Introduction: Patellofemoral joint
Abstract. Background. Little scientific evidence is available regarding the effect of knee joint line obliquity (JLO). Methods. 10 fresh-frozen human cadaveric knees were axially loaded to 1500 N in a materials testing machine with the joint line tilted 0, 4, 8, and 12 degrees varus and valgus, at 0, and 20 degrees of knee flexion. The mechanical compression axis was aligned to the centre of the tibial plateau. Contact pressures / areas were recorded by sensors inserted between the tibia and femur below the menisci. Changes in relative femoral and tibial position in the coronal plane were obtained by an optical tracking system. Results. medial and lateral JLO caused significant tibiofemoral
Metal-on-Metal devices generate significantly lower volumetric wear than conventional total hip replacements. However, clinically some patients may suffer some form of laxity in their joints leading to
INTRODUCTION. Analysis of retrieved ceramic components have shown areas of localized ‘stripe wear’, which have been attributed to joint laxity and/or impingement resulting in
Permanent patellar
Background: Recurrent peroneal tendon
Objective: Ex vivo studies have suggested that cartilage contact areas and pressure are of high clinical relevance in the ethiology of osteoarthritis in patients with patellar
Introduction. Clinical observations suggest mid-flexion instability may occur more commonly with rotating platform (RP) total knee arthroplasty (TKA), including increased revision rates and patient-reported instability and pain. We propose that increased gap laxity leads to liftoff of the lateral femoral condyle with decreased conformity between the femoral component and polyethylene (PE) insert surface leading to PE
Background. Rotatory
This is a retrospective study describing four patients who developed symptomatic
Objective: To review the hip
Traumatic rotatory atlanto-axial dislocation and
Background. Current literature of definition, classification and outcomes of fractures of talar body remains controversial. Our primary purpose is to present an unusual combination of fractures of talar body with pantalar involvement / dislocation / extension as a basis for modification of Müller AO / OTA Classification. Methods. We include four consecutive patients, who sustained talar body fractures with pantalar
Introduction: The efficacy and complications of the transarticular screw procedure have been reported by many authors. However, few have reported this procedure for child younger than 10 years old. We have treated two children for atlantoaxial
Scoliosis and hip
Aim: To evaluate the necessity for further radiological investigation in patients with suspicion of rotatory
Aims: To review the hip
Introduction: When we have operate children’s knee in habitual luxation of the patella we noted, that iliotibial band have branch going to patella and to patella tendon. It is important to the etiopathology of the patella luxation, but in valgus of the knee and in hyperpresion of the patella syndrome too. Material and Method: In years 2000–2007 we have performed surgical iliotibial band release In 70 children, 28 boys and 42 girls. In 19 children contracture of the iliotibial band were one-sided, in 51 children contracture were both-sided. Patients were divided in to groups with various pre-operative symptoms:. valgus of the knee – 40 patients (74 legs),. valgus of the knee with
This study of retrieved 28 mm Metasul™ (cemented) revealed for the first time adverse wear effects created by impingement-subluxation in MOM. The 10 cases selected (with femoral stems) had annual follow-up 3–11 years. (1) Unequivocal evidence here shows that all heads routinely subluxed from the Metasul liners. Femoral stems revealed well-demarcated notches (DN) on necks and trunnions (Fig. 1a: n = 6), shallow cosmetic blemishes (Fig. 1b CB: n = 4), and abrasion by cement (Fig. 1b: PMMA). As demonstrated by EOS radiographs, impingement locations varied with implant positioning, pelvic mobility and patient functionality – both anterior and posterior notching (Fig. 1). The first impingement notch occurred with head located (Fig. 2a), whereas the head had subluxed from the cup at 2. nd. notch (Fig. 2b). The model demonstrated that patients gained 20° motion by such head-subluxation manoeuvres. It was surprising that there was no collateral damage evident on the liners. Even with severe notching of Ti6Al4V and CoCr stems, the cup rims generally appeared well-polished. Femoral heads revealed macro-stripe damage on articular surfaces (Fig. 3), as did cups. Basal and polar macro-stripes on heads were always located at hip impingement positions. The equatorial stripes were formed at main-wear zone boundaries. Thus equatorial stripes were likely created by some form of rim-impact damage (micro-separation) or by local ingress of 3. rd. -body wear particles under the cup rim. Micro-grooving was evident within these macro-size stripes and frequently featured large raised lips (Fig. 3), interpreted as signs of adverse 3. rd. -body wear mechanisms, and rarely described.(2) It would appear that large metal particulates were released during MOM impingement-subluxation manoeuvres and circulated the hip joint to producing severe 3. rd. -body abrasion. Gradual decomposition of such large debris to nano-sized particulates under joint loading would then produce the often-referenced ‘self polishing’ effect of CoCr. EDS studies revealed metal smears on the CoCr surfaces containing the elements of titanium alloy (Ti, Al, V). This was further evidence of impingement-subluxation manoeuvres.(1, 3). In-vivo cup wear patterns also appeared much larger than those produced in MOM simulators. Such differences likely reflected head-subluxation in vivo, whereby heads unconstrained by the
Aim: The aim of the study was to assess the correlation of CE angle to the ratios of medial hip joint space width and femoral head diameter to acetabular width. Material and metod: Measurements were done on 196 AP pelvic radiographs of 10 years old and 20 years old males and females obtained with “siemens lconos r 200 axion. ®. ”. The patients were placed in the supine position with their hips extended and internally rotated 15°. Medial hip joint space width (mJSW), CE angle, femoral head diameter (FD) and acetabular width (AW) were measured. The intraobserver reproducibility was assessed by a randomly chosen subset of 50 radiographs and these were read 1 month apart. The levels of agreement were qualified using the intraclass correlation coefficient. The ratios of mJSW to AW and FD to AW were calculated. Results: Mean CE angles in 10 years old females and males were 33.87±3.64 ve 32.74±4.21 degrees respectively. CE angle was correlated to mJSW/AW in 10 years old females (r = − 0.446, p=0.043). CE angle was not correlated to mJSW/AW in 10 years old males (r = − 0.293, p=0.146). CE angle was not correlated to mJSW/AW in 20 years old females while CE angle was correlated to mJSW/AW in 20 years old males (r = 0. 694, p=0.001). CE angle was correlated to FD/AW only in 20 years old males (r=0.553, p= 0.002). Discussion: Ratios of medial hip joint space width and femoral head diameter to acetabular width are not correlated to CE angle in both preadelocent and postade-locent terms depending on sex. The expected inverse correlation of these parameters to CE angle was not dedected, so these parameters can be used in radiologic assessement of