Search Results (1,059)

(1) Background: This report aims to illustrate the development, progression, diagnosis, and treatment of chronically present articular surface lesions. (2) Methods: In this report, two patients are described from the point of the initial presentation of symptoms to surgical consultation based on radiologic findings. These patients underwent corrective surgery in the form of mosaicplasty to repair lesions present on the articular surface and the underlying subchondral bone. (3) Discussion: Diagnosing juvenile OCD remains challenging due to its variable clinical presentation and minute radiologic discoveries. X-rays are useful; however, the gold standard remains arthroscopy, which can be both diagnostic and therapeutic. Future prospects include the use of novel sonographic methods and the use of artificial intelligence within the given modalities. (4) Conclusions: The detailed imaging provided by MRI, combined with the insights from X-rays and potentially other modalities, allows for a nuanced understanding of this disease. This comprehensive approach ensures that treatment decisions are well-informed, optimising outcomes for young patients with this condition. Full article

With COVID-19, evidence indicates that the elderly will have worse biochemical markers related to health in social isolation. The objective was to analyze the impacts on physical fitness and biochemical parameters of older adults’ health during COVID-19 social isolation. Quantitative, longitudinal, and observational study was conducted between 2020, 2021, and 2022. Thirty-three older adults of both sexes were evaluated. A sociodemographic questionnaire, biomarkers, and health-related physical fitness were used. Significant differences were observed for the sum of maximum isometric right and left handgrip strength, with a reduction in 2022 (p = 0.009); getting up and walking (p < 0.001), reduction in 2021 and 2022 (p < 0.05); elbow flexion and extension (p = 0.004), reduction in 2021 (p = 0.006); and sitting and standing (p = 0.002), reduction in 2022 (p = 0.003) and peak oxygen consumption (p < 0.001), reduction in 2021 and 2022 (p < 0.05). Differences were observed in fasting blood glucose (p < 0.001), with increase in 2021 and 2022 (p < 0.05), triglycerides (p < 0.001), with increase in 2021 and 2022 (p < 0.05), triglyceride–glucose index (p < 0.001), with increase in 2021 and 2022 (p < 0.05), triglyceride–glucose index with waist circumference (p < 0.001), with increase in 2021 (p < 0.001); and triglyceride–glucose index with body mass index (p < 0.001), with increase in 2021 (p < 0.001). However, no differences were observed between anthropometric and body composition (p > 0.05). Conclusions: Older people had changes in biochemical and physical fitness parameters related to health during the social isolation of the COVID-19 pandemic. Full article

Introduction: Osteogenesis imperfecta (OI) is a hereditary disorder primarily caused by mutations in type I collagen genes, resulting in bone fragility, deformities, and functional limitations. Studies on upper extremity deformities and associated functional impairments in OI are limited. This cross-sectional study aimed to evaluate upper extremity deformities and functional outcomes in OI. Methods: We included patients regardless of their OI subtypes with a minimum age of 7 years. Radiographic analysis of radial head dislocation, ossification of the interosseous membrane, and/or radioulnar synostosis of the forearm were performed, and deformity was categorized as mild, moderate, or severe. Clinical evaluation was performed using the Quick Disabilities of Arm, Shoulder, and Hand (qDASH) questionnaire and shoulder-elbow-wrist range of motion (ROM). Three-dimensional motion analysis of the upper limb was conducted using the Southampton Hand Assessment Procedure (SHAP). The SHAP quantifies execution time through the Linear Index of Function (LIF) and assesses the underlying joint kinematics using the Arm Profile Score (APS). Additionally, the maximum active Range of Motion (aRoM) was measured. Results: Fourteen patients aged 8 to 73 were included. Radiographic findings revealed diverse deformities, including radial head dislocation, interosseous membrane ossification, and radioulnar synostosis. Six patients had mild, six moderate, and two severe deformities of the upper extremity. Severe deformities and radial head dislocation correlated with compromised ROM and worse qDASH scores. The qDASH score ranged from 0 to 37.5 (mean 11.7). APS was increased, and LIF was reduced in OI-affected persons compared with non-affected peers. APS and LIF also varied depending on the severity of bony deformities. aRoM was remarkably reduced for pro-supination. Conclusion: Patients with OI showed variable functional impairment from almost none to severe during daily life activities, mainly depending on the magnitude of deformity in the upper extremity. Larger multicenter studies are needed to confirm the results of this heterogeneous cohort. Level of evidence: Retrospective clinical study; Level IV. Full article

This study addresses the limitation of traditional non-destructive testing methods in real-time corrosion monitoring of pipe elbows by proposing the utilization of fiber Bragg grating (FBG) strain sensors, renowned for their resilience in harsh environments. However, the current mathematical relationship model for strain representation of elbow corrosion is still lacking. This paper develops a finite element model to scrutinize the strain changes in the elbow due to corrosion under hydrostatic pressure and bending loads. To mitigate temperature loading effects, the corrosion degree is evaluated through the disparity between hoop and axial strains. Simulation outcomes reveal that, under hydrostatic pressure, the strain difference exhibits minimal changes with the increase in corrosion degree, while under bending moment loading, the strain difference escalates proportionally with corrosion progression. Consequently, strain induced by bending moment loading solely characterizes the corrosion degree. Moreover, the optimal placement for FBG sensors is identified at the extrados of the pipe elbow, where strain is most prominent. These insights enhance comprehension of strain–corrosion dynamics in pipe elbows, offering valuable guidance for developing an FBG-based monitoring system for real-time corrosion tracking and predictive maintenance of pipeline infrastructures. Full article

Our study presents a novel design for a cable-driven robotic arm, emphasizing low cost, low inertia movement, and long-term cable durability. The robotic arm shares similar specifications with the UR5 robotic arm, featuring a total of six degrees of freedom (DOF) distributed in a 1:1:1:3 ratio at the arm base, shoulder, elbow, and wrist, respectively. The three DOF at the wrist joints are driven by a cable system, with heavy motors relocated from the end-effector to the shoulder base. This repositioning results in a lighter cable-actuated wrist (weighing 0.8 kg), which enhances safety during human interaction and reduces the torque requirements for the elbow and shoulder motors. Consequently, the overall cost and weight of the robotic arm are reduced, achieving a payload-to-body weight ratio of 5:8.4 kg. To ensure good positional repeatability, the shoulder and elbow joints, which influence longer moment arms, are designed with a direct-drive structure. To evaluate the design’s performance, tests were conducted on loading capability, cable durability, position repeatability, and manipulation. The tests demonstrated that the arm could manipulate a 5 kg payload with a positional repeatability error of less than 0.1 mm. Additionally, a novel cable tightener design was introduced, which served dual functions: conveniently tightening the cable and reducing the high-stress concentration near the cable locking end to minimize cable loosening. When subjected to an initial cable tension of 100 kg, this design retained approximately 80% of the load after 10 years at a room temperature of 24 °C. Full article

Background: This study aimed to compare clinical outcomes and recurrence of instability after arthroscopic Bankart repair (ABR) in patients with anterior shoulder instability, with and without a GLAD lesion, while distinguishing between primary and recurrent instability. Methods: Consecutive patients who underwent isolated ABR between January 2012 and December 2021 were included. Patients with a concomitant GLAD lesion were matched in with patients without a GLAD lesion according to the following criteria: age, sex, BMI, follow-up time, and primary versus recurrent instability. At minimum two-year follow-up, the clinical outcome (Rowe score, redislocation rate) and the functional outcome, including the American Shoulder and Elbow Surgeons (ASES) score, Western Ontario Shoulder Instability Index (WOSI), Oxford Shoulder Instability Score (OSIS), satisfaction (1–10 scale, 0 = unsatisfied, 10 = very satisfied), and Visual Analogue Scale (VAS), were compared between groups. Results: In total, 28 patients (14 GLAD vs. 14 Bankart; age: 32.5 ± 13.0 years; sex: 92.9% male; BMI: 24.6 ± 2.2) were included 6.9 ± 2.8 (2–11) years after isolated ABR (follow-up rate 63.6%). Clinical and functional outcome did not differ significantly between patients with versus without GLAD lesions (ASES score: 100 [96.5–100] vs. 97.5 [93.3–100], p = 0.27); WOSI (%): 9.0 [3.7–24.5] vs. 3.8 [0.8–8.9], p = 0.22; Rowe score: 90.0 [75.0–100] vs. 95.0 [78.8–100], p = 0.57; OSIS: 46 [44.7–48] vs. 46 [43.0–48], p = 0.54; satisfaction: 8.9 ± 1.4 vs. 8.0 ± 1.4, p = 0.78; VAS 0 [0–1.3] vs. 0 [0–1.0]. In both groups, two patients (14.3%) reported a redislocation during the observation period. Conclusions: At short- to mid-term follow-up, ABR showed favorable outcomes, low dislocation rates, and high patient satisfaction, regardless of the presence of a GLAD lesion or primary versus recurrent instability. However, follow-up time was heterogeneous, and the follow-up rate was marginal. Full article

Purpose: This study aimed to identify the demographic-, radiographic-, and surgery-related factors influencing postoperative functional internal rotation (fIR) following reverse total shoulder arthroplasty (RTSA). Methods: In this retrospective cohort study, patients who underwent RTSA between June 2013 and April 2018 at a single institution were assigned to two groups (“IROgood” or “IRObad”). Patients were classified as having good fIR (≥8 points in the Constant–Murley score (CS) and fIR to the twelfth thoracic vertebra or higher) or poor fIR (≤2 points in the CS and fIR to the twelfth thoracic vertebra or lower) after RTSA with a single implant model. The minimum follow-up period was two years. Standardized shoulder-specific scores (Visual Analogue Scale (VAS), Simple Shoulder Test (SST), American Shoulder and Elbow Surgeons Score (ASES), Constant–Murley score (CS)) were used to assess the pre- and postoperative functional status of patients. Postoperative radiographic evaluation included the distalization shoulder angle (DSA), lateralization shoulder angle (LSA), critical shoulder angle (CSA), acromiohumeral distance (AHD), glenoid inclination (GI), medialization of the center of rotation (COR), lateralization of the humerus, and distalization of the greater tuberosity. Additionally, preoperative evaluation included rotator cuff arthropathy according to Hamada, glenoid version, anterior or posterior humeral head subluxation, and fatty infiltration of the rotator cuff according to Goutallier. Univariate analysis of demographic, surgical, radiographic, and implant-associated parameters was performed to identify factors associated with postoperative fIR. The Shapiro–Wilk test assessed the normal distribution of the data. Intergroup comparisons regarding demographic and surgery-related factors were conducted using the Mann–Whitney-U Test. Radiographic changes were compared using chi-square or Fisher’s exact tests. The significance level was set at p < 0.05. Results: Of a total of 42 patients, 17 (age: 73.7 ± 5.0 years, follow-up (FU) 38 months [IQR 29.5–57.5]) were included in the “IRObad” group, and 25 (age: 72 ± 6.1 years, FU 47 months [IQR 30.5–65.5]) were included in the “IROgood” group. All patients were treated with the same type of implant (glenosphere size: 36 mm, 14.3%; 39 mm, 38.1%; 42 mm, 47.6%; neck-shaft angle: 135° in 68.0%; 155° in 32.0%) and had comparable indications. Univariate analysis did not reveal any of the investigated demographic, radiographic, or surgery-related parameters as risk factors for poor postoperative fIR (p > 0.05). Conclusion: None of the investigated factors, including implant-associated parameters, influenced postoperative fIR after RTSA in this cohort. Full article

As an important target for deep to ultra-deep carbonate oil and gas exploration, Fractured-Vuggy dolomite reservoirs have strong heterogeneity. Accurate characterization of reservoir facies is crucial for their exploration and exploitation. Three methods, including the unsupervised intelligent clustering method of improved Fuzzy C-means clustering Algorithm Based on Density Sensitive Distance and Fuzzy Partrition (FCM-DSDFP), the fusion method of Principal Components Analysis (PCA) dimensionality reduction and noise reduction, and the principle of clustering feature analysis are applied to identify reservoir facies based on logging data. Based on the PCA method, the logging response characteristics of the reservoir facies are excavated, and the fusion characterization data of dimensionality reduction and noise reduction are extracted. The FCM-DSDFP unsupervised intelligent clustering method, a model that approximates the subsurface conditions is established, and the reliability of the model is tested according to the elbow rule and silhouette coefficient. Combining drilling core observation, Fractured-Vuggy type, partially cemented Fractured-Vuggy type, Pore-Vuggy type, Pore Type I, Pore Type II, Tight Type I, and Tight Type II are divided in the Dengying Formation 4th Member. Fractured-Vuggy type, partially cemented Fractured-Vuggy type, Pore-Vuggy Type I, Pore-Vuggy Type II, Pore Type I, Pore Type II, and Tight Type are divided in the Dengying Formation 2nd Member, respectively. Two methods were applied to verify the reservoir facies identification results based on intelligent algorithms. The first method is to compare the identification results with the reservoir facies types identified by core observations (Well PT103 and PS13). The second method is to verify the recognition results of intelligent algorithms by utilizing the relationship between reservoir facies types and bitumen. The test results show that the accuracy of the reservoir level identification is higher than 0.9, and the applicability is better than the commonly used algorithms such as FCM and K-means. Full article

The use of virtual reality (VR) in older adults promotes improvements in mobility, strength, and balance. Changes in neuromuscular activation have been found to be associated with these improvements; however, during VR activities, this aspect has not been thoroughly investigated. The aim of this study was to investigate neuromuscular activation among older female adults during VR activities. Sixteen older female adults, with the use of VR, performed dynamic punching movements involving elbow flexion/extension for one minute, and the muscle activation of the bicep brachii was recorded with electromyography (EMG) and normalized to the maximal voluntary isometric contraction of elbow flexion. The one-minute activity was divided into three time phases: 0–10 s, 25–35 s, and 50–60 s. The five highest EMG amplitude values (%) in each phase were selected and averaged. Differences between phases were analyzed using repeated ANOVA (α_adj = 0.017). The EMG amplitude for the first phase was 39.1 ± 2.6%, that for the second phase was 44.8 ± 3.0%, and that for the third phase was 49.6 ± 3.1%. Statistically significant differences were found in all phases, with the first phase demonstrating a lower EMG amplitude (%) compared to the second (p = 0.002) and third phases (p = 0.000). The third phase demonstrated a higher EMG amplitude (%) compared to the second phase (p = 0.025). Engagement in VR activities can have significant effects on neuromuscular activation in older female adults, with our findings revealing a significant increase in the EMG amplitude within one minute of commencing a dynamic and challenging activity such as virtual boxing. Full article

Investigating the flow performance of Francis turbines from model to prototype is a complex but essential process for ensuring reliable and efficient turbine operation in hydropower plants. It ensures that Francis turbine designs operate efficiently under various operating conditions, extending from laboratory reduced-scale models to full-scale prototype installations. In this investigation, a Francis turbine model was tested under different operating conditions, and its properties were measured, including torque, hydraulic efficiency, power output, cavitation coefficient, rotational speed, flow rate, and pressure pulsations. The results of the Francis turbine model test indicate that it achieved the maximum torque with the designed discharge and designed head. The cavitation coefficient consistently remained higher than the critical cavitation coefficient. The initial cavitation bubbles were observed at 50% partial load but disappeared at full load. Pressure pulsations under different operating conditions showed the maximum peak-to-peak amplitude appearing at the turbine inlet domain and the minimum amplitude occurring at the draft tube elbow. A hill chart shows that the model’s best efficiency was 93.66%, and the estimated best efficiency of the prototype was 95.03% at the design head. The conclusions and methodology of this study can be generalized to other similar hydraulic turbines, especially prototype Francis turbines that lack experimental results. Full article

This paper deals with the design and kinematic analysis of a novel mechanism for the elbow joint of an upper-limb exoskeleton, with the aim of helping operators, in terms of effort and physical resistance, in carrying out heavy operations. In particular, the proposed eight-bar elbow joint exoskeleton mechanism consists of a motorized Watt I six-bar linkage and a suitable RP dyad, which connects mechanically the external parts of the human arm with the corresponding forearm by hook and loop velcro, thus helping their closing relative motion for lifting objects during repetitive and heavy operations. This relative motion is not a pure rotation, and thus the upper part of the exoskeleton is fastened to the arm, while the lower part is not rigidly connected to the forearm but through a prismatic pair that allows both rotation and sliding along the forearm axis. Instead, the human arm is sketched by means of a crossed four-bar linkage, which coupler link is considered as attached to the glyph of the prismatic pair, which is fastened to the forearm. Therefore, the kinematic analysis of the whole ten-bar mechanism, which is obtained by joining the Watt I six-bar linkage and the RP dyad to the crossed four-bar linkage, is formulated to investigate the main kinematic performance and for design purposes. The proposed algorithm has given several numerical and graphical results. Finally, a double-parallelogram linkage, as in the particular case of the Watt I six-bar linkage, was considered in combination with the RP dyad and the crossed four-bar linkage by giving a first mechanical design and a 3D-printed prototype. Full article

Intra-articular blood, iron and hemosiderin, hydroxyl radical cytokines, and neo-angiogenesis cause synovial inflammation, which leads to cartilage and joint damage. Platelet-rich plasma (PRP) inhibits most of the mediators that produce and maintain synovitis. We compile here our work showing the clinical effectiveness of intra-articular PRP injections and their potential role in stopping articular cartilage damage due to bleeding and its possible repair. A total of 116 joints, including knees (63%), elbows (19.8%), and ankles (17.2%), were treated with intra-articular injections of PRP. Moreover, we also show here the number of extracellular DNA traps (ETs) and the PRP effect in the synovial fluid of patients at the time of treatment and six months after. Clinically, it is demonstrated that PRP is effective in reducing bleeding episodes (p < 0.001) and pain (p < 0.0001) and improving the hemophilia joint health score (HJHS) (p < 0.001) at one year of follow-up. Furthermore, our results demonstrate that PRP inhibits ET formation in vitro and reconstitutes the immune system’s cellular components in the synovial fluid of patients after treatment. We conclude that PRP can be considered an effective, safe, and easy treatment for hemophilic synovitis. Full article

Background: Distal triceps brachii tendon rupture (DTTR) is a relatively rare injury that is common in bodybuilding and high-intensity contact sports and can lead to significant functional impairment of the elbow joint. This study was conducted to evaluate clinical outcomes and the rate of return to sports among competitive bodybuilders and high-demand strength athletes after surgical repair of DTTR. Methods: This retrospective case series was performed in an institutional setting in tertiary health care. Return to sports of 22 competing or high-demand strength athletes (meaning three or more exercises per week) were analyzed pre- and postoperatively after surgical repair of DTTR using a hybrid technique of transosseous sutures and anchor fixation. Descriptive statistics were used to analyze demographic variables, and independent and paired t-tests were used to assess clinical outcomes. Results: The follow-up showed that from pre- to postoperatively, there was no deterioration in the number of sports disciplines (2.4 and 2.5 sporting activities per person, respectively; p = 0.540) or in the frequency of weekly training (4.1 and 4.1 times per person, respectively; p = 0.329). The postoperative visual analog scale for pain (from 6.0 to 1.6, p < 0.001), level of fitness (from 5.1 to 2.6, p = 0.002), and ability to train (from 5.2 to 1.3, p < 0.001) improved significantly. The time of return to sports was 1.5–3 months and 4–6 months after the surgery for ten patients each. The overall rate of return to sports was 95%, whereas 86% returned to the preinjury level of sporting activity. Conclusions: Repair of DTTR leads to high rates of return to sports in competitive athletes. Full article

This study investigated the impact of early prosthetic intervention on children with upper limb agenesis or amputation. The aim was to assess both how early prosthetics improve a child’s movement and coordination skills, as well as how satisfied both the child and their parents are with the prosthesis. Twenty-nine children were evaluated using the Unilateral Below Elbow Test (UBET) and Child Amputee Prosthetics Project—Prothesis Satisfaction Inventory (CAPP-PSI). Results suggest that while children performed tasks faster and more fluidly without a prosthesis, they were satisfied with the prostheses and the service provided. This may be due to ongoing adaptation to the new device. The single child re-evaluated at 12 months showed improvement in prosthesis use, highlighting the potential benefits of early intervention coupled with motor re-education. Further research is needed to optimize prosthetic features and address initial challenges associated with prosthesis use. Full article

Tart cherry (TC) consumption has become a popular nutritional strategy for recovery, particularly for the attenuation of markers associated with muscle damage. However, there are relatively few studies that have examined an acute dosing strategy. The aim of this pilot study was to explore the feasibility of using powdered Vistula TC for recovery following a bout of muscle-damaging exercise. Twenty-two recreationally active participants (mean ± SD age, stature, and mass were 23 ± 3 years old, 173 ± 10 cm, and 74 ± 17 kg, respectively) performed 40 (5 sets of 8 repetitions) maximal lengthening contractions of the elbow flexors. The participants were randomised to receive either a spray-dried TC extract or a calorie-matched placebo (12 TC, 10 placebo) for 4 days in total, starting on the day of exercise. Dependent measures of maximal voluntary contraction (MVC), muscle soreness (assessed via visual analogue scales; VAS), pain pressure threshold (PPT), range of motion (ROM), and upper arm limb girth were taken at baseline (pre), 24, 48, and 72 h post damaging exercise. There were significant changes over time among all the variables (MVC, VAS, PPT, ROM, and girth, p ≤ 0.014). There were no significant differences between the conditions for any of the variables (MVC, VAS, PPT, ROM, and girth, p > 0.3). The TC group did not recover at an accelerated rate compared to the placebo. This study provides initial insights into the use of powdered Vistula TC and its effect following strenuous (damaging) exercise bouts. Vistula TC did not improve recovery when taken acutely following a bout of damaging exercise to the elbow flexors. Full article