Knee最新文献

Background: This study was designed to determine the relationship between age and osteotomy gap filling rate, aiming to discern the specific time period during which age exerts its impact on this process. The osteotomy gap filling rate after medial opening wedge high tibial osteotomy (MOWHTO) was assessed by evaluating the absolute value of gap filling utilizing computed tomography (CT) scan obtained at multiple time points postoperatively.

Methods: The data of 30 patients who underwent MOWHTO between September 2019 and July 2021 were retrospectively analyzed. Computed tomography findings were used to measure osteotomy gap filling rate at 6, 12, and 24 months postoperatively. Patients were divided into two age groups (those aged ≤ 55 and > 55 years) for comparison.

Results: Patients aged ≤ 55 years showed significantly greater osteotomy gap filling rate at the 6-month follow-up examination compared to that of older patients (p = 0.034). Pearson's correlation analysis revealed a negative correlation between age and osteotomy gap filling rate at 6 and 12 months postoperatively (r = -0.426, p = 0.019; r = -0.368, p = 0.046, respectively). Multiple linear regression analysis identified age as the sole predictor of osteotomy gap filling rate at 6 months postoperatively (β = -0.407, p = 0.039).

Conclusion: Age significantly influenced the osteotomy gap filling rate after MOWHTO. Patients aged ≤ 55 years demonstrated greater improvement in gap filling during the initial 6-month period compared to their older counterparts. These findings underscore the importance of age considerations when deciding on the indication for MOWHTO in cases of medial knee osteoarthritis in clinical practice.

Study design: Case series, Level of Evidence IV.

Background: Studies suggest that the development of a suitable patellar groove is highly dependent on a regular patellar position imprinting the patellofemoral joint. Furthermore, previous studies have shown that breech position also has an influence on the patellofemoral joint shape. The aim of this study is to exploratively analyze influences on patellar sagittal height in newborns.

Methods: In this ultrasound-based study, parameters influencing patellar height will be exploratively examined (i.e. patellofemoral joint parameters, hip dysplasia, sex, body and age characteristics of the parents and the newborn, intrauterine position). 98 newborns born between June 2023 and November 2023 at the University Hospital receiving an ultrasound hip screening examination received additional standardized ultrasounds of their knees.

Results: For all 3 measured patellar height indices patellar height was lower for newborns after breech positions. For one of the measured indices this result was significant (p = 0.018). Patellofemoral trochlear configuration also showed significant relationships to patellar height. A high sulcus angle and a lower internal rotation of the trochlea are significantly related to lower patellar heights (multiple linear regression model, model fit: p = 0.002, Coefficients: Sulcus angle p = 0.007, Trochlea angle p = 0.028).

Conclusions: Breech position, high sulcus angle and lower internal rotation of the trochlea are significantly related to lower patellar heights. This is the first study to describe these relationships in newborns and increases clinical awareness. As the exact nature of the relationships remains unclear further research should be conducted.

Background: During anatomical medial collateral ligament (MCL) reconstruction, the apex of the medial femoral epicondyle (ME-apex) is a significant bony landmark. The purpose of the present study was to evaluate the anatomical relationship between the superficial MCL (sMCL) and the ME-apex using gross anatomical, and histological observations.

Methods: Eight unpaired cadaveric knees were studied. The sMCL was traced from its tibial attachment, and its course at the ME-apex level was documented. The dynamic morphology of the sMCL in relation to the ME-apex was then observed throughout the range of motion, from full knee extension to 90° of knee flexion. Second, the femur, including the sMCL, was cut in the axial plane at the level of the ME-apex. Using this axial section, the anatomical relationships between the sMCL, ME-apex, and depression posterior to the ME-apex, and the morphology of the sMCL femoral attachment were examined histologically.

Results: Gross anatomical observation showed that the sMCL covered the ME-apex in full knee extension. As the knee flexed, the sMCL shifted posteriorly and the ME-apex became visible. At 90° knee flexion, two separate bundles of sMCL fibers with different directions were observed. There was no direct insertion of the sMCL femoral attachment anterior to the ME-apex, only from the ME-apex to the depression posterior.

Conclusion: The sMCL has the direct insertion from the ME-apex of the femur to the depression posterior to it, and shows two separate proximal fiber bundles during knee flexion. These findings offer valuable insights for improving anatomical MCL reconstruction techniques.