Length change pattern of the ankle deltoid ligament during physiological ankle motion

2022 ◽  
Author(s):  
Shengxuan Cao ◽  
Chen Wang ◽  
Chao Zhang ◽  
Jiazhang Huang ◽  
Xu Wang ◽  
...  
Keyword(s):  
Length Change ◽  
Deltoid Ligament ◽  
Ankle Motion ◽  
Change Pattern

Analysis of Graft Length Change Patterns in Medial Patellofemoral Ligament Reconstruction via a Fluoroscopic Guidance Method

2018 ◽  
Vol 46 (5) ◽  
pp. 1150-1157 ◽  
Author(s):  
Takehiko Matsushita ◽  
Daisuke Araki ◽  
Yuichi Hoshino ◽  
Shinya Oka ◽  
Kyohei Nishida ◽  
...  
Keyword(s):  
Medial Patellofemoral Ligament ◽  
Femoral Tunnel ◽  
Length Change ◽  
Lateral View ◽  
Mpfl Reconstruction ◽  
Original Position ◽  
Fluoroscopic Guidance ◽  
Change Pattern ◽  
Radiographic Parameters ◽  
Graft Length

Background: A fluoroscopic guidance method for medial patellofemoral ligament (MPFL) reconstruction has been widely used to determine the anatomic femoral attachment site. Purpose: To examine the graft length change patterns in MPFL reconstruction with a fluoroscopic guidance method. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Forty-four knees of 42 patients who underwent MPFL reconstruction for the treatment of recurrent patellar dislocation were examined prospectively. During surgery, suture anchors were inserted into the proximal one-third and center of the patella. A guide pin for the femoral tunnel was inserted into the position reported by Schöttle et al based on the true lateral view of the knee under fluoroscopic control. Changes in graft length patterns of the proximal and center anchors were examined through 0° to 120° of knee flexion. Favorable changes in length patterns were defined as meeting 2 of 3 criteria: (1) not long during flexion (≤3 mm between 30° and 120° of flexion) and either (2) nearly isometric during flexion between 0° and 90° or (3) slightly long during maximum extension (≤3 mm). Other patterns were considered unfavorable. If the change in length pattern was unfavorable, then the pin for the femoral tunnel was moved to different positions until it was favorable. Knees were separated into the favorable group and the unfavorable group. Differences between the groups regarding radiographic parameters were assessed. Student t test or chi-square test was used for statistical analysis. Results: Of the 44 knees, 31 (70.5%) showed favorable patterns. However, 13 knees (29.5%) showed unfavorable patterns; therefore, the position of the pin was changed. The mean ± SD distance from the original position to the final position was 5.3 ± 1.1 mm distal for 7 patients and 5.2 ± 0.4 mm posterodistal for 6 patients. Technical errors, including a nontrue lateral view and the tip of the wire not being in the determined area, were found for 4 of 13 knees in the unfavorable group. There was no statistical difference in radiographic parameters between the groups. Conclusion: The graft length change pattern could be nonphysiologic at the position determined through the fluoroscopic guidance method; thus, caution may be necessary. The change in length pattern should be checked before graft fixation. If the length change pattern is unfavorable, then it is advisable to move it approximately 5 to 7 mm distally or posterodistally from the first position.

An analysis of the medial patellofemoral ligament length change pattern using open-MRI

2010 ◽  
Vol 18 (11) ◽  
pp. 1470-1475 ◽  
Author(s):  
Tetsuo Higuchi ◽  
Yuji Arai ◽  
Hisatake Takamiya ◽  
Tatsuya Miyamoto ◽  
Daisaku Tokunaga ◽  
...  
Keyword(s):  
Medial Patellofemoral Ligament ◽  
Length Change ◽  
Ligament Length ◽  
Open Mri ◽  
Change Pattern

scholarly journals Validity of intraoperative observation of graft length change pattern for medial patellofemoral ligament reconstruction

2020 ◽  
Vol 21 ◽  
pp. 131-136
Author(s):  
Hiroki Katagiri ◽  
Kazumasa Miyatake ◽  
Toshifumi Watanabe ◽  
Masafumi Horie ◽  
Ichiro Sekiya ◽  
...  
Keyword(s):  
Ligament Reconstruction ◽  
Medial Patellofemoral Ligament ◽  
Length Change ◽  
Medial Patellofemoral Ligament Reconstruction ◽  
Change Pattern ◽  
Graft Length

Simultaneous Strain Measurement With Determination of a Zero Strain Reference for the Medial and Lateral Ligaments of the Ankle

2002 ◽  
Vol 23 (9) ◽  
pp. 825-832 ◽  
Author(s):  
Satoru Ozeki ◽  
Kazunori Yasuda ◽  
Kiyoshi Kaneda ◽  
Kenichi Yamakoshi ◽  
Takahiro Yamanoi
Keyword(s):  
Plantar Flexion ◽  
Full Range ◽  
Length Change ◽  
Anterior Talofibular Ligament ◽  
Neutral Position ◽  
Calcaneofibular Ligament ◽  
Ankle Ligaments ◽  
Ankle Motion ◽  
Ankle Ligament ◽  
Fresh Frozen

The strain changes of the central part of the anterior talofibular ligament (ATFL), the posterior talofibular ligament (PTFL), the calcaneofibular ligament (CFL), and the tibiocalcaneal ligament (TCL) were measured simultaneously for a full range of ankle motion. Twelve fresh frozen amputated ankles were used. To measure the strain changes of the ligaments, a Galium-lndium-filled silastic strain transducer was implanted in the center of each ligament. The zero strain reference was determined immediately after the measurement of strain changes in five of the 12 ankles by tensile testing of each bone-ligament-bone preparation. The maximum strain change of the ATFL, the PTFL, the CFL and the TFL were 7.9%, 5.9%, 5.3% and 5.2%, respectively. The ATFL was elongated in plantar flexion and shortened in dorsiflexion. The PTFL and the CFL were shortened in plantar flexion and elongated in dorsiflexion. The TCL was the longest around the neutral position and became shorter in planter flexion and dorsiflexion. The results showed that the ATFL was taut in plantar flexion over 16.2°, the PTFL and the CFL were taut in dorsiflexion over 18° and 17.8° respectively, and the TCL was taut between 9.5° of dorsiflexion and 9.5° of plantar flexion. The length change pattern was different among the ankle ligaments, although there was only a slight difference between that of the PTFL and the CFL. This study provides fundamental data useful in studying ankle ligament reconstruction.

The influence of thermal acclimation on power production during swimming. I. In vivo stimulation and length change pattern of scup red muscle

2001 ◽  
Vol 204 (3) ◽  
pp. 409-418 ◽  
Author(s):  
L.C. Rome ◽  
D.M. Swank
Keyword(s):  
Steady State ◽  
Power Output ◽  
Low Temperatures ◽  
Beat Frequency ◽  
Length Change ◽  
Change Pattern ◽  
Duty Cycles ◽  
Red Muscle ◽  
Tail Beat

Ectothermal animals are able to locomote in a kinematically similar manner over a wide range of temperatures. It has long been recognized that there can be a significant reduction in the power output of muscle during swimming at low temperatures because of the reduced steady-state (i.e. constant activation and shortening velocity) power-generating capabilities of muscle. However, an additional reduction in power involves the interplay between the non-steady-state contractile properties of the muscles (i.e. the rates of activation and relaxation) and the in vivo stimulation and length change pattern the muscle undergoes during locomotion. In particular, it has been found that isolated scup (Stenotomus chrysops) red muscle working under in vivo stimulus and length change conditions (measured in warm-acclimated scup swimming at low temperatures) generates very little power for swimming. Even though the relaxation of the muscle has slowed greatly, warm-acclimated fish swim with the same tail-beat frequencies and the same stimulus duty cycles at cold temperatures, thereby not affording the slow-relaxing muscle any extra time to relax. We hypothesize that considerable improvement in the power output of the red muscle at low temperatures could be achieved if cold acclimation resulted in either a faster muscle relaxation rate or in the muscle being given more time to relax (e.g. by shortening the stimulus duration or reducing the tail-beat frequency). We test these hypotheses in this paper and the accompanying paper. Scup were acclimated to 10 degrees C (cold-acclimated) and 20 degrees C (warm-acclimated) for at least 6 weeks. Electromyograms (EMGs) and high-speed cine films were taken of fish swimming steadily at 10 degrees C and 20 degrees C. At 10 degrees C, we found that, although there were no differences in tail-beat frequency, muscle strain or stimulation phase between acclimation groups, cold-acclimated scup had EMG duty cycles approximately 20 % shorter than warm-acclimated scup. In contrast at 20 degrees C, there was no difference between acclimation groups in EMG duty cycle, nor in any other muscle length change or stimulation parameter. Thus, in response to cold acclimation, there appears to be a reduction in EMG duty cycle at low swimming temperatures that is probably due to an alteration in the operation of the pattern generator. This novel acclimation probably improves muscle power output at low temperatures compared with that of warm-acclimated fish, an expectation we test in the accompanying paper using the work-loop technique.

scholarly journals Why Determining the Native Length Change Pattern of Medial Patellofemoral Ligament Is Still a Challenge: State-of-the-Art Review of Potential Sources of Heterogeneity within Studies Evaluating Isometry of MPFL

2021 ◽  
Vol 11 (11) ◽  
pp. 4771
Author(s):  
Marcin Mostowy ◽  
Katarzyna Kwas ◽  
Kacper Ruzik ◽  
Magdalena Koźlak ◽  
Adam Kwapisz ◽  
...  
Keyword(s):  
Study Design ◽  
State Of The Art ◽  
Real Life ◽  
Length Change ◽  
Working Environment ◽  
Iliotibial Band ◽  
Trochlear Groove ◽  
Change Pattern ◽  
Number Of Patients ◽  
Potential Sources

Background: In the literature there are divergent results as to the native MPFL length change pattern. The reason for such divergent results may be the heterogeneity of design of studies analyzing MPFL isometry. The hypothesis of this review was that studies assessing MPFL length change pattern are highly heterogenous. The aim was to present a state-of-the-art review of sources of this heterogeneity. Materials and Methods: A total of 816 records were identified through the initial search of MEDLINE and Scopus databases. After eligibility assessment, 10 original articles and five reviews were included. In the included studies, the following 15 potential sources of heterogeneity were assessed: number of patients/cadavers, age, males to females ratio (demographics), identification of measured fibers, measurement method, measurement precision, quadriceps muscle activity, iliotibial band activity, hamstrings activity (study design), patellar height, trochlear or patellar dysplasia, femoral anteversion, mechanical axis of the limb, tibial tubercle–trochlear groove distance, and condylar anteroposterior dimensions (morphology). Each variable was graded in every included article with 1 point if reported precisely and not introducing bias; or with 0 points if reported not precisely, introducing bias, or not reported at all. Results: Within original articles, the highest achieved score was 10 out of 15 possible points with mean score of 6.7, SD = 2.37, and minimum score of just 3 out of 15 points. In the demographics section, mean score was 2.4, SD = 0.8 (80% of maximum possible score of 3); in the study design section it was 3.1, SD = 1.87 (52% of maximum possible score of 6); and in the morphology section it was 1.5, SD = 1.43 (25% of maximum possible score of 6). Conclusions: There is high heterogeneity and incomplete reporting of potential sources of bias in studies assessing native MPFL length change pattern. Future investigators should be aware of the presented factors and their potential impact on MPFL isometry. All methodologic factors should be meticulously reported. Detailed description of demographic data is already a standard; however, authors should more extensively report variables concerning study design and morphology of patients’ patellofemoral joint. Furthermore, future studies should try to meticulously simulate the real-life working environment of MPFL and ensure usage of proper measurement methods.

Maisonneuve fracture

2020 ◽  
Vol 99 (2) ◽  
pp. 77-85
Keyword(s):  
Open Reduction ◽  
Lower Leg ◽  
Fracture Dislocation ◽  
Deltoid Ligament ◽  
Ct Reconstruction ◽  
Distal Fibula ◽  
Ct Examination ◽  
Maisonneuve Fracture ◽  
Fibular Fracture ◽  
Wide Range

Introduction: Maisonneuve fracture (MF) is a generally known entity in ankle trauma. However, details about this type of injury can be found only rarely in the literature. For these reasons we have decided to perform a study on MF epidemiology and pathoanatomy. Methods: The group comprised 70 patients (47 men, 23 women), with the mean age of 48 years, who sustained an ankle fracture-dislocation involving the proximal quarter of the fibula. Ankle radiographs in three views and lower leg radiographs in two views were performed in all patients. A total of 59 patients underwent CT examination in three views, including 3D CT reconstruction in 49 of these patients. MRI was performed in 4 patients. Operative treatment was used in 67 patients; open reduction of the distal fibula into the fibular notch was opted for in 54 of them. Results: The highest MF incidence rate was recorded in the 5th decade in the whole group and in men, while in women the peak incidence was in the 6th decade. After the age of 50, the share of women significantly increased. In 64 cases, the fibular fracture was subcapital, and in 6 cases it involved the fibular head. In 24% of the patients, the fibular fracture was seen only in the lateral radiograph of the lower leg. Widening of the tibiofibular clear space was shown by radiographs in 40 cases. Posterior dislocation of the fibula (Bosworth fracture) and tibiofibular diastasis were recorded in 2 cases each. An injury to the anterior and posterior tibiofibular ligaments was found in all 54 patients with open reduction of the distal fibula. A fracture of the medial malleolus was identified in 27 cases (39%) and a complete lesion of the deltoid ligament in 36 cases (51%); in 7 cases (10%) the medial structures were intact. A fracture of the posterior malleolus occurred in 54 (77%) patients. Osteochondral fracture of the talar dome was diagnosed in 2 patients and compression of the articular surface of the distal tibia in the region of the fibular notch in 1 patient. Conclusion: Maisonneuve fracture includes a wide range of injuries both to bone and ligamentous structures of the ankle. Therefore, CT examination is an indispensable part of assessment of this type of fracture.

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