scholarly journals Medial Femoral Trochlea Osteochondral Graft: A Quantitative Anatomic Comparison to the Proximal Pole of the Scaphoid

2020 ◽  
Vol 09 (04) ◽  
pp. 283-288
Author(s):  
J. Ryan Hill ◽  
Nathanael Heckmann ◽  
Braden McKnight ◽  
Eric A. White ◽  
Alidad Ghiassi ◽  
...  
Keyword(s):  
Articular Surface ◽  
Three Dimensional ◽  
Critical Factor ◽  
Rank Test ◽  
Radius Of Curvature ◽  
Osteochondral Graft ◽  
Proximal Pole ◽  
Femoral Trochlea ◽  
Articular Surfaces ◽  
Three Dimensional Models

Abstract Background Treatment of scaphoid proximal pole (SPP) nonunion with a vascularized osteochondral graft from the medial femoral trochlea (MFT) has been described, with positive outcomes thus far. However, our understanding of the congruency between the articular surfaces of these structures is incomplete. Objective Our purpose was to evaluate the congruency of the MFT and SPP using a quantitative anatomical approach. Methods The distal femur and ipsilateral scaphoid were dissected from 12 cadavers and scanned with computerized tomography. Three-dimensional models were created and articular surfaces were digitally “dissected.” The radius of curvature (RoC) of the radioulnar (RU) and proximodistal (PD) axes of the SPP and MFT, respectively, as well as the orthogonal axes (SPP, anteroposterior [AP]; MFT, mediolateral [ML]) were calculated. The RoC values were compared using the Wilcoxon signed-rank test. Results The RoC values for the SPP and MFT were not significantly different in the RU–PD plane (p = 0.064). However, RoC values for the SPP and MFT were significantly different in the AP-ML plane (p = 0.001). Conclusions For most individuals, the RU curvature of the SPP was similar to the PD curvature of the MFT. For nearly all individuals, the AP curvature of the SPP and the ML curvature of the MFT shared less congruence. Clinical Relevance Articular surface congruity may not be a critical factor associated with improvements in wrist function following this procedure.

Classification of dysplasia of the femoral trochlea in patients with patellar instability depends on the evaluation plane

2019 ◽  
Vol 4 (6) ◽  
pp. 290-295
Author(s):  
Yuzo Yamada ◽  
Yukiyoshi Toritsuka ◽  
Shuji Horibe ◽  
Norimasa Nakamura ◽  
Kazuomi Sugamoto ◽  
...  
Keyword(s):  
Patellar Instability ◽  
Articular Surface ◽  
Trochlear Dysplasia ◽  
Three Dimensional ◽  
Reference Plane ◽  
Transepicondylar Axis ◽  
Predisposing Factor ◽  
Femoral Trochlea ◽  
Dejour Classification ◽  
Axial View

ObjectiveTrochlear dysplasia is a major predisposing factor of patellar instability (PI). Dysplasia types are generally evaluated using the Dejour classification, but it is unclear whether this classification covers the entire spectrum. The objective of this study was to confirm whether the trochlear types on an axial view categorised according to the classification represent the entire trochlear shape.MethodsNinety knees from 81 patients with PI and 15 knees from 10 healthy volunteers (HVs) were evaluated. Three-dimensional knee models were created by MRIs. The femoral trochlear planes (FTPs) were defined as virtual cross sections including the transepicondylar axis, closer to the perpendicular plane of the articular surface. FTP 0 was defined as the reference plane including the proximal edge of the femoral trochlea and FTP θ as the plane making optional angle θ to FTP 0. Trochlear dysplasia types according to the classification were evaluated at every 10 degrees of FTPs up to 60 degrees (FTP 10, 20, 30, 40, 50 and 60). A trochlea with a sulcus angle <145° was defined as normal. Changes in the trochlear type according to FTPs, and agreement with clinical classification were evaluated.ResultsEighty-six knees (96%) in patients with PI and 12 (80%) in HVs showed changing trochlear types in different FTPs. Patterns of change varied among patients with PI and HVs. This suggests morphological variation of dysplastic trochleae. Agreement of trochlear type on each FTP with the clinically used Dejour classification was 42% on FTP 10, 49% on FTP 20, 33% on FTP 30, 22% on FTP 40, 22% on FTP 50% and 22% on FTP 60 in patients with PI, and 20% at FTP 10, 80% at FTP 20 and 100% on FTP 30 through FTP 60 in HVs. This suggests that the trochlear types in the clinically used plane do not always match the ones on the planes describing the contact surface to the patella.ConclusionThe trochlear types on an axial view provided by the Dejour classification do not represent the entire trochlear geometry. Multiple axial planes should be clinically used to more precisely describe the entire trochlear shape.

Topographic matching of distal radius and proximal fibula articular surface for distal radius osteoarticular reconstruction

2015 ◽  
Vol 41 (6) ◽  
pp. 657-663 ◽  
Author(s):  
H. Zhang ◽  
S. Chen ◽  
Z. Wang ◽  
Y. Guo ◽  
B. Liu ◽  
...  
Keyword(s):  
Distal Radius ◽  
Articular Surface ◽  
Three Dimensional ◽  
Three Dimensional Model ◽  
Optimal Position ◽  
Fibula Graft ◽  
Proximal Fibula ◽  
Articular Surfaces ◽  
Computed Tomography Scanning

During osteoarticular reconstruction of the distal radius with the proximal fibula, congruity between the two articular surfaces is an important factor in determining the quality of the outcome. In this study, a three-dimensional model and a coordinate transformation algorithm were developed on computed tomography scanning. Articular surface matching was performed and parameters for the optimal position were determined quantitatively. The mean radii of best-fit spheres of the articular surfaces of the distal radius and proximal fibula were compared quantitatively. The radial inclination and volar tilt following reconstruction by an ipsilateral fibula graft, rather than the contralateral, best resembles the values of the native distal radius. Additionally, the ipsilateral fibula graft reconstructed a larger proportion of the distal radius articular surface than did the contralateral. The ipsilateral proximal fibula graft provides a better match for the reconstruction of the distal radius articular surface than the contralateral, and the optimal position for graft placement is quantitatively determined.

Medial femoral trochlea flap reconstruction versus proximal row carpectomy for Kienböck’s disease: a morphometric comparison

2021 ◽  
pp. 175319342110318
Author(s):  
Amelia C. Van Handel ◽  
Leigha M. Lynch ◽  
Jimmy H. Daruwalla ◽  
James P. Higgins ◽  
Kari L. Allen ◽  
...  
Keyword(s):  
Three Dimensional ◽  
Proximal Row Carpectomy ◽  
Geometric Morphometric ◽  
Femoral Trochlea ◽  
Kienböck’S Disease ◽  
Kienböck's Disease ◽  
Articular Surfaces ◽  
Surgical Options ◽  
Geometric Morphometric Analysis ◽  
Kienbock’S Disease

Surgical options for advanced Kienböck’s disease include proximal row carpectomy or lunate reconstruction with a medial femoral trochlea osteochondral flap. This study compares morphology of the proximal capitate and the medial femoral trochlear surfaces to the proximal lunate using three-dimensional geometric morphometric analysis. Virtual articular surfaces were extracted from MRI studies of ten healthy volunteers. Distances between corresponding points on the proximal lunate and proximal capitate or medial femoral trochlear surfaces were measured. In seven subjects, mean inter-surface distance for the medial femoral trochlea–proximal lunate pair was significantly lower than the proximal capitate–proximal lunate pairing. In three subjects, mean proximal capitate–proximal lunate distance was significantly lower. We conclude that the medial femoral trochlear flap was anatomically closer to the shape of the proximal lunate in the majority of the examined subjects. However, we found that in three out of ten cases, the proximal capitate was a better match.

scholarly journals Medial Femoral Trochlea Graft for Scaphoid Waist Nonunion: A Case Report and Review of the Literature

2019 ◽  
Vol 09 (03) ◽  
pp. 186-189
Author(s):  
Bruno E. Crepaldi ◽  
Cameron Keating ◽  
Eugene T. Ek ◽  
Stephen K. Y. Tham
Keyword(s):  
Articular Surface ◽  
Scaphoid Fracture ◽  
Donor Site ◽  
Degenerative Change ◽  
Salvage Procedure ◽  
Scaphoid Nonunion ◽  
Review Of The Literature ◽  
Proximal Pole ◽  
Femoral Trochlea ◽  
Special Review

AbstractThe medial femoral trochlea (MFT) of the knee is a donor site for convex osteochondral vascularized bone that has been used for the salvage of fractures of the proximal pole of the scaphoid. Chronic nonunited fractures of the scaphoid may lead to a sequence of degenerative change often referred to as scaphoid nonunion advance collapse. The vascularized MFT osteochondral graft has been reported as a salvage procedure for fractures of the proximal pole of the scaphoid, in situations where fixation is not an option. In this “Special review,” we describe the technique of free vascularized MFT graft in a case in which the nonunited scaphoid fracture was associated with segmental loss of the articular surface of the scaphoid waist. Given the likely progression of arthritis, if left untreated, we elected to treat this by replacing the lost articular surface using a vascularized intercalary osteochondral MFT graft between the nonunited scaphoid segments.

scholarly journals Comparison of Bolton analysis and tooth size measurements obtained using conventional and three-dimensional orthodontic models

2013 ◽  
Vol 07 (S 01) ◽  
pp. S066-S070 ◽  
Author(s):  
Ruhi Nalcaci ◽  
Tolga Topcuoglu ◽  
Firat Ozturk
Keyword(s):  
Three Dimensional ◽  
Repeated Measurements ◽  
Rank Test ◽  
Digital Models ◽  
Signed Rank ◽  
Wilcoxon Signed Rank Test ◽  
Signed Rank Test ◽  
Manual Methods ◽  
Three Dimensional Models ◽  
Plaster Models

ABSTRACT Objectives: The aim of this study was to compare the accuracy, reproducibility, efficacy and effectiveness of measurements obtained using digital models with those obtained using plaster models. Materials and Methods: A total of 20 digital models were produced by the Ortho Three-dimensional Models (O3DM) Laboratory and their software (O3DM version 2) was used to obtain measurements. Identical plaster models were used to obtain measurements of teeth with a vernier caliper. The maximum mesiodistal width of each study model, from first molar to first molar, was measured. All measurements were repeated at least 1 month later by the same operator for both digital and manual methods. The data were analyzed using Cronbach α, Wilcoxon signed rank test and the McNemar test. Results: Cronbach α value of the data at T1 and T2 for 6 anterior and 12 overall teeth measured using the two methods was very close to the ideal value of 1, indicating high intra-observer reliability. The Wilcoxon signed rank test showed statistically significant differences between the two methods (p = 0.000, P < 0.001). The measurements obtained using the digital models were lower than those obtained using the plaster models. No statistically significant differences were found between the two methods for anterior Bolton discrepancies (p = 0.375) or overall Bolton discrepancies (p = 0.00). Paired comparisons of repeated measurements for Bolton ratios showed no statistically significant differences for anterior or overall Bolton discrepancies (p = 0.688 and P = 0.375, respectively). Conclusions: Use of O3DM software is an acceptable alternative to the traditional vernier caliper method in orthodontic practice.

scholarly journals A three-dimensional analysis of the sigmoid notch

2011 ◽  
Vol 3 (2) ◽  
pp. 17 ◽  
Author(s):  
Evan D. Collins ◽  
Faranak Vossoughi
Keyword(s):  
Distal Radius ◽  
Articular Surface ◽  
Three Dimensional ◽  
Distal Radioulnar Joint ◽  
Distal Radius Fractures ◽  
Radius Of Curvature ◽  
Radius Fractures ◽  
Sigmoid Notch ◽  
Radiocarpal Joint ◽  
Dimensional Reconstruction

Fractures of the distal radius are among the most common injuries of the upper extremity, though treatment has traditionally focused on restoration of the radiocarpal joint and late sequelae may persist. X-ray imaging underestimates sigmoid notch involvement following distal radius fractures. No classification system exists for disruption patterns of the sigmoid notch of the radius associated with distal radius fractures. This study quantifies the anatomy of the sigmoid notch and identifies the landmarks of the articular surface and proximal boundaries of the distal radioulnar joint (DRUJ) capsule. Computed tomography scans of freshly frozen cadaveric hands were used - followed by dissection, and three-dimensional reconstruction of the distal radius and sigmoid notch. The sigmoid notch surface was divided into two surfaces and measured. The Anterior Posterior (AP) and Proximal Distal (PD) widths of the articulating surface were reviewed, along with the radius of curvature, version angle and depth. The study showed that the sigmoid notch is flatter than previously believed - and only the distal 69% of its surface is covered by cartilage. On average, it has about nine degrees of retroversion, and its average inclination is almost parallel to the anatomical axis of the radius. Clinical implications exist for evaluation of the DRUJ involvement in distal radius fractures or degenerative diseases and for future development and evaluation of hemiarthroplasty replacement of the distal radius.

A B-Spline Least-Squares Surface-Fitting Method for Articular Surfaces of Diarthrodial Joints

1993 ◽  
Vol 115 (4A) ◽  
pp. 366-373 ◽  
Author(s):  
G. A. Ateshian
Keyword(s):  
Least Squares ◽  
Articular Surface ◽  
Three Dimensional ◽  
Surface Fitting ◽  
B Spline ◽  
Spline Surface ◽  
Articular Surfaces ◽  
Diarthrodial Joint ◽  
Surface Data ◽  
Fitting Method

The B-spline least-squares surface-fitting method is employed to create geometric models of diarthrodial joint articular surfaces. This method provides a smooth higher-order surface approximation from experimental three-dimensional surface data that have been obtained with any suitable measurement technique. Akima’s method for surface interpolation is used to provide complete support to the B-spline surface. The surface-fitting method is successfully tested on a known analytical surface, and is applied to the human distal femur. Applications to other articular surfaces are also shown. Results show that this method is precise, highly flexible, and can be successfully applied to a large variety of articular surface shapes.

scholarly journals Sex- and age-related variations in the three-dimensional orientations and curvatures of the articular surfaces of the human talus

2020 ◽  
Author(s):  
Shuhei Nozaki ◽  
Kota Watanabe ◽  
Atsushi Teramoto ◽  
Tomoaki Kamiya ◽  
Masaki Katayose ◽  
...  
Keyword(s):  
Computer Tomography ◽  
Articular Surface ◽  
Three Dimensional ◽  
The Elderly ◽  
Ct Images ◽  
Planar Approximation ◽  
Articular Surfaces ◽  
Age Related ◽  
Principal Axes ◽  
High Prevalence

Abstract Background The high prevalence of foot pathologies in women and the elderly is suggested to be linked to sex- and age-related differences in the calcaneal morphology. Given that, it is expected that there also exists sex- and age-related differences of the articular morphology in the keystone of the foot, the talus. The present study investigated the orientation and curvature of the three articular surfaces of the talus in relation to sex and age based on computer tomography (CT). Methods The CT images of 56 feet were used in this study. The orientations of the talocrural, subtalar, and talonavicular joints were quantified three-dimensionally by calculating normal and principal axes of the articular surfaces defined by planar approximation. The curvature radii of the articular surfaces were also quantified by cylindrical and spherical approximations. Results The talonavicular surface was significantly more twisted and less internally rotated in females than in males. With aging, the subtalar articular surface was significantly facing more posteriorly. Moreover, it was found that the curvature radii of the trochlea and navicular articular surfaces significantly increased with aging, indicating the flattening of the articular surfaces. Conclusion The sex- and age-related differences in talar articular morphology were observed. The substantial degeneration pattern of the talar morphology with aging could potentially lead to a higher prevalence of foot disorders in the elderly.

Morphological Measurements of the Proximal Interphalangeal Joint

2004 ◽  
Vol 29 (3) ◽  
pp. 242-247 ◽  
Author(s):  
T. LAWRENCE ◽  
I. A. TRAIL ◽  
J. NOBLE
Keyword(s):  
Articular Surface ◽  
Proximal Phalanx ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Implant Design ◽  
Radius Of Curvature ◽  
Middle Phalanx ◽  
Photographic Technique ◽  
Articular Surfaces ◽  
Palmar Surface

The morphology of the proximal interphalangeal joint was determined using a photographic technique. The head of the proximal phalanx, viewed end on, has a complex trapezoid appearance characteristic for each named digit. The asymmetric condyles diverge from one another and are separated by an intercondylar groove that increases in depth from the dorsal to the palmar surface. Saggital sections of the head of the proximal phalanx are not circular, but, sections taken in the plane of maximum dimensions of the condyle are circular with a radius of curvature of approximately one half of the height of the condyles. The articular surface of the base of the middle phalanx is not circular in outline in either the saggital or coronal plane. In coronal sections the articular surface is biconcave convex with a prominent median ridge separating the two adjacent concave articular surfaces. The implications of this varied morphology on implant design are discussed.

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