scholarly journals The Influence of the Femoral Condyle Sagittal Curvature on ACL Rupture

2021 ◽  
Author(s):  
Darko Milovanović ◽  
Marko Bumbaširević ◽  
Marko Kadija ◽  
Ninoslav Begović ◽  
Vuk Djulejić ◽  
...  
Keyword(s):  
Femoral Condyle ◽  
Lower Leg ◽  
Acl Rupture ◽  
Control Group ◽  
Lateral Condyle ◽  
Matched Pairs ◽  
Medial Condyle ◽  
Valgus Angle ◽  
Tibial Translation ◽  
Femoral Condyles

Abstract Purpose: The femoral condyle diameter may influence anterior tibial translation whose main stabilizer is the ACL. The aim of this study is to determine the influence of the size of the lateral and medial femoral condyles on ACL rupture. Methods: 41 matched pairs of subjects were included in the study who had suffered knee injury and were either professional or recreational athletes engaged in track and field or sports involving intensive rotation movements. The experimental group was composed of patients with ACL rupture, while the control group comprised patients with joint distortion without ACL. The diameter of the medial and lateral condyles were measured on sagittal MRI images of these patients’ knees. Results: Subjects with ACL rupture had a highly statistically significantly shorter diameter of the lateral condyle as compared to their matched pairs from the control group (p<0.01). Also, the lateral condyle of the subjects with ACL rupture had a significantly lesser diameter as compared to the medial condyle (p<0.01), which was not the case in patients without ACL rupture (p>0.05). Patients with intact ACL demonstrated significant indirect correlation of the diameter of both femoral condyles with the valgus angle of the lower leg (p<0.01). Conclusions: The shorter diameter of the lateral femoral condyle is connected with ACL rupture, both in women and men. The lack of correlation between the diameter of the femoral condyles and the valgus angle of the lower leg also represents a factor connected to ACL rupture.

Distal femoral morphological dysplasia is correlated with increased femoral torsion in patients with trochlear dysplasia and patellar instability

2020 ◽  
Vol 102-B (7) ◽  
pp. 868-873
Author(s):  
Guangmin Yang ◽  
Yike Dai ◽  
Conglei Dong ◽  
Huijun Kang ◽  
Jinghui Niu ◽  
...  
Keyword(s):  
Patellar Instability ◽  
Trochlear Dysplasia ◽  
Femoral Condyle ◽  
Pearson Correlation ◽  
Femoral Anteversion ◽  
Lateral Condyle ◽  
Anteversion Angle ◽  
Medial Condyle ◽  
Femoral Torsion ◽  
Condylar Morphology

Aims The purpose of this study was to explore the correlation between femoral torsion and morphology of the distal femoral condyle in patients with trochlear dysplasia and lateral patellar instability. Methods A total of 90 patients (64 female, 26 male; mean age 22.1 years (SD 7.2)) with lateral patellar dislocation and trochlear dysplasia who were awaiting surgical treatment between January 2015 and June 2019 were retrospectively analyzed. All patients underwent CT scans of the lower limb to assess the femoral torsion and morphology of the distal femur. The femoral torsion at various levels was assessed using the a) femoral anteversion angle (FAA), b) proximal and distal anteversion angle, c) angle of the proximal femoral axis-anatomical epicondylar axis (PFA-AEA), and d) angle of the AEA–posterior condylar line (AEA-PCL). Representative measurements of distal condylar length were taken and parameters using the ratios of the bianterior condyle, biposterior condyle, bicondyle, anterolateral condyle, and anteromedial condyle were calculated and correlated with reference to the AEA, using the Pearson Correlation coefficient. Results The femoral torsion had a strong correlation with distal condylar morphology. The FAA was significantly correlated with the ratio of the bianterior condyle (r = 0.355; p = 0.009), the AEA-PCL angle (r = 0.340; p = 0.001) and the ratio of the anterolateral condyle and lateral condyle (ALC-LC) (r = 0.309; p = 0.014). The PFA-AEA angle was also significantly correlated with the ratio of the bianterior condyle (r = 0.319; p = 0.008), the AEA-PCL angle (r = 0.231; p = 0.031), and the ratio of ALC-LC (r = 0.261; p = 0.034). In addition, the bianterior condyle ratio showed a significant correlation with the biposterior condyle ratio (r = -0.324; p = 0.027) and the AEA-PCL angle (r = 0.342; p = 0.021). Conclusion Increased femoral torsion correlated with a prominent anterolateral condyle and a shorter posterolateral condyle compared with the medial condyle. The deformities of the anterior and posterior condyles are combined deformities rather than being isolated and individual deformities in patients with trochlear dysplasia and patella instability. Cite this article: Bone Joint J 2020;102-B(7):868–873.

MANAGEMENT OF A CASE OF ISOLATED MEDIAL CONDYLE FEMUR FRACTURE IN A 65 YEARS OLD MALE WITH EXCELLENT FUNCTIONAL OUTCOME : CASE REPORT

2021 ◽  
pp. 77-78
Author(s):  
Saptarshi Mukherjee ◽  
Gourab Bose
Keyword(s):  
Range Of Motion ◽  
Femur Fracture ◽  
Femoral Condyle ◽  
Full Range ◽  
Lateral Condyle ◽  
Medial Condyle ◽  
Excellent Functional Outcome ◽  
Cancellous Screws ◽  
One Year

Isolated medial condyle femur fracture without fracture of the lateral condyle is relatively rare entity. Unlike lateral femoral condyle, there is no anatomically contoured plate available for the medial condyle xation. A 65 years old male presented to us with isolated medial condyle femur fracture. ORIF was done with cannulated cancellous screws and reconstruction plate. Post-operative early range of motion was started and the patient had full range of motion at the nal one-year follow-up.

Mathematical Reconstruction of Human Femoral Condyles

2011 ◽  
Vol 133 (6) ◽  
Author(s):  
Dawie J. van den Heever ◽  
Cornie Scheffer ◽  
Pieter Erasmus ◽  
Edwin Dillon
Keyword(s):  
Good Accuracy ◽  
Complex Geometry ◽  
Femoral Condyle ◽  
Lateral Condyle ◽  
B Splines ◽  
Normal Knee ◽  
Knee Replacements ◽  
Mathematical Techniques ◽  
Articulating Surface ◽  
Femoral Condyles

There is a direct correlation between ligament function and the articulating surface of the normal knee, and changes to any of these structures can affect the other. This is also true for knee replacements, where the articulating surface is greatly changed compared to the natural knee. This study investigated the morphometry of healthy knees and proposes a method to predict original normal knee profiles. A variety of mathematical techniques are compared in terms of the accuracy with which they can represent the original knee joint geometry. Additionally, a method of predicting the irregular femoral condyle geometry for an individual knee is described by making use of the mathematical techniques presented, and the accuracy of this method is also investigated. The mathematical approach using B-splines provides flexibility and can accurately describe the complex geometry of the femoral condyles in both the sagittal and transverse planes. It was further found that the condyles are highly asymmetrical; therefore simpler methods cannot portray the condyles sufficiently and are especially inaccurate in representing the lateral condyle. The study proposes a method for predicting the geometry of the femoral condyles with good accuracy. The B-spline model showed best results.

Transplantation of Aggregates of Autologous Synovial Mesenchymal Stem Cells for Treatment of Cartilage Defects in the Femoral Condyle and the Femoral Groove in Microminipigs

2019 ◽  
Vol 47 (10) ◽  
pp. 2338-2347 ◽  
Author(s):  
Shimpei Kondo ◽  
Yusuke Nakagawa ◽  
Mitsuru Mizuno ◽  
Kenta Katagiri ◽  
Kunikazu Tsuji ◽  
...  
Keyword(s):  
Femoral Condyle ◽  
Cartilage Regeneration ◽  
Medial Femoral Condyle ◽  
Cartilage Defects ◽  
Control Group ◽  
Osteochondral Defects ◽  
Medial Condyle ◽  
Femoral Groove ◽  
Articular Cartilage Regeneration

Background: Previous work has demonstrated that patients with cartilage defects of the knee benefit from arthroscopic transplantation of autologous synovial mesenchymal stem cells (MSCs) in terms of magnetic resonance imaging (MRI), qualitative histologic findings, and Lysholm score. However, the effectiveness was limited by the number of cells obtained, so large-sized defects (>500 mm2) were not investigated. The use of MSC aggregates may enable treatment of larger defects by increasing the number of MSCs adhering to the cartilage defect. Purpose: To investigate whether transplantation of aggregates of autologous synovial MSCs with 2-step surgery could promote articular cartilage regeneration in microminipig osteochondral defects. Study Design: Controlled laboratory study. Methods: Synovial MSCs derived from a microminipig were examined for in vitro colony-forming and multidifferentiation abilities. An aggregate of 250,000 synovial MSCs was formed with hanging drop culture, and 16 aggregates (for each defect) were implanted on both osteochondral defects (6 × 6 × 1.5 mm) created in the medial femoral condyle and femoral groove (MSC group). The defects in the contralateral knee were left empty (control group). The knee joints were evaluated at 4 and 12 weeks by macroscopic findings and histology. MRI T1rho mapping images were acquired at 12 weeks. For cell tracking, synovial MSCs were labeled with ferucarbotran before aggregate formation and were observed with MRI at 1 week. Results: Synovial MSCs showed in vitro colony-forming and multidifferentiation abilities. Regenerative cartilage formation was significantly better in the MSC group than in the control group, as indicated by International Cartilage Repair Society score (macro), modified Wakitani score (histology), and T1rho mapping (biochemical MRI) in the medial condyle at 12 weeks. Implanted cells, labeled with ferucarbotran, were observed in the osteochondral defects at 1 week with MRI. No significant difference was noted in the modified Wakitani score at 4 weeks in the medial condyle and at 4 and 12 weeks in the femoral groove. Conclusion: Transplantation of autologous synovial MSC aggregates promoted articular cartilage regeneration at the medial femoral condyle at 12 weeks in microminipigs. Clinical Relevance: Aggregates of autologous synovial MSCs could expand the indications for cartilage repair with synovial MSCs.

scholarly journals Giovanni Alfonso Borelli: The Precursor of Medial Pivot Concept in Knee Biomechanics

Joints ◽  
2018 ◽  
Vol 06 (03) ◽  
pp. 167-172
Author(s):  
Nicola Piolanti ◽  
Simone Polloni ◽  
Enrico Bonicoli ◽  
Michele Giuntoli ◽  
Michelangelo Scaglione ◽  
...  
Keyword(s):  
Knee Joint ◽  
Human Body ◽  
Scientific Revolution ◽  
Lateral Condyle ◽  
Knee Biomechanics ◽  
Range Of Movement ◽  
Medial Condyle ◽  
Medial Pivot ◽  
Almost All ◽  
Femoral Condyles

AbstractA new philosophy of science and medicine had spread throughout the 17th-century Italy: the “Scientific Revolution.” Giovanni Alfonso Borelli (1608–1679) was one of the most charismatic and brilliant scientists of his generation in Europe. He extended to biology the rigorous analytic methods developed by his indirect mentor Galileo in the field of mechanics. In his masterpiece “De Motu Animalium,” Borelli analyzed structure, motion, balance, and forces concerning almost all the principal joints of the human body, in static and dynamic situations. In particular, he accurately studied the anatomy and biomechanics of the knee joint. He sustained that femoral condyles shift backward during flexion, allowing a wider range of movement. Furthermore, he observed that, when the knee flexes, the lateral condyle moves backward more than the medial condyle: this concept is nowadays known as medial pivoting. The aim of this article is to describe the life and work of this important Italian scientist and to present his unrecognized contribution to modern knee biomechanics.

Introducing the Lateral Femoral Condyle Index as a Risk Factor for Anterior Cruciate Ligament Injury

2019 ◽  
Vol 47 (10) ◽  
pp. 2420-2426 ◽  
Author(s):  
Sandro Hodel ◽  
Method Kabelitz ◽  
Timo Tondelli ◽  
Lazaros Vlachopoulos ◽  
Reto Sutter ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Femoral Condyle ◽  
Cruciate Ligament ◽  
Area Under The Curve ◽  
Acl Injury ◽  
Tibial Slope ◽  
Acl Rupture ◽  
Control Group ◽  
Predictive Risk

Background: The asymmetry of the medial and lateral knee compartments contributes significantly to femorotibial biomechanics and pivoting, and it is reported to be a relevant risk factor for an anterior cruciate ligament (ACL) injury. Purpose: (1) To assess the role of femoral condyle sphericity as a risk factor for an ACL rupture and rerupture. (2) To compare the new risk factor with existing bony morphological risk factors via magnetic resonance imaging (MRI) and to assess the most predictive risk factor for an ACL rupture. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective case-control study of 60 patients was conducted. Three age- and sex-matched cohorts (each n = 20) were analyzed: ACL reruptures, primary ACL ruptures, and a control group consisting of isolated meniscal tears or patients with anterior knee pain without signs of trochlear dysplasia. The lateral femoral condyle index (LFCI) as a novel MRI measurement was developed to quantify femoral sphericity. In addition, previously known MRI risk factors associated with ACL injury were analyzed (notch width index, medial tibial slope, lateral tibial slope, medial tibial depth, and lateral tibial height). Differences among groups were compared; cutoff values were defined; and diagnostic performance of the risk factors was assessed. The risk factors were subsequently analyzed with multiple logistic regression. Results: The LFCI was significantly smaller in knees with ACL reruptures (median, 0.67; range, 0.59-0.75) and primary ACL ruptures (0.67; range, 0.60-0.75) than in the control group (0.76; range, 0.6-0.81; P < .01). The LFCI yielded the highest area under the curve among the analyzed risk factors: 0.82 (95% CI, 0.7-0.9). A cutoff of 0.70 yielded a sensitivity of 78% and a specificity of 80% to predict an ACL rupture or rerupture (odds ratio, 13.79; 95% CI, 3.67-51.75). In combination with lateral tibial height (cutoff, 3.8 mm) and lateral tibial slope (cutoff, 2.9°), the diagnostic performance was improved. The area under the curve was 0.86 (95% CI, 0.75-0.94), with a sensitivity of 90% and a specificity of 70% (odds ratio, 21.00; 95% CI, 5.10-85.80). Conclusion: A decreased LFCI is associated with an ACL injury. The LFCI, lateral tibial height, and lateral tibial slope are the most predictive risk factors for an ACL injury. These findings might aid clinicians in identifying patients at risk for an ACL injury and inform the patient after reconstruction for a higher risk of rerupture.

Arthroscopic examination and treatment of osteochondritis dissecans of the femoral condyle of six dogs

1997 ◽  
Vol 33 (5) ◽  
pp. 451-455 ◽  
Author(s):  
SG Bertrand ◽  
DD Lewis ◽  
JB Madison ◽  
JH de Haan ◽  
WP Stubbs ◽  
...  
Keyword(s):  
Subchondral Bone ◽  
Osteochondritis Dissecans ◽  
Postoperative Morbidity ◽  
Femoral Condyle ◽  
Effective Means ◽  
Bone Defects ◽  
Lateral Condyle ◽  
Medial Condyle ◽  
Arthroscopic Examination ◽  
Bilateral Lesions

Arthroscopy was used to diagnose and treat osteochondritis dissecans (OCD) of the femoral condyle in six dogs. Bilateral lesions were seen in two dogs. The medial condyle was affected in five stifles, and the lateral condyle was affected in three stifles. Subchondral bone defects were identified on radiographs in six of eight affected stifles. Resolution of the lameness associated with the arthroscopic procedure occurred one-to-14 days (mean, three days) following arthroscopy. Lameness resolved completely in four cases within two weeks and in one case six weeks following arthroscopy. Mild lameness persisted in one case. Arthroscopy is an effective means of diagnosis and treatment of OCD of the femoral condyle, and it is associated with minimal postoperative morbidity when compared to arthrotomy.

scholarly journals Secondary osteoarthritis of the knee due to 40-year nonunion of a medial femoral condyle fracture: A case with good outcome without arthroplasty

2020 ◽  
Vol 27 (2) ◽  
pp. 258-264
Author(s):  
Man Lung Moses Li ◽  
Kwong-Yin Chung ◽  
Kin-Wing Cheung ◽  
Ning Tang ◽  
Kwok-Hing Chiu
Keyword(s):  
Femoral Condyle ◽  
Femoral Fractures ◽  
Osteoarthritis Of The Knee ◽  
Lateral Condyle ◽  
Medial Condyle ◽  
Secondary Osteoarthritis ◽  
Non Union ◽  
Surgical Options ◽  
Condyle Fracture ◽  
Without Bone Graft

Isolated femoral condyle fracture is an uncommon entity. It accounts for only 0.65% of all femoral fractures, with lateral condyle involvement three times more frequently than the medial condyle. In neglected cases, nonunion and malalignment may occur, which results in osteoarthritis of the knee due to uneven distribution of load across respective compartments. In treating such cases, both osteoarthritis and nonunion have to be tackled to reconstruct a stable, mobile, pain-free, and well-aligned knee joint. There are a number of surgical options, including excision of the nonunion fragment, fixation of the nonunion fragment with or without bone graft, and total knee arthroplasty with or without stem extension. In the following, we present a case of 40-year non union of the lateral condyle and our rationale of management for a relatively young lady. During the course of treatment, there was an unexpected success even though arthroplasty was not performed. A management strategy for this challenging condition was also suggested.

scholarly journals The role-share-influence of the posterior tibial slope on rupture of the anterior cruciate ligament

2012 ◽  
Vol 69 (10) ◽  
pp. 864-868 ◽  
Author(s):  
Lazar Stijak ◽  
Zoran Blagojevic ◽  
Marko Kadija ◽  
Gordana Stankovic ◽  
Vuk Djulejic ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Tibial Slope ◽  
Acl Rupture ◽  
Posterior Tibial Slope ◽  
Control Group ◽  
Medial Condyle ◽  
Posterior Tibial ◽  
Tibial Condyle ◽  
Anterior Cruciate

Background/Aim. Posterior tibial slope is one of the most citated factors wich cause rupture of the anterior cruciate ligament (ACL). The aim of this study was to determine the association of a greather posterior tibial slope on the lateral condyle, that is a lesser posterior tibial slope on the medial condyle, with ACL rupture. Methods. The patients were divided into two groups. The study group included the patients with chronic instability of the knee besause of a previous rupture of ACL. The control group included the patients with knee lesion, but without ACL rupture. Posterior tibial slope measuring was performed by sagittal MR slices supported by lateral radiograph of the knee. We measured posterior tibial slope on lateral and medial condyles of the tibia. Using these values we calculated an average posterior tibial slope as well as the difference between slopes on lateral and medial condyles. Results. Patients with ACL rupture have highly statistically significantly greather posterior tibial slope (p < 0.01) on lateral tibial condyle (7.1? : 4.5?) as well as statistically significantly lesser posterior tibial slope (p < 0.05) on medial tibial condyle (5.0? : 6.6?) than patients with intact ACL. Conclusion. Great posterior tibial slope on lateral tibial condyle associated with the small posterior tibial slope on the medial tibial condyle, that is a positive differentce between lateral and medial tibial condyles are factors wich may cause ACL rupture.

scholarly journals The PCL Envelope Lack Sign (PELS) Is a Direct Arthroscopic Sign of Chronic Posterior Cruciate Ligament Insufficiency

2021 ◽  
Vol 11 (8) ◽  
pp. 3608
Author(s):  
Adrian Góralczyk ◽  
Marcin Mostowy ◽  
Michał Ebisz ◽  
Robert F. LaPrade ◽  
Aleksandra Sibilska ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Predictive Value ◽  
Femoral Condyle ◽  
Cruciate Ligament ◽  
Normal Space ◽  
Control Group ◽  
Study Group ◽  
Post Injury ◽  
Diagnostic Characteristics ◽  
Posterior Knee

Purpose: To present the arthroscopic “PCL envelope lack sign” (PELS) and to calculate its diagnostic characteristics in chronic PCL insufficiency. Methods: Recordings of knee arthroscopies performed in a single clinic between April 2015 to March 2020 were retrospectively evaluated, searching for the “PCL envelope”. It was defined as a “soft tissue cuff coursing around the PCL tibial attachment, visible with the arthroscope positioned between the PCL, medial femoral condyle and posterior horn of the medial meniscus at the level of its shiny white fibers”. PELS was defined as “the PCL adhering to the proximal tibia adjacent to the medial meniscal posterior root attachment, inability to observe the normal space between the PCL and posterior tibia and no soft tissue cuff around the PCL tibial attachment”. Inclusion criteria were possibility to evaluate the PELS presence on recordings. Patients who underwent PCL reconstruction were assigned to the study group. The rest of the patients were controls. Criteria to operate on symptomatic PCL patients were at least 5 mm of posterior instability in physical examination and at least 6 months post-injury. Results: Out of 614 available recordings, 592 patients (205 females, 387 males; mean age 45.2 years, SD = 14.36, range 14–81) were included: 38 in the study group and 554 in the control group. In the study group, PELS was positive in 36 of 38 cases (94.7%). In the control group, PELS was negative in 554 PCL-efficient patients (100%). Calculated PELS sensitivity was 94.7%, specificity 100%, positive predictive value 100%, negative predictive value 99.6%. The PELS was present significantly more often in PCL-insufficient patients, p < 0.001. Conclusions: The PCL envelope lack sign was found to be a highly effective tool to arthroscopically confirm chronic PCL insufficiency, and should be considered a direct sign of chronic posterior knee instability.

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