scholarly journals Measures of adult lower extremity function: The American Academy of Orthopedic Surgeons Lower Limb Questionnaire, The Activities of Daily Living Scale of the Knee Outcome Survey (ADLS), Foot Function Index (FFI), Functional Assessment System (FAS), Harris Hip Score (HHS), Index of Severity for Hip Osteoarthritis (ISH), Index of Severity for Knee Osteoarthritis (ISK), Knee Injury and Osteoarthritis Outcome Score (KOOS), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC™)

2003 ◽  
Vol 49 (S5) ◽  
pp. S67-S84 ◽  
Author(s):  
Joan C. Rogers ◽  
James J. Irrgang
Keyword(s):  
Lower Limb ◽  
Daily Living ◽  
Knee Injury ◽  
Hip Osteoarthritis ◽  
Assessment System ◽  
Harris Hip Score ◽  
Lower Extremity Function ◽  
Orthopedic Surgeons ◽  
Foot Function ◽  
Index Of Severity

scholarly journals Expression Pattern of iNOS, BCL-2 and MMP-9 in the Hip Synovium Tissue of Patients with Osteoarthritis

2021 ◽  
Vol 22 (3) ◽  
pp. 1489
Author(s):  
Davor Caric ◽  
Sandra Zekic Tomas ◽  
Natalija Filipovic ◽  
Violeta Soljic ◽  
Benjamin Benzon ◽  
...  
Keyword(s):  
Hip Osteoarthritis ◽  
Synovial Cell ◽  
Assessment System ◽  
Harris Hip Score ◽  
Hip Joints ◽  
Osteoarthritis Cartilage ◽  
Inflammatory Infiltration ◽  
Tissue Sections ◽  
Synovial Lining Cell ◽  
Neck Fracture

Hip osteoarthritis (HOA) is characterized by degradation of the cartilage and synovitis. However, the pathohistological effects of synovial tissue inflammation on HOA are not clear. The aim of this study was to evaluate the expression of iNOS, BCL-2 and MMP-9 markers in different synovial cell populations. A total of 32 patients were evaluated retrospectively. Age, sex, height, weight, body mass index were recorded and lymphocyte, fibrocytes and macrophages were analysed in tissue sections. Osteoarthritis cartilage histopathology assessment system (OARSI), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Krenn score, Harris Hip Score (HHS) and Kellgren–Lawrence (K-L) grading of the hip joints were performed. Total hip arthroplasty was performed on 32 patients and controls. Patients were divided into two groups according to their disease severity. The tissues were immunohistochemically analysed. K-L grade and Krenn score differ between all three groups, but also between moderate and severe OA. Synovial lining cell layer, resident cells in stroma and especially inflammatory infiltration were increasing with severity of OA. iNOS expression in both intima and subintima was positively correlated with Krenn score in moderate and severe osteoarthritis (OA) groups. Expression of BCL-2 in intima of severe OA patients was positively correlated with Krenn score. In conclusion, iNOS, BCL-2 and MMP-9 are involved in the regulation of HOA. Our study indicates a relationship between the pathohistological features, the synovial inflammation and the cartilage condition at the time of hip replacement due to OA or femoral neck fracture.

Group B and F Beta Streptococcus Necrotizing Infection–Surgical Challenges with a Deep Central Plantar Space Abscess

2016 ◽  
Vol 106 (3) ◽  
pp. 218-224 ◽  
Author(s):  
Jason M. Mendivil ◽  
David Jolley ◽  
Jodi Walters ◽  
Jim Dancho ◽  
Billy Martin
Keyword(s):  
Daily Living ◽  
Type Ii ◽  
Timely Manner ◽  
Lateral Aspect ◽  
Wound Culture ◽  
Necrotizing Infection ◽  
Deep Wound ◽  
Foot Function ◽  
Transmetatarsal Amputation ◽  
Group B

We present the case of a 66-year-old, type II diabetic male with a deep wound to the plantar-lateral aspect of his right hallux. On examination, the central plantar compartment of his right foot was moderately erythematous and tender on palpation. After obtaining a deep wound culture, treatment was complicated by a progression of a group B and F beta streptococcus, necrotizing infection. The patient underwent a right hallux amputation, followed by a plantar medial incision for drainage of an abscess to the medial and central plantar compartments of the foot. Due to the extent and limb threat of the infection, the patient ultimately underwent a transmetatarsal amputation. Advanced healing modalities were also employed to decrease wound healing times, which allowed the patient to achieve early weightbearing and return to activities of daily living. This study depicts how the astute podiatric surgeon needs to make a decision in a timely manner to surgically debride all nonviable and necrotic tissue in order to minimize further amputation and preserve foot function.

scholarly journals Lower Limb Kinematics in Individuals with Hip Osteoarthritis during Gait: A Focus on Adaptative Strategies and Interlimb Symmetry

2021 ◽  
Vol 8 (4) ◽  
pp. 47
Author(s):  
Micaela Porta ◽  
Massimiliano Pau ◽  
Bruno Leban ◽  
Michela Deidda ◽  
Marco Sorrentino ◽  
...  
Keyword(s):  
Lower Limb ◽  
Functional Limitations ◽  
Hip Osteoarthritis ◽  
Movement Analysis ◽  
Human Movement ◽  
Point Of View ◽  
Negative Effects ◽  
Gait Patterns ◽  
Limb Kinematics

Among the functional limitations associated with hip osteoarthritis (OA), the alteration of gait capabilities represents one of the most invalidating as it may seriously compromise the quality of life of the affected individual. The use of quantitative techniques for human movement analysis has been found valuable in providing accurate and objective measures of kinematics and kinetics of gait in individuals with hip OA, but few studies have reported in-depth analyses of lower limb joint kinematics during gait and, in particular, there is a scarcity of data on interlimb symmetry. Such aspects were investigated in the present study which tested 11 individuals with hip OA (mean age 68.3 years) and 11 healthy controls age- and sex-matched, using 3D computerized gait analysis to perform point-by-point comparisons of the joint angle trends of hip, knee, and ankle. Angle-angle diagrams (cyclograms) were also built to compute several parameters (i.e., cyclogram area and orientation and Trend Symmetry) from which to assess the degree of interlimb symmetry. The results show that individuals with hip OA exhibit peculiar gait patterns characterized by severe modifications of the physiologic trend at hip level even in the unaffected limb (especially during the stance phase), as well as minor (although significant) alterations at knee and ankle level. The symmetry analysis also revealed that the effect of the disease in terms of interlimb coordination is present at knee joint as well as hip, while the ankle joint appears relatively preserved from specific negative effects from this point of view. The availability of data on such kinematic adaptations may be useful in supporting the design of specific rehabilitative strategies during both preoperative and postoperative periods.

scholarly journals Cementless one-stage bilateral total hip arthroplasty in osteoarthritis patients: functional outcomes and complications

2017 ◽  
Vol 9 (2) ◽  
Author(s):  
Afshin Taheriazam ◽  
Amin Saeidinia
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Functional Outcomes ◽  
Hip Osteoarthritis ◽  
Harris Hip Score ◽  
Superficial Infection ◽  
Total Hip ◽  
One Stage ◽  
The Mean ◽  
Hardinge Approach

Total hip arthroplasty (THA) is one of the successful and cost-benefit surgical treatments. One-stage bilateral THA (BTHA) has a large number of advantages, although there are concerns about the higher complications in this procedure. Aim of our study was to evaluate the complications and outcomes of cementless one-stage BTHA in osteoarthritis patients. A total of 147 patients from 2009 till 2012, underwent one-stage BTHA in Milad and Erfan hospitals, Tehran, Iran. A prospective analysis of the functional outcomes and complications of one-stage BTHA through Hardinge approach in patients with osteoarthritis was performed. We evaluated all patients clinically and radiologically with serial followups. A clinical hip score based upon the modified Harris Hip Score (MHHS) was performed preoperatively and again postoperatively. During the period of study 89 men (60.5%) and 58 women (39.4%) with a mean age of 54.67±7.08 years at the time of presentation were recruited. The mean surgical time was 2.8±0.25 hrs. The mean hospital stay was 3.83±0.65 days. Hemoglobin level decreased significantly after operation (P=0.038). There was two deep venous thromboses, one superficial infection and one temporal proneal palsy but no pulmonary embolism, dislocation, periprosthetic fracture or heterotrophic ossification. The mean preoperative MHHS score was 41.64±5.42 in patients. MHHS score improved to 89.26±4.68 in the last followup (P=0.0001). Our results recommended the use of cementless one-stage BTHA through Hardinge approach in patients with bilateral hip osteoarthritis.

scholarly journals The effectiveness of additional core stability exercises in improving dynamic sitting balance, standing balance, lower-limb spasticity, falls and gait in subacute stroke patients (CORE-trial). Study protocol for a Randomized Controlled Trial

2021 ◽  
Author(s):  
Rosa Cabanas-Valdés ◽  
Lidia Boix-Sala ◽  
Montserrat Grau-Pellicer ◽  
Juan Antonio Guzmán-Bernal ◽  
Fernanda Maria Caballero-Gómez ◽  
...  
Keyword(s):  
Lower Limb ◽  
Daily Living ◽  
Controlled Trial ◽  
Core Stability ◽  
Standing Balance ◽  
Stroke Patients ◽  
Randomized Controlled ◽  
Limb Spasticity ◽  
Lower Limb Spasticity ◽  
Dynamic Sitting

Abstract BackgroundTrunk impairment produces disorders of motor control, balance, and gait that are correlated with increased risk of falls and reduced mobility in stroke survivors. This creates disability and dependency to perform their activities of daily living. Alterations in body alignment occur, requiring treatment strategies focused on improving the postural control. bearing. Core stability exercises (CSE) are a good strategy to improve local strength of trunk, dynamic sitting, standing balance, and gait. There is some evidence about its effectiveness but it is still necessary to run a large multicenter trial to ratify that existing evidence.MethodsThis is a single-blind multicenter randomized controlled trial. Two parallel groups are compared and both perform the same type of therapy. A control group (CG) (n=110) performs conventional physiotherapy (CP) (1 hour per session) focused on improving balance. An experimental group (EG) (n=110) performs CSE (30 minutes) in addition to CP (30 minutes) (1 hour/session in total). EG is divided in two subgroups, in which only half of patients (n=55) perform CSE plus transcutaneous electrical nerve stimulation (TENS). Primary outcome measures are dynamic sitting, assessed by Spanish-version of Trunk Impairment Scale and stepping, assessed by Brunel Balance Assessment. Secondary outcomes are postural control, assessed by Postural Assessment Scale for Stroke patients; standing balance and risk of fall assessed by Berg Balance Scale; gait speed by BTS G-Walk (accelerometer); rate of falls, lower-limb spasticity by Modified Ashworth Scale; activities of daily living by Barthel Index; and quality of life by EQ-5D-5L. These are evaluated at baseline (T0), at 3 weeks (T1), at 5 weeks -at the end of the intervention (T2), at 17 weeks (T3) and at 29 weeks (T4). Study duration per patient is 29 weeks (a 5-week intervention, followed by a 24-week post-intervention). DiscussionThe study will provide useful information on the short and long term effects of a physiotherapy rehabilitation program based on core stability exercises performed in subacute phase.Trial registrationClinicalTrials.gov Identifier NCT03975985. Data registration June 5th, 2019. Retrospectively registered. Date of registration in primary registry: June 5, 2019. Protocol version 1

Clinical Features and Outcomes Following Bilateral Lower Limb Amputation in Korea

2006 ◽  
Vol 30 (2) ◽  
pp. 155-164 ◽  
Author(s):  
Ji Cheol Shin ◽  
Eun Joo Kim ◽  
Chang Il Park ◽  
Eun Sook Park ◽  
Kyoo-Ho Shin
Keyword(s):  
Clinical Features ◽  
Lower Limb ◽  
Daily Living ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Medical Problems ◽  
Amputation Level ◽  
Significant Difference ◽  
Bilateral Lower Limb ◽  
Lower Limb Amputees

The objectives of this study were to evaluate the clinical features and outcomes of 43 bilateral lower limb amputees. The clinical features obtained included the causes of amputation, level of amputation, concurrent medical problems, and stump condition. Outcome measures were obtained using the activities of daily living (ADL) index, the Frenchay Activities Index (FAI), and mobility grading with prostheses or wheelchair. Of 33 amputees who were prosthetic ambulators, 22 (67%), mainly bilateral trans-tibial (TT) amputees, were community ambulators, and participated in activities which included stair-walking, and six of 11 household ambulators were combination trans-femoral (TF) and TT amputees. Of 10 amputees who were wheelchair ambulators, only one was able to perform wheelchair transfers independently and five were independent wheelchair ambulators. Using the ADL index and FAI, there was no significant difference in scores according to the level of amputation ( p > 0.05), but the scores of community prosthetic ambulators were significantly higher than those of wheelchair ambulators ( p < 0.05). Age was found to be negatively correlated with ADL index and FAI scores ( r = −0.518 vs. r = −0.550) ( p < 0.01). This study concludes that overall independence in ADL after bilateral lower limb amputation improved with young age and prosthetic mobility.

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