Dynamic foraminal dimensions during neck motion 6.5 years after fusion and artificial disc replacement.

Objective: To compare changes in foraminal motion at two time points post-surgery between artificial disc replacement (ADR) and anterior cervical discectomy and fusion (ACDF).

Methods: Eight ACDF and 6 ADR patients (all single-level C5-6) were tested at 2 years (T1) and 6.5 years (T2) post-surgery.

Correlation of neural foraminal motion after surgical treatment of cervical radiculopathy with long-term patient reported outcomes.

Background: Post-surgical changes in adjacent segment motion are considered a factor in further development of degeneration and cervical radiculopathy. The objective was to examine the extent of correlations between physiological motion of cervical foramina and long-term patient reported outcomes (PRO).

Methods: Biplane X-ray imaging and CT-based markerless tracking were used to measure 3D static and dynamic dimensions during neck axial rotation and extension from 18 patients treated for C5-6 radiculopathy with fusion or arthroplasty.

Shear wave elastography of the healing human patellar tendon following ACL reconstruction.

Purpose: Anterior cruciate ligament (ACL) ruptures are common and are frequently reconstructed using a patellar tendon (PT) autograft. Unfortunately, the time course of PT healing after ACL reconstruction is not particularly well understood. Thus, the primary objective of this study was to use shear wave elastography (SWE) to evaluate the extent to which shear wave speed (SWS) is associated with time after ACL reconstruction.

Clinical utilization of shear wave elastography in the musculoskeletal system.

Shear wave elastography (SWE) is an emerging technology that provides information about the inherent elasticity of tissues by producing an acoustic radiofrequency force impulse, sometimes called an "acoustic wind," which generates transversely-oriented shear waves that propagate through the surrounding tissue and provide biomechanical information about tissue quality. Although SWE has the potential to revolutionize bone and joint imaging, its clinical application has been hindered by technical and artifactual challenges. Many of the stumbling blocks encountered during musculoskeletal SWE imaging are readily recognizable and can be overcome, but progressive advances in technology and a better understanding of image acquisition are required before SWE can reliably be used in musculoskeletal imaging.

Dynamic foraminal dimensions during neck extension and rotation in fusion and artificial disc replacement: an observational study.

Background: Changes in the dimensions of the cervical neural foramina (CNF) are considered to be a key factor in nerve root compression and development of cervical radiculopathy. However, to what extent foraminal geometry differs between patients who underwent anterior cervical discectomy and fusion (ACDF) and those who underwent total disc arthroplasty with an artificial disc (AD) during physiological motion is largely unknown.

Purpose: The objective of this study is to compare CNF dimensions during physiological neck motion between ACDF and AD.

Association Between Years of Competition and Shoulder Function in Collegiate Swimmers.

Background: Shoulder injuries are common among competitive swimmers, and the progression of shoulder pathology is not well understood. The objective of this study was to assess the extent to which years of competitive swim training were associated with physical properties of the supraspinatus muscle and tendon, shoulder strength, and self-reported assessments of shoulder pain and function.

Hypothesis: Increasing years of competition will be associated with declining physical properties of the supraspinatus muscle/tendon and declining self-reported assessments of pain and function.

Effects of age and pathology on shear wave speed of the human rotator cuff.

Rotator cuff tears are common and often repaired surgically, but post-operative repair tissue healing, and shoulder function can be unpredictable. Tear chronicity is believed to influence clinical outcomes, but conventional clinical approaches for assessing tear chronicity are subjective. Shear wave elastography (SWE) is a promising technique for assessing soft tissue via estimates of shear wave speed (SWS), but this technique has not been used extensively on the rotator cuff.

Dynamic measurements of cervical neural foramina during neck movements in asymptomatic young volunteers.

Purpose: Neural foraminal dimensions are considered important in nerve root compression and development of cervical radiculopathy, but baseline data regarding their range during normal motion are not available. An in vivo study of cervical foraminal motion was conducted to characterize normal 3D dynamic foraminal dimensions during physiological neck motion and compare between different tasks and intervertebral segments.

Methods: Biplane X-ray imaging and computed tomography-based markerless tracking were used to measure foraminal height (FH) and width (FW) from five asymptomatic subjects during neck axial rotation and extension.

Effects of asymptomatic rotator cuff pathology on in vivo shoulder motion and clinical outcomes.

Background: The incidence of asymptomatic rotator cuff tears has been reported to range from 15% to 39%, but the influence of asymptomatic rotator cuff pathology on shoulder function is not well understood. This study assessed the effects of asymptomatic rotator cuff pathology on shoulder kinematics, strength, and patient-reported outcomes.

Methods: A clinical ultrasound examination was performed in 46 asymptomatic volunteers (age: 60.

Shear wave elastography of the supraspinatus muscle and tendon: Repeatability and preliminary findings.

Shear wave elastography (SWE) is a promising tool for estimating musculoskeletal tissue properties, but few studies have rigorously assessed its repeatability and sources of error. The objectives of this study were to assess: (1) the extent to which probe positioning error and human user error influence measurement accuracy, (2) intra-user, inter-user, and day-to-day repeatability, and (3) the extent to which active and passive conditions affect shear wave speed (SWS) repeatability. Probe positioning and human usage errors were assessed by acquiring SWE images from custom ultrasound phantoms.

Effects of Rotator Cuff Pathology and Physical Therapy on In Vivo Shoulder Motion and Clinical Outcomes in Patients With a Symptomatic Full-Thickness Rotator Cuff Tear.

Background: Physical therapy (PT) is often prescribed for patients with rotator cuff tears. The extent to which PT influences strength, range of motion (ROM), and patient-reported outcomes has been studied extensively, but the effect of PT on in vivo joint kinematics is not well understood.

Purpose: To assess the influence of symptomatic rotator cuff pathology and the effects of PT on shoulder motion, strength, and patient-reported outcomes.

Measuring Three-Dimensional Thorax Motion Via Biplane Radiographic Imaging: Technique and Preliminary Results.

Measures of scapulothoracic motion are dependent on accurate imaging of the scapula and thorax. Advanced radiographic techniques can provide accurate measures of scapular motion, but the limited 3D imaging volume of these techniques often precludes measurement of thorax motion. To overcome this, a thorax coordinate system was defined based on the position of rib pairs and then compared to a conventional sternum/spine-based thorax coordinate system.

Effect of Arthroscopic Stabilization on In Vivo Glenohumeral Joint Motion and Clinical Outcomes in Patients With Anterior Instability.

Background: Glenohumeral joint (GHJ) dislocations are common, and the resulting shoulder instability is often treated with arthroscopic stabilization. These procedures result in favorable clinical outcomes, but abnormal GHJ motion may persist, which may place patients at risk for developing osteoarthritis. However, the effects of shoulder instability and arthroscopic stabilization on GHJ motion are not well understood.

Fracture patterns on the infant porcine skull following severe blunt impact.

The objective of this study was to document patterns of fracture on infant porcine skulls aged 2-28 days (n = 57) because of a single, high energy blunt impact to the parietal bone with rigid (nondeformable) and compliant (deformable) interfaces. Fracture patterns were mapped using Geographic Information System software. For the same generated impact force, the rigid interface produced more fractures than the compliant interface for all ages.

Pure passive hyperextension of the human cadaver knee generates simultaneous bicruciate ligament rupture.

Knee hyperextension has been described as a mechanism of isolated anterior cruciate ligament (ACL) tears, but clinical and experimental studies have produced contradictory results for the ligament injuries and the injury sequence caused by the hyperextension loading mechanism. The hypothesis of this study was that bicruciate ligament injuries would occur as a result of knee hyperextension by producing high tibio-femoral (TF) compressive forces that would cause anterior translation of the tibia to rupture the ACL, while joint extension would simultaneously induce rupture of the posterior cruciate ligament (PCL). Six human knees were loaded in hyperextension until gross injury, while bending moments and motions were recorded.

Characteristics and prediction of cranial crush injuries in children.

This study documents four clinical cases of fatal crush injuries to children between 1.5 and 6 years of age with correlations between modeled stress and clinically observed fracture patterns. The clinical case fractures were concentrated in the basicranium, bridged the impact sites, and traversed the middle cranial fossa in the area of the spheno-occipital synchondrosis.

Age-dependent fracture characteristics of rigid and compliant surface impacts on the infant skull--a porcine model.

This study documents skull fracture characteristics on infant porcine specimens under known impact conditions with respect to age and interface. A single impact causing fracture was conducted on the skull of porcine specimens aged 2-28 days (n = 76). Paired rigid and compliant impacts at the same energy were conducted at each specimen age.

Age dependent mechanical properties of the infant porcine parietal bone and a correlation to the human.

An infant less than 18 months of age with a skull fracture has a one in three chance of abuse. Injury biomechanics are often used in the investigation of these cases. In addition to case-based investigations, computer modeling, and test dummies, animal model studies can aid in these investigations.

Tibiofemoral contact pressures and osteochondral microtrauma during anterior cruciate ligament rupture due to excessive compressive loading and internal torque of the human knee.

Background: The knee is one of the most frequently injured joints, including 80 000 anterior cruciate ligament (ACL) tears in the United States each year. Bone bruises are seen in over 80% of patients with ACL injuries, and have been associated with an overt loss of cartilage overlying those regions within 6 months of injury.

Hypothesis: The level of contact pressure developed in the human knee joint and the extent of articular cartilage and underlying subchondral bone injuries will depend on the mechanism of applied loads/moments during rupture of the ACL.