scholarly journals Radiographic Analysis of Glenoid Morphology after Arthroscopic Latarjet vs Distal Tibial Allograft in the Treatment of Anterior Shoulder Instability

2018 ◽  
Vol 6 (7_suppl4) ◽  
pp. 2325967118S0009 ◽  
Author(s):  
Ivan H. Wong ◽  
JP King ◽  
Gordon Boyd ◽  
Michael Mitchell ◽  
Catherine M. Coady
Keyword(s):  
Shoulder Instability ◽  
Distal Tibia ◽  
Cross Sectional Area ◽  
Anterior Shoulder Instability ◽  
Sectional Area ◽  
Common Procedure ◽  
Cross Sectional ◽  
Significant Difference ◽  
Glenoid Reconstruction ◽  
Graft Resorption

Objectives: The Latarjet procedure for autograft transposition of coracoid to the anterior rim of the glenoid remains the most common procedure for reconstruction of the glenoid after shoulder instability. The anatomic glenoid reconstruction using distal tibial allograft has gained popularity and is suggested to better match the normal glenoid size and shape. However, there is concern for decreased healing and increased resorption using an allograft bone. The purpose of this study was to evaluate the arthroscopic reconstruction of the glenoid with respect to the size, shape, healing, and resorption of autograft coracoid vs allograft distal tibia. Methods: A retrospective review of 50 consecutive patients who had an arthroscopic boney reconstruction of the glenoid (13 coracoid; 37 distal tibial), diagnosed with anterior shoulder instability, and CT confirmed glenoid bone loss >20%. Pre-and post-operative CT scans were reviewed by two fellowship trained musculoskeletal radiologists for: graft position, glenoid concavity, cross sectional area, width, version, total area, osseous union, and graft resorption. Results: Graft nonunion was seen in 3 (23.07%) of the coracoid patients, and in 2 (5.4%) of the tibial allograft patients (OR 5.25; 95% CI: 0.768-35.89). Odds ratios comparing allograft to coracoid for overall resorption was 5.00 (CI: 1.276-19.597). Graft resorption greater than 50% was seen in 3 (8.11%) of the allografts and was absent within the coracoid patients. Graft resorption lesser than 50% was greater in both groups with 27 (72.97%) allograft and 6 (46.15%) coracoid patients. However, no statistically significant difference was found between the two procedures regarding AP diameter of graft (p=0.818) or graft cross sectional area (p=0.797). Conclusion: Arthroscopic anatomic glenoid reconstruction using distal tibial allograft showed greater boney union but higher resorption compared to coracoid autograft. Even so, there was no statistically significant difference between the two procedures regarding final graft surface area and size of grafts. These short-term results suggest distal tibial allograft as an alternative to coracoid autograft in the recreation of glenoid boney morphology.

Radiographic Analysis of Glenoid Size and Shape After Arthroscopic Coracoid Autograft Versus Distal Tibial Allograft in the Treatment of Anterior Shoulder Instability

2018 ◽  
Vol 46 (11) ◽  
pp. 2717-2724 ◽  
Author(s):  
Ivan H. Wong ◽  
John Paul King ◽  
Gordon Boyd ◽  
Michael Mitchell ◽  
Catherine Coady
Keyword(s):  
Shoulder Instability ◽  
Odds Ratio ◽  
Cross Sectional Area ◽  
Anterior Shoulder Instability ◽  
Sectional Area ◽  
Cross Sectional ◽  
Significant Difference ◽  
Glenoid Reconstruction ◽  
Graft Resorption

Background: The Latarjet procedure for autograft transposition of the coracoid to the anterior rim of the glenoid remains the most common procedure for reconstruction of the glenoid after shoulder instability. The anatomic glenoid reconstruction using distal tibial allograft has gained popularity and is suggested to better match the normal glenoid size and shape. However, concerns about decreased healing and increased resorption arise when an allograft bone is used. Purpose: To use radiological findings to evaluate the arthroscopic reconstruction of the glenoid with respect to the size, shape, healing, and resorption of coracoid autograft versus distal tibial allograft. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective review was performed of 48 consecutive patients who had an arthroscopic bony reconstruction of the glenoid (12 coracoid autograft, 36 distal tibial allograft), diagnosed anterior shoulder instability, and computed tomography (CT)–confirmed glenoid bone loss more than 20%. Coracoid autograft was performed only when tibial allograft was not accessible from a bone bank. Two fellowship-trained musculoskeletal radiologists reviewed pre- and postoperative CT scans at a minimum follow-up of 6 months for the following: graft position, glenoid concavity, cross-sectional area, width, version, total area, osseous union, and graft resorption. Clinical outcome was noted in terms of instability, subluxation, and dislocation at a minimum follow-up of 2 years. Simple logistic regression, 2-tailed independent-sample t tests, paired t tests, and Fisher exact tests were performed. Results: Graft union was seen in 9 of the 12 patients (75%) who had coracoid autograft and 34 of the 36 patients (94%) who had tibial allograft (odds ratio, 5.66; 95% CI, 0.81-39.20; P = .08). The odds ratio comparing allograft to coracoid for overall resorption was 7.00 (95% CI, 1.65-29.66; P = .008). Graft resorption ≥50% was seen in 3 (8%) of the patients who had tibial allograft and none of the patients who had coracoid autograft. Graft resorption less than 50% was seen in the majority of patients in both groups: 27 (73%) patients with tibial allograft and 5 (42%) patients with coracoid autograft. No statistically significant difference was found between the 2 procedures regarding anteroposterior diameter of graft ( P = .81) or graft cross-sectional area ( P = .93). However, a significant difference was observed in step formation between the 2 procedures ( P < .001). Two patients experienced subluxations in the coracoid group (16%) as well as 2 patients in the tibial allograft group (6%) with a P value of .25. Conclusion: Arthroscopic anatomic glenoid reconstruction via distal tibial allograft showed similar bony union but higher resorption compared with coracoid autograft. Even so, no statistically significant difference was found between the 2 procedures regarding final graft surface area, the size of grafts, and the anteroposterior dimensions of the reconstructed glenoids. These short-term results suggest that distal tibial allografts can be used as an alternative to coracoid autograft in the recreation of glenoid bony morphologic features.

Guideline Values for Minimum Nasal Cross-Sectional Area in Children

2018 ◽  
Vol 55 (8) ◽  
pp. 1043-1050
Author(s):  
Maija T. Laine-Alava ◽  
Siiri Murtolahti ◽  
Ulla K. Crouse ◽  
Donald W. Warren
Keyword(s):  
Cleft Lip ◽  
Cross Sectional Area ◽  
Adult Size ◽  
Nasal Airway ◽  
Sectional Area ◽  
Cross Sectional ◽  
Age Cohorts ◽  
Guideline Values ◽  
Significant Difference ◽  
Research Criteria

Objective: The purpose was to determine age-specific values of the minimum cross-sectional area of the nasal airway in children without cleft lip or palate and to assess whether gender differences occur with growth in order to develop guidelines for assessment in children with clefts. Participants: All schoolchildren aged 8 to 17 years who met the research criteria were studied during rest breathing using the pressure-flow technique. The children came from a rural area of 3800 inhabitants. Consecutive age cohorts were used for comparisons. Results: Nasal cross-sectional area increased in females from 0.38 cm2 in 8-year-olds to 0.58 cm2 in 17-year-olds. There was a decrease in size at ages 10 to 11 and 14 to 15 years. In males, the area increased from 0.40 to 0.68 cm2 and decreased slightly from 9 to 10 and 14 to 15 years. The annual changes were statistically significant in females between 8 and 9 and 11 to 13 years of age, and in males from 11 to 12, 13 to 14, and 15 to 17 years of age. Across gender, the only significant difference occurred at age 16. Conclusions: Our results indicate that the increase in nasal airway size is not consistent during growth. Nasal airway size showed almost equal values for both genders in young children but was systematically larger in boys from 14 years of age on. The results refer that by 17 years of age nasal airway may not have reached adult size in males.

Relevance of classification by size to topographical differences in bronchial smooth muscle response

1993 ◽  
Vol 75 (5) ◽  
pp. 2013-2021 ◽  
Author(s):  
P. Chitano ◽  
S. B. Sigurdsson ◽  
A. J. Halayko ◽  
N. L. Stephens
Keyword(s):  
Smooth Muscle ◽  
Electrical Field Stimulation ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
Muscle Response ◽  
Bronchial Responsiveness ◽  
Sixth Generation ◽  
Significant Difference ◽  
And Control

To investigate heterogeneity of airway smooth muscle response, we studied strips of large and small branches from third- to sixth-generation bronchi obtained from ragweed antigen-sensitized and control dogs. The response to electrical field stimulation and carbamylcholine chloride was greater in strips from larger branches of the same generation when expressed as "tissue stress" (force per unit cross-sectional area of the whole tissue), whereas no difference emerged with use of the more appropriate "smooth muscle stress" (force per unit cross-sectional area of the muscle tissue). The response to histamine was significantly higher in small branches than in large ones, and histamine sensitivity [mean effective concentration (EC50)] was 7.79 x 10(-6) [geometric standard error of the mean (GSEM) 1.20] and 1.49 x 10(-5) M (GSEM 1.14), respectively (P < 0.01). Strips from control and sensitized animals at each site and strips from different generations did not show any significant difference. When we clustered our preparations according to dimensions, the response to histamine was significantly higher in small bronchi than in large ones and histamine EC50 was 8.95 x 10(-6) (GSEM 1.17) and 1.57 x 10(-5) M (GSEM 1.18), respectively (P < 0.05). We conclude that evaluation of muscle response in different tissues requires appropriate normalization. Furthermore, classification into generations is inadequate to study bronchial responsiveness, inasmuch as major differences originate from airway size.

Gender differences in upper airway compliance during NREM sleep: role of neck circumference

2002 ◽  
Vol 92 (6) ◽  
pp. 2535-2541 ◽  
Author(s):  
James A. Rowley ◽  
Carrie S. Sanders ◽  
Brian R. Zahn ◽  
M. Safwan Badr
Keyword(s):  
Gender Differences ◽  
Gender Difference ◽  
Upper Airway ◽  
Nrem Sleep ◽  
Neck Circumference ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
Significant Difference ◽  
Upper Airway Structure

It has been proposed that the gender difference in sleep apnea prevalence is related to gender differences in upper airway structure and function. We hypothesized that men would have smaller retropalatal cross-sectional area and higher compliance during sleep compared with women. Using upper airway imaging, we measured upper airway cross-sectional area and retropalatal compliance in wakefulness and non-rapid eye movement (NREM) sleep in 15 men and 15 women without sleep-disordered breathing. Cross-sectional area at the beginning of inspiration tended to be larger in men compared with women in both wakefulness [194.5 ± 21.3 vs. 138.8 ± 12.0 (SE) mm2] and NREM sleep (111.1 ± 17.6 vs. 83.3 ± 11.9 mm2; P = 0.058). There was no significant difference, however, after correction for body surface area. Retropalatal compliance also tended to be higher in men during both wakefulness (5.9 ± 1.4 vs. 3.1 ± 1.4 mm2/cmH2O; P = 0.006) and NREM sleep (12.6 ± 2.7 vs. 4.7 ± 2.6 mm2/cmH2O; P = 0.055). However, compliance was similar in men relative to women after correction for neck circumference. We conclude that the gender difference in retropalatal compliance is more accurately attributed to differences in neck circumference between the genders.

Superior-capsular elongation and its significance in atraumatic posteroinferior multidirectional shoulder instability in magnetic resonance arthrography

2010 ◽  
Vol 51 (3) ◽  
pp. 302-308 ◽  
Author(s):  
Yi-Chih Hsu ◽  
Ru-Yu Pan ◽  
Yen-Yu I. Shih ◽  
Meei-Shyuan Lee ◽  
Guo-Shu Huang
Keyword(s):  
Magnetic Resonance ◽  
Shoulder Instability ◽  
Mr Arthrography ◽  
Supraspinatus Tendon ◽  
Cross Sectional Area ◽  
Rotator Interval ◽  
Sectional Area ◽  
Cross Sectional ◽  
Control Subjects ◽  
Linear Distance

Background: Redundancy of the capsule has been considered to be the main pathologic condition responsible for atraumatic posteroinferior multidirectional shoulder instability; however, there is a paucity of measurements providing quantitative diagnosis. Purpose: To determine the significance of superior-capsular elongation and its relevance to atraumatic posteroinferior multidirectional shoulder instability at magnetic resonance (MR) arthrography. Material and Methods: MR arthrography was performed in 21 patients with atraumatic posteroinferior multidirectional shoulder instability and 21 patients without shoulder instability. One observer made the measurements in duplicate and was blinded to the two groups. The superior-capsular measurements (linear distance and cross-sectional area) under the supraspinatus tendon, and the rotator interval were determined on MR arthrography and evaluated for each of the two groups. Results: For the superior-capsular measurements, the linear distance under the supraspinatus tendon was significantly longer in patients with atraumatic posteroinferior multidirectional shoulder instability than in control subjects ( P<0.001). The cross-sectional area under the supraspinatus tendon, and the rotator interval were significantly increased in patients with atraumatic posteroinferior multidirectional shoulder instability compared to control subjects ( P<0.001 and P=0.01, respectively). Linear distance greater than 1.6 mm under the supraspinatus tendon had a specificity of 95% and a sensitivity of 90% for diagnosing atraumatic posteroinferior multidirectional shoulder instability. Cross-sectional area under the supraspinatus tendon greater than 0.3 cm2, or an area under the rotator interval greater than 1.4 cm2 had a specificity of more than 80% and a sensitivity of 90%. Conclusion: The superior-capsular elongation as well as its diagnostic criteria of measurements by MR arthrography revealed in the present study could serve as references for diagnosing atraumatic posteroinferior shoulder instability and offer insight into the spectrum of imaging findings corresponding to the pathologies encountered at clinical presentation.

The Effect of ACL Reconstruction on Involved and Contralateral Limb Vastus Lateralis Morphology and Histology: A Pilot Study

2019 ◽  
Author(s):  
Eric C. Leszczynski ◽  
Christopher Kuenze ◽  
Brett Brazier ◽  
Joseph Visker ◽  
David P. Ferguson
Keyword(s):  
Fiber Type ◽  
Vastus Lateralis ◽  
Knee Extension ◽  
Cross Sectional Area ◽  
Vastus Lateralis Muscle ◽  
Myosin Isoforms ◽  
Sectional Area ◽  
Cross Sectional ◽  
Contralateral Limb ◽  
Significant Difference

AbstractQuadriceps muscle weakness is a commonly reported issue post anterior cruciate ligament reconstruction (ACLR), with minimal information related to skeletal muscle morphology following surgery. The purpose is to examine the morphological and functional differences in the vastus lateralis muscle from patient's ACLR and contralateral leg. Three physically active ACLR participants were recruited and secured to a dynamometer to perform maximal voluntary isometric knee extension contractions (MVIC) of the ACLR and contralateral limb. Muscle biopsies of the ACLR and contralateral vastus lateralis were performed, then sectioned, and stained for myosin isoforms to determine fiber type. Confocal images were acquired, and ImageJ software was used to determine the fiber type and cross-sectional area (CSA). There was a significant reduction in CSA of the type IIa and type IIx muscle fiber cells between healthy (IIa: 7,718 ± 1,295 µm2; IIx; 5,800 ± 601 µm2) and ACLR legs (IIa: 4,139 ± 709 µm2; IIx: 3,708 ± 618 µm2) (p < 0.05), while there was no significant difference in knee extension MVIC torque between legs (healthy limb: 2.42 ± 0.52 Nm/kg; ACLR limb: 2.05 ± 0.24 Nm/kg, p = 0.11). The reduction in the cross-sectional area of the ACLR type II fibers could impair function and increase secondary injury risk.

Prediction Models for the Erector Spinae Muscle Cross-Sectional Area

2015 ◽  
Vol 137 (7) ◽  
Author(s):  
Celal Gungor ◽  
Ruoliang Tang ◽  
Richard F. Sesek ◽  
Kenneth Bo Foreman ◽  
Sean Gallagher ◽  
...  
Keyword(s):  
Prediction Models ◽  
Absolute Error ◽  
Cross Sectional Area ◽  
Erector Spinae ◽  
Low Back ◽  
Sectional Area ◽  
Cross Sectional ◽  
Erector Spinae Muscle ◽  
Significant Difference ◽  
Mri Scans

Accurate and reliable “individualized” low back erector spinae muscle (ESM) data are of importance to estimate its force producing capacity. Knowing the force producing capacity, along with spinal loading, enhances the understanding of low back injury mechanisms. The objective of this study was to build regression models to estimate the ESM cross-sectional area (CSA). Measurements were taken from axial-oblique magnetic resonance imaging (MRI) scans of a large historical population [54 females and 53 males at L3/L4, 50 females and 44 males at L4/L5, and 41 females and 35 males at L5/S1 levels]. Results suggest that an individual's ESM CSA can be accurately estimated based on his/her gender, height, and weight. Results further show that there is no significant difference between the measured and estimated ESM CSAs, and expected absolute error is less than 15%.

scholarly journals Comparison of MRI cross-sectional area and functions of core muscles among asymptomatic individuals with and without lumbar intervertebral disc degeneration

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Gyeong-tae Gwak ◽  
Ui-jae Hwang ◽  
Sung-hoon Jung ◽  
Hyun-a Kim ◽  
Jun-hee Kim ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Intervertebral Disc ◽  
Disc Degeneration ◽  
Intervertebral Disc Degeneration ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Endurance Test ◽  
Cross Sectional ◽  
Significant Difference ◽  
Asymptomatic Individuals

Abstract Background Previous studies suggested that patients with symptomatic intervertebral disc degeneration (IDD) of lumbar spine have reduced cross-sectional area (CSA) and functions of core muscles. However, reduced CSA and functions of core muscles have been observed not only in patients with symptomatic IDD but also in patients with other subgroups of low back pain (LBP). Thus, it is uncertain whether reduced CSA and functions of core muscles lead to IDD and LBP, or pain leads to reduced CSA and functions of core muscles in patients with symptomatic IDD. Therefore, this study aimed to compare the CSA and functions of core muscles between asymptomatic participants with and without IDD in magnetic resonance imaging (MRI). Methods Twenty asymptomatic participants (12 men and 8 women) participated in this study. Ten participants had asymptomatic IDD at L4–5. The others were healthy controls (without IDD at all levels of lumbar spine). The CSA of core muscles was measured using MRI. Maximal isometric trunk flexor strength and side bridge strength were measured by a Smart KEMA strength sensor. Trunk flexor endurance test, side bridge endurance test and plank endurance test were used to measure core endurance. Double legs loading test was used to measure core stability. Mann-Whitney U test was used to compare the differences between two groups. Results There were no significant differences in core muscle functions between the two groups (p > 0.05). Moreover, there was no significant difference in CSA between the two groups (p > 0.05). Conclusions There was no significant difference in CSA and core muscle functions between asymptomatic participants with and without IDD. These findings indicate that a degenerative or bulging disc in asymptomatic individuals has little effect on CSA and functions of core muscles, especially in young age. Therefore, the general core endurance test or strength test could not differentiate asymptomatic people with and without IDD of lumbar spine. Trial registration number Clinical Research information Service. KCT0004061. Registered 13 June 2019. retrospectively registered.

Lateral Division of the Rabbit Cricoid Cartilage: Its Effect on Cartilage Growth

1993 ◽  
Vol 108 (1) ◽  
pp. 63-69 ◽  
Author(s):  
Ilsa Schwartz ◽  
Frederick M. Silver ◽  
Charles M. Myer ◽  
Robin T. Cotton
Keyword(s):  
Cricoid Cartilage ◽  
Normal Growth ◽  
Group Iv ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cartilage Growth ◽  
Cross Sectional ◽  
Group I ◽  
Posterior Group ◽  
Significant Difference

Laryngotracheoplasty often includes bilateral lateral division of the cricoid cartilage, despite the theoretical risk that cartilage growth centers might be located in the lateral cricoid. To investigate the effect of lateral cricoid cartilage division on subsequent cartilage growth, 60 five-week-old New Zealand white rabbits were divided into four groups of 15 animals each. Group I was comprised of unoperated controls. The remaining animals underwent anterior (group II), anterior and posterior (group III), and anterior, posterior, and bilateral lateral (group IV) division of the cricoid cartilage. Animals were killed 20 weeks after surgery, and the cross-sectional area of each animal's cricoid cartilage and of each animal's airway was determined. There was no statistically significant difference in mean cartilage cross-sectional area between any of the four groups; the group IV mean was larger than that of any other group, though the difference was not significant. There was no significant difference in airway cross-sectional area between any of the groups operated on. From these results, lateral cricoid division in the growing animal does not appear to interfere with subsequent normal growth of the larynx.

Multifidus Muscle Size and Symmetry in Ballroom Dancers with and without Low Back Pain

2018 ◽  
Vol 39 (08) ◽  
pp. 630-635 ◽  
Author(s):  
Alyssa Smyers Evanson ◽  
Joseph Myrer ◽  
Dennis Eggett ◽  
Ulrike Mitchell ◽  
A. Johnson
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Cross Sectional Area ◽  
Muscle Size ◽  
Low Back ◽  
Sectional Area ◽  
Multifidus Muscle ◽  
Cross Sectional ◽  
Significant Difference ◽  
The Right

AbstractThe incidence of low back pain (LBP) among elite ballroom dancers is high and understanding associations between muscle morphology and pain may provide insight into treatment or training options. Research has linked multifidus muscle atrophy to LBP in the general and some athletic populations; however, this has not been examined in ballroom dancers. We compared the lumbar multifidus cross-sectional area (CSA) at rest in 57 elite level ballroom dancers (age 23±2.4 years; height, 174±11 cm; mass, 64±10 kg) divided into one of three pain groups, according to their self-reported symptoms, 1) LBP group (n=19), 2) minimal LBP (n=17), and 3) no LBP (n=21). There were no significant difference in demographics between the groups (P>0.05). The LBP group demonstrated significant differences in reported pain and Oswestry Disability Index scores compared to the other two groups. There was no significant difference between groups in multifidus cross-sectional area (P=0.49). Asymmetry was found in all groups with the overall left side being significantly larger than the right (P<0.002). Pain associated with segmental decrease in multifidus CSA was not observed in ballroom dancers with LBP, suggesting other reasons for persistent LBP in ballroom dancers.

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