Osteoarthritis of the patella, lateral femoral condyle and posterior medial femoral condyle correlate with range of motion

2013 ◽  
Vol 21 (11) ◽  
pp. 2584-2589 ◽  
Author(s):  
Takashi Suzuki ◽  
Sayaka Motojima ◽  
Shu Saito ◽  
Takao Ishii ◽  
Keinosuke Ryu ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Femoral Condyle ◽  
Medial Femoral Condyle ◽  
Lateral Femoral Condyle

scholarly journals Evaluation of the application value of a three-dimensional digital model of the knee in clinical practice

2020 ◽  
Vol 48 (5) ◽  
pp. 030006051988974
Author(s):  
Ajimu Keremu ◽  
Nuersimanguli Mijiti ◽  
Sirejiding Mijiti ◽  
Aikebaier Tuxun ◽  
Abulikemu Abudurexiti
Keyword(s):  
Knee Prosthesis ◽  
Femoral Condyle ◽  
Three Dimensional ◽  
Medial Femoral Condyle ◽  
Lateral Femoral Condyle ◽  
Transverse Diameter ◽  
Model Group ◽  
Product Model ◽  
Bone Parameters ◽  
Anatomical Basis

Objective To compare the knee shape and bone parameters between knee prosthesis products from overseas companies and a Chinese patient’s knee, and to apply the anatomical basis for Chinese knee prosthesis design. Methods Three-dimensional digital models were built, including prosthesis products for a normal adult. The relevant anatomy index was measured, and physical parameter, radiographic, geometric, knee kinematic, and distal geometry data were collected on the femur and tibia. Results The width of the femoral condyle (WFC), width of the medial femoral condyle (WMFC), width of the lateral femoral condyle (WLFC), depth of the intercondylar fossa (DICF), sagittal length of the medial femoral condyle (SLMFC), sagittal length of the lateral femoral condyle (SLLFC), angle of the medial femoral condyle (AMFC), and angle of the lateral femoral condyle (ALFC) in the femur and the transverse diameter (ML) and anteroposterior diameter (AP) of the tibial bone were measured. These parameters were significantly lower in the normal group compared with the prosthesis product model group. Conclusion When using an imported knee prosthesis, the osteotomy angle may not fit perfectly. Use of an imported prosthesis may be an important factor in the increasing failure of knee arthroplasty in China.

scholarly journals The Bony Resection Accuracy with Patient-Specific Instruments during Total Knee Arthroplasty: A Retrospective Case Series Study

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Liang Yuan ◽  
Bin Yang ◽  
Xiaohua Wang ◽  
Bin Sun ◽  
Ke Zhang ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Tibial Plateau ◽  
Femoral Condyle ◽  
Medial Femoral Condyle ◽  
Lateral Femoral Condyle ◽  
Patient Specific ◽  
Lateral Tibial Plateau ◽  
Bone Resection ◽  
Total Knee

Purpose. Bony resection is the primary step during total knee arthroplasty. The accuracy of bony resection was highly addressed because it was deemed to have a good relationship with mechanical line. Patient-specific instruments (PSI) were invented to copy the bony resection references from the preoperative surgical plan during a total knee arthroplasty (TKA); however, the accuracy still remains controversial. This study was aimed at finding out the accuracy of the bony resection during PSI-assisted TKA. Methods. Forty-two PSI-assisted TKAs (based on full-length leg CT images) were analyzed retrospectively. Resected bones of every patient were given a CT scan, and three-dimensional radiographs were reconstructed. The thickness of each bony resection was measured with the three-dimensional radiographs and recorded. The saw blade thickness (1.27 mm) was added to the measurements, and the results represented intraoperative bone resection thickness. A comparison between intraoperative bone resection thickness and preoperatively planned thickness was conducted. The differences were calculated, and the outliers were defined as >3 mm. Results. The distal femoral condyle had the most accurate bone cuts with the smallest difference (median, 1.0 mm at the distal medial femoral condyle and 0.8 mm at the distal lateral femoral condyle) and the least outliers (none at the distal medial femoral condyle and 1 (2.4%) at the distal lateral femoral condyle). The tibial plateau came in second (median difference, 0.8 mm at the medial tibial plateau and 1.4 mm at the lateral tibial plateau; outliers, none at the medial tibial plateau and 1 (2.6%) at the lateral tibial plateau). Regardless of whether the threshold was set to >2 mm (14 (17.9%) at the tibial plateau vs. 12 (14.6%) at the distal femoral condyle, p > 0.05 ) or >3 mm (1 (1.3%) at the tibial plateau vs. 1 (1.2%) at the distal femoral condyle, p > 0.05 ), the accuracy of tibial plateau osteotomy was similar to that of the distal femoral condyle. Osteotomy accuracy at the posterior femoral condyle and the anterior femoral condyle were the worst. Outliers were up to 6 (15.0%) at the posterior medial femoral condyle, 5 (12.2%) at the posterior lateral femoral condyle, and 6 (15.8%) at the anterior femoral condyle. The percentages of overcut and undercut tended to 50% in most parts except the lateral tibial plateau. At the lateral tibial plateau, the undercut percentage was twice that of the overcut. Conclusion. The tibial plateau and the distal femoral condyle share a similar accuracy of osteotomy with PSI. PSI have a generally good accuracy during the femur and tibia bone resection in TKA. PSI could be a kind of user-friendly tool which can simplify TKA with good accuracy. Level of Evidence. This is a Level IV case series with no comparison group.

scholarly journals ARTICULAR CARTILAGE THICKNESS IN PEDIATRIC AND ADOLESCENT KNEES DECREASES WITH AGE AND SKELETAL MATURITY: IMPLICATIONS FOR OSTEOCHONDRAL GRAFTING PROCEDURES

2020 ◽  
Vol 8 (4_suppl3) ◽  
pp. 2325967120S0019
Author(s):  
Sreetha Sidharthan ◽  
Annie Yau ◽  
Bryan Aristega Almeida ◽  
Kevin G. Shea ◽  
Kristofer J. Jones ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
Linear Regression ◽  
Skeletal Maturity ◽  
Femoral Condyle ◽  
Cartilage Thickness ◽  
Medial Femoral Condyle ◽  
Lateral Femoral Condyle ◽  
Cartilage Restoration ◽  
Text Figure ◽  
Mri Scans

Background: Quantifying native cartilage thickness in pediatric and adolescent knees can help match donor and recipient sites for articular cartilage restoration procedures such as osteochondral autograft transplantation (OATS) and osteochondral allograft transplantation (OCA). Hypothesis/Purpose: The purpose of the current study was to quantify articular cartilage thickness in pediatric and adolescent knees using magnetic resonance imaging (MRI). We hypothesized that cartilage thickness is inversely correlated with skeletal maturity and age. Methods: One hundred and twenty MRI scans were evaluated in a cohort of patients 9 to 18 years old without osteochondral lesions, chondral wear or pathology, intraarticular fractures, history of knee surgery, or inflammatory arthropathy. Measurements of articular cartilage thickness at the medial femoral condyle, lateral femoral condyle, lateral trochlea, and patella were made on axial, coronal, and sagittal MRI scans (Figure 1). Skeletal maturity was categorized as ‘open’, ‘closing’, or ‘closed’ based on the status of the proximal tibial and distal femoral growth plates. Descriptive statistics was used to evaluate cartilage thickness by age and sex. Independent samples t-test, analysis of variance (ANOVA), and linear regression were performed to investigate for associations with sex, skeletal maturity, and age. Results: On the femur, cartilage was thickest at the lateral trochlea with mean articular thickness of 4.2 ± 1.4 mm in males and 3.6 ± 1.3 mm in females ( p=0.015) (Table 1). Skeletally immature patients with open physes had significantly thicker cartilage at the medial femoral condyle, lateral femoral condyle, and lateral trochlea compared to patients with closing and closed physes (Figure 2). Linear regression analysis also revealed a significant association between femoral cartilage thickness and age (Figure 3). Age explained 63% of the variance at the medial femoral condyle (B=6.1, p<0.001), 64% of the variance at the lateral femoral condyle (B=4.9, p<0.001), and 68% of the variance at the lateral trochlea (B=8.2, p<0.001) (Table 2). In contrast, cartilage thickness at the patella did not significantly vary by age, sex, or skeletal maturity (Figures 2 and 4). Conclusion: There is a strong inverse association between increasing age and cartilage thickness of the femoral condyles and lateral trochlea. In particular, pediatric knees demonstrate relatively thick cartilage at the lateral trochlea that decreases with age. This information will help surgeons understand recipient site anatomy and identify appropriate donor site tissue for articular cartilage restoration procedures such as OATS and OCA in children and adolescents. Tables: [Table: see text][Table: see text] Figures: [Figure: see text][Figure: see text][Figure: see text][Figure: see text]

scholarly journals Contralateral Lateral Femoral Condyle Allografts Provide an Acceptable Surface Match for Simulated Classic Osteochondritis Dissecans Lesions of the Medial Femoral Condyle

2020 ◽  
Vol 8 (1) ◽  
pp. 232596711989841
Author(s):  
Nabeel Salka ◽  
John A. Grant
Keyword(s):  
Osteochondritis Dissecans ◽  
Femoral Condyle ◽  
Random Order ◽  
Medial Femoral Condyle ◽  
Lateral Femoral Condyle ◽  
Osteochondral Allograft ◽  
Effective Technique ◽  
Percentage Area ◽  
Surface Deviation ◽  
Fresh Frozen

Background: Osteochondral allograft transplantation is an effective technique for repairing large lesions of the medial femoral condyle (MFC), but its use is limited by graft availability. Purpose/Hypothesis: The present study aimed to determine whether contralateral lateral femoral condyle (LFC) allografts can provide an acceptable surface match for posterolateral MFC lesions characteristic of classic osteochondritis dissecans (OCD). The hypothesis was that LFC and MFC allografts will provide similar surface contour matches in all 4 quadrants of the graft for posterolateral MFC lesions characteristic of OCD. Study Design: Controlled laboratory study. Methods: Ten fresh-frozen recipient human MFCs were each size-matched to 1 ipsilateral medial and 1 contralateral LFC donor (N = 30 condyles). After a nano–computed tomography (nano-CT) scan of the native recipient condyle, a 20-mm circular osteochondral “defect” was created 1 cm posterior and 1 cm medial to the roof of the intercondylar notch (n = 10). A size-matched, random-order donor MFC or LFC plug was then harvested, transplanted, and scanned with nano-CT. Nano-CT scans were then reconstructed, registered to the initial scan of the recipient MFC, and processed in MATLAB to determine the height deviation ( d RMS) between the native and donor surfaces and percentage area unacceptably (>1 mm) proud (% A proud) and sunken (% A sunk). Circumferential step-off height ( h RMS) and percentage circumference unacceptably (>1 mm) proud (% C proud) and sunken (% C sunk) were measured using DragonFly software. The process was then repeated for the other allograft plug. Results: Both MFC and LFC plugs showed acceptable step-off heights in all 4 quadrants (range, 0.53-0.94 mm). Neither allograft type nor location within the defect had a significant effect on step-off height ( h RMS), surface deviation ( d RMS), % A proud, or % A sunk. In general, plugs were more unacceptably sunken than proud (MFC, 13.4% vs 2.4%; LFC, 13.2% vs 8.1%), although no significant differences in % C sunk were seen between allograft types or locations within the defect. In LFC plugs, % C proud in the lateral quadrant (28.0% ± 26.1%) was significantly greater compared with all other quadrants ( P = .0002). Conclusion: The present study demonstrates that 20-mm contralateral LFC allografts provide an acceptable surface match for posterolateral MFC lesions characteristic of OCD. Clinical Relevance: With comparable surface matching, MFC and LFC allografts can be expected to present similar stresses on the knee joint and achieve predictably positive clinical outcomes, thus improving donor availability and reducing surgical wait times for matches.

scholarly journals Osteochondral Allograft Transplant to the Medial Femoral Condyle Using a Medial or Lateral Femoral Condyle Allograft

2014 ◽  
Vol 42 (9) ◽  
pp. 2205-2213 ◽  
Author(s):  
Timothy S. Mologne ◽  
Esther Cory ◽  
Bradley C. Hansen ◽  
Angela N. Naso ◽  
Neil Chang ◽  
...  
Keyword(s):  
Femoral Condyle ◽  
Medial Femoral Condyle ◽  
Lateral Femoral Condyle ◽  
Osteochondral Allograft

scholarly journals Relationship Between Classification of Fabellae and the Severity of Keen Osteoarthritis: A Relevant Study in Chinese Population

2020 ◽  
Author(s):  
Lei Zhang ◽  
Youliang Wen ◽  
Chunying He ◽  
Yan Zeng ◽  
Jiangqin Luo ◽  
...  
Keyword(s):  
Statistical Difference ◽  
Femoral Condyle ◽  
Three Dimensional ◽  
Anatomical Variations ◽  
Medial Femoral Condyle ◽  
Lateral Femoral Condyle ◽  
Significant Statistical Difference ◽  
Imaging Characteristics ◽  
Dimensional Reconstruction

Abstract Background: The fabella is a sesamoid bone having anatomical variations and it is more common in patients with primary keen osteoarthritis (KOA). The purpose of this study was to classify the fabellae and discuss the relationship between the classification of fabellae and the severity of KOA in Chinese. Material and methods: 136 patients were measured and classified using CT three-dimensional reconstruction. According to the CT imaging characteristics, the fabellae were divided into 5 types: type Ⅰ, a fabella on the lateral femoral condyle; type Ⅱ, a fabella on the medial femoral condyle; type Ⅲ, a fabella on the lateral femoral condyle and a fabella on the medial femoral condyle; type Ⅳ, two fabellae on the medial femoral condyle and type Ⅴ, two fabellae on the lateral femoral condyle. The severity of KOA was assessed on the Recht grade by MRI. The data were analyzed with SPSS 24.0. Results: The classification of fabellae were correlated with KOA grades (c 2 =35.026, P<0.05). In terms of KOA grades, grade Ⅰ and grade Ⅱ were occupied most of fabellar type Ⅱ (32, 72.8%); type Ⅱ and other types were significant statistical difference (P<0.05). Grade Ⅰ and grade Ⅱ were also the most of fabellar type Ⅳ (4, 100%). Fabellar type Ⅴ’s biggest component were grade Ⅲ and grade Ⅳ (6, 75%). Type Ⅳ and type Ⅴ were significant statistical difference (P<0.05). Conclusion: The classification of fabellae were correlated with KOA grades. The type Ⅱ may mean the lower KOA grades while type Ⅴ may mean the higher KOA grades. Trial registration: the Ethics Inspection Committee at Southwest Medical University, V1.0/20180801. Registered 20 August 2018.

scholarly journals Contralateral Lateral Femoral Condyle Allografts Provide an Acceptable Surface Match for Simulated Classic Osteochondritis Dissecans Lesions of the Medial Femoral Condyle

2018 ◽  
Vol 6 (7_suppl4) ◽  
pp. 2325967118S0013 ◽  
Author(s):  
Nabeel Salka ◽  
John A. Grant
Keyword(s):  
Surface Topography ◽  
Clinical Outcomes ◽  
Articular Surface ◽  
Femoral Condyle ◽  
Standard Procedure ◽  
Medial Femoral Condyle ◽  
Lateral Femoral Condyle ◽  
Intercondylar Notch ◽  
Surface Deviation ◽  
Fresh Frozen

Objectives: The purpose of this study was to determine whether contralateral lateral femoral condyle (LFC) allografts can provide an acceptable surface topography match for classic osteochondritis dessicans (OCD) lesions of the medial femoral condyle (MFC). Achievement of an acceptable donor-recipient articular surface match (1 mm deviation) has been associated with physiological joint stresses and predictably positive clinical outcomes. It was hypothesized that LFC and MFC allografts would show no differences in step-off height or surface deviation in all four quadrants of the graft. Methods: ample size calculation suggested ten groups of fresh frozen size-matched human condyles, each group consisting of a donor MFC, donor LFC, and recipient MFC. A 20 mm circular osteochondral “defect” simulating a “classic” OCD lesion was created in the recipient MFC. Its most anterior position was 1 cm posterior and 1 cm medial to the roof of the intercondylar notch. A randomly selected donor MFC or LFC plug was then harvested and transplanted using standard procedure (Fig 1A). The transplanted condyle was scanned with nano-CT, reconstructed (Fig 1B), registered to an initial scan of the recipient MFC, and processed with a custom MATLAB program to determine the surface root mean squared deviation (dRMS) between the native and donor surfaces (Fig 1C), percent area unacceptably proud (>1 mm; %Aproud) and sunken (<-1 mm; %Asunk). Scans were uploaded into DragonFly software where step-off height (hRMS), percent circumference unacceptably proud (>1 mm; %Cproud) and sunken (< -1 mm; %Csunk) were measured (Fig 1D). The process was then repeated for the other allograft plug. Two-way mixed ANOVAs with Sidak corrections for multiple comparisons (α=0.05) were used. Exempt status was obtained from the University’s IRB. Results: Both MFC and LFC plugs showed acceptable step-off heights in all four quadrants. Neither allograft type nor location within the defect had a main effect on step-off height (hRMS). In general, plugs were more unacceptably sunken than proud, though no differences in %Csunk were seen between allograft types or locations within the defect. In LFC plugs, %Cproud was significantly greater laterally (by the intercondylar notch) compared to all other locations around the plug (p<0.0001), while no differences were seen based on location in MFC plugs. The cartilage surface deviationn (dRMS), %Aproud, and %Asunk were not significantly affected by allograft type or location (Table 1). Conclusion: Previous studies demonstrated that contralateral LFCs provide acceptable surface topography matches for centrally located defects of the MFC. In evaluating the utility of LFC allografts for more laterally located lesions characteristic of OCD, it was found that, similarly, allograft type does not have an effect on surface deviation or step-off height. With comparable surface deviations, both MFC and LFC allografts can be expected to present similar stresses on the knee joint and achieve predictably positive clinical outcomes, thus improving donor availability and reducing surgical wait times for matches. LFC plugs did not differ from MFC plugs in overall %Aproud, %Asunk, %Cproud, or %Csunk suggesting that well placed LFC plugs, like MFC plugs, may result in few post-surgical complications. Higher step-off heights of LFC plugs near the intercondylar notch may contribute to higher joint stresses and may serve as an area of focus in future studies. [Figure: see text][Table: see text]

scholarly journals Ultrasonographic Assessment of the Normal Femoral Articular Cartilage of the Knee Joint: Comparison with 3D MRI

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Kyösti Kauppinen ◽  
Victor Casula ◽  
Štefan Zbýň ◽  
Roberto Blanco Sequeiros ◽  
Simo S. Saarakkala ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
Femoral Condyle ◽  
Cartilage Thickness ◽  
Medial Femoral Condyle ◽  
Lateral Femoral Condyle ◽  
3D Mri ◽  
Acoustic Window ◽  
Femoral Cartilage ◽  
Femoral Sulcus ◽  
Thickness Measurements

Objective. Ultrasonography (US) has a promising role in evaluating the knee joint, but capability to visualize the femoral articular cartilage needs systematic evaluation. We measured the extent of this acoustic window by comparing standardized US images with the corresponding MRI views of the femoral cartilage. Design. Ten healthy volunteers without knee pathology underwent systematic US and MRI evaluation of both knees. The femoral cartilage was assessed on the oblique transverse axial plane with US and with 3D MRI. The acoustic window on US was compared to the corresponding views of the femoral sulcus and both condyles on MRI. The mean imaging coverage of the femoral cartilage and the cartilage thickness measurements on US and MRI were compared. Results. Mean imaging coverage of the cartilage of the medial femoral condyle was 66% (range 54%–80%) and on the lateral femoral condyle 37% (range 25%–51%) compared with MRI. Mean cartilage thickness measurement in the femoral sulcus was 3.17 mm with US and 3.61 mm with MRI (14.0% difference). The corresponding measurements in the medial femoral condyle were 1.95 mm with US and 2.35 mm with MRI (21.0% difference), and in the lateral femoral condyle, they were 2.17 mm and 2.73 mm (25.6% difference), respectively. Conclusion. Two-thirds of the articular cartilage of the medial femoral condyle, and one-third in the lateral femoral condyle, can be assessed with US. The cartilage thickness measurements seem to be underestimated by US. These results show promise for the evaluation of the weight-bearing cartilage of the medial femoral condyle with US.

The Effect of a Geographic Lateral Bone Bruise on Knee Inflammation after Acute Anterior Cruciate Ligament Rupture

2000 ◽  
Vol 28 (2) ◽  
pp. 152-155 ◽  
Author(s):  
Darren L. Johnson ◽  
David P. Bealle ◽  
Jefferson C. Brand ◽  
John Nyland ◽  
David N. M. Caborn
Keyword(s):  
Anterior Cruciate Ligament ◽  
Range Of Motion ◽  
Femoral Condyle ◽  
Cruciate Ligament ◽  
Anterior Cruciate Ligament Rupture ◽  
Lateral Femoral Condyle ◽  
Bone Bruise ◽  
Subchondral Fracture ◽  
Ligament Rupture ◽  
Anterior Cruciate

We prospectively evaluated 40 patients who had knee inflammation after isolated anterior cruciate ligament rupture with or without an associated “geographic” bone bruise/subchondral fracture of the lateral femoral condyle. All patients with acute ruptures documented by magnetic resonance imaging within 1 week of injury were evaluated for a geographic bone bruise/subchondral fracture of the lateral femoral condyle. Two groups of 20 patients each (bone bruise versus no bone bruise) were then enrolled. Variables measured at 1, 2, 3, and 4 weeks after injury included pain, range of motion, effusion, and number of days with an antalgic gait. Patients with a bone bruise had increased size and duration of effusion, increased number of days required to nonantalgic gait without external aids, increased days to achieve normal range of motion, and increased pain scores at measured time intervals. This study confirms results of previous clinical and histologic studies showing an associated articular cartilage lesion, otherwise known as bone bruise/subchondral fracture, is clinically significant. There appears to be an association between a geographic bone bruise and increased disability in patients with acute anterior cruciate ligament ruptures. Patients with a geographic bone bruise may require longer to reach normal homeostasis (range of motion, pain, neuromuscular control) before undergoing anterior cruciate ligament reconstruction.

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