MRI Analysis of Anteroposterior Stability in the Normal Human Knee

2009 ◽  
Author(s):  
Sally Arno ◽  
Rachel Forman ◽  
Philip Glassner ◽  
Ravinder Regatte ◽  
Peter S. Walker
Keyword(s):  
Shear Force ◽  
Medial Meniscus ◽  
Sagittal Plane ◽  
The Body ◽  
Lateral Side ◽  
Human Knee ◽  
Medial Side ◽  
Normal Human ◽  
Femoral Rollback ◽  
High Range

During activities the knee experiences compressive forces caused by the weight of the body and muscle forces. However, there is also an anterior shear force pushing the femur forwards on the tibia. It is likely to be important to the feeling of stability that the shear force is resisted so as to limit the anterior femoral displacement. The dished bearing surface of the medial tibial compartment in combination with the medial meniscus may well perform this function. In contrast, the lateral tibial surface is convex in the sagittal plane and the meniscus is too mobile to offer any anteroposterior (AP) restraint. Therefore, we hypothesize that if an anterior or posterior force is applied to the femur relative to the tibia, AP stability is provided by the medial side, while the lateral side allows for femoral rollback to facilitate a high range of flexion. At any flexion angle, rotational laxity will occur about a point on the medial side.

scholarly journals Macroscopic and microscopic analysis of the structures inserted in the posterior segment of the medial meniscus. How is the semimembranosus tendon involved in ramp lesions?

2021 ◽  
Vol 9 (2_suppl) ◽  
pp. 2325967121S0001
Author(s):  
Etienne Cavaignac ◽  
Remy Sylvie ◽  
Maxime Teulières ◽  
Andrea Fernandez ◽  
Bertrand Sonnery-Cottet
Keyword(s):  
Medial Meniscus ◽  
Sagittal Plane ◽  
Microscopic Analysis ◽  
Joint Capsule ◽  
Posterior Segment ◽  
The Body ◽  
Semimembranosus Tendon ◽  
Tibial Condyle ◽  
Meniscotibial Ligament ◽  
Macroscopic Analysis

Objectives: The anatomical description of the posterior segment of the medial meniscus is debatable. The aim of this study was to describe by macroscopic and microscopic analysis the histological nature of the posterior segment of the medial meniscus and the inserted structures (semimembranosus tendon and menisco-tibial ligament) Methods: Fourteen fresh knees were dissected. For each specimen, a stable anatomical piece was taken en bloc, including the medial femoral condyle, the medial tibial condyle, the entire medial meniscus, the cruciate ligaments and the joint capsule, and the distal insertion of the semimembranosus tendon was preserved in its entirety. At this stage, a macroscopic analysis was performed. The blocks were cut along the sagittal plane in order to isolate the distal insertion of the semimembranosus tendon on the posterior joint capsule and the posterior segment of the medial meniscus in the same section. Histological slides were produced from these samples and were microscopically analyzed. Results: In all patients, the macroscopic analysis showed direct semimembranosus tendon expansion and tendinous capsular expansion ending behind the posterior segment of the medial meniscus. It projected onto the joint capsule, on the meniscotibial ligament at the bottom and the meniscocapsular ligament at the top, but never ended directly in the meniscal tissue. On average, the tendon directly inserted 11 ± 2.8 mm below the articular surface of the tibial plateau. The length of the capsular expansion was 14.3 ± 4.4 mm. The meniscotibial ligament was inserted in the posterior-inferior edge of the posterior segment of the medial meniscus and the meniscocapsular ligament in the posterior-superior edge. There was a particularly vascularized adipocyte space delimited by the posterior segment of the medial meniscus, the meniscotibial ligament, the meniscocapsular ligament and the capsular expansion of the semimembranosus tendon. Conclusion: We repeatedly noted capsular expansion of the semimembranosus tendon that inserted behind the medial meniscus. There is an interposing zone between the tendon insertion and the body of the meniscus which creates a fragile zone. The capsular tendon expansion also inserts in the meniscotibial ligaments at the bottom and meniscocapsular ligaments at the top.

scholarly journals Morphometric analysis of menisci of adult human knee joint in North Indian population

2017 ◽  
Vol 5 (2) ◽  
pp. 569
Author(s):  
Jyoti Rohila ◽  
Suresh Kanta Rathee ◽  
Suresh Kumar Dhattarwal ◽  
Zile Singh Kundu
Keyword(s):  
Knee Joint ◽  
Indian Population ◽  
Medial Meniscus ◽  
Lateral Meniscus ◽  
The Body ◽  
Human Knee ◽  
Human Knee Joint ◽  
Meniscal Replacement ◽  
Adult Humans ◽  
Elastic Thread

Background: Of the synovial joints in the body knee joint is the largest. Each meniscus is a piece of fibrocartilage with a thickened outside edge and a thin inner edge so that it is wedge-shaped in cross section. The purpose of the present study was to establish database on standard dimensions in knee menisci of adults of north Indian population.Methods: The sample for this study was collected from April, 2012 to June, 2013. For this study, 200 menisci (100 right and left each) of 50 adult humans were taken for analysis. Measurements were done with the help of non-elastic thread and digital vernier calipers. All dissections were performed in a systematic fashion.Results: The width of the lateral meniscus was significantly different form medial meniscus with lateral and medial menisci widest in middle and posterior third respectively. The middle one third of both lateral and middle menisci was the thickest.Conclusions: It is always good to have a set of anatomical morphometric parameters of the menisci like the width and thickness. The measurements of suitable grafts may provide a more acceptable meniscal replacement in the future.

EFFECTS OF DISTAL NAIL-HOLE DIMENSION AND WALL THICKNESS ON THE FEMORAL NAILING STRESSES — FINITE-ELEMENT ANALYSIS

2009 ◽  
Vol 21 (03) ◽  
pp. 177-185 ◽  
Author(s):  
Kao-Shang Shih ◽  
Ching-Shiow Tseng ◽  
Chia-Ching Lee ◽  
Tung-Wu Lu ◽  
Sheng-Mou Hou ◽  
...  
Keyword(s):  
Finite Element ◽  
Wall Thickness ◽  
Sagittal Plane ◽  
Point Contact ◽  
Hole Diameter ◽  
Lateral Side ◽  
Projected Area ◽  
Screw Insertion ◽  
Size And Shape ◽  
Medial Side

Background. For the available systems, the two paired nail holes at the distal femoral portion were of identical size and shape. However, the higher incidence of the first nail-hole failure was reported at the medial than lateral side. In practice, the nail was initially stabilized by the screw insertion into the first hole from the lateral-to-medial side. If the lateral first hole was adequately strengthened, the larger nail-hole diameter could ease to insert the screws into the lateral hole. Methods. The finite-element method was used to investigate the effect of the configuration of the lateral first hole on the screw insertion and stress distribution of the distal nailing system. The distal nail-hole thickness was increased and its edge was intentionally chamfered to increase its effectively projected area onto the sagittal plane. There were eight variations of the nail-hole configuration in the parametric analyses. Findings. The deflected nail diagonally contacts the screws at the medial first and lateral second nail-screw sites. The medial first hole was the most stressed and the stress of the medial second hole was the least. The increase in the nail-hole thickness significantly reduces the concentrated stresses of all four holes, thus allowing the lateral first nail-hole diameter to be increased without the strength loss at that site. The enlargement and chamfer of the lateral first hole significantly increase the effective nail-hole projected area and potentially facilitate the screw insertion. Comparatively, the size and shape re-design of the lateral first hole induced the minor increase in stress values of the other holes and screws. Interpretation. In nature, the load-transferring mechanism between the distal nail-screw interfaces was the point-contact problem. If the wall-thickness, diameter, and chamfer of the lateral first hole were well-controlled, this re-design decreases the stress at the medial first distal hole where most failures occur and renders the overall system mechanically safer and more surgically effective.

scholarly journals Nasofrontal Complex Variation Frontal Sinus Drainage System Increases Frontal Rhinosinusitis Incident

2016 ◽  
Vol 8 (1) ◽  
pp. 49
Author(s):  
Abdul Qadar Punagi
Keyword(s):  
Ct Scan ◽  
Frontal Sinus ◽  
Sagittal Plane ◽  
Drainage System ◽  
Lateral Side ◽  
Significant Relation ◽  
Medial Side ◽  
Sinus Drainage ◽  
Group 1

BACKGROUND: This research was conducted to find out the relation of anatomy variation of nasofrontal complex on the frontal sinus drainage system with frontal rhinosinusitis incident. METHODS: This research was using cross-sectional design involving 75 patients with chronic rhinosinusitis. Coronal paranasal sinus CT scan with sagittal plane reformat was carried out to examine. The CT scan figures were analyzed from every side and there were 150 samples found as the result. Data was analyzed using chi square test. RESULTS: The research indicates that there is no significant relation between frontal cell types, agger nasi cell, chonca media bullosa with incident of frontal rhinosinusitis (p>0.05). Prevalence of superior attachment of uncinate process (UP), type 1 (UP superior attachment on lamina papiracea) was found on 43 sides (28.6%), type 6 (UP superior attachment to medial turbinate) was found in 29 sides (19.3%). Prevalence of frontal rhinosinusitis was found in 42 (28%) from 150 sides. Group 1 drainage (medial side drainage; drainage to meatus medius [type 1-3]) was found in 32 sides (76.2%) and group 2 drainage (lateral side drainage; drainage to infundibulum ethmoid [type 4-6]) was found in 10 sides (23.8%). CONCLUSION: There is significant relation between frontal rhinosinusitis incident with variation of frontal sinus drainage (p<0.05) and drainage on group 1 has significant existence statistically on frontal rhinosinusitis incident. KEYWORDS: frontal rhinosinusitis, anatomy variation, nasofrontal complex, frontal sinus drainage 

Body balance in a free-standing position in road and off-road cyclists

2014 ◽  
Vol 6 (4) ◽  
Author(s):  
Paulina Hebisz ◽  
Rafal Hebisz ◽  
Marek Zaton
Keyword(s):  
Sagittal Plane ◽  
Standing Position ◽  
The Body ◽  
Free Standing ◽  
Body Balance ◽  
Eyes Closed ◽  
Road Cycling ◽  
Progressive Exercise ◽  
Before And After ◽  
Road Cyclists

AbstractBackground: The purpose of this study was to compare body balance in road and off-road cyclists, immediately before and after the racing season.Material/Methods: Twenty individuals participated in the study and they were divided into two groups: specialists in road-cycling (n = 10) and in off-road cycling (n = 10). Immediately before and after the five-month racing season stabilographic trials were carried out (at rest and after progressive exercise). In assessing body balance the distance and velocity of the centre shifts (in the anterior-posterior and left-right direction) were analysed. The tests were performed with the cyclists’ eyes open, eyes closed, and in feedback.Results: After the racing season, in the off-road cyclists’ group, distance and velocity of the centre of pressure shifts increased after a progressive exercise.Conclusions: In the off-road cyclists’ group the balance of the body in the sagittal plane deteriorated after the racing season. Moreover, after the racing season off-road cyclists were characterized by a worse balance of the body, compared to road cyclists

Correction of Posture Deviations in the Sagittal Plane Using the Pilates Method

2019 ◽  
pp. 3-13
Author(s):  
Alexandru Cîtea ◽  
George-Sebastian Iacob
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Postural Control ◽  
Human Body ◽  
Sagittal Plane ◽  
The Body ◽  
Lower Limbs ◽  
Low Back ◽  
Pilates Method ◽  
The Relationship

Posture is commonly perceived as the relationship between the segments of the human body upright. Certain parts of the body such as the cephalic extremity, neck, torso, upper and lower limbs are involved in the final posture of the body. Musculoskeletal instabilities and reduced postural control lead to the installation of nonstructural posture deviations in all 3 anatomical planes. When we talk about the sagittal plane, it was concluded that there are 4 main types of posture deviation: hyperlordotic posture, kyphotic posture, rectitude and "sway-back" posture.Pilates method has become in the last decade a much more popular formof exercise used in rehabilitation. The Pilates method is frequently prescribed to people with low back pain due to their orientation on the stabilizing muscles of the pelvis. Pilates exercise is thus theorized to help reactivate the muscles and, by doingso, increases lumbar support, reduces pain, and improves body alignment.

Spinal Balance/Alignment—Clinical Relevance and Biomechanics

2019 ◽  
Vol 141 (7) ◽  
Author(s):  
Anoli Shah ◽  
Justin V. C. Lemans ◽  
Joseph Zavatsky ◽  
Aakash Agarwal ◽  
Moyo C. Kruyt ◽  
...  
Keyword(s):  
Social Interaction ◽  
Sagittal Balance ◽  
Sagittal Plane ◽  
The Body ◽  
Optimal Configuration ◽  
Sacral Slope ◽  
Sagittal Imbalance ◽  
Compensatory Mechanisms ◽  
Spinal Balance ◽  
Spinal Imbalance

In the anatomy of a normal spine, due to the curvatures in various regions, the C7 plumb line (C7PL) passes through the sacrum so that the head is centered over the pelvic-ball and socket hip and ankle joints. A failure to recognize malalignment in the sagittal plane can affect the patient's activity as well as social interaction due to deficient forward gaze. The sagittal balance configuration leads to the body undertaking the least muscular activities as possible necessary to maintain spinal balance. Global sagittal imbalance is energy consuming and often results in painful compensatory mechanisms that in turn negatively influence the patient's quality of life, self-image, and social interaction due to inability to maintain a horizontal gaze. Deformity, scoliosis, kyphosis, trauma, and/or surgery are some ways that this optimal configuration can be disturbed, thus requiring higher muscular activity to maintain posture and balance. Several parameters such as the thoracic kyphosis (TK), lumbar lordosis (LL), pelvic incidence (PI), sacral slope (SS), and hip and leg positions influence the sagittal balance and thus the optimal configuration of spinal alignment. This review examines the clinical and biomechanical aspects of spinal imbalance, and the biomechanics of spinal balance as dictated by deformities—ankylosing spondylitis (AS), scoliosis and kyphosis; surgical corrections—pedicle subtraction osteotomies (PSO), long segment stabilizations, and consequent postural complications like proximal and distal junctional kyphosis. The study of the biomechanics involved in spinal imbalance is relatively new and thus the literature is rather sparse. This review suggests several potential research topics in the area of spinal biomechanics.

scholarly journals Anatomical variants of pulmonary segments and uni-portal thoracoscopic segmentectomy for lung cancer in a patient with Kartagener syndrome: a case report

2021 ◽  
Author(s):  
Di Zhou ◽  
Ye Tian ◽  
Yao Lu ◽  
Xueying Yang
Keyword(s):  
Lung Cancer ◽  
Rare Variants ◽  
Sagittal Plane ◽  
Early Stage ◽  
Situs Inversus Totalis ◽  
Middle Lobe ◽  
The Body ◽  
Kartagener Syndrome ◽  
Early Stage Lung Cancer ◽  
Cancer Lesion

AbstractSitus inversus totalis (SIT) is an extremely uncommon congenital disease where the major organs of the body are transposed through the sagittal plane. Kartagener syndrome is a complication of SIT with immotility of bronchial cilia, bronchiectasis, and chronic sinusitis. There is no report describing patients with Kartagener syndrome who accept uni-portal segmentectomies for lung cancer in past studies. Here we report a 74-year-old female patient with both Kartagener syndrome and a small early-stage lung cancer lesion located in the apical segment of the left upper lobe (LS1). The pulmonary segment anatomy of the left upper lobe in this case, which had very rare variants, was presented and interpreted in detail. This patient underwent an anatomic segmentectomy to the LS1 and a partial excision to the left middle lobe with bronchiectasis through a single 3 cm length incision. We believe that the case can give surgeons some experience and inspiration.

scholarly journals Differential Contribution of the Medial and the Lateral Side of the Joint to Symptoms in Knee Osteoarthritis: A Radiographic and Laboratory Analysis in the Nagahama Study

Cartilage ◽  
2021 ◽  
pp. 194760352110258
Author(s):  
Kazuya Nigoro ◽  
Hiromu Ito ◽  
Tomotoshi Kawata ◽  
Shinichiro Ishie ◽  
Yugo Morita ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Clinical Outcomes ◽  
Knee Pain ◽  
High Sensitivity ◽  
Analysis Of Covariance ◽  
Radiographic Evaluation ◽  
Radiographic Feature ◽  
Lateral Side ◽  
Cross Sectional ◽  
Medial Side

Objective: This cross-sectional study aimed to explore the differences of the medial and lateral sides of the knee joint and precise radiographic abnormalities in contribution to the knee pain and clinical outcomes. Design: Participants 60 years or older who underwent radiographic evaluation were included. Knee radiography was assessed using grading systems of the Osteoarthritis Research Society International (OARSI) atlas. The Japanese Knee Osteoarthritis Measure (JKOM) was evaluated as clinical outcomes. Serum high-sensitivity C-reactive protein (hsCRP) was used to evaluate systemic inflammation. We divided the participants into normal, medial-, lateral-, and medial & lateral-OA types and compared their JKOM using an analysis of covariance. Furthermore, we analyzed the relationship between the knee pain and stiffness of JKOM and the grading of each radiographic feature using a multiple regression model. Results: Lateral- and medial & lateral-OA groups had a significantly worse symptoms in the total and the pain score, especially in movement subscales, in JKOM score. Lateral-OA groups had higher hsCRP than medial-OA group. Multivariate analysis showed that medial joint space narrowing (JSN), and lateral femoral and tibial osteophytes significantly affected knee pain (adjusted odds ratios: 1.73, 1.28, and 1.55, respectively). The radiographic changes are associated with pain more in JSN in the medial side and osteophytes in the lateral side. Conclusion: Lateral- and medial & lateral-OA groups showed worth symptom. In addition, medial JSN and lateral osteophytes have potent effects on the knee pain.

Sign in / Sign up

Export Citation Format

Share Document