Publications
64 results found
Shah D, Middleton C, Gurdezi S, et al., 2018, Alterations to wrist tendon forces following flexor carpi radialis or ulnaris sacrifice: a cadaveric simulator study, Journal of Hand Surgery (European Volume), Vol: 43, Pages: 886-888, ISSN: 0266-7681
Tenotomies, tendon transfers or nerve injuries can result in partial or complete loss of the flexor carpi radialis (FCR) or flexor carpi ulnaris (FCU) function. The aim of this study was to observe alterations in the distribution of muscle forces at the wrist due to the absence of each of these flexors. Cyclic planar and complex wrist motions were actively simulated in cadaveric specimens by applying tensile loads to six muscle tendons using a validated physiological wrist simulator. The absence of FCR or FCU resulted in higher forces in synergists, coupled with lower forces in antagonists, and an overall decrease in the total force of all tendons. Thus, alterations in wrist tendon forces following reconstructive procedures utilising a tendon may have clinical implications, such as muscle fatigue or reduced strength.
Vardakastani V, Bell H, Mee S, et al., 2018, Clinical measurement of dart throwing motion of the wrist: variability, accuracy and correction, Journal of Hand Surgery (European Volume), Vol: 43, Pages: 723-731, ISSN: 1753-1934
Despite being functionally important, dart throwing motion is difficult to assess accurately through goniometry. The objectives of this study were to describe a method for reliably quantifying the dart throwing motion using goniometric measurements within a healthy population. Wrist kinematics of 24 healthy participants were assessed using goniometry and optical motion tracking. Three wrist angles were measured at the starting and ending points of the motion: flexion-extension, radial-ulnar deviation and dart throwing motion angle. The orientation of the dart throwing motionplane relative to the flexion-extension axis ranged between 28° and 57° among the tested population. Plane orientations derived from optical motion capture differed from those calculated through goniometry by 25°. An equation to correct the estimation of the plane from goniometry measurements was derived. This was applied and differences in the orientation of the plane were reduced to non-significant levels, enabling dart throwing motion to be measured using goniometry alone.
Shah D, Middleton C, Gurdezi S, et al., 2018, The importance of abductor pollicis longus in wrist motions: a physiological wrist simulator study, Journal of Biomechanics, Vol: 77, Pages: 218-222, ISSN: 0021-9290
The abductor pollicis longus (APL) is one of the primary radial deviators of the wrist, owing to its insertion at the base of the first metacarpal and its large moment arm about the radioulnar deviation axis. Although it plays a vital role in surgical reconstructions of the wrist and hand, it is often neglected while simulating wrist motions in vitro. The aim of this study was to observe the effects of the absence of APL on the distribution of muscle forces during wrist motions. A validated physiological wrist simulator was used to replicate cyclic planar and complex wrist motions in cadaveric specimens by applying tensile loads to six wrist muscles – flexor carpi radialis (FCR), flexor carpi ulnaris, extensor carpi radialis longus (ECRL), extensor carpi radialis brevis, extensor carpi ulnaris (ECU) and APL. Resultant muscle forces for active wrist motions with and without actuating the APL were compared. The absence of APL resulted in higher forces in FCR and ECRL – the synergists of APL – and lower forces in ECU – the antagonist of APL. The altered distribution of wrist muscle forces observed in the absence of active APL control could significantly alter the efficacy of in vitro experiments conducted on wrist simulators, in particular when investigating those surgical reconstructions or rehabilitation of the wrist heavily reliant on the APL, such as treatments for basal thumb osteoarthritis.
Taylor SAF, Kedgley AE, Humphries A, et al., 2018, Simulated activities of daily living do not replicate functional upper limb movement or reduce movement variability, Journal of Biomechanics, Vol: 76, Pages: 119-128, ISSN: 0021-9290
Kinematic assessments of the upper limb during activities of daily living (ADLs) are used as an objective measure of upper limb function. The implementation of ADLs varies between studies; whilst some make use of props and define a functional target, others use simplified tasks to simulate the movements in ADLs. Simulated tasks have been used as an attempt to reduce the large movement variability associated with the upper limb. However, it is not known whether simulated tasks replicate the movements required to complete ADLs or reduce movement variability. The aim of this study is to evaluate the use of simulated tasks in upper limb assessments in comparison to functional movements. Therefore answering the following questions: Do simulated tasks replicate the movements required of the upper limb to perform functional activities? Do simulated tasks reduce intra- and inter-subject movement variability? Fourteen participants were asked to perform five functional tasks (eat, wash, retrieve from shelf, comb and perineal care) using two approaches: a functional and a simulated approach. Joint rotations were measured using an optoelectronic system. Differences in movement and movement variability between functional and simulated tasks were evaluated for the thorax, shoulder, elbow/forearm and wrist rotations. Simulated tasks did not accurately replicate the movements required for ADLs and there were minimal differences in movement variability between the two approaches. The study recommends the use of functional tasks with props for future assessments of the upper limb.
Edwards DS, Arshad MS, Luokkala T, et al., 2018, The contribution of the posterolateral capsule to elbow joint stability: a cadaveric biomechanical investigation., Journal of Shoulder and Elbow Surgery, Vol: 27, Pages: 1178-1184, ISSN: 1058-2746
BACKGROUND: Elbow posterolateral rotatory instability occurs after an injury to the lateral collateral ligament complex (LCLC) in isolation or in association with an osteochondral fracture of the posterolateral margin of the capitellum (Osborne-Cotterill lesion [OCL]). The contribution to elbow stability of the posterolateral capsule, attached to this lesion, is unknown. This study quantified the displacement of the radial head on simulated posterior draw with sectioning of the posterior capsule (a simulated OCL) or LCLC. METHODS: Biomechanical testing of the elbow was performed in 8 upper limb cadavers. With the elbow 0°, 30°, 60°, and 90° degrees of flexion, posterior displacement of the radius was measured at increments of a load of 5 N up to 50 N. A simulated OCL and LCLC injury was then performed. RESULTS: A simulated OCL results in significantly more displacement of the radial head compared with the intact elbow at 30° to 60° of elbow flexion. LCLC resection confers significantly more displacement. An OCL after LCLC resection does not create further displacement. CONCLUSIONS: The degree of radial head displacement is greater after a simulated OCL at 30° to 60° of flexion compared with the intact elbow with the same load but not as great as seen with sectioning of the LCLC. This study suggests that the posterior capsule attaching to the back of the capitellum is important to elbow stability and should be identified as the Osborne-Cotterill ligament. Clinical studies are required to determine the importance of these biomechanical findings.
Goislard de Monsabert B, Edwards T, Shah DS, et al., 2018, Importance of consistent datasets in musculoskeletal modelling: a study of the hand and wrist, Annals of Biomedical Engineering, Vol: 46, Pages: 71-85, ISSN: 0090-6964
Hand musculoskeletal models provide a valuable insight into the loads withstood by the upper limb; however, their development remains challenging because there are few datasets describing both the musculoskeletal geometry and muscle morphology from the elbow to the finger tips. Clinical imaging, optical motion capture and microscopy were used to create a dataset from a single specimen. Subsequently, a musculoskeletal model of the wrist was developed based on these data to estimate muscle tensions and to demonstrate the potential of the provided parameters. Tendon excursions and moment arms predicted by this model were in agreement with previously reported experimental data. When simulating a flexion-extension motion, muscle forces reached 90 N among extensors and a co-contraction of flexors, amounting to 62.6 N, was estimated by the model. Two alternative musculoskeletal models were also created based on anatomical data available in the literature to illustrate the effect of combining incomplete datasets. Compared to the initial model, the intensities and load sharing of the muscles estimated by the two alternative models differed by up to 180% for a single muscle. This confirms the importance of using a single source of anatomical data when developing such models.
Garland A, Shah D, Kedgley A, 2017, Wrist tendon moment arms: Quantification by imaging and experimental techniques, Journal of Biomechanics, Vol: 68, Pages: 136-140, ISSN: 0021-9290
Subject-specific musculoskeletal models require accurate values of muscle moment arms. The aim of this study was to compare moment arms of wrist tendons obtained from non-invasive magnetic resonance imaging (MRI) to those obtained from an in vitro experimental approach. MRI was performed on ten upper limb cadaveric specimens to obtain the centrelines for the flexor carpi radialis (FCR), flexor carpi ulnaris (FCU), extensor carpi radialis longus (ECRL), extensor carpi radialis brevis (ECRB), extensor carpi ulnaris (ECU), and abductor pollicis longus (APL) tendons. From these, the anatomical moment arms about each of the flexion-extension (FE) and radioulnar deviation (RUD) axes of the wrist were calculated. Specimens were mounted on a physiologic wrist simulator to obtain functional measurements of the moment arms using the tendon excursion method. No differences were observed between anatomical and functional values of the FE and RUD moment arms of FCR, ECRL and ECRB, and the RUD moment arm of ECU (p>0.075). Scaling the anatomical moment arms relative to ECRB in FE and ECU in RUD reduced differences in the FE moment arm of FCU and the RUD moment arm of APL to less than 15% (p>0.139). However, differences persisted in moment arms of FCU in RUD, and ECU and APL in FE (p<0.008). This study shows that while measurements of moment arms of wrist tendons using imaging do not always conform to values obtained using in vitro experimental approaches, a stricter protocol could result in the acquisition of subject-specific moment arms to personalise musculoskeletal models.
Shah DS, Middleton C, Gurdezi S, et al., 2017, The effects of wrist motion and hand orientation on muscle forces: a physiologic wrist simulator study, Journal of Biomechanics, Vol: 60, Pages: 232-237, ISSN: 0021-9290
Although the orientations of the hand and forearm vary for different wrist rehabilitation protocols, their effect on muscle forces has not been quantified. Physiologic simulators enable a biomechanical evaluation of the joint by recreating functional motions in cadaveric specimens. Control strategies used to actuate joints in 5 physiologic simulators usually employ position or force feedback alone to achieve optimum load distribution across the muscles. After successful tests on a phantom limb, unique combinations of position and force feedback – hybrid control and cascade control – were used to simulate multiple cyclic wrist motions of flexion-extension, radioulnar deviation, dart thrower’s motion, and 10 circumduction using six muscles in ten cadaveric specimens. Low kinematic errors and coefficients of variation of muscle forces were observed for planar and complex wrist motions using both novel control strategies. The effect of gravity was most pronounced when the hand was in the horizontal orientation, resulting in higher extensor forces (p<0.017) and higher out-of-plane kinematic errors (p<0.007), as compared to the vertically 15 upward or downward orientations. Muscle forces were also affected by the direction of rotation during circumduction. The peak force of flexor carpi radialis was higher in clockwise circumduction (p=0.017), while that of flexor carpi ulnaris was higher in anticlockwise circumduction (p=0.013). Thus, the physiologic wrist simulator accurately replicated cyclic planar and complex motions in cadaveric specimens. Moreover, the dependence of muscle 20 forces on the hand orientation and the direction of circumduction could be vital in the specification of such parameters during wrist rehabilitation.
Carpanen D, Kedgley AE, Plant D, et al., 2016, The risk of injury of the metacarpophalangeal and interphalangeal joints of the hand, International Research Council on the Biomechanics of Injury, Pages: 902-903
Nolte D, Tsang CK, Zhang KY, et al., 2016, Non-linear scaling of a musculoskeletal model of the lower limb using statistical shape models, Journal of Biomechanics, Vol: 49, Pages: 3576-3581, ISSN: 1873-2380
Accurate muscle geometry for musculoskeletal models is important to enable accurate subject-specific simulations. Commonly, linear scaling is used to obtain individualised muscle geometry. More advanced methods include non-linear scaling using segmented bone surfaces and manual or semi-automatic digitisation of muscle paths from medical images. In this study, a new scaling method combining non-linear scaling with reconstructions of bone surfaces using statistical shape modelling is presented. Statistical Shape Models (SSMs) of femur and tibia/fibula were used to reconstruct bone surfaces of nine subjects. Reference models were created by morphing manually digitised muscle paths to mean shapes of the SSMs using non-linear transformations and inter-subject variability was calculated. Subject-specific models of muscle attachment and via points were created from three reference models. The accuracy was evaluated by calculating the differences between the scaled and manually digitised models. The points defining the muscle paths showed large inter-subject variability at the thigh and shank – up to 26 mm; this was found to limit the accuracy of all studied scaling methods. Errors for the subject-specific muscle point reconstructions of the thigh could be decreased by 9% to 20% by using the non-linear scaling compared to a typical linear scaling method. We conclude that the proposed non-linear scaling method is more accurate than linear scaling methods. Thus, when combined with the ability to reconstruct bone surfaces from incomplete or scattered geometry data using statistical shape models our proposed method is an alternative to linear scaling methods.
Shah D, Kedgley AE, 2016, Control of a wrist joint motion simulator: a phantom study, Journal of Biomechanics, Vol: 49, Pages: 3061-3068, ISSN: 1873-2380
The presence of muscle redundancy and co-activation of agonist-antagonist pairs in vivo makes the optimization of the load distribution between muscles in physiologic joint simulators vital. This optimization is usually achieved by employing different control strategies based on position and/or force feedback. A muscle activated physiologic wrist simulator was developed to test and iteratively refine such control strategies on a functional replica of a human arm. Motions of the wrist were recreated by applying tensile loads using electromechanical actuators. Load cells were used to monitor the force applied by each muscle and an optical motion capture system was used to track joint angles of the wrist in real-time. Four control strategies were evaluated based on their kinematic error, repeatability and ability to vary co-contraction. With kinematic errors of less than 1.5°, the ability to vary co-contraction, and without the need for predefined antagonistic forces or muscle force ratios, novel control strategies – hybrid control and cascade control – were preferred over standard control strategies – position control and force control. Muscle forces obtained from hybrid and cascade control corresponded well with in vivo EMG data and muscle force data from other wrist simulators in the literature. The decoupling of the wrist axes combined with the robustness of the control strategies resulted in complex motions, like dart thrower’s motion and circumduction, being accurate and repeatable. Thus, two novel strategies with repeatable kinematics and physiologically relevant muscle forces are introduced for the control of joint simulators.
Amabile C, Bull A, Kedgley A, 2016, The centre of rotation of the shoulder complex and the effect of normalisation, Journal of Biomechanics, Vol: 49, Pages: 1938-1943, ISSN: 1873-2380
Shoulder motions consist of a composite movement of three joints and one pseudo-joint, which together dictate the humerothoracic motion. The purpose of this work was to quantify the location of the centre of rotation (CoR) of the shoulder complex as a whole. Dynamic motion of 12 participants was recorded using optical motion tracking during coronal, scapular and sagittal plane elevation. The instantaneous CoR was found for each angle of elevation using helical axes projected onto the three planes of motion. The location of an average CoR for each plane was evaluated using digitised and anthropometric measures for normalisation. When conducting motion in the coronal, scapular, and sagittal planes respectively, the coefficients for locating the CoRs of the shoulder complex are −61%, −61%, and −65% of the anterior-posterior dimension – the vector between the midpoint of the incisura jugularis and the xiphoid process and the midpoint of the seventh cervical vertebra and the eighth thoracic vertebra; 0%, −1%, and −2% of the superior-inferior dimension – the vector between the midpoint of the acromioclavicular joints and the midpoint of the anterior superior iliac spines; and 57%, 57%, and 78% of the medial-lateral dimension −0.129 times the height of the participant. Knowing the location of the CoR of the shoulder complex as a whole enables improved participant positioning for evaluation and rehabilitation activities that involve movement of the hand with a fixed radius, such as those that employ isokinetic dynamometers.
Ding Z, Nolte D, Tsang CK, et al., 2015, In Vivo Knee Contact Force Prediction Using Patient-Specific Musculoskeletal Geometry in a Segment-Based Computational Model., Journal of Biomechanical Engineering-Transactions of the ASME, Vol: 138, ISSN: 0148-0731
Segment-based musculoskeletal models allow the prediction of muscle, ligament and joint forces without making assumptions regarding joint degrees of freedom. The dataset published for the "Grand Challenge Competition to Predict In Vivo Knee Loads" provides directly-measured tibiofemoral contact forces for activities of daily living. For the "Sixth Grand Challenge Competition to Predict In Vivo Knee Loads", blinded results for "smooth" and "bouncy" gait trials were predicted using a customised patient-specific musculoskeletal model. For an unblinded comparison the following modifications were made to improve the predictions: • further customisations, including modifications to the knee centre of rotation; • reductions to the maximum allowable muscle forces to represent known loss of strength in knee arthroplasty patients; and • a kinematic constraint to the hip joint to address the sensitivity of the segment-based approach to motion tracking artefact. For validation, the improved model was applied to normal gait, squat and sit-to-stand for three subjects. Comparisons of the predictions with measured contact forces showed that segment-based musculoskeletal models using patient-specific input data can estimate tibiofemoral contact forces with root mean square errors (RMSEs) of 0.48-0.65 times body weight (BW) for normal gait trials. Tibiofemoral contact force patterns were estimated with an average coefficient of determination of 0.81 and with RMSEs of 0.46-1.01 times BW for squatting and 0.70-0.99 times BW for sit-to-stand tasks. This is comparable to the best validations in the literature using alternative models.
Kedgley AE, McWalter EJ, Wilson DR, 2015, The effect of coordinate system variation on <i>in vivo</i> patellofemoral kinematic measures, KNEE, Vol: 22, Pages: 88-94, ISSN: 0968-0160
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Zhang KY, Kedgley AE, Donoghue CR, et al., 2014, The relationship between lateral meniscus shape and joint contact parameters in the knee: a study using data from the Osteoarthritis Initiative, Arthritis Research and Therapy, Vol: 16, Pages: 1-9, ISSN: 1478-6354
IntroductionThe meniscus has an important role in force transmission across the knee, but a detailed three-dimensional (3D) morphometric shape analysis of the lateral meniscus to elucidate subject-specific function has not been conducted. The aim of this study was to perform 3D morphometric analyses of the lateral meniscus in order to correlate shape variables with anthropometric parameters, thereby gaining a better understanding of the relationship between lateral meniscus shape and its load-bearing function.MethodsThe lateral meniscus (LM) was manually segmented from magnetic resonance images randomly selected from the Osteoarthritis Initiative (OAI) non-exposed control subcohort. A 3D statistical shape model (SSM) was constructed to extract the principal morphological variations (PMV) of the lateral meniscus for 50 subjects (25 male and 25 female). Correlations between the principal morphological variations and anthropometric parameters were tested. Anthropometric parameters that were selected included height, weight, body mass index (BMI), femoral condyle width and axial rotation.ResultsThe first principal morphological variation (PMV) was found to correlate with height (r = 0.569), weight (r = 0.647), BMI (r = 0.376), and femoral condyle width (r = 0.622). The third PMV was found to correlate with height (r = 0.406), weight (r = 0.312), and femoral condyle width (r = 0.331). The percentage of the tibial plateau covered by the lateral meniscus decreases as anthropometric parameters relating to size of the subject increase. Furthermore, when the size of the subject increases, the posterior and anterior horns become proportionally longer and wider.ConclusionThe correlations discovered suggest that variations in meniscal shape can be at least partially explained by the levels of loads transmitted across the knee on a regular basis. Additionally, as the size of the subj
Kedgley AE, Shore BJ, Athwal GS, et al., 2013, An in-vitro study of rotator cuff tear and repair kinematics using single- and double-row suture anchor fixation, INTERNATIONAL JOURNAL OF SHOULDER SURGERY, Vol: 7, Pages: 46-51, ISSN: 0973-6042
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Kedgley AE, Fox A-MV, Jenkyn TR, 2012, Image intensifier distortion correction for fluoroscopic RSA: the need for independent accuracy assessment, JOURNAL OF APPLIED CLINICAL MEDICAL PHYSICS, Vol: 13, Pages: 197-204, ISSN: 1526-9914
Fluoroscopic images suffer from multiple modes of image distortion. Therefore, the purpose of this study was to compare the effects of correction using a range of two‐dimensional polynomials and a global approach. The primary measure of interest was the average error in the distances between four beads of an accuracy phantom, as measured using RSA. Secondary measures of interest were the root mean squared errors of the fit of the chosen polynomial to the grid of beads used for correction, and the errors in the corrected distances between the points of the grid in a second position. Based upon the two‐dimensional measures, a polynomial of order three in the axis of correction and two in the perpendicular axis was preferred. However, based upon the RSA reconstruction, a polynomial of order three in the axis of correction and one in the perpendicular axis was preferred. The use of a calibration frame for these three‐dimensional applications most likely tempers the effects of distortion. This study suggests that distortion correction should be validated for each of its applications with an independent “gold standard” phantom.
Fox A-MV, Kedgley AE, Lalone EA, et al., 2011, The effect of decreasing computed tomography dosage on radiostereometric analysis (RSA) accuracy at the glenohumeral joint, JOURNAL OF BIOMECHANICS, Vol: 44, Pages: 2847-2850, ISSN: 0021-9290
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Lalone EA, Fox A-MV, Kedgley AE, et al., 2011, The effect of CT dose on glenohumeral joint congruency measurements using 3D reconstructed patient-specific bone models, PHYSICS IN MEDICINE AND BIOLOGY, Vol: 56, Pages: 6615-6624, ISSN: 0031-9155
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Shultz R, Kedgley AE, Jenkyn TR, 2011, Quantifying skin motion artifact error of the hindfoot and forefoot marker clusters with the optical tracking of a multi-segment foot model using single-plane fluoroscopy, GAIT & POSTURE, Vol: 34, Pages: 44-48, ISSN: 0966-6362
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McWalter EJ, Kedgley AE, Wilson DR, 2011, OA Pathogenesis: Role of Mechanics, OARSI Online Primer, Editors: Henrotin, Hunter, Kawaguchi, Publisher: OARSI (Osteoarthritis Research Society International)
Mechanics play a role in the initiation, progression and successful treatment of osteoarthritis. While it is not possible to measure many important mechanical quantities directly at the joint, many conditions associated with mechanical disruptions to the joint (such as malalignment, muscle weakness and joint instability, injury, and bone deformity) have been studied, and a number of these are associated with osteoarthritis initiation and/or progression. There is no universally accepted explanation for how mechanical disruptions at the joint lead to osteoarthritis. While damage to the joint caused by direct overload is a widely accepted mechanism, other hypotheses address the potential importance of underloading, loading history, changes to the subchondral bone, changes to the location of load transmission on the cartilage, and friction at the joint surface. Surgical treatment strategies, such as osteotomies and soft tissue repair, and non-surgical treatment strategies, such as bracing, taping and wedge insoles, focus on correcting disrupted joint mechanics.
Kedgley AE, Dunning CE, 2010, An alternative definition of the scapular coordinate system for use with RSA, JOURNAL OF BIOMECHANICS, Vol: 43, Pages: 1527-1531, ISSN: 0021-9290
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Kedgley AE, Jenkyn TR, 2009, RSA calibration accuracy of a fluoroscopy-based system using nonorthogonal images for measuring functional kinematics, MEDICAL PHYSICS, Vol: 36, Pages: 3176-3180, ISSN: 0094-2405
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Kedgley AE, Birmingham T, Jenkyn TR, 2009, Comparative accuracy of radiostereometric and optical tracking systems, JOURNAL OF BIOMECHANICS, Vol: 42, Pages: 1350-1354, ISSN: 0021-9290
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Dunk NM, Kedgley AE, Jenkyn TR, et al., 2009, Evidence of a pelvis-driven flexion pattern: Are the joints of the lower lumbar spine fully flexed in seated postures?, CLINICAL BIOMECHANICS, Vol: 24, Pages: 164-168, ISSN: 0268-0033
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Bechard DJ, Nolte V, Kedgley AE, et al., 2009, Total kinetic energy production of body segments is different between racing and training paces in elite Olympic rowers, SPORTS BIOMECHANICS, Vol: 8, Pages: 199-211, ISSN: 1476-3141
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Kedgley AE, DeLude JA, Drosdowech DS, et al., 2008, Humeral head translation during glenohumeral abduction following computer-assisted shoulder hemiarthroplasty, JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, Vol: 90B, Pages: 1256-1259, ISSN: 0301-620X
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Kedgley AE, Mackenzie GA, Ferreira LM, et al., 2007, In <i>vitro</i> kinematics of the shoulder following rotator cuff injury, CLINICAL BIOMECHANICS, Vol: 22, Pages: 1068-1073, ISSN: 0268-0033
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Kedgley AE, Mackenzie GA, Ferreira LM, et al., 2007, Humeral head translation decreases with muscle loading, JOURNAL OF SHOULDER AND ELBOW SURGERY, Vol: 17, Pages: 132-138, ISSN: 1058-2746
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Kedgley AE, Takaki SE, Lang P, et al., 2007, The effect of cross-sectional stem shape on the torsional stability of cemented implant components, JOURNAL OF BIOMECHANICAL ENGINEERING-TRANSACTIONS OF THE ASME, Vol: 129, Pages: 310-314, ISSN: 0148-0731
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- Citations: 11
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