The coracoclavicular ligaments: an anatomic study

Purpose  

The treatment for the acromioclavicular joint dislocations has focused on anatomic restoration of the coracoclavicular ligaments. We reviewed the detailed anatomy of trapezoid ligaments and conoid ligaments using cadavers.     

Measure of horizontal and vertical displacement of the acromioclavicular joint after cutting ligament using X-ray and opto-electronic system

Introduction

Surgical versus orthopedic treatments of acromioclavicular disjunction are still debated. The aim of this study was to measure horizontal and vertical acromion’s displacement after cutting the ligament using standard X-ray and an opto-electronic system on cadaver.

Materials and methods

Ten cadaveric shoulders were studied. A sequential ligament’s section was operated by arthroscopy. The sequence of cutting was chosen to fit with Rockwood’s grade. The displacement of the acromion was measured on standard X-ray and with an opto-electronic system allowing measuring of the horizontal displacement. Statistical comparisons were performed using a paired Student’s t test with significance set at p?Results Cutting the coracoclavicular ligament and delto-trapezius muscles cause a statistical downer displacement of the acromion, but not after sectioning the acromioclavicular ligament. The contact surface between the acromion and the clavicle decreases statistically after sectioning the acromioclavicular ligament and the coracoclavicular ligament with no effect of sectioning the delto-trapezius muscles. Those results are superposing with those dealing with the anterior translation.

Discussion

The measure concerning the acromioclavicular distance and the coracoclavicular distance are superposing with those of Rockwood. However, there is a significant horizontal translation after cutting the acromioclavicular ligament. Taking into account this displacement, it may be interesting to choose either surgical or orthopedic treatment.

Conclusion

There is a correlation between anatomical damage and importance of instability. Horizontal instability is misevaluated in clinical practice.

Level of evidence

Basic science study.     

Normative Reference Values of Joint Space Width Estimated by Computer-aided Joint Space Analysis (CAJSA): The Distal Interphalangeal Joint

Purpose

The study introduces reference data for a computer-aided analysis. The semiautomated computer-aided diagnostic system provides the estimation of joint space width at the distal interphalangeal joints, considering gender-specific and age-related changes.

Patients and methods

869 subjects (351 female/518 male) with hand x-rays were included and underwent measurements of joint space distances at the distal interphalangeal articulation (JSD-DIP) of the second to the fifth finger using computer-aided joint space analysis (CAJSA).

Results

Data showed a notable age-related decrease of CAJSA parameters, and an accentuated age-related joint space narrowing in women. Males showed a significantly wider JSD-DIP (+ 16.7%) compared to the female cohort for all age groups. Both men and women revealed an accentuated decrease of JSD-DIP (total) in the age group from 10 to 15 years (for men ?10.5% and for women ?17.6%). After the age of 21 years a continuous decline of the JSD-DIP (total) is observed.

Conclusion

Our data present gender-specific and age-related normative reference data for computer-aided joint space analysis, which provide a valid and reliable differentiation between disease-related joint space narrowing and age-related joint space narrowing, particularly in patients with osteoarthritis of the fingers.

     

The mast cell stabilizer ketotifen reduces joint capsule fibrosis in a rabbit model of post-traumatic joint contractures

Objectives  

Using a rabbit model of post-traumatic joint contractures, we investigated whether treatment with a mast cell stabilizer after joint injury would lessen the molecular manifestations of joint capsule fibrosis.     

Passive contribution of the rotator cuff to abduction and joint stability

Purpose  

The purpose of this study is to compare shoulder joint biomechanics during abduction with and without intact non-functioning rotator cuff tissue.     

Relationship between knee and ankle degeneration in a population of organ donors

Background  

Osteoarthritis (OA) is a progressive degenerative condition of synovial joints in response to both internal and external factors. The relationship of OA in one joint of an extremity to another joint within the same extremity, or between extremities, has been a topic of interest in reference to the etiology and/or progression of the disease.     

Effects of clinical pathways in the joint replacement: a meta-analysis

Background  

A meta-analysis was performed to evaluate the use of clinical pathways for hip and knee joint replacements when compared with standard medical care. The impact of clinical pathways was evaluated assessing the major outcomes of in-hospital hip and knee joint replacement processes: postoperative complications, number of patients discharged at home, length of in-hospital stay and direct costs.     

Ovine synovial membrane-derived mesenchymal progenitor cells retain the phenotype of the original tissue that was exposed to in-vivo inflammation: evidence for a suppressed chondrogenic differentiation potential of the cells

Background  

The purpose of this study was to characterize the effect of post-surgery joint inflammation on the chondrogenic differentiation capacity of mesenchymal progenitor cells (MPCs) derived from the synovial membrane (SM).     

Safe working zones using the minimally invasive lateral retroperitoneal transpsoas approach: a morphometric study

Purpose  

The minimally invasive lateral retroperitoneal transpsoas approach is a recent technique developed for lumbar interbody fusion and discectomy. The proximity of the retroperitoneal vessels and ventral nerve roots to the surgical pathway increases the risk of injury to these anatomical structures. A precise knowledge of the regional anatomy of the lumbar plexus is required for safe passage through the psoas muscle. Preoperative examination of the axial MRI images will allow the surgeon to observe the neural structures at the operative levels and confirm that abdominal vessels do not obstruct the lateral disc space. The objective of this study was to determine the anatomic position of the ventral nerve roots and the retroperitoneal vessels in relation to the vertebral body in the degenerative spine and to delineate a safe working zone using magnetic resonance imaging (MRI).     

Suppression of ongoing experimental autoimmune myasthenia gravis by transfer of RelB-silenced bone marrow dentritic cells is associated with a change from a T helper Th17/Th1 to a Th2 and FoxP3+ regulatory T-cell profile

Objective  

To observe the therapeutic effect of RelB-silenced dendritic cells (DCs) in experimental autoimmune myasthenia gravis (EAMG), and further to investigate the mechanism of this immune system therapeutic.     

The anconeus, an active lateral ligament of the elbow: new anatomical arguments

Purpose  

As there are a few detailed anatomical studies of the active function of anconeus muscle in stabilizing the elbow, we aimed to look for anatomical features confirming its role as an active stabilizer of the humero-ulnar joint.     

Femoral malrotation from diaphyseal fractures results in changes in patellofemoral alignment and higher patellofemoral stress from a finite element model study

Background

Malrotation of the femur is a frequent complication in the management of a diaphyseal fracture. It is often responsible for pain and adverse functional results. Among these complications, contact stress effects on the patellofemoral joint are recognized as predictive factors of impaired results. The purpose of this study was to analyze the effect of malrotation on stress distribution on the patellofemoral joint, using radiological measurement and three-dimensional finite element models.

Psycho-education programme for temporomandibular disorders: a pilot study

Background  

Temporomandibular disorders (TMDs) are by far the most predominant condition affecting the temporomandibular joint (TMJ), however many patients have mild self-limiting symptoms and should not be referred for specialist care.     

微创喙锁韧带重建与锁骨钩钢板置入内固定治疗TossyⅢ型肩锁关节脱位：功能恢复的对照比较

背景：以往采用交叉克氏针固定、克氏针张力带固定、喙锁螺钉、桥接技术等治疗TossyⅢ型肩锁关节脱位的效果都不是很满意。 目的：分析微创喙锁韧带重建与锁骨钩钢板置入内固定治疗TossyⅢ型肩锁关节脱位的疗效差异。 方法：将63例TossyⅢ型肩锁关节脱位患者随机分为两组,分别采用微创喙锁韧带重建与锁骨钩钢板置入内固定治疗。 结果与结论：微创喙锁韧带重建组治疗后第1个月Karlesson疗效评价肩锁关节功能优质率为92%,第3个月为88%;锁骨钩钢板置入内固定组治疗后1个月Karlesson疗效评价肩锁关节功能优质率为79%,第3个月为76%。微创喙锁韧带重建组治疗后第1,3个月肩锁关节功能恢复优质率高于锁骨钩钢板置入内固定组(P < 0.05)。说明运用微创喙锁韧带重建治疗TossyⅢ型肩锁关节脱位较锁骨钩钢板置入内固定操作方便,创伤较小,疗效更加安全可靠。     

Pro-inflammatory action of Candida albicans DNA in zymosan-induced arthritis

Objective  

This study was designed to examine the potential ability of Candida albicans DNA to influence joint inflammation in a mouse model of zymosan-induced arthritis (ZIA) relating to Toll-like receptor-9 (TLR9) expression and cytokine production in different compartments.     

Ultrasound anatomy of the cervical paravertebral space: a preliminary study

Purpose  

The aim of the study was to examine the ultrasound anatomy of the cervical paravertebral space in order to facilitate the implementation of sonographically guided regional anesthesia techniques for this region.     

Morphometry of sacral hiatus and its clinical relevance in caudal epidural block

Background  

Sacral approach to epidural space produces reliable and effective block of sacral nerves. It is necessary to have a detailed knowledge of sacral hiatus (SH) for optimal access into sacral epidural space. This study was undertaken to evaluate various landmarks of SH.     

Preserving the superficial branch of the radial nerve during carpometacarpal and metacarpophalangeal joint arthroscopy: an anatomical study

Background  

The superficial branch of the radial nerve (SBRN) is potentially at risk during thumb carpometacarpal (TCM) or thumb metacarpophalangeal (TMP) joint arthroscopy. The aim of this anatomical study was to describe the different branching patterns of the SBRN and to optimize positioning of portals during TCM and TMP arthroscopy.     

Can l(+)-lactate be used as a marker of experimentally induced inflammation in rats?

Objective  

The purpose of this study was to investigate if l(+)-lactate (lactate) can be used as a marker of progression of joint inflammation in comparison with a reference marker, prostaglandin E2 (PGE₂), and to analyse implications for drug treatments.