2.Correlation analysis on the disorders of patella-femoral joint and torsional deformity of tibia.
Zhen-Jie SUN ; Yi YUAN ; Rui-Bo LIU
China Journal of Orthopaedics and Traumatology 2015;28(3):222-225
OBJECTIVETo reveal the possible mechanism involved in patella-femoral degenerative arthritis (PFDA) in- duced by torsion-deformity of tibia via analyzing the relationship between torsion-deformity of the tibia in patients with PFDA and the disorder of patella-femoral joint under the static and dynamic conditions.
METHODSFrom October 2009 to October 2010, 50 patients (86 knees, 24 knees of male patients and 62 knees of female patients) with PFDA were classified as disease group and 16 people (23 knees, 7 knees of males and 16 knees of females) in the control group. The follow indexes were measured: the torsion-angle of tibia on CT scanning imagings, the patella-femoral congruence angle and lateral patella-femoral angle under static and dynamic conditions when the knee bent at 30 degrees of flexion. Based on the measurement results, the relationship between the torsion-deformity of tibias and the disorders of patella-femoral joints in patients with PFDA were analyzed. Finally,the patients were divided into three groups including large torsion-angle group, small torsion-angle group and normal group according to the size of torsion-angle, in order to analyze the relationship between torsion-deformity and disorders of patella-femoral joint, especially under the dynamic conditions.
RESULTSCompared with patients without PFDA, the ones with PFDA had bigger torsion-angle (30.30 ± 7.11)° of tibia, larger patella-femoral congruence angle (13.20 ± 3.94)° and smaller lateral patella-femoral angle (12.30 ± 3.04)°. The congruence angle and lateral patella-femoral angle under static and dynamic conditions had statistical differences respectively in both too-big torsion-angle group and too-small torsion-angle group. The congruence angle and lateral patella-femoral angle under static and dynamic conditions had no statistical differences in normal torsion-angle group.
CONCLUSIONTorsion-deformity of tibia is the main reason for disorder of patella-femoral joint in the patients with PFDA. Torsion-deformity of tibia is always accompanied by instability of patella-femoral joint,especially under the dynamic condition, thus causing PFDA. It can not only provide arrangement information and degenerative condition of patella-femoral joint,but also provide guidance through the analysis on the relationship for better clinical prevention and early treatment of degenerative bone and joint disease.
Adult ; Female ; Femur ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Osteoarthritis, Knee ; diagnostic imaging ; etiology ; Patella ; diagnostic imaging ; Radiography ; Tibia ; diagnostic imaging ; Torsion Abnormality ; complications ; diagnostic imaging
3.The differences between left & right side development of osteophiphysis in estimating male juvenile age.
Jing ZHENG ; Hui-ling LU ; Le CHEN
Journal of Forensic Medicine 2003;19(3):138-142
OBJECTIVE:
The influence on age estimation by comparing the differences between left and right side development of osteophiphysis.
METHODS:
27 osteophiphysis development indexes in the X-ray films of 6 major joints and pelvises in 130 male juveniles were observed. The positions and levels of difference between left and right side development of osteophiphysis were compared. The male juvenile age by regression equation according to left side and right side were estimated respectively.
RESULTS:
In 76 cases, the age estimation results are the same for both sides. In 47 cases, the difference between left and right side is less than 6 months. In 7 cases, the difference is between 6 and 12 months. The error of 94.6% age estimation is within 6 months. The differences between left and right osteophiphysis development are often found in proximal humerus, distal radius, distal ulna and crista iliaca.
CONCLUSION
The subtle difference between left and right osteophiphysis development has no influence on age estimation.
Adolescent
;
Age Determination by Skeleton/methods*
;
Forensic Medicine
;
Humans
;
Humerus/diagnostic imaging*
;
Male
;
Osteogenesis
;
Radius/diagnostic imaging*
;
Tibia/diagnostic imaging*
4.Correlation analysis between imaging classification of varus knee osteoarthritis and axis angle of tibiofemoral and patellofemoral joints.
Xiao YU ; Yong MA ; Yang GUO ; Ling WANG ; Zhen GONG ; Li-Jia HUANG
China Journal of Orthopaedics and Traumatology 2023;36(4):364-370
OBJECTIVE:
To explore correlation between imaging classification of knee osteoarthritis (KOA) and axis angle of tibiofemoral and patellofemoral joints.
METHODS:
A retrospective analysis of 739 middle-aged and elderly patients with KOA (1 026 knee joints) who underwent vertical X-ray examination of both lower limbs and lateral knee joints from September 2018 to December 2020. Among them, 63 patients with K-L 0 grade (95 knee joints), 100 patients with K-L 1 grade (130 knee joints), 161 patients with K-L 2 grade (226 knee joints), 187 patients with K-L 3 grade (256 knee joints), and 228 patients of K-L 4 grade (319 knee joints). According to relative position of knee joint center and line between hip joint center and ankle joint center, the affected knee was divided into varus group(844 knees joints) and valgus group (182 knees joints). According to Install-Salvati method, the affected knee was divided into three groups, such as high patella (patella height>1.2 mm, 347 knees joints), median patella (patella height ranged from 0.8 to 1.2 mm, 561 knees joints), and low patella (patella height<0.8 mm, 118 knees joints). Lower femur angle, upper tibia angle, femoral neck shaft angle, femoral tibial angle, joint gap angle, hip-knee-ankle angle, patella-femoral angle and patella height among different groups were observed and compared.
RESULTS:
(1) In varus KOA group, there were statistical differnces in hip-knee-ankle angle, tibiofemoral angle, lower femoral angle, upper tibial angle, joint space angle, and femoral neck shaft angle of patients with different K-L grades (P<0.05). Hip-knee-ankle angle, tibiofemoral angle, lower femoral angle, upper tibial angle, joint space angle and K-L grade were significantly positively correlated at 0.01(P<0.05);femoral neck shaft angle and K-L grade showed negative correlation at 0.01(P<0.05). (2) In valgus KOA group, hip-knee-ankle angle, there were statistical differences in tibiofemoral angle, inferior femoral angle, superior tibial angle, joint space angle, and femoral neck shaft angle of patients with different K-L grades(P<0.05). Hip-knee-ankle angle, tibiofemoral angle, lower femoral angle, upper tibial angle, and femoral neck shaft angle showed negative correlation with K-L grades at level of 0.01 (P<0.05);joint gap angle and K-L grades showed significantly positive correlation at level of 0.01(P<0.05). (3) In high patella group, there were statistically differences in patellar height and patellar femoral angle of different K-L grades(P<0.05);there were no statistical difference in patella height and patellar femoral angle of different K-L grades in median patella group. There was no significant difference in patella heightin low patella group with different K-L grades(P>0.05), and there was statistical difference in patellofemoral angle(P<0.05). Patellar height and patella-femoral angle of high patella group were significantly positively correlated with K-L grades at the level of 0.01 (P<0.05);patella height and patella-femoral angle were not correlated with K-L grades in median patella group(P>0.05). There was no correlation between height of patella and K-L grade in low patella group (P>0.05). There was significant negative correlation between patella-femoral angle and K-L grade at level of 0.05 (P<0.05).
CONCLUSION
Inferior femoral angle, tibiofemoral angle, joint gap angle, hip-knee-ankle angle, femoral neck shaft angle and high patella are related to K-L classification of varus KOA, which could be used for early diagnosis and provide objective data for efficacy analysis of conservative treatment.
Aged
;
Middle Aged
;
Humans
;
Patellofemoral Joint/diagnostic imaging*
;
Osteoarthritis, Knee/diagnostic imaging*
;
Retrospective Studies
;
Knee Joint
;
Femur/diagnostic imaging*
;
Tibia
5."Do Not Touch": An Uncommon Benign Fatty Bone Tumour.
Sumer N SHIKHARE ; Wilfred Cg PEH
Annals of the Academy of Medicine, Singapore 2016;45(9):427-429
Adult
;
Bone Neoplasms
;
diagnosis
;
diagnostic imaging
;
pathology
;
Diagnosis, Differential
;
Diaphyses
;
diagnostic imaging
;
pathology
;
Humans
;
Knee Joint
;
diagnostic imaging
;
pathology
;
Lipoma
;
diagnosis
;
diagnostic imaging
;
pathology
;
Magnetic Resonance Imaging
;
Male
;
Radiography
;
Tibia
;
diagnostic imaging
;
pathology
6.Giant Synovial Chondromatosis of the Knee Mimicking a Parosteal Osteosarcoma: A Case Report.
Chang Ho KANG ; Jong Hoon PARK ; Dae Hee LEE ; Chul Hwan KIM ; Jeong Mi PARK ; Won Seok LEE
The Journal of the Korean Bone and Joint Tumor Society 2010;16(2):95-98
Synovial chondromatosis is a benign nodular cartilaginous proliferation arising in the synovium of joints. The radiolographic features of this condition are variable. Rarely, it would be confused with malignancy such as chondrosarcoma, osteosarcoma or synovial sarcoma. We report a case of primary synovial chondromatosis of the posterior aspect of the proximal tibia mimicking a parosteal osteoarcoma on the radiography, which showed a homogeneously radiopaque juxtacortical mass. However, subsequent computed tomography (CT) showed multiple intra-articular masses containing chondroid mineralization, suggesting synovial chondromatosis.
Chondromatosis, Synovial
;
Chondrosarcoma
;
Diagnostic Imaging
;
Joints
;
Knee
;
Osteosarcoma
;
Sarcoma, Synovial
;
Synovial Membrane
;
Tibia
7.Bilateral Brodie's abscess at the proximal tibia.
Halil BULDU ; Fikri Erkal BILEN ; Levent ERALP ; Mehmet KOCAOGLU
Singapore medical journal 2012;53(8):e159-60
Brodie's abscess is a form of subacute osteomyelitis, which typically involves the metaphyses of the long tubular bones, particularly in the tibia. The diagnosis is usually made incidentally, as there are no accompanying symptoms or laboratory studies. Bilateral involvement at the proximal tibia is unusual. However, orthopaedic surgeons should be aware of this entity, as it may present without symptoms. Checking the contralateral limb for concomitant Brodie's abscess is recommended.
Abscess
;
diagnosis
;
Adult
;
Female
;
Humans
;
Osteomyelitis
;
complications
;
diagnosis
;
Radiography
;
Tibia
;
diagnostic imaging
;
pathology
8.The histomorphological changes of tubular bone following widening distraction osteogenesis.
Zheng-xue HAN ; Chen-ping ZHANG
Chinese Journal of Plastic Surgery 2006;22(5):374-378
OBJECTIVEThe purpose of this experimental study was to investigate the histomorphological changes of tubular bone following widening distraction osteogenesis.
METHODSTwelve Chinese mountain goats were subjected to the study. After the procedure of vertical and horizontal osteotomy, two widening distraction osteogenesis devices were put in each goat's left tibiae. After an 8-day latency period, nine tibiae were widening distracted; another three tibiae served as sham control group. Every three animals from the experimental group were sacrificed in different consolidated periods including 1-month, 2-month, and 3-month. Radiography, tetracycline double labeling, histomorphology, as well as biomechanics were used to evaluate the quality and quantity of new generated bone in different consolidated period after distraction osteogenesis.
RESULTSAfter a distraction period, the average width of the tibiae is increased 7.83mm. From the end of distraction to 3-month after the consolidation period, radiography demonstrated that the distraction gaps gradually became vague. Tetracycline double labeling showed that the double labeling brands were rarely seen in normal cortex bone, but strongly increased in the distracted callus. Mineralization rates (MR) has a significant difference (P < 0.05) within distracted callus region compared with control cortex bone. Histomorphological study shows that there was a different result in two sides of vertical distracted gaps. The non-exposure side had a good bone formation, while a non-union of bone occurred at the exposure side. Three months after consolidation period, part of the gap in exposure side was filled with dense connection tissue, whereas the distracted callus had been remodeled and become lamellar bone in non-exposure side. The control group showed normal fracture healing procedure.
CONCLUSIONSThere was a different outcome in two sides distraction gaps of tubular bone following widening distraction osteogenesis. A viable and well-perfused soft-tissue envelope in the area of distraction osteogenesis is important for creation of sufficient amount of new bone during distraction osteogenesis.
Animals ; Biomechanical Phenomena ; Bone Regeneration ; Goats ; Osteogenesis ; Osteogenesis, Distraction ; methods ; Radiography ; Tibia ; diagnostic imaging ; physiology
9.Correlational on tibial intercondylar hyperplasia with the area of abnormal signalanterior cruciate ligament in patients with knee osteoarthritis.
China Journal of Orthopaedics and Traumatology 2013;26(12):1002-1004
OBJECTIVESTo investigate whether tibial intercondylar hyperplasia can cause anterior cruciate ligament (ACL) injuries.
METHODSFrom February 2009 to October 2012, 58 cases (including 70 knees) with knee osteoarthritis (KOA) without trauma history were selected from the out-patient department of orthopaedics in Guang'anmen Hospital attached to China Academy of Chinese Medical Science. All cases were tested by MRI scanning, then vertical height of the medial and lateral intercondylar spine in coronal position and the area of abnormal signal of ACL in sagittal position were tested from patients. Correlation between the height of intercondylar spine and the area of abnormal signal of ACL were analyzed.
RESULTSFives cases of 58 cases( 70 knees) were excluded from episome in knee joint, and other 65 knees were in accordance with the inclusion criteria. Among them, there were 10 males and 48 females aged from 39 to 79 years old with an average of 61 years old. The vertical height of the medial intercondylar spine was (10.02 +/- 1.46) mm and lateral was (8.92 +/- 1.69) mm. The area of abnormal signal ACL was (318.42 +/- 130.10) mm2. There was positive correlation between the height of medial intercondylar spine and the area of abnormal signal of ACL (r=0.06, P=0.00). But there was no correlation between lateral intercondylar spine and the area of abnormal signal of ACL (P=0.10).
CONCLUSIONThe height of medial intercondylar spine and the area of abnormal signal of ACL is positively correlated. The clinical significance is in study, while the clinical meaning still need further study.
Adult ; Aged ; Anterior Cruciate Ligament ; abnormalities ; diagnostic imaging ; surgery ; Female ; Humans ; Hyperplasia ; diagnostic imaging ; surgery ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Osteoarthritis, Knee ; diagnostic imaging ; surgery ; Radiography ; Tibia ; diagnostic imaging ; pathology ; surgery
10.Radiological characteristics of leg length discrepancy and knee varus/valgus deformity among unilateral developmental hip dislocation patients.
Dian-Zhong LUO ; Hui CHENG ; Hong ZHANG
Chinese Journal of Surgery 2013;51(6):513-517
OBJECTIVETo observe the leg length discrepancy and accompanied knee varus/valgus deformity in matured patients with unilateral dislocation of the hip.
METHODSFrom March 2011 to December 2012, 28 patients who had unilateral dislocation of hip (Hartofilakidis classification II 17 cases and III 11 cases) were involved in this study.There were 6 male patients and 22 female patients, the age of the patients were 13.4-66.2 years, with mean age of 29.8 years. The standing anteroposterior full leg length X-ray films were obtained. Leg length discrepancy, the length of the femur, the length of the tibia and identified the varus/valgus knee deformities were measured. Statistical analysis was performed. A student's t test for paired samples was done for comparison of the parameters in the same patient between dislocated and undislocated leg, and the χ(2) test were used to assess valgus and varus knees, leg length discrepancy in high dislocation and low dislocation groups.
RESULTSSeventeen (60.7%) cases had longer femur length on the dislocated side than that on the undislocated side (t = 1.328, P = 0.197), with the maximum lengthening of 32.7 mm and a mean lengthening of 9.5 mm. Twenty-one (75.0%) cases had longer tibia length on the dislocated side (t = 3.039, P = 0.006), with a maximum lengthening of 10.9 mm and a mean lengthening of 4.5 mm. Twenty (71.4%) cases had longer relative leg length on the dislocated side (t = 2.451, P = 0.022), with a maximum lengthening of 25.0 mm and a mean lengthening of 9.4 mm. On the dislocated side of the leg, the degree of valgus angle was 3° ± 4°,while on the undislocated side, that was -3° ± 4°(t = 5.642, P = 0.000). On the dislocated side, 12 cases (42.9%) were of valgus deformities and 1 case was of varus deformity. On the contralateral side, 15 cases of varus deformities (53.6%) and 1 case of valgus deformity were observed(χ(2) = 18.139,P = 0.000).
CONCLUSIONSMost dislocated legs are longer in length than the contralateral side, both femur and tibia have also lengthened accordingly. Many knees on the dislocated side present valgus deformity, half of the knees on the contralateral side present varus deformity.
Adolescent ; Adult ; Aged ; Female ; Femur ; abnormalities ; diagnostic imaging ; Hip Dislocation, Congenital ; complications ; radiotherapy ; Humans ; Knee Joint ; abnormalities ; diagnostic imaging ; Leg Length Inequality ; diagnostic imaging ; etiology ; Male ; Middle Aged ; Radiography ; Tibia ; abnormalities ; diagnostic imaging ; Young Adult