Effect of tibial tray inclination on the femoro-tibial contact pattern of a mobile total knee arthroplasty

Introduction: The posterior inclination of the tibial component is an important factor that can affect the success of total knee arthroplasty. It can reduce the posterior impingement and thus increase the range of flexion, but it may also induce instability in flexion, anterior impingement between the polyethylene of postero-stabilizing knee prosthesis, and anterior conflict with the cortical bone and the stem. Although the problem is identified, there is still a debate on the ideal inclination angle and the surgical technique to avoid an excessive posterior inclination. The aim of this study was to predict the effect of a posterior inclination of the tibial component on the contact pattern on the tibial insert, using a numerical musculoskeletal model of the knee joint. Methods: A 3D finite element model of the knee joint was developed to simulate an active and loaded squat movement after total knee arthroplasty. Flexion was actively controlled by the quadriceps muscle and muscle activations were estimated from EMG data and were synchronized by a feedback algorithm. Two inclinations of the tibial tray were considered: a posterior inclination of 0° or 10°. During the entire range of flexion, the following quantities were calculated: the tibiofemoral and patello-femoral contact force, and the contact pattern on polyethylene insert. The antero-posterior displacement of the contact pattern was also measured. Abaqus 6.7 was used for all analyses. Results: The tibio-femoral and patello-femoral contact forces increased during flexion and reached respectively 4 and 7 BW (bodyweight) at 90° of flexion. They were slightly affected by the inclination of the tibial tray. Without posterior inclination, the contact pattern on the tibial insert remained centered. The contact pressure was lower than 5 MPa below 60° of flexion, but exceeded 20 MPa at 90° of flexion. The posterior inclination displaced the contact point posteriorly by 2 to 4 mm. Conclusion: The inclination of the tibial tray displaced the contactpattern towards the posterior border of the tibial insert. However, even for 10° of inclination, the contact center remained far from the posterior border (12 mm). There was no instability predicted for this movement.

Audit report on the City of Center Point, Iowa for the year ended June 30, 2010

Audit report on the City of Center Point, Iowa for the year ended June 30, 2010

Musicoterapia para el estrés: cómo recobrar la calma interior

Se explica de qué manera afecta la música a los seres vivos y cómo se puede aprender a usar la Musicoterapia para manejar situaciones de estrés.

46, XY gonadal dysgenesis: new SRY point mutation in two siblings with paternal germ line mosaicism.

Stoppa-Vaucher S, Ayabe T, Paquette J, Patey N, Francoeur D, Vuissoz J-M, Deladoëy J, Samuels ME, Ogata T, Deal CL. 46, XY gonadal dysgenesis: new SRY point mutation in two siblings with paternal germ line mosaicism. Familial recurrence risks are poorly understood in cases of de novo mutations. In the event of parental germ line mosaicism, recurrence risks can be higher than generally appreciated, with implications for genetic counseling and clinical practice. In the course of treating a female with pubertal delay and hypergonadotropic hypogonadism, we identified a new missense mutation in the SRY gene, leading to somatic feminization of this karyotypically normal XY individual. We tested a younger sister despite a normal onset of puberty, who also possessed an XY karyotype and the same SRY mutation. Imaging studies in the sister revealed an ovarian tumor, which was removed. DNA from the father's blood possessed the wild type SRY sequence, and paternity testing was consistent with the given family structure. A brother was 46, XY with a wild type SRY sequence strongly suggesting paternal Y-chromosome germline mosaicism for the mutation. In disorders of sexual development (DSDs), early diagnosis is critical for optimal psychological development of the affected patients. In this case, preventive karyotypic screening allowed early diagnosis of a gonadal tumor in the sibling prior to the age of normal puberty. Our results suggest that cytological or molecular diagnosis should be applied for siblings of an affected DSD individual.

Trimestralización y conciliación de magnitudes económicas : una ampliación del método Chow-Lin

Una de las herramientas estadísticas más importantes para el seguimiento y análisis de la evolución de la actividad económica a corto plazo es la disponibilidad de estimaciones de la evolución trimestral de los componentes del PIB, en lo que afecta tanto a la oferta como a la demanda. La necesidad de disponer de esta información con un retraso temporal reducido hace imprescindible la utilización de métodos de trimestralización que permitan desagregar la información anual a trimestral. El método más aplicado, puesto que permite resolver este problema de manera muy elegante bajo un enfoque estadístico de estimador óptimo, es el método de Chow-Lin. Pero este método no garantiza que las estimaciones trimestrales del PIB en lo que respecta a la oferta y a la demanda coincidan, haciendo necesaria la aplicación posterior de algún método de conciliación. En este trabajo se desarrolla una ampliación multivariante del método de Chow-Lin que permite resolver el problema de la estimación de los valores trimestrales de manera óptima, sujeta a un conjunto de restricciones. Una de las aplicaciones potenciales de este método, que hemos denominado método de Chow-Lin restringido, es precisamente la estimación conjunta de valores trimestrales para cada uno de los componentes del PIB en lo que afecta tanto a la demanda como a la oferta condicionada a que ambas estimaciones trimestrales del PIB sean iguales, evitando así la necesidad de aplicar posteriormente métodos de conciliación