The effect of uterine fibroid region and depth on endometrial stress and strain: a finite element approach.

Uterine fibroids are common benign gynecological tumors that are observed in up to 80% of premenopausal women. It is understood that as the fibroid size increases, the surrounding tissues will be subject to greater loads. However, the effect of fibroid region on the uterine structure is not as clear.

The Value of Using Patient-Specific 3D-Printed Anatomical Models in Surgical Planning for Patients With Complex Multifibroid Uteri.

Objectives: To compare surgeon responses regarding their surgical plan before and after receiving a patient-specific three-dimensional (3D)-printed model of a patient's multifibroid uterus created from their magnetic resonance imaging.

Methods: 3D-printed models were derived from standard-of-care pelvic magnetic resonance images of patients scheduled for surgical intervention for multifibroid uterus. Relevant anatomical structures were printed using a combination of transparent and opaque resin types.

Individualized medicine using 3D printing technology in gynecology: a scoping review.

Objective: Developments in 3-dimensional (3D) printing technology has made it possible to produce high quality, affordable 3D printed models for use in medicine. As a result, there is a growing assessment of this approach being published in the medical literature. The objective of this study was to outline the clinical applications of individualized 3D printing in gynecology through a scoping review.

Endometriosis Imaging: Enter the Metaverse of Possibilities.

Although laparoscopy has classically been defined as the gold standard for diagnosis of endometriosis, there is now a strong recommendation for the use of advanced imaging in diagnosing the disease. In addition to playing a crucial role in the diagnosis of endometriosis, advanced imaging is also essential for assisting gynaecologic surgeons in planning the surgical management of complex cases of deep endometriosis. This case demonstrates a metaverse of high-level imaging modalities, including advanced ultrasound and magnetic resonance, which were further enhanced with medical virtual reality and used for the assessment of a patient seen in an outpatient tertiary care gynaecology clinic.

Altered movement strategy during functional movement after an ACL injury, despite ACL reconstruction.

Knee joint functional deficits are common after anterior cruciate ligament (ACL) injury, but different assessment methods of joint function seem to provide contradicting information complicating recovery monitoring. We previously reported improved perceived knee function and functional performance (forward lunge ground contact time) in patients with an ACL injury from pre to 10 months post ACL reconstruction without improvement in knee-specific biomechanics. To further investigate this discrepancy, we additionally analyzed knee extensor and flexor muscle strength, and movement quality in the forward lunge (subjective and objective evaluations) and performed a full lower limb biomechanical analysis of the forward lunge movement.

Females with knee osteoarthritis use a detrimental knee loading strategy when squatting.

Background: The purpose of this study was to identify sex differences in lower limb kinematics, kinetics, and muscle activation patterns between individuals with osteoarthritis and healthy controls during a two-legged squat.

Method: Thirty OA (15 females) and 30 healthy (15 females) participants performed three 2-legged squats. Sagittal and frontal plane hip, knee, and ankle kinematics and kinetics were calculated.

Outpatient hysteroscopy is effective for uterine cavity evaluation following failed office-based endometrial biopsy.

Background: Failure to obtain an office-based endometrial biopsy for abnormal uterine bleeding is not uncommon. Although operating room-based procedures are traditionally considered the gold standard assessment tool in these circumstances, outpatient hysteroscopy is a less invasive, more cost-effective, and safer alternative. However, there is no contemporary Canadian literature on the effectiveness of an outpatient approach for this specific population.

A review and guide to creating patient specific 3D printed anatomical models from MRI for benign gynecologic surgery.

Background: Patient specific three-dimensional (3D) models can be derived from two-dimensional medical images, such as magnetic resonance (MR) images. 3D models have been shown to improve anatomical comprehension by providing more accurate assessments of anatomical volumes and better perspectives of structural orientations relative to adjacent structures. The clinical benefit of using patient specific 3D printed models have been highlighted in the fields of orthopaedics, cardiothoracics, and neurosurgery for the purpose of pre-surgical planning.

Functional muscle synergies to support the knee against moment specific loads while weight bearing.

Objective: Externally applied abduction and rotational loads are major contributors to the knee joint injury mechanism; yet, how muscles work together to stabilize the knee against these loads remains unclear. Our study sought to evaluate lower limb functional muscle synergies in healthy young adults such that muscle activation can be directly related to internal knee joint moments.

Methods: Concatenated non-negative matrix factorization extracted muscle and moment synergies of 22 participants from electromyographic signals and joint moments elicited during a weight-bearing force matching protocol.

Bowel surgery for endometriosis: A practical look at short- and long-term complications.

Endometriosis involving the bowel requires a thorough evaluation prior to deciding upon surgical treatment. Patient symptoms, treatment goals, extent and location of disease, surgeon experience, and anticipated risks all play a part in the preoperative decision-making process. Short- and long-term complications after bowel surgery for endometriosis are the focus of this article.

Forward lunge before and after anterior cruciate ligament reconstruction: Faster movement but unchanged knee joint biomechanics.

The forward lunge (FL) may be a promising movement to assess functional outcome after ACL reconstruction. Thus, we aimed to investigate the FL movement pattern before and after ACL reconstruction with a comparison to healthy controls to determine if differences were present. Twenty-eight ACL injured participants and 28 matched healthy controls were included.

Predicting post-operative functional ability from pre-operative measures in ACL-injured individuals.

Purpose: This study aimed to quantify the relationship between objective and subjective measures of functional ability and determine if measures in the deficient (ACLd) state were correlated to, and capable of predicting a patient's objective and subjective measures in the reconstructed (ACLr) state.

Methods: Twenty ACL-injured participants completed hop and side cut movements prior to and 10 months post-reconstruction. Their subjective measures (Tegner, Lysholm, IKDC, KOOS, and KNEEs) were related to objective measures of functional ability (peak knee flexion, peak knee extensor moment, stiffness, knee joint center excursion (KJCE), and knee joint center boundary).

Experimental muscle pain of the vastus medialis reduces knee joint extensor torque and alters quadriceps muscle contributions as revealed through musculoskeletal modeling.

Background: Voluntary activation deficit of the quadriceps muscle group is a common symptom in populations with knee joint injury. Musculoskeletal modeling and simulations can improve our understanding of pathological conditions; however, they are mathematically complex which can limit their clinical application. A practical subject-specific modeling framework is introduced to evaluate knee extensor inhibition and muscle force contributions to isometric knee joint torques in healthy adults with and without experimentally induced quadriceps muscle pain.

Assessment of objective dynamic knee joint control in anterior cruciate ligament deficient and reconstructed individuals.

Background: There is a lack of objective dynamic knee joint control measures that can be related to the status of the anterior cruciate ligament (ACL). The purpose of this study was to introduce two novel measures and apply a third to determine how dynamic knee joint control changes in relation to ACL status during dynamic movements.

Methods: Twenty patients (13 male) were tested pre- (ACLd) and 10-months post- (ACLr) ACL reconstructive surgery and matched to an uninjured participant (CON).

Anterior cruciate ligament reconstruction improves subjective ability but not neuromuscular biomechanics during dynamic tasks.

Purpose: The purpose of this study was to identify high-functioning anterior cruciate ligament-deficient patients and assess the effects of reconstruction on their self-reported functionality, muscle activations and biomechanical properties.

Methods: Twenty young and active patients participated pre- (11.5 ± 14.

Differences in EMG-moment relationships between ACL-injured and uninjured adults during a weight-bearing multidirectional force control task.

Anterior cruciate ligament injury (ACLi) reduces mechanical knee joint stability. Differences in muscle activation patterns are commonly identified between ACLi individuals and uninjured controls (CON); however, how and which of these differences are adaptations to protect the knee or adversely increase risk of joint instability remain unclear. Since the neuromuscular system integrates activity of all muscles crossing the knee to create a moment-of-force that opposes an external load, this study sought to quantify differences in individual muscle electromyography (EMG)-moment relationships between ACLi and CON.

A hierarchy in functional muscle roles at the knee is influenced by sex and anterior cruciate ligament deficiency.

Background: Sex-related neuromuscular differences have been linked to greater risk of anterior cruciate ligament injuries in females. Despite this, it remains unclear if sex-related differences are present after injury. This study sought to determine if sex differences are present in the functional roles of knee joint muscles in an anterior cruciate ligament deficient population.

Neuromuscular adaptations in older males and females with knee osteoarthritis during weight-bearing force control.

Background: Females exhibit significantly greater incidence, prevalence, and severity of osteoarthritis (OA) compared to males. Despite known biological, morphological, and functional differences between males and females, there has been little sex-related investigation into sex-specific biomechanical and neuromuscular responses to OA.

Objective: To identify sex-related differences in OA-affected adults and within-sex differences between healthy and OA-affected adults' muscular activation patterns during lower limb loading.

Predicting the Functional Roles of Knee Joint Muscles from Internal Joint Moments.

Introduction: Knee muscles are commonly labeled as flexors or extensors and aptly stabilize the knee against sagittal plane loads. However, how these muscles stabilize the knee against adduction-abduction and rotational loads remains unclear. Our study sought 1) to classify muscle roles as they relate to joint stability by quantifying the relationship between individual muscle activation patterns and internal net joint moments in all three loading planes and 2) to determine whether these roles change with increasing force levels.

An approach for improving repeatability and reliability of non-negative matrix factorization for muscle synergy analysis.

The aim of this study was to evaluate non-negative matrix factorization (NMF) and concatenated NMF (CNMF) to analyze and reliably extract muscle synergies. NMF and CNMF were used to extract knee joint muscle synergies from surface EMGs collected during a weight bearing, force matching task. Repeatability and between subject similarity were evaluated for each method using intra-class correlation coefficients (ICCs).

Sex-related differences in neuromuscular control: Implications for injury mechanisms or healthy stabilisation strategies?

Sex-related differences in neuromuscular activation have been previously identified and are thought to be an underlying contributor to the ACL injury mechanism. During dynamic tasks evaluating the role of muscle action as it relates to joint stability is difficult since individual muscle contributions to force generation are confounded by biomechanical factors of movement. The purpose of this study was to examine sex-related differences in knee muscle action during a weight-bearing isometric exercise and identify the stabilising role of these muscles.

Joint stabilisers or moment actuators: the role of knee joint muscles while weight-bearing.

Previous investigations have identified the roles of knee joint muscles in supporting external loads during non-weight-bearing tasks and found these to depend on moment arm orientation (MAO). However, during weight-bearing tasks ground reaction forces (GRF) are transferred up through the knee, subjecting it to large multi-directional forces and stability is dependent on articular geometry, loading, and muscle activation. The purpose of this study was to investigate activation strategies used by healthy individuals to generate and support highly controlled GRF during weight-bearing.

Reliability of knee joint muscle activity during weight bearing force control.

We developed a novel approach that requires subjects to produce and finely tune ground reaction forces (GRFs) while standing. The aim of this study was to examine the reliability of electromyographic data recorded during these tasks. Healthy young adults stood with their dominant leg in a boot fixed to a force platform.