OBJECTIVEto investigate if the cartilaginous surface and corresponding osseous contour of the patellofemoral joint match in the axial plane for providing theoretical basis with evaluating alignment of patellofemoral joint and designing the part of patellofemoral joint in knee prosthesis.

METHODSfrom January 2009 to March 2010, 9 human cadaver knees were prepared, which chandra of patellofemoral joint didn't degenerate. Each specimen was sectioned in the axial plane at 20° to 30° knee flax. The cross-sections revealed characteristics in the bony anatomy and corresponding articular surface geometry of the patellofemoral joint in the axial plane. Evaluating parameters included osseous patella congruence angle (OPCA), chondral patella congruence angle (CPCA), patella chondral convex point parameter (PCCPP), patella subchondral osseous convex point parameter (PSOCPP), the parameters of the deepest (chondral or osseous) point of the intercondylar sulcus. After that, the osseous and cartilaginous contours and subchondral osseous contours of the patella in the axial plane were analyzed through MRI data of 11 patients who didn't degenerate in patellofemoral joint cartilage. Parameters as same as cadaver knees were compared.

RESULTSdata from specimens of OPCA was (-4.5 ± 1.1)°, CPCA was (0.5 ± 0.8)°, PCCPP was 1.13 ± 0.11, PSOCPP was 1.67 ± 0.14, PCDPIS was 1.35 ± 0.28, PODPIS was 1.38 ± 0.33. Date from MRI of OPCA was (-3.8 ± 1.4)°, CPCA was (0.7 ± 1.0)°, PCCPP was 1.05 ± 0.21, PSOCPP was 1.73 ± 0.18, PCDPIS was 1.41 ± 0.21, PODPIS was 1.37 ± 0.27. The patella exhibited significant differences in the bony vs. chondral anatomy (P < 0.05), but the intercondylar sulcus nearly match in the bony vs. chondral anatomy.

CONCLUSIONSthe cartilaginous surface and corresponding osseous contour of the patella don't match in the patellofemoral joint axial plane, but that of the trochlea nearly matches. This is very important for accurately evaluating alignment of patellofemoral joint because the normal osseous alignment of patellofemoral joint don't represent the normal alignment and helpful for designing the part of patellofemoral joint in knee prosthesis.

Biomechanical Phenomena ; Cartilage, Articular ; anatomy & histology ; Femur ; anatomy & histology ; Humans ; Patella ; anatomy & histology ; Patellofemoral Joint ; anatomy & histology

Hip fractures have high morbidity and mortality rate for the people as a complication of osteoporosis and is generally seen in old age. It is known that femoral geometric measurements are important in the assessment of hip fracture risks. This study aimed to examine the association between hip geometry and hip fracture in post-menopausal elderly females. In the present study, 232 hip X-rays were taken from women with no hip fractures (Group 1) and 29 post-menopausal women with hip fractures (Group 2) after a minor trauma. After standard anterior-posterior plain pelvic X-ray radiographs were obtained, various radiographic measurements were performed in all cases, including the hip axis length (HAL), femoral neck axis length (FAL), acetabular width (AW), femoral head width (HW), femoral neck width (FW), femoral shaft width (FSW), intertrochanteric width (TW), lateral and medial cortical thickness of the femoral shaft (LCT, SMCT), femoral neck cortical thickness (NMCT) and femoral neck-shaft angle (Q-angle). In group 1, the mean age, weight and height were 62.5 +/-7.4 years, 70.8 +/-12.5 kg, and 157.5 +/-6.7 cm, respectively. In group 2, these values were 70.17 +/-6.8 years, 64.7 +/-11.5 kg, and 158.3 +/-2.7 cm, respectively. There were no statistically significant differences in the measurements of HAL, FAL, AW and HW between the two groups. In group 2, the mean FW value was significantly higher than in group 1 (p= 0.01). The mean values for FSW, TW, NMCT, SMCT, LCT were statistically lower in group 2 than those in group 1 (p= 0.01, p=0.038, p=0.001, p< 0.001, p< 0.001, respectively). Q-angle was also significantly higher in cases with hip fracture than in cases with no hip fracture (p=0.01). The values of FW, FSW, TW, NMCT, SMCT, LCT and Q-angle seem to be important parameters in the evaluation of hip fracture risks. However, further studies are needed to clarify this conclusion.
Aged ; Body Mass Index ; Female ; Femur/*anatomy & histology ; Femur Neck/anatomy & histology ; Hip Fractures/*pathology ; Humans ; Middle Aged

OBJECTIVE: To measure the anatomic data of the proximal femur and to design an internal fixation instrument aiming at subtrochanteric fracture. METHODS: We measured the anatomic data of 56 pairs of the matching proximal femur specimens: the diameter of femoral head (HD), the axis length of femoral head (HAL), 135 degree femoral head-neck axis length (HNAL), 135 degree femoral head-neck axis upper length (HNAUL), 135 degree femoral head-neck axis underside length (HNADL), the anterior-posterior axis diameter of femoral neck (NAPD), the upper-underside diameter of femoral neck (NUUD), femoral neck-shaft angle (NFA), femoral shaft lateral cortex-greater trochanter angle (SLGA), the medial-lateral diameter of lesser trochanter level's femoral shaft (LSMLD), the anterior-posterior diameter of lesser trochanter level's femoral shaft (LSAPD), the medial-lateral diameter of 5 cm below lesser trochanter femoral shaft (5 cm MLD), and the anterior-posterior diameter of 5 cm below lesser trochanter femoral shaft (5 cm APD). Part of the data was analyzed and compared. RESULTS: HD was (46.69+/-3.73) mm, HAL was (39.22+/-4.17) mm, HNAL was (95.45+/-8.16) mm, HNAUL was (84.02+/-7.11) mm, HNADL was (99.95+/-9.34) mm, NAPD was (26.27+/-3.15) mm, NUUD was (32.24+/-3.31) mm, NFA was 126.21 degree+/-7.13 degree, SLGA was 16.38 degree+/-4.04 degree, LSMLD was (31.05+/-3.57) mm, LSAPD was (27.63+/-2.96) mm, 5 cm MLD was (26.36+/-3.22) mm, and 5 cm APD was (25.59+/-2.75) mm. NFA was positively correlated with SLGA (r=0.396, P=0.003). CONCLUSION It is necessary to design internal fixator to fit the anatomical feature of Chinese femur for the treatment of subtrochanteric fracture, and we should thoroughly consider the angle of the SLGA.
Anthropometry ; Cadaver ; Equipment Design ; Femur Head ; anatomy & histology ; Femur Neck ; anatomy & histology ; Fracture Fixation, Internal ; instrumentation ; Hip Fractures ; surgery ; Humans

OBJECTIVETo compare the difference in the manual measurement of Fengshi (GB 31) between the standing position and the supine position so as to determine the location.

METHODSA total of 197 volunteers were included in the manual measurement of Fengshi (GB 31) at the standing position and 92 volunteers at the supine position. The differences were compared between the two measurements.

RESULTSThe results in the manual measurement at the standing position showed that the distance was (39.27±3.83) cm from the greater trochanter of femur to the popliteal transverse crease [(39.96±4.21) cm in males, (38.82±3.49) cm in females, < 0.05]. The distance was (19.08±2.97) cm from the tip of the middle finger to the popliteal transverse crease [(18.96±3.50) cm in males, (19.16±2.58) cm in females]. After calculating according to the formula of proportional bone measurement, Fengshi (GB 31) was located (9.28±1.44) above the popliteal transverse crease [(9.07±1.64) in males, (9.42±1.29) in females]. The results in the manual measurement at the supine position showed that the distance was (41.89±3.88) cm from the greater trochanter of femur to the popliteal transverse crease [(42.36±3.88) cm in males, (41.67±3.89) cm in females]. The distance was (23.01±3.37) cm from the tip of the middle finger to the popliteal transverse crease [(22.50±3.73) cm in males, (23.25±3.20) cm in females]. After calculated according to the formula of proportional bone measurement, Fengshi (GB 31) was located (10.51±1.69) above the popliteal transverse crease [(10.16±1.75) in males, (10.67±1.63) in females].

CONCLUSIONFengshi (GB 31) is located on the femoral region, in the depression under the tip of the middle finger at the standing position. The simple localization of the acupoint at the supine position: at the supine, the palm touches the middle of the lateral side of the thigh, about 1 directly below the depression under the tip of the middle finger. The location of Fengshi (GB 31) in female is slightly upper than male.

Acupuncture Points ; Female ; Femur ; anatomy & histology ; Humans ; Male ; Meridians ; Posture ; Reference Standards ; Thigh ; anatomy & histology

OBJECTIVETo study the influences of head/neck ratio and femoral antetorsion on the safe-zone of operative acetabular orientations, which meets the criteria for desired range of motion (ROM) for activities of daily living in total hip arthroplasty (THA).

METHODSA three-dimensional generic, parametric and kinematic simulation module of THA was developed to analyze the cup safe-zone and the optimum combination of cup and neck antetorsion. A ROM of flexion > or =120 degree internal rotation > or = 45 degree at 90 degree flexion, extension > or = 30 degree and external rotation > or =40 degree was defined as the criteria for desired ROM for activities of daily living. The cup safe-zone was defined as the area that fulfills all the criteria of desired ROM before the neck impinged on the liner of the cup. For a fixed stem-neck (CCD)-angle of 130 degree theoretical safe-zones fulfilling the desired ROM were investigated at different general head-neck ratios (GR=2, 2.17, 2.37, 2.61 and 2.92) and femoral anteversions (FA equal to 0 degree,10 degree,20 degree and 30 degree).

RESULTSLarge GRs greatly increased the size of safe-zones and when the CCD-angle was 130 degree, a GR larger than 2.37 could further increase the size of safe-zones. There was a complex interplay between the orientation angles of the femoral and acetabular components. When the CCD-angle was 130 degree the optimum relationship between operative acetabular anteversion (OA) and femoral antetorsion (FA) could be estimated by the formula: OA equal to -0.80 multiply FA+47.06, and the minimum allowable operative acetabular inclination (OI(min)) would be more than 210.5 multiply GR(-2.255).

CONCLUSIONSLarge GRs greatly increase the size of safe-zones and it is recommended that the GR be more than 2.37 so as to extend the acceptable range of error that surgeons cannot avoid completely during operation. As to the optimum operative acetabular inclination (OI), surgeons need to make a decision combining with other factors, including stress distribution, soft tissue and cup wear conditions, as well as patients'individual situations and demands. The data obtained from this study and the module of THA can be used to assist surgeons to choose and implant appropriate implants.

Acetabulum ; anatomy & histology ; Arthroplasty, Replacement, Hip ; methods ; Computer Simulation ; Femur Head ; anatomy & histology ; physiology ; Femur Neck ; anatomy & histology ; physiology ; Humans ; Range of Motion, Articular

To determine the characteristics of magnetic resonance (MR) signals of normal growing cartilage and identify the difference in transverse relaxation times between physeal and epiphyseal cartilage in vivo. 24 distal femora of 12 two-week-old piglets were imaged on a 1.5 Tesla GE MR scanner. Comparison was made between signal intensity on MR images and the structure shown in corresponding histologic sections. T2 values were measured in eight piglets by means of multiecho spin-echo sequences. Our results showed that MR imaging delineated five regions between the secondary ossification center and the metaphysis, which histologically correspond to the zone of provisional calcification of the secondary ossification center, physis of the secondary ossification center, epiphyseal cartilage, physis and zone of provisional calcification. The T2 value in the physeal cartilage was much larger than that in the epiphyseal cartilage (P<0.05). It is concluded that MRI findings could differentiate the different regions of growing cartilage. T2 is longer in physeal than in epiphyseal cartilage, perhaps reflecting differences in water binding by proteoglycans.
Animals, Newborn ; Femur/anatomy & histology ; Femur/growth & development ; Femur/metabolism ; Growth Plate/*anatomy & histology ; Growth Plate/*growth & development ; Growth Plate/metabolism ; *Magnetic Resonance Imaging ; Osteogenesis/physiology ; Swine

OBJECTIVESTo investigate the relationships among rotational alignment reference axes of distal femur and tibial mechanical axis, and determine the safest rotational alignment reference axis.

METHODSDigital photos were taken of 30 cadaveric lower extremities with knee in extension and flexion at 90 degrees , angles were measured among tibial mechanical axis and a line perpendicular to clinical epicondylar axis, a line perpendicular to surgical epicondylar axis, Whiteside's line and femoral mechanical axis. Statistical analysis of relationships among those axes were performed.

RESULTSThe angles among the tibial mechanical axis and a line perpendicular to the clinical epicondylar axis, a line perpendicular to the surgical epicondylar axis, Whiteside's line and femoral mechanical axis were 0.6 degrees varus, 3.9 degrees varus, 0.2 degrees valgus and 3.0 degrees varus respectively. The angle between the femoral mechanical axis and the tibial mechanical axis was significantly larger than the angles among the tibial mechanical axis and a line perpendicular to the clinical epicondylar axis, the Whiteside's line (P < 0.05). There was no significant difference compared with the angle between a line perpendicular to the surgical epicondylar axis and the tibial mechanical axis. Angles of the clinical epicondylar axis, the surgical epicondylar axis and the Whiteside's line between knee extension and flexion were 2.3 degrees valgus, 0.9 degrees varus and 3.1 degrees valgus respectively.

CONCLUSIONThe surgical epicondylar axis rather than the clinical epicondylar axis or the Whiteside's line is the safest femoral rotational alignment reference axis intraoperatively.

Arthroplasty, Replacement, Knee ; Biomechanical Phenomena ; Femur ; anatomy & histology ; surgery ; Humans ; Knee Prosthesis ; Rotation ; Tibia ; anatomy & histology ; surgery

OBJECTIVETo measure anatomical data of the femoral tunnel anatomy reconstruction of anterior cruciate ligament (ACL), so provide anatomical basis for clinical anatomy reconstruction of ACL.

METHODSThere were 30 adults' cadaveric knee specimens. The ACL femoral tunnel was reconstructed through anterior medial approach (AMP) in genuflex position of 120 degree, and was marked by Kirschner. The soft tissue of the specimen was removed and the femoral condyle was split at the middle side. The index including length of the femoral tunnel, the distance from internal opening of tunnel to cortical edge of femoral condyle and vertical distance to the top of femoral intercondylar notch were measured. Then the time position of internal opening of tunnel in the intercondylar notch was recorded, and the location of outside opening of tunnel to the femoral condyle was detected.

RESULTSThe mean length of the femoral tunnel was (36.35 +/- 3.14) mm (ranged, 30.65 to 42.35 mm). The distance from internal opening of tunnel to cortical edge of femoral condyle was (17.84 +/- 3.35) mm (ranged, 14.02 to 23.49 mm), vertical distance to the top of femoral intercondylar notch was (14.05 +/- 2.32) mm (ranged, 9.17 to 20.08 mm). According to the way of circular dial,internal opening of tunnel located at 02:30 +/- 00:10 (ranged, 01:50 to 02:50) in the left knee,and 09:30 +/- 0:15 (ranged, 08:30 to 10:40) in the right knee. The outside opening of femoral tunnel located at (3.16 +/- 2.51) mm (ranged, 1.61 to 6.30 mm) to the proximal end of external epicondyle of femur, and (4.25 +/- 2.16) mm (ranged, 1.73 to 8.52 mm) to the posterior of external epicondyle of femur.

CONCLUSIONThe anatomical features of femoral tunnel for reconstruction of ACL is revealed,which will provide anatomical basis for clinical practice.

Adult ; Aged ; Anterior Cruciate Ligament ; anatomy & histology ; surgery ; Female ; Femur ; anatomy & histology ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures

This study was performed to identify the chronological changes of the knee angle or the tibiofemoral angles in normal healthy Korean children. Full-length anteroposterior view standing radiographs of 818 limbs of 452 Korean children were analyzed. The overall patterns of the chronological changes in the knee angle were similar to those described previously in western or Asian children, but the knee angle development was delayed, i.e., genu varum before 1 yr, neutral at 1.5 yr, increasing genu valgum with maximum a value of 7.8 degrees at 4 yr, followed by a gradual decrease to approximately 5-6 degrees of genu valgum of the adult level at 7 to 8 yr of age. These normative data on chronological changes of knee angles should be taken into consideration when evaluating lower limb alignment in children.
Adolescent ; Child ; Child Development ; Child, Preschool ; Female ; Femur/anatomy & histology ; Humans ; Infant ; Knee Joint/anatomy & histology/*growth & development ; Male ; Retrospective Studies ; Tibia/anatomy & histology

I examined the sphericity and the congruity of the femoral head and the acetabulum in 172 Korean fetuses and in 655 Korean adults. I found that Korean fetal acetabuli and femoral heads are spherical and that the proportion of the head contained in the acetabulum remains constant and congruous throughout the fetal life. Adult actabuli and femoral heads are also spherical in both gender and are there are no visible changes in the shape of the acetabuli and the femoral heads with respect to age. No evidence was found that the congruity of the hip joint is a cause of osteoarthritis of the hip joint. Clinical Relevance: Stable hip joints at the time of birth provide an explantation for the low incidence of congenital dislocation of the hip joint in Koreans. The spherical femoral head and acetabulum (congruous hip joint) seem to be a contributing factor to the low incidence of primary osteoarthritis of the hip in Koreans.
Acetabulum/*anatomy and histology/embryology ; Adult ; Female ; Femur Head/*anatomy and histology/embryology ; Fetus/anatomy and histology ; *Hip Joint/pathology ; Human ; Incidence ; Korea/epidemiology ; Male ; Osteoarthritis, Hip/epidemiology/*etiology/pathology