Gastrocnemius Muscle Architecture in Elite Basketballers and Cyclists: A Cross-Sectional Cohort Study

Eccentric and concentric actions produce distinct mechanical stimuli and result in different adaptations in skeletal muscle architecture. Cycling predominantly involves concentric activity of the gastrocnemius muscles, while playing basketball requires both concentric and eccentric actions to support running, jumping, and landing. The aim of this study was to examine differences in the architecture of gastrocnemius medialis (GM) and gastrocnemius lateralis (GL) between elite basketballers and cyclists. A trained sonographer obtained three B-mode ultrasound images from GM and GL muscles in 44 athletes (25 basketballers and 19 cyclists; 24 ± 5 years of age). The images were digitized and average fascicle length (FL), pennation angle (θ), and muscle thickness were calculated from three images per muscle. The ratio of FL to tibial length (FL/TL) and muscle thickness to tibial length (MT/TL) was also calculated to account for the potential scaling effect of stature. In males, no significant differences were identified between the athletic groups in all parameters in the GM, but a significant difference existed in muscle thickness in the GL. In basketballers, GL was 2.5 mm thicker (95% CI: 0.7–4.3 mm, p = 0.011) on the left side and 2.6 mm thicker (95% CI: 0.6–5.7 mm, p = 0.012) on the right side; however, these differences were not significant when stature was accounted for (MT/TL). In females, significant differences existed in the GM for all parameters including FL/TL and MT/TL. Female cyclists had longer FL in both limbs (MD: 11.2 and 11.3 mm), narrower θ (MD: 2.1 and 1.8°), and thicker muscles (MD: 2.1 and 2.5 mm). For the GL, female cyclists had significantly longer FL (MD: 5.2 and 5.8 mm) and narrower θ (MD: 1.7 and 2.3°) in both limbs; no differences were observed in absolute muscle thickness or MT/TL ratio. Differences in gastrocnemius muscle architecture were observed between female cyclists and basketballers, but not between males. These findings suggest that participation in sport-specific training might influence gastrocnemius muscle architecture in elite female athletes; however, it remains unclear as to whether gastrocnemius architecture is systematically influenced by the different modes of muscle activation between these respective sports.

Leg length discrepancy in patients with Perthes’ disease

Aims Perthes’ disease (PD) often results in femoral head deformity and leg length discrepancy (LLD). Our objective was to analyze femoral morphology in PD patients at skeletal maturity to assess where the LLD originates, and evaluate the effect of contralateral epiphysiodesis for length equalization on proximal and subtrochanteric femoral lengths. Methods All patients treated for PD in our institution between January 2013 and June 2020 were reviewed retrospectively. Patients with unilateral PD, LLD of ≥ 5 mm, and long-leg standing radiographs at skeletal maturity were included. Total leg length, femoral and tibial length, articulotrochanteric distance (ATD), and subtrochanteric femoral length were compared between PD side and the unaffected side. Furthermore, we compared leg length measurements between patients who did and who did not have a contralateral epiphysiodesis. Results Overall, 79 patients were included, of whom 21 underwent contralateral epiphysiodesis for leg length correction. In the complete cohort, the mean LLD was 1.8 cm (95% confidence interval (CI) 1.5 to 2.0), mean ATD difference was 1.8 cm (95% CI -2.1 to -1.9), and mean subtrochanteric difference was -0.2 cm (95% CI -0.4 to 0.1). In the epiphysiodesis group, the mean LLD before epiphysiodesis was 2.7 cm (95% CI 1.3 to 3.4) and 1.3 cm (95% CI -0.5 to 3.8) at skeletal maturity. In the nonepiphysiodesis group the mean LLD was 2.0 cm (95% CI 0.5 to 5.1; p = 0.016). The subtrochanteric region on the PD side was significantly longer at skeletal maturity in the epiphysiodesis group compared to the nonepiphysiodesis group (-1.0 cm (95% CI -2.4 to 0.6) vs 0.1 cm (95% CI -1.0 to 2.1); p < 0.001). Conclusion This study demonstrates that LLD after PD originates from the proximal segment only. In patients who had contralateral epiphysiodesis to balance leg length, this is achieved by creating a difference in subtrochanteric length. Arthroplasty surgeons need to be aware that shortening of the proximal femur segment in PD patients may be misleading, as the ipsilateral subtrochanteric length in these patients can be longer. Therefore, we strongly advise long-leg standing films for THA planning in PD patients in order to avoid inadvertently lengthening the limb. Cite this article: Bone Joint J 2021;103-B(11):1736–1741.

The Effect of Season of Birth On The Morphometrics of Newborn Belgian Blue Calves

Breed type and environmental factors such as breeding season may have a significant impact on neonatal weight loss calf size. We followed a total of 236 elective cesarean sections in Belgian Blue (BB) cattle, in which neonatal calves were morphometrically measured (in cm) in the first 72 hours after delivery of the child using a strictly standardized protocol. The influence of the season of birth on each calf measurement was analyzed using a mixed linear regression models, including farm of origin as a random effect. Calves born in spring had a longer diagonal length (P = 0.05) (69.7 ± 1.24) than those born in autumn (66.9 ± 1.16). The tibial length of calves born in spring (35.8 ± 0.48) was longer (P> 0.02) than those born in autumn (33.1 ± 0.57) or summer (34.1 ± 0.49). Calves born in autumn have a shorter head diameter (P> 0.02) (12.9 ± 0.23) than those born in summer (12.6 ± 0.29) or winter (13.5 ± 0.22). For all other parameters, no differences were found (P> 0.08). Based on the results of this study, it can be concluded that the birth season influences the morphometrics of neonatal BB calves, with a tendency for spring to be associated with the largest body size. The latter is important to know to avoid dystocia when BB cattle are crossed with other breeds.

Outcomes of Fixed-Hinged Knee Prosthesis for Distal Femoral Osteosarcoma in Skeletally Immature Patients: First Results

The best surgical choice for distal femur osteosarcoma in skeletally immature patients remains controversial. A fixed hinged knee prosthesis has been designed to preserve the growth plates in the adjacent tibia, expecting tibial growth to be continued. This study aims to report the (1) clinical outcomes after prosthetic replacement, (2) postoperative complications, and (3) length of discrepancy of the operative tibia with the unaffected tibia. Thirty-four skeletally immature patients (averaged 9 years at surgery; range, 5–12 years) with distal femoral osteosarcoma underwent placement of this hinged knee prosthesis between January 2015 and August 2018. Postoperative function and complications were assessed. Length discrepancy was measured using a series of full-length standing anteroposterior radiographs of the bilateral lower extremity. The average follow-up duration was 34 months (2.8 years). In the last follow-up, four patients expired because of pulmonary metastasis. Two patients presented with local recurrence of the soft tissue. Postoperatively, the flexion range of the knee joint range was between 100 and 130 degrees, with an average of 115.2 degrees. The mean functional score of living patients evaluated using the Musculoskeletal Tumor Society scoring system was 89.2% (range, 76.7–100%). Types 1 (three patients), 2 (one patient), 3 (two patients), and 5 (two patients) complications exist. Among them, three patients received revision surgery. The proximal tibial physis still grew after surgery, with an average of 74.3% (range, 30–100%) growth potential compared with the unaffected proximal tibial physis. Moreover, 27 children exhibited tibial length discrepancy compared with the contralateral tibia, and the mean discrepancy in tibial length was 1.1 cm (range, 0.2–3.1 cm). This hinged knee prosthesis can keep the growth potential in the adjacent tibia, provides satisfying functional outcomes, and has a lower postoperative complication rate. Thus, it could serve as an alternative intervention for distal femoral osteosarcoma in skeletally immature patients.

Estimation of Stature from Percutaneous Tibial Length amongst Nepalese Students in Nobel Medical College Teaching Hospital

Background: Estimation of stature is an integral part of forensic anthropology and identification process in dead bodies. Mutilated and skeletonized body parts, which are generally received during disasters and mass casualties, carries significant burden of identification for a forensic expert. This study is aimed at estimating stature from percutaneous tibial length. Material and Methods: A cross sectional study was conducted from February 2020 to February 2021 in Nobel Medical College Teaching Hospital. 350 Nepalese medical students, 183 males and167 females, who were between 18 – 30 years, were included in the study. Their height and percutaneous tibial length was measured. Simple regression analysis was done using SPSS software version 20 to obtain a correlation between two parameters. Results: The results showed a significant correlation between the stature and percutaneous tibial length in both sexes. The regression formulae derived for calculation of stature was 104.80 + 1.81 * percutaneous tibial length(cm) for male and 93.58 + 1.91 * percutaneous tibial length(cm) for female. All the measurements were higher in males than in females. Conclusion: The study revealed a significant correlation between stature and percutaneous tibial length for both sexes in Nepalese population. Hence stature can be estimated from tibial length in both sexes which can aid in identification process and anthropological studies in Nepal.

Normative Values for Femoral Length, Tibial Length, and the Femorotibial Ratio in Adults Using Standing Full-Length Radiography

Knowledge of the normal length and skeletal proportions of the lower limb is required as part of the evaluation of limb length discrepancy. When measuring limb length, modern standing full-length digital radiographs confer a level of clinical accuracy interchangeable with that of CT imaging. This study reports a set of normative values for lower limb length using the standing full-length radiographs of 753 patients (61% male). Lower limb length, femoral length, tibial length, and the femorotibial ratio were measured in 1077 limbs. The reliability of the measurement method was tested using the intra-class correlation (ICC) of agreement between three observers. The mean length of 1077 lower limbs was 89.0 cm (range 70.2 to 103.9 cm). Mean femoral length was 50.0 cm (39.3 to 58.4 cm) and tibial length was 39.0 cm (30.8 to 46.5 cm). The median side-to-side difference was 0.4 cm (0.2 to 0.7, max 1.8 cm) between 324 paired limbs. The mean ratio of femoral length to tibial length for the study population was 1.28:1 (range 1.16 to 1.39). A moderately strong inverse linear relationship (r = −0.35, p < 0.001, Pearson’s) was identified between tibial length and the corresponding femorotibial ratio. The PACS-based length measurement method used in this study displayed excellent inter-observer reliability (ICC of 0.99). This study presents a normal range of values for lower limb length in adults and is the first to identify a linear relationship between tibial length and the femorotibial ratio.

Effect of Astragaloside IV On Precartilaginous Stem Cells to Promote Bone Development in Rats

Objective To explore the effect of astragaloside IV in promoting bone development by promoting the proliferation of precartilaginous stem cells. Methods To co-cultured the cells from the resting chondrocyte of growth plate and LaCroix of 24-hours old rats,and identified by FGFR-3 staining. Choosing astragaloside IV induce precartilaginous stem cells cultured in vitro, using Collagen type Ⅱ monoclonal antibody staining and MTT to test cell biological characteristics. Four 4 weeks old SD rats were selected and divided into an experimental group and control group, 24 rats in each group. The rats in the experimental group were injected with astragalus injection in a dose of 8.0g / kg once a day. The rats in the other group were injected with the same amount of normal saline. The 3rd and 5th week after feeding, 12 rats were killed, and the tibial length was measured by vernier caliper.Rusults The FGFR-3 staining was positive, which proved that the cultured cells were precartilaginous stem cells. Collagen typeⅡmonoclonal antibody staining is positive and the OD value detected by MTT test was higher, after astragaloside IV induced the precartilaginous stem cells. After astragaloside IV injection, the tibial length of experimental group measured by vernier caliper was significantly higher than that of the control group.Conclusion astragaloside IV can promote the proliferation and biological characteristics of precartilaginous stem cells, and then promote bone development.

Effects of different prosthetic instrumentations on tibial bone resection in total knee arthroplasty

Our aim was to assess the accuracy of the obtained posterior tibial slope (PTS) with a fixed angle cutting block. 247 TKAs in 213 patients were reviewed. We included 104 Legion Prosthesis, 76 U2 Knee Prosthesis, 46 NexGen LPS-Flex Prosthesis, and 21 Vanguard Knee System products. Preoperative and postoperative PTS were measured via expanded lateral tibia radiographs. For postoperative PTS, the Legion group had significantly smaller slopes than the U2 Knee group and Vanguard group. However, there was no significant difference between the Legion and NexGen groups, and no significant difference among the NexGen, U2 Knee, and Vanguard groups. Multiple linear regression showed that the different tibial lengths and preoperative PTS had statistically significant effects on postoperative PTS. However, there were weak correlations between the tibial length and PTS, and between preoperative and postoperative PTS. For TKA, although the PTS is not completely consistent with the angle of the cutting block, using conventional tibial bone resection technology with different tibial cutting instrumentations provided by various manufacturers in TKA can obtain safe PTS.