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Cunningham G, Charbonnier C, Lädermann A, Chagué S, Sonnabend DH. Shoulder Motion Analysis During Codman Pendulum Exercises. Arthrosc Sports Med Rehabil 2020; 2:e333-e339. [PMID: 32875297 PMCID: PMC7451869 DOI: 10.1016/j.asmr.2020.04.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Accepted: 04/23/2020] [Indexed: 11/15/2022] Open
Abstract
Purpose To quantify shoulder motion during Codman pendulum exercises. Methods Shoulder kinematics were analyzed in 17 healthy volunteers using a validated biomechanical model coupling patient-specific imaging and motion capture. Participants were instructed to perform medio-lateral, antero-posterior and circular pendulum exercises. Glenohumeral (GH), scapulothoracic (ST), thoracohumeral (TH) ROM and overall exercise amplitude were calculated for each sequence. Linear regression analyses were carried out to determine association between different components of shoulder motion. Results Mean overall exercise amplitude was 40.59±11.24° (range, 25.38 to 70.25°) for medio-lateral exercises, 46.5±22.02° (range, 20.68 to 100.24°) for antero-posterior exercises, and 20.28±7.13° (range, 10.9 to 35.49°) for circular exercises. Mean GH and ST involvement remained minimal, ranging from 6.74 to 13.81°, and 1.5° to 5.12°, respectively. There was no significant correlation between overall exercise amplitude and GH (R = 0.31, p = 0.01) or ST ROM (adjusted R2 = 0.57, p < 0.001), but a moderate correlation with TH ROM (R = 0.73, p < 0.001). Conclusion This study demonstrates that Codman pendulum exercises depend mainly on truncal movement and produce very little movement in the GH and ST joints. Although they may be a safe way to promote early general stretching of the upper limb, they may be of limited further use in restoring passive shoulder ROM. Clinical Relevance This study quantifies motion during frequently administered shoulder rehabilitation exercises and shows that they do not produce significant movement in the shoulder. Their use in restoring passive range of motion is thus questionable.
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Affiliation(s)
- Gregory Cunningham
- Division of Orthopaedic and Trauma surgery, Geneva University Hospitals, Geneva, Switzerland.,Shoulder Center, Hirslanden Clinique La Colline, Geneva, Switzerland
| | - Caecilia Charbonnier
- Artanim Foundation, Medical Research Department, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Alexandre Lädermann
- Division of Orthopaedic and Trauma surgery, Geneva University Hospitals, Geneva, Switzerland.,Shoulder Center, Hirslanden Clinique La Colline, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Sylvain Chagué
- Artanim Foundation, Medical Research Department, Geneva, Switzerland
| | - David H Sonnabend
- Institute of Bone and Joint Surgery, University of Sydney, Australia
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Lädermann A, Chagué S, Preissmann D, Kolo FC, Rime O, Kevelham B, Bothorel H, Charbonnier C. Guided versus freehand acromioplasty during rotator cuff repair. A randomized prospective study. Orthop Traumatol Surg Res 2020; 106:651-659. [PMID: 32444201 DOI: 10.1016/j.otsr.2020.02.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 01/24/2020] [Accepted: 02/18/2020] [Indexed: 02/03/2023]
Abstract
INTRODUCTION There is no consensus on how to perform acromioplasty, particularly regarding the level and extent of bone resection, which depend on scapular and humeral morphologies. HYPOTHESIS We aimed to determine whether computer-assisted acromioplasty planning helps surgeons remove impinging bone, reduce unnecessary resections, and improve short-term outcomes of rotator cuff tears (RCR). PATIENTS AND METHODS We randomized 64 patients undergoing RCR of full-thickness supraspinatus tears into two groups: 'guided acromioplasty' (GA) and 'freehand acromioplasty' (FA). The pre- and post-operative scapula models were reconstructed using computed-tomography scans to quantify impinging bone removal, unnecessary bone resections, and identify zones of acromial bone removal. All patients were evaluated preoperatively and at 6 months to assess their range of motion (ROM), functional scores and tendon integrity using ultrasound. RESULTS The two groups did not differ in demographics, clinical or morphologic characteristics. Compared to FA, GA tended to lower impinging bone removal (55±26% vs. 43±27%, p=0.087) and to increase unnecessary resection of the total bone removed (49±22% vs. 57±27%, p=0.248). GA resulted in significant anterior under-resection, while FA resulted in significant medial over-resection. Clinical outcomes and ROM improved significantly for all patients, except for internal rotation in the GA group. There were no other significant differences between the two groups, neither in terms of post-operative scores nor in terms of clinical net improvements, nor tendon repair integrity. CONCLUSIONS This computer-assisted planning for acromioplasty during RCR proved no benefits in terms of bone removal, tendon healing, or clinical outcomes. Nonetheless such planning tools could help less experienced surgeons improve the efficacy of acromioplasty. LEVEL OF PROOF I, Randomized controlled trial (Therapeutic study).
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Affiliation(s)
- Alexandre Lädermann
- Division of Orthopaedics and Trauma Surgery, La Tour Hospital, Avenue J.-D.-Maillard 3, 1217 Meyrin, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland; Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland.
| | - Sylvain Chagué
- Medical Research Department, Artanim Foundation, Meyrin, Switzerland
| | - Delphine Preissmann
- Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, CH-1008 Prilly, Switzerland
| | | | - Olivier Rime
- Division of Physiotherapy, La Tour Hospital, Meyrin, Switzerland
| | - Bart Kevelham
- Medical Research Department, Artanim Foundation, Meyrin, Switzerland
| | | | - Caecilia Charbonnier
- Faculty of Medicine, University of Geneva, Geneva, Switzerland; Medical Research Department, Artanim Foundation, Meyrin, Switzerland
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Lädermann A, Chagué S, Preissmann D, Kolo FC, Zbinden O, Kevelham B, Bothorel H, Charbonnier C. Acromioplasty during repair of rotator cuff tears removes only half of the impinging acromial bone. JSES Int 2020; 4:592-600. [PMID: 32939492 PMCID: PMC7479029 DOI: 10.1016/j.jseint.2020.03.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background To date, there is no consensus on when and how to perform acromioplasty during rotator cuff repair (RCR). We aimed to determine the volume of impinging bone removed during acromioplasty and whether it influences postoperative range of motion (ROM) and clinical scores after RCR. Methods Preoperative and postoperative computed tomography scans of 57 shoulders that underwent RCR were used to reconstruct scapula models to simulate volumes of impinging acromial bone preoperatively and then compare them to the volumes of bone resected postoperatively to calculate the proportions of desired (ideal) vs. unnecessary (excess) resections. All patients were evaluated preoperatively and at 6 months to assess ROM and functional scores. Results The volume of impinging bone identified was 3.5 ± 2.3 cm3, of which 1.6 ± 1.2 cm3 (50% ± 27%) was removed during acromioplasty. The volume of impinging bone identified was not correlated with preoperative critical shoulder angle (r = 0.025, P = .853), nor with glenoid inclination (r = -0.024, P = .857). The volume of bone removed was 3.7 ± 2.2 cm3, of which 2.1 ± 1.6 cm3 (53% ± 24%) were unnecessary resections. Multivariable analyses revealed that more extensive removal of impinging bone significantly improved internal rotation with the arm at 90° of abduction (beta, 27.5, P = .048) but did not affect other shoulder movements or clinical scores. Conclusions Acromioplasty removed only 50% of the estimated volume of impinging acromial bone. More extensive removal of impinging bone significantly improved internal rotation with the arm at 90° of abduction.
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Affiliation(s)
- Alexandre Lädermann
- Division of Orthopaedics and Trauma Surgery, La Tour Hospital, Meyrin, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland
| | - Sylvain Chagué
- Medical Research Department, Artanim Foundation, Meyrin, Switzerland
| | - Delphine Preissmann
- Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland
| | | | - Olivia Zbinden
- Service of Orthopedics and Traumatology, Lausanne University Hospital, Lausanne, Switzerland
| | - Bart Kevelham
- Medical Research Department, Artanim Foundation, Meyrin, Switzerland
| | | | - Caecilia Charbonnier
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Medical Research Department, Artanim Foundation, Meyrin, Switzerland
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de Oliveira ME, Debarba HG, Lädermann A, Chagué S, Charbonnier C. A hand-eye calibration method for augmented reality applied to computer-assisted orthopedic surgery. Int J Med Robot 2018; 15:e1969. [DOI: 10.1002/rcs.1969] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 10/25/2018] [Accepted: 10/30/2018] [Indexed: 12/23/2022]
Affiliation(s)
| | | | - Alexandre Lädermann
- Division of Orthopedics and Trauma Surgery; La Tour Hospital; Geneva Switzerland
- Department of Orthopedic Surgery and Traumatology; Geneva University Hospital; Geneva Switzerland
| | - Sylvain Chagué
- Medical Research Department; Artanim Foundation; Geneva Switzerland
| | - Caecilia Charbonnier
- Medical Research Department; Artanim Foundation; Geneva Switzerland
- Faculty of Medicine; University of Geneva; Geneva Switzerland
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Charbonnier C, Chagué S, Kolo FC, Duthon VB, Menetrey J. Multi-body optimization with subject-specific knee models: performance at high knee flexion angles. Comput Methods Biomech Biomed Engin 2017; 20:1571-1579. [DOI: 10.1080/10255842.2017.1390568] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | - Sylvain Chagué
- Medical Research Department, Artanim Foundation, Meyrin, Switzerland
| | | | - Victoria B. Duthon
- Faculty of Medicine, Centre de Médecine de l’appareil locomoteur et du sport, Orthopedics and Trauma Service, University Hospitals of Geneva, Geneva, Switzerland
| | - Jacques Menetrey
- Centre de Médecine de l’appareil locomoteur et du sport, Orthopedics and Trauma Service, University Hospitals of Geneva, Geneva, Switzerland
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Charbonnier C, Lädermann A, Kevelham B, Chagué S, Hoffmeyer P, Holzer N. Shoulder strengthening exercises adapted to specific shoulder pathologies can be selected using new simulation techniques: a pilot study. Int J Comput Assist Radiol Surg 2017; 13:321-330. [DOI: 10.1007/s11548-017-1668-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 09/08/2017] [Indexed: 01/14/2023]
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Preissmann D, Charbonnier C, Chagué S, Antonietti JP, Llobera J, Ansermet F, Magistretti PJ. A Motion Capture Study to Measure the Feeling of Synchrony in Romantic Couples and in Professional Musicians. Front Psychol 2016; 7:1673. [PMID: 27833580 PMCID: PMC5082227 DOI: 10.3389/fpsyg.2016.01673] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 10/12/2016] [Indexed: 11/29/2022] Open
Abstract
The feeling of synchrony is fundamental for most social activities and prosocial behaviors. However, little is known about the behavioral correlates of this feeling and its modulation by intergroup differences. We previously showed that the subjective feeling of synchrony in subjects involved in a mirror imitation task was modulated by objective behavioral measures, as well as contextual factors such as task difficulty and duration of the task performance. In the present study, we extended our methodology to investigate possible interindividual differences. We hypothesized that being in a romantic relationship or being a professional musician can modulate both implicit and explicit synchronization and the feeling of synchrony as well as the ability to detect synchrony from a third person perspective. Contrary to our hypothesis, we did not find significant differences between people in a romantic relationship and control subjects. However, we observed differences between musicians and control subjects. For the implicit synchrony (spontaneous synchronization during walking), the results revealed that musicians that had never met before spontaneously synchronized their movements earlier among themselves than control subjects, but not better than people sharing a romantic relationship. Moreover, in explicit behavioral synchronization tasks (mirror game), musicians reported earlier feeling of synchrony and had less speed errors than control subjects. This was in interaction with tasks difficulty as these differences appeared only in tasks with intermediate difficulty. Finally, when subjects had to judge synchrony from a third person perspective, musicians had a better performance to identify if they were present or not in the videos. Taken together, our results suggest that being a professional musician can play a role in the feeling of synchrony and its underlying mechanisms.
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Affiliation(s)
- Delphine Preissmann
- Agalma FoundationGeneva, Switzerland; Department of Child and Adolescent Psychiatry, Faculty of Medicine, University of Geneva HospitalsGeneva, Switzerland; Cognitive Science Center, University of NeuchâtelNeuchâtel, Switzerland
| | | | - Sylvain Chagué
- Medical Research Department, Artanim Foundation Geneva, Switzerland
| | | | - Joan Llobera
- Immersive Interaction Group, Ecole Polytechnique Fédérale de Lausanne Lausanne, Switzerland
| | - Francois Ansermet
- Agalma FoundationGeneva, Switzerland; Department of Child and Adolescent Psychiatry, Faculty of Medicine, University of Geneva HospitalsGeneva, Switzerland
| | - Pierre J Magistretti
- Agalma FoundationGeneva, Switzerland; Division of Biological and Environmental Sciences and Engineering, King Abdullah University of Science and TechnologyThuwal, Saudi Arabia; Brain Mind Institute, École Polytechnique Fédérale de LausanneLausanne, Switzerland
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Lädermann A, Denard PJ, Tirefort J, Kolo FC, Chagué S, Cunningham G, Charbonnier C. Does surgery for instability of the shoulder truly stabilize the glenohumeral joint?: A prospective comparative cohort study. Medicine (Baltimore) 2016; 95:e4369. [PMID: 27495043 PMCID: PMC4979797 DOI: 10.1097/md.0000000000004369] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Despite the fact that surgery is commonly used to treat glenohumeral instability, there is no evidence that such treatment effectively corrects glenohumeral translation. The purpose of this prospective clinical study was to analyze the effect of surgical stabilization on glenohumeral translation.Glenohumeral translation was assessed in 11 patients preoperatively and 1 year postoperatively following surgical stabilization for anterior shoulder instability. Translation was measured using optical motion capture and computed tomography.Preoperatively, anterior translation of the affected shoulder was bigger in comparison to the normal contralateral side. Differences were significant for flexion and abduction movements (P < 0.001). Postoperatively, no patients demonstrated apprehension and all functional scores were improved. Despite absence of apprehension, postoperative anterior translation for the surgically stabilized shoulders was not significantly different from the preoperative values.While surgical treatment for anterior instability limits the chance of dislocation, it does not seem to restore glenohumeral translation during functional range of motion. Such persistent microinstability may explain residual pain, apprehension, inability to return to activity and even emergence of dislocation arthropathy that is seen in some patients. Further research is necessary to better understand the causes, effects, and treatment of residual microinstability following surgical stabilization of the shoulder.
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Affiliation(s)
- Alexandre Lädermann
- Division of Orthopaedics and Trauma Surgery, Clinique La Colline
- Faculty of Medicine, University of Geneva
- Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland
- Correspondence: Alexandre Lädermann, Division of Orthopaedics and Trauma Surgery, Clinique La Colline, Avenue de Beau-Séjour 6, 1206 Genève, Switzerland (e-mail: )
| | - Patrick J. Denard
- Southern Oregon Orthopedics, Medford
- Department of Orthopaedics and Rehabilitation, Oregon Health & Science University, Portland, OR
| | - Jérôme Tirefort
- Division of Orthopaedics and Trauma Surgery, Clinique La Colline
| | | | - Sylvain Chagué
- Artanim Foundation, Medical Research Department, Geneva, Switzerland
| | - Grégory Cunningham
- Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland
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Lädermann A, Chagué S, Kolo FC, Charbonnier C. Kinematics of the shoulder joint in tennis players. J Sci Med Sport 2014; 19:56-63. [PMID: 25481481 DOI: 10.1016/j.jsams.2014.11.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2014] [Revised: 10/19/2014] [Accepted: 11/07/2014] [Indexed: 01/26/2023]
Abstract
OBJECTIVES Shoulder pain and injury are common in tennis players. The precise causes for such pain remain unclear. Impingement at critical tennis positions and glenohumeral instability have never been dynamically evaluated in vivo. The purpose of this study was to evaluate the different types of impingement and stability during tennis movements. DESIGN Laboratory study. METHODS Type and frequency of impingement as well as percentage of subluxation were evaluated in 10 tennis players through a novel dedicated patient-specific measurement technique based on optical motion capture and Magnetic Resonance Imaging (MRI). RESULTS All volunteers, nine male and one female, had a clinically functional rotator cuff. MRI revealed 11 rotator cuff lesions in six subjects and six labral lesions in five subjects. Lateral subacromial, anterior subacromial, internal anterosuperior, and internal posterosuperior impingements were observed in four, three, two and seven subjects, respectively. No instability could be demonstrated in this population. CONCLUSIONS Tennis players presented frequent radiographic signs of structural lesions that could mainly be related to posterosuperior impingements due to repetitive abnormal motion contacts. This is the first study demonstrating that a dynamic and precise motion analysis of the entire kinematic chain of the shoulder is possible through a non-invasive method of investigation. This premier kinematic observation offers novel insights into the analysis of shoulder impingement and instability that could, with future studies, be generalized to other shoulder pathologies and sports. This original method may open new horizons leading to improvement in impingement comprehension.
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Affiliation(s)
- A Lädermann
- Division of Orthopaedics and Trauma Surgery, La Tour Hospital, Switzerland; Faculty of Medicine, University of Geneva, Switzerland.
| | - S Chagué
- Artanim Foundation, Medical Research Department, Switzerland
| | - F C Kolo
- Rive Droite Radiology Center, Switzerland
| | - C Charbonnier
- Artanim Foundation, Medical Research Department, Switzerland
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Charbonnier C, Chagué S, Kolo FC, Chow JCK, Lädermann A. A patient-specific measurement technique to model shoulder joint kinematics. Orthop Traumatol Surg Res 2014; 100:715-9. [PMID: 25281547 DOI: 10.1016/j.otsr.2014.06.015] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Revised: 06/09/2014] [Accepted: 06/24/2014] [Indexed: 02/02/2023]
Abstract
BACKGROUND Measuring dynamic in vivo shoulder kinematics is crucial to better understanding numerous pathologies. Motion capture systems using skin-mounted markers offer good solutions for non-invasive assessment of shoulder kinematics during dynamic movement. However, none of the current motion capture techniques have been used to study translation values at the joint, which is crucial to assess shoulder instability. The aim of the present study was to develop a dedicated patient-specific measurement technique based on motion capture and magnetic resonance imaging (MRI) to determine shoulder kinematics accurately. HYPOTHESIS Estimation of both rotations and translations at the shoulder joint using motion capture is feasible thanks to a patient-specific kinematic chain of the shoulder complex reconstructed from MRI data. MATERIALS AND METHODS We implemented a patient-specific kinematic chain model of the shoulder complex with loose constraints on joint translation. To assess the effectiveness of the technique, six subjects underwent data acquisition simultaneously with fluoroscopy and motion capture during flexion and empty-can abduction. The reference 3D shoulder kinematics was reconstructed from fluoroscopy and compared to that obtained from the new technique using skin markers. RESULTS Root mean square errors (RMSE) for shoulder orientation were within 4° (mean range: 2.0°-3.4°) for each anatomical axis and each motion. For glenohumeral translations, maximum RMSE for flexion was 3.7mm and 3.5mm for empty-can abduction (mean range: 1.9-3.3mm). Although the translation errors were significant, the computed patterns of humeral translation showed good agreement with published data. DISCUSSION To our knowledge, this study is the first attempt to calculate both rotations and translations at the shoulder joint based on skin-mounted markers. Results were encouraging and can serve as reference for future developments. The proposed technique could provide valuable kinematic data for the study of shoulder pathologies. LEVEL OF EVIDENCE Basic Science Study.
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Affiliation(s)
- C Charbonnier
- Artanim Foundation, Medical Research Department, Geneva, Switzerland.
| | - S Chagué
- Artanim Foundation, Medical Research Department, Geneva, Switzerland
| | - F C Kolo
- Rive Droite Radiology Center, Geneva, Switzerland
| | - J C K Chow
- Department of Geomatics Engineering, University of Calgary, Calgary, Canada
| | - A Lädermann
- Division of Orthopaedics and Trauma Surgery, La Tour Hospital, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland
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