placed in the body as is and not trimmed to fit each person. Surgeons don’t like the tiny pieces left from trimming.
I’d suggest a textile composite. A mesh like layer. Either a knitted, braided or non-woven structure for the matrix. And, as a guess, an elastomeric polymer . Both easily will conform to the shape. Both tend to easily yield to stretching and return to original shape. A benefit when adding it to your shape.
So the edges remain smooth you’ll need to insure the polymer completely encapsulates the textile material and the shape you show here. Assume a mold will need to be made.
However, all the fitting of a composite to your existing shape adds to less consistent product. I’d suggest adding the textile/fibrous material when your initial shape is being made. If that’s possible you’ll increase the consistency of the product. Also, in this example, I’d prefer a non-woven material. Also a mesh but fully integrated with the shape vs an add on layer.
L.A.C.
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Knee osteoarthritis need good handling of pain complian as a disability and limiting activity we suppose that those patient need a rehabiltation plane especially before knee replacement or arthroplasty
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PRP indications more as a minimally-invasive treatment to avoid or delay ultimate knee arthroplasty. RFA indications more as adjunctive modality of pain control pre-op (or post-op) for arthroplasty. Occasionally pain control might be significant enough to postpone surgery.
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Primary osteoarthritis - is
degenerative joint disease without any apparent underlying cause then what are the reasons of asymmetrical bilateral Knee OA?
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In coaching, it’s also called overuse injury; Soccer players, for example, may involve many repetitous activities favoring a tendency to play mostly with one foot deemed stronger or more precise. The opposite foot is then not developed with the same stressors applied symmetrically to the system: Excessive and differing knee strain is thus applied to both planting foot knee and kicking foot knee, with subsequent degenerative changes over time as Mohanty points out.
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All knee replacements, partial or total, will have parts made of a few different materials (likely metals and plastic). In most cases, each component is built from titanium, cobalt-chromium alloys, or a titanium and cobalt mixed metal.
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Dear Raman Kumar you can easily find very good information right here on RG. For example, please see this article entitled "Materials used for hip and knee implants". The article is freely available as public full text:
There is another potentially useful article available on RG which is entitled "Innovations in total knee replacement: New trends in operative treatment and changes in peri-operative management". This paper is Open Access and can be downloaded for free (see attached).
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I have used Vicon Nexus 2 for a walking trials with the lower body plug in gait model. However, the ASCII data exported has a column title Rknee angles and contains angles in X Y Z columns. Is there a way to directly output flexion/adduction/rotation angles instead ? Or am i missing something in the understanding of these XYZ outputs ?
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Dear Dr. Washeem,
Nexus (Plugin Gait - Helen Hayes model) calculates the Euler angles for the 3 joint rotations (Hip and Knee), but it is only possible to view the graphs in this software. Vicon uses Polygon software to generate reports (graphs, images, videos and texts) :
Another option for printing graphs and extracting information is the software Report Generator (Motion Lab Systems Inc) - you can try to evaluate a demo version of the software :
Best Regards,
Wagner de Godoy
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Hello all, I am working on Gait related data which has sequences of joint trajectories in x, y, z axis. I want to know how to calculate joint angle lets say Knee Angle if I have 3 coordinates of hip, knee and ankle?
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Dear Rahul, in accordance with Maxime, could you precise your question please?
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I've been trying to isolate total RNA from guinea pig's knee cartilage. I've tried Qiagen RNeasy kit, miRNeasy kit, trizol method with lots of modifications and have also used the RNaqueous total RNA isolation kit from Thermo Scientific but I've not been able to achieve RNA ratio of more than 1.4 for cartilage and 1.6 for synovium. In addition to the integrity the RNA conc. is also very low because the amount of cartilage available from the knee of guinea pig is very less (<15mg).
I homogenise the samples using Bead beater (bead mill).
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Hi Dikshit..because your starting material is less so, in Trizol method u can do overnight precipitation of RNA in isopropanol at -80°C as it will improve quantity as well as quality.
Hope it will work.
Thank u.
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If an MRI knee scan identifies a meniscal tear; what factors are taken into consideration to send for arthroscopy? If the scan has been generated from a GP referral: is there vetting to decide urgent or routine orthopaedic appointment from the results and onward freferral? Does it matter what type of tear? Do certain tears warrant more immediate intervention? If the scan also shows OA / degeneration, how much does that affect the decision to go ahead with a scope?
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Clinical evaluation of the knee joint remains the gold standard in deciding about the management in such scenario. Locked meniscus or bucket handle tears generally needs urgent treatment. As far as degenerative tears are concerned clinical examination commensurating with MRI findings can guide us about mode of treatment
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Hello,
I would like to calculate knee moments (for drop jump and one-leg jump for distance) using Vicon. How should I build the Dynamic Plug in Gait Pipeline? Force Plate Data are availabe + 15 markers.
Thank you in advance.
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Dear Wagner de Godoy,
The processing was successfull.
We took a static trial, labelled and used the static plug-in gait (run static gait model + static subject calibration) and then did the dynamic trial. After labelling and processing (core processing + gait cycle events + butterworth filter-model outputs) we received the model outputs we were looking for.
Thank you very much for your support.
Kind regards,
Lara Wolff
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would like to know about treatment protocols related to knee OA.
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Dear All
Actually I would like to know about actual practices in your OA clinics?
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I am starting to work on knee joint pain and see articles using paw withdrawal test to evaluate hyperalgesia occuring in the knee? Just curious why stimulating the hind paws instead of the knee to assess pain sensitivity. Much appreciate your inputs. Thank you very much.
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Pain can be induced by abnormal excitability of the pain pathways of the nervous system (peripheral and central). For this reason, the assessment of paw removal is performed in animal models of knee pain.
DOI: 10.1111/1756-185X.13450
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I’m implementing a relatively highly cited academic research paper: “Interobserver
Reproducibility of Quantitative Cartilage Measurements: Comparison of B-Spline
Snakes and Manual Segmentation”. In short, the paper outlines how you can get a
B-spline to outline knee cartilage in a 2D slice of an MRI. I am stuck at minimizing the
cost function using gradient descent. I do not know how to gracefully apply a partial derivative to a line integral where the line is a B-spline contour in a 2D image. A full explanation of the problem and my current solution is attached, however I make a poor assumption to get to that solution. If anyone could double check my math or has any ideas I would greatly appreciate it.
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question is more related to asking for collaborators to join me in this project. I experienced terrible knee pain due to emotional stress of losing a parent. Once I handled my emotional pain , the knee pain disappeared too. Am sure there are many out there with similar experiences, lets get together and work on it.
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Following
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How did a health crisis translate to an economic crisis? Why did the spread of the coronavirus bring the global economy to its knees?
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Health crisis is direct not unconnected to economic recession. Simply all measure efforts and funds will be directed to curb the crisis while other issues given less attention. Amid the crisis the productive members of the society could also be involved directly or indirectly leading to mass unproductivity and hence economy become hit hard, taking an open example of the current unprecedented crisis of COVID-19, then relate how the globe economy is hit. Thanks
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I'm working on a project which should identify problems in the human gait.
After a research I've made I decided to use an IMU sensor comprises from an accelerometer and gyroscope. I've attached it to my foot and to my knee and I'm getting x,y,z values of the accelerometer & gyro.
My question is - what next?
I red in some articles that I should combine the x,y,z of the 2 sensors or use Kalman filter, but actually I need some guidance about how to proceed from here.
my hardware is - Arduino Nano 33 IOT (with built in IMU)
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What is the problem you want to solve in human gait with accelerometer/ IMU?
Gait event detection? or maybe gait pattern classification?
After you decide what problem in gait you want to solve, then you can go for specific data processing and analysis.
There is a lot of paper discuss about detect gait event using IMU or classify gait pattern with IMU.
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I have to write a systematic review and I need maximum studies regarding knee osteoarthritis patients please suggest me all relevant databases.
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I think that for a complete examination of the pathology you could also refer to intra-articular therapies with radioisotopes. I enclose an old work of mine, which unfortunately is in Italian, but you can take a cue for a bibliographic research in this sense. The 198Au is no longer used, replaced by the Y90 which has better physical characteristics.
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Hi all,
I have been collecting cross-sections of a mouse knee joint, and I keep seeing some differently coloured, yellowish tissue on the anterior side of the joint, but I'm not too sure what this is?
Please refer to the attached optical scan of one of my sections and let me know if you have any insight.
Thanks in advance,
Jordan
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I think it is most likely a large blood vessel cut longitudinally which is still filled with erythrocytes. See uploaded image.
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is there literature about power lifting and weight lifting and the hamstring curl or knee flexor capabilities?
Most they do squat, deadlift, goodmorning, straight leg deadlift, but it seems the leg curl of knee flexors are less trained. For instance biceps femoris has an aponeurosis and the knee flexor could be underdeveloped.
In practice I see people squating 100+ but leg curl with very low KG.
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Dear Peter Griepink,
Trying to reply your question,
- Escamilla, R. F., Lowry, T. M., Osbahr, D. C., & Speer, K. P. (2001). Biomechanical analysis of the deadlift during the 1999 Special Olympics World Games. Medicine & Science in Sports & Exercise, 33(8), 1345-1353.
- Escamilla, R. F., Francisco, A. C., FLEISIG, G. S., Barrentine, S. W., WELCH, C. M., Kayes, A. V., ... & ANDREWS, J. R. (2000). A three-dimensional biomechanical analysis of sumo and conventional style deadlifts. Medicine & Science in Sports & Exercise, 32(7), 1265-1275.
- Cutrufello, P. T., Gadomski, S. J., & Ratamess, N. A. (2017). An evaluation of agonist: Antagonist strength ratios and posture among powerlifters. The Journal of Strength & Conditioning Research, 31(2), 298-304.
There are some papiers which analyse kinematically, the deadlifts.
And also more related with your question: Cutrufello, P.T. and Gadomski , S.J., (2017) examinated the agonist:antagonist strength ratios, and the ROMs to identify maximal isometric force using handheld dynamometry: shoulder flexion:extension, shoulder horizontal adduction:abduction, shoulder external rotation:internal rotation, hip flexion:extension, hip abduction:adduction, knee flexion:extension, and cervical flexion:extension.
All of this was done to identify any imbalances amon the powerlifters. I think it could be the answer, or the key point to search your own reponse.
I hope have been useful.
Cheers up for your work.
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For intra-articular injection of MIA, I have seen most people to inject 25 or 50 ul. Wondering for drug injection into the knee/synovial space, can I use a greater volume like a 100 ul? Or will it just cause leakage?
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Hi Mehnaz :-)
Mouse or rat ? I've been setting up the MIA-model recently, in mice, and have been using 10ul.. BUT be very careful, because apparently, if you use just a tiny bit more, the animals are not doing well, - I assume due to the volumen being to big, and therefore leakage of the very toxic compound.. The correct dose/concentration seems crucial, at least for mice !! Let me know if you have further questions, - I assume that you're using rats as usual, so my advise may not apply completely ;-)
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Hey, all there,
I have to write a systematic review and I need maximum studies regarding knee osteoarthritis patients please suggest me all relevant databases
Thanks
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Dear Sabir,
There are several databases that can be used in your systematic review. Most commonly used are Medline (via PubMed or Ovid), Scopus, PEDro, EMBASE, Cochrane Central Register for Controlled Trials (CENTRAL), and CINAHL.
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I am studying force transmission through the synovial layer of the knee and would like to dissolve the fat pad so that I can see the fibrous array. Does anyone know of a solution that allows one to do this?
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Hi Tom,
I know this was a long time ago, but I'm wondering if you ever found an answer to your question? I am trying to harvest the synovial membrane surrounding the knee from bovine and porcine stifle joints, but have a hard time surgically separating the fat pad from the membrane and have been wondering about a solution to dissolve as well.
Thanks for any advice you can provide!
Warmly,
Jenn
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Hello, everyone!!! I hope you all are doing well. I have a research project in which I have to evaluate certain variables among Knee Osteoarthritis patients. I am facing some limitations at my study location(Physiotherapy Clinic) as some of the patients (who have been diagnosed with knee OA) referred by a physician or orthopedic consultant come without any radiographic investigation. Due to the lack of patients, I have to allocate such patients in my study as well. Please suggest to me how I categorize such patients as with mild, moderate or severe OA conditions based on their symptoms and physical examination.
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You can read these articles, they expose the topic clearly and with useful information: 1. Dell’Isola A. PLoS One. 2018; 13(1): e0191045.
2. Grace H et al. Arthritis Rheumatol. 2015 Nov; 67(11): 2897–2904. doi: 10.1002/art.39271
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Physiotherapy and exercise show short-term improvements in physical function. I would like to know particularly cycling exercise for treatment.
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Cycling after a total knee replacement can improve range of motion. This exercise is often included in physical therapy after TKR, as early as the first week after surgery.
Early on, the seat can be raised to limit the amount of bending required. You might only be able to do partial revolutions at first, and this is normal. As motion improves, the seat can gradually be lowered.
Cycling for range of motion is performed slowly, pausing at the top to stretch into bending, and at the bottom of the revolution to stretch into extension — a straight-knee position. During the range of motion phase, there is no added resistance on the bike.
Avid exercisers may be accustomed to moderate to high-intensity workouts. However, for patients who have recently undergone a total knee replacement, it is important not to over-exert initially.
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  • Hello, everyone!!! I hope you all are doing well. I have a research project in which I have to evaluate certain variables among Knee Osteoarthritis patients. I am facing some limitations at my study location(Physiotherapy Clinic) as some of the patients (who have been diagnosed with knee OA) referred by a physician or orthopedic consultant come without any radiographic investigation. Due to the lack of patients, I have to allocate such patients in my study as well. Please suggest to me how I categorize such patients as with mild, moderate or severe OA conditions based on their symptoms and physical examination.
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Womac scores 1-4 as mild, moderate, severe and extreme so can use these figures
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What are the causes of knee pain; what are some remedies?
Context: I recently visited Pakistan and met many of my relatives in their 50s from a certain industrial region who had knee problems. My guess is that an underlying cause is bad water quality from chemical seepage into the drinking water. What are your thoughts?
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@ Dr. Gulzar Shah Sir,
Drinking of fluoride contaminated water causes knee pain.
Thanks!
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We have been culturing MSCs from knee bone chips in which the MSCs migrate out into the culture flask. These have been taken from someone else in our group and resurrected from frozen (P3-4). However, when we have cultured these cells from frozen we seem to be getting a cellular contamination that is rapidly proliferating (can generate 12 million cells in 5 days, T175) that takes over the flask that wasn't seen in culture with the other group. Can anyone help with identification of what these cells might be and suggest any flow markers that could show up?
Note: magnification on image is x20 and cells have been seeded at very low confluency to show morphology.
Thanks for your help.
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Morphology is a very inaccurate way of figuring out what these cells are. You should perform STR profiling. If it's not available at your own institution, it is widely available at ATCC and at a number of companies.
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I want an initial direction, like how can I use IMU sensors on knees (e.g upper leg and lower leg ) to estimate body state e.g running, walking, climbing, etc. The basic idea I have is to use 2 IMU sensors on knee position (upper and lower leg) , and to get data or make a data set of it. Then process it using deep learning e.g CNN or ANN etc. But point is..are there data sets available on which I can test CNN etc to see either it works or not. Need guidance about data sets, from where could I get IMU knee based data sets, so that I can focus on my algorithm only.
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It seems you are trying to solve a classic problem of human activity recognition based on body-worn sensors. A very good starting point for different datasets, mainly based on acceleration only, is this paper:
I wouldnt recommend using a naked CNN for testing. A classic machine learning approach with a proper preprocessing, some good extracted features (e.g. simpe statistical features, PCA or Codebook) and a classification that supports the understanding of the problem (e.g. kNN or SVM). Good luck and have fun trying :).
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I am trying to stain bone tissues from human knees however I am having a hard time with antigen retrieval. I use citrate buffer and a water bath set at 85 ° for 20 minutes and I leave the tissue in the solution until it reaches room temperature. I still have some tissue left but they become so fragile that they come off after a few washes during blocking step.
I do use positive charged slides too.
Can anyone suggest a good method for unmasking antigens when using bone and/or cartilage?
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Try 80 degrees for 20 min using autoclave and let them cool down slowly. It worked for my samples.
Best Regards
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Hello,
I am looking for a kinematic gait data set with knee osteoarthritis subjects. I'm having a tough time finding anything other than normal subject data.
I would specifically need a kinematic data set with minimally knee ad/abduction, flexion and extension.
Do you know of any possible sources?
Thank you.
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I don't think anyone is going to share their dataset, especially with such niche criteria. They would rather analyse and publish themselves.
My suggestion would be that you should be making the effort of collecting the data yourself with your clinical team in Orthopaedics.
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Hi all, thanks for your help in advance.
I have several health measures relating to pain that are included in a study I am working on. In case it's important, they are the following:
· Numerical rating scale for back pain
· Inflammatory back pain questionnaire
· Oswestry Disability Index
· Non arthritic hip score (NAHS)
· Knee osteoarthritis outcome score (KOOS)
· Disability arm shoulder hand (DASH) questionnaire
As you can see, they mostly refer to pain that resides in specific areas of the body. I am only interested in if they experience pain in any of these areas, so would like to merge them all into a 'pain' variable, likely binary (0=no pain 1=pain).
Are there are recommendations or procedures for doing this? The process could range from the very simple (1=report of moderate pain in any questionnaire) to the more complex (a confirmatory factor analysis of all the questions in each of these questionnaires using a 2 (no pain or pain)/3 (no pain, some pain, extreme pain) model framework).
This will end up in a structural equation model exploring how variable1 affects variable 2. Pain is associated with both variable 1 and 2. There will be a large sample size (>1000) but also potentially a lot of variables, hence the attempt to reduce these pain questionaires down into a single variable.
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Trying to merge scores without being validated will make the credibility of your work questionable and the possibility to get your work publish unlikely.
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Posterolateral knee pain can be associated with the presence of a fabella and this incidence may be referred to as a fabella syndrome. The fabella syndrome is a rare cause of posterolateral knee pain and usually not diagnosed.
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Yes it can.
PT can help in reducing knee pain due to various periarticular structures.
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I have followed the advice on this site, Penn State research papers and numerous www.ncbi.nim.nih.gov articles. A man was diagnosed with osteoarthritis of the knee due to a severe motocross accident. I've attached his x-rays from before and after the plates were finally removed from his leg which was one year after his crash. I need advice. Does the second set of x-rays reveal a total healing, or are we just seeing the effects of numerous chondroprotective supplements which were given to him in the hopes of opening the space in his knee? I ask because it seems to soon to experience this level of healing. I've also attached the patient's supplement list with dosages and dates. Please understand that the supplement list was created for my benefit and not necessarily to be read by others. By this, I mean I was only attempting to keep my research straight.
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On A/P radiograph measurements between the medial femoral condyle and the midpoint from medial tibial spine to medial border of the medial tibial condyle can provide Joint space measurements. Using the Baumgaertner score can help to determine clinical results with radiographs. (Bae et al J Korean Orthop Assoc 2008). However, if one is looking to determine cartilage healing, MRI, biopsy (histological assessment), arthroscopy, immunohistochemical staing and Western blotting test for type II collagen after microfracture can be used.
(Bae et al, J Arthroscop & Rel Surg 2006; Systematic Analysis microfracture technique, Mithoefer et al Amer J Sport Med, 2009). I hope this helps.
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I'm working with my senior design group to create a customizable brace for PCL injuries. We are able to find general specs for fitting. We are looking for screw hole sizes to give us a starting point to help us join the pieces together.
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We know that tibial components are the most vulnerable to loosening. We know that infection always needs to be excluded. We know that the problem is multifactorial and involves surgical, implant and patient factors. However, what should we do to minimise the risk of aseptic, tibial component loosening ?
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Interesting aspect to consider, Dr Gorelick. The fractal theory aspects of the bone/ implant interface would add another level of understanding to the surgical factors, patient comorbidities, bone quality and implant characteristics. Thank you.
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We use the ConceptBase system for analysing larger networks, e.g. enterprise models. Many queries rely on the transitive closure of some relations. If the graph has many loops (i.e. bi.directional transitive relations), then the DATALOG engine of ConceptBase gets to its knees.
Are there algorithms or heuristics known that deal specifically with this case? The DATALOG engine of ConceptBase does use tabling, i.e. it computes one fact only once. Still, graphs with many links pose a challenge.
Any hint is welcome!
Manfred
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Since ConceptBase has its own Datalog-neg engine (based on tabling), the background of my question is to improve the performance for large graphs. My (naive) idea is that connected components of a graph could be precomputed and then be collapsed to a single virtual node when computing the transitive closure: each outside connection of the virtual node applies to all members when using the transitive closure of a relation. The problem is that the computation of the connected component itself is costly.
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In TKR, a large amount of research focusses on improving the long term survivability of the prosthesis, which largely depends on component placement.
The rotation of the femoral and tibial component , amongst other aspects, can be variably decided amongst different surgeons depending upon the surgical/ anatomical landmarks chosen or the soft tissue tension/balancing.
I would like to know the preferred method followed by different surgeons and discuss the merits/ demerits of each.
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My preferred method is setting the femoral component external rotation 3 degrees with posterior condylar line. Then, you check if it is consistent with AP axis and epicondylar axis.
Not suitable in cases of hypoplastic lateral femoral condyle which is not frequently seen
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Septic knee is usually drained via lateral approach and lateral retinacular fibres are not repaired following the procedure. Will it be a concern when planning for medial parapetellr approach on the same knee for any procedures later?
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Dear Kalaventhan, my main concern is avoiding problems at the medial retinaculum that compromises the tracking and the blood supply. So that are the reasons that I prefer the lateral approach of the knee for draining septic arthritis.
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I would like to assess the pressure pain threshold in hip osteoarthritis and i cannot find reported sites of measurement as in knee osteoarthritis.
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Here is agood reference that may help; Quantitative sensory testing in painful osteoarthritis: a systematic review and meta-analysis
panelA.K.Suokas,D.A.Walsh,D.F.McWilliams†L.Condon B., Moreton V., Wylde‡L.Arendt-Nielsen§, W.Zhang Osteoarthritis and Cartilage
Volume 20, Issue 10, October 2012, Pages 1075-1085
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Looking for any papers that look at the use of ellipticals and knee stresses/kinetics alone and/or relative to walking/jogging.
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Research Quarterly for Exercise and Sport 2012. 83, No. 2
Peak Muscle Activation, Joint Kinematics, and Kinetics During Elliptical and Stepping Movement Pattern on a Precor Adaptive Motion Trainer
Matthew J. Rogatzki et al. is a more recent article. I hope this helps
-Paul
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Osteoarthritis is the second most common rheumatologic problem and it is the most frequent joint disease with a prevalence of 22% to 39% in India. OA is more common in women than men, but the prevalence increases dramatically with age.
As we all Know that Medicine get better, Technology get better, Diagnosis tool get better, Physiotherapy Prevention and management get better still the prevalence increases year by year..........
Thats mean all this get fail for reducing the prevalence of Knee OA among world.
What are the reasons for this?
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According to your risk factors for knee OA proven by existing peer reviewed research in your paper, I should be explaining to my patients that they should:
· Stop aging
· Stop being female
· Stop being obese
· Stop performing work that involves kneeling, squatting or lifting
· Stop performing high intensity exercises such as running over long periods
· Avoid mineralizing their bones too much
How much money, time and debate did it take to arrive at these conclusions?
I suggest that Sackett’s methodology when used to research knee OA is at the top of the error of your ways.
Your suggestion that “Generally speaking, researchers focus their studies on a very specific risk factor” is the pearl inside the shell of your paper. In future studies, it might be worthwhile for them to examine the impact of the interaction of two or more risk factors. A Stochastic Model of research that utilizes a multimodal treatment plan whose components are symbiotic and safe may produce better, more valid and more applicable clinical outcomes.
Theoretically, any methodology that improves overall foot and postural stability, support, strength, symmetry and balance should reduce the existence, progression and life-altering of knee OA (think foot typing).
The knee joint is akin to the transmission of a car in that it has little functional importance of stabilizing or moving the machine as a whole. It simply translates the motions and moments generated from the hips downward and the foot upwards in order to have a more efficient, more productive, less injured biomachine. While it is important for every car to have a well oiled and functional transmission, it is the ability of a car to resist degeneration, deformity and performance issues by dampening and buffering forces generated by the engine and the ability of the tires and chassis to absorb the impact shock of the road and degenerative forces of gravity, friction, etc.
You conclude that “In the future, it could also be useful to do systematic reviews of the effectiveness of care approaches that combine various treatment modalities”. Biomechanically, I have been doing that successfully for decades in real time. Perhaps with your insightful addition to the literature, more of us will consider your suggestions.
I remain available to assist any or all open minded researchers and clinicians in meeting this challenge.
Good fortune to all our knees.
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With dynamometer tests, we get torque values. However torque = distance x force. Since the biodex (or the labchart if you're reading the data from the data from the computer) does not ask for the lever length (e.g. for knee extensions, we have to adjust the attachment length accordingly to the participant's shin length), and since the motor of the dynamometer measures the force in the point of rotation, how can it calculate the torque without knowing the distance?
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Hi,
Adding to Mr. Warren's reply, it is stated by this document also;
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"How does the system know the lever length of the adapter shaft for calculation of torque?
It doesn't and is not required as torque is a rotational force measured at the axis of rotation. "
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Actually you can have same torque by different forces with different lever lengths, (FxLever arm could be same) . Hence your question is actually relevant for two persons having different limb lengths, i.e. same torque could be produced with lower force with longer limb.
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We observed lower-limbphagia from phalanx to knee in transection models of spinal cord injured rats. How can we manage and prevent it ?
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Hello,
Emad Yeganeh Khorasani We have encountered this issue a lot and we have successfully handled them. We make neck collars for them and make them wear it. The collar prevents them to reach their limb to leak or further damage it. Clean the wound with betadine and apply triple antibiotic. You can also use some local anesthetic like lidocaine and apply to wound. Inject painkiller too like buprenex as per your lab protocols. It has worked very well for us. If you want, I can send you dimension and instruction to make it.
HTH
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Dear Dr. Juneja:
Thank you so much for the pertinent information regarding stem cell development and its use regarding the knees or joints.
The article entitled, “Effective repair of joint cartilage using human pluripotent stem cell-derived tissue,” Retrieved from https://www.researchgate.net/publication/325635572_Effective_repair_of_joint_cartilage_using_human_pluripotent_stem_cell-derived_tissue, was very informative and gave me some hope on having the knee cartilage regenerated. The meaning of osteoarthritis deals with the fact that it is a degeration caused by the lack of important regenerative ability in the knee of an adult (Oliver F. W. Gardner, Subhash C. Juneja, Heather Whetstone, et al. 2018, June). The strategy of using (hPSC’s) human pluripotent stem cells to regenerate articular cartilage is performed (Oliver F. W. Gardner, Subhash C. Juneja, Heather Whetstone, et al. 2018, June). The findings demonstrated that after implantation, the hESC-derived cartilage kept a certain amount of collagen-rich substance (Oliver F. W. Gardner, Subhash C. Juneja, Heather Whetstone, et al. 2018, June). This means that it is a huge advance in the area of cartilage repair that has been clinically tested and applied to patients (Oliver F. W. Gardner, Subhash C. Juneja, Heather Whetstone, et al. 2018, June).
Reference
Oliver F. W. Gardner, Subhash C. Juneja, Heather Whetstone, et al. (2018, June). Effective repair of joint cartilage using human pluripotent stem cell-derived tissue. bioRxiv Preprint. doi:10.1101/340935
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Dear Friend,
I am wondering what is the new types of implant?
Thanks
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Femoral component - Cobalt Chrome or Oxinium
Tibial component - Titanium or Cobalt Chrome
Liner - Highly cross-linked polyethylene
Patella button - Highly cross-linked polyethylene
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I am doing a cross-sectional study, I want to find the sample size. the study is on the prevalence of neuropathic pain in knee osteoarthritis. I will use raosoft.com margin of error 5% and CI 95%
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There are many online sample size calculators, that you can use, such as:
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I have 3 objectives in ILP model.The first has to be maximized and the second, and the third should be minimized.
I would like to compute the knee point of the generated Pareto front.
Didi you have an idea about the formula ?
thanks
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Greetings,
The easiest way is to calculate the hypervolume of each solution and the one with the highest value is usually in the knee. But first, you have to flip the first goal, so that all goals are minimized. Just multiply the result of the first target by -1. Before you calculate the hypervolume, do not forget to normalize all the goals.
As a reference, you can check out "A Knee Point Driven Evolutionary Algorithm for Many-Objective Optimization" and "Finding Knees in Multi-Object Optimization".
Regards,
Miha
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I wanna investigate wear resistance of a part of some implant that need high wear resistance, but I don't khow which part has more need..
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Davood,
The femoral components of the THA and TKA would be most resistant to wear for the following reason. In the THA, ceramic and cobalt chrome femoral heads are known to have much harder surfaces then polyethylene and so are more resistant to wear.
Now, the new XLPE are much more wear resistant than the traditional UHMWPE. This may have an impact on the answer but I think it is reasonable to assume the femoral aspect of both the THA and TKA components are most resistant to wear.
Check out this paper on PubMed looking at XLPE: PMID: 29040124
Hope this helps,
Kind regards,
Gerard A. Sheridan
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IKDC purpose is to detect improvement or deterioration in symptoms, function, and sports activities due to knee impairment. and KOS (ADL) purpose is to determine symptoms and functional limitation in usual daily activities caused by various knee pathologies.
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Dear Hoda,
Maybe the following papers will help you on the subject:
Saraei-Pour S, Salavati M, Akhbari B, Kazem-Nezhad A. Translation and Adaptation of Knee Injury and Osteoarthritis Outcome Score (KOOS) in to Persian and Testing Persian Version Reliability Among Iranians with Osteoarthritis. Archives of Rehabilitation 2007;8(1):42-46. http://rehabilitationj.uswr.ac.ir/article-1-10-en.pdf
Salavati M, Mazaheri M, Negahban H, Sohani SM, Ebrahimian MR, Ebrahimi I, Kazemnejad A, Salavati M. Validation of a Persian-version of Knee injury and Osteoarthritis Outcome Score (KOOS) in Iranians with knee injuries. Osteoarthritis Cartilage 2008;16(10):1178-82. https://www.oarsijournal.com/article/S1063-4584(08)00068-X/pdf
Salavati M, Akhbari B, Mohammadi F, Mazaheri M, Khorrami M. Knee injury and Osteoarthritis Outcome Score (KOOS); reliability and validity in competitive athletes after anterior cruciate ligament reconstruction. Osteoarthritis Cartilage 2011;19(4):406-10. https://www.oarsijournal.com/article/S1063-4584(11)00023-9/pdf
Rahimi A, Nowrouzi A, Sohani SM. The Validity and Reliability of the Persian Version of the International Knee Documentation Committee (IKDC) Questionnaire in Iranian Patients after ACL and Meniscal Surgeries. Archives of Rehabilitation 2013;14(2):116-124. http://rehabilitationj.uswr.ac.ir/article-1-1214-en.pdf
Professor Dr. Mahyar Salavati of Department of Physical Therapy, University of Social Welfare and Rehabilitation (Tehran) is the author of the first three articles and could probably help you: https://www.researchgate.net/profile/Mahyar_Salavati
Best wishes from Germany,
Martin
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we face many patients, females, young and complaining from cartilage softening and only known while doing knee arthroscopy .
the alignment angles was within accepted range.
what to do to eradicate this lesions
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The most optimal method for working with young female patients with anterior knee pain is the development of an individualized rehabilitation program based upon a thorough subjective and objective assessments. SALTYCHEV Saltychev et al. in a review article concluded that there is no single treatment that works for all patients with patella-femoral pain J Rehabil Med 2018. Galloway et al. reported that females prepubescent may have maladaptive hip mechanics during landing and that may contribute to patella-femoral pain AJSM 2018. A systematic review by Lankhorst et al determined that weak knee extension strength is a risk factor for anterior knee pain JOSPT 2012. I have found that a strategy that can utilize dynamic control, manual therapy, strengthening, flexibility if an issue, along with proper shoewear and compliance with good home ex program and utilization of a good physical therapist has been successful.
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I'm looking for a joint ultrasound dataset, it can be knees, shoulders, feet, any kind of joint is ok. I have seen different musculoskeletal ultrasound images; however, nothing more than a few images.
Thanks.
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Dear Mr. Mauro Méndez
a general joint ultrasound dataset can be found in the following site. it consists of 8 different joints:
  • Shoulder
  • Elbow
  • Wrist and carpus
  • Fingers
  • Hip groin and buttock
  • Knee
  • Ankle
  • Foot
I hope it can be useful.
Regards
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