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Reliability and validity of OpenPose for measuring hip-knee-ankle angle in patients with knee osteoarthritis. Sci Rep 2023; 13:3297. [PMID: 36841842 PMCID: PMC9968277 DOI: 10.1038/s41598-023-30352-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 02/21/2023] [Indexed: 02/27/2023] Open
Abstract
We aimed to assess the reliability and validity of OpenPose, a posture estimation algorithm, for measuring hip-knee-ankle (HKA) angle in patients with knee osteoarthritis, by comparing it with radiography. In this prospective study, we analysed 60 knees (30 patients) with knee osteoarthritis. We measured HKA angle using OpenPose and radiography before or after total knee arthroplasty and assessed the test-retest reliability of each method with intraclass correlation coefficient (1, 1). We evaluated the ability to estimate the radiographic measurement values from the OpenPose values using linear regression analysis and used intraclass correlation coefficients (2, 1) and Bland-Altman analyses to evaluate the agreement and error between OpenPose and radiographic measurements. OpenPose had excellent test-retest reliability (intraclass correlation coefficient (1, 1) = 1.000) and excellent agreement with radiography (intraclass correlation coefficient (2, 1) = 0.915), with regression analysis indicating a large correlation (R2 = 0.865). OpenPose also had a 1.1° fixed error and no systematic error when compared with radiography. This is the first study to validate the use of OpenPose for the estimation of HKA angle in patients with knee osteoarthritis. OpenPose is a reliable and valid tool for measuring HKA angle in patients with knee osteoarthritis. OpenPose, which enables non-invasive and simple measurements, may be a useful tool to assess changes in HKA angle and monitor the progression and post-operative course of knee osteoarthritis. Furthermore, this validated tool can be used not only in clinics and hospitals, but also at home and in training gyms; thus, its use could potentially be expanded to include self-assessment/monitoring.
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Wu R, Fu G, Li M, Ma Y, Li Q, Deng Z, Zheng Q. Contralateral advanced radiographic knee osteoarthritis predicts radiographic progression and future arthroplasty in ipsilateral knee with early-stage osteoarthritis. Clin Rheumatol 2022; 41:3151-3157. [PMID: 35687166 DOI: 10.1007/s10067-022-06235-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 05/13/2022] [Accepted: 06/01/2022] [Indexed: 02/05/2023]
Abstract
PURPOSE To explore whether the severity of contralateral knee osteoarthritis (OA) is associated with OA progression in ipsilateral knee with early OA. METHODS Knees in early OA (Kellgren-Lawrence grade (KLG):1-2) with intact baseline demographic and clinical data were retrieved from OAI database and defined as target knees. The target knees were divided into the exposure group (contralateral knees KLG 3 to 4) and the control group (contralateral knees KLG 0 to 2). Both groups underwent propensity score matching (PSM) concerning demographic data, as well as radiographic and clinical outcomes at the baseline. The primary outcome was the upgrade of KLG in the target knee in the first 12 and 24 months. The secondary outcome was the incidence of knee arthroplasty in ipsilateral knee during the first 108 months. RESULTS One thousand seven hundred fifty-two knees were included, with 449 in the exposure cohort and 1276 in the control cohort. Four hundred thirty-four knees in each group were matched after PSM. Target knees in the exposure cohort showed a significantly higher rate of radiographic progression in the first 12 months (12.9% vs. 5.1%, P < 0.001) and 24 months (19.6% vs. 8.1%, P < 0.001). As for the risk of future arthroplasty, a significant difference was also found between the two groups (7.8% vs. 4.0%, P = 0.02). Kaplan-Meier analysis showed that the 108-month accumulated knee survival rate was significantly lower in the exposure group (P = 0.01). CONCLUSION The ipsilateral knee with early-stage OA is prone to have worse early to mid-, and long-term prognosis in the circumstance of contralateral radiographic advanced knee OA. Key Points •Identifying early knee osteoarthritis (OA) with a high risk of radiographic progression and future arthroplasty enables early personalized intervention. •This is a novel study to investigate the relationship between the risk of future arthroplasty and contralateral knee status. •Propensity score matching holds promise to minimize selection bias in observational studies. •Knees with early OA are prone to have a high risk of radiographic progression and future arthroplasty in the circumstance of contralateral advanced knee OA.
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Affiliation(s)
- Rongjie Wu
- Department of Orthopedics, Guangdong Province, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, People's Republic of China
- Guangdong Province, Shantou University Medical College, Shantou, People's Republic of China
| | - Guangtao Fu
- Department of Orthopedics, Guangdong Province, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, People's Republic of China
| | - Mengyuan Li
- Department of Orthopedics, Guangdong Province, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, People's Republic of China
| | - Yuanchen Ma
- Department of Orthopedics, Guangdong Province, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, People's Republic of China
| | - Qingtian Li
- Department of Orthopedics, Guangdong Province, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, People's Republic of China
| | - Zhantao Deng
- Department of Orthopedics, Guangdong Province, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, People's Republic of China
| | - Qiujian Zheng
- Department of Orthopedics, Guangdong Province, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, People's Republic of China.
- The Second School of Clinical Medicine, Guangdong Province, Southern Medical University, Guangzhou, People's Republic of China.
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Zeng Z, Shan J, Zhang Y, Wang Y, Li C, Li J, Chen W, Ye Z, Ye X, Chen Z, Wu Z, Zhao C, Xu X. Asymmetries and relationships between muscle strength, proprioception, biomechanics, and postural stability in patients with unilateral knee osteoarthritis. Front Bioeng Biotechnol 2022; 10:922832. [PMID: 36185430 PMCID: PMC9523444 DOI: 10.3389/fbioe.2022.922832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 08/02/2022] [Indexed: 11/23/2022] Open
Abstract
Background: The pathological mechanism of knee osteoarthritis (KOA) is unknown. KOA degeneration may be associated with changes in muscle strength, proprioception, biomechanics, and postural stability. Objective: This study aimed to assess asymmetries in muscle strength, proprioception, biomechanics, and postural stability of bilateral lower limbs in patients with unilateral KOA and healthy controls and analyze correlations between KOA and these parameters. Methods: A total of 50 patients with unilateral KOA (age range: 50-70) and 50 healthy subjects were recruited as study participants (age range: 50-70). Muscle strength, proprioception, femorotibial angle (FTA), femoral condylar–tibial plateau angle (FCTP), average trajectory error (ATE), and center of pressure (COP) sways areas were accessed in study participants, and the correlation between these variables was investigated. Results: In patients with unilateral KOA, lower limb muscle strength was significantly lower on the symptomatic side than on the asymptomatic side (p < 0.01), while the proprioception (degree error), FTA, FCTP, and ATE were substantially higher compared to the asymptomatic side (p < 0.01). However, no significant difference was observed in the healthy controls (p > 0.05). Patients with unilateral KOA had lower muscle strength than healthy controls (p < 0.05), but their proprioception (degree error: the difference between the target and reproduction angles), ATE, and COP sway areas were higher (p < 0.05). Muscle strength was found to be negatively correlated with ATE and COP sways areas (p < 0.05), whereas proprioception (degree error) was positively correlated with ATE and COP sways areas (p < 0.05) in all study participants. However, no correlation was found between FTA, FCTP, and ATE, COP sways areas in patients with unilateral KOA (p > 0.05). Conclusion: In patients with unilateral KOA, muscle strength, proprioception, biomechanics, and postural stability of bilateral limbs are asymmetrical in unilateral KOA patients. Muscle strength, proprioception, and postural stability are significantly associated variables, and changes in these variables should be considered in KOA prevention and rehabilitation.
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Affiliation(s)
- Ziquan Zeng
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Provincial Second Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Jiaxin Shan
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yilong Zhang
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yi Wang
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Congcong Li
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Junyi Li
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Weijian Chen
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zixuan Ye
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiangling Ye
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zehua Chen
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zugui Wu
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
- *Correspondence: Xuemeng Xu, ; Chuanxi Zhao, ; Zugui Wu,
| | - Chuanxi Zhao
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Provincial Second Hospital of Traditional Chinese Medicine, Guangzhou, China
- *Correspondence: Xuemeng Xu, ; Chuanxi Zhao, ; Zugui Wu,
| | - Xuemeng Xu
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Provincial Second Hospital of Traditional Chinese Medicine, Guangzhou, China
- *Correspondence: Xuemeng Xu, ; Chuanxi Zhao, ; Zugui Wu,
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Emre F, Çağlar C, Kaya Ö. Open reduction internal fixation versus minimally invasive percutaneous fixation for calcaneus fractures: Mid-term outcomes and social consequences. Jt Dis Relat Surg 2021; 32:825. [PMID: 34145821 PMCID: PMC8343830 DOI: 10.52312/jdrs.2021.95] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 04/26/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES This study aims to evaluate the mid-term clinical, functional, radiological, and socioeconomic outcomes of calcaneus fractures treated with open reduction-internal fixation (ORIF) versus minimally invasive percutaneous fixation (MIPF). PATIENTS AND METHODS A total of 48 patients (34 males, 14 females; mean age: 44.05 years; range, 19 to 64 years) who underwent either ORIF or MIPF for calcaneus fractures between January 2010 and January 2016 were retrospectively analyzed. The patients were divided into two groups as the ORIF group (n=36) and MIPF group (n=12). The American Orthopaedic Foot & Ankle Society (AOFAS) score, Maryland Foot Score (MFS), and the Short Form-36 (SF-36) scores were assessed for the clinical assessment. The mean duration of operation, mean length of hospitalization, pedobarographic gait analysis, the incidence of contralateral knee pain, increased shoe size, and change of profession due to significant heel pain were also evaluated. The Böhler's angle, Gissane angle, and calcaneal varus were measured for radiological assessment. RESULTS There was a significant difference in the mean operation time (p=0.001) and length of hospitalization (p=0.001) between the two groups. There was no significant difference between the pre- and postoperative third-year Böhler's and Gissane angles (p=0.05, p=0.07, p=0.09, respectively). There were no significant differences between the postoperative first-, second-, and third-year AOFAS, MFS, and SF-36 scores (p=0.57, p=0.55 p=0.85, p=0.64, p=0.21, p=0.51, p=0.20, p=0.15, p=0.22, respectively). Thirteen patients in the ORIF group and five patients in the MIPF group changed their job due to significant heel pain. The increased shoe size was correlated with the residual calcaneal varus (p=0.001). CONCLUSION Both methods have pros and cons in the treatment of calcaneal fractures. Although MIPF is more advantageous in terms of operation duration and length of hospitalization, more favorable radiological results can be obtained with ORIF. Calcaneal varus should be corrected to prevent the increased shoe size and contralateral knee pain.
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Affiliation(s)
| | - Ceyhun Çağlar
- Ankara Şehir Hastanesi Ortopedi ve Travmatoloji Kliniği, 06800 Çankaya, Ankara, Türkiye
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Yap YT, Gouwanda D, Gopalai AA, Chong YZ. The effect of asymmetrical gait induced by unilateral knee brace on the knee flexor and extensor muscles. Med Biol Eng Comput 2021; 59:711-720. [PMID: 33625670 DOI: 10.1007/s11517-021-02337-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 02/09/2021] [Indexed: 11/29/2022]
Abstract
Asymmetrical stiff knee gait is a mechanical pathology that can disrupt lower extremity muscle coordination. A better understanding of this condition can help identify potential complications. This study proposes the use of dynamic musculoskeletal modelling simulation to investigate the effect of induced mechanical perturbation on the kneeand to examine the muscle behaviour without invasive technique. Thirty-eight healthy participants were recruited. Asymmetrical gait was simulated using knee brace. Knee joint angle, joint moment and knee flexor and extensor muscle forces were computed using OpenSim. Differences inmuscle force between normal and abnormal conditions were investigated using ANOVA and Tukey-Kramer multiple comparison test.The results revealed that braced knee experienced limited range of motion with smaller flexion moment occuring at late swing phase. Significant differences were found in all flexormuscle forces and in several extensor muscle forces (p<0.05). Normal knee produced larger flexor muscle force than braced knee. Braced knee generated the largest extensor muscle force at early swing phase. In summary, musculoskeletal modelling simulation can be a computational tool to map and detect the differences between normal and asymmetrical gaits.
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Affiliation(s)
- Yi Ting Yap
- School of Engineering, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Selangor Darul Ehsan, Malaysia.
| | - Darwin Gouwanda
- School of Engineering, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Selangor Darul Ehsan, Malaysia
| | - Alpha A Gopalai
- School of Engineering, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Selangor Darul Ehsan, Malaysia
| | - Yu Zheng Chong
- Faculty of Engineering and Science, Universiti Tunku Abdul Rahman, Selangor Darul Ehsan, Malaysia
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Hao P, Yang L, He R, Chen H, Sun M, Liang S. [Analysis of gait and effectiveness after unicompartmental knee arthroplasty]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2020; 34:1369-1375. [PMID: 33191692 DOI: 10.7507/1002-1892.202004076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective To explore the gait trajectory characteristics and effectiveness after unicompartmental knee arthroplasty (UKA). Methods Thirty patients (30 knees) with anterior medial compartment osteoarthritis who were treated with UKA between January 2017 and December 2018 were selected as subjects (UKA group). According to age, gender, and side, 30 patients (30 knees) with knee osteoarthritis treated with total knee arthroplasty (TKA) were selected as control (TKA group). In addition to the range of motion (ROM) before operation showing significant difference between the two groups ( t=4.25, P=0.00), there was no significant difference in gender, age, disease duration, sides, body mass index, and preoperative hip-knee-ankle angle (HKA), Western Ontario and McMaster University Osteoarthritis Index (WOMAC) score between the two groups ( P>0.05). The incision length, drainage volume within 24 hours after operation, and the changes of hemoglobin and albumin were recorded. The WOMAC score, ROM, and HKA before and after operation were compared between the two groups. At 1 year after operation, the gait trajectory characteristics of two groups were analyzed by Vicon three-dimensional gait capture system, and the absolute symmetry index (ASI) of the lower limbs of the two groups was calculated. Results The incisions of the two groups healed by first intention, with no complications. The incision length, drainage volume within 24 hours, and the changes of hemoglobin and albumin after operation in the UKA group were significantly smaller than those in the control group ( P<0.05). All patients were followed up completely, the follow-up time ranged from 13 to 20 months of UKA group (mean, 18 months) and 16 to 24 months of control group (mean, 20 months). The imaging review showed that the lower limb alignment of the two groups were restored to a neutral position, and the position of prosthesis was good. At 1 year after operation, the WOMAC score, HKA, and ROM of two groups were significantly improved when compared with those before operation ( P<0.05); the postoperative WOMAC score and ROM of the UKA group were significantly better than those of the control group ( P<0.05), and there was no significant difference in HKA between the two groups ( t=1.54, P=0.13). Gait analysis at 1 year after operation showed that the walking speed, stride length, knee extension at mid-stance, and flexion at swing in the UKA group were significantly better than those in the TKA group ( P<0.05); there was no significant difference in cadence, knee flexion at initial contact, and knee flexion at loading response between the two groups ( P>0.05). The ASI of bilateral knee flexion in the UKA group was significantly greater than that in the TKA group during the initial contact and loading response period ( P<0.05). Conclusion Compared with TKA, UKA has the advantages of small incision, less blood loss, and quicker functional recovery. The early gait after UKA is mainly manifested as the increase in walking speed, stride length, knee flexion at swing, and extension at mid-stance phase. From the analysis of gait symmetry, during the initial contact and loading response phase, the operation side after UKA undertakes more shock absorption and joint stabilization functions than the contralateral side.
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Affiliation(s)
- Peng Hao
- Center for Joint Surgery, the First Affiliated Hospital, Army Medical University, Chongqing, 400038, P.R.China
| | - Liu Yang
- Center for Joint Surgery, the First Affiliated Hospital, Army Medical University, Chongqing, 400038, P.R.China
| | - Rui He
- Center for Joint Surgery, the First Affiliated Hospital, Army Medical University, Chongqing, 400038, P.R.China
| | - Hao Chen
- Center for Joint Surgery, the First Affiliated Hospital, Army Medical University, Chongqing, 400038, P.R.China
| | - Maolin Sun
- Center for Joint Surgery, the First Affiliated Hospital, Army Medical University, Chongqing, 400038, P.R.China
| | - Shuainan Liang
- Center for Joint Surgery, the First Affiliated Hospital, Army Medical University, Chongqing, 400038, P.R.China
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