Tibiofemoral rotation alignment in the normal knee joints among Chinese adults: a CT analysis

Abstract Background: Consensus on tibial rotation in total knee arthroplasty (TKA) remains controversial. The present study aimed to investigate the closest anatomical reference to surgical epicondylar axis (SEA) among 10 tibial markers in Chinese adults.Methods: This study included examination of 122 normal lower extremities. Briefly, 10 axes were drawn on the axial sections: transverse axis of tibia (TAT), axis of medial edge of patellar tendon (MEPT), axis of medial 1⁄3 of patellar tendon attachment (M1/3), Akagi line, Insall line, axis of medial border of tibial tubercle (MBTT), and axis of anterior border of the tibia 1-4 (ATC1-4). The mean angles between TAT and SEA and that between other axes and the line perpendicular to SEA were measured. Pairwise differences among the 10 tibial axes were examined by applying one-way analysis of variance (ANOVA) and paired t-test.Results: In all the knees, the mean angles of M1/3, Akagi line, Insall line, MBTT, ATC1, ATC2, ATC3, and ATC4 axes were compared to the line perpendicular to the projected SEA and found to be 10.2 ± 5.1°, 1.4 ± 5.0°, 11.9 ± 5.4°, 3.6 ± 4.8°, 12.0 ± 6.9°, 7.2 ± 8.6°, 7.1 ± 10.4°, and 6.6 ± 13.5° external rotation, respectively, and the MEPT axis was 1.6 ± 4.5° internal rotation. The mean angle for TAT was 4.1 ± 5.3° external rotation. The M1⁄3 and Insall line were significantly more externally rotated than Akagi line, MEPT, MBTT, TAT, ATC2, ATC3, and ATC4 axes. No significant differences were noted between the TAT axis and the MBTT axis and among the ATC2, ATC3, and ATC4 axes.Conclusion: The Akagi line, MBTT, and TAT showed good consistency with SEA in the axial femorotibial alignment with knee in extension. The middle segment of the anterior tibial crest also demonstrated good alignment consistency with SEA for the axial femorotibial alignment. Hence, these markers can be used as reliable references for rotational alignment of the tibial component in TKA.

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Popliteal cyst rupture in normal knee joints

BMJ ◽

10.1136/bmj.281.6252.1425-c ◽

1980 ◽

Vol 281 (6252) ◽

pp. 1425-1426

Author(s):

M Jayson

Keyword(s):

Knee Joints ◽

Popliteal Cyst ◽

Normal Knee ◽

Cyst Rupture

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Popliteal cyst rupture in normal knee joints.

BMJ ◽

10.1136/bmj.281.6249.1203 ◽

1980 ◽

Vol 281 (6249) ◽

pp. 1203-1204 ◽

Cited By ~ 14

Author(s):

D G Macfarlane ◽

P A Bacon

Keyword(s):

Knee Joints ◽

Popliteal Cyst ◽

Normal Knee ◽

Cyst Rupture

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Knee Joint Biomechanics in Physiological Conditions and How Pathologies Can Affect It: A Systematic Review

Applied Bionics and Biomechanics ◽

10.1155/2020/7451683 ◽

2020 ◽

Vol 2020 ◽

pp. 1-22 ◽

Cited By ~ 2

Author(s):

Li Zhang ◽

Geng Liu ◽

Bing Han ◽

Zhe Wang ◽

Yuzhou Yan ◽

...

Keyword(s):

Knee Joint ◽

Neurological Disorders ◽

Current Knowledge ◽

Knee Injuries ◽

Exercise Program ◽

Stair Climbing ◽

Knee Joints ◽

Future Research ◽

Normal Knee ◽

Joint Biomechanics

The knee joint, as the main lower limb motor joint, is the most vulnerable and susceptible joint. The knee injuries considerably impact the normal living ability and mental health of patients. Understanding the biomechanics of a normal and diseased knee joint is in urgent need for designing knee assistive devices and optimizing a rehabilitation exercise program. In this paper, we systematically searched electronic databases (from 2000 to November 2019) including ScienceDirect, Web of Science, PubMed, Google Scholar, and IEEE/IET Electronic Library for potentially relevant articles. After duplicates were removed and inclusion criteria applied to the titles, abstracts, and full text, 138 articles remained for review. The selected articles were divided into two groups to be analyzed. Firstly, the real movement of a normal knee joint and the normal knee biomechanics of four kinds of daily motions in the sagittal and coronal planes, which include normal walking, running, stair climbing, and sit-to-stand, were discussed and analyzed. Secondly, an overview of the current knowledge on the movement biomechanical effects of common knee musculoskeletal disorders and knee neurological disorders were provided. Finally, a discussion of the existing problems in the current studies and some recommendation for future research were presented. In general, this review reveals that there is no clear assessment about the biomechanics of normal and diseased knee joints at the current state of the art. The biomechanics properties could be significantly affected by knee musculoskeletal or neurological disorders. Deeper understanding of the biomechanics of the normal and diseased knee joint will still be an urgent need in the future.

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Serum amyloid A 1 protein isoforms induce Rheumatoid Arthritis

10.21203/rs.2.22482/v1 ◽

2020 ◽

Author(s):

Elaine Lai-Han Leung ◽

Huan-Ling Lai ◽

Run-Ze Li ◽

Hu-Dan Pan ◽

Ze-Bo Jiang ◽

...

Keyword(s):

Early Diagnosis ◽

Bone Destruction ◽

Joint Inflammation ◽

Protein Isoforms ◽

Knee Joints ◽

Micro Computed Tomography ◽

Bone Morphology ◽

Amyloid A ◽

Severity Prediction ◽

Ct Analysis

Abstract Background: SAA1 in RA pathogenesis and its complications remains unknown, making early diagnosis and risk prevention difficult. This study is to determine the pathogenetic mechanisms of three different SAA1 protein isoforms in RA progression. Methods: We modified an experimental adenovirus infection protocol in order to successfully introduce SAA1.2, SAA1.3, SAA1.5 gene alleles into the rear knee joints of C57BL/6 mice. Micro-computed tomography (micro-CT) analysis was applied to determine changes in bone morphology and density. Immunohistochemistry (IHC), flow cytometry, ELISA and real-time PCR were used to investigate disease progression and cytokine alterations in the course of adenoviral SAA-induced knee joint inflammation and bone destruction. Results: The pathogenetic functions of SAA1.2, SAA1.3 and SAA1.5 protein isoforms in promoting the initiation and progression of RA were determined. We established that SAA1.2 was the most aggressive factor in RA induction and progression. Mechanistically, we found that the arthritis-inducing effect of SAA1.2 transcription in the knee joints and mutant SAA1 protein secretion in blood results in stimulation of immune responses, leading to CD8+ T cell and pro-inflammatory cytokine elevation, with subsequent synovial inflammation and bone destruction. Conclusions: These findings indicate that SAA1 protein isoforms, particularly SAA1.2, play a significant role in the induction and progression of RA and may have potential value in the early diagnosis and severity prediction for RA.

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