scholarly journals ANTEROLATERAL LIGAMENT AS ROTATION STABILISER OF KNEE- JOINT. THE ROLE OF MRT AND ULTRASONOGRAPHY IN UNDERSTANDING ITS ANATOMY AND IN SELECTING SURGICAL TREATMENT STRATEGY FOR ITS INJURIES

2021 ◽  
Vol 29 (5) ◽  
pp. 581-589
Author(s):  
O.O. Kostrub ◽  
◽  
Iu.V. Poliachenko ◽  
M.A. Gerasimenko ◽  
V.V. Kotiuk ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Knee Joint ◽  
Treatment Strategy ◽  
Layer Structure ◽  
Attachment Site ◽  
Magnetic Resonance Tomography ◽  
Joint Capsule ◽  
Anterolateral Ligament ◽  
Knee Joints ◽  
Anatomical Parameters

Objective. To assess the variability of the anterolateral ligament according to MRT and ultrasonography data and to coordinate it with surgical treatment strategy for its injuries. Methods. The anterolateral ligament was analyzed on 100 series of MRI images of knee joints without traumatic pathology on Philips Achieva 1.5 T tomograph using the standard research protocol in three mutually perpendicular planes and 150 series of MRT images of knee joints with injuries and without injuries of the anterolateral ligament obtained on different tomographs from 0.2 to 3 Tesla. The quality of visualization of anterolateral ligament separate portions, the number of layers, and the contact with the joint capsule were evaluated. Both knee joints were analyzed by ultrasonography in 30 patients with anterior cruciate ligament injuries of one of the knee-joint and in 30 patients with intact knee-joints. Results. During the studies in the identification of anterolateral ligament with magnetic resonance tomography (MRT 1.5T)it was revealed at least partially in 92% of cases (in 68% as a two-layer structure; in 24% as a single-layer structure; in 14% as a thickening of the capsule or in 10% as a separate extracapsular structure), ultrasound examination - in 100% (the structure was not determined, however, in 26.67% of patients without clinically pronounced pathology of the knee-joint and significant trauma in anamnesis ultrasound scan revealed a violation of the integrity of the cortical layer at the tibial attachment site), Conclusion. According to MRT and ultrasonography data, the anterolateral ligament is a constant structure of the knee-joint, but very variable in its anatomical parameters, which in some cases may be poorly visualized on MRT, may have a two-layer structure, may be located either extracapsular or as a thickening of the knee-joint capsule. The variability of its anatomical structure makes it impossible to make the theoretical substantiation of the advantages of one separate method of its restoration, but, on the contrary, justifies a differentiated approach to the selection of optimal surgical treatment. What this paper adds With the help of current research methods, the normal anatomical parameters and anatomical variants of the anterolateral ligament of the knee joint have been clarified and detailed. It is necessary to emphasize the importance of a differentiated approach to choosethe optimal methods of surgical treatment for its injuries.

scholarly journals Variability of anterolateral ligament on MRI images – lack of survey standardization or anatomical variants?

2021 ◽  
Vol 18 (1) ◽  
pp. 58-68
Author(s):  
O. O. Kostrub ◽  
V. V. Кotiuk ◽  
Iu. V. Poliachenko ◽  
M. A. Gerasimenko ◽  
R. I. Blonskyi ◽  
...  
Keyword(s):  
Knee Joint ◽  
Layer Structure ◽  
Joint Capsule ◽  
Anterolateral Ligament ◽  
Anatomical Structure ◽  
Knee Joints ◽  
Anatomical Features ◽  
Common Features ◽  
Anatomical Element ◽  
History Of

The anterolateral ligament is a rotational stabilizer of the knee joint. It is not always clear what we actually see on MRI in the area of anterolateral ligament (ALL).The aim of the study was to evaluate the ALL variants on MRI images to summarize their common features and differences, and to try to find an explanation for the phenomenon of the ALL variability.200 series of MRI images of knee joints were analyzed. The presence of the ALL, the number of its layers, the relation to the joint capsule, and other anatomical features were assessed.The ALL was visualized on MRI at least partially in 88 % of cases. At least partially two-layer structure was detected in 68 % of all 200 MRI series. The wavy appearance of the certain portions of the anterolateral ligament was observed in some normal knee joints without a history of injuries.Determined that the ALL is a separate anatomical element of the knee joint that has a variable, but in most cases two-layered, anatomical structure and can be detected on MRI in at least 88 % of cases. Axial sections help to identify ALL in complex cases and allow analyzing its anatomy, but adding little in the diagnosis of ALL injury.

scholarly journals Clinical and microbiological characteristics of periprosthetic hip and knee infections

2020 ◽  
pp. 237-240
Author(s):  
Vladimir A. ​ Ivantsov ◽  
I.P. Bogdanovich ◽  
V.V. Lashkovskiy ◽  
V.S. Anosov
Keyword(s):  
Surgical Treatment ◽  
Knee Joint ◽  
Hip Joint ◽  
Joint Replacement ◽  
Periprosthetic Infection ◽  
Joint Infection ◽  
Knee Joints ◽  
Knee Joint Replacement ◽  
Hip Joint Replacement ◽  
Total Knee

Objective. To characterize periprosthetic joint infection in patients undergoing a total hip and knee joint replacement. Materials and Methods. A total of 77 patients with periprosthetic infection following hip and knee joint replacement hospitalized in Grodno City Clinical Hospital were studied over the period of 2014-2018. Wound discharge, tissue samples, and fistula’s wall swab were used for microbiological tests. The analysis of surgical treatment of patients with deep periprosthetic knee and hip joint infection has been performed. Results. Periprosthetic infection after hip joint arthroplasty was observed in 32 (41.6%) patients, and after total knee joint arthroplasty in 45 (58.4%) patients. Surgical treatment was performed in 18 (56.3%) and 32 (71.1%) patients with periprosthetic infection following total knee and hip joint replacement, respectively. A total of 10 (31.2%) of 32 cultures from patients with periprosthetic infection after total hip joint replacement and 8 (17.8%) of 45 cultures from patients with periprosthetic infection after total knee joint replacement were positive. Overall, Staphylococcus aureus was detected in 9 (50%) of 18 positive cultures. Gram-negative aerobic bacteria (Acinetobacter baumannii, Klebsiella pneumoniae Pseudomonas aeruginosa) were detected in 4⁄10 and 5⁄8 of positive cultures from patients with periprosthetic infection of hip and knee joints, respectively. Conclusions. The most common pathogens causing periprosthetic infection of hip and knee joints were S. aureus (50%) and Gram-negative bacteria. The surgical treatment was performed in 71.4% of patients with periprosthetic joint infection.

scholarly journals Methodology of Ultrasonographic Examination of the Anterolateral Ligament of the Knee Joint

2020 ◽  
Vol 106 (3) ◽  
pp. 30-41
Author(s):  
O.O. Kostrub ◽  
V.V. Kotiuk ◽  
L.Ye. Osadcha ◽  
R.V. Luchko ◽  
P.V. Didukh ◽  
...  
Keyword(s):  
Knee Joint ◽  
Reference Point ◽  
Insertion Site ◽  
Lower Leg ◽  
Anterolateral Ligament ◽  
Knee Joints ◽  
Lateral Condyle ◽  
Collateral Ligament ◽  
Fibular Collateral Ligament ◽  
Starting Point

Summary. Injury of the anterolateral ligament (ALL) accompanies more than half of the anterior cruciate ligament ruptures. However, the uncertainty in the anatomy of ALL raises many questions regarding its visualization on ultrasound. There are also very few ultrasonographic studies of the ALL in the scientific literature in the era of MRI and CT. Objective: to determine the optimal methods and techniques for identifying and improving the visualization of the ALL with ultrasonography. Materials and Methods. ALL ultrasonography was performed in 30 healthy volunteers without pathology of the knee joint on both knee joints using a linear high-frequency sensor (ACUSON NX2 Elite, 10 MHz) at different angles of bending and rotation. Results. Ultrasonography was able to visualize the ALL in all 30 patients as a fibrillar anisotropic structure. The distinctiveness of the ALL was significantly different between patients. It was easiest to find and visualize it well with an extended knee joint, and to assess the integrity and tension when bending the knee joint at an angle of 60° and in the maximum internal rotation of the lower leg. A clearly visible tubercle was revealed by ultrasonography at the site of attachment of the ALL to the tibia in 100% of patients, which has not been described previously and greatly facilitates its finding. There was a history of a violation of the integrity of the cortical layer at the site of attachment of the ALL to the tibia in 26.67% of patients without pathology of the knee joint and injuries. Ultrasonographic identification of the two-layer structure of the ALL failed. The femoral part of the ALL is usually woven into the initial part of the fibular collateral ligament and cannot be separated ultrasonographically from it. In all 30 patients with relatively healthy knee joints without traumatic pathology, the ALL in the contralateral joints looked similar, without statistically significant deviations in their morphometric parameters. Conclusions. Ultrasonography visualizes the tibial and femoral parts of the ALL particularly but not exclusively during movements; however, it almost does not show meniscus bundles separately. For a better visualization of the ALL and assessment of its integrity, we recommend starting its research with an extended knee joint, and then performing functional tests by alternating internal and external rotation of the lower leg at different angles of flexion of the knee joint. The starting point of the ALL is the origin of the fibular collateral ligament from the lateral condyle of the femur, and the reference point of attachment is the tubercle on the anterolateral surface of the tibia posterior to Gerdy tubercle uncovered by us with ultrasonography in all the patients, which is an important reference point that allows faster, easier, and more confident localization of the ALL tibial portion insertion site. On a healthy contralateral joint, the ALL can serve as a reference for comparison if its rupture is suspected.

scholarly journals STUDY OF THE ANTEROLATERAL LIGAMENT OF THE KNEE IN FORMALIN-EMBEDDED CADAVERS

2017 ◽  
Vol 25 (2) ◽  
pp. 89-92 ◽  
Author(s):  
Paloma Batista Almeida Fardin ◽  
Juliana Hott de Fúcio Lizardo ◽  
Josemberg da Silva Baptista
Keyword(s):  
Knee Joint ◽  
Cross Sections ◽  
Subcutaneous Tissue ◽  
Biceps Tendon ◽  
Joint Capsule ◽  
Anterolateral Ligament ◽  
Patellar Ligament ◽  
Collateral Ligament ◽  
Level Of Evidence ◽  
Iliotibial Tract

ABSTRACT Objective: To verify the incidence and characterize morphologically the anterolateral ligament of the knee (ALL) in cadaveric samples of the collection of the Laboratory of Anatomy of the Department of Morphology of the Universidade Federal do Espírito Santo. Methods: Dissections and cross sections were performed for mesoscopic analysis of the anterolateral region of 15 knees preserved in 4% formalin solution in order to identify the ALL. Results: After dissection of the skin and subcutaneous tissue of the knee anterolateral region, it was possible to identify the iliotibial tract (ITT), the patellar ligament and the femoral biceps tendon. The ITT was removed from the Gerdy tubercle and the following structures were visualized: knee joint capsule, fibular collateral ligament and popliteal tendon. However, the ALL was not identified in any of the samples. Conclusions: The ALL could not be identified in any of the specimens studied, either through dissection or mesoscopic analysis. Level of Evidence III, Diagnosis Studies - Investigation of an Exam for Diagnosis.

Surgical treatment strategy for small-sized, non-small cell lung cancer: A proposed algorithm for limited resection

2010 ◽  
Vol 24 (7) ◽  
pp. 1004-1010 ◽  
Author(s):  
Masayoshi Inoue ◽  
Masato Minami ◽  
Noriyoshi Sawabata ◽  
Yoshihisa Kadota ◽  
Yasushi Shintani ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Surgical Treatment ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Treatment Strategy ◽  
Small Cell ◽  
Limited Resection ◽  
Small Cell Lung

Visualization of Cartilage from Knee Joint Magnetic Resonance Images and Quantitative Assessment to Study the Effect of Age, Gender and Body Mass Index (BMI) in Progressive Osteoarthritis (OA)

2019 ◽  
Vol 15 (6) ◽  
pp. 565-572
Author(s):  
Mallikarjunaswamy Shivagangadharaiah Matada ◽  
Mallikarjun Sayabanna Holi ◽  
Rajesh Raman ◽  
Sujana Theja Jayaramu Suvarna
Keyword(s):  
Body Mass Index ◽  
Magnetic Resonance ◽  
Knee Joint ◽  
Body Mass ◽  
3D Visualization ◽  
Cartilage Degradation ◽  
Magnetic Resonance Images ◽  
Cartilage Thickness ◽  
Knee Joints ◽  
Data Set

Background: Osteoarthritis (OA) is a degenerative disease of joint cartilage affecting the elderly people around the world. Visualization and quantification of cartilage is very much essential for the assessment of OA and rehabilitation of the affected people. Magnetic Resonance Imaging (MRI) is the most widely used imaging modality in the treatment of knee joint diseases. But there are many challenges in proper visualization and quantification of articular cartilage using MRI. Volume rendering and 3D visualization can provide an overview of anatomy and disease condition of knee joint. In this work, cartilage is segmented from knee joint MRI, visualized in 3D using Volume of Interest (VOI) approach. Methods: Visualization of cartilage helps in the assessment of cartilage degradation in diseased knee joints. Cartilage thickness and volume were quantified using image processing techniques in OA affected knee joints. Statistical analysis is carried out on processed data set consisting of 110 of knee joints which include male (56) and female (54) of normal (22) and different stages of OA (88). The differences in thickness and volume of cartilage were observed in cartilage in groups based on age, gender and BMI in normal and progressive OA knee joints. Results: The results show that size and volume of cartilage are found to be significantly low in OA as compared to normal knee joints. The cartilage thickness and volume is significantly low for people with age 50 years and above and Body Mass Index (BMI) equal and greater than 25. Cartilage volume correlates with the progression of the disease and can be used for the evaluation of the response to therapies. Conclusion: The developed methods can be used as helping tool in the assessment of cartilage degradation in OA affected knee joint patients and treatment planning.

Ultrastructure of sensory nerve endings in monkey (Macaca fascicularis) knee joint capsule

1984 ◽  
Vol 2 (2) ◽  
pp. 169-176 ◽  
Author(s):  
Zdenek Halata ◽  
Marie A. Badalamente ◽  
Roger Dee ◽  
Michael Propper
Keyword(s):  
Knee Joint ◽  
Macaca Fascicularis ◽  
Sensory Nerve ◽  
Joint Capsule ◽  
Nerve Endings ◽  
Sensory Nerve Endings

Effects of N- and L-type calcium channel antagonists on the responses of nociceptive spinal cord neurons to mechanical stimulation of the normal and the inflamed knee joint

1996 ◽  
Vol 76 (6) ◽  
pp. 3740-3749 ◽  
Author(s):  
V. Neugebauer ◽  
H. Vanegas ◽  
J. Nebe ◽  
P. Rumenapp ◽  
H. G. Schaible
Keyword(s):  
Spinal Cord ◽  
Knee Joint ◽  
Calcium Channels ◽  
Mechanical Stimulation ◽  
Topical Administration ◽  
Knee Joints ◽  
Spinal Cord Neurons ◽  
Inflammatory Conditions ◽  
Voltage Dependent ◽  
Voltage Dependent Calcium Channels

1. The present study addresses the involvement of voltage-dependent calcium channels of the N and L type in the spinal processing of innocuous and noxious input from the knee joint, both under normal conditions and under inflammatory conditions in which spinal cord neurons become hyperexcitable. In 30 anesthetized rats, extracellular recordings were performed from single dorsal horn neurons in segments 1–4 of the lumbar spinal cord. All neurons had receptive fields in the ipsilateral knee joint. In 22 rats, an inflammation was induced in the ipsilateral knee joint by kaolin and carrageenan 4–16 h before the recordings. The antagonist at N-type calcium channels, omega-conotoxin GVIA (omega-CTx GVIA), was administered topically in solution to the dorsal surface of the spinal cord at the appropriate spinal segments in 6 rats with normal joints and in 12 rats with inflamed knee joints. The antagonist at L-type channels, nimodipine, was administered topically in 5 rats with normal joints and in 11 rats with inflamed knee joints. In another five rats with inflamed joints, antagonists at L-type calcium channels (diltiazem and nimodipine) and omega-CTx GVIA were administered ionophoretically with multibarrel electrodes close to the neurons recorded. 2. The topical administration of omega-CTx GVIA to the spinal cord reduced the responses to both innocuous and noxious pressure applied to the knee joint in a sample of 11 neurons with input from the normal joint and in a sample of 16 neurons with input from the inflamed joint (hyperexcitable neurons). The responses were decreased to approximately 65% of the predrug values within administration times of 30 min. A similar reduction of the responses to innocuous and noxious pressure was observed when omega-CTx GVIA was administered ionophoretically to nine hyperexcitable neurons. In neurons with input from the normal or the inflamed knee joint, the administration of omega-CTx GVIA led also to a reduction of the responses to innocuous and noxious pressure applied to the noninflamed ankle joint. 3. The topical administration of nimodipine decreased the responses to innocuous and noxious pressure applied to the knee in a sample of 9 neurons with input from the normal joint and in a sample of 16 neurons with input from the inflamed knee joint (hyperexcitable neurons). Within administration times of 30 min, the responses were reduced to approximately 70% of the predrug values. In hyperexcitable neurons, the responses to innocuous and noxious pressure applied to the knee were also decreased during ionophoretic administration of nimodipine (6 neurons) and diltiazem (9 neurons). When the noninflamed ankle was stimulated, the responses to innocuous pressure were reduced neither in neurons with input from the normal knee nor in neurons with input from the inflamed knee, but the responses of hyperexcitable neurons to noxious pressure onto the ankle were reduced. The ionophoretic administration of the agonist at the L-type calcium channel, S(-)-Bay K 8644, enhanced the responses to mechanical stimulation of the knee joint in all 14 hyperexcitable neurons tested. The effect of S(-)-Bay K 8644 was counteracted by both diltiazem (in 6 of 6 neurons) and nimodipine (in 5 of 5 neurons). 4. These data show that antagonists at both the N- and the L-type voltage-dependent calcium channels influence the spinal processing of input from the knee joint. The data suggest, therefore, that voltage-dependent calcium calcium channels of both the N and the L type are important for the sensory functions of the spinal cord. They are involved in the spinal processing of nonnociceptive as well as nociceptive mechanosensory input from the joint, both under normal and inflammatory conditions. The present results show in particular that N- and L-type channels are likely to be involved in the generation of pain evoked by noxious mechanical stimulation in normal tissue as well as in the mechanical hyperalgesia that is usually pres

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