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Bioengineering
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Biomechanics of Orthopaedic Rehabilitation
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Biomechanics of Orthopaedic Rehabilitation

A special issue of Bioengineering (ISSN 2306-5354). This special issue belongs to the section "Biomechanics and Sports Medicine".

Deadline for manuscript submissions: 31 December 2024 | Viewed by 5082

Special Issue Editor

Dr. Songning Zhang

E-Mail Website
Guest Editor
Department of Kinesiology, Recreation, & Sport Studies, University of Tennessee, Knoxville, TN, USA
Interests: total knee replacement; knee osteoarthritis; gait biomechanics; cycling biomechanics; intervention; footwear; performance and injury mechanisms on synthetic surface

Special Issue Information

Dear Colleagues,

Osteoarthritis (OA) is one of the most common orthopaedic diseases affecting lower extremity joints, especially the knee and hip. There is currently no cure for OA. Pharmaceutical and non- pharmaceutical therapies are often recommended for patients with earlier stages of OA. While joint arthroplasty including partial and total knee arthroplasty (TKA) and total hip arthroplasty (THA) arthroplasty is a popular choice for end-stage OA, post-surgery rehabilitation remains a challenge to the patients and clinicians.  

This Special Issue of “Biomechanics of Orthopaedic Rehabilitation” focuses on advances in biomechanics of rehabilitations related to joint arthroplasty and OA. The topics of this Special Issue are broadly defined and some suggested (but not limited) topics are listed below.

  • Gait rehabilitation;
  • Cycling-related applications in rehabilitation;
  • Muscle activation inhibition and kinesiophobia;
  • Edema and pain;
  • Muscle strengthening and conditioning;
  • Surgical techniques;
  • Implant designs.

Dr. Songning Zhang
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Bioengineering is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • orthopedic
  • rehabilitation
  • joint arthroplasty
  • biomechanics
  • osteoarthritis
  • rehabilitation
  • pain
  • muscle
  • gait
  • cycling
  • muscle activation inhibition

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Published Papers (5 papers)

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Research

9 pages, 7133 KiB  
Article
Comparison of Three Internal Fixation Constructs for AO/OTA 33-A3 Distal Femoral Fractures: A Biomechanical Study
by Wei Xie, Hui Liu, Shufen Chen, Weizhen Xu, Weibin Lin, Tianlai Chen, Lingqi Zhu, Wenliang Zhai and Jin Wu
Bioengineering 2024, 11(11), 1110; https://doi.org/10.3390/bioengineering11111110 - 4 Nov 2024
Viewed by 574
Abstract
Background: To compare the biomechanical performance of three internal fixation constructs for AO/OTA 33-A3 distal femoral fractures. Methods: Thirty AO/OTA 33-A3 synthetic distal femoral fracture models were constructed and randomly divided into three groups. Group A (dual-plate construct) was fixed with a medial [...] Read more.
Background: To compare the biomechanical performance of three internal fixation constructs for AO/OTA 33-A3 distal femoral fractures. Methods: Thirty AO/OTA 33-A3 synthetic distal femoral fracture models were constructed and randomly divided into three groups. Group A (dual-plate construct) was fixed with a medial locking plate combined with a less invasive stabilization system (LISS). Group B was fixed with a retrograde femoral nail (RFN) combined with an LISS (RFN + LISS construct), and Group C was fixed with a retrograde tibial nail (RTN) combined with an LISS (RTN + LISS construct). The axial displacement, axial stiffness, torsional displacement, torsional stiffness and maximum failure load of different internal fixation constructs were recorded and statistically analyzed. Results: In the axial compression test, the average stiffness of Group C was significantly higher than that of Groups A and B, and the average displacement of Group C was significantly smaller than that of Groups A and B. In the torsion test, the torsion degree of Group C was significantly lower than that of Groups A and B, and Group C had a higher torsional stiffness than Groups A and B. In the axial compression failure test, the average ultimate load (a displacement greater than 5 mm) of Group C was significantly higher than that of Groups A and B. Conclusion: The biomechanical strength of the RTN combined with a plate is higher than that of the RFN combined with plate and dual-plate constructs, which can be used as an internal fixation option for the treatment of comminuted distal femoral fractures. Full article
(This article belongs to the Special Issue Biomechanics of Orthopaedic Rehabilitation)
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12 pages, 1426 KiB  
Article
Functional Electrical Stimulation of the Lateral Knee Muscles Can Reduce Peak Knee Adduction Moment during Stepping: A Pilot Study
by Raziyeh Baghi, Gad Alon, Giovanni Oppizzi, Subham Badhyal, Peter Bowman and Li-Qun Zhang
Bioengineering 2024, 11(9), 881; https://doi.org/10.3390/bioengineering11090881 - 30 Aug 2024
Cited by 1 | Viewed by 785
Abstract
Knee osteoarthritis (KOA) is an age-dependent disease dominantly affected by mechanical loading. Balancing the forces acting on the medial knee compartment has been the focus of KOA interventions. This pilot study investigated the effects of functional electrical stimulation (FES) of the biceps femoris [...] Read more.
Knee osteoarthritis (KOA) is an age-dependent disease dominantly affected by mechanical loading. Balancing the forces acting on the medial knee compartment has been the focus of KOA interventions. This pilot study investigated the effects of functional electrical stimulation (FES) of the biceps femoris and lateral gastrocnemius on reducing peak knee adduction moment (pKAM) in healthy adults and individuals with medial KOA while stepping on an instrumented elliptical system. Sixteen healthy individuals and five individuals with medial KOA stepped on the robotic stepping system, which measured footplate-reaction forces/torques and ankle kinematics and calculated 3-D knee moments in real time using inverse dynamics. Participants performed four different tasks: regular stepping without FES as the baseline condition, stepping with continuous FES of the lateral gastrocnemius (FESLG), biceps femoris (FESBF), and simultaneous FES of both lateral gastrocnemius and biceps femoris (FESLGBF), throughout the elliptical cycle. The 3-D knee moments, tibia kinematics, and footplate-reaction forces were compared between the baseline and the three FES stepping conditions. Healthy participants demonstrated lower pKAM during each of the three FES conditions compared to baseline (FESLG (p = 0.041), FESBF (p = 0.049), FESLGBF (p = 0.048)). Participants with KOA showed a trend of lower pKAM during FES, which was not statistically significant given the small sample available. Incorporating elliptical + FES as a training strategy is feasible and may help to enhance selective force generation of the targeted muscles and reduce the medial knee compartment loading. Full article
(This article belongs to the Special Issue Biomechanics of Orthopaedic Rehabilitation)
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10 pages, 647 KiB  
Article
Feasibility of Stationary Cycling with Pedal Force Visual Feedback Post-Total Knee Arthroplasty: Implications for Inter-Limb Deficits in Knee Joint Biomechanics
by Erik T. Hummer, Jared Porter, Harold Cates and Songning Zhang
Bioengineering 2024, 11(8), 850; https://doi.org/10.3390/bioengineering11080850 - 20 Aug 2024
Cited by 1 | Viewed by 892
Abstract
The purpose of this study was to assess the biomechanical adaptations prompted by stationary cycling paired with visual feedback of vertical pedal reaction forces during both stationary cycling and overground walking for patients who underwent a total knee arthroplasty (TKA). Specifically, an emphasis [...] Read more.
The purpose of this study was to assess the biomechanical adaptations prompted by stationary cycling paired with visual feedback of vertical pedal reaction forces during both stationary cycling and overground walking for patients who underwent a total knee arthroplasty (TKA). Specifically, an emphasis on the inter-limb deficits in knee joint biomechanics were examined. Ten patients who underwent a TKA took part in an acute intervention with pre- and post-testing measurements of kinematics (240 Hz) and kinetics (1200 Hz) during stationary cycling and overground walking. The intervention phase consisted of six cycling sessions during which participants were provided with visual feedback of their bilateral peak vertical pedal reaction force, with instructions to maintain a symmetrical loading between limbs. A 2 × 2 (work rate/speed × time) repeated measures ANOVA (α = 0.05) was conducted on key outcome variables. Peak knee extension moment asymmetry during stationary cycling significantly improved (p = 0.038, η2p = 0.610) following the acute intervention. Walking velocities for both preferred (p = 0.001, d = 0.583) and fast (p = 0.002, d = 0.613) walking speeds displayed improvements from pre- to post-testing. Significant improvements in the total score (p = 0.009, d = 0.492) and ADL subscale score (p = 0.041, d = 0.270) for the Knee Injury and Osteoarthritis Outcome Score were present following the acute intervention. Stationary cycling with visual feedback may be beneficial post-TKA; however, further investigation is merited. Full article
(This article belongs to the Special Issue Biomechanics of Orthopaedic Rehabilitation)
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10 pages, 3177 KiB  
Article
A Biomechanical Comparison Study of Plate–Nail and Dual-Plate Fixation in AO/OTA 41-C2 Tibial Plateau Fractures
by Wei Xie, Deqing Luo, Li Xie, Lingqi Zhu, Liang Zhou, Kejian Lian, Dasheng Lin and Hui Liu
Bioengineering 2024, 11(8), 839; https://doi.org/10.3390/bioengineering11080839 - 17 Aug 2024
Cited by 1 | Viewed by 773
Abstract
Background Context: This study’s purpose was to evaluate the biomechanical performance of plate–nail and dual-plate fixation for the treatment of AO/OTA 41-C2 tibial plateau fractures. Methods: Twenty synthetic tibias were selected and randomly divided into a plate–nail group (n = 10) and [...] Read more.
Background Context: This study’s purpose was to evaluate the biomechanical performance of plate–nail and dual-plate fixation for the treatment of AO/OTA 41-C2 tibial plateau fractures. Methods: Twenty synthetic tibias were selected and randomly divided into a plate–nail group (n = 10) and a dual-plate group (n = 10). After the artificial tibias were osteotomized to simulate AO/OTA 41-C2 tibial plateau fractures in both groups, the plate–nail and the dual-plate methods, respectively, were used for fixation, and then axial compression loading, three-point bending, torsion, and axial failure tests were carried out. The data of each group were recorded and statistically analyzed. Results: In the axial compression test, the average stiffness of the plate–nail group was higher than that of the dual-plate group (p < 0.05). The displacement generated in the plate–nail group was significantly smaller than that in the dual-plate group (p < 0.05). In the resisting varus test, the stress of the plate–nail group was significantly higher than that of the dual-plate group (p < 0.05). In the resisting valgus test, the stress of the plate–nail group was slightly higher than that of the dual-plate group, but the difference was not statistically significant (p > 0.05). In the static torsion test, the load applied to the plate–nail group was smaller than that of the dual-plate group when rotated to 5° (p < 0.05). In the axial compression failure test, the average ultimate load of the plate–nail group was significantly higher than that of the dual-plate group (p < 0.05). Conclusion: The treatment of AO/OTA 41-C2 tibial plateau fractures with plate–nail fixation is superior to that with dual-plate fixation in resisting axial stress and preventing tibial varus deformity, while dual-plate fixation has better resisting torsional ability. Full article
(This article belongs to the Special Issue Biomechanics of Orthopaedic Rehabilitation)
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10 pages, 480 KiB  
Article
Investigation of Biomechanical Differences in Level Walking between Patients with Bilateral and Unilateral Total Knee Replacements
by Derek Yocum, Alejandro Ovispo-Martinez, Kevin A. Valenzuela, Chen Wen, Harold Cates and Songning Zhang
Bioengineering 2024, 11(8), 763; https://doi.org/10.3390/bioengineering11080763 - 28 Jul 2024
Cited by 1 | Viewed by 1057
Abstract
Due to the high risk of a bilateral total knee arthroplasty (TKR) following unilateral TKR, this study was performed to investigate bilateral TKR patients. Specifically, we examined biomechanical differences between the first replaced and second replaced limbs of bilateral patients. Furthermore, we examined [...] Read more.
Due to the high risk of a bilateral total knee arthroplasty (TKR) following unilateral TKR, this study was performed to investigate bilateral TKR patients. Specifically, we examined biomechanical differences between the first replaced and second replaced limbs of bilateral patients. Furthermore, we examined bilateral TKR effects on hip, knee, and ankle biomechanics, compared to the replaced and non-replaced limbs of unilateral patients. Eleven bilateral patients (70.09 ± 5.41 years, 1.71 ± 0.08 m, 91.78 ± 13.00 kg) and fifteen unilateral TKR patients (65.67 ± 6.18 years, 1.73 ± 0.10 m, 87.72 ± 15.70 kg) were analyzed while performing level walking. A repeated measures one-way ANOVA was performed to analyze between-limb differences within the bilateral TKR group. A 2 × 2 (limb × group) ANOVA was used to determine differences between bilateral and unilateral patients. Our results showed that the second replaced limb exhibited a lower peak initial-stance knee extension moment than the first replaced limb. No other kinematic or kinetic differences were found. Bilateral patients exhibited lower initial-stance knee extension moments, knee abduction moments, and dorsiflexion moments, compared to unilateral patients. Bilateral patients also exhibited lower push-off peak hip flexion moments and vertical GRF. The differences between the first and second replaced limbs of bilateral patients may indicate different adaptation strategies used following a second TKR. The significant group differences indicate that adaptations are different between these groups, and it is not recommended to use patients with unilateral and bilateral TKR together in gait analyses. Full article
(This article belongs to the Special Issue Biomechanics of Orthopaedic Rehabilitation)
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