Thesis (Ph. D.)--University of Rhode Island, 2005. / Typescript. Includes bibliographical references (leaves 189-201).

Thesis (M.S.)--Ohio State University. / Includes bibliographical references. Available online via OhioLINK's ETD Center

The anterior cruciate ligament (ACL) stabilizes the knee during various sporting activities and has great importance as the knee relies entirely on the ligaments and muscles for stabilization. The ACL commonly gets injured during sports activities such as basketball, soccer, and football. In the United States over 80,000 ACL injuries occur every year. There has been decades of research performed on ACL injuries regarding the injury mechanisms of non-contact ACL injuries, but yet they are still not well understood. This is mainly because trials and tests cannot be conducted on live subjects to understand the injury mechanisms. Existing in-vivo and in-vitro studies in the literature do not relate the effects of dynamic knee muscle forces and kinematics of sports activities with the strain in the ACL. In this thesis, in-vivo and in-vitro approaches are combined to quantify the effects of muscle group forces on ACL strain during jump landing. This is done by first obtaining muscle force profiles of the knee by performing motion capture and inputting the ground reaction forces and kinematics into a musculoskeletal model. Using the muscle forces and a six axis sagittal plane dynamic knee injury simulator the jump landing simulation can be performed. Six electromechanical actuators controlled by a multi-axis control system apply dynamic muscle forces at the insertion sites of the hamstrings, quadriceps, gastrocnemius, and a hip moment to simulate the hip flexors. The ACL strain is measured using a differential variable reluctance transducer mounted on the ACL. Our results show that the simulator is able to successfully perform jump landing. The muscle force-time profiles tracked the input very well. The ACL strain from our studies fell within a reasonable level compared to data from other studies of jump landing. This simulator has proven to be successful in simulating high-risk motions.

Thesis (M.S.E.S.)--University of Toledo, 2009. / Typescript. "Submitted as partial fulfillment of the requirements for The Master of Science degree in Exercise Science." "A thesis entitled"--at head of title. Bibliography: leaves 57-61.

Thesis (M.S.M.E.)--University of Delaware, 2009. / Principal faculty advisor: Jill S. Higginson, Dept. of Mechanical Engineering. Includes bibliographical references.

Thesis (Ph. D.)--University of Missouri-Columbia, 2003. / Typescript. Vita. Includes bibliographical references (leaves 112-124). Also available on the Internet.

Thesis (Ph. D.)--University of Missouri-Columbia, 2003. / Typescript. Vita. Includes bibliographical references (leaves 112-124). Also available on the Internet.

Introduction: This study aimed to assess the outcomes and implant survivorship in Chinese patients aged 55 years or younger. Methods: We reviewed our local joint replacement registry on a total of 102 knees from 68 Chinese patients aged 55 years or below at the time of surgery. All patients were operated on from January 2000 to July 2007. The mean followup was 8.3 years (range, 5 ? 12.5 years). We included patients with osteoarthritis (70 knees), rheumatoid arthritis (24 knees), hemophilia (4 knees), psoriatic arthropathy (1 knee), post?traumatic (1 knee) and tuberculosis (2 knees). All implants were cemented. 53 were posterior cruciate ligament (PCL) sacrificing, 47 were posterior stabilized implants and 1 was constrained implant. The preoperative and latest Knee Society Knee Scores, Knee Society Functional Score, knee range of motion and lower limb mechanical alignment on long film measurement were obtained. The postoperative occurrence of radiolucent lines, complications, revision operation and deaths were noted. Each knee was analyzed separately. Results: Mean Knee Society Knee Score improved from 41 (range: 13?79, SD 12.9) to 88 (range: 30?100, SD 13.3)(p <0.0001), while the mean Knee Society Functional Score improved from 41 (range: 0?80, SD 19.2) to 69 (range 0?100, SD 26.5 ) (p<0.0001). 70% achieved a postoperative coronal mechanical axis of within 3 from neutral alignment. Implant survivorship was 97% at 5 years and 85% at 10 years. 11 knees from 9 patients had complications requiring revision surgery. Aseptic loosening occurred in 10 knees of 8 patients. Among those with aseptic loosening, 3 knees from different patients had coexisting osteolysis. Heterotopic ossification occurred in 1 knee. There were no cases of infection. Rheumatoid arthritis patients when compared with osteoarthritis patients had a more valgus preoperative lower limb alignment (p<0.001), a lower mean preoperative KSFS (30 and 45 respectively, p=0.004) and a lower mean postoperative KSFS (53 and 74 respectively, p=0.006). There were no significant differences in mean improvement of KSFS, KSKS, radiological outcomes and implant survival. There were no statistically significant differences in clinical outcomes, radiological outcomes and implant survival between PCL sacrificing and PCL substituting implants. There were no statistically significant differences between the postoperatively neutrally aligned group and the outlying group in terms of clinical outcomes, radiological outcomes and implant survival. Conclusion: Total knee arthroplasty provides good clinical and functional outcomes in young Chinese comparable to those of international standards. Careful patient selection is crucial to avoid complications. / published_or_final_version / Orthopaedics and Traumatology / Master / Master of Medical Sciences

Objective: To investigate the effectiveness of glucosamine for knee osteoarthritis (KOA) through the examination of symptomatic and structural effectiveness of the compound, and to increase public awareness, especially in Hong Kong, about its potential benefits contingent upon the quality of the existing research. Methods, Results: All studies published between 1965 and 2011 in MEDLINE, and from 1980 to 2012 in EMBASE, which evaluated the effectiveness of glucosamine for KOA, were searched and identified using specific keywords. A total of 9 randomized controlled trials out of 672 articles from MEDLINE and 1712 articles from EMBASE were included in this systematic review. The included studies used different outcome measures to compare the effects of glucosamine with other remedies for treating KOA. Similar demographic and clinical characteristics of the subjects between the intervention and the control groups were recorded. The studies were from eight countries. The average age of the subjects in the nine studies were 55 years and they were generally overweight. Though there were discrepancies among the results generated in the included studies, the potential benefits of glucosamine could not be dismissed. Discussion: Factors about compliance, possible drug-to-drug interaction, unknown placebo, subject characteristics (disease progress and severity, age, gender, and occupation), as well as the dosage of glucosamine could have greatly affected the results of the included studies. Limitations on finding articles about the effectiveness of glucosamine for OA of different sites, the cost-effectiveness of the compound, the assumption of the language restriction, and the risks of biases were raised. More clinical trials with comprehensive considerations of all possible factors affecting the results, are necessary. Conclusion: Based on this systematic review, the potential effects of glucosamine for KOA remain unclear. More research of different ethnic groups, especially of people in Hong Kong, is needed to raise public awareness about the effectiveness of glucosamine for OA other than the knee globally as well as in Hong Kong. / published_or_final_version / Public Health / Master / Master of Public Health

Introduction: This retrospective comparative study was to define the validity and reliability of a translated, culturally adapted Chinese version questionnaire of the New Knee Society Knee Scoring System (NKSS). This study is aim to investigate the validity and reliability of the translated Chinese version of the NKSS and assess its feasibility of measuring the scale on Chinese patients by performing its cross-cultural adaptation for patients after Total Knee Arthroplasty (TKA) in Hong Kong. Methods: A total of 104 knees from 64 Chinese patients performed TKA were included in the study using the translated, culturally adapted Chinese version of the NKSS. All Patients were operated on from October 2010 to May 2013 at Queen Mary Hospital. Patients who participated in this study have been clinically screened and established a set of including criteria. The outpatients were evaluated by completing the five questionnaires containing the NKSS, the Knee Society Clinical Rating System (KSS), Medial Outcomes Study 36+Item Short Form (SF-36), Bristol Knee Score and Oxford Knee Score. Reliability was evaluated using the Split-half reliability, Chronbach's α coefficient and inter-item correlation. To assess validity, all patients filled in the same NKSS questionnaire, and previously validated Chinese version of the SF-36, Bristol Knee Score and Oxford Knee Score. The validity was determined with Content Validity and Contract Validity. Results: The NKSS showed ideal split-half reliability as evidenced by the high correlation coefficient (R>0.7, P<0.05). Chronbach's α coefficient for five major domains demographics, objective knee score, expectations, satisfaction and function was high (α>0.7. P<0.05). Also, the inter-item correlation was also excellent for all domains. For validity, the NKSS was found to have excellent correlation with Bristol Knee Score and Oxford Knee Score, good correlation with KSS and SF 36 Discussion: The NKSS as a validated approach is adapted to the diverse health-related quality of lives and activities of contemporary patients with TKA. Orthopaedics surgeons are allowed to appreciate differences in the priorities of individual patients and the interplay among function, expectation, symptoms, and satisfaction after TKA using this assessment instrument. Conclusion: The results of this study show that the NKSS as a functional status questionnaire has been translated into Chinese without missing any psychometric properties of the original version. This culturally and linguistics adapted Chinese version of the NKSS outcome assessment has satisfactory internal consistency and good validity. It is an adequate and helpful instrument for the evaluation of Chinese speaking patients after TKA in clinical studies. / published_or_final_version / Medical Sciences / Master / Master of Medical Sciences