An In Vitro Osteotomy Method to Expose the Medial Compartment of the Human Knee

1997 ◽  
Vol 119 (4) ◽  
pp. 379-385 ◽  
Author(s):  
T. A. Martens ◽  
M. L. Hull ◽  
S. M. Howell
Keyword(s):  
Contact Pressure ◽  
Pressure Measurement ◽  
Femoral Condyle ◽  
Compressive Load ◽  
Medial Femoral Condyle ◽  
Medial Compartment ◽  
New Method ◽  
Load Bearing ◽  
Coronary Ligament

This study was conducted to validate a new in vitro method to expose the medial compartment of the knee to be used in subsequent studies aimed at examining the load bearing capabilities of medial meniscal allografts. The new method involves an osteotomy and reattachment of the medial femoral condyle. The primary hypothesis was that the new method does not alter tibio-femoral contact pressure and area. To validate this method, the baseline contact pressure of the intact medial compartment was measured using a new nondestructive procedure for inserting pressure measurement film into the intact medial hemijoint. A secondary and related hypothesis was that incising the coronary ligament, a destructive method used by previous investigators to position pressure measurement film, alters the normal tibio-femoral contact pressure. To test these hypotheses, Fuji Prescale pressure-sensitive film was used to measure both tibio-femoral contact pressure and area within the medial compartment of the (1) intact knee, (2) the knee after osteotomizing and reattaching the medial femoral condyle, and (3) the osteotomized knee with an incised coronary ligament, using seven cadaver specimens. Measurements were taken at a compressive load of approximately two times body weight with the knee in 0, 15, 30, 45 deg of flexion. No significant differences between the intact and osteotomized knee were detected. Likewise, no significant differences were observed between the osteotomized knee and the osteotomized knee with an incised coronary ligament. These results confirm the utility of the new method in exposing the medial compartment for manipulation and placement of medial meniscal allografts in future studies examining the load-bearing characteristics of meniscal allografts.

The Effect of Arthroscopic Partial Medial Meniscectomy on Tibiofemoral Stability

2012 ◽  
Vol 41 (1) ◽  
pp. 73-79 ◽  
Author(s):  
Sally Arno ◽  
Scott Hadley ◽  
Kirk A. Campbell ◽  
Christopher P. Bell ◽  
Michael Hall ◽  
...  
Keyword(s):  
Femoral Condyle ◽  
Compressive Load ◽  
Quadriceps Tendon ◽  
Medial Femoral Condyle ◽  
Partial Meniscectomy ◽  
Posterior Horn ◽  
Full Extension ◽  
Medial Meniscectomy ◽  
Significant Difference ◽  
Intact Knee

Background: There is still little known regarding the effects of meniscus resection size on tibiofemoral stability. Purpose: To determine if partial medial meniscectomy of the posterior horn significantly alters tibiofemoral stability as measured by the anterior-posterior (AP) position and laxity of the medial femoral condyle. Study Design: Controlled laboratory study. Methods: Five cadaveric knees were dissected to the capsule, preserving all ligaments and the quadriceps tendon. Each specimen was first tested on a rig where the AP position and laxity of the medial femoral condyle were measured while a range of forces was applied from full extension to 90° of flexion. Magnetic resonance imaging (MRI) at 3 tesla was then performed for baseline measurements of the meniscus before partial meniscectomy. Arthroscopic partial medial meniscectomy aimed at 30% of the posterior horn was then performed, followed by repeat mechanical testing and MRI. The sequence was then repeated for arthroscopic partial meniscectomy aimed at 60% and 100% of the posterior horn of the medial meniscus. Results: The MRI analysis demonstrated that 22% ± 9% of the original width of the posterior horn was removed at the first resection, 46% ± 11% was removed at the second resection, and the third resection was 100% removal of the posterior horn for all specimens. After 22% resection, no significant difference in AP laxity was observed. A statistically significant increase in AP laxity was observed with 46% resection under a 500-N compressive load compared with the intact meniscus. After full resection, significant increases in AP laxity were observed under a 50-N compressive load compared with the intact and 22% and 46% resections. The 22% resection had similar AP positions as the intact knee, whereas the 46% resection and 100% removal of the posterior horn had statistically further posterior AP positions than the intact knee. Conclusion: Partial medial meniscectomy with ≥46% resection of the original width of the posterior horn significantly altered the AP position of the medial femoral condyle and also increased laxity. Clinical Relevance: These mechanical changes may lead to abnormal cartilage loading and early osteoarthritis.

Transplantation of Aggregates of Autologous Synovial Mesenchymal Stem Cells for Treatment of Cartilage Defects in the Femoral Condyle and the Femoral Groove in Microminipigs

2019 ◽  
Vol 47 (10) ◽  
pp. 2338-2347 ◽  
Author(s):  
Shimpei Kondo ◽  
Yusuke Nakagawa ◽  
Mitsuru Mizuno ◽  
Kenta Katagiri ◽  
Kunikazu Tsuji ◽  
...  
Keyword(s):  
Femoral Condyle ◽  
Cartilage Regeneration ◽  
Medial Femoral Condyle ◽  
Cartilage Defects ◽  
Control Group ◽  
Osteochondral Defects ◽  
Medial Condyle ◽  
Femoral Groove ◽  
Articular Cartilage Regeneration

Background: Previous work has demonstrated that patients with cartilage defects of the knee benefit from arthroscopic transplantation of autologous synovial mesenchymal stem cells (MSCs) in terms of magnetic resonance imaging (MRI), qualitative histologic findings, and Lysholm score. However, the effectiveness was limited by the number of cells obtained, so large-sized defects (>500 mm2) were not investigated. The use of MSC aggregates may enable treatment of larger defects by increasing the number of MSCs adhering to the cartilage defect. Purpose: To investigate whether transplantation of aggregates of autologous synovial MSCs with 2-step surgery could promote articular cartilage regeneration in microminipig osteochondral defects. Study Design: Controlled laboratory study. Methods: Synovial MSCs derived from a microminipig were examined for in vitro colony-forming and multidifferentiation abilities. An aggregate of 250,000 synovial MSCs was formed with hanging drop culture, and 16 aggregates (for each defect) were implanted on both osteochondral defects (6 × 6 × 1.5 mm) created in the medial femoral condyle and femoral groove (MSC group). The defects in the contralateral knee were left empty (control group). The knee joints were evaluated at 4 and 12 weeks by macroscopic findings and histology. MRI T1rho mapping images were acquired at 12 weeks. For cell tracking, synovial MSCs were labeled with ferucarbotran before aggregate formation and were observed with MRI at 1 week. Results: Synovial MSCs showed in vitro colony-forming and multidifferentiation abilities. Regenerative cartilage formation was significantly better in the MSC group than in the control group, as indicated by International Cartilage Repair Society score (macro), modified Wakitani score (histology), and T1rho mapping (biochemical MRI) in the medial condyle at 12 weeks. Implanted cells, labeled with ferucarbotran, were observed in the osteochondral defects at 1 week with MRI. No significant difference was noted in the modified Wakitani score at 4 weeks in the medial condyle and at 4 and 12 weeks in the femoral groove. Conclusion: Transplantation of autologous synovial MSC aggregates promoted articular cartilage regeneration at the medial femoral condyle at 12 weeks in microminipigs. Clinical Relevance: Aggregates of autologous synovial MSCs could expand the indications for cartilage repair with synovial MSCs.

An in vitro Comparison of Two Replacement Techniques Utilizing Fascia Lata after Cranial Cruciate Ligament Transection in the Dog

1993 ◽  
Vol 06 (02) ◽  
pp. 85-92 ◽  
Author(s):  
G. L. Coetzee
Keyword(s):  
Femoral Condyle ◽  
Cruciate Ligament ◽  
Maximum Load ◽  
Fascia Lata ◽  
Patellar Ligament ◽  
Cross Sectional ◽  
Cranial Cruciate Ligament ◽  
Replacement Technique ◽  
Over The Top

SummaryThe immediate postoperative biomechanical properties of an “underand-over” cranial cruciate ligament (CCL) replacement technique consisting of fascia lata and the lateral onethird of the patellar ligament, were compared with that of a modified intra- and extracapsular “under-and-over-the-top” (UOTT) method. The right CCL in twelve adult dogs was dissected out and replaced with an autograft. The contralateral, intact CCL served as the control. In group A, the graft was secured to the lateral femoral condyle with a spiked washer and screw. In group B the intracapsular graft was secured to the lateral femoro-fabellar ligament, and the remainder to the patellar tendon. Both CCL replacement techniques exhibited a 2.0 ± 0.5 mm anterior drawer immediately after the operation. After skeletonization of the stifles, the length and cross-sectional area of the intact CCL and CCL substitutes were determined. Each bone-ligament unit was tested in linear tension to failure at a fixed distraction rate of 15 mm/s with the stifle in 120° flexion. Data was processed to obtain the corresponding material parameters (modulus, stress and strain in the linear loading region, and energy absorption to maximum load).The immediate postoperative structural and material properties of the “under-and-over” cranial cruciate ligament replacement technique with autogenous fascia lata, were compared to that of a modified intra- and extracapsular “under-and-over-the-top” (UOTT) method. The combined UOT T technique was slightly stronger (6%), but allowed 2.8 ± 0.9 mm more cranial tibial displacement at maximum linear force.

A new method to express embryotoxic data obtained in vitro on whole murine embryos

Teratology ◽  
1987 ◽  
Vol 35 (3) ◽  
pp. 429-437 ◽  
Author(s):  
J. J. Picard ◽  
G. Van Maele-Fabry
Keyword(s):  
New Method ◽  
Murine Embryos

Osteoarthritis of the patella, lateral femoral condyle and posterior medial femoral condyle correlate with range of motion

2013 ◽  
Vol 21 (11) ◽  
pp. 2584-2589 ◽  
Author(s):  
Takashi Suzuki ◽  
Sayaka Motojima ◽  
Shu Saito ◽  
Takao Ishii ◽  
Keinosuke Ryu ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Femoral Condyle ◽  
Medial Femoral Condyle ◽  
Lateral Femoral Condyle
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