Anatomy of the Medial Meniscotibial Ligament of the Knee: A Systematic Review / Anatomia do ligamento meniscotibial medial do joelho: Uma revisão sistemática

Abstract Objectives To perform a systematic review of the literature on the anatomy of the medial meniscotibial ligaments (MTLs), and to present the most accepted findings, as well as the evolution of the anatomical knowledge on this structure. Materials and Methods An electronic search was conducted in the MEDLINE/PubMed, Google Scholar, EMBASE and Cochrane library databases with no date restrictions. The following index terms were used in the search: anatomy AND meniscotibial AND ligament AND medial. The review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We included anatomical studies of the knee were included, such as cadaver dissections, histological and/or biological investigations, and/or imaging of the medial MTL anatomy. Results Eight articles that met the inclusion criteria were selected. The first article was published in 1984 and the last, in 2020. The total sample in the 8 articles was of 96 patients. Most studies are purely descriptive in terms of the macroscopic morphological and microscopic histological findings. Two studies evaluated the biomechanical aspects of the MTL, and one, the anatomical correlation with the magnetic resonance imaging examination. Conclusion The main function of the medial MTL, a ligament that originates in the tibia and is inserted in the lower meniscus, is to stabilize and maintain the meniscus in its position on the tibial plateau. However, there is a limited amount of information regarding medial MTLs, primarily in terms of anatomy, especially vascularization and innervation.

Resumo Objetivos Fazer uma revisão sistemática da literatura sobre a anatomia dos ligamentos meniscotibiais (LMTs) mediais, e apresentar os achados mais aceitos e a evolução das informações anatômicas sobre essa estrutura. Materiais e Métodos A busca eletrônica foi realizada nos bancos de dados MEDLINE/PubMed, Google Scholar, EMBASE e Cochrane, sem restrições de data. Os seguintes termos de indexação foram utilizados: anatomy AND meniscotibial AND ligament AND medial. A revisão seguiu as recomendações da declaração de Principais Itens para Relatar Revisões Sistemáticas e Metanálises (Preferred Reporting Items for Systematic Reviews and Meta-Analyses, PRISMA, em inglês). Foram incluídos estudos anatômicos do joelho, como dissecções de cadáveres, investigações histológicas e/ou biológicas, e/ou imagens da anatomia do LMT medial. Resultados Oito artigos atenderam aos critérios de inclusão e foram selecionados. O primeiro foi publicado em 1984, e o último, em 2020. A amostra total nos 8 artigos foi de 96 pacientes. A maioria dos estudos é puramente descritiva em relação aos achados morfológicos macroscópicos e histológicos microscópicos. Dois estudos avaliaram os aspectos biomecânicos do LMT, e um analisou a correlação anatômica com o exame de ressonância magnética. Conclusão A principal função do LMT medial, ligamento que se origina na tíbia e se insere no menisco inferior, é estabilizar e manter a posição do menisco no platô tibial.

Absorción mineral y retención ósea en ratas normales en crecimiento por el consumo de un yogur experimental reducido en lactosa que contiene galactooligosacáridos (GOS) / Mineral absorption and bone retention in normal growing rats by consumption of an experimental lactose-reduced yogurt containing galactooligosaccharides (GOS)

Introducción: Los GOS son prebióticos naturales presentes en la leche materna que pue-den obtenerse enzimáticamente a partir de la lactosa de leche de vaca durante la fabricación de yogur. El producto lácteo resultante será reducido en lactosa y contendrá prebióticos y bacterias potencialmente probióticas. Sin embargo, mantendrá la baja relación Ca/Pi que aporta la leche de vaca, lo que podría alterar el remodelamiento óseo y la mineralización. Objetivo: comparar si un yogur reducido en lactosa que contiene GOS (YE) ofrece ventajas adicionales respecto de un yogur regular sin GOS (YR) sobre las absorciones (Abs) de Ca y Pi, retención y calidad ósea durante el crecimiento normal. Al destete, ratas machos fueron divididas en 3 grupos alimentados con AIN ́93-G (C), YE o YR durante 28 días. Resultados: YE mostró el mayor aumento de lactobacilos fecales; producción de ácidos grasos de cadena corta especialmente p, profundidad de las criptas colónicas y menor pH cecal. El %AbsCa y %AbsPi aumentó en el siguiente órden: YE> YR> C (p < 0,05). El contenido de Ca y Pi en fémur, la densidad y contenido mineral óseos y los parámetros biomecánicos fueron similares en YE y C, mientras que YR mostró valores significativa-mente menores (p < 0,05). Conclusiones: YE aumentó las Abs y biodisponibilidad de minerales, alcanzando la retención y calidad ósea de C. El aumento en las Abs observado en YR no logró obtener la retención y calidad ósea de C. Conclusión: YE habría contrarrestado el efecto negativo del mayor aporte de Pi de la leche de vaca y sería una buena estrategia para lograr el pico de masa ósea y calidad del hueso adecuados, especialmente en individuos intolerantes a la lactosa. (AU)

Breast milk contains an optimal calcium/phosphate (Ca/Pi) ratio and GOS. These natural prebiotics can be enzymatically produced via cow's milk lactose inyogurt manufacture. This milk product is low in lactose and contains prebiotics and potentially probiotic bacteria but maintains a low Ca/Pi ratio that could alter bone remodeling and mineralization. We evaluated if a lactose-reduced yogurt containing GOS (YE) offers additional advantages over regular yogurt without GOS (YR) on Ca and Pi absorption (Abs), bone retention and quality during normal growth. Weaning male rats were divided into 3 groups fed AIN'93-G (C), YE or YR for 28 days. Results: YE showed the highest increase in fecal lactobacilli; short-chain fatty acids production, especially propionate and butyrate; intestine crypt depth, and the lowest cecal pH. AbsCa% and AbsPi% increased in this order: YE> YR> C (p <0.05). Ca and Pi content in femur, bone density and mineral content, and biomechanical parameters were similar in YE and C, while YR showed the significantly lowest value (p < 0.05). Conclusions: YE increased mineral Abs reaching the retention and bone quality of C. Although YR increased Abs, bone retention and quality did not achieve C values. Seemingly, YE compensated for the negative effect of the higher Pi supply and would be a good strategy to achieve adequate peak bone mass and bone quality, especially in lactose intolerant individuals. (AU)

Efectos de la administración local de PTH 1-34 a bajas dosis en un modelo experimental de periodontitis: estudio piloto / Local effects of low dose of PTH 1-34 on experimental periodontitis: pilot study

La periodontitis es una patología inflamatoria que aumenta la resorción de hueso alveolar (HA), pérdida de la inserción dentaria y posible exfoliación. Evaluamos el efecto de la administración intermitente de bajas dosis de parathormona (PTH) 1-34 sobre la recuperación de la masa ósea pérdida en un modelo experimental de periodontitis inducida por una ligadura periodontal (LP) con hilo de algodón alrededor de la pieza dentaria. Las ratas fueron divididas luego de 5 días en instaurada la periodontitis en: CT LP sin trata-miento y PTH LP tratados con 0,2 µg/kg PTH 1-34 subcutánea local, tres veces por semana por 17 días. El control absoluto fue un tercer grupo sin LP (CT). Se estudiaron parámetros antropométricos, bioquímicos e histomosfométricos en tibias y hemimandibulas. La calcemia, fosfatemia, CTX sérico, PTHi y vo-lumen óseo (BV/TV%) de tibias fueron similares en los tres grupos. El BV/TV% del HA fue significativamente menor en PTH LP respecto de CT pero mayor que CT LP (p<0.05). La pérdida ósea de HA porcentual fue significativamente mayor en CT LP (p<0.05). La altura del ligamento periodontal fue significativamente menor en PTH LP que en CT (p<0.05) y mayor respecto de CT LP, sin alcanzar diferencias significativas. Los resultados del presente estudio piloto sugieren que la administración intermitente de PTH en bajas dosis y durante un periodo de tiempo corto disminuye la progresión de la enfermedad periodontal sin generar efectos sistémicos. Como no se logró regenerar totalmente el tejido periodontal se requieren estudios adicionales. (AU)

Periodontitis is an inflammatory chronic disease with high prevalence in adults that induces a progressive alveolar bone (AB) loss leading to tooth loss. Experimental periodontitis can be induced in rats by cotton ligature placement (LP) in the gingival sulcus around the molar teeth. The biofilm accumulation and disruption of the gingival epithelium lead to bone resorption. We investigated whether intermittent administration of a low dose of PTH 1-34 may recover the alveolar bone loss in the experimental periodontitis induced in female Wistar rats. Animals were randomly divided in two groups which were subcutaneously injected with: saline solution (CT LP) or 0,2 µg/kg PTH 1-34 (PTH LP) three times per week during 17 days. Unligated rats were taken as healthy controls (CT). Anthropometric, biochemical and histologic analysis of tibia and hemimandible were done. No differences in serum calcium, phosphorus, CTX, PTHi or subchondral tibia bone volume (BV/TV%) were observed between the three groups. AB BV/TV% was significantly lower in PTH LP than in CT but higher than in CT LP (p<0.05). The highest percentage of AB loss was observed in CT LP. The height of periodontal ligament was lower in PTH LP than in CT (p<0.05) but not significantly higher than CT LP.The increase in AB loss by experimental periodontitis appears to be corrected by the intermittent administration of low doses of PTH without systemic effect. As the recovery of periodontal tissue was only partial, additional studies should be done.

Presencia de cresta ósea en la epífisis proximal de la tibia: propuesta para su incorporación en la terminologia anatomica / Presence of a bony crest in the proximal epiphysis of the tibia: proposal for its incorporation in the terminologia anatomica

RESUMEN: La Terminologia Anatomica (TA) presenta las estructuras anatómicas en un lenguaje unificado para todas las estructuras del cuerpo humano. Sin embargo, hay características como algunos accidentes óseos que no se han considerado en las actualizaciones de la TA, ya sean epónimos que no se han relacionado con términos actuales o estructuras descritas clásicamente, como es el caso de una característica ósea que se observa y palpa fácilmente en la epífisis proximal de la tibia, a nivel del cóndilo lateral, uniendo el tubérculo anterolateral de la tibia con la tuberosidad de la misma. Esta característica corresponde a una elevación lineal, descrita como lugar de inserción del tracto iliotibial y del músculo tibial anterior. Basado en lo anterior, se analizaron 65 tibias de individuos Chilenos, adultos, de ambos sexos, 60 pertenecientes a la Universidad de La Frontera y 5 a la Universidad San Sebastián, considerando como criterio de inclusión la integridad del tejido compacto en la epífisis proximal. La revisión de las muestras reveló la presencia de una elevación lineal en el 100 % de los casos, uniendo la tuberosidad de la tibia con el tubérculo anterolateral (Gerdy), no observándose elevación similar desde la tuberosidad de la tibia en dirección al cóndilo medial. Esta elevación es utilizada como referencia en la palpación durante la evaluación de la rodilla. Por las evidencias presentadas, consideramos que esta elevación debe considerarse en la TA como una característica más de la tibia, en base a su disposición lineal y elevada, además de su dirección oblicua desde la tuberosidad de la tibia al tubérculo anterolateral de la misma, por lo que proponemos denominarla como cresta anterolateral de la tibia (Crista anterolateralis tibiae).

SUMMARY: Anatomical Terminology (AT) presents anatomical structures in a unified language for all structures of the human body. However, there are characteristics such as some bone accidents that have not been considered in the TA updates, whether they are eponyms that have not been related to current terms or classically described structures, as is the case of a characteristic bone that is easily observed and palpated in the proximal epiphysis of the tibia, at the level of the lateral condyle, joining the anterolateral tubercle of the tibia with the tuberosity of the tibia. This characteristic corresponds to a linear elevation, described as the insertion site of the iliotibial tract and the tibialis anterior muscle. Based on the above, 65 tibiae from Chilean individuals, adults, of both sexes, 60 belonging to the Universidad de La Frontera and 5 from the Universidad San Sebastián were analyzed, considering as an inclusion criterion the integrity of the compact tissue in the epiphysis proximal. The review of the samples revealed the presence of a linear elevation in 100 % of the cases, joining the tibial tuberosity with the anterolateral tubercle (Gerdy), not observing similar elevation from the tibial tuberosity in the direction of the medial condyle. This elevation is used as a reference for palpation during knee evaluation. Based on the evidence presented, we consider that this elevation should be considered in TA as one more characteristic of the tibia, based on its linear and elevated disposition, in addition to its oblique direction from the tibial tuberosity to the anterolateral tubercle of the tibia, for what we propose to call it the Crista anterolateralis tibiae (anterolateral crest of the tibia).

Fascículo distal del ligamento tibiofibular anterior: presencia, biometría y relación con la tróclea talar / Distal fascicle of the anterior tibiofibular ligament: presence, biometric characteristics and relation with the talar trochlea

El ligamento tibiofibular anterior suele presentar un fascículo distal independiente de la banda principal, denominado fascículo distal del ligamento tibiofibular anterior (FD-LTFA). Este discurre oblicuamente, cubriendo sus fibras más inferiores la zona anterolateral de la articulación talocrural. Su presencia se asocia a pellizcamiento del tobillo en esta zona, el cual puede producir un desgaste cartilaginoso de la cara anterolateral de la tróclea talar. El propósito de este estudio fue determinar la presencia y biometría del FD-LTFA, y su relación con la troclea talar en tobillos de un grupo de individuos Chilenos. En este estudio se utilizaron 30 miembros inferiores de cadáveres de individuos adultos. Se evaluó en el fascículo distal: Ancho en la inserción tibial, ancho en la inserción fibular, longitud del margen superior, longitud del margen inferior y el espesor. Se determinó si había contacto talar por parte del FD-LTFA y se observó desgaste articular en la superficie del domo talar, a nivel de la región de contacto del mencionado ligamento. El FD-LTFA fue encontrado en un 76,7 % de los casos, su anchura a nivel del sitio de fijación tibial fue de 5,30 mm (± 1,4) y a nivel fibular 4,43 mm (± 0,85). En cuanto a su longitud en el margen superior fue de 14,26 mm (± 3,66) y a nivel del margen inferior fue de 16,74 mm (± 2,91). Su espesor fue de 2,1 mm (± 0,36). En las 23 muestras de tobillo con presencia del FD-LTFA, hubo contacto talar en el 100 % de los casos y desgaste articular en esta zona en 3 de ellas (13,04 %). Los datos biométricos aportados por este estudio complementarán el conocimiento anatómico del FD-LTFA en la población Chilena.

The anterior tibiofibular ligament usually presents an independent distal fascicle of the main band, denominated distal fascicle of the anterior tibiofibular ligament (DF-ATiFL). Which obliquely passes, covering its most inferior fiber to the anterolateral corner of the talocrural articulation. Its presence is associated with the anterolateral impingement of the ankle in this area, which can produce cartilage wear of the anterolateral surface of the talar trochlea. The purpose of this study was to determine the presence and biometry of DF-ATiFL and its relation with the talar trochlea on the ankles of a group of Chilean individuals. Thirty inferior members were used in this study, all from adult individuals. It was evaluated: Width of the tibial insertion, width of the fibular insertion, length of the top margin, length of the bottom margin, and the thickness. It was determined whether there was talar contact by the distal fascicle of the anterior tibiofibular ligament. Also, it was observed the articular wear on the surface of the talar dome, at the level of the contact region of the distal fascicle of the anterior tibiofibular ligament. The DFATiFL was found in 76.7 % of the cases, its width at the level of the place of tibial fixation was 5.30 mm (± 1.40), and at the fibular level 4.43 mm (± 0.85). Regarding its length on the top margin was 14.26 mm (± 3.66), and at the bottom, the margin level was 16.74 mm (± 2.91). Its thickness was 2.1 mm (± 0.36). In the 23 ankles samples with the presence of DF-ATiFL, there was talar contact in 100 % of the cases and articular wear in this area in 3 of them (13.04 %). The biometric data contributed by this study will supplement the anatomical knowledge of the distal fascicle of the anterior tibiofibular ligament on the Chilean population.

Tubérculo de Gerdy: una estructura olvidada en la terminología anatómica internacional / Gerdy's tubercle: a forgotten structure in the international anatomical terminology

En la enseñanza de la anatomía, el uso de los epónimos es cada vez más escaso, sin embargo su uso aún es evidente incluso en la literatura actualizada, en este caso el uso del epónimo se acompaña generalmente del término correcto según la Terminología Anatómica Internacional (TAI). El denominado "Tubérculo de Gerdy" (TG) es un epónimo ampliamente usado en la literatura y la comunidad científica para denominar un reparo óseo ubicado en el cóndilo lateral de la tibia, corresponde a un referente anatómico y clínico importante para inserción de músculos, ligamentos y procedimientos medicoquirúrgicos de la rodilla. A pesar de esta amplia denominación, y en comparación con otros epónimos, la TAI no la incluye y no relaciona algún término oficial con esta estructura anatómica. El objetivo del trabajo fue revisar libros usados en la enseñanza de la anatomía y artículos científicos actualizados para ver la presencia y descripción de esta estructura a fin de proponer un término que se ajuste a los principios básicos de la Terminología Anatómica Internacional en concordancia con la tarea del Programa Federativo Internacional de Terminología Anatómica (FIPAT), organismo de la Federación Internacional de Asociaciones de Anatomistas (IFAA). El TG se describe como una estructura ubicada entre la tuberosidad de la tibia y la cabeza de la fíbula, refiriéndose a él con sinónimos como tubérculo del músculo tibial anterior, tubérculo del músculo tensor de la fascia lata, tubérculo del tracto iliotibial y tubérculo anterolateral de la tibia. En revistas morfológicas aparece en artículos actuales relacionados al ligamento anterolateral. Según la descripción de la literatura proponemos como término anatómico para esta estructura "Tuberculum anterolateralis tibiae", cuya traducción es usada como sinónimo por otros autores, ajustándose así a los principios básicos de la TAI. Pretendemos que estos antecedentes sean discutidos por los expertos que conforman el FIPAT.

In teaching anatomy, the use of eponyms is increasingly scarce. Nonetheless, eponyms remain evident in updated literature, in this case the use of the eponym is accompanied by the correct term according to the International Anatomical terminology (TAI) Gerdy´s tubercle (GT) is an eponym widely used in the literature and scientific community to name a lateral tubercle of the tibia. It is an insertion site of muscles and ligaments and an important anatomical reference in knee surgical procedures. Despite its importance, it is not included in the International Anatomical Terminology (IAT) and an official name for this structure is lacking. The aim of this work was to review classic books used in the anatomy teaching and recent scientific papers, and further, to propose an anatomical term for the Gerdy tubercle that fit IAT basic principles, in agreement with the International Federal Program of Anatomical Terminology (IFPAT), and organism that is part of the International Federation of Anatomist Associations (IFAA). The TG is described as a structure located between the tuberosity of the tibia and the head of the fibula, referring to it with synonyms such as tubercle of the anterior tibia, tubercle of the tensor fascia lata, tubercle of iliotibial tract and anterolateral tibial tubercle. In morphological journals it appears in current articles related to the anterolateral ligament. We propose as an anatomical term for the Gerdy´s tubercle the name of "Tuberculum anterolteralis tibiae" its translation is used as a synonym by other authors and fits the basic principles of TAI. We hope that this information be considered by the experts that make up the FIPAT.

Morfometria dos meniscos lateral e medial na articulação femorotibial de equinos / Morphometry of the lateral and medial meniscus in the equine femorotibial joint

As lesões dos meniscos são uma das principais causas de dor e claudicação em equinos. O objetivo do presente estudo foi avaliar a morfometria dos meniscos da articulação femorotibial de equinos. Foram utilizados 48 meniscos de 12 animais de ambos os sexos, com idade entre cinco e 15 anos e com peso entre 400kg e 500kg. A medida da extensão periférica compreendeu desde a parte mais cranial à mais caudal e denominou-se circunferência externa (CE). A margem interna, com o mesmo tratamento, foi chamada de circunferência interna (CI). Os meniscos foram divididos em terços craniais, médios e caudais. A espessura foi obtida nos pontos médios de cada terço. Foi calculada a área dos meniscos em contato com os côndilos femorais. O menisco medial apresentou maior CE com média de 126,38mm, enquanto o menisco lateral apresentou média de 115,32mm. O menisco lateral mostrou maior espessura nos terços médio e caudal, com valores médios de 16,00mm e 19,85mm, respectivamente, contra 13,75mm e 14,99mm dos meniscos mediais. Os resultados deste estudo mostraram relação importante entre os dados morfométricos e os achados clínicos na tentativa de explicar a maior incidência de lesões envolvendo o menisco medial.(AU)

Meniscal lesions are one of the main causes of pain and lameness in horses. The objective of this study was to evaluate the morphometry of the meniscus of the femorotibial joint of horses. 48 meniscus were used from 12 animals, aged between five and 15 years and weighing between 400kg and 500kg. The measurement of the peripheral extension went from the most cranial part to the most caudal, denominated external circumference (CE). The internal margin, with the same treatment, was called internal circumference (IC). The meniscus was divided into cranial, middle and caudal thirds. The thickness was obtained at the midpoints of each third. The area of the meniscus in contact with the femoral condyles was also calculated. The medial meniscus presented a higher CE with a mean of 126.38mm, while the lateral meniscus presented a mean of 115.32mm. The lateral meniscus showed greater thickness in the middle and caudal thirds, with mean values of 16.00mm and 19.85mm respectively, against 13.75mm and 14.99mm of the medial meniscus. The results of this study showed an important relationship between the morphometric data and the clinical findings in an attempt to explain the higher incidence of lesions involving the medial meniscus.(AU)

Morphological measurements of the normal distal femur and proximal tibia between han Chinese and Mongolian Chinese in a healthy Chinese population / Mediciones morfológicas del fémur distal normal y la tibia proximal entre chinos han y mongoles en una población china sana

This study aims to compare the knee morphological difference between Han and Mongolian Chinese in China. This will improve the knee prostheses design. A total of 37 natural knees of Han Chinese (13 males, 9 females) and Mongolian Chinese (8 males, 7 females) were measured used Mimics medical imaging program, and the parameters included fML (the femoral mediolateral length), fLAP (the femoral lateral condyle anteroposterior length), fMAP (the femoral medial condyle anteroposteriorlength), tML (The tibial mediolateral length ) , tLAP (The tibial lateral anteroposteriorlength) and tMAP (the tibial medial anteroposterior length), The aspect ratio (defined as fML/fAP and tML/tAP;). The sizes of femur and tibia of the males were larger than those of the female for Han Chinese (fML, fLAP and fMAP) mean ± standard deviation: 84.57 ± 4.70 vs.76.52 ± 3.56, 65.75 ± 2.70 vs. 60.53 ± 3.81 and 67.10 ± 3.67vs. 62.1 2± 3.55; tML, tLAP and tMAP: 74.68 ± 4.27 vs. 65.82 ± 3.51 , 36.13 ± 2.96 vs. 31.12 ± 2.91 and 44.54 ± 3.02 vs. 40.11 ± 3.80 and Mongolian Chinese (fML, fLAP and fMAP) : 88.20 ± 4.57 vs. 77.92 ± 2.97, 68.82 ± 4.22 vs. 61.31 ± 1.92 and 69.81 ± 3.53 vs. 62.13 ± 1.63; tML, tLAP and tMAP: 78.00 ± 3.80 vs. 66.71 ± 3.52, 40.17 ± 3.09 vs. 32.91 ± 1.68 and 48.65 ± 3.00 vs. 41.97 ± 2.48). The aspect ratio of the knee in Mongolian Chinese was smaller than those of Han Chinese (fML/fAP:1.28±0.04 vs.1.29±0.03 for males;1.27±0.04 vs.1.27±0.05; tML/tAP: 1.60±0.04 vs. 1.68±0.10 for the males, 1.59±0.13 vs. 1.65±0.10 for the females). The effects of nationality and sex on the size and shape of knee were significant (p<0.05). The results suggest that an anatomic matched knee prosthesis should be taken into account different nationalities even in the same race.

Este estudio tiene como objetivo comparar la diferencia morfológica de rodilla entre los chinos Han y los Mongoles en China. Esto mejorará el diseño de las prótesis de rodilla. Un total de 37 rodillas de chinos Han (13 hombres, 9 mujeres) y Mongoles (8 hombres 7 mujeres) se midieron utilizando el programa de imágenes médicas Mimics, y los parámetros incluyeron fML (la longitud mediolateral femoral), fLAP (la longitud anteroposterior del cóndilo lateral del fémur), fMAP (la longitud anteroposterior del cóndilo medial del fémur), tML (la longitud mediolateral de la tibia), tLAP (la longitud anteroposterior lateral de la tibia) y tMAP (la longitud anteroposterior media de la tibia), la relación de aspecto (definida como fML / fAP y tML / tAP;). Los tamaños de fémur y tibia de los hombres fueron mayores que los de las mujeres para los chinos Han (fML, fLAP y fMAP) [media ± desviación estándar: 84,57±4,70 vs. 76,52±3,56, 65,75±2,70 vs. 60,53±3,81 y 67,10±3,67 vs. 62,12±3,55; tML, tLAP y tMAP: 74,68±4,27 vs. 65,82±3,51, 36,13±2,96 vs. 31,12±2,91 y 44,54±3,02 vs. 40,11±3,80 y Chino Mongol (fML, fLAP y fMAP): 88,20±4,57 vs. 77,92±2,97, 68,82±4,22 vs. 61,31±1,92 y 69,81±3,53 vs. 62,13±1,63; tML, tLAP y tMAP: 78,00±3,80 vs. 6671±3,52, 40,17±3,09 vs. 32,91±1,68 y 48,65±3,00 vs. 41,97±2,48]. La relación de aspecto de la rodilla del Chino Mongol fue menor que la de los chinos Han (fML / fAP: 1,28±0,04 vs.1,29±0,03 para los hombres; 1,27±0,04 vs. 1,27±0,05; tML / tAP: 1,60±0,04 vs. 1,68±0,10 para los hombres, 1,59±0,13 vs. 1,65±0,10 para las mujeres). Los efectos de la nacionalidad y el sexo en el tamaño y la forma de la rodilla fueron significativos (p <0,05). Los resultados sugieren que una prótesis anatómica de rodilla emparejada debe tenerse en cuenta en las diferentes nacionalidades, incluso en la misma raza.

Precisión diagnóstica de la radiografía para la medición de túneles óseos en reconstrucción de ligamento cruzado anterior / X ray diagnostic accuracy for bone tunnel measurements in anterior cruciate ligament reconstruction

OBJETIVO: Determinar la precisión diagnóstica de las radiografías de rodilla para la medición de los diámetros de los túneles tibiales y femorales en reconstrucción de ligamento cruzado anterior (RLCA). MATERIALES Y PACIENTES: Estudio retrospectivo de precisión diagnóstica en pacientes con antecedentes de RLCA. Inclusión: RLCA realizada en el mismo centro, con el mismo equipo quirúrgico, entre 2011 y 2015; uso de cualquier tipo de injerto y de fijación; estudiados con radiografía (Rx) y tomografía computada (TC) durante postop en el mismo centro. Exclusión: desfase Rx-TC > 6 meses; cirugía entre estudios radiológicos. Análisis de túneles por 3 especialistas (OsiriX). La precisión diagnóstica consideró la TC como gold standard. Se midieron las diferencias inter e intra-observador, y las variables que interfirieron en las mediciones. RESULTADOS: 22 pacientes cumplieron los criterios de selección, determinando 528 mediciones en total (Rx y TC, fémur y tibia, 3 observadores, 2 tiempos). No hubo diferencias estadísticamente significativas en la medición de los túneles femorales (p » 0.8986), pero sí en cuanto a los diámetros tibiales (p » 0.0001). El análisis de precisión diagnóstica determinó una sobrevaloración de los diámetros óseos al usar la radiografía (10,5% en fémur, 10% en tibia). Hubo diferencias estadísticamente significativas inter-observador tanto en Rx como en TC (observador más joven con el resto); sin diferencias intra-observador. CONCLUSIÓN: La Rx como método diagnóstico del diámetro de túneles óseos luego de una RLCA sobreestima los valores reales, lo que empeora cuando el observador tiene menor experiencia.

OBJECTIVE: To determine the diagnostic accuracy of knee radiographs for the measurement of tibial and femoral tunnels diameters after an anterior cruciate ligament reconstruction (ACLR). MATERIALS AND PATIENTS: A retrospective study of the diagnostic accuracy in patients with a history of ACLR. Inclusion: surgery performed in the same center, same surgical team, between 2011 to 2015; any graft and fixation; studied with radiography (X-Ray) and computed tomography (CT) during postop in the same center. Exclusion: X-Ray-CT lag > 6 months; surgery between radiological studies. Tunnel analysis by 3 specialists (OsiriX). Diagnostic accuracy considered CT as a gold standard. The inter and intraobserver differences, and the variables that interfered in the measurements, were measured. RESULTS: 22 patients achieved the selection criteria, determining 528 measurements in total (X-Ray and CT, femur and tibia, 3 observers, 2 times). There were no statistically significant differences in the measurement of the femoral tunnels (p » 0.8986), but there were differences in the tibial diameters (p » 0.0001). Analysis of diagnostic accuracy determined an overestimation of the bone diameters when using the radiography (10.5% in the femur, 10% in the tibia). There were statistically significant inter-observer differences in both X-Ray and CT (younger observer with the rest); there were no intra-observer differences. CONCLUSION: X-Ray as a diagnostic method of the diameter of bone tunnels after an ACLR overestimates the real values, which worsens when the observer has less experience.

¿Existen diferencias entre la inclinación posterior de la tibia proximal y la inclinación meniscal entre pacientes con lesión del ligamento cruzado anterior y un grupo control? / Are there differences between posterior inclination of the proximal tibia and meniscal inclination between patients with ACL injury and a control group?

La inclinación posterior de la tibia proximal (IPTP) es uno de los factores de riesgo anatómicos más vinculados con lesiones del LCA. La presencia meniscal, fundamentalmente del menisco externo, podría representar un aspecto de gran importancia para la biomecánica de la rodilla y para el mecanismo lesional del LCA. La mayor altura del cuerno posterior del menisco externo (IM) podría actuar como un protector de la traslación anterior de la tibia proximal. El objetivo de este estudio es determinar el comportamiento de la IPTP y la IM en un grupo de pacientes con lesión del LCA y un grupo control y determinar el rol de la IM en la lesión del LCA. El grupo control fue conformado por pacientes que concurrieron a nuestra consulta y que realizaron RM de rodilla por cualquier motivo. El grupo de estudio fue conformado por pacientes que concurrieron a nuestra consulta con una RM de rodilla con lesión total del LCA y que cumplían los criterios de inclusión. Se analizaron en total 90 pacientes. 45 correspondieron al grupo control y 45 al grupo de estudio. El valor promedio de la IPTPL fue de 6,68º en el grupo control y 4,58º en el grupo de estudio. Con respecto a la IML, el valor promedio en el grupo control fue de ­0,59º y en el grupo de estudio ­0,95º. Los resultados obtenidos en nuestro estudio no permiten establecer una relación entre la mayor IM y el riesgo de lesión del LCA

The posterior inclination of the proximal tibia (PIPT) is one of the anatomical risk factors most related with ACL injuries. The meniscal presence, fundamentally of the lateral meniscus, could be very important for the biomechanics of the knee and for the injury mechanism of the ACL. The higher height of the posterior horn of the lateral meniscus (MI) could act as a protector of anterior translation of the proximal tibia. The goal of this study is to determine the behavior of PIPT and MI in a group of LCA injury patients and a control group and determine the role of MI in ACL injury. The control group was made up of patients who attended our institute and who performed knee MRI for any reason. The study group was made up of patients who attended our consultation with an MRI knee with total ACL injury and met the inclusion criteria. A total of 90 patients were tested. 45 corresponded to the control group and 45 to the study group. The average value of PIPTL was 6.68o in the control group 4.58degreein the study group. With respect to the MIL, the average value in the control group was ­ 0.59o and in the study group ­ 0.95o. The results obtained in our study do not allow for the establishment of a link between the highest MI and the risk of ACL injury

Standing height and its estimation utilizing tibia length measurements in adolescents from western region in Kosovo / La estatura de pie y su estimación utilizando mediciones de la longitud de tibia en adolescentes de la región occidental de Kosovo

SUMMARY: The purpose of this research is to examine standing height in both Kosovan genders in the Western Region as well as its association with tibia length, as an alternative to estimating standing height. A total of 664 individuals (338 male and 326 female) participated in this research. The anthropometric measurements were taken according to the protocol of ISAK. The relationships between body height and tibia length were determined using simple correlation coefficients at a ninety-five percent confidence interval. A comparison of means of standing height and tibia length between genders was performed using a t-test. After that a linear regression analysis were carried out to examine extent to which foot length can reliably predict standing height. Results displayed that Western Kosovan male are 179.71±5.99 cm tall and have a tibia length of 41.35±3.01 cm, while Western Kosovan female are 166.26±5.23 cm tall and have a tibia length of 37.60±2.52 cm. The results have shown that both genders made Western-Kosovans a tall group, somewhat taller that the general Kosovan population. Moreover, the tibia length reliably predicts standing height in both sexes but, not reliably enough as arm span. This study also confirms the necessity for developing separate height models for each region in Kosovo as the results from Western-Kosovans do not correspond to the general values.

RESUMEN: El propósito de esta investigación consistió en examinar la estatura de individuos de en ambos sexos de Kosovo en la región occidental, así como su asociación con la longitud de la tibia, como una alternativa a la estimación de la estatura de pie. Un total de 664 individuos (338 hombres y 326 mujeres) participaron en esta investigación. Las medidas antropométricas fueron tomadas según el protocolo de ISAK. Las relaciones entre la estatura del cuerpo y la longitud de la tibia se determinaron utilizando coeficientes de correlación simple en un intervalo de confianza del noventa y cinco por ciento. Se realizó una comparación de los medios de la altura de pie y la longitud de la tibia entre los sexos utilizando una prueba t. Después de eso, se llevó a cabo un análisis de regresión lineal para examinar en qué medida la longitud del pie puede predecir de manera confiable la altura del pie. Los resultados muestran que el hombre Kosovar occidental mide 179.71 ± 5.99 cm y tiene una longitud de tibia de 41.35 ± 3.01 cm, mientras que la mujer Kosovar occidental mide 166.26 ± 5.23 cm de alto y tiene una longitud de tibia de 37.60 ± 2.52 cm. Los resultados han demostrado que ambos sexos convirtieron a los kosovares occidentales en un grupo alto, de estatura algo mayor que la población general de Kosovo. Además, la longitud de la tibia predice de manera confiable la estatura en ambos sexos; pero, no lo suficientemente confiable como la extensión del brazo. Este estudio también confirma la necesidad de desarrollar modelos de estatura separados para cada región en Kosovo, ya que los resultados de los kosovares occidentales no corresponden con los valores generales.

Determination of sex based on the morphometric evaluation of the proximal tibia / Determinación del sexo basada en la evaluación morfométrica de la tibia proximal

SUMMARY: Anatomic differences are found between human males and females. These characteristics of sexual dimorphism vary across populations and have important implications for the study of human evolution. Researchers have employed anthropological tools for the characterization of human cadavers in different states of decomposition using complete skeletons, isolated bones or even bone fragments. The aim of the present study was to differentiate males and females based on morphometric aspects of human tibias from the Brazilian population. Sixty pairs of adult human tibias were obtained from bone collection of the Anatomy Sector of the Department of Animal Morphology and Physiology of the Rural Federal University of Pernambuco, Brazil. Ten measurements were made on the joint face of the tibial plateau: Anteroposterior diameter of the joint surface of the medial condyle (APM), Transverse diameter of the joint surface of the medial condyle (TM), Anteroposterior diameter of the joint surface of the lateral condyle (APL), Transverse diameter of the joint surface of the lateral condyle (TL), Anterior transverse measure of inter-condyle area (ATI), Posterior transverse measure of inter-condyle area (PTI), Middle transverse measure of inter-condyle area (MTI), Anteroposterior measure of inter-condyle area (API), Anterior measure of intercondyle area (AI) and Posterior measure of inter-condyle area (PI). The median morphometric values for the males' proximal tibia were: APM - 4.707 ± 0.406; TM - 3.024 ± 0.307; APL -4.023 ± 0.414; TL - 3.405 ± 0.323; ATI - 3.365 ± 0.425; PTIc - 1.788 ± 0.307; MTI - 1.167 ± 0.279; API - 5.140 ± 0.377; AI - 2.865 ± 0.249 and PI - 2.297 ± 0.344. The median morphometric numbers for the female's proximal tibia were: APM - 4.334 ± 0.317; TM - 2.702 ± 0.298; APL - 3.549 ± 0.382; TL - 2.991 ± 0.281; ATI - 2.818 ± 0.307; PTI - 1.555 ± 0.222; MTI - 1.054 ± 0.262; API - 4.596 ± 0.303; AI - 2.565 ± 0.21; PI - 2.031 ± 0.225. All parameters measured showed values significantly higher (p < 0.05) for the male's proximal tibia. The findings demonstrate sexual dimorphism in this leg bone, which can be used with considerable reliability for scientific and forensic purposes. The results of these studies can be useful in cases where other methods are not applicable, increasing the range of options for forensic investigation.

RESUMEN: Se encuentran diferencias anatómicas entre hombres y mujeres. Estas características del dimorfismo sexual varían entre las poblaciones y tienen implicaciones importantes para el estudio de la evolución humana. Los investigadores han empleado herramientas antropológicas para la caracterización de cadáveres humanos en diferentes estados de descomposición utilizando esqueletos completos, huesos aislados o incluso fragmentos óseos. El objetivo del presente estudio fue diferenciar a hombres y mujeres basándose en aspectos morfométricos de las tibias humanas de la población brasileña. Se obtuvieron sesenta pares de tibias adultas en la recolección ósea del Sector de Anatomía del Departamento de Morfología Animal y Fisiología de la Universidad Federal Rural de Pernambuco, Brasil. Se realizaron diez mediciones en la cara articular de la meseta tibial: Diámetro anteroposterior de la superficie articular del cóndilo medial (APM), diámetro transversal de la superficie articular del cóndilo medial (TM), diámetro anteroposterior de la superficie articular del códilo lateral (APL), diámetro transversal de la superficie articular del cóndilo lateral (TL), medida transversa anterior del área intercondílea (ATI), medida transversal posterior del área intercondílea (PTI), medida anteroposterior del área intercondílea (API), medida anterior del área intercondílea (AI) y medida posterior del área intercondílea (PI). Los valores morfométricos medianos para la tibia proximal de los varones fueron: APM - 4.707 ± 0.406; TM - 3,024 ± 0,307; APL 4,023 ± 0,414; TL - 3,405 ± 0,323; ATI - 3.365 ± 0,425; PTI - 1,788 ± 0,307; MTI - 1,167 ± 0,279; API - 5.140 ± 0.377; AI - 2,865 ± 0,249 y PI - 2,297 ± 0,344. Los números morfométricos medianos para la tíbia proximal de la hembra fueron: APM - 4.334 ± 0.317; TM - 2,702 ± 0,298; APL - 3,549 ± 0,382; TL - 2,991 ± 0,281; ATI - 2,818 ± 0,307; PTI - 1.555 ± 0.222; MTI 1,054 ± 0,262; API - 4.596 ± 0.303; AI - 2,565 ± 0,21; PI 2.031 ± 0,225. Todos los parámetros medidos mostraron valores significativamente más altos (p <0,05) para la tibia proximal del varón. Los hallazgos demuestran dimorfismo sexual en este hueso de la pierna, que se puede utilizar con una fiabilidad considerable para fines científicos y forenses. Los resultados de estos estudios pueden ser útiles en casos donde otros métodos no son aplicables, aumentando el rango de opciones para la investigación forense.

Relación entre la inclinación posterior de la tibia proximal y la inclinación meniscal. Estudio anatómico en resonancia magnética / The correlation between posterior tibial slope and meniscal slope. Anatomical study and magnetic resonance imaging

INTRODUCCIÓN: La geometría articular y las estructuras óseas se han mencionado como factores de riesgo para ruptura del ligamento cruzado anterior (LCA). La inclinación posterior de la tibia proximal (IPTP) es uno de los factores anatómicos mencionados. No se han encontrado estudios que reporten el rol del menisco externo en la estabilidad de la rodilla. El objetivo del siguiente estudio es determinar la relación entre la IPTP y la inclinación meniscal (IM) medidas por resonancia magnética (RM). MATERIAL Y MÉTODO: Se estudiaron 87 RM en 82 pacientes. Fueron excluidos pacientes con alteraciones anatómicas en la tibia proximal. Se realizaron las mediciones de la IPTP y la IM según el método de Hudeck. Se realizaron estudios de correlación para determinar la relación entre ambas variables. RESULTADOS: La edad media de los pacientes fue de 35.9 años. En el compartimento lateral la diferencia entre IPTP y la IM fue de 7.3° en promedio. El coeficiente Spearman entre IPTP del platillo externo y la IM es de 0.45. En el compartimento medial la diferencia entre la IPTP y la IM fue de 3.6°. El coeficiente Spearman entre la IPTP y la IM es de 0.57. CONCLUSIÓN: La correlación observada en ambos compartimentos es de baja a moderada lo que significa que la IPTP tiene poca participación en al valor final de la IM. Estos datos destacan la importancia del menisco externo en la biomecánica de la rodilla. Tipo de estudio: Serie de casos. Nivel de evidencia: IV.

BACKGROUND: Articular geometry and bony structures have been described as a risk factors for ACL ruptures. Posterior tibial slope´s one of the reported factors. We didn´t find studies describing the influence of the lateral meniscus in knee stability. Our aim is to determine the correlation between PTS and the meniscal slope (MS) in magnetic resonance images (MRI). METHODS: We studied 87 MRIs in 82 patients. Patients with anatomical changes in the proximal tibia (eg.: high tibial osteotomy) were discharged. The PTS and the MS was measured with the method of Hudeck. We did correlation tests to find any correlation between variables. RESULTS: Mean age was 35.9. In the lateral compartment the difference between PTS and MS was 7.3° and the Spearman tests was 0.45. In the medial compartment the difference between PTS and MS was 3.6° and the Spearmen tests was 0.57. CONCLUSIÓN: The correlation between both measures was low or moderate. The influence of the PTS in the MS it´s relative and we must consider the lateral meniscus in knee biomechanics. Type study: Number of cases. Level of evidence: IV.

Influência do posicionamento radiográfico no cálculo interobservador do ângulo do platô tibial em cães / Influence of radiographic positioning in the interobserver measuring of the tibial plateau angle in dogs

O objetivo deste trabalho foi demonstrar que o posicionamento radiográfico inadequado do membro pélvico de cães (imagens obliquadas) afeta a mensuração do ângulo do platô tibial (APT), levando à maior variação entre observadores. Foram realizadas duas projeções radiográficas nos membros pélvicos direito e esquerdo, uma em perfil verdadeiro e a outra com o membro obliquado em 21 cães provenientes do atendimento clínico cirúrgico do Hospital Veterinário da Universidade de Cuiabá, em Cuiabá-MT. Os critérios de inclusão foram cães livres de histórico ou afecção ortopédica nos membros pélvicos, pesando entre 15 e 40 quilos, sem predileção por raça ou sexo, entre dois e sete anos de idade. Foram obtidas 42 imagens radiográficas em perfil verdadeiro e 42 imagens radiográficas obliquadas. Três observadores com experiência em cálculo do APT fizeram as mensurações. Nos cálculos das imagens em perfil verdadeiro, o observador 1 obteve uma média de 23,35º ± 2,82; o observador 2, média de 23,88º ± 4,83; e o observador 3, média de 24,54º ± 4,01, não sendo encontrada diferença significativa entre o cálculo dos três avaliadores, P=0,944 (P > 0,05), nas imagens em perfil verdadeiro. Nos cálculos das imagens obliquadas, o observador 1 obteve uma média de 21,69º ± 4,22; o observador 2, média de 19,42º ± 5,92; e o observador 3, média de 22,64º ± 5,23, e foi encontrada diferença significativa entre o cálculo dos três observadores, P=0,016 (P < 0,05). Com esses dados, pôde-se demonstrar que a imagem radiográfica obliquada compromete o valor final do cálculo do ângulo do platô tibial em cães, levando à variação numérica estatisticamente significativa entre observadores. Conclui-se, assim, que um posicionamento correto do membro pélvico, em perfil verdadeiro, deve ser sempre utilizado para a obtenção de imagens, com o objetivo de mensurar o valor do APT.(AU)

This work aimed at demonstrating that an inadequate radiographic position of pelvic limbs of dogs, from a strict lateral radiographic view, resulted in oblique images, affecting the measurement of the tibial plateau angle (TPA). There were two radiographic projections of the right and the left pelvic limb, one in strict lateral radiographic view and another with inclined hind limb in 21 dogs from the clinical surgical assistance at Hospital Veterinário of Universidade de Cuiabá in Cuiabá-MT. Inclusion criteria were dogs free from pelvic hind limbs orthopedic affection records, weighing between 15 and 40 kilos, without a preference for breed or gender and ageing between two and seven years old. A total of 42 radiographic images in strict lateral radiographic view and 42 inclined limb radiographic views were obtained. Three observers with TPA calculation experience made measurements. In the calculus for the strict lateral radiographic view the first observer has reached an average of 23,35º ± 2,82, the second observer 23,88º ± 4,83 and the third observer 24,54º ± 4,01. No significant statistic differences among the calculus of the three evaluators p=0,944 (P>0,05) was found. In the calculus of the inclined limbs radiographic views the first observer reached an average of 21,69º ± 4,22, the second observer 19,42º ± 5,92 and the third observer 22,64º ±. 5,23. Significant statistic difference in the calculus of the three observers, p=0,016, that is to say, P<0,05 was found. The data indicated that the inclined limb radiographic image compromises the final value of the calculation of tibial plateau angle in dogs. Thus, correct positioning of the pelvic limb, in a strict lateral radiographic view, must be always used for obtaining images aiming at measuring the value of TPA.(AU)

Radiologic Measurement of Tibial Tuberosity-Trochlear Groove (TT-TG) Distance by Lower Extremity Rotational Profile Computed Tomography in Koreans

BACKGROUND: Tibial tuberosity-trochlear groove (TT-TG) distance is important in the assessment and treatment of patellofemoral disorders. However, normal and pathological TT-TG values have not been established in Koreans. The purpose of this study was to evaluate the TT-TG distance in the Korean population using lower leg rotational profile computed tomography (CT) scans. METHODS: One hundred rotational profile CT scans were retrospectively collected from patients without knee joint problems aged between 25 to 82 years. TT-TG distances were measured, and statistical analysis was performed. Each CT scan was measured twice in a blinded, randomized manner by three reviewers. Patients with pre-existing knee joint problems were excluded from the study; hence 15 of the 100 patients were excluded because of deformity or unreadable CT scans. Thus, 85 of the 100 patients were included in the study. RESULTS: Interobserver and intraobserver reliability of TT-TG distance measurements was good. The median TT-TG distance for this Korean population was 11.24 mm (mean, 10.24 +/- 0.8 mm). TT-TG distance measured nearly 2 mm less on rotational profile CT scans. CONCLUSIONS: Some of the TT-TG distances on rotational profile CT scans were significantly correlated, indicating that they could be accepted. Furthermore, the values on CT scans showed good reliability. In this study, the TT-TG distance in normal Korean people was approximately 10.24 mm without significant differences in TT-TG values between genders.

Changes in cortical bone channels network and osteocyte organization after the use of zoledronic acid

Objective The aim of this study was to evaluate the effects of zoledronic acid (ZA) on the cortical bone channels network (CBCN) and osteocyte organization in relation to the bone channels. Materials and methods Eighteen male Wistar rats were divided into control (CG) and test groups (TG). Twelve animals from TG received 3 ZA doses (7.5 µg/kg), and 6 animals from CG did not receive any medication. TG animals were euthanized at 14 (n = 6) and 75 (n = 6) dadys after drug injection. CBCN was analyzed in mandibles and tibias using computational routines. The osteocyte organization was qualitatively evaluated in tibias using a three-dimensional reconstruction of images from serial histological sections. Results Significant differences in CBCN of tibia were found between the treated and untreated rats, with a wider range of sizes and shapes of the channels after the use of ZA (channels area p = 0.0063, channels area SD p = 0.0276) and less bone matrix (bone volume p = 0.0388). The alterations in the channels’ morphology were more evident at 75 days after the drug injection (channels perimeter p = 0.0286). No differences were found in mandibles CBCN. The osteocyte distribution revealed more variable patterns of cell distribution in ZA groups, with non-homogeneous distribution of cells in relation to the bone channels. Conclusion Zoledronic acid induces structural changes in CBCN and modifies the osteocyte arrangement in cortical bone in the tibia; also, the variability in the morphology of bone channels became more evident after a certain time of the use of the drug.

Allometric relationships among body mass, MUZZLE-tail length, and tibia length during the growth of Wistar rats1

PURPOSE : To investigate allometric relationships among body mass (BM), muzzle-tail length (MTL), and tibia length (TL) in Wistar rats and establish their growth rate change parameters. METHODS : Eighteen male and 18 female Wistar rats were studied from the 3rd to the 21st week of age. BM, MTL, and TL were measured daily, and relative growth was compared using allometry. RESULTS : A positive correlation between BM and MTL (p<0.05) and BM and TL (p<0.05) was observed. Males and females showed comparable curves; however, females had turning points at a younger age. The allometric relationship between BM and MTL presented a regular increase until reaching a mass of 351 g (males) and 405 g (females). BM and TL showed an initial increase until 185 g (males) and 182 g (females), and then reached a plateau that finished at 412 g (males) and 334 g (females), to display another increase. CONCLUSIONS : The allometric relationship of body mass with animal length and tibia length was comparable for male and female rats, with female rats maturing earlier. Animal longitudinal growth occurred in a single stage. In contrast, tibia length depicted two stages of accelerated growth with an intermediate period of deceleration.

Anthropometry of the black adult tibia: a South African study / Antropometría de la tibia del negro adulto: un estudio sudafricano

The tibia is the medial long bone of the leg and is characterized by a shaft and two expanded extremities. Despite the recent advent of tibial bone graft harvesting, the tibia has also been confirmed to be of great forensic significance. As this appears to be the only tibial dry bone study done in Southern Africa, this study aimed to investigate morphological and morphometric parameters that are of clinical and anthropometric importance. Morphological and morphometric examination of 302 adult tibial bone specimens of Black South Africans obtained from the osteological bank of the Discipline of Clinical Anatomy at the University of KwaZulu-Natal was performed. The sample consisted of 168 males and 134 females with an age range of 15 to 87 years old. The number of nutrient foramina were: (a) One (male: 98.2%; female: 99.3%); (b) Double (male: 1.8%; female: 0.7%); Relationship of nutrient foramen to the soleal line: (a) infero-medial (male: 0.6%; female: 1.5%); (b) inferior but directly opposite the middle of the bone (male: 8.2%; female: 2.2%); (c) infero-lateral (male: 81.8%; female: 88.9%); (d) infero-lateral, along interrosseous crest (male: 4.1%; female: 3.0%); (e) supero-medial (male: 4.7%; female: 3.7%); (f) supero-medial, along interrosseous crest (male: 0.6%; female: 0%); (g) supero-lateral (male: 0%; female: 0.7%). Statistically significant differences were recorded in tibial morphometric parameters between males and females. The relationship between the number of nutrient foramina and the soleal line was of statistical significance (p= 0.002). The greater prevalence of a single foramen observed in this study compared favorably with that reported in previous literature. The recognition of the regional distribution of the nutrient foramina may prevent injury during tibial bone graft procedures. A thorough understanding of the tibial anatomy may also assist with the provision of demographic data required in forensic investigation.

La tibia es el hueso largo y medial de la pierna, con un eje y dos extremos expandidos. Además de ser considerado como posible donante de injerto, se ha confirmado su importancia en el ámbito forense. Este estudio tuvo como objetivo investigar los parámetros morfológicos, morfométricos y antropométricos de la tibia que son de importancia clínica. Se llevó a cabo un examen morfológico y morfométrico de 302 muestras de tibias perteneciente a negros sudafricanos adultos, obtenidas desde el banco osteológico del Departamento de Anatomía Clínica de la Universidad de KwaZulu-Natal. La muestra estuvo constituída por 168 hombres y 134 mujeres, con un rango etario entre 15 y 87 años. El número de forámenes nutricios fueron los siguientes: (a) Únicos (hombres: 98,2%; mujeres 99,3%); (b) Doble (hombres: 1,8%; mujeres: 0,7%). La relación del foramen nutricio con la línea del sóleo fue: (a) infero-medial (hombres: 0,6%; mujeres: 1,5%); (b) inferior y anterior a la mitad inferior del hueso (hombres: 8,2%; mujeres: 2,2%); (c) infero-lateral (hombres= 81,8%; mujeres= 88,9%); (d) infero-lateral, a lo largo del margen interóseo (hombres: 4,1%; mujeres: 3,0%); (e) supero-medial (hombres: 4,7%; mujeres: 3,7%); (f) supero-medial, a lo largo del margen interóseo (hombres: 0,6%; mujeres: 0%); (g) supero-lateral (hombres: 0%; mujeres: 0,7%). Estadísticamente, se registraron diferencias significativas en los parámetros morfométricos tibiales entre hombres y mujeres. La relación entre el número de forámenes nutricios y la línea del sóleo tuvo significación estadística (p= 0,002). La mayor prevalencia de un solo foramen nutricio observada en este estudio, se compara favorablemente con los casos reportados en la literatura analizada. El reconocimiento de la distribución regional de los forámenes nutricios puede evitar lesiones durante los procedimientos de injerto de hueso tibial. Un conocimiento profundo de la anatomía de la tibia también puede aportar datos demográficos necesarios para la investigación forense.

Diseño de un prototipo portátil para la medición del ángulo de torsión tibial, en pacientes adultos de ambos géneros / A prototype portable design for torsion angle measurements tibial, in patients both generos

La torsión tibial, es una patología en la cual la tibia presenta una rotación a lo largo de su eje. Para calcular la magnitud de la rotación es necesario realizar una serie de estudios y evaluaciones para determinar el ángulo, el problema radica que al realizar estos exámenes todo depende del juicio y experticia de la persona que lo realice, dado que los puntos clave como los ejes de rotación, pueden ser apreciados y determinados por métodos diferentes, y esto puede causar un impacto negativo en el resultado de la evaluación. El presente trabajo, propone diseñar un dispositivo que permita obtener, de una forma transparente y entendible, la diferencia de ángulos en el plano transverso entre los ejes de la rodilla y el tobillo, el cual indica la magnitud de la rotación. Para lograrlo se trabajó con una metodología de investigación de campo aplicada. Se analizaron diferentes propuestas de prototipos, para así elegir aquella que se adaptara mejor a las necesidades que se desean cubrir. El prototipo constó de sensores ultrasónicos, colocados en los extremos de los ejes de rotación y proporcionaran datos de distancia que mediante un algoritmo desarrollado, permitirá conocer el ángulo de torsión. Para validar el prototipo, se trabajó con pacientes del Centro de Salud Santa Inés y esto permitió comparar los resultados clínicos actuales, con los resultados del prototipo, demostrando que el dispositivo arrojaba los resultados esperados y funcionaba de acuerdo a las especificaciones(AU)

Tibial torsion is a condition in which the tibia has a rotation along its axis. To calculate the amount of rotation is necessary to conduct a series of studies and evaluations to determine the angle, the problem is that doing these tests all depends on the judgment and expertise of the person making the payment, as the key points as the axes rotation can be assessed and determined by different methods, and this can cause a negative impact on the outcome of the evaluation. This paper aims to design a device that provides, in a transparent and understandable way, the difference in the transverse plane angles between the axes of the knee and ankle, which indicates the amount of rotation. To achieve this we worked with a research methodology applied field. Different proposals for prototypes were analyzed and they choose the one that is best adapted to the needs that you want to cover. The prototype consisted of ultrasonic sensors located at the ends of the rotational axes and provide distance data using an algorithm developed which allow to know the angle of twist. To validate the prototype worked with patients of the Health Center Santa Inés and this allowed us to compare current clinical results with the results of the prototype, demonstrating that the device threw the expected results and work according to specifications

Bone Tunnel Diameter Measured with CT after Anterior Cruciate Ligament Reconstruction Using Double-Bundle Auto-Hamstring Tendons: Clinical Implications

OBJECTIVE: To evaluate the correlation between bone tunnel diameter after anterior cruciate ligament (ACL) reconstruction measured by computed tomography (CT) using multiplanar reconstruction (MPR) and stability or clinical scores. MATERIALS AND METHODS: Forty-seven patients (41 men and 6 women, mean age: 34 years) who had undergone ACL reconstruction with the double bundle technique using auto-hamstring graft and had subsequently received CT scans immediately after the surgery (T1: range, 1-4 days, mean, 2.5 days) and at a later time (T2: range, 297-644 days, mean, 410.4 days) were enrolled in this study. The diameter of each tunnel (two femoral and two tibial) at both T1 and T2 were independently measured using MPR technique by two radiologists. Stability and clinical scores were evaluated with a KT-2000 arthrometer, International Knee Documentation Committee objective scores, and the Lysholm score. Statistical analysis of the correlation between the diameter at T2 or the interval diameter change ratio ([T2 - T1] / T1) and clinical scores or stability was investigated. RESULTS: The tibial bone tunnels for the anteromedial bundles were significantly widened at T2 compared with T1 (observer 1, 0.578 mm to 0.698 mm, p value of 0.8) for both observers. Interobserver agreement for measurement was excellent (> 0.8) except for the most distal portion of the femoral bone tunnel for anterior medial bundle in immediate postoperative CT, which showed moderate agreement (concordance correlation coefficient = 0.6311). CONCLUSION: Neither the diameter nor its change ratio during interval follow-up is correlated with stability or clinical scores.