Dual-energy X-ray absorptiometry for measuring total bone mineral content in the rat: study of accuracy and precision

Sequential studies of osteopenic bone disease in small animals require the availability of non-invasive, accurate and precise methods to assess bone mineral content (BMC) and bone mineral density (BMD). Dual-energy X-ray absorptiometry (DXA), which is currently used in humans for this purpose, can also be applied to small animals by means of adapted software. Precision and accuracy of DXA was evaluated in 10 rats weighing 50-265 g. The rats were anesthetized with a mixture of ketamine-xylazine administrated intraperitoneally. Each rat was scanned six times consecutively in the antero-posterior incidence after repositioning using the rat whole-body software for determination of whole-body BMC and BMD (Hologic QDR 1000, software version 5.52). Scan duration was 10-20 min depending on rat size. After the last measurement, rats were sacrificed and soft tissues were removed by dermestid beetles. Skeletons were then scanned in vitro (ultra high resolution software, version 4.47). Bones were subsequently ashed and dissolved in hydrochloric acid and total body calcium directly assayed by atomic absorption spectrophotometry (TBCa[chem]). Total body calcium was also calculated from the DXA whole-body in vivo measurement (TBCa[DXA]) and from the ultra high resolution measurement (TBCa[UH]) under the assumption that calcium accounts for 40.5% of the BMC expressed as hydroxyapatite. Precision error for whole-body BMC and BMD (mean +/- S.D.) was 1.3% and 1.5%, respectively. Simple regression analysis between TBCa[DXA] or TBCa[UH] and TBCa[chem] revealed tight correlations (n = 0.991 and 0.996, respectively), with slopes and intercepts which were significantly different from 1 and 0, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

The effectiveness of laceback ligatures during initial orthodontic alignment: a systematic review and meta-analysis

Lacebacks may be used to limit unwanted incisor proclination during initial orthodontic alignment; however, their use has not met with universal approval. This systematic review aims to appraise the evidence in relation to the effectiveness of lacebacks in controlling incisor position during initial alignment. Electronic database searches of published literature (MEDLINE via Ovid, Cochrane Central Register of Controlled Trials, LILACS, and IBECS) and unpublished literature were performed. Search terms used included randomized controlled trial, controlled clinical trial, random allocation, double blind method, orthodontics, and laceback. Data were extracted using custom forms. Risk of bias assessment was made using the Cochrane Collaboration risk of bias tool. The quality of the evidence was also assessed using GRADE. Mean differences in incisor inclination and antero-posterior changes in incisor and molar position during alignment were calculated. Two studies involving 97 participants were found to be at low risk of bias and were included in the quantitative synthesis. The random effects meta-analysis demonstrated that the use of lacebacks was associated with 0.5 mm greater posterior movement of the incisors during alignment; this finding was of limited clinical importance and statistically non-significant [95 per cent confidence interval (CI): -1.25, 0.25, P = 0.19]. Little difference (0.46 mm) was also found between laceback and non-laceback groups with regards to mesial molar movement (95 per cent CI: -0.33, 1.24, P = 0.26). According to the GRADE assessment, the overall quality of evidence relating to the use of lacebacks was high. There is no evidence to support the use of lacebacks for the control of the sagittal position of the incisors during initial orthodontic alignment.

Unusual cause of myocardial infarction and congestive heart failure in a patient with prosthetic valve endocarditis

In a patient with staphylococcus lugdunensis prosthetic aortic valve endocarditis and coronary septic embolism accompanied by antero-lateral myocardial infarction, embolic material was successfully aspirated from the bifurcation of the left anterior descending coronary artery and the first diagonal branch. A good angiographic result was documented six months thereafter when the patient presented with a second complication, pulsatile compression of the left main coronary artery by an abscess cavity originating between the aortic and mitral annulus, leading to congestive heart failure. The patient underwent successful surgical replacement of the aortic valve prosthesis with concomitant patch reconstruction of the annulus as well as tricuspid annuloplasty.

High frequency repetitive transcranial magnetic stimulation (rTMS) of the left dorsolateral cortex: EEG topography during waking and subsequent sleep.

Repetitive transcranial magnetic stimulation (rTMS) is a novel research tool in neurology and psychiatry. It is currently being evaluated as a conceivable alternative to electroconvulsive therapy for the treatment of mood disorders. Eight healthy young (age range 21-25 years) right-handed men without sleep complaints participated in the study. Two sessions at a 1-week interval, each consisting of an adaptation night (sham stimulation) and an experimental night (rTMS in the left dorsolateral prefrontal cortex or sham stimulation; crossover design), were scheduled. In each subject, 40 trains of 2-s duration of rTMS (inter-train interval 28 s) were applied at a frequency of 20 Hz (i.e. 1600 pulses per session) and at an intensity of 90% of the motor threshold. Stimulations were scheduled 80 min before lights off. The waking EEG was recorded for 10-min intervals approximately 30 min prior to and after the 20-min stimulations, and polysomnographic recordings were obtained during the subsequent sleep episode (23.00-07.00 h). The power spectra of two referential derivations, as well as of bipolar derivations along the antero-posterior axis over the left and right hemispheres, were analyzed. rTMS induced a small reduction of sleep stage 1 (in min and percentage of total sleep time) over the whole night and a small enhancement of sleep stage 4 during the first non-REM sleep episode. Other sleep variables were not affected. rTMS of the left dorsolateral cortex did not alter the topography of EEG power spectra in waking following stimulation, in the all-night sleep EEG, or during the first non-REM sleep episode. Our results indicate that a single session of rTMS using parameters like those used in depression treatment protocols has no detectable side effects with respect to sleep in young healthy males.

Rib fractures at postmortem computed tomography (PMCT) validated against the autopsy

To evaluate the sensitivity of postmortem computed tomography (PMCT) in rib fracture detection validated against autopsy. Fifty-one forensic cases underwent a postmortem CT prior to forensic autopsy. Two image readers (radiologist and forensic pathologist) assessed high resolution CT data sets for rib fractures. Correct recognition rates (CRR), sensitivity and specificity values were calculated over all observations as well as individually for every rib and region. Additionally, for partial rib fractures the sensitivity of autopsy was calculated vice versa. 3876 entries in each study protocol (autopsy, PMCT radiologist and PMCT forensic pathologist) were investigated. A total of 690 fractures (autopsy), 491 (PMCT and radiologist) and 559 (PMCT and forensic pathologist) were detected. The CRR was 0.85. Sensitivity and specificity of PMCT for rib fracture detection were 0.63 (0.58 radiologist, 0.68 forensic pathologist) and 0.97 (both readers 0.97), respectively. Low CRR and sensitivity values were obtained for antero-lateral fractures. Partial rib fractures were better detected by PMCT. PMCT has a rather low sensitivity for rib fracture detection when validated against autopsy and indicates that clinical CT may also demonstrate a reasonable number of false negatives. Partial rib fractures often remain undetected at autopsy.

Tissue properties of the human vertebral body sub-structures evaluated by means of microindentation

Purpose The better understanding of vertebral mechanical properties can help to improve the diagnosis of vertebral fractures. As the bone mechanical competence depends not only from bone mineral density (BMD) but also from bone quality, the goal of the present study was to investigate the anisotropic indentation moduli of the different sub-structures of the healthy human vertebral body and spondylophytes by means of microindentation. Methods Six human vertebral bodies and five osteophytes (spondylophytes) were collected and prepared for microindentation test. In particular, indentations were performed on bone structural units of the cortical shell (along axial, circumferential and radial directions), of the endplates (along the anterio-posterior and lateral directions), of the trabecular bone (along the axial and transverse directions) and of the spondylophytes (along the axial direction). A total of 3164 indentations down to a maximum depth of 2.5 µm were performed and the indentation modulus was computed for each measurement. Results The cortical shell showed an orthotropic behavior (indentation modulus, Ei, higher if measured along the axial direction, 14.6±2.8 GPa, compared to the circumferential one, 12.3±3.5 GPa, and radial one, 8.3±3.1 GPa). Moreover, the cortical endplates (similar Ei along the antero-posterior, 13.0±2.9 GPa, and along the lateral, 12.0±3.0 GPa, directions) and the trabecular bone (Ei= 13.7±3.4 GPa along the axial direction versus Ei=10.9±3.7 GPa along the transverse one) showed transversal isotropy behavior. Furthermore, the spondylophytes showed the lower mechanical properties measured along the axial direction (Ei=10.5±3.3 GPa). Conclusions The original results presented in this study improve our understanding of vertebral biomechanics and can be helpful to define the material properties of the vertebral substructures in computational models such as FE analysis.

Synchrotron x ray induced axonal transections in the brain of rats assessed by high-field diffusion tensor imaging tractography

Since approximately two thirds of epileptic patients are non-eligible for surgery, local axonal fiber transections might be of particular interest for them. Micrometer to millimeter wide synchrotron-generated X-ray beamlets produced by spatial fractionation of the main beam could generate such fiber disruptions non-invasively. The aim of this work was to optimize irradiation parameters for the induction of fiber transections in the rat brain white matter by exposure to such beamlets. For this purpose, we irradiated cortex and external capsule of normal rats in the antero-posterior direction with a 4 mm×4 mm array of 25 to 1000 µm wide beamlets and entrance doses of 150 Gy to 500 Gy. Axonal fiber responses were assessed with diffusion tensor imaging and fiber tractography; myelin fibers were examined histopathologically. Our study suggests that high radiation doses (500 Gy) are required to interrupt axons and myelin sheaths. However, a radiation dose of 500 Gy delivered by wide minibeams (1000 µm) induced macroscopic brain damage, depicted by a massive loss of matter in fiber tractography maps. With the same radiation dose, the damage induced by thinner microbeams (50 to 100 µm) was limited to their paths. No macroscopic necrosis was observed in the irradiated target while overt transections of myelin were detected histopathologically. Diffusivity values were found to be significantly reduced. A radiation dose ≤ 500 Gy associated with a beamlet size of < 50 µm did not cause visible transections, neither on diffusion maps nor on sections stained for myelin. We conclude that a peak dose of 500 Gy combined with a microbeam width of 100 µm optimally induced axonal transections in the white matter of the brain.

Making minimally invasive THR safe: conclusions from biomechanical simulation and analysis.

The use of smaller surgical incisions has become popularized for total hip arthroplasty (THR) because of the potential benefits of shorter recovery and improved cosmetic appearance. However, an increased incidence of serious complications has been reported. To minimize the risks of minimally invasive approaches to THR, we have developed an experimental approach which enables us to evaluate risk factors in these procedures through cadaveric simulations performed within the laboratory. During cadaveric hip replacement procedures performed via posterior and antero-lateral mini-incisions, pressures developed between the wound edges and the retractors were approximately double those recorded during conventional hip replacement using Charnley retractors (p < 0.01). In MIS procedures performed via the dual-incision approach, lack of direct visualisation of the proximal femur led to misalignment of broaches and implants with increased risk of cortical fracture during canal preparation and implant insertion. Cadaveric simulation of surgical procedures allows surgeons to measure variables affecting the technical success of surgery and to master new procedures without placing patients at risk.

Age, trauma and the critical shoulder angle accurately predict supraspinatus tendon tears.

BACKGROUND The pathogenesis of full-thickness tears of the rotator cuff remains unclear. Apart from age and trauma, distinct scapular morphologies have been found to be associated with rotator cuff disease. The purpose of the present study was to evaluate whether a score formed using these established risk factors was able to predict the presence of a rotator cuff tear reliably. METHODS We retrospectively assessed a consecutive series of patients with a minimal age of 40 years old, who had true antero-posterior (AP) radiographs of their shoulders, as well as a magnetic resonance (MR) gadolinium-arthrography, between January and December 2011. In all of these patients, the critical shoulder angle (CSA) was determined, and MR images were assessed for the presence of rotator cuff tears. Additionally, the patients' charts were reviewed to obtain details of symptom onset. Based on these factors, the so-called rotator cuff tear (RCT) score was calculated. RESULTS Patients with full-thickness RCTs were significantly older and had significantly larger CSAs than patients with intact rotator cuffs. Multiple logistic regression, using trauma, age and CSA as independent variables, revealed areas under the curve (AUCs) for trauma of 0.55, for age of 0.65 and for CSA of 0.86. The combination of all three factors was the most powerful predictor, with an AUC of 0.92. CONCLUSION Age, trauma and the CSA can accurately predict the presence of a posterosuperior RCT. LEVEL OF EVIDENCE Level IV. Case series with no comparison groups.

Reconstruction of femoro-acetabular offsets using a short-stem

PURPOSE Despite the fact that new and modern short-stems allow bone sparing and saving of soft-tissue and muscles, we still face the challenge of anatomically reconstructing the femoro-acetabular offset and leg length. Therefore a radiological and clinical analysis of a short-stem reconstruction of the femoro-acetabular offset and leg length was performed. METHODS Using an antero-lateral approach, the optimys short-stem (Mathys Ltd, Bettlach, Switzerland) was implanted in 114 consecutive patients in combination with a cementless cup (Fitmore, Zimmer, Indiana, USA; vitamys RM Pressfit, Mathys Ltd, Bettlach, Switzerland). Pre- and postoperative X-rays were done in a standardized technique. In order to better analyse and compare X-ray data a special double coordinate system was developed for measuring femoral- and acetabular offset. Harris hip score was assessed before and six weeks after surgery. Visual analogue scale (VAS) satisfaction, leg length difference and the existence of gluteal muscle insufficiency were also examined. RESULTS Postoperative femoral offset was significantly increased by a mean of 5.8 mm. At the same time cup implantation significantly decreased the acetabular offset by a mean of 3.7 mm, which resulted in an increased combined femoro-acetabular offset of 2.1 mm. Postoperatively, 81.7 % of patients presented with equal leg length. The maximum discrepancy was 10 mm. Clinically, there were no signs of gluteal insufficiency. No luxation occurred during hospitalization. The Harris hip score improved from 47.3 before to 90.1 points already at six weeks after surgery while the mean VAS satisfaction was 9.1. CONCLUSION The analysis showed that loss of femoro-acetabular offset can be reduced with an appropriate stem design. Consequently, a good reconstruction of anatomy and leg length can be achieved. In the early postoperative stage the clinical results are excellent.

A complete-pelvis segmentation framework for image-free total hip arthroplasty (THA): methodology and clinical study

Background Complete-pelvis segmentation in antero-posterior pelvic radiographs is required to create a patient-specific three-dimensional pelvis model for surgical planning and postoperative assessment in image-free navigation of total hip arthroplasty. Methods A fast and robust framework for accurately segmenting the complete pelvis is presented, consisting of two consecutive modules. In the first module, a three-stage method was developed to delineate the left hemipelvis based on statistical appearance and shape models. To handle complex pelvic structures, anatomy-specific information processing techniques were employed. As the input to the second module, the delineated left hemi-pelvis was then reflected about an estimated symmetry line of the radiograph to initialize the right hemi-pelvis segmentation. The right hemi-pelvis was segmented by the same three-stage method, Results Two experiments conducted on respectively 143 and 40 AP radiographs demonstrated a mean segmentation accuracy of 1.61±0.68 mm. A clinical study to investigate the postoperative assessment of acetabular cup orientations based on the proposed framework revealed an average accuracy of 1.2°±0.9° and 1.6°±1.4° for anteversion and inclination, respectively. Delineation of each radiograph costs less than one minute. Conclusions Despite further validation needed, the preliminary results implied the underlying clinical applicability of the proposed framework for image-free THA.

Computer Assisted Diagnosis and Treatment Planning of Femoroacetabular Impingement (FAI)

Femoroacetabular impingement (FAI) is a dynamic conflict of the hip defined by a pathological, early abutment of the proximal femur onto the acetabulum or pelvis. In the past two decades, FAI has received increasing focus in both research and clinical practice as a cause of hip pain and prearthrotic deformity. Anatomical abnormalities such as an aspherical femoral head (cam-type FAI), a focal or general overgrowth of the acetabulum (pincer-type FAI), a high riding greater or lesser trochanter (extra-articular FAI), or abnormal torsion of the femur have been identified as underlying pathomorphologies. Open and arthroscopic treatment options are available to correct the deformity and to allow impingement-free range of motion. In routine practice, diagnosis and treatment planning of FAI is based on clinical examination and conventional imaging modalities such as standard radiography, magnetic resonance arthrography (MRA), and computed tomography (CT). Modern software tools allow three-dimensional analysis of the hip joint by extracting pelvic landmarks from two-dimensional antero-posterior pelvic radiographs. An object-oriented cross-platform program (Hip2Norm) has been developed and validated to standardize pelvic rotation and tilt on conventional AP pelvis radiographs. It has been shown that Hip2Norm is an accurate, consistent, reliable and reproducible tool for the correction of selected hip parameters on conventional radiographs. In contrast to conventional imaging modalities, which provide only static visualization, novel computer assisted tools have been developed to allow the dynamic analysis of FAI pathomechanics. In this context, a validated, CT-based software package (HipMotion) has been introduced. HipMotion is based on polygonal three-dimensional models of the patient’s pelvis and femur. The software includes simulation methods for range of motion, collision detection and accurate mapping of impingement areas. A preoperative treatment plan can be created by performing a virtual resection of any mapped impingement zones both on the femoral head-neck junction, as well as the acetabular rim using the same three-dimensional models. The following book chapter provides a summarized description of current computer-assisted tools for the diagnosis and treatment planning of FAI highlighting the possibility for both static and dynamic evaluation, reliability and reproducibility, and its applicability to routine clinical use.

Análisis biomecánico del segmento de la carrera a pie de la competición en triatlón

El principal objetivo de la presente investigación fue el conocer el perfil de rendimiento técnico de los triatletas, desde un punto de vista biomecánica, en el segmento carrera a pie durante la competición en triatlón. Asimismo, como el genero y el nivel deportivo del triatleta podrían influir en su respuesta motriz durante la competicion. Para ello, se necesitaba desarrollar y validar una técnica experimental que fuera lo suficientemente precisa (validez interna), con una alta fiabilidad y con una gran validez externa (ecologica) debido al entorno de la competicion. La muestra la formaron un total de 64 deportistas: 32 triatletas participantes en la Copa del Mundo de Triatlon de Madrid-2008 (16 hombres y 16 mujeres) y 32 triatletas participantes en el Clasificatorio del Campeonato de Espana Elite (16 hombres y 16 mujeres). El análisis de la técnica de carrera de los deportistas se realizo mediante un sistema fotogramétrico en 2d que permitió calcular las coordenadas (x,y) de los centros articulares con un error de 1.66% en el eje x y de un 2.10% en el eje y. Las imágenes fueron obtenidas por una cámara que filmaba el movimiento en un plano antero-posterior del triatleta. Algoritmos basados en la DLT (Abdel-Aziz & Karara, 1971) permitieron conocer las coordenadas reales a partir de las coordenadas digitalizadas en el plano y posteriormente las distintas variables analizadas. El análisis biomecánica de la carrera se realizo en 4 ocasiones diferentes durante la competición, correspondiendo con cada una de las vueltas de 2,5 km, que el triatleta tenía que realizar. La velocidad de carrera resulto estar íntimamente ligada al nivel deportivo del triatleta. Del mismo modo, 3 de los 4 grupos analizados presentaron valores inferiores a 3 minutos 30 segundos por kilometro recorrido, poniendo de manifiesto el altísimo nivel de los sujetos analizados. Del mismo modo parece que las chicos consiguen una mayor velocidad gracias a una mayor longitud de ciclo en relación a las chicas, ya que estas muestran valores mayores en cuanto a frecuencia de zancada. La frecuencia de zancada presento los valores más altos en la primera vuelta en todos los deportistas analizados. Asimismo, los triatletas de nivel internacional y las chicas fueron los que mostraron los mayores valores. La longitud de zancada presento distintas tendencias en función del nivel y el género del deportista. Así pues, en los deportistas internacionales y en los chicos los mayores valores se encontraron en la primera vuelta mientras que la tendencia fue al descenso, siendo probablemente la fatiga acumulada la causante de dicha tendencia. En cambio, aquellos deportistas de nivel nacional y las chicas mostraron valores mayores en la segunda vuelta que en la primera, evidenciando que además de la fatiga, el ciclismo previo tiene una incidencia directa sobre su rendimiento. Los tiempos de vuelo permanecieron constantes durante toda la carrera, encontrando cierta evolución en los tiempos de apoyo, la cual provoca una modificación en los porcentajes relativos en los tiempos de vuelo. Los tiempos de apoyo más bajos se encontraron en la primera vuelta. Del mismo modo, los deportistas de nivel internacional y los chicos mostraron valores inferiores. También, estos grupos fueron más constantes en sus valores a lo largo de las vueltas. Por el contrario, se encontraron tendencias al aumento en los triatletas de nivel nacional y en las chicas, los cuales no fueron capaces de mantener el mismo rendimiento debido seguramente a su menor nivel deportivo. La oscilación vertical de la cadera se mostro constante en los triatletas de mayor nivel, encontrándose tendencias al aumento en los de menor nivel. Del mismo modo, los valores más altos correspondieron a las chicas y a los deportistas de nivel nacional. La distancia de la cadera al apoyo permaneció constante a lo largo de las vueltas en todos los grupos, obteniéndose valores mayores en los triatletas de nivel internacional y en los chicos. El ángulo de la rodilla apoyada en el momento del despegue no mostro una tendencia clara. Los deportistas de nivel internacional y los chicos presentaron los valores más bajos. El ángulo de la rodilla libre en el momento del despegue mostro una correlación muy alta con la velocidad de carrera. Del mismo modo, los ángulos más pequeños se encontraron en los triatletas internacionales y en los chicos, debido seguramente a los mayores valores de velocidad registrados por ambos grupos. Los ángulos de los tobillos no mostraron ninguna tendencia clara durante la competición analizada. Los cuatro grupos de población presentaron valores similares, por lo que parece que no representan una variable que pueda incidir sobre el rendimiento biomecánica del triatleta. Los resultados obtenidos en el presente estudio de investigación avalan la utilización de la fotogrametría-video en 2d para el análisis de la técnica de carrera durante la competición en triatlón. Su aplicación en una competición de máximo nivel internacional ha posibilitado conocer el perfil técnico que presentan los triatletas a lo largo del segmento de carrera a pie. Del mismo modo, se ha podido demostrar como los estudios realizados en laboratorio no reflejan la realidad competitiva de un triatlón de máximo nivel. The aim of this research was to determine the running technique profile during a triathlon competition from a biomechanical perspective. Also, to analyze the triathlete gender’s and level of performance’s influence on this profile in competition. An accurate (internal validity) and reliable methodology with a high external validity (ecological) had to be developed to get those aims in competition. Sixty-four triathletes were analyzed. 32 (16 males, 16 females) took part in the Madrid 2008 Triathlon World Cup and 32 (16 males and 16 females) took part in the Spanish Triathlon National Championships. The biomechanical analyses were carried out by a photogrammetric system that allow to calculate the landmarks coordinates (x,y) with a 1.66% error in x axis, and a 2.10% error in y axis. The frames were obtained with a camera situated perpendicular to the triathletes’ trajectory, filming the saggittal plane. DLT based algorithms (Abdel-Aziz & Karara, 1971) were used to calculate the real coordinates from the digitalized ones and the final variables afterwards. The biomechanical analisys itself was performed in four different moments during the competition, according to each 2.5 km lap the triathletes had to do. Running speed was highly related to performance level. Also, 3 of the 4 analyzed groups showed speed values under the 3 minutes and 30 seconds per kilometer. It demonstrated the very high performance level of the analized triathletes. Furthermore, it seems that men get higher speeds because their longer stride length, while women shows higher stride frequency values. The highest stride frequency values were found in the first lap. Women and the international level triathletes showed the highest values. Stride length showed different tendencies according to the gender and level of performance. Men and international level triathletes showed the highest level in the first lap and a decreasing tendency after that. The accumulated fatigue was probably the reason of this tendency. On the other hand, higher values than in first lap were found in the second one in women and national level triathletes. It demonstrated the previous cycling can affect to those groups in terms of biomechanics. Flight times remained constant during the running part, while the contact times showed an increasing tendency that caused a variation in flight times percents. The lowest contact times were found in the first lap and in men and international triathletes’ values. Also, these two groups were more consistent during the whole running. On the other hand, increasing tendencies were found in women and national level triathletes, who were not able to maintain the same values probably due to their lower level of performance. Higher level triathletes showed more consistent hip vertical oscillation values than lower level triathletes, who presented increasing tendencies. The highest values were found in women and national level triathletes. The horizontal distance hip-toe cap remained constant among the laps in all the groups. Men and international level triathletes showed the highest values. The support knee angle at toe-off did not show a clear tendency. The lowest values were found in men and international level triathletes. A high correlation was found between the non-support knee angle and the running speed. Furthermore, men and international level triathletes showed the smallest values, due to the higher velocities reached by these two groups. Ankles angles did not show any tendency during the running part. Similar values were found in the four analyzed groups, so this variable does not seem to represent an important one within the triathlete’s performance. The results obtained in the present research support the use of the bidimensional photogrammetric video-system to analyze the running technique during a triathlon competition. Its application in international triathlon meetings has allowed determining the triathletes’ technique profile during the running part. Also, it has been demonstrated the laboratory-based studies does not reproduce a top-level competition.