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femoral torsion

Thitaporn Phetkaew, Marissak Kalpravidh, Rampaipat Penchome, Chalika Wangdee
OBJECTIVE:  This article aimed to determine and compare the angular values of the pelvic limb in normal and medial patellar luxation (MPL) stifles in Chihuahuas using radiography and computed tomographic (CT) scan, to identify the relationship between pelvic limb angles and severity of MPL. In addition, radiographic and CT images were compared to determine the more suitable method of limb deformity assessment. METHODS:  Sixty hindlimbs of Chihuahuas were divided into normal and grade 1, 2, 3 and 4 MPL groups...
February 2018: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
K C Geoffrey Ng, Mario Lamontagne, Jonathan R T Jeffers, George Grammatopoulos, Paul E Beaulé
BACKGROUND: As there is a high prevalence of patients with cam deformities and no ongoing hip dysfunction, understanding the biomechanical factors predicting the onset of symptoms and degenerative changes is critical. One such variable is how the spinopelvic parameters may influence hip and pelvic sagittal mobility. Hypothesis/Purpose: Pelvic incidence may predict sagittal hip and pelvic motions during walking and squatting. The purpose was to determine which anatomic characteristics were associated with symptoms and how they influenced functional hip and pelvic ranges of motion (ROMs) during walking and squatting...
March 1, 2018: American Journal of Sports Medicine
Tomoharu Mochizuki, Takashi Sato, Osamu Tanifuji, Satoshi Watanabe, Koichi Kobayashi, Naoto Endo
BACKGROUND: This study aimed to identify the factors affecting postoperative rotational limb alignment of the tibia relative to the femur. We hypothesized that not only component positions but also several intrinsic factors were associated with postoperative rotational limb alignment. METHODS: This study included 99 knees (90 women and 9 men) with a mean age of 77 ± 6 years. A three-dimensional (3D) assessment system was applied under weight-bearing conditions to biplanar long-leg radiographs using 3D-to-2D image registration technique...
February 13, 2018: Journal of Arthroplasty
Jean-Barthelemy Gnakamene, Michel E Safar, Bernard I Levy, Brigitte Escoubet
BACKGROUND: Left ventricular (LV) torsion plays a key role in cardiac efficiency. In hypertension, aortic stiffening augments cardiac afterload. However, little is known about the links between LV regional contraction and aortic stiffness. We, therefore, investigated these relationships and their contribution to LV diastolic function. METHODS AND RESULTS: The study included normotensive and hypertensive individuals with normal LV ejection. Apical, basal, and global LV rotation rate and LV global longitudinal strain were measured (2-dimensional speckle tracking echocardiography)...
February 28, 2018: Journal of the American Heart Association
F Longo, T Nicetto, T Banzato, G Savio, M Drigo, R Meneghello, G Concheri, M Isola
The aim of this ex vivo study was to test a novel three-dimensional (3D) automated computer-aided design (CAD) method (aCAD) for the computation of femoral angles in dogs from 3D reconstructions of computed tomography (CT) images. The repeatability and reproducibility of three manual radiography, manual CT reconstructions and the aCAD method for the measurement of three femoral angles were evaluated: (1) anatomical lateral distal femoral angle (aLDFA); (2) femoral neck angle (FNA); and (3) femoral torsion angle (FTA)...
February 2018: Veterinary Journal
Elyse Passmore, H Kerr Graham, Morgan Sangeux
Hip rotation during gait is a major indicator for femoral derotation osteotomy. However, repeatability of hip rotation is poor because of discrepancies in determining the medial-lateral axis of the femur. Combining 3D gait analysis with medical imaging allows in vivo evaluation of current clinical methods. We used the condylar axis, identified from low dose biplanar radiographs (EOS imaging Inc), as our reference to evaluate conventional, functional calibration and freehand 3D ultrasound methods to define the medial-lateral axis in children with lower-limb torsional deformities...
January 29, 2018: Journal of Biomechanics
Mirjam Niklasch, Matthias C Klotz, Sebastian I Wolf, Thomas Dreher
BACKGROUND: Recent studies showed rates of recurrence of internal rotation gait (IRG) after femoral derotation osteotomy (FDO) up to 40%. Some surgeons even advice overcorrection during FDO to avoid a later recurrence. RESEARCH QUESTION: Evaluation of the long-term development of limbs with initial overcorrection after FDO. METHODS: 29 limbs of 20 children (9.9 ± 3.2 years at surgery) with IRG, cerebral palsy (CP) and more than 5° external hip rotation postoperatively were included retrospectively...
January 17, 2018: Gait & Posture
Justin N Williams, Anuradha Valiya Kambrath, Roshni B Patel, Kyung Shin Kang, Elsa Mével, Yong Li, Ying-Hua Cheng, Austin J Pucylowski, Mariah A Hassert, Michael J Voor, Melissa A Kacena, William R Thompson, Stuart J Warden, David B Burr, Matthew R Allen, Alexander G Robling, Uma Sankar
Approximately 10% of all bone fractures do not heal, resulting in patient morbidity and healthcare costs. However, no pharmacological treatments are currently available to promote efficient bone healing. Inhibition of Ca2+ /calmodulin (CaM)-dependent protein kinase kinase 2 (CaMKK2) reverses age-associated loss of trabecular and cortical bone volume and strength in mice. In the current study, we investigated the role of CaMKK2 in bone fracture healing and show that its pharmacological inhibition using STO-609 accelerates early cellular and molecular events associated with endochondral ossification, resulting in a more rapid and efficient healing of the fracture...
January 3, 2018: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
Florian B Imhoff, Bastian Scheiderer, Philip Zakko, Elifho Obopilwe, Franz Liska, Andreas B Imhoff, Augustus D Mazzocca, Robert A Arciero, Knut Beitzel
BACKGROUND: Defining the optimal cutting plane for derotational osteotomy at the distal femur for correction of torsion in cases of patellofemoral instability is still challenging. This preliminary study investigates changes of frontal alignment by a simplified trigonometrical model and demonstrates a surgical guidance technique with the use of femur cadavers. The hypothesis was that regardless of midshaft bowing, a cutting plane perpendicular to the virtual anatomic shaft axis avoids unintended valgus malalignment due to derotation...
December 29, 2017: BMC Musculoskeletal Disorders
Jiali Wang, Yuanhao Wu, Huafang Li, Yang Liu, Xueling Bai, Wingho Chau, Yufeng Zheng, Ling Qin
Peri-tunnel bone loss after anterior cruciate ligament (ACL) reconstruction is often observed clinically, which may detrimentally affect tendon graft integration with surrounding bone tissue. Biodegradable magnesium (Mg) based fixators in terms of interference screws may be suitable for fixation of the tendon graft due to their favorable effects on promotion of new bone formation. However, the poor mechanical strength of Mg is still one of the major challenges for its clinical applications. The addition of alloying elements into Mg is one of the strategies to improve their mechanical properties...
December 11, 2017: Biomaterials
Emmanouil Liodakis, Christian Krettek, Nael Hawi
BACKGROUND: Despite promising results in experimental studies, computer-assisted femoral intramedullary nailing has not become established in the clinical practice for most orthopedic surgeons. The purpose of this study was to evaluate the advantages and disadvantages of computer-assisted reduction and nailing of femoral fractures as reported in clinical studies. MATERIAL AND METHODS: A systematic analysis of the available literature on the clinical application of computer-assisted femoral intramedullary nailing (Pubmed, Cochrane library and Embase) was carried out...
December 1, 2017: Der Unfallchirurg
David E Lazarus, Christine L Farnsworth, Megan E Jeffords, Nikolas Marino, Jericho Hallare, Eric W Edmonds
BACKGROUND: There is evidence that oblique tension band plating can affect torsional growth in long bones. This study sought to determine if the torsional growth could be modulated based on the angles of the tension band plating and whether or not oblique plating affected overall longitudinal growth. METHODS: New Zealand White rabbits (10.5 wk old) had one screw placed on the metaphyseal side and one on the epiphyseal side of both medial and lateral sides of the right knee distal femoral physis...
February 2018: Journal of Pediatric Orthopedics
Kathak Vachhani, Andrea Pagotto, Yufa Wang, Cari Whyne, Diane Nam
Fracture healing is a lengthy process which fails in 5-10% of cases. Lithium, a low-cost therapeutic used in psychiatric medicine, up-regulates the canonical Wingless pathway crucial for osteoblastic mineralization in fracture healing. A design-of-experiments (DOE) methodology was used to optimize lithium administration parameters (dose, onset time and treatment duration) to enhance healing in a rat femoral fracture model. In the previously completed first stage (screening), onset time was found to significantly impact healing, with later (day 7 vs...
October 28, 2017: Journal of Biomechanics
Kyle K Nishiyama, Sanchita Agarwal, Anna Kepley, Fernando Rosete, Yizhong Hu, X Edward Guo, Claire L Keating, Emily A DiMango, Elizabeth Shane
Individuals with cystic fibrosis (CF) have lower bone mineral density (BMD) by DXA and are at higher risk of fracture than healthy controls. However, the 2-dimensional measurement of areal BMD (aBMD) provided by DXA is influenced by bone size and the true extent of the bone deficit is unclear. Our objective was to use high-resolution peripheral quantitative computed tomography (HR-pQCT) and individual trabecula segmentation (ITS) analysis to compare volumetric BMD (vBMD), microarchitecture and estimated strength at the distal radius and tibia in 26 young adults with CF and 26 controls matched for age, gender, and race...
February 2018: Bone
Shigeru Takagi, Takashi Sato, Satoshi Watanabe, Osamu Tanifuji, Tomoharu Mochizuki, Go Omori, Naoto Endo
PURPOSE: Abnormalities of lower extremity alignment (LEA) in recurrent patella dislocation (RPD) have been studied mostly by two-dimensional (2D) procedures leaving three-dimensional (3D) factors unknown. This study aimed to three-dimensionally examine risk factors for RPD in lower extremity alignment under the weight-bearing conditions. METHODS: The alignment of 21 limbs in 15 RPD subjects was compared to the alignment of 24 limbs of 12 healthy young control subjects by an our previously reported 2D-3D image-matching technique...
November 17, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Franz Liska, Bernhard Haller, Andreas Voss, Julian Mehl, Florian B Imhoff, Lukas Willinger, Andreas B Imhoff
PURPOSE: Lateral distal femoral osteotomies (DFO) have recently been performed more frequently. In addition to realignment for varus and valgus deformity, the indication was extended with the introduction of torsional osteotomies in patellofemoral instability. The purpose of this study was to assess the general and technical risk factors for nonunion in lateral opening, closing and torsional DFO. METHODS: A total of 150 lateral DFO [98 opening wedge (LOWDFO) and 52 closing wedge (LCWDFO)] were analyzed in regard to potential risk factors for nonunion until plate removal...
November 8, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Markus Heinecke, Fabian Rathje, Frank Layher, Georg Matziolis
INTRODUCTION: The number of revision hip arthroplasties being performed is growing and implantation of a cementless stem has become established as the gold standard. For producing a primary stability, the press-fit procedure is the method of choice, but also can be achieved by multiple-point impactions. Specific femoral stems should follow the anatomical shape and provide a more extensive anchorage. The objective of this study was to evaluate the type, localization of the impaction and resulting primary stability of two different femoral revision stem designs (kinked vs...
November 7, 2017: Archives of Orthopaedic and Trauma Surgery
Federico Dettoni, Umberto Cottino, Silvia Spriano, Davide Edoardo Bonasia, Roberto Rossi
We report a case of two hemiarthroplasties (HAs) that underwent an unexpected mechanical failure. Two patients affected by femoral fractures were treated with an HA. At 5 and 7 years after surgery, they showed a breakage of the HA at the head-stem junction. We analyzed macroscopically and microscopically (by a scanning electron microscopy) the surfaces of the broken prostheses. In both cases, a fracture was detected starting at the joining point between the femoral head and the slot that receives the taper cone of the stem (the so-called bore), with the typical macroscopic and microscopic pattern of a fatigue fracture...
March 2017: Joints
Kathak Vachhani, Cari Whyne, Yufa Wang, David M Burns, Diane Nam
Osteoporotic bone fractures are highly prevalent and involve lengthy recovery. Lithium, commonly used in psychiatric medicine, inhibits glycogen synthase kinase-3β in the Wnt/β-catenin pathway, leading to up-regulation of osteogenesis. Our recent preclinical work demonstrated that a 20 mg/kg lithium dose administered beginning 7 days post-fracture for 14 days optimally improved femoral fracture healing in healthy rats at 4 weeks post fracture (46% higher torsional strength). In this study, lithium treatment was evaluated for healing of osteoporotic bone fractures...
November 6, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Jörg Dickschas, Felix Ferner, Christoph Lutter, Kolja Gelse, Jörg Harrer, Wolf Strecker
INTRODUCTION: Patellofemoral dysbalance may be caused by trochlear dysplasia, an elevated TTTG distance, femoral or tibial torsional deformities, patella alta, or a genu valgum. The surgical procedure for the treatment of a genu valgum is varisation osteotomy, usually in the femoral aspect. Several authors believe that a genu valgum is one cause of patellofemoral dysbalance, but studies about the outcome of the treatment with a varisation osteotomy are rare. MATERIALS AND METHODS: Nineteen knees in 18 patients, aged on average 28 (16-52) years were investigated in a retrospective study...
October 27, 2017: Archives of Orthopaedic and Trauma Surgery
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