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1.
Int. j. morphol ; 38(2): 472-476, abr. 2020. graf
Artículo en Español | LILACS | ID: biblio-1056464

RESUMEN

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.


Asunto(s)
Humanos , Tibia/anatomía & histología , Peroné/anatomía & histología , Ligamentos/anatomía & histología , Tobillo/anatomía & histología , Astrágalo/anatomía & histología
2.
Medicine (Baltimore) ; 99(9): e19328, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32118764

RESUMEN

We assessed factors associated with premature physeal closure (PPC) and outcomes after closed reduction of Salter-Harris type II (SH-II) fractures of the distal tibia. We reviewed patients with SH-II fractures of the distal tibia treated at our center from 2010 to 2015 with closed reduction and a non-weightbearing long-leg cast. Patients were categorized by immediate postreduction displacement: minimal, <2 mm; moderate, 2 to 4 mm; or severe, >4 mm. Demographic data, radiographic data, and Lower Extremity Functional Scale (LEFS) scores were recorded.Fifty-nine patients (27 girls, 31 right ankles, 26 concomitant fibula fractures) were included, with a mean (±SD) age at injury of 12.0 ±â€Š2.2 years. Mean maximum fracture displacements were 6.6 ±â€Š6.5 mm initially, 2.7 ±â€Š2.0 mm postreduction, and 0.4 ±â€Š0.7 mm at final follow-up. After reduction, displacement was minimal in 23 patients, moderate in 21, and severe in 15. Fourteen patients developed PPC, with no significant differences between postreduction displacement groups. Patients with high-grade injury mechanisms and/or initial displacement ≥4 mm had 12-fold and 14-fold greater odds, respectively, of PPC. Eighteen patients responded to the LEFS survey (mean 4.0 ±â€Š2.1 years after injury). LEFS scores did not differ significantly between postreduction displacement groups (P = .61).The PPC rate in this series of SH-II distal tibia fractures was 24% and did not differ by postreduction displacement. Initial fracture displacement and high-grade mechanisms of injury were associated with PPC. LEFS scores did not differ significantly by postreduction displacement.Level of Evidence: Level IV, case series.


Asunto(s)
Fijación de Fractura/normas , Fracturas de Salter-Harris/terapia , Adolescente , Niño , Femenino , Fijación de Fractura/métodos , Fijación de Fractura/estadística & datos numéricos , Humanos , Masculino , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/diagnóstico por imagen , Estudios Retrospectivos , Tibia/anatomía & histología , Tibia/lesiones , Tibia/fisiopatología , Resultado del Tratamiento
3.
Niger J Clin Pract ; 23(1): 7-11, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31929200

RESUMEN

Background: Angular deformities of the lower limbs are commonly encountered deformities in pediatric orthopedic clinics. The values of the tibiofemoral angle undergoes changes as the child grows and these changes are self-limiting. The aim of the study is to establish the normal variation of knee angles of children between 2 and 12 years of age in Enugu metropolis and to establish any correlation between the knee angles and the intermalleolar distances (IMDs). Subjects and Methods: This study was done on 630 school children in Enugu metropolis between the age groups of 2 and 12 years. Multistage sampling was used in the study. The tibiofemoral angles and intermalleolar/intercondylar distances were measured. Results: The maximum tibiofemoral angle from this study was 7.6° ± 2.4° and the age corresponding to this value was 4 years. Only 23 subjects (3.5%) had varus knee angle. The values of the mean tibiofemoral angle and IMDs plateaued from 8 to 12 years. There was a significant positive correlation between average knee angle and IMD (r = 0.785, P < 0.001). Conclusion: The physiological changes in the knee angle (tibiofemoral) follow a similar pattern as established in the literature and there was positive correlation between IMD and the tibiofemoral angle.


Asunto(s)
Fémur/anatomía & histología , Genu Valgum/fisiopatología , Genu Varum/fisiopatología , Articulación de la Rodilla/anatomía & histología , Tibia/anatomía & histología , Antropometría , Niño , Preescolar , Femenino , Humanos , Rodilla , Masculino , Nigeria
4.
J Pediatr Orthop ; 40(1): 23-28, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31815858

RESUMEN

BACKGROUND: Although the undulating shape of the distal tibial epiphysis is well recognized, its anatomic features have not been well quantified in the literature. To guide the placement of surgical implants about the distal tibial physis, we investigated the topographical anatomy of the distal tibial epiphysis and explored the ability of standard radiographs to visualize the physis. METHODS: We studied 30 cadaveric distal tibial epiphyses in specimens 3 to 14 years of age. Anteroposterior (AP) and lateral radiographs were obtained of each specimen and then repeated after flexible radiopaque markers were placed on the major undulations. All radiographs were analyzed to determine the height or depth of each landmark, and measurements with and without markers for each landmark were compared using intraclass correlation coefficients (ICC). In 9 specimens, similar measurements were obtained on high-resolution 3-dimensional (3D) surface scans. RESULTS: There were 4 distinct physeal undulations usually present: an anteromedial peak (Kump's bump), a posterolateral peak, an anterior central valley, and a posterior central valley. On the 3D scans, Kump's bump averaged 5.0 mm (range, 3.0 to 6.4 mm), the posterolateral peak 2.4 mm (range, 1.2 to 5.0 mm), the anterior valley 1.3 mm (range, 0 to 3.6 mm), and the posterior valley 0.77 mm (range, 0 to 2.7 mm). Lateral radiographs with markers correlated with measurements from 3D scans better than those without markers (ICC=0.61 vs. 0.24). For AP radiographs, correlation was good to excellent regardless of marker use (ICC=0.76 vs. 0.66). CONCLUSIONS: There are 4 major undulations of the distal tibial physis. Kump's bump is the largest. A centrally placed epiphyseal screw in the medial/lateral direction or screws from anterolateral to posteromedial and anteromedial to posterolateral would tend to avoid both valleys. Particular caution should be taken when placing metaphyseal screws in the anteromedial or posterolateral distal tibia. Physeal undulations were more difficult to visualize on the lateral view. CLINICAL RELEVANCE: This study provides quantitative data on the topography of the distal tibial physis to aid hardware placement. Lateral views should be interpreted with caution, as the physeal undulations are not as visible, whereas AP views can be interpreted with more confidence.


Asunto(s)
Tibia/anatomía & histología , Tibia/diagnóstico por imagen , Adolescente , Puntos Anatómicos de Referencia , Cadáver , Niño , Preescolar , Epífisis/anatomía & histología , Epífisis/diagnóstico por imagen , Humanos , Imagenología Tridimensional , Radiografía
5.
Niger J Clin Pract ; 22(12): 1728-1736, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31793481

RESUMEN

Background: Adult hip reconstruction following trauma and hip pathologies depends on a sound knowledge of the proximal femoral geometry (PFG), which varies from one ethnic population to another. Aim: The aim of the study, therefore, was to evaluate parameters of the proximal femoral geometry in Igbos of South Eastern Nigeria. Methodology: A 5-year review of normal X-rays of the pelvis showing both hips of patients' age 18-64 between 1 January 2012 to 31 December 2016 at Radiology Department of University of Nigeria Teaching Hospital Enugu was done. Results: There were 554 patients, 273 (49.3%) males and 281 (50.7%) females. The values of the head width established in this study showed there was a mean difference between the right and left proximal femurs, which was statistically significant (P < 0.05). There was statistical significant difference (P < 0.05) between the means of the parameters of the proximal femoral geometry when compared between gender, the only exception being the left medial cortical thicknes, which did not show any difference (P > 0.05). A comparison of means of PFG parameters of the Igbos and that of the Turkish population showed that there was statistically significant difference on both sides. Conclusion: Our study demonstrated that there was no difference in the means of both sides of femoral neck width and the intertrochanteric width of the left side. The correlations between PFG parameters showed that there was strong positive correlation that was significant apart from the right acetabular angle that did not correlate with other parameters.


Asunto(s)
Artroplastia de Reemplazo de Cadera , Tibia/anatomía & histología , Acetábulo/cirugía , Adolescente , Adulto , Grupo de Ascendencia Continental Africana , Femenino , Fémur/cirugía , Humanos , Masculino , Persona de Mediana Edad , Nigeria , Tibia/cirugía
6.
J Sports Sci Med ; 18(4): 596-603, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31827343

RESUMEN

This study aimed to investigate the expression of PGC-1α/FNDC5/irisin induced by attenuation of high-fat diet (HFD)-induced bone accrual and determine whether swimming exercise could improve attenuating bone accrual through this mechanism. Eight-week-old Sprague-Dawley rats were divided into two groups for the first 8 weeks: CD, control diet (n = 10); and HFD, high-fat diet (n = 20). HFD-fed rats were again divided into two groups for further 8 weeks treatment: HFD (n = 10) and HFD with swimming exercise (HEx, n = 10). During this time, the CD group continuously fed the normal diet. Throughout the 16 weeks study period, the rats were weighed once every week. Samples were collected for analysis after last 8 weeks of treatment in the 16 weeks. Morphological and structural changes of the femur and tibial bone were observed using micro-CT, and Osteocalcin, CTX-1 and irisin levels in the blood were measured by enzyme-linked immunosorbent assay. The expression of IL-1, ß-catenin, FNDC5 and PGC-1α, in the femur were evaluated by immunohistochemistry. Eight weeks of HFD increased body weight and epididymal fat mass and decreased bone mineral density (BMD). Subsequent 8 weeks of swimming exercise improved obesity, BMD, bone microstructure, and bone metabolic factors in the HEx group. The irisin levels in the blood and the expressions of FNDC5 and PGC-1α in the bone were significantly lower in the HFD group than in the CD group, but elevated in the HEx group than in the HFD group. Swimming exercise is effective in improving obesity-worsened bone health and increases blood irisin and bone PGC-1α and FNDC5 levels.


Asunto(s)
Huesos/metabolismo , Dieta Alta en Grasa , Fibronectinas/metabolismo , Osteoporosis/metabolismo , Coactivador 1-alfa del Receptor Activado por Proliferadores de Peroxisomas gamma/metabolismo , Natación/fisiología , Animales , Distribución de la Grasa Corporal , Huesos/anatomía & histología , Huesos/diagnóstico por imagen , Ciguatoxinas/sangre , Modelos Animales de Enfermedad , Fémur/anatomía & histología , Fémur/metabolismo , Fibronectinas/sangre , Humanos , Interleucina-1/metabolismo , Masculino , Osteocalcina/sangre , Osteoporosis/sangre , Osteoporosis/etiología , Distribución Aleatoria , Ratas Sprague-Dawley , Tibia/anatomía & histología , Tibia/metabolismo , Microtomografía por Rayos X , beta Catenina/metabolismo
7.
Int. j. morphol ; 37(4): 1305-1309, Dec. 2019. tab
Artículo en Español | LILACS | ID: biblio-1040129

RESUMEN

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.


Asunto(s)
Humanos , Tibia/anatomía & histología , Epónimos , Terminología como Asunto
8.
J Am Podiatr Med Assoc ; 109(6): 426-430, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31755771

RESUMEN

BACKGROUND: Confirmation of anatomical reduction of ankle syndesmosis is mandatory because improper reduction leads to poor functional results. Coronal plane evaluation of syndesmosis is well described in the literature, but there is little information about sagittal plane evaluation. We sought to evaluate the relationship of fibula and tibia in the sagittal plane and create a new reference that can be applied easily and reliably. METHODS: Lateral ankle radiographs of 337 individuals with no history of ankle fracture were evaluated. A line was drawn between the anterior and posterior cortices of the distal lateral tibia, and the length of this line was measured (line 1). The distance between the anterior and posterior cortices of the fibula on this line was measured, and the center of this second distance was identified and marked. The posterior half of the fibular width was divided by line 1 and was named the lateral posterior ankle ratio (LPAR). Statistical analysis was performed by side and sex. RESULTS: Mean patient age was 38.6 years; mean LPAR was 0.48. There was a significant difference between men and women by age (P < .001) and LPAR (P = .01). There was no significant difference between right and left ankles by age (P = .63) and LPAR (P = .64). The LPAR was less than 0.40 in 6.8% of the radiographs, 0.40 to 0.50 in 57.9%, and greater than 0.50 to 0.60 in 32.9%. CONCLUSIONS: The LPAR should approximate 50% in normal lateral ankle images and, by extrapolation, after syndesmotic reduction.


Asunto(s)
Articulación del Tobillo/anatomía & histología , Peroné/anatomía & histología , Radiografía , Tibia/anatomía & histología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Traumatismos del Tobillo/diagnóstico por imagen , Articulación del Tobillo/diagnóstico por imagen , Femenino , Peroné/diagnóstico por imagen , Humanos , Masculino , Persona de Mediana Edad , Valores de Referencia , Factores Sexuales , Tibia/diagnóstico por imagen , Adulto Joven
9.
Niger J Clin Pract ; 22(10): 1423-1429, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31607734

RESUMEN

Background: The morphological parameters of the proximal tibia play a major role in total knee replacement and there are ethnic and gender variations to these parameters. Aim: To evaluate parameters of the proximal tibia geometry amongst the Igbos of South Eastern Nigeria and discuss the clinical implications in total knee replacement. Methods: The proximal tibia parameters of 558 adult tibiae bones, 300 right-sided and 258 left-sided, collected from the osteological unit of the department of anatomy University of Nigeria Enugu campus were measured using a Venier calipers. Results: The values of the determined parameters are as follows: anterior posterior dimension (APD): 5.50 cm, medial lateral dimension (MLD):7.53 ± 5.56 cm, proximal length (PL): 7.32 ± 0.67 cm, proximal width (PW) CM: 4.10 ± 0.30 cm, medial tibia posterior slope (MTPS):11.36 ± 4.15° and lateral tibia posterior slope (LTPS):5.65 ± 2.72°. The correlation test between these parameters of the proximal tibia shows a strong significant correlation between LPTS and MPTS (r =0.814, P < .001). The comparison of the means of the MPTS of both sides using independent samples t test shows a mean difference that is not significant (p =0.628). A comparison of the values with other populations shows significant mean difference for MLD with that of Chinese and American populations (p < .05). The mean difference between the APD of this study and the Chinese is significant (p =0.007). A comparison of MPTS and LPTS for Malaysian, Chinese, and white Americans shows a significance difference for all the three populations (p <.05). Conclusion: These determined values should be taken into consideration during tibia surface coverage in total knee replacement amongst the Igbo population.


Asunto(s)
Artroplastia de Reemplazo de Rodilla , Tibia/anatomía & histología , Adulto , Grupo de Ascendencia Continental Africana , Femenino , Humanos , Masculino , Persona de Mediana Edad , Nigeria , Tibia/cirugía , Adulto Joven
10.
Forensic Sci Int ; 304: 109973, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31605880

RESUMEN

It is well-known that secular trends affect human stature and constitution, and this fact should be taken into consideration in forensic anthropology, especially in stature estimation. Recently, stature-group-specific equations have been developed to take into account these variations. The aim of the present study is to estimate living stature according to tibial length in different stature groups in a sample of Spanish adult males in order to improve the accuracy of previous equations. A cross-sectional study was conducted on a sample of 495 Spanish Caucasian participants who were randomized into two groups, the study group with 249 participants and the cross-validation group with 246 participants. Specific equations were obtained according to stature groups using the 15th and 85th percentiles as cut off points. The results showed that the coefficient of determination (R2) and standard error of estimation (SEE) were lower with the specific equations based on stature groups (R2=0.22-0.57; SEE=2.12-2.66cm) than the equation with all participants of the study group (R2 = 0.77; SEE=3.29cm). The equations were tested in the cross-validation group, whose results showed more accuracy in the equations for a stature <185.9cm (i.e., in people with short and medium statures). In conclusion, the stature-group-specific equations based on tibial lengths of Spanish adult males are more accurate for stature estimation than other equations that have been formulated in the Spanish population. In forensic settings, it is recommended to use regression equations specific to stature groups when estimating stature.


Asunto(s)
Estatura , Tibia/anatomía & histología , Adolescente , Adulto , Antropometría/métodos , Estudios Transversales , Grupo de Ascendencia Continental Europea , Antropología Forense , Humanos , Masculino , Persona de Mediana Edad , España , Adulto Joven
11.
BMC Musculoskelet Disord ; 20(1): 434, 2019 Sep 17.
Artículo en Inglés | MEDLINE | ID: mdl-31526379

RESUMEN

BACKGROUND: Maintenance of optimal knee joint line orientation (KJLO) is important after high tibial osteotomy (HTO). No tools, however, are currently available that could predict the value of postoperative KJLO before surgery. First, this study sought to determine the effects of various preoperative anatomical alignment parameters to postoperative KJLO. Based upon these analyses, we aimed to devise an equation that predicts the value of postoperative KJLO. METHODS: A total of 14 radiographic parameters were measured in preoperative and postoperative full-limb standing anteroposterior radiographs on 50 patients who underwent open-wedge HTO. The parameters were analysed using multivariable linear regression to predict KJLO after HTO. External validation of the equation was done with 20 patients who underwent HTO at another institution. RESULTS: After HTO, KJLO increased from - 0.8° to 2.9° (P < 0.001). Based on the multivariable linear regression analysis, an equation was derived that can estimate postoperative KJLO after HTO; postoperative KJLO(°) = 1.029 + 0.560 × preoperative KJLO(°) + 0.310 × preoperative tibia plateau inclination(°) + 0.463 × aimed correction angle(°). The adjusted coefficients of determination value for this equation was 0.721. The equation also showed good calibration and predictability in external validation with predicted squared correlation coefficient of 0.867. CONCLUSIONS: This study analysed the effects of preoperative anatomical alignment parameters on the postoperative KJLO. An equation which predicts postoperative KJLO with preoperative anatomical alignment factors was devised and validated. This equation would help in selecting optimal patients for HTO and in selecting the optimal target correction angle in HTO.


Asunto(s)
Desviación Ósea/cirugía , Articulación de la Rodilla/anatomía & histología , Modelos Biológicos , Osteoartritis de la Rodilla/cirugía , Osteotomía/métodos , Adulto , Desviación Ósea/etiología , Femenino , Humanos , Articulación de la Rodilla/diagnóstico por imagen , Articulación de la Rodilla/cirugía , Masculino , Persona de Mediana Edad , Osteoartritis de la Rodilla/complicaciones , Selección de Paciente , Periodo Posoperatorio , Periodo Preoperatorio , Radiografía , Estudios Retrospectivos , Tibia/anatomía & histología , Tibia/diagnóstico por imagen , Tibia/cirugía
12.
Eur J Radiol ; 119: 108645, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31521877

RESUMEN

PURPOSE: To describe the aspect of the anteromedial meniscofemoral ligament on MRI and to assess its prevalence. METHOD: One thousand five hundred sixty knee MRI studies were retrospectively evaluated for the presence of an anteromedial meniscofemoral ligament. In addition to these studies, nine full MRI studies from our department's image archive were also analysed. The anteromedial meniscofemoral ligament length, thickness, and angle with respect to the tibial plateau were evaluated independently by two radiologists. For comparison purposes, the anterior cruciate ligament was assessed in the same manner. RESULTS: There was a 0.77% prevalence of the anteromedial meniscofemoral ligament in the study population. Compared to the anterior cruciate ligament, the anteromedial meniscofemoral ligament was 80.6%-83.8% thinner according to both observers (P =  0.0002), with a mean thickness of 1.53 ±â€¯0.47 mm and 1.80 ±â€¯0.66 mm determined by observers 1 and 2, respectively. The anteromedial meniscofemoral ligament angles were 15%-17.7% lower than the anterior cruciate ligament angles (P <  0.003). Interobserver reproducibility was considered excellent for the length and angle measurements (ICCs varying from 0.85-0.97) and good for the thickness measurements (ICCs 0.66-0.77). CONCLUSIONS: The anteromedial meniscofemoral ligament is a rare structure that can be differentiated from the anterior cruciate ligament based on morphologic criteria.


Asunto(s)
Ligamento Cruzado Anterior/anatomía & histología , Ligamento Colateral Medial de la Rodilla/anatomía & histología , Adulto , Lesiones del Ligamento Cruzado Anterior/patología , Femenino , Humanos , Articulación de la Rodilla/anatomía & histología , Imagen por Resonancia Magnética/métodos , Masculino , Prevalencia , Reproducibilidad de los Resultados , Estudios Retrospectivos , Tibia/anatomía & histología
13.
Bone Joint J ; 101-B(9): 1058-1062, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31474133

RESUMEN

AIMS: Little is known about the risk factors that predispose to a rupture of the posterior cruciate ligament (PCL). Identifying risk factors is the first step in trying to prevent a rupture of the PCL from occurring. The morphology of the knee in patients who rupture their PCL may differ from that of control patients. The purpose of this study was to identify any variations in bone morphology that are related to a PCL. PATIENTS AND METHODS: We compared the anteroposterior (AP), lateral, and Rosenberg view radiographs of 94 patients with a ruptured PCL to a control group of 168 patients matched by age, sex, and body mass index (BMI), but with an intact PCL after a knee injury. Statistical shape modelling software was used to assess the shape of the knee and determine any difference in anatomical landmarks. RESULTS: We found shape variants on the AP and Rosenberg view radiographs to be significantly different between patients who tore their PCL and those with an intact PCL after a knee injury. Overall, patients who ruptured their PCL have smaller intercondylar notches and smaller tibial eminences than control patients. CONCLUSION: This study shows that differences in the shape of the knee are associated with the presence of a PCL rupture after injury. A smaller and more sharply angled intercondylar notch and a more flattened tibial eminence are related to PCL rupture. This suggests that the morphology of the knee is a risk factor for sustaining a PCL rupture. Cite this article: Bone Joint J 2019;101-B:1058-1062.


Asunto(s)
Traumatismos de la Rodilla/diagnóstico por imagen , Articulación de la Rodilla/diagnóstico por imagen , Ligamento Cruzado Posterior/lesiones , Tibia/diagnóstico por imagen , Adulto , Estudios de Casos y Controles , Femenino , Humanos , Traumatismos de la Rodilla/etiología , Articulación de la Rodilla/anatomía & histología , Masculino , Persona de Mediana Edad , Ligamento Cruzado Posterior/diagnóstico por imagen , Factores de Riesgo , Rotura , Tibia/anatomía & histología
14.
JAMA ; 322(8): 736-745, 2019 08 27.
Artículo en Inglés | MEDLINE | ID: mdl-31454046

RESUMEN

Importance: Few studies have assessed the effects of daily vitamin D doses at or above the tolerable upper intake level for 12 months or greater, yet 3% of US adults report vitamin D intakes of at least 4000 IU per day. Objective: To assess the dose-dependent effect of vitamin D supplementation on volumetric bone mineral density (BMD) and strength. Design, Setting, and Participants: Three-year, double-blind, randomized clinical trial conducted in a single center in Calgary, Canada, from August 2013 to December 2017, including 311 community-dwelling healthy adults without osteoporosis, aged 55 to 70 years, with baseline levels of 25-hydroxyvitamin D (25[OH]D) of 30 to 125 nmol/L. Interventions: Daily doses of vitamin D3 for 3 years at 400 IU (n = 109), 4000 IU (n = 100), or 10 000 IU (n = 102). Calcium supplementation was provided to participants with dietary intake of less than 1200 mg per day. Main Outcomes and Measures: Co-primary outcomes were total volumetric BMD at radius and tibia, assessed with high resolution peripheral quantitative computed tomography, and bone strength (failure load) at radius and tibia estimated by finite element analysis. Results: Of 311 participants who were randomized (53% men; mean [SD] age, 62.2 [4.2] years), 287 (92%) completed the study. Baseline, 3-month, and 3-year levels of 25(OH)D were 76.3, 76.7, and 77.4 nmol/L for the 400-IU group; 81.3, 115.3, and 132.2 for the 4000-IU group; and 78.4, 188.0, and 144.4 for the 10 000-IU group. There were significant group × time interactions for volumetric BMD. At trial end, radial volumetric BMD was lower for the 4000 IU group (-3.9 mg HA/cm3 [95% CI, -6.5 to -1.3]) and 10 000 IU group (-7.5 mg HA/cm3 [95% CI, -10.1 to -5.0]) compared with the 400 IU group with mean percent change in volumetric BMD of -1.2% (400 IU group), -2.4% (4000 IU group), and -3.5% (10 000 IU group). Tibial volumetric BMD differences from the 400 IU group were -1.8 mg HA/cm3 (95% CI, -3.7 to 0.1) in the 4000 IU group and -4.1 mg HA/cm3 in the 10 000 IU group (95% CI, -6.0 to -2.2), with mean percent change values of -0.4% (400 IU), -1.0% (4000 IU), and -1.7% (10 000 IU). There were no significant differences for changes in failure load (radius, P = .06; tibia, P = .12). Conclusions and Relevance: Among healthy adults, treatment with vitamin D for 3 years at a dose of 4000 IU per day or 10 000 IU per day, compared with 400 IU per day, resulted in statistically significant lower radial BMD; tibial BMD was significantly lower only with the 10 000 IU per day dose. There were no significant differences in bone strength at either the radius or tibia. These findings do not support a benefit of high-dose vitamin D supplementation for bone health; further research would be needed to determine whether it is harmful. Trial Registration: ClinicalTrials.gov Identifier: NCT01900860.


Asunto(s)
Densidad Ósea/efectos de los fármacos , Colecalciferol/administración & dosificación , Suplementos Dietéticos , Vitaminas/administración & dosificación , Absorciometría de Fotón , Administración Oral , Anciano , Relación Dosis-Respuesta a Droga , Método Doble Ciego , Femenino , Análisis de Elementos Finitos , Resistencia Flexional , Humanos , Masculino , Persona de Mediana Edad , Radio (Anatomía)/anatomía & histología , Radio (Anatomía)/diagnóstico por imagen , Tibia/anatomía & histología , Tibia/diagnóstico por imagen , Insuficiencia del Tratamiento , Vitamina D/análogos & derivados , Vitamina D/sangre
15.
BMC Musculoskelet Disord ; 20(1): 353, 2019 Jul 31.
Artículo en Inglés | MEDLINE | ID: mdl-31366348

RESUMEN

BACKGROUND: We assessed the morphological differences in the knee joint related to knee rotation angle in patients with hip dysplasia. These results may explain the anatomy of the knee in patients with hip dysplasia and aid in planning knee surgery. METHODS: We enrolled 73 women (146 legs, 35.6 ± 9.0 years) with bilateral hip dysplasia and 45 healthy women (90 legs, 49.0 ± 18.9 years) without lumbago, knee symptoms, or osteoarthritic findings of the knee or spine on plain radiographs. We examined the parameters affecting knee rotation angle, such as the condylar twist angle and femoral condyle measurements with a three-dimensional bone model using the correlation coefficients of each parameter. RESULTS: The condylar twist angle and the length of the posterior part of the lateral femoral condyle were statistically positively correlated with knee rotation angle in both the normal (condylar twist angle: r = 0.286, p = 0.007, posterolateral: r = 0.429, p < 0.001) and developmental dysplasia of the hip groups (condylar twist angle: r = 0.230, p = 0.033, posterolateral: r = 0.272, p = 0.005). Knee rotation angle had no statistical correlation with femoral neck anteversion in the developmental dysplasia of the hip group (r = 0.094, p = 0.264), but had a statistical correlation with femoral neck anteversion in the normal group (r = 0.243, p = 0.039). CONCLUSIONS: Knee joint morphology is affected by hip dysplasia. We found that the length of the posterior part of the lateral femoral condyle was significantly positively correlated with knee rotation angle in both the normal and developmental dysplasia of the hip groups, and this finding indicates that a greater posterolateral dimension was associated with a greater knee rotation angle. These morphological knee joint differences in patients with hip dysplasia may help determine the alignment of prostheses in total knee arthroplasty.


Asunto(s)
Fémur/anatomía & histología , Luxación Congénita de la Cadera/diagnóstico por imagen , Articulación de la Rodilla/anatomía & histología , Tibia/anatomía & histología , Adulto , Anciano , Artroplastia de Reemplazo de Rodilla/métodos , Estudios Transversales , Femenino , Fémur/diagnóstico por imagen , Voluntarios Sanos , Luxación Congénita de la Cadera/complicaciones , Humanos , Articulación de la Rodilla/diagnóstico por imagen , Persona de Mediana Edad , Osteoartritis de la Rodilla/etiología , Osteoartritis de la Rodilla/cirugía , Rotación , Posición Supina , Tibia/diagnóstico por imagen , Tomografía Computarizada por Rayos X
16.
Med Biol Eng Comput ; 57(10): 2159-2178, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31377963

RESUMEN

In finite element method (FEM) simulations of the mechanical response of bones, proper selection of stiffness versus density (E-ρ) formulae for bone constituents is necessary for obtaining accurate results. A considerable number of such formulae can be found in the biomechanics' literature covering both cortical and cancellous constituents. For determining the first and second modal frequencies (in both cranial-caudal and medial-lateral planes) of bovine tibia bone, this work assembled and numerically tested 22 isotropic and 21 orthotropic stiffness-density formulae combinations (cases). To accurately reproduce bone geometry, anatomical 3D models were generated from computed tomography (CT) scans. By matching the bone's digital mass to its actual mass, cortical and cancellous constituents were faithfully segmented by utilizing suitable values of three variables: (1) critical cutoff Hounsfield unit (HU) values, (2) cutoff density value, and (3) utilized number of sub-materials. Consequently, a balanced distribution of finite elements was generated with stiffness values congruent with their cancellous or cortical demarcations. Of the considered 22 isotropic formulae cases and 21 orthotropic (reduced to transversely isotropic) cases, only few yielded accurate frequency estimates. For verifying the accuracy of the solutions emanating from the various formulae, experimental vibration tests of corresponding mode frequencies and shapes (ProSig©) were conducted. When compared with the measured experimental frequency values, the most accurate isotropic formulae yielded numerical estimates of + 0.95% and + 10.65% for the first and second cranial-caudal (C-C) frequencies, respectively. The formulae yielding most accurate estimates also proved successful in estimating frequencies of a second tibia bone yielding numerical estimates within + 4.75% and + 1.88% of the said mode frequencies. For the transversely isotropic material assignment, the closest case scenario computed numerical estimates with a percentage difference of + 2.05% and + 9.36% for the first and second cranial-caudal (C-C) frequencies, respectively. Graphical abstract Mode shapes (left) 1 and (right) 2 for transversely isotropic case 15 T (Bone A): (a) cranial-caudal and (b) medial-lateral plane.


Asunto(s)
Tibia/anatomía & histología , Tibia/fisiología , Animales , Fenómenos Biomecánicos , Hueso Esponjoso/anatomía & histología , Hueso Esponjoso/fisiología , Bovinos , Hueso Cortical/anatomía & histología , Hueso Cortical/fisiología , Elasticidad , Análisis de Elementos Finitos , Modelos Biológicos , Análisis Numérico Asistido por Computador
17.
Arq. bras. med. vet. zootec. (Online) ; 71(4): 1179-1186, jul.-ago. 2019. tab, graf, ilus
Artículo en Portugués | LILACS, VETINDEX | ID: biblio-1038597

RESUMEN

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)


Asunto(s)
Animales , Tibia/anatomía & histología , Meniscos Tibiales/anatomía & histología , Fémur/anatomía & histología , Lesiones de Menisco Tibial/veterinaria , Caballos/anatomía & histología
18.
PLoS One ; 14(7): e0219404, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31329619

RESUMEN

Longitudinal studies of bone adaptation in mice using in vivo micro-computed tomography (µCT) have been commonly used for pre-clinical evaluation of physical and pharmacological interventions. The main advantage of this approach is to use each mouse as its own control, reducing considerably the sample size required by statistical power analysis. To date, multi-scale estimation of bone adaptations become essential since the bone activity that takes place at different scales may be associated with different bone mechanisms. Measures of bone adaptations at different time scales have been attempted in a previous study. This paper extends quantification of bone activity at different spatial scales with a proposition of a novel framework. The method involves applying level-set method (LSM) to track the geometric changes from the longitudinal in vivo µCT scans of mice tibia. Bone low- and high-spatial frequency patterns are then estimated using multi-resolution analysis. The accuracy of the framework is quantified by applying it to two times separated scanned images with synthetically manipulated global and/or local activity. The Root Mean Square Deviation (RMSD) was approximately 1.5 voxels or 0.7 voxels for the global low-spatial frequency or local high-spatial frequency changes, respectively. The framework is further applied to the study of bone changes in longitudinal datasets of wild-type mice tibiae over time and space. The results demonstrate the ability for the spatio-temporal quantification and visualisation of bone activity at different spatial scales in longitudinal studies thus providing further insight into bone adaptation mechanisms.


Asunto(s)
Huesos/anatomía & histología , Huesos/diagnóstico por imagen , Microtomografía por Rayos X , Algoritmos , Animales , Femenino , Estudios Longitudinales , Ratones Endogámicos C57BL , Tibia/anatomía & histología , Tibia/diagnóstico por imagen
19.
Medicine (Baltimore) ; 98(29): e16523, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31335730

RESUMEN

Indentation hardness test is a good in vitro method of bone quality assessment. The purpose of this study is to explore the distribution characteristics of bone tissue microhardness in tibial diaphysis and provide theoretical support for the test site selection of the reference point indentation technique.Three fresh right tibias were obtained from 3 cadaver donors. The tibial diaphysis was evenly divided into 6 sections. Bone specimens with a thickness of 3 mm were cut from each part. After appropriate management, micro-indentation tests were performed in various regions of the specimens to acquire the microhardness values of the tibial diaphysis. Statistical analysis was performed by randomized block design variance analysis to study the distribution characteristics of bone microhardness.72 regions were selected for 360 effective indentations. We found that the bone microhardness is inhomogeneous in tibia diaphysis. Mean hardness value of the anterior, medial, posterior, lateral region of tibia diaphysis was 45.58 ±â€Š4.39 Vickers hardness (HV), 52.33 ±â€Š3.93 HV, 54.00 ±â€Š4.21 HV, 52.89 ±â€Š4.44 HV, respectively. The anterior cortex exhibits lower microhardness value than the other regions (P < .001). Within the same region, microhardness varies significantly with positions in the tibial diaphysis. The variations in indentation hardness are bound to have a significant impact on the comparability of different reference point indentation (RPI) studies.The results of this study indicated the regional microhardness difference in the human tibia diaphysis. The microhardness of different planes in the same region is also inconsistent. Inhomogeneous distribution of indentation microhardness would have considerable influence in the test site selection of RPI technique. The data collected in our study would contribute to the design of highly precise 3D printing implants and bionic bones with gradient elastic modulus.


Asunto(s)
Pruebas de Dureza/métodos , Tibia/anatomía & histología , Fenómenos Biomecánicos , Cadáver , Hueso Cortical/anatomía & histología , Diáfisis/anatomía & histología , Femenino , Humanos , Masculino , Persona de Mediana Edad
20.
An Acad Bras Cienc ; 91(suppl 2): e20180643, 2019 Jun 19.
Artículo en Inglés | MEDLINE | ID: mdl-31241650

RESUMEN

The non-dinosaurian dinosauriform silesaurids are the closest relatives of crown-group dinosaurs and are thus, important for understanding the origins of that group. Here, we describe the limb bone histology of the Late Triassic silesaurid Sacisaurus agudoensis from the Candelária Sequence of the Santa Maria Supersequence, Rio Grande do Sul state, Brazil. The sampled bones comprise eight femora and one fibula from different individuals. The microscopic analysis of all elements reveals uninterrupted fibrolamellar bone tissue indicating rapid growth. A transition to slower growing peripheral parallel-fibered bone tissue in some individuals indicates a decrease in growth rate, suggesting ontogenetic variation within the sample. The osteohistology of Sacisaurus agudoensis is similar to that of other silesaurids and supports previous hypotheses that rapid growth was attained early in the dinosauromorph lineage. However, silesaurids lack the complex vascular arrangements seen in saurischian dinosaurs. Instead, they exhibit predominantly longitudinally-oriented primary osteons with few or no anastomoses, similar to those of some small early ornithischian dinosaurs. This simpler vascular pattern is common to all silesaurids studied to date and indicates relatively slower growth rates compared to most Dinosauria.


Asunto(s)
Huesos/anatomía & histología , Dinosaurios/anatomía & histología , Fósiles/anatomía & histología , Animales , Evolución Biológica , Dinosaurios/crecimiento & desarrollo , Fémur/anatomía & histología , Tibia/anatomía & histología
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