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Anatomy of femur and knee

Julio Brandao Guimaraes, Luca Facchetti, Benedikt J Schwaiger, Alexandra S Gersing, Xiaojuan Li, Thomas M Link
OBJECTIVES: To assess (i) normal imaging anatomy of the popliteomeniscal fascicles, (ii) prevalence and natural evolution of popliteomeniscal fascicle tears (PMFT) in subjects with traumatic anterior cruciate ligament (ACL) tears over 2 years and (iii) compare knee cartilage degeneration in subjects with and without PMFT longitudinally. METHODS: 57 subjects with ACL tears were screened for PMFT. Morphological (high-resolution 3D fast spin-echo) and compositional (T1ρ and T2 mapping) MR imaging was performed prior to and 2 years after ACL reconstruction...
February 23, 2018: European Radiology
Ke Li, Etienne Cavaignac, Wei Xu, Qiang Cheng, Nobert Telmon, Wei Huang
PURPOSE: Morphologic data of the knee is very important in the design of total knee prostheses. Generally, the designs of the total knee prostheses are based on the knee anatomy of Caucasian population. Moreover, in forensic medicine, a person's age and sex might be estimated by the shape of their knees. The aim of this study is to utilize three-dimensional morphometric analysis of the knee in Chinese population to reveal sexual dimorphism and age-related differences. MATERIALS AND METHODS: Sexually dimorphic differences and age-related differences of the distal femur were studied by using geometric morphometric analysis of ten osteometric landmarks on three-dimensional reconstructions of 259 knees in Chinese population...
February 20, 2018: International Orthopaedics
Hamidreza Yazdi, Ara Nazarian, John Y Kwon, Mary G Hochman, Reza Pakdaman, Poopak Hafezi, Morteza Ghahremani, Samad Joudi, Mohammad Ghorbanhoseini
BACKGROUND: The anatomical axis of the femur is crucial for determining the correct alignment in corrective osteotomies of the knee, total knee arthroplasty (TKA), and retrograde and antegrade femoral intramedullary nailing (IMN). The aim of this study was to propose the concept of different anatomical axes for the proximal and distal parts of the femur; compare these axes in normally aligned subjects and also to propose the clinical application of these axes. METHODS: In this cross-sectional study, the horizontal distances between the anatomical axis of the proximal and distal halves of the femur and the center of the intercondylar notch were measured in 100 normally aligned femurs using standard full length alignment view X-rays...
January 31, 2018: Journal of Orthopaedic Surgery and Research
Xavier Flecher, Matthieu Ollivier, Pascal Maman, Sébastien Pesenti, Sébastien Parratte, Jean-Noël Argenson
INTRODUCTION: Due to complex anatomical considerations, results of cementless-stem total hip arthroplasty (THA) in hip fusion remain controversial compared with conventional THA. We therefore aimed to analyse 3D anatomy of the fused hip based on pre-operative computed tomography (CT) scans, functional outcomes based on the Harris Hip Score (HHS) and the Hip Disability and Osteoarthritis Outcome Score (HOOS), modifications of hip anatomy based on post-operative standardised radiography, and determine complication rate and long-term survival based on Kaplan-Meier analysis...
January 19, 2018: International Orthopaedics
C Rivière, F Iranpour, S Harris, E Auvinet, A Aframian, S Parratte, J Cobb
INTRODUCTION: Kinematic (KA) and mechanical (MA) alignment techniques are two different philosophies of implant positioning that use the same TKA implants. This might generate differences in the resulting prosthetic trochleae parameters between the two techniques of alignment. Our study aim was to test the following hypotheses : (1) mechanically or kinematically aligned femoral implant understuffs the native trochlear articular surface and poorly restores the native groove orientation, and (2) the orientation of the prosthetic trochlear groove and trochlear fill are different between MA and KA...
December 6, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
V R Allen, R E Kambic, S M Gatesy, J R Hutchinson
Human patellae (kneecaps) are thought to act as gears, altering the mechanical advantage of knee extensor muscles during running. Similar sesamoids have evolved in the knee extensor tendon independently in birds, but it is unknown if these also affect the mechanical advantage of knee extensors. Here, we examine the mechanics of the patellofemoral joint in the helmeted guineafowl Numida meleagris using a method based on muscle and tendon moment arms taken about the patella's rotation centre around the distal femur...
November 2017: Journal of Zoology: Proceedings of the Zoological Society of London
Lauren H Redler, Kathleen N Meyers, Jacqueline M Brady, Elizabeth R Dennis, Joseph T Nguyen, Beth E Shubin Stein
PURPOSE: To assess the impact elevated tibial tubercle-trochlear groove (TT-TG) distance and patella height, as measured by the Caton-Deschamps Index (CDI), have on the isometry of a reconstructed medial patellofemoral ligament (MPFL). METHODS: Nine fresh-frozen cadaveric knees were placed on a custom testing fixture, with a fixed femur and a mobile tibia. A suture fixed to the MPFL origin on the patella and free to move at the Schöttle point on the femur represented a reconstructed MPFL...
October 31, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
Glenna T Clifton, Jennifer A Carr, Andrew A Biewener
Several groups of birds have convergently evolved the ability to swim using their feet despite facing trade-offs with walking. However, swimming relative to terrestrial performance varies across these groups. Highly specialized divers, such as loons and grebes, excel at swimming underwater but struggle to stand on land, whereas species that primarily swim on the water surface, such as Mallards, retain the ability to move terrestrially. The identification of skeletal features associated with a swimming style and conserved across independent groups suggests that the hindlimb of foot-propelled swimming birds has adapted to suit the physical challenges of producing propulsive forces underwater...
November 3, 2017: Journal of Anatomy
Fuhao Mo, Fan Li, Michel Behr, Zhi Xiao, Guanjun Zhang, Xianping Du
A lower limb-pelvis finite element (FE) model with active three-dimensional (3D) muscles was developed in this study for biomechanical analysis of human body. The model geometry was mainly reconstructed from a male volunteer close to the anthropometry of a 50th percentile Chinese male. Tissue materials and structural features were established based on the literature and new implemented experimental tests. In particular, the muscle was modeled with a combination of truss and hexahedral elements to define its passive and active properties as well as to follow the detailed anatomy structure...
October 16, 2017: Annals of Biomedical Engineering
Bradley M Kruckeberg, Jorge Chahla, Gilbert Moatshe, Mark E Cinque, Kyle J Muckenhirn, Jonathan A Godin, Taylor J Ridley, Alex W Brady, Elizabeth A Arendt, Robert F LaPrade
BACKGROUND: The qualitative and quantitative anatomy of the medial patellar stabilizers has been reported; however, a quantitative analysis of the anatomic and radiographic attachments of all 4 ligaments relative to anatomic and osseous landmarks, as well as to one another, has yet to be performed. PURPOSE: To perform a qualitative and quantitative anatomic and radiographic evaluation of the medial patellofemoral ligament (MPFL), medial patellotibial ligament (MPTL), medial patellomeniscal ligament (MPML), and medial quadriceps tendon femoral ligament (MQTFL) attachment sites, with attention to their relationship to pertinent osseous and soft tissue landmarks...
October 1, 2017: American Journal of Sports Medicine
Hongyi Shao, Chilung Chen, Daniel Scholl, Ahmad Faizan, Antonia F Chen
PURPOSE: The orientation and distance from the shaft of the femur and tibia to the articular surface centre is important for performing total knee arthroplasty (TKA) with cementless stems. It is important to understand anatomic differences between races to match the tibial and femoral shaft axis to the knee articular surface. Thus, the purpose of this study was to compare knee morphology between Caucasian and East Asian individuals to determine the optimal placement of tibial and femoral stems...
September 22, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Mohamed Morsy, Yoo Joon Sur, Osman Akdag, Amr Eisa, Tarek A El-Gammal, Nirusha Lachman, Steven L Moran
BACKGROUND: The lateral femoral condyle (LFC) flap is a vascularized bone flap based on the superior lateral genicular artery (SLGA). Harvest technique for this flap has not yet been demonstrated. The purpose of this study was to better delineate the blood supply to the bone and skin of this flap to allow for a safe and effective harvest. MATERIALS AND METHODS: Twenty-three lower extremities were injected with latex or a mixture of latex and barium sulfate. The SLGA was identified and dissected, documenting the course, diameter, anatomical relations, length, and branches...
August 16, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Abtin Alvand, Tanvir Khan, Cathy Jenkins, Jonathan L Rees, William F Jackson, Christopher A F Dodd, David W Murray, Andrew J Price
PURPOSE: Patient-specific instrumentation (PSI) has been proposed as a means of improving surgical accuracy and ease of implantation during technically challenging procedures such as unicompartmental knee arthroplasty (UKA). The purpose of this prospective randomised controlled trial was to compare the accuracy of implantation and functional outcome of mobile-bearing medial UKAs implanted with and without PSI by experienced UKA surgeons. METHODS: Mobile-bearing medial UKAs were implanted in 43 patients using either PSI guides or conventional instrumentation...
August 22, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Hiroshi Nakayama, Steffen Schröter, Chie Yamamoto, Tomoya Iseki, Ryo Kanto, Kenji Kurosaka, Shunichiro Kambara, Shinichi Yoshiya, Masaru Higa
PURPOSE: The purpose of this study was to analyse the resultant stress induced by joint-line obliquity after HTO for varus knee deformity using a three-dimensional (3D) finite element model analysis. METHODS: The geometrical bone data used in this study were derived from commercially available human bone digital anatomy media. The 3D knee models were developed using 3D computer-aided design software. The articular surface was overlaid with a 2-mm-thick cartilage layer for both femoral and tibial condyles...
August 22, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
M Del Pilar Duque Orozco, N C Record, K J Rogers, M B Bober, W G Mackenzie, A Atanda
PURPOSE: Achondroplasia is the most common form of skeletal dysplasia, affecting more than 250 000 individuals worldwide. In these patients, the developing knee undergoes multiple anatomical changes. The purpose of this study was to characterise the intra-articular knee anatomy in children with achondroplasia who underwent knee arthroscopy. METHODS: Records of achondroplasia patients who underwent knee arthroscopy between 2009 and 2014 were reviewed. Demographic data, operative reports, follow-up notes, MRI and arthroscopy images were reviewed...
June 1, 2017: Journal of Children's Orthopaedics
K Kumar, D Sharma
BACKGROUND: Multiple landmarks including the transepicondylar axis (TEA), posterior condylar axis (PCA) and anterior trochlear line (TL) have been used to set up the femoral component rotation, but each is faced with its own practical obstacle that limits its usage. Also a common practice is to set the femoral component rotation at 3° external rotation to PCA and valgus resection angle at 5°-7° to anatomical axis of femur. For the reason that the anatomy of each knee is different, it may not be justified to practice such a set protocol in all cases...
July 21, 2017: Musculoskeletal Surgery
Christian Ottow, Ronald Schulz, Heidi Pfeiffer, Walter Heindel, Andreas Schmeling, Volker Vieth
OBJECTIVES: To clarify the relevance of the bony fusion of the distal femoral and the proximal tibial epiphyses by means of magnetic resonance imaging (MRI), a prospective cross-sectional cohort study was performed with a special focus on a reliable determination of the 14th, 16th and 18th years of life. METHODS: We scanned 658 German volunteers in the age bracket 12-24 years using a 3.0 T MR-scanner and utilising a T1 turbo spin-echo sequence representing true bone anatomy...
December 2017: European Radiology
Enrico Vaienti, Giacomo Scita, Francesco Ceccarelli, Francesco Pogliacomi
The knee is the intermediate joint of the lower limb and it allows the movement between the femur, tibia and patella. Under normal conditions there is a normal distribution of the load forces on these three articular components in both the static load and during ambulation. The understanding of anatomy and knee biomechanics is important for the gait analysis, the diagnosis of joint diseases and the design and development of prosthetic implants. In the last decades comprehension of knee physiology and kinematics has led to the introduction of a wide range of enhanced prosthetic implant designs for a variety of indications...
June 7, 2017: Acta Bio-medica: Atenei Parmensis
Daisuke Araki, Eric Thorhauer, Scott Tashman
PURPOSE: This study quantified the error in anterior cruciate ligament (ACL) insertion site location and area estimated from three-dimensional (3D) isotropic magnetic resonance imaging (MRI) by comparing to native insertion sites determined via 3D laser scanning. METHODS: Isotropic 3D DESS MRI was acquired from twelve fresh-frozen, ACL-intact cadaver knees. ACL insertion sites were manually outlined in each MRI slice, and the resulting contours combined to determine the 3D insertion site shape...
June 13, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Jonathan A Godin, Jorge Chahla, Gilbert Moatshe, Bradley M Kruckeberg, Kyle J Muckenhirn, Alexander R Vap, Andrew G Geeslin, Robert F LaPrade
BACKGROUND: The qualitative anatomy of the distal iliotibial band (ITB) has previously been described. However, a comprehensive characterization of the quantitative anatomic, radiographic, and biomechanical properties of the Kaplan fibers of the deep distal ITB has not yet been established. It is paramount to delineate these characteristics to fully understand the distal ITB's contribution to rotational knee stability. Purpose/Hypothesis: There were 2 distinct purposes for this study: (1) to perform a quantitative anatomic and radiographic evaluation of the distal ITB's attachment sites and their relationships to pertinent osseous and soft tissue landmarks, and (2) to quantify the biomechanical properties of the deep (Kaplan) fibers of the distal ITB...
September 2017: American Journal of Sports Medicine
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