Clinical Biomechanics最新文献

{"title":"Age-dependence of semitendinosus tendon properties used for anterior cruciate ligament reconstruction differs in males and females","authors":"","doi":"10.1016/j.clinbiomech.2024.106329","DOIUrl":"10.1016/j.clinbiomech.2024.106329","url":null,"abstract":"<div><h3>Background</h3><p>The semitendinosus tendon is one of the most used autografts in anterior cruciate ligament reconstruction. Although recent evidence indicates that young patients, especially in females, may experience high rates of revision and residual instability, the reasons for the inferior outcomes in these patients remain unclear. To address this issue, we aimed to compare the mechanical properties of the semitendinosus tendon used for anterior cruciate ligament reconstruction in male and female patients of various ages.</p></div><div><h3>Methods</h3><p>The semitendinosus tendons harvested from 31 male and 29 female patients who underwent anterior cruciate ligament reconstruction surgery using the semitendinosus tendon autografts were used in this study. Using the distal part of the harvested semitendinosus tendon, the extent of cyclic loading-induced elongation (i.e., the extent of the increase in slack length) and the Young's modulus were measured during cyclic tensile testing.</p></div><div><h3>Findings</h3><p>Spearman correlation analyses revealed that the Young's modulus (|ρ| = 0.725, <em>P</em> &lt; 0.001), but not elongation (|ρ| ≤ 0.036, <em>P</em> ≥ 0.351) positively correlated with the patient age in male tendon samples. In contrast, for female tendon samples, the elongation (|ρ| ≥ 0.415, <em>P</em> ≤ 0.025), but not the Young's modulus (|ρ| = 0.087, <em>P</em> = 0.655) negatively correlated with the patient age.</p></div><div><h3>Interpretation</h3><p>These results indicate that the semitendinosus tendon used for anterior cruciate ligament reconstruction in young male patients is compliant, whereas that in young female patients is susceptible to elongation induced by cyclic loading.</p></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142011897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Individuals with asymptomatic hallux valgus exhibit altered foot kinematics during gait regardless of their foot posture","authors":"","doi":"10.1016/j.clinbiomech.2024.106319","DOIUrl":"10.1016/j.clinbiomech.2024.106319","url":null,"abstract":"<div><h3>Background</h3><p>A flatfoot has been believed to be closely associated with the development of hallux valgus; however, the association is still controversial. Abnormal foot kinematics has been identified as a possible risk factor for the development of hallux valgus, but it remains unclear whether foot posture contributes to abnormal foot kinematics. This is the first study to investigate the differences in foot kinematics during gait between individuals with and without hallux valgus, while controlling for foot posture.</p></div><div><h3>Methods</h3><p>Twenty-five females with hallux valgus and 25 healthy females aged 18 to 22 were recruited. Foot posture was measured using normalized navicular height truncated and the leg-heel angle. Foot kinematic and kinetic data during gait were recorded by a three-dimensional motion capture system. To investigate the characteristics of foot kinematics in individuals with hallux valgus while controlling for foot posture, we used a propensity score matching method. The matching was obtained by using the 1:1 nearest-neighbor procedure and a caliper width of 0.2.</p></div><div><h3>Findings</h3><p>Twelve pairs were matched. Individuals with hallux valgus had significantly increased midfoot dorsiflexion from 56% to 80% during stance phase, rearfoot eversion from 53% to 71%, and forefoot abduction from 5% to 29% compared with control.</p></div><div><h3>Interpretation</h3><p>Individuals with hallux valgus have a flexible foot that cannot suppress the dynamic deformation of the rearfoot and midfoot during gait. To suppress the development of hallux valgus, interventions that aim to prevent dynamic deformations of the rearfoot and midfoot during gait may be necessary, regardless of their static foot posture.</p></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An ex vivo sequential ligament transection model of flatfoot","authors":"","doi":"10.1016/j.clinbiomech.2024.106302","DOIUrl":"10.1016/j.clinbiomech.2024.106302","url":null,"abstract":"<div><h3>Background</h3><p>The ligaments implicated in the earliest stages of developing a progressive collapsing foot deformity are poorly understood. Commonly employed cadaveric flatfoot models are created from simultaneous transection of multiple ligaments, making it difficult to assess early changes in pressure distribution from ligaments critical for maintaining load distribution. A serial transection of ligaments may provide insight into changes in pressure distribution under the foot to identify a potential combination of ligaments that may be involved in early deformities.</p></div><div><h3>Methods</h3><p>Specimens were loaded using a custom designed axial and tendon loading system. Plantar pressure data for the forefoot and hindfoot were recorded before and after six sequential ligament complex transections.</p></div><div><h3>Findings</h3><p>Sectioning the plantar fascia (first) and short/long plantar ligaments (second) failed to generate appreciable differences in load distribution. Dividing the spring ligament (third) led to changes in hindfoot load distribution with a shift towards the lateral column indicative of hindfoot valgus angulation. All subsequent conditions resulted in similar patterns in hindfoot plantar load distribution. An anterior shift in the center of pressure only occurred after transection of all six ligament complexes.</p></div><div><h3>Interpretation</h3><p>Loss of the plantar fascia and short/long plantar ligaments are not critical in maintaining plantar load distribution or contact area. However, the additional loss of the spring ligament caused notable changes in hindfoot load distribution, indicating the combination of these three ligament complexes is particularly critical for preventing peritalar subluxation. Minimal changes in load distribution occurred when performing additional transections to reach a complete flatfoot deformity.</p></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141714402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The clinical utility of the prone hip extension test in the diagnosis of motor control impairments associated with low back pain: A cross-sectional study using motion capture and electromyography","authors":"","doi":"10.1016/j.clinbiomech.2024.106317","DOIUrl":"10.1016/j.clinbiomech.2024.106317","url":null,"abstract":"<div><h3>Background</h3><p>The prone hip extension test is used as a clinical tool to diagnose specific motor control impairments that have been identified in individuals with chronic low back pain. However, conventional protocols for performing the test are subjective and lack evidence for their effectiveness. The objective of the current study was to quantify lumbopelvic motion and muscle activation during this test and identify which motor control patterns best distinguish individuals with low back pain from asymptomatic controls.</p></div><div><h3>Methods</h3><p>18 individuals with sub-acute or chronic low back pain and 32 asymptomatic controls performed the prone hip extension test while a 3D motion capture system measured lumbar and pelvic movement patterns and an electromyography system measured the muscle activation patterns of the paraspinal, gluteus maximus, and hamstring muscles. A three-stage statistical analysis was performed, the final stage being a stepwise logistic regression analysis aimed at identifying the movement and muscle activation pattern variables that best distinguished the two groups.</p></div><div><h3>Findings</h3><p>The final regression model included three lumbar kinematic variables and several electromyographic amplitude variables for the gluteus maximus and hamstring muscles during right-sided prone hip extension. The final model correctly classified 86.7 % of the control group and 83.3 % of the low back pain group.</p></div><div><h3>Interpretation</h3><p>The subject of asymmetrical gluteus maximus and hamstring muscle activation appears to be a potentially interesting area for future research on the utility of the prone hip extension test as a clinical tool in diagnosing motor control impairments associated with low back pain.</p></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0268003324001499/pdfft?md5=36361bec939e7aa3c67df9eb2a5b2e5a&pid=1-s2.0-S0268003324001499-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141840618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamic gait stability in people with mild to moderate Parkinson's disease","authors":"","doi":"10.1016/j.clinbiomech.2024.106316","DOIUrl":"10.1016/j.clinbiomech.2024.106316","url":null,"abstract":"<div><h3>Background</h3><p>Falls are a serious health threat for people with Parkinson's disease. Dynamic gait stability has been associated with fall risk. Developing effective fall prevention interventions requires a sound understanding of how Parkinson's disease affects dynamic gait stability. This study compared dynamic gait stability within the Feasible Stability Region framework between people with and without Parkinson's disease during level walking at a self-selected speed.</p></div><div><h3>Methods</h3><p>Twenty adults with Parkinson's disease and twenty age- and gender-matched healthy individuals were recruited. Dynamic gait stability at two gait instants: touchdown and liftoff, was assessed as the primary outcome measurement. Spatiotemporal gait parameters, including stance phase duration, step length, gait speed, and cadence were determined as explanatory variables.</p></div><div><h3>Findings</h3><p>People with Parkinson's disease walked more slowly (<em>p</em> &lt; 0.001) with a shorter step (<em>p</em> = 0.05), and prolonged stance phase (<em>p</em> = 0.04) than their healthy peers with moderate to large effect sizes. Dynamic gait stability did not show any group-associated differences (<em>p</em> &gt; 0.36).</p></div><div><h3>Interpretation</h3><p>Despite the different gait parameters between groups, people with Parkinson's disease exhibited similar dynamic gait stability to their healthy counterparts. To compensate for the potential dynamic gait stability deficit resulting from slow gait speed, individuals with Parkinson's disease adopted a short step length to shift the center of mass motion state closer to the Feasible Stability Region. Our findings could provide insight into the impact of Parkinson's disease on the control of dynamic gait stability.</p></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141767972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical gait analysis reveals altered walking patterns in critical Covid 19 survivors","authors":"","doi":"10.1016/j.clinbiomech.2024.106318","DOIUrl":"10.1016/j.clinbiomech.2024.106318","url":null,"abstract":"<div><h3>Background</h3><p>Covid-19 has dramatically increased the number of admissions in intensive care units due to respiratory complications. In some cases, the arousal of neurological impairments, such as peripheral neuropathies, have been revealed. The purpose of this research was to characterize the gait pattern and muscle activity changes in Covid-19 survivors compared to physiological gait.</p></div><div><h3>Methods</h3><p>Twelve post-Covid-19 participants admitted to intensive care units and twelve non-disabled controls were considered. Kinematics, kinetics and surface electromyographic data were collected for each participant during walking. Post Covid-19 participants were further divided into two sub-groups, according to the number of days spent in the intensive care units. Lower limb joint angles, moments and powers were extracted as well as the muscle activity of four muscles bilaterally, the spatial, temporal and spatiotemporal parameters of gait and the ground reaction forces. The extracted variables were compared through OneWay-ANOVA or Kruskal-Wallis tests where appropriate (<em>p</em> &lt; 0.05).</p></div><div><h3>Findings</h3><p>Overall, the considered parameters revealed statistically significant reduction in gait speed, cadence, range of motion in the sagittal plane, anteroposterior and vertical ground reaction forces between pathological and control participants. Larger alterations of the gait patterns were highlighted in the post-Covid-19 group hospitalized in intensive care units longer than 35 days, where a reduced muscle activity was observed on all the analyzed muscles.</p></div><div><h3>Interpretation</h3><p>Results suggested that the severity of gait impairments in post-Covid-19 participants might be correlated with intensive care units-bedding period. Gait biomechanics assessment could be adopted in the clinical decision-making process to improve treatment protocols in post-Covid-19 survivors.</p></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0268003324001505/pdfft?md5=d9ed71edb82b879e80c5e7f98d34d4d5&pid=1-s2.0-S0268003324001505-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between cup fixation screw and iliopsoas impingement after total hip arthroplasty","authors":"","doi":"10.1016/j.clinbiomech.2024.106315","DOIUrl":"10.1016/j.clinbiomech.2024.106315","url":null,"abstract":"<div><h3>Background</h3><p>Iliopsoas impingement after total hip arthroplasty can result not only from acetabular cup but also from cup fixation screw. However, research addressing this screw impingement is scarce, leaving the details undetermined. This study aimed to elucidate the incidence and threshold of symptomatic iliopsoas impingement attributable to protrusion of the cup fixation screw into the iliopsoas muscle and to evaluate its impact on postoperative radiographic imaging findings and patient-reported outcome measures.</p></div><div><h3>Methods</h3><p>A total of 152 hips were included in this study. The symptomatic threshold of screw protrusion was determined using a receiver operating characteristic curve, and patients were divided into low-protrusion and high-protrusion groups using this threshold. The area and Hounsfield Unit values of the iliopsoas muscle on CT and the Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire postoperatively were investigated.</p></div><div><h3>Findings</h3><p>10 hips (6.5%) were exhibited symptoms of IPI in this series. The threshold for screw protrusion length was identified as 6.4 mm. Patients in the high protrusion group exhibited significantly larger area and lower Hounsfield Unit values of the iliopsoas muscle. In addition, the high protrusion group revealed significantly lower scores (total, pain, movement, mental). Furthermore, subscales scores (pain, movement) in the high protrusion group didn't improve from 3 months to 12 months postoperatively with significance.</p></div><div><h3>Interpretation</h3><p>This study underscores the imperative for surgeons to consider the length of the cup fixation screw. This careful consideration is crucial for mitigating the incidence of postoperative iliopsoas impingement and enhancing total hip arthroplasty outcomes.</p></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141838585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Females with hip pain walk with altered kinematics at peaks and throughout the gait cycle","authors":"","doi":"10.1016/j.clinbiomech.2024.106314","DOIUrl":"10.1016/j.clinbiomech.2024.106314","url":null,"abstract":"<div><h3>Background</h3><p>Females with acetabular dysplasia and/or labral tears (hip pain) exhibit altered walking kinematics, with studies reporting mixed results in sagittal and frontal planes compared to pain-free controls, often conducting only discrete analyses and warranting further investigation. The objective of this study was to investigate discrete and continuous hip and pelvic kinematics between females with and without hip pain in two walking conditions.</p></div><div><h3>Methods</h3><p>We collected kinematic walking data from 69 females (35 with hip pain, 34 controls) using motion capture and an instrumented treadmill in two conditions: preferred and fast (125% preferred). We used a general linear model and one-dimensional statistical parametric mapping to conduct discrete and continuous analyses comparing kinematics between groups, with and without adjustment for gait speed.</p></div><div><h3>Findings</h3><p>The hip pain group walked with reduced peak hip extension (Preferred: <em>P</em> <em>=</em> .046, Cohen's <em>d</em> = 0.41; Fast: <em>P</em> <em>=</em> .028, <em>d</em> = 0.48) and greater peak anterior pelvic tilt (Preferred: <em>P</em> <em>=</em> .011, <em>d</em> = 0.57; Fast: <em>P</em> <em>=</em> .012, <em>d</em> = 0.58) compared to controls. From continuous analyses, the hip pain group walked with reduced hip extension during terminal stance (Fast: <em>P</em> <em>=</em> .040), greater anterior pelvic tilt throughout (Preferred: <em>P</em> <em>=</em> .007; Fast: <em>P</em> <em>=</em> .004), and greater contralateral pelvic drop (Preferred: <em>P</em> <em>=</em> .045) during midstance. Adjusting for speed slightly affected <em>p</em>-values, but significance was retained for all prior variables except pelvic drop.</p></div><div><h3>Interpretation</h3><p>Kinematic differences between individuals with and without hip pain may provide insight into potential predisposing factors for hip pathology and/or compensations for pain or pathological processes. This work furthers understanding of altered movement patterns in individuals with hip pain and may inform physical therapy treatments.</p></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141838720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lower limb kinematic changes during gait after hallux valgus surgery: A prospective observational study","authors":"","doi":"10.1016/j.clinbiomech.2024.106304","DOIUrl":"10.1016/j.clinbiomech.2024.106304","url":null,"abstract":"<div><h3>Background</h3><p>Patients with hallux valgus are known to alter lower limb joint kinematics during gait. However, little information is available about gait changes following hallux valgus surgery. We aimed to longitudinally investigate lower limb kinematic changes at the mid and terminal stances of gait after hallux valgus surgery.</p></div><div><h3>Methods</h3><p>This prospective observational study included 11 female patients (17 feet), who underwent first metatarsal osteotomy. Gait analyses were performed preoperatively and 1- and 2-year postoperatively using a three-dimensional motion capture system. Toe-out angle, ankle, knee, and hip joint angles during gait were calculated from the recorded data. The spatiotemporal parameters and these angles at the mid and terminal stances of gait were statistically compared between preoperative and postoperative periods.</p></div><div><h3>Findings</h3><p>All spatiotemporal parameters remained unchanged postoperatively. The toe-out angle was significantly greater at 1- and 2-year postoperatively. The ankle pronation angle, the knee abduction angle, and the hip adduction angle at the mid and terminal stances of gait were smaller postoperatively compared to the preoperative. These angular changes showed a similar trend at 1 and 2 years postoperatively. However, the postoperative changes of the sagittal joint angles were relatively small.</p></div><div><h3>Interpretation</h3><p>Hallux valgus surgery can affect the toe-out angle and the lower limb coronal kinematics at the mid and terminal stances of gait in patients with hallux valgus. However, surgical correction of hallux valgus deformity did not directly improve the gait characteristics in patients with hallux valgus.</p></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141637696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contributions of capsular releases to femoral exposure in total hip arthroplasty via the direct anterior approach","authors":"Shuyang Han ,&nbsp;Zackary Byrd ,&nbsp;Sabir K. Ismaily ,&nbsp;Luis E. Delgadillo ,&nbsp;Adam M. Freedhand ,&nbsp;David Rodriguze-Quintana ,&nbsp;Philip C. Noble","doi":"10.1016/j.clinbiomech.2024.106303","DOIUrl":"10.1016/j.clinbiomech.2024.106303","url":null,"abstract":"<div><h3>Background</h3><p>In total hip arthroplasty via the direct anterior approach, appropriate exposure is critical to allow preparation of the femur. The objective of this study was to explore the optimal soft tissue releases needed to allow broaching of the femur through a combination of experimental tests and computer simulations.</p></div><div><h3>Methods</h3><p>Fourteen full-body cadaveric specimens were included in this study. Total hip arthroplasty was performed via the direct anterior approach with the femur at 20° adduction and 20°extension. Soft tissue releases were performed sequentially, namely, the transverse iliofemoral ligament, descending iliofemoral ligament, ischio-femoral ligament, conjoint tendon, and obturator externus. After each release, the femur mobility was assessed by applying a 6 Nm external rotation torque and a 120 N distraction force. Subsequently, using specimen-specific models and models of the broach and handle, the broach passage after each release was simulated, and the release that allowed broach passage was analyzed.</p></div><div><h3>Findings</h3><p>The average external rotation after releasing the transverse and descending iliofemoral ligaments increased by 14.1° ± 6.1° and 13.8° ± 5.3°. With subsequent soft tissue releases, the rotational mobility increased incrementally, though the impact decreased. Impingement between the broach passage and the pelvis was mainly at the anterior superior iliac spine and the anterior inferior iliac spine. The volume of impingement decreased from 4.8 ± 4.5 cm³ after resection of the femoral head to 1.8 ± 1.6 cm³ and 1.2 ± 1.9 cm³ after release of the transverse and descending iliofemoral ligament, respectively.</p></div><div><h3>Interpretation</h3><p>With sequential soft-tissue releases, the femur mobility increased incrementally. However, the number of releases needed for each femur varied extensively between specimens. Most (10/14) femurs became accessible after the release of the ilio-femoral or ischio-femoral ligament.</p></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}