具体描述
This text provides essential information needed to serve the large population of young athletic patients with cartilage defects who are not yet candidates for joint arthroplasty. Nearly 350 illustrations facilitate the understanding of examination and operative techniques, including arthroscopic debridement, electrothermal chondroplasty, marrow stimulation, osteochondral autograft transfer (OATS/Mosaicplasty), autologous chondrocyte implantation, and osteochondral allografting. The text also addresses joint specific injuries in the shoulder, elbow, and ankle that are often neglected in other literature. Key Features: Reviews normal cartilage anatomy and cartilage response to injury to illuminate appropriate treatment techniques and healing processes. Covers non-operative techniques including analgesics, oral anti-inflammatory medications, neutraceuticals, and hyaluronic acid injections/viscosupplementation, allowing the clinician to expand treatment options. Descriptions of adjunctive procedures, such as meniscal transplant and corrective osteotomy. Provides insights on future directions in the detection and treatment of cartilage injuries.
Advanced Biomechanics of Human Movement: Principles and Applications A Comprehensive Text for Understanding and Optimizing Locomotor Function This exhaustive volume delves deep into the intricate physical principles governing human motion, providing an unparalleled resource for researchers, clinicians, biomechanists, and advanced students in exercise science, physical therapy, and engineering. Moving beyond superficial descriptions of movement, this book establishes a rigorous foundation in Newtonian and analytical mechanics as they apply directly to musculoskeletal function, tissue loading, and athletic performance. The text is structured systematically, progressing from fundamental physical concepts to complex, integrated biological applications. Part I: Foundations of Biomechanical Analysis This section meticulously establishes the theoretical framework necessary for quantitative movement analysis. Chapter 1: Review of Classical Mechanics and Kinematics A detailed re-examination of fundamental concepts: vectors, forces, moments (torques), and equilibrium. Emphasis is placed on applying these principles to static musculoskeletal configurations, such as standing posture and isometric contractions. Kinematic analysis is introduced, focusing on descriptors of motion—position, velocity, and acceleration—in both fixed and moving reference frames relevant to biological systems. Techniques for the precise measurement of motion capture (MOCAP) systems are critically reviewed, including calibration procedures and error analysis pertinent to 3D trajectory reconstruction. Chapter 2: Kinetics and Ground Reaction Forces This chapter transitions to the causes of motion, focusing on the forces that generate or alter movement. Detailed coverage is given to the measurement and interpretation of Ground Reaction Forces (GRF) using force plates. Comprehensive techniques for analyzing the time-series data of GRF, including impulse calculation, loading rates, and the determination of the center of pressure (COP) trajectory, are presented. Advanced concepts such as the relationship between GRF components and joint kinetics through the use of inverse dynamics models are introduced here, setting the stage for subsequent joint analysis. Chapter 3: Principles of Work, Energy, and Power The relationship between mechanical work, kinetic energy, and potential energy provides a powerful alternative perspective to purely force-based analysis. This section meticulously details the calculation of mechanical work done at the whole body and individual limb segments. A significant portion is dedicated to the concept of mechanical power, defined both as the rate of work done and as the product of joint moment and angular velocity. Practical applications focus on analyzing explosive movements (e.g., jumping, sprinting) where power generation is the critical determinant of performance outcome. The concept of mechanical efficiency in human locomotion is explored through the lens of metabolic cost. Part II: Segmental Dynamics and Modeling Part II moves from whole-body forces to the detailed analysis of individual body segments, essential for understanding muscle action and joint loading. Chapter 4: Rigid Body Dynamics of Limb Segments This chapter addresses the mathematical description of individual body segments (thigh, shank, upper arm, etc.) treated as rigid bodies. Derivation and practical application of segment mass, center of mass location, and moment of inertia tensors are covered extensively. The focus is on deriving the equations of motion for a segment in isolation, utilizing Newton-Euler or Lagrangean formulations, preparing the reader for the integration required in whole-body models. Emphasis is placed on reliable techniques for estimating these parameters in vivo. Chapter 5: Inverse and Forward Dynamics in Musculoskeletal Analysis This is a core chapter detailing the computational methods for translating external forces into internal joint loads. Inverse Dynamics is treated comprehensively, showing how GRFs and kinematic data are used sequentially to calculate net internal joint moments (torques) required to produce observed motion. Detailed practical examples using standard gait cycle data illustrate the calculation process. Conversely, Forward Dynamics is introduced, detailing how known muscle forces or externally applied torques can be used to predict subsequent motion, a crucial step in simulation and perturbation studies. Chapter 6: Soft Tissue Mechanics and Viscoelasticity Moving beyond rigid body approximations, this section explores the mechanical behavior of biological soft tissues under load. Detailed treatments of stress, strain, and constitutive models (Hookean, Neo-Hookean, Ogden) are applied specifically to tendons, ligaments, and fascia. Viscoelastic behavior—time and rate dependence—is characterized using Maxwell and Voigt models, explaining phenomena like stress relaxation and creep observed in connective tissues during prolonged loading or cyclic movement. Part III: Integration and Application in Human Performance The final section applies the established mechanical principles to complex, real-world scenarios in human movement science and rehabilitation engineering. Chapter 7: Analysis of Normal and Deviant Gait A foundational application of the preceding chapters. Detailed kinematic and kinetic profiles of normal walking and running gait are presented, emphasizing temporal, spatial, and dynamic variables across the gait cycle. The chapter then systematically analyzes common deviations in pathological gait patterns (e.g., Trendelenburg gait, stiff-knee gait), linking observed mechanical deficits (altered ground reaction patterns, reduced power generation) back to underlying neuromuscular or structural impairments. Chapter 8: Biomechanics of Eccentric and Concentric Muscle Actions This chapter deepens the understanding of muscle mechanics by distinguishing between contractile element behavior and the resulting macroscopic joint torques. The Force-Velocity relationship is analyzed in detail, contrasting the high power output potential during concentric actions with the higher force production capabilities during eccentric muscle actions. The mechanical role of passive muscle stiffness in energy storage and return, particularly during rapid stretch-shortening cycles, is explored using experimental data sets. Chapter 9: Contact Mechanics and Joint Loading Estimation Focus shifts to the interaction surfaces within diarthrodial joints (e.g., knee, hip). Methods for estimating internal contact forces, including pressure distribution mapping via Finite Element Modeling (FEM) concepts applied to articular cartilage surfaces, are discussed. The implications of altered joint kinematics (e.g., increased valgus collapse during landing) on localized joint reaction forces and resulting long-term degenerative changes are examined through sensitivity analysis. Chapter 10: Design and Evaluation of Assistive and Restorative Devices The culmination of the text focuses on engineering solutions informed by biomechanics. Principles of orthotics and prosthetics design are analyzed through the lens of achieving optimal force transmission and minimizing injurious loading. Detailed methodologies for evaluating the efficacy of physical interventions—such as gait retraining protocols or the integration of functional electrical stimulation (FES)—are presented, requiring quantification of changes in power generation, joint moment production, and external work performed post-intervention. --- Target Audience: Graduate students in Biomechanics, Kinesiology, Physical Therapy, Biomedical Engineering. Sports Medicine Physicians, Athletic Trainers, and Research Scientists in Human Performance. Prerequisites: University-level calculus, physics (mechanics), and introductory human anatomy/physiology are assumed.
