Pelvic fixation is fundamental to multi-level spinal fusion constructs. Established techniques include conventional iliac, S1-alar-iliac (S1AI), S2-alar-iliac (S2AI), and S3-alar-iliac (S3AI) fixation. Novel porous sacral-alar-iliac (SAI) screws with integrated tulips are increasingly used in long constructs requiring bilateral pelvic fixation. The optimal pelvic fixation strategy remains debated. Conventional techniques include iliac screws and sacral-alar-iliac (SAI) variants, while combined constructs such as S1AI + S3AI remain underexplored. This study presents a finite element analysis (FEA) comparing the biomechanical impact of various fixation methods, with emphasis on combined S1AI + S3AI fixation.

Following ulnar shortening osteotomies, plates are often removed due to discomfort or irritation. The screw holes left after plate removal act as stress risers and predispose the bone to fracture. To our knowledge, calcium phosphate cement (CPC) is yet to be investigated for its use in reinforcing screw holes. The aim of this study was to determine if filling screw holes with CPC in a synthetic anatomical ulna model will improve its immediate mechanical strength compared to leaving screw holes unfilled.

Bone tumors often affect the knee, necessitating total knee arthroplasty for functional restoration. While rotating hinge prostheses enable biaxial movement, an ideal design should replicate natural multi-axis motion. A proposed ball-axis prosthesis with an open coronal plane has undergone in vitro finite element validation but lacks in vivo assessment. This study aims to deeply explore the influence of abduction-adduction freedom of the open prosthesis knee joint on the gait function of patients in vivo.

The anterolateral ligament (ALL) has structural diversity and is often injured concurrently with anterior cruciate ligament (ACL) tears. At present, the effect of ALL structural diversity on combined injury and associated reconstruction remains unclear.

Kinematically aligned total knee arthroplasty has gained popularity. This study aimed to evaluate kinematic alignment targeting the neutral ground mechanical axis (ground kinematic alignment) through a comparison between two modern prostheses.

Cerebral Palsy (CP) is a common motor disorder in children, leading to reduced physical activity (PA) and increased health risks. To complement traditional PA methods (e.g. accelerometers, self-reports), electromyography (EMG) provides physiologically relevant information on muscle activity during free-living. This study used EMG for assessing daily muscle activity in individuals with CP and their typically developing (TD) peers.

We predicted the fracture outcomes of simulated falls from standing height using biofidelic finite element models of older adults in Singapore. We further investigated the influence of trochanteric soft tissue thickness, measured from scans and equations estimating standing trochanteric soft tissue thickness from DXA and BMI, on predicted fracture outcomes.

Ankle osteoarthritis (OA) affects ∼1 % of the global population and impairs postural stability, increasing fall risk. Total ankle arthroplasty (TAA) is one of the most common surgical treatments, but balance impairments may persist post-op. The study examined differences in load symmetry across time for patients with ankle OA and post-TAA at low (LFR) or high fall risk (HFR) and then compared these groups with healthy controls.

Cortical contact of the stem is a key determinant for primary stability in cementless revision hip arthroplasty. This matched-pair cadaveric study evaluated whether implant designs that increase cortical contact improve primary fixation of cementless revision stems METHODS: Ten paired femora received either a tapered monoblock RECLAIM™ stem with advanced spline (RAS) geometry or an identically sized prototype solid stem. Axial seating and rotation were recorded using dynamic image correlation during implantation. Specimens were cyclically loaded up to 200 % body weight, after which torque-to-failure was measured FINDINGS: Both designs showed mean micromotion <50 μm during cyclic loading, consistently favourable for osseointegration. However, solid stems rotated more during implantation than RAS stems (3.6 ± 5.0° vs. 0.5 ± 0.6°, p = 0.088). The cortical contact area of the solid stems was 43.6 % larger than RAS stems (p < 0.001) without an impact on superior fixation: Axial subsidence and rotation during cyclic loading did not differ significantly between the designs but two solid-stem specimens fractured under high loading. Torque-to-failure of the RAS stems was 38.7 ± 7.5 nm, exceeding that of solid stems by 24.3 % (p = 0.032) INTERPRETATION: These findings suggest that maximising circumferential contact by implant design alone cannot compensate for irregularities of the femoral canal. Whereas solid stems wedge firmly only at the cost of positioning accuracy and increased fracture risk, the thin splines of the RAS design engage the cortex progressively, guide the implant to the planned depth, and augment torsional resistance without excessive press-fit. Tapered stems with cortex-indenting splines improve primary stability in cementless revision hip arthroplasty more effectively than increasing contact area alone.

Gait variability in spatiotemporal parameters, a measure related to gait stability, is associated with fall risk in patients with stroke. Assessing gait variability may also be critical for independent walking in patients with hemiparesis following stroke. However, it remains unclear whether gait variability can discriminate between independent walking. This study aimed to evaluate the efficacy of gait variability indicators in discriminating independent walking in patients with hemiparesis following stroke.

Treadmill exercise improves step length and velocity in Parkinson's disease (PD) but may not fully address all critical elements of gait, such as double support, which is closely associated with fall risk. Treadmill exercise combined with additional non-pharmacological strategies has the potential to yield a more comprehensive therapeutic approach. The application of automated mechanical peripheral stimulation (AMPS) has been identified as a potential intervention for gait rehabilitation, demonstrating efficacy in enhancing walking speed in PD. In principle, pre-activating sensory pathways via AMPS could prime the motor system for enhanced engagement during treadmill training. This study aimed to investigate the acute effects of AMPS combined with treadmill exercise in individuals with PD.

Pedicle screw density and rod contouring are crucial in the posterior spinal fusion (PSF) in adolescent idiopathic scoliosis (AIS) patients. This study evaluates the three-dimensional (3D) biomechanical interaction between rod contouring and the number/pattern of implants anchoring these rods to determine a range of advisable combinations that improve clinical outcomes.

Kinesiophobia, or fear of movement, is common in individuals with musculoskeletal pain, especially in those with patellofemoral pain, and it can lead to increased functional limitations. Although pain self-efficacy is known to affect kinesiophobia, the link between psychological factors and physical aspects such as movement patterns and pain intensity remains uncertain. This study aimed to assess the relationships between kinesiophobia and cognitive-behavioural factors, pain, and functional domains in participants with patellofemoral pain.

Multiple Sclerosis (MS) is an autoimmune disease of the central nervous system, which can impact postural control. The Margin of Stability (MoS) is a biomechanical measure of how close someone is to falling without corrective action. Walking MoS has been extensively studied in people with MS (PwMS), while standing MoS is less studied. This work explores the relationship between the standing MoS and clinical measures, identifying a standing MoS summary feature that quantifies the level of balance impairment due to MS, across a range of stances.

Gait speed is a major determinant of daily function and quality of life in hip osteoarthritis, yet evidence on how trunk muscles are associated with gait is scarce. We investigated factors associated with gait speed in hip osteoarthritis, focusing on the transversus abdominis (TrA).

Proximal femur fracture fixation fundamentally alters load transfer, which can trigger adverse bone remodeling, particularly after healing in osteoporotic bone. While previous studies have focused on early fixation stability or acute fracture healing, the long-term mechanical environment after fracture consolidation remains poorly understood. This study examines implant-specific strain behavior in the post-healed state to identify patterns that may predispose to late-stage implant failure or remodeling.

Altered gait biomechanics following anterior cruciate ligament reconstruction (ACLR) contribute to the 3-6 times greater risk of osteoarthritis development in this population compared to those without a knee injury. To mitigate the onset of osteoarthritis, it is necessary to understand gait recovery during the first year post-ACLR when patients have access to rehabilitative care. The purpose of this review was to compare ACLR limb gait biomechanics to the uninjured limb and healthy controls during the first year of recovery.

Individuals with hypermobile Ehlers-Danlos Syndrome (hEDS) and Hypermobility Spectrum Disorders (HSD) often experience chronic pain, muscle fatigue, and exercise intolerance, potentially due to altered muscle-tendon mechanics. This study investigated the influence of Achilles tendon (AT) compliance and plantar flexor muscle function on the metabolic cost of walking in individuals with and without HSD/hEDS.

Exercise-based rehabilitation is the standard conservative treatment for Achilles tendinopathy, however, symptoms often persist post-treatment. Forefoot biasing footwear may augment rehabilitation by influencing tendon loading and ankle kinematics. This study aims to determine its effect on Achilles tendon loading and ankle kinematics in individuals with Achilles tendinopathy.

Hip fractures associated with osteoporosis are a major healthcare concern. Existing drugs have limited efficacy in reducing hip fractures. However, clinical trials require large cohorts and lengthy follow-up. Computational models could potentially improve the development of more effective treatments. The aim of this study was to validate an In Silico Trial (BoneStrength) by reproducing a published clinical trial on the efficacy of alendronate. The predicted number of fractures was compared to the clinical data.

Severe arthrosis involving ankle and subtalar joints or hindfoot deformities refractory to other forms of treatment is currently managed by tibiotalocalcaneal arthrodesis (TTCA). Relief of pain and acceptable gait pattern along with appropriate alignment are primary goals of treatment. The spectrum of techniques includes using screws, plates, external fixators and various types of intramedullary nails. The aim of this study was to compare the biomechanical stability of a plate specifically developed for hindfoot arthrodesis to an well-established nailing system.