The sit-to-stand movement: differences in performance between patients after primary total hip arthroplasty and revision total hip arthroplasty with acetabular bone impaction grafting.

BACKGROUND: Little is known about the functional performance of patients after revision total hip arthroplasty with major acetabular bone impaction grafting. In general, these patients are assumed to perform worse due to a more advanced stage of periarticular tissue degeneration and multiple surgeries compared with patients with primary total hip arthroplasty (THA). OBJECTIVE: The main purpose of this study was to quantify the differences in performance of the sit-to-stand (STS) movement between patients with primary THA and patients with revision THA. DESIGN AND METHODS: In this study, the STS movement was analyzed kinematically (knee and hip angular extension velocity) and kinetically (loading symmetry ratio). Ten patients after primary THA and 10 patients after revision THA with acetabular bone impaction grafting were compared using these 3 rising parameters. RESULTS: The patients with revision THA performed the STS movement comparably to the patients with primary THA; there were no differences in knee and hip velocity or leg asymmetry during rising. LIMITATIONS: The study focused only on kinetic and kinematic aspects, and only patients who were satisfied with their THA were involved. CONCLUSIONS: This study showed that patients after a revision THA with acetabular bone impaction grafting and cement did not perform the STS movement differently, either kinematically or kinetically, compared with patients with a primary THA.

Sit-to-stand movement as a performance-based measure for patients with total knee arthroplasty.

BACKGROUND: Functional recovery of patients after a total knee arthroplasty (TKA) usually is measured with questionnaires. However, these self-report measures assess the patient's perspective on his or her ability to perform a task. Performance-based tests are needed to assess the patient's actual ability to perform a task. OBJECTIVE: The main purpose of this study was to quantify improvement in performance of the sit-to-stand movement of patients with a TKA. DESIGN AND METHODS: In this prospective study of 16 patients with end-stage knee osteoarthritis followed by a TKA, the maximal knee angular extension velocity and amount of unloading (shifting weight) of the affected leg during the sit-to-stand movement and the visual analog scale score for pain were assessed preoperatively and 6 months and 1 year postoperatively. These data were compared with data for a control group of individuals who were healthy (n=27). RESULTS: Before surgery, the participants in the TKA group unloaded their affected leg, but within 6 months after implantation, the affected leg was almost fully loaded again and comparable to the loading symmetry ratio of the control group. Furthermore, knee extension velocity also had increased, but remained lower than that of the control group. The changes in knee extension velocity took place during the first 6 months, after which a plateau was visible. Limitations A potential limitation of the study design was that the patients were not perfectly matched with the control subjects. CONCLUSIONS: Implantation of a total knee prosthesis partly improved performance of the sit-to-stand movement. Participants in the TKA group could fully load their operated leg, but they could not generate enough knee angular velocity during rising compared with the control group.

The accuracy of measuring the kinematics of rising from a chair with accelerometers and gyroscopes.

The purpose of this study was to assess the accuracy of measuring angle and angular velocity of the upper body and upper leg during rising from a chair with accelerometers, using low-pass filtering of the accelerometer signal. Also, the improvement in accuracy of the measurement with additional use of high-pass filtered gyroscopes was assessed. Two uni-axial accelerometers and one gyroscope (DynaPort) per segment were used to measure angles and angular velocities of upper body and upper leg. Calculated angles and angular velocities were compared to a high-quality optical motion analysis system (Optotrak), using root mean squared error (RMS) and correlation coefficient (r) as parameters. The results for the sensors showed that two uni-axial accelerometers give a reasonable accurate measurement of the kinematics of rising from a chair (RMS = 2.9, 3.5, and 2.6 degrees for angle and RMS = 9.4, 18.4, and 11.5 degrees /s for angular velocity for thorax, pelvis, and upper leg, respectively). Additional use of gyroscopes improved the accuracy significantly (RMS = 0.8, 1.1, and 1.7 degrees for angle and RMS = 2.6, 4.0 and 4.9 degrees /s for angular velocity for thorax, pelvis and upper leg, respectively). The low-pass Butterworth filter had optimal cut-off frequencies of 1.05, 1.3, and 1.05 for thorax, pelvis, and upper leg, respectively. For the combined signal, the optimal cut-off frequencies were 0.18, 0.2, and 0,38 for thorax, pelvis and upper leg, respectively. The filters showed no subject specificity. This study provides an accurate, inexpensive and simple method to measure the kinematics of movements similar to rising from a chair.

Residues 10-18 within the C5a receptor N terminus compose a binding domain for chemotaxis inhibitory protein of Staphylococcus aureus.

Chemotaxis inhibitory protein of Staphylococcus aureus (CHIPS) is excreted by the majority of S. aureus strains and is a potent inhibitor of C5a- and formylated peptide-mediated chemotaxis of neutrophils and monocytes. Recently, we reported that CHIPS binds to the C5a receptor (C5aR) and the formylated peptide receptor, thereby blocking activation by C5a and formylated peptides, respectively. The anaphylatoxin C5a plays an important role in host immunity and pathological inflammatory processes. For C5a a two-site binding model is proposed in which C5a initially binds the C5aR N terminus, followed by interaction of the C5a C-terminal tail with an effector domain on the receptor. We have shown here that CHIPS does not affect activation of the C5aR by a peptide mimic of the C5a C terminus. Moreover, CHIPS was found to bind human embryonic kidney 293 cells expressing only the C5aR N terminus. Deletion and mutation experiments within this C5aR N-terminal expression system revealed that the binding site of CHIPS is contained in a short stretch of 9 amino acids (amino acids 10-18), of which the aspartic acid residues at positions 10, 15, and 18 plus the glycine at position 12 are crucial. Binding studies with C5aR/C3aR and C5aR/IL8RA chimeras confirmed that CHIPS binds only to the C5aR N terminus without involvement of its extracellular loops. CHIPS may provide new strategies to block the C5aR, which may lead to the development of new C5aR antagonists.