Quantification of Cartilage Surface Degeneration by Curvature Analysis Using 3D Scanning in a Rabbit Model

Objective Accurate analysis to quantify cartilage morphology is critical for evaluating degenerative conditions in osteoarthritis (OA). Three-dimensional (3D) optical scanning provides 3D data for the entire cartilage surface; however, there is no consensus on how to quantify it. Our purpose was to validate a 3D method for evaluating spatiotemporal alterations in degenerative cartilages in a rabbit OA model by analyzing their curvatures at various stages of progression. Design Twelve rabbits underwent anterior cruciate ligament transection (ACLT) unilaterally and were divided into 4 groups: 4 weeks control, 4 weeks OA, 8 weeks control, and 8 weeks OA. 3D scanning, India ink staining, and histological assessments were performed in all groups. In 3D curvature visualization, the surfaces of the condyles were divided into 8 areas. The standard deviations (SD) of mean curvatures from all vertices of condylar surfaces and subareas were calculated. Results Regarding the site of OA change, curvature analysis was consistent with India ink scoring. The SD of mean curvature correlated strongly with the India ink Osteoarthritis Research Society International (OARSI) score. In curvature histograms, the curvature distribution in OA was more scattered than in control. Of the 8 areas, significant OA progression in the posterolateral part of the lateral condyle (L-PL) was observed at 4 weeks. The histology result was consistent with the 3D evaluation in terms of representative section. Conclusions This study demonstrated that 3D scanning with curvature analysis can quantify the severity of cartilage degeneration objectively. Furthermore, the L-PL was found to be the initial area where OA degeneration occurred in the rabbit ACLT model.

Visualization of osteochondral fragments in the cavity of the knee joint in case of patellar dislocation in children

The objective was to assess the capabilities of MRI and CT in visualizing free bone and cartilage fragments in the knee cavity after lateral dislocation of the patella. Materials and methods. CT and MRI were performed in 220 patients, including 127 girls and 93 boys aged 12 to 18 years (mean age 14.5 years), with acute lateral patellar dislocation. Results. Lateral dislocation of the patella in 25% of cases led to the appearance of osteochondral fragments. CT scan revealed and confirmed osteochondral fragments surgery in 55 people (100%), MRI scan - in 50 people (90%). The sites of the detachment of the osteochondral fragments were: a medial facet of the patella in 22 (38.8%), the outer edge of femur lateral condyle in 33 (58.2%), t patella and lateral condyle of the femur in 2 patients (3%). Free cartilage fragments not detected by CT were detected by MRI in 2 patients. Conclusion. Patellar dislocation is an injury that is likely to require surgery. The volume of osteochondral and soft tissue lesions can be established with the maximum degree of probability by MRI while detecting small osteochondral fragments is most reliable with CT. Combining these two observation methods provides the complete possible information about the extent of damage, which allows timely resolution of treatment tactics.

Epidemiological Evaluation of Pediatric Elbow Injuries: A Retrospective Observational Single Center

Introduction Elbow fractures are the commonest fractures in the pediatric age group. The aim of this study is to evaluate the epidemiology of fresh and neglected pediatric elbow fractures in a hilly state of India with a limited health care facility. Materials and Methods This was a retrospective observational single-center study conducted between January 2019 and January 2021. Results Supracondylar was the most common fracture in 58.7% of patients followed by lateral condyle and proximal radius fracture. The highest number of fractures were reported in the age group of 5 to 8 years. In addition, 19% of patients presented with associated complications, 8% of patients had combination injuries of the ipsilateral upper limb, 16% of patients presented to the hospital 1 week after the trauma, 48% of patients had the first contact with a bonesetter/native practitioner. Conclusion Supracondylar fracture was the most common elbow fracture followed by lateral condyle. The most common involved age group was 5 to 8 years. A significant number of elbow fractures are mismanaged by native practitioners in rural India.

Clinical value of MRI in evaluating and diagnosing of humeral lateral condyle fracture in children

Background Humeral lateral condyle fractures (HLCFs) are common paediatric fractures. Radiographs are hard to accurately evaluate and diagnose the damage of articular epiphyseal cartilage in HLCFs. Methods 60 children who should be suspected to be HLCFs in clinical practice from Dec 2015 to Nov 2017 were continuously included as the first part patients. Subsequently, 35 HLCFs patients with complete follow-up information who had no obvious displacement on radiograph were the second part patients. The sensitivity and specificity of radiograph and MRI in diagnosing of HLCFs and their stability were calculated respectively. Calculated the sensitivity and specificity of each scan sequence of MRI in diagnosing of HLCFs osteochondral fractures. The degree of fracture displacement was measured respectively. Compared the ratio of surgical treatment, secondary fracture displacement and complications between the stable fracture group and the unstable fracture group on MRI in part 2 patients. Results Sensitivity of diagnosing HLCFs by MRI was significantly higher than radiograph (100.00% vs. 89.09%, P = 0.03). Sensitivity of diagnosing integrity of trochlear cartilage chain by MRI was 96.30%, which was significantly higher than that by radiograph (62.96%, P < 0.01). The sensitivity of cartilage sensitive sequence (3D-FS-FSPGR/3D-FSPGR) was different with FS-PDWI and FS-T2WI (P = 0.01 and P = 0.02, respectively). The degree of HLCFs displacement by MRI was higher than radiograph (P < 0.05). In the unstable fracture group, 5 cases (45.45%) had a fracture displacement of more than 2 mm on MRI, which was significantly higher than that in stable fracture group (0.00%, P < 0.01). Conclusions MRI is superior to the radiograph of elbow joint in evaluating and diagnosing children HLCFs and their stability. The coronal 3D-FS-FSPGR/3D-FSPGR sequence is a significant sequence for diagnosing osteochondral fractures in HLCFs. MRI can provide important clinical value for treatment decisions of HLCFs without significant displacement.

Morphometric study of upper end of tibia and its implications in total knee replacement

: Knee deformities can be reliably assessed by using morphometric parameters of upper end of tibia. Total knee arthroplasties are done to treat many types of arthritis and injuries involving knee joint. So, there is a need to have data of various morphometric parameters of upper end of tibia in order to have better surgical outcomes. The present study was attempted to provide values of different parameters in the population of Bihar.: The present study was a cross-sectional and prospective study conducted on 50 tibia of unknown gender and age in the Department of Anatomy, Indira Gandhi Institute of Medical Sciences, Patna. Fully ossified, dried, macerated and thoroughly cleaned tibia were taken to measure different parameters of upper end with the help of digital vernier calliper. The data thus obtained were tabulated and analysed statistically using Microsoft excel software.: It was found that the diameters of medial condyle were more than the lateral condyle. The antero-posterior diameter was more than the transverse diameter in case of both the condyles. But the difference between the right and the left side was not statistically significant.: The present study will help in providing a baseline data for designing of the prosthesis used in total knee replacement surgeries. It will also be helpful to anthropologists and forensic experts.