Sensitivity of Plantar Pressure and Talonavicular Alignment to Lateral Column Lengthening in Flatfoot Reconstruction.

Sensitivity of plantar pressure and talonavicular alignment to lateral column lengthening in flatfoot reconstruction.

J Bone Joint Surg Am. 2013 Jun 19; 95(12): 1094-100
Oh I, Imhauser C, Choi D, Williams B, Ellis S, Deland J

Lateral column lengthening (LCL) of the calcaneus is commonly performed as part of correction of the adult acquired flatfoot deformity. Increases in postoperative lateral plantar pressure associated with pain in the lateral aspect of the foot have been reported. The aim of this study was to investigate changes in pressures in the lateral aspect of the forefoot with increments of 6, 8, and 10 mm of LCL in a cadaveric flatfoot model. The hypothesis was that increasing the LCL incrementally by 2 mm will linearly increase the plantar pressures in the lateral aspect of the forefoot.Eight fresh-frozen cadaveric foot specimens were used. A robot compressively loaded the foot to 400 N with a 310-N tensile load applied to the Achilles tendon. A flatfoot model was created by resecting the medial and inferior soft tissues of the midfoot, followed by axial load of 800 N for 100 cycles. Kinematic and plantar pressure data were gathered after the different amounts of LCL (6, 8, and 10 mm) were achieved.The talonavicular joint demonstrated a median abduction angle of 4.4° in the axial plane and -2.6° in the sagittal plane in the flatfoot condition as compared with the intact condition. The 6, 8, and 10-mm LCLs showed axial correction of talonavicular alignment by -1.4°, -4.9°, and -9.2° beyond that of the intact foot, and sagittal correction of -0.1°, 1.3°, and 2.9°, respectively. LCL of 6, 8, and 10 mm showed consistently increasing lateral forefoot average mean pressure, peak pressure, and contact area.LCL in 2-mm increments consistently reduced talonavicular abduction and consistently increased plantar pressure in the lateral aspect of the forefoot.The lateral column should be lengthened judiciously, as a 2-mm difference leads to significant difference not only in angular correction of the talonavicular joint but also with regard to pressure in the lateral aspect of the forefoot. HubMed – rehab


Elevated Mechanical Loading When Young Provides Lifelong Benefits to Cortical Bone Properties in Female Rats Independent of a Surgically-Induced Menopause.

Endocrinology. 2013 Jun 19;
Warden SJ, Galley MR, Hurd AL, Wallace JM, Gallant MA, Richard JS, George LA

Exercise that mechanically loads the skeleton is advocated when young to enhance lifelong bone health. Whether the skeletal benefits of elevated loading when young persist into adulthood and following menopause are important questions. This study investigated the influence of a surgically-induced menopause in female Sprague-Dawley rats on the lifelong maintenance of the cortical bone benefits of skeletal loading when young. Animals had their right forearm extrinsically loaded 3 days/week between 4 and 10 weeks of age using the forearm axial compression loading model. Left forearms were internal controls and not loaded. Animals were subsequently detrained (restricted to cage activities) for 94 weeks (until age=2 years), with ovariectomy (OVX) or sham-OVX surgery being performed at 24 weeks of age. Loading enhanced midshaft ulna cortical bone mass, structure and estimated strength. These benefits persisted lifelong and contributed to loaded ulnas having greater strength after detraining. Loading also had effects on cortical bone quality. The benefits of loading when young were not influenced by a surgically-induced menopause as there were no interactions between loading and surgery. However, OVX had independent effects on cortical bone mass, structure and estimated strength at early post-surgery time points (up to age=58 weeks) and bone quality measures. These data indicate skeletal loading when young had lifelong benefits on cortical bone properties that persisted independent of a surgically-induced menopause. This suggests that skeletal loading associated with exercise when young may provide lifelong anti-fracture benefits by priming the skeleton to offset the cortical bone changes associated with aging and menopause. HubMed – rehab


Microbiological Evaluation of Bacterial and Mycotic Seal in Implant Systems With Different Implant-Abutment Interfaces and Closing Torque Values.

Implant Dent. 2013 Jun 18;
Baggi L, Di Girolamo M, Mirisola C, Calcaterra R

OBJECTIVE:: The aim of this study was to evaluate the possible leakage of 3 species of bacteria (Streptococcus sanguinis, Fusobacterium nucleatum, and Actinomyces odontolyticus) and of Candida albicans and Candida glabrata in osseointegrated implants with different implant-abutment interface (IAI) geometry. MATERIALS AND METHODS:: Two groups of implants, (1) implant-abutment unit with a tube-in-tube interface and (2) implant-abutment unit with a flat-to-flat interface closed with different torque values, were compared in the study. In the first phase, the implants were assembled and cultured in vitro for 7 days. The implants and abutments were disconnected and samples were taken and cultured. In the second phase, the internal part of each implant was inoculated with 0.1 µL of microbial broth and then connected to the respective abutments. Afterward, medium samples were taken and cultured. RESULTS:: The group 1 implants were more resistant to colonization than those of group 2 (P < 0.05). The intragroup difference was significant between the implant-abutment units assembled with the recommended torque values and those with lower torque values (P < 0.01) for both the groups. CONCLUSION:: IAI geometry influences both bacterial and yeast colonization inside the implants as well as the torque value used to connect abutments to implants. HubMed – rehab



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