Morphological characteristics of the patellar tendon in runners, cyclists, triathletes, and physically active individuals.

The objective of the study was to compare measurements of length, thickness, and cross-section area (CSA) of the patellar tendon (PT) among cyclists, runners, triathletes, and physically active individuals (control group). Forty healthy individuals (10 cyclists, 10 runners, 10 triathletes, and 10 physically active individuals) aged between 18 and 45 years (30.3 ± 8.6 years) participated in the study. PT was measured by a B-mode ultrasound system. To measure the length and thickness (in 5, 10, 15, and 20 mm of the PT length) the probe was positioned parallel to the tendon and to measure the CSA the probe was positioned perpendicularly in 25, 50, and 75% of the PT length. PT length data were analyzed using a one-way ANOVA to compare between groups and PT CSA and thickness were analyzed using a two-way ANOVA (group vs. position) to compare the variables among the groups with the post-hoc Tukey test. All statistical analyses were performed considering p < 0.05. We observed a significant difference, where cyclists had smaller PT thickness (regardless of the location measured) compared to the group of triathletes (p = 0.001) and the physically active group (p = 0.043). All other variables (length, thickness, and CSA) and interactions (local and position) were not significant. We concluded that regardless of the position where PT thickness is measured, cyclists have smaller PT thickness compared to triathletes and physically active individuals but similar when compared to runners. And no differences in the length and CSA of the PT between groups.

Anatomical attributes of the musculus quadriceps femoris responsible for poor crawling ability in the greater horseshoe bat ( Rhinolophus ferrumequinum ) / Atributos anatómicos del músculo cuádriceps femoral responsable de la limitada capacidad de arrastre en el murciélago grande de herradura ( Rhinolophus ferrumequinum )

SUMMARY: In mammals, the Musculus quadriceps femoris is a well-developed extensor muscle of the thigh. It is also relatively well developed in bats. The muscle group consists of a distally elongated muscle belly, which is important for the full extension of the knee joint during terrestrial locomotion. However, most bats species demonstrate poor terrestrial locomotion, although several species are able to crawl on the ground. Among the crawling bats, knee joint extension is necessary for crawling. Among bat species generally, the M. quadriceps femoris has a distally elongated belly for extending the shank, although the feature also occurs among poor crawling bat species. The relationship between a relatively well-developed M. quadriceps femoris and poor crawling ability in bats is incongruous, but there is a possibility that bats with a reduced M. quadriceps femoris have not yet been found. The greater horseshoe bat (Rhinolophus ferrumequinum) has long been known to be incapable of crawling, but there are no detailed descriptions in the literature concerning this bat's M. quadriceps femoris. The findings of this study reveal that the M. quadriceps femoris of Rh. ferrumequinum has a short muscle belly attached to the proximal portion of the femur; furthermore, the insertional tendon of this muscle and its patellar ligament are very thin. These morphological features suggest that this species cannot exert a strong and long-distance extension of its knee joints, unlike most other bat species. In addition to the above described morphological features, the M. rectus femoris of Rh. ferrumequinum is fused with the vasti in the M. quadriceps femoris. This M. quadriceps femoris arises from the pelvis and inserts onto the femur. Therefore, Rh. ferrumequinum has an M. quadriceps femoris specialized for flexion of the hip joint.

RESUMEN: En los mamíferos, el Musculus quadriceps femoris es un músculo extensor bien desarrollado del muslo. Este músculo también está relativamente bien desarrollado en murciélagos. El grupo muscular consiste en un vientre muscular distalmente alargado, lo que es importante para la extensión completa de la articulación de la rodilla durante la locomoción terrestre. Sin embargo, la mayoría de las especies de murciélagos muestran limitada locomoción terrestre, aunque varias especies pueden arrastrarse por el suelo. Entre los murciélagos reptantes, la extensión de la articulación de la rodilla es necesaria para gatear. Entre las especies de murciélagos en general, el M. quadriceps femoris tiene un vientre distalmente alargado para extender la rodilla, aunque la característica también ocurre entre las especies de murciélagos de rastreo limitado. La relación entre un M. quadriceps femoris relativamente bien desarrollado y la escasa capacidad de rastreo en los murciélagos es incongruente, pero existe la posibilidad de que aún no se hayan encontrado murciélagos con M. cuádriceps femoral poco desarrollado. Se sabe desde hace tiempo que el murciélago de herradura (Rhinolophus ferrumequinum) es incapaz de gatear, pero no hay descripciones detalladas en la literatura sobre el M. quadriceps femoris de este murciélago. Los hallazgos de este estudio revelan que el M. quadriceps femoris de Rh. ferrumequinum tiene un vientre muscular corto, unido a la epífisis proximal del fémur; además, el tendón de inserción de este músculo y su ligamento patelar son muy delgados. Estas características morfológicas sugieren que esta especie no puede ejercer una extensión importante y de larga distancia de la articulación de la rodilla, a diferencia de la mayoría de otras especies de murciélagos. Además de las características morfológicas descritas anteriormente, el M. rectus femoris de Rh. ferrumequinum está fusionadocon el vasto del M. quadriceps femoris. El M. quadriceps femoris se origina de la pelvis y se inserta en el fémur. Por lo tanto, Rh. ferrumequinum tiene un M. quadriceps femoris especializado para la flexión de la articulación de la cadera.

Radiographic measurements of the hindlimbs in crab-eating foxes (Cerdocyon thous, Linnaeus, 1766).

Life expectancy of crab-eating foxes in captivity is approximately 11 years, which favours the development of diseases including orthopaedic disorders. However, to understand disorders that may affect these animals, it is worth determining a normal range of measurements. Therefore, this study aimed to evaluate radiographic measurements of joint angles of the hindlimbs and the ratio of patellar ligament length to patellar length in healthy crab-eating foxes. Fifteen captive crab-eating foxes (Cerdocyon thous), eight males and seven females, aged more than 1 year old, weighing 5.5-7.9 kg were used. Anatomic and mechanical femoral joint angles were assessed in ventrodorsal radiographic views, and mediolateral views were taken to measure patellar ligament length and patellar length, and the tibial plateau angle. The right and left hindlimbs were evaluated. All measurements were conducted in triplicate by the same investigator. No statistically significant differences were observed between sides in the radiographic measurements. The anatomic lateral proximal femoral angle and the anatomic lateral distal femoral angle recorded mean values of 95.43° and 92.75°, respectively. The mechanical lateral proximal femoral angle and the mechanical lateral distal femoral angle recorded mean values of 93.39° and 96.75°, respectively. Inclination angles measured according to the Tomlinson, Hauptman A and Hauptman B methods were 133.80°, 147.32° and 128.63°, respectively. The tibial plateau recorded 18.77°, and the ratio of the patellar ligament length to the patellar length was 1.99. In conclusion, the collected data are important to characterize the normal values of crab-eating fox limbs.

Determinação das propriedades biomecânicas do ligamento patelar de cães (Canis familiaris Linnaeus, 1758) / Determination of biomechanical properties of patellar ligament in dogs (Canis familiaris Linnaeus, 1758)

O estudo biomecânico de ligamentos articulares geram subsídios às pesquisas de biomateriais ou técnicas de tratamento para substituição ou reparação destas estruturas por ocasião de ruptura ou degeneração. Diante disto, realizaram-se ensaios biomecânicos de tração do ligamento patelar em 53 cães, totalizando 106 ligamentos patelares testados. Foram determinadas a capacidade máxima de resistência em Newtons (N) e a deformação expressa em milímetros (mm), sendo estes dados correlacionados à biometria corporal dos cadáveres dos cães utilizados. A resistência do ligamento patelar direito e esquerdo no grupo das fêmeas foi de 642,6N ±297,2N e 627,0N ±300,6N (p=0,028), respectivamente. Nos machos, verificaram-se valores superiores (p=0,035). O ligamento patelar direito teve capacidade máxima de resistência de 850,8N ±299,9N e o esquerdo 729,3N ±283,5N. Estatisticamente, foi evidenciado que não há correlação significativa (r>0,7) entre os parâmetros biométricos corporais aferidos e a resistência ou deformação do ligamento patelar. Mesmo não havendo correlação estatística significativa, os dados de resistência e deformação do ligamento patelar canino podem gerar embasamento para outras pesquisas, que visam corrigir rupturas de ligamentos articulares(AU)

The biomechanical study of articular ligaments generate subsidies for research of biomaterials or treatment techniques for replacement or repair of these structures on the occasion of rupture or degeneration. Therefore, We carried out a biomechanical traction assay of the patellar ligament in 53 dogs, totaling 106 patellar ligaments, determining maximum resistance in Newtons (N) and deformation in millimeters (mm). These data were correlated to body biometrics of the dogs used. The strength of the left and right patellar ligaments in the female group were 642.6N ±297.2N and 627.0N ±300.6N (p=0.028), respectively. Males presented higher values (p=0.035). The right patellar ligament had a maximum capacity of resistance of 850.8N ±299.9N, and the left one of 729.3N ±283.5N. Statistically, there is no significant correlation (r> 0.7) between the biometric parameters measured and the bodily strength or deformation of the patellar ligament. Despite no statistical significant correlation, data from the strength and deformation of the canine patellar ligament can support further research aimed at correcting ruptures of joint ligaments(AU)

Determinação das propriedades biomecânicas do ligamento patelar de cães (Canis familiaris Linnaeus, 1758) / Determination of biomechanical properties of patellar ligament in dogs (Canis familiaris Linnaeus, 1758)

O estudo biomecânico de ligamentos articulares geram subsídios às pesquisas de biomateriais ou técnicas de tratamento para substituição ou reparação destas estruturas por ocasião de ruptura ou degeneração. Diante disto, realizaram-se ensaios biomecânicos de tração do ligamento patelar em 53 cães, totalizando 106 ligamentos patelares testados. Foram determinadas a capacidade máxima de resistência em Newtons (N) e a deformação expressa em milímetros (mm), sendo estes dados correlacionados à biometria corporal dos cadáveres dos cães utilizados. A resistência do ligamento patelar direito e esquerdo no grupo das fêmeas foi de 642,6N ±297,2N e 627,0N ±300,6N (p=0,028), respectivamente. Nos machos, verificaram-se valores superiores (p=0,035). O ligamento patelar direito teve capacidade máxima de resistência de 850,8N ±299,9N e o esquerdo 729,3N ±283,5N. Estatisticamente, foi evidenciado que não há correlação significativa (r>0,7) entre os parâmetros biométricos corporais aferidos e a resistência ou deformação do ligamento patelar. Mesmo não havendo correlação estatística significativa, os dados de resistência e deformação do ligamento patelar canino podem gerar embasamento para outras pesquisas, que visam corrigir rupturas de ligamentos articulares

The biomechanical study of articular ligaments generate subsidies for research of biomaterials or treatment techniques for replacement or repair of these structures on the occasion of rupture or degeneration. Therefore, We carried out a biomechanical traction assay of the patellar ligament in 53 dogs, totaling 106 patellar ligaments, determining maximum resistance in Newtons (N) and deformation in millimeters (mm). These data were correlated to body biometrics of the dogs used. The strength of the left and right patellar ligaments in the female group were 642.6N ±297.2N and 627.0N ±300.6N (p=0.028), respectively. Males presented higher values (p=0.035). The right patellar ligament had a maximum capacity of resistance of 850.8N ±299.9N, and the left one of 729.3N ±283.5N. Statistically, there is no significant correlation (r> 0.7) between the biometric parameters measured and the bodily strength or deformation of the patellar ligament. Despite no statistical significant correlation, data from the strength and deformation of the canine patellar ligament can support further research aimed at correcting ruptures of joint ligaments

Evaluation of the marsh deer stifle joint by imaging studies and gross anatomy.

This study aimed to evaluate the stifle joint of marsh deer using imaging studies and in comparison with gross anatomy. Ten hindlimbs from 5 marsh deer (Blastocerus dichotomus) were used. Radiography, computed tomography (CT) and magnetic resonance imaging (MRI) were performed in each stifle joint. Two hindlimbs were dissected to describe stifle gross anatomy. The other limbs were sectioned in sagittal, dorsal or transverse planes. In the craniocaudal radiographic view, the lateral femoral condyle was broader than the medial femoral condyle. The femoral trochlea was asymmetrical. Subsequent multiplanar reconstruction revealed in the cranial view that the external surface of the patella was roughened, the medial trochlea ridge was larger than the lateral one, and the extensor fossa at the lateral condyle was next to the lateral ridge. The popliteal fossa was better visualized via the lateral view. Sagittal MRI images identified lateral and medial menisci, caudolateral and craniomedial bundles of cranial cruciate ligament, caudal cruciate ligament, patellar ligament and common extensor tendon. In conclusion, the marsh deer stifle presents some anatomical characteristics of the ovine stifle joint.

Morphometric analysis of the angle of the femoral trochlea

The possible association between disorders of the femoropatellar joint and geometrical anatomical variations in the patellar facet and femoral sulcus motivated us to conduct a morphometric study on the angle of the femoral sulcus and to correlate this with possible variation factors, such as: length, width at the midpoint of the femur, femur inclination angle, distance between condyles and depth of the patellar facet. The material consisted of 56 dry femurs of both sexes and various ages: 24 from the right side and 32 from the left side. The patellar facets were photographed at three positions: a) start level; b) middle level; and c) end level. The angle formed in each of these positions was measured using graphical tools in CorelDraw X4. To analyze the results, the statistical tests used were chi-square and Student’s t-test for correlations. The results obtained were: a) angle of the patellar facet: mean for start level of the patellar facet = 129°01; mean for middle level = 131°35 and mean for end level = 132°14; b) mean distance between condyles = 50.29  mm; c) mean depth of the patellar facet = 9.55 mm; d) mean for Ficat and Bizou’s condylar depth index = 5.45. We concluded that the angle of the femoral sulcus increased from the start of the patellar facet to its end, and that its variability was weakly influenced by the length, width, femur inclination angle and side, according to the t-test (significance of 5%) for the correlation coefficients found.

Relação entre o ligamento patelofemoral lateral e a largura da faceta patelar lateral / Relationship between the lateral patellofemoral ligament and the width of the lateral patellar facet

OBJETIVO: Avaliar a relação entre o comprimento e largura do ligamento patelofemoral lateral (LPFL) e a largura da faceta articular patelar lateral (FAPL) em cadáveres. A instabilidade patelofemoral está intimamente relacionada com a morfologia patelar e com a tensão das estruturas retinaculares laterais. Estudos evidenciam que quanto mais larga a faceta patelar lateral e quanto mais tenso o retináculo lateral, maior a propensão do desenvolvimento de uma enfermidade na articulação patelofemoral. MÉTODOS: Foram dissecados 20 joelhos em 20 cadáveres. Identificamos as peças quanto ao gênero, idade, lado dissecado, comprimento e largura do LPFL e a largura da FAPL. Foi utilizado o nível de significância estatística de 5 por cento (0,050) e a aplicação da análise de correlação de Spearman. RESULTADOS: O LPFL apresentou em média 16,05 milímetros de largura (desvio-padrão 2,48) e 42,10 milímetros de comprimento (desvio-padrão 8,84). A largura da FAPL variou de 23 a 37 milímetros (média 28,1). A relação entre a largura da FAPL e a largura do LPFL é estatisticamente não-significante (p=0,271), enquanto que a relação entre a largura FAPL e o comprimento do LPFL é estatisticamente significante (p=0,009). CONCLUSÃO: O comprimento do LPFL e a largura FAPL apresentam valores inversamente proporcionais.

OBJECTIVE: The aim of this study, with cadavers, is to evaluate the relationship between the width and length of the lateral patellofemoral ligament (LPFL) and the size of the lateral patellar articulate facet (LPAF). Patellofemoral instability is closely related to patellar morphology and the lateral retinacular layers. Studies evidence that the wider the lateral patellar facet and the more strained the lateral retinacule, the greater the tendency for development of pathology in the patellofemoral joint. METHODS: 20 knees were dissected in 20 cadavers. The parts were identified according to gender, age, dissected side, length and width of LPFL and width of LPAF. In order to carry out the statistical analysis we adopted the significance level of 5 percent (0.050) and also used Spearman's Coefficient of Rank Correlation. RESULTS: The LPFL presented a mean width of 16.05 millimeters (standard deviation 2.48) and 42.10 millimeters of length (standard deviation 8.84). The width of the LPAF varied from 23 to 37 millimeters (mean 28.1). It was observed that the relationship between the LPAF and LPFL widths is not statistically significant (p=0.271), whereas the relationship between the LPAF width and the LPFL length is statistically significant (p=0.009). CONCLUSION: The shorter the LPFL the greater the width of the LPAF.

Surgical anatomical measurements of patellar ligaments for blind method of medial patellar desmotomy of cattle during upward patellar fixation in Bangladesh / Mediciones anatómicas quirúrgicas del ligamento patelar por técnica ciega en la desmotomía medial patelar de ganado durante la fijación superior de la patela en Bangladesh

The study was aimed to determine the accurate location of giving incision and the width of the incision required to correct the problem of upward patellar fixation during blind method of medial patellar desmotomy. We took measurements of patellar ligaments in stifle joint of 50 indigenous and 50 crossbred slaughtered cattle without any apparent musculo-skeletal disorders were analysed. The average length and width of lateral, middle, and medial patellar ligaments for indigenous cattle were 9.360 +/- 0.339 and 3.056 +/- 0.226; 10.230 +/- 0.382 and 2.019 +/-0.258; 10.519 +/- 0.429 and 2.430 +/-0.232; for crossbred cattle 10.636 +/- 0.601 and 3.608 +/- 0.368; 11.580 +/- 0.724 and 2.330 +/- 0.205; 12.366 +/- 0.710 and 2.890 +/- 0.234 cm respectively. The average groove width for indigenous cattle and crossbred cattle between middle and medial ligament were 1.356 +/- 0.160 and 1.828 +/-0.186 cm and the highest width of groove between middle and medial patellar ligaments from the level of most cranial bulging of the cranial tibial tuberosity in the upward direction were 4.234 +/- 0.269 and 5.645 +/-0.358 cm respectively. Parameters measured were significantly different (p0.05) between indigenous and crossbred cattle. This study was suggested that incision should be made 4.234 +/- 0.269 and 5.645+/-0.398 cm proximally from the level of the most cranial bulging of cranial tibial tuberosity at the groove between middle and medial patellar ligaments, 2.430 +/-0.232 and 2.890+/-0.186 cm the mean width of the medial ligament to be cut during blind method of medial patellar desmotomy in indigenous and crossbred cattle respectively during surgical correction of upward patellar fixation.

El estudio fue dirigido a determinar la ubicación exacta de la incisión y el ancho necesario de la incisión para corregir el problema de la fijación superior patelar durante la técnica ciega de la desmotomia medial patelar. Se tomaron y analizaron medidas del ligamento patelar en la rodilla de 50 bovinos indígenas y 50 bovinos mestizos de criadero, sacrificados sin aparentes trastornos músculo-esqueléticos. El promedio de longitud y ancho lateral, central y medial del ligamento patelar para el ganado indígena fueron 9,360 +/- 0,339 y 3,056 +/- 0,226; 10,230 +/- 0,382 y 2,019 +/- 0,258; 10,519 +/- 0,429 y 2,430 +/- 0,232, y para el ganado mestizo 10,636 +/- 0,601 y 3,608 +/- 0,368; 11,580 +/- 0,724 y 2,330 +/- 0,205; 12,366 +/- 0,710 y 2,890 +/- 0,234 cm, respectivamente. El promedio del ancho del surco para el ganado bovino indígena y el mestizo entre el ligamento medio y ligamento medial fue 1,356 +/- 0,160 y 1,828 +/- 0,186 cm, y el máximo ancho del surco entre el ligamento medio y ligamento medial patelar desde el nivel más craneal del abultamiento de la tuberosidad tibial craneal en dirección hacia superior fueron 4,234 +/- 0,269 y 5,645 +/- 0,358 cm, respectivamente. Los parámetros medidos fueron significativamente diferentes (p 0,05) entre el ganado indígena y el ganado mestizo. Este estudio puede sugerir que la incisión puede ser hecha 4,234 +/- 0,269 y 5,645 +/- 0,398 cm proximalmente desde el nivel más craneal del abultamiento de la tuberosidad tibial craneal hasta el surco entre el ligamento patelar medio y medial. 2,430 +/- 0,232 y 2,890 +/- 0,186 cm fue la media del ancho del ligamento medio a ser cortada durante la técnica ciega de la desmotomía medial patelar del ganado indígena y mestizo respectivamente, durante la corrección quirúrgica de fijación superior patelar.

Metric measurements and attachment levels of the medial patellofemoral ligament: an anatomical study in cadavers.

OBJECTIVE: To determine the metric measurements and to verify the attachment levels of the medial patellofemoral ligament in human cadavers. METHODS: Seventeen knees (eight right and nine left knees) from 10 cadavers (nine male and one female) were dissected and stored in a 10% formaldehyde solution. All of the knees were whole and did not show any macroscopic signs of injuries. RESULTS: The medial patellofemoral ligament was present in 88% of the knees studied, localized transversally between the medial femoral epicondyle and the medial margin of the patella. Its dimensions were quite variable, even between the knees of the same individual. The width of the patellar insertion ranged from 16 to 38.8 mm, with a mean of 27.90 mm, and its mean length was 55.67 mm. The margins of the ligament were concave or rectilinear. At the upper margin, the concave form predominated and was better characterized, while at the lower margin, the rectilinear form predominated. CONCLUSIONS: The medial patellofemoral ligament is a very distinct structure with variable anatomical aspects and is always located in a plane inferior to the vastus medialis obliquus muscle.

Estudo anatômico do ligamento patelofemoral lateral em joelho de cadáveres / Anatomical study of the lateral patellofemoral ligament in cadaver knees

OBJETIVOS: Descrever o ligamento patelofemoral lateral (LPFL) por meio de dissecação anatômica de joelhos de cadáveres frescos. Na literatura existe particular interesse pelo LPFL. Essa especial atenção é dada pela sua importância anatômica, biomecânica e pela necessidade da sua reconstrução nos casos de instabilidade medial da patela. MÉTODOS: O LPFL foi estudado em 20 joelhos de 20 cadáveres frescos por meio de dissecações anatômicas. As dissecações foram padronizadas e os dados anotados enviados para análise estatística. RESULTADOS: O LPFL apresentou em média 16,05mm de largura (desvio-padrão: 2,48), 42,10mm de comprimento (desvio-padrão: 8,84). Sua inserção femoral mostrou-se no epicôndilo femoral lateral e com expansão em forma de leque das suas fibras, predominantemente na região posterior e proximal ao epicôndilo lateral. Na patela a inserção encontrada foi na região súpero-lateral (na metade do terço superior no plano coronal), também com expansão das fibras, mas com menor intensidade. No plano sagital, o ligamento situava-se na metade posterior da borda da patela. O LPFL foi isolado na segunda camada retinacular lateral, o retináculo transverso profundo. CONCLUSÃO: O LPFL situa-se na camada retinacular transversa profunda, com a presença de uma expansão das suas fibras em forma de leque, tanto na inserção femoral quanto na patelar. No epicôndilo femoral a inserção encontra-se mais posterior e proximalmente e na patela está na metade posterior da borda patelar (plano sagital) e no aspecto súpero-lateral.

OBJECTIVES: To describe the lateral patellofemoral ligament (LPFL) after anatomical dissection of fresh cadaver knees. The literature shows a particular interest for the LPFL. Such special attention is due to its anatomical and biomechanical importance, and also due to the need to reconstruct the ligament in the cases of medial patellar instability. METHODS: The LPFL was studied in 20 knees of 20 fresh cadavers by means of anatomical dissections. The dissections were standardized and the data were noted down and forwarded to statistical analysis. RESULTS: The LPFL presented a mean 16.05 mm width (standard deviation of 2.48), 42.10 mm length (standard deviation of 8.84). The femoral insertion was found at the lateral femoral epicondyle and with a fan-like expansion of the fibers, predominantly in the posterior region proximal to the lateral epicondyle. In the patella, the insertion found was in the upper-lateral region (in the middle of the upper third of the coronal plan), also with expanded fibers, but less intensely so. In the sagittal plan, the ligament was located in the posterior half of the border of the patella. The LPFL was isolated in the second lateral retinacular layer, the deep transverse retinaculum. CONCLUSION: The LPFL is located in the deep transverse retinacular layer with the presence of a fan-like expansion of its fibers both in the femoral and in the patellar insertions. The insertion is more posterior and proximal at the femoral epicondyle and in the posterior half of the patellar border (sagittal plan) and in the upper-lateral aspect.

Metric measurements and attachment levels of the medial patellofemoral ligament: an anatomical study in cadavers

OBJECTIVE: To determine the metric measurements and to verify the attachment levels of the medial patellofemoral ligament in human cadavers. METHODS: Seventeen knees (eight right and nine left knees) from 10 cadavers (nine male and one female) were dissected and stored in a 10 percent formaldehyde solution. All of the knees were whole and did not show any macroscopic signs of injuries. RESULTS: The medial patellofemoral ligament was present in 88 percent of the knees studied, localized transversally between the medial femoral epicondyle and the medial margin of the patella. Its dimensions were quite variable, even between the knees of the same individual. The width of the patellar insertion ranged from 16 to 38.8 mm, with a mean of 27.90 mm, and its mean length was 55.67 mm. The margins of the ligament were concave or rectilinear. At the upper margin, the concave form predominated and was better characterized, while at the lower margin, the rectilinear form predominated. CONCLUSIONS: The medial patellofemoral ligament is a very distinct structure with variable anatomical aspects and is always located in a plane inferior to the vastus medialis obliquus muscle.

Anatomia ultra-sonográfica dos ligamentos patelares de cavalos adultos / Ultrasonographic anatomy of the patellar Iigaments in the adults horses

Para descrever a anatomia ultra-sonográfica foram examinados os ligamentos patelares (medial, intermédio e lateral) e as estruturas relacionadas de 20 articulações fêmuro-tibio-patelares de cavalos adultos. Tanto a ecogenicidade como o alinhamento das fibras de colágeno, a espessura, a forma e relação com as estruturas vizinhas foram avaliadas. Os três ligamentos apresentaram ecogenicidade uniforme e paralelismo das fibras colágenas. Em secção longitudinal os ligamentos patelares medial (LPM) e intermédio (LPI) apresentaram maior espessura do segmento distal (p<0,01) quando comparado com o proximal. Comparando-se o mesmo segmento entre os três ligamentos, o LPI apresentou espessura maior (p<0,01) em relação ao LPM e ligamento patelar lateral (LPL). Em secção transversal (cm2) o LPL apresentou a maior área (p <0,01), seguido pelo LPI e LPM. Em secção transversal do segmento médio, o LPM apresentou forma triangular, o LPI em forma triangular ou circular, e o LPL formato achatado. As estruturas adjacentes identificadas durante o exame dos ligamentos foram cristas femorais, cartilagem articular, tecido gorduroso periligamentar, patela e tíbia proximal.(AU)

In order to describe the ultrasonographic anatomy of patellar ligaments (medial, middle, lateral) and associated structures, 20 femorotibiopatellar joints of adult horses were investigated. Echogenicity, collagen fibers alignment, size, shape and surrounding structures were evaluated. All ligaments presented uniform echogenicity and collagen fibers parallelism. The longitudinal section of the medial and middle patellar ligaments presented a significant larger thickness (p<0,01) of the distal region when compared to the proximal region. When comparing the same site between the three ligaments, LPI was thicker (p<0,01) than lateral patellar ligament (LPL) and LPM. The LPL transversal section (cm2) presented a significant larger area (p<0,01), followed by the LPI and LPM. The transversal section of the medium region revealed a LPM with triangular shape, triangular or circular LPI, and flattened LPL. The surrounding structures observed during the evaluation were: femoral groove, articular cartilages, periligamentar fat tissue, patella and proximal tibia.(AU)

Anatomia ultra-sonográfica dos ligamentos patelares de cavalos adultos / Ultrasonographic anatomy of the patellar Iigaments in the adults horses

Para descrever a anatomia ultra-sonográfica foram examinados os ligamentos patelares (medial, intermédio e lateral) e as estruturas relacionadas de 20 articulações fêmuro-tibio-patelares de cavalos adultos. Tanto a ecogenicidade como o alinhamento das fibras de colágeno, a espessura, a forma e relação com as estruturas vizinhas foram avaliadas. Os três ligamentos apresentaram ecogenicidade uniforme e paralelismo das fibras colágenas. Em secção longitudinal os ligamentos patelares medial (LPM) e intermédio (LPI) apresentaram maior espessura do segmento distal (p<0,01) quando comparado com o proximal. Comparando-se o mesmo segmento entre os três ligamentos, o LPI apresentou espessura maior (p<0,01) em relação ao LPM e ligamento patelar lateral (LPL). Em secção transversal (cm2) o LPL apresentou a maior área (p <0,01), seguido pelo LPI e LPM. Em secção transversal do segmento médio, o LPM apresentou forma triangular, o LPI em forma triangular ou circular, e o LPL formato achatado. As estruturas adjacentes identificadas durante o exame dos ligamentos foram cristas femorais, cartilagem articular, tecido gorduroso periligamentar, patela e tíbia proximal.

In order to describe the ultrasonographic anatomy of patellar ligaments (medial, middle, lateral) and associated structures, 20 femorotibiopatellar joints of adult horses were investigated. Echogenicity, collagen fibers alignment, size, shape and surrounding structures were evaluated. All ligaments presented uniform echogenicity and collagen fibers parallelism. The longitudinal section of the medial and middle patellar ligaments presented a significant larger thickness (p<0,01) of the distal region when compared to the proximal region. When comparing the same site between the three ligaments, LPI was thicker (p<0,01) than lateral patellar ligament (LPL) and LPM. The LPL transversal section (cm2) presented a significant larger area (p<0,01), followed by the LPI and LPM. The transversal section of the medium region revealed a LPM with triangular shape, triangular or circular LPI, and flattened LPL. The surrounding structures observed during the evaluation were: femoral groove, articular cartilages, periligamentar fat tissue, patella and proximal tibia.

The articular muscle of the knee: morphology and disposition

Con el objetivo de investigar los aspectos morfológicos y las relaciones del músculo articular de la rodilla, así como la disposición de las fibras musculares a nivel del fémur, además de comparar la masa muscular del referido músculo con el resto de la masa muscular del miembro inferior, fueron analizados 15 miembros inferiores de cadáveres humanos adultos, de ambos sexos, fijados en formol y seccionados transversalmente, a nivel del tercio medio del muslo y tercio proximal de la pierna. El músculo articular de la rodilla estaba presente en todo el material analizado y en el 93,3 por ciento de los casos tenía su punto de origen en la parte anterior distal del fémur. Entre las piezas analizadas, un 40 por ciento mostró una masa muscular bastante reducida y en forma trapezoidal. Ese músculo presentó en la inserción una distancia promedio de 3,07 cm arriba del borde superior de la tróclea, variando los haces musculares entre 2 y 7. Éstos, en su mayoría, presentaron una dirección vertical. El músculo mostró una disposición anterior en el tercio distal del fémur. Nuestro resultado sugiere que el tamaño y las relaciones del músculo articular de la rodilla con la bolsa sinovial suprapatelar, pueden estar directamente relacionados con el resto de masa muscular del miembro inferior. Por tal motivo, cuando se trabaja para aumentar el tono muscular del músculo recto femoral, se está provocando, de manera indirecta, la hipertrofia del músculo articular de la rodilla y potenciando su desempeño en la cavidad articular.

Estudo da rigidez do ligamento cruzado anterior do joelho e dos enxertos para sua reconstrução com o ligamento patelar e com os tendões dos músculos semitendíneo e grácil / Rigidity of the knee anterior cruciate ligament and grafts to reconstruct it with the patellar ligament and with the semitendinosus and gracilis muscles

Com o objetivo de avaliar a reigidez do ligamento cruzado anterior e dos enxertos preparados para sua reconstrução a partir da porção central do ligamento patelar e dos tendões dos músculos semitendíneo e grácil duplos, oriundos dos mesmos joelhos, o autor utiliza 20 joelhos de cadáveres humanos, frescos, todos masculinos, com idade média de 32,2 ñ8,9 anos, variando de 17 a 47 anos. As estruturas analisadas foram submetidas a três ensaios mecânicos de tração, com intervalos de 10 minutos para recuperação, em máquina Kratos K-5002 (eletromecânica), com velocidade de 20mm/min até atingir 147,15 N (15 kgf), mantendo-as alongadas por um período de 15 minutos. Todas as estruturas observadas apresentam um aumento da rigidez aos sucessivos testes realizados, exceto entre o 2§ e o 3§ teste do ligamento cruzado anterior onde não apresentou diferença estatística. A análise estatística permite concluir que os ciclos sucessivos dos ensaios mecânicos determinam um aumento da rigidez dos enxertos analisados.

Densidade linear do sistema de fibras elásticas dos ligamentos patelar, cruzado anterior e cruzado posterior / Linear density of the elastic fibers system in patellar and cruciate ligaments

Com o objetivo de comparar os ligamentos cruzados da articulação do joelho com o ligamento patelar, os autores realizaram análise da quantidade de fibras elásticas entre esses ligamentos por meio de amostras obtidas de ete cadáveres. O estudo histomorfométrico do sistema de fibras elásticas revelado por métodos seletivos de coloração mostrou não haver diferença na densidade linear de todo o sistema de fibras elásticas. Não foi observada diferença estatisticamente significante na quantidade de fibras elásticas maduras entre os três ligamentos estudados. Entretanto, a quantidade de fibras elásticas mduras e elaunínicas, fibras responsáveis pela elasticidade, foi maior no ligamento cruzado anterior. Dessas forma podemos inferir que o ligamento cruzado posterior e o ligamento patelar têm mais fibras oxitalânicas, que são responsáveis pela resistência tecidual. Os autores concluiram que o ligamento cruzado posterior e o ligamento patelar têm estrutura semelhante e parecem mais relacionados à transmissão de força, enquanto o ligamento cruzado anterior está relacionado à elasticidade da articulação de joelho.

A altura da patela em próteses totais de joelho / Patellar heiht in total knee prosthesis

Os autores apresentam uma casuística que compreende 136 pacientes submetidos a artroplastia total de joelho, durante o período de janeiro de 1989 a dezembro de 1995, totalizando 161 joelhos operados. O objetivo do trabalho é analisar a altura da patela no pré e no pós-operatório, comparando-se com os diferentes modelos de próteses utilizados. Os modelos de próteses utilizados durante esse período foram: Insall-Burstein I e II, PCA, Biomet Ortholoc II e Performance TC IV. Os autores concluem que ocorre discreto rebaixamento da patela de forma geral, apontam e discutem as possíveis causas desta modificatpo anatômica no pós-operatório.