4D-foot analysis on effect of arch support on ankle, subtalar, and talonavicular joint kinematics.

BACKGROUND: It has been difficult to study the effects of arch support on multiple joints simultaneously. Herein, we evaluated foot and ankle kinematics using a fully automated analysis system, "4D-Foot," consisting of a biplane X-ray imager and two-dimensional‒three-dimensional registration, with automated image segmentation and landmark detection tools. METHODS: We evaluated the effect of arch support on ankle, subtalar, and talonavicular joint kinematics in five healthy female volunteers without a clinical history of foot and ankle disorders. Computed tomography images of the foot and ankle and X-ray videos of walking barefoot and with arch support were acquired. A kinematic analysis using the "4D-Foot" system was performed. The ankle, subtalar, and talonavicular joint kinematics were quantified from heel-strike to foot-off, with and without arch support. RESULTS: For the ankle joint, significant differences were observed in dorsi/plantarflexion, inversion/eversion, and internal/external rotation in the late midstance phase. The dorsi/plantarflexion and inversion/eversion motions were smaller with arch support. For the subtalar joint, a significant difference was observed in all the dynamic motions in the heel-strike and late midstance phases. For the talonavicular joint, significant differences were observed in inversion/eversion and internal/external rotation in heel-strike and the late midstance phases. For the subtalar and talonavicular joints, the motion was larger with arch support. An extremely strong correlation was observed when the motion of the subtalar and talonavicular joints was compared for each condition and motion. CONCLUSIONS: The results indicated that the arch support decreased the ankle motion and increased the subtalar and talonavicular joint motions. Additionally, our study demonstrated that the in vivo subtalar and talonavicular joints revealed a strong correlation, suggesting that the navicular and calcaneal bones were moving similarly to the talus and that the arch support stabilizes the ankle joint and compensatively increases the subtalar and talonavicular joint motions.

Periprosthetic tibial fracture after total knee arthroplasty with popliteal artery injury-A case report.

We present the case of a 79-year-old woman who presented at our center with a periprosthetic tibial fracture with a popliteal artery injury after total knee arthroplasty. Anastomosis of the popliteal artery was performed on the day of injury, and was later treated by open reduction and internal fixation. The patient was able to walk 3 months after injury. The present case was difficult to treat because of the arterial injury associated with periprosthetic fracture. Although revision of the implant was considered, open reduction and internal fixation was selected because of the severity of soft-tissue damage. The mechanism of injury is not uncommon, and it is expected that similar fractures will become more prevalent in the future as the number of knee replacement surgeries increases.

Serological epidemiological surveillance for vapN-harboring Rhodococcus equi infection in goats.

Rhodococcus equi causes suppurative pneumonia in foals aged 1-3 months; moreover, it has emerged as a pathogenic cause of zoonotic diseases. After the initial report of the ruminant-pathogenic factor VapN encoded by the novel virulence plasmid pVAPN, several reports have described ruminant infections caused by vapN-harboring R. equi. Herein, we conducted a serological epidemiological surveillance in goats at a breeding farm (Farm A) and characterized the vapN-harboring R. equi isolates from this farm. First, we established a simple screening enzyme-linked immunosorbent assay (ELISA) using recombinant glutathione S-transferase-tagged VapN as an immobilized antigen. This method revealed that the VapN antibody titers were elevated in 12 of 42 goats. Subsequently, we attempted to isolate R. equi from the goat feces and soil of Farm A. choE+/vapN+R. equi was isolated from the feces of Goat No. 27 and a soil sample near the shed. The pulsed-field gel electrophoresis (PFGE) patterns of five vapN-harboring R. equi strains isolated from Farm A in 2013 and 2019 were investigated and found to be the same except for the strain (OKI2019F1). However, no difference was observed in VapN expression and growth in macrophages among these vapN-harboring R. equi isolates. Our results revealed that some goats had histories of vapN-harboring R. equi infections, and two genomic types of vapN-harboring R. equi were found in isolates from Farm A. Ruminant-specific (pVAPN-carrying) R. equi might be an unrecognized pathogen in Japan and further studies are required to determine its prevalence and distribution.