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Grassi A.,Laboratorio Of Biomeccanica Ed Innovazione Tecnologica | Quaglia A.,Humanitas Research Hospital | Canata G.L.,Centro Of Traumatologia Dello Sport | Zaffagnini S.,Laboratorio Of Biomeccanica Ed Innovazione Tecnologica

Muscle injuries are recognized to be among the most frequent injuries occurring in the sporting and athletic population, and they account for more than 30% of all injuries in professional soccer players. Despite their considerable frequency and impact, there is still a lack of uniformity in the categorization, description and grading of muscle injuries. Dozens of systems based on clinical signs, ultrasound imaging (Us) appearance or magnetic resonance imaging (MRi) findings have been proposed over the years. Most of them are three-grade systems that take into account pain, RoM limitation, swelling and hematoma, hypoechoic or hyperintense areas on Us or MRi, and muscle gap or tendon involvement; however, they still lack evidence-based prognostic value. Recently, new comprehensive classification systems have been proposed, with the aim of developing uniform muscle injury terminology and giving each severity grade prognostic value. The systems that combine detailed MRi and Us features with the clinical presentation, such as the Munich Muscle injury Classification, the isMuLt classification, and the British Athletic Classification, if used extensively, could improve the diagnosis, prognosis and management of muscle injuries. © 2016 CIC Edizioni Internazionali Unauthorized reproduction of this article is prohibited. Source

Bontempi M.,Istituto Ortopedico Rizzoli Laboratorio Nano Biotecnologie | Bontempi M.,Laboratorio Of Biomeccanica Ed Innovazione Tecnologica | Bettuzzi M.,University of Bologna | Visani A.,Laboratorio Of Biomeccanica Ed Innovazione Tecnologica
Medical Physics

Purpose: The Monte Carlo (MC) simulation is widely used to design and test complex physical phenomena. This paper presents a simulator of x-ray detector for imaging applications by providing a simple component that can be embedded into a MC code and allowing developers to focus their attention on the primary goals without hanging in the quality of the final output image. Methods: A simplified semiempirical model of x-ray detector was developed and implemented starting from the definition of absorber material and developing scintillator and photoconductor screens and detectors. The validation was done by comparing a Hamamatsu C10900D digital flat panel with a simulation of the same detector using the presented model: MTF, nNPS, and NEQ. Results: The results of validation tests shown excellent agreement of the simulation with respect to the experimental data. The simulation was fast and efficient even in older computers (2004) and it was excellent in newer multicore computers (2010). Conclusions: Comparisons between experimental data and simulations shown that the simulator is able to mimic the output of a real imaging system, and it can have many applications in fields such as industry, medical physics, and teaching. © 2012 American Association of Physicists in Medicine. Source

Russo L.R.,Videoinsightnter | Benedetti M.G.,Medicina Fisica e Riabilitativa | Mariani E.,Medicina Fisica e Riabilitativa | Roberti Di Sarsina T.,Laboratorio Of Biomeccanica Ed Innovazione Tecnologica | Zaffagnini S.,Laboratorio Of Biomeccanica Ed Innovazione Tecnologica
Knee Surgery, Sports Traumatology, Arthroscopy

Purpose: The purpose of this randomized double-blind study was to investigate the effectiveness of the Videoinsight® psychological enhancing method in promoting early recovery during rehabilitation following total knee arthroplasty. Methods: One-hundred and ten patients treated with cemented total knee arthroplasty were randomly assigned to Group A or Group B, and both groups underwent the same rehabilitation programme. Group A (55 patients) received one art video selected according to Videoinsight® concept. This art video promoting self-confidence and psychological support to the patient has been shown in the physical therapy department before any rehabilitation session, in the first 15 days after surgery and then three times a week for the next 4 weeks. Group B (55 patients) underwent the same rehabilitation protocol in the same setting, after TKA surgery, without the video support. Patients were evaluated pre-operatively and 3 months after surgery with Physical and Mental SF-36, State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI), Tampa Scale of Kinesiophobia (TSK), Knee Society Score (KSS), VAS, and WOMAC scores. Results: Eight patients were lost to follow-up, and 102 patients (Group A: 52 patients; Group B: 50 patients) were available at mean 3.0 ± 0.2 months follow-up. Age at surgery was 69.1 ± 13.0 years. The two groups were homogeneous regarding pre-operative demographic data and clinical outcomes. Significant improvements were observed in both groups compared to baseline and in Group A compared to Group B at final follow-up for functional and psychological scores except for SF-36. Respectively, Group A and Group B showed WOMAC 79.9 ± 13.0 and 69.7 ± 9.5 (p < 0.005), VAS 2.8 ± 1.6 and 4.0 ± 1.5, (p < 0.005), KSS 87.8 ± 9.6 and 78.3 ± 8.2 (p < 0.005), BDI 5.1 ± 4.8 and 9.4 ± 3.9 (p < 0.005), STAI 30.8 ± 7.9 and 34.8 ± 7.8 (p < 0.005), and TSK 24.4 ± 5.5 and 29.3 ± 4.8 (p < 0.005). Conclusion: The Videoinsight(®) psychological enhancing method, by the view of video art images, combined to an adequate rehabilitation protocol can be a means for further improving short-term clinical and functional outcomes by giving a psychological support to patients who underwent total knee arthroplasty. Level of evidence: I. © 2016 European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) Source

Signorelli C.,Laboratorio Of Biomeccanica Ed Innovazione Tecnologica | Bonanzinga T.,Laboratorio Of Biomeccanica Ed Innovazione Tecnologica | Lopomo N.,Laboratorio Of Biomeccanica Ed Innovazione Tecnologica | Lopomo N.,University of Brescia | And 3 more authors.
Knee Surgery, Sports Traumatology, Arthroscopy

Purpose: To quantitatively evaluate the biomechanical sealing function of an intact labrum and the effect of labral–chondral separation, cerclage suture labral repair, vertical mattress suture repair and partial labrectomy on distraction load and hip joint centre (HJC) displacement. Methods: Eight fresh-frozen cadaveric hips were tested using a navigation system for intra-operative kinematic analysis. A six-axis load cell was used to measure the manually applied force when performing the tests: hip pivoting movement and distraction. The HJC displacement that occurred during the distraction test has been evaluated in correspondence of seven different values of applied force. During the pivoting motion, the maximum value of HJC displacement was evaluated. Five different conditions were tested: labrum intact, labral–chondral separation, vertical mattress suture repair, cerclage suture repair, and partial labrectomy. Results: With regard to HJC displacement using at fixed value of force, the paired sample t test underscored the statistically significant differences (p < 0.05) for each of the five tested conditions among themselves. Only the comparison of intact versus labral–chondral separation was not significantly different. During pivoting motion, a statistically significantly greater displacement was identified after labrectomy when compared with the cerclage suture repair (p = 0.03) and vertical mattress repair (p < 0.01) in medial–lateral direction. Along proximal—distal direction, a significant lower displacement after labrectomy was identified when compared to the cerclage suture repair (p = 0.03). Performing the pivoting motion at the extreme ranges of motion demonstrated a higher value of displacement after labrectomy when compared with all the previously tested conditions. Conclusions: These results suggest that labral repair is important in the function of the hip and that the vertical mattress suture technique may be better than the cerclage suture repair. © 2015 European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) Source

Zaffagnini S.,Laboratorio Of Biomeccanica Ed Innovazione Tecnologica | Colle F.,Laboratorio Of Biomeccanica Ed Innovazione Tecnologica | Colle F.,Laboratorio Of Nano Biotecnologie Nabi | Colle F.,SantAnna School of Advanced Studies | And 6 more authors.
Knee Surgery, Sports Traumatology, Arthroscopy

Purpose: Retinacular restraints have a critical role in patellar tracking, limiting the movement of the patella in the trochlear groove. The medial patellofemoral ligament (MPFL) is probably the main stabilizer against lateral displacement; few studies are focused on MPFL role on patellofemoral kinematics and patellar stability. The main goal of this in vitro study was to analyse the influence of the MPFL on the kinematics of the patellofemoral joint and patellar stability. Methods: Using a non-image-based navigation system, kinematics and anatomical data of six fresh-frozen specimens were collected. A passive flexion-extension from 0° to 90° and static acquisitions at 0°, 30°, 60° and 90°, with and without 25 N of lateral load, were performed with intact and resected MPFL with a 60 N axial force applied to the isolated quadriceps tendon. Patellar tilt and shift were analysed. Results: The MPFL intact state showed a shift in medial direction during the first degrees of knee flexion-that disappeared in MPFL resected condition-followed by a lateral shift, similar to that of MPFL resected condition. Tilt analysis showed that patella rotated laterally until 85° of knee flexion for intact MPFL condition and until 70° for resected MPFL condition and after rotated medially. Static tests showed that patellar stability was significantly affected by MPFL resected condition in particular at 30° and 60°. Conclusions: The MPFL has an aponeurotic nature. It works as a restraint during motion, with an active role under high stress on lateral side, but with a small contribution during neutral knee flexion. Its biomechanical behaviour under loading conditions should be kept into account when performing surgical reconstruction of this ligamentous structure. © 2012 Springer-Verlag Berlin Heidelberg. Source

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