scholarly journals 728 Histomorphology Of the Subregions of The Scapholunate Interosseous Ligament and Its Enthesis

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
M Y Liew ◽  
J W Mortimer ◽  
J Z Paxton ◽  
S Tham ◽  
P A Rust
Keyword(s):  
Articular Cartilage ◽  
Wrist Joint ◽  
Surgical Reconstruction ◽  
Mechanical Function ◽  
Interosseous Ligament ◽  
Graft Incorporation ◽  
Outstretched Hand ◽  
Biomechanical Force ◽  
Fresh Frozen ◽  
Joint Biomechanics

Abstract Introduction The scapholunate interosseous ligament (SLIL) is commonly ruptured following a fall onto the outstretched hand. This ligament has three subregions: dorsal, proximal, and volar. The SLIL enthesis, a specialised region where this ligament attaches to the scaphoid and lunate, has not previously been studied despite its important mechanical function in the wrist joint biomechanics. This study therefore aims to compare the histomorphological differences between the three SLIL subregions, including at their entheses, to inform subregion prioritisation during surgical reconstruction. Method Twelve fresh-frozen human cadaveric wrists were dissected and the gross dimensions of the SLIL subregions measured. Subregions were histologically processed for analysis, including quantification of enthesis calcified fibrocartilage (CF) area. Results From the gross measurements, the dorsal subregion was the thickest (dorsal=3.04 ± 0.26mm, volar=1.69 ± 0.08mm, proximal=1.51 ± 0.06mm). The dorsal and volar subregions had fibrocartilaginous entheses while the proximal subregion was attached to articular cartilage. The dorsal subregion had significantly more CF than the volar subregion. Conclusions The dorsal subregion is the thickest and has the greatest CF area, which is consistent with the greatest biomechanical force subjected to this subregion. These results confirm that the dorsal subregion is the strongest subregion, suggesting important implications in the study of graft incorporation during SLIL reconstruction.

scholarly journals Histomorphology of the Subregions of the Scapholunate Interosseous Ligament and Its Enthesis

2021 ◽  
Author(s):  
Mei Yen Liew ◽  
Jeremy W. Mortimer ◽  
Jennifer Z. Paxton ◽  
Stephen Tham ◽  
Philippa A. Rust
Keyword(s):  
Articular Cartilage ◽  
Wrist Joint ◽  
Mechanical Function ◽  
Interosseous Ligament ◽  
Biomechanical Force ◽  
Significant Difference ◽  
Fresh Frozen ◽  
Joint Biomechanics ◽  
Morphological Differences ◽  
Biomechanical Forces

AbstractBackground The scapholunate interosseous ligament (SLIL) has three subregions: dorsal, proximal, and volar. The SLIL enthesis has not previously been studied despite its important mechanical function in wrist joint biomechanics.Questions/Purposes This study aims to compare the histomorphological differences between the SLIL subregions, including at their entheses. Three questions are explored: Do the gross dimensions differ between SLIL subregions? Does the enthesis qualitatively, and its calcified fibrocartilage (CF) quantitatively, differ between (a) SLIL subregions and (b) scaphoid and lunate attachments?Methods Twelve fresh-frozen human cadaveric wrists were dissected and the gross dimensions of the SLIL subregions measured. Subregions were histologically processed for morphological and compositional analyses, including quantification of enthesis CF area.Results The dorsal subregion was the thickest. The dorsal and volar subregions had fibrocartilaginous entheses, while the proximal subregion was attached to articular cartilage. The dorsal subregion had significantly more CF than the volar subregion. There was no significant difference in the enthesis CF between scaphoid and lunate attachments in the three subregions.Conclusions There are significant morphological differences between the SLIL subregions. The dorsal subregion has the largest amount of CF, which is consistent with the greater biomechanical force subjected to this subregion. The similar histomorphology of the ligament at the scaphoid and lunate entheses suggests that similar biomechanical forces are applied to both attachments.Clinical Relevance The histomorphological results confirm that the dorsal subregion is the strongest of the three subregions. The results from the entheseal region may have important implications in the study of graft incorporation during SLIL reconstruction.

Can a Polycarbonate-Urethane Meniscal Implant Protect Articular Cartilage? Histopathological Results in a Sheep Model

2009 ◽  
Author(s):  
Eran Linder-Ganz ◽  
Gal Zur ◽  
Jonathan Shani ◽  
Jonathan J. Elsner ◽  
Ori Brenner ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
Knee Joint ◽  
Clinical Studies ◽  
Load Distribution ◽  
Degenerative Arthritis ◽  
Sheep Model ◽  
Polycarbonate Urethane ◽  
Fresh Frozen ◽  
Joint Biomechanics ◽  
Histopathological Results

The menisci play an important role in the knee joint biomechanics [1]. Clinical studies have shown that the loss of the meniscus leads to degenerative arthritis attributed to the changes in load distribution and the loss of proprioception [2]. Clearly, there is a substantial need to protect the articular cartilage by either repairing or replacing the menisci. There are many difficulties dealing with both fresh frozen or cryopreserved allograft menisci, and the complexities of meniscal repairs may contribute to uneven distribution of load, instability and recurrence of degenerative damage. Hence there is a need for the development of an artificial meniscus that is available at the time of surgery in several sizes that can accommodate most patients.

Posterior Cruciate Ligament Femoral Insertion Site Characteristics: Importance for Reconstructive Procedures

2002 ◽  
Vol 30 (5) ◽  
pp. 643-651 ◽  
Author(s):  
Etienne A. Mejia ◽  
Frank R. Noyes ◽  
Edward S. Grood
Keyword(s):  
Articular Cartilage ◽  
Posterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Insertion Site ◽  
Femoral Shaft ◽  
Surgical Reconstruction ◽  
Anatomic Study ◽  
Reconstructive Procedures ◽  
Femoral Attachment ◽  
Site Characteristics

Background: Previous descriptions of the insertion site of the posterior cruciate ligament are inadequate. Hypothesis: More than one reference system is required to adequately represent the anatomy of the femoral attachment. Study Design: Descriptive anatomic study. Methods: Twelve cadaveric specimens were evaluated by using two measurement methods relative to the femoral articular cartilage margin and two methods relative to the intercondylar femoral roof. Results: Reference lines perpendicular to the articular cartilage best defined the 12- and 1-o'clock positions, and those perpendicular to the articular cartilage or parallel to the femoral shaft best defined the 2-, 3-, and 4-o'clock positions. The angle of the proximal attachment to the roof was 88° ± 5.5°. The posterior cruciate ligament was a continuum of fibers rather than two distinct bundles, and its attachment showed variability in shape and thickness, extending past the midline in the notch (11:21 ± 15 minutes to 4:12 ± 20 minutes, right knee). Conclusions: More than one measurement system is required to accurately describe the femoral origin of the posterior cruciate ligament. Clinical Relevance: Accurate assessment of the anatomy is crucial for successful surgical reconstruction of the posterior cruciate ligament femoral attachment.

scholarly journals First Tarsometatarsal Joint Shape and Orientation

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0020
Author(s):  
Cesar de Cesar Netto ◽  
Jackson Staggers ◽  
Walter Smith ◽  
Sung Lee ◽  
Sierra Phillips ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
Joint Angle ◽  
Frontal Plane ◽  
Cadaveric Specimen ◽  
X Ray ◽  
Horizontal Orientation ◽  
Medial Cuneiform ◽  
Flat Shape ◽  
Fresh Frozen ◽  
Joint Shape

Category: Bunion Introduction/Purpose: Studies have demonstrated that patients with hallux valgus (HV) deformities have increased mobility in the first tarsometatarsal (TMT) joint. Anatomical factors widely considered to play a role in the instability are shape and frontal plane orientation of the joint. An oblique rather than horizontal orientation of the articular surfaces and a round shape, rather than a flat shape, are believed to predispose to the deformity. The purpose of this study was to assess whether the shape and angulation of the first TMT joint are affected by the positioning of the foot and orientation of the x-ray beam. Methods: Ten adult above knee fresh frozen cadaveric specimens were used, with a mean age of 79.9 (range, 54-88) years. There were no clinical forefoot deformities noted in any of the feet. One of the specimens had moderate ankle arthritis and one had a mild cavus-varus. A radiolucent loading apparatus was built that, allowing neutral positioning of a plantigrade foot and controlled angulation of 5o, 10 o, 15o and 20o in dorsiflexion, plantarflexion, inversion and eversion. Fluoroscopic images were obtained of each cadaveric specimen in all seventeen different positions, with the x-ray beam perpendicular to the floor and aiming to the base of the 1st metatarsal. Two blinded orthopaedic surgeons independently measured the 1st tarsometatarsal (TMT) joint angle and graded the distal articular cartilage of the medial cuneiform as flat or curved. Readers also graded the image quality into assessing the joint into “Low”, “Intermediate” and “Good”. Results: 1st TMT joint angle was 112.92o ± 6.89o. Values were significantly different between cadaveric specimens (p<.0001). There was a tendency for increased valgus angulation of the joint in images positioned in neutral, plantarflexion and inversion and decreased valgus angulation with dorsiflexion and eversion.Regarding the shape of the distal articular cartilage of the medial cuneiform, joints with flat configuration showed significantly increased mean 1st TMT joint angle when compared to curved surfaces (115.9o vs. 110.7o, p<.0001). In 8 out of 10 of the cadaveric specimens (80%) the shape of the 1st TMT joint changed between curved or flat configuration depending on the positioning of the foot. In only 2/10 (20%) the joint configuration remained the same for all different positions (one flat and one curved). Conclusion: Our cadaveric study found that the shape and angulation of the first TMT joint is affected by the positioning of the foot and orientation of the x-ray beam. Clinical usefulness of the 1st TMT radiographic anatomical characteristics is limited and should not influence in the treatment of patients with possible instability the first tarsometatarsal (TMT) joint.

scholarly journals Quantitative Anatomic Analysis of the Medial Ulnar Collateral Ligament Complex of the Elbow

2018 ◽  
Vol 6 (3) ◽  
pp. 232596711876275 ◽  
Author(s):  
Christopher L. Camp ◽  
Hamidreza Jahandar ◽  
Alec M. Sinatro ◽  
Carl W. Imhauser ◽  
David W. Altchek ◽  
...  
Keyword(s):  
Surface Area ◽  
Ulnar Collateral Ligament ◽  
Surgical Reconstruction ◽  
Collateral Ligament ◽  
3 Dimensional ◽  
Visual Center ◽  
Bony Landmarks ◽  
Fresh Frozen ◽  
Detailed Assessment ◽  
The Mean

Background: A more detailed assessment of the anatomy of the entire medial ulnar collateral ligament complex (MUCLC) is desired as the rate of medial elbow reconstruction surgery continues to rise. Purpose: To quantify the anatomy of the MUCLC, including the anterior bundle (AB), posterior bundle (PB), and transverse ligament (TL). Study Design: Descriptive laboratory study. Methods: Ten unpaired, fresh-frozen cadaveric elbows underwent 3-dimensional (3D) digitization and computed tomography with 3D reconstruction. Ligament footprint areas and geometries, distances to key bony landmarks, and isometry were determined. A surgeon digitized the visual center of each footprint, and this location was compared with the geometric centroid calculated from the outline of the digitized footprint. Results: The mean surface area of the AB was 324.2 mm2, with an origin footprint of 32.3 mm2 and an elongated insertional footprint of 187.6 mm2 (length, 29.7 mm). The mean area of the PB was 116.6 mm2 (origin, 25.9 mm2; insertion, 15.8 mm2), and the mean surface area of the TL was 134.5 mm2 (origin, 21.2 mm2; insertion, 16.7 mm2). The geometric centroids of all footprints could be predicted within 0.8 to 1.3 mm, with the exception of the AB insertion centroid, which was 7.6 mm distal to the perceived center at the apex of the sublime tubercle. While the PB remained relatively isometric from 0° to 90° of flexion ( P = .606), the AB lengthened by 2.2 mm ( P < .001). Conclusion: Contrary to several historical reports, the insertional footprint of the AB was larger, elongated, and tapered. The TL demonstrated a previously unrecognized expansive soft tissue insertion directly onto the AB, and additional analysis of the biomechanical contribution of this structure is needed. Clinical Relevance: These findings may serve as a foundation for future study of the MUCLC and help refine current surgical reconstruction techniques.

Stability of the Arch of the Foot

1997 ◽  
Vol 18 (10) ◽  
pp. 644-648 ◽  
Author(s):  
Harold B. Kitaoka ◽  
Tae-Kun Ahn ◽  
Zong Ping Luo ◽  
Kai-Nan An
Keyword(s):  
Three Dimensional ◽  
Deltoid Ligament ◽  
Interosseous Ligament ◽  
Magnetic Tracking ◽  
Human Foot ◽  
Spring Ligament ◽  
Tarsal Bones ◽  
Before And After ◽  
Fresh Frozen ◽  
Tracking Device

We defined the relative contributions of six ligaments in stabilizing the arch of the foot: plantar aponeurosis, long-short plantar ligaments, plantar calcaneonavicular ligament (spring ligament), medial talocalcaneal ligament, talocalcaneal interosseous ligament, and tibionavicular portion of the deltoid ligament. Nineteen fresh-frozen human foot specimens were used. A load of 445 N was applied axially to simulate standing-at-ease posture. Three-dimensional positions of tarsal bones before and after ligament sectioning were determined with the use of a magnetic tracking device. The motions were presented in the form of screw axis displacements, quantitating rotation, and axis of rotation orientation. After sectioning one structure, the arch did not collapse on any specimen and there was no obvious change by visual inspection. There were, however, measurable changes in tarsal bone position. Metatarsal-to-talus total rotation difference was greatest with spring ligament and deltoid ligament sectioning, with an average of 2.1° ± 1.7° and 2.0° ± 0.2° difference, respectively. Calcaneus-to-talus rotation difference was greatest with talocalcaneal interosseous ligament sectioning, with an average of 1.7° ± 1.5°. The spring ligament, deltoid ligament, and talocalcaneal interosseous ligament were most important for arch stability.

scholarly journals The Anatomy of the Dorsal Capsulo-Scapholunate Septum: A Cadaveric Study

2017 ◽  
Vol 06 (03) ◽  
pp. 244-247 ◽  
Author(s):  
Marina Tommasini Carrara de Sambuy ◽  
Tanya Burgess ◽  
Christophe Mathoulin ◽  
Adeline Cambon-Binder
Keyword(s):  
Dorsal Surface ◽  
Anatomical Study ◽  
Biomechanical Properties ◽  
Scapholunate Ligament ◽  
Maximum Width ◽  
Interosseous Ligament ◽  
Gothic Architecture ◽  
Constant Structure ◽  
Fresh Frozen ◽  
The Mean

Background Tears of the dorsal radiocarpal capsule at the level of the scapholunate interosseous ligament (SLIL) have recently been described in association with predynamic scapholunate instability. Purpose The aim of this anatomical study of the dorsal capsulo-scapholunate septum (DCSS) was to examine the connection of the dorsal capsule on the SLIL and dorsal intercarpal ligament (DICL). Methods Fourteen fresh frozen wrists from seven adult cadavers were dissected through a dorsal approach. Any dorsal attachment of the DICL on the dorsal surface of the SLIL, that is, the DCSS, was identified and measured (height and width). Results The DCSS was consistently found connecting the DICL, the dorsal radiocarpal capsule, and the dorsal aspect of the SLIL. It was formed by the confluence of three arches like intersecting ribs in gothic architecture. The mean dimensions of the DCSS were 5.8 mm in height and 4.0 mm in maximum width. Conclusion The DCSS that connects the SLIL with the dorsal capsule and DICL could be a constant structure of dorsal wrist. Further investigation is required to study the histology of the DCSS and its biomechanical properties in isolation to know whether the DCSS can be considered a secondary stabilizer of the scapholunate ligament complex. Clinical Relevance A better anatomical knowledge of scapholunate ligament complex could help understand and manage instability of the wrist.

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