Arnold H. Menezes

Department of Neurosurgery, University of Iowa Hospitals & Clinics, Iowa City, Iowa, USA

The etiology of os odontoideum has been debated ever since its first description by Giacomini in 1886. There are proponents of congenital origin as well as reports of post-traumatic os odontoideum formation after early childhood craniovertebral junction (CVJ) trauma. We document CVJ ligamentous injury on MRI in an 18-month-old child with sequential imaging demonstrating the os odontoid formation. Our database of 260 surgically treated patients with os odontoideum was analyzed regarding etiology and associated abnormalities. The literature (1970-2022) is reviewed.

DOI: 10.29245/2767-5130/2023/3.1186 View / Download Pdf

Peter R. Reuter*, Mackenzie Brady

Department of Rehabilitation Sciences, Marieb College of Health & Human Services, Florida Gulf Coast University, Fort Myers, Florida, USA

This cross-sectional study aimed to explore the correlation between hypermobility of the spine and chronic neck/back pain in a university-aged population. Chronic musculoskeletal pain, especially joint pain, is said to be the main complaint of individuals with symptomatic joint hypermobility. Generalized joint hypermobility is usually limited to a small number of joints, with increased range of motion of the lumbar spine the most common form of joint hypermobility. The study collected data over a six-year period from undergraduate Anatomy & Physiology students at a university in the United States, using an anonymous survey. Based on the data from 1,211 respondents the study found that: 1) young adult females are more likely to have hypermobility of the spine than young adult males; 2) young females with spine hypermobility are not more likely to report chronic neck/back pain than females without spine hypermobility; 3) young adult males with spine hypermobility are more likely to report chronic neck/back pain than males without spine hypermobility; 4) young females and males with spine hypermobility experience the same average levels of pain intensity for their chronic neck/back pain than their peers without spine hypermobility; 5) young females with and without spine hypermobility report higher levels of chronic pain intensity than males for chronic neck/back pain.

DOI: 10.29245/2767-5130/2023/3.1185 View / Download Pdf

Ryan P. Bialaszewski1*, Robert H. Ablove2

1University of Texas Rio Grande Valley, School of Medicine, Edinburg, TX, USA

2UBMD Department of Orthopaedics and Sports Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USA

Introduction: Obesity is a global pandemic and public health crisis associated with a wide range of comorbidities, including osteoarthritis, leading to a significantly younger age at the time of primary total hip arthroplasty (THA) and an increased rate of complications compared to nonobese individuals. As our population continues to get older, combined with an increasing rate of obesity, an increased rate of consultations for total hip arthroplasty is expected. This has led to concerns regarding the implications of obesity on the need for THA itself and the associated complications, especially for arthroplasty surgeons. Unfortunately, few articles provide an all-encompassing review of different complications surrounding obesity within orthopedic surgery, and even fewer around total hip arthroplasty. This literature review aims to provide a comprehensive review of the implications obesity has on total hip arthroplasties, its associated complications, and how we can potentially modify these risks.

Methods: Sources and research articles were identified by searching the databases of PubMed, Google Scholar, and the National Center for Biotechnology Information (NCBI) from 2000 to July 2022. Our search used the specific terms located within the abstract/title, including: “total hip arthroplasty” AND “complications,” AND “obesity, OR obese.” Inclusion criteria for research articles were the English language and peer-reviewed articles published from inception to July 2022. Articles not directly examining the effect of obesity on the incidence of complications following primary THA were excluded. Studies with outcomes of interest included the incidence of postoperative complications, primary THA in obese patients, and clinical outcome measures. A total of 265 studies were identified upon initial search. Thirty-one articles were selected for reference in this literature review.

Results: Obese patients undergo primary THA at an earlier age and experience an increased duration of surgery, higher rates of infection, dislocation, periprosthetic fractures, and venous thromboembolism compared to nonobese patients. The role of pre-operative bariatric surgery before total hip arthroplasty has failed to show reductions in complication rates. Harris Hip Scores are lower in obese patients pre-operatively and post-operatively, but the degree of improvement following THA is similar compared to nonobese patients. Long-term survival of total hip prostheses is similar when compared to nonobese patients.

Conclusion: Current literature strongly suggests increased complication rates in obese patients who undergo THA. This phenomenon is not solely due to biomechanical forces and is multifactorial, including inflammatory and genetic predispositions, which need further study. The decision to perform THA on obese patients should not solely be based on BMI. Other factors, such as management of comorbidities, surgical exposure, and nursing care, should be considered when deciding on surgical candidacy.

DOI: 10.29245/2767-5130/2023/2.1184 View / Download Pdf

Rita Th. Harmsen1*, Marjolein E.M. den Ouden2, Pieter F. Schillemans3, Henk W. Elzevier1, Rob G. Nelissen1, Brenda L. Den Oudsten4

1Departments of Orthopaedics, Biomedical Data Sciences and Department of Urology and Medical Decision Making (H.W.E.), Leiden University Medical Center, The Netherlands

2Research Group Technology, Health & Care, Academy of Social Work, University of Applied Science Saxion, Enschede, The Netherlands

3Private Center of Ultra Sonography Care, NV Hoorn, The Netherlands

4Center of Research on Psychological and Somatic Disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands

Background: In-depth insight into couples’ experiences of sexual activity before and after total hip arthroplasty (THA) and total knee arthroplasty (TKA) is lacking. The aim of this study was to explore patients’ and partners’ experiences, complemented by surgeons’ opinions on safe resumption of sexual activity after surgery.

Methods: Mixed method study: 1) Semi-structured interviews among sexually active couples, 1.5 years postoperatively and 2) A survey among surgeons about recommendations of sexual activity after THA/TKA.

Results: Of the 150 invited couples, 90 (60%) responded (THA: n=39; TKA: n=42). Five couples participated (THA: n=3; TKA: n=2), while 85 (94%) couples refused participation. Two themes emerged: “Couples physically and mentally adjusted to the new situation” and “Couples undoubtedly trusted the surgeon as the provider of information.” In total, 27% (47/175) of THA surgeons participated. Fifty percent agreed with the recommended sexual positions researched by Charbonnier et al. Opinions differed widely regarding when to safely resume sexual activity. Of the TKA surgeons, 36% (76/211) responded. Almost all surgeons (95%) agreed that there were no restrictions. However, some discomfort was expected when patients bend the knee or kneel during sex. Half of the surgeons indicated that providing information about sex was necessary.

Conclusions: All couples physically and mentally adapted to the new situation without considering safety measures. Patients trusted surgeons in providing safety information. Surgeons should inform patients succinct and explicitly, especially since surgeons’ recommendations showed great variability. More motion research on hip and knee may add to uniform guidelines.

DOI: 10.29245/2767-5130/2023/2.1181 View / Download Pdf

Akshay V. Daji1, Devin Q. John1, Raj D. Rao2*

1HCA JFK Hospital/University of Miami Miller School of Medicine Orthopaedic Surgery Residency Program, FL, USA

2West Palm Beach VA Healthcare System, West Palm Beach, FL, USA

DOI: 10.29245/2767-5130/2023/2.1178 View / Download Pdf

Dariush Dowlat Alizadeh2*, Seyyed Mohammad Jalil Abrisham1, Mohammad Reza Sobhan1

1Department of Orthopedics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

2Orthopedic Surgery, Trauma Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

Background and Aim: Sagittal imbalance is often presented as one of the major problems in individuals suffering from orthopedic pain, particularly those affected by destructive hip joint osteoarthritis. In this regard, total hip arthroplasty (THA) as a therapeutic procedure for such patients has resulted in the restoration of sagittal balance. Therefore, the present study aimed to evaluate the changes in sagittal balance using EOS imaging before and after THA and also reflect on its effect on hip joint function, knee pain, and disability percentage due to low back pain (LBP).

Methods: Utilizing a prospective cohort study, a total number of 24 patients suffering from extreme unilateral hip osteoarthritis and in need of unilateral THA were selected based on the inclusion and exclusion criteria, and then, sagittal balance parameters, including pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), sacrofemoral angle (SFA), sacrofemoral distance (SFD), lumbar lordosis (LL), and stem angle (SA) were investigated after performing standing radiographs by means of the EOS device. One year after THA, all the above-mentioned parameters were also measured by EOS imaging before and after the surgery and the patients completed some questionnaires, which is the Oswestry Low Back Pain Disability Index (OLBPDI) to evaluate disability percentage resulting in LBP, the Knee Injury and Osteoarthritis Outcome Score (KOOS) instrument to assess knee pain, and the Harris Hip Score (HHS) measure to rate hip joint function, and then the results were analyzed using the SPSS Statistics software (ver. 17).

Results: The patients consisted of 13 males (54.2%) and 11 females (45.8%) with the mean age of 52.87±13.05. The mean score of the preoperative PI was also equal to 54.74±10.66 and it was 58.19±11.58 after the surgery (p=0.025). However, the mean values of other parameters at the preoperative stage did not show any significant changes. As well, hip joint function and knee pain resulting from LBP improved in the patients after the surgery (p<0.001).

Conclusion: The study findings demonstrated that THA probably influenced sagittal balance through PI. Moreover, the postoperative hip joint function, knee pain, and disability percentage caused by LBP significantly enhanced compared with those before the surgery. Thus, it was concluded that the evaluation of sagittal balance parameters could help patients with orthopedic pain.

DOI: 10.29245/2767-5130/2023/2.1164 View / Download Pdf

Michael Tang1, William Fowler1, Oday Al-Dadah1,2*

1Department of Trauma and Orthopaedic Surgery, South Tyneside District Hospital, Harton Lane, South Tyneside, United Kingdom

2Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Framlington Place, Newcastle-upon-Tyne, United Kingdom

Objectives: The Nottingham hip fracture score (NHFS) and the Surgical outcome risk tool (SORT) are both validated scoring systems used to predict mortality rates in patient with Fractured neck of femur (FnF). The primary aim of this study was to compare the accuracy of the predicted 30-day mortality rates between NHFS and SORT in patients with FnF. The secondary aim was to investigate the influence of patient and surgical factors on 30-day mortality.

Methods: The NHFS and SORT score was collected from 212 patients admitted with FnF. Variables including hip fracture type, surgical procedure and peri-operative haemoglobin, gender and ASA grade were also collected and further analysed to assess their influence on 30-day mortality rates.

Results: Overall actual 30-day mortality rate for the study population was 11.3% (n=24). There was a significant difference between the mean predicted 30-day mortality for the NHFS (8.0%) and the SORT score (7.0%, p=0.006). The was no difference in mortality rates between the different fracture types (p=0.889). There was a significant difference in mortality rates when comparing surgical procedures (p=0.031). Patients who had a notable fall in haemoglobin peri-operatively had significantly higher mortality rates (p<0.001). Males had significantly higher mortality rates compared to females (20.0% vs 8.6% respectively, p=0.027). Higher ASA grades also had significantly higher mortality rates (p=0.003).

Conclusion: NHFS was found to be significantly more accurate at calculating 30-day mortality rates compared to the SORT score in patients with FnF. Surgical procedure and patient factors including gender, ASA grade and peri-operative haemoglobin also significantly influenced mortality rates but fracture type did not.

DOI: 10.29245/2767-5130/2023/1.1166 View / Download Pdf

Thomas J. Kean

Biionix Cluster, Internal Medicine, College of Medicine, University of Central Florida, Orlando, FL, USA

DOI: 10.29245/2767-5130/2023/1.1172 View / Download Pdf

Amina Ait Belmahjoub Aamre MD1, Sergio Barroso Rosa FEBOT PhD1,2*

1Department of Medical and Surgical Sciences, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain

2Department of Orthopaedics, Complejo Hospitalario Universitario Insular Materno Infantil de Gran Canaria, Las Palmas de Gran Canaria, Spain

Introduction: Currently there are limited options for shoulder adhesive capsulitis treatment, some of which do not have sufficient backing scientific evidence. This entails a relevant setback for patients, especially in severe or refractory cases. In recent years, remote arterial embolization therapies have demonstrated usefulness in the management of diverse musculoskeletal conditions. This systematic review examines the therapeutic role of arterial embolization in patients with shoulder adhesive capsulitis.

Methods: A systematic review of articles published to date was performed, according to the methodology in the Cochrane Systematic Reviews Manual (MECIR) and the PRISMA checklists. PubMed, Scopus, Google Scholar, three other databases and three trial registries were examined for relevant studies. The ROBINS-I tool was used for quality assessment of included studies.

Results: Ninety four potential articles were found, seven of which were included. In the selected studies, arterial embolization was carried out in 127 patients, 113 of whom had abnormal vessels. In all studies, a reduction in pain and improvement in mobility was observed in less than six months after the procedure. There were no major adverse effects or recurrent symptoms reported. Due to large data heterogeneity, a meta-analysis was not performed. Three literature reviews were also included as part of the background discussion.

Conclusions: Arterial embolization is an effective and safe treatment option in patients with shoulder adhesive capsulitis, resulting in reduced pain and restored joint function. Controlled randomized trials are required to evaluate the attributable effect of the technique to the reported clinical improvement.

DOI: 10.29245/2767-5130/2023/1.1170 View / Download Pdf

Lauren McMichan1*, Dawn A. Skelton2, Sebastien F.M. Chastin2,3, Alexandra Mavroeidi1

1Department of Physical Activity for Health, School of Psychological Science and Health, University of Strathclyde, Glasgow, UK

2Research Centre for Health (ReaCH), Department of Physiotherapy and Paramedicine, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK

3Department of Movement and Sports Science, Ghent University, Ghent, Belgium

Introduction: Understanding daily movement patterns (i.e., the relative proportion of time spent on Sedentary behaviour (SB), light physical activity (LPA), moderate-vigorous physical activity (MVPA) and sleep) to establish links with chronic diseases is a contemporary topic. Little research has looked at the effects of 24-hour movement behaviour on bone health (particularly bone mineral density (BMD)) despite investigation on other health parameters.

The aim of this rapid narrative review was to build on previous work published on the association between SB and BMD in older adults by investigating the association of the more holistic 24- hour movement behaviours in relation to BMD.

Methods: A database search of Web of Science and NIH PubMed was conducted using broad MeSH terms (older adults, sedentary, and bone). Searches were limited from the year 2019 onward.

Results/Discussion: Five published articles were reviewed, and there are discrepancies amongst the findings which could be attributed to the different measurement methods (Peripheral Quantitative Computed Tomography (pQCT) versus Dual-energy X-Ray Absorptiometry (DEXA)) and the sites of measured BMD. There are also notable differences between genders, with BMD in men appearing to be most reliant on time spent in MVPA, compared to women who appear to see benefit to BMD with replacement of SB with LPA and not require more time spent in MVPA. This highlights the complexity of movement behaviours and requires further research.

DOI: 10.29245/2767-5130/2022/3.1167 View / Download Pdf

Marcus Wong*, Jonathan J Lee, Jaime Guerrero, Sean M Barber

Department of Neurosurgery, Houston Methodist Neurological Institute, Houston, TX, USA

DOI: 10.29245/2767-5130/2022/3.1165 View / Download Pdf

Eiko Sakai1*, Mari Sato2, Chikara Sato2,3,4

1Division of Dental Pharmacology, Department of Developmental and Reconstructive Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan

2National Institute of Advanced Industrial Science and Technology, Tsukuba, Japan

3School of Integrative and Global Majors (SIGMA), University of Tsukuba, Tsukuba, Japan

4Biological Science Course, Graduate School of Science and Engineering, Aoyama Gakuin University, Sagamihara, Japan

DOI: 10.29245/2767-5130/2022/3.1168 View / Download Pdf

Jennifer R. Arthurs1, Zubin Master2,  Shane A. Shapiro3*

1Regenerative Medicine Therapeutics Program, Mayo Clinic, Jacksonville, Florida, USA

2Biomedical Ethics Research Program and the Center for Regenerative Medicine, Mayo Clinic, Rochester, Minnesota, USA

3Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, Florida, USA

Stem cell therapies occupy a unique place in the American public’s consciousness which has led to excessive enthusiasm over their potential to cure orthopedic conditions. Much has been written about direct-to-consumer marketing of cell therapies for a myriad of medical conditions. Far less has been studied on the attitudes that drive many patients to seek stem cell and orthobiologic therapies for musculoskeletal conditions. Previously published research on patient motivations for seeking stem cell therapy to treat orthopedic maladies such as osteoarthritis and chronic tendinopathies has shown that some patients were motivated by factors not supported by current medical evidence. These differing responses strongly suggest the need for patient-centered counseling to address misinformation about stem cell therapies for musculoskeletal conditions and increase health literacy about outcomes of orthobiologics.

DOI: 10.29245/2767-5130/2022/3.1162 View / Download Pdf

Aneesh G. Patankar1*, Suleiman Y. Sudah2, Christopher R. Michel2, David S. Constantinescu3, Mariano E. Menendez4, Jeremy B. Ruskin5, Ajul Shah6

1Rutgers, Robert Wood Johnson Medical School, Piscataway, NJ, USA

2Department of Orthopedics, Monmouth Medical Center, Long Branch, NJ, USA

3Department of Orthopedic Surgery, University of Miami, Miami, FL, USA

4Midwest Orthopaedics at Rush, Rush University, Chicago, IL, USA

5Central Jersey Hand Surgery, Eatontown, NJ, USA

6The Center for Hand and Upper Extremity Surgery, Institute for Advanced Reconstruction, Shrewsbury, NJ, USA

Purpose: Sociodemographic factors have been shown to influence musculoskeletal health. However, little is known regarding the frequency of reporting and analysis of certain sociodemographic variables (e.g., age, sex, height, weight, body mass index (BMI), race, and ethnicity) in randomized clinical trials (RCTs) pertaining to hand surgery. The purpose of this study was to assess the rate of reporting and analysis of these variables in RCTs published in the Journal of Hand Surgery (JHS).

Methods: A systematic review was conducted of RCTs published in JHS between 2015 and 2021. For each study, we determined whether the following sociodemographic variables were reported and/or analyzed: age, sex, height, weight, BMI, race, and ethnicity. Frequencies were reported by year and as a cumulative total. Studies were evaluated using the Cochrane risk-of-bias tool.

Results: A total of 45 RCTs met inclusion criteria, with about half (53.3%) originating from the United States. Age (97.8%) and sex (91.1%) were the most frequently reported sociodemographic variables, followed by race (17.8%), BMI (11.1%), and ethnicity (8.9%). Age (17.8%) was the most frequently analyzed variable, followed by sex (13.3%), and race (4.4%); the remaining variables were not analyzed in any study.

Conclusions: While age and sex are reported at a high rate, only about 1 in 4 RCTs published in JHS report either race or ethnicity. All sociodemographic variables were infrequently included as part of statistical analysis. The significance of these findings should be recognized and used to interpret and enhance the methodology of future RCTs.

DOI: 10.29245/2767-5130/2022/2.1160 View / Download Pdf

Kathryn A. Barth, Claire D. Eliasberg, Karen M. Sutton*

Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA

There has been an increasing focus on sex-specific differences within the context of sports medicine. Differences exist between the sexes leading to disparities in the types of injuries female athletes sustain and the rates at which they experience them. Recognition and awareness of subtle differences between the sexes can lead to a more nuanced diagnosis and treatment of such injuries. The purpose of this study is to review shoulder pathologies that are relevant to the female athlete, specifically adhesive capsulitis, multidirectional instability, and traumatic unidirectional shoulder instability, and highlight the differences in diagnosis, treatment, and outcomes between the sexes. Women suffer from adhesive capsulitis at a greater rate than men and there are risk factors such as breast cancer surgery that are unique to women. Females are much more likely to experience atraumatic shoulder instability than their male counterparts. While females represent a minority of patients who suffer traumatic unidirectional shoulder instability, they should not be overlooked with regards to this condition. There are challenges related to the diagnosis and treatment of these pathologies that are distinctive to female athletes.

DOI: 10.29245/2767-5130/2022/2.1130 View / Download Pdf

Ryan S. Marder, Neil V. Shah, Aditya V. Maheshwari*

Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York (SUNY) Downstate Medical Center, Brooklyn, New York, USA

DOI: 10.29245/2767-5130/2022/2.1159 View / Download Pdf

Jenna M. Wahbeh1,2, Claire J. Bogosian1,3, Natalie M. Kistler1,4, Sang-Hyun Park1,5, Edward Ebramzadeh1,4,5, Sophia N. Sangiorgio1,2,5*

1The J. Vernon Luck, Sr., M.D. Orthopaedic Research Center, Orthopaedic Institute for Children in Alliance with UCLA, Los Angeles, CA, USA

2Department of Bioengineering, University of California, Los Angeles, CA, USA

3Department of Bioengineering, University of California, Berkeley, CA, USA

4Department of Biomedical Engineering, University of Southern California, Los Angeles, CA, USA

5Department of Orthopaedic Surgery, University of California, Los Angeles, CA, USA

Background: Reviews of total disc arthroplasty (TDA) performance have focused on prospective randomized controlled trials (RCTs), excluding potentially important clinical information reported by others. The goal of the present study was to perform a comprehensive review, including both RCTs and non-randomized cohorts with more than five years of clinical outcome. We further explored the differences in outcome between prospective RCT and non-randomized, including retrospective studies.

Methods: A systematic literature review was performed following PRISMA guidelines. Inclusion criteria were: clinical follow-up ≥ 5 years with quantitative clinical and radiographic outcome. All studies that met these criteria, including retrospective and non-randomized studies, were included, for a total of 62 studies. As anterior cervical discectomies and fusion (ACDF) was included as a control group in the majority of the studies, comparisons between TDA and ACDF were conducted.

Results: Overall, there was a statistically significant difference between the rates of secondary surgeries reported for prospective RCTs and all other studies, with reoperation rates of 5.4% for prospective RCT studies v. 7.5% in all others (P<0.01). Including all studies, the reoperation rate for TDA patients was 5.6% and for fusion patients (included as control groups), 7.8%, (P=0.06). Overall, the reported incidence of adjacent segment degeneration was 26.2% in TDA patients and 43.9% in fusion patients (P<0.001).

Conclusions: These findings demonstrated the need for including all available data to assess the current outcomes of cervical disc arthroplasty and account for potential biases.

DOI: 10.29245/2767-5130/2022/2.1158 View / Download Pdf

Ann Spence1*, Carrie Gilligan, Janine Bartholomew2

1Department of Nursing, Carlow University, Pittsburgh, PA, USA

2Department of Biology, Portage Learning, Beaver Falls, PA, USA

DOI: 10.29245/2767-5130/2022/1.1155 View / Download Pdf

Ashim Gupta

General Therapeutics, Cleveland Heights, OH, USA

Future Biologics, Lawrenceville, GA, USA

South Texas Orthopaedic Research Institute(STORI Inc.), Laredo, TX, USA

DOI: 10.29245/2767-5130/2022/1.1157 View / Download Pdf

Adeel Hamid*, Usman Gill, Mian Hanif

Department of Orthopaedic Surgery, Lahore General Hospital and Post Graduate Medical Institute, Lahore, Pakistan

In order to achieve good results following Total hip replacement , proper and reproducible acetabular cup placement is of paramount importance. The safe zone described by Lewwinick is still considered to be the target cup position. Various techniques have been used to improve the precision and accuracy of cup placement including the use of computer navigation which is often prohibitively expensive for developing countries. We present a ‘No touch smartphone technique’ to check positioning of acetabular cup intra operatively, without compromising the sterility of the operative field which we have found to be simple, quick, inexpensive and reproducible.

DOI: 10.29245/2767-5130/2022/1.1156 View / Download Pdf

Jingqiao Chen1,3#, Kaiwei Shen1#, Zhiming Lu1,2, Eryou Feng1*

1Department of Arthrosis Surgery, Fuzhou Second Hospital Affiliated to Xiamen University, Fuzhou, China

2The Third School of Clinical Medicine, Fujian Medical University, Fuzhou Fujian, China

3The Second School of Clinical Medicine, Fujian University of Traditional Chinese Medicine, Fujian, China

#These authors contributed equally to this work

Background: Patients with severe lumbar spine diseases run a high risk of dislocation after total hip arthroplasty. Therefore, it is essential to determine the pathological effect of common lumbar diseases on pelvic motions before the surgery.

Aim: This study reviewed the literature on the hip-spine relationship during total hip arthroplasty and explored the degenerative presentations and management of four common lumbar disorders. The review showed that patients with the spinal deformity in ankylosing spondylitis (AS) were characterized by thoracolumbar kyphosis with corresponding hip extension and pelvic retroversion, prone to anterior hip dislocation; patients with lumbar spinal fusion (LSF) were more susceptible to prosthetic impingement and ultimate dislocation, especially in the limited posterior tilt of the pelvis while sitting; those with degenerative disc disease (DDD) had a greater compensatory pelvic posterior angle while standing and greater hip joint flexion while sitting to compensate for the reduced lumbar flexion; those with degenerative lumbar spondylolisthesis (DSPL) demonstrated a pelvic flexibility with a much wider range and relative acetabular anteversion, especially when standing.

Recommendation: According to the literature, spinal osteotomy and total hip arthroplasty are the most common surgical interventions in AS cases. DSPL is classified into the Flexible & Unbalanced type and should be placed more posteriorly, but the literature suggests that patients with lumbar instability should first be placed in a more predictable position. In contrast, LSF and DDD are categorized as the Rigid & Balanced type. For these two types of disorders, the literature suggests that acetabular prostheses require more anterior tilt at the time of implantation.

Conclusion: These findings indicate that for degenerative lumbar disorders, a balance between stable component implantation and minimal wear should be based on the different changes in spinopelvic mobility.

DOI: 10.29245/2767-5130/2022/1.1151 View / Download Pdf

Ryan P. Hubble1,2, Henry Wang1,3, Paul Nagelkirk3, Jason M. Avedesian1,4, Robert Wilkinson1,3, D. Clark Dickin1,3*

1Biomechanics Laboratory, Ball State University, Muncie, IN, USA

2Wesley College of Health and Behavioral Sciences, Public and Allied Health, Delaware State University, Dover, DE, USA

3School of Kinesiology, Ball State University, Muncie, IN, USA

4Clemson University, Clemson, SC, USA

Plyometric training is one commonly used method of improving jump performance through improving explosive power generation. Research has also demonstrated that whole body vibration (WBV) can improve jumping and enhance explosive strength especially when supplementing resistance and plyometric training programs. With the drop jump being a common training skill, proper lower extremity landing mechanics are important to consider. Limited evidence suggests that WBV may reduce ground reaction forces and improve knee stability however, its influence on knee loading have not been reported. This study sought to examine the effects of WBV on ground reaction forces and knee valgus during a drop jump. 19 participants (10 female) completed drop jumps pre, immediately post, 10 & 20 minutes post WBV. Results were analyzed by repeated measures ANOVA. Main findings indicated that valgus knee angle increased significantly (p=0.011) post vibration and remained elevated across the 10 & 20 minute post vibration time intervals. Significant differences between sexes revealed that females demonstrated greater internal knee abduction moments (p=0.038). Findings that WBV increases knee valgus angle, a position linked to anterior cruciate ligament injury, suggest further investigation understand the effects of WBV on neuromuscular control and eccentric loading. Strength and conditioning professionals should exercise caution when incorporating WBV into plyometric protocols.

DOI: 10.29245/2767-5130/2021/1.1152 View / Download Pdf

Adel A Elbeialy1*, Abdlnby M Bauomi2, Basma M Elnaggar1, Hala M Elzomor1

1Department of Rheumatology, Al-Azhar faculty of Medicine, Cairo, Egypt

2Department of Radiology, Al-Azhar faculty of Medicine, Cairo, Egypt

DOI: 10.29245/2767-5130/2022/1.1153 View / Download Pdf

Freddy Mertens Bombah¹*, Alphonse Ngalame², René Essomba³, Yannick Ekani Boukar², Enrique Zoa Nkoa4, Daniel Handy Eone4

1Department of Surgery and Specialty, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Cameroon

2Department of Gynecology and Obstetrics, Faculty of Health Sciences, University of Buea, Cameroon

3Department of Surgery and Specialty, Higher Institute of Medical Technology, University of Douala, Cameroon

4Department of Surgery and Specialty, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Cameroon

Introduction: Obstetric fractures or Birth fractures are rare events following childbirth. Although fracture of the femur is a relatively uncommon injury, it is the most common fracture of the lower extremity in the newborn. Since evolution of cesarean section rates in Africa, it is one of the most commonly practiced modes of delivery for breech. We described one case of fracture of the femur at cesarean section treated at Adlucem hospital in bonabéri-Douala (Cameroon).

Case report: A 2.1 kg male infant was delivered by lower segment cesarean section for breech presentation. Clinical and radiological examination showed shaft fracture of femur with good evolution.

Discussion: Fractures of the long bones are associated with cesarean section, breech delivery with assistance and low birth weight. Femoral fractures are the most associated long bones fracture with cesarean section.

Conclusion: The clinical and paraclinical diagnosis is simple and the management is mostly non-operative. It is important to explain to the parents and especially to the mother the benignity of the lesion.

DOI: 10.29245/2767-5130/2021/3.1150 View / Download Pdf

Nicholas M Bertha, Adeshina Adeyemo, Kevin J Perry, Gary F Updegrove*

Department of Bone and Joint, Penn State Milton Hershey Medical Center, Hershey, Pennsylvania, USA

DOI: 10.29245/2767-5130/2021/3.1146 View / Download Pdf