femoropatellar joint

  • 文章类型: Journal Article
    马窒息关节的血管化模式在文献中描述不足,尽管人们越来越需要了解确切的血液供应,由于(i)关节镜和内窥镜手术技术越来越多地在马匹中进行,以及(ii)半月板的离体模型需要模仿体内情况的营养供应。这项研究的目的是描述参与窒息关节供应的血管以及the动脉的确切分支模式。将彩色乳胶注射到马尸体的九个骨盆肢体的动脉中(n=6),以评估发生情况。提供窒息关节的血管的变化和近似直径。在隐动脉和渐降动脉的分支旁边,马中可以描述十一条pop动脉分支,这些马为窒息关节的血管网络提供食物。关注半月板的血液供应,血管化图被创建以详细显示这些关节内结构的主要流入。这些发现对于临床医生为关节镜检查准备最合适的切口以及研究人员设计半月板研究的新方法和选择合适的动物模型都可能非常重要。
    The vascularization pattern of the equine stifle joint is insufficiently described in the literature, even though there is a growing need for knowledge of the exact blood supply, as (i) arthroscopy and endoscopic surgery techniques are increasingly performed in horses and (ii) ex vivo models of menisci need nutrient supply that mimic the in vivo situation. The aim of this study was to describe the vessels involved in the stifle joint supply and the exact branching pattern of the popliteal artery. Colored latex was injected into the arteries of nine pelvic limbs of equine cadavers (n = 6) to evaluate the occurrences, variations and approximate diameters of vessels that supplied the stifle joints. Next to a branch of the saphenous and descending genicular arteries, eleven branches of the popliteal artery could be described in horses that feed the vascular network of the stifle joint. With a focus on the blood supply of the menisci, a vascularization map was created to show the main influx to these intra-articular structures in detail. These findings are potentially of great importance to both clinicians in preparation of best-suited incisions for arthroscopy and researchers designing new approaches for meniscal studies and choosing suitable animal models.
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  • 文章类型: Journal Article
    背景:自全膝关节置换术开始以来,植入物对齐一直是讨论的中心点。尽管讨论的对齐理论多种多样,植入物的设计是统一的,这应该是基于“平均膝盖”。“假体设计和现代对准理论的稳步升级已经实现了改进。然而,膝关节置换术继续承受着相当比例的不满意患者的负担。在目前的膝关节置换术中,股骨植入物对齐由背侧和远端髁轴参考。没有充分考虑髌股关节变异。股骨髁的主要背侧和远端参考决定了前膝关节的术后形状。本研究调查了背侧和远端关节参数与髌股关节之间的可能关系。
    方法:在这项探索性回顾性单中心研究中,评估了100个天然膝关节的MRI横截面图像。通过根据皮尔逊确定参数相关性,这项研究调查了独立变量“股骨后髁角度”和“股骨远端外侧角度”是否与“滑车外侧倾斜”有关,“髌骨倾斜”,和“平分偏移”。
    结果:后髁角与外侧滑车倾角显著相关,髌骨倾斜,和平分偏移。与髌骨倾斜和平分偏移呈正相关,而与滑车外侧倾斜呈负相关。股骨远端外侧角度与研究参数无关。
    结论:滑车外侧倾角随着股骨后髁角的增大而减小。全膝关节置换术中股骨组件的后部参考同时建立了前膝关节的形状。我们的结果表明,后髁角度的增加与天然膝盖的扁平外侧滑车倾斜显着相关,并表明全膝关节置换术中存在系统的生物力学冲突。
    BACKGROUND: Since the beginning of total knee arthroplasty, implant alignment has been a central point of discussion. As diverse as the discussed alignment theories are, as uniform is the implant design, which is supposed to be based on the \"average knee.\" Steady upgrades in prosthesis design and modern alignment theories have achieved improvements. However, knee arthroplasty continues to be burdened by a significant percentage of dissatisfied patients. In current knee arthroplasty, femoral implant alignment is referenced by the dorsal and distal condylar axes. The patellofemoral joint variance is not sufficiently considered. Predominantly dorsal and distal referencing at the femoral condyle determines the postoperative shape of the anterior knee joint. The present study investigated a possible relationship between dorsal and distal joint parameters and the patellofemoral joint.
    METHODS: In this explorative retrospective monocentric study, MRI cross-sectional images of 100 native knee joints were evaluated. By determining parametric correlations according to Pearson, the study investigates whether the independent variables \"posterior femoral condyle angle\" and \"lateral distal femoral angle\" are related to \"lateral trochlear inclination\", \"patella tilt\", and \"bisect offset\".
    RESULTS: The posterior condylar angle significantly correlates with lateral trochlear inclination, patella tilt, and bisect offset. There is a positive correlation with patella tilt and bisect offset but a negative correlation with lateral trochlear inclination. The lateral distal femoral angle did not correlate with the studied parameters.
    CONCLUSIONS: The lateral trochlear inclination decreases with an increased posterior femoral condylar angle. The posterior referencing of the femoral component in total knee arthroplasty simultaneously establishes the shape of the anterior knee joint. Our results indicate that increasing posterior condyle angles significantly correlate with flattened lateral trochlear inclinations in native knees and suggest a systematic biomechanical conflict in total knee arthroplasty.
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  • 文章类型: Journal Article
    目的通过观察者间和观察者内的重复性测量,评估DavidDejour提出的描述膝关节滑车发育不良的分类方法。方法对10例滑车发育不良患者进行研究。三个医生,巴西膝关节外科协会的成员,被邀请评估图像。每隔一周进行观察者内部和观察者之间的分析。在四种情况下评估了可重复性:仅使用射线照相术;使用射线照相术和断层扫描;使用射线照相术并咨询分类;以及使用射线照相术和断层扫描,咨询分类。结果观察者内部评价结果不一致。在观察者间分析中,对于仅使用X线照相术的分析,一致性程度较低,对于同时使用X线照相术和X线照相术的分析,一致性程度优异.结论当仅使用X射线照相术时,Dejour分类的观察者内部和观察者之间的可重复性较低。事实证明,即使在有经验的观察者中,仅使用射线照相术进行分类也可能导致缺乏一致性。然而,当射线照相术和断层摄影相结合时,重现性得到改善。
    Objective  To evaluate the classification proposed by David Dejour to describe trochlear dysplasia of the knee through inter- and intraobserver reproducibility measurements. Methods  Ten patients with trochlear dysplasia were studied. Three physicians, members of the Sociedade Brasileira de Cirurgia do Joelho (Brazilian Society of Knee Surgery), were invited to evaluate the images. Intra- and interobserver analyses were performed at one-week intervals. Reproducibility was evaluated in four scenarios: using only radiography; using radiography and tomography; using radiography and consulting the classification; and using radiography and tomography, consulting the classification. Results  The intraobserver evaluation presented discordant results. In the interobserver analysis, the degree of agreement was low for the analyses that used only radiography and excellent for those in which both radiography and tomography were used. Conclusion  The Dejour classification presented a low intra- and interobserver reproducibility when only the profile radiography was used. It was demonstrated that the use of the radiography alone for classification may generate lack of uniformity even among experienced observers. However, when radiography and tomography were combined, reproducibility improved.
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  • 文章类型: Journal Article
    Osteochondrosis is common in young, athletic horses. Some lesions respond to conservative therapy. Surgical management is the mainstay of treatment. Arthroscopic debridement is useful in the femoropatellar joint, tarsocrural joint, fetlock joint, and shoulder joint. Debridement is associated with good outcomes, except in the shoulder joint. Osteochondrosis lesions in the elbow may be difficult to access arthroscopically, thereby transosseous debridement. Surgical management of subchondral cystic lesions of the medial femoral condyle consists of debridement, debridement with grafting, transcondylar screws, and intralesional corticosteroid injection. Surgical management is indicated with lameness and persistent effusion, and in many horses intended for athletic use.
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