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Sample records for acromioclavicular joint reconstruction

  1. Arthroscopically assisted acromioclavicular joint reconstruction.

    PubMed

    Baumgarten, Keith M; Altchek, David W; Cordasco, Frank A

    2006-02-01

    Arthroscopically assisted acromioclavicular joint reconstruction avoids the large incisions necessary with open reconstructions. This acromioclavicular joint reconstruction technique via the subacromial space does not violate the rotator interval or require screw removal. The patient is placed in a modified beach-chair position. The arthroscope is placed into the subacromial space, and a bursectomy is performed through a lateral subacromial portal. The coracoacromial ligament is released from the acromion with an electrocautery and an arthroscopic elevator. A nonabsorbable suture is passed through the coracoacromial ligament with a suture passer, and an arthroscopic suture grasper is used to deliver both ends of the suture out through the lateral portal. The coracoid is identified and isolated using a radiofrequency ablator placed through the anterior portal while visualizing through the lateral portal. A percutaneous shuttle device is passed through the skin superomedial to the coracoid. The shuttle is visualized entering superior to the coracoid and is passed just medial to the coracoid. Once the tip of the shuttle can be visualized in the recess inferior to the coracoid, the shuttle loop is advanced. A suture grasper is used to deliver both ends of the shuttle out through the anterior portal. A semitendinosus allograft is used to reconstruct the coracoclavicular ligament. A nonabsorbable suture is passed through both ends of the allograft. Three strands of nonabsorbable suture are braided together. The tendon and the braided suture are shuttled around the coracoid. At this point, both the braided suture and the allograft tendon enter the anterior portal, wrap around the coracoid base, and exit the anterior portal. A 3-cm incision is made over the distal clavicle. A hole is drilled through the clavicle with a 5-mm drill. A loop of 22-gauge wire is passed through the hole in the clavicle, and a looped suture is shuttled through the hole. A curved clamp is used to

  2. A modified surgical technique for reconstruction of an acute acromioclavicular joint dislocation

    PubMed Central

    Marchie, Anthony; Kumar, Arun; Catre, Melanio

    2009-01-01

    We report a modified surgical technique for reconstruction of coracoclavicular and acromioclavicular ligaments after acute dislocation of acromioclavicular joint using suture anchors. We have repaired 3 consecutive type III acromioclavicular dislocations with good results. This technique is simple and safe and allows anatomical reconstruction of the ligaments in acute dislocations. PMID:20671868

  3. Bone Osteolysis Following Acromioclavicular Joint Reconstruction Using Synthetic Ligament (Surgilig™)

    PubMed Central

    Sarda, Praveen; Richards, Andrew M.; Corbett, Steven A.

    2013-01-01

    Good short term results have led to increased use of synthetic ligaments for acute and chronic acromioclavicular joint (ACJ) disruption. They have proved quite safe in the short term but we present two cases of osteolysis following ACJ reconstruction using a synthetic ligament, reminding surgeons of potential complications with artificial ligaments. A high index of suspicion is needed to diagnose such complications early before irretrievable bone loss to osteolysis.

  4. [Outcome after late reconstruction of dislocations of the acromioclavicular joint].

    PubMed

    Zilch, H; Steuer, H G; Friedebold, G

    1983-10-01

    In a total of 130 cases with a complete luxation of the acromioclavicular joint (Tossy III) which were treated operatively, there are included 29 cases with older injuries (6 to 28 months after accident). Late reconstruction were regarded only such cases which needed a plastic reconstruction of the lig. coracoclaviculare. An account is given of the 21 cases, followed up on an average of 5,6 years after the operation. The material for the plastic reconstruction was autologous and heterologous tendons, fascia lata, carbon-fibres-ligaments, and especially lyodura. The results are very satisfied regarding to the mobility and stability of the shoulder joints. But there was seen a high rate of arthrosis of the a.c.-joint, which causes are discussed as well as the opportunity to make an osteotomy of the clavicula to degress the pressure at this point. The arthrosis is only painful in cases with a simultaneous instability. PMID:6138966

  5. Acromioclavicular joint reconstruction using the LockDown synthetic implant: a study with cadavers.

    PubMed

    Taranu, R; Rushton, P R P; Serrano-Pedraza, I; Holder, L; Wallace, W A; Candal-Couto, J J

    2015-12-01

    Dislocation of the acromioclavicular joint is a relatively common injury and a number of surgical interventions have been described for its treatment. Recently, a synthetic ligament device has become available and been successfully used, however, like other non-native solutions, a compromise must be reached when choosing non-anatomical locations for their placement. This cadaveric study aimed to assess the effect of different clavicular anchorage points for the Lockdown device on the reduction of acromioclavicular joint dislocations, and suggest an optimal location. We also assessed whether further stability is provided using a coracoacromial ligament transfer (a modified Neviaser technique). The acromioclavicular joint was exposed on seven fresh-frozen cadaveric shoulders. The joint was reconstructed using the Lockdown implant using four different clavicular anchorage points and reduction was measured. The coracoacromial ligament was then transferred to the lateral end of the clavicle, and the joint re-assessed. If the Lockdown ligament was secured at the level of the conoid tubercle, the acromioclavicular joint could be reduced anatomically in all cases. If placed medial or 2 cm lateral, the joint was irreducible. If the Lockdown was placed 1 cm lateral to the conoid tubercle, the joint could be reduced with difficulty in four cases. Correct placement of the Lockdown device is crucial to allow anatomical joint reduction. Even when the Lockdown was placed over the conoid tubercle, anterior clavicle displacement remained but this could be controlled using a coracoacromial ligament transfer. PMID:26637681

  6. Management of acromioclavicular joint injuries.

    PubMed

    Li, Xinning; Ma, Richard; Bedi, Asheesh; Dines, David M; Altchek, David W; Dines, Joshua S

    2014-01-01

    Acromioclavicular joint injuries are among the most common shoulder girdle injuries in athletes and most commonly result from a direct force to the acromion with the arm in an adducted position. Acromioclavicular joint injuries often present with associated injuries to the glenohumeral joint, including an increased incidence of superior labrum anterior posterior (SLAP) tears that may warrant further evaluation and treatment. Anteroposterior stability of the acromioclavicular joint is conferred by the capsule and acromioclavicular ligaments, of which the posterior and superior ligaments are the strongest. Superior-inferior stability is maintained by the coracoclavicular (conoid and trapezoid) ligaments. Type-I or type-II acromioclavicular joint injuries have been treated with sling immobilization, early shoulder motion, and physical therapy, with favorable outcomes. Return to activity can occur when normal shoulder motion and strength are obtained and the shoulder is asymptomatic as compared with the contralateral normal extremity. The management of type-III injuries remains controversial and is individualized. While a return to the previous level of functional activity with nonsurgical treatment has been documented in a number of case series, surgical reduction and coracoclavicular ligament reconstruction has been associated with a favorable outcome and can be considered in patients who place high functional demands on their shoulders or in athletes who participate in overhead sports. Surgical management is indicated for high-grade (≥type IV) acromioclavicular joint injuries to achieve anatomic reduction of the acromioclavicular joint, reconstruction of the coracoclavicular ligaments, and repair of the deltotrapezial fascia. Outcomes after surgical reconstruction of the coracoclavicular ligaments have been satisfactory with regard to achieving pain relief and return to functional activities, but further improvements in the biomechanical strength of these

  7. Modified Weaver-Dunn Procedure Versus The Use of Semitendinosus Autogenous Tendon Graft for Acromioclavicular Joint Reconstruction

    PubMed Central

    Hegazy, Galal; Safwat, Hesham; Seddik, Mahmoud; Al-shal, Ehab A.; Al-Sebai, Ibrahim; Negm, Mohame

    2016-01-01

    Background: The optimal operative method for acromioclavicular joint reconstruction remains controversial. The modified Weaver-Dunn method is one of the most popular methods. Anatomic reconstruction of coracoclavicular ligaments with autogenous tendon grafts, widely used in treating chronic acromioclavicular joint instability, reportedly diminishes pain, eliminates sequelae, and improves function as well as strength. Objective: To compare clinical and radiologic outcomes between a modified Weaver-Dunn procedure and an anatomic coracoclavicular ligaments reconstruction technique using autogenous semitendinosus tendon graft. Methods: Twenty patients (mean age, 39 years) with painful, chronic Rockwood type III acromioclavicular joint dislocations were subjected to surgical reconstruction. In ten patients, a modified Weaver-Dunn procedure was performed, in the other ten patients; autogenous semitendinosus tendon graft was used. The mean time between injury and the index procedure was 18 month (range from 9 – 28). Clinical evaluation was performed using the Oxford Shoulder Score and Nottingham Clavicle Score after a mean follow-up time of 27.8 months. Preoperative and postoperative radiographs were compared. Results: In the Weaver-Dunn group the Oxford Shoulder Score improved from 25±4 to 40±2 points. While the Nottingham Clavicle Score increased from 48±7 to 84±11. In semitendinosus tendon graft group, the Oxford Shoulder Score improved from 25±3 points to 50±2 points and the Nottingham Clavicle Score from 48±8 points to 95±8, respectively. Conclusion: Acromioclavicular joint reconstruction using the semitendinosus tendon graft achieved better Oxford Shoulder Score and Nottingham Clavicle Score compared to the modified Weaver-Dunn procedure. PMID:27347245

  8. Acromioclavicular joint cyst formation.

    PubMed

    Hiller, Andrew D; Miller, Joshua D; Zeller, John L

    2010-03-01

    Acromioclavicular joint (ACJ) cysts are an uncommon and unusual sequela associated with shoulder pathophysiology. The majority of literature on ACJ cysts consists of individual case reports with no definitive literature review currently available. In addition to a comprehensive literature review, four clinical cases are presented in this report. First described by Craig (1984), a total of 41 cases have been previously reported in the literature. Of these cases, five occurred with the rotator cuff musculature intact. The remaining 36 cases of ACJ cysts occurred in patients with a complete tear/avulsion of the rotator cuff. Previous attempts at compiling a complete record of all reported cases have combined several distinct conditions into a single category. This article presents two distinct etiologies for the pathogenesis of ACJ cyst formation. In the presence of an intact rotator cuff, a Type 1 cyst can form superficially and be limited to the ACJ. Following a massive or traumatic tear of the rotator cuff, mechanical instability of the humeral head can cause a deterioration of the inferior acromioclavicular capsule (cuff tear arthropathy) and an overproduction of synovial fluid. Overtime, a "geyser" of fluid can form between the glenohumeral and the ACJ, forming a Type 2 cyst. This differentiation and categorization is essential for appropriate classification and treatment. PMID:20069645

  9. Acromioclavicular joint reconstruction with coracoacromial ligament transfer using the docking technique

    PubMed Central

    Millett, Peter J; Braun, Sepp; Gobezie, Reuben; Pacheco, Iván H

    2009-01-01

    Background Symptomatic Acromioclavicular (AC) dislocations have historically been surgically treated with Coracoclavicular (CC) ligament reconstruction with transfer of the Coracoacromial (CA) ligament. Tensioning the CA ligament is the key to success. Methods Seventeen patients with chronic, symptomatic Type III AC joint or acute Type IV and V injuries were treated surgically. The distal clavicle was resected and stabilized with CC ligament reconstruction using the CA ligament. The CA ligament was passed into the medullary canal and tensioned, using a modified 'docking' technique. Average follow-up was 29 months (range 12–57). Results Postoperative ASES and pain significantly improved in all patients (p = 0.001). Radiographically, 16 (94%) maintained reduction, and only 1 (6%) had a recurrent dislocation when he returned to karate 3 months postoperatively. His ultimate clinical outcome was excellent. Conclusion The docking procedure allows for tensioning of the transferred CA ligament and healing of the ligament in an intramedullary bone tunnel. Excellent clinical results were achieved, decreasing the risk of recurrent distal clavicle instability. PMID:19144190

  10. Comparison of Results between Hook Plate Fixation and Ligament Reconstruction for Acute Unstable Acromioclavicular Joint Dislocation

    PubMed Central

    Yoon, Jong Pil; Lee, Byoung-Joo; Nam, Sang Jin; Chung, Seok Won; Jeong, Won-Ju; Min, Woo-Kie

    2015-01-01

    Background In the present study, we aimed to compare clinical and radiographic outcomes between hook plate fixation and coracoclavicular (CC) ligament reconstruction for the treatment of acute unstable acromioclavicular (AC) joint dislocation. Methods Forty-two patients who underwent surgery for an unstable acute dislocation of the AC joint were included. We divided them into two groups according to the treatment modality: internal fixation with a hook plate (group I, 24 cases) or CC ligament reconstruction (group II, 18 cases). We evaluated the clinical outcomes using a visual analog scale (VAS) for pain and Constant-Murley score, and assessed the radiographic outcomes based on the reduction and loss of CC distance on preoperative, postoperative, and final follow-up plain radiographs. Results The mean VAS scores at the final follow-up were 1.6 ± 1.5 and 1.3 ± 1.3 in groups I and II, respectively, which were not significantly different. The mean Constant-Murley scores were 90.2 ± 9.9 and 89.2 ± 3.5 in groups I and II, respectively, which were also not significantly different. The AC joints were well reduced in both groups, whereas CC distance improved from a mean of 215.7% ± 50.9% preoperatively to 106.1% ± 10.2% at the final follow-up in group I, and from 239.9% ± 59.2% preoperatively to 133.6% ± 36.7% at the final follow-up in group II. The improvement in group I was significantly superior to that in group II (p < 0.001). Furthermore, subluxation was not observed in any case in group I, but was noted in six cases (33%) in group II. Erosions of the acromion undersurface were observed in 9 cases in group I. Conclusions In cases of acute unstable AC joint dislocation, hook plate fixation and CC ligament reconstruction yield comparable satisfactory clinical outcomes. However, radiographic outcomes based on the maintenance of reduction indicate that hook plate fixation is a better treatment option. PMID:25729525

  11. Arthroscopic-Assisted Acromioclavicular Joint Reconstruction Using the TightRope Device With Allograft Augmentation: Surgical Technique

    PubMed Central

    Frank, Rachel M.; Trenhaile, Scott W.

    2015-01-01

    Surgical management of acromioclavicular (AC) joint separations remains challenging, especially in the revision setting. Most commonly, Rockwood type I and II injuries are managed nonoperatively whereas type IV, V, and VI injuries are managed with surgery. Type III separations are more controversial, with evidence supporting both nonoperative and operative treatment options. Multiple different arthroscopic techniques have been described; however, there is no current gold standard. AC joint reconstruction with the TightRope device (Arthrex, Naples, FL) with the patient in the lateral decubitus position is a method of restoring joint stability that allows for a minimally invasive, low-profile fixation construct using a single drill hole through the clavicle. Allograft augmentation of this fixation construct helps to eliminate the stress risers potentially created by this device while increasing overall repair construct stability. The purpose of this article is to describe the surgical technique for arthroscopic AC joint reconstruction using a TightRope device with allograft augmentation. PMID:26759765

  12. Arthroscopic treatment of acute and chronic acromioclavicular joint dislocation.

    PubMed

    Lafosse, Laurent; Baier, Gloria P; Leuzinger, Jan

    2005-08-01

    This article presents an all-arthroscopic technique for coracoclavicular ligament reconstruction by ligamentoplasty after acute or chronic acromioclavicular joint dislocation. A coracoacromial ligament transfer is done to reconstruct the torn coracoclavicular ligaments, similar to open surgery. The coracoacromial ligament is dissected from the undersurface of the acromion and is reinserted on the inferior clavicle by transosseous suture fixation. Additional wire or screw stabilization may be used. With this method, we achieve a very satisfactory reduction of the dislocated acromioclavicular joint. PMID:16086572

  13. Biomechanical Comparison of an Intramedullary and Extramedullary Free-Tissue Graft Reconstruction of the Acromioclavicular Joint Complex

    PubMed Central

    Garg, Rishi; Javidan, Pooya; Lee, Thay Q.

    2013-01-01

    Background Several different surgical techniques have been described to address the coracoclavicular (CC) ligaments in acromioclavicular (AC) joint injuries. However, very few techniques focus on reconstructing the AC ligaments, despite its importance in providing stability. The purpose of our study was to compare the biomechanical properties of two free-tissue graft techniques that reconstruct both the AC and CC ligaments in cadaveric shoulders, one with an extramedullary AC reconstruction and the other with an intramedullary AC reconstruction. We hypothesized intramedullary AC reconstruction will provide greater anteroposterior translational stability and improved load to failure characteristics than an extramedullary technique. Methods Six matched cadaveric shoulders underwent translational testing at 10 N and 15 N in the anteroposterior and superoinferior directions, under AC joint compression loads of 10 N, 20 N, and 30 N. After the AC and CC ligaments were transected, one of the specimens was randomly assigned the intramedullary free-tissue graft reconstruction while its matched pair received the extramedullary graft reconstruction. Both reconstructed specimens then underwent repeat translational testing, followed by load to failure testing, via superior clavicle distraction, at a rate of 50 mm/min. Results Intramedullary reconstruction provided significantly greater translational stability in the anteroposterior direction than the extramedullary technique for four of six loading conditions (p < 0.05). There were no significant differences in translational stability in the superoinferior direction for any loading condition. The intramedullary reconstructed specimens demonstrated improved load to failure characteristics with the intramedullary reconstruction having a lower deformation at yield and a higher ultimate load than the extramedullary reconstruction (p < 0.05). Conclusions Intramedullary reconstruction of the AC joint provides greater stability in the

  14. Acromioclavicular separation. Reconstruction using synthetic loop augmentation.

    PubMed

    Morrison, D S; Lemos, M J

    1995-01-01

    A total of 110 patients with a diagnosis of acromioclavicular joint separation were seen at our clinic between 1986 and 1991. Of these, 14 patients (12.7%) with grade III, IV, or V injuries required surgical reconstruction and were examined 2 years after surgery. All 14 patients underwent acromioclavicular reconstruction using a synthetic loop passed through drill holes in the base of the coracoid and the anterior third of the clavicle. When the loop is tightened, the clavicle is reduced anatomically without the anterior subluxation caused by simple clavicular cerclage. At an average followup of 44.2 months, patients were evaluated using the University of California, Los Angeles, rating scale. Twelve of the 14 had good or excellent results and returned to normal sport and work activities at 6 months. Of the two initial poor results, one required revision 1 month post-operatively because the patient was noncompliant, and the other required manipulation under anesthesia 3 months after surgery. The results in these two patients at 2 years were good and excellent, respectively. We concluded that, when medically indicated, fixation of the clavicle to the coracoid using this technique yields satisfactory results in an athletic population. PMID:7726339

  15. Arthroscopically Assisted Reconstruction of Acute Acromioclavicular Joint Dislocations: Anatomic AC Ligament Reconstruction With Protective Internal Bracing—The “AC-RecoBridge” Technique

    PubMed Central

    Izadpanah, Kaywan; Jaeger, Martin; Ogon, Peter; Südkamp, Norbert P.; Maier, Dirk

    2015-01-01

    An arthroscopically assisted technique for the treatment of acute acromioclavicular joint dislocations is presented. This pathology-based procedure aims to achieve anatomic healing of both the acromioclavicular ligament complex (ACLC) and the coracoclavicular ligaments. First, the acromioclavicular joint is reduced anatomically under macroscopic and radiologic control and temporarily transfixed with a K-wire. A single-channel technique using 2 suture tapes provides secure coracoclavicular stabilization. The key step of the procedure consists of the anatomic repair of the ACLC (“AC-Reco”). Basically, we have observed 4 patterns of injury: clavicular-sided, acromial-sided, oblique, and midportion tears. Direct and/or transosseous ACLC repair is performed accordingly. Then, an X-configured acromioclavicular suture tape cerclage (“AC-Bridge”) is applied under arthroscopic assistance to limit horizontal clavicular translation to a physiological extent. The AC-Bridge follows the principle of internal bracing and protects healing of the ACLC repair. The AC-Bridge is tightened on top of the repair, creating an additional suture-bridge effect and promoting anatomic ACLC healing. We refer to this combined technique of anatomic ACLC repair and protective internal bracing as the “AC-RecoBridge.” A detailed stepwise description of the surgical technique, including indications, technical pearls and pitfalls, and potential complications, is given. PMID:26052493

  16. Acromioclavicular joint reconstruction using a tendon graft: a biomechanical study comparing a novel “sutured throughout” tendon graft to a standard tendon graft

    PubMed Central

    Naziri, Qais; Williams, Nadine; Hayes, Westley; Kapadia, Bhaveen H.; Chatterjee, Dipal; Urban, William P.

    2016-01-01

    Background: With a recurrence rate of over 30%, techniques that offer stronger acromioclavicular (AC) joint reconstruction through increased graft strength may provide longevity. The purpose of our study was to determine the biomechanical strength of a novel tendon graft sutured throughout compared to a native tendon graft in Grade 3 anatomical AC joint reconstruction. Methods: For this in vitro experiment, nine paired (n = 18) embalmed cadaveric AC joints of three males and six females (age 86 years, range 51–94 years) were harvested. Anatomic repair with fresh bovine Achilles tendon grafts without bone block was simulated. Specimens were divided into two groups; with group 1 using grafts with ultra-high molecular-weight polyethylene (UHMWPE) suture ran throughout the entire length. In group 2, reconstruction with only native allografts was performed. The distal scapula and humerus were casted in epoxy compound and mounted on the mechanical testing machine. Tensile tests were performed using a mechanical testing machine at the rate of 50 mm/min. Maximum load and displacement to failure were collected. Results: The average load to failure was significantly higher for group 1 compared to group 2, with mean values of 437.5 N ± 160.7 N and 94.4 N ± 43.6 N, (p = 0.001). The average displacement to failure was not significantly different, with 29.7 mm ± 10.6 mm in group 1 and 25 mm ± 9.1 mm in group 2 (p = 0.25). Conclusion: We conclude that a UHMWPE suture reinforced graft can provide a 3.6 times stronger AC joint reconstruction compared to a native graft. PMID:27163106

  17. Clinical and radiological results after coracoclavicular ligament reconstruction for type III acromioclavicular joint dislocation using three different techniques. A retrospective study

    PubMed Central

    VASCELLARI, ALBERTO; SCHIAVETTI, STEFANO; BATTISTELLA, GIUSEPPE; REBUZZI, ENRICO; COLETTI, NICOLÒ

    2015-01-01

    Purpose the purpose of this retrospective study was to present the outcomes of three different techniques for the treatment of type III acromioclavicular joint dislocations: arthroscopic TightRope (TR), arthroscopic GraftRope (GR), and open reconstruction of the coracoclavicular (CC) ligament using the Ligament Augmentation and Reconstruction System (LARS). Methods eighteen patients underwent clinical and radiological evaluations after a mean follow-up time of 43 months. The following clinical outcome measures were considered: the Disability of the Arm, Shoulder and Hand outcome measure (DASH), the Nottingham Clavicle Score (NCS), and the Constant score (CS). On X-rays, the CC distance was measured. Results the median DASH score at follow-up was 12.5 in the TR group, 5 in the GR group, and 4.2 in the LARS group. The median NCS value was 88 in the TR group, 88 in the GR group, and 91 in the LARS group. The median CS was 100 in the TR group, 95 in the GR group, and 94.5 in the LARS group. The mean CC distance was 10.3 mm in the TR group, 13.8 in the GR group, and 16.6 in the LARS group. Conclusions all three techniques proved to be reliable in providing good clinical outcomes, although none of the studied techniques demonstrated reliability in maintaining anatomical reduction after surgery. Level of evidence Level III, retrospective comparative study. PMID:26605251

  18. Surgical technique affects outcomes in acromioclavicular reconstruction.

    PubMed

    Grassbaugh, Jason A; Cole, Chad; Wohlrab, Kurt; Eichinger, Josef

    2013-01-01

    Optimal treatment for acromioclavicular (AC) dislocation is unknown. Numerous surgical procedures for AC injuries have been described with little comparison. This study sought to compare the clinical and radiographic results of various surgical techniques in order to identify the optimal surgical technique. Ninety patients met inclusion criteria of AC reconstruction at this institution. A retrospective review of outcomes was performed using the electronic records system. Radiographs were measured for pre- and postoperative grade and percent elevation versus the contralateral side. Overall revision rate was 9%. Suture button fixation had a revision rate of 0% compared to 14% (p = .01). Reconstruction procedures performed with distal clavicle excision showed a higher revision rate, 17% compared to 0% (p = .003). There were no statistically significant clinical differences. AC reconstructions performed with suture button construct were superior to other surgical techniques. Procedures performed with distal clavicle excision were inferior to those without. PMID:23449059

  19. Arthroscopically Assisted Treatment of Acute Dislocations of the Acromioclavicular Joint

    PubMed Central

    Braun, Sepp; Beitzel, Knut; Buchmann, Stefan; Imhoff, Andreas B.

    2015-01-01

    Arthroscopically assisted treatments for dislocations of the acromioclavicular joint combine the advantages of exact and visually controlled coracoid tunnel placement with the possibility of simultaneous treatment of concomitant injuries. The clinical results of previous arthroscopically assisted techniques have been favorable at midterm and long-term follow-up. The presented surgical technique combines the advantages of arthroscopically positioned coracoclavicular stabilization with an additional suture cord cerclage of the acromioclavicular joint capsule for improved horizontal stability. PMID:26870646

  20. Editorial Commentary: Are Larger Screws the Answer When Anatomic Reconstruction of an Acromioclavicular Separation Fails?

    PubMed

    Denard, Patrick J

    2016-08-01

    Although fixation methods have improved, failure after fixation of an acromioclavicular joint separation is not uncommon. This biomechanical study shows that in the setting of graft slippage through previously well-placed clavicular tunnels, a revision anatomic reconstruction is feasible with larger tenodesis screws. Although the risk of clavicular fracture increases with larger tunnels, anatomic revision with larger screws is an option in select cases. PMID:27495861

  1. Surgical treatment of symptomatic acromioclavicular joint problems: a systematic review.

    PubMed

    Rabalais, R David; McCarty, Eric

    2007-02-01

    Excision of the distal clavicle has become the mainstay of surgical treatment for acromioclavicular joint arthritis and osteolysis refractory to nonoperative management. Surgical options for symptomatic acromioclavicular joint abnormalities refractory to nonoperative treatment are the classic open distal clavicle excision, direct (superior) arthroscopic excision, and indirect (bursal) arthroscopic distal clavicle excision. We asked whether any of these three procedures provided a better result. We systematically reviewed the medical literature (Medline, EMBASE), assigned a level of evidence for available studies, and critically identified the flaws and biases in the studies to provide comparisons between the published reports. We limited the literature review to clinical reports in the English language published in peer-reviewed journals. The literature supports surgical excision, but the reports are all Level III or IV evidence consisting largely of retrospective case series. Arthroscopic distal clavicle resection has provided more "good or excellent" results than has the open procedure, but is comprised of low-level evidence. Distal clavicle resection has provided satisfactory results when combined with other procedures. Simple distal clavicle resection may have worse outcomes when performed after preceding trauma. The published reports of the removal of medial acromial and inferior distal clavicle osteophytes when performing subacromial decompression are conflicting and may increase post-operative acromioclavicular symptoms. PMID:17159577

  2. Suture rupture in acromioclavicular joint dislocations treated with flip buttons.

    PubMed

    Motta, Pierorazio; Maderni, Alberto; Bruno, Laura; Mariotti, Umberto

    2011-02-01

    Acute acromioclavicular joint dislocations (ACDs) may be treated arthroscopically with flip buttons. This extra-articular fixation is easy to implant and is well tolerated. Between 2007 and 2009, 20 ACD patients (2 women and 18 men; mean age, 32 years) had surgery by the arthroscopic TightRope technique (Arthrex, Naples, FL). The main complication of this technique that has been reported is the partial loss of reduction at follow-up due to clavicular osteolysis under the superior flip button. We describe 4 cases with loss of reduction due to rupture of the sutures running across the buttons: 2 women with joint hyperlaxity and acute Rockwood grade IV ACD and 2 men, heavy manual workers, with joint hyperlaxity and acute Rockwood grade IV ACD. The use of flip buttons might not be indicated in patients with joint hyperlaxity because they are able to obtain immediate stability only on the vertical plane and not on the horizontal plane. Anteroposterior movements of the acromioclavicular joint might rub the suture against the bone tunnels leading to wear and cutting. PMID:21266279

  3. Ipsilateral Closed Clavicle and Scapular spine Fracture with Acromioclavicular Joint Disruption

    PubMed Central

    Kembhavi, Raghavendra s; James, Boblee

    2015-01-01

    Introduction: Injuries around shoulder and clavicle are quite common. Injuries involving lateral end of clavicle involving acromioclavicular joints are commoner injuries. In this rare injury, we report about a case involving clavicle and scapular spine fracture with acromioclavicular disruption which has never been described in English literature as per our knowledge. Case Report: A patient with closed clavicle and scapular spine fracture with acromioclavicular joint disruption was treated with open reduction and internal fixation of clavicle and scapular spine as a staged procedures. Six months post operatively, patient had excellent functional recovery with near full range of movements. Conclusion: Though rare complex injury, clavicle fracture with scapular spine fracture with acromioclavicular disruption, when managed properly with good physiotherapy protocol post operatively will result in good clinical and functional outcome. PMID:27299047

  4. Acromioclavicular joint dislocation with associated brachial plexus injury

    PubMed Central

    Gallagher, Charles Alexander; Blakeney, William; Zellweger, René

    2014-01-01

    We present the case of a 32-year-old female who sustained a left acromioclavicular (AC) joint type V injury and brachial plexus injury. The patient's AC joint injury was identified 6 days after she was involved in a motorbike accident where she sustained multiple other injuries. She required operative fixation of the AC joint using a locking compression medial proximal tibial plate. At 3 months post operatively, the patient was found to have a subluxed left shoulder as a result of an axonal injury to the upper trunk of the brachial plexus. In addition, the tibial plate had cut out. The plate was subsequently removed. At 8 months the glenohumeral articulation had been restored and the patient had clinically regained significant shoulder function. After 15 months the patient was pain free and could complete all her activities of daily living without impediment. She returned to playing competitive pool after 24 months. PMID:24855076

  5. Horizontal and Vertical Stabilization of Acute Unstable Acromioclavicular Joint Injuries Arthroscopy-Assisted

    PubMed Central

    Cisneros, Luis Natera; Sarasquete Reiriz, Juan; Besalduch, Marina; Petrica, Alexandru; Escolà, Ana; Rodriguez, Joaquim; Fallone, Jan Carlo

    2015-01-01

    We describe the technical aspects of an arthroscopy-assisted procedure indicated for the management of acute unstable acromioclavicular joint injuries, consisting of a synthetic augmentation of both the coracoclavicular and acromioclavicular ligaments, that anatomically reproduces the coracoclavicular biomechanics and offers fixation that keeps the torn ends of the ligaments facing one another, thus allowing healing of the native structures without the need for a second surgical procedure for metal hardware removal. PMID:26870653

  6. Effects of hook plate on shoulder function after treatment of acromioclavicular joint dislocation

    PubMed Central

    Chen, Chang-Hong; Dong, Qi-Rong; Zhou, Rong-Kui; Zhen, Hua-Qing; Jiao, Ya-Jun

    2014-01-01

    Introduction: Internal fixation with hook plate has been used to treat acromioclavicular joint dislocation. This study aims to evaluate the effect of its use on shoulder function, to further analyze the contributing factors, and provide a basis for selection and design of improved internal fixation treatment of the acromioclavicular joint dislocation in the future. Methods: A retrospective analysis was performed on patients treated with a hook plate for acromioclavicular joint dislocation in our hospital from January 2010 to February 2013. There were 33 cases in total, including 25 males and 8 females, with mean age of 48.27 ± 8.7 years. There were 29 cases of Rockwood type III acromioclavicular dislocation, 4 cases of type V. The Constant-Murley shoulder function scoring system was used to evaluate the shoulder function recovery status after surgery. Anteroposterior shoulder X-ray was used to assess the position of the hook plate, status of acromioclavicular joint reduction and the occurrence of postoperative complications. Results: According to the Constant-Murley shoulder function scoring system, the average scores were 78 ± 6 points 8 to 12 months after the surgery and before the removal of the hook plate, the average scores were 89 ± 5 minutes two months after the removal of hook plate. Postoperative X-ray imaging showed osteolysis in 10 cases (30.3%), osteoarthritis in six cases (18.1%), osteolysis associated with osteoarthritis in four cases(12.1%), and steel hook broken in one case (3%). Conclusion: The use of hook plate on open reduction and internal fixation of the acromioclavicular joint dislocation had little adverse effect on shoulder function and is an effective method for the treatment of acromioclavicular joint dislocation. Osteoarthritis and osteolysis are the two common complications after hook plate use, which are associated with the impairment of shoulder function. Shoulder function will be improved after removal of the hook plate. PMID

  7. All arthroscopic stabilization of acute acromioclavicular joint dislocation with fiberwire and endobutton system

    PubMed Central

    Spoliti, Marco; De Cupis, Mauro; Via, Alessio Giai; Oliva, Francesco

    2014-01-01

    Summary Introduction: acromioclavicular (AC) joint dislocation is common in athletes and in contact sports and about 9% of shoulder injuries involves this joint. The majority of these AC lesions can be successfully treated conservatively but high grade dislocation and some cases of type III dislocation need a surgical treatment. Many different operative techniques have been described over the years. The purpose of this study is to evaluate the results of arthroscopic stabilization of AC joint dislocation with TightRope® system. Materials and methods: nineteen patients with acute AC dislocation were treated by arthroscopic fixation with TightRope® system. Any associated lesions were repaired. All patients were assessed before surgery (T0), at 3 months (T1), at 6 months (T2) and at 1 year after the surgery (T3) using a visual analogic scale (VAS) and Constant-Murley Score (CMS). All patients were evaluated with X-ray. Results: six AC-joint dislocations involved the right shoulder and thirteen the left shoulder. Ten were type III dislocation, three were type IV and six were type V dislocation. We found a statistically significant reduction of pain (p< 0.01) at T1 compared to the pretreatment scores. The CMS measures showed an improvement between T1, T2 and T3, but the difference was statistically significant only between T1 and T3 (p= 0.017). The postoperative X-Ray of the shoulder showed a good reduction of the AC joint dislocation. We had 1 case of recurrence and 2 cases of loss of intraoperative reduction. Conclusion: arthroscopic technique for acute AC joint dislocations with the use of the TightRope® device is minimally invasive and it allows an anatomic restoration of the joint. It is a safe and effective procedure ensuring stable AC joint reconstruction and good cosmetic results. PMID:25767774

  8. Three-Dimensional Acromioclavicular Joint Motions During Elevation of the Arm

    PubMed Central

    TEECE, RACHAEL M.; LUNDEN, JASON B.; LLOYD, ANGELA S.; KAISER, ANDREW P.; CIEMINSKI, CORT J.; LUDEWIG, PAULA M.

    2009-01-01

    STUDY DESIGN Descriptive laboratory study. OBJECTIVES To determine the 3-dimensional motions occurring between the scapula relative to the clavicle at the acromioclavicular joint during humeral elevation in the scapular plane. BACKGROUND Shoulder pathology is commonly treated through exercise programs aimed at correcting scapular motion abnormalities. However, little is known regarding how acromio-clavicular joint motions contribute to normal and abnormal scapulothoracic motion. METHODS AND MEASURES Thirty subjects (16 males, 14 females) participated. Subjects with positive symptoms on clinical exam or past history of shoulder pathology, trauma, or surgery were excluded. Electromagnetic surface motion analysis was performed tracking the thorax, clavicle, scapula, and humerus. Subjects performed 3 repetitions of scapular plane abduction. Passive motion data were also collected for scapular plane abduction from cadaver specimens. Data were analyzed using within-session reliability and descriptive statistics as well as repeated-measures analyses of variance (ANOVAs) to determine the effect of elevation angle from rest to 90° humeral elevation. Reliability was determined from repeated trials in the same session without removing sensors or redigitizing landmarks. RESULTS Angular values were highly repeatable within session (ICC>0.94; SEM, <2.3°). During active scapular plane abduction from rest to 90°, average acromioclavicular joint angular values demonstrated increased internal rotation (approximately 4.3°), increased upward rotation (approximately 14.6°), and increased posterior tilting (approximately 6.7°) (P<.05). Passive motions on cadavers demonstrated similar kinematic patterns. CONCLUSIONS Significant motion occurs at the acromioclavicular joint during active humeral elevation, contributing to scapular motion on the thorax. This information provides a foundation for understanding normal acromioclavicular joint motion as a basis for further investigation

  9. ANATOMICAL RELATIONSHIP OF THE SUPRASCAPULAR NERVE TO THE CORACOID PROCESS, ACROMIOCLAVICULAR JOINT AND ACROMION

    PubMed Central

    Terra, Bernardo Barcellos; Gaspar, Eric Figueiredo; Siqueira, Karina Levy; Filho, Nivaldo Souza Cardozo; Monteiro, Gustavo Cará; Andreoli, Carlos Vicente; Ejnisman, Benno

    2015-01-01

    Objective: To establish the anatomical relationship of the suprascapular nerve (SSN) located in the suprascapular notch, to the medial border of the base of the coracoid process, the acromial joint surface of the acromioclavicular joint and the anterolateral border of the acromion. Methods: We dissected 16 shoulders of 16 cadavers (9 males and 7 females). The distances from the suprascapular nerve (at its passage beneath the transverse ligament) to certain fixed points on the medial border of the base of the coracoid process, the acromial joint surface of the acromioclavicular joint, and the anterolateral border of the acromion were measured with the aid of calipers and correlated with age and sex. Cadavers with previous surgical interventions were excluded. Results: The mean measurements from the notch of the suprascapular nerve were: 3.9 cm to the medial border of the base of the coracoid process (ranging from 3.1 cm to 5.2 cm); 4.7 cm to the acromioclavicular joint (ranging from 3.9 cm to 5.2 cm); and 6.1 cm to the anterolateral border of the acromion (ranging from 5.7 cm to 6.8 cm). Conclusion: Accurate anatomical knowledge of the nerves of the anterior region of the shoulder is essential in order to avoid iatrogenic injuries and to achieve satisfactory results in surgical treatment for shoulder diseases, whether performed as open or arthroscopic procedures. PMID:27022551

  10. Double-button Fixation System for Management of Acute Acromioclavicular Joint Dislocation

    PubMed Central

    Torkaman, Ali; Bagherifard, Abolfazl; Mokhatri, Tahmineh; Haghighi, Mohammad Hossein Shabanpour; Monshizadeh, Siamak; Taraz, Hamid; Hasanvand, Amin

    2016-01-01

    Background: Surgical treatments for acromioclavicular (AC) joint dislocation present with some complications. The present study was designed to evaluate the double-button fixation system in the management of acute acromioclavicular joint dislocation. Methods: This cross sectional study, done between February 2011 to June 2014, consisted of 28 patients who underwent surgical management by the double-button fixation system for acute AC joint dislocation. Age, sex, injury mechanism, dominant hand, side with injury, length of follow up, time before surgery, shoulder and hand (DASH), constant and visual analogue scale (VAS) scores, and all complications of the cases during the follow up were recorded. Results: The mean age of patients was 33.23±6.7 years. Twenty four patients (85.71%) were male and four (14.28%) were female. The significant differences were observed between pre-operation VAS, constant shoulder scores and post-operation measurements. There were not any significant differences between right and left coracoclavicular, but two cases of heterotrophic ossifications were recorded. The mean follow-up time was 16.17±4.38 months. Conclusion: According to the results, the double-button fixation system for management of acute acromioclavicular joint dislocation has suitable results and minimal damage to the soft tissues surrounding the coracoclavicular ligaments. PMID:26894217

  11. Chronic acromioclavicular joint dislocations treated by the GraftRope device

    PubMed Central

    Nordin, Jonas S; Aagaard, Knut E; Lunsjö, Karl

    2015-01-01

    Background and purpose Surgical treatment of chronic acromioclavicular joint dislocations is challenging, and no single procedure can be considered to be the gold standard. In 2010, the GraftRope method (Arthrex Inc., Naples, FL) was introduced in a case series of 10 patients, showing good clinical results and no complications. We wanted to evaluate the GraftRope method in a prospective consecutive series. Patients and methods 8 patients with chronic Rockwood type III–V acromioclavicular joint dislocations were treated surgically using the GraftRope method. The patients were clinically evaluated and a CT scan was performed to assess the integrity of the repair. Results and interpretation In 4 of the 8 patients, loss of reduction was seen within the first 6 weeks postoperatively. A coracoid fracture was the reason in 3 cases and graft failure was the reason in 1 case. In 3 of the 4 patients with intact repairs, the results were excellent with no subjective shoulder disability 12 months postoperatively. It was our intention to include 30 patients in this prospective treatment series, but due to the high rate of complications the study was discontinued prematurely. Based on our results and other recent reports, we cannot recommend the GraftRope method as a treatment option for chronic acromioclavicular joint dislocations. PMID:25323800

  12. Surgical treatment of an aseptic fistulized acromioclavicular joint cyst: a case report and review of the literature

    PubMed Central

    Murena, Luigi; D’angelo, Fabio; Falvo, Daniele A

    2009-01-01

    An acromioclavicular joint cyst is an uncommonly reported condition, which seems to result from a massive rotator cuff tear and degenerative osteoarthritis of the acromioclavicular joint. We present the case of an 81-year-old man affected by an acromioclavicular joint cyst, associated to a massive rotator cuff tear, proximal migration of the humeral head and osteoarthritis of the gleno-humeral joint. The mass was 7 × 2.5 cm in size and the overlying skin presented a fistula that drained clear synovial-like fluid. Plain X-ray examination of the left shoulder showed proximal migration of the humeral head migration and osteoarthritis of the gleno-humeral joint, and further MRI evaluation confirmed the clinical diagnosis of a complete rotator cuff tear and observed a large subcutaneous cyst in communication with the degenerative acromioclavicular joint. The patient underwent surgical excision of the cyst and lateral resection of the clavicle to prevent disease recurrence. To the best of our knowledge, this is the first reported case of an acromioclavicular joint cyst complicated by an aseptic fistula resulting from multiple aspirations. PMID:19918423

  13. Coracoid Process Avulsion Fracture at the Coracoclavicular Ligament Attachment Site in an Osteoporotic Patient with Acromioclavicular Joint Dislocation

    PubMed Central

    Umemoto, Takahisa; Fukuda, Kimitaka; Kajino, Tomomichi

    2016-01-01

    Coracoid fractures are uncommon, mostly occur at the base or neck of the coracoid process (CP), and typically present with ipsilateral acromioclavicular joint (ACJ) dislocation. However, CP avulsion fractures at the coracoclavicular ligament (CCL) attachment with ACJ dislocation have not been previously reported. A 59-year-old woman receiving glucocorticoid treatment fell from bed and complained of pain in her shoulder. Radiographs revealed an ACJ dislocation with a distal clavicle fracture. Three-dimensional computed tomography (3D-CT) reconstruction showed a small bone fragment at the medial apex of the CP. She was treated conservatively and achieved a satisfactory outcome. CP avulsion fractures at the CCL attachment can occur in osteoporotic patients with ACJ dislocations. Three-dimensional computed tomography is useful for identifying this fracture type. CP avulsion fractures should be suspected in patients with ACJ dislocations and risk factors for osteoporosis or osteopenia. PMID:27493819

  14. Coracoid Process Avulsion Fracture at the Coracoclavicular Ligament Attachment Site in an Osteoporotic Patient with Acromioclavicular Joint Dislocation.

    PubMed

    Onada, Yoshihiro; Umemoto, Takahisa; Fukuda, Kimitaka; Kajino, Tomomichi

    2016-01-01

    Coracoid fractures are uncommon, mostly occur at the base or neck of the coracoid process (CP), and typically present with ipsilateral acromioclavicular joint (ACJ) dislocation. However, CP avulsion fractures at the coracoclavicular ligament (CCL) attachment with ACJ dislocation have not been previously reported. A 59-year-old woman receiving glucocorticoid treatment fell from bed and complained of pain in her shoulder. Radiographs revealed an ACJ dislocation with a distal clavicle fracture. Three-dimensional computed tomography (3D-CT) reconstruction showed a small bone fragment at the medial apex of the CP. She was treated conservatively and achieved a satisfactory outcome. CP avulsion fractures at the CCL attachment can occur in osteoporotic patients with ACJ dislocations. Three-dimensional computed tomography is useful for identifying this fracture type. CP avulsion fractures should be suspected in patients with ACJ dislocations and risk factors for osteoporosis or osteopenia. PMID:27493819

  15. Acroplate--a modern solution for the treatment of acromioclavicular joint dislocation.

    PubMed

    Cîrstoiu, C; Rădulescu, R; Popescu, D; Ene, R; Circotă, G; Bădiceanu, Corina

    2009-01-01

    Two main ways to fix the reduction were imposed in surgical treatment of the acromioclavicular joint dislocations: fixation with trans acromioclavicular pin (Phemister method) and fixation with plate and screws type acroplate. The purpose of the present paper work is to compare immediate and later postoperative results between the two types of surgical interventions. During 2005-2007, 37 surgical reductions and fixation of acromioclavicular joint dislocations were performed in the Orthopedic-Traumatology Clinic of SUUB. In 17 cases a fixation with screws and plates type acroplate has been performed and in 20 cases with pins using the Phemister method. Sex ratio: 31 men and 8 women. Patients were aged between 17 and 56 years old. Follow up at 6 weeks, 3, 6, 12 and 18 post-operatory months. Osteosintesis material removing was done postoperatively, at 4 weeks in case of acroplate's and at 6 weeks in case of the pins. All patients treated of fixation with plate and screws acroplate type had a favorable evolution/development, starting with the shoulder joint mobilization at 24 hours postoperatively, with a complete recovery 4 weeks after the operation, at the same time with the ablation, and without immediate other late complications. As far as the patients treated by using the Phemister method are concerned, they were applied an immobilization, postoperatively. Desault bandage or the scarf for a period between 1 and 3 weeks, beginning with the shoulder joint mobilization later on and a full recovery after a minimum of 6 weeks. However, 3 of the cases showed a migration of one or both pins. Following the study, a more rapid recovery resulted, complete, and without complications of mobility in the shoulder joint, when using plate type acroplate vs pin. PMID:20108536

  16. Type IV acromioclavicular joint dislocation associated with a mid-shaft clavicle malunion

    PubMed Central

    Mohammed, Khalid D.; Stachiw, Danielle; Malone, Alex A.

    2016-01-01

    This reports presents the case of a combined clavicle fracture malunion and chronic Type IV acromioclavicular (AC) joint dislocation. The patient was seen acutely in the emergency department following a mountain bike accident at which time the clavicle fracture was identified and managed conservatively however the AC dislocation was not diagnosed. The patient presented 25 months following the injury with persistent pain and disability and was treated with clavicle osteotomy and AC stabilization. We document the clinical details, surgical treatment and outcome. PMID:26980988

  17. Type IV acromioclavicular joint dislocation associated with a mid-shaft clavicle malunion.

    PubMed

    Mohammed, Khalid D; Stachiw, Danielle; Malone, Alex A

    2016-01-01

    This reports presents the case of a combined clavicle fracture malunion and chronic Type IV acromioclavicular (AC) joint dislocation. The patient was seen acutely in the emergency department following a mountain bike accident at which time the clavicle fracture was identified and managed conservatively however the AC dislocation was not diagnosed. The patient presented 25 months following the injury with persistent pain and disability and was treated with clavicle osteotomy and AC stabilization. We document the clinical details, surgical treatment and outcome. PMID:26980988

  18. An analysis of acromioclavicular joint morphology as a factor for shoulder impingement syndrome

    PubMed Central

    Tavakkolizadeh, Adel; Sinha, Joydeep

    2014-01-01

    Background The present study aimed to determine whether acromioclavicular (AC) joint morphology was a factor in the development of symptomatic impingement necessitating AC joint excision. Methods We performed a prospective cohort study on all patients undergoing AC joint excision for symptomatic joint pain unresponsive to conservative treatment between 2009 and 2011. This involved 106 consecutive patients (57 women, 49 men, average age 54 years, age range 33 to 76 years). Prior to surgery, radiographic classification of the AC joint was performed producing three main groups: oblique, flat or curved. Pre- and postoperative assessment was performed using the Oxford Shoulder Score and the Disabilities of the Arm, Shoulder and Hand questionnaire. Results A significantly (p < 0.05) higher frequency of oblique AC joint morphology was seen in the AC joint excision study population compared to the normal population. Postoperative outcome demonstrated no significant difference (P > 0.05) between any of the three AC joint morphologies. Conclusions The present study demonstrates a significant association between the oblique AC joint morphology and those patients who develop AC joint pain requiring surgery. Outcomes of surgery were independent of joint morphology, gender or age, with all patient subgroups demonstrating significant improvement by the end of the study.

  19. Arthroscopic treatment of acromioclavicular joint injuries and results.

    PubMed

    Nuber, Gordon W; Bowen, Mark K

    2003-04-01

    Injuries and conditions that affect the AC joint are common. Low-grade separations, degenerative conditions, and osteolysis of the distal clavicle are frequently dealt with by the treating physician. Proper assessment requires a thorough history, examination, and radiologic work-up. An injection of bupivicaine into the AC joint can be a very useful test to evaluate the source of pain about the symptomatic shoulder. Most conditions affecting the AC joint can be treated conservatively, but patients who do not respond to these treatments or athletes who do not wish to modify their activities may require resection of the distal clavicle and the AC joint. Operative intervention can be performed as an open procedure with good results. Recent advances in operative arthroscopic procedures allow us to replicate and exceed the results of the open resection. Arthroscopic resection can be undertaken via a direct approach that does not violate the subacromial space or via an indirect or bursal approach. The indirect approach allows you to assess both the subacromial space and the AC joint because impingement pathology and subacromial compromise are frequently associated with AC change. The advantage of an arthroscopic resection is its ability to be performed as an outpatient procedure with less compromise of musculotendinous structures, shorter rehabilitation, and quicker return to activity. The amount of bone resection necessary is less than with the open procedure because of the ability to preserve the stabilizing properties of the superior AC ligaments. Resection of 4 mm to 8 mm of bone is all that may be required to give uniformly good results. Arthroscopic resection of the distal clavicle is technically demanding and requires skill and familiarity with other arthroscopic shoulder procedures. Complications related to this procedure are relatively infrequent and include infection, residual pain, lack of adequate bone resection, and instability, particularly in patients with

  20. Arthroscopic treatment of acute acromioclavicular joint dislocation with double flip button.

    PubMed

    Murena, L; Vulcano, Ettore; Ratti, C; Cecconello, L; Rolla, P R; Surace, M F

    2009-12-01

    The ideal treatment for acute acromioclavicular joint dislocation is still controversial, both in terms of indications and surgical technique. The clinical and radiographic outcomes of 16 patients affected by acute AC joint dislocation (type III-V) and arthroscopically treated with a coracoclavicular double flip button are presented. Despite the excellent clinical results both in terms of Constant score (mean 97 points) and patient satisfaction, at a mean follow-up of 31 months the radiographs showed partial loss of reduction due to distal migration of the flip button within the upper third of the clavicle in one-fourth of the cases. The technique presented here proved to be safe and minimally invasive while delivering good aesthetic results and allowing for the treatment of associated lesions. Furthermore, the technique could benefit from more advanced retention devices, which ought to reduce or avoid migration of the flip buttons. PMID:19554311

  1. The MRI geyser sign: acromioclavicular joint cysts in the setting of a chronic rotator cuff tear.

    PubMed

    Cooper, H John; Milillo, Ralph; Klein, Devon A; DiFelice, Gregory S

    2011-06-01

    We present the case of a 71-year-old man with a large acromioclavicular (AC) joint cyst successfully managed with surgical excision. AC joint cysts are soft tissue masses generally signifying underlying rotator cuff pathology. Traditionally, these cysts were identified with shoulder arthrography as a "geyser" of fluid escaping through the AC joint. Magnetic resonance imaging (MRI) is today's preferred imaging modality; we describe the MRI equivalent of the "geyser sign," signifying synovial fluid escaping through the cuff defect, across the subacromial bursa, and decompressing superiorly through a degenerated AC joint. Surgical management is preferred for symptomatic cysts. Based on a review of limited retrospective case series, recommendations for management of these lesions are as follows. Repair of the rotator cuff is preferable whenever possible. In the case of an irreparable defect, good results can be achieved through excisional AC joint arthroplasty and resection of the cyst base. Aspiration of these cysts should not be attempted, due to the high recurrence rate and potential for a draining sinus. Hemiarthroplasty also may be effective in indirectly decompressing these cysts; but given the invasive nature of this procedure, it should be reserved for patients who are also symptomatic from cuff arthropathy. PMID:21869946

  2. [Arthroscopically assisted techniques for treatment of acute and chronic acromioclavicular joint injuries].

    PubMed

    Braun, S; Imhoff, A B; Martetschläger, F

    2015-05-01

    Acute and chronic acromioclavicular (AC) joint dislocation is frequently encountered in the routine clinical practice. This injury can lead to significant impairment of shoulder girdle function. Therapy based on the severity of injury is recommended to re-establish correct shoulder function. The static radiographic Rockwood classification is used to define the degree of dislocation but the clinical aspects and functional x-ray imaging of horizontal AC joint instability should also be considered for selection of the appropriate procedure. Rockwood grades I and II injuries are treated non-operatively with early functional exercise. The approach for Rockwood grade III injuries should be individual and patient-specific, with non-surgical procedures for low functional requirement patients with a high risk for surgical interventions. For patients with high demands on shoulder function surgery is recommended. A detailed diagnostic assessment frequently reveals Rockwood grade III injuries to be type IV injuries. Rockwood types IV and V AC joint dislocations require surgery for sustained stability. Treatment of acute injuries is recommended within 1-3 weeks after trauma but there is no clear evidence of a cut-off for the presence of chronic injuries. Various surgical techniques have been described in the literature. This article presents an arthroscopically assisted technique that addresses both vertical and horizontal instability of the AC joint. PMID:25964020

  3. Arthroscopic resection of the distal clavicle in osteoarthritis of the acromioclavicular joint

    PubMed Central

    Park, Tae-Soo; Lee, Kwang-Won

    2016-01-01

    Background: Symptomatic acromioclavicular joint (ACJ) lesions are a common cause of shoulder complaints that can be treated successfully with both conservative and surgical methods. There are several operative techniques, including both open and arthroscopic surgery, for excising the distal end of the clavicle. Here, we present a new modified arthroscopic technique for painful osteoarthritis of the ACJ and evaluate its clinical outcomes. Our hypothesis was that 4- to 7-mm resection of the distal clavicle in an en bloc fashion would have several advantages, including no bony remnants, maintenance of stability of the ACJ, and reduced prevalence of heterotopic ossification, in addition to elimination of the pathologic portion of the distal clavicle. Materials and Methods: 20 shoulders of 20 consecutive patients with painful and isolated osteoarthritis of the ACJ who were treated by arthroscopic en bloc resection of the distal clavicle were included in the study. There were 10 males and 10 females with an average age of 56 years (range 42–70 years). The mean duration of followup was 6 years and 2 months (range 4–8 years 10 months). The results were evaluated using the University of California Los Angeles (UCLA) shoulder rating score. Results: The overall UCLA score was 13.7 preoperatively, which improved to 33.4 postoperatively. All subscores were improved significantly (P < 0.001). There were no specific complications at the latest followup. Conclusion: It is critical in this procedure to resect the distal clavicle evenly from superior to inferior in an en bloc fashion without any small bony remnants and to preserve the capsule and acromioclavicular ligament superoposteriorly. This arthroscopic procedure is a reliable and reproducible technique for painful osteoarthritis of the ACJ lesions in active patients engaged in overhead throwing sports and heavy labor. PMID:27512219

  4. Clinics in diagnostic imaging (151). Acromioclavicular joint geyser sign with chronic full-thickness supraspinatus tendon (SST) tear.

    PubMed

    Khor, Andrew Yu Keat; Wong, Steven Bak Siew

    2014-02-01

    An 82-year-old man presented with neck pain, right upper limb radiculopathy and right shoulder pain. Physical examination revealed a soft lump over the right shoulder joint, as well as reduced range of shoulder movements. On magnetic resonance imaging, the soft lump was shown to be a cystic mass over the acromioclavicular joint and was related to a full-thickness supraspinatus tendon tear. This is the classic geyser sign. The pathophysiology and clinical features of the geyser sign, and its imaging features with various imaging modalities, are discussed. PMID:24570312

  5. Clinics in diagnostic imaging (151). Acromioclavicular joint geyser sign with chronic full-thickness supraspinatus tendon (SST) tear.

    PubMed Central

    Khor, Andrew Yu Keat; Wong, Steven Bak Siew

    2014-01-01

    An 82-year-old man presented with neck pain, right upper limb radiculopathy and right shoulder pain. Physical examination revealed a soft lump over the right shoulder joint, as well as reduced range of shoulder movements. On magnetic resonance imaging, the soft lump was shown to be a cystic mass over the acromioclavicular joint and was related to a full-thickness supraspinatus tendon tear. This is the classic geyser sign. The pathophysiology and clinical features of the geyser sign, and its imaging features with various imaging modalities, are discussed. PMID:24570312

  6. Treatment of Rockwood type III acromioclavicular joint dislocation using autogenous semitendinosus tendon graft and endobutton technique

    PubMed Central

    Ye, Gang; Peng, Chao-An; Sun, Hua-Bin; Xiao, Jing; Zhu, Kang

    2016-01-01

    Background The aim of this study was to evaluate the therapeutic effect of autogenous semitendinosus graft and endobutton technique, and compare with hook plate in treatment of Rockwood type III acromioclavicular (AC) joint dislocation. Methods From April 2012 to April 2013, we treated 46 patients with Rockwood type III AC joint dislocation. Patients were randomly divided into two groups: Group A was treated using a hook plate and Group B with autogenous semitendinosus graft and endobutton technique. All participants were followed up for 12 months. Radiographic examinations were performed every 2 months postoperatively, and clinical evaluation was performed using the Constant–Murley score at the last follow-up. Results Results indicated that patients in Group B showed higher mean scores (90.3±5.4) than Group A (80.4±11.5) in terms of Constant–Murley score (P=0.001). Group B patients scored higher in terms of pain (P=0.002), activities (P=0.02), range of motion (P<0.001), and strength (P=0.004). In Group A, moderate pain was reported by 2 (8.7%) and mild pain by 8 (34.8%) patients. Mild pain was reported by 1 (4.3%) patient in Group B. All patients in Group B maintained complete reduction, while 2 (8.7%) patients in Group A experienced partial reduction loss. Two patients (8.7%) encountered acromial osteolysis on latest radiographs, with moderate shoulder pain and limited range of motion. Conclusion Autogenous semitendinosus graft and endobutton technique showed better results compared with the hook plate method and exhibited advantages of fewer complications such as permanent pain and acromial osteolysis. PMID:26811685

  7. Comparison of 3-Dimensional Shoulder Complex Kinematics in Individuals With and Without Shoulder Pain, Part 1: Sternoclavicular, Acromioclavicular, and Scapulothoracic Joints

    PubMed Central

    LAWRENCE, REBEKAH L.; BRAMAN, JONATHAN P.; LAPRADE, ROBERT F.; LUDEWIG, PAULA M.

    2015-01-01

    STUDY DESIGN Cross-sectional. OBJECTIVES To compare sternoclavicular, acromioclavicular, and scapulothoracic joint motion between symptomatic and asymptomatic individuals during shoulder motion performed in 3 planes of humerothoracic elevation. BACKGROUND Differences in scapulothoracic kinematics are associated with shoulder pain. Several studies have measured these differences using surface sensors, but the results of this technique may be affected by skin-motion artifact. Furthermore, previous studies have not included the simultaneous measurement of sternoclavicular and acromioclavicular joint motion. METHODS Transcortical bone pins were inserted into the clavicle, scapula, and humerus of 12 asymptomatic and 10 symptomatic individuals for direct, bone-fixed tracking using electromagnetic sensors. Angular positions for the sternoclavicular, acromioclavicular, and scapulothoracic joints were measured during shoulder flexion, abduction, and scapular plane abduction. RESULTS Differences between groups were found for sternoclavicular and scapulothoracic joint positions. Symptomatic individuals consistently demonstrated less sternoclavicular posterior rotation, regardless of angle, phase, or plane of shoulder motion. Symptomatic individuals also demonstrated less scapulothoracic upward rotation at 30° and 60° of humerothoracic elevation during shoulder abduction and scapular plane abduction. CONCLUSION The results of this study show that differences in shoulder complex kinematics exist between symptomatic and asymptomatic individuals. However, the magnitude of these differences was small, and the resulting clinical implications are not yet fully understood. The biomechanical coupling of the sternoclavicular and acromioclavicular joints requires further research to better understand scapulothoracic movement deviations and to improve manual therapy and exercise-based physical therapy interventions. PMID:25103135

  8. Results of Operative and Nonoperative Treatment of Rockwood Types III and V Acromioclavicular Joint Dislocation

    PubMed Central

    Joukainen, Antti; Kröger, Heikki; Niemitukia, Lea; Mäkelä, E. Antero; Väätäinen, Urho

    2014-01-01

    Background: The optimal treatment of acute, complete dislocation of the acromioclavicular joint (ACJ) is still unresolved. Purpose: To determine the difference between operative and nonoperative treatment in acute Rockwood types III and V ACJ dislocation. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: In the operative treatment group, the ACJ was reduced and fixed with 2 transarticular Kirschner wires and ACJ ligament suturing. The Kirschner wires were extracted after 6 weeks. Nonoperatively treated patients received a reduction splint for 4 weeks. At the 18- to 20-year follow-up, the Constant, University of California at Los Angeles Shoulder Rating Scale (UCLA), Larsen, and Simple Shoulder Test (SST) scores were obtained, and clinical and radiographic examinations of both shoulders were performed. Results: Twenty-five of 35 potential patients were examined at the 18- to 20-year follow-up. There were 11 patients with Rockwood type III and 14 with type V dislocations. Delayed surgical treatment for ACJ was used in 2 patients during follow-up: 1 in the operatively treated group and 1 in the nonoperatively treated group. Clinically, ACJs were statistically significantly less prominent or unstable in the operative group than in the nonoperative group (normal/prominent/unstable: 9/4/3 and 0/6/3, respectively; P = .02) and in the operative type III (P = .03) but not type V dislocation groups. In operatively and nonoperatively treated patients, the mean Constant scores were 83 and 85, UCLA scores 25 and 27, Larsen scores 11 and 11, and SST scores 11 and 12 at follow-up, respectively. There were no statistically significant differences in type III and type V dislocations. In the radiographic analysis, the ACJ was wider in the nonoperative than the operative group (8.3 vs 3.4 mm; P = .004), and in the type V dislocations (nonoperative vs operative: 8.5 vs 2.4 mm; P = .007). There was no statistically significant difference between study groups in

  9. Comparison of single and two-tunnel techniques during open treatment of acromioclavicular joint disruption

    PubMed Central

    2014-01-01

    Background Coracoclavicular (CC) ligament reconstruction with semitendinosus tendon (ST) grafts has become more popular and has achieved relatively good results; however optimal reconstruction technique, single-tunnel or two-tunnel, still remains controversial. This paper is to compare the clinical and radiographic data of allogenous ST grafting with single- or two-tunnel reconstruction techniques of the AC joint. Methods The outcomes of 21 consecutive patients who underwent anatomical reduction and ST grafting for AC joint separation were reviewed retrospectively. Patients were divided into two groups: single-tunnel group (11) and two-tunnel group (10). All patients were evaluated clinically and radiographically using a modified UCLA rating scale. Results The majority of separations (18 of 21) were Rockwood type V, with one each in type III, IV and VI categories. The overall mean follow-up time was 16 months, and at the time of the latest follow-up, the overall mean UCLA rating score was 14.1 (range 8–20). The percentage of good-to-excellent outcomes was significantly higher for patients with the two-tunnel technique than for those with the one-tunnel technique (70% vs. 18%, respectively, p = 0.03). Within the single-tunnel group, there was no statistically significant difference in percentage of good-to-excellent outcomes between patients with vs. without tightrope augmentation (17% vs 20%, p > 0.99). Similarly, within the two-tunnel group, there was no significant difference in the percentage of good-to-excellent outcomes between the graft only and augment groups (67% vs. 75%, p > 0.99). Conclusion Anatomical reduction of the AC joint and reconstruction CC ligaments are crucial for optimal joint stability and function. Two-tunnel CC reconstruction with an allogenous ST graft provides superior significantly better radiographic and clinical results compared to the single-tunnel reconstruction technique. PMID:25127715

  10. Acromioclavicular joint separations grades I-III: a review of the literature and development of best practice guidelines.

    PubMed

    Reid, Duncan; Polson, Kate; Johnson, Louise

    2012-08-01

    Acromioclavicular joint (ACJ) separation injuries are common injuries among sporting populations. ACJ separations are graded according to severity from grade I being a mild sprain to grade VI, which is severe dislocation with displacement. There is consensus in the literature that grade I-III ACJ separations are managed conservatively and grades IV-VI are managed surgically. Despite conservative care being recommended for lesser grades of injury, there is very little evidence in the literature as to what constitutes conservative care. Therefore, the purpose of this paper was, first, to review the relevant anatomy and kinematics of the ACJ and, second, to review the literature relating to current evidence of conservative management of ACJ injury. Using this data, a best practice guideline for conservative rehabilitation in grade I-III ACJ separations was developed. For the conservative management, a literature search was undertaken using the following databases in the Auckland University of Technology's electronic library resources; MEDLINE, CINAHL, SPORTDiscus™ and the Cochrane Library. The following keywords or phrases were used: 'acromioclavicular joint separations', 'injury', 'dislocations', 'rehabilitation', 'conservative care', 'physiotherapy' and 'exercise'. A total of 24 articles was identified. There were no randomized controlled trials (RCTs) that investigated conservative treatment for grade I-III ACJ sprains. Therefore, a narrative review was formulated covering the anatomy and biomechanics of the ACJ, injury mechanisms and relevant literature reviewed covering rehabilitation principles. Conservative management of grade I-III ACJ separations is still the main recommendation following this review. A best practice guideline for managing grade I-III ACJ separations is presented to help guide clinicians until well constructed RCTs are carried out to improve the conservative management of ACJ injuries. PMID:22784232

  11. Arthroscopic fixation of type III acromioclavicular dislocations.

    PubMed

    Somers, Jan F A; Van der Linden, Dietert

    2007-10-01

    Type III Acromio-Clavicular Joint dislocations can be treated successfully by surgical stabilisation in situ, with or without reconstruction of the coracoclavicular ligaments. The authors describe a simple and reliable mode of fixation, performed arthroscopically. The technique can be used for in situ fixation, or as part of an arthroscopically assisted Weaver and Dunn procedure. Using a metallic anchor loaded with a braided polyfilament suture, a strong and reliable fixation of the clavicle to the coracoid process is obtained. No hardware removal is necessary. Concomitant glenohumeral pathology can be treated simultaneously. PMID:18019910

  12. Clinical results of coracoacromial ligament transfer in acromioclavicular dislocations: A review of published literature.

    PubMed

    Sood, Aman; Wallwork, Nicholas; Bain, Gregory Ian

    2008-01-01

    Acromioclavicular joint dislocations are common injuries, which typically occur with trauma in young men. Treatment recommendations for these injuries are highly variable and controversial. There are greater than 100 surgical techniques described for operative treatment of this injury. One of the most widely recommended methods of surgical reconstruction for acromioclavicular joint dislocations is to utilize the coracoacromial ligament for stabilization of the distal clavicle. Several modifications of this procedure have been described which have involved adjunct coracoclavicular fixation or fixation across acromioclavicular joint. Although the literature is replete with descriptive papers, there is paucity of studies evaluating the surgical outcome of this procedure. We systematically reviewed the English language published literature in peer reviewed journals (Medline, EMBASE, SCOPUS) and assigned a level of evidence for available studies. We critically reviewed each paper for the flaws and biases and then evaluated the comparable clinical outcomes for various procedures and their modifications. The published literature consists entirely of case series (Level IV evidence) with variability in surgical technique and outcome measures. On review there is low level evidence to support the use of coracoacromial ligament for acromioclavicular dislocation but it has been associated with high rate of deformity recurrence. Adjunct fixation does not improve clinical results when compared to isolated coracoacromial ligament transfer. This is in part because of the high incidence of fixation related complications. Similar results are reported with coracoacromial ligament reconstruction for acute and chronic cases. The development of secondary acromioclavicular joint symptoms with distal clavicle retention is poorly reported with the incidence rate varying from 12% to 32%. Despite this, the retention or excision of distal clavicle did not affect overall clinical results except

  13. Salvage procedure for chronic acromioclavicular dislocation subsequent to overzealous distal clavicle resection.

    PubMed

    Zvijac, John E; Popkin, Charles A; Botto-van Bemden, Angie

    2008-12-01

    This article presents our surgical technique for reestablishing acromioclavicular stability after overzealous distal clavicular resection. Two cases are presented in which the clavicle of the affected acromioclavicular joint was unstable, causing pain with range of motion (ROM). To address the pathology, reconstruction of the coracoclavicular ligament and reattachment of the trapezius and deltoid to the clavicle were required. We reconstructed the coracoclavicular ligaments using an Achilles tendon calcaneal allograft. The bony end of the Achilles tendon allograft was used as an extension to lengthen the clavicle and the tendinous portion to reconstruct the coracoacromial ligament, thus stabilizing the clavicle. Once allograft reconstruction and stability had been achieved, a 1.5-cm gap remained between the acromion and the new allograft end of the clavicle. There was no evidence of acromioclavicular impingement. Supplemental fixation was not required. The trapezius, pectoralis, and deltoids were all reefed over the clavicle using Vicryl sutures (Ethicon, Inc, West Somerville, New Jersey) to reinforce the reduction and restore the natural contour of the shoulder girdle. Fifteen months postoperatively, both patients had maintained a reduced acromioclavicular joint. They had no pain with ROM, and full muscular strength was evident in all planes. Radiographs of their shoulders revealed a completely incorporated graft and a reduced clavicle. We recommend this novel technique for reestablishing acromiclavicular stability, as it provides good functional and subjective results. PMID:19226059

  14. Shoulder pain in primary care: diagnostic accuracy of clinical examination tests for non-traumatic acromioclavicular joint pain

    PubMed Central

    2013-01-01

    Background Despite numerous methodological flaws in previous study designs and the lack of validation in primary care populations, clinical tests for identifying acromioclavicular joint (ACJ) pain are widely utilised without concern for such issues. The aim of this study was to estimate the diagnostic accuracy of traditional ACJ tests and to compare their accuracy with other clinical examination features for identifying a predominant ACJ pain source in a primary care cohort. Methods Consecutive patients with shoulder pain were recruited prospectively from primary health care clinics. Following a standardised clinical examination and diagnostic injection into the subacromial bursa, all participants received a fluoroscopically guided diagnostic block of 1% lidocaine hydrochloride (XylocaineTM) into the ACJ. Diagnostic accuracy statistics including sensitivity, specificity, predictive values, positive and negative likelihood ratios (LR+ and LR-) were calculated for traditional ACJ tests (Active Compression/O’Brien’s test, cross-body adduction, localised ACJ tenderness and Hawkins-Kennedy test), and for individual and combinations of clinical examination variables that were associated with a positive anaesthetic response (PAR) (P≤0.05) defined as 80% or more reduction in post-injection pain intensity during provocative clinical tests. Results Twenty two of 153 participants (14%) reported an 80% PAR. None of the traditional ACJ tests were associated with an 80% PAR (P<0.05) and combinations of traditional tests were not able to discriminate between a PAR and a negative anaesthetic response (AUC 0.507; 95% CI: 0.366, 0.647; P>0.05). Five clinical examination variables (repetitive mechanism of pain onset, no referred pain below the elbow, thickened or swollen ACJ, no symptom provocation during passive glenohumeral abduction and external rotation) were associated with an 80% PAR (P<0.05) and demonstrated an ability to accurately discriminate between an PAR and NAR

  15. The prevalence of chondrocalcinosis (CC) of the acromioclavicular (AC) joint on chest radiographs and correlation with calcium pyrophosphate dihydrate (CPPD) crystal deposition disease

    PubMed Central

    Carrera, Guillermo; Baynes, Keith; Mautz, Alan; DuBois, Melissa; Cerniglia, Ross; Ryan, Lawrence M.

    2016-01-01

    Digital imaging combined with picture archiving and communication system (PACS) access allows detailed image retrieval and magnification. Calcium pyrophosphate dihydrate (CPPD) crystals preferentially deposit in fibrocartilages, the cartilage of the acromioclavicular (AC) joint being one such structure. We sought to determine if examination of the AC joints on magnified PACS imaging of chest films would be useful in identifying chondrocalcinosis (CC). Retrospective radiographic readings and chart reviews involving 1,920 patients aged 50 or more who had routine outpatient chest radiographs over a 4-month period were performed. Knee radiographs were available for comparison in 489 patients. Medical records were reviewed to abstract demographics, chest film reports, and diagnoses. AC joint CC was identified in 1.1 % (21/1,920) of consecutive chest films. Patients with AC joint CC were 75 years of age versus 65.4 in those without CC (p<0.0002). Four hundred eighty-nine patients had knee films. Six of these patients had AC joint CC, and of these, five also had knee CC (83 %). Of the 483 without AC joint CC, 62 (12 %) had knee CC (p=0.002). Patients with AC joint CC were more likely to have a recorded history of CPPD crystal deposition disease than those without AC joint CC (14 versus 1 %, p=0.0017). The prevalence of AC joint CC increases with age and is associated with knee CC. A finding of AC joint CC should heighten suspicion of pseudogout or secondary osteoarthritis in appropriate clinical settings and, in a young patient, should alert the clinician to the possibility of an associated metabolic condition. PMID:23609408

  16. Treatment of Chronic Acromioclavicular Joint Dislocation in a Paraplegic Patient with the Weaver-Dunn Procedure and a Hook-Plate

    PubMed Central

    Godry, Holger; Citak, Mustafa; Königshausen, Matthias; Schildhauer, Thomas A.; Seybold, Dominik

    2016-01-01

    In case of patients with spinal cord injury and concomitant acromioclavicular (AC) joint-dislocation the treatment is challenging, as in this special patient group the function of the shoulder joint is critical because patients depend on the upper limb for mobilization and wheelchair-locomotion. Therefore the goal of this study was to examine, if the treatment of chronic AC-joint dislocation using the Weaver-Dunn procedure augmented with a hook-plate in patients with a spinal cord injury makes early postoperative wheelchair mobilization and the wheelchair transfer with full weight-bearing possible. In this case the Weaver-Dunn procedure with an additive hook-plate was performed in a 34-year-old male patient with a complete paraplegia and a posttraumatic chronic AC-joint dislocation. The patient was allowed to perform his wheelchair transfers with full weight bearing on the first post-operative day. The removal of the hook-plate was performed four months after implantation. At the time of follow-up the patient could use his operated shoulder with full range of motion without restrictions in his activities of daily living or his wheel-chair transfers. PMID:27433301

  17. [Acute acromioclavicular dislocations].

    PubMed

    Riand, N; Sadowski, C; Hoffmeyer, P

    1999-12-01

    Acromioclavicular dislocations represent over 10% of acute traumatic injuries to the shoulder girdle. The mechanism is usually a direct impact on the shoulder with the arm in adduction, producing rupture of the acromioclavicular (AC) ligaments, then of the coracoclavicular (CC) ligament, with displacement of the lateral end of the clavicle. Rockwood described 6 grades of injury. Physical examination usually provides the diagnosis, which is confirmed by radiological examination. X-rays centered on the AC joint, if necessary with forceful adduction of both shoulders or under traction, are useful to evaluate the severity of the lesion. Grade I and II lesions are usually treated conservatively by simply immobilizing the arm for 3 to 4 weeks. Surgical treatment is usually advocated for grade IV, V and VI lesions: AC or CC fixation, sometimes associated with ligament repair, depending on the surgeons. AC pinning or C-C screw fixation are the techniques most often used. Management of grade III lesions remains controversial. Some authors advocate immediate surgical treatment in young, active patients, in heavy laborers and even in slender individuals. The choice of the operative technique is controversial, as no single technique has clearly proved to be superior to others. Other authors advocate conservative treatment, which gives functional results which patients consider quite acceptable, with faster recovery; patients should be informed that results are essentially similar, whatever the treatment. The possibility of performing secondary operations with good results in cases with failure of conservative management is a further argument in favor of applying conservative therapy first in acute injuries. PMID:10675933

  18. Comparison of surgical outcomes between fixation with hook plate and loop suspensory fixation for acute unstable acromioclavicular joint dislocation: a systematic review and meta-analysis.

    PubMed

    Arirachakaran, Alisara; Boonard, Manusak; Piyapittayanun, Peerapong; Phiphobmongkol, Vajarin; Chaijenkij, Kornkit; Kongtharvonskul, Jatupon

    2016-08-01

    Treatment of acute (≤4 weeks) high-grade acromioclavicular (AC) joint separation (types III-VI) is still controversial. Currently, the two modern techniques that are widely used include hook plate fixation and coracoclavicular (CC) ligament fixation using a suspensory loop device (tightrope, synthetic ligament or absorbable polydioxansulfate sling). These techniques are both reported to have superior clinical outcomes. This systematic review and meta-analysis aimed to assess and compare clinical outcomes of hook plate fixation versus fixation of the CC ligament using a loop suspensory fixation (LSF) device for the treatment of AC joint injury. These clinical outcomes consist of the Constant-Murley score (CMS), pain visual analog score (VAS) and postoperative complications. Relevant comparative studies were identified from MEDLINE and Scopus from inception to October 5, 2015. Five of 571 studies were eligible; 5, 3, 3, and 5 studies were included in the pooling of CMS, pain VAS, surgical time and postoperative complications, respectively. The unstandardized mean difference (UMD) of the CMS for LSF was 4.43 [95 % confidence interval (CI) 0.73, 8.14], which was statistically significantly higher than the CMS in hook plate fixation. For VAS, the UMD was 0.02 points (95 % CI -3.54, 3.73) higher than LSF but without statistical significance. The surgical time of LSF was 16.21 min (95 % CI 6.27, 26.15) statistically significantly higher than hook plate fixation. LSF had a lower chance of postoperative complications by 0.62 units (95 % CI 0.30, 1.32) when compared to hook plate fixation, but this also was not statistically significant. In acute high-grade AC joint injuries, loop suspensory fixation had higher postoperative functional CMS and mean surgical time when compared to hook plate fixation. However, for postoperative VAS and complication rates, there were no statistically significant differences between groups. PMID:27334621

  19. Complications following arthroscopic fixation of acromioclavicular separations: a systematic review of the literature

    PubMed Central

    Woodmass, Jarret M; Esposito, John G; Ono, Yohei; Nelson, Atiba A; Boorman, Richard S; Thornton, Gail M; Lo, Ian KY

    2015-01-01

    Purpose Over the past decade, a number of arthroscopic or arthroscopically assisted reconstruction techniques have emerged for the management of acromioclavicular (AC) separations. These techniques provide the advantage of superior visualization of the base of the coracoid, less soft tissue dissection, and smaller incisions. While these techniques have been reported to provide excellent functional results with minimal complications, discrepancies exist within the literature. This systematic review aims to assess the rate of complications following these procedures. Methods Two independent reviewers completed a search of Medline, Embase, PubMed, and the Cochrane Library entries up to December 2013. The terms “Acromioclavicular Joint (MeSH)” OR “acromioclavicular* (text)” OR “coracoclavicular* (text)” AND “Arthroscopy (MeSH)” OR “Arthroscop* (text)” were used. Pooled estimates and 95% confidence intervals were calculated assuming a random-effects model. Statistical heterogeneity was quantified using the I2 statistic. Level of evidence IV Results A total of 972 abstracts met the search criteria. After removal of duplicates and assessment of inclusion/exclusion criteria, 12 articles were selected for data extraction. The rate of superficial infection was 3.8% and residual shoulder/AC pain or hardware irritation occurred at a rate of 26.7%. The rate of coracoid/clavicle fracture was 5.3% and occurred most commonly with techniques utilizing bony tunnels. Loss of AC joint reduction occurred in 26.8% of patients. Conclusion Arthroscopic AC reconstruction techniques carry a distinct complication profile. The TightRope/Endobutton techniques, when performed acutely, provide good radiographic outcomes at the expense of hardware irritation. In contrast, graft reconstructions in patients with chronic AC separations demonstrated a high risk for loss of reduction. Fractures of the coracoid/clavicle remain a significant complication occurring predominately with

  20. Distal Clavicle Osteolysis after Modified Weaver-Dunn's Procedure for Chronic Acromioclavicular Dislocation: A Case Report and Review of Complications

    PubMed Central

    Santana, Fernando; Mingo, Felipe; Piñol, Ignasi; Solano, Albert; Puig-Verdié, Lluís; Torrens, Carles

    2014-01-01

    Distal clavicle osteolysis after acromioclavicular joint stabilization has only been described after the use of hardware for clavicle stabilization or synthetic graft causing a foreign body reaction. This paper reports a very rare case of distal clavicle osteolysis after modified Weaver-Dunn procedure for the treatment of chronic acromioclavicular joint dislocation. The paper also provides a comprehensive review of complications of this surgical technique and discusses a potential vascular etiology and preventive strategies aimed at avoiding clavicle osteolysis. PMID:25544923

  1. Posterior Cruciate Ligament Reconstruction in Patients with Generalized Joint Laxity

    PubMed Central

    Kim, Sung-Jae; Chang, Ji-Hoon

    2008-01-01

    Generalized joint laxity has been considered a risk factor causing late failure of reconstructed anterior cruciate ligaments, although it is unknown whether that is the case for reconstructed posterior cruciate ligaments. We hypothesized patients with generalized joint laxity, compared with those without laxity, would have similar postoperative knee stability, range of motion, and functional scores after posterior cruciate ligament reconstruction. The Beighton and Horan criteria were used to determine generalized joint laxity. We enrolled 24 patients with generalized joint laxity (Group L) and 29 patients without any positive findings of joint laxity (Group N) matched by gender and age. The average side-by-side differences of posterior tibial translation were 4.72 mm in Group L and 3.63 mm in Group N. We observed no differences in posterior tibial translation with differing graft materials or combined procedures. In Group L the International Knee Documentation Committee score was normal in 12.5% and nearly normal in 45.8% whereas in Group N, 24.1% were normal and 55.2% nearly normal. Patients with generalized joint laxity showed more posterior laxity than patients without joint laxity. Generalized joint laxity therefore appears to be a risk factor associated with posterior laxity after posterior cruciate ligament reconstruction. Level of Evidence: Level III, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence. PMID:18843524

  2. Advances in reconstruction of digital joints.

    PubMed

    Schenck, R R

    1997-01-01

    The recent development of dynamic traction provides several advantages for the treatment of intra-articular fractures of the hand: Ligamentotaxis reduces fracture fragments and realigns joint surfaces, Contracture of joint ligament and periarticular structures is prevented, Collapse of fracture fragments is prevented, Cartilage healing and regeneration are enhanced, Joint mobility is retained, Extensive surgery may be avoided, As Leonardo da Vinci stated, "To understand motion is to understand nature." PMID:9211036

  3. Diagnostic challenges in acromioclavicular septic arthritis.

    PubMed

    Williams, Mark

    2016-01-01

    A 69-year-old man with Klinefelter's syndrome presented with a painful shoulder and staphylococcal sepsis. He received intravenous antibiotics while investigations were performed to locate the source of infection. MRI demonstrated infection in the acromioclavicular joint (ACJ). The patient clinically improved and a further 5 weeks of oral antibiotics were given. He remained asymptomatic at 2-year follow-up. Although ACJ septic arthritis is rare, independent of immune-competent status, a high index of suspicion is essential for prompt diagnosis. The condition presents additional diagnostic challenges due to unfamiliarity, the challenges of interpreting imaging, desire for radiological guided arthrocentesis and low volume aspirates. Overcoming these pitfalls is essential to avoid significant morbidity and mortality. PMID:27257000

  4. Bilateral Acromioclavicular Septic Arthritis as an Initial Presentation of Streptococcus pneumoniae Endocarditis

    PubMed Central

    Hashemi-Sadraei, Neda; Gupta, Rohan; Machicado, Jorge D.; Govindu, Rukma

    2014-01-01

    Infective endocarditis (IE) is infrequently associated with septic arthritis. Moreover, septic arthritis of the acromioclavicular (AC) joint is rarely reported in the literature. We report a case of Streptococcus pneumoniae IE in a patient who presented with bilateral AC joint septic arthritis and we review the literature on the topic. PMID:24987538

  5. Anterior Cruciate Ligament Reconstruction in Patients with Generalized Joint Laxity

    PubMed Central

    Kim, Sung-Jae; Kumar, Praveen

    2010-01-01

    Generalized joint laxity is a genetically determined component of overall joint flexibility. The incidence of joint laxity in the overall population is approximately 5% to 20%, and its prevalence is higher in females. Recently it was noticed that individuals with generalized joint laxity are not only prone to anterior cruciate ligament injuries but also have inferior results after a reconstruction. Therefore, an anterior cruciate ligament reconstruction in patients with generalized laxity should be undertaken with caution due to the higher expected failure rate from the complexity of problems associated with this condition. It is also necessary to identify the risk factors for the injury as well as for the post operative outcome in this population. A criterion that includes all the associated components is necessary for the proper screening of individuals for generalized joint laxity. Graft selection for an anterior cruciate reconstruction in patients with ligament laxity is a challenge. According to the senior author, a hamstring autograft is an inferior choice and a double bundle reconstruction with a quadriceps tendon-bone autograft yields better results than a single bundle bone-patella tendon-bone autograft. Future studies comparing the different grafts available might be needed to determine the preferred graft for this subset of patients. Improved results after an anterior cruciate ligament reconstruction can be achieved by proper planning and careful attention to each step beginning from the clinical examination to the postoperative rehabilitation. PMID:20808583

  6. Joint Planck and WMAP CMB map reconstruction

    NASA Astrophysics Data System (ADS)

    Bobin, J.; Sureau, F.; Starck, J.-L.; Rassat, A.; Paykari, P.

    2014-03-01

    We present a novel estimate of the cosmological microwave background (CMB) map by combining the two latest full-sky microwave surveys: WMAP nine-year and Planck PR1. The joint processing benefits from a recently introduced component separation method coined"local-generalized morphological component analysis" (LGMCA) and based on the sparse distribution of the foregrounds in the wavelet domain. The proposed estimation procedure takes advantage of the IRIS 100 μm as an extra observation on the galactic center for enhanced dust removal. We show that this new CMB map presents several interesting aspects: i) it is a full sky map without using any inpainting or interpolating method; ii) foreground contamination is very low; iii) the Galactic center is very clean with especially low dust contamination as measured by the cross-correlation between the estimated CMB map and the IRIS 100 μm map; and iv) it is free of thermal SZ contamination. Appendix is available in electronic form at http://www.aanda.org

  7. Joint model of motion and anatomy for PET image reconstruction

    SciTech Connect

    Qiao Feng; Pan Tinsu; Clark, John W. Jr.; Mawlawi, Osama

    2007-12-15

    Anatomy-based positron emission tomography (PET) image enhancement techniques have been shown to have the potential for improving PET image quality. However, these techniques assume an accurate alignment between the anatomical and the functional images, which is not always valid when imaging the chest due to respiratory motion. In this article, we present a joint model of both motion and anatomical information by integrating a motion-incorporated PET imaging system model with an anatomy-based maximum a posteriori image reconstruction algorithm. The mismatched anatomical information due to motion can thus be effectively utilized through this joint model. A computer simulation and a phantom study were conducted to assess the efficacy of the joint model, whereby motion and anatomical information were either modeled separately or combined. The reconstructed images in each case were compared to corresponding reference images obtained using a quadratic image prior based maximum a posteriori reconstruction algorithm for quantitative accuracy. Results of these studies indicated that while modeling anatomical information or motion alone improved the PET image quantitation accuracy, a larger improvement in accuracy was achieved when using the joint model. In the computer simulation study and using similar image noise levels, the improvement in quantitation accuracy compared to the reference images was 5.3% and 19.8% when using anatomical or motion information alone, respectively, and 35.5% when using the joint model. In the phantom study, these results were 5.6%, 5.8%, and 19.8%, respectively. These results suggest that motion compensation is important in order to effectively utilize anatomical information in chest imaging using PET. The joint motion-anatomy model presented in this paper provides a promising solution to this problem.

  8. Type III acromioclavicular separation: results of a recent survey on its management.

    PubMed

    Nissen, Carl W; Chatterjee, Abhishek

    2007-02-01

    The issue of managing type III acromioclavicular (AC) separations remains controversial, and decisions about using operative versus conservative management have undergone many distinct changes over the years. To review current management preferences within the orthopedic community, we sent a mail-in survey to all members of the American Orthopaedic Society for Sports Medicine (AOSSM) and approved Accreditation Council for Graduate Medical Education (ACGME) orthopedic program residency directors. Of the 664 respondents (577 AOSSM members, 87 directors), 81% (71/87 AOSSM members) to 86% (502/577 directors) continue to treat uncomplicated type III AC separations conservatively. Providing a sling for comfort remains the preferred type of conservative management (AOSSM members, 91% [456/502]; directors, 89% [63/71]). For surgical management, respondents recommended resection of the distal clavicle slightly more often than not (AOSSM members, 57% [42/74]; directors, 59% [319/538]) and rigid stabilization of the AC joint during early postoperative rehabilitation (AOSSM members, 80% [444/555]; directors, 82% [61/74]). Finally, most recommended reconstructing either the coracoclavicular ligaments (69% [330/476] and 61% [33/54], respectively) or both the coracoclavicular ligaments and the AC ligaments (27% 130/476] and 33% [18/54]) when addressing this problem. Since the early 1990s, there has been little change in initial conservative management of type III AC separations. Furthermore, the surgical approach to reconstruction, when necessary, has also undergone relatively few changes, with the exception of an increased preference for primary distal clavicle excision. PMID:17405638

  9. Bayesian PET image reconstruction incorporating anato-functional joint entropy

    NASA Astrophysics Data System (ADS)

    Tang, Jing; Rahmim, Arman

    2009-12-01

    We developed a maximum a posterior (MAP) reconstruction method for positron emission tomography (PET) image reconstruction incorporating magnetic resonance (MR) image information, with the joint entropy between the PET and MR image features serving as the regularization constraint. A non-parametric method was used to estimate the joint probability density of the PET and MR images. Using realistically simulated PET and MR human brain phantoms, the quantitative performance of the proposed algorithm was investigated. Incorporation of the anatomic information via this technique, after parameter optimization, was seen to dramatically improve the noise versus bias tradeoff in every region of interest, compared to the result from using conventional MAP reconstruction. In particular, hot lesions in the FDG PET image, which had no anatomical correspondence in the MR image, also had improved contrast versus noise tradeoff. Corrections were made to figures 3, 4 and 6, and to the second paragraph of section 3.1 on 13 November 2009. The corrected electronic version is identical to the print version.

  10. Joint regularization for spectro-temporal CT reconstruction

    NASA Astrophysics Data System (ADS)

    Clark, D. P.; Badea, C. T.

    2016-03-01

    X-ray CT is widely used, both clinically and preclinically, for fast, high-resolution, anatomic imaging; however, compelling opportunities exist to expand its use in functional imaging applications. For instance, spectral information combined with nanoparticle contrast agents enables quantification of tissue perfusion levels, while temporal information details cardiac and respiratory dynamics. In previous work, we proposed and demonstrated a projection acquisition and reconstruction strategy for 5D CT (3D + dual-energy + time) which recovered spectral and temporal information without substantially increasing radiation dose or sampling time relative to anatomic imaging protocols. The approach relied on the approximate separability of the temporal and spectral reconstruction sub-problems, which enabled substantial projection undersampling and effective regularization. Here, we extend this previous work to more general, nonseparable 5D CT reconstruction cases (3D + muti-energy + time) with applicability to K-edge imaging of exogenous contrast agents. We apply the newly proposed algorithm in phantom simulations using a realistic system and noise model for a photon counting x-ray detector with six energy thresholds. The MOBY mouse phantom used contains realistic concentrations of iodine, gold, and calcium in water. Relative to weighted least-squares reconstruction, the proposed 5D reconstruction algorithm improved reconstruction and material decomposition accuracy by 3-18 times. Furthermore, by exploiting joint, low rank image structure between time points and energies, ~80 HU of contrast associated with the Kedge of gold and ~35 HU of contrast associated with the blood pool and myocardium were recovered from more than 400 HU of noise.

  11. Joint image reconstruction and sensitivity estimation in SENSE (JSENSE).

    PubMed

    Ying, Leslie; Sheng, Jinhua

    2007-06-01

    Parallel magnetic resonance imaging (pMRI) using multichannel receiver coils has emerged as an effective tool to reduce imaging time in various applications. However, the issue of accurate estimation of coil sensitivities has not been fully addressed, which limits the level of speed enhancement achievable with the technology. The self-calibrating (SC) technique for sensitivity extraction has been well accepted, especially for dynamic imaging, and complements the common calibration technique that uses a separate scan. However, the existing method to extract the sensitivity information from the SC data is not accurate enough when the number of data is small, and thus erroneous sensitivities affect the reconstruction quality when they are directly applied to the reconstruction equation. This paper considers this problem of error propagation in the sequential procedure of sensitivity estimation followed by image reconstruction in existing methods, such as sensitivity encoding (SENSE) and simultaneous acquisition of spatial harmonics (SMASH), and reformulates the image reconstruction problem as a joint estimation of the coil sensitivities and the desired image, which is solved by an iterative optimization algorithm. The proposed method was tested on various data sets. The results from a set of in vivo data are shown to demonstrate the effectiveness of the proposed method, especially when a rather large net acceleration factor is used. PMID:17534910

  12. EXTRA-ARTICULAR FRACTURE OF THE MEDIAL END OF THE CLAVICLE ASSOCIATED WITH TYPE IV ACROMIOCLAVICULAR DISLOCATION: CAAE REPORT

    PubMed Central

    Correa, Mário Chaves; Gonçalves, Lucas Braga Jacques; Vilela, Jose Carlos Souza; Leonel, Igor Lima; Costa, Lincoln Paiva; de Andrade, Ronaldo Percopi

    2015-01-01

    Fractures of the clavicle and acromioclavicular dislocations are very common injuries when they occur separately. The combination of an acromioclavicular dislocation and a fracture of the lateral third of the clavicle is not rare. However, there are very few reported cases of acromioclavicular dislocations associated with fractures of the middle third of the clavicle; those associated with fractures of the medial third are even rarer. We report the case of an adult male who suffered an acromioclavicular dislocation (type IV) associated with a displaced extra-articular fracture of the medial end of the clavicle (Almann group 3) in a cycling accident. The patient was treated during the acute phase with open reduction and internal fixation of the two lesions. At the clinical evaluation 12 months after the surgery, the patient was asymptomatic, with full active and passive mobility, and normal strength and endurance of the shoulder girdle. Radiographs and a three-dimensional CT scan showed persistent posterosuperior subluxation of the acromioclavicular joint and anatomical consolidation of the clavicular fracture. PMID:27027060

  13. Reconstructing DNA copy number by joint segmentation of multiple sequences

    PubMed Central

    2012-01-01

    Background Variations in DNA copy number carry information on the modalities of genome evolution and mis-regulation of DNA replication in cancer cells. Their study can help localize tumor suppressor genes, distinguish different populations of cancerous cells, and identify genomic variations responsible for disease phenotypes. A number of different high throughput technologies can be used to identify copy number variable sites, and the literature documents multiple effective algorithms. We focus here on the specific problem of detecting regions where variation in copy number is relatively common in the sample at hand. This problem encompasses the cases of copy number polymorphisms, related samples, technical replicates, and cancerous sub-populations from the same individual. Results We present a segmentation method named generalized fused lasso (GFL) to reconstruct copy number variant regions. GFL is based on penalized estimation and is capable of processing multiple signals jointly. Our approach is computationally very attractive and leads to sensitivity and specificity levels comparable to those of state-of-the-art specialized methodologies. We illustrate its applicability with simulated and real data sets. Conclusions The flexibility of our framework makes it applicable to data obtained with a wide range of technology. Its versatility and speed make GFL particularly useful in the initial screening stages of large data sets. PMID:22897923

  14. Arthroscopically Assisted Anatomic Coracoclavicular Ligament Reconstruction Technique Using Coracoclavicular Fixation and Soft-Tissue Grafts

    PubMed Central

    Millett, Peter J.; Warth, Ryan J.; Greenspoon, Joshua A.; Horan, Marilee P.

    2015-01-01

    Acromioclavicular joint injuries are common and are often seen in contact athletes. Good to excellent clinical results have been reported using soft-tissue grafts to reconstruct the coracoclavicular ligaments; however, complications remain. Some complications are unique to the surgical technique, particularly clavicle and coracoid fractures that are associated with drilling large or multiple bone tunnels. The described technique allows for an anatomic coracoclavicular reconstruction using a large soft-tissue graft while minimizing the risk of clavicle fracture by avoiding large bone tunnels. PMID:26900558

  15. Reconstruction of Temporomandibular Joint With a Fibula Free Flap: A Case Report With a Histological Study.

    PubMed

    Fariña, Rodrigo; Campos, Pía; Beytía, Javiera; Martínez, Benjamín

    2015-12-01

    Reconstruction of the temporomandibular joint (TMJ) for congenital or acquired deformities is a major challenge for maxillofacial surgeons. The alternatives for reconstructing the TMJ include free grafts (costochondral, iliac crest, clavicle, or metatarsus), free flaps (fibula), osteogenic distraction, and alloplastic grafts. The lack of biological knowledge of cartilaginous grafts and their reaction to the environment of the TMJ is largely responsible for the inability to predict growth. This report describes the use of a free flap for TMJ reconstruction. PMID:26342950

  16. Joint Line Reconstruction in Navigated Total Knee Arthroplasty Revision

    ClinicalTrials.gov

    2012-05-16

    Revision Total Knee Arthroplasty Because of; Loosening; Instability; Impingement; or Other Reasons Accepted as Indications for TKA Exchange.; The Focus is to Determine the Precision of Joint Line Restoration in Navigated vs. Conventional Revision Total Knee Arthroplasty

  17. Free fibula flap elbow-joint hemiarthroplasty reconstruction for chronic osteomyelitis of the distal humerus.

    PubMed

    Barnea, Yoav; Amir, Aharon; Shlomo, Dadia; Cohen, Nir; Zaretski, Arik; Leshem, David; Miller, Ehud; Meilik, Benny; Kollender, Yehuda; Meller, Isaac; Bickels, Jacob; Gur, Eyal

    2006-04-01

    The vascularized fibula flap has become a major tool in upper limb reconstruction. Free fibula flap reconstructions of the humeral part of the shoulder and the radial part of the wrist joints are well-documented, but reports of elbow joint reconstruction are rare. The authors report a 53-year-old patient with chronic osteomyelitis of the distal humerus that was unsuccessfully treated by many local surgical debridements and long-term systemic antibiotics. The patient underwent a wide debridement of the distal two-thirds of the humerus, and a spacer was inserted to fill the bony humeral gap. At a second stage, the distal humerus was reconstructed with a free fibula flap that included the proximal fibular head. The fibular shaft was used to bridge the bony gap and the fibular head created an elbow joint with the olecranon process. At an 18-month follow-up after surgery, the patient has stable and sufficient function of his elbow joint with no signs of infection. The free fibula flap has an important role for distal humerus reconstruction, both for bridging the bony gap with a vascularized bone, and for restoring elbow joint function. PMID:16780045

  18. The anatomic coracoclavicular ligament reconstruction: surgical technique and indications.

    PubMed

    Carofino, Brad C; Mazzocca, Augustus D

    2010-03-01

    The anatomic coracoclavicular ligament reconstruction (ACCR) is a surgical procedure to address acriomioclavicular joint instability. The coracoclavicular ligaments are reconstructed using a semitendinosus allograft passed beneath the coracoid and through bone tunnels in the clavicle. The graft is secured with interference screw fixation, and the acromioclavicular joint is retained. Here we describe the authors' surgical technique, indications, and rehabilitation protocol. Also, a preliminary case series of seventeen patients is presented. Patients demonstrated significant improvement in pain levels and function. The mean ASES score increased from 52 preoperatively to 92. The Constant Murley rose from 66.6 to 94.7. There were three failures in this series, and two required revision surgery. PMID:20188267

  19. Towards disparity joint upsampling for robust stereoscopic endoscopic scene reconstruction in robotic prostatectomy

    NASA Astrophysics Data System (ADS)

    Luo, Xiongbiao; McLeod, A. Jonathan; Jayarathne, Uditha L.; Pautler, Stephen E.; Schlacta, Christopher M.; Peters, Terry M.

    2016-03-01

    Three-dimensional (3-D) scene reconstruction from stereoscopic binocular laparoscopic videos is an effective way to expand the limited surgical field and augment the structure visualization of the organ being operated in minimally invasive surgery. However, currently available reconstruction approaches are limited by image noise, occlusions, textureless and blurred structures. In particular, an endoscope inside the body only has the limited light source resulting in illumination non-uniformities in the visualized field. These limitations unavoidably deteriorate the stereo image quality and hence lead to low-resolution and inaccurate disparity maps, resulting in blurred edge structures in 3-D scene reconstruction. This paper proposes an improved stereo correspondence framework that integrates cost-volume filtering with joint upsampling for robust disparity estimation. Joint bilateral upsampling, joint geodesic upsampling, and tree filtering upsampling were compared to enhance the disparity accuracy. The experimental results demonstrate that joint upsampling provides an effective way to boost the disparity estimation and hence to improve the surgical endoscopic scene 3-D reconstruction. Moreover, the bilateral upsampling generally outperforms the other two upsampling methods in disparity estimation.

  20. Immediate effects of neuromuscular joint facilitation intervention after anterior cruciate ligament reconstruction.

    PubMed

    Wang, Lei

    2016-07-01

    [Purpose] The aim of this study was to examine the immediate effects of neuromuscular joint facilitation (NJF) on the functional activity level after rehabilitation of anterior cruciate ligament (ACL) reconstruction. [Subjects and Methods] Ten young subjects (8 males and 2 females) who underwent ACL reconstruction were included in the study. The subjects were divided into two groups, namely, knee joint extension muscle strength training (MST) group and knee joint extension outside rotation pattern of NJF group. Extension strength was measured in both groups before and after the experiment. Surface electromyography (sEMG) of the vastus medialis and vastus lateralis muscles and joint position error (JPE) test of the knee joint were also conducted. [Results] JPE test results and extension strength measurements in the NJF group were improved compared with those in the MST group. Moreover, the average discharge of the vastus medialis and vastus lateralis muscles on sEMG in the NJF group was significantly increased after MST and NJF treatments. [Conclusion] The obtained results suggest that NJF training in patients with ACL reconstruction can improve knee proprioception ability and muscle strength. PMID:27512270

  1. Immediate effects of neuromuscular joint facilitation intervention after anterior cruciate ligament reconstruction

    PubMed Central

    Wang, Lei

    2016-01-01

    [Purpose] The aim of this study was to examine the immediate effects of neuromuscular joint facilitation (NJF) on the functional activity level after rehabilitation of anterior cruciate ligament (ACL) reconstruction. [Subjects and Methods] Ten young subjects (8 males and 2 females) who underwent ACL reconstruction were included in the study. The subjects were divided into two groups, namely, knee joint extension muscle strength training (MST) group and knee joint extension outside rotation pattern of NJF group. Extension strength was measured in both groups before and after the experiment. Surface electromyography (sEMG) of the vastus medialis and vastus lateralis muscles and joint position error (JPE) test of the knee joint were also conducted. [Results] JPE test results and extension strength measurements in the NJF group were improved compared with those in the MST group. Moreover, the average discharge of the vastus medialis and vastus lateralis muscles on sEMG in the NJF group was significantly increased after MST and NJF treatments. [Conclusion] The obtained results suggest that NJF training in patients with ACL reconstruction can improve knee proprioception ability and muscle strength. PMID:27512270

  2. Custom Anatomical 3D Spacer for Temporomandibular Joint Resection and Reconstruction.

    PubMed

    Green, John Marshall; Lawson, Sarah T; Liacouras, Peter C; Wise, Edward M; Gentile, Michael A; Grant, Gerald Thomas

    2016-03-01

    Two cases are presented using a two-stage approach and a custom antibiotic spacer placement. Temporomandibular reconstruction can be very demanding and accomplished with a variety of methods in preparation of a total joint and ramus reconstruction with total joint prostheses (TMJ Concepts, Ventura, CA). Three-dimensional reconstructions from diagnostic computed tomography were used to establish a virtually planned resection which included the entire condyle-ramus complex. From these data, digital designs were used to manufacture molds to facilitate intraoperative fabrication of precise custom anatomic spacers from rapidly setting antibiotic-impregnated polymethyl methacrylate. Molds were manufactured using vat polymerization (stereolithography) with a photopolymer in the first case and powder bed fusion (electron beam melting) with Ti6AL4V for the second. Surgical methodology and the use of molds for intraoperative spacer fabrication for each case are discussed. PMID:26889353

  3. Total reconstruction of the temporomandibular joint. Up to 8 years of follow-up of patients treated with Biomet(®) total joint prostheses.

    PubMed

    Westermark, A

    2010-10-01

    12 patients underwent temporomandibular joint (TMJ) reconstruction with Biomet total joint prostheses. Indications for TMJ reconstruction included ankylosis, rheumatoid arthritis, degenerative joint disease and condylar resorption. Five patients had unilateral procedures, seven had bilateral. The follow-up ranged between 2 and 8 years. Amongst the ankylotic patients the mean jaw-opening capacity increased from 3.8mm preoperatively to 30.2mm 1 year after surgery, and in most of those patients the opening capacity remained stable over the years. The other patients maintained a mean opening capacity of more than 35 mm. Joint related pain and interference with eating were eliminated after TMJ reconstruction. There were no permanent facial nerve disturbance, no postoperative infections and no device related complications. The outcome supports prosthetic TMJ reconstruction as a useful treatment modality in patients with advanced TMJ disease. PMID:20594807

  4. Joint reconstruction of white-matter pathways from longitudinal diffusion MRI data with anatomical priors.

    PubMed

    Yendiki, Anastasia; Reuter, Martin; Wilkens, Paul; Rosas, H Diana; Fischl, Bruce

    2016-02-15

    We consider the problem of reconstructing white-matter pathways in a longitudinal study, where diffusion-weighted and T1-weighted MR images have been acquired at multiple time points for the same subject. We propose a method for joint reconstruction of a subject's pathways at all time points given the subject's entire set of longitudinal data. We apply a method for unbiased within-subject registration to generate a within-subject template from the T1-weighted images of the subject at all time points. We follow a global probabilistic tractography approach, where the unknown pathway is represented in the space of this within-subject template and propagated to the native space of the diffusion-weighted images at all time points to compute its posterior probability given the images. This ensures spatial correspondence of the reconstructed pathway among time points, which in turn allows longitudinal changes in diffusion measures to be estimated consistently along the pathway. We evaluate the reliability of the proposed method on data from healthy controls scanned twice within a month, where no changes in white-matter microstructure are expected between scans. We evaluate the sensitivity of the method on data from Huntington's disease patients scanned repeatedly over the course of several months, where changes are expected between scans. We show that reconstructing white-matter pathways jointly using the data from all time points leads to improved reliability and sensitivity, when compared to reconstructing the pathways at each time point independently. PMID:26717853

  5. Kinematic reconstruction of the human arm joints in robot-aided therapies with Hermes robot.

    PubMed

    Bertomeu-Motos, Arturo; Morales, Ricardo; Lledo, Luis D; Diez, Jorge A; Catalan, Jose M; Garcia-Aracil, Nicolas

    2015-08-01

    This paper presents a kinematic reconstruction algorithm for the variables of the human arm joints in robot-aided neurorehabilitation therapies. The presented algorithm uses the end effector of a rehabilitation robot and an accelerometer placed onto the upper arm to compute accurate values of the human arm chain. The goal of this algorithm is to obtain the joint values of the patient's arm to provide objective information to the therapist about the progress of the patient and to study the effectiveness of these kind of therapies. PMID:26736479

  6. Joint reconstruction of absorption and refractive properties in propagation-based x-ray phase-contrast tomography via a non-linear image reconstruction algorithm

    NASA Astrophysics Data System (ADS)

    Chen, Yujia; Wang, Kun; Gursoy, Doga; Soriano, Carmen; De Carlo, Francesco; Anastasio, Mark A.

    2016-03-01

    Propagation-based X-ray phase-contrast tomography (XPCT) provides the opportunity to image weakly absorbing objects and is being explored actively for a variety of important pre-clinical applications. Quantitative XPCT image reconstruction methods typically involve a phase retrieval step followed by application of an image reconstruction algorithm. Most approaches to phase retrieval require either acquiring multiple images at different object-to-detector distances or introducing simplifying assumptions, such as a single-material assumption, to linearize the imaging model. In order to overcome these limitations, a non-linear image reconstruction method has been proposed previously that jointly estimates the absorption and refractive properties of an object from XPCT projection data acquired at a single propagation distance, without the need to linearize the imaging model. However, the numerical properties of the associated non-convex optimization problem remain largely unexplored. In this study, computer simulations are conducted to investigate the feasibility of the joint reconstruction problem in practice. We demonstrate that the joint reconstruction problem is ill-posed and sensitive to system inconsistencies. Particularly, the method can generate accurate refractive index images only if the object is thin and has no phase-wrapping in the data. However, we also observed that, for weakly absorbing objects, the refractive index images reconstructed by the joint reconstruction method are, in general, more accurate than those reconstructed using methods that simply ignore the object's absorption.

  7. Coracoclavicular Ligament Reconstruction

    PubMed Central

    Li, Qi; Hsueh, Pei-ling; Chen, Yun-feng

    2014-01-01

    Abstract Operative intervention is recommended for complete acromioclavicular (AC) joint dislocation to restore AC stability, but the best operative technique is still controversial. Twelve fresh-frozen male cadaveric shoulders (average age, 62.8 ± 7.8 years) were equally divided into endobutton versus the modified Weaver-Dunn groups. Each potted scapula and clavicle was fixed in a custom made jig to allow translation and load to failure testing using a Zwick BZ2.5/TS1S material testing machine (Zwick/Roell Co, Germany). A systematic review of 21 studies evaluating reconstructive methods for coracoclavicular or AC joints using a cadaveric model was also performed. From our biomechanical study, after ligament reconstruction, the triple endobutton technique demonstrated superior, anterior, and posterior displacements similar to that of the intact state (P > 0.05). In the modified Weaver-Dunn reconstruction group, however, there was significantly greater anterior (P < 0.001) and posterior (P = 0.003) translation after ligament reconstruction. In addition, there was no significant difference after reconstruction between failure load of the triple endobutton group and that of the intact state (686.88 vs 684.9 N, P > 0.05), whereas the failure load after the modified Weaver-Dunn reconstruction was decreased compared with the intact state (171.64 vs 640.86 N, P < 0.001). From our systematic review of 21 studies, which involved comparison of the modified Weaver-Dunn technique with other methods, the majority showed that the modified Weaver-Dunn procedure had significantly (P < .05) greater laxity than other methods including the endobutton technique. The triple endobutton reconstruction proved superior to the modified Weaver-Dunn technique in restoration of AC joint stability and strength. Triple endobutton reconstruction of the coracoclavicular ligament is superior to the modified Weaver-Dunn reconstruction in controlling both superior and

  8. Help Desk Answers: Surgery vs conservative management for AC joint repair: How do the 2 compare?

    PubMed

    Matchin, Bruce; Yee, Bruce; Mott, Timothy

    2016-04-01

    When not considering the grade of acromioclavicular (AC) joint dislocation, both conservative and surgical management lead to positive outcomes, although surgically managed patients require more time out of work. PMID:27262254

  9. Effects of neuromuscular training on knee joint stability after anterior cruciate ligament reconstruction.

    PubMed

    Shim, Jae-Kwang; Choi, Ho-Suk; Shin, Jun-Ho

    2015-12-01

    [Purpose] This study examined the effects of neuromuscular training on knee joint stability after anterior cruciate ligament reconstruction. [Subjects and Methods] The subjects were 16 adults who underwent arthroscopic anterior cruciate reconstruction and neuromuscular training. The Lysholm scale was used to assess functional disorders on the affected knee joint. A KT-2000 arthrometer was used to measure anterior displacement of the tibia against the femur. Surface electromyography was used to detect the muscle activation of the vastus medialis oblique, vastus lateralis, biceps femoris, and semitendinosus before and after neuromuscular training. [Results] There was significant relaxation in tibial anterior displacement of the affected and sound sides in the supine position before neuromuscular training. Furthermore, the difference in the tibial anterior displacement of the affected knee joints in the standing position was reduced after neuromuscular training. Moreover, the variation of the muscle activation evoked higher muscle activation of the vastus medialis oblique, vastus lateralis, biceps femoris, and semitendinosus. [Conclusion] Neuromuscular training may improve functional joint stability in patients with orthopedic musculoskeletal injuries in the postoperative period. PMID:26834316

  10. Reconstruction of shifting elbow joint compliant characteristics during fast and slow movements.

    PubMed

    Latash, M L; Gottlieb, G L

    1991-01-01

    The purpose of this study was to experimentally investigate the applicability of the equilibrium-point hypothesis to the dynamics of single-joint movements. Subjects were trained to perform relatively slow (movement time 600-1000 ms) or fast (movement time 200-300 ms) single-joint elbow flexion movements against a constant extending torque bias. They were instructed to reproduce the same time pattern of central motor command for a series of movements when the external torque could slowly and unpredictably increase, decrease, or remain constant. For fast movements, the total muscle torque was calculated as a sum of external and inertial components. Analysis of the data allowed reconstruction of the elbow joint compliant characteristics at different times during execution of the learned motor command. "Virtual" trajectories of the movements, representing time-varying changes in a central control parameter, were reconstructed and compared with the "actual" trajectories. For slow movements, the actual trajectories lagged behind the virtual ones. There were no consistent changes in the joint stiffness during slow movements. Similar analysis of experiments without voluntary movements demonstrated a lack of changes in the central parameters, supporting the assumption that the subjects were able to keep the same central motor command in spite of externally imposed unexpected torque perturbations. For the fast movements, the virtual trajectories were N-shaped, and the joint stiffness demonstrated a considerable increase near the middle of the movement. These findings contradict an hypothesis of monotonic joint compliant characteristic translation at a nearly constant rate during such movements. PMID:1922790

  11. Reconstruction of high voltage electric burn wound with exposed shoulder joint by thoracoacromial artery perforator propeller flap

    PubMed Central

    Rout, Debesh Kumar; Nayak, Bibhuti Bhusan; Choudhury, Arun Kumar; Pati, Ajit Kumar

    2014-01-01

    We describe the reconstruction of high voltage electric burn injury with exposed shoulder joint by thoracoacromial artery perforator propeller flap based on the delto-pectoral perforators of thoracoacromial artery. The successful use of this propeller flap to cover the exposed shoulder joint in a case with limited local flap options demonstrates its use as an alternative technique. PMID:25190925

  12. Newly developed anatomical and functional ligament reconstruction for the Lisfranc joint fracture dislocations: a case report.

    PubMed

    Hirano, Takaaki; Niki, Hisateru; Beppu, Moroe

    2014-09-01

    A 15-year-old male complained of pain in the left foot that occurred when changing direction while running and at presentation, he had difficulty in walking due to pain and swelling. Plain X-ray of the foot revealed a Myerson Type B2 Lisfranc fracture dislocation, and 3-D computed tomography (CT) revealed proximal fractures of the 2nd-4th metatarsals. The Lisfranc ligament was anatomically reconstructed using a graft of the gracilis tendon. During aftercare, partial weight bearing was permitted at 6 weeks postoperatively and full weight bearing at 8 weeks postoperatively. The patient resumed sporting activities 3 months postoperatively. A plain X-ray taken 12 months postoperatively showed favorable joint congruency, and the patient scored 100 points on the Japanese Society for Surgery of the Foot standard rating system midfoot scale. Our anatomical ligament reconstruction is a useful new method of anatomical reduction and maintenance, and it shortens the duration of aftercare. PMID:25103712

  13. A joint Richardson—Lucy deconvolution algorithm for the reconstruction of multifocal structured illumination microscopy data

    NASA Astrophysics Data System (ADS)

    Ströhl, Florian; Kaminski, Clemens F.

    2015-03-01

    We demonstrate the reconstruction of images obtained by multifocal structured illumination microscopy, MSIM, using a joint Richardson-Lucy, jRL-MSIM, deconvolution algorithm, which is based on an underlying widefield image-formation model. The method is efficient in the suppression of out-of-focus light and greatly improves image contrast and resolution. Furthermore, it is particularly well suited for the processing of noise corrupted data. The principle is verified on simulated as well as experimental data and a comparison of the jRL-MSIM approach with the standard reconstruction procedure, which is based on image scanning microscopy, ISM, is made. Our algorithm is efficient and freely available in a user friendly software package.

  14. Joint reconstruction of non-overlapping magnetic particle imaging focus-field data.

    PubMed

    Knopp, T; Them, K; Kaul, M; Gdaniec, N

    2015-04-21

    The focus field is a key component to enable clinical applications in magnetic particle imaging (MPI). Due to physiological constraints, the method of choice is to place the focus of a small acquisition volume at various static positions in space and acquire the full field-of-view using a multi-station approach. In the first experiments, overlapping drive-field patches were used and boundary artifacts between drive-field patches were reduced using image processing. In this work we show that artifact-free reconstruction of non-overlapping focus-field data is feasible by using a joint reconstruction algorithm. This enables maximum scanning efficiency in multi-station focus-field experiments, which is key for reaching sufficiently short acquisition times to image the human heart. PMID:25803656

  15. Joint reconstruction of non-overlapping magnetic particle imaging focus-field data

    NASA Astrophysics Data System (ADS)

    Knopp, T.; Them, K.; Kaul, M.; Gdaniec, N.

    2015-04-01

    The focus field is a key component to enable clinical applications in magnetic particle imaging (MPI). Due to physiological constraints, the method of choice is to place the focus of a small acquisition volume at various static positions in space and acquire the full field-of-view using a multi-station approach. In the first experiments, overlapping drive-field patches were used and boundary artifacts between drive-field patches were reduced using image processing. In this work we show that artifact-free reconstruction of non-overlapping focus-field data is feasible by using a joint reconstruction algorithm. This enables maximum scanning efficiency in multi-station focus-field experiments, which is key for reaching sufficiently short acquisition times to image the human heart.

  16. Computed Tomographic Image Analysis Based on FEM Performance Comparison of Segmentation on Knee Joint Reconstruction

    PubMed Central

    Jang, Seong-Wook; Seo, Young-Jin; Yoo, Yon-Sik

    2014-01-01

    The demand for an accurate and accessible image segmentation to generate 3D models from CT scan data has been increasing as such models are required in many areas of orthopedics. In this paper, to find the optimal image segmentation to create a 3D model of the knee CT data, we compared and validated segmentation algorithms based on both objective comparisons and finite element (FE) analysis. For comparison purposes, we used 1 model reconstructed in accordance with the instructions of a clinical professional and 3 models reconstructed using image processing algorithms (Sobel operator, Laplacian of Gaussian operator, and Canny edge detection). Comparison was performed by inspecting intermodel morphological deviations with the iterative closest point (ICP) algorithm, and FE analysis was performed to examine the effects of the segmentation algorithm on the results of the knee joint movement analysis. PMID:25538950

  17. Computed tomographic image analysis based on FEM performance comparison of segmentation on knee joint reconstruction.

    PubMed

    Jang, Seong-Wook; Seo, Young-Jin; Yoo, Yon-Sik; Kim, Yoon Sang

    2014-01-01

    The demand for an accurate and accessible image segmentation to generate 3D models from CT scan data has been increasing as such models are required in many areas of orthopedics. In this paper, to find the optimal image segmentation to create a 3D model of the knee CT data, we compared and validated segmentation algorithms based on both objective comparisons and finite element (FE) analysis. For comparison purposes, we used 1 model reconstructed in accordance with the instructions of a clinical professional and 3 models reconstructed using image processing algorithms (Sobel operator, Laplacian of Gaussian operator, and Canny edge detection). Comparison was performed by inspecting intermodel morphological deviations with the iterative closest point (ICP) algorithm, and FE analysis was performed to examine the effects of the segmentation algorithm on the results of the knee joint movement analysis. PMID:25538950

  18. Predictors of Lateral Compartment Joint Space Difference at a Minimum of Two Years after ACL Reconstruction

    PubMed Central

    Jones, Morgan H.; Reinke, Emily; Duryea, Jeffrey; Fleming, Braden C.; Obuchowski, Nancy; Winalski, Carl S.; Spindler, Kurt P.

    2016-01-01

    Objectives: ACL reconstruction effectively restores knee stability and allows a return to athletic activities after ACL injury, but patients are still at higher risk of developing post-traumatic OA. Patient reported outcomes from the Multicenter Orthopaedic Outcomes Network (MOON) prospective longitudinal cohort of over 1500 patients undergoing ACL reconstruction showed no increase in OA symptoms (KOOS subscale) at 2 or 6 years after surgery. Therefore, identification of structural changes of OA that may precede the onset of symptoms is of critical importance for determining risk factors for the initiation and progression of post-traumatic OA in addition to measuring the effectiveness of potential disease-modifying treatments. One structural measure of OA is radiographic joint space width (JSW). We previously demonstrated that meniscus treatment and age predict narrower medial compartment JSW. Methods: 335 patients from the MOON cohort (154 males, 181 females, median age 18 years at the time of surgery) were recruited at a minimum of 2 years following surgery for on-site evaluations including bilateral metatarsophalangeal joint (MTP) radiographs to assess JSW. To minimize bias related to pre-existing knee injury or OA, subjects were 35 years or younger, were injured playing a sport, had primary ACL reconstruction without prior meniscus or articular cartilage surgery, did not undergo subsequent ACL revision, and had a surgically normal contralateral knee. Radiographic JSW was measured in the lateral compartment of both knees using a validated semiautomated method. The association of age, sex, BMI, meniscus treatment, and articular cartilage treatment with lateral compartment JSW differences (JSD) between the reconstructed and normal knees was examined using multivariable generalized linear models. The Holm-Bonferroni method was used to account for multiple comparisons. Results: The mean lateral compartment JSW was 7.73 mm and (95% CI 7.61-7.85 mm) for ACL

  19. Joint Simultaneous Reconstruction of Regularized Building Superstructures from Low-Density LIDAR Data Using Icp

    NASA Astrophysics Data System (ADS)

    Wichmann, Andreas; Kada, Martin

    2016-06-01

    There are many applications for 3D city models, e.g., in visualizations, analysis, and simulations; each one requiring a certain level of detail to be effective. The overall trend goes towards including various kinds of anthropogenic and natural objects therein with ever increasing geometric and semantic details. A few years back, the featured 3D building models had only coarse roof geometry. But nowadays, they are expected to include detailed roof superstructures like dormers and chimneys. Several methods have been proposed for the automatic reconstruction of 3D building models from airborne based point clouds. However, they are usually unable to reliably recognize and reconstruct small roof superstructures as these objects are often represented by only few point measurements, especially in low-density point clouds. In this paper, we propose a recognition and reconstruction approach that overcomes this problem by identifying and simultaneously reconstructing regularized superstructures of similar shape. For this purpose, candidate areas for superstructures are detected by taking into account virtual sub-surface points that are assumed to lie on the main roof faces below the measured points. The areas with similar superstructures are detected, extracted, grouped together, and registered to one another with the Iterative Closest Point (ICP) algorithm. As an outcome, the joint point density of each detected group is increased, which helps to recognize the shape of the superstructure more reliably and in more detail. Finally, all instances of each group of superstructures are modeled at once and transformed back to their original position. Because superstructures are reconstructed in groups, symmetries, alignments, and regularities can be enforced in a straight-forward way. The validity of the approach is presented on a number of example buildings from the Vaihingen test data set.

  20. Hip reconstruction osteotomy by Ilizarov method as a salvage option for abnormal hip joints.

    PubMed

    Umer, Masood; Rashid, Haroon; Umer, Hafiz Muhammad; Raza, Hasnain

    2014-01-01

    Hip joint instability can be secondary to congenital hip pathologies like developmental dysplasia (DDH) or acquired such as sequel of infective or neoplastic process. An unstable hip is usually associated with loss of bone from the proximal femur, proximal migration of the femur, lower-extremity length discrepancy, abnormal gait, and pain. In this case series of 37 patients coming to our institution between May 2005 and December 2011, we report our results in treatment of unstable hip joint by hip reconstruction osteotomy using the Ilizarov method and apparatus. This includes an acute valgus and extension osteotomy of the proximal femur combined with gradual varus and distraction (if required) for realignment and lengthening at a second, more distal, femoral osteotomy. 18 males and 19 females participated in the study. There were 17 patients with DDH, 12 with sequelae of septic arthritis, 2 with tuberculous arthritis, 4 with posttraumatic arthritis, and 2 with focal proximal femoral deficiency. Outcomes were evaluated by using Harris Hip Scoring system. At the mean follow-up of 37 months, Harris Hip Score had significantly improved in all patients. To conclude, illizarov hip reconstruction can successfully improve Trendelenburg's gait. It supports the pelvis and simultaneously restores knee alignment and corrects lower-extremity length discrepancy (LLD). PMID:24895616

  1. Hip Reconstruction Osteotomy by Ilizarov Method as a Salvage Option for Abnormal Hip Joints

    PubMed Central

    Umer, Masood; Rashid, Haroon; Raza, Hasnain

    2014-01-01

    Hip joint instability can be secondary to congenital hip pathologies like developmental dysplasia (DDH) or acquired such as sequel of infective or neoplastic process. An unstable hip is usually associated with loss of bone from the proximal femur, proximal migration of the femur, lower-extremity length discrepancy, abnormal gait, and pain. In this case series of 37 patients coming to our institution between May 2005 and December 2011, we report our results in treatment of unstable hip joint by hip reconstruction osteotomy using the Ilizarov method and apparatus. This includes an acute valgus and extension osteotomy of the proximal femur combined with gradual varus and distraction (if required) for realignment and lengthening at a second, more distal, femoral osteotomy. 18 males and 19 females participated in the study. There were 17 patients with DDH, 12 with sequelae of septic arthritis, 2 with tuberculous arthritis, 4 with posttraumatic arthritis, and 2 with focal proximal femoral deficiency. Outcomes were evaluated by using Harris Hip Scoring system. At the mean follow-up of 37 months, Harris Hip Score had significantly improved in all patients. To conclude, illizarov hip reconstruction can successfully improve Trendelenburg's gait. It supports the pelvis and simultaneously restores knee alignment and corrects lower-extremity length discrepancy (LLD). PMID:24895616

  2. Reconstruction of knee joint soft tissue and patellar tendon defects using a composite anterolateral thigh flap with vascularized fascia lata.

    PubMed

    Kuo, Yur-Ren; An, Po-Chung; Kuo, Mei-Hui; Kueh, Nai-Siong; Yao, Sheng-Fa; Jeng, Seng-Feng

    2008-01-01

    Reconstruction of a complex knee trauma with knee joint exposure and composite soft tissue and patellar tendon deficiency remains a challenging task. Multiple-stage reconstruction is time-consuming and produces considerable suffering for patients. Early mobilization following knee reconstruction has achieved good outcomes. Herein, we reported one-stage reconstruction with an ALT myocutaneous flap with vascularized fascia lata was utilized for one patient with a large complex knee joint soft tissue defect, and segmental deficiency of the patellar tendon. The fascia lata sheet was rolled to mimic a patellar tendon. The exposed knee joint was obturated by the vastus lateralis muscle of the ALT myocutaneous flap. The skin and soft tissue defect was reconstructed using the skin paddle of the ALT flap. The patient's postoperative course was uneventful. An MRI examination demonstrated good continuity of the reconstructed patellar tendon. The active ROM of the injured knee reached 100 degrees (extension deficiency 20 degrees and flexion 120 degrees ) at 5 years. Objective functional assessment of the patella-femoral joint utilized a kinetic communicator machine (Kin-Com 500H, Chattecx, Chattanooga, TN, USA) revealed still mild extension insufficiency. However, the patient reported that he was able to perform normal daily activities without difficulty at 5-year follow-up. PMID:18215803

  3. Joint image reconstruction and motion parameter estimation for free-breathing navigator-gated cardiac MRI

    NASA Astrophysics Data System (ADS)

    Akçakaya, Mehmet; Basha, Tamer A.; Weingärtner, Sebastian; Nezafat, Reza

    2013-09-01

    We propose an acquisition and reconstruction technique for accelerated free-breathing cardiac MRI acquisitions. For the acquisition, a random undersampling pattern, including a fully-sampled center of k-space, is generated prospectively. The k-space lines specified by this undersampling pattern is acquired with respiratory navigating (NAV), where only the central k-space lines are acquired within the prespecified gating window. For the outer k-space lines, if the NAV signal corresponding to a k-space segment is outside the gating window, the segment is rejected, but not re-acquired. The reconstruction approach jointly estimates the underlying image using a compressed-sensing based approach, and the translational motion parameters for each segment for the outer k-space segments acquired outside the gating window. The feasibility of the approach is demonstrated in healthy adult subjects using whole-heart coronary MRI with a 3-fold accelerated random undersampling pattern. The proposed acquisition and reconstruction technique is compared to parallel imaging with uniform undersampling with 3-fold undersampling. The two techniques exhibit similar image quality with a shorter acquisition time for the proposed approach (4:25+/-0:31 minutes versus 6:52+/-0:19).

  4. Management of failed and infected first metatarsophalangeal joint implant arthroplasty by reconstruction with an acellular dermal matrix: a case report.

    PubMed

    Khoury, Wissam E; Fahim, Ramy; Sciulli, Jessica M; Ehredt, Duane J

    2012-01-01

    Management of failed first metatarsophalangeal joint implant arthroplasty, especially in the face of infection, is an area of debate without a clear consensus. The purpose of the present report was to explore a new option of reconstructing the joint with an acellular dermal matrix substance in a single case study during a 12-month follow-up period. A staged approach that began with removal of the failed 2-component great toe implant, Koenig(®), excisional debridement of the wound with resection of the necrotic bone (proximal phalanx and distal portion of the first metatarsal bones), and culture-specific antibiosis therapy. The final stage included incorporating the acellular dermal matrix, Graftjacket(®) into the joint in an accordion-type fashion, and reconstruction of the joint capsule. Postoperative radiographs revealed a more rectus joint with some improvement in length. At 6 months postoperatively, magnetic resonance imaging revealed incorporation of the graft material into the joint. Finally, at the 1-year mark, the patient was pain free with satisfactory function at the first metatarsophalangeal joint during gait. This is the first reported case of salvaging failed and infected first metatarsophalangeal joint implant arthroplasty with incorporation of the acellular dermal matrix and provides a new option to consider in the future. PMID:22704789

  5. The pedicle screw-rod system is an acceptable method of reconstructive surgery after resection of sacroiliac joint tumours

    PubMed Central

    Zhou, Yi-Jun; Yunus, Akbar; Tian, Zheng; Chen, Jiang-Tao; Wang, Chong; Xu, Lei-Lei

    2016-01-01

    Hemipelvic resections for primary bone tumours require reconstruction to restore weight bearing along anatomic axes. However, reconstruction of the pelvic arch remains a major surgical challenge because of the high rate of associated complications. We used the pedicle screw-rod system to reconstruct the pelvis, and the purpose of this investigation was to assess the oncology, functional outcome and complication rate following this procedure. The purpose of this study was to investigate the operative indications and technique of the pedicle screw-rod system in reconstruction of the stability of the sacroiliac joint after resection of sacroiliac joint tumours. The average MSTS (Musculoskeletal Tumour Society) score was 26.5 at either three months after surgery or at the latest follow-up. Seven patients had surgery-related complications, including wound dehiscence in one, infection in two, local necrosis in four (including infection in two), sciatic nerve palsy in one and pubic symphysis subluxation in one. There was no screw loosening or deep vein thrombosis occurring in this series. Using a pedicle screw-rod after resection of a sacroiliac joint tumour is an acceptable method of pelvic reconstruction because of its reduced risk of complications and satisfactory functional outcome, as well as its feasibility of reconstruction for type IV pelvis tumour resection without elaborate preoperative customisation. Level of evidence: Level IV, therapeutic study. PMID:27095944

  6. Joint space aspect reconstruction of wide-angle SAR exploiting sparsity

    NASA Astrophysics Data System (ADS)

    Stojanovic, Ivana; Cetin, Mujdat; Karl, William C.

    2008-04-01

    In this paper we present an algorithm for wide-angle synthetic aperture radar (SAR) image formation. Reconstruction of wide-angle SAR holds a promise of higher resolution and better information about a scene, but it also poses a number of challenges when compared to the traditional narrow-angle SAR. Most prominently, the isotropic point scattering model is no longer valid. We present an algorithm capable of producing high resolution reflectivity maps in both space and aspect, thus accounting for the anisotropic scattering behavior of targets. We pose the problem as a non-parametric three-dimensional inversion problem, with two constraints: magnitudes of the backscattered power are highly correlated across closely spaced look angles and the backscattered power originates from a small set of point scatterers. This approach considers jointly all scatterers in the scene across all azimuths, and exploits the sparsity of the underlying scattering field. We implement the algorithm and present reconstruction results on realistic data obtained from the XPatch Backhoe dataset.

  7. Electronic Bandgap and Edge Reconstruction in Phosphorene: An Experimental/Theoretical joint investigation

    NASA Astrophysics Data System (ADS)

    Liang, Liangbo; Wang, Jun; Lin, Wenzhi; Sumpter, Bobby G.; Pan, Minghu; Meunier, Vincent

    2015-03-01

    Phosphorene, or monolayer black phosphorus, is a new 2D layered material with high hole mobility and direct semiconducting bandgap. However, the direct bandgap of phosphorene has not been directly measured, and the properties of its edges have not been considered in detail. In a joint experimental/theoretical work, we studied the electronic properties of phosphorene and its edges [Liang et al., Nano Letters, 2014, 14, 6400]. A detailed scanning tunneling microscopy/spectroscopy (STM/S) study with first-principles calculations reveals the presence of a semiconducting 2 eV gap, the direct bandgap for phosphorene. More importantly, we were able to identify a sharp mono-step in phosphorene that allowed us to perform the first-ever investigation of edges. STS measurements across the step edge indicate nontrivial multiple edge states located inside the 2 eV gap and below the Fermi level. To understand these edge states, we have modeled a series of 1D phosphorene nanoribbons including armchair- and zigzag-edged PNRs. Extensive density functional theory calculations show that edge reconstructions are responsible for energy positions of these edge states. The reconstructions self-passivate most edge dangling bonds by switching the coordination number of phosphorus from 3 to 4 or 5. NYSTAR Program C080117 and the Office of Naval Research; Oak Ridge National Laboratory by U.S. Department of Energy.

  8. Simulated and reconstructed climate in Europe during the last five centuries: joint evaluation of climate models performance and the dynamical consistency of gridded reconstructions

    NASA Astrophysics Data System (ADS)

    José Gómez-Navarro, Juan; Bothe, Oliver; Wagner, Sebastian; Zorita, Eduardo; Werner, Johannes P.; Luterbacher, Jürg; Raible, Christoph C.; Montávez, Juan Pedro

    2015-04-01

    This study jointly analyses European winter and summer temperature and precipitation gridded climate reconstructions and a regional climate simulation reaching a resolution of 45 km over the period 1501-1990. In a first step, the simulation is compared to observational records to establish the model performance and to identify the most prominent caveats. It is found that the regional simulation is able to add value to the driving global simulation, which allows it to reproduce accurately the most prominent characteristics of the European climate, although remarkable biases can also be identified. In a second step, the simulation is compared to a set on independent reconstructions. The high-resolution of the simulation and the reconstructions allows to analyse the European area for nine sub-areas. An overall good agreement is found between the reconstructed and simulated climate variability across different areas, supporting a consistency of both products and the proper calibration of the reconstructions. However, biases appear between both datasets, that thanks to the evaluation of the model performance carried out before, can be attributed to deficiencies in the simulation. Although the simulation responds to external forcing, it largely differers with reconstructions in their estimates of the past climate evolution for European sub-regions. In particular, there are deviations between simulated and reconstructed anomalies during the Maunder and Dalton minima, i.e. the simulated response is much stronger than the reconstructed. This disagreement is to some extent expected given the prominent role of internal variability in the regional evolution of temperature and precipitation. However the inability of the model to reproduce any warm period similar to that recorded around 1740 in the reconstructions indicates fundamental limitations in the simulation that preclude reproducing exceptionally anomalous conditions. Despite these limitations, the simulated climate is a

  9. Equilibrium reconstruction based on core magnetic measurement and its applications on equilibrium transition in Joint-TEXT tokamak

    SciTech Connect

    Chen, J.; Zhuang, G. Jian, X.; Li, Q.; Liu, Y.; Gao, L.; Wang, Z. J.

    2014-10-15

    Evaluation and reconstruction of plasma equilibrium, especially to resolve the safety factor profile, is imperative for advanced tokamak operation and physics study. Based on core magnetic measurement by the high resolution laser polarimeter-interferometer system (POLARIS), the equilibrium of Joint-TEXT (J-TEXT) plasma is reconstructed and profiles of safety factor, current density, and electron density are, therefore, obtained with high accuracy and temporal resolution. The equilibrium reconstruction procedure determines the equilibrium flux surfaces essentially from the data of POLARIS. Refraction of laser probe beam, a major error source of the reconstruction, has been considered and corrected, which leads to improvement of accuracy more than 10%. The error of reconstruction has been systematically assessed with consideration of realistic diagnostic performance and scrape-off layer region of plasma, and its accuracy has been verified. Fast equilibrium transitions both within a single sawtooth cycle and during the penetration of resonant magnetic perturbation have been investigated.

  10. Total alloplastic temporomandibular joint reconstruction using Biomet stock prostheses: the University of Florida experience.

    PubMed

    Sanovich, R; Mehta, U; Abramowicz, S; Widmer, C; Dolwick, M F

    2014-09-01

    The purpose of this study was to report the subjective and objective outcomes of temporomandibular joint (TMJ) replacement with Biomet stock prostheses at a single institution in Florida. In this retrospective study, patients who underwent TMJ replacement using a Biomet stock prosthesis from 2005 to 2012 were analyzed. Subjective (pain, diet) and objective (maximal incisal opening) information was obtained. In addition, a quality of life measure was obtained pre- and postoperatively. Significance was set at <0.01. Thirty-six patients (26 bilateral, 6 left, and 4 right) who underwent TMJ replacement using a Biomet stock prosthesis were eligible for the study. Maximal incisal opening improved from 26.1mm preoperatively to a mean of 34.4mm postoperatively. The pain score decreased from 7.9 preoperatively to a mean of 3.8 postoperatively. Diet restriction decreased from 6.8 preoperatively to a mean of 3.5 postoperatively. Quality of life improved from a median of 4 preoperatively to a postoperative median of 2. Four implants were removed/replaced because of heterotopic bone formation, infection, and/or loose hardware. Follow-up ranged from 6 to 83 months. Overall, TMJ reconstruction using the Biomet stock joint is effective and safe in this patient population. PMID:24861472

  11. Isokinetic Identification of Knee Joint Torques before and after Anterior Cruciate Ligament Reconstruction

    PubMed Central

    Czaplicki, Adam; Jarocka, Marta; Walawski, Jacek

    2015-01-01

    The aim of this study was to evaluate the serial change of isokinetic muscle strength of the knees before and after anterior cruciate ligament reconstruction (ACLR) in physically active males and to estimate the time of return to full physical fitness. Extension and flexion torques were measured for the injured and healthy limbs at two angular velocities approximately 1.5 months before the surgery and 3, 6, and 12 months after ACLR. Significant differences (p ≤ 0.05) in peak knee extension and flexion torques, hamstring/quadriceps (H/Q) strength ratios, uninvolved/involved limb peak torque ratios, and the normalized work of these muscles between the four stages of rehabilitation were identified. Significant differences between extension peak torques for the injured and healthy limbs were also detected at all stages. The obtained results showed that 12 months of rehabilitation were insufficient for the involved knee joint to recover its strength to the level of strength of the uninvolved knee joint. The results helped to evaluate the progress of the rehabilitation and to implement necessary modifications optimizing the rehabilitation training program. The results of the study may also be used as referential data for physically active males of similar age. PMID:26646385

  12. Isokinetic Identification of Knee Joint Torques before and after Anterior Cruciate Ligament Reconstruction.

    PubMed

    Czaplicki, Adam; Jarocka, Marta; Walawski, Jacek

    2015-01-01

    The aim of this study was to evaluate the serial change of isokinetic muscle strength of the knees before and after anterior cruciate ligament reconstruction (ACLR) in physically active males and to estimate the time of return to full physical fitness. Extension and flexion torques were measured for the injured and healthy limbs at two angular velocities approximately 1.5 months before the surgery and 3, 6, and 12 months after ACLR. Significant differences (p ≤ 0.05) in peak knee extension and flexion torques, hamstring/quadriceps (H/Q) strength ratios, uninvolved/involved limb peak torque ratios, and the normalized work of these muscles between the four stages of rehabilitation were identified. Significant differences between extension peak torques for the injured and healthy limbs were also detected at all stages. The obtained results showed that 12 months of rehabilitation were insufficient for the involved knee joint to recover its strength to the level of strength of the uninvolved knee joint. The results helped to evaluate the progress of the rehabilitation and to implement necessary modifications optimizing the rehabilitation training program. The results of the study may also be used as referential data for physically active males of similar age. PMID:26646385

  13. An Inductive, Scaffold-Based, Regenerative Medicine Approach to Reconstruction of the Temporomandibular Joint Disk

    PubMed Central

    Brown, Bryan N.; Chung, William L.; Almarza, Alejandro J.; Pavlick, Matthew; Reppas, Serafim; Ochs, Mark W.; Russell, Alan J.; Badylak, Stephen F.

    2012-01-01

    Purpose A device composed of extracellular matrix (ECM) was investigated as an inductive template in vivo for reconstruction of the TMJ disk following discectomy. Methods A scaffold material composed of porcine derived ECM was configured to mimic the shape and size of the TMJ. This device was implanted in a canine model of bilateral TMJ discectomy. Following discectomy, one side was repaired with an ECM scaffold material and the contralateral side was left empty as a control. At 6 months post-implantation the joint space was opened, the joints evaluated for signs of gross pathologic degenerative changes, and newly formed tissue was excised for histologic, biochemical, and biomechanical analysis. Results The results show that implantation of an initially acellular material supported the formation of site-appropriate, functional host tissue which resembled that of the native TMJ disk. Further, this prevented gross degenerative changes in the temporal fossa and mandibular condyle. No tissue formation and mild to severe gross pathologic changes were observed in the contralateral controls. Conclusion These results suggest that an ECM based bioscaffold may represent an off-the-shelf solution for TMJ disk replacement. PMID:22365981

  14. Effects of Initial Graft Tension on the Tibiofemoral Compressive Forces and Joint Position Following ACL Reconstruction

    PubMed Central

    Brady, Mark F.; Bradley, Michael P.; Fleming, Braden C.; Fadale, Paul D.; Hulstyn, Michael J.; Banerjee, Rahul

    2007-01-01

    Background The initial tension applied to an ACL graft at the time of fixation modulates knee motion and the tibiofemoral compressive loads. Purpose To establish the relationships between initial graft tension, tibiofemoral compressive force, and the neutral tibiofemoral position in the cadaver knee. Study Design Controlled Laboratory Study. Methods The tibiofemoral compressive forces and joint positions were determined in the ACL-intact knee at 0°, 20° and 90° knee flexion. The ACL was excised and reconstructed with a patellar tendon graft using graft tensions of 1, 15, 30, 60 and 90 N applied at 0°, 20° and 90° knee flexion. The compressive forces and neutral positions were compared between initial tension conditions and the ACL-intact knee. Results Increasing initial graft tension increased the tibiofemoral compressive forces. The forces in the medial compartment were 1.8 times those in the lateral compartment. The compressive forces were dependent on the knee angle at which the tension was applied. The greatest compressive forces occurred when the graft was tensioned with the knee in extension. An increase in initial graft tension caused the tibia to rotate externally compared to the ACL-intact knee. Increases in initial graft tension also caused a significant posterior translation of the tibia relative to the femur. Conclusions Different initial graft tension protocols produced predictable changes in the tibiofemoral compressive forces and joint positions. Clinical Relevance The tibiofemoral compressive force and neutral joint position were best replicated with a low graft tension (1–15 N) when using a patellar tendon graft. PMID:17218659

  15. Anatomy assisted PET image reconstruction incorporating multi-resolution joint entropy

    PubMed Central

    Tang, Jing; Rahmim, Arman

    2015-01-01

    A promising approach in PET image reconstruction is to incorporate high resolution anatomical information (measured from MR or CT) taking the anato-functional similarity measures such as mutual information or joint entropy (JE) as the prior. These similarity measures only classify voxels based on intensity values, while neglecting structural spatial information. In this work, we developed an anatomy-assisted maximum a posteriori (MAP) reconstruction algorithm wherein the JE measure is supplied by spatial information generated using wavelet multi-resolution analysis. The proposed wavelet-based JE (WJE) MAP algorithm involves calculation of derivatives of the subband JE measures with respect to individual PET image voxel intensities, which we have shown can be computed very similarly to how the inverse wavelet transform is implemented. We performed a simulation study with the BrainWeb phantom creating PET data corresponding to different noise levels. Realistically simulated T1-weighted MR images provided by BrainWeb modeling were applied in the anatomy-assisted reconstruction with the WJE-MAP algorithm and the intensity-only JE-MAP algorithm. Quantitative analysis showed that the WJE-MAP algorithm performed similarly to the JE-MAP algorithm at low noise level in the gray matter (GM) and white matter (WM) regions in terms of noise versus bias tradeoff. When noise increased to medium level in the simulated data, the WJE-MAP algorithm started to surpass the JE-MAP algorithm in the GM region, which is less uniform with smaller isolated structures compared to the WM region. In the high noise level simulation, the WJE-MAP algorithm presented clear improvement over the JE-MAP algorithm in both the GM and WM regions. In addition to the simulation study, we applied the reconstruction algorithms to real patient studies involving DPA-173 PET data and Florbetapir PET data with corresponding T1-MPRAGE MRI images. Compared to the intensity-only JE-MAP algorithm, the WJE

  16. Anatomy assisted PET image reconstruction incorporating multi-resolution joint entropy

    NASA Astrophysics Data System (ADS)

    Tang, Jing; Rahmim, Arman

    2015-01-01

    A promising approach in PET image reconstruction is to incorporate high resolution anatomical information (measured from MR or CT) taking the anato-functional similarity measures such as mutual information or joint entropy (JE) as the prior. These similarity measures only classify voxels based on intensity values, while neglecting structural spatial information. In this work, we developed an anatomy-assisted maximum a posteriori (MAP) reconstruction algorithm wherein the JE measure is supplied by spatial information generated using wavelet multi-resolution analysis. The proposed wavelet-based JE (WJE) MAP algorithm involves calculation of derivatives of the subband JE measures with respect to individual PET image voxel intensities, which we have shown can be computed very similarly to how the inverse wavelet transform is implemented. We performed a simulation study with the BrainWeb phantom creating PET data corresponding to different noise levels. Realistically simulated T1-weighted MR images provided by BrainWeb modeling were applied in the anatomy-assisted reconstruction with the WJE-MAP algorithm and the intensity-only JE-MAP algorithm. Quantitative analysis showed that the WJE-MAP algorithm performed similarly to the JE-MAP algorithm at low noise level in the gray matter (GM) and white matter (WM) regions in terms of noise versus bias tradeoff. When noise increased to medium level in the simulated data, the WJE-MAP algorithm started to surpass the JE-MAP algorithm in the GM region, which is less uniform with smaller isolated structures compared to the WM region. In the high noise level simulation, the WJE-MAP algorithm presented clear improvement over the JE-MAP algorithm in both the GM and WM regions. In addition to the simulation study, we applied the reconstruction algorithms to real patient studies involving DPA-173 PET data and Florbetapir PET data with corresponding T1-MPRAGE MRI images. Compared to the intensity-only JE-MAP algorithm, the WJE

  17. Results of Arthroscopy-Assisted TightRope Repair of Acromioclavicular Dislocations

    PubMed Central

    Flinkkilä, Tapio E.; Ihanainen, Essi

    2013-01-01

    Background The present study assessed results of arthroscopy-assisted TightRope (Arthrex, Naples, FL, USA) repair of acute Rockwood grade III and V acromioclavicular (AC) dislocations. Methods We retrospectively reviewed the medical records of 57 patients with AC dislocations treated with TightRope fixation: 15 Rockwood grade III and 42 grade V. Functional results were assessed using the Constant score, and Disabilities of Arm, Shoulder and Hand (DASH) and RAND 36-ltem Health Survey scores after a mean 2.6 years of follow-up (range 1.0 years to 4.5 years). Radiographic results were assessed using the AC joint coracoclavicular (CC) distance. Results Postoperative radiographs showed anatomical AC joint reduction in all patients. In nine patients, fixation failed before 6 weeks postoperatively, mainly as a result of suture breakage. For the remaining 47 patients, CC distance was well maintained at 6 weeks. At follow-up, mean (SD) CC distance was significantly increased compared to the contralateral side or postoperative radiographs [17 (4) mm versus 10 (3) mm]. Mean DASH score was 9, Constant score was 88 and the RAND 36 score showed a quality of life similar to the Finnish reference population. Conclusions Despite initial good reduction of grade III and V AC dislocations using TightRope fixation, subluxation often recurs after 6 weeks. Patients suffer minor subjective complaints that do not worsen the quality of life.

  18. Reconstruction of Lisfranc joint dislocations secondary to Charcot neuroarthropathy using a plantar plate.

    PubMed

    Garchar, Dave; DiDomenico, Lawrence A; Klaue, Kaj

    2013-01-01

    Lisfranc joint dislocation secondary to Charcot arthropathy is a debilitating condition that often leads to ulceration and infection. After conservative treatment, such as bracing and appropriate shoe wear fail, the only option might be amputation. However, we have seen good clinical outcomes from applying a plate to the plantar (tension) side of the medial midfoot. In our retrospective study, 24 consecutive patients (25 feet) from April 1999 through July 2004 underwent Charcot reconstruction for Lisfranc dislocation. Clinical and radiographic follow-up examinations were performed every 3 weeks during the postoperative course. Union was achieved in 24 (96%) of the 25 feet. The average time to ambulation was 11.68 (range 7 to 20) weeks for the 24 patients. The average follow-up period was 38.0 (range 17 to 64) months. The union and interval to ambulation rates showed that a plate applied to the plantar aspect of the medial midfoot provides a strong, sturdy construct for arthrodesis and ambulation. PMID:23621976

  19. Atomic modeling of cryo-electron microscopy reconstructionsJoint refinement of model and imaging parameters

    PubMed Central

    Chapman, Michael S.; Trzynka, Andrew; Chapman, Brynmor K.

    2013-01-01

    When refining the fit of component atomic structures into electron microscopic reconstructions, use of a resolution-dependent atomic density function makes it possible to jointly optimize the atomic model and imaging parameters of the microscope. Atomic density is calculated by one-dimensional Fourier transform of atomic form factors convoluted with a microscope envelope correction and a low-pass filter, allowing refinement of imaging parameters such as resolution, by optimizing the agreement of calculated and experimental maps. A similar approach allows refinement of atomic displacement parameters, providing indications of molecular flexibility even at low resolution. A modest improvement in atomic coordinates is possible following optimization of these additional parameters. Methods have been implemented in a Python program that can be used in stand-alone mode for rigid-group refinement, or embedded in other optimizers for flexible refinement with stereochemical restraints. The approach is demonstrated with refinements of virus and chaperonin structures at resolutions of 9 through 4.5 Å, representing regimes where rigid-group and fully flexible parameterizations are appropriate. Through comparisons to known crystal structures, flexible fitting by RSRef is shown to be an improvement relative to other methods and to generate models with all-atom rms accuracies of 1.5–2.5 Å at resolutions of 4.5–6 Å. PMID:23376441

  20. Atomic modeling of cryo-electron microscopy reconstructions--joint refinement of model and imaging parameters.

    PubMed

    Chapman, Michael S; Trzynka, Andrew; Chapman, Brynmor K

    2013-04-01

    When refining the fit of component atomic structures into electron microscopic reconstructions, use of a resolution-dependent atomic density function makes it possible to jointly optimize the atomic model and imaging parameters of the microscope. Atomic density is calculated by one-dimensional Fourier transform of atomic form factors convoluted with a microscope envelope correction and a low-pass filter, allowing refinement of imaging parameters such as resolution, by optimizing the agreement of calculated and experimental maps. A similar approach allows refinement of atomic displacement parameters, providing indications of molecular flexibility even at low resolution. A modest improvement in atomic coordinates is possible following optimization of these additional parameters. Methods have been implemented in a Python program that can be used in stand-alone mode for rigid-group refinement, or embedded in other optimizers for flexible refinement with stereochemical restraints. The approach is demonstrated with refinements of virus and chaperonin structures at resolutions of 9 through 4.5 Å, representing regimes where rigid-group and fully flexible parameterizations are appropriate. Through comparisons to known crystal structures, flexible fitting by RSRef is shown to be an improvement relative to other methods and to generate models with all-atom rms accuracies of 1.5-2.5 Å at resolutions of 4.5-6 Å. PMID:23376441

  1. Partial arthroscopic trapeziectomy with ligament reconstruction to treat primary thumb basal joint osteoarthritis.

    PubMed

    Desmoineaux, P; Delaroche, C; Beaufils, P

    2012-11-01

    Since the outcome of partial trapeziectomy is not always satisfactory, we proposed using arthroscopy to perform partial trapeziectomy and to perform ligament reconstruction with the abductor pollicis longus tendon. A tendon strip was left intact at its insertion at the base of the first metacarpal and then slipped into the trapeziectomy space. It was fixed into a blind tunnel at the base of the second metacarpal with a bioabsorbable interference screw. Forty-nine patients were surgically treated between 2006 and 2009. With an average follow-up of 3.6 years, 83.5% of patients were satisfied with the procedure; 96% of thumbs were stable and 74% were pain free. The average recovery time was 4.5 months. There were four cases of radial nerve branch irritation and one case of flexor carpi radialis tendinitis; there were no cases of complex regional pain syndrome. This minimally-invasive technique is a less-aggressive treatment approach for thumb carpometacarpal joint arthritis, which simplify postoperative recovery. PMID:23098774

  2. dPIRPLE: A Joint Estimation Framework for Deformable Registration and Penalized-Likelihood CT Image Reconstruction using Prior Images

    PubMed Central

    Dang, H.; Wang, A. S.; Sussman, Marc S.; Siewerdsen, J. H.; Stayman, J. W.

    2014-01-01

    Sequential imaging studies are conducted in many clinical scenarios. Prior images from previous studies contain a great deal of patient-specific anatomical information and can be used in conjunction with subsequent imaging acquisitions to maintain image quality while enabling radiation dose reduction (e.g., through sparse angular sampling, reduction in fluence, etc.). However, patient motion between images in such sequences results in misregistration between the prior image and current anatomy. Existing prior-image-based approaches often include only a simple rigid registration step that can be insufficient for capturing complex anatomical motion, introducing detrimental effects in subsequent image reconstruction. In this work, we propose a joint framework that estimates the 3D deformation between an unregistered prior image and the current anatomy (based on a subsequent data acquisition) and reconstructs the current anatomical image using a model-based reconstruction approach that includes regularization based on the deformed prior image. This framework is referred to as deformable prior image registration, penalized-likelihood estimation (dPIRPLE). Central to this framework is the inclusion of a 3D B-spline-based free-form-deformation model into the joint registration-reconstruction objective function. The proposed framework is solved using a maximization strategy whereby alternating updates to the registration parameters and image estimates are applied allowing for improvements in both the registration and reconstruction throughout the optimization process. Cadaver experiments were conducted on a cone-beam CT testbench emulating a lung nodule surveillance scenario. Superior reconstruction accuracy and image quality were demonstrated using the dPIRPLE algorithm as compared to more traditional reconstruction methods including filtered backprojection, penalized-likelihood estimation (PLE), prior image penalized-likelihood estimation (PIPLE) without registration

  3. Relationship Between Functional Knee Joint Position Sense and Functional Performance Scores Following Anterior Cruciate Ligament Reconstruction (Pilot Study)

    PubMed Central

    Kafa, Nihan; Ataoglu, Muhammed Baybars; Hazar, Zeynep; Citaker, Seyit; Ozer, Mustafa

    2014-01-01

    Objectives: The aim of this study was to assess the relationship between functional knee joint position sense (JPS) and functional performance following ACL reconstruction Methods: Seven male patients (mean age=32,66 ±6,47) who had undergone ACL reconstruction and 10 male healthy control subjects participated in the study. Knee joint position sense was evaluated by reproduction of 20° knee flexion angle in weight-bearing position with single and bilateral limb movement into flexion and extension. The deviations in the angle were recorded and compared to both noninjured side and healthy controls’. Functional performance was evaluated with Single Leg Hop Test in both injured and non-injured sides. The scores were also compared with healthy controls and non-injured sides. Relationship between measured values was tested with Spearman Correlation Analysis. Results: There was no significant difference in knee joint position sense in functional position between the operated and uninjured knees of patients or between patients and healthy controls (p>0,05). However, there is significant difference in Single Leg Hop test scores between operated and non-operated or between patients and healthy controls (p=0,037; p<0,05). There was no significant correlation between Single Leg Hop test scores and knee joint position sense (p>0,05). Conclusion: There was no evidence of impaired joint position sense in weight-bearing positions in subjects with ACL reconstruction but there was a decrease in functional performance. This decrease in functional performance may depend on the other parameters except proprioceptive deficits.

  4. Phillips-Tikhonov regularization with a priori information for neutron emission tomographic reconstruction on Joint European Torus.

    PubMed

    Bielecki, J; Giacomelli, L; Kiptily, V; Scholz, M; Drozdowicz, K; Conroy, S; Craciunescu, T; Kempenaars, M

    2015-09-01

    A method of tomographic reconstruction of the neutron emissivity in the poloidal cross section of the Joint European Torus (JET, Culham, UK) tokamak was developed. Due to very limited data set (two projection angles, 19 lines of sight only) provided by the neutron emission profile monitor (KN3 neutron camera), the reconstruction is an ill-posed inverse problem. The aim of this work consists in making a contribution to the development of reliable plasma tomography reconstruction methods that could be routinely used at JET tokamak. The proposed method is based on Phillips-Tikhonov regularization and incorporates a priori knowledge of the shape of normalized neutron emissivity profile. For the purpose of the optimal selection of the regularization parameters, the shape of normalized neutron emissivity profile is approximated by the shape of normalized electron density profile measured by LIDAR or high resolution Thomson scattering JET diagnostics. In contrast with some previously developed methods of ill-posed plasma tomography reconstruction problem, the developed algorithms do not include any post-processing of the obtained solution and the physical constrains on the solution are imposed during the regularization process. The accuracy of the method is at first evaluated by several tests with synthetic data based on various plasma neutron emissivity models (phantoms). Then, the method is applied to the neutron emissivity reconstruction for JET D plasma discharge #85100. It is demonstrated that this method shows good performance and reliability and it can be routinely used for plasma neutron emissivity reconstruction on JET. PMID:26429441

  5. Phillips-Tikhonov regularization with a priori information for neutron emission tomographic reconstruction on Joint European Torus

    SciTech Connect

    Bielecki, J.; Scholz, M.; Drozdowicz, K.; Giacomelli, L.; Kiptily, V.; Kempenaars, M.; Conroy, S.; Craciunescu, T.; Collaboration: EUROfusion Consortium, JET, Culham Science Centre, Abingdon OX14 3DB

    2015-09-15

    A method of tomographic reconstruction of the neutron emissivity in the poloidal cross section of the Joint European Torus (JET, Culham, UK) tokamak was developed. Due to very limited data set (two projection angles, 19 lines of sight only) provided by the neutron emission profile monitor (KN3 neutron camera), the reconstruction is an ill-posed inverse problem. The aim of this work consists in making a contribution to the development of reliable plasma tomography reconstruction methods that could be routinely used at JET tokamak. The proposed method is based on Phillips-Tikhonov regularization and incorporates a priori knowledge of the shape of normalized neutron emissivity profile. For the purpose of the optimal selection of the regularization parameters, the shape of normalized neutron emissivity profile is approximated by the shape of normalized electron density profile measured by LIDAR or high resolution Thomson scattering JET diagnostics. In contrast with some previously developed methods of ill-posed plasma tomography reconstruction problem, the developed algorithms do not include any post-processing of the obtained solution and the physical constrains on the solution are imposed during the regularization process. The accuracy of the method is at first evaluated by several tests with synthetic data based on various plasma neutron emissivity models (phantoms). Then, the method is applied to the neutron emissivity reconstruction for JET D plasma discharge #85100. It is demonstrated that this method shows good performance and reliability and it can be routinely used for plasma neutron emissivity reconstruction on JET.

  6. Phillips-Tikhonov regularization with a priori information for neutron emission tomographic reconstruction on Joint European Torus

    NASA Astrophysics Data System (ADS)

    Bielecki, J.; Giacomelli, L.; Kiptily, V.; Scholz, M.; Drozdowicz, K.; Conroy, S.; Craciunescu, T.; Kempenaars, M.

    2015-09-01

    A method of tomographic reconstruction of the neutron emissivity in the poloidal cross section of the Joint European Torus (JET, Culham, UK) tokamak was developed. Due to very limited data set (two projection angles, 19 lines of sight only) provided by the neutron emission profile monitor (KN3 neutron camera), the reconstruction is an ill-posed inverse problem. The aim of this work consists in making a contribution to the development of reliable plasma tomography reconstruction methods that could be routinely used at JET tokamak. The proposed method is based on Phillips-Tikhonov regularization and incorporates a priori knowledge of the shape of normalized neutron emissivity profile. For the purpose of the optimal selection of the regularization parameters, the shape of normalized neutron emissivity profile is approximated by the shape of normalized electron density profile measured by LIDAR or high resolution Thomson scattering JET diagnostics. In contrast with some previously developed methods of ill-posed plasma tomography reconstruction problem, the developed algorithms do not include any post-processing of the obtained solution and the physical constrains on the solution are imposed during the regularization process. The accuracy of the method is at first evaluated by several tests with synthetic data based on various plasma neutron emissivity models (phantoms). Then, the method is applied to the neutron emissivity reconstruction for JET D plasma discharge #85100. It is demonstrated that this method shows good performance and reliability and it can be routinely used for plasma neutron emissivity reconstruction on JET.

  7. The effect of CT dose on glenohumeral joint congruency measurements using 3D reconstructed patient-specific bone models

    NASA Astrophysics Data System (ADS)

    Lalone, Emily A.; Fox, Anne-Marie V.; Kedgley, Angela E.; Jenkyn, Thomas R.; King, Graham J. W.; Athwal, George S.; Johnson, James A.; Peters, Terry M.

    2011-10-01

    The study of joint congruency at the glenohumeral joint of the shoulder using computed tomography (CT) and three-dimensional (3D) reconstructions of joint surfaces is an area of significant clinical interest. However, ionizing radiation delivered to patients during CT examinations is much higher than other types of radiological imaging. The shoulder represents a significant challenge for this modality as it is adjacent to the thyroid gland and breast tissue. The objective of this study was to determine the optimal CT scanning techniques that would minimize radiation dose while accurately quantifying joint congruency of the shoulder. The results suggest that only one-tenth of the standard applied total current (mA) and a pitch ratio of 1.375:1 was necessary to produce joint congruency values consistent with that of the higher dose scans. Using the CT scanning techniques examined in this study, the effective dose applied to the shoulder to quantify joint congruency was reduced by 88.9% compared to standard clinical CT imaging techniques.

  8. Recent advances and future directions in the management of knee osteoarthritis: Can biological joint reconstruction replace joint arthroplasty and when?

    PubMed Central

    Paschos, Nikolaos K

    2015-01-01

    In this article, a concise description of the recent advances in the field of osteoarthritis management is presented. The main focus is to highlight the most promising techniques that emerge in both biological joint replacement and artificial joint arthroplasty. A critical view of high quality evidence regarding outcome and safety profile of these techniques is presented. The potential role of kinematically aligned total knee replacement, navigation, and robotic-assisted surgery is outlined. A critical description of both primary and stem cell-based therapies, the cell homing theory, the use of biologic factors and recent advancements in tissue engineering and regenerative medicine is provided. Based on the current evidence, some thoughts on a realistic approach towards answering these questions are attempted. PMID:26495242

  9. Recent advances and future directions in the management of knee osteoarthritis: Can biological joint reconstruction replace joint arthroplasty and when?

    PubMed

    Paschos, Nikolaos K

    2015-10-18

    In this article, a concise description of the recent advances in the field of osteoarthritis management is presented. The main focus is to highlight the most promising techniques that emerge in both biological joint replacement and artificial joint arthroplasty. A critical view of high quality evidence regarding outcome and safety profile of these techniques is presented. The potential role of kinematically aligned total knee replacement, navigation, and robotic-assisted surgery is outlined. A critical description of both primary and stem cell-based therapies, the cell homing theory, the use of biologic factors and recent advancements in tissue engineering and regenerative medicine is provided. Based on the current evidence, some thoughts on a realistic approach towards answering these questions are attempted. PMID:26495242

  10. Arthroscopic stabilisation of an acute acromioclavicular dislocation grade III in a patient with ectopic insertion of the pectoralis minor: technical considerations.

    PubMed

    Minuesa-Asensio, Alvaro; Barrio-Asensio, Carmen; González-Gómez, Ignacio; Murillo-González, Jorge

    2016-07-01

    The different approaches used in arthroscopic stabilisation of the acromioclavicular joint are well known. However, and despite a great incidence of ectopic pectoralis minor insertion, an alternative choice for the use of arthroscopic portal has not being sufficiently described. Here, we describe a case of acute acromioclavicular dislocation grade III. The arthroscopic stabilisation was achieved using the TightRope (Arthrex, Naples, USA) implant. Through this technique, the approach to the articular portion of the coracoid process can be made intra-articularly or from the subacromial space. We accessed intra-articularly, by opening the rotator interval to reach the coracoid process from the joint cavity. After opening the rotator interval, an ectopic insertion of the pectoralis minor was observed. The choice of approach of the coracoid process from the subacromial space would have complicated the intervention, making it necessary to sever the ectopic tendon to complete the technique, lengthening the surgical time and increasing the chance of complications. For this reason, the use of a standard posterior portal providing intra-articular arthroscopic access through the rotator interval is recommended since the aforementioned anatomical variation is not infrequent. Level of evidence Therapeutic studies-investigating the results of treatment, Level V. PMID:25448140

  11. A rare case of floating clavicle and a novel technique for stabilizing the sternoclavicular joint

    PubMed Central

    Webb, Mark; Wallace, Angus

    2014-01-01

    We present the first ever case report of a floating clavicle with a unique combination of a posterior sternoclavicular joint dislocation and an associated grade III acromioclavicular joint dislocation. We treated this injury surgically by stabilizing both ends of clavicle using a polyester surgical mesh device (LockDown™; Mandaco 569 Limited, Redditch, UK; previously called the Nottingham Surgilig).

  12. Maximum-likelihood joint image reconstruction and motion estimation with misaligned attenuation in TOF-PET/CT

    NASA Astrophysics Data System (ADS)

    Bousse, Alexandre; Bertolli, Ottavia; Atkinson, David; Arridge, Simon; Ourselin, Sébastien; Hutton, Brian F.; Thielemans, Kris

    2016-02-01

    This work is an extension of our recent work on joint activity reconstruction/motion estimation (JRM) from positron emission tomography (PET) data. We performed JRM by maximization of the penalized log-likelihood in which the probabilistic model assumes that the same motion field affects both the activity distribution and the attenuation map. Our previous results showed that JRM can successfully reconstruct the activity distribution when the attenuation map is misaligned with the PET data, but converges slowly due to the significant cross-talk in the likelihood. In this paper, we utilize time-of-flight PET for JRM and demonstrate that the convergence speed is significantly improved compared to JRM with conventional PET data.

  13. Joint Cross-Range Scaling and 3D Geometry Reconstruction of ISAR Targets Based on Factorization Method.

    PubMed

    Lei Liu; Feng Zhou; Xue-Ru Bai; Ming-Liang Tao; Zi-Jing Zhang

    2016-04-01

    Traditionally, the factorization method is applied to reconstruct the 3D geometry of a target from its sequential inverse synthetic aperture radar images. However, this method requires performing cross-range scaling to all the sub-images and thus has a large computational burden. To tackle this problem, this paper proposes a novel method for joint cross-range scaling and 3D geometry reconstruction of steadily moving targets. In this method, we model the equivalent rotational angular velocity (RAV) by a linear polynomial with time, and set its coefficients randomly to perform sub-image cross-range scaling. Then, we generate the initial trajectory matrix of the scattering centers, and solve the 3D geometry and projection vectors by the factorization method with relaxed constraints. After that, the coefficients of the polynomial are estimated from the projection vectors to obtain the RAV. Finally, the trajectory matrix is re-scaled using the estimated rotational angle, and accurate 3D geometry is reconstructed. The two major steps, i.e., the cross-range scaling and the factorization, are performed repeatedly to achieve precise 3D geometry reconstruction. Simulation results have proved the effectiveness and robustness of the proposed method. PMID:26886991

  14. Ligamentous Reconstruction of Traumatic Dislocation of Thumb Carpometacarpal Joint: Case Report and Review of Literature

    PubMed Central

    Annappa, Rajendra; Kotian, Prem; P, Janardhana Aithala; Mudiganty, Srikanth

    2015-01-01

    Introduction: Thumb carpometacarpal dislocation is a rare injury with many treatment options described in literature. Case Description: A 47-year-old male patient presented to hospital with an isolated dorsal dislocation of the thumb carpometacarpal joint. Closed reduction of the dislocation could be easily done but joint was grossly unstable and redislocated. Repair of ruptured dorsoradial ligament and joint capsule was done with immobilization for 6 weeks. At 2-years follow-up evaluation, the patient was pain free and returned to his previous level of activity. No restriction of carpometacarpal movements or residual instability was noticed. Radiographic examination showed normal joint congruity and no signs of osteoarthritis. Conclusion: Capsuloligamentous repair can be considered the treatment of choice in thumb carpometacarpal dislocations with instability after closed reduction.

  15. Fast Monte Carlo based joint iterative reconstruction for simultaneous 99mTc/ 123I SPECT imaging.

    PubMed

    Ouyang, Jinsong; El Fakhri, Georges; Moore, Stephen C

    2007-08-01

    Simultaneous 99mTC/ 123I SPECT allows the assessment of two physiological functions under identical conditions. The separation of these radionuclides is difficult, however, because their energies are close. Most energy-window-based scatter correction methods do not fully model either physical factors or patient-specific activity and attenuation distributions. We have developed a fast Monte Carlo (MC) simulation-based multiple-radionuclide and multiple-energy joint ordered-subset expectation-maximization (JOSEM) iterative reconstruction algorithm, MC-JOSEM. MC-JOSEM simultaneously corrects for scatter and cross talk as well as detector response within the reconstruction algorithm. We evaluated MC-JOSEM for simultaneous brain profusion (99mTc-HMPAO) and neurotransmission (123I-altropane) SPECT. MC simulations of 99mTc and 123I studies were generated separately and then combined to mimic simultaneous 99mTc/ 123I SPECT. All the details of photon transport through the brain, the collimator, and detector, including Compton and coherent scatter, septal penetration, and backscatter from components behind the crystal, were modeled. We reconstructed images from simultaneous dual-radionuclide projections in three ways. First, we reconstructed the photopeak-energy-window projections (with an asymmetric energy window for 1231) using the standard ordered-subsets expectation-maximization algorithm (NSC-OSEM). Second, we used standard OSEM to reconstruct 99mTc photopeak-energy-window projections, while including an estimate of scatter from a Compton-scatter energy window (SC-OSEM). Third, we jointly reconstructed both 99mTc and 123I images using projection data associated with two photo-peak energy windows and an intermediate-energy window using MC-JOSEM. For 15 iterations of reconstruction, the bias and standard deviation of 99mTc activity estimates in several brain structures were calculated for NSC-OSEM, SC-OSEM, and MC-JOSEM, using images reconstructed from primary

  16. Acromioclavicular dislocation: postoperative evaluation of the coracoclavicular ligaments using magnetic resonance☆

    PubMed Central

    Faria, Rafael Salomon Silva; Ribeiro, Fabiano Rebouças; Amin, Bruno de Oliveira; Tenor Junior, Antonio Carlos; da Costa, Miguel Pereira; Filardi Filho, Cantídio Salvador; Batista, Cleber Gonçalves; Brasil Filho, Rômulo

    2015-01-01

    Objective To radiologically evaluate the healing of the coracoclavicular ligaments after surgical treatment for acromioclavicular dislocation. Methods Ten patients who had undergone surgical treatment for acromioclavicular dislocation via a posterosuperior route at least one year earlier were invited to return for radiological assessment using magnetic resonance. This evaluation was done by means of analogy with the scale described in the literature for studying the healing of the anterior cruciate ligament of the knee and for measuring the healed coracoclavicular ligaments. Results A scar structure of fibrous appearance had formed in 100% of the cases. In 50% of the cases, the images of this structure had a good appearance, while the other 50% were deficient. Conclusion Late postoperative evaluation using magnetic resonance, on patients who had been treated for acute acromioclavicular dislocation using a posterosuperior route in the shoulder, showed that the coracoclavicular ligaments had healed in 100% of the cases, but that this healing was deficient in 50%. PMID:26229916

  17. Arthrodesis versus Mayo resection: the management of the first metatarsophalangeal joint in reconstruction of the rheumatoid forefoot.

    PubMed

    Grondal, L; Broström, E; Wretenberg, P; Stark, A

    2006-07-01

    In a prospective randomised study 31 patients were allocated to either arthrodesis or Mayo resection of the first metatarsophalangeal joint as part of a total reconstruction of the rheumatoid forefoot. Of these, 29 were re-examined after a mean of 72 months (57 to 80), the Foot Function Index was scored and any deformity measured. Load distribution was analysed using a Fscan mat in 14 cases, and time and distance were measured in 12 of these patients using a 3D Motion system. We found excellent patient satisfaction and a significant, lasting reduction of the Foot Function Index, with no statistically significant differences between the groups. There were no significant differences in recurrence of the deformity, the need for special shoes, gait velocity, step length, plantar moment, mean pressure or the position of the centre of force under the forefoot. The cadence was higher and the stance phase shorter in the fusion group. These results suggest that a Mayo resection may be an equally good option for managing the first metatarsophalangeal joint in reconstruction of the rheumatoid forefoot. PMID:16798995

  18. 3D reconstruction of bony elements of the knee joint and finite element analysis of total knee prosthesis obtained from the reconstructed model

    PubMed Central

    Djoudi, Farid

    2013-01-01

    Two separate themes are presented in this paper. Aims The first theme is to present a graphical modeling approach of human anatomical structures namely, the femur and the tibia. The second theme involves making a finite element analysis of stresses, displacements and deformations in prosthetic implants (the femoral implant and the polyethylene insert). Objectives The graphical modeling approach comes in two parts. The first is the segmentation of MRI scanned images, retrieved in DICOM format for edge detection. In the second part, 3D-CAD models are generated from the results of the segmentation stage. The finite element analysis is done by first extracting the prosthetic implants from the reconstructed 3D-CAD model, then do a finite element analysis of these implants under objectively determined conditions such as; forces, allowed displacements, the materials composing implant, and the coefficient of friction. Conclusion The objective of this work is to implement an interface for exchanging data between 2D MRI images obtained from a medical diagnosis of a patient and the 3D-CAD model used in various applications, such as; the extraction of the implants, stress analysis at the knee joint and can serve as an aid to surgery, also predict the behavior of the prosthetic implants vis-a-vis the forces acting on the knee joints. PMID:24396234

  19. Improvement of the size estimation of 3D tracked droplets using digital in-line holography with joint estimation reconstruction

    NASA Astrophysics Data System (ADS)

    Verrier, N.; Grosjean, N.; Dib, E.; Méès, L.; Fournier, C.; Marié, J.-L.

    2016-04-01

    Digital holography is a valuable tool for three-dimensional information extraction. Among existing configurations, the originally proposed set-up (i.e. Gabor, or in-line holography), is reasonably immune to variations in the experimental environment making it a method of choice for studies of fluid dynamics. Nevertheless, standard hologram reconstruction techniques, based on numerical light back-propagation are prone to artifacts such as twin images or aliases that limit both the quality and quantity of information extracted from the acquired holograms. To get round this issue, the hologram reconstruction as a parametric inverse problem has been shown to accurately estimate 3D positions and the size of seeding particles directly from the hologram. To push the bounds of accuracy on size estimation still further, we propose to fully exploit the information redundancy of a hologram video sequence using joint estimation reconstruction. Applying this approach in a bench-top experiment, we show that it led to a relative precision of 0.13% (for a 60 μm diameter droplet) for droplet size estimation, and a tracking precision of {σx}× {σy}× {σz}=0.15× 0.15× 1~\\text{pixels} .

  20. Evaluation of Proximal Joint Kinematics and Muscle Strength Following ACL Reconstruction Surgery in Female Athletes

    PubMed Central

    Noehren, Brian; Abraham, Autumn; Curry, Melisa; Johnson, Darren; Ireland, Mary Lloyd

    2015-01-01

    Background\\Purpose Despite the intense focus on outcomes following an anterior cruciate ligament (ACL) reconstruction, it is not yet known whether unresolved abnormal hip and trunk neuromuscular control exists. The purpose of this study was to compare trunk and hip kinematics during running, hip abductor and external rotator strength, and trunk control between females who had undergone an ACL reconstruction and healthy control participants. Methods We compared 20 ACL reconstructed females to 20 healthy individuals, measuring abduction and external rotation strength, a trunk control test, and performed an instrumented gait evaluation during running. Comparisons between groups were made for non-sagittal peak hip angles, forward trunk lean, trunk ipsilateral lean at initial contact, trunk control and hip abduction and external rotation strength. Results We found no significant differences in hip abduction (p = 0.25), hip external rotation strength (p = 0.63), peak hip adduction (p = 0.11) or hip internal rotation angle (p = 0.47). The ACL group did have a significantly greater ipsilateral trunk lean (p = 0.028), forward lean (p = 0.004), and had higher errors on the trunk stability test (p = 0.007). Conclusion We found significant differences in trunk control, suggesting further attention should be devoted to this component of rehabilitation. PMID:25044305

  1. Acromioclavicular Dislocation Associated with Coracoid Process Fracture: Report of Two Cases and Review of the Literature

    PubMed Central

    Kose, Ozkan; Canbora, Kerem; Guler, Ferhat; Kilicaslan, Omer Faruk; May, Hasan

    2015-01-01

    Acromioclavicular dislocation associated with coracoid process fracture is a rare injury. Herein we reported two further cases with such combination of injuries and reviewed all previously published cases in current literature. In this review, we discussed the demographic characteristics, mechanism of injury, diagnosis, and treatment options extensively. PMID:26491588

  2. The effect of wrist surgery on the kinematic consistency of joint axis reconstruction in a static posture.

    PubMed

    Kraszewski, Andrew P; Osei, Daniel A; Garg, Rohit; Jang, Eugene; Hillstrom, Howard J; Lenhoff, Mark W; Wolfe, Scott W

    2015-09-01

    Three-dimensional analysis of wrist motion is a growing focus in orthopedic research, however, our understanding of its validity (accuracy and reliability) remains limited. Nine human cadavers were tested to estimate wrist joint axes alignment in a postural static pose. The objective was to investigate a rater's ability to reliably align three skin- tracked wrist joint coordinate system (WJCS) definitions across baseline and reconstructive wrist states (intact, mid-carpal arthrodesis, and proximal-row carpectomy). Two WJCSs (legacy, anatomic) were based on palpated bony landmarks and the third (functional) was based on both landmarks and passive flexion-extension motion. A coordinate frame based on the anatomic definition was tracked with bone pins and served as a reference. Each WJCS was tested in each wrist state and in three forearm position (45° pronation, neutral, 45° supination). The angular offset about each axis of the WJCS frames were calculated with respect to the reference in flexion-extension, radial-ulnar deviation, and pronation-supination for every iteration. Reliability and root mean square deviation values were analyzed across wrist states. Our data suggest that no WJCS is uniformly more reliable than another. The functional WJCS definition was most consistent across intact and post-operative states for pronation-supination offset, but this was dependent on rater interpretation. It still however offers the practical benefit of requiring fewer landmarks. PMID:25940572

  3. Influence of plasma diagnostics and constraints on the quality of equilibrium reconstructions on Joint European Torus.

    PubMed

    Gelfusa, M; Murari, A; Lupelli, I; Hawkes, N; Gaudio, P; Baruzzo, M; Brix, M; Craciunescu, T; Drozdov, V; Meigs, A; Peluso, E; Romanelli, M; Schmuck, S; Sieglin, B

    2013-10-01

    One of the main approaches to thermonuclear fusion relies on confining high temperature plasmas with properly shaped magnetic fields. The determination of the magnetic topology is, therefore, essential for controlling the experiments and for achieving the required performance. In Tokamaks, the reconstruction of the fields is typically formulated as a free boundary equilibrium problem, described by the Grad-Shafranov equation in toroidal geometry and axisymmetric configurations. Unfortunately, this results in mathematically very ill posed problems and, therefore, the quality of the equilibrium reconstructions depends sensitively on the measurements used as inputs and on the imposed constraints. In this paper, it is shown how the different diagnostics (Magnetics Measurements, Polarimetry and Motional Stark Effect), together with the edge current density and plasma pressure constraints, can have a significant impact on the quality of the equilibrium on JET. Results show that both the Polarimetry and Motional Stark Effect internal diagnostics are crucial in order to obtain reasonable safety factor profiles. The impact of the edge current density constraint is significant when the plasma is in the H-mode of confinement. In this plasma scenario the strike point positions and the plasma last closed flux surface can change even by centimetres, depending on the edge constraints, with a significant impact on the remapping of the equilibrium-dependent diagnostics and of pedestal physics studies. On the other hand and quite counter intuitively, the pressure constraint can severely affect the quality of the magnetic reconstructions in the core. These trends have been verified with several JET discharges and consistent results have been found. An interpretation of these results, as interplay between degrees of freedom and available measurements, is provided. The systematic analysis described in the paper emphasizes the importance of having sufficient diagnostic inputs and of

  4. Influence of plasma diagnostics and constraints on the quality of equilibrium reconstructions on Joint European Torus

    SciTech Connect

    Gelfusa, M.; Gaudio, P.; Peluso, E.; Murari, A.; Baruzzo, M.; Lupelli, I.; Hawkes, N.; Brix, M.; Drozdov, V.; Meigs, A.; Romanelli, M.; Schmuck, S.; Sieglin, B.; Collaboration: JET-EFDA Contributors

    2013-10-15

    One of the main approaches to thermonuclear fusion relies on confining high temperature plasmas with properly shaped magnetic fields. The determination of the magnetic topology is, therefore, essential for controlling the experiments and for achieving the required performance. In Tokamaks, the reconstruction of the fields is typically formulated as a free boundary equilibrium problem, described by the Grad-Shafranov equation in toroidal geometry and axisymmetric configurations. Unfortunately, this results in mathematically very ill posed problems and, therefore, the quality of the equilibrium reconstructions depends sensitively on the measurements used as inputs and on the imposed constraints. In this paper, it is shown how the different diagnostics (Magnetics Measurements, Polarimetry and Motional Stark Effect), together with the edge current density and plasma pressure constraints, can have a significant impact on the quality of the equilibrium on JET. Results show that both the Polarimetry and Motional Stark Effect internal diagnostics are crucial in order to obtain reasonable safety factor profiles. The impact of the edge current density constraint is significant when the plasma is in the H-mode of confinement. In this plasma scenario the strike point positions and the plasma last closed flux surface can change even by centimetres, depending on the edge constraints, with a significant impact on the remapping of the equilibrium-dependent diagnostics and of pedestal physics studies. On the other hand and quite counter intuitively, the pressure constraint can severely affect the quality of the magnetic reconstructions in the core. These trends have been verified with several JET discharges and consistent results have been found. An interpretation of these results, as interplay between degrees of freedom and available measurements, is provided. The systematic analysis described in the paper emphasizes the importance of having sufficient diagnostic inputs and of

  5. Spatial Change of Cruciate Ligaments in Rat Embryo Knee Joint by Three-Dimensional Reconstruction

    PubMed Central

    Zhang, Xiangkai; Aoyama, Tomoki; Takaishi, Ryota; Higuchi, Shinya; Yamada, Shigehito; Kuroki, Hiroshi; Takakuwa, Tetsuya

    2015-01-01

    This study aimed to analyze the spatial developmental changes of rat cruciate ligaments by three-dimensional (3D) reconstruction using episcopic fluorescence image capture (EFIC). Cruciate ligaments of Wister rat embryos between embryonic day (E) 16 and E20 were analyzed. Samples were sectioned and visualized using EFIC. 3D reconstructions were generated using Amira software. The length of the cruciate ligaments, distances between attachment points to femur and tibia, angles of the cruciate ligaments and the cross angle of the cruciate ligaments were measured. The shape of cruciate ligaments was clearly visible at E17. The lengths of the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) increased gradually from E17 to E19 and drastically at E20. Distances between attachment points to the femur and tibia gradually increased. The ACL angle and PCL angle gradually decreased. The cross angle of the cruciate ligaments changed in three planes. The primordium of the 3D structure of rat cruciate ligaments was constructed from the early stage, with the completion of the development of the structures occurring just before birth. PMID:26098761

  6. Comparison of Short-term Complications Between 2 Methods of Coracoclavicular Ligament Reconstruction

    PubMed Central

    Rush, Lane N.; Lake, Nicholas; Stiefel, Eric C.; Hobgood, Edward R.; Ramsey, J. Randall; O’Brien, Michael J.; Field, Larry D.; Savoie, Felix H.

    2016-01-01

    Background: Numerous techniques have been used to treat acromioclavicular (AC) joint dislocation, with anatomic reconstruction of the coracoclavicular (CC) ligaments becoming a popular method of fixation. Anatomic CC ligament reconstruction is commonly performed with cortical fixation buttons (CFBs) or tendon grafts (TGs). Purpose: To report and compare short-term complications associated with AC joint stabilization procedures using CFBs or TGs. Study Design: Cohort study; Level of evidence, 3. Methods: We conducted a retrospective review of the operative treatment of AC joint injuries between April 2007 and January 2013 at 2 institutions. Thirty-eight patients who had undergone a procedure for AC joint instability were evaluated. In these 38 patients with a mean age of 36.2 years, 18 shoulders underwent fixation using the CFB technique and 20 shoulders underwent reconstruction using the TG technique. Results: The overall complication rate was 42.1% (16/38). There were 11 complications in the 18 patients in the CFB group (61.1%), including 7 construct failures resulting in a loss of reduction. The most common mode of failure was suture breakage (n = 3), followed by button migration (n = 2) and coracoid fracture (n = 2). There were 5 complications in the TG group (25%), including 3 cases of asymptomatic subluxation, 1 symptomatic suture granuloma, and 1 superficial infection. There were no instances of construct failure seen in TG fixations. CFB fixation was found to have a statistically significant increase in complications (P = .0243) and construct failure (P = .002) compared with TG fixation. Conclusion: CFB fixation was associated with a higher rate of failure and higher rate of early complications when compared with TG fixation. PMID:27504468

  7. Fast Monte Carlo based joint iterative reconstruction for simultaneous {sup 99m}Tc/{sup 123}I SPECT imaging

    SciTech Connect

    Ouyang Jinsong; El Fakhri, Georges; Moore, Stephen C.

    2007-08-15

    Simultaneous {sup 99m}Tc/{sup 123}I SPECT allows the assessment of two physiological functions under identical conditions. The separation of these radionuclides is difficult, however, because their energies are close. Most energy-window-based scatter correction methods do not fully model either physical factors or patient-specific activity and attenuation distributions. We have developed a fast Monte Carlo (MC) simulation-based multiple-radionuclide and multiple-energy joint ordered-subset expectation-maximization (JOSEM) iterative reconstruction algorithm, MC-JOSEM. MC-JOSEM simultaneously corrects for scatter and cross talk as well as detector response within the reconstruction algorithm. We evaluated MC-JOSEM for simultaneous brain profusion ({sup 99m}Tc-HMPAO) and neurotransmission ({sup 123}I-altropane) SPECT. MC simulations of {sup 99m}Tc and {sup 123}I studies were generated separately and then combined to mimic simultaneous {sup 99m}Tc/{sup 123}I SPECT. All the details of photon transport through the brain, the collimator, and detector, including Compton and coherent scatter, septal penetration, and backscatter from components behind the crystal, were modeled. We reconstructed images from simultaneous dual-radionuclide projections in three ways. First, we reconstructed the photopeak-energy-window projections (with an asymmetric energy window for {sup 123}I) using the standard ordered-subsets expectation-maximization algorithm (NSC-OSEM). Second, we used standard OSEM to reconstruct {sup 99m}Tc photopeak-energy-window projections, while including an estimate of scatter from a Compton-scatter energy window (SC-OSEM). Third, we jointly reconstructed both {sup 99m}Tc and {sup 123}I images using projection data associated with two photopeak energy windows and an intermediate-energy window using MC-JOSEM. For 15 iterations of reconstruction, the bias and standard deviation of {sup 99m}Tc activity estimates in several brain structures were calculated for NSC

  8. Saving a Child's Elbow Joint: A Novel Reconstruction for a Tumour of the Distal Humerus.

    PubMed

    Graci, Calogero; Gaston, Czar Louie; Grimer, Robert; Jeys, Lee; Ozkan, Korhan

    2015-01-01

    Reconstruction after wide resection of a malignant bone tumor can be obtained using several techniques such as the use of prostheses, allograft, autograft, or combined procedure. We describe a 12-year-old girl with parosteal osteosarcoma of the distal right humerus treated by en bloc resection, intraoperative extracorporeal irradiation, and implantation. We inserted a nonvascularised fibular autograft through the middle of irradiated graft to obtain a greater stability. We have not recorded any complication associated with this technique such as nonunion, pathological fracture, infection, and bone necrosis and we obtained an excellent functional result. 10 years after surgery, the patient had no recurrence. Extracorporeal irradiation and reimplantation is a valid and inexpensive technique for the treatment of bone tumors when there is reasonable residual bone stock. With this procedure we have a precise fit being the patient's own bone. In this way we avoid all the problems related to the adaptation of the shape and size. PMID:25648359

  9. Saving a Child's Elbow Joint: A Novel Reconstruction for a Tumour of the Distal Humerus

    PubMed Central

    Graci, Calogero; Gaston, Czar Louie; Grimer, Robert; Jeys, Lee; Ozkan, Korhan

    2015-01-01

    Reconstruction after wide resection of a malignant bone tumor can be obtained using several techniques such as the use of prostheses, allograft, autograft, or combined procedure. We describe a 12-year-old girl with parosteal osteosarcoma of the distal right humerus treated by en bloc resection, intraoperative extracorporeal irradiation, and implantation. We inserted a nonvascularised fibular autograft through the middle of irradiated graft to obtain a greater stability. We have not recorded any complication associated with this technique such as nonunion, pathological fracture, infection, and bone necrosis and we obtained an excellent functional result. 10 years after surgery, the patient had no recurrence. Extracorporeal irradiation and reimplantation is a valid and inexpensive technique for the treatment of bone tumors when there is reasonable residual bone stock. With this procedure we have a precise fit being the patient's own bone. In this way we avoid all the problems related to the adaptation of the shape and size. PMID:25648359

  10. Anatomic dorsal and volar radioulnar ligament reconstruction with Mersilene augmentation for distal radioulnar joint instability.

    PubMed

    Stein, Andrew J; Adabi, Kian; Schofield, Jennifer L; Marsh, Mike; Paulo, Jerry

    2015-03-01

    Instability of the distal ulna is a fairly common problem after acute distal radius fracture (DRF), distal radius malunion, triangular fibrocartilage complex injury, and a host of other types of trauma. We present a new anatomic technique to stabilize the distal ulna with a tendon graft augmented with Mersilene tape, which has been used primarily to treat unidirectional (dorsal or volar) instability, but could be used for global instability as well. Of the 12 patients who underwent this procedure, 9 had stability fully restored and the remaining 3 had only mild instability after surgery. The procedure is an effective treatment for distal radioulnar joint instability and we believe that this surgical technique will be a valuable adjunct to the existing described procedures for hand surgeons. We present a retrospective single-surgeon case series with outcome measures. PMID:25575187

  11. Biomechanical loading of the shoulder complex and lumbosacral joints during dynamic cart pushing task.

    PubMed

    Nimbarte, Ashish D; Sun, Yun; Jaridi, Majid; Hsiao, Hongwei

    2013-09-01

    The primary objective of this study was to quantify the effect of dynamic cart pushing exertions on the biomechanical loading of shoulder and low back. Ten participants performed cart pushing tasks on flat (0°), 5°, and 10° ramped walkways at 20 kg, 30 kg, and 40 kg weight conditions. An optoelectronic motion capturing system configured with two force plates was used for the kinematic and ground reaction force data collection. The experimental data was modeled using AnyBody modeling system to compute three-dimensional peak reaction forces at the shoulder complex (sternoclavicular, acromioclavicular, and glenohumeral) and low back (lumbosacral) joints. The main effect of walkway gradient and cart weight, and gradient by weight interaction on the biomechanical loading of shoulder complex and low back joints was statistically significant (all p < 0.001). At the lumbosacral joint, negligible loading in the mediolateral direction was observed compared to the anterioposterior and compression directions. Among the shoulder complex joints, the peak reaction forces at the acromioclavicular and glenohumeral joints were comparable and much higher than the sternoclavicular joint. Increased shear loading of the lumbosacral joint, distraction loading of glenohumeral joint and inferosuperior loading of the acromioclavicular joint may contribute to the risk of work-related low back and shoulder musculoskeletal disorder with prolonged and repetitive use of carts. PMID:23566675

  12. A sequential data assimilation approach for the joint reconstruction of mantle convection and surface tectonics

    NASA Astrophysics Data System (ADS)

    Bocher, M.; Coltice, N.; Fournier, A.; Tackley, P. J.

    2016-01-01

    With the progress of mantle convection modelling over the last decade, it now becomes possible to solve for the dynamics of the interior flow and the surface tectonics to first order. We show here that tectonic data (like surface kinematics and seafloor age distribution) and mantle convection models with plate-like behaviour can in principle be combined to reconstruct mantle convection. We present a sequential data assimilation method, based on suboptimal schemes derived from the Kalman filter, where surface velocities and seafloor age maps are not used as boundary conditions for the flow, but as data to assimilate. Two stages (a forecast followed by an analysis) are repeated sequentially to take into account data observed at different times. Whenever observations are available, an analysis infers the most probable state of the mantle at this time, considering a prior guess (supplied by the forecast) and the new observations at hand, using the classical best linear unbiased estimate. Between two observation times, the evolution of the mantle is governed by the forward model of mantle convection. This method is applied to synthetic 2-D spherical annulus mantle cases to evaluate its efficiency. We compare the reference evolutions to the estimations obtained by data assimilation. Two parameters control the behaviour of the scheme: the time between two analyses, and the amplitude of noise in the synthetic observations. Our technique proves to be efficient in retrieving temperature field evolutions provided the time between two analyses is ≲10 Myr. If the amplitude of the a priori error on the observations is large (30 per cent), our method provides a better estimate of surface tectonics than the observations, taking advantage of the information within the physics of convection.

  13. POSTEROSUPERIOR SURGICAL ACCESS ROUTE FOR TREATMENT OF ACROMIOCLAVICULAR DISLOCATIONS: RESULTS FROM 84 SURGICAL CASES

    PubMed Central

    Dal Molin, Danilo Canesin; Ribeiro, Fabiano Rebouças; Filho, Rômulo Brasil; Filardi, Cantídio Salvador; Tenor, Antonio Carlos; Stipp, Willian Nandi; Petros, Rodrigo Souto Borges

    2015-01-01

    Objective: To evaluate the results from surgical treatment of 84 cases of acute acromioclavicular dislocation, using a posterosuperior access route. Methods: Eighty-four cases of acute acromioclavicular dislocation (grade III in the Allman-Tossy classification) operated between November 2002 and May 2010 were evaluated. The patients’ mean age was 34 years. The diagnoses were made using clinical and radiographic evaluations. The patients were operated by the same surgical team, within three weeks of the date of the trauma, using a posterosuperior approach to the shoulder to access the top of the base of the coracoid process for placement of two anchors, which were used in reducing the dislocation. The minimum follow-up was 12 months. The postoperative clinical-radiographic evaluation was done using the modified Karlsson criteria and the University of California at Los Angeles (UCLA) score. Results: 92.8% of the 84 patients treated presented good or excellent results, and 7.2% presented fair or poor results, using the UCLA assessment score. According to the modified Karlsson criteria, 76.2% were assessed as grade A, 17.9% as grade B and 5.9% as grade C. Conclusion: The posterosuperior access route to the shoulder is a new option for accessing the coracoid process and treating acromioclavicular dislocation, with clinical and radiographic results equivalent to those in the literature. PMID:27047866

  14. Quadruple-component superficial circumflex iliac artery perforator (SCIP) flap: A chimeric SCIP flap for complex ankle reconstruction of an exposed artificial joint after total ankle arthroplasty.

    PubMed

    Yamamoto, Takumi; Saito, Takafumi; Ishiura, Ryohei; Iida, Takuya

    2016-09-01

    Total ankle arthroplasty (TAA) is becoming popular in patients with rheumatoid arthritis (RA)-associated ankle joint degeneration. However, ankle wound complications can occur after TAA, which sometimes requires challenging reconstruction due to anatomical complexity of the ankle. Superficial circumflex iliac artery (SCIA) perforator (SCIP) flap has been reported to be useful for various reconstructions, but no case has been reported regarding a chimeric SCIP flap for complex ankle reconstruction. We report a case of complex ankle defect successfully reconstructed with a free quadruple-component chimeric SCIP flap. A 73-year-old female patient with RA underwent TAA, and suffered from an extensive ankle soft tissue defect (13 × 5 cm) with exposure of the implanted artificial joint and the extensor tendons. A chimeric SCIP flap was raised based on the deep branch and the superficial branch of the SCIA, which included chimeric portions of the sartorius muscle, the deep fascia, the inguinal lymph node (ILN), and the skin/fat. The flap was transferred to the recipient ankle. The sartorius muscle was used to cover the artificial joint, the deep fascia to reconstruct the extensor retinaculum, the ILN to prevent postoperative lymphedema, and the adiposal tissue to put around the extensor tendons for prevention of postoperative adhesion. Postoperatively, the patient could walk by herself without persistent leg edema or bowstringing of the extensor tendons, and was satisfied with the concealable donor scar. Although further studies are required to confirm efficacy, multicomponent chimeric SCIP has a potential to be a useful option for complex defects of the ankle. PMID:27423250

  15. A Three-Dimensional Skeletal Reconstruction of the Stem Amniote Orobates pabsti (Diadectidae): Analyses of Body Mass, Centre of Mass Position, and Joint Mobility.

    PubMed

    Nyakatura, John A; Allen, Vivian R; Lauströer, Jonas; Andikfar, Amir; Danczak, Marek; Ullrich, Hans-Jürgen; Hufenbach, Werner; Martens, Thomas; Fischer, Martin S

    2015-01-01

    Orobates pabsti, a basal diadectid from the lower Permian, is a key fossil for the understanding of early amniote evolution. Quantitative analysis of anatomical information suffers from fragmentation of fossil bones, plastic deformation due to diagenetic processes and fragile preservation within surrounding rock matrix, preventing further biomechanical investigation. Here we describe the steps taken to digitally reconstruct MNG 10181, the holotype specimen of Orobates pabsti, and subsequently use the digital reconstruction to assess body mass, position of the centre of mass in individual segments as well as the whole animal, and study joint mobility in the shoulder and hip joints. The shape of most fossil bone fragments could be recovered from micro-focus computed tomography scans. This also revealed structures that were hitherto hidden within the rock matrix. However, parts of the axial skeleton had to be modelled using relevant isolated bones from the same locality as templates. Based on the digital fossil, mass of MNG 10181 was estimated using a model of body shape that was varied within a plausible range to account for uncertainties of the dimension. In the mean estimate model the specimen had an estimated mass of circa 4 kg. Varying of the mass distribution amongst body segments further revealed that Orobates carried most of its weight on the hind limbs. Mostly unrestricted joint morphology further suggested that MNG 10181 was able to effectively generate propulsion with the pelvic limbs. The digital reconstruction is made available for future biomechanical studies. PMID:26355297

  16. A Three-Dimensional Skeletal Reconstruction of the Stem Amniote Orobates pabsti (Diadectidae): Analyses of Body Mass, Centre of Mass Position, and Joint Mobility

    PubMed Central

    Nyakatura, John A.; Allen, Vivian R.; Lauströer, Jonas; Andikfar, Amir; Danczak, Marek; Ullrich, Hans-Jürgen; Hufenbach, Werner; Martens, Thomas; Fischer, Martin S.

    2015-01-01

    Orobates pabsti, a basal diadectid from the lower Permian, is a key fossil for the understanding of early amniote evolution. Quantitative analysis of anatomical information suffers from fragmentation of fossil bones, plastic deformation due to diagenetic processes and fragile preservation within surrounding rock matrix, preventing further biomechanical investigation. Here we describe the steps taken to digitally reconstruct MNG 10181, the holotype specimen of Orobates pabsti, and subsequently use the digital reconstruction to assess body mass, position of the centre of mass in individual segments as well as the whole animal, and study joint mobility in the shoulder and hip joints. The shape of most fossil bone fragments could be recovered from micro-focus computed tomography scans. This also revealed structures that were hitherto hidden within the rock matrix. However, parts of the axial skeleton had to be modelled using relevant isolated bones from the same locality as templates. Based on the digital fossil, mass of MNG 10181 was estimated using a model of body shape that was varied within a plausible range to account for uncertainties of the dimension. In the mean estimate model the specimen had an estimated mass of circa 4 kg. Varying of the mass distribution amongst body segments further revealed that Orobates carried most of its weight on the hind limbs. Mostly unrestricted joint morphology further suggested that MNG 10181 was able to effectively generate propulsion with the pelvic limbs. The digital reconstruction is made available for future biomechanical studies. PMID:26355297

  17. A practical method for three-dimensional reconstruction of joints using a C-arm system and shift-and-add algorithm

    SciTech Connect

    Li Senhu; Jiang Huabei

    2005-06-15

    Currently, radiography with C-arm systems is playing a major role in the assessment of arthritis. However, the radiographic two-dimensional projection images of joints often interfere with physicians' efforts to better understand and measure the structure changes of joints due to the overlap of bone structures at different depths. An accurate, low-cost, and practical three-dimensional (3D) reconstruction approach of joints will be beneficial in diagnosing arthritis. Toward this end, a novel method is developed in this paper based on a C-arm system. The idea is to apply the shift-and-add algorithm (commonly used in digital tomosynthesis) on the segmented projection images at multiple angles, which results in accurate reconstruction of the 3D structures of joints. The method provides a new solution to precisely distinguish objects from blurring background. The proposed method has been tested and evaluated on simulated cylinders, a chicken bone phantom with known structure, and an in vivo human index finger. The results are demonstrated and discussed.

  18. Biological Reconstruction of the Knee Joint in a Case of Giant Cell Tumor of the Tibia of 15yrs Followup- A Case Report

    PubMed Central

    Ravindranath, V S; Sastri, V.R.K.

    2014-01-01

    Introduction: A 40 year old male patient presented to us with Giant Cell Tumor of upper end of Tibia involving both condyles with a breach in the posterior cortex. In this case report we tried to retain the joint function by biological reconstruction using the Patella after the wide excision of the tumor mass. Case Report: A radical excision of the upper end of the Tibia was done. The Patella was used as an articular surface supported by ipsilateral Fibula as struts, thus the joint was reconstructured biologically. The case was followed for 15years. Conclusion: The tumor was excised in toto, the knee joint was restored by the Patella and the Fibular struts. The results were discussed in details. PMID:27299004

  19. Meniscus treatment and age associated with narrower radiographic joint space width 2 – 3 years after ACL reconstruction: Data from the MOON onsite cohort

    PubMed Central

    Jones, Morgan H.; Spindler, Kurt P.; Fleming, Braden C.; Duryea, Jeffrey; Obuchowski, Nancy A.; Scaramuzza, Erica A.; Oksendahl, Heidi L.; Winalski, Carl S.; Duong, Carol L.; Huston, Laura J.; Parker, Richard D.; Kaeding, Christopher C.; Andrish, Jack T.; Flanigan, David C.; Dunn, Warren R.; Reinke, Emily K.

    2015-01-01

    Objective To identify risk factors for radiographic signs of post-traumatic OA 2–3 years after ACL reconstruction through multivariable analysis of minimum joint space width (mJSW) differences in a specially designed nested cohort. Methods A nested cohort within the Multicenter Orthopaedic Outcomes Network cohort included 262 patients (148 females, average age 20) injured in sport who underwent ACL reconstruction in a previously uninjured knee, were 35 or younger, and did not have ACL revision or contralateral knee surgery. mJSW on semi-flexed radiographs was measured in the medial compartment using a validated computerized method. A multivariable generalized linear model was constructed to assess mJSW difference between the ACL reconstructed and contralateral control knees while adjusting for potential confounding factors. Results Unexpectedly, we found the mean mJSW was 0.35 mm wider in ACL reconstructed than in control knees (5.06 mm (95% CI 4.96 – 5.15 mm) versus 4.71 mm (95% CI 4.62 – 4.80 mm), p<0.001). However, ACL reconstructed knees with meniscectomy had narrower mJSW compared to contralateral normal knees by 0.64 mm (95% C.I. 0.38 – 0.90 mm) (p<0.001). Age (p<0.001) and meniscus repair (p=0.001) were also significantly associated with mJSW difference. Conclusion Semi-flexed radiographs can detect differences in mJSW between ACL reconstructed and contralateral normal knees 2–3 years following ACL reconstruction, and the unexpected wider mJSW in ACL reconstructed knees may represent the earliest manifestation of post-traumatic osteoarthritis and warrants further study. PMID:25559582

  20. Arthroscopic reconstruction of chronic AC joint dislocations by transposition of the coracoacromial ligament augmented by the Tight Rope device: a technical note.

    PubMed

    Hosseini, Hamid; Friedmann, Svenja; Tröger, Markus; Lobenhoffer, Philipp; Agneskirchner, Jens D

    2009-01-01

    We present a new arthroscopic technique for chronic AC joint dislocations with coracoacromial ligament transposition and augmentation by the Tight Rope device (Arthrex, Naples, USA). First the glenohumeral joint is visualised to repair concomitant lesions, such as SLAP lesions, if needed. Once the rotator interval is opened and the coracoid is identified, the arthroscope is moved to an additional anterolateral portal. A 1.5 cm incision is made 2 cm medial to the AC joint. After drilling a 4 mm hole with a cannulated drill through the clavicle and coracoid a Tight Rope is inserted, the clavicule is reduced and stabilized with the implant. The arthroscope is moved to the subacromial space and a partial bursectomy is performed to visualise the CA ligament and lateral clavicle. The CA ligament is armed with a strong braided suture using a Lasso stitch and dissected from the undersurface of the acromion. It is then reattached to the distal part of the clavicle by transosseous suture fixation after abrasion of its undersurface. Although this combined arthroscopic procedure of AC joint augmentation with a Tight Rope combined with a ligament transposition is technically demanding, it is a safe method to reconstruct the coracoclavicular ligaments and achieve a sufficient reduction of the clavicle without the need of further implant removal or autologous tendon transplantation. PMID:18836701

  1. Surgical treatment of acute type-V acromioclavicular injuries in athletes.

    PubMed

    Verhaven, E; DeBoeck, H; Haentjens, P; Handelberg, F; Casteleyn, P P; Opdecam, P

    1993-01-01

    In a prospective study, 18 consecutive athletes with an acute type-V acromioclavicular sprain were treated with a coracoclavicular repair using a double velour Dacron graft. All patients were reviewed after a mean follow-up period of 6 years (range: 2-9 years). At follow-up, 12 patients (66.7%) showed a good or excellent result according to the Imatani evaluation system, and six patients (33.3%) demonstrated a fair or poor result according to the same system. Loss of reduction was encountered in eight shoulders (44.4%) despite an initial anatomical reduction. No correlation was seen between the overall scores at follow-up and the degree of residual dislocation, between the overall scores and the presence of coracoclavicular calcifications or ossifications, between the overall scores and the development of post-traumatic arthritic changes, or between the overall scores and the presence of osteolysis of the distal clavicle. PMID:8357696

  2. Joint reconstruction of galaxy clusters from gravitational lensing and thermal gas. I. Outline of a non-parametric method

    NASA Astrophysics Data System (ADS)

    Konrad, S.; Majer, C. L.; Meyer, S.; Sarli, E.; Bartelmann, M.

    2013-05-01

    We present a method of estimating the lensing potential from massive galaxy clusters for given observational X-ray data. The concepts developed and applied in this work can be easily combined with other techniques to infer the lensing potential, e.g. weak gravitational lensing or galaxy kinematics, to obtain an overall best-fit model for the lensing potential. After elaborating on the physical details and assumptions the method is based on, we explain how the numerical algorithm itself is implemented with a Richardson-Lucy algorithm as a central part. Our reconstruction method is tested on simulated galaxy clusters with a spherically symmetric NFW density profile filled with gas in hydrostatic equilibrium. We describe in detail how these simulated observational data sets are created and how they need to be fed into our algorithm. We tested the robustness of the algorithm against small parameter changes and estimate the quality of the reconstructed lensing potentials. As it turns out, we achieve a very high degree of accuracy in reconstructing the lensing potential. The statistical errors remain below 2.0%, whereas the systematical error does not exceed 1.0%.

  3. Enhanced knee joint function due to accelerated rehabilitation exercise after anterior cruciate ligament reconstruction surgery in Korean male high school soccer players.

    PubMed

    Lee, Myungchun; Sung, Dong Jun; Lee, Joohyung; Oh, Inyoung; Kim, Sojung; Kim, Seungho; Kim, Jooyoung

    2016-02-01

    This study was conducted on Korean male high school soccer players who underwent anterior cruciate ligament reconstruction (ACLR) to identify the effects of an accelerated rehabilitation exercise (ARE) program on knee joint isometric strength, thigh circumference, Lysholm score, and active balance agility. We assigned eight test participants each to a physical therapy group (PTG) and an accelerated rehabilitation exercise group (AREG), and compared differences between the groups. Both the PTG and AREG showed significant increases in 30° away and 60° toward isometric strength after treatment. In addition, significant differences were observed in these strength tests between the two groups. Both groups also showed significant increases in thigh circumference, Lysholm score, and active balance agility after treatment, but no significant differences were observed between the two groups. We conclude that the ARE treatment was more effective for improving isometric strength of the knee joint than that of physical therapy, and that an active rehabilitation exercise program after ACLR had positive effects on recovery performance of patients with an ACL injury and their return to the playing field. PMID:26933657

  4. Enhanced knee joint function due to accelerated rehabilitation exercise after anterior cruciate ligament reconstruction surgery in Korean male high school soccer players

    PubMed Central

    Lee, Myungchun; Sung, Dong Jun; Lee, Joohyung; Oh, Inyoung; Kim, Sojung; Kim, Seungho; Kim, Jooyoung

    2016-01-01

    This study was conducted on Korean male high school soccer players who underwent anterior cruciate ligament reconstruction (ACLR) to identify the effects of an accelerated rehabilitation exercise (ARE) program on knee joint isometric strength, thigh circumference, Lysholm score, and active balance agility. We assigned eight test participants each to a physical therapy group (PTG) and an accelerated rehabilitation exercise group (AREG), and compared differences between the groups. Both the PTG and AREG showed significant increases in 30° away and 60° toward isometric strength after treatment. In addition, significant differences were observed in these strength tests between the two groups. Both groups also showed significant increases in thigh circumference, Lysholm score, and active balance agility after treatment, but no significant differences were observed between the two groups. We conclude that the ARE treatment was more effective for improving isometric strength of the knee joint than that of physical therapy, and that an active rehabilitation exercise program after ACLR had positive effects on recovery performance of patients with an ACL injury and their return to the playing field. PMID:26933657

  5. Adult acquired flatfoot deformity at the talonavicular joint: reconstruction of the spring ligament in an in vitro model.

    PubMed

    Deland, J T; Arnoczky, S P; Thompson, F M

    1992-01-01

    The mobile unilateral flatfoot deformity of chronic posterior tibial tendon insufficiency has been difficult to correct by soft tissue procedures. The procedures can decrease pain, but they do not always correct the longitudinal arch or relieve all the symptoms. Using 10 fresh frozen cadaveric specimens and a rig for stimulation of weightbearing, the deformity associated with chronic posterior tibial tendon insufficiency was produced by multiple ligamentous release and documented by AP and lateral radiographs. Reconstruction of the spring ligament using a ligament bone autograft from the superficial deltoid ligament was then performed and tested under load. The mean correction was within 2.5 degrees of normal (over or undercorrection) on both the AP and lateral radiographs with the specimens under load. Clinical Relevance. In posterior tibial tendon insufficiency, it may be possible to address the ligament as well as tendon insufficiency to gain a corrected arch. The success of such a procedure will depend upon adequate tendon and ligament reconstruction in a fully mobile deformity. Questions remain as to the adequacy of this ligament graft, and a stronger free ligament graft, as well as correction of any bony malalignment, may be required. PMID:1398361

  6. Effectiveness of surgical reconstruction to restore radiocarpal joint mechanics after scapholunate ligament injury: an in vivo modeling study.

    PubMed

    Johnson, Joshua E; Lee, Phil; McIff, Terence E; Toby, E Bruce; Fischer, Kenneth J

    2013-05-31

    Disruption of the scapholunate ligament can cause a loss of normal scapholunate mechanics and eventually lead to osteoarthritis. Surgical reconstruction attempts to restore scapholunate relationship show improvement in functional outcomes, but postoperative effectiveness in restoring normal radiocarpal mechanics still remains a question. The objective of this study was to investigate the benefits of surgical repair by observing changes in contact mechanics on the cartilage surface before and after surgical treatment. Six patients with unilateral scapholunate dissociation were enrolled in the study, and displacement driven magnetic resonance image-based surface contact modeling was used to investigate normal, injured and postoperative radiocarpal mechanics. Model geometry was acquired from images of wrists taken in a relaxed position. Kinematics were acquired from image registration between the relaxed images, and images taken during functional loading. Results showed a trend for increase in radiocarpal contact parameters with injury. Peak and mean contact pressures significantly decreased after surgery in the radiolunate articulation and there were no significant differences between normal and postoperative wrists. Results indicated that surgical repair improves contact mechanics after injury and that contact mechanics can be surgically restored to be similar to normal. This study provides novel contact mechanics data on the effects of surgical repair after scapholunate ligament injury. With further work, it may be possible to more effectively differentiate between treatments and degenerative changes based on in vivo contact mechanics data. PMID:23618131

  7. Dose reconstruction for the Urals population: Joint Coordinating Committee on Radiation Effects Research Project 1.1. Final report

    SciTech Connect

    Degteva, M.O.; Drozhko, E.; Anspaugh, L.R.; Napier, B.A.; Bouville, A.C.; Miller, C.W.

    1996-01-01

    Population exposure in the Urals occurred as a result of failures in the technological processes at the Mayak plutonium facility in the 1950s. Construction of the Mayak facility began in 1945 and was completed in 1948. Initially this complex consisted of three main parts: Reactor plant, radiochemical facility, and waste-management facilities. The major sources of radioactive contamination were the discharges of 2.7 x 10{sup 6}Ci of liquid wastes into the Techa River (1949-1956); an explosion in the radioactive waste storage facility in 1957 (the so-called Kyshtym Accident) that formed the East Urals Radioactive Trace (EURT) due to dispersion. of 2 x 10{sup 6}Ci into the atmosphere; and gaseous aerosol releases (about 560,000 Ci of {sup 131}I in total) within the first decades of the facility`s operation. The significant portion of activity for the Techa River and EURT consists of long-lived radionuclides, mainly {sup 9O}Sr. These releases resulted in the long-lived contamination of surrounding territories. The predominant radionuclide for operating gaseous aerosol releases was short-lived {sup 131}I resulting from reprocessing of nuclear fuel. The maximal annual rates, which occurred in 1952-1953, were reconstructed on the basis of technological records by the Mayak team.

  8. Dose reconstruction for the Urals population. Joint Coordinating Committee on Radiation Effects Research, Project 1.1 -- Final report

    SciTech Connect

    Degteva, M.O.; Drozhko, E.; Anspaugh, L.R.; Napier, B.A.; Bouville, A.C.; Miller, C.W.

    1996-02-01

    This work is being carried out as a feasibility study to determine if a long-term course of work can be implemented to assess the long-term risks of radiation exposure delivered at low to moderate dose rates to the populations living in the vicinity of the Mayak Industrial Association (MIA). This work was authorized and conducted under the auspices of the US-Russian Joint Coordinating Committee on Radiation Effects Research (JCCRER) and its Executive Committee (EC). The MIA was the first Russian site for the production and separation of plutonium. This plant began operation in 1948, and during its early days there were technological failures that resulted in the release of large amounts of waste into the rather small Techa River. There were also gaseous releases of radioiodines and other radionuclides during the early days of operation. In addition, there was an accidental explosion in a waste storage tank in 1957 that resulted in a significant release. The Techa River Cohort has been studied for several years by scientists from the Urals Research Centre for Radiation Medicine and an increase in both leukemia and solid tumors has been noted.

  9. Anterior tibial artery perforator plus flaps for reconstruction of post-burn flexion contractures of the knee joint

    PubMed Central

    Adhikari, S.; Bandyopadhyay, T.; Saha, J.K.

    2012-01-01

    Summary Background. Post-burn flexion contractures of the knee may arise even with adequate treatment of the burn injury. After release of the contracture, most of these defects require flap coverage. Here we describe the application of the perforator plus flap concept in the management of these contractures. Method. Between December 2010 and December 2011 five female and two male patients with knee contractures were operated on using a perforator plus flap from the anterior tibia artery perforator. In one patient both sides were operated on and the rest had unilateral surgeries. All patients had mature scars and the aetiology was thermal burn injury. All these contractures were categorized as Category 4 and Level 3 by the ICIDH guidelines with an average contracture angle of 87.5 degrees. The flap was raised after release of the defect and a Doppler study located the perforator below the fibular head. The base of the flap was kept intact at all times. The flap was then transposed towards the defect and inset in a tensionless manner. Results. All flaps survived well with marginal necrosis in only one flap, providing stable coverage to the knee joint. The average residual contracture was around 10 degrees and the average range of flexion was 10-120 degrees. Conclusion. The perforator plus flap can be an excellent choice in defects over the posterior aspect of the knee where important neurovascular structures and tendons are exposed. Level of evidence: Level IV. PMID:23233827

  10. Coracoclavicular joint, an osteological study with clinical implications: a case report

    PubMed Central

    Stavrakas, Marios-Efstathios; Stoltidou, Alexandra

    2009-01-01

    Introduction The presence of an anomalous coracoclavicular joint was studied in a human male skeleton aged 73 years old from the Osteology Collection of our Department. Case presentation We describe the exact morphology of this variation that is occasionally reported as an anatomical or radiological curiosity in the literature (0.55-21%). Conclusion Although coracoclavicular diarthrosis is of no significance other than academic, it is important to recognize this variation and the clinical symptoms that may occur, as it is a cause of shoulder pain and arthritis in this or the adjacent sternoclavicular and acromioclavicular joint. Consequently, it is vital to apply the appropriate treatment. PMID:19918399

  11. Joint Spatial-Spectral Reconstruction and k-t Spirals for Accelerated 2D Spatial/1D Spectral Imaging of 13C Dynamics

    PubMed Central

    Gordon, Jeremy W.; Niles, David J.; Fain, Sean B.; Johnson, Kevin M.

    2014-01-01

    Purpose To develop a novel imaging technique to reduce the number of excitations and required scan time for hyperpolarized 13C imaging. Methods A least-squares based optimization and reconstruction is developed to simultaneously solve for both spatial and spectral encoding. By jointly solving both domains, spectral imaging can potentially be performed with a spatially oversampled single echo spiral acquisition. Digital simulations, phantom experiments, and initial in vivo hyperpolarized [1-13C]pyruvate experiments were performed to assess the performance of the algorithm as compared to a multi-echo approach. Results Simulations and phantom data indicate that accurate single echo imaging is possible when coupled with oversampling factors greater than six (corresponding to a worst case of pyruvate to metabolite ratio < 9%), even in situations of substantial T2* decay and B0 heterogeneity. With lower oversampling rates, two echoes are required for similar accuracy. These results were confirmed with in vivo data experiments, showing accurate single echo spectral imaging with an oversampling factor of 7 and two echo imaging with an oversampling factor of 4. Conclusion The proposed k-t approach increases data acquisition efficiency by reducing the number of echoes required to generate spectroscopic images, thereby allowing accelerated acquisition speed, preserved polarization, and/or improved temporal or spatial resolution. Magn Reson Med PMID:23716402

  12. Biomechanical Comparison of Fracture Risk Created by 2 Different Clavicle Tunnel Preparations for Coracoclavicular Ligament Reconstruction

    PubMed Central

    Nuzzo, Michael S.; Adamson, Gregory J.; Lee, Thay Q.; McGarry, Michelle H.; Husak, Lisa

    2014-01-01

    than the 2-tunnel group. Conclusion: The single anterior-to-posterior clavicle tunnel had similar biomechanical properties to the 2-tunnel technique. However, the single-tunnel technique better reproduced the anatomic footprint of the conoid ligament. Utilizing this single-tunnel technique may yield an anatomic advantage that may also reduce the rate of complications caused by posterior wall blowout. Clinical Relevance: Acromioclavicular joint injuries are common in collision sports. Surgical management is often indicated to reconstruct the joint. This study assesses the feasibility of a novel surgical approach. PMID:26535281

  13. Joint-sparing Corrections in Malunited Lisfranc Joint Injuries.

    PubMed

    Nery, Caio; Raduan, Fernando; Baumfeld, Daniel

    2016-03-01

    Lisfranc fracture-dislocations are very serious and potentially disabling injuries. Unfortunately, they are often misdiagnosed. Multiplanar midfoot deformities that result from these fracture-dislocations are precursors of joint degeneration and significant functional disabilities. Anatomic reduction with different types of internal fixation is an efficient method to reconstruct midfoot alignment and stability. Joint-preserving reconstruction techniques emerge as a viable alternative to corrective fusion as they achieve stable joint realignment with preserved motion. PMID:26915786

  14. Kalman filter-based fast track reconstruction for charged particles in a Compressed Baryonic Matter experiment using parallel computing on a multicore server at the Laboratory of Information Technologies, Joint Institute for Nuclear Research

    NASA Astrophysics Data System (ADS)

    Ablyazimov, T. O.; Zyzak, M. V.; Ivanov, V. V.; Kisel, P. I.

    2015-05-01

    One of the main goals in the Compressed Baryonic Matter (CBM) experiment (GSI, Germany) is to find parameters of charged particle trajectories. An online full event reconstruction is planned to be carried out in this experiment, thus demanding fast algorithms be developed, which make the most of the capabilities of modern CPU and GPU architectures. This paper presents the results of an analysis of the Kalman filter-based track reconstruction for charged particles implemented by using various code parallelization methods. A multicore server located at the Laboratory of Information Technologies, Joint Institute for Nuclear Research (LIT JINR), with two CPU Intel Xeon X5660 processors and a GPU Nvidia GTX 480 video card is used.

  15. Joint swelling

    MedlinePlus

    Swelling of a joint ... Joint swelling may occur along with joint pain . The swelling may cause the joint to appear larger or abnormally shaped. Joint swelling can cause pain or stiffness. After an ...

  16. Coracoclavicular joint: osteologic study of 1020 human clavicles

    PubMed Central

    Gumina, S; Salvatore, M; De Santis, P; Orsina, L; Postacchini, F

    2002-01-01

    We examined 1020 dry clavicles from cadavers of Italian origin to determine the prevalence of the coracoclavicular joint (ccj), a diarthrotic synovial joint occasionally present between the conoid tubercle of the clavicle and the superior surface of the horizontal part of the coracoid process. Five hundred and nine clavicles from individuals of different ages were submitted to X-ray examination. Using radiography, we measured the entire length and the index of sinuosity of the anterior lateral curve, on which the distance between the conoid tubercle and the coracoid process depends. We also used radiography to record the differences in prevalence of arthritis in two neighbouring joints, the acromioclavicular and sternoclavicular joints. Of the 1020 clavicles, eight (0.8%) displayed the articular facet of the ccj. No statistical correlation was found between clavicular length and the index of sinuosity of the anterior lateral curve. The prevalence of arthritis in clavicles with ccj was higher than that revealed in clavicles without ccj. The prevalence of ccj in the studied clavicles is lower than that observed in Asian cohorts. Furthermore, ccj is not conditioned by either length or sinuosity of the anterior lateral curve of the clavicle. Finally, the assumption that ccj is a predisposing factor for degenerative changes of neighbouring joints is statistically justified. PMID:12489763

  17. [The effect of platelet-rich plasma on graft healing in reconstruction of the anterior cruciate ligament of the knee joint: prospective study].

    PubMed

    Komzák, M; Hart, R; Šmíd, P; Puskeiler, M; Jajtner, P

    2015-01-01

    PURPOSE OF THE STUDY Growth factors produced by platelets enhance tissue healing. The aim of this study was to confirm or disprove the hypothesis that, in anterior cruciate ligament (ACL) reconstruction, the application of platelet-rich plasma (PRP) into the tibial and femoral tunnels and in the graft enhances graft maturation and graft-bone interface healing and thus improves knee function at 3 and 12 months post-operatively in comparison with the control group. MATERIAL AND METHODS A total of 40 patient had the surgery; 20 underwent single-bundle hamstring reconstruction with PRP application (PRP group) and 20 had the same surgery without PRP addition (control group). A 5 ml amount of PRP was obtained from the patient's peripheral blood. A graft inserted in the bone tunnels was fixed with interference screws and, after intra-articular fluid aspiration, 1 ml of PRP was injected into each tunnel and 3 ml were evenly applied to the intra-articular portion of the graft. The patients were examined by MRI at 3 and 12 months after surgery. The subsidence of swelling in the tunnelsurrounding tissues was taken as a sign of graft-bone interface healing, and increased signal intensity of the graft was considered as a result of its ligamentisation. The knee functional status was evaluated at 3 and 12 post-operative months, using the scoring systems (Cincinnati score, IKDC score). RESULTS Bone swelling was found at 3 post-operative months in 18 of 20 patients in both the PRP and the control group. Graft signal intensity was increased in most patients (19 of the PRP group; 18 control patients; p = 0.949). The Cincinnati score at 3 months had an average value of 72.7 (34-100; SO, 18.7) in the PRP group and 73.4 (42-99; SO, 16.3) in the control group (p = 0.793). The functional score after 12 months improved to 97.5 (75-100; SO, 12.8) in the PRP group and to 95.1 (66-100; SO, 13.1) in the control group; there was no significant difference between the groups (p = 0.885) at either

  18. Joint surface reconstruction and 4D deformation estimation from sparse data and prior knowledge for marker-less Respiratory motion tracking

    SciTech Connect

    Berkels, Benjamin; Rumpf, Martin; Bauer, Sebastian; Ettl, Svenja; Arold, Oliver; Hornegger, Joachim

    2013-09-15

    Purpose: The intraprocedural tracking of respiratory motion has the potential to substantially improve image-guided diagnosis and interventions. The authors have developed a sparse-to-dense registration approach that is capable of recovering the patient's external 3D body surface and estimating a 4D (3D + time) surface motion field from sparse sampling data and patient-specific prior shape knowledge.Methods: The system utilizes an emerging marker-less and laser-based active triangulation (AT) sensor that delivers sparse but highly accurate 3D measurements in real-time. These sparse position measurements are registered with a dense reference surface extracted from planning data. Thereby a dense displacement field is recovered, which describes the spatio-temporal 4D deformation of the complete patient body surface, depending on the type and state of respiration. It yields both a reconstruction of the instantaneous patient shape and a high-dimensional respiratory surrogate for respiratory motion tracking. The method is validated on a 4D CT respiration phantom and evaluated on both real data from an AT prototype and synthetic data sampled from dense surface scans acquired with a structured-light scanner.Results: In the experiments, the authors estimated surface motion fields with the proposed algorithm on 256 datasets from 16 subjects and in different respiration states, achieving a mean surface reconstruction accuracy of ±0.23 mm with respect to ground truth data—down from a mean initial surface mismatch of 5.66 mm. The 95th percentile of the local residual mesh-to-mesh distance after registration did not exceed 1.17 mm for any subject. On average, the total runtime of our proof of concept CPU implementation is 2.3 s per frame, outperforming related work substantially.Conclusions: In external beam radiation therapy, the approach holds potential for patient monitoring during treatment using the reconstructed surface, and for motion-compensated dose delivery using

  19. [Fractures of the elbow joint].

    PubMed

    Nowak, T E; Dietz, S O; Burkhart, K J; Müller, L P; Rommens, P M

    2012-02-01

    Fractures around the elbow joint comprise fractures of the distal humerus, the radial head, the olecranon and the coronoid process. Combined lesions are particularly demanding for the surgeon. Accurate knowledge of the anatomy and of the biomechanics is an essential requirement for a specific diagnosis and therapy. A stable and painless movable elbow joint is essential for most of the activities of daily living. Risk factors for the development of posttraumatic elbow joint arthrosis are non-anatomically reconstructed joint surfaces, axial malalignment of the joint axis and untreated concomitant injuries. Modern angular stable and anatomically preshaped implants facilitate a biomechanically adequate osteosynthesis and avoid or decrease functional impairment. In consideration of an increasing number of osteoporotic elbow joint fractures, endoprosthetic replacement has gained significance. PMID:22271056

  20. Hypermobile joints

    MedlinePlus

    ... too far. In children with hypermobility syndrome, those ligaments are loose or weak. This may lead to: Arthritis, which may develop over time Dislocated joints, which is a separation of two bones where they meet at a joint Sprains and strains Children with hypermobile joints also often have flat ...

  1. Joint Disorders

    MedlinePlus

    A joint is where two or more bones come together, like the knee, hip, elbow, or shoulder. Joints can be damaged by many types of injuries or diseases, including Arthritis - inflammation of a joint. It causes pain, stiffness, and swelling. Over time, ...

  2. Immediate traumatic thumb loss reconstruction: case reports.

    PubMed

    Bervar, M

    2004-01-01

    In the article we present and evaluate our successful immediate attempts of traumatic thumb loss reconstruction in the last fourteen years: early passive stump elongation, immediate pollicization and replantation. Our experience confirms the known fact that in spite of unfavorable oblique transarticular thumb amputation with interphalangeal joint destruction, considerable bone shortening and interphalangeal joint fusion, successful replantation offered us better cosmetic and partially functional outcome than the one we have obtained ealier with other methods of immediate thumb reconstruction. PMID:15274470

  3. Distal radioulnar joint injuries.

    PubMed

    Thomas, Binu P; Sreekanth, Raveendran

    2012-09-01

    Distal radioulnar joint is a trochoid joint relatively new in evolution. Along with proximal radioulnar joint, forearm bones and interosseous membrane, it allows pronosupination and load transmission across the wrist. Injuries around distal radioulnar joint are not uncommon, and are usually associated with distal radius fractures,fractures of the ulnar styloid and with the eponymous Galeazzi or Essex_Lopresti fractures. The injury can be purely involving the soft tissue especially the triangular fibrocartilage or the radioulnar ligaments. The patients usually present with ulnar sided wrist pain, features of instability, or restriction of rotation. Difficulty in carrying loads in the hand is a major constraint for these patients. Thorough clinical examination to localize point of tenderness and appropriate provocative tests help in diagnosis. Radiology and MRI are extremely useful, while arthroscopy is the gold standard for evaluation. The treatment protocols are continuously evolving and range from conservative, arthroscopic to open surgical methods. Isolated dislocation are uncommon. Basal fractures of the ulnar styloid tend to make the joint unstable and may require operative intervention. Chronic instability requires reconstruction of the stabilizing ligaments to avoid onset of arthritis. Prosthetic replacement in arthritis is gaining acceptance in the management of arthritis. PMID:23162140

  4. Anatomic Anterior Cruciate Ligament Reconstruction

    PubMed Central

    Murawski, Christopher D.; Wolf, Megan R.; Araki, Daisuke; Muller, Bart; Tashman, Scott

    2013-01-01

    Anatomic anterior cruciate ligament (ACL) reconstruction is common procedure performed by orthopedic surgeons, particularly in association with sports-related injuries. Whereas traditional reconstruction techniques used a single bundle graft that was typically placed in a non-anatomic position, a renewed interest in anatomy has facilitated the popularization of anatomic reconstruction techniques. Recently, a focus has been placed on individualizing ACL surgery based on each patient’s native anatomical characteristics (e.g., insertion site size, notch size, and shape), thereby dictating the ultimate procedure of choice. As subjective outcome measurements have demonstrated varying outcomes with respect to single- versus double-bundle ACL reconstruction, investigators have turned to more objective techniques, such as in vivo kinematics, as a means of evaluating joint motion and cartilage contact mechanics. Further investigation in this area may yield important information with regard to the potential progression to osteoarthritis after ACL reconstruction, including factors affecting or preventing it. PMID:26069663

  5. Late reconstruction of condylar neck and head fractures.

    PubMed

    Davis, Ben

    2013-11-01

    Condyle fractures are a common injury, but only a few of these injuries require immediate or late reconstruction. The complications that most frequently necessitate condylar reconstruction include proximal segment degeneration, malunion, and ankylosis. Costochondral grafts and total joint prostheses, both stock and custom, remain the most common methods of reconstruction. Reconstruction plates with condylar extensions should only be used temporarily as an unacceptable number cause serious complications. Distraction osteogenesis may have an occasional role in reconstructing the posttraumatic condyle. PMID:24021625

  6. Penile Reconstruction

    PubMed Central

    Salgado, Christopher J.; Chim, Harvey; Tang, Jennifer C.; Monstrey, Stan J.; Mardini, Samir

    2011-01-01

    A variety of surgical options exists for penile reconstruction. The key to success of therapy is holistic management of the patient, with attention to the psychological aspects of treatment. In this article, we review reconstructive modalities for various types of penile defects inclusive of partial and total defects as well as the buried penis, and also describe recent basic science advances, which may promise new options for penile reconstruction. PMID:22851914

  7. Ceramic joints

    DOEpatents

    Miller, Bradley J.; Patten, Jr., Donald O.

    1991-01-01

    Butt joints between materials having different coefficients of thermal expansion are prepared having a reduced probability of failure of stress facture. This is accomplished by narrowing/tapering the material having the lower coefficient of thermal expansion in a direction away from the joint interface and not joining the narrow-tapered surface to the material having the higher coefficient of thermal expansion.

  8. Posttraumatic temporomandibular joint disorders.

    PubMed

    Giannakopoulos, Helen E; Quinn, Peter D; Granquist, Eric; Chou, Joli C

    2009-05-01

    The temporomandibular joint (TMJ) has many essential functions. None of its components are exempt from injury. Facial asymmetry, malocclusion, disturbances in growth, osteoarthritis, and ankylosis can manifest as complications from trauma to the TMJ. The goals of initial treatment include achievement of pretraumatic function, restoration of facial symmetry, and resolution of pain. These same objectives hold true for late repairs and reconstruction of the TMJ apparatus. Treatment is demanding, and with opposing approaches. The following article explores various treatment options for problems presenting as a result of a history of trauma to the TMJ. PMID:22110802

  9. Penile reconstruction

    PubMed Central

    Garaffa, Giulio; Sansalone, Salvatore; Ralph, David J

    2013-01-01

    During the most recent years, a variety of new techniques of penile reconstruction have been described in the literature. This paper focuses on the most recent advances in male genital reconstruction after trauma, excision of benign and malignant disease, in gender reassignment surgery and aphallia with emphasis on surgical technique, cosmetic and functional outcome. PMID:22426595

  10. Image reconstruction

    SciTech Connect

    Defrise, Michel; Gullberg, Grant T.

    2006-04-05

    We give an overview of the role of Physics in Medicine andBiology in development of tomographic reconstruction algorithms. We focuson imaging modalities involving ionizing radiation, CT, PET and SPECT,and cover a wide spectrum of reconstruction problems, starting withclassical 2D tomogra tomography in the 1970s up to 4D and 5D problemsinvolving dynamic imaging of moving organs.

  11. Temporomandibular Joint, Closed

    MedlinePlus

    ... Oral Health > The Temporomandibular Joint, Closed The Temporomandibular Joint, Closed Main Content Title: The Temporomandibular Joint, Closed Description: The temporomandibular joint connects the lower ...

  12. Photometric Lunar Surface Reconstruction

    NASA Technical Reports Server (NTRS)

    Nefian, Ara V.; Alexandrov, Oleg; Morattlo, Zachary; Kim, Taemin; Beyer, Ross A.

    2013-01-01

    Accurate photometric reconstruction of the Lunar surface is important in the context of upcoming NASA robotic missions to the Moon and in giving a more accurate understanding of the Lunar soil composition. This paper describes a novel approach for joint estimation of Lunar albedo, camera exposure time, and photometric parameters that utilizes an accurate Lunar-Lambertian reflectance model and previously derived Lunar topography of the area visualized during the Apollo missions. The method introduced here is used in creating the largest Lunar albedo map (16% of the Lunar surface) at the resolution of 10 meters/pixel.

  13. Joint Problems

    MedlinePlus

    ... ankles and toes. Other types of arthritis include gout or pseudogout. Sometimes, there is a mechanical problem ... for more information on osteoarthritis, rheumatoid arthritis and gout. How Common are Joint Problems? Osteoarthritis, which affects ...

  14. Joint pain

    MedlinePlus

    ... or conditions. It may be linked to arthritis , bursitis , and muscle pain . No matter what causes it, ... Autoimmune diseases such as rheumatoid arthritis and lupus Bursitis Chondromalacia patellae Crystals in the joint: gout (especially ...

  15. Compliant joint

    NASA Technical Reports Server (NTRS)

    Eklund, Wayne D. (Inventor); Kerley, James J. (Inventor)

    1990-01-01

    A compliant joint is provided for prosthetic and robotic devices which permits rotation in three different planes. The joint provides for the controlled use of cable under motion. Perpendicular outer mounting frames are joined by swaged cables that interlock at a center block. Ball bearings allow for the free rotation of the second mounting frame relative to the first mounting frame within a predetermined angular rotation that is controlled by two stop devices. The cables allow for compliance at the stops and the cables allow for compliance in six degrees of freedom enabling the duplication or simulation of the rotational movement and flexibility of a natural hip or knee joint, as well as the simulation of a joint designed for a specific robotic component for predetermined design parameters.

  16. Anatomic reconstruction of chronic coracoclavicular ligament tears: arthroscopic-assisted approach with nonrigid mechanical fixation and graft augmentation.

    PubMed

    Natera, Luis; Sarasquete Reiriz, Juan; Abat, Ferran

    2014-10-01

    It has recently been suggested that all coracoclavicular ligament tears could be considered for surgery because nonoperative management might result in irreversible changes in the scapular position that could lead to muscle kinematic alterations that would perturb the shoulder girdle function and result in pain. In this technical note we describe an anatomic technique for the treatment of chronic coracoclavicular ligament tears that overcomes the issues related to open surgery, metal hardware, the inferior resistance to secondary displacement of only grafting and nonanatomic techniques, and the saw effect and anterior loop translation that can be seen in systems that surround the base of the coracoid. Our technique incorporates the use of a tendon graft and a nonrigid mechanical stabilizer that protects the graft from stretching during the process of healing and integration into bone, guaranteeing the maintenance of a reduced acromioclavicular joint. PMID:25473611

  17. Anatomic Reconstruction of Chronic Coracoclavicular Ligament Tears: Arthroscopic-Assisted Approach With Nonrigid Mechanical Fixation and Graft Augmentation

    PubMed Central

    Natera, Luis; Sarasquete Reiriz, Juan; Abat, Ferran

    2014-01-01

    It has recently been suggested that all coracoclavicular ligament tears could be considered for surgery because nonoperative management might result in irreversible changes in the scapular position that could lead to muscle kinematic alterations that would perturb the shoulder girdle function and result in pain. In this technical note we describe an anatomic technique for the treatment of chronic coracoclavicular ligament tears that overcomes the issues related to open surgery, metal hardware, the inferior resistance to secondary displacement of only grafting and nonanatomic techniques, and the saw effect and anterior loop translation that can be seen in systems that surround the base of the coracoid. Our technique incorporates the use of a tendon graft and a nonrigid mechanical stabilizer that protects the graft from stretching during the process of healing and integration into bone, guaranteeing the maintenance of a reduced acromioclavicular joint. PMID:25473611

  18. Breast reconstruction.

    PubMed

    DellaCroce, Frank J; Wolfe, Emily T

    2013-04-01

    As diagnostic technology has progressed and the understanding of the disease process has evolved, the number of mastectomies performed in the United States has increased. Breast reconstructive techniques have commensurately become more sophisticated along the same timeline. The result is that those facing mastectomy have the potential to simultaneously retain physical beauty and wholeness. Only 33% of women who are otherwise candidates for immediate reconstruction at the time of mastectomy choose reconstruction. Patients generally have a high level of satisfaction with the option they choose, contributing to a feeling of overall recovery and physical and emotional wholeness. PMID:23464695

  19. Reconstruction of the anterior cruciate ligament.

    PubMed

    Seedhom, B B

    1992-01-01

    Ligaments are strong collagenous structures that act as constraints on joint motion, thus confining the articular surfaces to more or less the same paths. In so doing they prevent arbitrary apposition of these surfaces from occurring and resulting in abnormal stresses which may damage the joint surfaces. Ligaments rupture due to excessive loads, particularly those resulting from trauma occurring during sporting events or motor vehicle accidents. Knee and ankle joints have the highest frequency of ligamentous injuries. This paper is a brief review of the current approaches to the reconstruction of the knee ligaments with specific reference to the anterior cruciate ligament (ACL) being the most frequently reconstructed. This is not only because it is frequently injured but also because of the debilitating consequences of such an injury. Approaches ranging from the conservative to those that advocate the use of frank prosthetic replacement have been adopted by surgeons at both ends of the spectrum. Following a discussion of the rationale for reconstruction of the ACL, the mechanical and biological considerations of the reconstructive procedure are discussed. The different methods of ACL reconstruction are reviewed. These include: (a) primary repair, (b) reconstruction with different tissues, including autogenous allografts and xenografts, (c) reconstruction employing different synthetic devices. A brief discussion of the procedures used for reconstruction with different types of tissue and of the surviving examples of the synthetic devices will follow. PMID:1418190

  20. Labral Reconstruction: When to Perform and How

    PubMed Central

    White, Brian J.; Herzog, Mackenzie M.

    2015-01-01

    Over the past decade, the understanding of the anatomy and function of the hip joint has continuously evolved, and surgical treatment options for the hip have significantly progressed. Originally, surgical treatment of the hip primarily involved resection of damaged tissue. Procedures that maintain and preserve proper hip anatomy, such as labral repair and femoroacetabular impingement correction, have shown superior results, in terms of pain reduction, increased function, and ability to return to activities. Labral reconstruction is a treatment option that uses a graft to reconstruct the native labrum. The technique and outcomes of labral reconstruction have been described relatively recently, and labral reconstruction is a cutting edge procedure that has shown promising early outcomes. The aim of this article is to review the current literature on hip labral reconstruction. We will review the indications for labral reconstruction, surgical technique and graft options, and surgical outcomes that have been described to date. Labral reconstruction provides an alternative treatment option for challenging intra-articular hip problems. Labral reconstruction restores the original anatomy of the hip and has the potential to preserve the longevity of the hip joint. This technique is an important tool in the orthopedic surgeon’s arsenal for hip joint treatment and preservation. PMID:26217668

  1. ACL reconstruction

    MedlinePlus

    ... Tissue taken from a donor is called an allograft. The procedure is usually performed with the help ... This increases the chance you may have a meniscus tear. ACL reconstruction may be used for these ...

  2. [Eyebrow reconstruction].

    PubMed

    Baraër, F; Darsonval, V; Lejeune, F; Bochot-Hermouet, B; Rousseau, P

    2013-10-01

    The eyebrow is an essential anatomical area, from a social point of view, so its reconstruction, in case of skin defect, must be as meticulous as possible, with the less residual sequela. Capillary density extremely varies from one person to another and the different methods of restoration of this area should absolutely take this into consideration. We are going to review the various techniques of reconstruction, according to the sex and the surface to cover. PMID:23896574

  3. Characteristics of temporomandibular joint in patients with temporomandibular joint complaint

    PubMed Central

    Li, Yanfeng; Guo, Xiaoqian; Sun, Xiaoxue; Wang, Ning; Xie, Min; Zhang, Jianqiang; Lv, Yuan; Han, Weili; Hu, Min; Liu, Hongchen

    2015-01-01

    Introduction: This study was to investigate whether there was statistical difference between the bilateral temporomandibular joint (TMJ) in patients with unilateral TMJ pain or joint sounds, using cone beam computed tomography (CBCT). Methods: TMJ CBCT images of 123 cases were used to preliminarily determine the indicators suitable for the measuring method. TMJ CBCT image reconstruction was performed and 19 indicators were measured. Thirty-six cases without TMJ complaint served as controls. The comparison of bilateral TMJs was analyzed by paired t-test to find out the indicators without statistical significance. Twenty-nine patients with unilateral TMJ pain or joint sounds who underwent CBCT at the hospital were enrolled for the comparative study. The measured values were analyzed by paired t-test to determine the indicators with statistical difference. Results: In the control group, only radius value of bilateral TMJ was different statistically (P < 0.05). In the TMJ complaint group, the vertical 60° joint space of the bilateral TMJ was statistically different (P < 0.05) and the rest of the measured values showed no statistical difference. Conclusions: In the patients with unilateral TMJ pain or joint sounds, the vertical 60° joint space of the symptomatic side was significantly increased comparing with the asymptomatic side. PMID:26629112

  4. Joint lubrication.

    PubMed

    McCutchen, C W

    1983-01-01

    The fine-pored, easily compressed articular cartilage provides animal joints with self-pressurized hydrostatic (weeping) lubrication. The solid skeletons of the cartilages press against each other, but so lightly that their rubbing is lubricated successfully by synovial fluid--a boundary lubricant too weak to lubricate ordinary bearings. PMID:6317095

  5. Performance analysis of a cellular automaton algorithm to solve the track-reconstruction problem on a multicore server at the laboratory of information technologies, Joint Institute of Nuclear Research

    NASA Astrophysics Data System (ADS)

    Kulakov, I. S.; Baginyan, S. A.; Ivanov, V. V.; Kisel, P. I.

    2013-03-01

    The results of tests for the track-reconstruction efficiency and the speed of the algorithm and its scalability with respect to the number of cores of the server with two Intel Xeon E5640 CPUs (in total 8 physical or 16 logical cores) are presented and discussed.

  6. Reconstructing Validity

    ERIC Educational Resources Information Center

    Moss, Pamela A.

    2007-01-01

    In response to Lissitz and Samuelsen (2007), the author reconstructs the historical arguments for the more comprehensive unitary concept of validity and the principles of scientific inquiry underlying it. Her response is organized in terms of four questions: (a) How did validity in educational measurement come to be conceptualized as unitary, and…

  7. Vaginal reconstruction

    SciTech Connect

    Lesavoy, M.A.

    1985-05-01

    Vaginal reconstruction can be an uncomplicated and straightforward procedure when attention to detail is maintained. The Abbe-McIndoe procedure of lining the neovaginal canal with split-thickness skin grafts has become standard. The use of the inflatable Heyer-Schulte vaginal stent provides comfort to the patient and ease to the surgeon in maintaining approximation of the skin graft. For large vaginal and perineal defects, myocutaneous flaps such as the gracilis island have been extremely useful for correction of radiation-damaged tissue of the perineum or for the reconstruction of large ablative defects. Minimal morbidity and scarring ensue because the donor site can be closed primarily. With all vaginal reconstruction, a compliant patient is a necessity. The patient must wear a vaginal obturator for a minimum of 3 to 6 months postoperatively and is encouraged to use intercourse as an excellent obturator. In general, vaginal reconstruction can be an extremely gratifying procedure for both the functional and emotional well-being of patients.

  8. Project Reconstruct.

    ERIC Educational Resources Information Center

    Helisek, Harriet; Pratt, Donald

    1994-01-01

    Presents a project in which students monitor their use of trash, input and analyze information via a database and computerized graphs, and "reconstruct" extinct or endangered animals from recyclable materials. The activity was done with second-grade students over a period of three to four weeks. (PR)

  9. ACL reconstruction - discharge

    MedlinePlus

    Anterior cruciate ligament reconstruction - discharge; ACL reconstruction - discharge ... had surgery to reconstruct your anterior cruciate ligament (ACL). The surgeon drilled holes in the bones of ...

  10. Joint assembly

    NASA Technical Reports Server (NTRS)

    Wilson, Andrew (Inventor); Punnoose, Andrew (Inventor); Strausser, Katherine (Inventor); Parikh, Neil (Inventor)

    2010-01-01

    A joint assembly is provided which includes a drive assembly and a swivel mechanism. The drive assembly features a motor operatively associated with a plurality of drive shafts for driving auxiliary elements, and a plurality of swivel shafts for pivoting the drive assembly. The swivel mechanism engages the swivel shafts and has a fixable element that may be attached to a foundation. The swivel mechanism is adapted to cooperate with the swivel shafts to pivot the drive assembly with at least two degrees of freedom relative to the foundation. The joint assembly allows for all components to remain encased in a tight, compact, and sealed package, making it ideal for space, exploratory, and commercial applications.

  11. Breast Reconstruction After Mastectomy

    MedlinePlus

    ... around the cancer removed (lumpectomy or breast-conserving surgery) might not need reconstruction, but sometimes they do. Breast reconstruction is done by a plastic surgeon. Should I have breast reconstruction? Breast reconstruction ...

  12. Dorsal finger joint soft tissue loss: two case reports.

    PubMed

    Bervar, M

    2003-01-01

    This article brings our experience, standpoints and management guidelines for early reconstruction of traumatic soft tissue loss on the dorsal aspect of the finger joints, with the aim of preserving acceptable late functional ability of the hand. Two interesting and unusual cases of reconstruction are presented. PMID:14989334

  13. Dutch Universities' Joint Aid to Vietnam

    ERIC Educational Resources Information Center

    Higher Education and Research in the Netherlands, 1975

    1975-01-01

    A survey is presented of the joint aid in the reconstruction of North and South Vietnam provided by Dutch universities. The hospital project, solid matter physics project, micro-electronics project, agricultural project and dentistry project are defined. (Author/PG)

  14. Temporomandibular joint: true sagittal computed tomography with meniscus visualization

    SciTech Connect

    Sartorix, D.J.; Neumann, C.H.; Riley, R.W.

    1984-01-01

    Accessory patient support equipment was constructed that allows patient positioning for true sagittal projection of the temporomandibular joint using a GE 8800 CT/T scanner. Range of motion abnormalities, osseous alterations of the mandibular condyle and temporal bone, joint-space narrowing, and meniscal configuration may be demonstrated. The technique has potential advantages over other CT projections and sagittal reconstruction for evaluation of temporomandibular joint dysfunction.

  15. Tracheal reconstructions.

    PubMed

    Srikrishna, S V; Shekar, P S; Shetty, N

    1998-12-01

    Surgical reconstruction of the trachea is a relatively complex procedure. We had 20 cases of tracheal stenosis. We have a modest experience of 16 tracheal reconstructions for acquired tracheal stenosis. Two patients underwent laser treatment while another two died before any intervention. The majority of these cases were a result of prolonged ventilation (14 cases), following organophosphorous poisoning (11 cases), Guillain-Barré syndrome, bullet injury, fat embolism and surprisingly only one tumor, a case of mucoepidermoid carcinoma, who had a very unusual presentation. There were 12 males and 4 females in this series, age ranging from 12-35 years. The duration of ventilation ranged from 1-21 days and the interval from decannulation to development of stridor was between 5-34 days. Six of them were approached by the cervical route, 5 by thoracotomy and cervical approach, 2 via median sternotomy and 3 by thoracotomy alone. Five of them required an additional laryngeal drop and 1 required pericardiotomy and release of pulmonary veins to gain additional length. The excised segments of trachea measured 3 to 5 cms in length. All were end to end anastomosis with interrupted Vicryl sutures. We have had no experience with stents or prosthetic tubes. Three patients developed anastomotic leaks which were controlled conservatively. Almost all of them required postoperative tracheo-bronchial suctioning with fibreoptic bronchoscope. We had one death in this series due to sepsis. PMID:9914459

  16. Joint instability and osteoarthritis.

    PubMed

    Blalock, Darryl; Miller, Andrew; Tilley, Michael; Wang, Jinxi

    2015-01-01

    Joint instability creates a clinical and economic burden in the health care system. Injuries and disorders that directly damage the joint structure or lead to joint instability are highly associated with osteoarthritis (OA). Thus, understanding the physiology of joint stability and the mechanisms of joint instability-induced OA is of clinical significance. The first section of this review discusses the structure and function of major joint tissues, including periarticular muscles, which play a significant role in joint stability. Because the knee, ankle, and shoulder joints demonstrate a high incidence of ligament injury and joint instability, the second section summarizes the mechanisms of ligament injury-associated joint instability of these joints. The final section highlights the recent advances in the understanding of the mechanical and biological mechanisms of joint instability-induced OA. These advances may lead to new opportunities for clinical intervention in the prevention and early treatment of OA. PMID:25741184

  17. Joint x-ray

    MedlinePlus

    X-ray - joint; Arthrography; Arthrogram ... x-ray technologist will help you position the joint to be x-rayed on the table. Once in place, pictures are taken. The joint may be moved into other positions for more ...

  18. Joint Instability and Osteoarthritis

    PubMed Central

    Blalock, Darryl; Miller, Andrew; Tilley, Michael; Wang, Jinxi

    2015-01-01

    Joint instability creates a clinical and economic burden in the health care system. Injuries and disorders that directly damage the joint structure or lead to joint instability are highly associated with osteoarthritis (OA). Thus, understanding the physiology of joint stability and the mechanisms of joint instability-induced OA is of clinical significance. The first section of this review discusses the structure and function of major joint tissues, including periarticular muscles, which play a significant role in joint stability. Because the knee, ankle, and shoulder joints demonstrate a high incidence of ligament injury and joint instability, the second section summarizes the mechanisms of ligament injury-associated joint instability of these joints. The final section highlights the recent advances in the understanding of the mechanical and biological mechanisms of joint instability-induced OA. These advances may lead to new opportunities for clinical intervention in the prevention and early treatment of OA. PMID:25741184

  19. The Arthroscopic Superior Capsular Reconstruction.

    PubMed

    Adams, Christopher R; Denard, Patrick J; Brady, Paul C; Hartzler, Robert U; Burkhart, Stephen S

    2016-01-01

    In a subset of patients with rotator cuff tears, the glenohumeral joint has minimal degenerative changes and the rotator cuff tendon is either irreparable or very poor quality and unlikely to heal. Reverse shoulder arthroplasty (RSA) is often considered for these patients despite the lack of glenohumeral arthritis. However, due to the permanent destruction of the glenohumeral articular surfaces, complication rates, and concerns about implant longevity with RSA, we believe the superior capsular reconstruction (SCR) is a viable alternative. In this article, we describe our technique for the SCR. PMID:27552457

  20. Spacesuit mobility knee joints

    NASA Technical Reports Server (NTRS)

    Vykukal, H. C. (Inventor)

    1979-01-01

    Pressure suit mobility joints are for use in interconnecting adjacent segments of an hermetically sealed spacesuit in which low torques, low leakage and a high degree of reliability are required. Each of the joints is a special purpose joint characterized by substantially constant volume and low torque characteristics and includes linkages which restrain the joint from longitudinal distension and includes a flexible, substantially impermeable diaphragm of tubular configuration spanning the distance between pivotally supported annuli. The diaphragms of selected joints include rolling convolutions for balancing the joints, while various joints include wedge-shaped sections which enhance the range of motion for the joints.

  1. Spacesuit mobility joints

    NASA Technical Reports Server (NTRS)

    Vykukal, H. C. (Inventor)

    1978-01-01

    Joints for use in interconnecting adjacent segments of an hermetically sealed spacesuit which have low torques, low leakage and a high degree of reliability are described. Each of the joints is a special purpose joint characterized by substantially constant volume and low torque characteristics. Linkages which restrain the joint from longitudinal distension and a flexible, substantially impermeable diaphragm of tubular configuration spanning the distance between pivotally supported annuli are featured. The diaphragms of selected joints include rolling convolutions for balancing the joints, while various joints include wedge-shaped sections which enhance the range of motion for the joints.

  2. Unusual lesions mimicking impingement syndrome in the shoulder joint - Think medially.

    PubMed

    Singh, Rohit; Malhotra, Akshay; Cribb, Gillian; Cool, Paul; Hay, Stuart

    2016-09-01

    Impingement syndrome is usually caused by irritation of the rotator cuff within the sub acromial space and this includes the coraco-acromial arch (Acromion and Coraco-acromial ligament), the acromio-clavicular joint and occasionally the coracoid. Iatrogenic causes such as sutures, pins, plates or wires left from previous surgery can cause similar symptoms. We present a series of four cases mimicking "classical" impingement symptoms/signs in which the causal pathology was identified outside the sub-acromial space. Magnetic Resonance Imaging (MRI) showed lesions that were present in the supra-spinatus fossa but were causing pressure effects on the sub-acromial space, namely - a ganglion cyst in one case, lipomata in two other cases, and a glomus tumour. A ganglion cyst and glomus tumour mimicking impingement syndrome is a rare reported case to our knowledge. These are unusual causes that should be considered when investigating classical impingement syndrome and particularly those who may have failed to respond to decompression surgery. They highlight the potential value of looking beyond the sub-acromial space for causal lesions and in these cases, at a time when limited ultrasound investigation has become increasingly popular; MRI has clearly played an important and was essential in planning surgery as these lesions would not have been identified on USS. Even though the symptoms were classical. PMID:27594993

  3. Joint fluid Gram stain

    MedlinePlus

    Gram stain of joint fluid ... A sample of joint fluid is needed. The fluid sample is sent to a lab where a small drop is placed in a ... on how to prepare for the removal of joint fluid, see joint fluid aspiration .

  4. Butt Joint Tool Commissioning

    SciTech Connect

    Martovetsky, N N

    2007-12-06

    ITER Central Solenoid uses butt joints for connecting the pancakes in the CS module. The principles of the butt joining of the CICC were developed by the JAPT during CSMC project. The difference between the CSMC butt joint and the CS butt joint is that the CS butt joint is an in-line joint, while the CSMC is a double joint through a hairpin jumper. The CS butt joint has to carry the hoop load. The straight length of the joint is only 320 mm, and the vacuum chamber around the joint has to have a split in the clamp shell. These requirements are challenging. Fig.1 presents a CSMC joint, and Fig.2 shows a CS butt joint. The butt joint procedure was verified and demonstrated. The tool is capable of achieving all specified parameters. The vacuum in the end was a little higher than the target, which is not critical and readily correctable. We consider, tentatively that the procedure is established. Unexpectedly, we discover significant temperature nonuniformity in the joint cross section, which is not formally a violation of the specs, but is a point of concern. All testing parameters are recorded for QA purposes. We plan to modify the butt joining tool to improve its convenience of operation and provide all features necessary for production of butt joints by qualified personnel.

  5. Neuromagnetic source reconstruction

    SciTech Connect

    Lewis, P.S.; Mosher, J.C.; Leahy, R.M.

    1994-12-31

    In neuromagnetic source reconstruction, a functional map of neural activity is constructed from noninvasive magnetoencephalographic (MEG) measurements. The overall reconstruction problem is under-determined, so some form of source modeling must be applied. We review the two main classes of reconstruction techniques-parametric current dipole models and nonparametric distributed source reconstructions. Current dipole reconstructions use a physically plausible source model, but are limited to cases in which the neural currents are expected to be highly sparse and localized. Distributed source reconstructions can be applied to a wider variety of cases, but must incorporate an implicit source, model in order to arrive at a single reconstruction. We examine distributed source reconstruction in a Bayesian framework to highlight the implicit nonphysical Gaussian assumptions of minimum norm based reconstruction algorithms. We conclude with a brief discussion of alternative non-Gaussian approachs.

  6. Ligament reconstruction tendon interposition with mersilene augmentation.

    PubMed

    Stein, Andrew J; Schofield, Jennifer L; Marsh, Mike; Paulo, Jerry

    2011-03-01

    Many surgical procedures have been described for the treatment of thumb basilar joint osteoarthritis. Augmentation of the standard ligament reconstruction tendon interposition procedure with the use of a Mersilene suture tape suspension-plasty, to recreate the stability provided by the anterior oblique ligament and increase pinch strength, will be described. Satisfaction with this procedure was evaluated through surveys completed by patients. In addition, independent physical assessments were performed to demonstrate stability, range of motion, and strength. PMID:21358518

  7. Metatarsal phalangeal joint arthroscopy.

    PubMed

    Shonka, T E

    1991-01-01

    An overview of metatarsophalangeal joint (MPJ) arthroscopy is presented. Indications, technique, and perioperative management are discussed. The author believes it is the operative treatment of choice for various pathology encountered in this joint. PMID:2002183

  8. Culture - joint fluid

    MedlinePlus

    Joint fluid culture ... fungi, or viruses grow. This is called a culture. If these germs are detected, other tests may ... is no special preparation needed for the lab culture. How to prepare for the removal of joint ...

  9. Hip joint replacement - slideshow

    MedlinePlus

    ... this page: //medlineplus.gov/ency/presentations/100006.htm Hip joint replacement - series—Normal anatomy To use the sharing ... to slide 5 out of 5 Overview The hip joint is made up of two major parts: the ...

  10. Hip joint injection

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/007633.htm Hip joint injection To use the sharing features on this ... injection is a shot of medicine into the hip joint. The medicine helps relieve pain and inflammation. It ...

  11. Hip joint replacement

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/002975.htm Hip joint replacement To use the sharing features on this page, please enable JavaScript. Hip joint replacement is surgery to replace all or part ...

  12. Knee joint replacement - slideshow

    MedlinePlus

    ... page: //medlineplus.gov/ency/presentations/100088.htm Knee joint replacement - series—Normal anatomy To use the sharing ... of 4 Overview The knee is a complex joint. It contains the distal end of the femur ( ...

  13. Knee joint replacement

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/002974.htm Knee joint replacement To use the sharing features on this page, please enable JavaScript. Knee joint replacement is a surgery to replace a knee ...

  14. Large displacement spherical joint

    DOEpatents

    Bieg, Lothar F.; Benavides, Gilbert L.

    2002-01-01

    A new class of spherical joints has a very large accessible full cone angle, a property which is beneficial for a wide range of applications. Despite the large cone angles, these joints move freely without singularities.

  15. Temporomandibular Joint Dysfunction

    MedlinePlus

    The temporomandibular joint (TMJ) connects your jaw to the side of your head. When it works well, it enables you to ... For people with TMJ dysfunction, problems with the joint and muscles around it may cause Pain that ...

  16. Sacroiliac joint pain - aftercare

    MedlinePlus

    ... page: //medlineplus.gov/ency/patientinstructions/000610.htm Sacroiliac joint pain - aftercare To use the sharing features on this page, please enable JavaScript. The sacroiliac joint (SIJ) is a term used to describe the ...

  17. Sacroiliac joint imaging.

    PubMed

    Tuite, Michael J

    2008-03-01

    The sacroiliac (SI) joint has several unique anatomical features that make it one of the more challenging joints to image. The joint is difficult to profile well on radiographic views, and therefore the radiographic findings of sacroiliitis are often equivocal. Computed tomography images can usually show the findings of sacroiliitis and osteoarthritis earlier than radiographs. Magnetic resonance imaging performed with proper sequences is excellent for diagnosing even very early sacroiliitis and for following treatment response. The SI joint is often involved in patients with osteoarthritis or one of the inflammatory spondyloarthritides, most notably ankylosing spondylitis. Ankylosing spondylitis often presents with sacroiliitis, which appears as erosions, sclerosis, and joint space narrowing, eventually leading to ankylosis. Several disorders can cause sacroiliitis-like changes of the joint, including hyperparathyroidism and repetitive shear-stress injuries in athletes. The joint can become painful during pregnancy as it widens and develops increased motion, and some postpartum women develop iliac sclerosis adjacent to the joint termed osteitis condensans ilii. Another cause of SI joint pain is a disorder called sacroiliac joint dysfunction, which typically has few abnormal imaging findings. Patients with SI joint dysfunction, as well as sacroiliitis, often get relief from image-guided SI joint therapeutic injections. PMID:18382946

  18. Joint Enrollment Report, 2014

    ERIC Educational Resources Information Center

    Iowa Department of Education, 2014

    2014-01-01

    The Iowa Department of Education collects information on joint enrollment in Iowa's 15 community colleges. Jointly enrolled students are high school students enrolled in community college credit coursework. Most jointly enrolled students enroll through Senior Year Plus (SYP) programs such as Postsecondary Enrollment Options (PSEO) and concurrent…

  19. Arch & Chord Joint Detail; Crossbracing Center Joint Detail; Chord, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Arch & Chord Joint Detail; Crossbracing Center Joint Detail; Chord, Panel Post, Tie & Diagonal Brace Joint Detail; Chord, Panel Post, Tie & Crossbracing Joint Detail - Dunlapsville Covered Bridge, Spanning East Fork Whitewater River, Dunlapsville, Union County, IN

  20. Breast Reconstruction after Mastectomy

    PubMed Central

    Schmauss, Daniel; Machens, Hans-Günther; Harder, Yves

    2016-01-01

    Breast cancer is the leading cause of cancer death in women worldwide. Its surgical approach has become less and less mutilating in the last decades. However, the overall number of breast reconstructions has significantly increased lately. Nowadays, breast reconstruction should be individualized at its best, first of all taking into consideration not only the oncological aspects of the tumor, neo-/adjuvant treatment, and genetic predisposition, but also its timing (immediate versus delayed breast reconstruction), as well as the patient’s condition and wish. This article gives an overview over the various possibilities of breast reconstruction, including implant- and expander-based reconstruction, flap-based reconstruction (vascularized autologous tissue), the combination of implant and flap, reconstruction using non-vascularized autologous fat, as well as refinement surgery after breast reconstruction. PMID:26835456

  1. Head and face reconstruction

    MedlinePlus

    Head and face reconstruction is surgery to repair or reshape deformities of the head and face (craniofacial). ... How surgery for head and face deformities (craniofacial reconstruction) ... and the person's condition. Surgical repairs involve the ...

  2. Head and face reconstruction

    MedlinePlus

    ... Birth defects and deformities from conditions such as cleft lip or palate , craniosynostosis , Apert syndrome Deformities caused by ... Orbital-craniofacial surgery; Facial reconstruction Images Skull Skull Cleft lip repair - series Craniofacial reconstruction - series References Baker SR. ...

  3. Spring ligament reconstruction using the autogenous flexor hallucis longus tendon.

    PubMed

    Lee, Woo-Chun; Yi, Young

    2014-07-01

    The calcaneonavicular (spring) ligament complex is the soft tissue most often seen to fail in flatfoot pathology and is associated with deformity of the talonavicular joint. The spring ligament complex supports the talar head, preventing it from displacing into excessive plantar flexion/adduction. An anatomical reconstruction of the spring ligament should replicate this function. A new method of spring ligament reconstruction using autogenous flexor hallucis longus tendon transfer is reported. PMID:24992052

  4. Methods of Voice Reconstruction

    PubMed Central

    Chen, Hung-Chi; Kim Evans, Karen F.; Salgado, Christopher J.; Mardini, Samir

    2010-01-01

    This article reviews methods of voice reconstruction. Nonsurgical methods of voice reconstruction include electrolarynx, pneumatic artificial larynx, and esophageal speech. Surgical methods of voice reconstruction include neoglottis, tracheoesophageal puncture, and prosthesis. Tracheoesophageal puncture can be performed in patients with pedicled flaps such as colon interposition, jejunum, or gastric pull-up or in free flaps such as perforator flaps, jejunum, and colon flaps. Other flaps for voice reconstruction include the ileocolon flap and jejunum. Laryngeal transplantation is also reviewed. PMID:22550443

  5. Reoperative midface reconstruction.

    PubMed

    Acero, Julio; García, Eloy

    2011-02-01

    Reoperative reconstruction of the midface is a challenging issue because of the complexity of this region and the severity of the aesthetic and functional sequela related to the absence or failure of a primary reconstruction. The different situations that can lead to the indication of a reoperative reconstructive procedure after previous oncologic ablative procedures in the midface are reviewed. Surgical techniques, anatomic problems, and limitations affecting the reoperative reconstruction in this region of the head and neck are discussed. PMID:21126882

  6. Editorial Commentary: The Larger Holes or Larger Number of Holes We Drill in the Coracoid, the Weaker the Coracoid Becomes.

    PubMed

    Brady, Paul

    2016-06-01

    The larger holes or larger number of holes we drill in the coracoid, the weaker the coracoid becomes. Thus, minimizing bone holes (both size and number) is required to lower risk of coracoid process fracture, in patients in whom transosseous shoulder acromioclavicular joint reconstruction is indicated. A single 2.4-mm-diameter tunnel drilled through both the clavicle and the coracoid lowers the risk of fracture, but the risk cannot be entirely eliminated. PMID:27263761

  7. Digital tomosynthesis rendering of joint margins for arthritis assessment

    NASA Astrophysics Data System (ADS)

    Duryea, Jeffrey W.; Neumann, Gesa; Yoshioka, Hiroshi; Dobbins, James T., III

    2004-05-01

    PURPOSE: Rheumatoid arthritis (RA) of the hand is a significant healthcare problem. Techniques to accurately quantity the structural changes from RA are crucial for the development and prescription of therapies. Analysis of radiographic joint space width (JSW) is widely used and has demonstrated promise. However, radiography presents a 2D view of the joint. In this study we performed tomosynthesis reconstructions of proximal interphalangeal (PIP), and metacarpophalangeal (MCP) joints to measure the 3D joint structure. METHODS: We performed a reader study using simulated radiographs of 12 MCP and 12 PIP joints from skeletal specimens imaged with micro-CT. The tomosynthesis technique provided images of reconstructed planes with 0.75 mm spacing, which were presented to 2 readers with a computer tool. The readers were instructed to delineate the joint surfaces on tomosynthetic slices where they could visualize the margins. We performed a quantitative analysis of 5 slices surrounding the central portion of each joint. Reader-determined JSW was compared to a gold standard. As a figure of merit we calculated the average root-mean square deviation (RMSD). RESULTS: RMSD was 0.22 mm for both joints. For the individual joints, RMSD was 0.18 mm (MCP), and 0.26 mm (PIP). The reduced performance for the smaller PIP joints suggests that a slice spacing less than 0.75 mm may be more appropriate. CONCLUSIONS: We have demonstrated the capability of limited 3D rendering of joint surfaces using digital tomosynthesis. This technique promises to provide an improved method to visualize the structural changes of RA.

  8. Synergistic image reconstruction for hybrid ultrasound and photoacoustic computed tomography

    NASA Astrophysics Data System (ADS)

    Matthews, Thomas P.; Wang, Kun; Wang, Lihong V.; Anastasio, Mark A.

    2015-03-01

    Conventional photoacoustic computed tomography (PACT) image reconstruction methods assume that the object and surrounding medium are described by a constant speed-of-sound (SOS) value. In order to accurately recover fine structures, SOS heterogeneities should be quantified and compensated for during PACT reconstruction. To address this problem, several groups have proposed hybrid systems that combine PACT with ultrasound computed tomography (USCT). In such systems, a SOS map is reconstructed first via USCT. Consequently, this SOS map is employed to inform the PACT reconstruction method. Additionally, the SOS map can provide structural information regarding tissue, which is complementary to the functional information from the PACT image. We propose a paradigm shift in the way that images are reconstructed in hybrid PACT-USCT imaging. Inspired by our observation that information about the SOS distribution is encoded in PACT measurements, we propose to jointly reconstruct the absorbed optical energy density and SOS distributions from a combined set of USCT and PACT measurements, thereby reducing the two reconstruction problems into one. This innovative approach has several advantages over conventional approaches in which PACT and USCT images are reconstructed independently: (1) Variations in the SOS will automatically be accounted for, optimizing PACT image quality; (2) The reconstructed PACT and USCT images will possess minimal systematic artifacts because errors in the imaging models will be optimally balanced during the joint reconstruction; (3) Due to the exploitation of information regarding the SOS distribution in the full-view PACT data, our approach will permit high-resolution reconstruction of the SOS distribution from sparse array data.

  9. Autologous Microvascular Breast Reconstruction

    PubMed Central

    Ramakrishnan, Venkat

    2013-01-01

    Autologous microvascular breast reconstruction is widely accepted as a key component of breast cancer treatment. There are two basic donor sites; the anterior abdominal wall and the thigh/buttock region. Each of these regions provides for a number of flaps that are successfully utilised in breast reconstruction. Refinement of surgical technique and the drive towards minimising donor site morbidity whilst maximising flap vascularity in breast reconstruction has seen an evolution towards perforator based flap reconstructions, however myocutaneous flaps are still commonly practiced. We review herein the current methods of autologous microvascular breast reconstruction. PMID:23362474

  10. Engineering Alloplastic Temporomandibular Joint Replacements

    PubMed Central

    Sinno, Hani; Tahiri, Youssef; Gilardino, Mirko; Bobyn, Dennis

    2011-01-01

    Temporomandibular disorders (TMD) are part of a heterogeneous group of pathologies that manifest with a constellation of signs and symptoms. They are the most frequent cause of chronic orofacial pain and are prevalent in 12% of the general population. Despite the debilitating nature of these disorders, there is no standardization for treatment of the diseased temporomandibular joint (TMJ). In this review, we present an overview of the functional anatomy of the TMJ and the engineering concepts that must be understood to better understand the indications for surgical management, the types of available treatments and the requirements for reconstruction. A comparison is made of the clinical outcomes with autogenous versus alloplastic reconstruction, including a history of alloplastic materials and the design features of currently available implants. Emphasis is made on material selection, modulus, stiffness, notch sensitivity and modularity. For the treatment of TMD, engineered TMJ alloplastic replacements have had considerable promise with additional room for improvement using new materials and recent design concepts. PMID:22363183

  11. Facial transplantation: the next frontier in head and neck reconstruction.

    PubMed

    Park, Eunice E; Genden, Eric M

    2009-05-01

    Facial reconstruction poses a unique surgical challenge-restoring the aesthetic form and function of the face. Established techniques for reconstruction include skin grafts, local cutaneous tissue flaps, and free flap autografts. The anatomic complexity of the face renders it challenging, however, to obtain a successful cosmetic and functional result. The success of recent hand, knee joint, and larynx allotransplantation and advances in immunosuppressive regimens have pushed the technical frontiers of composite tissue transfer to include partial facial transplantation. This article reviews current techniques for reconstruction of facial defects, with a focus on the microsurgical, immunologic, and ethical considerations of facial allotransplantation. PMID:19393949

  12. Quantum-state reconstruction by maximizing likelihood and entropy.

    PubMed

    Teo, Yong Siah; Zhu, Huangjun; Englert, Berthold-Georg; Řeháček, Jaroslav; Hradil, Zdeněk

    2011-07-01

    Quantum-state reconstruction on a finite number of copies of a quantum system with informationally incomplete measurements, as a rule, does not yield a unique result. We derive a reconstruction scheme where both the likelihood and the von Neumann entropy functionals are maximized in order to systematically select the most-likely estimator with the largest entropy, that is, the least-bias estimator, consistent with a given set of measurement data. This is equivalent to the joint consideration of our partial knowledge and ignorance about the ensemble to reconstruct its identity. An interesting structure of such estimators will also be explored. PMID:21797584

  13. Experimental study of the subtalar joint axis: preliminary investigation.

    PubMed

    Zographos, S; Chaminade, B; Hobatho, M C; Utheza, G

    2000-01-01

    An experimental study of the subtalar joint has been conducted with the aim of establishing its axis of movement as well as analysing the associated movement. For description of the axis, CT data for five positions of a single foot were reconstructed using a 3D programme, the 3D data was processed by Patran software. Measures of angular displacements were made from three amputated feet placed in a specially constructed foot frame. Four instantaneous axes of movement could be defined. Calculation of displacements showed an important rolling of the calcaneus (45 degrees). Tacking was evident in inversion, with an opposite displacement between the front and rear part of the calcaneus, whereas during eversion tacking affected only the rear part of the bone: these results were confirmed by 3D reconstructions. Henke's axis was described as that for the talonavicular joint, but acceptable for the subtalar joint. Several authors investigating the coordinates of this axis have reported large differences and described screw-like movements, the latter being incompatible with a fixed axis: instantaneous axes, however are compatible with a screw-like movement. The subtalar joint appears to work as a pivot joint during inversion and as a plane joint during eversion. Although Henke's axis has pedagogical value the subtalar joint has a series of instantaneous axes. PMID:11236321

  14. 21 CFR 872.3940 - Total temporomandibular joint prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... reconstruct the temporomandibular joint. (b) Classification. Class III. (c) Date PMA or notice of completion of a PDP is required. A PMA or a notice of completion of a PDP is required to be filed with the Food... approved PMA or a declared completed PDP in effect before being placed in commercial distribution....

  15. 21 CFR 872.3940 - Total temporomandibular joint prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... reconstruct the temporomandibular joint. (b) Classification. Class III. (c) Date PMA or notice of completion of a PDP is required. A PMA or a notice of completion of a PDP is required to be filed with the Food... approved PMA or a declared completed PDP in effect before being placed in commercial distribution....

  16. Perspectives Do Matter: "Joint Screen", a Promising Methodology for Multimodal Interaction Analysis

    ERIC Educational Resources Information Center

    Arend, Béatrice; Sunnen, Patrick; Fixmer, Pierre; Sujbert, Monika

    2014-01-01

    This paper discusses theoretical and methodological issues arising from a video-based research design and the emergent tool "Joint Screen'"when grasping joint activity. We share our reflections regarding the combined reading of four synchronised camera perspectives combined in one screen. By these means we reconstruct and analyse…

  17. Recent Advances in Computational Mechanics of the Human Knee Joint

    PubMed Central

    Kazemi, M.; Dabiri, Y.; Li, L. P.

    2013-01-01

    Computational mechanics has been advanced in every area of orthopedic biomechanics. The objective of this paper is to provide a general review of the computational models used in the analysis of the mechanical function of the knee joint in different loading and pathological conditions. Major review articles published in related areas are summarized first. The constitutive models for soft tissues of the knee are briefly discussed to facilitate understanding the joint modeling. A detailed review of the tibiofemoral joint models is presented thereafter. The geometry reconstruction procedures as well as some critical issues in finite element modeling are also discussed. Computational modeling can be a reliable and effective method for the study of mechanical behavior of the knee joint, if the model is constructed correctly. Single-phase material models have been used to predict the instantaneous load response for the healthy knees and repaired joints, such as total and partial meniscectomies, ACL and PCL reconstructions, and joint replacements. Recently, poromechanical models accounting for fluid pressurization in soft tissues have been proposed to study the viscoelastic response of the healthy and impaired knee joints. While the constitutive modeling has been considerably advanced at the tissue level, many challenges still exist in applying a good material model to three-dimensional joint simulations. A complete model validation at the joint level seems impossible presently, because only simple data can be obtained experimentally. Therefore, model validation may be concentrated on the constitutive laws using multiple mechanical tests of the tissues. Extensive model verifications at the joint level are still crucial for the accuracy of the modeling. PMID:23509602

  18. Pipeline joint protector

    SciTech Connect

    Baker, R.

    1989-02-28

    This patent describes a weight coated pipeline joint protective apparatus for protecting pipeline joints against impact or high stress concentrations. It consists of a high density plastic sheet wrapped around a pipeline joint with the opposite edges of such sheet overlaying the weight of coat material on the abutting pipes forming the joint. The first end of the sheet overlaps the wrapped sheet with means for securing such first end to the sheet surface near or adjacent to the opposite end of such sheet.

  19. Lower Eyelid Reconstruction.

    PubMed

    Holds, John B

    2016-05-01

    Lower eyelid defects are common, and a systematic approach to reconstruction of the lower eyelid is required. Attention to the bilaminar eyelid anatomy and canthal support structures, with efforts to maintain functionally important structures, such as the lacrimal canalicular system, is vital to appropriate lower eyelid reconstruction. Techniques of advancement and rotation flaps and grafting of skin and mucosa are mainstays of lower eyelid reconstruction. An appropriate armamentarium of techniques allows for optimal surgical results. PMID:27105804

  20. Flexor pulley reconstruction.

    PubMed

    Dy, Christopher J; Daluiski, Aaron

    2013-05-01

    Flexor pulley reconstruction is a challenging surgery. Injuries often occur after traumatic lacerations or forceful extension applied to an acutely flexed finger. Surgical treatment is reserved for patients with multiple closed pulley ruptures, persistent pain, or dysfunction after attempted nonoperative management of a single pulley rupture, or during concurrent or staged flexor tendon repair or reconstruction. If the pulley cannot be repaired primarily, pulley reconstruction can be performed using graft woven into remnant pulley rim or looping graft around the phalanx. Regardless of the reconstructive technique, the surgeon should emulate the length, tension, and glide of the native pulley. PMID:23660059

  1. Head and neck reconstruction

    PubMed Central

    Yadav, Prabha

    2013-01-01

    Whatever is excisable, is reconstructable! “You excise, we will reconstruct” are the confident words of reconstructive surgeons today. Reconstruction with multiple flaps has become routine. Radial artery (FRAF), Antero lateral thigh (ALT) and Fibula osteo cutaneous flap (FFOCF) are three most popular free flaps which can reconstruct any defect with excellent asthetics and performance. Radial Artery provides thin, pliable innervated skin; ALT large amount of skin & bulk; and FFOCF strong 22 to 25 centimetres of bone and reliable skin paddle. Free flap survival has gone to 98% in most of the renouned institutes and is an established escalator in management of defects. PMID:24501464

  2. Compound solder joints

    NASA Technical Reports Server (NTRS)

    Batista, R. I.; Simonson, R. B.

    1976-01-01

    Joining technique prevents contamination, may be used to join dissimilar metal tubes, minimizes fluid and gas entrapment, expedites repairs, and can yield joints having leakage rates less than 0.000001 standard cubic cm He/min. Components of joint are solder sleeve, two solder rings, Teflon sleeve, and tubing to be joined.

  3. Wedge Joints for Trusses

    NASA Technical Reports Server (NTRS)

    Wood, Kenneth E.

    1987-01-01

    Structure assembled rapidly with simple hand tools. Proposed locking wedge joints enable rapid assembly of lightweight beams, towers, scaffolds, and other truss-type structures. Lightweight structure assembled from tubular struts joined at nodes by wedge pins fitting into mating slots. Joint assembled rapidly by seating wedge pin in V-shaped slots and deforming end of strut until primary pawl engages it.

  4. "Nonfloating" universal joint

    NASA Technical Reports Server (NTRS)

    Appleberry, W. T.

    1978-01-01

    Modified crowned-spline joint is lightweight, durable, and requires minimum of parts. It does not use rubber cushions to limit play and is useful over wide temperature range. It has inner ball and socket to provide rigid connection with no axial play. Joint can be adapted to form pinned connection between segmented torque tubes.

  5. Sacroiliac joint pain - aftercare

    MedlinePlus

    The sacroiliac joint (SIJ) is a term used to describe the place where the sacrum and the iliac bones join. The ... The main purpose of the joint is to connect the spine and the pelvis. As a result, there is very little movement at the SIJ. Major reasons ...

  6. Pure Varus Injury to the Knee Joint.

    PubMed

    Yoo, Jae Ho; Lee, Jung Ha; Chang, Chong Bum

    2015-06-01

    A 30-year-old male was involved in a car accident. Radiographs revealed a depressed marginal fracture of the medial tibial plateau and an avulsion fracture of the fibular head. Magnetic resonance imaging showed avulsion fracture of Gerdy's tubercle, injury to the posterior cruciate ligament (PCL), posterior horn of the medial meniscus, and the attachments of the lateral collateral ligament and the biceps femoris tendon. The depressed fracture of the medial tibial plateau was elevated and stabilized using a cannulated screw and washer. The injured lateral and posterolateral corner (PLC) structures were repaired and augmented by PLC reconstruction. However, the avulsion fracture of Gerdy's tubercle was not fixed because it was minimally displaced and the torn PCL was also not repaired or reconstructed. We present a unique case of pure varus injury to the knee joint. This case contributes to our understanding of the mechanism of knee injury and provides insight regarding appropriate treatment plans for this type of injury. PMID:26217477

  7. Education for Reconstruction.

    ERIC Educational Resources Information Center

    Phillips, David; And Others

    This report describes the main questions that various international agencies must address in order to reconstruct education in countries that have experienced crisis. "Crisis" is defined as war, natural disaster, and extreme political and economic upheaval. Many of the problems of educational reconstruction with which the Allies contended in…

  8. Bitzer's Model Reconstructed.

    ERIC Educational Resources Information Center

    Lybarger, Scott; Smith, Craig R.

    1996-01-01

    Reconstructs Lloyd Bitzer's situational model to serve as a guide for the generation of multiperspectival critical assessments of rhetorical discourse. Uses two of President Bush's speeches on the drug crisis to illustrate how the reconstructed model can account for such modern problems as multiple audiences, perceptions, and exigencies. (PA)

  9. The CMS Reconstruction Software

    NASA Astrophysics Data System (ADS)

    Lange, David J.; CMS Collaboration

    2011-12-01

    We report on the status and plans for the event reconstruction software of the CMS experiment. The CMS reconstruction algorithms are the basis for a wide range of data analysis approaches currently under study by the CMS collaboration using the first high-energy run of the LHC. These algorithms have been primarily developed and validated using simulated data samples, and are now being commissioned with LHC proton-proton collision data samples. The CMS reconstruction is now operated routinely on all events triggered by the CMS detector, both in a close to real-time prompt reconstruction processing and in frequent passes over the full recorded CMS data set. We discuss the overall software design, development cycle, computational requirements and performance, recent operational performance, and planned improvements of the CMS reconstruction software.

  10. MISR JOINT_AS Data

    Atmospheric Science Data Center

    2014-07-21

    Joint Aerosol Product (JOINT_AS) The MISR Level 3 Products are global or regional ... field campaigns at daily and monthly time scales. The Joint Aerosol product provides a monthly global statistical summary of MISR ...

  11. Single stage treatment of ankylosis of the temporomandibular joint using patient-specific total joint replacement and virtual surgical planning.

    PubMed

    Haq, Jahrad; Patel, Nishma; Weimer, Katherine; Matthews, N Shaun

    2014-04-01

    Ankylosis of the temporomandibular joint (TMJ) is a debilitating condition that can result in pain, trismus, and a poor quality of life. It can be caused by injury, infection, and rheumatoid disease. Current management includes gap arthroplasty, interpositional arthroplasty, and reconstruction. Traditionally, joints are reconstructed using stock implants, or the procedure is done in two stages with an additional computed tomography (CT) scan between the resective and reconstructive procedures and use of stereolithographic models to aid the design of the definitive prostheses. We describe a technique for the resection of ankylosis and reconstruction of the joint in a single operation using virtually designed custom-made implants. Five patients with ankylosis of the TMJ had a single stage operation with reconstruction between 2010 and 2012. All had preoperative high-resolution CT with contrast angiography. During an international web-based teleconference between the surgeon and the engineer a virtual resection of the ankylosis was done using the reconstructed CT images. The bespoke cutting guides and implants were designed virtually at the same time and were then manufactured precisely using computer-aided design and manufacture (CAD-CAM) over 6 weeks. After release of the ankylosis and reconstruction, the patients underwent an exercise regimen to improve mouth opening. Follow-up was for a minimum of 6 months. Four patients had one operation, and one patient had two. Median/Mean maximum incisal opening increased from 0.6mm before operation to 25 mm afterwards (range 23-27), and there was minimal surgical morbidity. This new method effectively treats ankylosis of the TMJ in a single stage procedure. Fewer operations and hospital stays, and the maintenance of overall clinical outcome are obvious advantages. PMID:24480620

  12. Pressure vessel flex joint

    NASA Technical Reports Server (NTRS)

    Kahn, Jon B. (Inventor)

    1992-01-01

    An airtight, flexible joint is disclosed for the interfacing of two pressure vessels such as between the Space Station docking tunnel and the Space Shuttle Orbiter bulkhead adapter. The joint provides for flexibility while still retaining a structural link between the two vessels required due to the loading created by the internal/external pressure differential. The joint design provides for limiting the axial load carried across the joint to a specific value, a function returned in the Orbiter/Station tunnel interface. The flex joint comprises a floating structural segment which is permanently attached to one of the pressure vessels through the use of an inflatable seal. The geometric configuration of the joint causes the tension between the vessels created by the internal gas pressure to compress the inflatable seal. The inflation pressure of the seal is kept at a value above the internal/external pressure differential of the vessels in order to maintain a controlled distance between the floating segment and pressure vessel. The inflatable seal consists of either a hollow torus-shaped flexible bladder or two rolling convoluted diaphragm seals which may be reinforced by a system of straps or fabric anchored to the hard structures. The joint acts as a flexible link to allow both angular motion and lateral displacement while it still contains the internal pressure and holds the axial tension between the vessels.

  13. Tissue Engineering: Step Ahead in Maxillofacial Reconstruction

    PubMed Central

    Rai, Raj; Raval, Rushik; Khandeparker, Rakshit Vijay Sinai; Chidrawar, Swati K; Khan, Abdul Ahad; Ganpat, Makne Sachin

    2015-01-01

    Within the precedent decade, a new field of “tissue engineering” or “tissue regeneration” emerge that offers an innovative and exhilarating substitute for maxillofacial reconstruction. It offers a new option to supplement existing treatment regimens for reconstruction/regeneration of the oral and craniofacial complex, which includes the teeth, periodontium, bones, soft tissues (oral mucosa, conjunctiva, skin), salivary glands, and the temporomandibular joint (bone and cartilage), as well as blood vessels, muscles, tendons, and nerves. Tissue engineering is based on harvesting the stem cells which are having potential to form an organ. Harvested cells are then transferred into scaffolds that are manufactured in a laboratory to resemble the structure of the desired tissue to be replaced. This article reviews the principles of tissue engineering and its various applications in oral and maxillofacial surgery. PMID:26435634

  14. Optimal Discretization Resolution in Algebraic Image Reconstruction

    NASA Astrophysics Data System (ADS)

    Sharif, Behzad; Kamalabadi, Farzad

    2005-11-01

    In this paper, we focus on data-limited tomographic imaging problems where the underlying linear inverse problem is ill-posed. A typical regularized reconstruction algorithm uses algebraic formulation with a predetermined discretization resolution. If the selected resolution is too low, we may loose useful details of the underlying image and if it is too high, the reconstruction will be unstable and the representation will fit irrelevant features. In this work, two approaches are introduced to address this issue. The first approach is using Mallow's CL method or generalized cross-validation. For each of the two methods, a joint estimator of regularization parameter and discretization resolution is proposed and their asymptotic optimality is investigated. The second approach is a Bayesian estimator of the model order using a complexity-penalizing prior. Numerical experiments focus on a space imaging application from a set of limited-angle tomographic observations.

  15. Clinical Outcomes After Anterior Cruciate Ligament Reconstruction

    PubMed Central

    Tibor, Lisa M.; Long, Joy L.; Schilling, Peter L.; Lilly, Ryan J.; Carpenter, James E.; Miller, Bruce S.

    2010-01-01

    Background: Clinical outcomes of autograft and allograft anterior cruciate ligament (ACL) reconstructions are mixed, with some reports of excellent to good outcomes and other reports of early graft failure or significant donor site morbidity. Objective: To determine if there is a difference in functional outcomes, failure rates, and stability between autograft and allograft ACL reconstructions. Data Sources: Medline, Cochrane Central Register of Controlled Trials (Evidence Based Medicine Reviews Collection), Cochrane Database of Systematic Reviews, Web of Science, CINAHL, and SPORTDiscus were searched for articles on ACL reconstruction. Abstracts from annual meetings of the American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America were searched for relevant studies. Study Selection: Inclusion criteria for studies were as follows: primary unilateral ACL injuries, mean patient age less than 41 years, and follow-up for at least 24 months postreconstruction. Exclusion criteria for studies included the following: skeletally immature patients, multiligament injuries, and publication dates before 1990. Data Extraction: Joint stability measures included Lachman test, pivot-shift test, KT-1000 arthrometer assessment, and frequency of graft failures. Functional outcome measures included Tegner activity scores, Cincinnati knee scores, Lysholm scores, and IKDC (International Knee Documentation Committee) total scores. Results: More than 5000 studies were identified. After full text review of 576 studies, 56 were included, of which only 1 directly compared autograft and allograft reconstruction. Allograft ACL reconstructions were more lax when assessed by the KT-1000 arthrometer. For all other outcome measures, there was no statistically significant difference between autograft and allograft ACL reconstruction. For all outcome measures, there was strong evidence of statistical heterogeneity between

  16. First metatarsophalangeal joint arthrodesis.

    PubMed

    Rajczy, Robert M; McDonald, Patrick R; Shapiro, Howard S; Boc, Steven F

    2012-01-01

    Arthrodesis of the first metatarsophalangeal joint (MTPJ) is used primarily for end-stage hallux rigidus whereby pain, crepitus, and limitation of motion is noted at the joint. Arthrodesis at the first MTPJ also has it uses as a primary procedure for rheumatoid arthritis when severe deformity is present, as well as for salvage procedures for failed joint arthroplasties with or without implant, fractures with intra-articular extension, avascular necrosis, and infection management. A first MTPJ arthrodesis should provide stable fixation, attain suitable positioning for a reasonable gait, maintain adequate length, and create a stable platform for a plantigrade foot type. PMID:22243568

  17. Compliant Joints For Robots

    NASA Technical Reports Server (NTRS)

    Kerley, James J., Jr.

    1990-01-01

    Compliant joints devised to accommodate misalignments of tools and/or workpieces with respect to robotic manipulators. Has characteristics and appearance of both universal-joint and cable-spring-type flexible shaft coupling. Compliance derived from elastic properties of short pieces of cable. Compliance of joint determined by lengths, distances between, relative orientations, thickness of strands, number of strands, material, amount of pretwist, and number of short pieces of cable. Worm-drive mechanism used to adjust lengths to vary compliance as needed during operation.

  18. Keyhole Flap Nipple Reconstruction

    PubMed Central

    Cash, Camille G.; Iman, Al-Haj; Spiegel, Aldona J.; Cronin, Ernest D.

    2016-01-01

    Summary: Nipple-areola reconstruction is often one of the final but most challenging aspects of breast reconstruction. However, it is an integral and important component of breast reconstruction because it transforms the mound into a breast. We performed 133 nipple-areola reconstructions during a period of 4 years. Of these reconstructions, 76 of 133 nipple-areola complexes were reconstructed using the keyhole flap technique. The tissue used for the keyhole dermoadipose flap technique include transverse rectus abdominus myocutaneous flaps (60/76), latissimus dorsi flaps (15/76), or mastectomy skin flaps after tissue expanders (1/76). The average patient follow-up was 17 months. The design of the flap is based on a keyhole configuration. The base of the flap determines the width of the future nipple, whereas the length of the flap determines the projection. We try to match the projection of the contralateral nipple if present. The keyhole flap is simple to construct yet reliable. It provides good symmetry and projection and avoids the creation of new scars. The areola is then tattooed approximately 3 months after the nipple reconstruction.

  19. Keyhole Flap Nipple Reconstruction.

    PubMed

    Chen, Joseph I; Cash, Camille G; Iman, Al-Haj; Spiegel, Aldona J; Cronin, Ernest D

    2016-05-01

    Nipple-areola reconstruction is often one of the final but most challenging aspects of breast reconstruction. However, it is an integral and important component of breast reconstruction because it transforms the mound into a breast. We performed 133 nipple-areola reconstructions during a period of 4 years. Of these reconstructions, 76 of 133 nipple-areola complexes were reconstructed using the keyhole flap technique. The tissue used for the keyhole dermoadipose flap technique include transverse rectus abdominus myocutaneous flaps (60/76), latissimus dorsi flaps (15/76), or mastectomy skin flaps after tissue expanders (1/76). The average patient follow-up was 17 months. The design of the flap is based on a keyhole configuration. The base of the flap determines the width of the future nipple, whereas the length of the flap determines the projection. We try to match the projection of the contralateral nipple if present. The keyhole flap is simple to construct yet reliable. It provides good symmetry and projection and avoids the creation of new scars. The areola is then tattooed approximately 3 months after the nipple reconstruction. PMID:27579228

  20. Improved orthopedic arm joint

    NASA Technical Reports Server (NTRS)

    Dane, D. H.

    1971-01-01

    Joint permits smooth and easy movement of disabled arm and is smaller, lighter and less expensive than previous models. Device is interchangeable and may be used on either arm at the shoulder or at the elbow.

  1. Knee joint replacement

    MedlinePlus

    The results of a total knee replacement are often excellent. The operation relieves pain for most people. Most people do not need help walking after they fully recover. Most artificial knee joints last 10 ...

  2. Joint fluid Gram stain

    MedlinePlus

    Gram stain of joint fluid ... result means no bacteria are present on the Gram stain. Normal value ranges may vary slightly among ... Abnormal results mean bacteria were seen on the Gram stain. This may be a sign of a ...

  3. Temporomandibular Joint Disorder

    MedlinePlus

    ... 2008 Previous Next Related Articles: Temporomandibular Joint Disorder (TMD) Are You Biting Off More Than You Can Chew? Equilibration May Lessen TMD Pain Fender-benders: Source of TMD? First Comes ...

  4. Nasal reconstruction after epithelioma.

    PubMed

    Rodríguez-Camps, S

    2001-01-01

    In this paper we present our procedure for the treatment, histopathological diagnosis, and resection of skin cancer in the nasal pyramid and its subsequent reconstruction. Because we are dealing with the most important anatomical feature of the face our goal is an aesthetic reconstruction [2,4] according to the anatomical subunits criterion of Burget [3]. First, a histopathological diagnosis is made to determine the nature of the tumor. Then, we proceed with the resection according to the Mohs Micrographic Surgery [1,5,7]. Then we begin with the first step of the nasal reconstruction. PMID:11568830

  5. Evolutionary reconstruction of networks

    NASA Astrophysics Data System (ADS)

    Ipsen, Mads; Mikhailov, Alexander S.

    2002-10-01

    Can a graph specifying the pattern of connections of a dynamical network be reconstructed from statistical properties of a signal generated by such a system? In this model study, we present a Metropolis algorithm for reconstruction of graphs from their Laplacian spectra. Through a stochastic process of mutations and selection, evolving test networks converge to a reference graph. Applying the method to several examples of random graphs, clustered graphs, and small-world networks, we show that the proposed stochastic evolution allows exact reconstruction of relatively small networks and yields good approximations in the case of large sizes.

  6. A symptomatic coracoclavicular joint.

    PubMed

    Cheung, T F S; Boerboom, A L; Wolf, R F E; Diercks, R L

    2006-11-01

    Bilateral coracoclavicular joints were found in a 44-year-old male patient following a fall. He had an Indonesian mother and a Dutch father. Prior to the injury he was asymptomatic and had full range of movement in both shoulders but the trauma resulted in pain and limitation of movement in the left shoulder which required resection of the anomalous joint, after which full pain-free movement was restored. PMID:17075101

  7. High pressure ceramic joint

    DOEpatents

    Ward, M.E.; Harkins, B.D.

    1993-11-30

    Many recuperators have components which react to corrosive gases and are used in applications where the donor fluid includes highly corrosive gases. These recuperators have suffered reduced life, increased service or maintenance, and resulted in increased cost. The present joint when used with recuperators increases the use of ceramic components which do not react to highly corrosive gases. Thus, the present joint used with the present recuperator increases the life, reduces the service and maintenance, and reduces the increased cost associated with corrosive action of components used to manufacture recuperators. The present joint is comprised of a first ceramic member, a second ceramic member, a mechanical locking device having a groove defined in one of the first ceramic member and the second ceramic member. The joint and the mechanical locking device is further comprised of a refractory material disposed in the groove and contacting the first ceramic member and the second ceramic member. The present joint mechanically provides a high strength load bearing joint having good thermal cycling characteristics, good resistance to a corrosive environment and good steady state strength at elevated temperatures. 4 figures.

  8. High pressure ceramic joint

    DOEpatents

    Ward, Michael E.; Harkins, Bruce D.

    1993-01-01

    Many recuperators have components which react to corrosive gases and are used in applications where the donor fluid includes highly corrosive gases. These recuperators have suffered reduced life, increased service or maintenance, and resulted in increased cost. The present joint when used with recuperators increases the use of ceramic components which do not react to highly corrosive gases. Thus, the present joint used with the present recuperator increases the life, reduces the service and maintenance, and reduces the increased cost associated with corrosive action of components used to manufacture recuperators. The present joint is comprised of a first ceramic member, a second ceramic member, a mechanical locking device having a groove defined in one of the first ceramic member and the second ceramic member. The joint and the mechanical locking device is further comprised of a refractory material disposed in the groove and contacting the first ceramic member and the second ceramic member. The present joint mechanically provides a high strength load bearing joint having good thermal cycling characteristics, good resistance to a corrosive environment and good steady state strength at elevated temperatures.

  9. Panel Post & Diagonal Brace Joint Detail; Crossbracing Center Joint ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Panel Post & Diagonal Brace Joint Detail; Crossbracing Center Joint Detail; Chord, Panel Post, Tie Bar, & Diagonal Brace Joint Detail; Chord, Tie Bar, & Crossbracing Joint Detail - Medora Bridge, Spanning East Fork of White River at State Route 235, Medora, Jackson County, IN

  10. Advances in Tracheal Reconstruction

    PubMed Central

    Salna, Michael; Waddell, Thomas K.; Hofer, Stefan O.

    2014-01-01

    Summary: A recent revival of global interest for reconstruction of long-segment tracheal defects, which represents one of the most interesting and complex problems in head and neck and thoracic reconstructive surgery, has been witnessed. The trachea functions as a conduit for air, and its subunits including the epithelial layer, hyaline cartilage, and segmental blood supply make it particularly challenging to reconstruct. A myriad of attempts at replacing the trachea have been described. These along with the anatomy, indications, and approaches including microsurgical tracheal reconstruction will be reviewed. Novel techniques such as tissue-engineering approaches will also be discussed. Multiple attempts at replacing the trachea with synthetic scaffolds have been met with failure. The main lesson learned from such failures is that the trachea must not be treated as a “simple tube.” Understanding the anatomy, developmental biology, physiology, and diseases affecting the trachea are required for solving this problem. PMID:25426361

  11. Breast Reconstruction After Mastectomy

    MedlinePlus

    ... Women who have autologous tissue reconstruction may need physical therapy to help them make up for weakness experienced ... 127(1):15–22. [PubMed Abstract] Monteiro M. Physical therapy implications following the TRAM procedure. Physical Therapy. 1997; ...

  12. Breast Reconstruction and Prosthesis

    MedlinePlus

    ... feel of the breast after a mastectomy. A plastic surgeon can do it at the same time ... want breast reconstruction. • Have you talked with your plastic surgeon about your options? You may not be ...

  13. Reconstruction of Mandibular Defects

    PubMed Central

    Chim, Harvey; Salgado, Christopher J.; Mardini, Samir; Chen, Hung-Chi

    2010-01-01

    Defects requiring reconstruction in the mandible are commonly encountered and may result from resection of benign or malignant lesions, trauma, or osteoradionecrosis. Mandibular defects can be classified according to location and extent, as well as involvement of mucosa, skin, and tongue. Vascularized bone flaps, in general, provide the best functional and aesthetic outcome, with the fibula flap remaining the gold standard for mandible reconstruction. In this review, we discuss classification and approach to reconstruction of mandibular defects. We also elaborate upon four commonly used free osteocutaneous flaps, inclusive of fibula, iliac crest, scapula, and radial forearm. Finally, we discuss indications and use of osseointegrated implants as well as recent advances in mandibular reconstruction. PMID:22550439

  14. Overview of Image Reconstruction

    SciTech Connect

    Marr, R. B.

    1980-04-01

    Image reconstruction (or computerized tomography, etc.) is any process whereby a function, f, on Rn is estimated from empirical data pertaining to its integrals, ∫f(x) dx, for some collection of hyperplanes of dimension k < n. The paper begins with background information on how image reconstruction problems have arisen in practice, and describes some of the application areas of past or current interest; these include radioastronomy, optics, radiology and nuclear medicine, electron microscopy, acoustical imaging, geophysical tomography, nondestructive testing, and NMR zeugmatography. Then the various reconstruction algorithms are discussed in five classes: summation, or simple back-projection; convolution, or filtered back-projection; Fourier and other functional transforms; orthogonal function series expansion; and iterative methods. Certain more technical mathematical aspects of image reconstruction are considered from the standpoint of uniqueness, consistency, and stability of solution. The paper concludes by presenting certain open problems. 73 references. (RWR)

  15. Cosmic tidal reconstruction

    NASA Astrophysics Data System (ADS)

    Zhu, Hong-Ming; Pen, Ue-Li; Yu, Yu; Er, Xinzhong; Chen, Xuelei

    2016-05-01

    The gravitational coupling of a long-wavelength tidal field with small-scale density fluctuations leads to anisotropic distortions of the locally measured small-scale matter correlation function. Since the local correlation function is known to be statistically isotropic in the absence of such tidal interactions, the tidal distortions can be used to reconstruct the long-wavelength tidal field and large-scale density field in analogy with the cosmic microwave background lensing reconstruction. In this paper we present the theoretical framework of cosmic tidal reconstruction and test the reconstruction in numerical simulations. We find that the density field on large scales can be reconstructed with good accuracy and the cross-correlation coefficient between the reconstructed density field and the original density field is greater than 0.9 on large scales (k ≲0.1 h /Mpc ), with the filter scale ˜1.25 Mpc /h . This is useful in the 21 cm intensity mapping survey, where the long-wavelength radial modes are lost due to a foreground subtraction process.

  16. Microsurgical breast reconstruction.

    PubMed

    Avraham, Tomer; Clavin, Nicolas; Mehrara, Babak J

    2008-01-01

    Breast cancer, the most common cancer diagnosed in American women, often necessitates mastectomy. Many studies have demonstrated improved quality of life and well-being after breast reconstruction. Numerous techniques are available for breast reconstruction including tissue expander implants and autologous tissues. Microsurgical tissue transfer involves the use of excess skin and fat (flaps) from a remote location to reconstruct the breast. Most often, tissues are transferred from the abdomen and buttocks. Less commonly, thigh flaps are used. These operations can provide durable, esthetic reconstructions. In addition, advances in microsurgical techniques have improved operative success rates to the range of 99%. The selection of an appropriate flap for microsurgical breast reconstruction is multifactorial and is based on patient and oncologic factors. These factors include patient comorbidities, body habitus/availability of donor tissues, cancer stage, and the need for postoperative adjuvant radiation therapy, as well as the risk of cancer in the contralateral breast. Appropriate choice of flap and surgical technique can minimize the risk of operative complications. Additionally, several large series have established that microsurgical breast reconstruction has no impact on survival, or locoregional/distant recurrence rates. PMID:18677132

  17. The Reconstruction Problem Revisited

    NASA Technical Reports Server (NTRS)

    Suresh, Ambaby

    1999-01-01

    The role of reconstruction in avoiding oscillations in upwind schemes is reexamined, with the aim of providing simple, concise proofs. In one dimension, it is shown that if the reconstruction is any arbitrary function bounded by neighboring cell averages and increasing within a cell for increasing data, the resulting scheme is monotonicity preserving, even though the reconstructed function may have overshoots and undershoots at the cell edges and is in general not a monotone function. In the special case of linear reconstruction, it is shown that merely bounding the reconstruction between neighboring cell averages is sufficient to obtain a monotonicity preservinc,y scheme. In two dimensions, it is shown that some ID TVD limiters applied in each direction result in schemes that are not positivity preserving, i.e. do not give positive updates when the data are positive. A simple proof is given to show that if the reconstruction inside the cell is bounded by the neighboring cell averages (including corner neighbors), then the scheme is positivity preserving. A new limiter that enforces this condition but is not as dissipative as the Minmod limiter is also presented.

  18. Dissimilar metals joint evaluation

    NASA Technical Reports Server (NTRS)

    Wakefield, M. E.; Apodaca, L. E.

    1974-01-01

    Dissimilar metals tubular joints between 2219-T851 aluminum alloy and 304L stainless steel were fabricated and tested to evaluate bonding processes. Joints were fabricated by four processes: (1) inertia (friction) weldings, where the metals are spun and forced together to create the weld; (2) explosive welding, where the metals are impacted together at high velocity; (3) co-extrusion, where the metals are extruded in contact at high temperature to promote diffusion; and (4) swaging, where residual stresses in the metals after a stretching operation maintain forced contact in mutual shear areas. Fifteen joints of each type were prepared and evaluated in a 6.35 cm (2.50 in.) O.D. size, with 0.32 cm (0.13 in.) wall thickness, and 7.6 cm (3.0 in) total length. The joints were tested to evaluate their ability to withstand pressure cycle, thermal cycle, galvanic corrosion and burst tests. Leakage tests and other non-destructive test techniques were used to evaluate the behavior of the joints, and the microstructure of the bond areas was analyzed.

  19. Arthroscopic Hip Labral Reconstruction and Augmentation Using Knotless Anchors

    PubMed Central

    McConkey, Mark O.; Moreira, Brett; Mei-Dan, Omer

    2015-01-01

    Biomechanical stability is the primary function of the acetabular labrum. It provides a hip suction seal and optimal joint function. Labral tears are a common reason for hip arthroscopy, to improve patient function and to prevent long-term degenerative arthropathy. Arthroscopic labral repair has shown significantly better outcomes in return to premorbid activity levels when compared with labral debridement. Injury to the acetabular labrum is a challenge and can lead to long-term complications. In this scenario, arthroscopic labral reconstruction has shown good results regarding patient subjective and objective outcomes. We describe a technique for complete arthroscopic labral reconstruction using tensor fascia lata allograft. PMID:26870649

  20. Periprosthetic joint infection.

    PubMed

    Kapadia, Bhaveen H; Berg, Richard A; Daley, Jacqueline A; Fritz, Jan; Bhave, Anil; Mont, Michael A

    2016-01-23

    Periprosthetic joint infections are a devastating complication after arthroplasty and are associated with substantial patient morbidity. More than 25% of revisions are attributed to these infections, which are expected to increase. The increased prevalence of obesity, diabetes, and other comorbidities are some of the reasons for this increase. Recognition of the challenge of surgical site infections in general, and periprosthetic joint infections particularly, has prompted implementation of enhanced prevention measures preoperatively (glycaemic control, skin decontamination, decolonisation, etc), intraoperatively (ultraclean operative environment, blood conservation, etc), and postoperatively (refined anticoagulation, improved wound dressings, etc). Additionally, indications for surgical management have been refined. In this Review, we assess risk factors, preventive measures, diagnoses, clinical features, and treatment options for prosthetic joint infection. An international consensus meeting about such infections identified the best practices and further research needs. Orthopaedics could benefit from enhanced preventive, diagnostic, and treatment methods. PMID:26135702

  1. Quick acting gimbal joint

    NASA Technical Reports Server (NTRS)

    Wood, William B. (Inventor); Krch, Gary D. (Inventor)

    1993-01-01

    The present invention relates to an adjustable linkage assembly for selectively retaining the position of one member pivotable with respect to another member. More specifically, the invention relates to a linkage assembly commonly referred to as a gimbal joint, and particularly to a quick release or quick acting gimbal joint. The assembly is relatively simple in construction, compact in size, and has superior locking strength in any selected position. The device can be quickly and easily actuated, without separate tooling, by inexperienced personnel or by computer controlled equipment. It also is designed to prevent inadvertent actuation.

  2. Prosthetic Joint Infection

    PubMed Central

    Tande, Aaron J.

    2014-01-01

    SUMMARY Prosthetic joint infection (PJI) is a tremendous burden for individual patients as well as the global health care industry. While a small minority of joint arthroplasties will become infected, appropriate recognition and management are critical to preserve or restore adequate function and prevent excess morbidity. In this review, we describe the reported risk factors for and clinical manifestations of PJI. We discuss the pathogenesis of PJI and the numerous microorganisms that can cause this devastating infection. The recently proposed consensus definitions of PJI and approaches to accurate diagnosis are reviewed in detail. An overview of the treatment and prevention of this challenging condition is provided. PMID:24696437

  3. Joint for deployable structures

    NASA Technical Reports Server (NTRS)

    Craighead, N. D., II; Preliasco, R. J.; Hult, T. D. (Inventor)

    1985-01-01

    A joint is described for connecting a pair of beams to pivot them between positions in alignment or beside one another, which is of light weight and which operates in a controlled manner. The joint includes a pair of fittings and at least one center link having opposite ends pivotally connected to opposite fittings and having axes that pass through centerplates of the fittings. A control link having opposite ends pivotally connected to the different fittings controls their relative orientations, and a toggle assemly holds the fittings in the deployed configuration wherein they are aligned. The fittings have stops that lie on one side of the centerplane opposite the toggle assembly.

  4. Augmented Likelihood Image Reconstruction.

    PubMed

    Stille, Maik; Kleine, Matthias; Hägele, Julian; Barkhausen, Jörg; Buzug, Thorsten M

    2016-01-01

    The presence of high-density objects remains an open problem in medical CT imaging. Data of projections passing through objects of high density, such as metal implants, are dominated by noise and are highly affected by beam hardening and scatter. Reconstructed images become less diagnostically conclusive because of pronounced artifacts that manifest as dark and bright streaks. A new reconstruction algorithm is proposed with the aim to reduce these artifacts by incorporating information about shape and known attenuation coefficients of a metal implant. Image reconstruction is considered as a variational optimization problem. The afore-mentioned prior knowledge is introduced in terms of equality constraints. An augmented Lagrangian approach is adapted in order to minimize the associated log-likelihood function for transmission CT. During iterations, temporally appearing artifacts are reduced with a bilateral filter and new projection values are calculated, which are used later on for the reconstruction. A detailed evaluation in cooperation with radiologists is performed on software and hardware phantoms, as well as on clinically relevant patient data of subjects with various metal implants. Results show that the proposed reconstruction algorithm is able to outperform contemporary metal artifact reduction methods such as normalized metal artifact reduction. PMID:26208310

  5. Multi-contrast magnetic resonance image reconstruction

    NASA Astrophysics Data System (ADS)

    Liu, Meng; Chen, Yunmei; Zhang, Hao; Huang, Feng

    2015-03-01

    In clinical exams, multi-contrast images from conventional MRI are scanned with the same field of view (FOV) for complementary diagnostic information, such as proton density- (PD-), T1- and T2-weighted images. Their sharable information can be utilized for more robust and accurate image reconstruction. In this work, we propose a novel model and an efficient algorithm for joint image reconstruction and coil sensitivity estimation in multi-contrast partially parallel imaging (PPI) in MRI. Our algorithm restores the multi-contrast images by minimizing an energy function consisting of an L2-norm fidelity term to reduce construction errors caused by motion, a regularization term of underlying images to preserve common anatomical features by using vectorial total variation (VTV) regularizer, and updating sensitivity maps by Tikhonov smoothness based on their physical property. We present the numerical results including T1- and T2-weighted MR images recovered from partially scanned k-space data and provide the comparisons between our results and those obtained from the related existing works. Our numerical results indicate that the proposed method using vectorial TV and penalties on sensitivities can be made promising and widely used for multi-contrast multi-channel MR image reconstruction.

  6. Population exposure dose reconstruction for the Urals Region

    SciTech Connect

    Degteva, M.O.; Kozheurov, V.P.; Vorobiova, M.I.; Burmistrov, D.S.; Khokhryakov, V.V.; Suslova, K.G.; Anspaugh, L.R.; Napier, B.A.; Bouville, A.

    1996-06-01

    This presentation describes the first preliminary results of an ongoing joint Russian-US pilot feasibility study. Many people participated in workshops to determine what Russian and United States scientists could do together in the area of dose reconstruction in the Urals population. Most of the results presented here came from a joint work shop in St. Petersburg, Russia (11-13 July 1995). The Russians at the workshop represented the Urals Research Center for Radiation Medicine (URCRM), the Mayak Industrial Association, and Branch One of the Moscow Biophysics Institute. The US Collaborators were Dr. Anspaugh of LLNL, Dr. Nippier of PNL, and Dr. Bouville of the National Cancer Institute. The objective of the first year of collaboration was to look at the source term and levels of radiation contamination, the historical data available, and the results of previous work carried out by Russian scientists, and to determine a conceptual model for dose reconstruction.

  7. Adaptive iterative reconstruction

    NASA Astrophysics Data System (ADS)

    Bruder, H.; Raupach, R.; Sunnegardh, J.; Sedlmair, M.; Stierstorfer, K.; Flohr, T.

    2011-03-01

    It is well known that, in CT reconstruction, Maximum A Posteriori (MAP) reconstruction based on a Poisson noise model can be well approximated by Penalized Weighted Least Square (PWLS) minimization based on a data dependent Gaussian noise model. We study minimization of the PWLS objective function using the Gradient Descent (GD) method, and show that if an exact inverse of the forward projector exists, the PWLS GD update equation can be translated into an update equation which entirely operates in the image domain. In case of non-linear regularization and arbitrary noise model this means that a non-linear image filter must exist which solves the optimization problem. In the general case of non-linear regularization and arbitrary noise model, the analytical computation is not trivial and might lead to image filters which are computationally very expensive. We introduce a new iteration scheme in image space, based on a regularization filter with an anisotropic noise model. Basically, this approximates the statistical data weighting and regularization in PWLS reconstruction. If needed, e.g. for compensation of the non-exactness of backprojector, the image-based regularization loop can be preceded by a raw data based loop without regularization and statistical data weighting. We call this combined iterative reconstruction scheme Adaptive Iterative Reconstruction (AIR). It will be shown that in terms of low-contrast visibility, sharpness-to-noise and contrast-to-noise ratio, PWLS and AIR reconstruction are similar to a high degree of accuracy. In clinical images the noise texture of AIR is also superior to the more artificial texture of PWLS.

  8. Flux distributions in jointed ? tapes

    NASA Astrophysics Data System (ADS)

    Koblischka, M. R.; Johansen, T. H.; Bratsberg, H.; Vase, P.

    1998-06-01

    Superconducting joints between monofilamentary, Ag-sheathed 0953-2048/11/6/005/img8 tapes were investigated by means of magneto-optic imaging. Two types of joint were studied; one joint with direct contact between the tape cores, and the other one with an Ag layer between them. The local flux distributions directly reveal the obstacles hindering the current flow through the joints. The direct contact of the tape cores provides joints which can carry about 80% of the current of the original tape, whereas the joints with the Ag layer are considerably worse. This difference becomes even more drastic in applied magnetic fields.

  9. Upper Eyelid Reconstruction.

    PubMed

    Espinoza, Gabriela Mabel; Prost, Angela Michelle

    2016-05-01

    Reconstruction of the upper eyelid is complicated because the eyelid must retain mobility, flexibility, function, and a suitable mucosal surface over the delicate cornea. Defects of the upper eyelid may be due to congenital defects or traumatic injury or follow oncologic resection. This article focuses on reconstruction due to loss of tissue. Multiple surgeries may be needed to reach the desired results, addressing loss of tissue and then loss of function. Each defect is unique and the laxity and availability of surrounding tissue vary. Knowing the most common techniques for repair assists surgeons in the multifaceted planning that takes place. PMID:27105803

  10. First metatarsophalangeal joint arthrodesis.

    PubMed

    Yu, Gerard V; Gorby, Paul O

    2004-01-01

    First MTP joint arthrodesis continues to be a time-honored, effective, and valuable procedure as a primary or secondary surgery for various pathologies afflicting the first ray segment. Though commonly thought of as a salvage procedure, it has proven beneficial in the management of primary hallux limitus and rigidus, geriatric hallux valgus deformity, severe arthritis of any etiology, and conditions in which joint instability or deformity are not readily correctable by more traditional approaches. Since its initial description in the 1800s, the procedure has continued to be popular among orthopedic and podiatric surgeons. Success of the procedure is highly dependent on the position of fusion. Though surgeons are often fascinated and at times obsessed with a particular fixation technique, it cannot be over-emphasized that this takes a back seat to the importance of achieving proper position to meet the needs of an individual patient. Unlike joint resection or implant arthroplasty procedures, which commonly leave the hallux lacking stability and propulsion, first MPJ fusion has been shown to be effective during weight bearing and propulsion. The success enjoyed by the senior author continues to reinforce that motion is not necessary at the first MTP joint for good, pain-free function. PMID:15012033

  11. Human temporomandibular joint morphogenesis.

    PubMed

    Carini, Francesco; Scardina, Giuseppe Alessandro; Caradonna, Carola; Messina, Pietro; Valenza, Vincenzo

    2007-01-01

    Temporomandibular joint morphogenesis was studied. Ranging in age of fetuses examined was from 6 to14 weeks' gestation. Our results showed the condyle so first element that appear between 6 degrees and 8 degrees week (condylar blastema). After a week appear temporal elements. Disk appear at the same time of glenoid blastema and it reaches an advanced differentation before of the condyle and temporal element, so these don't effect machanical compression on mesenchyma where we find the disk. So we think that the disk result of genetic expression and it isn't the result of mechanical compression. The inferior joint cavity appear to 12 week. The superior joint cavity appear to 13-14 week. In conclusion, the appearance of the condyle is the first event during TMJ morphogenesis, with its initial bud, in form of a mesenchymal thickening, becoming detectable between the sixth and eight week of development, when all the large joints of the limbs are already well defined. PMID:18333411

  12. Imaging the temporomandibular joint

    SciTech Connect

    Katzberg, R.W.; Manzione, J.V.; Westesson, P.L.

    1988-01-01

    This book encompasses all imaging modalities as they apply to the Temporomandibular Joint and its disorders. The volume employs correlative line drawings to elaborate on diagnostic images. It helps teach methods of TMJ imaging and describes findings identified by different imaging modalities to both radiologists and dental clinicians.

  13. The point-source method for 3D reconstructions for the Helmholtz and Maxwell equations

    NASA Astrophysics Data System (ADS)

    Ben Hassen, M. F.; Erhard, K.; Potthast, R.

    2006-02-01

    We use the point-source method (PSM) to reconstruct a scattered field from its associated far field pattern. The reconstruction scheme is described and numerical results are presented for three-dimensional acoustic and electromagnetic scattering problems. We give new proofs of the algorithms, based on the Green and Stratton-Chu formulae, which are more general than with the former use of the reciprocity relation. This allows us to handle the case of limited aperture data and arbitrary incident fields. Both for 3D acoustics and electromagnetics, numerical reconstructions of the field for different settings and with noisy data are shown. For shape reconstruction in acoustics, we develop an appropriate strategy to identify areas with good reconstruction quality and combine different such regions into one joint function. Then, we show how shapes of unknown sound-soft scatterers are found as level curves of the total reconstructed field.

  14. Transition, Reconstruction and Stability in South-Eastern Europe. The Role of Vocational Education and Training. Working Document. [European Training Foundation and Kulturkontakt Austria Joint Workshop on "Civil Society and Vocational Education Training. The Role of Democratic Citizenship and Diversity Education" (Mavrovo, Former Yugoslav Republic of Macedonia, September 9-11, 1999)].

    ERIC Educational Resources Information Center

    European Training Foundation, Turin (Italy).

    This document includes the following papers: "The European Training Foundation's Experience in Supporting Human Resource Development in South-Eastern Europe" (Peter de Rooij); "Transition, Reconstruction and Stability in South-Eastern Europe; The Role of Vocational Education and Training" (Cesar Birzea, Peter Grootings, Tzako Panteelev, Carsten…

  15. New Joint Sealants. Criteria, Design and Materials.

    ERIC Educational Resources Information Center

    Building Research Inst., Inc., Washington, DC.

    Contents include--(1) sealing concrete joints, (2) sealing glass and metal joints, (3) metal and glass joint sealants from a fabricator's viewpoint, (4) a theory of adhesion for joint sealants, (5) geometry of simple joint seals under strain, (6) joint sealant specifications from a manufacturer's viewpoint, (7) joint sealant requirements from an…

  16. Total joint replacement at the base of the thumb.

    PubMed

    Braun, R M; Feldman, C W

    1991-04-01

    Total joint replacement at the base of the thumb has been used for almost two decades in cases of trapezium-metacarpal arthritis. The procedure involves the insertion of a titanium metacarpal component and a polyethylene trapezium implant. The system articulates in a semiconstrained ball and socket joint that allows a full range of motion with inherent stability. Methylmethacrylate cement is optional for the metacarpal component and is routinely used in the trapezium. Revision components are available if excision of the trapezium is required because of fracture, severe arthritic deterioration, or loss of bone stock. A trapezium revision procedure converts the system into a spacer arthroplasty, which requires standard soft tissue stabilization. There have been no implant fractures or evidence of excessive wear, infections, or unstable articulated components in 80 cases that have been carefully followed up for over 10 years. Trapezium components loosening in cement cases and metacarpal subsidence in uncemented cases have a complication rate of less than 10%. These cases respond to revision procedures that permit continued functional use of the thumb. Total joint replacement appears to be safe and reliable. It is especially helpful in older patients in whom host tissues are not optimal for joint stabilization and early mobilization is desired. Total joint replacement can also be combined with associated procedures such as metacarpal phalangeal joint capsulodesis, carpal tunnel release, and tendon transfers in performing complex reconstruction of the thumb. PMID:10149610

  17. Colored 3D surface reconstruction using Kinect sensor

    NASA Astrophysics Data System (ADS)

    Guo, Lian-peng; Chen, Xiang-ning; Chen, Ying; Liu, Bin

    2015-03-01

    A colored 3D surface reconstruction method which effectively fuses the information of both depth and color image using Microsoft Kinect is proposed and demonstrated by experiment. Kinect depth images are processed with the improved joint-bilateral filter based on region segmentation which efficiently combines the depth and color data to improve its quality. The registered depth data are integrated to achieve a surface reconstruction through the colored truncated signed distance fields presented in this paper. Finally, the improved ray casting for rendering full colored surface is implemented to estimate color texture of the reconstruction object. Capturing the depth and color images of a toy car, the improved joint-bilateral filter based on region segmentation is used to improve the quality of depth images and the peak signal-to-noise ratio (PSNR) is approximately 4.57 dB, which is better than 1.16 dB of the joint-bilateral filter. The colored construction results of toy car demonstrate the suitability and ability of the proposed method.

  18. Reconstructing Community History

    ERIC Educational Resources Information Center

    Shields, Amy

    2004-01-01

    History is alive and well in Lebanon, Missouri. Students in this small town in the southwest region of the state went above and beyond the community's expectations on this special project. This article describes this historical journey which began when students in a summer mural class reconstructed a mural that was originally created by a…

  19. Reconstructing Glaciers on Mars

    NASA Astrophysics Data System (ADS)

    Hubbard, A., II; Brough, S.; Hubbard, B. P.

    2015-12-01

    Mars' mid-latitudes host a substantial volume of ice, equivalent to a ~1 - 2.5 m-thick global layer or the sum of Earth's glaciers and ice caps outside of Antarctica and Greenland. These deposits are the remnants of what is believed to have been a once far larger 'ice age', culminating in a last martian glacial maximum. Despite the identification of >1,300 glacier-like forms (GLFs) - the first order component of Mars' glacial landsystem - in Mars' mid-latitudes, little is known about their composition, dynamics or former extent. Here, we reconstruct the former 3D extent of a well-studied GLF located in eastern Hellas Planitia. We combine high-resolution geomorphic and topographic data, obtained from the High-Resolution Imaging Science Experiment (HiRISE) camera, to reconstruct the GLF's former limits. We then apply a perfect plasticity rheological model, to generate multiple flow-parallel ice-surface transects. These are combined with the GLF's boundary to guide interpolation using ArcGIS' 'Topo to Raster' function to produce a continuous 3D surface for the reconstructed former GLF. Our results indicate that, since its reconstructed 'recent maximum' extent, the GLF's volume has reduced by 0.31 km3 and its area by 6.85 km2, or 70%. On-going research is addressing the degree to which this change is typical of Mars' full GLF population.

  20. Reconstructive Middle Ear Surgery

    PubMed Central

    Ruby, R.R.F.; Ballagh, R.H.

    1992-01-01

    Conductive hearing loss is a common cause of deafness and disability, particularly in children and young adults. This article presents a brief overview of the various methods currently available for reconstructing the tympanic membrane and middle ear ossicular chain, including some comments as to their indications and limitations. Schematic diagrams showing these techniques illustrate the various types of repair described. PMID:21221356

  1. Breast reconstruction - natural tissue

    MedlinePlus

    ... muscle flap; TRAM; Latissimus muscle flap with a breast implant; DIEP flap; DIEAP flap; Gluteal free flap; ... If you are having breast reconstruction at the same time as mastectomy, the surgeon may do either of the following: Skin-sparing mastectomy. This means ...

  2. Reconstructing Playschool Experiences

    ERIC Educational Resources Information Center

    Einarsdottir, Johanna

    2011-01-01

    The current study was conducted with groups of first grade children (aged six years) in two primary schools in Reykjavik in an endeavour to ascertain how they recalled and reconstructed their playschool experiences. The children's playschool teachers were co-researchers participating in the data generation; they were, at the same time participants…

  3. Reconstruction of the auricle

    PubMed Central

    Siegert, Ralf; Magritz, Ralph

    2008-01-01

    Reconstructive and aesthetic surgery of the auricle is one of the most challenging and diverse tasks in plastic head and neck surgery. Injuries, defects and malformations require multiple different techniques, some of which are standardized, other situations require huge experience and artistic creativity. It is a specialty that will never become monotone. PMID:22073078

  4. Reconstructing Progressive Education

    ERIC Educational Resources Information Center

    Kaplan, Andy

    2013-01-01

    The work of Colonel Francis W. Parker, the man whom Dewey called "the father of progressive education," provides a starting point for reconstructing the loose ambiguities of progressive education into a coherent social and educational philosophy. Although progressives have claimed their approach is more humane and sensitive to children, we need…

  5. Shoulder Joint For Protective Suit

    NASA Technical Reports Server (NTRS)

    Kosmo, Joseph J.; Smallcombe, Richard D.

    1994-01-01

    Shoulder joint allows full range of natural motion: wearer senses little or no resisting force or torque. Developed for space suit, joint offers advantages in protective garments for underwater work, firefighting, or cleanup of hazardous materials.

  6. Stability of climate reconstructions

    NASA Astrophysics Data System (ADS)

    Lohmann, Gerrit; Rimbu, Norel; Wagner, Axel; Dima, Mihai

    2014-05-01

    Reconstruction of climate mode indices using proxy data as predictors is limited due to non-stationarity in atmospheric teleconnections. In this paper a method is presented to identify stable predictors for the reconstruction of the Arctic Oscillation (AO) index. Using the 20th Century reanalysis data, the AO index is calculated for the last 140 years and correlated with global two meter temperature, precipitation, and sea surface temperature anomalies in various moving windows. The stability of the correlation was checked in every point of the global grids. Anomalies from the regions where the correlation of the AO index is stable are used as stable predictors for the AO index. It is shown that the predictors identified through our analysis lead to proper AO reconstructions. Statistical analysis of a global climate simulation covering the last millennium reveals that the stability correlation map of model AO and temperature are very similar to the corresponding observed correlation stability map. It is shown that the stability correlation maps of the AO, as derived from the model, are insensitive to different climate forcing and can be used to systematically select stable predictors for the AO reconstruction during the last millennium and most likely for the late Holocene. Finally, several high resolution proxy data from the stable regions are selected and used for a reconstruction of the AO index during the last three centuries. We argue that selection of proxy data from the stable regions of AO teleconnections leads to a suitable AO reconstruction. Furthermore, the hypothesis of stable teleconnections is tested using atmospheric circulation model experiments. For climate conditions with other ice sheet distributions on the Northern Hemisphere, such as the last glacial maximum climate, considerable changes are detected in the atmospheric variability pattern compared to the present day. Correlation maps of pseudo proxy records over Europe, the Red Sea area, and

  7. Determination of Parachute Joint Factors using Seam and Joint Testing

    NASA Technical Reports Server (NTRS)

    Mollmann, Catherine

    2015-01-01

    This paper details the methodology for determining the joint factor for all parachute components. This method has been successfully implemented on the Capsule Parachute Assembly System (CPAS) for the NASA Orion crew module for use in determining the margin of safety for each component under peak loads. Also discussed are concepts behind the joint factor and what drives the loss of material strength at joints. The joint factor is defined as a "loss in joint strength...relative to the basic material strength" that occurs when "textiles are connected to each other or to metals." During the CPAS engineering development phase, a conservative joint factor of 0.80 was assumed for each parachute component. In order to refine this factor and eliminate excess conservatism, a seam and joint testing program was implemented as part of the structural validation. This method split each of the parachute structural joints into discrete tensile tests designed to duplicate the loading of each joint. Breaking strength data collected from destructive pull testing was then used to calculate the joint factor in the form of an efficiency. Joint efficiency is the percentage of the base material strength that remains after degradation due to sewing or interaction with other components; it is used interchangeably with joint factor in this paper. Parachute materials vary in type-mainly cord, tape, webbing, and cloth -which require different test fixtures and joint sample construction methods. This paper defines guidelines for designing and testing samples based on materials and test goals. Using the test methodology and analysis approach detailed in this paper, the minimum joint factor for each parachute component can be formulated. The joint factors can then be used to calculate the design factor and margin of safety for that component, a critical part of the design verification process.

  8. Cellular Pressure-Actuated Joint

    NASA Technical Reports Server (NTRS)

    McGuire, John R.

    2003-01-01

    A modification of a pressure-actuated joint has been proposed to improve its pressure actuation in such a manner as to reduce the potential for leakage of the pressurizing fluid. The specific joint for which the modification is proposed is a field joint in a reusable solid-fuel rocket motor (RSRM), in which the pressurizing fluid is a mixture of hot combustion gases. The proposed modification could also be applicable to other pressure-actuated joints of similar configuration.

  9. Sustainability of Forefoot Reconstruction for the Rheumatoid Foot.

    PubMed

    Whitt, Kathie J; Rincker, Sarah A; Hyer, Christopher F

    2016-01-01

    Ninety percent of patients with rheumatoid arthritis will display foot and ankle pathologic features, including hallux valgus, lesser metatarsophalangeal (MTP) joint subluxation/dislocation, and hammertoe deformity. Recently, a trend has ensued toward joint preservation with distal metatarsal osteotomies and various bunion corrective procedures. However, the reference standard remains first MTP joint fusion, lesser metatarsal head resection, and lesser proximal interphalangeal joint fusion. The present retrospective study followed the results of 4 different surgeons who had performed the reference standard rheumatoid forefoot reconstruction from August 2008 to August 2012 on patients with rheumatoid arthritis. Radiographic and statistical analysis of the data from 20 patients determined an overall first MTP joint fusion rate of 90%, often occurring by 108 (range 64 to 202) days postoperatively. Radiographic nonunion occurred in 2 of the 20 patients (10%), although both were asymptomatic, with no revision necessary. Lesser digit deformity revision occurred in 1 patient (5%), and mild to moderate infection developed in 4 patients (20%). The radiographic and clinical follow-up period was 12 months. Our study found that this technique provides exceptional radiographic improvement, an acceptable time to fusion, a low reoperation rate, and minimal complications. In addition, correction of the deformity was maintained at 1 year postoperatively. In conclusion, first MTP joint fusion with lesser metatarsal head resection should remain the reference standard for surgical intervention of the rheumatoid foot. PMID:26970909

  10. Achieving joint benefits from joint implementation

    SciTech Connect

    Moomaw, W.R.

    1995-11-01

    Joint Implementation (JI) appears to have been born with Applied Energy Services Guatemala project in 1988. That project, to plant 52 million trees, protect existing forests from cutting and fire, and enhance rural development, is being implemented by CARE Guatemala to offset 120 per cent of the emissions of a small coal burning power plant that has been built in Connecticut. Since that time, several utilities and governments have initiated additional projects. Not all of these necessarily consist of tree planting in other countries, but may consist of energy efficiency or energy conservation programs designed to reduce carbon emissions by at least as much as the additional releases from a new facility. All JI projects share the characteristic of linking the release of greenhouse gases in an industrial country with an offset that reduces or absorbs a comparable amount in another country. The emitter in the industrial country is willing to pay for the reduction elsewhere because costs are less than they would be at home.

  11. Ankle Arthroscopic Reconstruction of Lateral Ligaments (Ankle Anti-ROLL)

    PubMed Central

    Takao, Masato; Glazebrook, Mark; Stone, James; Guillo, Stéphane

    2015-01-01

    Ankle instability is a condition that often requires surgery to stabilize the ankle joint that will improve pain and function if nonoperative treatments fail. Ankle stabilization surgery may be performed as a repair in which the native existing anterior talofibular ligament or calcaneofibular ligament (or both) is imbricated or reattached. Alternatively, when native ankle ligaments are insufficient for repair, a reconstruction of the ligaments may be performed in which an autologous or allograft tendon is used to reconstruct the anterior talofibular ligament or calcaneofibular ligament (or both). Currently, ankle stabilization surgery is most commonly performed through an open incision, but arthroscopic ankle stabilization using repair techniques has been described and is being used more often. We present our technique for anatomic ankle arthroscopic reconstruction of the lateral ligaments (anti-ROLL) performed in an all–inside-out manner that is likely safe for patients and minimally invasive. PMID:26900560

  12. Arthroscopic Labral Reconstruction of the Hip Using Semitendinosus Allograft

    PubMed Central

    Redmond, John M.; Cregar, William M.; Martin, Timothy J.; Vemula, S. Pavan; Gupta, Asheesh; Domb, Benjamin G.

    2015-01-01

    The labrum of the hip is recognized as being important to the stability of the hip and a major cause of hip pain. Damage to the labrum may result in increased joint stress and articular damage. Labral damage is often treated through various methods, among them simple stitch repair, base refixation, and debridement. Labral reconstruction becomes necessary when the labrum is too damaged to salvage, which renders labral repair improbable and labral debridement ineffective. In contrast to other methods that have been described for this treatment, our technique uses a semitendinosus allograft as a graft source, allowing for arthroscopic hip labral reconstruction. This technique has many advantages and is easily reproducible. It has shown promising results in patients with labral damage. The purpose of this article is to detail the step-by-step surgical technique of labral reconstruction using a semitendinosus allograft, in addition to the indications, pearls, and pitfalls of the technique. PMID:26759770

  13. Swivel Joint For Liquid Nitrogen

    NASA Technical Reports Server (NTRS)

    Milner, James F.

    1988-01-01

    Swivel joint allows liquid-nitrogen pipe to rotate through angle of 100 degree with respect to mating pipe. Functions without cracking hard foam insulation on lines. Pipe joint rotates on disks so mechanical stress not transmitted to thick insulation on pipes. Inner disks ride on fixed outer disks. Disks help to seal pressurized liquid nitrogen flowing through joint.

  14. Double slotted socket spherical joint

    DOEpatents

    Bieg, Lothar F.; Benavides, Gilbert L.

    2001-05-22

    A new class of spherical joints is disclosed. These spherical joints are capable of extremely large angular displacements (full cone angles in excess of 270.degree.), while exhibiting no singularities or dead spots in their range of motion. These joints can improve or simplify a wide range of mechanical devices.

  15. Method for reinforcing tubing joints

    NASA Technical Reports Server (NTRS)

    Kinzler, J.; Lee, W. S.

    1968-01-01

    Joint repair technique uses a longitudinally split aluminum shield over the joint ferrule and immediately adjacent tubing to reseal or reinforce leaking or weak joints in small tubing. Epoxy resin coating on inside surfaces of the two shield halves provides a tightly sealed bond between shield and tubing.

  16. Phase 1 Program Joint Report

    NASA Technical Reports Server (NTRS)

    Nield, George C. (Editor); Vorobiev, Pavel Mikhailovich (Editor)

    1999-01-01

    This report consists of inputs from each of the Phase I Program Joint Working Groups. The Working Groups were tasked to describe the organizational structure and work processes that they used during the program, joint accomplishments, lessons learned, and applications to the International Space Station Program. This report is a top-level joint reference document that contains information of interest to both countries.

  17. PET image reconstruction: mean, variance, and optimal minimax criterion

    NASA Astrophysics Data System (ADS)

    Liu, Huafeng; Gao, Fei; Guo, Min; Xue, Liying; Nie, Jing; Shi, Pengcheng

    2015-04-01

    Given the noise nature of positron emission tomography (PET) measurements, it is critical to know the image quality and reliability as well as expected radioactivity map (mean image) for both qualitative interpretation and quantitative analysis. While existing efforts have often been devoted to providing only the reconstructed mean image, we present a unified framework for joint estimation of the mean and corresponding variance of the radioactivity map based on an efficient optimal min-max criterion. The proposed framework formulates the PET image reconstruction problem to be a transformation from system uncertainties to estimation errors, where the minimax criterion is adopted to minimize the estimation errors with possibly maximized system uncertainties. The estimation errors, in the form of a covariance matrix, express the measurement uncertainties in a complete way. The framework is then optimized by ∞-norm optimization and solved with the corresponding H∞ filter. Unlike conventional statistical reconstruction algorithms, that rely on the statistical modeling methods of the measurement data or noise, the proposed joint estimation stands from the point of view of signal energies and can handle from imperfect statistical assumptions to even no a priori statistical assumptions. The performance and accuracy of reconstructed mean and variance images are validated using Monte Carlo simulations. Experiments on phantom scans with a small animal PET scanner and real patient scans are also conducted for assessment of clinical potential.

  18. Channeled spectropolarimetry using iterative reconstruction

    NASA Astrophysics Data System (ADS)

    Lee, Dennis J.; LaCasse, Charles F.; Craven, Julia M.

    2016-05-01

    Channeled spectropolarimeters (CSP) measure the polarization state of light as a function of wavelength. Conventional Fourier reconstruction suffers from noise, assumes the channels are band-limited, and requires uniformly spaced samples. To address these problems, we propose an iterative reconstruction algorithm. We develop a mathematical model of CSP measurements and minimize a cost function based on this model. We simulate a measured spectrum using example Stokes parameters, from which we compare conventional Fourier reconstruction and iterative reconstruction. Importantly, our iterative approach can reconstruct signals that contain more bandwidth, an advancement over Fourier reconstruction. Our results also show that iterative reconstruction mitigates noise effects, processes non-uniformly spaced samples without interpolation, and more faithfully recovers the ground truth Stokes parameters. This work offers a significant improvement to Fourier reconstruction for channeled spectropolarimetry.

  19. Preparing for Breast Reconstruction Surgery

    MedlinePlus

    ... after breast reconstruction surgery Preparing for breast reconstruction surgery Your surgeon can help you know what to ... The plan for follow-up Costs Understanding your surgery costs Health insurance policies often cover most or ...

  20. Joint hypermobility syndrome pain.

    PubMed

    Grahame, Rodney

    2009-12-01

    Joint hypermobility syndrome (JHS) was initially defined as the occurrence of musculoskeletal symptoms in the presence of joint laxity and hypermobility in otherwise healthy individuals. It is now perceived as a commonly overlooked, underdiagnosed, multifaceted, and multisystemic heritable disorder of connective tissue (HDCT), which shares many of the phenotypic features of other HDCTs such as Marfan syndrome and Ehlers-Danlos syndrome. Whereas the additional flexibility can confer benefits in terms of mobility and agility, adverse effects of tissue laxity and fragility can give rise to clinical consequences that resonate far beyond the confines of the musculoskeletal system. There is hardly a clinical specialty to be found that is not touched in one way or another by JHS. Over the past decade, it has become evident that of all the complications that may arise in JHS, chronic pain is arguably the most menacing and difficult to treat. PMID:19889283

  1. Analysis of minor fractures associated with joints and faulted joints

    NASA Astrophysics Data System (ADS)

    Cruikshank, Kenneth M.; Zhao, Guozhu; Johnson, Arvid M.

    In this paper, we use fracture mechanics to interpret conditions responsible for secondary cracks that adorn joints and faulted joints in the Entrada Sandstone in Arches National Park, U.S.A. Because the joints in most places accommodated shearing offsets of a few mm to perhaps 1 dm, and thus became faulted joints, some of the minor cracks are due to faulting. However, in a few places where the shearing was zero, one can examine minor cracks due solely to interaction of joint segments at the time they formed. We recognize several types of minor cracks associated with subsequent faulting of the joints. One is the kink, a crack that occurs at the termination of a straight joint and whose trend is abruptly different from that of the joint. Kinks are common and should be studied because they contain a great deal of information about conditions during fracturing. The sense of kinking indicates the sense of shear during faulting: a kink that turns clockwise with respect to the direction of the main joint is a result of right-lateral shear, and a kink that turns counterclockwise is a result of left-lateral shear. Furthermore, the kink angle is related to the ratio of the shear stress responsible for the kinking to the normal stress responsible for the opening of the joint. The amount of opening of a joint at the time it faulted or even at the time the joint itself formed can be estimated by measuring the kink angle and the amount of strike-slip at some point along the faulted joint. Other fractures that form near terminations of pre-existing joints in response to shearing along the joint are horsetail fractures. Similar short fractures can occur anywhere along the length of the joints. The primary value in recognizing these fractures is that they indicate the sense of faulting accommodated by the host fracture and the direction of maximum tension. Even where there has been insignificant regional shearing in the Garden Area, the joints can have ornate terminations. Perhaps

  2. Effects of ACL Reconstruction on In-Vivo, Dynamic Knee Function

    PubMed Central

    Tashman, Scott; Araki, Daisuke

    2012-01-01

    Synopsis The purposes of this article are to discuss key factors for assessing joint function, to present some recent findings and to address the future directions for evaluating the function of the ACL-injured/reconstructed knees. Well-designed studies, using state-of-the art tools to assess knee kinematics under in vivo, dynamic, high-loading conditions, are necessary to evaluate the relative performance of different procedures for restoring normal joint motion. PMID:23177461

  3. Controversies in Parotid Defect Reconstruction.

    PubMed

    Tamplen, Matthew; Knott, P Daniel; Fritz, Michael A; Seth, Rahul

    2016-08-01

    Reconstruction of the parotid defect is a complex topic that encompasses restoration of both facial form and function. The reconstructive surgeon must consider facial contour, avoidance of Frey syndrome, skin coverage, tumor surveillance, potential adjuvant therapy, and facial reanimation when addressing parotid defects. With each defect there are several options within the reconstructive ladder, creating controversies regarding optimal management. This article describes surgical approaches to reconstruction of parotid defects, highlighting areas of controversy. PMID:27400838

  4. Optimized bolted joint

    NASA Technical Reports Server (NTRS)

    Hart-Smith, L. J.; Bunin, B. L.; Watts, D. J. (Inventor)

    1986-01-01

    A method is disclosed for joining segments of the skin of an aircraft. The ends of the skin are positioned in close proximity or abutt each other. The skin is of constant thickness throughout the joint and is sandwiched between splice plates, which taper in thickness from the last to the first bolt rows in order to reduce the stiffness of the splice plate and thereby reduce the load transfer at the location where bypass loads are the highest.

  5. Prosthetic elbow joint

    NASA Technical Reports Server (NTRS)

    Weddendorf, Bruce C. (Inventor)

    1994-01-01

    An artificial, manually positionable elbow joint for use in an upper extremity, above-elbow, prosthetic is described. The prosthesis provides a locking feature that is easily controlled by the wearer. The instant elbow joint is very strong and durable enough to withstand the repeated heavy loadings encountered by a wearer who works in an industrial, construction, farming, or similar environment. The elbow joint of the present invention comprises a turntable, a frame, a forearm, and a locking assembly. The frame generally includes a housing for the locking assembly and two protruding ears. The forearm includes an elongated beam having a cup-shaped cylindrical member at one end and a locking wheel having a plurality of holes along a circular arc on its other end with a central bore for pivotal attachment to the protruding ears of the frame. The locking assembly includes a collar having a central opening with a plurality of internal grooves, a plurality of internal cam members each having a chamfered surface at one end and a V-shaped slot at its other end; an elongated locking pin having a crown wheel with cam surfaces and locking lugs secured thereto; two coiled compression springs; and a flexible filament attached to one end of the elongated locking pin and extending from the locking assembly for extending and retracting the locking pin into the holes in the locking wheel to permit selective adjustment of the forearm relative to the frame. In use, the turntable is affixed to the upper arm part of the prosthetic in the conventional manner, and the cup-shaped cylindrical member on one end of the forearm is affixed to the forearm piece of the prosthetic in the conventional manner. The elbow joint is easily adjusted and locked between maximum flex and extended positions.

  6. Temporomandibular joint dislocation.

    PubMed

    Sharma, Naresh Kumar; Singh, Akhilesh Kumar; Pandey, Arun; Verma, Vishal; Singh, Shreya

    2015-01-01

    Temporomandibular joint (TMJ) dislocation is an uncommon but debilitating condition of the facial skeleton. The condition may be acute or chronic. Acute TMJ dislocation is common in clinical practice and can be managed easily with manual reduction. Chronic recurrent TMJ dislocation is a challenging situation to manage. In this article, we discuss the comprehensive review of the different treatment modalities in managing TMJ dislocation. PMID:26668447

  7. Temporomandibular joint dislocation

    PubMed Central

    Sharma, Naresh Kumar; Singh, Akhilesh Kumar; Pandey, Arun; Verma, Vishal; Singh, Shreya

    2015-01-01

    Temporomandibular joint (TMJ) dislocation is an uncommon but debilitating condition of the facial skeleton. The condition may be acute or chronic. Acute TMJ dislocation is common in clinical practice and can be managed easily with manual reduction. Chronic recurrent TMJ dislocation is a challenging situation to manage. In this article, we discuss the comprehensive review of the different treatment modalities in managing TMJ dislocation. PMID:26668447

  8. The neuropathic joint.

    PubMed

    Sequeira, W

    1994-01-01

    Neuropathic arthritis is a destructive arthropathy frequently associated with loss of proprioception. A third of patients, however, may have no demonstrable neurological deficit. Patients with diabetes, syphilis, syringomyelia and other neuropathies are particularly prone to developing this joint disease. The diagnosis of Charcot's joints should be considered in anyone who develops what appears to be a severe osteoarthritis or a transverse fracture of the tibia or fibula after minor trauma. Scoliosis with particularly destructive changes on radiography should prompt a search for syringomyelia or syphilis. The most common radiographic abnormalities are those of distension in 3D (Dislocation, Destruction and Degeneration). An atrophic form with resorption of the proximal humerus, most frequently described in syringomyelia, has been observed in diabetes. Loss of the distal end of the clavicle has not been described before in the neuropathies. These changes coupled with speckled calcification or shards of bone in the periarticular soft tissue confirm the diagnosis. Infection and CPPD crystal disease can be difficult to exclude. The joint fluid may be inflammatory and infection may be a complication. Treatment includes anti-inflammatories and splinting. Indications for surgery are limited. PMID:8070170

  9. Formation of tough composite joints

    SciTech Connect

    Brun, M.K.

    1997-05-01

    Joints which exhibit tough fracture behavior were formed in a composite with a Si/SiC matrix reinforced with Textron SCS-6 fibers with either boron nitride or silicon nitride fiber coatings. In composites with BN coatings fibers were aligned uniaxially, while composites with Si{sub 3}N{sub 4}-coated fibers had a 0/90{degree} architecture. Lapped joints (joints with overlapping fingers) were necessary to obtain tough behavior. Geometrical requirements necessary to avoid brittle joint failure have been proposed. Joints with a simple overlap geometry (only a few fingers) would have to be very long in order to prevent brittle failure. Typical failure in these joints is caused by a crack propagating along the interfaces between the joint fingers. Joints of the same overall length, but with geometry changed to be symmetric about the joint centerline and with an extra shear surface exhibited tough fractures accompanied with extensive fiber pullout. The initial matrix cracking of these joints was relatively low because cracks propagated easily through the ends of the fingers. Joints with an optimized stepped sawtooth geometry produced composite-like failures with the stress/strain curves containing an elastic region followed by a region of rising stress with an increase of strain. Increasing the fiber/matrix interfacial strength from 9 to 25 MPa, by changing the fiber coating, increased matrix cracking and ultimate strength of the composite significantly. The best joints had matrix cracking stress and ultimate strength of 138 and 240 MPa, respectively. Joint failure was preceded by multiple matrix cracking in the entire composite. The high strength of the joints will permit building of structures containing joints with only a minor reduction of design stresses.

  10. Finite element analysis of human joints

    SciTech Connect

    Bossart, P.L.; Hollerbach, K.

    1996-09-01

    Our work focuses on the development of finite element models (FEMs) that describe the biomechanics of human joints. Finite element modeling is becoming a standard tool in industrial applications. In highly complex problems such as those found in biomechanics research, however, the full potential of FEMs is just beginning to be explored, due to the absence of precise, high resolution medical data and the difficulties encountered in converting these enormous datasets into a form that is usable in FEMs. With increasing computing speed and memory available, it is now feasible to address these challenges. We address the first by acquiring data with a high resolution C-ray CT scanner and the latter by developing semi-automated method for generating the volumetric meshes used in the FEM. Issues related to tomographic reconstruction, volume segmentation, the use of extracted surfaces to generate volumetric hexahedral meshes, and applications of the FEM are described.

  11. Cartilage tissue engineering for degenerative joint disease.

    PubMed

    Nesic, Dobrila; Whiteside, Robert; Brittberg, Mats; Wendt, David; Martin, Ivan; Mainil-Varlet, Pierre

    2006-05-20

    Pain in the joint is often due to cartilage degeneration and represents a serious medical problem affecting people of all ages. Although many, mostly surgical techniques, are currently employed to treat cartilage lesions, none has given satisfactory results in the long term. Recent advances in biology and material science have brought tissue engineering to the forefront of new cartilage repair techniques. The combination of autologous cells, specifically designed scaffolds, bioreactors, mechanical stimulations and growth factors together with the knowledge that underlies the principles of cell biology offers promising avenues for cartilage tissue regeneration. The present review explores basic biology mechanisms for cartilage reconstruction and summarizes the advances in the tissue engineering approaches. Furthermore, the limits of the new methods and their potential application in the osteoarthritic conditions are discussed. PMID:16574268

  12. Tibiofemoral cartilage contact biomechanics in patients after reconstruction of a ruptured anterior cruciate ligament.

    PubMed

    Hosseini, Ali; Van de Velde, Samuel; Gill, Thomas J; Li, Guoan

    2012-11-01

    We investigated the in vivo cartilage contact biomechanics of the tibiofemoral joint in patients after reconstruction of a ruptured anterior cruciate ligament (ACL). A dual fluoroscopic and MR imaging technique was used to investigate the cartilage contact biomechanics of the tibiofemoral joint during in vivo weight-bearing flexion of the knee in eight patients 6 months following clinically successful reconstruction of an acute isolated ACL rupture. The location of tibiofemoral cartilage contact, size of the contact area, cartilage thickness at the contact area, and magnitude of the cartilage contact deformation of the ACL-reconstructed knees were compared with those previously measured in intact (contralateral) knees and ACL-deficient knees of the same subjects. Contact biomechanics of the tibiofemoral cartilage after ACL reconstruction were similar to those measured in intact knees. However, at lower flexion, the abnormal posterior and lateral shift of cartilage contact location to smaller regions of thinner tibial cartilage that has been described in ACL-deficient knees persisted in ACL-reconstructed knees, resulting in an increase of the magnitude of cartilage contact deformation at those flexion angles. Reconstruction of the ACL restored some of the in vivo cartilage contact biomechanics of the tibiofemoral joint to normal. Clinically, recovering anterior knee stability might be insufficient to prevent post-operative cartilage degeneration due to lack of restoration of in vivo cartilage contact biomechanics. PMID:22528687

  13. Algebraic reconstruction techniques for spectral reconstruction in diffuse optical tomography

    SciTech Connect

    Brendel, Bernhard; Ziegler, Ronny; Nielsen, Tim

    2008-12-01

    Reconstruction in diffuse optical tomography (DOT) necessitates solving the diffusion equation, which is nonlinear with respect to the parameters that have to be reconstructed. Currently applied solving methods are based on the linearization of the equation. For spectral three-dimensional reconstruction, the emerging equation system is too large for direct inversion, but the application of iterative methods is feasible. Computational effort and speed of convergence of these iterative methods are crucial since they determine the computation time of the reconstruction. In this paper, the iterative methods algebraic reconstruction technique (ART) and conjugated gradients (CGs) as well as a new modified ART method are investigated for spectral DOT reconstruction. The aim of the modified ART scheme is to speed up the convergence by considering the specific conditions of spectral reconstruction. As a result, it converges much faster to favorable results than conventional ART and CG methods.

  14. Improved high-temperature gimbal joint

    NASA Technical Reports Server (NTRS)

    Winemiller, J. R.; Yee, S. T.; Neal, B. H.

    1972-01-01

    Development and characteristics of bellows gimbal joint for reduction of thermal stress effects are discussed. Reactions of designed joint to changes in temperature are described. Illustrations of conventional gimbal joint and improved gimbal joint are provided.

  15. Formation of tough composite joints

    SciTech Connect

    Brun, M.K.

    1998-12-01

    Joints that exhibited tough fracture behavior were formed in a Si/SiC matrix reinforced with Textron SCS-6 fibers with either boron nitride or silicon nitride fiber coatings. Lapped joints (joints with overlapping fingers) were necessary to obtain tough behavior. Geometrical requirements necessary to avoid brittle joint failure were proposed. Joints with a simple overlap geometry (only a few fingers) had to be very long in order to prevent brittle failure. Joints with an optimized stepped sawtooth geometry produced composite-like failures with the stress/strain curves containing an elastic region followed by a region of rising stress with an increase of strain. Increasing the fiber/matrix interfacial strength, by changing the fiber coating, significantly increased matrix cracking and ultimate strength of the joints. The best joints had matrix cracking stress and ultimate strength of 138 and 240 MPa, respectively. Joint failure was preceded by multiple matrix cracking in the entire composite. The high strength of the joints should permit building of structures containing joints with only a minor reduction of design stresses.

  16. Stochastic reconstruction of sandstones

    PubMed

    Manwart; Torquato; Hilfer

    2000-07-01

    A simulated annealing algorithm is employed to generate a stochastic model for a Berea sandstone and a Fontainebleau sandstone, with each a prescribed two-point probability function, lineal-path function, and "pore size" distribution function, respectively. We find that the temperature decrease of the annealing has to be rather quick to yield isotropic and percolating configurations. A comparison of simple morphological quantities indicates good agreement between the reconstructions and the original sandstones. Also, the mean survival time of a random walker in the pore space is reproduced with good accuracy. However, a more detailed investigation by means of local porosity theory shows that there may be significant differences of the geometrical connectivity between the reconstructed and the experimental samples. PMID:11088546

  17. LOFAR sparse image reconstruction

    NASA Astrophysics Data System (ADS)

    Garsden, H.; Girard, J. N.; Starck, J. L.; Corbel, S.; Tasse, C.; Woiselle, A.; McKean, J. P.; van Amesfoort, A. S.; Anderson, J.; Avruch, I. M.; Beck, R.; Bentum, M. J.; Best, P.; Breitling, F.; Broderick, J.; Brüggen, M.; Butcher, H. R.; Ciardi, B.; de Gasperin, F.; de Geus, E.; de Vos, M.; Duscha, S.; Eislöffel, J.; Engels, D.; Falcke, H.; Fallows, R. A.; Fender, R.; Ferrari, C.; Frieswijk, W.; Garrett, M. A.; Grießmeier, J.; Gunst, A. W.; Hassall, T. E.; Heald, G.; Hoeft, M.; Hörandel, J.; van der Horst, A.; Juette, E.; Karastergiou, A.; Kondratiev, V. I.; Kramer, M.; Kuniyoshi, M.; Kuper, G.; Mann, G.; Markoff, S.; McFadden, R.; McKay-Bukowski, D.; Mulcahy, D. D.; Munk, H.; Norden, M. J.; Orru, E.; Paas, H.; Pandey-Pommier, M.; Pandey, V. N.; Pietka, G.; Pizzo, R.; Polatidis, A. G.; Renting, A.; Röttgering, H.; Rowlinson, A.; Schwarz, D.; Sluman, J.; Smirnov, O.; Stappers, B. W.; Steinmetz, M.; Stewart, A.; Swinbank, J.; Tagger, M.; Tang, Y.; Tasse, C.; Thoudam, S.; Toribio, C.; Vermeulen, R.; Vocks, C.; van Weeren, R. J.; Wijnholds, S. J.; Wise, M. W.; Wucknitz, O.; Yatawatta, S.; Zarka, P.; Zensus, A.

    2015-03-01

    Context. The LOw Frequency ARray (LOFAR) radio telescope is a giant digital phased array interferometer with multiple antennas distributed in Europe. It provides discrete sets of Fourier components of the sky brightness. Recovering the original brightness distribution with aperture synthesis forms an inverse problem that can be solved by various deconvolution and minimization methods. Aims: Recent papers have established a clear link between the discrete nature of radio interferometry measurement and the "compressed sensing" (CS) theory, which supports sparse reconstruction methods to form an image from the measured visibilities. Empowered by proximal theory, CS offers a sound framework for efficient global minimization and sparse data representation using fast algorithms. Combined with instrumental direction-dependent effects (DDE) in the scope of a real instrument, we developed and validated a new method based on this framework. Methods: We implemented a sparse reconstruction method in the standard LOFAR imaging tool and compared the photometric and resolution performance of this new imager with that of CLEAN-based methods (CLEAN and MS-CLEAN) with simulated and real LOFAR data. Results: We show that i) sparse reconstruction performs as well as CLEAN in recovering the flux of point sources; ii) performs much better on extended objects (the root mean square error is reduced by a factor of up to 10); and iii) provides a solution with an effective angular resolution 2-3 times better than the CLEAN images. Conclusions: Sparse recovery gives a correct photometry on high dynamic and wide-field images and improved realistic structures of extended sources (of simulated and real LOFAR datasets). This sparse reconstruction method is compatible with modern interferometric imagers that handle DDE corrections (A- and W-projections) required for current and future instruments such as LOFAR and SKA.

  18. Reconstruction of vaginal agenesis.

    PubMed

    Ozkan, Ozlenen; Erman Akar, Münire; Ozkan, Omer; Doğan, N Utku

    2011-06-01

    Vaginal ageneses are by no means rare anomalies. Complete Mullerian agenesis is the most common reason for vaginal agenesis requiring reconstruction. Patients usually present with pain, hematocolpos, or hematometra in puberty, and later with amenorrhea and dyspareunia. Detailed information is given here regarding etiologies, timing of surgery, and current treatment options for vaginal agenesis. Outcomes and short- and long-term complications of recent treatment options are also discussed. PMID:21372677

  19. [Reconstruction of pulpectomized teeth].

    PubMed

    Colon, P; Picard, B

    1990-04-01

    The general principles governing the choice of materials for reconstruction of devitalized teeth are determined on the basis of mechanical and biological imperatives as well as degradation phenomena. In describing the various techniques for clinical implementation, particular emphasis is placed on the imperatives and limitations of each protocol. A decisive factor in the durability of restorations is their homogeneity, as well as the clinical conditions under which they are performed. PMID:2135782

  20. Secondary femoropopliteal reconstruction.

    PubMed Central

    Whittemore, A D; Clowes, A W; Couch, N P; Mannick, J A

    1981-01-01

    Retrospective analysis of the authors' experience with 109 primary femoropopliteal bypass vein grafts that failed allows description of three distinct modes of failure. Within 30 days of surgery, failure resulted primarily from technical or judgmental errors. The development of stenotic lesions within the vein graft caused a second group of failures during the first year after bypass. The third group most commonly failed due to progression of peripheral atherosclerosis a year or more following original bypass. No correlation was found, however, between the mode of failure and results of secondary femoropopliteal-tibial reconstruction, which yielded an overall 50% five-year cumulative limb salvage rate. The results indicate that this salvage rate can be anticipated regardless of the number of secondary operations required. The highest long-term patency rate was achieved when frequent postoperative follow-up examinations allowed recognition of graft failure prior to total occlusion. Under such circumstances a simple vein patch of stenotic lesions yielded an 85% five-year graft patency. Following actual thrombosis, however, the highest five-year patency rate was achieved when reconstruction was performed using a new vein graft; saphenous vein and arm vein were equally effective. When prosthetic material was used, no secondary graft remained patent beyond three years. Finally, when a proximal or distal portion of the original vein graft proved adequate in caliber following thrombectomy, it could be successfully incorporated in a secondary reconstruction with the expectation of a 50% five-year limb salvage rate. No statistically significant difference was found in salvage rates among each of the patient groups representing the three common modes of graft failure. This finding, coupled with an acceptable 2.5% operative mortality rate, provides justification for an aggressive approach toward secondary femoropopliteal reconstruction. Images Fig. 1a. Fig. 1c. PMID:7458449

  1. Kinky tomographic reconstruction

    SciTech Connect

    Hanson, K.M.; Cunningham, G.S.; Bilisoly, R.L.

    1996-05-01

    We address the issue of how to make decisions about the degree of smoothness demanded of a flexible contour used to model the boundary of a 2D object. We demonstrate the use of a Bayesian approach to set the strength of the smoothness prior for a tomographic reconstruction problem. The Akaike Information Criterion is used to determine whether to allow a kink in the contour.

  2. Paleoproductivity Reconstructions Using Radiolarians

    NASA Astrophysics Data System (ADS)

    Lazarus, D. B.

    2003-12-01

    This talk reviews the use of radiolarian assemblages in paleoproductivity reconstruction. Molina-Cruz and CLIMAP co-workers first identified a distinct radiolarian assemblage whose modern geographic distribution closely matched that of an upwelling region (eastern Pacific Peru-Chile). Nigrini and Caulet subsequently identified additional species largely endemic to various upwelling environments. They applied this in the form of an Upwelling Radiolarian Index (URI) in down-core studies of upwelling history. Recently, Jacot des Combes and Weinheimer have used published distributions of living radiolarians in the water-column to assign fossil taxa to surface vs subsurface groups. They used ratios of thermocline to surface taxa (e.g., the Thermocline to Surface Radiolarian Index, or TSRI), which measures relative enhancement of thermocline to surface radiolarian production in regions of upwelling, to reconstruct past ocean productivity. Both methods appear to perform well, although neither is always reliable. Both the URI and TSRI methods are based on a small number of taxa (ca. 10 each), although biogeographic and water depth information are now available for ca. 100 living species. The use of additional taxa should make reconstructions more robust by reducing the effects of single species ecology, and making index values less sensitive to evolutionary changes in taxa over Neogene time intervals. Taxonomic assemblage reconstructions of productivity have some inherent advantages over bulk flux proxies, being less sensitive to preservation problems or the age model employed. Radiolarian assemblages are particularly useful in upwelling regions where carbonate fossils are poorly preserved. All are however limited by our sparse knowledge of the ecology of the various species used. Among the major microfossil groups, radiolarian ecology and biology are in particular relatively poorly known; even the descriptive taxonomy of living species is not yet complete. Despite these

  3. Bayesian image reconstruction in astronomy

    NASA Astrophysics Data System (ADS)

    Nunez, Jorge; Llacer, Jorge

    1990-09-01

    This paper presents the development and testing of a new iterative reconstruction algorithm for astronomy. A maximum a posteriori method of image reconstruction in the Bayesian statistical framework is proposed for the Poisson-noise case. The method uses the entropy with an adjustable 'sharpness parameter' to define the prior probability and the likelihood with 'data increment' parameters to define the conditional probability. The method makes it possible to obtain reconstructions with neither the problem of the 'grey' reconstructions associated with the pure Bayesian reconstructions nor the problem of image deterioration, typical of the maximum-likelihood method. The present iterative algorithm is fast and stable, maintains positivity, and converges to feasible images.

  4. Sparse decomposition learning based dynamic MRI reconstruction

    NASA Astrophysics Data System (ADS)

    Zhu, Peifei; Zhang, Qieshi; Kamata, Sei-ichiro

    2015-02-01

    Dynamic MRI is widely used for many clinical exams but slow data acquisition becomes a serious problem. The application of Compressed Sensing (CS) demonstrated great potential to increase imaging speed. However, the performance of CS is largely depending on the sparsity of image sequence in the transform domain, where there are still a lot to be improved. In this work, the sparsity is exploited by proposed Sparse Decomposition Learning (SDL) algorithm, which is a combination of low-rank plus sparsity and Blind Compressed Sensing (BCS). With this decomposition, only sparsity component is modeled as a sparse linear combination of temporal basis functions. This enables coefficients to be sparser and remain more details of dynamic components comparing learning the whole images. A reconstruction is performed on the undersampled data where joint multicoil data consistency is enforced by combing Parallel Imaging (PI). The experimental results show the proposed methods decrease about 15~20% of Mean Square Error (MSE) compared to other existing methods.

  5. Optimized Quasi-Interpolators for Image Reconstruction.

    PubMed

    Sacht, Leonardo; Nehab, Diego

    2015-12-01

    We propose new quasi-interpolators for the continuous reconstruction of sampled images, combining a narrowly supported piecewise-polynomial kernel and an efficient digital filter. In other words, our quasi-interpolators fit within the generalized sampling framework and are straightforward to use. We go against standard practice and optimize for approximation quality over the entire Nyquist range, rather than focusing exclusively on the asymptotic behavior as the sample spacing goes to zero. In contrast to previous work, we jointly optimize with respect to all degrees of freedom available in both the kernel and the digital filter. We consider linear, quadratic, and cubic schemes, offering different tradeoffs between quality and computational cost. Experiments with compounded rotations and translations over a range of input images confirm that, due to the additional degrees of freedom and the more realistic objective function, our new quasi-interpolators perform better than the state of the art, at a similar computational cost. PMID:26390452

  6. 17 CFR 300.105 - Joint accounts.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Joint accounts. 300.105... Customers of Sipc Members § 300.105 Joint accounts. (a) A joint account shall be deemed to be a “qualifying joint account” if it is owned jointly, whether by the owners thereof as joint tenants with the right...

  7. 49 CFR 213.351 - Rail joints.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 4 2013-10-01 2013-10-01 false Rail joints. 213.351 Section 213.351... Rail joints. (a) Each rail joint, insulated joint, and compromise joint shall be of a structurally sound design and dimensions for the rail on which it is applied. (b) If a joint bar is cracked,...

  8. 49 CFR 213.351 - Rail joints.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 4 2011-10-01 2011-10-01 false Rail joints. 213.351 Section 213.351... Rail joints. (a) Each rail joint, insulated joint, and compromise joint shall be of a structurally sound design and dimensions for the rail on which it is applied. (b) If a joint bar is cracked,...

  9. 17 CFR 300.105 - Joint accounts.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 17 Commodity and Securities Exchanges 3 2012-04-01 2012-04-01 false Joint accounts. 300.105... Customers of Sipc Members § 300.105 Joint accounts. (a) A joint account shall be deemed to be a “qualifying joint account” if it is owned jointly, whether by the owners thereof as joint tenants with the right...

  10. 49 CFR 213.351 - Rail joints.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 4 2014-10-01 2014-10-01 false Rail joints. 213.351 Section 213.351... Rail joints. (a) Each rail joint, insulated joint, and compromise joint shall be of a structurally sound design and dimensions for the rail on which it is applied. (b) If a joint bar is cracked,...

  11. 17 CFR 300.105 - Joint accounts.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 17 Commodity and Securities Exchanges 3 2013-04-01 2013-04-01 false Joint accounts. 300.105... Customers of Sipc Members § 300.105 Joint accounts. (a) A joint account shall be deemed to be a “qualifying joint account” if it is owned jointly, whether by the owners thereof as joint tenants with the right...

  12. 17 CFR 300.105 - Joint accounts.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 17 Commodity and Securities Exchanges 4 2014-04-01 2014-04-01 false Joint accounts. 300.105... Customers of Sipc Members § 300.105 Joint accounts. (a) A joint account shall be deemed to be a “qualifying joint account” if it is owned jointly, whether by the owners thereof as joint tenants with the right...

  13. 49 CFR 213.351 - Rail joints.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 4 2012-10-01 2012-10-01 false Rail joints. 213.351 Section 213.351... Rail joints. (a) Each rail joint, insulated joint, and compromise joint shall be of a structurally sound design and dimensions for the rail on which it is applied. (b) If a joint bar is cracked,...

  14. 17 CFR 300.105 - Joint accounts.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 17 Commodity and Securities Exchanges 3 2011-04-01 2011-04-01 false Joint accounts. 300.105... Customers of Sipc Members § 300.105 Joint accounts. (a) A joint account shall be deemed to be a “qualifying joint account” if it is owned jointly, whether by the owners thereof as joint tenants with the right...

  15. Small joint arthroscopy in foot and ankle.

    PubMed

    Lui, Tun Hing; Yuen, Chi Pan

    2015-03-01

    The clinical application of small joint arthroscopies (metatarsophalangeal joint, Lisfranc joint, Chopart joint, and interphlangeal joint) in the foot has seen significant advancements in the past decades. This article reviews the clinical indications, technical details, outcomes, and potential complications of small joint arthroscopies of the foot. PMID:25726488

  16. Unbiased measurements of reconstruction fidelity of sparsely sampled magnetic resonance spectra.

    PubMed

    Wu, Qinglin; Coggins, Brian E; Zhou, Pei

    2016-01-01

    The application of sparse-sampling techniques to NMR data acquisition would benefit from reliable quality measurements for reconstructed spectra. We introduce a pair of noise-normalized measurements, and , for differentiating inadequate modelling from overfitting. While and can be used jointly for methods that do not enforce exact agreement between the back-calculated time domain and the original sparse data, the cross-validation measure is applicable to all reconstruction algorithms. We show that the fidelity of reconstruction is sensitive to changes in and that model overfitting results in elevated and reduced spectral quality. PMID:27459896

  17. Unbiased measurements of reconstruction fidelity of sparsely sampled magnetic resonance spectra

    PubMed Central

    Wu, Qinglin; Coggins, Brian E.; Zhou, Pei

    2016-01-01

    The application of sparse-sampling techniques to NMR data acquisition would benefit from reliable quality measurements for reconstructed spectra. We introduce a pair of noise-normalized measurements, and , for differentiating inadequate modelling from overfitting. While and can be used jointly for methods that do not enforce exact agreement between the back-calculated time domain and the original sparse data, the cross-validation measure is applicable to all reconstruction algorithms. We show that the fidelity of reconstruction is sensitive to changes in and that model overfitting results in elevated and reduced spectral quality. PMID:27459896

  18. Unbiased measurements of reconstruction fidelity of sparsely sampled magnetic resonance spectra

    NASA Astrophysics Data System (ADS)

    Wu, Qinglin; Coggins, Brian E.; Zhou, Pei

    2016-07-01

    The application of sparse-sampling techniques to NMR data acquisition would benefit from reliable quality measurements for reconstructed spectra. We introduce a pair of noise-normalized measurements, and , for differentiating inadequate modelling from overfitting. While and can be used jointly for methods that do not enforce exact agreement between the back-calculated time domain and the original sparse data, the cross-validation measure is applicable to all reconstruction algorithms. We show that the fidelity of reconstruction is sensitive to changes in and that model overfitting results in elevated and reduced spectral quality.

  19. Image reconstruction from phased-array data based on multichannel blind deconvolution.

    PubMed

    She, Huajun; Chen, Rong-Rong; Liang, Dong; Chang, Yuchou; Ying, Leslie

    2015-11-01

    In this paper we consider image reconstruction from fully sampled multichannel phased array MRI data without knowledge of the coil sensitivities. To overcome the non-uniformity of the conventional sum-of-square reconstruction, a new framework based on multichannel blind deconvolution (MBD) is developed for joint estimation of the image function and the sensitivity functions in image domain. The proposed approach addresses the non-uniqueness of the MBD problem by exploiting the smoothness of both functions in the image domain through regularization. Results using simulation, phantom and in vivo experiments demonstrate that the reconstructions by the proposed algorithm are more uniform than those by the existing methods. PMID:26119418

  20. Synostosis of the proximal tibiofibular joint.

    PubMed

    Sferopoulos, Nikolaos K

    2010-01-01

    The incidence of synostosis of the proximal tibiofibular joint (TFJ) was assessed among 1029 patients examined for osteoarthritis of the knee in a 4-year period. Radiographic evidence of a synostosis of the proximal TFJ was demonstrated in 3 knees (3 patients). The synostosis appeared incidental and was not the cause of symptoms in any of them. These patients were further examined with MRI and/or CT scans. In two cases, which were found to be primary (idiopathic), the synostosis was complete and bony. In a third case the lesion was secondary (acquired) to surgical reconstruction for a depressed fracture of the lateral tibial plateau. This iatrogenic complication followed open reduction, internal fixation, and grafting with synthetic bone. The bridging of the joint on the CT views was partial and compatible with ectopic calcification rather than ossification. The patients were treated conservatively and were followed for an average period of 3 years. No evidence that the synostosis accelerated the onset or progression of the degenerative changes to the ipsilateral knee could be verified. PMID:20592991

  1. Synostosis of the Proximal Tibiofibular Joint

    PubMed Central

    Sferopoulos, Nikolaos K.

    2010-01-01

    The incidence of synostosis of the proximal tibiofibular joint (TFJ) was assessed among 1029 patients examined for osteoarthritis of the knee in a 4-year period. Radiographic evidence of a synostosis of the proximal TFJ was demonstrated in 3 knees (3 patients). The synostosis appeared incidental and was not the cause of symptoms in any of them. These patients were further examined with MRI and/or CT scans. In two cases, which were found to be primary (idiopathic), the synostosis was complete and bony. In a third case the lesion was secondary (acquired) to surgical reconstruction for a depressed fracture of the lateral tibial plateau. This iatrogenic complication followed open reduction, internal fixation, and grafting with synthetic bone. The bridging of the joint on the CT views was partial and compatible with ectopic calcification rather than ossification. The patients were treated conservatively and were followed for an average period of 3 years. No evidence that the synostosis accelerated the onset or progression of the degenerative changes to the ipsilateral knee could be verified. PMID:20592991

  2. [Capsular ligament lesions of the knee joint. Conservative and surgical treatment].

    PubMed

    Gradinger, R; Haller, W; Rodammer, G; Rechl, H

    1989-02-28

    On the basis of our experience with more than 600 reconstructed capsular ligament injuries of the knee joint, we conclude that conservative functional treatment should be preserved for patients with capsular ligament lesions with no loss of stability. On an individual basis, it must be decided whether, in the event of a more or less large degree of instability presenting, conservative mobilising treatment (patients older than 45 years), or surgical reconstructive treatment should be provided. Surgical procedures aim at achieving anatomical reconstruction, which is only approximately possible with secondary reconstruction in the presence of chronic instability. For the reconstruction of the anterior cruciate ligament, the use of the semitendinosus tendon for reinforcement with possible reattachment of the cruciate ligament can be recommended. Otherwise, the free patellar ligament transplant, as far as possible with additional synovialisation--which permits better revitalisation of the ligament--should be employed. PMID:2703203

  3. Joint bone radiobiology workshop

    SciTech Connect

    Tomich, P.A.

    1991-01-01

    The Joint Bone Radiobiology Workshop was held on July 12--13, 1991 in Toronto, Canada. This document contains the papers presented at the meeting. The five sections were: Dose-effects, Endogenous Cofactors, Tumorigenesis, New Methods and Medical Implications. The papers covered risk assessment, tissue distribution of radionuclides, lifetime studies, biological half-lifes, the influence of age at time of exposure, tumor induction by different radionuclides, microscopic localization of radionuclides, and nuclear medicine issues including tissue distribution in the skeleton and bone marrow transplantation. (MHB)

  4. Joint hypermobility syndrome.

    PubMed

    Fikree, Asma; Aziz, Qasim; Grahame, Rodney

    2013-05-01

    Although perceived as a rare condition, joint hypermobility syndrome is common. Its prevalence in rheumatology clinics is extremely high. Early estimates suggest that it may be the most common of all rheumatologic conditions. The problem lies in the general lack of awareness of the syndrome, its means of recognition, and the resultant failure to diagnose it correctly when present. It is a worldwide problem. This article provides an overview of hypermobility and hypermobility syndrome, stressing its multisystemic nature and the negative impact that it may have on quality of life, with particular reference to gastrointestinal involvement. PMID:23597972

  5. Tarsometatarsal/Lisfranc joint.

    PubMed

    DiDomenico, Lawrence A; Cross, Davi

    2012-04-01

    Accurate early diagnosis with adequate reduction and maintenance of anatomic alignment of the dislocation or fracture within the Lisfranc joint complex have been found to be the key to successful outcomes regarding this injury. Because of the anatomic variations, the thin soft tissue envelop, and the abundance of ligamentous and capsular structures in the region, repair of these injuries can be a challenge. The classification systems used to describe these injuries aid in describing the mechanism of injury or displacement type present, which may aid in determining what treatment modality can provide the best outcome. PMID:22424486

  6. Optical rotary joint

    NASA Astrophysics Data System (ADS)

    May, R. G., Jr.

    1982-06-01

    The primary objective of this contract is the design, fabrication, and testing of an optical rotary joint which permits transmission of signals through optical fibers across the interface of two environments rotating relative to each other. Outstanding optical performance is achieved through the use of gradient index lenses to couple radiation across the separation between two fibers. The salient features of this device are bidirectional operation at two wavelengths (850 nm and 1300 nm), low insertion loss, low rotationally induced variation of attenuation, a seven-circuit electrical slip-ring assembly, and rugged construction. The device is designed to facilitate the application of future designs to pressurized, subsea environments.

  7. Bladder operated robotic joint

    NASA Technical Reports Server (NTRS)

    Robertson, Glen A. (Inventor)

    1993-01-01

    This invention is a robotic joint which is operated by inflatable bladders and which can be used in applications where it is desired to move or hold an object. A support block supports an elongated plate to which is pivotally attached a finger. A tension strip passes over a lever attached to the finger and is attached at its ends to the support block on opposite sides of the plate. Bladders positioned between the plate and the tension strip on opposite sides of the plate can be inflated by pumps to pivot the finger, with one of the bladders being inflated while the other is being deflated.

  8. Digital resection and reconstruction of TMJ synovial chondrosarcoma involving the skull base: report of a case

    PubMed Central

    Ye, Zhou-Xi; Yang, Chi; Chen, Min-Jie; Huang, Dong; Abdelrehem, Ahmed

    2015-01-01

    Synovial chondrosarcoma (SCS) is a very rare malignant cartilaginous tumor. To the best of our knowledge, only three reported studies presented the involvement of the temporomandibular joint (TMJ). Hereby, we present a case of surgical management of a SCS of the TMJ, arising from SC and involving the skull base. The surgical procedure includes digital design, resection guided by digital templates, as well as immediate reconstruction with free iliac bone graft (IBG) and pedicled sternoclavicular joint (SCJ). At 1-year follow-up, the TMJ function and form were improved with no sign of local recurrence or metastasis to bone or other joints. However, its distant metastasis to lung was observed. PMID:26379987

  9. Optical tomographic imaging of vascular and metabolic reactivity in rheumatoid joints

    NASA Astrophysics Data System (ADS)

    Lasker, Joseph M.; Dwyer, Edward; Hielscher, Andreas H.

    2005-04-01

    Our group has recently established that joints affected by Rheumatoid Arthritis (RA) can be distinguished from healthy joints through measurements of the scattering coefficient. We showed that a high scattering coefficient in the center of the joint is indicative of a joint with RA. While these results were encouraging, data to date still suffers from low sensitivity and specificity. Possibly higher specificities and sensitivities can be achieved if dynamic measurements of hemodynamic and metabolic processes in the synovium are considered. Using our dual-wavelength imaging system together with previously implemented model-based iterative image reconstruction schemes, we have performed initial dynamic imaging studies involving healthy human volunteers and patients affected by RA. These case studies seem to confirm our hypothesis that differences in the vascular reactivity exist between affected and unaffected joints.

  10. Quantitative three-dimensional photoacoustic tomography of the finger joints: an in vivo study

    NASA Astrophysics Data System (ADS)

    Sun, Yao; Sobel, Eric; Jiang, Huabei

    2009-11-01

    We present for the first time in vivo full three-dimensional (3-D) photoacoustic tomography (PAT) of the distal interphalangeal joint in a human subject. Both absorbed energy density and absorption coefficient images of the joint are quantitatively obtained using our finite-element-based photoacoustic image reconstruction algorithm coupled with the photon diffusion equation. The results show that major anatomical features in the joint along with the side arteries can be imaged with a 1-MHz transducer in a spherical scanning geometry. In addition, the cartilages associated with the joint can be quantitatively differentiated from the phalanx. This in vivo study suggests that the 3-D PAT method described has the potential to be used for early diagnosis of joint diseases such as osteoarthritis and rheumatoid arthritis.

  11. Simultaneous Volar Dislocations of Carpometacarpal and Metacarpophalangeal Joints of the Thumb

    PubMed Central

    Khan, Hayat; Darcy, Peter; Magnussen, Peter

    2012-01-01

    Introduction: Multiple dislocations of joints in the hand are rare. Double dislocations of the thumb joints have only been reported on four previous occasions, in all cases reported to date, the joints have dislocated dorsally. Case Report: We present the case of a 26-year-old male patient with simultaneous volar dislocations of the carpometacarpal and metacarpophalangeal joints of the thumb. There was delayed operative treatment of this injury with ligament reconstruction and stabilization of the metacarpophalangeal joint. Conclusions: This rare case provides a mechanism to this type of injury, highlights the importance of initial, and repeated clinical and radiographic review, highlights the soft tissue component to this injury, and demonstrates how even delayed treatment can result in a good functional outcome.

  12. On representations for joint moments using a joint coordinate system.

    PubMed

    O'Reilly, Oliver M; Sena, Mark P; Feeley, Brian T; Lotz, Jeffrey C

    2013-11-01

    In studies of the biomechanics of joints, the representation of moments using the joint coordinate system has been discussed by several authors. The primary purpose of this technical brief is to emphasize that there are two distinct, albeit related, representations for moment vectors using the joint coordinate system. These distinct representations are illuminated by exploring connections between the Euler and dual Euler bases, the "nonorthogonal projections" presented in a recent paper by Desroches et al. (2010, "Expression of Joint Moment in the Joint Coordinate System," ASME J. Biomech. Eng., 132(11), p. 11450) and seminal works by Grood and Suntay (Grood and Suntay, 1983, "A Joint Coordinate System for the Clinical Description of Three-Dimensional Motions: Application to the Knee," ASME J. Biomech. Eng., 105(2), pp. 136-144) and Fujie et al. (1996, "Forces and Moment in Six-DOF at the Human Knee Joint: Mathematical Description for Control," Journal of Biomechanics, 29(12), pp. 1577-1585) on the knee joint. It is also shown how the representation using the dual Euler basis leads to straightforward definition of joint stiffnesses. PMID:24008987

  13. PROPRIOCEPTION, BODY BALANCE AND FUNCTIONALITY IN INDIVIDUALS WITH ACL RECONSTRUCTION

    PubMed Central

    Furlanetto, Tássia Silveira; Peyré-Tartaruga, Leonardo Alexandre; do Pinho, Alexandre Severo; Bernardes, Emanuele da Silva; Zaro, Milton Antonio

    2016-01-01

    Objective : To evaluate and compare proprioception, body balance and knee functionality of individuals with or without unilateral anterior cruciate ligament (ACL) reconstruction. Methods : Forty individuals were divided in two groups: Experimental group, 20 individuals with ACL reconstruction at six months postoperative, and control group, 20 individuals with no history of lower limb pathologies. In the experimental group, we assessed lower limbs with reconstructed ACL and contralateral limb; in the control group the dominant and the non-dominant lower limbs were assessed. All subjects were submitted to joint position sense test to evaluate proprioception, postural control measure in single-limb, and step up and down (SUD) test for functional assessment. Results : There were no deficits in proprioception and postural control. In the SUD test, a 5% decrease in lift up force was found in reconstructed ACL lower limbs, however, a statistically not significant difference. The impact and step down force during the course of test were 30% greater in anatomic ACL than in control lower limbs. Conclusion : The individuals with ACL reconstruction at six months postoperative did not show changes in proprioception and postural control, but showed motor control changes, influencing knee functionality. Level of Evidence IV, Prognostic Studies. PMID:26981038

  14. Joint collaborative technology experiment

    NASA Astrophysics Data System (ADS)

    Wills, Michael; Ciccimaro, Donny; Yee, See; Denewiler, Thomas; Stroumtsos, Nicholas; Messamore, John; Brown, Rodney; Skibba, Brian; Clapp, Daniel; Wit, Jeff; Shirts, Randy J.; Dion, Gary N.; Anselmo, Gary S.

    2009-05-01

    Use of unmanned systems is rapidly growing within the military and civilian sectors in a variety of roles including reconnaissance, surveillance, explosive ordinance disposal (EOD), and force-protection and perimeter security. As utilization of these systems grows at an ever increasing rate, the need for unmanned systems teaming and inter-system collaboration becomes apparent. Collaboration provides a means of enhancing individual system capabilities through relevant data exchange that contributes to cooperative behaviors between systems and enables new capabilities not possible if the systems operate independently. A collaborative networked approach to development holds the promise of adding mission capability while simultaneously reducing the workload of system operators. The Joint Collaborative Technology Experiment (JCTE) joins individual technology development efforts within the Air Force, Navy, and Army to demonstrate the potential benefits of interoperable multiple system collaboration in a force-protection application. JCTE participants are the Air Force Research Laboratory, Materials and Manufacturing Directorate, Airbase Technologies Division, Force Protection Branch (AFRL/RXQF); the Army Aviation and Missile Research, Development, and Engineering Center Software Engineering Directorate (AMRDEC SED); and the Space and Naval Warfare Systems Center - Pacific (SSC Pacific) Unmanned Systems Branch operating with funding provided by the Joint Ground Robotics Enterprise (JGRE). This paper will describe the efforts to date in system development by the three partner organizations, development of collaborative behaviors and experimentation in the force-protection application, results and lessons learned at a technical demonstration, simulation results, and a path forward for future work.

  15. Jointly Sponsored Research Program

    SciTech Connect

    Everett A. Sondreal; John G. Hendrikson; Thomas A. Erickson

    2009-03-31

    U.S. Department of Energy (DOE) Cooperative Agreement DE-FC26-98FT40321 funded through the Office of Fossil Energy and administered at the National Energy Technology Laboratory (NETL) supported the performance of a Jointly Sponsored Research Program (JSRP) at the Energy & Environmental Research Center (EERC) with a minimum 50% nonfederal cost share to assist industry in commercializing and effectively applying highly efficient, nonpolluting energy systems that meet the nation's requirements for clean fuels, chemicals, and electricity in the 21st century. The EERC in partnership with its nonfederal partners jointly performed 131 JSRP projects for which the total DOE cost share was $22,716,634 (38%) and the nonfederal share was $36,776,573 (62%). Summaries of these projects are presented in this report for six program areas: (1) resource characterization and waste management, (2) air quality assessment and control, (3) advanced power systems, (4) advanced fuel forms, (5) value-added coproducts, and (6) advanced materials. The work performed under this agreement addressed DOE goals for reductions in CO{sub 2} emissions through efficiency, capture, and sequestration; near-zero emissions from highly efficient coal-fired power plants; environmental control capabilities for SO{sub 2}, NO{sub x}, fine respirable particulate (PM{sub 2.5}), and mercury; alternative transportation fuels including liquid synfuels and hydrogen; and synergistic integration of fossil and renewable resources.

  16. Thumb Carpometacarpal Joint Stabilization in Ehlers-Danlos Syndrome--Case Report.

    PubMed

    Breahna, Anca Nicoleta; Meads, Bryce Maurice

    2015-10-01

    We report the case of an 18-years-old patient with thumb carpometacarpal ligament laxity due to Ehlers-Danlos syndrome who was treated with trapezial opening wedge osteotomy combined with volar ligaments reconstruction. Two years postoperatively she is pain free and the thumb carpometacarpal joint is stable. PMID:26388011

  17. Strength of Welded Aircraft Joints

    NASA Technical Reports Server (NTRS)

    Brueggeman, W C

    1937-01-01

    This investigation is a continuation of work started in 1928 and described in NACA-TR-348 which shows that the insertion of gusset plates was the most satisfactory way of strengthening a joint. Additional tests of the present series show that joints of this type could be improved by cutting out the portion of the plate between the intersecting tubes. T and lattice joints in thin-walled tubing 1 1/2 by 0.020 inch have somewhat lower strengths than joints in tubing of greater wall thickness because of failure by local buckling. In welding the thin-walled tubing, the recently developed "carburizing flux" process was found to be the only method capable of producing joints free from cracks. The "magnetic powder" inspection was used to detect cracks in the joints and flaws in the tubing.

  18. Metal to ceramic sealed joint

    DOEpatents

    Lasecki, J.V.; Novak, R.F.; McBride, J.R.

    1991-08-27

    A metal to ceramic sealed joint which can withstand wide variations in temperature and maintain a good seal is provided for use in a device adapted to withstand thermal cycling from about 20 to about 1000 degrees C. The sealed joint includes a metal member, a ceramic member having an end portion, and an active metal braze forming a joint to seal the metal member to the ceramic member. The joint is positioned remote from the end portion of the ceramic member to avoid stresses at the ends or edges of the ceramic member. The sealed joint is particularly suited for use to form sealed metal to ceramic joints in a thermoelectric generator such as a sodium heat engine where a solid ceramic electrolyte is joined to metal parts in the system. 11 figures.

  19. Metal to ceramic sealed joint

    DOEpatents

    Lasecki, John V.; Novak, Robert F.; McBride, James R.

    1991-01-01

    A metal to ceramic sealed joint which can withstand wide variations in temperature and maintain a good seal is provided for use in a device adapted to withstand thermal cycling from about 20 to about 1000 degrees C. The sealed joint includes a metal member, a ceramic member having an end portion, and an active metal braze forming a joint to seal the metal member to the ceramic member. The joint is positioned remote from the end portion of the ceramic member to avoid stresses at the ends or edges of the ceramic member. The sealed joint is particularly suited for use to form sealed metal to ceramic joints in a thermoelectric generator such as a sodium heat engine where a solid ceramic electrolyte is joined to metal parts in the system.

  20. Evolutionary tree reconstruction

    NASA Technical Reports Server (NTRS)

    Cheeseman, Peter; Kanefsky, Bob

    1990-01-01

    It is described how Minimum Description Length (MDL) can be applied to the problem of DNA and protein evolutionary tree reconstruction. If there is a set of mutations that transform a common ancestor into a set of the known sequences, and this description is shorter than the information to encode the known sequences directly, then strong evidence for an evolutionary relationship has been found. A heuristic algorithm is described that searches for the simplest tree (smallest MDL) that finds close to optimal trees on the test data. Various ways of extending the MDL theory to more complex evolutionary relationships are discussed.

  1. Line profile reconstruction: validation and comparison of reconstruction methods

    NASA Astrophysics Data System (ADS)

    Tsai, Ming-Yi; Yost, Michael G.; Wu, Chang-Fu; Hashmonay, Ram A.; Larson, Timothy V.

    Currently, open path Fourier transform infrared (OP-FTIR) spectrometers have been applied in some fenceline monitoring, but their use has been limited because path-integrated concentration measurements typically only provide an estimate of the average concentration. We present a series of experiments that further explore the use of path-integrated measurements to reconstruct various pollutant distributions along a linear path. Our experiments were conducted in a ventilation chamber using an OP-FTIR instrument to monitor a tracer-gas release over a fenceline configuration. These experiments validate a line profile method (1-D reconstruction). Additionally, we expand current reconstruction techniques by applying the Bootstrap to our measurements. We compared our reconstruction results to our point samplers using the concordance correlation factor (CCF). Of the four different release types, three were successfully reconstructed with CCFs greater than 0.9. The difficult reconstruction involved a narrow release where the pollutant was limited to one segment of the segmented beampath. In general, of the three reconstruction methods employed, the average of the bootstrapped reconstructions was found to have the highest CCFs when compared to the point samplers. Furthermore, the bootstrap method was the most flexible and allowed a determination of the uncertainty surrounding our reconstructions.

  2. Mandibular Reconstruction Based on the Concept of Double Arc Reconstruction.

    PubMed

    Sarukawa, Shunji; Noguchi, Tadahide; Kamochi, Hideaki; Sunaga, Ataru; Uda, Hirokazu; Nishino, Hiroshi; Sugawara, Yasushi

    2015-09-01

    The natural mandible has 2 arcs, the marginal arc and the occlusal arc. The marginal arc is situated along the lower margin of the mandible and affects the contour of the lower third of the face. The occlusal arc is situated along the dental arc and affects the stability of prosthodontics. The gap between these 2 arcs widens in the molar area. Our developed concept of "double arc reconstruction" involves making these 2 arcs for the reconstructed mandible. For the double-barrel fibula reconstruction, 2 bone segments are used to make both arcs. For reconstructions using the iliac crest, the double arc is made by inclination of the top of the bone graft toward the lingual side. Ten patients underwent double arc reconstruction: 2 underwent reconstruction with the double-barrel fibula, and 8 underwent reconstruction with the iliac crest. Four patients had a removable denture prosthesis, 1 had an osseointegrated dental implant, and 5 did not require further prosthodontic treatment. The shape of the reconstructed mandible after double arc reconstruction resembles the native mandible, and masticatory function is good with the use of a dental implant or removable denture prosthesis, or even without prosthodontics. PMID:26335321

  3. Ball-joint grounding ring

    NASA Technical Reports Server (NTRS)

    Aperlo, P. J. A.; Buck, P. A.; Weldon, V. A.

    1981-01-01

    In ball and socket joint where electrical insulator such as polytetrafluoroethylene is used as line to minimize friction, good electrical contact across joint may be needed for lightning protection or to prevent static-charge build-up. Electrical contact is maintained by ring of spring-loaded fingers mounted in socket. It may be useful in industry for cranes, trailers, and other applications requiring ball and socket joint.

  4. [Biomechanics of the knee joint].

    PubMed

    Witzel, U

    1993-01-01

    The capsular and ligamentous structures as control system of a healthy knee-joint supported by the muscular system are responsible for the rolling and gliding motion of the femoral condyles on the tibial plateau. Both the condyles and the tibial plateau have individually developed but to each other adjusted shapes and fine structures thereby. These structures consist of hyaline cartilage at their three-dimensional surfaces and of closely packed fibrils (lamina splendens) as the final gliding zone for tensile load. The orientation of the collagenous fibres can be made visible by split lines. The chondral surfaces are indirectly in contact to each other and orthogonally stressed at the particular point of contact. The indirect contact of the cartilaginous surfaces happens under interposition of the menisci. The meniscus serves to reduce and equalize the surface pressure by its own projected surface on the one hand and by maintaining of a hydraulic pressure of the synovial fluid on the other hand. Deviations of the condylar position as a result on ligamentous instabilities or ruptures with a following occurring loss of congruence, meniscal lesions or traumatic ruptures lead to a rapid discharge of the synovial fluid under load. The result is a hydraulic head loss with direct contact of the chondral surfaces under stress leading to arthrotic deformations. Severe arthrotic deformations or very much every meniscectomy produce intraarticular lumped loads resulting in a hyper-physiologic chondral pressure and malnutrition thereby. Further on there develop subchondral stress concentrations (caused by the lumped loads) leading to osseous damages, too. MR-pictures can make visible these damages. Chondromalacia, fissure or even chondrolysis are arthroscopically detectable sometimes. As after-effects of deficient knee ligaments occur pathological deviations of the femoral condyles and resulting destructions of the articular surfaces under stress enormously intensified by

  5. Ossiculoplasty with hydroxyapatite bone cement: our reconstruction philosophy.

    PubMed

    Gérard, Jean-Marc; De Bie, Gersende; Franceschi, Daniel; Deggouj, Naima; Gersdorff, Michel

    2015-07-01

    The main objective of this study is to analyze results obtained with hydroxyapatite bone cement (HABC) ossiculoplasties. This is a retrospective study of a case series. This study was conducted in an academic hospital and tertiary referral center. A total of 127 ossiculoplasties using HABC were evaluated. Ears were divided into three groups according to procedure: group 1 involved reinforcement of the incudostapedial joint with cement and reconstruction of an incus long process defect with cement. Group 2 involved partial ossicular reconstruction between the stapes and malleus handle with HABC. Group 3 was divided into two subgroups. Group 3B entailed reconstruction of the stapes with a mobile footplate (Austin-Kartush type B = group 3B) and group 3F with a fixed footplate (Austin-Kartush type F = group 3F) using a K-Helix piston (Grace Medical, Memphis, TN, USA) or a classical titanium piston (Kurz, Fuerth, Germany) glued to the incus remnant or malleus handle with cement. Anatomical and pre- and postoperative audiological results were assessed. The mean follow-up was 26 ± 14 months. Percentages of average postoperative air-bone gap ≤ 20 dB were 95, 82.5, 50 and 83.3%, and for air-bone gap ≤ 1 0 dB, 80, 50.9, 16.6 and 50% for groups 1, 2, 3B and 3F, respectively. No complications related to the cement or extrusion occurred. Hearing outcomes also remained stable over time. In our experience, ossiculoplasty with cement provides good and stable functional results, is safe, cost effective, and easy to use. HABC with or without biocompatible ossicular prostheses allows repair of different types of ossicular defects with preservation of the anatomical and physiological ossicular chain, as well as improved stability. Reconstruction of the incus long process or incudostapedial joint defect with cement is preferred over partial ossicular reconstruction. PMID:24615652

  6. Outcome of rail fixator system in reconstructing bone gap

    PubMed Central

    Lakhani, Amit; Singh, Deepinderjit; Singh, Randhir

    2014-01-01

    Background: Bone loss following open fracture or infected gap nonunion is a difficult situation to manage. There are many modes of treatment such as bone grafting, vascularized bone grafting and bone transport by illizarov and monolateral fixator. We evaluated the outcome of rail fixator treatment in reconstructing bone and limb function. We felt that due to problems such as heavy apparatus, persistent pain, deformity of joints and discomfort caused by an Ilizarov ring fixator, rail fixator is a good alternative to treat bone gaps. Materials and Methods: 20 patients (17 males and 3 females with mean age 30.5 years) who suffered bone loss due to open fracture and chronic osteomyelitis leading to infected gap nonunion. Ten patients suffered an open fracture (Gustilo type II and type III) and 10 patients suffered bone gap following excision of necrotic bone after infected nonunion. There were 19 cases of tibia and one case of humerus. All patients were treated with debridement and stabilization of fracture with a rail fixator. Further treatment involved reconstructing bone defect by corticotomy at an appropriate level and distraction by rail fixator. Result: We achieved union in all cases. The average bone gap reconstructed was 7.72 cm (range 3.5-15.5 cm) in 9 months (range 6-14 months). Normal range of motion in nearby joint was achieved in 80% cases. We had excellent to good limb function in 85% of cases as per the association for the study and application of the method of ilizarov scoring system[ASAMI] score. Conclusion: All patients well tolerated rail fixator with good functional results and gap reconstruction. Easy application of rail fixator and comfortable distraction procedure suggest rail fixator a good alternative for gap reconstruction of limbs. PMID:25404775

  7. Management of the Temporomandibular Joint after Ablative Surgery

    PubMed Central

    Bredell, Marius; Grätz, Klaus; Obwegeser, Joachim; Gujer, Astrid Kruse

    2014-01-01

    Management of the temporomandibular joint in ablative head and neck surgery is controversial with no standardized approach. The aim of the study was to establish risk-based guidelines for the management of the temporomandibular joint after ablative surgery. Analysis of all patients' records receiving ablative surgery involving the temporomandibular joint in the Department of Cranio-Maxillofacial and Oral Surgery, University Hospital of Zürich, from 2001 to 2012, was performed, identifying 15 patients and 14 reconstructive procedures. A literature search was done identifying all relevant literature on current approaches. Applicable cohorts were constructed, and relevant risks were extrapolated. Evaluated studies are not uniform in their reporting with nonhomogeneous patient groups. A diverse approach is used in the management of these patients with complications such as infection, ankylosis, limited mouth opening, plate penetration in the skull base, and plate loosening. Risk factors for complications appear to be radiation, costochondral graft, disk loss, and plate use alone. Clinical data suggest use of a plate with metal condyle reconstructions and previous radiation therapy as potential risks factors. Employing literature evidence and cumulated clinical data, a risk-based flowchart was developed to assist surgical decision making. Risk factors such as radiation, disk preservation, and soft tissue conditions are important complication-associated factors when planning surgery. Free vascularized fibula grafts appear to have the least complications that must be weighed against donor site morbidity. PMID:25379124

  8. Implementation of Open and Closed Kinetic Chain Quadriceps Strengthening Exercises after Anterior Cruciate Ligament Reconstruction.

    ERIC Educational Resources Information Center

    Ross, Michael D.; Denegar, Craig R.; Winzenried, Jay A.

    2001-01-01

    Reviews the effects of open kinetic chain (OKC) and closed kinetic chain (CKC) exercise on anterior cruciate ligament (ACL) strain and patellofemoral joint stress, suggesting a combination of the two for quadriceps strengthening after ACL reconstruction. Both OKC and CKC exercises may be modified and implemented for quadriceps strengthening after…

  9. Reconstructing Cctv, Beijing

    NASA Astrophysics Data System (ADS)

    Forcella, V.; Mussio, L.

    2011-09-01

    This paper deals with the reconstruction of a building, starting from a point cloud. The shape of this building is a non-stellar concave and multi-connected structure, composed of sowns and chains. A sown is the representation of a horizontal plane formed by dense points. A chain is a planar loop modeled by rare points. CCTV structure is defined only by the three orthogonal Cartesian coordinates. The reconstruction uses a sequence of procedures and the desired output is a consistent 3D model. The first procedure is devoted to attributing points to their voxel and to estimating the three values needed afterwards. The second procedure is devoted to analyzing clusters vertically and horizontally, to preliminarily distinguishing chains from sowns and to generating relational matching. The third procedure is devoted to building closed loops between all chains and all their projections on sowns. The fourth procedure is devoted to connecting points with triangles. The fifth procedure, still being implemented, is devoted to interpolating triangles with triangular splines.

  10. Reconstruction in Fourier space

    NASA Astrophysics Data System (ADS)

    Burden, A.; Percival, W. J.; Howlett, C.

    2015-10-01

    We present a fast iterative fast Fourier transform (FFT) based reconstruction algorithm that allows for non-parallel redshift-space distortions (RSDs). We test our algorithm on both N-body dark matter simulations and mock distributions of galaxies designed to replicate galaxy survey conditions. We compare solenoidal and irrotational components of the redshift distortion and show that an approximation of this distortion leads to a better estimate of the real-space potential (and therefore faster convergence) than ignoring the RSD when estimating the displacement field. Our iterative reconstruction scheme converges in two iterations for the mock samples corresponding to Baryon Oscillation Spectroscopic Survey CMASS Data Release 11 when we start with an approximation of the RSD. The scheme takes six iterations when the initial estimate, measured from the redshift-space overdensity, has no RSD correction. Slower convergence would be expected for surveys covering a larger angle on the sky. We show that this FFT based method provides a better estimate of the real-space displacement field than a configuration space method that uses finite difference routines to compute the potential for the same grid resolution. Finally, we show that a lognormal transform of the overdensity, used as a proxy for the linear overdensity, is beneficial in estimating the full displacement field from a dense sample of tracers. However, the lognormal transform of the overdensity does not perform well when estimating the displacements from sparser simulations with a more realistic galaxy density.

  11. Biomaterials for craniofacial reconstruction

    PubMed Central

    Neumann, Andreas; Kevenhoerster, Kevin

    2011-01-01

    Biomaterials for reconstruction of bony defects of the skull comprise of osteosynthetic materials applied after osteotomies or traumatic fractures and materials to fill bony defects which result from malformation, trauma or tumor resections. Other applications concern functional augmentations for dental implants or aesthetic augmentations in the facial region. For ostheosynthesis, mini- and microplates made from titanium alloys provide major advantages concerning biocompatibility, stability and individual fitting to the implant bed. The necessity of removing asymptomatic plates and screws after fracture healing is still a controversial issue. Risks and costs of secondary surgery for removal face a low rate of complications (due to corrosion products) when the material remains in situ. Resorbable osteosynthesis systems have similar mechanical stability and are especially useful in the growing skull. The huge variety of biomaterials for the reconstruction of bony defects makes it difficult to decide which material is adequate for which indication and for which site. The optimal biomaterial that meets every requirement (e.g. biocompatibility, stability, intraoperative fitting, product safety, low costs etc.) does not exist. The different material types are (autogenic) bone and many alloplastics such as metals (mainly titanium), ceramics, plastics and composites. Future developments aim to improve physical and biological properties, especially regarding surface interactions. To date, tissue engineered bone is far from routine clinical application. PMID:22073101

  12. Parallel ptychographic reconstruction

    PubMed Central

    Nashed, Youssef S. G.; Vine, David J.; Peterka, Tom; Deng, Junjing; Ross, Rob; Jacobsen, Chris

    2014-01-01

    Ptychography is an imaging method whereby a coherent beam is scanned across an object, and an image is obtained by iterative phasing of the set of diffraction patterns. It is able to be used to image extended objects at a resolution limited by scattering strength of the object and detector geometry, rather than at an optics-imposed limit. As technical advances allow larger fields to be imaged, computational challenges arise for reconstructing the correspondingly larger data volumes, yet at the same time there is also a need to deliver reconstructed images immediately so that one can evaluate the next steps to take in an experiment. Here we present a parallel method for real-time ptychographic phase retrieval. It uses a hybrid parallel strategy to divide the computation between multiple graphics processing units (GPUs) and then employs novel techniques to merge sub-datasets into a single complex phase and amplitude image. Results are shown on a simulated specimen and a real dataset from an X-ray experiment conducted at a synchrotron light source. PMID:25607174

  13. Stardust Entry Reconstruction

    NASA Technical Reports Server (NTRS)

    Desai, Prasun N.; Qualls, Garry D.

    2008-01-01

    An overview of the reconstruction analyses performed for the Stardust capsule entry is described. The results indicate that the actual entry was very close to the pre-entry predictions. The capsule landed 8.1 km north-northwest of the desired target at Utah Test and Training Range. Analyses of infrared video footage and radar range data (obtained from tracking stations) during the descent show that drogue parachute deployment was 4.8 s later than the pre-entry prediction, while main parachute deployment was 19.3 s earlier than the pre-set timer indicating that main deployment was actually triggered by the backup baroswitch. Reconstruction of a best estimated trajectory revealed that the aerodynamic drag experienced by the capsule during hypersonic flight was within 1% of pre-entry predications. Observations of the heatshield support the pre-entry estimates of small hypersonic angles of attack, since there was very little, if any, charring of the shoulder region or the aftbody. Through this investigation, an overall assertion can be made that all the data gathered from the Stardust capsule entry were consistent with flight performance close to nominal pre-entry predictions. Consequently, the design principles and methodologies utilized for the flight dynamics, aerodynamics, and aerothermodynamics analyses have been corroborated.

  14. Stereoscopic liver surface reconstruction

    PubMed Central

    Karwan, Adam; Rudnicki, Jerzy; Wróblewski, Tadeusz

    2012-01-01

    The paper presents a practical approach to measuring liver motion, both respiratory and laparoscopic, with a tool guided in the operating room. The presented method is based on standard operating room equipment, i.e. rigid laparoscopic cameras and a single incision laparoscopic surgery trocar. The triangulation algorithm is used and stereo correspondence points are marked manually by two independent experts. To calibrate the cameras two perpendicular chessboards, a pinhole camera model and a Tsai algorithm are used. The data set consists of twelve real liver surgery video sequences: ten open surgery and two laparoscopic, gathered from different patients. The setup equipment and methodology are presented. The proposed evaluation method based on both calibration points of the chessboard reconstruction and measurements made by the Polaris Vicra tracking system are used as a reference system. In the analysis stage we focused on two specific goals, measuring respiration and laparoscopic tool guided liver motions. We have presented separate examples for left and right liver lobes. It is possible to reconstruct liver motion using the SILS trocar. Our approach was made without additional position or movement sensors. Diffusion of cameras and laser for distance measurement seems to be less practical for in vivo laparoscopic data, but we do not exclude exploring such sensors in further research. PMID:23256023

  15. Passive Ball Capture Joint

    NASA Technical Reports Server (NTRS)

    Cloyd, Richard A. (Inventor); Bryan, Thomas C. (Inventor)

    2003-01-01

    A passive ball capture joint has a sleeve with a plurality of bores distributed about a circumference thereof and formed therethrough at an acute angle relative to the sleeve's longitudinal axis. A spring-loaded retainer is slidingly fitted in each bore and is biased such that, if allowed, will extend at least partially into the sleeve to retain a ball therein. A ring, rotatably mounted about the bores, has an interior wall defining a plurality of shaped races that bear against the spring-loaded retainers. A mechanized rotational force producer is coupled to the ring. The ring can be rotated from a first position (that presses the retainers into the sleeve to lock the ball in place) to a second position (that allows the retainers to springback out of the sleeve to release the ball).

  16. CRUCIFORM CONTROL ROD JOINT

    DOEpatents

    Thorp, A.G. II

    1962-08-01

    An invention is described which relates to nuclear reactor control rod components and more particularly to a joint between cruciform control rod members and cruciform control rod follower members. In one embodiment this invention provides interfitting crossed arms at adjacent ends of a control rod and its follower in abutting relation. This holds the members against relative opposite longitudinal movement while a compression member keys the arms against relative opposite rotation around a common axis. Means are also provided for centering the control rod and its follower on a common axis and for selectively releasing the control rod from its follower for the insertion of a replacement of the control rod and reuse of the follower. (AEC)

  17. Corynebacterium Prosthetic Joint Infection

    PubMed Central

    Cazanave, Charles; Greenwood-Quaintance, Kerryl E.; Hanssen, Arlen D.

    2012-01-01

    Identification of Corynebacterium species may be challenging. Corynebacterium species are occasional causes of prosthetic joint infection (PJI), but few data are available on the subject. Based on the literature, C. amycolatum, C. aurimucosum, C. jeikeium, and C. striatum are the most common Corynebacterium species that cause PJI. We designed a rapid PCR assay to detect the most common human Corynebacterium species, with a specific focus on PJI. A polyphosphate kinase gene identified using whole-genome sequence was targeted. The assay differentiates the antibiotic-resistant species C. jeikeium and C. urealyticum from other species in a single assay. The assay was applied to a collection of human Corynebacterium isolates from multiple clinical sources, and clinically relevant species were detected. The assay was then tested on Corynebacterium isolates specifically associated with PJI; all were detected. We also describe the first case of C. simulans PJI. PMID:22337986

  18. Inaudible temporomandibular joint vibrations.

    PubMed

    Widmalm, Sven E; Bae, Hanna E K; Djurdjanovic, Dragan; McKay, Duane C

    2006-07-01

    The aim was to test the hypothesis that inaudible vibrations with significant amounts of energy increasing during jaw movements can be recorded in the temporomandibular joint (TMJ) area. Twenty one subjects, who could perform wide opening movements without feeling discomfort, 12 with and 9 without TMJ sounds audible at conventional auscultation with a stethoscope, were included. Recordings were made during opening-closing, 2/s without tooth contact, and during mandibular rest, using accelerometers with a flat frequency response between the filter cutoff frequencies 0.1 Hz and 1000 Hz. The signals were digitized using a 24 bits card and sampled with the rate 96000 Hz. Power spectral analyses, and independent and paired samples t-tests were used in the analysis of the vibration power observed in frequency bands corresponding to audible and inaudible frequencies. An alpha-level of 5% was chosen for accepting a difference as being significant. In the group with audible sounds, about 47% of the total vibration energy was in the inaudible area below 20 Hz during opening-closing and about 76% during mandibular rest. In the group without audible sounds, the corresponding proportions were significantly different, 85% vs. 69%. The energy content of the vibrations, both those below and those above 20 Hz, increased significantly during jaw movement in both groups. Furthermore, percentage of signal energy above 20 Hz showed a noticeable increase in the group of subjects with audible sounds. This can physically be explained by decreased damping properties of damaged tissues surrounding the TMJ. Vibrations in the TMJ area can be observed with significant portions in the inaudible area below 20 Hz both during mandibular rest and during jaw movements whether or not the subjects have audible joint sounds. Further studies are needed to identify sources and evaluate possible diagnostic value. PMID:16933462

  19. Bone and Joint Infections in Older Adults.

    PubMed

    Mears, Simon C; Edwards, Paul K

    2016-08-01

    Bone and joint infections in the elderly patient include septic native joints, osteomyelitis, and prosthetic joint infection. Infections are difficult to treat and require a team approach. Surgical debridement and intravenous antibiotics are the keys to treatment. Prosthetic joint infections often need a two-stage approach to treatment. First the infected joint is removed and the infection treated, then a second prosthetic joint is placed. Prosthetic joint infection is becoming the most common complication after joint replacement surgery. Outcomes of treatment of bone and joint infections are related to the severity of the infection and condition of the host. Because the elderly are often frail, treatment is challenging. PMID:27394023

  20. Robotic joint experiments under ultravacuum

    NASA Technical Reports Server (NTRS)

    Borrien, A.; Petitjean, L.

    1988-01-01

    First, various aspects of a robotic joint development program, including gearbox technology, electromechanical components, lubrication, and test results, are discussed. Secondly, a test prototype of the joint allowing simulation of robotic arm dynamic effects is presented. This prototype is tested under vacuum with different types of motors and sensors to characterize the functional parameters: angular position error, mechanical backlash, gearbox efficiency, and lifetime.

  1. Exercise and the Knee Joint.

    ERIC Educational Resources Information Center

    Clarke, H. Harrison, Ed.

    1976-01-01

    This report by the President's Council on Physical Fitness and Sports examines the effects of various forms of physical exercise on the knee joint which, because of its vulnerability, is especially subject to injury. Discussion centers around the physical characteristics of the joint, commonly used measurements for determining knee stability,…

  2. Knee and Ankle Reconstruction With Reverse Anterolateral Thigh and Free Anterolateral Thigh Flap From One Donor Site.

    PubMed

    Choi, KyeongBeom; Cho, JaeHo; Park, MyongChul; Park, Dong Ha; Lee, Il Jae

    2016-09-01

    Traditionally, the anterolateral thigh (ALT) free flap is used in distal lower extremity reconstruction. Reverse ALT flap has become one of the most popular choices for knee joint soft tissue defects. A 53-year-old man sustained a degloving injury in the right lateral side of the lower extremity from the lateral malleolar area to the knee joint area. The contamination was severe, necessitating serial debridement and negative pressure wound therapy. After 4 weeks, no more soft tissue necrosis was evident. No more microorganism growth was confirmed by swab culture. ALT free flap using proximal perforator was planned for lateral malleolar area reconstruction and reverse ALT flap using distal perforator was planned to cover knee joint after confirming the pedicle length was sufficient for simultaneous knee and lateral malleolar area reconstruction. PMID:27317019

  3. 20 CFR 410.645 - Joint hearings.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Joint hearings. 410.645 Section 410.645..., Finality of Decisions, and Representation of Parties § 410.645 Joint hearings. When two or more hearings... joint hearing, a joint hearing may not be held. Where joint hearings are held, a single record of...

  4. 14 CFR 27.935 - Shafting joints.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Shafting joints. 27.935 Section 27.935... STANDARDS: NORMAL CATEGORY ROTORCRAFT Powerplant Rotor Drive System § 27.935 Shafting joints. Each universal joint, slip joint, and other shafting joints whose lubrication is necessary for operation must...

  5. 37 CFR 1.45 - Joint inventors.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2012-07-01 2012-07-01 false Joint inventors. 1.45 Section... Patent § 1.45 Joint inventors. (a) Joint inventors must apply for a patent jointly and each must make the... joint application under 35 U.S.C. 116. If multiple inventors are named in a provisional...

  6. 7 CFR 97.14 - Joint applicants.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 3 2012-01-01 2012-01-01 false Joint applicants. 97.14 Section 97.14 Agriculture... PLANT VARIETY AND PROTECTION The Application § 97.14 Joint applicants. (a) Joint owners shall file a joint application by signing as joint applicants. (b) If an application for certificate is made by...

  7. 7 CFR 97.14 - Joint applicants.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 3 2014-01-01 2014-01-01 false Joint applicants. 97.14 Section 97.14 Agriculture... PLANT VARIETY AND PROTECTION The Application § 97.14 Joint applicants. (a) Joint owners shall file a joint application by signing as joint applicants. (b) If an application for certificate is made by...

  8. 14 CFR 29.935 - Shafting joints.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Shafting joints. 29.935 Section 29.935... STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Powerplant Rotor Drive System § 29.935 Shafting joints. Each universal joint, slip joint, and other shafting joints whose lubrication is necessary for operation...

  9. 14 CFR 29.935 - Shafting joints.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Shafting joints. 29.935 Section 29.935... STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Powerplant Rotor Drive System § 29.935 Shafting joints. Each universal joint, slip joint, and other shafting joints whose lubrication is necessary for operation...

  10. 14 CFR 29.935 - Shafting joints.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Shafting joints. 29.935 Section 29.935... STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Powerplant Rotor Drive System § 29.935 Shafting joints. Each universal joint, slip joint, and other shafting joints whose lubrication is necessary for operation...

  11. 14 CFR 27.935 - Shafting joints.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 1 2012-01-01 2012-01-01 false Shafting joints. 27.935 Section 27.935... STANDARDS: NORMAL CATEGORY ROTORCRAFT Powerplant Rotor Drive System § 27.935 Shafting joints. Each universal joint, slip joint, and other shafting joints whose lubrication is necessary for operation must...

  12. 14 CFR 27.935 - Shafting joints.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Shafting joints. 27.935 Section 27.935... STANDARDS: NORMAL CATEGORY ROTORCRAFT Powerplant Rotor Drive System § 27.935 Shafting joints. Each universal joint, slip joint, and other shafting joints whose lubrication is necessary for operation must...

  13. 14 CFR 27.935 - Shafting joints.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Shafting joints. 27.935 Section 27.935... STANDARDS: NORMAL CATEGORY ROTORCRAFT Powerplant Rotor Drive System § 27.935 Shafting joints. Each universal joint, slip joint, and other shafting joints whose lubrication is necessary for operation must...

  14. 7 CFR 97.14 - Joint applicants.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 3 2013-01-01 2013-01-01 false Joint applicants. 97.14 Section 97.14 Agriculture... PLANT VARIETY AND PROTECTION The Application § 97.14 Joint applicants. (a) Joint owners shall file a joint application by signing as joint applicants. (b) If an application for certificate is made by...

  15. 14 CFR 29.935 - Shafting joints.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 1 2012-01-01 2012-01-01 false Shafting joints. 29.935 Section 29.935... STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Powerplant Rotor Drive System § 29.935 Shafting joints. Each universal joint, slip joint, and other shafting joints whose lubrication is necessary for operation...

  16. 14 CFR 29.935 - Shafting joints.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Shafting joints. 29.935 Section 29.935... STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Powerplant Rotor Drive System § 29.935 Shafting joints. Each universal joint, slip joint, and other shafting joints whose lubrication is necessary for operation...

  17. 20 CFR 410.645 - Joint hearings.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Joint hearings. 410.645 Section 410.645..., Finality of Decisions, and Representation of Parties § 410.645 Joint hearings. When two or more hearings... joint hearing, a joint hearing may not be held. Where joint hearings are held, a single record of...

  18. 37 CFR 1.45 - Joint inventors.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2011-07-01 2011-07-01 false Joint inventors. 1.45 Section... Patent § 1.45 Joint inventors. (a) Joint inventors must apply for a patent jointly and each must make the... joint application under 35 U.S.C. 116. If multiple inventors are named in a provisional...

  19. 14 CFR 27.935 - Shafting joints.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Shafting joints. 27.935 Section 27.935... STANDARDS: NORMAL CATEGORY ROTORCRAFT Powerplant Rotor Drive System § 27.935 Shafting joints. Each universal joint, slip joint, and other shafting joints whose lubrication is necessary for operation must...

  20. 37 CFR 1.45 - Joint inventors.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Joint inventors. 1.45 Section... Patent § 1.45 Joint inventors. (a) Joint inventors must apply for a patent jointly and each must make the... joint application under 35 U.S.C. 116. If multiple inventors are named in a provisional...

  1. 7 CFR 97.14 - Joint applicants.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 3 2011-01-01 2011-01-01 false Joint applicants. 97.14 Section 97.14 Agriculture... PLANT VARIETY AND PROTECTION The Application § 97.14 Joint applicants. (a) Joint owners shall file a joint application by signing as joint applicants. (b) If an application for certificate is made by...

  2. Arthritis at the shoulder joint.

    PubMed

    Sankaye, Prashant; Ostlere, Simon

    2015-07-01

    The shoulder is a complex joint with numerous structures contributing to mobility and stability. Shoulder pain is a common clinical complaint that may be due to a wide spectrum of disorders including rotator cuff disease, instability, and arthropathy. Primary osteoarthritis of the shoulder joint is uncommon because it is a non-weight-bearing joint. Significant osteoarthritis of the glenohumeral joint is unusual in the absence of trauma, and the detection of advanced degenerative changes in patients without a known history of trauma should alert the clinician to search for other disorders. This article reviews the pathogenesis, clinical manifestations, and key imaging findings of the common categories of the arthritis affecting the glenohumeral joint. PMID:26021591

  3. Method of forming a joint

    DOEpatents

    Butt, Darryl Paul; Cutler, Raymond Ashton; Rynders, Steven Walton; Carolan, Michael Francis

    2006-08-22

    A method of joining at least two sintered bodies to form a composite structure, including providing a first multicomponent metallic oxide having a perovskitic or fluorite crystal structure; providing a second sintered body including a second multicomponent metallic oxide having a crystal structure of the same type as the first; and providing at an interface a joint material containing at least one metal oxide containing at least one metal identically contained in at least one of the first and second multicomponent metallic oxides. The joint material is free of cations of Si, Ge, Sn, Pb, P and Te and has a melting point below the sintering temperatures of both sintered bodies. The joint material is heated to a temperature above the melting point of the metal oxide(s) and below the sintering temperatures of the sintered bodies to form the joint. Structures containing such joints are also disclosed.

  4. Space Station alpha joint bearing

    NASA Technical Reports Server (NTRS)

    Everman, Michael R.; Jones, P. Alan; Spencer, Porter A.

    1987-01-01

    Perhaps the most critical structural system aboard the Space Station is the Solar Alpha Rotary Joint which helps align the power generation system with the sun. The joint must provide structural support and controlled rotation to the outboard transverse booms as well as power and data transfer across the joint. The Solar Alpha Rotary Joint is composed of two transition sections and an integral, large diameter bearing. Alpha joint bearing design presents a particularly interesting problem because of its large size and need for high reliability, stiffness, and on orbit maintability. The discrete roller bearing developed is a novel refinement to cam follower technology. It offers thermal compensation and ease of on-orbit maintenance that are not found in conventional rolling element bearings. How the bearing design evolved is summarized. Driving requirements are reviewed, alternative concepts assessed, and the selected design is described.

  5. Shock transmissibility of threaded joints

    SciTech Connect

    Hansen, N.R.; Bateman, V.I.; Brown, F.A.

    1996-12-31

    Sandia National Laboratories (SNL) designs mechanical systems with threaded joints that must survive high shock environments. These mechanical systems include penetrators that must survive soil and rock penetration; drilling pipe strings that must survive rock-cutting, shock environments; and laydown weapons that must survive delivery impact shock. This paper summarizes an analytical study and an experimental evaluation of compressive, one-dimensional, shock transmission through a threaded joint in a split Hopkinson bar configuration. Thread geometries were scaled to simulate large diameter threaded joints with loadings parallel to the axis of the threads. Both strain and acceleration were evaluated with experimental measurements and analysis. Analytical results confirm the experimental conclusions that in this split Hopkinson bar configuration, the change in the one-dimensional shock wave by the threaded joint is localized to a length equal to a few diameters` length beyond the threaded joint.

  6. Autologous gastrointestinal reconstruction.

    PubMed

    Bianchi, A

    1995-02-01

    The patient with short bowel syndrome is essentially unable to absorb sufficient nutrients. This is caused by either short mucosal contact time, insufficient mucosal surface area (enterocyte mass), or a combination of the two. Management consists primarily in sustaining health and growth by intravenous nutrition and in enhancing the natural intestinal adaptation response. Surgery in the form of autologous gastrointestinal reconstruction (AGIR) is designed to redistribute the patient's own residual absorptive bowel to enhance adaptation and, possibly, to increase the absorptive mucosal surface by neomucosal growth. The alternative and ultimate fallback procedure in the management of intestinal failure is bowel transplantation, with its associated serious immunosuppression-related complications. Imaginative AGIR techniques provide new hope for the future. PMID:7728509

  7. Metrological digital audio reconstruction

    DOEpatents

    Fadeyev; Vitaliy , Haber; Carl

    2004-02-19

    Audio information stored in the undulations of grooves in a medium such as a phonograph record may be reconstructed, with little or no contact, by measuring the groove shape using precision metrology methods coupled with digital image processing and numerical analysis. The effects of damage, wear, and contamination may be compensated, in many cases, through image processing and analysis methods. The speed and data handling capacity of available computing hardware make this approach practical. Two examples used a general purpose optical metrology system to study a 50 year old 78 r.p.m. phonograph record and a commercial confocal scanning probe to study a 1920's celluloid Edison cylinder. Comparisons are presented with stylus playback of the samples and with a digitally re-mastered version of an original magnetic recording. There is also a more extensive implementation of this approach, with dedicated hardware and software.

  8. Reconstruction Using Witness Complexes

    PubMed Central

    Oudot, Steve Y.

    2010-01-01

    We present a novel reconstruction algorithm that, given an input point set sampled from an object S, builds a one-parameter family of complexes that approximate S at different scales. At a high level, our method is very similar in spirit to Chew’s surface meshing algorithm, with one notable difference though: the restricted Delaunay triangulation is replaced by the witness complex, which makes our algorithm applicable in any metric space. To prove its correctness on curves and surfaces, we highlight the relationship between the witness complex and the restricted Delaunay triangulation in 2d and in 3d. Specifically, we prove that both complexes are equal in 2d and closely related in 3d, under some mild sampling assumptions. PMID:21643440

  9. Reconstruction Using Witness Complexes.

    PubMed

    Guibas, Leonidas J; Oudot, Steve Y

    2008-10-01

    We present a novel reconstruction algorithm that, given an input point set sampled from an object S, builds a one-parameter family of complexes that approximate S at different scales. At a high level, our method is very similar in spirit to Chew's surface meshing algorithm, with one notable difference though: the restricted Delaunay triangulation is replaced by the witness complex, which makes our algorithm applicable in any metric space. To prove its correctness on curves and surfaces, we highlight the relationship between the witness complex and the restricted Delaunay triangulation in 2d and in 3d. Specifically, we prove that both complexes are equal in 2d and closely related in 3d, under some mild sampling assumptions. PMID:21643440

  10. On phase reconstruction

    NASA Astrophysics Data System (ADS)

    Lee, Chung-Min

    This thesis focuses on the mathematical analysis of the optical phase reconstruction problem. Phase information of light waves has played an important role in many optical applications. However, the phase function of a light wave cannot be measured directly. In 1983, Teague proposed the idea of an intensity senor for measuring phase functions of light waves. It uses an elliptic partial differential equation called the Transport of Intensity Equation (TIE), which relates intensity to the phase function of a light wave. Teague's study was followed by Roddier and others. When intensity decreases to zero at the boundary, the equation has singularity since the diffusion coefficient vanishes. In 1996, Gureyev and Nugent claimed that no boundary conditions are needed for getting a unique solution of the TIE in this singular case. We present in this thesis the theoretical analysis of the necessity of boundary conditions for solving the TIE. A hybrid theoretical-numerical boundary condition is also derived for solving the TIE numerically in the case of vanishing intensity at the boundary. Numerical tests and optical simulations over discs verified the potency of this theoretical-numerical hybrid boundary condition and the algorithm. Another approach studied is the Weighted Least Action Principle (WLAP), which is proposed by Rubinstein and Wolansky in the year 2004. The WLAP states a variational principle for finding the light rays mapping between two planes using the intensity profiles on the planes, and it writes the problem of phase reconstruction in the functional form. Minimizing the associated functional, we obtain the ray mapping of the light wave in question. The phase function can be derived from the optimized ray mapping. A numerical algorithm was designed to carry out the process. Simulations and tests are reported to show the feasibility of the methods proposed.

  11. Reconstructing the Alcatraz escape

    NASA Astrophysics Data System (ADS)

    Baart, F.; Hoes, O.; Hut, R.; Donchyts, G.; van Leeuwen, E.

    2014-12-01

    In the night of June 12, 1962 three inmates used a raft made of raincoatsto escaped the ultimate maximum security prison island Alcatraz in SanFrancisco, United States. History is unclear about what happened tothe escapees. At what time did they step into the water, did theysurvive, if so, where did they reach land? The fate of the escapees has been the subject of much debate: did theymake landfall on Angel Island, or did the current sweep them out ofthe bay and into the cold pacific ocean? In this presentation, we try to shed light on this historic case using avisualization of a high-resolution hydrodynamic simulation of the San Francisco Bay, combined with historical tidal records. By reconstructing the hydrodynamic conditions and using a particle based simulation of the escapees we show possible scenarios. The interactive model is visualized using both a 3D photorealistic and web based visualization. The "Escape from Alcatraz" scenario demonstrates the capabilities of the 3Di platform. This platform is normally used for overland flooding (1D/2D). The model engine uses a quad tree structure, resulting in an order of magnitude speedup. The subgrid approach takes detailed bathymetry information into account. The inter-model variability is tested by comparing the results with the DFlow Flexible Mesh (DFlowFM) San Francisco Bay model. Interactivity is implemented by converting the models from static programs to interactive libraries, adhering to the Basic ModelInterface (BMI). Interactive models are more suitable for answeringexploratory research questions such as this reconstruction effort. Although these hydrodynamic simulations only provide circumstantialevidence for solving the mystery of what happened during the foggy darknight of June 12, 1962, it can be used as a guidance and provides aninteresting testcase to apply interactive modelling.

  12. Vortical flow in human elbow joints: a three-dimensional computed tomography modeling study.

    PubMed

    Adikrishna, Arnold; Kekatpure, Aashay L; Tan, Jun; Lee, Hyun-Joo; Deslivia, Maria Florencia; Jeon, In-Ho

    2014-10-01

    The human elbow joint has been regarded as a loose hinge joint, with a unique helical motion of the axis during extension-flexion. This study was designed to identify the helical axis in the ulnohumeral joint during elbow extension-flexion by tracking the midpoint between the coronoid tip and the olecranon tip of the proximal ulna in a three-dimensional (3D) computed tomography (CT) image model. The elbows of four volunteers were CT-scanned at four flexion angles (0°, 45°, 90°, and 130°) at neutral rotation with a custom-made holding device to control any motion during scanning. Three-dimensional models of each elbow were reconstructed and a 3D ulnohumeral joint at 45°, 90°, and 130° was superimposed onto a fully extended joint (0°) by rotating and translating each 3D ulnohumeral joint along the axes. The midpoints of the olecranon and coronoid tips were interpolated using cubic spline technique and the dynamic elbow motion was plotted to determine the motion of the helical axis. The means and standard deviations were subsequently calculated. The average midpoint pattern of joint motion from extension to flexion was elliptical-orbit-like when projected onto a sagittal plane and continuously translated a mean 2.14 ± 0.34 mm (range, 1.83-2.52 mm) to the lateral side during elbow extension-flexion. In 3D space, the average midpoint pattern of the ulnohumeral joint resembles a vortical flow, spinning along an imaginary axis, with an inconsistent radius from 0° to 130° flexion. The ulnohumeral joint axis both rotates and translates during elbow extension-flexion, with a vortex-flow motion occurring during flexion in 3D model analysis. This motion should be considered when performing hinged external fixation, total elbow replacement and medial collateral ligament reconstruction surgery. PMID:25100632

  13. Ptychographic reconstruction of attosecond pulses

    NASA Astrophysics Data System (ADS)

    Lucchini, M.; Brügmann, M. H.; Ludwig, A.; Gallmann, L.; Keller, U.; Feurer, T.

    2015-11-01

    We demonstrate a new attosecond pulse reconstruction modality which uses an algorithm that is derived from ptychography. In contrast to other methods, energy and delay sampling are not correlated, and as a result, the number of electron spectra to record is considerably smaller. Together with the robust algorithm, this leads to a more precise and fast convergence of the reconstruction.

  14. An update on penile reconstruction

    PubMed Central

    Garaffa, Giulio; Raheem, Amr Abdel; Ralph, David John

    2011-01-01

    Penile reconstruction still represents a formidable challenge for the urologist. In this review, the most recent advances in penile reconstruction after trauma, excision of benign and malignant disease and in patients with micropenis, aphallia or female to male gender dysphoria are reported. PMID:21540867

  15. Image Contrast in Holographic Reconstructions

    ERIC Educational Resources Information Center

    Russell, B. R.

    1969-01-01

    The fundamental concepts of holography are explained using elementary wave ideas. Discusses wavefront reconstruction and contrast in hemigraphic images. The consequence of recording only the intensity at a given surface and using an oblique reference wave is shown to be an incomplete reconstruction resulting in image of low contrast. (LC)

  16. Shoulder separation - aftercare

    MedlinePlus

    Separated shoulder - aftercare; Acromioclavicular joint separation - aftercare; A/C separation - aftercare ... Shoulder separation is not an injury to the main shoulder joint itself. It is an injury to the top ...

  17. Shoulder separation - aftercare

    MedlinePlus

    Separated shoulder - aftercare; Acromioclavicular joint separation - aftercare; A/C separation - aftercare ... Shoulder separation is not an injury to the main shoulder joint itself. It is an injury to ...

  18. Accuracy assessment of 3D bone reconstructions using CT: an intro comparison.

    PubMed

    Lalone, Emily A; Willing, Ryan T; Shannon, Hannah L; King, Graham J W; Johnson, James A

    2015-08-01

    Computed tomography provides high contrast imaging of the joint anatomy and is used routinely to reconstruct 3D models of the osseous and cartilage geometry (CT arthrography) for use in the design of orthopedic implants, for computer assisted surgeries and computational dynamic and structural analysis. The objective of this study was to assess the accuracy of bone and cartilage surface model reconstructions by comparing reconstructed geometries with bone digitizations obtained using an optical tracking system. Bone surface digitizations obtained in this study determined the ground truth measure for the underlying geometry. We evaluated the use of a commercially available reconstruction technique using clinical CT scanning protocols using the elbow joint as an example of a surface with complex geometry. To assess the accuracies of the reconstructed models (8 fresh frozen cadaveric specimens) against the ground truth bony digitization-as defined by this study-proximity mapping was used to calculate residual error. The overall mean error was less than 0.4 mm in the cortical region and 0.3 mm in the subchondral region of the bone. Similarly creating 3D cartilage surface models from CT scans using air contrast had a mean error of less than 0.3 mm. Results from this study indicate that clinical CT scanning protocols and commonly used and commercially available reconstruction algorithms can create models which accurately represent the true geometry. PMID:26037323

  19. Component Approach to the Temporomandibular Joint and Coronoid Process

    PubMed Central

    Pfaff, Miles J.; Clune, James; Steinbacher, Derek

    2014-01-01

    Reconstruction of the temporomandibular joint (TMJ) region is challenging. The conventional direct preauricular incision permits only limited access to the TMJ and surrounding structures, therefore risking injury to the facial nerve during retraction. The ideal approach allows sufficient exposure, preservation of underlying neurovascular structures, and achieves an optimal aesthetic outcome. We describe a preauricular posttragal incision with a superficial musculoaponeurotic system flap to allow wide exposure of the zygomatic arch, TMJ, condyle, and coronoid process. We postulate that this approach improves access, lessens the amount of retraction required, and creates a more inconspicuous scar. PMID:25383157

  20. Component approach to the temporomandibular joint and coronoid process.

    PubMed

    Pfaff, Miles J; Clune, James; Steinbacher, Derek

    2014-12-01

    Reconstruction of the temporomandibular joint (TMJ) region is challenging. The conventional direct preauricular incision permits only limited access to the TMJ and surrounding structures, therefore risking injury to the facial nerve during retraction. The ideal approach allows sufficient exposure, preservation of underlying neurovascular structures, and achieves an optimal aesthetic outcome. We describe a preauricular posttragal incision with a superficial musculoaponeurotic system flap to allow wide exposure of the zygomatic arch, TMJ, condyle, and coronoid process. We postulate that this approach improves access, lessens the amount of retraction required, and creates a more inconspicuous scar. PMID:25383157

  1. Nasal Reconstruction: Extending the Limits

    PubMed Central

    Corsten, Marcus; Haack, Sebastian; Gubisch, Wolfgang M.; Fischer, Helmut

    2016-01-01

    Summary: Reconstructing the 3-dimensional structure of the nose requires the maintenance of its aesthetic form and function. Restoration of the correct dimension, projection, skin quality, symmetrical contour, and function remains problematic. Consequently, modern approaches of nasal reconstruction aim at rebuilding the units rather than just covering the defect. However, revising or redoing a failed or insufficient reconstruction remains very challenging and requires experience and creativity. Here, we present a very particular case with a male patient, who underwent 37 operations elsewhere and presented with a failed nasal reconstruction. We describe and illustrate the complex steps of the nasal rereconstruction, including the reconstruction of the forehead donor site, surgical delay procedures for lining, and the coverage with a third paramedian forehead flap. PMID:27536483

  2. Nasal Reconstruction: Extending the Limits.

    PubMed

    Rezaeian, Farid; Corsten, Marcus; Haack, Sebastian; Gubisch, Wolfgang M; Fischer, Helmut

    2016-07-01

    Reconstructing the 3-dimensional structure of the nose requires the maintenance of its aesthetic form and function. Restoration of the correct dimension, projection, skin quality, symmetrical contour, and function remains problematic. Consequently, modern approaches of nasal reconstruction aim at rebuilding the units rather than just covering the defect. However, revising or redoing a failed or insufficient reconstruction remains very challenging and requires experience and creativity. Here, we present a very particular case with a male patient, who underwent 37 operations elsewhere and presented with a failed nasal reconstruction. We describe and illustrate the complex steps of the nasal rereconstruction, including the reconstruction of the forehead donor site, surgical delay procedures for lining, and the coverage with a third paramedian forehead flap. PMID:27536483

  3. Convex accelerated maximum entropy reconstruction

    NASA Astrophysics Data System (ADS)

    Worley, Bradley

    2016-04-01

    Maximum entropy (MaxEnt) spectral reconstruction methods provide a powerful framework for spectral estimation of nonuniformly sampled datasets. Many methods exist within this framework, usually defined based on the magnitude of a Lagrange multiplier in the MaxEnt objective function. An algorithm is presented here that utilizes accelerated first-order convex optimization techniques to rapidly and reliably reconstruct nonuniformly sampled NMR datasets using the principle of maximum entropy. This algorithm - called CAMERA for Convex Accelerated Maximum Entropy Reconstruction Algorithm - is a new approach to spectral reconstruction that exhibits fast, tunable convergence in both constant-aim and constant-lambda modes. A high-performance, open source NMR data processing tool is described that implements CAMERA, and brief comparisons to existing reconstruction methods are made on several example spectra.

  4. Arthroscopic interposition arthroplasty of the first carpometacarpal joint.

    PubMed

    Adams, J E; Merten, S M; Steinmann, S P

    2007-06-01

    First carpometacarpal joint arthritis is a common condition encountered by hand surgeons. Traditionally, surgical approaches have included arthrodesis, trapeziectomy or reconstructive arthroplasty techniques. Previously, we described a technique for arthroscopic debridement and interposition arthroplasty of the first carpometacarpal joint. Patients with Eaton stages II and III symptomatic first carpometacarpal joint arthritis recalcitrant to >6 months of non-operative therapy underwent arthroscopic debridement of the first carpometacarpal joint with interposition of an acellular dermal matrix allograft (GRAFTJACKET). In this paper, we describe outcomes following this procedure. Postoperatively, all patients reported symptomatic relief and 94% stated that they were partially, or completely, satisfied. More than 70% of patients reported no to mild difficulty in performing activities of daily living (average grip strength = 18.5 kg, pinch strength = 3.9kg). Complications were minimal. Outcomes from this study compare favourably to those of other series, demonstrating that this technique is a viable option for treatment of Eaton stages II and III first carpometacarpal arthritis. PMID:17276564

  5. Revision Anterior Cruciate Ligament Reconstruction

    PubMed Central

    Wilde, Jeffrey; Bedi, Asheesh; Altchek, David W.

    2014-01-01

    Context: Reconstruction of the anterior cruciate ligament (ACL) is one of the most common surgical procedures, with more than 200,000 ACL tears occurring annually. Although primary ACL reconstruction is a successful operation, success rates still range from 75% to 97%. Consequently, several thousand revision ACL reconstructions are performed annually and are unfortunately associated with inferior clinical outcomes when compared with primary reconstructions. Evidence Acquisition: Data were obtained from peer-reviewed literature through a search of the PubMed database (1988-2013) as well as from textbook chapters and surgical technique papers. Study Design: Clinical review. Level of Evidence: Level 4. Results: The clinical outcomes after revision ACL reconstruction are largely based on level IV case series. Much of the existing literature is heterogenous with regard to patient populations, primary and revision surgical techniques, concomitant ligamentous injuries, and additional procedures performed at the time of the revision, which limits generalizability. Nevertheless, there is a general consensus that the outcomes for revision ACL reconstruction are inferior to primary reconstruction. Conclusion: Excellent results can be achieved with regard to graft stability, return to play, and functional knee instability but are generally inferior to primary ACL reconstruction. A staged approach with autograft reconstruction is recommended in any circumstance in which a single-stage approach results in suboptimal graft selection, tunnel position, graft fixation, or biological milieu for tendon-bone healing. Strength-of-Recommendation Taxonomy (SORT): Good results may still be achieved with regard to graft stability, return to play, and functional knee instability, but results are generally inferior to primary ACL reconstruction: Level B. PMID:25364483

  6. Blob-enhanced reconstruction technique

    NASA Astrophysics Data System (ADS)

    Castrillo, Giusy; Cafiero, Gioacchino; Discetti, Stefano; Astarita, Tommaso

    2016-09-01

    A method to enhance the quality of the tomographic reconstruction and, consequently, the 3D velocity measurement accuracy, is presented. The technique is based on integrating information on the objects to be reconstructed within the algebraic reconstruction process. A first guess intensity distribution is produced with a standard algebraic method, then the distribution is rebuilt as a sum of Gaussian blobs, based on location, intensity and size of agglomerates of light intensity surrounding local maxima. The blobs substitution regularizes the particle shape allowing a reduction of the particles discretization errors and of their elongation in the depth direction. The performances of the blob-enhanced reconstruction technique (BERT) are assessed with a 3D synthetic experiment. The results have been compared with those obtained by applying the standard camera simultaneous multiplicative reconstruction technique (CSMART) to the same volume. Several blob-enhanced reconstruction processes, both substituting the blobs at the end of the CSMART algorithm and during the iterations (i.e. using the blob-enhanced reconstruction as predictor for the following iterations), have been tested. The results confirm the enhancement in the velocity measurements accuracy, demonstrating a reduction of the bias error due to the ghost particles. The improvement is more remarkable at the largest tested seeding densities. Additionally, using the blobs distributions as a predictor enables further improvement of the convergence of the reconstruction algorithm, with the improvement being more considerable when substituting the blobs more than once during the process. The BERT process is also applied to multi resolution (MR) CSMART reconstructions, permitting simultaneously to achieve remarkable improvements in the flow field measurements and to benefit from the reduction in computational time due to the MR approach. Finally, BERT is also tested on experimental data, obtaining an increase of the

  7. Reconstruction of large traumatic segmental defects of the femur using segmental allograft with vascularized fibula inlay.

    PubMed

    Ridha, Hyder; Bernard, Jason; Gateley, David; Vesely, Martin J

    2011-07-01

    Segmental defects of the distal femur following trauma pose a reconstructive challenge. A stable reconstruction capable of withstanding high forces while allowing early mobility is paramount. The Capanna technique of reconstruction combining allograft with vascularized bone graft provides such a construct and has been described for oncological resection. We describe a modified Capanna technique, the "inlay" construct. Three reconstructions were performed for distal femoral segmental loss following trauma. One patient had bilateral reconstructions. Bone defects measuring 11, 9, and 8 cm were reconstructed using a large segmental allograft and free fibular flap inlay assembly. Both patients made uneventful recoveries and achieved full weight-bearing without walking aids 6 months postreconstruction. Range of movement of each knee joint achieved at least 90 degrees of active flexion. We have shown that large segmental traumatic defects of the femur can be successfully reconstructed using segmental allograft with vascularized fibula inlay. This reconstruction provides early mechanical stability, protecting the fibula from fracturing and allowing axial loading of healing bone. The inlay assembly allows a large area of bony contact between allograft and vascularized bone, optimizing bony healing. It is a good alternative to other established techniques of managing significant segmental defects of the distal femur. PMID:21717390

  8. Porcelain three-dimensional shape reconstruction and its color reconstruction

    NASA Astrophysics Data System (ADS)

    Yu, Xiaoyang; Wu, Haibin; Yang, Xue; Yu, Shuang; Wang, Beiyi; Chen, Deyun

    2013-01-01

    In this paper, structured light three-dimensional measurement technology was used to reconstruct the porcelain shape, and further more the porcelain color was reconstructed. So the accurate reconstruction of the shape and color of porcelain was realized. Our shape measurement installation drawing is given. Because the porcelain surface is color complex and highly reflective, the binary Gray code encoding is used to reduce the influence of the porcelain surface. The color camera was employed to obtain the color of the porcelain surface. Then, the comprehensive reconstruction of the shape and color was realized in Java3D runtime environment. In the reconstruction process, the space point by point coloration method is proposed and achieved. Our coloration method ensures the pixel corresponding accuracy in both of shape and color aspects. The porcelain surface shape and color reconstruction experimental results completed by proposed method and our installation, show that: the depth range is 860 ˜ 980mm, the relative error of the shape measurement is less than 0.1%, the reconstructed color of the porcelain surface is real, refined and subtle, and has the same visual effect as the measured surface.

  9. Joint services electronics program

    NASA Astrophysics Data System (ADS)

    Peters, Leon, Jr.

    1992-11-01

    The report represents the fifteenth annual summary of The Ohio State University Joint Services Electronics Program (JSEP). The transfer of the compact range identification technology initiated under JSEP support for time domain studies continues to make large advances. We are also assisting Rockwell (Tulsa) to update their RCS facilities. This work is on a subcontract to the ESL from the Air Force. This has lead to involvement in the study of Ultra Wide Band radar systems. The research activities devoted to the Generalized Ray and Gaussian Beams continues. Our JSEP research continues to be expanded by external funding. This program is being expanded by use of such funds which are more focussed on the requirements of the sponsors which includes both the Air Force and the Navy. Our JSEP research continues to focus on electromagnetic related topics. There are four major electromagnetics areas that were pursued in the past year. The Diffraction Studies Work Unit has initiated research on a time domain version of the Uniform Theory of Diffraction. A second topic under the Diffraction Studies Work Unit involves further extensions of the generalized resistive boundary condition and the generalized impedance boundary condition. These have been applied to scattering from a chiral slab. A third topic of interest is the diffraction from a corner. A fourth task involves the reflection/diffraction of a Gaussian beam. This represents an approach to replace the usual ray optics solution for very complex geometries where the versatile ray optics solution becomes cumbersome.

  10. Well pipe joint

    SciTech Connect

    Ortloff, D.J.; Landriault, L.S.

    1987-08-25

    For use in forming a pipe joint, a threaded tubular member adapted for connecting to another threaded member to form a threaded connection between the two members is described comprising a tubular body, a projecting helical rib on the body forming screw threads having load flanks shaped to have clearance between the flanks of the thread and the load flanks of the threads of the threaded member to which the member is adapted to be connected and a torque shoulder on the body to engage a torque shoulder on the other threaded member as the connection is being made up to limit the distance one of the members can enter the other for a given make-up torque. The threads are formed on the body so that selected threads away from the torque shoulder will have less clearance between them and the mating threads on the other member than do the threads on the member adjacent the torque shoulder and the mating threads on the other member when the torque shoulders engage so that the selected threads will engage the mating threads on the other member before the other threads adjacent the torque shoulder and the mating threads on the other member engage to cause the selected threads to be loaded initially to provide the initial force between the torque shoulders and to more uniformly load all of the threads when the connection is made-up and additional external loads are applied.

  11. Reconstructing neural dynamics using data assimilation with multiple models

    NASA Astrophysics Data System (ADS)

    Hamilton, Franz; Cressman, John; Peixoto, Nathalia; Sauer, Timothy

    2014-09-01

    Assimilation of data with models of physical processes is a critical component of modern scientific analysis. In recent years, nonlinear versions of Kalman filtering have been developed, in addition to methods that estimate model parameters in parallel with the system state. We propose a substantial extension of these tools to deal with the specific case of unmodeled variables, when training data from the variable is avaiable. The method uses a stack of several, nonidentical copies of a physical model to jointly reconstruct the variable in question. We demonstrate the ability of this technique to accurately recover an unmodeled experimental quantity, such as an ion concentration, from a single voltage trace after the training period is completed. The method is applied to reconstruct the potassium concentration in a neural culture from multielectrode array voltage measurements.

  12. Localization and trajectory reconstruction in surveillance cameras with nonoverlapping views.

    PubMed

    Pflugfelder, Roman; Bischof, Horst

    2010-04-01

    This paper proposes a method that localizes two surveillance cameras and simultaneously reconstructs object trajectories in 3D space. The method is an extension of the Direct Reference Plane method, which formulates the localization and the reconstruction as a system of linear equations that is globally solvable by Singular Value Decomposition. The method's assumptions are static synchronized cameras, smooth trajectories, known camera internal parameters, and the rotation between the cameras in a world coordinate system. The paper describes the method in the context of self-calibrating cameras, where the internal parameters and the rotation can be jointly obtained assuming a man-made scene with orthogonal structures. Experiments with synthetic and real--image data show that the method can recover the camera centers with an error less than half a meter even in the presence of a 4 meter gap between the fields of view. PMID:20224125

  13. Reconstruction of Genome Ancestry Blocks in Multiparental Populations.

    PubMed

    Zheng, Chaozhi; Boer, Martin P; van Eeuwijk, Fred A

    2015-08-01

    We present a general hidden Markov model framework called R: econstructing A: ncestry B: locks BIT: by bit (RABBIT) for reconstructing genome ancestry blocks from single-nucleotide polymorphism (SNP) array data, a required step for quantitative trait locus (QTL) mapping. The framework can be applied to a wide range of mapping populations such as the Arabidopsis multiparent advanced generation intercross (MAGIC), the mouse Collaborative Cross (CC), and the diversity outcross (DO) for both autosomes and X chromosomes if they exist. The model underlying RABBIT accounts for the joint pattern of recombination breakpoints between two homologous chromosomes and missing data and allelic typing errors in the genotype data of both sampled individuals and founders. Studies on simulated data of the MAGIC and the CC and real data of the MAGIC, the DO, and the CC demonstrate that RABBIT is more robust and accurate in reconstructing recombination bin maps than some commonly used methods. PMID:26048018

  14. Qualification of improved joint heaters

    NASA Technical Reports Server (NTRS)

    Cook, M.

    1989-01-01

    Qualification testing of the Redesigned Solid Rocket Motor improved igniter-to-case joint and field joint heaters was conducted on the fired TEM-04 static test motor and was completed on 7 Sep. 1989. The purpose of the test was to certify the installation and performance of the improved joint heaters for use on flight motors. The changes incorporated in the improved heaters improve durability and should reduce handling damage. The igniter-to-case joint and field joint primary heater circuits were subjected to five 20-hr ON cycles. The heater redundant circuits were then subjected to one 20-hr ON cycle. Voltage, current, and temperature set point values were maintained within the specified limits for both heaters during each ON cycle. When testing was complete, both heaters were removed and inspected. No discolorations or any other anomalies were found on either of the heaters. Based on the successful completion of this test, it is recommended that the improved igniter-to-case joint and field joint heaters be used on future flight motors.

  15. Common Bolted Joint Analysis Tool

    NASA Technical Reports Server (NTRS)

    Imtiaz, Kauser

    2011-01-01

    Common Bolted Joint Analysis Tool (comBAT) is an Excel/VB-based bolted joint analysis/optimization program that lays out a systematic foundation for an inexperienced or seasoned analyst to determine fastener size, material, and assembly torque for a given design. Analysts are able to perform numerous what-if scenarios within minutes to arrive at an optimal solution. The program evaluates input design parameters, performs joint assembly checks, and steps through numerous calculations to arrive at several key margins of safety for each member in a joint. It also checks for joint gapping, provides fatigue calculations, and generates joint diagrams for a visual reference. Optimum fastener size and material, as well as correct torque, can then be provided. Analysis methodology, equations, and guidelines are provided throughout the solution sequence so that this program does not become a "black box:" for the analyst. There are built-in databases that reduce the legwork required by the analyst. Each step is clearly identified and results are provided in number format, as well as color-coded spelled-out words to draw user attention. The three key features of the software are robust technical content, innovative and user friendly I/O, and a large database. The program addresses every aspect of bolted joint analysis and proves to be an instructional tool at the same time. It saves analysis time, has intelligent messaging features, and catches operator errors in real time.

  16. [Reconstructions after inveterated fractures and dislocations of the foot].

    PubMed

    Zwipp, H

    2014-11-01

    Inveterated fractures or dislocations of the foot which are defined as being more than 6-12 weeks old can be secondarily reconstructed anatomically in only very rare cases. All other cases need reorientation of all axes of the foot requiring single or combined joint fusion. In cases of significant posttraumatic bone necrosis the dead bone has to be radically resected and substituted by an autogenous bone graft from the iliac crest. Old cases of dislocation, for example after subtalar dislocation without anatomical reduction, need reorientation of the foot axes by performing arthrodesis. Subluxation of the medial Lisfranc joint after an unrecognized rupture of Lisfranc ligament can be controlled later by anatomical repair of this ligament by using half of the extensor digitorum longus tendon and thus avoiding arthrodesis. PMID:25338655

  17. [Reconstructions after inveterated fractures and dislocations of the foot].

    PubMed

    Zwipp, H

    2014-01-01

    Inveterated fractures or dislocations of the foot which are defined as being more than 6-12 weeks old can be secondarily reconstructed anatomically in only very rare cases. All other cases need reorientation of all axes of the foot requiring single or combined joint fusion. In cases of significant posttraumatic bone necrosis the dead bone has to be radically resected and substituted by an autogenous bone graft from the iliac crest. Old cases of dislocation, for example after subtalar dislocation without anatomical reduction, need reorientation of the foot axes by performing arthrodesis. Subluxation of the medial Lisfranc joint after an unrecognized rupture of Lisfranc ligament can be controlled later by anatomical repair of this ligament by using half of the extensor digitorum longus tendon and thus avoiding arthrodesis. PMID:24441651

  18. Errors and Uncertainties in Dose Reconstruction for Radiation Effects Research

    SciTech Connect

    Strom, Daniel J.

    2008-04-14

    Dose reconstruction for studies of the health effects of ionizing radiation have been carried out for many decades. Major studies have included Japanese bomb survivors, atomic veterans, downwinders of the Nevada Test Site and Hanford, underground uranium miners, and populations of nuclear workers. For such studies to be credible, significant effort must be put into applying the best science to reconstructing unbiased absorbed doses to tissues and organs as a function of time. In many cases, more and more sophisticated dose reconstruction methods have been developed as studies progressed. For the example of the Japanese bomb survivors, the dose surrogate “distance from the hypocenter” was replaced by slant range, and then by TD65 doses, DS86 doses, and more recently DS02 doses. Over the years, it has become increasingly clear that an equal level of effort must be expended on the quantitative assessment of uncertainty in such doses, and to reducing and managing uncertainty. In this context, this paper reviews difficulties in terminology, explores the nature of Berkson and classical uncertainties in dose reconstruction through examples, and proposes a path forward for Joint Coordinating Committee for Radiation Effects Research (JCCRER) Project 2.4 that requires a reasonably small level of effort for DOSES-2008.

  19. Sideline Management of Joint Dislocations.

    PubMed

    Schupp, Christian M; Rand, Scott E; Hanson, Travis W; Lee, Bryan M; Jafarnia, Korsh; Jia, Yuhang; Moseley, J Bruce; Seaberg, John P; Seelhoefer, Gregory M

    2016-01-01

    Athletes can sustain a large variety of injuries from simple soft tissue sprains to complex fractures and joint dislocations. This article reviews and provides the most recent information for sports medicine professionals on the management of simple and complex joint dislocations, i.e., irreducible and/or associated with a fracture, from the sidelines without the benefit of imaging. For each joint, the relevant anatomy, common mechanisms, sideline assessment, reduction techniques, initial treatment, and potential complications will be discussed, which allow for the safe and prompt return of athletes to the field of play. PMID:27172077

  20. Compliant Prosthetic Or Robotic Joint

    NASA Technical Reports Server (NTRS)

    Kerley, James J.; Eklund, Wayne D.

    1989-01-01

    Rotation partly free and partly restrained by resilience and damping. Joint includes U-shaped x- and y-axis frames joined by cables that cross in at center piece. The y-axis frame rotates about y-axis on roller bearing within predetermined angular range. The y-axis frame rotates slightly farther when arm strikes stop, because cables can twist. This mimics compliant resistance of knee joint reaching limit of its forward or backward motion. Used in prosthetic device to replace diseased or damage human joint, or in robot linkage to limit movement and cushion overloads.

  1. [Infection after anterior cruciate ligament reconstruction: grave error in treatment?].

    PubMed

    Regauer, M; Neu, J

    2012-09-01

    A 28-year-old patient showed clear signs of knee joint infection 8 days after arthroscopic reconstruction of the anterior cruciate ligament. The treating physicians recommended further observation although they stated that a knee joint infection could not be reliably excluded. One week later arthroscopic revision was performed and intraoperative smear tests showed infection by Pseudomonas aeruginosa. Therefore, another 6 days later the obviously infected transplant had to be removed. In the long run painful and limited range of motion of the affected knee joint persisted. The patient complained about medical malpractice concerning management of the complication. The expert opinion stated that due to the fateful course of infection the tendon graft could not be retrieved after the eighth day post surgery anyway. Thus, only flawed delay of treatment was criticized. The arbitration board argued, however, that scientific data concerning the fate of infected tendon grafts do not support the expert opinion and that immediate arthroscopy and antibiotic treatment at least had the potential to influence the course of infection in a positive manner. Evidence clearly shows that survival of an infected tendon graft depends on early diagnosis and emergency treatment rather than just on fate. Due to the fact that, although having in mind the possibility of a knee joint infection, the necessary therapy was delayed for 8 days, the arbitration board considered the described medical malpractice a severe treatment error, leading to reversal of evidence in favour of the patient. PMID:22706649

  2. Vulvovaginal reconstruction for neoplastic disease.

    PubMed

    Höckel, Michael; Dornhöfer, Nadja

    2008-06-01

    Current treatment of neoplastic disease that involves the external female genitalia aims to achieve local disease control, but not to restore form and function of these organs. Despite a growing trend to reduce the extent of surgical resection, impaired quality of life after surgery due to severe sexual dysfunction and disturbed body image is common. We postulate that the integration of surgical techniques for vulvar and vaginal reconstruction into primary treatment would improve aesthetic and functional results and therefore quality of life. We systematically searched the literature for surgical procedures designed and validated for vulvovaginal reconstruction. Various skin flaps, both with random vascularisation and those based on vascular territories (ie, axial pattern, fasciocutaneous, musculocutaneous, and bowel flaps), can restore important parts of vulvovaginal form and function with acceptable morbidity at the donor and recipient sites. Appropriate vulvovaginal reconstruction cannot be achieved by doing a few standardised procedures; rather, it necessitates specialists who are familiar with general principles of reconstructive surgery to master many techniques to select the optimum procedure for the individual patient. Vulvovaginal reconstructive surgery has limitations, particularly achievement of functional restoration in irradiated tissue. Physicians who treat women with neoplastic disease of the external genitalia should be aware of the current state of vulvovaginal reconstructive surgery. Prospective controlled clinical trials are warranted to assess the effect of vulvovaginal reconstruction on morbidity and quality of life after treatment. PMID:18510987

  3. Reconstructive compounding for IVUS palpography.

    PubMed

    Danilouchkine, Mikhail G; Mastik, Frits; van der Steen, Antonius F W

    2009-12-01

    This study proposes a novel algorithm for luminal strain reconstruction from sparse irregularly sampled strain measurements. It is based on the normalized convolution (NC) algorithm. The novel extension comprises the multilevel scheme, which takes into account the variable sampling density of the available strain measurements during the cardiac cycle. The proposed algorithm was applied to restore luminal strain values in intravascular ultrasound (IVUS) palpography. The procedure of reconstructing and averaging the strain values acquired during one cardiac cycle forms a technique, coined as reconstructive compounding. The accuracy of strain reconstruction was initially tested on the luminal strain map, computed from 3 in vivo IVUS pullbacks. The high quality of strain restoration was observed after systematically removing up to 90% of the initial elastographic measurements. The restored distributions accurately reproduced the original strain patterns and the error did not exceed 5%. The experimental validation of the reconstructed compounding technique was performed on 8 in vivo IVUS pullbacks. It demonstrated that the relative decrease in number of invalid strain estimates amounts to 92.05 +/- 6.03% and 99.17 +/- 0.92% for the traditional and reconstructive strain compounding schemes, respectively. In conclusion, implementation of the reconstructive compounding scheme boosts the diagnostic value of IVUS palpography. PMID:20040400

  4. A novel use for suture button suspension: reconstruction of the dorsal ulnar ligament to treat thumb metacarpal dislocation

    PubMed Central

    Shah, Ajul; Martin, Garry; Thomson, James Grant

    2015-01-01

    Abstract There are numerous treatment algorithms that have been developed to treat thumb carpometacarpal (CMC) arthritis. A newer treatment option for these patients is CMC stabilization using suture button suspensionplasty. The authors of this case report have extensive experience with the suture-button suspensionplasty using the Mini TightRope CMC technique (Arthrex). We present a novel usage of the suture-button suspensionplasty to reconstruct the dorsal ulnar ligament (in contrast to the usual reconstruction of the volar beak ligament) to treat a patient with persistent thumb metacarpal dislocation at the CMC joint. Two separate patients are presented. One patient demonstrates volar beak ligament instability, and the other demonstrates dorsal ulnar ligament instability. Both patients’ demographics and operative indications are described. The operative technique for the novel usage of the suture-button suspensionplasty is described. Operative results of the dorsal ulnar ligament reconstruction are reviewed. After suture-button suspension of the thumb metacarpal to the trapezium, the dorsal ulnar ligament has been reconstructed. The patient demonstrated stability of the thumb CMC joint without dorsal or radial dislocation. The authors of this case report present a novel usage of the suture-button suspensionplasty to treat a patient with proximal thumb metacarpal dislocation at the trapezial-metacarpal interface. This method, in contrast to the referenced method of volar beak ligament reconstruction, allows reconstruction of the dorsal ulnar ligament. This allows stabilization of the joint by preventing dorsal and radial dislocation of the metacarpal.

  5. High resolution three-dimensional photoacoustic imaging of human finger joints in vivo

    NASA Astrophysics Data System (ADS)

    Xi, Lei; Jiang, Huabei

    2015-08-01

    We present a method for noninvasively imaging the hand joints using a three-dimensional (3D) photoacoustic imaging (PAI) system. This 3D PAI system utilizes cylindrical scanning in data collection and virtual-detector concept in image reconstruction. The maximum lateral and axial resolutions of the PAI system are 70 μm and 240 μm. The cross-sectional photoacoustic images of a healthy joint clearly exhibited major internal structures including phalanx and tendons, which are not available from the current photoacoustic imaging methods. The in vivo PAI results obtained are comparable with the corresponding 3.0 T MRI images of the finger joint. This study suggests that the proposed method has the potential to be used in early detection of joint diseases such as osteoarthritis.

  6. Facial Reconstruction and Rehabilitation.

    PubMed

    Guntinas-Lichius, Orlando; Genther, Dane J; Byrne, Patrick J

    2016-01-01

    Extracranial infiltration of the facial nerve by salivary gland tumors is the most frequent cause of facial palsy secondary to malignancy. Nevertheless, facial palsy related to salivary gland cancer is uncommon. Therefore, reconstructive facial reanimation surgery is not a routine undertaking for most head and neck surgeons. The primary aims of facial reanimation are to restore tone, symmetry, and movement to the paralyzed face. Such restoration should improve the patient's objective motor function and subjective quality of life. The surgical procedures for facial reanimation rely heavily on long-established techniques, but many advances and improvements have been made in recent years. In the past, published experiences on strategies for optimizing functional outcomes in facial paralysis patients were primarily based on small case series and described a wide variety of surgical techniques. However, in the recent years, larger series have been published from high-volume centers with significant and specialized experience in surgical and nonsurgical reanimation of the paralyzed face that have informed modern treatment. This chapter reviews the most important diagnostic methods used for the evaluation of facial paralysis to optimize the planning of each individual's treatment and discusses surgical and nonsurgical techniques for facial rehabilitation based on the contemporary literature. PMID:27093062

  7. Total airway reconstruction.

    PubMed

    Connor, Matthew P; Barrera, Jose E; Eller, Robert; McCusker, Scott; O'Connor, Peter

    2013-02-01

    We present a case of obstructive sleep apnea (OSA) that required multilevel surgical correction of the airway and literature review and discuss the role supraglottic laryngeal collapse can have in OSA. A 34-year-old man presented to a tertiary otolaryngology clinic for treatment of OSA. He previously had nasal and palate surgeries and a Repose tongue suspension. His residual apnea hypopnea index (AHI) was 67. He had a dysphonia associated with a true vocal cord paralysis following resection of a benign neck mass in childhood. He also complained of inspiratory stridor with exercise and intolerance to continuous positive airway pressure. Physical examination revealed craniofacial hypoplasia, full base of tongue, and residual nasal airway obstruction. On laryngoscopy, the paretic aryepiglottic fold arytenoid complex prolapsed into the laryngeal inlet with each breath. This was more pronounced with greater respiratory effort. Surgical correction required a series of operations including awake tracheostomy, supraglottoplasty, midline glossectomy, genial tubercle advancement, maxillomandibular advancement, and reconstructive rhinoplasty. His final AHI was 1.9. Our patient's supraglottic laryngeal collapse constituted an area of obstruction not typically evaluated in OSA surgery. In conjunction with treating nasal, palatal, and hypopharyngeal subsites, our patient's supraglottoplasty represented a key component of his success. This case illustrates the need to evaluate the entire upper airway in a complicated case of OSA. PMID:22965285

  8. Balance Ability and Proprioception after Single-Bundle, Single-Bundle Augmentation, and Double-Bundle ACL Reconstruction

    PubMed Central

    Ma, Yubao; Iwaki, Daisuke; Asaeda, Makoto; Adachi, Nobuo; Ochi, Mitsuo

    2014-01-01

    Purpose. The present study sought to determine the influences of single-bundle (SB), single-bundle augmentation (SBA), and double-bundle (DB) reconstructions on balance ability and proprioceptive function. Methods. 67 patients who underwent a single- or double-bundle ACL reconstruction or a SBA using multistranded autologous hamstring tendons were included in this study with a 1-year follow-up. Body sway and knee kinesthesia (using the threshold to detect passive motion test (TTDPM)) were measured to indicate balance ability and proprioceptive function, respectively. Additionally, within-subject differences in anterior-posterior stability of the tibia and lower extremity muscle strength were evaluated before and after surgery. Results. At 6 and 12 months after surgery, DB reconstruction resulted in better balance and proprioceptive function than SB reconstruction (P < 0.05). Although no significant difference was observed in balance ability or proprioceptive function between the SBA and DB reconstructions, knee stability was significantly better with SBA and DB reconstructions than SB reconstruction (P < 0.05). No significant differences were found in quadriceps and hamstrings strength among the three reconstruction techniques. Conclusions. Our findings consider that joint stability, proprioceptive function, and balance ability were superior with SBA and DB reconstructions compared to SB reconstruction at 6 and 12 months after surgery. PMID:25614884

  9. Bayesian reconstruction of projection reconstruction NMR (PR-NMR).

    PubMed

    Yoon, Ji Won

    2014-11-01

    Projection reconstruction nuclear magnetic resonance (PR-NMR) is a technique for generating multidimensional NMR spectra. A small number of projections from lower-dimensional NMR spectra are used to reconstruct the multidimensional NMR spectra. In our previous work, it was shown that multidimensional NMR spectra are efficiently reconstructed using peak-by-peak based reversible jump Markov chain Monte Carlo (RJMCMC) algorithm. We propose an extended and generalized RJMCMC algorithm replacing a simple linear model with a linear mixed model to reconstruct close NMR spectra into true spectra. This statistical method generates samples in a Bayesian scheme. Our proposed algorithm is tested on a set of six projections derived from the three-dimensional 700 MHz HNCO spectrum of a protein HasA. PMID:25218584

  10. Two- and three-dimensional optical tomography of finger joints for diagnostics of rheumatoid arthritis

    NASA Astrophysics Data System (ADS)

    Klose, Alexander D.; Hielscher, Andreas H.; Hanson, Kenneth M.; Beuthan, Juergen

    1998-12-01

    Rheumatoid arthritis (RA) is one of the most common diseases of human joints. This progressive disease is characterized by an inflammation process that originates in the inner membrane (synovalis) of the capsule and spreads to other parts of the joint. In early stages the synovalis thickness and the permeability of this membrane changes. This leads to changes in the optical parameters of the synovalis and the synovial fluid (synovia), which occupies the space between the bones. The synovia changes from a clear yellowish fluid to a turbid grayish substance. In this work we present 2 and 3-dimensional reconstruction schemes for optical tomography of the finger joints. Our reconstruction algorithm is based on the diffusion approximation and employs adjoint differentiation techniques for the gradient calculation of the objective function with respect to the spatial distribution of optical properties. In this way, the spatial distribution of optical properties within the joints is reconstructed with high efficiency and precision. Volume information concerning the synovial space and the capsula are provided. Furthermore, it is shown that small changes of the scattering coefficients can be monitored. Therefore, optical tomography has the potential of becoming a useful tool for the early diagnosis and monitoring of disease progression in RA.

  11. Analytical and semi-analytical inverse kinematics of SSRMS-type manipulators with single joint locked failure

    NASA Astrophysics Data System (ADS)

    Xu, Wenfu; She, Yu; Xu, Yangsheng

    2014-12-01

    Redundant space manipulators, including Space Station Remote Manipulator System (SSRMS), Special Purpose Dexterous Manipulator (SPDM) and European Robotic Arm (ERA), have been playing important roles in the construction and maintenance of International Space Station (ISS). They all have 7 revolute joints arranged in similar configurations, and are referred to as SSRMS-type manipulators. When a joint is locked in an arbitrary position due to some failures, a 7R manipulator degrades to a 6R manipulator. Without a spherical wrist or three consecutive parallel joints, the inverse kinematics of the 6R manipulator is very complex. In this paper, we propose effective methods to resolve the inverse kinematics for different cases of any joint locked in an arbitrary position. Firstly, configuration characteristics of the SSRMS-type redundant manipulators are analyzed. Then, an existing of closed-form inverse kinematics is discussed for locking different joints. Secondly, D-H frames and corresponding D-H parameters of the new 6-DOF manipulator formed by locking a joint in an arbitrary position are re-constructed. A unified table is then created to describe the kinematics for all possible cases of single joint locking failure. Thirdly, completely analytical and semi-analytical methods are presented to solve the inverse kinematics equations, and the former is used for locking joint 1, 2, 6 or 7 while the latter for locking joint 3, 4 or 5. Finally, typical cases for single joint locking are studied. The results verify the proposed methods.

  12. Tomographic reconstruction of binary fields

    NASA Astrophysics Data System (ADS)

    Roux, Stéphane; Leclerc, Hugo; Hild, François

    2012-09-01

    A novel algorithm is proposed for reconstructing binary images from their projection along a set of different orientations. Based on a nonlinear transformation of the projection data, classical back-projection procedures can be used iteratively to converge to the sought image. A multiscale implementation allows for a faster convergence. The algorithm is tested on images up to 1 Mb definition, and an error free reconstruction is achieved with a very limited number of projection data, saving a factor of about 100 on the number of projections required for classical reconstruction algorithms.

  13. Autologous staged fat tissue transfer in post-traumatic lower extremity reconstruction.

    PubMed

    Benjamin, Martin A; Schwarzman, Garrett; Eivazi, Mariet; Zachary, Lawrence

    2015-01-01

    Autologous fat tissue transfer for aesthetic reconstruction has been described in the literature for soft tissue damage as early as 1893. One area that has yet to be described is the role of fat grafting in post-traumatic lower extremity injuries. In this case report, we present a patient who had significant injury to her right lower extremity and presented for reconstruction. The patient is a 52-year-old female who presented to clinic after a right lower extremity traumatic injury that required multiple re-operations, which lead to dense scarring and volume loss along the extremity inferior to the knee joint. The patient received two staged autologous fat injections and reported positive outcomes. Our case report demonstrates the utility of fat transfer in reconstruction of the lower extremity in staged fashion. Further research in the refinement of this technique and patient follow-up will lead to better graft survival and reconstructive outcomes. PMID:26572154

  14. Autologous staged fat tissue transfer in post-traumatic lower extremity reconstruction

    PubMed Central

    Benjamin, Martin A.; Schwarzman, Garrett; Eivazi, Mariet; Zachary, Lawrence

    2015-01-01

    Autologous fat tissue transfer for aesthetic reconstruction has been described in the literature for soft tissue damage as early as 1893. One area that has yet to be described is the role of fat grafting in post-traumatic lower extremity injuries. In this case report, we present a patient who had significant injury to her right lower extremity and presented for reconstruction. The patient is a 52-year-old female who presented to clinic after a right lower extremity traumatic injury that required multiple re-operations, which lead to dense scarring and volume loss along the extremity inferior to the knee joint. The patient received two staged autologous fat injections and reported positive outcomes. Our case report demonstrates the utility of fat transfer in reconstruction of the lower extremity in staged fashion. Further research in the refinement of this technique and patient follow-up will lead to better graft survival and reconstructive outcomes. PMID:26572154

  15. Campus/Industry Joint Ventures.

    ERIC Educational Resources Information Center

    McDonald, Eugene J.

    1985-01-01

    Opportunities for joint economic ventures of colleges and industry are discussed, and a variety of ventures undertaken by Duke University are outlined, including a health club, hotel, and office building. Tax and financing considerations are noted. (MSE)

  16. Update on rehabilitation following ACL reconstruction

    PubMed Central

    Nyland, John; Brand, Emily; Fisher, Brent

    2010-01-01

    As anterior cruciate ligament (ACL) reconstruction has evolved to less invasive, more anatomical approaches, rehabilitation of the injured athlete has likewise become more progressive and innovative, with a sound understanding of graft and fixation strength and biologic healing-remodeling constraints. This review discusses these innovations including specific considerations before surgery, when planning rehabilitation timetables, and the importance of reestablishing nonimpaired active and passive knee range of motion and biarticular musculotendinous extensibility in positions of function. Concepts of self-efficacy or confidence and reestablishing the “athlete role” are also addressed. Since ACL injury and reinjury are largely related to the influence of structure-form-function on dynamic knee joint stability, the interrelationships between sensorimotor, neuromuscular, and conventional resistance training are also discussed. Although pivot shift “giving way” relates to function loss following ACL injury, anterior translational laxity often does not. Although there is growing evidence that progressive eccentric training may benefit the patient following ACL reconstruction, there is less evidence supporting the use of functional ACL knee braces. Of considerable importance is selecting and achieving a criteria-based progression to sports-specific training, reestablishing osseous homeostasis and improved bone density, blending open and closed kinetic chain exercises at the appropriate time period, and appreciating the influence of the trunk, upper extremities, and sports equipment use on knee loads. We believe that knee dysfunction and functional recovery should be considered from a local, regional, and global perspective. These concepts are consolidated into our approach to prepare patients for return to play including field testing and maintenance training. PMID:24198553

  17. Joint probabilities and quantum cognition

    SciTech Connect

    Acacio de Barros, J.

    2012-12-18

    In this paper we discuss the existence of joint probability distributions for quantumlike response computations in the brain. We do so by focusing on a contextual neural-oscillator model shown to reproduce the main features of behavioral stimulus-response theory. We then exhibit a simple example of contextual random variables not having a joint probability distribution, and describe how such variables can be obtained from neural oscillators, but not from a quantum observable algebra.

  18. Joint probabilities and quantum cognition

    NASA Astrophysics Data System (ADS)

    de Barros, J. Acacio

    2012-12-01

    In this paper we discuss the existence of joint probability distributions for quantumlike response computations in the brain. We do so by focusing on a contextual neural-oscillator model shown to reproduce the main features of behavioral stimulus-response theory. We then exhibit a simple example of contextual random variables not having a joint probability distribution, and describe how such variables can be obtained from neural oscillators, but not from a quantum observable algebra.

  19. Pyrothermal treatment of welded joints

    SciTech Connect

    Serikov, S.V.; Idiyatullin, R.S.; Myakushkin, S.N.; Yaufman, V.V.

    1992-03-01

    The results of investigation of the structure and distribution of residual stresses in welded joints in pipes after heat treatment, which includes heating of the surface being treated due to combustion of plates formed from a thermite-type material of pyrotechnic composition, placed around the perimeter of the welded joint, and also an assessment of the level of residual stresses prior to and after pyrotechnic treatment demonstrated the promising nature of the proposed method. 5 refs., 5 figs.

  20. Anatomical reconstruction of the spring ligament using peroneus longus tendon graft.

    PubMed

    Choi, Kyungjin; Lee, Samuel; Otis, James C; Deland, Jonathan T

    2003-05-01

    Posterior tibial tendon insufficiency is often associated with failure of the spring ligament and flatfoot deformity. Arch correction procedures involving bony realignment, such as lateral column lengthening or joint fusions, can predispose to arthritis. Soft tissue reconstruction may provide a more anatomical correction without these complications. The purpose of this investigation was to compare the ability of three different spring ligament reconstruction procedures to correct flatfoot deformity. A deformity model of 5 degrees - 15 degrees talonavicular abduction was created in 10 cadaver foot-ankle specimens. Three reconstructions utilizing the peroneus longus tendon were evaluated for their ability to correct talonavicular abduction and subtalar eversion under 357 N vertical GRF load. A superomedial/plantar passage of the tendon through the calcaneus and navicular was shown to be more effective than either of the other two approaches, correcting the talonavicular joint from 9.1 degrees +/- 8.1 degrees abducted to 1.0 degree +/- 6.8 degrees adducted, and the subtalar joint from 3.1 degrees +/- 3.3 degrees everted to 0.4 degrees +/- 4.2 degrees inverted. Thus, an anatomical reconstruction of a model of a failed spring ligament was demonstrated to be effective in the correction of a flatfoot deformity produced in cadaver foot-ankle specimens. PMID:12801201