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.

What Is the Relationship Between the Distal Semimembranosus Tendon and the Medial Meniscus? A Gross and Microscopic Analysis From the SANTI Study Group

2020 ◽  
pp. 036354652098007
Author(s):  
Etienne Cavaignac ◽  
Rémi Sylvie ◽  
Maxime Teulières ◽  
Andrea Fernandez ◽  
Karl-Heinz Frosch ◽  
...  
Keyword(s):  
Laboratory Study ◽  
Tibial Plateau ◽  
Medial Meniscus ◽  
Sagittal Plane ◽  
Microscopic Analysis ◽  
Joint Capsule ◽  
Posterior Horn ◽  
Ligament Injury ◽  
Semimembranosus Tendon ◽  
Meniscotibial Ligament

Background: Some authors have suggested that the semimembranosus tendon is involved in the pathophysiology of ramp lesions. This led us to conduct a gross and microscopic analysis of the posterior horn of the medial meniscus and the structures inserted on it. Hypothesis: (1) The semimembranosus tendon has a tendinous branch inserting into the posterior horn of the medial meniscus, and (2) the meniscotibial ligament is inserted on the posteroinferior edge of the medial meniscus. Study Design: Descriptive laboratory study. Methods: In total, 14 fresh cadaveric knees were dissected. From each cadaveric donor, a stable anatomic specimen was harvested en bloc, including the medial femoral condyle, medial tibial plateau, whole medial meniscus, cruciate ligaments, joint capsule, and distal insertion of the semimembranosus tendon. The harvested blocks were cut along the sagittal plane to isolate the distal insertion of the semimembranosus tendon on the posterior joint capsule and the posterior horn of the medial meniscus in a single slice. Histological slides were made from these samples and analyzed under a microscope. Results: In all knees, gross examination revealed a direct branch of the semimembranosus and a tendinous capsular branch ending behind the posterior horn of the medial meniscus. This capsular branch protruded over the joint capsule, over the meniscotibial ligament below and the meniscocapsular ligament above, but never ended directly in the meniscal tissue. The capsular branch was 14.3 ± 4.4 mm long (mean ± SD). The direct tendon inserted 11 ± 2.8 mm below the articular surface of the tibial plateau. The meniscotibial ligament inserted on the posteroinferior edge of the medial meniscus, and the meniscocapsular ligament insertion was on its posterosuperior edge. Highly vascularized adipose tissue was found, delimited by the posterior horn of the medial meniscus, meniscotibial ligament, meniscocapsular ligament, and capsular branch of the semimembranosus tendon. Conclusion: In all knees, our study found a capsular branch of the semimembranosus tendon inserted behind the medial meniscus. The meniscotibial ligament was inserted on the posteroinferior edge of the medial meniscus. Histological analysis of this area revealed that this ligament inserted differently from the insertion previously described in the literature. Clinical Relevance: This laboratory study provides insight into the pathophysiology of ramp lesions frequently associated with anterior cruciate ligament injury. To restore anatomy, it is mandatory to reestablish meniscotibial ligament continuity in ramp repairs.

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.

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.

Prosthesis Design for Bilateral Hip Disarticulation Management

2014 ◽  
Vol 664 ◽  
pp. 423-428
Author(s):  
Mauricio Plaza Torres ◽  
William Aperador
Keyword(s):  
Body Weight ◽  
Lower Extremity ◽  
Hip Joint ◽  
Joint Capsule ◽  
The Body ◽  
Body Weight Support ◽  
Patient Mobility ◽  
Weight Support ◽  
Crush Injuries ◽  
High Level

Hip disarticulation is an amputation through the hip joint capsule, removing the entire lower extremity, with closure of the remaining musculature over the exposed acetabulum. Tumors of the distal and proximal femur were treated by total femur resection; a hip disarticulation sometimes is performance for massive trauma with crush injuries to the lower extremity. This article discusses the design a system for rehabilitation of a patient with bilateral hip disarticulations. The prosthetics designed allowed the patient to do natural gait suspended between parallel articulate crutches with the body weight support between the crutches. The care of this patient was a challenge due to bilateral amputations at such a high level and the special needs of a patient mobility.

scholarly journals POSTURAL PROFILE OF INDIVIDUALS WITH HAM/TSP

2013 ◽  
Vol 1 (2) ◽  
Author(s):  
Maíra Carvalho Macêdo ◽  
Abrahão Fontes Baptista ◽  
Bernardo Galvão Castro-Filho ◽  
Edelvita Fernanda Duarte ◽  
Naiane Patrício ◽  
...  
Keyword(s):  
Sagittal Plane ◽  
The Body ◽  
Forward Displacement ◽  
Ankle Angle ◽  
Postural Assessment ◽  
De Medicina

Objectives:The aim of this survey was to delineate the profile of patients with HTLV-1 associated with HAM/TSP. Methods:This was cross-sectionalconducted at the HTLV Center of "EscolaBahiana de Medicina e SaúdePública,Bahia",Brazil,30 volunteerswith HAM / TSP werepairedwith 30 healthysubjects, whounderwent a postural evaluationbymeansof a Postural Assessment Software (SAPO®).Results:A trend characterized by postural projection of the trunk forward or backward, forward displacement of the body, bending the knees and ankle angle reduction was noted.Conclusion:This study demonstrates that there is a posture typical of the HAM/TSP patient which manifests itself with changes in the sagittal plane.

A Novel Training Bike and Camera System to Evaluate Pose of Cyclists

2020 ◽  
Author(s):  
Raman Garimella ◽  
Koen Beyers ◽  
Thomas Peeters ◽  
Stijn Verwulgen ◽  
Seppe Sels ◽  
...  
Keyword(s):  
Inertial Sensors ◽  
Sagittal Plane ◽  
Aerodynamic Drag ◽  
Linear Regression Analysis ◽  
The Body ◽  
Frontal Area ◽  
Motion Sensors ◽  
Joint Angles ◽  
Camera System ◽  
Flexion Extension

Abstract Aerodynamic drag force can account for up to 90% of the opposing force experienced by a cyclist. Therefore, aerodynamic testing and efficiency is a priority in cycling. An inexpensive method to optimize performance is required. In this study, we evaluate a novel indoor setup as a tool for aerodynamic pose training. The setup consists of a bike, indoor home trainer, camera, and wearable inertial motion sensors. A camera calculates frontal area of the cyclist and the trainer varies resistance to the cyclist by using this as an input. To guide a cyclist to assume an optimal pose, joint angles of the body are an objective metric. To track joint angles, two methods were evaluated: optical (RGB camera for the two-dimensional angles in sagittal plane of 6 joints), and inertial sensors (wearable sensors for three-dimensional angles of 13 joints). One (1) male amateur cyclist was instructed to recreate certain static and dynamic poses on the bike. The inertial sensors provide excellent results (absolute error = 0.28°) for knee joint. Based on linear regression analysis, frontal area can be best predicted (correlation > 0.4) by chest anterior/posterior tilt, pelvis left/right rotation, neck flexion/extension, chest left/right rotation, and chest left/right lateral tilt (p < 0.01).

scholarly journals THE IMPACT OF PILATES EXERCISES ON THE POSTURAL ALIGNMENT OF HEALTHY ADULTS

2016 ◽  
Vol 22 (6) ◽  
pp. 485-490
Author(s):  
Bruna Krawczky ◽  
Míriam Raquel Meira Mainenti ◽  
Antonio Guilherme Fonseca Pacheco
Keyword(s):  
Sagittal Plane ◽  
Positive Impact ◽  
Healthy Adults ◽  
The Body ◽  
Exercise Session ◽  
Post Intervention ◽  
Horizontal Alignment ◽  
Postural Alignment ◽  
Pilates Method ◽  
The Impact

ABSTRACT Introduction: Exercises of Pilates method have been widely used to improve postural alignment. There is strong evidence favoring their use in improving flexibility and balance, as well as some evidence of improvement in muscle strength. However, the benefits related to posture are not well established. Objective: To investigate in healthy adults, the impact of the Pilates method in the postural alignment through some angles in the sagittal plane and the occurrence of pain before and after an exercise session, and after the completion of a 16-session program. Methods: This is a quasi-experimental study of pre and post-intervention type. Healthy adults (n = 37) interested in starting Pilates were evaluated for acute effects on posture after a Pilates session (n = 37) and after a 16-session program, for a period of 10 weeks (n = 13). Using the postural assessment software (SAPO), six angles were analyzed: head horizontal alignment (HHA), pelvis horizontal alignment (PHA), hip angle (HA), vertical alignment of the body (VAB), thoracic kyphosis (TK), and lumbar lordosis (LL). The occurrence of pain was investigated to control adverse effects. Results: Statistically significant (p<0.05) differences found after one session include increased HHA (left view), decreased VAB (left view) and TK (both side views). After 16 sessions, we observed an increase of HHA, and a decrease of TK, LL (both side views) and HA (right view). All the differences point to an improvement of postural alignment. A significant reduction of prevalence of pain was verified after the first session (40.5% vs. 13.5%; p=0.004) and after the full program (30.8% vs. 15.3%; p=0.02). Conclusions: Our results suggest that the Pilates method has a positive impact on postural alignment in healthy adults, besides being a safe exercise.

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