scholarly journals Pressure Change Of Fixed Rotational Deformities In The Femur In Human Cadaver Knees-A Biomechanical Study

2021 ◽  
Author(s):  
Yuwen Peizhi ◽  
Hongzhi Lv ◽  
Yanbin Zhu ◽  
Wenli Chang ◽  
Ning Wei ◽  
...  
Keyword(s):  
Knee Joint ◽  
Internal Rotation ◽  
Contact Pressure ◽  
Tibial Plateau ◽  
Lower Limbs ◽  
Lateral Side ◽  
Neutral Position ◽  
Relative Pressure ◽  
Rotational Deformity ◽  
Significant Difference

Abstract Background: Closed intramedullary interlocking nailing is a standard treatment for femoral shaft fractures, but incidences of rotational malalignment after operation is really high. Poor reduction and postoperative malunion lead to many clinical symptoms and long term degenerative arthritis. It has been proved that uneven stress is the mechanical cause of knee joint degeneration, but few studies pay attention to the effect of femur rotational deformity on knee joint contact pressure.This study aim to quantitatively evaluate the relation between residual rotational deformity in femur and contact pressure of knee joint. Methods: Fourteen cadaveric Lower limbs were selected and autopsied, rotatory fixation model with different angles were then made. Connect each model on the biomechanical machine and apply a vertical load to 400N. The contact pressure was quantitatively measured using ultra-low-pressure sensitive film technology. FPD-305E density meter and FPD-306E pressure converter were used to read relative pressure values. Contact pressure on medial and lateral tibial plateau in different femoral rotational deformities were compared. Analysis were done using SPSS software.Results: The medial group show a significant difference on tibial plateau (F=92.114, P<0.01), further test showed statistically significant differences of pairwise comparisons between 0°, 5°, 10°, 15° internal rotation deformity (P<0.05). There is no significant difference in lateral group (ꭓ2=9.967, P<0.01). The medial contact pressure is 0.940±0.177 MPa and the lateral is 1.008±0.219 MPa at neutral position, no statistically significant was found, so is 5° of internal rotational deformity. But the medial contact pressure are all higher than the lateral side at 5°, 10°, 15° of external rotation, and 10°, 15° of internal rotation. Conclusion: Obvious contact pressure changes on tibial plateau were observed in rotatory deformity femur, which is closely related to the occurrence of knee osteoarthritis. Doctors should detect rotational deformity as much as possible during operation and perform anatomical reduction, for patients with residual rotational deformities, indication of osteotomy should not be too broad.

scholarly journals Pressure Change Of Fixed Rotational Deformities In The Femur In Human Cadaver Knees-A Biomechanical Study

2021 ◽  
Author(s):  
Peizhi Yuwen ◽  
Hongzhi Lv ◽  
Yanbin Zhu ◽  
Wenli Chang ◽  
Ning Wei ◽  
...  
Keyword(s):  
Internal Rotation ◽  
Contact Pressure ◽  
Tibial Plateau ◽  
Pressure Change ◽  
Lower Limbs ◽  
Lateral Side ◽  
Neutral Position ◽  
Relative Pressure ◽  
Rotational Deformity ◽  
Significant Difference

Abstract Objective: To reveal the contact pressure change on tibial plateau in malalignment femur. Methods: Fourteen cadaveric Lower limbs were selected and autopsied, rotatory fixation model with different angles were then made. Connect each model on the biomechanical machine and apply a vertical load to 400N. The contact pressure was quantitatively measured using ultra-low-pressure sensitive film technology. FPD-305E density meter and FPD-306E pressure converter were used to read relative pressure values. Contact pressure on medial and lateral tibial plateau in different femoral rotational deformities were compared. Analysis were done using SPSS software.Results: The medial group show a significant difference on tibial plateau (F=92.114, P<0.01), further test showed statistically significant differences of pairwise comparisons between 0°, 5°, 10°, 15° internal rotation deformity (P<0.05). There is no significant difference in lateral group (c2=9.967, P<0.01). The medial contact pressure is 0.940±0.177 MPa and the lateral is 1.008±0.219 MPa at neutral position, no statistically significant was found, so is 5° of internal rotational deformity. But the medial contact pressure are all higher than the lateral side at 5°, 10°, 15° of external rotation, and 10°, 15° of internal rotation. Conclusion: Obvious contact pressure changes on tibial plateau were observed in rotatory deformity femur, which is closely related to the occurrence of knee osteoarthritis. Doctors should detect rotational deformity as much as possible during operation and perform anatomical reduction, for patients with residual rotational deformities, indication of osteotomy should not be too broad.

scholarly journals Pressure Change Of Fixed Rotational Deformities In The Femur In Human Cadaver Knees-A Biomechanical Study

2020 ◽  
Author(s):  
Peizhi Yuwen ◽  
Hongzhi Lv ◽  
Yanbin Zhu ◽  
Wenli Chang ◽  
Ning Wei ◽  
...  
Keyword(s):  
Internal Rotation ◽  
Contact Pressure ◽  
Tibial Plateau ◽  
External Rotation ◽  
Pressure Change ◽  
Lateral Side ◽  
Neutral Position ◽  
Relative Pressure ◽  
Rotational Deformity ◽  
Significant Difference

Abstract Objective: To reveal the contact pressure change on tibial plateau in malalignment femur. Methods: Fourteen adult cadaver were selected, after autopsy, 14 cadaveric knee were established and fixed at neutral position (0°, anatomically reduced), 5°, 10°, 15° of external rotation, and 5°, 10°, 15° of internal rotation. Connect the rotatory fixation model on the biomechanical machine and apply a vertical load to 400N. The contact pressure on medial and lateral tibial plateau was quantitatively measured using ultra-low-pressure sensitive film technology. FPD-305E density meter and FPD-306E pressure converter were used to read relative pressure value. Data were analyzed using SPSS software. Results: The medial group show a significant difference on tibial plateau ( F =92.114, P <0.01), further test showed statistically significant differences of pairwise comparisons between 0°, 5°, 10°, 15° internal rotation deformity ( P <0.05). There is no significant difference in lateral group ( c 2 =9.967, P <0.01). The medial contact pressure is 0.940±0.177 MPa and the lateral is 1.008±0.219 MPa at neutral position, no statistically significant was found, so is 5° of internal rotational deformity. But the medial contact pressure are all higher than the lateral side at 5°, 10°, 15° of external rotation, and 10°, 15° of internal rotation. Conclusion: Obvious contact pressure changes on tibial plateau were observed in rotatory deformity femur, which is closely related to the occurrence of knee osteoarthritis. Doctors should detect rotational deformity as much as possible during operation and perform anatomical reduction, for patients with residual rotational deformities, indication of osteotomy should not be too broad.

scholarly journals Biomechanical study on the stress distribution of the knee joint after residual rotation deformity of tibial fracture

2020 ◽  
Author(s):  
Ming Li ◽  
Yanbin Zhu ◽  
Ning Wei ◽  
Wenli Chang ◽  
Zeyue Jin ◽  
...  
Keyword(s):  
Stress Distribution ◽  
Knee Joint ◽  
Lower Limb ◽  
External Rotation ◽  
Biomechanical Study ◽  
Lower Limbs ◽  
Neutral Position ◽  
Lateral Stress ◽  
Significant Difference ◽  
The Difference

Abstract Objectives To investigate the effect of residual rotation deformity on the stress distribution of the knee joint after surgery to treat middle and upper tibial fractures. Methods Fourteen adult cadaver specimens that were preserved with formalin were included, and the tibias were randomly positioned at 0 degree, 5 degrees, 10 degrees, and 15 degrees from the line of force of the lower limb. These positions modeled deformities of 5 degrees, 10 degrees, and 15 degrees from the line of force. Low-pressure pressure-sensitive film technology measured the stress distribution of the knee joint under different degrees of rotation deformity. Results Under a vertical load of 400 N, the difference between the medial and lateral stress of the knee joint was significantly different between the different tibia deformities (P<0.05), and the medial stress of the knee joint was higher than the lateral stress. The current study showed that there were statistically significant differences in the medial stress on the knee joint at all angles (including the neutral position of 0 degrees) (F=89.753, P<0.001) . There was a statistically significant difference in the lateral stresses of the knee joint between different rotation deformities (including the neutral position of 0 degrees) (F=102.998, P<0.001). Conclusions Residual rotation deformity after fracture of middle and upper tibia can lead to poor alignment of lower limb force and change of articular contact characteristics of knee joint, especially external rotation of tibia.Therefore, orthopedic surgeons should correct the malalignment of lower limbs to the greatest extent and reduce the rotation deformity as far as possible.

SURGICAL APPROACH FOR KNEE JOINT ARTHROPLASTY IN CHILDREN WITH CANCER: THE INTRODUCTION OF A LATERAL APPROACH FOR SEGMENTAL RESECTION OF THE PROXIMAL TIBIA

2021 ◽  
Vol 100 (3) ◽  
pp. 227-233
Author(s):  
N.A. Bolshakov ◽  
◽  
A.Yu. Artemov ◽  
A.S. Slinin ◽  
E.O. Bezdolnova ◽  
...  
Keyword(s):  
Knee Joint ◽  
Surgical Approach ◽  
Ewing’S Sarcoma ◽  
Rating Scale ◽  
Ewing's Sarcoma ◽  
Functional Results ◽  
Lateral Approach ◽  
Joint Arthroplasty ◽  
Lateral Side ◽  
Significant Difference

The aim of the study was to analyze our own experience of using the lateral approach in knee joint arthroplasty in children with oncopathology. Materials and methods of research: the results of a retrospective nonrandomized uncontrolled single-center study are analyzed, within the framework of which 97 endoprosthetics of the knee joint were performed in children and adolescents with oncological pathology over 7 years (2012–2018). Lateral approach was used in 28 patients. The functional results were assessed using the MSTS rating scale 6 and 12 months after the surgery. Postoperative complications were analyzed according to the Henderson classification (modified by the ISOLS committee). Results: when comparing the functional outcome depending on the surgical approach, no statistically significant difference was found either after 6 months (p=0,124) or after 12 months (p=0,755). There is no more frequent development of complications detected (p=0,551). The access used also did not affect overall survival in osteosarcoma (p=0,577), in Ewing's sarcoma (p=0,493), as well as on event-free survival in osteosarcoma (p=0,829) and in Ewing's sarcoma (p=0,886). Conclusion: the use of the lateral surgical approach for knee arthroplasty in children with oncopathology does not affect the treatment results, however, it provides the surgeon with greater variability of actions during preoperative planning. This is especially true for patients whose biopsy tract is located on the lateral side.

Strain in the Lateral Ligaments of the Ankle

Foot & Ankle ◽  
1988 ◽  
Vol 9 (2) ◽  
pp. 59-63 ◽  
Author(s):  
P. Renstrom ◽  
M. Wertz ◽  
S. Incavo ◽  
M. Pope ◽  
H.C. Ostgaard ◽  
...  
Keyword(s):  
Internal Rotation ◽  
External Rotation ◽  
Anterior Talofibular Ligament ◽  
Neutral Position ◽  
Calcaneofibular Ligament ◽  
Ankle Ligaments ◽  
Significant Difference ◽  
Ligament Strain ◽  
Pronation External Rotation ◽  
Relaxing Effect

Strain was measured in the normal anterior talofibular ligament (ATF) and the calcaneofibular ligament (CF) using Hall effect strain transducers in five cadaveric ankles. These measurements were made in both ligaments with the ankle in neutral position and with the foot moving from 10° dorsiflexion to 40° plantarflexion in an apparatus that permits physiologic motion. The ankle ligaments were then tested with the foot placed in six different positions that combined supination, pronation, external rotation, and internal rotation. In the neutral position, through a range of motion of 10° dorsiflexion to 40° plantarflexion, the anterior talofibular ligament underwent an increasing strain of 3.3%. No significant strain increase was found with internal rotation. The only significant difference from the strains at the neutral position was in external rotation, which decreased strain 1.9%. In all positions, increased strain occurred with increased plantarflexion. The calcaneofibular ligament was essentially isometric in the neutral position throughout the flexion arc. The calcaneofibular ligament strain was significantly increased by supination and external rotation. However, with increasing plantarflexion in these positions, the strain in the calcaneofibular ligament decreased. Therefore, plantarflexion has a relaxing effect on the calcaneofibular ligament. Thus, the anterior talofibular and calcaneofibular ligaments are synergistic, such that when one ligament is relaxed, the other is strained and vice versa.

scholarly journals Biomechanical study on the stress distribution of the knee joint after distal femoral fracture malunion with residual varus-valgus deformity 

2020 ◽  
Author(s):  
Ming Li ◽  
Pan Hu ◽  
Lijie Ma ◽  
Di Zhang ◽  
Wenli Chang ◽  
...  
Keyword(s):  
Stress Distribution ◽  
Knee Joint ◽  
Femoral Fracture ◽  
Femoral Fractures ◽  
Valgus Deformity ◽  
Biomechanical Study ◽  
Lower Limbs ◽  
Neutral Position ◽  
Distal Femoral Fracture ◽  
Lateral Plateau

Abstract Background: To investigate the effect of residual varus and valgus deformity on the stress distribution of knee joint after distal femoral fracture malunion. Methods: Fourteen adult cadaver specimens with formalin were selected to establish the femoral fractures models, which were fixed subsequently at neutral position (anatomical reduction) and malunion positions (at 3 degrees, 7 degrees, 10 degrees valgus positions and 3 degrees, 7 degrees, and 10 degrees varus positions). The stress distribution on the medial and lateral plateau of the tibia was quantitatively measured using ultra-low pressure sensitive film technology. The change of stress distribution of knee joint after femoral fracture malunion and the relationship between stress value and residual varus varus or valgus deformity were analyzed.Results: Under 400 N vertical load, the stress values on the medial and lateral plateau of the tibia at the neutral position were 1.162±0.114 MPa and 1.103±0.144 MPa, respectively. When compared with the stress values measured at the neutral position, the stress on the medial plateau of tibia were significantly higher at varus deformities and lower at valgus deformities, and the stress on the lateral plateau was significantly higher at valgus deformity and lower at varus deformities (all P<0.05). The stress values on the medial plateau of tibia were significantly higher than the corresponding data on the lateral plateau at neutral and 3 degrees, 7 degrees, 10 degrees varus deformities, respectively (all P<0.05), and significantly lower than the corresponding data on the lateral plateau at 3 degrees, 7 degrees, 10 degrees valgus deformities, respectively (all P<0.05). Conclusions: Residual varus and valgus deformity after femoral fracture malunion can cause obvious changes of the stress distribution of knee joint. Therefore, the distal femoral fracture should be anatomically reduced and rigidly fixed to avoid residual varus-valgus deformity and malalignment of lower limbs.

scholarly journals Is there difference and correlation between medial and lateral tibial plateau coronal obliquity in native knee? A radiographic study

2021 ◽  
Vol 28 ◽  
pp. 221049172110569
Author(s):  
Thomas Ka Chun Leung ◽  
Will Wai Hong Lau ◽  
Wing Chiu Fung ◽  
Vincent Wai Kwan Chan ◽  
Amy Cheung ◽  
...  
Keyword(s):  
Knee Joint ◽  
Tibial Plateau ◽  
Articular Surface ◽  
Young Patients ◽  
Joint Line ◽  
Significant Implication ◽  
Lateral Tibial Plateau ◽  
Radiographic Measurements ◽  
Significant Difference ◽  
Joint Line Obliquity

Background/Purpose Knee joint line is commonly defined as a tangent to medial and lateral tibial plateaus in various radiographic measurements. We aim to investigate radiographic differences between medial and lateral knee joint line coronal obliquity. It has significant implication on radiographic analysis following unicompartmental knee arthroplasty. Methods We analysed the knee radiographs of 48 young patients (mean age 25.1 + /-5.6 years) with 50 anterior cruciate ligament-deficient knees. Medial and lateral tibial plateau coronal obliquity were defined as angles between femoral knee joint line and the tangent to articular surface of each tibial plateau. Mediolateral differences and linear correlation were analysed. Results Significant difference was found between medial (mean = -1.5, SD = 2.4 degrees) and lateral obliquity (mean =  + 0.6, SD = 3.0 degrees) ( p < 0.001). The mean mediolateral difference was 3.1 degrees (SD = 2.8, range 0–11.8 degrees), without significant correlation (r = 0.085, p = 0.56). Conclusion Mediolateral differences exist in knee joint line obliquity. Each compartment should be considered separately when measuring knee joint line obliquity.

scholarly journals RADIOLOGICAL ASSESSMENT OF KNEE JOINT WIDTH DIFFERENCES IN OLDER ADULTS WITH SYMPTOMATIC MEDIAL KNEE OSTEOARTHRITIS

2021 ◽  
Author(s):  
SAMWON YOON ◽  
YOUNGJOO CHA ◽  
HYUNSIK YOON ◽  
KYOUNGTAE KIM ◽  
ILBONG PARK ◽  
...  
Keyword(s):  
Older Adults ◽  
Knee Joint ◽  
Knee Osteoarthritis ◽  
Joint Space Width ◽  
Lower Limbs ◽  
Unaffected Side ◽  
Medial Knee ◽  
Knee Oa ◽  
Affected Side ◽  
Significant Difference

Knee osteoarthritis (OA) is a degenerative articular disease. The knee joint space width (JSW) is used for grading the severity of knee OA. However, there is a lack of research on differences in the widths of knee joints between both lower limbs in unilateral OA. The purpose of this research was to examine the radiological difference in the affected knee joint and contralateral knee joint by analyzing unilateral older adults with medial knee OA using both knees’ JSW differences. Twenty-five subjects with unilateral medial knee OA participated. X-ray radiographs were used to assess knee JSW, and the paired [Formula: see text]-test was performed to assess the knee joint gap width between the affected side and the unaffected side in the respective medial and lateral sides. The independent [Formula: see text]-test compared the differences between the lateral and medial knee JSWs on the affected side and unaffected side. The paired [Formula: see text]-test did not show a significant difference in the medial and lateral knee JSW on the affected side compared to the unaffected side ([Formula: see text]; 0.11). Meanwhile, the independent [Formula: see text]-test revealed a significant difference between the affected and unaffected sides ([Formula: see text]). This study showed no significant changes in affected knee JSWs compared to unaffected sides, but the difference between the lateral and medial JSWs was significant between the knees affected and unaffected by OA in the older adults with medial knee OA.

scholarly journals Stiffness of the Gastrocnemius–Achilles Tendon Complex Between Amateur Basketball Players and the Non-athletic General Population

2020 ◽  
Vol 11 ◽  
Author(s):  
Tian-Tian Chang ◽  
Zhe Li ◽  
Xue-Qiang Wang ◽  
Zhi-Jie Zhang
Keyword(s):  
General Population ◽  
Achilles Tendon ◽  
Ankle Joint ◽  
Healthy Subjects ◽  
Lower Limbs ◽  
Medial Gastrocnemius ◽  
Neutral Position ◽  
Basketball Players ◽  
Significant Difference ◽  
Repeated Training

Muscle and tendon stiffness are related to sports performance, tendinopathy, and tendon degeneration. However, the effects of habitual loading on muscle and tendon mechanical properties are unclear. Using amateur basketball players as examples, we investigated the effects of mechanical loading on the stiffness of the gastrocnemius–Achilles tendon (AT) complex in non-dominant and dominant lower limbs. Then, we evaluated the correlation between gastrocnemius and AT stiffness. Forty participants (20 amateur basketball players; 20 normal non-athletic persons) were recruited for this study. Stiffness of the gastrocnemius–AT complex was assessed using MyotonPRO at neutral position and 10° dorsiflexion of the ankle joint in participants from amateur basketball players and the non-athletic general population. Our results showed a greater stiffness of the gastrocnemius–AT complex in amateur basketball players than that in healthy non-athletic subjects at neutral position and 10° dorsiflexion of the ankle joint (P &lt; 0.05). No significant difference in stiffness was found between the non-dominant and dominant lower limbs either in amateur basketball players or in generally healthy subjects (P &gt; 0.05). A significant positive correlation was obtained between stiffness of the AT and medial gastrocnemius (MG) in amateur basketball players (neutral position: r = 0.726 and P = 0.001; dorsiflexion 10°: r = 0.687 and P = 0.001). The amateur basketball players exhibit significantly higher stiffness value in Achilles and gastrocnemius. This is possibly caused by repeated training effects. The symmetric stiffness of the AT and gastrocnemius exists both in amateur basketball players and generally healthy subjects. A significant correlation between the AT and the MG was found in amateur basketball players.

scholarly journals A Quantifiable Risk Factor for ACL Injury: Applied Mathematics to Model the Posterolateral Tibial Plateau Surface Geometry

2021 ◽  
Vol 9 (4) ◽  
pp. 232596712199831
Author(s):  
Jimmy Tat ◽  
Drew Crapser ◽  
Motaz Alaqeel ◽  
Justin Schupbach ◽  
Jacob Lee-Howes ◽  
...  
Keyword(s):  
Internal Rotation ◽  
Tibial Plateau ◽  
Applied Mathematics ◽  
Femoral Condyle ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Surface Geometry ◽  
Lateral Tibial Plateau ◽  
Acl Injuries ◽  
Significant Difference

Background: The mechanism for traumatic ruptures of the native anterior cruciate ligament (ACL) is frequently a noncontact injury involving a valgus moment with internal rotation of the tibia. The abnormal rotation and translation of the lateral femoral condyle posteroinferiorly relative to the lateral tibial plateau is thought to be related to the geometry of the tibial plateau. Purpose/Hypothesis: The purpose of the study was to mathematically model the posterior tibial plateau geometry in patients with ACL injuries and compare it with that of matched controls. The hypothesis was that increased convexity and steepness of the posterior aspect of the lateral plateau would subject knees to higher forces, leading to a potentially higher risk of ACL injury. Study Design: Cross-sectional study; Level of evidence, 3. Methods: We mathematically modeled the posterior curvature of the lateral tibial plateau in 64 patients with ACL injuries and 68 matched controls. Using sagittal magnetic resonance imaging scans of the knee, points on the articular cartilage of the posterolateral tibial plateau were selected and curve-fitted to a power function ( y = a × xn). For coefficient a and coefficient n, both variables modulated the shape of the curve, where a larger magnitude represented an increase in slope steepness. Groups were compared using a Mann-Whitney test and α < .05. Results: There was a significant difference in surface geometry between the patients with ACL injuries and matched controls. The equation coefficients were significantly larger in the patients with ACL injuries: coefficient a (ACL injury, 0.9 vs control, 0.68; P < .0001) and coefficient n (ACL injury, 0.34 vs control, 0.30; P = .07). For coefficient a, there was a 78.9% sensitivity, 77.5% specificity, and odds ratio of 12.6 (95% CI, 5.5-29.0) for ACL injury using a cutoff coefficient a = .78. Conclusion: Patients with ACL injuries had a significantly greater posterolateral plateau slope. The steeper drop off may play a role in higher anterior translation forces, coupled with internal rotation torques on the knee in noncontact injury, which could increase ACL strain and predispose to ACL injury.

Sign in / Sign up

Export Citation Format

Share Document