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Clinical Significance Guided growth for correction of rotational deformities has been reported in several preclinical and clinical studies. Different adverse effects, like growth retardation, articular deformities, and rebound effect have been reported. We have tested a novel plate concept (RotOs PlateTM) intended for the correction of rotational deformities of long bones by guided growth in a porcine model. The plate has sliding screw holes intended to allow for longitudinal growth. Fourteen skeletally immature female pigs were included in the study in a paired design. Mean duration of intervention was 88 days (83–98). CTscans and X‐rays were performed at plate insertion and removal. From the CTscans, 3D‐models of the left and right femora were made and used for measuring the achieved rotation. Three pigs were excluded for reasons not related to the plate design. The plates rotated as intended in all pigs. In two pigs, there was a cut‐out of the proximal screw on the lateral side. Data from these two pigs were included in the results. We observed a mean difference in rotation between the left and right femur of 5.7° in the external direction (CI: 3.7°−7.7°). No statistically significant deformities in the coronal and sagittal plane were observed. The plate worked as intended, that is, the intended rotation was achieved.This large animal study shows promising results for the feasibility of the method. It is an important first step in validating the technique and detecting possible adverse effects before clinical studies. [ABSTRACT FROM AUTHOR]

This single group pre and posttest study evaluated the feasibility of a new 10-week group-based motor skills enhancement intervention: "Moving Together," and associated use of the Challenge assessment and Gait Outcomes Assessment List (GOAL). Participant attendance/completion and satisfaction with the assessments and intervention were evaluated, and a first estimate of associated motor skill-related changes obtained. Ten ambulatory children with cerebral palsy (7–14 years) and their parents participated. Ninety percent of Challenge sessions were attended and 82.5% of GOAL questionnaires completed. Program attendance was 83% overall. Satisfaction with assessments was high for the Challenge and moderate for the GOAL, and intervention satisfaction was high. Mean change scores (95% CI) post-intervention for the Challenge and GOAL were 4.2 (−11.4 to 3.1) and 3.6 (−14.4 to 4.0) points (/100) respectively. Challenge and GOAL use was feasible and appropriate for "MovingTogether" and associated with gains in motor skill performance and functional abilities. [ABSTRACT FROM AUTHOR]

Background: The role of physical activity (PA) monitoring during the recovery after orthopaedic surgeries is unclear. This study aimed to explore early changes in the pattern and level of PA following orthopedic surgeries. Methods: This observational feasibility study included 11 hip replacement patients (four females) with a mean age of 66 years and five knee replacement patients (four females) with a mean age of 65 years. A PA tracker was used to collect the patients' daily PA data, including duration of various activity categories, steps taken, and activity intensity count. The PA tracker recorded data from two weeks prior to surgery until four weeks after the surgery. Ratios of PA parameters for each of the first four weeks following surgery were calculated in relation to preoperative measurements. Results: Compared to preoperative measurements, during the first four weeks after the surgery, the time spent in a recumbent position decreased from 112% to 106%, while continuous walking time and activity intensity count increased from 27% to 77% and from 35% to 73%, respectively. Step counts increased from 18% to 67%, and sit-to-stands rose from 65% to 93%. No significant changes were found in sitting, standing, sporadic walk time, and sporadic steps. Conclusion: Continuously measuring PA using wearable sensors was feasible in orthopedic patients during the perioperative period. Continuous step count, walking time, activity intensity count showed noticeable changes and stable patterns demonstrating their potential for remote monitoring of patients during the early postoperative period. [ABSTRACT FROM AUTHOR]

Purpose: Postoperative assessment of surgical interventions for correcting femoral rotational deformities necessitates a comparative analysis of femoral rotation pre‐ and post‐surgery. While 2D assessment methods are commonly employed, ongoing debate surrounds their accuracy and reliability. To address the limitations associated with 2D analysis, we introduced and validated a 3D model‐based analysis method for quantifying the angular and rotational impact of corrective rotational osteotomy in the growing femur. Methods: The method is based on surface registration of the pre‐ and post‐intervention 3D femoral models. To this end, 3D triangulated surface models were generated using CT images for the right femurs of 11 skeletally immature pigs, each scanned at two distinct time points with a 12‐week interval between scans. In our validation procedures, femoral corrective rotational osteotomy of the post‐12‐week femur was simulated at varying angles of 5, 10, 15 and 20 degrees in three dimensions. Subsequently, a surface 3D/3D registration‐based approach was applied to determine the 3D femoral angulation and rotation between the two models to assess the method's detection accuracy of the predefined twist angles as ground truth references. Results: The results document the precision and accuracy of the registration‐based method in evaluating rotation angles. Consistently high accuracy was observed across all angles, with an accuracy rate of 92.97% and a coefficient of variance of 8.14%. Conclusion: This study has showcased the potential for improving post‐operative assessments with significant implications for experimental studies evaluating the effects of correcting rotational deformities in the growing femur. Level of Evidence: Not applicable. [ABSTRACT FROM AUTHOR]

This study aimed to develop a method using computer vision techniques to accurately detect and delineate the proximal femur in radiographs of Legg–Calvé–Perthes disease (LCPD) patients. Currently, evaluating femoral head deformity, a crucial predictor of LCPD outcomes, relies on unreliable categorical and qualitative classifications. To address this limitation, we employed the pretrained object detection model YOLOv5 to detect the proximal femur on over 2000 radiographs, including images of shoulders and chests, to enhance robustness and generalizability. Subsequently, we utilized the U‐Net convolutional neural network architecture for image segmentation of the proximal femur in more than 800 manually annotated images of stage IV LCPD. The results demonstrate outstanding performance, with the object detection model achieving high accuracy (mean average precision of 0.99) and the segmentation model attaining an accuracy score of 91%, dice coefficient of 0.75, and binary IoU score of 0.85 on the held‐out test set. The proposed fully automatic proximal femur detection and segmentation system offers a promising approach to accurately detect and delineate the proximal femoral bone contour in radiographic images, which is essential for further image analysis in LCPD patients. Clinical significance: This study highlights the potential of computer vision techniques for enhancing the reliability of Legg–Calvé–Perthes disease staging and outcome prediction. [ABSTRACT FROM AUTHOR]

Aim: We investigated the reliability and validity of the Danish child and parent versions of the Gait Outcomes Assessment List (GOAL) questionnaires for ambulatory children with cerebral palsy (CP). Methods: Translation and cultural adaptations were performed and content validity evaluated. Participants were enrolled between 2016 and 2018 from Aarhus University Hospital, Denmark. Children and parents completed the GOAL questionnaires twice for test–retest reliability. Discriminative validity was evaluated by comparing the child and parent GOAL scores between children with Gross Motor Function Classification System (GMFCS) levels I and II. The concurrent validity of the GOAL questionnaires were investigated by comparing them with Challenge‐20, which assesses motor skills in children with CP. Results: We studied 59 children (57% boys) with CP and GMFCS I‐II at a mean age of 10.6 years. Test–retest intra‐class correlations were excellent for the children (0.91, 95% confidence interval (CI) 0.83–0.96) and good for the parents (0.83, 95% CI 0.67–0.91). GOAL scores decreased with increasing GMFCS (p < 0.05). Both versions correlated well. The mean children's scores were significantly (6.2/100) higher than the parents' (p < 0.001). The GOAL scores correlated positively with Challenge‐20. Conclusion: The Danish GOAL child and parent questionnaires demonstrated good reliability and content and discriminative and concurrent validity. [ABSTRACT FROM AUTHOR]