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Objective To compare the discrepancy and consistency in mechanical axis and component position measured by electromagnetic navigation and radiograph in total knee arthroplasty (TKA)to assess whether the navigation system can be used as a substitute for radiograph.Methods A perspective study was performed on 40 cases (61 knees) undergone primary TKA under electromagnetic navigation from July 2006 to December 2006.There were 4 males and 36 females,at a mean age of (66.9 ±8.1) years (range,58-79 years).Mechanical axis angle,distal femoral and proximal tibial cut slope in coronal view (angles cα,β) were recorded both pre-and post-operatively with an intraoperative navigation system and compared against the mechanical axis angle,coronal femoral and tibial slope (angles α,β)measured via full-length radiograph of the lower limb preoperatively and at postoperative 3 months.Consistency in measurement of the same parameters with the two methods was assessed using intraclass coefficiency correlation (ICC).Results Mechanical axis determined by navigation and radiograph showed a mean valgus angle of 9.60° and 9.99° preoperatively and of 1.23° and 1.64° postoperatively,but the two pair parameters revealed no significant differences in the non-parametric test.Mean angle α determined by navigation and radiograph was 89.98° and 88.96° respectively (P ＜ 0.05),and mean angleβ was 90.21 ° and 89.59°respectively (P ＜ 0.05).With deviation value ≤3°,ICC for pre-and post-operative mechanical axis angles,angle α and angleβ was 0.887,0.754,0.632,0.640 respectively.Conclusions Within the acceptable range of deviation,intraoperative navigation data can reflect the pre-and post-operative mechanical axis and prosthesis position evaluated by radiograph.However,the advantages over the consistency of the two measurement methods rest with the evaluation of pre-and post-operative mechanical
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Objective To compare the lower limb alignment and prosthesis position after total knee arthroplasty (TKA) with or without using electromagnetic navigation.Methods Sixty-four patients (100 knees) underwent TKA under electromagnetic navigation,while 62 patients (100 knees) underwent conventional TKA.Three months after operation,the mechanical axial line angle and prosthesis position (angels α,β,γ) were measured via the full-length radiograph of both lower limbs and anteriorposterior and lateral Xrays of the knee.Results The average mechanical axial line angle and angle α were 1.20°±1.92°and 89.33°±1.64° in navigation group,respectively,and 2.31°±2.25° and 88.68°±2.57° in conventional group.And the differences were significant with regard to the above two indexes between two groups.The average angle β and angle γ were 89.64°±1.47° and 90.86°±2.37° in navigation group,respectively,and 89.26°±2.05° and 90.59°±3.44° in conventional group.However,the differences were not significant with regard to the above two indexes between two groups.After operation,mechanical axial line angle error was within ±3°in 86％ of patients in navigation group,while in 79％ of patients in conventional group; there was no significant difference between them.The angle α error was within 90°±3° in 92％ of patients in navigation group,while in 77％ of patients in conventional group; there was significant difference between them.However,there were no significant differences in percentage of patients whose errors of angle β and angle γ were within 90°±3° between two groups.Conclusion With using electromagnetic navigation in TKA,more precise prosthesis position and the mechanical axis can be achieved compared with the conventional technique.And its advantages mainly contribute to the coronal plane of the femoral side rather than the tibial side.
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BACKGROUND: The purpose of this study is to evaluate intercostal neuropathy after rib fracture and to determine the severity of intercostal neuropathy with using a numerical rating scale and according to the duration of pain and the body mass index. MATERIAL AND METHOD: We measured the positive sharp wave and fibrillation on the intercostal and paraspinal muscles in the thoracic region by performing needle electromyography in 47 patients who had intercostal neuralgia after rib fracture and who had needed daily analgesic for more than three months. RESULT: We diagnosed 11 cases as intercostal neuropathy among the 47 cases. Of the total 11 cases, 8 were male and 3 were female and they were most often of an active generation in the community. The common location of intercostal neuropathy was the intercostal space below the rib fracture and from the 7th to the 12th intercostal rib area. The incidence of intercostal neuropathy was significantly related with multiple rib fracture rather than single rib fracture. The symptoms observed were chest pain (90.9%), sensory change (81.8%), paresthesia and numbness (63.6%), back pain (27.2%) and muscle atrophy (18.2%). The numerical rating scale, the duration of pain and the body mass index showed no significant correlation with the severity of intercostal neuropathy. CONCLUSION: We concluded that the electrodiagnostic approach with considering the affecting factors and the clinical findings will be helpful for diagnosing and treating persistent intercostal neuralgic pain (more than 3 months) after rib fracture.
Subject(s)
Female , Humans , Male , Back Pain , Body Mass Index , Chest Pain , Electromagnetic Phenomena , Electromyography , Hypesthesia , Incidence , Intercostal Nerves , Muscles , Muscular Atrophy , Needles , Neuralgia , Paresthesia , Rib Fractures , RibsABSTRACT
Introdução - A estimulação magnética transcraniana (E.M.T) tem sido muito estudada recentemente. As aplicações de estimulação magnética (E.M) diretamente no músculo estriado esquelético, por outro lado, têm sido objeto de poucos estudos. Como os experimentos de Bickford em músculos humanos comprovaram ocorrência de contração muscular, hipotetizou-se que a estimulação direta do músculo com repetições freqüentes levará a movimentos semelhantes ao exercício voluntário com possível ganho de força muscular. Sendo assim, decidiu-se verificar a possibilidade de simular a contração muscular voluntária com a A.M1,8,10-11, e se é possível substituir a NMES (Estimulação Neuro Muscular) pela E.M para aplicações musculares. Material e Métodos - Foram selecionadas sete voluntárias, sedentárias e sem disfunções músculo-esqueléticas. após avaliação da resistência máxima com dinamômetro digital, as voluntárias foram submetidas a 10 sessões de E.M com intensidade de 35% da potência total do aparelho diretamente no músculo bíceps braquial. Resultados - Após os movimentos involuntários induzidos pela E.M. os sujeitos relataram todas as sensações que geralmente seguem o exercício físico; ocorreu ganho de força significativo (p<0,05) em todas as voluntárias. Conclusão - A E.M é capaz de reproduzir um padrão de contrações musculares isotônicas repetidas semelhantes às contraçõesvoluntárias; a E.M é de fácil aplicação, não sendo necessário localizar o ponto motor; a E.M é bem tolerada, o protocolo de E.M proposto pode ser intensificado se estiver disponível equipamento de E.M de alta freqüência, com refrigeração. O padrão motor produzido pela E.M difere daquele provocado pela NMES oferecendo a possibilidade de associação das duas técnicas em pacientes.
Introduction - Transcranial magnetic stimulation (MS) has been widely studied in the past few years. Reports of muscular MS, with stimuli directly applied over skeletal muscles, however, are still rare. Since the studies carried out by Bickford in the human muscle have demonstrated the induction of muscle contractions, we have hypothesised that MS, frequently applied to skeletalmuscles, might lead to increases in muscle strength. We have tested the possibility of simulating normal voluntary contractions through the use of MS; the potential use of MS as a substitute for electrical stimulation was also considered. Material and Methods - Seven healthy volunteers, sedentary and without muscular diseases, were enrolled in the study. After determination of maximal strength with a digital handlheld dynamometer, all volunteers underwent 10 MS sessions, with stimuli at 35% of maximal stimulator output applied directly over the biceps muscle. Results - After involuntary movements induced by MS, subjects reported all the subjective sensations that usually follow voluntary exercise; there was a significat (p<0.05) increase in muscle strength in all volunteers. Conclusion - We have concluded that: MS in capable of inducing a pattern of repetitive isotonic contractions similar to voluntary isotonic exercise; MS is easily applied, and there is no need for locating the motor point, MS is very well tolerated the MS protocol may be intensified by use of a high-frequency stimulator, with a built-in cooling system; the motor pattern produced by MS is different from that induced by electrical stimulation, and this suggests a possible advantage in the combined use of these techniques in patients.
Subject(s)
Humans , Exercise , Electric Stimulation Therapy , Muscle, Skeletal , Transcranial Magnetic Stimulation , Muscle Strength , Muscle Contraction , Electric StimulationABSTRACT
PURPOSE: We compared the efficacy of two shock wave energy sources; the newer electromagnetic lithotriptor(EML, Dornier Compact Delta(R)) and electroconductive lithotriptor(ECL, EDAP-Sonolith Praktis) that were used for treatment of the urinary calculi. MATERIALS AND METHODS: From January 2004 to October 2006, 614 patients were treated with EML. From January 2000 to October 2006, 936 patients were treated with ECL. Following lithotripsy, a plain abdominal film was taken 1 week after each session to determine if there were residual stones and assessed the need for retreatment. Success was defined as no residual stones. We analyzed the site and size of stones, success rate, mean session, mean treatment time, causes of failure and complications. RESULTS: The success rate was 95.9% for EML compared to 93.6% for ECL (p=0.048). The success rate was decreased for 20mm or larger stones. The treatment mean session wasn't different but the total treatment time was significantly longed for EML(58.5+/-27.1 min) compared for ECL(39.7+/-21.7 min)(p<0.05). No statistically significant difference were found in complications and failure between both groups. Insufficient fragment was most common cause of failure in both groups(1.8% for EML versus 2.4% for ECL). Gross hematuria were noted 26.4% of patient treated with EML and 26.6% of those treated with ECL. CONCLUSIONS: The EML has a little advantages over the ECL in terms of total success rate, but ECL has its advantage in mean and total treatment time. Ultimately, these two contemporary energy sources are acceptable. They are equally efficacious, judging from single center treatment and follow-up criteria.