Arthrogryposis

Researchers are evaluating advanced surgical simulation techniques for correcting complex skeletal deformities and abnormalities in children, adolescents, and young adults with musculoskeletal disorders. These conditions often involve rare and severe abnormalities in bone, joint, and muscle-tendon development, affecting multiple limbs and presenting challenges in standardizing treatment and predicting outcomes. The study focuses on improving surgical planning and support tools using 3D modeling and printing technologies, aiming to enhance precision, safety, and reproducibility of surgeries. The study involves surgeries to correct bone deformities, supported by preoperative virtual surgical planning and the use of patient-specific instruments created through 3D printing. These include Patient-Specific Instruments (PSI) and Graft-Specific Instruments (GSI), which are designed to improve surgical accuracy. The research is conducted within specialized 3D laboratories at the Musculoskeletal Apparatus Network centers, where surgical simulations and planning procedures are systematically organized and standardized. Participants will undergo assessments including radiological follow-up and clinical-functional evaluations at the time of surgery and after one year. Researchers will measure outcomes such as the degree of skeletal correction achieved, operating room times, fluoroscopy times, blood loss, and any intra- or peri-operative complications. The suitability of the patient-specific instruments and bone grafts will also be evaluated. The study aims to improve surgical quality and efficiency while monitoring participants throughout a one-year period post-surgery.

This research aims to develop and evaluate a specialized rehabilitation exercise program for adults with foot problems and tight calf muscles. It compares patients who choose minimally invasive ultrasound-guided surgery combined with rehabilitation to those who follow the rehabilitation program alone. The study focuses on differences in recovery of ankle movement and the return to sports and daily activities. Participants will be divided into two groups: one group will undergo a 12-week rehabilitation exercise program three times a week, while the other group will have minimally invasive gastrocnemius muscle surgery followed by a more intensive rehabilitation regimen three times daily for four weeks. Both groups receive the same rehabilitation protocol, with the surgical group starting exercises after surgery. Throughout the study, participants will have assessments before treatment, at two months, and six months to measure ankle movement, foot posture, pressure on the foot, pain, and function. Researchers will use gait analysis and baropodometric exams to evaluate progress. The study will compare outcomes between groups to understand the added impact of surgery combined with rehabilitation. The total study duration includes initial assessments and follow-ups over six months.

Researchers are studying how muscles are affected in children and adolescents with cerebral palsy (CP) or acquired brain injury (ABI), focusing on the muscle changes that cause weakness, stiffness, joint contractures, and difficulty walking. The study compares muscle and tendon samples from these participants to those from typically developed children undergoing surgery for other reasons. The goal is to understand the underlying mechanisms leading to muscle problems and contractures to guide future treatments that may protect muscle and joint health. During clinically needed orthopedic surgeries, muscle and tendon biopsies along with blood samples are collected from children with CP or ABI and from typically developed controls. These samples are analyzed for inflammatory markers, muscle growth signals, connective tissue growth, and muscle and tendon pathology. By comparing muscles used in walking to those used more voluntarily, and flexor muscles to extensors, researchers aim to uncover differences related to contractures and muscle function. Blood analysis includes measuring pro-inflammatory cytokines and a protective compound called humanin. Participants are involved during their planned surgeries when the necessary samples are taken without affecting clinical function. Clinical data on joint contractures and CP severity are recorded before surgery. The study measures muscle and tendon structure, muscle metabolism, and muscle fiber area over the years 2002 to 2027. This observational research helps deepen understanding of muscle changes in CP and ABI, with participant involvement mainly during surgery and clinical assessments before surgery.

Researchers are evaluating the impact of upper limb assistance devices used by people with disabilities, focusing on both clinical and psychosocial aspects. This study is part of a broader project developing robotic exoskeletons for upper and lower limbs to improve interaction with various environments, from rehabilitation to daily life. It aims to understand how these devices affect users' independence, satisfaction, quality of life, social participation, and economic factors. Participants are regular users of CE-marked upper limb assistance devices, including types such as grasping gloves, mealtime aids, robotic arms, and arm supports. The study collects information through interviews and questionnaires about users' experiences and caregivers' perspectives. No new devices are provided; participants share their experiences with their own devices as integrated into their daily routines. During the study, participants complete questionnaires and semi-structured interviews to assess psychosocial impact, satisfaction, quality of life, caregiver burden, and economic considerations. Data collection occurs from enrollment (Day 0) through a clinical evaluation phase lasting up to 60 days. The study includes both patient-users and caregiver-users, with assessments conducted via videoconference. The overall participation duration varies but focuses on capturing real-life use and effects of the devices.

Researchers are studying the safety and effectiveness of pediatric orthopedic implants used in conditions such as hip disorders, fractures, limb deformities, and implant complications. These devices are essential for maintaining bone alignment, promoting healing, and preventing joint problems. New European regulations require careful follow-up to understand how well these implants perform over time and to monitor their safety. The study follows patients who receive pediatric orthopedic implants as part of their usual medical care. Data is collected both before and after surgery, including medical history, surgical details, and any device-related issues. Follow-up includes routine clinical visits where X-rays and other assessments help track bone healing, device condition, and any adverse events. Data is gathered through established registries and entered into a secure research database. Participants will be monitored for up to two years after their implant surgery. During this time, researchers collect information on device-related adverse effects, implant survival, and implant effectiveness. Additional measurements include pain levels and quality of life assessments. The study captures all scheduled and unscheduled visits, tracking any complications or implant removals to provide a comprehensive picture of implant outcomes and safety.

Researchers are evaluating the effectiveness of percutaneous needle fasciotomy with or without corticosteroid injection for treating Dupuytren's contracture affecting the metacarpophalangeal (MCP) joints. This randomized controlled trial aims to compare these two treatment options in patients aged 45 to 99 years with this joint condition. The study is led by Regionshospitalet Silkeborg and is designed as a Phase 4 clinical trial with double masking. The study includes two treatment groups: one group will receive percutaneous needle fasciotomy combined with corticosteroid injection (Depo-Medrol), and the other group will receive the same fasciotomy combined with a saline injection as a placebo comparator. The fasciotomy procedure follows the Lermusiaux and Debeyre technique. Participants must have sufficient correction of the MCP joint during treatment, with less than 20 degrees passive extension deficit. Participants will be monitored for outcomes including the recurrence rate of contracture after two years. Assessments will focus on the correction of joint contracture, with follow-up visits to measure the effectiveness and safety of the treatments. The trial will also evaluate secondary outcomes related to joint function and patient well-being over the study period ending in March 2030.

Researchers are studying how the growth plate behaves in children who have undergone temporary hemi-epiphysiodesis or epiphysiodesis, procedures used to treat limb length differences and axial deviations in the lower limbs. This observational study uses radiostereometric analysis (RSA) to accurately measure growth in three dimensions, helping to detect asymmetric growth and determine the best timing for implant removal. The study involves children treated with guided growth for axial deviations or temporary epiphysiodesis for limb length discrepancies. During surgery, small tantalum beads are implanted near the growth plate, allowing precise RSA imaging to monitor growth patterns during and after the procedures. This method offers microscopic accuracy in tracking changes over time. Participants will be monitored over a period of four years to observe growth plate behavior following surgery. The study includes regular follow-up imaging using RSA to measure growth in three planes. Researchers aim to gather detailed data on growth changes to improve treatment timing and outcomes for children with these conditions.

This research focuses on children and adolescents with skeletal defects and deformities of the lower limbs, which can be congenital or acquired. These conditions may cause deformities, short stature, and disability, affecting both physical and mental health as well as family life. The study aims to support clinical practice through a comprehensive evaluation of these deformities and gather data on treatment approaches used in leading centers. The study observes patients receiving various management approaches, including physiotherapy and prostheses as conservative treatments, single or multi-stage surgeries with different techniques to correct deformities, and amputations when necessary to improve walking function using prostheses. Treatments are personalized depending on each patient's needs and surgical preferences. Participants will undergo clinical examinations and assessments of lower limb function and mental health at the start of the study and after one year. Researchers will collect data using the Pediatric Outcomes Data Collection Instrument and monitor changes over time. The study is observational and prospective, lasting at least one year with regular follow-up evaluations to understand the outcomes of different treatment methods.

This research aims to evaluate the effectiveness of 3D-printed titanium alloy implants in treating adults with long bone defects caused by trauma or tumor resection. The study focuses on reconstructing these bone defects to improve limb function and recovery. Participants undergo a full CT scan of both limbs to help design a custom implant based on the healthy limb's data. The implant is made from Titanium - 6 Aluminum - 4 Vanadium ELI using Electron Beam Melting technology and tested for mechanical strength in Australia. Once approved, the implant is post-processed, sterilized, and prepared for surgery. During the study, researchers will record surgical details like blood loss and operative time. Participants' limb function will be assessed from 1 to 12 months after surgery using functional and radiological imaging outcomes. Complications will be monitored throughout the study, which lasts approximately one year.

Researchers are studying how to best increase physical activity in people with mobility impairments through a 32-week program using a design called SMART (Sequential Multiple Assignment Randomized Trial). This approach tests the best way to combine teleexercise with predictive analytics to adapt the support participants receive based on their exercise adherence. The study aims to find effective strategies for improving activity levels while exploring factors that influence outcomes and testing the accuracy of prediction methods. Participants first complete a run-in period including consent, surveys, and setup of an exercise tracker and band. They are then randomly assigned to either an Asynchronous Exercise Program (AEP) or AEP plus Smart Health Coaching (SHC). All receive access to an online platform with exercise videos and wellness articles. After 4 weeks, participants are assessed for response; those not responding are re-randomized to receive live one-on-one or group exercise sessions via Zoom for the next 4 weeks. Following this, all participants enter a 24-week maintenance phase with access to prerecorded content only. Throughout the study, participants wear a tracker to monitor steps and activity, complete surveys at baseline, week 8, week 16, and week 32, and may have reminder calls to encourage survey completion. Data collected includes physical activity, health literacy, secondary health conditions, and activity limitations. Interviews are conducted after the adoption phases to gather further insights. The total participation lasts 32 weeks, with ongoing collection of exercise and website usage data to evaluate the adaptive interventions.