No abstract

This paper reports a comparison of the gait patterns of trans-femoral amputees using a single-axis prosthetic knee that coordinates ankle and knee flexions (Proteor's Hydracadence system) with the gait patterns of patients using other knee joints without a knee-ankle link and the gait patterns of individuals with normal gait. The two patient groups were composed of 11 male trans-femoral amputees: six patients had the Hydracadence joint (Group 1) and five patients had other prosthetic knees (Group 2). The reference group was made up of 23 normal volunteers (Group 3). In this work, trunk, hip, knee, and ankle 3-D motion was assessed using the VICON system. Kinetic data were collected by two AMTI force plates, and the knee moment was calculated via the 3-D equilibrium equations. An original questionnaire was used to assess the participants' activity level and clinical background. The results reveal that, during stance, all knee types guaranteed security. After heel strike, the plantar flexion of the ankle enabled by the Hydracadence prosthesis seems to increase stability. During swing phase, hip and knee sagittal motion was nearly the same in both Group 1 and Group 2. By contrast, hallux and sole vertical positions were significantly higher in Group 1 than in Group 2; thus, it seems the link between the ankle joint and the knee joint makes foot clearance easier. No alteration of the lateral bending of the trunk was observed. The protocol proposed in this paper allows a functional comparison between prosthetic components by combining clinical data with objective 3-D kinematic and kinetic information. It might help to determine which prosthetic knees are best for a specific patient.

To predict bone strength in the case of osteoporosis, it could be a real benefit to assess the three-dimensional (3D) geometry and the bone mineral density (BMD) with a single low-dose X-ray device, such as the EOS system (Biospace Med, Paris, France). EOS 3D reconstructions of the spine have already been validated. Thus, this study aims at evaluating the accuracy of this low-dose system as a densitometer first ex vivo. The European Spine Phantom (ESP) (number 129) was scanned ten times using both the EOS and a Hologic device (Hologic, Inc., Massachusetts, USA). Accuracy was given by the sum of the systematic error (difference between BMDs assessed and true values given by the phantom manufacturer) and the random error (coefficient of variation). EOS BMDs and Hologic BMDs of 41 ex-vivo vertebrae were calculated and compared. The reproducibility of the method evaluating the EOS BMD was assessed giving the coefficient of variation of three measurements of the 41 vertebrae. The accuracy of the EOS system is below 5.2 per cent, versus 7.2 per cent for the Hologic system in the same conditions. EOS BMDs are significantly higher than Hologic BMDs, but they are strongly correlated. The reproducibility of the method of assessment is equal to 0.95 per cent. The EOS system is accurate for ex-vivo BMD assessments, which is promising regarding the use of this new system to predict vertebral strength.