scholarly journals Sub-SMAS Transposition of the Buccal Fat Pad

2019 ◽  
Author(s):  
Ozan Bitik
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Images ◽  
Surface Measurement ◽  
Fat Pad ◽  
Buccal Fat Pad ◽  
Level Of Evidence ◽  
Curvilinear Surface ◽  
3 Dimensional ◽  
Volume Deficit ◽  
Dimensional Models

AbstractBackgroundRegardless of the technique chosen to treat the aging midface, the isolated lateral approach facelift has a limited impact on the midface volume deficit. In an effort to overcome this limitation, modern facial rejuvenation procedures incorporate an additional modality for replenishing the midface volume. Some of the author’s facelift patients present with bulging buccal fat pads despite volume deficiency in the inframalar region. The author’s technique is designed to utilize the buccal fat pad to replenish the inframalar volume deficit.ObjectivesThe author sought to present the fat pad transposition surgical technique along with objective outcome data.MethodsThis study was a retrospective review of nonconsecutive cases where the sub-superficial-musculo-aponeurotic-system transposition of the buccal fat pad was performed. A total of 22 patients underwent the fat pad transposition technique by the author (O.B.) between July 2013 and December 2017. Patient data were obtained from patient records, 3-dimensional models, magnetic resonance images, and standardized photography. Preoperative differences in midface volume were assessed utilizing curvilinear surface measurements on 3-dimensional models and the Allergan midface volume deficit scale on standardized photography.ResultsThe average midface volume deficit score significantly improved, and the average midfacial curvilinear surface measurement significantly increased after surgery. Magnetic resonance imaging confirmed a stable position of the buccal fat pad after surgery.ConclusionsThe sub-superficial-musculo-aponeurotic-system transposition of the buccal fat pad is an effective technique that can be safely employed for autologous inframalar augmentation in patients with a favorable facial morphology.Level of Evidence: 4

Comparing Tendinous and Ligamentous Ankle Pathology in Atraumatic Overweight and Nonoverweight Patients

2014 ◽  
Vol 7 (6) ◽  
pp. 449-456 ◽  
Author(s):  
Melissa M. Galli ◽  
Nicole M. Protzman ◽  
Eiran M. Mandelker ◽  
Amit Malhotra ◽  
Edward Schwartz ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Magnetic Resonance ◽  
Present Report ◽  
Case Series ◽  
Magnetic Resonance Images ◽  
Exclusion Criteria ◽  
Level Of Evidence ◽  
Prevalence Of Obesity ◽  
Prospective Longitudinal ◽  
Prospective Longitudinal Cohort

With the increased prevalence of obesity, there has been a parallel rise in musculoskeletal disorders. However, the effect of body mass index (BMI) on pathology of the hindfoot and ankle is scarcely understood. The purpose of the present report was to compare the number of tendinous and ligamentous pathologies within the hindfoot and ankle between overweight (BMI ≥ 25.00 kg/m2) and nonoverweight (BMI < 25.00 kg/m2) atraumatic patients. We hypothesized that overweight patients would demonstrate more tendinous and ligamentous pathologies compared with their nonoverweight counterparts. Five hundred consecutive magnetic resonance images were reviewed. One hundred eight patients met the inclusion and exclusion criteria. Sixty-six patients were overweight and 42 patients were nonoverweight. Ninety-eight percent of overweight patients demonstrated pathology of a tendinous or ligamentous nature, whereas 62% of nonoverweight patients demonstrated pathology of a tendinous or ligamentous nature. Thus, the prevalence of pathology was 1.59 times higher among overweight patients compared with nonoverweight patients. Moreover, controlling for age, overweight patients demonstrated approximately twice as many tendinous and ligamentous pathologies compared with nonoverweight patients (adjusted mean ± SD = 4.44 ± 2.14 vs 1.98 ± 2.07, respectively), which was statistically significantly different ( P < .001). To definitively assess causation and the clinical evolution of hindfoot and ankle pathology, prospective, longitudinal cohort studies are warranted. Level of Evidence: Diagnostic, Level III: Case series

Osteochondral Transplantation in the Elbow Leads to Good Clinical and Radiologic Long-term Results

2011 ◽  
Vol 39 (12) ◽  
pp. 2619-2625 ◽  
Author(s):  
Stephan Vogt ◽  
Sebastian Siebenlist ◽  
Daniel Hensler ◽  
Lizzy Weigelt ◽  
Patrick Ansah ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Case Series ◽  
Magnetic Resonance Images ◽  
Weight Lifting ◽  
Long Term Results ◽  
Osteochondral Lesions ◽  
Osteochondral Transplantation ◽  
Level Of Evidence

Background: In the long-term follow-up after debridement, microfracture, or drilling of osteochondral lesions in the elbow, subsequent osteoarthritis is a problem. Osteochondral transplantation for these defects has become a more common procedure. However, long-term results are unknown. Purpose: This study was undertaken to evaluate long-term clinical and radiologic outcomes of advanced osteochondral lesions in the elbow treated with osteochondral transplantation. Study Design: Case series; Level of evidence, 4. Methods: The study included 8 patients with osteochondral lesions in the elbow who were treated by autologous osteochondral transplantation between 1996 and 2002. Patients (average age, 17 years) were evaluated pre- and postoperatively by Broberg-Morrey score to assess elbow function and by American Shoulder and Elbow Surgeons (ASES) score for pain analysis. In addition, radiographs (at the first postoperative day, and at 5-year and 10-year follow-up) and magnetic resonance images (8 to 12 weeks postoperatively, and at 5-year and 10-year follow-up) were made to evaluate the joint status. At last follow-up (range, 8-14 years postoperatively), 7 of 8 patients were seen for clinical examination and radiologic analysis. Results: The Broberg-Morrey score increased from an average of 75.9 ± 13.1 to 96.4 ± 2.4 and ASES score significantly improved as follows: worst pain, 7.9 ± 1.1 to 1.6 ± 1.9; rest pain, 3.14 ± 2.7 to 0.6 ± 1.5; weight-lifting pain, 7.6 ± 0.8 to 3.1 ± 1.6; and repetitive movement pain, 5.3 ± 2.4 to 1.6 ± 1.5. Compared with the contralateral side, there was a mean preoperative flexion lag of 12.5° ± 11.6°. At the final follow-up, flexion was free. The mean extension lag was reduced from average 5.4° ± 5.7° to 0°. Radiographs of 2 patients made at final follow-up showed mild signs of osteoarthritis (Kellgren and Lawrence grade I). Postoperative magnetic resonance images showed graft viability in all and a congruent chondral surface in 6 of 7 patients. Conclusion: Clinical long-term results after osteochondral transplantation in the elbow are good to excellent and comparable with midterm results in the literature. Therefore, this technique is a reliable option for satisfactory long-term results regarding treatment of advanced osteochondral lesions in the elbow.

Assessment of mandibular growth and response to orthopedic treatment with 3-dimensional magnetic resonance images

2005 ◽  
Vol 128 (1) ◽  
pp. 16-26 ◽  
Author(s):  
Lucia H.S. Cevidanes ◽  
Alexandre A. Franco ◽  
Guido Gerig ◽  
William R. Proffit ◽  
Dennis E. Slice ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Images ◽  
Orthopedic Treatment ◽  
Mandibular Growth ◽  
3 Dimensional

Quadriceps fat pad edema: significance on magnetic resonance images of the knee

2006 ◽  
Vol 35 (5) ◽  
pp. 269-274 ◽  
Author(s):  
Nogah Shabshin ◽  
Mark E. Schweitzer ◽  
William B. Morrison
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Images ◽  
Fat Pad

scholarly journals An Unusual Cause of Posterior Elbow Impingement: Detachment of a Hypertrophied Posterior Fat Pad

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Daisuke Hamada ◽  
Tetsuya Matsuura ◽  
Kosuke Sugiura ◽  
Tadahiro Higuchi ◽  
Naoto Suzue ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Images ◽  
Differential Diagnoses ◽  
Fat Pad ◽  
Full Extension ◽  
Elbow Arthroscopy ◽  
Elbow Pain ◽  
Left Elbow ◽  
Posterior Impingement ◽  
The Right

We report a case of a 47-year-old woman who developed posterior impingement of the elbow due to detachment of a hypertrophied posterior fat pad. She reported acute left elbow pain after leaning back onto a hard object with her hand and subsequently experienced a “catching” sensation. Comparison with the magnetic resonance images of a normal elbow revealed a hypertrophied posterior fat pad interposed between the olecranon and olecranon fossa in both elbows, with the fat pad in the left elbow located more inferiorly than that in the right elbow. Elbow arthroscopy showed the olecranon fossa covered by the fat pad, a portion of which was detached from the rest of the pad. Debridement of the detached portion was performed until no impingement was evident. Postoperatively, full extension of the elbow did not elicit pain. Clinicians should include this pathology among the differential diagnoses for posterior elbow pain.

scholarly journals Preliminary diagnosis of medial meniscus posterior root tears using the Rosenberg radiographic view

2019 ◽  
Vol 31 (1) ◽  
Author(s):  
Yuya Kodama ◽  
Takayuki Furumatsu ◽  
Yusuke Kamatsuki ◽  
Takaaki Hiranaka ◽  
Tomohiro Takahata ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Medial Meniscus ◽  
Femoral Condyle ◽  
Weight Bearing ◽  
Magnetic Resonance Images ◽  
Control Group ◽  
Posterior Root ◽  
Level Of Evidence ◽  
Group A ◽  
Group B

Abstract Purpose To verify the effectiveness of detecting medial meniscus posterior root tears (MMPRTs) using weight-bearing posterior-anterior (PA) radiographs. Materials and methods Twenty-three patients were diagnosed with an MMPRT using magnetic resonance imaging (Group A), with 23 matched individuals forming the control group (Group B). The distance between medial tibial eminence and the lateral edge of the medial femoral condyle (MTE–MFC distance) and medial joint space (MJS) width were measured on weight-bearing PA radiographs, with the knee flexed at 45° (Rosenberg view). Absolute medial meniscus extrusion (MME) was measured on magnetic resonance images. Results The MTE–MFC distance was greater and the MJS width was smaller in Group A than Group B (7.7 ± 1.7 mm versus 6.0 ± 1.24 mm and 3.2 ± 0.8 mm versus 4.5 ± 0.7 mm, respectively; P < 0.05). The MTE–MFC distance and MJS width correlated with MME (r = 0.603 and 0.579, respectively; P < 0.05), and the extent of MME was greater in Group A than Group B (4.1 ± 1.1 mm versus 1.8 ± 1.5 mm, respectively; P < 0.05). Conclusions MMPRTs increase the MTE–MFC distance and decrease the MJS width, with these measurements correlating to the MME. Therefore, measurement of the MTE–MFC distance and MJS width on the Rosenberg view could be a useful preliminary method for the diagnosis of an MMPRT. Level of evidence IV

scholarly journals Decreasing the Abnormal Internally Rotated Talus After Lateral Ankle Stabilization Surgery

2021 ◽  
Vol 9 (8) ◽  
pp. 232596712110234
Author(s):  
Hong-Yun Li ◽  
Li Cao ◽  
Hong Li ◽  
Ying-Hui Hua ◽  
Shi-Yi Chen
Keyword(s):  
Magnetic Resonance ◽  
Internal Rotation ◽  
Ankle Instability ◽  
Magnetic Resonance Images ◽  
Ligament Repair ◽  
Lateral Instability ◽  
Level Of Evidence ◽  
Lateral Ankle ◽  
Significant Difference ◽  
Before And After

Background: Increased internal rotation of the talus has been found in patients with mechanical ankle instability (MAI). Purpose/Hypothesis: To evaluate and compare the talar rotation position before and after lateral ankle lateral stabilization surgery in patients with MAI. We hypothesized that the abnormal internal talus rotation in patients with MAI will decrease after surgery for ankle lateral instability and that there will be no significant difference in internal talus rotation between the ligament repair and reconstruction groups. Study Design: Case-control study; Level of evidence, 3. Methods: We retrospectively studied 56 patients with MAI who underwent ankle lateral stabilization surgery after arthroscopic evaluation (repair, 36 cases; reconstruction, 20 cases). Before and after the operation, magnetic resonance images of all the participants were reviewed. The rotated position of the talus was measured and calculated by the Malleolar Talus Index at the magnetic resonance axial plane. Results: The internal rotation of the talus decreased significantly after ankle lateral stabilization surgery in patients with MAI as compared with before surgery (mean ± SD, 83.3° ± 3.3° vs 86.7° ± 3.9°; P < .01). However, there was no statistically significant difference between the ligament repair and reconstruction groups before or after the operation. Conclusion: Abnormal internal rotation of the talus in patients with MAI was decreased after ankle lateral stabilization surgery.

scholarly journals Do Sex-Specific Differences Exist in ACL Attachment Location? An MRI-Based 3-Dimensional Topographic Analysis

2020 ◽  
Vol 8 (11) ◽  
pp. 232596712096447
Author(s):  
Dimitris Dimitriou ◽  
Zhongzheng Wang ◽  
Diyang Zou ◽  
Naeder Helmy ◽  
Tsung-Yuan Tsai
Keyword(s):  
Risk Factor ◽  
Female Athletes ◽  
Cruciate Ligament ◽  
Magnetic Resonance Images ◽  
Acl Rupture ◽  
Level Of Evidence ◽  
Predisposing Factor ◽  
Topographic Analysis ◽  
3 Dimensional ◽  
Flexion Extension

Background: Female sex is an independent risk factor for an anterior cruciate ligament (ACL) injury, as the incidence of an ACL rupture is 4- to 6-fold higher in female athletes compared with their male counterparts. The ACL attachment location as a potential risk factor for the increased ACL rupture rate in women has never been reported in the literature. Purpose/Hypothesis The purpose of the present study was to investigate the 3-dimensional topographic anatomy of the ACL bundle attachment in female and male patients, with and without an ACL rupture, and identify potential sex-related differences. We hypothesized that the ACL attachment location would be significantly different between men and women, in both the intact- and ruptured-ACL states. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Magnetic resonance images of the knee from 90 patients (55 men, 35 women) with a ruptured ACL and 90 matched controls (55 men, 35 women), who suffered a noncontact knee injury without ACL rupture, were used to create 3-dimensional models of the femur and tibia. The ACL bundles’ origin and insertion were outlined on each model, and their location was measured using an anatomical coordinate system. A 2-way analysis of variance was used to compare the ACL attachment location between male and female patients, with and without an ACL rupture. Results: No significant differences were found between female and male participants regarding ACL attachment location (femoral origin and tibial insertion). Patients with a ruptured ACL demonstrated a significantly different ACL origin compared with the participants with an intact ACL by an average difference of 8.9% more posterior ( P < .05) and 4.0% more proximal ( P < .05) in men and 13.0% more posterior ( P < .05) and 5.5% more proximal ( P < .05) to the flexion-extension axis of the knee in women. Conclusion: The ACL attachment location should not be considered a risk factor for the increased ACL rupture rates in female compared with male athletes. However, a more posterior and proximal location of the femoral ACL origin might be a predisposing factor to an ACL rupture regardless of sex.

Buccal Fat Pad Excision: Hydrodissection Technique

2019 ◽  
Vol 39 (10) ◽  
pp. 1037-1045 ◽  
Author(s):  
Luis C Valencia ◽  
Giovanny F Pérez ◽  
Jordan Kaplan ◽  
Ricardo Fernández-Riera
Keyword(s):  
Postoperative Pain ◽  
Operative Time ◽  
Fat Pad ◽  
Buccal Fat Pad ◽  
Level Of Evidence ◽  
Pain Scores ◽  
Randomized Clinical Study ◽  
Maximum Pain ◽  
Group A ◽  
Group B

Abstract Background Buccal fat pad (BFP) excision is a procedure in which the fat pad is extracted in order to achieve a more youthful appearance. Objectives The aim of this study was to describe an alternative technique that utilizes hydrodissection to extract the BFP. Methods This is a controlled, prospective, randomized clinical study involving 2 groups. Group A (n = 27) underwent BFP excision with hydrodissection, during which 15 mL of a vasoconstricting anesthetic solution was injected into the BFP. Group B (n = 27) underwent BFP excision, during which 3 mL of lidocaine 2% with epinephrine was injected. All procedures were performed by the same surgeon. Variables analyzed were surgical time, intraoperative bleeding, and postoperative pain directly following surgery 2 hours after the procedure, as well as maximum pain within 72 hours of surgery and complications. Postoperative care was standardized, and patient follow-up extended over a 6-month period. Results Pain scores for 54 patients were recorded on a visual analog scale (0–10). Mean ± standard deviation transoperative pain scores were 0.5 ± 0.8 for Group A and 1.3 ± 1.3 for Group B (P = 0.01); 2 hours postoperation the scores were 1.2 ± 0.7 for Group A and 2.6 ± 1 for Group B (P < 0.0001). Maximum pain occurred within 72 hours, and scored 1.6 ± 0.6 for Group A and 3.1 ± 1 for Group B (P < 0.0001). Mean operative time was 8:18 ± 0:47 minutes for Group A and 14:08 ± 2:28 minutes for Group B (P < 0.0001). There was a positive correlation between operative time and pain. Overall, 5.5% of patients suffered postoperative complications. Conclusions BFP excision by hydrodissection is an effective procedure that decreases surgical times by facilitating extraction of the BFP with less manipulation, thereby resulting in decreased postoperative pain and a more tolerable recovery. Level of Evidence: 2

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