Feasibility and Clinical Outcomes of Individualized Bone Cement Prosthetic Replacement for Advanced Lunate Bone Necrosis

Retrocalcaneal pain is a common presenting complaint, which can lead to severe limitation of function. It is commonly due to pathology involving the Achilles tendon or inflammation of the so called retrocalcaneal bursa. Both these sites are frequent targets of medicinal injections. In some cases though, despite these measures, the problems persist. We present a series of cases whereby the symptoms were caused by fibrotic tissue in a poorly described region between the Achilles tendon and the calcaneus. We include relevant imaging to highlight the pathology.

Purpose: In the fitness industry, several different traits are measured using many different tests. Therefore, a need exists to study and evaluate the convergent and divergent validity of different fitness traits across their tests. The purpose of this study was to examine the measurement properties of different fitness tests designed to assess the five components of health-related physical fitness. Methods: A total of N=131 college students attending a rural public institution participated in this crosssectional study. Four different fitness tests were administered for each of the five fitness traits: cardiorespiratory, muscular strength, muscular endurance, body composition, and flexibility. A modified MultiTrait-MultiMethod (MTMM) matrix was used to simultaneously examine the measurement properties of the fitness assessments, which included internal consistency reliability, convergent validity, and divergent validity. Results: The overall modified MTMM matrix indicated strong internal consistency (alpha=0.89) across the twenty fitness tests. Each fitness component showed at least moderate reliability (alphas=0.68-0.88) with the exception of flexibility (alpha=0.38). Same trait convergent validity coefficients (CVST) were significant (ps<0.05) for all traits with exception of flexibility. Majority of different trait convergent validity coefficients (CVDT) were significant for all traits with exception of flexibility. Conclusions: Results from this study provide moderate to strong validity evidence for fitness assessments in college students. However, several tests appear to lack strong convergence with their same trait counterpart tests. Furthermore, flexibility appears to lack convergence with its same trait tests as well as other fitness trait tests.

Chronic calf strain injuries are an uncommon but potentially debilitating injury which may result in significant functional impairment in runners and time lost from play in athletes. In athletes and runners with previous calf injury, we believe that scarring between gastrocnemius and soleus aponeuroses, particularly in relation to the plantaris tendon, may result in altered calf muscle biomechanics that may predispose to re-injury. Clinically, these patients may present with ‘incipient’ calf tears or recurrent calf tears. We describe the clinical and imaging findings in chronic calf strain injury and report on a new technique for the management of these injuries, calf aponeurosis adhesiolysis, which may help to restore the normal biomechanical relationship between the gastrocnemius and soleus aponeuroses and the plantaris tendon during activity.

Problem: Pulley-lesions of the fingers are typical injuries in climbing sports. In general, a rupture of the A2-pulley is found, without significant medical impact. Complex pulley-lesions may be devastating for a high-level career in sports climbing. Standard MRI in stretched finger position is not able to evaluate the A3- pulley, which is crucial for graduation of complex pulley lesions. Methods: We introduce stress MRI in a flexed finger position. This allows quantification of the distance between the palmar plate and the deep flexor tendon (A3-distance). Results: According to our data following MRI-examinations of 24 high-level sports climbers an A3-distance of 4 mm or more indicates rupture. An A3- distance up to 1 mm seems to be normal in high-level sports climber. However, due to the small sample number we did not find a clear cut-off point between strain and rupture. Discussion: The rather small and elastic A3-pulley defines the complexity of pulley-lesions. Conservative treatment is preferable if there is still continuity of the A3-pulley. Beside diagnostic imaging, Stress MRI of the fingers give some functional information about an inured A3-pulley in addition. Conclusion: Stress MRI of the fingers is an easy to perform tool for evaluation of the A3-pulley in every MRI-scanner available.

Background : Active commuting is a practical way to increase Physical Activity (PA). E-cycling elicits Moderate-To-Vigorous Intensity PA (MVPA) with experimental health benefits. Less is known about real-life commuter e-cycling impact on changes in MVPA, total sedentary time (SED-time), fitness and perceived health.

Methods : 33 subjects (min-max: 27-70 years) imminently starting commuter e-cycling were monitored for 3 to 5 months. Declarative measurements in MVPA and SED-time were analyzed by multilevel modeling. Fitness (stress test and adiposity), SF12-v2 and EMAPS scores were pre-post compared.

Results : High and stable adherence to commuter e-cycling averaged 84% (95%CI, 75-91). Mean MVPA increased and plateaued after e-cycling onset, reaching 56.7 MET-h/week (95%CI 49.9-64.3) (+21 MET-h/week over baseline). Larger increases were associated with age and e-cycling volume. High SED-time persisted over time, averaging 8.6 hours/day (95%CI, 8.1-9.) though decreasing for older and initially most sedentary subjects. Cardiorespiratory fitness improved (+0.48 METs, p=0.001) as well as effort perception, heart-rate response, waist-to-height ratio and SF12-v2 Mental Score.

Conclusions : New commuter e-cyclists experience a major increase in MVPA and a persistent high sedentary behavior, associated with benefits in fitness, adiposity and perceived mental health. Results from this pilot study need to be confirmed in larger cohorts overtime.

Acutely, altitude may disrupt RPE association with sea level physiological responses, potentially altering workload selection during RPE production. To assess the impact of altitude on perceptually anchored intensity regulation. Males (n=6) and females (n=6) (VO₂ max = 50.1 + 7.8 ml?kg-1?min-1) completed counterbalanced production trials at sea level (SEA) and altitude (ALT, ~3400m) at RPE 4 and RPE 7, blinded to velocity (VEL) (1% grade). ANOVA’s (trial x RPE) showed no significant difference for VEL (m?min-1) within RPE 4 (SEA = 186 ± 23, ALT = 190 ± 29) or RPE 7 (SEA = 253 ± 31, ALT = 255 ± 40). However, PO₂ (%) was significantly lower for ALT within RPE 4 (96.4 ± 2.0 vs. 83.5 ± 5.4) and RPE 7 (97.2 ± 0.9 vs. 83.1 ± 3.4). HR (b?min-1) was significantly higher for ALT within RPE 4 (133 ± 19 vs. 153 ± 17), and RPE 7 (163 ± 18 vs. 175 ± 12). Session RPE was not significantly different between SEA and ALT within RPE 4 (ALT = 3.9 ± 0.8, SEA = 3.7 ± 0.7) or RPE 7 (ALT = 6.7 ± 0.5, SEA = 6.8 ± 0.8). Physiological variables (HR, PO₂) seem subsidiary to workload (VEL) in mediating the RPE production paradigm at altitude with those observations consistent for Session RPE. Correspondence between perceptual responses and other physiological factors, (lactate, VO₂, etc) at altitude warrants further consideration including responses across varying fitness levels, exercise modalities and following acclimatization periods.