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Knee anatomy and injury

Levi Reina Fernandes, Herve Ouanezar, Adnan Saithna, Bertrand Sonnery-Cottet
The Segond fracture (SF) is considered pathognomonic of an anterior cruciate ligament (ACL) tear. However, the anatomy of the soft-tissue attachments responsible for the avulsion of SFs has been a cause of controversy. A 31-year-old male patient presented with an injury to his right knee that resulted in ACL tear and a SF. Open SF fixation and arthroscopic ACL reconstruction were performed. The anatomical dissection demonstrated that the avulsion of SFs had occurred because of the tibial attachment of the anterolateral ligament (ALL) with an intact Iliotibial band...
March 20, 2018: BMJ Case Reports
Kadir Buyukdogan, Michael S Laidlaw, Mark D Miller
The management of multiligament knee injury is a complex process starting with the adequate identification of the injury. A detailed physical and radiographic examination with a thorough understanding of knee anatomy is crucial to assess all damaged structures: anterior cruciate ligament, posterior cruciate ligament, posteromedial corner including the medial collateral ligament, and posterolateral corner including the lateral collateral ligament. Several surgical techniques have been developed throughout the years to adequately address these ligament insufficiencies...
February 2018: Arthroscopy Techniques
Michael Day, Michael Ryan, Eric Strauss
The management of meniscal root injuries has changed as biomechanical studies have demonstrated the importance of meniscal integrity in load distribution across the knee joint. Meniscal injury causes altered joint mechanics, which is postulated to be related to the onset of arthrosis. Arthroscopic meniscal root repair has been shown to restore more normal joint mechanics and is considered a treatment option in the appropriately indicated patient. Short- and midterm clinical results of meniscal root repair are promising, but long-term results are yet to be established...
March 2018: Bulletin of the Hospital for Joint Diseases
Bin Yuan, Bao-Jian Ge, Bai-Yi Meng
Dislocation of proximal tibiofibular joint(PTFJ) is relatively infrequent in clinic, it can be either isolated or associated with tibia fracture, fibular fracture and ankle injury and so on. Chronic symptomatic PTFJ instability are easily mixed with meniscal tears. It was easily neglected because of the mild clinical presentation and atypical change on radiography. Early diagnosis and treatment are crucial to prevent chronic knee pain and instability. The paper concluded the anatomy, classification, complication, diagnosis, treatment, clinical effect and insufficient of the dislocation of PTFJ, to direct the diagnosis and treatment of proximal tibiofibular joint dislocation in clinical work...
October 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Innocent Ouko, James Kigera, Kevin Ongeti, Anne Pulei
PURPOSE: Meniscal tears are common in Kenya, with prevalence rates ranging from 45 to 78% of intracapsular knee pathology. Diagnosis of these injuries relies on the use of both clinical signs and symptoms as well as radiological investigations. In a few instances, radiological detection could be difficult, partly because of variant attachment patterns of the medial meniscal anterior horn. Some of these unusual attachments of the anterior horn of the medial meniscus could even be mistaken for meniscal tears...
February 16, 2018: International Orthopaedics
Gang Ji, Yifei Sun, Jiangfeng Lu, Yingzhen Niu, Fei Wang
The purpose of this study was to explore the anatomy and discuss functional regions of the medial patellofemoral ligament (MPFL). Twelve fresh-frozen knees specimens were dissected. All medial surfaces of knees were intact and did not have indication of injury. General feature of the MPFL were observed. All anatomical landmarks were carefully identified and marked. The length of the two functional regions were conducted and recorded. All data were obtained, described, and analyzed in the form of mean ± standard deviation...
February 14, 2018: Journal of Knee Surgery
Brian Grawe, Amanda J Schroeder, Rafael Kakazu, Malynda S Messer
The lateral collateral ligament is the primary varus stabilizer of the tibiofemoral joint. Diagnosing an injury to this ligament can be challenging in the setting of multiligamentous trauma; however, failure to recognize these injuries can result in instability of the knee and unsatisfactory outcomes after cruciate ligament reconstruction. Recent literature exploring the anatomy and biomechanics of the lateral collateral ligament has enhanced our understanding and improved diagnosis and management of these injuries...
March 15, 2018: Journal of the American Academy of Orthopaedic Surgeons
Santiago Pache, Zachary S Aman, Mitchell Kennedy, Gilberto Yoshinobu Nakama, Gilbert Moatshe, Connor Ziegler, Robert F LaPrade
The posterior cruciate ligament (PCL) is the largest and strongest ligament in the human knee, and the primary posterior stabilizer. Recent anatomy and biomechanical studies have provided an improved understanding of PCL function. PCL injuries are typically combined with other ligamentous, meniscal and chondral injuries. Stress radiography has become an important and validated objective measure in surgical decision making and post-operative assessment. Isolated grade I or II PCL injuries can usually be treated non-operatively...
January 2018: Archives of Bone and Joint Surgery
Michael L Redondo, Adam J Beer, Adam B Yanke
The treatment of patellofemoral cartilage defects presents several distinct challenges when compared with cartilage restoration techniques used for other compartments of the knee due to the unique anatomy and distribution of forces. The etiologies of patellofemoral articular cartilage lesions include acute traumatic instability injuries, such as dislocation and subluxation, osteochondritis dissecans, and chronic degenerative changes. Regardless of the etiology, untreated patellofemoral cartilage lesions can contribute to activity-limiting anterior knee pain...
March 2018: Journal of Knee Surgery
Mark A Prissel, Justin L Daigre, Roberto A Brandão, Terrence M Philbin, Christopher F Hyer, Gregory C Berlet
Fractures of the distal fibula secondary to rotational ankle injuries are one of the most common injuries requiring surgical intervention. The aim of this study was to describe the anatomy of the distal fibular medullary canal as a means of aiding in surgical management with an intramedullary device. Twenty fresh cadaveric below-knee specimens (group 1, 10 in 2015, group 2, 10 in 2016) were dissected to expose the distal fibular. Fifteen (10 mm each) segments were sectioned with a sagittal saw from the distal tip proximally and measured with a digital caliper...
January 1, 2018: Foot & Ankle Specialist
Assem Mohamed Noureldin Zein, Mohamed Elshafie, Ahmed Nady Saleh Elsaid, Mohamed Ahmed Elsaid Elrefai
The results of arthroscopic anterior cruciate ligament (ACL) reconstruction are so far satisfactory and improving over time as a result of the improved understanding of the anatomy and biomechanics of the ACL. Rotational instability confirmed by a positive pivot shift is present in more than 15% of cases who underwent successful ACL reconstruction. Persistent rotational instability interferes with performing pivoting sports, and also may lead to meniscal and chondral injuries, or re-rupture of the reconstructed ACL...
August 2017: Arthroscopy Techniques
Oog-Jin Shon, Jae-Woo Park, Beum-Jung Kim
The number of posterolateral corner (PLC) injury patients has risen owing to the increased motor vehicle accidents and sports activities. Careful examination is required because this injury is easy to overlook and may lead to chronic instability. The purpose of this article is to review the anatomy, biomechanics, diagnosis, classification and, treatment of PLC injuries and summarize the recent literatures regarding the treatment outcomes.
December 1, 2017: Knee Surgery & related Research
Joseph J Ruzbarsky, Gabrielle Konin, Naaman Mehta, Robert G Marx
Magnetic resonance imaging and a thorough understanding of its interpretation in the diagnosis and management of injuries to the ligaments about the knee is an essential skill for orthopedists. The goal of this review is to provide a description of the native and injured anatomy through magnetic resonance imaging and its correlations, when appropriate, as seen through the arthroscope at the time of surgery. The ligaments of focus include the anterior cruciate ligament, the posterior cruciate ligament, the medial collateral ligament, the posterolateral corner, the anterolateral ligament, and the medial patellofemoral ligament...
December 2017: Sports Medicine and Arthroscopy Review
Uwe Maus, Carlos J Marques, David Scheunemann, Frank Lampe, Djordje Lazovic, Hagen Hommel, Dennis Vogel, Martin Haunschild, Tilman Pfitzner
PURPOSE AND HYPOTHESIS: Patient-specific instrumentation (PSI) uses 3D preoperative imaging to produce individualized cutting blocks specific to patients' anatomy and according to the preoperative plan with the aim to reduce the number of mechanical leg alignment (MLA) outliers, to improve implant positioning and to decrease surgery time. The primary purpose of this study was to investigate the efficacy of a specific PSI in comparison with standard instrumentation (SI) in reducing the number of MLA outliers...
October 25, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Frantzeska Zampeli, Ioannis Terzidis, João Espregueira-Mendes, Jim-Dimitris Georgoulis, Manfred Bernard, Evangelos Pappas, Anastasios D Georgoulis
PURPOSE: Anterior cruciate ligament (ACL) reconstruction (ACLR) aims to restore normal knee joint function, stability and biomechanics and in the long term avoid joint degeneration. The purpose of this study is to present the anatomic single bundle (SB) ACLR that emphasizes intraoperative correction of tibiofemoral subluxation that occurs after ACL injury. It was hypothesized that this technique leads to optimal outcomes and better restoration of pathological tibiofemoral joint movement that results from ACL deficiency (ACLD)...
October 24, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Andrew P Dold, Stephanie Swensen, Eric Strauss, Michael Alaia
The posteromedial corner of the knee encompasses five medial structures posterior to the medial collateral ligament. With modern MRI systems, these structures are readily identified and can be appreciated in the context of multiligamentous knee injuries. It is recognized that anteromedial rotatory instability results from an injury that involves both the medial collateral ligament and the posterior oblique ligament. Like posterolateral corner injuries, untreated or concurrent posteromedial corner injuries resulting in rotatory instability place additional strain on anterior and posterior cruciate ligament reconstructions, which can ultimately contribute to graft failure and poor clinical outcomes...
November 2017: Journal of the American Academy of Orthopaedic Surgeons
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
C Benjamin Ma
Injury to the posterolateral corner of the knee is a difficult condition to treat. We know a lot about the anatomy and different methods with which we can reconstruct this complex area of the knee. Despite these advances, injuries to this area still do not lead to great surgical outcomes.
October 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
Lars Blønd
PURPOSE: A proportion of patients having years of chronic anterior knee pain(AKP) that have not responded to non-operative modalities. Trochlear dysplasia have been found to be a cause for AKP. By restoring the anatomy with a trochleoplasty procedure the patellofemoral joint is unloaded. This study is a prospective 2year follow-up study, based on two cases with chronic AKP for several years and having severe trochlear dysplasia and both were successfully treated by arthroscopic deepening trochleoplasty...
2017: International Journal of Surgery Case Reports
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