scholarly journals Evaluation of Hindlimb Deformity and Posture in Dogs with Grade 2 Medial Patellar Luxation during Awake Computed Tomography Imaging while Standing

2021 ◽  
Author(s):  
Yuma Tomo ◽  
Kazuya Edamura ◽  
Atsushi Yamazaki ◽  
Koji Tanegashima ◽  
Mamiko Seki ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Rotation Angle ◽  
External Rotation ◽  
Standing Position ◽  
Control Group ◽  
Standing Posture ◽  
Convergence Angle ◽  
Stifle Joint ◽  
Postural Abnormalities ◽  
Bone Deformities

Abstract Objective The aim of this study was to determine the degree of bone deformities and hindlimb postural abnormalities in a standing position in awake Toy poodles with and without grade 2 medial patellar luxation (MPL) using high speed 320-row computed tomography (CT). Methods The limbs with grade 2 MPL (MPL-G2 group) and without any orthopaedic disorders (control group) were imaged in a standing position, without sedation or anaesthesia, using CT. In MPL-G2 group, images were obtained when the patella was luxated (G2-L group) and reduced (non-luxation, G2-NL group). Bone morphologies of the femur and tibia were quantified three-dimensionally. Hindlimb standing posture was evaluated by measuring femoral rotation and abduction angles, tibial rotation angle, metatarsal rotation angle, foot rotation angle, angle between the femoral anatomical axis and the mechanical axis of hindlimb and stifle joint line convergence angle. Results There were no significant differences in bone morphologic parameters between the MPL-G2 group (5 limbs) and the control group (6 limbs). In the G2-NL group, there were no significant hindlimb postural abnormalities. In contrast, in the G2-L group, significant hindlimb postural abnormalities including external rotation of femur, internal rotation of tibia and foot, external rotation of tarsal joint, large stifle joint convergence angle, genu varum and toe-in standing were observed. Conclusion Dogs with grade 2 MPL have no bone deformities but show abnormal standing posture when the patella is luxated.

The Utility of MRI to Diagnose Ischifemoral Impingement by Assessing the Ischiofemoral and Quadratus Femoris Spaces During Femoral External Rotation

2021 ◽  
Vol 17 ◽  
Author(s):  
Ping Zhang ◽  
Yu Xiang Zhang ◽  
Bao Hai Yu ◽  
Shu Ying Shao ◽  
Xiao Shuai Chen ◽  
...  
Keyword(s):  
Operating Characteristic ◽  
Rotation Angle ◽  
External Rotation ◽  
Control Group ◽  
Case Group ◽  
Neutral Position ◽  
Cutoff Values ◽  
Healthy Control ◽  
Ischiofemoral Space ◽  
Hip Rotation

Objective: The purpose of this study was to explore if the dimensions of the ischiofemoral space on MRI vary with changes in external femoral rotation in Ischifemoral Impingement patients relative to healthy control; if so, to determine the optimal diagnostic cutoff values of these dimensions in Ischifemoral Impingement. Methods: The study included 43 clinically confirmed Ischifemoral Impingement patients and 50 healthy volunteers. All subjects underwent hip MRI examinations with their hips externally rotated at 0°, 30°, and 60°. The IFS and QFS were measured respectively at each angle. The measurements were compared between the IFI group and the control group to determine the optimal diagnostic cutoff values for diagnosing IFI by using IFS and QFS measurements. Results: In the IFI group, the spaces were smaller than those of the control group at all rotation angles (P < 0.05 for each). When external rotation angles were increased, the IFS and QFS tended to decrease. QFSs were smaller in the case group than the control group at each rotation angle. The receiver operating characteristic areas under the curves of IFS and QFS in a neutral position of 0° were highest. Conclusion: Both of the IFS and QFS spaces of IFI patients were found to be smaller than those of the control group, regardless of the external hip rotation angles. A neutral position of 0° was deemed the best position for diagnosing IFI. The diagnostic cutoff values of IFS and QFS were 2.44cm and 1.34cm in the neutral position, respectively.

scholarly journals A biomechanics study about the mechanism of ligaments injury in anterior posterior compression type Ⅱ pelvic injury

2020 ◽  
Author(s):  
xiaolong Shui ◽  
Jianzhong kong ◽  
Yupeng Chu ◽  
Chengwei Zhou ◽  
Shuaibo Sun ◽  
...  
Keyword(s):  
Sacroiliac Joint ◽  
Rotation Angle ◽  
External Rotation ◽  
Pubic Symphysis ◽  
Separation Distance ◽  
Pelvic Injury ◽  
Control Group ◽  
Sacrospinous Ligament ◽  
Restricted Group ◽  
Anterior Posterior

Abstract Background The anterior and posterior compression (APC) pelvis fracture is a classic pelvic injury, and APC type II is considered to be a typical one caused by the destruction of pelvic ligaments, while the mechanism of ligaments injury and treatment of which is still controversial. This study aims to explore ligaments injury in anterior posterior compression(APC)type II pelvic injury. Method: Fourteen human cadaveric pelvis samples (5 female, 9 male) with the sacrospinous, sacrotuberous, anterior sacroiliac ligaments and partial bone retaining unilaterally were made for this study. To simulate the APC pattern pelvic injury, the samples were divided into two groups randomly, set one group as hemipelvis restricted group (experimental group) and the other one as unrestricted group (control group). According to the biomechanical data, eye observation, motion capture system and real-time video system to record the separation distance of the pubic symphysis and anterior sacroiliac joint, external rotation angle and force when the anterior sacroiliac ligament ruptured. Continuing the external rotation violence, observing the bone and posterior ligaments change since sacrospinous and sacrotuberous ligaments from being damaged to completely ruptured. Result When anterior sacroiliac ligament failed, the mean separation distance of pubic symphysis and anterior sacroiliac joint between restricted group and unrestricted group was 28.6 ± 8.4 mm to 23.6 ± 8.2 mm(P = 0.11) and 11.4 ± 3.8 mm to 9.7 ± 3.9 mm (P = 0.30) respectively. In addition, the external rotation angle and force was 33.9 ± 5.5° to 48.9 ± 5.2°(P < 0.01) and 553.9 ± 82.6 N to 756.6 ± 41.4 N (P < 0.01) respectively. The two distances were not significantly different (P > 0.05), however, the external rotation angle and violence was significantly different (P < 0.05), which was bigger in the unrestricted group. In the unrestricted group, when anterior sacroiliac ligament ruptured, no distinct sacrospinous or sacrotuberous ligaments injury was observed, but in the restricted group, all of samples had two ligaments injury and even two samples had ligaments failed. Moreover, with the extreme external rotation violence continuing, there was still no sacrospinous or sacrotuberous ligaments injury in the unrestricted group. But interosseous sacroiliac ligament, posterior sacroiliac ligaments injury and slight sagittal rotation and sacroiliac joint displacement appeared. In the control group, the sacrospinous ligament ruptured firstly and then the sacrotuberous ligament ruptured. When both of the two ligaments failed, the interosseous sacroiliac ligament was damaged while posterior ligament was not. In the restricted group, when all of the anterior sacroiliac ligament, sacrospinous ligament or sacrotuberous ligament failed, mean separation distance of pubic symphysis and anterior sacroiliac joint increased significantly (from 28.6 ± 8.4 to 42.0 ± 7.6 mm, 11.4 ± 3.8 to 16.7 ± 4.2 mm respectively, all P < 0.05). Conclusion We have three main findings: First, pelvic external rotation injury can divide into two situations: hemipelvis is restricted and unrestricted, which result into two different outcomes. When anterior sacroiliac ligament rupture, the unrestricted group needs more external rotation angle and force, without obvious sacrotuberous or sacrospinous ligaments injury. But in the restricted group, both of two ligaments injury appear. Second, when anterior sacroiliac ligament fail, pubic symphysis displacement ranges from 14 to 40 mm, which has a high fluctuation. Third, when the anterior sacroiliac ligament is damaged, we dose not observe the inevitable destruction of the pelvic floor ligaments (sacrospinous ligament and sacrotubercular ligament).

Computed tomographic evaluation of femoral and tibial conformation in English Staffordshire Bull Terriers with and without congenital medial patellar luxation

2017 ◽  
Vol 30 (03) ◽  
pp. 191-199 ◽  
Author(s):  
Katja Voss ◽  
Mark Newman
Keyword(s):  
Computed Tomography ◽  
Clinical Decision Making ◽  
External Rotation ◽  
Femoral Condyle ◽  
Clinical Decision ◽  
Femoral Anteversion ◽  
Femoral Diaphysis ◽  
Control Group ◽  
Anteversion Angle ◽  
Tibial Valgus

SummaryObjective: To compare hindlimb conformation of English Staffordshire Bull Terriers with and without medial patellar luxation using computed tomography.Methods: Hindlimb computed tomography (CT) was performed on six English Staffordshire Bull Terriers with grade II or III medial patellar luxation, and six without medial patellar luxation. Inclination angle, femoral condyle trochanteric angle, anteversion angle (AA), distal anteversion angle (DAA), proximal anteversion angle (PAA), femoral varus angle (FVA), tibial valgus angle (TVA), and tibial torsion angle (TTA) were measured. Student’s T-test was conducted to compare normal limbs to limbs with medial patellar luxation, all limbs of dogs with medial patellar luxation to limbs of the control group, and medial patellar luxation affected limbs (normal limbs of unilaterally affected dogs excluded) to the control group. P-values less than 0.05 were considered significant.Results: Two dogs with medial patellar luxation were only affected unilaterally. Limbs of English Staffordshire Bull Terriers with medial patellar luxation had significantly diminished AA and DAA, in addition to decreased TVA. These differences were similar regardless of how the unaffected limbs from affected dogs were treated in our analysis.Discussion and conclusion: Medial patellar luxation in this population of English Staffordshire Bull Terriers was characterized by a decrease in femoral anteversion, external rotation of the femoral diaphysis, and decreased tibial valgus. These findings may help inform clinical decision making when performing osteotomy for treatment of medial patellar luxation in this breed.

scholarly journals Correlations between intra and extraarticular factors measured by computed tomography in patients with recurrent patellar dislocation

2020 ◽  
Vol 3 (1) ◽  
pp. 20-28
Author(s):  
Georgian Iacobescu ◽  
Adrian Cursaru ◽  
Dan Anghelescu ◽  
Mihnea Popa ◽  
Dan Popescu
Keyword(s):  
Computed Tomography ◽  
Patellar Dislocation ◽  
Rotation Angle ◽  
Tibial Tuberosity ◽  
Tibial Tubercle ◽  
Control Group ◽  
Study Group ◽  
Trochlear Groove ◽  
Tibial Tubercle Osteotomy ◽  
Lateral Patellar Dislocation

AbstractIntroduction: Lateral patellar dislocation (LPD) is a common injury of the knee, most frequent in young patients. It has a multifactorial etiology with several underlying risk factors. In most cases, patellar dislocation occurs on the lateral side, with the rupture of the medial patellofemoral ligament (MPFL), appearing in more than 80% of the cases. The tibial tuberosity-trochlear groove (TT-TG) distance of 20 mm or more in patients with lateral patellar dislocation is a gold standard for the surgical indication of tibial tubercle osteotomy (TTO).Hypothesis: Our investigation aimed to establish whether there is a correlation between the TT-TG distance and other bony landmarks, like trochlear groove medialization, tibial tuberosity lateralization, and knee rotation angle, in the surgical algorithm for the patient with patellar dislocation.Methods: We conducted a prospective study, analyzing and comparing data from two groups, 33 patients with a diagnosis of patellar dislocation, and a control group of 30 patients, with meniscal injury, but healthy contralateral limb. Using computed tomography, we measured the TT-TG distance, femoral anteversion, tibial torsion, knee rotation angle, tuberosity lateralization, and trochlear groove medialization of all the patients in our study. The measurements were conducted by two independent orthopedic surgeons in a randomized manner. Using an unpaired t test, we compared and analyzed each parameters value from the study and the control group.Results: Comparing the two groups, we observed a significant difference for TT-TG distance, knee rotation angle and tibial tuberosity lateralization with higher values in the study group compared to the control group (CI 95% 6.44-9.72, CI 95% 8.64-10.39, CI 95% 3.77-5.46, respectively), with a p value < 0.0001 in all cases. Also, the TT-TG distance positively correlated with knee rotation angle (r=.97, p=0.01) and tibial tuberosity lateralization (r=.86, p=0.0001) in the study group.Conclusions: The TT-TG distance measurement usually defines the lateralization of the tibial tuberosity; yet, in some cases, it can be caused by the trochlear groove medialization, or high rotation between the femur and tibia. Our study revealed that knee rotation and tuberosity lateralization were factors implicated in patellar dislocation and they should be taken into account when making the decision of tibial tubercle osteotomy.

Isolated Lateral Meniscal Tear in the Dog

1988 ◽  
Vol 01 (03/04) ◽  
pp. 152-154
Author(s):  
S. Johnson ◽  
D. Hulse
Keyword(s):  
External Rotation ◽  
Femoral Condyle ◽  
Meniscal Tear ◽  
Lateral Meniscus ◽  
Surgical Excision ◽  
Human Beings ◽  
Stifle Joint ◽  
Microscopic Pathology ◽  
Bucket Handle Tear ◽  
Bucket Handle

degenerative changes of the involved stifle joint associated with a “bucket handle” tear of the caudal body of the lateral meniscus. Surgical excision of the torn section of meniscus was beneficial in the first patient but this patient had persistant difficulty with the leg after exercise. Gross and microscopic pathology of the involved stifle in the second patient showed the meniscal lesion to be associated with severe cartilage fibrillation of the overlying lateral femoral condyle. As in human beings, the mechanism of injury may have been placement of the foot during vigorous external rotation of the femur with the stifle flexed. Extension of the limb from this position could have resulted in an isolated tear of the lateral meniscus.

Computed Tomography-Based Patient-Specific Instrumentation Loses Accuracy with Significant Varus Preoperative Misalignment

2020 ◽  
Author(s):  
Vicente Jesús León-Muñoz ◽  
Mirian López-López ◽  
Alonso José Lisón-Almagro ◽  
Francisco Martínez-Martínez ◽  
Fernando Santonja-Medina
Keyword(s):  
Computed Tomography ◽  
Deformity Correction ◽  
Patient Specific ◽  
Control Group ◽  
X Rays ◽  
Varus Alignment ◽  
Patient Specific Instrumentation ◽  
Conventional Instrumentation ◽  
The Mean ◽  
Valgus Alignment

AbstractPatient-specific instrumentation (PSI) has been introduced to simplify and make total knee arthroplasty (TKA) surgery more precise, effective, and efficient. We performed this study to determine whether the postoperative coronal alignment is related to preoperative deformity when computed tomography (CT)-based PSI is used for TKA surgery, and how the PSI approach compares with deformity correction obtained with conventional instrumentation. We analyzed pre-and post-operative full length standing hip-knee-ankle (HKA) X-rays of the lower limb in both groups using a convention > 180 degrees for valgus alignment and < 180 degrees for varus alignment. For the PSI group, the mean (± SD) pre-operative HKA angle was 172.09 degrees varus (± 6.69 degrees) with a maximum varus alignment of 21.5 degrees (HKA 158.5) and a maximum valgus alignment of 14.0 degrees. The mean post-operative HKA was 179.43 degrees varus (± 2.32 degrees) with a maximum varus alignment of seven degrees and a maximum valgus alignment of six degrees. There has been a weak correlation among the values of the pre- and postoperative HKA angle. The adjusted odds ratio (aOR) of postoperative alignment outside the range of 180 ± 3 degrees was significantly higher with a preoperative varus misalignment of 15 degrees or more (aOR: 4.18; 95% confidence interval: 1.35–12.96; p = 0.013). In the control group (conventional instrumentation), this loss of accuracy occurs with preoperative misalignment of 10 degrees. Preoperative misalignment below 15 degrees appears to present minimal influence on postoperative alignment when a CT-based PSI system is used. The CT-based PSI tends to lose accuracy with preoperative varus misalignment over 15 degrees.

Clinical Study of Qingpeng Ointment Treatment of Shoulder-Hand Syndrome After Cerebral Hemorrhage During the Rehabilitation Period

2020 ◽  
Vol 23 ◽  
Author(s):  
Ruihuan Pan ◽  
Shanshan Ling ◽  
Haodong Yang ◽  
Yan Huang ◽  
Lechang Zhan ◽  
...  
Keyword(s):  
Treatment Group ◽  
Cerebral Hemorrhage ◽  
Clinical Medicine ◽  
External Rotation ◽  
Statistical Significance ◽  
Hand Function ◽  
Tibetan Medicine ◽  
Controlled Study ◽  
Control Group ◽  
The Difference

Background: Shoulder-hand syndrome (SHS) refers to a syndrome causing sudden edema, shoulder pain and limited hand function. Qingpeng ointment, a kind of Tibetan medicine, can reduce swelling, relieve pain, tonify stagnation and clear the meridians, which is consistent with the pathological mechanism of SHS after stroke. Therefore, if clinical trials can be used to explore the effectiveness of Qingpeng ointment for treatment of poststroke SHS and promote its application in clinical medicine, this is of specific significance for the treatment of poststroke SHS. Objective: To investigate the clinical efficacy and safety of Qingpeng ointment in the treatment of poststroke SHS. To provide an objective basis for a better therapeutic treatment for poststroke SHS． Method: A prospective, randomized, controlled study was conducted. This study recruited 120 patients with poststroke SHS who met the inclusion criteria. They were randomized into the treatment group and the control group, with 60 patients allocated to each group. The treatment group received routine medical treatment and rehabilitative care after using the Qingpeng ointment, while the patients in the control group received only routine treatment without the ointment. All patients received clinical assessment with the Visual Analogue Scale (VAS), measurement of the range of motion (ROM) of the upper-limb joints, the Fugl-Meyer Assessment of Upper Extremity (FMA-U) and the Modified Barthel Index Score (MBI) before and after the whole treatment. Results: After 4 weeks of treatment, the VAS scores of both groups were decreased significantly (P＜0.05), and the difference between the two groups was statistically significant (P < 0.05). There is no statistical significance for the difference between the treatment group and control group in terms of the FMA-U and MBI scores and the forward bend, backward, outstretch, external rotation and pronation angles after treatment. The increases in the values of VAS, FMA-M and MBI in the treatment group were greater than those in the control group, and the difference was statistically significant (P < 0.05). The increases in the values of the forward bend, outreach and external rotation angles in the treatment group were greater than those in the control group, and the difference was statistically significant (P < 0.05). Conclusion: The treatment group showed better results than the control group in terms of the relief of pain symptoms, the improvement of motor function and the improvement of the activities of daily living for patients with shoulder-hand syndrome after cerebral hemorrhage. Qingpeng ointment is effective and safe in treating poststroke SHS.

scholarly journals Comparative Morphological Studies of the Stifle Menisci in Donkeys, Goats and Dogs

2019 ◽  
Vol 36 (02) ◽  
pp. 072-084 ◽  
Author(s):  
Mohamed M.A. Abumandour ◽  
Naglaa Fathi Bassuoni ◽  
Samir El-Gendy ◽  
Ashraf Karkoura ◽  
Raafat El-Bakary
Keyword(s):  
Computed Tomography ◽  
Cross Sections ◽  
Medial Meniscus ◽  
Lateral Meniscus ◽  
Current Work ◽  
Medial Condyle ◽  
Morphological Studies ◽  
Stifle Joint ◽  
Meniscofemoral Ligament ◽  
Anatomical Information

AbstractThe present work aims to provide more anatomical information on the stifle joint of the investigated species using computed tomography with gross anatomical cross-sections. The current work analyzed the stifle joint of the pelvic limbs of 12 adult donkeys, goats and dogs of both genders. The medial condyle of the femur was larger than the lateral one in the donkey, while it was smaller and lower than the lateral one in the goat and in the dog. The unsuitable femoral and tibial condyles were adapted by the presence of menisci. In the donkey, the medial meniscus was crescentic in shape, but it was semicircular in the goat, while in the dog, the medial and lateral menisci were C-shaped. In the donkey, the medial meniscus was larger than the lateral one, but in the goat and in the dog, the lateral meniscus was the largest, and more concave and thicker. The lateral meniscus was semicircular in the donkey, but it was shaped like an elongated kidney in the goat. In the goat and in the dog, the central border of two menisci was thin, concave and notched centrally. The meniscal ligaments included cranial and caudal ligaments of the medial and lateral menisci, and meniscofemoral ligament of the lateral meniscus. In the dog, the cranial ligament of the medial meniscus was absent, and the medial meniscus had no bony attachment to the tibia but it attached to the transverse intermeniscal ligament, which connected the cranial horn of the medial meniscus with the cranial ligament of the lateral meniscus. The meniscofemoral ligament connected the caudal pole of the lateral meniscus with the intercondyloid fossa of the femur.

Hip and ankle strength and range of motion in female soccer players with dynamic knee valgus

2021 ◽  
pp. 1-6
Author(s):  
Young Jin Jo ◽  
Young Kyun Kim
Keyword(s):  
Range Of Motion ◽  
Female Athletes ◽  
External Rotation ◽  
Preventive Measure ◽  
Control Group ◽  
Knee Valgus ◽  
Strength Ratio ◽  
Flexion Extension ◽  
Hip Abduction ◽  
Single Leg Squat

BACKGROUND: Dynamic knee valgus (DKV) is a known risk factor for acute and chronic knee injuries and is more frequently diagnosed in females. A real-time single-leg squat test (SLST) could screen for DKV to prevent injuries. OBJECTIVE: To compare the differences in lower extremity strength and range of motion (ROM) in female soccer athletes with and without DKV during an SLST. METHODS: Eighteen subjects with DKV (DKV group) and 18 subjects without DKV (control group) during a single-leg squat were included. Hip strength (flexion, extension, abduction, adduction, internal rotation, and external rotation) was measured with a hand-held dynamometer. Hip ROM (internal and external rotation), and ankle ROM (dorsiflexion with the knee flexed and extended) were measured. Independent t-test was used to compare the averages of the groups. RESULTS: There were significant differences in hip abduction to adduction strength ratio (DKV: 1.48 ± 0.3, control: 1.22 ± 0.26, p< 0.01) and ankle dorsiflexion with knee flexed (DKV: 17.22 ± 6.82, control: 21.22 ± 4.55, p< 0.05) and extended (DKV: 10.14 ± 4.23, control: 14.75 ± 3.40, p< 0.001) between the groups. CONCLUSION: The hip abduction to adduction strength ratio and gastrocnemius and soleus flexibility may be associated factors in dynamic knee valgus and therefore should be assessed and treated, if indicated, as a possible preventive measure in female athletes with this variation.

3D-printed Poly-Lactic Co-Glycolic Acid (PLGA) scaffolds in non-critical bone defects impede bone regeneration in rabbit tibia bone

2021 ◽  
pp. 1-7
Author(s):  
Jin Xi Lim ◽  
Min He ◽  
Alphonsus Khin Sze Chong
Keyword(s):  
Computed Tomography ◽  
Bone Regeneration ◽  
Bone Defect ◽  
Volume Ratio ◽  
Bone Defects ◽  
Control Group ◽  
Micro Computed Tomography ◽  
Rabbit Tibia ◽  
3D Printed ◽  
Critical Bone Defects

BACKGROUND: An increasing number of bone graft materials are commercially available and vary in their composition, mechanism of action, costs, and indications. OBJECTIVE: A commercially available PLGA scaffold produced using 3D printing technology has been used to promote the preservation of the alveolar socket after tooth extraction. We examined its influence on bone regeneration in long bones of New Zealand White rabbits. METHODS: 5.0-mm-diameter circular defects were created on the tibia bones of eight rabbits. Two groups were studied: (1) control group, in which the bone defects were left empty; (2) scaffold group, in which the PLGA scaffolds were implanted into the bone defect. Radiography was performed every two weeks postoperatively. After sacrifice, bone specimens were isolated and examined by micro-computed tomography and histology. RESULTS: Scaffolds were not degraded by eight weeks after surgery. Micro-computed tomography and histology showed that in the region of bone defects that was occupied by scaffolds, bone regeneration was compromised and the total bone volume/total volume ratio (BV/TV) was significantly lower. CONCLUSION: The implantation of this scaffold impedes bone regeneration in a non-critical bone defect. Implantation of bone scaffolds, if unnecessary, lead to a slower rate of fracture healing.

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