Hip joint

髋关节
  • 文章类型: Journal Article
    髋臼唇(AL)在髋关节的正常生理功能中起着至关重要的作用。本研究旨在概述有关AL的现状和研究热点,并从文献计量学的角度探讨该领域。从WebofScienceCoreCollection数据库中收集了2000年1月1日至2023年11月8日之间发布的1918年与AL相关的记录。通过利用HisCite等工具,CiteSpace,VOSviewer,和R包“参考书库”,“各地区,机构,期刊,作者,并对关键词进行了分析,以预测AL研究的最新趋势。与该主题相关的全球研究兴趣和出版物产出继续升级。美国在国际合作方面处于领先地位,出版物数量,和引用频率,强调其在这一领域的卓越地位。美国髋关节研究所成为最多产的机构,对出版物做出最大的贡献。值得注意的是,关节镜和美国运动医学杂志是该领域最受欢迎的2种期刊,占出版物的13.29%和10.1%,分别,也被发现是被共同引用最多的期刊。在作者中,本杰明·G·多姆以160篇文章(8.35%)领先,而MarcJ.Philippon是最常被引用的作者。关键词共现网络显示3个热点集群,包括“AL,股骨髋臼撞击(FAI),“和”骨关节炎。\"此外,“幸存者,\"\"FAI,“”和“患者报告的结果”被确定为未来探索的趋势主题。这项研究代表了第一次全面的文献计量分析,总结了AL研究的现状和未来趋势。这些发现为学者提供了宝贵的资源,提供对该领域内关键信息的实用见解,并在不久的将来确定潜在的研究前沿和新兴方向。
    The acetabular labrum (AL) plays a crucial role in the normal physiological functioning of the hip joint. This study aims to present an overview of the current status and research hotspots concerning the AL and to explore the field from a bibliometric perspective. A total of 1918 AL-related records published between January 1, 2000 and November 8, 2023 were gathered from the Web of Science Core Collection database. By utilizing tools such as HisCite, CiteSpace, VOSviewer, and the R package \"bibliometrix,\" the regions, institutions, journals, authors, and keywords were analyzed to predict the latest trends in AL research. Global research interest and publication output related to this topic continues to escalate. The United States leads in international collaborations, number of publications, and citation frequency, underscoring its preeminent position in this field. The American Hip Institute emerged as the most prolific institution, making the greatest contribution to publications. Notably, Arthroscopy and the American Journal of Sports Medicine are the 2 most popular journals in this domain, accounting for 13.29% and 10.1% of publications, respectively, and were also found to be the most co-cited journals. Amongst authors, Benjamin G. Domb leads with 160 articles (8.35%), while Marc J. Philippon is the most frequently cited author. The keyword co-occurrence network showed 3 hot clusters, including \"AL,\" \"femoral acetabular impingement (FAI),\" and \"osteoarthritis.\" In addition, \"survivorship,\" \"FAI,\" and \"patient-reported outcomes\" were identified as trending topics for future exploration. This study represents the first comprehensive bibliometric analysis, summarizing the present state and future trends in AL research. The findings serve as a valuable resource for scholars, offering practical insights into key information within the field and identifying potential research frontiers and emerging directions in the near future.
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  • 文章类型: Journal Article
    探讨直接前入路(DAA)在全髋关节置换术(THA)中的应用效果及对改善髋关节功能的影响。这项回顾性分析包括2017年12月至2020年12月在东莞医院接受THA的94例患者,广州中医药大学.研究组包括50名接受DAA的患者,而对照组包括接受后外侧入路(PA)的44例患者。随访时间为12个月。根据围手术期指标(手术时间、术中失血,住院时间,卧床时间,切口长度,疼痛评分),助行器使用的持续时间,术后并发症的发生率,髋关节功能(Harris评分),生活质量(SF-36),日常生活活动(ADL)。研究组治疗有效率高于对照组(P<0.05)。研究组手术时间较长,降低术中失血量,缩短住院时间和卧床时间,较小的切口长度,治疗后视觉模拟量表(VAS)评分降低,差异有统计学意义(P<0.05)。研究组术后使用助行器的时间也较短(P<0.05)。研究组治疗后Harris评分高于对照组(P<0.05)。此外,研究组治疗后SF-36评分和ADL评分均高于对照组(P<0.05)。两组患者术后并发症发生率差异无统计学意义(P>0.05)。THA中的DAA导致疼痛和术中失血减少,有助于促进短期预后良好的患者的术后恢复。这一程序值得进一步推广。
    To investigate the outcomes of the direct anterior approach (DAA) in total hip arthroplasty (THA) and its impact on improving hip joint function. This retrospective analysis included 94 patients who underwent THA between December 2017 and December 2020 at Dongguan Hospital, Guangzhou University of Chinese Medicine. The study group comprised 50 patients who received the DAA, while the control group comprised 44 patients who received the postero-lateral approach (PA). The follow-up period was 12 months. A comparison was made between the 2 groups based on perioperative indicators (operation time, intraoperative blood loss, hospitalization time, bed rest time, incision length, pain score), duration of walker use, incidence of postoperative complications, hip joint function (Harris score), quality of life (SF-36), and activities of daily living (ADL). The treatment effectiveness rate was higher in the study group (P < .05). The study group had a longer operation time, lower intraoperative blood loss, shorter hospitalization and bed rest time, smaller incision length, and lower visual analog scale (VAS) score after treatment, with statistically significant differences (P < .05). The study group also had a shorter duration of walker use after surgery (P < .05). The Harris score after treatment was higher in the study group compared to the control group (P < .05). Additionally, the study group had higher SF-36 scores and ADL scores after treatment (P < .05). There was no significant difference in the incidence of postoperative complications between the 2 groups (P > .05). The DAA in THA resulted in reduced pain and intraoperative blood loss, contributing to the promotion of postoperative recovery in patients with good short-term outcomes. This procedure warrants further promotion.
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  • 文章类型: Journal Article
    目的:建立AI辅助MRI模型,以确定小儿髋关节和关节周围感染的手术目标区域。
    方法:对2010年1月至2023年1月在中国3家医院接受磁共振成像(MRI)检查的髋关节和关节周围感染患儿进行回顾性研究。总共选择了7970张轴向短Tau反转恢复(STIR)图像,使用Labelme软件标记骨髓炎(标签1)和脓肿(标签2)的相应区域。将图像随机分为训练组,验证组,和试验组的比例为7:2:1。构建并优化了MaskR-CNN模型,使用接受者工作特征(ROC)曲线评估识别标签1和标签2的性能。计算模型和专家在测试组中处理图像所用的平均时间。与四位骨科医生比较该模型在MRI图像解释中的准确性,P<0.05,具有统计学意义。
    结果:共纳入275例患者,由197名男性和78名女性组成,平均年龄为7.10±3.59岁,从0.00年到14.00年不等。曲线下面积(AUC),准确度,灵敏度,特异性,精度,模型识别标签1的F1评分分别为0.810、0.976、0.995、0.969、0.922和0.957。AUC,准确度,灵敏度,特异性,精度,模型识别标签2的F1评分分别为0.890、0.957、0.969、0.915、0.976和0.972。该模型表现出显著的速度优势,只需0.2s处理图像,而专家平均需要10s。该模型以0.976的准确性识别骨髓炎,以0.957的准确性识别脓肿,两者在统计学上都优于四位骨科医生。P<0.05。
    结论:MaskR-CNN模型对于确定小儿髋关节和关节周围感染的手术目标区域是可靠的,提供更方便和快速的选择。它可以帮助没有经验的医生进行治疗前评估,减少漏诊和误诊的风险。
    OBJECTIVE: To develop an AI-assisted MRI model to identify surgical target areas in pediatric hip and periarticular infections.
    METHODS: A retrospective study was conducted on the pediatric patients with hip and periarticular infections who underwent Magnetic Resonance Imaging(MRI)examinations from January 2010 to January 2023 in three hospitals in China. A total of 7970 axial Short Tau Inversion Recovery (STIR) images were selected, and the corresponding regions of osteomyelitis (label 1) and abscess (label 2) were labeled using the Labelme software. The images were randomly divided into training group, validation group, and test group at a ratio of 7:2:1. A Mask R-CNN model was constructed and optimized, and the performance of identifying label 1 and label 2 was evaluated using receiver operating characteristic (ROC) curves. Calculation of the average time it took for the model and specialists to process an image in the test group. Comparison of the accuracy of the model in the interpretation of MRI images with four orthopaedic surgeons, with statistical significance set at P < 0.05.
    RESULTS: A total of 275 patients were enrolled, comprising 197 males and 78 females, with an average age of 7.10 ± 3.59 years, ranging from 0.00 to 14.00 years. The area under curve (AUC), accuracy, sensitivity, specificity, precision, and F1 score for the model to identify label 1 were 0.810, 0.976, 0.995, 0.969, 0.922, and 0.957, respectively. The AUC, accuracy, sensitivity, specificity, precision, and F1 score for the model to identify label 2 were 0.890, 0.957, 0.969, 0.915, 0.976, and 0.972, respectively. The model demonstrated a significant speed advantage, taking only 0.2 s to process an image compared to average 10 s required by the specialists. The model identified osteomyelitis with an accuracy of 0.976 and abscess with an accuracy of 0.957, both statistically better than the four orthopaedic surgeons, P < 0.05.
    CONCLUSIONS: The Mask R-CNN model is reliable for identifying surgical target areas in pediatric hip and periarticular infections, offering a more convenient and rapid option. It can assist unexperienced physicians in pre-treatment assessments, reducing the risk of missed and misdiagnosis.
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  • 文章类型: Journal Article
    目的:踝关节背屈受限的个体在行走过程中观察到异常的下肢运动模式。这项研究的目的是研究步行站立阶段踝关节背屈角度峰值与相应时刻下肢生物力学的关系,并确定步行过程中功能性有限踝关节背屈的临界值。
    方法:在步行过程中测量了70名健康参与者的运动学和动力学数据。计算Spearman相关系数,以建立峰值踝关节背屈与踝关节角度和力矩之间的关联。膝盖,和臀部,地面反作用力,和踝关节背屈高峰期的骨盆运动。通过因子分析,提取了与踝关节背屈峰值显着相关的所有变量作为共同因素。使用最大选择的Wilcoxon统计量进行截止值分析。
    结果:踝关节背屈峰值与踝关节足底屈曲力矩呈正相关(r=0.432;p=0.001),踝关节外转力矩(r=0.251;p=0.036),髋部伸展角(r=0.281;p=0.018),髋关节屈曲力矩(r=0.341;p=0.004),骨盆同侧旋转角度(r=0.284;p=0.017),和中间,前,和垂直地面反作用力(r=0.324;p=0.006,r=0.543;p=0.001,r=0.322;p=0.007),与膝关节外旋角度(r=-0.394;p=0.001)和髋关节内收角度(r=-0.256;p=0.032)呈负相关。所有70名参与者的截止基线值为9.03°。
    结论:步行过程中踝关节背屈峰值与下肢生物力学之间存在相关性。如果踝关节背屈峰值角小于9.03°,下肢运动模式将发生显著变化。
    OBJECTIVE: Abnormal lower limb movement patterns have been observed during walking in individuals with limited ankle dorsiflexion. The purpose of this study was to investigate the relationships of peak ankle dorsiflexion angle during the stance phase of walking with the lower extremity biomechanics at the corresponding moment and to determine a cutoff value of functional limited ankle dorsiflexion during walking.
    METHODS: Kinematic and kinetic data of 70 healthy participants were measured during walking. Spearman\'s correlation coefficients were calculated to establish the association between peak ankle dorsiflexion and angle and moment of ankle, knee, and hip, ground reaction force, and pelvic movement at peak ankle dorsiflexion. All variables significantly related to peak ankle dorsiflexion were extracted as a common factor by factor analysis. Maximally selected Wilcoxon statistic was used to perform a cutoff value analysis.
    RESULTS: Peak ankle dorsiflexion positively correlated with ankle plantar flexion moment (r = 0.432; p = 0.001), ankle external rotation moment (r = 0.251; p = 0.036), hip extension angle (r = 0.281; p = 0.018), hip flexion moment (r = 0.341; p = 0.004), pelvic ipsilateral rotation angle (r = 0.284; p = 0.017), and medial, anterior, and vertical ground reaction force (r = 0.324; p = 0.006, r = 0.543; p = 0.001, r = 0.322; p = 0.007), negatively correlated with knee external rotation angle (r = -0.394; p = 0.001) and hip adduction angle (r = -0.256; p = 0.032). The cutoff baseline value for all 70 participants was 9.03°.
    CONCLUSIONS: There is a correlation between the peak ankle dorsiflexion angle and the lower extremity biomechanics during walking. If the peak ankle dorsiflexion angle is less than 9.03°, the lower limb movement pattern will change significantly.
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  • 文章类型: Journal Article
    在过去的10年里,髋关节镜检查越来越多地用于有效诊断和安全治疗一系列髋关节病变。随着髋关节镜相关研究的不断扩大,与髋关节镜检查相关的文章数量也一直在增长。我们旨在调查髋关节镜相关研究的趋势和热点,并分析前100篇被引用最多的髋关节镜检查文章。我们在1900年至2022年的WebofScience数据库中搜索了(\"髋关节镜\")和(\"文章\"或\"综述\")和\"English\",该数据库用于获取与髋关节镜有关的所有出版物。国家分布,附属机构,journal,作者,使用VOSviewer分析引文频率和关键词。从1900年到2022年,共从WebofScienceCoreCollection(WoSCC)中选择了1094篇文章。随着时间的推移,有关髋关节镜检查的出版物数量呈上升趋势。在这些国家中,美国成为文章数量最大的贡献者。最高的多产机构是美国髋关节研究所。在期刊中,排名最高的杂志是“关节镜-关节镜及相关外科杂志”,“有8316个引文计数和262篇文章。最感兴趣的研究领域是该领域的诊断和治疗。近年来,关于髋关节镜的科学文章不断增加。美国是全球最具影响力的国家,对这一领域做出了最重要的贡献。我们首次确定了研究方向和趋势,并提供了有关髋关节镜的最新文献计量学分析,这可能有助于研究人员进行髋关节镜检查的研究。
    Over the past 10 years, hip arthroscopy has been increasingly employed to effectively diagnose and safely treat a range of hip pathologies. With research related to hip arthroscopy continually expanding, the number of articles connected with hip arthroscopy has also consistently grown. We aimed to investigate trends and hotspots in hip arthroscopy-related research, and analyze the top 100 most-cited articles on hip arthroscopy. We searched for (\"hip arthroscopy\") AND (\"article\" OR \"review\") AND \"English\" in the Web of Science database from 1900 to 2022, which was used to obtain all publications relating to hip arthroscopy. Distribution of country, affiliated institution, journal, authors, citation frequency and keywords were analyzed using VOSviewer. A total of 1094 articles were selected from the Web of Science Core Collection (WoSCC) from 1900 to 2022. The number of publications concerning hip arthroscopy displayed an ascending trend over time. Among the countries, the United States emerged as the largest contributor to the number of articles. The highest prolific institution was American Hip Institute. Among the journals, the highest-ranking journal was \"Arthroscopy-the Journal of Arthroscopic and Related Surgery,\" with 8316 citation counts and 262 articles. The area of greatest research interest was diagnosis and therapy in the field. The scientific articles on the subject of hip arthroscopy have risen continuously in recent years. The United States was the most influential country and made the most significant contributions to this field globally. We identified the research direction and trend for the first time and provided the most recent bibliometric analysis on hip arthroscopy, which may assist researchers in conducting studies on hip arthroscopy.
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  • 文章类型: Journal Article
    股骨calcar,默克尔于1874年首次确认,在股骨近端的承重能力中起着举足轻重的作用,其结构完整性对于有效分配机械载荷至关重要。起源于股韧带锚定的垂直脊,这种骨突出在中性轴后面从内侧到外侧横向延伸。它的存在不仅是解剖学上的好奇心,而且还通过提供额外的强度和支撑来抵抗诸如步行或跳跃之类的活动期间遇到的压缩力,从而显着影响髋关节的生物力学。尽管它在骨科文献中有明确的描述,关于它的确切功能和重要性的误解仍然存在。本文深入研究了股骨cal的细微差别的解剖学和生物力学特性,提供详细的基于文献的检查,证明其在临床实践中的相关性。该评论强调了股骨cal的坚固性如何有助于预防股骨颈骨折以及髋部假体的稳定。此外,讨论了股骨calcar在手术结果中不可或缺的作用,特别是在骨折修复和关节置换的背景下,从而说明其在当代医学应用中的持久意义。
    The calcar femorale, first identified by Merkel in 1874, plays a pivotal role in the weight-bearing capacity of the proximal femur, and its structural integrity is crucial for the efficient distribution of mechanical loads. Originating at the vertical ridge where the pubofemoral ligament anchors, this bony prominence extends laterally behind the neutral axis from the medial to lateral aspects. Its presence is not merely an anatomical curiosity but significantly influences the biomechanics of the hip joint by providing additional strength and support against compressive forces encountered during activities such as walking or jumping. Despite its clear description in orthopedic texts, misconceptions persist about its exact function and importance. This article delves into the nuanced anatomy and biomechanical properties of the calcar femorale, offering a detailed literature-based examination that demonstrates its relevance in clinical practice. The review highlights how the robustness of the calcar femorale contributes to the prevention of femoral neck fractures as well as the stabilization of hip prostheses. Furthermore, the indispensable role of the calcar femorale in surgical outcomes is discussed, especially in the context of fracture repair and joint replacement, thus illustrating its enduring significance in contemporary medical applications.
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  • 文章类型: English Abstract
    目的:用有限元方法分析CroweⅢ型发育性髋关节发育不良(DDH)全髋关节置换术(THA)中髋臼解剖重建与非解剖重建的髋关节生物力学。为临床上THA中解剖性髋臼重建提供了理论基础和实验依据。
    方法:本研究选择1例继发于CroweⅢ型DDH的左终末期髋关节关节炎患者,2020年4月在蚌埠医学院第一附属医院骨科接受全髋关节置换术。这个病人是女性,57岁。术前、术后对患者进行骨盆三维CT扫描。14种不同前倾的髋臼杯模型,在Mimics和3-Matic软件中建立了倾斜度和旋转中心高度。在Abaqus软件中设置边界和载荷条件。计算并观察髋关节的VonMises和应力分布。
    结果:在CroweⅢ型DDHTHA中,如果髋部旋转中心在解剖学上恢复并且髋臼杯的倾斜度设定为40°,杯子的前倾从5°到25°不等,髋臼杯和聚乙烯内衬的VonMises值最低出现在20°前移;如果在解剖学上恢复髋关节旋转中心,髋臼杯前移设置为15°,杯子的倾斜度从35°变化到55°,髋臼杯和聚乙烯内衬的VonMises值最低出现在35°倾斜;如果髋臼杯的前倾和倾斜分别设置为15°和40°,髋部中心的向上迁移从0毫米到20毫米不等,髋臼杯和聚乙烯衬垫的最低VonMises值发生在10mm向上迁移。在所有十四个模型中,髋臼的VonMises值,髋臼杯前倾和内倾为15°时,髋臼杯和聚乙烯衬垫最低,分别为35°,以及旋转中心在解剖学上得到恢复。
    结论:在CroweⅢ型DDH的全髋关节置换术中,建议解剖恢复髋臼旋转中心,髋臼杯前倾15°,倾斜35°,建议同时在髋臼杯上方进行植骨和附加螺钉,以进一步减少髋关节的VonMises。
    OBJECTIVE: To analyze the hip joint biomechanics of the acetabular anatomical reconstruction and nonanatomical reconstruction in total hip arthroplasty (THA) for Crowe type Ⅲ developmental dysplasia of the hip (DDH) by finite element method, which provided theoretical foundation and experimental basis for the anatomical acetabular reconstruction during THA in clinical practice.
    METHODS: One patient with left end-stage hip arthritis secondary to Crowe type Ⅲ DDH was selected in this study, who underwent total hip arthroplasty in the orthopedic department of the First Affiliated Hospital of Bengbu Medical College in April 2020. This patient was female, 57 years old. The preoperative and postoperative three dimentional CT scan of the patient\'s pelvis were performed. Fourteen acetabular cup models with different anteversion, inclination and rotation center height were established in Mimics and 3-Matic software. The boundary and load conditions were set in Abaqus software. The Von Mises and stress distribution of the hip joint were calculated and observed.
    RESULTS: In the Crowe type Ⅲ DDH THA, if the hip rotation center was restored anatomically and the acetabular cup\'s inclination was set as 40°, the cup\'s anteversion varied from 5° to 25°, the lowest Von Mises value of acetabular cup and polyethylene liner occured in 20°anteversioin;if the hip rotation center was restored anatomically and the acetabular cup\'s anteversion was set as 15°, the cup\'s inclination varied from 35° to 55°, the lowest Von Mises value of acetabular cup and polyethylene liner occured in 35° inclination;if the acetabular cup\'s anteversion and inclination were set as 15°and 40°respectively, the up migration of hip rotaion center varied from 0 mm to 20 mm, the lowest Von Mises value of acetabular cup and polyethylene liner occured in 10 mm up migration. In all fourteen models, the Von Mises value of the acetabulum, acetabulum cup and polyethylene liner were lowest when the acetabular cup\'s anteversion and inlcination were 15°, 35° respectively, as well as the rotation center was restored anatomically.
    CONCLUSIONS: In total hip arthroplasty for Crowe type Ⅲ DDH, the anatomical restoration of hip rotation center with 15° anteversion and 35° inclination of the acetabular cup are suggested, bone graft above the acetabular cup and additional screws are recommended simultaneously to further reduce the Von Mises of hip joint.
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  • 文章类型: English Abstract
    目的:探讨血清D-二聚体(D-D)的价值,纤维蛋白原(FIB),血小板(PLT),C反应蛋白(CRP)和组织纤溶酶原激活物抑制物(PAI)-1水平预测老年髋关节术后下肢深静脉血栓形成(DVT).
    方法:回顾性分析2020年2月至2022年5月收治的165例老年髋关节手术患者,其中男89例,女76例。年龄60至75岁,平均(66.43±5.48)岁,股骨颈骨折102例,股骨头坏死63例。血清D-D水平,FIB,PLT,所有患者在入院后24小时内进行CRP和PAI-1检测,根据患者是否发生DVT分为DVT组和非DVT组。
    结果:D-D的水平,FIB,PLT,CRP,DVT组及PAI-1均高于非DVT组(P<0.001)。Spearman分析显示DVT与PLT呈正相关,CRP,D-D,FIB,和PAI-1水平(r=0.382、0.213、0.410、0.310、0.353,均P<0.001)。二元Logistic回归分析结果显示,D-D和PLT是影响DVT发生的独立因素(OR=0.038、0.960,P=0.032、0.011)。D-D曲线下面积(AUC),FIB,PLT,CRP,PAI-1和DVT的五个组合预测分别为0.843、0.692、0.871、0.780、0.819和0.960。5项联合预测的AUC均高于单项预测(P<0.05)。
    结论:D-D,FIB,PLT,CRP和PAI-1可有效预测老年人髋部术后DVT,五因素的联合预测具有较高的疗效。
    OBJECTIVE: To explore the value of serum D-dimer (D-D), fibrinogen (FIB), platelet (PLT), C-reactive protein (CRP) and tissue plasminogen activator inhibitor (PAI)-1 levels in predicting lower extremity deep vein thrombosis (DVT) after hip joint surgery in the elderly.
    METHODS: A retrospective analysis was performed on 165 elderly patients with hip joint surgery admitted from February 2020 to May 2022, including 89 males and 76 females, aged from 60 to 75 years old with an average of (66.43±5.48) years, and there were 102 cases of femoral neck fracture and 63 cases of femoral head necrosis. Serum levels of D-D, FIB, PLT, CRP and PAI-1 tests were performed in all patients within 24 hours after admission, and the patients were divided into DVT group and non-DVT group according to whether they developed DVT.
    RESULTS: The levels of D-D, FIB, PLT, CRP, and PAI-1 in the DVT group were higher than those in the non-DVT group (P<0.001). Spearman analysis showed that DVT was positively correlated with PLT, CRP, D-D, FIB, and PAI-1 levels (r=0.382, 0.213, 0.410, 0.310, 0.353, all P<0.001). The results of binary Logistic regression analysis showed that D-D and PLT were independent factors affecting the occurrence of DVT (OR=0.038, 0.960, P=0.032, 0.011). The area under curve (AUC) of D-D, FIB, PLT, CRP, PAI-1, and the five combined predictions for DVT were 0.843, 0.692, 0.871, 0.780, 0.819, and 0.960, respectively. The AUC of the five combined predictions was higher than that of the single prediction (P<0.05).
    CONCLUSIONS: D-D, FIB, PLT, CRP and PAI-1 are effective in predicting DVT after hip surgery in the elderly, and the combined prediction of the five factors has higher efficacy.
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  • 文章类型: Journal Article
    本研究的目的是探讨术前联合术后中等强度渐进性阻力训练(PRT)对全髋关节置换术(THA)的髋关节骨关节炎(HOA)患者的影响。该研究旨在评估这种联合干预对肌肉力量的影响,步态,balance,和髋关节功能在一个受控的,可测量,客观的态度。此外,这项研究的目的是比较这种联合干预措施与术前或术后单独进行的肌力训练的结果。
    共有90例计划进行单侧原发性THA的HOA患者被随机分为三组:术前组(术前PRT),术后组(术后PRT),Pre&Post组(术前联合术后PRT)关注髋关节屈曲,扩展,内收,绑架手术方。肌肉力量,步态参数,balance,在12个月随访期间的特定时间点评估髋关节功能.
    三组的肌肉力量均有显著改善,Pre&Post小组展示了最显著和持续的收益。与其他组相比,Pre&Post组在术后1个月和3个月随访时的步态速度和步调显着提高。同样,Pre&Post组在术后3个月和12个月随访时表现出优异的平衡性能。在所有随访间隔中,前和后组的Harris髋关节评分也显示出更好的结果。
    在接受THA的HOA患者中,术前结合术后中等强度的PRT可以改善肌肉力量,步态,balance,和髋关节功能与术前或术后单独PRT相比。这种干预在优化THA术后康复和提高患者预后方面显示出重大希望。
    UNASSIGNED: The aim of this study is to investigate the effects of a preoperative combined with postoperative moderate-intensity progressive resistance training (PRT) of the operative side in patients with hip osteoarthritis (HOA) who are undergoing total hip arthroplasty (THA). The study seeks to evaluate the impact of this combined intervention on muscle strength, gait, balance, and hip joint function in a controlled, measurable, and objective manner. Additionally, the study aims to compare the outcomes of this combined intervention with those of preoperative or postoperative muscle strength training conducted in isolation.
    UNASSIGNED: A total of 90 patients with HOA scheduled for unilateral primary THA were randomly assigned to three groups: Pre group (preoperative PRT), Post group (postoperative PRT), and Pre& Post group (preoperative combined with postoperative PRT) focusing on hip flexion, extension, adduction, and abduction of operated side. Muscle strength, gait parameters, balance, and hip function were assessed at specific time points during a 12-month follow-up period.
    UNASSIGNED: All three groups showed significant improvements in muscle strength, with the Pre& Post group demonstrating the most pronounced and sustained gains. Gait velocity and cadence were significantly improved in the Pre& Post group at 1-month and 3-month postoperative follow-ups compared to the other groups. Similarly, the Pre& Post group exhibited superior balance performance at 3-month and 12-month postoperative follow-ups. The Harris Hip Score also showed better outcomes in the Pre& Post group at all follow-up intervals.
    UNASSIGNED: Preoperative combined with postoperative moderate-intensity PRT in HOA patients undergoing THA led to superior improvements in muscle strength, gait, balance, and hip joint function compared to preoperative or postoperative PRT alone. This intervention shows significant promise in optimizing postoperative rehabilitation and enhancing patient outcomes following THA.
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  • 文章类型: Journal Article
    探索合金中增强物浓度较高的高强度材料被证明是一项具有挑战性的任务。这项研究探索了具有碳化钨增强剂的镁基复合材料(AZ31B合金),通过联赛冠军优化来增强医疗关节置换的实力。主要目标是使用镁基复合材料增强医疗关节置换生物材料,强调含碳化钨增强剂的AZ31B合金。搅拌铸造方法用于制造镁基复合材料(MMC),包括不同百分比的碳化钨(WC)。机械特性,如显微硬度,抗拉强度,和屈服强度,已经进行了评估,并与计算模拟进行了比较。已经进行了磨损研究以分析复合材料的摩擦学行为。此外,这项研究调查了骨和关节结构内部的应力和力分布的预测,因此,为生物医学研究领域做出了重大贡献。这项研究考虑使用镁基MMC来发现适用于医疗关节置换的生物材料。研究重点是镁合金AZ31B,颗粒的大小范围从40到60微米用作基质材料。此外,结果表明,当与基于AZ31B-镁基质的MMC结合使用时,WC颗粒成为轻质制造的高效增强材料,高强度生物医学复合材料。本研究使用联赛冠军优化(LCO)方法来确定影响AZ31B基镁合金MgMMCs合成的关键变量。仔细分析了扫描电子显微镜(SEM)图像,以描绘WC颗粒的分散以及镁(Mg)基体和WC增强体之间的界面。SEM分析探索了粒子拔出的潜在机制,粒子间区域的特征,和AZ31B基体对增强复合材料力学特性的影响。正在使用有限元分析(FEA)的应用来预测髋关节模型中的应力分布和力的相互作用。这项研究比较了WC的物理力学和摩擦学特征与0%的不同组合,5%,10%和15%,及其对性能改进的影响。SEM分析证实了这一发现,提高了强度和硬度,特别是当加入10%-15%的WC时。在镁合金基体中掺入10%的WC颗粒后,研究结果表明,强度和硬度都有所提高,此外,通过利用SEM分析已经很明显。使用ANSYS,预测结构变形和应力水平,连同强度特性,如71HRC的附加硬度,拉伸强度为140-150MPa,和屈服强度接近100-110兆帕。这些模拟对关节在各种载荷条件下的行为产生了重要的见解,从而增强了这项研究在生物医学环境中的意义。
    Exploring high strength materials with a higher concentration of reinforcements in the alloy proves to be a challenging task. This research has explored magnesium-based composites (AZ31B alloy) with tungsten carbide reinforcements, enhancing strength for medical joint replacements via league championship optimisation. The primary objective is to enhance medical joint replacement biomaterials employing magnesium-based composites, emphasising the AZ31B alloy with tungsten carbide reinforcements. The stir casting method is utilised in the manufacture of magnesium matrix composites (MMCs), including varied percentages of tungsten carbide (WC). The mechanical characteristics, such as micro-hardness, tensile strength, and yield strength, have been assessed and compared with computational simulations. The wear studies have been carried out to analyse the tribological behaviour of the composites. Additionally, this study investigates the prediction of stress and the distribution of forces inside bone and joint structures, therefore offering significant contributions to the field of biomedical research. This research contemplates the use of magnesium-based MMCs for the discovery of biomaterials suitable for medical joint replacement. The study focuses on the magnesium alloy AZ31B, with particles ranging in size from 40 to 60 microns used as the matrix material. Moreover, the outcomes have revealed that when combined with MMCs based on AZ31B-magnesium matrix, the WC particle emerges as highly effective reinforcements for the fabrication of lightweight, high-strength biomedical composites. This study uses the league championship optimisation (LCO) approach to identify critical variables impacting the synthesis of Mg MMCs from an AZ31B-based magnesium alloy. The scanning electron microscopy (SEM) images are meticulously analysed to depict the dispersion of WC particulates and the interface among the magnesium (Mg) matrix and WC reinforcement. The SEM analysis has explored the mechanisms underlying particle pull-out, the characteristics of inter-particle zones, and the influence of the AZ31B matrix on the enhancement of the mechanical characteristics of the composites. The application of finite element analysis (FEA) is being used in order to make predictions regarding the distribution of stress and the interactions of forces within the model of the hip joint. This study has compared the physico-mechanical and tribological characteristics of WC to distinct combinations of 0%, 5%, 10% and 15%, and its impact on the performance improvements. SEM analysis has confirmed the findings\' improved strength and hardness, particularly when 10%-15% of WC was incorporated. Following the incorporation of 10% of WC particles within Mg-alloy matrix, the outcomes of the study has exhibited enhanced strength and hardness, which furthermore has been evident by utilising SEM analysis. Using ANSYS, structural deformation and stress levels are predicted, along with strength characteristics such as additional hardness of 71 HRC, tensile strength of 140-150 MPa, and yield strength closer to 100-110 MPa. The simulations yield significant insights into the behaviour of the joint under various loading conditions, thus enhancing the study\'s significance in biomedical environments.
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