Changes in landing mechanics in patients following anterior cruciate ligament reconstruction when wearing an extension constraint knee brace.

BACKGROUND: Anterior cruciate ligament (ACL) reconstruction is associated with a high incidence of second tears (graft tears and contralateral ACL tears). These secondary tears have been attributed to asymmetrical lower extremity mechanics. Knee bracing is one potential intervention that can be used during rehabilitation that has the potential to normalize lower extremity asymmetry; however, little is known about the effect of bracing on movement asymmetry in patients following ACL reconstruction. HYPOTHESIS: Wearing a knee brace would increase knee joint flexion and joint symmetry. It was also expected that the joint mechanics would become more symmetrical in the braced condition. OBJECTIVE: To examine how knee bracing affects knee joint function and symmetry over the course of rehabilitation in patients 6 months following ACL reconstruction. STUDY DESIGN: Controlled laboratory study. LEVEL OF EVIDENCE: Level 3. METHODS: Twenty-three adolescent patients rehabilitating from ACL reconstruction surgery were recruited for the study. The subjects all underwent a motion analysis assessment during a stop-jump activity with and without a functional knee brace on the surgical side that resisted extension for 6 months following the ACL reconstruction surgery. Statistical analysis utilized a 2 × 2 (limb × brace) analysis of variance with a significant alpha level of 0.05. RESULTS: Subjects had increased knee flexion on the surgical side when they were braced. The brace condition increased knee flexion velocity, decreased the initial knee flexion angle, and increased the ground reaction force and knee extension moment on both limbs. Side-to-side asymmetry was present across conditions for the vertical ground reaction force and knee extension moment. CONCLUSION: Wearing a knee brace appears to increase lower extremity compliance and promotes normalized loading on the surgical side. CLINICAL RELEVANCE: Knee extension constraint bracing in postoperative ACL patients may improve symmetry of lower extremity mechanics, which is potentially beneficial in progressing rehabilitation and reducing the incidence of second ACL tears.

Patient expectation is the most important predictor of discharge destination after primary total joint arthroplasty.

The purpose of this study was to identify preoperative predictors of discharge destination after total joint arthroplasty. A retrospective study of three hundred and seventy-two consecutive patients who underwent primary total hip and knee arthroplasty was performed. The mean length of stay was 2.9 days and 29.0% of patients were discharged to extended care facilities. Age, caregiver support at home, and patient expectation of discharge destination were the only significant multivariable predictors regardless of the type of surgery (total knee versus total hip arthroplasty). Among those variables, patient expectation was the most important predictor (P < 0.001; OR 169.53). The study was adequately powered to analyze the variables in the multivariable logistic regression model, which had a high concordance index of 0.969.

Unipedal balance is affected by lower extremity joint arthroplasty procedure 1 year following surgery.

Lower Extremity Joint Arthroplasty (LEJA) surgery is an effective way to alleviate painful osteoarthritis. Unfortunately, these surgeries do not normalize the loading asymmetry during the single leg stance phase of gait. Therefore, we examined single leg balance in 234 TJA patients (75 hips, 65 knees, 94 ankles) approximately 12 months following surgery. Patients passed if they maintained single leg balance for 10s with their eyes open. Patients one year following total hip arthroplasty (THA-63%) and total knee arthroplasty (TKA-69%) had similar pass rates compared to a total ankle arthroplasty (TAA-9%). Patients following THA and TKA exhibit better unilateral balance in comparison with TAA patients. It may be beneficial to include a rigorous proprioception and balance training program in TAA patients to optimize functional outcomes.

Percent body fat more associated with perioperative risks after total joint arthroplasty than body mass index

Copyright © 2014 Elsevier Inc. All rights reserved.Understanding the impact of obesity on elective total joint arthroplasty (TJA) remains critical. Perioperative outcomes were reviewed in 316 patients undergoing primary TJA. Higher percent body fat (PBF) was associated with postoperative blood transfusion, increased hospital length of stay (LOS) >3 days, and discharge to an extended care facility while no significant differences existed for BMI. Additionally, PBF of 43.5 was associated with a 2.4× greater likelihood of blood transfusion, PBF of 36.5 with a 1.9× greater likelihood for LOS >3 days, and PBF of 36.0 with a 1.4× greater likelihood for discharge to an extended care facility. PBF may be a more effective measure than BMI to use in screening for perioperative risks and acute outcomes associated with obese total joint patients.

Measurement of the cross section and angular correlations for associated production of a Z boson with b hadrons in pp collisions at √s = 7 TeV

A study of proton-proton collisions in which two b hadrons are produced in association with a Z boson is reported. The collisions were recorded at a centre-of-mass energy of 7TeV with the CMS detector at the LHC, for an integrated luminosity of 5:2 fb-1. The b hadrons are identified by means of displaced secondary vertices, without the use of reconstructed jets, permitting the study of b-hadron pair production at small angular separation. Differential cross sections are presented as a function of the angular separation of the b hadrons and the Z boson. In addition, inclusive measurements are presented. For both the inclusive and differential studies, different ranges of Z boson momentum are considered, and each measurement is compared to the predictions from different event generators at leading-order and next-to-leading-order accuracy. Copyright CERN.

Proper-motion binaries in the Hipparcos catalogue: comparison with radial velocity data

Context. This paper is the last in a series devoted to the analysis of the binary content of the Hipparcos Catalogue. Aims. The comparison of the proper motions constructed from positions spanning a short (Hipparcos) or long time (Tycho-2) makes it possible to uncover binaries with periods of the order of or somewhat larger than the short time span (in this case, the 3 yr duration of the Hipparcos mission), since the unrecognised orbital motion will then add to the proper motion. Methods. A list of candidate proper motion binaries is constructed from a carefully designed χ2 test evaluating the statistical significance of the difference between the Tycho-2 and Hipparcos proper motions for 103 134 stars in common between the two catalogues (excluding components of visual systems). Since similar lists of proper-motion binaries have already been constructed, the present paper focuses on the evaluation of the detection efficiency of proper-motion binaries, using different kinds of control data (mostly radial velocities). The detection rate for entries from the Ninth Catalogue of Spectroscopic Binary Orbits (SB9) is evaluated, as well as for stars like barium stars, which are known to be all binaries, and finally for spectroscopic binaries identified from radial velocity data in the Geneva-Copenhagen survey of F and G dwarfs in the solar neighbourhood. Results. Proper motion binaries are efficiently detected for systems with parallaxes in excess of ∼20 mas, and periods in the range 1000-30 000 d. The shortest periods in this range (1000-2000 d, i.e. once to twice the duration of the Hipparcos mission) may appear only as DMSA/G binaries (accelerated proper motion in the Hipparcos Double and Multiple System Annex). Proper motion binaries detected among SB9 systems having periods shorter than about 400 d hint at triple systems, the proper-motion binary involving a component with a longer orbital period. A list of 19 candidate triple systems is provided. Binaries suspected of having low-mass (brown-dwarf-like) companions are listed as well. Among the 37 barium stars with parallaxes larger than 5 mas, only 7 exhibit no evidence for duplicity whatsoever (be it spectroscopic or astrometric). Finally, the fraction of proper-motion binaries shows no significant variation among the various (regular) spectral classes, when due account is taken for the detection biases. © ESO 2007.

Numerical modelling of solder joint formation

Solder materials are used to provide a connection between electronic components and printed circuit boards (PCBs) using either the reflow or wave soldering process. As a board assembly passes through a reflow furnace the solder (initially in the form of solder paste) melts, reflows, then solidifies, and finally deforms between the chip and board. A number of defects may occur during this process such as flux entrapment, void formation, and cracking of the joint, chip or board. These defects are a serious concern to industry, especially with trends towards increasing component miniaturisation and smaller pitch sizes. This paper presents a modelling methodology for predicting solder joint shape, solidification, and deformation (stress) during the assembly process.

A computational modelling framework to predict macroscopic phenomena in solder joint formation

A computational model of solder joint formation and the subsequent cooling behaviour is described. Given the rapid changes in the technology of printed circuit boards, there is a requirement for comprehensive models of solder joint formation which permit detailed analysis of design and optimization options. Solder joint formation is complex, involving a range of interacting phenomena. This paper describes a model implementation (as part of a more comprehensive framework) to describe the shape formation (conditioned by surface tension), heat transfer, phase change and the development of elastoviscoplastic stress. The computational modelling framework is based upon mixed finite element and finite volume procedures, and has unstructured meshes enabling arbitrarily complex geometries to be analysed. Initial results for both through-hole and surface-mount geometries are presented.

An integrated modeling approach to solder joint formation

The attachment of electronic components to printed circuit boards using solder material is a complex process. This paper presents a novel modeling methodology, which integrates the governing physics taking place. Multiphysics modeling technology, imbedded into the simulation tool—PHYSICA is used to simulate fluid flow, heat transfer, solidification, and stress evolution in an integrated manner. Results using this code are presented, detailing the mechanical response of two solder materials as they cool, solidify and then deform. The shape that a solder joint takes upon melting is predicted using the SURFACE EVOLVER code. Details are given on how these predictions can be used in the PHYSICA code to provide a modeling route by which the shape, solidification history, and resulting stress profiles can be predicted.

Optimisation modelling for flip-chip solder joint reliability

This paper details and demonstrates integrated optimisation-reliability modelling for predicting the performance of solder joints in electronic packaging. This integrated modelling approach is used to identify efficiently and quickly the most suitable design parameters for solder joint performance during thermal cycling and is demonstrated on flip-chip components using “no-flow” underfills. To implement “optimisation in reliability” approach, the finite element simulation tool – PHYSICA, is coupled with optimisation and statistical tools. This resulting framework is capable of performing design optimisation procedures in an entirely automated and systematic manner.

The effect of thermal cycle profiles on solder joint damage

The relationship between the damage caused at different thermal cycles is very important. The whole of accelerated thermal cycle testing is based on the premise that damage at one cycle is representative of damage at a different cycle. In this paper, the relative damage caused by six thermal cycle profiles are predicted using Finite Element (FE) modelling and the results validated against experiments. Both creep strain and strain energy density were used as damage indicators and creep strain was found to correlate better with experiment. The validated FE model is then used to investigate the effect of altering each of the thermal profile parameters (ramp and swell times, hot and cold temperatures). The components used for testing are surface mount resistors - 1206, 0805 and 0603. The solders investigated are eutectic SnAgCu and eutectic SnAg.

Study of Anisotropic Conductive Adhesive Joint Behaviour under 3-Point Bending

Flip chip interconnections using anisotropic conductive film (ACF) are now a very attractive technique for electronic packaging assembly. Although ACF is environmentally friendly, many factors may influence the reliability of the final ACF joint. External mechanical loading is one of these factors. Finite element analysis (FEA) was carried out to understand the effect of mechanical loading on the ACF joint. A 3-dimensional model of adhesively bonded flip chip assembly was built and simulations were performed for the 3-point bending test. The results show that the stress at its highest value at the corners, where the chip and ACF were connected together. The ACF thickness was increased at these corner regions. It was found that higher mechanical loading results in higher stress that causes a greater gap between the chip and the substrate at the corner position. Experimental work was also carried out to study the electrical reliability of the ACF joint with the applied bending load. As per the prediction from FEA, it was found that at first the corner joint failed. Successive open joints from the corner towards the middle were also noticed with the increase of the applied load.