Mechanical loading to bone cells using simple sine wave or constant wave fluid flow has been widely used for in vitro experiments. Human gait is characterized by a complex loading to bones of lower extremities which results from a series of events consisting of heel strike, foot flat and push-off during the stance phase of the gait cycle. Telemetric force analyses have shown that human femora are subject to multiphasic loading. Therefore, it would be ideal if the physiologic loading conditions during human walking can be used for in vitro mechanotransduction studies. Here, for a mechanotransduction study, we develop it fluid flow system (FFS) in order to simulate human physiologic mechanicalloading on bone cells. The development methods of the FFS including the COR (Center for Orthopedic Research), monitor program are presented. The FFS could generate various multiphasic loading conditions of human gaits with output flow. Wall shear distribution was very uniform, with 81 % of the effective loading area of the culture on a glass slide. Our results demonstrated that the FFS, provide a new translational approach for unveiling molecular mechanotransduction pathways in bone cells.
Friedman, Darren J;Ko, Sang-Hun;Park, Ki-Bong;Jun, Hyung-Min;Kim, Tae-Won;Lim, Hyun-Woo;Yum, Young-Jin
Clinics in Shoulder and Elbow
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v.12
no.2
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pp.207-214
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2009
Purpose: In arthroscopic rotator cuff repairs there are generally weak link in tendon suture interface, arthroscopic rotator cuff repairs can have higher retear rates than open repairs. The purpose of this study was to compare the strength of UU (Ulsan University) suture than open modified MA (Mason-Allen) suture when suture anchored into bone. Materials and Methods: The human supraspinatus tendons were harvested from the shoulder of the cadaver and split in 2 times, producing four tendons per one shoulder, for a total of 24 specimens. Two suture configurations (UU, MA) were randomized and checked on each set of tendons. Specimens were cyclically loaded under force control between 5 and 30 N at 0.25 Hz for fifty cycles. Each specimen was loaded to failure under displacement control at 1 mm/sec. Cyclic elongation, peak to peak displacement, stiffness, ultimate tensile load, mode of failure were checked. Results: No significant difference was found between two suture configuration with respect to peak to peak displacement, cyclic elongation, and stiffness. With regard to ultimate failure load, there were no significant difference statistically between the UU suture and modified MA suture (109.4 N, 110.6 N). The most common mode of failure between both sutures was suture pull-out through the tendon. Conclusion: The UU suture and modified MA suture produced similar biomechanical properties.
The objectives of the present study are 1)to find the effect of the diameter of transpedicular screws on their fixational strength in pedicles under static pull-out loading, 2)to determine the biomechanical correlation between the pedicle diameter and the screw diameter, and 3)to find the effects of other factors in the screw design, such as materials, screw pitch, thread height and shape on their fixational strength. Biomechanical tests (Test I) were performed to evaluate the effect of the screw diameter on pull-out strength by using 60 porcine pedicls and six groups of custom-made pedicle screws with different diameters (the major and the minor diameter of the screws used in the testing varied from 4mm upto 9mm and from 3mm upto 8mm, respectively) while all other factors (materials, screw pitch, thread height and shape etc.) were fixed. In Test II, by using 61 porcine pedicles, the relationship between the ratio of the pedicle diameter and the screw diameter(=aspect ratio) of the custum-made screw and the pull-out strength of the screw was investigated. Test III was performed with 94 porcine pedicles and 8 different types of the commercial screws from 6 major productors in order to determine the effect of the screw diameter, pitch and the thread shape on the pull-out strength of the screw, respectively. The results of Test I showed that the axial pull-out resistance of the screw could be increased prportionaly to the screw diameter(P<0.05). But this increase in the pull-out resistance did not found when the screws of 4mm or 9mm in the diameter were employed. It was found from the results of Test II that the screws had its maximum pull-out resistant force when the aspect ratio ranging 40 - 69% (P<0.05). based on the results for the major diameter against the minor diameter of screw, the maximal pull-out resistance was found at 60-65% (P<0.05). According to these biomechanical testing results, it seems that the screw with a moderately large pitch is more desirable and the buttress-shaped screw can provide stronger fixation than the V-shape one can, if other designal factor and conditions were fixed.
The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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v.11
no.2
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pp.83-95
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2005
The purpose of this study is to analyze, durability of motor effort after finishing rehabilitation program and the influence from the isotonic lumbar region extension exercise after an operation according to the different operation way in invasive degrees. We selected randomly 80 patients who have no complication and musculoskeletal system diseases with finishing the 12 weeks' rehabilitation program after getting laser discectomy, but fail to conservative treatment, about Lumbar HNP, and divided into minimal invasive groups 38 and invasive groups 42 for study. As the results, in minimal invasive group, after finishing cure and 6 months later, the degree of hold muscle of women is much better than that of men. but in Invasive group, that of men is better than that of women, in case of women, the $0^{\circ}$ and $72^{\circ}$ in lumbar flexion angle have weaken or no improvement than before beginning exercise. and muscle force in $72^{\circ}$ in lumbar flexion angle increased to all men and women than before beginning exercise in Minimal invasive group. but in invasive group. it decreased. When analyze the lapsed time in Minimal invasive group, the groups who start the exercise within 3 months are better than the groups who start the exercise above 3 months after an operation the hold muscle degree all angles after finishing cure and 6 months later. Meanwhile, in invasive group, the groups who start the exercise within 3 months are better than the groups who start the exercise above 3 months after an operation about the hold muscle degree in 36-72 of lumbar flexion angle but 0-36 are not good after finishing cure and 6 months later. When analyze BMI in Minimal invasive group, the normal groups are better than the overweight groups about hold muscle degree in all angles after finishing cure and 6 months later.
Park, Soo-Kyoung;Lee, Hyun-Ok;Kim, Jong-Soon;Kim, Suhn-Yeop
The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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v.11
no.2
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pp.71-82
/
2005
The couple force of the scapular stabilizers for upward rotation that include the upper and lower trapezius, serratus anterior muscles is essential to maintain the stability of shoulder joint. But if there is an imbalance of these muscles, it would occur many problems of shoulder joint. A push-up plus exercise with an unstable support is used in order to increase the muscle activity and stimulate the proprioception of shoulder joint. The purpose of this study was to compare the muscle activity of upper and lower trapezius, serratus anterior muscles and to determine which exercise is more effective when subjects perform push-up plus exercise in the stable support and unstable support. 15 healthy subjects and 15 painful subjects with injury of shoulder joint participated in this study. Surface electromyography data were collected during plus phase of push-up plus exercise. The types of push-up plus exercise were composed of three conditions. Stable type is subjects performed the push-up plus exercise on the fixed support and unstable type 1 is on the sling without shaking and unstable type 2 is on the sling with shaking by tester's manual. The upper and lower trapezius activities of injured group were higher than uninjured group at three measure conditions, but serratus anterior activities were not. The UT/SA ratio of injured group was higher than uninjured group at three measure conditions. The serratus anterior activities were most high at unstable 2 measure in both groups. The UT/SA ratio was most low at unstable 2 measure condition in injured group only. The present result revealed that push-up plus exercise in the unstable support with shaking which took most high serratus anterior activities and most low of UT/SA ratio is optimal cure method that can improve the imbalance of the scapular stabilizer.
Purpose: The purpose of this study was to evaluate retrospectively the clinical results of closed reduction and percutaneous screw fixation for unstable injuries on stress radiographs in subtle injuries of Lisfranc joint. Materials and Methods: From June 1997 to March 2003, 6 cases of unstable injuries on stress radiograph in subtle injuries of Lisfranc joint were treated by percutaneous cannulated screw fixation after closed reduction. All cases were injuried by indirect force (twisting injury). The average diastasis between the 1st and 2nd metatarsal base was 3 mm (2-4 mm) on initial nonweight bearing AP radiograph. The average follow-up period was 20 months. Clinical evaluation was assessed according to the American Orthopedic Foot and Ankle Society (AOFAS) midfoot score. Results: The AOFAS midfoot score was average 86 (80-90) points. The average diastasis between 1st and 2nd metatarsal base was 2 mm (1-3 mm) on weight bearing AP radiograph in final follow up. The final diastasis was increased slightly than diastasis in initial postoperative radiographs. But the clinical results were good. There was no correlation between the degree of diastasis and the clinical results. On weight bearing lateral radiograph, the average difference with normal foot in the distance between plantar aspect of 5th metatarsus and medial cuneiform was 2 mm (0-3 mm). One case had mild arthritic change on the radiographs. Conclusion: When the Lisfranc injuries, especially in the subtle injuries were suspicious, the stress views are helpful to assess stability of the Lisfranc injuries and planning of treatment. For unstable injuries on stress radiographs in subtle injuries of Lisfranc joint, closed reduction and percutaneous screw fixation is useful method to expect good clinical results.
Objective: To evaluate the effects of facemask therapy, which was anchored from the zygomatic buttresses of the maxilla by using two miniplates, in skeletal Class III patients with maxillary deficiency. Methods: Eighteen skeletal Class III patients (10 girls and 8 boys; mean age, $11.4{\pm}1.28$ years) with maxillary deficiency were treated using miniplate-anchored facemasks, and their outcomes were compared with those of a Class III control group (9 girls and 9 boys; mean age, $10.6{\pm}1.12$ years). Two I-shaped miniplates were placed on the right and left zygomatic buttresses of the maxilla, and a facemask was applied with a 400 g force per side. Intragroup comparisons were made using the Wilcoxon test, and intergroup comparisons were made using the Mann-Whitney U-test (p < 0.05). Results: In the treatment group, the maxilla moved 3.3 mm forward, the mandible showed posterior rotation by $1.5^{\circ}$, and the lower incisors were retroclined after treatment. These results were significantly different from those in the control group (p < 0.05). No significant anterior rotation of the palatal plane was observed after treatment. Moreover, changes in the sagittal positions of the maxillary incisors and molars were similar between the treatment and control groups. Conclusions: Skeletally anchored facemask therapy is an effective method for correcting Class III malocclusions, which also minimizes the undesired dental side effects of conventional methods in the maxilla.
Papasotiriou, Antonios N.;Prevezas, Nikolaos;Krikonis, Konstantinos;Alexopoulos, Evangelos C.
Safety and Health at Work
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v.8
no.2
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pp.162-168
/
2017
Background: Pelvic ring fractures (PRFs) may influence the daily activities and quality of life of the injured. The aim of this retrospective study was to explore the functional outcomes and factors related to return to work (RTW) after PRF. Methods: During the years 2003-2012, 282 injured individuals aged 20-55 years on the date of the accident, were hospitalized and treated for PRFs in a large tertiary hospital in Athens, Greece. One hundred and three patients were traced and contacted; 77 who were on paid employment prior to the accident gave their informed consent to participate in the survey, which was conducted in early 2015 through telephone interviews. The questionnaire included variables related to injury, treatment and activities, and the Majeed pelvic score. Univariate and multiple regression analyses were used for statistical assessment. Results: Almost half of the injured (46.7%) fully RTW, and earning losses were reported to be 35% after PRF. The univariate analysis confirmed that RTW was significantly related to accident site (labor or not), the magnitude of the accident's force, concomitant injuries, duration of hospitalization, time to RTW, engagement to the same sport, Majeed score, and complications such as limp and pain as well as urologic and sexual complaints (p < 0.05 for all). On multiple logistic regression analysis, the accident sustained out of work (odds ratio: 6.472, 95% confidence interval: 1.626-25.769) and Majeed score (odds ratio: 3.749, 95% confidence interval: 2.092-6.720) were identified as independent predictive factors of full RTW. Conclusion: PRFs have severe socioeconomic consequences. Possible predictors of RTW should be taken into account for health management and policies.
The purpose of this study was to analyze the stress distribution and the displacement in the maxillary complex after the application of the three kinds of the head gear. (high pull head gear, straight pull head gear, cervical pull head gear.) Orthopedic force, 300 gram, was applied to the maxilla of the dry human skull in a high, straight and cervical direction. The stress distribution and the displacement within the maxillary complex was analyzed by a 3-dimensional finite element method. The results were as follow: 1. In won, the stress of conical pull head gear was the greatest stress and straight pull head gear was the medium stress and high pull head gear was the least stress. 2. The compressive stress was observed on the anterior portion of premaxilla, especially anterior nasal spine area, when the three kinds of head gear were applied to the dry kuman skull. 3. It appeared that the stress of the anterior portion of the zygomatic bone was greater than the posterior portion in the case of three kinds of head gear application and compressive stress was noted only at the below of the frontozygomatic suture of the zygomatic bone. 4. The backward, upward, sideward displacement of the alveolar area was observed in a high pull head gear application but in the case of straight pull head gear and cervical pull head gear application, the backward, downward, sideward displacement was observed. 5. The forward, downward, sideward displacement was observed on the midpalatine suture and premaxilla on the sagittal plane and transverse palatine suture in the case of three kinds of headgear application.
Spatial change of craniofacial structures from growth or orthopedic force is usually evaluated by cephalometric superimpositions at different points in time.As the evaluation cu be changed according to cephalometric superimposition method,selettion for correct superimposition method is very important.Double registration of nineteen pairs of female lateral head films,their growth period is average 3.7 years and age is overage 10.7 years,were performed by two observers.Comparisions was made between two methods and the results revealed the following, 1. NS line and ACB superimpositions ate not markedly different in reliability due to almost same registration error of them. 2. The investigation was undertaken to examine interobserver difference.In NS line method, there is no significance in all measurements. In ACB method,significant difference was revealed in 4 measurements of 7 measurements was 3. In the investigation of intermethod difference, there is no significance between NS line and ACB superimpositions
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