scholarly journals Adductor tubercle

2018 ◽  
Author(s):  
Hamish Smith ◽  
Shanalie Dias
Keyword(s):  
Adductor Tubercle

Anatomic and Biomechanical Properties of Flat Medial Patellofemoral Ligament Reconstruction Using an Adductor Magnus Tendon Graft: A Human Cadaveric Study

2021 ◽  
pp. 036354652110095
Author(s):  
Danko Dan Milinkovic ◽  
Christian Fink ◽  
Christoph Kittl ◽  
Petri Silanpää ◽  
Elmar Herbst ◽  
...  
Keyword(s):  
Medial Patellofemoral Ligament ◽  
Biomechanical Properties ◽  
Mpfl Reconstruction ◽  
Maximum Elongation ◽  
Skeletally Immature ◽  
Femoral Insertion ◽  
Adductor Tubercle ◽  
Adductor Magnus ◽  
Load To Failure ◽  
The Mean

Background: In contrast to the majority of existing techniques for reconstruction of the medial patellofemoral ligament (MPFL), the technique described in this article uses the adductor magnus muscle tendon to gain a flat, broad graft, leaving its distal femoral insertion intact, and does not require drilling within or near the femoral physis. It also allows for soft tissue patellar fixation and could facilitate anatomic MPFL reconstruction in skeletally immature patients. Purpose: To evaluate the anatomic and structural properties of the native MPFL and the adductor tendon (AT), followed by biomechanical evaluation of the proposed reconstruction. Study Design: Descriptive laboratory study. Methods: The morphological and topographical features of the AT and MPFL were evaluated in 12 fresh-frozen cadaveric knees. The distance between the distal insertion of the AT on the adductor tubercle and the adductor hiatus, as well as the desired length of the graft, was measured to evaluate this graft’s application potential. Load-to-failure tests were performed to determine the biomechanical properties of the proposed reconstruction construct. The construct was placed in a uniaxial testing machine and cyclically loaded 500 times between 5 and 50 N, followed by load to failure, to measure the maximum elongation, stiffness, and maximum load. Results: The mean ± SD length of the AT was 12.6 ± 1.5 cm, and the mean distance between the insertion on the adductor tubercle and adductor hiatus was 10.8 ± 1.3 cm, exceeding the mean desired length of the graft (7.5 ± 0.5 cm) by 3.3 ± 0.7 cm. The distal insertion of the AT was slightly proximal and posterior to the insertion of the MPFL. The maximum elongation after cyclical loading was 1.9 ± 0.4 mm. Ultimately, the mean stiffness and load to failure were 26.2 ± 7.6 N/mm and 169.7 ± 19.2 N, respectively. The AT graft failed at patellar fixation in 2 of the initially tested specimens and at the femoral insertion in the remaining 10. Conclusion: The described reconstruction using the AT has potential for MPFL reconstruction. The AT graft presents a graft of significant volume, beneficial anatomic topography, and adequate tensile properties in comparison with the native MPFL following the data from previously published studies. Clinical Relevance: Given its advantageous anatomic relationship as an application that avoids femoral drilling and osseous patellar fixation, the AT may be considered a graft for MPFL reconstruction in skeletally immature patients.

scholarly journals GASTROCNEMIUS TUBERCLE IN INDIAN POPULATION: A NEW ANATOMICAL ENTITY?. Tubérculo gastrocnemio en la población india: Una nueva entidad anatómica?

2016 ◽  
Vol 7 (2) ◽  
pp. 107-111
Author(s):  
Shilpa Gosavi ◽  
Rajendra Garud ◽  
Surekha Jadhav
Keyword(s):  
Gastrocnemius Muscle ◽  
Indian Population ◽  
Knee Injuries ◽  
Medial Epicondyle ◽  
Anatomical Entity ◽  
Medial Condyle ◽  
Posterior Oblique Ligament ◽  
Adductor Tubercle ◽  
Bony Prominence ◽  
Bilateral Differences

Los libros de texto comunes de anatomía describen dos protuberancias óseas presentes en el cóndilo medial del fémur. A parte del tubérculo aductor (TA) y del epicóndilo medial (EPM) del fémur también se ha observado una tercera protuberancia ósea en muchos huesos. En la literatura publicada previamente se lo denomina tubérculo gastrocnemio. La cabeza medial del músculo gastrocnemio y el ligamento oblicuo posterior están adheridos al mismo. Hemos observado 396 (derecha-204 e izquierda-192) fémures secos de pacientes indios. Se observó la presencia en el cóndilo medial de la tercera protuberancia ósea, es decir, el tubérculo gastrocnemio (TGC) junto con el tubérculo aductor y el epicóndilo medial. Se advirtió la presencia o ausencia de TGC. Se comparó el tamaño del TGC y del TA. Se midió la distancia entre TA y TGC y se midió asimismo la distancia entre TGC y EPM utilizando un calibre vernier digital con un grado de precisión de hasta 0,01 mm. Para la elaboración de datos se calculó el porcentaje, la distancia media, el rango y la desviación estándar. Se comprobó la presencia de TGC en 207 huesos, es decir 52,27% (derecha-109 e izquierda-98). En la mayoría de los fémures (80,7%) el TA es de tamaño mayor que el TGC. La distancia media entre TGC y TA en el lado derecho es 10,8 ± 2,4 mm y en el lado izquierdo es 10,9 ± 2,3.  Se observó una distancia entre TGC y EPM de 14,8 ± 0,5 mm en el lado derecho y de 14,9 ± 2.9 mm en el lado izquierdo. Las diferencias bilaterales no son significativas en términos estadísticos. Es importante para los clínicos identificar el TGC para evitar la reparación no anatómica de lesiones del ligamento medial de la rodilla. The standard textbooks of anatomy describe two bony prominences on the medial condyle of femur. In addition to adductor tubercle (AT) and medial epicondyle (MEP) of femur a third bony prominence was also observed in many bones. In previously published literature it was named as gastrocnemius tubercle. The medial head of gastrocnemius muscle and posterior oblique ligament were attached close to it. We observed three hundred and ninety six (right-204 and left-192) dry femora belonging to Indian population. The medial condyle was observed for the presence of third bony prominence - gastrocnemius tubercle (GCT) along with adductor tubercle and medial epicondyle. The presence or absence of GCT was noted. The size of GCT and AT was compared. The distance between the most prominent point on AT and GCT and between GCT and MEP was measured using digital Vernier caliper accurate up to 0.01 mm. The percentage, mean, range and standard deviation was calculated for the data. Presence of GCT was noted in 207 bones (52.27%) (right-109 and left-98). In majority (80.7%) of the femora AT was larger than GCT. Mean distance between GCT and AT on right side was 10.8 ± 2.4 mm and on left side it was 10.9 ± 2.3.  Distance between GCT and MEP on right side was observed as 14.8 ± 0.5 mm and on left side 14.9 ± 2.9. The bilateral differences were not significant statistically. It is important for clinicians to identify GCT to avoid non-anatomical repair of medial knee injuries.

A Study to Assess the Accuracy of Adductor Tubercle as a Reliable Landmark Used to Determine the Joint Line of the Knee in a Chinese Population

2017 ◽  
Vol 32 (4) ◽  
pp. 1351-1355 ◽  
Author(s):  
Jianlin Xiao ◽  
Shengqun Wang ◽  
Wei Chen ◽  
Yuhui Yang ◽  
Tong Liu ◽  
...  
Keyword(s):  
Chinese Population ◽  
Joint Line ◽  
Adductor Tubercle

Estimation of Stature from Parts of Bones—Lower End of Femur and Upper End of Radius

1980 ◽  
Vol 20 (4) ◽  
pp. 283-286 ◽  
Author(s):  
V. L. Mysorekar ◽  
P. K. Verma ◽  
A. N. Mandedkar ◽  
T. C. S. R. Sarmat
Keyword(s):  
Biceps Brachii ◽  
Biceps Brachii Muscle ◽  
Adductor Tubercle ◽  
Total Length ◽  
Radial Tuberosity ◽  
High Degree

A hundred and one right and 109 left dry, fully ossified, human femora have been studied to derive regression formulae for the establishment of the total length of the femur from the length of the lower end taken from the adductor tubercle. The formulae are statistically significant and their validity has been tested on 62 right and 59 left femora. A hundred and fifteen right and 106 left dry, fully ossified radii have been studied to derive regression formulae for establishment of the total length of the radius from the length of the upper end taken to the lower level of insertion of the biceps brachii muscle on the radial tuberosity. The validity of the formulae which are statistically significant has been tested on 51 right and 56 left dry and fully ossified random radii. All the regression formulae have a high degree of prediction, and are valuable in establishing the stature of an individual.

scholarly journals Accuracy of Ultrasound-Guided Genicular Nerve Block: A Cadaveric Study

2015 ◽  
Vol 5;18 (5;9) ◽  
pp. E899-E904
Author(s):  
Dr. Serdar Kesikburun
Keyword(s):  
Knee Pain ◽  
Nerve Block ◽  
Medial Collateral Ligament ◽  
Medial Epicondyle ◽  
Cadaveric Study ◽  
Ultrasound Guided ◽  
Collateral Ligament ◽  
Anatomic Landmarks ◽  
Adductor Tubercle ◽  
Chronic Knee Pain

Background: Genicular nerve block has recently emerged as a novel alternative treatment in chronic knee pain. The needle placement for genicular nerve injection is made under fluoroscopic guidance with reference to bony landmarks. Objective: To investigate the anatomic landmarks for medial genicular nerve branches and to determine the accuracy of ultrasound-guided genicular nerve block in a cadaveric model. Study Design: Cadaveric accuracy study. Setting: University hospital anatomy laboratory. Methods: Ten cadaveric knee specimens without surgery or major procedures were used in the study. The anatomic location of the superior medial genicular nerve (SMGN) and the inferior medial genicular nerve (IMGN) was examined using 4 knee dissections. The determined anatomical sites of the genicular nerves in the remaining 6 knee specimens were injected with 0.5 mL red ink under ultrasound guidance. The knee specimens were subsequently dissected to assess for accuracy. If the nerve was dyed with red ink, it was considered accurate placement. All other locations were considered inaccurate. Results: The course of the SMGN is that it curves around the femur shaft and passes between the adductor magnus tendon and the femoral medial epicondyle, then descends approximately one cm anterior to the adductor tubercle. The IMGN is situated horizontally around the tibial medial epicondyle and passes beneath the medial collateral ligament at the midpoint between the tibial medial epicondyle and the tibial insertion of the medial collateral ligament. The adductor tubercle for the SMGN and the medial collateral ligament for the IMGN were determined as anatomic landmarks for ultrasound. The bony cortex one cm anterior to the peak of the adductor tubercle and the bony cortex at the midpoint between the peak of the tibial medial epicondyle and the initial fibers inserting on the tibia of the medial collateral ligament were the target points for the injections of SMGN and IMGN, respectively. In the cadaver dissections both genicular nerves were seen to be dyed with red ink in all the injections of the 6 knees. Limitations: The small number of cadavers might have led to some anatomic variations of genicular nerves being overlooked. Conclusions: The result of this cadaveric study suggests that ultrasound-guided medial genicular nerve branch block can be performed accurately using the above-stated anatomic landmarks. Key words: Knee pain, genicular nerve, nerve block, osteoarthritis, ultrasonography, cadaver study, injection, accuracy

The adductor tubercle: an important landmark to determine the joint line level in revision total knee arthroplasty

2015 ◽  
Vol 24 (10) ◽  
pp. 3212-3217 ◽  
Author(s):  
Francesco Iacono ◽  
Giovanni Francesco Raspugli ◽  
Giuseppe Filardo ◽  
Danilo Bruni ◽  
Stefano Zaffagnini ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Revision Total Knee Arthroplasty ◽  
Joint Line ◽  
Adductor Tubercle ◽  
Important Landmark ◽  
Total Knee ◽  
Line Level

Radiographic Morphology and Method for Localization of the Adductor Tubercle on Anterior–Posterior Knee Radiographs

2017 ◽  
Vol 31 (08) ◽  
pp. 747-753 ◽  
Author(s):  
Kuan-Lin Liu ◽  
Chen-Chie Wang ◽  
Ing-Ho Chen ◽  
Chia-Ming Chang ◽  
Wen-Tien Wu ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Femoral Shaft ◽  
Joint Line ◽  
Inflexion Point ◽  
Direct Identification ◽  
Adductor Tubercle ◽  
Line Identification ◽  
Posterior Knee ◽  
Anterior Posterior

AbstractThe adductor tubercle (AT) is a landmark for joint line identification in knee arthroplasty. Up to now, there has not been a dedicated study to define its morphology on an anterior–posterior (AP) radiograph. As a result, radiographic localization of the AT has been inconsistent and confusing. Ten bone specimens, each with the AT labeled with a metal marker, were radiographed to demonstrate the AT appearance on AP radiographs. Based on this knowledge, a method to locate the AT was developed. A total of 200 clinical radiographs were examined to further confirm the observed radiographic morphology with emphasis on the visibility of the AT and its association with the rotational status of the knee on radiographs. One hundred of them were used to test the reliability of this method of AT identification. Of the 200 ATs, 153 (76%) were clearly visible on radiographs as a faint pyramid-shaped shadow protruding outward from the inflexion point of the concave–convex silhouette over the femoral shaft-condylar junction, allowing direct identification. For invisible ATs (24%), this inflexion point was found to be a useful surrogate landmark for their identification. Locating the AT using this technique showed a good intra- and interobserver reliabilities. The proposed method may be valuable for the consistent use of this landmark in joint line identification on radiographs.

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